bluuebunny/crossref_metadata_2025_split huggingface dataset:
Glaucoma secondary to cosmetic iris implants in congenital iris coloboma
Authors: Sharma Arjun , Bitrian Elena 
Published: February 2024

Introduction:
To report a case of angle closure and corneal decompensation requiring surgical intervention secondary to BrightOcular cosmetic iris implantation in a patient with a history of congenital bilateral iris coloboma.

Patient and Clinical Findings:
A 40-year-old male patient with a history of bilateral congenital coloboma presented to the emergency department with reduced visual acuity to count fingers and moderate pain in the left eye 4 months after bilateral BrightOcular iris implant surgery in Mexico. Intraocular pressure (IOP) was 70 mm Hg with little response to maximal medical therapy. Gonioscopy revealed dense pigment obstructing angle inferiorly.

Diagnosis, Interventions, and Outcomes:
The patient was diagnosed with angle closure, pigment dispersion syndrome, and corneal decompensation secondary to bilateral cosmetic iris implants. IOP stabilized after emergency Ahmed valve and Baerveldt shunt placement. Corneal decompensation addressed first with endothelial keratoplasty, however ultimately failed leading to penetrating keratoplasty in the left eye. Fellow eye required glaucoma shunt placement 4 years after initial presentation due to persistent glaucoma not controlled with laser and medical therapy.

Conclusions:
The use of iris implants for cosmetic reasons can have serious ocular morbidity in patients with iris coloboma. Close monitoring and explantation should be strongly recommended at the earliest sign of complication.
Digital inhalers for asthma management
Authors: Mosnaim Giselle , Rathkopf Melinda 
Published: February 2024

Purpose of review
Although digital inhaler systems for asthma management have been commercially available for over a decade, their current use in clinical practice is limited. This review outlines barriers and offers potential solutions to their implementation.

Recent findings
Digital inhaler systems demonstrate increased controller medication adherence, decreased quick-relief medication use, and improved asthma control.

Summary
Use of digital inhaler systems is supported by data from large clinical trials demonstrating improved asthma outcomes. Navigating telemedicine during the coronavirus disease 2019 pandemic has led to advances clearing the path for increased adoption of digital inhaler systems. Progress in areas including patient education and onboarding, clinical management, coding and billing, privacy and security have facilitated implementation in clinical practice.
Viral infections causing asthma exacerbations in the age of biologics and the COVID-19 pandemic
Authors: Lamothe Pedro A. , Capric Violeta , Lee F. Eun-Hyung 
Published: February 2024

Purpose of review
Asthma exacerbations are associated with substantial symptom burden and healthcare costs. Viral infections are the most common identified cause of asthma exacerbations. The epidemiology of viral respiratory infections has undergone a significant evolution during the COVID-19 pandemic. The relationship between viruses and asthmatic hosts has long been recognized but it is still incompletely understood. The use of newly approved asthma biologics has helped us understand this interaction better.

Recent findings
We review recent updates on the interaction between asthma and respiratory viruses, and we address how biologics and immunotherapies could affect this relationship by altering the respiratory mucosa cytokine milieu. By exploring the evolving epidemiological landscape of viral infections during the different phases of the COVID-19 pandemic, we emphasize the early post-pandemic stage, where a resurgence of pre-pandemic viruses with atypical seasonality patterns occurred. Finally, we discuss the newly developed RSV and SARS-CoV-2 vaccines and how they reduce respiratory infections.

Summary
Characterizing how respiratory viruses interact with asthmatic hosts will allow us to identify tailored therapies to reduce the burden of asthma exacerbations. New vaccination strategies are likely to shape the future viral asthma exacerbation landscape.
Lobar or sublobar resection of peripheral stage I non-small cell lung cancer
Authors: Lima Pedro Guimarães Rocha , Glorion Matthieu , Liberman Moishe 
Published: February 2024

Purpose of review
We aim to highlight two recent clinical trials that have altered the approach of the management of stage I nonsmall cell lung cancer.

Recent findings
The JCOG 0802 and CALGB 140503 trials demonstrated that sublobar resection is noninferior to lobectomy for overall and disease-free survival in patients with stage I nonsmall cell lung cancer.

