OpenMed/multicare-articles huggingface dataset:
Risk factors for treatment failure in women with uncomplicated lower urinary tract infection
Authors: Romain Martischang, Maciek Godycki-Ćwirko, Anna Kowalczyk, Katarzyna Kosiek, Adi Turjeman, Tanya Babich, Shachaf Shiber, Leonard Leibovici, Elodie von Dach, Stephan Harbarth, Angela Huttner
Journal: PLoS One (2021)
MeSH terms: Urinary Tract Infections / epidemiology, Multicenter Study, Randomized Controlled Trial, Age Distribution, Bacteria / isolation & purification, Female, Humans, Middle Aged, Multivariate Analysis, Risk Factors, Treatment Failure, Urinary Tract Infections / microbiology

Given rising antibiotic resistance and increasing use of delayed prescription for uncomplicated lower urinary tract infections (UTI), patients at risk for treatment failure should be identified early. We assessed risk factors for clinical and microbiological failure in women with lower UTI. This case-control study nested within a randomized clinical trial included all women in the per-protocol population (PPP), those in the PPP with microbiologically confirmed UTI, and those in the PPP with UTI due to Escherichia coli. Cases were women who experienced clinical and/or microbiologic failure; controls were those who did not. Risk factors for failure were assessed using multivariate logistic regression. In the PPP, there were 152 clinical cases for 307 controls. Among 340 women with microbiologically confirmed UTI, 126 and 102 cases with clinical and microbiological failure were considered with, respectively, 214 and 220 controls. Age ≥52 years was independently associated with clinical (adjusted OR 3.01; 95%CI 1.84-4.98) and microbiologic failure (aOR 2.55; 95%CI 1.54-4.25); treatment with fosfomycin was associated with clinical failure (aOR 2.35; 95%CI 1.47-3.80). The association with age persisted among all women, and women with E. coli-related UTI. Diabetes was not an independent risk factor, nor were other comorbidities. Postmenopausal age emerged as an independent risk factor for both clinical and microbiological treatment failure in women with lower UTI and should be considered to define women at-risk for non-spontaneous remission, and thus for delayed antibiotic therapy; diabetes mellitus was not associated with failure.
Case report: Acute Talaromyces marneffei mediastinitis in an HIV-negative patient
Authors: Liangyu Chen, Meichun Zhang, Weihong Guo, Wenshuang Ding, Jinwen Tan, Hong Du, Ziwen Zhao, Weinong Zhong
Journal: Front Microbiol (2022)
Keywords: ebus-tbna, hiv-negative, talaromyces marneffei, immunocompetent, mediastinal mass, mediastinitis, nebulized amphotericin b
MeSH terms: Case Reports

Talaromyces marneffei (T. marneffei) is one of the most important opportunistic human pathogens endemic in Southeast Asia. Talaromycosis, which was once regarded as an opportunistic infectious disease in patients with acquired immunodeficiency syndrome, is being increasingly reported in HIV-negative populations. Since T. marneffei infection can be localized or disseminated, patients may present with a variety of symptoms. However, mediastinal infection attributed to T. marneffei is extremely rare. We report the case of a 32-year-old female who manifested a large mediastinal mass and was eventually diagnosed as acute T. marneffei mediastinitis. The patient was HIV-negative and had no direct contact with intermediate hosts. We successfully managed to treat the patient with inhaled amphotericin B deoxycholate and observed lesion absorption in subsequent CT examinations. To our knowledge, this is the first published case of T. marneffei mediastinitis and first use of inhaled antifungal monotherapy on patients with T. marneffei infection.
Labyrinthectomy after Cochlear Implantation: A Case of a Novel Approach for Vertigo Control
Authors: I Todt, K Wilms, H Sudhoff
Journal: Case Rep Otolaryngol (2019)
MeSH terms: Case Reports

Vertigo control in cases of Ménière disease and deafness can be achieved by labyrinthectomy before or as a single-stage procedure during cochlear implantation. The aim was to describe a case in which a labyrinthectomy was performed after cochlear implantation. The scar tissue was removed from the electrode cable, and the receiver was removed from the periostal pocket and placed out without electrode dislocation. Labyrinthectomy was performed after securing the electrode at the external canal. The patient disclaimed after three months no disabling vertigo. Intraoperatively, the electrode was not dislocated. A labyrinthectomy can be performed even after cochlear implantation to treat vertigo.
Fibrolipoma on upper eyelid in child
Authors: Rafael Corredor-Osorio, Nelly Ramos-Pineda, María Eugenia Orellana
Journal: GMS Ophthalmol Cases (2016)
Keywords: benign tumor, fibrolipoma, lipoma
MeSH terms: Case Reports

