21,308 results match your criteria case intermittent


Case report: Caesarean scar endometriosis - A rare entity.

Int J Surg Case Rep 2021 Jul 16;85:106204. Epub 2021 Jul 16.

Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Cipto Mangunkusumo Hospital, Jakarta, Indonesia.

Introduction And Importance: Caesarean scar endometriosis (CSE) is a rare form of endometriosis due to previous surgical scars from obstetrical and gynecological procedures. The incidence of CSE was 0.08% and quite difficult to diagnose. Read More

View Article and Full-Text PDF

Low flow intermittent bronchoscopic oxygen insufflation to identify occult tracheo-esophageal fistulas.

Respir Med 2021 Jul 24;186:106544. Epub 2021 Jul 24.

Pulmonary Institute, Schneider Children's Medical Center, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel.

Background: Esophageal atresia and tracheo-esophageal fistula (TEF), a well described congenital anomaly of the aero-digestive tract, commonly presents with inability to swallow and feed immediately after birth. However, diagnosis of recurrent or isolated TEF can be challenging and requires a combination of endoscopic and contrast studies. We describe a hitherto unreported technique of low flow intermittent oxygen insufflation into the suspicious tract and examine its safety and diagnostic yield for identification of occult TEF. Read More

View Article and Full-Text PDF

Directional deep brain stimulation of the posteromedial hypothalamus for refractory intermittent explosive disorder: a case series using a novel neurostimulation device and intraoperative microdialysis.

World Neurosurg 2021 Jul 26. Epub 2021 Jul 26.

Division of Neuroscience, Sírio-Libanês Hospital, São Paulo, Brazil; LIM 23, Institute of Psychiatry, University of Sao Paulo, School of Medicine, Sao Paulo, Brazil.

Background: Intermittent Explosive Disorder (IED) is a psychiatric disorder characterized by recurrent outbursts of aggressive behaviour. Deep brain stimulation (DBS) in the posteromedial nucleus of the hypothalamus (pHyp) is an alternative therapy for extreme cases and shows promising results. Intraoperative microdialysis can help elucidate the neurobiological mechanism of pHyp-DBS. Read More

View Article and Full-Text PDF

A rare case of toxocariasis presenting with hypereosinophilic pericardial effusion and mycotic aneurysm.

Trop Doct 2021 Jul 29:494755211034327. Epub 2021 Jul 29.

Department of Pediatrics, Post Graduate Institute of Medical Sciences and Research, Chandigarh, India.

Parasitic infections are the leading cause of hypereosinophilia in the paediatric population in tropical countries. We report an unusual case of infection in an eight-year-old boy who presented with intermittent fever, hypereosinophilia complicated by massive pericardial effusion and a mycotic aneurysm. This child received treatment with four weeks of albendazole and steroids. Read More

View Article and Full-Text PDF

A Clinical Perspective of Low Carbohydrate Ketogenic Diets: A Narrative Review.

Front Nutr 2021 12;8:642628. Epub 2021 Jul 12.

Unità Operativa Complessa di Medicina Interna e Nutrizione Clinica, Dipartimento ad Attività Integrata di Medicina Interna Scienze Endocrino-Metaboliche e Malattie Infettive, Azienda Ospedaliera Universitaria Policlinico Umberto I, Rome, Italy.

Low carbohydrates diets (LCDs), which provide 20-120 g of carbohydrates per day, have long been used as therapeutic options in the treatment of severe obesity, type 2 diabetes mellitus and other morbid conditions, with good results in terms of weight loss and control of the main metabolic parameters, at least in the short and medium term. According to the caloric content and the macronutrient composition, we can classify LCDs in hypocaloric, normoproteic diets [such as the Very Low-Calorie Ketogenic Diet (VLCKD) or the protein-sparing modified fasting (PSMF)], hypocaloric, hyperproteic and hyperlipidic diets (e.g. Read More

View Article and Full-Text PDF

Case Report: Dexmedetomidine for Intractable Clusters of Myoclonic Jerks and Paroxysmal Sympathetic Hyperactivity in Progressive Encephalomyelitis With Rigidity and Myoclonus.

Front Neurol 2021 12;12:703050. Epub 2021 Jul 12.

Department of Neurology, Kitasato University School of Medicine, Sagamihara, Japan.

