bluuebunny/crossref_metadata_2025 huggingface dataset:
Association between types of abdominopelvic cancer in patients with situs inversus total: Systematic review
Authors: Valenzuela-Fuenzalida Juan José , Martínez Hernández Daniela , Milos-Brandenberg Daniel , Koscina Zmilovan , Avila-Sepulveda Roberto , Baez Belen , Perez-Jimenez Daniela , Nova Baeza Pablo , Orellana Donoso Mathias , Bruna-Mejias Alejandro
Published: February 2024

Background:

Situs inversus is a rare congenital anatomical variant that involves a group of anomalies regarding the arrangement of intrathoracic and intraabdominal organs. Being able to find in the abdominal region the liver, gallbladder, inferior vena cava, and head of the pancreas and ascending colon on the left side of the abdomen, while on the right side there is the spleen, the stomach, the body of the pancreas, the ligament of Treitz, descending colon among others. In this same way, the thoracic organs, lungs and heart, are changed in their position in a mirror translocation.

Methods:

We systematically searched MEDLINE, Web of Science, Google Scholar, CINAHL, Scopus, and LILACS; the search strategy included a combination of the following terms: “Situs inversus,” “Situs inversus totalis,” “Cancer,” “Neoplasm,” “Abdominopelvic regions,” and “clinical anatomy.”

Results:

Within the 41 included studies, 46 patients with situs inversus who had cancer, in addition to being found in this organ and in these regions, we also found as a result that the majority of the studies in the research were in stage II; finally, no one study could assert the direct relationship between the situs inversus totalis and the cancer.

Conclusion:

If our hallmarks could make us think that more exhaustive follow-up of the stomach and other organs should be carried out in these patients, there could also be other predisposing factors for cancer, which is why more studies are suggested to give future diagnostic and treatment guidelines treatment.
Association with the plasma atherogenic index with hepatic steatosis and fibrosis in the US population
Authors: Li Yijing , Men Xiaoping , Liu Yangyang , Jiang Haiyan , Bi Chaoran , Qu Yanan , Wang Kuisong , Wang Xinyang , Jing Jing , Liu Yanjing
Published: February 2024

Plasma atherogenic index (AIP) reflects a novel intricate biochemical indicator of lipids’ metabolism. The involvement of lipid metabolism for pathogenesis concerning nonalcoholic fatty liver disease (NAFLD) has been established. However, the precise association across AIP and hepatic steatosis and fibrosis remains unclear. This present investigation explored the potential correlation across AIP, hepatic steatosis and fibrosis. Data were acquired through National Health and Nutrition Examination Survey (NHANES) from 2017 to 2020. Hepatic steatosis was detected through the controlled attenuation parameter (CAP), while hepatic fibrosis was examined via liver stiffness measurement (LSM). The study employed multiple linear, Fitted smoothed curves and subgroup analyses were used for investigating relationships between the AIP, CAP, and LSM. The study recruited 6239 participants. In multivariate linear regression analysis, findings indicated a remarkable correlation between AIP and exacerbated NAFLD risk [odds ratio (95% confidence interval), 1.17 (1.12, 1.21)]. Analysis further revealed a positive link across AIP and hepatic steatosis, as indicated through the CAP [β (95% CI), 4.07 (3.32, 4.82)]. Tests for non-linearity, revealed a non-linear correlation between AIP and CAP (inflection point = 0.22). Subgroup analyses assessed the consistency of the link across AIP and CAP, indicating that the association remained comparable across all subgroups. Following the adjustment for all relevant variables, the linear regression analysis revealed a lack of statistical significance across the AIP and hepatic fibrosis. [LSM, β (95% CI), −0.39 (−1.06, 0.28), P = .2501]. Smooth-fitting curves examined the link across AIP and LSM and showed a U-shaped pattern, indicating their positive correlation with AIP less than 0.48. However, no significant correlation was observed with AIP more than 0.48. This study highlighted a substantial positive relationship across AIP and hepatic steatosis, as measured through CAP, and suggests that it may be used as an efficient and rapid measure for clinical prediction of hepatic steatosis.
Role of autophagy in skin photoaging: A narrative review
Authors: Zhong Xiaojiao , Deng Ying , Yang Hongqiu , Du Xiaoshuang , Liu Ping , Du Yu
Published: February 2024

As the largest organ of the human body, the skin serves as the primary barrier against external damage. The continuous increase in human activities and environmental pollution has resulted in the ongoing depletion of the ozone layer. Excessive exposure to ultraviolet (UV) radiation enhances the impact of external factors on the skin, leading to photoaging. Photoaging causes physical and psychological damage to the human body. The prevention and management of photoaging have attracted increased attention in recent years. Despite significant progress in understanding and mitigating UV-induced photoaging, the precise mechanisms through which autophagy contributes to the prevention of photoaging remain unclear. Given the important role of autophagy in repairing UV-induced DNA damage and scavenging oxidized lipids, autophagy is considered a novel strategy for preventing the occurrence of photoaging and other UV light-induced skin diseases. This review aims to elucidate the biochemical and clinical features of photoaging, the relationship of skin photoaging and chronological aging, the mechanisms underlying skin photoaging and autophagy, and the role of autophagy in skin photoaging.
Causes of death and nomogram for patients with oncologic hepato-biliary-pancreatic disorders: A large-cohort study
Authors: Xu Jia , Huang Shu , Yan Qiong , Jiang Jiao , Hu Nan , Zhang Wei , Shi Lei , Deng Mingming , Tang Xiaowei , Liao Jingyuan
Published: February 2024

