bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impacts of Symptomatic HIV Infection on In-Hospital Cardiopulmonary Resuscitation Outcomes: &#x2028;A Population-Based Cohort Study in South Korea
Authors: Oh Tak Kyu , Jo You Hwan , Song Kyoung-Ho , Song In-Ae 
Published: March 2022

Abstract

Background
The impact of HIV infection on survival outcomes after in-hospital cardiopulmonary resuscitation (ICPR) remains controversial. This study aimed to investigate the impacts of HIV infection on both short-term and long-term outcomes after ICPR.

Methods
This nationwide, population-based cohort study used data taken from the South Korean National Health Insurance Service database. All adult (≥18 years old) patients who experienced ICPR between January 1, 2010, and December 31, 2019, were included.

Results
A total of 298 676 adult patients who underwent ICPR were initially included in the analysis. Among them, 586 (0.2%) patients were assigned to the patients with symptomatic HIV infection (PWH) group, while 298 090 (99.8%) patients were assigned to the control group. After 1:10 propensity score (PS) matching, 586 patients in the PWH group and 5845 patients in the control group were included in the analysis. Logistic regression analysis after PS matching showed that the PWH group had a 20% lower live discharge rate after ICPR compared with the control group (odds ratio, 0.80; 95% CI, 0.65–0.97; P = .024). However, Cox regression analysis after PS matching showed that the risks of 6-month survival (hazard ratio [HR], 1.01; 95% CI, 0.93–1.11; P = .768) and 1-year survival (HR, 1.02; 95% CI, 0.93–1.11; P = .702) were not significantly different between the PWH and control groups.

Conclusions
Although the PWH group showed lower live discharge rates compared with the control group after ICPR, long-term survival outcomes from 6 months and 1 year were not significantly different.
Tunga penetrans causing a rapidly progressing foot ulcer in a patient with uncontrolled type 2 diabetes mellitus
Authors: Ebrahim Ashabilan A , Mpango Elisia P , Temba Joseph A , Abbas Zulfiqarali G , Mashili Fredirick L 
Published: March 2022

ABSTRACT
Tungiasis is a parasitic disease resulting from infestation by a female flea Tunga penetrans. The parasites are endemic in the tropics and can infect patients with diabetes mellitus (DM). Augmented by uncontrolled hyperglycemia and pre-existing neuropathy, the parasite may trigger a locally spreading inflammation, which may aggravate the trauma introduced during its extraction, leading into a rapidly progressing foot ulcer. To the best of our knowledge, no such cases in patients with type 2 diabetes have ever been published from Tanzania and likely none worldwide. This case report shows that, in diabetic patients, the wound resulting from the extraction of T. penetrans may get infected and aggravated by the ongoing inflammatory reaction, rapidly evolve into limb-threatening condition and mortality. Preventive measures are necessary and should be emphasized in patients with DM. Studies are needed to increase our understanding of the pathophysiology, proper management and sequalae of ulcers of this nature.
Pyoderma gangrenosum induced by transcutaneous electrical nerve stimulation: a case report with literature review
Authors: Costescu Strachinaru Diana Isabela , De Greef Axel , Marot Liliane , Lerate Valérie , Paridaens Marie-Sophie 
Published: March 2022

ABSTRACT
Pyoderma gangrenosum (PG) is one of the neutrophilic dermatosis, a heterogenous group of rare inflammatory diseases affecting the skin. It is often associated with systemic diseases such as inflammatory bowel disease, rheumatoid arthritis or hematological malignancies. Classical PG is characterized by painful ulcers with violaceous, undermined border, often developing at sites of injury because of the typical pathergy phenomenon. Because of its polymorphic presentation, misdiagnosis and delayed diagnosis are common. We present a case of PG occurring after transcutaneous electrical nerve stimulation (TENS) in a young female patient with ulcerative colitis. Although electric current has previously been incriminated as a trigger for PG, to the best of our knowledge this is the first case precipitated by TENS. We report a typical case of PG occurring after an unusual stimulus and highlight the challenges that the diagnosis of this relatively rare pathology poses to the clinician.
The use of Sonidegib in the adjuvant and advanced phases of Sonic Hedge Hog Mutant Medulloblastomas
Authors: Yuile Alexander K , Kastelan Marina , Lee Adrian PS , Back Michael , Drummond James , Wheeler Helen R 
Published: March 2022

