Comparison of Subungual Glomus Tumours in Terms of Nail Aesthetics and Recurrence According to Size and Location in the Germinal or Sterile Matrix.

PURPOSE: The aim of this retrospective study was to investigate the effect of subungual glomus tumour size and localization in the germinal or sterile matrix on tumour recurrence and aesthetic outcomes. PATIENTS AND METHODS: From 35 patients who underwent surgery for a subungual glomus tumour between February 2013 and February 2020, 26 patients - 17 women and 9 men - with 27 subungual glomus tumours fulfilled the inclusion criteria. The average age was 37.3 (22-58) years. According to the patients' surgical notes and preoperative magnetic resonance images 14 tumours were located in the sterile, 13 in the germinal matrix, and the mean size of the glomus tumours located in the germinal matrix was 4.9±1.7 mm, in the sterile matrix 3.6±1.0 mm. At the postoperative 12th month follow-up visit nail aesthetic was evaluated objectively according to Zook's fingernail appearance scoring. In addition, patients were asked to evaluate the pain and nail appearance in the involved finger by VAS (Visual Analog Scale 0-10). Patients who experienced recurrence were noted. RESULTS: No significant Zook's fingernail appearance score differences were observed between germinal and sterile matrix groups (p=0.097). Comparison of VAS score for pain and VAS score for nail appearance between the two groups also yielded similar values (p=0.449 and 0.395, respectively). The recurrence rate was similar at both locations (p=0.557) with 3 recurrences in the germinal, and 2 in the sterile matrix group. There was no relation between tumour size, Zook's fingernail appearance score (p=0.874) and recurrence (p=0.784). The observed germinal matrix glomus tumours were significantly larger than the sterile matrix tumours (p=0.031). CONCLUSION: Neither subungual glomus tumour size nor localization in the germinal or sterile matrices has different effects on nail appearance and recurrence.

SYMBALS: A Systematic Review Methodology Blending Active Learning and Snowballing.

Research output has grown significantly in recent years, often making it difficult to see the forest for the trees. Systematic reviews are the natural scientific tool to provide clarity in these situations. However, they are protracted processes that require expertise to execute. These are problematic characteristics in a constantly changing environment. To solve these challenges, we introduce an innovative systematic review methodology: SYMBALS. SYMBALS blends the traditional method of backward snowballing with the machine learning method of active learning. We applied our methodology in a case study, demonstrating its ability to swiftly yield broad research coverage. We proved the validity of our method using a replication study, where SYMBALS was shown to accelerate title and abstract screening by a factor of 6. Additionally, four benchmarking experiments demonstrated the ability of our methodology to outperform the state-of-the-art systematic review methodology FAST2.

Percutaneous radiofrequency ablation for osteoid osteoma under guidance of threedimensional fluoroscopy.

PURPOSE: To evaluate the outcome of percutaneous radiofrequency ablation under guidance of 3-dimensional fluoroscopy in 17 patients with osteoid osteoma. METHODS: Records of 11 male and 6 female consecutive patients aged 4 to 28 (mean, 13.8) years who underwent radiofrequency ablation under guidance of 3-dimensional fluoroscopy for osteoid osteoma and were followed up for a mean of 15.8 (range, 12-28) months were reviewed. All patients had been treated with analgesics but failed to achieve lasting pain relief. Visual analogue score (VAS) for pain was assessed pre- and post-operatively. Absence of pain was considered recovery. RESULTS: The mean operating time was 55 (range, 20-95) minutes, and the mean length of hospital stay was 2.8 (range, 2-7) days. The mean amount of radiation was 390.2 (range, 330.5-423.6) mGy/cm. Relief of pain occurred within the first 24 hours in 11 patients and by the end of the first week in 3 patients. Pain persisted in 3 patients at one month; they underwent revision surgery and achieved complete recovery. The mean VAS for pain was 7.2 (range, 6-9) in 17 patients preoperatively and decreased to 0.64 (range, 0-2) in the 14 patients with pain relief and 0.66 (range, 0-1) in the 3 patients after revision surgery. Two patients had severe discharge from the wound secondary to fat necrosis, which resolved within a week with antibiotics and local dressings. No patient had cellulitis, vasomotor instability, neurovascular injury, fracture, or deep infection. CONCLUSION: Percutaneous radiofrequency ablation under guidance of 3-dimensional fluoroscopy is a viable treatment option for osteoid osteoma.