Cemento en el corazón de un hombre.
Un trozo de cemento de 10 centímetros (4 pulgadas) se atascó en el corazón de un hombre de 56 años después de viajar por el torrente sanguíneo después de un procedimiento quirúrgico.
El hombre ingresó en la sala de emergencias después de experimentar dolor en el pecho y dificultad para respirar durante dos días. Una radiografía y una tomografía computarizada confirmaron que había un objeto extraño en su corazón. Durante la cirugía, los médicos encontraron el objeto, que resultó ser un trozo delgado y afilado de cemento que había atravesado la cámara superior derecha del corazón del hombre y había perforado su pulmón derecho.
El cemento procedía de un procedimiento que el hombre se había sometido una semana antes para tratar una vértebra rota. Los médicos le inyectaron un tipo especial de cemento para restaurar su vértebra. Aunque este procedimiento suele ser seguro, en este caso el cemento se filtró del hueso a las venas del paciente. Luego, el cemento se endureció y viajó a través del torrente sanguíneo del hombre hasta su corazón. Se recuperó un mes después de la cirugía para retirar el cemento.
Feto en el cerebro de un niño pequeño
Los médicos extirparon quirúrgicamente un feto que se encontró en el cerebro de una niña de 1 año.
Esta rara afección, llamada fetus in fetu intraventricular, se descubrió después de que el niño desarrolló una cabeza agrandada y un retraso en el desarrollo de sus habilidades motoras. El feto provino del mismo óvulo fertilizado que la niña, por lo que si el feto se hubiera desarrollado normalmente, habría sido su gemela idéntica. Sin embargo, cuando un feto envuelve al otro, el gemelo absorbido normalmente deja de desarrollarse.
El feto en feto es muy raro y ocurre sólo en aproximadamente 1 de cada 500.000 nacimientos. La mayoría de los casos del fenómeno ocurren en el abdomen, más que en la cabeza.
Estudiante capaz de cambiar el tamaño de la pupila
La mayoría de nosotros no podemos saber qué están haciendo nuestras pupilas, ya que normalmente se dilatan automáticamente en la oscuridad para dejar entrar más luz y se contraen en ambientes brillantes para limitar la cantidad de luz que fluye a través de ellas. Sin embargo, un estudiante en Alemania descubrió que podía agrandar y reducir sus alumnos voluntariamente.
El joven de 23 años dijo a los investigadores que contraer las pupilas era como tensar algo, mientras que al agrandarlas se sentía como si estuviera relajando completamente los ojos. Al principio, cambió el tamaño de sus pupilas enfocándose delante o detrás de un objeto y luego, con la práctica, aprendió a hacerlo simplemente concentrándose en sus ojos. Aunque algunas personas pueden lograr este efecto indirectamente, como pensando en el sol, los investigadores no pudieron encontrar ningún indicio de que el estudiante estuviera usando ese método.
La plaga del baile
Uno de los mayores misterios sin resolver de la salud pública es qué causó la "plaga danzante" que duró tres siglos en Europa.
Según se informa, a partir del siglo XIII, la gente de Alemania, los Países Bajos e Italia se reunían en grandes multitudes y bailaban frenéticamente hasta agotarse o morir. En cada reunión participarían hasta 1.100 personas. Hay relatos detallados de estas plagas danzantes en la literatura, pero se desconoce la causa exacta. Es probable que esta plaga del baile, o coreomanía, fuera provocada por una combinación de factores.
Los relatos históricos sugieren que fue un fenómeno psicológico de masas desencadenado por la adversidad social y que se presentó en forma de danza debido a la cultura subyacente de la época.
Insomnio fatal
Un paciente dormía sólo dos o tres horas por noche en un caso de insomnio familiar fatal (FFI). El hombre de 57 años había experimentado un deterioro progresivo de la memoria durante un año antes de ser ingresado en el hospital. Durante el día, a menudo se sentía débil y muchas veces terminaba quedándose dormido cuando estaba sentado o acostado. Su capacidad para usar los palillos empeoró rápidamente y poco después desarrolló problemas para caminar. El hombre murió pocos meses después de ser ingresado en el hospital.
