bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cutaneous Deciduosis: A Rare Cutaneous Lesion Mimicking Malignancy
Authors: Tinguria Mukund , Chorneyko Katherine , Boutross-Tadross Odette 
Published: July 2024

Abstract:
Cutaneous deciduosis is an extremely rare condition that clinically presents as a nodular lesion in the skin as a scar or neoplasm. Histologically, this may pose a diagnostic challenge simulating malignant epithelioid neoplasms including sarcoma. Histologically, a nodular growth pattern of large monomorphic epithelioid cells is observed. The epithelioid cells in deciduosis can appear atypical with considerable nuclear pleomorphism, mimicking a malignancy. These features can be misinterpreted as a primary cutaneous or metastatic malignancy by dermatopathologists who are not familiar with gynecologic pathology. Failure to correctly diagnose this condition may result in unnecessary diagnostic studies for the patient. In this article, we report a case of cutaneous deciduosis in a 35-year-old woman with a cesarean scar. Histological examination revealed nodular proliferation of large epithelioid cells with pale eosinophilic cytoplasm and large nuclei with prominent nucleoli. Compressed atrophic slit-like glands resembling endometrial glands were present in some areas. Histopathological features of decidual cells, along with appropriate immunohistochemical studies, help establish the diagnosis and rule out other neoplastic mimics of deciduosis.
Local Cutaneous Scrotal Involvement of Paratesticular Mesothelioma
Authors: Maniam Ganesh , Tekin Burak , Gupta Sounak , Nguyen Giang , Agrawal Shruti 
Published: July 2024

Abstract:
Paratesticular mesothelioma (malignant mesothelioma arising from the tunica vaginalis of the testis) represents a small proportion of mesothelial neoplasms, and cutaneous involvement by paratesticular mesothelioma is very rare. Cutaneous involvement can manifest as scrotal subcutaneous nodules from regional spread, distant metastasis, or direct extension through surgical scars. Mesothelioma has 3 histopathologic classifications that include epithelioid, biphasic, and sarcomatoid, which is rarely seen in paratesticular mesothelioma. Given the rarity of this condition, cutaneous mesothelioma may be misdiagnosed as histologic mimics, such as metastatic adenocarcinoma or adnexal neoplasms; thus, appropriate immunohistochemical workup and clinical correlation are required to make an accurate diagnosis. In this case, a 75-year-old man with a history of paratesticular mesothelioma, status postorchiectomy, presented with right-sided scrotal swelling, erythema, and subcutaneous nodules. These nodules were identified as local recurrence with cutaneous involvement by paratesticular mesothelioma on histopathologic examination. This case highlights the clinical and histopathologic features of this diagnosis and underscores the importance of dermatopathologists being aware of this condition to ensure accurate diagnosis.
Evaluating Access and Outcomes in Gender-affirming Breast Augmentation: A Comparative Study of a County Hospital and an Academic Center
Authors: McLaughlin Matthew F. , Rosser Mica , Song Siyou , Mehta Nina , Terry Michael J. , Kim Esther A. 
Published: July 2024

Background:
Research on the diverse patient population undergoing gender-affirming breast augmentation remains scarce. We compared patients undergoing this procedure at San Francisco General Hospital (ZSFG), a county hospital, and the University of California, San Francisco (UCSF), an academic medical center.

Methods:
This was a retrospective cohort study of patients who underwent primary gender-affirming breast augmentation at ZSFG (August 2019 to June 2023) and UCSF (March 2015 to June 2023). Differences in sociodemographic characteristics, surgical access, and outcomes between sites were assessed.

Results:
Of 195 patients, 122 patients had surgery at UCSF and 73 patients at ZSFG. ZSFG patients were more likely to be unstably housed (P < 0.001), Spanish-speaking (P = 0.001), and to have obesity (P = 0.011) and HIV (P = 0.004). Patients at ZSFG took hormones for longer before surgical consultation (P < 0.001) but had shorter referral-to-surgery intervals (P = 0.024). Patients at ZSFG more frequently underwent a subglandular approach (P = 0.003) with longer operative times (P < 0.001). Major surgical complications were uncommon (2.1%) with no differences between sites. Aesthetically, implant malposition/rotation occurred more often in patients at UCSF (P = 0.031), but revision rates were similar at both sites. Patients at UCSF had longer follow-up periods (P = 0.008).

