Journal of medical cases最新文献_第7页

A Rare Case of Gas Forming Enterobacter cloacae Leading to Bleeding Mycotic Pseudoaneurysm of Transplant Renal Artery Culminating in Graft Nephrectomy 一例罕见病例：气体形成的泄殖腔肠杆菌导致移植肾动脉出血性霉菌性假性动脉瘤，最终导致移植肾切除术

Journal of medical cases Pub Date : 2024-06-01 DOI: 10.14740/jmc4231

Muhammad Abdul Mabood Khalil, Nihal Mohammed Sadagah, M. Alqurashi, Ahmed Abdelahad Basha, Hisham Ismael Mohamed Sakran, Ibrahim Mohammed Nasser Assiri, Ghaleb A Aboalsamh, Salem H. Al-Qurashi

引用次数: 0

Recurrent Takotsubo Cardiomyopathy due to Pheochromocytoma Managed With Venoarterial Extracorporeal Membrane Oxygenation. 用静脉体外膜氧合治疗嗜铬细胞瘤引起的复发性塔克次氏心肌病

Journal of medical cases Pub Date : 2024-05-01 Epub Date: 2024-05-02 DOI: 10.14740/jmc4195

Georgia Karmioti, Stefanos Sakellaropoulos, Inan Sarikaya, Antonia Kastoris, Christina Hadjilouka, Christos Efseviou, Michael Myrianthefs, Andreas Mitsis

{"title":"Recurrent Takotsubo Cardiomyopathy due to Pheochromocytoma Managed With Venoarterial Extracorporeal Membrane Oxygenation.","authors":"Georgia Karmioti, Stefanos Sakellaropoulos, Inan Sarikaya, Antonia Kastoris, Christina Hadjilouka, Christos Efseviou, Michael Myrianthefs, Andreas Mitsis","doi":"10.14740/jmc4195","DOIUrl":"10.14740/jmc4195","url":null,"abstract":"Pheochromocytoma-induced Takotsubo cardiomyopathy is a rare but life-threatening condition, caused by excessive plasma catecholamine levels, resulting in acute myocardial dysfunction. Clinical presentation includes a rapid development of heart failure due to regional wall motion abnormalities (most commonly affecting all mid to apical left ventricle (LV) wall segments) causing the \"octopus-trap-like\" LV shape. A 45-year-old female patient presented with acute cardiogenic shock of non-ischemic etiology. Her past medical history included a similar episode, which was followed by full recovery, but at this admission she required hemodynamic support with venoarterial extracorporeal membrane oxygenation. The systolic function was restored, and further investigation revealed high 24-h urine metanephrine levels and a mass of the left adrenal gland, leading to the diagnosis of pheochromocytoma. After treatment with firstly alpha-blockers and then beta-blockers, the pheochromocytoma was surgically removed.","PeriodicalId":101328,"journal":{"name":"Journal of medical cases","volume":"15 4-5","pages":"72-77"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11073464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140878369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Anesthetic Management of a Patient With Trisomy 18 Undergoing a Multilevel Spinal Fusion. 对一名接受多级脊柱融合术的 18 三体综合征患者的麻醉管理

Journal of medical cases Pub Date : 2024-05-01 Epub Date: 2024-05-02 DOI: 10.14740/jmc4202

Davis Frease, David Rico Mora

{"title":"Anesthetic Management of a Patient With Trisomy 18 Undergoing a Multilevel Spinal Fusion.","authors":"Davis Frease, David Rico Mora","doi":"10.14740/jmc4202","DOIUrl":"10.14740/jmc4202","url":null,"abstract":"Trisomy 18 is the second most common autosomal trisomy aside from trisomy 21. Anesthesiologists were unlikely to manage such patients in the past, specifically those surviving later into childhood due to the 90% mortality rate within the first year of life and the lack of procedural options that were available. However, a paucity of literature regarding the anesthetic management of such patients exists. Trisomy 18 patients present a unique anesthetic challenge, given the presence of associated dysmorphic facial features and the involvement of multiple organ systems, leading to difficult airway and hemodynamic disturbances. In this case report, we present the anesthetic management of a 9-year-old patient with trisomy 18 undergoing a multilevel spinal fusion. Despite significant intraoperative hemorrhage, the patient was able to tolerate the procedure without complications, likely owing to the meticulous preoperative preparation and the patient's survival later into childhood. This case contributes to a small subset of literature which suggests that patients with trisomy 18 who survive later into childhood have an improved ability to tolerate general anesthesia.","PeriodicalId":101328,"journal":{"name":"Journal of medical cases","volume":"15 4-5","pages":"78-81"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11073463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140878365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Improvements in Gut Microbiome Composition and Clinical Symptoms Following Familial Fecal Microbiota Transplantation in a Nineteen-Year-Old Adolescent With Severe Autism. 对一名十九岁的重度自闭症青少年进行家族性粪便微生物群移植后，其肠道微生物群组成和临床症状均有所改善。

