bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ingenol Mebutate
Authors: Peterson Hannah , Luke Janiene 
Published: December 2020

ABSTRACT
An actinic keratosis is a premalignant lesion of abnormal keratinocytes that develops on sun-exposed areas of the skin. Actinic keratoses are concerning because they can progress to squamous cell carcinoma in a minority of cases. The purpose of this column is to highlight some of the more commonly encountered drugs in dermatology. Ingenol mebutate (Picato) is a topical cream derived from the sap of the Euphorbia peplus plant and is approved by the Food and Drug Administration for use in the treatment of actinic keratoses. In this article, the role of ingenol mebutate as a dermatologic treatment for actinic keratoses will be discussed, and more specifically, this article will bring further understanding to the mechanism of action, administration, dosage, patient education points, adverse effects, and viable alternatives to this medication.
Case Study
Authors: Russell Nancy Gentry 
Published: December 2020

ABSTRACT
Squamous cell carcinoma is the second most common nonmelanoma skin cancer, and it may present in a variety of ways. Several common conditions, including some that are benign, may mimic squamous cell carcinoma. It is critical for clinicians to be knowledgeable of the presentation of squamous cell carcinoma and other conditions that may present similarly to prevent a delayed or missed diagnosis. This case will be helpful for providers in general dermatology practice as it describes a presentation of squamous cell carcinoma and differential diagnoses considered.
The Prescription of Long-Acting Opioids for Working-Age Patients With Workers’ Compensation or Chronic Illness Diagnoses in the United States
Authors: Topper Leah , Rosas Valeria Menendez , Aarkoti Malathi , Doucette John , Nabeel Ismail 
Published: December 2020

Objective:To examine associations of workers’ compensation, chronic conditions, age, sex, and race/ethnicity with primary prescription of long-acting opioids (LAO) among working-age patients in ambulatory care.Methods:Using the National Ambulatory Medical Care Survey (2010 to 2016), we conducted descriptive, bivariate, and multivariate logistic regression analyses of patients aged 18 to 64 with an LAO as their primary medication.Results:Those prescribed an LAO were more likely to be men (adjusted odds ratio [aOR] = 1.48, 95% CI 1.13, 1.91), have workers’ compensation (aOR = 2.00, 95% CI 1.12, 3.57), or have diagnoses of lower back pain (aOR = 4.70, 95% CI 3.51, 6.29), arthritis (aOR = 1.53, 95% CI 1.11, 2.09), or depression (aOR = 1.69; 95% CI 1.24, 2.31). Hispanic ethnicity/race had a lower likelihood of LAO use compared with non-Hispanic White (aOR = 0.58; 95% CI 0.37, 0.90).Conclusions:Male sex, workers’ compensation, and diagnoses of lower back pain, arthritis, or depression were independently associated with increased LAO prescription odds.
The role of CHA2DS2-VASc score in evaluating patients with atrial fibrillation undergoing percutaneous coronary intervention
Authors: Parfrey Shane , Teh Andrew W. , Roberts Louise , Brennan Angela , Clark David , Duffy Stephen J. , Ajani Andrew E. , Reid Christopher M. , Freeman Melanie 
Published: December 2020

Objective
The aim of the review was to assess whether CHA2DS2-VASc score is predictive of mortality in patients with atrial fibrillation undergoing percutaneous coronary intervention (PCI).

Background
The CHA2DS2-VASc score is validated in predicting stroke risk in atrial fibrillation. The optimum management strategy for these patients undergoing PCI is still debated.

Methods
The CHA2DS2-VASc score was calculated in consecutive patients with atrial fibrillation undergoing PCI in a large Australian registry between 2007 and 2013. Patients were divided into low (1–2), intermediate (3–4) and high (≥5) groups. Clinical and procedural data, 30-day, 1-year and long-term outcomes were compared between the groups.

