bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Case of Congenital Syphilis—Focus on Histopathology and Literature Review
Authors: Balaban Alexandra , Al-Rohil Rami N. 
Published: February 2022

Abstract:
Although a rare disease, the incidence of congenital syphilis is on the rise in the US. We report a case of early congenital syphilis in a 1-day-old premature boy with positive Rapid plasma reagin titer, respiratory insufficiency, disseminated intravascular coagulation, and encephalopathy, born to a mother with known syphilis infection. Skin examination showed diffuse truncal petechiae, desquamation of the distal extremities, and violaceous, retiform plaques on the buttocks and lower extremities. A biopsy was performed to rule out an infectious etiology or vasculitis. Histopathologic examination revealed irregular epidermal acanthosis with orthokeratosis and parakeratosis. There were foci of neutrophilic infiltrate forming rare pustules within the stratum corneum and focal intraepidermal eosinophils, neutrophils, and rare dyskeratotic keratinocytes. In the dermis, there was some minimal endothelial swelling with a perivascular, interstitial, and periadnexal infiltrate of lymphocytes, eosinophils, and rare plasma cells. A Treponema pallidum immunostain highlighted spirochetes present within the epidermis and within the eccrine ducts. Penicillin G therapy was administered for 10 days. The infant's Rapid plasma reagin titer trended downward until it was negative 6 months after birth. Literature review reveals 8 case reports within the last 20 years describing the histopathology of rashes in congenital syphilis. Herein we summarize the reported histopathology of rashes in congenital syphilis and compare it to the histopathology of rashes in secondary syphilis in adults.
Wells Syndrome-Like Histologic Pattern Caused by a Permanent Tattoo
Authors: Kazmi Maha , Elsensohn Ashley , Junkins-Hopkins Jacqueline M. 
Published: February 2022

Abstract:
Tattoo reactions have become more common as tattoos gain visibility and popularity worldwide. A variety of inflammatory patterns have been described in association with tattoos— more commonly fibrosing, granulomatous, lichenoid, pseudolymphomatous, and spongiotic patterns. To date, there has been one case report of a Wells syndrome-like inflammatory pattern associated with a temporary Henna tattoo. Here we present the first case of a permanent tattoo with resulting flame figures, histologically resembling Wells syndrome. We believe this uncommon histologic pattern might be of interest for pathologists to be aware of.
Pilomatrical Acanthoma: An Extremely Rare Intraepidermal Variant of Pilomatricoma
Authors: He Lin , Hosler Gregory A. 
Published: February 2022

Abstract:
Pilomatrical differentiation can be observed in a variety of benign and malignant tumors, with the most common prototype being pilomatricoma. Pilomatricoma often presents in the deep dermis or subcutis, and the sole involvement of epidermis is extremely rare. In our current case series, specimens from 5 patients were included with an average age of 68 years. All lesions presented as solitary verrucous or keratotic papules on the extremities, with 1 lesion having a prominent horn. All lesions have a variable mixture of basaloid matrical cells and shadow cells, and all lesions express β-catenin (strong nuclear and cytoplasmic), lymphoid enhancer–binding factor 1 within the matrical component, and pleckstrin homology-like domain family A member 1. The histomorphology and immunoprofile of all lesions are of pilomatrical differentiation, confined to the level of the epidermis. Based on these findings and analogous to the terminology used for other benign intraepidermal proliferations (hidroacanthoma simplex and epidermolytic acanthoma), we propose the term “pilomatrical acanthoma” for these rare lesions.
Ecological studies of COVID-19 and air pollution: How useful are they?
Authors: Villeneuve Paul J. , Goldberg Mark S. 
Published: February 2022

Background:
Results from ecological studies have suggested that air pollution increases the risk of developing and dying from COVID-19. Drawing causal inferences from the measures of association reported in ecological studies is fraught with challenges given biases arising from an outcome whose ascertainment is incomplete, varies by region, time, and across sociodemographic characteristics, and cannot account for clustering or within-area heterogeneity. Through a series of analyses, we illustrate the dangers of using ecological studies to assess whether ambient air pollution increases the risk of dying from, or transmitting, COVID-19.

Methods:
We performed an ecological analysis in the continental United States using county-level ambient concentrations of fine particulate matter (PM2.5) between 2000 and 2016 and cumulative COVID-19 mortality counts through June 2020, December 2020, and April 2021. To show that spurious associations can be obtained in ecological data, we modeled the association between PM2.5 and the prevalence of human immunodeficiency virus (HIV). We fitted negative binomial models, with a logarithmic offset for county-specific population, to these data. Natural cubic splines were used to describe the shape of the exposure-response curves.

