bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gonorrhea and Chlamydia Rates Among 12- to 24-Year-Old Patients in an Urban Health System
Authors: Douglas Claudia M. , O’Leary Sonja C. , Tomcho Margaret M. , Wu Florence J. , Penny Lara , Federico Steven G. , Wilson Michael L. , Rinehart Deborah J. , Frost Holly M. 
Published: October 2020

Background

Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) infection rates continue to rise. Screening guidelines have largely focused on sexually active female individuals and men who have sex with men populations. Health care system testing and infection rates, particularly among heterosexual male individuals, are poorly understood. Our aim was to evaluate CT and GC testing and prevalence among 12- to 24-year-old patients in an urban federally qualified health center system.

Methods
This retrospective study analyzed electronic health record data from 2017 to 2019 in a large system of federally qualified health centers in Denver, CO. Abstracted data included demographics, sexual activity, sexual orientation, and laboratory results. χ2 Tests were used to evaluate differences between groups.

Results
Of the 44,021 patients included, 37.6% were tested, 15.0% were positive for CT, and 3.4% were positive for GC. Heterosexual male patients had a testing rate of 22.8% and positivity rates of CT and GC at 13.1% and 3.0%, respectively. Among tested patients documented as not sexually active, 7.5% were positive for CT. Multiple or reinfections were detected in 29% of patients.

Conclusions
This study shows low testing rates and high rates of CT and GC infections among all patients, including heterosexual male patients and those documented as not sexually active. Improved screening of these populations in the primary care setting may be key to combating the sexually transmitted disease epidemic.
Opt-Out, Routine Emergency Department Syphilis Screening as a Novel Intervention in At-Risk Populations
Authors: Stanford Kimberly A. , Hazra Aniruddha , Friedman Eleanor , Devlin Samantha , Winkler Nolan , Ridgway Jessica P. , Schneider John 
Published: October 2020

Background
With syphilis rates rising rapidly in the United States, novel means of reaching high-risk populations for screening and treatment are needed. Building on successful models for emergency department (ED) HIV screening, a routine opt-out syphilis screening program was implemented in a large, urban, tertiary care hospital ED in May 2019. This study aims to assess the prevalence of syphilis in this population and to evaluate the routine, opt-out syphilis screening model.

Methods
A retrospective chart review was performed of all patients screened for syphilis in the ED from June to December 2019. Demographic information, HIV status, chief complaint, and follow-up visits were examined.

Results
During the study period, 9198 people aged 18 to 64 years were screened for syphilis. Of these, 97 (1.1%) had presumed active syphilis infection (PAI), 354 (3.8%) were presumed not to have active syphilis, and 8747 (95.1%) were negative for infection. Patients with PAI were more likely to be male (67%; adjusted odds ratio, 3.5; 95% confidence interval, 2.3–5.3; P < 0.001), although the percentage of women was considerably higher than the nationally reported rate, and most were non-Hispanic Black (93.8%). Among patients with PAI, 23 (23.7%) were HIV positive. Only 18.6% of patients with PAI presented with complaints related to sexually transmitted infections.

Conclusions
Syphilis rates in this community are very high, and many infections were found in populations traditionally considered at lower risk by demographic or presenting complaint, indicating that universal screening is needed. Routine ED syphilis screening in high-prevalence communities will be critical to addressing the syphilis epidemic.
The Effect of Age on Fat Distribution in the Neck Using Volumetric Computed Tomography
Authors: Orra Susan , Tadisina Kashyap , Charafeddine Ali , Derakhshan Adeeb , Halliburton Sandra , Hashem Ahmed , Doumit Gaby , Zins James E. 
Published: October 2020

Background:
Neck fat distribution plays an important role in aging, yet how fat distribution changes with age is largely unknown. This study used volumetric computed tomography in live patients to characterize neck fat volume and distribution in young and elderly women.

Methods:
A retrospective analysis was conducted of head and neck computed tomographic angiographs of 20 young (aged 20 to 35 years) and 20 old (aged 65 to 89 years) women. Fat volume in the supraplatysmal and subplatysmal planes was quantified. Distribution of fat volume was assessed by dividing each supraplatysmal and subplatysmal compartment into upper, middle, and lower thirds.

