OpenMed/multicare-articles huggingface dataset:
Reducing traffic violations in the online food delivery industry-A case study in Xi'an City, China
Authors: Xin-Wei Lu, Xiao-Lu Guo, Jing-Xiao Zhang, Xiao-Bing Li, Li Li, Steven Jones
Journal: Front Public Health (2022)
Keywords: conditional psm model, crashes, demand shunting, hierarchical food delivery framework, online food delivery, traffic violations
MeSH terms: Commerce, Income, China, Cities, Surveys and Questionnaires

Online food delivery (OFD) is one of the top industries in the Online-to-offline (O2O) commerce sector. Deliverymen need to complete a large number of delivery orders in limited default time every day, which cause high working stress to them. Therefore, a high level of traffic violations and crashes by deliverymen and corresponding negative impact on public safety are observed. To reduce traffic violations by deliverymen and resulting crashes, a hierarchical online food delivery framework is proposed, which is based on data from questionnaire surveys conducted in Xi'an City, China. The study includes the analysis of the root cause correlated with traffic violations during online food delivery as part of an empirical study on the priority delivery fee by applying a conditional price sensitivity measurement (PSM) model. The feasibility and rationality of the framework are further investigated by using cross analysis of urban dwellers' occupation, income, and commuting cost. The results identify that, through rationally shunting the demand of online food delivery, prolonging the default delivery duration, and providing diversified delivery services, the proposed hierarchical online food delivery mechanism is able to relieve the stress of deliverymen during peak hours of food requests. This reduces the willingness of deliverymen to engage in traffic violations, and other risky behaviors during food delivery trips. All of which facilitate high-quality and timely online food delivery service while enabling improved safety of deliverymen and others as part of enhanced public safety and health.
Endobronchial One-Way Valve Therapy Facilitates Weaning from Extracorporeal Membrane Oxygenation in a Patient with ARDS and Persistent Air Leak
Authors: Alessandro Ghiani, Matthias Hansen, Konstantinos Tsitouras, Claus Neurohr
Journal: Case Rep Crit Care (2018)
MeSH terms: Case Reports

Prolonged pulmonary air leak (PAL) is a common clinical problem, associated with significant morbidity and mortality. There are numerous reports of treatment of PAL using endobronchial valves (EBV) in respiratory stable patients, but only few reports on critically ill patients, and there is virtually no practical knowledge in the treatment of PAL in mechanically ventilated patients with acute respiratory distress syndrome (ARDS), treated with veno-venous extracorporeal membrane oxygenation (vvECMO). We describe a case where EBV placement was performed in a patient with ARDS and PAL, treated with mechanical ventilation and vvECMO. Despite a lung protective ventilation strategy, a persistent air leak along with a large left-sided pneumothorax was observed. After bronchoscopic localisation of the fistula, two endobronchial valves were inserted into the left upper lobe, leading to an immediate decrease in the air flow and reexpansion of the left lung. During the following two weeks, the patient was weaned from vvECMO, and after another three weeks, complete liberation from mechanical ventilation was accomplished. EBV placement seems to be a safe method even in the presence of coagulopathy and may facilitate mechanical ventilation and weaning from vvECMO in patients with ARDS and PAL.
Gallstone ileus of the sigmoid colon: an unusual cause of large-bowel obstruction
Authors: Nadir Osman, Daren Subar, Mong-Yang Loh, Andrzej Goscimski
Journal: HPB Surg (2010)
MeSH terms: Biliary Fistula / surgery, Gallstones / complications, Ileus / surgery, Intestinal Fistula / surgery, Intestinal Obstruction / surgery, Sigmoid Diseases / surgery, Case Reports, Aged, 80 and over, Biliary Fistula / diagnostic imaging, Biliary Fistula / etiology, Gallstones / diagnostic imaging, Humans, Ileus / diagnostic imaging, Ileus / etiology, Intestinal Fistula / diagnostic imaging, Intestinal Fistula / etiology, Intestinal Obstruction / diagnostic imaging, Intestinal Obstruction / etiology, Male, Sigmoid Diseases / diagnostic imaging, Sigmoid Diseases / etiology, Tomography, X-Ray Computed