Results
A total of 564 patients were included in our analysis. Patients with high CHA2DS2-VASc scores had higher mortality rates at 1-year (2, 8, 15; P = 0.002) and long-term (6, 20, 37; P < 0.001). High-risk patients were more likely to have renal impairment and multivessel disease. Increasing CHA2DS2-VASc score was associated with increased risk of stroke (0, 2, 6; P = 0.03). However, only 41.9% received anticoagulation, with no difference across the risk groups. When compared to low-risk, intermediate [HR 3.57; 95% confidence interval (CI), 1.28–9.92; P = 0.015] and high (hazard ratio 7.82; 95% CI, 2.88–21.24; P < 0.001) CHA2DS2-VASc scores were significant predictors of long-term mortality.

Conclusions:
Higher CHA2DS2-VASc scores in patients with atrial fibrillation undergoing PCI are associated with significantly worse outcomes. Despite being high-risk, the patients in this cohort are likely undertreated with anticoagulation. Close clinical follow-up with greater utilization of anticoagulation and optimal medical therapy has the potential to improve long-term outcomes.
Contribution of Th17 cells to tissue injury in hypertension
Authors: Basile David P. , Abais-Battad Justine M. , Mattson David L. 
Published: December 2020

Purpose of review
Hypertension has been demonstrated to be a chief contributor to morbidity and mortality throughout the world. Although the cause of hypertension is multifactorial, emerging evidence, obtained in experimental studies, as well as observational studies in humans, points to the role of inflammation and immunity. Many aspects of immune function have now been implicated in hypertension and end-organ injury; this review will focus upon the recently-described role of Th17 cells in this pathophysiological response.

Recent findings
Studies in animal models and human genetic studies point to a role in the adaptive immune system as playing a contributory role in hypertension and renal tissue damage. Th17 cells, which produce the cytokine IL17, are strongly pro-inflammatory cells, which may contribute to tissue damage if expressed in chronic disease conditions. The activity of these cells may be enhanced by physiological factors associated with hypertension such as dietary salt or Ang II. This activity may culminate in the increased sodium retaining activity and exacerbation of inflammation and renal fibrosis via multiple cellular mechanisms.

Summary
Th17 cells are a distinct component of the adaptive immune system that may strongly enhance pathways leading to increased sodium reabsorption, elevated vascular tone and end-organ damage. Moreover, this pathway may lend itself towards specific targeting for treatment of kidney disease and hypertension.
Bisphosphonates and management of kidney stones and bone disease
Authors: Prochaska Megan 
Published: December 2020

Purpose of review
Kidney stones are strongly associated with low bone density and bone fracture. Clinical management focuses on prevention of kidney stones and bone fracture. We reviewed literature of kidney stones and bone disease with a special focus on updates in therapeutic strategies. We will review the literature regarding dietary management, supplements, and medications and emphasize the recent studies on bisphosphonates and kidney stone management.

Recent findings
Bisphosphonate medications are commonly used in management of low bone density. Previous studies showed that they reduce urinary calcium. A recent large prospective study found that bisphosphonates may reduce the risk of kidney stones in individuals who have low bone density. In addition to lowering urinary calcium, a recent study found that bisphosphonates may act as an inhibitor in the urinary space.

Summary
There are multiple dietary and pharmacologic strategies that can be considered for kidney stones and bone disease, such as low salt and normal calcium diet, as well as thiazides, alkali, and bisphosphonate medications. Bisphosphonates may have an important role in reducing bone resorption and reducing overall risk of kidney stone and bone disease.
Clonal hematopoiesis in hematopoietic stem cell transplantation
Authors: Wilk C. Matthias , Manz Markus G. , Boettcher Steffen 
Published: December 2020

Purpose of review
Clonal hematopoiesis (CH) is characterized by the acquisition of somatic mutations and subsequent expansion of mutated hematopoietic stem and progenitor cell (HSPC) clones without clinical evidence for a hematologic neoplasm. The prevalence of CH continuously increases with age reaching double-digit percentages in individuals >60 years. CH is associated with an increased risk for hematologic neoplasms and cardiovascular disease. We will review recent efforts to investigate how CH influences patient outcomes in hematopoietic stem cell transplantation – both autologous (ASCT) and allogeneic (allo-HSCT).

