OpenMed/multicare-articles huggingface dataset:
Effect of grazing and climatic factors on biodiversity-ecosystem functioning relationships in grassland ecosystems - a case study of typical steppe in Inner Mongolia, China
Authors: Yiran Zhang, Wuriliga, Pengtao Liu, Ruyue Fan, Jing Guo, Li Liu, Yong Ding
Journal: Front Plant Sci (2023)
Keywords: inner mongolia steppe, aboveground productivity, biodiversity, climatic fluctuation, grazing intensity

Biodiversity underpins grassland ecological functions and productive capacities. By studying the mechanisms for the maintenance of species diversity in animal communities, we can provide important theoretical guidance for the optimization of grazing management and biodiversity protection. The typical grassland of Xilingol in Inner Mongolia, China, was used as the experimental area, and a grazing intensity experiment was set up. This consisted of four gradient levels that were grazed by sheep, which were available for continuous monitoring, namely control standard sheep unit·day·hectare-1·year-1 (CK, 0 SSU·d·hm-2y-1), light grazing (LG, 170 SSU·d·hm-2·y-1), moderate grazing (MG, 340 SSU·d·hm-2·y-1), and high grazing (HG, 510 SSU·d·hm-2·y-1). Nine consecutive years of multi-indicator monitoring of vegetation was carried out from 2014-2022, using monitoring data coupled with time series and inter-annual climatic (relative moisture index, RMI) fluctuations. This was done to analyze the impacts of disturbances, such as grazing use and climatic fluctuations, on the diversity of species and above-ground productivity of the community, thereby exploring the relationship between diversity and productivity, and provide possible explanations for the emergence of a range of ecological responses. The statistical analysis methods used were One-way Analysis of Variance (ANOVA), general linear regression and mixed-effects models. The main conclusions of this study are as follows: (1) The grassland in the experimental area under CK had the highest diversity and productivity and the ecosystem was better able to buffer the negative impacts of climatic drought. Furthermore, the effect of climate on productivity and diversity weakened as the intensity of grazing increased. (2) LG to MG had a constant diversity. (3) Grazing utilization changed the relationship between community species diversity and aboveground productivity by releasing spatial community resources, altering the structure of plant communities, weakening competitive exclusion, and strengthening complementary effects. However, under all of the conditions there is a brief stage in the time series when diversity is stimulated to increase, and the higher the grazing intensity, the earlier this occurs.
The safety and efficacy of the re-administration of gilteritinib in a patient with FLT3-mutated R/R AML with CNS relapse: a case report
Authors: Yueru Ji, Zhuo Wan, Jian Yang, Miaowang Hao, Li Liu, Weiwei Qin
Journal: Front Oncol (2024)
Keywords: aml, cns relapse, flt3-itd, gilteritinib, target therapy
MeSH terms: Case Reports

FLT3-ITD is a type of poor prognostic factors in acute myeloid leukemia (AML) disease. Gilteritinib, the second-generation FLT3 tyrosine kinase inhibitor, improved the overall survival of patients with relapsed/refractory FLT3-mutated AML in the ADMIRAL phase III trial. However, few data are available on the efficacy and safety of gilteritinib-based therapy for FLT3-mutated AML with central nervous system (CNS) involvement. We performed gilteritinib to treat a patient with CNS relapsed AML after allogeneic hematopoietic stem cell transplantation. The positive antileukemic effect of gilteritinib may bring new hope for the treatment of FLT3-mutated AML with CNS relapse.
Twinkle Artifact Observed During POCUS of a Human Myiasis Caused by the Dermatobia hominis Botfly
Authors: David Jerome, Matthew Stacey, Joseph Newbigging
Journal: POCUS J (2023)
Keywords: emergency medicine, point of care ultrasound(pocus), infectious disease, travel medicine, wilderness medicine
MeSH terms: Case Reports

An 81-year-old man presented to urgent care for assessment of an area of erythema and tenderness on his right thigh after recent travel to Belize. Point of care ultrasound (POCUS) revealed a hyperechoic structure with acoustic shadowing in the subcutaneous tissue. Colour Doppler assessment of the structure produced a twinkle artifact. The structure was removed and pathology identified the object as a Dermatobia hominis larva (human botfly). The use of POCUS helped identify and localize the subcutaneous foreign body. The use of colour Doppler produced the twinkle artifact, which has not been previously reported as a finding produced during ultrasonographic assessment of botfly larvae.
Improvements during long-term fasting in patients with long COVID - a case series and literature review
Authors: Franziska Grundler, Robin Mesnage, Alberto Cerrada, Françoise Wilhelmi de Toledo
Journal: Front Nutr (2023)
Keywords: case report, long covid, long-term fasting, post-sars-cov-2 syndrome, well-being
MeSH terms: Case Reports

