bluuebunny/crossref_metadata_2025_split huggingface dataset:
Postoperative analgesia of intraoperative nefopam in patients undergoing anterior cervical spine surgery: A prospective randomized controlled trial
Authors: Raksakietisak Manee , Rushatamukayanunt Pranee , Wilaiwan Kulanong , Homprasert Chakkarin , Nitising Akkapong , Sawasdiwipachai Prasert , Pantubtim Chanitda 
Published: October 2022

Background:
Nefopam is a non-opioid, non-nonsteroidal anti-imflammatory drug, analgesic drug that inhibits the reuptake of serotonin, norepinephrine, and dopamine. It is widely used as an adjuvant for pain. This study investigated whether the intraoperative, intravenous infusion of nefopam (20 mg) reduces postoperative morphine consumption, pain scores, and alleviates neuropathic pain in patients undergoing cervical spine surgery.

Methods:
A prospective, paralleled design, randomized study was conducted on 50 patients (aged 18–75 years) in a university-based hospital. The patients were assigned to an intervention or a control group (25 patients in each). The intervention group received a 1-hour infusion of nefopam (20 mg) before the end of surgery. The control group received normal saline (NSS). The outcome measures were morphine consumption during the first 24 postoperative hours, numerical rating scale (NRS) pain scores, and scores for the Thai version of the Neuropathic Pain Symptom Inventory (NPSI-T) in patients with neuropathic pain and adverse drug reactions. The NPSI-T scores were assessed on the preoperative day, postoperative day 1, 3, 15, and 30. The outcome assessors were blinded to group allocation.

Results:
Fifty patients were analyzed. During the first 24 postoperative hours, morphine consumption was 8 mg (nefopam) and 12 mg (NSS; P = .130). The intervention and control groups demonstrated no significant differences in the median NRS scores or total NPSI-T scores or adverse drug reactions.

Conclusions:
A single, intraoperative infusion of 20 mg of nefopam did not significantly reduce postoperative (24 hours) morphine consumption in patients undergoing anterior cervical spine surgery.
A case of hemophagocytic lymphohistiocytosis after BNT162b2 COVID-19 (Comirnaty®) vaccination
Authors: Shimada Yoshitaka , Nagaba Yasushi , Okawa Hiroyuki , Ehara Kaori , Okada Shinya , Yokomori Hiroaki 
Published: October 2022

Rationale:
Coronavirus disease (COVID-19), an infectious disease caused by the severe acute respiratory syndrome coronavirus 2 virus, was reported in Wuhan of China in December 2019. The world is still in a state of pandemic owing to COVID-19. COVID-19 vaccines help our bodies develop immunity against the virus that causes COVID-19 without having to get the illness. Herein, we describe a rare case of a critical disorder, hemophagocytic lymphohistiocytosis (HLH), in a patient with nephritic sclerosis associated with hypertension, following mRNA COVID-19 vaccination. HLH is a life-threatening hyperinflammatory syndrome caused by aberrantly activated macrophages and cytotoxic T cells that may rapidly progress to terminal multiple organ failure.

Patient concerns:
An 85-year-old Japanese woman with chronic renal failure and hypertension was included in this study. Routine laboratory investigations provided the following results: white blood cell (WBC) count, 4.6 × 109/L; hemoglobin (Hb), 8.1 g/dL; platelet count, 27 × 109/L; blood urea nitrogen 48.9 mg/dL, and serum creatinine 3.95 mg/dL. The patient developed malaise, vomiting, and persistent high fever (up to 39.7°C) on the 12th day after receiving the second dose of the vaccine. Initial evaluation revealed neutropenia. The total WBC count was 0.40 × 109/L (Neutrophils 0, Lymphocytes 240/μ, blast 0%); Hb 9.0 g/dL, platelet count 27 × 109/L; and, C Reactive Protein 9.64 mg/dL.

Diagnosis:
Further tests showed hyperferritinemia (serum ferritin 2284.4 μg/L). Bone marrow examination revealed haemophagocytosis. A provisional diagnosis of HLH associated with the Comirnaty® vaccination was made based on the HLH-2004 diagnostic criteria.

Interventions:
The patient was treated with granulocyte colony-stimulating factor and 500 mg methylprednisolone.