An 18-months-old male infant presented with a rapidly growing tumor on the right upper eyelid. Orbital computed tomography (CT) revealed a large, well-circumscribed mass with low density signal in the right upper eyelid. Magnetic resonance images (MRI) showed a lesion of mixed T1-signal intensity and high signal intensity in T2-weighted images. The tumor was treated by simple anterior orbitotomy with excisional biopsy, and the diagnosis of fibrolipoma was made by histopathologic examination. There was no evidence of tumor at the four-year follow-up. Fibrolipoma is one of the rare variant of the lipoma and only four cases have been reported in the orbit including the present case. Except for this case all other cases were reported in adults.
Case Report and Literature Review of Insulinoma in the Geriatric Population: An 86-Year-Old Female with Syncope of Unknown Origin
Authors: Gerry Samantha Eichelberger, Jordan Carbono, Zachary Field, KanwarAnoop Kainaur, Federico Montalvo
Journal: Case Rep Endocrinol (2020)
MeSH terms: Case Reports

Insulinomas are extremely rare pancreatic endocrine tumors. The tumor is characterized by endogenous hypersecretion of insulin and ensuing development of symptoms of neuroglycopenia and the catecholaminergic response. Symptoms may not always be present, particularly in patients compensating appropriately with increased appetites and caloric intake due to low glucose levels. Early localization of the disease is essential to prevent lethal hypoglycemia and timely treatment. This case report and literature review depict the case of a pancreatic insulinoma in an 86-year-old female, an exceptionally rare presentation based on age and absence of clinical symptoms for one or more years prior to hospitalization. Despite its rarity, similar presentations have been reported in the literature and are further outlined with characteristics and treatment plans. This case highlights a unique presentation of insulinoma and suggests the need for clinical vigilance and further study. It also discusses diagnosis, localization, and management of this uncommon disease in patients above the age of seventy-five.
The risk of SARS-CoV-2 outbreaks in low prevalence settings following the removal of travel restrictions
Authors: Rahil Sachak-Patwa, Helen M Byrne, Louise Dyson, Robin N Thompson
Journal: Commun Med (Lond) (2021)
Keywords: dynamical systems, viral infection

Background:
Countries around the world have introduced travel restrictions to reduce SARS-CoV-2 transmission. As vaccines are gradually rolled out, attention has turned to when travel restrictions and other non-pharmaceutical interventions (NPIs) can be relaxed.
Methods:
Using SARS-CoV-2 as a case study, we develop a mathematical branching process model to assess the risk that, following the removal of NPIs, cases arriving in low prevalence settings initiate a local outbreak. Our model accounts for changes in background population immunity due to vaccination. We consider two locations with low prevalence in which the vaccine rollout has progressed quickly - specifically, the Isle of Man (a British crown dependency in the Irish Sea) and the country of Israel.
Results:
We show that the outbreak risk is unlikely to be eliminated completely when travel restrictions and other NPIs are removed. This general result is the most important finding of this study, rather than exact quantitative outbreak risk estimates in different locations. It holds even once vaccine programmes are completed. Key factors underlying this result are the potential for transmission even following vaccination, incomplete vaccine uptake, and the recent emergence of SARS-CoV-2 variants with increased transmissibility.
Conclusions:
Combined, the factors described above suggest that, when travel restrictions are relaxed, it may still be necessary to implement surveillance of incoming passengers to identify infected individuals quickly. This measure, as well as tracing and testing (and/or isolating) contacts of detected infected passengers, remains useful to suppress potential outbreaks while global case numbers are high.
Disseminated primary diffuse leptomeningeal gliomatosis: a case report with liquid based and conventional smear cytology
Authors: Masha Bilic, Cynthia T Welsh, Zoran Rumboldt, Rana S Hoda
Journal: Cytojournal (2005)

