bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cannabinoid Hyperemesis Syndrome Presumed Secondary to CBD Use: A Case Report
Authors: Lefebvre Emilie , Simons Luc , Duval Mélanie , Laforgue Edouard-Jules , Victorri-Vigneau Caroline 
Published: September 2024

Introduction
Cannabinoid hyperemesis syndrome is characterized by recurrent episodes of severe nausea and vomiting, often associated with prolonged and excessive cannabis use. With the recent legalization and rising consumption of cannabidiol (CBD) in Europe and the United States, concerns have emerged about its potential role in triggering similar symptoms.

Case Report
A 32-year-old male with a history of cannabis, tobacco and alcohol use disorder experienced multiple cyclic vomiting episodes after switching from cannabis to CBD. Initially, the patient presented with abdominal pain and vomiting after ceasing cannabis use, with symptoms alleviated by hot showers. Three months later, similar symptoms reappeared despite abstinence from cannabis but regular CBD consumption. Over the next 6 months, recurrent episodes of abdominal pain and vomiting persisted with daily CBD use but no cannabis consumption. Clinical data, laboratory results, and treatment responses were analyzed to investigate the connection between CBD consumption and symptom onset.

Discussion
The pathophysiology of cannabis-induced cyclic vomiting is poorly understood. Hypotheses include tetrahydrocannabinol accumulation in adipose tissue, pyrolytic conversion of CBD into tetrahydrocannabinol, and CBD’s intrinsic effects, particularly its interaction with transient receptor potential vanilloid 1 receptors. Our analysis suggests that high doses of CBD may activate transient receptor potential vanilloid 1 receptors, inducing proemetic effects.

Conclusions
Although the connection between CBD and cyclic vomiting remains uncertain, it warrants further investigation. The increasing use of CBD, perceived as a safe dietary supplement, underscores the need to understand its potential health impacts better.
Effects of High Temperature and High Humidity on the Degree of Ocular Damage Caused by 60 GHz Millimeter Wave Exposure
Authors: Kojima Masami , Tasaki Takafumi , Kamijo Toshio , Hada Aki , Suzuki Yukihisa , Ikehata Masateru , Sasaki Hiroshi 
Published: September 2024

Abstract
Millimeter waves (MMW) are pervasive in society; however, studies on the biological effects of MMW exposure are usually performed in laboratory settings not reflecting global environmental diversity. We investigated the effects of a 6-min exposure to 60 GHz MMW (wavelength, 5.0 mm) at incident power densities of 200 and 300 mW cm−2 in eyes (exposed right eyes vs. unexposed left eyes) under various ambient temperature/relative humidity environments (24 °C/50%, 45 °C/20%, and 45 °C/80%) using an in vivo rabbit model. Correlations were examined with adverse ocular events, including corneal epithelial damage (assessed using fluorescein staining), corneal opacity (evaluated by slit-lamp microscopy), and corneal thickness (measured via optical coherence tomography). Our findings indicate that higher temperatures and humidity tend to exacerbate MMW-induced ocular damage, albeit not significantly in the present study. Further research with a larger sample size is warranted. Incident power density emerged as a factor that was directly linked to the ocular damage threshold. High ambient temperature and humidity tended to exacerbate ocular damage from MMW exposure, although the effect was secondary. Ocular damage in a high-temperature (45 °C), high-humidity (80%) environment was increased to the same extent as that by incident power density increased by approximately 100 mW cm−2 in an ocular damage model in a standard environment (24 °C, 50%). In a high-humidity environment, the internal ocular tissue temperature increased at a high ambient temperature of 45 °C, suggesting that the eyeball may respond differently compared to other tissues.
Time to cycle regularity and health risks
Authors: Naveed Amna , Whooten Rachel 
Published: September 2024

Purpose of review
Adolescents often have irregular menstrual cycles after menarche until the reproductive axis fully matures. This review explores how menstrual regularity is established and the health risks associated with prolonged time to cycle regularity in adolescents.

Recent findings
Cross-sectional studies show an association between prolonged time to cycle regularity in adolescents and increased risks for ongoing menstrual dysfunction, cardiometabolic disorders, cancers, and overall mortality. Importantly, some of these cardiometabolic associations are independent of PCOS status.

