Case Reports in Gastroenterology最新文献

{"title":"COVID-19 Induced Cholangiopathy: A Case Report.","authors":"Bassem Al Hariri, Muhammad Sharif, Lujain Al-Emadi, Richard Shamoon, Memon Noor Illahi, Nabil S Mahmood, Muayad Kasim Khalid","doi":"10.1159/000546723","DOIUrl":"https://doi.org/10.1159/000546723","url":null,"abstract":"<p><strong>Introduction: </strong>COVID-19, although primarily a respiratory illness, has been linked to complications in multiple organ systems, including the liver. Proposed mechanisms for liver injury include direct viral cytopathic effects, systemic inflammation, hypoxia, and drug-induced liver injury (DILI). Moreover, post-COVID cholangiopathy is an emerging entity with features that may overlap with autoimmune phenomena.</p><p><strong>Case presentation: </strong>A 60-year-old male patient with multiple comorbidities presented with fever, chills, and cough for 1 day. In the emergency department, he tested positive for COVID-19 by PCR and his chest X-ray revealed features suggestive of pulmonary edema. The patient was intubated and admitted to the Medical Intensive Care Unit (MICU) for management of COVID-19 pneumonia with pulmonary edema. During hospitalization, he developed cardiac complications that required targeted management. Approximately 1 week after admission, his liver enzymes began to rise. Although drug-DILI was initially suspected and hepatotoxic medications were discontinued with the initiation of ursodeoxycholic acid (UDCA), the liver function tests (LFTs) remained elevated. Subsequent magnetic resonance cholangiopancreatography revealed periportal inflammation with intrahepatic biliary dilatation and stricturing, findings consistent with COVID-19 induced cholangiopathy. The UDCA dosage was doubled, resulting in gradual biochemical improvement; however, the patient ultimately discharged against medical advice.</p><p><strong>Conclusion: </strong>COVID-19-induced cholangiopathy is a rare but serious liver complication. Effective management requires a multidisciplinary team. Ongoing research is needed to better understand long-term liver effects and improve care strategies.</p>","PeriodicalId":9614,"journal":{"name":"Case Reports in Gastroenterology","volume":"19 1","pages":"519-526"},"PeriodicalIF":0.5,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12266703/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648676","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}

{"title":"Case Report of Hepatic Sinusoidal Obstruction Syndrome Complicated with Myeloproliferative Neoplasm and Focal Segmental Glomerulosclerosis.","authors":"Yuxuan Song, Yajing Zhen, Hui Ma, Bo Feng, Yandi Xie","doi":"10.1159/000546801","DOIUrl":"10.1159/000546801","url":null,"abstract":"<p><strong>Introduction: </strong>A 19-year-old male presented with a 6-month history of recurrent ascites and lower limb edema, prompting a detailed diagnostic evaluation at our hospital.</p><p><strong>Case presentation: </strong>The patient displayed a ruddy complexion, deepening pigmentation in the limbs and abdomen, visible reticular skin pattern changes, and pronounced abdominal striae. Diagnostic investigations included a renal biopsy, which confirmed focal segmental glomerulosclerosis, and an abdominal enhanced CT scan, suggesting hepatic sinusoidal obstruction syndrome. Hematological tests revealed elevated white blood cell count (19.73 × 10⁹/L), hemoglobin level (183 g/L), and platelet count (395 × 10⁹/L). Bone marrow morphology indicated proliferation of red blood cells, white blood cells, and platelets, suspicious for myeloproliferative neoplasm. PCR testing confirmed the presence of the JAK2 V617F mutation, leading to a diagnosis of polycythemia vera. The patient was administered a comprehensive treatment regimen consisting of methylprednisolone, telmisartan, rivaroxaban, furosemide, and spironolactone. This therapeutic approach led to a decrease in the patient's weight and 24-h urinary protein, along with a significant reduction in pleural and abdominal effusions.</p><p><strong>Conclusion: </strong>This case underscores the significance of a meticulous diagnostic process in uncovering multiple concurrent severe pathologies presenting with nonspecific symptoms. It also highlights the importance of a targeted treatment strategy to achieve clinical improvement. The successful management of this patient's complex case illustrates the value of a multidisciplinary approach in addressing polycythemia vera, hepatic sinusoidal obstruction syndrome, and focal segmental glomerulosclerosis.</p>","PeriodicalId":9614,"journal":{"name":"Case Reports in Gastroenterology","volume":"19 1","pages":"502-508"},"PeriodicalIF":0.5,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12245151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607501","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}

