OpenMed/multicare-articles huggingface dataset:
Personal travel blogs as texts for studying intercultural interactions: a pilot test case study of an American sojourner's blogs from Zimbabwe
Authors: Rick Malleus, Elizabeth Slattery
Journal: Springerplus (2014)
Keywords: cross-cultural comparison, culture shock, travel blogs, zimbabwe

This paper makes the argument that personal travel blogs are an important site for studying self-reports of face-to-face intercultural interaction. The guiding research question is "Are personal travel blogs good sources of intercultural communication data?" A content analysis of an American woman's travel blog, written on a sojourn to Zimbabwe, was performed using four intercultural communication constructs that served as frameworks for developing a rubric and for analysis. Those constructs are: culture shock, intercultural communication challenges, cross-cultural comparison and intercultural adaptation. Results provide evidence of written reflections by the blogger in all four coding categories. The evidence of culture shock provided in the blog was multifold, multifaceted, and congruent with many of the well-established elements of culture shock reported in the field. The evidence of cross-cultural comparison in the personal travel blog was, overwhelmingly, comprised of reflections comparing host and home cultures, both in environment and cultural practices. There was limited evidence of reflections about communication challenges or adaptation by the blogger on her sojourn. The article concludes with a discussion of the implications these findings have for the potential travel blogs might provide for analysis of intercultural communication as well as addressing the limitations of the study's findings.
Two Case Reports of Varicocele Rupture during Sexual Intercourse and Review of the Literature
Authors: Chalil Arif, Konstantinos Kotoulas, Chrysostomos Georgellis, Konstantinos Frigkas, Athanasios Bantis, Emmanouil Patris
Journal: Case Rep Urol (2018)
MeSH terms: Case Reports

Varicocele is characterized by the dilatation of the veins of the spermatic cord. Its prevalence in general male population is 15% while in the infertile population the prevalence rises up to 25%. The varicocele is considered an etiological factor for male infertility. Although different pathophysiological patterns have been proposed, there is no consensus in the urological society to date. In most of the cases varicocele is asymptomatic but sometimes gives mild symptoms as dull pain at the scrotal region. A rare complication of this condition is the spontaneous or traumatic rupture and hematoma formation, either as spermatic cord hematoma or as scrotal hematoma. We are presenting two cases of varicocele rupture, presented with acute painful swelling of the left inguinal and scrotal region during sexual intercourse. Imaging studies revealed a scrotal hematoma in the first case and a spermatic cord hematoma in the second case, without signs of active bleeding. Both patients were treated conservatively and recovered uneventfully. Subsequently, we reviewed the literature in an effort to find the key points for the diagnosis and treatment of this condition.
Multimodal optical imaging and genetic features of AB variant GM2 gangliosidosis: a case report
Authors: Qin Chen, Fang Lu
Journal: Front Pediatr (2023)
Keywords: ab variant gm2 gangliosidosis, cherry-red spot, fundus fluorescein angiography (ffa), gene, optical coherence tomography
MeSH terms: Case Reports

Background:
AB variant GM2 gangliosidosis is an extremely rare autosomal recessive lysosomal storage disease. Macular cherry-red spots are the most commonly described ocular sign in this disease. Here, for the first time we report a case of an infant with AB variant GM2 gangliosidosis, along with multimodal optical imaging and genetic testing results.
Case description:
A 7-month-old Chinese girl presented to the hospital with nystagmus for 2 months. Her family history for this condition showed negative results, and her parents were not known to be consanguineous. Fundus photography showed a cherry-red spot with a ring of whitish infiltrate surrounding both macula. Fundus fluorescein angiography showed normal retinal circulation and vessels. Optical coherence tomography (OCT) revealed a thickening and increased reflectivity of the inner retinal layers with a shadowing effect on the outer structures. The patient had no obvious neurological symptoms, and the MRI results of the head were normal. The whole-exome genome sequencing results showed that there was a homozygous deletion (chr5: 150639196-150639548) of exon 2 in the GM2A gene. Finally, the patient was diagnosed with AB variant GM2 gangliosidosis.
Conclusions:
AB variant GM2 gangliosidosis is a rare disease affecting multiple nervous systems. Before the occurrence of typical neurological symptoms, the clinical features of fundus photography and OCT help us diagnose GM2 gangliosidosis.
Life-threatening clostridial sepsis in a postmenopausal patient with degenerating uterine leiomyoma
Authors: Christopher S Bryant, Latoya Perry, Jay P Shah, Sanjeev Kumar, Gunter Deppe
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Clostridium perfringens is a fulminant infection that affects patients with a high rate of morbidity and mortality. Fortunately, C. perfringens-associated sepsis and death in the gynecologic patient is rarely encountered. We report a case of intrauterine C. perfringens presenting as life-threatening sepsis in a postmenopausal patient.
Double half-cone flap umbilicoplasty for proboscoid umbilical hernia in a 2 years old child with satisfactory results 2 years later
Authors: Eseme Ebai Ashu, Guifo Marc Leroy, Bang Guy Aristide, Bitang Mafok Louis Joss, Jemea Bonaventure, Savom Eric Patrick, Fotso Guegne Myriam
Journal: Pan Afr Med J (2015)
Keywords: double half-cone flap, proboscoid umbilical hernia, umbilicoplasty
MeSH terms: Hernia, Umbilical / surgery, Herniorrhaphy / methods, Plastic Surgery Procedures / methods, Umbilicus / surgery, Case Reports, Child, Preschool, Follow-Up Studies, Humans, Male, Surgical Flaps

