OpenMed/multicare-articles huggingface dataset:
Something Got Your Tongue? A Unique Cause of Hypoglossal Nerve Palsy
Authors: Alan Tesson, Peter Kranz, Ali Zomorodi, Joel Morgenlander
Journal: Case Rep Neurol Med (2022)
MeSH terms: Case Reports

Introduction:
The authors report a rare cause of isolated hypoglossal nerve palsy caused by a high cervical osteophyte. This case increases clinical knowledge of an underreported condition and teaches the clinician radiologic pearls in making the diagnosis. To their knowledge, this is the first case report showing surgical remediation of this condition. Symptoms and Clinical Findings. A 73-year-old female presented with several months of occipital headache, progressive dysarthria, dysphagia, and tongue deviation to the right. Her neurologic exam was significant for atrophy of the right hemitongue with tongue fasciculations. On protrusion, her tongue deviated rightward. Diagnosis and Therapeutic Intervention. Careful review of her initial head computed tomography (CT) imaging revealed that a high cervical osteophyte caused unilateral, isolated hypoglossal nerve palsy. Neurosurgery performed a right, far lateral approach for decompression of this osteophyte and over the ensuing months her symptoms improved.
Conclusion:
High cervical osteophyte is an underrecognized cause of isolated hypoglossal nerve palsy. The imaging investigation should be systematic and focus on the skull base with magnetic resonance imaging (MRI) or CT. This is a rare occasion when high resolution CT of the skull base can actually be the more helpful imaging modality. As shown in this case, an osteoarthritic cause can be surgically ameliorated.
Spigelian hernia in gynaecology
Authors: Anastasia Ussia, Fabio Imperato, Larissa Schindler, Arnaud Wattiez, Philippe R Koninckx
Journal: Gynecol Surg (2017)
Keywords: deep endometriosis, endometriosis, pelvic pain, spigelian hernia

Background:
A Spigelian hernia is a rare hernia through the Spigelian fascia between the rectus muscle and the semilunar line. This hernia is well known in surgery. Symptoms vary from insidious to localised pain, an intermittent mass and/or a bowel obstruction.
Results:
The Spigelian hernia is poorly known in gynaecology. Spigelian hernias may be causally related to secondary trocar insertion. This review is written to increase awareness in gynaecology and is illustrated by a case report in which the diagnosis was missed for 4 years even by laparoscopy. Smaller hernias risk not to be diagnosed and will thus not be treated. Even larger Spigelian hernias might not be recognised and treated appropriately.
Conclusions:
The gynaecologist should consider a Spigelian hernia in women with localised pain in the abdominal wall lateral of the rectus muscle some 5 cm below the umbilicus. Smaller hernias can be closed by laparoscopy without a mesh. Larger hernias require a mesh repair.
Intravenous Thrombolysis for Acute Ischemic Stroke in Patients With Cardiac Myxoma: A Case Series and Pooled Analysis
Authors: Jie Rao, Zi Tao, Qiongqiong Bao, Mingxia Jiang, Enyang Zhou, Xueli Cai, Fangwang Fu
Journal: Front Neurol (2022)
Keywords: alteplase, bridging therapy, efficacy, intravenous thrombolysis, myxoma, stroke

