bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surgical approach to congenital nasal dermoid sinus cyst in adult with external rhinoplasty and endoscopic approach: a case report
Authors: Mostafa Kheder , Mostafa Rokiah , Nezam Sara , Nezam Nezam , Shaheen Fahed 
Published: October 2024

Introduction and importance:
Nasal dermoid sinus cysts (NDSCs) are rare congenital nasal lesions which typically arise in early childhood. Complete surgical excision is the only therapy, and many approaches have been used according to the location and the extension of the mass. Several studies have advocated external rhinoplasty and endoscopy.

Case presentation:
A 21-year-old female presented with a mass on the root of the nose, which appeared since childhood, and enlarged after puberty. Investigations including imaging revealed a lobulated mass extending from the osteocartilaginous junction towards the nasion, affecting the left lateral nasal wall. And its upper pole was resting on the floor of the left frontal sinus. Complete resection was performed using external rhinoplasty and endoscopy approaches, which improved esthetic results. Lateral osteotomy was used to compensate for the lateral nasal bone loss by narrowing the width of the nose. After 10 weeks of follow-up, no complications occurred, and the patient was satisfied with the cosmetic results.

Clinical discussion:
Nasal dermoid sinus cysts are congenital midline nasal lesions that can present as an isolated mass, or associated with intracranial extension. External rhinoplasty and endoscopy approaches are recommended for complete excision of NDSCs extending to the anterior skull base, especially when there is no intracranial involvement or in case of small intracranial extension. These two methods allow for repairing bone defects of the anterior skull base and improve esthetic results. However, in cases of large intracranial extension, craniotomy is preferred.

Conclusion:
The surgical approach used in the treatment of nasal dermoid sinus cysts should be a minimally invasive technique that reduces bone morbidity and provides good cosmetic results.
Cachexia in tuberculosis in South-East Asian and African regions: knowledge gaps and untapped opportunities
Authors: Mistry Dhruv , Patil Prashant , Beniwal Shreya Singh , Penugonda Raghav , Paila Sushmitha , Deiveegan Dharani Swarna , Tibrewal Charu , Yousef Ghazal Kamal , Anveshak  , Nikhil Padakanti Suraj Sai , Chauhan Jugalkishor , Reddy A Likhitha , Sofia Cummings Kareema R. , Reddy Molakala Surya Simha , Saini Pulkit , Abdullahi Omar Mohamed , Vandara Mansi , Ijantkar Saakshi A. 
Published: October 2024

Tuberculosis (TB) and cachexia are clinical entities that have a defined relationship, making them often found together. TB can lead to cachexia, while cachexia is a risk factor for TB. This article reviews cachexia in Tuberculosis patients in Southeast Asian and African regions by conducting a comprehensive literature search across electronic databases such as PubMed, Google Scholar, and Research Gate between 2013 and 2024 using keywords including ‘Africa’, ‘cachexia’, ‘prevalence’, ‘implications’, ‘tuberculosis’, and ‘Southeast Asia. This article utilized only studies that satisfied the inclusion criteria, revealing knowledge gaps and untapped opportunities for cachexia in TB across Southeast Asian and African regions. Many Southeast Asian and Western Pacific patients initially receive a tuberculosis diagnosis. Sub-Saharan African countries are among the 30 high TB burden nations, according to the WHO. Food inadequacy and heightened energy expenditure can impair the immune system, leading to latent TB and subsequently, active infection. Symptoms needing attention: shortness of breath, productive cough, hyponatremia at 131 mmol/l, hypoalbuminemia at 2.1 g/dl, elevated aspartate transaminase at 75 U/l, increased lactate dehydrogenase at 654, and normocytic anemia. Comorbidities, such as kidney disease, cardiovascular disease, and asthma, can influence the nutritional status of individuals with TB. While efforts like screening, contact tracing, and utilizing gene Xpert to detect TB cases were implemented, only a few proved effective. It is essential to conduct further studies, including RCTs, in Southeast Asia and Africa to evaluate and manage cachexia in TB patients.
Diagnosis and management of spontaneous coronary artery dissection: Two cases and a review of the literature
Authors: Ahmad Adeel , Arshad Khurram , Ali Farman , Latif Rabia , Mozaffari Mohammad Ali , Khan Muhammad Waqas 
Published: October 2024

Introduction and importance:
Spontaneous coronary artery dissection (SCAD) is a rare but potentially fatal condition, often underdiagnosed despite its significance in acute coronary syndrome (ACS). The true prevalence remains uncertain due to diagnostic challenges. Identifying SCAD cases is crucial for reducing mortality and morbidity, especially considering the recurrence risk. The authors present two cases highlighting the importance of multimodality imaging in diagnosing and managing SCAD.

