bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of Active Renin Content With Mortality in Critically Ill Patients: A Post hoc Analysis of the Vitamin C, Thiamine, and Steroids in Sepsis (VICTAS) Trial*
Authors: Busse Laurence W. , Schaich Christopher L. , Chappell Mark C. , McCurdy Michael T. , Staples Erin M. , Ten Lohuis Caitlin C. , Hinson Jeremiah S. , Sevransky Jonathan E. , Rothman Richard E. , Wright David W. , Martin Greg S. , Khanna Ashish K. ,   on behalf of the Vitamin C, Thiamine, and Steroids in Sepsis (VICTAS) Investigators
Published: November 2023

OBJECTIVE:
Sepsis is a leading cause of mortality. Predicting outcomes is challenging and few biomarkers perform well. Defects in the renin–angiotensin system (RAS) can predict clinical outcomes in sepsis and may outperform traditional biomarkers. We postulated that RAS dysfunction (elevated active renin, angiotensin 1-7 [Ang-(1-7)], and angiotensin-converting enzyme 2 (ACE2) activity with depressed Ang-II and ACE activity) would be associated with mortality in a cohort of septic patients.

DESIGN:
Post hoc analysis of patients enrolled in the Vitamin C, Thiamine, and Steroids in Sepsis (VICTAS) randomized controlled trial.

SETTING:
Forty-three hospitals across the United States.

PATIENTS:
Biorepository samples of 103 patients.

INTERVENTIONS:
We analyzed day 0 (within 24 hr of respiratory failure, septic shock, or both) and day 3 samples (n = 103 and 95, respectively) for assessment of the RAS. The association of RAS values with 30-day mortality was determined using Cox proportional hazards regression with multivariable adjustments for age, sex, VICTAS treatment arm, systolic blood pressure, Sequential Organ Failure Assessment Score, and vasopressor use.

MEASUREMENTS AND MAIN RESULTS:
High baseline active renin values were associated with higher 30-day mortality when dichotomized to the median of 188.7 pg/mL (hazard ratio [HR] = 2.84 [95% CI, 1.10–7.33], p = 0.031) or stratified into quartiles (Q1 = ref, HRQ2 = 2.01 [0.37–11.04], HRQ3 = 3.22 [0.64–16.28], HRQ4 = 5.58 [1.18–26.32], p for linear trend = 0.023). A 1-sd (593.6 pg/mL) increase in renin from day 0 to day 3 was associated with increased mortality (HR = 3.75 [95% CI, 1.94–7.22], p < 0.001), and patients whose renin decreased had improved survival compared with those whose renin increased (HR 0.22 [95% CI, 0.08–0.60], p = 0.003). Ang-(1-7), ACE2 activity, Ang-II and ACE activity did not show this association. Mortality was attenuated in patients with renin over the median on day 0 who received the VICTAS intervention, but not on day 3 (p interaction 0.020 and 0.137, respectively). There were no additional consistent patterns of mortality on the RAS from the VICTAS intervention.

CONCLUSIONS:
Baseline serum active renin levels were strongly associated with mortality in critically ill patients with sepsis. Furthermore, a greater relative activation in circulating renin from day 0 to day 3 was associated with a higher risk of death.
Prevalence and Clinical Features of Radial Fundus Autofluorescence in High Myopic Women
Authors: Wang Shih-Wen , Igarashi-Yokoi Tae , Mochida Shiho , Fujinami Kaoru , Ohno-Matsui Kyoko 
Published: November 2023

Abstract

Purpose:
To determine the prevalence and characteristics of radial fundus autofluorescence (FAF) in highly myopic women.

Methods:
This was a retrospective, observational case study to determine the prevalence of radial FAF in the ultra-widefield FAF images in women. The clinical characteristics of these patients were evaluated.

Results:
Fifteen of 1935 (0.78%) highly myopic women were found to have radial FAF. Their mean age was 36.6±25.6 years, and their mean best-corrected visual acuity was 0.3±0.42 logMAR units. The mean axial length (AL) was 28.8±2.8 mm. Among the 15 cases, eight did not have pigmentary changes and 7 had pigmentary changes in the ultra-widefield FAF images. The women with the pigmentary changes were significantly older (P=0.021), had poorer BCVA (P=0.001), and had longer ALs (P=0.002). The visual fields and electroretinograms were worse in the eyes with pigmentary changes.

