bluuebunny/crossref_metadata_2025 huggingface dataset:
Reliability and Agreement of Keratometry Measurements Obtained With Eye Surface Profilometry and Partial Coherence Interferometry
Authors: Martínez-Plaza Elena , Molina-Martín Ainhoa , Piñero David P.
Published: July 2023

Purpose:

The aim of this study was to assess the repeatability of keratometry parameters obtained using the Eye Surface Profiler (ESP) system and their agreement with the IOL Master 500 device.

Methods:

Seventy-one eyes of 71 healthy participants were evaluated. Three repeated measurements were performed using the ESP system. Simulated keratometry in the flat (SimKf) and steep (SimKs) meridians, astigmatism, and axis were obtained. The same parameters were measured using the IOL Master 500 device. The J0 and J45 vector components of the astigmatism were calculated. The intrasession repeatability was analyzed using within-subject SD (Sw) and intraclass correlation coefficient (ICC). Agreement was assessed using paired statistical tests and the Bland–Altman method.

Results:

The Sw was 0.07 mm, 0.04 mm, 0.51 D, 0.33 D, and 0.22 D, and the ICC was 0.96, 0.98, 0.74, 0.61, and 0.55 for SimKf, SimKs, astigmatism, J0, and J45, respectively. The mean difference and limits of agreement when comparing the ESP system with the IOL Master 500 device were 0.37 mm (0.08/0.66) for SimKf (P < 0.001), 0.18 mm (0.00/0.35) for SimKs (P < 0.001), −0.93 D (−2.42/0.56) for astigmatism (P < 0.001), 0.51 D (−0.22/1.24) for J0 (P < 0.001), and 0.06 D (−0.48/0.60) for J45 (P = 0.09).

Conclusions:

The ESP system provides consistent values for simulated keratometry, showing moderate consistency for astigmatism parameters. Contact lens practitioners should be aware that the ESP system and IOL Master 500 device provide different simulated keratometry from a clinically viewpoint.
External Compressive Ischemic Orbitopathy: A Rising Clinical Entity
Authors: Ghiam Benjamin K. , Liu Brian J. , Echegaray Jose J. , Prendes Mark A.
Published: July 2023

Purpose:

Saturday night retinopathy, the term coined by Jayam et al. in 1974, is a rare condition in which external compression of the orbit during a drug and alcohol stupor causes a unilateral orbitopathy with ophthalmoplegia and ischemic retinopathy. This condition has been increasingly reported in the last decade, correlating with an increasing burden of substance use. This condition mirrors a similar entity typically reported in patients following spinal surgery, where a headrest supporting the patient’s face compresses the orbit. The current authors combine these 2 entities, entitled external compressive ischemic orbitopathy, and present a comprehensive literature review describing this entity.

Methods:

A systematic review was carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. All related publications of vision loss in the setting of orbital compression were reviewed. Data collected included patient demographics, precipitating circumstances of vision loss, presenting ocular symptoms, outcomes, and ancillary imaging.

Results:

In total 31 articles were selected for inclusion, yielding 46 patients. A total of 10 patients suffered orbitopathy in the setting of a drug stupor, and 36 following prone-positioned surgery. However, 79% of patients presented with visual acuity of light perception or worse. Also, 86% of patients presented with ophthalmoplegia, 92% with proptosis and orbital edema, and 86% with varying degrees of retinal ischemia. When compared with iatrogenic cases, self-induced stuporous cases demonstrated worse presenting visual acuity, ophthalmoplegia, retinal and choroidal filling, and worse final outcomes.

Conclusion:

External compressive ischemic orbitopathy is a severe vision-threatening condition that has been increasingly reported in the last decade.
Periorbital Necrotizing Sweet’s Syndrome: A Case Report
Authors: Watson Samantha L. , Kuo Andy , Kishi Susan H. , Fat Marisa N. , Boxrud Cynthia A.
Published: July 2023

Sweet’s syndrome (acute febrile neutrophilic dermatosis) is an uncommon inflammatory condition most often associated with painful skin lesions of the head, neck, and upper extremities. To the authors’ knowledge, this case report is the only published record of the necrotizing clinical variant of Sweet’s syndrome in the periorbital space. This case follows a 91-year-old female who presented with generalized cutaneous eruptions of tender erythematous plaques, including a necrotic plaque of the left upper eyelid, and pancytopenia. A biopsy of an inner thigh lesion was consistent with Sweet’s syndrome. Initially diagnosed with preseptal cellulitis, the patient experienced marked clinical improvement with corticosteroids. This, coupled with the histopathologic findings of her thigh biopsy and the absence of eyelid margins, led to the diagnosis of periorbital necrotizing Sweet’s syndrome. Although cases of Sweet’s syndrome in the periorbital region are rare, these diagnoses should not be overlooked and may be critical to patient care.
Periocular Infection With Nocardia nova Following Dacryocystorhinostomy With Silicone Stent Intubation
Authors: Bruce Carleigh N. , Esmaili Neda
Published: July 2023

Nocardia species are aerobic, rod-shaped, Gram-positive bacteria that are ubiquitous throughout the environment. Nocardia nova has been reported as the second most prevalent Nocardia species. However, reports of ocular and periocular infection caused by this organism are rare. The authors present a case of a 58-year-old woman with a medical history of acquired nasolacrimal duct obstruction of the left eye who underwent a revision dacryocystorhinostomy with silicone stent intubation and developed a surgical site infection that was culture-positive for N. nova. Treatment consisted of removal of the silicone stent and a prolonged course of oral antibiotics, resulting in the patient’s full recovery. This is the second reported case of postoperative periocular N. nova infection after dacryocystorhinostomy and silicone stent intubation.
Interobserver agreement between central topography and Scheimpflug tomography for premium intraocular lens selection
Authors: Brar Sheetal , Ganesh Sri , Murkey Vedant
Published: July 2023

Purpose:

To assess the inter-observer agreement and reliability of central topography (CT) of IOL Master 700 with that of Pentacam HR, as a screening tool for determining the suitability for premium (toric, monofocal and presbyopia correcting) intraocular lens (IOL) implants.