Summary
Since 1962, lobectomy has been deemed the gold standard treatment for operable lung cancer. However, two recent clinical trials have demonstrated that, for select patients, sublobar resection is oncologically noninferior; results, which are leading us into a new era for the surgical management of lung cancer. Notwithstanding the progress made by these studies and the opportunities that have been put forth, questions remain. This review aims at reviewing the results of both trials and to discuss future perspectives for the surgical treatment of lung cancer.
IgA vasculitis nephritis: insights from kidney biopsies
Authors: Haas Mark 
Published: February 2024

Purpose of review
To present findings indicating the value of kidney biopsy in assessing prognosis and guiding clinical approach to patients with IgA vasculitis nephritis (IgAVN), including a recent international study examining the value of the Oxford (MEST-C) classification.

Recent findings
Historically, kidney biopsies with IgAVN are scored using the International Society for Kidney Diseases in Children (ISKDC) classification. However, this classification has limited prognostic value, and most biopsies fall into just two of the six ISKDC grades. There are few studies examining the clinical value of the Oxford classification, which is well documented to be predictive of kidney outcomes in IgA nephropathy, in IgAVN. However, a recent study of 361 biopsied patients with IgAVN showed that endocapillary hypercellularity (Oxford E1) predicted a subclass of patients showing initial improvement in kidney function with immunosuppressive treatment, followed by a later decline.

Summary
Kidney outcome in patients with biopsied IgAVN treated with immunosuppression is determined by clinical factors and endocapillary hypercellularity. The latter is not part of the ISKDC classification and supports including MEST-C scores in biopsy reports of IgAVN. Even patients showing a good initial response to immunosuppression require long-term follow-up due to risk of subsequent kidney function decline.
The modified Rajan’s heart failure risk score predicts all-cause mortality in patients hospitalized for heart failure with reduced ejection fraction: a retrospective cohort study
Authors: Rajan Rajesh , Hui Jeremy Man Ho , Al Jarallah Mohammad A. , Tse Gary , Chan Jeffrey Shi Kai , Satti Danish Iltaf , Hui Chloe Tsz Ching , Sun Yuxi , Lee Yan Hiu Athena , Liu Ying , Vijayaraghavan Govindan , Al-Zakwani Ibrahim , AlObaid Laura 
Published: February 2024

Background:
The dimensionless Rajan’s heart failure (R-hf) risk score was proposed to predict all-cause mortality in patients hospitalized with chronic heart failure (HF) and reduced ejection fraction (EF) (HFrEF).

Purpose:
To examine the association between the modified R-hf risk score and all-cause mortality in patients with HFrEF.

Methods:
Retrospective cohort study included adults hospitalized with HFrEF, as defined by clinical symptoms of HF with biplane EF less than 40% on transthoracic echocardiography, at a tertiary centre in Dalian, China, between 1 November 2015, and 31 October 2019. All patients were followed up until 31 October 2020. A modified R-hf risk score was calculated by substituting brain natriuretic peptide (BNP) for N-terminal prohormone of BNP (NT-proBNP) using EF× estimated glomerular filtration rate (eGFR)× haemoglobin (Hb))/BNP. The patients were stratified into tertiles according to the R-hf risk score. The measured outcome was all-cause mortality. The score performance was assessed using C-statistics.

Results:
A total of 840 patients were analyzed (70.2% males; mean age, 64±14 years; median (interquartile range) follow-up 37.0 (27.8) months). A lower modified R-hf risk score predicted a higher risk of all-cause mortality, independent of sex and age [1st tertile vs. 3rd tertile: adjusted hazard ratio (aHR), 3.46; 95% CI: 2.11–5.67; P<0.001]. Multivariate Cox regression analysis indicated that a lower modified R-hf risk score was associated with increased cumulative all-cause mortality [univariate: (1st tertile vs. 3rd tertile: aHR, 3.45; 95% CI: 2.11–5.65; P<0.001) and multivariate: (1st tertile vs. 3rd tertile: aHR 2.21, 95% CI: 1.29–3.79; P=0.004)]. The performance of the model, as reported by C-statistic was 0.67 (95% CI: 0.62–0.72).

