bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pelvic metastatic squamous cell carcinoma of unknown primary site: A case report and brief literature review
Authors: Zhu Qi-Zhou , Li Hui-Juan , Li Yuan-Qiang , Yu Xiao-Hong , Shu Kuan-Yong 
Published: January 2024

Rationale:
Cancer with unknown primary site is a kind of disease that is difficult to deal with clinically, accounting for 2% to 9% of all newly diagnosed cancer cases. Here, we report such a case with pelvic metastatic squamous cell carcinoma of an unknown primary site and review the relevant literature.

Patient concerns & Diagnoses:
A 43-year-old Chinese female patient was referred to our hospital and initially diagnosed as “malignant tumor of right adnexal area?, obstruction of right ureter, secondary hydronephrosis”.

Interventions:
Thereafter cytoreductive surgery was performed which included a total hysterectomy, left adnexectomy, partial omentum resection, pelvic lymph node dissection, and para-aortic lymph node dissection. The primary lesion could not be identified by supplementary examination and postoperative pathology. The patient was diagnosed as pelvic metastatic squamous cell carcinoma whose primary site was unknown. To prevent a recurrence, we administered adjuvant chemotherapy for the patient.

Outcomes:
The patient was followed up after treatment, complete remission has been maintained for 72 months, and no recurrence or metastasis has been found.

Lessons:
Our case demonstrates that surgery combined with chemotherapy could be helpful for pelvic metastatic squamous cell carcinoma of unknown primary site.
The influence of perioperative nursing intervention in patients with ureteral calculi treated with URSL and its correlation to adverse event incidence: A retrospective study
Authors: Tang Wei , Zhu Xinying 
Published: January 2024

To evaluate the effectiveness of perioperative nursing intervention in patients undergoing ureteroscopic lithotripsy (URSL) for ureteral stones and its implications for the incidence of adverse events, a total of 144 patients with ureteral stones admitted to our hospital from January 2021 to December 2022 were selected for retrospective analysis. They were divided into 2 groups based on their different nursing methods, with 72 patients in each group. The control group (CG) received routine nursing intervention, while the study group (SD) received refined perioperative nursing intervention. The surgical situation, effective stone removal rate, postoperative pain, inflammatory factors, stress response, and incidence of adverse events were compared between the 2 groups.
In comparison with the CG, the SD demonstrated a significant reduction in gastrointestinal recovery time, urinary catheter removal time, and hospitalization duration, all presenting statistically significant disparities (P < .05). Notably, the SD exhibited a one-time stone removal rate significantly superior to that of the CG (P < .05). Similarly, the postoperative pain index was significantly lower in the SD (P < .05). Pre- and post-surgical serotonin (5-HT) levels in the SD were markedly lower than in the CG (P < .05). Postoperative levels of Interleukin-10 (IL-10), C-reactive protein (CRP), and white blood cells (WBC) were elevated in both groups, and gradually declined as the patients recovered. However, postoperative levels of IL-10, CRP, and WBC were significantly lower in the SD (P < .05). The SD also showed significantly lower levels of malondialdehyde and higher levels of superoxide dismutase (P < .05). Postoperative levels of cortisol, adrenocorticotropic hormone, and norepinephrine were elevated and progressively returned to normal over time, and were significantly lower in the study group (P < .05). Furthermore, the SD experienced a significant reduction in adverse event incidence compared with the CG (P < .05). Implementing refined perioperative nursing interventions for patients undergoing URSL can effectively decrease the incidence of adverse events, diminish the surgical stimulation of inflammation markers and oxidative stress indicators, and foster patient recovery.
Temporal bone management in external and middle ear carcinoma
Authors: Gowrishankar Shravan , Borsetto Daniele , Marinelli John , Panizza Ben 
Published: January 2024

Purpose of review
The purpose of this review is to outline the temporal bone management of external and middle ear carcinoma. The review will outline the current evidence involved in deciding which surgical approach to take, as well as new advances in auditory rehabilitation and immunotherapy.

Recent findings
Traditional surgical approaches include lateral temporal bone resection, subtotal temporal bone resection and total temporal bone resection. They can also involve parotidectomy and neck dissection depending on extension of disease into these areas. Options for auditory rehabilitation include osseointegrated hearing aids, transcutaneous bone-conduction implants, and active middle ear implants. Recent advances in immunotherapy have included the use of anti-PD-1 monoclonal antibodies.

