bluuebunny/crossref_metadata_2025_split huggingface dataset:
VENOUS THROMBOEMBOLIC RISK AND PREVENTION IN ACUTE MEDICAL ILLNESS
Authors: Hampton KK 
Published: April 2023

SUMMARYWe describe a case in which an elderly woman is hospitalised for acute medical illness and ask how this patient's risk of venous thromboembolism should be assessed and managed. Venous thromboembolism was previously regarded as a surgical problem, but occurs at least as frequently among medical patients. The risk of venous thromboembolism varies, but recent studies have provided detailed data on the risk in patients with acute medical illness, in particular those patients with acute heart failure, respiratory failure and acute infectious disease. As the evidence has accumulated, specific guidelines recommend provision of thromboprophylaxis to patients at risk. An approach to venous thromboembolic risk assessment and prevention in acutely ill medical patients is presented.
CHURG‐STRAUSS SYNDROME IN AN HCV SEROPOSITIVE PATIENT
Authors: Dikensoy O , Bayram NG , Erbagci Z , Namiduru M , Filiz A , Ekinci E 
Published: April 2023

SUMMARYChurg‐Strauss syndrome was considered rare until leukotriene modifiers were introduced into medical practice in 1996. Since then, an increasing number of reports considering a possible relationship between leukotriene receptor antagonists and the Churg‐Strauss syndrome have been published. Hepatitis C virus (HCV) is a blood‐borne infection and a major health problem with an increasing prevalence worldwide. Previously, numerous reports suggested a relationship between HCV and certain autoimmune disorders such as cryoglobulinaemia and polyarteritis nodosa. We present a patient with HCV seropositive Churg‐Strauss syndrome and a history of systemic corticosteroid and leukotriene receptor antagonist use, and discuss the possible risk factors in the aetiology of Churg‐Strauss syndrome.
BLOODY DIARRHOEA: A RARE PRESENTATION OF A SYSTEMIC DISEASE
Authors: Mann SD , Young* A , Barrison IG , Catnach SM 
Published: April 2023

SUMMARYBloody diarrhoea in adolescents is usually due to enteric infection or inflammatory bowel disease. We describe a patient with bloody diarrhoea and endoscopic features of colitis in association with a systemic vasculitis. Positive anti‐proteinase‐3 antineutrophil cytoplasmic antibodies and cutaneous vasculitis on biopsy confirmed the diagnosis of Wegener's granulomatosis. He was started on high dose steroids and cyclophosphamide but required plasmapheresis for a declining renal function. The case highlights the need for vigilance with common clinical problems, because a life‐threatening condition may be averted by prompt recognition and urgent therapy with immunosuppressants.
TELITHROMYCIN: THE FIRST KETOLIDE ANTIBACTERIAL FOR THE TREATMENT OF COMMUNITY‐ACQUIRED RESPIRATORY TRACT INFECTIONS
Authors: Lorenz J 
Published: April 2023

SUMMARYTelithromycin is the first ketolide antibacterial to be approved for clinical use. The ketolides represent a novel class of antibacterial agents structurally related to the macrolides, which has been developed specifically to offer an optimal spectrum for the treatment of upper and lower respiratory tract infections (RTIs) caused by common and atypical pathogens, including strains that are resistant to currently used antibiotics. The innovative structural changes that distinguish telithromycin from macrolides contribute to its unique microbiological profile. Its well‐balanced spectrum of antibacterial activity is highly appropriate for the empirical treatment of upper and lower community‐acquired RTIs, offering activity against common, including resistant, and atypical/intracellular pathogens. Furthermore, telithromycin demonstrates a low propensity to select for or induce resistance to macrolide‐lincosamide‐streptogramin antibacterials. A once‐daily dose of telithromycin 800 mg rapidly achieves high concentrations in both plasma and respiratory tissues and fluids and is maintained at effective levels throughout the 24‐hour dosing period. In clinical trials, telithromycin has demonstrated high clinical and bacteriological efficacy in the treatment of community‐acquired pneumonia, acute exacerbations of chronic bronchitis, acute sinusitis and group A β‐haemolytic streptococcal tonsillitis/pharyngitis. High efficacy was maintained in those patient groups considered to be at high risk of complications and those with infections caused by penicillin and/or macrolide (erythromycin) resistant Streptococcus pneumoniae. Together with its favourable tolerability profile and short course of once‐daily therapy, these properties indicate that telithromycin will be a valuable new antibacterial for the empirical treatment of community‐acquired RTIs.
THE SKATE STUDY: INTERIM ANALYSIS
Authors: Elger Christian , Sander Ley , Owen Olwen Glynn 
Published: April 2023

