bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neglected bilateral geno valgum deformity managed with a dynamic compression plate and the ilizarov construct: a case report
Authors: Ibrahim Yasin B. , Mohamed Abdullahi Y. , Ibrahim Hassan S. , Cicek Engin I. , Mohamed Abdulkhalek H. , MAY Hasan 
Published: April 2023

Introduction:
Deformities of the lower limb are common in childhood; however, they are mainly variations of the natural growth pattern. The rare case showed up late with a genu valgum deformity centered on both tibias and a closed physis.

Case presentation:
A 20-year-old male has suffered from bilateral knee pain and genu valgum deformity centered at both tibias with a closed physis. Management was challenging, requiring multiple surgeries and high patient cooperation. The patient underwent two surgeries: a right-sided osteotomy and Ilizarov fixation with gradual deformity correction. In the second operation, a proximal tibia osteotomy of the left side was executed with acute correction of the deformity and open reduction and internal fixation of the tibia with a medial tibial dynamic compression plate. Ultimately, the authors successfully corrected both leg deformities.

Conclusion:
This results reflect the efficacy of dynamic compression plates and Ilizarov for correcting genu valgum deformity in patients with closed epiphyseal plates.
The sCD14-ST predictive value in the development of adverse outcomes in operated colorectal cancer patients (diagnostic study)
Authors: Turgunov Yermek , Ogizbayeva Alina , Avdiyenko Olga , Mugazov Miras , Shakeyev Kayrat , Komarov Timofey , Asamidanova Sofiko 
Published: April 2023

Background:
The main aim was to analyze dynamic changes in the level of soluble CD14 subtype (sCD14-ST) in blood serum and assess it as a possible risk factor for the development of systemic inflammatory response syndrome, infectious and inflammatory complications, organ dysfunction, and mortality in operated colorectal cancer (CRC) patients.

Materials and methods:
For the period 2020–2021, 90 operated CRC patients were examined. Patients were divided into two groups: 1 – 50 patients operated on for CRC without acute bowel obstruction (ABO); 2 – 40 patients operated on for tumor ABO caused by CRC. To determine sCD14-ST by the ELISA (enzyme-linked immunosorbent assay) method, venous blood was taken 1 h before surgery and 72 h after it (third day).

Results:
sCD14-ST levels were higher in CRC patients with ABO, organ dysfunction, and dead patients. If the sCD14-ST level on the third day after surgery is greater than 520 pg/ml, the risk of a fatal outcome is 12.3 times higher than at its lower level [odds ratio (OR): 12.3, 95% CI: 2.34–64.20]. With the increase in the sCD14-ST level on the third day after surgery from baseline or its decrease by no more than 8.8 pg/ml, the risk of organ dysfunctions is 6.5 times higher than with its greater decline (OR: 6.5, 95% CI: 1.66–25.83).

Conclusions:
This study has demonstrated that in CRC patients, sCD14-ST can be used as a predictive criterion for the development of organ dysfunction and death. Significantly worse results and prognosis were observed in the patients with higher levels of sCD14-ST on the third day after surgery.
Emergent surgical interventions in noncritical traumatic long bone fractures and lactate monitoring: a retrospective cohort study
Authors: Hong Jeffrey , Malkoc Aldin , Salahpour Sofia , Wong David T. , Dong Fanglong , Neeki Michael 
Published: April 2023

Background:
Serum lactate levels have been recommended as a standard in guiding resuscitation and management of post-traumatic orthopedic injuries. Studies have suggested an increased incidence of postoperative complications in trauma patients with injury severity scores (ISSs) greater than 18. However, in trauma patients without an elevated ISS, the role of lactate in guiding operative timing has not been explored. This study considers the role of lactate measurement with respect to surgical timing and predicting postoperative complications in trauma patients with long bone fractures and an ISS less than 16.

Materials and methods:
A total of 164 patients, ages 18 and above with long bone fractures and ISS less than 16 were sampled in the last 5 years. Demographic data was ascertained. Patients were placed into two cohorts with a serum preoperative lactate greater than or equal to 2.0 mmol/l and a serum preoperative lactate less than 2.0 mmol/l. Key endpoints included hospital mortality, length of hospitalization (LOH), discharge designation, and postoperative complications.

