bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nasal Methicillin-Resistant Staphylococcus aureus Culture Screens in the Setting of Universal Decolonization
Authors: Saha Arunava , O'Shea Paudel Erin 
Published: December 2023

Introduction
The negative predictive value (NPV) of nasal methicillin-resistant Staphylococcus aureus (MRSA) screens has been compromised by universal decolonization practices. We aimed to determine the reliability of the nasal MRSA culture screen to deescalate antibiotic therapy in the setting of decolonization with ethyl alcohol.

Methodology
A retrospective observational cohort study was conducted using 62% ethanol solution intranasally per protocol. Patients were divided into 2 groups based on whether they received decolonization. Data were analyzed to determine NPV of the nasal MRSA culture screen with and without decolonization.

Results
A total of 505 cases were screened, and 128 subjects were included. One hundred two received decolonization, whereas 26 did not. Baseline characteristics were well balanced. Overall MRSA infection prevalence was 31.25%. The NPV was 73% in the decolonized group compared with 80% in the group without. Positive predictive value was 63% in the group receiving decolonization compared with 100% in the group without. There was also a higher specificity but lower sensitivity of the nasal MRSA culture screen in the decolonization group. Nine patients in the decolonization group required reescalation of antibiotics compared with nil in the other group.

Conclusions
Culture-based nasal MRSA screens are less accurate than PCR tests, as ethyl alcohol leads to false-negative results. A lower NPV in the decolonization group predisposes to increased false negative results, leading to inappropriate antibiotic deescalation and often requiring reinitiation. Nasal MRSA culture screen is less reliable if alcohol has already been administered for decolonization and cannot be used as an appropriate tool to guide antibiotic deescalation.
Remifentanil-induced hyperalgesia in healthy volunteers: a systematic review and meta-analysis of randomized controlled trials
Authors: Dello Russo Cinzia , Di Franco Valeria , Tabolacci Elisabetta , Cappoli Natalia , Navarra Pierluigi , Sollazzi Liliana , Rapido Francesca , Aceto Paola 
Published: December 2023

Abstract
Recent literature suggests that the withdrawal of remifentanil (RF) infusion can be associated with hyperalgesia in clinical and nonclinical settings. We performed a systematic review and a meta-analysis of randomized controlled trials with cross-over design, to assess the effect of discontinuing RF infusion on pain intensity and areas of hyperalgesia and allodynia in healthy volunteers. Nine studies were included. The intervention treatment consisted in RF infusion that was compared with placebo (saline solution). The primary outcome was pain intensity assessment at 30 ± 15 minutes after RF or placebo discontinuation, assessed by any pain scale and using any quantitative sensory testing. Moreover, postwithdrawal pain scores were compared with baseline scores in each treatment. Secondary outcomes included the areas (% of basal values) of hyperalgesia and allodynia. Subjects during RF treatment reported higher pain scores after discontinuation than during treatment with placebo [standardized mean difference (SMD): 0.50, 95% confidence interval (CI): 0.03-0.97; P = 0.04, I2 = 71%]. A significant decrease in pain scores, compared with baseline values, was found in the placebo treatment (SMD: −0.87, 95% CI: −1.61 to −0.13; P = 0.02, I2 = 87%), but not in the RF treatment (SMD: −0.28, 95% CI: −1.18 to 0.62; P = 0.54, I2 = 91%). The area of hyperalgesia was larger after RF withdrawal (SMD: 0.55; 95% CI: 0.27-0.84; P = 0.001; I2 = 0%). The area of allodynia did not vary between treatments. These findings suggest that the withdrawal of RF induces a mild but nonclinically relevant degree of hyperalgesia in HVs, likely linked to a reduced pain threshold.
Nurse practitioner and physician assistant transition to practice: A scoping review of fellowships and onboarding programs
Authors: Morgan Perri , Barnes Hilary , Batchelder Heather R. , Tuttle Brandi , Faraz Covelli Asefeh , Everett Christine , Jackson George L. , Anglin Lorraine , Ortiz Pate Nathalie , Dieter Patricia , Bludorn Janelle 
Published: December 2023

ABSTRACT

Background:
Newly graduated nurse practitioners (NPs) and physician assistants (PAs) benefit from transition-to-practice (TTP) support to move successfully into practice. Transition-to-practice programs (i.e., onboarding programs and fellowships/residencies) hold promise for improving workforce outcomes.

