UCC Journals (Univ. College Cork)
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Between Traditions: Religious Identity and Self-Identification in the Case of Simeon of Polotsk
No full textThis article re-examines the confessional identity of Simeon of Polotsk (1629–1680), a key Belarusian intellectual and the first professional poet and playwright in Moscow. Building on textual, contextual and intellectual-historical analysis, the study reassesses Simeon’s religious affiliation by examining his sermons, catechisms, didactic poetry and the confessional character of his library. By situating Simeon within the contested religious landscape of the Polish–Lithuanian Commonwealth and seventeenth-century Muscovy, the article challenges established interpretations that present him as strictly Orthodox or covertly Uniate. Instead, it argues that Simeon’s identity emerged at the intersection of Catholic, Orthodox and Uniate traditions, shaped by the ideological, political and cultural pressures of his time. Through a multi-method approach, the study offers a more historically grounded understanding of confessional hybridity in early modern Eastern Europe
A rare case of paediatric meningioma
No full textBackground: Meningiomas are arachnoid cell-originating tumours which rarely present in the paediatric population. Characteristic symptoms include focal or generalised seizures, although many patients are asymptomatic. These tumours are commonly seen in patients suffering from neurofibromatosis type 2, and almost half of patients presenting with meningiomas have allele losses in the DAL-1 and NF2 genes.
Case description: A 3-year-old female patient presented with a bony protuberance on the apex of her cranium. As part of her investigations, computed tomography imaging was performed, which showed a large intracranial calcified mass arising from the falx cerebri in the interhemispheric fissure, invading the overlying bone. As part of her treatment, a complete resection of the tumour was done, along with the surrounding dura mater and the overlying bone in June of 2023. During the postoperative recovery period, the patient developed an infection in the dural graft and cranioplasty with a cerebrospinal fluid leak. This was managed by the patient undergoing a staged cranial reconstruction 10 months after her original operation, with hopes of discharging her on the first anniversary of her original resection surgery.
Conclusions: We present an atypical case of paediatric meningioma originating from the falx cerebri and a review of literature which explores the occurrence of meningiomas in the paediatric population, its aetiology, presentation and management. The final objective of the surgery should be tumour resection using the Simpson Grade and management using systemic approaches such as mTOR inhibitors or antiangiogenic treatments have also shown promising results.
Keywords: Meningioma, paediatric brain tumour, paediatric meningioma, complete resection, staged cranial reconstructio
When STEMI isn’t STEMI: a case of severe aortic stenosis masquerading as Acute Coronary Syndrome
No full textBackground: Aortic stenosis (AS) is a progressive valvular heart disease that, in severe cases, can present with angina, syncope, and heart failure. Severe aortic stenosis can mimic acute coronary syndromes but rarely presents with ST-elevation myocardial infarction (STEMI)-like features, which presents a diagnostic challenge. This case emphasizes the importance of considering valvular pathology in patients with ischemic ECG changes and non-obstructive coronary arteries.
Case Presentation: We describe a 69-year-old female who presented to the emergency department (ED) with acute chest pain, progressive dyspnea, and transient loss of consciousness episodes. Her medical history included Type II diabetes mellitus, hypertension, hypercholesterolemia, and a history of smoking. Initial electrocardiography (ECG) revealed ST-elevation in leads V2-V5, prompting concern for anterior STEMI. However, a coronary angiogram showed non-obstructive coronary disease, and bedside transthoracic echocardiography confirmed the presence of severe AS.
Investigations & Diagnosis: The patient’s physical examination findings included an S4 gallop, a grade III-IV harsh systolic ejection murmur radiating to the base, and bibasilar crackles. Laboratory investigations revealed an elevated N-terminal pro-brain natriuretic peptide (NT-proBNP) level of 290 pg/mL, with otherwise normal blood counts and urinalysis. Echocardiographic Doppler imaging demonstrated heavily calcified aortic valve leaflets, ventricular hypertrophy, increased left atrial volume, and elevated right-sided pressures consistent with critical AS.
