bluuebunny/crossref_metadata_2025_split huggingface dataset:
CHOROIDAL NEOVASCULAR MEMBRANE ASSOCIATED WITH CHOROIDAL LYMPHOMA
Authors: Ebert Jared J. , Di Nicola Maura , Williams Basil K. 
Published: December 2021

Purpose:
A patient with choroidal lymphoma associated with a choroidal neovascular membrane (CNVM) is described.

Methods:
Observational case report.

Results:
A 70-year-old man was referred for evaluation of bilateral uveitis with concern for intraocular lymphoma. Fundoscopic examination was notable for vitreous opacities and diffuse yellow–white, creamy choroidal infiltrates in both eyes. In the left eye, areas of hemorrhage and intraretinal fluid in the macula consistent with a CNVM were noted. Multimodal imaging confirmed the diagnosis of bilateral choroidal lymphoma with a CNVM in the left eye. The patient subsequently underwent external beam radiation therapy. The CNVM was treated with intravitreal bevacizumab.

Conclusion:
This case highlights the rare finding of a patient with a CNVM associated with choroidal lymphoma. Recognition and treatment of concurrent disease processes in the setting of choroidal lymphoma is important to achieve maximum visual potential.
Dermatoscopy in the Diagnosis of Vulvar Basal Cell Carcinoma: A Case Report
Authors: de los Cobos Davaios Diego Adolfo , Cepeda-Valdes Rodrigo , Favela-Fernandez Luis Fernando , Villarreal-Carrillo Claudia , Salas-Alanis Julio Cesar 
Published: December 2021

Abstract

Introduction:
Basal cell carcinoma (BCC) is the most common human malignancy commonly in white people, but in less than 1% of cases it may appear on unexposed areas, like the perineal and anal regions. Vulvar BCC is often diagnosed late because it grows slowly and tends to be asymptomatic, with no specific physical findings.
Here, we present a rare Latin patient with a 10-year history of vulvar BCC with dermatoscopic and histopathologic findings.

Case report:
A 65-year-old Latin woman presented with a nodule on her left labium majus, which she first noted 10 years ago, and that had grown slowly but constantly. She also reported a 20-year history of pruritus and occasional pain. Physical examination showed a 3.5 cm × 3.0 cm erythematous lesion with a central rough without inguinal lymphadenopathy. Contact dermatoscopy (Dermalite DL3 Gen.) showed one blurred cluster of arborising vessels in a pinkish background with white homogeneous areas and lines radial converging. An incisional biopsy was realized, and histopathology diagnosed BCC.

Discussion:
Vulvar BCC is a rare malignancy that affects mainly Caucasian women over 70 years of age. The most common etiology for BCC is ultraviolet radiation, but as the vulva is unexposed its cause is unclear. Mutations in tumor suppressor and regulatory genes such as p53 are present in 50% of cases. Gorlin syndrome, chronic radiation, chronic arsenic exposure, xeroderma pigmentosum, and immunosuppression have been considered as risk factors.

Conclusion:
Vulvar BCC characteristics are the same as other cutaneous forms, featuring blue ovoid nests and arborizing telangiectasia, confused with inflammatory diseases, such as eczema, psoriasis, and chronic infection (especially if it is accompanied by pruritus), this makes diagnosis complex, with a delay of 5 to 6 years on average, with an average size of 2.1 cm. Diagnosis is enhanced with dermatoscopy, as the preferred treatment for most BCC cases is wide surgical excision.
Identification of key genes and microRNAs for multiple sclerosis using bioinformatics analysis
Authors: Xu Zhong-bo , Feng Xin , Zhu Wei-na , Qiu Ming-liang 
Published: December 2021

