bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidemiological study of the hand tumors in Tunisia: About 383 cases
Authors: Hassini Lassaad , Alaya Zeineb , Jedidi Mehdi , Khalifa Mohamed Ali , Osman Walid , Ben Ayèche Mohamed Laaziz 
Published: January 2019

Background:
Tumors of the hand constitute a reason for regular consultation. They represent 15% of the soft-tissue tumors. Epidemiological data available in this area remain few and sometimes discordant as to the regained prevalence. In this context, it appeared interesting to carry out a study of these lesions to try to identify the epidemiological notions relevant to the daily medical practice.

Methods:
We conducted a retrospective study of all hand tumors operated on in the Orthopedic Department of Sahloul University Hospital in Sousse, Tunisia over a period of 18 yr.

Results:
During the period of our study, 383 patients were admitted with a diagnosis of hand tumor. A female predominance was found: 221 women, or 58% of the cases. The average age of patients was 39.5 yr with extremes ranging from 1 to 94 yr. There were 221 soft-tissue tumors (i.e. 57.7% of our population), 114 skin-tissue tumors (29.8%), and 48 bone tumors (12.5%). The prevalence of malignant tumors was therefore 6.26%.

Conclusions:
Our series included 385 hand tumors in 383 patients. It was the sixth largest population in the literature. The data found in this study are comparable to other published data. Soft-tissue tumors were the most frequent, with a prevalence ranging from 69.7% to 97.4%. The prevalence of cutaneous tumors varied from 4.5 to 35.6%. They are benign in 72% to 95%. Finally, in view of these epidemiological data, we can only suggest certain etiopathogenic hypotheses whose truths remain to be confirmed by research.
CORRELATION OF EN FACE OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY AVERAGING VERSUS SINGLE-IMAGE QUANTITATIVE MEASUREMENTS WITH RETINAL VEIN OCCLUSION VISUAL OUTCOMES
Authors: Jung Jesse J. , Chen Michael H. , Shi Yue , Nassisi Marco , Marion Kenneth , Sadda Srinivas R. , Hoang Quan V. 
Published: January 2019

Purpose:
To demonstrate the effect of averaging multiple en face optical coherence tomography angiography images on the correlation between retinal microvasculature quantitative metrics and best-corrected visual acuity (BCVA) in eyes with retinal vein occlusion.

Methods:
A cross-sectional cohort with unilateral retinal vein occlusion was imaged in both eyes. Five 3 mm × 3-mm spectral domain optical coherence tomography angiography images were averaged, and quantitative parameters from averaged versus single images were correlated with logMAR BCVA. Regression analyses were performed to correlate quantitative metrics with BCVA.

Results:
Ten patients (5 male, average age 64.3 years) were included. Among retinal vein occlusion eyes, vessel length density was significantly less in averaged versus a single image for both the superficial retinal layer (15.5 ± 2.5 vs. 17.8 ± 2.4/mm, P = 0.05) and deep retinal layer (16.2 ± 1.4 vs. 18.5 ± 1.6/mm, P = 0.003). Multivariate linear regression showed an increased R2 value with averaging (0.93 to 0.95, for single and averaged groups, respectively). Foveal avascular zone circularity was associated with BCVA on single images (coefficient = −0.96, P = 0.002), but not with averaged images (P = 0.063).

Conclusion:
Scan averaging of en face optical coherence tomography angiography images improves the clarity of vessels and may allow for more accurate quantification of vessel metrics. Quantitative metrics are significantly associated with BCVA, and averaging does not further improve this association compared with single-scan analysis.
Qualitative Assessment of a Medical Protocols Mobile Application at the Boston Marathon 2016
Authors: Tseng David , d'Hemecourt Pierre , Baggish Aaron L. , Troyanos Chris , Liu James H. , Breaud Alan H. , Dyer K. Sophia 
Published: January 2019

Objective:
To examine the creation of a medical protocols mobile application for the Boston Marathon and its use by medical volunteers for the 2016 Boston Marathon.

Design:
Anonymous questionnaire.

Setting:
2016 Boston Marathon.

Participants:
Two hundred ninety-four marathon medical volunteers.

Main Outcome Measures:
Responses regarding ease of use, acceptability, and usefulness of the International Institute of Race Medicine mobile application.

