bluuebunny/crossref_metadata_2025_split huggingface dataset:
A novel EGFR exon 21 indel mutation in lung adenocarcinoma and response to dacomitinib: A case report
Authors: Zhou Tao , Xiong Qiang , Hong Chen , Wang Qian , Wang Wenxian , Xu Chunwei , Cai Jing 
Published: August 2022

Rationale:
Uncommon epidermal growth factor receptor (EGFR) mutations are increasingly being identified in non-small cell lung cancer. Insertion and deletion mutations have been detected in exons 18, 19, and 20, but not in exon 21. In patients with uncommon mutations, the second-generation EGFR tyrosine kinase inhibitor afatinib has shown good efficacy, whereas that of dacomitinib, another second-generation EGFR-tyrosine kinase inhibitor, remains unknown. Here, we reported a patient with a novel EGFR21 exon insertion-deletion (indel) mutation and demonstrated the efficacy of dacomitinib.

Patient concerns:
A 59-year-old nonsmoking Chinese male was admitted to the hospital with lung cancer after a chest computed tomography for coughing and sputum. The patient’s condition progressed after multiple treatments including surgery, chemotherapy, and radiotherapy.

Diagnosis:
The patient had clinical manifestations of cough and sputum and was pathologically confirmed to have T2bN1M0 (stage IIB) lung adenocarcinoma according to the seventh edition of tumor-node-metastasis staging. The patient underwent a second operation after detection of recurrence, and postoperative pathology confirmed adenocarcinoma of the lung. The patient progressed again after surgery, and the tumor-node-metastasis stage was changed to T4N0M1a (stage IVA) before treatment with dacomitinib.

Interventions:
After detection of the EGFR exon 21 indel mutation, the patient began treatment with dacomitinib (45 mg once a day) on March 12, 2021.

Outcomes:
After 1 month of targeted therapy, the patient showed a partial response to dacomitinib. As of March 19, 2022, his condition remained stable and he continued to receive dacomitinib. Progression-free survival reached 12.4 months. The patient experienced mild adverse reactions of pruritus during the use of dacomitinib, but recovered after drug treatment.

Lesson:
We reported a novel EGFR exon 21 indel mutation in a lung adenocarcinoma patient. Dacomitinib showed efficacy in the treatment of a patient with this mutation, suggesting that its efficacy in patients with uncommon mutations should be explored further. The next-generation sequencing is recommended as a guiding tool for the treatment of advanced non-small cell lung cancer.
Cardiomyopathy induced by premature ventricular contractions with ventricular escape beats in the compensatory pause: A case report and brief review of the literature
Authors: Sun Yuanjun , Yu Xiaohong , Xiao Xianjie , Dai Shiyu , Zhang Rongfeng , Wang Zhongzhen , Ma Chengming , Yin Xiaomeng , Gao Lianjun , Yang Yanzong , Xia Yunlong 
Published: August 2022

Rationale:
We reported a case with cardiomyopathy induced by frequent premature ventricular contractions (PVCs) and followed ventricular escape beats (VEBs). PVCs with VEBs in the compensatory pause which induced cardiomyopathy is rarely reported. Also, the case exhibited many characteristics of PVCs which were more likely to induce cardiomyopathy, like the location of origin, the longer coupling interval, and the QRS wave companied with the P wave.

Patient concerns:
A 53-year-old man with left ventricular (LV) dysfunction presented with palpation, chest distress, and dyspnea for 3 years. Holter revealed a high burden of ventricular rhythm of PVCs and another wide QRS patterns (96,562 total beats with 87,330 wide QRS beats in 24 hours). The LV ejection fraction decreased to 34% and the left ventricle, right and left atria all dilated.

Diagnosis:
He was diagnosed with PVC-induced cardiomyopathy.

Interventions:
The patient experienced intracardiac electrophysiological examination which revealed frequent PVCs followed by VEBs in the compensatory pause. Activation mapping of the PVCS and ablation were performed.

Outcomes:
PVCs and VEBs disappeared after ablation. The LV ejection fraction increased to 46% at 2 days after the procedure. The diameters of the right and left atria were also significantly reduced.