Background:
Post-acute sequelae of a severe acute respiratory syndrome coronavirus 2 infection, also known as long COVID, comprises a variety of symptoms that impair the quality of life. This represents a growing public health burden, with millions of individuals worldwide affected.
Case description:
We present a case series of 14 COVID-19 patients with post-acute symptoms who underwent medically supervised long-term fasting (6 to 16 days) according to the peer-reviewed Buchinger Wilhelmi protocol. The EQ-5D-5L questionnaire and visual scales were used to evaluate the intensity of the symptoms, retrospectively during the acute phase, and prospectively before and after long-term fasting. Blood tests were also performed before and after fasting. Thirteen patients reported that fasting caused an enhancement in their perceived overall health. Only one patient had no improvement. Both frequent (fatigue, breathlessness, muscle and joint pains) and less frequent (cognitive impairment, smell and taste disorders) sequelae ameliorated. Body weight and other risk factors for cardiometabolic diseases like blood pressure, blood glucose, total cholesterol, low-density-lipoprotein cholesterol, and triglycerides were reduced. No severe side effects occurred.
Discussion:
This case series reports beneficial changes in self-perceived symptoms in patients with long COVID after long-term fasting. This highlights the potential of long-term fasting as an effective intervention for managing and treating long COVID.
A stochastic programming approach to perform hospital capacity assessments
Authors: Robert L Burdett, Paul Corry, Belinda Spratt, David Cook, Prasad Yarlagadda
Journal: PLoS One (2023)
MeSH terms: Hospital Bed Capacity, Hospitals, Research Support, Non-U.S. Gov't

This article introduces a bespoke risk averse stochastic programming approach for performing a strategic level assessment of hospital capacity (QAHC). We include stochastic treatment durations and length of stay in the analysis for the first time. To the best of our knowledge this is a new capability, not yet provided in the literature. Our stochastic programming approach identifies the maximum caseload that can be treated over a specified duration of time subject to a specified risk threshold in relation to temporary exceedances of capacity. Sample averaging techniques are applied to handle probabilistic constraints, but due to the size and complexity of the resultant mixed integer programming model, a novel two-stage hierarchical solution approach is needed. Our two-stage hierarchical solution approach is novel as it combines the application of a meta-heuristic with a binary search. It is also computationally fast. A case study of a large public hospital has been considered and extensive numerical tests have been undertaken to highlight the nuances and intricacies of the analysis. We conclude that the proposed approach is effective and can provide extra clarity and insights around hospital outputs. It provides a way to better calibrate hospitals and other health care infrastructure to future demands and challenges, like those created by the COVID pandemic.
Cytomegalovirus Infection in Patient with Clear Cell Renal Cell Carcinoma
Authors: Ikhwan Rinaldi, Abdul Muthalib, Januar Widodo Sutandar, Hendro Adi Kuncoro, Bambang Irawan Harsono, Nelly Susanto, Tjondro Setiawan, Kevin Winston, Idham Rafly Dewantara, Ihya Fakhrurizal Amin, Yuli Maulidiya Shufiyani
Journal: Case Rep Med (2023)
MeSH terms: Case Reports

Introduction:
Cytomegalovirus (CMV) infection is a widespread condition that can affect individuals of all ages. Most cases of CMV infection are mild and resolve on their own. However, in immunocompromised individuals, such as post-transplant patients or those with cancer, severe infections can occur. While there have been several studies on CMV infection in post-transplant patients, there is limited literature on CMV infection in cancer, particularly in kidney cancer. Case Report. In this case report, we present the case of a 61-year-old man with clear cell renal cell carcinoma who underwent targeted therapy with the receptor tyrosine kinase (RTK) inhibitor lenvatinib and the mammalian target of rapamycin (mTOR) inhibitor everolimus. The patient was hospitalized for 26 days and admitted to the intensive care unit (ICU) due to shortness of breath, decreased oxygen saturation, and irregular breathing. Cytomegalovirus polymerase chain reaction (PCR) test results were positive. Given the high prevalence of CMV infection in developing countries, it is likely that the patient had a reactivation of CMV. As such, the patient was subsequently treated with ganciclovir for 14 days and showed improvement in symptoms such as shortness of breath, cough, fever, and increased oxygen saturation. Following recovery, the patient received maintenance therapy with oral valganciclovir for 7 days. No further symptoms appeared during subsequent cancer treatments.
Conclusion:
Cancer patients who are undergoing treatment are at a higher risk for developing opportunistic infections, which can result in morbidity and mortality. Therefore, healthcare professionals should be aware of the possibility of CMV infection in cancer patients and be prepared to diagnose and treat the infection, particularly in areas where the prevalence of CMV infection is high.
Endoscopic Endonasal Repair and Reconstruction of Traumatic Anterior Skull Base Defects
Authors: Isabelle J M Williams, Annakan V Navaratnam, Mark Wilson, Mark S Ferguson
Journal: Case Rep Otolaryngol (2023)
MeSH terms: Case Reports