Results:
Total supraplatysmal fat volume was greater than subplatysmal in all patients. Young patients had more total supraplatysmal fat than old patients (p < 0.0001). No difference was found between age groups in subplatysmal fat (p > 0.05). No difference was found between upper/middle/lower third supraplatysmal fat volumes in young patients. When comparing supraplatysmal thirds within the elderly population, the middle third fat volume (28.58 ± 20.01 cm3) was greater than both upper (18.93 ± 10.35 cm3) and lower thirds (15.46 ± 11.57 cm3) (p < 0.01).

Conclusions:
This study suggests that total supraplatysmal fat volume decreases with age. Older patients had more fat volume in the upper and middle thirds compared with the lower third of the supraplatysmal fat compartment, whereas young patients had more evenly distributed fat. These results suggest that fat deposition and redistribution in the neck occur with age and may be a contributing factor to the obtuse cervicomandibular angle of the elderly.
Association of Breast Implants with Nonspecific Symptoms, Connective Tissue Diseases, and Allergic Reactions: A Retrospective Cohort Analysis
Authors: Barbosa Monica R. , Makris Una E. , Mansi Ishak A. 
Published: October 2020

Background:
Given the rising media attention regarding various adverse conditions attributed to breast implants, the authors examined the association between breast implantation and the risk of being diagnosed with connective tissue diseases, allergic reactions, and nonspecific constitutional complaints in a cohort study with longitudinal follow-up.

Methods:
Women enrolled in a regional military health care system between 2003 and 2012 were evaluated in this retrospective cohort study. A propensity score was generated to match women who underwent breast implantation with women who did not undergo breast implantation. The propensity score included age, social history, health care use, comorbidities, and medication use. Outcomes assessed included International Classification of Diseases, Ninth Revision, diagnoses codes for (1) nonspecific constitutional symptoms, (2) nonspecific cardiac conditions, (3) rheumatoid arthritis and systemic lupus erythematosus, (4) other connective tissue diseases, and (5) allergic reactions.

Results:
Of 22,063 women included in the study (513 breast implants and 21,550 controls), we propensity score–matched 452 breast implant recipients with 452 nonrecipients. Odds ratios and 95 percent confidence intervals in breast implant recipients compared to nonrecipients were similar, including nonspecific constitutional symptoms (OR, 0.77; 95 percent CI, 0.53 to 1.13), nonspecific cardiac conditions (OR, 0.97; 95 percent CI, 0.69 to 1.37), rheumatoid arthritis and systemic lupus erythematosus (OR, 0.66; 95 percent CI, 0.33 to 1.31), other connective tissue diseases (OR, 1.02; 95 percent CI, 0.78 to 1.32), and allergic reactions (OR, 1.18; 95 percent CI, 0.84 to 1.66).

Conclusions:
Women with breast implants did not have an increased likelihood of being diagnosed with nonspecific constitutional symptoms, connective tissue disorders, and/or allergic reaction conditions.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.
Long-Term Outcomes after Surgical Treatment of Radial Sensory Nerve Neuromas: Patient-Reported Outcomes and Rate of Secondary Surgery
Authors: Gottlieb Rachel W. , Westenberg Ritsaart F. , Chen Neal C. , Coert J. Henk , Eberlin Kyle R. 
Published: October 2020

Background:
This study aimed to (1) describe long-term patient-reported outcomes of surgically treated symptomatic radial sensory nerve neuromas on function, pain interference, pain intensity, and satisfaction; (2) assess which factors were associated with worse function, higher pain intensity, and more pain interference; and (3) describe the secondary surgery rate and factors associated with secondary surgery.

Methods:
The authors conducted a retrospective review of patients surgically treated for radial sensory nerve neuroma from 2002 to 2016 (n = 54). Twenty-five of these 54 patients completed a follow-up survey including the Patient-Reported Outcomes Measurement Information System (PROMIS) upper extremity, pain interference, and depression scales; numerical rating scale pain and satisfaction instruments; and the global rating scale of change, at a mean period of 10.7 ± 4.3 years after neuroma surgery.

