bluuebunny/crossref_metadata_2025_split huggingface dataset:
Venous Flap Reconstruction following Wide Local Excision for Primary Cutaneous Malignancies in Extremities
Authors: Deguchi Ayaka , Motomura Hisashi , Hatano Takaharu , Fujikawa Heishiro , Maeda Shusaku 
Published: March 2022

Background:
Cutaneous malignancies in the extremities are relatively common, and radical treatment such as ray amputation was performed for certain advanced skin cancer cases in the past. The concept of surgical treatment of primary cutaneous malignant tumor has gradually changed, and preservation of the extremity by performing the appropriate excision and reconstruction became possible. Various reconstructive methods after the resection of malignant tumors such as skin grafts, local flaps, and free flaps, including perforator flaps have been noted. Due to limitations and some disadvantages of these reconstructive materials for extremities, the arterialized venous flap arose as an alternative method. The arterialized venous flap, which has arterial inflow through an afferent vein perfusing the flap and venous outflow through the efferent veins, is considered to function as a great reconstructive material for distal extremities. Although efficacy of this flap has been noted in the past, usage of the flap considering the oncological aspects and application of the flap to the toes and feet have never been reported.

Methods:
Thirteen reconstructive cases from October 2005 to October 2016 using venous flaps after excision of primary cutaneous malignancy in the distal extremities were performed in our institution.

Results:
For all cases, satisfactory functional and cosmetic outcomes were observed.

Conclusions:
Reconstruction using the arterialized venous flap is considered a reliable and versatile method. Careful application of this flap satisfies functional, cosmetic, and oncological aspects of all distal extremities with cutaneous malignancy.
Frontalis Suspension in Muscular Dystrophy: 16-years Follow-up
Authors: Abdulrauf Badr M. I. 
Published: March 2022

Summary
Acquired eyelid ptosis in adults, with complete loss of levator palpebrae superiosis function, can be a challenging problem to diagnose and treat. A 48-year-old woman with chronic bilateral severe blepharoptosis of 10 years duration is presented, whose neurological investigations excluded myasthenia gravis. The patient was preliminarily diagnosed with chronic progressive external ophthalmoplegia. The levator excursion was negligible, and a frontalis suspension procedure was considered using a conventional autogenous fascia lata graft. An optimal outcome was achieved with over 16-years follow-up. Although the patient was healthy otherwise upon first presentation, 10 years later, she developed other neurologic manifestations, including dysphagia and oral dryness. The fact that blepharoptosis did not recur over the years in this case differentiates an oculo-pharyngeal type of muscular dystrophy in this patient from other types and from the more frequent condition of chronic progressive external ophthalmoplegia.
COMPARISON BETWEEN SCLERAL BUCKLING AND VITRECTOMY IN THE ONSET OF CYSTOID MACULAR EDEMA AND EPIRETINAL MEMBRANE AFTER RHEGMATOGENOUS RETINAL DETACHMENT REPAIR
Authors: Gharbiya Magda , Visioli Giacomo , Iannetti Ludovico , Iannaccone Andrea , Tamburrelli Anna Clara , Marenco Marco , Albanese Giuseppe Maria 
Published: March 2022

Purpose:
To investigate the incidence and risk factors for the main complications in patients with rhegmatogenous retinal detachment treated with scleral buckling (SB) or pars plana vitrectomy (PPV).

Methods:
A retrospective, comparative, observational study was conducted. The medical records of 107 patients with primary rhegmatogenous retinal detachment who were managed with SB (n = 57) or PPV (n = 50) were reviewed. Scleral buckling was performed using scleral encircling solid silicone band and circumferential solid silicone exoplant to support the break. Pars plana vitrectomy was combined with phacoemulsification in phakic eyes and with scleral encircling in inferior detachments. Follow-ups, including spectral-domain optical coherence tomography examination, were scheduled at 1, 3, and 12 months after surgery. Propensity score matching was used to adjust for potential preoperative selection bias.

Results:
The overall incidence of postoperative cystoid macular edema (CME) and epiretinal membrane was 14.95% and 30.84%, respectively. Compared with SB, CME was more frequent in the PPV (P = 0.021) and in the PPV pseudophakic eyes (P = 0.027). Postoperative CME was an early, predominantly transient complication and regressed in 67% of SB and in 77% of PPV eyes within 12 months after surgery. No differences were observed regarding epiretinal membrane development. Except for the surgical technique, no preoperative factors associated with CME were identified. A correlation between epiretinal membrane and patients' age was found (P = 0.028).

