OpenMed/multicare-articles huggingface dataset:
Bronchiolitis obliterans syndrome associated with an immune checkpoint inhibitor in a patient with non-small cell lung cancer
Authors: Kenichiro Takeda, Hideki Miwa, Masato Kono, Ryutaro Hirama, Yuiko Oshima, Yasutaka Mochizuka, Akari Tsutsumi, Yoshihiro Miki, Dai Hashimoto, Hidenori Nakamura
Journal: Respir Med Case Rep (2023)
Keywords: bronchiolitis obliterans syndrome, immune checkpoint inhibitor, immune-related adverse events, non-small cell lung cancer, pembrolizumab
MeSH terms: Case Reports

A 75-year-old woman was admitted to our hospital with progressive dyspnea 7 months after second-line treatment with pembrolizumab for advanced non-small cell lung cancer. Chest radiography revealed hyperinflation in both lung fields, and pulmonary function tests revealed severe obstructive dysfunction without bronchodilator reversibility. There were no identifiable causes such as infections or autoimmune diseases. Therefore, bronchiolitis obliterans syndrome associated with immune checkpoint inhibitors was clinically diagnosed. Pembrolizumab was discontinued, but the respiratory dysfunction was irreversible and resulted in death. Bronchiolitis obliterans syndrome is an extremely rare but potentially severe adverse event associated with immune checkpoint inhibitor-related lung disease.
Permanent draft genome sequence of Frankia sp. NRRL B-16219 reveals the presence of canonical nod genes, which are highly homologous to those detected in Candidatus Frankia Dg1 genome
Authors: Amir Ktari, Imen Nouioui, Teal Furnholm, Erik Swanson, Faten Ghodhbane-Gtari, Louis S Tisa, Maher Gtari
Journal: Stand Genomic Sci (2017)
Keywords: actinorhizal symbiosis, canonical nod genes, ceanothus, frankia, genome, plant-microbe interactions
MeSH terms: Case Reports

Frankia sp. NRRL B-16219 was directly isolated from a soil sample obtained from the rhizosphere of Ceanothus jepsonii growing in the USA. Its host plant range includes members of Elaeagnaceae species. Phylogenetically, strain NRRL B-16219 is closely related to "Frankia discariae" with a 16S rRNA gene similarity of 99.78%. Because of the lack of genetic tools for Frankia, our understanding of the bacterial signals involved during the plant infection process and the development of actinorhizal root nodules is very limited. Since the first three Frankia genomes were sequenced, additional genome sequences covering more diverse strains have helped provide insight into the depth of the pangenome and attempts to identify bacterial signaling molecules like the rhizobial canonical nod genes. The genome sequence of Frankia sp. strain NRRL B-16219 was generated and assembled into 289 contigs containing 8,032,739 bp with 71.7% GC content. Annotation of the genome identified 6211 protein-coding genes, 561 pseudogenes, 1758 hypothetical proteins and 53 RNA genes including 4 rRNA genes. The NRRL B-16219 draft genome contained genes homologous to the rhizobial common nodulation genes clustered in two areas. The first cluster contains nodACIJH genes whereas the second has nodAB and nodH genes in the upstream region. Phylogenetic analysis shows that Frankia nod genes are more deeply rooted than their sister groups from rhizobia. PCR-sequencing suggested the widespread occurrence of highly homologous nodA and nodB genes in microsymbionts of field collected Ceanothus americanus.
Non-heparinized ECMO serves a rescue method in a multitrauma patient combining pulmonary contusion and nonoperative internal bleeding: a case report and literature review
Authors: Pei-Hung Wen, Wai Hung Chan, Ying-Cheng Chen, Yao-Li Chen, Chien-Pin Chan, Ping-Yi Lin
Journal: World J Emerg Surg (2015)
Keywords: acute pulmonary contusion, ecmo, heparin-free, internal bleeding, polytraumatic