Summary
The mainstay of management of temporal bone disease involves surgical resection. Early-stage tumours classified according to the Pittsburgh staging tool can often be treated with lateral temporal bone resection, whereas late-stage tumours might need subtotal or total temporal bone resection. Parotidectomy and neck dissection might also be indicated if there is a risk of occult regional disease. Recent advances in immunotherapy have been promising, particularly around anti-PD-1 inhibitors. However, larger clinical trials will be required to test the extent of efficacy, particularly around combination use with surgery.
Head and neck nonmelanoma skin cancers: surgical management and debated issues
Authors: Rampinelli Vittorio , Pinacoli Aurora , Piazza Cesare 
Published: January 2024

Purpose of review
This review critically assesses the current literature and guidelines, aiming to clarify some of the most important factors that impact surgical strategies of head and neck nonmelanoma skin cancers (NMSCs), focusing on squamous, basal, and Merkel cell carcinomas.

Recent findings
Recent developments underscore the complexity of treatment for NMSC, particularly in the head and neck region. There is a lack of high-level evidence for the management of these tumors, especially in advanced stages. The need to tailor the extent of surgical margins and parotid/neck management to different histotypes, considering the varying risk factors for recurrence, is beginning to emerge in the literature. Moreover, the role of immunotherapy and targeted therapies for locally advanced disease, alongsi
de traditional treatment options, is progressively growing.

Summary
NMSCs represent a heterogeneous group of malignancies with varying treatment complexities and prognoses. Management of NMSC is evolving towards an increasingly personalized strategy within a multidisciplinary therapeutic framework.
No Evidence of Progressive Proinflammatory Cytokine Storm in Brain-dead Organ Donors—A Time-course Analysis Using Clinical Samples
Authors: Bera Katarzyna D. , Tabak Joel , Ploeg Rutger J. 
Published: January 2024

Background.
Solid organ transplantation is a cost-effective treatment for end-stage organ failure. Organ donation after brain death is an important source of transplanted organs. Data are limited on the effects of brain injury or donor management on grafts. The consensus view has been that brain death creates a progressively proinflammatory environment. We aimed to investigate time-course changes across a range of cytokines in a donation after brain death cohort of donors who died of intracranial hemorrhage without any other systemic source of inflammation.

Methods.
A donor cohort was defined using the UK Quality in Organ Donation biobank. Serum levels of proteins involved in proinflammatory and brain injury pathways (tumor necrosis factor-alpha, interleukin-6, complement C5a, neuron-specific enolase, and glial fibrillary acidic protein) were measured from admission to organ recovery. Moving median analysis was used to combine donor trajectories and delineate a time-course.

Results.
A cohort of 27 donors with brain death duration between 10 and 30 h was created, with 24 donors contributing to the time-course analysis. We observed no increase in tumor necrosis factor-alpha or interleukin-6 throughout the donor management period. Neuronal injury marker and complement C5a remain high from admission to organ recovery, whereas glial fibrillary acidic protein rises around the confirmation of brain death.

Conclusions.
We found no evidence of a progressive rise of proinflammatory mediators with prolonged duration of brain death, questioning the hypothesis of a progressively proinflammatory environment. Furthermore, the proposed approach allows us to study chronological changes and identify biomarkers or target pathways when logistical or ethical considerations limit sample availability.
Esketamine Augmentation in Treatment-Resistant Obsessive-Compulsive Disorder: A Retrospective Chart Review
Authors: Alves-Pereira Raíza , Fontes Mariana , Cordeiro Vivian , Bandeira Igor D. , Faria-Guimarães Daniela , Silva Samantha S. , Mello Rodrigo P. , Leal Gustavo C. , Sampaio Aline S. , Quarantini Lucas C. 
Published: January 2024

Objective
Converging evidence supports the role of the glutamate, an excitatory amino acid neurotransmitter, in the pathophysiology of obsessive-compulsive disorder (OCD). Ketamine and esketamine, both noncompetitive N-methyl-d-aspartate antagonists, have emerged as a promising medication for this psychiatric disorder, given its possible efficacy with faster onset and good tolerability. The purpose of this retrospective chart review is to evaluate whether unbiased clinical documentation supports formal clinical trials of esketamine for an OCD indication.

