bluuebunny/crossref_metadata_2025_split huggingface dataset:
Extensive subdural ossification with meningioma
Authors: Feng Yang , Zeng Xi , Tan Renzhao , Xu Xueyou , Yang Hua 
Published: April 2021

Abstract

Rationale:
Intracranial tumors can stimulate the occurrence of intracranial ossification, and previous studies have reported intracranial ossification with astrocytoma, glioblastoma multiforme and growth hormone adenoma. For meningiomas derived from arachnoid cells, the outcome of abnormal arachnoid cells is not only tumorigenesis, but also calcium deposition. To the best of our knowledge, meningioma with subdural ossification has not been reported.

Patient concerns:
A 60 year old woman was admitted to the hospital with a 1-year-old history of right blepharoptosis.

Diagnoses:
The preoperative examination of the patient was suggestive of meningioma on magnetic resonance imaging plain scan and enhancement. After the surgery, Endothelial cell type meningioma (WHO I grade) with intracranial ossification was diagnosed.

Interventions:
The patient underwent right extended pterional approach craniotomy and the neoplasm was gross totally resected. The patient was scheduled for follow-up and regular observation of the intracranial ossification.

Outcomes:
Intracranial computed tomography showed that extensive ossification still existed, but the symptoms of right blepharoptosis were significantly improved.

Lessons:
The authors report a rare case of meningioma complicated with extensive subdural ossification. Further studies are needed to confirm whether intracranial ossification in meningioma is related to arachnoid granulosa cells.
Granulomatosis with polyangiitis associated with rapidly progressive glomerulonephritis, diffuse alveolar hemorrhage, cerebral vasculitis, and peripheral nerve neuropathy
Authors: Nawata Takashi , Oishi Keiji , Shibuya Masaki , Sano Yasuteru , Kubo Makoto , Obayashi Masakazu , Kawai Motoharu , Yano Masafumi 
Published: April 2021

Abstract

Rationale:
Granulomatosis with polyangiitis (GPA) is a type of anti-neutrophil cytoplasmic antibody-associated vasculitis which predominantly affects systemic small and medium-sized blood vessels. GPA involving multiple organs can lead to a fatal outcome if left untreated.

Patient concerns:
An 83-year-old Japanese woman with rapidly progressive glomerulonephritis, diffuse alveolar hemorrhage, cerebral vasculitis, and peripheral neuropathy was admitted to our hospital. Her multiple organ involvement increased during an untreated period following the patient's initial decision not to receive immunotherapy.

Diagnoses:
GPA associated with rapidly progressive glomerulonephritis, diffuse alveolar hemorrhage, cerebral vasculitis, and peripheral nerve neuropathy.

Interventions:
The patient was treated with glucocorticoids and rituximab.

Outcomes:
Therapy with glucocorticoids and rituximab achieved remission.

Lessons:
This case suggests the clinical course of GPA may progress to involve multiple organs and appropriate immunosuppressive therapy should be considered even for elderly patients.
Marchiafava-bignami disease in a chinese patient with mild cognitive impairment
Authors: Wang Jie , Lu Li , Wu Lirong 
Published: April 2021

Abstract

Introduction:
Marchiafava-Bignami disease (MBD) is a rare outcome often associated with chronic alcohol abuse. Clinical manifestations are diverse. Recently, brain magnetic resonance imaging has paved the way for the diagnosis of MBD.

Patient concerns:
A 62-year-old man was admitted to our hospital because of headache and mild cognitive impairment. He had an alcohol consumption (500 g/d) history for over 20 years.

Diagnosis:
Based on Magnetic Resonance Imaging, he was diagnosed with Marchiafava-Bignami disease (MBD).

Interventions:
The patient was asked to stop alcohol consumption, and was prescribed with B-vitamins (thiamine, B6, B12) to improve his symptoms.

Outcomes:
After one week of treatment, the patient could communicate with others fluently. His memory improved significantly.

