OpenMed/multicare-articles huggingface dataset:
Evaluation of the implementation fidelity of the seasonal malaria chemoprevention intervention in Kaya health district, Burkina Faso
Authors: Rachidatou Compaoré, Maurice Wambi Evariste Yameogo, Tieba Millogo, Halima Tougri, Seni Kouanda
Journal: PLoS One (2017)
MeSH terms: Antimalarials / therapeutic use, Malaria / prevention & control, Seasons, Burkina Faso / epidemiology, Child, Child, Preschool, Female, Humans, Malaria / epidemiology, Male, Patient Compliance, Antimalarials

Background:
Burkina Faso implemented the seasonal malaria chemoprevention (SMC) in 2014 in seven pilot health districts, following the new recommendation by the WHO in 2012 for the prevention of the disease in children under five years old, for areas of highly seasonal malaria transmission.The objective of this study was to assess the implementation fidelity of the seasonal malaria chemoprevention strategy in one of the districts, Kaya Health District.
Methodology:
We conducted a case study, with a quantitative and qualitative mixed methods. Data were collected after two campaigns of implementation of the intervention, in 2014 and 2015, through a review of specific documents of SMC intervention, and individual interview with key informants (n = 21) involved at various levels in the implementation of the strategy and a household survey with the parents (n = 284) of eligible children for the SMC strategy in 2015 in the Kaya health district. The analysis framework focused on the fidelity of the intervention's content, its coverage, and its schedule, as well as the potential moderating factors, using the model proposed by Hasson, originally from Carroll.
Results:
All components of the intervention were implemented. Villages and sectors were covered at 100%. In terms of intervention doses received, less than one-third of eligible children (32.3%) received the recommended four doses in 2015. Implementation of the strategy faced some difficulties due to insufficient training of community distributors, inadequate supply of inputs and insufficient financial resources for remuneration, advocacy and supervision, but also because of the contextual constraints due to the rainy season. Moreover, an interaction between the different moderating factors, influencing the degree of implementation of the strategy was noted.
Conclusion:
Taking into account the moderating factors of the implementation is necessary for achieving the highest possible degree of implementation fidelity and then, reach the expected beneficial effects.
Identification of Peptoniphilus harei From Blood Cultures in an Infected Aortic Aneurysm Patient: Case Report and Review Published Literature
Authors: Xue Wan, Shuang Wang, Min Wang, Jinhua Liu, Yu Zhang
Journal: Front Cell Infect Microbiol (2021)
Keywords: 16s rdna sequencing, maldi–tof, peptoniphilus harei, bacteremia, gram-positive anaerobic cocci
MeSH terms: Aortic Aneurysm, Gram-Positive Cocci, Case Reports, Research Support, Non-U.S. Gov't, Blood Culture, Firmicutes, Humans, Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization, Peptoniphilus harei

Gram-positive anaerobic cocci (GPAC) are a commensal part of human flora but are also opportunistic pathogens. This is possibly the first study to report a case of Peptoniphilus harei bacteremia in an abdominal aortic aneurysm (AAA) patient. Matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) failed to identify the isolate and molecular analysis confirmed it as P. harei. A comprehensive literature review revealed that P. harei is an emergent pathogen. This study serves as a reminder for practicing clinicians to include anaerobic blood cultures as part of their blood culture procedures; this is particularly important situations with a high level of suspicion of infection factors in some noninfectious diseases, as mentioned in this publication. Clinical microbiologists should be aware that the pathogenic potential of GPAC can be greatly underestimated leading to incorrect diagnosis on using only one method for pathogen identification. Upgradation and correction of the MALDI-TOF MS databases is recommended to provide reliable and rapid identification of GPAC at species level in medical diagnostic microbiology laboratories.
Percutaneous Coronary Intervention for Iatrogenic Right Coronary Artery Dissection Post Bentall Procedure: A Case Report and Minireview
Authors: Sameer Saleem, Mubbasher A Syed, Khalid Changal, Abdulelah Nuqali, Mujeeb Sheikh
Journal: Case Rep Cardiol (2018)
MeSH terms: Case Reports