Background:
Primary diffuse leptomeningeal gliomatosis is a rare neoplasm confined to the meninges without evidence of primary tumor in the brain or spinal cord parenchyma. Cerebrospinal fluid diversion via ventriculoperitoneal shunt may be used as a therapeutic modality. Herein, we describe the first report of cytologic findings of a case of this neoplasm with shunt-related peritoneal metastasis.
Case presentation:
A 19-year-old male presented with a 6-month history of severe headaches. He had bilateral papilledema on physical exam. Cerebrospinal fluid examination was negative. Four months later a ventriculoperitoneal shunt was placed. Shortly thereafter, he was diagnosed with primary diffuse leptomeningeal gliomatosis based on the biopsy of an intradural extramedullary lesion adjacent to the lumbar spinal cord at a referral cancer center. The histology featured an infiltrating growth pattern of pleomorphic astrocytes with diffuse positivity for glial fibrillary acidic protein. A couple of months later he presented at our institution with ascites and an anterior peritoneal mass. Repeat cerebrospinal fluid cytology and fine needle aspiration of the mass confirmed disseminated gliomatosis. Cytologic characteristics included clusters of anaplastic cells of variable size, high nuclear to cytoplasm ratio and scant to moderate cytoplasm. Occasional single bizarre multinucleated cells were seen with eccentric "partial wreath-like" nuclei, clumped chromatin and prominent nucleoli. Patient expired 13 months after initial presentation.
Conclusion:
Disseminated primary diffuse leptomeningeal gliomatosis should be considered in the differential diagnosis of chronic aseptic meningitis and in the presence of a peritoneal tumor in patients with ventriculoperitoneal shunts. Immunocytochemistry may be of diagnostic value.
Sporadic spinal psammomatous malignant melanotic nerve sheath tumor: A case report and literature review
Authors: Giulio Bonomo, Alessandro Gans, Elio Mazzapicchi, Emanuele Rubiu, Paolo Alimonti, Marica Eoli, Rosina Paterra, Bianca Pollo, Guglielmo Iess, Francesco Restelli, Jacopo Falco, Francesco Acerbi, Marco Paolo Schiariti, Paolo Ferroli, Morgan Broggi
Journal: Front Oncol (2023)
Keywords: case report, malignant melanotic nerve sheath tumor, melanotic schwannoma, nerve sheath, psammomatous, spinal, sporadic, tumor
MeSH terms: Case Reports

Background:
Sporadic Spinal Psammomatous Malignant Melanotic Nerve Sheath Tumor (SSP-MMNST) is a rare subgroup of peripheral nerve sheath tumors arising along the spine. Only a few reports of SSP-MMNST have been described. In this paper, we review the literature on SSP-MMNST focusing on clinical, and diagnostic features, as well as investigating possible pathogenetic mechanisms to better implement therapeutic strategies. We also report an illustrative case of a young female presenting with cervicobrachial pain due to two SSP-MMNSTs arising from C5-6 right spinal roots.
Case description:
We report a case of a 28-year-old woman presenting with right arm weakness and dysesthesia. Clinical examination and neuroimaging were performed, and, following surgical removal of both lesions, a histological diagnosis of SSP-MMNST was obtained.
Results:
The literature review identified 21 eligible studies assessing 23 patients with SSP-MMNST, with a mean onset age of 41 years and a slight male gender preference. The lumbar district was the most involved spinal segment. Gross-total resection (GTR) was the treatment of choice in all amenable cases, followed in selected cases with residual tumor by adjuvant radiotherapy or chemotherapy. The metastatic and recurrence rates were 31.58% and 36.8%, respectively.
Conclusion:
Differently from common schwannomas, MMNST represents a rare disease with known recurrence and metastatization propensity. As reported in our review, SSP-MMNST has a greater recurrence rate when compared to other forms of spinal MMNST, raising questions about the greater aggressiveness of the former. We also found that residual disease is related to a higher risk of systemic disease spreading. This metastatic potential, usually associated with primary lumbar localization, is characterized by a slight male prevalence. Indeed, whenever GTR is unachievable, considering the higher recurrence rate, adjuvant radiation therapy should be taken into consideration.
Recurrent Aphthous Stomatitis Improved after Eradication Therapy for Helicobacter pylori
Authors: Yinglin Gao, Nikhil Gupta, Maisa Abdalla
Journal: Case Rep Gastrointest Med (2021)
MeSH terms: Case Reports

