OpenMed/multicare-articles huggingface dataset:
Evidence for Detrimental Cross Interactions between Reactive Oxygen and Nitrogen Species in Leber's Hereditary Optic Neuropathy Cells
Authors: Micol Falabella, Elena Forte, Maria Chiara Magnifico, Paolo Santini, Marzia Arese, Alessandro Giuffrè, Kristina Radić, Luciana Chessa, Giulia Coarelli, Maria Chiara Buscarinu, Rosella Mechelli, Marco Salvetti, Paolo Sarti
Journal: Oxid Med Cell Longev (2016)
MeSH terms: Optic Atrophy, Hereditary, Leber / pathology, Reactive Nitrogen Species / chemistry, Reactive Oxygen Species / chemistry, Case Reports, Research Support, Non-U.S. Gov't, Adenosine Triphosphate / chemistry, Adult, Cell Survival, Female, Flow Cytometry, Fluorometry, Humans, Leukocytes, Mononuclear / metabolism, Lymphocytes / cytology, Mutation, Nitrites / chemistry, Nitrogen, Optic Atrophy, Hereditary, Leber / metabolism, Oxidative Stress, Oxygen, Oxygen Consumption, Tyrosine / analogs & derivatives, Tyrosine / chemistry, Nitrites, Reactive Nitrogen Species, Reactive Oxygen Species, 3-nitrotyrosine, Tyrosine, Adenosine Triphosphate, Nitrogen, Oxygen

Here we have collected evidence suggesting that chronic changes in the NO homeostasis and the rise of reactive oxygen species bioavailability can contribute to cell dysfunction in Leber's hereditary optic neuropathy (LHON) patients. We report that peripheral blood mononuclear cells (PBMCs), derived from a female LHON patient with bilateral reduced vision and carrying the pathogenic mutation 11778/ND4, display increased levels of reactive oxygen species (ROS) and reactive nitrogen species (RNS), as revealed by flow cytometry, fluorometric measurements of nitrite/nitrate, and 3-nitrotyrosine immunodetection. Moreover, viability assays with the tetrazolium dye MTT showed that lymphoblasts from the same patient are more sensitive to prolonged NO exposure, leading to cell death. Taken together these findings suggest that oxidative and nitrosative stress cooperatively play an important role in driving LHON pathology when excess NO remains available over time in the cell environment.
Gubernaculum Sparing Laparoscopic Orchiopexy in Cryptorchidism with Ipsilateral Congenital Absence of the Vas Deferens: Unique Outcome
Authors: Ebtehal Althobaiti, Hattan Badr, Maryam Aloqalaa, Raghdah Alsharif, Naif Alqarni
Journal: Case Rep Urol (2019)
MeSH terms: Case Reports

Congenital absence of the vas deferens (CAVD) is an uncommon anomaly that occurs in up to 1% of the male population. It can be associated with various other anomalies, including cryptorchidism and renal anomalies, such as renal agenesis. We here present a case of cryptorchidism with ipsilateral congenital absence of the vas deferens and renal agenesis and used the Stephen-Fowler technique for Orchiopexy depending on gubernacular vessels. A 7-month-old boy was referred to our center with left grade 2 hydronephrosis, right renal agenesis, and right impalpable, undescended testis. Examination under anesthesia and laparoscopic exploration with staged Stephen-Fowler orchiopexy were performed. The patient was followed up at 3, 6, and 12 months and had an excellent outcome. Cryptorchidism with congenital ipsilateral absence of the vas deferens and renal agenesis is a rare diagnostic entity. Our case supports the suggested theory that the gubernacular vessels can increase the blood supply to the testis, although further studies are needed to confirm this hypothesis.
Spontaneous Heparin-Induced Thrombocytopenia and Venous Thromboembolism following Total Knee Arthroplasty
Authors: Kevin Baker, Ming Y Lim
Journal: Case Rep Hematol (2017)
MeSH terms: Case Reports

A 72-year-old Caucasian woman was admitted for an elective left total knee arthroplasty. Her surgery was uncomplicated and she was discharged to a rehabilitation facility. Twelve days later, she developed acute shortness of breath followed by a syncopal episode. She was hypoxic and cyanotic, requiring hospitalization and intubation, and was subsequently diagnosed with bilateral submassive pulmonary emboli and bilateral lower extremity deep vein thrombosis. She was started on unfractionated heparin infusion. Within 24 hours of exposure, she had an acute decrease in platelet count to 48,000. Heparin was discontinued and argatroban was initiated due to concern for heparin-induced thrombocytopenia (HIT). Both quantitative enzyme immunoassay and functional assay confirmed the diagnosis of HIT. The patient had no prior lifetime heparin exposure. Given the absence of preceding heparin therapy, this case is consistent with the diagnosis of spontaneous HIT.
Fever-Associated Supraventricular Tachycardia after 4CMenB Vaccination in an Infant
Authors: Erdem Gönüllü, Burcu Topçu, Naci Öner, Ahmet Soysal, Metin Karaböcüoğlu
Journal: Case Rep Pediatr (2019)
MeSH terms: Case Reports

