OpenMed/multicare-articles huggingface dataset:
Worksite health promotion in six varied US sites: beta testing as a needed translational step
Authors: Diane L Elliot, Kerry S Kuehl, Linn Goldberg, Carol A DeFrancesco, Esther L Moe
Journal: J Environ Public Health (2011)
MeSH terms: Health Promotion / methods, Occupational Health Services / methods, Evaluation Study, Research Support, N.I.H., Extramural, Adult, Cohort Studies, Female, Firefighters, Health Behavior, Health Services Needs and Demand, Humans, Male, Patient Education as Topic, United States, Workplace

Background:
Dissemination of health promotion interventions generally has followed an efficacy, effectiveness to full scale paradigm, and most programs have failed to traverse that sequence.
Objective:
Report national dissemination of a health promotion program and juxtapose sequential case study observations with the current technology transfer literature.
Design:
Multiple department-level case studies using contact logs, transcribed interactions, augmented with field notes and validated by respondent review; at least two investigators independently generated site summaries, which were compared to formulate a final report.
Results:
Adoption was facilitated with national partners and designing branded materials. Critical site influences included departmental features, local champions, and liaison relationships. Achieving distal reach and fidelity required sequential process and program revisions based on new findings at each site.
Conclusions:
Beta testing to redesign program elements and modify process steps appears to be a needed and often ignored translational step between efficacy and more widespread dissemination.
Handling variability and incompleteness of biological data by flexible nets: a case study for Wilson disease
Authors: Jorge Júlvez, Duygu Dikicioglu, Stephen G Oliver
Journal: NPJ Syst Biol Appl (2018)

Mathematical models that combine predictive accuracy with explanatory power are central to the progress of systems and synthetic biology, but the heterogeneity and incompleteness of biological data impede our ability to construct such models. Furthermore, the robustness displayed by many biological systems means that they have the flexibility to operate under a range of physiological conditions and this is difficult for many modeling formalisms to handle. Flexible nets (FNs) address these challenges and represent a paradigm shift in model-based analysis of biological systems. FNs can: (i) handle uncertainties, ranges and missing information in concentrations, stoichiometry, network topology, and transition rates without having to resort to statistical approaches; (ii) accommodate different types of data in a unified model that integrates various cellular mechanisms; and (iii) be employed for system optimization and model predictive control. We present FNs and illustrate their capabilities by modeling a well-established system, the dynamics of glucose consumption by a microbial population. We further demonstrate the ability of FNs to take control actions in response to genetic or metabolic perturbations. Having bench-marked the system, we then construct the first quantitative model for Wilson disease-a rare genetic disorder that impairs copper utilization in the liver. We used this model to investigate the feasibility of using vitamin E supplementation therapy for symptomatic improvement. Our results indicate that hepatocytic inflammation caused by copper accumulation was not aggravated by limitations on endogenous antioxidant supplies, which means that treating patients with antioxidants is unlikely to be effective.
Young people's tech identity performances: why materiality matters
Authors: Spela Godec, Uma Patel, Louise Archer, Emily Dawson
Journal: Int J STEM Educ (2020)
Keywords: barad, butler, identity performativity, intra-action, materiality, technology

Background:
Identity provides a useful conceptual lens for understanding educational inequalities in science, technology, engineering and mathematics (STEM). In this paper, we examine how paying attention to physical and digital 'materiality' enriches our understanding of identity work, by going beyond the spoken, written and embodied dimensions of identity performances that currently dominate the area of STEM identity scholarship. We draw on a multimodal ethnographic study with 36 young people aged 11-14 carried out over the course of one year at four UK-based informal STEM learning settings. Data collection included a series of interviews, observations and youth-created portfolios focused on STEM experiences. Illustrative case studies of two young men who took part in a community-based digital arts centre are discussed in detail through the theoretical lenses of Judith Butler's identity performativity and Karen Barad's intra-action.
Results:
We argue that physical and digital materiality mattered for the performances of 'tech identity' in that (i) the focus on the material changed our understanding of tech identity performances; (ii) digital spaces supported identity performances alongside, with and beyond physical bodies, and drew attention to new forms of identity recognition; (iii) identity performances across spaces were unpredictable and contained by the limits of material possibilities; and (iv) particular identity performances associated with technology were aligned with dominant enactments of masculinity and might thus be less accessible to some young people.
Conclusion:
We conclude the paper by suggesting that accounting for materiality in STEM identity research not only guides researchers in going beyond what participants say and are observed doing (and thus engendering richer insights), but also offers more equitable ways of enacting research. Further, we argue that more needs to be done to support the translation of identity resources across spaces, such as between experiences within informal and online spaces, on the one hand, and formal education, on the other.
Prenatal diagnosis of penoscrotal hypospadia in third trimester by two- and three-dimensional ultrasonography: a case report
Authors: Lívia Teresa Moreira Rios, Edward Araujo Júnior, Luciano Marcondes Machado Nardozza, Liliam Cristine Rolo, Alan Roberto Hatanaka, Antonio Fernandes Moron, Marília da Glória Martins
Journal: Case Rep Urol (2012)