The improvement of digestive cancer survival results in increased morbidity of noncancerous comorbidities. This study aimed at clarifying causes of death (COD) and predicting overall survival (OS) in patients diagnosed with liver cancer, gallbladder cancer, cholangiocarcinoma, and pancreatic cancer. We used the Surveillance, Epidemic, and End Results database to extract information. Nomograms of multivariate Cox regression was used to predict OS of cancer patients. The models were evaluated using the concordance indexes (C-indexes), the receiver operating characteristic curves and calibration curves. Respectively 58,895, 15,324, 30,708, and 109,995 cases with cancer of liver, gallbladder, bile duct or pancreas were retrieved between 2000 and 2020. Approximately 80% deaths occurred within 1 years after cancer diagnosis. Sequence in noncancerous COD proportion was diverse, while diseases of heart always accounted for a great part. Risks of death from most noncancerous COD were significantly higher than that of the cancer-free population. Nomograms were developed by predictors of interest such as age, therapy and TNM stage. The concordance indexes of nomograms were 0.756, 0.729, 0.763, and 0.760 respectively, well-calibrating to the reality. The 0.5-, 1-, and 2-year areas under the receiver operating characteristic curve were about 0.800, indicating good reliability and accuracy. Noncancerous COD accounted for larger part in gallbladder cancer and cholangiocarcinoma. Noncancerous COD showed an upward trend as follow-up time extended and the majorities were diseases of heart, cerebrovascular disease, chronic liver disease and cirrhosis. The novel OS-nomograms can provide personalized prognosis information with satisfactory accuracy.
Case report: Cardiac arrest after radiofrequency ablation in a 76-year-old male
Authors: Jin Geya , Li Shuyu , Wang Yafeng , Pu Jianyi
Published: February 2024

Rationale:

Previous studies have found that the main treatment of sinus arrest is pacemaker treatment. It is rare to have 12 s of sinus arrest after radiofrequency ablation, and whether a permanent pacemaker is implanted immediately in this case is not described in the guidelines.

Patient concerns:

A 76-year-old male patient with persistent atrial fibrillation (AF) developed sinus arrest lasting 12 s in the early morning of the fourth day after using radiofrequency ablation for pulmonary vein isolation.

Diagnosis:

The patient was diagnosed with AF and sinus arrest.

Interventions:

The patient received cardiopulmonary resuscitation, intravenous injection of atropine 1 mg, and intravenous infusion of isoproterenol 1mg and immediately recovered consciousness thereafter. Approximately, 1.5 h later, the patient underwent surgery to install a temporary pacemaker in the right femoral vein.

Outcomes:

The patient had repeated episodes of sinus arrest after the implantation of a temporary pacemaker. After 3 weeks, the patient stabilized and was discharged. The patient was followed up for 1 year and did not experience any recurrence of sinus arrest or AF.

Lessons:

We consider the potential for postoperative myocardial edema, injury to the sinoatrial node during the procedure, propafenone poisoning, and autonomic dysfunction as contributors to the occurrence of sinus arrest after radiofrequency ablation. When sinus arrest occurs after radiofrequency ablation, we can choose the appropriate treatment according to the patient’s condition.
Case report: remedial microdissection testicular sperm extraction after onco-microdissection testicular sperm extraction failure
Authors: Zheng Yi , Li Ding-Ming , Li Fu-Ping , Jiang Xiao-Hui , Yang Luo , Qu Rui , Bai Heng-Zhou , Zhao Gui-Cheng , Tian Kun
Published: February 2024

Background:

Testicular cancer (TC) mostly occurs in men aged 14 to 44. Studies have shown that TC seriously damages male fertility, and 6% to 24% of patients with TC were even found to suffer from azoospermia when they are diagnosed. At present, some studies have pointed out that onco-microdissection testicular sperm extraction (mTESE) can extract sperm from tumor testicles. However, there are almost no reports on remedial measures after onco-mTESE failure. Given the valuable opportunity for fertility preservation in patients with TC and azoospermia, it is necessary to provide effective remedial methods for patients with failed onco-mTESE.

Methods:

Two young men, who were diagnosed with TC and also found to have azoospermia, tried onco-mTESE while undergoing radical orchiectomy for fertility preservation. However, sperm extraction failed in both patients. Subsequently, the isolated testicular tissue of the patient in case 1 suffered from TC again, and the patient in case 2 was scheduled to receive multiple cycles of gonadotoxic chemotherapy. Because both had a plan to have a birth in the future, we performed remedial mTESE.

Results:

Sperm was successfully extracted from both patients. The patient recovered well, without complications. The patient couple in case 1 underwent 1 intracytoplasmic sperm injection (ICSI) cycle but did not achieve clinical pregnancy.

