OpenMed/multicare-articles huggingface dataset:
Uniportal Thoracoscopic Debridement for Children With Refractory Pleural Empyema: Case Series of 21 Patients
Authors: Jin-Xi Huang, Qiang Chen, Song-Ming Hong, Jun-Jie Hong, Hua Cao
Journal: Front Pediatr (2021)
Keywords: children, pleural empyema, pyothorax, uniportal, video-assisted thoracoscopic surgery

Purpose: The effectiveness of video-assisted thoracic surgery (VATS), even uniportal VATS (U-VATS), in the treatment of pleural empyema has recently been demonstrated. However, few works have evaluated its safety and feasibility for children. We review our experience with U-VATS in the treatment of pleural empyema for children under 11 years old. Methods: From January 2019 to December 2020, we consecutively enrolled 21 children with stage II and stage III pleural empyema in our institution. A 1.0 cm utility port was created in the 5th intercostal space at the anterior axillary line. A rigid 30°5 mm optic thoracoscope was used for vision, and two or three instruments were used through the port. Surgery was based on three therapeutic columns: removal of pleural fluid, debridement, and decortication. A chest tube was inserted through the same skin incision. Perioperative data and outcomes were summarized. Results: The procedures were successful, and satisfactory debridement of the pleural cavity was achieved in all cases. The mean age was 4.1 years (range: 6 months to 11 years old). The mean operating time was 65.7 ± 23.2 min. No intraoperative conversion or major complications were identified among the patients. The mean hospital stay was 5.0 ± 0.6 days. At a follow-up of more than 4 months after operating, all patients had recovered well without recurrence. Conclusion: According to our experience, U-VATS debridement is feasible for the surgical management of stage II and III empyema in the pediatric population. Indeed, U-VATS permits easier performance and complete debridement and decortication, with a very low risk for conversion.
Clean Label Trade-Offs: A Case Study of Plain Yogurt
Authors: Sara Maruyama, Juyun Lim, Nadia A Streletskaya
Journal: Front Nutr (2021)
Keywords: choice experiment, clean label, consumer preferences, ingredient list, price, texture

Consumer demand for clean label has risen in recent years. However, clean label foods with simple and minimalistic ingredient lists are often expensive to produce and/or may possess less desirable sensory qualities. Accordingly, understanding consumer preferences regarding the clean label trend would be of great interest to the food industry. Here we investigate how ingredient lists and associated sensory quality descriptions may influence consumer preferences using a hypothetical choice experiment. In particular, we test the impacts of four common stabilizers (carrageenan, corn starch, milk protein concentrate, and pectin) and textural characteristics on preferences and willingness to pay for plain yogurt. A total of 250 yogurt consumers participated in the study. The results of a mixed logit analysis suggest that clean labeling significantly increases the likelihood of consumer choice, while poor texture reduces consumer choice. More importantly, the negative impact of poor texture seems to be less significant for clean label yogurts compared to that for yogurts with longer ingredient lists. Among all stabilizers, corn starch in particular has a significant negative impact on consumer choice. The estimated average consumer willingness to pay for clean labels is between $2.54 and $3.53 for 32 oz yogurt formulations. Furthermore, clean labels minimize the negative impact of textural defects with consumers willing to pay an estimated premium of $1.61 for the family size yogurt with a simple ingredient list. Results of latent class modeling reveal two classes of consumers with similar patterns of demand who prefer clean labels and, on average, would rather purchase a yogurt with a textural defect than opt out of purchasing a yogurt entirely. Implications for the food industry are discussed.
Apocrine Adenocarcinoma of the Vulva: A Case Report and Review of the Literature
Authors: Kohei Aoyama, Hiroshi Matsushima, Morio Sawada, Taisuke Mori, Satoru Yasukawa, Jo Kitawaki
Journal: Case Rep Obstet Gynecol (2016)

