bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does Rectoanal Intussusception Limit Improvements in Clinical Outcome and Quality of Life after Sacral Nerve Stimulation for Fecal Incontinence?
Authors: Dawes Aaron J. , Mariscal Juan , White Peter , Midura Emily F. , Sirany Anne E. , Lowry Ann C. , Jensen Christine C. , Thorsen Amy J. 
Published: March 2023

BACKGROUND:
Sacral nerve stimulation is a treatment option for severe, medically refractory fecal incontinence, although its use in patients with anatomic abnormalities remains controversial.

OBJECTIVE:
To determine if patients with rectoanal intussusception achieve similar benefits from device implantation to patients without rectoanal intussusception

DESIGN:
Retrospective review of a prospectively maintained database. Demographics and clinical data were collected for each patient, including pre-operative pelvic floor testing. Defecographies were re-analyzed in a blinded fashion. Pre-operative rectoanal intussusception was determined based on the Oxford system (grade III-IV vs. not; grade V excluded).

SETTINGS:
Academic-affiliated pelvic health center

PATIENTS:
All patients undergoing sacral nerve stimulation for fecal incontinence between July 2011 and July 2019

MAIN OUTCOME MEASURES:
Cleveland Clinic Florida Incontinence/Wexner Scores, Fecal Incontinence Severity Indices, Fecal Incontinence Quality of Life Indices at 1 year

RESULTS:
169 patients underwent sacral nerve stimulation for fecal incontinence during the study period. The average age was 60.3 years old and 91% were female. Forty-six patients (27.2%) had concomitant rectoanal intussusception (38 [22.5%] grade III and 8 [4.7%] grade IV). Before surgery, patients reported an average of 10.8 accidents per week and a Wexner score of 15.7 with no difference between patients with and without rectoanal intussusception (p = 0.22 and 0.95). At 1 year after surgery, the average Wexner score was 9.5. There was no difference in post-operative Wexner scores (10.4 vs. 9.2, p = 0.23) or improvement over time between patients with and without rectoanal intussusception (-6.7 vs. -5.7, p = 0.40). Similarly, there was no difference in quality of life or frequency of incontinence to liquid or solid stool.

LIMITATIONS:
Single institution, moderate sample size, incomplete survey response

CONCLUSION:
Concomitant rectoanal intussusception does not appear to affect clinical outcomes or quality of life after sacral nerve stimulation for fecal incontinence. Appropriate patients with fecal incontinence and rectoanal intussusception can be considered for sacral nerve stimulation placement.
The comparison of caesarean section bleeding between volatile and total intravenous anaesthesia in a Japanese nationwide database
Authors: Shimada Kensuke , Iwagami Masao , Makito Kanako , Shigemi Daisuke , Uda Kazuaki , Ishimaru Miho , Komiyama Jun , Morita Kojiro , Matsui Hiroki , Fushimi Kiyohide , Yasunaga Hideo , Tanaka Makoto , Tamiya Nanako 
Published: March 2023

BACKGROUND
Volatile anaesthesia may increase blood loss because of the uterine-relaxing effect of the volatile anaesthetics during caesarean section under general anaesthesia.

OBJECTIVE
This study compared the bleeding risk during caesarean section between volatile anaesthesia and total intravenous anaesthesia (TIVA) using a nationwide inpatient database in Japan.

DESIGN
Observational study.

SETTING
Nationwide inpatient database in Japan from April 2012 to March 2020.

PATIENTS
Women who underwent caesarean section under general anaesthesia.

MAIN OUTCOME MEASURES
Volume of blood loss.

RESULTS
We identified 26 585 women, including 19 320 in the volatile anaesthesia group (mean age = 32.9 ± 5.5 years) and 7265 in the TIVA group (mean age = 32.8 ± 5.5 years). The mean blood loss was 1113 ± 909 and 1136 ± 944 ml and the proportion of blood transfusion was 14.7 and 16.0% in the volatile and TIVA groups, respectively. With conventional regression analyses, volatile anaesthesia was associated with a slightly lower risk of bleeding: the adjusted mean difference for blood loss (95% CI) was −56.1 (−81.4 to −30.7). However, in the instrumental variable analysis, volatile anaesthesia was associated with a higher risk of bleeding: adjusted mean difference for blood loss (95% CI) was 154.3 (112.4 to 196.3) ml.