Hypospadia is an abnormal development of the corpus spongiosum, that involves cavernosa urethra, as a result of an inadequate fusion of the urethral folds. The incidence ranges from 0.2 to 4.1 per 1,000 live births. Among the markers of hypospadia, isolated ventral or lateral curvature of the penis associated with shortening are the most important markers and, in severe cases, can result in the classic "tulip sign." The diagnosis of hypospadia is uncommon unless there is a routine of detailed analysis of fetal genitalia morphology. The prenatal diagnosis is of great importance for genetic counseling and allows better planning of postnatal treatment. The three-dimensional ultrasonography (3DUS) in rendering mode enables better comprehension of the pathology by parents, facilitating postnatal planning. We report a case of penoscrotal hypospadia diagnosed at 33 weeks of gestation, suspected due to the absence of testicles in the scrotum and difficulty of penis visualization. We emphasize the findings of 3DUS and its importance in the pathology compression by parents.
Lesser Trochanter Migration following Intramedullary Fixation of an Intertrochanteric Femur Fracture
Authors: Carlo Montoli, Cecilia Pasquali, Elia Paiusco, Vincenzo Pellecchia, Ettore Vulcano
Journal: Case Rep Orthop (2016)

Intertrochanteric femur fractures are commonly observed in the elderly and may be associated with a complete fracture of the lesser trochanter in over 50% of cases. The migration of the lesser trochanter secondary to the psoas muscle contracture is a rare event. This case report presents a rare case of sudden groin pain three-week status after intramedullary fixation of a intertrochanteric femur fracture.
Polypoid Basal Cell Carcinoma on the Nose Tip
Authors: Mutsuki Hirakawa, Yuki Ishikura, Taketoshi Futatsuya, Reimon Yamaguchi, Akira Shimizu
Journal: Case Rep Dermatol Med (2022)
MeSH terms: Case Reports

Basal cell carcinoma (BCC) is usually seen on the face as a pigmented nodule. We herein report a patient who presented with a polypoid BCC on the nose tip. Clinically, we suspected adnexal tumor; however, the findings of dermoscopy were consistent with that of BCC. Although the tumor was excised at the stalk, it was completely resected. Since the clinical manifestation was characteristic, we reviewed previously reported polypoid BCCs and found that this tumor can occur at any site, including the trunk and inguinal region, which are not preferential sites for ordinary BCC. There have been no reports of polypoid BCC on the nasal tip. The initial diagnoses varied, including adnexal tumors, and dermoscopic examinations proved useful for suspecting polypoid BCC. Histopathologically, the tumor cells in the resected specimens were within the polypoid area. Although BCC is a common tumor, polypoid BCC has distinct clinical features, and we should keep this rare subtype in mind.
Thoracic compartment syndrome after penetrating heart and lung injury
Authors: Holger Rupprecht, Harald Dormann, Katharina Gaab
Journal: GMS Interdiscip Plast Reconstr Surg DGPW (2019)
Keywords: bogota bag, compartment syndrome, myocardial and lung edema, packing, penetrating heart and lung injury
MeSH terms: Case Reports