Background and purpose:
Acute ischemic stroke (AIS) is a major life-threatening consequence of cardiac myxoma (CM) and leads to a poor prognosis. Although intravenous thrombolysis (IVT) is the first-line treatment for AIS, its efficacy and safety in CM-AIS have not been established. Currently, there are only limited data from case reports. Our study aimed to investigate the clinical characteristics of CM-AIS and evaluate the safety and efficacy of IVT for CM-AIS patients.
Methods:
Fourteen CM-AIS patients who received IVT between January 2016 and December 2021 were identified from our multicenter stroke registry databases. Clinical, neuroimaging and outcome data were analyzed. We then performed a pooled analysis of the published literature from inception to December 2021.
Results:
Of the 14 CM-AIS patients, nine were treated with IVT alone, and five were treated with bridging therapy (BT). The median age was 51.5 years, and 57.1% were female. The median onset-to-needle time was 160 min. The median National Institute of Health Stroke Score (NIHSS) decreased from 15.5 at presentation to 13 24 h after IVT. Very early neurological improvement (VENI) was observed in one patient. Hemorrhagic transformation (HT) was observed in five (35.7%) patients, and only one patient was symptomatic (7.1%). Three-month favorable outcomes were achieved in six patients (66.7%) who underwent IVT alone and three patients (60%) who received BT, which resulted in a total proportion of favorable outcomes of 64.3%. None of the patients died at 3 months follow-up. Forty-seven cases (15 BT patients) were included for the pooled analysis. The median NIHSS score was 16.5, and VENI was observed in 10 (21.3%) patients. HT was detected in 11 patients (23.4%), and four (8.5%) patients were symptomatic. Favorable outcomes at 3 months were achieved in 61.7% of patients, 56.3% of patients who underwent IVT alone, and 73.3% of patients who received BT. The 3-month mortality rate was 4.3%.
Conclusions:
IVT is a potentially safe and efficient treatment for CM-AIS patients. Further studies with larger sample sizes are required to provide more evidence on the safety and efficacy of IVT and BT in CM-AIS patients.
Neuromuscular and Muscle Metabolic Functions in MELAS Before and After Resistance Training: A Case Study
Authors: Massimo Venturelli, Federica Villa, Federico Ruzzante, Cantor Tarperi, Doriana Rudi, Chiara Milanese, Valentina Cavedon, Cristina Fonte, Alessandro Picelli, Nicola Smania, Elisa Calabria, Spyros Skafidas, Gwenael Layec, Federico Schena
Journal: Front Physiol (2019)
Keywords: melas, exercise, muscle respiratory capacity, neuromuscular function, resistance training

Mitochondrial encephalomyopathy, lactic acidosis, and recurrent stroke-like episodes syndrome (MELAS) is a rare degenerative disease. Recent studies have shown that resistant training (RT) can ameliorate muscular force in mitochondrial diseases. However, the effects of RT in MELAS are unknown. The aim of this case report was to investigate the effects of RT on skeletal muscle and mitochondrial function in a 21-years old patient with MELAS. RT included 12 weeks of RT at 85% of 1 repetition maximum. Body composition (DXA), in vivo mitochondrial respiration capacity (mVO2) utilizing Near-infrared spectroscopy on the right plantar-flexor muscles, maximal voluntary torque (MVC), electrically evoked resting twitch (EET) and maximal voluntary activation (VMA) of the right leg extensors (LE) muscles were measured with the interpolated twitch technique. The participant with MELAS exhibited a marked increase in body mass (1.4 kg) and thigh muscle mass (0.3 kg). After the training period MVC (+5.5 Nm), EET (+2.1 N⋅m) and VMA (+13.1%) were ameliorated. Data of mVO2 revealed negligible changes in the end-exercise mVO2 (0.02 mM min-1), Δ mVO2 (0.09 mM min-1), while there was a marked amelioration in the kinetics of mVO2 (τ mVO2; Δ70.2 s). This is the first report of RT-induced ameliorations on skeletal muscle and mitochondrial function in MELAS. This case study suggests a preserved plasticity in the skeletal muscle of a patient with MELAS. RT appears to be an effective method to increase skeletal muscle function, and this effect is mediated by both neuromuscular and mitochondrial adaptations.
Secondary tuberculosis of breast: case report
Authors: Imtiaz Wani, Ali M Lone, Rayees Malik, Khursheed A Wani, Rauf A Wani, Irfan Hussain, Natasha Thakur, Vilam Snabel
Journal: ISRN Surg (2011)
MeSH terms: Case Reports