Setting:

Nethradhama Superspeciality Eye Hospital, Bangalore, India.

Method:

200 eyes of eligible patients undergoing unilateral or bilateral phacoemulsification with premium IOL's were included in the study. Preoperatively, IOL Master 700 CT and Pentacam scans were performed for corneal topography evaluation. 2 experienced clinicians were randomised to interpret the axial map of either of the scans at a time and their responses were then enclosed in an envelope, and forwarded to a third observer for analysis. If there was a conflict, final decision was based on the interpretation of the Pentacam scan.

Results:

Of the total scans interpreted by the 2 observers, 77.5% (n = 155) showed agreement whereas 22.5% (n = 45) showed disagreement. The sensitivity, specificity, positive predictive value and negative predictive value (NPV) of IOL Master 700 CT in diagnosing irregular corneas when compared with Pentacam HR, was 72.73%, 78.09%, 29.09% and 95.86% respectively. The Cohen's κ inter-observer agreement value was 0.44, signifying a moderate degree of agreement, which was statistically significant (P < .00).

Conclusions:

High NPV of IOL Master CT suggested that the device efficiently ruled out irregular corneas, while any suspicious scan should be confirmed with Pentacam HR or a similar device for appropriate decision-making regarding premium IOL selection.

Trial Registration Number:

CTRI/2021/11/038053.
Radial keratotomy and cataract surgery: A quest for emmetropia
Authors: Fram Nicole R. , Hovanesian John A. , Narang Priya , Narang Rhea , Moloney Greg , Lin David T.C. , Ferguson Tanner J. , Thompson Vance , Schneider Rachel , Yeu Elizabeth , Trattler William , Zaldivar Roger
Published: July 2023

A 75-year-old man with an ocular history of 8-cut radial keratotomy (RK) in both eyes presented for cataract surgery evaluation. He was previously correctable in spectacles in years prior despite his irregular corneas to 20/25 in the right eye and 20/30 in the left eye. He recently noticed a change in his overall visual function with significant nighttime glare and difficulty reading despite spectacle correction. Of note, he was unable to tolerate contact lenses and was resistant to refitting despite additional encouragement. Cataract surgery was delayed for many years, given he was correctable in spectacles and the concern of uncovering a highly aberrated cornea after removing his cataracts (Figures 1 and 2

JOURNAL/jcrs/04.03/02158034-202308000-00021/figure1/v/2023-07-21T030437Z/r/image-tiff

JOURNAL/jcrs/04.03/02158034-202308000-00021/figure2/v/2023-07-21T030437Z/r/image-tiff

). Of note, the patient was interested in returning to the spectacle independence he enjoyed in the past.

Ocular examination revealed a corrected distance visual acuity (CDVA) of 20/30 in the right eye and 20/60 in the left eye, with a manifest refraction of +4.50 −0.50 × 177 in the right eye and +5.75 −1.75 × 14 in the left eye. Glare testing was 20/50 in the right eye and 20/100 in the left eye, with retinal acuity meter testing of 20/25 in each eye. Pupils, confrontation visual fields, and intraocular pressures were normal. Pertinent slitlamp examination revealed corneal findings of 8-cut RK with nasal-gaping arcuate incisions in both eyes and lens findings of 2+ nuclear sclerosis with 2+ cortical changes in the right eye and 3+ nuclear sclerosis with 3+ cortical changes in the left eye. Cup-to-disc ratios of the optic nerves measured 0.5 with temporal sloping in the right eye and 0.6 with temporal sloping in the left eye. The dilated fundus examination was unremarkable.

What intraocular lens (IOL) options would you offer this patient and how would you counsel regarding realistic expectations? What additional diagnostic testing would be helpful in your assessment? How would you calculate the IOLs?
Effect of Exercise Rehabilitation in Patients With Acute Heart Failure
Authors: Liang Qian , Wang Zhiwei , Liu Jian , Yan Zeping , Liu Jing , Lei Meirong , Zhang Hongwei , Luan Xiaorong
Published: July 2023

Background

Exercise rehabilitation is conducive to increasing functional ability and improving health outcomes, but its effectiveness in patients with acute heart failure (AHF) is still controversial.

Purpose

In this study, our aim was to systematically examine the efficacy of exercise rehabilitation in people with AHF.

Methods

A search was conducted for randomized controlled trial studies on exercise rehabilitation in patients with AHF up to November 2021. Two investigators conducted literature selection, quality assessments, and data extractions independently. The primary outcome was 6-minute walk distance, and the secondary outcomes were left ventricular ejection fraction, quality of life, Short Physical Performance Battery, readmission, and mortality. RevMan (version 5.3) software was used for the meta-analysis.

