OpenMed/multicare-articles huggingface dataset:
Quantitative assessment and genomic profiling of Campylobacter dynamics in poultry processing: a case study in the United Arab Emirates integrated abattoir system
Authors: Ihab Habib, Mohamed-Yousif Ibrahim Mohamed, Glindya Bhagya Lakshmi, Hassan Mohamed Al Marzooqi, Hanan Sobhy Afifi, Mohamed Gamal Shehata, Mushtaq Khan, Akela Ghazawi, Afra Abdalla, Febin Anes
Journal: Front Microbiol (2024)
Keywords: campylobacter, united arab emirates, chicken meat, enumeration, slaughterhouse, whole genome sequencing

In the United Arab Emirates, no previous research has investigated the dynamics of the foodborne pathogen Campylobacter in broiler abattoir processing. This study conducted in one of the largest poultry producers in the UAE, following each key slaughter stage-defeathering, evisceration, and final chilling-five broiler carcasses were collected from 10 slaughter batches over a year. Additionally, one caecum was obtained from 15 chickens in each slaughter batch to evaluate the flock colonization. In total, 300 samples (150 carcasses and 150 caeca) were collected and enumerated for Campylobacter using standard methods. Campylobacter was pervasive in caecal samples from all slaughter batches, with 86% of carcasses post-defeathering and evisceration stages and 94% post-chilling tested positive for Campylobacter. Campylobacter coli predominates in 55.2% of positive samples, followed by Campylobacter jejuni in 21%, with both species co-existing in 23.8% of the samples. Campylobacter counts in caecal contents ranged from 6.7 to 8.5 log10 CFU/g, decreasing post-defeathering and evisceration to 3.5 log10 CFU/g of neck skin and further to 3.2 log10 CFU/g of neck skin post-evisceration. After chilling, 70% of carcasses exceeded 3 log10 CFU/g of neck skin. Whole-genome sequencing (WGS) of 48 isolates unveiled diverse sequence types and clusters, with isolates sharing the same clusters (less than 20 single nucleotide polymorphisms) between different farms, different flocks within the same farm, as well as in consecutive slaughter batches, indicating cross-contamination. Multiple antimicrobial resistance genes and mutations in gyrA T86I (conferring fluoroquinolone resistance) and an RNA mutation (23S r.2075; conferring macrolide resistance) were widespread, with variations between C. coli and C. jejuni. WGS results revealed that selected virulence genes (pglG, pseD, pseI, flaA, flaB, cdtA, and cdtC) were significantly present in C. jejuni compared to C. coli isolates. This study offers the first insights into Campylobacter dynamics in poultry processing in the UAE. This work provides a base for future research to explore additional contributors to Campylobacter contamination in primary production. In conclusion, effective Campylobacter management demands a comprehensive approach addressing potential contamination sources at every production and processing stage, guided by continued microbiological surveillance and genomic analysis to safeguard public health and food safety.
Teprotumumab for Treatment of Pretibial Myxedema
Authors: Michelangelo P Reyes, John Cabrera, Jasvir Singh, Dennis Turnbull
Journal: JCEM Case Rep (2023)
Keywords: pretibial myxedema, teprotumumab, thyroid eye disease
MeSH terms: Case Reports

Pretibial myxedema (PTM), also called thyroid dermopathy, is a dreaded and potentially debilitating manifestation of thyroid disease, more commonly Graves' disease, which can occur at any time over the course of the disease. No substantial long-term therapies have been able to target the condition, and management has typically been supportive (eg, compression socks, weight loss), with courses of moderate-intensity steroids. Teprotumumab has been approved for the management of thyroid eye disease (TED), and it is believed that the 2 share a similar pathophysiology likely related to type 1 insulin-like growth factor receptor, which may explain why some patients have also experienced improvement in PTM. Here we present a patient who received 8 doses of teprotumumab for TED who, over the course of management and into follow-up, experienced significant improvement in her pretibial myxedema. The patient noted considerable improvement in quality of life and ability to perform daily activities. We present this case to consider further investigation into the utilization of teprotumumab for thyroid disease-related PTM in patients with impaired quality of life.
Opposing objective and subjective wellbeing outcomes within an environmentally vulnerable delta: a case study of Volta Delta, Ghana
Authors: Laurence Cannings, Craig W Hutton, Alessandro Sorichetta, Kristine Nilsen
Journal: Front Psychol (2024)
Keywords: agriculture, climate, hazards, landscape, objective wellbeing, subjective wellbeing

