OpenMed/multicare-articles huggingface dataset:
Impacts of COVID-19 on clinical research in the UK: A multi-method qualitative case study
Authors: David Wyatt, Rachel Faulkner-Gurstein, Hannah Cowan, Charles D A Wolfe
Journal: PLoS One (2021)
MeSH terms: COVID-19 / epidemiology, Research / statistics & numerical data, Research Support, Non-U.S. Gov't, COVID-19 / virology, Decision Making, Humans, Interviews as Topic, Research Personnel / psychology, SARS-CoV-2 / isolation & purification, United Kingdom / epidemiology

Background:
Clinical research has been central to the global response to COVID-19, and the United Kingdom (UK), with its research system embedded within the National Health Service (NHS), has been singled out globally for the scale and speed of its COVID-19 research response. This paper explores the impacts of COVID-19 on clinical research in an NHS Trust and how the embedded research system was adapted and repurposed to support the COVID-19 response.
Methods and findings:
Using a multi-method qualitative case study of a research-intensive NHS Trust in London UK, we collected data through a questionnaire (n = 170) and semi-structured interviews (n = 24) with research staff working in four areas: research governance; research leadership; research delivery; and patient and public involvement. We also observed key NHS Trust research prioritisation meetings (40 hours) and PPI activity (4.5 hours) and analysed documents produced by the Trust and national organisation relating to COVID-19 research. Data were analysed for a descriptive account of the Trust's COVID-19 research response and research staff's experiences. Data were then analysed thematically. Our analysis identifies three core themes: centralisation; pace of work; and new (temporary) work practices. By centralising research prioritisation at both national and Trust levels, halting non-COVID-19 research and redeploying research staff, an increased pace in the setup and delivery of COVID-19-related research was possible. National and Trust-level responses also led to widescale changes in working practices by adapting protocols and developing local processes to maintain and deliver research. These were effective practical solutions borne out of necessity and point to how the research system was able to adapt to the requirements of the pandemic.
Conclusion:
The Trust and national COVID-19 response entailed a rapid large-scale reorganisation of research staff, research infrastructures and research priorities. The Trust's local processes that enabled them to enact national policy prioritising COVID-19 research worked well, especially in managing finite resources, and also demonstrate the importance and adaptability of the research workforce. Such findings are useful as we consider how to adapt our healthcare delivery and research practices both at the national and global level for the future. However, as the pandemic continues, research leaders and policymakers must also take into account the short and long term impact of COVID-19 prioritisation on non-COVID-19 health research and the toll of the emergency response on research staff.
A large thigh mass: a blood clot or a rare skeletal muscle metastasis from renal cell carcinoma
Authors: Vipin Lohiya, Sheela Lohiya, Kevin Windsor
Journal: Springerplus (2013)
Keywords: fdg-pet/ct, renal cell carcinoma, skeletal muscle metastasis
MeSH terms: Case Reports

Background:
Renal cell carcinoma (RCC) is a tumor known for its unusual presentations and high rate of metastasis. Metastasis to lung, liver, bone and brain are common, but to skeletal muscle(SM) is very rare. Because only 11% of the RCC metastases to SM present after 10 years of initial presentation, there is no general consensus for its annual surveillance.
Methods:
We report a case of a 58 year old male with a history of RCC, initially diagnosed 11 years ago, who presented with a large SM mass. A large mass measuring more than 25 cm was located in left posterior thigh and was present for more than a year. It initially was diagnosed as a large blood clot and was treated with warfarin for more than 6 months. Clinical work up including FDG-PET/CT and MRI raised the possibility of a tumor, but a negative biopsy made the diagnosis uncertain. Because of high suspicion for a tumor, patient underwent a complete resection of the mass.
Results:
The resected mass measuring 28 × 18 × 7 cm was detailed as the largest skeletal muscle metastasis from RCC ever reported.
Conclusion:
This case emphasizes the importance of maintaining a high suspicion for metastasis even in less common metastatic sites mainly in patients with a history of RCC. It also highlights the importance of annual surveillance for metastasis in patients with RCC even after 10 years of initial presentation using FDG-PET/CT.
Intestinal Behcet's syndrome with an unusual complication bladder-intestines fistula and urinary tract infections-A case report
Authors: Jiewen Deng, Xuanming Fan, Hui Guo, Jie Gao, Xuan Li, Wei Wan
Journal: Front Cell Infect Microbiol (2023)
Keywords: biological agents, capsule endoscope, fistula formation and urinary tract infections, intestinal behcet’s syndrome, perforation of the intestine
MeSH terms: Behcet Syndrome / complications, Behcet Syndrome / diagnosis, Fistula / complications, Intestinal Perforation / diagnosis, Intestinal Perforation / etiology, Intestinal Perforation / surgery, Urinary Tract Infections / complications, Urinary Tract Infections / diagnosis, Case Reports, Adult, Humans, Intestines, Male, Urinary Bladder / diagnostic imaging