SUMMARYThe Safety of Keppra as Adjunctive Therapy in Epilepsy (SKATE) study is a continuing phase IV open‐label evaluation of the antiepileptic drug levetiracetam (Keppra) as an adjunctive therapy in adult patients with uncontrolled partial seizures. The study, which began in April 2000, is scheduled to include 1400 patients from 300 centres in 16 countries. An interim analysis of the first 731 patients from 117 centres in nine countries treated over a 16‐week period showed that seizure frequency was reduced by half or more in 49% of patients across all seizure types. A substantial 17.2% of patients achieved complete freedom from seizures. Levetiracetam was well tolerated overall. Adverse events were predominantly mild to moderate and rarely led to discontinuation. The most commonly reported symptoms were asthenia, somnolence, headache and dizziness.
A SPINAL NEURENTERIC CYST PRESENTING AS BURNING FEET SYNDROME
Authors: Jain RS 
Published: April 2023

SUMMARYSpinal neurenteric cysts are rare congenital cysts of endodermal origin. A 34‐year‐old man presented with burning feet syndrome lasting two years. Magnetic resonance imaging (MRI) revealed an intradural extramedullar cystic mass extending from l_2 to L5 causing severe compression of the terminal portion of the conus medullaris and the filum terminale with displacement to the right side. A tethered cord and filar lipoma were also present. The cystic mass and filar lipoma were resected and the tethered cord released. Histopathology confirmed a neurenteric cyst. This case is reported in view of its peculiar presentation.
ENFUVIRTIDE (FUZEON®): THE FIRST FUSION INHIBITOR
Authors: Williams IG 
Published: April 2023

SUMMARYWith the number of people living with HIV infection increasing and the problems of drug resistance and long‐term toxicity associated with current antiretroviral agents continuing, there is a growing need for new therapy options. Enfuvirtide is the first fusion inhibitor, a new class of drug, to be licensed for the treatment of HIV infection and is a welcome addition to the arsenal of antiretrovirals. This paper, which is the result of a multidisciplinary discussion meeting, reviews current practice in treating HIV infection, the clinical data available on enfuvirtide and discusses its introduction into clinical practice. Data available to date indicate that enfuvirtide is appropriate for use in patients who have previously taken nucleoside reverse transcriptase inhibitor (NRTI), non‐NRTI and protease inhibitor containing regimens and are either intolerant of them or have experienced virological failure. Enfuvirtide should ideally be used while the patient still has other active drug options available to them to combine with enfuvirtide in an effective therapy regimen.
Chylothorax associated with pulmonary compressive atelectasis in an emperor tamarin (Saguinus imperator)
Authors: Santana Clarissa Helena , da Silva Laice Alves , de Paula Nayara Ferreira , dos Reis de Souza Lucas , Oliveira Ayisa Rodrigues , dos Santos Daniel Oliveira , Tinoco Herlandes Penha , Coelho Carlyle Mendes , Gonçalves Ângela Tinoco Pessanha Ribeiro , Silva Rodrigo Otávio Silveira , da Paixão Tatiane Alves , Santos Renato Lima 
Published: April 2023

AbstractChylothorax is the accumulation of lymph in the thoracic cavity, and it has never been reported in neotropical primates. An emperor tamarin died and at necropsy chylothorax associated with pulmonary compressive atelectasis was diagnosed. Idiopathic chylothorax can be a cause of respiratory insufficiency and death in tamarins.
Niraparib as a therapeutic agent for the treatment of ovarian cancer meningeal dissemination with BRCA1 mutation
Authors: Nei Takashi , Tamauchi Satoshi , Ikeda Yoshiki , Yoshikawa Nobuhisa , Niimi Kaoru , Kajiyama Hiroaki 
Published: April 2023

