OpenMed/multicare-articles huggingface dataset:
Unique case study: Impact of single-session neuromuscular biofeedback on motor unit properties following 12 days of Achilles tendon surgical repair
Authors: Carlos De la Fuente, Rony Silvestre, Julio Botello, Alejandro Neira, Macarena Soldan, Felipe P Carpes
Journal: Physiol Rep (2024)
Keywords: case-report, decomposition, neuromechanical adaptation, rehabilitation, surface electromyography
MeSH terms: Achilles Tendon / surgery, Case Reports, Biofeedback, Psychology, Correlation of Data, Electromyography, Extremities, Humans, Male, Middle Aged

We explored the first evidence of a single-session neuromuscular biofeedback effect on motor unit properties, neuromuscular activation, and the Achilles tendon (AT) length 12 days after undergoing AT surgical repair. We hypothesized that immediate neuromuscular biofeedback enhances motor unit properties and activation without causing AT lengthening. After 12 days AT surgical repair, Medial Gastrocnemius (MG) motor unit decomposition was performed on a 58-year-old male before and after a neuromuscular biofeedback intervention (surface electromyography (sEMG) and ultrasonography), involving unressited plantar flexion. The analysis included motor unit population properties, sEMG amplitude, force paradigm, and AT length. There were increased MG motor unit recruitment, peak and average firing rate, coefficient of variation, and sEMG amplitude, and decreased recruitment and derecruitment threshold in the repaired AT limb. The non-injured limb increased the motor unit recruitment, and decreased the coefficient of variation, peak and average firing rate, inter-pulse interval, derecruitment threshold and sEMG amplitude. The AT length experienced -0.4 and 0.3 cm changes in the repaired AT and non-injured limb, respectively. This single-session neuromuscular biofeedback 12 days after AT surgery shows evidence of enhanced motor unit properties and activation without signs of AT lengthening when unresisted plantar flexion is performed in the repaired AT limb.
Case Report: Coil embolization of ascending aortic pseudoaneurysm in patient with Behcet's disease
Authors: Mengyang Kang, Bo Zhang, Honggang Pang, Huishe Hu, Junbo Zhang
Journal: Front Cardiovasc Med (2024)
Keywords: behcet’s disease, ascending aortic pseudoaneurysm, coil embolization, computed tomography angiography, thoracic endovascular repair
MeSH terms: Case Reports

Background:
Behcet's disease (BD) is a systematic vasculitis that affects vessels with various sizes, presenting as venous thrombosis and arterial pseudoaneurysms. The most severe manifestation in BD is ascending aortic pseudoaneurysm, which is associated with high risks of rupture and mortality.
Case presentation:
We present a case of ascending aortic pseudoaneurysm in a 50-year-old patient with BD. After preoperative evaluation, coil embolization was successfully performed to treat the pseudoaneurysm, resulting in a satisfactory outcome at the 1-year follow-up.
Conclusion:
Coil embolization serves as an effective treatment option for ascending aortic pseudoaneurysm in BD when open surgical repair and stent graft placement are unsuitable.
The Endonasal Endoscopic Transsphenoidal Approach to Paediatric Optic Chiasma Glioma: A Case Report and Literature Review
Authors: Norah S Al Shareef, Ali Almomen, Retaj Alawadhi, Abdulrhman Alkhatib, Sultan Alsaiari
Journal: Cureus (2024)
Keywords: endonasal endoscopic transsphenoidal approach, endoscopic endonasal skull base surgery, neurofibromatosis type, optic pathway gliomas, otolaryngology
MeSH terms: Case Reports

Optic pathway gliomas (OPGs) are rare pediatric tumors that pose significant challenges in management due to their location and clinical manifestations. Traditional transcranial approaches have been the mainstay for surgical intervention, but recent advancements in endoscopic endonasal transsphenoidal surgery offer a less invasive alternative. Here, we present a case of a 10-year-old female child with neurofibromatosis type-1 and an aggressive OPG who underwent endoscopic endonasal transsphenoidal debulking surgery. The pre-operative evaluation confirmed complete vision loss, and imaging revealed tumor progression. The surgery was successful, resulting in a subtotal resection and a diagnosis of pilocytic astrocytoma, WHO grade 1. Post-operative assessments showed no complications. This case highlights the feasibility of the endoscopic endonasal transsphenoidal approach for OPGs and emphasizes the importance of careful patient selection and multidisciplinary collaboration in achieving successful outcomes for these challenging tumors.
Neurological and cardiopulmonary manifestations of pulmonary arteriovenous malformations
Authors: Weida Lu, Honggang Dai, Yunyi Li, Xiao Meng
Journal: Front Med (Lausanne) (2024)
Keywords: cerebral abscess, hypoxemia, pulmonary arteriovenous malformations, stroke, treatment
MeSH terms: Review

