OpenMed/multicare-articles huggingface dataset:
A domain-knowledge modeling of hospital-acquired infection risk in Healthcare personnel from retrospective observational data: A case study for COVID-19
Authors: Phat K Huynh, Arveity R Setty, Quan M Tran, Om P Yadav, Nita Yodo, Trung Q Le
Journal: PLoS One (2022)
MeSH terms: COVID-19 / epidemiology, Cross Infection / prevention & control, Virus Diseases, Research Support, N.I.H., Extramural, Research Support, U.S. Gov't, Non-P.H.S., Bayes Theorem, Cross-Sectional Studies, Delivery of Health Care, Hospitals, Humans, Personnel, Hospital, Retrospective Studies

Introduction:
Hospital-acquired infections of communicable viral diseases (CVDs) have been posing a tremendous challenge to healthcare workers globally. Healthcare personnel (HCP) is facing a consistent risk of viral infections, and subsequently higher rates of morbidity and mortality.
Materials and methods:
We proposed a domain-knowledge-driven infection risk model to quantify the individual HCP and the population-level risks. For individual-level risk estimation, a time-variant infection risk model is proposed to capture the transmission dynamics of CVDs. At the population-level, the infection risk is estimated using a Bayesian network model constructed from three feature sets, including individual-level factors, engineering control factors, and administrative control factors. For model validation, we investigated the case study of the Coronavirus disease, in which the individual-level and population-level infection risk models were applied. The data were collected from various sources such as COVID-19 transmission databases, health surveys/questionaries from medical centers, U.S. Department of Labor databases, and cross-sectional studies.
Results:
Regarding the individual-level risk model, the variance-based sensitivity analysis indicated that the uncertainty in the estimated risk was attributed to two variables: the number of close contacts and the viral transmission probability. Next, the disease transmission probability was computed using a multivariate logistic regression applied for a cross-sectional HCP data in the UK, with the 10-fold cross-validation accuracy of 78.23%. Combined with the previous result, we further validated the individual infection risk model by considering six occupations in the U.S. Department of Labor O*Net database. The occupation-specific risk evaluation suggested that the registered nurses, medical assistants, and respiratory therapists were the highest-risk occupations. For the population-level risk model validation, the infection risk in Texas and California was estimated, in which the infection risk in Texas was lower than that in California. This can be explained by California's higher patient load for each HCP per day and lower personal protective equipment (PPE) sufficiency level.
Conclusion:
The accurate estimation of infection risk at both individual level and population levels using our domain-knowledge-driven infection risk model will significantly enhance the PPE allocation, safety plans for HCP, and hospital staffing strategies.
Cutaneous infection by non-diphtheria-toxin producing and penicillin-resistant Corynebacterium diphtheriae strain in a patient with diabetes mellitus
Authors: Max Roberto Batista Araújo, Mireille Ângela Bernardes Sousa, Luisa Ferreira Seabra, Letícia Aparecida Caldeira, Carmem Dolores Faria, Sérgio Bokermann, Lincoln Oliveira Sant'Anna, Louisy Sanches Dos Santos, Ana Luíza Mattos-Guaraldi
Journal: Access Microbiol (2021)
Keywords: corynebacterium diphtheriae, maldi-tof ms, cutaneous diphtheria, diabetes, diphtheria toxin, penicillin-resistance
MeSH terms: Case Reports

Diphtheria is a potentially fatal infection, mostly caused by diphtheria toxin (DT)-producing Corynebacterium diphtheriae strains. During the last decades, the isolation of DT-producing C. diphtheriae strains has been decreasing worldwide. However, non-DT-producing C. diphtheriae strains emerged as causative agents of cutaneous and invasive infections. Although endemic in countries with warm climates, cutaneous diphtheria is rarely reported in Brazil. Presently, an unusual case of skin lesion in a Brazilian elderly diabetic patient infected by a penicillin-resistant non-DT-producing C. diphtheriae strain was reported. Laboratory diagnosis included mass spectrometry and multiplex PCR analyses. Since cutaneous diphtheria lesions are possible sources of secondary diphtheria cases and systemic diseases and considering that penicillin is the first line of antimicrobial agent for the treatment of these infections, the detection of penicillin-resistant strains of diphtheria bacilli should be a matter of concern. Thus, cases similar to the presently reported should be appropriately investigated and treated, particularly in patients with risk factor (s) for the development of C. diphtheriae invasive infections, such as diabetes. Moreover, health professionals must be aware of the presence of C. diphtheriae in cutaneous lesions of lower limbs, a common type of morbidity in diabetic patients, especially in tropical and subtropical countries.
Malignant perivascular epithelioid cardiac sarcomas: a case report and a review of the literature
Authors: Candice Baldeo, Abdul Wahab Hritani, Robert Ali, Sana Chaudhry, Fawad N Khawaja
Journal: Case Rep Cardiol (2015)