Results:
In total, 88% of medical volunteers who participated in the study felt that the medical protocols mobile application was easy to use. Approximately 72% would use the app again, and 79% would recommend the app to others. However, only 15% of volunteers consistently used the app during the event, and 37% felt like it contributed to clinical decision-making.

Conclusions:
A medical protocols app was found to be useful and well accepted among medical volunteers who reported using the app, but only a minority of respondents used the app on marathon day or felt like it contributed to clinical care. Although new, mobile apps in race medicine should continue to be an area of development as providers increasingly integrate their use into clinical practice.
Evaluation of alexithymia in patients affected by rheumatoid arthritis and psoriatic arthritis
Authors: Chimenti Maria Sole , Fonti Giulia Lavinia , Conigliaro Paola , Hitaj Juna , Triggianese Paola , Teoli Miriam , Galluzzo Marco , Talamonti Marina , Kroegler Barbara , Greco Elisabetta , Perricone Roberto 
Published: January 2019

Abstract
Rheumatoid arthritis (RA) and psoriatic arthritis (PsA) are chronic autoimmune diseases leading to joint damage, functional limitation, and disability and are typically associated with several comorbidities. Alexithymia is a personality trait characterized by a disregulation of emotion processing and regulation of emotions that involves a dissociation of emotional and physical responses to life events. A broad association between alexithymia and symptoms as depression, inflammation, and pain has been demonstrated. We aimed at evaluate an association among inflammatory arthritis, as RA and PsA, and alexithymia, and a possible link with clinical characteristics and disease activity.
In this cross-sectional study, we enrolled, from January to December 2017, patients affected by RA or PsA referring to the outpatient's clinic of the Rheumatology Unit of the University of Rome Tor Vergata. The 20-item Toronto Alexithymia Scale (TAS-20) was used to assess alexithymia. Disease activity, function, quality of life, and clinimetric indexes were assessed.
A total of 50 RA patients and 51 PsA patients were enrolled. The TAS-20 score showed 38.6% (39/101) patients had alexithymia, 26.7% (27/101) patients were in the borderline of alexithymia and 34.7% (35/101) patients did not have alexithymia. A statistical significant association was observed between alexithymia and inflammatory indices (ESR: P = .029, CRP: P = .043) and between alexithymia and clinimetric parameters (ptVAS, pVAS, GH, P < .0001 for all comparisons). A significant trend of association has been demonstrated between alexithymia and female gender and concomitant steroid therapy. No correlations among variables such as age, duration of disease, and comorbidities and alexithymia status were observed.
This study suggests that alexithymia assessment should be a part of the comprehensive management of RA and PsA patients.
Clinical diagnostic value of contrast-enhanced ultrasound and TI-RADS classification for benign and malignant thyroid tumors
Authors: Xu Yan , Qi Xiaojie , Zhao Xia , Ren Wenfeng , Ding Wei 
Published: January 2019

Abstract
To evaluate the diagnostic efficacy and clinical value of contrast-enhanced ultrasonography (CEUS) plus TI-RADS classification in benign and malignant thyroid tumors compared with either method alone.
The informed consent was signed all patients. A total of 370 patients with thyroid tumors of TI-RADS category 3 and 4 were recruited, with 432 thyroid nodules. They respectively received routine ultrasonography and CEUS. The nodules were reclassified according to CEUS scoring, and a combined diagnosis was made. The pathological results were taken as the gold standard. The sensitivity (Se), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV) and area under the ROC curve were calculated for the 3 diagnostic methods. The diagnostic efficacy was compared by using Student t test, Pearson chi-square (χ
2) test, McNemar chi-square (χ
2) test or Z test. Student t test and logistic regression were employed for comparing different imaging features of benign and malignant thyroid tumors on CEUS and risk analysis.
Of 432 thyroid nodules, there were 258 malignant nodules (59.72%) and 174 benign ones (40.28%). By logistic regression, 6 suspicious features on CEUS were considered significant for differentiating malignant from benign tumors: slow entry of contrast agents during enhancement stage (OR = 15.610, P = .001), slow time to peak (OR = 7.416, P = .002), non-uniform enhancement (OR = 10.076, P = .023), enhancement pattern (irregular) (OR = 36.233, P = .002), enhancement boundary (unclear) (OR = 25.300, P = .012), and no ring-like enhancement (OR = 25.297, P = .004). CEUS plus TI-RADS classification showed a higher diagnostic efficacy for differentiating between benign and malignant thyroid tumors. The Se was 85.66% (0.806–0.896), Sp 83.33% (0.768–0.884), PPV 88.40% (0.836–0.919), NPV 79.67% (0.729–0.851), and AUC 0.867 ± 0.019 (0.815–0.889). The above indicators were of statistical significance as compared with TI-RADS classification or CEUS alone (P <.05).
CEUS can more clearly visualize microvascular distribution of the nodules and offers a new approach to diagnose benign and malignant thyroid tumors. TI-RADS classification plus CEUS is more accurate than TI-RADS classification alone. This combined approach is worthy of clinical popularization.
Hypoplasia of the left lung presenting as hemoptysis
Authors: Zhang Lei , Ai Tao , Wang Li , Zhang Libin , Zhang Ying 
Published: January 2019

