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J Pak Med Assoc 2022 Jun;72(6):1218-1221

Department of Chemical Pathology, Armed Forces Institute of Pathology, Rawalpindi, Pakistan.

Haemoglobin contains iron in a ferrous form. When the iron is oxidized, it is called Methaemoglobin (MetHb). MetHb leads to tissue hypoxia, cyanosis, and secondary polycythemia. Read More

Children (Basel) 2022 Jun 10;9(6). Epub 2022 Jun 10.

Department of Emergency Medicine, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore 229899, Singapore.

Patients with osteogenesis imperfecta (OI) are at an increased risk of pathological rib fractures even if there is no history of trauma. Early and accurate identification of such fractures are crucial for appropriate management. We present a case of a child with OI type 3 with multiple rib fractures who presented with transient cyanosis and increased work of breathing without a history of significant trauma. Read More

Emergencias 2022 Jun;34(3):240

Servicio de Medicina Intensiva, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, España. Institut d'Investigació Biomèdica de Bellvitge (Idibell), L'Hospitalet de Llobregat, España.

Cardiol Young 2022 Jun 22:1-8. Epub 2022 Jun 22.

Department of Cardiology, Santa Marta Hospital, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal.

A 40-year-old female is admitted for paroxysmal episodes of exertional dyspnoea, with associated cyanosis, improving with squatting, and a holosystolic murmur radiating to the interscapular area. Echocardiography showed a subaortic ventricular septal defect with left-to-right shunt and overriding aorta. The characteristic murmur prompted us to seek right ventricular outflow tract obstruction. Read More

J Trop Pediatr 2022 Jun;68(4)

Department of Pediatrics, Dr. R.M.L. Institute of Medical Sciences, Lucknow, India.

Background: Pneumonia acquired in the community is a leading cause of hospitalization and death in under-five children. Predicting mortality in children remains a challenge. There is a need of consolidated scoring system to predict mortality in under-five children in developing nations. Read More

J Card Surg 2022 Jun 21. Epub 2022 Jun 21.

Department of Cardiac Surgery, Wuhan Asia Heart Hospital, Wuhan, China.

Cardiac inflammatory myofibroblastic tumor (IMT) is a rare benign tumor that occurs mainly in infants and children. We report a case of right atrial IMT in a 1-month-old girl with episodic cyanosis. Both echocardiography and cardiac computed tomography revealed a right atrial mass. Read More

J Med Case Rep 2022 Jun 21;16(1):244. Epub 2022 Jun 21.

Centre Hospitalier Epicura - site d'Ath, Rue Maria Thomée 1, 7800, Ath, Belgium.

Background: Methemoglobinemia is an excess of oxidized hemoglobin in the blood, affecting oxygen transportation. It is characterized by central cyanosis that does not respond to oxygen therapy. Prognosis is excellent when treated adequately and rapidly. Read More

Ann Allergy Asthma Immunol 2022 Jun 16. Epub 2022 Jun 16.

Division of Allergy and Clinical Immunology, Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, Montreal, QC, Canada. Electronic address:

Background: Data are sparce regarding tree nut-induced anaphylaxis (TNA).

Objective: We aimed to characterize rate, clinical characteristics, and management of TNA in children (0-17 years old) across Canada, and assess factors associated with severe reactions and epinephrine use.

Methods: Between April 2011 and May 2020, data were collected on children presenting to five emergency departments (EDs) in Canada. Read More

J Card Surg 2022 Jun 19. Epub 2022 Jun 19.

Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, New Delhi, India.

Background And Aim: To review the anatomical details, diagnostic challenges, associated cardiovascular anomalies, and techniques and outcomes of management, including re-interventions, for the rare instances of transposition physiology with concordant ventriculo-arterial connections.

Methods: We reviewed clinical and necropsy studies on diagnosis and surgical treatment of individuals with transposition physiology and concordant ventriculo-arterial connections, analyzing also individuals with comparable flow patterns in the setting of isomerism.

