bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predominance of Infection With Blastocystis hominis in Patients With Colorectal Cancer and Its Association With High Mucin Content, Infiltration of Inflammatory Cells and Elevated Serum Tumor Necrosis Factor α
Authors: Hawash Yousry A. , Ismail Khadiga Ahmed , Saber Taisir , Eed Emad M. , Khalifa Amany S. , Alsharif Khalaf F. , Alghamdi Saleh A. , Dahlawi Haytham A. , Alsanie Walaa , Khalifa Ahmed M. , Khalifa Osama Mahmoud 
Published: September 2020

Background

Blastocystis hominis is a unicellular protozoan parasite with a worldwide distribution. It was hypothesized that the infection with B. hominis plays a role in the pathogenesis of colorectal cancer in humans.

Objective
We aimed to test this hypothesis in a 1-year study using patients from Saudi Arabia with colorectal cancer.

Subjects and Methods
Colorectal cancer patients with various stages were enrolled in the study as cases (n = 75) along with a noncolorectal cancer patients as controls (n = 25). All participants in the study were subjected to history taking and investigated for B. hominis infection by microscopy and molecular-based tests applied to their fecal samples. Also, the tumor necrosis factor α in serum collected from both patients and controls was calculated in our study.

Results
The B. hominis were identified more in cases (20/75; 26.6%) than in controls (2/25; 8%), with significant difference (P < 0.05). Marked inflammatory cells infiltrate and mucin contents were demonstrated more in colorectal cancer patients infected with B. hominis, particularly those with stage 3 and stage 4 cancers. In patients with stage 4 colorectal cancer, there was a significantly higher level of mucin content and serum level of tumor necrosis factor α compared with colorectal cancer patients with less advanced stages (P < 0.05). In colorectal cancer cases, a statistically significant higher serum level of tumor necrosis factor α was observed compared with the controls (P < 0.05).

Conclusions
The findings of our study support the hypothesis that the infection with B. hominis has a possible role in the pathogenesis of colorectal cancer because it increases inflammatory cells infiltration and proinflammatory cytokines (tumor necrosis factor α) in the study's setting. This possibility demands future cohort prospective studies to prove whether the infection induces the colonic tissue to form a tumor or exacerbates the existing tumor. After this, we suggest that the study's population be screened for B. hominis, especially those suffering from colorectal cancers.
Outcomes of Central Nervous System Infections Treated by an Outpatient Parenteral Antimicrobial Therapy Program in a Public Teaching Hospital
Authors: Cummins Sarah A. , Beeler Cole , Muloma Eva , Erdman Sharon M. 
Published: September 2020

Background
Outpatient parenteral antimicrobial therapy (OPAT) has been safely used to treat a variety of infections. However, limited data are available on the safety and efficacy of OPAT for central nervous system (CNS) infections.

Methods
This was a retrospective, single-center study evaluating the safety and efficacy of OPAT in patients with CNS infections between July 1, 2009, and May 31, 2016. Demographic, medical, infection-specific, and drug-specific data were collected for each patient. Patients were categorized as clinical cure, probable cure, or treatment failure based on resolution or recurrence of infection for up to 1 year after OPAT completion. Safety of OPAT was evaluated through adverse drug event (ADE) and line complication (LC) monitoring. Readmission rates from OPAT-related ADE and LC were also recorded.

Results
Forty-seven patients with CNS infections (mean age, 45.3 years; 70.2% male) received OPAT for a median duration of 12 days (range, 2–144 days); 1 patient was excluded from efficacy analysis because of hospice transition. Thirty-seven patients (80.4%) achieved clinical cure, 7 patients (15.2%) had probable cure, and 2 patients (4.3%) experienced treatment failure. Three patients (6.4%) experienced ADE and 4 patients (8.5%) experienced LC during OPAT. Five patients (10.6%) required rehospitalization because of worsening infection (n = 1), LC (n = 2), cerebrospinal fluid leak repair (n = 1), and insurance issues (n = 1). Six patients (12.8%) required a therapy change because of ADE or LC.

