bluuebunny/crossref_metadata_2025_split huggingface dataset:
Successful percutaneous cannulation of foramen ovale obstructed by completely ossified pterygoalar ligament using the Hartel approach: Two case reports
Authors: Shang Qingqing , Lin Feng , Mu Qingchao , Tan Shuying , Wang Hongyan , Gao Yong 
Published: June 2023

Rationale:
Ossification of the pterygoalar ligament, which lies inferolateral to the exocranial opening of the foramen ovale, is traditionally considered to be a bony bar that could obstruct percutaneous needle access to the foramen ovale using the Hartel approach. We herein present two case reports of successfully penetrating the foramen ovale by a needle across the pterygoalar bar. Lack of knowledge of this type of presentation might lead to a change in the surgical approach.

Patient concerns:
A 27-year-old woman had an 11-year history of facial pain because of a space-occupying lesion in the left cerebellopontine angle. Neither open surgery nor drug therapy resolved her facial pain. Another 67-year-old woman developed episodic facial pain because of herpes zoster infection 20 days earlier, and she could not achieve pain relief from drug therapy.

Diagnoses:
Both patients were diagnosed with secondary trigeminal neuralgia.

Interventions:
The patients underwent radiofrequency thermocoagulation of the semilunar ganglion via the foramen ovale.

Outcomes:
The three-dimensional computed tomography scan showed that the ipsilateral foramen ovale was obstructed by the pterygoalar bar. However, percutaneous needle cannulation of the foramen ovale was successful using the anterior approach. The facial pain was immediately and completely resolved without complications except for facial numbness.

Lessons:
During percutaneous radiofrequency thermocoagulation for the treatment of trigeminal neuralgia, the Hartel approach can still be used when the foramen ovale is blocked by a pterygoalar bar. To our knowledge, this is the first report of such a treatment. Moreover, we herein provide specific technical recommendations to assist surgeons who may encounter such cases in the future.
Unpredictable refeeding syndrome with severe hypophosphatemia in borderline personality disorder comorbidity: A case report
Authors: Hamada Kazumasa , Sagiyama Kenichiro , Nishi Ryusei , Fukumoto Takamasa , Kato Ryuichi , Fuku Yuuki , Amitani Haruka , Asakawa Akihiro 
Published: June 2023

Rationale:
Refeeding syndrome (RS) is a fatal condition caused by rapid calorie intake during starvation. Self-neglected fasting in psychiatric disorders is associated with RS. However, overeating resulting from circumventing the clinician’s instructions does not have a reportedly high risk of RS.

Patient concerns:
A 47-year-old undernourished woman with borderline personality disorder was hospitalized for nausea, vomiting, and diarrhea.

Clinical findings:
She had not eaten much for 10 days and had lost weight (56.5–51.1 kg) over 3 weeks. No abnormalities were indicated on physical examination and imaging examinations.

Diagnoses, interventions, and outcomes:
Infectious diseases and malignancies were excluded from the differential diagnosis. On the third day of admission, the patient’s serum phosphorus level significantly decreased to 0.7 mg/dL, and additional sodium phosphate was administered intravenously. On the fourth day, despite our instructions, the patient was found to be eating nonhospital food from the first day of admission. In conjunction with her history, a final diagnosis of RS was made. After appropriate treatments, the patient was discharged on the 15th day of hospitalization. The patient’s nausea, vomiting, and diarrhea were improved.

Lessons:
When undernourished patients have psychiatric disorders, including borderline personality disorder or schizophrenia, the occurrence of RS should be considered based on the patients’ poor adherence to physicians’ instructions.
Systematic review and meta-analysis of completely retroperitoneoscopic nephroureterectomy versus traditional retroperitoneoscopic nephroureterectomy in upper tract urothelial carcinoma
Authors: Zhao Yan , Lu Ke , Yin Zhi-Xiang , Peng Yu-Hao , Pei Chang-Song 
Published: June 2023

Background:
This systematic review and meta-analysis aim to evaluate the efficacy and safety of completely retroperitoneoscopic nephroureterectomy (CRNU) for the treatment of upper urinary tract urothelial carcinoma (UTUC).