Conclusions:
County hospital patients seeking gender-affirming breast augmentation have distinct sociodemographic profiles and more comorbidities than academic medical center patients. County patients might experience greater barriers that delay surgical eligibility, such as stable housing. Nevertheless, this procedure can be safely and effectively performed in both patient populations.
Electrophysiological Changes in Patients with Postoperative Cross-facial Nerve Graft in a Tertiary Care Center
Authors: González-Woge Osmar R. , Salazar Trujillo Bruno A. , Elnecavé Olaiz Alejandro , González-Woge Miguel Á. , Aragón Luna Victoria , Loreto Francisca S. , González-Navarro Mauricio 
Published: July 2024

Background:
Facial nerve palsy is a multifaceted pathology that causes facial disfigurement, affecting eye closure, speech articulation, oral competence, and emotional expression, with functional, aesthetic, and psychological consequences. Standardized electrophysiological tests, such as electroneurography and electromyography, allow an objective evaluation of the functional state of the nerve. Here, we aimed to compare and correlate clinical findings with electromyography in patients with facial nerve palsy, before and after facial nerve reanimation with cross-facial nerve grafts.

Methods:
Eight patients with traumatic or nontraumatic facial paralysis with complete clinical records who underwent surgical reanimation of facial nerve with cross nerve grafts.

Results:
The median time from diagnosis to treatment was 173 days (interquartile range = 222). Outcomes were evaluated using standard clinical scales (House-Brackmann, Sunnybrook, and eFACE) and electromyography. The median time for postoperative outcome evaluation was 768 days (interquartile range = 1053). A statistically significant difference was found between pre- and postoperative outcomes according to eFACE (Δ median = 13, P = 0.003), House-Brackmann (Δ median = −2, P = 0.008), and electromyography (Δ mean = 855, P = 0.005). A positive correlation between electromyography and clinical evaluation with eFACE was observed (r = 0.751, 95% confidence interval = 0.174–0.944, P = 0.019).

Conclusions:
Our results suggest that cross nerve grafts are associated with clinical and electromyographic improvement of the paralyzed face. Electromyography and eFACE scores validate the reliability of eFACE scale for measuring postoperative outcomes. We suggest postoperative electromyography as an objective measure of postoperative evaluation in patients with a delay in improvement at 6–9 months.
Reconstruction of Total Hand Degloving Injury with Combined Free and Pedicled Flaps and Ilizarov Minifixator
Authors: Hayashi Kota , Hattori Yasunori , Sakamoto Sotetsu , Gour Vijayendrasingh , Sasaki Jun , Doi Kazuteru 
Published: July 2024

Summary:
Total hand degloving injuries present a significant challenge in treatment, with no consensus yet on the optimal choice of flap for coverage. Functional reconstruction necessitates careful consideration of syndactyly release, particularly after flap coverage. A 64-year-old woman sustained a total hand degloving injury and underwent extensive reconstructive surgery. Initially, a free superficial circumflex iliac perforator flap was applied to the thumb, whereas pedicled groin and superficial inferior epigastric artery flaps were used for the remaining fingers. However, partial necrosis at the edges of the pedicled flaps necessitated the adduction of the fingers, followed by suturing the skin flaps closed. This led to the formation of adduction contractures, requiring careful release and skin flap extension for effective syndactyly release. Subsequently, the innovative use of an Ilizarov minifixator was used for the dual purpose of interdigital widening and elongation of the flap. At the 27-month follow-up, the patient demonstrated significant functional recovery of the hand and fingers, showing the effectiveness of this multifaceted surgical approach. Despite some residual flexion contractures, the patient regained the ability to write and perform pinching motions with the thumb and middle finger, expressing satisfaction with the surgical outcome. In conclusion, for a functional reconstruction of the thumb and fingers, the thumb and other fingers should be covered separately. When the fingers are in adduction and there is insufficient skin stock for syndactyly release, using an external fixator to expand the interdigital spaces before the syndactyly release proved to be effective.
Ocular dominance shift in refractive cataract surgery: prospective, observational study
Authors: Song Tingting , Nie Fen , Zhao Yang , Liao Menglian , He Lian , Tang Qiongyan , Duan Xuanchu 
Published: July 2024