La FFI es un tipo de enfermedad hereditaria de la proteína priónica para la que no existe un tratamiento eficaz. Las enfermedades priónicas ocurren cuando las células producen proteínas disfuncionales que se acumulan en el cerebro y provocan un daño progresivo. Los síntomas de FFI incluyen insomnio, trastornos del movimiento y cambios hormonales. Las pruebas suelen revelar mutaciones en un gen llamado PRNP; una mutación llamada D178N está vinculada tanto a FFI como a una segunda enfermedad priónica.
gusano renal gigante
Un joven acudió a urgencias porque no podía orinar y llevaba dos días con fiebre. Sus signos vitales eran normales excepto por un ritmo cardíaco rápido. El personal del hospital colocó un catéter y le administró al hombre líquidos por vía intravenosa y una combinación de medicamentos. Pero en su segundo día en el hospital, el paciente encontró un gusano en su bolsa de orina.
El departamento de microbiología del hospital confirmó que el gusano, que era rojo y medía casi 30 cm (12 pulgadas) de largo, era el raro parásito Dioctophyma renale . Cuando se analizó su orina, no se encontraron rastros de los huevos del parásito. Aunque los médicos lo desaconsejaron, el hombre abandonó el hospital después de haber contagiado el gusano.
D. renale es uno de los nematodos parásitos más grandes conocidos. Se encuentra principalmente en los riñones de los mamíferos carnívoros, como perros y lobos, que luego excretan sus huevos en la orina. Los humanos podrían infectarse al comer pescado crudo o poco cocido o ranas que contengan larvas. En este caso particular, el paciente había comido pescado crudo de un lago cercano a su casa. No era la primera vez que le pasaban esos gusanos. En casos complicados, el único tratamiento es la extirpación del riñón infectado.
Sobredosis accidental de cafeína tras error de medición
Un error al medir la cafeína en polvo tuvo consecuencias fatales para un hombre en el Reino Unido. El entrenador personal de 29 años pidió una pequeña bolsa de cafeína en polvo para añadirla a sus bebidas. Aunque tenía la intención de agregar hasta 300 miligramos (0,01 onzas) de polvo, la báscula que usó tenía un peso inicial de 2 gramos (0,07 onzas). Inmediatamente después de consumir su bebida, sintió que su corazón latía aceleradamente y comenzó a echar espuma por la boca. Su esposa llamó a una ambulancia, pero el hombre murió ese mismo día.
En ese momento, el forense encontró un nivel de cafeína de 392 miligramos por litro en la sangre de la víctima, el equivalente a entre 100 y 200 tazas de café. El forense dijo que parecía que el hombre apuntaba a la mitad del rango de la dosis de cafeína recomendada, pero se equivocó en sus cálculos.
hipo persistente
Aunque el hipo suele desaparecer por sí solo al poco tiempo, no siempre es así. De hecho, casi 4.000 personas ingresan en el hospital de Estados Unidos cada año por hipo.
Un hombre de 22 años informó haber tenido hipo todo el día durante dos años. Los tratamientos médicos anteriores, que no se describieron en el informe, no ayudaron. Debido a su hipo crónico, dejó su trabajo y su vida social se vino abajo. También empezó a sentir dolor abdominal y tenía anemia.
Finalmente, decidió someterse a una cirugía para tratar su reflujo gastroesofágico, que se pensaba que era la causa del hipo, y tuvo hipo durante todo el procedimiento. Aunque la frecuencia de su hipo disminuyó después de la cirugía, no se curó por completo. Si bien a menudo no es posible identificar una causa única del hipo crónico, algunos casos incluyen enfermedad por reflujo gastroesofágico e insuficiencia suprarrenal.
Niño que comía "de todo menos comida"
En un informe de caso, los médicos describieron cómo una niña de 7 años acudió a su departamento con antecedentes de dolor abdominal durante tres años, dientes desgastados y caries. La niña llevaba cinco años comiendo trozos de ladrillos, a pesar de las advertencias de sus padres.