Conclusion:
Acute MBD is not always fatal; early diagnosis and prompt treatment can greatly improve its prognosis. Radiological findings can aid the clinical diagnosis of MBD. The lesions are usually localized in or spread throughout the corpus callosum.
Endobronchial blood patch with thrombin injection
Authors: Perwaiz Muhammad K. , Pasrich Rajiv , Grewal Gurjot , Durrance Richard J. 
Published: April 2021

Abstract

Introduction:
Persistent pulmonary air leaks present a challenging clinical problem, often requiring surgical intervention that not all patients can withstand.

Patient concerns:
An elderly female with severe emphysematous Chronic Obstructive Pulmonary Disease and dependent on continuous home oxygen supplementation developed recurrent pneumothoraces. On evaluation, the patient was considered a poor surgical candidate for Video assisted thoracoscopic surgery, and therefore a less invasive approach to treat the recurrent pneumothoraces was required.

Diagnosis:
A diagnosis of recurrent right pneumothorax due to Pulmonary-parenchymal fistula (either alveolo-pleural fistula or broncho-pleural fistula) was made

Interventions:
Due to the fragile overall condition of the patient, the peri-procedure risk of video assisted thoracoscopic surgery was not acceptable. Hence bronchoscopic evaluation with an endobronchial blood patch with thrombin injection was performed using a swan-ganz catheter.

Outcomes:
The patient had significant reduction in air leak post procedure and achieved complete resolution on day 3. She was successfully discharged home later.

Conclusion:
In patients with significant comorbidities that preclude standard interventions for persistent pulmonary-pleural fistulas, endobronchial blood patch repair with thrombin injection can be safely performed utilizing a swan-ganz catheter.
Congenital erythropoietic porphyria
Authors: Li Xiao-Ling 
Published: April 2021

Abstract

Rationale:
Congenital erythropoietic porphyria (CEP) is an autosomal recessive, hereditary disorder. Its rarity underlies a general low awareness by clinicians, and only scarce reports of CEP exist in the literature. Herein we report a rare case of CEP and its treatment strategies.

Patient concerns:
A 4-year-old female suffered from papular vesicles and blisters on the face and hands, which had originally developed 3 years prior. Upon presentation at our clinic, we noted old facial appearance, cutaneous atrophic scaring, brown teeth (fluorescing pink under Wood's light), and dark-brown urine (fluorescing orange-red under Wood's light). The major findings of laboratory examinations were elevated 1.6 gHb for intracellular porphyrin, and strong positivity (2+) for urinary porphyrin.

Diagnoses:
The final diagnosis was CEP.

Interventions:
Sun protection and oral administration of β-carotene (15 mg/d).

Outcomes:
After 2 months, the papules and papulovesicles were significantly reduced.

Lessons:
CEP is a rare, autosomal recessive, hereditary disorder. The decrease in or lack of uroporogen III synthetase is the major pathogenic factor and there is no specific treatment for this disease. Through this study of a case of CEP, it is suggested that clinicians should strengthen their understanding of the typical clinical manifestations and laboratory findings of this disease.
Ticagrelor Utilization in Patients With Non-ST Elevation Acute Coronary Syndromes in Romania
Authors: Cotoban Alexandru-George , Udroiu Cristian Alexandru , Vinereanu Dragos 
Published: April 2021

BACKGROUND:
Dual antiplatelet therapy (DAPT) represents a major tool of non-ST elevation acute coronary syndrome (NSTE-ACS) management. The real-world usage of potent P2Y12 inhibitors within DAPT in middle-income countries is poorly described.

STUDY QUESTION:
To assess the factors that influence P2Y12 inhibitor choice at discharge in invasively managed NSTE-ACS patients, without an indication for oral anticoagulation, treated across Romania.

STUDY DESIGN:
The Romanian National NSTE-ACS Registry allows the consecutive enrollment of NSTE-ACS patients admitted in 11 (of 24) interventional centers reimbursed from public funds.

MEASURES AND OUTCOMES:
NSTE-ACS patients that received DAPT at discharge were identified. Deceased patients, those with an indication for oral anticoagulation or not receiving DAPT at discharge, were excluded. P2Y12 inhibitor choice was analyzed based on demographic, clinical, and invasive management characteristics.