Abstract

Rationale:
Congenital pulmonary dysplasia (CPD), a congenital lung anomaly, is a heterogeneous group of developmental disorders with diverse clinical and imaging manifestations, including pulmonary agenesis, pulmonary aplasia, and pulmonary hypoplasia. Patients with CPD always have recurrent respiratory tract infections, dyspnea, and/or wheezing. To the best of the author's knowledge, no case of CPD with mild to moderate hemoptysis has been reported so far. Considering the rarity of this presentation, we herein report a case of hemoptysis caused by CPD.

Patient concerns:
We report on an 11-year-old girl who survived for 11 years with hypoplasia of the left lung without any associated complications except hemoptysis.

Diagnosis:
Left pulmonary hypoplasia.

Interventions:
The patient underwent left lower pulmonary lobe resection.

Outcomes:
The patient recovered favorably after the operation, and no complications were observed. The hemoptysis was controlled and the cough disappeared after the surgery.

Lessons:
CPD is a life-threatening disorder rarely encountered in the clinic, which plays an important role in various pediatric respiratory diseases. Misdiagnosis or delayed diagnosis of pulmonary malformations results in unnecessary treatments and hospitalization. The patients should undergo pulmonary contrast-enhanced CT and bronchoscopy for accurate and timely diagnosis, followed by surgical treatment.
Chronic nodules of sigmoid perforation caused by incarcerated intrauterine contraception device
Authors: Huang Xiaohui , Zhong Rui , Zeng Liqin , He Xuhui , Deng Qingshan , Peng Xiuhong , Li Jieming , Luo Xiping 
Published: January 2019

Abstract

Rationale:
It is extremely rare for an intrauterine contraception device (IUD) to cause uterine perforation and Sigmoid perforation for a long time without being detected.

Patient concerns:
We present a case of a patient who has suffered from abdominal pain after 4 years of placement of an IUD, and found that the IUD was incarcerated by ultrasound.

Diagnoses:
Laparoscopic and hysteroscopic examination revealed that the incarcerated IUD caused uterine perforation and sigmoid perforation for a long time. One end of the intrauterine device completely penetrated the anterior wall muscle layer of the uterus and the full layer of the sigmoid colon, located in the intestinal lumen, and the perforated portion of the sigmoid colon formed a chronic nodule.

Interventions:
We extended the sigmoid colon perforation and uterine perforation by laparoscopy, removed the incarcerated IUD from the uterus through the vagina, trimmed the chronic nodules of the sigmoid perforation, repaired the sigmoid colon, and repaired the uterine perforation.

Outcomes:
The patient was cured and discharged 22 days after surgery. The patient was naturally pregnant 3 months after surgery and delivered by cesarean section 12 months after surgery. We saw a good recovery of the uterus and sigmoid colon during cesarean section.

Lessons:
The patient was placed with an intrauterine device made of a special material and was not monitored after placement, causing the uterus and sigmoid perforation to be undetected for a long time. The IUD placed in the patient should be monitored regularly. If the IUD is found to be incarcerated or displaced, attention should be paid to uterine perforation and intestinal perforation.
Novel PANK2 mutation in a Chinese boy with PANK2-associated neurodegeneration
Authors: Zhang Yingying , Zhou Dong , Yang Tianhua 
Published: January 2019

Abstract

Rationale:
Pantothenate kinase-associated neurodegeneration (PKAN), also called Hallervorden–Spatz Syndrome (HSS), is a rare neurodegeneration with brain iron accumulation from pantothenate kinase 2 gene (PANK2) mutation characterized as extrapyramidal symptoms. However, few studies involving PKAN patients were reported in China. This study was conducted to identify the genetic mutations in a Chinese boy with PKAN, and to review all PANK2 mutations reported in Chinese cases with PKAN.