Gallstone ileus of the colon is an exceedingly rare cause of large-bowel obstruction. It is usually the result of fistula formation between the gallbladder and large bowel facilitating entry of the stone into gastrointestinal tract. Contrast enhanced abdominal computed tomography is an important diagnostic aid. Surgical management is the treatment of choice to prevent the disastrous complications of large-bowel obstruction. We describe the case of a 92-year-old man who presented with symptoms and signs of large-bowel obstruction. Radiological investigation showed a large gallstone impacted in the sigmoid colon. Open enterolithotomy was undertaken relieving the obstruction and the patient made a full recovery.
Congenital infiltrating lipomatosis of the face: a case report
Authors: Asha Mahadevappa, Vanisri H Raghavan, Sunila Ravishankar, Gubbanna V Manjunath
Journal: Case Rep Pediatr (2012)
MeSH terms: Case Reports

Congenital infiltrating lipomatosis of the face is a rare lesion that comprises a subgroup of lipomatous tumor-like lesions of infancy and childhood. It is characterized by (1) no encapsulation, (2) diffuse infiltration of mature adipose tissue over normal muscle fiber and surrounding structures of face, (3) osseous hyperplasia of subjacent bone, and (4) a high recurrence rate. We report a case of a nine-month-old infant who presented with swelling over right face since birth. Early diagnosis of this lesion provides better surgical approach to control the infiltrative nature of its growth with recurrence and aesthetic appearance.
A Case of Schwannoma of the Submandibular Region
Authors: Babatunde O Bamgbose, Akiko Sato, Yoshinobu Yanagi, Miki Hisatomi, Yohei Takeshita, Irfan Sugianto, Junichi Asaumi
Journal: Open Dent J (2018)
Keywords: antoni type a, antoni type b, heterogeneous hypointensity, mri, schwannoma, submandibular region
MeSH terms: Case Reports

Background:
We herein described a rare case of schwannoma of the hypoglossal nerve in the submandibular region with diagnostic imaging and histopathological findings.
Case report:
A 31-years-old woman has had a palpable firm, rubbery, freely mobile mass in the submandibular region. Of imaging, MR images showed homogeneous isointensity on T1-weighted imaging (T1-WI), heterogeneous hypointensity on T2-WI, heterogeneous hyperintensity on short T1 inversion recovery (STIR), and heterogeneous enhancement on contrast-enhanced T1-WI. A clear capsule was observed on the margin and showed hypointense on T2-WI. Dynamic MRI showed heterogeneous gradual increased enhancement. The uptake of contrast medium was regionally slow. Diagnostic imaging using CT and MRI was suspected of salivary gland tumor or neurogenic tumor. In consideration of imaging diagnosis, a pleomorphic adenoma or a schwannoma was suspected. Final diagnosis was confirmed on the basis of histopathological finding and intraoperative findings.
Conclusion:
1. Histopathologic examination is inevitable, because MR findings are not specific.2. Schwannomas were said to have specific MRI properties, including specific signs (split-fat sign, fascicular sign, target sign). However, they are not always observed.3. This case confirmed the differential diagnosis on the basis of the intraoperative finding that the tumor was continuous with the hypoglossal nerve.
A Case Report of Bowel Perforation in a Gravid COVID-19 Patient
Authors: A T Guiritan, J G Cataluña
Journal: Case Rep Med (2023)
MeSH terms: Case Reports

Background:
Bowel perforation in a pregnant patient with COVID-19 infection is a rarely reported complication. With the uncovering of the different treatment modalities and complications of this disease, this case highlights diagnostic and therapeutic dilemmas and limitations in a special population. Clinical Presentation. A 35-year-old female, Gravida 2 Para 1 at 31 weeks age of gestation (AOG) who underwent cesarean section for nonreassuring fetal status in 2019, was admitted for severe COVID-19 infection presenting with dyspnea. During her hospitalization, she developed progressive dyspnea from worsening of COVID-19 infection. Patient was eventually intubated and was given a total of two doses of tocilizumab, adequate antibiotic treatment, remdesivir, and dexamethasone. An emergency repeat cesarean section was performed due to maternal deterioration and poor variability of the fetus. She delivered to a live preterm baby girl, with an Apgar score of 1 and 7 on the 1st and 5th minute of life respectively. During the postoperative days, patient remained intubated and sedated. Increasing residuals were noted per nasogastric tube (NGT). Serial scout film of the abdomen (SFA) and medical management were performed. Upon weaning from sedation, patient complained of right lower quadrant pain. A whole abdominal computed tomography (CT) scan with contrast was requested which revealed large bowel obstruction. Patient was referred to surgery service. Upon assessment, abdomen was noted to be rigid with guarding during palpation. A scout film of the abdomen was requested and revealed extensive amount of pneumoperitoneum with scanty to absent colonic gas suggestive of bowel perforation. Patient underwent emergency exploratory laparotomy. Upon opening the peritoneum, free air was evacuated. Approximately 1.4 liters of fecaloid peritoneal fluid was suctioned and adhesive band was noted at the pelvic area. A 2 cm full thickness perforation at the cecum with 17 cm serosal tear from the cecum to ascending colon was noted. Bowel loops proximal to the perforation were dilated. Nasogastric tube was inserted for bowel decompression. Right hemicolectomy was performed. Specimen was sent for histopathology. Acute inflammatory cells infiltrating the blood vessels and possible microthrombi and beginning thrombus formation were noted in the subserosa. Patient eventually expired on the 14th hospital day from sepsis.
Conclusion:
This case highlights a rarely reported complication of COVID-19 infection. Confluence of factors that predisposed the patient include pregnancy, COVID-19 infection, use of tocilizumab, and recent surgery. High index of suspicion is vital in the management and improvement of outcomes.
Hypogonadotropic Hypogonadism and Kleefstra Syndrome due to a Pathogenic Variant in the EHMT1 Gene: An Underrecognized Association
Authors: Ana Patricia Torga, Juanita Hodax, Mari Mori, Jennifer Schwab, Jose Bernardo Quintos
Journal: Case Rep Endocrinol (2018)
MeSH terms: Case Reports