Pulmonary contusion and acute respiratory distress syndrome (ARDS) is a common manifestation in polytraumatic patients. Although mechanical ventilation is still the first choice of treatment, a group of patients are still unable to maintain their oxygenation. The role of extracorporeal membrane oxygenation (ECMO) has been more clarified when the lung is extensively damaged and when conventional modality failed. ECMO provides the lung an opportunity to rest by permitting reduced ventilator settings and limiting further barotraumas. However, ECMO is still considered contraindicated in polytramatic patients combining pulmonary contusion and other organ hemorrhage because of systemic anticoagulation during the treatment. We herein report a patient who successfully survive a multitrauma combining pulmonary contusion and grade IV liver laceration using non-heparinized venovenous extracorporeal membrane oxygenation (vv-ECMO). The associated literature were reviewed.
Intimate geographies of virginal blood
Authors: Elisabeth Militz
Journal: Cult Geogr (2023)
Keywords: instagram, kyrgyzstan, geographies of the body, heterosexuality, intimate justice, marriage, resistance, virginity

Feminist scholars, activists, and artists have long addressed the topic of virginity and have dismantled it as a powerful, globally circulating, and gendered myth. It affects how many woman-identifying people experience how their bodies become (a)sexual. Centrally, the myth of virginity has been shown to be mobilized in support of colonial, ethnonationalist identity projects. In Kyrgyzstan, disciplining women through policing their sexual behavior co-constituted nation-building projects after the dissolution of the Soviet Union. Drawing on data collected since 2017 (qualitative interviews in Bishkek and Osh and qualitative research on Instagram), I examine intimate geographies of the virginity myth in Kyrgyzstan. Building on geographic scholarship on intimacy and body parts, I discuss the ways in which virginal blood works both to submit to and to reclaim one's intimate body spaces and sexual practices. I argue that people affected by the virginity myth create the foundations for intimate justice in Kyrgyzstan. On the one hand, people are reclaiming authority over their intimate bodies through subverting sexist systems of sexual control and through expanding discursive horizons of virginity performances. On the other hand, activists on Instagram are supporting digital public spaces that allow to author virginal blood narratives and provide resources on intimate body knowledge. Analyzing the scalar doings of virginal blood, the paper contributes a case study on intimate justice and the geographies of the body in Kyrgyzstan. My analysis encourages further examination of the capacities of the body to better understand how certain body parts turn into key sites of (geo)political struggles and can transform them.
Genomics as a Clinical Decision Support Tool for Identifying and Addressing Modifiable Causes of Cognitive Decline and Improving Outcomes: Proof of Concept Support for This Personalized Medicine Strategy
Authors: Sharon Hausman-Cohen, Carol Bilich, Sandeep Kapoor, Eduardo Maristany, Anne Stefani, Alexandra Wilcox
Journal: Front Aging Neurosci (2022)
Keywords: apoe ε4, alzheimer’s, mci, clinical decision support, genomics, natural products, personalized medicine, precision medicine

The landscape of therapeutics for mild cognitive impairment and dementia is quite limited. While many single-agent trials of pharmaceuticals have been conducted, these trials have repeatedly been unable to show improvement in cognition. It is hypothesized that because Alzheimer's, like many other chronic illnesses, is not a monogenic illness, but is instead caused by the downstream effects of an individual's genetic variants interacting with each other, the environment, and lifestyle, that improving outcomes will require a personalized, precision medicine approach. This approach requires identifying and then addressing contributing genomic and other factors specific to each individual in a simultaneous fashion. Until recently, the utility of genomics as part of clinical decision-making for Alzheimer's and cognitive decline has been limited by the lack of availability of a genomic platform designed specifically to evaluate factors contributing to cognitive decline and how to respond to these factors The clinical decision support (CDS) platform used in the cases presented focuses on common variants that relate to topics including, but not limited to brain inflammation, amyloid processing, nutrient carriers, brain ischemia, oxidative stress, and detoxification pathways. Potential interventions based on the scientific literature were included in the CDS, but the final decision on what interventions to apply were chosen by each patient's physician. Interventions included supplements with "generally regarded as safe (GRAS)" rating, along with targeted diet and lifestyle modifications. We hypothesize that a personalized genomically targeted approach can improve outcomes for individuals with mild cognitive impairment who are at high risk of Alzheimer's. The cases presented in this report represent a subset of cases from three physicians' offices and are meant to provide initial proof of concept data demonstrating the efficacy of this method and provide support for this hypothesis. These patients were at elevated risk for Alzheimer's due to their apolipoprotein E ε4 status. While further prospective and controlled trials need to be done, initial case reports are encouraging and lend support to this hypothesis of the benefit of a genomically targeted personalized medicine approach to improve outcomes in individuals with cognitive decline who are at high risk for Alzheimer's.
Retroperitoneal Hydropic Leiomyoma Mimicking an Ovarian Cyst
Authors: Pei-Hsuan Lai, Dah-Ching Ding
Journal: Case Rep Obstet Gynecol (2022)
MeSH terms: Case Reports

