bluuebunny/crossref_metadata_2025 huggingface dataset:
Development and Evaluation of a Data-driven, Interactive Workshop to Facilitate Communication and Teamwork in Ambulatory Medical Oncology Settings
Authors: Blok Amanda C. , Costa Deena Kelly , Wright Nathan C. , Manojlovich Milisa , Friese Christopher R.
Published: June 2023

Background:

While adverse events and toxicities related to cancer drug therapy in the ambulatory oncology setting are common and often rooted in communication challenges, few studies have examined the problems of communication or tested tools to improve communication in this unique, high-risk setting.

Objective:

To determine the feasibility and acceptability of a virtual interdisciplinary communication workshop designed to strengthen communication across ambulatory oncology team members.

Methods:

Surveys of patients and clinicians in 1 ambulatory oncology clinic were analyzed and informed the communication intervention: an interdisciplinary virtual workshop. Workshop evaluation included an implementation survey measure and a structured debrief with workshop attendees.

Results:

In total 87 patients and 56 clinicians participated in preworkshop surveys that revealed patient satisfaction with timely care and information, yet a range of rating communication experiences with the clinical team, and clinicians perceiving a high amount of organizational safety, yet rated discussion of alternatives to normal work processes low. Survey results guided reflection and discussion within the workshop. Six clinicians participated in the interactive workshop. Feasibility and acceptability of the virtual workshop were supported by formative and summative data, along with suggestions for improvement.

Conclusions:

The patient and clinician surveys coupled with an interactive virtual workshop were feasible and acceptable.

Implications for Practice:

The workshop identified opportunities for the individual- and system-level improvements in clinical team communication. This promising strategy requires replication in larger, diverse practice samples.

Foundational:

Clinicians accepted an interactive workshop that incorporated clinic-specific data and communication strategies. The program is feasible and acceptable in ambulatory oncology settings.
Eight rules for the haemodynamic management of traumatic brain-injured patients
Authors: Di Filippo Simone , Messina Antonio , Pelosi Paolo , Robba Chiara
Published: June 2023

Traumatic brain injury (TBI), a leading cause of death and poor neurological outcomes in trauma patients, is a primary cause of severe disability among survivors and a major public health burden globally. Optimal haemodynamic management is a keystone of care in avoiding secondary brain injury, and contributes to minimising mortality and morbidity. Although some important progress has been achieved, a paucity of high-quality recommendations still exists. The purpose of this article is to review the current knowledge on TBI-associated haemodynamic tenets, in order to summarise the most important aspects of this heterogeneous and complex field.
A consensus statement on the meaning, value and utility of training programme outcomes, with specific reference to anaesthesiology
Authors: Shorten George , Bahrey Lisa , Bardia Amit , De Hert Stefan , Guasch Emilia , Holmboe Eric , McCormack Martin , O’Brien Brian , Power Camillus , Rock Bernadette , Sabelnikovs Olegs
Published: June 2023

It is timely and necessary to consider what Postgraduate Medical Training Programme outcomes are, how they are defined and revised over time, and how they can be used to align health professional performance with the healthcare needs of society. This article which addresses those issues, with specific reference to training in anaesthesiology, was prepared using a modified nominal group (or expert panel) approach.
Clinical Relevance of High Plasma Trough Levels of the Kinase Inhibitors Crizotinib, Alectinib, Osimertinib, Dabrafenib, and Trametinib in NSCLC Patients
Authors: Lin Lishi , Barkman Hannerieke J. , Smit Egbert F. , de Langen Adrianus J. , Steeghs Neeltje , Beijnen Jos H. , Huitema Alwin D. R.
Published: June 2023

Background:

the study aims to evaluate whether high plasma trough levels of the kinase inhibitors (K.I.s) crizotinib, alectinib, osimertinib, dabrafenib, and trametinib were associated with a higher risk of toxicity in non–small-cell lung cancer patients.

Methods:

In this retrospective cohort study, patients with non–small-cell lung cancer treated with the selected K.I.s were included if at least one plasma trough level at steady state (Cmin,ss) was available. Data were extracted from electronic medical records and laboratory databases. The high group for each K.I. was defined as 10% of patients with the highest first Cmin,ss. The remaining patients were placed in the non-high group. The frequency of dose-limiting toxicities (DLTs), defined as adverse events leading to dose reduction, dose interruption, or permanent discontinuation, was compared between the 2 groups.

Results:

A total of 542 patients were included in the different K.I. groups. A high Cmin,ss of crizotinib (n = 96), alectinib (n = 105), osimertinib (n = 227), dabrafenib (n = 52), and trametinib (n = 62) correlated with a Cmin,ss ≥490, ≥870, ≥405, ≥150, and ≥25 ng/mL, respectively. DLTs were more common in the alectinib high group than in the alectinib non-high group (64% vs. 29%, P = 0.036). Liver toxicity was observed in 4 (36%) patients in the high group and 5 (5%) patients in the non-high group (P = 0.007). For other K.I.s, no significant differences were observed in the frequency of DLTs between the high and non-high groups.

