bluuebunny/crossref_metadata_2025 huggingface dataset:
Personalized 90Y-resin microspheres dose determination: a retrospective study on the impact of dosimetry software on the treatment of patients with selective internal radiotherapy
Authors: Pinaquy Jean-Baptiste , Lapuyade Bruno , Blanc Jean-Frederic , Hindié Elif , Papadopoulos Panteleimon , Debordeaux Frederic
Published: March 2023

Introduction

The calculation of resin yttrium-90 (90Y-) microspheres activity for selective internal radiotherapy (SIRT) needs to be investigated.

Methods and materials

Analyses using Simplicit90Y (Boston Scientific, Natick, Massachusetts, USA) dosimetry software were performed to determine the concordance between the absorbed doses to the tumor (DT1 and DT2) and healthy liver (DN1 and DN2) during the pre-treatment and the post-treatment phases. An optimized calculation of the activity of 90Y-microspheres performed using dosimetry software was applied retrospectively to assess the impact of this calculation method on the treatment.

Results

DT1 ranged from 38.8 to 372 Gy, with a mean value of 128.9 ± 73.6 Gy and median of 121.2 Gy [interquartile range (IQR): 81.7–158.8 Gy]. The median DN1 and DN2 was 10.5 Gy (IQR: 5.8–17.6). A significant correlation was between DT1 and DT2 (r = 0.88, P < 0.001) and DN1 and DN2 (r = 0.96, P < 0.001). The optimized activities were calculated; the target dose to the tumor compartment was 120 Gy. No activity reduction was applied in accordance with the tolerance of the healthy liver. Optimization of the microspheres dosages would have resulted in a significant increase in activity for nine treatments (0.21–2.54 GBq) and a reduction for seven others (0.25–0.76 GBq).

Conclusions

The development of customized dosimetry software adapted to clinical practice makes it possible to use dosimetry to optimize the dosage for each patient.
Sub 4 minute superfast single-photon emission computed tomography/computed tomography as an add-on for problem-solving in planar bone scintigraphy: a time-saving solution for departments without whole-body single-photon emission computed tomography/computed tomography
Authors: Isherwood Amanda C. , Cabral Rita , Avery Ged
Published: March 2023

Whole-body bone scintigraphy remains widely used in nuclear medicine as it is a relatively inexpensive and quick test in which the whole body can be imaged with good sensitivity. However, one downside of the technique is its lack of specificity. The difficulty comes when there is a single ‘hot spot’ which usually requires further anatomical imaging to identify the cause and differentiate malignant from benign lesions. In this situation, hybrid imaging with single-photon emission computed tomography/computed tomography (SPECT/CT) can be a useful problem solver. The addition of SPECT/CT can however, be time-consuming, adding up to 15–20 min for every bed position required, a process that can tax the compliance of the patient and reduce the scanning capacity of the department. We report the successful implementation of a new superfast SPECT/CT protocol comprising a 1 s per view over 24 views point and shoot approach, reducing the SPECT scan time to less than 2 min and the whole SPECT/CT to under 4 min while still producing images that allow diagnostic certainty in previously equivocal lesions. This is faster than previously reported ultrafast SPECT/CT protocols. The utility of the technique is demonstrated in a pictorial review of four disparate causes of solitary bone lesions: fracture, metastasis, degenerative arthropathy and Paget’s disease. This technique may prove a cost-effective problem-solving adjunct in nuclear medicine departments unable to yet offer whole-body SPECT/CT to every patient, without adding much burden to the department’s gamma camera usage and patient throughput.
Volume-based 18F-FDG PET analysis of cardiac sarcoidosis using the descending aorta as a reference tissue
Authors: Tsujimoto Masakazu , Fukushima Ayami , Kawai Hideki , Watanabe Masanori , Tanahashi Shingo , Sarai Masayoshi , Toyama Hiroshi
Published: March 2023

Objective

18F-FDG PET can be used to calculate the threshold value of myocardial volume based on the mean standardised uptake value (SUVmean) of the aorta to detect highly integrated regions of cardiac sarcoidosis. The present study investigated the myocardial volume when the position and number of volumes of interest (VOIs) were changed in the aorta.

Methods

The present study examined PET/computed tomography images of 47 consecutive cardiac sarcoidosis cases. VOIs were set at three locations in the myocardium and aorta (descending thoracic aorta, superior hepatic margin and near the pre-branch of the common iliac artery). The volume was calculated for each threshold using 1.1–1.5 times the SUVmean (median of three cross-sections) of the aorta as the threshold to detect high myocardial 18F-FDG accumulation. The detected volume, correlation coefficient with the visually manually measured volume and the relative error were also calculated.

Results

The optimum threshold value for detecting high 18F-FDG accumulation was 1.4 times that of the single cross-section of the aorta and showed the smallest relative errors of 33.84% and 25.14% and correlation coefficients of 0.974 and 0.987 for single and three cross-sections, respectively.

