bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcomes of Corneal Transplant in Childhood Glaucoma
Authors: Vidal-Villegas Beatriz , Burgos-Blasco Barbara , Ariño-Gutierrez Mayte , Cuiña Sardiña Ricardo , Mendez-Hernandez Carmen Dora , Torres-Gonzalez Juan Ignacio , Mendez-Fernandez Rosalía , Díaz-Valle David , García-Feijóo Julián 
Published: May 2023

Précis:
Childhood glaucoma produces alterations in the postnatal development and function of various ocular structures, including the cornea. Childhood glaucoma patients present lower corneal transplant survival rates. Our series shows outcomes of corneal transplant in childhood glaucoma with survival rates of 29% at 2 years.

Objective:
To investigate the surgical outcome of different types of keratoplasty in eyes with childhood glaucoma.

Patients and Methods:
A retrospective review was made of the medical records from 17 eyes of 15 patients who were diagnosed with childhood glaucoma and received a corneal transplantation between January 2010 and July 2020. Patient demographics, intraocular pressure, previous ocular surgery, comorbidities, corneal transplant surgery, and follow-up outcome were collected. The primary efficacy endpoint was graft survival (in months) until failure, the latter being considered as irreversible loss of corneal transparency. Secondary efficacy points were the need for an increase in topical hypotensive therapy and the need for additional surgery.

Results:
Seventeen eyes of 15 patients were included, 11 eyes (10 patients) with primary congenital glaucoma and 6 with other types of childhood glaucoma. Corneal transplantation was performed at the mean age of 23.76 ± 14.86 years. At the time of the transplantation, the number of topical medications was 1.35 ± 1.27, intraocular pressure was 15.00 ± 8.34 mm Hg, and patients had received up to 7 glaucoma surgeries. Descemet stripping automated endothelial keratoplasty was performed in 13 eyes (76%) and penetrating keratoplasty in 4 (24%). After surgery, 7 (41%) eyes required increased topical treatment and 2 (12%) glaucoma surgery. Twelve eyes (71%) developed graft failure at 24 months, the mean time of survival being 13.88 ± 8.25 months.

Conclusions:
Management of corneal decompensation in childhood glaucoma poses a challenge. In this series of childhood glaucoma with corneal transplantations, the survival rate was 29% at 24 months.
Effect Modification of Racial Differences in Pediatric COVID-19 Inpatient Admissions in a Large Healthcare Database
Authors: Watson Dave , Spaulding Alicen , Norton Laura 
Published: May 2023

Background:
Coronavirus disease 2019 (COVID-19) has been more severe in racial and ethnic minorities relative to non-Hispanic White populations. Here, we investigate how these disparities vary across effect modifiers in a pediatric population.

Methods:
Using the TriNetX Dataworks Network from April 2020 to September 2021, we compared inpatient rates between non-Hispanic Black and non-Hispanic White patients among pediatric COVID-19 cases. Following propensity score matching, comparisons were performed within subgroups of 4 potential effect modifiers: age group (0–2, 3–5, 6–11 and 12–18 years), presence of complex comorbidities, quarter of the year (from 2020 Q2 to 2021 Q3) and geographic regions of the United States.

Results:
The cohort included 47,487 COVID-19 cases, of which 13,130 were Black patients. Among most subgroups of effect modifiers, inpatient rates were higher among the Black patients. The largest variation in disparities was observed across age groups and the presence of complex comorbidities. Twelve to 18 years old Black children had a 1.7% point [confidence interval (CI): 0.8–2.4] higher inpatient rate than the matched White children, whereas 0–2 years old Black children had a 2.5% point (CI: 0.9–4.1) lower rate than the matched White children. Among children with complex comorbidities, inpatient rates for Black children was 6.2 (CI: 3.4–8.9) percentage points higher than the White children; however, among kids without complex comorbidities, inpatient rates were comparable.

Conclusions:
Among pediatric patients experiencing COVID-19, higher inpatient rates for Black compared with White patients were observed among older children and those with complex comorbidities. These findings can spur discussions of potential root causes of these disparities, including structural racism.
Clinical Presentation and Outcome of Acute Respiratory Illnesses in South African Children During the COVID-19 Pandemic
Authors: Redfern Andrew , van der Zalm Marieke M. , Lishman Juanita , Goussard Pierre , Smit Liezl , Dagan Ron , Barday Mikhail , Mare Minette , Claassen Mathilda , Van Zyl Gert , Rabie Helena , Verhagen Lilly M. 
Published: May 2023

Background:
Data from low- and middle-income countries (LMICs) show higher morbidity and mortality in children with acute respiratory illness (ARI) from severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). However, whether SARS-CoV-2 infection is distinct from other causes of ARI in this regard is unclear. We describe clinical characteristics and outcomes of South African children with SARS-CoV-2 and non-SARS-CoV-2 ARIs.

