OpenMed/multicare-articles huggingface dataset:
Decoding of Self-paced Lower-Limb Movement Intention: A Case Study on the Influence Factors
Authors: Dong Liu, Weihai Chen, Ricardo Chavarriaga, Zhongcai Pei, José Del R Millán
Journal: Front Hum Neurosci (2017)
Keywords: brain-machine interface (bmi), electroencephalography (eeg), lower-limb movement, movement-related cortical potentials (mrcps), onset detection, sensory motor rhythms (smrs)

Brain-machine interfaces (BMIs) have been applied as new rehabilitation tools for motor disabled individuals. Active involvement of cerebral activity has been shown to enhance neuroplasticity and thus to restore mobility. Various studies have focused on the detection of upper-limb movement intention, while the fewer study has investigated the lower-limb movement intention decoding. This study presents a BMI to decode the self-paced lower-limb movement intention, with 10 healthy subjects participating in the experiment. We varied four influence factors including the movement type (dorsiflexion or plantar flexion), the limb side (left or right leg), the processing method (time-series analysis based on MRCP, i.e., movement-related cortical potential or frequency-domain estimation based on SMR, i.e., sensory motor rhythm) and the frequency band (e.g., delta, theta, mu, beta and MRCP band at [0.1 1] Hz), to estimate both single-trial and sample-based performance. Feature analysis was then conducted to show the discriminant power (DP) and brain modulations. The average detection latency was -0.334 ± 0.216 s in single-trial basis across all conditions. An average area under the curve (AUC) of 91.0 ± 3.5% and 68.2 ± 4.6% was obtained for the MRCP-based and SMR-based method in the classification, respectively. The best performance was yielded from plantar flexion with left leg using time-series analysis on the MRCP band. The feature analysis indicated a cross-subject consistency of DP with the MRCP-based method and subject-specific variance of DP with the SMR-based method. The results presented here might be further exploited in a rehabilitation scenario. The comprehensive factor analysis might be used to shed light on the design of an effective brain switch to trigger external robotic devices.
Muscle metastases from gallbladder cancer
Authors: L Gilardi, G Paganelli
Journal: Ecancermedicalscience (2011)
MeSH terms: Case Reports

Gallbladder cancer is a highly fatal disease with poor prognosis; indeed, a high proportion of tumours are diagnosed at an advanced stage. Metastases are commonly detected in regional lymph nodes, liver and peritoneum, but unusual sites of spread such as thyroid and breast have also been described in the literature.We report a case of unsuspected muscle metastases, associated to pulmonary metastases, detected by FDG-PET/CT in a patient with previously removed gallbladder cancer and persistent episodes of haemoptysis.
The theory of a co-creative process in advanced palliative home care nursing encounters: A qualitative deductive approach over time
Authors: Elisabeth Bergdahl, Britt-Marie Ternestedt, Carina Berterö, Birgitta Andershed
Journal: Nurs Open (2018)
Keywords: caring, case study research, nurse–patient relationship, palliative care

Aims and objectives:
The aim of this study was to test the theoretical conceptualization of the co-creative process in home care nursing encounters over time.
Method and design:
This was a multiple case study with a deductive analysis of qualitative data over time, using interviews and observations collected from three cases.
Results:
The co-creative process was complex and contained main, sub- and micro-processes. Time was important and valuable, giving the patient and relatives space to adjust the process to their own pace. Some processes were worked on more intensively in accordance with the patients' and relatives' needs, and these are considered the main-process. The further developed theory of the co-creative process and its main, sub- and microprocesses can be understood as a concretization of how good nursing care can be performed within caring relationships in the context of advanced palliative home care.
Posterior reversible leukoencephalopathy syndrome (PRES) after kidney transplantation: a case report
Authors: Carla Beatriz Davi, Bruna Pinheiro de Moraes, Bruno Fontes Lichtenfels, João Batista Saldanha de Castro Filho, Marcelle Maria Portal, Rosangela Munhoz Montenegro, Roberto Ceratti Manfro
Journal: J Bras Nefrol (2018)
MeSH terms: Kidney Transplantation, Posterior Leukoencephalopathy Syndrome / diagnosis, Postoperative Complications / diagnosis, Case Reports, Female, Humans, Middle Aged

