bluuebunny/crossref_metadata_2025_split huggingface dataset:
Successful treatment of thrombotic thrombocytopenic purpura with plasmapheresis and anti-CD20 antibodies in a patient with immune thrombocytopenia and systemic lupus erythematosus
Authors: Jung Ju-Yang , Kim Ji-Won , Suh Chang-Hee , Kim Hyoun-Ah 
Published: April 2022

Abstract

Rationale:
Systemic lupus erythematosus (SLE) is an autoimmune disease of unknown etiology with diverse clinical and laboratory manifestations, including thrombocytopenia. About 25% of patients with SLE may be affected by thrombocytopenia, many of whom are asymptomatic. Some patients, however, experience platelet counts that drop quite low and predispose them to bleeding. Thrombotic thrombocytopenic purpura (TTP) is defined with a classic pentad of clinical features, such as thrombocytopenia, microangiopathic hemolytic anemia, neurological symptoms and signs, renal symptoms and signs, and fever. The association of TTP and SLE has been sporadically reported in the literature.

Patient concerns and diagnosis:
We describe a 16-year-old girl with SLE and immune thrombocytopenia, in whom TTP was diagnosed.

Interventions and outcomes:
She was treated with pulse methylprednisolone, whose platelet counts normalized after therapy with plasmapheresis and an anti-CD20 monoclonal antibody (rituximab).

Conclusion:
A pediatric patient with SLE and immune thrombocytopenia in whom TTP developed was treated with plasmapheresis and rituximab therapy successfully, though the patient experienced a disease relapsed after 18 months, which was controlled by the same management.
Effectiveness and safety of aromatherapy massage for knee osteoarthritis
Authors: Pang Tingting , Liu Chang , Li Jiahui , Yao Junjie , Li Zhongxu , Lei Siyuan , Zhang Jiangchun , Li Xuefei , Dong Li , Wang Yufeng 
Published: March 2022

Abstract

Background:
The purpose of this study was to evaluate the effectiveness and safety of aromatherapy massage in the treatment of knee osteoarthritis.

Methods:
To collect relevant literature, we will research following databases: PubMed, Web of Science, Scopus, Cochrane Library, Embase, China National Knowledge Infrastructure, China Science and Technology Journal Database and Wanfang Data the time is from inception to December 30, 2021, and the language is limited to Chinese and English. In addition, we will retrieve other literature resources, including the Chinese Clinical Trial Register, conference papers. Two reviewers will independently complete the literature screen and data extraction, and quality assessment of the included studies will be independently completed by 2 other researchers. The primary outcomes included the Western Ontario and McMaster Universities Osteoarthritis Index scale, the visual analog scale, symptom score, Lysholm knee scoring scale, adverse events, and adverse reactions as secondary outcomes would be assessed. RevMan V.5.4.1 software will be used for meta-analysis, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) will be used to assess the quality of evidence.

Results:
This systematic review will be showed a high-quality synthesis to evaluate the efficacy and safety of aromatherapy massage in the treatment of knee osteoarthritis, providing reference for the safe and effective treatment of knee osteoarthritis.

Conclusion:
This study provides evidence of whether aromatherapy massage is effective.
Systematic review registration: INPLASY202210010
URL: https://inplasy.com/inplasy-2022-1-0010/
A case report of low grade fetal lung adenocarcinoma with TP53 mutation
Authors: Wang Bo , Jin Huri 
Published: March 2022

Abstract

Rationale:
Fetal lung adenocarcinoma (FLAC) is a rare malignant tumor that occurs in the alveolar epithelium. FLAC, as a distinct entity, is a malignancy with a very low incidence, accounting for less than 0.5% of all lung tumors, with a high rate of misdiagnosis due to its rarity, lack of typical presentation and imaging signs. According to histopathological differences, FLAC is further divided into 2 types: low-grade FLAC and high-grade FLAC. In the article, we report a young woman who was diagnosed with low-grade fetal-type lung adenocarcinoma.

Patient concerns:
An 18-year-old female patient was admitted due to cough and chest distress.

Diagnosis:
The final pathological examination confirmed that the lesion was a low-grade fetal lung adenocarcinoma.

Interventions:
The patient underwent thoracoscopic left lower lobectomy and regional lymph node dissection.

Outcomes:
The postoperative course was stable, and no recurrence was observed 1 year after operation.