Progressive encephalomyelitis with rigidity and myoclonus (PERM) is a severe form of stiff-person spectrum disorder characterized by painful spasms, myoclonic jerks, hyperekplexia, brainstem dysfunction, and dysautonomia, which is sometimes resistant to γ-amino-butyric acid (GABA)-ergic agents. The response to immunotherapy varies depending on identified autoantibodies. We report a dramatic response to dexmedetomidine in a patient with glycine receptor (GlyR) antibody-positive PERM who developed intractable clusters of myoclonic jerks and paroxysmal sympathetic hyperactivity (PSH) that was highly refractory to conventional symptomatic treatment with GABAergic drugs and immunotherapy. Read More

View Article and Full-Text PDF

Long-Term Evolution of SARS-CoV-2 in an Immunocompromised Patient with Non-Hodgkin Lymphoma.

mSphere 2021 Jul 28:e0024421. Epub 2021 Jul 28.

Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health Dr. Ricardo Jorge (INSA), Lisbon, Portugal.

Recent studies have shown that persistent SARS-CoV-2 infections in immunocompromised patients can trigger the accumulation of an unusual high number of mutations with potential relevance at both biological and epidemiological levels. Here, we report a case of an immunocompromised patient (non-Hodgkin lymphoma patient under immunosuppressive therapy) with a persistent SARS-CoV-2 infection (marked by intermittent positivity) over at least 6 months. Viral genome sequencing was performed at days 1, 164, and 171 to evaluate SARS-CoV-2 evolution. Read More

View Article and Full-Text PDF

TSH, Hyperthyroidism, and Bone Mass.

J Clin Endocrinol Metab 2021 Jul 28. Epub 2021 Jul 28.

The Mount Sinai Bone Program, Departments of Pharmacological Sciences and Medicine, and Center of Translational Medicine and Pharmacology, Icahn School of Medicine at Mount Sinai, New York, USA.

Thyrotropin, traditionally seen as a pituitary hormone that regulates thyroid glands, has additional roles in physiology including skeletal remodeling. Population-based observations in subjects with euthyroidism or subclinical hyperthyroidism indicated a negative association between bone mass and low-normalTSH. The findings of correlative studies were supported by small intervention trials using recombinant human TSH (rhTSH) injection, and genetic and case-based evidence. Read More

View Article and Full-Text PDF

Severe Intermittent Transvalvular Mitral Valve Regurgitation: Serious Complication of Mitral Valve Replacement With Subvalvular Preservation.

JACC Case Rep 2021 Apr 21;3(4):663-667. Epub 2021 Apr 21.

Department of Cardiovascular Medicine, Ankara University School of Medicine, Ankara, Turkey.

Mitral valve replacement with subvalvular preservation is a favorable technique to protect left ventricular function and improve long-term survival. However, complications of the procedure should be considered. We report the case of a patient with a history of prosthetic mitral valve replacement with severe intermittent transvalvular mitral regurgitation and reduced ejection fraction. Read More

View Article and Full-Text PDF

Intermittent Loss of Telemetry Data: Lessons From a Leadless Pacemaker.

JACC Case Rep 2021 Jan 20;3(1):146-149. Epub 2021 Jan 20.

Cardiology Department, Lancashire Cardiac Centre, Blackpool Teaching Hospitals National Health Service Foundation Trust, Blackpool, United Kingdom.

We present the case of a 63-year-old female patient who presented to the pacemaker clinic for a scheduled interrogation of her leadless pacemaker. The device interrogation was suggestive of intermittent under-sensing with failure to pace. Connecting the electrocardiogram lead to the pacing system analyzer raised the suspicion of intermittent loss of telemetry data. Read More

View Article and Full-Text PDF
January 2021

Calcified Nodules in the Superficial Femoral Artery Confirmed by Intravascular Ultrasound, Angioscopy, and Histology.

JACC Case Rep 2020 Oct 21;2(12):1862-1866. Epub 2020 Oct 21.

Division of Cardiology, Sakurabashi Watanabe Hospital, Osaka, Japan.