Pulmonary arteriovenous malformations (PAVMs) are direct pulmonary artery-to-vein connections without pulmonary capillaries that result in intrapulmonary right-to-left blood shunts. Although most patients with PAVMs may be entirely asymptomatic, PAVMs can induce a series of complications involving the neurological, cardiovascular, and respiratory systems that can lead to catastrophic and often fatal clinical sequelae. In this study we review the available literature and summarize the reported PAVM-related complications among patients with PAVMs. The reviewed studies included observational studies, case studies, prospective studies, and cohort studies, and we provide an overview of PAVM-related neurological and cardiopulmonary manifestations, including stroke, cerebral abscess, transient ischemic attack, cerebral hemorrhage, migraine, seizure, dizziness, cardiac failure, arrhythmia, myocardial infarction, cough, hypoxemia, dyspnea, respiratory failure, hemoptysis, and hemothorax. Identifying and treating PAVMs before the presentation of major complication is important because this can prevent the occurrence of complications and can result in better outcomes. PAVM patients should thus be better evaluated and managed by a multidisciplinary team because they may be in a treatable phase prior to their condition becoming life-threatening.
Case Report: Renal artery stenosis in children: ultrasound as a decisive diagnostic and therapy-accompanying technique!
Authors: Maire Brasseler, Ilja Finkelberg, Carsten Müntjes, Metin Cetiner
Journal: Front Pediatr (2023)
Keywords: case report, diagnostic, pediatrics, renal artery stenosis, ultrasound
MeSH terms: Case Reports

Introduction:
Renal artery stenosis in children is rare, and the recommended diagnostic algorithm, including techniques such as catheter-based angiography, CT angiography, magnetic resonance angiography, and ultrasound, is controversial in pediatric cohorts.
Case presentation:
We report a case of an 11-year-old girl with renal artery stenosis in whom ultrasonography played a decisive role in confirming the diagnosis and accompanying therapeutic percutaneous transluminal renal artery angioplasty.
Conclusion:
Improved ultrasound techniques and the examiner's experience contribute to improving renal artery stenosis diagnosis in children. In particular, localized sensitive blood flow velocity analysis indicates the advantages of ultrasound compared to other imaging modalities in renal artery stenosis. Therefore, ultrasound should be a focus of future study designs addressing the search for the best diagnostic algorithm.
Summary:
The advantages of ultrasound techniques in pediatric patients with renal artery stenosis compared to other imaging modalities are highlighted.
Case report: Ofatumumab treatment in anti-DPPX autoimmune encephalitis
Authors: Peicai Fu, Zhenqiong Hu, Guopeng Zhang, Zhijun Li
Journal: Front Immunol (2024)
Keywords: anti-dipeptidyl peptidase-like protein 6 (anti-dppx), autoimmune encephalitis, immunotherapy, neuropsychiatric symptoms, ofatumumab
MeSH terms: Antibodies, Monoclonal, Humanized / therapeutic use, Autoantibodies / blood, Autoantibodies / cerebrospinal fluid, Autoantibodies / immunology, Encephalitis / diagnosis, Encephalitis / drug therapy, Encephalitis / immunology, Case Reports, Dipeptidyl-Peptidases and Tripeptidyl-Peptidases, Female, Hashimoto Disease / diagnosis, Hashimoto Disease / drug therapy, Hashimoto Disease / immunology, Humans, Male, Middle Aged, Nerve Tissue Proteins, Potassium Channels, Treatment Outcome, Antibodies, Monoclonal, Humanized, ofatumumab, Autoantibodies, Dipeptidyl-Peptidases and Tripeptidyl-Peptidases, DPP6 protein, human, Nerve Tissue Proteins, Potassium Channels, Hashimoto's encephalitis

