bluuebunny/crossref_metadata_2025_split huggingface dataset:
Paracetamol overdose associated with cortical blindness-complicated acute leukoencephalopathy: a case report
Authors: Khasawneh Ruba , Keewan Nour , Aburahma Samah K. , Khurfan Basel Waleed 
Published: November 2024

Abstract
Background
Paracetamol is one of the most used antipyretics and analgesics among pediatrics, and its overdose is highly encountered among pediatrics especially in the pre-school age. While it is well-known that paracetamol overdose may lead to toxicities including severe hepatic toxicity, some recent reports have highlighted its “in situ” toxicity on brain tissue at high doses, even in the absence of hepatotoxicity. This can result in acute leukoencephalopathy (AL), coma, or even death. This report describes a case of a child who developed cortical blindness-complicated AL, following a paracetamol overdose.

Case presentation
An 18-month-old previously healthy girl accidentally ingested 300 mg/kg of paracetamol suspension. After ingestion, the child was in an initial bad condition that has gradually improved. Several days after ingestion, the patient lost her vision, and she remained blind since then despite a newer appreciation to light. The initial brain magnetic resonance imaging (MRI) suggested AL demonstrated as a faint high T2/fluid-attenuated inversion recovery (FLAIR) signal intensity in the cortical and subcortical regions of both parieto-occipital lobes with sulcal effacement and restricted diffusion. After around 3 months, the subsequent brain MRI showed involutional changes that were manifested as a brain volume loss in the same areas with evidence of gyri-form laminar necrosis in both parieto-occipital regions without restricted diffusion. Other brain MRI findings include right cerebral convexity hyperacute subdural hematoma with prominent subarachnoid spaces.

Conclusions
The child developed cortical blindness-complicated AL following a paracetamol overdose. It is well- known that AL may result from several toxins by their direct and/or indirect effect on the cerebral white matter. However, there is still no enough data in the literature clearly explaining the relation of paracetamol overdose to AL. The generally proposed effect of paracetamol on the brain is mainly justified by the excessive oxidative stress. Further studies at the cellular and genetic levels are still needed to investigate the exact association between paracetamol overdose and AL, as well as the underlying mechanisms involved.
Concurrent spinal schwannoma and meningioma without neurofibromatosis: case presentation and review of literature
Authors: Elnoamany Hossam , Salim Mohammud 
Published: November 2024

Abstract
Background
Concurrent multiple tumors developing in the spinal cord are rare, except for in genetic disorders, such as neurofibromatosis and von Hippel–Lindau disease. The presence of multiple histologically different spinal tumors in the absence of NF-2 is extremely rare. Schwannoma and meningioma can be explained partly by their common origin from the same mesenchymal cell, there is currently no explanation for the simultaneous existence of different spinal tumors other than simple coincidence.

Case presentation
After review of literature, there are thirteen such cases reported in the literature in addition to the present case. The current patient presents with lower limb weakness, and the patient radiology revealed intradural mass opposite the fourth lumbar vertebra with contrast enhancement and intradural extramedullary mass opposite the tenth dorsal vertebra with contrast enhancement in MRI spine. The coexistence of these tumors may be coincidental or might be due to a common histological origin of the Schwann cells and the meningocytes.

Conclusion
Schwannoma and meningioma have different radiological characteristics and require different managing procedures such as dural base coagulation in meningiomas and rootlet sacrifice in schwannomas.
Exploring “Mandai”: gastronomy of Banjar ethnic in Kalimantan, Indonesia
Authors: Gozali Gozali , Setyawati Ria , Duari I Putu Hardani Hesti , Zulkarnain Zulkarnain , Nooryastuti Nandyan Ayu , Yudistira Sukma , Purwaningrum Hesti 
Published: November 2024

AbstractMandai is a traditional food product made from the inner skin of the cempedak fruit (Artocarpus champeden), processed using a fermentation method, and discovered by the Banjar ethnic group in Kalimantan. This article aims to review the history, development, fermentation process, derivative products, and Mandai in Banjar ethnic gastronomy, and to discuss the potential of Mandai as a tourism product. A narrative literature review was used to describe the Mandai phenomenon from various relevant sources. These results depict that Mandai is a traditional fermented food that continues to grow and has the potential to support the tourism industry in the respective region. This article is the first international review that examines Mandai from a scientific perspective. The findings of this study enrich knowledge about traditional fermented foods and serve as a guide for gastronomy and tourism professionals in Kalimantan in the future Mandai development.
Significance of three-dimensional turbo spin-echo magnetic resonance imaging with semiquantitative assessment of knee osteoarthritis: correlation to two-dimensional routine magnetic resonance imaging
Authors: Hashem Aya Mohamed Bassam , El-Liethy Nevien Ezzat Mohamed , El-Din Osama Mohamed Helmy Noor , Mahmoud Mostafa Ezzat , Hashem Lamiaa Mohamed Bassam 
Published: November 2024

