bluuebunny/crossref_metadata_2025_split huggingface dataset:
E69 Localised intraarticular pigmented villonodular synovitis in an adolescent patient: a case-based review of the literature
Authors: Adenitan Ajibade , Yerima Abubakar , Olaosebikan Hakeem , Faleye Ayodele , Lawan Aliyu Ibrahim 
Published: August 2023

Abstract

Introduction
Pigmented villonodular synovitis (PVNS) is a rare, locally aggressive subtype of tenosynovial giant cell tumours that affect the synovium of the joints and tendons, occurring either focally or diffusely associated with the deposition of hemosiderin into the involved joint(s) and soft tissues. Although PVNS is historically considered an inflammatory process, recent evidence suggests the possibility of a neoplastic transformation. In addition, despite being typically found as a monoarticular knee disorder, other large and small joints can also be affected.
The disease is rarely reported in African children, with most reported cases not histologically confirmed. We, therefore, present the first histologically proven case of localised intraarticular PVNS in an African teenager who presented with unilateral left knee swelling and pain.

Method/Setting
We report the case of a 16-year-old male teenager who presented to the rheumatology clinic with a nine-month history of non-traumatic anterior left knee swelling and pain that increased over time with associated difficulty walking and standing without aid. After clinical examination and relevant investigations, Magnetic Resonant Imaging (MRI) was done to confirm our suspicion of PVNS.

Findings/Treatment
Examination revealed a tender, swollen knee with a fluctuant palpable infrapatellar mass. Knee arthrocentesis yielded about 200mls of non-clotted hemorrhagic effusions. The patient had an open synovectomy following MRI, which was highly suggestive of pigmented villonodular synovitis with extensive suprapatellar bursitis. Specific histological findings (below) further confirmed the diagnosis. He commenced early physiotherapy, and symptoms resolved without recurrence of swelling eleven months after surgery.

Conclusion
This case highlights the visual presentation of an uncommon joint disorder and suggests it is considered a differential diagnosis of non-traumatic monoarticular pain and swelling in our rheumatology clinic set-up and among teenagers in whom juvenile rheumatoid arthritis would have been the first differential.
Key words: Pigmented villonodular synovitis, Synovectomy, Multinucleated giant cells
Contribution statement: AA conceived the idea to write the case report, draft the first manuscript, and manage the patient. YA, HO and AF edited the manuscript, while AIL interpreted the histological findings. All the authors approved the final version of the manuscript.
Disclosure statement: None declared.
Ethics and patient consent: This case report adheres to the Helsinki declaration, and the patient’s parents gave written consent to publish the details of the information.
Additional information: Any institution did not fund this publication.
Acknowledgements: We thank Dr Isaac Akanbi and Dr Bukar for interpreting the MRI and performing the surgery.
Workforce survey of PAs' genetic-genomic knowledge, attitudes, and application in practice
Authors: Patterson Wesley G. , Tribble Leta M. , Hopkins Casey S. , Fasolino Tracy K. , Ward Linda D. 
Published: August 2023

ABSTRACT

Objective:
This study surveyed practicing physician associates/assistants (PAs) about their genetics-genomics knowledge, attitudes, and application in practice.

Methods:
A 25-question electronic survey was emailed to each constituent organization of the American Academy of Physician Associates (AAPA) with a description of the study and a request to forward to their members. Additionally, a posting was displayed in the bulletin board section of the online AAPA Huddle.

Results:
Of the 420 PAs who completed the survey, few are knowledgeable (25%) about or confident (13%) in applying a genomic approach to patient care, although most (61%) think genetics-genomics is important to delivering high-quality care. Remarkably, 97% of PAs surveyed are interested in genetics-genomics continuing medical education.