Es común que los bebés pasen por un período temporal en el que se llevan todo tipo de cosas a la boca. Sin embargo, cuando un niño que pasa esta fase comienza a comer cosas que no son alimentos nuevamente, hay motivos de preocupación. Cuando las personas empiezan a comer artículos no alimentarios como piedras, ladrillos, tiza y jabón, la afección se conoce como pica. Las posibles causas de la pica incluyen deficiencia de hierro y exposición al plomo.
La niña del informe del caso recibió suplementos de hierro, zinc y calcio, y su hábito abandonó después de seis meses.
Convulsiones provocadas por el Sudoku
En un caso desconcertante, un hombre alemán sufrió convulsiones mientras intentaba resolver un rompecabezas de Sudoku.
According to the report of the man's case, he hadn't always reacted this way to Sudoku. During a ski trip in 2008, he was buried in the snow by an avalanche, knocked unconscious and then given CPR. The man survived, but because his brain was deprived of oxygen for 15 minutes, he developed muscle jerks in his mouth and legs. After being given anti-epileptic medication, he started to recover.
But while trying to solve a Sudoku puzzle at a rehabilitation facility, the man started experiencing involuntary jerking motions, called clonic seizures, in his left arm. Doctors later discovered that the seizures were triggered when the man imagined the numbers in Sudoku grids in three dimensions, which reportedly helped him solve the puzzles. Unfortunately, that put an end to the man's hobby, as it was the only way he could avoid the seizures.
Girl born with hair all over her body
Since birth, a 2-year-old girl had hair all over her body, except on her palms, soles, mouth, eyes and nose.
In a report of the case, doctors noted that the girl had no other complications related to the condition, known as congenital generalized hypertrichosis terminalis. The main reason she was brought in for medical attention was that her parents were alarmed by her physical appearance. Doctors assured her parents that the condition was benign and listed some hair-removal options for the child.
Long-lost contact lens found decades later
While playing badminton, a 14-year-old girl was hit in the eye with a shuttlecock. She was wearing a contact lens, which she couldn't find; she assumed it fell out of her eye and was lost. However, she was in for a surprise when she went to the doctor due to swelling in her left upper eyelid 28 years later.
An MRI showed a cyst, which was surgically removed. When it was removed, the cyst burst — and there, lo and behold, was the long-lost contact lens, her doctors explained. It turned out that during the badminton injury, the lens migrated to the woman's left upper eyelid, where it remained hidden for 28 years.
Police officer who recognized everyone
"Where do I know you from?" a police officer kept asking strangers. The 46-year-old had developed intermittent episodes of anxiety each lasting about 15 seconds; six months after these episodes began, he had a seizure. His MRI results and neurological exam were normal. However, a month after the seizure, he reported new symptoms. In addition to memory problems, he experienced an odd phenomenon: Every person he saw looked familiar.
A case report detailed how the officer's "hyperfamiliarity" also occurred to a lesser extent with faces in photos and on TV, but not with voices. Patients with hyperfamiliarity for faces (HFF) quickly realize that they're mistaken. They usually have lesions on the left hemisphere and temporal lobe of the brain, but the right hemisphere and frontal areas of their brains remain normal.
The left hemisphere is involved in identifying unique facial features, while the right is known to link faces with emotional and personal meaning. Thus, HFF may occur when the left hemisphere is impaired and the right hemisphere overcompensates, leading to a false sense of familiarity. The authors of the report suggested that HFF is more common than suspected, since the vast majority of cases likely go unrecognized.
Man living normally with small brain
A 44-year-old man who worked as a civil servant was leading a normal life, despite his brain being at least half the average size.
This case was described in the journal The Lancet after the man sought medical help because he had felt weakness in his left leg for two weeks. When he was 6 months old, doctors had placed a shunt in his head to relieve fluid buildup in his brain. At age 14, he lost full control of his left leg but recovered it after the shunt was altered. His neurological development and the rest of his medical history were otherwise normal.
However, after he sought medical help for the weakness in his leg, brain scans showed several abnormalities. His condition caused a buildup of fluid in his skull, which left him with just a thin sheet of brain tissue, because the fluid left little room for brain tissue. Feeling returned to his leg after a new shunt was inserted to drain the excess fluid.