Outcomes:
A significant improvement was observed in the patient’s condition; the abnormal laboratory results resolved gradually, and the patient was discharged.

Lessons:
This case serves to create awareness among clinicians that HLH is a rare complication of COVID-19 vaccination and should be considered, especially in patients with a history of chronic renal failure and hypertension.
Cervical repetitive peripheral magnetic stimulation relieves idiopathic persistent hiccups: A preliminary study of case report
Authors: Cai Weisen , Xu Guangqing , Tian Zongguang , Xiong Feng , Yang Jiajing , Wang Tong 
Published: October 2022

Objective:
We postulated that repetitive peripheral magnetic stimulation (rPMS) might treat idiopathic persistent hiccups. This study aimed to determine the clinical effect of rPMS on hiccup alleviation.

Methods:
Seven patients with idiopathic persistent hiccups experienced the cervical rPMS session (1 Hz, 656 stimuli) in this prospective clinical series from November 2018 to May 2021. The rPMS session was applied once daily until the hiccups were utterly relieved. During the treatment, the round coil was transversally positioned over the upper nape area, and the center of the coil was placed at the level of the C4 vertebrae. The subjective assessment scale (SAS) scores and the hiccup frequency were assessed before and after rPMS treatment.

Results:
A total of 7 patients were enrolled. All were male post-stroke patients ([mean ± SD] age, 58.5 ± 9.85 years) with dysphasia, 3 patients (3/7) were fed with a nasogastric tube, and 4 patients (4/7) were with dysarthria. The mean duration of hiccups was 4.14 ± 3.63 days (range 2–12 days). The rPMS therapy eliminated hiccups in all 7 patients. The mean sessions which stopped hiccupping were 3.43 ± 2.57 (range 1–9). The mean value of the SAS scores before rPMS therapy was 7 ± 1 (range 6–8), and it was decreased to zero after the therapy (0). No recurrence of hiccups was observed within 2 weeks of the last rPMS session. rPMS therapies were not associated with severe adverse effects.

Conclusion:
The cervical rPMS therapy is beneficial in treating idiopathic persistent hiccups, particularly in post-stroke patients.
Role of ultrasound-guided technique in the treatment of gynecologic diseases: A systematic review and meta-analysis
Authors: Xuan Min , Wu Chunyan , Zhang Jing , Zhou Fengsheng 
Published: October 2022

Background:
The efficacy and safety of ultrasound-guided interventional procedures for gynecologic diseases have not been evaluated comprehensively. Therefore, we aimed to provide an evidence-based medical reference for clinical treatment in this meta-analysis.

Methods:
The literature searches were conducted in databases of PubMed, Embase, and Web of Science for eligible studies published from 2002 to May 2022. All literature was searched, screened, and reviewed by 2 researchers separately. RevMan 5.3.0 was used to analyze the relevant data.

Results:
A total of 12 articles consisting of 2854 patients were included. Compared with the control group, meta-analysis showed that ultrasound-guided technique in the experimental group was associated with a higher effective rate [risk ratio = 0.84, 95% confidence interval (CI) (0.84, 0.84)], a lower probability of recurrence [odds ratio = 0.13, 95% CI (0.13, 0.13), P < .00001], and a greater effective reintervention rate [odds ratio = 3.39, 95% CI (1.29, 8.86), P = .01]. However, it was not significantly associated with fewer adverse reactions.

Conclusions:
Ultrasound-guided technique in treating gynecologic diseases exerted a positive effect and had fewer adverse reactions, which could be popularized and applied in clinical practice.
Disseminated cryptococcosis mimicking malignant lymphoma on 18F-FDG PET/CT: A case report
Authors: Zhang Xinchao , Hu Yujing , Tian Congna , Wei Qiang , Bian Yanzhu 
Published: October 2022

Rationale:
Disseminated cryptococcosis is extremely rare and is easily misdiagnosed as a malignant lymphoma. 18F-Fluorodeoxyglucose Positron Emission Tomography (PET)/ computed tomography (CT) may be useful to assess the involvement of disseminated cryptococcosis and to evaluate residual disease after treatment.

Patient Concerns:
A 21-years-old man presented with fever and cough for a month, with multiple red nodules scattered on the skin. 18F- Fluorodeoxyglucose PET/CT revealed multiple hypermetabolic lymph nodes in the upper and lower parts of the diaphragmatic region and hypermetabolic nodules in the skin. According to the PET/CT results, malignant lymphoma was considered a possibility, especially T-cell lymphoma involving the skin.