Methods
A retrospective chart review of patients with treatment-resistant OCD receiving a single dose of esketamine (0.5mg/kg) added to standard therapy was conducted. The Yale-Brown Obsessive-Compulsive Scale and the Montgomery-Åsberg Depression Rating Scale were used to evaluate OCD and depressive symptoms respectively at baseline, 24 hours, and 7 days after esketamine administration. Descriptive statistics were used to analyze the data.

Results
Eight subjects were identified in this retrospective chart review: esketamine was administered subcutaneously in 7 and intravenously in 1. One week after infusion, 25% of the sample met criteria for treatment response and 50% for partial response. Major depressive disorder was a comorbid diagnosis in 75% of the sample and 2 of these subjects showed a positive antidepressant response.

Conclusions
Our findings provide preliminary evidence that esketamine may reduce obsessive-compulsive symptoms in a subset of treatment-resistant OCD patients.
Coronary Artery Calcification and Risk of Cardiac Complication in Geriatric Trauma Population
Authors: King Sarah A , Jenkins Jacob D , Livesay James , Yune Ji-Ming , Mannino Elizabeth , Webb Jason M , Hill Haddon C , Baljepally Raj , Daley Brian J , Smith Lou M 
Published: January 2024

BACKGROUND:
Better means of identifying patients with increased cardiac complication (CC) risk is needed. Coronary artery calcification (CAC) is reported on routine chest CT scans. We assessed the correlation of CAC and CCs in the geriatric trauma population.

STUDY DESIGN:
A prospective, observational study of patients 55 years and older who had chest CT scan from May to September 2022 at a level 1 trauma center. Radiologists scored CAC as none, mild, moderate, or severe. None-to-mild CAC (NM-CAC) and moderate-to-severe CAC (MS-CAC) were grouped and in-hospital CCs assessed (arrhythmia, ST elevation myocardial infarction [STEMI], non-STEMI, congestive heart failure, pulmonary edema, cardiac arrest, cardiogenic shock, and cardiac mortality). Univariate and bivariate analyses were performed.

RESULTS:
Five hundred sixty-nine patients had a chest CT, of them 12 were excluded due to missing CAC severity. Of 557 patients, 442 (79.3%) had none-to-mild CAC and 115 (20.7%) has MS-CAC; the MS-CAC group was older (73.3 vs 67.4 years) with fewer male patients (48.7% vs 54.5%), had higher cardiac-related comorbidities, and had higher abbreviated injury scale chest injury scores. The MS-CAC group had an increased rate of CC (odds ratio [OR] 1.81, p = 0.016). Cardiac complications statistically more common in MS-CAC were congestive heart failure (OR 3.41, p = 0.003); cardiogenic shock (OR 3.3, p = 0.006); non-STEMI I or II (OR 2.8, p = 0.017); STEMI (OR 5.9, p = 0.029); and cardiac-caused mortality (OR 5.27, p = 0.036). No statistical significance between pulmonary edema (p = 0.6), new-onset arrhythmia (p = 0.74), or cardiac arrest (p = 0.193).

CONCLUSIONS:
CAC as reported on chest CT scans demonstrates a significant correlation with CC and should warrant additional cardiac monitoring.
Early Cholecystectomy in Patients with Sickle Cell Disease with Uncomplicated Cholelithiasis Is Associated with Better Outcomes
Authors: Zeineddin Ahmad , Cornwell Edward E , Fullum Terrence M , Chu Quyen D , Kearse LaDonna , Ayad Marco H , Li Sandy , Williams Mallory 
Published: January 2024

BACKGROUND:
Up to 85% of patients with sickle cell disease (SCD) will develop gallstones by their third decade. Cholecystectomy is the most commonly performed procedure in these patients. Cholecystectomy is recommended for patients with SCD with symptomatic cholelithiasis and leads to lower morbidity. No contemporary large studies have evaluated this recommendation or associated clinical outcomes. This study evaluates clinical outcomes after cholecystectomy in patients with SCD and cholelithiasis with specific advanced clinical presentations.