Recent findings
Donor-engrafted CH is common in allo-HSCT recipients. Apart from a higher incidence of chronic GvHD and the rare but devastating complication of donor-derived leukemia, CH does not appear to negatively impact outcomes in allo-HSCT recipients. In lymphoma patients undergoing ASCT, however, CH is associated with an excess mortality driven by therapy-related myeloid neoplasms and cardiovascular events. Interestingly, inferior overall survival in patients with CH undergoing ASCT for multiple myeloma (MM) is due to an increased rate of MM progression.

Summary
CH is highly prevalent in both allo-HSCT and ASCT patients suggesting a clinically relevant but context-dependent impact on adverse outcomes. Given the current lack of therapeutic interventions, systematic screening for CH in the transplant setting is currently not indicated outside of clinical studies.
Transcutaneous Electrical Nerve Stimulation for Pain Management for Women in Labor
Authors: Daniel Linda , Benson Jennifer , Hoover Stephen 
Published: December 2020

Abstract

Purpose:
To determine effectiveness of a transcutaneous electrical nerve stimulation (TENS) unit to improve labor pain management and patient satisfaction with overall labor experience among women in labor at term.

Study Design:
Prospective, exploratory design using convenience sampling.

Methods:
Pregnant women at term, anticipating a vaginal birth at our tertiary care hospital, were invited to participate in the TENS study to help manage early labor pain. Pain level was assessed on entry into the study and 2 hours post-TENS application using the Wong-Baker FACES® Pain Rating Scale. A TENS satisfaction survey was conducted during postpartum. Pain scores were analyzed using a matched Wilcoxon signed-rank test.

Results:
There were 272 women enrolled in the study; 255 completed the patient satisfaction survey and 263 had measured pain assessments pre- and post-TENS application. There was a significant reduction in pain scores after application of TENS, (7.09 vs. 6.74, p = 0.02). Most women 78% (199/255) agreed that TENS helped manage early labor pain, 80% (203/255) would recommend TENS for management of early labor pain, and 72% (183/255) would use TENS again.

Clinical Implications:
TENS therapy provides nurses with an opportunity to offer women a low-cost, low-intervention treatment for managing early labor. TENS provides a distraction from contractions and generates a sense of control to help women manage the discomforts of labor and possibly remain home longer.
Huge Free-Floating Thrombus in the Internal Carotid Artery Under Duplex Ultrasound Surveillance
Authors: Zhang Lin-Jie , Qin Jie , Zhang Li-Hua , Yu De-Lin 
Published: December 2020

Introduction:
Carotid free-floating thrombus (FFT) is an unusual finding in acute ischemic stroke. Atherosclerosis is the most common etiology of FFT formation.

Case Report:
Here we report a 42-year-old male patient admitted to our department with left temporal and parietal lobe ischemic stroke with normal magnetic resonance angiography. A huge FFT in the left internal carotid artery were found by duplex ultrasound. Acute thrombosis based on atherosclerotic plaque were considered as the reason of this embolization. The thrombus shrunk significantly under anticoagulation and antiplatelet treatment.

Conclusions:
Evaluation of the intracranial vessel in the emergency is not enough and early carotid duplex ultrasound can help find of the FFT in time, which help to choose the early intervene by neurosurgeon. Early antithrombotic treatment can be a safe treatment option for reducing huge thrombus based on the nature of thrombus formation. Computed tomography angiography and high-resolution magnetic resonance imaging to certify the character of the plaque are recommended for plaque evaluation.
Comparative Evaluation of Stroke Awareness of Individuals Whose First-Degree Relatives had a Stroke and that of Individuals Whose First-Degree Relatives Did Not
Authors: Haki Cemile , Ali Asuman 
Published: December 2020

Objective:
To assess the stroke awareness levels of individuals whose first-degree relatives had a stroke and to compare the results with those of individuals whose first-degree relatives did not have a stroke.

Materials and Methods:
This cross-sectional study was conducted between March and May 2019, with first-degree relatives of patients who had a stroke (group 1) and a comparable set of individuals whose first-degree relatives did not have a stroke (group 2). Participants were asked to complete a questionnaire asking about signs and symptoms, risk factors, treatment options, information sources, responses after the development of stroke, and early treatment of stroke.