{"title":"Acute Intestinal Obstruction from Small Bowel Stricture following Superior Mesenteric and Portal Vein Thrombosis: A Case Report.","authors":"Saurabh Raj, Rudrakshi Mahaldar, Bishal Saha, Subhra Banerjee","doi":"10.1159/000546789","DOIUrl":"https://doi.org/10.1159/000546789","url":null,"abstract":"<p><strong>Introduction: </strong>Portal vein thrombosis (PVT) is a critical factor in portal hypertension, often linked to liver disease but also occurring independently. Superior mesenteric vein thrombosis and PVT can lead to mesenteric ischemia, even without predisposing hepatic or abdominal conditions. While acute or chronic PVT may present with variable occlusion, the development of intestinal strictures is rare. Persistent symptoms necessitate close follow-up for early detection and timely intervention.</p><p><strong>Case presentation: </strong>A male patient in his early 40s presented with 15 days of progressive upper abdominal pain and one day of vomiting. He had a history of diabetes and hypertension. Examination revealed tachycardia and epigastric tenderness. Laboratory tests showed neutrophilic leukocytosis and positive occult blood in the stool. Contrast-enhanced CT (CECT) revealed PVT extending into its right branch, jejunal wall thickening, and mesenteric engorgement suggestive of ischemia. Upper GI endoscopy showed esophageal varices and portal hypertensive gastropathy. He was managed conservatively with anticoagulation and discharged. One month later, he returned with recurrent vomiting, worsened by solid food. Repeat CECT showed jejunal obstruction with a 3-cm stricture. Exploratory laparotomy revealed dense adhesions; adhesiolysis, bowel resection, anastomosis, and feeding jejunostomy were performed. Histopathological examination showed a sealed-off perforation with acute suppurative inflammation and fibrotic changes consistent with ischemic stricture.</p><p><strong>Conclusion: </strong>While mesenteric venous thrombosis is primarily managed with anticoagulation, progressive bowel strictures may develop over time, necessitating surgical intervention. Long-term follow-up is crucial, as delayed complications can arise despite initial success in preventing infarction.</p>","PeriodicalId":9614,"journal":{"name":"Case Reports in Gastroenterology","volume":"19 1","pages":"509-518"},"PeriodicalIF":0.5,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12245150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607500","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}

{"title":"A Case Report of Gastric Squamous Cell Carcinoma Associated with Pancreatic Adenocarcinoma and Literature Review.","authors":"Shiwei Yao, Xueyong Deng","doi":"10.1159/000546802","DOIUrl":"10.1159/000546802","url":null,"abstract":"<p><strong>Introduction: </strong>It is common for advanced pancreatic adenocarcinoma to infiltrate the gastric wall, and the tumor cells invading the gastric wall are usually consistent with pancreatic adenocarcinoma. However, it is very rare for the tumor cells infiltrating the gastric wall to be squamous cell carcinoma.</p><p><strong>Case presentation: </strong>In this case, we report a 57-year-old man who presented with weight loss for 2 months. CT revealed a pancreatic mass. Endoscopic ultrasound biopsy of the pancreatic mass confirmed pancreatic adenocarcinoma. He refused treatment. Eight months later, he developed melena. CT revealed that the pancreatic mass had invaded the gastric wall. Gastric squamous cell carcinoma was confirmed by biopsy of gastric tissue under gastroscopy.</p><p><strong>Conclusion: </strong>By observing the evolution process of this case, we found that the occurrence of gastric squamous cell carcinoma in this case was consistent with one of its pathogenesis: the theory of adenocarcinoma differentiating into squamous cell carcinoma. It provides certain clinical significance for the study of the mechanism of gastric squamous cell carcinoma.</p>","PeriodicalId":9614,"journal":{"name":"Case Reports in Gastroenterology","volume":"19 1","pages":"496-501"},"PeriodicalIF":0.5,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12240571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599534","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}