STUDY DESIGN:
The Nationwide Inpatient Sample was queried for patients with SCD and gallbladder disease between 2006 and 2015. Patients were divided into groups based on their disease presentation, including uncomplicated cholelithiasis, acute and chronic cholecystitis, and gallstone pancreatitis. Clinical outcomes associated with disease presentation were analyzed. Statistical analysis was performed using the Student’s t-test, chi-square test, ANOVA, and logistic regression.

RESULTS:
There were 6,662 patients with SCD who presented with cholelithiasis. Median age was 20 (interquartile range 16 to 34) years and 54% were female patients. Cholecystectomy was performed in 1,779 patients with SCD with the most common indication being chronic cholecystitis (44%), followed by uncomplicated cholelithiasis (27%), acute cholecystitis (21%), and choledocholithiasis or gallstone pancreatitis (8%). On multivariable regression, advanced clinical presentation was the strongest predictor of perioperative vaso-occlusive crisis, which was the most common complication. Patients undergoing cholecystectomy for uncomplicated cholelithiasis were at lower risk than those with acute cholecystitis (odds ratio [OR] 2.37; 95% CI 1.64 to 3.41), chronic cholecystitis (OR 1.74; 95% CI 1.26 to 2.4), and choledocholithiasis or gallstone pancreatitis (OR 2.24; 95% CI 1.41 to 3.57).

CONCLUSIONS:
Seventy-three percent of patients with SCD have advanced clinical presentation at the time of their cholecystectomy. After cholecystectomy, perioperative vaso-occlusive events were significantly increased in patients with advanced clinical presentation. These data support screening abdominal ultrasounds and early cholecystectomy for cholelithiasis in patients with SCD.
Clinical and Legal Differences in the Use of Involuntary Electroconvulsive Therapy for Life-Threatening Illness Across European Countries
Authors: Krarup Mette , Kellner Charles H. , Østergaard Søren D. 
Published: January 2024

Objectives
Electroconvulsive therapy (ECT) can be life-saving in situations where patients are at risk of dying from severe manifestations of psychiatric illness. In some of these cases, patients are unwilling/unable to consent to ECT, and involuntary ECT is required. Such use of involuntary ECT varies substantially across European countries for unclear reasons. The aim of this study was to examine clinical and legal differences in this use of involuntary ECT across European countries.

Methods
A questionnaire based on a case vignette (a 55-year-old female inpatient with psychotic depression at imminent risk of dying from metabolic derangement because of refusal to eat and drink) was sent to an ECT practitioner in each of 31 European countries.

Results
We received responses from ECT practitioners in 18 countries. In 7 of these countries, involuntary ECT could be carried out without approval from others and/or involvement of the court system in the case described in the vignette. Practitioners in the remaining 11 countries responded that they either could not carry out involuntary ECT or would have to meet certain requirements before initiating involuntary ECT (e.g., approval from medical/ethics committee and second opinion from an independent psychiatrist). Notably, the rules regarding involuntary ECT differed for adults and minors (more restrictive for the latter) in 6 of the 18 countries.

Conclusions
In many European countries, legislation precludes or delays the use of involuntary ECT. Harmonization of the legislation on involuntary ECT across European countries to allow for better access to this potentially life-saving treatment seems warranted.
Catatonia in Preadolescent Children
Authors: De Stefano Lara , Palffy Alexander , Ghaziuddin Neera 
Published: January 2024

Objective
The aim of the study is to describe prepubescent catatonia in very young children, which is poorly documented in the current literature and, as a result, overlooked in medical settings.

Methods
We examined a convenience sample of 10 patients at an academic center who were younger than 12 years and met criteria for catatonia. After institutional review board approval, we extracted from the electronic medical records demographic and diagnostic information, comorbidity, developmental history, and laboratory testing. Bush Francis Catatonia Rating Scales at initial presentation and other symptomatology were gathered in addition to treatment received. Fifty percent of patients in this group were seen and diagnosed with catatonia at their presentation in an outpatient clinic, whereas the remaining 50% were diagnosed upon hospitalization, by the psychiatry consultation liaison team.

Results
All patients but one was diagnosed with a comorbid condition before the diagnosis of catatonia, including 70% with a previous diagnosis of autism spectrum disorder. Three patients had concurrent anti-N-methyl-D-aspartate receptor encephalitis, and one initially presented with seizures. All patients were treated for catatonia with lorazepam, and two patients additionally received electroconvulsive therapy. Regardless of the presence of early regression invariably associated with an autism spectrum diagnosis, secondary symptoms of regression were noted in each case at the time of diagnosing catatonia.