Case presentation:
Case 1: A 53-year-old man with a history of brain aneurysm presented with chest pain and shortness of breath. Despite negative EKGs and stress tests, coronary computed tomography angiography (CCTA) revealed non-obstructive dissection flaps. Medical management improved his condition.
Case 2: A 55-year-old woman with no significant medical history experienced recurrent chest pain. Initial tests were negative, but CCTA revealed SCAD. Further screening uncovered undiagnosed fibromuscular dysplasia.

Clinical discussion:
SCAD poses diagnostic challenges, often mimicking other cardiac conditions. Traditional tests may yield negative results, necessitating advanced imaging techniques like CCTA. Recognizing SCAD’s association with connective tissue disorders (CTD) is vital for comprehensive patient care. The authors’ cases emphasize the importance of a systematic approach to diagnosing chest pain, including noninvasive modalities and considering underlying etiologies.

Conclusion:
SCAD diagnosis requires a high index of suspicion, especially when traditional cardiac tests are inconclusive. Beyond treatment, patients should undergo further evaluation for CTDs, particularly in those with minimal risk factors for atherosclerosis. Increased awareness and a multimodal diagnostic approach are crucial for timely intervention and improved outcomes in SCAD patients.

Learning objectives:
The authors aim to increase awareness regarding different clinical presentations of SCAD to decrease the risk of missed or late diagnosis. The authors’ case series also signifies the multimodal imaging approach’s role in evaluating chest pain. Upon diagnosis of SCAD, it is imperative to go beyond treatment and implement a reverse algorithmic strategy to discover any underlying causes and risk factors for SCAD predisposition.
Clinical outcomes following hospitalization for COVID-19 in patients with cardiac sarcoidosis in the United States: a propensity-matched analysis from national inpatient sample database from April 2020 to December 2021
Authors: Mactaggart Sebastian , Ahmed Raheel , Riaz Asma , Tabassum Shehroze , Ramphul Kamleshun , Bilal Maham , Jamil Yumna , Dulay Mansimran Singh , Liu Alexander , Ahmed Mushood , Sawatari Hiroyuki , Pekyi-Boateng Prince K. , Azzu Alessia , Wells Athol , Kouranos Vasilis , Chahal Anwar , Sharma Rakesh 
Published: October 2024

Background:
The highly arrhythmogenic nature of cardiac sarcoidosis (CS) leads to high morbidity and mortality, the rates of which may be higher in COVID-19 patients. This study aimed to evaluate the outcomes of CS patients admitted to hospitals with COVID-19.

Methods:
The study utilised the 2020–2021 National Inpatient Sample database, examining primary COVID-19 cases in adults aged older than or equal to 18 years. Those with CS were identified using ICD-10 code “D86.85” and compared with and without propensity matching (1:10) to those without CS for baseline characteristics and primary outcomes of acute kidney injury (AKI), use of mechanical ventilation, cardiac arrest and mortality.

Results:
In total, 2 543 912 COVID-19 cases were identified. Before propensity matching, CS patients were more likely to be younger (58.0 vs. 64.0 years, P<0.01), male (64.0% vs. 52.6%, P=0.011), of Black ethnicity (60.0% vs. 15.9%, P<0.01), exhibit higher Charlson Comorbidity Index (CCI) scores (3.00 vs. 1.00, P<0.01) and had a higher incidence of in-hospital cardiac arrest (aOR 2.649, 95% CI 1.366–5.134, P=0.004). After propensity matching (CS, N=95; non-CS, N=875), those with CS were at a statistically significant reduced risk of AKI (aOR 0.484, P=0.01); however, the outcomes of death, cardiac arrest, mechanical ventilation, length of stay (LOS) and healthcare costs did not reach significance.

