bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hidradenocarcinoma of the Chest With Axillary Lymph Node Metastasis: Report of 2 Cases and Systematic Literature Review of a Breast Cancer Mimicker
Authors: Fortarezza Francesco , Maggioni Giuseppe , Colagrande Anna , Cazzato Gerardo , Dei Tos Angelo Paolo 
Published: December 2024

Abstract:
Hidradenocarcinoma (HAC) is a rare malignant neoplasm originating from eccrine sweat glands, often presenting diagnostic challenges because of its resemblance to other malignancies, particularly breast cancer when occurring in the chest region. This report describes 2 cases of HAC with axillary lymph node metastasis, both initially misinterpreted clinically. The first case involved a 63-year-old woman with a sternal mass, near the right breast, initially suspected to be a sebaceous cyst. Histologic examination revealed a solid-cystic epithelial tumor with features suggestive of HAC, confirmed by immunohistochemical analysis. The second case concerned an 81-year-old woman with a subcutaneous growth in the sternal area, also diagnosed as HAC after histopathologic and immunohistochemical assessment. Both cases demonstrated strong estrogen receptor positivity, leading to the recommendation of hormonal therapy. A systematic review of the literature identified 21 similar cases of HAC in the chest wall, highlighting the diagnostic complexities and the potential for these tumors to mimic breast carcinoma. This review underscores the need for careful histologic and immunohistochemical evaluation to differentiate HAC from other malignancies, particularly in the breast region. Given the rare and the potential aggressive nature of HAC, early and accurate diagnosis is crucial for guiding appropriate therapeutic strategies and improving patient outcomes.
The Prognostic Significance of Tumor Budding and Tumor-Infiltrating Lymphocytes in Patients Diagnosed With Malignant Melanoma
Authors: Yavuz Ayşen , Şimşek Kübra , Başsorgun Cumhur İbrahim , Elpek Gülsüm Özlem , Ünal Betül 
Published: December 2024

Abstract:
The tumor microenvironment plays a critical role in malignant melanoma, influencing progression and patient outcomes, particularly through tumor budding (TB) and tumor-infiltrating lymphocytes (TILs). Despite the importance of TB, its detailed impact still needs to be explored, especially its interaction with TILs. This study evaluates the prognostic significance of TB and TILs in malignant melanoma, assessing their potential as indicators for disease progression and survival. Conducted at Akdeniz University, the research included 92 patients diagnosed between 2014 and 2021. TB was evaluated according to the International Tumor Budding Consensus Conference guidelines, and TILs were assessed by the International Immuno-Oncology Biomarker Working Group standards. The analysis revealed significant correlations between TB and the level of anatomic invasion, Breslow thickness, satellite nodules, lymph node metastasis, distant metastasis, and stage (P < 0.05). A notable inverse relationship between TB and intratumoral TILs suggested their different roles in tumor progression. Tumor subtype, level of anatomic invasion, satellite nodules, lymphovascular invasion, lymph node metastasis, distant metastasis, stage, TILs, and TB were significant risk factors associated with poor prognosis (P < 0.005). Multivariate Cox regression identified histologic subtype and TB >10 as independent prognostic factors, underscoring the need for further research to integrate TB and TILs into clinical practice for better patient management and treatment planning.
Life-course exposure to air pollution and the risk of dementia in the Lothian Birth Cohort 1936
Authors: Jutila Otto-Emil I. , Mullin Donncha , Vieno Massimo , Tomlinson Samuel , Taylor Adele , Corley Janie , Deary Ian J. , Cox Simon R. , Baranyi Gergő , Pearce Jamie , Luciano Michelle , Karlsson Ida K. , Russ Tom C. 
Published: December 2024

Background:
Air pollution in later life has been associated with dementia; however, limited research has investigated the association between air pollution across the life course, either at specific life periods or cumulatively. The project investigates the association of air pollution with dementia via a life-course epidemiological approach.

Methods:
Participants of the Lothian Birth Cohort, born in 1936, provided lifetime residential history in 2014. Participant’s air pollution exposure for time periods 1935, 1950, 1970, 1980, 1990, 2001, and 2007 was modeled using an atmospheric chemistry transport model. Lifetime cumulative exposures were calculated as time-weighted mean exposure. Of 572 participants, 67 developed all-cause dementia [35 with Alzheimer's dementia (AD)] by wave 5 (~82 years). Cox proportional hazards and competing risk models assessed the association between all-cause dementia and AD with particulate matter (diameter of ≤2.5 µm) PM2.5 and nitrogen dioxide (NO2) exposure at specific life periods and cumulatively. False discovery rate (FDR) correction was applied for multiple testing.

