bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reapplication of the Pavlik Harness for Treatment of Developmental Dysplasia of the Hip After Initial Pavlik Harness Failure
Authors: Tomaru Yohei , Kamegaya Makoto , Saisu Takashi , Murakami Reiko , Sakuma Akitoshi , Oikawa Yasuhiro , Kakizaki Jun , Segawa Yuko , Tsukagoshi Yuta , Kamada Hiroshi , Yamazaki Masashi 
Published: November 2023

Objective:
The Pavlik harness (PH) has been widely used as the standard treatment for infants with developmental dysplasia of the hip (DDH). When the initial application of the PH fails, alternative treatments, such as closed reduction, open reduction, and reapplication of the PH will be considered. Compared with other treatments, reapplication of the PH offers certain advantages, including simplicity and reduced physical, and psychological stress, on both infants and caregivers. This study aims to investigate the effectiveness of reapplying the PH in patients with DDH.

Methods:
This study included patients with DDH (complete dislocation) who were treated by reapplication of PH between 1988 and 2012. Patients who were able to follow-up for more than 5 years were included. We examined the reduction rate and several factors to identify indicators associated with successful reduction during reapplication, including age, sex, side of hip dislocation, and the presence of the Ortolani sign. At the final follow-up, hip development was assessed using the Severin classification, whereas avascular necrosis (AVN) was evaluated using the Kalamchi classification and the Salter criteria.

Results:
A total of 56 patients (48 females and 8 males) and 57 hips were included in this study. The mean age at first and second application of PH was 4.2 months old (range: 0.12 to 6.4), and 5.8 months old (3.0 to 11.4), respectively. The reduction rate was 49% (28 out of 57 hips). Among the successfully reduced hips, the AVN rate was 3.6% (1 out of 28 hips). The Severin classification revealed 27 hips in class I and 1 hip in class III. Statistical analysis indicated a significantly higher proportion of left hip involvement in the reduction group (85% vs 41%, χ2 test, P < 0.001). Although not statistically significant, the rate of positive Ortolani sign tended to be higher in the reduction group (61% vs 38%, χ2 test, P = 0.06).

Conclusion:
The reapplication method demonstrated a 49% reduction rate and a low AVN rate of 3.6% in our study. It is worth considering for patients who fail the initial PH treatment, particularly in cases of left-side dislocation and a positive Ortolani sign during the initial application.
Melanocytic Neoplasm With KIT and APC Mutations: A New Subtype of Melanocytoma?
Authors: Donati Michele , Grossmann Petr , Mansour Boulos , Kazakov Dmitry V. 
Published: November 2023

Abstract:
We report a very unusual case of melanocytic neoplasm appearing clinically as a 0.5-cm dome-shaped pigmented papule on the chest of a 63-year-old man. Microscopically, it was an asymmetric, entirely dermally based neoplasm characterized by a multinodular, vaguely plexiform architecture composed of moderately pleomorphic spindled melanocytes with ample, dusty pigmented cytoplasm and scattered multinucleated cells. The tumor cells were strongly positive for Melan-A, HMB45, S100, and PRAME, whereas p16 showed diffuse nuclear loss. β-catenin presented a strong and diffuse cytoplasmic staining, while nuclei were negative. Despite an increased cellularity, mitotic count was low (1/mm2). Fluorescence in situ hybridization revealed no copy number alteration in melanoma-related genes (CDKN2A, MYB, MYC, CCND1 and RREB1). DNA and RNA sequencing identified KIT c.2458G>T and APC c.6709C>T mutations. No further genetic alteration was detected including TERT-promoter (TERT-p) hot-spot mutation. A re-excision was performed. A sentinel lymph node biopsy was negative. Clinical investigations revealed no extracutaneous involvement. The patient is disease-free after a follow-up period of 8 months. Given the peculiar morphologic and molecular findings, we hypothesize the lesion may represent a novel subtype of an intermediate grade melanocytic tumor (melanocytoma).
Connexin 43 in Dermatofibroma and Dermatofibrosarcoma Protuberans: Diagnostic, Pathogenic, and Therapeutic Implications
Authors: Fernandez-Flores Angel , Varela-Vazquez Adrian , Mayan Maria D. , Fonseca Eduardo 
Published: November 2023