Summary
The menstrual cycle can be used as a vital sign for assessing overall health. While further longitudinal studies are needed to establish causal relationships, these findings highlight a crucial window for early intervention in adolescents with prolonged time to cycle regularity to mitigate future risks.
‘Misdiagnosis of diffuse large B-cell lymphoma in the maxillary sinus as a dental abscess’
Authors: Jabr Obai , Haddad Sentia , Almohareb Mumdouh , Al-Rashdan Omar , Basha Zein , Haddad Sultaneh , Jaber Fouad , Jasim Radhi Ali Walaa M. , Alnour Amirah 
Published: September 2024

Introduction:
Diffuse large B-cell Lymphoma (DLBCL) is a heterogeneous group of malignant tumors with diverse prognoses, histological appearances, and clinical symptoms. While it commonly affects lymphoid tissues, its occurrence in the nasal cavity and paranasal sinuses is rare and poses significant diagnostic challenges.

Case Presentation:
The authors present a case of a 53-year-old man with a history of testicular non-Hodgkin lymphoma treated 5 months prior. He presented with symptoms initially misdiagnosed as a dental abscess, which was later identified as DLBCL in the maxillary sinus.

Discussion:
The etiology of primary lymphoma in the oral region remains unclear. Due to its rarity, specific prognostic factors, and optimal treatment strategies are not well-established. This case highlights the diagnostic challenges and underscores the importance of considering lymphoma in the differential diagnosis of nonresponsive dental abscesses.

Conclusion:
This case underscores the importance of thorough investigation in patients with nonresponsive dental abscesses. Early identification and appropriate management of DLBCL in uncommon sites require heightened clinical awareness and interdisciplinary collaboration. The optimal treatment approach remains debated and warrants further research.
Laryngotracheal stenosis: a single-center retrospective analysis of endoscopic treatment strategies and recurrence
Authors: Abu Asabeh Ekhlass , Zeer Zahraa M. M. , Idkedek Mayar , Qumsieh Salam , Deeb Maher , Abu Asbeh Yousef 
Published: September 2024

Background:
Laryngotracheal stenosis is a process of fibrosis that results in airway obstruction; it may be congenital or acquired. Acquired cases are due to iatrogenic, traumatic, infectious and autoimmune causes. Patients present with a spectrum of breathing difficulties that might be fatal.

Objectives:
This article presents a unique retrospective cross-sectional study of patients with laryngotracheal stenosis who had endoscopic dilatation, and some had open surgical procedures to describe the evolution after the therapy, to compare the outcomes of the dilatation in comparison to surgical interventions and associated complications in other studies, to provide knowledge to help in dealing with these patients, and to enable educated, independent patient decision-making.

Material and methods:
In this observational and descriptive study, we aimed to highlight the clinical features, management, and treatment outcomes among twenty-nine patients with laryngotracheal stenosis who were managed by open and endoscopic surgical intervention over a period of 5 years. Data were collected retrospectively from the patients’ medical records from February 2016 until July 2022 at a hospital in Jerusalem, which is a tertiary healthcare facility and the only referral center for similar cases from the West Bank, East Jerusalem, and Gaza, with a population of around 8 million. Tables and graphs are used to highlight the statistical study’s findings. Data were analyzed using Microsoft Excel software.

Results:
Twenty-nine patients were involved in the study, with an average age of 32.2 years; 51.7% of them were males. The patients had one or more chronic conditions, such as hypertension and coronary artery disease. The majority of patients (65.5%) had stenosis as a result of orotracheal intubation, and the most common site was the subglottic (68.9%). According to the Cotton–Myer classification, 44.8% of the patients were classified in grade III, 34.4% were included in grade I, 13.7% in grade II, and 6.8% in grade IV. Six patients (20.68%) received surgery for stenosis, and 23 patients had an endo-laryngeal dilatation. Restenosis happened in (58.6%). Mortality rates are almost negligible.

