OpenMed/multicare-articles huggingface dataset:
Laryngeal tuberculosis without pulmonary involvement
Authors: Keyvan Kiakojuri, Mohammad Reza Hasanjani Roushan
Journal: Caspian J Intern Med (2012)
Keywords: hoarseness, primary, tuberculosis, vocal cord
MeSH terms: Case Reports

Background:
Tuberculosis of the larynx is a rare form of tuberculosis. Patients usually present with hoarseness or dysphagia and other nonspecific constitutional symptoms like fever or localized pain. In this study, we present a case of primary vocal cord lesion with tuberculosis.
Case presentation:
A 72 year old man presented with hoarseness of voice, low grade fever, and night sweating with in three month duration. Laryncoscopic study showed unilateral thickening of vocal cord and biopsy of the lesion showed granuloma with caseous necrosis. Chest x-ray was normal. The patient was treated with standard regimen of tuberculosis and was cured after 6 months of therapy.
Conclusion:
Laryngeal tuberculosis should be considered in the differential diagnosis of patients with hoarseness without pulmonary involvement in endemic regions of tuberculosis.
Bowler's Thumb: Case Report and Review of the Literature
Authors: Jordan N Halsey, Paul J Therattil, Stephen L Viviano, Earl J Fleegler, Edward S Lee
Journal: Eplasty (2015)
Keywords: bowler’s neuroma, bowler’s thumb, digital neuroma, nerve wrap, thumb neuroma
MeSH terms: Case Reports

Objective:
Traumatic neuropathy of the ulnar digital nerve of the thumb occurs in patients who undergo chronic frictional irritation of the nerve. The condition is aptly termed bowler's thumb, as it commonly afflicts patients who bowl and keep their thumb in the ball for an extended period of time. It is a pathology that rarely appears in the literature and for which standard treatment is unclear.
Methods:
A 68-year-old man with a history of avid bowling presented with a chief complaint of left thumb numbness and tingling for several months. Physical examination demonstrated a small tender mass along the ulnar surface of the left thumb with a positive Tinel's sign and diminished 2-point discrimination distal to the mass. The patient's symptoms did not improve with conservative measures. Here, we describe his surgical treatment and review the current literature.
Results:
Our patient underwent neurolysis of the ulnar digital nerve of the thumb, with placement of a porcine extracellular matrix nerve wrap. The patient reported improvement of symptoms within 2 weeks and was able to return to his previous level of activity. In the literature, treatment has included from conservative measures such as pressure relief and splinting to surgical intervention including neurolysis, transposition, or neurectomy with nerve grafting.
Conclusions:
We present neurolysis for treating bowler's thumb as a viable option that may relieve symptoms rapidly while obviating need for adductor transection. Porcine extracellular matrix nerve wrap can be placed in an attempt to prevent recurrence of neuroma, but long-term follow-up is necessary.
Augmentation of Psychotherapy through Alternative Preconscious Priming: A Case Series Exploring Effects on Residual Symptoms
Authors: Melha Zidani, Jean-Sébastien Audet, François Borgeat, Frederick Aardema, Kieron Philip O'Connor, Yasser Khazaal
Journal: Front Psychiatry (2017)
Keywords: generalized anxiety disorder, preconcious, priming, psychotherapy research, social anxiety disorder/social phobia
MeSH terms: Case Reports

The current paper describes a case series using a new strategy for facilitating change based on Augmentation of Psychotherapy through Alternative Preconscious Priming (APAP) (1) in the treatment of eight treatment-resistant patients suffering from social phobia or generalized anxiety disorder. The patients had previously only shown a partial response to cognitive behavioral therapy (CBT) despite good treatment adherence. The patients completed APAP using a computerized program, which consisted of three steps during which alternative, more functional thoughts and beliefs relevant to the idiosyncratic difficulties experienced by the patients were formulated. Subsequently, these formulations were recorded and mixed with masking relaxing music, which the patient listened to in a passive state twice daily for 20 min for a period of 8 weeks. This case series aimed to assess the effect and acceptability of APAP using quantitative and qualitative measures administered before, after, and 16 weeks' posttreatment. Results showed a reduction in dysfunctional idiosyncratic thoughts reported by most patients, as well as mild improvements in anxiety and important improvements in quality of life. APAP could be a valuable addition to CBT by facilitating or enhancing cognitive and symptom change. Further studies are needed to confirm these promising results.
Long-term follow up of a boy with unilateral autosomal dominant polycystic kidney disease and contralateral renal agenesis
Authors: Grażyna Krzemień, Agnieszka Turczyn, Małgorzata Pańczyk-Tomaszewska, Aleksandra Jakimów-Kostrzewa, Agnieszka Szmigielska
Journal: Dev Period Med (2017)
Keywords: children, hypertension, adpkd, autosomal dominant polycystic kidney disease, chronic renal disease, renal agenesis
MeSH terms: Congenital Abnormalities / pathology, Glomerular Filtration Rate, Kidney / abnormalities, Kidney Diseases / congenital, Polycystic Kidney, Autosomal Dominant / pathology, Case Reports, Adolescent, Congenital Abnormalities / diagnostic imaging, Follow-Up Studies, Humans, Kidney / diagnostic imaging, Kidney / pathology, Kidney Diseases / diagnostic imaging, Kidney Diseases / pathology, Kidney Function Tests, Male, Polycystic Kidney, Autosomal Dominant / diagnostic imaging, Risk Factors, Hereditary renal agenesis