Thoracic injuries are the most lethal penetrating injuries. After attempting suicide, two patients with a penetrating thoracic wound were admitted to our emergency department. During CT scan they became hemodynamically unstable, which is why we had to perform an emergency thoracotomy. In both cases, a perforation in the left ventricle as well as multiple lesions of the lung parenchyma and vessel injuries were found. After the treatment of the different injuries, a massive edema of the heart and lung prevented a primary closure of the thorax. Due to massive diffuse bleeding, a "packing" of the pleural cavity became necessary. To prevent a thoracic compartment syndrome, the thoracic wall was left open and the skin was closed with a plastic sheet. Due to the "open chest" procedure combined with "packing" of the thoracic cavity, the majority of patients with an edema of the heart and lung after a penetrating chest injury can be saved. Pitfalls of preclinical and clinical treatment, aspects of diagnostics and surgery are discussed.
Surgical Treatment for Profunda Femoris Artery Aneurysms: Five Case Reports
Authors: Kimihiro Igari, Toshifumi Kudo, Takahiro Toyofuku, Yoshinori Inoue
Journal: Case Rep Vasc Med (2015)

Profunda femoris artery aneurysm (PFAA) is an extremely rare entity, with most cases being asymptomatic, which makes obtaining an early diagnosis difficult. We herein report a case series of PFAA, in which more than half of the PFAAs, which presented with no clinical symptoms, were discovered incidentally. All PFAAs were treated surgically with aneurysmectomy with or without vascular reconstruction. In cases involving a patent superficial femoral artery (SFA), graft replacement of the profunda femoris artery (PFA) is not mandatory; however, preserving the blood flow of the PFA is necessary to maintain lower extremity perfusion in patients with occlusion of the SFA. Therefore, the treatment of PFAAs should include appropriate management of both the aneurysmectomy and graft replacement, if possible.
Parastomal Varices with Recurrent Bleeding in the Absence of Liver Cirrhosis
Authors: Jonathan Kopel, Rebeccah Baucom, Samuel Campbell, Gregory L Brower
Journal: Case Rep Gastrointest Med (2020)
MeSH terms: Case Reports

Gastrointestinal (GI) bleeding is a common problem in patients with portal hypertension. One of the most common causes of GI bleeding are varices (e.g., esophageal varices). In some instances, varices can develop between an intestinal stoma and the abdominal wall vasculature, known as parastomal varices. Specifically, parastomal varices are common in patients with a preexisting stoma and concurrent chronic portal hypertension. These patients often present with recurrent bleeding and may require regular transfusions. Herein, we report on a patient with parastomal varices and portal hypertension without hepatic cirrhosis. Given the high morbidity and mortality associated with surgical interventions, most clinical guidelines encourage observation and medical management of bleeding from parastomal varices. Among the nonsurgical interventions, manual compression and local maneuvers often successfully stop the bleeding. However, subsequent rebleeding from parastomal varices can remain a problem requiring additional treatment. Further research is needed to investigate appropriate medical or surgical alternatives for managing parastomal varices bleeding.
Influenza A H5N1 replication sites in humans
Authors: Mongkol Uiprasertkul, Pilaipan Puthavathana, Kantima Sangsiriwut, Phisanu Pooruk, Kanittar Srisook, Malik Peiris, John M Nicholls, Kulkanya Chokephaibulkit, Nirun Vanprapar, Prasert Auewarakul
Journal: Emerg Infect Dis (2005)
MeSH terms: Influenza A Virus, H5N1 Subtype, Influenza A virus / physiology, Influenza, Human / virology, Intestines / virology, Lung / virology, Virus Replication / physiology, Case Reports, Research Support, Non-U.S. Gov't, Child, Humans, Influenza, Human / pathology, Lung / pathology, Male

Tissue tropism and pathogenesis of influenza A virus subtype H5N1 disease in humans is not well defined. In mammalian experimental models, H5N1 influenza is a disseminated disease. However, limited previous data from human autopsies have not shown evidence of virus dissemination beyond the lung. We investigated a patient with fatal H5N1 influenza. Viral RNA was detected by reverse transcription-polymerase chain reaction in lung, intestine, and spleen tissues, but positive-stranded viral RNA indicating virus replication was confined to the lung and intestine. Viral antigen was detected in pneumocytes by immunohistochemical tests. Tumor necrosis factor-? mRNA was seen in lung tissue. In contrast to disseminated infection documented in other mammals and birds, H5N1 viral replication in humans may be restricted to the lung and intestine, and the major site of H5N1 viral replication in the lung is the pneumocyte.
The role of soluble fibrin during anticoagulant therapy: a case report
Authors: Tohru Kawakami, Nobukiyo Tanaka, Hiroki Ishihara, Hiroyoshi Ohno
Journal: Thromb J (2015)
Keywords: apixaban, atrial fibrillation, dabigatran, deep vein thrombosis, pulmonary thromboembolism, soluble fibrin, warfarin
MeSH terms: Case Reports