Primary vulvar adenocarcinomas are very rare. We describe the rare case of primary vulvar apocrine adenocarcinoma, a histologically rare subtype of vulvar adenocarcinoma. A 57-year-old Japanese woman presented with an enlarging vulvar mass. A dark-red, hemorrhagic, ulcerated tumor was on the right side of the anterior labial commissure measuring approximately 3.5 × 3.5 cm. Preoperative biopsy showed poorly differentiated carcinoma with partial differentiation to adenocarcinoma. Systemic examination revealed lymph node metastases in both inguinal regions and no other primary source. We performed radical vulvectomy and bilateral inguinal and pelvic lymphadenectomy. Histopathologic diagnosis was apocrine adenocarcinoma of the vulva with inguinal lymph node metastases, pT1bN2bM0. Surgical margins were negative. The patient received no adjuvant chemotherapy or radiation. Inguinal lymph node recurrence occurred after six months. Reresection and adjuvant tomotherapy were performed. After a further 12 months of observation, no rerecurrence was observed. The patient is now on follow-up.
Case Report: Complete Response to Nivolumab in a Patient With Programmed Cell Death 1 Ligand 1-Positive and Multiple Gene-Driven Anaplastic Lymphoma Kinase Tyrosine Kinase Inhibitor-Resistant Lung Adenocarcinoma
Authors: Wen Dong, Pengfei Lei, Xin Liu, Qin Li, Xiangyang Cheng
Journal: Front Immunol (2021)
Keywords: eml4-alk, pd-l1, complete remission, lung cancer, nivolumab
MeSH terms: Adenocarcinoma of Lung / drug therapy, Adenocarcinoma of Lung / genetics, Lung Neoplasms / drug therapy, Lung Neoplasms / genetics, Nivolumab / therapeutic use, Case Reports, Adenocarcinoma of Lung / pathology, Adult, Anaplastic Lymphoma Kinase / genetics, B7-H1 Antigen / genetics, Cell Cycle Proteins / genetics, Humans, Lung Neoplasms / pathology, Male, Microtubule-Associated Proteins / genetics, Mutation, Nivolumab / pharmacology, Protein Kinase Inhibitors / therapeutic use, Proto-Oncogene Proteins B-raf / genetics, Serine Endopeptidases / genetics, Treatment Outcome, Tumor Microenvironment, B7-H1 Antigen, Cell Cycle Proteins, Microtubule-Associated Proteins, Protein Kinase Inhibitors, Nivolumab, ALK protein, human, Anaplastic Lymphoma Kinase, BRAF protein, human, Proto-Oncogene Proteins B-raf, EML4 protein, human, Serine Endopeptidases

Multiple gene-driven programmed cell death 1 ligand 1 (PD-L1)-expressing non-small-cell lung cancer (NSCLC) is very rare. Previous studies have shown that patients with NSCLC with anaplastic lymphoma kinase (ALK) gene rearrangement rarely benefit from PD-L1 inhibitors. Besides the secondary mutations in ALK gene, other mechanisms might contribute to tumor resistance to ALK tyrosine kinase inhibitors (ALK-TKIs). Herein, we present a case of PD-L1-overexpressing lung adenocarcinoma that harbors both EML4-ALK gene rearrangement and BRAF mutation. In particular, a second molecular analysis after resistance to first- and second-generation ALK-TKIs revealed a high PD-L1 expression and tumor mutation burden. Therefore, treatment with nivolumab monotherapy, an anti-PD-1 inhibitor, was started and the patient achieved complete remission. This case report suggested that PD-1 inhibitors might be an effective treatment option for patients with multiple gene-driven PD-L1-expressing NSCLC harboring ALK gene rearrangement.
Bronchogenic cyst of the neck in an elder patient: A case report
Authors: Inês Santos, João Barros, Teresa Lopes, Margarida Mesquita, Leonor Barroso, Isabel Amado
Journal: Int J Surg Case Rep (2019)
Keywords: bronchogenic cyst, case report, duplication cyst, neck

