OpenMed/multicare-articles huggingface dataset:
Case report: Steroid-responsive acute chorea as first presentation of the coexistence of Moyamoya and Graves' disease
Authors: Wei-Sheng Wang, Shey-Lin Wu, Wei-Chieh Chan, Yen-Chung Chen
Journal: Front Neurol (2023)
Keywords: graves' disease, moyamoya disease, cerebral perfusion scan, chorea, hyperthyroidism
MeSH terms: Case Reports

Background:
Chorea is a movement disorder characterized by abrupt, rapid, and uncontrollable, random movements from one part of the body to another with motor impersistence. Sporadic chorea is rarely caused by either thyrotoxicosis or Moyamoya disease (MMD).
Methods and results:
In this case report, we describe a female patient with chorea with the rare coexistence of Graves' disease and Moyamoya disease. Tc-99m ethyl cysteinate dimer (ECD) brain perfusion single-photon emission computed tomography (SPECT) showed mild to moderate hypoperfusion in bilateral frontal and left temporal regions. After administering dexamethasone 20 mg for 5 days, her choreic movement symptoms recovered rapidly.
Conclusion:
Although uncommon, thyrotoxicosis and Moyamoya disease can co-occur, especially in Asian female adults. Excessive thyroid hormones contribute to the dysregulation of neurotransmitters in basal ganglia-thalamocortical circuits. Moyamoya disease is responsible for ischemic changes affecting the excitatory-inhibitory circuits between the basal ganglia and the neocortex. Under a state of coexistence, thyrotoxicosis exaggerates cerebral metabolism, aggravating the impaired cerebral perfusion induced by Moyamoya disease. Moreover, inflammatory reactions caused by thyroid autoantibodies may also promote the progression of Moyamoya disease. In our experience, treatment with steroids may not only synergize the anti-thyroid effect but may also be a way to modulate the neurotransmitters within the basal ganglia or restore cerebral perfusion. We suggest that evaluation of the thyroid function status in Moyamoya disease is essential.
Unique Findings and Novel Treatment Strategy of a Giant Coronary Artery Aneurysm Associated with a Significant Pericardial Effusion
Authors: Osayi Lawani, Rick Ganim
Journal: Case Rep Cardiol (2020)
MeSH terms: Case Reports

Giant coronary artery aneurysms are a rare, asymptomatic occurrence. Presently, there is a lack of substantial research performed in the U.S., likely due to its low prevalence. As we are increasingly becoming a global community, strengthening data for seemingly rare disease processes such as this need to be addressed, particularly when they can progress to involve complications such as pericardial effusion caused by aneurysmal rupture or infection. A popular treatment option for these aneurysms is polytetrafluoroethylene-covered stents; they have been favorable with obtaining a high percentage of procedural success rates in aneurysms not associated with myocardial infarctions. In this paper, we present a case of a giant coronary artery aneurysm located in the left circumflex coronary artery that was complicated by a pericardial effusion. We will also present its unusual repair using a long drug-eluting stent as a scaffold to overlap covered coronary stents used to help exclude the aneurysm.
Geographic Stomatitis with Multiple Areas Involvement of Oral Cavity: A Case Report and Review of Literatures
Authors: Farid Abbasi, Aliyeh Sehatpour, Seyed Masoud Sajedi, Parisa Bahadori, Mohadeseh Nouri
Journal: Galen Med J (2021)
Keywords: geographic stomatitis, geographic tongue, oral mucosa