Abstract
To better understand the molecular mechanism underlying the pathogenesis of multiple sclerosis (MS), we aimed to identify the key genes and microRNAs (miRNA) associated with MS and analyze their interactions. Differentially expressed genes (DEGs) and miRNAs (DEMs) based on the gene miRNA dataset GSE17846 and mRNA dataset GSE21942 were determined using R software. Next, we performed functional enrichment analysis and constructed a protein–protein interaction network. Data validation was performed to ensure the reliability of hub genes. The miRNA-mRNA regulatory network was constructed. In total, 47 DEMs and 843 DEGs were identified. Protein–protein interaction network analysis identified several hub genes, including JUN, FPR2, AKT1, POLR2L, LYZ, CXCL8, HBB, CST3, CTSZ, and MMP9, especially LYZ and CXCL8. We constructed an miRNA-mRNA regulatory network and found that hsa-miR-142-3p, hsa-miR-107, hsa-miR-140-5p, and hsa-miR-613 were the most important miRNAs. This study reveals some key genes and miRNAs that may be involved in the pathogenesis of MS, providing potential targets for the diagnosis and treatment of MS.
Prognostic indicators for the onset of ischaemic versus haemorrhagic stroke in stable coronary artery disease
Authors: Wang Wei-Ting , Wu Tao-Cheng , Tseng Wei-Kung , Wu Yen-Wen , Lin Tsung-Hsien , Yeh Hung-I , Chang Kuan-Cheng , Wang Ji-Hung , Leu Hsin-Bang , Yin Wei-Hsian , Wu Chau-Chung , Chen Jaw-Wen 
Published: December 2021

Abstract
The incidence of stroke may be increased in patients with coronary artery disease (CAD). We aimed to investigate the specific risk factors for the development of ischaemic and haemorrhagic stroke in stable CAD patients.
Patients with stable CAD were prospectively enrolled for future cardiovascular events in Taiwan. All the patients had received coronary interventions and were stable for least 1 month before enrolment. The incidence of ischaemic stroke was identified and confirmed by telephone and hospital records. Baseline characteristics, including demographic data, lipid profiles, medications, and biomarkers for potential inflammatory and atherosclerosis, were analysed.
In total, 1428 patients (age, 63.07 ± 11.4 years; 1207 males) were under standard medical treatment and regularly followed-up for at least 4 years. Multivariate logistic regression analysis showed that baseline serum myeloperoxidase (MPO) level (hazard ratio [HR]: 1.89, 95% CI: 1.16–3.10, P = .01) and statin use (HR: 0.37; 95% CI: 0.17–0.79, P = .01) were independently associated with the onset of ischaemic stroke. Age (HR: 1.07, 95% CI: 1.00–1.14, P = .04) and angiotensin receptor blocker (ARB) use (HR: 0.37, 95% CI: 0.17–0.79, P = .01) were independently associated with future onset of intracranial haemorrhage (ICH), implying the different mechanisms of ischaemic stroke and ICH.
Age and ARB use were related to ICH onset. Baseline MPO level and statin use were independently associated with longer and shorter future ischaemic stroke onset in stable CAD patients, respectively. Further studies are indicated to confirm the potential mechanisms and advance individual risk stratification for the onset of different types of stroke in clinical CAD.
Prediction of anemia on enhanced computed tomography of the thorax using virtual non-contrast reconstructions
Authors: Iuga Andra-Iza , Pennig Lenhard , Caldeira Liliana Lourenco , Maintz David , Hickethier Tilman , Doerner Jonas 
Published: December 2021

