OpenMed/multicare-articles huggingface dataset:
Navigating in the Gray Area of Coach-Athlete Relationships in Sports: Toward an In-depth Analysis of the Dynamics of Athlete Maltreatment Experiences
Authors: Élise Marsollier, Denis Hauw
Journal: Front Psychol (2022)
Keywords: athlete lack of power, enaction, maltreatment acceptance, maltreatment rejection, sports situation

Several studies have revealed the abusive behaviors directed against athletes in various sports contexts, but knowledge about the processes by which the athletes realize and accept or reject maltreatment is underdeveloped. Thus, it is difficult to establish a solid scientific basis for characterizing the mechanisms of maltreatment from the athletes' perspective regarding the forms of maltreatment they endure and the impact on their performance and wellbeing. The main goals of this paper are to show how the enactive approach (including theoretical assumptions and methodological standards) can meet these challenges, as it is well-suited to (a) describe the evolving interactions between athletes and the sports situations that lead to maltreatment (i.e., navigating in the gray area of coach-athlete relationships), (b) identify those alert landmarks that help us assess the level of risk of athlete maltreatment, and (c) provide concrete guidelines to prevent and deal with sports-related maltreatment. We illustrate our approach by a case study that examines the experience of a retired high-level boxer who faced several forms of maltreatment. Our results reveal a dynamic change in the interactions between the boxer and the maltreatment situations that led her through (a) Acceptance (i.e., future-oriented positive involvement), (b) Regulation attempt (i.e., negative feelings about weight loss, exhaustion and loneliness, questioning the compromise between performance and health, acceptance and loneliness), (c) Distancing (i.e., reopening to others) and (d) Rejection (i.e., rebellion and the decision to stand up to her coach and leave). Based on our results, we present concrete guidelines to prevent and address sports-related maltreatment, with four progressive alert landmarks that help situate the athlete in the gray area of coach-athlete relationships and suggest a "timeline" of maltreatment escalation with key warnings.
Case Report: Histiocytic Necrotizing Lymphadenitis (Kikuchi-Fujimoto Disease) Concurrent With Aseptic Meningitis
Authors: Yanna Song, Shan Liu, Lei Song, Huaqiu Chen, Miaoshui Bai, Jinhua Yan, Tianfei Luo, Kangding Liu, Li Sun, Yang Zhao
Journal: Front Neurol (2021)
Keywords: kikuchi-fujimoto disease, aseptic meningitis, case report, histiocytic necrotizing lymphadenitis, lymphadenopathy
MeSH terms: Case Reports

Kikuchi-Fujimoto disease (KFD), also known as histiocytic necrotizing lymphadenitis, is a rare, benign, self-limiting disease characterized by local lymphadenopathy. Central nervous system involvement in KFD is extremely rare and remains a diagnostic challenge. Only 41 cases of aseptic meningitis associated with KFD have been reported worldwide, with just four cases (including our case) of KFD with meningitis as the first symptom. We report a case of KFD accompanied by aseptic meningitis with severely high intracranial pressure (400 mmH2O), increased white blood cell count (56 × 106/L), and moderately elevated protein level (0.52 g/L). This case is unique in the delayed appearance of lymphadenopathy. After 1 month of treatment with steroids, fever, headache, and lymphadenopathy gradually disappeared, and the result of cerebrospinal fluid examination gradually became normal. In conclusion, based on our case findings and our literature review on KFD with aseptic meningitis, a diagnosis of KFD should be considered when delayed appearance of lymphadenopathy is observed in patients with aseptic meningitis.
Continuous Visual Focal Status Epilepticus as the Primary Presentation of NMDA-R and GAD65-R Autoimmune Epilepsy
Authors: Elma M Paredes-Aragón, Héctor E Valdéz-Ruvalcaba, Andrea Santos-Peyret, Marcela Cisneros-Otero, Raúl Medina-Rioja, Sandra Orozco-Suárez, Miriam M Hernandez, Michele D L Breda-Yepes, Verónica Rivas-Alonso, José J Flores-Rivera, Iris E Martínez-Juárez
Journal: Front Neurol (2020)
Keywords: gad65-receptor antibodies, nmda-receptor antibodies, aura continua, autoimmune epilepsy, epilepsia partialis continua, epilepsy
MeSH terms: Case Reports