Background:
Geographic stomatitis is an uncommon migratory benign lesion of oral mucosa with unknown etiology. It can affect all the areas of the oral mucosa, but the dorsum and lateral borders of the tongue are the most commonly involved areas called geographic tongue. The clinical appearance of this condition is the oval or circular erythematous areas with irregular elevated keratotic borders. These characteristic features of geographic stomatitis are diagnostic for all clinicians when appearing on the dorsum of the tongue, despite other affected areas of oral mucosa that can confuse clinicians. This condition may be associated with some diseases such as psoriasis, Reiter's syndrome, and atopic conditions, so the clinicians should rule out these diseases and diagnose the geographic stomatitis.
Case report:
A 17-year-old male attended to our department for a routine dentistry checkup. During the intraoral examination, we found multiple erythematous areas surrounded by a thin white border on different surfaces of his oral cavity. His extraoral examinations were completely normal.
Conclusion:
Due to the rarity of this lesion on the other sites of oral mucosa rather than dorsum and lateral borders of the tongue such as labial mucosa, buccal mucosa, the floor of the mouth, ventral surface of the tongue, and palate, it is necessary to report, study and evaluate each case of this condition that clinicopathologic findings have confirmed this diagnosis, to treat and advice these patients on the best approach.
Gossypiboma: the failure of a successful intervention
Authors: Atef Mejri, Khaoula Arfaoui, Badreddine Aloui, Jasser Yaakoubi
Journal: Pan Afr Med J (2020)
Keywords: surgery, complication, gastrointestinal perforation, iatrogenia, textiloma
MeSH terms: Abdominal Pain / diagnosis, Abdominal Pain / etiology, Cesarean Section / adverse effects, Foreign Bodies / diagnosis, Case Reports, Abdominal Pain / surgery, Adult, Diagnosis, Differential, Female, Foreign Bodies / complications, Foreign Bodies / surgery, Humans, Iatrogenic Disease, Intestinal Perforation / diagnosis, Intestinal Perforation / etiology, Intestinal Perforation / surgery, Laparotomy, Surgical Sponges / adverse effects, Treatment Outcome

If successful surgery is the primary quest of any surgeon, unintentionally leaving behind surgical items in the operative field remains his most feared obsession. This rare but dramatic accident can lead to potentially fatal complications and turn both lives of the surgeon and the patient upside down. We present the case of a 29-year-old female patient who presented to the ER with three days history of severe diffuse abdominal pain associated with fever, biological inflammatory syndrome and well-tolerated iron deficiency anaemia. She had no past medical history except for a lower segment cesarean section 5 months ago. Abdominal MRI allowed the diagnosis of two gossypibomas responsible for two intra-abdominal collections. An emergency laparotomy allowed the removal of these foreign bodies and the management of their serious complications of intestinal perforation by the construction of a double intestinal stoma. The patient made a post-operative uneventful recovery. This observation emphasizes the need to raise the practitioner´s awareness about this differential diagnosis in every case of any poorly localized abdominal pain occurring after surgery.
Concurrent Primary Repair of a Glenoid Labrum Articular Disruption and a Bankart Lesion in an Adolescent: A Case Report of a Novel Technique
Authors: Avinesh Agarwalla, Richard N Puzzitiello, Natalie L Leong, Brian Forsythe
Journal: Case Rep Orthop (2019)
MeSH terms: Case Reports

Glenoid labrum articular disruption (GLAD) lesions are an uncommon concomitant injury associated with labral tears, occurring in 1.5-2.9% of cases. In previous reported cases, the articular lesion is debrided during repair of the labral injury, which may predispose patients to osteoarthritis, a longitudinal complication seen in articular debridement of the hip. We report the case of a 15-year-old healthy adolescent male swimmer who sustained a labral injury with a concomitant GLAD lesion. During operative management, three Polyetheretherketone (PEEK) SutureTaks were placed on the glenoid. #2 FiberWire was used to imbricate capsular tissue, passed beneath the labrum, and was then subsequently advanced through the fibrous rim of the displaced cartilage flap/GLAD lesion at the site of each suture anchor. This construct restored tension to the anterior band of the inferior glenohumeral ligament, recreated the anteroinferior labral bumper, and effectively reduced the cartilage flap/GLAD lesion to the anterior inferior glenoid. By six months postoperatively, the patient demonstrated near-normal function with full range of motion and evidence of a stable construct on MRI. Unlike previously described cases, this is the first report of a hybrid technique that simultaneously performed a primary repair of both labral and articular injuries without the use of additional implants for the articular lesion. Primary repair of the labral and articular lesions should provide longitudinal benefit to the patient by reducing the risk of developing glenohumeral osteoarthritis.
BAP1 Tumour Predisposition Syndrome Due to Whole BAP1 Gene Deletion
Authors: Dinusha Pandithan, Sonja Klebe, Grace McKavanagh, Lesley Rawlings, Sui Yu, Jillian Nicholl, Nicola Poplawski
Journal: Case Rep Genet (2022)
MeSH terms: Case Reports