Conclusions
Treating CNS infections with OPAT seems to be safe and effective based on the low failure and complication rates observed in this study.
Multisystem Inflammatory Syndrome in an Adult After COVID-19
Authors: Shan Yizhi , Dalal Vishal , Nahass Ronald G. , Rodricks Michael B. , Teichman Amanda L. 
Published: September 2020

Abstract
We describe the first case of multisystem inflammatory syndrome in an adult patient after coronavirus disease-19 (COVID-19). A 34-year-old Hispanic man, who tested positive for severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) 1 month before presentation, was admitted for fever, abdominal pain, headache, and myalgia. The patient deteriorated, developing multisystem organ failure. He required intensive care unit admission, mechanical ventilation, vasopressors, and continuous renal replacement therapy. Laboratory workup showed depletion of serum complement levels. After immunosuppressive therapy with intravenous immunoglobulin and corticosteroids, complement levels improved, and the patient made a full recovery.
Immunotherapy and Thyroid Dysfunction
Authors: Gregorio Maria Laura , Gomez Juan Sebastian , Arora Surender , Ramachandran Anil , Takalkar Amol 
Published: September 2020

Abstract
We report a case of a 66-year-old woman with small cell lung cancer (stage IIB, T2N1M0), who received immunotherapy with nivolumab monthly for 2 months and then presented with thyrotoxic symptoms associated with suppressed thyroid-stimulating hormone levels and elevated free thyroid hormone levels, although previous thyrotropin performed 1 month ago was normal. Thyroid uptake and scan demonstrated diffusely decreased uptake in both thyroid lobes. The 4-hour percentage uptake was 0.7%, and the 24-hour percentage uptake was 0.3%. This was followed by development of hypothyroidism within few weeks. Findings suggested drug-induced thyroiditis secondary to nivolumab therapy.
Quality and Safety in Healthcare, Part LXXIII
Authors: Harolds Jay A. 
Published: September 2020

Abstract
Disruptive behavior in the healthcare system is costly because it has an adverse effect on patient outcomes, staff morale, and referrals to a healthcare organization, and it increases staff turnover. A small proportion of medical providers exhibit disruptive behavior, but those individuals may exhibit this behavior frequently in some healthcare institutions so that this type of conduct is not uncommonly there. Each healthcare institution should have policies and procedures to address disruptive behavior and decrease the frequency of this type of conduct.
Cavernosal Metastasis From Prostate Cancer on 18F-Fluciclovine PET/CT
Authors: Nguyen Ba D. 
Published: September 2020

Abstract
Uncommon penile metastasis from prostate cancer has been reported on PET/CT imaging with 18F-FDG, 18F-fluorocholine, 11C-choline, and 68Ga-PSMA. The author presents an additional case of 18F-fluciclovine PET/CT depiction of proximal and distal cavernosal metastases from prostate cancer with corresponding contrast-enhanced CT findings.
Pitfalls in the Detection of Insulinomas With Glucagon-Like Peptide-1 Receptor Imaging
Authors: Antwi Kwadwo , Hepprich Matthias , Müller Natasha A. , Reubi Jean Claude , Fani Melpomeni , Rottenburger Christof , Nicolas Guillaume , Kaul Felix , Christ Emanuel R. , Wild Damian 
Published: September 2020

Purpose
Physiological pancreaticoduodenal uptake of radiolabeled exendin-4 in Brunner glands of the proximal duodenum is the most common pitfall for false interpretation of glucagon-like peptide-1 receptor (GLP-1R) imaging. The aim of this study was to analyze the pancreaticoduodenal uptake in GLP-1R PET/CT and SPECT/CT images and to identify additional potential reading pitfalls in patients with suspected insulinoma.