Results

Twelve studies with 1215 participants were included. Exercise rehabilitation significantly improved the 6-minute walk distance (mean difference [MD], 33.04; 95% confidence interval [CI], 31.37–34.70; P < .001; I
2 = 0%), quality of life (MD, −11.57; 95% CI, −19.25 to −3.89; P = .003; I
2 = 98%), Short Physical Performance Battery (MD, 1.40; 95% CI, 1.36–1.44; P < .001; I
2 = 0%), and rate of readmission for any cause (risk ratio, 0.48; 95% CI, 0.26–0.88; P = .02; I
2 = 7%), compared with routine care. However, no statistically significant effects on left ventricular ejection fraction (MD, 0.94; 95% CI, −1.62 to 3.51; P = .47; I
2 = 0%) and mortality (risk ratio, 1.07; 95% CI, 0.64–1.80; P = .79; I
2 = 0%) were observed.

Conclusions

Compared with routine care, exercise rehabilitation improved functional ability and quality of life, reducing readmission in patients with AHF.
Problems Paying Medical Bills Among Adults With Diagnosed HIV in the United States
Authors: Luna-Gierke Ruth E. , Tie Yunfeng , Yuan Xin , Luo Qingwei , Beer Linda , Dasgupta Sharoda
Published: July 2023

Problems paying medical bills may affect HIV outcomes among people with HIV (PWH), thus limiting progress toward achieving national HIV prevention goals. We analyzed nationally representative data from CDC's Medical Monitoring Project collected during 6/2018–5/2020. Among 8,108 PWH, we reported weighted percentages of characteristics and examined associations between problems paying medical bills and clinical outcomes using prevalence ratios with predicted marginal means, adjusting for potential confounding. Nineteen percent of PWH reported problems paying medical bills. Problems paying medical bills were more prevalent among persons who experienced homelessness (26.9% vs. 18.3%). People with problems paying medical bills were more likely to have adverse HIV outcomes and were more likely to have ≥1 emergency room visit (prevalence ratio [PR]: 1.59; 95% CI [1.51–1.68]) or hospitalization (PR: 1.72; 95% CI [1.55–1.91]) in the past year. Identifying PWH experiencing financial barriers and expanding access to safety net programs could improve access to care and outcomes.
Affordable Care Act Medicaid expansion associated with increased liver transplant waitlist access without worsening mortality
Authors: Wahid Nabeel , Lee Jihui , Rosenblatt Russell , Kaplan Alyson , Tipirneni Renuka , Fortune Brett E. , Safford Monika , Brown Robert S.
Published: July 2023

It is unclear what impact Affordable Care Act (ACA) Medicaid expansion has had on the liver transplantation (LT) waitlist. We aimed to assess associations between ACA Medicaid expansion and LT waitlist outcomes. The United Network for Organ Sharing Standard Transplant Analysis and Research (UNOS STAR) database was queried for patients listed for LT between January 1, 2009, and December 31, 2018. Our primary outcome was waitlist mortality and our secondary outcomes included Medicaid use on the LT waitlist and transplant rate. States were divided into groups based on their expansion status and the study period was divided into 2 time intervals—pre-expansion and post-expansion. Difference-in-difference (DiD) models were created to assess the impacts of expansion on each of the outcomes and for racial/ethnic and sex groups. In total, 56,414 patients from expansion states and 32,447 patients from nonexpansion states were included. Three-year waitlist mortality decreased at a similar rate in both cohorts [DiD estimate: 0.1, (95% CI, −1.1, −1.4), p = 0.838], but Medicaid use increased [DiD estimate: +7.7, (95% CI, 6.7, 8.7), p < 0.001] to a greater degree in expansion states after expansion than nonexpansion states. Between the 2 time intervals, Medicaid use on the LT waitlist increased from 19.4% to 26.1% in expansion states but decreased from 13.4% to 12.1% in nonexpansion states. In patients on Medicaid, there was a slight increase in the 3-year transplant rate associated with Medicaid expansion [DiD estimate +5.0, (95% CI, 1.8, 8.3), p = 0.002], which may in part be explained by differences in patient characteristics. Medicaid expansion was associated with increased Medicaid use on the LT waitlist without worsening overall waitlist mortality or transplant rate, suggesting that lenient and widespread public health insurance may increase access to the LT waitlist without adversely affecting outcomes.
Donor-derived disorders of hemostasis and thrombosis in liver transplantation: Considerations for deceased donor liver selection
Authors: Atthota Srilakshmi , MacDonald Anne , Markmann James F. , Kuter David , Elias Nahel , Yeh Heidi , Dzik Walter H. , Dageforde Leigh Anne
Published: July 2023

OLT is known to be associated with a precarious perioperative hemostatic state due to dysregulation of procoagulant and anticoagulant factors, endothelial injury, and inflammation. Transmission of inherited bleeding and clotting disorders from the liver donor to the recipient may further complicate hemostasis during and after transplantation. As a result, consideration of congenital coagulation disorders in the liver donor is a practical concern for donor selection. However, there is no clear consensus regarding the selection of donors with known or suspected thrombophilia or bleeding disorders. While multiple case reports and retrospective studies, subject to reporting bias, describe donor-derived thrombophilic and bleeding disorders, there are no large-scale studies in the adult liver transplant literature that examine the frequency of transmission, utility of donor screening, or clinical impact of donor hemostatic disorders. Based on the reported literature, we summarize our approach for donor selection with an aim to balance improved organ utility and optimal post-transplant outcomes.
Pharmacologic Procedural Distress Management During Laceration Repair in Children
Authors: Siu Annisa , Tran Nam-Anh , Ali Samina , Coyle Doug , Mahood Quenby , Marks Yanara , Pechlivanoglou Petros , Poonai Naveen , Heath Anna
Published: July 2023

Objectives

To systematically appraise the literature on the relative effectiveness of pharmacologic procedural distress management agents for children undergoing laceration repair.

