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A 'shark'-masked electrocardiogram: case report of a Tako-Tsubo syndrome.

Eur Heart J Case Rep 2021 May 7;5(5):ytab132. Epub 2021 May 7.

Division of Cardiology, Ospedale degli Infermi, ASL Biella, Via dei Ponderanesi, 13900 Biella, Italy.

Background: Triangular ST-segment elevation or 'shark-fin' sign has been described as a specific indicator of acute coronary occlusion and large myocardial ischaemia, translating into poorer prognosis. However, this electrocardiographic presentation has been reported in rare cases of Tako-Tsubo syndrome and associated with more severe physical stressors and neurological involvement.

Case Summary: We present a rare case of a 51-year-old woman presenting with incoming epileptic attacks and concomitant pyometra. Read More

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Physical Activity and Female Sexual Dysfunction: A Lot Helps, But Not Too Much.

J Sex Med 2021 Jun 5. Epub 2021 Jun 5.

Department of Experimental Clinical and Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy; Andrology, Women's Endocrinology and Gender Incongruence Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy; I.N.B.B. (Istituto Nazionale Biostrutture e Biosistemi), Rome, Italy. Electronic address:

Background: Research on the relationship between physical activity (PA) and female sexual dysfunction (FSD) is lacking.

Aim: To investigate the clinical, psychological, and sexual correlates of PA in women with FSD.

Methods: A non-selected series of n = 322 pre- and post-menopausal patients consulting for FSD was retrospectively studied. Read More

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Absent pulmonary valve with tricuspid atresia/stenosis: literature review with new three long-term cases.

Heart Vessels 2021 Jun 5. Epub 2021 Jun 5.

Department of Pediatric Cardiology, Osaka City General Hospital, Osaka, Japan.

Absent pulmonary valve (APV) syndrome with tricuspid atresia or tricuspid stenosis (TA/TS) is an extremely rare malformation recently reported as a variant of APV with intact ventricular septum (VS). The condition, however, has univentricular physiology and unique structural and clinical features. The purpose of this study was to update the current knowledge about this condition by describing long-term outcomes of three new cases and reviewing the available literatures. Read More

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Cardiac Failure Requiring Veno-Arterial Extracorporeal Membrane Oxygenation (VA-ECMO) Management in a Refeeding Syndrome Patient with Diabetic Ketoacidosis: A Case Report.

Am J Case Rep 2021 Jun 3;22:e930568. Epub 2021 Jun 3.

Department of Intensive Care Medicine, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan.

BACKGROUND Refeeding syndrome is a complex metabolic disorder that develops following rapid nutritional administration after a long period of undernutrition. The onset mechanism involves intracellular transport of phosphorus, potassium, and water, in association with rapid glucose administration. The resulting hypophosphatemia is extremely dangerous and can cause severe heart failure and fatal arrhythmia. Read More

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The Association of Periodontitis and Peripheral Arterial Occlusive Disease in a Prospective Population-Based Cross-Sectional Cohort Study.

J Clin Med 2021 May 11;10(10). Epub 2021 May 11.

Department of Vascular Medicine, University Heart and Vascular Center UKE Hamburg, Research Group GermanVasc, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.

Objectives: Peripheral arterial occlusive disease (PAOD) and periodontitis are common chronic diseases, which together affect almost 1 billion people worldwide. There is growing evidence suggesting a relationship between chronic inflammatory conditions such as periodontitis and PAOD. This study aims to determine an association between both entities using high quality research data and multiple phenotypes derived from an epidemiological cohort study. Read More

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A strangulated internal hernia beneath the left external iliac artery after radical hysterectomy with laparoscopic pelvic lymphadenectomy: a case report and literature review.

BMC Surg 2021 May 31;21(1):273. Epub 2021 May 31.

Department of Gastrointestinal Surgery, Shaoxing People's Hospital (Shaoxing Hospital of Zhejiang University), Shaoxing, 312000, China.