Lessons:
VEBs may occur during the compensatory pause of PVCs. PVCs with VEBs can lead to a high burden of ventricular rhythm and LV dysfunction. Ablation of the PVCs can also eliminate VEBs and improve the LV function.
IgG4-related lung disease with multifocal pulmonary consolidations near the pleura: A case report
Authors: Tanaka Hitomi , Anno Takatoshi , Takenouchi Haruka , Koyama Katsumasa , Kaneto Hideaki , Oga Toru , Monobe Yasumasa , Tomoda Koichi 
Published: August 2022

Rationale:
Immunoglobulin G4 (IgG4)-related disease (IgG4-RD) is a systemic immune-mediated condition that can cause fibroinflammatory lesions in multiple organs. Approximately 35% of IgG4-RD patients have some symptoms in the chest and IgG4-related lung disease (IgG4-RLD) is observed in about 10% of IgG4-RD cases. In addition, it is thought that glucocorticoid therapy is effective for IgG4-RD and IgG4-RLD. It is difficult to diagnose IgG4-RLD complicated with another lung disease.

Patient concerns:
An 85-year-old Japanese man was hospitalized due to pulmonary consolidations just below the pleura in chest computed tomography while being treated with antibiotics. Previously, an upper lobectomy of the right lung was performed for an upper lung mucinous adenocarcinoma, and he was diagnosed with chronic obstructive pulmonary disease. Although he took antibiotics before admission, C-reactive protein levels were elevated.

Diagnosis:
IgG4 levels were also elevated (IgG4; 733 mg/dL), and lung biopsy histology showed an abundance of IgG4-positive plasma cell infiltration; about 40% of the affected area was occupied by such infiltration. Based on such findings, we finally diagnosed him as IgG4-RLD.

Interventions:
We administered 20 mg/d prednisolone.

Outcomes:
About 2 weeks after administration of prednisolone by intravenous injection, his multifocal pulmonary consolidations just below the pleura were markedly improved and his pulmonary symptoms disappeared. Four weeks after glucocorticoid therapy, IgG4 levels decreased from 831 mg/dL (peak) to 547 mg/dL.

Lessons:
We should consider IgG4-RLD, a rare disease, when lesions are detected as pulmonary consolidations near the pleura and are unresponsive to antibiotic therapy. Glucocorticoid therapy, however, is very effective for such IgG4-RLD.
Massive pericardial effusion due to chronic active Epstein–Barr virus infection successfully treated with PD-1 blockade: A case report
Authors: Pi Yubo , Wang Jingshi , Wang Zhao 
Published: August 2022

Rationale:
Chronic active Epstein–Barr virus (EBV) infection (CAEBV) is a rare but life-threatening EBV-positive lymphoproliferative disorder. Currently, treatment options for CAEBV are limited. Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is the only way to cure CAEBV. Here, we report a rare case of CAEBV manifesting as massive pericardial effusion that was successfully treated with programmed cell death protein-1 (PD-1) blockade immunotherapy.

Patient concerns:
A 36-year-old woman with intermittent chest distress and dyspnea for 8 months was admitted to our center on October 25, 2021. Laboratory tests showed leukocytopenia and elevated liver enzyme levels. Initial echocardiography revealed massive pericardial effusion.

Diagnosis:
High levels of EBV-DNA were detected in the pericardial fluid by metagenomic next-generation sequencing. The pathological diagnosis of her left inguinal lymph node and skin lesions revealed systemic CAEBV.

Interventions:
The patient received sintilimab injection at a dose of 200 mg every 2 weeks in combined with lenalidomide 10 mg once daily.

Outcomes:
The patient achieved complete resolution of pericardial effusion 5 months after PD-1 blockade immunotherapy without apparent adverse effects.

Lessons:
CAEBV is a rare but life-threatening EBV-positive lymphoproliferative disease. We present a rare case of massive pericardial effusion caused by systemic CAEBV, which was successfully treated with sintilimab. This case highlights the promising curative effect of PD-1 blockade immunotherapy in systemic CAEBV, especially for patients not suitable for allo-HSCT.
Lip cyanosis as the first symptom of Leigh syndrome associated with mitochondrial complex I deficiency due to a compound heterozygous NDUFS1 mutation: A case report
Authors: Men Lina , Feng Jinxing , Huang Weimin , Xu Mingguo , Zhao Xiaoli , Sun Ruixin , Xu Jianfang , Cao Liming 
Published: August 2022

Background:
Leigh syndrome (LS) is a rare, progressive, and fatal neurodegenerative disease that occurs mainly in infants and children. Neonatal LS has not yet been fully described.