An 84-year-old man was admitted to the authors' hospital for the treatment of intermittent claudication. Angiography revealed an exophytic calcified nodules in the distal superficial femoral artery. Angioscopy also revealed abundant exophytic atherosclerotic calcification. Read More

View Article and Full-Text PDF
October 2020

What can we learn from the effect of trihexyphenidyl on motor fluctuations during continuous levodopa-carbidopa intestinal gel infusion (LCIG)? - First documented case.

Clin Park Relat Disord 2020 26;3:100071. Epub 2020 Aug 26.

Department of Gastroenterology, Eisei Hospital, Tokyo, Japan.

Motor fluctuations can be seen even during treatment with continuous levodopa-carbidopa intestinal gel infusion (LCIG). We report on a middle-aged man with advanced Parkinson's disease (PD) on LCIG in which motor fluctuations have been improved with an anticholinergic. To the best of our knowledge, there have been no previous LCIG cases reported with motor fluctuations responding to non-dopaminergic agent, which might reveal some clues to its pathophysiology. Read More

View Article and Full-Text PDF

Bronchobiliary fistula: a rare postoperative complication of spilled gallstones from laparoscopic cholecystectomy.

BMJ Case Rep 2021 Jul 27;14(7). Epub 2021 Jul 27.

Radiology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA

Bronchobiliary fistula (BBF) is defined as the abnormal connection between the biliary system and the bronchial tree, which presents clinically as an irritant cough with bilioptysis. Many conditions can lead to its development. We present a case of an acquired BBF in a 61-year-old man with a significant history of spilled gallstones from a prior laparoscopic cholecystectomy and subsequent presentation of intermittent right upper quadrant pain and recurrent pneumonia. Read More

View Article and Full-Text PDF

The level of carbon dioxide is the determinant of successful non-invasive ventilation pressure titration in patients with non-hypercapnic primary central sleep apnea: a case report.

J Clin Sleep Med 2021 Jul 27. Epub 2021 Jul 27.

Respiratory and Critical Care Medicine Department of Tianjin Medical University General Hospital, Tianjin, China.

Primary central sleep apnea (CSA) is classified as non-hypercapnic CSA. High loop gain, lower carbon dioxide (CO) reserves, and other reasons can lead to hypocapnia in patients who develop intermittent hyperventilation during sleep. Therefore, it is necessary to monitor nocturnal CO level for these patients. Read More

View Article and Full-Text PDF

Lipoprotein glomerulopathy associated with the Osaka/Kurashiki APOE variant: two cases identified in Latin America.

Diagn Pathol 2021 Jul 26;16(1):65. Epub 2021 Jul 26.

Division of Nephrology, University of São Paulo School of Medicine, São Paulo, Brazil.

Background: Lipoprotein glomerulopathy (LPG) is a rare autosomal dominant disease caused by mutations in APOE, the gene which encodes apolipoprotein E. LPG mainly affects Asian individuals, however occasional cases have also been described in Americans and Europeans. Herein we report two unrelated Brazilian patients with LPG in whom genetic analyses revealed the APOE-Osaka/Kurashiki variant. Read More

View Article and Full-Text PDF

Bromide toxicosis (bromism) secondary to a decreased chloride intake after dietary transition in a dog with idiopathic epilepsy: a case report.

BMC Vet Res 2021 Jul 22;17(1):253. Epub 2021 Jul 22.

Department of Internal Medicine/ Neurology, University of Toulouse, ENVT, Toulouse, France.

Background: Bromide is a halide ion of the element bromine usually administered in the form of potassium salt as monotherapy or add-on treatment in epileptic dogs. It is excreted unchanged in the urine and undergoes tubular reabsorption in competition with chloride. Thus, dietary chloride content affects serum bromide concentrations. Read More

View Article and Full-Text PDF

A Real Saline Challenge: Diagnosing Primary Aldosteronism in the Setting of Chronic Kidney Disease.

J Investig Med High Impact Case Rep 2021 Jan-Dec;9:23247096211034337

University of Texas Southwestern Medical Center, Dallas, TX, USA.

Primary aldosteronism (PA) is the most common cause of secondary hypertension but remains largely undiagnosed. Chronic kidney disease (CKD) complicates the diagnosis of PA by affecting the biochemical screening evaluation and confirmatory testing, and by increasing the complication rate of adrenal venous sampling (AVS). To raise clinician awareness of the challenges of PA diagnosis in CKD, we present an illustrative case with subsequent review of the literature and discuss some recent developments in PA diagnostic strategies particularly applicable to the CKD population. Read More

View Article and Full-Text PDF

Intrathoracic giant solitary fibrous tumor of the pleura: Case report.