Helicobacterpylori (H. pylori) is a Gram-negative bacterium that colonizes gastric mucosa and is often transmitted through direct contact with saliva, contaminated food or water, and vomit. The majority of the infected individuals remain asymptomatic for a long period. Infection with H. Pylori often presents with dyspepsia, nausea, frequent belching, bloating, abdominal discomfort, burning abdominal pain, and peptic ulcer. A potential association between H. Pylori and recurrent aphthous stomatitis was previously reported; however, the presence of causative relationship between the two remained controversial. We are presenting a case of recurrent aphthous stomatitis of twenty-four-year history resolved after H. pylori treatment.
A Rare Case of Multiorgan Calciphylaxis in a Patient with Stage 5 Chronic Kidney Disease
Authors: Abdulrahman Ahmad, Ali Albaghli, Adel Michael, Khaled Refaat, Mohammad Omar, Ahmad Ibrahim, Bahaa Elmenshawy, Ashraf Maher, Rasha Alramah, Sami Mikhail, Mustafa Almahmid, Husain Alenezi, Yahya Elshebiney
Journal: Case Rep Urol (2018)
MeSH terms: Case Reports

Calciphylaxis or calcific uremic arteriolopathy (CUA) is a potentially life-threatening vasculopathy involving the skin and subcutaneous tissues. It is usually associated with chronic kidney disease (CKD) and rarely with acute renal failure or predialysis patients. The clinical diagnosis of calcific uremic arteriolopathy relies on high index of suspicion. CUA is commonly associated with secondary hyperparathyroidism and high serum calcium and phosphate products. Moreover, using biopsy as a diagnostic tool is controversial, due to the high risk of poor wound healing and sepsis. Radiological studies usually reveal extensive calcification of branching vessels such as penile arteries, eventually leading to gangrene formation in extremities and penis. Histopathological analysis confirms the diagnosis of calcific uremic arteriolopathy and rules out the presence of malignancy. CUA is a systematic disease that involves multiple organs, and to the best of our knowledge this is the first reported case involving the penis, bladder, and eyes.
Relapse of skull osteoma after hydroxyapatite cement cranioplasty: Case Report
Authors: Xiang Yang, Yanhui Liu, Yuekang Zhang
Journal: Front Oncol (2023)
Keywords: cranioplasty, dura, hydroxyapatite cement (hac), osteoma, pathogenesis
MeSH terms: Case Reports

In this case report, we present an extremely rare and previously unreported case of skull osteoma relapse without any attachment to the skull after hydroxyapatite cement (HAC) cranioplasty. The 49-year-old male patient was admitted with recurrence of the left frontal skull lesion; he underwent craniectomy and HAC cranioplasty for a left frontal osteoma 14 years before. Intraoperative findings disclosed multiple irregular lesions located on the HAC flap without any attachment to the bony structure and the roots of the lesions originating from the outer layer of the dura through several reserved holes. Pathological diagnosis was osteoma. The purpose of this report is to document this rare occurrence and provide the most probable pathogenesis for this rare event.
A Novel SCN5A Mutation Associated with Drug Induced Brugada Type ECG
Authors: Isik Turker, Takeru Makiyama, Matteo Vatta, Hideki Itoh, Takeshi Ueyama, Akihiko Shimizu, Tomohiko Ai, Minoru Horie
Journal: PLoS One (2016)
MeSH terms: Anti-Arrhythmia Agents / adverse effects, Brugada Syndrome / genetics, Mutation, Missense, NAV1.5 Voltage-Gated Sodium Channel / genetics, Case Reports, Aged, Atrial Fibrillation / drug therapy, Atrial Fibrillation / physiopathology, Atrial Flutter / drug therapy, Atrial Flutter / physiopathology, Base Sequence, Brugada Syndrome / chemically induced, Brugada Syndrome / physiopathology, DNA Mutational Analysis, Electrocardiography, HEK293 Cells, Humans, Lidocaine / adverse effects, Lidocaine / analogs & derivatives, Male, Anti-Arrhythmia Agents, NAV1.5 Voltage-Gated Sodium Channel, SCN5A protein, human, Lidocaine, pilsicainide