Results:
Our analyses revealed that the shape of the exposure-response curve between PM2.5 and COVID-19 changed substantially over time. Analyses of COVID-19 mortality through June 30, 2021, suggested a positive linear relationship. In contrast, an inverse pattern was observed using county-level concentrations of PM2.5 and the prevalence of HIV.

Conclusions:
Our analyses indicated that ecological analyses are prone to showing spurious relationships between ambient air pollution and mortality from COVID-19 as well as the prevalence of HIV. We discuss the many potential biases inherent in any ecological-based analysis of air pollution and COVID-19.
Precise characterization of a solitary pulmonary nodule using tumor shadow disappearance rate-corrected F-18 FDG PET and enhanced CT
Authors: Park Ki Seong , Seon Hyun Ju , Yun Ju-Sik , Yoo Su Woong , Lee Changho , Kang Sae-Ryung , Kim Jahae , Cho Sang-Geon , Song Ho-Chun , Bom Hee-Seung , Min Jung-Joon , Kwon Seong Young 
Published: February 2022

Abstract
We aimed to characterize solitary pulmonary nodule (SPN) using imaging parameters for F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) or enhanced CT corrected by tumor shadow disappearance rate (TDR) to reflect the tissue density.
We enrolled 51 patients with an SPN who underwent PET/CT and chest CT with enhancement. The FDG uptake of SPN was evaluated using maximum standardized uptake value (SUVmax) on PET/CT. The mean Hounsfield unit (HU) for each SPN was evaluated over the region of interest on nonenhanced and enhanced CT images. The change in mean HU (HUpeak-pre) was quantified by subtracting the mean HU of the preenhanced CT from that of the post-enhanced CT. TDR was defined as the ratio of the tumor area, which disappears at a mediastinal window, to the tumor area of the lung window. We investigated which parameters (SUVmax or HUpeak-pre) could contribute to the characterization of SPN classified by TDR value and whether diagnostic performance could be improved using TDR-corrected imaging parameters.
For SPN with higher tissue density (TDR <42%, n = 22), high value of SUVmax (≥3.1) was a significant factor to predict malignancy (P = .006). High value of HUpeak-pre (≥38) was a significant factor to characterize SPN (P = .002) with lower tissue density (TDR ≥42%, n = 29). The combined approach using TDR-corrected parameters had better predictive performance to characterize SPN than SUVmax only (P = .031).
Applying imaging parameters such as SUVmax or HUpeak-pre in consideration of tissue density calculated with TDR could contribute to accurate characterization of SPN.
The efficacy and safety of triptorelin-therapy following conservative surgery for deep infiltrating endometriosis
Authors: Zhu Libo , Guan Zheng , Huang Yan , Hua Keqin , Ma Liguo , Zhang Jian , Yang Dazhen , Perrot Valerie , Li Hongbo , Zhang Xinmei 
Published: February 2022

Abstract
Triptorelin is one of the most commonly used gonadotropin-releasing hormone agonists and has been used in the treatment of deep infiltrating endometriosis (DIE). This study aimed to evaluate the efficacy and safety of up to 24 weeks of triptorelin treatment after conservative surgery for DIE.
This prospective, non-interventional study was performed in 18 tertiary hospitals in China. Premenopausal women aged ≥18 years treated with triptorelin 3.75 mg once every 28 days for up to 24 weeks after conservative surgery for DIE were included. Endometriosis symptoms were assessed, using a visual analogue scale (0–10 cm) or numerical range (0–10), at baseline (pre-surgery) and routine visits 3, 6, 9, 12, 18, and 24 months after surgery. Changes in symptom intensity over time were primary outcome measures.
A total of 384 women (mean [standard deviation] age, 33.4 [6.2] years) were analyzed. Scores for all symptoms (pelvic pain, dysmenorrhea, ovulation pain, dyspareunia, menorrhagia, metrorrhagia, and gastrointestinal and urinary symptoms) assessed decreased from baseline over 24 months. Cumulative improvement rates in pelvic pain, dysmenorrhoa, ovulation pain, and dyspareunia were 74.4%, 83.6%, 55.1%, and 66.9%, respectively. The 24-month cumulative recurrence rate (≥1 symptom) was 22.2%. The risk of symptom recurrence was higher in patients with ≥2 versus 1 lesion (odds ratio [OR] 2.539; 95% CI: 1.458–4.423; P = .001) and patients with moderate (OR 5.733; 95% CI: 1.623–20.248; P = .007) or severe (OR 8.259; 95% CI: 2.449–27.851; P = .001) pain versus none/mild pain. Triptorelin was well tolerated without serious adverse events.
Triptorelin after conservative surgery for DIE improved symptoms over 24 months of follow up. The recurrence rate of symptoms was low and triptorelin was generally well tolerated.
Trial registration number: ClinicalTrials.gov, NCT01942369.
Clinical and genetic features of four patients with Pearson syndrome
Authors: Son Ji Soo , Seo Go Hun , Kim Yoon-Myung , Kim Gu-Hwan , Jin Hee Kyung , Bae Jae-sung , Im Ho Joon , Yoo Han-Wook , Lee Beom Hee 
Published: February 2022

