bluuebunny/crossref_metadata_2025_split huggingface dataset:
Do Danish ICU Survivors Remain Employed After ICU Discharge? A Register-Based Longitudinal Cohort Study
Authors: Hellmann Sophie Sell , Estrup Stine , Poulsen Lone Musaeus , Gøgenur Ismail , Mathiesen Ole , Thygesen Lau Caspar 
Published: November 2024

OBJECTIVES:
Admission to ICU is associated with long-term consequences for the survivors. The study explores whether Danish ICU survivors remain employed after ICU discharge.

DESIGN:
A longitudinal register study of 16,284 Danish ICU survivors 25–67 years old 1:1 sex- and age-matched with general population references. Weekly prevalence proportions (%) of employed, public benefits, and deceased individuals were calculated based on the Danish Register-Based Evaluation and Marginalization Database and the Danish Civil Registration System until December 31, 2019. Age- and multivariate-adjusted hazard ratios (HRs) with 95% CIs were determined by Cox and Fine-Gray models.

SETTING:
Denmark has tax-funded healthcare and social security ensuring hospital treatment and social benefits free of charge for all Danish residents.

SUBJECTS:
The study included Danish residents acutely admitted to public ICU treatment for critical illness from 2010 to 2018.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
The prevalences of employed ICU survivors increased from 30% at 2–8 weeks to 56% at 52 weeks after ICU discharge showing minor delay in women. The prevalences declined by age being 63%, 58%, 55%, and 52% in ages 25–42, 43–52, 53–58, and 59–63 years, respectively, 52 weeks after ICU discharge. The prevalences of employed ICU survivors declined by level of comorbidity being 64%, 53%, and 37% in ICU survivors of Charlson Comorbidity Index score 0, 1–2, or greater than or equal to 3, respectively, 52 weeks after ICU discharge. ICU survivors had higher risks of becoming retired (HR, 14.86; 95% CI, 8.69–25.41) or sickness absent (HR, 7.56; 95% CI, 7.16–7.98) when accounting for competing risks compared with the general population references.

CONCLUSIONS:
About half of ICU survivors remained employed 52 weeks after ICU discharge. Age and comorbidity were effect modifiers.
Sebaceous Carcinoma Arising in a Precursor Benign Sebaceoma: Rare Example Highlighting the Utility of Immunohistochemistry Including p53
Authors: Daruish Maged , Oguntunde Olubanji , Richards Martyn , Taibjee Saleem 
Published: November 2024

Abstract:
Reports of sebaceous carcinoma arising from a pre-existing benign precursor are extremely sparse in the literature. We describe a case in which there was clear transition between sebaceoma and sebaceous carcinoma, with a different pattern of p53 staining in each component.
Immunohistochemistry for Immunoglobulin G4 on Paraffin Sections as a Diagnostic Test for Pemphigus
Authors: Abadjieva Tsvetana I. , Genova Sylvia N. , Pencheva Mina M. , Zhelyazkova Zhaneta H. 
Published: November 2024

Abstract:
Pemphigus is a group of autoimmune bullous diseases mediated by autoantibodies most often of the immunoglobulin G class, subclasses immunoglobulin G1, and immunoglobulin G4 (IgG4), directed against desmosomal adhesion proteins of keratinocytes. This study aimed to evaluate IgG4 immunoreactivity on paraffin sections using immunohistochemistry in patients with pemphigus as a diagnostic test. Fifty formalin-fixed paraffin-embedded specimens from patients with pemphigus were selected. Fifty formalin-fixed paraffin-embedded specimens from patients with bullous diseases other than pemphigus were used as controls. Biopsies were performed on active lesions in newly diagnosed patients. Immunohistochemistry for IgG4 was performed on paraffin sections with an anti-immunoglobulin G4 antibody. Positivity was defined as distinctive, uninterrupted immunoreactivity localized to the intercellular junctions of keratinocytes. A finding that did not meet these criteria was defined as negative. Forty-three (86.0%) of the examined patients had pemphigus vulgaris and 7 (14%) had pemphigus foliaceus. Forty-nine (98.0%) specimens from patients with pemphigus were immunoreactive for IgG4, 1 (2%) upper back biopsy from the patient with oral pemphigus showed negative immunoreactivity for IgG4. Negative immunoreactivity was found in 45 (90%) controls. Five (10%) controls with bullous pemphigoid showed immunoreactivity for IgG4. Sensitivity of the method was established to be 98% and specificity 90%. Immunohistochemical examination for IgG4 for the diagnosis of pemphigus can be applied when direct immunofluorescence examination is unavailable. The advantage of this method is that it does not require special equipment and the histology slides are permanent.
Pigmented Syringomatous Carcinoma/Sweat Gland Carcinoma of the Vulva With Melanocytic Colonization: An Uncommon Presentation of a Rare Sweat Gland Neoplasm
Authors: Shaker Nada , Alazawi Sama , Sangueza Omar 
Published: November 2024