Iatrogenic coronary artery dissection is a potentially life-threatening complication of cardiovascular interventions. The optimal management of iatrogenic coronary artery dissection is not clear; however, both conservative management and percutaneous or surgical revascularization have been performed depending on the patient's clinical status and the extent of dissection. We present the first reported case of right coronary artery dissection after Bentall procedure performed for ascending aortic aneurysm. Urgent percutaneous intervention using adjunctive coronary imaging was performed with excellent clinical recovery. In this article, we highlight coronary artery dissection after Bentall procedure as a possible complication, provide an insight into various options in its management, and review published data on iatrogenic coronary artery dissection. We also discuss the challenges in percutaneous treatment of coronary artery dissection with special focus on intracoronary imaging for accurate diagnosis and guidance in the management of this complex lesion.
Case report: Interdisciplinary treatment of complex C1/C2 fractures in a patient with concomitant three-vessel coronary artery disease requiring bypass surgery
Authors: M E Di Francesco, H Magunia, A Örgel, M Tatagiba, M Radwan, S D Adib
Journal: Front Surg (2023)
Keywords: jefferson's fracture, coronary artery disease, interdisciplinary, intradiploic arachnoid cyst, odontoid fracture
MeSH terms: Case Reports

Background:
Acute myocardial infarction (MI) frequently leads to consciousness disturbance following hemodynamic collapse. Therefore, MI can occur together with upper cervical spine trauma. Herein, we report the successful treatment of complex C1/C2 fractures in a patient with concomitant three-vessel coronary artery disease (CAD).
Case presentation:
A 70-year-old patient presented in our emergency outpatient clinic after a hemodynamic collapse without neurological deficits or heart-related complaints. Computed tomography (CT) scan of the cervical spine revealed a dislocated odontoid fracture Anderson and D'Alonzo type II and an unstable Gehweiler type III injury (Jefferson's fracture). An intradiploic arachnoid cyst in the posterior wall of the posterior fossa was a coincident radiological finding. Furthermore, coronary angiography confirmed three-vessel CAD with high-grade coronary artery stenosis. Indication for upper cervical spine surgery and bypass surgery was given. An interdisciplinary team of neurosurgeons, cardiothoracic surgeons and anesthesiologists evaluated the patient's case to develop the most suitable therapy concept and alternative strategies. Finally, in first step, C1-C2 fusion was performed by Harms technique under general anesthesia with x-ray guidance, spinal neuronavigation, Doppler ultrasound and cardiopulmonary monitoring. Cardiothoracic surgeons were on standby. One month later bypass surgery was performed uneventfully. Follow-up CT scan of cervical spine revealed intraosseous screw positioning and beginning fusion of the fractures. The patient did not develop neurological deficits and recovered completely from both surgeries.
Conclusions:
Treating complex C1/C2 fractures with concomitant severe CAD requiring treatment is challenging and carries a high risk of complications. To our knowledge, the literature does not provide any guidelines regarding therapy of this constellation. To receive upper cervical spine stability and to prevent both, spinal cord injury and cardiovascular complications, an individual approach is required. Interdisciplinary cooperation to determine optimal therapeutic algorithms is needed.
Follicular thyroid carcinoma in a patient with myasthenia gravis and thymoma: a rare association
Authors: H Ni, A Htet
Journal: Ecancermedicalscience (2012)
Keywords: follicular carcinoma of thyroid, myasthenia gravis, thymoma, thyroid carcinoma
MeSH terms: Case Reports

Myasthenia gravis (MG) is an autoantibody-mediated disorder affecting the neuromuscular junction causing characteristic fatigable muscle weakness. Though it can be associated with tumours of the thymus as well as thyroid disorders, it is rare for both to coexist. The exact prevalence of thyroid carcinoma in MG with thymoma is not known but only about a dozen cases have been reported in the literature. We report a case of a 38-year-old Myanmar lady who presented with weakness and breathlessness due to MG with neck swelling. On examination, she had fatigable proximal muscle weakness and thyroid enlargement with no obvious features of hyperthyroidism. Mediastinal widening and an enlarged thyroid gland were noted on her chest X-ray and chest CT. A subtotal thyroidectomy and thymectomy were done. The histology showed follicular carcinoma of the thyroid and benign thymoma. The majority of the reported cases of thyroid carcinoma in association with MG were papillary carcinoma. Follicular carcinoma thyroid associated with MG has not yet been reported in the literature.
Human granulocytic ehrlichiosis complicating early pregnancy
Authors: Tyler Muffly, T Chad McCormick, Christopher Cook, Jeffrey Wall
Journal: Infect Dis Obstet Gynecol (2008)
MeSH terms: Ehrlichiosis / diagnosis, Ehrlichiosis / drug therapy, Ehrlichiosis / microbiology, Ehrlichiosis / physiopathology, Pregnancy Complications, Infectious / diagnosis, Pregnancy Complications, Infectious / drug therapy, Pregnancy Complications, Infectious / microbiology, Pregnancy Complications, Infectious / physiopathology, Pregnancy Trimester, First, Case Reports, Abortion, Spontaneous, Adult, Anti-Bacterial Agents / therapeutic use, Disseminated Intravascular Coagulation, Doxycycline / therapeutic use, Exanthema, Female, Fever, Granulocytes, Humans, Missouri, Pregnancy, Rural Population, Anti-Bacterial Agents, Doxycycline