CONCLUSION
This large observational study with instrumental variable analyses suggested an increased bleeding risk associated with volatile anaesthesia, and the results were not identical to those in the conventional regression analyses.
Exposure-response relationship of residential dampness and mold damage with severe lower respiratory tract infections among under-five children in Nigeria
Authors: Fakunle Adekunle Gregory , Jafta Nkosana , Okekunle Akinkunmi Paul , Smit Lidwien A. M , Naidoo Rajen N. 
Published: March 2023

Background:
Previous epidemiological studies demonstrated an increased risk of respiratory health effects in children and adults exposed to dampness or mold. This study investigated associations of quantitative indicators of indoor dampness and mold exposure with severe lower respiratory tract infections (LRTI) among children aged 1–59 months in Ibadan, Nigeria.

Methods:
In-home visits were conducted among 178 children hospitalized with LRTI matched by age (±3 months), sex, and geographical location with 180 community-based children without LRTI. Trained study staff evaluated the indoor environment using a standardized home walkthrough checklist and measured visible dampness and mold damage. Damp-moldy Index (DMI) was also estimated to quantify the level of exposure. Exposure-response relationships of dampness and mold exposure with severe LRTI were assessed using multivariable restricted cubic spline regression models adjusting for relevant child, housing, and environmental characteristics.

Results:
Severe LRTI cases were more often male than female (61.8%), and the overall mean (SD) age was 7.3 (1.35) months. Children exposed to dampness <0.3 m2 (odds ratio [OR] = 2.11; 95% confidence interval [CI] = 1.05, 4.36), and between 0.3 and 1.0 m2 (OR = 2.34; 95% CI = 1.01, 7.32), had a higher odds of severe LRTI compared with children not exposed to dampness. The restricted cubic spline showed a linear exposure-response association between severe LRTI and residential dampness (P < 0.001) but a nonlinear relationship with DMI (P = 0.01).

Conclusions:
Residential dampness and DMI were exposure-dependently associated with higher odds of severe LRTI among under-five children. If observed relationships were causal, public health intervention strategies targeted at reducing residential dampness are critically important to mitigate the burden of severe LRTI among under-five children.
Quantifying The Burden of Persistent Musculoskeletal Pain in Employees at Rolls-Royce in The United Kingdom
Authors: Abraham Lucy , Russell Rachel , Sanchez-Riera Lidia , Emir Birol , Roomes David , Green Katy , Taylor-Stokes Gavin , Mirams Laura , Wallis Hannah , Burton Kim 
Published: March 2023

Objective
We aimed to investigate the burden of persistent musculoskeletal (MSK) pain in Rolls-Royce UK employees.

Methods
Employees with (n = 298) and without (n = 329) persistent MSK pain completed a cross-sectional survey. Weighted regression analyses were conducted to compare sickness absence, work ability, workplace accommodations/adaptations, and emotional well-being between these cohorts, controlling for confounders.

Results
Persistent MSK pain (particularly back pain) had a significant impact on physical work ability and was associated with increased sickness absence due to pain. Many employees (56%) had not disclosed their condition to their managers. Of these, 30% felt uncomfortable doing so, and 19% of employees reported insufficient support at work for their pain.

Conclusions
These findings highlight the importance of creating a workplace culture that encourages the disclosure of work-relevant pain, enabling organizations to consider improved, tailored support for employees.
Comparable Levels of Objectively Measured Physical Activity and Cardiorespiratory Fitness in Firefighters From Two Midwest Fire Departments
Authors: Brin Halle N. , Perumal Mohan D. , Kopp Samantha R. , Hutcheson Evan L. , Dicks Nathan D. , Walch Tanis J. , Carper Michael J. , Barry Allison M. 
Published: March 2023

Objective
The aim of the study is to objectively assess if firefighters are meeting the National Fire Protection Association (NFPA) cardiorespiratory fitness (CRF) and American College of Sports Medicine/American Heart Association physical activity (PA) guidelines.

Methods
Two independent fire departments from the Midwest participated in the study. Firefighters wore an accelerometer to track PA and associated intensities. In addition, firefighters completed a stage-graded exercise test TO determine their maximal oxygen uptake (V˙O2max).

Results
A total of 43 career firefighters completed the study (fire department 1 [FD1]: n = 29, FD2: n = 14). Almost half (44.8% FD1 and 42.9% FD2) met the NFPA CRF guidelines. Compared with the American College of Sports Medicine PA Guidelines of 30 min/d of moderate-to-vigorous PA, more than half of FD2 (57.1%) met the recommended amount of PA, whereas FD1 had less than half (48.3%).