Conclusions
The prevalence of radial FAF was 0.78% in women with high myopia. These patients might have mutations in the RPGR or RP2 genes and can develop high myopia and retinitis pigmentosa. Ultra-widefield FAF images should be examined in all highly myopic patients for early detection of radial FAF, and myopia prevention and genetic counseling for possible genetic therapy are recommended.
Incidence and Risk Factors for Exudative Retinal Detachment Following Laser Photocoagulation for ROP
Authors: Cohen Devin , Binenbaum Gil , El-Jack Khalid , Spiller Alyssa , Yu Yinxi , Ying Gui-shuang , Jensen Anne , Scoles Drew 
Published: November 2023

Abstract

Purpose:
Exudative retinal detachment (ERD) may result from laser photocoagulation for retinopathy of prematurity (ROP). While risk factors have been hypothesized from case reports, comparative studies have not been reported. We sought to evaluate risk factors for ERD following laser, comparing affected and unaffected infants.

Methods:
Retrospective cohort study of infants undergoing ROP laser at Children’s Hospital of Philadelphia over 6 years. All received near-confluent laser of avascular retina. Demographic, medical, and procedural risk factors for ERD were evaluated in univariate analysis, due to the rarity of ERD.

Results:
Among 149 lasered infants, 6 (4%, 95%CI 1.5%-8.6%) infants developed ERD. Race was a significant risk factor (p=0.01). Among 71 African American or Hispanic infants, 6 (8.5%, 95% CI 3.2%-17.5%) developed ERD. Among 78 non-African American or Hispanic infants, 0 (0%, 95% CI 0%-4.6%) developed ERD. There were no significant differences in the other studied factors.

Conclusions:
ERD was uncommon (4%) following ROP laser. Despite so few cases, darker pigmented race with likely increased pigmented fundi was significantly associated with increased ERD risk. Further study may reveal if increased choroidal pigment causes greater laser tissue damage or makes it difficult to discern the ora, resulting in inadvertent lasering of the ciliary body, leading to ERD.
Predictive factors of surgical success with the Inverted ILM Flap Technique
Authors: Nawrocka Zofia Anna , Nawrocki Jerzy 
Published: November 2023

ABSTRACT

Purpose:
To present new morphological features correlating with functional and anatomical outcomes of the Inverted internal limiting membrane Flap Technique (iILMFT) in full-thickness macular hole (FTMH).

Methods:
A retrospective study of 51 successful and 22 failed FTMH surgeries. In all eyes, preoperative SD-OCT or SS-OCTs were reviewed. The presence of supra-RPE (retinal pigment epithelium) granular deposits, presence of an epiretinal membrane (ERM) or epiretinal proliferation (EP), visibility of posterior hyaloid, continuity of the interdigitation zone or external limiting membrane, presence of cystoid spaces, irregular surface of the margins of FTMH, visibility of the suprachoroidal space, diameters of FTMH were analyzed.

Results:
In multivariate analysis, the success of the first surgery depended solely on the absence of ERM (p<0.05).
In univariate analysis, the success of the first surgery was correlated moreover with the absence of preoperative supra-RPE granular deposits (p=0.0010), the absence of an EP (p=0.0060), and the absence of an irregular border of the hole (p=0.010).

Conclusions:
In multivariate analysis, ERMs were a negative prognostic factor for macular hole closure when the iILMFT was used. Worse final visual acuity was observed in patients with primary anatomical failure, even if the hole was successfully closed during the second intervention.
ATYPICAL FOVEAL AND PARFOVEAL ABNORMALITIES IN SICKLE CELL DISEASE
Authors: Orssaud Christophe. , Flammarion E. , Michon A. , Ranque B. , Arlet J.B. 
Published: November 2023

ABSTRACTPurpose:The primary aim was to describe patterns of para macular involvement, not yet reported but that OCT-A can now detect in SCD patients. The secondary aim was to search arguments concerning the physio pathogeny of para macular involvement.Methods:This institutional cohort retrospective study was conducted in a Referral Center for Ophthalmological Rare Diseases. Follow-up included an ophthalmological examination with optical coherent tomography and optical coherent tomography angiography.Results:Hundred and thirty-two sickle cell patients were included. Typical sickle cell maculopathy was observed in temporal area in 84 eyes (40.0 %) of SS patients and 8 eyes (14.8 %) of SC patients (p < 0.001). Enlargement of the foveal avascular zone was observed in 10 eyes whom 8 of SS patients. Two atypical parafoveal abnormalities were found in SS patients only. The first one consisted in macular thinning with normal vascularization in 15 eyes of 11 patients. The second atypical maculopathy was large areas of loss of vascularization without retina thinning 10 eyes of six patients. Multivariate analysis did not show a statistically significant relation between the PSR stage and the different type of sickle cell maculopathy (p = 0.21)Conclusion:Those atypical sickle cell maculopathy may correspond to early forms preceding a typical SCM. This would point towards several physiopathogenic mechanisms. The first one included the existence of ischemia which can be related to anemia. Presence of retinal thinning without vascular involvement point out to a neurogenic mechanism.
Pelvic Floor Dysfunction: A Common Cause of Chronic Orchialgia
Authors: Zheng Amy , Bramwell Austin K. , Kane Jennifer A. , Pham Jonathan T. , MacDonald Susan M. 
Published: November 2023

Purpose:
We determined the prevalence of pelvic floor dysfunction (PFD) as an etiology for chronic orchialgia in a single tertiary care practice and characterized the presenting symptoms of chronic orchialgia patients with PFD.

