bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Use of a Dehydrated Complete Human Placental Membrane Allograft for Mohs Surgical Defects of the Nose
Authors: Wilmas Kelly M. , Patel Jigar , Silapunt Sirunya , Doan Hung Q. , Migden Michael R. 
Published: February 2023

BACKGROUND
Repair options for Mohs surgical defects include primary closure, flap or graft, or healing by second intention. These options may not be optimal in all cases. A dehydrated complete human placental membrane (dCHPM) allograft may serve as an alternative repair option.

OBJECTIVE
To assess the aesthetic and functional outcomes of an alternative repair technique for Mohs surgical defects of the nose.

METHODS
Twenty patients with Mohs surgical defects of the nose repaired with a dCHPM allograft were retrospectively identified. Photographs were used to demonstrate surgical technique and outcomes. Two blinded observers evaluated final outcomes using the Patient and Observer Scar Assessment Scale.

RESULTS
Observers rated the scar outcome a combined mean score of 8.4 ± 3.2 (scale 5–50). Patients rated their outcomes a mean of 12.6 ± 7.4 (scale 6–60). The mean “Overall Opinion score” was 2.5 ± 1.8 by patients and 1.9 ± 1.3 by observers (scale 1–10).

Limitations
This was a single institution study with a small sample size.

CONCLUSION
Our study demonstrates that dCHPM allografts are a viable alternative repair option for Mohs surgical defects of the nose.
Highly Purified Microdroplet Liquid Injectable Silicone for the Treatment of Acne Scars in Lighter and Darker Skin Types: A Retrospective Review
Authors: Salame Nicole , Brody Harold J. 
Published: February 2023

BACKGROUND
Treatment of acne scarring in darker skin types is fraught with challenges. Highly purified liquid injectable silicone (LIS) is effective in the treatment of acne scars, although its use in darker skin types has yet to be evaluated.

OBJECTIVE
Retrospective evaluation of the safety and efficacy of highly purified LIS for the treatment of acne scars in lighter and darker skin types.

MATERIALS AND METHODS
A retrospective chart review of patients who received highly purified LIS for acne scars between July 2010 and March 2021.

RESULTS
Two hundred six total treatments in 96 patients, 32.29% (n = 31) of whom were Fitzpatrick skin type IV (n = 20, 20.83%) and V (n = 11, 11.46%), with depressed and both broad-based and shallow acne scarring were reviewed. Mean age was 50.77 years (SD 16.77), and 83% were female. Complications such as granuloma formation, migration, extrusion of silicone, hyperpigmentation, hematoma, or infection were not observed. The average follow-up time was 6.31 years (SD 3.02).

CONCLUSION
Highly purified LIS is a safe and effective permanent treatment for acne scars in all skin types. Injection of highly purified LIS using small volume microdroplet technique at 6- to 8-week intervals did not yield any complications, including in patients with darker skin types.
Efficacy and Safety of the Micro-insulated Needle Radiofrequency Device for Reduction of Submental Fat
Authors: Kim Bo Ri , Kim Minjae , Kim Jee Woo , Shin Jung-Won , Na Jung-Im , Huh Chang-Hun 
Published: February 2023

BACKGROUND
Recently, it has been reported that a micro-insulated needle radiofrequency (RF) system is effective at achieving subcutaneous fat reduction; however, no study has yet applied this technique to reduce submental fat.

OBJECTIVE
To evaluate the efficacy and safety of a fractional RF device with a micro-insulated needle to reduce submental fat.

MATERIALS AND METHODS
In this prospective, single-blinded, pre–post comparative study, 24 adults with excess submental fat were treated once using a micro-insulated needle RF device. Outcomes included efficacy (submental fat rating by an independent investigator, fat volume quantified with a 3-dimensional camera, and patient satisfaction), assessed 1 and 2 months after the procedure, and safety (adverse events), assessed throughout the study.

RESULTS
The patients' Physician-Assisted Submental Fat Rating Scale score significantly decreased after 1 month and further decreased after 2 months. The average volume of submental fat was significantly decreased after 2 months (20.44 ± 5.53 cc to 16.41 ± 4.58 cc, p < .001). Patient satisfaction was high. Transient and mild local skin reactions without long-term sequelae were observed in 4 patients.