Lessons:
To the best of our knowledge, there are no previous case reports of low-grade fetal-type adenocarcinoma, TP53 gene mutation, and the significance of its mutation is not extensively studies. FLAC, although extremely rare, is considered in the differential diagnosis of lung cancer. In addition, biopsy, histopathology, and specific immunohistochemical staining of larger tissue specimens are helpful for accurate diagnosis of FLAC.
Does COVID-19 infection increase the risk of pressure injury in critically ill patients?
Authors: Baron Miriam Viviane , Santos Michele Paula dos , Werle Taís Michele , Scherer Gabriela D.L.G. , Santos Mariana Martins Dantas , Dominguez Luis Manuel Ley , Brandenburg Cristine , Feltez Gabriela , Sampaio Aline Ronis , de Mello Pinto Marcus Vinicius , Carvalho Sonia , Meyer Patrícia Froes , Picariello Felice , Pacheco Esteban Fortuny , Reinheimer Isabel Cristina , Sancho Alexandre Gomes , da Costa Bartira Ercília Pinheiro 
Published: March 2022

Abstract
Patients with severe COVID-19 may have endothelial dysfunction and a hypercoagulable state that can cause skin damage. In the presence of external pressure on the tissues, the local inflammatory process regulated by inflammatory cytokines can increase and prolong itself, contributing to the formation of pressure injury (PI). PI is defined as localized damage to the skin or underlying tissues. It usually occurs as a result of intense and/or prolonged pressure in combination with shear. The aim of the study is to perform a narrative review on the physiological evidence of increased risk in the development of PI in critically ill patients with COVID-19.
In patients with severe COVID-19 a pattern of tissue damage consistent with complement-mediated microvascular injury was found in the lungs and skin of critically ill COVID-19 patients, suggesting sustained systemic activation of complement pathways. Theoretically, the same thrombogenic vascular changes related to COVID-19 that occur in the skin also occur in the underlying tissues, making patients less tolerant to the harmful effects of pressure and shear. Unlike the syndromes typical of acute respiratory illnesses and other pathologies that commonly lead to intensive care unit admission, COVID-19 and systemic viral spread show that local and systemic factors overlap. This fact may be justified by current epidemiological data showing that the prevalence of PI among intensive care unit patients with COVID-19 was 3 times higher than in those without COVID-19. This narrative review presents physiological evidence to suggesting an increased risk of developing PI in critically ill patients with COVID-19.
Can adjuvant chemotherapy improve the prognosis of adult ovarian granulosa cell tumors?
Authors: Zhuang Yuan , Zhang Shushan , Liu Yao , Yang Hua 
Published: March 2022

Abstract
Adult granulosa cell tumors (aGCTs) are rare ovarian neoplasms with a relatively favorable prognosis. They follow an indolent course, characterized by a prolonged natural history and a tendency to late recurrences, Around a quarter of patients develop recurrence and More than 70% of women with recurrence die from their disease, The percentage of patients received chemotherapy increases over time, whether adjuvant chemotherapy improve the prognosis of aGCTs is equivocal? The purpose of this review is to summarize the previously published evidence to evaluate whether adjuvant chemotherapy improve the prognosis of aGCTs to provide guidance for clinical practice. EMBASE, PubMed, Web of Science, WanFang Data and Chinese National Knowledge Infrastructure are searched up to December 2020, used the search strategy of ovar* and granulosa cell* and (tumor* or tumour* or malignan* or cancer* or carcinom* or neoplasm*) and chemotherapy. The screening process was conducted strictly based on inclusion and exclusion criteria. Clinical studies based on human including randomized controlled trial, quasi-randomised controlled trials, nonrandomised trials cohort study and case control study were included without restriction of time. The percentage of patients received chemotherapy increases over time, but the benefit of adjuvant chemotherapy is lack of high-grade evidence of prospective study, based on the current retrospective studies, we still do not have the evidence to confirm the survival benefit of adjuvant chemotherapy in early stage, advanced stage or recurrent aGCT with no residual tumor, but for inoperable disseminated disease or disease with suboptimal cytoreduction, adjuvant chemotherapy maybe an Optable options. Multinational prospective randomised controlled trials are urgently needed to validate the role of adjuvant chemotherapy. Further research on molecular mechanisms and developing novel targeted medicines may improve the survival of aGCTs.
Clinical outcomes and etiology of acquired sixth cranial nerve palsy
Authors: Oh Shin Yeop 
Published: March 2022

