OpenMed/multicare-articles huggingface dataset:
Landscape changes and livelihood outcomes in rural tea farming communities: A case study in Fuding City, Fujian Province, Southeast China
Authors: Chengchao Wang, Xianqiang Song, Dongshen Luo, Xu Dan, Tingting Lin
Journal: PLoS One (2023)
MeSH terms: Agriculture, Rural Population, Aged, China, Farms, Humans, Tea, Tea

Landscape changes driven by cash crop plantations have been prevalent in tropical and subtropical regions worldwide in recent decades. Investigating the landscape changes and concluding livelihood outcomes are fundamental to figure out the solutions for rural sustainability. This paper examined the landscape changes which was caused by land use changes in tea plantations as well as investigated the resultant livelihood impacts, based on a case study in Fuding City, Southeast China. A questionnaire survey of 114 rural households in four sampled villages was conducted. Results demonstrated that expansion and intensification of tea plantations were two major proximate causes of landscape changes in recent decade. Our survey indicated that some existing intensively-managed tea plantations had derived from intensification and expansion of tea plantations, respectively. We identified four underlying driving forces of landscape changes, including economic benefit, governmental policies, wildlife destruction on grain crops, and rural return migration. Our study confirmed that landscape changes have significant positive effects on farmers' livelihoods, including increasing employment and incomes, raising living standards, enhancing livelihood assets and livelihood sustainability. Especially, the aged rural populations could have a relatively decent living standard. Meanwhile, the excessive expansion of tea plantations may impair livelihood resilience. Lastly, three policy suggestions based on different time scales have been put forward to promote rural households' livelihood sustainability and resilience.
Case report: Dual-targeted BCMA and CS1 CAR-T-cell immunotherapy in recurrent and refractory extramedullary multiple myeloma
Authors: Xiangjun Shi, Yue Wu, Xingchen Yao, Boran Du, Xinru Du
Journal: Front Immunol (2024)
Keywords: bcma, car-t, cs1, immunotherapy, multiple myeloma
MeSH terms: B-Cell Maturation Antigen / immunology, Immunotherapy, Adoptive / methods, Multiple Myeloma / immunology, Multiple Myeloma / therapy, Case Reports, Humans, Male, Middle Aged, Neoplasm Recurrence, Local / therapy, Receptors, Chimeric Antigen / genetics, Receptors, Chimeric Antigen / immunology, B-Cell Maturation Antigen, TNFRSF17 protein, human, Receptors, Chimeric Antigen

Background:
The development of CAR-T-cell immunotherapy has notably elevated the efficacy of treating multiple myeloma. Currently, a variety of targets, including BCMA, CS1, CD38, FcRH5, and GPRC5D, are being investigated. Despite these significant advancements, challenges such as antigen escape, limited persistence of CAR-T cells, and the intricate nature of the tumor microenvironment persist, leading to relapses following treatment.
Case presentation:
We report the case of a patient with recurrent and refractory multiple myeloma (RRMM) who developed a substantial extramedullary plasmacytoma in the muscles of the lower limb following multiple rounds of radiotherapy and chemotherapy. The patient underwent CAR-T-cell immunotherapy targeting BCMA and CS1; however, the tumor progressed despite treatment. Surgical resection of the extramedullary plasmacytoma was subsequently performed. Upon comparison of the tumor tissue with the adjacent tissue, increased expression of MYBL2 was noted in the tumor tissue, potentially contributing to the lack of improvement in extramedullary relapse after dual-targeted CAR-T cell therapy.
Conclusions:
In patients with recurrent and refractory multiple myeloma who underwent multiple cycles of chemotherapy and radiotherapy, dual-targeted CAR-T cell therapy aimed at BCMA and CS1 failed to effectively manage extramedullary relapse. Elevated expression of MYBL2 in multiple myeloma correlates with a poorer prognosis.
A Common Symptom With an Uncommon Diagnosis: A Case of Primary Esophageal Diffuse Large B-cell Lymphoma
Authors: Shruthi Narasimha, Rasiq Zackria, Jonathan Hughes, Vijay Jayaraman
Journal: Cureus (2024)
Keywords: cancer, diffuse large b-cell lymphoma, dysphagia, endoscopy, esophagus
MeSH terms: Case Reports

Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin's lymphoma. Although it can have gastrointestinal involvement, there are limited recorded cases that show primary esophageal DLBCL. This report discusses the case of an 85-year-old female who initially presented with weight loss associated with dysphagia and was later diagnosed with an esophageal mass by endoscopy. Pathology showed large, atypical lymphocytes, and the final morphologic, immunohistochemical, and molecular findings were most consistent with a diagnosis of primary esophageal DLBCL.
Case Report: Tumor-to-tumor metastasis with prostate cancer metastatic to lung cancer: the first reported case
Authors: Shiyue Liu, Hong Li, Youhong Dong, Dongdong Zhang
Journal: Front Oncol (2023)
Keywords: adenocarcinoma, lung cancer, metastases, prostate cancer, tumor-to-tumor metastasis
MeSH terms: Case Reports

Tumor-to-tumor metastasis (TTM) occurs rarely in tumor progression, but this event has significant clinical implications. Although the impact of TTM on patient prognosis and survival has been increasingly recognized, understanding of TTM biology and treatment is limited. Prostate cancer is among the most common malignancies threatening male health. Prostate cancer can potentially metastasize to primary lung Cancer; however, this is an exceedingly rare event. We here report for the first time a case of TTM from a prostate cancer to a coexisting primary lung cancer.
Cytomegalovirus-Induced Hypertensive Anterior Uveitis: Diagnostic Challenge in an Immunocompetent Patient
Authors: João Romano, Gonçalo Godinho, João Chaves, Nuno Oliveira, João P Sousa
Journal: Cureus (2024)
Keywords: angle closure glaucoma, anterior uveitis, cytomegalovirus, glaucoma, hypertensive anterior uveitis, immunocompetent, intraocular pressure management, posner-schlossman syndrome, uveitic glaucoma, uveitis
MeSH terms: Case Reports

Hypertensive anterior uveitis poses diagnostic challenges owing to its multiple potential etiologies. Cytomegalovirus (CMV) infection is an under-recognized cause that exhibits diverse clinical presentations. This case report focuses on the intricate diagnostic challenge encountered in a 66-year-old immunocompetent patient with CMV-induced hypertensive anterior uveitis. The patient's history, encompassing angle closure glaucoma and topiramate use, contributed to the hypertensive crisis. Initial management included intraocular pressure (IOP)-lowering medication, topiramate discontinuation, and bilateral phacoemulsification, successfully normalizing IOP. However, a subsequent recurrence prompted a detailed investigation. The identification of keratic precipitates and a synechial closed angle led to aqueous humor sampling and polymerase chain reaction (PCR) testing, unveiling the presence of CMV-DNA. Treatment led to a favorable response, resolving ocular inflammation and effectively controlling IOP. This case underscores the complexity of diagnosing and managing CMV-induced hypertensive anterior uveitis, emphasizing the critical role of a comprehensive approach in achieving successful outcomes.
Case Report: Ventricular preexcitation-induced dilated cardiomyopathy improved by the pharmacologic suppression of ventricular preexcitation in three infants, and literature review
Authors: Dai Chencheng, Zhong Min, Shi Wanming, Shangguan Wen, Guo Baojing, Xiao Yanyan, Han Ling, Long Deyong
Journal: Front Pediatr (2024)
Keywords: amiodarone, dilated cardiomyopathy, left ventricular dyssynchrony, propafenone, ventricular preexcitation
MeSH terms: Case Reports