Introduction:
Posterior reversible leukoencephalopathy syndrome (PRES) was first described by Hinchey in 1996. The syndrome is characterized by altered level of consciousness, headache, visual changes, and seizures associated with a vasogenic edema of the white matter that occurs predominantly in the occipital and parietal lobes. Imaging tests such as computed tomography (CT) and especially magnetic resonance imaging (MRI) support the diagnosis.
Case report:
We report a case of a 48-year-old female patient who underwent a deceased donor kidney transplant and received tacrolimus as a part of the immunosuppressive regimen. Five weeks after transplantation she was admitted to the emergency due to sudden onset of confusion, disorientation, visual disturbances, and major headache. PRES was suspected and the diagnosis confirmed by brain MRI. Tacrolimus was withdrawn and rapid improvement of the neurological signs occurred leading to the conclusion that this drug triggered the syndrome.
Conclusion:
PRES is an unusual complication after organ transplantation and should be considered in the appropriate clinical setting. Physicians must be aware of this condition in order to provide early detection and appropriate treatment since delay in removing the cause may lead to permanent sequelae.
Incidental diagnosis of pulmonary cryptococcosis by rebiopsy for epidermal growth factor receptor T790M mutation: A case report
Authors: Hiroshi Kobe, Shinya Yokoe, Tadashi Ishida
Journal: Thorac Cancer (2023)
Keywords: cryptococcosis, epidermal growth factor receptor, lung cancer, rebiopsy, ruxolitinib
MeSH terms: Antineoplastic Agents / therapeutic use, Carcinoma, Non-Small-Cell Lung / pathology, Cryptococcosis / diagnosis, Cryptococcosis / drug therapy, Cryptococcosis / genetics, Lung Neoplasms / diagnosis, Lung Neoplasms / drug therapy, Lung Neoplasms / genetics, Case Reports, Biopsy / methods, Drug Resistance, Neoplasm / genetics, ErbB Receptors / therapeutic use, Humans, Mutation, Protein Kinase Inhibitors / therapeutic use, ErbB Receptors, Antineoplastic Agents, Protein Kinase Inhibitors

Cryptococcosis is an invasive fungal infection that can occur in cancer patients. A case of pulmonary cryptococcosis in a patient treated with erlotinib + ramucirumab for epidermal growth factor receptor (EGFR) L858R point mutation-positive non-small cell lung cancer is presented. During chemotherapy, a new pulmonary nodule was found and considered progressive disease. Examination of the biopsy specimen taken to identify EGFR T790M mutation incidentally led to the diagnosis of pulmonary cryptococcosis. Three months after taking fluconazole, chest computed tomography showed that the pulmonary nodule had shrunk. New pulmonary nodules during lung cancer treatment require careful attention, not only because of disease progression, but also because of the possibility of infection in an immunocompromised host.
A Rare Case of Persistent Bacteremia: Leadless Micra Pacemaker Endocarditis
Authors: Himax Patel, Sean Harrell, Haitham Hreibe, Musa Sharkawi, Wael AlJaroudi
Journal: Case Rep Cardiol (2023)
MeSH terms: Case Reports

Leadless pacing systems have revolutionized the field of electrophysiology given its low complication rates and almost non-existent rate of infections compared with traditional pacemakers. These devices boast resistance to infections given its unique features; however, as described in this report, device-related infection from these leadless devices is still possible. In patients with leadless pacing system that is persistently bacteremic in the future, evaluation of the device with transesophageal echocardiogram or intracardiac echocardiography should be performed, and if vegetation is noted on the device, device extraction should highly be considered, along with empiric intravenous antibiotics. Lastly, new leadless device should not be re-implanted within 2 weeks of the removal of the infected device to prevent seeding of the new device.
Graves' Disease as a Manifestation of Immune Reconstitution in HIV-Infected Individuals after Initiation of Highly Active Antiretroviral Therapy
Authors: Samad Rasul, Robert Delapenha, Faria Farhat, Jhansi Gajjala, Syeda Mehreen Zahra
Journal: AIDS Res Treat (2011)
MeSH terms: Case Reports