Abstract:
Primary vulvar carcinomas are rare and constitute a diverse group of neoplasms. These primary tumors are typically classified based on their presumed tissue of origin or histological characteristics. Among these, carcinomas of sweat gland origin are particularly significant. They closely resemble similar malignancies in nonvulvar skin, including various cutaneous adnexal-type cancers such as apocrine and eccrine adenocarcinomas. Syringomatous carcinoma of the vulva is a rare malignant sweat gland neoplasm known for its infiltrative growth and tendency for local recurrence. Typically, these malignancies manifest as nonulcerated nodules or plaques, primarily in the head and neck region. The occurrence of syringomatous carcinoma in the vulvar region is exceptionally rare. Herein, we present a unique case of a 35-year-old woman with a dark mole measuring 1.5 × 1.0 cm on the vulva. Complete excision was performed to exhibit an infiltrative haphazard proliferation of elongated ductules and tubules, displaying significant cytologic atypia characterized by irregular nuclear contours and variably prominent nucleoli. Extensive melanocytic pigment deposition and stromal fibrosis were also observed. Immunohistochemical staining demonstrated positive expression of epithelial markers, including keratins (AE1/AE3) and epithelial membrane antigen, supporting the diagnosis of syringomatous carcinoma. CK7 and carcinoembryonic antigen were negative, whereas SOX10 and pan melanin highlighted admixed, cytologically bland melanocytes within the epidermis and neoplastic nests. This case represents a highly unusual presentation of syringomatous carcinoma associated with melanocyte colonization. Due to limited data on the optimal management strategies, a multidisciplinary approach involving gynecologic oncologists, dermatopathologists, and radiation oncologists is essential for treatment decisions. Long-term follow-up is crucial, considering the potential for local recurrence and metastatic spread, emphasizing the importance of comprehensive clinical management for favorable patient outcomes of this rare malignancy.
Unveiling Patient Expectations: Insights From a Cross-Sectional Study on Facial Aesthetic Treatments
Authors: Germani Marcelo , Borba Pietra Roschel , Carnevali Ana C.N. , Almeida Cláudia , Wille Isadora , Giro Gabriela , Munoz-Lora Victor R.M. 
Published: November 2024

BACKGROUND
Patient expectations play a crucial role in aesthetic treatments, influencing satisfaction of treatment outcomes.

OBJECTIVE
To explore and assess the expectations of 102 participants undergoing various cosmetic interventions using the FACE-Q expectations scale.

MATERIALS AND METHODS
Participants, aged 20 to 64 years, seeking different facial aesthetic procedures completed the FACE-Q expectations scale before treatment. Data were analyzed, and the influence of age and treatment type on expectations was investigated.

RESULTS
The analysis revealed moderate overall expectations among participants, with no significant differences across different treatment modalities (p = .263). However, age significantly influenced expectations (p = .009), with younger adults (30–39 years) exhibiting higher expectations compared with older age groups. Correlation analysis confirmed a significant weak negative correlation between age and expectations (r = −0.210, p = .034). Multiple linear regression further identified age as a significant predictor of expectations (β = −0.564, p = .037).

CONCLUSION
This study provides insights into patient expectations in facial aesthetic procedures, emphasizing the role of age in shaping expectations. These findings underscored consistent beliefs in positive outcomes, irrespective of the cosmetic procedure to be realized. Future research should consider international collaborations and longitudinal studies to enhance understanding and optimize patient satisfaction in aesthetic treatments.
EVALUATION OF RETINAL ARTERIOLES IN RETINITIS PIGMENTOSA
Authors: Ota Junya , Inooka Taiga , Tomita Ryo , Kominami Taro , Koyanagi Yoshito , Ito Yasuki , Terasaki Hiroko , Nishiguchi Koji M. , Ueno Shinji 
Published: November 2024

Purpose:
Retinal arterioles are attenuated in eyes with retinitis pigmentosa, but dimensions such as lumen diameter and wall thickness have not been thoroughly investigated. The aim of the study was to determine the dimensions of reduced retinal arterioles in eyes with retinitis pigmentosa.

