OpenMed/multicare-articles huggingface dataset:
Physiological alterations after a marathon in the first 90-year-old male finisher: case study
Authors: Sandro Manuel Mueller, Beat Knechtle, Patrizia Knechtle, Marco Toigo
Journal: Springerplus (2014)
Keywords: countermovement jump, dual-energy x-ray absorptiometry, impulse, multiple one-legged hopping, peripheral quantitative computed tomography

Introduction:
Endurance performance decreases during ageing due to alterations in physiological characteristics, energy stores, and psychological factors. To investigate alterations in physiological characteristics and body composition of elderly master athletes in response to an extreme endurance event, we present the case of the first ninety-year-old official male marathon finisher.
Case description:
Before and directly after the marathon, a treadmill incremental test, dual-energy X-ray absorptiometry, peripheral quantitative computed tomography, mechanography, and dynamometry measurements were conducted. The athlete finished the marathon in 6 h 48 min 55 s, which corresponds to an average competition speed of 6.19 km h(-1).
Discussion and evaluation:
Before the marathon, [Formula: see text] was 31.5 ml min(-1) kg(-1) body mass and peak heart rate was 140 beats min(-1). Total fat mass increased in the final preparation phase (+3.4%), while leg fat mass and leg lean mass were slightly reduced after the marathon (-3.7 and -1.6%, respectively). Countermovement jump (CMJ) peak power and peak velocity decreased after the marathon (-16.5 and -14.7%, respectively). Total impulse during CMJ and energy cost of running were not altered by the marathon. In the left leg, maximal voluntary ground reaction force (F m1LH) and maximal isometric voluntary torque (MIVT) were impaired after the marathon (-12.2 and -14.5%, respectively).
Conclusions:
Side differences in F m1LH and MIVT could be attributed to the distinct non-symmetrical running pattern of the athlete. Similarities in alterations in leg composition and CMJ performance existed between the nonagenarian athlete and young marathon runners. In contrast, alterations in total body composition and m1LH performance were markedly different in the nonagenarian athlete when compared to his younger counterparts.
Pseudoaneurysm following Two-Stage Hip Revision with Fasciotomy
Authors: Jordan R Pollock, Kade S McQuivey, Collin L Braithwaite, Jennifer Swanson, Joshua S Bingham
Journal: Case Rep Orthop (2022)
MeSH terms: Case Reports

In the setting of total hip arthroplasty (THA), pseudoaneurysms are extremely rare and can be difficult to diagnose, as clinical symptoms can mimic symptoms of other more common complications, such as periprosthetic joint infection, hematoma, and nerve damage. We present a case of a 69-year-old male with a history of slipped capital femoral epiphysis 56 years prior and subsequent right THA. The right hip primary arthroplasty was subsequently complicated by multiple dislocations and recurrent prosthetic joint infections. The most recent infection was treated with debridement, antibiotics, and implant retention (DAIR) in 2017. The patient later presented in 2019 with right thigh pain. Upon further analysis, he was diagnosed with Streptococcus bovis positive periprosthetic joint infection. The patient underwent a two-stage revision of the hip using an antibiotic spacer. Two weeks following the second stage, he presented with a sudden onset of uncontrolled atrial fibrillation with rapid ventricular response and a low hemoglobin. The computed tomography scan revealed a large hematoma involving both the anterior and posterior thigh compartments with lab markers that were questionable for infection. An operation to remove the hematoma revealed no purulence, and a large pulsatile pseudoaneurysm on the posterolateral aspect at the mid femur was found. A sharp bone fragment was noted next to the pseudoaneurysm. The pseudoaneurysm was repaired by a vascular surgeon, and the bone fragment was removed. Following this procedure, the patient developed a subsequent periprosthetic joint infection requiring a double DAIR procedure six weeks following the pseudoaneurysm repair and is now on chronic antibiotic suppression. Orthopedic surgeons should be aware of the potential for pseudoaneurysm in the setting of total joint arthroplasty when treating a postsurgical hematoma of sudden onset.
Case report: Successful thromboprophylaxis with enoxaparin in a pregnant woman with internal jugular vein agenesis
Authors: Pierpaolo Di Micco, Luana Orlando, Donato Cataldo, Egidio Imbalzano
Journal: Front Med (Lausanne) (2022)
Keywords: enoxaparin, internal jugular agenesis, pregnancy, thromboprophylaxis, venous thromboembolism
MeSH terms: Case Reports

