bluuebunny/crossref_metadata_2025_split huggingface dataset:
Challenges With Diagnosis of Labial Agglutination Due to Lichen Sclerosus
Authors: Ghosalkar Esha , Epstein Samantha , Epstein Allison , Mauskar Melissa , Pope Rachel 
Published: February 2025

Objective
Labial adhesion (LA) lacks a clear etiology but is associated with low estrogen levels and lichen sclerosus (LS). Genitourinary Syndrome of Menopause is a contributor due to low estrogen, needing surgical resection if symptoms persist after topical estrogen use. Early diagnosis and treatment of LS can decrease the risk of development of LA. The objective is to investigate LS prevalence as an etiological factor and evaluate the necessity for enhanced biopsy rates in LA patients.

Methods
TrinetX provided data from 80 global health care centers, focusing on patients with LA using ICD-10-CM coding. The cohort was stratified based on vulva surgery 2 years post-LA diagnosis to establish a causal relationship.

Results
A total of 11,875 women over the age of 18 were diagnosed with LA from 2000 to 2023. Of those, 3,673 (30.93%) underwent a surgical procedure on the female genital system within 2 years. Demographic data included a mean age of 45 years, 67.9% identified as White, 6.53% as Black/African American, 20.52% unknown, and 2.45% other races. Of the 3,673 total women, 11% had a documented biopsy prior to or with the surgery, leading to 11% (395 women) being diagnosed with LS. Limitations include inconsistent medical coding, uncertain causality between conditions, and potential data inconsistencies from the national database.

Conclusions
Labial adhesion has a complex etiology, yet is associated with LS, emphasizing the need for biopsy in management when the first-line estrogen cream approach fails. Future studies on LA etiologies can improve approaches to female sexual health care disorders, enhancing patient care.
A Mixed-Methods Study Examining Guideline-Concordant Colposcopy Practices Among a National Cohort of US Colposcopists
Authors: Perkins Rebecca B. , Fuzzell Lindsay , Brownstein Naomi C. , Fontenot Holly B. , Michel Alexandra , Neggers Marena , Lake Paige , Vadaparampil Susan T. 
Published: February 2025

Objectives
The 2017 ASCCP Colposcopy Standards guidelines were designed to maximize the diagnostic yield of colposcopy. However, guideline adoption is often slow, and few studies have examined management of patients undergoing colposcopy.

Methods
To elucidate factors associated with utilization of the 2017 ASCCP Colposcopy Standards guidelines for patients undergoing colposcopic cervical biopsy, we cross-sectionally surveyed and interviewed physicians and advanced practice providers who perform colposcopy. Clinicians responded to a clinical vignette describing a common colposcopy scenario. Clinicians were asked to describe where they would biopsy and why. Binomial logistic regression models determined factors associated with guideline concordance. Qualitative interviews further explored practice patterns.

Results
A total of 671 colposcopists participated from across the United States. A total of 541 (81%) participants reported colposcopy practice concordant with the 2017 ASCCP Colposcopy Standards guidelines. A total of 490 (73%) participants reported that they were using the 2017 ASCCP Colposcopy Standards guidelines. Male colposcopists and those who were internal and family medicine clinicians were less likely to report guideline-concordant management than females and obstetrician-gynecologists. Colposcopists discussed the rationale behind guideline-concordant aspects of care, including taking targeted biopsies and using excisional rather than ablation procedures.

Conclusions
Most colposcopists perform biopsies and treatment consistent with the 2017 ASCCP Colposcopy Standards guidelines and understand the rationale behind multiple targeted biopsies.
The modified lateral window technique for retrieving root stumps from the maxillary sinus: Case report
Authors: Liu Chongyuan , Cheng Lidi , Xu Qingying , Yang Fen , Liu Fengjia 
Published: February 2025

Rationale:
Tooth extraction is a common surgical procedure in oral and maxillofacial surgery. Extraction of the upper molar teeth may result in root fracture for anatomical reasons, leading to the migration of fractured roots into the maxillary sinus. This can cause serious complications such as oroantral fistula, sinusitis, cellulitis, and subdural abscesses. To mitigate the risk of these complications, it is important to promptly remove the root stumps from the maxillary sinus and preserve alveolar bone for subsequent prosthetic rehabilitation.

Patient concerns:
A 30-year-old male patient presented for the removal of a root stump that had migrated into the maxillary sinus following the extraction of a right upper posterior tooth. A 28-year-old male patient sought dental implant restoration following the extraction of an upper left posterior tooth. Imaging revealed a residual root in the maxillary sinus, which could affect subsequent restoration.