Results:
The mean follow-up was 11.26 years. One standard deviation (SD) higher exposure to air pollution in 1935 (PM2.5 = 14.03 μg/m3, NO2 = 5.35 μg/m3) was positively linked but not statistically significant to all-cause dementia [PM2.5 hazard ratio (HR) = 1.16, 95% confidence interval (CI) = 0.90, 1.49; NO2 HR = 1.13, 95% CI = 0.88, 1.47] and AD (PM2.5 HR = 1.38, 95% CI = 1.00, 1.91; NO2 HR = 1.35, 95% CI = 0.92, 1.99). In the competing risk model, one SD elevated PM2.5 exposure (1.12 μg/m3) in 1990 was inversely associated with dementia (subdistribution HR = 0.82, 95% CI = 0.67, 0.99) at P = 0.034 but not after FDR correction (P
FDR = 0.442). Higher cumulative PM2.5 per one SD was associated with an increased risk of all-cause dementia and AD for all accumulation models except for the early-life model.

Conclusion:
The in-utero and early-life exposure to PM2.5 and NO2 was associated with higher AD and all-cause dementia risk, suggesting a sensitive/critical period. Cumulative exposure to PM2.5 across the life course was associated with higher dementia risk. Midlife PM2.5 exposure’s negative association with all-cause dementia risk may stem from unaddressed confounders or bias.
Clinical Efficacy and Safety of Vancomycin Based on Unbound Vancomycin Concentration Monitoring
Authors: Ren Fefei , Li Shan , Liu Yixin , Li Xiangchen , Wu Xikun , Zhang Zhiqing 
Published: December 2024

Objective:
To monitor total trough concentration (Cmin_total) and unbound trough concentration (Cmin_free) of vancomycin in clinical samples and analyze the factors influencing them, and to assess their correlation with clinical efficacy and acute kidney injury (AKI).

Methods:
Plasma samples were processed by protein precipitation, followed by hollow-fiber centrifugal ultrafiltration to separate unbound vancomycin from plasma. Thereafter, Cmin_total and Cmin_free were determined using high-performance liquid chromatography. Clinical data of patients were collected. Factors affecting vancomycin Cmin_total, Cmin_free, and their correlation with clinical efficacy and nephrotoxicity were investigated.

Results:
A total of 146 samples from 105 included patients were collected. Cmin_total and Cmin_free of vancomycin ranged from 0.62 to 56.08 mcg·mL−1 and 0.61–38.51 mcg·mL−1, respectively. Cmin_total and Cmin_free were correlated (r = 0.8899), influenced by basal creatinine and cystatin C. Higher level of Cmin_free (˃8.6 mcg·mL−1) and nephrotoxic drugs concomitant were risk factors of vancomycin-associated AKI (P < 0.05); Cmin_total and Cmin_free thresholds of vancomycin-associated AKI were 15.35 and 6.83 mcg·mL−1, respectively.

Conclusions:
vancomycin Cmin_total and Cmin_free, higher Cmin_total and Cmin_free were correlated and higher concentrations of both may increase the risk of AKI.
Unbound Ceftriaxone Concentrations in Plasma Measured Using Ultrafiltration Versus Equilibrium Dialysis: A Short Communication
Authors: Gijsen Matthias , Vanneste Dorian , Annaert Pieter , Debaveye Yves , Wauters Joost , Spriet Isabel 
Published: December 2024

Background:
Ceftriaxone is a first-line beta-lactam antibiotic used in diverse clinical settings. Owing to pharmacokinetic alterations, ceftriaxone therapeutic drug monitoring is currently recommended for patients in the intensive care unit. Ultrafiltration is typically used to measure unbound ceftriaxone concentrations, as it is less costly and time-consuming compared with equilibrium dialysis. However, the reference method, equilibrium dialysis, has not been compared with equilibrium dialysis for ceftriaxone to measure the unbound ceftriaxone concentrations. Therefore, unbound ceftriaxone fractions measured by ultrafiltration versus equilibrium dialysis were compared in patients in the intensive care unit.