A 33-year-old male patient with a 17-year Behcet's syndrome history showed abdominal pain and fever symptoms. The abdominal CT was suggestive of an acute ileocecal intestinal perforation. In addition, the symptoms disappeared after the conservative treatment. Some related examinations, including capsule endoscopy, were performed to explain the phenomenon of the food residue urine. These results indicated the intestine-urinary tract fistula formation, supposed to be the outcome of intestinal Behcet's syndrome perforation. This is a rare case of intestinal Behcet's syndrome with abdominal symptoms as the main manifestation. It was complicated by entero-urinary fistula formation and urinary tract infections. Now, we report this story to emphasize that capsule endoscopy is conducive to the diagnosis and assessment of the intestinal Behcet's syndrome; moreover, anti-inflammatory treatment including biological agents is effective to relieve the disease at the acute stage in addition to surgical methods.
Intraparenchymal Renal Artery Pseudoaneurysm and Arteriovenous Fistula on a Solitary Kidney Occurring 38 Years after Blunt Trauma
Authors: Daniel Benamran, Benedicte de Clippele, Frank Hammer, Bertrand Tombal
Journal: Case Rep Urol (2017)
MeSH terms: Case Reports

Pseudoaneurysm and arteriovenous fistulae of the renal artery are rare complications of kidney trauma. They commonly result from open traumas and occur within days after the injury. Common symptoms include acute haematuria, pain, or hypertension. We report the case of a fifty-three-year-old man presenting with symptomatic complex chronic high flow kidney arteriovenous fistula with interposition of a pseudoaneurysmal pouch and arterial aneurysmal dilatation in a solitary left kidney 38 years after a blunt trauma. Those conditions were successfully treated by endovascular embolization followed by regular radiologic, biological, and clinical follow-up. To the best of our knowledge, few similar cases were reported more than 20 years after trauma. However, no case combining an arteriovenous fistula and a pseudoaneurysm revealing as late as 38 years after trauma was found. In addition, management of those conditions on a solitary kidney and outcomes has not been described. We believe that our case depicts the clinical presentation and management of this rare entity that should not be unrecognized due to its potential lethal implications.
Delayed Presentation of Tetralogy of Fallot with Isolated Cyanosis
Authors: Zachary Zemore, Avni Sharma, Kerri Carter, Aline Baghdassarian
Journal: Case Rep Pediatr (2018)
MeSH terms: Case Reports

A pediatric patient with hypoxia or cyanosis can frighten even the most seasoned emergency providers. Patients with these symptoms require immediate evaluation and intervention to stabilize their condition. While the differential can be broad, specific attention must be paid to cardiopulmonary etiologies. Tetralogy of Fallot is the most common cyanotic congenital heart abnormality, and routine screening surprisingly misses a significant amount of these cases. This case serves as an example of a missed diagnosis by screening efforts and reaffirms the resuscitation algorithm of a hypoxic pediatric patient that all emergency providers should be familiar with.
The Anaesthesiologist and Palliative Care in a Newborn with the Adam "Sequence"
Authors: Alberto Vieira Pantoja, Maria Emília Gonçalves Estevez, Bruno Lima Pessoa, Fernando de Paiva Araújo, Bruno Mendonça Barcellos, Ciro Augusto Floriani, Marco Antonio Cardoso de Resende
Journal: Case Rep Anesthesiol (2017)
MeSH terms: Case Reports