Teen speaking only in a foreign language
A 17-year-old in the Netherlands lost his ability to speak and understand Dutch for 24 hours after an orthopedic surgery. During this case of foreign language syndrome (FLS), he could communicate only in English, which he'd never spoken outside of a classroom.
According to the case report, it started when the teen went to the hospital for knee surgery following an incident during a soccer game. This was his first time being operated on and undergoing general anesthesia. When he woke up, he was confused and thought he was in the United States, specifically Utah. A psychiatrist confirmed that the teen could answer questions only in English — adequately but not fluently.
When friends came to visit him around 24 hours after the surgery, the boy spontaneously began to understand and speak Dutch again. During a mental exam the next day, the teen said he could remember himself only speaking and understanding English. However, it could be that he thought this because he was told about the incident.
The authors of the case report believe this was the first scientifically reported case of FLS in a child or adolescent. It's unclear what caused the teen to experience FLS, but the authors hypothesized that it might have been linked to the anesthetic he was given.
Severe side effect of holding in a sneeze
A man in his 30s was driving when he felt the urge to sneeze. He stifled his sneezes by pinching his nose and closing his mouth but immediately felt severe neck pain. When he went to the ER, a CT scan of his neck and chest revealed a quarter-inch-long (half a centimeter) tear in his trachea, or windpipe.
Doctors decided against surgery, since the man's vital signs were otherwise normal. Nevertheless, the patient was kept under observation. Five weeks after he was discharged, a follow-up CT scan showed that his trachea had healed.
"We suspect the trachea perforated due to a rapid build-up of pressure in the trachea while sneezing with a pinched nose and closed mouth," the care team wrote in the journal BMJ Case Reports. They advised people not to stifle sneezes in this way.
Double teeth
When a 14-year-old boy went in for a routine dental checkup, dentists found that his left first premolar had two crowns. He had no symptoms related to the tooth and did not want any treatment for it, according to the report of the case.
Tooth gemination, commonly known as "double teeth," is a development disorder of a tooth's shape coming from a single tooth germ's unsuccessful attempt to divide. The exact cause of gemination is unknown, but environmental factors such as trauma or vitamin deficiencies may play a role.
Mermaid syndrome
A report describes the case of a baby with sirenomelia, also known as "mermaid syndrome," a condition in which a baby is born with a single middle lower limb instead of two legs. The baby was born with fused lower limbs and fused feet, which were rotated and aligned abnormally, making them resemble fins. The baby was transferred to a neonatal unit but died after seven hours of life.
Risk factors for mermaid syndrome include maternal diabetes and drug abuse, but the exact cause remains unknown.
Woman who couldn't feel pain
A 58-year-old woman had a long history of insensitivity to pain and recalled how, as a child, she would get cuts that she could not feel. She also did not feel pain when touching extremely hot or cold water, although she could tell the difference between the two, her doctors described in a case report. The woman, who has two children, didn't feel pain during childbirth, either.
She was diagnosed with a condition called congenital insensitivity to pain (CIP), a rare disease caused by mutations in the SCN9A gene. People who have CIP can feel different sensations but can't perceive pain.
Similar to others with CIP, the woman had anosmia, meaning she couldn't smell.
Giant, lung-shaped blood clot
A man was admitted to the intensive care unit when his symptoms of chronic heart failure suddenly worsened. After admission he started coughing up blood and also had trouble breathing. He was given blood-thinning medication, which increased his risk of bleeding, for the serious heart condition. At one point, he started coughing violently — and he hacked up a giant blood clot in the shape of part of his lung. Basically, it was a mold of clotted blood in the shape of a branched airway called a bronchial tree.
The 36-year-old man died a week later due to complications of heart failure. Doctors published the image of the blood clot in a case report in The New England Journal of Medicine.
Navy-blue blood
One night, a 25-year-old woman in Rhode Island applied large amounts of numbing medication to a tooth that was hurting her. The next day, she went to the ER because she felt weak and fatigued, was experiencing shortness of breath and had skin discoloration.
When her blood was drawn, it appeared a deep, navy blue instead of red. According to the case report, the woman had a condition called methemoglobinemia, where there's an increased level of a type of hemoglobin called methemoglobin, which, unlike the regular form of hemoglobin, can't carry oxygen to the rest of the body.