Introduction:
Despite a growing interest in the measurement and conceptualization of wellbeing, the integration within sustainability research, and the understanding of how different wellbeing outcomes relate, is limited. Many studies focus on singular, often objectively measured, outcomes, without acknowledging the breadth of available measures. This approach can result in crucial subjective information, which can be explored to understand actors' behaviors and responses, being omitted from research and policy. This study explores objective and subjective wellbeing outcomes, and how they relate, within an environmentally vulnerable context. Wellbeing and environmental services are intrinsically interlinked, therefore, appropriate policy solutions are required to address human needs and pressures on supporting ecosystems.
Methods:
This paper uses binary logistic regression modelling, and qualitative participatory rural appraisal methods, to understand the environmental conditions, including climatic hazards and landscape characteristics, associated with households experiencing different objective/subjective wellbeing outcomes within Volta Delta, Ghana.
Results:
The mixed method approach highlights a differing relationship between inland agricultural areas impacted by drought and erosion, and coastal/riverine, peri-urban landscapes exposed to flooding and salinization. Agricultural areas associate with "poor but happy" outcomes, whereas peri-urban landscapes associate with being "non-poor but unhappy." Drawing on existing literature, and both quantitative and qualitative results, these varying outcomes are hypothesized to be driven by differences in livelihood vulnerability, relative comparisons to others, responses to climatic hazards, and individualistic/collective wellbeing conceptualizations.
Discussion:
Our study concludes that environmental conditions influence objective and subjective wellbeing through different mechanisms. Sustainable development research should incorporate both objective and subjective measures when implementing and monitoring policy to more comprehensibly capture, and improve, wellbeing in environmentally vulnerable locations.
Case report: Clinical profile, molecular genetics, and neuroimaging findings presenting in a patient with Kearns-Sayre syndrome associated with inherited thrombophilia
Authors: Anca Elena Gogu, Dragos Catalin Jianu, Florina Parv, Andrei Gheorghe Marius Motoc, Any Axelerad, Alina Zorina Stuparu, Andreea Alexandra Gogu
Journal: Front Neurol (2024)
Keywords: kearns-sayre syndrome (kss), brain magnetic resonance imaging, genetic tests, heart conduction block, inherited thrombophilia
MeSH terms: Case Reports

Background:
Kearns-Sayre syndrome (KSS) is classified as one of the mitochondrial DNA (mtDNA) deletion syndromes with multisystemic involvement. Additionally, the negative prognosis is associated with inherited thrombophilia, which includes the presence of homozygous Factor V G1691A Leiden mutation, MTHFR gene polymorphisms C677T and A1298C, and PAI-1 675 homozygous genotype 5G/5G.
Case presentation:
This case report presents a 48-year-old man with chronic progressive external ophthalmoplegia, bilateral ptosis, cerebellar ataxia, cardiovascular signs (syncope, dilated cardiomyopathy, and cardiac arrest) with electrocardiographic abnormalities (first-degree atrioventricular block and major right bundle branch block), endocrine dysfunction (short stature, growth hormone insufficiency, primary gonadal insufficiency, hypothyroidism, and secondary hyperparathyroidism), molecular genetic tests (MT-TL2 gene), and abnormal MRI brain images, thus leading to the diagnosis of KSS. The patient came back 4 weeks after the diagnosis to the emergency department with massive bilateral pulmonary embolism with syncope at onset, acute cardiorespiratory failure, deep left femoral-popliteal vein thrombophlebitis, and altered neurological status. In the intensive care unit, he received mechanical ventilation through intubation. Significant improvement was seen after 2 weeks. The patient tested positive for inherited thrombophilia and was discharged in stable conditions on a new treatment with Rivaroxaban 20 mg/day. At 6 months of follow-up, ECG-Holter monitoring and MRI brain images remained unchanged. However, after 3 months, the patient died suddenly while sleeping at home.
Conclusion:
The genetic tests performed on KSS patients should also include those for inherited thrombophilia. By detecting these mutations, we can prevent major complications such as cerebral venous sinus thrombosis, coronary accidents, or sudden death.
Pneumothorax Revealing the Rupture of a Primary Pleural Hydatid Cyst
Authors: Chaynez Rachid, Anas Kandil, Mohamed Ijim, Oussama Fikri, Lamyae Amro
Journal: Cureus (2024)
Keywords: ecchinococus granulosis, endemic countries, hydatid cyst, pneumothorax, thoracic surgery
MeSH terms: Case Reports

