OpenMed/multicare-articles huggingface dataset:
Human Infection with Fusobacterium necrophorum without Jugular Venous Thrombosis: A Varied Presentation of Lemierre's Syndrome
Authors: Muhammad Asim Rana, Yashwant Kumar, Abdullah Ali Lashari, Ahmed F Mady
Journal: Case Rep Infect Dis (2017)
MeSH terms: Case Reports

Lemierre's syndrome is also known as postangina septicemia, which is commonly caused by Fusobacterium necrophorum also known as Necrobacillus and also by other microorganisms like Staphylococcus, Streptococcus, Peptostreptococcus, and Bacteroides. Though the disease starts as an upper respiratory tract infection, it may spread and cause thrombophlebitis of the internal jugular vein. It may present itself through cranial nerve palsy or sepsis involving distant organs like the lungs or bones. It is also known as forgotten disease because of its rarity. Fusobacterium necrophorum usually causes infection in animals and rarely affects humans. We hereby present a case of Necrobacillus infection which did not cause any thrombophlebitis but resulted in severe pneumonia and acute kidney injury, leading to respiratory failure and requiring mechanical ventilation.
Case Report: Remdesivir and Convalescent Plasma in a Newly Acute B Lymphoblastic Leukemia Diagnosis With Concomitant Sars-CoV-2 Infection
Authors: Giovanni Battista Dell'Isola, Matteo Felicioni, Luigi Ferraro, Ilaria Capolsini, Carla Cerri, Grazia Gurdo, Elena Mastrodicasa, Maria Speranza Massei, Katia Perruccio, Mariangela Brogna, Alessandra Mercuri, Barbara Luciani Pasqua, Paolo Gorello, Maurizio Caniglia, Alberto Verrotti, Francesco Arcioni
Journal: Front Pediatr (2021)
Keywords: covid-19, sars–cov−2, convalescent plasma, leukemia, remdesevir
MeSH terms: Case Reports

Introduction: The spread of Covid-19 has worsened the prognosis of oncology patients, interrupting or delaying life-saving therapies and contextually increasing the risk of severe SARS-CoV-2 infections. Acute lymphoblastic leukemia (ALL) is the most frequent cancer in pediatric age and the management of this disease with concomitant SARS-COV-2 infection represents a challenging situation. Case presentation: We present the case of a 6-year-old female newly diagnosed with ALL during a documented SARS-CoV-2 infection. Our patient was admitted 20 days after SARS-CoV-2 detection for evening-rise fever. Laboratory testing showed severe neutropenia while chest x-ray detected moderate pulmonary involvement. Acute lymphoblastic leukemia diagnosis was made through morphological and molecular analysis on bone marrow aspirate. Given the stability of the blood count and clinical conditions, antiviral therapy with Remdesivir and Convalescent Plasma was started before antileukemic treatment, obtaining a rapid resolution of the infection. Conclusion: In our experience, the treatment with Remdesivir and Convalescent Plasma led to a rapid resolution of Sars-Cov-2 infection. Our case did not present any adverse event to the therapy. Thus, this treatment could be considered in patients with malignancies, in order to accelerate the resolution of the infection and begin immunosuppressive treatment safely. Further studies are required to confirm this hypothesis.
Treatment of painful calciphylaxis with methadone in a palliative care unit: A case report
Authors: Shannon Jade King, Jayamangala Sampath Kondasinghe
Journal: Clin Nephrol Case Stud (2023)
Keywords: calciphylaxis, hemodialysis, methadone, pain, palliative care
MeSH terms: Case Reports

A 72-year-old female was admitted with severe calciphylaxis-associated bilateral leg pain on a background of end-stage renal failure on hemodialysis. Palliative care input was requested, and following transfer to our unit she was commenced on low-dose methadone as adjunctive analgesic therapy. A remarkable and sustained analgesic response was observed. Calciphylaxis is associated with severe pain, and careful consideration of analgesic agents and their pharmacokinetics in patients with end-stage renal failure is required.
Model checking in multiple imputation: an overview and case study
Authors: Cattram D Nguyen, John B Carlin, Katherine J Lee
Journal: Emerg Themes Epidemiol (2017)
Keywords: cross-validation, diagnostics, missing data, model checking, multiple imputation, posterior predictive checking