Diagnoses:
Residual root in the maxillary sinus.

Interventions:
Two cases of root stumps displaced into the maxillary sinus were treated using the modified lateral window technique, with good recovery. Besides, the second patient underwent a successful implant placement 4 months postoperatively.

Outcomes:
Two cases of root stumps displaced into the maxillary sinus were removed though the modified lateral window technique, with good recovery. The second patient, who underwent implant restoration 4 months postoperatively, demonstrated good implant stability during subsequent follow-up assessments.

Lessons:
This paper presents a modified lateral window technique, which is used to remove the stump in the maxillary sinus, resulting in a good postoperative recovery and providing sufficient bone for implant placement. It should be noted that this surgical approach is not applicable to the scenario “the root is free within the sinus”, precise localization of the foreign body becomes challenging, and alternative surgical methods may need to be considered.
Granulocytic sarcoma as an initial manifestation of acute promyelocytic leukemia: A case report with literature review
Authors: Liu Yuyang , Huang Xiao 
Published: February 2025

Rationale:
Granulocytic sarcoma (GS) is a rare tumor consisting of myeloid blasts with or without maturation and occurs in sites other than the bone marrow. Due to its low prevalence, clinical cases and pathogenesis need to be studied. Therefore, we present a rare case of humerus GS occurring simultaneously with acute promyelocytic leukemia (APL) and studied a retrospective analysis of clinical characteristics and related treatment strategies, hoping that it could help to standardize the early diagnosis and treatment of APL/GS.

Patient concerns:
We present a case of humerus GS complicated with APL in a 22-year-old woman who experienced pain in right clavicle and shoulder for 6 months without any cause. While the aggravated pain were persistent for 2 months, causing limited movement of her right upper arm.

Diagnoses:
The presence of tumor in her right proximal humerus and end of clavicle was revealed by positron emission tomography–computed tomography. Subsequently, the mass collected during the operation was confirmed to be GS by the pathological immunohistochemical examination. Further progression to APL was based on marrow smears, flow cytometry, fluorescence in situ hybridization, and PML/RARα gene detection.

Interventions and outcomes:
The patient underwent the tumorectomy, and then received 28-day induction therapy with all-trans retinoic acid (ATRA) (25 mg/m2/d) and arsenic trioxide. The posttreatment bone marrow smear and flow cytometry showed that she was in a complete remission. Consolidation treatment was performed with ATRA 25 mg/m2 PO BID for 2 weeks every 4 weeks and arsenic trioxide 0.16 mg/kg IV 5 days a week for 4 weeks every 8 weeks for a total of 6 cycles. Currently, the patient was routinely followed-up at an outpatient clinic, and has been maintained complete remission for 15 months.

Lessons:
We present an uncommon case of a humeral APL/GS, and conducted a comprehensive analysis of 28 cases of APL/GS. Despite the rarity of APL/GS, it should be diagnosed at an early stage. Furthermore, ATRA are recommended in the treatment plan of APL/GS.
An asymptomatic ectopic impacted tooth in the mandibular ramus region with congenital loss of the second lower right premolar: A rare case report
Authors: Xu Shencong , Ji Mingyi , Xu Chengrui , Xu Junfeng 
Published: February 2025

Rationale:
Ectopic teeth may be supernumerary, deciduous, or permanent and rarely occur in the general population, with an incidence of ≈0.1% to 1% according to the literature. This report presents a rare case of an ectopic impacted tooth in the mandibular ramus region, aiming to enhance clinical recognition of this condition and explore the etiology of the ectopic tooth.

Patient concerns:
In a patient with an asymptomatic ectopic impacted tooth in the mandibular ramus region, accompanied by congenital loss of the second lower right premolar, we found an ectopic impacted tooth in the mandibular ramus region.

Diagnoses:
Ectopic teeth, impacted teeth, and congenital loss of the second lower right premolar.

Interventions:
The impacted tooth was not extracted, and regular oral radiographs were obtained every year. For congenital loss of the second lower right premolar, we recommend implant restoration in the position of the second right mandibular premolar.

Outcomes:
The patient accepted our recommendation and underwent implant restoration at the position of the second right mandibular premolar.