Reports focusing on biomedical principlism and the role of anaesthesiologists in palliative care are rare. We present the case of a newborn with multiple craniofacial anomalies and a diagnosis of ADAM "sequence," in which surgical removal of placental adhesions to the dura mater and the correction of meningocele was not indicated due to the very short life expectancy. After 48 hours, the odor from the placenta indicted a necrotic process, which prevented the parents from being close to the child and increased his isolation. Urgent surgery was performed, after which the newborn was transported to the ICU and intubated under controlled mechanical ventilation. The patient died a week later. The principles of beneficence, nonmaleficence, justice, and respect for autonomy are simultaneously an inspiratory and regulatory framework for clinical practice. Although only necessary procedures are defended, which suggests a position contrary to invasive interventions at the end of life, sometimes they are the best palliative measures that can be taken in cases like the one described here.
Increased dosage of infliximab is a potential cause of Pneumocystis carinii pneumonia
Authors: Takuya Iwama, Aki Sakatani, Mikihiro Fujiya, Kazuyuki Tanaka, Shugo Fujibayashi, Yoshiki Nomura, Nobuhiro Ueno, Shin Kashima, Takuma Gotoh, Junpei Sasajima, Kentaro Moriichi, Katsuya Ikuta
Journal: Gut Pathog (2016)
MeSH terms: Case Reports

Methods:
Pneumocystis carinii pneumonia occasionally appears in immunodeficient patients. While several reports have shown that Pneumocystis carinii pneumonia occurred in the early phase of starting infliximab treatment in patients with Crohn's disease (CD), the present case suggests for the first time that an increased dosage of infliximab may also lead to pneumonia.
Results:
A 51-year-old male had been taking 5 mg of infliximab for the treatment of CD for 10 years with no adverse events. Beginning in September 2013, the dose of infliximab had to be increased to 10 mg/kg because his status worsened. Thereafter, he complained of a fever and cough, and a CT scan revealed ground-glass opacities in the lower lobes of the bilateral lung with a crazy-paving pattern. Bronchoscopy detected swelling of the tracheal mucosa with obvious dilations of the vessels. A polymerase chain reaction using a bronchoalveolar lavage fluid sample detected specific sequences for Pneumocystis jirovecii; thus he was diagnosed with Pneumocystis carinii (jirovecii) pneumonia. After discontinuing infliximab and starting antibiotic treatment, his symptoms and CT findings were dramatically improved.
Conclusions:
The administration of an increased dosage of infliximab can cause Pneumocystis carinii pneumonia in CD patients.
Unilateral Congenital Lacrimal Fistula with Renal Agenesis and Pelvic Kidney: A Case Report and Review of the Literature
Authors: A Altun, S A Kurna, T Sengor, G Altun, A Oflaz, H S Sonmez
Journal: Case Rep Ophthalmol Med (2015)

A 12-year-old boy presented to the clinic of ophthalmology because of watering and discharge from his left lower eyelid. The inspection examination revealed an orifice that was associated with congenital lacrimal fistula (CLF). He underwent a complete ophthalmologic and systemic evaluation to explore possible associated findings. Systemic evaluation revealed multiple renal anomalies: right renal agenesis and left ectopic pelvic kidney. This case is unique because this is the first reported case of CLF accompanied with ectopic pelvic kidney in the literature.
An indwelling urethral catheter knotted around a double-j ureteral stent: an unusual complication after kidney transplantation
Authors: E G Warmerdam, R J Toorop, A C Abrahams, P Berger
Journal: Case Rep Nephrol (2011)
MeSH terms: Case Reports

Urethral catheterization is a common procedure with a relatively low complication rate. Knotting of an indwelling urethral catheter is a very rare complication, and there are only a few case reports on knotted catheters, most of them concerning children. We report an especially rare case where a urethral catheter formed a knot around a double-J ureteral stent after a kidney transplantation. We will discuss the various risk factors for knotting of a catheter and the methods to untangle a knot.
Massive Lymphocele Associated with Allograft Hydronephrosis: An Ultrasound Case Study
Authors: Harini Bejjanki, Kawther F Alquadan, Abhilash Koratala
Journal: POCUS J (2022)
Keywords: allograft, hydronephrosis, lymphocele, point of care ultrasound, renal transplant
MeSH terms: Case Reports

Lymphocele is a lymphocyte-rich fluid collection that results from disruption of lymphatics in the recipient during renal transplantation. While small collections resolve spontaneously, larger, symptomatic ones may cause obstructive nephropathy requiring percutaneous or laparoscopic drainage. Prompt diagnosis using bedside sonography may obviate the need for renal replacement therapy. Herein, we present a case of a 72-year-old kidney transplant recipient who developed allograft hydronephrosis secondary to compression by a lymphocele.
Superficial granulomatous pyoderma of the face: a case report and review of the literature
Authors: Sarah M Persing, Donald Laub Jr
Journal: Eplasty (2012)