In patients with autosomal dominant polycystic kidney disease (ADPKD) coexisting abnormalities of the urinary tract are considered rare. Only a few patients with ADPKD and congenital abnormalities of the kidney and urinary tract- renal agenesis, hypoplasia, aplasia, horseshoe kidney, ectopic multicystic dysplasic kidney, or subpelvic junction obstruction were reported. Renal agenesis occurs in approximately 1 in 1.500.000-3.000.000 patients with ADPKD. We report a boy with ADPKD and renal agenesis diagnosed at the age of 12 years. ADPKD was diagnosed in some other members of the family. Additionally to kidney changes, mitral valve prolapse was found on echocardiography. At the age of 18 years high normal blood pressure was recognized and laboratory tests demonstrated: serum creatinine 1.0 mg/dl, glomerular filtrate rate 97.9 ml/min/1.73m2 , isotopic creatinine clearance (Tc-99mDTPA) 99 ml/min/1.73m2 , normal urinalysis, no microalbuminuria.
Conclusions:
In children with positive family history of ADPKD, screening ultrasonography of the kidney performed at the request of the family, allows the early diagnosis of sporadic present abnormalities of the kidney and urinary tract.
Unveiling the Hidden Culprit: A Case of Bile Leakage Post-Cholecystectomy Caused by a Luschka Duct
Authors: Sébastien Selleslag, Mathieu Vandeputte, Marie-Sofie Walgraeve
Journal: J Belg Soc Radiol (2023)
Keywords: luschka duct, mri, bile duct, bile leak, cholecystectomy, laparoscopy, subvesical bile duct, subvesicular duct
MeSH terms: Case Reports

Teaching Point: Recognize anatomical bile duct anomalies as a potential etiology of bile leakage post-cholecystectomy, and emphasize the importance of adequate radiological evaluation for correct management.
Sciatica caused by lumbar epidural gas
Authors: Hatim Belfquih, Brahim El Mostarchid, Ali Akhaddar, Miloudi gazzaz, Mohammed Boucetta
Journal: Pan Afr Med J (2014)
Keywords: epidural gas, intradiscal vacuum phenomenon, lumbar spine, sciatica
MeSH terms: Gases, Radiculopathy / etiology, Sciatica / etiology, Case Reports, Epidural Space, Female, Humans, Intervertebral Disc, Lumbar Vertebrae, Middle Aged, Radiculopathy / diagnosis, Radiculopathy / therapy, Sciatica / diagnosis, Sciatica / therapy, Tomography, X-Ray Computed / methods, Gases

Gas production as a part of disc degeneration can occur but rarely causes nerve compression syndromes. The clinical features are similar to those of common sciatica. CT is very useful in the detection of epidural gas accumulation and nerve root compression. We report a case of symptomatic epidural gas accumulation originating from vacuum phenomenon in the intervertebral disc, causing lumbo-sacral radiculopathy. A 45-year-old woman suffered from sciatica for 9 months. The condition worsened in recent days. Computed tomography (CT) demonstrated intradiscal vacuum phenomenon, and accumulation of gas in the lumbar epidural space compressing the dural sac and S1 nerve root. After evacuation of the gas, her pain resolved without recurrence.
The perceived knowledge of the menstruation cycle and adjustment of swimming sets by swimming coaches based on menstrual-related issues
Authors: N Marais, H Morris-Eyton, N Janse van Rensburg
Journal: S Afr J Sports Med (2022)
Keywords: adolescent swimmers, female swimmer, prescription, swimming coach, swimming training