Purpose:
The purpose of this scoping review was to describe the literature regarding NP/PA TTP programs.

Methodology:
Using the Joanna Briggs Institute methodology, a specific approach for systematically conducting reviews, publications from January 1990 to May 2022 were included for review if they addressed fellowships/residencies or onboarding programs for NPs or PAs. Final data extraction involved 216 articles.

Results:
The pace of publication increased over time, with a noticeable increase since 2015. Articles were most commonly about fellowships/residencies, NPs, and programs set in United States nonrural, acute care settings, and academic health centers.

Conclusions/Implications:
There is a gap in our understanding of onboarding programs and programs focusing on PAs, as well as TTP support in rural and primary care settings. In addition, there are few articles that assess TTP program outcomes such as benefits and costs. This review describes the need for more published literature in these areas.
College women with a disability and interpersonal violence: A call to action
Authors: Mueller Susan D. , Sutherland Melissa A. 
Published: December 2023

ABSTRACT
Interpersonal violence is a serious public health issue, particularly in the young adult population. College women are more likely to experience interpersonal violence than the general population; college women with disabilities are at particularly high risk of victimization. Despite this reality, screening rates for interpersonal violence in college health centers remain low, and college women, both disabled and not, report unsatisfactory interactions with college health providers after an interpersonal violence experience. We provide suggestions for nurse practitioners working in college health which will assist them in their endeavors to screen college women, specifically college women with a disability, for interpersonal violence and to respond to the outcomes of those screenings using a trauma and disability-informed practice lens.
Liddle syndrome presenting with normal aldosterone levels: A case report
Authors: Wang Rongrong , Zhang Yan , Pan Runzhou , Zhang Rongju , Zhao Yongcai 
Published: December 2023

Introduction:
Liddle syndrome is an autosomal dominant disorder characterized by hypertension, hypokalemia, low aldosterone levels, and reduced renin activity. Atypical Liddle syndrome can be easily misdiagnosed due to its clinical phenotypes resembling hyperaldosteronism.

Patient concern:
The patient was diagnosed with primary aldosteronism due to hypertension and hypokalemia, and underwent left adrenalectomy. After the operation, the patient still had hypertension and hypokalemia that were not easy to control and correct, and had acute cerebral infarction.

Diagnosis:
The genetic test showed that the base duplication in the coding region of SCN1B gene caused a frameshift mutation:c.1789dupC (p.Arg597fs), Liddle syndrome was diagnosed.

Intervention and outcomes:
The patient was treated with a low-sodium diet and oral triamterene. The serum potassium level returned to normal and the blood pressure was controlled.

Lessons:
Some Liddle syndrome may present with normal aldosterone levels, genetic testing is necessary for the diagnosis. If the diagnostic test of primary aldosteronism is positive, but the treatment with spironolactone is ineffective, we should actively search for other causes.
Horizontal semicircular canal benign paroxysmal positional vertigo treated by acupuncture and moxibustion: A case report
Authors: Cai Ying , Zhang Qi Wen , Li Shan , Zhang Quan Ai 
Published: December 2023

Rationale:
Horizontal semicircular canal benign paroxysmal positional vertigo (HSC-BPPV) is a second common canal of Benign Paroxysmal Positional Vertigo (BPPV); its actual incidence may have been underestimated because of its complex pathogenesis. Although the canalith repositioning maneuver is the treatment of choice, it has a high recurrence rate, affecting some patients’ lives and psychology. We submit a case report describing acupuncture and wheat grain moxibustion treatment for HSC-BPPV.

Patient concerns:
A 70-year-old patient with HSC-BPPV had low acceptability of the otolith repositioning treatment strategy and reported intolerance during the procedure. He turned to acupuncture as a result of recurrent attacks of vertigo.

Diagnoses:
Horizontal semicircular canal benign paroxysmal positional vertigo.

Interventions:
The intervention project was acupuncture followed by wheat grain moxibustion treatment, administered once every 2 days, 3 times a week. The whole treatment period lasted for 2 months.

