bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pöschl Reformations Created from High-Resolution Noncontrast Enhanced CT Head Exams Can Be Used to Detect and Classify Superior Semicircular Canal Abnormalities
Authors: Matari Nahill H. , Mingomataj Erli , Famuyide Akinrinola , Nguyen Pamela , Lalwani Anil K. , Garcon Ernst 
Published: January 2025

Objective
To compare the diagnostic capability of Pöschl reformations created from temporal bone CT (TBCT) and high-resolution noncontrast CT head exams (HR-NECTH) to detect and classify superior semicircular canal (SSC) abnormalities.

Study Design
Retrospective case review.

Setting
Tertiary referral center.

Patients
Individuals with normal and abnormal SSC who received TBCT and HR-NECTH.

Interventions
Pöschl reformations of each patient’s temporal bones (TB) were created using TBCT and HR-NECTH. Screenshots displaying the SSC were randomized into an interpretation test sent to neuroradiologists who interpreted the SSC as normal/abnormal and classified abnormalities as thinning (SST)/dehiscence (SSD).

Main Outcome Measure
Analysis of responses to interpretation test, interrater reliability, and sensitivity, specificity, and positive/negative predictive values of Pöschl reformations from TBCT and HR-NECTH.

Results
Fourteen patients were enrolled, 28 TB were reviewed. Sixteen TB demonstrated SST/SDD and 12 were normal as per gold standard TBCT. Interpretation test displaying screenshots of the SSC, in a randomized, blinded fashion, was completed by four neuroradiologists. Analysis of TBCT and HR-NECTH Pöschl reformation interpretations yielded no statistically significant difference in proportion of true/false-positive/negative responses (χ
2 = 3.37, p = 0.83), similar and substantial interrater reliability (k = 0.78 vs. 0.73, respectively), and similar sensitivity, specificity, and positive/negative predictive values (0.86, 1, 1, 0.84 vs. 0.78, 0.96, 0.96, 0.77, respectively). Neuroradiologists also correctly classified SST/SSD on TBCT and HR-NECTH Pöschl reformations at a rate of 70.9% vs. 78.0%, respectively.

Conclusion
Pöschl reformations created from HR-NECTH demonstrated similar diagnostic capability as those created from TBCT to detect and classify SSC abnormalities.
Comparative effectiveness of massage combined with lifestyle intervention and lifestyle intervention alone for simple obesity: A systematic review and meta-analysis
Authors: Wang Gaofeng , Ju Hongyu , Zhang Zepeng , Wu Xingquan , Niu Heli , Zhang Lili , Chen Lili , Lou Huijuan , Yang Yonggang 
Published: January 2025

Background:
This study aimed to assess the comparative effectiveness of massage combined with lifestyle intervention and lifestyle intervention alone in patients with simple obesity.

Methods:
The PubMed, Embase, Cochrane Library, CNKI, VIP Database, and Wanfang Data were searched. Meta-analysis was conducted in accordance with the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Primary outcomes were body weight (BW) and body mass index (BMI). Secondary outcomes were waist circumference (WC), hip circumference (HC), total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), fasting insulin (FINS), and homeostasis model assessment–insulin resistance (HOMA-IR) and adverse events.

Results:
Thirteen randomized controlled trials were included. The meta-analysis showed that massage combined with lifestyle intervention significantly decreased BW (mean difference [MD]: −4.85; 95% confidence interval [CI]: −8.25 to −1.46; P = .005), BMI (MD: −2.65; 95% CI: −4.05 to −1.24; P = .0002), WC (MD: −3.63; 95% CI: −6.28 to −0.98; P = .007), TC (MD: −0.52; 95% CI: −0.84 to −0.20; P = .001), TG (MD: −0.23; 95% CI: −0.45 to −0.02; P = .003), LDL-C (MD: −0.48; 95% CI: −0.54 to −0.42; P < .00001), HDL-C (MD: −0.11; 95% CI: −0.17 to −0.05; P = .0004), FINS (MD: −1.64; 95% CI: −3.16 to −0.12; P = .03), and HOMA-IR (MD: −0.42; 95% CI: −0.65 to −0.18; P = .0005) compared with lifestyle intervention alone. In subgroup analyses, more obvious reduction in BMI (P = .02, I
2 = 80.3%) for the children and adolescents subgroup, more obvious reduction in HC (P = .04, I
2 = 76.1%) for the adults subgroup, more significant reduction in TC (P < .00001, I
2 = 98.3%), LDL-C (P < .00001, I
2 = 95.6%), and HDL-C (P < .0001, I
2 = 94.1%) for intermittent treatment subgroup and more significant reduction in TC (P < .00001, I
2 = 95.9%) and HDL-C (P < .0001, I
2 = 94.1%) for treatment times ≤30 subgroup were detected.