Meningococcal serogroup B vaccine 4CMenB (Bexsero) is a new four-component protein vaccine developed to prevent Neisseria meningitidis serogroup B infections. Case. We report a girl with fever and supraventricular tachycardia (SVT) 6-8 hours after the second dose of 4CMenB. SVT was unresponsive to the first dose of adenosine but terminated after the fourth dose of adenosine. During three months of follow-up, she was free of further SVT attacks. Conclusion. This is the first report of ECG-proven SVT after 4CMenB vaccination. Even if fever is coexistent, SVT should be considered after persistent tachycardia and 4CMenB vaccination.
Genomic characterization of Pantoea anthophila strain UI705 causing urinary tract infections in China
Authors: Yingmiao Zhang, Yue Fan, Yu Zhan, Hao Wang, Xun Li, Hui Wang, Tian Feng, Lifeng Shi, Jing Wang, Zhongxin Lu
Journal: Front Cell Infect Microbiol (2023)
Keywords: 16s rrna, maldi-tof ms, pantoea anthophila, urinary tract infection, whole genome sequencing (wgs)
MeSH terms: Pantoea / genetics, Urinary Tract Infections / microbiology, Case Reports, Research Support, Non-U.S. Gov't, Aged, Base Sequence, Genomics, Humans, Male, Pantoea anthophila

Introduction:

Pantoea anthophila (P. anthophila) is a Gram-negative bacterium initially isolated from Impatiens balsamina in India. P. anthophila has been characterized with low pathogenicity, and no human infections caused by this organism have been reported yet. We report the first case of urinary tract infection caused by P. anthophila in a 73-year-old man after bladder cancer surgery.
Methods:
The bacterial isolate gained from urine was named UI705 and identified as P. anthophila by MALDI-TOF mass spectrometry. The genome sequencing and analysis were performed to further characterize the pathogenesis of the clinical isolate.
Result and discussion:
To the best of our knowledge, this is the first report of human infection caused by P. anthophila in China. The draft genome sequence of P. anthophila UI705 provides a fundamental resource for subsequent investigation of its virulence factors, antibiotic resistance, host-pathogen interactions, and comparative genomics of genus Pantoea.
A medical records and data capture and management system for Lassa fever in Sierra Leone: Approach, implementation, and challenges
Authors: Jeffrey G Shaffer, John S Schieffelin, Michael Gbakie, Foday Alhasan, Nicole B Roberts, Augustine Goba, Jessica Randazzo, Mambu Momoh, Troy D Moon, Lansana Kanneh, Danielle C Levy, Rachel M Podgorski, Jessica N Hartnett, Matt L Boisen, Luis M Branco, Robert Samuels, Donald S Grant, Robert F Garry, Viral Hemorrhagic Fever Consortium
Journal: PLoS One (2019)
MeSH terms: Databases, Factual, Lassa Fever / diagnosis, Research Support, N.I.H., Extramural, Antibodies, Viral / blood, Blood Chemical Analysis, Disease Outbreaks, Hospitals, District, Humans, Information Dissemination, Lassa Fever / epidemiology, Lassa Fever / mortality, Lassa virus / genetics, Lassa virus / immunology, Lassa virus / isolation & purification, Medical Records, RNA, Viral / metabolism, Sierra Leone / epidemiology, Software, Survival Rate, Antibodies, Viral, RNA, Viral

