bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incidental discovery of unilateral hydronephrosis unveiling psoas major desmoid-type fibromatosis in a 24-year-old male: A case report with a 5-year follow-up
Authors: Almjersah Abdulrahman , Olaisheh Habib , Salloum Rabab , Alshehabi Zuheir , Almjersah Emad 
Published: July 2024

Rationale:
Desmoid-type fibromatosis (DTF), also known as aggressive fibromatosis, is a rare neoplasm originating from the fascial or musculoaponeurotic tissues. While benign and characterized by slow growth, it exhibits local aggressiveness and lacks specific clinical characteristics. However, in a considerable percentage of patients, it could be asymptomatic and discovered by accident during routine clinical examinations. Only a few cases of DTF arising from the psoas major muscle have been reported in the medical literature.

Patient concerns:
A 24-year-old male, asymptomatic and without significant personal or family medical history, was diagnosed with grade 2 hydronephrosis by abdominal ultrasonography during a routine physical examination. This diagnosis was made 15 days after undergoing uncomplicated open-heart surgery to repair an atrial septal defect.

Diagnosis:
Intravenous pyelogram revealed hydronephrosis with dilation of the pelvicalyceal system. Ureteroscopy ruled out any intrinsic lesions of the ureter. Contrast-enhanced computed tomography identified a 3.5 × 2 × 5.2 cm mass in the retroperitoneum, closely associated with the psoas muscle and enveloping the ureter adjacent to the iliac artery. Postoperative pathological analysis confirmed a definitive diagnosis of sporadic DTF.

Interventions:
The patient underwent exploratory abdominal surgery, during which the tumor was resected without any intraoperative complications.

Results:
After close monitoring over a 5-year follow-up period, which included periodic physical examinations, magnetic resonance imaging, and ultrasonography, no local recurrence was detected.

Lessons:
Achieving an accurate preoperative diagnosis presents a challenge in cases involving retroperitoneal tumors originating from the psoas major muscle and encasing the ureter. However, the insertion of a double J stent is deemed a crucial step in the surgical process, facilitating the dissection and isolation of the ureter from the tumor while preserving kidney function.
Prenatal detection of distal 18p deletion by chromosomal microarray analysis: Three case reports and literature review
Authors: Xu Tangfei , Yue Fagui , He Jing , Zhang Hongguo , Liu Ruizhi 
Published: July 2024

Background:
Chromosome 18p deletion syndrome is caused by total or partial deletion of the short arm of chromosome 18 and associated with cognitive impairment, growth retardation and mild facial dysmorphism. However, most studies on the genotype-phenotype correlations in the 18p region are diagnosed postnatally. Prenatal reports involving 18p deletions are limited.

Methods:
Three pregnant women opted for invasive prenatal testing due to noninvasive prenatal testing indicating high risk for chromosome 18 abnormalities. Karyotypic analysis and chromosomal microarray analysis (CMA) were performed simultaneously. The pregnancy outcomes for all cases were followed up. Meanwhile, we also made a literature review on prenatal phenotypes of 18p deletions.

Results:
G-banding analysis showed that 2 fetuses presented abnormal karyotypes: 45,XN,der(18)t(18;21)(p11; q11),-21 (case 2) and 46,XN,18p- (case 3). The karyotype of case 1 was normal. Meanwhile, CMA detected 4.37 Mb (case 1), 7.26 Mb (case 2) and 14.97 Mb (case 3) deletions in chromosome 18p region. All 3 pregnancies were terminated finally according to genetic counseling based upon abnormal CMA results.

Conclusion:
Prenatal diagnosis of 18p deletion syndrome is full of challenges due to the phenotypic diversity, incomplete penetrance and lack of prenatal phenotypes. Increased nuchal translucency and holoprosencephaly are common prenatal phenotypes of distal 18p deletion. For fetuses carrying 18p deletions with atypical sonographic phenotypes, noninvasive prenatal testing could be adopted as an effective approach.
Effects of kinesio taping combined with upper extremity function training home program on upper limb function and self-efficacy in stroke patients: An experimental study
Authors: Yang Seo-Won , Choi Jong-Bae 
Published: July 2024

Background:
The purpose of this study is to investigate the effects of kinesio taping and an upper extremity function home program on the upper extremity function and self-efficacy of stroke patients, and to present therapeutic evidence for home program intervention to improve upper extremity function.