Dipeptidyl peptidase-like protein 6 (DPPX) antibody encephalitis is a rare autoimmune encephalitis. Diagnosis and treatment of DPPX remain challenging, particularly in patients with refractory disease. Herein, we report the first case of anti-DPPX encephalitis treated with ofatumumab. The patient had a chronic insidious onset and predominantly presented with severe neuropsychiatric symptoms and the typical triad of symptoms (weight loss, central nervous system hyperexcitability, and cognitive dysfunction). Positive anti-DPPX antibodies in the serum (1:1,000) and cerebrospinal fluid (CSF) (1:100) were detected at the disease peak. The patient was unresponsive to four types of standard immunotherapies (intravenous globulin, plasma exchange, steroids, and tacrolimus), resulting in a treatment switch to ofatumumab. After five doses of injection and 12 months of follow-up, the patient improved well, with only a mild cognitive deficit.
Acute Heart Failure as a First Manifestation of Primary Adrenal Insufficiency: Highly Lethal If Not Diagnosed!
Authors: Maryam Heidarpour, Mohammad Mehdi Zare, Shiva Armani, Hedie Torkashvan, Sadegh Mazaheri-Tehrani, Davood Shafie
Journal: Case Rep Endocrinol (2024)
MeSH terms: Case Reports

Background:
Primary adrenal insufficiency is an uncommon condition that manifests as nonspecific symptoms such as fatigue, weight loss, salt craving, and hyperpigmentation. Common cardiovascular presentations of AI are hypotension, arrhythmias, and syncope. However, acute heart failure is an uncommon presentation. Case Presentation. Here, a 26-year-old man was hospitalized with vasopressor-resistant cardiogenic shock, which was finally attributed to an adrenal crisis. His past medical history was notable for Hashimoto's disease, controlled with oral levothyroxine.
Conclusion:
AI should be considered among patients with cardiogenic shock who are unresponsive to conventional inotropes. Additionally, a history of autoimmune diseases may increase the suspicion of AI. Although the presentation of cardiogenic shock in a patient with undiagnosed AI is considered a rarity, delay in prompt treatment can lead to life-threatening conditions.
Palliative Stenting for Gastric Outlet Obstruction Secondary to Pancreatic Adenocarcinoma
Authors: Dhruv Patel, Furqan A Bhullar, Ariana R Tagliaferri, Gabriel Melki, Matthew A Grossman
Journal: Cureus (2024)
Keywords: end of life and hospice care, gastric outlet obstruction, interventional gastroenterology, palliative stenting, pancreatic adenocarcinoma
MeSH terms: Case Reports

Pancreatic cancer is one of the most fatal malignancies due to its advanced stages at the time of presentation. Often, it is only diagnosed when patients present with late-stage complications, such as gastric outlet obstruction (GOO). Many patients experience a poor quality of life due to the side effects of GOO, such as persistent nausea, vomiting, and an inability to tolerate an oral diet, and as such, patients deteriorate quickly after their diagnosis. Because pancreatic cancer is diagnosed at advanced stages, many patients are not surgical candidates, and thus treatment is tailored for palliative measures. With GOO specifically, gastrojejunostomy has been the mainstay of palliative management; however, endoscopic stent placement is a new, innovative, and minimally invasive alternative option. Herein, we present a case of GOO as a complication of pancreatic adenocarcinoma, treated with palliative endoscopic stent placement. Further research is warranted to identify patients who would most benefit from this modality of palliation in the treatment of advanced pancreatic cancer.
Case report: Environmental adjustment for visual hallucinations in dementia with Lewy bodies based on photo assessment of the living environment
Authors: Daiki Ishimaru, Hideki Kanemoto, Maki Hotta, Yuma Nagata, Fuyuki Koizumi, Yuto Satake, Daiki Taomoto, Manabu Ikeda
Journal: Front Psychiatry (2024)
Keywords: dlb, case report, environmental factor, non-pharmacology, visual hallucination
MeSH terms: Case Reports

Background:
Visual hallucinations (VH) are associated with visual prediction error in patients with dementia with Lewy bodies (DLB). Given this relationship, environmental adjustments have been suggested, but detailed contents for implementing such environmental adjustments and assessments are poorly documented. This case report preliminarily demonstrates methods for improving VH through our experience with two patients with DLB. We conducted familial interviews to assess the phenomenological features of VH and reviewed photographs of patients' homes to identify the environmental triggers of VH, known as photo assessment of the living environment (PA-LE).
Case description:
Patient 1 was a 78-year-old woman with a Mini-Mental State Examination (MMSE) score of 11/30. She experienced seeing a stranger, children, and cats at home, which frightened her. VH frequently occurred in the living room and bedroom. The PA-LE showed that several environmental features, such as cushions on a sofa, the pattern on a carpet under a table, and clothing on hangers, were suggestive triggers of VH. Patient 2 was an 88-year-old woman with a MMSE score of 5/30. She had seen strangers, children, and animals at home, some of which were linked to a theft delusion. VH frequently occurred in the living room and bedroom. The PA-LE found that several environmental features, such as clothing on hangers and dolls, were suggestive of VH triggers. Non-pharmacological approaches were tailored to the patients' environmental and psychological states using interviews and PA-LE. This included removing environmental triggers, reducing negative mood, and providing coping strategies for VH. This improved their VH and their caregivers' knowledge of VH.
Conclusion:
Phenomenological assessments using photographs of the patient's home could identify the environmental triggers associated with VH in patients with DLB and assist in environmental adjustments.
A Rare Case of Cavernous Intramuscular Hemangioma of the Forearm
Authors: Taha El Aissaoui, Adnane Lachkar, Najib Abdeljaouad, Hicham Yacoubi
Journal: Cureus (2024)
Keywords: forearm tumor, intramuscular hemangioma, musculoskeletal tumor, total excision, tumor
MeSH terms: Case Reports

