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Thymoma-associated autoimmune encephalitis with positive Titin antibodies: A case report.

J Neuroimmunol 2021 Jul 22;358:577670. Epub 2021 Jul 22.

Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China. Electronic address:

We report a case of thymoma-associated autoimmune encephalitis with positive Titin antibodies. The patient had cognitive dysfunction, psychiatric symptoms and symptomatic epilepsy. PET-CT indicated space-occupied lesion at the thoracic entrance. Read More

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Development of the smooth newt, Lissotriton vulgaris, as observed in a garden pond during lockdown.

Dev Dyn 2021 Jul 29. Epub 2021 Jul 29.

Division of Biology and Biological Engineering, California Institute of Technology.

Background: Lissotriton vulgaris ('smooth newt') was an important organism for experimental embryology, especially in the early 20 century. The stages of development of L. vulgaris from the appearance of the first cleavage to metamorphosis have previously been described, but only through drawings. Read More

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Day-case unicompartmental knee arthroplasty: a literature review and development of a novel hospital pathway.

Ann R Coll Surg Engl 2021 Jul 29. Epub 2021 Jul 29.

University College London Hospitals, UK.

Introduction: We have seen unparalleled changes in our healthcare systems globally as a result of the COVID-19 pandemic. As we strive to regenerate our full capacity elective services in order to contest the increasing demand for lower limb arthroplasty, this pandemic has allowed us a rare opportunity to revise and develop novel elective arthroplasty pathways intended to improve patient care and advance healthcare efficiency. We present an extensive evidence-based review of the approaches used to achieve day-case unicompartmental arthroplasty (UKA) as well as the development of a day-case UKA care pathway in a UK NHS institution based on the evidence provided in the literature. Read More

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[Reflections on the Application of Critical Care Ultrasound in Viral Pneumonia Patients with Circulatory Dysfunction-New Classification and Precision Treatment Based on Ciritical Care Ultrasound].

Sichuan Da Xue Xue Bao Yi Xue Ban 2021 Jul;52(4):555-560

Emergency Department and Intensive Care Unit, West China School of Public Health, West China Fourth Hospital, Sichuan University, Chengdu 610041, China.

Viruses are among the main pathogens of pulmonary infection and tend to cause pandemics of viral pneumonia. Severe viral pneumonia tends to be accompanied by acute respiratory distress syndrome (ARDS) manifestations, displaying highly specific clinical symptoms that are most prominently expressed in the circulatory system. Shock occurred rarely, it occured at a rather late stage in this outbreak of viral pneumonia. Read More

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Case Report: Uroenteric Fistula in a Pediatric-en-bloc Kidney Transplant Manifests as Deceptive Watery Diarrhea and Normal Anion Gap Acidosis.

Front Pediatr 2021 12;9:687396. Epub 2021 Jul 12.

Division of Pediatric Nephrology, Department of Pediatrics, University of Miami/Holtz Children's Hospital, Miami, FL, United States.

The diagnosis of a post-surgical uroenteric fistula can be challenging and may be delayed for months after symptoms begin. A normal anion gap metabolic acidosis has been reported in up to 100% of patients after ureterosigmoidostomy, and bladder substitution using small bowel and/or colonic segments. Here, we describe a rare case of a pediatric patient who developed a uroenteric fistula from the transplant ureters into the small bowel, after an en-bloc kidney transplantation resulting in profound acidosis and deceptive watery diarrhea. Read More

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Laparoscopic liver resection for colorectal liver metastases - short- and long-term outcomes: A systematic review.

World J Gastrointest Oncol 2021 Jul;13(7):732-757

Department of Digestive and Hepatobiliary/Pancreatic Surgery, AZ Groeninge, Kortrijk 8500, Belgium.

Background: For well-selected patients and procedures, laparoscopic liver resection (LLR) has become the gold standard for the treatment of colorectal liver metastases (CRLM) when performed in specialized centers. However, little is currently known concerning patient-related and peri-operative factors that could play a role in survival outcomes associated with LLR for CRLM.