Background:
Menstruation is the recurring discharge of the endometrial lining of the uterus as menstrual blood and tissue. The menstruation cycle affects most adolescent females and, although largely overlooked, affects women participating in sports.
Objectives:
The aim of this study was to determine whether coaches were aware of their swimmers' menstrual cycles and whether coaches considered this information when adjusting training sets.
Methods:
Within the case study, a partial mixed-method, sequential dominant status approach was used. Data were collected in the form of questionnaires, focus group discussions, and one-on-one interviews. Coaches' awareness of their female swimmers' menstrual cycles was based more on observation than communication from the swimmer.
Results:
Coaches explained that training is adjusted based on their observations, but whether this is being done correctly during the menstrual cycle requires more research. Swimmers and coaches alike seem to have minimal knowledge of menstruation, its effects on training, and how to adapt to, or overcome, those effects during training or competition.
Conclusion:
In future, this knowledge could ensure the longevity of female swimmers in the sport. Understanding whether coaches and swimmers recognise the effect of the menstrual cycle within training and competition provides a more inclusive approach to ensure athlete longevity after puberty. This approach is grounded in creating an understanding between the swimmer and coach about the effect of menstruation during training and competition. It ensures an extended and more successful participation which may also assist in dealing with the 'taboo' surrounding menstruation and the female athlete.
Dorsal dislocation of the intermediate cuneiform with a medial cuneiform fracture: a case report and review of the literature
Authors: Burak Akan, Tugrul Yildirim
Journal: Case Rep Orthop (2013)

Dorsal dislocation of the intermediate cuneiform and isolated medial cuneiform fractures are rare injuries. In this report, we present a patient who sustained a dislocation of the intermediate cuneiform and describe predisposing factors and the treatment procedure.
Anti-γ-aminobutyric acid-A receptor encephalitis with refractory seizures and cognitive impairment in a young woman: A case report
Authors: Xue Yang, Bo Deng, Shengjun Wang, Xiaotang Wang, Lili Cao, Xiangjun Chen, Xiuhe Zhao
Journal: Front Neurol (2022)
Keywords: anti-gabaar encephalitis, case report, encephalitis, neurology, seizures
MeSH terms: Case Reports

Anti-γ-aminobutyric acid-A receptor (GABAAR) encephalitis is an underappreciated cause of autoimmune encephalitis and remains refractory to antiepileptic therapies unless autoimmune responses are addressed. Herein, we reported a case of anti-GABAAR encephalitis in a young woman. A 29-year-old woman was admitted because of seizures for 10 months, memory decline for 7 months, and paroxysmal limbs jerking for 5 months. At admission, the patient showed mild cognitive impairment. Cell-based assays found no antibodies associated with common autoimmune encephalitis in the cerebrospinal fluid (CSF) and no antibodies in the plasma and CSF against central nervous system demyelination-associated proteins. MRI revealed multiple cortical-subcortical abnormalities and electroencephalography demonstrated periodic epileptiform discharges during paroxysmal clonus. A second test 1 month after admission detected antibodies against GABAAR α1/β3/γ2 in the plasma and CSF, leading to a diagnosis of anti-GABAAR encephalitis. The patient received intravenous immunoglobulin, prednisone, azathioprine, and levetiracetam and recovered from limb jerks and was no longer amnesic. A second episode occurred after an apparent cold and was managed by intravenous immunoglobulin, cyclophosphamide, and methylprednisolone with subsequent prednisone and levetiracetam. The patient was able to speak and ambulate after 15 days of treatment. Her MMSE, MoCA, and MRS scores improved. Physicians should harbor a high index of suspicion of anti-GABAAR encephalitis in refractory encephalitis patients with the manifestation of seizures or psychiatric disorders. Tests for a comprehensive panel of antibodies associated with anti-GABAAR encephalitis should be carried out in suspected cases and immunotherapy should be promptly initiated upon diagnosis to prevent irreversible neurological damage.
Recurrent Nausea and Vomiting in a Pregnant Woman with Chronic Marijuana Use
Authors: Hyunyoung G Kim, Jeremiah Moon, Heather Dixon, Paul Tullar
Journal: Case Rep Obstet Gynecol (2018)
MeSH terms: Case Reports