Conclusions:
PAs lack knowledge and confidence in integrating genetics-genomics into patient care; however, they have a positive attitude toward genetics-genomics and want to improve their knowledge and confidence through education.
Whole Blood Administration for Obstetric-Related Hemorrhage During Prehospital Transport
Authors: Polzin Abigail , Smith Kaihlen , Rumpza Thomas 
Published: August 2023

BACKGROUND:
Whole blood transfusion has been used for resuscitation in trauma patients; however, case reports of whole blood transfusion for obstetric-related hemorrhage are limited. Whole blood transfusion typically is accomplished with low titer O-positive whole blood, and, despite success in trauma, use in persons with childbearing potential is of concern due to risk of alloimmunization.

CASE:
We present a case series of patients who received low titer O-positive whole blood for obstetric hemorrhage. One patient was Rh-negative and received immune globulin treatment after whole blood transfusion. All patients survived to hospital discharge. None experienced transfusion-related complications.

CONCLUSION:
Whole blood can be successfully administered both in and out of the hospital setting, even for obstetric hemorrhage. The benefits of easily administered balanced resuscitation, limited donor exposure, and improved patient outcomes likely outweigh potential alloimmunization, especially in resource-limited settings. Addressing concerns of alloimmunization cannot be accomplished without more research, and we encourage others to investigate using whole blood in this population.
Urinary levels of cortisol but not catecholamines are associated with those of 8-hydroxy-2’-deoxyguanosine in uncomplicated primary hypertension
Authors: Tomoda Fumihiro , Koike Tsutomu , Nitta Atsumi , Kurosaki Hiroko , Sugimori Hiroko , Oh-hara Maiko , Kinugawa Koichiro 
Published: August 2023

Objectives:
The relationships between stress hormones and oxidative DNA damage have not yet been explored in human hypertension. We investigated the associations of urinary levels of cortisol or catecholamines with those of 8-hydroxy-2′-deoxyguanosine, a marker of oxidative DNA damage in primary hypertension.

Methods:
Untreated 156 primary hypertensives without apparent cardiovascular diseases were entered into the study. Following blood sampling after an overnight fast, 24-h blood pressure monitoring and 24-h urinary sampling were performed simultaneously to determine 24-h averaged values for blood pressure and urinary levels of cortisol, catecholamines and 8-hydroxy-2′-deoxyguanosine.

Results:
Urinary cortisol significantly correlated positively with urinary 8-hydroxy-2′-deoxyguanosine in all studied participants (r = 0.334, P < 0.001). Contrary, either urinary adrenaline or urinary noradrenaline did not significantly correlate with urinary 8-hydroxy-2′-deoxyguanosine (r = 0.050, P = 0.553 or r = 0.063, P = 0.435). Additionally, the positive association of urinary cortisol with urinary 8-hydroxy-2′-deoxyguanosine remained highly significant after the adjustments for multiple confounders of oxidative stress such as age, gender, body mass index, smoking status, 24-h blood pressure, C-reactive protein and estimated glomerular filtration rate (partial r = 0.323, P < 0.001), although only approximately 10% of the variance in urinary cortisol was attributable to differences in urinary 8-OHdG (partial r
2 = 0.104). Thus, our data indicate that cortisol but not catecholamines could at least partially contribute to the occurrence of oxidative DNA damage in primary hypertensives.

Conclusion:
The present study suggested the possibility that the overactivation of hypothalamic−pituitary−adrenal axis rather than sympathoadrenal system could enhance oxidative stress and attendant DNA oxidation in uncomplicated primary hypertension.
Pseudoprogression in the era of immunotherapy-based strategies for recurrent head and neck squamous cell carcinoma achieving complete response: A case report
Authors: Zhou Jiawei , Luo Jie , Gu Jiajia , Zhang Jingyuan , Gu Dayong , Zhang Xiuming , Wang Feijiang , He Xia , Wu Lirong 
Published: August 2023

Rationale:
In the last few years, treatment of head and neck squamous cell carcinoma (HNSCC) has been enhanced by the emergence of immunotherapy. A biological phenomenon unique to immunotherapy is pseudoprogression, an increase in tumor burden or the appearance of a new lesion subsequently followed by tumor regression.

Patient concerns:
A 78-year-old man complaining of a lump (6*4 cm) gradually swelling on the right side of his neck with recurrent buccal mucosa squamous cell carcinoma presented to our institution. Two months prior, he received resection of the buccal lesion but refused suggested adjuvant chemoradiotherapy after the operation.