Conclusion

The SUVmean of the descending aorta may be detected in good agreement with the visual high accumulation by multiplying the same threshold constant for both single and multiple cross-sections.
Ewing sarcoma in calcenous presented as chronic osteomyelitis: a case report and literature review
Authors: Tos Salem M. , Al-Karaja Layth , Giacaman Narmeen , Ibdah Mohammad G. , Hussein Abdallah , Ass’ad Omar M. , Nour Ibrahim R. , Mansour Mamoun M.H.
Published: March 2023

Ewing’s sarcoma (ES) is an uncommon primary malignant tumor of the bone, mostly affecting 5–20 years of age with male predominance. It commonly affects the diaphysial region of long bones, while the small bones of hands and feet are extremely rare (3–5%) to be affected. The authors report a case of calcaneal ES which was misdiagnosed as bacterial chronic osteomyelitis and treated inappropriately. A high index of suspicion is required in diagnosing tumors at rare sites to avoid undue delay in initiating appropriate therapy. As the overall prognosis of ES of the calcaneum is lower compared to other sites, these tumors should have an extensive radiological evaluation and histological confirmation, as misdiagnosis and treatment delays will have detrimental outcomes.
Gallstone ileus of the sigmoid colon: case report
Authors: Mouni Omar , Bouziane Mohamed , Gennuso Federico , Ramdani Abdelbassir , Sair Khalid
Published: March 2023

Introduction:

Gallstone ileus is an uncommon cause of intestinal obstruction. It is caused when a gallstone migrates through an enterobiliary fistula (most often between the duodenum and the gallbladder) and is impacted in the digestive system, most often in the terminal ileum toward the ileocaecal valve.

Case Presentation:

Here the authors report the case of a 74-year-old woman who was admitted to Compiegne Hospital in France for a gallstone ileus with the sigmoid colon as the impaction site, which is an even more rare cause of intestinal obstruction. The enterobiliary fistula was between the colon and the gallbladder.

The gallstone was removed surgically with a colotomy, without treating the fistula, and after a failed endoscopic attempt to extract the stone. The follow-up was without complications, and a colposcopy showed spontaneous closure of the fistula after 6 weeks.

Discussion and Conclusion:

The surgical closure of an enterobiliary fistula is an option that should be considered, but it can lead to higher morbidity. That is why the authors opted out of it, especially considering that spontaneous closure of the fistulae can happen, as it did in our case.
The effectiveness of real-time computer-aided and quality control systems in colorectal adenoma and polyp detection during colonoscopies: a meta-analysis
Authors: Aslam Muhammad Fawad , Bano Shehar , Khalid Mariam , Sarfraz Zouina , Sarfraz Azza , Sarfraz Muzna , Robles-Velasco Karla , Felix Miguel , Deane Kitson , Cherrez-Ojeda Ivan
Published: March 2023

Aims:

This meta-analysis aims to quantify the effectiveness of artificial intelligence (AI)-supported colonoscopy compared to standard colonoscopy in adenoma detection rate (ADR) differences with the use of computer-aided detection and quality control systems. Moreover, the polyp detection rate (PDR) intergroup differences and withdrawal times will be analyzed.

Methods:

This study was conducted adhering to PRISMA guidelines. Studies were searched across PubMed, CINAHL, EMBASE, Scopus, Cochrane, and Web of Science. Keywords including the following ‘Artificial Intelligence, Polyp, Adenoma, Detection, Rate, Colonoscopy, Colorectal, Colon, Rectal’ were used. Odds ratio (OR) applying 95% CI for PDR and ADR were computed. SMD with 95% CI for withdrawal times were computed using RevMan 5.4.1 (Cochrane). The risk of bias was assessed using the RoB 2 tool.

Results:

Of 2562 studies identified, 11 trials were included comprising 6856 participants. Of these, 57.4% participants were in the AI group and 42.6% individuals were in in the standard group. ADR was higher in the AI group compared to the standard of care group (OR=1.51, P=0.003). PDR favored the intervened group compared to the standard group (OR=1.89, P<0.0001). A medium measure of effect was found for withdrawal times (SMD=0.25, P<0.0001), therefore with limited practical applications.

Conclusion:

AI-supported colonoscopies improve PDR and ADR; however, no noticeable worsening of withdrawal times is noted. Colorectal cancers are highly preventable if diagnosed early-on. With AI-assisted tools in clinical practice, there is a strong potential to reduce the incidence rates of cancers in the near future.
A 4 mm vesicoureteric junction stone causing rupture of pelvicoureteric junction – case report
Authors: Narayan Prabhat , Salimi Zahra , Salimi Fatemeh
Published: March 2023

We discuss the case of a 67-year-old man who presented with a right-sided abdominal pain and on subsequent radiological imaging(s) in the form of an enhanced computed tomography scan of the abdomen and pelvis followed by a delayed excretory phase (computed tomography urogram), found to have a distal 4 mm vesicoureteric junction stone which had caused a pelvicoureteric junction rupture which was evident on extravasation of contrast. This warranted an urgent surgical intervention in the form of ureteric stent insertion. This case clearly depicts that with even a small stone associated with severe flank pain, rupture or pelvicoureteric junction/calyces should be suspected and we should never overlook symptoms and push for medical expulsive therapy in patients who do not appear to be septic or obstructed. This work has been reported in line with the Surgical CAse REport (SCARE) criteria.
Spontaneous coronary artery dissection (SCAD): a case report
Authors: Britel Driss , Nikièma Soumaila , Massimbo Désiré , Graham Emmanuel , Benyass Aatif , Lakhal Zouhair
Published: March 2023

Introduction and Importance:

Spontaneous coronary artery dissection (SCAD) is often revealed by an acute coronary syndrome classified then as a MINOCA. The typical patient is a female patient with no or few cardiovascular risk factor. Our work aims to illustrate the effectiveness of medical treatment in patients with SCAD.