Conclusions:

There is still an opportunity to extract sperm successfully using onco-mTESE, despite the difficulty of fertility preservation in TC patients with azoospermia. If sperm extraction from the tumor testis fails, implementing remedial mTESE as early as possible would likely preserve the last chance of fertility for these patients.
The role of botulinum neurotoxin BoNT-A in the management of oily skin and acne vulgaris: A comprehensive review
Authors: Dayel Salman Bin , Hussein Ramadan S. , Gafar Huda H.
Published: February 2024

Oily skin and acne vulgaris are prevalent dermatological conditions with a significant impact on both physical and emotional well-being. Despite numerous available treatments, there is a pressing need for effective, long-term solutions. Botulinum Neurotoxin (BoNT-A) has emerged as a potential therapeutic option. However, existing reviews in this area are often limited. This review aims to comprehensively assess the use of BoNT-A in managing oily skin and acne vulgaris while addressing gaps in previous publications. It integrates the latest research, clinical trials, and case studies to provide an up-to-date analysis of BoNT-A mechanisms of action, efficacy, safety, and long-term outcomes. The review systematically analyzes existing evidence, critically evaluates study strengths and limitations, and explores potential synergies with other treatments. It also examines the safety profile of BoNT-A and its potential long-term effects. This review uncovers promising insights into how BoNT-A affects oily skin and acne vulgaris, including its ability to regulate sebum production, reduce inflammation, and potentially shrink pore size. It provides a comprehensive overview of relevant studies and clinical trials, detailing their methodologies, protocols, measures, and results. Collectively, these studies show significant reductions in sebum production, increased patient satisfaction, and smaller pores following BoNT-A treatment. In conclusion, this review addresses knowledge gaps and provides a comprehensive analysis of BoNT-A as a therapeutic option for oily skin and acne vulgaris. By consolidating evidence and highlighting areas for further investigation, it guides clinicians and researchers toward more effective, personalized treatments for individuals with these dermatological challenges.
Cause of death among gastric cancer survivors in the United States from 2000 to 2020
Authors: Liao Jingyuan , Xu Jia , Huang Shu , Jiang Jiao , Hu Nan , Zhang Wei , Shi Lei , Deng Mingming , Tang Xiaowei , Yan Qiong
Published: February 2024

A number of studies have been conducted to explore the survival of gastric cancer (GC) patients, while studies about non-cancer causes of death in patients with GC are not well-conducted. The aim of this study was to deeply investigate the causes of death (COD) in GC patients, especially non-cancer ones. The Surveillance, Epidemiology and End Results (SEER) database was used to extract information including demographics, tumor characteristics and causes of death of GC patients meeting the inclusion criteria. The patients were stratified by demographic and clinical parameters. Standardized mortality ratios (SMRs) were calculated for all causes of death at different follow-up periods. A total of 116,437 patients with GC diagnosed between 2000 and 2020 were retrieved from the SEER database. Of these, 85,827 deaths occurred during the follow-up period, most of which occurred within 1 year after GC diagnosis. GC (n = 49,746; 58%) was the leading COD, followed by other cancer (n = 21,135; 25%) and non-cancer causes (n = 14,946; 17%). Diseases of heart were the most common non-cancer cause of death, accounting for 30%, followed by cerebrovascular diseases (n = 917; 6%) and chronic obstructive pulmonary disease (n = 900; 6%). Although gastric cancer remains the most common cause of death in gastric cancer patients, it should not be ignored that the risk of non-cancer causes tends to increase with the length of the latency period. These findings may provide important insights into the healthcare management of gastric cancer patients at various follow-up intervals.
Machine learning models for predicting unscheduled return visits of patients with abdominal pain at emergency department and validation during COVID-19 pandemic: A retrospective cohort study
Authors: Hsu Chun-Chuan , Chu Cheng-C.J. , Ng Chip-Jin , Lin Ching-Heng , Lo Hsiang-Yun , Chen Shou-Yen
Published: February 2024

Machine learning (ML) models for predicting 72-hour unscheduled return visits (URVs) for patients with abdominal pain in the emergency department (ED) were developed in a previous study. This study refined the data to adjust previous prediction models and evaluated the model performance in future data validation during the COVID-19 era. We aimed to evaluate the practicality of the ML models and compare the URVs before and during the COVID-19 pandemic. We used electronic health records from Chang Gung Memorial Hospital from 2018 to 2019 as a training dataset, and various machine learning models, including logistic regression (LR), random forest (RF), extreme gradient boosting (XGB), and voting classifier (VC) were developed and subsequently used to validate against the 2020 to 2021 data. The models highlighted several determinants for 72-hour URVs, including patient age, prior ER visits, specific vital signs, and medical interventions. The LR, XGB, and VC models exhibited the same AUC of 0.71 in the testing set, whereas the VC model displayed a higher F1 score (0.21). The XGB model demonstrated the highest specificity (0.99) and precision (0.64) but the lowest sensitivity (0.01). Among these models, the VC model showed the most favorable, balanced, and comprehensive performance. Despite the promising results, the study illuminated challenges in predictive modeling, such as the unforeseen influences of global events, such as the COVID-19 pandemic. These findings not only highlight the significant potential of machine learning in augmenting emergency care but also underline the importance of iterative refinement in response to changing real-world conditions.
Association between patient adherence and treat-to-target in gout: A cross-sectional study
Authors: Hu Shasha , He Sihui , Zhang Jianyong , Ma Wukai , Geng Hongling , Zhan Zhiying , Yao Xueming , Zhong Li , Wei Jiaxin , Qiu Xia , Jia Ertao
Published: February 2024