ABSTRACT
Medulloblastomas are rare embryonal primary brain tumours originating in the cerebellum. Most medulloblastomas arising in adults are associated with mutations in the Sonic Hedge Hog (SHH) pathway. Patient 1 was prescribed Sonidegib for recurrent metastatic SHH mutated medulloblastoma multiple lines of treatment. His leptomeningeal disease responded after 3 months of therapy. The drug was continued for a further 3 months until progressive central nervous system (CNS) and leptomeningeal disease arose. Progression free survival (PFS) from initiation of Sonidegib of 3 months was observed (overall survival 8.8 years). Patient 2 presented with un-resectable SHH mutated meduloblastoma with high risk of relapse who received 14 months of adjuvant Sonidegib. Following biopsy she was treated with chemotherapy and cranio-spinal radiotherapy, followed by 14 months of adjuvant Sonigedib. She remains free of disease over 51 months later. Both clinical scenarios are poorly described in the literature or evaluated in clinical trials with Sonidegib.
Dengue and malaria coinfection: the first case report in Nepal
Authors: Gautam Arun , Aryal Ujjwal , Bhandari Sudeep , Pradhan Saugat , Bhattarai Urza , Mishra Akshat , Sharma Sanjib Kumar 
Published: March 2022

ABSTRACT
A 21-year-old male from Nepal, with a history of travel to Mumbai 2 months ago, presented with fever with chills and rigors, vomiting and multiple joint pain for 1 week. Clinical examination was noteworthy for tachycardia, hypotension and positive tourniquet test. Lab reports showed NS1-Ag positive, thrombocytopenia, lymphocytosis, transaminesemia, hyperbilirubinemia, increased urea and creatinine. He was treated for severe dengue. His laboratory parameters started improving; however, he had fever with chills and rigors daily and persistent vomiting. Repeat peripheral smear for Malaria showed schizonts and trophozoites of Plasmodium vivax. He recovered following treatment with IV fluids and injection artesunate. The presence of fever even in a critical phase of dengue, the typical rise of temperature daily, and jaundice gave a clue of coinfection with Malaria. On follow-up, after 2 weeks, he had no symptoms, and all the laboratory parameters were normal.
A huge metaplastic breast carcinoma with chest wall invasion and pulmonary metastasis: a rare case report
Authors: Kherbek Haidara , Deeb Ismaeel , Ali Haya , Halloum Mais , Alshehabi Zuheir , Ali Wassim 
Published: March 2022

ABSTRACT
Metaplastic breast carcinoma (MBC) is a diverse group of invasive breast carcinoma, in which the neoplastic epithelium differentiates toward squamous cells or mesenchymal looking elements, including but not restricted to spindle, osseous and chondroid cells. MBC was formally considered a distinct pathological pattern by WHO classification of breast tumors in 2000. We report the case of a 49-year-old Syrian female who presented to our hospital due to a painful huge mass in her right breast. Radiographic and clinical findings were highly indicative of breast carcinoma. Therefore, a core needle biopsy was performed, and surprisingly, microscopic examination suggested the diagnosis of soft tissue sarcoma, whereas immune stains confirmed the diagnosis of metaplastic carcinoma. We aim to introduce a challenging case that clarifies the rarity of this tumor, and the methods we used in diagnosing, examining and treating this malignancy.
Focal-onset seizure due to left internal carotid artery dissection in the context of confounding hyperglycaemia
Authors: Moulder Zachary , Kosela Monika , Zafar M Ahtsham , Jha Abhinav , Gopal Karthik , Pandey Anmol 
Published: March 2022