Graves' disease after the initiation of highly active antiretroviral therapy (HAART) in certain HIV-1-infected individuals has been described as an immune reconstitution inflammatory syndrome (IRIS). This phenomenon should be suspected in individuals who present with clinical deterioration and a presentation suggestive of hyperthyroidism despite good virological and immunological response to HAART. Signs and symptoms of hyperthyroidism may be discrete or overt and typically develop 8-33 months after initiating therapy. One to two percent of HIV-infected patients can present with overt thyroid disease. Relatively few cases of Graves' IRIS have been reported in the literature to date. We describe four cases of Graves' IRIS in HIV-infected patients who were started on HAART therapy.
Single Coronary Artery from Right Sinus of Valsalva: A Single Center Experience of Seven Cases
Authors: Kanhai Lalani, M Sudhakar Rao, Padmakumar Ramachandran, A J Ashwal, Abdul U K Razak, Tom Devasia, Ganesh Paramasivam, Pankti Parikh
Journal: Case Rep Med (2022)
MeSH terms: Case Reports

Background:
Single coronary artery (SCA) is a rare anomaly with a prevalence of 0.024-0.066%. Some anomalies are merely benign anatomical variants, whereas some can result in myocardial ischemia or life-threatening arrhythmia. Case Presentation. We described seven cases in which all three major coronaries emerged from the right sinus of Valsalva via a single ostium and supplied the vast majority of the myocardium. A smaller branch arising from the left sinus supplied a modest quantity of myocardium in some of those few cases. These SCA variations do not exactly fit into any existing classification. It is unclear whether we need to modify previous classification systems or newer classification systems.
Conclusions:
SCA is divided based on its anomalous course and is usually a benign condition but it may present with cardiovascular complications. Clinicians should be aware of this entity along with the role of CT angiogram in its diagnosis and management.
Bilateral pneumothoraces following central venous cannulation
Authors: F Pazos, K Masterson, C Inan, J Robert, B Walder
Journal: Case Rep Med (2009)
MeSH terms: Case Reports

We report the occurrence of a bilateral pneumothoraces after unilateral central venous catheterization of the right subclavian vein in a 70-year-old patient. The patient had no history of pulmonary or pleural disease and no history of cardiothoracic surgery. Two days earlier, she had a median laparotomy under general and epidural anaesthesia. Prior to the procedure, the patient was hemodynamically stable and her transcutaneous oxygen saturation was 97% in room air. We punctured the right pleural space before cannulation of the right subclavian vein. After the procedure, the patient slowly became hemodynamically instable with respiratory distress. A chest radiograph revealed a complete left-side pneumothorax and a mild right-side pneumothorax. The right-side pneumothorax became under tension after left chest tube insertion. The symptoms finally resolved after insertion of a right chest tube. After a diagnostic work-up, we suspect a congenital "Buffalo chests" explaining bilateral pneumothoraces and a secondary tension pneumothorax.
A Case of First Branchial Cleft Fistula Presenting with an External Opening on the Root of the Helical Crus
Authors: Sung Il Cho
Journal: Case Rep Med (2018)
MeSH terms: Case Reports

Background:
First branchial cleft anomalies (FBCA) are rare clinical entities of the head and neck. Typically, the tract of the FBCA begins in the external auditory canal and ends in the postauricular or submandibular region.
Case presentation:
We present a case of a 23-year-old man who had a first branchial cleft fistula with atypical opening on the root of the helical crus. Complete excision of the tract, including the cuff of surrounding cartilage, was performed. Histopathology revealed a fistular tract lined with squamous epithelium. To our knowledge, this is the first case to be reported of type I FBCA with an opening on the root of the helical crus. The low incidence and varied presentation often result in misdiagnosis and inappropriate treatment.
Conclusions:
In the patients with FBCA, careful recognition of atypical variants is essential for complete excision.
A rare presentation of penile keloids after traditional circumcision: Case report
Authors: Laura Siyabonga Madalitso Cappuyns, Devor Kumiponjera, Simbarashe Gift Mungazi
Journal: Int J Surg Case Rep (2019)
Keywords: case report, corticosteroid, penile keloids, traditional circumcision