Conclusions:
Compared with lifestyle intervention alone, massage combined with lifestyle intervention significantly decreased BW, BMI, WC, TC, TG, LDL-C, FINS, and HOMA-IR, but produced less effect in increasing HDL-C. And different ages, treatment intervals, and treatment times can all affect treatment outcomes.
Spontaneous retroperitoneal hematoma after COVID-19 infection: A case report
Authors: Chen Xi , Li Zheng , Zou Liangping , Lan Yupin , Wu Xiaoling , Wang Hui 
Published: January 2025

Rationale:
Spontaneous retroperitoneal hematoma (SRH) is a rare but potentially fatal condition, often associated with anticoagulation therapy. With the global prevalence of COVID-19 and the widespread use of anticoagulants in its management, there is an increasing need to recognize rare but serious complications like SRH. This case report aims to emphasize the importance of early recognition and intervention of SRH in patients with COVID-19 undergoing anticoagulation therapy, to improve patient outcomes and reduce mortality.

Diagnoses:
An 86-year-old male with a history of COVID-19 presented with recurrent cough, hemoptysis, and fever. Initial treatment included antiviral and anticoagulant therapy. The patient later developed abdominal distension, pain, and eventually hypovolemic shock, leading to the diagnosis of SRH confirmed by imaging and a significant drop in hemoglobin levels.

Interventions:
The patient received comprehensive supportive care, including noninvasive ventilation, antiviral therapy, and anticoagulants. Upon the onset of SRH, emergency interventions included fluid resuscitation, vasopressors, and interventional embolization of the bleeding vessels.

Outcomes:
The patient initially responded well to COVID-19 treatment but developed SRH, which was managed successfully with interventional embolization. Post-procedure, the patient’s vital signs stabilized, hemoglobin levels gradually increased without the need for further transfusions, and he regained full consciousness. Over the following weeks, the patient showed continuous improvement, with resolution of abdominal pain and a return to baseline mobility. He was discharged in stable condition with scheduled follow-ups.

Lessons:
This case underscores the critical need for vigilance in monitoring patients on anticoagulation therapy, particularly those with COVID-19, for signs of SRH. Early recognition and prompt intervention are essential to improve outcomes. Clinicians should maintain a high index of suspicion for SRH in patients presenting with unexplained abdominal pain and hypovolemic shock, even in the absence of typical risk factors.
Primary solitary fibrous tumor of the stomach: A case report and a review of literature
Authors: Dong Ling-Yun , Li Ying-Chun , Tong Hai-Chao , Guo Yao-xing , Li Le-Yao , Zhang Wan-Lin , Ma Shuang , Yang Lian-He , Petersen Philip , Wang Endi 
Published: January 2025

Rationale:
Solitary fibrous tumors (SFTs) are spindle cell tumors that typically occur in the pleura and peritoneum, but very rarely in the stomach. To our best knowledge, there are only 10 cases reported in English literature. We reported a case of primary stomach SFT and summarized the characteristics of all previous cases, suggesting that pathologists and surgeons should include this disease in the differential diagnosis list of primary mesenchymal tumor of the stomach.

Patient concerns:
The patient suffered from epigastric pain for 5 months. Gastroscopy revealed a submucosa mass along the greater curvature centered on the gastric body. A repeat gastroscopy after 6 months showed a slight increase in mass size.

Diagnoses:
Endoscopic ultrasound showed the mass in the middle and lower portion of the stomach body, measuring 3.1cm in diameter, with a smooth surface. The patient was initially diagnosed with a gastrointestinal stromal tumor by gastroscopy. However, the pathologic morphology and immunohistochemical staining of resected specimens after surgery support a diagnosis of primary gastric SFT.

Interventions:
The patient underwent a laparoscopic gastric mass resection.