Lessons:
Asymptomatic ectopic impacted teeth in the mandibular ramus region are rare. Dental development is a complex process that is influenced by a variety of factors, including genetic or acquired factors, and is regulated at many levels and in different time periods; however, it is still not clear.
Hypercalcemia in children with APL caused by interactions between voriconazole and all-trans retinoic acid: A case report and literature review
Authors: Wu Namei , Lin Zhihang , Zhuang Shuquan , Wu Shuifa , Cai Zhiming , Wang Xiaofang 
Published: February 2025

Rationale:
All-trans retinoic acid (ATRA) and voriconazole (VRZ) are pivotal drugs for the treatment of acute promyelocytic leukemia (APL) and invasive fungal infections, respectively. When ATRA is co-administered with VRZ, clinically significant drug interactions may occur due to alterations in drug metabolism and clearance.

Patient concerns:
We report a case of hypercalcemia caused by the interaction between ATRA and VRZ in a child with APL.

Diagnoses and interventions:
A 14-year-old boy received arsenictrioxide (ATO) for APL and VRZ for invasive fungal infections, followed by planned maintenance therapy with ATRA monotherapy and combination of ATRA and ATO. He experienced no adverse reactions during the concurrent use of ATO and VRZ, while on the 12th day of combined ATRA and VRZ administration, his blood calcium levels significantly increased, accompanied by a series of symptoms. Following the discontinuation of VRZ and continuation of ATRA monotherapy, and subsequent maintenance chemotherapy with ATRA and ATO, his blood calcium levels decreased and remained within the normal range.

Outcomes:
We reviewed the published literature and excluded primary hyperparathyroidism or ectopic parathyroid hormone secretion as the cause of hypercalcemia in the child. He did not use other cytochrome inhibitors that may affect ATRA metabolism other than VRZ. Multiple measurements of VRZ trough concentrations ranged from 1.2 to 3 μg/mL. According to the Drug Interaction Probability Scale (5 points) and Naranjo Probability Scale (4 points), the drug interaction between VRZ and ATRA is probable. The hypercalcemia and other clinical manifestations may be caused by the inhibition of ATRA metabolism by VRZ.

Lessons:
During clinical use of ATRA, it is necessary to closely monitor the adverse drug interactions such as hypercalcemia and limit the use of drugs that may affect cytochrome P450 enzyme such as VRZ.
Sintilimab-induced photodistributed bullous pemphigoid: A case report
Authors: Cui Wenjuan , Wang Su , Xu Junzhu , Shen Xiaowei , Hu Murong 
Published: February 2025

Rationale:
Immune-checkpoint inhibitors have emerged as a frontline treatment for a growing list of malignancies. Immunotherapy-induced bullous pemphigoid (BP) is a rare dermatological immune-related adverse event of immune-checkpoint inhibitor therapy immune-checkpoint inhibitor therapy. We report a case of immunotherapy-associated BP, with lesions presenting in a photodistribution. This case report aims to emphasize the early recognition of rare clinical manifestations induced by immunotherapy to improve patient prognosis.

Patient concerns:
The patient was a 77-year-old man with a history of right upper lung squamous cell carcinoma on sintilimab (anti-programmed cell death protein-1 [PD-1]) for over a year. After 12 months of initiation of PD-1 inhibitors, nonspecific cutaneous eruption appeared on his head, face, and extremities, mostly pruritic eczematous dermatitis with papules and plaques. The time to development of bullae after medication initiation was 16 months.

Diagnoses:
Sintilimab-induced BP.

Intervention:
Oral prednisone was gradually tapered to discontinuation following intravenous methylprednisolone; the skin lesions have basically recovered.

Outcomes:
Follow-up for 19 months showed no recurrence of the skin lesions.

Lessons:
This case report emphasizes that the clinical manifestations of BP induced by PD-1/programmed death ligand-1 inhibitors can be diverse. Dermatologists need to increase their awareness of BP caused by PD-1/programmed death ligand-1 inhibitors.
Refractory immune thrombocytopenia treated with low-dose decitabine combined with recombinant human thrombopoietin or eltrombopag: Two case reports
Authors: Jiang Yuxia , Xu Yani , Wu Haiying , He Minxia , Jiang Huifang , Xu Xiaofeng 
Published: February 2025

Rationale:
Immune thrombocytopenia (ITP) is an autoimmune-mediated disorder caused by antibody-mediated platelet destruction and impaired platelet production by megakaryocytes. Treating refractory ITP remains a significant challenge.

Patient Concerns and Diagnoses:
We report 2 patients with refractory ITP.