Kleefstra syndrome is a genetic condition characterized by intellectual disability, childhood hypotonia, and facial dysmorphisms. Genital anomalies such as micropenis, cryptorchidism, and hypospadias have been reported in 30-40% of males diagnosed with the disease. However, endocrinological investigations have been limited. We describe a case of an adolescent male with Kleefstra syndrome due to a pathogenic variant in the EHMT1 gene whose workup for isolated micropenis is suggestive of a partial hypogonadotropic hypogonadism. A possible endocrine mechanism of the genital anomaly associated with Kleefstra syndrome is discussed.
A case report of mycobacterium avium complex peritonitis in an AIDS patient
Authors: Yihenew Negatu, Eyasu Mekonen
Journal: Case Rep Infect Dis (2013)

Peritonitis due to Mycobacterium avium complex (MAC) infection is uncommon. The risk for MAC in AIDS patients is greatest in those with severely depressed CD4 count. The organs most commonly involved in disseminated MAC infection include spleen, mesenteric lymph nodes, liver, and intestines. The involvement of peritoneum by MAC infection is rare. This is a case of MAC peritonitis in a 26-year-old female AIDS patient who is noncompliant to highly active antiretroviral therapy (HAART). This patient presented with abdominal pain and distension, anorexia, diarrhea, and cough. She was treated with rifabutin, clarithromycin, and ethambutol along with atovaquone for Pneumocystis jiroveci pneumonia prophylaxis and so the patient's condition improved. MAC peritonitis should be considered in a patient presenting with nonspecific abdominal symptoms in the setting of AIDS and low CD4 count.
Anesthetic management of a patient with factor VII deficiency undergoing laparoscopic colectomy: a case report
Authors: Akari Yoshida, Yoshiki Kimoto, Kanako Ejiri, Yasuyuki Mitani, Tomoyuki Kawamata
Journal: JA Clin Rep (2016)
Keywords: coagulation management, congenital fvii deficiency, recombinant activated fvii, surgical bleeding

Background:
Congenital factor VII (FVII) deficiency is a rare autosomal recessive coagulation disorder that is characterized by prolongation of prothrombin time. Recombinant activated FVII (rFVIIa) is widely used in the management of bleeding in patients with congenital FVII deficiency. We experienced anesthetic management of a patient with congenital FVII deficiency who was scheduled for laparoscopic colectomy using rFVIIa.
Case presentation:
We report a 67-year-old man with rectal cancer who was diagnosed with congenital FVII deficiency. He was scheduled for laparoscopic colectomy. General anesthesia was performed with propofol, remifentanil, and rocuronium without epidural anesthesia. For coagulation management, 1 mg of rFVIIa was intravenously administered before starting surgery. During surgery, FVII activity and prothrombin time-international normalized ratio (PT-INR) were maintained to be above 10 % and within the normal range (0.8-1.2), respectively. The surgery was uneventfully completed.
Conclusions:
We reported successful management of a patient with congenital FVII deficiency undergoing laparoscopic colectomy with monitoring of FVII activity and/or PT-INR.
Simultaneous resection of a gastric submucosal lipoma in the setting of bariatric surgery: A case report and review of current literature
Authors: Slava Agafonoff, Tracy Pitt, Joshua Max, Steven Udelhofen, Timothy S Braverman, Robert S Lenobel
Journal: Int J Surg Case Rep (2019)
Keywords: endoscopic mucosal resection, endoscopic ultrasound, sleeve gastrectomy, submucosal lipoma