Abstract
Background
As one of the most prevalent chronic degenerative diseases, knee osteoarthritis (KOA) is associated with the progressive degradation of articular cartilage, meniscus, synovium, ligaments, bone, muscles, and tendons. Knee osteoarthritis affects the quality of life and can cause chronic disability worldwide. Magnetic resonance imaging (MRI) is a crucial imaging modality for the morphological assessment of cartilage and all other joint tissues involved in osteoarthritis. The objective of this study was to evaluate the effectiveness of the three-dimensional (3D) turbo spin-echo (TSE) MRI and to compare its relevance to two-dimensional (2D) routine MRI in adding additional information and in the early detection of KOA.

Results
Total agreement between the two techniques ranged between 82.7% (cartilage degeneration), 91.4% (osteophytes), 98.3% for bone marrow edema and periarticular cyst up to 100% of other several features regarding meniscal injury and ligamentous tear.

Conclusions
When compared to standard 2D TSE MRI, 3D TSE MRI demonstrates substantial to almost complete agreement and high accuracy for semiquantitative assessment of knee osteoarthritis (OA). 3D TSE MRI also takes less time, which is important for large OA studies and can be used for the detection of early knee joint changes.
Thymoma-associated paraneoplastic encephalitis resolved by robotic-assisted radical thymectomy: a case report
Authors: Becherano Gaston , Podgaetz Eitan , Ahmed Shair , Ringenberg Sigrid , Schwartz Gary 
Published: November 2024

Abstract
Background
We present a rare case of autoimmune encephalitis associated with an incidentally discovered thymoma. Limited case reports exist of thymoma-associated paraneoplastic encephalitis. The unique clinical presentation and subsequent surgical intervention offer valuable insights into the management of similar cases.

Case presentation
A 41-year-old female presented with irritability, personality changes, fatigue, and seizures. Physical examination and bloodwork on first encounter were unremarkable. Neurological evaluation was done, and a brain magnetic resonance imaging (MRI) with and without contrast demonstrated numerous hyperintensity foci within bilateral cerebral cortices on T2-/FLAIR-weighted images affecting only the supratentorial brain, findings highly suggestive of encephalitis. A chest computed tomography (CT) revealed an anterior mediastinal mass compatible with a thymoma. Cerebrospinal fluid from a lumbar puncture was unremarkable. Paraneoplastic autoantibody evaluation was positive, and the patient was diagnosed with autoimmune encephalitis believed to be associated with an incidentally discovered thymoma. Given her rapid neurological deterioration, the thoracic surgery team was urgently consulted.
Patient underwent robotic-assisted radical thymectomy with prompt resolution of symptoms. During her 2-week postoperative visit, she was neurologically intact with no residual deficits. Follow-up MRI at 6 months demonstrated resolution of abnormal signal intensities, with continued improvement noted 1-year post-operation. Chest CT scans at 6 and 12 months revealed no residual or recurrent thymic tissue.

Conclusions
This case illustrates the connection between thymoma and autoimmune neurological disorders like encephalitis. It emphasizes the significance of comprehensive neurological and oncological assessments for patients with unexplained neurological symptoms. Prompt diagnosis and treatment led to positive outcomes in this case, underscoring the potential for full recovery in similar cases.
Clustering of hepatitis C infection among family members in Aden, Yemen
Authors: Gubran Ali N.M. , Al-Barq Ali Mohsen Mohammed , Hashem Mohammed Abdulbaset Mohammed , Saleh Noura Ramzy Mohammed , Saleh Abdulsalam Abdullah Mohammed , Mohammed Shaima Rashad Saleh Ali , Bn Zead Wala Salem Saleh Salem , Muswat Fatima Luai Ali Saeed , Bahumaish Arwa Khaled Ali Mohammed , Al-Saadi Yousif Fahmi Qasim 
Published: November 2024

Abstract
Background
Hepatitis C infection is a common cause of liver diseases such as cirrhosis and liver carcinoma. This study aims to determine the clustering of HCV infection among family members of HCV-positive patients (index cases) and the association between internal and external risk factors and HCV infection among these family members.

