Archives of Clinical and Medical Case Reports
EISSN : 2575-9655
Current Publisher: Fortune Journals (10.26502)
Total articles ≅ 283
Latest articles in this journal
Archives of Clinical and Medical Case Reports; doi:10.26502/acmcr
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Archives of Clinical and Medical Case Reports, Volume 4, pp 97-105; doi:10.26502/acmcr.96550173
Purpose: The present study aims to describe the differences in the prevalence of EGFR mutation of lung adenocarcinoma between private and public healthcare institutions. Methods: This was a descriptive, observational, retrospective, multicenter study with confirmed diagnosis of non-small cell lung cancer, adenocarcinoma subtype, distributed between two private practice centers and one public healthcare institution. After a pathology review to determine whether there was enough tumor tissue to make a molecular biology study, mutations were determined using real-time PCR for EGFR tyrosine-kinase domain gene. Results: After exclusions a total of 328 patients results for the final analysis. Two hundred thirty-five patients (71.64%) attended a public healthcare institution and ninety-three patients (28.35%) to a private healthcare institution (Table 1). From the public healthcare institution, 113 (34.45%) patients had a positive EGFR mutation, while only 27 patients (8.23%) from the private healthcare institution were positive for an EGFR mutation. When comparing the total number of patients in the study, this difference was statistically significant when comparing public versus private hospitals (p=0.002). Conclusion: We found that there is a statistically significant difference between the frequency of EGFR mutations between populations attending public and private healthcare institutions, probably related to ethnic differences between populations. Despite what has been reported in the present study, these conclusions cannot be generalized and further investigation is needed.
Archives of Clinical and Medical Case Reports, Volume 4, pp 924-931; doi:10.26502/acmcr.96550281
Angioleiomyoma rarely occurs in the oral cavity, and it is extremely rare for this tumor to occur in the facies inferior linguae. We describe an exceptional angioleiomyoma that presented in the right facies inferior linguae in an obese 51-year-old female with hepatopathy. MRI showed high signal on T2-weighted image and the clear visualization of muscle and iso-signal on T1-weighted image. We excised the tumor under general anesthesia as the clinical diagnosis of benign tongue tumor. The tumor was covered by a capsule, and the split surface was yellowish white. Hematoxylin-eosin staining revealed that the wide, spindle-shaped cells with eosinophilic cytoplasm had a bundle-like and complex array, and slit-like blood vessels with branching were scattered. The smooth muscle of the blood vessel wall was observed to have grown. Immunohistochemical staining was positive for αSMA, HHF-35 and caldesmon, somewhat positive for desmin, and negative for CD31, CD34, S100 and Ki-67. The tumor was finally diagnosed as angioleiomyoma. We review the literature’s case reports of angioleiomyoma of the tongue. Chronic estrogen metabolism abnormality due to liver dysfunction may have been the cause of this tumor. This case suggests that MRI imaging and an immunohistochemical analysis are useful for the diagnosis of this tumor.
Archives of Clinical and Medical Case Reports, Volume 4, pp 913-919; doi:10.26502/acmcr.96550279
Conjoint twins are a rare type of monoamniotic twins, with an estimated incidence of 1.5 per 100,000 births worldwide. Fusion occurs between same body parts due to a defect in embryological development. Cardiovascular and other congenital anomalies lead to dismal prognosis with conjoined twins. Early prenatal diagnosis can help in parental counseling regarding the management of pregnancy, including termination or post-natal surgical separation. Ultrasonography and other imaging techniques are vital in making the anatomical survey for evaluating future options. We report a rare variant of conjoined twins, Dicephalus Dipus Dibrachius, where the fetus has two heads, but a single trunk, with two upper and two lower limbs, diagnosed at 9 weeks and 4 days of gestation, with the help of ultrasonography and color Doppler imaging.
Archives of Clinical and Medical Case Reports, Volume 4, pp 920-923; doi:10.26502/acmcr.96550280
Nasopharyngeal swab (NPS) RT-PCR SARS-CoV-2 detection has approximately 100% specificity and 70% sensitivity. We report a case of a 94-year-old patient without significant comorbidities, who developed respiratory symptoms 7 days after being transferred for wrist-fracture rehabilitation. NPS RT-PCR for SARS-CoV-2 was negative on day 1, 7, 12 and 19 after symptom onset. No other viral or bacterial pathogens were detected, nor was there improvement with different empirical antibiotics. CT showed non-specific five-lobe involvement. She slowly recovered clinically and radiologically. SARS-CoV-2 antibody testing became available in Belgium, revealing specific IgG in this patient. Despite serial testing and a cumulative sensitivity of 96%, COVID-19 could not be detected through NPS. This underlines the precaution that should be taken in interpreting a negative test result when the clinical suspicion is high, as well as the need for detailed information about pre- and post-test probabilities in different settings.
Archives of Clinical and Medical Case Reports, Volume 4, pp 903-912; doi:10.26502/acmcr.96550278
Patient admission to intensive care unit (ICU) due to suggested intoxication either because of suicide or because of accident is not uncommon. We describe the case of a 49-year-old male patient who was admitted to our hospital after ingestion of approximately 75 tablets, consisting of beta-blockers, angiotensin-converting enzyme (ACE) inhibitors, dihydropyridine-type calcium antagonists and allopurinol. Only few hours after ingestion, the patient developed cardiac arrest in presence of preclinical healthcare professionals. Therefore, he was transferred to our heart-catheterization lab under mechanical supported chest compression and we commenced veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) therapy. Heart function almost completely recovered, and finally, after explantation of VA- ECMO, he could be transferred to neurorehabilitation.