Primary pleural hydatid cysts are exceptionally uncommon, even in areas where this parasitic infection is prevalent. The occurrence of pneumothorax can serve as an indicator of this condition, presenting a challenge in both diagnosis and treatment when compared to more common causes of pneumothorax. Moreover, hydatid serology often yields negative results, further complicating the diagnosis. Our case study involves a 15-year-old male who experienced a pneumothorax, subsequently revealing a primary pleural hydatid cyst. This report focuses on elucidating its genesis mechanism and outlining its indicative clinical, radiological, and biological characteristics.
Rhinocerebral mucormycosis and Trichosporon asahii fungemia in a pediatric patient with acute lymphoblastic leukemia: a rare coinfection
Authors: Liuyang Hu, Guiliang Liu, Xingchun Chen
Journal: Rev Inst Med Trop Sao Paulo (2024)
MeSH terms: Coinfection / microbiology, Fungemia / drug therapy, Fungemia / microbiology, Mucormycosis / complications, Mucormycosis / diagnosis, Precursor Cell Lymphoblastic Leukemia-Lymphoma / complications, Trichosporonosis / diagnosis, Trichosporonosis / drug therapy, Trichosporonosis / microbiology, Case Reports, Antifungal Agents / therapeutic use, Basidiomycota, Fatal Outcome, Humans, Infant, Male, Opportunistic Infections / complications, Opportunistic Infections / microbiology, Pseudomonas Infections / complications, Pseudomonas Infections / drug therapy, Pseudomonas Infections / microbiology, Antifungal Agents, Trichosporon asahii

Mucormycosis is a rare life-threatening opportunistic infection, with rhinocerebral mucormycosis (ROCM) being the most common presentation. Trichosporon asahii is an emerging pathogen that often causes fatal infections in patients with underlying hematologic malignancies due to its high drug resistance. We report a rare case of concomitant rhinocerebral mucormycosis and T. asahii fungemia secondary to Pseudomonas aeruginosa sepsis in a patient with neutropenia and acute lymphoblastic leukemia. A boy aged one year and two months was diagnosed with B-cell acute lymphoblastic leukemia on January 10 and underwent three courses of regular chemotherapy. He experienced neutropenia for 154 days and was hospitalized for vomiting, diarrhea and fever for 3 days. The day after hospitalization, Pseudomonas aeruginosa was isolated by blood culture and ceftazidime/avibactam was administered. Extracorporeal Membrane Oxygenation (ECMO) was used to provide continuous extracorporeal respiration and circulation for the patient. On day 8, the patient developed T. asahii fungemia. On day 10, he presented with necrotizing skin caused by Rhizopus delemar. He was treated with liposomal amphotericin B for Rhizopus delemar and voriconazole for T. asahii infection. Unfortunately, his health deteriorated and he died on day 11 due to the rapid progression of the infection and multiple organ failure. The management and treatment of such a complex infection requires a multidisciplinary approach and close monitoring of the patient's condition. Therefore, it is imperative to continue to research and report rare cases such as this to further understand the complexities of mucormycosis and trichosporidiosis coinfection and improve patient outcomes.
Case report: Oxaliplatin-induced idiopathic non-cirrhotic portal hypertension: a case report and literature review
Authors: Jiayuan Ye, Yilian Xie, Yaojiang Xu, Nan Chen, Yifei Tu
Journal: Front Med (Lausanne) (2023)
Keywords: case report, gastrointestinal tumors, idiopathic non-cirrhotic portal hypertension, oxaliplatin, variceal banding
MeSH terms: Case Reports

