bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pattern of symptom improvement following endoscopic sinus surgery for chronic rhinosinusitis
Authors: Al Sharhan Salma S. , Al Bar Mohammed H. , Assiri Shahad Y. , AlOtiabi Assayl R. , Bin-Nooh Deemah M. , AlSugair Fozia K. , AlRashidi Nada F. , AlSaied Abdulmalik S. , Alghamdi Amal A. 
Published: June 2021

Abstract
Background
Chronic rhinosinusitis (CRS) is a common inflammation of the nose and the paranasal sinuses. Intractable CRS cases are generally treated with endoscopic sinus surgery (ESS). Although the effect of ESS on CRS symptoms has been studied, the pattern of symptom improvement after ESS for CRS is yet to be investigated. The aim of this study was to determine the magnitude and sequence of symptom improvement after ESS for CRS, and to assess the possible preoperative factors that predict surgical outcomes in CRS patients.

Methods
This was a longitudinal prospective study of 68 patients who had CRS (with or without nasal polyps). The patients underwent ESS at King Fahd Hospital of the University, Al Khobar, Saudi Arabia. The Sino-nasal Outcome Test-22 (SNOT-22) questionnaire was used for assessment at four time points during the study: pre-ESS, 1-week post-ESS, 4 weeks post-ESS, and 6 months post-ESS.

Results
The difference between the mean scores recorded for the five SNOT-22 domains pre-ESS and 6 months post-ESS were as follows: rhinologic symptoms (t-test = 7.22, p-value =  < 0.001); extra-nasal rhinologic symptoms (t-test = 4.87, p-value =  < 0.001); ear/facial symptoms (t-test = 6.34, p-value =  < 0.001); psychological dysfunction (t-test = 1.99, p-value = 0.049); and sleep dysfunction (t-test = 5.58, p-value =  < 0.001). There was a significant difference between the mean scores recorded for the five domains pre-ESS and 6 months post-ESS. Rhinologic symptoms had the largest effect size (d = 1.12), whereas psychological dysfunction had the least effect size (d = 0.24). The only statistically significant difference in the SNOT-22 mean scores recorded 4 weeks post-ESS was observed between allergic and non-allergic patients (t = − 2.16, df = 66, p = 0.035).

Conclusion
Understanding the pattern of symptom improvement following ESS for CRS will facilitate patient counselling and aid the optimization of the current treatment protocols to maximize surgical outcomes and quality of life.

Level of evidence
Prospective observational.
Esophageal granular cell tumor and eosinophils: a multicenter experience
Authors: Reddi Deepti , Chandler Christropher , Cardona Diana , Schild Michael , Westerhoff Maria , McMullen Emily , Tomizawa Yutaka , Clinton Lani , Swanson Paul E. 
Published: June 2021

AbstractBackgroundEsophageal granular cell tumor (eGCT) is rare, and the recent literature suggests a link between eosinophilic esophagitis (EoE) and eGCT. The aim of our study was to determine if EoE or other disorders associated with eosinophilia are consistently associated with eGCT.MethodsWe retrospectively searched pathology databases of three academic institutions from 1999 to 2018 for eGCTs. The archived slides and medical records were reviewed.ResultsFrom 294,855 esophagogastroduodenoscopy procedures, 45 patients (17 males and 28 females) with eGCTs were identified. The patients (30–73 years in age, median 50) had eGCT 0.2–2.0 cm in size (average 0.71). Thirteen had a history of gastroesophageal reflux disease, 5 had Barrett esophagus/goblet cell metaplasia and 1 had EoE. Thirty-four eGCTs had intralesional eosinophils (14 with peak > 10 eosinophils/400x hpf); of these, 21 also had eosinophils in lamina propria (9 with peak > 10 eosinophils/hpf). eGCT with atypical features (including nuclear enlargement and prominent nucleoli) were more likely to have increased eosinophils in non-epithelial compartments than those without atypia. Pleomorphism and spindled cells were seen in 3 eGCT cases (mean peak intralesional eosinophils: 43 per hpf); 2 of these had goblet cell metaplasia. We found no association between EoE and eGCT,p = 0.5966, (95% C.I. 0.0276, 6.5389, Fisher’s exact test). Instead, most patients had gastroesophageal reflux disease or Barrett esophagus.ConclusionEosinophilia, common in eGCT and adjacent stroma, likely drives atypical/reactive histologic features, but a pathogenic relationship between eosinophil rich inflammatory conditions and eGCT has not yet been established.
Prevalence of BRCA1 and BRCA2 Mutations Among Patients With Ovarian, Primary Peritoneal, and Fallopian Tube Cancer in India: A Multicenter Cross-Sectional Study
Authors: Gupta Sudeep , Rajappa Senthil , Advani Suresh , Agarwal Amit , Aggarwal Shyam , Goswami Chanchal , Palanki Satya Dattatreya , Arya Devavrat , Patil Shekhar , Kodagali Rohit 
Published: June 2021