Results:
A total of 148 patients had a lactate level less than 2.0 mmol/l and 16 had a lactate greater than or equal to 2.0 mmol/l. There was no significant difference in demographics between these two preoperative lactate groups. There was no statistical difference when considering mortality, discharge designation, LOH, and postoperative complications.

Conclusion:
Lactate levels assist providers in guide resuscitative efforts in trauma patients. However, this study finds that preoperative lactate measurements and efforts made to normalize lactate level are not correlated with mortality, LOH, and postoperative complications in trauma patients with an ISS less than 16. This study does not support preoperative lactate normalization in guiding surgical timing.
High incidence of adult respiratory distress syndrome associated with amphetamine use in the burn population: a retrospective cohort study
Authors: Wong David T. , Malkoc Aldin 
Published: April 2023

Background:
A high incidence of adult respiratory distress syndrome (ARDS) is observed in patients with a history of amphetamine use with limited studies addressing this exact topic. The authors sought to understand and compare the clinical features of patients experiencing amphetamine-associated lung injury with features of similar patients naïve to amphetamines, in a population of burn patients. Patients in this population tend to be young with few comorbidities offering a unique opportunity to study the relationship between amphetamine use and ARDS.

Materials and methods:
A total of 188 patients age 18 and older with total body surface area (TBSA) between 20 and 60% were sampled over 5 years. To capture the moderate to severe burn population, a lower limit of 20% was chosen while 60% was used as the upper limit to exclude patients likely to die from the burns alone. Patients eligible to be include in the study had to meet the TBSA criteria. Demographic data was ascertained. Patients were placed into two cohorts: the amphetamine positive group (AmPOS), the amphetamine negative group (AmNEG). Key endpoints included hospital mortality, length of ICU stay, development of ARDS, and cardiac output parameters. Nonparametric data was evaluated with the Mann–Whitney test and categorical variables were compared using χ
2.

Results:
Data from 49 patients with ARDS were collected retrospectively out of the 188 patients in this TBSA range. The incidence of amphetamine abuse in these burn patients is 14.9%. The average age of AmPOS and AmNEG patients was 36 and 34 and the average TBSA of burns in the AmPOS and AmNEG group was 51.8 and 45.2%. The mean onset of ARDS was 2.2 days for the AmPOS versus 3.3 days for the AmNEG (P=0.19). At admission, patients with amphetamine use exhibited less inhalational injury and a lower Acute Physiology and Chronic Health Evaluation II (APACHE II) score. In AmPOS, 64% developed ARDS compared to 19% in AmNEG (P<0.001). Mortality, time on a ventilator, ICU days, packed Red Blood Cell, Fresh Frozen Plasm, platelets transfused, and initial cardiac parameters all were not statistically significant. On the initial date of ARDS diagnosis, there was no statistically significant difference with PaO2/FiO2 and compliance (P=0.67), but positive end expiratory pressure requirements was higher in AmPOS (P=0.018).

Conclusions:
Amphetamine Use was associated with increased risk of developing ARDS in the burn population. This is despite having a better APACHE II and lower incidence of inhalational injury in the AmPOS group, supporting amphetamine as an independent risk factor for ARDS.
The role of magnetic resonance tumour regression grade in the prediction of regression and survival of rectal adenocarcinoma after long-course chemoradiotherapy: a cohort study
Authors: Chen Hui Lionel Raphael , Seow-En Isaac , Chok Aik Yong , Ngo Nye Thane , Cheng Tim-Ee Lionel , Tan Kwong-Wei Emile 
Published: April 2023

Introduction:
Rectal cancer response to neoadjuvant long-course chemoradiotherapy (LCCRT) is assessed by magnetic resonance tumour regression grade (mrTRG) and this has an impact on surgical management. However, there is limited data on the correlation between mrTRG and pathological tumour regression grade (pTRG). This study aims to evaluate the correlation between mrTRG and pTRG and the prognostic value of mrTRG on survival.

Methods:
Between 2011 and 2016, patients with rectal cancer who underwent LCCRT and had post-LCCRT MRI were included in the study. Both mrTRG and pTRG were dichotomised into good responders (mrTRG 1–3 and pTRG 0–1) and poor responders (mrTRG 4–5 and pTRG 2–3). Correlation between mrTRG and pTRG was assessed with Cohen κ analysis. Survival analysis was performed with Kaplan–Meier test and Cox proportional hazard models.