Background: Ileum obstruction due to internal hernia beneath external iliac artery after pelvic lymph node dissection (PLND) is extremely rare. We reported a case of acute strangulated internal hernia between the left external iliac artery and psoas major as late complication of laparoscopic hysterectomy with pelvic lymphadenectomy.

Case Presentation: A 46-year-old woman, who with histories of laparoscopic hysterectomy, bilateral salpingo-oophorectomy and PLND 9 years ago for the cervical malignant tumor, open appendectomy 18 years ago, visited our hospital complaining of aggravated left lower abdominal pain, bloating, nausea and vomiting from few hours ago. Read More

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Imaging diagnosis of aberrant proper hepatic and gastroduodenal arteries prior to pancreaticoduodenectomy: A case report.

Radiol Case Rep 2021 Jul 30;16(7):1650-1654. Epub 2021 Apr 30.

Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.

In hepatobiliary and pancreatic surgery, an understanding of hepatic artery anomalies is of great importance to surgeons. Cases of the proper hepatic artery originating from the superior mesenteric artery and the gastroduodenal artery originating from the celiac trunk are extremely rare. To our knowledge, there are no reports of these arterial variants being diagnosed before hepatobiliary and pancreatic surgery. Read More

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Serum biomarker discovery related to pathogenesis in acute coronary syndrome by proteomic approach.

Biosci Rep 2021 Jun;41(6)

Department of Senior Healthcare, Graduate School, Eulji University, Seongnam 13135, Korea.

Acute coronary syndrome (ACS) results from inadequate supply of blood flow from the coronary arteries to the heart or ischemia. ACS has an extremely high morbidity and mortality. The levels of biomarkers currently used for detection of ACS also increase in response to myocardial necrosis and other diseases and are not elevated immediately after symptoms appear, thus limiting their diagnostic capacity. Read More

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Aortic quadfurcation with persistent left sciatic artery: an extremely rare anatomic variant in a 3-year-old boy.

J Vasc Surg Cases Innov Tech 2021 Jun 28;7(2):262-265. Epub 2021 Jan 28.

Interventional Radiology Service, Children's National Hospital, Washington, D.C.

Reports of aortoiliac variant anatomy are rare, especially in the pediatric population. A 3-year-old male patient with hypertension and left foot polydactyly with syndactyly was referred to our interventional radiology service for evaluation of a possible renovascular cause of the hypertension. Angiograms revealed an extremely rare anatomic variant consisting of the absence of the common iliac arteries bilaterally, resulting from quadfurcation of the abdominal aorta into the bilateral internal and external iliac arteries. Read More

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Early Clinical Diagnosis and Treatment of Traumatic Aortic Injury Caused by Thoracic and Abdominal Injuries: A Series of Four Cases with Literature Review.

Biomed Res Int 2021 29;2021:9995749. Epub 2021 Apr 29.

Department of Traumatic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.

Aortic injury, particularly traumatic aortic dissection caused by thoracic and abdominal injuries, is extremely rare. The diagnosis rate of blunt aortic injury caused by chest and abdominal injuries is often low, and its clinical manifestations are atypical. Once missed or misdiagnosed, the consequences are serious. Read More

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Anomalous origin of right vertebral artery from right common carotid artery.

Radiol Case Rep 2021 Jun 21;16(6):1574-1579. Epub 2021 Apr 21.

Department of Radiology, King Hamad University Hospital, Manama, Bahrain.

Anomalous origin of vertebral arteries is a rare vascular anomaly and mostly discovered as incidental findings during computed tomography angiogram , magnetic resonance angiography or digital subtracted angiogram of the aortic arch and cerebral vessels. Herein, we present an extremely rare case of a 31-year-old female who presented with headache after emotional trauma. A conventional cerebral angiogram showed anomalous origin of the right vertebral artery. Read More

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Type 2 persistent primitive olfactory artery associated with bilateral ophthalmic arteries arising from the middle meningeal arteries diagnosed by magnetic resonance angiography.

Surg Radiol Anat 2021 May 13. Epub 2021 May 13.