Methods:
First, 53 stroke patients were randomly assigned to 2 groups: 26 experimental subjects and 27 controls. The experimental group performed kinesio taping on the dorsal part of the hand along with upper extremity functional training home program and the control group performed only upper extremity functional training home program. The intervention was conducted for a total of 30 sessions over 6 weeks. To evaluate changes in upper extremity function, wrist extensor muscle activation via the Surface Electromyography, the Chedoke Arm and Hand Activity Inventory-9 (CAHAI-9), and the motor activity log (including amount of use and quality of movement) were evaluated. In addition, the Self-Efficacy Scale (SES) was evaluated to examine the change in the self- efficacy of the study subjects.

Results:
The experimental group participating in the kinesio taping and upper limb function home program showed a statistically significant improvement (P < .01) before and after the intervention in the Surface Electrography the Chedoke Arm and Hand Activity Inventory-9 evaluation item in the upper limb function change. The SES evaluation, a self-esteem evaluation, also showed a statistically significant improvement (P < .01) before and after the intervention. Chedoke Arm and Hand Activity Inventory-9, motor activity log (quality of movement), and SES evaluation showed statistically significant differences (P < .05) between the experimental and control groups.

Conclusion:
It was confirmed that the upper extremity function training home program performed in parallel with the kinesio taping technique had a positive effect on the recovery of upper extremity function and self-esteem in stroke patients. The kinesio taping technique provides stability to the wrist while performing a home program that patients can perform on their own at home and appears to improve upper extremity function more effectively than when performing the upper extremity function home program alone.
Efficacy, safety and immunogenicity of the biosimilar etanercept compared to the reference formulation original etanercept in patients with rheumatoid arthritis: An open-label, randomized, comparative, multicenter study
Authors: Pekhenko Valentyna , Udovitskiy Vlad , Barbukho Olena 
Published: July 2024

Background:
The objective of this phase III clinical randomized trial was to establish the therapeutic equivalence of biosimilar etanercept (bio-etanercept) with original etanercept (O-etanercept) for patients diagnosed with rheumatoid arthritis.

Methods:
The study (NCT04079374) enrolled patients with moderate to high disease activity rheumatoid arthritis. Enrolled patients were randomized 1:1 into 2 treatment groups, 1 receiving bio-etanercept (study drug) and the other receiving O-etanercept (comparator) at a dose of 25mg twice weekly, for 24 weeks. The primary efficacy endpoint was the number of patients with an ACR20 response after 24 weeks of treatment. Safety (adverse reaction/adverse event) and immunogenicity of both drugs were evaluated.

Results:
Among 156 patients (79 in the bio-etanercept group and 77 in the O-etanercept group) who completed 24-week treatment and 4-week follow-up, 82.3% (65 patients) and 90.9% (70 patients) achieved an ACR20 response in the bio-etanercept and O-etanercept groups, respectively. There was no significant difference between the 2 groups (P = .16). No significant differences in the occurrence of adverse reactions/adverse events were found between the 2 groups regardless of severity (P = .63 for mild, P = .43 for moderate and P > .99 for severe). The development of antibodies in the bio-etanercept group was observed in 4 (5.1%; visit 6), 4 (5.0%; visit 9), and 3 (3.8%; visit 11) patients, and in 5 (6.4%), 5 (6.5%), and 3 (4.1%) patients in the O-etanercept group. The differences between the 2 groups were not significant (P > .99).

Conclusions:
This study showed that bio-etanercept was equivalent to the reference formulation.
Determination of the effective dose of remimazolam combined with sufentanil for inhibiting body movement during surgical abortion: An up-and-down sequential allocation trial
Authors: Liu Yang , Gu Jinye , Liu Jianbo , Fu Lei , Lin Xiaoyan , Sun Bona , Li Xiaoyu , Lu Bo 
Published: July 2024

Background:
Remimazolam, a recently developed anesthetic characterized by its rapid and ultra-short-acting properties, exhibits pharmacological attributes that make it potentially suitable for painless surgical abortion procedures. The objective of this study was to determine the effective dose of remimazolam when administered in combination with sufentanil, with the intention of inhibiting body movement during surgical abortion. Additionally, a secondary objective was to assess the recovery profile from general anesthesia.