Internal jugular agenesis is a vascular malformation that is often associated with a history of recurrent headache. Due to the resulting abnormalities in intracranial venous drainage, it may be complicated by neurological dysfunction, such as intracranial hypertension, intracranial micro-thromboses, and neurodegenerative diseases such as multiple sclerosis. The simultaneous presence of jugular vein agenesis and thrombosis is possible in cases of acute illness, hormonal treatment, pregnancy, hypomobility, or venous drainage abnormalities (VDA) (e.g., May-Thurner syndrome). In particular, the literature still lacks data on thromboprophylaxis in pregnant women with jugular vein agenesis. Here, we report a positive experience with prophylaxis using enoxaparin during pregnancy in a patient with internal jugular agenesis.
Vertebral Artery Thrombosis in Chronic Idiopathic Thrombocytopenic Purpura
Authors: Zakaria Hindi, Nirmal Onteddu, Christopher A Ching, Abdallah A Khaled
Journal: Case Rep Hematol (2017)
MeSH terms: Case Reports

Introduction:
Immune thrombocytopenic purpura (ITP) is an autoimmune hematological disorder that causes decreased production and destruction of platelets leading to thrombocytopenia. Although thrombocytopenia usually causes hemorrhagic problems, thrombotic events like strokes, although rare, can still occur. Management of thrombotic events in patients with ITP differs from that of patients with normal platelet count function and count.
Case description:
A 32-year-old female with a history of ITP presented with ischemic stroke. The patient was treated in the hospital with IV immunoglobulin, discharged to a rehabilitation facility, and had complete resolution of symptoms when examined at a follow-up visit 3 months later.
Conclusion:
Although stroke in patients with ITP is very rare due to thrombocytopenia, it has been reported in several other published cases and is likely associated with increased platelet microparticle levels, a byproduct of platelet destruction. While usage of antiplatelet therapy in such patients is debated, immunosuppression therapy has been the mainstay treatment in all published cases.
Acute Esophageal Necrosis in an Alcoholic after Successful Resuscitation from Cardiac Arrest
Authors: Amish Shah, Viveksandeep Thoguluva Chandreskar, Ravi Doobay, Arundeep Kahlon, Ioana Amzuta
Journal: Case Rep Gastrointest Med (2017)
MeSH terms: Case Reports

Introduction:
We present a patient who presented to the ICU after successful resuscitation from cardiac arrest who was subsequently diagnosed with AEN.
Case presentation:
A 66-year-old female presented after cardiac arrest in which return of spontaneous circulation was achieved within 7 minutes after the initiation of CPR. She was intubated on the scene and found to have coffee ground emesis in her bathroom when found unresponsive. Due to the hemodynamically significant GI bleed, patient was started on IV proton pump inhibitor, octreotide, and levophed. Subsequent endoscopy showed diffuse severe mucosal changes characterized by blackness, erythema, friability, granularity, inflammation, and decreased vascular pattern in the middle third of the esophagus and in the lower third of the esophagus.
Discussion:
AEN is a rare syndrome with a prevalence ranging from 0.001 to 0.2% of EGD. This patient is especially rare as this patient was female and had AEN in the middle esophagus along with lower esophagus. The pathophysiology in this patient is hypothesized that she had cardiac arrest secondary to acute upper GI hemorrhage. Subsequent low-flow state (cardiac arrest) in addition to being in the setting of severe alcohol abuse led to esophageal necrosis.
Motivation for postgraduate studies by nonacademic optometrists: A case study at a South African university
Authors: Rekha Hansraj, Nishanee Rampersad
Journal: Health SA (2022)
Keywords: academia, institutional reputation, optometrist, optometry, postgraduate, postgraduate studies, research, supervision