{"title":"Hepatic Angiosarcoma Presenting as Ascites: Case Report of a Rare yet Lethal Disease.","authors":"Archit Garg, Mehak Bassi, Capecomorin Pitchumoni, Arkady Broder","doi":"10.1159/000546375","DOIUrl":"10.1159/000546375","url":null,"abstract":"<p><strong>Introduction: </strong>Angiosarcomas, constituting less than 1% of all sarcomas, are rare soft tissue tumors originating from the endothelial cells. Hepatic angiosarcoma (HAS) is a rare and aggressive primary hepatic malignancy accounting for only 0.5%-2% of all liver tumors. The patients often endorse nonspecific symptoms like vague abdominal pain, nausea, vomiting, and jaundice making the diagnosis challenging. Most patients succumb to death within 6 months of diagnosis due to liver failure or hemorrhage from spontaneous rupture of HAS. Therapeutic guidelines remain undefined, and management often involves a multidisciplinary approach. Surgical resection is the only potentially curative option, which has been shown to be most beneficial when HAS is limited to one lobe. Hepatic artery embolization is used in the case of rupture of HAS. Chemotherapy can be used for palliative care in cases of advanced tumors. We present a fatal case of metastatic HAS to underscore diagnostic pitfalls and therapeutic challenges.</p><p><strong>Case description: </strong>A 56-year-old male presented with 2 months of abdominal pain, distension, fatigue, and weight loss. Imaging revealed multifocal hypodense liver and splenic lesions. Laboratory findings included severe anemia (Hb 6.1 g/dL), thrombocytopenia (63 × 10³/mm³), and elevated liver enzymes. Ascitic fluid analysis demonstrated exudative, bloody ascites (SAAG <1.1) without malignant cytology. Liver biopsy confirmed HAS, showing atypical spindle cells infiltrating vascular channels, positive for CD34 and factor VIII. Despite transfusions, paracentesis, and palliative care, the patient developed disseminated intravascular coagulation and died 2 weeks post-diagnosis.</p><p><strong>Conclusion: </strong>HAS is a rapidly fatal malignancy often diagnosed at advanced stages due to nonspecific symptoms and lack of definitive risk factors in most cases. Multidisciplinary collaboration is essential for symptom management, though treatment options remain limited, and prognosis is poor. Therefore, it becomes imperative for clinicians to keep in mind the common presentation of a rare but lethal disease.</p>","PeriodicalId":9614,"journal":{"name":"Case Reports in Gastroenterology","volume":"19 1","pages":"488-495"},"PeriodicalIF":0.5,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12215201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144552416","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}