Methods
A post hoc analysis of a prospective study, including 52 consecutive patients, was performed. All patients underwent 1 68Ga-exendin-4 PET/CT and 2 111In-exendin-4 SPECT/CT scans (4 and 72 hours postinjection) in a randomized crossover order. Three board-certified nuclear medicine physicians read all scans independently. They were unaware of other results. Reference standard was surgery with histopathological confirmation of an insulinoma/nesidioblastosis and normalization of blood glucose levels after surgery.

Results
There were no false-positive readings. However, there were a number of false-negative PET/CT and SPECT/CT readings, respectively: (1) due to false interpretation of uptake in the pancreaticoduodenal region (falsely interpreted as physiological uptake in Brunner glands instead of an insulinoma in 0.6% vs 9.0%), (2) due to ectopic insulinoma (0% vs 2.6%), (3) due to small insulinoma (1.9% vs 5.1%), (4) due to insulinoma overlap with kidneys (1.9% vs 4.5%), and (5) due to nesidioblastosis (0.6% and 1.9%). Pitfalls were identified in all GLP-1R PET/CT and SPECT/CT scans.

Conclusions
Peripancreatic uptake, small size of an insulinoma, insulinoma overlap with kidneys, and presence of nesidioblastosis are potential pitfalls in GLP-1R imaging, which can lead to false reading results.
Clinical Impact of PET Imaging in Patients With Metastatic Prostate Cancer
Authors: Tuncel Murat , Tuncalı Meltem Çağlar , Telli Tuğçe , Erman Mustafa 
Published: September 2020

Abstract
Prostate cancer (Pca) is the most common cancer and the second leading cause of death among men. Although conventional bone scans and abdominal CT are preferred in most of the guidelines and clinical trials, PET/CT has already started to become the inevitable part of Pca management because of its higher sensitivity and specificity. Radiotracers used for PET imaging show different molecular aspects of the disease process. Although 68Ga–prostate-specific membrane antigen offers the highest sensitivity and specificity, other PET radiotracers such as 18F-FDG and 68Ga-DOTATATE still have a role in patients with prostate-specific membrane antigen–negative diseases such as Pca with neuroendocrine differentiation. In this pictorial essay, we have presented a series of patients with metastatic Pca who had PET images with different radiotracers and discussed the clinical role of this imaging modality in patient management.
99mTc-MDP Bone Scintigraphy in Gaucher Disease
Authors: Kesim Selin , Turoglu Halil Turgut , Tutar Engin , Ozguven Salih , Erdil Tanju Yusuf 
Published: September 2020

Abstract
In this case report, we present the bone scintigraphic findings of a 9-year-old boy with Gaucher disease who has a history of fractures to evaluate the extent of his osseous lesions. Gaucher disease is a genetic deficiency of lysosomal enzyme glucocerebrosidase, which results in the accumulation of glucocerebroside in the macrophages in the reticuloendothelial cells of the spleen, liver, and bone marrow. Most patients with type 1 Gaucher disease present a clinical or radiographic evidence of infiltrative bone disease. Lipid-filled macrophages called Gaucher cells infiltrate the bone marrow, leading to medullary expansion, diffuse osteoporosis, ischemic necrosis, and fractures.
Multimodality Imaging Features of a Misleading Sacral Giant Cell Tumor in 18F-FDG PET/CT, Bone Scan, and MRI
Authors: Dejust Sebastien , Jallerat Pascaline , Soibinet-Oudot Pauline , Jouannaud Christelle , Morland David 
Published: September 2020

Abstract
We report the case of an asymptomatic 66-year-old woman referred for initial staging of an invasive ductal breast carcinoma. Initial workup incidentally revealed a bone tumor of right sacral wing corresponding to a giant cell tumor (GCT). We present the imaging characteristics of GCT on 99mTc-HDP bone scan (doughnut sign), 18F-FDG PET/CT (intense and heterogeneous uptake of a prominent geographic lytic lesion with partial rupture of cortical), and MRI (hyposignal with gadolinium enhancement on T1-weighted images and heterogeneous hypersignal on T2-weighted images). GCT is a benign but locally aggressive primary bone tumor, constituting a pitfall and diagnostic challenge.
Quality and Safety in Healthcare, Part LXXV
Authors: Harolds Jay A. , Miller Laura B. 
Published: September 2020