Background:
The goal of this case is to review the zoonotic infection, human granulocytic ehrlichiosis, presenting with pyrexia. Case. A 22-year-old multigravid female presented to the emergency department with a painful skin rash, high fever, and severe myalgias. The patient underwent a diagnostic evaluation for zoonotic infections due to her geographical and seasonal risk factors. Treatment of human granulocytic ehrlichiosis was successful though the patient spontaneously aborted presumably due to the severity of the acute illness.
Conclusion:
Treatment of human granulocytic ehrlichiosis in pregnancy presents unique challenges. Management of pyrexia during pregnancy is limited to external cooling in the setting of thrombocytopenia and elevated aminotransferases. Extensive counseling regarding teratogenic potential of medications allows the patient to weigh the pros and cons of treatment.
Challenging case of treating fungal keratitis
Authors: Darko Ler, Aida Pidro, Ajla Pidro Miokovic
Journal: Rom J Ophthalmol (2022)
Keywords: antifungal medication, fungal keratitis, intrastromal application
MeSH terms: Corneal Ulcer / diagnosis, Corneal Ulcer / drug therapy, Corneal Ulcer / microbiology, Eye Infections, Fungal / diagnosis, Eye Infections, Fungal / drug therapy, Eye Infections, Fungal / microbiology, Keratitis / diagnosis, Keratitis / drug therapy, Keratitis / microbiology, Case Reports, Antifungal Agents / therapeutic use, Female, Humans, Middle Aged, Voriconazole / therapeutic use, Antifungal Agents, Voriconazole

Objective: Treating fungal keratitis is always a challenge due to limited antifungal medication, their poor penetration, and often, the delay in diagnosis. The purpose of this study is to present new routes of medication delivery, such as intrastromal application for advanced cases not responding to topical therapy. Methods: A 60-year-old female presented with fungal keratitis, complaining of decreased vision, redness in her left eye followed by frequent pain, which got worse a few days prior. Visual acuity was limited to hand motion. Slit-lamp examination showed advanced conjunctival hyperemia, a very deep white feathery lesion in the central cornea, with satellite lesions on the periphery, and pseudohypopyon of 3 mm in the anterior chamber. She was started on oral fluconazole 100 mg b.i.d, followed by corneal debridement and topical hourly voriconazole eye drops and intrastromal voriconazole application as her local findings did not show any improvement. Results: After repeating the procedure three times, the inflammatory reaction was decreased, the central ulcer healed, satellite lesions disappeared and pseudohypopyon did not recur even after discontinuation of the topical therapy. Conclusion: Intrastromal voriconazole application showed its safety and efficacy in treating advanced fungal keratitis with deep intrastromal lesions. Abbreviations: NSAID = non-steroid anti-inflammatory drugs, BCVA = best corrected visual acuity, MIC = mean inhibitory concentration.
Congenital tongue base cyst presenting with laryngeal stridor in youth: a case report
Authors: Zouheir Zaki, Naouar Ouattassi, Noureddine Alami
Journal: Case Rep Otolaryngol (2012)

Introduction. Tongue base cyst is an uncommon but potentially dangerous cause of stridor in neonates and infants. Case Presentation. We report a case of a 2-month-old Arabic male infant with a congenital tongue base cyst revealed by inspiratory stridor and recurrent respiratory distress. Diagnosis of cyst was suspected at endoscopy and confirmed by MRI imaging. The cyst was marsupialized with CO(2) laser. One year later, the child remains asymptomatic without recurrence of the mass. Conclusion. Tongue base cysts should be considered in differential diagnosis in new borns with stridor, respiratory difficulties, or swallowing problems. Definitive therapy requires large marsupialization under general anesthesia.
Zinner syndrome: an unusual cause of bladder outflow obstruction
Authors: Sonali Shah, Ramesh Patel, Rakesh Sinha, Maya Harris
Journal: BJR Case Rep (2017)
MeSH terms: Case Reports