Abstract
Pearson syndrome (PS) is a multisystem mitochondrial cytopathy arising from deletions in mitochondrial DNA. Pearson syndrome is a sporadic disease that affects the hematopoietic system, pancreas, eyes, liver, and heart and the prognosis is poor. Causes of morbidity include metabolic crisis, bone marrow dysfunction, sepsis, and liver failure in early infancy or childhood. Early diagnosis may minimize complications, but suspicion of the disease is difficult and only mitochondrial DNA gene testing can identify mutations. There is no specific treatment for PS, which remains supportive care according to symptoms; however, hematopoietic stem cell transplantation may be considered in cases of bone marrow failure.
We herein describe the clinical and genetic characteristics of four patients with PS. One patient presented with hypoglycemia, two developed pancytopenia, and the final patient had hypoglycemia and acute hepatitis as the primary manifestation. All patients had lactic acidosis. Additionally, all patients showed a variety of clinical features including coagulation disorder, pancreatic, adrenal, and renal tubular insufficiencies. Two patients with pancytopenia died in their early childhood. Our experience expands the phenotypic spectrum associated with PS and its clinical understanding.
Patterns of Concerns Among Hematological Cancer Survivors
Authors: Mayo Samantha J. , Brennenstuhl Sarah , Panesar Prabdeep , Bryant Ashley Leak 
Published: February 2022

Background
Advances in treatment for hematological cancers warrant greater attention on survivorship concerns.

Objective
The aims of this study were to describe survivorship concerns among hematological cancer survivors, identify subgroups of survivors with distinct classes of concerns, and examine sociodemographic and clinical differences across subgroups.

Methods
We conducted a cross-sectional analysis of data from 1160 hematological cancer survivors, who rated their degree of concern regarding 20 physical, emotional, and practical changes. Clusters of concerns were identified using latent class analysis. Associations between respondent characteristics and cluster membership were calculated using multinomial logistic regression.

Results
Survivors had a mean of 7.5 concerns (SD, 4.6; range, 0–19), the most frequent being fatigue/tiredness (85.4%); anxiety, stress, and worry about cancer returning (70.2%); and changes to concentration/memory (55.4%). Three distinct classes of concerns were identified: class 1 (low, 47.0%), characterized by low endorsement of most concerns, apart from fatigue; class 2 (moderate, 32.3%), characterized by high endorsement of a combination of concerns across domains; and class 3 (high, 20.7%), characterized by the highest number of concerns out of the 3 identified classes, including greater endorsement of concerns relating to sexual well-being. Class membership was differentiated by survivor age, sex, marital status, and diagnosis.

Conclusions
Three distinct patterns of concerns were detected in a large sample of hematological cancer survivors. Patterns of concerns could be differentiated by survivor characteristics.

Implications for Practice
Our study highlights the concerns experienced by hematological cancer survivors and provides support for a tailored biopsychosocial approach to survivorship care in this context.
How Caregivers Cope and Adapt When a Family Member Is Diagnosed With a Hematologic Malignancy: Informing Supportive Care Needs
Authors: Albrecht Tara A. , Hoppe Rebecca , Winter Marcia A. 
Published: February 2022

Background
Informal family caregivers (FCs) of adults with various diseases including hematologic malignancy (HM) experience low quality of life and psychological well-being. Although HMs are life-threatening cancers associated with high mortality, numerous symptoms, and lengthy hospitalizations and are therefore likely to be challenging for FCs to cope with, there is scant research exploring FC experiences.

Objective
The aim of this study was to describe the coping and adaptation of FCs of patients during diagnosis and treatment of HM.

