bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cyclic Hematochezia: A Sign of Intestinal Endometriosis? An Evaluation by Magnetic Resonance Imaging and Colonoscopy
Authors: Lüchinger Annemarie B. , Busard Milou P.H. , Mijatovic Velja , van Waesberghe Jan Hein T.M. , Mulder Chris J. , Hompes Peter G.A. 
Published: May 2021

Purpose Intestinal bowel endometriosis is reported in up to 37% of women with proven endometriosis. The aim of this study was to evaluate by colonoscopy and magnetic resonance imaging, patients suspected of deep infiltrating endometriosis (DIE) including the bowel wall that presented with cyclic hematochezia. Methods Twenty-four patients with cyclic hematochezia were retrospectively analyzed on colonoscopic features of colonoscopy, corresponding biopsy data, and outcome of magnetic resonance imaging evaluation. Fifteen out of 24 patients underwent bowel resection because of insufficient response to hormonal treatment (N=14) or obstructive ileus (N=1). Outcome of surgery and histologic examination of the resected specimens were evaluated. Results Colonoscopy proved intestinal endometriosis in only one out of 24 (4%) patients with cyclic hematochezia. In 13 out of 15 bowel resections endometriosis was found at histopathology. The location and dimension of lesions during surgery correlated well with magnetic resonance imaging findings. However, magnetic resonance imaging revealed a limited capacity to detect luminal narrowing of the bowel. Conclusions This study shows that colonoscopic findings of bowel endometriosis are aspecific. Colonoscopy, an invasive investigation, should therefore not be performed to diagnose endometriosis infiltrating the bowel wall. Magnetic resonance imaging provides good diagnostic work-up and in selected patients a roadmap to surgery.
Gastro-Intestinal Symptoms and Dietary Intolerance in Women with Endometriosis
Authors: Baron Yves Muscat , Dingli Maximilian , Agius Rodianne Camilleri , Neville Calleja , Brincat Mark 
Published: May 2021

Purpose A comprehensive assessment of gynecologic, general, and gastrointestinal complaints of a group of women with laparoscopically confirmed endometriosis compared to another group of women without endometriosis was performed. The possibility of dietary intolerance in relation to the coexistence of endometriosis was also assessed. Methods This was a prospective, comparative study conducted on 57 patients who had had laparoscopies for various gynecologic complaints. These women were recruited sequentially into the study so as to avoid selection bias (age range 20 to 55). Twenty-three patients were diagnosed with endometriosis while the other 34 did not have this pathology. Prior to laparoscopy these patients were asked through a telephone questionnaire about associated long-term gastrointestinal symptoms, dietary intolerance, and general and gynecologic symptoms. Results Twenty-three women were diagnosed as having pelvic endometriosis. The remaining thirty-four patients were noted to suffer from pathology other than endometriosis. Gastro-intestinal symptoms such as dyspepsia (P<.01) and diarrhea (P< .05) were significantly more common in the endometriosis group compared to the other group of women. Women with endometriosis complained of more gastrointestinal symptoms (53% vs. 31%) and food intolerance (26% vs. 14%) than the women without endometriosis. These differences between both groups did not attain statistical significance possibly because the study was not suitably powered to reveal this. No significant differences were noted for most of the other aggregated gynecologic and general symptoms except for shorter menstrual cycles (P<.01) and depression (P<.05) in the women diagnosed with endometriosis. Conclusions Patients suffering from endometriosis in this study complained of significantly more gastrointestinal symptoms. A nonsignificant trend of dietary intolerance was noted in the women shown to suffer from endometriosis. These findings may shed some light on the pathogenesis and the management of endometriosis.
Pylephlebitis Complicating Concurrent Sigmoid Endometriosis and Diverticulosis: A Case Report
Authors: Hayes Alastair J. , Reddy Reddivari AK. , Haugk Beate , Gallagher Hugh J. 
Published: May 2021