Abstract:
Connexins play a crucial role in the formation of gap junctions that connect cells to each other, as well as cells to the surrounding environment. In recent years, connexin 43 has been extensively studied in various human tumors. In this study, we conducted an immunohistochemical analysis to evaluate the expression of connexin in 16 dermatofibromas (DFs) and 13 dermatofibrosarcoma protuberans (DFSP). Connexin was diffusely expressed in the cytoplasm of all DFs with moderate or strong intensity, whereas all DFSPs showed negative staining. In addition to its diagnostic implications, the loss of Cx43 may elucidate the invasive capacity of DFSP and offer a potential avenue for future therapeutic interventions.
Melanoma Mimicker: Pigmented Mammary Paget Disease in a Man
Authors: Kenny Mary Grace , Nguyen Mai , Modi Mitul , Eilers David , Souchik Adam 
Published: November 2023

Abstract:
Male breast cancer comprises less than 1% of all breast cancer cases. Mammary Paget disease (MPD) represents a subset of breast cancer that presents with skin changes of the nipple and areola, and is frequently misdiagnosed clinically due to similarities with other disease states, leading to an average delay in diagnosis of 1 month to 2 years. Pigmented mammary Paget disease (PMPD) is an uncommon variant of MPD that clinically and histologically resembles malignant melanoma. Due to variable immunohistochemical staining patterns, analysis can be challenging and often requires interpretation of panels for accurate diagnosis. We present a rare case of PMPD in a male, originally diagnosed both clinically and histologically as malignant melanoma, to highlight the diagnostic challenges that this entity presents, and to review staining patterns which may be useful in its diagnosis.
Nodular-Type Lichen Myxedematosus: A Rare Variant With Exclusive Involvement of the Hands—Report of Two Cases With a Comprehensive Review of the Literature
Authors: Cerroni Lorenzo , Rongioletti Franco 
Published: November 2023

Abstract:
Lichen myxedematosus (LM) is an uncommon cutaneous mucinosis characterized by the deposition of mucin and fibroblast proliferation in the dermis. This condition can be classified into 2 forms: a diffuse/generalized LM, also known as scleromyxedema, associated with monoclonal gammopathy and systemic implications, and a localized form, primarily affecting the skin. Within the localized form, nodular-type LM is a rare variant presenting as firm, skin-colored to pinkish mucinous nodules. In this article, we report 2 new cases of nodular-type LM with exclusive involvement of the hands and provide a comprehensive review of the diagnosis, histopathological aspects, and therapeutic considerations of this rare condition.
Artificial Intelligence in Melanoma Dermatopathology: A Review of Literature
Authors: Neimy Hannah , Helmy John Elia , Snyder Alan , Valdebran Manuel 
Published: November 2023

Abstract:
Pathology serves as a promising field to integrate artificial intelligence into clinical practice as a powerful screening tool. Melanoma is a common skin cancer with high mortality and morbidity, requiring timely and accurate histopathologic diagnosis. This review explores applications of artificial intelligence in melanoma dermatopathology, including differential diagnostics, prognosis prediction, and personalized medicine decision-making.
Squamous Carcinoma of the Oral Cavity in Patient with Fanconi Anemia: A Challenging Reconstruction with Double-barrel Free Fibula Flap Case Report
Authors: Gargiulo Maurizio , Petroccione Carlo , Razzano Sergio , La Torre Francesca , Manfellotto Vincenzo , D’Aniello Giuseppe , Barbieri Gerarda , d’Alessio Matteo , Nicoletti Giovanni Francesco , Ferraro Giuseppe Andrea 
Published: November 2023

Summary:
Fanconi anemia (FA) is a very rare form of aplastic anemia. Patients with FA have a higher risk of developing solid tumors such as head and neck squamous cell carcinoma, higher risk of local recurrence, and impaired resistance to chemotherapy and radiotherapy treatments than the normal population. In this article, we describe the challenging clinical case of a patient with FA who underwent surgery for the removal of a large squamous cell carcinoma in the oral cavity. Mandibular reconstruction was performed using a biaxial double-barrel fibular flap, with excellent functional aesthetic outcomes.
Lumbar Osteomyelitis and Epidural Abscess Caused by Cardiobacterium hominis—First Reported Case in the Pediatric Population: The Role of Universal 16S rRNA Gene PCR and Sequencing
Authors: Al Zoubi Moamen , Khan Huma M. , Najafi Sona 
Published: November 2023