Methods:
The study design was approved by the ethics review board of Shenzhen Children’s Hospital.

Results:
A 24-day-old full-term male infant presented with a 2-day history of lip cyanosis when crying in September 2021. He was born to nonconsanguineous Asian parents. After birth, the patient was fed poorly. A recurrent decrease in peripheral oxygen saturation and difficulty in weaning from mechanical ventilation during hospitalization were observed. There were no abnormalities on brain magnetic resonance imaging (MRI) or blood and urine organic acid analyses on admission. His lactic acid level increased markedly, and repeat MRI showed symmetrical abnormal signal areas in the bilateral basal ganglia and brainstem with disease progression. Trio whole-exome sequencing revealed 2 heterozygous mutations (c.64C > T [p.R22X] and c.584T > C [p.L195S]) in NDUFS1. Based on these findings, mitochondrial respiratory chain complex I deficiency-related LS was diagnosed. The patient underwent tracheal intubation and mechanical ventilation for respiratory failure. His oxygen saturation levels were maintained at normal levels with partially assisted ventilation. He was administered broad-spectrum antibiotics, oral coenzyme Q10, multivitamins, and idebenone. During hospitalization, the patient developed progressive consciousness impairment and respiratory and circulatory failure. He died on day 30.

Conclusion:
Lip cyanosis is an important initial symptom in LS. Mild upper respiratory tract infections can induce LS and aggravate the disease. No abnormal changes in the brain MRI were observed in the early LS stages in this patient. Multiple MRIs and blood lactic acid tests during disease progression and genetic testing are important for prompt and accurate diagnosis of LS.
Integrative medicine in patients with degenerative arthritis of the knee: A pilot randomized control study
Authors: Kwak Sang Gyu , Jung Hyun Jung , Choi Won-Kee 
Published: August 2022

Background:
We aimed to comparatively analyze the effect of integrative medicine treatments (lifestyle change education, use of anti-inflammatory drugs, acupuncture, manual therapy-type massage) and conventional medical treatments (lifestyle change education and use of anti-inflammatory drugs) on pain control, knee function improvement, and quality of life improvement in patients with degenerative knee arthritis.

Methods:
In this study, 30 patients were randomly divided into the control group (n = 15) and the experimental group (n = 15). Both groups were prescribed anti-inflammatory drugs and lifestyle change education for 12 weeks. The experimental group underwent acupuncture including electroacupuncture, moxibustion, and manual therapy-type massage 12 times during the first 6 weeks. Evaluations were performed at 3 visits: visit 1 (before treatment), visit 2 (6 weeks after initial treatment), and visit 3 (12 weeks after initial treatment). The effect of each treatment was measured using Visual Analog Scale (VAS, 0–10), Western Ontario and McMaster Universities index (WOMAC), and SF-36.

Results:
From visit 1 to visit 2, the mean value of VAS decreased by 0.72 and 3.17 in the control and experimental groups, respectively. From visit 2 to visit 3, the mean VAS value decreased by 0.25 in the control group but increased by 0.87 in the experimental group. Among the sub-area of SF-36, the physical role restriction area and mental health area showed significant differences between the 2 groups over time (P = .024, P = .006).

Conclusion:
Integrative medicine treatment has superior effects in pain control over conventional medical treatment. In integrative medicine treatment, pain control tends to decrease with time, but still superior over conventional medical treatment up to 6 weeks after treatment (12 weeks after initial treatment).
Quality of Care for US Adults With Medicaid Insurance and Type 2 Diabetes in Federally Qualified Health Centers Compared With Other Primary Care Settings
Authors: Knitter Alexandra C. , Murugesan Manoradhan , Saulsberry Loren , Wan Wen , Nocon Robert S. , Huang Elbert S. , Bolton Joshua , Chin Marshall H. , Laiteerapong Neda 
Published: August 2022

Objective:
The objective of this study was to evaluate indicators of diabetes quality of care for US nonelderly, adult Medicaid enrollees with type 2 diabetes and compare federally qualified health centers (FQHCs) versus non-FQHCs.

Research Design and Methods:
We analyzed diabetes process measures and acute health services utilization with 2012 US fee-for-service and managed care Medicaid claims in all 50 states and DC. We compared FQHC (N=121,977) to non-FQHC patients (N=700,401) using propensity scores to balance covariates and generalized estimating equation models.