Conclusion:
The modified R-hf risk score predicted all-cause mortality in patients hospitalized with HFrEF. Further validation of the modified R-hf risk score in other cohorts of patients with HFrEF is needed before clinical application.
Assessing the impact of lubricant on liquid-based Pap smear test outcomes: a randomized clinical trial
Authors: Yaraghi Mansooreh , Gharavi Sarvenaz , Najafian Ayda , Hazari Vajihe 
Published: February 2024

Background:
Since today cervical cancers are growing, there is an increasing need to use screening and examination methods. Meanwhile, liquid-based Pap smear test is a common screening method for women, which is widely applied today. Studies have found that use of lubricant gel in this test can affect the pathology and cytology results. Accordingly, the authors intended to evaluate the effect of use of lubricant gel on the Pap smear test results.

Methods:
This study was of single-blind clinical trial, the study population consisted of candidate patients for screening in terms of cervical pathology, for whom liquid-based Pap smear was done. In this study, 506 patients participated, divided into two groups of 253. One group used lubricant gel during the Pap smear, while the other group underwent this test without lubricant. The data were analyzed by SPSS 21.

Results:
The study results indicated that once the two groups were compared in terms of age, interval of menstruation time and intercourse time from the sampling, no significant relationship was found between the two groups (P>0.05). It was also found that use of lubricant did not affect the cytology and pathology results of patients (P>0.05).

Conclusion:
The use of lubricant gel in patients can reduce pain in patients during examination and testing, but does not affect the cytological and pathological results of patients.
A 16-year-old adolescent with a history of minor abdominal trauma diagnosed with a giant isolated primary splenic hydatid cyst: a case report
Authors: Vantankhah Abulfazl , Ameri Leila , Bahrami Taqanaki Pegah , Bayat Tork Mohammad Jawed , Parvizi Mashhadi Mahdi 
Published: February 2024

Introduction:
Hydatosis is a zoonotic parasitic disease caused by echinococcosis larval infection. South America, Africa, the Middle East, South Europe, India, and Australia are endemic to this disease. Splenic involvement is a rare and complicated hydatid disease presentation. A splenic hydatid cyst is an infrequent clinical occurrence, even in regions where the disease is endemic.

Case presentation:
A 16-year-old male, having a background of mild abdominal trauma and non-resolving dull abdominal pain attended a paediatric surgical outpatient office and following a thorough examination, was diagnosed with a giant solitary isolated splenic hydatid cyst. Subsequently, the patient received albendazole and underwent total splenectomy, necessitated by the considerable size of the cyst, classified as a giant.

Clinical discussion:
Splenic involvement of hydatid disease is a rare presentation (0.5–8%.). With the initial clinical finding often involving the accidental discovery of a palpable mass, the most frequently reported symptoms and signs include the presence of a palpable mass, fever, dull pain, or splenomegaly. Ultrasound and computed tomography are the most helpful tools for evaluating focal splenic diseases. The preferred treatment involves the use of antihelminthic drugs such as albendazole or mebendazole in conjunction with splenectomy. Total splenectomy is the preferred approach and is associated with decreased hospital stay, reduced healthcare costs, and a lower likelihood of recurrence.

Conclusion:
in endemic areas, in patients with splenic cysts, hydatidosis should be contemplated.
The interplay between diabetes and non-alcoholic fatty liver disease: a cross-sectional study from Pakistan
Authors: Akhtar Ayesha , Ijaz Huda , Waseem Maria , Khan Muhammad Ijaz , Saif Yasir , Iqbal Haris , Batool Syeda Aasia , Kumari Usha , Surani Salim , Khan Aarash 
Published: February 2024

Background and Objectives:
Nonalcoholic fatty liver disease (NAFLD) is characterized by ectopic deposition of fat in the liver, in the absence of other secondary causes of fat buildup. The relationship between NAFLD, including alanine aminotransferase (ALT), and glycated hemoglobin (HbA1c), is important for predicting the severity of disease and prognosis. This study aims to investigate the association of HbA1c in type 2 diabetes mellitus (T2DM) patients with NAFLD via measuring the ALT levels.