Abstract
To determine if anemia can be predicted on enhanced computed tomography (CT) examinations of the thorax using virtual non-contrast (VNC) images, in order to support clinicians especially in diagnosing primary asymptomatic patients in daily routine.
In this monocentric study, 100 consecutive patients (50 with proven anemia), who underwent a contrast-enhanced CT examination of the thorax due to various indications were included. Attenuation was measured in the descending thoracic aorta, the intraventricular septum, and the left ventricle cavity both in the conventional contrast-enhanced and in the VNC images.
Two experienced radiologists annotated the delineation of a dense interventricular septum or a hyperattenuating aortic wall sign for all patients.
Hemoglobin levels were then correlated with the measured attenuation values, as well as the visualization of the aortic wall or interventricular septum.
Good correlation was shown between hemoglobin levels and CT attenuation values of the left ventricular cavity (r = .59), aorta (r = .56), and ratio between left ventricular cavity and the intraventricular septum (r = .57). Receiver operating characteristic curve revealed ≤ 36.5 hounsfield units (left ventricular cavity) as the threshold for diagnosing anemia. Predicting anemia by visualization of a hyperattenuating aortic wall or a dense interventricular septum yielded a specificity of 98% and 92%, respectively.
Predicting anemia on enhanced CT examinations using VNC is feasible. A threshold value of ≤ 36.5 hounsfield units (left ventricular cavity) best defines anemia. Aortic wall or interventricular septum visualization on VNC is a specific anemia indicator.
Ataxia due to injury of the cortico-ponto-cerebellar tract in patients with mild traumatic brain injury
Authors: Jang Sung Ho , Lee Han Do 
Published: December 2021

Abstract

Introduction:
The cortico-ponto-cerebellar tract (CPCT) is involved in coordination of movement; injury of the CPCT can therefore be accompanied by ataxia. In this study, using diffusion tensor tractography (DTT), we investigated injury of the CPCT in patients with mild traumatic brain injury (TBI).

Methods:
We recruited 45 consecutive patients with ataxia following mild TBI and 20 normal control subjects. The score of assessment and rating of ataxia (SARA) was used to evaluate of ataxia. The patients were classified into 2 groups based on the SARA; patient group A had with post-traumatic ataxia and patient group B had without post-traumatic ataxia. The fractional anisotropy (FA) value and fiber number (FN) of the CPCT was measured.

Results:
Significant differences were observed in the FA and FN values of the CPCT between patient group A and the control group and between patient groups A and B (P < .05). In addition, a significant difference was observed in the FA value only of the CPCT between patient group B and the control group (P < .05). However, no significant difference was observed in the FN value of the CPCT between patient group B and the control group (P > .05).

Conclusion:
By using DTT, injury of the CPCT was demonstrated in patients who showed ataxia following mild TBI. These results suggest that DTT would be useful for evaluation of the CPCT in patients with ataxia after mTBI because mTBI usually does not show any abnormalities on conventional brain MRI.
Risk factors of postoperative complications following total knee arthroplasty in Korea
Authors: Ko Min-Seok , Choi Chong-Hyuk , Yoon Han-Kook , Yoo Ju-Hyung , Oh Hyun-Cheol , Lee Jin-Ho , Park Sang-Hoon 
Published: December 2021

Abstract

Background:
The number of patients undergoing total knee arthroplasty (TKA) is gradually increasing and there is also increase in postoperative complications. The patient's demographic, socio-economic factors, hospital and clinical factors are all factors that can influence postoperative complications. The purpose of this study was to determine the risk factors associated with complications following TKA in a large national cohort.

Methods:
Among patients diagnosed with primary knee arthrosis, a total of 560,954 patients older than 50 years who underwent TKA from January 1, 2005 to December 31, 2018 were included in the study. The risk of postoperative complications (surgical site infection, sepsis, cardiovascular complications, respiratory complications, pulmonary embolism, stroke, acute renal failure, periprosthetic joint infection, and periprosthetic fracture) were assessed with eight independent variables: gender, age, place of residence, household income, hospital bed size, procedure type (unilateral or bilateral, primary or revision TKA), length of stay (LOS), use of transfusion. Multivariable Cox Proportional Hazard model analysis was used. The significant predictors for complications (P < .05) were as follows.