Results:
There were 59 patients included in this study. There were significant reductions in anal sphincter and circumferential resection margin involvement in post-LCCRT MRI. Fair agreement was found between mrTRG and pTRG (κ=0.345). Sensitivity, specificity and accuracy of mrTRG 1–3 to predict good pathological response were 100%, 46.3% and 62.7%, respectively. On survival analysis, mrTRG 1–3 was not associated with improved overall survival and recurrence-free survival.

Conclusions:
While there is fair agreement in correlation between mrTRG and pTRG, MRI remains an objective, noninvasive assessment of tumour response. Further studies are required to improve the ability of mrTRG to predict good responders to LCCRT and evaluate its role as a prognostic marker for survival.
A prospective, international, bicentric study to evaluate PremiCron suture material for cardiac valve surgery – PREMIVALVE a cohort study
Authors: Rufa Magdalena , Ursulescu Adrian , Baumann Petra , Ferrer Manel T. 
Published: April 2023

Introduction:
The most common age-related heart valve diseases include aortic valve stenosis and mitral valve insufficiency. The suture material is not the focus of most studies. The aim of the study was to assess the performance of PremiCron suture material for cardiac valve reconstruction and/or replacement under clinical routine. Performance was evaluated using the incidence of major adverse cardiac and cerebrovascular events (MACCE) combined with endocarditis.

Materials and methods:
The study was designed as an international, prospective, bicentric, observational, single-arm study to evaluate the PremiCron suture material in cardiac valve surgery and compare the outcome with literature data regarding postoperative complications. The primary endpoint was a composite of MACCE acquired in the hospital, combined with endocarditis occurring up to 6 months postoperatively. The secondary parameters were intraoperative handling of the suture, incidence of MACCE and other relevant complications and quality of life up to 6 months after surgery. Patients were examined at discharge, 30 days, and 6 months postoperatively.

Results:
A total of 198 patients were enrolled in two centers in Europe. The cumulative primary endpoint event rate was 5.0%, lower than the reference value of 8.2% from the literature. Comparison of the incidence of individual MACCE until discharge and endocarditis rate 6 months postoperatively also showed that our data were within the range of the published rates. Quality of life significantly increased from preoperatively to 6 months after surgery. Ease of handling of the suture material was rated as very good.

Conclusion:
The PremiCron suture material is safe and very eligible for cardiac valve replacement and/or cardiac valve reconstruction in a broad patient population with a cardiac valve disorder treated under daily clinical practice.
Xanthogranulomatous pyelonephritis mimicking renal cell carcinoma: a case report
Authors: Daoud Nagham , Ismaiel Nahar , Bashour George , Nammour Ali , Barri Ali , Alshehabi Zuheir 
Published: April 2023

Introduction and importance:
Xanthogranulomatous pyelonephritis (XGPN) is a rare, serious, and chronic inflammatory disorder of the kidney characterized by a destructive process that invades the renal parenchyma, which is most commonly associated with urinary tract obstruction and infection. It affects women more often than men.

Case presentation:
Herein, the authors report a case of a 48-year-old male presented to their hospital with complaints of malaise, fever, chills, left flank pain, and a history of a staghorn calculus in the renal pelvis, which was removed by surgery 7 years ago. Ultrasonography and computed tomography scans showed an enlarged left kidney with cystic formation and pelvicalyceal system dilation with the presence of multiple large stones. The renogram showed a dysfunctioning left kidney. An open radical left nephrectomy was performed. Renal cell carcinoma (RCC) was suspected in both the gross and microscopic examinations. The immunohistochemistry was the decisive factor in confirming the diagnosis of XGPN.

Clinical discussion:
Preoperative and postoperative diagnosis of XGPN can sometimes be difficult due to diverse differential diagnoses. The misinterpretation of ‘foam cells’ as ‘clear cells’ consistent with RCC is the most important diagnostic challenge for pathologists.

Conclusion:
The unusual findings of this case report suggest a careful evaluation of patients with a renal cystic mass, that can be misdiagnosed as a RCC. A combined computed tomography scan evaluation together with histopathology and immunohistochemistry are essential for a correct diagnosis of this rare renal entity.
De novo mutation of the TSC2 gene in patient with Tuberous Sclerosis Complex-Associated Neuropsychiatric Disorders (TAND) Phenotype: a case report
Authors: Triono Agung , Herini Elisabeth S. , Iskandar Kristy , Hadiyanto Marissa L. , Diantika Kania , Wijayanti Veronica W. , Gunadi  
Published: April 2023

Introduction:
Tuberous sclerosis complex (TSC) is a neurocutaneous disease caused by a mutation in the TSC1 or TSC2 gene. There are several neuropsychiatric manifestations associated with TSC known as TSC-associated neuropsychiatric disorder (TAND). This article concerns neuropsychiatric manifestations in children with the TSC2 gene mutation, with genetic analysis findings using whole-exome sequencing.

