bluuebunny/crossref_metadata_2025_split huggingface dataset:
Worse Preoperative 12-Item Veterans Rand Physical Component Scores Prognosticate Inferior Outcomes Following Outpatient Lumbar Decompression
Authors: Anwar Fatima N. , Roca Andrea M. , Loya Alexandra C. , Medakkar Srinath S. , Kaul Aayush , Wolf Jacob C. , Federico Vincent P. , Sayari Arash J. , Lopez Gregory D. , Singh Kern 
Published: June 2024

Study Design:
Retrospective Review.

Objective:
Evaluate the influence of the 12-Item veterans Rand (VR-12) physical component score (PCS) on patient-reported outcome measures (PROMs) in an outpatient lumbar decompression (LD) cohort.

Summary of Background Data:
The influence of baseline VR-12 PCS on postoperative clinical outcomes has not been evaluated in patients undergoing outpatient LD.

Methods:
Patients undergoing primary, elective, 1/2-level outpatient LD with baseline VR-12 PCS scores were retrospectively identified from a prospectively maintained single-surgeon database. Cohorts were preoperative VR-12 PCS<30 and VR-12 PCS≥30. Patient/perioperative characteristics and preoperative/postoperative 6-week/final follow-up (FF) PROMs were collected. Physical health PROMs included the VR-12 PCS, 12-Item Short Form (SF-12) PCS, patient-reported outcome measure information system-physical function (PROMIS-PF), visual analog scale (VAS)-back/leg, and Oswestry disability index (ODI). Mental health PROMs included the VR-12/SF-12 mental component score (MCS) and the patient-health questionnaire-9 (PHQ-9). Average FF was 13.8±8.9 months postoperatively. PROM improvements at 6 weeks/FF and minimal clinically important difference (MCID) achievement rates were determined. χ2 analysis and the Student’s t tests compared demographics, perioperative data, and preoperative PROMs. Multivariate linear/logistic regression compared postoperative PROMs, PROM improvements, and MCID achievement rates.

Results:
Six weeks postoperatively, VR-12 PCS<30 reported worse baseline PROMs (P≤0.042, all) and worse scores except VR-12/SF-12 MCS (P≤0.043, all). Compared with VR-12 PCS≥30, VR-12 PCS<30 had worse FF VR-12 PCS, SF-12 PCS/MCS, PROMIS-PF, PHQ-9, and VAS-Back (P≤0.033, all). VR-12 PCS<30 experienced greater 6-week improvements in VR-12/SF-12 PCS, PHQ-9, VAS-Back, and ODI (P≤0.039, all). VR-12 PCS<30 had greater FF improvements in VR-12/SF-12 PCS, PHQ-9, and ODI (P≤0.001, all) and greater overall MCID achievement in VR-12 PCS/MCS, SF-12 PCS, PHQ-9, and ODI (P≤0.033, all).

Conclusions:
VR-12 PCS<30 patients-reported worse baseline/postoperative mental/physical health scores. However, they reported greater improvements in physical function, depressive burden, back pain, and disability by 6 weeks and FF and experienced greater MCID achievement for physical functioning, mental health, and disability scores.
Long-term clinical outcomes in elderly patients with chronic total occlusion and type 2 diabetes: the impact of coronary collateralization following successful recanalization
Authors: Wang Ming , Zhang Shuyi , Zhai Xinrong , Guan Shaofeng , Gan Qian , Han Wenzheng , Qu Xinkai 
Published: June 2024

Background and purpose:
Chronic total occlusion (CTO) lesions commonly affect elderly patients, especially those with type 2 diabetes mellitus (T2DM), often associated with coronary collaterals (CC). However, it remains unclear whether CC influences the prognosis of CTO. This retrospective single-center study aimed to evaluate the prognostic relevance of CC in elderly patients with T2DM after successful revascularization for CTO.

Methods:
We analyzed data from 416 patients diagnosed with CTO who underwent successful revascularization between January 2013 and January 2017. Patients were categorized into two groups: the Non-T2DM group and T2DM group. Subgroup analyses were performed based on the status of CC. The primary outcome was the occurrence of major adverse cardiac events (MACE) during the follow-up period, with the secondary outcomes including all-cause mortality, cardiac death, and repeat revascularization.