Leiomyoma is the most common benign neoplasm of the reproductive organs in women. Retroperitoneal hydropic leiomyoma is rare type of myoma. Herein, we present the case of a 46-year-old (gravida 0) woman with retroperitoneal hydropic leiomyoma that was preoperatively diagnosed as an ovarian cyst. Transvaginal sonography and abdominal computed tomography revealed a mass, measuring 8.1 × 3.8 cm, with solid and cystic components in the right pelvic cavity. The patient underwent laparoendoscopic single-site surgery for the tumor excision. During the surgery, a retroperitoneal cystic tumor was resected from the right retroperitoneal cavity. Histopathologic and microscopic examinations revealed a hydropic leiomyoma with infarction. This case is impressive because of the rare location and hydropic degeneration of the leiomyoma. Furthermore, it mimicked an ovarian cyst at its initial presentation making accurate diagnosis difficult. By warning of this case, surgeons can recognize the disease entities and provide the necessary treatment.
Juxtarenal Modular Aortic Stent Graft Infection Caused by Staphylococcus aureus
Authors: Róbert Novotný, Petr Mitáš, Jaroslav Hlubocký, Ján Hrubý, Andrey Slautin, Rudolf Špunda, Jaroslav Lindner
Journal: Case Rep Vasc Med (2016)

Introduction. We are presenting a case report of an infected modular abdominal stent graft. Case Presentation. A 67-year-old male patient three years after Cook's modular abdominal aortic aneurysm (AAA) graft implantation for juxtarenal AAA with an implantation of a stent extension into the right common iliac artery for type Ib endoleak. The patient was admitted into our center in severe condition with suspected retroperitoneal bleeding. Computed tomography angiography (CTAG) confirmed retroperitoneal bleeding in the right common iliac artery. An urgent surgical revision was indicated; destructed arterial wall around the stent extension in the right common iliac artery was discovered. Due to the severe state of health of the patient, a resection of the infected stent and affected arterial wall was performed, followed by an iliac-femoral crossover bypass. The patient was transported to the intensive care unit with hepatic and renal failure, with maximal catecholamine support. Combined antibiotic treatment was started. The patient died five hours after the procedure. The cause of death was multiorgan failure caused by sepsis. Hemocultures and perioperative microbiological cultures showed the infection agent to be Staphylococcus aureus methicillin sensitive. Conclusion. Stent graft infection is a rare complication. Treatment is associated with high mortality and morbidity.
Liver transplantation for giant hemangioma of the liver: A case report and review of the literature
Authors: Yun Zhao, Xiu-Ping Li, Yuan-Yuan Hu, Ji-Chang Jiang, Li-Jin Zhao
Journal: Front Med (Lausanne) (2022)
Keywords: case report, cavernous hemangioma, giant hemangioma, hepatic hemangioma, liver transplantation
MeSH terms: Case Reports

Large benign hepatic masses as a rare indication for liver transplantation have been reported less frequently. These liver transplantations are complex, with high intraoperative bleeding, high perioperative complication rates, and high mortality rates due to difficulties in visualization, especially when they have undergone various percutaneous operations or open surgery, resulting in severe perihepatic adhesions. Here is a case report of a patient admitted to our hospital who underwent liver transplantation after suffering from a giant hemangioma in liver transplantation for 10 years and who had received multiple interventional treatments ineffective in the past.
Hepatic angiomyolipoma: A case report and literature review
Authors: Simone A Günster, Mia Kim, Johan F Lock, Katica Krajinovic
Journal: Int J Surg Case Rep (2020)
Keywords: case report, haml, hepatic angiomyolipoma, hepatic lobectomy, liver tumour, mesenchymal liver tumor
MeSH terms: Case Reports