The implementation of a treat-to-target (T2T) approach has been widely recommended for achieving optimal outcomes in gout treatment, as substantiated by a wealth of compelling evidence. However, a paucity of knowledge exists regarding the barriers hindering effective T2T management in China. This study seeks to investigate the factors contributing to treatment failure within the context of the T2T strategy. A cross-sectional, multi-center investigation was conducted, involving the completion of electronic questionnaires by outpatients undergoing urate-lowering treatment for a duration exceeding 6 months. These questionnaires encompassed demographic information, disease-related conditions, comorbid conditions, and management. The study analyzed factors associated with serum uric acid levels exceeding 360 µmol/L, poor disease control, and poor medication adherence. A total of 425 valid questionnaires were collected, representing 90.8% of the patients. The T2T implementation rate was 26.82% (n = 114). Factors linked to serum uric acid levels surpassing 360 µmol/L included moderate medication adherence (odds ratio (OR) = 2.35; 95% confidence interval (CI) 1.17–4.77; P = .016), poor medication adherence (OR = 4.63; 95% CI 2.28–9.51; P < .001), and management by general practitioners (OR = 0.60; 95% CI 0.37–0.97; P = .036). The rate of well-controlled patients was 14.35% (n = 61). Predictors of not well controlled encompassed the presence of tophi (OR = 2.48; 95% CI 1.17–5.61; P = .023), general medication adherence (OR = 2.78; 95% CI 1.28–6.05; P = .009), poor medication adherence (OR = 6.23; 95% CI 2.68–14.77; P < .001), and poor patient’s perception of gout (OR = 4.07; 95% CI 1.41–13.91; P = .015). A poor medication adherence rate of 55.29% (n = 235) was observed, with lower rates of poor medication adherence associated with the use of febuxostat (OR = 0.35; 95% CI 0.14–0.83; P = .02), uric acid levels exceeding 360 µmol/L (OR = 3.05; 95% CI 1.84–5.12; P = .00), moderate patient education (OR = 2.28; 95% CI 1.29–4.15; P = .01), moderate diet control (OR = 1.98; 95% CI 1.17–3.41; P = .01), and poor diet control (OR = 3.73; 95% CI 1.26–12.83; P = .02). The rate of T2T implementation in China is notably low among patients undergoing urate-lowering treatment of gout beyond 6 months. Importantly, medication adherence demonstrates a significant association with T2T outcomes.
Teres minor denervation and pathologies resulting in shoulder joint instability and rotator cuff tears: A retrospective cross-sectional MRI study
Authors: Lee Joo Yeon , Yoo Yon-Sik , Shon Kilhwan
Published: February 2024

Teres minor denervation (TMD) has gained increasing attention in recent years, particularly with the advent of magnetic resonance imaging (MRI). The potential association between TMD and shoulder instability or rotator cuff tear remains a subject of interest in the orthopedic community. In this retrospective and cross-sectional study, authors aim to investigate the potential association between TMD and shoulder instability or rotator cuff tears. Authors retrospectively analyzed MRI findings from 105 patients with TMD, focusing on rotator cuff pathologies, posterior labrocapsular complex (PLCC) tears, and posteroinferior glenohumeral joint capsule alterations. Authors assessed the association between TMD and rotator cuff and PLCC tears. For the multivariate analysis, partial proportional odds models were constructed for subscapularis (SSC) and SSP tears. Rotator cuff tears were present in 82.9% of subjects, with subscapularis (SSC) tears being the most frequent (77.1%). A significant association was observed between TMD and rotator cuff pathology (P = .002). PLCC tears were found in 82.3% of patients, and humeral position relative to the osseous glenoid was noted in 60% of patients with TMD. A significant association was identified between TMD and shoulder instability or labral/capsular abnormalities (P < .001). More than half of the cases exhibited a long tethering appearance toward the axillary neurovascular bundle on T1-weighted sagittal images. Our findings suggest that TMD is significantly associated with rotator cuff tears and shoulder instability. This study highlights the importance of identifying and treating PLCC tears in patients with TMD to address shoulder instability. Further research is needed to elucidate the role of TMD in the pathogenesis of shoulder instability and rotator cuff pathology.
Prognostic factors and clinical survival outcome in patients with primary mediastinal diffuse large B-cell lymphoma in rituximab era: A population-based study
Authors: Hang Haifang , Zhou Hui , Ma Liyuan
Published: February 2024

The goal of this study was to investigate the clinical characteristics, prognostic variables, and survival of patients with primary mediastinal diffuse large B cell lymphoma (PMBCL) in the rituximab era. The Surveillance, Epidemiology, and End Results (SEER) database was used to identify PMBCL patients diagnosed between 2000 and 2019. The Kaplan–Meier (K-M) technique and log-rank test were used to assess overall survival (OS) and disease-specific survival (DSS). The independent prognostic variables for OS and DSS were identified using univariate and multivariate Cox regression analysis. Nomograms were created to predict survival prospects according to identified prognostic indicators. Totally, 841 patients were enrolled with PMBCL. One-year, 5-year, and 10-year OS rates were 93.99%, 85.04%, and 81.76%, and the corresponding DSS rates were 95.27%, 87.37%, and 85.98%. The results of multivariate Cox regression analysis demonstrated that age, years of diagnosis, Ann arbor staging, and chemotherapy were independent prognostic factors for survival. Nomograms designed exclusively for PMBCL were created to forecast the likelihood of 1-year, 5-year, and 10-year OS and DSS, respectively. The Harrell concordance index (C-index) for the nomograms predictions of OS and DSS were 0.704 and 0.733, respectively, which showed the established model harboring powerful and accurate performance. The present study revealed that incidence of PMBCL has been consistently rising over the last 20 years. Simultaneously, survival rates have improved tremendously. Rituximab based immunochemotherapy has emerged as an effective treatment option, leading to enhanced OS and DSS outcomes. Furthermore, the nomograms specifically developed for PMBCL have demonstrated robustness and accuracy in forecasting OS and DSS rates at 1, 5, and 10 years. These predictive tools can be valuable for clinicians in accurately estimating prognosis and establishing personalized treatment plans and follow-up protocols.
Importance of differential diagnosis of EBV mucocutaneous ulcer and EBV-positive diffuse large B-cell lymphoma: A case report
Authors: Hong Yoo Ree , Kwon Jeong-Seung , Ahn Hyung-Joon , Han Seung-Yong , Cho Eunae , Kim Bok Eum
Published: February 2024