Situated in southeastern Sierra Leone, Kenema Government Hospital (KGH) maintains one of the world's only Lassa fever isolation wards and was a strategic Ebola virus disease (EVD) treatment facility during the 2014 EVD outbreak. Since 2006, the Viral Hemorrhagic Fever Consortium (VHFC) has carried out research activities at KGH, capturing clinical and laboratory data for suspected cases of Lassa fever. Here we describe the approach, progress, and challenges in designing and maintaining a data capture and management system (DCMS) at KGH to assist infectious disease researchers in building and sustaining DCMS in low-resource environments. Results on screening patterns and case-fatality rates are provided to illustrate the context and scope of the DCMS covered in this study. A medical records system and DCMS was designed and implemented between 2010 and 2016 linking historical and prospective Lassa fever data sources across KGH Lassa fever units and its peripheral health units. Data were captured using a case report form (CRF) system, enzyme-linked immunosorbent assay (ELISA) plate readers, polymerase chain reaction (PCR) machines, blood chemistry analyzers, and data auditing procedures. Between 2008 and 2016, blood samples for 4,229 suspected Lassa fever cases were screened at KGH, ranging from 219 samples in 2008 to a peak of 760 samples in 2011. Lassa fever case-fatality rates before and following the Ebola outbreak were 65.5% (148/226) and 89.5% (17/19), respectively, suggesting that fewer, but more seriously ill subjects with Lassa fever presented to KGH following the 2014 EVD outbreak (p = .040). DCMS challenges included weak specificity of the Lassa fever suspected case definition, limited capture of patient survival outcome data, internet costs, lapses in internet connectivity, low bandwidth, equipment and software maintenance, lack of computer teaching laboratories, and workload fluctuations due to variable screening activity. DCMS are the backbone of international research efforts and additional literature is needed on the topic for establishing benchmarks and driving goal-based approaches for its advancement in developing countries.
Polymicrobial Bacteremia Involving Comamonas testosteroni
Authors: Jose Orsini, Eric Tam, Naomi Hauser, Salil Rajayer
Journal: Case Rep Med (2014)

Comamonas spp. are uncommon isolates in microbiology laboratories and have been rarely observed as an infectious agent in clinical practice. They have widespread environmental distribution and have been isolated from water, soil, and plants as well as from some hospital devices such as intravenous catheters and water contained in humidifier reservoirs used in respiratory treatment. The genus Comamonas originally contained the following species: acidovorans, testosteroni, kerstersii, terrigena, denitrificans, and nitrativorans. It now contains 17 species, while acidovorans spp. have been reclassified as Delftia acidovorans. In spite of its uncommon human pathogenesis, there are few reports on the aggressive manner of it as an opportunistic pathogen, mostly related to testosteroni spp. We present a case of polymicrobial bacteremia involving Comamonas testosteroni. The aim of this case report is to alert clinicians to the potential diagnosis of bloodstream infections caused by uncommon pathogens.
Diagnostic Lessons from a Complex Case of Postintestinal Transplantation Enteropathy
Authors: Cian Wade, Philip Allan, Elena Collantes, Srikanth R Reddy, Peter J Friend, Georgios Vrakas
Journal: Case Rep Transplant (2017)
MeSH terms: Case Reports

Recent advances in the field of intestinal transplantation have been mitigated by the incidence of allograft rejection. In such events, early identification and appropriate timing of antirejection therapy are crucial in retaining graft function. We present the case of a patient who suffered severe postintestinal transplantation allograft enteropathy, primarily characterized by extensive mucosal ulcerations, and was refractory to all conventional therapy. This progressed as chronic rejection; however crucially this was not definitively diagnosed until allograft function had irreversibly diminished. We argue that the difficulties encountered in this case can be attributed to the inability of our current array of investigative studies and diagnostic guidelines to provide adequate clinical guidance. This case illustrates the importance of developing reliable and specific markers for guiding the diagnosis of rejection and the use of antirejection therapeutics in this rapidly evolving field of transplant surgery.
Esophageal schwannoma: Case report and epidemiological, clinical, surgical and immunopathological analysis
Authors: Luiz Carlos de Araújo Souza, Thiago David Alves Pinto, Hugo Oliveira de Figueiredo Cavalcanti, Alexandre Rezende Rezende, Ana Luiza Alves Nicoletti, Cinthia Mares Leão, Vinícius Carvalhêdo Cunha
Journal: Int J Surg Case Rep (2019)
Keywords: cd 117, cd 34, case report, esophageal schwannoma, s-100 protein