Outcomes:
The patient returned to hospital after 3 months with no recurrence or postoperative complications. During the 18-month follow-up period, the patient did not experience any tumor recurrence or metastasis.

Lessons:
This case teaches us that SFT should be included in the differential diagnoses of gastric primary spindle cell tumors, even though it is very rare in the stomach.
Blind nasoenteric tube placement risks: A case report of misplacement into the pleural cavity
Authors: Yuan You , Zhong Wei , Gao Huiming , Zhang Xia , Chen Junxi , Qing Yuanqin , Hu Rujun 
Published: January 2025

Rationale:
Enteral nutrition is a critical component of care for critically ill patients. However, the blind insertion of a nasoenteric tube, despite being a simple procedure, carries inherent risks that necessitate a reevaluation of the technique.

Patient concerns:
A case of a 60-year-old female experienced the rare yet critical complication of a misplaced nasoenteric tube entering the thoracic cavity during a blind insertion procedure for enteral nutrition following a liver transplant.

Diagnosis:
Following liver transplantation, the patient was diagnosed with severe pneumonia, a right-sided hydropneumothorax, and severe malnutrition.

Interventions:
After the misplacement of the nasoenteric tube into the pleural cavity was detected from the chest X-ray, the tube was immediately removed, and the pneumothorax was actively managed. Subsequently, with the support of contrast radiography, the nasoenteric tube was successfully reinserted to provide the patient with nutritional support and promote rehabilitation.

Outcomes:
The patient responded well to the intervention and was discharged in stable condition following complete recovery.

Lessons:
The case prompts a reevaluation of blind placement techniques and calls for the adoption of more reliable technologies to prevent similar incidents and ensure patient safety, such as electromagnetic and visualized guided placement technique.
Laparoscopic cholecystectomy for triple gallbladder malformation: A comprehensive case report and literature review
Authors: Zhou Shuang-hao , Li Zhen-hua , Wei Yao-chen , Wu Zhi-yu , Fu Qing-jiang , Cao Li-ying , Ma Xiang-ming 
Published: January 2025

Rationale:
Triple gallbladder is a rare congenital anatomical abnormality because of the incomplete regression of rudimentary bile ducts and is often not found until it is accidentally detected during imaging research.

Patient concerns:
We report a rare case of triple gallbladder malformation and review the English literature on biliary tract variation caused by gallbladder malformation. The diagnosis, treatment, and postoperative situation of the patients were summarized and analyzed.

Diagnoses:
The patient was diagnosed with triple gallbladder malformation.

Interventions:
We conducted laparoscopic cholecystectomy for the patient.

Outcomes:
We successfully removed all 3 gallbladders by laparoscopic cholecystectomy, and the patient had no postoperative complications such as bleeding or bile leakage and recovered well.

Lessons:
At present, the best treatment for triple gallbladder malformation is to remove all 3 gallbladders by laparoscopic cholecystectomy, which can effectively prevent the occurrence of “postcholecystectomy syndrome” caused by individual gallbladder residue. However, the diagnosis of triple gallbladder is very challenging and often requires a combination of advanced imaging methods. However, sometimes preoperative imaging does not fully reveal biliary tract variation. Therefore, we need to rely on the guidance of evidence-based medicine before surgery and the accurate evaluation of surgical plans to complete the operation without risk.
Intradural extramedullary double primary ependymoma and meningioma rare condition: Case report and literature review
Authors: Yuan Xingyue , Li Ruibo , Liu Qian 
Published: January 2025

Rationale:
Ependymomas are commonly prevalent intramedullary neoplasms in adults, with hardly any cases of exophytic extramedullary ependymoma being reported. Meningiomas, on the contrary, are one of the most common intradural extramedullary (IDEM) tumors. However, the occurrence of both IDEM tumors simultaneously is extremely rare.

Patient concerns:
A 63-year-old female who presented with pain and numbness in both lower limbs, and symptoms rapidly progressed over the past 5 months.

Diagnosis:
Based on the patient’s clinical symptoms and imaging features, we conducted pathological examination and genetic testing, ultimately confirming that the patient had IDEM double primary ependymoma and meningioma.

Interventions:
Surgery was performed to remove double spinal tumors, decompress spinal nerve roots, and perform laminectomy, and she was treated with electrocardiogram monitoring, antibiotics, hemostasis, and antiedema therapy.

