Pub Date : 2025-01-01Epub Date: 2025-08-20DOI: 10.26502/acmcr.96550727
Minghsun Liu, William D King, Derrick Butler, Mitchell H Liu
As the population of people living with HIV (PWH) ages, they face increased risks of chronic diseases and may require care in nursing homes (NHs). This study identifies systemic barriers to optimal HIV care in NHs through three case examples, illustrating issues such as knowledge gaps in HIV management across the care spectrum, miscommunication during transition of care, and stigma. Proposed solutions include targeted education, improved drug interaction software, and enhanced protocols for HIV care in NHs. Addressing these gaps is crucial for improving outcomes for this aging and vulnerable population.
{"title":"Care of HIV Patients in Long-Term Care Facilities: A Growing Concern and a Call to Action.","authors":"Minghsun Liu, William D King, Derrick Butler, Mitchell H Liu","doi":"10.26502/acmcr.96550727","DOIUrl":"10.26502/acmcr.96550727","url":null,"abstract":"<p><p>As the population of people living with HIV (PWH) ages, they face increased risks of chronic diseases and may require care in nursing homes (NHs). This study identifies systemic barriers to optimal HIV care in NHs through three case examples, illustrating issues such as knowledge gaps in HIV management across the care spectrum, miscommunication during transition of care, and stigma. Proposed solutions include targeted education, improved drug interaction software, and enhanced protocols for HIV care in NHs. Addressing these gaps is crucial for improving outcomes for this aging and vulnerable population.</p>","PeriodicalId":72280,"journal":{"name":"Archives of clinical and medical case reports","volume":"9 4","pages":"164-170"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12410836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01Epub Date: 2025-03-10DOI: 10.26502/acmcr.96550707
Pachiyappan Kamarajan, Ahmad Kassem, Allan Radaic, James Wohlschlegel, Yvonne L Kapila
Objective: Nisin is a bioactive peptide with antibacterial properties that has been examined for its therapeutic potential. This case report documents the development of a targeted mass spectrometry assay that accurately measures nisin levels in human urine following oral ingestion.
Case presentation: Nisin ZP was orally ingested by a 59-year-old healthy white female then LC-MS/MS methodology was used to detect its excretion in human urine over time over 2 days. Briefly, 20 grams of nisin were ingested in two doses of 10 grams/150 ml of water. Sterile urine was then collected over 2 days. Urine was centrifuged to precipitate insoluble material followed by filtration through a 10 kilodalton molecular weight cutoff membrane. The filtrate was then concentrated by lyophilization, desalted, and then analyzed by LC-MS/MS. After online fractionation using C18 reversed-phase chromatography, the sample was electrosprayed into a Thermo Fusion Lumos mass spectrometer. Data was acquired using a parallel reaction monitoring (PRM) strategy focused on the +5 charge states of nisin. Extracted ion chromatograms for MS/MS fragments corresponding to those charge states were generated using the skyline algorithm and used for quantitation of nisin. Western blotting was also used to evaluate the presence of nisin in the urine samples.
Results: Orally ingested nisin can be detected early in human urine after oral ingestion. Mass spectrometry data revealed that nisin was detected in urine samples 4-20 hours after the first ingestion and up to 14 hours after the second ingestion, indicating a potentially fast turnover and excretion of nisin in the human body. In line with the mass spectrometry data, immunoblotting data validated the findings, further supporting the notion of a fast turnover and excretion of nisin.
Conclusion: We successfully applied the LC-MS/MS method to analyze nisin in urine obtained after oral administration of therapeutic doses of nisin. To the best of our knowledge, this constitutes the first report of nisin's detection following human oral ingestion and its presence in urine after excretion.