Methods:
The study enrolled a total of 25 healthy women aged 20 to 40, with a body mass index between 18 and 28 kg/m2, in their first trimester of pregnancy (up to 12 weeks), and American Society of Anesthesiologists status I and II. Anesthesia induction was initiated by administering sufentanil at a dose of 0.1 μg/kg. The modified Dixon up-and-down method was employed to determine the induction dose of remimazolam for each patient.

Results:
The 50% and 95% effective dose of remimazolam for inhibitory effects of body movement was estimated using centered isotonic regression to be 0.145 mg/kg (95% CI: 0.115, 0.207), and 0.242 mg/kg (95% CI: 0.232, 0.620), respectively. Five out of 25 (20%) experienced hiccups, with 1 patient having persistent hiccups until the end of the surgery. The mean time to first eye-opening was 51.4 ± 20.5 seconds, and the time to obey verbal command was 54.5 ± 20.6 seconds. Upon arrival at the postanesthesia care unit, 95.7% of the patients achieved a Modified Aldrete score ≥ 9.

Conclusions:
The 50% and 95% effective dose of remimazolam for inhibiting body movement during surgical abortion when used in combination with 0.1 μg/kg of sufentanil were 0.145 mg/kg and 0.242 mg/kg, respectively.
Successful treatment with traditional Japanese medicine (kampo medicine) Yokukansan as a migraine prophylactic drug: A case report
Authors: Akiyama Hisanao , Hasegawa Yasuhiro , Yamano Yoshihisa 
Published: July 2024

Rationale:
The use of anti-CGRP antibody drugs as migraine preventive drugs is increasing worldwide, but there are still a certain number of cases where antibody drugs are ineffective or cannot be used due to high prices. Conventional prophylactic drugs or traditional Japanese medicine (kampo medicine) are still often used in such cases. However, to date, only limited evidence supports the efficacy of kampo medicine for headaches because these treatments have been used primarily empirically and traditionally. However, in recent years studies have begun to be published that describe the efficacy of kampo medicine for various types of headache. Here, we report the case of a patient who achieved a marked reduction in migraine frequency and severity by prophylactic therapy with the kampo drug yokukansan (TSUMURA Yokukansan Extract Granules).

Patient concerns and diagnoses:
The patient was a 50-year-old woman. She began to experience headaches around high school age and was diagnosed with migraine without aura at 42 years of age.

Interventions and outcomes:
She started prophylactic therapy with amitriptyline and topiramate and this treatment reduced the frequency of migraines for several years. However, the frequency began to increase again around 47 years, which is when she presented at our hospital. We achieved a temporary reduction in migraine frequency by adjusting the dose of drugs in her prophylactic therapy regimen, but the frequency increased again around age 49. We then tried monotherapy with the kampo medicine yokukansan, and this markedly reduced migraine frequency and severity over the following year. This therapy has remained effective to date.

Lessons:
We speculate that, in this case, migraine without aura was improved by prophylactic therapy with yokukansan due to its action on the glutamatergic system or serotonin system through suppression of orexin-A secretion or its anti-inflammatory effects as reported in previous animal studies. Yokukansan could be a usable kampo medicine for migraine prophylaxis in countries all over the world and should be investigated in a large clinical trial as soon as possible.
Raney clip left behind the titanium mesh after cranial surgery: Case report
Authors: Zhang Qin Ling , Su Yan , Richard Seidu A. , Lan Zhigang 
Published: July 2024

Rationale:
Raney clips are commonly used in neurosurgical procedures to hold the scalp in place and stop bleeding during surgery. The removal of Raney clips is often the last process during cranial surgery prior to the closure of skin incision. Thus, a Raney clip found underneath the titanium mesh resulting in fever is a very rare occurrence.

Patient concerns:
An 18-year-old male patient underwent cranial surgery due to intracranial abscess in the frontal lobe and subsequently underwent frontal skull repair using titanium mesh during which a Raney clip was unintentional left underneath the titanium mesh resulting in fever.

Diagnosis:
A thin-slice computed tomography (CT) scan was used to identify the Raney clip.

Intervention:
A third surgery was performed to remove the Raney clip.