Tuberculosis of breast is a rare disease which is difficult to differentiate from carcinoma of breast. The involvement of breast can be primary or secondary to some focus in body. A case of secondary tuberculosis of right breast in a 21-year-old female from Kashmir, India, is being reported. Presentation was as a painless discharging sinus of right breast. A tubercular foci of rib was the affecting source of disease. No other evidence of tuberculosis was present in the body. Resection of involved rib segment, along with the discharging sinus, was performed. The patient had antitubercular therapy for 9 months, with no recurrence seen in followup.
Pharmacotherapy of Patients Taking New Psychoactive Substances: A Systematic Review and Analysis of Case Reports
Authors: Michal Ordak, Aleksandra Zmysłowska, Miłosz Bielski, Daniel Rybak, Maja Tomaszewska, Katarzyna Wyszomierska, Aleksandra Kmiec, Natalia Garlicka, Maria Zalewska, Michal Zalewski, Tadeusz Nasierowski, Elzbieta Muszynska, Magdalena Bujalska-Zadrozny
Journal: Front Psychiatry (2021)
Keywords: case report, new psychoactive drugs, pharmacotherapy, psychopharmacology, substances abuse
MeSH terms: Systematic Review

Background: In recent years, an increase in the frequency of hospitalizations of patients taking newer and newer psychoactive substances has been observed around the world. Each year, authors publish case reports of patients who consumed previously unknown NPS. Most publications of this type concern the period between 2014 and 2016. However, no publication systematically reviews the pharmacotherapy used in these cases. This study aims to review the case reports of patients taking NPS published between 2010 and 2019, as well as analyzing the pharmacotherapy used. Methods: We searched the Thomson (Web of Knowledge), PubMed/Medline, Science Direct, Scopus and Google Scholar databases. The search was performed using all possible combinations of the term "case report" describing the use of NPS, also referred to as designer medications, internet medications, research chemicals and herbal highs. Results: We analyzed 51 case reports on the intake of various types of NPS. Most of them (p < 0.001) concerned the use of synthetic cannabinoids (41.2%) and cathinones (31.4%). The pharmacotherapy applied primarily (p < 0.001) consisted of administering benzodiazepines to patients (62.7%), most of whom took only this group of medications (25.5%), followed by groups receiving benzodiazepines combined with neuroleptics (15.7%) and muscle relaxants (11.8%). Opioids were administered primarily to patients taking synthetic opioids (p < 0.001). Of the 5 cases of deaths from NPS reported in the literature, three relate specifically to the synthetic opioid MT-45. The later the time period, the more medications patients were administered (p = 0.02). Conclusion: In the pharmacotherapy for NPS poisoning, one should focus primarily on combating psychomotor agitation.
A unique intraluminal growth of juvenile nasopharyngeal angiofibroma: A case report
Authors: Mojtaba Mohammadi Ardehali, Shirin Irani, Mohammadreza Firouzifar
Journal: Biomedicine (Taipei) (2020)
Keywords: angiofibroma, intraluminal growth, sinus endoscopy
MeSH terms: Case Reports

