OpenMed/multicare-articles huggingface dataset:
Sciatica-like pain caused by cervical spondylotic myelopathy: four case reports and systematic review
Authors: Changsheng Han, Jingming Wang, Lei Wang, Qinglei Gong, Weimin Huang
Journal: Front Med (Lausanne) (2024)
Keywords: case report, cervical spondylotic myelopathy, misdiagnose, sciatica, systematic review
MeSH terms: Case Reports

Objective:
This study aimed to demonstrate and characterize a rare cervical spondylotic myelopathy (CSM) with sciatica-like pain as the main clinical manifestation through case presentation and systematic review.
Methods:
Four cases of CSM with sciatica-like pain as the main clinical manifestation were retrospectively studied. A systematic review of electronic databases such as PubMed, Embase, and Web of Science was conducted to explore the clinical characteristics of CSM with sciatica.
Results:
All four cases of CSM symptomatic of sciatica-like pain were initially diagnosed with lumbar degenerative conditions. However, due to the presence of neurological signs such as hyperactive tendon reflexes, a positive Babinski sign, or a Hoffmann sign, they underwent further cervical MRI scans. Eventually, all four cases were diagnosed with CSM and experienced relief from sciatica after cervical decompression surgery. The systematic review analyzed a total of four studies with a combined sample size of 10 cases, all of whom experienced a reduction in sciatica-like pain following cervical decompression surgery.
Conclusion:
CSM symptomized by sciatica-like pain can often be misdiagnosed as lumbar degenerative disease. Preoperative abnormal neurological signs associated with CSM may aid in diagnosing this condition. In addition, the clinical presentation of hyperextension of the cervical spine resulting in worsening lower limb pain may serve as diagnostic indicators for this disease.
Unilateral alacrimia as a presenting symptom of Meckel's cave tumour
Authors: Ignacio Manuel López Miñarro, Laura Prieto Domínguez, Víctor Manuel Asensio-Sánchez
Journal: GMS Ophthalmol Cases (2024)
Keywords: alacrimia, middle cranial fossa, trigeminal nerve diseases
MeSH terms: Case Reports

Meckel's cave tumour, a rare benign tumour originating from the Schwann cells surrounding the trigeminal nerve within the Meckel's cave region, can present with a variety of clinical manifestations. We report a case of a 44-year-old male patient who presented with symptoms of tear deficiency, including dryness, ocular discomfort, and blurred vision. Diagnostic evaluation revealed the presence of a Meckel's cave tumour harming the trigeminal nerve, leading to alacrimia. This case highlights the association between Meckel's cave tumour and tear deficiency disorders.
Disseminated tuberculosis in a child during the COVID-19 pandemic: a case report and literature review
Authors: Taoping Weng, Yaqiong Dong, Niwen Huang, Chenqu Zhao, Lei Zhang, Shan Cao, Jing Tang, Danni Zhang, Xianming Zhang
Journal: Front Immunol (2023)
Keywords: covid-19, case report, disseminated tuberculosis, immunosuppression, treatment, tuberculosis
MeSH terms: COVID-19, Mycobacterium tuberculosis, Tuberculosis, Pleural, Review, Case Reports, Research Support, Non-U.S. Gov't, Adolescent, Child, Female, Humans, Isoniazid / therapeutic use, Pandemics, Isoniazid

Background:
Disseminated tuberculosis is an uncommon but devastating form of tuberculosis, possibly developing with the immune response of patients. COVID-19 infection may produce an immunosuppressive effect with possible implications for tuberculosis dissemination.
Case presentation:
A 17-year-old female patient with a history of tuberculous pleurisy presented to the hospital with a high fever and life-threatening dyspnea after contracting a COVID-19 infection. Her condition deteriorated rapidly with grand mal epilepsy and acute gastrointestinal bleeding with a grossly depressed CD4 T-cell count, which was indicative of her profoundly immunosuppressed state. After identifying Mycobacterium tuberculosis in her cerebrospinal fluid and a subcutaneous abscess in her left lower back, she was diagnosed with disseminated tuberculosis involving both lungs, the central nervous system, the terminal ileum, the liver, bilateral adnexal tissue, and subcutaneous soft tissue in accordance with the chest and abdominal CT. Empirical treatment was initiated with dexamethasone (5 mg/day) and an anti-tuberculosis regimen of isoniazid, rifampicin, pyrazinamide, amikacin, and meropenem, which was replaced with faropenem after she left the hospital. The therapeutic effect was considered satisfied in the second month of follow-up.
Conclusion:
To the best of our knowledge, we report the first case report of disseminated tuberculosis after COVID-19 infection. Tuberculosis may disseminate and progress during the COVID-19 pandemic, requiring more significant studies to provide better diagnosis and treatment options for the co-infection.
Navigating the complexity of Guillain-Barré syndrome and Miller-Fisher syndrome overlap syndrome: a pediatric case report
Authors: Kamal Chafiq, Youssef Hadzine, Adel Elmekkaoui, Othmane Benlenda, Houssam Rajad, Soukaina Wakrim, Hicham Nassik
Journal: Pan Afr Med J (2024)
Keywords: guillain-barré syndrome, miller-fisher syndrome, case report, overlap syndrome
MeSH terms: Guillain-Barre Syndrome / complications, Guillain-Barre Syndrome / diagnosis, Guillain-Barre Syndrome / physiopathology, Guillain-Barre Syndrome / therapy, Magnetic Resonance Imaging, Miller Fisher Syndrome / diagnosis, Miller Fisher Syndrome / physiopathology, Case Reports, Child, Humans, Immunoglobulins / administration & dosage, Male, Treatment Outcome, Immunoglobulins