Journal of medical cases Pub Date : 2024-05-01 Epub Date: 2024-05-02 DOI: 10.14740/jmc4209

Sabine Hazan, Jonathan Haroon, Sheldon Jordan, Stephen J Walker

{"title":"Improvements in Gut Microbiome Composition and Clinical Symptoms Following Familial Fecal Microbiota Transplantation in a Nineteen-Year-Old Adolescent With Severe Autism.","authors":"Sabine Hazan, Jonathan Haroon, Sheldon Jordan, Stephen J Walker","doi":"10.14740/jmc4209","DOIUrl":"10.14740/jmc4209","url":null,"abstract":"This case report describes a novel therapy for patients with severe autism spectrum disorder (ASD) that is worth further investigation. A 19-year-old male adolescent with ASD, who was not responding to standard treatment received fecal microbiota transplant (FMT) using donor material from his typically developing female sibling. The patient's ASD symptoms were assessed by assessors who were blind to the patient's past ASD symptomatology. Assessors used the Childhood Autism Rating Scale (CARS), an observation-based rating scale to assess developmental delay in children with autism (range of CARS scores is 15 - 60; a score > 28 is indicative of autism; higher score is positively correlated with degree of severity), at baseline and again at six timepoints post-FMT. The patient experienced marked improvements in microbiome diversity and composition over the year and a half period that followed the FMT procedure. Additionally, the patient who was previously nonverbal said his first two words and experienced a reduction in aggression 1-month post-FMT. To the authors' knowledge, this is the first report to demonstrate the use of familial FMT in an adolescent patient with ASD. Given that ASD symptom improvements post-FMT tend to occur in younger patients, the authors hypothesize that the use of a familial donor may be an important factor that contributed to the improved outcomes experienced by this older child.","PeriodicalId":101328,"journal":{"name":"Journal of medical cases","volume":"15 4-5","pages":"82-91"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11073461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140878366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Norepinephrine and Dobutamine-Induced Dynamic Left Ventricular Outflow Tract Obstruction Caused by Systolic Anterior Motion. 去甲肾上腺素和多巴酚丁胺诱发收缩期前移导致的左心室流出道动态阻塞

Journal of medical cases Pub Date : 2024-05-01 Epub Date: 2024-05-02 DOI: 10.14740/jmc4204

Tran Duc Hung, Pham Vu Thu Ha, Do Van Chien

{"title":"Norepinephrine and Dobutamine-Induced Dynamic Left Ventricular Outflow Tract Obstruction Caused by Systolic Anterior Motion.","authors":"Tran Duc Hung, Pham Vu Thu Ha, Do Van Chien","doi":"10.14740/jmc4204","DOIUrl":"10.14740/jmc4204","url":null,"abstract":"This study presents a case of norepinephrine and dobutamine-induced dynamic left ventricular outflow tract obstruction (LVOTO) caused by systolic anterior motion (SAM) in a patient experiencing acute anterior myocardial infarction (MI). In a 76-year-old patient presenting with acute MI, intensive use of norepinephrine and dobutamine may lead to the development of dynamic LVOTO and SAM. The presence of hypotension and a new cardiac murmur may suggest a mechanical complication such as acute mitral regurgitation (MR) or ventricular septal rupture (VSR). The assessment of the left ventricular outflow tract (LVOT) using echocardiography plays a critical role in the diagnosis of SAM and its associated MR and dynamic LVOTO. The patient's condition was stabilized through the cessation of inotropes and the implementation of aggressive fluid resuscitation, resulting in improved hemodynamics. In conclusion, prompt identification of the underlying pathophysiological mechanisms is imperative for effectively managing this condition and preventing hemodynamic exacerbation.","PeriodicalId":101328,"journal":{"name":"Journal of medical cases","volume":"15 4-5","pages":"67-71"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11073465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140878368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Long Segment Colon Degloving From Blunt Abdominal Trauma. 腹部钝伤导致长段结肠脱落