Methods:
Total and unbound ceftriaxone plasma fractions were measured by ultrafiltration (9500g at 37°C for 30 minutes) and equilibrium dialysis (12 kDa, 37°C for 4 hours) in 32 plasma samples from 28 patients who were critically ill collected during a previous prospective pharmacokinetic study. Passing–Bablok regression and Bland–Altman analyses were performed to evaluate the agreements between both methods.

Results:
The median (range) total ceftriaxone plasma concentration was 108.6 (5.2–233) mg/L. The median unbound concentration measured by equilibrium dialysis and ultrafiltration was 14.5 (0.7–52.9) and 23.3 (0.9–79.2) mg/L, respectively, showing a significant difference. Passing–Bablok regression analysis revealed significant proportional and systematic bias. This result was confirmed by Bland–Altman analysis, with a mean relative bias of 43.3% and wide agreement limits (−21% to 108%).

Conclusions:
Ultrafiltration substantially overestimates the unbound ceftriaxone fraction compared with equilibrium dialysis at 37°C. It is important to report methodological details and consider this information when interpreting unbound fractions of ceftriaxone and other drugs. These findings may impact the therapeutic drug monitoring of ceftriaxone.
Prevalence and Severity of Corneal Guttata After Descemet Membrane Endothelial Keratoplasty
Authors: Rickmann Annekatrin , Darwisch Warda , Menkene Louise Massia , Wahl Silke , Szurman Peter , Thaler Sebastian , Bodenbender Jan-Philipp , Seitz Berthold , Roberts Philipp K. 
Published: December 2024

Purpose:
The postoperative occurrence of corneal guttae (CG) in patients after Descemet membrane endothelial keratoplasty (DMEK) can lead to a significant reduction in visual acuity (VA) with the subsequent need for repeat DMEK. Therefore, the aim of this study was to analyze the prevalence and clinical significance of CG in transplanted corneas after DMEK.

Methods:
The prevalence and progression of CG after DMEK of 1657 patients were examined using endothelial specular microscopy images. The severity grade of CG was classified into 3 grades (G1 <40%, G2 40-80%, G3 >80%). Central corneal thickness, VA, and endothelial cell density (ECD) were examined during a postoperative follow-up time of 19.5 ± 17.6 months (range 6–84 months).

Results:
The prevalence of CG postoperatively was 1.3% (22/1657 eyes) after 4-6 weeks. We could classify 15/22 (68%) as G1, 5/22 (23%) as G2, and 2/22 (9%) as G3. In 12/22 (55%), either preparation and/or implantation was conspicuously difficult. None of the eyes showed an increase in CG during follow-up. 21/22 were stable in VA, central corneal thickness, and ECD during the entire follow-up. One patient with G3 required a repeat DMEK after 12 months (secondary graft failure).

Conclusions:
The prevalence of CG in our study population was notably lower than previously described and was mainly characterized by mild, low-grade findings without clinical significance and were stable during the follow-up. Preoperative overlook of CG in the tissue bank cannot be completely excluded, but the remarkable proportion of intraoperative complications in this group may have led to the occurrence of these CG.
Validation of the Nurse Practitioner Knowledge and Attitudes of Patient Obesity Scale: A pilot study
Authors: Willenbrock Donna , Rose Sage 
Published: December 2024

ABSTRACT

Background:
Obesity is a chronic, complex, relapsing disease requiring medical intervention that has reached epidemic proportions globally. Most patients are still experiencing bias and stigma related to their disease—even by health care providers. Our goal in this pilot study is twofold: to develop a scale to accurately measure nurse practitioner knowledge and attitude regarding the disease of obesity to determine whether bias exists and to potentially identify gaps in knowledge that can be targeted with future educational interventions.

Purpose:
To determine whether nurse practitioners in the Northeast have less stigmatized knowledge and attitudes regarding obesity.

Methodology:
A survey was created by the primary investigator as the “Nurse Practitioner Knowledge and Attitudes of Patient Obesity Scale” and distributed through email to New York State Nurse Practitioner Association members. Questions explored knowledge related to treatment of the patient living with obesity and nurse practitioner attitudes toward the disease.

Results:
The sample (N = 45) was homogenous, which did not allow for generalization. Preliminary results show that a large percentage of respondents were aware of the definition of obesity as a disease and treatment guidelines. The scale met reliability and validity criteria and showed that Nurse Practitioners (NPs) with continuing education had more positive views.