Purpose To explain an unusually severe presentation of concurrent sigmoid diverticulosis and endometriosis. Intestinal endometriosis can be complicated by colonic obstruction, perforation, fistula formation, and sepsis. Suppurative thrombosis of the portal system (pylephlebitis) complicating intestinal endometriosis has not been previously reported. Methods A previously fit and well 44-year-old woman presented with a two-day history of severe, intermittent left iliac fossa pain and loose, brown stools. CT scan revealed thickening of the sigmoid colon and inferior mesenteric and intra-hepatic vein thrombosis with patchy liver perfusion. Conservative management failed and an exploratory laparotomy showed a sigmoid inflammatory phlegmon. The inferior mesenteric vein containing pus and thrombus was excised together with the sigmoid mass. Results Histology revealed sigmoid colonic diverticulosis and endometriosis associated with extensive subserosal abscess formation. Widespread suppurative necrotizing venulitis with partial thrombosis of mesenteric veins was found. Literature review revealed that endometriotic cells produce a variety of pro-inflammatory mediators. Conclusions We postulate that endometriotic tissue within the diverticular sigmoid colon triggered an inflammatory cascade, leading to bacterial translocation and pylephlebitis.
Oral Ketorolac as an Adjuvant Agent for Postoperative Pain Control After Arthroscopic Rotator Cuff Repair: A Prospective, Randomized, Controlled Study
Authors: Sivasundaram Lakshmanan , Mengers Sunita , Trivedi Nikunj N. , Strony John , Salata Michael J. , Voos James E. , Victoroff Brian N. , Karns Michael R. , Gillespie Robert J. 
Published: May 2021

Background:
Arthroscopic rotator cuff repair (RCR) is associated with substantial postoperative pain. Oral narcotic agents are the preferred analgesic postoperatively. However, these agents are associated with several side effects and a potential for abuse. This study evaluates the efficacy of ketorolac as an adjunctive agent for postoperative pain control after arthroscopic RCR.

Methods:
Adult patients undergoing arthroscopic RCR were prospectively enrolled and randomized to one of two groups. The control received our institution's standard-of-care pain protocol, including oxycodone-acetaminophen 5 to 325 mg on discharge. The ketorolac group received the standard-of-care protocol, intravenous ketorolac at the completion of the procedure, and oral ketorolac on discharge. Pain and functional outcome scores and narcotic utilization were recorded three times per day for the first 5 days after surgery. Repeat magnetic resonance imaging was done at least 6 months postoperatively.

Results:
In our study, 39 patients were included for final analysis; the mean age of the cohort was 55.7 ± 10.6 years, and 66.7% of patients were male. No differences were observed in preoperative demographics, comorbidities, cuff tear morphology, and functional scores between the two groups. Over the first 5 days after surgery, patients in the ketorolac group consumed a mean of 10.6 fewer narcotic pills, a consumption reduction of 54.6% (19.42 versus 8.82, P < 0.001). No difference was observed in functional outcome scores at up to 6 weeks postoperatively between the two groups. No difference was observed in adverse events between the two groups with no reported cases of gastritis or gastrointestinal bleeding. Twenty-two of 39 patients underwent repeat magnetic resonance imaging at a mean of 7.9 months postoperatively, of which 5 (22%) demonstrated a retear of their rotator cuff. No significant difference was observed between the ketorolac and control groups in the rate of retear (P = 1.00).

Discussion:
Adjunctive ketorolac substantially reduces narcotic utilization after arthroscopic RCR.
2021/3 Application of a collective agreement and discrimination based on membership (non-membership) of a trade union (LT)
Authors: Petrylaitė Vida 
Published: May 2021

2021/3 Application of a collective agreement and discrimination based on membership (non-membership) of a trade union (LT)
On 16 December 2020, the Supreme Court of Lithuania (Cassation Court) delivered a ruling in a case where an employee claimed that the employer, JSC ‘Lithuanian Railways’, did not apply the regulations of the company’s employer-level collective agreement and did not pay a special bonus – an anniversary benefit (i.e. a benefit paid to employees on reaching a certain age) – because the employee was not a member of the trade union which had signed the collective agreement. According to the employee, she was discriminated against because of her membership of another trade union, i.e membership of the ‘wrong’ trade union.The Supreme Court held that combatting discrimination under certain grounds falls within the competence and scope of EU law, but that discrimination on the grounds of trade union membership is not distinguished as a form of discrimination. Also, the Court ruled that in this case (contrary to what the employee claimed in her cassation appeal) Article 157 of the Treaty on the Functioning of the European Union (TFEU) is not applicable because it regulates the prohibition of discrimination on other (sex) grounds. Moreover, the Court found that there was no legal basis for relying on the relevant case law of the ECJ which provides clarification on other forms of discrimination, but not on discrimination based on trade union membership.
2021/4 Budget considerations can justify indirect discrimination (UK)
Authors: Soakell Carolyn 
Published: May 2021