Diagnoses:
Recurrent buccal mucosa squamous cell carcinoma.

Interventions:
Induction immunotherapy was initiated, followed by a new node appearing on the surface of the neck mass. We considered the presence of pseudoprogression and continued with immunotherapy. The patient received immunotherapy combined with chemotherapy and intensity-modulated radiation therapy (IMRT) consecutively.

Outcomes:
The patient experienced an excellent recovery with the disappearance of pain and the lump, along with return of a healthy appetite, weight gain and positive outlook. Complete response (CR) was also noted by magnetic resonance imaging (MRI) scan, with the upper right neck mass significantly retreated to unclear display. The patient is still alive with stable, asymptomatic disease at the time of this writing.

Lessons:
These results provide confidence in the safety and efficacy of radical chemo-radio-immunotherapy for the treatment of recurrent, unresectable or metastatic HNSCC.
Effect of tibialis anterior muscle resistance training on ankle and foot dorsum extension function in hypertensive cerebral hemorrhage hemiplegia patients: A randomized controlled trial
Authors: Li Qiaoliang , Chen LiGang 
Published: August 2023

Background:
This study aimed to investigate the effect of tibialis anterior muscle resistance training on ankle and foot dorsum extension function in patients with hemiplegia caused by hypertensive cerebral hemorrhage.

Methods:
Fifty cases of hypertensive cerebral hemorrhage in patients with hemiplegia were selected according to the random number table method. The patients were divided into the treatment group and control group. Each group included 25 cases, and the treatment group was given routine rehabilitation treatment and passive and active foot back stretch training (300 times/d). The control group received conventional rehabilitation treatment. The conventional rehabilitation treatment included stretching, muscle strengthening and other conventional rehabilitation treatment techniques. Surface electromyography was used to evaluate the muscle strength and tension of the triceps and tibialis anterior muscles of the affected side of the patients before and after treatment. The root mean square value of the surface electromyography (RMS) of the passive triceps extension before and after treatment was used to evaluate the muscle strength and tension of the affected side. The ratio of passive traction and relaxation of the triceps before and after treatment and the ratio of active contraction and relaxation of the tibialis anterior muscle before and after treatment were recorded.

Results:
There was no significant difference in surface electromyography between the 2 groups before treatment (P > .05). After 2 months of treatment, the results of patients in both groups improved compared with those before treatment. The RMS of triceps in the treatment group was significantly lower than that in the control group, and the ratio of RMS of triceps in the treatment group was significantly lower than that in the control group. The RMS during active contraction and the RMS ratio between active contraction and relaxation of the tibialis anterior muscle in the treatment group were significantly higher than those in the control group (P < .05).

Conclusions:
Tibialis anterior muscle resistance training can effectively improve the strength of the tibialis anterior muscle in patients with hemiplegia caused by hypertensive cerebral hemorrhage, reduce tension in the triceps calf muscle, and improve ankle joint function and foot dorsum extension.
Evaluating the efficacy of moving cupping for chronic low back pain using shear wave elastography: A parallel-arm, randomized controlled trial
Authors: Kim Yeonhak , Kim Jihun , Lee Taewook , Kim Eunseok , Kim Kun Hyung , Yang Gi Young 
Published: August 2023

Background:
Chronic low back pain (CLBP) is a common condition that affects millions of people worldwide. Moving cupping has gained popularity as a complementary therapy for managing CLBP owing to its noninvasive and cost-effective nature. However, the lack of objective measures to assess its therapeutic effect has been a considerable challenge in evaluating the effectiveness of moving cupping for CLBP management.

Methods:
We developed a randomized controlled trial (RCT) protocol for evaluating the effectiveness of a noninvasive treatment using moving cupping by assessing muscle relaxation with shear wave elastography (SWE). It involves the recruitment of 68 patients with CLBP and randomly assigns them to either the treatment or control group. The treatment group will receive moving cupping therapy for 2 weeks, while the control group will receive placebo treatment. It will utilize SWE to evaluate muscle relaxation at baseline, after 2 weeks of treatment, and 1 week after the end of treatment. Subjective reports of pain intensity and quality of life are also recorded at each time point.