Introduction:
Bronchogenic cysts are rare malformations, mostly diagnosed in children. We report the rare case of a neck bronchogenic cyst diagnosed in an elderly patient.
Presentation of case:
The patient complained of a long-standing submental mass. The diagnostic work-up resulted in a thyroglossal duct cyst diagnosis for which the patient underwent a Sistrunk procedure. However, the histological analysis of the lesion ultimately revealed a bronchogenic cyst.
Discussion:
Neck bronchogenic cysts are rare and, in adults, normally asymptomatic. Imaging exams can suggest the diagnosis but they are most important for surgical planning. Surgery is the elected treatment for bronchogenic cysts and the histopathologic exam of the specimen provides definitive diagnosis.
Conclusion:
This case demonstrates than even though they are a rare diagnosis, bronchogenic cysts should be considered in the diagnostic work-up of neck cysts, even in elderly patients.
Conservative Management of Asymptomatic Pneumoperitoneum; Report of Two Cases
Authors: Leila Alizadeh, Mahdieh Shakeri-Darzekonani, Amin Sadrazar, Masoud Nouri-Vaskeh, Sedigheh Basirjafari
Journal: Arch Acad Emerg Med (2019)
Keywords: peptic ulcer perforation, conservative treatment, pneumoperitoneum, proton pump inhibitors
MeSH terms: Case Reports

Peptic ulcer disease is a common gastrointestinal disorder, the prevalence of which has reduced in recent years due to effective new treatments. Peptic ulcer perforation is an emergent life-threatening condition that causes pneumoperitoneum and septic shock. It often requires surgical procedures. We describe two cases of peptic ulcer perforation with only mild discomfort on the epigastric region since several months before. The patients were treated with a high dose proton pump inhibitor and conservative treatment without surgical procedures. Weekly follow up of the cases showed that the clinical condition of patients remained stable without any new signs and symptoms. This report shows that noninvasive treatment alone can be effective in some cases with mild symptoms.
Auxiliary Liver Graft Can Be Protected From HBV Infection in HBsAg Positive Blood Circulation
Authors: Lin Wei, Hai-Ming Zhang, Chi-Dan Wan, Wei Qu, Zhi-Gui Zeng, Ying Liu, Jun Xiong, Li-Ying Sun, Zhi-Jun Zhu
Journal: Front Med (Lausanne) (2021)
Keywords: apolt, entecavir, hepatitis b recurrence, liver cirrhosis, liver regeneration

Auxiliary grafts have a high risk of Hepatitis B virus (HBV) infection in patients with chronic HBV-related diseases. Hepatitis B virus-related auxiliary partial orthotopic liver transplantation (APOLT) cases were reviewed to show the results of current methods to block native-to-graft HBV transmission. Three patients received APOLT for HBV-related liver cirrhosis and a recurrent upper gastrointestinal hemorrhage between April 2015 and January 2017 by the liver transplant team of Beijing Friendship Hospital affiliated with Capital Medical University. All three patients were positive for HBV surface antigen (HBsAg) and had a negative HBV DNA test result before transplantation. After auxiliary transplantations, HBsAg was found to be positive in two patients and negative in one patient. To avoid graft infection of HBV, entecavir-based therapy was employed and the remnant native livers of the recipients were removed 51-878 days after liver transplantation. Then, serum conversions of HBsAg were found in all three cases. For the first time, this case series shows the possibility of blocking the transmission of HBV from a native liver to a graft in auxiliary transplantation by entecavir-based therapy. Among the cases, a left lobe graft was successfully implanted as a replacement of the right lobe of the recipient, which is also discussed.
Cervical Ripening Balloon in Combination with Methotrexate and Potassium Chloride for the Treatment of a 13-week Cervical Ectopic Pregnancy
Authors: Alina Tvina, Emily Smith, Meredith Cruz
Journal: Case Rep Obstet Gynecol (2023)
MeSH terms: Case Reports