Introduction:
Hepatic angiomyolipoma (HAML) is a rare mesenchymal liver tumour which belongs to the family of perivascular epithelioid cell tumours (PEComas). It is typically composed of blood vessels, smooth muscle, and adipose cells, and shows strong immunoreactivity for HMB-45.
Presentation of the case:
A 57-year-old woman was referred to our hospital with an unclear liver lesion. A fine needle biopsy revealed a suspicion of hepatic angiomyolipoma with extramedullary haematopoiesis. Preoperative imaging revealed a tumour 17 cm in diameter in the left liver lobe segments II and III. A lobectomy of the left lobe segments II and III was performed. The pathological diagnosis of hepatic angiomyolipoma was obtained.
Discussion:
Variations in the predominance of the tissue components in HAML impedes diagnosis based on imaging alone. The most promising evidence of HAML is the histological identification of lipomatous, myomatous, and angiomatous tissue combined with immunohistochemical positivity for HMB-45. Although the tumour is considered benign, some cases have been described with malignant behaviour. Surgical resection should be considered in case of symptoms, inconclusive biopsy, or growth in follow-up. Other surgical indications may include aggressive patterns such as vascular invasion, p53 immunoreactivity, or rapidly proliferating tumour cells.
Conclusion:
HAML is a rare liver tumour. In patients with symptoms, uncertain diagnosis, or tumour growth, surgical resection should be performed according to oncological criteria.
Role of bedside ultrasound in CMV retinitis: a case report
Authors: Lauren Westafer, L Connor Nickels, Eike Flach, Giuliano De Portu, Latha Ganti Stead
Journal: Case Rep Emerg Med (2012)

We present a case of retinal detachment diagnosed by emergency department bedside ultrasonography in a patient with CMV retinitis. The indications and findings of ocular ultrasonography are discussed.
A Case of Primary Refractory Immune Thrombocytopenia: Challenges in Choice of Therapies
Authors: Hanyin Wang, Hande Tuncer
Journal: Case Rep Hematol (2018)
MeSH terms: Case Reports

The value of combination therapy for refractory ITP is not well defined. We present the case of a 29-year-old male with severe ITP refractory to initial standard therapy including steroids, IVIG, and subsequent splenectomy, who was treated with the combination therapy of rituximab, romiplostim, and mycophenolate and eventually developed thrombocytosis requiring plateletpheresis. Our case highlights the importance of the need to understand predictors of response to standard upfront treatment of acute ITP.
Primary Pericardial Mesothelioma, Which Was Veiled by a Pleural Empyema: A Case Report and Review
Authors: Morad Tajjiou, Wolfgang Wild, Nasir Sayed, Alexander Flauaus, Markus Divo, Matthias Schwarzbach
Journal: Case Rep Surg (2019)
MeSH terms: Case Reports

This case report shows that pleural empyema limits the diagnostic significance of imaging techniques. Hereafter, we present the case of an 82-year-old patient with primary pericardial mesothelioma, which was veiled by a pleural empyema. The patient met the typical triad of signs of heart failure (dyspnea, lower leg oedema), pericardial effusion, and pericarditis. Echocardiography in the identification of pericardial mesotheliomas is low. In this case, the cardiac function could be imaged well, but the tumor could not be imaged. The CT showed a pericardial effusion and a pleural effusion. Here, the tumor could not be diagnosed either. Only the operation led to diagnosis.
Management of unerupted maxillary deciduous central incisor: a case report
Authors: Karam Abu Shakra
Journal: Int J Clin Pediatr Dent (2014)
Keywords: eruption, fibroma, primary incisor
MeSH terms: Case Reports