ABSTRACT
A 36-year-old diabetic woman presented to hospital with a seizure that started with shaking of the right hand which sequentially progressed to the entire right side of the body with associated loss of consciousness. Capillary Blood Glucose was 29 mmol/L. HbA1c was 133 mmol/L. Non-contrast computerised tomography (CT) scan of the brain was normal suggesting that the cause of her seizure was hyperglycaemia. However, Magnetic Resonance Imaging (MRI) of the brain showed infarcts in the left paracentral lobule and caudate nucleus. It also identified loss of signal flow void in the intracranial segment of the left internal carotid artery (ICA) raising the suspicion for thrombosis secondary to dissection. This was later confirmed on CT angiogram. This case demonstrates how the initial CT Head was non-diagnostic. We stress the importance of taking a careful seizure history and subsequently obtaining an MRI scan to fully exclude structural pathology.
Detection of highly correlated optical and X-ray variations in SS Cygni with Tomo-e Gozen and NICER
Authors: Nishino Yohei , Kimura Mariko , Sako Shigeyuki , Beniyama Jin , Enoto Teruaki , Minezaki Takeo , Nakaniwa Nozomi , Ohsawa Ryou , Takita Satoshi , Yamada Shinya , Gendreau Keith C 
Published: March 2022

Abstract
We report on simultaneous optical and X-ray observations of the dwarf nova SS Cyg with Tomo-e Gozen/1.05 m Kiso Schmidt and Neutron star Interior Composition ExploreR (NICER)/International Space Station (ISS). A total of four observations were carried out in the quiescent state and highly correlated light variations between the two wavelengths were detected. We have extracted local brightness peaks in the light curves with a binning interval of 1 s, called “shots,” and have evaluated time lags between the optical and X-ray variations by using a cross-correlation function. Some shots exhibit significant optical lags to X-ray variations and most of them are positive, ranging from +0.26 to +3.11 s, which have never been detected. They may be ascribable to X-ray reprocessing in the accretion disk and/or the secondary star. This analysis is possible thanks to the high timing accuracy and the high throughput of NICER and the matching capability of Tomo-e Gozen. Also, it is confirmed that the correlation between the optical and X-ray variations changed in the middle of one of our observation windows and that the X-ray spectrum softer than 2 keV varied in accordance with the correlation.
UPDATED AGE-SPECIFIC EXTERNAL DOSE AND EXPOSURE RATE COEFFICIENTS FOR 131I PATIENT RELEASE
Authors: Aziz L , Dewji S 
Published: March 2022

Abstract
Updated effective dose rate and exposure rate coefficients for age-specific receptors representing members of the public were computed for external exposures from age-specific patients administered 131I to treat thyroid dysfunction for patient release evaluation. Coefficients were compared to the simplified point source method described by United States Nuclear Regulatory Commission Regulatory Guide (RG) 8.39, which does not consider age-specific parameters, morphometry or time-dependent 131I biodistribution. Monte Carlo age-specific phantom simulations were correlated with modified continuous voiding patient biokinetic models approximating age-specific dose and exposure rates as a function of time postadministration. Dose rates resulted in an overapproximation by a factor of ~3 from differentiated thyroid cancer patients (5% uptake) and by ~2 from hyperthyroid patients (80%) at 8 h postadministration compared to RG8.39. This study provides a paradigm where age-specific morphometry and biokinetic integration must be jointly considered when developing patient release guidelines for 131I and future radionuclide therapies.
Evaluation of suvorexant for trauma-related insomnia
Authors: Mellman Thomas A , Birku Kiya , Sandhu Ishaan , Lavela Pewu , Kobayashi Ihori 
Published: March 2022

Abstract

Study Objectives
Effective pharmacological treatments for sleep disturbance related to trauma with and without co-occurring posttraumatic stress disorder (PTSD) are needed. There is debate regarding what effects on rapid eye movement sleep (REMS) would be beneficial. Suvorexant is the first dual orexin receptor antagonist (DORA) approved for the treatment of insomnia. In contrast to most psychotropic agents, DORAs can enhance REMS while reducing arousal. We evaluated 6 weeks of suvorexant treatment for trauma-related insomnia in a double-blind, placebo-controlled clinical trial with clinical and polysomnographic evaluation.

Methods
Participants with insomnia that followed a traumatic event were recruited from the community. Representation of current, past-only, and never having met criteria for PTSD was similar and most participants had experienced trauma-related nightmares. Participants were randomly assigned to receive suvorexant or placebo, initially at 10 mg and increased to 20 mg after 1 week, if tolerated. Polysomnography was obtained for screening, at baseline, and at 2 weeks of treatment.

