OpenMed/multicare-articles huggingface dataset:
Recurrent Acute Disseminated Encephalomyelitis (ADEM) after COVID-19-vaccination and after subsequent COVID-19-infection: A case report (part II)
Authors: Khouloud Poli, Markus Kowarik, Klaus Hamprecht, Thomas Iftner, Ulrike Ernemann, Ulf Ziemann, Sven Poli
Journal: Front Neurol (2023)
Keywords: adem, covid-19, csf, sars-cov-2 antigen-specific igg, biomarkers, recurrent
MeSH terms: Case Reports

Acute disseminated encephalomyelitis (ADEM) is an autoimmune disorder of the central nervous system (CNS), which is commonly associated to previous viral infection or immunization. Cases of ADEM with a potential relationship to both severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and vaccination have been reported. We recently published a rare case of a 65-year-old patient who suffered from a corticosteroid- and immunoglobulin-refractory multiple autoimmune syndrome including ADEM following Pfizer-BioNTech coronavirus disease (COVID)-19 vaccination, and whose symptoms largely resolved after repeated plasma exchange (PE). Four months later, the patient was diagnosed with SARS-CoV-2 omicron variant infection after experiencing mild upper respiratory tract symptoms. Few days later, the patient developed severe tetraparesis with magnetic resonance imaging (MRI) showing multiple new inflammatory contrast-enhancing lesions in the left middle cerebellar peduncle, cervical spinal cord, and ventral conus medullaris. Repeated cerebrospinal fluid (CSF) analyses indicated blood-brain barrier damage (increased albumin ratio) without signs of SARS-CoV-2 invasion (mild pleocytosis, no intrathecal antibody production). SARS-CoV-2 specific immunoglobulin G (IgG) were detected in serum and to a much lower degree in CSF with close correlation between both concentrations over time, reflecting antibody dynamics of vaccine- and infection-induced immune response, and blood-brain barrier patency. Daily PE therapy was initiated. Given the patient's lack of improvement after seven PE, treatment with rituximab was considered. After a first dose, however, the patient suffered epididymo-orchitis leading to sepsis, and declined rituximab continuation. At 3-months follow-up, clinical symptoms had dramatically improved. The patient regained walking ability without assistance. This case of recurrent ADEM after COVID-19-vaccination and after subsequent COVID-19-infection strongly supports the hypotheses of neuroimmunological complications in these conditions being promoted by a systemic immune response and mediated by molecular mimicry of, both, viral and vaccine SARS-CoV-2 antigens and CNS self-antigens.
The geopolitics of the European super league: A historiographical approach and a media analysis of the failed project in 2021
Authors: Xavier Ginesta, Carles Viñas
Journal: Front Sports Act Living (2023)
Keywords: european super league, competitive balance, football (soccer), geopolitics, sports industry

Introduction:
The main objective of this article is to analyse the reasons why the 2021 European Super League project failed. The authors ask whether, in addition to the popular clamour against a semi-closed competition, it was the combination of geopolitical interests of the different actors currently involved in European elite football that prevented the project from going ahead.
Methods:
The main methodological framework is based on a case study, which follows an Stakian approach. To do so, on the one hand, a historiographical analysis of the case has been done; on the other hand, authors have complemented this case study with an analysis of 23 pieces of news published on the website of five mainstream newspapers (from April to June 2021) from those countries with the most significant European football leagues: The United Kingdom (The Guardian), Spain (El País), France (Le Monde), Italy (La Repubblica) and Germany (Der Spiegel). To supplement the analysis of this phenomenon, authors have also considered other relevant news published in other mainstream press or news agencies (such as The New York Times, Politico, The Yorkshire Post, The Times, Marca, Bloomberg and Reuters).
Results and discussion:
The authors conclude that, while financially the Super League debate has not been closed, in defending the current business and competition model of European football, UEFA has had the complicity of owners and shareholders of the founding clubs outside of their traditional historical roots, as well as governments that have made football an asset because of their geopolitical positioning, such as Qatar and the UK post-Brexit.
Successful Treatment of a Patient with COVID-19-Induced Severe ARDS, Pneumothorax, and Pneumomediastinum with Awake vv-ECMO Implantation
Authors: Julian Umlauf, Stefanie Eilenberger, Oliver Spring
Journal: Case Rep Crit Care (2022)
MeSH terms: Case Reports