Background:
An increasing number of optometrists who are nonacademics are pursuing postgraduate studies, despite such qualifications traditionally being more relevant to an academic rather than a clinical setting.
Aim:
This study set out to explore possible reasons for the increase in postgraduate studies by nonacademic optometrists and their experiences thereof.
Setting:
Postgraduate optometry students who were registered at a selected South African university within the period 2010-2020 participated in the study.
Methods:
A descriptive cross-sectional research design was used, which entailed an online survey and a follow-up questionnaire focused on the motivation for postgraduate studies, choice of institution, research area, expectations and outcomes and supervision received. Convenience sampling was used to recruit the participants, and data were analysed with descriptive statistics.
Results:
Responses were received from 54 optometrists who were pursuing postgraduate studies but not currently in academia. The main reasons reported for enrolling in postgraduate studies were interest in research (69.2%) and academia (61.5%). Institutional reputation was the reason provided by 48.1% of respondents for their choice of institution for their postgraduate studies. Fifty per cent of respondents opted for research in the public health field. To be a better researcher was the most common expectation (88.5%), with 73.1% indicating achieving this outcome. Most respondents indicated that they had received constructive and timeous supervision during their studies.
Conclusion:
Interest in research and academia are important factors influencing nonacademic optometrists to pursue postgraduate studies; however, the postgraduate experience is likely to also facilitate development of other professional and clinical skills.
Contribution:
This study provides an insight into the motivation and experiences of non academic optometrists who pursue postgraduate degrees.
Lower Limb Serratia marcescens Necrotizing Fasciitis Complicated by Nosocomial COVID-19
Authors: Raiyyan Aftab, Jing Qin Tay, Philip Sauvé, Ankur Pandya, Zhi Yang Ng
Journal: Cureus (2023)
Keywords: covid-19, lower limb, necrotizing fasciitis (nf), nosocomial infections, serratia
MeSH terms: Case Reports

Serratia marcescens represents an unusual yet potentially deadly cause of lower limb necrotizing fasciitis (NF). Compounding the already high mortality of NF, S. marcescens infections are usually associated with worse outcomes (i.e., amputation). Here we present the case of a 56-year-old immunocompromised man due to lupus nephritis who developed lower limb NF secondary to S. marcescens followed by nosocomial coronavirus disease 2019 (COVID-19) pneumonitis. Successful limb salvage was achieved through a multidisciplinary team approach from various specialties including plastic surgery, orthopedic surgery, anesthesiology, intensive care, respiratory medicine, and nephrology. At 11 months' follow-up, the patient was largely independent with activities of daily living and was able to ambulate. Unfortunately, he suffered a myocardial infarction at 19 months post-operatively and passed away. A review of the literature revealed only a handful of cases of lower limb NF due to S. marcescens and none with subsequent COVID-19. Therefore, this is the first report of such a case which should help with the clinical management of such cases going forward, especially with COVID-19 now becoming endemic in our communities and contributing to delayed presentations and increased mortality in NF.
Case report: Bilateral posterior ischemic optic neuropathy in a patient with atrial fibrillation and multifocal embolic stroke
Authors: Jin-Ju Kang, Eun-Su Lee, Haeng-Jin Lee, Seungbae Hwang, Myung-Ja Chung, Sun-Young Oh
Journal: Front Neurol (2022)
Keywords: atrial fibrillation (af), embolic stroke, ischemic optic neuropathy, optic nerve, posterior ischemic optic neuropathy (pion)
MeSH terms: Case Reports

An 80-year-old female with a history of diabetes mellitus (DM) and hypertension presented with sudden onset of sequential bilateral visual loss. The best visual acuity was light perception in the right eye and finger counting in the left eye, however, bilateral fundus did not reveal optic disc edema. Diffusion-weighted magnetic resonance imaging (MRI) of the brain revealed acute embolic stroke and diffusion restriction in the posterior portion of both optic nerves. The 24-h Holter monitor showed persistent atrial fibrillation (AF) with rapid ventricular response. The presence of painless and severe visual loss at onset unaccompanied by optic disc edema in the patient with newly detected uncontrolled AF and multiple embolic infarctions favored a diagnosis of non-arteritic posterior ischemic optic neuropathy (PION). The current case contributes to better understanding of PION pathophysiology and associated risk factors, indicating a possible relationship between non-arteritic PION and uncontrolled AF and embolic cerebral infarction.
Case report: Continuous infusions of ceftazidime-avibactam and aztreonam in combination through elastomeric infusors for 12 weeks for the treatment of bone and joint infections due to metallo-β-lactamase producing Enterobacterales
Authors: Yanis Merad, Anne Conrad, Sophie Brosset, Axel Schmidt, Camille Hanriat, Sebastien Lustig, Frederic Laurent, Camille Kolenda, Tiphaine Roussel-Gaillard, Cecile Batailler, Tristan Ferry, Lyon BJI Study group
Journal: Front Med (Lausanne) (2023)
Keywords: enterobacterales, antibiotic resistance, aztreonam, bone and joint infections, ceftazidime-avibactam, elastomeric infusor, metallo-beta-lactamase
MeSH terms: Case Reports