Results
The thirty-seven evaluable participants had significant improvement of PTSD and insomnia symptoms, however, there were no significant interactions with treatment condition. Medication was well tolerated with only one dropout being related to side effects. Within the suvorexant group increased REM segment duration correlated with concurrent PTSD symptom reduction. Nightmares remitted in all of the participants who received suvorexant and all but one of those receiving placebo.

Conclusions
A robust placebo response undermined detecting a medication effect. Further evaluation of DORAs for trauma-related insomnia, as well as factors contributing to placebo-response, are warranted.
Association between hospital-diagnosed sleep disorders and suicide: a nationwide cohort study
Authors: Høier Nikolaj Kjær , Madsen Trine , Spira Adam P , Hawton Keith , Eriksen Benros Michael , Nordentoft Merete , Erlangsen Annette 
Published: March 2022

Abstract

Study Objectives
Sleep disorders are related to mental disorders. Yet few studies have examined their association with suicide. We examined whether males and females diagnosed with sleep disorders had higher rates of suicide than individuals not diagnosed with sleep disorders.

Methods
In a cohort study, nationwide data on all males and females aged over 15 years living in Denmark during 1980–2016 were analyzed. Sleep disorders were identified through diagnoses recorded during contacts to somatic hospitals. Incidence rate ratios (IRR) were estimated using Poisson regression models and adjusted for covariates.

Results
In all, 3 674 563 males and 3 688 164 females were included, of whom 82 223 (2.2%, mean age: 50.2 years, SD: 17.5) males and 40 003 (1.1%, mean age: 50.6 years, SD: 19.9) females had sleep disorder diagnoses. Compared with those with no sleep disorders, the adjusted IRR for suicide were 1.6 (95% CI, 1.4 to 1.7) and 2.2 (95% CI, 1.8 to 2.6) for males and females with sleep disorders, respectively. Excess rates for narcolepsy were found for males (IRR: 1.2, 95% CI, 1.0 to 1.5) and females (IRR: 3.3, 95% CI, 3.0 to 4.1), and for sleep apnea in males (IRR: 1.8, 95% CI, 1.5 to 2.2). A difference with respect to age and sex was observed (p &lt; 0.001) between males and females. Males and females had IRR of 4.1 (95% CI, 3.1 to 5.5) and 7.0 (95% CI, 4.8 to 10.1), during the first 6 months after being diagnosed with a sleep disorder.

Conclusions
Sleep disorders were associated with higher suicide rates even after adjusting for preexisting mental disorders. Our findings suggest attention toward suicidality in patients with sleep disorders is warranted.
Both-Ear Method for the Analysis of Audiometric Data
Authors: Chen Chen , Zhang Ning , Curhan Gary C. , Curhan Sharon G. , Wang Molin 
Published: March 2022

Objective:
Single-ear hearing measurements, such as better-ear, worse-ear or left/right ear, are often used as outcomes in auditory research, yet, measurements in the two ears of the same individual are often strongly but not perfectly correlated. We propose a both-ear method using the Generalized Estimating Equation approach for analysis of correlated binary ear data to evaluate determinants of ear-specific outcomes that includes information from both ears of the same individual.

Design:
We first theoretically evaluated bias in odds ratio (OR) estimates based on worse-ear and better-ear hearing outcomes. A simulation study was conducted to compare the finite sample performances of single-ear and both-ear methods in logistic regression models. As an illustrative example, the single-ear and both-ear methods were applied to estimate the association of Dietary Approaches to Stop Hypertension adherence scores with hearing threshold elevation among 3135 women, aged 48 to 68 years, in the Nurses’ Health Study II.

Results:
Based on statistical theories, the worse-ear and better-ear methods could bias the OR estimates. The simulation results led to the same conclusion. In addition, the simulation results showed that the both-ear method had satisfactory finite sample performance and was more efficient than the single-ear method. In the illustrative example, the confidence intervals of the estimated ORs for the association of Dietary Approaches to Stop Hypertension scores and hearing threshold elevation using the both-ear method were narrower, indicating greater precision, than for those obtained using the other methods.