{"title":"Case of Nisin Oral Ingestion and its LC-MS/MS Detection in Human Urine Over Time: A Case Report.","authors":"Pachiyappan Kamarajan, Ahmad Kassem, Allan Radaic, James Wohlschlegel, Yvonne L Kapila","doi":"10.26502/acmcr.96550707","DOIUrl":"10.26502/acmcr.96550707","url":null,"abstract":"<p><strong>Objective: </strong>Nisin is a bioactive peptide with antibacterial properties that has been examined for its therapeutic potential. This case report documents the development of a targeted mass spectrometry assay that accurately measures nisin levels in human urine following oral ingestion.</p><p><strong>Case presentation: </strong>Nisin ZP was orally ingested by a 59-year-old healthy white female then LC-MS/MS methodology was used to detect its excretion in human urine over time over 2 days. Briefly, 20 grams of nisin were ingested in two doses of 10 grams/150 ml of water. Sterile urine was then collected over 2 days. Urine was centrifuged to precipitate insoluble material followed by filtration through a 10 kilodalton molecular weight cutoff membrane. The filtrate was then concentrated by lyophilization, desalted, and then analyzed by LC-MS/MS. After online fractionation using C18 reversed-phase chromatography, the sample was electrosprayed into a Thermo Fusion Lumos mass spectrometer. Data was acquired using a parallel reaction monitoring (PRM) strategy focused on the +5 charge states of nisin. Extracted ion chromatograms for MS/MS fragments corresponding to those charge states were generated using the skyline algorithm and used for quantitation of nisin. Western blotting was also used to evaluate the presence of nisin in the urine samples.</p><p><strong>Results: </strong>Orally ingested nisin can be detected early in human urine after oral ingestion. Mass spectrometry data revealed that nisin was detected in urine samples 4-20 hours after the first ingestion and up to 14 hours after the second ingestion, indicating a potentially fast turnover and excretion of nisin in the human body. In line with the mass spectrometry data, immunoblotting data validated the findings, further supporting the notion of a fast turnover and excretion of nisin.</p><p><strong>Conclusion: </strong>We successfully applied the LC-MS/MS method to analyze nisin in urine obtained after oral administration of therapeutic doses of nisin. To the best of our knowledge, this constitutes the first report of nisin's detection following human oral ingestion and its presence in urine after excretion.</p>","PeriodicalId":72280,"journal":{"name":"Archives of clinical and medical case reports","volume":"9 2","pages":"38-45"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12439769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anne-Sophie Peaucelle, C. Gay, M. Lefèvre, M. Barrau, G. Boschetti, S. Nancey, X. Roblin
. Soon, she complained about occurrence of
． 不久，她抱怨了发生的事
{"title":"An Unusual Skin Adverse Event after Switching from Intravenous to Subcutaneous VEDOLIZUMAB Therapy in Patients with Ulcerative Colitis","authors":"Anne-Sophie Peaucelle, C. Gay, M. Lefèvre, M. Barrau, G. Boschetti, S. Nancey, X. Roblin","doi":"10.26502/acmcr.96550576","DOIUrl":"https://doi.org/10.26502/acmcr.96550576","url":null,"abstract":". Soon, she complained about occurrence of","PeriodicalId":72280,"journal":{"name":"Archives of clinical and medical case reports","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69343888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ghassan Zakhia-Douaihy, Yehia Tfayli, Ahmad Salaheddine Naja, M. Issa, Jean Paul Rizk
The Sauvé-Kapandji technique is considered a useful treatment option for distal radioulnar joint instability encountered in many conditions, such as Madelung deformity or in post-traumatic entities. However, post-operative instability of the proximal ulnar stump and radioulnar convergence may be symptomatic and is still a major concern. Despite proximal ulnar stump stabilization with various techniques, many patients still complain of pain and limitation of wrist movement. We report a case of a patient with Madelung disease treated initially by corrective radial and ulnar osteotomy, and then encountered a post-traumatic distal radioulnar joint instability. This condition was treated with a modified Sauvé-Kapandji procedure using a single endobutton suture, leading to good clinical and radiological results.
{"title":"Case Report of Modified Sauvé-Kapandji Technique Using Endobutton Suture in Secondary Treatment of Madelung Deformity","authors":"Ghassan Zakhia-Douaihy, Yehia Tfayli, Ahmad Salaheddine Naja, M. Issa, Jean Paul Rizk","doi":"10.26502/acmcr.96550587","DOIUrl":"https://doi.org/10.26502/acmcr.96550587","url":null,"abstract":"The Sauvé-Kapandji technique is considered a useful treatment option for distal radioulnar joint instability encountered in many conditions, such as Madelung deformity or in post-traumatic entities. However, post-operative instability of the proximal ulnar stump and radioulnar convergence may be symptomatic and is still a major concern. Despite proximal ulnar stump stabilization with various techniques, many patients still complain of pain and limitation of wrist movement. We report a case of a patient with Madelung disease treated initially by corrective radial and ulnar osteotomy, and then encountered a post-traumatic distal radioulnar joint instability. This condition was treated with a modified Sauvé-Kapandji procedure using a single endobutton suture, leading to good clinical and radiological results.","PeriodicalId":72280,"journal":{"name":"Archives of clinical and medical case reports","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69343955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Nicolosi, Chiara Maria Dellacasa, M. Novo, A. Busca, R. Freilone, B. Botto
Received: April 17, 2023 Accepted: May 25, 2023 Published: June 21, 2023 Abstract Mediastinal Gray-zone lymphoma (GZL) is a rare entity of lymphoma, with a typical overlapping in terms of biologic and morphologic features between classic Hodgkin lymphoma (cHL) and primary mediastinal large B-cell lymphoma (PMBCL). The therapeutic approaches for these patients remain controversial, and most standard approaches include a combination of chemotherapy, immunotherapy, and, recently, radiation. Unfortunately, overall survival (OS) and progression free survival (PFS) remain dreary. This case report will discuss an adult patient with mediastinal GZL treated as first line with chemotherapy approaches; after an initial lack of response, we decided for a strategy with the anti PD-1 blockade Nivolumab as bridge to the allogeneic hematopoietic stem cell transplant (HSCT). The patient obtained a complete response before the HSCT maintaining this result after the HSCT with temporary grade I and II GVHD, suggesting the important role of the checkpoint inhibitor in this setting of patients. Clinical trials, with larger groups of patients, and longer follow-up are needed to better define safety and prognostic impact of anti PD1 and subsequent allogeneic HCT for the treatment of GZL.