Results: Among reported cases, just over two-thirds were diagnosed during surgery, after initial palliation, or after necropsy. Read More

Sci Rep 2022 Jun 17;12(1):10273. Epub 2022 Jun 17.

Unit of Rare Diseases of the Nervous System in Childhood, Department of Clinical and Experimental Medicine, Section of Pediatrics and Child Neuropsychiatry, University of Catania, 95124, Catania, Italy.

Herein, authors present a retrospective, multi-center study to determine the number of accesses to Pediatric Emergency Unit (PEU) of patients within 28 days of life, admitted to (1) the Acute and Emergency Pediatric Unit, San Marco University Hospital, Catania, Italy; (2) Garibaldi Hospital for Emergency Care, Catania, Italy; (3) Cannizzaro Hospital for Emergency Care, Catania, Italy. We included neonates admitted for neurologic problems, from January 2015 to December 2020, to the 1-Acute and Emergency Access of the San Marco University Hospital, Catania, Italy [observation center 1 (OC1)]; 2-Garibaldi Hospital for Emergency Care, Catania, Italy (Observation Center 2-OC2); 3-Cannizzaro Hospital for Emergency Care, Catania, Italy (Observation Center 3-OC3). For each patient, we evaluated the severity of urgency, by studying the admission triage-coloured codes, the clinical data at admission and the discharge diagnosis. Read More

Vasc Specialist Int 2022 Jun 17;38:14. Epub 2022 Jun 17.

Department of Surgery, Division of Vascular Surgery and Endovascular Therapy, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubirán, México City, México.

Chronic limb-threatening ischemia is rarely associated with previous traumatic injury. We present a case of a 28-year-old male with progressive digit ulcers, a weak pulse, cyanosis, and a cold limb. Eight months prior, he had a motorcycle accident resulting in a right clavicle fracture and brachial plexus injury. Read More

BMC Infect Dis 2022 Jun 13;22(1):538. Epub 2022 Jun 13.

Department of Pediatrics, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran.

Background: Bronchiolitis, the most common cause of hospitalization in infancy has not yet a definitive treatment. This study was conducted to assess the effect of Zinc and vitamin D on treatment of infants with bronchiolitis.

Methods: In this double blind, randomized clinical trial, 94 infants aged 2 to 23 months, admitted in Mousavi Hospital in Zanjan, Iran, with the diagnosis of acute bronchiolitis were randomly assigned into 3 groups. Read More

Cureus 2022 May 7;14(5):e24811. Epub 2022 May 7.

Pulmonary and Critical Care, Richmond University Medical Center, Staten Island, USA.

Superior vena cava (SVC) syndrome is a clinical entity with signs and symptoms resulting from obstruction of blood flow through the SVC. The resulting obstruction leads to edema in the upper body, including the head, neck, and upper extremities. Clinical signs and symptoms can include plethora, cyanosis, dyspnea, stridor, cough, and hoarseness, as well as more serious complications such as cerebral edema leading to headache, confusion, and coma. Read More

J Cardiol Cases 2022 Jun 28;25(6):408-412. Epub 2022 Mar 28.

Cairo University Hospital, Cairo, Egypt.

Pulmonary arterio-venous fistula (PAVF) is an uncommon cause of cyanosis and should be suspected when normal cardiac examination is associated without evidence of intra-cardiac shunt. Off-label use of occluder devices in the catheter laboratories can be helpful and safe when chosen according to the morphology, site, and the size of the fistula, and it is considered a good alternative to surgery as it selectively occludes the PAVF while preserving the normal pulmonary vessels. Our case was a young boy accidentally discovered and diagnosed as having huge PAVF, after false diagnosis of coronavirus disease 2019. Read More

Presse Med 2022 Jun 1;51(3):104127. Epub 2022 Jun 1.