Abstract
The objective of this study was to investigate the difference in clinical features according to age and factors affecting recovery of acquired sixth cranial nerve (CN6) palsy.
A total of 156 patients with acute CN6 palsy between March 2016 and August 2021 who were followed up for at least 3 months were included in this study. Etiology, rate of recovery, and factors associated with recovery were retrospectively investigated.
The average age of patients with CN6 palsy was about 60years and the mean duration of recovery was about 2.5 months. Of 156 patients, 72 (46.15%) had a microvascular etiology and 25 (16.03%) patients had a brain vascular lesions. Brain neoplasm, trauma, and “others” were found in 10 (6.41%), 11 (7.05%), and 15 (9.62%) patients, respectively. Among the total of 156 patients, 28 (17.95%) failed to completely recover. Non-isolated CN6 palsy with other cranial nerve palsies were recorded in 29 (18.59%) cases. Comparison of age (<50years vs ≥50years), between recovery and non-recovery groups showed that etiology was significantly different.
The recovery rate of acquired CN6 palsy was about 82% and about 27% of patients had brain lesions. Also, varying rates and duration of recovery were found according to etiology, so we should be pay attention to diagnosis of causative disease in CN6 palsy patients.
Evaluation of response to stereotactic body radiation therapy for nonsmall cell lung cancer: PET response criteria in solid tumors versus response evaluation criteria in solid tumors
Authors: Han Jixia , Song Qi , Guo Feng , Du Rui , Fang Henghu , Kang Jingbo , Lu Zejun 
Published: March 2022

Objective
Recommendations for surveillance after stereotactic body radiation therapy (SBRT) for early-stage nonsmall cell lung cancer (NSCLC) are not well defined. Recently, PET response criteria in solid tumors (PERCIST) have been proposed as a new standardized method to assess radiotherapeutic response both quantitatively and metabolically. The aim of this study was to evaluate therapeutic response following SBRT in early-stage NSCLC patients by comparing PERCIST with the currently widely used RECIST.

Materials and methods
Forty-nine patients with early-stage NSCLC who had been prescribed SBRT were studied. Responses of lesion were evaluated using CT and 18F-FDG PET according to the RECIST and PERCIST methods. PET-CT scans were obtained before SBRT and 3–6 months after SBRT. Associations between overall survival (OS) and clinicopathologic results (histology, tumor location, tumor size, lymphatic invasion, clinical stage, and radiotherapeutic responses in RECIST and PERCIST) were statistically analyzed. The median patient follow-up was 30 months.

Results
Thirteen patients had stage IA, 9 stage IB, 10 stage IIA, and 17 stage IIB biopsy-proven NSCLC. Three-year OS was 79.6%. CT scans indicated three regional recurrences. PET-CT/chest indicated three regional recurrences and distant metastasis. Significant differences were observed in response classification between RECIST and PERCIST (Wilcoxon signed-rank test, P = 0.0041). Univariate analysis showed that clinical stage, RECIST, and PERCIST were significant factors associated with OS, whereas by multivariate analysis PERCIST was the only predictor of OS. SMD, PMD/PMR, and CMR in PERCIST criteria were indicative of a 9.900-fold increase in the risk of OS in early NSCLC patients [risk ratio, 9.900 (95% CI, 1.040–21.591); P = 0.001].

Conclusion
RECIST based on the anatomic size reduction rate did not demonstrate the correlation between radiotherapeutic response and prognosis in patients with early-stage NSCLC receiving SBRT. However, PERCIST was shown as the strongest independent predictor of outcomes. PERCIST might be considered more suitable for the evaluation of NSCLC tumor response to SBRT than RECIST.
Social Determinants of Health
Authors: Johnson Charla B. , Luther Brenda , Wallace Andrea S. , Kulesa Marjorie Gibson 
Published: March 2022