Surgical repair of large umbilical hernias may present a challenging surgical problem; standard surgical techniques have proven to be inadequate for both closing the fascial defect of the umbilicus and providing a satisfactory cosmetic result. We describe here a case of double half-cone flap umbilicoplasty that was performed in a 2 years old boy. The case of a 2 years old child with proboscoid umbilical hernia. The protruding umbilical skin was excised sharply by two V-shaped cuts leaving two half cones, a short cephalic (0.5cm) and a long caudal (1cm). A classic herniotomy was carried out, with repair of the facial defect. The caudal half cone was sutured from its apex till half it's length upon itself with interrupted sutures and it was anchored deeply to the fascia. Then we inverted the cephalic half cone which was sutured to the caudal cone to form the new umbilicus. The early result was excellent with no complications and the result after 2years revealed a cosmetically satisfactory shape of the umbilicus. this technique provides a good solution for reconstruction of the protruding umbilical skin and it is easy to learn, easy to be taught and perform in surgical environments and may be applicable for any kind of umbilical reconstruction.
Severe Community-Acquired Bloodstream Infection with Acinetobacter ursingii in Person who Injects Drugs
Authors: Helmut J F Salzer, Thierry Rolling, Stefan Schmiedel, Eva-Maria Klupp, Christoph Lange, Harald Seifert
Journal: Emerg Infect Dis (2016)
Keywords: acinetobacter ursingii, maldi-tof, bacteria, community-acquired bloodstream infection, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry, person who injects drugs, severe sepsis
MeSH terms: Acinetobacter / pathogenicity, Acinetobacter Infections / microbiology, Bacteremia / microbiology, Community-Acquired Infections / microbiology, Case Reports, Acinetobacter / drug effects, Acinetobacter Infections / drug therapy, Bacteremia / drug therapy, Community-Acquired Infections / drug therapy, Female, Humans, Meropenem, Middle Aged, Thienamycins / therapeutic use, Thienamycins, Meropenem

We report a community-acquired bloodstream infection with Acinteobacter ursingii in an HIV-negative woman who injected drugs. The infection was successfully treated with meropenem. Species identification was performed by using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Improved identification of Acinetobacter spp. by using this method will help identify clinical effects of this underdiagnosed pathogen.
Successful Long-Term Use of Eltrombopag in a Patient with Refractory Severe Thrombocytopenia Associated with Chronic Lymphocytic Leukemia That Allowed Oral Anticoagulant Treatment for Severe Cardiomyopathy
Authors: Juárez Salcedo Luis Miguel, Gil-Fernández Juan José
Journal: Case Rep Hematol (2017)
MeSH terms: Case Reports