Discussion:
The protocol developed here utilizes SWE to objectively measure muscle stiffness, and coupled with moving cupping therapy, may be effective in conveying relative comparisons before and after treatment. Moving cupping therapy is expected to promote muscle relaxation and pain relief in patients with CLBP. This study has the potential to contribute to the development of objective measures for evaluating the therapeutic effects of traditional therapies and to provide valuable insight into their efficacy.
Surgical treatment of subchondral osteonecrosis of the humeral head: A case report and literature review
Authors: Liu Yongsheng , Zhong Jia , Jiang Zhaowei , Shen Duo , Zhao Daohong 
Published: August 2023

Background:
Osteonecrosis of the humeral head is an uncommon subchondral bone disease with many etiologies, and there is currently no definite evidence to support an optimal surgical treatment plan. We report a case of surgical treatment of left humeral head necrosis. To the best of our knowledge, this is the youngest patient with non-drug-induced humeral head necrosis and the largest collapsed area.

Case presentation:
The case involved a 16-year-old male who injured his left shoulder 1 year ago. The patient was admitted to the hospital because of shoulder pain after activity in the year following the injury. During the physical examination, the left glenohumeral joint space was tender, the pain was obvious when the shoulder joint was rotated and squeezed, and the active and passive range of motion was normal. X-ray, magnetic resonance imaging, and computed tomography + 3D computed tomography scans all showed subchondral osteonecrosis of the left humeral head. Left humeral head lesion removal and autologous osteochondral transplantation were performed, and the patient was followed up.

Conclusion:
Non-drug-induced humeral head necrosis is rare. Autologous osteochondral transplantation is currently one of the most mature and effective treatment methods. The short-term curative effect in this patient is satisfactory, but the patient is young and has a large collapsed area, so long-term follow-up is worthwhile.
Efficacy and safety of an extended-release sebacoyl dinalbuphine ester for laparoscopic cholecystectomy: A randomized controlled trial
Authors: Lee Ying-En , Fu Chen-Yu , Shiue Yow-Ling , Lu Chu-Yun , Chen Chung-Yen , Chen Jian-Han , Chen Jen-Lung , Lam Chen-Fuh 
Published: August 2023

Background:
A long-acting κreceptor agonist parenteral analgesic may theoretically improve acute pain and reduce incidence of chronic postsurgical pain (CPSP) after laparoscopic cholecystectomy with minimal drug-related side effects of the traditional μreceptor opioids.

Methods:
Eighty adult patients undergoing elective laparoscopic cholecystectomy were randomly assigned to receive single intramuscular injection of an extended-release sebacoyl dinalbuphine ester (SDE, Naldebain 150 mg; n = 40) or placebo (n = 40) after anesthesia induction. Standard multimodal analgesia (MMA) was administered for postoperative pain control. The primary endpoint was pain intensity within 7 days after surgery. The secondary endpoints were incidence CPSP at 3 months and adverse reactions up to 7 days after surgery.

Results:
The highest visual analogue scale (VAS) and area under the curve of VAS 0 to 48 hours after operation were not different between the two groups and a similar proportion of patients requested rescue parenteral analgesics. Average pain intensities were also not different at 72 hours and 7 days after surgery. Incidence of CPSP was 22.5% and 13.1% in patients who received placebo and SDE treatment, respectively (P = .379). Significantly higher incidence of drug-related adverse events, including dizziness, nausea and injection site reactions, were recorded in the SDE group.