Department of Diagnostic Radiology, Saitama Medical University International Medical Center, Hidaka, Japan.

Persistent primitive olfactory artery (PPOA) is a relatively rare variation of the proximal anterior cerebral artery (ACA). Traditionally, there are two types: Type 1 is a common type, which generally follows an anteroinferior course and which takes a hairpin turn before continuing to the A2 segment of the ACA. Type 2 is an extremely rare variation that continues to the anterior ethmoidal artery without a hairpin turn. Read More

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Sacral dural arteriovenous fistula supplied by bilateral lateral sacral arteries: case report and literature review.

Br J Neurosurg 2021 May 13:1-4. Epub 2021 May 13.

Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, PR China.

Sacral dural arteriovenous fistulas (DAVFs) with bilateral arterial supplies are extremely rare. To date, only two cases with arterial supply from bilateral lateral sacral arteries (LSAs) were reported. We report a rare case of sacral DAVF with arterial supply from bilateral LSAs. Read More

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[Mobile Thrombus in the Ascending Aorta Detected Incidentally in the Patient with Fever before Surgery for Esophageal Cancer:Report of a Case].

Kyobu Geka 2021 May;74(5):383-387

Department of Cardiovascular Surgery, Yamanashi Prefectural Central Hospital, Kofu, Japan.

A mobile thrombus in the ascending aorta is extremely rare. A 57-year-old man was referred to our hospital with suspected esophageal cancer. Following thorough evaluation, he was diagnosed with esophageal cancer( UtMt type0-Ⅱa T1b, Mt type0-Ⅱc T1a N0M0 cStageⅠ) and tongue cancer in situ. Read More

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[Ascending aorta injury followed by cardiac tamponade after sternal puncture].

Khirurgiia (Mosk) 2021 (5):125-128

Moscow City Clinical Hospital No. 40, Moscow, Russia.

Heart or great outflow vessel injury followed by cardiac tamponade is an extremely rare event. However, it is the most dangerous complication of sternal puncture requiring urgent surgical intervention. The effectiveness of specialized care directly depends on its availability and timely diagnosis. Read More

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Giant cell arteritis presenting as a stroke in the internal carotid artery territory: a case-based review.

Reumatologia 2021 27;59(2):121-125. Epub 2021 Apr 27.

Department of Medicine, Surgery and Neurosciences, Rheumatology Unit, University of Siena, Italy.

Giant cell arteritis (GCA) is a large-vessel vasculitis, typically affecting the aorta and its branches. The involvement of vertebral and internal carotid arteries occurs in a limited number of cases, and stroke as a presenting symptom of GCA is extremely unusual: this subset of the disease has a poor prognosis and rarely responds to immunosuppression. We report the case of a 70-year-old woman, who presented to the Emergency Department for ischemic stroke, which appeared to be the first and only symptom of GCA. Read More

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A Rare Anatomic Variant of Double Replaced Hepatic Arteries: A Case Report and Brief Review of the Anomalous Hepatic Vasculature Literature.

Am J Case Rep 2021 May 9;22:e930990. Epub 2021 May 9.

Division of Surgical Oncology, Department of Surgery, University of Toledo Medical Center, Toledo, OH, USA.

BACKGROUND The liver is a frequent site of surgical resection for both benign and malignant lesions. Advanced knowledge of the hepatic arterial system and its variants is crucial to avoid incidental injuries during a resection procedure. Many variants have been previously described in the literature, yet extremely rare cases continue to be encountered in clinical practice. Read More

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Laparoscopic distal pancreatectomy in a patient with aberrant splenic artery originating from the superior mesenteric artery: A case report.

Medicine (Baltimore) 2021 May;100(18):e25704

Department of Hepatobiliary and Pancreatic Surgery.

Rationale: Splenic artery originating from the superior mesenteric artery is extremely rare. Because of this, its significance in laparoscopic distal pancreatectomy has never been reported. Here, we present the first case of laparoscopic distal pancreatectomy in a patient with a splenic artery arising from the superior mesenteric artery. Read More

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Adult Pilocytic Astrocytoma in the insula: Case report and review of the literature.