Case Report:

We report a case of a 56-year-old female patient who was admitted after 3 days of infarct-like thoracic pain related to an anterior extended ST-elevation myocardial infarction. The coronarography showed a SCAD of the left anterior descending coronary artery. The patient was discharged under medical treatment. Six weeks later, coronarography showed a perfused coronary artery.

Discussion:

Most cases of SCAD present as acute coronary syndrome. Coronary angiography remains the ‘first-line’ examination. The use of endocoronary imaging such as IVUS and optical coherence tomography is necessary in case of diagnostic doubt (especially in SCAD type 2 and 3). The optimal management of SCAD remains unclear. A conservative approach should be the preferred strategy.

Conclusion:

SCAD should be considered in any young woman presenting with suspicious chest pain with positive troponin. The diagnosis is initially angiographic and may require endocoronary imaging for greater accuracy. Conservative treatment remains the best option.
Collapsing focal segmental glomerulosclerosis secondary to COVID-19: A systematic review and meta-analysis
Authors: Qamar Mohammad A. , Kogut Lucas M. , Tebha Sameer S. , Arif Aabiya , Ninmol Jesse , Abdul Razzaque Muhammad R. , Qamar Khulud , Yosufi Abubakr
Published: March 2023

Introduction:

The renal system manifestations of coronavirus disease-2019 have been documented extensively; however, scientific literature remains scarce regarding collapsing glomerulopathy hence the need for this investigation.

Methods:

A comprehensive review was conducted covering a timeline from 1 January 2020 to 5 February 2022 without any restrictions. The data extraction was conducted independently, and articles were assessed for the risk of bias. Data analysis was conducted using Comprehensive Meta-Analysis version 3.3.070 and RevMan version 5.4 for pooled proportions and risk ratio (RR) between dialysis-dependent and independent treatment groups with aP-value less than 0.05 considered significant.

Results:

A total of 38 studies were included in this review, including 74 (65.9%) males. The mean age was 54.2 years old. The most common symptoms reported were related to the respiratory system (59.6%, 95% CI: 50.4–68.2%) and hematuria (34.2%, 95% CI: 26.1–43.4). Antibiotics (25.9%, 95% CI: 12.9–45.3%) was the commonest management used. Proteinuria was the most reported laboratory finding at 89.5% (95% CI: 82.4–93.9%), while the commonest microscopic finding was acute tubular injury (77.2%, 95% CI: 68.6–84.0%). An increased risk of the presence of symptoms (P=0.005) and microscopic findings (P=0.0003) related to collapsing glomerulopathy in dialysis-dependent group was noted with increased management (P=0.01) used in this group for coronavirus disease-2019 infection.

Conclusion:

The findings of this study portray the prognostic value of the variables (symptoms and microscopic findings, etc.) reported in the analysis. Hence this study serves as a foundation for future investigations that minimize the study’s limitations to provide a more robust conclusion.
Revisiting the blind spot of substandard and fake drugs as drivers of antimicrobial resistance in LMICs
Authors: Gulumbe Bashar H. , Adesola Ridwan O.
Published: March 2023

One of the most significant risks to public health is ongoing antimicrobial resistance (AMR). Substandard and fraudulent medications, particularly in low- and middle-income countries (LMICs), are thought to have a role in the genesis and spread of AMR. There are numerous reports concerning the availability of subpar pharmaceuticals in developing countries, with no scientific evidence as to what exactly is included in some of the prescriptions supplied there. These counterfeit and inferior pharmaceuticals are a financial burden of up to US$200 billion, causing thousands of patient deaths, endangering both individual and public health,and undermining patient trust in the healthcare system. Poor quality and counterfeit antibiotics are often disregarded as possible causes of AMR in AMR studies. Therefore, we examined the issue of fake drugs in LMICs and its possible links to the emergence and spread of AMR.
Prostatic adenocarcinoma with transitional cell features among the Saudi Arabian population: a registry review
Authors: Ghazwani Yahya , Sabbah Belal N. , Algahfees Mohammad A. , Arabi Tarek Z. , Alageel Abdulrahman K. , Musalli Ziyad F. , Almutairi Ebtesam S. , Alasker Ahmed
Published: March 2023

Introduction:

Prostate cancer is the third leading cause of death from cancer among American men. Acinar adenocarcinoma is the most common form of prostate cancer; however, there are several nonacinar adenocarcinoma variants, such as transitional cell carcinoma of the prostate and ductal adenocarcinoma.

Materials and Methods:

A retrospective cohort study was conducted on all Saudi patients diagnosed with adenocarcinoma of the prostate with transitional cell features. The data was collected from the Saudi Cancer Registry, which collects tumor data from all private, military, and Health Ministry hospitals in Saudi Arabia through five regional offices.

Results:

Out of 3608 patients, only 16 (0.44%) had adenocarcinoma with transitional cell features. All the tumors under investigation were malignant and constituted. Only 6.2% of the tumors were well-differentiated, 43.8% were moderately differentiated, and 50.0% were poorly differentiated. Among the included patients, 56.3% of the patients (n=9) died. There were no significant factors associated with death among patients, including the demographic and tumor-related variables.