Outcomes:
The patient’s clinical symptoms of vertigo improved significantly after 8 weeks of acupuncture and wheat grain moxibustion treatment. The Dizziness Handicap Inventory (DHI) and Visual Vertigo Analogue Scale (VVAS) scores decreased, thus verifying that the severity of vertigo was reduced.

Lessons:
This brief clinical report suggests that acupuncture therapy may be a complementary option for treating HSC-BPPV.
Effect of TCM rehabilitation program on activities of daily living in patients with post-stroke limb spasticity: An observational study
Authors: Zhu Chuanxi , Qiu Long , Sun Weichen , Yang Chong , Cong Deyu , Wang Yufeng , Ji Guangcheng 
Published: December 2023

Background:
Stroke is a neurological disease with many common complications that reduce the activities of daily living and the quality of life of patients. Traditional Chinese medicine (TCM) rehabilitation techniques, scalp acupuncture, and TCM can relieve spasticity symptoms and recovery from physical obstacles is significant.

Methods:
Three hundred twenty-one patients with post-stroke limb spasticity were randomly divided into trial and control groups, with 159 and 162 patients in the trial and control groups, respectively. The control group received basic treatment combined with modern rehabilitation techniques, whereas the trial group received basic treatment combined with TCM, Tuina, and scalp acupuncture with kinesiotherapy. The treatment course in both groups was 4 weeks. The Modified Ashworth Scale, magnetic resonance imaging, and Stroke Specific Quality of Life Scale were used to evaluate limb spasticity, activities of daily living, and quality of life, respectively. PASW 18.0 was used for statistical analysis.

Results:
With a longer treatment period, the improvement in limb spasticity was greater in the trial group than in the control group (P < .05). Similarly, improvements in activities of daily living and quality of life were better in the trial group than in the control group (P < .05).

Conclusion:
The TCM rehabilitation program using Tongjing Tiaoxing combined with scalp acupuncture and kinesiotherapy can effectively treat spasticity symptoms in stroke patients and improve their activities of daily living and quality of life.
Effective cochlear implantation for idiopathic hypertrophic pachymeningitis with bilateral profound hearing loss: A case report
Authors: Idei Katsuyoshi , Kitamura Mitsuru , Shimanuki Marie N. , Hosoya Makoto , Tsuzuki Nobuyoshi , Hasebe Natsuki , Nishiyama Takanori , Ozawa Hiroyuki , Oishi Naoki 
Published: December 2023

Rationale:
Hypertrophic pachymeningitis (HP) is a local or diffuse fibrous thickness of the dura mater of the brain or spinal cord, caused by infection or connective tissue disease. Headache is the most common clinical symptom, followed by various cranial nerve disorders such as visual impairment, diplopia, and hearing loss. HP can be classified into secondary and idiopathic. Here, we report a case of bilateral progressive profound sensorineural hearing loss diagnosed in a patient with idiopathic HP, where a cochlear implant was effectively used.

Patient concerns:
The patient was a 77-year-old woman. Hearing loss gradually progressed bilaterally, and magnetic resonance imaging showed a space-occupying lesion with a continuous contrast enhancement in the bilateral internal auditory canals, and diffused dural thickening from the middle to the posterior cranial fossa.

Diagnoses:
A trans-labyrinthine biopsy was conducted, and a definite diagnosis of idiopathic HP was made. Thickening of the dura mater in the bilateral internal auditory canals was thought to cause profound hearing loss.

Interventions and outcomes:
A cochlear implant was implemented 4 months after biopsy, and a favorable hearing response was obtained postoperatively.

Lessons:
This is the first report of a cochlear implant in a patient with idiopathic HP. Cochlear implantation was considered a good treatment for profound hearing loss due to idiopathic HP, which provides a reference for patients to receive timely and correct treatment.
Atrial myxoma embolization of the basilar artery presenting with a convulsive seizure: Case report
Authors: Xu Yaning , Jiang Jiaojin , Zhang Meng 
Published: December 2023

Background:
Basilar artery occlusion (BAO) is a rare cause of convulsive seizure. Such patients who are treated for epilepsy will miss the optimal time for treatment. Atrial myxoma is a rare cause of stroke and should be surgically removed as soon as possible after diagnosis.

Case summary:
We report a patient who presented with convulsions as the initial symptom and was diagnosed with BAO by computed tomographic angiography. After transthoracic echocardiogram, the cause of the disease was diagnosed as atrial myxoma. The patient recovered well after endovascular treatment and resection of the atrial myxoma.