Conclusion:
A single dose of extended-release analgesic SDE given intraoperatively did not provide sufficient add-on effect for acute and chronic pain management after laparoscopic cholecystectomies in patients who received standard postoperative MMA. Intramuscular injection of 150 mg SDE in patients with average body mass causes adverse events that could have been overlooked. More clinical studies are warranted to determine the target populations who may benefit from SDE injections for improvement of acute and chronic postsurgical pain management.
Efficacy and safety of tralokinumab in the treatment of atopic dermatitis: A systematic review and meta-analysis of randomized controlled trials
Authors: Zhao Dan-Jie , Huang Ling-Mei , Xiao Jie , Chen Long , Li Xia , Lin Hai-Xia 
Published: August 2023

Background:
To assess the efficacy and safety of Tralokinumab in the treatment of moderate-to-severe atopic dermatitis (AD).

Methods:
PubMed, Embase, Clinical Trials Website, and Cochrane Library were systematically searched for eligible randomized controlled trials which assessed the effects of Tralokinumab on AD. Primary outcomes included Scoring Atopic Dermatitis score, EASI-75%, and Investigator’s Global Assessment score of 0 or 1 in 12 to 16 weeks. Secondary outcomes included the Eczema area and severity index score, the Numeric Rating Scales score, the dermatology life quality index score, and the overall incidence of adverse events. The quality of included studies was evaluated using the Cochrane System and the modified Jadad scale. Analysis was performed using Stata 16 software.

Results:
Eight randomized controlled trials involving 2878 patients were included in this meta-analysis. Compared to placebo, Tralokinumab treatment exhibited a significantly higher Scoring Atopic Dermatitis score [SMD = −0.53, 95% confidence intervals [CI]: −0.62 to −0.44, P < .00001], an increased number of patients with EASI-75% [odds ratio (OR) = 2.44, 95% CI: 2.00–2.97, P < .00001] and Investigator’s Global Assessment score of 0 or 1 in 12 to 16 weeks [OR = 2.12, 95% CI: 1.71–2.63, P < .00001]. No significant difference was observed in the incidence of overall adverse events [OR = 1.00, 95% CI: 0.85–1.18, P = 1.00] between the 2 groups.

Conclusion:
Tralokinumab is effective and safe in treatment of moderate-to-severe AD.
Efficacy and safety of scalp acupuncture for poststroke depression: A meta-analysis and systematic review
Authors: Jiang Wenxi , Jiang Xicheng , Yu Tianyang , Gao Yang , Sun Yuanzheng 
Published: August 2023

Background:
Poststroke depression (PSD) is a common clinical poststroke complication that adversely affects cognitive and physical function rehabilitation. Scalp acupuncture (SA) can significantly improve somatic dysfunction and emotional disorder in stroke patients. This meta-analysis aims to evaluate the effectiveness and safety of SA in the treatment of PSD.

Methods:
We conducted a comprehensive search of multiple electronic databases, including PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge Internet, China Science and Technology Journal Database, Wan Fang Data Knowledge Service Platform, and China Biology Medicine databases until December 20, 2022, to identify randomized controlled trials investigating the efficacy of SA in the treatment of PSD. Two independent researchers screened the literature, extracted data, and assessed the risk of bias in the included studies based on the inclusion and exclusion criteria. We performed a meta-analysis of the eligible literature using RevMan 5.4.1 and Stata 15.0 software.

Results:
This study comprised a total of 14 randomized controlled trials, 10 of which used SA and 4 of which used SA in combination with electroacupuncture therapy. The results of the meta-analysis revealed that the effective rate of the SA group was significantly higher than that of the Western medicine group (relative risk = 1.09, 95% confidence interval (CI) [1.02, 1.16], P = .008). Moreover, compared to the Western medicine group, the SA group demonstrated significant improvements in Hamilton depression scale scores (mean difference = −2.29, 95% CI [−3.88, −0.70], P = .005) and neurological function deficit scores (mean difference = −3.06, 95% CI [−5.91, −0.21], P = .04). Additionally, the SA group has a lower incidence of adverse events than the western medicine group (relative risk = 0.12, 95% CI [0.05, 0.29], P < .00001).

Conclusion:
SA has superior efficacy and safety compared to Western medicine for PSD. These findings suggest that SA could be a promising alternative treatment for the assessed condition. Due to the limited number and quality of the included literature, the above conclusions must be confirmed by additional high-quality research.