Zinner syndrome is a rare condition comprising a triad of unilateral renal agenesis, ipsilateral seminal vesicle obstruction and ipsilateral ejaculatory duct obstruction. The mutual embryological origins of the seminal vesicle and the ureteral bud result in both anomalous genital and urinary tracts. We present the case of a 39-year-old patient where the initial presentation of this condition was bladder outflow obstruction. In this paper, we discuss the embryological origin of this condition, the range of imaging tools used to diagnose Zinner syndrome and the inherent benefits and shortcomings of each modality.
A young child with acute perforated appendicitis due to Comamonas kerstersii: a rare case report
Authors: Hind Bennani, Assia El Ouarradi, Asmaa Lamrani Hanchi, Nabila Soraa
Journal: Pan Afr Med J (2022)
Keywords: bacteremia, comamonas kerstersii, case report, perforated appendicitis
MeSH terms: Appendicitis / diagnosis, Bacteremia, Comamonas, Intestinal Perforation, Case Reports, Acute Disease, Child, Humans, Male, Comamonas kerstersii

Comamonas species are rarely associated with human infections. Recent reports found that Comamonas kerstersii was associated with severe diseases such as abdominal infection and bacteremia. However, Comamonas kerstersii may be confused with Comamonas testosteroni using the automatic bacterial identification systems currently available. An 8-year-old boy who had a right iliac fossa pain and classic migration of pain at the temperature of 38.9°C. The positive strain of aerobic and anaerobic bottles of blood cultures was identified. The patient was diagnosed as acute peritonitis and perforated appendix with abdominal abscess. The bacterium was identified by routine methods, MALDI-TOF-MS. The patient was treated with exploratory laparotomy, appendectomy, tube drainage, and prescribing antibiotic treatment. The patient was discharged with complete recovery. The organisms were confirmed as Comamonas kerstersii by MALDI-TOFMS and a combination of the other results. Our findings suggest that Comamonas kerstersii infection occurs most often in association with perforated appendix and bacteremia. We presume that Comamonas kerstersii is an opportunistic pathogen or commensal with the digestive tract and appendix bacteria.
Analysis of a multilevel diagnosis decision support system and its implications: a case study
Authors: Alejandro Rodríguez-González, Javier Torres-Niño, Miguel A Mayer, Giner Alor-Hernandez, Mark D Wilkinson
Journal: Comput Math Methods Med (2012)
MeSH terms: Decision Support Systems, Clinical, Decision Support Techniques, Physicians, Algorithms, Expert Systems, Gastroenteritis / diagnosis, Humans, Influenza, Human / diagnosis, Knowledge Bases, Male, Medical Informatics, Middle Aged, Models, Statistical, Pneumonia / diagnosis, Pyelonephritis / diagnosis, Reproducibility of Results, Sensitivity and Specificity

Medical diagnosis can be performed in an automatic way with the use of computer-based systems or algorithms. Such systems are usually called diagnostic decision support systems (DDSSs) or medical diagnosis systems (MDSs). An evaluation of the performance of a DDSS called ML-DDSS has been performed in this paper. The methodology is based on clinical case resolution performed by physicians which is then used to evaluate the behavior of ML-DDSS. This methodology allows the calculation of values for several well-known metrics such as precision, recall, accuracy, specificity, and Matthews correlation coefficient (MCC). Analysis of the behavior of ML-DDSS reveals interesting results about the behavior of the system and of the physicians who took part in the evaluation process. Global results show how the ML-DDSS system would have significant utility if used in medical practice. The MCC metric reveals an improvement of about 30% in comparison with the experts, and with respect to sensitivity the system returns better results than the experts.
Leber's hereditary optic neuropathy - Case report
Authors: Raluca Eugenia Iorga, Ruxandra Mihailovici, Manuela Ramona Ozturk, Dănuţ Costin
Journal: Rom J Ophthalmol (2018)
Keywords: leber’s hereditary optic neuropathy, idebenone, mitochondrial dna test, optic coherence tomography
MeSH terms: Optic Atrophy, Hereditary, Leber / diagnosis, Optic Atrophy, Hereditary, Leber / genetics, Optic Atrophy, Hereditary, Leber / therapy, Case Reports, Adult, DNA, Mitochondrial, Humans, Male, Optic Nerve, Tomography, Optical Coherence, Visual Acuity, DNA, Mitochondrial