Methods

Six databases were searched in August 2021, and the search was updated in January 2023. We included completed randomized or quasi-randomized trials involving (a) children younger than 15 years undergoing laceration repair in the emergency department; (b) randomization to at least one anxiolytic, sedative, and/or analgesic agent versus any comparator agent or placebo; (c) efficacy of procedural distress management measured on any scale. Secondary outcomes were pain during the procedure, administration acceptance, sedation duration, additional sedation, length of stay, and stakeholder satisfaction. Cochrane Collaboration's risk-of-bias tool assessed individual studies. Ranges and proportions summarized results where applicable.

Results

Among 21 trials (n = 1621 participants), the most commonly studied anxiolytic agents were midazolam, ketamine, and N2O. Oral midazolam, oral ketamine, and N2O were found to reduce procedural distress more effectively than their comparators in 4, 3, and 2 studies, respectively. Eight studies comparing routes, doses, or volumes of administration of the same agent led to indeterminate results. Meta-analysis was not performed because of heterogeneity in comparators, routes, and outcome measures across studies.

Conclusions

Based on procedural distress reduction, this study favors oral midazolam and oral ketamine. However, this finding should be interpreted with caution because of heterogeneous comparators across studies and minor conflicting results. An optimal agent for procedural distress management cannot be recommended based on the limited evidence. Future research should seek to identify the minimal, essential measures of patient distress during pharmacologic anxiolysis and/or sedation in laceration repair to guide future trials and reviews.
Contextualizing Response Rates During the COVID-19 Pandemic: Experiences From a Boston-Based Community Health Centers Study
Authors: LeBlanc Merrily E. , Testa Christian , Waterman Pamela D. , Reisner Sari L. , Chen Jarvis T. , Breedlove Emry R. , Mbaye Farimata , Nwamah Alicetonia , Mayer Kenneth H. , Oendari Apriani , Krieger Nancy
Published: July 2023

Objectives:

The focus of this study was to calculate and contextualize response rates for a community-based study conducted during the COVID-19 pandemic, a topic on which scant data exist, and to share lessons learned from recruiting and enrolling for implementation of future studies.

Design:

The Life+Health Study, a cross-sectional population-based study designed to advance novel methods to measure and analyze multiple forms of discrimination for population health research.

Setting:

The study recruited participants from 3 community health centers in Boston, Massachusetts, between May 2020 and July 2022.

Participants:

A total of 699 adult participants between the ages of 25 and 64 years who were born in the United States and had visited one of the health centers within the last 2 years.

Main Outcome Measures:

The response rate was calculated as follows: (number of completions + number of dropouts)/(dropouts + enrollments). To contextualize this response rate, we synthesized evidence pertaining to local COVID-19 case counts, sociopolitical events, pandemic-related restrictions and project protocol adjustments, and examples of interactions with patients.

Results:

Our study had a lower-than-expected response rate (48.4%), with the lowest rates from the community health centers serving primarily low-income patients of color. Completion rates were lower during periods of higher COVID-19 case counts. We describe contextual factors that led to challenges and lessons learned from recruiting during the pandemic, including the impact of US sociopolitical events.

Conclusions:

The Life+Health Study concluded recruitment during the pandemic with a lower-than-expected response rate, as also reported in 4 other US publications focused on the impact of COVID-19 on response rates in community-based studies. Our results provide an example of the impact of the pandemic and related US sociopolitical events on response rates that can serve as a framework for contextualizing other research conducted during the pandemic and highlight the importance of best practices in research recruitment with underserved populations.
MPOWER Measures and Its Effect on Tobacco Control: A Cross-sectional Comparison of Global Adult Tobacco Surveys, India
Authors: Pednekar Mangesh S. , Sharma Khushbu , Narake Sameer
Published: July 2023

Objectives:

To study the MPOWER measures over time (GATS-1 vs GATS-2) and their effects on tobacco control indicators in India.

Study Design and Methods:

The study used a cross-sectional design to compare the common questions identified from GATS-1 and GATS-2. Odds ratios for various MPOWER measures were estimated using a multivariate logistic regression model.

Results:

Compared with GATS-1, the current any tobacco use was reduced by 32% in females and 17% in males in GATS-2 (M-measures). The P-measures have reduced across the survey periods. Under O-measures, compared with mixed users, only the male smokeless tobacco (SLT) users reported receiving more advice from a doctor to quit and reported trying more to stop SLT use. Compared with never users (W-measures), the health warnings were noticed on SLT products more by past users, smokers (males), and SLT users, while it was noticed on cigarette packages more by male past users and smokers. Promotion (E-measures) of cigarette and bidi was reported more by smokers (including mixed users), and promotion of SLT product was reported more by smokers (including mixed users) and male SLT users than by never users.

Conclusion:

Overall, MPOWER measures have shown improvement, with most changes highly reported by the never users and past users than by the current tobacco users. Stringent methods for the enforcement of MPOWER measures to reach all forms of tobacco users and integration of the National Tobacco Control Programme with other national health programs are imperative for highest achievements. Also, specific targeted strategies for the effective control of SLT use are highly recommended to be included in the MPOWER package.
NYS Nonprofit Hospital Assessment and Response to Environmental Pollution as Community Health Need: Prevalence in Community Benefit Practices
Authors: Valentine Sarah K. , Jacelon Cynthia S. , Cavanagh Stephen J.
Published: July 2023

Context:

Given the impact of environmental pollution on health and health inequity, there may be substantial value in integrating assessment and response to pollution into nonprofit hospital community benefit processes. Such hospital engagement has not yet been studied.