Results:
CC did not significantly impact clinical endpoints in the overall elderly patient population. However, we observed a lower incidence of MACE, cardiac death, all-cause mortality, and repeat revascularization in the Non-T2DM group compared to the T2DM group. In patients without T2DM, poor-CC was associated with higher rates of all-cause mortality (9% vs. 18%, P = 0.041), an increased risk of cardiac death (5% vs. 12%, P = 0.042), and a greater incidence of MACE (15% vs. 28%, P = 0.031), whereas no such associations were observed in T2DM patients. Furthermore, in multivariate Cox analysis, T2DM emerged as an independent factor influencing the time to MACE (adjusted hazard ratio [HR]:1.847, 95% confidence interval [95% CI]: 1.215–2.810, P = 0.004) and repeat revascularization (adjusted HR: 2.093, 95% CI: 1.310–3.344, P = 0.002) in elderly CTO patients, rather than coronary collateralization. Notably, regardless of the quality of CC, elderly patients with T2DM exhibited a poorer prognosis.

Conclusions:
Elderly patients without T2DM derived greater long-term survival benefits from successful revascularization of CTO compared to those with T2DM. Additionally, good collateralization was associated with a decreased risk of adverse clinical outcomes specifically in Non-T2DM patients.
Diffuse Dermal Angiomatosis in a Patient With Rheumatoid Arthritis: Case Report
Authors: Faria Jessia Pagan , Seko Gabriele Harumi , Mioto Eldis , Gubert Marina , Collete Mariana , Siqueira Icaro Allysson , Malia Alisson Rombi , Finatti Izabela 
Published: June 2024

Diffuse dermal angiomatosis is a rare vascular disorder of skin tissue in the spectrum of cutaneous reactive angiomatosis. Clinically, it presents as violaceous plaques that may ulcerate and is characterized by endothelial proliferation within the dermis on microscopic examination. It is mainly located in the breasts and extremities.

Case Presentation:
We report a case of erythematoviolaceous cutaneous plaques in an uncommon location (abdomen and dorsum) in a patient with rheumatoid arthritis and without other disorders such as atherosclerotic disease, macromastia and smoking.

Discussion and Conclusion:
It is believed that ischemia or inflammation creates local hypoxia, leading to an increase in pro-angiogenic cytokines with subsequent endothelial proliferation and neovascularization. We report a case of a patient with rheumatoid arthritis (autoimmune disease) who presented with an asymptomatic cutaneous violaceous and roundish lesion in the trunk that may be related to diffuse dermal angiomatosis.
Cutaneous Ciliated Cysts: 2 Case Reports and Review of Literature
Authors: Yalçın Anıl Can , Yalçın Nazlıcan , Çakmak Halil İbrahim , Bedir Recep 
Published: June 2024

Abstract:Cutaneous ciliated cysts are rare benign lesions most commonly seen in the lower extremities of young female patients. There is still ongoing debate about the origin of these cysts, with the most common theories being Mullerian heterotopia and eccrine gland metaplasia. To further increase the data pool, we present 2 new cutaneous ciliated cyst cases and gathered data about all 67 cases of literature. We want to highlight that immunohistochemistry and demographic information may play a key role in distinguishing between the 2 possible origins of this cyst, namely estrogen receptor, progesterone receptor, and carcinoembryonic antigen immunohistochemistry. Estrogen receptor and progesterone receptor nuclear positivity is proof of Mullerian origin, but when they are negative with a positive carcinoembryonic antigen, the most likely origin is eccrine gland metaplasia. We advocate using the terms “Cutaneous Mullerian Cyst” and “Ciliated Cutaneous Eccrine Cyst” instead of “Cutaneous Ciliated Cyst” to accurately indicate their distinct origins.
Spitz Melanoma With SLC20A1::ALK Fusion: A Novel Fusion Previously Undescribed in Spitz Melanocytic Neoplasm
Authors: Cho Woo Cheal , Prieto Victor G. , Yang Richard K. 
Published: June 2024

Abstract:
Spitz melanocytic neoplasms exhibit frequent chromosomal rearrangements leading to recurring gene fusions, such as ALK fusions. TPM3 and DCTN1 emerge as the predominant fusion partners of ALK, although less common partners such as NPM1, TPR, CLIP1, GTF3C2, MLPH, EEF2, MYO5A, and KANK1 have also been documented. Although ALK fusions are primarily associated with Spitz nevi or atypical Spitz tumors, instances of Spitz melanoma with ALK fusions documented in the English literature are exceedingly rare. Here, we present a case of Spitz melanoma harboring SLC20A1::ALK fusion, highlighting a novel fusion transcript not previously reported in Spitz melanocytic neoplasms, including Spitz melanomas. In addition, the tumor exhibits multiple aberrant chromosomal alterations characteristic of melanoma, along with a somatic mutation in GRM3.
Pulmonary tumor thrombotic microangiopathy: Two case reports and literature review
Authors: Ma Hua , Gao Jian-Mei , Wang Jing , Huang Ling-Yan , Tian Xing-Cang , Tian Zhi-Gang , Wang Shao-Jin , Ma Gang , Tan Hai , Zhang Shu-Xiang 
Published: June 2024