Background:
Cannabinoid hyperemesis syndrome is a condition characterized by chronic cannabis use and cyclic episodes of nausea, vomiting, and abdominal pain, relieved by compulsive bathing. The syndrome is likely to be underdiagnosed in pregnant women due to its similarity with hyperemesis gravidarum in the presentation.
Case:
We report a 20-year-old pregnant woman with multiple admissions for recurrent nausea and vomiting who was observed to be taking frequent hot showers. Without other identifiable causes, she was diagnosed with cannabinoid hyperemesis syndrome and managed with antiemetics and abstinence.
Conclusion:
Abstinence from cannabis use is highly recommended in pregnant women due to its potential harm in fetal development and stimulation of intractable nausea and vomiting. Recognizing the symptoms and proper history taking prompt early diagnosis, allowing timely and adequate treatment.
Spectrum of immune checkpoint inhibitors-induced endocrinopathies in cancer patients: a scoping review of case reports
Authors: Meng H Tan, Ravi Iyengar, Kara Mizokami-Stout, Sarah Yentz, Mark P MacEachern, Li Yan Shen, Bruce Redman, Roma Gianchandani
Journal: Clin Diabetes Endocrinol (2019)
Keywords: cancer immunotherapy, endocrine immune-related aes, ici-induced endocrinopathies, immune checkpoint inhibitors (ici)
MeSH terms: Review

Background:
Since 2011 six immune checkpoint inhibitors (ICI) have been approved to treat patients with many advanced solid tumor and hematological malignancies to improve their prognosis. Case reports of their endocrine immune-related adverse events [irAEs]) are increasingly published as more real-world patients with these malignancies are treated with these drugs. They alert physicians of a drug's AEs (which may change during a drug's life cycle) and contribute to post-marketing safety surveillance. Using a modified framework of Arksey and O'Malley, we conducted a scoping review of the spectrum and characteristics of ICI-induced endocrinopathies case reports before and after ICIs are marketed.
Methods:
In July 2017, we searched, without date and language restrictions, 4 citation databases for ICI-induced endocrinopathies. We also hand-searched articles' references, contents of relevant journals, and ran supplemental searches to capture recent reports through January 2018. For this study, a case should have information on type of cancer, type of ICI, clinical presentation, biochemical tests, treatment plus temporal association of ICI initiation with endocrinopathies. Two endocrinologists independently extracted the data which were then summarized and categorized.
Results:
One hundred seventy nine articles reported 451 cases of ICI-induced endocrinopathies - 222 hypopituitarism, 152 thyroid disorders, 66 diabetes mellitus, 6 primary adrenal insufficiencies, 1 ACTH-dependent Cushing's syndrome, 1 hypoparathyroidism and 3 diabetes insipidus cases. Their clinical presentations reflect hormone excess or deficiency. Some were asymptomatic and others life-threatening. One or more endocrine glands could be affected. Polyglandular endocrinopathies could present simultaneously or in sequence. Many occur within 5 months of therapy initiation; a few occurred after ICI was stopped. Mostly irreversible, they required long-term hormone replacement. High dose steroids were used when non-endocrine AEs coexisted or as therapy in adrenal insufficiency. There was variability of information in the case reports but all met the study criteria to make a diagnosis.
Conclusions:
The spectrum of ICI-induced endocrinopathies is wide (5 glands affected) and their presentation varied (12 endocrinopathies). Clinical reasoning integrating clinical, biochemical and treatment information is needed to properly diagnose and manage them. Physicians should be vigilant for their occurrence and be able to diagnose, investigate and manage them appropriately at onset and follow-up.
Epistaxis: the cause found beyond the nose
Authors: Rahul Verma, Vinay Nagaraja Gowda, Ashok Singh, Madhu Priya, Sanjeev Kishore, Prashant Pranesh Joshi
Journal: Autops Case Rep (2020)
Keywords: carcinoma, renal cell, epistaxis, paranasal sinuses
MeSH terms: Case Reports

Renal cell carcinoma (RCC) is a malignant disease that is often diagnosed at a metastatic stage. The head and neck represent up to 3% of the metastatic RCC, and the paranasal sinus area is one of the least involved sites. Here, we introduce the case of a 74-year-old female patient who presented with a history of traumatic nasal bleed. A cranial computed tomography scan and magnetic resonance imaging showed a fronto-ethmoidal mass with pachymeningeal involvement. A nasal biopsy from the paranasal sinuses was taken. On histopathological examination, metastatic clear cell carcinoma was the main hypothesis, which later was confirmed to be RCC on immunohistochemistry. On further radiological examination, an exophytic mass was depicted in the kidney's upper and middle pole. The patient had no renal complaints and was asymptomatic. Fronto-ethmoidal sinus is a rare site for metastatic RCC, especially in cases where the patient is asymptomatic. Early detection by keeping RCC metastasis as the differential diagnosis in such cases can lead to early treatment and improve the overall survival of the patient.
Split-Hand Malformation in a 4-Year-Old Child
Authors: Girish Gulab Meshram, Kanwaljeet Singh Hura, Neeraj Kaur
Journal: Case Rep Pediatr (2017)
MeSH terms: Case Reports