Among carbapenem-resistant Enterobacterales, metallo-beta-lactamase producing strains represent a growing therapeutic challenge. While the association of aztreonam and ceftazidime-avibactam has been investigated in recent years for the treatment of infections involving these strains, little to no clinical data support the use of this association for the treatment of bone and joint infections. We report two cases of complex bone and joint infections involving metallo-beta-lactamase-producing Enterobacterales, successfully treated at our referral center with aztreonam and ceftazidime-avibactam for 12 weeks in continuous infusions through elastomeric infusors.
Primary vulval rhabdoid tumor in an adult: a case report, immunohistochemical profile and literature review
Authors: Maria A Arafah, Muna I Aljuboury
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

We report a rare case of primary vulval rhabdoid tumor in an adult. The diagnosis was confirmed using the recently emerging INI1/BAF47 immunostain. We also demonstrate the expression of ER and PR hormonal receptors by the tumor cells.
Case Report: H3K27M-Mutant Glioblastoma Simultaneously Present in the Brain and Long-Segment Spinal Cord Accompanied by Acute Pulmonary Embolism
Authors: Buajieerguli Maimaiti, Salamaitiguli Mijiti, Ting Jiang, Yinyin Xie, Weixuan Zhao, Yu Cheng, Hongmei Meng
Journal: Front Oncol (2022)
Keywords: h3k27m-mutant glioblastoma, brain glioblastoma, case report, multicentric glioblastoma, pulmonary embolism, spinal glioblastoma
MeSH terms: Case Reports

Background:
Glioblastoma multiforme (GBM) is a highly malignant glioma that rarely presents as an infratentorial tumor. Multicentric (MC) gliomas involve lesions widely separated in space or time, and MC gliomas involving supra- and infratentorial brain regions are rare. In most cases, the infratentorial lesion is seen after surgical manipulation or radiation therapy; it is typically located in the cerebellum or the cervical region, manifesting as metastasis originating from the brain. Besides, venous thromboembolism in brain tumors is usually seen after craniotomy.
Case presentation:
We present an uncommon adult case of symptomatic H3K27M-mutant MC glioblastoma simultaneously present in the brain, fourth ventricle, and cervical and lumbar spinal cord regions accompanied by acute pulmonary artery embolism in an adult woman who had not undergone previous therapeutic interventions. We also review the literature on this interesting presentation.
Conclusion:
Our report highlights that clinicians should be alert to the potential alarming presentation of GBM. The incidence of spinal metastasis of cerebral GBM is increasing. Patients with a prior diagnosis of GBM with or without any new onset in the spinal cord should undergo an early MRI of the spinal cord to confirm the diagnosis at an early stage. While management of GBM remains controversial, more research is needed to explore molecular features of GBM further and develop novel targeted therapies for these patients.
Multi-level computational methods for interdisciplinary research in the HathiTrust Digital Library
Authors: Jaimie Murdock, Colin Allen, Katy Börner, Robert Light, Simon McAlister, Andrew Ravenscroft, Robert Rose, Doori Rose, Jun Otsuka, David Bourget, John Lawrence, Chris Reed
Journal: PLoS One (2017)
MeSH terms: Data Mining / methods, Interdisciplinary Studies, Libraries, Digital, Models, Theoretical, Research, Humans

We show how faceted search using a combination of traditional classification systems and mixed-membership topic models can go beyond keyword search to inform resource discovery, hypothesis formulation, and argument extraction for interdisciplinary research. Our test domain is the history and philosophy of scientific work on animal mind and cognition. The methods can be generalized to other research areas and ultimately support a system for semi-automatic identification of argument structures. We provide a case study for the application of the methods to the problem of identifying and extracting arguments about anthropomorphism during a critical period in the development of comparative psychology. We show how a combination of classification systems and mixed-membership models trained over large digital libraries can inform resource discovery in this domain. Through a novel approach of "drill-down" topic modeling-simultaneously reducing both the size of the corpus and the unit of analysis-we are able to reduce a large collection of fulltext volumes to a much smaller set of pages within six focal volumes containing arguments of interest to historians and philosophers of comparative psychology. The volumes identified in this way did not appear among the first ten results of the keyword search in the HathiTrust digital library and the pages bear the kind of "close reading" needed to generate original interpretations that is the heart of scholarly work in the humanities. Zooming back out, we provide a way to place the books onto a map of science originally constructed from very different data and for different purposes. The multilevel approach advances understanding of the intellectual and societal contexts in which writings are interpreted.
Pulmonary Intravascular B-Cell Lymphoma with Angiotropism/Angioinvasion Mimicking Interstitial Lung Disease: A Clinical Dilemma and Potential Diagnostic Challenge
Authors: Florentina Matea, Salem Alowami, Michael Bonert, Monalisa Sur, Yaron Shargall, Asghar H Naqvi
Journal: Case Rep Hematol (2018)
MeSH terms: Case Reports