AbstractThis report presents a case of a 14-year-old female patient diagnosed with lumbar (L2–L3) epidural abscess and vertebral osteomyelitis caused byCardiobacterium hominis. The diagnosis was made using universal 16S rRNA polymerase chain reaction. To the best of our knowledge, this is the first reported case ofC. hominislumbar epidural abscess and vertebral osteomyelitis in pediatric population. This case serves to illustrate the potential value of polymerase chain reaction and DNA sequencing in diagnosing culture-negative vertebral osteomyelitis and the potential role ofC. hominisin causing this infection.
Effect of intrastromal corneal ring segments on in vivo corneal biomechanics in keratoconus: 1-year results
Authors: Vinciguerra Riccardo , Fernández-Vega-Cueto Luis , Roberts Cynthia J. , Poo-Lopez Arancha , Eliasy Ashkan , Merayo-Lloves Jesús , Elsheikh Ahmed , Madrid-Costa David , Lisa Carlos , Alfonso José F. 
Published: November 2023

Purpose:
To evaluate the 1-year effects of the implantation of intrastromal corneal ring segments (ICRS) in keratoconus (KC) on the dynamic corneal response (DCR) parameters obtained with the Corvis.

Setting:
Fernández-Vega Ophthalmological Institute, Oviedo, Spain.

Design:
Prospective, single-center, clinical study.

Methods:
Included were patients who underwent ICRS implantation for KC over a period of 1 year. On the day of the surgery and at least 6 months after ICRS implantation, the following measurements were made: corrected distance and uncorrected distance visual acuity, corneal tomography indices with the Pentacam, biomechanically corrected intraocular pressure and the Corvis DCRs (integrated inverse concave radius, deformation amplitude ratio, stiffness parameter at first applanation, stress–strain index [SSI] and the highest concavity radius).

Results:
30 eyes were included with a mean follow-up time of 15 months. Statistical analysis showed that ICRS implantation induced significant improvements in corneal biomechanics measurements between preoperative and long-term follow-up as demonstrated by a significant increase in SSI (P = .003). To confirm that this difference was actually induced due to a stiffening between early postoperative (previously published) and long-term an additional t-test was done between month 1 and late follow-up which confirmed a significant stiffening in the value of SSI (P = .01).

Conclusions:
Patients implanted with ICRS alone for KC showed a significantly stiffer response due to increased structural support compared with preoperative values and 1 month postoperative.
Prosthetic Curricular Threads: Pilot Survey of Clinical Practice and Physical Therapy Education
Authors: Corio Frances M. , Troiano Robert , Lee Daniel J. 
Published: November 2023

ABSTRACT

Introduction
Physical therapists play a critical role in the rehabilitation of persons with limb loss/limb difference. The introduction to the skills and knowledge necessary to provide skilled care occurs during the physical therapist’s education in an accredited physical therapy program. Although clinical practice evolves as technological changes manifest and the evidence base progresses, it is unclear whether physical therapy education is adapting to stay current with clinical practice.

Purpose
The aim of this study was to explore the alignment of clinical practice with physical therapy education as it relates to prosthetic-specific curriculum.

Methods
Surveys were sent to inpatient rehabilitation hospitals, prosthetic service clinics, and accredited physical therapy programs. Each survey was designed to assess both limb loss/limb difference rehabilitation and prosthetic specific-content germane to the setting being surveyed.

Results
Sixty-eight physical therapy programs, 48 prosthetic-service providers, and 14 rehabilitation hospitals responded. Just over one third of physical therapy education programs reported having a course dedicated solely to prosthetic-related content.
There was general alignment between what is being taught and what is being practiced in the clinics; however, there was variation in specific content and time devoted to prosthetic-related curriculum across programs.

Conclusions
Further alignment of prosthetic-related content and clinical practice is needed in physical therapy programs.

Clinical Relevance Statement
More careful alignment of prosthetic curricular content with clinical practice in physical therapy programs will increase the effectiveness of rehabilitation programs and help persons with amputations regain more function and quality of life.
Effect of carotid corrected flow time combined with perioperative fluid therapy on preventing hypotension after general anesthesia induction in elderly patients: A prospective cohort study
Authors: Huang Shishi , Liao Zhenqi , Chen Andi , Wang Jiali , Xu Xiaodong , Zhang Liangcheng 
Published: November 2023

Background:
Hypotension often occurs following the induction of general anesthesia in elderly patients undergoing surgery and can lead to severe complications. This study assessed the effect of carotid corrected flow time (FTc) combined with perioperative fluid therapy on preventing hypotension after general anesthesia induction in elderly patients.