PURPOSE There are deficient data on prevalence of germline mutations in breast cancer susceptibility genes 1 and 2 ( BRCA1/ BRCA2) in Indian patients with ovarian cancer who are not selected by clinical features. METHODS This prospective, cross-sectional, noninterventional study in nine Indian centers included patients with newly diagnosed or relapsed epithelial ovarian, primary peritoneal, or fallopian tube cancer. The primary objective was to assess the prevalence of BRCA1/ BRCA2 mutations, and the secondary objective was to correlate BRCA1/ BRCA2 status with clinicopathologic characteristics. Mutation testing was performed by a standard next-generation sequencing assay. RESULTS Between March 2018 and December 2018, 239 patients with a median age of 53.0 (range, 23.0-86.0 years) years were included, of whom 203 (84.9%) had newly diagnosed disease, 36 (15.1%) had family history of ovarian or breast cancer, and 159 (66.5%) had serous subtype of epithelial ovarian cancer. Germline pathogenic or likely pathogenic mutations in BRCA1 and BRCA2 were detected in 37 (15.5%; 95% CI, 11.1 to 20.7) and 14 (5.9%; 95% CI, 3.2 to 9.6) patients, respectively, whereas variants of uncertain significance in these genes were seen in four (1.7%; 95% CI, 0.5 to 4.2) and six (2.5%; 95% CI, 0.9 to 5.4) patients, respectively. The prevalence of pathogenic or likely pathogenic BRCA mutations in patients with serous versus nonserous tumors, with versus without relevant family history, and ≤ 50 years versus > 50 years, were 40 of 159 (25.2%; 95% CI, 18.6 to 32.6) versus 11 of 80 (13.8%; 95% CI, 7.1 to 23.3; P = .0636), 20 of 36 (55.6%; 95% CI, 38.1 to 72.1) versus 41 of 203 (20.2%; 95% CI, 14.9 to 26.4; P < .0001), and 20 of 90 (22.2%; 95% CI, 14.1 to 32.2) versus 31 of 149 (20.8%; 95% CI, 14.6 to 28.2; P = .7956), respectively. CONCLUSION There is a high prevalence of pathogenic or likely pathogenic germline BRCA mutations in Indian patients with ovarian cancer.
Risk of Breast Cancer Among Carriers of Pathogenic Variants in Breast Cancer Predisposition Genes Varies by Polygenic Risk Score
Authors: Gao Chi , Polley Eric C. , Hart Steven N. , Huang Hongyan , Hu Chunling , Gnanaolivu Rohan , Lilyquist Jenna , Boddicker Nicholas J. , Na Jie , Ambrosone Christine B. , Auer Paul L. , Bernstein Leslie , Burnside Elizabeth S. , Eliassen A. Heather , Gaudet Mia M. , Haiman Christopher , Hunter David J. , Jacobs Eric J. , John Esther M. , Lindström Sara , Ma Huiyan , Neuhausen Susan L. , Newcomb Polly A. , O'Brien Katie M. , Olson Janet E. , Ong Irene M. , Patel Alpa V. , Palmer Julie R. , Sandler Dale P. , Tamimi Rulla , Taylor Jack A. , Teras Lauren R. , Trentham-Dietz Amy , Vachon Celine M. , Weinberg Clarice R. , Yao Song , Weitzel Jeffrey N. , Goldgar David E. , Domchek Susan M. , Nathanson Katherine L. , Couch Fergus J. , Kraft Peter 
Published: June 2021