Split-hand deformity is one of the milder manifestations of a congenital disorder called split-hand/split-foot malformation. We present a case of a 4-year-old child with split-hand malformation in his left hand since birth. A median cleft was present in the affected hand with absence of the 3rd and 4th digits, giving rise to a characteristic lobster-claw appearance. Functionality of the affected hand was modestly impaired. As none of the close family members of the patient had similar limb malformations, the deformity was postulated to arise most likely from a de novo mutation. The patient was discharged after the parents were provided with genetic counseling.
Diffuse alveolar hemorrhage; An under-diagnosed and rare complication of glycoprotein IIb/IIIa inhibitors
Authors: Hamidreza Hekmat, Zahra Vahabi, Maryam Shojaeifard, Fatemeh Sadat Mirzadeh
Journal: J Cardiovasc Thorac Res (2022)
Keywords: acute coronary syndromes, alveolar hemorrhage, glycoprotein iib/iiia inhibitors, percutaneous coronary intervention
MeSH terms: Case Reports

Glycoprotein IIb/IIIa inhibitors play a key role in the treatment of patients who have acute coronary syndromes and undergone percutaneous coronary intervention. However, its serious complication is diffused alveolar hemorrhage. A 73-year-old diabetic woman presented with chest pain and dynamic ST elevation in ECG and positive troponin. She had occlusion in two coronary arteries and underwent percutaneous coronary intervention. The eptifibatide was administered. After hours, she showed respiratory symptoms, as well as drop of blood pressure and hemoglobin. All differential diagnoses suggested for her clinical presentation were evaluated, and finally, on the sixth day diffuse alveolar hemorrhage was diagnosed. Although respiratory symptoms such as hemoptysis and dyspnea may occur as complications of pulmonary edema and/or pneumonia, assumed clinical suspicion for pulmonary hemorrhage leading to early detection of it. Moreover, there is no definitive guideline for decreased bleeding complications and treatment of alveolar hemorrhage caused by glycoprotein IIb/IIIa receptor inhibitors.
A Case of Uterine Lymphangioleiomyomatosis Complicated by Tuberous Sclerosis Complex
Authors: Kaori Yamada, Yukio Yamanishi, Junichi Aratake, Nanayo Sasagasako, Yoshihide Inayama, Rei Gou, Atsuko Kawamura, Megumi Yamanishi, Kenzo Kosaka
Journal: Case Rep Obstet Gynecol (2022)
MeSH terms: Case Reports

Lymphangioleiomyomatosis (LAM) is one of the presentations of perivascular epithelioid cell neoplasm that is frequently complicated by tuberous sclerosis complex (TSC). Here, we report an uncommon case of uterine LAM treated with everolimus, which is a mechanistic target of rapamycin (mTOR) inhibitor. A 42-year-old female patient (gravida 0) with a history of TSC presented with abdominal pain. Pelvic magnetic resonance imaging showed multiple masses in the uterine myometrium, suggesting tumors that may contain internal hemorrhagic components. The lesions were suspected as the root cause of her symptoms. After everolimus was administered for a previously diagnosed renal angiolipoma, her uterine tumors temporarily decreased in size. Subsequently, laparoscopic hysterectomy and bilateral salpingectomy were performed since she could not tolerate everolimus for a long period due to the medication's side effects. Furthermore, the patient was diagnosed with LAM through histopathological examination after surgical resection. Therefore, it is advisable to suspect and investigate uterine LAM when a patient with a history of TSC presents with irregular genital bleeding or abdominal pain. Moreover, mTOR inhibitors may be a treatment option, in addition to surgery, in cases of uterine LAM exacerbation.
Complete Heart Block Complicating Takotsubo Syndrome: Case Report and Literature Review
Authors: Michael J McGee, William Yu, Joshua McCarthy, Malcolm Barlow, Rosemary Hackworthy
Journal: Case Rep Cardiol (2020)
MeSH terms: Case Reports

An 81-year-old woman presents with shortness of breath resulting in a diagnosis of picornavirus and complete heart block. Troponin was elevated and there was concern about acute coronary syndrome. The final diagnosis after echocardiogram and coronary angiogram was Takotsubo syndrome in addition to the heart block which required pacemaker insertion.