Aim: To provide an extensive summary of reported outcomes and prognostic factors associated with LLR for CRLM. Read More

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Unusual case of malignant pleural mesothelioma.

BMJ Case Rep 2021 Jul 28;14(7). Epub 2021 Jul 28.

Respiratory Medicine, Cambridge University Hospitals NHS Foundation Trust, Cambridge, Cambridgeshire, UK.

We present the case of a 65-year-old woman who presented with progressive dysphagia and was diagnosed with achalasia. She subsequently developed bilateral chylous pleural effusions, with no cause identified despite extensive investigations (including computed tomography (CT) scans, gastroscopy and medical thoracoscopy (MT)) and review at a dedicated pleural multidisciplinary team meeting.Despite optimal supportive management she deteriorated and was admitted to the intensive care unit, where she passed away due to sepsis and respiratory failure 10 months after initial presentation. Read More

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Detailed statistical analysis plan for the short-term versus long-term mentalisation-based therapy for outpatients with subthreshold or diagnosed borderline personality disorder randomised clinical trial (MBT-RCT).

Trials 2021 Jul 28;22(1):497. Epub 2021 Jul 28.

Copenhagen Trial Unit, Centre for Clinical Intervention Research, Department 7812, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.

Background: Psychotherapy for borderline personality disorder is often extensive and resource-intensive. Mentalisation-based therapy is a psychodynamically oriented treatment option for borderline personality disorder, which includes a case formulation, psychoeducation, and group and individual therapy. The evidence on short-term compared with long-term mentalisation-based therapy is currently unknown. Read More

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Periocular invasive melanoma manifestation in a patient using bimatoprost: case report and literature review.

Orbit 2021 Jul 28:1-8. Epub 2021 Jul 28.

Department of Ophthalmology and Visual Sciences, Dalhousie University, Halifax, Nova Scotia, Canada.

Prostaglandin F analogs (PGAs) are considered efficacious in the first-line treatment of glaucoma. They have however been associated with a number of periocular side effects. We present a case of periocular hyperpigmentation and progression to lentigo maligna melanoma (LMM) in a patient using bimatoprost eye drops. Read More

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Case Report: Polyvinylpyrrolidone deposition disease from repeated injection of opioid substitution drugs: report of a case with a fatal outcome.

F1000Res 2021 19;10:300. Epub 2021 Apr 19.

Department of Pathology, Haukeland University Hospital, Post box 1, 5021 Bergen, Norway.

: Intravenous injection of oral opioid substitution drugs (OSD) is widespread among injecting drug users. Several OSDs contain the polymer polyvinylpyrrolidone (PVP) as an excipient. Parenterally administered PVP of high molecular weight may accumulate in tissues and organs. Read More

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Covid-19 Breakthrough Infections in Vaccinated Health Care Workers.

N Engl J Med 2021 Jul 28. Epub 2021 Jul 28.

From the Infection Prevention and Control Unit (M.B., T.G., C.C., E.G.L., C.R., I.T., M.Z., G.R.-Y.), the Department of Clinical Microbiology (S.A.), General Management (Y.K.), and the Central Virology Laboratory, Public Health Authority, Ministry of Health (Y.L., M.M., V.I., N.Z.), Sheba Medical Center Tel Hashomer, Ramat Gan, Sackler School of Medicine, Tel Aviv University, Tel Aviv (T.G., Y.L., M.M., E.G.L., Y.K., G.R.-Y.), and the Laboratory Wing, Asaf Harofe Medical Center, Be'er Ya'akov (A.B.-C.) - all in Israel; St. George's School of Medicine of London and Faculty of Medicine, University of Nicosia, Nicosia, Cyprus (M.B.); and Harvard T.H. Chan School of Public Health, Boston (M.L.).

Background: Despite the high efficacy of the BNT162b2 messenger RNA vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), rare breakthrough infections have been reported, including infections among health care workers. Data are needed to characterize these infections and define correlates of breakthrough and infectivity.