Epilepsia partialis continua (EPC) has changed in its clinical and pathophysiological definition throughout time. Several etiologies have been described in addition to classic causes of EPC. The following case depicts a young woman who had a peculiar onset of epilepsy with a continuous visual aura becoming a form of chronic recurrent and non-progressive EPC. The patient was initially misdiagnosed as a non-neurological entity (assumed psychiatric in origin), but finally, an immune-mediated epilepsy was diagnosed, and EEG showed focal status epilepticus during evolution. Once the diagnosis was achieved and immune treatment was established, the patient is seizure free. Early identification of an immune basis in patients with epilepsy is important because immunotherapy can reverse the epileptogenic process and reduce the risk of chronic epilepsy. To date, this is the only case reported with EPC manifesting as a continuous visual aura associated with antiglutamic acid decarboxylase 65 (anti-GAD65) and anti-N-methyl-d-aspartate (anti-NMDA) antibodies.
Case Report of Three Immature Cystic Teratomas in Northern Ghana
Authors: E M Der, S Seidu
Journal: Case Rep Obstet Gynecol (2019)
MeSH terms: Case Reports

Background:
Preoperative diagnosis of immature cystic teratoma can be challenging for clinicians. In this report, we present three cases.
Methods:
We describe three women aged 10, 20, and 23 years, respectively, who presented with abdominal masses which were diagnosed by abdominal ultrasound as mature cystic teratomas. All women had emergency laparotomy and oophorectomy.
Results:
Histopathological examination reported these ovarian tumours to be immature cystic teratomas. This case report also provided a brief summary of the clinicopathological features of all ovarian teratomas diagnosed in two centres during the period of review.
Conclusion:
Immature ovarian teratoma affects primarily younger patients; it is important for clinicians to have a high sense of suspicion whenever the diagnosis of a germ cell tumour is entertained.
A Case of Eating Disorder Diagnosed As Orthorexia Nervosa
Authors: Ai Yoshimura, Yoshiki Kusama, Yuka Omura, Mariko Shibata, Toshiro Maihara
Journal: Cureus (2023)
Keywords: anorexia nervosa (an), covid-19, dsm-ⅴ, eating disorder, orthorexia nervosa
MeSH terms: Case Reports

A 13-year-old girl presented to our hospital with chief complaints of rapid weight loss, fatigue, discomfort, chills in the extremities, and alopecia. We initially suspected anorexia nervosa (AN). However, she did not express fear of gaining weight or have a distorted perception of her weight or body shape; thus, her presentation was not typical of AN. We also suspected avoidant/restrictive food intake disorder (ARFID), but she did not exhibit any food-avoidance behaviors. However, she was obsessed with nutrition control, so we diagnosed her with orthorexia nervosa (ON). She was hospitalized, given education on proper nutrition, and her eating behavior subsequently improved. After discharge, we administered the ORTO-15, which assesses the propensity for ON, and her score met the diagnostic criteria for ON. The incidence of ON has increased during the COVID-19 pandemic. In this case, her obsession was brought about by information she read in magazines and on social media that promoted an unbalanced diet centered almost exclusively on vegetables. Pediatricians should raise awareness of misinformation regarding children's health to ensure healthy growth.
Exceptional Extension of Benign Angiomyolipoma in the Renal Vein
Authors: Darius Lepot, Patrick Mailleux, Stéphane B Van den Broeck
Journal: J Belg Soc Radiol (2022)
Keywords: abdominal imaging, angiomyolipoma, renal neoplasm, renal vein extension, unenhanced ct
MeSH terms: Case Reports

Teaching Point: When a renal angiomyolipoma (AML) is incidentally detected on imaging, the venous system should be assessed for intravascular fat component.
The Forgotten Disease: A Case of Lemierre's Syndrome with Distal Extremity Involvement
Authors: John Gaskill, Michael Aronson
Journal: Case Rep Infect Dis (2020)
MeSH terms: Case Reports