Conclusion:
The incidence of CME after rhegmatogenous retinal detachment repair was higher in patients who underwent PPV, either alone or combined with phacoemulsification, than in those treated with SB. Epiretinal membrane development was correlated to older age, regardless of the surgical procedure.
Delayed intracapsular hematoma after use of iris retractor hooks
Authors: Wagner Isabella V. , Dorairaj Syril K. , Miller Darby D. , Ten Hulzen Richard D. , Stewart Michael W. 
Published: March 2022

Introduction:
To the author's knowledge, this is the first reported case of a delayed intracapsular hematoma after complex femtosecond laser–assisted cataract surgery (FLACS) and the use of iris retractor hooks for intraoperative floppy-iris syndrome. It is important that cataract surgeons be aware of this association.

Patient and Clinical Findings:
An 83-year-old man underwent FLACS with astigmatic keratotomy and intraocular lens implantation. Iris retractor hooks were used to counter intraoperative miosis. Hyphema, corneal edema, and subconjunctival hemorrhage were observed on postoperative day (POD) 1. The patient returned on POD 3 with further decrease in vision due to Descemet folds, advanced corneal edema, layered hyphema, and a dense intracapsular hematoma.

Diagnosis, Intervention, and Outcomes:
Minimal improvement of the hematoma occurred through 4 weeks, at which time the hematoma was drained with Nd:YAG laser posterior capsulotomy. The hematoma reabsorbed within 1 month with full recovery of vision.

Conclusions:
The iris retractor hooks in the setting of complex FLACS likely caused postoperative bleeding with accumulation of blood within the capsule. Nd:YAG laser posterior capsulotomy is an effective treatment option for nonclearing intracapsular hematoma.
Effect of prolonged experimental neck pain on exercise-induced hypoalgesia
Authors: Christensen Steffan Wittrup McPhee , Elgueta-Cancino Edith , Simonsen Morten Bilde , Silva Priscila de Brito , Sørensen Line Bay , Graven-Nielsen Thomas , Hirata Rogerio Pessoto 
Published: March 2022

Abstract
Neck pain is a common musculoskeletal problem often accompanied by reduced exercise-induced hypoalgesia (EIH) or hyperalgesia compared with an asymptomatic population. This study investigated EIH in a healthy population during experimental neck pain. Forty participants were randomized into this double-blinded parallel-group study. On 4 separate test days (day 0, day 2, day 4, and day 15), participants completed the Neck Disability Index and scored neck pain intensity during head movements on a numerical rating scale. At the end of day 0 and day 2, nerve growth factor (NGF) or isotonic saline (control) was injected into the right splenius capitis muscle. Pressure pain thresholds (PPTs) were recorded bilaterally over splenius capitis (neck), temporalis (head), and tibialis anterior (leg) muscles on all days. On day 0, day 4, and day 15, PPTs were recorded before and after a hand-bike exercise. Exercise-induced hypoalgesia was defined as the PPT increase caused by the exercise. Compared with the control group, the NGF group demonstrated higher Neck Disability Index scores at day 2 and day 4 (P < 0.001, η2 > 0.557) and higher numerical rating scale scores (P < 0.03, η2 > 0.09) along with reduced neck PPTs (P < 0.01, d > 0.44) at day 2 (right: 95% confidence interval [CI] [26.0-54.0]; left: 95% CI [6.8-26.9]), day 4 (right: 95% CI [40.5-67.9]; left: 95% CI [6.9-28.2]), and day 15 (right: 95% CI [5.6-37.2]; left: 95% CI [6.9-34.8]). Across days, the EIH effect was reduced at the neck site in the NGF group compared with the control group (P < 0.001,

= 0.367, 95% CI [−34.5 to −13.7]). At the head and leg sites, the NGF group showed reduced EIH effect compared with the control group (P < 0.05, d > 0.43) on day 4 (head: 95% CI [−61.4 to −22.9]; leg: 95% CI [−154.7 to −72.4]) and day 15 (head: 95% CI [−54.3 to −7.6]; leg: 95% CI [−122.7 to −34.4]). These results indicate that a few days of clinically comparable neck pain and hyperalgesia might have a negative impact on EIH responses and may help explain why some patients with neck pain do not experience immediate positive effects of exercise.
Diagnostic values of supine and erect abdominal radiographs for patients with acute abdomen: which is better for decision making?
Authors: Lee Chia-Ying , Chen Jen-Dar 
Published: March 2022

Background:
Plain abdominal radiography including supine and erect abdominal radiographs (SAR and EAR) is a frequently used image modality for preliminary evaluation of acute abdomen. We aimed to explore which one of the SAR or EAR has a higher diagnostic value in overall diagnosis of acute abdomen, including their respective advantages over each other for the various underlying diseases.