CONCLUSION
The micro-insulated needle RF device is beneficial for the reduction of submental fat and has tolerable safety profiles.

Trial registration

ClinicalTrials.gov Identifier: NCT05517824.
Airway Edema after Keloid Resection and Superficial Radiation: Unexpected Event in an Unusual Location
Authors: Bailey Virginia Elizabeth , Knowles Ariel , Glass Donald , Albuquerque Kevin , Nagarkar Purushottam 
Published: February 2023

Summary:
Postoperative radiation therapy has been shown to significantly reduce recurrence rates of keloids after surgical excision. Adverse effects of radiation therapy in this setting are generally minimal because the radiation utilized quickly dissipates below the skin, and the radiation effects on the internal organs are usually negligible. This case report describes a patient who underwent excision of a wide anterior neck keloid and received postoperative external beam radiation therapy of the incision. She presented with extensive upper airway edema, dyspnea, and dysphagia requiring readmission and steroids. Re-evaluation of the radiation protocol revealed an inadvertent intersection of the multiple abutting radiation fields at the supraglottic region, resulting in tripling of the dose in the area, and likely leading to her complication. She did well with conservative management with IV steroids, and did not require intubation. She has had no long-term sequelae and no recurrence at 6 months postoperative.
Retrospective Detection Sensitivity for GPS-based Gamma Radiation Surveys
Authors: Alecksen Tyler , Whicker Randy 
Published: February 2023

Abstract
A probabilistic method for a priori calculation of the expected minimum detectable concentration of a contaminant radionuclide in soil while scanning (“scan MDC”) with a GPS-based gamma radiation survey system has previously been described. This paper presents supporting evidence for the validity of respective use of a statistical minimum detectable count rate (MDCR) as described in the Multi-Agency Radiation Survey and Site Investigation Manual (MARSSIM) and builds on related concepts to develop a technical basis for a posteriori estimation of MDCR and scan MDC sensitivity metrics for geospatially rendered datasets. Nearest-neighbor averaging of multiple data points from a geospatial population of gamma survey data permits retrospective quantification of MDCR values based on statistical reductions in the variance in both background and source data distributions. A retrospective MDCR can be used to calculate a posteriori scan MDCs based on detection efficiencies modeled with the probabilistic method for various radionuclides, source dimensions, detector heights, and scan speeds.
A Telestroke Nurse and Neuroradiologist Model for Extended Window Code Stroke Triage
Authors: Helms Anna Maria , Yang Hongmei , Karamchandani Rahul R. , Williams Laura , Singh Sam , DeFilipp Gary J. , Asimos Andrew W. 
Published: February 2023

ABSTRACT

BACKGROUND: Distinguishing features of our stroke network include routine involvement of a telestroke nurse (TSRN) for code stroke activations at nonthrombectomy centers and immediate availability of neuroradiologists for imaging interpretation. On May 1, 2021, we implemented a new workflow for code stroke activations presenting beyond 4.5 hours from last known well that relied on a TSRN supported by a neuroradiologist for initial triage. Patients without a target large vessel occlusion (LVO) were managed without routine involvement of a teleneurologist, which represented a change from the preimplementation period. METHODS: We collected data 6 months before and after implementation of the new workflow. We compared preimplementation process metrics for patients managed with teleneurologist involvement with the postimplementation patients managed without teleneurologist involvement. RESULTS: With the new workflow, teleneurologist involvement decreased from 95% (n = 953) for patients presenting beyond 4.5 hours from last known well to 37% (n = 373; P < .001). Compared with patients in the preimplementation period, postimplementation patients without teleneurologist involvement experienced less inpatient hospital admission and observation (87% vs 90%; unadjusted P = .038, adjusted P = .06). Among the preimplementation and postimplementation admitted patients, there was no statistically significant difference in follow-up neurology consultation or nonstroke diagnoses. A similar percentage of LVO patients were transferred to the thrombectomy center (54% pre vs 49% post, P = .612), whereas more LVO transfers in the postimplementation cohort received thrombectomy therapy (75% post vs 39% pre, P = .014). Among LVO patients (48 pre and 41 post), no statistical significance was observed in imaging and management times. CONCLUSION: Our work shows the successful teaming of a TSRN and a neuroradiologist to triage acute stroke patients who present beyond an eligibility window for systemic thrombolysis, without negatively impacting care and process metrics. This innovative partnering may help to preserve the availability of teleneurologists by limiting their involvement when diagnostic imaging drives decision making.
A fatal retroperitoneal bleeding from iliolumbar artery following open reduction and internal fixation of an unstable pelvic ring injury: A case report
Authors: Song Suk-Kyoon , Park Jinkyu , Lee Sungho 
Published: February 2023