Juvenile nasopharyngeal angiofibroma (JNA) is a rare, hypervascular, benign tumor which is mainly seen among male adolescents. The tumor typically originates from the sphenopalatine fossa, but could spread through natural foramens and fissures. There are some reports of atypical growth of this tumor in literature but the intraluminal growth, which could be seen in paraganglioma and glomus tumors, has not reported yet in angiofibroma. In this article we present a case of extensive angiofoibroma with intraluminal involvement of the ophthalmic vein. Our patient was a 19-year-old boy with a complaint of nasal obstruction and occasional epistaxis since a year ago, without any visual or neurologic complaints. The patient underwent an endoscopic resection of the tumor after embolization via the nasal cavity. The intraoperative findings revealed the tumor extension to the orbit, intracranial space and cavernous sinus via inferior orbital fissure. The intracranial extension of the tumor was extradural and was successfully excised without CSF leakage. An interesting finding in this patient, was an intraluminal extension of the tumor in to the ophthalmic vein, which was completely excised endoscopically. (pre and post operation pictures are available in the full text). The definitive treatment of angiofibroma is surgical excision. Different surgical approaches are used but nowadays endoscopic resection with or without pre-operative embolization is the first choice of treatment. The intraluminal growth of the tumor was also excised as a pedunculated mass separately.
Legionella longbeachae and endocarditis
Authors: Nicola Leggieri, Frédérique Gouriet, Frank Thuny, Gilbert Habib, Didier Raoult, Jean-Paul Casalta
Journal: Emerg Infect Dis (2012)
MeSH terms: Endocarditis, Bacterial / microbiology, Legionella longbeachae / isolation & purification, Legionellosis / microbiology, Prosthesis-Related Infections / microbiology, Case Reports, Aged, Anti-Bacterial Agents / therapeutic use, Bioprosthesis / microbiology, Endocarditis, Bacterial / drug therapy, Endocarditis, Bacterial / surgery, Heart Valve Prosthesis / microbiology, Humans, Legionellosis / drug therapy, Legionellosis / surgery, Male, Anti-Bacterial Agents

We report a case of infectious endocarditis attributable to Legionella longbeachae. L. longbeachae is usually associated with lung infections. It is commonly found in composted waste wood products. L. longbeachae should be regarded as an agent of infectious endocarditis, notably in the context of gardening involving handling of potting soils.
Interventricular septum hematoma during cineventriculography
Authors: Andrea Grohmann, Thomas Elgeti, Stephan Eddicks, Fabian Knebel, Wolfgang Rutsch, Christoph Melzer, Gert Baumann, Adrian C Borges
Journal: Cardiovasc Ultrasound (2008)
MeSH terms: Cardiac Catheterization / adverse effects, Contrast Media / adverse effects, Heart Septal Defects, Ventricular / diagnostic imaging, Heart Septal Defects, Ventricular / etiology, Hematoma / etiology, Myocardial Infarction / etiology, Case Reports, Contrast Media / administration & dosage, Echocardiography, Stress, Electrocardiography, Heart Septal Defects, Ventricular / therapy, Hematoma / therapy, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Myocardial Infarction / therapy, Radiography, Stents, Contrast Media

Background:
Intraseptal hematoma and subsequent myocardial infarction due to accidental contrast agent deposition complicating diagnostic cineventriculography is a previously undescribed complication of angiography.
Case presentation:
A 61 year old man was admitted at intensive care unit because of unstable angina pectoris 1 hour after coronary angiography. Transthoracic contrast echocardiography showed a non-perfused area in the middle of interventricular septum with an increase of thickening up to 26 mm. Review of cineventriculography revealed contrast enhancement in the interventricular septum after contrast medium injection and a dislocation of the pigtail catheter tip. Follow up by echocardiography and MRI showed, that intramural hematoma has resolved after 6 weeks. After 8 weeks successful stent implantation in LAD was performed and after 6 month the patient had a normal LV-function without ischemic signs or septal thickening demonstrated by stressechocardiography.
Conclusion:
A safe and mobile position of the pigtail catheter during ventriculography in the middle of the LV cavity should be ensured to avoid this potentially life-threatening complication. For assessment and absolute measurement of intramural hematoma contrast-enhanced echocardiography is more feasible than MRI and makes interchangeable results.
Unusual Mechanisms of Penile Amputation
Authors: Julian Fazi, David Adkins, Jennifer Knight, Adam Luchey
Journal: Case Rep Urol (2019)
MeSH terms: Case Reports