Results:
Surgical site infection: male, procedure type (bilateral, revision), LOS (≥35 days), transfusion. Sepsis: male, household income, procedure type (bilateral, revision), LOS (≥35 days), transfusion. Cardiovascular complications: male, age, household income, procedure type (bilateral, revision), LOS (≥35 days), transfusion. Respiratory complications: male, household income, procedure type (bilateral, revision), LOS (≥35 days), transfusion. Pulmonary embolism: male, household income, procedure type (bilateral, revision), LOS (≥35 days), transfusion. Stroke: male, age, procedure type (bilateral, revision), LOS (≥35 days), transfusion. Acute renal failure: male, household income, procedure type (bilateral, revision), LOS (≥35 days), transfusion. Periprosthetic joint infection: male, household income, procedure type (bilateral, revision), LOS (≥35 days), transfusion. Periprosthetic fracture: male, procedure type (bilateral, revision), LOS (≥35 days), transfusion.

Conclusion:
In summary, male, procedure type (bilateral, revision), LOS (≥35 days), and use of transfusion were shown to be risk factors of postoperative complications following TKA.
A cross-sectional follow up study to estimate seroprevalence of coronavirus disease 2019 in Kobe, Japan
Authors: Doi Asako , Iwata Kentaro , Kuroda Hirokazu , Hasuike Toshikazu , Nasu Seiko , Nishioka Hiroaki , Tomii Keisuke , Morimoto Takeshi , Kihara Yasuki 
Published: December 2021

Abstract
We conducted a study to estimate the seroprevalence of coronavirus disease 2019 (COVID-19) in Kobe, Japan with positive immunoglobulin G (IgG) rate of 3.3% (95% confidence interval [CI] 2.3%–4.6%) in April 2020. Because there were large concerns about the spread of COVID-19 among citizens thereafter, we conduct a follow-up cross-sectional study to estimate the seroprevalence, and we also added a validation study using a different assay.
We conducted cross-sectional serologic testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody using 1000 samples from patients at outpatient settings who visited the clinic from May 26 to June 7, 2020, stratified by the decade of age and sex. We used both Kurabo and Abbott serology assays to identify IgG against SARS-CoV-2.
There were 18 and 2 positive IgG among 1000 serum samples using Kurabo and Abbott serology assays, respectively (1.8%, 95% CI 1.1%–2.8%, and 0.2%, 95% CI 0.02%–0.7% respectively). By applying the latter figure to the census of Kobe City (population: 1,518,870), it is estimated that the number of people with positive IgG is 3038 (95% CI: 304–10,632) while a total of 285 patients were identified by polymerase chain reaction (PCR) testing at the end of the study period. Assuming Abbott assay as the reference, Kurabo assay had calculated sensitivity and specificity of 100% and 98.4% respectively. Age and sex adjusted prevalence of positivity was calculated to be 0.17%.
We found a lower seroprevalence than 2 months before in Kobe city although the figures were still higher than those detected by PCR. Kurabo assay showed more false positives than true positives despite reasonable sensitivity and specificity, due to low prevalence in Kobe.
Relapsed/refractory acute promyelocytic leukemia with RARA-LBD region mutation was salvaged by venetoclax
Authors: Li Youli , Yu Jieni , Xu Qinhong , Zhang Kejie 
Published: December 2021

Abstract

Rationale:
Acute promyelocytic leukemia (APL) is one of the most curable cancers. However, relapse of the disease is a difficult issue in clinical practice and it remains a great challenge that patients have a poor effect of conventional treatment in the clinic. Therefore, new and more effective therapeutic measures are urgently needed. Herein, we report a case of relapsed and refractory APL harboring a RARA-LBD region mutation successfully treated with venetoclax (VEN).

Patient concerns:
A 37-years-old woman was admitted to our hospital with worsening spontaneous gingival bleeding and skin ecchymosis. Physical examination revealed multiple petechiae and ecchymosis in the extremities.

Diagnoses:
The patient was diagnosed with L-type PML-RARα-positive APL, harboring a RARA-LBD region mutation, low-risk, based on bone marrow cytology, immunophenotypic analysis by flow cytometry, karyotype analysis, and molecular analysis.

