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Clinical Medicine Insights. Case Reports

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https://www.readbyqxmd.com/read/29326535/very-rare-presentation-of-cerebrovascular-accident-in-20-year-old-man-with-familial-mediterranean-fever-case-report
#1
Miramir Aghdashi, Seyed-Mostafa Seidmardani, Sara Vossoughian, Seyed Arman Seyed Mokhtari
Familial Mediterranean fever (FMF) is characterized by recurrent episodes of fever accompanied by serosal, synovial, or cutaneous inflammation. The central nervous system (CNS) is rarely involved in FMF. The CNS involvement includes demyelinating lesions, posterior reversible encephalopathy syndrome, pseudotumor cerebri, optic neuritis, and cerebral vasculitis. Here, we present a 20-year-old man, a known case of FMF with abrupt left-sided hemiparesis. Brain magnetic resonance imaging revealed right periventricular infarction...
2018: Clinical Medicine Insights. Case Reports
https://www.readbyqxmd.com/read/29308019/case-series-spontaneous-relapse-after-recovery-from-peripartum-cardiomyopathy
#2
Madeline K Mahowald, Melinda Davis
Background: Peripartum cardiomyopathy (PPCM) is a distinct type of heart failure with reduced ejection fraction (EF) with variable outcomes. Rates of recovery range from 29% to 72% and mortality rates range from 0% to 25%. In studies, outcomes are often determined at 6 to 12 months following diagnosis, and many of those who recover stop following with cardiology and are lost to follow-up. Case report: Patient 1 was a 25-year-old G2P1 who was diagnosed with PPCM 5 days after childbirth with an EF of 25%...
2017: Clinical Medicine Insights. Case Reports
https://www.readbyqxmd.com/read/29270041/a-new-procedure-for-wrapped-negative-pressure-wound-therapy-for-congestion-after-arterialized-venous-flap-surgery
#3
Yosuke Niimi, Satoko Mori, Masaki Takeuchi
Negative pressure wound therapy (NPWT) is a method for treating wound. However, there are no case reports using NPWT for treating congestion after arterialized venous flap. Therefore, this study reported favorable outcomes after using a single-use NPWT system for managing congestion. A 39-year-old man had his index finger caught by a press machine. The finger had a soft tissue defect at the ventral part. An arterialized venous flap taken from the right forearm was transplanted. Perfusion of the flap was favorable, but on postoperative day 5, congestion and the edema of the flap were found...
2017: Clinical Medicine Insights. Case Reports
https://www.readbyqxmd.com/read/29270040/the-effects-of-astym-therapy%C3%A2-on-a-child-with-spastic-diplegic-cerebral-palsy
#4
Mandi M Miller, Jessica M Ray, R Scott Van Zant
Purpose: Limited research exists regarding use of Astym® therapy with neurologic conditions. The purpose of this case was to describe using Astym therapy in treating spastic diplegic cerebral palsy (CP). Case description: A 6-year-old female was treated more than 9 months (36 sessions) for decreased flexibility, muscle weakness, spasticity, and abnormal gait. Examination findings: Gait performed with articulated ankle-foot orthoses (75% of the time) or foot orthosis (25%); lack of active dorsiflexion (DF); lack of heel strike during gait; spasticity in hamstrings, gastrocnemius, hip adductors; hamstring flexibility (90/90 test position) 50° right and 60° left; gastrocnemius flexibility neutral bilaterally; and Peabody Developmental Motor Scales, second edition (PDMS-2) age equivalence (in months) 23 locomotion, 25 object manipulation, and 21 stationary tasks...
2017: Clinical Medicine Insights. Case Reports
https://www.readbyqxmd.com/read/29270039/peritoneal-dialysis-and-retroperitoneal-laparoscopic-radical-nephrectomy-a-favorable-experience-with-a-patient-complicated-by-renal-cell-carcinoma
#5
Reika Imai, Tetsu Akimoto, Takaaki Kimura, Marina Kohara, Toshihiro Shimizu, Kentaro Oka, Miwa Shuto, Maki Asakura, Izumi Nagayama, Shin-Ichi Takeda, Takashi Yagisawa, Shigeaki Muto, Daisuke Nagata
Peritoneal dialysis (PD) is an accepted modality for managing end-stage kidney disease. We herein report a 75-year-old female patient on chronic PD who was complicated by renal cell carcinoma. She was successfully treated with retroperitoneal laparoscopic radical nephrectomy followed by a prompt resumption of the procedure. Various surgeries disturbing the abdominal wall integrity often disrupt the regular PD schedule, and using minimally invasive approaches is therefore an attractive therapeutic option. Our experience emphasizes the feasibility and safety of a retroperitoneal approach-based laparoscopic technique based on several empirical examples...