The condition can be either congenital or a side effect of some drugs, including some anesthetics. The woman was quickly treated with intravenous methylene blue, which improved her breathing and reduced her skin discoloration. The medication helped by restoring iron to its proper form within her blood, and in this case, the woman made a complete recovery.
Beer-making belly
A man was arrested for "drunk driving" even though he insisted he hadn't been drinking. After this incident, he went to an Ohio clinic, where doctors found strains of Saccharomyces boulardii and Saccharomyces cerevisiae, known as brewer's yeast, in his stool samples.
It turned out that the man had a condition called auto-brewery syndrome, in which microbes in the gut transform carbohydrates into alcohol, according to a case report in the journal BMJ Open Gastroenterology. This diagnosis also explained why he had episodes of mysterious drunkenness and "brain fog." The man was cured after doctors placed him on antifungal agents and a carbohydrate-free diet for six weeks.
Green "furry" tongue
A man found that his tongue was sprouting green "hairs" after he developed a benign condition known as hairy tongue. Lingua villosa, as it is also called, happens when the tiny bumps on the tongue, called papillae, don't shed as they normally would and thus grow beyond their normal length, which is usually around 0.04 inch (1 millimeter) long. As the bumps grow, they turn a particular color — typically green, brown, white, green or pink — depending on the food, bacteria and other material they encounter.
The condition is fairly common, affecting about 13% of people at some point in their lives. Eating soft foods and drinking large amounts of coffee, tea or alcohol can increase the risk of developing hairy tongue. The 64-year-old in this case followed his doctors' instructions to scrub his tongue daily with a toothbrush, and his tongue turned back to normal in six months, the case report noted.
Teeth in a baby's brain
A 4-month-old boy was taken for medical tests because his head appeared to be growing faster than what was normal for his age. A brain scan confirmed that he had a brain tumor. However, during brain surgery to remove the tumor, doctors found that it contained several fully formed teeth, according to the case report.
It turned out that the child had a craniopharyngioma, a rare type of benign brain tumor. After the surgery, his doctor said the boy was "doing extremely well, all things considered."
Baboon syndrome
Penicillin is one of the most commonly used antibiotics globally, but as with any other drug, it can have side effects. A 40-year-old man with a sore throat was given penicillin to treat tonsillitis. Days later, he developed a rash on his armpits, groin and buttocks in a case of "baboon syndrome," named after its resemblance to the red coloration on the rears of some monkeys.
The condition, formerly called "symmetrical drug-related intertriginous and flexural exanthema," is usually caused by an allergic reaction to penicillin or other substances, such as mercury. According to the man's case report, the rash disappeared after his medication was changed.
Baby's changing eye color
A 6-month-old's eyes turned from brown to a deep indigo blue after he was given the antiviral favipiravir to treat COVID-19.
Favipiravir stops viruses from replicating their genetic material. Less than a day after the antiviral drug was given to the infant, his eyes started shining blue in the sunlight. A medical examination revealed a buildup of blue pigment in both of his corneas — the clear, outer part of the eye. Five days after the antiviral was stopped, the boy's eyes returned to their original brown.
The blue may have been caused by the buildup of fluorescent chemicals in the cornea as the drug was broken down by the body, the case report authors suggested.
Temporary wrinkles
When a man put his hands in water, he developed "excessive wrinkling" on his hands that would disappear around 30 minutes after they dried, according to a case report in the journal JAMA Dermatology.
The condition, called aquagenic syringeal acrokeratoderma (ASA), is a rare skin disease that usually occurs in young women, but in this instance, it affected a man in his 20s. It occurs mostly in people with cystic fibrosis.
The man sought medical help after experiencing the condition for three years, with the skin on his hands becoming swollen, wrinkly and scaly whenever they made contact with water. The man's palms were unaffected, which is unusual, but he was nonetheless diagnosed with ASA. He was treated with an ointment containing a corticosteroid and moisturizer, and his symptoms started improving within a month.
Allergy to water
In an extremely rare case, an 18-month-old was diagnosed with an allergy to water, known medically as aquagenic urticaria. Within just 15 seconds of coming into contact with water, she experienced severe skin reactions, including hives and rashes.