Objectives:

We take a preliminary step of inquiry in investigating if nonprofit hospitals in New York State (NYS) assess, identify, or respond to environmental pollution as part of community benefit processes.

Design:

This study is of retrospective, observational design. Data were abstracted from community health needs reports (2015-2017), associated implementation plans, and related IRS (Internal Revenue Service) filings from a randomly geographically stratified selection of NYS nonprofit hospitals.

Participants:

The sample includes 53 hospitals from 23 counties. The sampling frame consists of NYS nonspecialty private nonprofit hospitals.

Main Outcome Measures:

Dichotomous findings for the following: (1) engagement of environmental pollution in the process of assessment of community health needs; (2) environmental pollution concern identified as a priority community health need; (3) strategic planning present to address pollution identified as community health need; and (4) action taken on same.

Results:

We found that 60.5% (95% confidence interval [CI], 0.46-0.74) of hospitals evidenced some form of assessment of environmental pollution and 18.9% (95% CI, 0.09-0.32) identified pollution as a priority community health need. However, no hospital went on to take independent or collaborative planning or action to address pollution. In additional analysis, we found that social justice in hospital mission was a positive predictor of assessment of environmental pollution.

Conclusions:

For NYS hospitals, we found a substantial presence of assessment and identification of pollution as a community health concern. Our finding of the absence of response to environmental pollution represents a gap in community benefit implementation. This indicates a yet untaken opportunity to address racial and economic environmental health injustices and to improve population health.
Early Effects of the New York City Paid Safe and Sick Leave Law
Authors: Maury Matthew , Slopen Meredith , Lim Sungwoo , Levanon Seligson Amber , Waldfogel Jane , Wimer Christopher
Published: July 2023

Context:

Paid sick leave (PSL) is a public health strategy associated with benefits for workers, businesses, and consumers. In the absence of a federal law, in 2014, New York City (NYC) joined other state and municipal governments with local PSL policies.

Objectives:

To examine changes in PSL after the implementation of NYC's 2014 Paid Safe and Sick Leave Law and to assess which communities remain less likely to use PSL.

Design:

This study uses data from multiple panels of the NYC Longitudinal Survey of Wellbeing (NYC-LSW)—a population-representative study of NYC adults—to track changes in PSL, using data collected before and after NYC's Paid Safe and Sick Leave Law was implemented. We use weighted cross-tabulations and multinomial logistic regression models to assess changes in payment for sick leave since the implementation of the law.

Setting and Participants:

The study includes 2985 NYC adults aged 18 to 64 years who reported working for pay in the year preceding the survey where PSL questions were asked (2014-2019).

Main Outcome Measure(s):

Use of sick leave and payment for sick leave.

Results:

Weighted descriptive results show a 7-percentage-point increase (P = .02) in the rate of being paid for all sick days and a 6-percentage-point decrease (P = .02) in not being paid for any sick days. Results from multinomial logistic regression models, adjusting for potential confounders, show that after implementation of the law, workers with low levels of education, who are younger, Latino, and foreign-born remain less likely than their peers to use PSL.

Conclusions:

We demonstrate that the PSL mandate expanded access for employees but not evenly across groups. These results offer guidance to other jurisdictions implementing PSL policies, suggesting the need for targeted education and enforcement efforts to ensure policies reach sectors where low-wage workers are most prevalent.
Metastatic Pulmonary Desmoplastic Small Round Cell Tumor on FDG PET/CT
Authors: Hou Wenxiu , Dai Jiaona , Tian Rong
Published: July 2023

A 33-year-old woman presents with cough and hemoptysis for 1 month. Chest CT showed a soft tissue mass in the left upper lobe of the lung. FDG PET/CT showed multiple foci of intense activity not only in the lung but also in the lymph nodes and the bones, which was diagnosed as lung malignancy with metastases. Histopathology revealed desmoplastic small round cell tumor. Our case indicated that, although the incidence is low, desmoplastic small round cell tumor should be considered among differential diagnoses of lung malignancies.
99mTc-MIBI SPECT/CT in a Case of Renal Oncocytosis
Authors: Zhao Qian , Dong Aisheng , Zuo Changjing , Yang Bo
Published: July 2023

Renal oncocytosis is a very rare oncologically indolent form of renal neoplasia characterized by diffuse involvement of renal parenchyma by numerous oncocytic nodules. We describe contrast-enhanced CT and 99mTc-MIBI SPECT/CT findings in a patient with renal oncocytosis presenting with metachronous bilateral renal tumors. Contrast-enhanced CT showed numerous tumors ranging from several millimeters up to 3.9 cm in the left kidney. The tumors showed hypervascularity in the corticomedullary phase and washout in the excretory phase mimicking renal cell carcinoma. The larger tumors showed higher 99mTc-MIBI uptake than the adjacent renal parenchyma, suggesting renal oncocytoma confirmed by biopsy.
The Influence of Long-Acting Somatostatin Analogs on 68Ga-DOTATATE Uptake in Patients With Neuroendocrine Tumors
Authors: Chahid Youssef , Hashimi Khaled , van de Garde Ewoudt M.W. , Klümpen Heinz-Josef , Hendrikse N. Harry , Booij Jan , Verberne Hein J.
Published: July 2023

Purpose

A high SUVmax tumor-to-liver ratio (TLR) of 68Ga-DOTATATE can be used to select patients with neuroendocrine tumors (NETs) for peptide receptor radionuclide therapy (PRRT). In addition, an SUVmax TLR ≥ 8.1 is associated with increased progression-free survival in NET patients treated with somatostatin analogs (SSAs). To avoid a theoretical interaction, several guidelines recommend performing PET/CT just before the monthly administration of long-acting SSAs. We aimed to investigate the effect of SSA on the SUVmax of 68Ga-DOTATATE in patients with NET and to identify independent predictors for high SUVmax TLR.