Outcomes:
The patient fever total resolved after the third surgery with no further neurological deficits and 2-years follow-up revealed the patient is well and go about his daily activities.

Lessons:
It is crucial to ensure that all foreign objects are removed after the surgery by counting all instruments used at and after each step during the operation, including all Raney clips. This will help prevent complications and ensure the safety as well as the well-being of the patient.
Surgical treatment of one traumatic carotid artery dissection: A case report and review of the literature
Authors: Jia Xiaojian , Zhu Yuefeng 
Published: July 2024

Rationale:
Dissection of the cervical arteries is the most commonly identified cause of stroke in young patients. This report helps to investigate the etiology, diagnosis, and treatment of cervical artery dissection (CAD).

Patient concerns:
A 40-year-old female presented with a 3-week history of right carotid artery dissection due to a fall. The patient was admitted to the local hospital 3 weeks ago with a right neck impingement after a fall, and presented with right neck pain. The local hospital CT scan showed a dissection of the middle segment of the right common carotid artery.

Diagnoses:
The patient clinical manifestations and imaging tests confirmed that right carotid artery dissection.

Interventions:
Medical treatment with antiplatelet failed, and the CT scan showed progression of dissection. Carotid endarterectomy (CEA) was performed, and the prognosis is good.

Outcomes:
This patient was followed up at 1 and 6 months after the operation, CT scan showed the original stenotic vessels returned to standard diameter.

Lessons:
Diagnosis of CAD mainly depends on clinical manifestations and imaging. we recommend that clinicians can prescribe either anticoagulants or antiplatelet therapy. CAD can be effectively treated by surgical reconstruction, if medical treatment with anticoagulation or antiplatelet fails or if carotid aneurysms and/or high-grade carotid stenosis persisted or have newly developed.
Concomitant pyogenic spondylodiscitis and empyema following tongue cancer resection and wisdom tooth extraction: A case report and literature review
Authors: Yoshizawa Kunio , Yagi Takashi , Uchida Tsuyoshi , Moriguchi Takeshi , Moroi Akinori , Ueki Koichiro 
Published: July 2024

Rationale:
Pyogenic spondylodiscitis is an infectious spinal disease that causes significant motor dysfunctions. Its diagnosis can be challenging owing to its rapid onset and nonspecific symptoms.

Patient concerns:
A 79-year-old Japanese man with a history of type 2 diabetes mellitus and polymyalgia rheumatica presented to our department with tongue pain. Following partial glossectomy and wisdom tooth extraction under general anesthesia, on 10 postoperative day (POD) the patient developed right-sided abdominal pain and difficulty in walking. On 12 POD, the patient was admitted to a municipal hospital due to respiratory distress and paraplegia.

Diagnoses:
The patient was diagnosed with pyogenic spondylodiscitis and empyema. Blood tests revealed elevated C-reactive protein levels (36.5), white blood cell count (19,570), and neutrophil count (17,867).

Interventions:
The patient received meropenem hydrate 3 g/2 days as empiric antibiotic treatment for acute infection. Upon admission to the emergency department on 16 POD, the lung abscess was drained, hemilaminectomy was performed.

Outcomes:
Blood cultures, sputum tests, and cultures from the thoracic and spinal abscesses drained during surgery revealed methicillin-sensitive Staphylococcus aureus. The infection was successfully managed, and the respiratory disturbance and inflammatory response improved. However, the lower half of the patient body remained paralyzed. Subsequently, the patient was transferred to a rehabilitation facility on 45 POD. The patient continued to undergo functional restoration training, gradually regained function, and eventually achieved the ability to walk with grasping gait.

Lessons:
This is the first case report of S aureus causing pyogenic spondylodiscitis and empyema due to blood stream infection from a post-oral surgical wound. Pyogenic spondylodiscitis arising from a secondary hematogenous infection is difficult to diagnose and can lead to severe functional impairment. Prompt and appropriate diagnosis and treatment based on detailed patient interviews, additional blood tests, and computed tomography are essential.
Primary ovarian leiomyoma with calcification: A case report
Authors: Lu Dajiang , Chen Hua , Yang Chengfang , Liu Yanzhen , Mo Haishan , Zhang Yongguo 
Published: July 2024

Rationale:
Primary ovarian leiomyoma is a rare benign tumor. The exact histological origin and pathogenesis of primary ovarian leiomyoma are still unclear, while its preoperative imaging diagnosis is often challenging and prone to misdiagnosis. The study aims to elucidate the diagnosis of primary ovarian leiomyoma and to distinguish it from fibroma.