Case:
A 17-year-old girl presented with TSC, absence and focal epilepsy, borderline intellectual functioning, organic psychosis, and renal angiomyolipoma. She was emotionally unstable and preoccupied with irrelevant fears. In the physical examination, we found multiple hypomelanotic maculae, angiofibroma, and a shagreen patch. The intellectual assessment result with the Wechsler Adult Intelligence Scale at 17 was borderline intellectual functioning. Brain MRI showed cortical and subcortical tubers in the parietal and occipital lobes. Whole-exome sequencing was conducted, and the result was a missense mutation in exon 39 of the TSC2 gene [NM_000548.5:c.5024C>T (NP_000539.2:p.Pro1675Leu)]. The Sanger sequencing of the patient’s parents revealed no mutations in the TSC2 gene, confirming the patient’s de novo mutation. The patient was given several antiepileptic and antipsychotic drugs.

Clinical discussion:
Neuropsychiatric manifestation is a common phenotype in the TSC variant, and psychosis is one of the rare TAND symptoms in children.

Conclusions:
The neuropsychiatric phenotype and genotype in TSC patients are rarely reported and evaluated. We reported a female child with epilepsy, borderline intellectual functioning, and organic psychosis associated with a de novo mutation of the TSC2 gene. Organic psychosis is a rare symptom of TAND which also manifested in our patient.
Acute cerebral ischemic stroke as a presentation of polycythemia vera: a case report and a review of literature
Authors: Siyad Mohamed Osman , Osman Mohamed Farah , Adan Abdisamad Mohamed , Hassan Mohamed Sheikh , Jeele Mohamed Osman Omar 
Published: April 2023

Introduction:
Polycythemia vera (PV) is a disease of stem cells characterized by pan hyperplastic, malignant, and neoplastic bone marrow conditions. It is characterized by an increased absolute red blood cell count due to uncontrolled red blood cell synthesis, as well as excessive white blood cell and platelet production. Although the relationship between PV and stroke, especially ischemic stroke, is widely known around the world, no previous cases have been reported from Somalia.

Case presentation:
In the presenting study, we report a 60-year-old male patient who presented with a right-side weakness for 3 days. After laboratory and brain imaging, he was diagnosed with an acute cerebral infarct affecting the left basal ganglion secondary to PV.

Conclusions:
PV as the cause of ischemic stroke is a rare condition but can be encountered in clinical practice, and clinicians should be familiar with this combination.
Subpectoral Implant Placement is not Protective Against Postmastectomy Radiotherapy-Related Complications Compared to Prepectoral Placement
Authors: Hassan Abbas M. , Asaad Malke , Morris Natalie , Kumar Saloni , Liu Jun , Mitchell Melissa P. , Shuck John W. , Clemens Mark W. , Butler Charles E. , Selber Jesse C. 
Published: April 2023

Background:
Postmastectomy radiotherapy (PMRT) is associated with altered cosmetic outcomes and higher complication rates in implant-based breast reconstruction (IBR). Conventional wisdom suggests that muscle coverage is somewhat protective against PMRT-related complications. In this study, we compared surgical outcomes in patients who underwent two-stage prepectoral versus subpectoral IBR in the setting of PMRT.

Methods:
We performed a retrospective cohort study of patients who underwent mastectomy and PMRT with two-stage IBR from 2016 to 2019. The primary outcome was breast-related complications, including device infection; the secondary outcome was device explantation.

Results:
We identified 179 reconstructions (101 prepectoral, 78 subpectoral) in 172 patients with a mean follow-up time of 39.7±14.4 months. There were no differences between the prepectoral and subpectoral reconstructions in rates of breast-related complications (26.7% and 21.8%, respectively; P = .274), device infection (18.8% and 15.4%, respectively; P = .307), skin flap necrosis (5.0% and 1.3%, respectively; P = .232), or device explantation (20.8% and 14.1%, respectively; P = .117). In adjusted models, compared with prepectoral device placement, subpectoral device placement was not associated with a lower risk of breast-related complications (hazard ratio [HR], 0.75; 95% confidence interval [CI], 0.41-1.36), device infection (HR, 0.73; 95% CI, 0.35-1.49), or device explantation (HR, 0.58; 95% CI, 0.28-1.19).