Background:
Multiple imputation has become very popular as a general-purpose method for handling missing data. The validity of multiple-imputation-based analyses relies on the use of an appropriate model to impute the missing values. Despite the widespread use of multiple imputation, there are few guidelines available for checking imputation models.
Analysis:
In this paper, we provide an overview of currently available methods for checking imputation models. These include graphical checks and numerical summaries, as well as simulation-based methods such as posterior predictive checking. These model checking techniques are illustrated using an analysis affected by missing data from the Longitudinal Study of Australian Children.
Conclusions:
As multiple imputation becomes further established as a standard approach for handling missing data, it will become increasingly important that researchers employ appropriate model checking approaches to ensure that reliable results are obtained when using this method.
User perspectives on the future of mobility assistive devices: Understanding users' assistive device experiences and needs
Authors: Leah Morris, Mary Cramp, Ailie Turton
Journal: J Rehabil Assist Technol Eng (2022)
Keywords: impaired mobility, amputation, independent living, rehabilitation, stroke

Introduction:
Current assistive devices are inadequate in addressing the needs of some people living with impaired mobility. This study explored the experiences of living with impaired mobility in relation to how wearable assistive adaptive and rehabilitative technologies may improve their quality of life.
Methods:
A cross-case study approach was adopted; the case being defined as the experience of impaired mobility. Semi-structured interviews were utilised. The sample (n = 8) was purposefully selected to have impaired mobility due to stroke, age-related frailty, or lower limb amputation. From the interview transcripts, in-depth case illustrations were written to provide personal stories and thematic analysis was carried out to provide a cross-case analysis.
Results:
There were two overarching themes: lifestyle changes; and wishes and desires for assistive devices. There were shared experiences across participant groups, such as falls and fear of falling. All participants identified a wish for increased speed of walking. However, the reasons for their difficulties differed depending on personal factors and their condition. Participants wanted devices to be adjustable to their perceived ability on a day-to-day basis.
Conclusions:
Although common concerns and impacts of living with impaired mobility were apparent, individuals have unique requirements that should inform the design of assistive technology devices.
Case Report: Carcinoma en Cuirasse in a Middle-Aged Woman Mimicking Postirradiation Morphea
Authors: Haiqing Wang, Chengbei Bao, Ting Gong, Chao Ji
Journal: Front Oncol (2021)
Keywords: breast cancer, carcinoma en cuirasse, cutaneous metastases, postirradiation morphea, radiation dermatitis
MeSH terms: Case Reports

Breast carcinoma en cuirasse (CeC) is an extremely rare form of cutaneous metastases of breast cancer, characterized by diffuse sclerodermoid induration of the skin. It may be difficult to distinguish CeC from some skin diseases, including postirradiation morphea, inflammatory breast cancer, radiation dermatitis, and other cutaneous metastases, but it can be easily discerned by histology. Because of the small number of documented cases, the treatment consensus has not been clearly defined. Here, we show a 45-year-old woman with grade III infiltrating ductal carcinoma manifesting as CeC to the chest wall. Early diagnosis and treatment are essential to prevent the catastrophic natural progression of this rare malignancy.
Bacteremia due to Acinetobacter ursingii in infants: Reports of two cases
Authors: Nurhayat Yakut, Eda Kadayifci Kepenekli, Ayse Karaaslan, Serkan Atici, Gulsen Akkoc, Sevliya Ocal Demir, Ahmet Soysal, Mustafa Bakir
Journal: Pan Afr Med J (2016)
Keywords: bacteremia, acinetobacter ursingii, child
MeSH terms: Acinetobacter / isolation & purification, Acinetobacter Infections / diagnosis, Anti-Bacterial Agents / therapeutic use, Bacteremia / diagnosis, Case Reports, Acinetobacter Infections / drug therapy, Acinetobacter Infections / microbiology, Ampicillin / therapeutic use, Bacteremia / drug therapy, Bacteremia / microbiology, Humans, Infant, Male, Opportunistic Infections / diagnosis, Opportunistic Infections / drug therapy, Opportunistic Infections / microbiology, Sulbactam / therapeutic use, Anti-Bacterial Agents, sultamicillin, Ampicillin, Sulbactam

Acinetobacter ursingii is an aerobic, gram-negative, opportunistic microorganism which is rarely isolated among Acinetobacter species. We present two immunocompetent infants who developed bacteremia due to A. ursingii. The first patient is a two -month- old boy who had been hospitalized in pediatric surgery unit for suspected tracheo-esophageal fistula because of recurrent aspiration pneumonia unresponsive to antibiotic therapy. The second patient is a fourteen -month- old boy with prolonged vomiting and diarrhea. A. ursingii was isolated from their blood cultures. They were successfully treated with ampicillin-sulbactam. Although A. ursingii has recently been isolated from a clinical specimen; reports of infection with A. ursingii in children are rare. A. ursingii should be kept in mind as an opportunistic microorganism in children.
Acanthomatous Ameloblastoma of Mandible in a Paediatric Patient
Authors: Narasimhan Malathi, G V V Giri, Deepak A Pandyan, Ramalingam Suganya, Harikrishnan Thamizhchelvan
Journal: Case Rep Pediatr (2018)
MeSH terms: Case Reports