Journal of medical cases Pub Date : 2024-05-01 Epub Date: 2024-05-02 DOI: 10.14740/jmc4205

Aldin Malkoc, Lana Mamoun, Harpreet Gill, Danielle Cremat, Gbemisola Lawal, William Sherman

{"title":"Long Segment Colon Degloving From Blunt Abdominal Trauma.","authors":"Aldin Malkoc, Lana Mamoun, Harpreet Gill, Danielle Cremat, Gbemisola Lawal, William Sherman","doi":"10.14740/jmc4205","DOIUrl":"10.14740/jmc4205","url":null,"abstract":"It is extremely rare for blunt abdominal trauma to result in serious injuries to hollow organs. Degloving injuries of the colon are one of the rarest injuries following blunt abdominal trauma. Intestinal degloving is often seen following rapid deceleration, changes in velocity, crushes and motor vehicle collisions (MVCs). Victims with intestinal degloving injuries can experience vague symptoms despite the severity of the lesion. We present the case of a 21-year-old male with insulin-dependent type 1 diabetes who was involved in a high-speed MVC. He sustained second- and third-degree burns to the extremities, right carotid artery dissection, and multiple fractures to the mandible, pelvis and forearm. Free fluid was also noted in the pelvis prompting an emergent exploratory laparotomy. In the operating room, he was found to have a cecal serosal injury involving more than 50% of the circumference and a sigmoid and descending colon degloving injury of 50 cm. The injured segments were resected, and primary anastomoses were created. Degloving of the colon is extremely rare and the sigmoid is one of the more frequently documented locations of injury. Our case contributes to the limited literature available pertaining to the treatment of evolution of these severe colon injuries.","PeriodicalId":101328,"journal":{"name":"Journal of medical cases","volume":"15 4-5","pages":"92-96"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11073462/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140878367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Refractory Pseudomonas Osteomyelitis of the Skull Base With Gradenigo’s Syndrome: Early Dysphagia and Late Abducens Nerve Palsy 难治性颅底假单胞菌骨髓炎伴格拉登尼戈综合征：早期吞咽困难和晚期视神经麻痹

Journal of medical cases Pub Date : 2024-04-01 DOI: 10.14740/jmc4191

F. Mammarella, A. Loperfido, Gianluca Velletrani, F. Casorati, Alessandro Stasolla, Stefano Di Girolamo, G. Bellocchi

{"title":"Refractory Pseudomonas Osteomyelitis of the Skull Base With Gradenigo’s Syndrome: Early Dysphagia and Late Abducens Nerve Palsy","authors":"F. Mammarella, A. Loperfido, Gianluca Velletrani, F. Casorati, Alessandro Stasolla, Stefano Di Girolamo, G. Bellocchi","doi":"10.14740/jmc4191","DOIUrl":"https://doi.org/10.14740/jmc4191","url":null,"abstract":"Gradenigo’s syndrome (GS) is a rare entity characterized by otitis media, pain in the trigeminal nerve distribution and abducens nerve palsy. The classic triad is uncommon, making the diagnostic workup challenging. Specifically, the diagnostic approach includes medical history, a complete otorhinolaryngological examination, a pure-tone audiogram and radiological investigation such as contrast-enhanced computed tomography scan and magnetic resonance imaging of head and neck. Broad-spectrum antibiotics are the first-line treatment, such as intravenous (IV) ceftriaxone and IV metronidazole. Here, we present the case of a 71-year-old man with a previous history of otitis media and poorly controlled type 2 diabetes mellitus. He presented to our attention with facial pain, left hemilarynx paralysis, dysphagia and otorrhea. The patient was treated with broad-spectrum antibiotics without any clinical improvement. Imaging evaluations demonstrated the presence of wide and poorly defined pathological material with epicenter in the masticatory space, involving all nearby structures. The patient underwent multiple biopsies without obtaining a definitive tissue diagnosis of neoplasia. After 2 months, the patient developed delayed VI cranial nerve palsy, providing evidence of GS. Although incomplete, GS has been described in the literature; however, none of the cases exhibited a latent abducent deficit. To the best of our knowledge, this is the only case with a delayed onset of abducens nerve palsy.","PeriodicalId":101328,"journal":{"name":"Journal of medical cases","volume":"170 ","pages":"43 - 48"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140762168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Renal Function Improvement With Glucagon-Like Peptide-1 Receptor Agonist in a Patient With Type 2 Diabetes 胰高血糖素样肽-1 受体激动剂改善 2 型糖尿病患者的肾功能