The therapy of ventricular preexcitation-induced dilated cardiomyopathy in very small infants or infants with a high risk of ablation is tough and related articles are rare. Effective pharmacotherapy to suppress ventricular preexcitation is valuable.
Aims:
To evaluate the effectiveness and safety of pharmacotherapy for cardiac resynchronization in infants with ventricular preexcitation-induced dilated cardiomyopathy.
Methods and results:
Three infants with ventricular preexcitation-induced dilated cardiomyopathy, due to the disappearance of ventricular preexcitation during the placement of catheter, intermittent WPW pattern, and right mid septal accessory pathway respectively, had received pharmacotherapy for cardiac resynchronization. The initial dosage of oral amiodarone was 5 mg/kg.d and it was followed by the maintenance dosage of 2-2.5 mg/kg.d 4 weeks later. Propafenone (15 mg/kg.d) served as a supplement since amiodarone was not adequate in case 3. The three infants achieved successful pharmacologic suppression of ventricular preexcitation 10, 6.5, and 4.5 weeks after the initiation of amiodarone respectively. They all got normalized contraction of interventricular septum and LVEF as well as reduced LVEDD gradually after the disappearance of ventricular preexcitation. No side effects associated with pharmacotherapy happened during the follow-up. Amiodarone had been withdrawn for 2 years and 5 months in Cases 1 and 2. They both remained free from ventricular preexcitation and retained normal LVEF and LVEDD.
Conclusions:
Pharmacotherapy for cardiac resynchronization with oral amiodarone or in combination with propafenone for infants with ventricular preexcitation-induced dilated cardiomyopathy is effective and safe. Pharmacotherapy for cardiac resynchronization served as another therapeutic choice besides ablation.
A fatal case of disseminated pulmonary and renal mucormycosis caused by Rhizopus microspores
Authors: Liuyang Hu, Xingchun Chen
Journal: Rev Inst Med Trop Sao Paulo (2023)
MeSH terms: Diabetes Mellitus, Type 2, Mucormycosis / complications, Mucormycosis / diagnosis, Case Reports, Adrenal Cortex Hormones, Humans, Immunocompromised Host, Male, Middle Aged, Rhizopus, Adrenal Cortex Hormones

Rhinocerebral and pulmonary mucormycosis are the main manifestations of mucormycosis; however, disseminated pulmonary associated with renal mucormycosis is rarely reported. In this paper, we report a rare fatal case of disseminated pulmonary and renal mucormycosis caused by Rhizopus microsporus in a 50-year-old man with poorly controlled hypertension, type 2 diabetes, and prolonged use of corticosteroids for the treatment of his reiterative gouty arthritis. In this patient, the use of corticosteroids and poorly controlled diabetes were considered underlying risk factor for his disseminated mucormycosis, along with acute renal dysfunction, suggesting the need for clinical suspicion of disseminated pulmonary and renal mucormycosis in hospitalized patients with poorly controlled diabetes and immunocompromised host.
Sudden transient blindness following ureteroscopy: an uncommon complication of a common procedure (a case report)
Authors: Wael Gazzah, Sedki Masmoudi, Hamza Chakroun, Rayen Lahouar, Bacem Zaidi, Badreddine Ben Khalifa, Sahbi Naouar, Braiek Salem
Journal: Pan Afr Med J (2024)
Keywords: blindness, case report, intraoperative complications, ureteroscopy, urology
MeSH terms: Blindness / diagnosis, Blindness / etiology, Optic Neuropathy, Ischemic / diagnosis, Optic Neuropathy, Ischemic / etiology, Postoperative Complications / diagnosis, Postoperative Complications / etiology, Ureteroscopy / adverse effects, Ureteroscopy / methods, Case Reports, Female, Humans, Kidney Calculi / surgery, Middle Aged, Risk Factors, Visual Acuity

Perioperative vision loss following non-ophthalmic surgical procedures represents a rare but potentially serious complication. Although its occurrence in urology is infrequent, the consequences for patients and legal implications are significant. We present the case of a 53-year-old woman with no notable medical history, treated for renal lithiasis. Following the ureteroscopy, the patient experienced a sudden reduction in visual acuity. The diagnosis made was that of posterior ischemic optic neuropathy. This case illustrates a rare complication associated with ureteroscopy, highlighting the importance of increased awareness and rigorous postoperative monitoring, especially in patients with risk factors such as anemia or hypertension. Fortunately, the patient's rapid and complete recovery is encouraging, suggesting that early identification and appropriate management can lead to a favorable prognosis.
Case report: a cataract induced by bleomycin in a patient with testicular cancer
Authors: Wan Zhang, Yinghua Ji, Yufei Sun, Keya Zhi, Han Yang, Min Zhang, Ping Lu, Yana Zhang
Journal: Front Pharmacol (2024)
Keywords: adverse effects, bleomycin, cataract, chemotherapy, testicular cancer
MeSH terms: Case Reports