Conclusion:
Device placement plane was not predictive of complication rates in IBR in the setting of PMRT. Two-stage prepectoral IBR provides safe long-term outcomes with acceptable postoperative complication rates comparable to those with subpectoral IBR, even in the setting of PMRT.
Tsuneonella litorea sp. nov., a novel carotenoid-producing bacterium isolated from coastal sediment
Authors: He Yizhou , Liu Yang , Pei Tao , Duan Jiao , Du Juan , Deng Xiaoqin , Zhu Honghui 
Published: April 2023

A Gram-stain-negative, aerobic, non-motile and pleomorphic bacterium designated as YG55T was isolated from a coastal sediment sample. Growth was found to occur at 10–37 °C (optimum, 28 °C), at pH 6–9 (optimum, pH 8) and in 0–6 % NaCl (optimum, 1 %). The results of 16S rRNA gene-based analysis showed that strain YG55T was related to the members of the genus

Tsuneonella

and shared the highest identity of 99.4 % with

Tsuneonella dongtanensis

GDMCC 1.2307T, followed by

Tsuneonella troitsensis

JCM 17037T (98.4 %). The phylogenomic results indicated that strain YG55T formed an independent branch distinct from the reference type strains. The 22.7 and 21.8 % digital DNA–DNA hybridization (dDDH) values and 83.0 and 81.8 % average nucleotide identity (ANI) values between strain YG55T and the two relatives were below the species definition thresholds of 70 % (dDDH) and 95–96 % (ANI), indicating that the strain represents a novel genospecies. The results of chemotaxonomic characterization indicated that the major cellular fatty acids of strain YG55T were summed feature 8 (C18 : 1
ω6c and/or C18 : 1
ω7c), C14 : 0 2OH and C16 : 0; the main polar lipids comprised diphosphatidylglycerol, phosphatidylethanolamine, phosphatidylglycerol, phosphatidylcholine and sphingoglycolipid; the respiratory quinone was ubiquinone-10. The genomic size and DNA G+C contents were 3.03 Mbp and 66.98 %. The strain contained carotenoid biosynthesis genes and could produce carotenoids. Based on its genotypic and phenotypic characteristics, strain YG55T is concluded to represent a novel species of the genus

Tsuneonella

, for which the name Tsuneonella litorea sp. nov. is proposed. The type strain is YG55T (=GDMCC 1.2590 T=KCTC 82812T).
Utility of a new lower limb and trunk functional evaluation for pitchers with focus on the physical characteristics of players with a throwing disorder
Authors: Matsui Tomoyuki , Azuma Yoshikazu , Hiramoto Machiko , Seo Kazuya , Miyazaki Tetsuya , Matsuzawa Kanta , Kida Noriyuki , Morihara Toru 
Published: April 2023

AbstractObjectivesA pitching motion involves three-dimensional whole body movement. Proper pelvic and trunk rotation movement are important for the prevention of throwing injuries. Given that throwing is not a simple rotation movement, the evaluation of proper motion should reflect muscle strength as well as coordination and pitching motion characteristics. We have devised a throwing rotational assessment (TRA) as a new evaluation of the total rotation angle required for throwing. The purpose of this study was to examine the characteristics of players with throwing disorders compared to a pain-free group using TRA.Materials and methodsThe subjects consisted of 164 high school baseball pitchers who participated in a medical check. Pain-induced tests included an elbow hyperextension test and an intra-articular shoulder impingement test. Pitchers who felt pain in either test were classified into a disorder group (n=61). With the subjects in a position similar to the foot contact phase of throwing, the rotation angles of the pelvis and trunk were measured. All tests were performed in the throwing and opposite directions.ResultsThe disorder group had significantly lower average rotation angles of the pelvis and trunk in the throwing direction and the rotation angle of the trunk in the opposite direction compared to the healthy group.ConclusionTRA reflects the complex whole body rotation movement. Reductions in rotational angles as assessed in TRA may be associated with throwing disorders. TRA is a simple method that may be useful in the early detection of a throwing disorder and could be used in the systematic evaluation during a medical check, as well as during self-check in the sports field.