Results:
Overall, laboratory-based process measures occurred more frequently (range, 65.7%–76.6%) than measures requiring specialty referrals (retinal examinations, 33.3%; diabetes education, 3.4%). Compared with non-FQHC patients, FQHC patients had about 3 percentage point lower rates of each process measure, except for higher rates of diabetes education [relative risk=1.09, 95% confidence interval (CI): 1.03–1.16]. FQHC patients had fewer overall [incident rate ratio (IRR)=0.87, 95% CI: 0.86–0.88] and diabetes-related hospitalizations (IRR=0.79, 95% CI: 0.77–0.81), but more overall (IRR=1.06, 95% CI: 1.05–1.07) and diabetes-related emergency department visits (IRR=1.10, 95% CI: 1.08–1.13).

Conclusions:
This national analysis identified opportunities to improve diabetes management among Medicaid enrollees with type 2 diabetes, especially for retinal examinations or diabetes education. Overall, we found slightly lower rates of most diabetes care process measures for FQHC patients versus non-FQHC patients. Despite having higher rates of emergency department visits, FQHC patients were significantly less likely to be hospitalized than non-FQHC patients. These findings emphasize the need to identify innovative, effective approaches to improve diabetes care for Medicaid enrollees, especially in FQHC settings.
Racial/Ethnic Disparities in Substance Use Treatment in Medicaid Managed Care in New York City
Authors: Alegría Margarita , Falgas-Bague Irene , Fukuda Marie , Zhen-Duan Jenny , Weaver Cole , O’Malley Isabel , Layton Timothy , Wallace Jacob , Zhang Lulu , Markle Sheri , Lincourt Pat , Hussain Shazia , Lewis-Fernández Roberto , John Dolly A. , McGuire Thomas 
Published: August 2022

Objective:
The aim was to assess the magnitude of health care disparities in treatment for substance use disorder (SUD) and the role of health plan membership and place of residence in observed disparities in Medicaid Managed Care (MMC) plans in New York City (NYC).

Data Source:
Medicaid claims and managed care plan enrollment files for 2015–2017 in NYC.

Research Design:
We studied Medicaid enrollees with a SUD diagnosis during their first 6 months of enrollment in a managed care plan in 2015–2017. A series of linear regression models quantified service disparities across race/ethnicity for 5 outcome indicators: treatment engagement, receipt of psychosocial treatment, follow-up after withdrawal, rapid readmission, and treatment continuation. We assessed the degree to which plan membership and place of residence contributed to observed disparities.

Results:
We found disparities in access to treatment but the magnitude of the disparities in most cases was small. Plan membership and geography of residence explained little of the observed disparities. One exception is geography of residence among Asian Americans, which appears to mediate disparities for 2 of our 5 outcome measures.

Conclusions:
Reallocating enrollees among MMC plans in NYC or evolving trends in group place of residence are unlikely to reduce disparities in treatment for SUD. System-wide reforms are needed to mitigate disparities.
Measuring Equity in the Hospital Setting
Authors: Beckett Megan K. , Hambarsoomian Katrin , Martino Steven C. , Agniel Denis , Hudson Scholle Sarah , Maksut Jessica L. , Mathews Megan , Orr Nate , Elliott Marc N. 
Published: August 2022

Background:
Health care quality varies by patient factors, including race-and-ethnicity and preferred language. Addressing inequities requires identifying them and incentivizing equity.

Objectives:
We apply an approach first implemented in the Medicare Advantage setting to measure equity in patient experiences by race-and-ethnicity [Asian American and Native Hawaiian or Pacific Islander (AA and NHPI), Black, Hispanic, vs. White] and language preference (English-preferring vs. another-language-preferring). We identify characteristics of hospitals providing high-quality equitable care.

Research Design:
We estimated, standardized, and combined performance measures into a Health Equity Summary Score (HESS) using 2016–2019 Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey data. The HCAHPS HESS considered current cross-sectional performance, within-hospital improvement, and overall improvement by race-and-ethnicity and language preference.

Subjects:
A total of 3333 US hospitals with 2019 HCAHPS Star Ratings.