Methods:
A systematic review of PubMed and Web of Science databases was conducted to identify trials comparing the outcomes of CRNU and other surgical procedures. A total of 6 case-control studies were selected for analysis. The efficacy and safety of CRNU were evaluated using mean difference or hazard ratio (HR) with 95% CIs, employing continuous or dichotomous method with a random or fixed-effect model. Meta-analysis was performed using STATA 11.0 software.

Results:
The meta-analysis indicated that CRNU in subjects with UTUC was significantly associated with a shorter operation time (standardized mean difference, −1.36; 95% CI, −1.61 to −1.11, P < .001) and lower blood loss (standardized mean difference, −0.54; 95% CI, −0.77 to −0.31, P < .001) when compared to traditionally retroperitoneoscopic nephroureterectomy (TRNU). No significant difference was observed in the occurrence of grade I & II complications (HR, 1.04; 95% CI, 0.49–2.2, P = .915) and total complications (HR, 0.69; 95% CI, 0.38–1.27, P = .238) between CRNU and TRNU.

Conclusion:
The findings suggest that CRNU is an advanced surgical technique that is safe and effective for the treatment of UTUC. We recommend that CRNU be further employed for patients with UTUC. Further randomized, multicenter trials are needed to validate these results, given the limitations of this study.
Prognostic value of pretreatment systemic immune-inflammation index in Chinese esophageal squamous cell carcinoma patients receiving radical radiotherapy: A meta-analysis
Authors: Zeng Xiaoxiao , Ye Ling , Luo Mingying , Zeng Danli , Chen Yang 
Published: June 2023

Background:
The association between pretreatment systemic immune-inflammation index (SII) and long-term survival among Chinese esophageal squamous cell carcinoma (ESCC) patients who received radical radiotherapy remains unclear. The aim of this study was to identify the prognostic role of pretreatment SII in Chinese ESCC patients receiving radical radiotherapy based on current evidence.

Methods:
The PubMed, EMBASE, Web of Science and CNKI databases were searched up to March 18, 2023. Primary and secondary outcomes were overall survival (OS) and progression-free survival (PFS), respectively. The hazard ratios (HRs) with corresponding 95% confidence intervals (CIs) were combined to assess the predictive role of pretreatment SII for long-term survival of Chinese ESCC patients receiving radiotherapy. All statistical analyses were conducted by STATA 15.0 software.

Results:
A total of 8 eligibility studies involving 2101 cases were included in this meta-analysis. The pooled results demonstrated that elevated pretreatment SII was significantly related to worse OS (HR = 1.59, 95% CI: 1.24–2.02, P < .001) and PFS (HR = 1.33, 95% CI: 1.13–1.57, P < .001). Besides, subgroup based on TNM stage showed similar results.

Conclusion:
Pretreatment SII could serve as a novel prognostic factor in Chinese ESCC patients receiving definitive radiotherapy and patients with an elevated SII may experience poorer survival.
Prenatal ultrasound diagnosis of fetal giant pericardial cyst: A case report
Authors: Wang Xiaoqing , Zhang Weixia , Wang Mijie , Jiao Ronghong 
Published: June 2023

Rationale:
We describe 1 case of fetal giant pericardial cyst was diagnosed by fetal echocardiography in the second trimester, and the changes of the cyst were recorded by follow-up observation in the late trimester and after birth. We then review and discuss the knowledge about its diagnosis and treatment.

Patient concerns:
A 34-year-old pregnant woman was referred to our hospital because of a diagnosis of a fetal pericardial effusion at 22 5/7 weeks at another hospital.

Diagnosis:
Fetal echocardiography revealed an irregular anechoic area in the right side of the fetal right atrium and right ventricle that was closely related to but not communicated with the pericardiumis and suggested fetal pericardial cyst. Fetal cardiothoracic magnetic resonance imaging showed cystic FIESTA signal in the right lung region, with clear boundary, and a seemingly line-like low signal shadow within.

Interventions:
Since fetal pericardial cysts keep decreasing in size during maternal pregnancy, follow-up observation measures are taken.

Outcomes:
Fetal pericardial cysts disappear on their own 4 months after delivery.

Lessons:
Asymptomatic pericardial cysts in the fetal period can be followed up and observed, and intervention is performed only when the cyst rapidly enlarges or ruptures and becomes infected in the fetal or neonatal period. Echocardiography can be used as a first-line detection method for their initial detection and follow-up.
Cushing syndrome caused by an ectopic ACTH-producing pituitary adenoma of the clivus region: A rare case report and literature review
Authors: He Yutao , Tang Ziyi , Tang Na , Lu Yu , Niu Fangfang , Ye Jiao , Zhang Zheng , Fang Chenghong , Yao Lei 
Published: June 2023

Rationale:
Ectopic ACTH-producing pituitary adenoma (EAPA) of the clivus region is extraordinarily infrequent condition and merely a few reports have been reported to date.