Management & Outcomes: The patient was initially managed for a STEMI with dual antiplatelet therapy before echocardiographic findings led to a shift in diagnosis and management thereafter. Once severe AS was identified, an intra-aortic balloon pump was inserted, which resulted in rapid disease improvement. She subsequently underwent aortic valve replacement (AVR), and was symptom-free at 8 weeks. DISCUSSION &
Conclusion: This case underscores the importance of considering AS as a differential diagnosis in patients presenting with STEMI-like ECG findings, particularly in those without significant coronary artery disease. Echocardiography is pivotal in distinguishing AS from myocardial infarction, preventing unnecessary thrombolysis or percutaneous interventions. The definitive treatment for severe AS remains AVR, either via surgical or transcatheter approaches. Clinicians should maintain a high index of suspicion for valvular heart disease in atypical STEMI presentations to ensure timely and appropriate intervention
The Folklore Society’s Annual Conference 2025: “Folklore and the Senses”
No full textEvent: The Folklore Society’s Annual Conference: “Folklore and the Senses”Venue: University College Cork Date: 20th to 22nd Jun
Review: Revisiting Minjung, New Perspectives on the Cultural History of 1980s South Korea, edited by Sunyoung Park
No full textLuke O\u27Brien reviews Revisiting Minjung: New Perspectives on the Cultural History of 1980s South Korea, edited by Sunyoung Park. University of Michigan Press, 2019. 311 pp. $34.95 (ISBN 9780472074129 (Paperback) | doi: https://doi.org/10.3998/mpub.10027900)
Lithium-induced cardiotoxicity mimicking Acute Coronary Syndrome: a case report
No full textIntroduction: Lithium toxicity, a complication of chronic lithium therapy used in the treatment of bipolar disorder (BPD), commonly presents with gastrointestinal and neurological symptoms. However, rare cardiac manifestations of lithium cardiotoxicity can occur. This case describes a 51-year-old woman with BPD on long-term lithium therapy who developed neurological symptoms (confusion, resting tremor, dysarthria). Investigations were notable for elevated troponin levels and transthoracic echocardiogram revealed a novel reduced left ventricular ejection fraction. Coronary artery disease and other potential causes were ruled out, and lithium-induced cardiotoxicity was determined to be the etiology of the patient’s presentation.
Methods: A thorough clinical evaluation was conducted, including history, physical examination, and diagnostic testing. Investigations included an electrocardiogram (ECG), transthoracic echocardiogram (TTE), coronary angiography, chest X-ray, neuroimaging (CT and MRI brain), and blood tests (troponins, lithium levels, thyroid panel). The patient declined a CT angiogram of the head, leading to an alternative MRI assessment.
Results: The patient presented to the emergency department with confusion, bilateral resting tremors, gait instability, and dysarthria. Non-contrast CT and MRI of the head ruled out hemorrhagic and ischemic stroke, respectively. Chest X-ray confirmed mild pulmonary congestion. ECG showed bradycardia with 1st-degree atrioventricular block and TTE revealed global systolic dysfunction with a reduced ejection fraction 35-40%. Laboratory findings indicated elevated high sensitivity troponin I of 105 ng/L. Coronary angiography showed no evidence of significant coronary artery disease. Lithium levels were elevated at 3.3mmol/L on admission. The patient remained conscious and interactive, with no indications for emergent hemodialysis. This resulted in the diagnosis of acute-on-chronic lithium neuro- and cardiotoxicity. Cardiac function improved with standard lithium toxicity management, including lithium cessation, IV hydration, and monitoring.
Conclusion: This case describes lithium-induced cardiotoxicity, a rare yet critical differential diagnosis in patients with suspected coronary artery syndrome in the context of lithium treatment. Unlike ischemic cardiac disease, it presents with global rather than regional myocardial dysfunction. Early recognition and lithium cessation are essential for management
Ramsay Hunt Syndrome misdiagnosed as Bell’s Palsy: a case report
No full textIntroduction: Ramsay Hunt Syndrome (RHS) is a neurological disorder caused by the reactivation of latent varicella-zoster virus in the facial nerve. It often presents with ipsilateral facial palsy, otalgia, and vesicular eruptions. RHS is often misdiagnosed as Bell’s palsy, which results in delayed treatment and increases the risk of long-term complications. This case highlights a 38-year-old male initially diagnosed with Bell’s palsy whose symptoms persisted despite standard therapy. He later developed ear pain, discharge, vesicles, and gait instability, prompting a revised diagnosis of RHS.
Methods: A comprehensive clinical assessment was conducted, including a detailed patient history, neurological and otologic examination, and laboratory investigations. Diagnostic imaging and serological tests confirmed varicella-zoster virus reactivation. The patient was treated with antiviral therapy (acyclovir), corticosteroids, and symptomatic pain management.