Patient concern:
We reported a 23-year-old Chinese boy with PKAN, exhibiting difficulty in writing and manipulation using right hand with slow progression for 12 years. He spoke with a severe stutter when he was 15 years old.

Diagnosis:
Considering results of magnetic resonance images, brain computed tomography and medical history, the case was suspected to be related to genetic factors.

Interventions:
Whole exome sequencing was arranged, and the mutations were identified in his parents’ genome.

Outcomes:
In the present study, whole exome sequencing revealed 2 novel mutations (c.1696C > G in exon 7 and c.1160_c.1161insG in exon3) of the PANK2 gene in the proband. c.1696C > G and c.1160_c.1161insG, respectively, were confirmed in his father and mother. We also reviewed 14 different PANK2 mutations, most of which were missense type in Chinese cases. Those mutations did not show apparent hotspots, but exon 3 and 4 were frequently involved.

Lessons:
Two novel compound heterozygous mutations were identified and considered to be pathogenic in PKAN patients. This review of the reports indicated that atypical PKAN is the more common phenotype in China and no apparent genotype-phenotype correlation was found.
Illicit massive silicone injections always induce chronic and definitive silicone blood diffusion with dermatologic complications
Authors: Bertin Chloé , Abbas Rachid , Andrieu Valérie , Michard Florence , Rioux Christophe , Descamps Vincent , Yazdanpanah Yazdan , Bouscarat Fabrice 
Published: January 2019

Abstract
Male-to-female transgender (MtF TG) individuals often report using illegal subcutaneous silicone injections for body feminisation. It leads to silicone dissemination and various dermatologic complications.
We report the long-term complications of these feminisation procedures with blood smear examination and dermatologic examination.
Between July 2015 and December 2015, 77 MtF TG consulting at Bichat Hospital (Paris, France) were included in this cross-sectional study. Blood smear examinations were performed by a trained haematologist to quantify the presence of silicone vacuoles in monocytes.
All patients reported a history of massive amounts of silicone injections (mean 4 L, range 0.5–15 L). Most patients were South American (75/77, 97%). Fifty-nine (59/75, 79%) were HIV-seropositive, mostly with undetectable HIV RNA plasma levels (46/58, 80%). Clinical examinations reported dermatologic complications for all patients: lymphatic or subcutaneous migration of silicone (59%), inflammation (50%), varicose veins (39%), post-inflammatory pigmentation (20%), infection (14%) and abscesses (4%). Blood smear examination showed intracytoplasmic vacuoles containing silicone in monocytes in all patients.
We did not chemically prove the silicone nature of the vacuoles. The design of this study does not allow evaluation of short-term complications that should not be minimized.
Illicit massive silicone injections always induced chronic and definitive silicone blood diffusion with dermatologic complications. This study highlights the dangers and the inefficiency of clandestine esthetic surgery. There is a need for targeted information campaigns with transgender populations about silicone injections. Otherwise, these practices may persist.
Pharmacological and non-pharmacological treatments for opioid-induced constipation
Authors: Zhang Jing , Mao Lanfang , Wang Longde , Lu Cuncun , Du Xiaojuan , Liang Qiankun , Yang Bo , Wu Hongli 
Published: January 2019

Abstract

Background:
Pain is very common and its management with a huge burden for patients and the healthcare system. And the network meta-analysis was designed to provide reference for the clinical practice.

Methods:
PubMed, EMBASE, Cochrane library, CNKI, VIP, Wan Fang, and CBM will be systematically searched their inception to November 2018. Randomized controlled trials that compared the effect of differently pharmacological or non-pharmacological treatments for opioid-induced constipation will be included. The primary outcome is the efficacy of therapeutic regimens. Risk of bias assessment of the included studies will be performed using the Cochrane risk of bias tool. A network meta-analysis will be performed using STATA 13.0 software with WinBUGS 1.4.3 software. Grading of Recommendations Assessment, Development, and Evaluation will be used to assess the overall quality of evidence.

Results:
This study is ongoing and will be submitted to a peer-reviewed journal for publication.

Conclusion:
This study will provide a comprehensive evidence on the effectiveness and safety of pharmacological and non-pharmacological treatments for opioid-induced constipation.