Methods: At the largest medical center in Israel, we identified breakthrough infections by performing extensive evaluations of health care workers who were symptomatic (including mild symptoms) or had known infection exposure. Read More

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Bilateral frosted branch angiitis in an initial case of systemic lupus erythematosus.

Arq Bras Oftalmol 2021 Jul 14. Epub 2021 Jul 14.

Departamento de Oftalmologia, Medicina Especializada, Centro de Ciências da Saúde, Universidade Federal do Espírito, Vitória, ES, Brazil.

Frosted branch angiitis is a rare and severe form of retinal vasculitis. It may be idiopathic or arise secondary to a systemic disease. We have reported here an unusually severe case of frosted branch angiitis in a previously healthy 13-year old girl who presented with significantly reduced vision in both eyes. Read More

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Ophthalmic artery occlusion due to orbital compartment syndrome after a frontotemporal craniotomy.

Indian J Ophthalmol Case Rep 2021 Apr-Jun;1(2):383-385. Epub 2021 Apr 1.

Department of Ophthalmology, New York University, New York, NY, USA.

A 32-year-old female with a right frontal lobe glioma underwent an elective frontotemporal craniotomy. One hour postoperatively, the patient developed a right orbital compartment syndrome (OCS) with unilateral acute vision loss, proptosis, afferent pupillary defect, and complete ophthalmoplegia. The patient underwent emergent lateral canthotomy and inferior cantholysis. Read More

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Leukemic Infiltration of Myocardium Presenting as Cardiac Arrest.

JACC Case Rep 2021 Jun 16;3(6):922-927. Epub 2021 Jun 16.

Smidt Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.

Clinically significant myocardial infiltration by leukemic cells is a rare phenomenon. We describe a case of a 47-year-old woman with newly diagnosed acute myeloid leukemia and pleuritic chest pain with rapid cardiopulmonary decompensation. Post-mortem analyses showed fibrinous pericarditis and extensive leukemic infiltration of the myocardium. Read More

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Echocardiographic Diagnosis of Bland-White-Garland Syndrome in an Asymptomatic Adult.

JACC Case Rep 2020 Jun 17;2(7):1021-1024. Epub 2020 Jun 17.

Department of Medicine, Division of Cardiology, St. Elizabeth's Medical Center, Brighton, Massachusetts.

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital defect and usually diagnosed within the first 2 months of life. Only 10% of patients survive to adulthood largely in part to the formation of extensive collaterals from the right to left coronary arteries. We present a case of ALCAPA diagnosed in an asymptomatic adult through a transthoracic echocardiogram (TTE). Read More

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Late Type A Dissection After Transfemoral Aortic Valve Replacement.

JACC Case Rep 2020 Jun 17;2(6):877-881. Epub 2020 Jun 17.

Division of Cardiothoracic Surgery, Department of Surgery, Oregon Health & Science University, Portland, Oregon.

An 87-year-old woman had residual moderate to severe aortic insufficiency following transcatheter aortic valve replacement. A year later, she developed extensive Stanford type A aortic dissection originating at the supra-annular aortic edge of the transcatheter aortic valve replacement nitinol frame. Dissection repair, frozen elephant trunk with exclusion of prior insufficiency while preserving the transcatheter aortic valve replacement valve was performed. Read More

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Rerouting of Cerebral Circulation: Extensive Transcatheter Aortic Arch Revision.

JACC Case Rep 2020 Jun 17;2(6):855-859. Epub 2020 Jun 17.

Children's Healthcare of Atlanta, Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia.

We describe an adolescent with long-standing atresia of the head/neck arteries and severe aortic coarctation. Because of progressive symptoms, a series of interventions was undertaken to provide direct aorta-to-carotid artery flow and coarctation treatment. This case highlights the unusual physiological features associated with atresia of all head and neck arteries. Read More

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Takayasu Arteritis With Extensive Cardiovascular, Neurovascular, and Mesenteric Involvement.