Rationale:

Epstein-Barr virus mucocutaneous ulcers (EBVMCUs) were officially recognized as a clinicopathologic entity in the 2017 revision of the World Health Organization classification, which often occurs in the elderly or in immunosuppressive condition presented as an isolated ulcerative lesion. EBVMCUs are defined as “shallow, sharply circumscribed, mucosal or cutaneous ulcers with underlying polymorphous infiltration.” It mostly involves oral mucosa, but some appear in skin or gastrointestinal tract. Typically, patients with EBVMCUs display a slow disease progression and may even undergo spontaneous regression.

Patient concerns:

This report describes the case of a 76-year-old woman who visited our outpatient clinic with the chief complaint of inflammation and ulceration on lower labial, lower right lingual gingiva seemed like acute necrotizing ulcerative gingivitis, and malignancy.

Diagnoses:

She was diagnosed with EBVMCU after tissue biopsy.

Interventions:

Since most oral ulcerations usually appear in nonspecific form, it is important to check thoroughly for any underlying immunosuppressive systemic conditions and laboratory test results in case of viral infection. But she has no remarkable underlying immunosuppressive disorder.

Outcomes:

For this patient, she was initially diagnosed with EBVMCU and showed spontaneous healing, but then relapsed after 4 to 6 months. The patient was re-diagnosed as EBV-positive diffuse large B-cell lymphoma (EBV-positive DLBCLs) after re-biopsy.

Lessons:

EBVMCU shows similar symptoms to malignant lesions or acute necrotizing ulcerative gingivitis but shows spontaneous healing. However, in case of EBV-positive DLBCLs, failing to detect and treat the disease in its early stages can lead to a fatal outcome. Thus, this case report highlights the differential diagnosis and appropriate treatment of EBVMCU and EBV-positive DLBCLs.
Adult-onset congenital intestinal malrotation: A case report and literature review
Authors: Yin Meng-Di , Hao Li-Liang , Li Guang , Li Yu-Tao , Xu Bao-Li , Chen Xin-Rui
Published: February 2024

Background:

Intestinal malrotation is an infrequent congenital anomaly primarily observed in neonates, and adult-onset cases are exceedingly rare. Studies on adult congenital intestinal malrotation are limited.

Methods:

A case with congenital intestinal malrotation is reported in our study. The clinical data were collected and the treatment process and effect were evaluated.

Results:

A 45-year-old female who had been experiencing vomiting for over 40 years was admitted to our hospital. According to the result of CT scan, intestinal volvulus accompanied by bowel obstruction was suspected. Then laparoscopic examination was applied to the patient and was ultimately diagnosed with adult congenital intestinal malrotation. We performed Ladd’s procedure combined with gastrojejunostomy and Braun anastomosis. The patient recovered well and was successfully discharged from the hospital on the 13th day after surgery. After a 6-month follow-up, the symptom of vomiting was significantly alleviated and body weight was gained for 10 kg. She was very satisfied with the treatment.

Conclusion:

Adult congenital intestinal malrotation is a rare disease that is often misdiagnosed owing to nonspecific clinical manifestations. Therefore, awareness about this condition should be enhanced. Surgery remains the cornerstone of treatment for this disease. Combining gastrojejunostomy and Braun anastomosis with the traditional Ladd procedure can optimize surgical outcomes.
Chemotherapy-associated hemorrhagic posterior reversible encephalopathy syndrome (PRES) with considerations for circle of Willis variants on cerebral blood flow and autoregulation: A case report
Authors: Srichawla Bahadar S. , Presti Kendall , Kipkorir Vincent , Berrios Morales Idanis
Published: February 2024

Rationale:

Hodgkin lymphoma, a lymphatic system cancer, is treated by chemotherapy, radiation therapy, and hematopoietic stem cell transplantation. Posterior reversible encephalopathy syndrome (PRES) is a rare neurotoxic effect associated with several drugs and systemic conditions. This case study emphasizes the potential risks of intensive chemotherapy regimens and postulates the impact of the circle of Willis variants on the heterogeneity of hemispheric lesions in PRES.

Patient concerns:

A 42-year-old woman diagnosed with stage IIA nodular sclerosing Hodgkin lymphoma and chronic thrombocytopenia presented after 6 years of initial diagnosis and 4 years post-haploidentical transplant. She underwent planned chemotherapy with ifosfamide, carboplatin, and etoposide.

Diagnoses:

She developed an alteration in her mental status. A computerized tomography scan and angiogram of the head and neck revealed findings consistent with PRES and a left fetal-type posterior cerebral artery with an aplastic A1 segment of the left anterior cerebral artery. One hour later she was found comatose with clinical sequelae of an uncal herniation.