Cavernous intramuscular hemangiomas are a part of a group of rare benign tumors. This case report outlines a unique instance involving a 72-year-old patient who sought medical advice at our department due to a progressively enlarging mass in the posterior aspect of her right forearm. Physical examination revealed a painless, mobile mass with no apparent skin abnormalities. Radiographs showed normal results, and an MRI raised suspicion of a fibrous tumor. A subsequent biopsy confirmed the diagnosis of cavernous hemangioma. The patient underwent a total excision procedure, resulting in favorable outcomes with no observed functional impairment or tumor recurrence over four years. This case is notable for its singularity, involving both the advanced age of the patient and the uncommon location of the tumor.
Rare adrenal cavernous hemangioma: a case report highlighting diagnostic challenges
Authors: Ryan Michael Antar, Christian Mark Farag, Kirolos Youssef, Vincent Xu, Arthur Drouaud, Noah Panitch, Zoon Tariq, Ali Alzeer, Michael J Whalen
Journal: Front Surg (2023)
Keywords: adrenal mass, adrenalectomy, adrenaloma, cavernous hemangioma, hemangioma, incidentaloma

Introduction:
Adrenal cavernous hemangiomas are rare benign vascular tumors that pose significant diagnostic challenges. Despite their benign nature, features overlapping with malignancies often complicate management decisions.
Case presentation:
A 64-year-old male presented with a 4.4 cm necrotic left adrenal mass discovered incidentally on imaging. His medical history included papillary thyroid carcinoma, with subsequent thyroidectomy and radioactive iodine ablation. Evaluations for hiccups revealed multiple lung nodules, hypertrophic cardiomyopathy, and anemia. Given the patient's previous cancer history, elevated aldosterone/renin ratio, and mass size, our multidisciplinary tumor board decided to proceed with a left adrenalectomy. Post-surgical pathology confirmed a diagnosis of adrenal cavernous hemangioma.
Conclusion:
The occurrence of ambiguous adrenal mass with other pathologies, such as our patient's papillary thyroid carcinoma, complicates the diagnostic and therapeutic landscape. As demonstrated in our case, opting for surgery remains a viable solution for adrenal cavernous hemangiomas, especially for masses greater than 4 cm. Interdisciplinary collaboration, exemplified by our tumor board's decision-making process, is crucial for optimal management. This case underscores the need for a multifaceted approach when confronting adrenal masses with such diagnostic ambiguity.
Fatal nephrobronchial fistula arising from xanthogranulomatous pyelonephritis: a case report
Authors: María Alejandra Burbano, H A Nati-Castillo, Natalia Castaño-Giraldo, Gildardo López, Romina Placencia-André, Camila Salazar-Santoliva, Melissa Villavicencio-Gomezjurado, Juan S Izquierdo-Condoy
Journal: Front Med (Lausanne) (2024)
Keywords: chronic infection, fatal outcome, lung abscess, nephrobronchial fistula, xanthogranulomatous pyelonephritis
MeSH terms: Case Reports

Introduction:
Nephrobronchial fistula is an exceptionally rare complication of renal infections, including the uncommon xanthogranulomatous pyelonephritis. Existing literature is limited to a few case reports, with antibiotic therapy and nephrectomy being the preferred treatments.
Case:
We present the case of a 63-year-old woman with a history of recurrent xanthogranulomatous pyelonephritis in her right kidney, requiring drainage through lumbotomy. She presented with a chronic dry cough and weight loss, without other noticeable symptoms. Imaging suggested a pulmonary abscess and nephrobronchial fistula. Despite antibiotic treatment and surgical intervention, her condition progressed fatally.
Conclusion:
Nephrobronchial fistulas are extremely complications of renal infections, often presenting with nonspecific symptoms. This case highlights their significant impact on morbidity and mortality, especially in resource-limited settings, and underscoring the urgent need for prompt diagnosis and treatment.
Listeria monocytogenes Brain Abscess Presenting With Stroke-Like Symptoms: A Case Report
Authors: Roxana M Dragomir, Olivia Mattner, Veronica Hagan, Marc A Swerdloff
Journal: Cureus (2024)
Keywords: brain abscess, case report, diagnosis, listeria, treatment
MeSH terms: Case Reports