Professeur Emeritus, Université de Paris, France. Electronic address:

The Spanish flu occurred at the end of the First world war, in disastrous epidemiological conditions on populations exhausted by four years of war. At that time, there were no vaccines, no antibiotics, no oxygen and no resuscitation. It was even thought that the infectious agent was a bacterium. Read More

J UOEH 2022 ;44(2):185-190

Department of Emergency Medicine, School of Medicine, University of Occupational and Environmental, Health, Japan. Yahatanishi-ku, Kitakyushu 807-8555, Japan.

Toluidine is a known cause of bladder cancer, but it is less widely recognized as a cause of methemoglobinemia because methemoglobinemia is rare. We herein report a case of methemoglobinemia caused by toluidine in a 50-year-old man. A solution of toluidine overflowed from its container during transportation and adhered to the man's clothes, but he drove to his workplace 100 km away without changing his clothes or undergoing decontamination. Read More

Respir Med Case Rep 2022 24;38:101675. Epub 2022 May 24.

Dept. Respiratory Diseases, University Hospitals Leuven, Leuven, Belgium.

Methemoglobinemia is a rare blood disorder that should be suspected in patients with cyanosis and low oxygen saturation of around 85%, especially when both do not improve despite supplemental oxygen. We describe the case of a 67-year-old lung transplant patient who was treated with primaquine and clindamycin because of a positive polymerase chain reaction on bronchoalveolar lavage fluid. Soon thereafter the patient developed increasing shortness of breath, central cyanosis and hypoxia, with an oxygen saturation of 86% on pulse oximetry despite supplemental oxygen. Read More

Front Cardiovasc Med 2022 13;9:882817. Epub 2022 May 13.

Department of Rheumatology, Affiliated Hangzhou First People's Hospital, School of Medicine, Zhejiang University, Hangzhou, China.

Background: Erdheim-Chester disease (ECD) is a rare disease that affects multiple systems and is characterized by non-Langerhans cell histiocytosis. Classic clinical signs include long bone infiltration, central nervous system involvement, diabetes insipidus, and sheathing of the entire aorta. However, thrombosis is not recognized as a typical cardiac manifestation of ECD. Read More

Ann Med Surg (Lond) 2022 May 26;77:103629. Epub 2022 Apr 26.

Mogadishu Somali Turkish Training and Research Hospital, Mogadishu, Somalia.

Massive pulmonary embolism (PE) combined with right atrial (RA) thrombus is associated with significant mortality. Hemodynamic collapses, which can manifest as hypotension, severe dyspnea; cyanosis, syncope, shock, and right ventricular heart failure are the hallmark of massive PE. Moreover, hemodynamic collapse can be the earliest clinical presentation and the most common cause of death in the first days. Read More

Children (Basel) 2022 May 6;9(5). Epub 2022 May 6.

Congenital Cardiac Surgery, ASST Grande Ospedale Metropolitano Niguarda, 20126 Milan, Italy.

Cor triatriatum dexter (CTD) is an extremely uncommon and underreported congenital cardiac anomaly in which the persistence of the embryonic right venous valve separates the right atrium into two chambers with varying degrees of obstruction to antegrade flow and variable degree of right to left shunt at atrial level. Depending on the size of the valves, clinical manifestations vary from absence of symptoms to severe hypoxia, requiring urgent surgical correction. We herein describe the diagnostic difficulties in a case of neonatal CTD, who developed increasingly severe and unresponsive cyanosis, first interpreted as postnatal maladjustment with pulmonary hypertension. Read More

J Vis Exp 2022 05 26(183). Epub 2022 May 26.

An erratum was issued for: Myocardial Infarction by Percutaneous Embolization Coil Deployment in a Swine Model. The Protocol and Discussion sections were updated. Step 3. Read More

Cureus 2022 Apr 17;14(4):e24214. Epub 2022 Apr 17.

Department of Radiology, Aga Khan University Hospital, Karachi, PAK.