Rationale:
Retroperitoneal bleedings are the result of injury to parenchymal tissue or vascular structures within retroperitoneal cavity. This may arise spontaneously, as a result of trauma or iatrogenically. Patients usually do not manifest clinically apparent signs and symptoms until a substantial amount of blood loss has occurred. Therefore, it is associated with high morbidity and mortality. Herein we present and discuss a case of fatal iatrogenic retroperitoneal bleeding following open reduction and internal fixation of an unstable pelvic ring injury.

Patient concerns:
A 66-year-old female patient presented to the Level I regional trauma center with severe pelvic pain after a pedestrian collision by a car.

Diagnoses:
In initial radiography and computed tomography, she was diagnosed with unstable pelvic ring injury.

Interventions:
Definitive surgery for open reduction and internal fixation through the anterior approach to the sacroiliac joint and anterior intrapelvic approach was performed on the 8th day after the injury.

Outcomes:
Patient died 3 days after the surgery due to a massive retroperitoneal bleeding from iliolumbar artery.

Lessons:
Insidious retroperitoneal bleeding from the small vessel may lead to fatal massive retroperitoneal hematoma. Therefore, active retroperitoneal bleeding should be suspected in cases of unexplained unstable hemodynamic status following orthopedic pelvic and acetabular surgery.
Offer of integrative and complementary health practices for the elderly in health services: A protocol for systematic review and meta analysis
Authors: Diniz Nathália Priscilla Medeiros Costa , da Silva José Felipe Costa , Sampaio Ana Tânia Lopes , Torres Gilson de Vasconcelos , Schveitzer Mariana Cabral , Nobre Thaiza Teixeira Xavier 
Published: February 2023

Introduction:
Integrative and complementary health practices (ICHP) question the hegemony of the biomedical, technical and hospital paradigm, as they are an important axis in the process of redefining the health care model. Understanding how ICHP are offered to the elderly population can help to improve the production of changes in care and in the daily life of health services.

Objective:
To identify and summarize the scientific evidence on the provision of ICHP for the elderly in health services.

Methods:
This is a research protocol for a scoping review following the recommendations of the Extension for Scoping Reviews method proposed by the Joanna Briggs Institute. Studies will be collected in the following databases, Latin American and Caribbean Health Sciences Literature, Web of Science, Scopus, Scielo, Online System for Searching and Analyzing Medical Literature (MEDLINE), Embase, Virtual Library in Health and gray literature. Two independent reviewers will perform screening, data extraction, and risk of bias assessment using the Joanna Briggs Institute Critical Assessment Checklist. For the quality of evidence, the Grading of Recommendations, Assessment, Development and Evaluation analysis will be used.

Results:
This review will provide information on the provision of ICHP for the elderly population in health services.

Conclusions:
This scoping review will provide evidence to help health professionals, managers and users to recognize more effective therapeutic inventions for promoting, preventing and protecting comprehensive health at different levels of care.
Axenfeld–Rieger syndrome combined with ectropion uveae and pigment dispersion syndrome: A case report
Authors: Li Yang , Liu Jie , Tian Qingmei , Ma Xianzhen , Zhao Yuhui , Bi Hongsheng 
Published: February 2023

Background:
In January 2021, we found one case of Axenfeld–Rieger syndrome combined with pigment dispersion syndrome (PDS), and this patient additionally manifested a symptom of ectropion uveae. The co-existence of both 2 syndromes is very rare and has not been reported in any literature yet.

Case presentation:
A 34-year-old female truck driver presented to our institution with a dimness of vision in her right eye. The patient had obvious posterior embryotoxons at bitamporal, and peripheral anterior synechia could be visualized by the slit lamp. The dispersion of pigment granules was observed behind the cornea. The pupil was slightly shifted upwards the nose, with 360° ectropion uveae. Gonioscopy revealed pigment accumulation on the trabecular meshwork. The patient underwent cataract surgery on her right eye, during which, flaky pigmentation around the posterior capsule was observed. These signs were consistent with Axenfeld–Rieger syndrome and PDS.