BRCA-1-associated protein-1 (BAP1) tumour predisposition syndrome (BAP1-TPDS) is a dominant hereditary cancer syndrome. The full spectrum of associated malignancies is yet to be fully characterised. We detail the phenotypic features of the first reported family with a whole BAP1 gene deletion. This report also adds to the emerging evidence that the rhabdoid subtype of meningioma is a part of the clinical spectrum of this tumour predisposition syndrome.
Choanal stenosis post radiotherapy for nasopharyngeal carcinoma: about an endoscopic management
Authors: Youssef Lakhdar, Sara Rochd, Mohamed Elbouderkaoui, Youssef Rochdi, Hassan Nouri, Abdelaziz Raji
Journal: Pan Afr Med J (2019)
Keywords: choanal stenosis, endoscopic surgery, nasopharyngeal cancer, radiotherapy
MeSH terms: Nasopharyngeal Carcinoma / radiotherapy, Nasopharyngeal Neoplasms / radiotherapy, Nose Diseases / etiology, Case Reports, Constriction, Pathologic / etiology, Endoscopy / methods, Humans, Male, Middle Aged, Nasal Obstruction / etiology, Nasopharynx / diagnostic imaging, Nasopharynx / pathology, Nose Diseases / diagnostic imaging, Tomography, X-Ray Computed

Choanal atresia is a rare complication of radiation for nasopharyngeal carcinoma, which has to be early detected. Its treatment is based on endoscopic endonasale surgery. We report a rare case of choanal stenosis observed in a 54-year-old patient, Ho presented 4 years after the end of radiotherapy for nasopharyngeal carcinoma, a progressive bilateral nasal obstruction, anosmia, and rhinorrhea without bleeding. The diagnostic of fibrous stenosis was confirmed by endonasal endoscopic examination coupled to CT scan of nasopharynx. The recanalization via endoscopic endonasal surgery with tube calibration gave a great functional result with the improvement of nasal symptoms. Even after 6 months of follow-up, there were no signs of restenosis.
Ictal kissing with subdural EEG recording
Authors: Abdulaziz Alsemari, Faisal Alotaibi, Salah Baz
Journal: Epilepsy Behav Case Rep (2013)
Keywords: ictal kissing, nondominant temporal lobe, subdural eeg

Purpose:
Ictal kissing has been described in the literature. Five cases were reported and associated with temporal lobe epilepsy lateralizing to the nondominant hemisphere.
Methods:
A case of ictal kissing was identified. The aim was to demonstrate the clinical, clinical and electrophysiological features (as recorded by subdural electrodes). The surgical procedure, histopathology, and imaging data were reviewed and correlated with the literature.
Results:
A 29-year-old right-handed female, who presented with ictal right hand left arm dystonic posturing, and lip smacking, was studied. The automatism was usually followed by prolonged emotional gestures and by hugging and kissing her relative and/or attendant nurse. Magnetic resonance imaging of the brain showed right small cortical and subcortical lesions of the right inferior frontal lobe with gliosis but without mass effect and normal-sized hippocampi. The PET scan showed hypometabolism of the right temporal lobe. Neuropsychological evaluation showed deficit in her nonverbal memory. The subdural electrodes showed high amplitude spikes over right mesial temporal lobe strips. The offsite of the ictal discharges was usually at the right frontal strips. Right standard temporal lobectomy with amygdalohippocampectomy and right inferior frontal lesionectomy were performed. The patient continued to be seizure-free for one year postoperatively.
Conclusion:
Our case report supports with subdural EEG recording the findings of the few reported cases of ictal kissing behavior lateralized to the nondominant hemisphere. However, the affectionate kissing behavior was associated with spread of the epileptic discharges to the right frontal lobe.
The work-relatedness at a case of acute lymphoblastic leukemia in a radiation oncologist
Authors: Bong Hyun Kim, Young-Jun Kwon, Young-Su Ju, Bong Kyu Kim, Hyun Seok Lee, Sang-Gil Lee, Yun Kyung Chung
Journal: Ann Occup Environ Med (2017)
Keywords: acute lymphoblastic leukemia, brachytherapy, cesium, radiation oncologist
MeSH terms: Case Reports