Guillain-Barré syndrome/Miller-Fisher syndrome (GBS/MFS) overlap syndrome is an extremely rare variant of Guillain-Barré syndrome (GBS) in which Miller-Fisher syndrome (MFS) coexists with other characteristics of GBS, such as limb weakness, paresthesia, and facial paralysis. We report the clinical case of a 12-year-old patient, with no pathological history, who acutely presents with ophthalmoplegia, areflexia, facial diplegia, and swallowing and phonation disorders, followed by progressive, descending, and symmetrical paresis affecting first the upper limbs and then the lower limbs. An albuminocytological dissociation was found in the cerebrospinal fluid study. Magnetic resonance imaging of the spinal cord showed enhancement and thickening of the cauda equina roots. The patient was treated with immunoglobulins with a favorable clinical outcome.
A Cotton Rope in the Colon: A Rare Cause of Chronic Abdominal Pain
Authors: Imran Ali Syed, Kashif Rafi, Hafiz Muhammad Wasif Khan, Ahmad Karim Malik, Usman Iqbal Aujla
Journal: ACG Case Rep J (2024)
Keywords: abdominal pain, diathermic needle knife, endoscopic innovation, gossypiboma
MeSH terms: Case Reports

Retained surgical sponge is a relatively rare medical condition with potential serious medicolegal implications. The term "gossypiboma" is frequently used to describe this condition. We present a case of a 40-cm-long retained surgical sponge in a 43-year-old woman who presented with unexplained chronic abdominal pain for several years. She had a history of open cholecystectomy, hepaticojejunostomy, and enteroenterostomy. Computed tomography scan revealed a large cotton sponge anchored within the large bowel. Surgical exploration is usually required for the retrieval of gossypiboma. However, it was successfully removed endoscopically using a diathermic needle knife with no immediate complications. The patient was discharged after 48 hours with marked improvement in her abdominal pain. This case emphasizes the emerging role of novel endoscopic interventions, resulting in excellent clinical outcomes, avoiding major surgical interventions, and providing cost-effective benefits.
Catheter-directed thrombolysis guided by pulmonary artery pressure registration in pulmonary embolism: a case report
Authors: Ehssan Berenjkoub, Charlotte Kemper, Nicole Lewandowski, Marc Horlitz, Dennis Rottländer
Journal: Eur Heart J Case Rep (2024)
Keywords: case report, pulmonary artery pressure, pulmonary embolism, ultrasound-assisted catheter-directed thrombolysis
MeSH terms: Case Reports