Oxaliplatin has become a widely used agent in neoadjuvant chemotherapy for gastrointestinal tract tumors and is an integral part of the therapeutic approach for managing colorectal cancer recurrences and metastases, resulting in a more favorable prognosis for patients. Nevertheless, oxaliplatin can give rise to idiopathic non-cirrhotic portal hypertension (INCPH). The emergence of INCPH can disrupt tumor chemotherapy and incite persistent adverse reactions in later stages, significantly complicating clinical management. Consequently, we have presented a case report of INCPH induced by oxaliplatin chemotherapy with the aim of advancing the diagnosis and treatment of this condition, with a particular focus on the clinical manifestations. This study has ascertained that the condition is primarily attributed to complications related to portal hypertension, such as gastrointestinal bleeding, splenomegaly, and hypersplenism. The pathological features primarily involve hepatic sinus dilation and congestion, portal obstruction, absence, stenosis, shunting, localized venous and perisinusoidal fibrosis, as well as hepatocellular atrophy. Treatment primarily concentrates on strategies typically employed for cirrhosis. Endoscopic ligation, sclerotherapy, and non-selective beta-blockers (NSBBs) can be selected to prevent and treat variceal hemorrhage. Transjugular intrahepatic portosystemic shunt (TIPS) and liver transplantation can also be chosen for severe cases. Notably, despite the timely discontinuation of oxaliplatin, most patients continue to experience disease progression, ultimately resulting in a poor prognosis due to either tumor advancement or the ongoing progression of portal hypertension. This emphasizes the importance for physicians to be aware of and consider the risk of INCPH when prescribing oxaliplatin.
Characterization of Diabetic Striatopathy With Repeated Follow-Up Using Multiple Imaging Studies
Authors: Ayumi Nishimura, Tomonobu Kado, Kazuyuki Tobe
Journal: Cureus (2024)
Keywords: diabetes mellitus, diabetic chorea, diabetic striatopathy, hyperglycemic non-ketotic hemiballism, hyperglycemic non-ketotic hemichorea, neuroimaging
MeSH terms: Case Reports

Diabetic striatopathy is a rare condition with a prevalence of less than one in 100,000. Herein, we report a case of diabetic striatopathy exacerbated by hyperglycemia and hypoglycemia, with repeated follow-up with multiple imaging studies. This case suggested that putamen neuronal loss and dysfunction, gliosis, and ischemia are associated with diabetic striatopathy pathophysiology. In addition, striatal hyperintensity on T1-weighted MRI images was more pronounced after symptom remission when evaluated several times over a short period. Therefore, clinicians should be aware that even if MRI findings are normal in the very early stages of the onset of diabetic striatopathy, repeating MRIs at intervals may reveal typical findings.
Spontaneous rupture of a splenic artery aneurysm causing acute abdomen in a 19-year-old male patient: a case report
Authors: Yumna Njoum, Abdallah Deghles Barqawi, Mohammed Maree
Journal: Front Surg (2023)
Keywords: acute abdomen, aneurysm, hemoperitoneum, splenectomy, splenic artery, spontaneous rupture
MeSH terms: Case Reports

Introduction:
A splenic artery aneurysm is considered an abnormal dilatation of the splenic artery layers greater than 1 cm in diameter. First described by Beaussier in 1770, it affects 1% of the population but carries a major risk for life-threatening complications of rupture in 3%-10% of cases regardless of its congenital or acquired etiology. The presentation is highly variable, from asymptomatic incidental discovery during routine imaging to aneurysmal rupture causing acute abdomen, massive gastrointestinal bleeding, and hemorrhagic shock.
Case presentation:
Herein, we present a 19-year-old male patient who presented with epigastric pain and abdominal rigidity associated with a moderate amount of free peritoneal fluid that was found to be a ruptured SAA after immediate laparoscopy, which was successfully managed with splenectomy.
Conclusion:
SAAs are a rare etiology of acute abdomen and hemorrhagic shock but have a very high risk of mortality even upon immediate intervention, requiring a very high level of vigilance and a low threshold for surgical intervention in unstable patients presenting with abdominal pain.
VIABAHN® Stent Graft Implantation for Iatrogenic Arteriovenous Fistula and Pseudoaneurysm of the Deep Femoral Artery
Authors: Daisuke Yamazaki, Takahide Fujihashi, Hirokazu Amamizu, Tomoka Kobayashi, Toru Takahashi
Journal: Case Rep Cardiol (2024)
MeSH terms: Case Reports