Ann Med Surg (Lond) 2021 May 15;65:102300. Epub 2021 Apr 15.

Department of Surgery, King Hussein Cancer Center, Amman, Jordan.

Introduction: and Importance: Adult Pilocytic Astrocytomas (APA) are infrequent low grade tumors. While supratentorial APA is considered rare, insular APA is extremely rare.

Case Presentation: We present a case of pure insular APA along with surgical outcomes. Read More

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Haemobilia secondary to a cystic artery pseudoaneurysm as complication of VLC.

Acta Biomed 2021 04 30;92(S1):e2021125. Epub 2021 Apr 30.

Department of Surgery, Department of Applied Clinical Science and Biotechnology, University of L'Aquila, L'Aquila.

Introduction: The laparoscopic approach has become the gold standard for cholecystectomy. However, it could have some major complications. Among them, it can be considered postoperative pseudoaneurysms of the cystic or hepatic arteries. Read More

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Endovascular treatment of massive hemorrhage arising from inferior thyroid artery after fine needle aspiration of thyroid: a case report.

BMC Surg 2021 Apr 27;21(1):220. Epub 2021 Apr 27.

Department of Radiology, Chungbuk National University Hospital, 776, 1sunhwan-ro, Seowon-g, Cheongju-si, Chungcheongbuk-do, Republic of Korea.

Background: Fine needle aspiration (FNA) of the thyroid gland is an effective and safe method for evaluating thyroid nodules; catastrophic complications following FNA of thyroid are rare. Massive hematomas with active bleeding leading to airway compromise are extremely rare complications of FNA, with only a few reported cases in literature.

Case Presentation: An 80 year-old man presented to the emergency room with severe respiratory distress, four hours after undergoing thyroid FNA for the evaluation of a thyroid nodule. Read More

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Pulmonary infarction caused by sarcoidosis vascular involvement: A case report.

Pathol Int 2021 Apr 26. Epub 2021 Apr 26.

Department of Pathology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.

Sarcoidosis is a systemic granulomatous disease. In pulmonary sarcoidosis, granulomatous vascular involvement is a common feature that occurs in all types of vessels, including large elastic arteries to venules, but sarcoidosis complicated with pulmonary infarction has not been reported. We report a case of a 60 years old female, who was operated on a clinical diagnosis of lung cancer, and histological examination revealed a pulmonary infarction and sarcoidosis. Read More

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Temporary pacemaker implantation through umbilical vein in a low birth weight neonate with congenital complete heart block.

Cardiol Young 2021 Apr 23:1-3. Epub 2021 Apr 23.

Department of Pediatric Cardiology, Max Superspeciality Hospital, Saket, Delhi, India.

Congenital heart block is a rare and lethal condition in paediatric population associated with maternal connective tissue disorders and rarely with structural cardiac disease like atrioventricular canal defects with or without left isomerism and congenitally corrected transposition of great arteries. Pacing in neonate if indicated is generally accomplished by epicardial pacing systems. However, in cases of significant bradycardia and haemodynamic instability, temporary pacemaker implantation via transvenous approach remains as a suitable option. Read More

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Successful Treatment of Protein-Losing Enteropathy After Superior Mesenteric Artery Occlusion without Surgery.

Am J Case Rep 2021 Apr 12;22:e931114. Epub 2021 Apr 12.

Division of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Nagano, Japan.

BACKGROUND Protein-losing enteropathy as a complication of superior mesenteric artery occlusion is extremely rare and severe, and sometimes requires intestinal resection. However, the ideal treatment strategy has not yet been determined. CASE REPORT A 77-year-old man with underlying hypertension and diabetes was admitted to the Emergency Department with acute abdominal pain after eating. Read More

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Clinically Suspected Segmental Arterial Mediolysis of the Splanchnic Arteries: A Report of 2 Rare Cases.