Int J Surg Case Rep 2021 Jul 22;85:106224. Epub 2021 Jul 22.

Department of Radiology, Addis Ababa University, Addis Ababa, Ethiopia.

Introduction: Solitary Fibrous Tumor of the Pleura(SFTP) is exceedingly rare mesenchymal tumor commonly arising from the visceral pleura and accounts for <5% of all pleural tumors. Although it commonly has benign histologic characteristics, the tumor behavior is often unpredictable and less understood due to limited number of cases.

Case Presentation: We present a rare case of Intrathoracic Giant SFTP in a 65 years old female who presented with a progressive worsening of shortness of breath of 1 year duration associated with intermittent dry cough, low grade fever, easy fatigability and loss of appetite. Read More

View Article and Full-Text PDF

Impaired vagal adaptation to an exercise task in women with gestational diabetes mellitus versus women with uncomplicated pregnancies.

Hormones (Athens) 2021 Jul 26. Epub 2021 Jul 26.

Department of Sports Science At Serres, Exercise Physiology and Biochemistry Laboratory, Aristotle University of Thessaloniki, Thessaloniki, Greece.

Purpose: Gestational diabetes mellitus (GDM) is associated with an increased risk for maternal and fetal complications. Patients with GDM have an increased cardiovascular risk in later life. The aim of this study was to investigate cardiac autonomic nervous system (ANS) function at rest and during exercise in women with GDM vs. Read More

View Article and Full-Text PDF

Renal Function Decline With Small Interfering RNA Silencing Aminolevulinic Acid Synthase 1 (ALAS1).

Kidney Int Rep 2021 Jul 15;6(7):1904-1911. Epub 2021 Apr 15.

Service de Néphrologie, Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, France.

Introduction: Givosiran is an RNA interference therapeutic designed to block the synthesis of the aminolevulinic acid (ALA) synthase 1 (ALAS1) enzyme in patients with acute intermittent porphyria (AIP). Givosiran may have adverse effects on the kidney.

Methods: We performed a descriptive case series of renal function parameters of all the patients who received givosiran in France. Read More

View Article and Full-Text PDF

Spinal dural arteriovenous fistula 8 years after lumbar discectomy surgery: A case report and review of literature.

World J Clin Cases 2021 Jul;9(20):5594-5604

Department of Orthopaedics, The Second Hospital of Jilin University, Changchun 130041, Jilin Province, China.

Background: Spinal dural arteriovenous fistula (SDAVF) is an extremely rare vascular malformation of the central nervous system that is often confused with degenerative spinal disorders due to similar early symptoms and clinical features. Here, we report a case of SDAVF recurrence 8 years after lumbar spine surgery and summarize relevant literature.

Case Summary: A 54-year-old male was admitted to our hospital complaining of lower back pain, numbness in both lower extremities and intermittent claudication. Read More

View Article and Full-Text PDF

Ectopic opening of the common bile duct into the duodenal bulb with recurrent choledocholithiasis: A case report.

World J Clin Cases 2021 Jul;9(19):5332-5338

The Fourth Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou 730000, Gansu Province, China.

Background: Ectopic opening of the common bile duct is a condition with low incidence. Patients with an ectopic common bile duct opening have a high incidence of common bile duct stones and acute cholangitis. Patients with atypical symptoms and imaging findings are easily misdiagnosed; moreover, it is difficult to retrieve stones by endoscopic retrograde cholangiopancreatography, and common bile duct stones are prone to postsurgical recurrence. Read More

View Article and Full-Text PDF

Radiological and Clinical Findings of Multiple Cerebellar Liponeurocytoma: A Case Report.

Front Surg 2021 7;8:686892. Epub 2021 Jul 7.

Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.

Cerebellar liponeurocytoma is an extremely rare benign tumor which generally occurs in cerebellum and is almost always solitary. Multifocal cerebellar liponeurocytoma is exceedingly rare, only 8 cases has been reported so far. Herein we present the 9th case of multifocal cerebellar liponeurocytoma in a 70-year-old woman with the complete clinical course and comprehensive imaging findings. Read More

View Article and Full-Text PDF

Tricuspid Valve Replacement in a Patient with a Leadless Cardiac Pacemaker: Current Guidelines and Recommendations for Perioperative Management.