Rationale:Pulmonary tumor thrombotic microangiopathy (PTTM) is a rare but serious complication in patients with malignancy; its main manifestation includes acute pulmonary hypertension with severe respiratory distress. More than 200 cases have been reported since it was first identified in 1990. PTTM accounts for approximately 0.9% to 3.3% of deaths due to malignancy, but only a minority of patients are diagnosed ante-mortem, with most patients having a definitive diagnosis after autopsy.Patient concerns:Two middle-aged women both died within a short period of time due to progressive dyspnea and severe pulmonary hypertension.Diagnoses:One patient was definitively confirmed as a gastrointestinal malignant tumor by liver puncture biopsy pathology. Ultimately, the clinical diagnosis was pulmonary tumor thrombotic microangiopathy.Interventions:The patient was treated symptomatically with oxygen, diuresis, and anticoagulation, while a liver puncture was perfected to clarify the cause.Outcomes:Two cases of middle-aged female patients with rapidly progressive pulmonary hypertension and respiratory failure resulted in death with malignant neoplasm.Lessons:PTTM has a rapid onset and a high morbidity and mortality rate. Our clinicians need to be more aware of the need for timely diagnosis through a targeted clinical approach, leading to more targeted treatment and a better prognosis.
Giant sciatic nerve schwannoma: a rare case report and literature review
Authors: Sarmiento M. Eddy , Espinoza C. Fernando , López C. Limber , Fuentes-Rocabado Nicole , Chaurasia Bipin 
Published: June 2024

Introduction and importance:
Schwannomas are benign tumors that arise from Schwann cells commonly located in peripheral nerves. Depending on the size and location of sciatic nerve Schwannoma clinical manifestations can either varies from symptoms simulating radiculopathies such as positive Lasegue sign on the affected side, gait weakness and paresthesia or just present with pain and an associated palpable mass.

Case presentation:
The authors present a case of a 34-year-old female patient suffering from pain, gait weakness, and a palpable mass since many months. The palpable mass was present in the posterior region of the left lower limb. Imaging studies reveal an extensive lesion measuring 35 cm×8 cm that extends from the gluteal region to the left popliteal fossa.

Clinical discussion:
The finding of a palpable mass during physical examination guided us towards the diagnostic suspicion and thus necessitating the direct imaging studies. When approaching such type of patients, a history of neurofibromatosis must be ruled out due to its frequent association. Surgical resection should focus on the preservation of neurovascular structures, which offers improvement of the symptoms and the quality of life of patients.

Conclusion:
Giant sciatic nerve schwannoma if excised completely can lead to relieve of symptoms. Although recurrences are uncommon follow-up for years is necessary.
Treatment of recurrent uveitis and ankylosing spondylitis with Golimumab: a case report, Letter to Editor
Authors: Kudsi Maysoun , Drie Tasneem , Dumirieh Sumaya 
Published: June 2024

Introduction and importance:
Uveitis, as an extra-articular presentation, is found in 23% of patients with ankylosing spondylitis (AS) and is a challenging disease to treat.

Case presentation:
The authors presented a 32-year-old male to the out-hospital, complaining of recurrent anterior uveitis 8 years earlier in his left eye, and suffered from inflammatory lumber pain for 2 years. So a diagnosis of AS after the failure of many therapeutic strategies, 50 mg /month subcutaneous Golimumab was started with clinical remission of AS and uveitis.

Clinical discussion:
The American College of Rheumatology recommends the use of etanercept and adalimumab in the treatment of recurrent uveitis in AS patients. Similarly, the European League Against Rheumatism recommended using Infliximab, Adalimumab, or Certolizumab to prevent the recurrence of uveitis recurrence. Till now, a case about treating refractory uveitis with Golimumab in AS patients was published.

Conclusion:
Golimumab was found to be effective in the treatment of uveitis associated with spondyloarthritis refractory at least one immunosuppressive drug.
A case report on posterior reversible encephalopathy syndrome (PRES) in an elderly female
Authors: Adhikari Sonu , Shrestha Neeyal , Shrestha Dinuj , Raut Rupesh , Ray Prajeet , Bista Prakash , Bhattarai Ayam 
Published: June 2024

Introduction and importance:
Posterior reversible encephalopathy syndrome (PRES) is a medical condition characterized by symptoms such as headache, altered consciousness, visual abnormalities, seizures, and associated radiological vasogenic edema. The condition, as its name suggests, is generally reversible. PRES typically affects individuals around the age of 45 and is rarely seen in the elderly population.