Materials and methods:
The prospective cohort study was divided into two parts. The first part (Part Ⅰ) consisted of 112 elderly patients. Carotid FTc was measured using Color Doppler Ultrasound 5 minutes before anesthesia induction. Hypotension was defined as a decrease of greater than 30% decrease in systolic blood pressure (SBP) or a decrease of greater than 20% decrease in mean arterial pressure (MAP) from baseline, or an absolute SBP below 90 mmHg and MAP below 60 mmHg within 3 minutes after induction of general anesthesia. The predictive value of carotid FTc were determined using Receiver Operating Characteristic (ROC) curve. The second part (Part Ⅱ) consisted of 65 elderly patients. Based on the results in Part Ⅰ, elderly patients with carotid FTc below the optimal cut-off value received perioperative fluid therapy at a volume of 8 ml/kg balanced crystalloids (lactated Ringer solution) in 30 minutes before induction. The effect of carotid FTc combined with perioperative fluid therapy was assessed by comparing observed incidence of hypotension after induction.

Results:
The areas under the ROC for carotid FTc to predict the hypotension after induction were 0.876 [95% confidence interval (CI) 0.800-0.952, P<0.001]. The optimal cut-off value was 334.95 ms (sensitivity of 87.20%; specificity of 82.20%). The logistic regression analysis revealed that carotid FTc is an independent predictor for post-induction hypotension in elderly patients. The incidence of post-induction hypotension was significantly lower (P<0.001) in patients with Carotid FTc<334.95 ms who received perioperative fluid therapy (35.71%) compared to those who did not (92.31%).

Conclusions:
Carotid FTc combined with the perioperative fluid therapy could significantly reduce the incidence of hypotension after the induction of general anesthesia in elderly patients.
Short- and long-term outcomes after robotic versus open hepatectomy in patients with large hepatocellular carcinoma: a multicenter study
Authors: Zhang Xiu-Ping , Jiang Nan , Zhu Lin , Lin Zhao-Yi , Guo Wei-Xing , Chen Xiong , Ma Yun-Tao , Zhang Fan , Tang Yu-Fu , Chen Zi-Li , Yan Mao-Lin , Zhao Zhi-Ming , Li Cheng-Gang , Lau Wan Yee , Cheng Shu-Qun , Hu Ming-Gen , Liu Rong 
Published: November 2023

Background:
Robotic hepatectomy (RH) is currently widely accepted and it is associated with some benefits when compared to open hepatectomy (OH). However, whether such benefits can still be achieved for patients with large hepatocellular carcinoma (HCC) remain unclear. This study aimed to evaluate the short- and long-term outcomes of patients undergoing RH or OH.

Methods:
Perioperative and survival data from patients with large HCC who underwent RH or OH between January 2010 and December 2020 were collected from eight centers. Propensity score matching (PSM) was performed to minimize potential biases.

Results:
Using predefined inclusion criteria, 797 patients who underwent OH and 309 patients who underwent RH were enrolled in this study. After PSM, 280 patients in the robotic group had shorter operative time (median 181 vs. 201 min, P<0.001), lower estimated blood loss (EBL) (median 200 vs. 400 mL, P<0.001), and shorter postoperative length of stay (LOS) (median 6 vs. 9 d, P<0.001) than 465 patients in the open group. There were no significant differences between the two groups in overall survival (OS) and recurrence-free survival (RFS). Cox analysis showed AFP >400 ng/mL, tumour size >10 cm, and microvascular invasion were independent risk factors for OS and RFS. After PSM, subgroup analysis showed that patients with a huge HCC (diameter >10 cm) who underwent RH had significantly lower EBL (median 200.0 vs. 500.0 minutes, P<0.001), and shorter LOS (median 7 vs. 10 d, P<0.001) than those who underwent OH.