PURPOSEThis study assessed the joint association of pathogenic variants (PVs) in breast cancer (BC) predisposition genes and polygenic risk scores (PRS) with BC in the general population.METHODSA total of 26,798 non-Hispanic white BC cases and 26,127 controls from predominately population-based studies in the Cancer Risk Estimates Related to Susceptibility consortium were evaluated for PVs in BRCA1, BRCA2, ATM, CHEK2, PALB2, BARD1, BRIP1, CDH1, and NF1. PRS based on 105 common variants were created using effect estimates from BC genome-wide association studies; the performance of an overall BC PRS and estrogen receptor–specific PRS were evaluated. The odds of BC based on the PVs and PRS were estimated using penalized logistic regression. The results were combined with age-specific incidence rates to estimate 5-year and lifetime absolute risks of BC across percentiles of PRS by PV status and first-degree family history of BC.RESULTSThe estimated lifetime risks of BC among general-population noncarriers, based on 10th and 90th percentiles of PRS, were 9.1%-23.9% and 6.7%-18.2% for women with or without first-degree relatives with BC, respectively. Taking PRS into account, more than 95% of BRCA1, BRCA2, and PALB2 carriers had > 20% lifetime risks of BC, whereas, respectively, 52.5% and 69.7% of ATM and CHEK2 carriers without first-degree relatives with BC, and 78.8% and 89.9% of those with a first-degree relative with BC had > 20% risk.CONCLUSIONPRS facilitates personalization of BC risk among carriers of PVs in predisposition genes. Incorporating PRS into BC risk estimation may help identify > 30% of CHEK2 and nearly half of ATM carriers below the 20% lifetime risk threshold, suggesting the addition of PRS may prevent overscreening and enable more personalized risk management approaches.
Levine Cancer Institute Financial Toxicity Tumor Board: A Potential Solution to an Emerging Problem
Authors: Raghavan Derek , Keith Nicole A. , Warden Hughes R. , Chai Seungjean , Turan Wendy Jo , Moroe Jaynie , Feild Donna , Knight Thomas Gregory 
Published: June 2021

PURPOSE: Fiscal distress or “financial toxicity,” in which patients experience challenges in paying for treatment, are becoming dominant problems for patients with cancer because of burgeoning health care costs and strategies implemented by health insurance payers to reduce their level of expenditure. We report the structure and function of the first Financial Toxicity Tumor Board (FTTB). Modeled on the concept of a conventional multidisciplinary tumor board, FTTB functions as a multidisciplinary conference providing broad problem-solving approaches to financial toxicity. METHODS: The FTTB, with participation from physicians, nurses, financial counselors, nurse navigators, social workers, and administrators, meets monthly and is focused on financial toxicity and financial worry experienced by patients with cancer. It is linked to a Patient Assistance Program for oncologic pharmaceutical agents as this domain constitutes a critical area of financial toxicity for many patients. RESULTS: In the first years of function, more than $55-$60 million of personal expenditure has been avoided for 1,749 and 1,819 patients, respectively, as well as more than $1.3 million copay assistance provided for financially challenged patients. Problems addressed have included payer impediments, underinsurance, complexities of certification, coding or billing issues, and inadequate internal standard operating procedures. CONCLUSION: A focus on proactive management of financial toxicity through the function of multidisciplinary FTTBs substantially ameliorates this burgeoning international problem. This concept is presented early as it may be leveraged readily in other centers.
Longitudinal Dynamics of Circulating Tumor Cells and Circulating Tumor DNA for Treatment Monitoring in Metastatic Breast Cancer
Authors: Gerratana Lorenzo , Davis Andrew A. , Zhang Qiang , Basile Debora , Rossi Giovanna , Strickland Kimberly , Franzoni Alessandra , Allegri Lorenzo , Mu Zhaomei , Zhang Youbin , Flaum Lisa E. , Damante Giuseppe , Gradishar William John , Platanias Leonidas C. , Behdad Amir , Yang Hushan , Puglisi Fabio , Cristofanilli Massimo 
Published: June 2021