Abstract
The Magnet Recognition Program® and the Pathway to Excellence® program of the American Nurses Credentialing Center are not only designed to improve the working conditions of nurses, but also to elevate nursing as a profession and ultimately increase quality, safety, and outcomes for patients. There is much overlap in the programs but the Magnet Recognition Program® specifically addresses outcomes and the Pathway to Excellence® program specifically addresses the well-being of nurses.
Non-Hodgkin Lymphoma With an Atypical Presentation
Authors: Shen Guohua , Kuang Anren 
Published: September 2020

Abstract
An 81-year-old woman was admitted with chest tightness and shortness of breath. Chest CT revealed massive pleural effusion on the right side as well as a right paravertebral soft tissue mass at the T8 to T10 level, showing intense enhancement. Her symptoms were successfully relieved by thoracentesis catheter drainage. On PET/CT, the paravertebral lesion demonstrated increased FDG uptake with an SUVmax of 7.5, indicating a suspected diagnosis of malignancy. Eventually, a CT-guided needle biopsy was performed, which confirmed the diagnosis of non-Hodgkin lymphoma.
Whole-Body 177Lu–Prostate-Specific Membrane Antigen Scan Pattern With Excess Free 177Lu-Chloride in a Metastatic Castration-Resistant Prostate Cancer Patient
Authors: Askari Emran , Moghadam Soroush Zarehparvar , Divband Ghasemali , Aryana Kamran 
Published: September 2020

Abstract
A 56-year-old man with metastatic castration-resistant prostate cancer was referred for radioligand therapy with 177Lu–prostate-specific membrane antigen. In the third cycle, a posttherapy whole-body scan showed unexpected skeletal and joint uptake apart from his known metastatic lesions. This observation raised suspicion for possible impurity (mainly free lutetium) in the applied radiopharmaceutical product. After contacting the radiopharmaceutical company, we were informed that the radiochemical purity of the used batch of 177Lu–prostate-specific membrane antigen had been 95%. This is the first report of excess free lutetium scan pattern and its complications in a patient undergoing radioligand therapy.
99mTc-RBC SPECT/CT for Duodenal Bleeding Point Detection
Authors: Kang Seo Young , Moon Byung Seok , Kim Hye Ok , Yoon Hai-Jeon , Kim Bom Sahn 
Published: September 2020

Abstract
This is a case of a 63-year-old man who presented with acute melena and low hemoglobin. Upper and lower gastrointestinal evaluations failed to localize the bleeding focus. 99mTc-RBC planar scintigraphy identified 2 sites of suspected bleeding in the lower abdomen area. Subsequent SPECT/CT was performed and identified the precise main focus of active bleeding, the second and third parts of the duodenum, and also described the blood accumulation in the jejunum. Esophagogastroduodenoscopy was immediately performed, and results confirmed spurting blood from the small vessel with multiple ulcers in the second part of the duodenum.
Complete Metabolic Response Assessed by FDG PET/CT to FOLFOXIRI-Bevacizumab in First-Line Treatment of BRAFV600E Mutated Metastatic Colorectal Cancer
Authors: Amrane Karim , le Pennec Romain , Schick Ulrike , Metges Jean-Philippe , Abgral Ronan 
Published: September 2020