Background:
Class IC antiarrhythmic agents may induce acquired forms of Brugada Syndrome. We have identified a novel mutation in SCN5A, the gene that encodes the α-subunit of the human cardiac sodium channel (hNav1.5), in a patient who exhibited Brugada- type ECG changes during pharmacotherapy of atrial arrhythmias.
Objective:
To assess whether the novel mutation p.V1328M can cause drug induced Brugada Syndrome.
Methods:
Administration of pilsicainide, a class IC antiarrhythmic agent, caused Brugada- type ST elevation in a 66-year-old Japanese male who presented with paroxysmal atrial fibrillation (PAF), type I atrial flutter and inducible ventricular fibrillation (VF) during electrophysiological study. Genetic screening using direct sequencing identified a novel SCN5A variant, p.V1328M. Electrophysiological parameters of WT and p.V1328M and their effects on drug pharmacokinetics were studied using the patch-clamp method.
Results:
Whole-cell sodium current densities were similar for WT and p.V1328M channels. While p.V1328M mutation did not affect the voltage-dependence of the activation kinetics, it caused a positive shift of voltage-dependent steady-state inactivation by 7 mV. The tonic block in the presence of pilsicainide was similar in WT and p.V1328M, when sodium currents were induced by a low frequency pulse protocol (q15s). On the contrary, p.V1328M mutation enhanced pilsicainide induced use-dependent block at 2 Hz. (Ki: WT, 35.8 μM; V1328M, 19.3 μM).
Conclusion:
Our study suggests that a subclinical SCN5A mutation, p.V1328M, might predispose individuals harboring it to drug-induced Brugada Syndrome.
Case Report: Detection of Symptomatic Treatment-Related Changes in a Patient With Anaplastic Oligodendroglioma Using FET PET
Authors: Elena Katharina Bauer, Jan-Michael Werner, Gereon R Fink, Karl-Josef Langen, Norbert Galldiks
Journal: Front Oncol (2021)
Keywords: amino acid pet, chemoradiation, diagnostic challenge, oligodendroglioma, pseudoprogression
MeSH terms: Case Reports

Following local and systemic treatment of gliomas, the differentiation between glioma relapse and treatment-related changes such as pseudoprogression or radiation necrosis using conventional MRI is limited. To overcome this limitation, various amino acid PET tracers such as O-[2-(18F)-fluoroethyl]-L-tyrosine (FET) are increasingly used and provide valuable additional clinical information. We here report neuroimaging findings in a clincally symptomatic 53-year-old woman with a recurrent anaplastic oligodendroglioma with MRI findings highly suspicious for tumor progression. In contrast, FET PET imaging suggested treatment-related changes considerably earlier than the regression of contrast enhancement on MRI. In patients with oligodendroglioma, the phenomenon of symptomatic treatment-related changes is not well described, making these imaging findings unique and important for clinical decision-making.
Left subclavian artery malperfusion due to thoracic outlet syndrome during total vertebrectomy for invasive lung cancer: a case report
Authors: Kazuyuki Mizunoya, Kentaro Ueda, Yoshifumi Takeda, Koichi Takita, Yuji Morimoto
Journal: JA Clin Rep (2017)
Keywords: artery malperfusion, interarm pressure difference, prone position, thoracic outlet syndrome, total vertebrectomy

Thoracic outlet syndrome (TOS) can interrupt blood flow to upper limbs by vascular compression. We report a case of a 52-year-old man who presented left subclavian artery malperfusion due to TOS during total vertebrectomy (Th2-4) in the prone position for invasive lung cancer. At the time of resection of the vertebral bodies, his left radial systolic blood pressure had begun to drop intermittently and we noticed an interarm pressure difference. Accordingly, we began to monitor the right radial artery pressure and found that only the left radial artery pressure decreased as a result of compressive force from the surgical site. The operation was continued with intermittent malperfusion of the left arm, and when it was prolonged, we asked the surgeons to release the compression. No symptoms of ischemia or nerve injuries in the left arm were observed after the surgery. Retrospective review of his preoperative enhanced computed tomography images suggested a slightly compressed left subclavian artery in the costoclavicular space. Combination of the prone position and a specific upper limb position may be a risk factor for intraoperative TOS. An interarm blood pressure difference is a clue to detect accidental arterial TOS during general anesthesia.
Ectopic intrauterine device in the bladder of a pregnant woman
Authors: Zehra Kurdoglu, Kadir Ceylan, Mertihan Kurdoglu, Ayse Guler, Hanim Guler Sahin
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Background. Uterine perforation and transvesical migration of an intrauterine device are rare complications. Case. A 28-year-old woman who had an intrauterine device was admitted to our outpatient clinic with complaints of amenorrhea lasting 5 weeks and pelvic pain lasting a year. Transvaginal ultrasonography revealed embedding of the intrauterine device in the bladder. The misplaced device was removed by laparotomy. Conclusion. The followup of intrauterine device localization with transvaginal ultrasonography is essential for early detection of possible serious complications.