The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity report recognizes nurses' impact on the medical and social factors that drive health outcomes (National Academies of Sciences, Engineering, and Medicine [NASEM], 2021). The report calls for nursing to take bold steps to address individual and structural level social determinants of health (SDoH)—or social and environmental factors contributing to poor health, poor health outcomes, and health disparities (NASEM, 2021, p. 5). Nurses must recognize the significance of SDoH on patient health outcomes in order to advance health equity and employ nursing interventions to affect positive change for our patients. SDoH are part of our patients' stories, and holistic nursing means we know the whole patient story.
Although it is now widely recognized that SDoH affect health outcomes, a key challenge for nurses is that they represent an enormous range of factors—from food and housing insecurity to personal safety and environmental exposures—that may be more or less able to change with interventions in clinical settings. Furthermore, concerns have been raised that screening for SDoH—especially when not done with sensitivity, cultural competence, or ready intervention—may compromise therapeutic relationships and marginalize patients (Wallace et al., 2020). However, despite these concerns, healthcare systems are widely adopting SDoH assessments, generally through electronic health record screening questions, and attempting to implement associated workflows and interventions. Given this landscape, the purpose of this article, within this special issue of Orthopaedic Nursing, is to provide an overview of SDoH factors, identify best practices related to screening and referral, and highlight nurse-directed interventions in clinical settings.
Hypertensive Disorders of Pregnancy: Common Clinical Conundrums
Authors: Ohamadike Onyinye , Lim Stephanie L. , Siegel Anne , Zemtsov Gregory , Kuller Jeffrey A. , Dotters-Katz Sarah 
Published: March 2022

Importance
Hypertensive complications of pregnancy comprise 16% of maternal deaths in developed countries and 7.4% of deaths in the United States. Rates of preeclampsia increased 25% from 1987 to 2004, and rates of severe preeclampsia have increased 6.7-fold between 1980 and 2003.

Objective
The aim of this study was to review current and available evidence for common clinical questions regarding the management of hypertensive disorders of pregnancy.

Evidence Acquisition
Original research articles, review articles, and guidelines on hypertension in pregnancy were reviewed.

Results
Severe gestational hypertension should be managed as preeclampsia with severe features. Serum uric acid levels can be useful in predicting development of superimposed preeclampsia for women with chronic hypertension. When presenting with preeclampsia with severe features before 34 weeks, expectant management should be considered only when both maternal and fetal conditions are stable. In the setting of hypertensive disorders of pregnancy, oral antihypertensive medications should be initiated when systolic blood pressure is greater than 160 mm Hg or when diastolic blood pressure is greater than 110 mm Hg, with the most ideal agents being labetalol or nifedipine. Furthermore, although risk of preeclampsia recurrence in future pregnancy is low, women with a history of preeclampsia should be managed with 81 mg aspirin daily for preeclampsia prevention.

Conclusion and Relevance
Despite the frequency with which hypertensive disorders of pregnancy are encountered clinically, situations arise frequently with limited evidence to guide providers in their management. An urgent need exists to better understand this disease to optimize outcomes for impacted patients.

Target Audience
Obstetricians and gynecologists, family physicians

Learning Objectives
After completing this activity, the learner should be better able to describe the diagnosis and delineation between various preeclampsia spectrum disorders; distinguish imitators of preeclampsia from preeclampsia; and explain best practices for management of various clinical conundrums related to hypertensive disorders of pregnancy.
Gluteal and Posterior Thigh Pain From a Suture Compared With an Anchor-Based Device in Patients Undergoing Sacrospinous Ligament Fixation: A Randomized Controlled Trial
Authors: Plair Andre , Smith Whitney , Hines Katherine , Schachar Jeffrey , Parker-Autry Candace , Matthews Catherine 
Published: March 2022

(Abstracted from Obstet Gynecol 2022;139:97–106)
Repair of apical vaginal prolapse is commonly performed by suspension of the vaginal apex or cervix to the sacrospinous ligament. Some widely used suture-capturing devices for sacrospinous suspension are associated with postoperative pain in the gluteal and posterior thigh.
Children With a Soft Scalp Hematoma Presenting to the Emergency Department More Than 24 Hours After a Head Injury
Authors: Ferro Valentina , Boccuzzi Elena , Colafati Giovanna Stefania , De Benedictis Alessandro , Supino Maria Chiara , Faa Maria Francesca , Musolino Anna Maria , Reale Antonino , Raucci Umberto 
Published: March 2022

Objectives
The soft scalp hematoma is one of the clinical markers used as a predictor for the presence of intracranial injury in children with a head trauma. We evaluated the significance of time presentation in the management of these patients.

Methods
We conducted a retrospective study of children and adolescents aged 0 to <18 years by comparing the clinical, radiological, and epidemiological features in those presenting within 24 hours with those presenting greater than 24 hours after a head injury.