Once coined the "Forgotten Disease," Lemierre's syndrome is a rare condition that results from oropharyngeal infection with the gram-negative, anaerobic Fusobacterium necrophorum. The typical progression of illness involves spread to adjacent structures such as the internal jugular vein with resulting thrombophlebitis. Septic emboli to distant sites are also a common sequela. Here, we present a case of Lemierre's syndrome in a 20-year-old, otherwise healthy, male. The patient presented with fever, sore throat, and dysphagia. Imaging revealed peritonsillar multiloculated fluid collections and necrotizing pneumonia with multiple pulmonary abscesses. The patient's hospital course was complicated by the development of necrotizing fasciitis in his right lower leg, which required incision and drainage with surgical washout. In addition to systemic intravenous antibiotics and anticoagulation, he underwent multiple thoracentesis procedures. The patient was ultimately transferred to a tertiary care center due to persistent fevers and lung abscesses. This case highlights the challenges of initial diagnosis, as well as the treatment choices faced by the attending physicians.
Successful treatment of arrhythmia-induced cardiomyopathy in an infant with tuberous sclerosis complex
Authors: Noriko Motoki, Yuji Inaba, Satoshi Matsuzaki, Yohei Akazawa, Takafumi Nishimura, Tetsuhiro Fukuyama, Kenichi Koike
Journal: BMC Pediatr (2016)
MeSH terms: Adrenergic beta-Antagonists / therapeutic use, Arrhythmias, Cardiac / etiology, Carbazoles / therapeutic use, Cardiomyopathy, Dilated / drug therapy, Propanolamines / therapeutic use, Tuberous Sclerosis / complications, Case Reports, Arrhythmias, Cardiac / diagnosis, Cardiomyopathy, Dilated / diagnosis, Cardiomyopathy, Dilated / etiology, Carvedilol, Humans, Infant, Male, Adrenergic beta-Antagonists, Carbazoles, Propanolamines, Carvedilol

Background:
Tuberous sclerosis complex (TSC) is an autosomal-dominant tumor suppressor gene syndrome that is characterized by the development of distinctive benign tumors and malformations in multiple organ systems (N Eng J Med 355:1345-1356, 2006). Cardiac rhabdomyomas are intracavitary or intramural tumors observed in 50-70 % of infants with TSC but only cause serious clinical problems in a very small fraction of these patients (N Eng J Med 355:1345-1356, 2006; Pediatrics 118:1146-1151, 2006; Eur J Pediatr 153:155-7, 1994); most individuals have no clinical symptoms and their tumors spontaneously regress. However, despite being clinically silent, these lesions can provoke arrhythmias and heart failure (Pediatrics 118:1146-1151, 2006; Eur J Pediatr 153:155-7, 1994).
Case presentation:
We here report the clinical findings of an infant suffering from TSC complicated with dilated cardiomyopathy (DCM) after the regression of cardiac rhabdomyomas. Although his tumors improved spontaneously, tachycardia and irregular heart rate due to frequent premature ventricular and supraventricular contractions persisted from the newborn period and were refractory to several medications. His cardiomyopathy was suspected to have been induced by the tachycardia or arrhythmia. We found carvedilol therapy to be safe and highly effective in treating the cardiomyopathy. To our knowledge, this is the first case report of TSC with DCM after regression of cardiac tumors and its successful treatment.
Conclusion:
The patient's clinical course suggests that careful life-long disease management is important, even in TSC patients without apparent symptoms.
A case of an AIDS patient with Cryptococcus neoformans infection
Authors: Bramantono Bramantono, Ahmad Danial, Usman Hadi
Journal: Pan Afr Med J (2020)
Keywords: cryptococcus neoformans, hiv/aids, opportunistic infection
MeSH terms: AIDS-Related Opportunistic Infections / diagnosis, Antifungal Agents / administration & dosage, Cryptococcosis / diagnosis, HIV Infections / complications, Case Reports, AIDS-Related Opportunistic Infections / drug therapy, AIDS-Related Opportunistic Infections / microbiology, Adult, Anti-HIV Agents / administration & dosage, Cryptococcosis / drug therapy, HIV Infections / drug therapy, Humans, Male, Anti-HIV Agents, Antifungal Agents

Cryptococcosis is the most common fungal disease in HIV-infected persons. It is known as the AIDS-defining illness for 60-70% of HIV-infected patients. Before antiretroviral therapy (ARV) was discovered, fungal and other opportunistic infections were a major problem for people with advanced HIV/AIDS. Presented here is a case of a 43-year-old man who was newly diagnosed HIV, in which he was admitted due to shortness of breath and decreased consciousness. His clinical symptoms, physical examination, laboratory and radiologic findings indicated a Cryptococcus neoformans infection. The patient had received treatment using anti-fungal and ARV that showed a clinical improvement during observation.
Challenging Obstetrical Management in Generalized Peritonitis during Pregnancy
Authors: Susana Patrícia Lima Oliveira, Ana Isabel Sousa, Nuno Nogueira Martins
Journal: Case Rep Obstet Gynecol (2022)
MeSH terms: Case Reports