Case presentation:
In this report, the authors present the case of an 83-year-old woman who presented to the emergency department with a history of seizures and visual disturbances. Upon examination, her Glasgow Coma Scale (GCS) was 14, and she had bilateral round,reactive, regular pupils. A plain computed tomography (CT) head was performed, which revealed multiple hemorrhagic areas in the occipital region associated with vasogenic edema. magnetic resonance imaging was done which was suggestive of PRES. The individual underwent conservative management in the authors’ institute and gradually recovered.

Clinical discussion:
PRES typically presents in middle-aged individuals, with infrequent occurrences in the elderly population. Early radiological and clinical assessments are crucial for the prompt diagnosis of this condition. Additionally, it is essential to identify predisposing factors such as hypertension, eclampsia, electrolyte imbalances, renal failure, autoimmune diseases, and the use of cytotoxic drugs for optimum management of the patient.

Conclusion:
PRES is generally reversible, as its name implies. Maintaining a high level of suspicion based on radiological and clinical correlations, coupled with the effective management of underlying conditions, can contribute to its potential reversibility.
Breaking barriers: addressing inequities in Alzheimer’s disease diagnosis and treatment in Africa
Authors: Uwishema Olivier , Kassahun Bekele Bezawit , Nazir Abubakar , Filbert Luta Erick , Abdulnaser Al-Saab Elaf , Jacques Desire Irakiza , Franklin Ozioma Chukwuma , Wojtara Magda 
Published: June 2024

Introduction:
Alzheimer’s disease represents a substantial and escalating public health threat across Africa. Alzheimer’s disease leads to substantial cognitive impairment and memory loss, placing a heavy burden on the affected individuals and their families, friends, and caregivers. It affects 2.67 million people in Africa, the majority of whom live in sub-Saharan Africa. The prevalence of this disease is expected to rise drastically to approximately 150 million individuals worldwide by 2050, as estimated by the WHO.

Aim:
This paper offers an integrative profile of Alzheimer’s disease in Africa, spanning known genetic and modifiable risks, discusses the existing challenges in diagnosis and treatment, projections on prevalence and disability-adjusted life year burden through 2050, and priority policy responses needed to rebalance the equation.

Methods:
This paper examines available literature to summarize current knowledge on risk factors, diagnosis, treatments, and burden of Alzheimer’s disease in Africa. Gather epidemiological assessments, clinical guidelines, and commentary related to Alzheimer’s disease in Africa.

Results:
The data reveals concerning realities regarding Alzheimer’s disease diagnosis and care in Africa. Diagnostic infrastructure shortcomings, resource limitations, and knowledge gaps emerge as recurring barriers. Positron emission tomography scans, cerebrospinal fluid assays, and other mainstay detection modalities common in developed countries show restricted availability.

Conclusion:
Addressing Africa’s Alzheimer’s disease crisis demands a multipronged strategy to uplift diagnostic capacities, treatment availability, specialist training, public awareness, and coordinated policymaking. Prioritizing biomarkers and imaging to confirm early neurodegeneration is foundational, alongside drug access expansion.
The Mediating Role of Resilience in the Relationship Between Hope and Spiritual Well-being in Cancer Patients
Authors: Uğuz Özkan , Keskin Gülseren 
Published: June 2024

Background
Cancer is a significant public health concern in the healthcare landscape. Amidst this challenging journey, the levels of hope, spiritual well-being, and resilience in patients with cancer have emerged as pivotal factors influencing the healing process.

Objective
This study aimed to evaluate the relationship between hope and spiritual well-being in cancer patients and the mediating role of resilience in the relationship between hope and spiritual well-being levels.

Methods
This study is a descriptive, cross-sectional, correlational study. The study included 152 cancer patients undergoing treatment. A patient information form, the 12-item Functional Assessment of Chronic Illness Therapy–Spiritual Well-Being (FACIT-SP-12) Scale, the Dispositional Hope Scale, and the Brief Resilience Scale were used to collect study data.