Management of acute respiratory distress syndrome (ARDS) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is still a challenge for the staff on intensive-care units (ICU's) around the world. Many of these patients are treated with invasive ventilation. Sometimes, the occurrence of pneumothorax and/or pneumomediastinum can complicate the course of the disease because initiation of invasive ventilation might be fatal in those patients. Venovenous extracorporal membrane oxygenation (vv-ECMO) is increasingly used to prevent patients with severe ARDS from hypoxia. However, clear recommendations for or against the initiation of vv-ECMO in awake patients are currently lacking. We present the case of a 42-year-old patient with COVID-19-associated severe ARDS, pneumothorax, and pneumomediastinum. To preserve sufficient oxygenation and to avoid invasive ventilation, we implanted a vv-ECMO while the patient was awake. The patient recovered and was discharged home 41 days after transfer to our hospital. We therefore suggest that awake implantation of vv-ECMO might be useful in a subgroup of patients with severe ARDS caused by SARS-CoV-2. However, further evidence is needed to verify our hypothesis.
Sciatica leading to the discovery of a renal cell carcinoma
Authors: Mohamed Amine Lakmichi, Redouane Jarir, Jamal Kabour, Zakaria Dahami, Mohamed Said Moudouni, Ismail Sarf
Journal: Pan Afr Med J (2011)
Keywords: renal carcinoma, cytoreductive nephrectomy, kidney cancer, metastatic renal cell cancer
MeSH terms: Carcinoma, Renal Cell / secondary, Kidney Neoplasms / diagnosis, Sciatica / etiology, Spinal Neoplasms / secondary, Thoracic Vertebrae / diagnostic imaging, Thoracic Vertebrae / pathology, Case Reports, Review, Cachexia / etiology, Carcinoma, Renal Cell / complications, Carcinoma, Renal Cell / diagnosis, Carcinoma, Renal Cell / radiotherapy, Carcinoma, Renal Cell / surgery, Combined Modality Therapy, Fatal Outcome, Humans, Kidney Neoplasms / complications, Kidney Neoplasms / radiotherapy, Kidney Neoplasms / surgery, Male, Middle Aged, Neoplasm Invasiveness, Nephrectomy, Osteolysis / diagnostic imaging, Osteolysis / etiology, Palliative Care, Paresthesia / etiology, Spinal Canal / pathology, Spinal Neoplasms / diagnostic imaging, Spinal Neoplasms / radiotherapy, Tomography, X-Ray Computed

Metastatic renal cell cancer is not exceptional in kidney cancer (30% of patients with kidneyl cancer). Its prognosis is particularly severe. However, sciatic neuralgia (sciatica) remains an exceptional revealing clinical sign of this disease. The authors report the case of a patient admitted with right sciatica as chief complain, leading to the discovery of a renal cell carcinoma. Although uncommon, renal cell carcinoma spine metastasis should be included in the differential diagnosis of back pain and sciatica.
Corneal Opacity Induced by Antiglaucoma Agents Other Than Brimonidine Tartrate
Authors: Yuka Kasuya, Ichiya Sano, Shinji Makino, Hidetoshi Kawashima
Journal: Case Rep Ophthalmol Med (2020)
MeSH terms: Case Reports

The aim of this study is to report a patient with corneal opacity that developed after the use of topical antiglaucoma medications other than brimonidine tartrate (BT). An 85-year-old woman presented with corneal opacity and neovascularization in both eyes. A diagnosis of glaucoma was made 20 years previously, and antiglaucoma agents were prescribed (latanoprost, tafluprost, timolol maleate, travoprost, bimatoprost, ripasudil hydrochloride hydrate, and brinzolamide/timolol maleate) for both eyes. Ocular examination revealed semicircular fan-shaped corneal sterile infiltration with neovascularization. Anterior-segment optical coherence tomography (OCT) showed marked corneal opacity and thickened corneal stroma. The topical drugs were discontinued and replaced with 0.1% betamethasone eye drops. Two weeks after topical drugs were discontinued and replaced with betamethasone, the corneal sterile infiltration markedly improved, although the corneal opacity remained across the stromal layer. In addition, corneal opacity, intermixed with separate transparent sections, was observed as a striped shape. OCT showed an improvement of the thickened corneal stroma. Six weeks after the initial visit, the remaining corneal opacity could be seen as a mixture of opaque and nonopaque areas in stripes. The corneal stromal thickness decreased almost back to the normal range, while the area of the corneal opacity remained unchanged. In vivo laser confocal microscopy showed hyperreflective materials with needle-like structures in the corneal stroma. The corneal opacity showed several similarities to the previous reports of the cases treated with BT. Therefore, clinicians should be mindful of a possible development of corneal opacity in patients treated with antiglaucoma medications other than BT.
A Case of Spontaneous Spinal Subdural Hematoma Complicated by Cranial Subarachnoid Hemorrhage and Spinal Adhesive Arachnoiditis
Authors: Taihei Go, Toshiyuki Tsutsui, Yasuaki Iida, Katsunori Fukutake, Ryoichi Fukano, Kosei Ishigaki, Kazuaki Tsuchiya, Hiroshi Takahashi
Journal: Case Rep Orthop (2019)
MeSH terms: Case Reports