Outcomes:
Histopathology confirmed World Health Organization grade II ependymoma at L2 and World Health Organization grade I meningioma at T12-L1. MYCN amplification and other genetic alterations were absent. Postoperative recovery was favorable, with no recurrence at 6-month follow-up.

Lessons:
This is the first reported case of IDEM double primary ependymoma and meningioma, highlighting the rarity of such cases and the importance of thorough diagnostic workup and surgical excision for IDEM tumors. Genetic analysis adds to the understanding of these rare tumors and guides management strategies.
De novo KCNB1 missense variant causing developmental and epileptic encephalopathy: Two case reports
Authors: Ren Ying , Hu Wandong , Gao Zaifen , Shi Jianguo , Liu Yong , Zhang Hongwei 
Published: January 2025

Rationale:
Developmental and epileptic encephalopathy (DEE) defines a group of severe and heterogeneous neurodevelopmental disorders. The voltage-gated potassium channel subfamily 2 voltage-gated potassium channel α subunit encoded by the KCNB1 gene is essential for neuronal excitability. Previous studies have shown that KCNB1 variants can cause DEE. Herein, we report the cases of 2 children with DEE caused by pathogenic variants in the KCNB1 gene. Trio whole-exome sequencing identified novel KCNB1 genotypes, c. 1160C > A and c.1012C > T, which had not been reported previously, in 2 unrelated patients.

Patient concerns:
Two children were admitted to our hospital for a detailed evaluation of frequent seizures. And both of these children have abnormal electroencephalogram and brain magnetic resonance imaging results, accompanied by developmental delay.

Diagnoses:
A genetic study using trio-whole-exome sequencing confirmed the diagnosis of KCNB1-related developmental and epileptic encephalopathy.

Interventions:
Both patients accepted the treatment of antiepileptic drugs. 1 patient had seizure remission with a combination of sodium valproate and lamotrigine, and the other was lost to follow-up.

Outcomes:
Trio-whole-exome sequencing technology was used to determine the etiology of the 2 children with DEE.

Lessons:
This study confirmed that genetic testing provides a basis for the diagnosis of children with abnormal electroencephalogram and brain magnetic resonance imaging findings and developmental delay, and provides data supporting a future phenotype–genotype correlation study.
Treatment of very high risk membranous nephropathy complicated by pulmonary embolism with glucocorticoids and rituximab: Case report
Authors: Khan Umer Farooq , Sia Charmaine , Thamboo Thomas Paulraj , Chua Horng Ruey , Chan Gek Cher 
Published: January 2025

Rationale:
We report the efficacy of combination prednisolone and intravenous (IV) rituximab as an immunosuppressive regimen for a young male presenting with extensive venous thromboembolism including a submassive pulmonary embolism secondary to life-threatening nephrotic syndrome from very high risk anti-phospholipase-A2 receptor (PLA2R) positive membranous nephropathy. Initial treatment was with mechanical thrombectomy and anticoagulation. Thereafter, oral prednisolone was initiated to induce remission, during a period of uninterrupted anticoagulation. He subsequently underwent a kidney biopsy for histological confirmation and IV rituximab was administered as definitive treatment.

Patient concerns:
A 33-year-old Chinese male with no chronic conditions presented with shortness of breath and left-sided pleuritic chest pain.

Diagnoses:
He was diagnosed with a submassive pulmonary embolism which was confirmed on computer tomography imaging with additional extensive clot burden in the inferior vena cava and renal veins. Further workup revealed nephrotic syndrome, with proteinuria of 6.5g/day, and serum Albumin 26 g/L, associated with anti-PLA2R of 223 RU/ml. His presenting serum creatinine was 108 µmol/L (CKD-EPI eGFR 77ml/min/1.73m2). Additional workup for malignancy and infections were negative.

Interventions:
As part of acute management, immediate anticoagulation was initiated. The patient then underwent endovascular thrombectomy and inferior vena cava filter placement. Given the emergent indication for and need for 4 weeks of uninterrupted anticoagulation, his kidney biopsy had to be delayed. The patient was then preemptively treated with IV Methylprednisolone 500mg for 3 days followed by 0.5mg/kg of oral prednisolone after taking into consideration the specificity of PLA2R positivity for membranous nephrology.