AbstractThis study analyzed a 63‐year‐old woman with hereditary BRCA1 mutation. She underwent interval debulking surgery after neoadjuvant chemotherapy for high‐grade serous ovarian carcinoma (HGSOC). After 2 years of postoperative chemotherapy, she developed headache and dizziness, and a suspected metastatic cerebellar mass in left ovary was detected. Pathological analysis of the mass revealed HGSOC, which was removed surgically. Eight months and another 6 months after the surgery, local recurrence was noted; hence, she underwent CyberKnife treatment. After 3 months, cervical spinal cord metastasis was found, evidenced by left shoulder pain. Moreover, meningeal dissemination was present around the cauda equina. Chemotherapy treatment, including bevacizumab, was ineffective and increased lesions were observed. After CyberKnife treatment for the cervical spinal cord metastasis, niraparib was initiated for the meningeal dissemination. The cerebellar lesions and meningeal dissemination improved within 8 months of niraparib treatment. Although meningeal dissemination is challenging to treat, niraparib may be useful in BRCA‐mutated HGSOC.
Characterising approaches to steroid therapy in paediatric multisystem inflammatory syndrome temporally associated with SARS‐CoV‐2
Authors: McGlacken‐Byrne Sinéad M , Johnson Mae , Penner Justin , du Pré Pascale , Katugampola Harshini 
Published: April 2023

AimWe describe approaches to steroid therapy use in paediatric multisystem inflammatory syndrome temporally associated with SARS‐CoV‐2 (PIMS‐TS) and examine the association between steroid therapy and key clinical markers of severity.MethodsWe conducted a retrospective review of children (<18 years) admitted to a tertiary paediatric hospital in the UK with PIMS‐TS. We collected data on if and why steroid therapy was used; the duration, type and dosing of steroids prescribed; and approaches to hypothalamo‐pituitary‐adrenal (HPA) axis monitoring, if performed. We examined associations between steroid exposure/total steroid dose (mg/m2/day) and paediatric intensive care unit admission, mechanical ventilation and inotropic support.ResultsSteroid therapy was commenced in most children (84.9%, n = 104) with a median total daily steroid dose (hydrocortisone equivalent) of 271.0 mg/m2/day (interquartile range 232.5–355.5) and treatment length of 26.0 days (interquartile range 19.0–32.0). Dosing regimens predominantly involved a short course of high‐dose methylprednisolone followed by tapering oral prednisolone. Basal and/or dynamic testing of the HPA axis was conducted in a minority (11.8%, n = 15) and was normal. Duration of steroid therapy correlated positively with durations of paediatric intensive care unit admission (r = 0.407, P < 0.001) and mechanical ventilation (r = 0.797, P < 0.001). A greater proportion of children receiving steroid therapy also received inotropic support compared to those that did not receive steroid therapy (71.4% vs. 45.5%, P = 0.025).ConclusionProlonged, high‐dose steroid therapy is often used in the management of severe PIMS‐TS with the potential for HPA axis suppression and should be withdrawn carefully.
Post‐operative pain in children: Comparison of pain scores between parents and children
Authors: Niu Tianchen , Liu Mengjie , Fang Yu , Liu Yuping , Zhang Xiaoman 
Published: April 2023

AimTo compare the relationship between parent–child postoperative pain scores and explore the factors that led to the difference in the score.MethodsConvenience sampling was used to select children and their parents who were 5–14 years old and scheduled for elective surgery as study subjects. When the child returned to the ward after surgery, the parent and child used the pain assessment tool to score the child's postoperative pain, respectively.ResultsA total of 214 children and their parents were included in the study. The results showed that the postoperative pain scores of parents and children were 3.69 ± 2.47 and 4.05 ± 2.90, respectively, and there were differences between the scores (P < 0.05). The results of multiple linear regression indicated that whether the child used Patient‐Controlled Analgesia, different types of surgery and parents' pre‐operative anxiety may be the reasons for the differences in parent–child scores.ConclusionThe parents' pain scores differed from their children's pain scores. If health‐care professionals wanted to use the parents' pain score to replace the child's pain score, consideration should be given to whether children used patient‐controlled analgesia, different types of surgery and the parents' pre‐operative anxiety on the parents' pain score.
Effectiveness of AI‐driven remote monitoring technology in improving oral hygiene during orthodontic treatment
Authors: Snider Vivian , Homsi Karen , Kusnoto Budi , Atsawasuwan Phimon , Viana Grace , Allareddy Veerasathpurush , Gajendrareddy Praveen , Elnagar Mohammed H. 
Published: April 2023