Introduction:
Only few cases of penile keloids have been reported in the literature. There have been no published reports on penile keloids following traditional circumcision in Africa.
Case report:
We present a case of a 13-year-old boy with penile keloids following traditional circumcision. The patient was successfully treated with complete excision of the keloid followed by a course of adjuvant treatment with corticosteroid injection.
Discussion:
Penile keloids are a rare complication despite penile surgery being common. Male circumcision is a standard operation performed worldwide for medical, religious as well as cultural reasons. Traditional circumcision continues to be practised in many African countries. Keloids are a benign hyperproliferative growth of scar tissue that can complicate wound healing. Successful treatment is classically multimodal.
Conclusion:
This case highlights one of the more serious complications of circumcision. Although penile keloids are rare, the techniques involved in traditional circumcision potentially predispose to keloid formation in a genetically prone population.
HCG-responsive aldosteronoma with transient secretion during pregnancy confirmed through HCG-stimulated adrenal venous sampling
Authors: Frederic Castinetti, Carole Guerin, Estelle Louiset, André Lacroix
Journal: Front Endocrinol (Lausanne) (2023)
Keywords: lhcg receptor, aberrant g protein coupled receptor, aldosteronoma, pregnancy, primary aldosteronism
MeSH terms: Adrenocortical Adenoma / complications, Hyperaldosteronism / complications, Hyperaldosteronism / diagnosis, Hyperaldosteronism / surgery, Case Reports, Review, Adrenal Glands / metabolism, Adrenalectomy, Aldosterone / metabolism, Female, Humans, Pregnancy, Aldosterone

Primary aldosteronism can be regulated by the ectopic expression of G-protein coupled receptors in aldosteronomas or bilateral hyperplasias. We report a rare case of a young woman in whom 2 pregnancies were complicated by pre-eclampsia and 1 miscarriage. The transient primary aldosteronism during pregnancies suggested the possibility of HCG stimulated aberrant adrenal expression of LHCG receptor in her adrenal tissues. This was supported by increased aldosterone and renin suppression during 5-day HCG stimulation test outside of pregnancy. Following a second 5-day HCG stimulation test, bilateral simultaneous adrenal vein sampling identified a lateralized source of aldosterone from an 8 mm right adrenal nodule. A right laparoscopic adrenalectomy resulted in clinical and biochemical cure and allowed a further uneventful pregnancy a few years later. This case illustrates the indication to investigate for potential primary aldosteronism in woman with transient hypertension during pregnancy.
Stromal tumor of the lesser omentum : a case report
Authors: Hossam Behammane, Younes Aggouri, Morad Oussaid, Said Ait Laalim, Imane Toughrai, Karim Ibn majdoub, Khalid Mazaz
Journal: Pan Afr Med J (2014)
Keywords: cd117, lesser omentum, extragastrointestinal stromal tumor, surgical resection
MeSH terms: Gastrointestinal Stromal Tumors / pathology, Omentum / pathology, Proto-Oncogene Proteins c-kit / analysis, Case Reports, Female, Gastrointestinal Stromal Tumors / diagnosis, Humans, Middle Aged, Proto-Oncogene Proteins c-kit

Gastrointestinal stromal tumors (GISTs) represent the majority of primary non-epithelial neoplasms of the digestive tract, most frequently expressing the KIT protein detected by immunohistochemical staining for the CD117 antigen. Extragastrointestinal stromal tumors (EGISTs), neoplasms with immunohistological features overlapping those of GISTs, are found in the abdomen outside of the gastrointestinal tract with no connection to the gastric or intestinal wall. We report the clinical, macroscopic and immunohistological features of an EGIST arising in the lesser omentum of a 58-year-old woman. This is a very rare location of intra abdominal stromal tumors.
Postpartum Methicillin-Resistant Staphylococcus aureus Toxic Shock Syndrome Caused by a Perineal Infection
Authors: Yoko Deguchi, Yuko Horiuchi, Kensaku Shojima, Naoyuki Iwahashi, Miwa Ikejima, Kazuhiko Ino, Kenichi Furukawa
Journal: Case Rep Obstet Gynecol (2018)
MeSH terms: Case Reports