Results:
In response to the questions about the signs and symptoms of stroke, group 1 mentioned dizziness and comprehension disorder as a symptom of stroke more frequently than the other group. Stress was the second most frequently mentioned risk factor (by 81% of group 1 and 80.5% in group 2). When the participants were asked about the sources of information about stroke, family circle and friends were the most frequently mentioned sources for both groups.

Conclusion:
The present study can serve as a guide in planning training to improve stroke awareness in the future, especially by including individuals whose first-degree relatives had a stroke.
Application of Shear Wave Elastography to Evaluate the Stiffness of Normal Testes and Inflammatory Epididymal Tail Masses
Authors: Chen Fei , Mao Lin , Zhou Xiaohua , Qiao Xueyan , Luo Yanhua , Zhu Zhimin , Chen Rui , Qiu Shaodong , Zeng Bidan 
Published: December 2020

Objective
This study aimed to investigate the application value of shear wave elastography in examining normal testes and inflammatory epididymal tail masses.

Methods
We examined 110 healthy male volunteers (with a total of 220 testes) and 25 patients with epididymitis via conventional scrotal ultrasonography and shear wave elastography. The mean (E
mean), minimal (E
min), maximal (E
max), and standard deviation (E
SD) values of elasticity were acquired. The inflammatory masses were assessed at initial diagnosis, at weeks 1 and 2 of standard anti-inflammatory treatment, upon remission, and at 2 weeks after remission.

Results
The E
mean values of different regions in testes varied in the following order: center region (3.14 ± 0.35 kPa) < upper- or lower-pole capsule (upper, 3.94 ± 0.90 kPa; lower, 3.94 ± 0.97 kPa) < posterior capsule (5.96 ± 1.46 kPa) < anterior capsule (6.27 ± 1.58 kPa). The E
mean value of the center of the testicular parenchyma in the short axis was significantly larger than that in the long axis (3.47 ± 0.32 vs 3.14 ± 0.35 kPa; P < 0.05). There were significant differences in the E
mean value between inflammatory epididymal tail masses at initial diagnosis, at 1 and 2 weeks after treatment, upon remission, and at 2 weeks after remission (P < 0.05).

Conclusions
Shear wave elastography can be used to reflect the relative hardness of normal testes and inflammatory epididymal tail masses.
Recognizing the Ultrasound Patterns of Mesenteric Panniculitis
Authors: Whittle Carolina , Schiappacasse Giancarlo , Maldonado Ignacio , Villacres Fabian , Hebel Esteban , González Felipe 
Published: December 2020

Abstract
Mesenteric panniculitis (MP) is a rare, benign, and nonspecific chronic fibrosing inflammation of the mesenteric adipose tissue. Abdominal pain is the most frequent presentation.
The objective was to recognize ultrasound (US) features in MP. A retrospective 9-year review of computed tomography– (CT) or US-diagnosed cases of MP recorded in the radiology department was performed. The inclusion criteria included an US recorded in PACS imaging data base within 10 days before CT, to compare and evaluate the correlation of MP diagnosis.
The prevalence of MP on CT was 2.8%. The 120 selected patients had an abdominal US 10 days before CT. Male-to-female ratio was 4:1. Fifty-three percent of MP was suggested by US. The US finding was increased volume with fatty mass in the mesentery root (98%). The fatty mesenteric mass had oval shape or convex anterior border in 94%, central abdominal location in 91%, and focal mesenteric increased echogenicity in 95%. Lateral bowel loop displacement was observed in 59%. Detection of lymph nodes was less frequent (55%).
In conclusion, MP is an entity to be considered in the differential diagnosis of abdominal pain. Knowledge and recognition of the US findings of MP and central abdominal compression may improve detection during the abdominal US examination.
Thoracoscopic Esophageal Atresia Repair: Outcomes Analysis Between Primary and Staged Procedures
Authors: Marinho Ana S. , Saxena Amulya K. 
Published: December 2020

Purpose:
Thoracoscopic repair of esophageal atresia (EA) is analyzed in this systematic review that compares outcomes between primary and staged repairs.