Conclusion:

To the authors’ knowledge, this is the first study describing the prevalence of adenocarcinoma with transitional cell features and its characteristics in Saudi Arabia. The authors have demonstrated that this rare subtype may be more prevalent than what was originally believed. It is necessary for future studies to assess the effectiveness of various treatment modalities to combat it. Furthermore, identifying risk factors – if any – may be crucial in the prevention of its development among men worldwide.
Pseudoaneurysm of the external carotid artery following parotitis: a case report
Authors: Nahal Chahed , Nahal Ghadi , Alcheikh Refaat , Assad Mounzer , Alshehabi Zuheir
Published: March 2023

Pseudoaneurysms of the external carotid artery of nontraumatic causes are very rare; those of infectious causes in adults are also quite unusual and are often preceded by bacteremia. Infection-related cases such as the one described here are scarce in the literature since the complication is not often calculated or expected. We present a case report of an elderly female patient who, after dental treatment and parotitis, noticed a mass behind the right mandible. After examination, the case was diagnosed as a pseudoaneurysm of the external carotid artery of an infectious cause. Management could be by surgical intervention, but the high positioning of the pseudoaneurysm and the age of the patient were contraindications. The choice was made to avoid surgery and keep the patient under long-term follow-up; no increase in its mass was observed after 3 years of follow-up.
Late diagnosis of tuberous sclerosis complex in a 40-year-old female presenting with abdominal pain: a case report
Authors: Aryal Sajiva , Sharma Suraj , Aryal Saman , Bhattarai Vikash
Published: March 2023

Tuberous sclerosis (TS) is a rare autosomal-dominant neurocutaneous disorder that is characterized by hamartomas affecting a variety of organs, including the brain, heart, kidneys, skin, lungs, and liver. TS can emerge in a wide variety of clinical and phenotypic forms at any age, all with varying degrees of severity, and is brought on by mutations in the tumor suppressor genes TSC1 or TSC2. This case report is about a 40-year-old female with facial angiofibromas and abdominal symptoms who was referred to the radiology department of our hospital for ultrasonography of the abdomen, which revealed echogenic mass lesions/angiomyolipomas in bilateral kidneys. Subsequent contrast-enhanced computed tomography of the abdomen revealed large fat-attenuating mass lesions which were confirmed to be angiomyolipomas. Similarly, noncontrast computed tomography of the head showed multiple calcified nodules/tubers in subependymal, subcortical, and cortical locations of the brain. High-resolution computed tomography of the chest showed multiple cystic lesions in bilateral lungs suggestive of lymphangioleiomyomatosis. The aim of this case report is to highlight the late presentation of tuberous sclerosis complex.
Acute severe thrombocytopenia following iodinated radiographic contrast medium infusion: a case report
Authors: Sharawi Baraa M.M. , Bashir Bahaa M. , Al-Tell Abdallah , Hamdan Musab , Abulihya Mohand W. , Karama Akram J.
Published: March 2023

Introduction:

Acute contrast-induced thrombocytopenia is an unusual complication, and it is a rare event with the use of modern low-osmolarity iodinated contrast medium. There are only a few reports that exist in English literature.

Case presentation:

The authors report the case of a 79-year-old male patient with severe, life-threatening thrombocytopenia after administration of intravenous nonionic low-osmolarity contrast medium. His platelet count dropped from 179×109/l to 2×109/l after 1 h of radiocontrast infusion. Which has returned gradually to normal level within days with corticosteroid administration and platelet transfusion.

Conclusion:

Iodinated contrast-induced thrombocytopenia is a rare complication with an unknown causative mechanism. There is no definitive treatment for this condition, with corticosteroids being used in most cases. The platelet count normalizes within a few days regardless of any interventions, but supportive treatment is important to avoid any unwanted complications. Further studies are still needed for a better understanding of the exact mechanism of this condition.
Mononeuropathy multiplex as a first manifestation of renal cell carcinoma: a case report
Authors: ALahmad Ali , Abbas Mona , Nakawah Aman M.O. , Yasmeeneh Abeer M. , Hamzeh Ghassan
Published: March 2023

Introduction and Importance:

The neurologic symptoms that appear due to paraneoplastic syndrome may give manifestations of undiagnosed tumor, and give an opportunity for early detection and treatment of it.

Case Presentation:

Here the authors present a case of a 54-year-old woman who suffered from rapidly progressive muscle weakness, accompanied by right third cranial nerve palsy.

Clinical Discussion:

The nerve conduction study consistent with multiple mononeuropathy, and laboratories revealed undiagnosed diabetes mellitus but elevated erythrocyte sedimentation rate and the rapid progression prompted for additional investigations. Brain MRI, repetitive nerve stimulation, lumbar puncture, and paraneoplastic panel were all negative. Computed tomography scan with contrast for the abdomen showed a right renal mass consistent with renal cell carcinoma. The tumor was removed and steroids and intravenous immunoglobulin was started but without any clinical improvement because of the late presentation.