Conclusions:
We report a rare case of Axenfeld–Rieger syndrome with PDS and uveal eversion. Although the patient did not present with glaucoma, follow-up should be noted. Besides, the correlation between these 2 syndromes needs to be demonstrated by more cases or further evidence.
Immediate hypersensitivity reaction to intravitreal injection of triamcinolone acetonide following treatment by pars plana vitrectomy: A case report
Authors: Zhang Wei , Liao Mengyu , Yan Hua 
Published: February 2023

Rationale:
Hypersensitivity reactions to intravitreal injection of triamcinolone acetonide (TA) were very rare and had been infrequently reported. In this study, we reported the clinical features of hypersensitivity reactions of TA, explored its management, and analyze the relative factors.

Patient concerns, diagnosis, interventions, and outcomes:
We described a case of an immediate hypersensitivity reaction to intravitreal injection of TA following the treatment by pars plana vitrectomy. A 27-year-old man was reported with an immediate hypersensitivity reaction following an intravitreal injection of TA. 0.1 mL TA (40 mg/mL) was injected into the vitreous cavity and then white punctate edema appeared on the surface of the retina. Three days later, the visual acuity was 20/500 and white punctate edema disappeared on the surface of the retina without specific treatment.

Conclusions and importance:
Hypersensitivity reaction must be considered in cases of intravitreal injection of TA that may resolve without specific treatment. The clinical intravitreal injection of TA requires filtration to remove excipients.
Successful chemotherapy with continuous immunotherapy for primary pulmonary endovascular epithelioid hemangioendothelioma: A case report
Authors: Guo Wenliang , Zhou Daibing , Huang Houquan , Chen Haiming , Wu Xiaofeng , Yang Xin , Ye Huiling , Hong Cheng 
Published: February 2023

Rationale:
Epithelioid hemangioendothelioma (EHE) is a rare, low to moderate-grade malignancy, even less in pulmonary endovascular neoplasm. Patients with pulmonary EHE have no optimal treatment, resulting in poor prognoses.

Patient concerns:
We reported a 42-year-old man with multiple mild metabolic uptakes in pulmonary endovascular filling defect with a maximum standardized uptake value of 4.5 by 18-fluorodeoxyglucose/fibroblast associated protein inhibitor-positron emission tomography/ computed tomography. Anticoagulant treatment was not effective with the diagnosis of acute pulmonary embolism.

Diagnoses:
A primary endovascular EHE pulmonary endovascular epithelioid hemangioendothelioma was diagnosed by endovascular biopsy with positive stains for molecular CD31, CD34 and CAMTA1, and it had low proliferative capacity characterized by Ki-67 of 5%. The mutation gene MSH2 (p.Y656 in exon 12) (mutation abundance of 0.07%) from peripheral blood indicates the potential benefit of an immune checkpoint inhibitor, pembrolizumab.

Interventions and outcomes:
The patient was treated with tri-weekly paclitaxel (175mg/m2) and carboplatin (AUC 5) chemotherapy regimen. He exerted a remarkable response after 5 cycles (21 days per cycle) and Pembrolizumab (200mg once monthly) as maintenance treatment.

Lessons:
This case highlights the diagnostic challenge of differentiating endovascular lesions and optimal therapy for pulmonary EHE. Importantly, it indicated that the mutation gene MSH2 (p.Y656) might influence the pathogenesis of EHE.
Durable response of tislelizumab plus cisplatin, nab-paclitaxel followed by concurrent chemoradiotherapy in locoregionally advanced nasopharyngeal carcinoma: A case report
Authors: Tang Haifeng , Yang Donghong , Luo Guoqing , He Jiaqi , Yi Guihua , Chen Zihong , Li Haiwen , Luo Qianbing , Huang Ningxin , Luo Haiqing 
Published: February 2023

Rationale:
Limited patients with locoregionally advanced nasopharyngeal carcinoma (LA-NPC) have achieved complete response (CR) from induction chemotherapy (IC). Neoadjuvant immunotherapy combined with chemotherapy has marked therapeutic effects in some locoregionally advanced solid tumors. However, its efficacy and safety of NPC have not been reported so far. The rapid response of neoadjuvant tislelizumab combined with chemotherapy on LA-NPC may be associated with long-term survival benefit.