Purpose:To explore the features of the dominant and nondominant eyes in patients with cataracts and predict ocular dominance shift (ODS) based on preoperative indicators.Setting:Changsha Aier Eye Hospital, Changsha, Hunan, China.Design:Prospective, observational study.Methods:Patients with age-related cataracts who underwent unilateral cataract surgery were enrolled in this study. Before the procedure, uncorrected distance visual acuity (UDVA) was assessed and noncycloplegic subjective refraction evaluations were conducted to determine corrected distance visual acuity. Total astigmatism, corneal astigmatism, and intraocular astigmatism were measured using OPD-Scan III. Cataract type was assessed using slitlamp biomicroscopy based on the Lens Opacities Classification System III. Ocular dominance (OD) was determined under corrected conditions using the hole-in-card test. Follow-up visits occurred at 1 day, 1 week, and 1 month postoperatively. After 1 month, OD was re-evaluated, and participants completed the 9-item Short-Form Cataract Questionnaire.Results:94 patients (188 eyes) were enrolled in the study. The analysis showed that the ODS rate of unilateral cataract surgery was 40.4%. In addition, age, UDVA of the nondominant eye, posterior subcapsular cataract, and total astigmatism were risk factors for ODS. No difference in vision-related quality of life was detected between patients who had ODS and those who did not.Conclusions:Several preoperative parameters as potential risk factors of ODS after cataract surgery were identified. These findings provide guidance for predicting changes in the dominant eye and may improve the precise selection of intraocular lenses and implementation of monovision strategies.
Atrial Fibrillation and Older Age Predict Serum Brain-Derived Neurotrophic Factor Levels Among Patients With Heart Failure
Authors: Pressler Susan J. , Jung Miyeon , Dorsey Susan G. , Giordani Bruno , Titler Marita G. , Wierenga Kelly L. , Clark David G. , Smith Dean G. , Smith Asa B. , Gradus-Pizlo Irmina , Pressler Milton L. 
Published: July 2024

Background
Predictors have not been determined of serum brain-derived neurotrophic factor (BDNF) levels among patients with heart failure (HF).

Objective
The primary purpose was to evaluate history of atrial fibrillation, age, gender, and left ventricular ejection fraction as predictors of serum BDNF levels at baseline, 10 weeks, and 4 and 8 months after baseline among patients with HF.

Methods
This study was a retrospective cohort analyses of 241 patients with HF. Data were retrieved from the patients' health records (coded history of atrial fibrillation, left ventricular ejection fraction), self-report (age, gender), and serum BDNF. Linear multiple regression analyses were conducted.

Results
One hundred three patients (42.7%) had a history of atrial fibrillation. History of atrial fibrillation was a significant predictor of serum BDNF levels at baseline (β = −0.16, P = .016), 4 months (β = −0.21, P = .005), and 8 months (β = −0.19, P = .015). Older age was a significant predictor at 10 weeks (β = −0.17, P = .017) and 4 months (β = −0.15, P = .046).

Conclusions
Prospective studies are needed to validate these results. Clinicians need to assess patients with HF for atrial fibrillation and include treatment of it in management plans.
Patient-Perceived Disability Following Transtibial Amputation and Prosthetic Limb Fitting
Authors: Ferdowsian Ryan , Pinzur Michael S. , Adams William , Angelico John 
Published: July 2024

ABSTRACT

Introduction
Patients’ perception of their disability following lower-limb amputation is currently measured using patient-reported outcomes (PROs) instruments. The validity is determined by comparing instruments designed to measure patient-perceived impact on amputation-specific health-related quality of life. The goal of this investigation was to compare patient-perceived disability from an outcomes instrument specific to individuals with amputation to a well-accepted outcomes instrument used to measure disability and response to treatment in generic musculoskeletal disease.

Materials and Methods
Twenty-one patients completed the Prosthesis Evaluation Questionnaire (PEQ) and the Short Musculoskeletal Functional Assessment (SMFA) at a minimum of 3 months following transtibial amputation while undergoing prosthetic limb fitting and gait training. A functional measure of their walking ability based on Medicare ambulatory function (Amputee Mobility Predictor [AMP]) was scored by a trained rehabilitation professional.