RESULTS:
One thousand fifty (63 ± 10 years, 73% male) of 1418 patients enrolled between 2016 and 2019 were analyzed. The P2Y12 inhibitor pretreatment rate was 90%. Obstructive coronary artery disease was found in 95.3% of patients. 84.6% underwent percutaneous coronary interventions (PCIs). Single vessel PCI was reported in 84% of PCI patients. The clopidogrel usage rate was 49.6%, ticagrelor 50.0%, and prasugrel 0.4%. Overall, higher ticagrelor usage was associated with: non-ST elevation myocardial infarction (P 0.035), age below 65 (P < 0.001), prior treatment with ticagrelor (P < 0.001), PCI during admission (P < 0.001), and its full 12-month reimbursement (since November 2017). Reimbursement increased the use of ticagrelor from 23.7% in 2016–2017 to 56.9% in 2018–2019 (P < 0.001). In PCI patients, ticagrelor use was associated with PCI with stenting (P 0.016) and multivessel PCI (0.013).

CONCLUSIONS:
DAPT, P2Y12 inhibitor pretreatment, and single vessel PCI are the standards of care in invasively managed NSTE-ACS patients in Romania. Besides the clinical and invasive characteristics that favor its use, the full reimbursement of ticagrelor introduced in November 2017 doubled its yearly usage.
Optimal inflammatory bowel disease management during the global coronavirus disease 2019 pandemic
Authors: El Ouali Sara , Rubin David T. , Cohen Benjamin L. , Regueiro Miguel D. , Rieder Florian 
Published: April 2021

Purpose of review
This review aims to summarize the current evidence regarding the risks and implications of coronavirus disease 2019 (COVID-19) in patients with inflammatory bowel disease (IBD) and discuss optimal management of IBD during this pandemic.

Recent findings
Patients with IBD are not at increased risk of COVID-19 but several risk factors for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 infection) have been identified, such as active IBD, obesity, and corticosteroid use. COVID-19 outcomes are similar among patients with IBD and the overall population. Although biologics have not been shown to increase the risk of severe COVID-19 complications, several risk factors have been associated with negative COVID-19 outcomes in patients with IBD, including older age, obesity, the presence of comorbidities, active disease, and corticosteroid use. IBD therapy should, therefore, be continued with the aim of attaining or maintaining remission, except for corticosteroids, which should be held or reduced to the minimal effective dose. Although it has been recommended that immunosuppressive therapy be held during a case of COVID-19, the half-lives of these drugs and data on the timing of restarting therapy limit the strength of these recommendations. We recommend COVID-19 vaccination for IBD patients whenever available, as benefits to the individual and to society outweigh the risks.

Summary
As our understanding of SARS-CoV-2 and COVID-19 continues to evolve, we are learning more about its impact in patients with IBD and how to better manage patients in this setting. Managing IBD during this pandemic has also highlighted the importance of restructuring services in order to adapt to current and potential future outbreaks. The COVID-19 pandemic has transformed IBD care through the expansion of telemedicine and development of novel approaches to remote monitoring.
Social media in inflammatory bowel disease: the patient and physician perspective
Authors: Ahmed Waseem , Taft Tiffany H. , Charabaty Aline 
Published: April 2021

Purpose of review
Social media use by patients with inflammatory bowel disease (IBD) and their respective providers continues to increase, promoting disease awareness and scholarship. In this review article, we summarize the current literature regarding social media use and IBD, discuss both the patient and physician perspective, and provide guidance to avoid commonly encountered pitfalls.

Recent findings
Patients and providers commonly rely on social media to share medical information, advocate for improved IBD care, and to network and collaborate on common research interests. This shift from more traditional formats of education and networking continues to grow exponentially, and even more rapidly so during the COVID-19 pandemic.

Summary
Social media use in the IBD community will continue to grow and lead to further innovation. Providers should be aware of social media as a valuable tool for their patients and themselves.
Depression and cardiovascular disease
Authors: Hare David L. 
Published: April 2021

Purpose of review
The purpose of this review is to outline the relationship between cardiovascular disease (CVD) and depression, both as a cause of and a result of CVD.