Introduction:
Superficial granulomatous pyoderma (SGP) is a rare variant of pyoderma gangrenosum (PG) and differs from classic PG in its indolent clinical course, lack of associated underlying disease, the finding of a granulomatous infiltrate on histology, and better prognosis with less-aggressive therapies.
Methods:
We report on a case of SGP involving the face following local reexcision of a biopsy scar.
Results:
The patient developed an indolent ulceration following an excision of an unfavorable scar on her face.
Discussion:
Superficial granulomatous pyoderma is usually responsive to conservative treatment with antibacterial or local anti-inflammatory agents. Facial involvement with SGP is particularly rare and tends to be more refractory to conservative management. Superficial granulomatous pyoderma involving the face appears to respond better to intensive treatment with systemic corticosteroids or immunosuppressants. To prevent poor cosmetic and functional outcomes in patients with nonhealing lesions, it is important for surgeons to recognize the clinical and histopathologic presentation of SGP and consider initiating a more aggressive management approach for SGP involving the face.
Paralytic Ileus Secondary to Methamphetamine Abuse: A Rare Case
Authors: Mark Aidan McKelvie, Yuksel Gercek
Journal: Case Rep Surg (2017)
MeSH terms: Case Reports

Methamphetamine hydrochloride, colloquially referred to as "crystal meth," is a potent psychoactive amphetamine derivate. Methamphetamine produces stimulant effects in the user including increased energy and alertness as well as inducing intense euphoric symptoms and suppressing appetite through its dopaminergic, serotonergic, and adrenergic actions. Use of methamphetamine can adversely affect cardiovascular, neurological, and gastrointestinal physiology leading to significant morbidity. We present a rare case of paralytic ileus secondary to methamphetamine abuse which has only once before been described in the literature.
A case of cystic dysplasia of the rete testis in a 17-months-old boy
Authors: Anna Poupalou, George Spyridis, Marina Vakaki, Panagiota Giamarelou, George Petousis, Pantelis Nikolaidis
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

Cystic dysplasia of the testis (CDT) is a benign, congenital malformation of the testis and a rare cause of painless scrotal swelling in children, mimicking testicular cancer. It is commonly unilateral, often associated with ipsilateral wolffian duct and ureteral abnormalities. Cystic dysplasia of the rete testis (CDT) represents a diagnostic challenge made easier if age, precise localisation, typical ultrasonographic features, the presence or absence of associated genitourinary malformations, as well as tumor markers are considered. The definite treatment of such a benign lesion is testis-sparing surgery, however in most cases watch and wait strategy can be recommended. We present a case of cystic dysplasia of the testis in a 17-month-old boy with right multicystic dysplastic kidney, epididymal cyst, history of vesicoureteral reflux (VUR), as well as of solitary umbilical artery. We performed epididymidal cyst enucleation and right testicular biopsy.
Graves' disease following hypothyroidism due to Hashimoto's thyroiditis in a black South African lady: a case report
Authors: Chukwuma Ekpebegh, Khaled Elmezughi, Lungiswa Mtingi
Journal: Pan Afr Med J (2019)
Keywords: graves´ disease, hashimoto´s thyroiditis, south africa, autoimmune thyroid disease, hyperthyroidism, hypothyroidism
MeSH terms: Graves Disease / diagnosis, Hashimoto Disease / complications, Hypothyroidism / diagnosis, Case Reports, Black People, Female, Graves Disease / etiology, Humans, Hypothyroidism / etiology, Middle Aged

Graves' disease and Hashimoto's thyroiditis are autoimmune thyroid disorders with distinct pathological and histopathological features. The conversion from Hashimoto's thyroiditis to Graves' disease has been rarely reported throughout the world with no reports in the African race to our knowledge. We here report an African lady who was initially diagnosed with primary hypothyroidism following Hashimoto's disease but later became thyrotoxic due to Graves' disease.
A case of granulomatous slack skin cutaneous T-cell lymphoma: PET/CT imaging findings
Authors: A T Kendi, S Parker, D Parker, B Barron
Journal: BJR Case Rep (2015)
MeSH terms: Case Reports

A 24-year-old female presented with granulomatous slack skin (GSS) cutaneous T-cell lymphoma. The patient underwent systemic chemotherapy. Owing to the development of several chemotherapy-related complications, therapy was discontinued. Subsequently, disease progression was noted clinically. Our patient's disease progression was clearly demonstrated by 18F-fludeoxyglucose positron emission tomography (PET)/CT findings. PET/CT imaging findings of GSS have not yet previously been reported. In this report, we present PET/CT characteristics of a patient with GSS.