Warfarin, dabigatran, and apixaban are used for preventing ischemic stroke due to non-valvular atrial fibrillation (NVAF). However, it is often challenging to select the appropriate anticoagulant. We present the case of a 70-year-old male patient with persistent NVAF who developed pulmonary thromboembolism (PTE), deep vein thrombosis (DVT), and left atrial thrombus during anticoagulant therapy with warfarin. Intravenous recombinant tissue plasminogen activator was administered during his acute PTE. Heparin and apixaban were administered over 28 days; heparin was discontinued after the DVT resolved, while apixaban was administered to prevent ischemic stroke. Two days after heparin was discontinued, the patient experienced an ischemic stroke. Dabigatran was administered for secondary ischemic stroke prevention. Soluble fibrin (SF) levels remained elevated during treatment with heparin and apixaban and returned to normal after apixaban was replaced with dabigatran. Monitoring of SF may be useful as an index for selection of anticoagulants.
Case Report: GPi DBS for Non-parkinsonian Midline Tremor: A Normative Connectomic Comparison to a Failed Thalamic DBS
Authors: Takashi Morishita, Yuki Sakai, Takayasu Mishima, George Umemoto, Michael S Okun, Saori C Tanaka, Yoshio Tsuboi, Tooru Inoue
Journal: Front Hum Neurosci (2021)
Keywords: case report, deep brain stimulation, globus pallidus, normative connectome, thalamus, tremor, ventral intermediate nucleus
MeSH terms: Case Reports

Introduction: The clinical efficacy of deep brain stimulation (DBS) for midline tremor has been heterogenous. Here, we present an atypical case with facial and palatal tremor treated with DBS. We aimed to show the difference between the fibers affected by stimulation of the two targets [globus pallidus interna (GPi) and ventral intermediate (Vim) thalamic nucleus] using a normative connectome analysis. Case Report: A 76-year-old woman with a 4-year history of severe facial and palatal tremor due to craniofacial dystonia. Following a failed bilateral Vim DBS, explantation of preexisting leads and implantation of bilateral GPi leads resulted in the resolution of tremor symptoms following a failed bilateral Vim DBS. We performed a normative connectome analysis using the volume of tissue activated (VTA) as a region of interest. The results revealed that the fiber tracts associated with VTA of GPi DBS had connections with the facial area of the motor cortex while the Vim DBS did not. Conclusion: This case study suggests the possibility that GPi DBS may be considered for midline tremor, and that the normative connectome analysis may possibly offer clues as to the structures underpinning a positive response. We may refine targets for some of the more difficult to control symptoms such as the midline tremor in this case.
Clear cell adenocarcinoma arising from abdominal wall endometriosis
Authors: Thouraya Achach, Soumaya Rammeh, Amel Trabelsi, Rached Ltaief, Soumaya Ben Abdelkrim, Moncef Mokni, Sadok Korbi
Journal: J Oncol (2008)
MeSH terms: Case Reports

Endometriosis is a frequent benign disorder. Malignancy arising in extraovarian endometriosis is a rare event. A 49-year-old woman is presented with a large painful abdominal wall mass. She underwent a myomectomy, 20 years before, for uterus leiomyoma. Computed tomography suggested that this was a desmoid tumor and she underwent surgery. Histological examination showed a clear cell adenocarcinoma associated with endometriosis foci. Pelvic ultrasound, computed tomography, and endometrial curettage did not show any malignancy or endometriosis in the uterus and ovaries. Adjuvant chemotherapy was recommended, but the patient was lost to follow up. Six months later, she returned with a recurrence of the abdominal wall mass. She was given chemotherapy and then she was reoperated.
TIPS Placement via Combined Transjugular and Transhepatic Approach for Cavernous Portal Vein Occlusion: Targeted Approach
Authors: Natanel Jourabchi, Justin Pryce McWilliams, Edward Wolfgang Lee, Steven Sauk, Stephen Thomas Kee
Journal: Case Rep Radiol (2013)