Acute abdomen in pregnancy represents a diagnostic and therapeutic challenge, despite the current advances in modern medicine, since the typical symptoms and altered laboratory parameters mimic normal pregnancy. Acute appendicitis is the most common nonobstetric surgical emergency during pregnancy, with an incidence of 1 per 500-2000 pregnancies. Delayed diagnosis and reluctance to operate on a pregnant woman predispose to adverse maternal and fetal outcomes. The elective termination of pregnancy or interventions to prolong it in the presence of appendicitis is controversial. We present a case of a 38-year-old Caucasian woman, G2P0, admitted to the Obstetric Emergency Department at 13 4/7 weeks of gestation with a primary complaint of severe nausea and vomiting associated with progressive diffuse abdominal pain which had started 7 days before. After the difficulty of inherent differential diagnosis, she was diagnosed with generalized peritonitis due to acute perforated appendicitis. Prompt exploratory laparotomy with appendectomy and drainage of multiple abscesses were performed. Conservative obstetrical management was assumed, with subsequent periodic monitoring of the fetal focus. Due to abdominal compartment syndrome, the abdomen was left open for 4 days. After 7 days in the intensive care unit, recovery was favorable, pregnancy remained uneventful, and a healthy full-term baby was born 27 weeks later. This case represents a successful example of how the cooperation of the obstetrics and general surgery teams and the decision of conservative obstetrical management in the surgical environment contributed to optimizing maternal health, achieving the best obstetrical outcome.
Nuss Procedure for a Patient with Negative Haller Index
Authors: Mariela Dore, Paloma Triana Junco, Carlos De La Torre, Alejandra Vilanova-Sánchez, Monserrat Bret, Gaspar Gonzalez, Vanesa Nuñez Cerezo, Javier Jimenez Gomez, Jose Luis Encinas, Francisco Hernandez, Leopoldo Martínez Martínez, Manuel Lopez Santamaria
Journal: European J Pediatr Surg Rep (2018)
Keywords: haller index, mirpe, nuss, children, pectus excavatum
MeSH terms: Case Reports

Introduction Minimally invasive repair for pectus excavatum (MIRPE) is controversial in extremely severe cases of pectus excavatum (PE) and an open repair is usually favored. Our aim is to describe a case of a patient with an extremely severe PE that underwent a minimally invasive approach. Case report An 8-year-old girl with severe sternum depression was assessed. She had a history of exercise intolerance, nocturnal dyspnea, fatigue, and shortness of breath. Chest computed tomography showed that sternum depression was posterior to the anterior vertebral column; therefore, Haller and correction index could not be measured. Spirometry indicated an obstructive ventilation pattern (forced expiratory volume in 1 second = 74.4%), and echocardiogram revealed a dilated inferior vena cava, mitral valve prolapse with normal ventricular function. After multidisciplinary committee evaluation, a MIRPE approach was performed. All symptoms had disappeared at the 3-month postoperative follow-up; the desired sternum shape was achieved and normalization of cardiopulmonary function was observed. The Nuss bars were removed after a 2-year period. After 18-month follow-up, the patient can carry out normal exercise and is content with the cosmetic result. Conclusion Nuss procedure is feasible in our 8-year-old patient. In this case, both the Haller and correction index were not useful to assess the severity of PE. Therefore, under these circumstances, other radiologic parameters have to be taken into consideration for patient evaluation.
Protracted Clonal Trajectory of a JAK2 V617F-Positive Myeloproliferative Neoplasm Developing during Long-Term Remission from Acute Myeloid Leukemia
Authors: Stephen E Langabeer, Karl Haslam, Maria Anne Smyth, John Quinn, Philip T Murphy
Journal: Case Rep Hematol (2018)
MeSH terms: Case Reports

Although transformation of the myeloproliferative neoplasms (MPNs) to acute myeloid leukemia (AML) is well documented, development of an MPN in patients previously treated for, and in remission from, AML is exceedingly rare. A case is described in which a patient was successfully treated for AML and in whom a JAK2 V617F-positive MPN was diagnosed after seven years in remission. Retrospective evaluation of the JAK2 V617F detected a low allele burden at AML diagnosis and following one course of induction chemotherapy. This putative chemoresistant clone subsequently expanded over the intervening seven years, resulting in a hematologically overt MPN. As AML relapse has not occurred, the MPN may have arose in a separate initiating cell from that of the AML. Alternatively, both malignancies possibly evolved from a common precursor defined by a predisposition mutation with divergent evolution into MPN through acquisition of the JAK2 V617F and AML through acquisition of different mutations. This case emphasizes the protracted time frame from acquisition of a disease-driving mutation to overt MPN and further underscores the clonal complexity in MPN evolution.
Hemagophagocytic lymphohistiocytosis associated with recurrent Babesiosis with Lyme disease co-infection in an immunocompromised host on anti-CD20 monoclonal antibody therapy: A case report
Authors: Aleena Zahra, Luis A Marcos
Journal: IDCases (2022)
Keywords: babesiosis, hemagophagocytic lymphohistiocytosis, infectious complication with anti-cd20 antibody therapy, lyme and babesiosis co-infection, tick-borne disease
MeSH terms: Case Reports