Femoral arteriovenous access is most commonly used in endovascular diagnosis and treatment. Complications arising during femoral arteriovenous access include hematoma, retroperitoneal hemorrhage, pseudoaneurysm, and arteriovenous fistula. A 66-year-old woman diagnosed with paroxysmal atrial fibrillation was treated with catheter ablation. This patient had a high femoral artery bifurcation, and we punctured the femoral vein by the conventional Merkmal method, which led to a femoral vein puncture through the deep femoral artery. The next day, echography revealed a pseudoaneurysm communicating with the deep femoral artery. We performed a thrombin injection without complication, and the pseudoaneurysm was occluded. However, echography three days after thrombin embolization showed a recurrence of the pseudoaneurysm and an arteriovenous fistula connecting to the common femoral vein. The first choice for the treatment of pseudoaneurysms and arteriovenous fistula is surgical treatment, but in addition to the lack of vascular surgery in our hospital, the patient did not want an invasive treatment and strongly preferred to be treated with a catheter. We performed endovascular treatment by VIABAHN® stent graft insertion. VIABAHN® stent graft was implanted at the deep femoral artery, and the patient was discharged without complications. VIABAHN® stent graft placement in the deep femoral artery sealed the entrance of the pseudoaneurysm and the arteriovenous fistula at once, which simultaneously treated both the pseudoaneurysm and AV fistula, and helped avoid the use of an invasive surgical procedure.
Case report: Paternal uniparental disomy on chromosome 7 and homozygous SUGCT mutation in a fetus with overweight after birth
Authors: Xiufen Bu, Xu Li, Can Peng, Hongyu Li, Shihao Zhou, Zesen Zhu, Jun He, Siyuan Linpeng
Journal: Front Genet (2023)
Keywords: sugct, case report, invasive prenatal diagnosis, overweight, paternal uniparental disomy, prenatal diagnosis
MeSH terms: Case Reports

Background: Paternal uniparental disomy (UPD) of chromosome 7 is extremely rare, and only a few postnatal cases have been reported. The effects on growth were discordant in these cases, and the relevance of paternal UPD(7) to growth caused by imprinting remains questionable. Case presentation: Here, we report a prenatal case that underwent invasive prenatal diagnosis due to the high risk of Down's syndrome and failed noninvasive prenatal screening. The fetus had a normal karyotype and no apparent copy number variation. Homozygous copy-neutral regions on chromosome 7 were identified using a single nucleotide polymorphism (SNP) array; the data for the parent-child trios showed that the fetus carried the whole paternal isodisomy of chromosome 7. Whole exome and Sanger sequencing revealed a homozygous frameshift mutation in SUGCT at 7p14.1, from the heterozygous carrier father, with no contribution from the mother. The parents decided to continue with the pregnancy after genetic counseling, and the neonate had normal physical findings at birth and showed overweight after birth during a long-term intensive follow-up. Conclusion: We report the first prenatal case who carried paternal UPD(7) and homozygous SUGCT mutation with an overweight phenotype after birth. The overweight may be caused by paternal UPD(7) or homozygous frameshift mutation of SUGCT, or both of them, but it is unclear which contributes more.
Cerebellar Leukoencephalopathy following Fentanyl Intoxication. A case report and review of the literature
Authors: Hamzah Adel Ramawad, Amirmohammad Toloui, Victor Chen, Yan Sun
Journal: Qatar Med J (2024)
Keywords: fentanyl overdose, addiction medicine, altered mental status, ataxia, leukoencephalopathy, opioid
MeSH terms: Case Reports

The opioid crisis has become a significant public health concern in recent years. Although respiratory depression and overdose are the most reported side effects of fentanyl, there have been rare cases of cerebellar leukoencephalopathy (CLE) following fentanyl intoxication. A 29-year-old man with a history of opioid use disorder and intravenous drug use presented to the emergency room with significant ataxia and dysarthria following fentanyl intoxication. According to the patient, the symptoms began four days prior after "chasing the dragon" with "pure fentanyl", and he reported experiencing nausea and dizziness, particularly during ambulation. Neurological examination revealed a positive Romberg test, ataxia, and delayed speech. Brain magnetic resonance imaging (MRI) indicated there was toxic degeneration of the cerebellar white matter that extended into the posterior limbs of the internal capsule. Urine drug screening was positive for opioids, making fentanyl-induced cerebellar leukoencephalopathy the most likely diagnosis in this case. This case of opioid-induced CLE underscores the critical significance of early recognition, which is vital for enhancing a patient's recovery and averting the development of severe neurological complications.