Case Rep Anesthesiol 2021 1;2021:5559830. Epub 2021 Jul 1.

Division of Cardiovascular and Thoracic Anesthesiology, West Virginia University, 1 Medical Center Drive, Morgantown, WV 26506, USA.

Leadless cardiac pacemakers were developed to reduce complications associated with conventional transvenous pacemakers. While this technology is still relatively new, devices are increasingly being implanted. The perioperative management of patients with these devices has been underreported; we thus seek to add to the limited body of knowledge of perioperative management of patients with leadless cardiac pacemakers. Read More

View Article and Full-Text PDF

A large renal bullet that resembles a large renal stone. A rare case scenario.

Int J Surg Case Rep 2021 Jul 12;85:106180. Epub 2021 Jul 12.

Urology Department, King Saud Medical City, Riyadh, Saudi Arabia.

Introduction: Genitourinary trauma secondary to a gunshot wound is uncommon as it only occurs in about 10% of cases. We present a case of a gentleman who suffered a gunshot wound to the kidney.

Presentation Of Case: A 28 year old man presented with irritative lower urinary tract symptoms (LUTs) since three months. Read More

View Article and Full-Text PDF

Prurigo pigmentosa following a ketogenic diet: a case report.

Eur J Clin Nutr 2021 Jul 23. Epub 2021 Jul 23.

Faculty of Medicine and Health, The University of New South Wales, Kensington, NSW, Australia.

A 19-year-old female of South Asian descent presented with a three-day history of pruritic, clustered papules and vesicles on her abdomen, associated with significant pruritus and intermittent pain. She commenced a ketogenic diet four days prior to the emergence of the rash. Histopathological and clinical findings were in keeping with prurigo pigmentosa, an uncommon dermatosis characterised by pruritic, erythematous papules and vesicles presenting reticulated on the back, chest and neck. Read More

View Article and Full-Text PDF

Development of an Early Alert System for an Additional Wave of COVID-19 Cases Using a Recurrent Neural Network with Long Short-Term Memory.

Int J Environ Res Public Health 2021 07 9;18(14). Epub 2021 Jul 9.

Laboratory for Industrial and Applied Mathematics, Department of Mathematics and Statistics, York University, Toronto, ON M3J 1P3, Canada.

The impact of the still ongoing "Coronavirus Disease 2019" (COVID-19) pandemic has been and is still vast, affecting not only global human health and stretching healthcare facilities, but also profoundly disrupting societal and economic systems worldwide. The nature of the way the virus spreads causes cases to come in further recurring waves. This is due a complex array of biological, societal and environmental factors, including the novel nature of the emerging pathogen. Read More

View Article and Full-Text PDF

Retinal emboli after cervicopetrous junction internal carotid artery pseudoaneurysm stenting.

Am J Ophthalmol Case Rep 2021 Sep 9;23:101164. Epub 2021 Jul 9.

Department of Ophthalmology, Wayne and Gladys Valley Center for Vision, University of California San Francisco, 490 Illinois Street, 5th Floor, San Francisco, CA, 94143, USA.

Purpose: To describe acute and chronic retinal ischemic changes following an internal carotid artery pseudoaneurysm stenting procedure, and to review current evidence for risk factors and management of post-procedural retinal ischemic events.

Observation: A 50-year-old man presented with a 3-month history of pulsatile tinnitus, headache, and intermittent blurry vision. A CT angiogram of head and neck showed bilateral cervicopetrous internal carotid artery (ICA) pseudoaneurysms. Read More

View Article and Full-Text PDF
September 2021

Gastric Neuroendocrine Tumor.

Surg J (N Y) 2021 Jul 19;7(3):e142-e146. Epub 2021 Jul 19.

Department of General Surgery, Maulana Azad Medical College, New Delhi, India.

Gastric neuroendocrine tumor (gNET) is a rare carcinoid of the stomach whose incidence is increasing due to widespread use of upper gastrointestinal endoscopy (UGIE). There are four types of gNETs with different management strategies and prognosis. Here, we present a patient who came with abdomen pain and intermittent melena. Read More

View Article and Full-Text PDF