Eighty percent of cerebrospinal fluid leaks (CSF) occur following trauma and complicate 12 to 13% percent of all basilar skull fractures (Prosser, Vender, and Solares, 2011). An endoscopic endonasal approach (EEA) is often the preferred method of repair with greater than 90% success rates (Prosser, Vender, and Solares, 2011). We report a case of a 37-year-old man who presented to our regional level 1 trauma centre with multiple facial injuries. Initial cross-sectional imaging revealed multiple, continuous anterior skull base fractures with associated pneumocephalus. Though initially managed conservatively, the patient represented five days later with unilateral left-sided rhinorrhoea. An endoscopic endonasal repair with a multilayer fat, tensor fascia lata, free mucosal graft, and vascularised local flap reconstruction was undertaken. This case highlights the importance of maintaining a high level of suspicion for delayed CSF leak in traumatic base of skull injury. The EEA enables meticulous dissection and thorough inspection of the skull base, facilitating multilayered repair and reconstruction of defects.
Case report: Exploring autosomal recessive woolly hair: genetic and scanning electron microscopic perspectives on a Japanese patient
Authors: Satoko Minakawa, Yasushi Matsuzaki, Toshihide Higashino, Tamio Suzuki, Hirofumi Tomita, Eijiro Akasaka, Daisuke Sawamura
Journal: Front Med (Lausanne) (2024)
Keywords: liph, hypotrichosis, lipase h, lysophosphatidic acid receptor 6, woolly hair
MeSH terms: Case Reports

Woolly hair (WH) is a hair shaft anomaly characterized by tightly curled hair that typically stops growing at a few inches. Autosomal recessive WH (ARWH; OMIM no. 278150/604379/616760) has been reported to be caused by variants in genes coding lysophosphatidic acid receptor 6 (LPAR6), lipase H (LIPH), or keratin 25 (KRT25). In this study, we conducted a scanning electron microscopic (SEM) examination of the hair of a 3-year-old Japanese ARWH patient. The SEM revealed that her affected hair had an irregular and rough cuticle compared to her mother's hair. Many irregular small projections and longitudinal grooves were seen on the surface of the patient's hair shaft, and some free margins of the hair cortex were raised or serrated. Her hairs were oval-shaped on the cross-section. Mutation analysis revealed a homozygous pathogenic variant (c.736 T > A; Cys246Ser) in exon 6 in LIPH. In our clinic, we identified three additional cases with the homozygous Cys246Ser variant and one case with compound heterozygous variants in LIPH: Cys246Ser and c.671C > G (Pro224Arg). Consequently, genetic analyses, including genotype-phenotype correlation involving rare LIPH variants, have become more crucial in the Japanese population.
Case Report: Modified endoscopic hook for extracting magnetic esophageal foreign bodies in a rural area
Authors: Hamsu Kadriyan, Ika Primayanti, Syamsidar Syamsidar, Lalu Fauzan Fakhrussiam, Moh Fahrur Rozi, Hijrinelly Hijrinelly
Journal: F1000Res (2024)
Keywords: foreign bodies, aerodigestive tract, endoscopic hook, esophagoscopy
MeSH terms: Esophagus / surgery, Foreign Bodies / surgery, Case Reports, Child, Preschool, Esophagoscopy / methods, Humans, Magnets, Male, Rural Population

Foreign bodies (FB) in the aerodigestive tract are common, especially in children. The type of foreign body in the esophagus can vary and include magnets. A magnet that lodges in the esophagus should be extracted within 24 hours to prevent complications due to associated chemical reactions. In rural areas, there are several limitations to extracting FBs from the esophagus. We report a case of a magnetic FB that lodged in the esophagus of a three-year-old boy. The extraction was successfully done by esophagoscopy with the modification of a hook that was attached to the endoscope. This innovation may help physician all over the world, especially in rural areas. In the future, this innovation could be produced on an industrial scale.
Beneath the surface: a case report on nonencapsulated Streptococcus pneumoniae-associated invasive disease in an immunocompromised patient
Authors: Jonathan Zintgraff, Nahuel Sanchez Eluchans, Paula Gagetti, Celeste Martinez, Dina Pedersen, María Moscoloni, Adrian Lewis, Claudia Lara, Alejandra Corso
Journal: Access Microbiol (2024)
Keywords: wgs, invasive pneumococcal disease, nonencapsulated streptococcus pneumoniae, transmission electron microscopy
MeSH terms: Case Reports