Methods:
We retrospectively analyzed the imaging findings of plain abdominal radiography of patients with acute abdomen who received abdominal computed tomography (CT) within 24 hours at the emergency department of a medical center in northern Taiwan between October 2019 and February 2020. Final diagnosis was made by CT reports and clinical data. The relevance between the imaging findings and clinical diagnosis in the groups of SAR and EAR were compared.

Results:
A total of 1009 cases with acute abdomen were included, of which 341 (33.8%) underwent EAR and 668 (66.2%) underwent SAR. Among them, 820 cases had final diagnosis confirmed by CT and clinical data. In comparison of the diagnostic relevance of SAR and EAR, there were no significant difference in the overall acute abdomen, but EAR showed a better diagnostic relevance in cases with bowel obstruction than SAR did (100% vs 87.2%, p < 0.05). No statistical difference in other abdominal diseases.

Conclusion:
There is no significant difference between SAR and EAR in evaluation of overall acute abdomen. However, EARs has a diagnostic advantage over SAR for evaluation of suspected bowel obstruction.
Sexual Function and Fertility in Males With Vascular Malformations of the Genitourinary Tract and Pelvis
Authors: Stewart Jessica K. , Hartman Terry , Adams Denise M. , Fishman Steven J. , Blatt Julie 
Published: March 2022

Objectives:
A subset of males with vascular malformations (VM) have involvement of their genitourinary (GU) tract. The purpose of this study was to survey males with VM to investigate whether patients with GU involvement experience problems with sexual function and fertility.

Methods:
An anonymous survey was designed based on modifications of Patient-Reported Outcomes Measurement Information System and International Index of Erectile Function surveys to examine sexual interest, function, satisfaction, and fertility. Surveys were sent electronically to 709 males 18 years or older (or parents of minor males under age 18) with VM through the Klippel-Trenaunay Support Group, the CLOVES Syndrome Community, and the Lymphangiomatosis & Gorham’s Disease Alliance.

Results:
Evaluable responses were received from 42 surveys (5.9%). Thirty-three of the 42 responses (79%) were from males with VM involving the GU tract (4.6% of surveys sent). Of the 33 with GU VM, 17 (52%) reported one or more problems including pain with masturbation and/or intercourse, bleeding with masturbation and/or intercourse, lack of interest in sex, and erectile dysfunction. Fourteen of 33 reported that they had fathered children. There was no statistically significant difference in these symptoms compared with responses from men with VM not involving the pelvis.

Conclusion:
Males with VM involving or not involving the GU system may experience problems with sexual function and satisfaction. While prospective studies are needed to clarify the prevalence and extent of these symptoms, providers should be aware that such symptoms can occur in this patient population.
Rural Hospital Closures
Authors: Andreyeva Elena , Kash Bita , Averhart Preston Veronica , Vu Lan , Dickey Nancy 
Published: March 2022

Background:
Access to health care continues to be a challenge, especially in remote areas. Since 2013, 70 rural hospitals have closed in the United States further exacerbating barriers to health care access in rural areas.

Objective:
The objective of this study is to identify the impact of rural hospital closures on total medical spending and utilization among the commercially insured rural population.

Research Design:
We use a pre-post study design with a comparison group. Individual‐level Texas commercial claims data in 2014–2019 were linked to the Centers for Medicare & Medicaid Services (CMS) Provider of Services Current Files, Area Health Resource File, and Census American Community Survey. We performed an event study to test for pre-trends.

Subjects:
Analysis sample included commercially insured individuals 19–64 years of age residing in Texas.

Measures:
Total medical spending and counts of health care encounters.

Results:
Individuals residing in rural Texas areas affected by a hospital closure experienced decreases in outpatient and emergency department (ED) utilization and no statistically significant changes in total medical spending relative to the unaffected individuals. Outpatient and ED utilization decreased by 0.133 (<0.1) and 0.015 (7<0.05) visits, respectively. Heterogeneity analysis showed that individuals residing in urban Texas experienced increases in total medical spending by $12.2 per month (<0.01) as well as individual spending subcategories.