Methods:
The study included 66 patients with retinitis pigmentosa (66 eyes) and 36 control participants (36 eyes) for whom adaptive optics recordings of the retinal arteries were available. Lumen diameter and wall thickness were measured on the adaptive optics images. The correlations between arteriole dimensions and clinical parameters were determined.

Results:
The mean lumen diameter was significantly smaller in patients with retinitis pigmentosa than in controls, while the mean wall thickness did not differ significantly. Lumen diameter was significantly and positively correlated with the mean deviation of the Humphrey 10-2 field analyzer and ellipsoid zone width. The wall thickness and wall-to-lumen ratio were significantly and positively correlated with age and systolic blood pressure but not with mean deviation and ellipsoid zone width.

Conclusion:
Retinal arteriole dimensions were significantly correlated with retinal degeneration and systemic factors.
Femoral neck fracture in a senile patient with primary hyperparathyroidism: A case report
Authors: Zhu Hong-Xia , Fu Lei , Xie Yu , Yuan Xiao , Chen Sheng-Tao , Xie Lun-Li 
Published: November 2024

Rationale:
As a rare cause of femoral neck fracture, usually, hyperparathyroidism is missed diagnosed by orthopedist. Patient can present with various disappearance of clinical manifestations. Primary hyperparathyroidism in senile male population is commonly an asymptomatic disorder discovered incidentally through routine lab testing. Here, this study reports a case of femoral neck fracture in a senile patient with primary hyperparathyroidism.

Patients concerns:
A 70-year-old male patient with a known right femoral neck fracture associated with primary hyperparathyroidism.

Diagnoses:
A neck ultrasound (US) and computed tomography revealed a solid mass below the right lobe of the thyroid. X-ray plain and computed tomography confirmed right femoral neck fracture and multiple bone lesions. The routine lab testing showed hypercalcemia and hyperkalemia.

Interventions:
Before undergoing total hip arthroplasty surgery, patient was temporarily treated with hydration, diuretics, and calcitonin. Besides, the patient underwent parathyroidectomy of the enlarged parathyroid gland. Oral calcium preparations were routinely used for prevention of hypocalcemia.

Outcomes:
After completing all surgery, the patient was discharged without any complications including hypercalcemia and hyperkalemia.

Lessons:
Femoral neck fracture associated with primary hyperparathyroidism is a rare presentation. This case highlights that hypercalcemia and multiple osteopathy should be considered in the differential diagnosis in patients with pathological fracture caused by micro-traumatic injury.
Assessment of the piriformis muscle and piriformis syndrome via Web of Science database: A bibliometric analysis
Authors: Polat Sema , Tunç Mahmut , Aksay Ufuk Can , Sönmez Elif İpek , Özşahin Esin , Göker Pinar 
Published: November 2024

Background:
Piriformis syndrome, which is seen as the cause of 0.3% to 6% of low back pain, is a painful condition that occurs as a result of compression of the piriformis muscle on the sciatic nerve. Although there are many studies in the literature about piriformis syndrome, no bibliometric analysis has been found. This study aims to evaluate piriformis syndrome and conduct a bibliometric analysis of studies related to piriformis muscle and syndrome.

Methods:
This study was conducted on March 27, 2024, using data recorded in the Web of Science Core Collection Database. The search was made as “Topic = Piriformis OR Piriformis Syndrome.” Accordingly, 1345 results were found, and as a result of the necessary inclusion and exclusion criteria, 961 documents remained. The data was transferred to the VOSviewer software for further analysis.

Results:
961 documents based on piriformis muscle or piriformis syndrome were obtained. The country with the most publications was reported to be the USA with 31.42%. Other countries are ranked at around 5% or less. While 9 of the top 10 most cited institutions are based in the USA, clinics that make significant research contributions also attract attention among these institutions. Journals that publish articles containing piriformis syndrome are prominently surgery, physical therapy, anatomy, and general medicine journals. The most repeated keywords were reported as piriformis syndrome, diagnosis, pain, muscle, sciatic nerve, and hip. In contrast, the most repeated clinical terms were reported as approach, surgery, piriformis muscle, injection, sciatica, and compression.