2021/4 Budget considerations can justify indirect discrimination (UK)
If an employer has a policy which is indirectly discriminatory and the employer’s aim is no more than saving money, the Court of Appeal (CA) has ruled that this cannot justify the discrimination. However, needing to balance the books can potentially be a valid justification for indirect discrimination.
2021/5 Upper age limit for entrance to police force found discriminatory (IR)
Authors: O’Leary Orla 
Published: May 2021

2021/5 Upper age limit for entrance to police force found discriminatory (IR)
An adjudication officer of the Irish Workplace Relations Commission has ruled that an upper age limit for entrance to An Garda Síochána (the national police force) was discriminatory on the grounds of age.
2021/6 Conclusion of the ECJ case on whether obesity may constitute a disability (DK)
Authors: Clasen Christian K. 
Published: May 2021

2021/6 Conclusion of the ECJ case on whether obesity may constitute a disability (DK)
In 2014, the ECJ was presented with a preliminary reference from the District Court in Kolding on the matter of whether EU law provides protection against discrimination on grounds of obesity with regard to employment and occupation. Following the ECJ’s ruling, first the District Court and later the High Court found that an employee’s obesity as such did not constitute a disability within the meaning of Directive 2000/78/EC establishing a general framework for equal treatment in employment and occupation since his obesity had not constituted a limitation or inconvenience in the performance of his job.
2021/12 Expiry of untaken annual leave and entitlement to compensation (SI)
Authors: Smolnikar Petra , Marinček Tjaša 
Published: May 2021

2021/12 Expiry of untaken annual leave and entitlement to compensation (SI)
Following ECJ case law, the Supreme Court of the Republic of Slovenia has ruled that a worker is entitled to compensation for unused annual leave in the event that the termination of employment has occurred 15 months after the end of the transfer period (i.e. the period for the transfer of the right to use annual leave) provided for in national legislation. The relevant transposition period is therefore three months longer than the transposition period set out in the Slovenian law.
Nutritional Composition of Game Meat from Wild Species Harvested in Europe
Authors: Soriano Almudena , Sánchez-García Carlos 
Published: May 2021

A discussion about the nutritional composition of game meat, with specific focus on wild species harvested in Central and Mediterranean European countries has been conducted. Given the wide range of species, and the climate and vegetation differences among the harvesting areas, game meat shows heterogeneous characteristics and chemical composition, the latter being also affected by sex, age, body condition, physiological and sexual status, and hunting period. However, there are similarities which make it clearly distinguishable from livestock meat. When considering the most consumed species (red and fallow deer, wild boar, hare and wild rabbit), their meat has low fat content (<3 g/100 g for large and <4 g/100 g for small wild game species), high protein content (20–26 g/100 g) and low energy content (90–113 kcal/100 g). Wild game meat has a healthier fatty-acids profile compared to other meats, showing a higher proportion of PUFA, especially n-3, and consequently more favorable PUFA/SAF ratio. Wild ruminants’ meat shows a favorable n-6/n-3 ratio (lower or close to 4). It has a high content of K, followed by P and micro-minerals such as Zn and Fe, together with B-group vitamins and vitamin E. Game meat from wild species harvested in Europe can diversify the market being an alternative to others red meats owing to its nutritional quality and organoleptic characteristics.
Malign Plevral Mezotelyoma Tanısında 18F-FDG PET/BT Görüntülemenin Rolü
Authors: KAPLAN İhsan 
Published: May 2021