Conclusion:

Patients with renal cell carcinoma can present with paraneoplastic syndromes but multiple mononeuropathy are extremely rare. It is crucial to investigate for all possible causes of neuropathy and not attributing it to a new discovered diabetes in the presence of clinical and laboratory red flags such as rapid progression and elevated erythrocyte sedimentation rate.
Observational findings of transbronchial lung biopsy in patients with interstitial lung disease: a retrospective study in Aleppo University Hospital
Authors: Kashkash Fateh , Khorri Abdullah
Published: March 2023

Background:

Clinicians face a significant obstacle when attempting to diagnose interstitial lung disease (ILD) patients. However, a thorough clinical examination together with the proper imaging and diagnostic techniques may provide a reliable diagnosis of a particular kind of ILD, and invasive tests such as rigid bronchoscopy or surgical lung biopsy may not be necessary. The aim of this study is to determine the histologic outcomes of an ILD transbronchial lung biopsy (TBLB) carried out at the university hospital in Aleppo.

Methods:

This retrospective cohort research was done between 1 January 2020 and 18 April 2022 at the pulmonary department of Aleppo University Hospital, Syria, using patient records. In our study, 174 patients were examined. We included patients over the age of 18 who were referred or admitted to our department at Aleppo University Hospital after being diagnosed with diffuse parenchymal lung disease based on high-resolution computed tomography and clinical symptoms, while excluding other respiratory diseases such as tuberculosis and coronavirus disease 2019.

Results:

Patients in the research were 53±7.1 years old on average. Cough and dyspnea were the most common clinical complaints among the patients, which accounted for 79.12 and 78.16%, respectively. A significant fraction of ground-glass opacity was detected on the high-resolution computed tomography, amounting to 102 (58.62%) and 74 (42.53%) for the reticular lesions, respectively. As a complication there were 40 patients with bleeding, of whom 24 had moderate bleeding, and 11 had major bleeding. We also had three patients with pneumothorax. The diagnostic yield of the TBLB in our ILD patients was 66.66%.

Conclusion:

An adequate diagnostic accuracy (66.66%) was detected in the TBLB in confirming the diagnosis of ILD; in addition, the bleeding was the most prevalent complication of this procedure. More interventional studies are needed to compare the diagnostic accuracy of this procedure with other invasive and noninvasive diagnostic methodologies of ILD.
Activation of tuberculosis in recovered COVID-19 patients: a case report
Authors: Al-kayali Rawaa S. , Kashkash Mohamad F. , Alhussein Alhajji Azzam H. , Khouri Abdullah
Published: March 2023

Introduction and Importance:

Currently, coronavirus disease 2019 (COVID-19) and tuberculosis (TB) are among the most important causes of respiratory infections around the world. Both of them are sources of concern for human health and life safety. COVID-19 caused the deaths of millions of people, and many of them suffered from what has become known as ‘post-COVID squeal’. Immunosuppression is one of the most important of these symptoms that leave patients susceptible to severe infections like TB.

Case Presentation:

In these two cases, the authors observed the development of active TB after a period of COVID recovery. Two patients who were admitted to the hospital complained mainly, among other symptoms, of fever and a continuous cough after a period of COVID-19 recovery.

Clinical Discussion:

Radiological examination revealed a caving density in the two cases, and the Gene-Xpert test proved the presence of Mycobacterium tuberculosis bacteria despite the negative result of the Ziehl–Neelsen stain. The two patients were improved after standard TB treatment.

Conclusion:

Patients with post‐COVID‐19 chronic respiratory symptoms should be screened for TB, especially in TB-endemic areas, even though the result of the Ziehl–Neelsen stain was negative.
Assessment of motivating and demotivating factors to undergo bariatric surgery in high-risk populations with correlation to generalized anxiety disorder and influence of others: a cross-sectional study
Authors: Mousa Ahmed H. , Alahmad Kutaiba O. , Alsharabi Ayman H. , Ibrahim Abdullatif S. , Aljaber Abdulrahman J. , Baabbad Hasan M. , Althoubity Abdullah D. , Aldeghari Ahlam A. , Ikram Nadeem
Published: March 2023

Background:

Very few research have looked at the causes and influences that push individuals into bariatric surgery. Although bariatric surgery is effective in boosting self-esteem, little is known about the precise physical characteristics people want to alter.

Methods:

This study was a descriptive, correlational cross-sectional study to achieve the objectives of the study. All overweight and obese population in Jeddah, Saudi Arabia. Study instrument was designed based on the data present in the latest literature. Study tool consisted of: (1) sociodemographic data, (2) motives of bariatric surgery, (3) concerns about bariatric surgery, (4) people affecting the decision of seeking bariatric surgery, and (5) general anxiety disorder scale.

Results:

The study included 567 participants. More than half of the study participants were females (n=335, 59.1%). The mean age among study participants was 27.88 years. Most of the participants selected themselves as the main person (n=329). In the second place comes “person who had the surgery” (n=72). A family member was prevalent among 59 participants and a friend among 57 participants. The partner has the least frequency. The most common reason was self-esteem among 26% followed by body image among 20%. The most frequent factor was “I am satisfied with my current weight loss method) among 220 participants followed by “I am afraid of any surgery and will avoid it unless absolutely needed” among 51 participants.