Conclusion:
Subglottic stenosis is still a challenging condition to manage. The authors describe a single-center experience approach dealing with these conditions. Long-term follow-up for these cases is mandatory as the recurrence rate is still high.
Deep brain stimulation for post-stroke rehabilitation in Pakistan
Authors: Idrees Muhammad , Taimuri Muskan A. , Azhar Ayesha , Khan Najam A. , Kalsoom Umme , Sajid Aiman , Akilimali Aymar 
Published: September 2024

Stroke has a high prevalence in Pakistan, at an alarming rate of 250 per 100 000 people. Although various treatment options are available, they are not ideal for Pakistan due to their high cost, restricted availability, and time sensitivity. In 1997, the FDA-approved deep brain stimulation (DBS) for Parkinson’s disease and it was first performed in Pakistan in 2014. DBS has also proved effective for restoring post-stroke mobility, according to a trial from August 2023. DBS has the potential to revolutionize post-stroke rehabilitation in Pakistan; however, further research is required into its effectiveness and its limitations must be addressed first.
Mucosal infection with Tsukamurella species following nasal septum procedure: a rare case report
Authors: Sidhu Alamjeet K. , Khandelwal Shreya , Dominic Savio Francis V. , Bedi Simranjeet , Pathak Yashash D. 
Published: September 2024

Introduction and importance:
Tsukamurella species are rare, aerobic, gram-positive bacteria known to cause infections, primarily in immunocompromised individuals. This case report presents a rare instance of a mucosal infection caused by Tsukamurella species following a nasal septum procedure in an immunocompetent patient.

Case presentation:
A 51-year-old man with a history of multiple hereditary exostosis, allergic rhinitis, and recent nasal fracture repair presented with persistent fevers and low back pain. Postoperatively, he developed sinus pain and small oral lesions, initially treated with antibiotics for presumed sinusitis. Despite treatment, his fever persisted, leading to an emergency department visit. Laboratory tests indicated sepsis, but a CT scan of the sinuses showed no sinusitis. Despite broad-spectrum antibiotics, the patient’s fever continued. On admission day 9, nasal endoscopy and culture identified Tsukamurella species. The patient was treated with augmentin, fluconazole, and levofloxacin, leading to the resolution of symptoms and discharge with ongoing treatment.

Clinical discussion:
Tsukamurella species are uncommon pathogens that are often associated with bacteremia in immunocompromised individuals. This case highlights the diagnostic challenges and the importance of considering unusual pathogens in postprocedural infections, even in immunocompetent patients. Accurate identification and appropriate management are critical in improving outcomes for patients with Tsukamurella infections.

Conclusion:
This case underscores the need for vigilance in diagnosing rare infections like Tsukamurella, even in immunocompetent individuals. The successful resolution with combination therapy highlights the importance of appropriate antibiotic selection in managing such infections.
Ogilvie syndrome with caecal perforation following cesarean section: a rare case report from Jordan
Authors: Obeidat Rawan A. , Alshwayyat Sakhr , Alshwayyat Tala , Abdulla Ahmad , Aljaafreh Almoutuz , Hanifa Hamdah 
Published: September 2024

Introduction:
Ogilvie syndrome is a rare condition characterized by acute colonic dilation. In 1948, H. Ogilvie first described it in medical literature. Its incidence is estimated at 100 cases per 100 000 per year in the US. Both abdominal distention and pain are considered major symptoms.

Presentation of case:
A 32-year-old woman, 36+1 weeks pregnant, experienced labour pain and was admitted to the hospital. Upon examination, she was in labour, but the foetus was in a breech position, necessitating a caesarean section. After 36 h later, she returned to the emergency department with severe, 1-day-old diffuse abdominal pain, accompanied by moderate bilious vomiting and significant abdominal distension. Abdominal CT with contrast revealed pneumoperitoneum, abdominal wall emphysema, and pneumatosis intestinalis involving the caecum and ascending colon, suggesting bowel necrosis. Emergency laparotomy revealed a caecal perforation, which was closed surgically without resection.

Clinical discussion:
Ogilvie syndrome is more common in males but can occur in females for several reasons, including pregnancy, caesarean section, pelvic surgeries, and trauma. Several factors contribute to the occurrence of this syndrome, such as pelvic fractures and cardiac events. Surgery may be required if there is suspicion of bowel perforation or ischaemia.