Amaç: Malign plevral mezotelyoma (MPM) ön tanısı ile 18F-FDG PET/BT görüntülemesi yapılan hastalarda, plevral kalınlık ve mediastinal lenf nodlarının, boyut ile SUVmax değerlerinin tanısal etkinliğini araştırmayı amaçladık.
Yöntemler: Mayıs 2018 ile Şubat 2020 tarihleri arasında kliniğimize, MPM ön tanısıyla başvuran ve 18F-FDG PET/BT görüntülemesi yapılan 54 hasta retrospektif olarak incelendi. Hastaların 28’i kadın (%51,8) ve 26’sı erkek (%48,2) olup ortalama yaşları 58,8 idi. Tüm hastaların plevral kalınlık değerleri, mediastinal lenf nodlarının boyutları ve tüm lezyonların SUVmax değerleri ölçüldü. PET/BT görüntüleme sonrası yapılan histopatolojik inceleme sonucu hastaların 23’ünde MPM, 20’sinde benign plevral hastalık (BPH) ve 11’inde metastatik plevral hastalık (MPH) saptandı.
Bulgular: Tüm gruplar arasında plevral kalınlığın median SUVmax değeri açısından yapılan karşılaştırmada; istatistiki anlamlılık bulundu (p=0.003). Plevral kalınlığın median SUVmax parametresi ikili grup karşılaştırılmalarında; BPH grubun median SUVmax değeri MPM ve MPH’ya göre istatistiki anlamlı olacak şekilde düşük bulundu (p değerleri sırasıyla p:0.034 ve p:0.023). Diğer parametrelerde ise MPM ile diğer gruplar karşılaştırıldığında istatistiki anlamlı fark bulunmadı. MPM grubunu tespit etmedeki SUVmax cut-off değeri 6,75 alındığında %69,6 sensitivite ve %67,6 spesifiteye sahip olup istatistiki anlamlı fark bulundu.
Sonuç: Malign plevral mezotelyomayı diğer plevral patolojilerden ayırt etmede plevral kalınlığın median SUVmax değerinin kullanılabileceği sonucuna varıldı.
Maraş Otunun Ağrı Şiddeti, Ağrı Eşiği ve Ağrı Toleransı Üzerine Etkisi
Authors: SERİNGEÇ AKKEÇECİ Nurten 
Published: May 2021

Amaç: Bu çalışma, dumansız bir tütün formu olan maraş otunun kronik kullanımının ağrı şiddeti, ağrı eşiği ve ağrı toleransı üzerine herhangi bir etkisinin olup olmadığını belirlemek amacı ile planlanmıştır.
Yöntemler: Çalışmaya herhangi bir hastalığı bulunmayan 18-39 yaş arası, en az 5 yıldır maraş otu kullanan 10 kişi ve maraş otu ya da herhangi bir tütün ürünü kullanmayan 10 kişi olmak üzere toplam 20 sağlıklı erkek dahil edildi. Maraş otu kullanan kişilere deneylerden en az 12 saat önce maraş otu kullanmamaları söylendi. Maraş otu kullanan ve kullanmayan kişilerin ağrı şiddetleri, ağrı eşikleri ve ağrı toleransları karşılaştırıldı. Ağrı şiddeti vizüel analog skala (VAS) ile değerlendirildi. Ağrı eşiği ve ağrı toleransı soğuk pressör testi ile ölçüldü. Çalışmanın sonuçları Mann-Whitney U testi kullanılarak analiz edildi.
Bulgular: Maraş otu kullanan kişilerde ağrı eşiği 17,11±4,59, ağrı toleransı 47,82±16,27 ve VAS 5,78±0,83; Maraş otu ya da herhangi bir tütün ürünü kullanmayan kişilerde ise ağrı eşiği 21,79±6,11, ağrı toleransı 72,82±22,36 ve VAS 3,78±0,97 olarak tespit edildi. Maraş otu kullanan kişilerin kullanmayanlara göre ağrı şiddeti (VAS) anlamlı olarak yüksek bulunurken (p=0,001); ağrı eşiği ve ağrı toleransı anlamlı olarak düşük bulundu (p=0,016, p=0,012; sırasıyla).
Sonuç: Bu çalışmadan elde edilen sonuçlar kronik maraş otu kullanan kişilerin kullanmayanlara göre hissettikleri ağrı şiddetinin daha yüksek olduğunu, ağrı eşiği ve ağrı toleranslarının ise daha düşük olduğunu göstermiştir. Dumansız tütün ürünlerinin ağrı üzerine etkilerini araştıran daha fazla çalışmaya ihtiyaç vardır.
Giant Mucinous Carcinoma Originating from the Appendix: A Case Report
Authors: Takeda Makoto , Onuki Yoshinori , Oishi Kosuke , Kubota Osamu , Uchiyama Takashi , Arai Yoshifumi , Takeuchi Hiroya 
Published: May 2021

Introduction
Appendiceal mucinous neoplasms can involve peritoneal pseudomyxoma or invasion of adjacent organs. This report describes a rare case in which a giant appendiceal mucinous carcinoma expansively developed in the retroperitoneum without perforating the abdominal cavity.