2017: Clinical Medicine Insights. Case Reports
https://www.readbyqxmd.com/read/29147081/skull-meningioma-associated-with-intradural-cyst-a-case-report
#6
Genshin Mouri, Hidenori Suzuki, Seiji Hatazaki, Toshio Matsubara, Waro Taki
We present the first report of intraosseous meningioma accompanied by intradural cyst formation. A 76-year-old woman had previously undergone breast cancer treatment, so the preoperative diagnosis was metastatic breast cancer. This case reminds us that the possibility of meningioma should be kept in mind in patients with breast cancer, irrespective of neuroimaging findings.
2017: Clinical Medicine Insights. Case Reports
https://www.readbyqxmd.com/read/29118586/successful-surgical-resection-of-iatrogenic-antecubital-venous-pseudoaneurysm-following-venipuncture-a-2-case-report
#7
Yosuke Niimi, Takashi Yamaki, Kejiro Hori, Miho Kirita, Yoji Nagashima, Hiroyuki Sakurai
Iatrogenic venous pseudoaneurysm (VP) formation after venipuncture is rare. This report showed 2 cases of VP following venipuncture, and VPs were resected surgically. A 58-year-old woman and a 56-year-old woman developed a soft antecubital mass after blood sampling from the basilic veins. One patient had the sensory disturbance of forearm. The mass was diagnosed as a VP with thrombus by duplex ultrasound and magnetic resonance imaging. The aneurysm was resected completely, and the sensory disturbance of the patient was improved...
2017: Clinical Medicine Insights. Case Reports
https://www.readbyqxmd.com/read/29104431/a-case-of-rare-diffuse-alveolar-hemorrhage-and-review-of-literature
#8
Viviana Scollo, Luca Zanoli, Elisa Russo, Giulio Distefano, Francesco Rapisarda
It is well known that some disorders can cause concomitant kidney dysfunction with lung involvement. These syndromes, characterized by the simultaneous presence of intra-alveolar hemorrhage and acute glomerulonephritis, are caused by numerous and variable disorders. The most frequent are the antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitis and Goodpasture syndrome. A quick discerning of the underlying causes and initiation of adequate treatment is crucial to prevent acute respiratory failure and irreversible loss of renal function...
2017: Clinical Medicine Insights. Case Reports
https://www.readbyqxmd.com/read/29104430/pitfalls-in-the-diagnosis-and-management-of-invasive-pneumococcal-meningoencephalitis-what-we-can-learn-from-a-case
#9
Pascale S Grzonka, Raoul Sutter
Invasive pneumococcal meningitis is a life-threatening infectious disease affecting the central nervous system. It continues to be the most common type of community-acquired acute bacterial meningitides. Despite advances in neuro-critical care, the case fatality rate remains high. Rapid diagnosis and initiation of antibiotic therapy precludes mortality and long-term neurological sequelae in survivors. However, not all cases are easily recognised, and unanticipated complications may impede optimal course and outcome...
2017: Clinical Medicine Insights. Case Reports
https://www.readbyqxmd.com/read/29085240/pleuroperitoneal-communication-and-ovarian-cancer-complicating-peritoneal-dialysis-a-case-report-of-a-patient-with-end-stage-kidney-disease
#10
Tetsu Akimoto, Tomoyuki Yamazaki, Marina Kohara, Saki Nakagawa, Yoshihiko Kanai, Sayoko Izawa, Hisashi Yamamoto, Eiko Nakazawa, Takahiro Masuda, Takahisa Kobayashi, Osamu Saito, Shigeaki Muto, Eiji Kusano, Daisuke Nagata
Peritoneal dialysis has been a widely accepted modality for treating end-stage kidney disease, but a regular dialysis schedule can be seriously disrupted by various comorbid conditions requiring surgical intervention. A 40-year-old woman who had been receiving peritoneal dialysis was sequentially but separately complicated by pleuroperitoneal communication and ovarian cancer. Despite the need for temporary interruption of her peritoneal dialysis schedule, it was successfully resumed after the relevant surgeries for each disease...