The exact cause of this condition remains unknown. Some theories suggest the hives could be caused by a substance that's dissolved in the water, such as chlorine, rather than the water itself, or that something on patients' skin produces a toxic substance when it touches water.
Folded stomach
Doctors managed to save a girl's life after she developed a rare and potentially life-threatening condition called gastric volvulus, in which part or all of the stomach rotates by more than 180 degrees. When this happened to the 12-year-old girl, she was left in crippling pain, could not breathe properly and couldn't pass stools.
Gastric volvulus can lead to an obstructed stomach, blocking the movement of food, blood and oxygen. According to the report of her case, the girl survived, thanks to the prompt diagnosis and surgical treatment. However, the condition is fatal in about 30% to 50% of cases.
Gastric volvulus is usually caused by a hernia, in which part of the stomach pushes into the chest cavity through an opening in the diaphragm. However, in the girl's case, the stomach folded over itself because the ligaments anchoring her stomach in place were loose.
Tumor in "extra" breast
A 63-year-old woman felt painful swelling in her armpit and sought medical help. Doctors saw that she had a mass of tissue, which an ultrasound revealed was an "extra breast." However, doctors also found a spherical tumor growing in one of the milk ducts in the extra breast. The tumor was benign and was successfully removed, according to the patient's case report.
Este tipo de tumor afecta hasta al 3% de las personas en el tejido mamario normal, pero no se encuentra comúnmente en el tejido mamario adicional. La polimastia, que se refiere a tener tejido mamario adicional, es una afección relativamente común que afecta hasta al 6% de las mujeres y al 3% de los hombres.
Los vasos sanguíneos con fugas del buceador
Los buceadores planifican su ritmo de ascenso para evitar la enfermedad por descompresión (EDC), que puede poner en peligro la vida. La DCS ocurre cuando los gases disueltos en la sangre de una persona forman burbujas en el torrente sanguíneo y los tejidos de una persona. El rápido ascenso de un buceador desde un ambiente de alta presión en las profundidades del mar hasta la presión más baja en la superficie podría desencadenar una DCS. Los síntomas incluyen dolor en las articulaciones, náuseas y dolores de cabeza.
Un buzo tuvo una complicación extremadamente rara de DCS en la que el líquido comenzó a salir de sus células, explicaron los médicos en la revista BMJ Case Reports. El hombre, de unos 40 años, acudió a urgencias con dificultad para respirar después de una inmersión de 30 metros (100 pies). Si bien los médicos podrían haber sospechado DCS, un experto en síndrome de fuga capilar sistémica (SCLS) identificó los síntomas del buzo y ayudó a proporcionar el tratamiento adecuado para la complicación.
Se sospechaba que se formaban burbujas de aire en los vasos sanguíneos del paciente, lo que desencadenaba una "cascada proinflamatoria que hacía que los vasos se volvieran más permeables, lo que provocaba una fuga de proteínas y líquidos", explicó entonces el experto. El SCLS puede ser fatal, pero en este caso el diagnóstico y tratamiento rápidos significaron que el buzo fue dado de alta en menos de una semana.
Síndrome de enclaustramiento
Un informe de caso describe el caso de un hombre de 54 años con síndrome de enclaustramiento (LIS), un trastorno neurológico poco común en el que los pacientes no pueden moverse ni hablar, pero por lo demás pueden pensar con normalidad. Se ha descrito como "ser prisionero de [tu] propio cuerpo".
Históricamente, las personas con LIS han interactuado con otras moviendo los ojos o parpadeando; Hoy en día, sin embargo, hay varios dispositivos de asistencia disponibles y en desarrollo para ayudar a las personas a comunicarse. La principal causa de LIS es el daño a una parte del cerebro llamada puente ventral; el daño suele deberse a un derrame cerebral, pero también puede ser causado por un traumatismo; infección; masas, como tumores; o trastornos desmielinizantes, como la esclerosis múltiple.
Los pacientes pueden vivir durante años con LIS. Sin embargo, este paciente tuvo infecciones recurrentes y murió de neumonía 36 días después de haber sido diagnosticado con la enfermedad.