Diagnosis:
Cryptococcosis was diagnosed using inguinal lymph node biopsy and blood culture.

Interventions:
The patient received two months of amphotericin B, fluconazole, and half a month of meropenem.

Outcomes:
The patient’s body temperature returned to normal and the red nodules on the skin disappeared. Most of the hypermetabolic enlarged lymph nodes disappeared, which was confirmed by reexamination with PET/CT.

Lessons:
Disseminated cryptococcosis is easily misdiagnosed as malignant lymphoma, especially when the lymph nodes are more involved. When multiple hypermetabolic enlarged lymph nodes appear on PET/CT, except for lymphoma, specific infections should also be considered.
Hereditary motor and sensory neuropathy with SOD1-mutant: A case report
Authors: Luo Zhong , Zhang Linhai , Yang Juan , Zhang Haiqing , Liang Tao 
Published: October 2022

Rationale:
Hereditary motor-sensory peripheral neuropathy, or Charot-Marie-Tooth (CMT) Charcot-Marie-Tooth disease is an inherited peripheral neuropathy characterized by progressive limb weakness and muscle atrophy. As the disease progresses, sensory and autonomic involvement may occur. We report a case of CMT associated with SOD1 gene mutation, in order to provide new ideas for clinical disease diagnosis.

Patient concerns:
A 50-years-old female patient was admitted to the hospital with “progressive weakness of the right lower extremity for 5 years, aggravating, and weakness of the left lower extremity for 4 months”.

Diagnosis:
The patient was diagnosed CMT.

Intervention:
Nerve nutrition and rehabilitation therapy were given, but the patient’s condition still did not improve significantly.

Outcomes:
The improvement of symptoms was not obvious.

Lessons:
The clinical manifestations and electromyography results of this patient are consistent with the characteristics of CMT. The peripheral nerve-related hereditary gene test found mutation in SOD1. It is possible that this mutation is linked to CMT. The disease is a neurodegenerative disease, that may be slowed by physical therapy and rehabilitation, but could not be healed.
Network exploration of gene signatures underlying low birth weight induced metabolic alterations
Authors: Zhou Fei , Cheng Tiantian , Xing Yuling , Ma Huijuan , Yang Linlin 
Published: October 2022

Background:
This study explored underlying gene signatures of low birth weight (LBW) by analyzing differentially expressed genes (DEGs) between LBW and normal birth weight (NBW) subjects.

Methods:
Subjects with different birth weight was collected from GEO database. P < .05 and | logFC | ≥ 1.0 were used for screening DEGs. David (2021 Update) was used to perform GO annotation and KEGG signaling pathway enrichment analysis. The protein-protein interaction network of DEGs was constructed using the STRING database, in which hub genes were mined through Cytoscape software.

Results:
A total of 326 DEGs were identified, including 287 up-regulated genes and 39 down-regulated genes. The GO biological processes enriched by DEGs mainly involved epidermal growth, keratinization and intermediate fibrous tissue. The DEGs were significantly enriched in intracellular insoluble membranes, desmosomes and extracellular space. Their molecular functions mainly focused on structural molecular activity, structural components of epidermis and structural components of cytoskeleton. PI3K/AKT signaling pathway and tight junction were highlighted as critical pathways enriched by DEGs. Ten hub genes which included KRT14, EGF, DSP, DSG1, KRT16, KRT6A, EPCAM, SPRR1B, PKP1, and PPL were identified from the constructed protein-protein interaction network.

Conclusion:
A total of 326 DEGs and 10 hub genes were identified as candidates for metabolic disorders in LBW individuals. Our results indicated PI3K/AKT signaling pathway as an intrauterine adaptive mechanism for LBW individuals. We observed activated PI3K/AKT pathway in LBW individuals, which would promote growth and development at the early stage of life, but adversely introduce extra metabolic stress and thereby potentially induce metabolic disorders in adulthood.
Comparison of Obsessive-Compulsive Disorder and Schizophrenia With Comorbid Obsessive-Compulsive Disorder in Terms of Insight, Metacognitive Beliefs, and Clinical Features
Authors: Şenay Olcay , Tükel Raşit 
Published: October 2022