Methods
This cross-sectional study was conducted during a period from January to June 2024. One hundred and seventeen family members belonging to 26 index cases were enrolled in this study. Blood samples were collected from all family members, and then sera were separated and tested for anti-HCV antibodies by using a commercially available Cobas technique based on ECLIA.

Results
Among 117 family members, the majority 55.6% were females. The clustering of HCV infection among family members was 7.7%. The highest rates were 9.6% among males and 11.8% among members who were in close contact with female-positive cases, 12.8% in the age group 20–29 years, and 27.3% among brothers, but there were no HCV-positive cases detected among fathers, daughters, and husbands. There was a significant association between HCV infection and some behaviors of family members such as sharing the same sleeping places, nail clippers, and towels with index cases and exposure to cupping (p = 0.0001, 0.002, 0.017, and 0.050), respectively.

Conclusion
The HCV infection among family members in Aden, Yemen, was low in comparison with most studies globally. The highest rates were found among males, those in contact with female index cases, in the age group 20–29 years, and brothers as relatives, but there were no positive cases among fathers, husbands, daughters, and other relatives.
Associations Between Sensitivity to Thyroid Hormones and Visceral Adiposity in Euthyroid Adults
Authors: Wei Ying , Yang Mengge , Liu Jia , Wang Ying , Wang Guang 
Published: November 2024

Abstract

Objectives
The study aimed to explore the association between thyroid hormone (TH) sensitivity and obesity assessed by body mass index (BMI) and visceral adiposity index (VAI) in euthyroid adults.

Methods
This cross-sectional study used the Thyroid Feedback Quantile-based Index (TFQI), TSH index (TSHI), and thyrotrophic T4 resistance index (TT4RI) to indicate central TH sensitivity, and VAI to assess visceral obesity. Participants were categorized according to tertiles. We used logistic and linear regressions to explore the associations stratified by sex.

Results
The study enrolled 5411 men and 5749 women with normal thyroid function. Men with the highest tertile of TT4RI had 1 kg/m2 higher BMI compared with men with the lowest tertile of TT4RI (P = .001) after adjustment for age, hypertension, hyperlipidemia, diabetes, hyperuricemia, and renal function. There was no significant difference in BMI across tertiles of TFQI and TSHI in men, and TFQI, TSHI, and TT4RI in women after adjustment for other risk factors. TH sensitivity indices were positively related to VAI after adjustment for confounders in women but not in men. There were 1.21 (95% CI, 1.02-1.44; P = .03), 1.43 (95% CI, 1.20-1.70; P &lt; .001), and 1.47 (95% CI, 1.23-1.75; P &lt; .001) times higher odds of having high VAI among women in the highest TFQI, TSHI, and TT4RI tertiles, respectively, compared to women in the lowest tertile.

Conclusion
Reduced central TH sensitivity was associated with increased visceral adiposity in women but not men. Our findings supplemented the evidence of the importance of TH sensitivity to metabolic disorders, especially among women.
Use of Whole-Exome Sequencing and Pedigree Analysis to Identify X-linked Hypophosphatemia in Saudi Arabian Families
Authors: Al-Hamed Mohamed H , Bakhamis Sarah , Abdelfattah Sara I , Alsagheir Afaf 
Published: November 2024

Abstract

Context
X-linked hypophosphatemia (XLH) is the most common form of inherited hypophosphatemic rickets (HR), caused by pathogenic variants in the PHEX gene. Genetic diagnosis of XLH facilitates early treatment optimization, especially for patients suitable for burosumab, a recombinant anti-fibroblast growth factor-23 monoclonal antibody.

Objective
This study aimed to use whole-exome sequencing (WES) and pedigree analysis to identify patients with XLH.

Methods
Medical records at a single center in Saudi Arabia were screened between 2014 and 2024 to identify patients with suggested HR. Of the 800 patients identified, 27 had had suspected XLH. The genetic study comprised 100 patients drawn from these 27 families.

Results
Clinical manifestations were widespread and variable within families. Severe disease was reported in 55% of children and 25% of adults. At presentation, all children were receiving either conventional therapy (60%) or burosumab (40%); however, 53% of adults were not treated. WES provided a genetic diagnosis in 23 families: alterations in the PHEX gene (20 families), with homozygous ENPP1 and DMP1 variants detected in 2 and 1 families, respectively. Pathogenic/likely pathogenic variants were detected in 23 families (diagnostic yield 85%). Ten novel likely pathogenic variants were detected. Pedigree analysis provided information to support disease-specific patient management.