Patient concerns:
A 57-year-old male patient presented with a 2-month history of bloody nasal discharge and right neck mass for 2 weeks.

Diagnosis:
The patient was eventually diagnosed with nasopharyngeal nonkeratinizing undifferentiated cell carcinoma (stage IVA).

Interventions:
The patient received tislelizumab combined with nanoparticle albumin-bound paclitaxel (nab-paclitaxel) nab-paclitaxel plus cisplatin for 4 cycles, followed by cisplatin-based concurrent chemoradiotherapy (CCRT).

Outcomes:
A partial response (PR) was achieved after 2 cycles of tislelizumab and nab-paclitaxel plus cisplatin, and CR was achieved after 4 cycles of neoadjuvant treatment. The duration of response lasted 24 months, and the patient was still in CR as of November 2022. The patient had no serious adverse event (AEs) during the treatment.

Lessons:
This case report showed that tislelizumab combined with cisplatin plus nab-paclitaxel followed CCRT for treatment of patients with LA-NPC may receive a fast and durable response with a manageable safety profile and long-term survival.
The effectiveness of motherwort injection in preventing postabortion hemorrhage after induced abortion: A protocol for systematic review and meta-analysis
Authors: Xiang Yanjie , Wang Xiaohan , Gong Yongqian , Xiang Jianfeng 
Published: February 2023

Background:
Unintended pregnancy is a problem that women encounter throughout their reproductive age. Excessive and prolonged uterine bleeding is one of the most common and critical adverse reactions of induced abortion, for it increases the risk of anemia and intrauterine infection. To provide reliable clinical evidence, we performed a protocol for systematic review and meta-analysis to evaluate the hemostatic effect of motherwort in postabortion.

Methods:
This review protocol has been registered in the international prospective register of systematic reviews. The statement of Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols will be used as guidelines for reporting present review protocol. Original clinical randomized controlled trials assessing the beneficial effects and safety of motherwort on induced abortion will be included. Databases searched include China National Knowledge Infrastructure, Chinese Scientific Journals Database, Wanfang Database, China Biological Medicine Database, PubMed, and EMBASE Database and Cochrane Central Register of Controlled Trials. Cochrane collaboration tool is used to assess the risk of bias of included randomized controlled trials. All calculations are carried out with Stata 11.0 (The Cochrane Collaboration, Oxford, United Kingdom).

Results:
This systematic review and meta-analysis will provide a detailed summary of the current evidence related to the efficacy of motherwort injection preventing postabortion hemorrhage after induced abortion.

Conclusion:
This evidence will be useful to practitioners, patients, and health policy-makers regarding the use of motherwort injection in induced abortion.
Hem coagulase induced cerebral venous sinus thrombosis in patients with uterine fibroids surgery
Authors: Sun Bei , Liu Tingting , Xu Bingchao , Zhang Guanghui , Xie Kang 
Published: February 2023

Background:
Cerebral venous sinus thrombosis (CVST) is a rare, high-risk, and easily misdiagnosed disease. Currently, there are case reports of hem coagulase-induced thrombotic events, but no reports of CVST being associated with hem coagulase.

Case summary:
A 35-years-old woman presented to the outpatient clinic with a severe headache and sudden memory loss with intravenous hem coagulase for postoperative bleeding after uterine fibroids surgery. Abnormal neurological signs included slowed reactions, poor memory, and decreased numeracy. Magnetic resonance imaging and computed tomography scan showed multiple cerebral infarcts, and the infarct area was non-arterial. Brain magnetic resonance venography showed obstruction of the left sigmoid sinus. High-resolution magnetic resonance imaging of the left sigmoid sinus showed abnormally high signal. The patient was treated with a subcutaneous Low-Molecular-Weight Heparin Sodium injection 0.4 ml, twice a day (7 days), and oral Warfarin Sodium 3 mg, once a day, while monitoring the international normalized ratio, adjust the warfarin sodium dosage according to the international normalized ratio level. One month later, the patient had no neurological symptoms and her cognitive function returned to normal.

Conclusion:
hem coagulase may be a contributing factor to CVST in patients undergoing uterine fibroids surgery and should be administered intravenously with caution.