Journal of medical cases Pub Date : 2024-04-01 DOI: 10.14740/jmc4189

H. Yanai

{"title":"Renal Function Improvement With Glucagon-Like Peptide-1 Receptor Agonist in a Patient With Type 2 Diabetes","authors":"H. Yanai","doi":"10.14740/jmc4189","DOIUrl":"https://doi.org/10.14740/jmc4189","url":null,"abstract":"Diabetic kidney disease (DKD) includes hypertensive nephrosclerosis, aging, obesity, and atherosclerosis-related renal diseases, in addition to classical diabetic nephropathy. Sodium-glucose co-transporter 2 inhibitors (SGLT2is) have been approved for diabetic and non-diabetic patients at risk of chronic kidney disease progression. As the main mechanism for SGLT2i-mediated improvement of renal function, the normalization of tubulo-glomerular feedback (TGF) has been proposed. Enhanced TGF and resulting glomerular hypertension are observed in diabetic patients, and SGLT2is normalize TGF, reducing the intraglomerular pressure, which may reduce albuminuria and improve renal function. A type 2 diabetic patient with DKD complicated with hypertensive nephrosclerosis, whose renal function was deteriorated by SGLT2i and improved by glucagon-like peptide-1 receptor agonists (GLP-1RAs), was presented. In patients with hypertensive nephrosclerosis such as this case, the normalization of TGF by SGLT2i may further reduce afferent arteriolar blood flow which may worsen glomerular ischemia, resulting in deterioration of renal function. GLP-1RAs have no effect on TGF and have multiple effects to improve vascular endothelial function, which may be associated with an improvement in renal function in this patient.","PeriodicalId":101328,"journal":{"name":"Journal of medical cases","volume":"54 ","pages":"37 - 42"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140783924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Lifestyle Interventions in a Patient Identified as Super-Super Obese With a Body Mass Index of 90.5 对一名体重指数为 90.5 的超级肥胖患者进行生活方式干预

Journal of medical cases Pub Date : 2024-04-01 DOI: 10.14740/jmc4194

Ghadeer Al Ghareeb, D. Abdoh, Mostafa Kofi, Ayman Afify Konswa

{"title":"Lifestyle Interventions in a Patient Identified as Super-Super Obese With a Body Mass Index of 90.5","authors":"Ghadeer Al Ghareeb, D. Abdoh, Mostafa Kofi, Ayman Afify Konswa","doi":"10.14740/jmc4194","DOIUrl":"https://doi.org/10.14740/jmc4194","url":null,"abstract":"Obesity is a growing global health concern. Saudi Arabia is experiencing a higher prevalence of obesity compared to the globe. This case report focuses on a 38-year-old female with a body mass index (BMI) of 90.5 kg/m2, prediabetes, and obstructive sleep apnea who successfully underwent a lifestyle modification process resulting in remarkable weight loss. The patient’s past unsuccessful attempts at weight loss had left her with a reluctance to try again initially. A multidisciplinary team collaborated to develop a management plan starting with an intensive lifestyle intervention. Lifestyle was assessed, then a structured personalized lifestyle intervention based on a plant-based diet and a gradual increase in physical activity was implemented. Over 6 months, the patient succeeded in losing 23 kg, a percent weight loss of 11.9%. An additional 5 kg was lost when liraglutide “Saxenda” was added. This case report represents the effectiveness of intensive lifestyle interventions in patients with super-super obesity for weight loss and long-term health improvement. Additional research is required to determine if the positive outcomes seen in treating a single patient can be applied to a larger population with super-super obesity. This brings up the question of whether pharmacotherapy or surgical interventions should be the primary approaches for addressing these cases, considering that surgical interventions usually involve lifestyle changes. What we already know about such cases: patients with super-super obesity often require interventions such as surgery or medication to aid in weight reduction, as they typically do not respond to lifestyle interventions alone. What this case report adds to existing knowledge: the use of lifestyle interventions proved effective in such cases as super-super obesity and delayed the need for surgical intervention even without weight reduction medications.","PeriodicalId":101328,"journal":{"name":"Journal of medical cases","volume":"286 1","pages":"55 - 59"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140780399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Upper Tract Urothelial Carcinoma Complicated by Skeletal Muscle Metastases 并发骨骼肌转移的上尿路癌

Journal of medical cases Pub Date : 2024-04-01 DOI: 10.14740/jmc4201

Joelle N. Friesen, Bibek Saha, Ashley Hickman, Jian L. Campian

引用次数: 0