Conclusions:

For alectinib, high Cmin,ss was correlated with a higher risk of DLT. No differences in the frequency of DLTs were observed between the high and non-high groups for crizotinib, osimertinib, dabrafenib, and trametinib.
Effect of I-125 Seed Implantation on Lung Cancer and Its Environmental Impact
Authors: Lin Chunlong , Yang Zhi , Liu Qi
Published: June 2023

This paper compares the efficacy and adverse effects of iodine-125 (125I) seed implantation and external beam radiotherapy (EBRT) in the treatment of lung cancer as well as impact of the 125I radiation on the environment around the patients. A total of 40 patients who were admitted with lung cancer to our hospital from October 2017 to October 2018 were enrolled into this study. The patients were randomly assigned into study groups treated with 125I seed implantation (20 patients) and a control group treated with EBRT (20 patients). The patients were followed up for 6 mo by CT scanning of the tumor size as well as measuring serum carcinoembryonic antigen (CEA), cytokeratin fragment (CYRA21-1), and neurospecific enolase (NSE) levels. The dose rate of 125I at various distances and times after implantation was also measured. The local tumor control rate was higher in the study group than in the control group. CEA, NSE and CYFRA21-1 significantly decreased from the pre-treatment baseline in both groups (p < 0.05). Side effects of pneumothorax, hemoptysis, chest pain, and leukopenia occurred in the patients treated with 125I seed implantation. Radiation of the 125I isotope, which was correlated with the number of implanted 125I seeds, decreased rapidly in a time- and distance-dependent manner. A lead apron could significantly block radiation of 125I. Compared to EBRT, brachytherapy with 125I seed implantation in the lung cancer had a better therapeutic outcome with fewer complications. A lead apron could protect members of patient’s family as well as public from 125I radiation.
Clinical and Epidemiologic Characteristics of Infants Hospitalized with Respiratory Syncytial Virus Infection During the 2022–2023 Season in Mexico
Authors: Esparza-Miranda Luis A. , Juárez-Tobías Susana , Muñoz-Escalante Juan C. , Oliva-Jara Ulrik A. , Cadena-Mota Sandra , Wong-Chew Rosa M. , Noyola Daniel E.
Published: June 2023

In 2022, several countries reported an increase in respiratory syncytial virus (RSV) infections. We assessed the clinical characteristics and outcomes of infants hospitalized with RSV and compared them with infants hospitalized between 2009 and 2015. No significant differences in underlying disorders, intensive care unit admission rates and mortality were observed suggesting currently circulating RSV strains do not show heightened virulence.
Clinical Characteristics and Outcomes of Long COVID-19 Hospitalized Children in Vietnam
Authors: Huynh Dieu Hien Thi , Nguyen Thu Suong Thi , Nguyen Bao An Huynh , Nguyen Quoc Tung , Duong Vinh An Thi , Lam Anh Ngoc Thi , Le Ton Bao , Le Thanh Nhan Nguyen , Tran Anh Tuan , Tran Huy Dung , Vo Giau Van , Nguyen Minh Nam
Published: June 2023

A cross-sectional study was conducted on 205 pediatric patients, including 150 post-COVID-19 patients and 55 noninfected patients. The study identified 10 common respiratory symptoms in post-COVID-19 patients, with significant differences in clinical symptoms between the 2 groups. Post-COVID-19 pediatric patients had a lower lymphocyte count and a higher rate of pneumonia diagnosis, which can persist for up to 16 weeks after discharge. The study’s findings can help monitor and manage the clinical burden of post-COVID-19 symptoms in the pediatric population.
The Role of Healthcare Technology Management Professionals in Adverse Event Reporting
Authors: Silva Ferreira Antonio , Waheed Saphia
Published: June 2023

Healthcare technology management professionals play a key role in the medical device environment. By sharing their insights and expertise on medical devices issues with the US Food and Drug Administration, healthcare technology management professionals help the agency resolve medical device safety concerns and help improve patient safety. This article presents two real-world case study examples in which medical device reports containing critical healthcare technology management input were submitted to the US Food and Drug Administration's MedSun (Medical Product Safety Network) reporting program and helped contribute to 2 recalls. The details in the reports, provided by the hospital reporting team, offer a unique perspective for identifying the device concern and greatly contribute to the investigation and resolution of the reported device safety issue.
Medical Equipment Maintenance Management System
Authors: Khider Mohamed Omer , Hamza Alnazier Osman
Published: June 2023