Recent findings
The prevalence of depression seems to be increasing in the general population.
It is likely that depression will be even more of a problem for CVD patients in the post-COVID-19 pandemic era.
New studies confirm the independent association of depression with later incident CVD, although perhaps not as strong as suggested by some previous studies.
Depression seems to be becoming even more prevalent in CVD patients, with new data for stroke and peripheral arterial disease patients.
Cardiologists rarely screen for depression and most do not believe that they have a responsibility for detecting or treating depression.
There are new data suggesting that patients who are more in control of their lives have better outcomes and that change is possible.

Summary
Depression is preventable and treatable. It is imperative to detect and manage depression in CVD patients. Additional research is required to see whether or not comprehensive patient screening for depression translates into both better quality of life and improved clinical outcomes.
Organ allocation and procurement in cardiac transplantation
Authors: Altshuler Peter J. , Helmers Mark R. , Atluri Pavan 
Published: April 2021

Purpose of review
There is a critical shortage of organs in cardiac transplantation. Recent advancements in both organ allocation and donor utilization have intended to address this shortage and optimally allocate allografts. This review evaluates several important aspects of recipient and donor management. For recipients, the focus is placed on the evolving mechanical circulatory support population and its bidirectional impact on organ allocation. From the donor standpoint, organ utilization is assessed with respect to increasing access to previously unused allografts.

Recent findings
Implementation of the new heart allocation system in the United States has better stratified waitlist candidates by illness acuity. Compared to the prior system, those requiring venoarterial extracorporeal membrane oxygenation support are less likely to die on the waitlist, although conflicting data exists whether this has improved their posttransplant survival. The use of pretransplant intra-aortic balloon pumps has markedly increased, whereas transplantation of patients with dischargeable left ventricular assist devices has decreased. Although some studies have reported inferior short- to mid-term posttransplant survival in the new system compared to its predecessor, others report similar outcomes.
Several recent advancements in donor utilization have also been noted. Coinciding with the global increase in drug overdose deaths, efforts have been made to increase use of these donors who are frequently considered ‘increased risk’ and are hepatitis C-positive. Grafts from these donors appear safe to use. These, alongside donation after circulatory death donors, represent potentially underutilized populations that may effectively expand the donor pool.

Summary
Recent changes in organ allocation, alongside efforts to expand the donor pool, have attempted to improve cardiac allograft utilization and reduce the imbalance between organ supply and demand. Ongoing monitoring and continuous re-evaluation of these efforts will help guide future practice.
A Quality Improvement Initiative to Reduce the Frequency of Delays in Initiation and Restarts of Continuous Renal Replacement Therapy
Authors: Cordoza Makayla , Rachinski Kristen , Nathan Kristin , Crain Elisa B. , Braxmeyer Diane , Gore Sarah , Dubuc Stephanie D. , Wright Joel 
Published: April 2021

Background:
Continuous renal replacement therapy (CRRT) is a lifesaving intervention for critically ill patients. Delays in initiation, or an inability to resume CRRT following a temporary suspension in therapy (CRRT restart), can result in suboptimal CRRT delivery.

Local Problem:
Intensive care units across the health care system were experiencing significant delays in CRRT initiation and restarts.

Approach:
A multimodal quality improvement initiative was implemented across 7 adult intensive care units, which allowed unit-based staff nurses to initiate and restart CRRT, a task that had previously been delegated to non–unit-based dialysis nurses.

Outcomes:
A 75% reduction in CRRT initiation delays and a 90% reduction in CRRT restart delays were observed in the 12 months following the initiative. There were no adverse events or increased disposable CRRT circuit usage following the initiative.

Conclusions:
Implementation of CRRT initiation and restarts by unit-based nurses were achievable and resulted in substantial improvements in timeliness of CRRT delivery.
Biomechanical models: key considerations in study design
Authors: Augat Peter , Hast Michael W. , Schemitsch Geoffrey , Heyland Mark , Trepczynski Adam , Borgiani Edoardo , Russow Gabriele , Märdian Sven , Duda Georg N. , Hollensteiner Marianne , Bottlang Michael , Schemitsch Emil H. 
Published: April 2021