Methods
This study used a qualitative descriptive design to analyze semi-structured interview responses from FCs (N = 28) within 3 months of the patients’ HM diagnosis. A content analysis was conducted to generate common themes.

Results
Family caregivers endorsed adaptive and maladaptive coping. Adaptive strategies included taking one day at a time, spirituality, engaging in pastimes, and utilizing emotional and instrumental family and community support. Maladaptive coping included wishful thinking, harmful habits, avoidance, and lacking or being unable to accept family and community support.

Conclusions
Findings highlight the complexities of caregiver burden as they support their loved ones with HM.

Implications for Practice
Family caregivers would benefit from receiving an interdisciplinary family-centered approach as their HM person is initiating treatment. Nurses should consider assessing the FCs’ psychosocial needs to help facilitate appropriate services, such as palliative care consultations, social work referrals, support groups, and/or counseling.
Posterior Vault Distraction Osteogenesis: Rates of Ossification in Bone Gaps After Consolidation
Authors: Naran Sanjay , Mazzaferro Daniel M. , Wes Ari M. , Larson Jordan H. , Bartlett Scott P. , Taylor Jesse A. 
Published: February 2022

Abstract:
The authors observe significant bone gaps upon distractor removal in posterior vault distraction osteogenesis (PVDO). The purpose of this study was to quantify bone gaps upon distractor removal, determine whether they close over time, determine if they predispose to relapse, and investigate whether age affects rate and degree of re-ossification. The authors performed a retrospective review of PVDO patients and included those with computed tomography (CT) scans at 2 timepoints: 1 at completion of consolidation and another at least 4 months later. Using Mimics software, bone gaps were traced to calculate total surface area. A paired t test and linear regression were used to compare size of bone gaps, presence of relapse, and rates of re-ossification. Sixty-nine patients were identified, with 7 meeting inclusion criteria. Three were under 1 year. Consolidation began 28.3 ± 6.0 days after surgery and continued for 64.9 ± 14.5 days. Length of time between CT scans was 7.5 ± 2.7 months. A significant decrease in bone gaps occurred between scans (33.4 ± 14.6 cm2 versus 19.2 ± 17.2 cm2, P = 0.005). After consolidation, ossification occurred at a rate of 2.4 cm2/month (P = 0.046). The rate of bony regeneration in patients under and over 1 year was 4.3 cm3/month (P = 0.025) and 1.5 cm3/month (P = 0.552), respectively. Despite differential bony regeneration rates, no patient demonstrated relapse. From this study, the authors conclude the following. Calvarial bone gaps are present after PVDO consolidation. These gaps undergo re-ossification at a rate that appears to be faster in infants. Overall, they decrease in size over time. The presence of bone gaps does not correlate with relapse of cranial expansion.
Reconstruction of Cranial Bone Defects Using Polyamide 12 Patient-Specific Implant: Long Term Follow Up
Authors: Arafat Shereen W. , Ibrahim Waleed H. , Shaker Shady , AlDainy Duaa Gawad , Salama Dina , Shaheen Hamed A. 
Published: February 2022

Abstract:
The main objective of this study was to evaluate the use of patient-specific polyamide 12 implants in cranial bone defect reconstruction.
Ten patients who underwent prior decompression craniectomy were selected for the current study. Skull scanning by computerized tomography was performed and used to make virtual planning of the implants to be transformed into physical implant using selective laser sintering. Cranioplasty was performed through coronal surgical approach where cranial implants were fixated using 2.0-mm mini-screws, and plates. Patients follow-up was from 12 to 36 months. Glasgow Outcome Score recorded 1 (good recovery) for all patients. Patient and surgeon satisfaction for the esthetic outcome were measured using visual analog scale as mean of 10 ± 0 and 9 ± 1, respectively. Cranial symmetry index was calculated as mean score of 98% ± 1%, indicating highly accurate symmetry, and preoperative virtual planning and postoperative outcome were compared for accuracy analysis with a mean difference of 0.3197 ± 0.1649, which indicates high accuracy.
Polyamide12 cranial implants seem to offer a promising option to cranial bone reconstruction with patient-specific implants. This study ensures proper cosmetic and clinical outcome.
Reconstruction of the Defect at Temporal Hairline by a Scalp Keystone Island Flap: Clinical Experience on 14 Cases
Authors: Tang Weiya , Xu Jianguo , Lou Xiaoli , Jin Ying , Tao Ran , Bi Hongda 
Published: February 2022

Background:
The reconstructions of defects at the temporal hairline always require more complicated designs and higher surgical skills to acquire better aesthetic results. By taking advantage of the unique anatomy of the temporal region, the authors designed a scalp keystone island flap pedicled by superficial temporal fascia to repair defects on the temporal hairline.