Conclusion:
The findings obtained in this study are thought to be important for understanding to providing literature with new perspectives on this subject. They will also focus on the missing parts of the subject from this perspective. Also, this study would provide a novel perspective to the studies about piriformis syndrome and contribute to the researchers about the limits of the topic, and being aware of the active journals that publish papers on this issue would facilitate the work of the researchers.
Ultrasound-guided femoral nerve block reduced the incidence of postoperative delirium after total knee arthroplasty: A double-blind, randomized study
Authors: Zhao Longbiao , Qiu Dongjie 
Published: November 2024

Background:
Postoperative delirium (POD) is an acute brain dysfunction that mainly occurs in elderly patients after surgery. Postoperative pain is an important factor in the occurrence of POD, and effective pain management can reduce the risk of POD. Our study aims is to investigate the effect of ultrasound-guided femoral nerve block (FNB) on postoperative pain and the occurrence of POD after knee arthroplasty, and whether its mechanism is related to oxidative stress, inflammatory factors.

Methods:
Patients aged 65 to 80 years who were scheduled to undergo knee arthroplasty under general anesthesia from 2020 to 2023 were randomly divided into 2 groups: the control group (NC group) and the FNB analgesia group (FNB group). After anesthesia induction, the FNB group received ultrasound-guided FNB, whereas the NC group received an equal volume of normal saline. Visual analog scale (VAS), incidence of POD. the postoperative Quality of Recovery-15-Chinese version (QoR-15C) was been evaluated. Venous blood samples were collected from patients to detect the level of malondialdehyde (MDA), glutathione peroxidase (GSH-Px), and C-reactive protein (CRP).

Results:
The VAS scores in the FNB group were significantly lower than those in the NC group at 24h. The summation of perioperative remifentanil usage and the number of remedial analgesia in the FNB group were significantly lower than those in the NC group. The incidence rate of POD in the FNB group is lower than the NC group. The occurrence of POD was markedly lower in the FNB group compared to the NC group. Compared with the NC group, the levels of MDA, GSH-Px, and CRP in the FNB group were lower on the first and third days after surgery. The QoR-15C score in the FNB group was higher on the 5th day after surgery.

Conclusion:
Ultrasound-guided FNB can reduce the incidence of POD after knee replacement surgery, and its mechanism may be related to analgesia improvement and reduction of postoperative inflammatory reaction.
Transcatheter closure of paravalvular leakage through multiple approaches after surgical mechanical valve replacements: A retrospective study
Authors: Liu Yang , Xu Chennian , Jin Ping , Zhai Mengen , Tang Hao , Tian Zhiyuan , Wen Anguo , Qiao Rui , Yang Jian 
Published: November 2024

Background:
Transcatheter closure of percutaneous paravalvular leak (PVL) is a technically challenging procedure, especially after surgical mechanical valve replacements (SMVR), as the risk of interference with the prosthetic valve discs and the complex interventional techniques required for mitral PVL closure. Our study was designed to review the results with transcatheter closure of PVL after SMVR.

Methods:
From January 2018 through December 2023, a total of 64 patients with PVL after SMVR underwent transcatheter closure with the help of preoperative 3-dimensional printing model and simulator for image evaluation. We reviewed the catheter techniques, perioperative characteristics, and prognosis.

Results:
The median follow-up was 28 (3–58) months. The procedure was successful in 60/64 (93.8%) patients. There were 36 aortic PVLs, 27 mitral PVLs, and 1 combined aortic and mitral PVL which were repaired by the transcatheter approach. A total of 24 patients had aortic valve replacements and 20 patients had mitral valve replacements, while 20 patients had previously combined aortic and mitral valve replacements. Procedural time was 35 to 300 (106.6±51.2) minutes. Fluoroscopic time was 8 to 50 (17.6±11.3) minutes. The hospital stay was 5 to 21 (8.1±3.5) days. A total of 47 (78.3%) patients improved by ≥1 New York Heart Association functional class at the 1-year follow-up.