We present a case of Listeria monocytogenes brain abscess in an immunocompromised patient admitted for stroke-like symptoms of headache and aphasia. Computerized tomography of the head revealed a 1.7 x 1.3 cm left frontal lobe lesion with surrounding edema, secondary to stroke, tumor, or abscess. Magnetic resonance imaging brain revealed a ring-enhancing lesion and a small contralateral area of restricted diffusion. Two of the two blood cultures grew an organism identified as L. monocytogenes using matrix-assisted laser desorption ionization time-of-flight mass spectrometry. Treatment with ampicillin and trimethoprim-sulfa yielded marked symptomatic improvement. A brain biopsy was consistent with bacterial abscess. The patient's clinical course was favorable, with improved aphasia and negative follow-up blood cultures. A literature review found a limited number of L. monocytogenes abscess cases and none had clear guidelines for diagnosis. Recent studies have proposed five criteria for diagnosis. Our patient fulfilled three of these proposed guidelines.
Steroids for the Treatment of Misophonia and Misokinesia
Authors: Jadon Webb, Afton Williamson
Journal: Case Rep Psychiatry (2024)
MeSH terms: Case Reports

Misophonia and misokinesia are disorders characterized by intensely negative physical and emotional reactions to specific auditory and visual stimuli. The availability of effective treatments, especially pharmacological ones, is limited. This report presents a case of a 35-year-old male with severe misophonia and misokinesia who experienced nearly complete resolution of symptoms while undergoing high-dose steroid therapy for an unrelated muscular injury. Two days after starting a 20 mg oral prednisone taper pack (in which the steroid dose is reduced by 4 mg daily), his Amsterdam Misophonia Scale (A-Miso-S) score drastically reduced from a baseline of 23 (i.e., extreme symptoms) to 1, with symptom relief persisting for approximately 2 weeks after completing the taper. Months later, a daily dose of prednisone (4 mg) was reintroduced. This again resulted in a marked reduction in symptoms (A-Miso-S of 6), enabling him to resume working in an office setting despite his triggers. Symptom improvement remained stable over several months. This case raises the possibility of the steroid prednisone as a novel treatment for misophonia and misokinesia. However, further investigation is needed to determine the generalizability of this observation.
Dysuria and Vaginal Pain, Unusual Manifestations of B-acute Lymphoblastic Lymphoma
Authors: Ananya Datta Mitra, Anupam Mitra, Jong H Chung, Elham Vali Betts
Journal: Clin Pathol (2024)
Keywords: b-lymphoblastic leukemia, b-lymphoblastic lymphoma, case report, dysuria, vaginal pain
MeSH terms: Case Reports

Urinary symptoms are one of the most common reasons for emergency visits in females of pediatric age group and can be associated with various conditions like infections (most common), sexual trauma and rarely neoplastic processes. Here, we report a case of a 7-year-old female who presented in the emergency multiple times with the complaints of urinary symptoms and vaginal pain and was empirically treated with antibiotics and antifungals without symptomatic improvement. Her blood tests, physical examination during this time remained unrevealing. She was then transferred to our institution on her third emergency visit for further evaluation. On imaging studies, she was noted to have expansile lesions on her vertebral body at the L4 and T6 levels with compressive myelopathy with multiple bone and soft tissue lesions throughout her lower extremities. Patient developed saddle anesthesia requiring emergent decompression and biopsy of the epidural mass with the final pathology coming back as B-lymphoblastic leukemia/lymphoma. B-ALL/B-LBL is the most common pediatric hematologic malignancy and usually presents with fever, hepatosplenomegaly, lymphadenopathy, bone pain and bleeding. Occasionally, atypical presentations like bone and joint pain, osteoporosis, palpable paravertebral mass have been described. However, this is the first case report to describe a very unusual and unfamiliar presentation of this disease causing significant diagnostic difficulty resulting in delayed treatment. This case report can aid as a reminder that unusual pain or any nonspecific manifestations in pediatric patients, refractory to common treatment should be investigated with extreme diligence not to miss this neoplastic process.