Patient concerns:
The patient was a 53-year-old woman who presented with Cushing-like appearances and a soft tissue mass in the clivus region.

Diagnoses:
The final diagnosis of clivus region EAPA was established by clinical, radiological and histopathological findings.

Interventions:
The patient underwent gross total clivus tumor resection via transsphenoidal endoscopy.

Outcomes:
Half a year after surgery, the patient Cushing-like clinical manifestations improved significantly, and urinary free cortisol and serum adrenocorticotropin (ACTH) returned to normal.

Lessons:
Given the extreme scarcity of these tumors and their unique clinical presentations, it may be possible to misdiagnose and delayed treatment. Accordingly, it is especially crucial to summarize such lesions through our present case and review the literature for their precise diagnosis and the selection of optimal treatment strategies.
Early Life Oral Antibiotics Are Associated With Pediatric-Onset Inflammatory Bowel Disease—A Nationwide Study
Authors: Jawad Ali Bashir , Jansson Sabine , Wewer Vibeke , Malham Mikkel 
Published: June 2023

Objectives:
Early-life environmental triggers are thought to play a larger role in pediatric-onset inflammatory bowel disease (pIBD) compared to adult-onset IBD. We aimed to assess the risk of developing pIBD after exposure to oral antibiotics during the first 5 years of life.

Methods:
In a nation-wide cohort study, we identified all patients diagnosed with pIBD (<18 years at diagnosis) in Denmark between 1995 and 2018 from the National Patient Registry and matched them with up to 10 reference individuals. Antibiotic exposure was defined as being prescribed antibiotics during first 5 years of life. Data were retrieved from the National Prescription Register. Outcome was developing pIBD. Risk estimates are presented by hazard ratios (HR) with 95% confidence intervals (CI).

Results:
We identified 1927 pIBD patients and 18,318 reference individuals. Oral antibiotic exposure during the first 5 years of life was associated with a higher risk of developing pIBD (HR = 1.33 [95% CI: 1.2–1.5], P <0.0001). The risk was also increased if patients had ≥4 antibiotic prescriptions compared to no antibiotics (HR = 1.33 [95% CI: 1.2–1.5], P <0.0001). Broad-spectrum antibiotics increased the risk of pIBD compared to narrow-spectrum antibiotics (HR = 1.29 [95% CI: 1.2–1.4], P < 0.0001). When stratified by IBD subtypes, only Crohn disease was significantly associated with exposure to antibiotics (HR = 1.37 [95% CI: 1.1–1.7], P = 0.002).

Conclusions:
In this nationwide registry-based study, we found that oral antibiotic exposure during first 5 years of life was associated with an increased risk of pIBD. Repeated antibiotic exposures increased risk estimates.
Validation and Reference Scores of the Transition Readiness Assessment Questionnaire in Adolescent and Young Adult IBD Patients
Authors: van Gaalen Martha A.C. , van Gijn Emma , van Pieterson Merel , de Ridder Lissy , Rizopoulos Dimitris , Escher Johanna C. 
Published: June 2023

Objectives:
Transition readiness can predict a successful transition from pediatric to adult care. This study aimed to validate and develop age-dependent reference scores for the (Dutch version of) Transition Readiness Assessment Questionnaire (TRAQ), in adolescents and young adults (AYAs) with inflammatory bowel disease (IBD).

Methods:
TRAQ has 20 items (score 1–5) distributed over 5 domains (total sum score 100) and is completed by AYAs. Following the COnsensus-based Standards for the selection of health Measurement INstruments methodology, we conducted the translation, back-to back translation, pretesting, and validation of the final Dutch version of TRAQ (TRAQ-NL) questionnaire. We used a Rasch model for structural validation, hypothesis testing for construct validity, and Cronbach alpha to demonstrate reliability. Reference scores were calculated using percentiles.