Conclusion
WES detected a diagnostic molecular abnormality in 85% of families with HR phenotypes; PHEX variants were the most common. Combined use of WES and pedigree analysis highlighted the underdiagnosis of adult XLH in this population, with most family members being diagnosed after the pedigree analysis.
The Impact of Hypothyroidism on Cardiovascular-Related Healthcare Utilization in the US Population With Diabetes
Authors: Ramirez Marcelo , Bianco Antonio C , Ettleson Matthew D 
Published: November 2024

Abstract

Context
Suboptimal treatment of hypothyroidism (HT) is associated with adverse cardiovascular disease (CVD) outcomes, for which patients with diabetes mellitus (DM) are at increased risk.

Objective
This study aimed to compare CVD-related healthcare utilization in DM patients with and without HT in the US population.

Methods
Participant data were collected from the Medical Expenditure Panel Survey (MEPS) over 10 years (2011-2020). Medical conditions were identified by ICD-9/ICD-10 codes associated with expenditures. Healthcare utilization outcomes included number of emergency, hospital, and outpatient visits associated with coronary artery disease (CAD), stroke/transient ischemic attack (TIA), or heart failure; prescriptions related to CVD; and number of visits to specialty providers. A propensity score-based fine stratification matching approach was used to balance sociodemographic covariates to determine the relative risk (RR) contributed by HT on CVD-related care utilization.

Results
A total of 15 580 adult participants with DM were identified, of whom 11.9% had treated HT. In the weighted analysis, a significantly greater proportion of participants with HT had CAD and stroke/TIA-associated visits compared to those without HT (respectively, 22.4% vs 17.8%, P = .002; and 7.3% vs 5.4%, P = .020). In the matched analysis, participants with HT were more likely to see a specialist (cardiology, endocrinology, and nephrology). Participants with HT were more likely to be treated with cholesterol-lowering medications, beta-blockers, and diuretics.

Conclusion
HT as a comorbidity with DM was associated with increased healthcare utilization related to CVD, specifically visits associated with stroke/TIA, increased use of specialty care, and greater utilization of CVD-related medications.
Racial and Ethnic Disparities in Epidural Blood Patch Utilization Among Obstetric Patients in the United States: A Nationwide Analysis, 2016–2020
Authors: Potnuru Paul P. , Jonna Srikar , Orlando Barbara , Nwokolo Omonele O. 
Published: November 2024

BACKGROUND:
Racial and ethnic disparities in health care delivery can lead to inadequate peripartum pain management and associated adverse maternal outcomes. An epidural blood patch (EBP) is the definitive treatment for moderate to severe postdural puncture headache (PDPH), a potentially debilitating neuraxial anesthesia complication associated with significant maternal morbidity if undertreated. In this nationwide study, we examine the racial and ethnic disparities in the inpatient utilization of EBP after obstetric PDPH in the United States.

METHODS:
In this retrospective observational study, we used the National Inpatient Sample, a nationally representative database of discharge records for inpatient admissions in the United States, from 2016 to 2020. We analyzed delivery hospitalizations of women of childbearing age (15–49 years) diagnosed with PDPH. Adjusting for maternal and hospitalization characteristics as confounders, we used a multilevel mixed-effects logistic regression model to compare the rates of EBP utilization by race and ethnicity. Secondarily, among hospitalizations with an EBP, we examined the association between race and ethnicity and the timing of the EBP procedure.

RESULTS:
We analyzed 49,300 delivery hospitalizations with a diagnosis of PDPH. An EBP was performed in 24,075 (48.8%; 95% confidence interval [CI], 47.8%–49.9%) of these hospitalizations. EBP was performed in 52.7% (95% CI, 51.3%–54.1%) of White non-Hispanic patients with PDPH. Compared to White non-Hispanic patients, Black non-Hispanic (adjusted odds ratio [aOR] = 0.69; 99% CI, 0.56–0.84), Hispanic (aOR = 0.80, 99% CI, 0.68–0.95), and Asian or Pacific Islander patients (aOR = 0.74, 99% CI, 0.58–0.96) were less likely to receive an EBP. The median (interquartile range [IQR]) time to perform an EBP was 2 (1–3) days after admission, with 90% of EBP procedures completed within 4 days of admission. There was no significant association between race and ethnicity and the timing of EBP placement.