Autoimmune cytopenias (AICs) are frequently associated with chronic lymphocytic leukemia (CLL). The most common of these AICs is autoimmune hemolytic anemia (AIHA); the second most is immune thrombocytopenia (ITP). Here, we report on a patient with CLL-associated ITP, with thrombocytopenia refractory to corticosteroids and intravenous immunoglobulins, in which continuous oral treatment with Eltrombopag allowed initiation and maintenance of an oral anticoagulation treatment with Acenocoumarol that was indicated because of a severe arrhythmogenic cardiomyopathy.
Pulse corticosteroid therapy in the treatment of steroid-refractory immune checkpoint inhibitor-related pneumonitis: Case report and review
Authors: Kuan-Chang Lai, Yi-Han Hsiao, San-Chi Chen
Journal: Front Immunol (2022)
Keywords: pulse corticosteroid therapy, immune checkpoint inhibitors, immune-related adverse event, nivolumab, pneumonitis, steroid-refractory
MeSH terms: Antineoplastic Agents, Immunological / therapeutic use, Pneumonia / chemically induced, Pneumonia / diagnosis, Pneumonia / drug therapy, Case Reports, Research Support, Non-U.S. Gov't, Adrenal Cortex Hormones / therapeutic use, Female, Humans, Immune Checkpoint Inhibitors / adverse effects, Immunosuppressive Agents / therapeutic use, Methylprednisolone / therapeutic use, Nivolumab / adverse effects, Adrenal Cortex Hormones, Antineoplastic Agents, Immunological, Immune Checkpoint Inhibitors, Immunosuppressive Agents, Nivolumab, Methylprednisolone

Immune checkpoint inhibitors (ICIs) have demonstrated promising therapeutic outcomes in treating a variety of malignancies, but immune-related adverse events (irAE) may develop. Among all the irAE, immune-related pneumonitis was relatively common and life-threatening. High-dose corticosteroid was recommended for the initial management, but a part of patients developed steroid-refractory pneumonitis. Other immunosuppressants were recommended, but the optimal treatment is still controversial. Here, we report two cases of steroid-refractory immune-related pneumonitis who were successfully treated with pulse corticosteroid therapy. Case 1 was hepatocellular carcinoma treated with nivolumab for 5 months. She developed acute respiratory distress syndrome due to grade 4 immune-related pneumonitis that was refractory to intravenous methylprednisolone 2 mg/kg/day treatment. Methylprednisolone 500 mg for 3 days followed by 2 mg/kg/day steroid as maintenance therapy was given. Subsequently, her pneumonitis was regressed, and the endotracheal tube was successfully removed on day 9 after the start of pulse therapy. Case 2 presented with grade 4 immune-related pneumonitis in spite the use of methylprednisolone 1 mg/kg for his skin rash. Pulse corticosteroid therapy was prescribed, then his pneumonitis was completely regressed on day 12. In this report, we demonstrated the potential role of pulse corticosteroid therapy for steroid-refractory pneumonitis.
Clinical outcomes of gemcitabine-loaded callispheres drug-eluting beads for patients with advanced and inoperable lung cancer: A case series study
Authors: Yonghua Bi, Bo Zhang, Jianzhuang Ren, Xinwei Han, Wenze Wu
Journal: Front Pharmacol (2022)
Keywords: callispheres beads, drug-eluting beads transarterial chemoembolization (deb-tace), gemcitabine, lung cancer, transarterial chemoembolization (tace)

Aim: Drug-eluting beads transarterial chemoembolization (DEB-TACE) has not been widely used in patients with advanced and inoperable lung cancer. We aimed to report the preliminary outcomes of DEB-TACE with gemcitabine-loaded CalliSpheres beads for patients with advanced and inoperable lung cancer. Methods: From November 2017 to October 2021, 37 patients (29 males, mean age 64.7 ± 10.3 years) with advanced and inoperable lung cancer underwent DEB-TACE with gemcitabine-loaded CalliSpheres beads. The primary endpoint was overall response rate, and the secondary endpoints were overall survival and progression-free survival. Results: A total of 54 sessions of DEB-TACE were performed in 37 patients, with a technique success rate of 100%. Fourteen patients received a second session of DEB-TACE. The mean follow-up time was 18.7 ± 11.9 months. After 1, 3, and 6 months, overall response rate and disease control rate were 27.8% and 91.7%, 25.8% and 74.2%, 32.1%, and 67.9%, respectively. The median progression-free survival was 8.8 months (95% CI 7.5, 12.5 months). The 3-, 6- and 12- month progression-free survival rates were 67.1%, 57.0%, and 30.1%, respectively. The median overall survival was 10.0 months (95% CI 4.5, 13.1 months). The 3-, 6-, and 12- month overall survival rates were 88.5%, 72.7%, and 40.9%, respectively. Minor complications were observed in 14 patients (37.8%), with no procedure-related deaths or severe adverse events. Conclusion: DEB-TACE with gemcitabine-loaded CalliSpheres beads is a safe, feasible and effective treatment strategy for patients with advanced and inoperable lung cancer.
Response after Infection-Associated Rise in Clozapine Levels in Treatment-Resistant Schizoaffective Disorder
Authors: Nina H Grootendorst-van Mil, Anna R M Huiskens, Sieds Dieleman, Tom K Birkenhäger
Journal: Case Rep Psychiatry (2018)
MeSH terms: Case Reports