Background:
Duration and dosage of thrombolysis for ultrasound-assisted catheter-directed thrombolysis (UACDT) in patients with intermediate high-risk pulmonary embolism remain controversial and treatment protocols vary.
Case summary:
A 58-year-old female patient suffered from a right-sided urolithiasis. The clinical course was complicated by an intermediate high-risk pulmonary embolism [pulmonary embolism severity index (PESI) score 108 points and simplified PESI ≥1] with bilateral proximal thrombus and significant right heart dysfunction. The pulmonary embolism response team (PERT) made a decision towards UACDT. The standard duration of UACDT ranges between 6 and 15 h depending on clinical parameters. In this particular case, the clinical parameters such as heart rate (no tachycardia) or oxygen saturation (chronic obstructive pulmonary disease) might lead to premature termination of UACDT. Therefore, PERT decided to additionally monitor pulmonary artery pressure (PAP) continuously during the UACDT via a separate pigtail catheter in the pulmonary artery. Ultrasound-assisted catheter-directed thrombolysis was performed using 1 mg/h recombinant tissue plasminogen activator (rtPA) per catheter, while PAP was registered continuously. Heart rate and oxygen saturation remained unchanged during UACDT. However, after 6 h of UACDT, systolic PAP decreased slightly from 62 to 55 mmHg and therapy was prolonged to 15 h. Pulmonary artery pressure dropped to 46 mmHg after 15 h. The patient was discharged from hospital at Day 7, and echocardiography revealed no signs of right heart dysfunction.
Discussion:
Dosage of the thrombolysis agent and duration of UACDT are still a matter of debate. Besides clinical parameters and transthoracic echocardiography, invasive real-time PAP monitoring during UACDT could facilitate important information for therapy guidance in selected cases.
Emergency Surgical Treatment of a Large Pedunculated Subserosal Uterine Leiomyoma With Torsion: A Rare Cause of Acute Abdomen
Authors: Anna Thanasa, Efthymia Thanasa, Vasiliki Grapsidi, Ioannis Paraoulakis, Ioannis Thanasas
Journal: Cureus (2024)
Keywords: abdominal pain, case report, emergency surgical treatment, pedunculated subserosal leiomyoma, preoperative diagnosis, torsion
MeSH terms: Case Reports

Torsion of pedunculated subserosal leiomyoma of the uterus is a rare cause of acute abdomen. A 27-year-old female patient with twisted subserosal pedunculated uterine leiomyoma misdiagnosed as an adnexal mass underwent laparotomy. The patient came to the Emergency Department of General Hospital of Trikala with symptoms of acute abdomen. Primarily, clinical-laboratory examination, transabdominal ultrasound, raised the suspicion of a twisted adnexal mass. Intraoperatively, a twisted pedunculated subserosal leiomyoma of the uterus was identified and myomectomy was performed. Histological examination of the surgical specimen confirmed the diagnosis. On the third postoperative day, our patient was discharged. This paper underscores the rarity of torsion of the uterine pedunculated subserosal leiomyoma and emphasizes the necessity of urgent surgical intervention. The challenges of preoperative diagnosis are highlighted, especially when modern diagnostic imaging modalities are unavailable.
Delta-8 gummies causing visual snow: a case report
Authors: Michael S Vaphiades
Journal: Front Ophthalmol (Lausanne) (2024)
Keywords: delta-8 gummies, delta-8 tetrahydrocannabinol, hallucinogen persisting perception disorder (hppd), visual snow (vs), visual snow syndrome (vss)
MeSH terms: Review

A 26-year-old man developed visual snow syndrome (VSS) after consuming a little less than half of a delta-8 gummy (estimated at 4 mg of delta-8 tetrahydrocannabinol). Secondary VSS and hallucinogen-persisting perception disorder (HPPD) are discussed, and clinicians who evaluate patients with VS and VSS should ask about delta-8 gummies as an etiology of secondary VSS.
Contrast-enhanced ultrasound evaluation of primary renal squamous cell carcinoma: a case report
Authors: Yuhao Jia, Qunxia Zhang
Journal: Front Oncol (2023)
Keywords: contrast-enhanced ultrasound (ceus), diagnosis, imaging, renal, squamous cell carcinoma
MeSH terms: Case Reports

Renal squamous cell carcinoma (RSCC) is very rare, and there are few reports about it so far. Here we report a unique case of renal squamous cell carcinoma examined by contrast-enhanced ultrasound(CEUS), which has never been reported before. In addition, the results of CEUS showed some unique features, different from other imaging examinations. The purpose of this case report is to clarify the CEUS findings of this case and analyze its potential value in early diagnosis of RSCC.
Pattern transitions in diary data of MDD patients: a mixed-methods multiple case study of psychotherapy dynamics
Authors: Sontje Nordholt, Philipp Garrison, Wolfgang Aichhorn, Matthias Ochs, Günter Schiepek
Journal: Front Psychol (2024)
Keywords: change dynamics in psychotherapy, diary texts, mixed grounded theory, mixed-methods approach, pattern transitions, process monitoring