Although toxic shock syndrome (TSS) is rare, multiorgan failure can occur without early identification and appropriate therapy. In particular, a few cases of postpartum TSS due to methicillin-resistant Staphylococcus aureus (MRSA) have been reported. Here, we describe a rare case in which a 32-year-old Japanese woman had TSS due to MRSA that was caused by a perineal infection after a normal vaginal delivery. Twelve days after giving birth to a healthy child, she was readmitted to our hospital due to a 2-day fever and perineal pain without uterine tenderness. She developed emesis and watery diarrhea on the night of admission. On the second day, a diffuse cutaneous macular rash appeared over her trunk. Laboratory data revealed deteriorated renal function and thrombocytopenia. Her history and clinical results were compatible with a typical course of TSS. Administration of ceftriaxone and clindamycin was started immediately after admission and was effective. The patient recuperated steadily over the next week with desquamation of the skin. MRSA was isolated from her vaginal discharge and was found to produce TSS toxin 1 (TSST-1). Furthermore, since MRSA was not detected in the nasal and vaginal cavity during pregnancy, it suggests that vaginal colonization can also occur postpartum and be the disease source in mothers. Therefore, MRSA infections should be considered when treating for postpartum TSS.
Case Report: Genetic and immune microenvironmental characteristics of a rectal cancer patient with MSS/PD-L1-negative recurrent hepatopulmonary metastasis who achieved complete remission after treatment with PD-1 inhibitor
Authors: Yang Song, Juan Long, Xiaona Su, Zhuo Chen, Yue He, Weikang Shao, Bin Wang, Chuan Chen
Journal: Front Immunol (2023)
Keywords: mss, hepatopulmonary metastasis, immunotherapy, rectal cancer, tumor immune microenvironment
MeSH terms: Colorectal Neoplasms / drug therapy, Colorectal Neoplasms / genetics, Rectal Neoplasms / drug therapy, Rectal Neoplasms / genetics, Case Reports, Research Support, Non-U.S. Gov't, B7-H1 Antigen, Humans, Immune Checkpoint Inhibitors / therapeutic use, Microsatellite Instability, Microsatellite Repeats, Immune Checkpoint Inhibitors, B7-H1 Antigen, Turcot syndrome

Currently, microsatellite high instability (MSI-H)/mismatch repair protein deletion (dMMR) has become a crucial biomarker for utilizing immune checkpoint inhibitors in patients with advanced colorectal cancer (mCRC). However, the proportion of MSI-H/dMMR in advanced patients is only about 5% and mCRC patients with microsatellite stability (MSS)/proficient mismatch repair (pMMR) exhibit poor responses to immunotherapy. Although diverse immune combination therapy regimens have been examined in patients with advanced colorectal cancer who demonstrate MSS/pMMR, these approaches have not yielded favorable efficacy and only a limited proportion of patients have benefited, especially for advanced colorectal cancer patients with liver metastases. Therefore, the mechanism of benefit and potential biomarkers of immunotherapy in patients with MSS/pMMR mCRC deserve more in-depth exploration. Here, we present a case study of a rectal cancer patient with MSS and PD-L1-negative recurrent hepatopulmonary metastases who attained complete remission (CR) and sustained benefits with immunotherapy after systemic therapy had failed. The analysis of the patient's genetic and immune microenvironmental characteristics revealed that mutations in DNA damage repair (DDR) pathway genes and the existence of abundant tumor-infiltrating lymphocytes could contribute to his potential benefit.
Primary cutaneous mantle cell lymphoma: a case report
Authors: L D Mazzuoccolo, G A Castro Perez, I Sorin, A I Bravo
Journal: Case Rep Dermatol Med (2013)

Primary cutaneous mantle cell lymphoma (MCL) is a rare cutaneous proliferation of naive pregerminal CD-5 positive B cells in the skin with no extracutaneous involvement. Overexpression of cyclin D1 is pathognomonic of this condition, and surgery and radiation therapy are the most common therapeutic options. In this case, we describe the clinical, histopathological, immunohistochemical, and molecular characteristics of a new case of primary cutaneous MCL.