Failure of eruption of primary teeth can be considered rare, especially in maxillary anterior teeth. The problem can be either mechanical obstruction of eruption or a failure of the eruption mechanism. This case report presents failure of eruption of the maxillary right deciduous central incisor in a 4-year-old girl. The unerupted primary tooth was removed surgically. The histological finding revealed fibroma with reactive giant cells. Periodic follow-up visits were advised to monitor the developing dentition and to ensure enough space for the permanent incisor. How to cite this article: Shakra KA. Management of Unerupted Maxillary Deciduous Central Incisor: A Case Report. Int J Clin Pediatr Dent 2014;7(1):58-60.
Painful and Prolonged Muscle Cramps following Insulin Injections in a Patient with Type 2 Diabetes Mellitus: Revisiting the 1992 Duke Case
Authors: Rami A Ballout, Asma Arabi
Journal: Front Endocrinol (Lausanne) (2017)
Keywords: adverse reaction, case report, cramps, diabetes, insulin analogs, insulin aspart
MeSH terms: Case Reports

A 56-year-old middle-eastern male with a long-standing history of poorly controlled type 2 diabetes mellitus presented to us complaining of severely painful bilateral upper and lower extremity cramps occurring shortly after his rapid-acting insulin analog injection(s). The cramps had started 6 months ago and have been occurring intermittently in non-predictable episodes since then. He had otherwise never experienced any insulin-related adverse reaction(s) before. His cramps are very painful and debilitating, interfering with his daily activities and placing him in a state of constant fear/anxiety of re-experiencing them. This caused him to become non-adherent with his prescribed treatment and poorly compliant with his follow-up regimens. Thorough examination showed a diffuse loss of sensation over the lower limbs. This was subsequently confirmed with a combined electromyography-nerve conduction study which indicated extensive diabetic axonal polyneuropathy. By contrast, lower extremity segmental arterial pressures were negative for peripheral vasculo-occlusive disease, ruling out vascular insufficiency as a possible etiology of the cramps. We then measured the levels of serum electrolytes right-before and 30 min right-after injecting the patient with his insulin. Potassium dropped by about 16% from its initial level, compared to a drop of only around 4% for calcium and none (0%) for magnesium. Thus, we speculated this insulin-induced sharp drop in serum potassium levels as potentiating the patient's already existing advanced diabetic neuropathy, thereby leading to muscle cramping. However, attempting potassium supplementation for a brief period of time led to a rapid resolution of cramps when they occurred and an overall reduction in their frequency of recurrence. This tilted our diagnosis toward the insulin-induced acute drop in serum potassium levels as the most likely etiology underlying the patient's cramps. Such an observation has been made only once previously within the literature, back in 1992, at the Duke University Medical Center.
Pericardial Effusion due to Infliximab Therapy for Ulcerative Colitis
Authors: Muhammad Mirza, Maira Mirza, Vagishwari Murugesan, Arrel Olano
Journal: Case Rep Gastrointest Med (2018)
MeSH terms: Case Reports

Ulcerative colitis is characterized by ulcers and inflammation of the inner lining of the gastrointestinal tract. Antitumor necrosis factor alpha (anti-TNF alpha) agents such as infliximab are drugs that have been used for the treatment of ulcerative colitis for decades. Infliximab is known to be associated with various adverse effects including anti-TNF alpha induced lupus (ATIL). We present a rare case of a 51-year-old female with pericardial effusion secondary to infliximab therapy for treatment of her ulcerative colitis. Discontinuation of infliximab led to resolution of the pericardial effusion.
Case Report: Diagnosis of hypogeusia after oral exposure to commercial cleaning agent and considerations for clinical taste testing
Authors: Marie Jetté, Catherine Anderson, Vijay Ramakrishnan
Journal: F1000Res (2017)
Keywords: burning mouth syndrome, dysgeusia, hypogeusia, taste, tongue

Few reports in the literature document acute taste disturbance following exposure to toxic chemicals. We describe the case of a 54-year-old man who presented with primary complaint of tongue numbness and persistent problems with taste 1.5 years following oral exposure to a commercial cleaning agent. A test of olfaction revealed normosmia for age and gender. Lingual tactile two-point discrimination testing showed reduced somatosensation. Taste threshold testing using a 3-drop method demonstrated severe hypogeusia, though the patient was able to discriminate tastants at lower concentrations with a whole mouth swish and spit test. We conclude that clinical evaluation of dysgeusia can be performed using a number of previously published testing methods, however, determining causative factors may be confounded by duration since exposure, lack of knowledge of baseline taste function, and medications. Although many testing options exist, basic taste testing can be performed with minimal expertise or specialized equipment, depending on the patient history and goals of evaluation.