In the Northeastern United States, a nationally notifiable emerging infectious disease caused by a protozoan infecting erythrocytes is endemic. Transmitted by a deer tick, Ixodes scapularis, this protozoan, Babesia microti, has a complex life cycle including multiple mammalian hosts with humans affected as a dead end reservoir. Although humans are not necessary for the survival of this protozoan, if human erythrocytes are infected by it, especially in a host that is immunocompromised, devastating clinical illness with a significant risk of mortality occurs. Erythrocytic infection of the human host causes many pathogenic changes within the human body, leading to red blood cell destruction and release of pro inflammatory cytokines (3). This pro-inflammatory cascade can very rarely lead to a cycle of further erythrocytic destruction through development of a rare syndrome with high mortality, hemagophagocytic lymphohistocytosis (HLH), which requires early recognition and diagnosis for treatment. This case discusses infection in an immunocompromised host with Babesiosis with complications of HLH and co-infection with Lyme disease requiring multiple diagnostic and therapeutic decisions.
Intravitreal Ranibizumab for Stage IV Proliferative Sickle Cell Retinopathy: A First Case Report
Authors: Panagiotis G Mitropoulos, Irini P Chatziralli, Efstratios A Parikakis, Vasileios G Peponis, Georgios A Amariotakis, Marilita M Moschos
Journal: Case Rep Ophthalmol Med (2014)

Purpose. To present the case of a 27-year-old male patient with stage IV proliferative sickle cell retinopathy, treated with one intravitreal injection of ranibizumab, showing regression of the neovascularization and no recurrence at the 9-month follow-up. Methods. A 27-year-old male patient presented with blurred vision and floaters in the right eye since three days. His best corrected visual acuity was 6/18. Ophthalmological examination and fluorescein angiography revealed proliferative sickle cell retinopathy stage IV with vitreous hemorrhage and sea fan neovascularization, as well as ischemic areas at the temporal periphery. Results. The patient was treated with one intravitreal injection of ranibizumab, presenting improvement in the visual acuity from 6/18 to 6/6, resolution of vitreous hemorrhage, and regression of the neovascularization. Additionally, he underwent scatter laser photocoagulation at the ischemic areas. At the 9-month follow-up there was no recurrence, while no adverse effects were noticed. Conclusions. Intravitreal ranibizumab may be a useful adjunct to laser photocoagulation in the management of proliferative sickle cell retinopathy and may permit some patients to avoid pars plana vitrectomy for vitreous hemorrhage.
Henoch-Schönlein Nephritis Manifesting with Purpura 15 years after Diagnosis of IgA Nephropathy
Authors: Hideaki Yamabe, Mitsuaki Kaizuka, Satoru Tsunoda, Tasuku Nagasawa, Kazuo Nomura, Michiko Shimada
Journal: Case Rep Nephrol (2019)
MeSH terms: Case Reports

Henoch-Schönlein nephritis or immunoglobulin A (IgA) vasculitis is characterized by purpura, arthralgia, abdominal pain, and glomerulonephritis with glomerular IgA deposition. Notably, the presence of purpura is essential to diagnose this disease. We report the case of a patient in whom proteinuria and haematuria were detected during screening tests and he was diagnosed with IgA nephropathy at 20 years of age. Corticosteroids were administered for 7 years and were subsequently tapered. At 35 years of age, he noticed purpura on his lower extremities and was diagnosed with anaphylactoid purpura. Following the appearance of purpura, urinalysis revealed an increase in urinary protein levels from 0.7 g/g creatinine (Cr) to 1.4 g/gCr, and his serum Cr levels increased from 1.1 mg/dL to 1.35 mg/dL. Two months later purpura subsided, and his urinary protein level and serum Cr level were restored to the former levels. Although the cause remains unknown, an interval may occasionally be observed between the appearance of purpura and urinary abnormalities. However, to our knowledge to date, a 15-year interval is the longest interval, in such cases, reported in the literature.