Interventions:
Complete remission was achieved after the first induction therapy of all-trans retinoic acid (ATRA) combined with arsenic trioxide, but relapse was observed only after 11 months. Reinduction with ATRA and arsenic trioxide combined with anthracycline failed. Therefore, we tried to provide a new treatment with the Bcl-2 inhibitor VEN orally (100 mg d1, 200 mg d2 to d18, followed by 300 mg daily continuously).

Outcomes:
Clinical symptoms and laboratory indicators improved rapidly with VEN treatment. A complete hematologic response was achieved with VEN-based therapy.

Lessons:
Related drug resistance gene monitoring should be performed canonically in relapsed and refractory APL. Some relapsed and refractory APL that failed to respond to conventional treatment were at risk of death. Bcl-2 inhibitors are expected to be an effective salvage therapy for patients with resistance to ATRA, which is worthy of further discussion.
Predictors of Covid-19 vaccination acceptance in IBD patients: a prospective study
Authors: Viola Anna , Muscianisi Marco , Li Voti Raffaele , Costantino Giuseppe , Alibrandi Angela , Fries Walter 
Published: December 2021

Background
Adherence to vaccinations is unsatisfactory in the inflammatory diseases (IBD) population because of concerns regarding adverse events or low perception of infectious risk. The aim of this study was to maximise adherence to anti-Covid-19 vaccination in IBD patients.

Methods
In the third trimester of 2020, all IBD patients were informed concerning the need for anti-Covid-19 vaccination and family physicians were advised to proceed with anti-Influenza and anti-pneumococcus vaccinations. Demographic data, disease-related data together with acceptance of vaccinations were recorded. From May 2021, vaccinations of IBD patients were directly arranged at our hospital. We registered performance, procrastination or denial of anti-Covid-19 vaccination, type of vaccine and adverse events.

Results
Five hundred and twenty-three patients were included (Crohn’s: 266, ulcerative colitis: 257; M/F 289/234; mean age 48 ± 17 years); 53 patients were excluded from analysis as they became infected with SARS-CoV-2 during the study period; overall adherence to vaccination was 400/470 (85%), procrastinators 44 (9%) and 27 patients (6%) refused. Compared with influenza (58%) and pneumococcus (65%) vaccinations, acceptance was higher for anti-Covid-19 vaccination (P < 0.0001, both). Mild adverse events occurred in 31% and two (0.5%) needed precautionary but uneventful hospitalization. On multiple stepwise regression analysis, factors positively associated with adherence to vaccination were age (P < 0.039; OR, 1.016, 95% CI: 1.001–1.031) and previous anti-influenza vaccination (P < 0.008; OR, 2.071, 95% CI: 1.210–3.545).

Conclusions
Direct counselling and on-site administration were associated with a satisfactory acceptance of anti-Covid-19 vaccination, whereas vaccinations against influenza and pneumococcus remained below expected levels. Increased risk perception may account for the observed differences.
ANGPTL4: a new mode in the regulation of intravascular lipolysis
Authors: Ploug Michael 
Published: December 2021

Purpose of review
Lipoprotein lipase (LPL) is the rate-limiting enzyme for intravascular processing of circulating triglyceride-rich lipoproteins (TRLs). One emerging strategy for therapeutic lowering of plasma triglyceride levels aims at increasing the longevity of LPL activity by attenuating its inhibition from angiopoietin-like proteins (ANGPTL) 3, 4 and 8. This mini-review focuses on recent insights into the molecular mechanisms underpinning the regulation of LPL activity in the intravascular unit by ANGPTLs with special emphasis on ANGPTL4.