Results:
Two hundred fifty TRAQ questionnaires were evaluated in 136 AYAs with IBD [56% Crohn disease, 58% male, median age 17.5 years (range 15.7–20.4)]. The overall mean item score was 3.87 (range 1.45–5). With good reliability (Cronbach alpha 0.87), TRAQ-NL discriminated well between knowledge levels, especially in the lower levels. Transition readiness was defined as low, moderate, adequate, or excellent in patients with TRAQ percentile scores (PC) <25th (<3.375 mean item score), 25th–50th (3.375–3.9), 50th–90th (3.91–4.7), or >90th (>4.7). Younger patients, concomitant illness, fewer visits to the transition clinic, and parental dependence were associated with significantly lower TRAQ scores.

Conclusion:
TRAQ(-NL) is reliable and valid, with age-dependent PC to identify (in)adequate transfer readiness. TRAQ can now be more easily used as a patient-reported outcome measure to monitor transition readiness longitudinally in routine care for AYAs IBD patients.
Paradigm Shifts in Alloplastic Breast Reconstruction: A Nationwide Analysis of Direct-To-Implant Trends
Authors: Yesantharao Pooja S. , Arquette Connor , Cheesborough Jennifer E. , Lee Gordon K. , Nazerali Rahim S. 
Published: June 2023

BACKGROUND:
Direct-to-implant breast reconstruction is an attractive choice for appropriately-selected patients, as a single-stage procedure can enhance global metrics of care. In an era of high-value healthcare, therefore, it is important to investigate utilization of such procedures. This study investigated direct-to-implant trends over the past decade on a nationwide basis.

METHODS:
This was a retrospective investigation of direct-to-implant reconstruction between 2010-2018 in the United States, using the National Inpatient Sample (NIS) database. All study analyses were undertaken using Stata v15.0.

RESULTS:
The weighted sample included 287,093 women who underwent implant-based reconstruction between 2010-2018, of whom 43,064 (15%) underwent direct-to-implant reconstruction. Across the study period, the proportion of direct-to-implant procedures significantly increased (p=0.03), relative to staged and delayed implant-based procedures. While direct-to-implant patients were younger, more likely to be white and privately-insured, the proportion of non-white, publicly-insured patients undergoing direct-to-implant reconstruction significantly increased by 2018 (p<0.05). Furthermore, direct-to-implant utilization amongst Medicaid patients increased at 2.2 times the rate in Medicaid expansion states compared to non-expansion states. Direct-to-implant patients had significantly higher APR-DRG risk scores in 2018 than in 2010 (p=0.02), indicating expanding clinical indications for this procedure. Direct-to-implant reconstruction had significantly lower inpatient charges than staged procedures (p=0.03), when considering expander placement and expander-implant exchange.

CONCLUSION:
Overall, utilization of direct-to-implant breast reconstruction has significantly increased over the past decade, facilitated by expanding clinical indications and improved insurance coverage. However, certain disparities continue to exist. Further work should investigate drivers of disparities to allow continued expansion of direct-to-implant reconstruction as clinically appropriate.
Reduction of Tendon Fibrosis Using Galectin-3 Inhibitors
Authors: Spielman Amanda F. , Griffin Michelle F. , Titan Ashley L. , Guardino Nicholas , Cotterell Asha C. , Akras Deena , Wan Derrick C. , Longaker Michael T. 
Published: June 2023

Background:
Fibrosis is a complication of both tendon injuries and repairs. The authors aimed to develop a mouse model to assess tendon fibrosis and to identify an antifibrotic agent capable of overcoming it.

Methods:
The Achilles tendon of adult C57Bl/6 mice was exposed via skin incision, followed by 50% tendon injury and abrasion with sandpaper. Sham operations were conducted on contralateral hindlimbs. Histologic analyses and immunofluorescent staining for fibrotic markers (collagen type 1 [Col1], α-smooth muscle actin [α-SMA]) were used to confirm that the model induced tendon fibrosis. A second experiment further examined the role of α-SMA in adhesion formation using α-SMA.mTmG mice (6 to 8 weeks old; n = 3) with the same injury model. Lastly, α-SMA.mTmG mice were randomized to either condition 1 (tendon injury [control group]) or condition 2 (tendon injury with galectin-3 inhibitor [Gal3i] treatment at time of injury [treatment group]).