Conclusions:
The worse-ear and better-ear methods may lead to biased estimates, and the left/right ear method typically results in less-efficient estimates. In certain settings, the both-ear method using the Generalized Estimating Equation approach for analyses of audiometric data may be preferable to the single-ear methods.
Internal Joint Stabilizer: A Safe Treatment for Traumatic Elbow Instability
Authors: Fene Evan S. , Grewal Ishvinder S. , Eakin John L. , Sanders Drew Thomas , Starr Adam Jennings 
Published: March 2022

Objectives:
To report early results of the “Internal Joint Stabilizer of the Elbow” (IJS-E) in the treatment of terrible triad injuries and other unstable traumatic elbow dislocations.

Design:
Retrospective cohort study.

Setting:
Level 1 trauma center.

Patients/Participants:
Seventeen patients with traumatic elbow instability treated with IJS-E over a 2-year period; 7 of whom sustained terrible triad-type injuries.

Interventions:
Open reduction internal fixation with the “IJS-E”.

Main Outcome Measures:
Elbow stability and arc of motion were assessed radiographically and clinically. Disabilities of the Arm, Shoulder and Hand scores were collected by telephone.

Results:
All elbows were radiographically stable at the time of IJS-E removal. Mean time of follow-up was 9 months from index operation (range, 2.5–24 months). Mean elbow arc of motion was restored to flexion-extension 92 degrees (range, 5–125; SD, 31 degrees) and forearm pronation-supination 139 degrees (range, 0–180; SD, 48 degrees). Mean Disabilities of the Arm, Shoulder and Hand score was 22.2 (range, 7.5–45.7; SD, 13.3) for patients at least 1 month from surgery on the ipsilateral extremity. Five patients (30%) developed complications, and —2 (12%) required revision for implant failure.

Conclusions:
The IJS-E offered reliable treatment of traumatic elbow instability, particularly terrible triad-type injuries. It permited early range of motion and was effective in restoring elbow stability. We believe that the use of this relatively novel system should be further explored.

Level of Evidence:
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Autologous Cell Harvesting System as Adjunct for Soft-tissue Reconstruction of Necrotizing Soft Tissue Infection
Authors: Collins Reagan A. , Van Spronsen Nicole R. , Couch Brandon R. , Garcia Liza M. , Griswold John A. , Bharadia Deepak R. 
Published: March 2022

Summary:
Necrotizing soft tissue infections (NSTIs) cause rapidly progressing destruction of skin and soft tissue, leaving large soft tissue defects and necessitating complex reconstruction. RECELL, an autologous cell harvesting device, provides a regenerative epidermal suspension (RES) from a small split-thickness skin biopsy for the substitution of (or in addition to) split-thickness skin grafting (STSG). We present a case of a 56-year-old man with extensive NSTI managed by serial debridement, leading to a degloving injury to the right upper extremity, axilla, flank and back, which was later reconstructed using RES application in conjunction with STSG and Integra placement. At his 2-week hospital follow-up, the patient was healing well with limited right upper extremity range of motion, but continued improvement seen with physical and occupational therapy. Due to the patient’s significant soft tissue defect, a unique reconstructive plan was required using both Integra and RECELL in conjunction with STSG. RECELL, in conjunction with STSG, should be considered for the treatment of significant soft tissue defects such as those found in NSTI.
Human Frontalis Muscle Innervation and Morphology
Authors: Welter Laura , Bramke Silvia , May Christian Albrecht 
Published: March 2022

Background:
Due to its clinical importance and due to a suggestion regarding the afferent innervation, the microscopic appearance of the frontalis muscle was investigated.

Methods:
From seven human cadavers, serial sections of the frontalis muscle were studied using light microscopy. Immunhistochemistry was performed using antibodies against collagen XXII and neurofilament.

Results:
The macroscopic appearance of the muscle was in accordance with the literature. At both insertion sides, the muscle fiber endings expressed collagen XXII, a marker for myotendinous junctions, although no tendons were present at the origin side. Neuromuscular junctions were seen in the middle part of the muscle belly (insertion of the nerve fibers of the facialis nerve) and in the cranial part toward the galea aponeurotica (possible afferent fibers?).

Conclusions:
This study summarizes the microscopic appearance of the frontalis muscle. It is a first example that collagen XXII can be expressed even without tendon formation. It confirms the absence of corpuscular afferent neuronal structures within the muscle.