Aim:
Mixed-methods approaches promise a deep understanding of psychotherapeutic processes. This study uses qualitative and quantitative data from daily diary entries and daily self-assessments during inpatient treatment. The aim of the study is to get an insight into the similarities and differences between both types of data and how they represent self-organized pattern transitions in psychotherapy. While a complete correlation of results is not expected, we anticipate observing amplifying and subsidiary patterns from both perspectives.
Materials and methods:
Daily, five MDD patients wrote diaries and completed self-assessments using the Therapy Process Questionnaire, a questionnaire for monitoring the change dynamics of psychotherapy. The data were collected using the Synergetic Navigation System, an online tool for real-time monitoring. Diary entries of the patients described their experiences in everyday life. The qualitative text analysis was conducted using Mixed Grounded Theory, which provided categories representing the patients' ongoing experiences of transformation and stagnation. The time series data was analyzed using the dynamic complexity algorithm and the pattern transition detection algorithm. Results from qualitative and quantitative analyses were combined and compared. Following the process of data triangulation, the leading perspective came from the theory of self-organization. In addition to presenting the overall results for all five patients, we delve into two specific case examples in greater detail.
Results:
Specific and highly diversified diary entries of 5 patients were classified into the categories of perceived pattern stability, noticing improvement, broadening the perspective, critical instability, and experiencing moments of Kairos. Patients reported problems not only related to their disorder (e.g., lack of energy and hopelessness) but also to phases and steps of change, which could be related to the theory of self-organization (e.g., problem attractors, critical fluctuations, pattern transitions, and Kairos). Qualitative and quantitative analysis provide important supplementary results without being redundant or identical.
Conclusion:
Data triangulation allows for a comprehensive and multi-perspective understanding of therapeutic change dynamics. The different topics expressed in the diary entries especially help to follow micro-psychological processes, which are far from being a simple reaction to interventions. The way patients experience themselves being in stability or instability and stagnation or transformation is surprisingly close to the general features of self-organizing processes in complex systems.
Case Report: Abruptio placentae and epileptic seizure after occurrence of perinatal hyperglycaemia in woman with gestational diabetes mellitus and hypertriglyceridemia-induced acute pancreatitis
Authors: Yanlang He, Zhijie Huang, Changli Wei, Jianyong Chen
Journal: Front Endocrinol (Lausanne) (2023)
Keywords: abruptio placentae, epileptic seizure, gestational diabetes mellitus, hyperglycaemia, hypertriglyceridemia-induced
MeSH terms: Abruptio Placentae / etiology, Diabetes, Gestational, Epilepsy / complications, Hyperglycemia / complications, Hypertriglyceridemia / complications, Pancreatitis / complications, Case Reports, Research Support, Non-U.S. Gov't, Acute Disease, Female, Humans, Insulin, Pregnancy, Seizures, Insulin

Hypertriglyceridemia-induced acute pancreatitis seldom occurs in the second trimester of pregnancy with gestational diabetes mellitus. For these patients, the existing knowledge on concomitant hyperglycemia is not sufficient. We report a case of abruptio placentae and epileptic seizure following perinatal hyperglycaemia in woman with gestational diabetes mellitus and hypertriglyceridemia-induced acute pancreatitis. The occurrence of abruptio placentae and epileptic seizure may be associated with concomitant hyperglycemia, and the epileptic seizure was terminated after she underwent treatment with insulin. We should pay more attention to the adverse effects of perinatal hyperglycemia and continue to give appropriate insulin treatment even if patients have passed the acute phase of hypertriglyceridemia-induced acute pancreatitis.
Isolated cryptococcal osteomyelitis in the setting of immune reconstitution inflammatory syndrome
Authors: Pamela Horton Embrey, Alexandra Long, Rasha Alfattal, Suimin Qiu, Joseph Patrik Hornak
Journal: Ther Adv Infect Dis (2024)
Keywords: cryptococcus, hiv/aids, case report, fluconazole, immune reconstitution inflammatory syndrome
MeSH terms: Case Reports

Cryptococcal infections, though rare, must be considered in all immunocompromised patients. Patients with HIV/AIDS on antiretrovirals may have a treatment course complicated by immune reconstitution inflammatory syndrome. Here we present a case of a 38-year-old woman with HIV/AIDS with knee pain who only began to experience severe pain after induction of antiretroviral therapy. She was found to have cryptococcal osteomyelitis without dissemination to the central nervous system, an unusual presentation for immunocompromised patients. She was treated with oral fluconazole with a resolution of symptoms. This case report suggests conservative management of isolated cryptococcal infection with fluconazole, regardless of immune status.
Case report: a missed case of chronic Q fever infective endocarditis demonstrating the ongoing diagnostic challenges
Authors: Victoria Grey, Peter Simos, Naomi Runnegar, Jared Eisemann
Journal: Access Microbiol (2023)
Keywords: q fever, dual pathology, infective endocarditis
MeSH terms: Case Reports