Abstract
The aim was to compare insight levels into obsessive-compulsive symptoms (OCS), and metacognitions of patients with obsessive-compulsive disorder (OCD) and with schizophrenia with comorbid OCD (SZ-OCD). Thirty OCD patients and 30 SZ-OCD patients were evaluated; no significant difference was found between the groups in the Brown Assessment of Beliefs Scale (BABS) and the Metacognition Questionnaire-30 (MCQ-30). When all patients were divided into two groups regardless of the presence or absence of schizophrenia as “good insight” and “poor or no insight,” the MCQ-30 total score was found to be higher in the “poor or no insight” group and showed a significant but moderate positive correlation with the BABS score. This study supports that the level of insight into OCS in SZ-OCD is not significantly different from patients with OCD. Metacognitions differ not according to the distinction between OCD and SZ-OCD but according to the level of insight in whole OCD sample.
Evaluation of a Novel Point-of-Care Ultrasound Curriculum for First-Year Pediatric Residents
Authors: Hulse Whitley N. , Bell Colin R. , Roosevelt Genie E. , Sabbadini Linda , Germano Rocco , Hopkins Emily , Kendall John , Toney Amanda G. 
Published: October 2022

Objective
The aim of the study is to evaluate a novel point-of-care ultrasound (POCUS) educational curriculum for pediatric residents.

Methods
The cohort study in graduate medical education was completed from January 2017 to March 2019. Postgraduate year 1 (PGY1) pediatric residents attended the educational curriculum that consisted of 3 half-day sessions over a 3-month period. Each session consisted of a lecture (introduction, extended focused assessment with sonography for trauma, soft tissue/musculoskeletal, cardiac, and resuscitative applications) followed by supervised hands-on scanning sessions. Group ratio was 3 learners to 1 machine/expert instructor. Main outcome measures included pre– and post–written test scores, as well as objective structured clinical examination (OSCE) scores.

Results
Forty-nine PGY1 residents (78% women) completed the curriculum. The mean (SD) pretest score was 68% (8.5), and the mean posttest score was 83% (8.3) with a difference of 15 (95% confidence interval, 12.5–17.6; P < 0.001). Mean (SD) focused assessment with sonography for trauma OSCE score after the curriculum was 88.7% (11.9). The number of PGY1 pediatric residents that were comfortable performing POCUS examinations increased from pretraining to posttraining for soft tissue/musculoskeletal (14%–61%, P < 0.001), extended focused assessment with sonography for trauma (24%–90%, P < 0.001), and cardiac (18%–86%, P < 0.001). All participants found the curriculum useful, and 42 of 49 (86%) stated the curriculum increased their ability to acquire and interpret images.

Conclusions
Postgraduate year 1 pediatric residents learned the basics of POCUS through 3 brief educational sessions. The increase in posttest scores demonstrated improved POCUS knowledge, and the high OSCE score demonstrated their ability to acquire ultrasound images. Point-of-care ultrasound guidelines are needed for pediatric residency programs.
A Systematic Review of Primary Rhinoplasty in Patients With Bilateral Cleft Lip
Authors: Di Chiaro Bianca , Santiago Gaia , Santiago Chiara , Zelko Ian , Choudhary Akriti , Purnell Chad A. 
Published: October 2022

Background:
Primary rhinoplasty (PR)at the time of cleft lip repair is controversial. We previously performed a systematic review that supported PR during unilateral cleft lip repair. We now aim to determine whether the same idea translates to care of patients with bilateral cleft lip.

Methods:
A systematic review was conducted adhering to Preferred Reporting Items for Systematic Reviews and Meta-analysis statement guidelines. PubMed and Embase databases were searched for studies that met our inclusion criteria: (1) English language, (2) human subjects, (3) rhinoplasty at the time of bilateral cleft lip repair, and (4) evaluation of nasal outcome. Studies were excluded in case of: (1) inclusion of a large proportion of syndromic patients, (2) case reports, (3) editorials, (4) letters, (5) reviews, and (6) exclusive to unilateral clefts. Out of 281 studies that showed up on initial search, 12 were included in our review. Research quality and level of evidence rating were determined for each study.