Introduction:
Schwannoma is a tumor of the peripheral nervous system originated in the Schwann cells of the neural sheath.
Presentation of case:
A 43-years-old male complained of odynophagia, dysphagia and hemoptysis. The upper gastrointestinal endoscopy showed a smooth elevated lesion, 20 cm from the incisor teeth, occupying the entire lumen of the esophagus. The chest computed tomography (CT) scan showed a lesion of 7 cm and superior mediastinal, lower paraesophageal and cardiac enlarged lymph nodes. A posterolateral thoracotomy was performed with total esophagectomy without intraoperative complications. The anatomopathological analysis revealed fusocellular mesenchymal neoplasia of low malignancy potential. The immunohistochemical study showed positivity for S-100 protein and KI67 antibodies and absence of staining for CD117, CD34, ALK protein, SMA and Desmin. Thus, the morphological and immunohistochemical findings pointed to the diagnosis of esophageal Schwannoma.
Discussion:
Although rare and indolent, Schwannoma occurs in the peripheral nervous system, being uncommon in the esophagus.
Conclusion:
The immunohistochemical study is essential for the diagnosis, which is based on the positivity for S-100 protein and absence of staining for CD34 and CD117.
Primary Adenoid Cystic Carcinoma of the Upper Anterior Mediastinum Mimicking a Thyroid Tumor: A Case Report and Review of Literature
Authors: Qiuji Wu, Weizi Sun, Jiajun Bu, Yuanhang Xiang, Yahua Zhong
Journal: Front Endocrinol (Lausanne) (2020)
Keywords: adenoid cystic carcinoma, case report, diagnosis and treatment, literature review, thyroid neoplasms
MeSH terms: Carcinoma, Adenoid Cystic / diagnosis, Mediastinal Neoplasms / diagnosis, Thyroid Neoplasms / diagnosis, Case Reports, Research Support, Non-U.S. Gov't, Review, Carcinoma, Adenoid Cystic / complications, Carcinoma, Adenoid Cystic / surgery, Diagnosis, Differential, Female, Humans, Mediastinal Neoplasms / complications, Mediastinal Neoplasms / surgery, Middle Aged, Prognosis, Thyroid Neoplasms / complications, Thyroid Neoplasms / surgery

Primary adenoid cystic carcinoma (ACC) of the upper anterior mediastinum mimicking a thyroid tumor has rarely been seen in clinical practice and lacks a standard of care therapy. Here, we report a 47-year old female patient with an ACC originated from the upper anterior mediastinum presenting as a thyroid gland tumor. The patient received gross surgical resection of the tumor and underwent post-surgical chemotherapy and radiotherapy. The patient was free from local recurrence 3-years following initial treatment, but developed multiple lung metastases. She remains under clinical observation without discomfort and is still followed as an outpatient. Here, we also summarized recent reports of similar cases with hope to provide some experience for future clinical practice.
Case Report: Long-term complete response to PSMA-targeted radioligand therapy and abiraterone in a metastatic prostate cancer patient
Authors: David Parker, Jessica Zambelli, Montana Kay Lara, Trevor Hamilton Wolf, Amber McDonald, Erica Lee, Lotfi Abou-Elkacem, Eva J Gordon, Richard P Baum
Journal: Front Oncol (2023)
Keywords: lu-psma-617, psma, case report, metastatic castration resistant prostate cancer, prostate cancer, radioligand therapy, theranostics
MeSH terms: Case Reports

Despite decades of research and clinical trials, metastatic castration-resistant prostate cancer (mCRPC) remains incurable and typically fatal. Current treatments may provide modest increases in progression-free survival but can come with significant adverse effects and are disaggregated from the diagnostic imaging needed to fully assess the spread of metastatic disease. A theranostic approach, using radiolabeled ligands that target the cell surface protein PSMA, simplifies the visualization and disease treatment process by enabling both to use similar agents. Here, we describe an exemplary case wherein a gentleman in his 70s with mCRPC on diagnosis was treated with 177Lu-PSMA-617 and abiraterone, and remains disease-free to date, over five years later.
COVID-19 in Brazil-Preliminary Analysis of Response Supported by Artificial Intelligence in Municipalities
Authors: Hugo M P Morales, Murilo Guedes, Jennifer S Silva, Adriano Massuda
Journal: Front Digit Health (2021)
Keywords: covid-19, access, artificial intelligence, care coordination, chatbot, public health

The novel coronavirus disease (COVID-19) forced rapid adaptations in the way healthcare is delivered and coordinated by health systems. Brazil has a universal public health system (Sistema Unico de Saúde-SUS), being the main source of care for 75% of the population. Therefore, a saturation of the system was foreseen with the continuous increase of cases. The use of Artificial Intelligence (AI) to empower telehealth could help to tackle this by increasing a coordinated patient access to the health system. In the present study we describe a descriptive case report analyzing the use of Laura Digital Emergency Room-an AI-powered telehealth platform-in three different cities. It was computed around 130,000 interactions made by the chatbot and 24,162 patients completed the digital triage. Almost half (44.8%) of the patients were classified as having mild symptoms, 33.6% were classified as moderate and only 14.2% were classified as severe. The implementation of an AI-powered telehealth to increase accessibility while maintaining safety and leveraging value amid the unprecedent impact of the COVID-19 pandemic was feasible in Brazil and may reduce healthcare overload. New efforts to yield sustainability of affordable and scalable solutions are needed to truly leverage value in health care systems, particularly in the context of middle-low-income countries.
Case Report: Afatinib Treatment in a Patient With NSCLC Harboring a Rare EGFR Exon 20 Mutation
Authors: Sabine Zöchbauer-Müller, Bettina Kaserer, Helmut Prosch, Agnieszka Cseh, Flavio Solca, Markus Johann Bauer, Leonhard Müllauer
Journal: Front Oncol (2021)
Keywords: egfr mutation, h773dup, nsclc, afatinib, exon 20 insertion, long-term response, uncommon mutation
MeSH terms: Case Reports