Background:
Cervical pregnancy, an uncommon type of ectopic pregnancy, can lead to devastating consequences if not diagnosed and treated early. Despite this, there are no specific guidelines on how to treat such pregnancies especially in advanced gestational ages (GAs).
Case:
This is a 35-year-old patient who presented to our hospital at 13 weeks GA after failing systemic multidose methotrexate therapy for a cervical ectopic pregnancy. Given desire to preserve fertility, a minimally invasive conservative approach was taken involving potassium chloride (KCl) and methotrexate injections into the gestational sac, followed by immediate Cook intracervical double balloon placement under direct ultrasound visualization, with removal of the balloon after 72 hours, and ultimately resolution of the pregnancy 12 weeks after the removal.
Conclusion:
Advanced first trimester cervical ectopic pregnancy after failure of methotrexate therapy was managed successfully with minimally invasive KCl and methotrexate injections in combination with cervical ripening balloon.
Prevention of High-Dose Cytosine Arabinoside-Induced Acute Pericarditis with Preemptive Dexamethasone Administration: A Case Report and Literature Review
Authors: Weerapat Owattanapanich, Theera Ruchutrakool
Journal: Case Rep Hematol (2018)
MeSH terms: Case Reports

Pericarditis/pericardial effusion (PC/PEEF) is a rare but fatal complication of cytosine arabinoside (Ara-C). We report an acute myeloid leukemia (AML) patient who developed massive pericardial effusion after a second Ara-C exposure. As Ara-C was most beneficial in controlling the leukemia, she was treated with a further cycle of Ara-C along with dexamethasone to prevent the complication from reoccurring. No PC/PEEF was subsequently detected.
A Case of Strongyloidiasis: An Immigrant Healthcare Worker Presenting with Fatigue and Weight Loss
Authors: Tarundeep Grewal, Heela Azizi, Alexa Kahn, Zaid Shakir, Sahar Takkouche, Khin N Aung, William Lois, Muhammad Hasan
Journal: Case Rep Infect Dis (2017)
MeSH terms: Case Reports

Background:

Strongyloides stercoralis is an intestinal nematode parasite classified as a soil-transmitted helminth, endemic in tropical and subtropical regions. Strongyloides stercoralis can remain dormant for decades after the initial infection.
Case:
We describe a patient who was diagnosed with Strongyloides stercoralis infection three weeks after a left inguinal hernia repair and discuss approaches to prevention, diagnosis, and treatment.
Conclusions:
Physicians in the United States often miss opportunities to identify patients with chronic strongyloidiasis. Symptoms may be vague and screening tests have limitations. We review current strategies for diagnosis and treatment of chronic intestinal strongyloidiasis in immigrant patients who have significant travel history to tropical regions and discuss the clinical features and management of the infection.
Failure of Nonoperative Management following Angioembolization for Blunt Splenic and Pancreatic Tail Injury
Authors: Kazuhiro Nishida, Tadao Kubota
Journal: Case Rep Emerg Med (2020)
MeSH terms: Case Reports