Abstract
This manuscript summarizes presentations of a symposium on key considerations in design of biomechanical models at the 2019 Basic Science Focus Forum of the Orthopaedic Trauma Association. The first section outlines the most important characteristics of a high-quality biomechanical study. The second section considers choices associated with designing experiments using finite element modeling versus synthetic bones versus human specimens. The third section discusses appropriate selection of experimental protocols and finite element analyses. The fourth section considers the pros and cons of use of biomechanical research for implant design. Finally, the fifth section examines how results from biomechanical studies can be used when clinical evidence is lacking or contradictory. When taken together, these presentations emphasize the critical importance of biomechanical research and the need to carefully consider and optimize models when designing a biomechanical study.
The induced membrane technique for bone defects: Basic science, clinical evidence, and technical tips
Authors: Hoit Graeme , Kain Michael S. , Sparkman Jeremy W. , Norris Brent L. , Conway Janet D. , Watson J. Tracy , Tornetta Paul , Nauth Aaron 
Published: April 2021

Abstract
The clinical management of large bone defects continues to be a difficult clinical problem to manage for treating surgeons. The induced membrane technique is a commonly employed strategy to manage these complex injuries and achieve bone union. Basic science and clinical evidence continue to expand to address questions related to the biology of the membrane and how interventions may impact clinical outcomes. In this review, we discuss the basic science and clinical evidence for the induced membrane technique as well as provide indications for the procedure and technical tips for performing the induced membrane technique.
A Pilot Evaluation of Expedited Partner Treatment and Partner Human Immunodeficiency Virus Self-Testing Among Adolescent Girls and Young Women Diagnosed With Chlamydia trachomatis and Neisseria gonorrhoeae in Kisumu, Kenya
Authors: Omollo Victor , Bukusi Elizabeth A. , Kidoguchi Lara , Mogaka Felix , Odoyo Josephine B. , Celum Connie , Morton Jennifer , Johnson Rachel , Baeten Jared M. 
Published: April 2021

Background
Expedited partner treatment (EPT) is effective for preventing sexually transmitted infection recurrence, but concerns about intimate partner violence and missed opportunities for human immunology virus (HIV) testing have limited its use in African settings.

Methods
We conducted a pilot prospective evaluation of EPT among adolescent girls and young women (AGYW) accessing HIV preexposure prophylaxis in an implementation project in Kisumu, Kenya. Those with etiologic diagnosis of Chlamydia trachomatis and Neisseria gonorrhoeae were treated and given the option of delivering sexually transmitted infection medication and HIV self-test kits to their current sexual partner(s). At enrollment, we assessed their reasons for declining. Three months after they delivered medication and kits to the partner(s), we assessed their reasons for failing to deliver medication and kits to their partner and reported partner's reactions.

Results
Between September 2018 and March 2020, 63 AGYW were enrolled. The majority (59/63 [94%]) accepted EPT, and 50 (79%) of 63 partner HIV self-testing (HIVST). Three quarters (46/59) of those accepting EPT returned for the assessment visit with 41 (89%) of 46 successfully delivering medication to 54 partners, of whom 49 (91%) used it. Seventy percent (35/50) who took partner HIVST kits returned for the assessment, with 80% (28/35) reporting providing kits to 40 partners, of whom 38 (95%) used it. Reported barriers to EPT and partner HIVST uptake among women who declined included anticipated fear that their partner could become angry or violent and loss of relationship.

Conclusions
Both EPT and partner HIVST were acceptable despite noted barriers among Kenyan AGYW with etiologic diagnosis of Chlamydia trachomatis/Neisseria gonorrhoeae and their partners.
Spatial and Temporal Epidemiology of Infectious Syphilis in Victoria, Australia, 2015–2018
Authors: Aung Ei T. , Chen Marcus Y. , Fairley Christopher K. , Higgins Nasra , Williamson Deborah A. , Tomnay Jane E. , Cook Kathryn A. , Peel Joanne , Dharmakulasinghe Vino , Alpren Charles , Chow Eric P.F. 
Published: April 2021

Abstract
This analysis of notified syphilis cases in Victoria, Australia between 2015 and 2018 shows that the syphilis epidemic in Victoria has become more generalized, with increases among heterosexual men and women residing in outer Melbourne suburbs—areas that differ from those of gay men.