Results:
The mean PROMIS scores were 45.0 ± 12.1 for upper extremity, 55.5 ± 10.3 for pain interference, and 49.9 ± 10.2 for depression, and were within 1 SD of the general population. Eight patients (32 percent) reported symptoms as unchanged or worse following neuroma surgery. The median numerical rating scale pain was 3 (interquartile range, 1 to 6) and the global rating scale of change satisfaction was 10 (interquartile range, 7 to 10). Older patients (p = 0.002) and patients with higher PROMIS pain interference (p < 0.001), higher numerical rating scale for pain (p = 0.012), and lower global rating scale of change scores (p = 0.01) had worse PROMIS upper extremity scores. The secondary surgery rate was 20 percent and was associated with the presence of multiple neuromas (p = 0.001).

Conclusions:
Radial sensory nerve neuromas remain difficult to treat. They have a high secondary surgery rate (20 percent), with only 68 percent of patients reporting improvement after surgical intervention. Patient-reported outcomes after surgery are similar to conditions of the general population; however, the range of outcomes is wide.
Efficacy of Nonoperative Treatments for Lateral Epicondylitis: A Systematic Review and Meta-Analysis
Authors: Kim You J. , Wood Shannon M. , Yoon Alfred P. , Howard Julia C. , Yang Lan Y. , Chung Kevin C. 
Published: October 2020

Background:
Lateral epicondylitis is a common overuse injury affecting approximately 1 to 3 percent of the population. Although symptoms may disappear spontaneously within 1 year, the clinical guidelines for conservative treatment are not clear. The authors’ objective was to examine the outcomes of nonsurgical treatments for lateral epicondylitis through a meta-analysis and provide a treatment recommendation using the available evidence.

Methods:
The authors searched the PubMed, EMBASE, Scopus, and Web of Science databases to identify primary research articles studying conservative treatments (electrophysiotherapy, physical therapy, and injections) for lateral epicondylitis. The authors included randomized controlled trials published in peer-reviewed journals. Data related to outcomes (pain, grip strength, Patient-Rated Tennis Elbow Evaluation score, and Disabilities of the Arm, Shoulder and Hand score) and complications were extracted.

Results:
Fifty-eight randomized controlled trials were included in the meta-analysis. Electrophysiotherapy was effective in improving pain [mean difference, −10.0 (95 percent CI, −13.8 to −6.1)], Patient-Rated Tennis Elbow Evaluation score [mean difference, −10.7 (95 percent CI, −16.3 to −5.0)], and Disabilities of the Arm, Shoulder and Hand score [mean difference, −11.9 (95 percent CI, −15.8 to −7.9)]; and physical therapy improved pain [mean difference, −6.0 (95 percent CI, −9.7 to −2.3)] and Patient-Rated Tennis Elbow Evaluation scores [mean difference, −7.5 (95 percent CI, −11.8 to −3.2)] compared to placebo. Injections did not improve any outcome measures. Patients who received electrophysiotherapy and injections reported higher adverse effects than physical therapy patients.

Conclusions:
Patients who received electrophysiotherapy and physical therapy reported statistically and clinically improved scores in pain and function compared to placebo. Injections may put patients at higher risk for adverse effects compared to other conservative treatments. When managing lateral epicondylitis conservatively, electrophysiotherapy and physical therapy should be prioritized before other interventions.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, I.
Postirradiation Capsular Contracture in Implant-Based Breast Reconstruction: Management and Outcome
Authors: Haran Oriana , Bracha Gal , Tiosano Alon , Menes Tehillah , Madah Ehab , Gur Eyal , Barnea Yoav , Arad Ehud 
Published: October 2020

Background:
Implant-based breast reconstruction is commonly avoided in the setting of radiation therapy, mainly because of risks of capsular contracture. Nevertheless, as breast reconstruction is becoming more available, more patients undergo both implant-based breast reconstruction and radiotherapy. The dilemma is how to manage capsular contracture if it does occur. The goal of this study was to examine the outcome of patients with implant-based breast reconstruction who developed postirradiation capsular contracture and were treated with capsulotomy or capsulectomy, with or without fat grafting.

Methods:
The authors reviewed charts of patients who developed capsular contracture following alloplastic breast reconstruction followed by radiation therapy, between 2008 and 2018. The surgical treatment methods for capsular contracture were evaluated along with their outcomes. A follow-up of at least 1 year was required.

Results:
Forty-eight breasts with postirradiation capsular contracture underwent surgical implant exchange with capsular release, of which 15 had combined fat grafting and 33 did not. Overall, 35 breasts (72.9 percent) showed long-term resolution of capsular contracture; 24 underwent a single procedure and 11 required an additional fat grafting procedure. Some patients [six breasts (12.5 percent)] were offered a consecutive round of fat grafting, and some [seven breasts (14.5 percent)] were offered autologous reconstruction because of lack of improvement. Fat grafting increased the success rate by more than 30 percent when it was initially and consecutively used.