Patients and Methods

For this retrospective study, 192 68Ga-DOTATATE PET/CT scans of 165 patients without (n = 115) and with (n = 77) SSA (octreotide or lanreotide) in the 3 months before PET/CT were collected and reviewed. The effect of SSA on SUVmax values was analyzed by a maximum likelihood mixed model.

Results

Patients with SSA had a significantly higher median SUVmax TLR than patients without SSA (4.7 [IQR], 3.1–7.7) versus 3.2 [IQR, 2.0–5.4]; P < 0.001). Multivariable logistic regression analysis showed that SSA use was an independent predictor for SUVmax TLR ≥ 8.1 (odds ratio, 2.91; 95% confidence interval, 1.26–6.72; P = 0.012).

Conclusions

Our data suggest that higher SSA concentrations do not have a negative effect on 68Ga-DOTATATE uptake in tumor lesions. In addition, we found that only SSA use was associated with SUVmax TLR ≥ 8.1. Our results are consistent with previously conducted studies and in line with the recently published guideline that suggests that the relatively recent use of SSA does not necessitate any delay in 68Ga-DOTATATE PET/CT imaging.
18F-FDG PET/CT Reveals Localized Inflammation in Lupus Enteritis
Authors: Sakuma Shota , Abe Yoshiyuki , Takeuchi Motoki , Makiyama Ayako , Tamura Naoto
Published: July 2023

Lupus enteritis is classified into the colon poly-ulcerative type and the small intestine ischemic serositis type. Colon poly-ulcerative lupus enteritis is a disease that is mainly due to mesenteric arteritis. In recent years, 18F-FDG PET/CT has been frequently used to assess the extent of the disease in patients with systemic vasculitis. We present the case report of 18F-FDG PET/CT results in a 57-year-old woman with colon poly-ulcerative lupus enteritis.
Extraction of a Severe Impacted Submerged Second Deciduous Molar: A Case Report
Authors: Yang Yong , Hu Jiale , Ying Binbin
Published: July 2023

Objectives:

Provide some references for diagnosis and treatment of submerged deciduous teeth.

Case Report:

Here the authors reported a severely impacted submerged second deciduous molar accompanied by an impacted second premolar by detailed consultation, oral examination, and radiological analysis. The impacted teeth were both extracted considering the patient's age, the position of the teeth, and orthodontic purposes.

Conclusions:

Dentists should analyze the inspection results seriously and choose the optimal decision for submerged deciduous teeth.
Treatment of Sagittal Fracture of the Zygomatic Arch Root
Authors: Lee Jung Ho , Ryu Jeong Yeop , Lee Joon Seok , Yang Jung Dug , Chung Ho Yun , Cho Byung Chae , Choi Kang Young
Published: July 2023

A sagittal fracture at the temporal root of the zygomatic arch (ZAR) often occurs as a component of zygomaticomaxillary complex (ZMC) fractures. However, this area is difficult to access, and anchorage is limited due to the unstable structure around it. Therefore, a preauricular approach using single-screw fixation is proposed, and this study reports its results and usefulness. Forty-four patients with sagittal fractures of ZAR occurring with ZMC fractures were evaluated from 2012 to 2021. Open reduction and internal fixation were performed on all patients with ZMC fractures. Closed reduction using Dingman incision and external finger pressure in group A (indirect approach; 30 patients) and single-screw fixation using a preauricular approach in group B (direct approach; 14 patients) were performed to address sagittal fractures in ZAR. For single-screw fixation, the additional mean operation time was 11.34±3.25 minutes. On postoperative 3-dimensional computed tomography and plain radiographs, group B showed more accurate reduction and less deformity and trismus (P<0.05). Moreover, a normal diet was initiated more quickly in group B than in group A (P<0.05). Some cases in group A showed nonunion or malunion. This study revealed that a direct approach (group B) toward sagittal fractures of ZAR is recommended due to more accurate results and fewer complications than those observed with the indirect approach (group A). Moreover, the total operation time and complications may be lesser than those with the bicoronal approach.
Factors Affecting Complete Oral Rehabilitation in Patients With Vascularized Free Fibula Flap Mandibular Reconstruction: A 10-Year Retrospective Study
Authors: Oldén Alexandra , Wamalwa Alex O. , Jonsson Eva Lindell , Thor Andreas , Lorenzo Andrés Rodriguez
Published: July 2023

The fibula is the preferred bone flap for mandibular reconstructions due to its many advantages, including the possibility to insert dental implants. All patients who received a mandibular reconstruction with a vascularized free fibula flap at the Uppsala University Hospital between 2009 and 2019 were retrospectively examined regarding the proportion of implant insertion and factors that affected implant outcome. Forty-one patients had 42 fibula flap reconstructions. Eleven patients (27%) received dental implants and 8 (20%) completed dental rehabilitation. Patient death and cancer recurrence were the main reasons for not receiving implants. The survival rates of implants placed in irradiated and nonirradiated fibulas were 15% and 76%, respectively. Less than 20% of reconstructed patients received an implant-supported prosthesis. Implants placed in an irradiated fibula should be considered at high risk for implant loss.
Craniofacial Epidermoid and Dermoid Cysts
Authors: Oh Hyun Jun , Eo Mi Young , Sodnom-Ish Buyanbileg , Amponsah Emmanuel Kofi , Frimpong Paul , Myoung Hoon , Kim Soung Min
Published: July 2023

Background:

Epidermoid and dermoid cysts are benign developmental anomalies that can form anywhere in the body. Despite the rarity of incidence in the head and neck, they can arise at a variety of craniofacial locations. The purpose of this study was to analyze the clinical features of epidermoid and dermoid cysts arising in the craniofacial region with a literature review.