A 76-year-old woman with a spinal subdural hematoma (SDH) was presented with severe back pain without headache. Magnetic resonance imaging (MRI) performed 4 days after onset showed SDH extending from Th2 to L3. She was diagnosed with spontaneous SDH without neurological manifestation, and conservative treatment was selected. Transient disturbance of orientation appeared 7 days after onset. Small subarachnoid hemorrhage (SAH) was detected on head CT, and strict antihypertensive therapy was started. Symptoms changed for the better. Back pain disappeared 4 weeks after onset. On follow-up MRI at 6 months after onset, the SDH had been resolved spontaneously. Although adhesive arachnoiditis was observed at Th4-6, the recurrence of clinical symptoms was not observed at one year and a half after onset. Spinal subdural space is almost avascular; a hematoma in a subdural space is considered to come from a subarachnoid space when it is a lot. A hemorrhage in subarachnoid space was flushed by cerebral spinal fluid; hematoma or arachnoiditis was not formed in general. In our case, hemorrhage was a lot and expansion of SDH was large enough to cause cranial SAH and arachnoiditis. But longitudinally expanded SDH did not show neurological manifestation and resolved spontaneously in our case.
Paraneoplastic syndromes revealing ovarian teratoma in young and menopausal women: report of two cases
Authors: Majdouline Boujoual, Ihsan Hakimi, Farid Kassidi, Youssef Akhoudad, Nawal Sahel, Adil Rkiouak, Mohamed Allaoui, Hafsa Chahdi, Mohamed Oukabli, Jaouad Kouach, Driss Rahali Moussaoui, Mohamed Dehayni
Journal: Pan Afr Med J (2016)
Keywords: paraneoplastic syndrome, diagnosis, management, ovarian teratoma
MeSH terms: Ovarian Neoplasms / diagnosis, Paraneoplastic Syndromes / diagnosis, Teratoma / diagnosis, Case Reports, Adult, Female, Humans, Immunotherapy / methods, Menopause, Middle Aged, Ovarian Neoplasms / pathology, Ovarian Neoplasms / therapy, Paraneoplastic Syndromes / pathology, Paraneoplastic Syndromes / therapy, Prognosis, Teratoma / pathology, Teratoma / therapy, Teratoma, Ovarian

Paraneoplastic syndromes are a heterogeneous group of clinical and biological manifestations caused by underling neoplasms. They can reveal ovarian teratoma which express neuroendocrine proteins, or contain mature or immature neural tissue inducing an autoimmune response. The etiological investigation is then crucial to early identification of the tumor in order to optimize the prognosis and to limit neurological sequelae. In case of ovarian teratoma, management is essentially based on surgical resection sometimes associated with immunotherapie. We report two new cases of ovarian teratoma revealed by paraneoplastic syndromes in young and menopausal woman.
Case Report: Coexistent Wolff-Parkinson-White Syndrome and Brugada Phenocopy in a Patient With Pneumonia and Myocarditis
Authors: Li Wang, Yana Zhao, Lan Ma
Journal: Front Cardiovasc Med (2021)
Keywords: brugada phenocopy, wolff-parkinson-white syndrome, case report, electrocardiogram (ecg), fever
MeSH terms: Case Reports