Results:
Histologic analyses confirmed tendon thickening and collagen deposition after tendon injury and abrasion compared with control. Immunofluorescence showed higher levels of Col1 and α-SMA protein expression after injury compared with sham (P < 0.05). Real-time quantitative polymerase chain reaction also demonstrated increased gene expression of Col1 and α-SMA after injury compared with sham (P < 0.05). Gal3 protein expression also increased after injury and colocalized with α-SMA
+ fibroblasts surrounding the fibrotic tendon. Gal3i treatment decreased collagen deposition and scarring observed in the treatment group (P < 0.05).

Conclusions:
The authors’ study provides a reproducible and reliable model to investigate tendon fibrosis. Findings suggest the potential of Gal3i to overcome fibrosis resulting from tendon injuries.

Clinical Relevance Statement:
Tendon injuries are common presentations to hand surgeons. Complications include adhesion formation, which results in reduced strength and frequent reinjury. Advancements in management require a better understanding of the mechanisms behind tendon fibrosis in order to identify ways to overcome it.
Midface Prelamination by Using a Three-Dimensional Cervicothoracic Prefabricated Flap
Authors: Li Haizhou , Gao Yashan , Gu Bin , Ren Jieyi , Xie Feng , Zhou Shuangbai , Xie Yun , Zan Tao , Li QingFeng 
Published: June 2023

Summary:
The midface is an important area in aesthetics and function and a complex area to manage after burn injuries, trauma, and tumor resection. Traditional treatment to reconstruct midface defects involving the nose, lips, and cheeks requires multiple sequential flap operations but results in a patch-like appearance, which remains a major challenge for head and neck reconstructive surgeons. This article describes how the authors perform prelamination using the prefabricated cervicothoracic flap on the anterior chest for midface reconstruction. The key point of the authors’ procedure is to three-dimensionalize the cervicothoracic prefabricated flap with flap folding; flap rotation; and cartilage grafts for coverage, lining, and support of the nose and lips. This technique may be indicated for extensive midface defects involving total nose and lip loss. It provides a uniform matched facial appearance and significant functional improvement. Donor-site morbidity and the need for multiple flap procedures could be reduced.
Immunophenotypic analysis in participants with Kaposi sarcoma following pomalidomide administration
Authors: Lurain Kathryn , Polizzotto Mark N. , Krug Laurie T. , Shoemaker Griffin , Singh Amrit , Jensen Stig M.R. , Wyvill Kathleen M. , Ramaswami Ramya , Uldrick Thomas S. , Yarchoan Robert , Sereti Irini 
Published: June 2023

Objective:
Evaluate baseline differences by HIV status and the impact of pomalidomide on lymphocyte counts and T cell subsets in patients with Kaposi sarcoma (KS).

Design:
We prospectively evaluated CD4+ and CD8+ T cell phenotypes in 19 participants with KS enrolled on a phase 1/2 study of pomalidomide (NCT01495598), 7 without HIV and 12 with HIV on antiretroviral therapy.

Methods:
Trial participants received pomalidomide 5 mg orally for 21 days of 28-day cycles for up to 1 year. Flow cytometry was performed on peripheral blood mononuclear cells at baseline, after 3 cycles, and at end-of-treatment. Lymphocyte count and T cell subset comparisons were evaluated by Wilcoxon signed-rank and Mann-Whitney tests.

Results:
At baseline, HIV+ participants had lower CD4+ counts (median 416 vs 742 CD4+ T cells/μL, p = 0.006), and a decreased proportion of CD57+ (senescent) CD8+ T cells (p = 0.007) compared with HIV- participants. After 3 cycles, pomalidomide led to an increased proportion of CD45RO+CD27+ (central memory) CD4+ (p = 0.002) and CD8+ (p = 0.002) T cells, a decrease in CD45RO-CD27- (effector) CD4+ cells (p = 0.0002), and expansion of CD38+/HLADR+ (activated) CD4+ (p = 0.002) and CD8+ (p= < 0.0001) T cells. Increased numbers of activated CD8+ T cells persisted at end-of-treatment (p = 0.002). After 3 cycles and at end-of-treatment, there was reduction in the proportion of CD57+ (senescent) CD4+ (p = 0.001, 0.0006) and CD8+ (p =  < 0.0001, 0.0004) T cells.

Conclusions:
Administration of pomalidomide decreased T cell senescence and increased T cell activation in patients with KS, suggesting pomalidomide activity in KS stems in part from its immunomodulatory effects.