Purpose. We report a novel technique which aided recanalization of an occluded portal vein for transjugular intrahepatic portosystemic shunt (TIPS) creation in a patient with symptomatic portal vein thrombosis with cavernous transformation. Some have previously considered cavernous transformation a contraindication to TIPS. Case Presentation. 62-year-old man with chronic pancreatitis, portal vein thrombosis, portal hypertension and recurrent variceal bleeding presents with melena and hematemesis. The patient was severely anemic, hemodynamically unstable, and required emergent portal decompression. Attempts to recanalize the main portal vein using traditional transjugular access were unsuccessful. After percutaneous transhepatic right portal vein access and navigation of a wire through the occluded main portal vein, an angioplasty balloon was inflated at the desired site of shunt takeoff. The balloon was targeted and punctured from the transjugular approach, and a wire was passed into the portal system. TIPS placement then proceeded routinely. Conclusion. Although occlusion of the portal vein increases difficulty of performing TIPS, it should not be considered an absolute contraindication. We have described a method for recanalizing an occluded portal vein using a combined transhepatic and transjugular approach for TIPS. This approach may be useful to relieve portal hypertension in patients who fail endoscopic and/or surgical therapies.
A Novel CDC42 Mutation in an 11-Year Old Child Manifesting as Syndromic Immunodeficiency, Autoinflammation, Hemophagocytic Lymphohistiocytosis, and Malignancy: A Case Report
Authors: Aleksandra Szczawinska-Poplonyk, Rafal Ploski, Ewa Bernatowska, Malgorzata Pac
Journal: Front Immunol (2020)
Keywords: cdc42, gene mutation, hemophagocitic lymphohistiocytosis, immunodeficiency, malignancy
MeSH terms: Immunologic Deficiency Syndromes / etiology, Inflammation / etiology, Lymphohistiocytosis, Hemophagocytic / etiology, Mutation, Neoplasms / etiology, cdc42 GTP-Binding Protein / genetics, Case Reports, Child, Humans, Immunologic Deficiency Syndromes / genetics, Lymphohistiocytosis, Hemophagocytic / genetics, Male, cdc42 GTP-Binding Protein / physiology, CDC42 protein, human, cdc42 GTP-Binding Protein

Background: The CDC42 (Cell Division Cycle 42) gene product, CDC42, is a member of the family of small Rho GTPases, which are implicated in a broad spectrum of physiological functions in cell cycle regulation, including establishing and controlling of the cell actin cytoskeleton, vesicle trafficking, cell polarity, proliferation, motility and migration, transcription activation, reactive oxygen species production, and tumorigenesis. The CDC42 gene mutations are associated with distinct clinical phenotypes characterized by neurodevelopmental, growth, hematological, and immunological disturbances. Case presentation: We report the case of an 11-year-old boy with syndromic features, immunodeficiency, and autoinflammation who developed hemophagocytic lymphohistiocytosis and malignant lymphoproliferation. In this patient, a novel heterozygous p.Cys81Tyr mutation in the CDC42 gene was found by whole exome sequencing. Conclusions: The Cdc42 molecule plays a pivotal role in cell cycle regulation and a wide array of tissue-specific functions, and its deregulation may result in a broad spectrum of molecular and cellular dysfunctions, making patients with CDC42 gene mutations susceptible to infections, immune dysregulation, and malignancy. In the patient studied, a syndromic phenotype with facial dysmorphism, neurodevelopmental delay, immunodeficiency, autoinflammation, and hemophagocytic lymphohistiocytosis shares common features with Takenouchi-Kosaki syndrome and with C-terminal variants in CDC42. It is important to emphasize that Hodgkin's lymphoma is described for the first time in the medical literature in a pediatric patient with the novel p.Cys81Tyr mutation in the CDC42 gene. Further studies are required to delineate precisely the CDC42 genotype-phenotype correlations.