Conclusion:
Complex catheter techniques were included in percutaneous closure of mechanical PVL. However, this minimally closure treatment could provide reliable outcomes and shorter hospital stays in selected patients.
Urinary calculi successfully expelled in a patient through traditional Chinese exercise: A case report
Authors: You Chengheng , Li Jing Xian , Li Guanwu , Dun Rongliang , Fang Min , Zhu Qingguang 
Published: November 2024

Rationale:
Urinary calculi are hard mineral deposits that typically require medication or surgery, such as lithotripsy. This case report presents traditional Chinese exercises (TCEs) as a potential alternative for stone expulsion.

Patient concerns:
A 41-year-old male with no history of urinary tract stones, experienced sudden severe lower back and abdominal pain accompanied by nausea and vomiting.

Diagnosis:
Computed tomography scan revealed a small calculus at the distal end of the left ureter (within the bladder wall), approximately 2 mm in size, with mild hydronephrosis in the ureter and renal pelvis.

Interventions:
The patient was initially prescribed medication for pain relief and was advised to engage in TCEs.

Outcomes:
Follow-up computed tomography scan after the exercise regimen showed complete expulsion and disappearance of the urinary calculi. The patient reported significant improvement in physical and mental health with no recurrence of calculi observed in subsequent checkups.

Lessons:
This case suggests that TCEs may facilitate the expulsion of small urinary calculi, offering a noninvasive treatment option. Further research is needed to confirm the therapeutic effects of TCEs on urinary calculi and to explore its potential mechanisms.
The combination of Qing Kailing injection and clindamycin injection leads to systemic adverse reactions: Case report
Authors: Zhou Shenghui , Wang Shouhui , Wang Yajun , Xi Fenglin 
Published: November 2024

Rationale:
It is imperative to be cautious about the potential systemic allergic reaction caused by the combined use of Qing Kailing Injection (QKI) and clindamycin as it may be life-threatening.

Patient concerns:
A 48-year-old female with a history of hypertension was admitted to a private hospital with a fever and cough. She was diagnosed with lung infection and received QKI infusion, followed by clindamycin infusion. During clindamycin infusion, the patient experienced convulsions followed by nausea and vomiting (gastric contents). Upon arrival at the emergency room, she lost consciousness, became agitated and sweaty, and had incontinence. Respiratory rate was measured at 32 breaths per minute, pulse rate was 180 beats per minute, temperature was 42°C, and blood pressure was unmeasurable.

Diagnosis:
Drug hypersensitivity reactions.

Interventions:
The patient immediately discontinued clindamycin, administered dexamethasone 10 mg intravenously, and was subsequently referred to our hospital for further treatment. Emergency physicians immediately provided oxygen inhalation via a face mask, administered midazolam for sedation and ibuprofen combined with physical measures for cooling, carried out fluid replacement, administered furosemide for diuresis, and avoided using allergenic drugs.

Outcomes:
The patient regained consciousness, without experiencing further convulsions, nausea, vomiting, fever, or abnormal urination, and their vital signs stabilized.

Lessons:
Caution should be exercised in the concurrent use of traditional Chinese medicine injections and antibacterial drugs in clinical treatment because of the potential for allergic reactions to both medications. If combination therapy is deemed necessary, adequate flushing of the infusion pipe with saline or replacement with a new infusion device is recommended, while closely monitoring the patient for any signs of allergic reactions.
Shifting the Landscape of Spine and Non-Spine Bone Metastases
Authors: Udovicich Cristian , Lo Simon S. , Guckenberger Matthias , Sahgal Arjun 
Published: November 2024

Abstract
Both spine and nonspine bone metastases are frequent sites of spread from solid organ malignancies. As bone metastases frequently cause significant morbidity for patients, it is critical to offer a treatment that can achieve rapid and durable symptomatic relief and local control, without being associated with serious risks of toxicity. Conventional palliative radiation therapy has a key treatment component in the multidisciplinary management of these patients; however, over the past decade, it has evolved to routinely deliver high biologically effective doses with precision in the form of stereotactic body radiation therapy. This change in paradigm is a result of the shifting landscape in cancer care, such that short-term pain relief is no longer the sole therapeutic aim for selected patients, and durable symptom relief and local tumor control are the goals. This review discusses the randomized prospective evidence, ongoing trials, approach to surveillance imaging, and treatment delivery for stereotactic body radiation therapy, to both spine and nonspine bone metastases, with a specific section on sacral metastases.