{"title":"Nivolumab PD-1 Blockade as Bridge to Allogeneic Stem Cell Transplant (HSCT) in Gray-Zone Lymphoma: Case Report","authors":"M. Nicolosi, Chiara Maria Dellacasa, M. Novo, A. Busca, R. Freilone, B. Botto","doi":"10.26502/acmcr.96550614","DOIUrl":"https://doi.org/10.26502/acmcr.96550614","url":null,"abstract":"Received: April 17, 2023 Accepted: May 25, 2023 Published: June 21, 2023 Abstract Mediastinal Gray-zone lymphoma (GZL) is a rare entity of lymphoma, with a typical overlapping in terms of biologic and morphologic features between classic Hodgkin lymphoma (cHL) and primary mediastinal large B-cell lymphoma (PMBCL). The therapeutic approaches for these patients remain controversial, and most standard approaches include a combination of chemotherapy, immunotherapy, and, recently, radiation. Unfortunately, overall survival (OS) and progression free survival (PFS) remain dreary. This case report will discuss an adult patient with mediastinal GZL treated as first line with chemotherapy approaches; after an initial lack of response, we decided for a strategy with the anti PD-1 blockade Nivolumab as bridge to the allogeneic hematopoietic stem cell transplant (HSCT). The patient obtained a complete response before the HSCT maintaining this result after the HSCT with temporary grade I and II GVHD, suggesting the important role of the checkpoint inhibitor in this setting of patients. Clinical trials, with larger groups of patients, and longer follow-up are needed to better define safety and prognostic impact of anti PD1 and subsequent allogeneic HCT for the treatment of GZL.","PeriodicalId":72280,"journal":{"name":"Archives of clinical and medical case reports","volume":"2017 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69344313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
H. Wozniak, Jeanne-Laure Vionnet, M. Schibler, Claudia Paula Heidegger, J. Pugin, L. Spahr, S. Cereghetti
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{"title":"Human Herpesvirus 6 Reactivation: A Rare Case of Acute Liver Failure and Literature Review","authors":"H. Wozniak, Jeanne-Laure Vionnet, M. Schibler, Claudia Paula Heidegger, J. Pugin, L. Spahr, S. Cereghetti","doi":"10.26502/acmcr.96550564","DOIUrl":"https://doi.org/10.26502/acmcr.96550564","url":null,"abstract":",","PeriodicalId":72280,"journal":{"name":"Archives of clinical and medical case reports","volume":"65 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69344326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Manami Tanaka, Tomoo Tanaka, Fei Teng, Xiaolong Zhu, Hong Lin, Zhu-Quan Luo, S. Sadahiro, Toshiyuki Suzuki, Y. Maeda, Ding Wei, Zheng Lu
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{"title":"Huaier Effects on Prevention and Inhibition of Spontaneous SARS-CoV-2 Virion Production by Repeated Pfizer-BioNTech mRNA Vaccination","authors":"Manami Tanaka, Tomoo Tanaka, Fei Teng, Xiaolong Zhu, Hong Lin, Zhu-Quan Luo, S. Sadahiro, Toshiyuki Suzuki, Y. Maeda, Ding Wei, Zheng Lu","doi":"10.26502/acmcr.96550568","DOIUrl":"https://doi.org/10.26502/acmcr.96550568","url":null,"abstract":",","PeriodicalId":72280,"journal":{"name":"Archives of clinical and medical case reports","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69344338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pozzetti E, Garibaldi J, Cassinotto E, Figliomeno E, Merlini A
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{"title":"Piezosurgery Removal of Mandibular Tori: A Case Series","authors":"Pozzetti E, Garibaldi J, Cassinotto E, Figliomeno E, Merlini A","doi":"10.26502/acmcr.96550615","DOIUrl":"https://doi.org/10.26502/acmcr.96550615","url":null,"abstract":",","PeriodicalId":72280,"journal":{"name":"Archives of clinical and medical case reports","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69344351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C. Zeeni, C. Karam, Nancy Abou Nafeh, M. Aouad, R. Kaddoum, S. Siddik-Sayyid, Amro Khalili
Artificial intelligence (AI) is defined as the science of creating intelligent machines. AI has grown exponentially, and its systems have made their way into the anesthesia field. The purpose of this review is to explore how the practice of anesthesiology in the gastrointestinal (GI) endoscopy suite changed with AI. Current AI anesthesia systems in the endoscopy suite include open and closed loop anesthesia delivery systems. The most widely used open loop system is the target-controlled infusion (TCI). During TCI, a drug is given automatically using a pump controlled by a computer. The aim is to achieve a chosen target plasma concentration, based on the hypothesis that the pharmacological effect is