Conclusions
These data demonstrate the need to improve firefighters’ PA levels, CRF, and overall health.
Depressive symptomatology in pregnant adolescents: considerations for care
Authors: Wittenberg Madeleine F. , Fitzgerald Shannon , Pluhar Emily 
Published: March 2023

Purpose of review
Adolescents who are pregnant experience higher levels of depressive symptoms than nonpregnant peers and pregnant adults. Clinicians caring for youth are often the first point of clinical contact for pregnant adolescents but report low confidence in assessing and treating reproductive health concerns. In the current review, we outline risk factors for depressive symptoms among pregnant adolescents and provide guidance on best practices in assessment and treatment of depressive symptoms in this pediatric sub-population.

Recent findings
Depressive symptoms are persistent across pregnancy. In adolescents, they are linked to greater risk of suicidal ideation, suicidal behavior, and nonsuicidal self-injury. Risk factors for prenatal depressive symptoms among adolescents include lower levels of income, history of depression, exposure to childhood maltreatment and/or recent abuse, and/or lifetime exposure to racial/ethnic discrimination. These risk factors likely interact with each other.

Summary
Clinicians should assess carefully for depressive symptoms in all pregnant adolescents using a standardized, validated measure supplemented by thoughtful clinical interviewing. Clinicians can educate adolescents on the distinction between symptoms of pregnancy versus symptoms of depression. We encourage clinicians to increase their comfort in providing psychopharmacological treatment, consulting with colleagues in psychiatry, and referring adolescents for psychopharmacological treatment and therapy as needed.
Neurological manifestations of mycetoma: a cross-sectional community-based study
Authors: Ali Elkhansa A. , Hussien Mohamed Ahmed Khabab Abbasher , Alhusseini Radi Tofaha , Abdallah Abdallah M. , Ibrahim Muaz A. , Siddig Amira , Bahi Eilaf O. , Mahmmoud Fadelallah Eljack Mohammed , Hussien Abbasher 
Published: March 2023

Introduction:
Mycetoma is a chronic specific granulomatous progressive and disfiguring subcutaneous inflammatory disease. It is caused by true fungi (Eumycetoma) or by higher bacteria (actinomycetoma). Mycetoma mainly affects the lower limbs, followed by the upper limbs, back, and rarely the head and neck. Mycetoma is mainly transmitted through trauma with infected sharp objects. Herein, we want to determine the neurological manifestations of mycetoma in Sudanese patients.

Methodology:
A descriptive cross-sectional community-based study included 160 patients with mycetoma seen in the White Nile state. A team of doctors collected data using standardized questionnaires that included clinical history, neurological examination, investigations including laboratory, neurophysiological studies, and imaging.

Results:
Almost 160 patients were included in the study; 90% of them were male. Two patients presented with entrapment neuropathy, one presented with proximal neuropathy, one had peripheral neuropathy, one had dorsal spine involvement and presented with spastic paraplegia with sensory level, one had cervical cord compression, and one patient had repeated attacks of convulsion.

Conclusion:
Although it is rare, clinicians should highly suspect neurological involvement in mycetoma patients.
Synovial sarcoma in the buttocks: an exceptional location – case report according to SCARE guidelines
Authors: Elmir Siham , Arghal Mohammed , Malki Samia , Bennani Amal , Skiker Imane , Abdeljaouad Najib , Yacoubi Hicham , Daoudi Abdelkrim , Bouziane Mohammed , El Oumri Ahmed A. 
Published: March 2023

Introduction and Importance:
Pelvic pain is a frequent reason for consultation; the management is complex, given the differences in symptomatic and anatomical orientation. We present an exceptional case of intergluteal synovial sarcoma rarely described in the literature, with an incidence of about 1/1 000 000 and less than 10 cases of intergluteal location are published.

Case Presentation:
Through this publication, we present a very exceptional case of synovial sarcoma. It concerns a 44-year-old male followed for probable intergluteal lipoma for 3 months and admitted for intergluteal mass bleeding. The clinical examination revealed an intergluteal tumor mass, and the surgical resection was in favor of a synovial sarcoma.
The objectives of this work are threefold: to enrich the poor literature with this new case; to underline the importance of multidisciplinary management; to recommend the obligation of anatomopathological evidence to make the diagnosis of lipoma in front of a soft tissue tumor.