The clinical management of patients with treatment-resistant psychotic disorders is still challenging despite years of extensive research. If first-line antipsychotic treatment proves ineffective, clozapine is considered golden standard. Herein, we report on a patient with schizoaffective disorder that initially showed no response to treatment with clozapine and ECT and therefore reached a therapeutic dead end. After an unintentional exposure to supratherapeutic clozapine levels, related to a pneumonia, a significant and persistent reduction of psychotic symptoms occurred. The report suggests a careful reevaluation of the clozapine dose in cases of treatment-resistant psychotic disorders with failed trials of clozapine. Further increase of dose may prove efficacious, although side effects should be closely monitored. Research to determine the upper threshold of clozapine for antipsychotic efficacy is warranted.
Case report: Homozygous variants of NEB and KLHL40 in two Arab patients with nemaline myopathy
Authors: Cristina Skrypnyk, Aseel Ahmed Husain, Hisham Y Hassan, Jameel Ahmed, Abdulla Darwish, Latifa Almusalam, Noureddine Ben Khalaf, Fahad Al Qashar
Journal: Front Genet (2023)
Keywords: klhl40, neb, wes, congenital, myopathy, nemaline
MeSH terms: Case Reports

Objective: Nemaline myopathies are a heterogeneous group of congenital myopathies caused by mutations in different genes associated with the structural and functional proteins of thin muscular filaments. Most patients have congenital onset characterized by hypotonia, respiratory issues, and abnormal deep tendon reflexes, which is a phenotype encountered in a wide spectrum of neuromuscular disorders. Whole-exome sequencing (WES) contributes to a faster diagnosis and facilitates genetic counseling. Methods: Here, we report on two Arab patients from consanguineous families diagnosed with nemaline myopathy of different phenotype spectrum severities. Results: Clinical assessment and particular prenatal history raised suspicion of neuromuscular disease. WES identified homozygous variants in NEB and KLHL40. Muscle biopsy and muscle magnetic resonance imaging studies linked the genetic testing results to the clinical phenotype. The novel variant in the NEB gene resulted in a classical type 2 nemaline myopathy, while the KLHL40 gene variant led to a severe phenotype of nemaline myopathy, type 8. Both patients were identified as having other gene variants with uncertain roles in their complex phenotypes. Conclusions: This study enriches the phenotypic spectrum of nemaline myopathy caused by NEB and KLHL40 variants and highlights the importance of detailed prenatal, neonatal, and infancy assessments of muscular weakness associated with complex systemic features. Variants of uncertain significance in genes associated with nemaline myopathy may be correlated with the phenotype. Early, multidisciplinary intervention can improve the outcome in patients with mild forms of nemaline myopathies. WES is essential for clarifying complex clinical phenotypes encountered in patients from consanguineous families. Targeted carrier screening of extended family members would enable accurate genetic counseling and potential genetic prevention.
A case of mammary-type myofibroblastoma of the inguinal region
Authors: Atsushi Ishihara, Takeo Yasuda, Yukari Sakae, Masayuki Sakae, Tooru Hamada, Hideki Tsukazaki, Takashi Tsukazaki, Masaru Furumoto
Journal: Int J Surg Case Rep (2018)
Keywords: case report, inguinal tumor, mammary-type myofibroblastoma

Introduction:
Myofibroblastoma is usually occurred in the breast and extra-mammary disease is rare.
Presentation of case:
A 38-year-old man was admitted to our hospital for further examination of the left inguinal tumour, present and enlarging for 16 months. The tumor was 50 mm in diameter, well-circumscribed, firm, and painless. Ultrasonogaphy, computed tomography(CT) and magnetic resonance imaging (MRI) could not provide the definitive diagnosis. Surgical exploration confirmed a 50 mm tumour with a clear surface with a thin capsule. Complete excision was achieved. Histopathology confirmed the tumor had oval and spindle shaped fibroblastic cells with rich collagen deposition. It stained positive for ER, CD34, desmin and CD10 but negative for -smooth muscle actin and S-100. A mammary-type myofibroblastoma was diagnosed based on these results.
Discussion:
An extra-mammary myofibroblastoma is very rare and first reported in 2001. Since then, over 160 cases have been reported. On immunohistochemistry, these lesions are characteristically positive for CD34 and desmin, with variable staining for α-smooth muscle actin. Once the diagnosis is made, regardless of size or location, this tumour behaves in a benign fashion after surgical excision reported so far.
Conclusion:
This case is rare, but the correct diagnosis and treatment is important for good prognosis.
Perianal plaques of cytomegalovirus in a patient with central nervous system lymphoma
Authors: Scott K Heysell, Brian Wispelwey
Journal: Case Rep Infect Dis (2012)
MeSH terms: Case Reports