Materials and Methods:
PubMed/Embase databases were reviewed for articles on thoracoscopic repair of EA, and articles were selected for primary and staged repairs. Descriptive statistics were used to analyze the quantitative parts of the study.

Results:
Thirty-six articles identified between 1999 and 2019 met the inclusion criteria and offered 776 patients for this analysis. Primary repairs were performed in n=703 and staged repairs in n=73. Comparative analysis showed that esophageal anastomosis was performed using absorbable suture in 88% primary and 78% staged repairs. Anastomotic leak rates were comparable between primary n=65/696 (9%) and staged repairs n=8/73 (11%). The re-fistulation rate was 2% in primary and 1% in staged repairs. There was no difference between suture material and re-fistulation (P>0.05; NS). In primary repairs, nonabsorbable sutures were found to be associated with more leaks than absorbable sutures (P<0.05*). The conversion rate was similar between 2 approaches; primary n=49/680 (7%) and staged n=6/73 (8%); P>0.05. No significant differences were found in the rate of anastomosis strictures between primary n=135/703 (19%) and staged repair n=21/73 (29%); P>0.05. The overall mortality was n=20/703 (3%) in primary and n=1/73 (1%) in staged repairs; P>0.05.

Conclusions:
Successful thoracoscopic primary- and staged-EA repairs have been reported with low rate of complications. Outcomes between primary and staged repairs do not show significant differences with regards to re-fistulation, anastomotic leaks, conversion rates, and mortality.
Source Analysis of Triphasic Waves Using Quantitative Neuroimaging
Authors: Meira Alex Tiburtino , Alves Karen Fernanda , Rezende Thais O. P. , Schelp Arthur Oscar , Betting Luiz Eduardo 
Published: December 2020

Purpose:
Triphasic waves (TWs), a common EEG pattern, are considered a subtype of generalized periodic discharges. Most patients with TWs present with an altered level of consciousness, and the TW pattern is believed to represent thalamocortical dysfunction. However, the exact meaning and mechanism of TWs remain unclear. The objective of the current study was to evaluate the source of TWs using EEG source imaging and computerized tomography.

Methods:
Twenty-eight patients with TWs were investigated. Source analysis was performed on the averaged TWs for each individual, and source maps were extracted. Normalization and automatic segmentation of gray matter were performed on computerized tomography scans before analysis. Finally, voxelwise correlation analyses were conducted between EEG source maps and gray matter volumes.

Results:
Source analyses showed that the anterior cingulate cortex was mainly involved in TWs (16/28 patients, 57%). Correlation analyses showed moderate positive and negative correlations between source location and gray matter volumes for the posterior cingulate (T = 2.85; volume = 6,533 mm3; r = 0.53; P = 0.002) and the superior frontal gyrus (T = 2.54; volume = 18,167 mm3; r = −0.48; P < 0.0001), respectively.

Conclusions:
The results suggest that the anterior cingulate is involved in the origin of TWs. Furthermore, the volumes of posterior brain regions were positively correlated with TWs, indicating a possible preservation of these structures. Conversely, the volumes of anterior regions were negatively correlated with TWs. These findings may indicate a structural pattern necessary for the generation of the abnormal network responsible for TWs.
Veterinary endectocides for malaria control and elimination: prospects and challenges
Authors: Chaccour Carlos 
Published: December 2020

Residual transmission is the persistence of malaria transmission after scale-up of appropriate vector control tools and is one of the key challenges for malaria elimination today. Although long associated with outdoor biting, other mosquito behaviours such as partly feeding upon animals contribute greatly to sustaining transmission. Peri-domestic livestock can be used as decoy to protect humans from blood-seeking vectors but this approach often leads to an increased malaria risk in a phenomenon known as zoopotentiation. Treating the said livestock with drugs capable of killing intestinal parasites as well as mosquitoes that feed upon them has the potential to tackle malaria through a previously unexplored mechanism. The advantages and challenges associated with this approach are briefly discussed here. Numerous references are purposely provided.
This article is part of the theme issue ‘Novel control strategies for mosquito-borne diseases’.