Results
The results of the outcomes scores provided initial evidence that the PEQ and SMFA assessments are correlated (i.e., provide some evidence of convergent validity). For every 100-point improvement in patients’ PEQ score, their SMFA Bother score declined by approximately 7 points (b = −6.94; P = 0.001) and Dysfunction score declined by approximately 7 points (b = −6.74; P < 0.001). Conversely, the SMFA and PEQ subscores were not associated with the AMP K-level (all P's > 0.05).

Conclusions
The findings suggested that the PEQ and SMFA PRO instruments are correlated in their ability to measure impact on health-related quality of life. Additionally, we found that PROs (PEQ and SMFA) did not predict physical ability as measured by the AMP K-level. The value of this investigation suggests that the easy-to-administer SMFA correlates well with the accepted PEQ, making testing both less cumbersome and time-consuming. Neither measure correlated with eventual ambulatory function. Rehabilitation following lower-limb amputation demands patient-specific goals. Available tools appear valuable in assisting the rehabilitation team in developing realistic objective tools for rehabilitation following lower-limb amputation.

Clinical Relevance
The simple-to-use SMFA appears to be comparable to the more cumbersome PEQ in assessing patient outcomes following transtibial amputations. Neither outcome instrument is correlated with functional task performance in this patient population.
Comparison of gallbladder extraction via the subxiphoid port and the supraumbilical port during laparoscopic cholecystectomy: a prospective randomized clinical trial
Authors: Ye Xiwen , Niu Xiaoya , Bai Dan , Cao Yu , Mao Yaling , Liu Huizhen , Luo Yuting , Fuyu-Li  , Cheng Nansheng , You Zhen 
Published: July 2024

Background:
Postoperative pain after laparoscopic cholecystectomy (LC) is the most frequent postoperative complaint. To date, gallbladder extraction via the subxiphoid port (SXP) versus the supraumbilical port (SUP) is still controversial. Thus, the authors performed this randomized controlled trial to compare postoperative pain between the SXP and SUP for LC.

Method:
From June 2021 to June 2023, patients who met the inclusion criteria were randomly assigned to two groups. The perioperative data of both groups were recorded and compared.

Results:
A total of 253 patients were enrolled in the analysis. There were 126 in the SXP group and 127 in the SUP group. There was no significant difference between the two groups in terms of the duration of gallbladder extraction, whether the incision was extended, the least rate of pain, the average rate of pain, the right-now rate of pain, postoperative pain on the 5th, 7th, and 14th days, postoperative complications and Vancouver Scar scale. However, the SUP group had a lower the worst rate of pain (4.24±2.45 vs. 4.91±2.45, P=0.031) and 3 days of pain (3.35±1.57 vs. 3.75±1.52, P=0.045) than did the SXP group. The influence of pain on general activity (4.51±2.90 vs. 3.76±2.92, P=0.041), mood (3.62±2.66 vs. 2.92±2.36, P=0.028), walking ability (4.40±3.01 vs. 3.66±2.76, P=0.044), and enjoyment of life (3.19±2.68 vs. 2.32±2.34, P=0.007) in the SXP was more severe than that in the SUP.

Conclusion:
The extraction of the gallbladder via the SUP is superior to that via the SXP because the early postoperative 24 h pain and pain on the third day are mild and do not increase the duration of gallbladder extraction or the risk of infection or hernia.
Efficacy and Safety of Endoscopic Through-the-Scope Suture System for Gastrointestinal Defects
Authors: Aziz Muhammad , Haghbin Hossein , Gangwani Manesh Kumar , Beran Azizullah , Dahiya Dushyant Singh , Ali Hassam , Sohail Amir Humza , Lee-Smith Wade , Hamdani Syed Uzair , Kamal Faisal , Adler Douglas G. 
Published: July 2024

Objective:
Recently, a through-the-scope suturing (TTSS) system has received FDA approval and has been evaluated for closing mucosal defects postintervention. We hereby performed a systematic review and pooled meta-analysis of available studies to assess the safety and efficacy of this intervention.

Methods:
We queried the following databases through April 26, 2023: Embase, MEDLINE, Cochrane Central Register of Controlled Trials, and Web of Science Core Collection. Endoscopists utilizing TTSS for the following reasons were included: endoscopic mucosal resection, endoscopic submucosal dissection, peroral endoscopic myotomy, perforation, fistula closure, and/or stent fixation. The outcomes assessed were technical success, primary clinical success (closure of defect without additional intervention), and overall clinical success (closure of defect with/without additional intervention). Random effects model with the DerSimonian Laird approach was used to report event rates expressed as proportions with a 95% CI.