Interventions:

Subsequent events led to emergent intubation, and administration of 23.4% hypertonic saline. A repeat computerized tomography scan showed a right intraparenchymal hemorrhage with fluid-fluid levels measuring up to 4.7 cm, bilateral subarachnoid hemorrhage, right uncal herniation, and 15 mm of leftward midline shift. She emergently underwent a right decompressive hemi-craniectomy.

Outcomes:

An magnetic resonance imaging of the brain demonstrated bilateral cytotoxic edema involving the parieto-occipital lobes. Despite interventions, the patient’s neurological condition deteriorated, leading to a declaration of brain death on the 8th day.

Lessons:

This case underscores the importance of recognizing the severe neurological complications, including PRES, associated with chemotherapeutic treatments in Hodgkin lymphoma. PRES may also be exacerbated by coagulopathies such as thrombocytopenia in this case. The circle of Willis variants may influence cerebral blood flow, autoregulation, and other factors of hemodynamics, leading to increased susceptibility to both radiographic lesion burden and the worst clinical outcomes.
Curcumin suppresses metastasis of triple-negative breast cancer cells by modulating EMT signaling pathways: An integrated study of bioinformatics analysis
Authors: Chen Ze , Lu Pinjun , Li Menghan , Zhang Qing , He Tao , Gan Lin
Published: February 2024

This study aimed to use bioinformatics approaches for predicting the anticancer mechanisms of curcumin on triple-negative breast cancer (TNBC) and to verify these predictions through in vitro experiments. Initially, the Cell Counting Kit-8 (CCK8) assay was employed to rigorously investigate the influence of curcumin on the proliferative capacity of TNBC cells. Subsequently, flow cytometry was employed to meticulously assess the impact of curcumin on cellular apoptosis and the cell cycle regulation.Transwellassays were employed to meticulously evaluate the effect of curcumin on the motility of TNBC cells. RNA sequencing was conducted, followed by Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses of differentially expressed genes, aiming to elucidate the potential anticancer mechanisms underlying curcumin’s effects. To thoroughly elucidate the interactions among multiple proteins, we constructed a protein–protein interaction (PPI) network. Finally, the expression levels of several key proteins, including fibronectin, mTOR, β-Catenin, p-Akt, Akt, N-Cadherin, p-S6, and S6, were assessed using the western blot. The CCK8 assay results showed that curcumin significantly inhibited the proliferation of Hs578T and MDA-MB-231 cells. Flow cytometry results showed that curcumin induced apoptosis in these cells and arrested the cell cycle at the G2/M phase. Additionally,Transwellassay results showed that curcumin effectively reduced the motility of Hs578T and MDA-MB-231 cells. Enrichment analysis of RNA sequencing data showed that the mechanism of action of curcumin was significantly associated with signaling pathways such as pathways in cancer, focal adhesion, and PI3K-Akt signaling pathways. Subsequently, we constructed a protein–protein interaction network to elucidate the interactions among multiple proteins. Finally, Western blotting analysis showed that curcumin significantly decreased the expression levels of key proteins including Fibronectin, mTOR, β-Catenin, p-Akt, Akt, N-Cadherin, p-S6, and S6. Curcumin exhibits its therapeutic potential in TNBC by modulating multiple signaling pathways. It may inhibit the epithelial-mesenchymal transition process by downregulating the expression of proteins involved in the mTOR and PI3K-Akt signaling pathways, thereby suppressing the motility of TNBC cells. These findings provide experimental evidence for considering curcumin as a potential therapeutic strategy in the treatment of TNBC.
Complaint management system and patient satisfaction in grassroots hospitals
Authors: Li Gaiping , Chen Yuanru , Lou Xiaowen
Published: February 2024

Primary healthcare institutions face limitations in medical resources, leading to concerns from patients and their families regarding the quality of medical services, resulting in complaints against these institutions. This study aims to analyze the causes of complaints and implement improvement measures to enhance the service quality of primary healthcare institutions, increase satisfaction among patients and their families, and reduce the number of complaints. Relevant data were collected, and verified complaints were categorized based on departments, administrative office, and category. Pearson Chi-square test, Spearman correlation analysis, as well as univariate logistic regression were employed to analyze factors influencing patient satisfaction. A complaint-handling process was established, and regulations pertaining to complaints were formulated. Pearson Chi-square test results indicated a significant correlation between satisfaction and departments (P = .016) and administrative office (P = .022). Spearman correlation analysis revealed a significant correlation between satisfaction and departments (ρ = 0.157,P = .017) and administrative office (ρ = 0.151,P = .021). Univariate logistic regression analysis demonstrated a significant correlation between satisfaction and other related complaints in administrative office (OR = 3.321, 95% CI = 1.196–9.218,P = .021). Complaints related to departments and administrative offices are significantly correlated with satisfaction. After the implementation of a complaint management system in primary healthcare institutions, there is a notable improvement in service quality, enhanced patient experience, increased satisfaction, and a reduction in hospital complaints.
Research state of the herbal medicine Huangqi (Radix Astragali): A global and bibliometric study
Authors: Chen Yan-Jun , Xie Ming-Rong , Zhou Sheng-Qiang , Liu Fang
Published: February 2024

Background:

Huangqi (Radix Astragali) is a natural medicine with a wide range of uses. The research related to Huangqi is getting hotter and the number of publications is gradually increasing. This study aims to explore the current status and emerging trends of Huangqi-related research.