JACC Case Rep 2020 May 8;2(5):697-701. Epub 2020 Apr 8.

Division of Cardiology, Department of Medicine, University of California-Los Angeles, Los Angeles, California.

Takayasu arteritis is a rare large vessel vasculitis with an incidence of 1 to 3 per million. This disease typically involves the aorta and its primary branches but has been found to involve the coronary arteries in 7% to 9% of cases. We highlight the need for prompt diagnosis and treatment. Read More

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Circulating Heterophile Antibodies Causing Cardiac Troponin Elevation: An Unusual Differential Diagnosis of Myocardial Disease.

JACC Case Rep 2020 Mar 18;2(3):456-460. Epub 2020 Mar 18.

Department of Cardiology, Leiria Hospital Centre, Leiria, Portugal.

We present the case of a female patient who developed persistently elevated levels of cardiac troponin (cTn) after a previous episode of clinically presumed myocarditis. Extensive investigation concluded that the presence of heterophile antibodies was causing false positive cTn elevation. (). Read More

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Lipomatous Hypertrophy of the Interatrial Septum Manifesting as Third Degree Atrioventricular Block.

JACC Case Rep 2020 Nov 11;2(14):2235-2239. Epub 2020 Nov 11.

Department of Cardiac Surgery, St. Vincent Heart Center of Indiana, Indianapolis, Indiana.

A 55-year-old patient was found to have complete heart block during preoperative assessment. Cardiac magnetic resonance imaging revealed an interatrial mass suggestive of primary cardiac tumor. Extensive evaluation including intracardiac biopsy and finally open resection revealed lipomatous hypertrophy masquerading as tumor. Read More

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November 2020

Lenalidomide-Induced Myocarditis, Rare But Possibly Fatal Toxicity of a Commonly Used Immunotherapy.

JACC Case Rep 2020 Nov 30;2(13):2095-2100. Epub 2020 Sep 30.

Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, Texas.

A 66-year-old woman with follicular lymphoma on lenalidomide and rituximab presented with chest pain. High-sensitivity troponin T peaked at 7,566 ng/l. Cardiac biopsy revealed extensive inflammation consistent with medication-induced myocarditis. Read More

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November 2020

Catheter-Directed Thrombolysis for Submassive Pulmonary Embolism in the Third Trimester of Pregnancy.

JACC Case Rep 2020 Oct 21;2(12):1899-1904. Epub 2020 Oct 21.

Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California-San Francisco, School of Medicine, San Francisco, California.

A 37-year-old woman presented with chest pain and shortness of breath in the third trimester of pregnancy. Diagnostic imaging demonstrated a saddle pulmonary embolism, severe impairment of right ventricular function, and an extensive deep venous thrombus. She underwent catheter-directed thrombolysis with tissue plasminogen activator and delivered a healthy infant at term. Read More

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October 2020

Idiopathic Constrictive Pericarditis and Eggshell Calcification of the Heart.

JACC Case Rep 2020 Aug 19;2(10):1542-1544. Epub 2020 Aug 19.

Department of Cardiology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

Extensive pericardial calcification is rare in patients with chronic constrictive pericarditis (CCP). We report the case of a young man who had CCP with "eggshell" calcification of the pericardium and the classic features of CCP on echocardiography and cardiac catheterization. The patient had an uneventful recovery following surgical pericardiectomy. Read More

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A Challenging Case of Extensive Spontaneous Coronary Artery Dissection.

JACC Case Rep 2020 Aug 19;2(10):1437-1442. Epub 2020 Aug 19.

Division of Cardiology, Weill Cornell Medicine, New York Presbyterian Hospital, New York, New York.

The detection of spontaneous coronary artery dissection (SCAD) causing myocardial infarction is integral in pursuing the appropriate management. Our case posed a diagnostic challenge, with Takotsubo cardiomyopathy and coronary embolism among the potential differential diagnoses upon the initial presentation. Extensive propagation of spontaneous coronary artery dissection subsequently resulted in a significant challenge to management requiring surgical revascularization. Read More

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Novel Presentation of Homozygous Familial Hypercholesterolemia With Homozygous Variants in Both LDLR and APOB Genes.