Background:
Over several decades, standard management of blunt spleen injury (BSI) has been changed from operative intervention to the selective operative and nonoperative management (NOM). However, some patient needs laparotomy first. This article describes a case of a BSI patient who failed nonoperative management after angioembolization (AE). Case Presentation. A 58-year-old man fell from his motorcycle and was brought to our hospital. His vital sign was stable after extracellular fluid bolus. A contrast-enhanced computed tomography scan of the abdomen showed AAST grade V spleen injury. AE was performed for the splenic artery, but his systolic blood pressure suddenly dropped under 60 mmHg. The resuscitative endovascular balloon occlusion of the aorta was inserted, and immediate laparotomy was performed. A pancreatic tail injury was detected, and the splenic artery and vein were burst at the pancreatic tail and controlled by hemostatic suture. After splenectomy, a drain was placed at the pancreatic tail and the abdomen was temporally closed. The postoperative course was not remarkable except for abdominal abscess treated with antibiotics, and he was discharged on foot.
Conclusion:
Although NOM is becoming one of the choices for severe BSI, there will still be a patient who requires surgery. Surgeons should be aware of the mechanism of injury and the limitation of AE as an adjunct to NOM. Patient selection for initial NOM and timing to convert to laparotomy are important.
Minimally invasive repair of iatrogenic right ventricular perforation guided by bedside contrast-enhanced ultrasound: A case report and literature review
Authors: Yanchun Zhao, Yucheng Lin, Zhiliang Hong, Baochun Lai, Lianghua Lian, Lin Chen, Qi Xie, Xiaofen Zhou, Songsong Wu
Journal: Front Cardiovasc Med (2022)
Keywords: bedside ultrasound, cardiac perforation, case report, leadless pacemaker, pericardial tamponade
MeSH terms: Case Reports

This case report involves a 93-year-old female patient with atrioventricular block and suffered right ventricular free wall perforation during installation of Micra Leadless Pacemaker (MLP). Pericardial tamponade occurred shortly, and we adopted pericardial catheter drainage as the primary emergency treatment. Considering the patient's physical conditions and leveraging the special treatment facilitates of the Intensive Care Unit (ICU), we tried a new emergency treatment approach. After putting the patient under intravenous anesthesia (no cardiac arrest), we made a small intercostal incision and performed bedside minimally invasive repair of right ventricular free wall perforation. It should be noted that ultrasound played a key role in pinpointing the breach and intraoperative guidance. We first used contrast-enhanced ultrasound (CEUS) to locate the breach. Then guided by bedside ultrasound, we accessed the perforation with the minimum incision size (5 cm). Our experience in this case may serve as a good reference in the emergency treatment for right ventricular free wall perforation.
Unilateral non-rotated left kidney with vascular and ureter variations in a cadaver: a unique case report with embryological and educational aspects
Authors: Kusum Gandhi, Judith Jaison, Eti Mantri
Journal: J Vasc Bras (2021)
Keywords: kidney, non-rotation, partial nephrectomy, renal arteries, ureter
MeSH terms: Review

The kidneys and ureters are retroperitoneal structures in the upper part of the paravertebral gutters, tilted against the structures on the sides of the lowest two thoracic and upper three lumbar vertebrae, so that their anterior and posterior surfaces face antero-laterally and postero-medially, respectively. Congenital anomalies of the urinary tract are often the underlying cause of renal pathologies; 40% of these pathological conditions are due to variations in location, shape, and size of the kidney(s), calyces, ureter, or bladder. This case report describes the presence of a unilateral non-rotated left kidney with vascular and ureter variations found during routine cadaveric dissection for medical graduates. Alterations in rotation of the kidney and its relation to structures at the hilum have great clinical significance when conducting surgical procedures like partial nephrectomy, nephron sparing surgery, and renal transplantation.
An Avid Imitator
Authors: Dimitrios Farmakiotis, Alexis Liakos, Michael B Miller, Jeffrey F Krane, Lindsey R Baden, Sarah P Hammond
Journal: J Clin Med Res (2016)
Keywords: cryptococcus, lymphoma, opportunistic infections
MeSH terms: Case Reports

We present a case of disseminated cryptococcal disease, coexisting with and mimicking lymphoma. Determination of serum cryptococcal antigen should be considered for lymphopenic patients with hematologic malignancies, presenting with unexplained fever, and/or lymphadenopathy and/or pulmonary findings. Patients with hematologic malignancies treated with chemotherapy regimens are susceptible to diverse opportunistic infections. Therefore, in this patient population, it is often necessary to obtain a definitive pathologic diagnosis, to diagnose uncommon syndromes and guide management.
Post-transplant de-novo renal phospholipidosis in a kidney transplant recipient: Fabry disease or something else?
Authors: Muhammad Saad Naseer, Raj Chand, Stefano Coppola, Adrian Abreo, Mukesh Sharma, Neeraj Singh
Journal: Clin Nephrol Case Stud (2020)
Keywords: fabry disease, cationic amphiphilic drugs, lamellar inclusions, myelin bodies, renal phospholipidosis
MeSH terms: Case Reports