Penile amputation is an uncommon and highly morbid injury. Many mechanisms have been reported ranging from self-mutilation and domestic violence to traumatic circumcisions. We present two unusual cases of traumatic penile amputation. An older gentleman endured extensive perineal trauma after being trapped underneath an industrial-sized lawnmower, and a young adolescent was bitten by an English bulldog and suffered amputation of the glans of his penis. These unique and very different cases of penile amputation highlight differences in operative managements, complications, and reconstructive possibilities.
[Description of 8 cases with gonadal dysgenesis syndrome type 46XY]
Authors: E Deligeoroglou, P Fotaki, D Kokkalis, G Creatsas
Journal: Akush Ginekol (Sofiia) (2001)
MeSH terms: Gonadal Dysgenesis, 46,XY / diagnosis, Gonadal Dysgenesis, 46,XY / diagnostic imaging, Gonadal Dysgenesis, 46,XY / genetics, Case Reports, 17-Hydroxysteroid Dehydrogenases / deficiency, Adolescent, Amenorrhea / etiology, Androgen-Insensitivity Syndrome / diagnosis, Androgen-Insensitivity Syndrome / surgery, Androgen-Insensitivity Syndrome / therapy, Female, Hormone Replacement Therapy, Humans, Male, Retrospective Studies, Ultrasonography, Uterus / diagnostic imaging, 17-Hydroxysteroid Dehydrogenases

The nondiphtheriae corynebacteria are uncommon but increasingly recognized as important agents of community-acquired endocarditis in patients with underlying structural heart disease, as well as of prosthetic-valve endocarditis. We describe three cases of nondiphtheriae corynebacterial endocarditis, including the first reported case of endocarditis caused by Corynebacterium amycolatum, occurring over an 18-month period, all in association with indwelling intravascular devices.
Vacuum assisted closure for the treatment of complex wounds and enterocutaneous fistulas in full term and premature neonates: a case report
Authors: Filomena Valentina Paradiso, Lorenzo Nanni, Laura Merli, Erika Adalgisa De Marco, Vincenzo Davide Catania, Alessandra Taddei, Carlo Manzoni, Giorgio Conti
Journal: Ital J Pediatr (2016)
MeSH terms: Anal Canal / abnormalities, Anus, Imperforate / surgery, Intestinal Fistula / therapy, Intestinal Perforation / surgery, Intestinal Volvulus / surgery, Negative-Pressure Wound Therapy, Rectum / abnormalities, Surgical Wound Dehiscence / therapy, Case Reports, Anal Canal / surgery, Anorectal Malformations, Female, Humans, Infant, Newborn, Infant, Premature, Male, Rectum / surgery

Background:
The Vacuum Assisted Closure (VAC) system has become an effective treatment for acute and chronic wound defects. Although its use has been reported in wound care of children and premature infants, the management of the device in this population has not been well established.
Case presentation:
We report the satisfactory results in two neonates (one full-term and one preterm) with complex wounds secondary to major abdominal surgery. In the premature baby an enterocutaneous fistula was also present. Complete epithelialization of the wounds was achieved in both patients within a few weeks thus avoiding any further surgical procedure.
Case presentation:
The use of VAC system in neonates is safe and effective in the management of complex wounds and should be considered as a first line treatment in the event of a major dehiscence.
Autoimmune Thyroid Disease and Psoriasis Vulgaris after COVID-19 in a Male Teenager
Authors: Nadia K Qureshi, Sanjay K Bansal
Journal: Case Rep Pediatr (2021)
MeSH terms: Case Reports

COVID-19 is implicated in triggering autoimmune, dermatologic, and thyroid diseases. We present a first known case of development of Graves' disease and psoriasis vulgaris in a previously healthy male teenager without any family history, diagnosed after COVID-19 infection. Evaluation of "long COVID syndrome" should include thorough history and thyroid evaluation.
Sustained Regression of Hydroxycarbamide Induced Actinic Keratoses after Switching to Anagrelide
Authors: Georgios Gaitanis, Dora Gougopoulou, Eleni Kapsali, Ioannis D Bassukas
Journal: Case Rep Dermatol Med (2018)
MeSH terms: Case Reports