Background:

Streptococcus pneumoniae, a prominent human pathogen linked to various systemic diseases, includes non-typeable pneumococci marked by the absence of a detectable capsule. However, the majority of invasive infections are attributed to encapsulated strains. This case report details the first documented instance of invasive disease caused by non-typeable S. pneumoniae in Argentina since 2017.
Case presentation:
A 19-year-old woman presented with haemorrhagic injuries attributed to chronic oral mucosa irritation. Subsequent hospitalization revealed bone marrow aplasia, leading to antibiotic, antifungal, antiviral, and immunosuppressive treatments, culminating in her discharge. Two weeks later, she was readmitted with sepsis related to a respiratory focus, exhibiting a negative COVID-PCR test. After ten days, ICU admission revealed additional infections: positive COVID-PCR test, fungal sinusitis, and S. pneumoniae bacteremia. Targeted treatments led to improvement, and the patient was subsequently discharged.
S pneumoniae characterization:
Verification of the capsule's absence utilized traditional methods such as the Quellung reaction, transmission electron microscopy, molecular assays, and Whole Genome Sequencing (WGS). The isolate, identified as ST18335, displayed genetic features and antibiotic resistance patterns, concordant between WGS and the agar dilution method. It demonstrated non-susceptibility to penicillin and cefotaxime, based on meningitis breakpoints, as well as meropenem and cotrimoxazole.
Conclusion:
This case underscores the clinical significance of non-typeable S. pneumoniae, emphasizing the necessity for a comprehensive approach to identification and characterization. The findings contribute to ongoing discussions regarding the challenges posed by non-typeable strains in vaccine development, understanding clinical impacts, and addressing antibiotic resistance. As the pneumococcal epidemiological landscape evolves, this case serves as a valuable addition to the evolving knowledge surrounding non-typeable S. pneumoniae, highlighting the continued need for surveillance and research in infectious diseases.
Efficacy of osimertinib and the role of sequential liquid biopsy in patients diagnosed with NSCLC harboring EGFR and BRAF mutations at baseline: insights from two case reports
Authors: Loc Carlo Bao, Alessia Padovan, Andrea Boscolo Bragadin, Lorenzo Calvetti, Valentina Guarneri, Laura Bonanno, Stefano Indraccolo
Journal: Front Oncol (2024)
Keywords: braf, egfr, ngs, nsclc, co-mutation, liquid biopsy, osimertinib
MeSH terms: Case Reports

Epidermal Growth Factor Receptor (EGFR) and B-Raf (BRAF) mutations are two of the most important drivers identified in non-small-cell lung cancer (NSCLC). This report highlights two cases of patients diagnosed with metastatic NSCLC bearing concurrent EGFR and BRAF mutations at baseline and treated with osimertinib as first-line treatment. Molecular profiling was conducted in the tissue and plasma at the time of initial diagnosis, and subsequent repeated liquid biopsy examinations were planned after 10 days, 28 days, and at the time of radiological progression in the frame of the prospective translational study REM. These cases suggest that osimertinib may maintain its therapeutic effectiveness even in patients presenting with a baseline BRAF co-mutation. Notably, radiological responses align with liquid biopsy observations: in both instances, follow-up liquid biopsies indicate the clearance of EGFR-mutated circulating tumor DNA (ctDNA).
Case report: Magnetic resonance imaging features with postoperative improvement of atypical cervical glioma characterized by predominant extramedullary distribution in a dog
Authors: Junyoung Kim, Kihoon Kim, Dai Jung Chung, Yebeen Kim, Kitae Kim, Dayoung Oh, Namsoon Lee, Jihye Choi, Junghee Yoon
Journal: Front Vet Sci (2024)
Keywords: canine, histopathology, laminotomy, oligodendroglioma, spinal tumors
MeSH terms: Case Reports