Leber's hereditary optic neuropathy is the most common mitochondrial condition and is characterized by bilateral, painless, subacute visual loss that develops during young adult life. LHON is a rare condition and this lack of knowledge can make doctors suspect and treat for other causes of vision loss. Typically, a series of tests are performed to confirm LHON diagnosis or exclude any other conditions. We presented the case of two brothers, HB, of 40 years old and HF, of 38 years old, who presented with a decrease in visual acuity in both eyes. The patients had been diagnosed with optic atrophy of unknown cause a long time ago, but no further investigations were made. They were treated with corticosteroids, antioxidants and vasodilators, but with no significant benefit. A blood test of the mitochondrial DNA, a magnetic resonance imaging and an optic coherence tomography of the optic nerve and macula were part of the following assessment of our patients. The mitochondrial DNA analyses revealed the 3460 G>A mutation on the mtND1 gene in both patients. Based on the medical history, the fundus aspect, the optic coherence tomography and the paraclinical investigations of the diagnosis of Leber's hereditary optic neuropathy were established in both patients. We started the treatment with idebenone and we evaluated the patients after three months.
Abbreviations:
LHON = Leber's hereditary optic neuropathy, mtDNA = mitochondrial DNA, VA = visual acuity, CF = count fingers, OCT = optical coherence tomography, RNFL = retinal nerve fiber layer, GCL = ganglion cells layer, MS = multiple sclerosis, MRI = magnetic resonance imaging, MTI = magnetization transfer imaging, MTR = magnetization transfer ratio.
Coprophagia and Entomophagia in a Patient with Alcohol Related Dementia
Authors: João B Fonseca, Pedro Morgado
Journal: Case Rep Psychiatry (2017)
MeSH terms: Case Reports

Coprophagia and entomophagia are two phenomena not commonly reported in the medical literature and their occurrence is usually associated with mental disorders. We present the case of a 59-year-old man with a history of alcohol abuse who was evaluated due to cognitive deterioration and disturbed eating habits including feces and living insects. Organic causes were ruled out and an important cognitive impairment became evident on neuropsychological formal test. The behavior remitted after antipsychotic pharmacologic therapy and alcohol detoxification, leaving the diagnostic impression of alcohol related dementia. This report shows a rare association of these two conditions in a patient with dementia.
Case Report: Response to Intra-arterial Cisplatin and Concurrent Radiotherapy Followed by Salvage Surgery in a Patient With Advanced Primary Sinonasal Low-Grade Non-intestinal Adenocarcinoma
Authors: Hirohiko Tachino, Hiromasa Takakura, Hideo Shojaku, Michiro Fujisaka, Katsuichi Akaogi, Hideto Kawabe, Norihito Naruto, Hiroko Shojaku, Kyo Noguchi, Shigeharu Miwa, Johji Imura, Yoshinobu Maeda
Journal: Front Surg (2020)
Keywords: t4a, complete remission, intra-arterial cisplatin, low grade, non-intestinal type, oncurrent chemoradiotherapy, sinonasal adenocarcinoma
MeSH terms: Case Reports

Background: The clinical usefulness of concurrent chemoradiotherapy before surgery in the treatment of primary, locally advanced sinonasal low-grade, non-intestinal type adenocarcinoma (LG non-ITAC) is unclear. Methods: We present the first case report of the efficacy of super-selective intra-arterial cisplatin (CDDP) infusion concurrent with conventional fractionated radiotherapy (RT) for LG non-ITAC in a Japanese patient. Results: A white, rugged-marginal mass that was histopathologically diagnosed as LG non-ITAC occupied the right nasal cavity. Based on the imaging findings, including computed tomography, magnetic resonance imaging, and positron emission tomography, the tumor was diagnosed as T4aN0M0, stage IVa. After treatment, the nasal tumor disappeared leaving only a small bulge in the medial wall of the middle turbinate. The patient also underwent right transnasal ethmoidectomy performed as salvage surgery. A histopathological examination revealed that the lesion was replaced by granulation tissue with lymphocytic infiltration and hemosiderin-laden macrophages, and no viable tumor cells remained. In the seven years after treatment, the patient has not experienced any local recurrence or regional or distant metastasis. Conclusions: Super-selective intra-arterial CDDP infusion concurrent with conventional fractionated RT followed by salvage surgery might be useful for the management of sinonasal LG non-ITAC.