Ameloblastoma is a slow-growing, benign odontogenic tumor derived from odontogenic epithelial components with a mature fibrous stroma. It is the second most common odontogenic neoplasm following odontome. Acanthomatous ameloblastoma histologically presents with squamous epithelial metaplastic transformation of odontogenic tissue. The present case report of a 12-year-old male exclusively elaborates the issues concerned with the aggressive nature of acanthomatous ameloblastoma (AA) which is a distinctive variant of ameloblastoma.
Sintilimab induced ICIAM in the treatment of advanced HCC: A case report and analysis of research progress
Authors: Hongxiang Ji, Zhijian Wen, Bin Liu, Hongbiao Chen, Qian Lin, Zhan Chen
Journal: Front Immunol (2022)
Keywords: ici-associated myocarditis (iciam), hepatocellular carcinoma (hcc), immune checkpoint inhibitor-associated adverse reactions (iraes), programmed cell death receptor 1/ligand 1 (pd-1/pd-l1), sintilimab
MeSH terms: Carcinoma, Hepatocellular / drug therapy, Liver Neoplasms / drug therapy, Myocarditis, Case Reports, Research Support, Non-U.S. Gov't, Antibodies, Monoclonal, Humanized / adverse effects, Humans, Antibodies, Monoclonal, Humanized, sintilimab

Immune checkpoint inhibitor-associated adverse reactions (irAEs) are a clinical treatment issue that requires additional attention when ICIs have significant survival benefits in patients with advanced hepatocellular carcinoma (HCC). Among them, ICIs-associated myocarditis (ICIAM) is a kind of severe irAE with a high mortality rate (17%-50%). Despite its low incidence (PD1/PD-L1 related: 0.41%-0.8%), ICIAM can significantly disturb the decision making of therapeutic schemes and even the survival outcomes of patients. ICIAM induced by sintilimab has not been reported in any complete clinical studies yet and understanding the clinical characteristics involved may inform better practices for the management. Here, we reported a 78 y/o patient with advanced HCC, who experienced ICIAM induced by sintilimab within a short course from treatment onset and found that adequate baseline examination before the implementation of the therapeutic scheme, regular monitoring of myocardial enzymonram and cardiac imaging were measures for the early detection, while glucocorticoid pulse therapy is still the best choice with timely and sufficient application. Simultaneously, the combination of other immunosuppressants may lead to better results. New-predictive markers and examination methods are still required to facilitate the early detection.
Leptomeningeal metastases in a patient with an extragonadal germ cell tumor
Authors: Yoshiaki Kinebuchi, Masakuni Ishikawa, Osamu Ishizuka, Osamu Nishizawa, Kazuhiro Hongo
Journal: Clin Med Oncol (2008)
Keywords: brain metastasis, chemotherapy, germ cell tumor, leptomeningeal metastasis, surgery
MeSH terms: Case Reports

We present a case of leptomeningeal metastases in a 30-year-old man with an extragonadal germ cell tumor. The patient was referred to our hospital for treatment of an occipital brain metastasis. This lesion was resected, followed by whole brain radiotherapy and further chemotherapy, and a temporary complete remission was achieved. However, leptomeningeal recurrence developed, and despite salvage chemotherapy, the patient died of disease. Although multidisciplinary treatment is given to treat brain metastases of germ cell tumors, the patients' prognosis has been unsatisfactory. The identification of a standard/effective treatment is required.
Successful treatment of a unique chronic multi-bacterial scalp infection with N-chlorotaurine, N-bromotaurine and bromamine T
Authors: Anthony M Kyriakopoulos, Markus Nagl, Dorothea Orth-Höller, Janusz Marcinkiewicz, Stella Baliou, Vassilis Zoumbourlis
Journal: Access Microbiol (2020)
Keywords: n-bromotaurine, n-chlorotaurine, bromamine t, chronic multi-bacterial skin infection
MeSH terms: Case Reports