Outcomes:
After 4 weeks of treatment, serum albumin improved to 32 g/L and anti-PLA2R levels improved significantly to 27 RU/ml. His subsequent kidney biopsy confirmed membranous nephropathy and 2 doses of IV rituximab 1g were administered 14 days apart. Six months after initial presentation, the patient is in partial remission. Albumin has improved to 41 g/L, Anti PLA2R < 2 RU/ml, and proteinuria is 1.18g/day.

Lessons:
This case demonstrates that preemptive treatment in patients with anti-PLA2R positive membranous nephropathy can initiated without a histological diagnosis when there are strong contraindications against a kidney biopsy. Treatment with a combination of steroids and IV rituximab could be a viable treatment option for patients with very high-risk membranous nephropathy over conventional therapy with cyclophosphamide.
Paraspinal synovial sarcoma mimicking tuberculosis: A case report and literature review
Authors: Liu Jie , Huang Xiajie , Liang Xinyun , Xian Xinhua , Mo Yangzhou , Wu Xiaomei , Lu William , Li Jian , Chen Yan 
Published: January 2025

Rationale:
Synovial sarcoma (SS) is a rare and highly malignant soft tissue sarcoma. When SS occurs in atypical locations, it can present significant diagnostic challenges. We report a case of paraspinal SS initially misdiagnosed as spinal tuberculosis, highlighting the diagnostic difficulties and the importance of considering SS in the differential diagnosis.

Patient concerns:
A 23-year-old woman presented with progressively worsening lower left back pain over 3 weeks, accompanied by weakness and numbness in her left lower limb. She was initially misdiagnosed with spinal tuberculosis at 2 different hospitals based on weakly positive anti-tuberculosis antibodies and imaging findings. Despite ongoing anti-tuberculosis treatment, her condition continued to deteriorate.

Diagnoses:
The first surgery revealed findings inconsistent with spinal tuberculosis, but a tumor could not be excluded. However, the initial pathological biopsy was inconclusive. A second surgery confirmed the diagnosis of SS through histopathological examination.

Interventions:
The patient underwent a second surgery for mass resection and biopsy confirmation. Unfortunately, by the time the correct diagnosis was made, the disease had metastasized to her lungs, and the optimal window for surgical intervention had been missed.

Outcomes:
The patient’s delayed diagnosis resulted in extensive diffuse metastasis to both lungs, significantly impacting her survival.

Lessons:
This case underscores the need to consider malignancies such as SS in the differential diagnosis of spinal lesions, particularly when clinical response to treatment is poor. Early diagnosis and timely surgical intervention are critical to improving patient outcomes. Our literature review provides further insights into the characteristics of paraspinal SS and strategies to prevent misdiagnosis, emphasizing the importance of early and accurate diagnosis to enhance patient survival.
Primary malignant melanoma of the vagina: A case report of a rare disease that is difficult to diagnose
Authors: Park Soyoung , Park Jung-Woo , Rha Seo-Hee , Kim Sujin 
Published: January 2025

Rationale:
Malignant melanoma is a rare cancer that accounts for approximately 1% of all cancers. Primary malignant melanoma of the female genital tract accounts for approximately 3% to 7% of all malignant melanomas, and 0.3% to 0.8% of all melanomas in women. It affects postmenopausal women ages 60 to 80 years. Various hormonal factors, including puberty, pregnancy, menopause, oral contraceptive use, and human papillomavirus infection are associated with primary malignant melanoma of the vagina.

Patient concerns:
Symptoms often include vaginal bleeding, discharge, and pain; however, it can also present as pigmented or nonpigmented lesions, making diagnosis challenging.

Diagnoses:
Diagnosis involves detailed history, physical examination, and imaging (CT, MRI, and positron emission tomography). Immunohistochemical staining for markers, such as human melanoma black-45 and Melan-A, is crucial for confirmation. The diagnosis was made through careful physical examination, imaging studies, and immunohistochemistry.

Interventions:
The treatment includes wide local excision, radical surgery, radiotherapy, chemotherapy, and immunotherapy. The prognosis of primary malignant melanoma of the vagina is usually poor owing to late diagnosis, and the 5-year survival rate is 5% to 25%.

Outcomes and lessons:
To consider the possibility of primary malignant melanoma of vagina, postmenopausal women, particularly those who with human papillomavirus infection, should be performed thorough examination regardless of symptoms of vaginal bleeding or discharge.