Conclusion:
In a propensity-matched cohort admitted with COVID-19, CS patients had a reduced risk of AKI, but comparable LOS, rates of cardiac arrest, mechanical ventilator use, and mortality. Future research is warranted to develop evidence-based guidelines for managing COVID-19 in patients with CS.
TFE3-rearranged RCC with osseous metaplasia found on bone mass densitometry
Authors: Nasrallah Oussama G. , AlJardali Baraa , El Asmar Jose M. , El Kasti Abdallah , El Hajj Albert 
Published: October 2024

Introduction and importance:
Renal cell carcinoma (RCC) is the most common primary renal malignancy in patients between the ages of 50 and 70. A rare described variant of RCC is transcription factor for immunoglobulin heavy-chain enhancer 3 (TFE3) rearranged RCC. Osseous metaplasia, which refers to the occurrence of normal bone tissue in soft tissue, has been observed in all subtypes of renal cell carcinoma (RCC); however, only three previous case reports have documented the occurrence of osseous metaplasia in TFE3-rearranged RCC.

Case presentation:
We present a case of a 65-year-old woman presenting with an incidentally discovered calcified Bi-lobed renal mass detected on bone densitometry composed of a calcified thick-walled cyst measuring 7×6.5×6.5 cm showing intraluminal densities and heterogeneous content, and a lobulated partially exophytic renal mass measuring 4.5×5.5×4.5 cm. The patient underwent robotic-assisted radical nephrectomy confirming the diagnosis of RCC with osseous metaplasia extending into the pelvic calyces and renal sinus fat implicating a pathological stage of T3a.

Clinical discussion:
TFE3-rearranged RCCs represent a rare sub-classification in adult RCCs. It may be associated with unfavorable prognosis and aggressive patterns of disease in the presence of osseous metaplasia.

Conclusion:
This is the first case in the literature of TFE3-rearranged RCC with osseous metaplasia on bone mass densitometry scan and the fourth case of TFE3-rearranged RCC with osseous metaplasia. The patient is to be treated as a high-risk patient and to be monitored closely for recurrence of malignancy, as indicated in the EAU guidelines.
Improvements in Transitional Care Among Medicaid-Insured Patients With Serious Mental Illness
Authors: Nikpour Jacqueline , Langston Christine , Brom Heather , Sliwinski Kathy , Mason Aleigha , Garcia Dianne , Grantham-Murillo Marsha , Bennett Jovan , Cacchione Pamela Z. , Brooks Carthon J. Margo 
Published: October 2024

Background:
The Thrive program is an evidenced-based care model for Medicaid-insured adults in the hospital-to-home transition. A substantial portion of Thrive participants live with serious mental illness (SMI), yet Thrive’s efficacy has not been tested among these patients.

Purpose:
To compare 30-day postdischarge outcomes between Thrive participants with and without SMI and explore Thrive’s appropriateness and acceptability among participants with SMI.

Methods:
We conducted a sequential explanatory mixed-methods study of 252 (62 with SMI) Thrive participants discharged from an academic medical center from February 2021 to August 2023. Interviews of participants with SMI were analyzed using rapid qualitative analysis.

Results:
Participants with and without SMI experienced similar rates of 30-day readmissions, emergency room visits, and postdischarge follow-up visits, with these differences being nonsignificant. Participants with SMI were highly satisfied with Thrive’s care coordination and attention to social needs, yet participants suggested stronger connections to behavioral health care.

Conclusions:
Participants with and without SMI benefit equitably from Thrive.
Sociodemographic Characteristics, Anxiety, Depression Levels, and Emotional and Behavioral Problems in Hospitalized COVID-19–Positive Children and Adolescents
Authors: Kizilyaprak Eda , Arslan Semiha Comertoglu , Altun Hatice , Gunes Hatice , Dincer Serpil 
Published: October 2024

Abstract
This study aimed to investigate anxiety, depression levels, and emotional/behavioral problems of children and adolescents while being treated in the COVID-19 unit. The present study included 50 children who were COVID-19 positive, aged 7–18 years, and 50 age- and gender-matched healthy controls. The sociodemographic data form and Revised Child Anxiety and Depression Scale–Child Version (RCADS-C) were applied to all children, and all families were asked sociodemographic data form, Revised Child Anxiety and Depression Scale–Parent Version (RCADS-P), and Strengths and Difficulties Questionnaire (SDQ). There was no significant difference between the patient and control groups in terms of anxiety, depression levels, and emotional/behavioral problems. The conduct problems subscale score of SDQ in the patient group was found to be significantly lower than the control group (p = 0.037). Separation anxiety subscale scores of RCADS (p = 0.034) and the rate of accompanying companions (p = 0.01) in the patient group were found to be significantly higher in preadolescents than in adolescents. In conclusion, this study demonstrated that children and adolescents who were COVID-19 positive were not different from healthy children in terms of anxiety and depression levels, and emotional and behavioral problems in the acute period during inpatient treatment.
The Mediating Role of Trauma Centrality in the Correlation Between Coping Self-Efficacy and Posttraumatic Growth Level of Disaster Volunteers
Authors: Arpacı Rabia , Ayar Duygu , Karasu Fatma 
Published: October 2024