Materials and Methods:
An IRB-approved retrospective review was performed for patients diagnosed with chronic orchialgia from 2016 to 2021 using CPT codes N50.82 (scrotal pain), N50.819 (testicle pain), and G89.29 (chronic pain in testicle). Patients with acute orchialgia (<3 months) were excluded. PFD was diagnosed on a 360-degree digital rectal examination when increased tone or pain to palpation of the levator ani muscle group was noted. Suspected etiology of the orchialgia and accompanying urinary, bowel, or sexual symptoms were recorded. Unpaired t-tests were used to determine significant associations while accounting for differences in sample size.

Results:
Of 136 patients with chronic orchialgia, the most common etiologies were classified as idiopathic (37.7%); prior surgery (32.1%); varicocele, hydrocele, or spermatocele (28.3%); PFD (17.6%); and postinfection (11.3%). Chronic orchialgia patients with PFD (n = 24) were significantly more likely to present with accompanying urinary (P < .01), bowel (P < .01), and sexual dysfunction (P = .04) symptoms. Orchialgia patients with PFD were more likely to report symptoms of functional obstruction, particularly urinary hesitancy (P < .01), constipation (P < .01), and painful ejaculation (P < .01), compared with patients without PFD.

Conclusions:
PFD was determined to be the etiology in 1 in 6 patients with chronic orchialgia. All patients presenting with chronic orchialgia and obstructive symptoms warrant a 360-degree rectal examination as part of their initial evaluation.

IRB Protocol Number:
10677.
Leuconostoc mesenteroides subsp. strain NTM048 ameliorated nasal symptoms in patients with Japan cedar pollinosis: Randomized, double-blind, and placebo-controlled trial
Authors: Yamamoto Yuta , Sugita Gen , Hiraoka Masanobu , Takagi Saori , Yamagishi Naoko , Kawashima Shuji , Tanioka Kensuke , Nishi Toshio , Yamamoto Sachi , Kakutani Chiemi , Yanase Agi , Kanai Yoshimitsu , Kato Seiya , Hotomi Muneki 
Published: November 2023

Background:

Lactobacillales including L mesenteroides have beneficial effects on human health, including improvement of psychological status and alleviation of allergic rhinitis. In mice, L mesenteroides subsp. strain NTM048 (NTM048) increased intestinal s-IgA. In humans, however, the effects of NTM048 on s-IgA secretion have been unclear.

Study:
This 16-week trial was performed using a double-blind, placebo-controlled, parallel group design. We aimed to establish whether Leuconostoc mesenteroides subsp. strain NTM048 increases the secretion of s-IgA in saliva. Forty healthy adults and forty patients with Japanese cedar pollinosis were recruited. Participants took either 2 test capsules including NTM048 (1010 CFU/day), or 2 placebo capsules per day, for 16 weeks. They were asked to collect their saliva and answered POMS2, a questionnaire about psychological status. The patients also answered questions about nasal symptoms. Blood samples were collected from the patients with Japanese Cedar pollinosis. Stool samples were collected at the start and on the last day of the trial.

Results:
All subjects completed the trial. It was conducted during the season when Japanese cedar pollen is most scattered. Serum concentration of Japanese cedar pollen-specific IgE was > 2.0 UA/mL in patients with Japanese cedar pollinosis. The amount of s-IgA in saliva was not increased by NTM048 in overall subjects, and Japanese cedar pollen-specific IgE was not changed by NTM048 in patients with Japanese cedar pollinosis. The symptom of nasal blockage was improved by NTM048 12 weeks after the start of trial. post hoc analysis indicated a positive correlation between improving psychological status and the increase in occupation ratio of lactobacillus including NTM048.