Conclusions:
Rural hospital closures led to significant decreases in outpatient and ED utilization while having no effect on health care spending. Close attention must be paid to rural hospital closures to ensure equitable health care access, especially for underserved populations.
Autoerotic Death by Electrocution
Authors: McLeod Elizabeth V. , Loughney Elizabeth K. , Baker Andrew M. , Berg Eric W. , Warren Wendy S. 
Published: March 2022

Abstract
Autoerotic death is defined as an accidental death that occurs when some type of apparatus is used to enhance sexual stimulation and causes an unintended death. We present the case of an atypical autoerotic death of a 23-year-old man found deceased in a bathroom. An electrical cord with a standard wall plug on one end and exposed wires twisted into loops on the other end was on the floor near his body. Minute black burns were present on each nipple. The outlet was protected by a ground fault circuit interrupter that was demonstrated to be in working order. An electrical consultant concluded that the cause of death could not be electrocution. Ground fault circuit interrupters work by detecting differences in current within a circuit. If a ground fault occurs, the circuit is broken to prevent a fatal electrocution. In the present case, the ground fault circuit interrupter did not shut off because the decedent had wired himself in parallel with the circuit. This, with the other scene findings, indicated this to be a case of atypical autoerotic death. Autoerotic deaths by means other than asphyxiation are rare. This case serves to illustrate the circumstances of an atypical autoerotic death by means of electrocution.
Low back pain definitions: effect on patient inclusion and clinical profiles
Authors: Massé-Alarie Hugo , Angarita-Fonseca Adriana , Lacasse Anaïs , Pagé M. Gabrielle , Tétreault Pascal , Fortin Maryse , Léonard Guillaume , Stone Laura S. , Roy Jean-Sébastien ,   on behalf of the Quebec Low Back Pain Consortium
Published: March 2022

Abstract

Introduction:
Numerous definitions of acute low back pain (aLBP) exist. The use of different definitions results in variability in reported prevalence or incidence, conflicting data regarding factors associated with the transition to chronic LBP (cLBP), and hampers comparability among studies.

Objective:
Here, we compare the impact of 3 aLBP definitions on the number of aLBP cases and participants' characteristics and explore the distribution of participants across definitions.

Methods:
A sample of 1264 participants from the Quebec Low Back Pain Study was included. Three definitions of aLBP were used: (1) not meeting the National Institutes of Health (NIH) cLBP definition (“nonchronic”), (2) pain beginning <3 months ago (“acute”), and (3) pain beginning <3 months with a preceding LBP-free period (“new episode”).

Results:
There were 847, 842, and 489 aLBP cases meeting the criteria for the 3 definitions, respectively. Participants included in the “nonchronic” had lower pain interference, greater physical function scores, and fewer participants reporting >5 years of pain than in the other definitions. Half the participants meeting the “acute” definition and one-third of participants meeting the “new episode” definition were also classified as cLBP based on the NIH definition.

Conclusions:
Our results highlight the importance of the definition used for aLBP. Different definitions influence the sample size and clinical profiles (group's characteristics). We recommended that cohort studies examining the transition from aLBP to cLBP ensure that the definitions selected are mutually exclusive (ie, participants included [aLBP] differ from the expected outcome [cLBP]).
Custom-made foot orthoses with and without heel plugs and their effect on plantar pressures during treadmill walking
Authors: Balsdon Megan E. R. , Dombroski Colin E. 
Published: March 2022

Background:
Foot orthoses have consistently demonstrated an improvement in pain scores for plantar fasciitis. The fabrication of custom-made foot orthoses (CFOs) can vary between clinicians and may include the use of different materials and casting techniques. This cross-sectional study's objective was to quantify plantar pressure for two CFOs, one with a heel plug (HP) and one without.

Methods:
Fourteen healthy participants (8 men and 6 women; 35.4 ± 7.7 years) were cast by the same practitioner. Both CFOs were made with the same materials and specifications, except for the HP orthosis, which replaced hard material under the heel with a softer blue PORON ® plug for added cushioning. Plantar pressures were recorded during treadmill walking for both devices in a running shoe. Average pressure, peak pressure, and pressure contact area were determined for three regions of the foot: hindfoot, midfoot, and forefoot. A paired samples t-test determined differences in each region (P < 0.05).