Method:

Huangqi-related literature was systemically obtained from the Web of Science database. The CiteSpace, VOSviewer, and, R package “Bibliometrix” tools were used to analyze the number of publications, countries, research institutions, journals, authors, keywords, references, and trends.

Results:

A total of 2255 papers were retrieved for analysis. These papers were written by 11,247 authors from 1927 institutions in 71 countries, published in 570 journals, and cited 73,534 references from 11,553 journals. From 1999 to 2022, the number of publications gradually increased. China was the country with the highest number of publications. The most prolific institution was Shanghai University of Chinese Medicine. Evidence-Based Complementary and Alternative Medicine was the journal publishing the most Huangqi-related literature. Dr Karl Wah Keung Tsim was the authors with the most output publications. The Review, entitle “Review of the Botanical Characteristics, Phytochemistry, and Pharmacology of Astragalus membranaceous (Huangqi),” was the reference being cited most frequently. The major keywords were apoptosis, oxidative stress, and inflammation. Gut microbiota and epithelial-mesenchymal transitions were new research hotspots in recent years.

Conclusion:

This study used quantitative and visual analysis of Huangqi to provide insights into the research priorities, frontier research hotspots, and future research trends in this field.
Interleukin gene polymorphisms and alopecia areata: A systematic review and meta-analysis
Authors: Tishe Zasia Hossain , Shawkat Sanjana , Popy Meherun Nessa , Ahmed Ashfaq , Mumu Sadia Biswas , Apu Mohd Nazmul Hasan , Mostaid Md Shaki
Published: February 2024

Background:

Alopecia areata (AA) is an autoimmune disease which results in non-scarring hair loss on the scalp or any surface with hair. Several genetic polymorphisms of the interleukin genes have been linked with this disease but the results are inconsistent. This systematic review and meta-analysis were done to find the association between rs3118470, rs2275913, rs3212227, and rs10889677 of the IL2RA, IL17A, IL12B, and IL23R genes, respectively, of the interleukin family with alopecia areata.

Methods:

A comprehensive search for relevant research articles was conducted in Pubmed, Google Scholar, and Embase databases. Our search yielded 8 relevant articles with 1940 cases and 1788 controls. The odds ratio with 95% confidence intervals was calculated using fixed effect and random effect models. Heterogeneity was determined using the Q-test and I
2 test. Publication bias was determined and funnel plots were used to adjust the odds ratio.

Results:

We found a significant risk effect for rs3118470 of the IL2RA gene with alopecia areata in the dominant model (CC + CT vs TT; OR = 1.54, 95% confidence interval = 1.05–2.26, P < .05, I
2 = 69.03%) and homozygous model (CC vs TT; OR = 2.00, 95% confidence interval = 1.07–3.71, P < .05, I
2 = 72.84%). For the other single nucleotide polymorphisms, we could not find any statistically significant association with the disease.

Conclusion:

Our analysis showed that mutation of rs3118470 of IL2RA gene possesses a significant risk effect for alopecia areata. Future studies with larger sample sizes and ethnic backgrounds are warranted to confirm our findings.
The mechanism of action for laryngeal manual therapies: the need for an update
Authors: Fritz Walt
Published: February 2024

Purpose of review

To propose a pathway for expanding the understanding of potential mechanisms of action with laryngeal-based manual therapy (LMT) for muscle tension dysphonia (MTD). This review may help determine if current LMT literature has kept up with advances in the more general manual therapy (MT) findings.

Recent findings

Studies over the past thirty years, including recently published articles, have confirmed the efficacy of various manual therapy interventions in treating MTD. However, gaps exist between current LMT literature and that being presented in the more general MT field. Instead of viewing peripheral manipulation's influences as a local cause/effect process, the MT literature paints a richer tapestry of centrally mediated impacts.

Evidence from outside the LMT field has introduced a broad tapestry of factors that may contribute to the efficacy of MT, extending beyond the local effects reported in LMT literature. To better understand the effect and mechanism of action touch-based interventions have on a patient's voice and to potentially improve outcomes, it is necessary to broaden investigations to include a broader range of perspectives.
A systematic review and meta-analysis of randomized controlled head-to-head trials of recommended drugs for neuropathic pain
Authors: Sadegh Ayda Asadizadeh , Gehr Nina Lykkegaard , Finnerup Nanna Brix
Published: February 2024

Neuropathic pain is a challenging chronic pain condition. Limited knowledge exists regarding the relative effectiveness of pharmacological treatments, and differences in trial design and impact of the placebo response preclude indirect comparisons of efficacy between drug classes. The purpose of this systematic review and meta-analysis of head-to-head trials was to compare the efficacy and tolerability of drugs recommended for neuropathic pain. We conducted a systematic review and meta-analysis of direct-comparison double-blind randomized trials. Primary outcomes were mean change in pain intensity and number of responders with a 50% reduction in pain intensity. Secondary outcomes encompassed quality of life, sleep, emotional functioning, and number of dropouts because of adverse events. We included 30 trials (4087 patients), comprising 16 crossover and 14 parallel-group design studies. All studies were conducted in adults, and the majority were investigator-initiated trials. We found moderate-quality evidence for equivalence (no clinically relevant difference) between tricyclic antidepressants (TCA) and gabapentin/pregabalin with a combined mean difference in pain score of 0.10 (95% CI −0.13 to 0.32). We could not document differences between TCA and serotonin–noradrenaline reuptake inhibitors (SNRI), between SNRI and gabapentin/pregabalin, or between opioids and TCA (low quality of evidence). We found more dropouts because of adverse events with SNRI and opioids compared with TCA (low quality of evidence). We did not identify any studies that included topical treatments. This systematic review of direct-comparison studies found evidence for equivalence between TCA and gabapentin/pregabalin and fewer dropouts with TCA than SNRI and opioids.
Plastic Surgery in Burn Care
Authors: Pandya Sumaarg , Liu Hilary Y. , Alessandri Bonetti Mario , Jeong Tiffany , Egro Francesco
Published: February 2024

