Notes

Chronic Neutrophilic The leukemia disease with Monocytosis.
Unexpectedly, 11 NH4+-N/NO3--N (NH4NO3) significantly improved the positive response of plant community ANPP to precipitation (it had the biggest slope value). Our results suggest that precipitation was the main determinant of the influence of NH4+-N/NO3--N ratios on plant community ANPP. Therefore, the results of our study showed that without referring to NH4+-N/NO3--N ratios and precipitation, models using NH4NO3 enrichment may overestimate the positive effect of atmospheric N deposition on ecosystem ANPP in semi-arid ecozones.Seabirds are apex predators in the marine environment and well-known ecosystem engineers, capable of changing their terrestrial habitats by introducing marine-derived nutrients via deposition of guano and other allochthonous inputs. However, with the health of the world's oceans under threat due to anthropogenic pressures such as organic, inorganic, and physical pollutants, seabirds are depositing these same pollutants wherever they come to land. Using data from 2018 to 2020, we quantify how the Flesh-footed Shearwater (Ardenna carneipes) has inadvertently introduced physical pollutants to their colonies on Lord Howe Island, a UNESCO World Heritage site in the Tasman Sea and their largest breeding colony, through a mix of regurgitated pellet (bolus) deposition and carcasses containing plastic debris. The density of plastics within the shearwater colonies ranged between 1.32 and 3.66 pieces/m2 (mean ± SE 2.18 ± 0.32), and a total of 688,480 (95% CI 582,409-800,877) pieces are deposited on the island each year. Our research demonstrates that seabirds are a transfer mechanism for marine-derived plastics, reintroducing items back into the terrestrial environment, thus making seabird colonies a sink for plastic debris. This phenomenon is likely occurring in seabird colonies across the globe and will increase in severity as global plastic production and marine plastic pollution accelerates without adequate mitigation strategies.Dissipation kinetics of atrazine and trifluralin in a clay loam soil was investigated in a laboratory incubation experiment under different temperature and moisture conditions. The soil was spiked with diluted atrazine and trifluralin concentrations at 4.50 and 4.25 mg/kg soil, respectively, the moisture content adjusted to 40, 70, and 100% of field capacity (FC) and then incubated in three climatic chambers at 10, 20, and 30 °C. For each of the herbicides, soil samples were collected at 0, 7, 21, 42, 70, and 105 days and analysed by Gas Chromatography-Electron Capture Detector (GC-ECD). A stochastic gamma model was used to model the dissipation of herbicides from the clay loam soil by incorporating environmental factors as covariates to determine half-life and days to complete dissipation. Results showed that temperature played a greater role on atrazine persistence than soil moisture; while the interaction effect of temperature and moisture was significant on the persistence of trifluralin over time. Atrazine dissipated more rapidly at 30 °C compared to 10 and 20 °C, with a half-life of 7.50 days and 326.23 days to reach complete dissipation. Rapid loss of trifluralin was observed at 70% moisture content when incubated at 30 °C, with a half-life of 5.80 days and 182.01 days to complete dissipation. It was observed that the half-life of both herbicides tended to double with every 10 °C decreases of temperature over the range tested. The model indicated that both atrazine and trifluralin have the potential to persist in clay loam soil for several years at temperature ≤20 °C; which could potentially affect following crops in rotation.
Immediately after experiencing a non-fatal overdose, many people who inject drugs (PWID) engage in harm-minimizing behavior change, including engagement in drug treatment. To inform the implementation of tailored interventions designed to facilitate drug treatment engagement in rural communities, we sought to identify correlates of starting any form of drug treatment after their most recent overdose among PWID who reside in a rural county in West Virginia.

Data are from a PWID population estimation study in Cabell County, West Virginia. We used multivariable logistic regression to identify independent sociodemographic and substance use-related correlates of any form of drug treatment engagement after an overdose among 179 PWID who had overdosed in the past 6 months.

One-third of our sample (33.0%) started any form of drug treatment in the 30 days following their most recent overdose. Factors associated with engaging in drug treatment included recent buprenorphine or Suboxone injection (aOR 2.39, 95% CI 1.15, 4.96), someone calling 911 after their most recent overdose (aOR 3.29, 95% CI 1.63, 6.65), and older age (aOR per year of age 0.95, 95% CI 0.91, 0.99).