Conclusions:
More research is needed to understand nurse practitioner knowledge and attitudes regarding the disease of obesity and the benefit of continuing education in reducing bias and stigma.

Implications:
This may serve to improve NP obesity continuing education.
Nutritional specificity of frailty: from epidemiological and clinical evidence to potential mechanisms
Authors: Lengelé Laetitia , de França Natasha A. Grande , de Souto Barreto Philipe , Rolland Yves 
Published: December 2024

Purpose of review
Considering the ageing of the population, age-related syndromes, such as frailty, are prominent. In this context, nutrition is a modifiable factor considered a key nonpharmacological approach to prevention and treatment. Yet, its contribution to the frailty pathophysiology is conflicting in the literature. This paper discusses the recent literature (January 2023–June 2024) on the implication of nutrition in frailty management.

Recent findings
Malnutrition is one of the main frailty risk factors. Proteins are the targeted macronutrient for their effects on muscle anabolism, not only in terms of quantity consumed but also in terms of sources. The diversity in plant and animal sources demonstrates better results than relying on a single source. More globally, anti-inflammatory and antioxidant diets are associated with a lower risk of frailty, like the Mediterranean Diet and specific food groups, like seafood, nuts, and seeds. Nutrition is pivotal in frailty prevention and treatment, and multidomain interventions providing exercises seem to yield even better results.

Summary
Diverse protein sources and anti-inflammatory and antioxidant diets associated with exercises are the primary recommendations for frailty prevention and treatment. However, there is a need to evaluate how to achieve and maintain this healthy behaviour in real life.
C1 lateral mass reconstruction using a titanium cage following total resection of the aneurysmal bone cyst: illustrative cases and literature insights
Authors: Ebrahimzadeh Kaveh , Mirahmadi Eraghi Mohammad , Hallajnejad Mohammad , Ansari Mohammad , Hoseini Tavassol Hesameddin , Mousavinejad Seyed Ali , Samadian Mohammad 
Published: December 2024

Introduction:
There are limited reports of C1 lateral mass reconstruction using a titanium mesh cage following the surgical removal of an aneurysmal bone cyst (ABC). We describe two uncommon and challenging cases of C1 ABC, highlighting the obstacles and complexities involved in selecting the appropriate approach for tumor resection, C1 stabilization, and reconstruction.

Case discussion:

Case 1: A 12-year-old boy presented with 3 months of progressive upper cervical and occipital pain with no history of trauma. A heterogeneous lytic lesion with fluid-fluid levels in the right lateral mass of the atlas was detected. A gross total resection(GTR) of the C1 lateral mass ABC was performed through a posterior approach, followed by constructing the C1 lateral mass.
Case 2
: An 11-year-old girl presented with cervical pain for the past 6 months. A cervical computed tomography (CT) scan without contrast revealed a lytic-expansile mass lesion with bony erosion in the right transverse process of the C1 vertebra. A similar surgical plan was tailored for this patient. A follow-up examination at 6 weeks demonstrated complete pain relief, and routine neurologic evaluations were uneventful.

Discussion:
ABCs are uncommon, non-malignant, and highly vascular tumors, accounting for approximately 1% of all bone tumors and 15% of primary spinal tumors. The treatment of choice in this region is total resection, followed by C1 reconstruction.

Conclusion:
C1 lateral mass reconstruction using an expandable cage with vertebral artery (VA) preservation is recommended for extensive C1 lateral mass resection due to ABC.
99mTc-Sestamibi SPECT/CT Evaluation of Renal Oncocytomas
Authors: Nelson Nadia , Eichhorn Joshua , Palot Manzil Fathima Fijula 
Published: December 2024

Abstract
We present 2 cases of the benign renal neoplasm, oncocytoma, evaluated with 99mTc-sestamibi single-photon emission computed tomography/computed tomography (SPECT/CT) imaging. Oncocytoma is a benign, solid enhancing renal mass that resembles the much more common renal cell carcinoma on standard imaging studies. Differentiation can be difficult due to shared imaging and histological characteristics; therefore, diagnosis historically primarily relied on resection. However, in a subset of patients who are poor candidates for surgical excision or percutaneous biopsy, a possible option for planning follow-up management is 99mTc-sestamibi SPECT/CT imaging. These cases highlight the role of 99mTc-sestamibi SPECT/CT imaging in differentiating benign oncocytomas from malignant renal cell carcinomas.
Kidney Outcomes in Children Receiving Extracorporeal Membrane Oxygenation: A Single-Center Acute Cohort From 2009 to 2019, Followed to 2021
Authors: Strong Amy E. , Makeneni Spandana , Campos Diego , Fulchiero Rosanna , Kilbaugh Todd J. , Connelly James , Laskin Benjamin L. , Zee Jarcy , Denburg Michelle R. 
Published: December 2024

Objectives:
Long-term kidney outcomes after extracorporeal membrane oxygenation (ECMO) are little quantified and understood. We aimed to describe the frequency of kidney dysfunction screening during follow-up and the prevalence of long-term kidney disease.