AbstractObjectiveThis study aimed to evaluate the effectiveness of Dental Monitoring™ (DM™) Artificial Intelligence Driven Remote Monitoring Technology (AIDRM) technology in improving the patient's oral hygiene during orthodontic treatment through AI‐based personalized active notifications.MethodsA prospective clinical study was conducted on two groups of orthodontic patients. DM Group: (n = 24) monitored by DM weekly scans and received personalized notifications on the DM smartphone application regarding their oral hygiene status. Control Group (n = 25) not monitored by DM. Both groups were clinically assessed using Plaque Index (OPI) and the Modified Gingival Index (MGI). DM Group was followed for 13 months and the Control Group was followed for 5 months. Student‐independent t test and paired t tests were used to investigate the mean differences between study groups and between time points for each group respectively.ResultsAt all time points, the mean differences indicated that the DM group had lower OPI and MGI values than the control group. The mean value for OPI and MGI were statistically significantly lower in the DM group (OPI = 1.96, MGI = 1.56) than in the control group (OPI = 2.41, MGI = 2.17) after 5 months. A rapid increase in mean OPI and MGI values was found between T0 and T1 for both study groups. A plateau effect for OPI scores appeared to occur from T1 to T5 for both study groups, but the plateau effect seemed to be more pronounced for the DM group than the study group. The MGI values for both study groups also increased dramatically from baseline to T5, however, a plateau effect was not observed.ConclusionsThe oral hygiene of orthodontic patients rapidly worsens over the first 3 months and plateaus after about 5 months of treatment. AIDRM by weekly DM scans and personalized active notifications may improve oral hygiene over time in orthodontic patients.
Longevity and potential reusability of cardiac implantable electronic devices explanted in funeral homesPublisher
Authors: Lorenzo Ruiz Iñigo 
Published: April 2023

AbstractBackgroundWhile in high‐income countries (HICs) the implantation of cardiac implantable electronic devices (CIEDs) is common, in certain low‐ and middle‐income countries (LMICs) access to devices is limited and insufficient to meet the demand. Between 17% and 30% of CIEDs explanted post‐mortem in HICs appears to have enough battery life to be reused but devices are not routinely programmed to no pacing output and continue to consume battery after the patient's death. Therefore, we conducted a prospective analysis of CIEDs collected from funeral homes, controlling variables such as the date of explantation and limiting the time until the date of interrogation to 6 months. The objective was to perform an accurate analysis of the reusability of post‐mortem explanted CIEDs to assess the possibility of implementing a local effort of CIED reuse in LMICs.MethodsA descriptive study of post‐mortem explanted CIEDs in funeral homes was conducted. Participating centers stored all devices explanted between December 2020 to December 2021 for collection and interrogation.ResultsThe participating centers attended 6472 deaths (28.05% of total deaths registered in the region). Two hundred fourteen CIEDs were collected (90.2% pacemakers and 9.8% defibrillators). Of the 214 collected devices, 100 CIEDs (46.7%) had >4 years or >75% battery remaining, preserved external integrity, and no evidence of malfunction and therefore were considered reusable.ConclusionsBased on stablished criteria 46.7% of recovered devices were considered reusable. Therefore, recovery from funeral homes of HICs comprises a potential source of reusable devices for LMICs.
High‐frequency ultrasound biomicroscopy findings of the skin of dogs with atopic dermatitis
Authors: Mantis Panagiotis , Sofou Evangelia I. , Aleksandrova Svetlina , Badulescu Elisabeta , Church David , Lloyd David , Koutsouvelis Panagiotis , Mpairamoglou Stathis , Chatzis Manolis , Saridomichelakis Manolis 
Published: April 2023

AbstractBackgroundThe high‐frequency ultrasonographic appearance of skin of dogs with atopic dermatitis (cAD) has not been described.ObjectivesTo compare high‐frequency ultrasonographic findings among lesional, macroscopically nonlesional skin of dogs with cAD, and the macroscopically nonlesional skin of healthy dogs. Additionally, to determine whether there is any correlation between the ultrasonographic findings in lesional skin and local Canine Atopic Dermatitis Extent and Severity Index, 4th iteration (CADESI‐04) or its domains (erythema, lichenification, excoriations/alopecia). As a secondary aim, six cAD dogs were re‐evaluated after management intervention.AnimalsTwenty dogs with cAD (six were re‐examined after treatment) and six healthy dogs.Materials and MethodsIn all dogs, ultrasonographic examination was performed on the same 10 skin sites, using a 50 MHz transducer. Wrinkling of skin surface, presence/width of subepidermal low echogenic band, hypoechogenicity of dermis and thickness of the skin were evaluated and scored/measured blindly.ResultsDermal hypoechogenicity was more common and severe in lesional compared to macroscopically nonlesional skin of dogs with cAD. In lesional skin, presence/severity of wrinkling of skin surface and of dermal hypoechogenicity were positively correlated with presence/severity of lichenification, while severity of dermal hypoechogenicity was positively correlated with local CADESI‐04. A positive correlation between the change in skin thickness and the change in the severity of erythema during treatment was noted.Conclusions and Clinical RelevanceHigh‐frequency ultrasound biomicroscopy may be useful for the evaluation of skin of dogs with cAD and for evaluating the progression of skin lesions during treatment.
Bilateral corneal dermoids associated with bilateral choroido–scleral colobomas in a cat: retinographic and optical coherence tomography study with surgical outcome and follow–up
Authors: Cognard Sophie Andree , Cassagnes Charles , Chaudieu Gilles , Manning Heather 
Published: April 2023