Background:
Bleomycin is a glycopeptide antibiotic with outstanding anti-tumor effects. A major adverse effect of bleomycin is lung fibrosis. However, the development of cataracts as a severe adverse effect has not been reported.
Case summary:
Herein, we describe the first case of cataract induced by bleomycin therapy in a 22-year-old male with testicular cancer. After surgical intervention and following five successive chemotherapy cycles of the BEP regimen, including bleomycin, etoposide and cisplatin, the patient reported a gradual painless loss of vision, with substantial decline in visual ability, especially in the right eye. Following comprehensive eye examinations, a cataract was diagnosed. Eventually, the patient underwent phacoemulsification and received replacement of the intraocular lenses.
Conclusion:
Bleomycin can cause cataracts, which induces a significant loss of vision. Therefore, clinicians should observe early symptoms and properly adjust treatment to prevent aggravation of symptoms.
Insights into uveitis from Brentuximab vedotin in refractory Hodgkin's lymphoma: a case report and brief review
Authors: Mengyuan Liu, Kexing Ren, Ping Ai, Liqun Zou
Journal: Front Oncol (2024)
Keywords: brentuximab vedotin, hodgkin’s lymphoma, mmae, antibody-drug conjugate, case report, uveitis
MeSH terms: Case Reports

This case report describes a 16-year-old patient with refractory Hodgkin's lymphoma who developed bilateral anterior and intermediate uveitis as an adverse reaction to Brentuximab vedotin (BV). This is a rare case of an ocular adverse reaction potentially related to BV, with symptoms like blurred vision, decreased visual acuity, photophobia, and redness. Potential mechanisms include BV targeting CD30+ T cells in the uveal tissue or an immune response triggered by the microtubule-disrupting agent MMAE within BV. This highlights the need for vigilant monitoring of ocular adverse events in BV-treated patients and further research into their mechanisms and management.
Tenecteplase Catheter-Directed Thrombolytic Therapy in Submassive Pulmonary Embolism: A Case Report
Authors: Dania Ghaziri, Hisham Bou Fakhreddine, Fadi Sawaya, Farah Jaber, Imad Bou Akl
Journal: Case Rep Crit Care (2024)
Keywords: catheter-directed thrombolysis, pulmonary embolism, tenecteplase
MeSH terms: Case Reports

Introduction: In pulmonary embolism (PE), when used for catheter-directed thrombolysis (CDT), low-dose alteplase is associated with good outcomes. Tenecteplase has been only used as intravenous for this indication. In the context of our national economic crisis where alteplase was unavailable, we describe our experience with tenecteplase CDT. Case: A 73-year-old male, hypertensive and smoker with COPD, presented to the ED with intermediate high-risk PE.(ED) with intermediate high-risk PE. Heparin infusion was initiated. A few hours later, the patient developed atrial fibrillation (AF) for which amiodarone infusion was started. Also, a left femoral and popliteal vein thrombosis was also confirmed by the lower extremity duplex. As the patient remained dyspneic with unstable vital signs, the decision was to perform a CDT. In the absence of alteplase, tenecteplase was used at 0.5 mg/h over 30 h, for a total of 15 mg. Result: Twenty-four hours after tenecteplase initiation, dyspnea and vital signs had significantly improved. Oxygen support was gradually dropping to finally stop. Being on concomitant heparin infusion, the patient had a mild blood oozing at the femoral vein site of entry; however, this did not require any transfusion or discontinuation of heparin. The patient regained his baseline physical and mental functions and was discharged on enoxaparin and amiodarone tablet. Discussion: This is the first experience describing the use of tenecteplase as part of CDT in a patient with acute intermediate high-risk PE. The combination to therapeutic heparin infusion, already described in different clinical scenarios with intravenous tenecteplase, was safe and well tolerated Conclusion: CDT with tenecteplase was, for the first time, safely and effectively used in an intermediate high-risk PE patient. However, more studies are needed to confirm and establish these findings.
Breaking the cycle with trauma-focused mentalization-based treatment: theory and practice of a trauma-focused group intervention
Authors: Maaike L Smits, Jasmijn de Vos, Eva Rüfenacht, Liesbet Nijssens, Lisa Shaverin, Tobias Nolte, Patrick Luyten, Peter Fonagy, Anthony Bateman
Journal: Front Psychol (2024)
Keywords: borderline personality disorder, complex ptsd, mentalization, mentalizing, posttraumatic stress disorder (ptsd), trauma