Discussion and Conclusion:
Our case enriches the poor literature on intergluteal synovial sarcoma, where less than 10 similar reports are available. We hope through our presentation to highlight this exceptional etiology of gluteal tumor and to recall that there is no relationship between the name of this tumor and the synovium as an anatomical entity.
Bleeding cavernous hemangioma of lower lip: a case report
Authors: Sigdel Brihaspati , Subedi Bipin 
Published: March 2023

Introduction:
Hemangioma is a common benign vascular tumor. However, bleeding cavernous hemangioma of the lower lip are a rare condition.

Case presentation:
A 67-year-old female presented with bleeding from the lower lip. The bleeding increased with palpation. A clinical diagnosis of hemangioma of the lower lip was made. It was difficult to localize with ultrasound. It was explored and excised successfully.

Clinical discussion:
Hemangioma can be superficial, deep, or mixed. Generally, hemangioma involute spontaneously. Bleeding hemangioma causing functional disturbances need to be treated, for which various modalities are available, including excision.

Conclusion:
Hemangioma of the lip is a benign tumor of vascular origin. In selected cases, excision can be performed.
Clinicopathological correlation of aspartate aminotransferase-to-platelet ratio (APRI) and aspartate aminotransferase-to-alanine aminotransferase ratio (AAR) with survival in esophageal carcinoma patients: a retrospective cohort analysis of 951 patients
Authors: Zafar Muhammad Talha , Zia Beenish Fatima , Khalid Saleha Rashid , Bai Jharna , Memon Zahid Ali , Jan Zaka Ullah , Jadoon Sarosh Khan , Khan Noman Ahmed , Kajal Diksha , Ali Farukh , Kirmani Tooba Ahmed , Asghar Muhammad Sohaib 
Published: March 2023

Background:
Esophageal cancer is the eighth most prevalent cancer globally. Previously, several biomarkers have been used to predict the prognosis, although with variable reliability. Interestingly, it is noted that changes in liver function tests levels before and after neoadjuvant treatment are predictive in terms of cancer recurrence.

Objectives:
The objectives of the current study were to associate novel markers, including aspartate aminotransferase-to-platelet ratio (APRI) and aspartate aminotransferase-to-alanine aminotransferase ratio (AAR) with survival in esophageal malignancy.

Materials and Methods:
A retrospective study in a tertiary care hospital (single-center) included 951 patients having diagnosed esophageal carcinoma of any age group.

Results:
The median (interquartile range) age of study participants were 50 (38–60) years, including 43% males and 57% female patients, while the median (interquartile range) levels of AAR and APRI were 0.97 (0.81–1.25) and 0.19 (0.13–0.29), respectively. AAR was found to be higher in dysphagia for solids only and dysphagia for both liquids and solids rather than liquids only (P=0.002), while other associations included well-differentiated tumor grade (P=0.011), finding of esophageal stricture on esophagogastroduodenoscopy (P=0.015), and characteristic of mass on computerized tomography scan being both circumferential and mural (P=0.005). APRI was found to be higher in adenocarcinoma (P=0.038), and finding of circumferential±ulcerated mass on esophagogastroduodenoscopy (P<0.001). On survival analysis, adenocarcinoma (P<0.001), luminal narrowing (P=0.002), AAR greater than 1.0 (P=0.006), and APRI greater than 0.2 (P=0.007) were found to be poor survival predictors. On Cox proportional hazards regression, APRI was found to be more associated with poor survival than AAR (Hazard ratio: 1.682, 1.208–2.340, P=0.002).

Conclusion:
This study correlated clinical and pathological features of esophageal malignancy with noninvasive markers of hepatic function.
Is damage control surgery useful in the treatment of colorectal perforation? A single-center case–control study
Authors: Kunitatsu Kosei , Ueda Kentaro , Nasu Toru , Kawashima Shuji , Okishio Yuko , Kato Seiya 
Published: March 2023

Background:
Colorectal perforation with systemic peritonitis requires prompt surgical attention, and damage control surgery (DCS) is performed in patients with severe injuries. This study aimed to retrospectively investigate the efficacy of DCS in patients with colonic perforation.

Materials and Methods:
From January 2013 to December 2019, 131 patients with colorectal perforation underwent emergency surgery at our hospital. Among these, 95 patients required postoperative intensive care unit management and were included in this study; of these patients, 29 (31%) underwent DCS, and 66 (69%) underwent primary abdominal closure (PC).