Results:
The HP orthosis reduced the overall means of average pressure, peak pressure, and pressure contact area in the hindfoot while tending to increase these measures in the midfoot and forefoot. The three measures showed statistically significant decreases in the hindfoot, whereas a statistically significant increase was seen in average and peak pressures in the midfoot (P < 0.05).

Conclusions:
CFOs with HPs are more effective than regular CFOs in offloading plantar pressures in the hindfoot while increasing pressures in the midfoot. This is an important finding because offloading the hindfoot is critical in pathologies such as plantar fasciitis to decrease pain and increase function.
Prevalence and Risk Factors of Low Bone Mineral Density in HIV/AIDS Patients: A Chinese Cross-Sectional Study
Authors: Meng Weiqing , Chen Meiling , Song Yangzi , Zhang Huan , Xie Ruming , Zhang Fujie 
Published: March 2022

Introduction:
Our study aimed to investigate the prevalence and risk factors of low bone mineral density (BMD) among HIV/AIDS patients in China.

Methods:
We performed a cross-sectional analysis of HIV-infected patients from October 2017 to August 2020. Demographic information, clinical data, and serum parameters were obtained. Univariable and multiple logistic regression analyses were performed.

Results:
A total of 1143 patients were included. In the ART-naive group, low BMD was diagnosed in 19.2% (117/608), including osteoporosis in 1.0% (6/608) and osteopenia in 18.3% (111/608). In the ART group, low BMD was diagnosed in 32.2% (231/717), including osteoporosis in 2.4% (17/717) and osteopenia in 29.8% (214/717). Using multivariate analysis, we identified age older than 50 years, body mass index < 18.5 kg/m2, and treatment based on tenofovir disoproxil fumarate as independent risk factors for low BMD. Low high-density lipoprotein cholesterol was a protective factor for low BMD. Among low BMD participants, the most common number of low BMD sites for a patient to have was 4 (33.6%, 117/348).

Conclusion:
We confirmed a high prevalence of low BMD and osteoporosis in HIV/AIDS patients, and we identified age older than 50 years, low body mass index, and a treatment based on tenofovir disoproxil fumarate as risk factors for low BMD. Low high-density lipoprotein cholesterol had a protective effect against low BMD. Among low BMD patients, patients most commonly had 4 sites with low BMD, which has been associated with fracture risk. In addition, bone changes to L1 can present before low BMD diagnosis and may be a potentially useful indicator that low BMD is developing.
The tryptophan catabolite or kynurenine pathway in Alzheimer’s disease: a systematic review and meta-analysis
Authors: Almulla Abbas F. , Supasitthumrong Thitiporn , Amrapala Arisara , Tunvirachaisakul Chavit , Abdul Jaleel Al-Karrar Kais , Oxenkrug Gregory , Al-Hakeim Hussein K. , Maes Michael 
Published: March 2022

AbstractBackgroundAlzheimer’s disease (AD), characterized by gradual brain dysfunction and memory loss, is one of the major elderly health issues worldwide. Neuroinflammation and increased oxidative stress contribute to the pathophysiology of AD, thereby presumably inducing tryptophan (TRP) degradation through the TRP catabolite (TRYCAT) pathway.ObjectivesTo delineate the activity of the TRYCAT pathway along with levels of TRP and tryptophan catabolites (TRYCATs) in AD patients.MethodsWe employed PubMed, Google Scholar, Web of Science, and SciFinder to obtain the relevant articles through a search process lasting the entire February 2022. We found 19 eligible articles which involved 738 patients and 665 healthy controls.ResultsOur result revealed a significant difference (p= 0.008) in the kynurenine (KYN)/TRP ratio (standardized mean difference, SMD = 0.216, 95% confidence interval, CI: 0.057; 0.376), and a significant decrease in TRP in AD patients (SMD = -0.520, 95% CI: -0.738; -0.302, p < 0.0001). Moreover, we also found a significant increase in the central nervous system (CNS, brain and cerebrospinal fluid, CSF) kynurenic acid (KA)/KYN ratio but not in peripheral blood, as well as a significant decrease in plasma KA and xanthurenic acid (XA) in the CNS and blood.ConclusionsAD is characterized by TRP depletion but not by an overactivity of the TRYCAT pathway. IDO-induced production of neurotoxic TRYCATs is not a key factor in the pathophysiology of AD.