Hippokratia
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In the literature, several reports are describing the coexistence of Huntington's disease (HD) or myasthenia gravis (MG) with other neurodegenerative and autoimmune disorders. Herein, we report a rare case of HD in a 66-year-old male with MG. Description of the case: The diagnosis of MG was established by acetylcholine receptor antibodies testing and compatible clinical presentation. The diagnosis of HD was based on clinical features, family history, and DNA testing. Several immunologic mechanisms have been proposed regarding the pathogenesis of HD and MG, respectively. Sharing a common autoimmune aspect could be an uncertain but potential association between the two disorders. ⋯ The probability of HD and MG occurring in the same patient is extremely small. While a number of neurological and autoimmune disorders have been reported with HD and MG, this is the first described coexistence of these two entities. HIPPOKRATIA 2019, 23(1): 28-29.
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The syndrome of inappropriate secretion of antidiuretic hormone (SIADH) is a disorder which is characterized by the inability to suppress the secretion of antidiuretic hormone (ADH), leading to impaired water excretion and hyponatremia. The syndrome should be suspected in any patient with hyponatremia, hypo-osmolality and a urine osmolality >100 mOsm/kg, while urine sodium concentration is above 40 mEq/L. ⋯ The patient suffered from chronic idiopathic hyponatremia and osteoporosis, which often coexists in patients with chronic idiopathic SIADH and was treated with alendronate/cholecalciferol. The scenario of the presence of SIADH was further strengthened by the fact that hyponatremia did not improve after isotonic normal saline administration, but only with fluid restriction. HIPPOKRATIA 2019, 23(1): 42-44.
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Tourette syndrome (TS) is a neurodevelopmental motor disorder. The first diagnosis during adult life involves cases of pre-existing undiagnosed TS. ⋯ Despite delays in TS diagnosis, only a few patients remain undiagnosed by the age of 45. Both TS under- and misdiagnosis have an impact on patients' outcomes. HIPPOKRATIA 2019, 23(1): 47-48.
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Trigger pain points are commonly found on the trunk, especially in the neck and shoulders. Dry needling is an effective treatment option in musculoskeletal pain caused by trigger pain points. ⋯ Although it is an infrequent adverse event, healthcare professionals should be aware of reflex anoxic seizure, which could be triggered by dry needling, and therefore always perform this procedure with adequate first aid facilities available on site. HIPPOKRATIA 2019, 23(1): 45-46.
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This retrospective case series assessed the results of a treatment protocol for patients with infected para-articular knee nonunions. The aim was to demonstrate that knee function and quality-of-life (QoL) can be improved. ⋯ Staged management can improve QoL and functional knee outcome. HIPPOKRATIA 2018, 22(4): 183-187.