Abstract
Volunteers who respond to disasters play a crucial role in disaster management. However, their indirect exposure to traumatic events during their duties can adversely affect their mental health. The aim of the study was to determine the correlation among trauma centrality, coping self-efficacy, and posttraumatic growth and trauma centrality as possible mediator role in this relationship. A total of 112 disaster volunteers participated. The data were collected with a Demographic Form, the Centrality of Events Scale, the Post-Traumatic Growth Scale, and the Coping Self-Efficacy Scale. Disaster volunteers exhibited above average event centrality, high levels of posttraumatic growth, and coping self-efficacy. A positive correlation was identified among trauma centrality, posttraumatic growth, and coping self-efficacy, with trauma centrality playing a full mediating role. This study will be instrumental in better understanding the posttraumatic processes of disaster volunteers and in strengthening coping capacities, guiding the implementation of preventive and protective psychosocial interventions.
Cytokine Signature Differences in Major Phenotypic Groups of Behçet Disease
Authors: Deniz Rabia , Emrence Zeliha , Punar Şeyma , İleri Berk , Arga Kazım Yalçın , Alibaz-Öner Fatma , Bes Cemal , Direskeneli Haner , Gül Ahmet , Erzik Can 
Published: October 2024

Objectives
Behçet disease (BD) has heterogeneous presentations, mainly mucocutaneous, vascular, and ocular manifestations. The mechanisms associated with different phenotypes have not been clarified. We aimed to investigate the expression of innate and adaptive immunity–related cytokines in these 3 main BD phenotypes in active and untreated states and remission after treatment to be able to develop a cytokine-based treatment algorithm.

Methods
Serum samples were isolated from 41 patients with newly diagnosed active BD (aBD), which consisted of 19 mucocutaneous aBD, 11 ocular aBD (o-aBD), and 11 vascular aBD patients, 35 patients in remission (rBD), and 9 healthy controls (HC). Serum levels of each cytokine were measured with sandwich enzyme-linked immunosorbent assay and analyzed as both raw measurements and corrected levels for each 1 million white blood cells.

Results
The study included 41 aBD patients (female/male [F/M]: 9/32; median age, 29 years), 35 rBD patients (F/M: 9/26; median age, 29 years), and 9 HC (F/M: 3/6; median age, 28 years). The serum interferon γ level was significantly higher in the aBD group than in the rBD (116 vs. 92 pg/mL, p = 0.022). The serum interleukin 35 (IL-35) level was significantly higher in the HC group compared with aBD and rBD (p = 0.05). IL-17–related cytokines were lower in o-aBD. With treatment, they increased in o-aBD but decreased in mucocutaneous aBD and vascular aBD patients.

Conclusion
This study supports the involvement of both innate and TH1-predominated adaptive immune responses across all BD phenotypes. The IL-17 and TH17-related immune responses appear less prominent in ocular BD, which may explain the ineffectiveness of IL-17 blockade in treating ocular BD. These findings support the need for further studies using comprehensive gene expression analyses to develop targeted treatment strategies for BD phenotypes.
Positional Plagiocephaly Side and Neurodevelopmental Delay: Study on 408 Infants
Authors: Pinyot Joan , Lacambra David , Garriga Maria , Pinyot Maria , Niubó Josep Maria 
Published: October 2024

Objective:
Provide data on a cross-sectional study of neurodevelopmental delays in positional plagiocephaly (PP) based on severity and flattening side on early childhood patients.

Methods:
Neurodevelopment of 408 PP in patients with an age range of 3 to 59 months was assessed with Battelle Developmental Inventory (BDI) tests during and after their cranial orthotic treatment. Data obtained were compared with the cranial anthropometric measurements taken the same day the test was made, and results were segregated by flattening side, grouped by diagnosis and severity, segmented by age group, and split by sex.