Conclusions
Similar to previous observations in adolescents, prepubescent catatonia seems strongly associated with neurodevelopmental disorders, secondary regression, variability in presentation, and comorbidity with other neurological conditions. Delayed recognition of catatonia can hinder rapid and effective treatment in young children.
Prediction of myeloid malignant cells in Fanconi anemia using machine learning
Authors: Flores-Mejía Luis A. , Siliceo-Portugal Pablo , Figueroa Ulises Juárez , Quezada Iram García , Barcenas Martínez Bibiana T. , Sosa David , Rivera Anet , Tovar Hugo , Frías Sara , Rodríguez Alfredo 
Published: January 2024

ABSTRACTFanconi anemia (FA) is an inherited bone marrow failure syndrome with cancer predisposition. Most FA patients develop aplastic anemia during childhood and have an extremely high cumulative risk to develop cancer during their lifespan. Myeloid malignancy is one of the main tumor risks for patients with FA, including high-risk myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML). Although bone marrow transplantation is the treatment of choice for FA patients that develop aplastic anemia, patients with a more stable bone marrow remain at a high risk of presenting MDS/AML and should be monitored for appearance of myeloid malignant clones. Markers for an as-early-as-possible identification of emerging myeloid malignant cells are needed for the monitoring of patients with FA, since quick medical action after detection of neoplastic transformation is needed.In this work we have leveraged publicly available single cell RNA seq (scRNAseq) datasets of patients with MDS and AML for training deep neural networks (DNN). We have generated two machine learning models aimed to identify myeloid malignant transcriptional profiles in scRNAseq datasets from the bone marrow of patients with FA, one for detection of MDS and a second one for AML. Both predictors displayed high sensitivity, specificity, and accuracy for detection of single cell resolution myeloid malignant transcriptional profiles.Multiple tools for analysis of single cell transcriptional data were implemented to characterize the predicted MDS and AML cells. Our analysis suggests that the predicted MDS and AML cells from FA patients are enriched in the lympho-myeloid-primed progenitor (LMPP) and the granulocyte-monocyte progenitor (GMP) populations. The predicted MDS and AML cells have gene expression and master transcriptional factor profiles that suggest malignant transformation and that differ from the rest of FA cells. Also cues of immune evasion were detected using single cell pathway analysis (SCPA) and cell-cell communication profiles. Next work will be aimed to find potential cell surface markers on the predicted MDS and AML cells as well as to assess our predictions in primary samples from FA patients.
Glutaminase as a metabolic target of choice to counter acquired resistance to Palbociclib by colorectal cancer cells
Authors: Tarrado-Castellarnau Míriam , Foguet Carles , Tarragó-Celada Josep , Palobart Marc , Hernández-Carro Claudia , Perarnau Jordi , Zodda Erika , Polat Ibrahim H. , Marin Silvia , Suarez-Bonnet Alejandro , Lozano Juan José , Yuneva Mariia , Thomson Timothy M. , Cascante Marta 
Published: January 2024

SummarySeveral mechanisms of resistance of cancer cells to cyclin-dependent kinase inhibitors (CDKi) have been identified, including the upregulation of metabolic regulators such as glutaminase. However, whether such mechanisms and targets are optimal has not been determined. Here, we have systematically analyzed metabolic reprogramming in colorectal cancer cells exposed to Palbociclib, a CDKi selectively targeting CDK4/6, or Telaglenestat, a selective glutaminase inhibitor. Through multiple approaches, we show that Palbociclib and Telaglenestat elicit complementary metabolic responses and are thus uniquely suited to counter the metabolic reprogramming induced by the reciprocal drug. As such, while Palbociclib induced reduced tumor growthin vivo, and Telaglenestat did not show a significant effect, the drug combination displayed a strong synergistic effect on tumor growth. Likewise, initial responses to Palbociclib were followed by signs of adaptation and resistance, which were prevented by combining Palbociclib with Telaglenestat. In conclusion, combination with Telaglenestat optimally forestalls acquired resistance to Palbociclib in cancer cells.