{"title":"Beyond Inflammatory Bowel Disease: Calprotectin as a Marker for Trichobezoar? A Case Report.","authors":"Ammar Khayat","doi":"10.1159/000546623","DOIUrl":"10.1159/000546623","url":null,"abstract":"<p><strong>Introduction: </strong>Trichobezoar is an aggregation of swallowed hair strands that entangle in the stomach. It presents with abdominal pain, vomiting, and diarrhea. Diagnosis is usually made by imaging and endoscopy. Surgical removal is typically required, but endoscopic retrieval has been successful. Fecal calprotectin is a biomarker of inflammation that is typically elevated in inflammatory bowel disease (IBD) but is also elevated in other gastrointestinal (GI) disorders such as infections. Trichobezoar is not known to precipitate GI inflammation and has never been reported among the etiologies of elevated fecal calprotectin. Herein is a case presenting with vague abdominal pain and elevated fecal calprotectin that was attributed solely to a trichobezoar.</p><p><strong>Case presentation: </strong>A 7-year-old girl presented with abdominal pain for 6 months associated with occasional vomiting and diarrhea. Family history was positive for ulcerative colitis. Physical examination was unremarkable including normal growth. Diagnostic workup revealed elevated fecal calprotectin at 433.9 mg/kg. Upper and lower endoscopies were performed. A trichobezoar with Rapunzel syndrome was incidentally found in the stomach extending into the duodenum without frank obstruction. Histology showed reactive gastropathy in a few areas of mechanical rubbing by hair strands; otherwise, it was completely unremarkable in both upper and lower GI biopsies. Endoscopic retrieval of piecemeal hair locks was done. Surgical removal was subsequently done due to the generous size of the mass.</p><p><strong>Conclusion: </strong>Fecal calprotectin is an important biomarker for IBD, as well as other unusual GI pathologies, and clinical context is crucial when interpreting its value.</p>","PeriodicalId":9614,"journal":{"name":"Case Reports in Gastroenterology","volume":"19 1","pages":"482-487"},"PeriodicalIF":0.5,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12187109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144483259","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}

{"title":"Gastroduodenal Strongyloidiasis Diagnosed during Iron Deficiency Anemia Workup.","authors":"Malek Kreidieh, Neville Mobarakai, Sherif Andrawes, Robert Colef, Lara Kreidieh, Hassan Al Moussawi, Jean M Chalhoub","doi":"10.1159/000539769","DOIUrl":"10.1159/000539769","url":null,"abstract":"<p><strong>Introduction: </strong>The Strongyloidae family includes at least fifty species of intestinal nematode worms, and <i>Strongyloides stercoralis</i> is the most prevalent one among humans. As a result of this parasite's complex lifecycle, it can either remain localized in the intestines or disseminate to different organs throughout the body, culminating in hyperinfection in case of immunosuppression. Strongyloidiasis is rarely encountered in the USA, and an associated gastric involvement is uncommon.</p><p><strong>Case presentation: </strong>In this case report, we describe the case of an asymptomatic and immunocompetent Liberian patient with gastroduodenal strongyloidiasis whose diagnosis was based on histologic findings during endoscopic evaluation for iron deficiency anemia.</p><p><strong>Conclusion: </strong>This case sheds light on the importance of suspecting the diagnosis of disseminated strongyloidiasis in high-risk individuals with iron deficiency anemia in combination with peripheral eosinophilia.</p>","PeriodicalId":9614,"journal":{"name":"Case Reports in Gastroenterology","volume":"19 1","pages":"467-475"},"PeriodicalIF":0.5,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12180792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144367943","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}

{"title":"A Rare Cause of Ascites: Vesicoabdominal Fistula as a Late Complication of Radiation-Induced Cystitis - A Case Report.","authors":"Jakub Klevar, Pavel Hrabák, Radan Brůha, Libor Zámečník","doi":"10.1159/000546596","DOIUrl":"10.1159/000546596","url":null,"abstract":"<p><strong>Introduction: </strong>Vesico-peritoneal fistula (VPF) is an uncommon type of fistula in the urogenital tract and a rare cause of ascites.</p><p><strong>Case presentation: </strong>Although VPF mainly occurs as an early postoperative complication of gynecological surgery, we report a case of a 71-year-old female patient who presented with ascites, pseudo-renal failure, and peritonitis caused by a VPF as a delayed complication of radiotherapy.</p><p><strong>Conclusion: </strong>In this case report, we discuss treatment strategies based on previously published case studies and our experience. We provide a diagnostic overview of commonly available imaging techniques, such as computed tomography scans and magnetic resonance imagings. Despite their widespread use, these imaging modalities have not led to any shift in the diagnostic process, with the definitive diagnosis being confirmed only by retrograde cystography.</p>","PeriodicalId":9614,"journal":{"name":"Case Reports in Gastroenterology","volume":"19 1","pages":"476-481"},"PeriodicalIF":0.5,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12180782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144367942","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}