Materials and Methods:
This retrospective cross-sectional study enrolled 130 patients with T2DM and NAFLD. The association between levels of HbA1c and ALT in patients of NAFLD with controlled and uncontrolled T2DM, respectively, was investigated. Stratification was done based on gender and diabetic control, using HbA1c levels as a marker of glycemic control. Serum ALT levels were also compared in both groups.

Results:
The mean age of the participants was 50.2±5.7 years. The total participants were 130, of which 77 (59.3%) were females and 53 (40.7%) were males. The numbers of patients having uncontrolled T2DM (HbA1c >7%), and controlled T2DM (HbA1c <7%) were 78 (60%) and 52 (40%) respectively. Moreover, 46 (35.3%) females and 32 (24.7%) males had uncontrolled T2DM, and 31 (23.8%) females and 21 (16.2%) males had controlled T2DM. The mean ALT level for uncontrolled and controlled T2DM in female patients was found to be 24.6±3.4 and 13.5±2.4, respectively, (P-value <0.05). For male patients, it was found to be 54.0±4.9 and 29.1±5.4, respectively (P-value 0.008).

Conclusion:
There is a positive association between elevated HbA1c and ALT levels in T2DM patients with NAFLD.
Homicide Manner-of-Death Classification in Arrest-Related Death
Authors: Kroll Mark W. , Wolf Dwayne A. , Cobb J. Celia , Greenberg Tasha Z. , Kunz Sebastian N. , Brewer James E. , Williams Howard E. 
Published: February 2024

Abstract
Multiple studies have documented various factors that influence or determine forensic pathologist classification of manner of death. There do not appear to be any published studies on manner of death classification specifically regarding arrest-related deaths (ARDs). The goal of this study was to consider a large body of cases of nonfirearm ARDs to analyze the homicide classification with regards to numerous decedent and practitioner (medical examiner/coroner [ME/C]) variables. We analyzed 1145 US autopsy reports from the years 2006–2020, inclusive, and considered decedent variables of age, ethnicity, height, weight, body mass index, toxicology, and mention of a conducted electrical weapon and ME/C influence variables of gender, country region, and year. We found that the homicide classification likelihood increased by a factor of 1.04–1.05 per year, 1.34–1.37 for a female medical examiner, and 1.4–1.5 going from Southern states to Western states. There is an increasing trend for ME/C to label nonfirearm ARDs as homicides in the United States. The homicide classification is more common in Western states and less common in Southern states, and it was more common with a female ME/C.
The relationship of age and comorbid conditions to hospital and nursing home days in Medicaid recipients with HIV
Authors: Wilson Ira B. , Cole Megan B. , Lee Yoojin , Shireman Theresa I. , Justice Amy C. , Rahman Momotazur 
Published: February 2024

Objective:
To determine how aging impacts healthcare utilization in persons with HIV (PWH) compared with persons without HIV (PWoH).

Design:
Matched case–control study.

Methods:
We studied Medicaid recipients in the United States, aged 18–64 years, from 2001 to 2012. We matched each of 270 074 PWH to three PWoH by baseline year, age, gender, and zip code. Outcomes were hospital and nursing home days per month (DPM). Comorbid condition groups were cardiovascular disease, diabetes, liver disease, mental health conditions, pulmonary disease, and renal disease. We used linear regression to examine the joint relationships of age and comorbid conditions on the two outcomes, stratified by sex at birth.

Results:
We found small excesses in hospital DPM for PWH compared with PWoH. There were 0.03 and 0.07 extra hospital DPM for female and male individuals, respectively, and no increases with age. In contrast, excess nursing home DPM for PWH compared with PWoH rose linearly with age, peaking at 0.35 extra days for female individuals and 0.4 extra days for male individuals. HIV-associated excess nursing home DPM were greatest for persons with cardiovascular disease, diabetes, mental health conditions, and renal disease. For PWH at age 55 years, this represents an 81% increase in the nursing home DPM for male individuals, and a 110% increase for female individuals, compared PWoH.