Introduction:
Gastric submucosal lipoma is an uncommon finding in the stomach. A benign fatty tumor that is asymptomatic majority of the time. However, symptomatic and bigger tumors can be difficult to manage surgically and require detailed surgical planning prior to proceeding with bariatric surgery.
Presentation of case:
58year old female who presented for weight loss consultation. Underwent an esophagogastroduodenoscopy (EGD) that demonstrated a 3cm mass near the incisura. Endoscopic ultrasound (EUS) and biopsy demonstrated a submucosal lipoma. Due to the lipoma's location, resection was critical, as it would have led to obstructive symptoms following sleeve gastrectomy. The patient underwent a simultaneous laparoscopic vertical gastrectomy, gastric lipoma excision, EGD, and laparoscopic cholecystectomy DISCUSSION: Gastric lipomas are benign gastric submucosal tumors, representing less than 3% of all benign gastric neoplasms. Computer tomography and endoscopic ultrasound are important in establishing diagnosis. In current literature, excision with negative margins is standard of care, but small asymptomatic lesions can be followed without intervention.
Conclusion:
Gastric lipoma are a rare type of gastric submucosal tumors. Size is highly variable. Observation is a reasonable approach when small and asymptomatic, but multiple surgical modalities can be utilized to remove the tumor. Careful utilization of pre-operative imaging including EUS is critical in choosing the appropriate surgery if simultaneous bariatric management is undertaken.
Carpopedal spasm in a 4 year old boy with persisted vomiting and dyselectrolytemia in Wesley Guild Hospital Ilesa
Authors: Oluwasola Julius Oke, Kazeem Olarenwaju Amoo, Ifeoluwa Alex Akinwumi, Omomayowa Omotola Fawale, Adewuyi Temidayo Adeniyi, Emmanuel Oluwatosin Adeniji, Hammed Hassan Adetola, Busayo Gideon Ologun, Oluwatobi Faith Folarin, Dedmilade Kehinde Kuti
Journal: Pan Afr Med J (2019)
Keywords: child, carpopedal spasm, dyselectrolytemia
MeSH terms: Spasm / etiology, Vomiting / complications, Water-Electrolyte Imbalance / complications, Case Reports, Calcium / metabolism, Child, Preschool, Hand, Humans, Male, Water-Electrolyte Imbalance / etiology, Calcium

Carpopedal spasm have various causes ranging from dsyselecrolytemia, syndromic, metabolic or endocrine causes. Any of these could cause a decrease in ionized calcium and tetany. Excessive vomiting leading to alkalosis, hypokaleamia and decreased ionised calcium should be kept in mind for early etiological diagnosis of carpopedal spasm. We report a case of 4-year-old boy presenting with a history of recurrent painful spasm and flexion of bilateral hands following excessive vomiting and electrolyte derangement.
Intra- abdominal sepsis from a perforated duodenal ulcer-Management of a difficult surgical abdomen
Authors: Mutua Irene, Mariga Denver, Marilyn Omondi, Kiptoon Dan
Journal: Int J Surg Case Rep (2019)
Keywords: intra-abdominal sepsis, multiple abdominal surgeries, open abdomen, peptic ulcer disease, peritonitis

Introduction:
Peptic ulcer perforation is a common surgical emergency that is a complication of 9% of patients with peptic ulcer disease (Kjetil et al., 2015 [1]). Despite advances in the management of peptic ulcer disease, the number of acute complications have remained constant. Intra-abdominal sepsis is defined as inflammation of the peritoneum caused by pathogenic micro-organisms and their products (Pavlidis, 2003).
Case presentation:
We present a case report on intra-abdominal sepsis in a 20 yr old patient admitted in the intensive care unit at our institution following a perforated duodenal ulcer that was repaired by modified Graham patch method but leaked and he had multiple surgeries thereafter necessitating the open abdomen.
Discussion:
The open abdomen remains an option to the surgeon as the patient may have severe peritonitis or be in septic shock. Hence the need of damage control laparotomy due to severe physiological derangement or a planned second look laparotomy if there is failed source control.
Conclusion:
Intra-abdominal sepsis management of patient in an intensive care unit set-up with adequate surgery, open abdomen treatment and antibiotics given based on blood culture and sensitivity results enables successful management of difficult surgical abdomens.
Adenosquamous Carcinoma of Gallbladder with Unusual Prognosis: A Case Report
Authors: Siddinath Gyawali, Biraj Pokhrel, Deepak Sharma, Naveen Chandra Bhatta, Bishnu Prasad Kandel, Paleswan Joshi Lakhey
Journal: JNMA J Nepal Med Assoc (2023)
Keywords: carcinoma, case reports, cholecystectomy, prognosis
MeSH terms: Carcinoma, Adenosquamous / diagnosis, Carcinoma, Adenosquamous / surgery, Gallbladder Neoplasms / diagnosis, Gallbladder Neoplasms / surgery, Case Reports, Aged, Female, Humans, Prognosis