Trauma-Focused mentalization-based treatment (MBT-TF) is an adaptation of mentalization-based treatment (MBT) specifically developed for patients suffering from attachment or complex trauma, with the possibility of co-occurring borderline personality pathology. The creation of MBT-TF was driven by previous research and observations that interventions centered on mentalizing could be significantly improved by directly addressing the impact of trauma. MBT-TF aims to mitigate symptoms that arise post-trauma, such as hyperarousal, hypervigilance, intrusions, flashbacks, avoidance behaviors, dissociative experiences, negative perceptions of self and others, and ensuing relational difficulties. Implemented as a group intervention, MBT-TF typically spans 6-12 months. From a mentalizing perspective, trauma, particularly attachment trauma, leads to a failure in processing the effects of trauma through and with others. Stress and attachment behavioral systems are disrupted, which undermines the capacity for epistemic trust, and impairs mentalizing abilities. This paper offers a concise summary of the reasoning for MBT-TF's creation, its theoretical underpinnings, and its clinical strategy for addressing the adverse impacts of trauma. It further details the treatment phases, their main goals, and their interventions, supplemented by clinical case examples that underscore MBT-TF's distinctive attributes and frequent clinical hurdles.
Circulating tumor DNA determining hyperprogressive disease after CAR-T therapy alarms in DLBCL: a case report and literature review
Authors: Jiajie He, Rui Zou, Liqing Kang, Lingzi Yu, Peng Wang, Yang Shao, Junheng Liang, Depei Wu, Zhengming Jin, Changju Qu
Journal: Front Oncol (2023)
Keywords: chimeric antigen receptor t cell therapy (car-t), circulating tumor dna (ctdna), diffuse large b-cell lymphoma (dlbcl), hyperprogressive disease (hpd), pseudoprogression
MeSH terms: Case Reports

Chimeric antigen receptor T-cell therapy (CAR-T) has been widely applied in the clinical practice of relapse/refractory (R/R) diffuse large B-cell lymphoma (DLBCL) due to its promising effects. Hyperprogressive disease (HPD) has gained attention for rapid tumor progression and has become a therapeutic and prognostic challenge. Here, we present a patient who had suffered from several recurrences previously and controlled well with a very small tumor lesion left was infused with CD19/CD22 bispecific CAR-T, with no immune effector cell-associated neurotoxicity syndrome, or cytokine release syndrome observed. However, rapid deterioration, subsequent imaging examination, circulating tumor DNA, and serum biomarkers detection identified HPD. The patient did not respond to salvage treatment and died 40 days after infusion. To our knowledge, only one case of HPD in DLBCL after CAR-T therapy has been reported. This fatal case alarmed the risk of HPD and the ctDNA profile monitoring we used was performed as a non-invasive method to diagnose HPD, providing far-reaching practical instruction for CAR-T therapy.
Case report: Crigler-Najjar syndrome type 1 in Croatia-more than a one in a million: a case series
Authors: Matea Kovačić Perica, Ivana Todorić, Nedo Marčinković, Petra Džepina, Mirna Natalija Aničić, Anna Mrzljak, Jurica Vuković
Journal: Front Pediatr (2023)
Keywords: croatia, ugt1a1, bilirubin udp-glucuronosyltransferase, case report, case series, crigler-najjar syndrome, hyperbilirubinemia
MeSH terms: Case Reports

Crigler-Najjar syndrome (CNS) is an exceedingly rare autosomal recessive disease with an estimated incidence of 1 in a million live births. CNS type 1 (CNS1) is the most severe form, characterized by severe unconjugated hyperbilirubinemia since birth due to the absence of hepatic uridine 5'-diphosphate glucuronyltransferase (UGT1A1) activity. Daily phototherapy (PT) and liver transplant (LT) are the mainstays of therapy. Here, we present a higher-than-expected incidence of CNS1 in Croatia (6,1 in a million). In the last 31 years, we treated eight CNS1 patients from five families with no reported consanguinity. Four patients are descendants of an isolated enclave in Kosovo with a small gene pool and a high potential for inbreeding. Severe unconjugated hyperbilirubinemia was verified in a neonatal period and PT was initiated. Four patients underwent LT from living-related donors. One of them had unsuccessful hepatocyte transplantation earlier. LT was successful in three patients, and one patient died due to primary graft dysfunction. Four patients are currently treated with 9-12 h daily PT with inconsistent disease control, and gradually increasing bilirubin. One patient developed kernicterus before LT, while others have normal psychomotor development and no neurologic impairment. Genetic testing of the UGT1A1 gene in six patients from three families revealed three different homozygous mutations (c.722_723 delAG, c.717_718 delAG, and c.1021 C >T), all previously described in other populations. There is a possibility of the founder effect as an explanation for the higher incidence of CNS1 in at least a subgroup of Croatians.