Recent findings
Our knowledge on the molecular interplays between LPL, its endothelial transporter GPIHBP1, and its inhibitor(s) ANGPTL4, ANGPTL3 and ANGPTL8 have advanced considerably in the last 2 years and provides an outlined on how these proteins regulate the activity and compartmentalization of LPL. A decisive determinant instigating this control is the inherent protein instability of LPL at normal body temperature, a property that is reciprocally impacted by the binding of GPIHBP1 and ANGPTLs. Additional layers in this complex LPL regulation is provided by the different modulation of ANGPTL4 and ANGPTL3 activities by ANGPTL8 and the inhibition of ANGPTL3/8 complexes by apolipoprotein A5 (APOA5).

Summary
Posttranslational regulation of LPL activity in the intravascular space is essential for the differential partitioning of TRLs across tissues and their lipolytic processing in response to nutritional cues.
Frequency, Predisposing Factors, and Clinical Outcome of Azathioprine-Induced Pancreatitis Among Patients With Inflammatory Bowel Disease
Authors: Eskazan Tugce , Bozcan Selma , Atay Kadri , Yildirim Suleyman , Demir Nurhan , Celik Sinem , Tuncer Murat , Hatemi Ibrahim , Celik Aykut Ferhat , Erzin Yusuf 
Published: December 2021

Objective
The aim of the study was to identify the frequency of azathioprine-induced acute pancreatitis (AZA-AP) and related factors.

Methods
Seven hundred eighty-seven inflammatory bowel disease (IBD) patients on AZA therapy were retrospectively analyzed. Azathioprine-induced AP was diagnosed with positive imaging and/or an at least 3-fold increased amylase level, in presence of typical abdominal pain. The AZA-AP group was compared with patients on AZA therapy with no history of pancreatitis and 4 numerical adjacent cases with the same diagnosis were selected (group B).

Results
Fifty-four patients developed gastrointestinal symptoms (6.9%); however, only half of them (26 of 54) had pancreatitis, except 1, all within the first 2 months under AZA. When the AZA-AP group was compared with group B, only budesonide usage and active smoking were significantly more common in group A (46.2% vs 25%, P = 0.034, and 77% vs 51%, P = 0.017, respectively). Active smoking was the only independent risk factor for AZA-AP development (odds ratio, 3.208 [95% confidence interval, 1.192–8.632]).

Conclusions
All IBD patients developed AZA-AP nearly all within the first 2 months. Azathioprine intolerance may be a hidden diagnosis in at least half of the patients with AZA-AP symptoms. All smoker IBD patients should be monitored closely for AZA-AP development.
Prevalence, Incidence, and Risk of Progression of Asymptomatic Pancreatic Cysts in Large Sample Real-world Data
Authors: Schweber Adam B. , Agarunov Emil , Brooks Christian , Hur Chin , Gonda Tamas A. 
Published: December 2021

Objectives
Using large-sample, real-world administrative claims data, we evaluated the prevalence of putatively asymptomatic pancreatic cysts, the historical growth in their incident diagnosis, and their risk of malignant progression.

Methods
Data were sourced from IBM MarketScan administrative claims databases of more than 200 million patients. Period prevalence was assessed using 700,000 individuals without conditions that predispose to pancreatic cyst. The standardized cumulative incidence was compared with the cross-sectional abdominal imaging rate from 2010–2017. The risk of progression to pancreatic cancer for 14,279 newly diagnosed patients with a cyst was estimated using Kaplan-Meier analysis.

Results
Standardized prevalence increased exponentially with age and was 1.84% (95% confidence interval, 1.80%–1.87%) for patients older than 45. Standardized incidence nearly doubled from 2010–2017 (6.3 to 11.4 per 10,000), whereas the imaging rate changed from only 8.0% to 9.4%. The cumulative risk of pancreatic cancer at 7 years was 3.0% (95% confidence interval, 2.4%–3.5%), increasing linearly (R
2 = 0.991) with an annual progression risk of 0.47%.

Conclusions
Using large-sample data, we show a significant burden of asymptomatic pancreatic cysts, with an annual risk of progression to cancer of 0.47% for 7 years. Rapid growth in cyst diagnosis over the last decade far outpaced increases in the imaging rate.