The adenosquamous carcinoma of the gallbladder is a rare variant accounting for only 1-4% of all primary gallbladder carcinoma. Regardless of the histological types, all gallbladder carcinomas have silent and rapid progression resulting in delayed diagnosis and poor prognosis. Even with medical and/or surgical interventions, the median survival of patients with adenosquamous carcinoma, one of the histological variants, is less than a year. However, we present a case of adenosquamous carcinoma with an unusually better prognosis. A 70-year-old female patient, after being diagnosed with gallbladder carcinoma was suggested for surgical resection but was lost to follow-up since then. Two years later, the patient presented and was managed with extended cholecystectomy. The slow progression and non-recurrence of the tumour during follow-up for two years after the surgery indicates a better prognosis in this case.
Keywords:
carcinoma; case reports; cholecystectomy; prognosis.
Chorea Associated with Lamotrigine Use
Authors: Sofia Rael, Negin Badihian, Kelsey M Smith, Elizabeth A Coon
Journal: Tremor Other Hyperkinet Mov (N Y) (2023)
Keywords: chorea, antiseizure medications, depression, hyperkinetic, lamotrigine, movement disorder
MeSH terms: Chorea, Movement Disorders, Review, Case Reports, Research Support, N.I.H., Extramural, Adult, Female, Humans, Lamotrigine, Middle Aged, Retrospective Studies, Lamotrigine

Background:
Movement disorders, including chorea, have been cited as a side effect of lamotrigine use. However, the association is controversial and clinical characteristics in such cases are unclear. We sought to explore whether chorea may be associated with lamotrigine use.
Methods:
We performed a retrospective chart review of all patients diagnosed with chorea who had concurrent use of lamotrigine between 2000-2022. Demographic information and clinical characteristics were analyzed, including medical comorbidities and concurrent medication use. A literature search and review were conducted, with additional cases of lamotrigine-associated chorea analyzed.
Results:
Eight patients met the inclusion criteria for the retrospective review. In 7 patients, other causes of chorea were considered more likely. However, a 58-year-old woman with bipolar disorder on lamotrigine for mood stabilization had a clear association of chorea induced by lamotrigine. The patient was on multiple centrally active medications. Three additional cases of lamotrigine-associated chorea were identified through a literature review. In 2 of these cases, other centrally acting agents were used, and chorea was resolved with weaning lamotrigine.
Discussion:
Chorea is infrequently seen in the setting of lamotrigine use. In these rare cases, the presence of other centrally acting medications with lamotrigine may contribute to chorea.
Highlights:
Lamotrigine use is associated with movement disorders, including chorea, but the characteristics are not clearly defined. From our retrospective review, one adult had clear temporal and dose-related association between chorea and lamotrigine. We analyzed this case in conjunction with a literature review of cases of chorea associated with lamotrigine.
Use of Chlorothiazide in the Management of Central Diabetes Insipidus in Early Infancy
Authors: Manish Raisingani, Resmy Palliyil Gopi, Bina Shah
Journal: Case Rep Pediatr (2017)
MeSH terms: Case Reports

Management of central diabetes insipidus in infancy is challenging. The various forms of desmopressin, oral, subcutaneous, and intranasal, have variability in the duration of action. Infants consume most of their calories as liquids which with desmopressin puts them at risk for hyponatremia and seizures. There are few cases reporting chlorothiazide as a temporizing measure for central diabetes insipidus in infancy. A male infant presented on day of life 30 with holoprosencephaly, cleft lip and palate, and poor weight gain to endocrine clinic. Biochemical tests and urine output were consistent with central diabetes insipidus. The patient required approximately 2.5 times the normal fluid intake to keep up with the urine output. Patient was started on low renal solute load formula and oral chlorothiazide. There were normalization of serum sodium, decrease in fluid intake close to 1.3 times the normal, and improved urine output. There were no episodes of hyponatremia/hypernatremia inpatient. The patient had 2 episodes of hypernatremia in the first year of life resolving with few hours of hydration. Oral chlorothiazide is a potential bridging agent for treatment of central DI along with low renal solute load formula in early infancy. It can help achieve adequate control of DI without wide serum sodium fluctuations.