Results:
The HCAHPS HESS was calculable for 44% of hospitals. High-scoring (4–5 diamonds on a 1-diamond to 5-diamond scale) hospitals tended to be smaller than intermediate-scoring [3 diamonds (14% of high-scoring hospitals had <100 beds vs. 7% of intermediate-scoring hospitals, P<0.001) and were less often for-profit (20% vs. 31%, P<0.001)]. While a significant percentage (29%) of patients served by high-scoring hospitals were AA and NHPI, Black, or Hispanic, and 9% were another-language-preferring, there were smaller proportions of Black and Hispanic patients in high-scoring versus other hospitals. HESS performance was negatively associated with the percentage of patients preferring another language to English. HESS scores were moderately correlated with overall Star Ratings (r=0.70).

Conclusions:
The HCAHPS HESS and practices of high-scoring hospitals could promote more equitable patient experiences.
Louisiana Medicaid Expansion and Pent-Up Demand
Authors: Walker Brigham , Zhou Danju , Callison Kevin 
Published: August 2022

Background:
Nearly half a million newly eligible people enrolled in Louisiana Medicaid following its expansion.

Objectives:
To evaluate postexpansion utilization trends in Louisiana Medicaid.

Research Design:
We plotted utilization trends for expansion and traditional Medicaid beneficiaries and conducted regression analyses to evaluate differences in monthly trends for over 2 years following expansion.

Subjects:
We restricted our sample to a balanced panel of beneficiaries aged 18–64. The expansion population included beneficiaries who enrolled in the first month of eligibility. The nonexpansion group enrolled at least a year pre-expansion.

Measures:
Monthly office visits, emergency department visits, and inpatient stays per 1000 enrollees, drawn from the Louisiana Medicaid Data Warehouse claims database.

Results:
Compared with trends among traditional Medicaid beneficiaries, expansion beneficiaries utilized 4.59 [P=0.08] more monthly office visits per 1000 enrollees in their first year, increasing to 6.33 [P<0.01] more per month thereafter. Monthly emergency department visit trends were not statistically significantly different in the first year but were 0.71 [P<0.01] monthly visits lower for expansion beneficiaries thereafter. Trends in monthly inpatient stays were 0.23 [P=0.02] stays per 1000 enrollees higher in the first year for expansion beneficiaries but were not statistically significantly different thereafter.

Conclusions:
Louisiana Medicaid expansion beneficiaries experienced lower initial rates of office visits compared with traditional Medicaid beneficiaries, but these rates consistently increased over the first 2 years after expansion. The expansion population had uniformly higher levels of emergency department and inpatient visits throughout the study period. After the first postexpansion year, emergency department visits among expansion beneficiaries fell relative to traditional beneficiaries while inpatient utilization trends leveled off after an initial increase.
Effect of the 2012 US Preventive Services Task Force Recommendations on Prostate-Specific Antigen Screening in a Medicare Advantage Population
Authors: Zhu Yingying , Koethe Benjamin , Ollendorf Daniel A. , Wong John B. , Neumann Peter J. , Kim David D. 
Published: August 2022

Background:
In 2012, the US Preventive Service Task Force revised its recommendations for prostate-specific antigen (PSA) screening from “insufficient evidence” to “do not recommend” for men aged 70–74 while maintaining “do not recommend” for men aged 75+.

Methods:
Using the difference-in-difference approach, we evaluated whether the rate of change in the use of low-value PSA screening differed between the control group (men aged 75+, N=7,856,204 person–years) and the intervention group (men aged 70–74, N=5,329,192 person–years) enrolling in the Medicare Advantage plan without a history of prostate cancer within the OptumLabs Data Warehouse claims data (2009–2019). A generalized estimating equation logistic model was specified with independent variables: an intervention group indicator, a pre- and post-period (after 2012 Q2) indicator, index time, and interaction terms. We assumed a 12-month dissemination period.

Results:
Before the revised recommendation in 2012, the trends did not significantly differ between the 2 age groups with the odds of receiving PSA screening decreasing by 1.2% (95% confidence interval [1.0, 1.4%]) per quarter. However, the odds of receiving PSA screening increased by 3.0% [2.8, 3.2%] per quarter across both groups since the revision. There was no significant additional change in the trend for those aged 70–74 (0.1% [−0.2, 0.5%]).

Conclusions:
Although the 2012 US Preventive Service Task Force’s recommendations were expected to only change behaviors among men aged 70–74, our analysis found that men aged 70–74 and aged 75+ exhibited similar trends from 2009 to 2019, including the increased use of low-value PSA screening since 2016. Multifaceted efforts to discourage low-value PSA screening would be important for a sustained impact.