Results:
A total of 12 studies with 512 patients (mean age of 61.5 ± 18.4 y, 54.6% females) were included. The technical success rate was 96.0% (CI: 94.3%-97.7%). The primary clinical success rate was 74.8% (CI: 65.5%-84.1%). The overall clinical success rate was 95.4% (CI: 92.6-98.2%). Only 1 mortality case unrelated to intervention was reported.

Conclusion:
The TTSS appears safe and effective for closing mucosal defects after therapeutic endoscopic interventions. Further cost-effective studies should be performed comparing with endoclips for use in clinical settings.
Decreased Completion of Ordered Laboratories and Imaging in Telehealth Compared With In-person Hepatology Encounters
Authors: Henson Jacqueline B. , Patel Yuval A. , Wall April H. , Muir Andrew J. 
Published: July 2024

Objective:
To evaluate order completion after telehealth compared with in-person encounters.

Background:
Completion of ordered testing, including laboratories and imaging, is an important aspect of successful outpatient care of patients with liver disease. Whether the completion of orders from telehealth encounters differs from in-person visits is unknown.

Materials and Methods:
Completion of ordered laboratories and imaging from hepatology encounters at our center from 2021 to 2022 were evaluated and compared between video telehealth and in-person visits. Laboratory completion was evaluated at 14 days, 30 days, and 90 days, and imaging completion was assessed at 1 year.

Results:
Telehealth encounters were significantly less likely to have laboratories completed at all evaluated time points (14 d: 40.7% vs 90.9%; 30 d: 50.9% vs 92.2%; 90 d: 63.9% vs 94.3%, P< 0.001 for all). Among telehealth encounters, encounters in patients more remote from the center were less likely to have laboratories completed. Imaging ordered at telehealth encounters was also less likely to be completed within 1 year (62.5% vs 70.1%, P< 0.001), including liver ultrasounds (59.1% vs 67.6%, P= 0.001), which persisted when limited to encounters for cirrhosis (55.8% vs 66.4%, P= 0.01).

Conclusions:
Telehealth encounters were significantly less likely to have ordered laboratories and imaging completed compared with in-person visits, which has important clinical implications for effective outpatient care of patients with liver disease. Further research is needed to better understand the barriers to order completion for telehealth visits and ways to optimize this to improve the effectiveness of this visit modality.
PrEP Use in a US National Sample of Trans Men and Other Transmasculine People Who Have Sex With Men: A Longitudinal Analysis
Authors: Carneiro Pedro B. , Radix Asa E. , Golub Sarit , Grosskopf Nicholas , Grov Christian 
Published: July 2024

Introduction:
Efforts to improve pre-exposure prophylaxis (PrEP) uptake among gay men, transgender women, and Black cisgender women are evident across the United States, responding to epidemiologic data showing a disproportionate HIV burden in these communities. However, transgender men and other transmasculine people who have sex with men (TMSM)—those assigned female at birth who identify otherwise and have sex with cisgender men—are often excluded from these statistics. This community has unique vulnerabilities and prevention needs. National HIV prevention and planning has yet to include transgender men as a group with increased vulnerability to HIV seroconversion. This study follows a cohort of TMSM to characterize PrEP use longitudinally.

Methods:
Using data from a prospective US national cohort of TMSM not on PrEP, we analyzed annual PrEP uptake, discontinuation, and other HIV prevention measures over 24 months. We also used generalized estimating equations modeling to assess demographic, healthcare access, gender-affirming, and behavioral factors associated with PrEP uptake over time.

Results:
Our cohort of 196 TMSM was demographic and regionally diverse. 29% of our sample reported uptake of PrEP in 24 months, with about one-third of users discontinuing within 1 year. Health insurance, having had lower surgery, used post-exposure prophylaxis, or recently having a sexually transmitted infection were associated with increased odds of PrEP use.

Conclusion:
We found low uptake of PrEP and high discontinuation rates in a US national sample of TMSM over 24 months, despite significant need for HIV prevention. It is vital to increase efforts and investments to support this neglected community.