PURPOSE Liquid biopsy–based biomarkers, including circulating tumor cells (CTCs) and circulating tumor DNA (ctDNA), are increasingly important for the characterization of metastatic breast cancer (MBC). The aim of the study was to explore CTCs and ctDNA dynamics to better understand their potentially complementary role in describing MBC. METHODS The study retrospectively analyzed 107 patients with MBC characterized with paired CTCs and ctDNA assessments and a second prospective cohort, which enrolled 48 patients with MBC. CTCs were immunomagnetically isolated and ctDNA was quantified and then characterized through next-generation sequencing in the retrospective cohort and droplet digital polymerase chain reaction in the prospective cohort. Matched pairs variations at baseline, at evaluation one (EV1), and at progression were tested through the Wilcoxon test. The prognostic role of ctDNA parameters was also investigated. RESULTS Mutant allele frequency (MAF) had a significant decrease between baseline and EV1 and a significant increase between EV1 and progression. Number of detected alterations steadily increased across timepoints, CTCs enumeration (nCTCs) significantly increased only between EV1 and progression. MAF dynamics across the main altered genes was then investigated. Plasma DNA yield did not vary across timepoints both in the retrospective cohort and in the prospective cohort, while the short fragments fraction showed a potential role as a prognostic biomarker. CONCLUSION nCTCs and ctDNA provide complementary information about prognosis and treatment benefit. Although nCTCs appeared to assess tumor biology rather than tumor burden, MAF may be a promising biomarker for the dynamic assessment of treatment response and resistance.
Ulnar-Sided Wrist Pain in the Athlete: Sport-Specific Demands, Clinical Presentation, and Management Options
Authors: Rios-Russo Jose L. , Lozada-Bado Lianette S. , de Mel Sandra , Frontera Walter , Micheo William 
Published: June 2021

Abstract
Ulnar-sided wrist injuries are common in sports that require repeated pronosupination, wrist radial/ulnar deviation, axial loading, and gripping equipment. Common anatomic structures affected include the triangular fibrocartilage complex, extensor carpi ulnaris tendon, distal radioulnar and ulnocarpal joints, and hamate bone. Presenting symptoms include pain with activity, swelling, possible snapping or clicking, and reproduction of symptoms with provocative maneuvers. Imaging may confirm or rule out pathologies, but abnormal findings also may present in asymptomatic athletes. Initial treatment is usually nonoperative with splinting, load management, activity modification, strengthening the components of the kinetic chain of the particular sport, and pain management. Surgery is usually indicated in ulnar-wrist pain pathology such as hook of hamate fractures and required in associated instability. Future research should address specific treatment and rehabilitation protocols, emphasizing the complete kinetic chain along with the injured wrist.
Achilles Tendinopathy: Evaluation, Rehabilitation, and Prevention
Authors: von Rickenbach Kristian J. , Borgstrom Haylee , Tenforde Adam , Borg-Stein Joanne , McInnis Kelly C. 
Published: June 2021

Abstract
Achilles tendinopathy is a common overuse condition that is characterized by degenerative, cumulative tissue microtrauma. It is largely a clinical diagnosis in which the patient typically presents with localized pain that is worse with tendon-loading activities. Imaging modalities may be helpful with the diagnosis of difficult cases or in the planning of interventional procedures. Midportion (noninsertional) and insertional tendinopathy have distinct features and differences for therapeutic paradigms. Overall, Achilles tendinopathy has a good clinical prognosis with most patients improving with activity modification and rehabilitation, with a focus on progressive tendon-loading. Recalcitrant cases may require adjuvant treatment with procedures (e.g., injections, shockwave therapy) and rarely surgical intervention.
The Warrior Wellness Study: A Randomized Controlled Exercise Trial for Older Veterans with PTSD
Authors: Hall Katherine S. , Morey Miriam C. , Beckham Jean C. , Bosworth Hayden B. , Pebole Michelle M. , Pieper Carl F. , Sloane Richard 
Published: June 2021

ABSTRACT
Posttraumatic stress disorder (PTSD) affects up to 30% of military veterans. Older veterans, many of whom have lived with PTSD symptoms for several decades, report a number of negative health outcomes. Despite the demonstrated benefits of regular exercise on physical and psychological health, no studies have explored the effect of exercise in older veterans with PTSD. This article describes the development, design, and implementation of the Warrior Wellness exercise pilot study for older veterans with PTSD. Veterans ≥60 yr old with a Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition diagnosis of PTSD will be recruited and randomized to (a) Warrior Wellness, a 12-wk supervised, facility-based exercise intervention, or (b) usual care for 12 wk. Warrior Wellness is a theory- and evidence-based behavioral intervention that involves three sessions per week of multicomponent exercise training that targets strength, endurance, balance, and flexibility. Warrior Wellness focuses on satisfaction with outcomes, self-efficacy, self-monitoring, and autonomy. Factors associated with program adherence, defined as the number of sessions attended during the 12 wk, will be explored. Primary outcomes include PTSD symptoms and cardiovascular endurance, assessed at baseline and 12 wk. Compared with those in usual care, it is hypothesized that those in the Warrior Wellness condition will improve on these efficacy outcomes. The Warrior Wellness study will provide evidence on whether a short-term exercise intervention is feasible, acceptable, and effective among older veterans with PTSD, and explore factors associated with program adherence.