Conclusion:

Bariatric surgery patients want to improve their health and live longer. Several people are dissatisfied with their bodies and seek cosmetic surgery. Patients desire bariatric surgery for their own and their loved ones’, physicians’, and peers’ reasons. This study supports emphasizing the reasons why Jeddah, Saudi Arabia residents choose bariatric surgery and the demotivating issues.
Validation of cost-effective model for breast self-examination
Authors: Idrees Sarrah , Mayilvaganan Sabaretnam , Jagannath Spandana , Mishra Prabhaker , Chand Gyan , Mishra Anjali , Agarwal Gaurav , Agarwal Amit
Published: March 2023

Introduction:

The incidence of breast cancer is increasing in India; it predominantly affects women in their 30s and 40s. The disease burden is very high given the high incidence of triple-negative disease in a large portion of the population. Early detection can save lives and aid in breast conservation surgery. Breast self-examination (BSE) is a valid tool for early breast cancer detection. If performed with the help of a simulation model that resembles a given culture and tradition, it can result in good outcomes from screening programs. We designed and validated an Indian model for BSE and reported the feasibility of this model.

Materials and methods:

We designed an Indian model for the BSE based on the cultural mindset of Indian women. The design was finalized, and the model was constructed. It was then compared with preexisting international models and validated by in-depth interviews with validation experts from various fields involved in breast cancer management. Minor design revisions were made, followed by testing and re-testing. Finally, it was ready for public use.

Results:

The in-depth interview was conducted using a validated modified animation multimedia questionnaire. The majority of the validation experts had used stimulation models before, and all stated that it could help teach women about BSE, and it was comparable with other preexisting internationally validated models (91.33±4.98%).

Conclusion:

Using a breast model, women can learn to detect breast cancer as early as possible, and this can lead to good outcomes. We designed the model using easily available, cheap, and safe materials to keep it as realistic and useful as possible. The Indian BSE model can be used by Indian women to learn to detect breast lumps early. It is easily reproducible and cost-effective.
Acute tubular necrosis after transurethral resection of the prostate: a case report
Authors: Al-Hajjaj Maher , Alqasem Omar , Elrayah Mohamed Amna , Al-Ashi Ahmad , Abokhsab Mahmoud M.
Published: March 2023

Introduction:

Transurethral resection of the prostate (TURP) is currently the gold standard for the surgical treatment of benign prostatic hyperplasia. This surgery may lead to TURP syndrome and in some cases, acute tubular necrosis can develop.

Case Presentation:

We had a 67-year-old male patient who had benign prostate hyperplasia unresponsive to tamsulosin. He underwent TURP surgery. After that, he had acute tubular necrosis because of hemolysis. We performed hemodialysis to decrease serum creatinine level.

Discussion:

Acute tubular necrosis is the result of hemolysis. Rapid absorption of large volumes of glycerin may lead to hypotension and acute kidney injury.

Conclusion:

Using distilled water for irrigation during TURP may lead to severe complications like hypotension and acute tubular necrosis.
A systematic review and meta-regression for validation of the Alvarado score as a tool for predicting acute appendicitis
Authors: Gupta Sapna , Kolli Venkata S. , Da Costa Kimberly , Javed Sariya , Ammar Ahmed , Rasheed Ashraf
Published: March 2023

Background:

The Alvarado score (AS) has not been widely used for diagnosing acute appendicitis although it has shown to be a good predictor for diagnosing appendicitis. The aim was to perform a systematic review of the available literature and synthesize the evidence.

Methods:

A systematic review was performed as per the PRISMA guidelines using search engines like Ovid, PubMed, and Google Scholar with predefined, strict inclusion and exclusion criteria. The quality assessment of included studies was performed using the QUADAS 2 tool. Summary statistics were performed for all variables. A linear regression model was performed between dependent and independent variables using STATA software. Heterogeneity testing showed significant heterogeneity within the included studies; hence, a forest plot with pooled estimates could not be constructed, and therefore a meta-regression was performed.

Results:

Seventeen full-text articles met inclusion and exclusion criteria. Ten of which were identified as low-risk studies. Five studies were included in final data pooling with total patients being 2239 and mean age of 31.9 years. (1) Linear regression demonstrated an association between ‘histological appendicitis’ and ‘AS 7–0’ with patients receiving intervention, with a significantPvalue of less than 0.005. (2) Meta-regression demonstrated a positive coefficient (0.298), a positiveZscore of 2.20 with a significantPvalue of 0.028 for patients with ‘high AS’ who received interventions that were significantly proven to be ‘histologically appendicitis’, indicating a cause-and-effect relationship.

Conclusion:

High AS (7 and above) is a significant predictor of acute appendicitis. The authors recommend further prospective randomized clinical trials to establish a cause-and-effect relationship.
Availability of Extragenital Chlamydia and Gonorrhea Testing in 6 High-Incidence States
Authors: Vu Kathy Linh , Patani Henna , Bhargava Anisha , Sukhija-Cohen Adam Carl
Published: March 2023

Background

Extragenital testing (rectal and oropharyngeal) of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) increases the detection of CT/NG infections, compared with genital testing alone. The Centers for Disease Control and Prevention recommends annual extragenital CT/NG screening for men who have sex with men, and additional screenings for women and transgender or gender-diverse individuals if certain sexual behaviors and exposures are reported.

Methods

Prospective computer-assisted telephonic interviews were conducted with 873 clinics between June 2022 and September 2022. The computer-assisted telephonic interview followed a semistructured questionnaire that included closed-ended questions on the availability and accessibility of CT/NG testing.