Abstract
Triplet chemotherapy (FOLFOXIRI) + bevacizumab regimen is indicated as first-line treatment of BRAFV600E-mutated metastatic colorectal cancer (mCRC). Nevertheless, its proven therapeutic efficacy in clinical trials was solely based on partial morphologic responses assessed by CT. To date, only 1 case of complete response assessed by FDG PET/CT was reported in literature in BRAFV600E-mutated mCRC, but treated with doublet chemotherapy (FOLFIRI) + cetuximab regimen. We report a complete metabolic response assessed by FDG PET/CT, maintained over time (13 months) in a 60-year-old woman with BRAFV600E-mutated mCRC treated by FOLFOXIRI-bevacizumab. This also confirms that FDG PET/CT is emerging as a useful approach for therapeutic assessment of targeted drugs in mCRC.
Incidental Detection of Lung Adenocarcinoma Presenting as an Anterior Mediastinal Mass on 18F-Fluciclovine PET/CT in a Patient With Primary Prostate Cancer
Authors: Abiodun-Ojo Olayinka A. , Akintayo Akinyemi A. , Sica Gabriel L. , Alemozaffar Mehrdad , Schuster David M. 
Published: September 2020

Abstract

18F-fluciclovine is a PET radiotracer approved for detection of recurrent prostate cancer, with utility in other malignancies being investigated. We present the case of a 71-year-old man with high-risk primary prostate cancer (Gleason score 9, prostate-specific antigen 34 ng/mL) and newly diagnosed lung adenocarcinoma. As part of a clinical trial (NCT03081884), preoperative 18F-fluciclovine PET/CT showed localized abnormal uptake in the prostate gland with extracapsular extension. Additionally, an incidental anterior mediastinal mass measuring 2.2 × 1.8 cm demonstrated abnormal radiotracer uptake. Biopsy of the mediastinal mass confirmed invasive lung adenocarcinoma with solid and acinar patterns and high programmed death 1 ligand expression.
Radioligand Therapy With 177Lu–Prostate-Specific Membrane Antigen in a Patient With Non–Prostate-Specific Antigen–Secreting Metastatic Prostate Cancer
Authors: Pirayesh Elahe 
Published: September 2020

Abstract
Progression of prostate cancer and prostate-specific antigen (PSA) elevation are closely associated. In fewer than 1% of all cases, disease progression may occur despite low or undetectable PSA levels. In these conditions, androgen deprivation therapy is relatively ineffective, and the prostate cancer progresses very quickly. We present a 65-year-old man with non–PSA-secreting prostate cancer and widespread metastases with rather fair response to 177Lu-prostate-specific membrane antigen radioligand therapy.
Acute Aortic Dissection Initially Suspected on 18F-FDG PET/CT
Authors: Ulaner Gary A. , Muehlbauer Stefan , Goldberg Zoe 
Published: September 2020

Abstract
A 64-year-old man with anal cancer underwent follow-up 18F-FDG PET/CT to evaluate chemoradiation therapy response 5 months after an initial PET/CT. The follow-up 18F-FDG PET/CT demonstrated new FDG-avid curvilinear soft tissue adjacent to the abdominal aorta, interpreted as an aortic dissection. Despite lack of clinical symptoms, the patient was directed to an emergency room the same day, where a contrast-enhanced CT confirmed an aortic aneurysm with dissection. The patient underwent endovascular surgical repair the following day. This case demonstrates that newly FDG-avid aortic soft tissue should be recognized and may need further evaluation to characterize clinically significant vascular pathology.
Quality and Safety in Healthcare, Part LXXVIII
Authors: Harolds Jay A. , Miller Laura B. 
Published: September 2020

Abstract
Numerous expected competencies of a chief nursing officer are outlined in this article including communication, ability to build relationships, expertise about the environment of healthcare and its future directions, leadership, expertise in business matters, combating bullying, encouraging shared decision making, and optimizing interdisciplinary teams and the use of advanced practice providers. These skills are also expected of most other healthcare executives, whether or not they are nurses, because using these competencies increases quality, safety, and value for the patients and improves conditions for the healthcare organization and those who work there.
Rare Extramedullary Cardiac Involvement of Recurrent Multiple Myeloma Suspected on 18F-FDG and Confirmed on 18F-Fluorocholine
Authors: Zhang-Yin Jules , Garderet Laurent , Martino Suella , Montravers Françoise , Talbot Jean-Noël 
Published: September 2020