ClinicalTrials.gov Identifier: NCT02295995
Content and efficiency of the technique, aimed at formation of "working" and "dynamic position" of lower acrobates, taking into account the requirements of the chosen specialty
Authors: Denysenko Vladyslava , Maksymova Yuliya , Filippov Mikhail 
Published: June 2021

The content of the methodology aimed at the formation of “working” and “dynamic posture” of bottom acrobats who train at the stage of preliminary basic training is discussed in the article presented. The methodology mentioned was developed with taking into account the requirements of the athletes’ chosen specialty, as well as on the basis of the kinematic structure of motor action which form the basis of functional duties of the bottom acrobat. It solved the following tasks: formation of a “working posture”, formation of “rational dynamic posture” of a bottom acrobat in the performance of functional duties; optimization of balancing technique and throwing actions of the bottom acrobats. The sequential implementation of the following stages created the algorithm of the methodology developed. It included formation of a “working posture” under simple conditions; formation of a “working posture” under the conditions of an increased load on the muscles that fix the “working posture”; formation of the “working posture” under the various spatio-temporal conditions; formation of a “rational dynamic posture” under simple conditions; formation of “rational dynamic posture” under conditions with a reduced support area; formation of “working posture” and “rational dynamic posture” under the conditions close to the performance of acrobatic exercises. AS a result of the experiment the Authors has shown that the use of the technique developed contributes to the optimization of the balancing technique and technique of throwing actions of the bottom acrobats. So among main group acrobats the indicators of “working posture” and “dynamic posture” significantly differ (p<0.05) from those in control group and approach the model characteristics.
The most common injuries, rehabilitation and recovery among soccer practitioners
Authors: Mojsiewicz Karol , Kempińska-Podhorodecka Agnieszka 
Published: June 2021

Introduction. Soccer is the most popular sport in the world. As a contact sport it has a high risk and incidence of injuries, which most often affect the lower limb. For the player to recover it is neessary to attend to well planned rehabilitation. Purpose. Analyzing the most common injuries among people practicing soccer and determining the role of rehabilitation in the treatment of these injuries.Material and methods. The research group was 101 individuals, 88 male and 13 female who played soccer as amateurs or professionals, aged 10 to 45 and had been training for a minimum of 2 years.Results. There were 487 injuries in total among all respondents, of which 370 were related to the lower limb and 117 to the upper body. Contussions and ankle sprains were the most common injuries. Every single preson included in the studies suffered from injury, but only 75.2% of them went to see a doctor after the incident and only 56,4% attended rehabilitation. Statistical significance has been present in the time to return to sports depending on the continuation of physical exertion after the injury, in the time to return to sport due to treatment or the lack of it, in the time to return to sports in relation to whether or not rehabilitation took place for patients with serious injury.Conclusion. The most common sports injuries in soccer are lower limb injuries, including damage to muscles and tendons. Recovery time is related to the type of injury, treatment options and rehabilitation methods. People practicing soccer should monitor their training loads with a physiotherapist. This can reduce the amount of problems later in career or daily life.
Look under the sheets – a case report of diabetic foot
Authors: Makuch Marcin , Makuch Marcelina 
Published: June 2021

Diabetic foot is a long-term complication of diabetes mellitus that results directly from peripheral arterial disease or sensory neuropathy affecting the feet in diabetes mellitus. Diabetic foot is rare, but potentially lethal complication associated with the diabetes. The management of diabetic foot infections requires assessing the microbial etiology, attentive wound management, good nutrition, antimicrobial therapy and glycemic control. In several clinical circumstances, surgical resection is preferable. A 65-year-old patient with 2-month necrosis of the second toe of the left foot and recurrent fever is presented. Diabetic foot developed. Citrobacter koseri was isolated from bone cultures. Intravenous treatment with amoxicillin + clavulanic acid and metronidazole was administered for 2 weeks and the wound was poorly recovered. After a surgical consultation, the patient was qualified for the amputation of the second toe of the left foot.