Cardiac tumors, either benign or malignant, are difficult to diagnose due to their rarity, variety, and nonspecific presentation. Since primary cardiac sarcoma remains an unusual diagnosis, the literature on its presentation, diagnosis, and optimal management remains scarce. To our knowledge the following case of cardiac perivascular epithelioid cell tumor is the fourth reported case found in the literature. Although complete surgical resection remains the gold standard for cardiac sarcomas, our case demonstrates that not all of them can be completely resected.
EGFR mutations and high PD-L1 expression of lung squamous cell carcinoma patients achieving pCR following neoadjuvant immuno-chemotherapy: Case report
Authors: Xiangyu Xu, Zixia Shi, Dan Fu, Depei Huang, Zheng Ma
Journal: Front Oncol (2022)
Keywords: epidermal growth factor receptor (egfr), lung squamous cell carcinoma, mutations, neoadjuvant immunotherapy, pembrolizumab, programmed death ligand-1 (pd-l1)
MeSH terms: Case Reports

The treatment of lung cancer has fully entered the era of immunotherapy, which has significantly elevated the survival rate of patients with advanced non-small cell lung cancer (NSCLC), thus shedding light on resectable NSCLC. Previous clinical trial data suggested that neoadjuvant immuno-chemotherapy obtained a significant objective response rate (ORR) and disease control rate (DCR). Here, a case that achieved an excellent outcome following neoadjuvant immuno-chemotherapy was reported. The patient admitted to our hospital was 58 years old, female, with a rare case of stage IB lung squamous cell carcinoma (LUSC) harboring both epidermal growth factor receptor (EGFR) p.L858R mutations and high expression of programmed death ligand-1 (PD-L1) (tumor proportion score (TPS)=80%). Her tumor substantially shrunk following two cycles of neoadjuvant immuno-chemotherapy. The patient successively received single-port right upper thoracoscopic lobectomy + mediastinal lymph node dissection, which attained pathologic complete response (pCR). Additionally, the patient had grade 2 myelosuppression during the two cycles, which was treated with polyethylene glycol recombinant human granulocyte colony-stimulating factor (rhG-CSF). The patient was discharged uneventfully without any procedure-related complications. Two courses of adjuvant immuno-chemotherapy were administered postoperatively, leaving the patient in good physical condition at the 5-month follow-up visit. This case provided evidence for the feasibility and effectiveness of neoadjuvant immuno-chemotherapy in treating early-stage LUSC with EGFR mutations and high expression of PD-L1. However, randomized and multi-center controlled trials are required to validate the findings.
Nonthrombotic Pulmonary Embolism: A Potential Complication of Polyacrylamide Hydrogel Cosmetic Injection
Authors: Faisal Inayat, Ahmad R Cheema, Hafeez Ul Hasan Virk, Daniel J Yoon, Salman Farooq, Abdul Manan
Journal: Case Rep Med (2016)

Context. Polyacrylamide hydrogel (PAAG) has gained importance as a synthetic soft tissue filling agent. It has been commonly employed by physicians in Europe for facial contouring and soft tissue augmentation. Previously, PAAG is considered nontoxic and well tolerated with a few mild procedural complications. Case Presentation. A 26-year-old female was hospitalized for dry cough, worsening dyspnea, and chest discomfort after 3 hours of multiple PAAG injections in buttocks. The patient's condition deteriorated and rapidly advanced to acute respiratory failure. Therein, the diagnosis of nonthrombotic pulmonary embolism (NTPE) was established on standard set of investigations. She was intubated; corticosteroid and empiric antibiotic therapy was initiated resulting in improvement of her condition. Subsequently, extubation was done, and she was discharged from the hospital after an uneventful recovery. On 1-month follow-up, the patient had no previous symptoms. Conclusion. This report implicates clinicians to maintain a high index of suspicion for NTPE in patients presenting with respiratory symptoms following PAAG usage.
The "Prosthetic Orthodontic Approach": An Application of the Biologically Oriented Preparation Technique Protocol
Authors: Luca Casula
Journal: Case Rep Dent (2021)
MeSH terms: Case Reports