Methods:
We performed a cross-sectional study including 0–13 years old children admitted to Tygerberg Hospital between May and December 2020 with an ARI. Routine clinical data were collected by the attending clinicians. All children underwent SARS-CoV-2 polymerase chain reaction testing. For severity of disease, the need for respiratory support and duration of support was considered. Multivariable logistic regression models were built to determine the factors associated with SARS-CoV-2 infection and severity.

Results:
Data for 176 children were available, 38 (22%) children were SARS-CoV-2 polymerase chain reaction positive and 138 (78%) were negative. SARS-CoV-2 positive children were more likely to be female (OR: 2.68, 95% CI: 1.18–6.07), had lower weight-for-age Z score (OR: 0.76, 95% CI: 0.63–0.93), presented more frequently with fever (OR: 3.56, 95% CI: 1.54–8.24) and less often with cough (OR: 0.27, 95% CI: 0.11–0.66). SARS-CoV-2 infection was associated with significantly longer duration of oxygen treatment (median 8 vs. 3 days; OR: 1.1, 95% CI: 1.01–1.20). Overall, 66% of children had viral coinfection, with no significant difference between the groups. In total, 18% of SARS-CoV-2 positive children were readmitted within 3 months for a respiratory reason, compared with 15% SARS-CoV-2 negative children (P = 0.64).

Conclusions:
Our data show that ARIs from SARS-CoV-2 cannot be easily differentiated, but were associated with a higher morbidity compared with ARIs from other causes. Overall outcomes were good. The long-term implications of severe SARS-CoV-2 pneumonia in young children in low- and middle-income countries require further study.
Immunotherapy-related pneumonitis and the synergic impact of thoracic radiation and preexisting interstitial lung disease
Authors: Azhar Maria , Abrencillo Rodeo , Gandhi Saumil , Altan Mehmet , Sheshadri Ajay 
Published: May 2023

Purpose of review
Immune checkpoint inhibitors (ICIs) are the frontline of therapy for most cancers. Although ICIs are sometimes considered to be less harmful than systemic chemotherapies, ICIs may cause immune-related adverse events, which are cases of off-target inflammation in healthy tissues. Pneumonitis, an immune-related adverse event, is the leading cause of therapy-related mortality with ICIs. The aim of this review is to discuss how preexisting interstitial lung disease (ILD) and thoracic radiation increase the risk for ICI-pneumonitis. We discuss potential mechanisms of lung injury and how pneumonitis may impact cancer treatments.

Recent findings
Preexisting ILD and thoracic radiation are major risk factors for ICI-pneumonitis. The mechanisms of injury are still not fully understood but may involve the same inflammatory and profibrotic cytokines as those seen in sporadic ILD. Thoracic radiation increases the risk for ICI-pneumonitis and may synergize with preexisting ILD to worsen toxicity.

Summary
Preexisting ILD and thoracic radiation may increase the risk for the future development of ICI-pneumonitis. However, while these should not preclude potentially life-saving immunotherapy, in some cases, an alternative treatment strategy may be advisable. A multidisciplinary approach is required involving oncologists, pulmonologists, and radiation oncologists to guide in the selection of cancer treatment and in the diagnosis and treatment of pneumonitis.
High-throughput metagenomics analysis in early and precise diagnosis of eosinophilic meningoencephalitis complicated with respiratory failure: A case report
Authors: Qiu Guoqing , Zhu Liqun , Chen Sida , Li Na , Ye Chunxing , Zhuo Songming , Shen Yan 
Published: May 2023

Rationale:
Human infection with Angiostrongylus cantonensis is uncommon and has only been sporadically reported in the literature. Patients infected with A cantonensis usually have a delayed diagnosis and sometimes a poor prognosis.

Patient concerns:
A 70-year-old woman presented to the respiratory department with complaints of headache, chest pain, myalgia, fatigue, and anorexia for 7 days.

Diagnoses:
Complete blood count showed eosinophilia. The serum was tested showing a positive finding of A cantonensis antibody. Cerebrospinal fluid was tested using high-throughput metagenomics analysis and 16 reads for A cantonensis were mapped. The patient was diagnosed with A cantonensis infection.

Interventions:
The patient received a 7-day course of albendazole and 4-day course of prednisone.