Results

Of the 873 clinics, CT/NG testing was offered in 751 clinics (86.0%), and extragenital testing was offered in only 432 clinics (57.5%). Most clinics (74.5%) with extragenital testing do not offer tests unless patients request them and/or report symptoms. Additional barriers to accessing information on available CT/NG testing include clinics not picking up the telephone, disconnecting the call, and unwillingness or inability to answer questions.

Conclusions

Despite evidence-based recommendations from the Centers for Disease Control and Prevention, the availability of extragenital CT/NG testing is moderate. Patients seeking extragenital testing may encounter barriers such as fulfilling specific criteria or being unable to access information on testing availability.
Effects of stimulation area and temperature rates on offset analgesia
Authors: Szikszay Tibor M. , Melz Nina , von Glasenapp Barbara , Adamczyk Wacław M. , Luedtke Kerstin
Published: March 2023

Introduction:

Offset analgesia describes the effect of a slightly reduced nociceptive stimulus, resulting in a disproportionate large reduction in the pain perception. This effect may be associated with descending pain inhibition, but parameters influencing this phenomenon are poorly understood.

Objectives:

In this study, 2 separate experiments were conducted to investigate both, the spatial aspects of offset analgesia and the influence of different rates of temperature rise.

Methods:

In both experiments, 29 healthy participants received individualized and heat-based offset analgesia paradigms applied to the forearm, with continuous assessment of pain intensity. In experiment 1, offset analgesia paradigms with 3 different rates of temperature rise were applied, whereas in experiment 2, offset analgesia paradigms with 2 different heat application areas were used.

Results:

The results of experiment 1 showed that different temperature rates had no effect on the offset analgesia response (P > 0.05). Experiment 2, however, showed the influence of the size of a stimulated area on offset analgesia (P = 0.009), which can be explained mainly by the influence of spatial summation of pain and habituation processes.

Conclusions:

The study showed a lack of influence of different temperature rates on offset analgesia; however, spatial aspects of offset analgesia could be identified. These are most likely based on spatial summation of pain and altered adaptation to pain.
Sensory processing sensitivity in adolescents reporting chronic pain: an exploratory study
Authors: Koechlin Helen , Donado Carolina , Locher Cosima , Kossowsky Joe , Lionetti Francesca , Pluess Michael
Published: March 2023

Introduction:

Sensory processing sensitivity (SPS) describes a genetically influenced trait characterized by greater depth of information processing, lower sensory threshold, and ease of overstimulation. It is hypothesized that SPS plays a crucial role in the context of chronic pain.

Objectives: This exploratory study examined SPS as a correlate of pain intensity and pain-related disability in a sample of adolescents reporting chronic pain.

Methods:

Adolescents reporting chronic pain were contacted through social media and through specialized pain clinics. Participants completed online questionnaires on their levels of SPS, pain features, emotion regulation, and quality of life. A series of analysis of variances (ANOVAs) were calculated to detect differences between 3 SPS groups (ie, high, medium, and low sensitivity) regarding emotion regulation, quality of life, and pain features. Multiple linear regressions were conducted to predict pain intensity, pain-related disability, and quality of life.

Results:

In total, 103 participants completed the survey (68.9% female, Mage 17.9). Back pain was the most frequently reported pain location. Proportion of highly sensitive individuals was large (45.68%). The ANOVA revealed significant differences between sensitivity groups related to quality-of-life subscales, namely, for physical (F(2, 100) = 7.42, P < 0.001), emotional (F(2, 100) = 6.11, P < 0.001), and school functioning (F(2, 100) = 3.75, P = 0.03). High sensitivity was not predictive of pain but of health-related quality of life.

Conclusions:

Our results indicate that SPS is an important and prevalent characteristic to consider in the context of chronic pain in adolescents, specifically regarding the quality of life.
’Treating the Saddlebag Deformity in Massive Weight Loss Patients: The Vertical Lower Body Lift versus the Lower Body Lift’’
Authors: Janssen Nicky , Geerards Daan , Berg Lisa van den , Van der Hulst René R. W. J. , Hoogbergen Maarten M.
Published: March 2023

The saddlebag deformity remains a persistent and difficult-to-treat problem following body contouring surgery (BCS). A new way to handle the saddlebag deformity is with the vertical lower body lift (VLBL) as described by Pascal [1]. This retrospective cohort study evaluated the overall reconstruction outcome of the VLBL in 16 patients, respectively 32 saddlebags, and compared it to standard LBL. The BODY-Q as well as the Pittsburgh Rating Scale (PRS)-saddlebag scale were used in the evaluation process.