Abstract
A man experienced pain in the right hemithorax 6 months after a first-line therapy for multiple myeloma (MM). FDG PET/CT showed a large extramedullary extent in the right hemithorax, which was biopsy proven. During the second-line treatment, FDG PET/CT showed no response as well as a suspected myocardium spread, a rare extramedullary location in MM. 18F-Fluorocholine PET/CT and then MRI confirmed myocardium lesions. This case confirms that 18F-fluorocholine PET/CT is able to detect MM recurrence and may be used to complete FDG PET/CT in difficult cases such as suspicion of cardiac MM.
Primary Atrial Undifferentiated Sarcoma Found on FDG PET/CT Mimicking Cardiac Myxoma
Authors: Wang Rang , Shen Guohua , Tian Rong 
Published: September 2020

AbstractA 52-year-old man had shortness of breath and chest discomfort for 2 months. Chest CT and MRI showed a mass in the left atrium attached to the mitral annulus without obvious enhancement. Initial diagnosis was suspected of myxoma. Preoperative FDG PET/CT demonstrated the corresponding lesion with abnormal FDG uptake, indicating a malignancy. Finally, histopathologic examination revealed primary undifferentiated sarcoma.
Absent 18F-FDG Uptake in the Brain—Unsuspected Brain Death
Authors: Pedersen Mette Abildgaard , Jensen-Fangel Søren , Nielsen Edith , Borghammer Per , Vendelbo Mikkel Holm 
Published: September 2020

Abstract
Brain death is the complete, irreversible cessation of brain function, including the capacity for brainstem, respiratory, and vegetative activities. It is a clinical diagnosis that can be supplemented with brain perfusion imaging. Absent cerebral blood flow can be visualized with CT angiography or perfusion scintigraphy. 18F-FDG PET/CT, visualizing glucose uptake, is another approach that has been shown to indicate brain death in small case series. We here present a case with unsuspected absent 18F-FDG uptake and thus no metabolic activity, in the brain. The patient was declared brain dead later the same day.
De Novo Presentation of Sarcoidosis on Restaging FDG PET/CT in Rectal Carcinoma With Self-resolution
Authors: Santhosh Sampath , Jeeva Godwin , Thirumalairaj Raja 
Published: September 2020

Abstract
Sarcoidosis is a systemic disorder of unknown etiology characterized by development of noncaseating granulomas in more than 1 organ system. Development of sarcoidosis during or immediately after chemotherapy and immunotherapy is not uncommon. We present a 61-year-old woman in whom restaging 18F-FDG PET/CT detected asymptomatic sarcoidosis after neoadjuvant chemoradiotherapy for carcinoma rectum, which resolved spontaneously by the end of adjuvant chemotherapy with no specific treatment. Recognition of anatomic-metabolic pattern of sarcoidosis could prevent erroneous upstaging of the primary malignancy during restaging PET/CT following chemotherapy, and such lesions may show self-resolution.
18F-FDG PET/CT Findings in a Rare Myoepithelial Carcinoma Arising in the Parapharyngeal Space
Authors: Li Chongjiao , Tian Yueli , Shen Ying , Wen Bing , He Yong 
Published: September 2020

Abstract
Myoepithelial carcinoma is an exceedingly rare malignant neoplasm that most frequently occurs in the salivary gland. We here report a case of myoepithelial carcinoma in a 57-year-old man. Unenhanced and contrast-enhanced CT scans showed an ill-defined, heterogeneous, contrast-enhancing mass in the left parapharyngeal space, which suggested malignancy. 18F-FDG PET/CT showed a hypermetabolic mass and multiple FDG-avid lymph nodes in the bilateral cervical regions. An incision biopsy was performed, and the pathological examination confirmed the mass to be a myoepithelial carcinoma.