In this study, three cases involving patients who required multidisciplinary treatment for the aesthetic and functional rehabilitation of the maxillary or mandibular arch are described. In particular, an indication for preprosthetic orthodontic treatment, such as orthodontic extrusion, tooth realignment, correction of malocclusion, and diastemata closure, was present in all cases. Preprosthetic orthodontic treatment to resolve these issues before the restorative procedures was proposed; however, all patients refused preprosthetic orthodontic treatment. Thus, to restore aesthetics and function, solely a feather-edge prosthetic protocol has been used. The biologically oriented preparation technique was used to prepare the teeth that were moved in the established direction by preparing the abutment more on one side than the opposite. This so called "prosthetic orthodontic approach" allowed resolving clinical issues that would typically require preprosthetic orthodontic treatment, such as complete clinical crown loss, occlusal vertical dimension loss, tooth misalignment, malocclusion, tooth agenesis, and severe multiple diastemata. The degree of reciprocal movement of the prepared teeth achievable through this approach was minor and not comparable to a traditional wide-range orthodontic movement. Besides, the technique resulted in a modification of the gingival tissues and improvement of their thickness although it is unclear what effect this technique has on the gingival biotype. None of the patients had prosthetic or periodontal complications for at least 12 months following the procedure. Gingival health was excellent, and the prosthetic procedure did not affect the pulp survival of the vital teeth. The biologically oriented preparation technique used with a prosthetic orthodontic approach can effectively manage complicated cases without the need for preprosthetic orthodontics.
Endocarditis Presenting as Right Atrial Mass, Diagnosed with 18F-Fluorodeoxyglucose-PET: A Case Report
Authors: Alexandra Ramos, Isadora Sande Mathias, Mouaz Al-Mallah, Miguel Quinones
Journal: Methodist Debakey Cardiovasc J (2023)
Keywords: fdg-pet, endocarditis, transesophageal echocardiogram
MeSH terms: Atrial Fibrillation, Endocarditis / diagnostic imaging, Endocarditis, Bacterial / diagnostic imaging, Methicillin-Resistant Staphylococcus aureus, Staphylococcal Infections / diagnostic imaging, Case Reports, Echocardiography, Transesophageal, Fluorodeoxyglucose F18, Humans, Male, Middle Aged, Positron-Emission Tomography, Fluorodeoxyglucose F18

We report a case of a 55-year-old male with a history of methicillin-resistant staphylococcus aureus bacteremia whose initial transesophageal echocardiography revealed a cardiac mass attached to the right atrium. Because of the uncommon location of the mass, 18F-fluorodeoxyglucose-PET was used to confirm the diagnosis of infective endocarditis.
Gemtuzumab-Ozogamicin-Related Impaired Hemoglobin-Haptoglobin Scavenging as On-Target/Off-Tumor Toxicity of Anti-CD33 AML Therapy: A Report of Two Cases
Authors: Hanna L M Rajala, Veli-Jukka Anttila, Mikko Haapio, Mikko A I Keränen, Ulla Wartiovaara-Kautto, Riikka Räty
Journal: Case Rep Hematol (2021)
MeSH terms: Case Reports

Gemtuzumab-ozogamicin (GO) is a humanized anti-CD33 antibody, which is conjugated to a cytotoxic calicheamicin. It is used to treat acute myeloid leukemia (AML) in combination with chemotherapy. We describe here two GO-treated acute myeloid leukemia (AML) cases: both patients suffered from a toxic syndrome, which manifested as impaired hemoglobin-haptoglobin scavenging and accumulation of hemolysis-related products. Our observations and earlier reports indicated that the reaction was caused by GO-targeted destruction of CD33 + CD163+ monocytes/macrophages, which are responsible for the clearance of hemoglobin-haptoglobin complexes. The rise of plasma lactate dehydrogenase was an early sign of the reaction, and both patients had high levels of free plasma hemoglobin, but plasma haptoglobin and bilirubin levels were paradoxically normal. Symptoms included septic fever and abnormalities in cardiac tests and in the case of the first patient, severe neurological symptoms which required intensive care unit admittance. Therapeutic plasma exchanges supported the patients until the recovery of normal hematopoiesis. The symptoms may be easily confounded with infectious complications-related organ damage. Regarding the increasing use of gemtuzumab-ozogamicin and other emerging CD33-targeted cell therapies, we want to highlight this mostly unknown and probably underdiagnosed toxicity.
Provision and continuation of antiretroviral therapy during acute conflict: the experience of MSF in Central African Republic and Yemen
Authors: Cecilia Ferreyra, Daniel O'Brien, Beatriz Alonso, Abdulbasset Al-Zomour, Nathan Ford
Journal: Confl Health (2018)
Keywords: conflict, contingency plan, emergency response, hiv