Design:
Retrospective cohort of pediatric ECMO patients with estimated glomerular filtration rate (eGFR) (mL/min/1.73 m2) using all post-discharge serum creatinine values to define three kidney outcomes: 1) acute kidney injury (AKI), with eGFR of less than 60 mL/min/1.73 m2, which subsequently improved to normal (≥ 90 mL/min/1.73 m2); 2) abnormal eGFR of less than 90 mL/min/1.73 m2 at last follow-up; and 3) chronic kidney disease (CKD) with eGFR of less than 90 mL/min/1.73 m2 on at least two occasions separated by greater than or equal to 90 days, without an intervening or subsequently normal eGFR.

Setting:
Single-center tertiary care children’s hospital system.

Patients:
All pediatric patients surviving ECMO from 2009 to 2019.

Interventions:
None.

Measurements and Main Results:
In the 10-year cohort of 666 patients, 399 (60%) survived at least 3 months post-discharge. Of these, 382 of 399 (96%) were followed at our institution for a median of 5 years (interquartile range, 3–8 yr). Two hundred sixty-four of 382 (69%) had at least one creatinine value post-discharge, and 209 of 382 (55%) had at least two values three months apart. Of the 264 with at least one creatinine value, 61 (23%) had an abnormal eGFR; of the 209 with at least two values greater than or equal to 90 days apart, 18 (9%) met criteria for CKD. Of those with CKD, 12 of 18 had AKI during ECMO, and seven of 18 had AKI events post-discharge (range, 1–6 episodes).

Conclusions:
This 2009–2019 pediatric ECMO cohort of survivors, followed for a median of 5 years, shows the subsequent high burden of kidney disease. We found that monitoring and following kidney function was not complete in this population, which is a concern since the rate of later AKI events and CKD is significant. Further study is needed to mitigate this post-ECMO vulnerability.
Association of Klotho and Gout in Middle-Aged and Older Adults
Authors: Wang Chaolan , Lin Ke , Jiang Yan , Wu Kangrong , Zhang Hong , Chen Jian , Li Na , Luo Wanpei , Liu Tianbao , Du Shuang 
Published: December 2024

Background
Klotho, which is known to negatively regulate metabolic disorders and kidney disease, has a role in gout that remains unclear. This research explored how klotho levels correlate with the prevalence of gout.

Methods
Participants aged 40 to 79 from the National Health and Nutrition Examination Survey (2007–2016) were examined in both lines. The connection between klotho levels and gout was analyzed through weighted multivariate logistic regression. Restricted cubic splines were used to assess linearity and investigate the dose-response relationship. To ensure the stability of the results, subgroup and sensitivity analyses were conducted.

Results
In total, 9660 individuals participated, with the weighted sample size calculated at 88,892,738.77. The group included 47.79% males (4793), with the median age being 57.00 years. Upon adjusting for all covariates, the multivariate analysis indicated an odds ratio of 0.51 (95% confidence interval [CI]: 0.33~0.78, p = 0.003) for the likelihood of occurrence of gout. When compared with the lowest klotho quartile Q1 (≥151.3, <655.3 pg/mL), the adjusted odds ratios for the subsequent quartiles Q2 (≥655.5, <800.9 pg/mL), Q3 (≥801.0, <991.6 pg/mL), and Q4 (≥991.7, ≤3998.5 pg/mL) were 0.97 (95% CI: 0.68~1.38), 0.78 (95% CI: 0.50~1.21), and 0.48 (95% CI: 0.32~0.73), respectively. Analyses focusing on subgroups and sensitivity confirmed these results.

Conclusions
This research found a negative correlation between serum α-klotho concentrations and the occurrence of gout. Those with the highest levels of klotho exhibited the lowest likelihood of gout, indicating potential importance for future studies and clinical uses.