Outcomes:
When discharged from the hospital, the patient still suffered from fatigue and poor memory. Aminotransferase levels were high due to albendazole’s liver toxicity. In a post-discharge follow-up about 1 month later she had recovered completely both physically and mentally, and peripheral eosinophil count and aminotransferase levels were both normal.

Lessons:
Because the direct identification of parasites is difficult, high-throughput metagenomics analysis may provide a reliable alternative tool for the diagnoses of infection with A cantonensis. When albendazole is prescribed, caution must be taken with respect to its liver toxicity.
Shared decision-making intervention regarding dialysis modality in patients with CKD stage 5
Authors: Lee Young-Ki , Kim Yang-Hyeon , Kim Do-Hyoung , Kim Jin-Heog , Lee Jeong-Hwan , Park Ji Hyeon , Ko Gang-Jee , Hwang Won-Min , Gil Hyo-Wook , Kang Young-Sun , Jin Kyu-Bok , Do Jun-Young , Kim Se-Joong , Kim Beom-Seok , Shin Ho Sik 
Published: May 2023

Background:
Patients with kidney failure must make complicated decisions about the dialysis modalities used either at home or in-hospital. Different options have varying levels of impact on patients’ physical and psychological conditions and their social life. The purpose of this study was to evaluate the implementation of an intervention designed to achieve shared decision making (SDM) in patients’ options for dialysis.

Methods:
SDM was performed after consent was written for stage 5 chronic kidney disease patients before dialysis, and 435 cases were performed in 408 patients from December 16, 2019 to June 30, 2021. Among these, 101 patients were compared by SDM measurement scale, patient satisfaction, disease recognition scale survey, and dialysis method.

Results:
The average age of participants was 56 years, with a gender composition of 55 males (54.5%) and 46 females (45.5%). Following SDM, the final dialysis methods decided upon by patients and clinicians were peritoneal dialysis (67 patients, 66.3%), hemodialysis (22 patients, 21.8%), and kidney transplantation (1 patient, 1.0%).

Conclusions:
Among participating patients, SDM was effective when used to decide on dialysis treatment, and patients were satisfied with the dialysis method decision process. On the disease awareness scale, those who participated in this project had relatively high positive and low negative perceptions, so it can be concluded that SDM was relatively effective. The implementation of SDM was helpful in selecting patients’ best dialysis methods, and SDM scale results were higher in the peritoneal dialysis group than in the hemodialysis group.
Benign pancreatic lesion on 18F-FDG PET-MRI: A case report
Authors: Xiao Yuqiang , Zha Yong , Li Jindan , Yang Conghui , Chen Long , Xie Ran 
Published: May 2023

Rationale:
Differentiation of benign and malignant lesions in the head of pancreas is the key. When the mass is small, it is difficult to distinguish via conventional imaging modalities. Positron emission tomography and magnetic resonance imaging (PET/MRI) can distinguish benign and malignant lesions from the perspective of metabolism, which provides a new idea for the diagnosis of pancreatic head mass.

Patient concerns:
We report the case of a 44-year-old male patient who underwent an 18F-fluorodeoxyglucose PET/MRI for medical examination. The patient did not complain of special discomfort.

Diagnoses:
PET-MRI revealed in the head of the pancreas, there is a circular space-occupying lesion without obvious fluorodeoxyglucose accumulation, which tends to be benign based on its MRI and metabolic characteristics.

Interventions:
The patient refused further laboratory examination or ultrasound gastroscopy as there is no discomfort.

Outcomes:
No special discomfort was found in the patient after 6 months follow-up.

Lessons:
If routine examination fails to diagnose benign or malignant pancreatic head occupying, and the patient refuses invasive examination, PET-MRI can be performed for identification.
A case report and literature review on primary solitary fibrous tumor of the bladder
Authors: Li Tian Yu , Zhang Bo , Zhang Ji 
Published: May 2023

Rationale:
Solitary fibrous tumors (SFT) is a rare mesenchymal tumor originating from a CD34-positive dendritic mesenchymal cell, most of which is benign, the most common sites is pleura and mediastinum, and rarely in the bladder. The clinical manifestations are mainly related to the tumor volume. When the tumor volume is large, it will compress the surrounding tissues or organs and cause corresponding symptoms. Laparoscopic Incision biopsy is effective means for diagnosing SFT.

Patient concerns:
A 70-year-old female patient was admitted to the hospital with a bladder neoplasm detected by computed tomography scan after experiencing intestinal obstruction 3 days following esophageal cancer surgery. She denied any history of tumor disease.