2017: Clinical Medicine Insights. Case Reports
https://www.readbyqxmd.com/read/28979176/noncanonical-adult-human-neurogenesis-and-axonal-growth-as-possible-structural-basis-of-recovery-from-traumatic-vegetative-state
#11
Yulia Vainshenker, Vsevolod Zinserling, Alexander Korotkov, Svyatoslav Medvedev
Patient recovering from traumatic vegetative state has suddenly died from cardiac arrest. In-life improvement of consciousness appeared after reduction of generalized spasticity due to botulinum toxin administration. Neuropathologic examination revealed Musashi1+, Nestin+, PCNA+, and Ki67+ cells in the hippocampus, frontal, parietal and occipital cortex, caudate, thalamus, mammillary bodies, brainstem, cerebellum, and near the posterior horn of the lateral ventricle. New neurons with neurite growth (TUC4+) appeared in corpus callosum...
2017: Clinical Medicine Insights. Case Reports
https://www.readbyqxmd.com/read/28979175/recurrence-and-severe-worsening-of-hepatotoxicity-after-reintroduction-of-atorvastatin-in-combination-with-ezetimibe
#12
Silje Bergland Ellingsen, Elisabet Nordmo, Knut Tore Lappegård
Severe hepatotoxicity is a rare but well-known adverse reaction to statins. However, despite the widespread use of statins, only a few cases describing statin reexposure or switch to another statin after liver injury have been published. The literature on hepatotoxicity with ezetimibe alone or in combination with statins is also scarce. We report a case where a patient with a history of elevated liver enzymes while using atorvastatin, but prior and subsequent good tolerance to simvastatin and pravastatin, developed drug-induced liver injury on reexposure to a combination of atorvastatin and ezetimibe...
2017: Clinical Medicine Insights. Case Reports
https://www.readbyqxmd.com/read/28979174/delayed-onset-of-isolated-unilateral-oculomotor-nerve-palsy-caused-by-post-traumatic-pituitary-apoplexy-a-case-report
#13
Tomoki Ishigaki, Yotaro Kitano, Hirofumi Nishikawa, Genshin Mouri, Shigetoshi Shimizu, Fumitaka Miya, Hidenori Suzuki
Post-traumatic pituitary apoplexy is uncommon, most of which present with a sudden onset of severe headache and visual impairments associated with a dumbbell-shaped pituitary tumor. We experienced an unusual case of post-traumatic pituitary apoplexy with atypical clinical features. A 66-year-old man presented with mild cerebral contusion and an incidentally diagnosed intrasellar tumor after a fall accident with no loss of consciousness. The patients denied any symptoms before the accident. After 4 days, the left oculomotor nerve palsy developed and deteriorated associated with no severe headache...
2017: Clinical Medicine Insights. Case Reports
https://www.readbyqxmd.com/read/28904525/knowing-about-device-algorithms-to-understand-the-rhythm-and-role-of-managed-ventricular-pacing
#14
Antoine Kossaify, Hiba Hamdar
A 66-year-old patient with a DR pacemaker for intermittent atrioventricular block presented with an electrocardiogram (ECG) showing some P waves non followed by QRS complexes, raising suspicion of device dysfunction. The device was equipped with a special algorithm (Managed Ventricular Pacing; Medtronic), and the observed ECG tracing was a normal consequence of the function of such algorithms. Being aware of the function of specific algorithms is essential to adequately analyze rhythms.
2017: Clinical Medicine Insights. Case Reports
https://www.readbyqxmd.com/read/28890660/flow-cytometric-immune-profiling-in-infliximab-associated-tuberculosis
#15
Kelly Pennington, Humberto C Sasieta, Guiherme P Ramos, Courtney L Erskine, Virginia P Van Keulen, Tobias Peikert, Patricio Escalante
Tumor necrosis factor α antagonists are increasingly used to treat inflammatory and autoimmune disorders and are associated with increased risk of active tuberculosis. Diagnosis of active tuberculosis in patients taking tumor necrosis factor α antagonists can be challenging owing to increased incidence of extrapulmonary manifestations and false-negative results on current available diagnostic tests. We present a case of a young woman on infliximab for ulcerative colitis who presented with disseminated tuberculosis...
