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Hypertriglyceridemia-Induced Pseudo –High Anion Gap Metabolic Acidosis Manifesting as Ischemic Stroke
Hypertriglyceridemia is a metabolic disorder characterized by elevated levels of triglycerides in the bloodstream.1 The underlying causes are multifactorial and range from metabolic syndrome and genetic predisposition to lifestyle choices.1 The management of hypertriglyceridemia usually involves a combination of lifestyle modifications, control of low-density lipoprotein and high-density lipoprotein levels, and pharmacotherapy when necessary.1 The clinical presentation is predominantly asymptomatic; however, some patients present with abdominal pain, nausea, vomiting, and pancreatitis.
Source: Mayo Clinic Proceedings - September 1, 2023 Category: Internal Medicine Authors: Abdul R. Akkawi, Mason Fawcett, Abhiram Challa, Timothy Nguyen, Jennifer Jackson, Richard Muraga Tags: Letter to the editor Source Type: research

A Case of Infective Endocarditis Caused by Streptococcus sanguinis Resulting in Stroke, Ruptured Infected Pseudoaneurysm of Superior Mesenteric Artery, and Rapidly Progressive Glomerulonephritis
Intern Med. 2023 Jun 21. doi: 10.2169/internalmedicine.2017-23. Online ahead of print.ABSTRACTA 71-year-old-man was admitted to our hospital with a cerebral embolism and diagnosed with infective endocarditis (IE) caused by Streptococcus sanguinis. Mitral valve replacement was performed. About one month later, he experienced sudden abdominal pain and shock due to a ruptured infected mesenteric artery pseudoaneurysm. Forty-four days after abdominal surgery, he presented with rapidly progressive glomerulonephritis with anti-glomerular basement membrane antibodies. He was treated with plasma exchange and prednisolone, and his ...
Source: Internal Medicine - June 21, 2023 Category: Internal Medicine Authors: Go Takahashi Tomoyuki Watanabe Takeshi Satoh Source Type: research

Tuina for shoulder pain after stroke: A protocol for systematic review and meta-analysis
Conclusion: This systematic review will provide evidence to determine whether Tuina is an effective and safe intervention for treating patients with post-stroke shoulder pain. PROSPERO registration number: CRD42022360401.
Source: Medicine - November 18, 2022 Category: Internal Medicine Tags: Research Article: Study Protocol Systematic Review Source Type: research

The effect of extracorporeal shock wave therapy on large neurogenic heterotopic ossification in a patient with pontine hemorrhage: A case report and literature review
We report a case of a 36-year-old man who developed HO around both hip joints 3 months after bilateral pontine hemorrhage. Interventions: Seven months after HO development, ESWT was administered to the area of HO every other day for a total of 10 sessions. Outcomes: Immediately following treatment, the ROM of both hip joints increased. Thus the patient was able to maintain a sitting posture without having to be bound to the wheelchair. In addition, the tolerable sitting time before groaning increased from less than ten minutes to almost 60 minutes by the end of all ESWT sessions. Unlike other previous reports...
Source: Medicine - October 28, 2022 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Avellis syndrome with ipsilateral prosopalgia, glossopharyngeal neuralgia, and central post-stroke pain: A case report and literature review
We reported a case of Avellis syndrome who manifested as the typical reported manifestations. The patient, what’s more, presented with ipsilateral trigeminal, glossopharyngeal neuralgia, and central poststroke pain which were described for the first time. It is of great significance for clinicians to recognize the typical as well as other manifestations which helps to make a clear diagnosis.
Source: Medicine - September 30, 2022 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Bilateral ptosis caused by patent foramen ovale-associated stroke
A 39-year-old woman presented with sudden onset bilateral ptosis and binocular diplopia for 3 days. The double vision was horizontal and most prominent when she was looking to the left side. The severity of symptoms does not vary over the day. She denied vertigo, headache, ocular pain, limb weakness, paresthesia, alcohol usage and botulinum toxin injection. Past medical history and family history were unremarkable. Neurological examination revealed bilateral ptosis, limited adduction in the right eye and normal pupils (Figure  1A). Other cranial nerves, extremity strength, coordination and sensory tests were intact. Deep ...
Source: QJM - August 16, 2022 Category: Internal Medicine Source Type: research

Intramedullary spinal cord abscess associated with right-to-left shunt via right superior vena cava draining into left atrium: A case report
We report the first case of ISCA associated with RSVC-LA RL shunt. Patient concerns: A 36-year-old man developed progressive paraparesis, dysuria, and spontaneous pain in the lumbar region and lower extremities. Spinal magnetic resonance imaging revealed an intramedullary lesion extended from Th12 to L2 with ring-shaped gadolinium enhancement. Cerebrospinal fluid (CSF) study exhibited a marked pleocytosis, and CSF culture grew Streptococcus intermedius. Cardiovascular computed tomography angiography identified RSVC-LA RL shunt, which caused transient acute cardiac syndrome due to air embolus. Diagnoses: The p...
Source: Medicine - July 1, 2022 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

54-Year-Old Woman With Altered Mental Status and Abdominal Pain
A 54-year-old woman was transferred to our medical center with altered mental status, abdominal pain, and hypotension. Her medical history included type 2 diabetes mellitus, hypertension, hyperlipidemia, active tobacco use, prior cholecystectomy, and a recent stroke. One month earlier, she presented to an outside facility with right-sided facial weakness and numbness. Brain magnetic resonance imaging (MRI) at that time revealed multiple small lacunar-type infarcts. Computed tomography (CT) angiography of the head and neck, 48-hour Holter monitoring, and transesophageal echocardiography did not reveal an embolic source.
Source: Mayo Clinic Proceedings - June 29, 2022 Category: Internal Medicine Authors: Caroline L. Matchett, Nikita Rafie, Jacob C. Jentzer Tags: Residents ’ Clinic Source Type: research

Ruyi Zhenbao Pills for Patients with Motor and Sensory Dysfunction after Stroke: A Double-Blinded, Randomized Placebo-Controlled Clinical Trial
ConclusionRZPs improved limb motor, balance, and sensory functions of stroke patients during recovery period with good safety. (Trial registration No. NCT04029701)
Source: Chinese Journal of Integrative Medicine - June 20, 2022 Category: Internal Medicine Source Type: research

28-Year-Old Man With Joint Pain
A 28-year-old man presented to the emergency department with right shoulder pain that radiated to the right arm as well as pain of the right hip and lower back. His medical history is significant for sickle cell disease (SCD) with the HbSS genotype (homozygous for the S globin). He had a hemorrhagic stroke in the setting of venous sinus thrombosis 2 years earlier with no persisting neurologic deficits as well as osteonecrosis of bilateral hips and right knee requiring right total hip arthroplasty and right total knee arthroplasty.
Source: Mayo Clinic Proceedings - June 1, 2022 Category: Internal Medicine Authors: Emily B. Butts, Albert Bui, Razvan M. Chirila Tags: Residents ’ clinic Source Type: research

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