AbstractPurposeTo report a case of feline bilateral corneal dermoids, associated with unilateral iris coloboma and bilateral choroido‐scleral colobomas in the same dorsolateral position, to describe retinographic and optical coherence tomography (OCT) characteristics, surgical outcome, and follow‐up.Animal studiedA 9‐month‐old domestic shorthaired cat in which a full ophthalmoscopic examination was performed for evaluation of dermoids resulting in a diagnosis of associated iris coloboma in one eye and posterior colobomas in both eyes.ProceduresRetinographies and OCT were performed under anesthesia to characterize the lesions of both fundi and allow surgical excision of the corneal dermoids.ResultsOphthalmoscopy and retinographies revealed oval lesions in the dorsolateral fundi of both eyes. The lesions precisely mirrored their respective dermoids' (10‐11 h OD and 1‐2 h OS) clock positions, lacked a tapetum lucidum and choroidal vessels, and featured thin retinal vessels plunging to a posterior plane of the fundus. OCT crossline scans demonstrated preservation of retinal thickness and morphological layering in the fundic colobomas leading to the conclusion that the colobomas were purely choroido‐scleral. The outcome of the surgical excision of the dermoids was satisfactory without hair recurrence and with acceptable corneal clarity making it possible to visualize the unilateral associated iris coloboma. Follow‐ups did not reveal any fundic evolution nor retinal detachment.ConclusionsRetinographies and OCT made possible the characterization of choroido‐scleral colobomas associated with corneal dermoids in this first reported case in a cat. We hypothesize that the recently described superior ocular sulcus might be the embryological link between these anomalies.
Verbal Encouragement Improves Game Intensity, Technical Aspects, and Psychological Responses During Soccer-Specific Training
Authors: Selmi Okba , Levitt Danielle E. , Aydi Bilel , Ferhi Waad , Bouassida Anissa 
Published: April 2023

Background: Soccer match outcomes rely on technical accuracy, intensity of play, and athlete motivation, and these parameters can be developed during sport-specific practice such as during small-sided games (SSGs). Verbal encouragement as a coaching technique improves exercise intensity and athlete enjoyment (indicative of motivation), but the impact on technical performance alongside these critical parameters remains unknown. Purpose: To examine the effects of verbal encouragement on technical performance, exercise intensity, and enjoyment during SSGs. Methods: Sixteen male youth soccer players (mean [SD]; age: 17.2 [0.4] y; height: 176.3 [7.0] cm; body mass: 68.0 [4.1] kg; body fat: 11.9% [2.2%]) completed 4 sessions of 4-per-side SSG without a goalkeeper. Two sessions were conducted as SSGs with verbal encouragement and 2 without verbal encouragement. Each SSG lasted 25 minutes (4 × 4-min work, 3-min passive recovery between bouts) on a 25 × 35-m pitch. Heart rate (HR) was continuously recorded, and rating of perceived exertion was collected after each SSG. Video analysis was used to quantify technical actions during SSG. Enjoyment was assessed after each SSG using the Physical Activity Enjoyment Scale. Results: Paired t tests revealed that SSGs with verbal encouragement induced higher HR (% maximum HR and mean HR), rating of perceived exertion, and Physical Activity Enjoyment Scale score than SSGs without verbal encouragement (all P < .001, all d ≥ 0.92, large). Compared with SSGs without verbal encouragement, SSGs with verbal encouragement resulted in an increased percentage of successful passes (P < .001, d = 0.73, medium) and number of interceptions (P < .001, d = 0.89, large) and fewer lost balls (P < .001, d = 0.68, medium). Conclusions: Coaches should use verbal encouragement during SSGs to improve physical effort, technical performance, and psychological status in soccer players.