Maintenance management is an orderly and systematic approach for planning, organizing, monitoring, and evaluating maintenance activities and their costs. A good maintenance management system coupled with knowledgeable and capable maintenance staff can prevent health and safety problems and environmental damage; yield longer asset life with fewer breakdowns, and result in lower operating costs and a higher quality of life. The medical equipment maintenance could be either preventive or corrective. The medical equipment management professionals ensure that equipment used in the patients care is operational, safe, and properly configured to meet the mission of the medical treatment facility and continue to function effectively in a good working condition. For example, proper maintenance can extend the life of equipment. This is essential for providing good health services and saving the scarce resources. A comprehensive review on the subject of medical devices maintenance management system has been done to give an overview of the development of this system in the hospitals and to shine what could be enhanced and improved in this system to promote the patient's healthcare.
Association Between Selective Serotonin Reuptake Inhibitors Prevalent Use and COVID-19–Related Mortality
Authors: Osores Pablo Ignacio , Vivacqua María Noelia , Vazquez Carolina , Marciano Sebastián , Giunta Diego Hernán , Faccioli José Luis
Published: June 2023

Purpose/Background

Since the emergence of the coronavirus disease 2019 (COVID-19), many efforts have been made to prevent and to treat the disease. In this line, the anti-inflammatory effect of selective serotonin reuptake inhibitors (SSRI) as alternatives for treating chronic inflammatory diseases has been studied. There is previous evidence of the usefulness of these drugs for reducing COVID-19 impact.

Methods/Procedures

We conducted a retrospective single-center cohort study of adult patients with a positive reverse transcriptase-polymerase chain reaction for COVID-19, evaluating the association between SSRI use and in-hospital mortality.

Findings/Results

Of 1689 included patients, 182 (10.8%) were exposed to SSRI. A total of 291 patients died during the hospitalization, representing an in-hospital mortality of 17.2% (95% confidence interval [CI], 15.4%–19.0%): 44 (24.2%) of the exposed to SSRIs versus 247 (16.4%) of those not exposed to SSRIs (crude odds ratio [OR], 1.62; 95% CI, 1.12–2.34; P = 0.009). No independent effect of SSRIs on in-hospital mortality was found when applying either the inverse probability of treatment weighting (OR, 1.15; 95% CI, 0.71–1.89; P = 0.56) or with conventional multivariable analysis 0.81 (95 % CI: 0.28–2.31, P = 0.69).

Implications/Conclusions

In the present retrospective study of patients hospitalized for COVID-19, prior use of SSRIs did not reduce mortality.
An unrecognized undifferentiated tumor of the pancreas: a case report
Authors: Pang Chaoyu , Fan Zhiyao , Su Peng , Zhan Hanxiang
Published: June 2023

SMARCA4-deficient tumors are gaining attention, and this type of tumor is highly malignant with a poor prognosis. The frequency of SMARCA4 deletion varies in different tumors. However, it has never been identified in the pancreas. A 67-year-old woman presented with upper abdominal pain lasting for half a month. Computed tomography indicated a space-occupying lesion in the head of the pancreas, considered a malignant tumor. Further Endoscopic ultrasound fine-needle aspiration was performed and reported as SMARCA4-deficient undifferentiated pancreatic tumor. The patient received no treatment and survived only two and a half months from diagnosis to death. We are the first to report SMARCA4-deficient pancreatic undifferentiated tumor in which this new tumor entity presents with poorer overall survival. We also summarized the advances of SMARCA4 in oncology and treatment.
Prognostic impact of fluorescent lymphography on gastric cancer
Authors: Park Sung Hyun , Kim Ki-Yoon , Cho Minah , Kim Yoo Min , Kim Hyoung-Il , Hyung Woo Jin
Published: June 2023

Background:

Fluorescent lymphography-guided lymphadenectomy for gastric cancer is gaining popularity. However, its impact on prognosis is not known. This study aimed to assess the prognostic impact of fluorescent lymphography-guided lymphadenectomy in gastric cancer patients.

Materials and Methods:

This study retrospectively analyzed 5,678 gastric cancer patients who underwent gastrectomy from 2013 to 2017. The survival was compared between the fluorescent lymphography-guided lymphadenectomy (FL group) and the conventional lymphadenectomy (non-FL group) using 1:1 propensity score matching after exclusion. Patients in the FL group underwent gastrectomy with systematic lymphadenectomy after endoscopic peritumoral injection of indocyanine green the day before surgery.