Introduction:
Intramedullary cord tumors present diagnostic and therapeutic challenges. Furthermore, spinal cord tumors can move across compartments, making antemortem diagnosis difficult, even with advanced imaging. This report presents a rare case of a cranial cervical spinal glioma, confirmed by surgical histopathology, with postoperative improvement in a dog.
Case description:
A 9-year-old female Maltese dog presented with kyphotic posture, progressive left hemiparesis, and decreased appetite. Neurological examination revealed neck pain and decreased proprioception in the left limbs along with intact deep pain perception. Two days later, the patient developed non-ambulatory tetraparesis. Magnetic resonance imaging (MRI) revealed an ovoid, well-defined mass with homogeneously marked contrast enhancement in the second cervical spinal cord that severely compressed the spinal cord. This mass was heterogeneously hyperintense on T2-weighted images and iso-to-hypointense on T1-weighted images, showing an appearance resembling the "golf-tee" and "dural tail" signs. The MRI findings suggested an intradural extramedullary tumor. Intraoperatively, a well-demarcated mass which was locally adherent to the spinal meninges was removed. Both histopathological and genomic tumor tests were indicative of a glioma. Approximately 2 weeks postoperatively, the patient's neurological signs returned to normal.
Conclusion:
This case report describes an atypical cervical glioma with complicated MR characteristics in a dog, where MRI helped guide surgical intervention.
Confirmation of intestinal and bladder perforations in a peritoneal dialysis patient using SPECT/CT: a case report and review of literature
Authors: Xinchao Zhang, Yujing Hu, Fenglian Jing, Congna Tian, Qiang Wei, Kang Li, Lu Zheng, Jiale Liu, Jingjie Zhang, Yanzhu Bian
Journal: Front Med (Lausanne) (2024)
Keywords: 99mtc, spect/ct, bladder perforation, intestinal perforation, peritoneal dialysis
MeSH terms: Case Reports

Background:
Peritoneal dialysis (PD) is a common treatment method for patients with renal failure. While peritonitis and tube floating migration are commonly observed complications, visceral perforation caused by PD is relatively rare. We present a case report of a patient undergoing PD due to renal failure, who encountered two instances of visceral perforation. In both occurrences, Single-Photon Emission Computed Tomography/Computed Tomography (SPECT/CT) played a pivotal role in providing accurate diagnoses and precise localization of the perforation sites. This report underscores the paramount significance of SPECT/CT in diagnosing visceral perforations in the context of PD.
Case presentation:
A 73-year-old elderly male has been undergoing PD for 1 year due to renal failure. Recently, there has been impaired drainage of the PD catheter. The clinical team suspected the occurrence of peritonitis. The patient underwent a 99mTc Sodium Pertechnetate (99mTc-NaTcO4) SPECT/CT examination, which identified intestinal perforation. After 20 days of conservative treatment, a SPECT/CT follow-up examination revealed the resolution of the intestinal perforation, but a new bladder perforation emerged. The dialysis catheter was methodically and gradually withdrawn in stages while simultaneously performing bladder decompression. Following these interventions, the patient remained free from peritonitis and cystitis.
Conclusion:
The utilization of SPECT/CT proved to be highly valuable in the accurate diagnosis of visceral perforation, a relatively rare complication observed in PD patients.
Superior ophthalmic vein thrombosis in unique double origin: a case report
Authors: Taha Boutaj, Hamza Lazaar, Romaissae Benkirane, Latifa Sbai, Manal Tabchi, Zineb Hilali, Rim El Hachimi, Samira Tachfouti, Abdellah Amazouzi, Ouafa Cherkaoui
Journal: Pan Afr Med J (2024)
Keywords: diabetes, case report, exophthalmos, infection, magnetic resonance imaging
MeSH terms: Magnetic Resonance Imaging, Venous Thrombosis / diagnosis, Venous Thrombosis / drug therapy, Case Reports, Anti-Bacterial Agents / administration & dosage, Diabetic Ketoacidosis / complications, Diabetic Ketoacidosis / diagnosis, Female, Humans, Middle Aged, Orbit / blood supply, Orbit / diagnostic imaging, Thrombolytic Therapy / methods, Anti-Bacterial Agents

Superior ophthalmic vein thrombosis (SOVT) is a rare orbital pathology. It can cause serious complications if it isn´t diagnosed appropriately. It can be secondary to many etiologies, septic or aseptic ones. Diabetic ketoacidosis (DKA) may disturb the vascular endothelium and promote a prothrombotic state. The presence of which is related to a significantly increased risk of morbidity and mortality. We report the case of a 45-year-old woman who presented a SOVT revealing DKA. Orbit magnetic resonance imaging (MRI) showed thrombosis of the right superior ophthalmic vein. A treatment based on thrombolytic treatment, associated with antibiotic coverage and a glycemic balance was initiated. This case highlights the importance of considering both infection and diabetes as an important part of the diagnosis and management of SOVT.