PROSPERO registration number:
CRD42018116533.
Risk assessment model for predicting ventricular tachycardia or ventricular fibrillation in ST-segment elevation myocardial infarction patients who received primary percutaneous coronary intervention
Authors: Huang Jiabing , Peng Xiaofan , Fang Zhenfei , Hu Xinqun , Zhou Shenghua 
Published: January 2019

Abstract
Ventricular tachycardia/ventricular fibrillation (VT/VF) is a kind of malignant arrhythmia in ST-segment elevation myocardial infarction (STEMI) patients who received primary percutaneous coronary intervention (PPCI). However, there are no risk assessment tools to anticipate the occurrence of VT/VF.
This study is to build a risk assessment model to predict the possibility of VT/VF onset in STEMI patients undergoing PPCI.
A retrospective study was conducted to analyze the patients who underwent PPCI from January 2006 to May 2015. Subjects were divided into VT/VF group and no VT/VF group based on whether VT/VF had occurred or not. In addition, the VT/VF group was further separated into early-onset group (from the time that symptoms began to before the end of PPCI) and late-onset group (after the end of PPCI) based on the timing of when VT/VF happened. Multivariate regression analysis was carried out to distinguish the independent risk factors of VT/VF and an additional statistical method was executed to build the risk assessment model.
A total of 607 patients were enrolled in this study. Of these patients, 67 cases (11%) experienced VT/VF. In addition, 91% (61) of patients experienced VT/VF within 48 h from the time that the symptoms emerged. Independent risk factors include: age, diabetes mellitus, heart rate, ST-segment maximum elevation, ST-segment total elevation, serum potassium, left ventricular ejection fraction (LVEF), culprit artery was right coronary artery, left main (LM) stenosis, Killip class > I class, and pre-procedure thrombolysis in myocardial infarction (TIMI) flow zero grade. Risk score model and risk rank model have been established to evaluate the possibility of VT/VF. Class I: ≤ 4 points; Class II: > 4 points, ≤ 5.5 points; Class III: > 5.5 points, < 6.5 points; and Class IV ≥ 6.5 points. The higher the class, the higher the risk.
The incidence of VT/VF in STEMI patients undergoing PPCI is 11% and it occurs more frequently from the time that symptoms begin to before the end of PPCI, which, in most cases, occurs within 48 h of the event. Our risk assessment model could predict the possible occurrence of VT/VF.
Gene polymorphism associated with endothelial nitric oxide synthase (4VNTR, G894T, C786T) and unexplained recurrent spontaneous abortion risk
Authors: Zhao Xiaoxuan , Li Qiang , Yu Feifei , Lin Lina , Yin Wenqing , Li Jiawei , Feng Xiaoling 
Published: January 2019

Abstract
To evaluate the association between endothelial nitric oxide synthase gene polymorphisms (4VNTR A/B, G894T, C786T) and risk of URSA.
Related case-control studies were collected by computers. A meta-analysis was conducted using Stata 12.0 software to assess the strength of association.
Altogether 37 articles were examining the relationship between endothelial nitric oxide synthase gene polymorphisms and URSA, among which sixteen (16) studies were related to 4VNTR, twelve (12) to G894T, and nine (9) to C786T, the study suggested that 4VNTR A/B polymorphism was closely connected with URSA risk under all gene models except for recessive model (AA vs. BB + AB). The integrated result which indicated the association between G894T gene mutation and URSA risk had been shown under homozygote (TT vs. GG; OR 1.585, 95%CI 1.175–2.138) and recessive models (TT vs. TG + GG; OR 1.530, 95%CI 1.142–2.052). Considering heterogeneity in the remaining gene models, subgroup analysis was performed on ethnicity, and the results showed that it was the dominant (TT + TG vs. GG; OR 1.585, 95%CI 1.175–2.138) and additive models (T vs. G; OR 1.727, 95%CI 1.372–2.175) of G894T in Asians and the heterozygote model (TG vs. GG; OR 1.015, 95%CI 0.846–1.217) in Caucasians that were associated with URSA (P < .05). Besides C786T gene was significantly connected with URSA under all models except for additive model (T vs. C).
It is of great guiding significance for screening out and preventing URSA among high-risk women via testing on 4VNTR A/B, G894T, C786T eNOS under gene models mentioned above which are closely associated with URSA.