Methods:

A retrospective study was designed, and clinical features and surgical considerations were investigated from a literature review. Cases of epidermoid cysts in the scalp, temporal area, glabellar area, mouth floor, and buccal mucosa were described.

Results:

Dermoid cysts in more lateral regions of the scalp are rarely associated with intracranial extension. Because temporal dermoid cysts have a high rate of intracranial extension, radiological evaluation of the lesions in the temporal area is imperative. Epidermoid cysts in the glabellar area are usually superficial. Consideration of the surgical approach for an epidermoid cyst of the mouth floor is important. Because epidermoid cysts in the buccal mucosa are extremely rare, differential diagnosis was emphasized. Epidermoid cysts in the scalp, in the temporal intradiploic area, on the glabellar area in the periorbital region, in the mouth floor, and in the buccal mucosa were surgically excised considering the depth and location. Ten cases of epidermoid cysts in the buccal mucosa were retrieved from the literature review.

Conclusions:

Consideration of the anatomic locations of epidermoid and dermoid cysts in the craniofacial region might help facilitate accurate diagnosis and treatment.
A Simple and Minimal Invasive Method in Reduction of Depressed Nasal Bone Fracture by Using a Foley Catheter Ballooning Technique
Authors: Xue Ke , Liu Kai , Qi Lin
Published: July 2023

The nasal bone fracture is the most common type of facial bone fracture. Closed reduction with metal reduction instrument is commonly conducted for the treatment of a type II nasal bone fracture. The authors defined a new catheter dilation technique and used it in patients with type II depressed nasal bone fractures. Preoperative and postoperative nasal appearance and radiologic examination of the patients were compared. There was a statistically significant improvement in the nasal appearance of all patients. No recurrence or dorsal irregularity has been observed. This new, easily applicable catheter dilation method of closed reduction may be a simple and less invasive solution to treat type II nasal bone fractures.
Comparison of Outcomes between Surveillance Ultrasound and Completion Lymph Node Dissection in Children and Adolescents with Sentinel Lymph Node Positive Cutaneous Melanoma
Authors: Scoville Steven D. , Stanek Joseph R. , Rinehardt Hannah , Sutthatarn Pattamon , Abdelhafeez Abdelhafeez H. , Talbot Lindsay J. , Malek Marcus , Leraas Harold J. , Tracy Elisabeth T. , Chen Stephanie Y. , Kim Eugene S. , Lotakis Dimitra M. , Ehrlich Peter F. , Favela Juan G. , Le Hau D. , Davidson Jacob , Wilson Claire A. , Seemann Natashia M. , Osman Yasmin , Piche Nelson , Hoang Victoria , Petroze Robin T. , Polites Stephanie F. , McKay Katlyn G. , Correa Hernan , Lovvorn Harold N. , Lee Yu M. , Balagani Akshitha , Dasgupta Roshni , Aldrink Jennifer H.
Published: July 2023

Objective:

To determine the impact of nodal basin ultrasound surveillance (US) versus completion lymph node dissection (CLND) in children and adolescents with sentinel lymph node (SLN) positive melanoma

Summary of Background Data:

Treatment for children and adolescents with melanoma are extrapolated from adult trials. However, there is increasing evidence that important clinical and biological differences exist between pediatric and adult melanoma.

Methods:

Patients ≤18 years diagnosed with cutaneous melanoma between 2010-2020 from 14 pediatric hospitals were included. Data extracted included demographics, histopathology, nodal basin strategies, surveillance intervals, and survival information.

Results:

Of 252 patients, 90.1% (n=227) underwent SLN biopsy (SLNB), 50.9% (n=115) had at least 1 positive node. 67 total patients underwent CLND with 97.0% (n=65/67) performed after a positive SLNB. In contrast, 46 total patients underwent US observation of nodal basins with 78.3% (n=36/46) of these occurring after positive SLNB. Younger patients were more likely to undergo US surveillance (median age 8.5 years) than CLND (median age 11.3 years; P=0.0103). Overall, 8.9% (n=21/235) experienced disease recurrence: 6 primary, 6 nodal, and 9 distant. There was no difference in recurrence (11.1% vs 18.8%; P=0.28) or death from disease (2.2% vs 9.7%; P=0.36) for those who underwent US vs CLND, respectively.

Conclusions:

Children and adolescents with cutaneous melanoma frequently have nodal metastases identified by SLN. Recurrence was more common among patients with thicker primary lesions and positive SLN. No significant differences in oncologic outcomes were observed with US surveillance and CLND following the identification of a positive SLN.
Improving Surgical Outcomes in Pelvic Exenteration Surgery
Authors: van Kessel Charlotte S. , Waller Jacob , Steffens Daniel , Lee Peter J. , Austin Kirk K.S. , Stalley Paul D. , Solomon Michael J.
Published: July 2023

Objective:

To assess the effect of changing our sacrectomy approach from prone to anterior on surgical and oncological outcomes.