Conclusion:
OS is a rare condition in women, often seen after childbirth or pelvic surgery, with an unclear cause but believed to be related to autonomic nervous system imbalance. Patients with abdominal pain and distension, without evidence of obstruction, should be evaluated for pseudo-obstruction using abdominal pelvic CT, and treatment may involve conservative measures, medication, and colonoscopic decompression.
Virtual Reality to Reduce Pain, Fatigue, and Emotional Distress in People With Cancer
Authors: Cuñado-Pradales Rebeca , Soto-Ruiz Nelia , Escalada-Hernández Paula , San Martín-Rodríguez Leticia , García-Vivar Cristina 
Published: September 2024

Background
Cancer and its treatments cause symptoms such as pain, fatigue, and emotional distress, which affect the quality of life of patients at different stages of cancer. Virtual reality (VR) has emerged as a promising alternative for addressing these symptoms by immersing patients in a virtual environment that isolates them from reality.

Objective
To describe the existing evidence on the use of VR to improve pain, fatigue, and emotional distress in people with cancer at different stages of the cancer trajectory.

Methods
A scoping review was conducted following the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) guidelines. Search was conducted in PubMed and CINAHL until October 2023.

Results
Twenty-three primary studies related to the study topic were identified, and the following information was collected: type of VR (immersive vs nonimmersive) used in oncology services, purpose (distraction, training, or relaxation), devices used (head-mounted display, headset, or virtual controller), and the environment simulated (natural environment, skill games, or educational environment). The effects of VR on pain, fatigue, and emotional distress are described, highlighting its ability to mitigate these symptoms in the short term.

Conclusions
Virtual reality has been shown to be an effective technique for reducing pain, fatigue, and emotional distress in people with cancer in the short term.

Implications for practice
Nurses can use VR as a complementary tool to promote virtual environments that improve the care for and therefore the quality of life of people with cancer.
HIV-1 Elite Controllers Are Characterized by Elevated Levels of CD69-Expressing Natural Killer Cells
Authors: Batohi Nikayla , Shalekoff Sharon , Martinson Neil A. , Ebrahim Osman , Tiemessen Caroline T. , Thobakgale Christina F. 
Published: September 2024

Background:
HIV type 1 ((human immunodeficiency virus) HIV-1) elite controllers (ECs) are a rare subset of people living with HIV-1 (PLWH) who control viral replication in the absence of antiretroviral treatment (ART) and may provide a model for a functional cure. We investigated the role of natural killer (NK) cells in HIV-1 ECs from South Africa.

Methods:
Phenotypic (CD69, CD38, CD57, PD-1), functional (CD107a, IFN-γ (inferferon gamma)), and nutrient transporter profiles (glucose transporter 1, CD98) of NK cells from ECs (n = 20), viremic progressors (VPs; n = 19), PLWH on ART (n = 20), and people without HIV-1 (PWOH; n = 21) were analyzed using flow cytometry. The Kruskal–Wallis test and followed by the Mann–Whitney U test were used to determine differences among the study groups. The Spearman rank correlation coefficient was used to determine significant associations.

Results:
Compared with the other study groups, the percentage of CD69-expressing NK cells was higher in ECs, whereas the percentage of CD38-expressing NK cells was higher in VPs. Percentages of CD69+CD38− NK cells were elevated in ECs compared with VPs (P = 0.003), but were not different to PLWH on ART and PWOH. Differentiation, exhaustion, and metabolic profiles were not different in ECs compared with PLWH on ART and PWOH; however, NK cell function was lower than in PWOH.

Conclusions:
These findings demonstrate that NK cells from ECs have an activated, mature profile with low levels of immune exhaustion and a reduced metabolic phenotype suggesting functional competence. This insight could inform the development of novel immunotherapeutic strategies for treating HIV-1.
Assessing the Viability of Polycaprolactone Mesh in Bilateral Orbital Floor Reconstruction: Insights From Le Fort II Fracture Cases
Authors: Kim Min Ji , Lee Jun Suk 
Published: September 2024

Objective:
This study aims to evaluate the effectiveness of pure polycaprolactone (PCL) mesh in reconstructing complex bilateral orbital floor fractures associated with Le Fort II fractures. PCL mesh is traditionally viewed as less suitable for severe fractures due to its perceived weakness. This study challenges that perception by demonstrating the utility of PCL mesh in high-severity cases.

Materials and Methods:
Two patients with Le Fort II fractures and bilateral orbital floor fractures underwent orbital reconstruction using a 3D-printed PCL mesh. The mesh was molded and inserted through subciliary or transconjunctival incisions. Orbital volumes were analyzed preoperatively and postoperatively using CT scans and a 3D Analysis program.