Results:
Of the 12 included studies, 9 supported PR at the time of bilateral cleft lip repair; 8 studies evaluated nasal growth and found no restriction over time; 4 studies followed 158 patients to an average of 15 years and showed 77% did not need secondary rhinoplasty.

Conclusion:
Although the available literature supports PR in patients with bilateral cleft lip with respect to subjective and objective outcomes, nasal growth, and reducing the need for secondary/revision rhinoplasty, there are significant limitations, necessitating large volume studies.
Can Frailty Indices Predict Surgical Risk in Open Reduction and Fixation of Facial Fractures?
Authors: Katz Abigail , Alerte Eric , Akhavan Arya , Kuruvilla Annet , Ibelli Taylor , Liu Helen , Etigunta Suhas , Taub Peter J. 
Published: October 2022

Purpose:
The present study sought to evaluate whether the mFI-5 and modified Charlson Comorbidity Index (mCCI) are stronger predictors of 30-day postoperative complications after open reduction of facial fractures compared with historic risk proxies.

Methods:
A retrospective review of the American College of Surgeons’ National Surgical Quality Improvement Program (ACS-NSQIP) database was conducted to investigate patients who underwent open reduction facial fracture surgery between 2013 and 2018. Risk factors including age, smoking status, body mass index (BMI), comorbidities, and American Society of Anesthesiologists (ASA) class were extracted for each patient. The mFI-5 score and mCCI score were calculated based on this data. Univariate logistic regressions were performed (P<0.05)

Results:
A total of 2667 cases were included. Of these, 2131 (80%) were male. The strongest predictors for overall 30-day complications and complication severity were ASA class ≥3 (Odds Ratio [OR]=3.34), comorbidities ≥2 (OR=2.78), mCCl score ≥2 (OR=2.19), and mFI-5 ≥1 (OR=1.96). Smoking status and BMI were not strong predictors of total complications or complication severity. Age was found to be a statically significant, but low-impact, predictor of complications, and severity (OR=1.02, P<0.001). The only significant predictors of surgical site infections (SSI) were smoking status (OR=1.56) and ASA class ≥3 (OR=2.40). mFI-5 ≥1 was a significant predictor of hospital readmission. BMI was not associated with any increased risk.

Conclusions:
The mCCI and mFI-5 are statistically significant predictors of total complications and complication severity in open reduction of facial fracture repair, and thus provide a tool to inform decision making and improve care. Smoking status may increase risk for SSIs following facial fracture repair.
Case Report: Dose-Dependent Enuresis in Methylphenidate Use
Authors: Güleşen Oya , Bodur Şahin , Cöngöloğlu Ayhan 
Published: October 2022

Objectives
Attention deficit hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders of childhood. Although enuresis is a very common disorder in child diagnosed with ADHD, it may also develop because of methylphenidate.

Methods
Authors report here on a child case of ADHD that developed a probable enuresis related to methylphenidate.

Results and Conclusions
Clinicians should be aware that methylphenidate used in ADHD causes dose-dependent enuresis.
Virologic, clinical, and immunological characteristics of a dengue virus 3 human challenge model
Authors: Waickman Adam T. , Newell Krista , Lu Joseph Q. , Fang HengSheng , Waldran Mitchell , Gebo Chad , Currier Jeffrey R. , Friberg Heather , Jarman Richard G. , Klick Michelle D. , Ware Lisa A. , Endy Timothy P. , Thomas Stephen J. 
Published: October 2022

AbstractDengue human infection models present an opportunity to explore a vaccine, antiviral, or immuno-compound’s potential for clinical benefit in a controlled setting. Herein, we report the outcome of a phase 1, open-label assessment of a DENV-3 challenge model. In this study, 9 participants received a subcutaneous inoculation with 0.5ml of a 1.4×103PFU/ml suspension of the DENV-3 strain CH53489. All subjects developed RNAemia within 7 days of inoculation, with peak titers ranging from 3.13×104to 7.02×108GE/ml. Symptoms and clinical lab abnormalities consistent with mild dengue infection were observed in all subjects. DENV-3 specific seroconversion was observed by 14 days after inoculation, along with DENV-3 specific memory T cell responses. RNAseq and serum cytokine analysis revealed the presence of an antiviral transcriptional and cytokine response to infection that overlapped with the period of viremia. The magnitude and frequency of clinical and immunologic endpoints correlated with an individual’s peak viral titer.