Unlike most other primary epidermal growth factor receptor (EGFR) mutations in non-small cell lung cancer (NSCLC), exon 20 insertions, comprising approximately 4% to 10% of all EGFR mutations, are generally considered to be resistant to EGFR tyrosine kinase inhibitors (TKIs). However, EGFR exon 20 insertions are structurally and pharmacologically heterogeneous, with variability in their position and size having implications for response to different EGFR TKIs. The second-generation ErbB family blocker, afatinib, is approved for the first-line treatment of EGFR mutation-positive NSCLC and has been shown to have a broad inhibitory profile against common and uncommon EGFR mutations. Here, we describe a patient with bilateral multifocal lung adenocarcinoma harboring a very rare EGFR exon 20 insertion (c.2317_2319dup3; p.H773dup), who has been receiving treatment with afatinib for 4.5 years. To our knowledge, this is the first report describing long-term benefit for a patient treated with afatinib with this rare exon 20 insertion. We are aware of two further cases with this rare EGFR mutation. One patient, also reported here, has early-stage lung adenocarcinoma and has not yet received systemic therapy for NSCLC. The other patient received afatinib in the context of a global compassionate use program and had progressive disease. Our findings may be of clinical relevance for patients carrying tumors with this rare mutation as epidemiological evidence suggests that p.H773dup may function as a driver mutation in NSCLC. Together with previous preclinical and clinical evidence for the activity of afatinib against certain EGFR exon 20 insertions, these findings warrant further investigation.
Internal Mammary Artery Injury without Chest Wall Fractures after Cardiopulmonary Resuscitation: A Case Report
Authors: Sayuri Tokioka, Shinichiro Masuda, Masamitsu Shirokawa, Takashi Shibui
Journal: Case Rep Emerg Med (2018)
MeSH terms: Case Reports

High-quality cardiopulmonary resuscitation (CPR) is crucial for survival from cardiac arrest. However, various chest compression-associated injuries have been reported. Internal mammary artery (IMA) injury is one of the rare complications after CPR, and most of cases include rib and sternum fractures. In this report, we describe a rare case of IMA injury without chest wall fractures after CPR. An 85-year-old man with a history of acute myocardial infarction 2 weeks prior visited to our hospital for sustained ventricular tachycardia (VT). After admission, sustained VT requiring CPR occurred several times. Emergency coronary angiogram revealed 90% stenosis at the left anterior descending artery. Hence, emergency percutaneous coronary intervention (PCI) was performed. During the PCI, blood gas analysis showed decreasing serum hemoglobin levels. Contrast computed tomography revealed hemothorax and extravasation at the branch of the right IMA without chest wall fractures. The patient's deteriorating hemodynamic condition precluded thoracotomy or embolization to stop the bleeding. The patient died on the next day of hospitalization. IMA injury can occur after CPR, regardless of chest wall fractures and can be fatal without early diagnosis. For an emergency physician, IMA injury should be considered as a cause of unknown anemia after CPR.
4DCT Differentiation of Parathyroid Adenoma: A Case Report
Authors: Tana Bupe Mwewa, Steven Raeymaeckers
Journal: J Belg Soc Radiol (2023)
Keywords: ct, head and neck, hyperparathyroidism, parathyroid adenoma
MeSH terms: Case Reports

We report the case of a 72-year-old patient presenting with recurrent primary hyperparathyroidism after total thyroidectomy and parathyroidectomy with presternal autotransplantation. Methionine-PET-CT proved false-positive and Tc-99m-tetrofosmine imaging false-negative. Using a novel multiphase-4DCT technique we identified an anterior mediastinal nodule demonstrating contrast wash-in and wash-out, suggesting parathyroid adenoma. Traditional 4DCT-protocols obtain fewer phases; therefore, this enhancement pattern might have gone unnoticed. After surgical resection the bloodwork normalized, histopathology confirmed a parathyroid adenoma.
Teaching point:
Multiphase 4DCT is a potentially helpful technique for the detection of parathyroid adenomas after total thyroidectomy and parathyroidectomy.