Renal phospholipidosis is a rare cause of proteinuria and kidney dysfunction. We describe a kidney transplant recipient who presented with slowly rising serum creatinine, nephrotic range proteinuria, and lower extremity edema 10 years post transplant. He was diagnosed with renal phospholipidosis on the transplant kidney biopsy. Patient did not have prior history or current symptoms or signs of Fabry disease. Serum α-galactosidase level was normal. The etiology was suspected to be due to chronic use of sertraline, a previously reported cause of drug-induced renal phospholipidosis. Sertraline was discontinued, and proteinuria declined with stabilization of kidney function at 6-months follow-up.
Case report: Craniofrontonasal syndrome caused by a novel variant in the EFNB1 gene in a Colombian woman
Authors: Harry Pachajoa, Diana Marcela Vasquez-Forero, Sebastian Giraldo-Ocampo
Journal: Front Genet (2023)
Keywords: efnb1 gene, case report, craniosynostosis, frontonasal dysplasia, hypertelorism
MeSH terms: Case Reports

Craniofrontonasal Syndrome is a very rare dominant X-linked genetic disorder characterized by symptoms such as hypertelorism, craniosynostosis, eye alterations, bifid nose tip, and longitudinal ridging and splitting of nails. Heterozygous females are usually the patients severely affected. To date, clinical or genetic data have not been published for these patients in Colombia. Here we report a female proband with coronal craniosynostosis, hypertelorism, strabismus, rotational nystagmus, high-arched palate, dental crowding, scoliosis, severe pectus excavatum, unilateral breast hypoplasia, and brachydactyly; diagnosed with Craniofrontonasal Syndrome with the novel heterozygous variant c.374A>C (p.Glu125Ala) in the EFNB1 gene. So far, she has been treated with physical therapy and surgical correction of the bifid nose and an umbilical hernia. To the best of our knowledge, this is the first report of a patient with this rare genetic disorder in Colombia, expanding its mutational spectrum and highlighting the importance of genetic evaluation of patients with craniosynostosis and facial dysmorphism.
Neuromyelitis optica spectrum disorders associated with AQP4-positive-cancer-A case series
Authors: Yinghui Duan, Xin Wang, Xiaoyu Duan, Hanqing Gao, Xiaopei Ji, Xinyi Xiao, Feng Zhu, Qun Xue
Journal: Front Neurol (2022)
Keywords: aquaporin-4, autoimmune disease, cancer, neuro-oncology, neuromyelitis optic
MeSH terms: Case Reports

Neuromyelitis optica spectrum disorders (NMOSD) are autoimmune, astrocytopathic diseases affecting the central nervous system(CNS), especially the central optic nerve and spinal cord. Aquaporin 4-immunoglobulin G (AQP4-IgG) is the dominant pathogenic antibody and can be detected in about 80% of patients with NMOSD. Although only a few cases were reported on NMOSD associated with cancer, they demonstrated the potential paraneoplastic link between cancer and NMOSD. In the present study, we report three NMOSD cases associated with cancer, which are teratoma and lung adenocarcinoma, teratoma, and transverse colon adenocarcinoma, respectively. Pathological staining of tumor sections revealed a high AQP4 expression. After tumor removal, all cases were stable and suffered no further relapses, which revealed the potential paraneoplastic mechanism between cancer and NMOSD. One of our patient's serum AQP4-IgG was transiently slightly elevated even though AQP4 was highly expressed in tumor cells, which indicates that AQP4 is not the main pathogenic antibody but might be induced by other underlying pathogenic antibody-antigen reactions.