Am J Case Rep 2021 Apr 8;22:e929013. Epub 2021 Apr 8.

Radiology Unit I, Department of Medical Surgical Sciences and Advanced Technologies, University Hospital 'Policlinico - Vittorio Emanuele', University of Catania, Catania, Italy.

BACKGROUND Segmental arterial mediolysis (SAM) is an uncommon vascular pathology characterized by arteriopathy, mainly of medium-sized abdominal splanchnic vessels, without an atherosclerotic, inflammatory, infectious, or autoimmune underlying etiology. Segmental arterial mediolysis is clinically heterogeneous and symptoms may be completely nonspecific. The knowledge of radiological features of segmental arterial mediolysis and the exclusion of other pathologies should direct early diagnosis and refer patients for correct treatment. Read More

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Cognitive and Behavioral Disorders in Patients with Precuneal Infarcts.

Eur Neurol 2021 7;84(3):157-167. Epub 2021 Apr 7.

Neurology Department, Ege University Medical School Hospital, İzmir, Turkey.

Objective: Ischemic stroke of the precuneal cortex (PC) alone is extremely rare. This study aimed to evaluate the clinical, neurocognitive, and behavioral characteristics of isolated PC infarcts.

Methods: We assessed neuropsychological and behavioral findings in 12 patients with isolated PC infarct among 3,800 patients with ischemic stroke. Read More

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[Surgical treatment of a post-traumatic giant pseudoaneurysm of the axillary artery: a case report].

Angiol Sosud Khir 2021 ;27(1):159-163

Department of General Surgery #1, Perm State Medical University named after Academician E.A. Wagner under the RF Ministry of Public Health, Perm, Russia.

A false aneurysm of the axillary artery is an extremely rare complication of a lesion of this vessel. As few as several dozens of similar cases have been described in the available literature. We herein report a clinical case concerning surgical treatment of a 41-year-old patient who after a knife-inflicted injury had developed a 66x67 mm pseudoaneurysm of the axillary artery. Read More

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Abdominal paraaortic paraganglioma: Management of intraoperative hemodynamic emergencies during elective resection procedures (A case presentation).

Exp Ther Med 2021 May 23;21(5):543. Epub 2021 Mar 23.

Department of Cardiovascular Surgery, 'Prof. Dr. C. C. Iliescu' Institute of Emergency for Cardiovascular Diseases, 022322 Bucharest, Romania.

Paragangliomas are extremely rare neuroendocrine tumors. We report a case of a 44-year-old man with hypertension who presented a tumoral mass located retroperitoneally at the aortic bifurcation which included both the common iliac arteries and the posterior left iliac vein, who experienced an unpredictable intraoperative cardiac arrest with electromechanical dissociation at 5 min after laparotomy. After successful resuscitation and hemodynamic stability, the lesion was fully excised. Read More

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Ischemic Cerebellar Stroke in a 4-Year-Old Boy After Chickenpox: An Atypical Vascular Involvement.

J Stroke Cerebrovasc Dis 2021 Jun 1;30(6):105719. Epub 2021 Apr 1.

Child Development Centre, Pediatric Hospital, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal. Electronic address:

Cerebrovascular events in pediatric population are very rare. Up to 30% may result from varicella zoster (VZV) arteriopathy, usually as a delayed complication of varicella primary infection. The most typical pattern includes involvement of anterior brain circulation arteries, probably by VZV migration from the trigeminal ganglia. Read More

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Spontaneous dissection of bilateral internal carotid and vertebral arteries.

BMJ Case Rep 2021 Mar 29;14(3). Epub 2021 Mar 29.

Neurology, SUNY Upstate Medical University, Syracuse, New York, USA.

Spontaneous dissection of the major arteries of the neck is known to increase the risk of stroke or transient ischaemic attack in young and middle-aged adults. Most of the reported cases of arterial dissections in the neck involve one or both paired extracranial carotid or vertebral arteries. Spontaneous dissection of the bilateral internal carotid and vertebral arteries is extremely rare. Read More

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