Results:
Patients who underwent DCS had significantly higher Acute Physiology and Chronic Health Evaluation II (23.9 [19.5–29.5] vs. 17.6 [13.7–22]; P<0.0001) and Sequential Organ Failure Assessment (SOFA) (9 [7–11] vs. 6 [3–8]; P<0.0001) scores than did those who underwent PC. The initial operation time was significantly shorter for DCS than for PC (99 [68–112] vs. 146 [118–171]; P<0.0001). The 30-day mortality and colostomy rates were not significantly different between the two groups.

Conclusions:
The results suggest that DCS is useful in the management of acute generalized peritonitis caused by colorectal perforation.
A rare case of Weil’s disease with acute pancreatitis and acute kidney injury: focus on management – a case report
Authors: Hutajulu Reynaldo B. , Bramantono Bramantono , Rusli Musofa , Arifijanto Muhammad V. , Hadi Usman 
Published: March 2023

Introduction and importance:
The clinical spectrum of leptospirosis ranges from subclinical infection and anicteric fever to Weil’s disease, a severely fatal infection. Acute inflammation of the pancreas is a rare manifestation of Weil’s disease, and renal involvement is a hallmark in severe forms, leading to acute kidney injury (AKI) and representing a major risk factor for death. The aim of the case report was to present the clinical manifestations of Weil’s disease with acute pancreatitis and AKI and to highlight the management of its complications.

Case presentation:
A 22-year-old male patient presented to the hospital with a chief complaint of a persisting fever, abdominal pain, nausea and vomiting, decreased appetite, malaise, and urine and feces discoloration. The patient’s residence had flooded 2 weeks ago. Laboratory tests were performed and the patient was diagnosed with Weil’s disease with the complication of acute pancreatitis, AKI, hyperkalemia, hyponatremia, hypotonic hypovolemic, metabolic acidosis, and hypoalbuminemia.

Clinical discussion:
The patient was treated with intravenous (i.v.) ceftriaxone at a dose of 2×1 g, i.v. metoclopramide at a dose of 3×10 mg, i.v. calcium gluconate at a dose of 1 g followed by dextrose (D) 40% with insulin 2 IU for six times, avoided nephrotoxic drugs, and fluid balance was maintained at I=O+500 ml. The patient received hemodialysis due to refractory hyperkalemia. Posttreatment follow-up presented improvements in complaints and laboratory parameters.

Conclusion:
Management of severe leptospirosis or Weil’s disease with the complication of acute pancreatitis and AKI requires antibiotics and supportive therapy including adequate fluid resuscitation, proper and adequate nutrition, as well as the initiation of hemodialysis.
Primary tracheal carcinoid tumor misdiagnosed as asthma: a rare case report
Authors: Shrateh Oadi N. , Jobran Afnan W.M. , Jaber Saja , Kahla Ahmad , Shamieh Bashar S. , Bakri Izzeddin A. , Abu Asbeh Yousef 
Published: March 2023

Introduction:
About 2% of all lung malignancies are pulmonary carcinoid tumors, a family of neuroendocrine tumors. Rarely does a typical tracheal carcinoid of the trachea manifest as an endoluminal polypoidal tumor.

Case presentation:
The author describe a 61-year-old nonsmoker who complained of growing nonexertional shortness of breath 5 years ago. She also had a wheezy chest and a dry cough. The results of the chest radiography and electrocardiogram revealed no noteworthy abnormalities. The results of the pulmonary function test supported the diagnosis of bronchial asthma. A patient’s treatment has not advanced. After performing a bronchoscopy, a biopsy was taken and sent for pathological analysis. The endobronchial lining was found to have a subepithelial tumor infiltrate made up of nests of homogeneous bland cells with central nuclei and mild granular cytoplasm, according to histopathologic analysis. Considering all of these findings, the patient was diagnosed with a primary tracheal carcinoid tumor, which was misdiagnosed and treated as bronchial asthma.

Discussion and conclusion:
People with stridor or trepopnea symptoms should undergo a computed tomography scan since central airway tumors can mimic the symptoms of bronchial asthma while a chest radiograph may be normal. Tracheal carcinoid that has not progressed to the mediastinum can be successfully removed with flexible bronchoscopy and electrocautery, but the excision site needs to be continuously watched for recurrence.