Background: In recent years, Wolff-Parkinson-White (WPW) syndrome and Brugada electrocardiogram (ECG) patterns have been reported as coexistent in the same patient. In most cases, the two waveforms appeared separately. Here, we described combinations of different waveforms on one ECG, such as the Brugada pattern with delta waves and the Brugada pattern with paroxysmal supraventricular tachycardia (PSVT). Importantly, we recorded an alternate conversion of these combined ECG waveforms, which has not previously been reported in the literature. At the same time, we confirmed that the change in the waveform was related to fever by analyzing Holter data. Case: A 48-year-old male was admitted to our hospital due to palpitations and fever. The patient had a history of a cold 3 days ago. Laboratory examinations showed an elevated neutrophil percentage (85%) and troponin I level (0.86 ng/ml). A chest computed tomography (CT) scan showed inflammation in the right lung. The diagnosis of pneumonia and myocarditis was made. ECG indicated WPW syndrome and the Brugada pattern. We recorded the dynamic changes in this combination of delta waves and Brugada waves with a Holter monitor, and we found the changes would happen when the patient's body temperature rose. The doctors thought that the patient's pulmonary infection led to fever, which caused the changes in waveform. After treatment with antibacterial therapy and supportive care, his body temperature returned to normal. The various laboratory indicators also gradually returned to normal. The doctor recommended that the patient undergo further pre-excitation bypass radiofrequency ablation treatment, but the patient refused and was discharged. Conclusion: Delta waves and Brugada ECG patterns could appear on one ECG at the same time. There were dynamic changes of QRS complex, relating to fever.
Intensive Outpatient Treatment of Depression in a Spinocerebellar Ataxia Type 1 Patient
Authors: Eric Black
Journal: Case Rep Psychiatry (2019)
MeSH terms: Case Reports

Objective:
Spinocerebellar ataxia type 1 (SCA1) is but one subtype of spinocerebellar ataxia (SCA), each of which can possibly be considered a separate neurological condition (N. Whaley, S. Fujioka, Z. K. Wszolek, 2011). SCA is hereditary, progressive, and degenerative. SCA1 symptoms initially include coordination problems and ataxia. SCA1 can also include speech and swallowing difficulties, spasticity, ophthalmoplegia, cognitive difficulties, and even sensory neuropathy, dystonia, atrophy, and fasciculations. Literature has established that depressive symptoms can be exhibited with spinocerebellar ataxia patients regardless of type (T. Schmitz-Hübsch, 2011). While a higher risk for depression occurs with more severe SCA disease, successful treatment to mitigate symptoms has been documented (N. Okamoto, M. Ogawa, Y. Murata, et al., 2010). In this case a SCA1 patient with advanced neurological disease was enrolled in a psychiatric intensive outpatient (IOP) treatment program in the midwestern United States to address his comorbid depressive symptoms. This treatment option allowed a less restrictive environment while providing a more structured therapeutic setting and social support for the patient, much more so than that which is typically offered in a traditional outpatient setting.
Case report:
A patient with relatively advanced SCA1 successfully participated in a psychiatric IOP program or depressive symptoms and benefitted from the program's structure and additional psychosocial support.
Conclusion:
Awareness among physicians, particularly psychiatrists and neurologists, regarding IOP programs as a treatment option for comorbid depression in the clinical setting of progressive SCA or other neurological conditions can be beneficial to patients requiring an increased level of psychiatric treatment.
Intrathoracic caecal perforation presenting as dyspnea
Authors: Vincent Granier, Emmanuel Coche, Philippe Hantson, Maximilien Thoma
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Introduction. Bochdalek hernia is a congenital defect of the diaphragm that is usually diagnosed in the neonatal period and incidentally in asymptomatic adults. Small bowel incarceration in a right-sided Bochdalek hernia is exceptional for an adult. Case Presentation. A 54-year-old woman was admitted for acute dyspnea, tachycardia, hypotension, and fever. Five days before, she had been experiencing an episode of diffuse abdominal pain. The admission chest X-ray was interpreted as right pleural effusion and pneumothorax with left mediastinal shift. Chest tube drainage was purulent. The thoracoabdominal CT examination suspected an intestinal incarceration through a right diaphragmatic defect. At laparotomy, a right-sided Bochdalek hernia was confirmed with a complete necrosis of the incarcerated caecum. Ileocaecal resection was performed, but the patient died from delayed septic complications. Conclusion. Intrathoracic perforation of the caecum is a rare occurrence; delayed diagnosis due to misleading initial symptoms may lead to severe complications and poor prognosis.
Incidental Morgagni hernia found during laparoscopic repair of hiatal hernia: Case report & review of literature
Authors: Ali Hassan, Marwah Alabdrabalmeer, Mohammad Alealiwi, Omran Al Danan, Saeed Alshomimi
Journal: Int J Surg Case Rep (2019)
Keywords: hiatal hernia, incidental, laparoscopic, morgagni hernia