Interventions and Outcomes:
Two patients received low-dose decitabine combined with recombinant human thrombopoietin or eltrombopag. Platelet counts in both patients increased to within the normal range.

Lessons:
Low-dose decitabine combined with recombinant human thrombopoietin or eltrombopag may exert a synergistic effect in the treatment of refractory ITP.
Hemosuccus pancreaticus post-EUS-FNA in multicystic pancreatic tail formation: A case report
Authors: Bokan Goran , Mislej Eva , Štabuc Borut , Siuka Darko 
Published: February 2025

Rationale:
Hemosuccus pancreaticus (HP) is a rare but serious cause of gastrointestinal bleeding, characterized by hemorrhage from the papilla of Vater via the pancreatic duct. It is typically associated with vascular or pancreatic pathologies, including pancreatic cysts, tumors, or pseudoaneurysms involving adjacent arteries such as the splenic or gastric artery.

Patient concerns:
A 68-year-old male patient was evaluated for a pancreatic tail cyst detected on magnetic resonance cholangiopancreatography (MRCP). The lesion was described as a 20-mm multilocular cystic formation with septations, raising suspicion of malignancy.

Diagnosis:
HP was diagnosed following an episode of gastrointestinal bleeding after endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) of the pancreatic tail cystic lesion.

Interventions:
The patient underwent EUS-FNA via a transgastric approach to obtain a tissue sample for further evaluation.

Outcomes:
The procedure was complicated by gastrointestinal bleeding and later confirmed to be HP. The bleeding was managed conservatively, and the patient remained hemodynamically stable with spontaneous resolution of symptoms.

Lessons:
This case underscores a rare but significant complication of EUS-FNA. Given the limited number of reported cases, further research is needed to establish the incidence, risk factors, and preventive measures for HP in similar clinical scenarios.
Causes of failed anterior cruciate ligament reconstruction: A retrospective case series
Authors: Jin Xiao , Lin Zihan , Yang Meiping , Zhao Jinlong , Zeng Lingfeng , Liu Jun , Liang Guihong , Yang Weiyi , Pan Jianke 
Published: February 2025

Rationale:
The number of anterior cruciate ligament reconstruction (ACLR) surgeries in China is steadily increasing. To enhance the success rate of ACLR, it is crucial to understand the reasons for ACLR failure. The purpose of this study is to determine the primary reasons for ACLR failure and evaluate the technical skills associated with the revision procedure.

Patient concerns:
A retrospective clinical data analysis was performed for all patients who underwent anterior cruciate ligament revision surgery between January 2014 and September 2022. Each patient’s data set consisted of the 3 items listed below: standardized imaging data, medical records, and all arthroscopic images and recordings from the revision surgery.

Diagnoses:
A total of 65 patients underwent a failed ACLR surgery and then had to undergo revision surgery. Among these patients, the causes of revision were inappropriate tunnel placement (12, 18.75%), graft fixation problems (4, 6.25%), traumatic reinjury (35, 54.69%), graft failure (8, 12.5%), multiple ligament injuries (1, 1.56%), and infection (5, 7.81%).

Interventions and Outcomes:
In patients with inappropriate tunnel placement, the femoral canal deviated anteriorly in 6 cases, posteriorly in 4 cases, and the tibial canal deviated anteriorly in 2 cases. In patients with graft fixation failure, the loop plate was loose in 1 case, the screw was not screwed in 2 cases, and the metal guidewire was not pulled out in 1 case. Of patients who suffered traumatic reinjury, 24 suffered high-power trauma, whereas 11 suffered low-power trauma. Graft relaxation occurred in 3 cases, and absorption was noted in 5 cases among graft failure patients. Joint instability resulted from multiple knee ligament injuries, along with medial and lateral collateral ligament damage. In cases of infection, knee joint infection occurred in 3 cases, while 1 case involved wound infection combined with bone tunnel lysis, and another case involved a knee joint infection emerging after the revision procedure.

Lessons:
ACLR failure is associated with traumatic reinjury, inappropriate tunnel placement, graft failure, graft fixation problems, infection, and multiple ligament injuries. Particular emphasis should be placed on the precise positioning of bone tunnels during surgical procedures. Proper manipulation of the aforementioned influencing factors is crucial to the success rate and therapeutic efficacy of arthroscopic ACLR.
Scoring systems to predict thrombotic complications in solid tumor patients
Authors: Sharma Swati , Sahni Sumit , Antoniak Silvio 
Published: February 2025

Purpose of review
To explore the use of large datasets in predicting and managing cancer-associated venous thromboembolism (CAT) by stratifying patients into risk groups. This includes evaluating current predictive models and identifying potential improvements to enhance clinical decision-making.