Conclusion:
The amount of s-IgA in saliva was not increased by NTM048, but nasal blockage was improved by it. Psychological status might be improved if dosage of NTM048 is raised to the degree that NTM048 might be increased in the intestinal tract.
Idiopathic generalized epilepsy with phantom absences, absence status, and generalized tonic-clonic seizures: A case report
Authors: Jiang Yongning , Zhou Xiangqin 
Published: November 2023

Rationale:
Phantom absences refer to mild and short-lasting absence seizures, which are usually accompanied by infrequent generalized tonic-clonic seizures and absence status. Generally, phantom absences do not impair the individual neurological functions. Herein, we report the case of a young woman with idiopathic generalized epilepsy, phantom absences, absence status, and generalized tonic-clonic seizures.

Patient concerns:
A 31-year-old woman presented with a 16-year history of paroxysmal convulsions.

Diagnoses:
Electroencephalogram (EEG) showed recurrent universal and synchronized 3~4 Hz spike waves and spike-slow waves in the interictal phase with normal background activity. During the ictal phases, EEG revealed bursts of 3~4 Hz spike waves and spike-slow waves that were universal, synchronized, and symmetrical. Additionally, there was 1 seizure episode induced by a 3-Hz flash in the current case. Based on these findings, a diagnosis of idiopathic generalized epilepsy was made.

Interventions:
The patient was treated with oral sodium valproate, and the epileptic seizures were controlled.

Outcomes:
The frequency of absence seizures was significantly reduced and there were no generalized tonic-clonic seizures.

Lessons:
Idiopathic generalized epilepsy with phantom absences, absence status, and generalized tonic-clonic seizures is an extremely rare condition. EEG is the exclusive method for diagnosis. Antiepileptic drugs are effective for controlling epileptic seizures in this disease.
Association of noncoding RNAs with Kawasaki disease: A meta-analysis based on the current evidences
Authors: Zhong Xiaoling , Wang Hui , Jia Xufeng , Chen Guihua , Li Hongxia , Li Pingping , Liu Wen , Yang Taoyi , Xie Jiang 
Published: November 2023

Background:
In recent years, many studies have focused on the relationship between noncoding RNAs (ncRNAs) and Kawasaki disease (KD). Studies have indicated that ncRNAs are associated with the occurrence and development of KD. Thus, we performed a systematic review and meta-analysis to investigate the diagnostic value of ncRNAs in KD patients.

Methods:
We searched the PubMed, Web of Science, Embase and Cochrane Library, China National Knowledge Infrastructure, VIP, China Biology Medicine disc databases, and Wanfang databases until August 25, 2023 and screened all eligible studies focusing on the diagnostic performance of ncRNAs in KD patients.

Results:
In total, 535 articles were found, and 28 articles were included in this systematic review and meta-analysis. The calculated area under the curve value was 0.880 (95% confidence intervals, 0.840–0.900). The pooled sensitivity, specificity, positive likelihood ratio and negative likelihood ratio were 0.790, 0.830, 4.610, and 0.260, respectively. The pooled diagnostic odds ratio was 17.890 (95% confidence intervals, 13.110–24.420), indicating a relatively good diagnostic performance of the ncRNAs for detecting KD. In addition, the diagnostic value of micro RNAs in KD was better than that of long noncoding RNAs and circular noncoding RNAs. A subgroup analysis by specimen indicated a better diagnostic value of ncRNAs in plasma and platelet than serum. The diagnostic accuracy of ncRNAs was better in febrile controls than in healthy control groups, indicating a relatively good accuracy in distinguishing KD patients from febrile diseases.

Conclusions:
This systematic review and meta-analysis demonstrated that ncRNAs could be used as novel biomarkers for detecting KD. More studies should be conducted in the future to verify the diagnostic values of ncRNAs in KD.
Sintilimab-related diabetes mellitus and psoriasis: A case report and literature review
Authors: Huang Wenying , Liu Yan , Li Min , Xue Yuan , Bao Weichao , Guo Ying 
Published: November 2023

Rationale:
With the popularity of ICIs in different oncology treatments, immune-related adverse events have raised concerns, mostly occurring in skin and endocrine gland injury. This disease involves different organ systems and presents with a variety of clinical manifestations. Most patients with immune checkpoint inhibitor-induced type 1 diabetes are reported to have no combination of autoimmune disease. We report a case of Sintilimab-related diabetes mellitus and psoriasis.

Patient concerns:
We report a case of a 65-year-old female with Sintilimab-related diabetes mellitus and psoriasis.