{"title":"Spinal Cord Stimulation for Diffuse Visceral Hyperalgesia in the Abdomen: A Case Report and Literature Review.","authors":"James Mamaril-Davis, Ryan Palsma, Martin Weinand","doi":"10.1159/000546229","DOIUrl":"10.1159/000546229","url":null,"abstract":"<p><strong>Introduction: </strong>Spinal cord stimulation (SCS) for chronic abdominal pain is not novel. However, this has been explored only when the pain has a clear dermatomal association such as the right upper quadrant for sphincter of Oddi dysfunction or the left upper quadrant for post-traumatic splenectomy. The present report thereby discusses the utility of SCS when the visceral pain is diffusely distributed across all four quadrants of the abdomen.</p><p><strong>Case presentation: </strong>A patient in their 70s presented with a 30-year history of chronic abdominal pain diffusely located in all four quadrants. The patient had a pancreatic cyst removed via pancreaticoduodenectomy in 1991 complicated by chronic pancreatitis and visceral hyperalgesia. After failed pharmacological management and various outpatient nerve blocks and trigger point injections, the patient underwent SCS placement via five 4-contact paddle leads at the mid- to superior thoracic 7 level. At 1-month follow-up, the patient's visual analog scale score decreased from 8/10 (prior to implantation) to 0/10. The patient also discontinued his chronic opioid regimen post-SCS placement but continued duloxetine. Device settings remained the same throughout the postoperative period: pulse width of 500 microseconds (inter-burst) and 1,000 microseconds, frequency of 40 Hertz, and current of 1.7 milliamperes. At 12-month follow-up, the patient continued to report >90% pain relief at nearly the same SCS settings as the initial programming.</p><p><strong>Conclusion: </strong>SCS may be a reliable treatment option for chronic abdominal, visceral hyperalgesia when the pain is diffusely located in all 4 quadrants and without a clear dermatomal pattern.</p>","PeriodicalId":9614,"journal":{"name":"Case Reports in Gastroenterology","volume":"19 1","pages":"461-466"},"PeriodicalIF":0.5,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324495","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}

{"title":"Effects of Neuromuscular Electrical Stimulation on Chronic Dysphagia in a Single Subject after Anterior Cervical Discectomy and Fusion Surgery: A Case Report.","authors":"Anna Munson, Matthew Dumican, Katherine Rigley","doi":"10.1159/000546013","DOIUrl":"10.1159/000546013","url":null,"abstract":"<p><strong>Introduction: </strong>The purpose of this single subject study was to describe the dysphagia presentation, treatment course, and post-treatment swallowing function in a patient with chronic dysphagia after anterior cervical discectomy and fusion (ACDF) surgery.</p><p><strong>Case presentation: </strong>An 83-year-old male experienced dysphagia >2 months post-ACDF. The patient presented with a narrowed pharyngoesophageal segment due to cervical hardware and reduced epiglottic inversion due to pharyngeal narrowing on videofluoroscopic swallow study (VFSS). He completed dysphagia therapy using neuromuscular electrical stimulation (NMES). Structural alterations and a complicated medical course after treatment impacted therapeutic outcomes. Reductions in penetration or aspiration and improved hyoid excursion were found post-treatment, though impairment persisted. The patient ended therapy after the post-treatment VFSS and began to experience odynophagia and submental pain. The patient experienced a complicated post-treatment course including bilateral cancerous masses at the base of tongue with subsequent surgery and chemoradiation.</p><p><strong>Conclusions: </strong>While considered rare, these findings present a post-operative course of chronic dysphagia post-ACDF surgery where morphological changes to the pharynx significantly altered swallowing function. Swallowing function should be tracked routinely and longitudinally in post-ACDF surgery patients. NMES may be a potential dysphagia therapy modality to explore.</p>","PeriodicalId":9614,"journal":{"name":"Case Reports in Gastroenterology","volume":"19 1","pages":"445-454"},"PeriodicalIF":0.5,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12173443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144315957","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}