Conclusion:
Efforts to understand and interrupt this pronounced excess pattern of nursing home DPM among PWH compared with PWoH are needed and may new insights into how HIV and comorbid conditions jointly impact aging with HIV.
Ureter Metastasis From Colorectal Cancer Revealed on 18F-FDG PET/CT
Authors: Zhang JiaNing , Yang Lan , Wei LingGe , Guo ZiYu , Xie Peng 
Published: February 2024

Abstract
The involvement of the ureter as a site of metastasis of colorectal cancer is quite rare. Here we present FDG PET/CT findings of the right ureter metastasis from colon cancer in a patient after colectomy 6 years ago. 18F-FDG PET/CT showed increased 18F-FDG uptake in the right ureter with SUVmax of 4.3. The pathology and immunohistochemistry confirmed the diagnosis of ureter metastasis from colon cancer.
Mandibulotomy Technique and Permanent Molar Injury After Mandibular Distraction Osteogenesis in Infants
Authors: Sprow Holly N. , Danis Ⅲ David O. , Zee Robert Y.L. , Scott Andrew R. , Marston Alexander P. 
Published: February 2024

Objective:
The risk that mandibular distraction osteogenesis (MDO) poses to the developing mandibular dentition is well-known; however, less is understood about how the choice of instrumentation used for mandibular osteotomy might affect the development of permanent molars.

Methods:
Retrospective chart review examining infants with micrognathia who underwent MDO from 2010 to 2018 at a single tertiary care children’s hospital using external, multivector devices. The first and second permanent mandibular molars were radiographically examined years after surgery to determine whether osteotomy cutting techniques affect the risk of injury to the permanent dentition.

Results:
Thirty-seven infants and children underwent MDO from 2010 to 2018. Follow-up dental radiographs were available for 17 patients; 6 patients were excluded based on the use of preoperative computed tomography, utilization of virtual surgical planning technology, use of buried internal distractors, or older age at the time of distraction surgery. This yielded a total of 11 patients who underwent MDO with external hardware without virtual surgical planning representing 22 osteotomies. Sixteen osteotomies were performed using a side-cutting burr and 6 with a piezoelectric saw. The median age at distraction surgery was 3 weeks. The rate of an abnormal permanent first or second mandibular molar finding per osteotomy was 88% (14/16) in the side-cutting group versus 17% (1/6) with the piezoelectric technique (P = 0.004).

Conclusion:
Mandibular distraction osteogenesis risks injury to the mandibular molars; however, this study suggests a significant risk reduction in molar injury if the piezoelectric device is utilized.
Factors Associated with Delayed Palatoplasty Before, During, and After the COVID-19 Pandemic
Authors: Khansa Ibrahim , Pollard Sarah Hatch , Fogolin Alyssa , Baylis Adriane , Sitzman Thomas J. , Chapman Kathy L. , Kirschner Richard E. 
Published: February 2024

Background:
Cleft palatoplasty is typically performed around 10 to 12 months of age in the US, and delays can negatively affect speech development. Early during COVID-19, elective surgeries were canceled. The aims of this study were to (1) identify overall risk factors for greater age at palatoplasty and (2) analyze delays in palatoplasty during COVID-19.

Methods:
This study was part of a larger prospective, multicenter comparative study of speech outcomes in palatoplasty. Participants underwent palatoplasty between March 2019 and September 2022 at 18 pediatric hospitals in the United States. Ages were corrected for prematurity. Dates of palatoplasty were divided into 4 periods corresponding to different phases of the pandemic. Factors analyzed included region, language, adoption status, sex, ethnicity, race, rurality, health insurance type, and cleft type. Analyses were performed using ANOVA, Student’s test, and multivariable linear regression, with a P value of ≤0.05 being significant.

Results:
Nine hundred twenty-eight participants were included. Average corrected age at palatoplasty was 374 days. In univariable analysis, palatoplasty was performed later in children who were Hispanic (P=0.003), of a race other than White, Black, or Asian (P<0.001), and without private insurance (P<0.001). On multivariable regression, predictors of delayed palatoplasty were Hispanic ethnicity (P=0.015), from other race (P<0.001), and without private insurance (P<0.001). During COVID-19, disproportionate delays occurred in patients who were female, of other races, from nonrural areas, and on Medicaid.

Conclusions:
Palatoplasty was performed later in vulnerable populations. Some of these populations were also disproportionately affected by COVID-19 delays. Providers should be aware of these differences as they pertain to equitable access to craniofacial care.

Level of Evidence:
III