Background:
Unstable settings present challenges for the effective provision of antiretroviral treatment (ART). In this paper, we summarize the experience and results of providing ART and implementing contingency plans during acute instability in the Central African Republic (CAR) and Yemen.
Case presentation:
In CAR, MSF has provided HIV care in three conflict-affected rural regions; these were put on hold throughout the acute phase of violence. "Run-away bags" containing 3 or 4 months of ART were distributed to patients at MSF facilities. Among 1820 HIV patients enrolled into care, 1440 (79%) initiated ART. By December 2016, 782 (54%) patients were still under ART, 354 (25%) have been lost to follow up and 182 (13%) had died. In 2013, when violence disrupted services, 683 patients were receiving ART. Between September-December 2013, 594 (87%) patients received runaway bags and by February 2014, 313 (53%) of these patients returned to the clinic.In Yemen, when violence erupted, patients received a health card that included a helpline to call in case of drug shortages in admission to emergency stocks; this was not possible in CAR due to lack of a functioning telephone network. One thousand six hundred fifty-five PLWHA have been enrolled in care and 1470 (89%) initiated ART; 1056 (72%) are still followed on ART, 126 (9%) were lost to follow up, and 288 (20%) died. In January 2011 clashes began and by April 2011 MSF medical activities were interrupted. Of the 363 patients receiving ART, 363 (100%) received emergency bags to cover 9 months and by February 2012, 354 (98%) patients returned to care. In March 2015 a new wave of conflict affected Yemen, forcing HIV activities to revert to contingency planning.
Conclusions:
This experience provides further evidence that provision of HIV treatment and emergency drug stocks can be successfully provided to most patients in both conflict-affected settings.
Panspinal Epidural Abscess: A Devastating Complication of Group B Streptococcal Bacteremia
Authors: Rehmat Ullah Awan, Ambreen Nabeel, Mohammed Alsaggaf
Journal: Case Rep Infect Dis (2022)
MeSH terms: Case Reports

Background:
SEAs are infrequent; however, panspinal infections are even rarer, especially when GBS infection is involved. The cornerstone of treatment is based on early diagnosis and use of targeted antimicrobial therapy; in case of cord compression or neurological compromise, urgent surgical intervention should be pursued. Overall, it is an infrequent condition and therefore requires prospective multicenter studies. Case Presentation. We describe a case who presented with diabetic lower extremity wounds; however, soon the patient developed bowel and bladder incontinence in the setting of back pain, secondary to panspinal epidural abscess. The patient's case is unique in two aspects: firstly, it is panspinal, and secondly, its causative agent is GBS.
Conclusion:
Prompt diagnosis of SEA is critical in the preservation of neurological function. Anyone presenting with fevers, back pain, and neurological changes should have urgent MRI evaluation of the spine.
Pathogenic Acanthamoeba T4 Genotype Isolated from Mucosal Tissue of a Patient with HIV Infection: A Case Report
Authors: Fatemeh Memari, Maryam Niyyati, Zeynab Joneidi
Journal: Iran J Parasitol (2017)
Keywords: acanthamoeba, hiv/aids, iran
MeSH terms: Case Reports

Opportunistic infections due to free-living amoebae such as Granulomatous Amoebic Encephalitis (GAE), cutaneous acanthamoebiasis and disseminated infections could be the causative agent of mortality in people living with HIV/AIDS. In this study, we report the occurrence of the Acanthamoeba belonging to the T4 genotype isolated from nasal and oral swabs of a 15-yr-old man with HIV infection. HIV was confirmed using ELISA kit and RT-PCR assay. The isolated strain showed pathogenic potential using thermo and osmotolerance assays. This patient might be vulnerable to develop GAE or disseminated infections and depending on the immunologic status of the patient, this could be a health threat. Monitoring of such patients, appropriate diagnostic procedures and improved-HIV related care can alter the outcome of such infections.
Isolated metacarpal bone tuberculosis-a case report
Authors: R A S Kushwaha, Surya Kant, Sanjay Kumar Verma, Sanjay, Sumit Mehra
Journal: Lung India (2008)