Archives of Clinical and Medical Case Reports, Volume 4, pp 1023-1030; doi:10.26502/acmcr.96550293
Morning glory syndrome (MGS) is a congenital optic disc anomaly caused by abnormal closure of the embryonic fissure. Retinal detachment is commonly associated with MGS, though the association of choroidal neovascularization (CNV) with MGS is rare. Herein, we report a case of CNV associated with MGS, which was successfully treated with a single intravitreal injection of bevacizumab. A 32-year-old Japanese woman consulted at our clinic for blurred vision in her left eye for five days. Her best-corrected decimal visual acuity (BCVA) was 1.5 (S-1.0) OS. The fundus examination revealed subretinal hemorrhage associated with MGS in the temporal margin of the optic disc. As she was pregnant, we planned to continue follow-up without further invasive testing and treatment; however, her visit to the hospital was interrupted. Ten months later, she returned with complaints of poor vision and central scotoma in her left eye for six months. The BCVA was 0.5 (S-1.0/C-1.0/45°) OS. The fundus examination showed that subretinal hemorrhage increased, and the subretinal fluid extended below the fovea. Multimodal imaging revealed type 2 CNV on the temporal and nasal disc margins. After she received an intravitreal injection of bevacizumab (1.25 mg), rapid absorption of subretinal fluid and regression of CNV were observed. The BCVA improved to 1.5 (S-0.5/C-0.75/35°) OS. No recurrence of CNV was observed for 26 months after the injection. During the follow-up of MGS cases, we should pay attention, not only to retinal detachment, but also to the occurrence of CNV around the disc margins.
Archives of Clinical and Medical Case Reports, Volume 4, pp 1038-1043; doi:10.26502/acmcr.96550295
Malaria is a potentially life-threatening disease that is transmitted by the bite of an infected Anopheles mosquito. Five known species of genus Plasmodium infect humans: Plasmodium vivax, Plasmodium ovale, Plasmodium Knowlesi, Plasmodium Malariae and Plasmodium falciparum. Malaria infection during pregnancy is a significant public health problem with substantial risks for the pregnant woman, her fetus and the newborn child.. The symptoms and complications vary according to malaria transmission intensity in the given area and the individual’s level of acquired immunity. Presented below is a case of a 26-years old primigravida, who returned to the UK from Nigeria after one week presenting with a 24 hour history of abdominal pain, nausea, vomiting and signs of sepsis. During her hospitalization, despite being treated for sepsis, the patient’s overall condition did not improve, therefore suspicion for malaria became very questionable. In consideration of the patient’s history and clinical presentation; a thorough investigation was to take in effect for this possible infection. Once diagnosis of malaria was confirmed, the appropriate treatment was administered.
Archives of Clinical and Medical Case Reports, Volume 4, pp 1014-1020; doi:10.26502/acmcr.96550291
Purpose: To determine the prevalence of ocular and visual anomalies in students with Autism Spectrum Disorder (ASD). Methods: This case-series in 2015-16 included students with ASD of two special schools of Bangalore, India. Comprehensive ocular and vision examination also included accommodation by dynamic retinoscopy and convergence. The amplitude of accommodation was calculated by Hofstetter minimum formula. The accommodative facility was measured by referring to the cycles of accommodative flippers, used ± 2.50D and 14 cycles/min considered as normal. Saccades were tested using Marsden ball movements. Additional eye testing at our institute was with Vision therapy system, ocular motility testing and alternate prism cover test. Result: The 120 students with ASD had a mean age of 12.9 ± 1.7 years. They included autism 58 (48.3%), ASD 27 (22.5%) and other 34 (28.3%). Spectacles correction was needed in 62 (51.7%) students. Refractive error included myopia (57; 92%), hyperopia (5; 8%), myopic astigmatism (3; 4.8%), and mixed astigmatism (2; 3.2%). The compliance of spectacle wear was 12/62 (19.4%) only. Strabismus was seen in 68 (56.7%) students. Accommodative convergence was 4 to 28 mm. Non-accommodative convergence was 4 to 37 mm. Pursuit movements were poor in 35 (29.2%), average in 39 (32.5%), good in 46 (38.3%) students. The saccadic eye movements were good in 100 (83.3%), average in 15 (12.5%) and poor in 5 (4.2%) students. Conclusion: More than half of students with ASD had at least one ocular morbidity. The commonest was refractive errors followed by strabismus. Periodic and comprehensive ocular assessment of autistic students is recommended.
Archives of Clinical and Medical Case Reports, Volume 4, pp 1052-1066; doi:10.26502/acmcr.96550297
The phosphatidylinositol 3-kinase catalytic subunit (PI3KCA) is an oncogene involved in the control of cellular proliferation. Some somatic mosaic heterozygous mutations of PI3KCA are associated with overgrowth malformations in skin, vasculature, bones, fat or brain tissues, gathered under the common term of “PI3KCA-related overgrowth spectrum” (PROS) syndromes. Since PROS patients may be exposed to ionizing radiation through anti-tumor radiotherapy and radiodiagnosis, the evaluation of the radiation-induced risk potentially linked to PROS syndrome is needed. However, no radiobiological characterization of this syndrome was available yet. Primary fibroblast and osteoblast cell lines derived from a PROS patient were exposed to radiation in realistic conditions. The PROS patient cells appeared to be associated with a moderate but significant radiosensitivity, a delayed radiation-induced nucleoshuttling of the ATM kinase, and an impairment of DNA double-strand breaks repair and signaling. Such phenotype may be partially corrected by using bisphosphonates combined with statins, which renders cells more radioresistant. Our data suggest that the PI3KCA protein may contribute to the individual Archives of Clinical and Medical Case Reports 1053 radiation response, as an ATM substrate. Furthermore, our findings suggest that exposure to radiation of PROS patients should be therefore justified carefully.