Patient concerns:
A 34-year-old female was admitted to the hospital with complaints of pelvic mass found for one year. One years ago, the patient went to a local hospital for examination due to irregular menstruation.

Diagnoses:
The ultrasound report of the patient showed ovarian teratoma. The postoperative pathological results showed ovarian leiomyoma and calcification.

Interventions:
The patient underwent laparoscopic right ovarian leiomyoma resection.

Outcomes:
The patient was discharged home three days after surgery. At the most recent follow-up (five months after operation) of the patients, ultrasound was performed and no abnormal echoes were suggested in the adnexal region.

Lessons:
In the diagnosis of primary ovarian leiomyoma, our case emphasizes the importance of microscopic features as an effective approach to distinguish it from ovarian fibroma, leiomyosarcoma, and stromal tumors. Additionally, personalized treatment should be considered based on the patient age and fertility needs.
A case report of systemic lupus erythematosus complicating interstitial lung disease and thickened pericardium treated with tofacitinib
Authors: Li Xiaoying , Luo Kaoye , Yang Dandan , Hou Chunfeng 
Published: July 2024

Rationale:
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that damages multiple organs and systems, including the lungs, kidneys, and heart. The respiratory system is commonly affected by SLE, leading to problems such as pleurisy, pleural effusion, and interstitial lung disease (ILD). In addition, SLE can involve the heart, with pericarditis being the most common manifestation. Notably, pericardial effusion frequently accompanies pericarditis involved by SLE, and aspects such as thickened pericardium (TP) can be challenging to detect early on. There are limited reports on TP and even fewer reports on the treatment of ILD with TP. This study investigates the clinical treatment of SLE complicating ILD and TP and reports on a successful case treated with tofacitinib, offering new strategies for managing such patients.

Patient concerns:
A 35-year-old female patient presented to the hospital with polyarticular swelling and pain that had been ongoing for over 4 years, as well as recurrent chest pain for 2 years that worsened over the course of 1 day.

Diagnoses:
The patient was diagnosed with SLE complicating ILD and TP, with hematologic involvement.

Interventions:
Treatment involved the administration of tofacitinib in combination with low-dose methylprednisolone (MP) and mycophenolate mofetil (MMF).

Outcomes:
The patient experienced recurrent chest pain and difficulty in reducing glucocorticoids (GCs), but the patient conditions were improved upon the addition of tofacitinib. The patient has been followed up for 16 months, and the patient MP dosage has been reduced to 6 mg once daily. The patient condition remains stable without recurrence, and the patient quality of life has improved.

Lessons:
In cases of SLE complicating ILD and TP, when tapering GCs is difficult, treatment with tofacitinib can be effective in achieving remission and maintaining stability.
Hyalinizing clear cell carcinoma of the sublingual gland: A case report and literature review
Authors: Guan Li , Tang Yuyang , Yang Zhenglin , Guo Lijuan , Yang Sen 
Published: July 2024

Rationale:
Hyalinizing clear cell carcinoma (HCCC) of the salivary glands is a rare low-grade malignant tumor. This type of tumor is particularly uncommon in the sublingual glands.

Patient concerns:
A 57-year-old female with a mass on the left side of the floor of the mouth that had been present for 2 months. The computed tomography scan of the neck revealed a nodular abnormal density shadow in the left sublingual area, measuring approximately 2.6 cm × 1.9 cm.

Diagnoses:
Primary HCCC of the sublingual gland.

Interventions:
The patient underwent surgical treatment and reconstruction using a left anterolateral femoral free flap, which showed immunohistochemical positivity for CK 5/6, CK 7, CK (AE1/AE3), and Ki-67 (<5%), but negative for SMA and S-100.

Outcomes:
No recurrence was observed during the 12-month postoperative follow-up period.

Lessons:
The absence of characteristic clinical manifestations makes HCCC highly susceptible to misdiagnoses. This case presents a rare instance of HCCC in the sublingual gland, providing a reference for the clinical diagnosis and treatment of the disease.