Results
We identified 188 and 98 patients with early presentation and late presentation, respectively. The percentage of children aged 0 to <6 months was lower in those with late presentation (6.12%) than those with early presentation (20.21%) with a significant difference (P < .001). Likewise, the percentage of children aged ≥24 months was lower in children with late presentation (7.14%) than those with early presentation (34.04%) with a significant difference (P < .001). The severe mechanism rate was more elevated in early presentation (38.83%) with a significant difference (−14.34%; 95% confidence interval [CI], −25.34% to −3.34%; P = .015). The symptom rate resulted higher in early presentation (14.36%) with a significant difference (−11.30%; 95% CI, −17.36% to 5.22%; P = .003). The parietal scalp hematoma occurred mostly in children with late presentation (85.71%) with a significant difference (19.76%; 95% CI, 10.07% to 29.45%; P < .001). The occipital scalp hematoma rate was higher in early presentation with a significant difference (−17.50%; 95% CI, −22.99% to −12.12%; P < .001). There was no significant difference in the prevalence of different types of intracranial injury, and the only 5 patients needing a neurosurgical intervention were exclusively children with an early presentation.

Conclusion
Although children with soft scalp hematoma presenting to the emergency department greater than 24 hours after a head injury may have pathological findings on computed tomography, all of them had a good short- and long-term outcomes, and no neurological deterioration aroused the medical attention on follow-up. For this subset of patients that does not experience red flags (neurological symptoms, focal signs on examination, or severe injury mechanism), a wait-and-see approach might be more appropriate rather than neuroimaging.
Clinical Characteristics of Acute Hematogenous Osteomyelitis With and Without Subperiosteal Abscesses in the Acute Care Setting
Authors: Hartman Neal R. , Gerard James M. , Puryear Aki , Sethi Anchal , Flood Robert G. 
Published: March 2022

Background
Acute hematogenous osteomyelitis (AHO) is a common pediatric disease that can progress to involve nearby structures leading to complications including subperiosteal abscesses (SPAs). Those with SPAs, in particular, often require surgical intervention for complete treatment. Staphylococcus aureus remains one of the most common causes of AHO. With the emergence of community-associated methicillin-resistant Ataphylococcus aureus and its propensity to form abscesses, there has been an observed increased frequency of AHO with SPAs in children. Although magnetic resonance imaging (MRI) remains the gold standard of imaging for AHO, it is not readily available on a 24/7 basis and often necessitates procedural sedation in children. Delay in MRI and surgical intervention in patients with SPAs may lead to increased complications. The goal of this study is to identify, using clinical features easily obtained in the acute care setting, patients at high risk for AHO with SPAs who may benefit from emergent MRI and/or surgical intervention.

Design/Methods
A retrospective chart review of patients aged birth to younger than 18 years diagnosed with AHO, who presented to a tertiary pediatric hospital from June 10, 2012, to November 1, 2017, were evaluated. Demographic, clinical, laboratory, and imaging data were collected. Patients were divided into 2 groups: AHO alone and AHO with SPAs.

Results
A final cohort of 110 subjects were included and analyzed. Of these, 73 (66%) were identified as having AHO alone and 37 (33.6%) as having AHO with SPAs. Patients had a higher risk of AHO with SPAs if they had a history of fever, decreased range of motion, edema, or elevated laboratory studies including white blood cell, absolute neutrophil count, erythrocyte sedimentation rate, and C-reactive protein. C-reactive protein was shown to have the highest correlation of AHO with SPAs, with an optimal cut point of 10.3 mg/dL, yielding a sensitivity of 67.7% and specificity of 77.6%. Patients with AHO with SPAs were at higher risk of having a positive blood culture for methicillin-resistant Staphylococcus aureus.

Conclusions
Clinicians in acute care settings should have a high index of suspicion of AHO with SPAs in children with history of fever, decreased range of motion, or elevated laboratory values (white blood cell, absolute neutrophil count, erythrocyte sedimentation rate, and C-reactive protein). In particular, those with a significantly elevated CRP are at a higher risk for having AHO with SPAs in comparison with an uncomplicated AHO. However, with the significant overlap in historical and clinical variables in the initial presentations of children with AHO with and without SPAs, the clinical urgency in obtaining a magnetic resonance imaging must continue to be individualized based on overall clinical suspicion and availability of resources.