The authors showed that surgical outcomes regarding the saddlebag deformity are in favor of the VLBL technique in patients with marked saddlebag deformity. A decrease of 1.16 in mean PRS-saddlebag score and relative change of 61.67% is observed for the VLBL group, while the LBL group shows only a mean decrease of 0.29 and relative change of 21.6%. BODY-Q endpoint and change in scores did not differ between the VLBL and LBL group at 3 months follow-up and were at one year follow-up in favor of the VLBL group in the body appraisal domain. Patients are greatly satisfied with the contour and appearance of their lateral thigh despite the extra scarring that had to be made by using this novel technique. Therefore, the authors advise clinicians to consider performing a VLBL instead of the standard LBL in massive weight loss patients with a notable saddlebag.
Are surgical drains needed in DIEP surgery? The drain-free DIEP concept
Authors: Evgeniou Evgenios , Liew Julian , Lee Geoffrey , Power Kieran , Khan Aadil , Cole DJ. , Tasoulis Marios , Nanidis Theodore
Published: March 2023

INTRODUCTION:

Studies support an inherent morbidity associated with the use of surgical drains, such as post-operative pain, infection, reduction in mobility and delay in patient discharge, whilst not preventing seroma or haematoma. Our series aims to evaluate the feasibility, benefits and safety of performing drainless DIEP surgery and to formulate an algorithm for when this can be employed.

MATERIALS-METHODS

Retrospective review of DIEP reconstruction outcomes of two surgeons. Over the course of 24 months, consecutive DIEP flap patients were included from the Royal Marsden Hospital in London and Austin Hospital in Melbourne and drain use, drain output, length of stay (LOS) and complications were analysed.

RESULTS

One hundred and seven DIEP reconstructions were performed by two surgeons. Thirty-five patients had abdominal drainless DIEPs and 12 patients had totally drainless DIEPs. Mean age was 52 years (Range: 34-73) with a mean BMI of 26.8 kg/m 2 (Range: 19.0-41.3 kg/m 2). Abdominal drainless patients showed a potential trend towards shorter hospital stays as compared to the ones with drains (mean LOS (3.74 vs 4.05 days; p=0.154). Totally drainless patients had an even shorter, statistically significant, mean LOS of 3.10 days, as compared to patients with drains 4.05 days (p=0.002), with no increase in complications.

CONCLUSIONS

The avoidance of abdominal drains in DIEPs reduces hospital stay without increasing complications and this has become our standard practice for patients with a BMI of less than 30. It is our opinion that the totally drainless DIEP procedure is safe in selected patients.

LEVEL OF EVIDENCE:

Therapeutic: IV Case series with post test only
The Underutilized Superomedial Pedicle Reduction Mammoplasty: Safe and Effective Outcomes
Authors: Morrison Kerry A. , Karp Nolan S , Choi Mihye
Published: March 2023

Background:

The superomedial pedicle for reduction mammoplasty remains less commonly performed than the inferior pedicle. This study seeks to delineate the complication profiles and outcomes for reduction mammoplasty using a superomedial pedicle technique in a large series.

Methods:

A retrospective review was conducted of all consecutively performed reduction mammoplasty cases at a single institution by two plastic surgeons over a two-year period. All consecutive superomedial pedicle reduction mammoplasty cases for benign symptomatic macromastia were included.

Results:

Four hundred sixty-two breasts were analyzed. Mean age was 38.3±13.38 years, mean BMI 28.5±4.95, and mean reduction weight 644.4±299.16 grams. Regarding surgical technique, a superomedial pedicle was used in all cases, and Wise pattern incision in 81.4% and short-scar incision in 18.6%. The mean sternal notch-to-nipple measurement was 31.2±4.54 cm. There was a 19.7% rate of any complication, the majority of which were minor in nature, including any wound healing complications treated with local wound care (7.5%) and scarring with intervention in the office (8.6%). There was no statistically significant difference in breast reduction complications and outcomes using the superomedial pedicle, regardless of sternal notch-to-nipple distance. BMI (p=0.029) and breast reduction specimen operative weight (p=0.004) were the only significant risk factors for a surgical complication, and with each additional gram of reduction weight, the odds of a surgical complication increased by 1.001. Mean follow up time was 40.5±7.1 months.

Conclusion:

The superomedial pedicle is an excellent option for reduction mammoplasty, portending a favorable complication profile and long-term outcomes.
Acquiring Bifidobacteria species from formula-fed and breast-fed newborns, identifying, quantifying, and creating an antibiogram.
Authors: kammara Rajagopal , Nellikka Anagha
Published: March 2023

After examining the Bifidobacterium spp. population in faeces samples from breastfed and formula-fed infants, an antibiogram was created. The prevalence of Bifidobacterium spp. in faeces was determined using common bacterial growth media, including Man Rogos Sharpe (MRS), Brain Heart Infusion (BHI), Luria Bertani (LB) broth, and Bifidobacteria agar. According to the findings, infants who are breastfed have a high population of Bifidobacterium spp. in their faeces, whereas newborns who are fed formula have a low population. Through using phylogenetic analysis of the 16S rRNA, (Xylose/Fructose-6-phosphate phosphoketolase) xfp, and RFLP mapping of Bifidobacterium isolates, it was possible to identify new and unique Bifidobacterium species. The intensity of the reddish brown colour produced during the F6PPK (Fructose-6-phosphate phosphoketolase) assay is an accurate indicator of the proportion of various Bifidobacteria present. Bifidobacteria agar media produced the greatest amounts of Bifidobacteria diversity and recovery. Small (SCV) and large colony variations (BCV) were formed during growth on different mediums. We are aware that the varied antibiotic minimum inhibitory concentration (MIC) values can change depending on the use of different media, growth circumstances, bile salt treatment, and low pH. The findings of this study demonstrate that test conditions also impact the diversity of microbiological conditions that distinguish between resistant and susceptible bacteria.