Background:
Clinicians who perform radiation therapy (RT) are exposed to radiation, which may negatively affect their health. The present study reports a case of acute lymphoblastic leukemia in a healthcare provider who was exposed to radiation at work; we also present a literature review of this topic.
Case presentation:
A 45-year-old patient, who had been a radiation oncologist and had been exposed to radiation while performing brachytherapy 10 years ago, complained of chest pain and was suspected of having leukemia based on the results of a blood test in an outpatient clinic. He was diagnosed with acute lymphoblastic leukemia, and subsequently underwent chemotherapy. However, the case died during treatment. Through epidemiological investigation, it was found that the case's cumulative exposure dose based on personal exposure and spatial dose measured during the work period was in the range of 6.08-12.15 mSv.
Conclusions:
Based on the following considerations, acute lymphoblastic leukemia was highly correlated with the level of radiation to which the case was exposed while performing brachytherapy on patients with cancer. Firstly, the latent period of acute lymphoblastic leukemia in the case closely matched the latency time reported in previous published studies (5-10 years). In addition, numerous studies have reported significantly higher relative risks of cancer among clinicians who perform RT compared with the general population. The case was also atypically exposed to radiation through his hands, despite wearing protective equipment. Lastly, the case's coworkers were also found to have been exposed to high levels of radiation. Investigation into the influence of radiation exposure through atypical routes during RT on the health of clinicians is recommended.
Case Report: Double penile fracture
Authors: Felipe Mercado-Olivares, J Antonio Grandez-Urbina, Giomar Farfan-Daza, Juan Pacheco-Sauñe, Luciano Nuñez-Bragayrac
Journal: F1000Res (2018)
Keywords: injuries, penile diseases, penile induration, urologic surgical procedures
MeSH terms: Penile Diseases / surgery, Case Reports, Adult, Coitus, Humans, Male, Penis, Rupture, Urethra

Penile fracture is an underreported surgical emergency. It usually occurs as a single rupture of the tunica albuginea in one of two corpora cavernosa; a rupture of both masses is an uncommon finding. We report a case of a young male who presented to the emergency department two hours after sustaining penile trauma. Prompt surgical exploration was performed four hours post-injury. He was found to have one fracture on each corpora cavernosa, without urethral injury, which were repaired successfully. The patient had a favorable recovery and was discharged on the third postoperative day without complications. The aim of this report is to highlight the importance of complete degloving of the penile shaft for a meticulous search during surgery to avoid missed injuries. This approach will ensure a successful outcome avoiding physical and psychological disabilities.
Paroxysmal nocturnal hemoglobinuria presenting as cerebral venous sinus thrombosis: a case report
Authors: Abdul Rauf Memon, Rizwan Khan, Mohammad Uzair Abdul Rauf, Kashif Shafique
Journal: Int Arch Med (2014)
MeSH terms: Case Reports

Paroxysmal Nocturnal Hemoglobinuria (PNH) is a rare type of acquired hemolytic anemia that is frequently associated with thrombophilia. It may rarely present with cerebral venous sinus thrombosis, which manifests clinically with signs of raised intracranial pressure and requires lifelong anticoagulation therapy. One such rare presentation was seen in a 28 years old male who had history of recurrent episodes of passing red colored urine and this time presented with severe headache. He was diagnosed to have cerebral venous sinus thrombosis and on further workup was found to be suffering from PNH.
Giant bullous emphysema mistaken for traumatic pneumothorax
Authors: Edson Gonçalves Ferreira Junior, Philippos Apolinario Costa, Larissa Melo Freire Golveia Silveira, Luis Enrique Maurera Almeida, Nayane Carolina Pertile Salvioni, Bruna Menon Loureiro
Journal: Int J Surg Case Rep (2019)
Keywords: bullectomy, giant bullous emphysema, traumatic pneumothorax, vanishing lung

Introduction:
Giant bullous emphysema (GBE) is defined by giant bullae in one or both upper lobes, occupying at least one-third of the hemithorax and compressing the surrounding parenchyma [1]. Symptoms include dyspnea, hypoxia, chest pain and pressure, and hemoptysis [2], which can be complicated by pneumothorax and infection of the bullae [3].
Case presentation:
A 50-year-old male was brought to the emergency department after he fell 5 m in a suicide attempt. The patient was in respiratory distress and had bilateral absence of breath sounds. He was intubated and bilateral chest tubes were inserted. A computerized tomography (CT) scan showed bilateral giant bullous emphysema in the upper lobes, confirming a diagnosis of GBE. As a result of the insertion of chest tubes, he developed bilateral high flow fistulas. During his hospitalization, he developed sepsis secondary to ventilator-associated pneumonia. In an attempt to control the fistulas, a right bullectomy was performed. Despite antibiotic treatment and surgical intervention, the patient died due to septic shock.
Discussion:
The clinical picture of a patient with GBE can be similar to that of pneumothorax, and GBE has been reported as being misdiagnosed as pneumothorax [4,5]. A CT scan can play an important role in differentiating these conditions [6], thus avoiding needle decompression, which can be catastrophic [6].
Conclusion:
Giant bullous emphysema can represent a pitfall in trauma assessment. We recommend that in cases where pneumothorax is suspected, if the patient is clinically stable, imaging studies should be performed prior to chest tube placement.
Case Report: Pelvic mass and massive ascites as the first symptom in cervical adenocarcinoma: report of two cases and literature review
Authors: Mingwei Yuan, Yan Zhang, Kana Wang, Mingrong Xi
Journal: Front Oncol (2023)
Keywords: ascites, case report, cervical adenocarcinoma, gastric-type endocervical adenocarcinoma (g-eac), pelvic mass
MeSH terms: Case Reports