Pulmonary arteriovenous malformation (PAVMs) are abnormal communications between pulmonary arteries and veins. The rarity of their occurrence, coupled with the risks they pose, including brain abscess, embolic stroke, and myocardial infarction, mandates that they should not be overlooked in the differential diagnosis of patients presenting with haemoptysis, dyspnea, clubbing, cyanosis, hypoxemia, or epistaxis. We present the case of a 41-year-old local female who presented to our hospital as an outpatient with decreased oxygen saturation (SpO) of 70%-80% for the past two years with a final diagnosis of PAVM. Read More

Cureus 2022 Apr 15;14(4):e24152. Epub 2022 Apr 15.

Hematology, Guthrie Robert Packer Hospital, Sayre, USA.

Methemoglobin (MetHb) is a form of hemoglobin in which iron in Hb is in an oxidized form (ferric) instead of ferrous, making it difficult to bind with oxygen. Usually, MetHb is present in small quantities (<1%) in humans, but once MetHb increases beyond 3%, the condition is known as methemoglobinemia. It can be further classified into hereditary and acquired. Read More

Front Pediatr 2022 2;10:846408. Epub 2022 May 2.

Department of Cardiology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.

Background And Aim: Heart failure in children differs substantially from the adult population. Clinical characteristics of pediatric diastolic heart failure has rarely been reported. In this study, we aimed to summary the causes, clinical features, lab tests, and treatment effect of pediatric diastolic heart failure. Read More

Front Cardiovasc Med 2022 25;9:786278. Epub 2022 Apr 25.

Department of Cardiovascular Function, People's Hospital of China Medical University, People's Hospital of Liaoning Province, Shenyang, China.

Total anomalous systemic venous drainage (TASVD) is a rare congenital heart malformation. Here, we report a case of a 40-year-old male patient who had a total anomalous systemic venous drainage. It was diagnosed as the TASVD for the first time through multimodal imaging combined Transthoracic (TTE), transesophageal (TEE) and three-dimensional (3D-TTE) echocardiography, contrast echocardiography and computed tomography angiography (CTA). Read More

Cardiol Young 2022 May 12:1-4. Epub 2022 May 12.

Istanbul Medipol University Faculty of Medicine, Department of Cardiovascular Surgery, Turkey.

Congenital rupture of tricuspid chordae tendinea leading to severe tricuspid insufficiency is an extremely rare pathology associated with signs and symptoms of congestive heart failure presenting at birth. If the diagnosis and treatment of this pathology are not made early in life fetal demise may become inevitable.We herein present a neonate with central cyanosis and congestive heart failure due to rupture of an anterior leaflet chordae resulting in severe insufficiency of the tricuspid valve who was treated with appropriate surgery. Read More

Saudi J Kidney Dis Transpl 2021 Sep-Oct;32(5):1497-1498

Department of Pediatric Nephrology, Akron Children's Hospital, Ohio, Cleveland, USA.

Front Pediatr 2022 21;10:794053. Epub 2022 Apr 21.

Department of Pediatrics, International University of Health and Welfare, Tokyo, Japan.

Background: Isolated right ventricular hypoplasia (IRVH), not associated with severe pulmonary or tricuspid valve malformation, is a rare congenital myocardial disease. This study aims to evaluate the clinical status and outcome of IRVH.

Methods: A systematic search of keywords on IRVH was conducted. Read More

Ann Pediatr Cardiol 2021 Oct-Dec;14(4):550-553. Epub 2022 Mar 25.

Department of Cardiac Surgery, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, Karnataka, India.

Anomalies of systemic venous connections are extremely rare. We describe the case of an asymptomatic 29-year-old woman who was found to have systemic desaturation in the peripartum period and referred to us for suspected cyanotic heart disease. She was diagnosed to have hemianomalous systemic venous connection of the inferior vena cava (IVC) into the left atrium (LA). Read More