Cutaneous manifestations of cytomegalovirus (CMV) in patients without human immunodeficiency virus remain rare. Perianal CMV may be observed due to periodic fecal shedding but may be confused for other pathogens, and definitive diagnosis requires histopathologic examination. An instructive case is described, and the literature reviewed.
Effect of long-term climbing training on cerebellar ataxia: a case series
Authors: Marianne Anke Stephan, Sylvie Krattinger, Jérôme Pasquier, Shahid Bashir, Thomas Fournier, Dieter Georg Ruegg, Karin Diserens
Journal: Rehabil Res Pract (2011)

Background. Efficient therapy for both limb and gait ataxia is required. Climbing, a complex task for the whole motor system involving balance, body stabilization, and the simultaneous coordination of all 4 limbs, may have therapeutic potential. Objective. To investigate whether long-term climbing training improves motor function in patients with cerebellar ataxia. Methods. Four patients suffering from limb and gait ataxia underwent a 6-week climbing training. Its effect on ataxia was evaluated with validated clinical balance and manual dexterity tests and with a kinematic analysis of multijoint arm and leg pointing movements. Results. The patients increased their movement velocity and achieved a more symmetric movement speed profile in both arm and leg pointing movements. Furthermore, the 2 patients who suffered the most from gait ataxia improved their balance and 2 of the 4 patients improved manual dexterity. Conclusion. Climbing training has the potential to serve as a new rehabilitation method for patients with upper and lower limb ataxia.
Excessive paranasal sinuses and mastoid aeration as a possible cause of chronic headache
Authors: Panagiotis Kousoulis, Jiannis Hajiioannou, Vassiliki Florou, Dimitrios Kretzas, George Korres
Journal: Case Rep Otolaryngol (2013)

The objective of this case report is to present a patient with chronic headache who was diagnosed with excessive aeration of all paranasal sinuses and mastoid air cells using computed tomography imaging. The volume and linear measurements of all of the cavities revealed values greater than the greatest values reported in the literature. To date, this is the second reported case of excessive enlargement of all paranasal sinuses and the first which includes the enlargement of the mastoid air cells. No surgical intervention was required for the patient, but in similar cases, with more severe symptoms, surgical treatment is a challenge for the surgeon and may mandate a multidisciplinary approach.
Successfully treated infected aneurysm caused by Listeria monocytogenes
Authors: Hirokazu Toyoshima, Koji Hirano, Motoaki Tanigawa, Naoto Masuda, Chiaki Ishiguro, Hiroyuki Tanaka, Yuki Nakanishi, Shigetoshi Sakabe
Journal: IDCases (2021)
Keywords: in-situ graft placement, infected aneurysm, listeria monocytogenes, mycotic aneurysm, rapid diagnostic testing
MeSH terms: Case Reports

Infected aneurysms caused by Listeria monocytogenes are extremely rare. Therefore, there is no standard procedure for their diagnosis and treatment. A 76-year-old Japanese man with diabetes and hypertension was diagnosed with a left common iliac aneurysm caused by L. monocytogenes, using multidetector computed tomographic angiography and rapid diagnostic testing of the positive blood culture. He was successfully treated with a combination of ampicillin administration, timely surgical debridement, and in-situ Y-graft placement with revascularization and omental implantation. Vancomycin and third-generation cephalosporins, to which L. monocytogenes is resistant, are used as an empirical regimen for infected aneurysms. Therefore, the use of a rapid diagnostic testing is important as it identifies L. monocytogenes within 24 h from obtaining the blood cultures, and guides the administration of the appropriate antibiotics. In-situ Y-graft placement restores nearly normal blood flow, following the confirmation of negative conversion of blood culture in response to the intensive intravenous ampicillin therapy. Appropriate and timely microbiological examinations, in addition to radiographic examinations, can be the key for selecting the optimal therapeutic procedures for each patient and achieving the best possible outcomes.