Intravascular large B cell lymphoma (IVLBCL) is a rare type of extranodal diffuse large B-cell lymphoma. Patients typically present with nonspecific findings, particularly bizarre neurologic symptoms, fever, and skin lesions. IVLBCL with primary lung presentation is very rare and difficult to diagnose. The authors report a case of a 75-year-old male who presented with neurological symptoms and showed diffuse pulmonary ground glass opacities on computed tomography scan (CT scan). Surgical lung biopsy was performed. Light microscopic examination of the specimen showed diffuse alveolar septal widening caused by neoplastic lymphocytes, which were positive for CD20. These atypical lymphoid cells also demonstrated angiotropism/angioinvasion of the medium sized pulmonary vessels. The patient was diagnosed with IVLBCL and underwent chemotherapy. The patient is still alive 12 months after diagnosis.
Regenerative Endodontic Management of an Immature Necrotic Premolar Using Advanced Platelet-Rich Fibrin
Authors: Sepideh Hosseini, Nazanin Chitsaz, Mohammad Hassan Hamrah, Donya Maleki, Emad Taghizadeh
Journal: Case Rep Dent (2023)
MeSH terms: Case Reports

Regenerative endodontic management is a feasible treatment for immature teeth with periapical radiolucency and necrotic pulp that simplifies continued root creation. Among the most prevalent health problems in an immature root is dental pulp necrosis, which is caused by caries, improper endodontic treatments, and trauma. Necrosis of the dental pulp can affect long-term tooth survival and preservation and serve as a source of bacteria infecting the periapical tissue and the maxillofacial space. Here, we report on the application of advanced platelet-rich fibrin plus (A-PRF+) therapy, as a regenerative endodontic treatment (RET), in a 12-year-old with necrotic pulp and asymptomatic apical periodontitis. Over a 24-month follow-up post-treatment, we observed resolving of symptoms and a complete root formation with considerable periapical healing.
Pulmonary hypertension in pulmonary langerhans cell granulomatosis
Authors: Matthias Held, Philipp Schnabel, Arne Warth, Berthold Jany
Journal: Case Rep Med (2012)
MeSH terms: Case Reports

Introduction. Pulmonary Langerhans cell granulomatosis is a rare disease with a variable course. In pulmonary Langerhans cell granulomatosis pulmonary hypertension is frequent and has an independent prognostic impact. A vasculopathy which ist not related to ventilatory disturbance and fibrosis has been identified. An arteriopathy and even a venulopathy have been described. Due to this possible venulopathy vasodilators carry a significant risk for pulmonary congestion and edema. No drugs have been approved until now. Case Presentation. One female with PLCG developed severe PH four years after primary diagnosis of pulmonary Langerhans cell granulomatosis. Retrospective analysis of lung biopsies revealed an arterial vasculopathy at the time of primary diagnosis without clinical signs of PH at this time. Sildenafil led to a sustained improvement of hemodynamic features and exercise capacity. Conclusion. This paper underlines that patients with PLCG with an arterial vasculopathy-related PH might improve under sildenafil. Further trials addressing treatment of PH and vasculopathy are needed.
Riedel's Procedure: A Modification to Obliterate Step Defect
Authors: Abdul Nassimizadeh, Mohammad Nassimizadeh, Shahzada Ahmed
Journal: Case Rep Otolaryngol (2019)
MeSH terms: Case Reports

Sinus surgery was first introduced by the ancient Egyptians. In 1750 was the first modern description of frontal sinus surgery. In 1898, Riedel advocated complete removal of the anterior table and floor of the frontal sinus while simultaneously stripping the mucosa. The major postoperative issue involved gross forehead deformity. We aim to provide a modification to reduce the postoperative "step" defect. Riedel's procedure is an effective way of managing frontal sinus disease when endoscopic surgery has repetitively failed. Use of a pedicled pericranial/galeal soft tissue flap can effectively reduce cosmetic deformity postoperatively.