Conclusion:
A small number of patients with BAO present with convulsive seizures. It is very important to make a timely diagnosis. Direct thrombaspiration may be the best choice for basilar artery cardioembolization, and thrombectomy for distal moderate vascular occlusion in posterior circulation is feasible. Atrial myxoma is a rare cause of cardioembolic stroke and should be resected as soon as possible to prevent further embolic complications.
The effect of atopic dermatitis in pediatric patients on height: Reflections triggered by a real-life case report
Authors: Zhang Mei , He Ming , Tang Ting 
Published: December 2023

Rationale:
Atopic dermatitis (AD) is a burdensome skin disorder, especially in children. The prevalence of children with AD is increasing year by year in China. Typical symptoms like eczema-like lesions and severe pruritus can seriously affect the sleep quality and the growth and development of pediatric patients.

Patient concerns:
We observed a pair of fraternal twins, in which the younger sister had AD, while the elder one had no relevant medical history. At present, the height of the 2 individuals is significantly inconsistent, with a difference of about 10 cm.

Diagnoses:
Based on the little patient’s medical history and clinical manifestations, the diagnosis of AD was made.

Interventions:
This little patient was treated with oral routine antihistamines, topical glucocorticoids and Dupilumab.

Outcomes:
At present, her rash and xerosis have significant improvement. She also have relief of generalized itching and improved sleep quality.

Lessons:
Previous studies have indeed shown that AD has a negative impact on children’s height. This case leads us to consider the association between AD and height. It also gave us the opportunity to observe subsequent height changes after the intervention was carried out.
Treatment outcomes of tubal pregnancy with tubal preservation: A meta-analysis
Authors: Long Yan , Lin Yong , He Jin , Zhu Rong 
Published: December 2023

Background:
Ectopic pregnancy is a common gynecological emergency that poses a significant risk of maternal mortality during the first trimester. It also increases the incidence of infertility and repeated ectopic pregnancy. The aim of this study was to evaluate whether there is a difference in the degree of tubal patency between salpingostomy and systemic treatment with methotrexate (MTX), as well as the odds of intrauterine pregnancy and repeat ectopic pregnancy, and the degree of tubal patency in salpingectomy with or without tubal suturing.

Methods:
We searched PubMed, EMBASE, and the Cochrane Library up to April 2023. Four randomized controlled trials were included in the review. We analyzed the combined data using Review Manager 5.3 software and Stata 12.0 software, utilizing a random effects model.

Results:
When comparing salpingostomy and systemic treatment with MTX, there was no significant difference in the degree of tubal patency (OR = 1.09, 95% CI (0.54–2.38), P = .83). For salpingostomy with or without tubal suturing, there were no significant differences in the rates of intrauterine pregnancy, repeat ectopic pregnancy, and tubal patency degree [(OR = 1.05, 95% CI (0.41–2.68), P = .92), (OR = 0.68, 95% CI (0.19–2.42), P = .92), (OR = 1.68, 95% CI (0.14–20.33), P = .68)].

Conclusion:
This meta-analysis demonstrates that systemic treatment with MTX is an effective treatment for patients who wish to preserve their fallopian tubes without undergoing surgery. This form of treatment can help avoid surgical procedures that may damage the fallopian tubes and improve fertility prospects. If choosing surgery, we believe that opting for salpingostomy without tubal suturing could reduce the operation time and minimize damage.
Acute generalized exanthematous pustulosis caused by hydroxychloroquine in a patient with rheumatoid arthritis and CARD14 mutation: Case report
Authors: Luo Feng , Yuan Xue-Mei , Xiong Hong , Chen Chang-Ming , Ma Wu-Kai , Yao Xue-Ming 
Published: December 2023

Rationale:
Acute generalized exanthematous pustulosis (AGEP) is a serious adverse skin reaction characterized by the rapid appearance of densely distributed, small, sterile pustules with erythema. However, its pathogenesis is not fully understood. Hydroxychloroquine is widely used for the treatment of autoimmune diseases. Some patients presenting with AGEP have IL36RN and CARD14 gene mutations. Our report describes a patient with rheumatoid arthritis and AGEP associated with hydroxychloroquine and a newly discovered CARD14 gene mutation.