Background:

In patients with advanced pelvic malignancy involving the sacrum, pelvic exenteration (PE) with en-bloc sacrectomy is the only potential curative option but morbidity is high. Over time sacrectomy techniques have evolved from prone sacrectomy (PS) to abdominolithotomy sacrectomy (ALS,

S3) and high anterior cortical sacrectomy (HACS, >S3) to optimize surgical outcomes.

Methods:

A retrospective, single institution analysis of prospectively collected data for patients undergoing PE with en-bloc sacrectomy between 1994 and 2021 was performed.

Results:

363 patients were identified and divided into PS (n=77, 21.2%), ALS (n=247, 68.0%) and HACS (n=39, 10.7%). Indications were: locally advanced (n=92) or recurrent (n=177) rectal cancer, primary other (n=31), recurrent other (n=60) and benign disease (n=3). PS resulted in longer operating time (P<0.01) and more blood loss (P<0.01). Patients with HACS had more major nerve (87.2%) and vascular (25.6%) resections (P<0.01). VRAM flap repair was less common following HACS (7.7%) than ALS (25.5%) and PS (27.3%) (P=0.040). R0 rate was 80.8%, 65.8% and 76.9% following ALS, PS and HACS, respectively (P=0.024). Wound-related complications and re-operations were significantly reduced following ALS and HACS compared to PS.

Conclusion:

Changing our practice from PS to an anterior approach with ALS or HAS has been safe and improved overall surgical and peri-operative outcomes, while maintaining good oncological outcomes. Given the improved peri-operative and surgical outcomes, it would be important for surgeons to learn and adopt the anterior sacrectomy approaches.
Reactive oxygen species: role in obesity and mitochondrial energy efficiency
Authors: Corkey Barbara E.
Published: July 2023

Changes correlating with increasing obesity include insulin resistance, hyperlipidaemia, hyperinsulinaemia, highly processed food and environmental toxins including plastics and air pollution. The relationship between the appearance of each of these potential causes and the onset of obesity is unknown. The cause(s) must precede obesity, the consequence, and temporally relate to its rising incidence. Macronutrients such as carbohydrates or fats are unlikely to cause obesity since these have long been constituents of human diets. Furthermore, food consumption and body weight have been well-regulated in most humans and other species until recent times. Thus, attention must focus on changes that have occurred in the last half-century and the relationship between such changes and specific populations that are impacted. The hypothesis presented here is that substances that have entered our bodies recently cause obesity by generating false and misleading information about energy status. We propose that this misinformation is caused by changes in the oxidation–reduction (redox) potential of metabolites that circulate and communicate to organs throughout the body. Examples are provided of food additives that generate reactive oxygen species and impact redox state, thereby, eliciting inappropriate tissue-specific functional changes, including insulin secretion. Reversal requires identification, neutralization, or removal of these compounds.

This article is part of a discussion meeting issue ‘Causes of obesity: theories, conjectures and evidence (Part I)’.
Fat-free mass and resting metabolic rate are determinants of energy intake: implications for a theory of appetite control
Authors: Hopkins Mark , Gibbons Catherine , Blundell John
Published: July 2023

Any explanation of appetite control should contain a description of physiological processes that could contribute a drive to eat alongside those that inhibit eating. However, such an undertaking was largely neglected until 15 years ago when a series of independent research programmes investigated the physiological roles of body composition and appetite. These outcomes demonstrated that fat-free mass (FFM), but not fat mass, was positively associated with objectively measured meal size and energy intake (EI). These findings have been accompanied by demonstrations that resting metabolic rate (RMR) is also positively associated with EI, with the influence of FFM largely mediated by RMR. These findings re-introduce the role of drive into models of appetite control and indicate how this can be integrated with processes of inhibition. The determinants of EI fit into an evolutionary perspective in which the energy demands of high metabolic rate organs and skeletal tissue constitute a need state underlying a tonic drive to eat. This approach should lead to the development of integrated models of appetite that include components of body composition (FFM) and energy expenditure (RMR) as tonic biological signals of appetite alongside other traditional tonic (adipose tissue derived) and episodic signals (gastrointestinal tract derived).

This article is part of a discussion meeting issue ‘Causes of obesity: theories, conjectures and evidence (Part I)’.
From dearth to excess: the rise of obesity in an ultra-processed food system
Authors: Hall Kevin D.
Published: July 2023

More people now have obesity than suffer from starvation thanks to our modern food system. Agriculture was transformed over the 20th century by a variety of technological advancements that relied heavily on fossil fuels. In the United States, government policies and economic incentives led to surplus production of cheap inputs to processed food industries that produced a wide variety of heavily marketed, convenient, rewarding, timesaving, and relatively inexpensive ultra-processed foods. The energy available in the food supply increased by much more than the population needs, albeit with large inequities in nutrition security. While most of the rise in
per capita
food availability during the late 20th and early 21st centuries in the United States resulted in increased food waste, a variety of mechanisms have been proposed by which changes in the increasingly ultra-processed food environment resulted in excess energy intake disproportionately in people genetically susceptible to obesity. As populations continue to grow, substantial investments in coordinated nutrition and agricultural research are needed to transform our current food system to one that relies less on fossil fuels, preserves biodiversity, ensures environmental health, and provides equitable access to affordable, safe and nutritious food that reduces the prevalence of chronic diet-related diseases like obesity.

This article is part of a discussion meeting issue ‘Causes of obesity: theories, conjectures and evidence (Part I)’.