Cervical adenocarcinoma accounts for 10%-25% of total cases of cervical carcinoma. But in recent years, the incidence of adenocarcinoma has risen both proportionally and absolutely. Clinically, most cervical adenocarcinoma show no symptom or present with abnormal uterine bleeding or vaginal discharge, similar to squamous cell carcinoma. What different about it is that cervical cytological testing demonstrates a high false-negative rate of cervical adenocarcinoma, potentially leading to the failure in detecting in early stage. This report presents two cases both with pelvic masses, and massive ascites served as the initial symptom, which is similar to the clinical symptom of ovarian cancer, but ultimately diagnosed with cervical adenocarcinoma through surgical specimens. There are few literature reports on this situation. Hence, a literature review also has been performed to improve the recognition for cervical adenocarcinoma presenting with pelvic masses and massive ascites, and to avoid misdiagnosis.
Dreams of the Rarebit Fiend: food and diet as instigators of bizarre and disturbing dreams
Authors: Tore Nielsen, Russell A Powell
Journal: Front Psychol (2015)
Keywords: diet, dreaming, fasting, food, internal awareness, nightmares, sleep

In the early 1900s, the Dream of the Rarebit Fiend comic strip conveyed how the spicy cheese dish Welsh rarebit leads to bizarre and disturbing dreams. Today, the perception that foods disturb dreaming persists. But apart from case studies, some exploratory surveys, and a few lab studies on how hunger affects dreaming, there is little empirical evidence addressing this topic. The present study examines three aspects of the food/dreaming relationship; it attempts to: (1) assess the prevalence of the perception of food-dependent dreaming and the types of foods most commonly blamed; (2) determine if perceived food-dependent dreaming is associated with dietary, sleep or motivational factors; and (3) explore whether these factors, independent of food/dreaming perceptions, are associated with reports of vivid and disturbing dreams. Three hundred and ninety six students completed questionnaires evaluating sleep, dreams, and dietary habits and motivations. Items queried whether they had noticed if foods produced bizarre or disturbing dreams and if eating late at night influenced their dreams. The perception of food-dependent dreaming had a prevalence of 17.8%; with dairy products being the most frequently blamed food category (39-44%). Those who perceived food-dependent dreaming differed from others by reporting more frequent and disturbing dreams, poorer sleep, higher coffee intake, and lower Intuitive Eating Scale scores. Reports of disturbing dreams were associated with a pathological constellation of measures that includes poorer sleep, binge-eating, and eating for emotional reasons. Reports of vivid dreams were associated with measures indicative of wellness: better sleep, a healthier diet, and longer times between meals (fasting). Results clarify the relationship between food and dreaming and suggest four explanations for the perception of food-dependent dreaming: (1) food specific effects; (2) food-induced distress; (3) folklore influences, and (4) causal misattributions. Research and clinical implications are discussed.
Intussusception associated with pneumatosis cystoides intestinalis in a male adolescent: A case report
Authors: Yugo Horiuchi, Kazuya Miyaguchi, Hisashi Matsumoto, Hideki Ohgo, Yoshikazu Tsuzuki, Hidetomo Nakamoto, Hiroyuki Imaeda
Journal: DEN Open (2023)
Keywords: colonoscopy, hyperbaric enema, intussusception, oxygen therapy, pneumatosis cystoides intestinalis
MeSH terms: Case Reports

Pneumatosis cystoides intestinalis is an uncommon disease that rarely causes intussusception. We report the case of a 16-year-old male patient with intermittent abdominal pain who was diagnosed with intussusception. The patient had no history of raw food ingestion, fever, diarrhea, or hematochezia. Computed tomography revealed intussusception characterized by a crab-finger appearance, and pneumatosis cystoides intestinalis was diagnosed by colonoscopy. Treatment with hyperbaric enema and low-flow oxygen therapy resulted in a prominent improvement of the lesion. No recurrence was observed for > 1 year. Intermittent abdominal pain without diarrhea or hematochezia in male adolescents may represent pneumatosis cystoid-related intussusception, and the addition of low-flow oxygen therapy may help avoid surgery.