Results:
Both cases demonstrated significant correction of orbital volume differences postoperatively, leading to improved symmetry and successful reconstruction. For case 1, the preoperative orbital volume difference of 3.2 cc was reduced to 1.1 cc postoperatively. For case 2, the preoperative orbital volume difference of 1.18 cc was reduced to 0.4 cc postoperatively. The PCL mesh provided adequate structural support and facilitated effective tissue integration. Despite the radiolucency of the PCL mesh on CT scans, volumetric analysis confirmed stable and balanced orbital volumes.

Conclusions:
Pure PCL mesh is a viable alternative for orbital floor reconstruction in severe craniofacial fractures, offering a balance of structural support and biocompatibility. To validate these findings, further research with larger samples and long-term follow-up is recommended.
Prevalence and Risk Factors for Malignant Nodal Involvement in Early Esophago-Gastric Adenocarcinoma
Authors: Pucher Philip H. , Rahman Saqib A. , Bhandari Pradeep , Blencowe Natalie , Chidambaram Swathikan , Crosby Tom , Evans Richard P.T. , Griffiths Ewen A. , Kamarajah Sivesh K. , Markar Sheraz R. , Trudgill Nigel , Underwood Timothy J. , Gossage James A. ,   on behalf of the CONGRESS collaborative
Published: September 2024

Objective:
The aim of this study was to quantify lymph node metastasis (LNM) risk and outcomes following treatment of early esophago-gastric (EG) adenocarcinoma.

Background:
The standard of care for early T1N0 EG cancer is endoscopic resection (ER). Radical surgical resection is recommended for patients perceived to be at risk of LNM. Current models to select organ-preserving versus surgical treatment are inconsistent.

Methods:
CONGRESS is a UK-based multicenter retrospective cohort study. Patients diagnosed with clinical or pathological T1N0 EG adenocarcinoma from 2015 to 2022 were included. Outcomes and rates of LNM were assessed. Cox regression was performed to assess the impact of prognostic and treatment factors on overall survival.

Results:
A total of 1601 patients from 26 centers were included, with median follow-up 32 months (IQR 14–53). 1285/1612 (80.3%) underwent ER, 497/1601 (31.0%) underwent surgery. Overall rate of LNM was 13.5%. On ER staging, tumour depth (T1bsm2-3 17.6% vs T1a 7.1%), lymphovascular invasion (17.2% vs 12.6%), or signet cells (28.6% vs 13.0%) were associated with LNM. In multivariable regression analysis, these were not significantly associated with LNM rates or survival. Adjusting for demographic and tumour variables, surgery after ER was associated with significant survival benefit, HR 0.33 (0.15–0.77), P=0.010.

Conclusions:
This large multicenter data set suggests that early EG adenocarcinoma is associated with significant risk of LNM. These data are representative of current real clinical practice with ER-based staging, and suggests previously held beliefs regarding reliability of predictive factors for LNM may need to be reconsidered. Further research to identify patients who may benefit from organ-preserving versus surgical treatment is urgently required.
Medical and neurologic management of brain tumor patients
Authors: Ospina Juan Pablo , Wen Patrick Y. 
Published: September 2024

Purpose of review
This article discusses commonly encountered medical and neurological complications in patients with brain tumors and highlights recommendations for their management based on updated evidence.

Recent findings
Use of dexamethasone is correlated with worse prognosis in patients with glioblastoma, and in brain metastases, high doses may lead to increased side effects without additional clinical benefit. There are multiple antiseizure medications (ASM) to choose from and possible interactions and toxicity must be considered when choosing an agent. Additionally, there is growing interest in the use of AMPA receptor blockers as ASM in patients with brain tumors. Nonpharmacological strategies for the management of fatigue remain paramount. Cognitive decline is common after whole brain radiation (WBRT) and hippocampal-sparing WBRT results in superior cognitive outcomes. Venous thromboembolism is a common complication and there is growing evidence on the use of direct oral anticoagulants (DOACs) in this population.

Summary
There is evolving evidence on the management of medical and neurological complications in patients with brain tumors. These complications, require early identification and multidisciplinary collaboration and expertise.