Diagnosis of chronic Q fever is often difficult for clinicians, particularly in the presence of a second pathology. In addition to the chronic constitutional symptoms, the most common manifestations of chronic Q fever include infective endocarditis and endovascular infection. We describe a case of prosthetic valve infective endocarditis caused by both Streptococcus sanguinis and Coxiella burnetti on a background of a previous aortic graft and bioprosthetic aortic valve replacement 2 years earlier. The diagnosis of chronic Q fever infective endocarditis was delayed because the significance of the abnormal valve histology from the patient's previous surgery was initially overlooked. It was only after the patient had relapsed on appropriate therapy for the S. sanguinis prosthetic valve endocarditis that a subsequent review of the operative valve histology, along with the patient's epidemiological risk factors, led to consideration of an additional culture-negative cause for infective endocarditis. Histological examination of the valve tissue had shown exophytic fibrin vegetations and acute inflammation. Further clinical assessment revealed previous exposure to Q fever and C. burnetti DNA was detected via polymerase chain reaction on the valve tissue. Q fever infective endocarditis must be considered if valves are inflamed or have vegetations with a subsequent negative culture. It should also still be considered in the presence of an alternative bacteraemia if the patient has risk factors for exposure.
One-Stage Approach to Rehabilitate a Hopeless Tooth in the Maxilla by Means of Immediate Dentoalveolar Restoration: Surgical and Prosthetic Considerations
Authors: Gabriel Mulinari-Santos, Fabio Luiz Ferreira Scannavino, Erica Dorigatti de Avila, Luiz Antonio Borelli Barros-Filho, Leticia Helena Theodoro, Luiz Antonio Borelli Barros, Rafael Scaf de Molon
Journal: Case Rep Dent (2024)
MeSH terms: Case Reports

Contemporary dentistry has increased the demand for predictable functional and esthetic results in a short period of time without compromising the long-term success of rehabilitation. Recent advances in surgical techniques have provided alternatives that allow the prosthetic rehabilitation of complex implant-supported cases through minimally invasive techniques. In this context, immediate dentoalveolar restoration (IDR) was described aiming at restoring function and esthetics through the reconstruction of lost periodontal tissues followed by immediate implant placement in order to minimize treatment time and surgical morbidity in a one-stage approach. Therefore, the aim of this clinical case is to describe the reconstruction and rehabilitation of a hopeless tooth in the maxillary region in a one-stage approach by means of IDR. The proposed steps to rehabilitate the case involved atraumatic dental extraction, immediate implant placement, and hard tissue augmentation by means of cortical-medullary bone graft harvested from the maxillary tuberosity. Afterwards, a provisional restoration was manufactured and installed to the implant allowing immediate prosthesis provisionalization and function in the same operatory time. Six months after the surgical procedure, the final prosthesis was manufactured and installed. The follow-up of nine years demonstrated the preservation of hard and soft tissue without tissue alteration and a successful esthetic outcome. The surgical protocol used allowed the ideal three-dimensional placement of the implant with the restoration of the bone buccal wall, favoring the esthetic and functional outcome of the case with harmony between white and pink esthetics. In conclusion, the employed treatment validated immediate implant-supported restoration of the missing tooth with high predictability. Furthermore, this protocol resulted in fewer surgical interventions, regeneration, and preservation of peri-implant tissues reaching the patient's expectations.
Interprofessional approach to fall prevention in hospital care
Authors: Anna Carolina da Silva Albertini, Marina Peduzzi
Journal: Rev Esc Enferm USP (2024)
MeSH terms: Accidental Falls / prevention & control, Hospitalization, Humans, Interprofessional Relations, Patient Care Team / organization & administration

Objective:
To understand the perception and experience of health professionals regarding fall prevention practices in hospital inpatient units.
Method:
This is a qualitative exploratory and descriptive case study based on the Canadian framework of interprofessional competences. Data was collected from two focus groups, with different health professionals in each group, and thematic content analysis was used.
Results:
Five categories were drawn up which showed intense convergence between the participants of the two focus groups, within the context of fall prevention practices: communication between professionals and patients/carers for fall prevention, interprofessional communication for fall prevention, clarification of roles for fall prevention, health education about risk and fall prevention and continuing education for fall prevention.
Conclusion:
Teamwork and collaborative practice are important for achieving good results in the prevention of falls in hospital care, but for this to happen, health professionals need to acquire the necessary competences for collaborative action.