Introduction:
Morgagni hernia is rare clinical entity accounting for 3% of all surgically treated diaphragmatic hernias. Similarly, paraesophageal hernia constitutes only 5% of all hiatal hernia. The co-existing of these two hernias is extremely rare with only 10 cases reported in the literature.
Presentation of case:
We present a case of 53-year-old female patient with 6-year history of reflux disease. Her symptoms were poorly controlled by medications and she was seeking a surgical treatment. Preoperative assessment revealed a giant paraesophageal hernia for which a laparoscopic repair was planned. During the surgery, left-sided Morgagni hernia was discovered and both hernias were repaired at the same time. The patient tolerated the procedure well without complications.
Conclusion:
The co-existence of Morgagni and Hiatal hernia is rare and the simultaneously laparoscopic repair of both hernias is safe and feasible.
Amyand's Hernia in a Neonate Presenting with Inguinoscrotal Erythema: A Difficult Diagnosis
Authors: Ahmed Mohamed, Anas Fagelnor
Journal: European J Pediatr Surg Rep (2019)
Keywords: amyand's, appendicitis, inguinal hernia, neonate
MeSH terms: Case Reports

The presence of the vermiform appendix, whether inflamed or not, inside a hernial sac is known as Amyand's hernia. Due to nonspecific signs, preoperative diagnosis is not common and requires a high index of suspicion along with awareness of this rare entity. It is more commonly mistaken for a strangulated or incarcerated inguinal hernia. Most cases of reported Amyand's hernia with appendicitis were in pre-term babies, infants, and post-menopausal women. We present a similar case in a 19-day-old, full-term baby presenting with inguinoscrotal edema, erythema, and without a palpable inguinoscrotal mass.
Multimodal imaging in a case of bilateral astrocytic hamartoma with retinitis pigmentosa
Authors: Sugandha Goel, Debmalya Das, Kumar Saurabh, Rupak Roy
Journal: GMS Ophthalmol Cases (2023)
Keywords: astrocytic hamartoma, multicolor imaging, retinitis pigmentosa
MeSH terms: Case Reports

Astrocytic hamartoma is a benign glial tumor. It may be associated with tuberous sclerosis and can also be found incidentally on retinal examination as an isolated presentation. Here, we describe multimodal imaging characteristics of astrocytic hamartoma in a patient with retinitis pigmentosa. Spectral domain optical coherence tomography of both eyes showed moth-eaten optically empty spaces and hyperreflective dots along with foveal thinning. Multicolor image highlighted mulberry appearance of the lesion with green shift signifying elevated lesion. In infrared reflectance, lesion was hyporeflective with its margins well delineated. Green reflectance and blue reflectance highlighted calcification as multiple hyperreflective dots. Autofluorescence showed typical hyperautofluorescence.
Reattachment of fractured tooth fragment with fiber post: a case series with 1-year followup
Authors: C M Sapna, R Priya, N B Sreedevi, Rakesh R Rajan, Renjith Kumar
Journal: Case Rep Dent (2014)

Coronal fractures of the anterior teeth are common sequelae of dental trauma. In case of complex fractures, where the fractured segment is available and there is close approximation of the segment to the remaining tooth, root canal treatment followed by reattachment of the fractured segment with fiber post reinforcement is a feasible option. The procedure is simple and economic and needs less chair-side time as compared to many conventional methods. In addition, the procedure provides good and long-lasting esthetics, because the original morphology, color, and surface texture are maintained. This paper reports three cases of complex coronal tooth fracture successfully managed using tooth fragment reattachment.
Vertical parasagittal hemispherotomy for Sturge-Weber syndrome in early infancy: case report and literature review
Authors: Xiangyu Liu, Taisuke Otsuki, Akio Takahashi, Takanobu Kaido
Journal: Springerplus (2016)
Keywords: epilepsy surgery, seizure, sturge–weber syndrome, vertical parasagittal hemispherotomy

Introduction:
The authors here present a rare case of a 3-month-old infant with unilateral Sturge-Weber syndrome (SWS) who had excellent seizure control and no aggravation of previous existed neurological deficits after vertical parasagittal hemispherotomy (VPH). To our knowledge, this patient with SWS was the youngest one who received VPH.
Case description:
The use of VPH results in a successful treatment of intractable epilepsy in a patient with seizure onset in early infancy. At follow-up, the patient's neurodevelopmental status has been improved since the surgery.
Discussion:
It is generally accepted that early-onset seizures in children with SWS are associated with worse neurological and developmental outcomes. However, when surgical treatment should be considered and how it should be performed remain a longstanding controversy. We promote early surgery in children with SWS and early-onset epilepsy.
Conclusion:
We suggest that VPH may be a useful adjuvant in the management of SWS with refractory epilepsy in early infancy and this procedure carries low neurological risk.