A 10 year cohort of patients admitted to a verified burn unit were analyzed to assess the role of plastic surgeons in the operative management of those patients. All 3843patients were admitted during this study period. Of these, 1509 of those patients underwent surgical procedures. Plastic surgeons performed 658 operations on these patients, including acute and delayed reconstruction of hand and facial burn injuries. In this population, plastic surgeons played a critical role in acute and reconstructive burn injuries in anatomically complex areas. This series illustrates the need for plastic surgery training in burn care.
Privacy-proof Live Surgery Streaming
Authors: De Backer Pieter , Simoens Jente , Mestdagh Kenzo , Hofman Jasper , Eckhoff Jennifer A. , Jobczyk Mateusz , Van Eetvelde Ellen , D’Hondt Mathieu , Moschovas Marcio Covas , Patel Vipul , Van Praet Charles , Fuchs Hans F. , Debbaut Charlotte , Decaestecker Karel , Mottrie Alexandre
Published: February 2024

Objective:

Develop a pioneer surgical anonymization algorithm for reliable and accurate real-time removal of out-of-body images, validated across various robotic platforms.

Summary Background data / Background:

The use of surgical video data has become common practice in enhancing research and training. Video sharing requires complete anonymization, which, in the case of endoscopic surgery, entails the removal of all nonsurgical video frames where the endoscope can record the patient or operating room staff. To date, no openly available algorithmic solution for surgical anonymization offers reliable real-time anonymization for video streaming, which is also robotic-platform- and procedure-independent.

Methods:

A dataset of 63 surgical videos of 6 procedures performed on four robotic systems was annotated for out-of-body sequences. The resulting 496.828 images were used to develop a deep learning algorithm that automatically detected out-of-body frames. Our solution was subsequently benchmarked against existing anonymization methods. In addition, we offer a post-processing step to enhance the performance and test a low-cost setup for real-time anonymization during live surgery streaming.

Results:

Framewise anonymization yielded an ROC AUC-score of 99.46% on unseen procedures, increasing to 99.89% after post-processing. Our Robotic Anonymization Network (ROBAN) outperforms previous state-of-the-art algorithms, even on unseen procedural types, despite the fact that alternative solutions are explicitly trained using these procedures.

Conclusions:

Our deep learning model ROBAN offers reliable, accurate, and safe real-time anonymization during complex and lengthy surgical procedures regardless of the robotic platform. The model can be used in real-time for surgical live streaming and is openly available.
Impact of Change in Sizing Protocol on Outcome of Magnetic Sphincter Augmentation
Authors: Sarici Inanc S. , Eriksson Sven E. , Zheng Ping , Moore Olivia , Jobe Blair A. , Ayazi Shahin
Published: February 2024

Objective:

To evaluate and compare magnetic sphincter augmentation (MSA) device sizing protocols on postoperative outcomes and dysphagia.

Background:

Among predictors of dysphagia after MSA, device size is the only factor that may be modified. Many centers have adopted protocols to increase device size. However, there are limited data on the impact of MSA device upsizing protocols on surgical outcomes.

Methods:

Patients who underwent MSA were implanted with 2 or 3 beads above the sizing device’s pop-off point (POP). Clinical and objective outcomes >1 year after surgery were compared between patients implanted with POP+2-versus-POP+3 sizing protocols. Multiple subgroups were analyzed for the benefit of upsizing. Preoperative and postoperative characteristics were compared between the size patients received, regardless of protocol.

Results:

A total of 388 patients were implanted under POP+2 and 216 under POP+3. At a mean of 14.2 (7.9) months, pH normalization was 73.6% and 34.1% required dilation, 15.9% developed persistent dysphagia, and 4.0% required removal. The sizing protocol had no impact on persistent dysphagia (P=0.908), pH normalization (P=0.822), or need for dilation (P=0.210) or removal (P=0.191). Subgroup analysis found that upsizing reduced dysphagia in patients with <80% peristalsis (10.3% vs 31%, P=0.048) or distal contractile integral >5000 (0% vs 30.4%, P=0.034). Regardless of sizing protocol, as device size increased there was a stepwise increase in the percent male sex (P<0.0001), body mass index >30 (P<0.0001), and preoperative hiatal hernia >3 cm (P<0.0001), Los Angeles grade C/D esophagitis (P<0.0001), and DeMeester score (P<0.0001). Increased size was associated with decreased pH normalization (P<0.0001) and need for dilation (P=0.043) or removal (P=0.014).

Conclusions:

Upsizing from POP+2 to POP+3 does not reduce dysphagia or affect other MSA outcomes; however, patients with poor peristalsis or hypercontractile esophagus do benefit. Regardless of sizing protocol, preoperative clinical characteristics varied among device sizes, suggesting size is not a modifiable factor, but a surrogate for esophageal circumference.