Conclusions:
Postirradiation capsular contracture may be treated successfully by secondary procedures, sustaining implant-based breast reconstruction in over 70 percent of breasts. Fat grafting may elevate resolution rates even further, to 86 percent. Larger prospective studies are required to validate these findings.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.
Incidental Discovery of a COVID-19 Infection on a Reevaluation FDG PET/CT in a Patient Treated for Hodgkin Lymphoma
Authors: Simand Celestine , Bund Caroline , Guffroy Blandine , Chaban Vitaliy , Herbrecht Raoul 
Published: September 2020

Abstract
We report the results of 18F-FDG PET/CT in an asymptomatic case of COVID-19 infection. A 27-year-old woman underwent FDG PET/CT for revaluation of a stage IIIE B Hodgkin lymphoma after the fourth cycle of chemotherapy. It showed intense avid FDG subpleural mixed ground-glass and consolidative lesions, especially in the left lung. Because of this morpho-metabolic aspect and the epidemic context, a viral pneumopathy was suspected. The patient who was initially asymptomatic was admitted for fever 28 hours after the PET/CT. The nasopharyngeal swab was positive for COVID-19, and the outcome was favorable.
Segmentation in Non–Small Cell Lung Tumors Using 18F-FDG PET/CT
Authors: Jiménez Londoño Germán Andrés , Pérez-Beteta Julián , Bosque Jesús J. , Honguero-Martinez Antonio Fancisco , García Vicente Ana Maria 
Published: September 2020

Abstract
The assessment of tumor parameters derived from 18F-FDG PET/CT in oncology provides valuable information in non–small cell lung cancer. A proper segmentation should delineate tumor with high accuracy, being the most important step to measure metabolic parameters. However, there is still no consensus about the optimal methodology. Additionally, some clinical conditions inherently tied to tumor and imaging can limit the proper tumor delineation. We present some practical cases that represent different aspects to consider during segmentation of primary non–small cell lung cancer by using 18F-FDG-PET/CT and some possible solutions to tackle with the most common limitations in clinical practice.
The Use of FDG PET Parametric Imaging in the Diagnosis of Olivopontocerebellar Atrophy
Authors: Harfouch Nassier , Finkelstein Mark , Sathe Swati , Raden Mark , Brenner Arnold I. 
Published: September 2020

Abstract
Olivopontocerebellar atrophy is a rare neurodegenerative syndrome associated with 2 distinct disorders: multiple system atrophy and spinocerebellar ataxia. We present a case involving a 66-year-old man with adult-onset progressing cerebellar signs reflective of a cerebellar syndrome with no significant family history and unremarkable genetic testing for spinocerebellar ataxia. This case was found to be most consistent with sporadic olivopontocerebellar atrophy, which falls under the multiple system atrophy category. This diagnosis can be made using 18F-FDG PET/CT scanning and with MRI in some cases. However, in this case, relatively new PET/CT quantification and parametric imaging software was used for analysis, CortexID Suite.
Primary Pancreatic Lymphoma on FDG PET/CT
Authors: Wang Peipei , Cheng Xin , Huo Li , Li Fang 
Published: September 2020

Abstract
A 69-year-old man underwent FDG PET/CT to evaluate a right upper abdominal mass. The images showed peripherally increased activity with central photopenic region in the head of the pancreas, which was consistent with pancreatic malignancy. Histopathologic findings showed characteristic findings of diffuse large B-cell lymphoma. The activity was diminished on follow-up PET/CT after 8 courses of chemotherapy.
Dynamic Whole-Body 18F-FDG PET for Minimizing Patient Motion Artifact
Authors: Kaji Tomohito , Osanai Kouji , Nakata Tomoaki , Tamaki Nagara 
Published: September 2020