Diagnoses:
No abnormality was found in the physical examination and laboratory testing after admission. Ultrasound imaging showed a large solid mass with low echogenicity in the bladder. Urological computed tomography with 3D reconstruction revealed a large cystic-solid mass located on the right wall of the bladder, measuring approximately 6.8 cm × 7.1 cm × 6.5 cm, with uneven density and mild inhomogeneous enhancement after contrast administration. Cystoscopy revealed a large mucosal bulge on the right wall of the bladder and laparoscopic exploration revealed a smooth-surfaced round mass, approximately 7 cm in size.

Interventions:
Incision biopsy was performed to make a clear diagnosis, and appropriate tissue specimens were obtained for pathological testing.

Outcomes:
The patient was diagnosed as SFT according to pathology. The patient was followed up for 6 months after surgery, and no recurrence was observed.

Lessons:
SFT occurring in the bladder are extremely rare, and the site is scarcely reported in the relevant literature; thus, it is easy to misdiagnose and laparoscopic incision biopsy may be a good choice.
Intraoperative phenylephrine infusion to reduce perioperative shivering in lower segment caesarean section: A randomised controlled study
Authors: Tan Sook Kuan Jessica , Musthafa Qurratu Aini , Abdullah Farah Hanim , Sayed Masri Syarifah Noor Nazihah 
Published: May 2023

Background:
Shivering is described as an involuntary, repetitive activity of the skeletal muscles that can have deleterious effects on anaesthetized patients. This study aimed to evaluate the effectiveness of phenylephrine infusion in preventing perioperative shivering in patients undergoing lower segment cesarean section under spinal anesthesia and to observe the change in the patient’s core temperature between the study and control groups.

Methods:
A total of 118 patients scheduled for elective lower segment cesarean section under spinal anesthesia were recruited for this prospective, double-blind, randomized controlled study. The patients were randomized into 2 groups with 59 patients per group. The phenylephrine Group received phenylephrine infusion at a rate of 0.5 mcg/kg/minutes, while the Control Group received normal saline at an equivalent rate. Systolic and diastolic blood pressure, heart rate, core temperature, and the presence and intensity of shivering were recorded before induction and every 15 minutes intraoperatively and postoperatively.

Results:
The incidence of intraoperative shivering was significantly lower in the Phenylephrine Group compared to control group (29.1% vs 47.5% respectively; P = .044). Postoperatively, the Phenylephrine Group also had a lower incidence of shivering (34.5% vs 42.4%), but the difference was not statistically significant (P value = 0.391). There were no significant differences in the intensity of shivering between the 2 groups perioperatively, as well as in the systolic and diastolic blood pressure and core temperature. The phenylephrine Group showed a significantly lower heart rate at 15, 30, and 45 minutes after spinal block (P value = .005, .000, and .008, respectively), and at 0 and 30 minutes (P value = .004 and .020 respectively) in the recovery room. There were no significant differences in perioperative adverse events such as hypotension, hypertension, and bradycardia.

Conclusion:
Phenylephrine infusion reduces the incidence of perioperative shivering in lower segment cesarean sections under spinal anesthesia.
Progressive unilateral leg weakness after lumbar decompression due to ischemic monomelic neuropathy misdiagnosed as epidural hematoma: A CARE-compliant case report
Authors: Lee Gun Woo , Park Wook-Tae , Chang Min Cheol 
Published: May 2023

Rationale:
Ischemic monomelic neuropathy (IMN) is a disease that occurs after acute arterial occlusion or steal phenomenon in an extremity that results in single or multiple axonal mononeuropathies in the distal limb without the classical features of limb ischemia, including a skin color change, limb swelling, and ischemic claudication. IMN can easily be misdiagnosed as any other neuropathic disorder. Here we present a case of IMN that was misdiagnosed as spinal epidural hematoma.

Patient concerns:
A 77-year-old man presented with sudden motor weakness and pain in his left foot and calf 5 days after a bilateral L4 to 5 posterior decompression for lumbar spinal stenosis. His symptoms progressed over the next 5 days. The strengths of the left ankle dorsiflexors, first toe extensors, and ankle plantar flexors were Medical Research Council 0. On brain and whole-spine magnetic resonance imaging, no specific abnormalities correlated with his symptoms were observed. Computed tomography angiography of the lower extremities revealed segmental occlusion of the left common femoral artery and multifocal severe stenoses in the bilateral anterior and posterior tibial arteries of the left leg. No skin color change or swelling was observed in the left lower extremity.