Methods:
The authors retrospectively analyzed the clinical data of 14 patients who had lesions adjacent to the temporal hairline between April 2018 and June 2020. Patients were diagnosed with basal cell carcinoma, squamous-cell carcinoma, or seborrheic keratosis. These lesions were resected and reconstructed by scalp keystone island flaps. The defects ranged from 2.0 cm × 1.5 cm to 3.0 cm × 3.5 cm.

Results:
All patients were satisfied with postoperative morphology and reported no recurrence at the 6 to 24 months follow-up. Flaps in two patients were partially necrosed but eventually healed by dressing changes. The rest had the first intention of healing.

Conclusions:
The scalp keystone island flap is a very useful method to repair small or medium defects at the temporal hairline. This flap can be flexibly designed and easily performed with a high survival rate and good aesthetic results. It provides another surgical option for complicated reconstruction.
Survival of a Blank Cartridge Gunshot Injury to the Soft Palate in a Soldier
Authors: Lee Hojun , Hwang Kun , Lee Yoonhyun , Jeong Sung Yub 
Published: February 2022

Abstract:
The authors report a case of a soldier who survived after shooting a blank round from a K2 rifle into the oral cavity.
For committing suicide, a 22-year-old male soldier shot a K2 rifle into his oral cavity. Because the first shot was a blank fire, he received an injury to his oral cavity, especially to his palate. On arrival hospital via air evacuation, the patient's vital signs were relatively stable and Glasgow Coma Scale score was 15. Profound epistaxis was noted from both nostrils, and his mouth was filled with blood. Intubation was performed immediately, followed by tracheostomy. On computed tomography scan, the palate was injured and laryngeal edema was seen.
On operative field, severe swelling of the larynx was observed. Gunpowder remained present throughout nearly the entire palate. His palate was burned, and there was a 3-cm-diameter mucosal defect. The bleeding point was cauterized, and bleeding was controlled using oral packing. The packing was changed every morning for the first 2 days, and finally removed on the third day of hospitalization. On the eighth day of hospitalization, the defect of his soft palate showed healing by secondary intention, and a planned reconstructive operation was not needed. Tracheostomy was removed on the 45th day. He was able to eat and speak at the time of discharge (93rd day).
The authors cannot overemphasize the importance of the airway in oral injuries. Packing for bleeding control under a safe airway should be followed as a routine part of the protocol for similar cases.
Changes in Direction of Eyelashes After Epiblepharon Surgery Using the Hotz Procedure
Authors: Youn Jimin , Kim Joohyun , Lee Hyunkyu , Lee Hwa , Park Jinhwan , Baek Sehyun 
Published: February 2022

Purpose:
To analyze the change of direction of eyelashes after epiblepharon surgery using the Hotz procedure and to propose the appropriate correction amount to reduce the risk of undercorrection or overcorrection.

Methods:
Surgical correction using the Hotz procedure was performed in 60 patients who then were followed for 3 months in Korea University Anam Hospital. Clinical photographs were collected before and after the correction to measure the angle of the lower eyelashes.

Result:
The average angle before and after correction was 38.5° and −24.1°, respectively. The lower eyelashes gradually became introverted, and the amount of angle change was 9.3° at postoperative 1 month (P < 0.001). These lashes become slightly extroverted to −15.0° at 3 months after the correction.

Conclusions:
Lower eyelashes become introverted to about 9 degrees after surgical correction. They become more introverted after operation when the epiblepharon is more severe and when they are more reconditioned to extroversion immediately after the operation.
A Modified Technique for Treating Post-Traumatic Temporomandibular Joint Ankylosis in a Pediatric Patient
Authors: Liang Jiayu , Liu Lei , Li Hui 
Published: February 2022

Abstract:
Treatment of post-traumatic temporomandibular joint ankylosis is still a challenge. A modified technique that included surgery navigation technique, ultrasonic osteotome, bovine acellular dermal matrix, and abdominal dermis fat transplantation, was applied to treat a case of post-traumatic temporomandibular joint ankylosis. A 11-year-old girl with right temporomandibular joint bony ankylosis received surgical treatment in our department. Immediately restoration of functions and prevention of re-ankylosis have been achieved. Therefore, this case report demonstrated the safety and effectiveness of this modified technique in the management of temporomandibular joint ankylosis surgery.