Case Presentation
The patient was a 55-year-old woman with no relevant history who was admitted to our hospital after imaging examination revealed a retroperitoneal tumor. The clinical diagnosis was a retroperitoneal tumor involving the hedge mucin. The patient underwent right hemicolectomy and partial resection of the duodenum and right abdominal wall to ensure complete tumor resection. Histopathologic findings suggested that the tumor was a mucinous carcinoma arising from the appendix. The postoperative course was uneventful. Although adjuvant chemotherapy was performed for 6 months, peritoneal recurrence developed 7 years and 4 months postoperatively. Nine years have passed since the surgery, and the patient is alive and receiving chemotherapy.

Conclusion
Detailed pathologic examinations revealed that the tumor originated from the appendix. The characteristics of mucinous carcinoma contributed to the extensive growth of the tumor.
Common Rule of Research with Human Subjects
Authors: Coleman Carl H 
Published: May 2021

Abstract

The Common Rule is a set of U.S. federal regulations that govern research with human subjects conducted or supported by certain federal departments and agencies. With the exception of specific types of low‐risk studies, the Common Rule requires all covered research to be reviewed and approved by an interdisciplinary ethics committee known as an ‘institutional review board’ (IRB). IRBs are charged with ensuring that the risks to subjects are minimised; that the risks are reasonable in relation to the anticipated benefits of the research; that, except in limited circumstances, informed consent will be appropriately obtained and documented; that the selection of subjects will be equitable; and, when appropriate, that the research includes adequate provisions for data monitoring and adequate provisions to protect subjects' privacy and the confidentiality of data.

Key Concepts

The Common Rule is a set of U.S. regulations governing research with human subjects conducted or supported by certain federal departments or agencies.

With the exception of certain types of low‐risk studies, the Common Rule requires all covered research to be reviewed and approved by an institutional review board.

The Common Rule applies only to activities that are designed to develop or contribute to generalisable knowledge.

The Common Rule applies only to studies that involve either obtaining information or biospecimens through intervention or interaction with individuals; or using, studying, analysing or generating identifiable private information or identifiable biospecimens.

IRBs exist both within research institutions and as free‐standing entities that review research submitted by external investigators.

IRBs must have at least five members with diverse professional and demographic backgrounds, including at least one member whose primary concerns are in nonscientific areas and at least one member who is not affiliated with the institution.

With limited exceptions, any institution in the United States engaged in cooperative research with other institutions must rely on a single IRB to approve any portion of the research conducted in the United States.

IRBs are charged with weighing the risks and benefits of proposed research, ensuring the adequacy of the informed consent process, ensuring that the selection of subjects will be equitable, and, when appropriate, ensuring that the research includes adequate provisions for data monitoring and adequate provisions to protect subjects' privacy and the confidentiality of data.

In studies involving the storage, maintenance and secondary research use of identifiable private information or identifiable biospecimens, the Common Rule permits subjects or their representatives to consent to broad categories of future research before the details of those studies are known.

In limited circumstances, the Common Rule permits IRBs to waive the requirement to obtain or document informed consent.
Genetics of Fibrodysplasia Ossificans Progressiva
Authors: Mukaddam Mona Al , Pignolo Robert J 
Published: May 2021

Abstract

Fibrodysplasia ossificans progressiva (FOP, OMIM# 135100) is an ultra‐rare genetic disease that turns skeletal muscle, tendons and connective tissue into bone. FOP is due to an over‐activating mutation in ACVR1/ALK2 receptor that leads to prenatal bone and joint abnormalities, most notably the malformed big toe, and postnatal episodes of soft tissue swelling or ‘flare‐ups’ that lead to heterotopic ossification (HO). The most common pathogenic variant c.617G>A; p.R206H is reported in about 97% of known FOP cases; less common reported pathogenic variants can be associated with milder or more severe phenotypes and other atypical FOP findings. Inheritance is autosomal dominant; however, most of the reported cases are sporadic. Currently, there is not a cure or approved treatment for FOP however several drugs are in clinical development.

Key Concepts

FOP is a genetic form of heterotopic ossification due to an activating pathogenic variant in
ACVR1/ALK2
.

Inheritance is autosomal dominant, however, most reported cases are sporadic.

The R206H pathogenic variant is reported in approximately 97% of known FOP cases.

Genotype‐phenotype correlations have been reported but there is significant variation in disease progression.

Genetic variants in
ACVR1
could provide therapeutic pathways.