Abstract
Recent PET/CT systems permit short acquisition with acceptable image quality. In addition, continuous-bed-motion mode is available for whole-body PET imaging with some PET cameras providing better uniformity and reproducibility throughout the field of view. We demonstrate a case with patient motion during the dynamic scan. Although the total summation of serial whole-body scan showed image artifact, the first 15 minutes’ summation of the serial scans provided high-quality images by eliminating the frames with motion. This acquisition mode seems to be particularly useful to perform for those who may likely to move during PET scan.
18F-FBPA PET in Sarcoidosis
Authors: Watabe Tadashi , Shimamoto Hiroaki , Naka Sadahiro , Kamiya Takashi , Murakami Shumei 
Published: September 2020

Abstract
A 68-year-old man with sarcoidosis showed high 18F-FDG uptake in the mediastinal and hilar lymph nodes on 18F-FDG PET, suggesting active inflammation. 18F-fluoro-boronophenylalanine (FBPA) PET showed no significant uptake in the mediastinal and hilar lymph nodes, suggesting its cancer specificity as a substrate of l-type amino acid transporter 1. 18F-fluoro-boronophenylalanine PET can be used for precise evaluation in oncology when the differentiation between inflammation and metastasis is inconclusive on 18F-FDG PET.
Performance of Chest Computed Tomography in Differentiating Coronavirus Disease 2019 From Other Viral Infections Using a Standardized Classification
Authors: Borges da Silva Teles Gustavo , Kaiser Ururahy Nunes Fonseca Eduardo , Yokoo Patricia , Marques Almeida Silva Murilo , Yanata Elaine , Shoji Hamilton , Bastos Duarte Passos Rodrigo , Caruso Chate Rodrigo , Szarf Gilberto 
Published: October 2020

Background:
An expert consensus recently proposed a standardized coronavirus disease 2019 (COVID-19) reporting language for computed tomography (CT) findings of COVID-19 pneumonia.

Purpose:
The purpose of the study was to evaluate the performance of CT in differentiating COVID-19 from other viral infections using a standardized reporting classification.

Methods:
A total of 175 consecutive patients were retrospectively identified from a single tertiary-care medical center from March 15 to March 24, 2020, including 87 with positive reverse transcription-polymerase chain reaction (RT-PCR) test for COVID-19 and 88 with negative COVID-19 RT-PCR test, but positive respiratory pathogen panel. Two thoracic radiologists, who were blinded to RT-PCR and respiratory pathogen panel results, reviewed chest CT images independently and classified the imaging findings under 4 categories: “typical” appearance, “indeterminate,” “atypical,” and “negative” for pneumonia. The final classification was based on consensus between the readers.

Results:
Patients with COVID-19 were older than patients with other viral infections (P=0.038). The inter-rater agreement of CT categories between the readers ranged from good to excellent, κ=0.80 (0.73 to 0.87). Final CT categories were statistically different among COVID-19 and non-COVID-19 groups (P<0.001). CT “typical” appearance was more prevalent in the COVID-19 group (64/87, 73.6%) than in the non-COVID-19 group (2/88, 2.3%). When considering CT “typical” appearance as a positive test, a sensitivity of 73.6% (95% confidence interval [CI]: 63%-82.4%), specificity of 97.7% (95% CI: 92%-99.7%), positive predictive value of 97% (95% CI: 89.5%-99.6%), and negative predictive value of 78.9% (95% CI: 70%-86.1%) were observed.

Conclusion:
The standardized chest CT classification demonstrated high specificity and positive predictive value in differentiating COVID-19 from other viral infections when presenting a “typical” appearance in a high pretest probability environment. Good to excellent inter-rater agreement was found regarding the CT standardized categories between the readers.
Mandibular Chondrosarcoma Reconstructed Using Custom Implant and Radial Forearm Free Flap
Authors: Bitner Benjamin F. , Wang Beverly , Tjoa Tjoson 
Published: September 2020

Abstract
We describe the case of a 40-year-old male presenting with an enlarging left facial and temporal chondrosarcoma centered on the left mandibular coronoid process resulting in pathologic fractures of the zygomatic arch and focal erosion of the temporal bone. The patient underwent surgical resection via a combined hemicoronal and parotidectomy approach. The zygomatic arch was reconstructed with a patient-specific polyetheretherketone implant, and temporal contour was restored with a buried de-epithelialized radial forearm free flap. Final pathology demonstrated conventional central chondrosarcoma. This case demonstrates an unusual presentation of a rare head and neck chondrosarcoma that originated from the mandibular coronoid process with the unique use of a custom polyetheretherketone implant and vascularized fat and fascial reconstruction.