Our results suggest that contact with emergency personnel after an overdose may represent an important opportunity to link PWID to drug treatment. The implementation of response teams trained in linking PWID to the services they require and helping persons navigate treatment systems maybe be a valuable intervention to reduce the harms of the opioid overdose crisis.
Our results suggest that contact with emergency personnel after an overdose may represent an important opportunity to link PWID to drug treatment. The implementation of response teams trained in linking PWID to the services they require and helping persons navigate treatment systems maybe be a valuable intervention to reduce the harms of the opioid overdose crisis.Distal fibula resection is a procedure that has been described as early as 1938 for the treatment of neoplastic lesions. There have been several techniques described for the reconstruction of the remaining tibiotalar joint to prevent deformity and maintain as much function as possible. While these reconstruction techniques provide an option for limb salvage with the removal of disease, patients are faced with chronic pain, loss of function, valgus instability, need for long term orthosis, early arthritis, or significant morbidity related to proximal dissection and disruption of native knee anatomy. We present a case series that is compliant with PROCESS1 criteria to demonstrate the effective treatment with distal fibular excision and a reconstruction technique inspired by the original Tommy John procedure of the elbow. GW4064 This procedure has allowed these two patients long-term stability of the ankle, maintenance of full function, and high levels of function. The first case is a 23-year-old female with high-grade osteosarcoma and the second patient is a 19-year-old female with Ewing sarcoma. Details of the procedure as well as clinical and radiographic follow up of these two patients will be described.
Malignant phyllodes tumours of the breast represent less than 1% of all breast cancers. Few cases of phyllodes tumours have been reported in men.

We present the case of a 60-year-old man who was operated on one year ago for a breast tumour that had undergone a lumpectomy with an anatomopathological study in favour of a grade 2 phylloid tumour. He was admitted to hospital with a palpable mass in his right breast. The lumpectomy enlarged to the right pectoralis major muscle was then performed with clear surgical margins. Microscopic examination revealed high-grade malignant phyllodes. Postoperatively, after 3 months, the patient was given a breast MRI and a PET/CT scan which returned without abnormalities. The patient is followed for eight months and has shown no signs of recurrence.

Malignant phyllodes tumours of the breast show clinical and mammographic signs comparable to those of benign lesions. The diagnosis is confirmed by histology, treatment is based on surgery, which may be a large lumpectomy or mastectomy, and the prognosis depends on several factors, the most important of which is the margin for surgical resection.

The best treatment is a wide local excision with a safety margin of 1 cm, unless it is metastatic. Early diagnosis and surgery improves the prognosis.
The best treatment is a wide local excision with a safety margin of 1 cm, unless it is metastatic. Early diagnosis and surgery improves the prognosis.
Atraumatic splenic rupture is a rare but life-threatening condition which may be associated with hematological malignancies.

We present the case of a 63-year-old male patient with a history of chronic myelomonocytic leukemia and sarcoidosis under therapy with prednisone, who suffered an atraumatic splenic rupture with hemodynamic instability. He was managed with proximal splenic artery embolization and secondary open splenectomy. On pathology the diagnosis of peliosis lienalis was established.

Peliosis is a rare pathological entity, which presents with multiple blood-filled cavities within parenchymatous organs and is of unknown etiology and pathogenesis. In retrospect a rapid increase in splenomegaly and inhomogeneous parenchyma of the spleen on sonography was realized.

Sonographic changes in size and parenchyma of the spleen in patients with hematological malignancies might help suspecting peliosis lienalis with impending splenic rupture and could alter clinical management towards a prophylactic splenectomy.
Sonographic changes in size and parenchyma of the spleen in patients with hematological malignancies might help suspecting peliosis lienalis with impending splenic rupture and could alter clinical management towards a prophylactic splenectomy.
Synovial sarcoma is a rare tumor to be encountered in the head and neck region and is always a challenge in terms of diagnosis, treatment, as our case.

We present a 23-year old female patient with synovial sarcoma of posterolateral pharyngeal wall. The radiological and clinicopathological features along with various diagnostic tests and treatment options are discussed.

The objective of this study is to describe - from a clinical case reported from our institution, and from literature review- the clinical, radiological and histological features of pharyngeal synovial sarcoma and to discuss its therapeutic management.

Synovial sarcoma of pharynx is extremely a rare tumor in current practice.
Synovial sarcoma of pharynx is extremely a rare tumor in current practice.
Endovascular repair of infra renal aortic aneurysm is becoming the preferable method of intervention compared to open surgery due to the lower early morbidity rates. One of the complications during the procedure is contra-lateral gate (CLG) maldeployment. Learning the endovascular salvage options is necessary to avoid the morbidities of open surgical conversion.

we present a case of maldeployment during an endovascular exclusion of aortic aneurysm in a high cardiac risk patient for whom an endovascular management was successful.

We discuss the detailed technical aspect in managing CLG maldeployment in our case as well as variable options from literature.

Despite the available possibility to convert to open, there are multiple endovascular bail out alternatives to manage maldeployment that can be successfully performed by experienced interventionalist.
Despite the available possibility to convert to open, there are multiple endovascular bail out alternatives to manage maldeployment that can be successfully performed by experienced interventionalist.
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