Conclusion:
Safety and feasibility of RH and OH for patients with large HCC were comparable. RH resulted in similar long-term survival outcomes as OH.
Predictive factors for persistent hypercalcemia following parathyroidectomy in patients with persistent hyperparathyroidism after kidney transplantation: A retrospective cohort study
Authors: Kim Byung-Chang , Kim Hyosang , Baek Chung Hee , Kim Young Hoon , Pak Shin Jeong , Kwon Douk , Cho Jae Won , Lee Yu-mi , Sung Tae-Yon , Chung Ki-Wook , Kim Won Woong 
Published: November 2023

Background:
Surgery for irreversible hyperparathyroidism is the preferred management for kidney transplant patients. We analyzed the factors associated with persistent hypercalcemia after parathyroidectomy in kidney transplant patients and evaluated the appropriate extent of surgery.

Materials and Methods:
We retrospectively analyzed 100 patients who underwent parathyroidectomy because of persistent hyperparathyroidism after kidney transplantation at a tertiary medical center between June 2011 and February 2022. Patients were divided into two groups: 22 with persistent hypercalcemia after parathyroidectomy and 78 who achieved normocalcemia after parathyroidectomy. Persistent hypercalcemia was defined as having sustained hypercalcemia (≥10.3 mg/dL) 6 months after kidney transplantation. We compared the biochemical and clinicopathological features between the two groups. Multivariate logistic regression analysis was used to identify potential risk factors associated with persistent hypercalcemia following parathyroidectomy.

Results:
The proportion of patients with serum intact parathyroid hormone (PTH) level >65 pg/mL was significantly high in the hypercalcemia group (40.9% vs. 7.7%). The proportion of patients who underwent less than subtotal parathyroidectomy was significantly high in the persistent hypercalcemia group (19.2% vs. 50%). Patients with a large remaining size of the preserved parathyroid gland (≥0.8 cm) had a high incidence of persistent hypercalcemia (29.7% vs. 52.6%). In the multivariate logistic regression analysis, the drop rate of intact PTH <88% on postoperative day (POD) 1 (odds ratio [OR] 10.3, 95% confidence interval [CI]: 2.7–39.1, P=0.001) and the removal of≤2 parathyroid glands (OR 6.8, 95% CI: 1.8–26.7, P=0.001) were identified as risk factors for persistent hypercalcemia.

Conclusion:
The drop rate of intact PTH <88% on POD 1 and appropriate extent of surgery for controlling the autonomic function were independently associated with persistent hypercalcemia. Confirmation of parathyroid lesions through frozen section biopsy or intraoperative PTH monitoring can be helpful in preventing the inadvertent removal of a parathyroid gland and achieving normocalcemia after parathyroidectomy.
Efficacy of Antiobesity Medications in Patients With Celiac Disease on a Gluten-free Diet
Authors: Anazco Diego , Fansa Sima , Ghusn Wissam , Gala Khushboo , Nicolalde Bryan , Tama Elif , Calderon Gerardo , Bledsoe Adam C. , Hurtado Maria D. , Murray Joseph A. , Acosta Andres 
Published: November 2023

Goals:
We aim to describe the weight loss outcomes of patients with celiac disease (CeD) taking antiobesity medications (AOMs) and compare it with the weight loss outcomes of patients without CeD taking AOMs.

Background:
Increasing rates of obesity and obesity-associated comorbidities have been previously reported in patients with CeD on a gluten-free diet. The effectiveness of AOMs in this population has not been previously described.

Methods:
In our retrospective cohort study, we matched 39 patients with treated CeD to 78 patients without CeD based on sex and AOM. We assessed the weight loss outcomes at 3, 6, and 12 months after starting the AOM in both cohorts and analyzed if there was a differential response when comparing by type of AOM [injectable glucagon-like peptide 1 (GLP-1) receptor agonists vs. oral non-GLP-1 AOMs].

Results:
Both cohorts had similar baseline demographic and anthropometric characteristics. At 12 months, the CeD cohort had a nonsignificantly inferior total body weight loss percentage compared with the cohort without CeD (6.5% vs. 9.5%, P=0.13). The CeD cohort had a similar proportion of patients achieving a total body weight loss percentage of ≥5% than the cohort without CeD (72.7% vs. 72.1%, P=1.00). No significant difference was observed when comparing the weight loss outcomes of injectables (GLP-1 receptor agonists) to oral AOMs. The proportion of patients reporting side effects was similar for both groups, regardless of the type of AOM.

Conclusion:
Patients with CeD taking AOMs had similar weight loss outcomes to patients without CeD. Hence, AOMs can be a safe and effective therapy for weight management in patients with CeD.