Hydroxycarbamide (HC) is the first-line treatment for certain myeloproliferative neoplasms, such as polycythemia vera and essential thrombocytosis (ET). In a subset of these patients long-term treatment with HC can result in the development of confluent actinic keratoses (AK) followed by invasive keratinocytic carcinomas ("squamous dysplasia"), preferentially on sun-exposed skin. Discontinuation or dose reduction of HC may result in partial improvement. A 59-year-old farmer after 14 years on HC (2 gr/d) and acetylsalicylic acid (100 mg/d) for ET, was referred for numerous, hyperkeratotic AK on face, scalp, and hands that could not be controlled with repeated (N = 15) cryosurgery sessions in the previous 3 years. Acitretin (0.32 mg/kg daily) and topical treatments (cryosurgery with ingenol mebutate) were initiated with only marginal improvement after 3 months. Acitretin dose was doubled and HC was switched to anagrelide (0.5 mg twice daily). Within a month the AK load regressed significantly and, at 3 months follow-up, complete clinical remission was achieved and acitretin was discontinued. Twenty months later the patient is clear from AK. In conclusion, the impressive and sustainable AK remission under anagrelide draws attention to a possible role of the phosphodiesterase 3 pathway, the major pharmacological target of anagrelide, as a potential therapeutic target for keratinocytic cancers.
Catatonia Secondary to Sudden Clozapine Withdrawal: A Case with Three Repeated Episodes and a Literature Review
Authors: John Bilbily, Betsy McCollum, Jose de Leon
Journal: Case Rep Psychiatry (2017)
MeSH terms: Case Reports

A literature search identified 9 previously published cases that were considered as possible cases of catatonia secondary to sudden clozapine withdrawal. Two of these 9 cases did not provide enough information to make a diagnosis of catatonia according to the Diagnostic and Statistical Manual, 5th Edition (DSM-5). The Liverpool Adverse Drug Reaction (ADR) Causality Scale was modified to assess ADRs secondary to drug withdrawal. From the 7 published cases which met DSM-5 catatonia criteria, using the modified scale, we established that 3 were definitive and 4 were probable cases of catatonia secondary to clozapine withdrawal. A new definitive case is described with three catatonic episodes which (1) occurred after sudden discontinuation of clozapine in the context of decades of follow-up, (2) had ≥3 of 12 DSM-5 catatonic symptoms and serum creatinine kinase elevation, and (3) required medical hospitalization and intravenous fluids. Clozapine may be a gamma-aminobutyric acid (GABA) receptor agonist; sudden clozapine withdrawal may explain a sudden decrease in GABA activity that may contribute to the development of catatonic symptoms in vulnerable patients. Based on the limited information from these cases, the pharmacological treatment for catatonia secondary to sudden clozapine withdrawal can include benzodiazepines and/or restarting clozapine.
Primary intrathoracic gastric volvulus in the neonatal period: a differential diagnosis of esophageal atresia
Authors: Driss El Azzouzi
Journal: Pan Afr Med J (2014)
Keywords: gastric volvulus, newborn
MeSH terms: Contrast Media, Esophageal Atresia / diagnosis, Hernia, Hiatal / diagnosis, Stomach Volvulus / diagnosis, Case Reports, Acute Disease, Diagnosis, Differential, Esophageal Atresia / physiopathology, Esophageal Atresia / surgery, Female, Hernia, Hiatal / physiopathology, Hernia, Hiatal / surgery, Humans, Infant, Newborn, Stomach Volvulus / physiopathology, Stomach Volvulus / surgery, Contrast Media, Gastric Volvulus, Intrathoracic

Intrathoracic gastric volvulus in the neonatal period is a rare surgical emergency. Delays in diagnosis and treatment are life-threatening due to progressive deterioration of the gastric walls. Presentation in this period can be confused with the possibility of esophageal atresia or esophageal web. The upper gastrointestinal tract contrast study is diagnostic in this disease. The authors report a case of acute intrathoracic gastric volvulus diagnosis by radiologic-contrast-study in 1-day-old girl that was confirmed at surgery. The physiopathology, classification and different presentations of this entity are briefly reviewed.