Recent findings
Cancer patients are at an elevated risk of developing venous thromboembolism (VTE), which significantly impacts mortality and quality of life. Traditional approaches to risk assessment fail to account for the procoagulant changes associated with cancer, making individualized risk prediction a challenge. Current clinical guidelines as per ASCO recommend risk assessment before chemotherapy and endorse thromboprophylaxis as a standard preventive measure. Since any cancer population is highly heterogeneous in terms of VTE risk, predicting the risk of CAT is an oncological challenge. To address this, different predictive models have been developed to stratify patients by risk, enabling targeted thromboprophylaxis. However, these models vary in accuracy and utility. The present review discusses the pros and cons of these different models.

Summary
The review examines existing CAT risk prediction models, highlighting their strengths, limitations, and diagnostic performance. It also identifies additional variables that could enhance these models to improve their effectiveness in guiding clinicians toward better risk stratification and treatment decisions for cancer patients.
The Impact of Intraoperative CO2 Pneumoperitoneum Pressure in Gastrointestinal Surgery: A Systematic Review
Authors: Mahapatra Roy , Fok Matthew , Manu Nicola , Cameron Maria , Johnson Aimee , Kler Aaron , Fowler Hayley , Clifford Rachael , Vimalachandran Dale 
Published: February 2025

Introduction:
Pneumoperitoneum is widely used in gastrointestinal surgery, particularly for laparoscopic or robotic procedures, with suggested advantages associated with low pressure. While existing data predominantly focuses on laparoscopic cholecystectomy, the assessment of intra-abdominal pressures in other gastrointestinal surgeries remains unexplored.

Methods:
This study conducted an electronic literature search for randomized control trials comparing low-pressure pneumoperitoneum to standard or high-pressure counterparts.

Results:
Out of 26 articles meeting inclusion criteria, encompassing 2077 patients, 15 demonstrated positive associations with low-pressure pneumoperitoneum. No significant difference in postoperative pain was found in the remaining papers. Methodological variations, diverse outcome reporting, and a prevalent high risk of bias precluded meta-analysis.

Conclusions:
The study highlights substantial outcome variability, urging cautious interpretation of aggregated results. Despite positive associations in specific cases, insufficient evidence was found to support the superiority of low-pressure pneumoperitoneum. The study recommends future research employing validated patient-reported outcome measures and standardized reporting to help guide the development of evidence-based guidelines and optimize patient care in abdominal surgeries.
Parental Education, Midlife Hypertension, and Disparities in Late-Life Cognitive Test Scores
Authors: Adrien Tamare V. , Hirst Andrew K. , Turney Indira C. , Peterson Rachel L. , Zahodne Laura B. , Chen Ruijia , Crane Paul K. , Levy Shellie-Anne , Andrews Ryan M. , Mayeda Elizabeth R. , Whitmer Rachel A. , Gilsanz Paola , Jackson John W. , Hayes-Larson Eleanor 
Published: February 2025

Background:
Parental education is an important determinant of late-life cognition, but the extent to which intervening on midlife risk factors, such as hypertension, mitigates the impact of early-life factors is unclear. Novel methodological approaches, such as causal decomposition, facilitate the assessment of contributors to health inequities through hypothetical interventions on mediating risk factors.

Methods:
Using harmonized cohorts (Kaiser Healthy Aging and Diverse Life Experiences Study; Study of Healthy Aging in African Americans) and a ratio of mediator probability weights decomposition approach, we quantified disparities in late-life cognitive test scores (semantic memory, executive function, and verbal memory z-scores) across high versus low parental education, and evaluated whether socioeconomic disparities in late-life cognitive test scores would change if the corresponding disparity in midlife hypertension were eliminated.

Results:
We observed substantial disparities across levels of parental education in late-life cognitive test scores (eg,

=−0.72 95% CI: −0.84 to −0.60 for semantic memory). Hypothetical intervention on midlife hypertension did not substantially reduce disparities in any cognitive domain. Patterns were similar when stratified by race.

Conclusions:
Future work should evaluate other points of intervention across the lifecourse (eg, participant education) to reduce late-life cognitive disparities across levels of parental education.