2017: Clinical Medicine Insights. Case Reports
https://www.readbyqxmd.com/read/28890659/loeffler-endocarditis-a-unique-presentation-of-right-sided-heart-failure-due-to-eosinophil-induced-endomyocardial-fibrosis
#16
Amit Alam, Shankar Thampi, Shahryar G Saba, Rita Jermyn
Loeffler endocarditis is a rare restrictive cardiomyopathy caused by abnormal endomyocardial infiltration of eosinophils, with subsequent tissue damage from degranulation, eventually leading to fibrosis. Although an uncommon entity, it is still a disease with significant morbidity and mortality. Often identified only at late stages, treatment options are limited once fibrosis occurs, usually requiring heart failure medications or surgical intervention. We present a unique case of a woman with remote history of hypereosinophilic syndrome, attributed to treatment of rheumatoid arthritis with infliximab, who presented with symptoms of heart failure refractory to medical management and was found to have Loeffler endocarditis...
2017: Clinical Medicine Insights. Case Reports
https://www.readbyqxmd.com/read/28811743/retroperitoneal-bleeding-an-experience-during-prophylactic-anticoagulation-in-a-patient-with-nephrotic-syndrome
#17
Mari Okada, Tetsu Akimoto, Mutsumi Kawamata, Toshimi Imai, Erika Hishida, Marina Kohara, Atsushi Miki, Takuya Murakami, Taro Sugase, Takahiro Masuda, Yuko Ono, Yoshihiko Ueda, Osamu Saito, Shigeaki Muto, Daisuke Nagata
The association between nephrotic syndrome (NS) and a hypercoagulable state has been demonstrated. Controlling the blood clotting activity may therefore be attractive for patients with nephrosis in terms of thromboembolism prophylaxis. We herein report a 75-year-old woman with minimal change disease who developed pains in the right back, groin, and thigh because of retroperitoneal bleeding during prophylactic anticoagulation with unfractionated heparin. Although this procedure has not been accepted as the standard of care for patients with nephrosis, pharmacologic prophylaxis may already be practiced empirically, as in the present patient...
2017: Clinical Medicine Insights. Case Reports
https://www.readbyqxmd.com/read/28811742/respiratory-t-wave-inversion-in-a-patient-with-chest-pain
#18
Himani Sharma, Abhinav Tiwari
T-wave inversion on electrocardiogram (ECG) is always a concerning finding as it is often associated with myocardial ischemia or ventricular strain. Respiratory variation in the T-wave morphology has been reported in the literature; however, the frequency of this observation remains unknown as this is not routinely evaluated. Although the exact physiological mechanisms underlying this ECG change are unclear, it is proposed to be due to the respiratory variation of the heart position resulting in an alteration in T-wave polarity...
2017: Clinical Medicine Insights. Case Reports
https://www.readbyqxmd.com/read/28680269/baclofen-related-neurotoxicity-implication-in-a-fatality-associated-with-hepatorenal-syndrome
#19
Larry K Golightly, Lauren E Grecheck, Ike I Kim
No abstract text is available yet for this article.
2017: Clinical Medicine Insights. Case Reports
https://www.readbyqxmd.com/read/28579861/cryptogenic-organizing-pneumonia-with-lung-nodules-secondary-to-pulmonary-manifestation-of-crohn-disease
#20
Taufiq Zaman, Joseph Watson, Mohammad Zaman
Crohn disease is an immune-mediated inflammatory condition with gastrointestinal and extraintestinal manifestations in patients. Pulmonary involvement of Crohn disease is one manifestation. There have been case reports which have shown Crohn disease and lung nodules which were noted to be histopathological as cryptogenic organizing pneumonia (COP). In our case, a 22-year-old woman with Crohn disease was seen with complaints of chest pain and cough. Computed tomographic scan of chest showed multiple bilateral lung nodules, for which biopsy was done, which showed COP...
2017: Clinical Medicine Insights. Case Reports
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