Results
Positive and meaningful correlations were observed between the Dispositional Hope Scale and FACIT-SP-12, Brief Resilience Scale, and FACIT-SP-12 (r = 0.390, P < .05; r = 0.246, P < .05). Mediation analysis indicated that Brief Resilience Scale scores partially mediated the relationship between the Dispositional Hope Scale and FACIT-SP-12 Scale scores; the indirect effect of hope on spiritual well-being through resilience was 0.351 (P < .05).

Conclusion
The study has indicated a direct relationship between hope and spiritual well-being, and resilience partially mediated the relationship between hope and spiritual well-being.

Implications for Practice
It is significant to provide psychosocial care to cancer patients to increase their resilience levels and to support their hope and spiritual well-being.
“Nothing Is More Powerful than Words:” How Patient Experience Narratives Enable Improvement
Authors: Grob Rachel , Lee Yuna S.H. , Shaller Dale , Warne Emily , Matta Sasmira , Schlesinger Mark , Nembhard Ingrid M. 
Published: June 2024

Background and Objectives:Patient experience narratives (narratives) are an increasingly important element of both measurement approaches and improvement efforts in healthcare. Prior studies show that narratives are considered by both clinicians and staff to be an appealing, meaningful, and credible form of evidence on performance. They also suggest that making concrete use of narratives within organizational settings to improve care can be complex and challenging. Our qualitative study was designed to explore how middle managers working in a health system’s outpatient clinics value and use written narratives in their day-to-day work.Methods:We conducted qualitative interviews with 20 middle managers working in 8 outpatient clinics. Interviews were fully transcribed, loaded into MAX-QDA software, and coded using thematic analysis techniques. Code reports were extracted and reanalyzed for subthemes related to the objectives of this paper.Results:Middle managers across sites described valuing narratives as a tool to: enable better patient experience assessment by augmenting data from patient experience scores; deepen understanding of and relationships with patients; provide insight about operational issues; identify areas for needed improvement and potential solutions; and facilitate strategic work. They reported using narratives for a range of activities related to their roles as supervisors, such as focusing attention on positive practices and needed improvements, promoting deeper group learning, motivating change, reinforcing sense of purpose for staff, recognizing staff strengths and training needs, and inspiring transformational thinking. Finally, interviewees reported numerous specific quality improvement projects (both short- and longer-term) that were informed by narratives—for example, by identifying an issue to be addressed or by suggesting a workable solution. Together, these interviews suggest a collective “narrative about narratives” woven by these organizational actors—a story which illustrates how narratives are highly relevant for how middle managers derive meaning from their work, put organizational values such as responsive service provision into practice, and enact their roles as supervisors.Conclusions:Our results add to the nascent literature a detailed description of how narratives can be used both as a tool for middle managers in their leadership and supervisory roles, and as a blueprint for improvement work within outpatient settings. They also illuminate why patient experience scores may improve when narrative data are collected and used. Finally, our results suggest that for middle managers, perhaps “nothing is more powerful than words” because narratives function as both an insight provider and a compelling tool that adds direction and meaning to workplace endeavors.
Does Piroxicam have an Added Benefit on Arthrocentesis in the Management of Internal Derangement in Female Patients?: A Randomized Clinical Trial
Authors: Helmy Haitham Ahmed , Elhadidi Yasser Nabil , Taha Mustafa Mohamed Sayed 
Published: June 2024

Background:
Arthrocentesis is an accepted treatment modality for internal derangement. Piroxicam is an NSAID that can be injected into the TMJ.

Purpose:
The primary objective of this study was to improve mouth opening, and the secondary objective was to decrease TMD-associated pain.

Methods:
A randomized controlled trial (RCT) was performed on patients suffering from anterior disk displacement with reduction. Patients were divided into 2 groups: a study in which patients underwent arthrocentesis followed by an injection of 20 mg of piroxicam. Independent and paired sample t-tests were used to assess mouth opening. The χ2 test was used to assess the pain data; the P value was fixed at 0.05.

Results:
Twenty female patients were included in the current study. To ensure that covariables did not affect the study results, an intergroup assessment using Student’s t-test for unassisted mouth opening without pain preoperatively showed that the maximum unassisted opening without pain was 20.8±3.9 mm in the control group, and the average maximum unassisted opening without pain was 19.7±1.1 mm in the case study group. The unassisted mouth opening in the control group was 30.9±3.4 mm and 31.8±3.6 mm, respectively, and there was no significant difference (P=0.6, 95% CI: −2.5 to 4.32). There was no significant difference in pain between the study and control groups (P=0.3).

Conclusion and Recommendation:
Based on the results of the present study, arthrocentesis using piroxicam does not have any benefit over conventional arthrocentesis.