CONCLUSIONS:
In this nationwide analysis of delivery hospitalizations from 2016 to 2020 in the United States with a diagnosis of PDPH, we identified racial and ethnic disparities in the utilization of EBP. Minoritized patients identified as Black non-Hispanic, Hispanic, or Asian or Pacific Islander were less likely to receive an EBP for the treatment of PDPH compared to White non-Hispanic patients. Suboptimal treatment of PDPH may be associated with adverse long-term outcomes such as postpartum depression, posttraumatic stress disorder, and chronic headaches. Racial and ethnic disparities in EBP utilization should be further investigated to ensure equitable health care delivery.
Supratotal Resection Versus Gross Total Resection for Isocitrate Dehydrogenase-Wildtype Glioblastoma and Grade 4 Isocitrate Dehydrogenase-Mutant Astrocytoma: Meta-Analysis of Individual Patient Data
Authors: Verly Gabriel , Delfino Thiffany , Bresciani Lucas , Oliveira Matheus , Oyon Daniel , Chandler James , Galvão Gustavo da Fontoura 
Published: November 2024

BACKGROUND AND OBJECTIVES:
IDH-wildtype glioblastoma multiforme (GBM) and grade 4 IDH-mutant astrocytoma are challenging to manage in oncology. This study explores the contrast between gross total resection (GTR) and supratotal resection (SupTR) for IDH-wildtype GBM and grade 4 IDH-mutant astrocytoma, aiming to summarize their influence on crucial clinical outcomes.

METHODS:
This systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. PubMed, Web of Science, Embase, Scopus, and Cochrane were searched for articles until December 2023.

RESULTS:
Ten studies were included, involving 1043 patients with IDH-wildtype GBM and grade 4 IDH-mutant astrocytoma who underwent GTR or SupTR. SupTR demonstrated a favorable impact on long-term overall survival (OS) and progression-free survival (PFS) compared with GTR. The hazard ratio for OS was 0.655 (95% CI: 0.5703-0.7522, P < .0001), and for PFS, it was 0.732 (95% CI: 0.6279-0.8540, P = .0001) in the long-term analysis. Short-term analysis (18 months) reinforced the superiority of SupTR, with a hazard ratio for OS of 0.544 (95% CI: 0.450-0.659, P < .0001), and for PFS, it was 0.697 (95% CI: 0.586-0.830, P < .0001) in this timespan.

CONCLUSION:
SupTR appears to be a promising alternative to GTR for treating IDH-wildtype GBM and grade 4 IDH-mutant astrocytoma, showing improved OS and PFS outcomes. More robust studies that are less susceptible to bias are needed to strengthen this conclusion.
Prenatal Exercise Decreases Urinary Incontinence in Late Pregnancy and 3 Months Postpartum: A Randomized Controlled Trial
Authors: ZHANG DINGFENG , SÁNCHEZ-POLÁN MIGUEL , SILVA-JOSE CRISTINA , DÍAZ-BLANCO ÁNGELES , BRIK MAIA , ARIAS ARANZAZU MARTÍN , HERNANDO PALOMA , BARAKAT RUBÉN 
Published: November 2024

ABSTRACT

Purpose
This study aimed to evaluate the impact of a supervised exercise program, including pelvic floor muscle training, throughout pregnancy on Urinary Incontinence (UI).

Methods
A randomized clinical trial (NCT04563065) was conducted. Initially, 600 pregnant women were screened for eligibility, with data from 356 participants eventually analyzed. Of these, 172 were allocated to the exercise group (EG) and 184 to the control group (CG). Participants in the EG engaged in a supervised moderate exercise program 3 d·wk−1, each session lasting 60 min, from 8–10 to 38–40 wk of gestation, achieving an adherence rate of 73.5%.

Results
A lower prevalence of UI in the EG compared with the CG was observed during late pregnancy (χ
2 = 20.04; P = 0.001) and at 3 months postpartum (χ
2 = 12.52; P = 0.03), as well as in birth weight (F = 4.16; P = 0.04). No significant differences were found between the groups in other maternal and newborn outcomes.

Conclusions
Supervised exercise during pregnancy, which included pelvic floor muscle training, effectively reduced the incidence of UI in late pregnancy and at 3 months postpartum.