Diagnosis:
The patient treated with anti-programmed cell death protein 1 (Sintilimab) for 4 cycles. The patient presented with inexplicable bouts of nausea and vomiting, accompanied by chest discomfort and a feeling of breathlessness, prompting their admission to the local hospital. The initial assessment upon admission revealed an abrupt elevation in blood glucose levels, alongside normal ketone levels, lactic acidosis, and hyperuricemia. A comprehensive regimen was provided to regulate glucose levels and address the symptoms, resulting in notable improvement and subsequent discharge. Regrettably, the patient’s personal decision to discontinue medication for a single day led to the emergence of acute ketoacidosis, coupled with a recurrence of psoriasis vulgaris. Consequently, readmission became necessary. Based on the patient’s medical history and diabetes antibody testing, the diagnosis of immune checkpoint inhibitor induced diabetes mellitus has been confidently established.

Interventions:
The patient ceased treatment with Sintilimab and was initiated on insulin therapy for glycemic control, alongside symptomatic management for psoriasis. Upon stabilization of the condition, long-term administration of exogenous insulin was implemented as a substitute treatment.

Outcome:
Outside of the hospital, insulin therapy effectively maintained stable blood glucose levels, and there were no further episodes of psoriasis flare-ups.

Lesson:
The clinical manifestations of immune checkpoint inhibitor induced diabetes mellitus are variable, and in this case the patient presented with unique primary symptoms. Therefore, it is crucial to accumulate relevant cases, understand the different clinical presentations and identify the underlying mechanisms of the disease. This will provide further evidence for early therapeutic intervention in similar patients in the future.
Prognostic value of pretreatment modified Glasgow Prognostic Score in small cell lung cancer: A meta-analysis
Authors: Xie Yulian , Li Hongjun , Hu Yang 
Published: November 2023

Background:The prognostic role of pretreatment modified Glasgow Prognostic Score (mGPS) in small cell lung cancer (SCLC) patients remains unclear now.Methods:The PubMed, EMBASE, Web of Science, and CNKI electronic databases were searched up to December 14, 2022. The primary and secondary outcomes were overall survival and progression-free survival, respectively. The hazard ratios (HRs) and 95% confidence intervals (CIs) were combined to assess the association between pretreatment mGPS and survival of SCLC patients. Subgroup analysis based on the country, tumor stage, treatment and comparison of mGPS were further conducted and all statistical analyses were performed by STATA 15.0 software.Results:A total of ten retrospective studies involving 2831 SCLC patients were included. The pooled results demonstrated that elevated pretreatment mGPS was significantly related to poorer overall survival (HR = 1.90, 95% CI: 1.36–2.63,P < .001) and progression-free survival (HR = 1.40, 95% CI: 1.13–1.74,P = .002). Subgroup analysis stratified by the country, tumor stage, treatment and comparison of mGPS also showed similar results.Conclusion:Pretreatment mGPS was significantly associated with prognosis in SCLC and patients with elevated mGPS experienced obviously worse survival. Thus, pretreatment mGPS could serve as a novel and reliable prognostic indicator in SCLC patients.
Successful reconstruction using a buccal fat pad flap in misdiagnosed buccinators intramuscular synovial sarcoma: A case report
Authors: Lee Da Woon , Kim Hyun , Si-Hyong Jang , Byeon Je Yeon , Choi Hwan Jun 
Published: November 2023

Introduction:
Synovial sarcoma (SS) is a subtype of soft tissue sarcoma that primarily usually occurs in the lower extremities but rarely arises in the head and neck areas, including the oral cavity. Due to its variable presentation and similarity to benign masses in terms of age at onset, growth rate, and favorable outcomes, SS is often misdiagnosed as a benign tumor. However, it is a malignant tumor.

Patient concerns:
We report the case of intramuscular SS in the oral cavity. Initially, the lesion was clinically suspected as a benign mass but was ultimately confirmed as malignant SS.

Diagnosis:
Although histopathological examination is the first step in diagnosing SS, molecular testing to confirm the presence of SYT-SSX fusion can provide a definitive diagnosis when the histopathology is inconclusive. In this patient as well, the postoperative pathological report confirmed the diagnosis of biphasic SS, and molecular testing revealed positive SYT/SSX fusion.

Therapeutics interventions:
Following the recommendation of multidisciplinary care system, a wide excision was performed including the buccinators muscle, and reconstruction was performed using a buccal fat pad flap to prevent cheek depression.

Outcomes:
On the final pathologic report, SS was removed margin-free, and there were no metastatic lymph nodes. No evidence of cheek dimpling was observed, and follow-up neck CT showed no significant changes in the lymph nodes. As a result of observation up to several months after surgery, there were no functional and aesthetic complications.

Conclusions:
We report a successful case of intramuscular SS resection, initially misdiagnosed as a benign mass, using a buccal fat pad flap. We also highlight the importance of correctly diagnosing SS, especially in the craniofacial region where it can be mistaken for benign masses.