proportional to the drug’s plasma concentration. Closed loop systems regulate the drug’s dosage by checking a controlling parameter such as the patient himself in patient-maintained sedation, or the bispectral index in computer-assisted personalized sedation. As such, the closed loop system regulates the dose according to continuous feedback from the patient. Recent innovations in AI include machine learning and deep learning models that may have future applications in the endoscopy suite. Machine learning models look for patterns in vast amounts of data to draw conclusions. Deep learning models gain the ability to learn new information that they were not “explicitly programmed” to learn and make changes to their function based on that new information. Although the future of AI in anesthesia and the GI endoscopy suite seems bright, one must always keep in mind its shortcomings.
{"title":"Artificial Intelligence for Smart Procedural Sedation in the Gastrointestinal Endoscopy Suite","authors":"C. Zeeni, C. Karam, Nancy Abou Nafeh, M. Aouad, R. Kaddoum, S. Siddik-Sayyid, Amro Khalili","doi":"10.26502/acmcr.96550624","DOIUrl":"https://doi.org/10.26502/acmcr.96550624","url":null,"abstract":"Artificial intelligence (AI) is defined as the science of creating intelligent machines. AI has grown exponentially, and its systems have made their way into the anesthesia field. The purpose of this review is to explore how the practice of anesthesiology in the gastrointestinal (GI) endoscopy suite changed with AI. Current AI anesthesia systems in the endoscopy suite include open and closed loop anesthesia delivery systems. The most widely used open loop system is the target-controlled infusion (TCI). During TCI, a drug is given automatically using a pump controlled by a computer. The aim is to achieve a chosen target plasma concentration, based on the hypothesis that the pharmacological effect is proportional to the drug’s plasma concentration. Closed loop systems regulate the drug’s dosage by checking a controlling parameter such as the patient himself in patient-maintained sedation, or the bispectral index in computer-assisted personalized sedation. As such, the closed loop system regulates the dose according to continuous feedback from the patient. Recent innovations in AI include machine learning and deep learning models that may have future applications in the endoscopy suite. Machine learning models look for patterns in vast amounts of data to draw conclusions. Deep learning models gain the ability to learn new information that they were not “explicitly programmed” to learn and make changes to their function based on that new information. Although the future of AI in anesthesia and the GI endoscopy suite seems bright, one must always keep in mind its shortcomings.","PeriodicalId":72280,"journal":{"name":"Archives of clinical and medical case reports","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69344463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K Otto, O Ebertz, C Matsingou, D Andrikos, R L De Wilde, H Krentel
Dysgerminoma is a rare malignant germ cell tumor of the ovary that often affects women in reproductive age. The presurgical differentiation of dysgerminoma from benign conditions is challenging. In early stages, malignant dysgerminoma can be treated with fertility sparing surgery. We present a pictorial non-systematic review of literature, discuss diagnostic challenges in ultrasound and radiological imaging and present laparoscopic treatment options in a young woman with dysgerminoma.
{"title":"Ovarian Dysgerminoma - Challenging Presurgical Diagnosis and Mini-Mally Invasive Treatment.","authors":"K Otto, O Ebertz, C Matsingou, D Andrikos, R L De Wilde, H Krentel","doi":"10.26502/acmcr.96550573","DOIUrl":"https://doi.org/10.26502/acmcr.96550573","url":null,"abstract":"<p><p>Dysgerminoma is a rare malignant germ cell tumor of the ovary that often affects women in reproductive age. The presurgical differentiation of dysgerminoma from benign conditions is challenging. In early stages, malignant dysgerminoma can be treated with fertility sparing surgery. We present a pictorial non-systematic review of literature, discuss diagnostic challenges in ultrasound and radiological imaging and present laparoscopic treatment options in a young woman with dysgerminoma.</p>","PeriodicalId":72280,"journal":{"name":"Archives of clinical and medical case reports","volume":"7 1","pages":"66-69"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9979950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10844525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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