Microbial species can act in synergy to circumvent environmental stress conditions and survive. In addition, biofilms are a serious public-health issue globally and constitute a clinical emergency. Infection persistence, increased morbidity and mortality, and antibiotic resistance are consequences of poly-microbial synergy. Due to inherited complexity and synergy between numerous species, newer antimicrobial agents of increased efficacy and tolerability are needed. In this unique medical case, a chronic (9 year) multi-bacterial scalp infection was differentially diagnosed from other inflammatory skin disorders by prolonged microbiological culture. The bacterial species found seem to have caused lesions of visible biofilm not documented previously in the medical literature. This complicated infection was treated successfully and rapidly with the combined topical application of the active halogen compounds N-chlorotaurine, N-bromotaurine and bromamine T, which is in contrast to the previous failed systemic and topical therapeutic approaches. This study strengthens the case for the use of active halogen compounds against multi-bacterial infections of the skin in the future, without the occurrence of resistance.
Case report: Right atrial appendage hybrid access to bailout a stuck stent from the inferior vena cava of a small child
Authors: Radityo Prakoso, Aditya Agita Sembiring, Latifa Hernisa, Brian Mendel, Olfi Lelya, Oktavia Lilyasari
Journal: Front Cardiovasc Med (2023)
Keywords: ductal stenting, inferior vena cava, patent ductus arteriosus, single ventricle, strutted stent
MeSH terms: Case Reports

A three-month-old baby boy (5. 4 Kg) with pulmonary atresia, subaortic ventricular septal defect (VSD), and patent ductus arteriosus (PDA) was sent for ductal stenting from the femoral vein. The route to the PDA was extremely tortuous and the procedure was complicated with a stent stuck in the abdominal inferior vena cava (IVC). Transfemoral stent recapture was technically laborious and the stent was successfully recaptured across a 10-Fr right atrial appendage (RAA) hybrid access avoiding a cardiopulmonary bypass (CBP). The PDA was subsequently stented for the femoral artery with satisfactory clinical outcomes.
Cardiogenic shock due to reverse takotsubo syndrome triggered by multiple sclerosis brainstem lesions: a case report and mini review
Authors: Joas Brandner, Henri Lu, Olivier Muller, Elissavet Eskioglou, Jean-Daniel Chiche, Panagiotis Antiochos, Yaniv Chocron
Journal: Front Cardiovasc Med (2023)
Keywords: brainstem lesions, cardiogenic shock, inverted takotsubo, multiple-sclerosis, reverse takotsubo, takotsubo, takotsubo (stress) cardiomyopathy, takotsubo syndrome
MeSH terms: Case Reports

Background:
Takotsubo syndrome (TTS) is mainly characterized by chest pain, left ventricular dysfunction, ST-segment deviation on electrocardiogram (ECG) and elevated troponins in the absence of obstructive coronary artery disease. Diagnostic features include left ventricular systolic dysfunction shown on transthoracic echocardiography (TTE) with wall motion abnormalities, generally with the typical "apical ballooning" pattern. In very rare cases, it involves a reverse form which is characterized by basal and mid-ventricular severe hypokinesia or akinesia, and sparing of the apex. TTS is known to be triggered by emotional or physical stressors. Recently, multiple sclerosis (MS) has been described as a potential trigger of TTS, especially when lesions are located in the brainstem.
Case summary:
We herein report the case of a 26-year-old woman who developed cardiogenic shock due to reverse TTS in the setting of MS. After being admitted for suspected MS, the patient presented with rapidly deteriorating clinical condition, with acute pulmonary oedema and hemodynamic collapse, requiring mechanical ventilation and aminergic support. TTE found a severely reduced left ventricular ejection fraction (LVEF) of 20%, consistent with reverse TTS (basal and mid ventricular akinesia, apical hyperkinesia). Cardiac magnetic resonance imaging (MRI) performed 4 days later showed myocardial oedema in the mid and basal segments on T2-weighted imaging, with partial recovery of LVEF (46%), confirmed the diagnosis of TTS. In the meantime, the suspicion of MS was also confirmed, based on cerebral MRI and cerebral spinal fluid analyses, with a final diagnosis of reverse TTS induced by MS. High-dose intravenous corticotherapy was initiated. Subsequent evolution was marked by rapid clinical improvement, as well as normalization of LVEF and segmental wall-motion abnormalities.
Conclusion:
Our case is an example of the brain-heart relationship: it shows how neurologic inflammatory diseases can trigger a cardiogenic shock due to TTS, with potentially serious outcomes. It sheds light on the reverse form, which, although rare, has already been described in the setting of acute neurologic disorders. Only a handful of case reports have highlighted MS as a trigger of reverse TTS. Finally, through an updated systematic review, we highlight the unique features of patients with reversed TTS triggered by MS.
Use of tocilizumab in a patient with severe COVID-19 in a Teaching Hospital in Ghana: a case report
Authors: Yasmine Oladele Hardy, Kojo Awotwi Hutton-Mensah, Divine Aseye Yao Amenuke, James Amoah-Dankwah
Journal: Pan Afr Med J (2020)
Keywords: covid-19, tocilizumab, case report, interleukin-6, sub-saharan africa
MeSH terms: Antibodies, Monoclonal, Humanized / therapeutic use, COVID-19 Drug Treatment, Case Reports, COVID-19 / diagnosis, Ghana, Hospitals, Teaching, Humans, Male, Middle Aged, Severity of Illness Index, Antibodies, Monoclonal, Humanized, tocilizumab