Diagnosis:
Based on his clinical features and imaging findings, he was diagnosed with IMN.

Intervention:
The patient underwent thrombectomy of the left femoral artery.

Outcomes:
After the treatment, his pain almost completely disappeared.

Lessons:
When patients exhibit acute-onset pain in the unilateral limb with or without motor weakness but no correlated abnormality on spinal magnetic resonance imaging or computed tomography, clinicians should consider the possibility of IMN.
Acute mesenteric ischemia diagnosed using the aquarium sign: A case report
Authors: Higashijima Ushio , Sekino Motohiro , Iwasaki Naoya , Araki Hiroshi , Motokawa Tetsufumi , Inoue Yusuke , Taniguchi Yasuhiro , Sato Shinya , Miyazaki Yasushi , Hara Tetsuya 
Published: May 2023

Rationale:
The diagnosis of mesenteric ischemia in critically ill patients remains challenging; however, the aquarium sign, comprising a large number of bubble images in the right cardiac chambers on echocardiography, may be used as a point-of-care ultrasound finding to diagnose acute mesenteric ischemia (AMI).

Patient concerns:
A 65-year-old woman diagnosed with lymphoma was urgently admitted to the intensive care unit with suspected tumor lysis syndrome. High-dose vasopressor and inotropic agents were required to manage the patient’s shock with marked lactic acidosis and peripheral hypoperfusion with mottled skin, and multidisciplinary treatment was initiated. By day 6, the lactate levels normalized and there were no abnormal abdominal findings. An echocardiogram was performed to examine the mass lesion associated with lymphoma in the right atrium and evaluate the hemodynamics; it revealed an “aquarium sign.” Similar findings were found in the inferior vena cava and portal vein.

Diagnoses:
Contrast-enhanced computed tomography of the abdomen revealed hepatic portal vein gas, poor contrast of the colon wall, and intramural emphysema, and a diagnosis of AMI was made. Lower gastrointestinal endoscopy showed necrosis of the colon.

Interventions:
The patient underwent urgent subtotal colorectal resection.

Outcomes:
Although a tracheostomy was required, the patient’s general condition improved after surgery, and she was discharged to the ward without mechanical ventilatory support in the intensive care unit on Day 19.

Lessons:
In patients with risk factors for AMI, repeated evaluation for the presence of aquarium signs by echocardiography may be warranted, even if there are no abdominal findings or abnormalities in biomarkers, such as lactate levels and trends. When the aquarium sign is found, AMI should be aggressively suspected, and a definitive diagnosis should be made to initiate early therapeutic intervention.
A case of West syndrome and global developmental delay in a child with a heterozygous mutation in the TBL1XR1 gene: A case report
Authors: Wu Xiao-Hui , Lin Shuang-Zhu , Liu Zhen-Xian , Qi Yang-Fan , Wang Wan-Qi , Li Jia-Yi , Chen Qian-Dui , Yang Lu-Lu 
Published: May 2023

Background:

TBL1XR1, also known as IRA1 or TBLR1, encodes a protein that is localized in the nucleus and is expressed in most tissues. TBL1XR1 binds to histones H2B and H4 in vitro and functions in nuclear receptor-mediated transcription. TBL1XR1 is also involved in the regulation of the Wnt–β-catenin signaling pathway. Mutations in the TBL1XR1 gene impair the Wnt–β-catenin signaling pathway’s ability to recruit Wnt-responsive element chromatin, affecting brain development. Mutations in this gene cause various clinical phenotypes, including Pierpont syndrome, autism spectrum disorder, speech and motor delays, mental retardation, facial dysmorphism, hypotonia, microcephaly, and hearing impairment.

Case Summary:
A 5-month-old female child was admitted with “episodic limb tremors for more than 1 month.” At the time of admission, the child had recurrent episodes of limb tremors with motor retardation and a partially atypical and hypsarrhythmic video electroencephalogram. It was determined that a heterozygous mutation in the TBL1XR1 gene caused West syndrome and global developmental delay. Recurrent episodes persisted for 6 months following oral treatment with topiramate; the addition of oral treatment with vigabatrin did not show any significant improvement, and the disease continued to recur. The child continued to have recurrent episodes of limb tremors at follow-up until 1 year and 3 months of age. Additionally, she developed poor eye contact and a poor response to name-calling.

Conclusion:
We report the case of a child with West syndrome and a global developmental delay caused by a heterozygous mutation in the TBL1XR1 gene. This study adds to our understanding of the clinical phenotype of TBL1XR1 mutations and provides a realistic and reliable basis for clinicians.