JACC Case Rep 2019 Oct 18;1(3):346-349. Epub 2019 Sep 18.

Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine; and the Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland.

This case report describes a 50-year-old-woman from Southeast Asia with extensive atherosclerotic cardiovascular disease, found to have homozygous familial hypercholesterolemia caused by variants of uncertain significance in both the APOB and LDLR genes. Medications were insufficient, and thus LDL apheresis was initiated to further decrease LDL-C. (). Read More

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October 2019

Atypical primary hyperparathyroidism due to parathyroid lipoadenoma: a case report.

J Surg Case Rep 2021 Jul 23;2021(7):rjab308. Epub 2021 Jul 23.

Department of General Surgery, Luigi Sacco University Hospital, Milan, Italy.

Parathyroid lipoadenoma is a very rare cause of primary hyperparathyroidism. Preoperative imaging techniques often fail to detect such lesions, and even during surgery they can be misinterpreted just as fat tissue. A 62-year-old woman clinically monitored for primary hyperparathyroidism, with hypertension and a left nephrectomy for hydrouretheronephrosis caused by recurrent kidney stones. Read More

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Intron splicing: U12 spliceosomal introns not so 'minor' after all.

Authors:
Naomi M Fast

Curr Biol 2021 Jul;31(14):R912-R914

Biodiversity Research Centre, Department of Botany, University of British Columbia, Vancouver, BC V6T 1Z4, Canada. Electronic address:

Whereas most eukaryotic genes are interrupted by introns removed by the U2 (major) spliceosome, U12-type introns are extremely rare. New work uncovers a case of extensive U12-type intron gain, and an unexpectedly flexible and efficient U12 (minor) spliceosome. Read More

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Bipolar symptoms, somatic burden and functioning in older-age bipolar disorder: Analyses from the Global Aging & Geriatric Experiments in Bipolar Disorder Database project.

Bipolar Disord 2021 Jul 27. Epub 2021 Jul 27.

Department of Psychiatry, University of California San Diego, and Desert-Pacific Mental Illness Research Education and Clinical Center, VA San Diego Healthcare System, San Diego, CA, USA.

Objective: Literature on older-age bipolar disorder (OABD) is limited. This first-ever analysis of the Global Aging & Geriatric Experiments in Bipolar Disorder Database (GAGE-BD) investigated associations among age, BD symptoms, comorbidity, and functioning.

Methods: This analysis used harmonized, baseline, cross-sectional data from 19 international studies (N = 1377). Read More

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A vascular lesion in hip revision arthroplasty: a case report.

Acta Biomed 2021 Jul 26;92(S3):e2021031. Epub 2021 Jul 26.

Orthopedic and Traumatology Unit, Ospedale San Bortolo - Vicenza.

Vascular injuries during hip revision surgery can be life-threatening complications for patients. There are many aspects to consider when approaching this type of surgery for an optimal diagnostic and therapeutic strategy, as a careful planning with extensive preoperative investigations, a full attention during the surgical procedure and the use of suitable material for a proper treatment. This kind of surgery can require a dedicated and trained multidisciplinary team. Read More

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Stiff-person syndrome: an atypical presentation and a review of the literature.

Hosp Pract (1995) 2021 Jul 27. Epub 2021 Jul 27.

Department of Neurology, Lehigh Valley Health Network, Allentown, PA, USA.

: Stiff-person syndrome (SPS) is a rare autoimmune neurological disorder associated with muscle rigidity and spasms. A number of antibodies have been associated with disorder, including anti-glutamic acid decarboxylase and anti-amphiphysin.: In this report, we present a rare case of a 79-year-old woman who presented with bilateral lower extremity weakness who was ultimately diagnosed with stiff-limb syndrome, a rare variant of SPS. Read More

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