The outbreak of coronavirus disease 2019 (COVID-19) in December 2019 has rapidly spread globally with significant negative impact on health. There is an urgent need for a drug or vaccine certified for treating and preventing COVID-19 respectively. Tocilizumab, an interleukin-6 monoclonal receptor antibody, has been used in some centers for mitigating the severe inflammatory response seen in patients with severe COVID-19 with encouraging results. To the best of our knowledge, reports detailing the outcomes of patients with severe COVID-19 undergoing treatment with tocilizumab are sparse in sub-Saharan Africa. We describe the clinical and laboratory profile, chest Computed Tomography (CT) scan findings and clinical outcome in a Ghanaian patient with severe COVID-19 pneumonia treated with tocilizumab. A 54-year-old hypertensive male presented with fever, productive cough, pleuritic chest pain and breathlessness. He tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by polymerase chain reaction analysis done on a nasopharyngeal swab sample. His respiratory symptoms worsened while on admission despite receiving standard of care. His C-reactive protein (CRP) was elevated to 80.59mg/L and chest CT scan findings were indicative of severe COVID-19 pneumonia. He was treated with a single 400mg dose of intravenous tocilizumab with a positive clinical outcome, rapid decline in CRP and improvement in chest CT findings. Our experience shows that tocilizumab shows great promise as drug therapy for COVID-19 pneumonia.
Lymph node metastasis after a soft tissue sarcoma of the leg: a case report and a review of the literature
Authors: S D Nelen, F J Vogelaar, F Gilissen, J C Van der Linden, K Bosscha
Journal: Case Rep Surg (2013)

Introduction. Soft tissue sarcomas (STSs) represent 1 percent of all adult malignancies and sarcomas only rarely spread to the regional lymph nodes. Case Presentation. We present a case of a woman with a dermatofibrosarcoma protuberans and a sarcoma not therwise specified of the lower extremity. The patient had no distant metastasis during follow-up, but did develop a regional lymph nodemetastasis (RLNM) in the groin. We reviewed the literature about RLNM in STSs. Discussion. Reviewing the literature we see that within specific histological types RLNM occurs as often as distant metastasis. Furthermore RLNM occurs in over 10% for specific histological types and in 24% of all patients with a soft tissue sarcoma of the lower extremity. Except for radical lymphadenectomy with a 5-year survival rate of 46% there is no appropriate treatment. Conclusion. The risk for a RLNM in certain histological types and anatomical locations might transcend the risk for a distant lung metastasis.
Breast Cancer Suspicion in a Transgender Male-to-Female Patient on Hormone Replacement Therapy Presenting with Right Breast Mass: Breast Cancer Risk Assessment and Presentation of a Rare Lesion
Authors: Krystina Tongson, Victoria Konovalova, Naveen Dhawan, Steffi Sharma, Jaya Bahl, Mohammad Masri
Journal: Case Rep Oncol Med (2017)
MeSH terms: Case Reports

There has been an increasing use of hormonal therapy among male-to-female (MtF) transgender individuals. This long-term hormone replacement therapy (HRT) renders MtF individuals a unique patient subgroup in terms of breast cancer risk. This case describes a MtF transgender who presented with a breast lesion concerning for malignancy following hormonal replacement therapy. The patient additionally had a strong family history of breast cancer. Final pathology revealed lobular hyperplasia in the setting of gynecomastia and pseudoangiomatous stromal hyperplasia (PASH). Both pathology findings are rare in biological females, let alone in the setting of hormone replacement therapy in a MtF individual. While the number of reported cases of suspicious breast lesions in this population remains scarce, it presents both a diagnostic and therapeutic challenge due to the nature of the treatment course and the lack of research in this recently growing subgroup of patients.