Results:
From 3983 patients with positional skull deformities and simple craniosynostosis, 526 patients accepted to participate and took a total of 1261 BDI tests. Premature, patients with neurological diseases, cranial malformations, tests taken when positional skull deformity was corrected, and tests without plagiocephaly were excluded. The resulting database was made of 408 PP patients (300 boys and 108 girls) and 883 BDI tests (345 with left-side plagiocephaly and 538 with right-side plagiocephaly). Significant neurodevelopmental delay in more than one BDI domain on left-side plagiocephaly tests is observed in 76.4% of female and 92.2% of male patients and on right-side plagiocephaly tests in 75.5% of female and 95.5% of male patients. Neurodevelopmental delay difference between flattening sides, when both plagiocephaly sides presented significant delays, ranges from 0.2 to 3 months (BDI domain fine motor, Cephalic Index range ≥85 <100; BDI communication, age group 18–23).

Conclusion:
Neurological delay may vary depending on plagiocephaly side, thus when evaluating plagiocephaly patients the flattening side should be noted.
Immediate Injections of Botulinum Toxin A After Surgical Excision for Ear Keloids: A Retrospective Study
Authors: Li Shu Hua , Shan Xiu Juan , Wang Zhen Hua , Tao Shu Jie 
Published: October 2024

Background:
Ear keloids are pathologic scar hyperplasia in the ear region. The most therapeutic approach was surgical shave excision with radiation therapy. However, radiation therapy is easily delivered to healthy surrounding tissues. In the last years, injections with botulinum toxin type A (BTX-A) have been proven to improve surgical scars effectively in clinical trials. This study aimed to evaluate the effect of immediate injections of BTX-A after surgical excision for ear keloids.

Methods:
From January 2020 to January 2023, 33 consecutive patients with ear keloids were enrolled. All patients underwent scar excision and revision at the same time when they needed BTX-A. It was injected into surgical wound closure immediately after surgery. The results of this study were evaluated at follow-up from 7 to 18 months using the Vancouver Scar Scale (VSS) and the Visual Analogue Scale (VAS).

Results:
From January 2020 to January 2023, 33 patients received concomitant therapy of immediate injections of BTX-A after surgery for ear keloids. The patients were evaluated at follow-ups lasting 7 to 18 months. Only one case recurred within the follow-up period, and no adverse effects were reported.

Conclusion:
This study demonstrates that significant cosmetic outcomes in ear keloid treatment were achieved after early postsurgical BTX-A injections. The patients reported high satisfaction and few complications.
Application of Indocyanine Green Fluorescence Imaging During Laparoscopic Reoperations of the Biliary Tract Enhances Surgical Precision and Efficiency
Authors: Xu Ding-Wei , Li Xin-Cheng , Li Ao , Zhang Yan , Hu Manqin , Huang Jie 
Published: October 2024

Background:
A history of abdominal surgery is considered a contraindication for laparoscopic procedures. However, the advancements in laparoscopic instruments and techniques have facilitated the performance of increasingly intricate operations, even in patients with prior abdominal surgeries. ICG fluorescence imaging technology offers advantages in terms of convenient operation and clearer intraoperative bile duct imaging, as confirmed by numerous international clinical studies on its feasibility and safety. The application of ICG fluorescence imaging technology in repeat laparoscopic biliary surgery, however, lacks sufficient reports.

Methods:
The clinical data of patients who underwent elective reoperation of the biliary tract in our department between January 2020 and June 2022 were retrospectively analyzed. ICG was injected peripherally before the operation, and near-infrared light was used for 3-dimensional imaging of the bile duct during the operation.

Results:
Altogether, 143 patients were included in this study and divided into the fluorescence and nonfluorescence groups according to the inclusion criteria. Among the 26 patients in the fluorescence group, cholangiography was successfully performed in 24 cases, and the success rate of intraoperative biliary ICG fluorescence imaging was 92.31%. The intraoperative biliary tract identification time was significantly different between the fluorescence and nonfluorescence groups, but no statistical difference was observed in the final operation method, operative time, and intraoperative blood loss between the 2 groups. Although there was no significant difference in the postoperative ventilation rate, incidence of bile leakage, and stone recurrence rate at 6 months postoperatively between the 2 groups (P>0.05), a significant difference in postoperative hospitalization days was observed (P=0.032).

Conclusion:
The application of ICG fluorescence imaging technology in laparoscopic reoperation of the biliary tract is useful for the early identification of the biliary tract during operation, thereby shortening the operative time and reducing the risk of damage to nonoperative areas. This approach also enhances the visualization of the biliary system and avoids secondary injury intraoperatively due to poor identification of the biliary system. This technique is safe for repeat biliary tract surgery and has a good application prospect.