Patient concerns:
A 28-year-old woman with rheumatoid arthritis, treated with leflunomide therapy without marked relief of joint pain, developed multiple rashes with pruritis covering the body 5 days after switching to hydroxychloroquine treatment.

Diagnoses:
Based on the patient’s history, symptoms, and histopathological findings, AGEP was diagnosed.

Interventions:
Whole-exome sequencing and Sanger validation revealed no mutations in the IL36RN gene; however, a CARD14 gene mutation was present. The patient was treated using ketotifen fumarate tablets, dexamethasone sodium phosphate, calcium gluconate injection, methylprednisolone injection, vitamins C and B12, hydrocortisone butyrate cream, Reed acne cream, potassium chloride tablets, and pantoprazole enteric-coated capsules.

Outcomes:
The rash improved after 15 days.

Lessons subsections:
There has been little basic research on AGEP-related genetics, and the CARD14 mutation may underlie several pustular rashes, including AGEP and generalized pustular psoriasis. Follow-up studies and further accumulation of patient data are required.
Efficacy of DAIR in managing Candida parapsilosis-infected total knee arthroplasty with five-year follow-up: A case report and review of literature
Authors: Li Menglong , Fan Mingrui , Zhang Yuchen , Xiao Jianlin , Liu Tong , Yu Qingwei 
Published: December 2023

Rationale:
Fungal periprosthetic joint infections (fPJIs) are relatively uncommon, accounting for approximately 1% of all PJIs. Revision surgery is typically recommended for fungal infections; however, the physical and financial impact on patients is significant. In this report, we present a case of fPJI successfully treated with debridement, antibiotics, and implant retention (DAIR) with a favorable outcome over a 5-year period.

Patient Concern:
A 56-year-old male patient presented with a non-healing surgical incision 1 week after undergoing primary total knee arthroplasty on the right side.

Diagnosis:
Microbiological culture of the wound effusion identified Candida parapsilosis. Postoperatively, the patient exhibited a significant decrease in serum albumin levels and poor glycemic control. Both C-reactive protein and erythrocyte sedimentation rate were elevated.

Interventions:
A comprehensive DAIR procedure was performed, along with continuous closed irrigation using fluconazole for 1 week. The patient received intravenous voriconazole for 4 weeks, followed by oral fluconazole for an additional 3 months.

Outcomes:
At 1- and 5-year follow-up appointments, the patient C-reactive protein and erythrocyte sedimentation rate levels were within normal limits, and there was no evidence of swelling, erythema, or tenderness in the right knee joint, indicating no signs of infection.

Lessons:
DAIR is an effective treatment for early fPJIs, and continuous closed irrigation may provide specific advantages. The patient nutritional status plays a crucial role in the management of periprosthetic infections.
Laparoscopic resection for appendiceal mucocele secondary to endometriosis: A case report
Authors: Hara Hitoshi , Shimizu Seito , Muto Yasuhide , Kido Tomoki , Miyata Ryohei 
Published: December 2023

Introduction:
This case report describes a patient who underwent laparoscopic resection of the mucocele of the appendix secondary to endometriosis, a rarity in clinical practice.

Patient concerns:
The patient was a 38-year-old woman with a history of endometriosis and an ovarian cyst who sought medical advice with a chief complaint of mild right lower abdominal pain.

Diagnoses:
Computed tomography and ultrasonography of the abdomen revealed a cystic lesion at the distal end of the appendix without definitive findings of malignancy. Colonoscopy revealed a submucosal tumor-like elevation at the appendiceal orifice. Appendiceal mucocele was suspected preoperatively.

Interventions:
The lesion was resected laparoscopically. Secondary ileocecal resection with lymphadenectomy was possible if the resected specimen was pathologically diagnosed as a malignant tumor with the risk of lymph node metastasis.

Outcomes:
The resected specimen was pathologically diagnosed as an appendiceal mucocele secondary to endometriosis; therefore, additional surgery was avoided.

Conclusion:
Although appendiceal mucoceles secondary to endometriosis are rare, laparoscopic surgery in which only the lesion was resected is a useful strategy for the treatment and pathological diagnosis of appendiceal mucoceles without findings of malignancy.