Tuberculous involvement of the metacarpals and phalanges is a rare presentation of extrapulmonary tuberculosis in adult. Here is a case of tubercular dactylitis in a 27 year old female presenting as discharging sinus over proximal part of third metacarpalbone of left hand.
A Case of Prolonged Catatonia Caused by Sjögren's Syndrome
Authors: Takahiko Inagaki, Kotaro Kudo, Naoki Kurimoto, Takashi Aoki, Kenichi Kuriyama
Journal: Case Reports Immunol (2020)
MeSH terms: Case Reports

Sjögren's syndrome (SS) is a chronic autoimmune disorder, often associated with some neuropsychiatric symptoms as well as systemic lupus erythematosus. Although catatonia is frequently reported in patients with systemic lupus erythematosus, it has been rarely reported in patients with SS. Herein, we present a case of SS with catatonia effectively and safely treated with modified electroconvulsive therapy (ECT). A 58-year-old woman showed prolonged catatonia and depressive mood along with pathologically dried eye and mouth. Based on physical findings and blood tests, she was diagnosed with SS. Because of the presence of pressure sores, we were unable to perform lumbar puncture for the diagnosis of abacterial encephalitis. Alternatively, single-photon emission computed tomography of her brain revealed multifocal hypoperfused areas in the parietotemporal region. Consequently, we performed ECT for the treatment of catatonia comorbid with SS. Following 20 sessions of ECT, the catatonia was improved without obvious adverse effects. One week after the last ECT, elevated levels of interleukin-6 were identified in the cerebral fluid. After receiving steroid pulse therapy, she has not experienced catatonia for more than 5 years. SS can cause catatonia, and ECT is a safe and effective option for the treatment of catatonia with SS.
Mucopolysaccharidosis Type II: A Kenyan Case Series
Authors: L N Wainaina Mungai, C M Njeru, L A Nyamai, M Maina
Journal: Int J Endocrinol (2021)

Hunter syndrome, or mucopolysaccharidosis type 2 (MPS2), is a lysosomal storage disorder associated with the involvement of multiple organs such as the central nervous system, hepatomegaly, musculoskeletal, respiratory, cardiac, and hearing. This is due to the accumulation of glycosaminoglycans in body tissues leading to organ failure. Since the laboratories in Kenya do not screen for metabolic diseases, there is the likelihood of assumption that these patients do not exist. These first cases were referred from the eastern part of Kenya where the majority of inhabitants are from the same ethnic community. It was noted that there was increased mortality among boys below the age of 20 years, and hence, the families sought for help in the national referral and teaching hospital. The case series is meant to show that these cases exist and the majority of the patients may be dying before the diagnosis is made. There are no data on MPS2 from Kenya, and the prevalence and incidence are unknown. In this retrospective study, we present a case series of 6 Kenyan boys with MPS2 from a national referral hospital. They were part of 17 patients who had had their blood analyzed for metabolic diseases. All of them were symptomatic with varying degrees of central nervous system involvement. They had undetectable levels of iduronate-2-sulfatase (I2S) enzyme, and three genetic mutations were detected in the IDS gene.
Unsuspected Cause of Respiratory Distress: Unrecognized Esophageal Foreign Body
Authors: Naima Baddouh, Lahcen Arjdal, Abdelaziz Raji, Mounir Bourrous
Journal: Case Rep Pediatr (2018)
MeSH terms: Case Reports

Summary:
Foreign bodies in esophagus are avoidable accidents that occur most often in children younger than 3 years. The most common presenting symptoms are dysphagia, drooling, and vomiting. Revelation by respiratory distress is a rare and unusual condition.
Objective:
We describe and discuss the case of an esophageal foreign body, in which the patient presented with respiratory distress.
Case report:
A two-year-old child was admitted to the emergency department for acute respiratory distress. He had no history of choking episodes or dysphagia. Nevertheless, he was brought by his parents several times for a persistent cough and wheezing that was treated as asthma for a month. Pulmonary examination had revealed polypnea, suprasternal recession, scattered snoring, and diffuse wheeze. As part of his assessment, a chest X-ray was demanded. It had shown, as unexpected, a nonmetallic foreign body in the upper thoracic esophagus. A clothing button was removed by hypopharyngoscopy under sedation without any incident. Subsequent follow-up had not shown any complications related to this episode.
Conclusion:
Large esophageal foreign bodies can impinge on the trachea causing upper respiratory tract signs. We alert clinicians on variation in the presentation of foreign body ingestion, and we emphasize the importance of an early diagnosis and management.