Results: The patient initially presented with progressive facial nerve dysfunction refractory to Bell’s palsy treatment, and subsequently developed vesicular ear lesions and balance disturbances. Examination revealed asymmetric facial weakness, inflamed auricular vesicles, and an unsteady gait. Laboratory results confirmed RHS. Following initiation of antiviral and steroid therapy, symptoms improved, though residual facial weakness persisted.
Conclusion: This case underscores the importance of early diagnosis of RHS in order to prevent long term complications. When diagnosing idiopathic Bell’s palsy, RHS should be considered, particularly when new otologic symptoms emerge. Unlike Bell’s palsy, RHS is associated with a lower rate of full recovery due to greater nerve degeneration. Clinicians should maintain a high index of suspicion for RHS in cases of persistent facial palsy, ensuring timely diagnosis and intervention in order to improve patient outcomes
Melatonin as a reactive treatment for post-operative delirium in patients in the cardiac ICU: a retrospective cohort study
No full textIntroduction: ICU delirium is a significant problem in post-operative cardiothoracic patients, contributing to prolonged ICU and hospital stays and increased mortality. Current pharmacological treatments, such as benzodiazepines and antipsychotics, have notable adverse effects, leading to interest in safer alternatives. A systematic review has shown melatonin’s effectiveness as a prophylactic agent for delirium in surgical and ICU patients. This study aims to assess the use of melatonin as a reactive therapeutic agent in post-operative delirium in cardiac ICU patients.
Methods: This retrospective cohort study analysed data from 127 patients diagnosed with delirium, confirmed through a positive CAM-ICU score. Patients were divided into two groups: one that received melatonin (n=57) as part of their delirium management and another that did not (n=70). The primary outcome was delirium regression, measured by a negative CAM-ICU score during the ICU stay. Secondary outcomes included ICU length of stay, hospital length of stay, and duration of mechanical ventilation. Statistical analyses included the Mann-Whitney U test for continuous variables, the Chi-square test for categorical variables, and binomial regression analysis to determine predictors of delirium regression.
Results: Delirium regression was slightly lower in the non-melatonin group (23/57, 32.9%) compared to the melatonin group (24/70, 42.1%), though this difference was not statistically significant (p=0.356). Binomial regression revealed an odds ratio of 0.845 (95% CI: 0.329-2.172, p=0.727) for melatonin’s effect on delirium regression. Statistically significant predictors of delirium regression included ICU length of stay (1.126, 95% CI: 1.041-1.219, p=0.003) and mechanical ventilation (0.897, 95% CI: 0.833-0.965, p=0.004).
Conclusion: Melatonin showed a loose association with delirium regression but did not demonstrate significant effectiveness as a reactive treatment for post-operative delirium in cardiac ICU patients. Larger studies with more controlled environments are needed to better assess its potential as a treatment for ICU delirium
Management of neonatal abdominal immature teratoma in a resource-limited South African hospital: a case report
No full textIntroduction: Abdominal immature teratomas, rare congenital tumors, primarily originate from the gonads but can also present in extragonadal locations. Typically identified prenatally, these tumors carry a high risk of in-utero complications, often leading to fetal demise. This case report details the successful management of an abdominal immature teratoma in a neonate at a resource-limited hospital in South Africa, highlighting unique treatment adaptations for such complex cases in low-resource settings.
Methods: A 28-day-old neonate with abdominal distention underwent initial imaging, revealing a heterogeneous mass in the left retroperitoneum. Following a multidisciplinary evaluation, the patient was initially managed with chemotherapy based on a differential diagnosis including neuroblastoma. However, a biopsy confirmed an immature teratoma, necessitating a shift in management to surgical resection. The neonate underwent a left nephrectomy and excision of the tumor, followed by postoperative intensive care to address complications from both chemotherapy and surgery.
Results: The patient faced significant challenges, including nosocomial infections, neutropenic sepsis, and respiratory issues requiring prolonged ventilation. Despite these obstacles, the tumor was successfully excised, and postoperative complications were managed with targeted therapies, including antibiotic and antifungal treatments, blood transfusions, and hemodynamic support. The patient’s condition stabilized postoperatively, and she is currently stable.
Conclusion: This case demonstrates the feasibility of managing complex congenital tumors like abdominal immature teratomas in resource-limited settings. Multidisciplinary collaboration and flexible treatment protocols were essential to achieving a positive outcome. The case offers valuable insights into adaptable management strategies that may be applied in similar cases within low-resource environments, expanding the understanding of congenital tumor care in underserved regions