Results:

After propensity score matching, the FL and non-FL groups each had 1064 patients with similar demographic and clinicopathological characteristics. All matched variables had a standardized mean difference under 0.1. The FL group showed a significantly higher number of retrieved lymph nodes (56.2±20.1) than the non-FL group (46.2±18.2, P<0.001). The FL group also had more stage III patients (P=0.044) than the non-FL group. The FL group demonstrated higher overall survival (P=0.038) and relapse-free survival (P=0.036) in stage III compared to the non-FL group. However, no significant differences in overall and relapse-free survival were observed between the two groups for stages I (P=0.420 and P=0.120, respectively) and II (P=0.200 and P=0.280, respectively).

Conclusion:

Fluorescent lymphography-guided lymphadenectomy demonstrated a higher survival in stage III gastric cancer patients by the more accurate staging resulting from larger lymph node retrieval. Thus, given its potential to improve prognostication by enhancing staging accuracy, it is recommended as an option to consider the use of fluorescent lymphography-guided lymphadenectomy in clinical practice.
Changes in pain scores and walking distance after transforaminal epidural steroid injection in patients with lumbar foraminal spinal stenosis
Authors: Kim Minsoo , Bak Jiwon , Goh Daehun , Bae Jangho , Shin Kiyoung , Son Hee-Jeong , Huh Jin , Kang Seong-Sik , Hwang Byeongmun
Published: June 2023

Transforaminal epidural steroid injections (TFESI) are widely used in patients with lumbar foraminal spinal stenosis. Previous studies have evaluated the effects of TFESI on lumbar foraminal spinal stenosis using only pain scores. However, no study has evaluated the effect of TFESI on pain scores and walking distance in patients with lumbar foraminal spinal stenosis. This study aimed to assess the effect of TFESI on pain scores and walking distance in patients with lumbar foraminal spinal stenosis stratified according to disease severity. This retrospective study reviewed the medical records of patients who received TFESI for lumbar foraminal spinal stenosis. A total of 128 patients were divided into the moderate and severe groups based on the extent of fat obliteration and the presence of nerve root compression. A significant decrease in the numeric rating scale (NRS) scores was observed in the moderate and severe groups compared with the corresponding baseline values 4 weeks after TFESI; however, the NRS pain scores were lower in the moderate group than those in the severe group. In addition, the proportion of patients who experienced pain reduction (≥50%) was higher in the moderate group than that in the severe group. The moderate and severe groups showed a significant increase in walking distance compared with the baseline values 4 weeks after the treatment. However, the walking distance values did not differ significantly between the moderate and severe groups. Furthermore, the degree of satisfaction was higher in the moderate group than that in the severe group. Lumbar TFESI may reduce pain scores and increase walking distance in patients with moderate or severe lumbar foraminal spinal stenosis. Patients with moderate foraminal stenosis had better pain relief outcomes than those with severe foraminal stenosis.
A malignant proliferating trichilemmal cyst arising on the elbow of a man: A case report and review of the literature
Authors: Lee Dong Yun , Han Kang Min , Yoon Jung Soo
Published: June 2023

Introduction:

Trichilemmal cysts (TCs) are common benign cysts that form from the hair follicles in the skin. Proliferating trichilemmal cysts (PTCs) are rare types of TCs characterized by rapid cellular proliferation. Malignant transformation of PTC (MPTC) is a rare adnexal tumor that account for <0.1% of all skin cancers. TCs and PTCs are benign tumors; however, MPTCs grow rapidly and are prone to metastasis.

Case presentation:

A 77-year-old man was referred to our hospital with a solitary pinkish mass on his left elbow. Trichilemmal carcinoma arising from a PTC was confirmed through excisional biopsy, and wide excision was performed. One month postoperatively, a cystic mass was observed and was suspected to have local recurrence; however, bursitis was confirmed after excisional biopsy. After 1 year of follow-up, the patient maintained an improvement without recurrence or any other surgical complications.

Conclusions:

In addition to being a very rare disease, MTPC occurred in the elbow of a man who does not fit the general etiology; therefore, it is considered an interesting case, and we report this case for academic contribution.
Effect of combination of prophylactic or therapeutic anticoagulation with aspirin on the outcomes of hospitalized COVID-19 patients: An observational retrospective study
Authors: Mina Jonathan , Fleifel Mohamad , Haykal Tony , Dimassi Hani , Nasr Janane , Harb Ranime , Mahdi Ahmad , El Hout Ghida , Franjieh Elissar , Mokhbat Jacques , Farra Anna , Husni Rola
Published: June 2023

Regimens for managing thromboembolic complications of COVID-19 are still not very well established. The present study compares the clinical characteristics and outcomes of patients hospitalized with COVID-19 receiving different anticoagulation regimens with and without aspirin. This is a retrospective observational study of 491 patients hospitalized for COVID-19 from August 2020 to April 2021. Data regarding clinical characteristics, laboratory findings, and outcomes of patients receiving different anticoagulation with and without aspirin regimens was collected, according to which 5 patient groups were defined: received no anticoagulation (NAA), prophylactic anticoagulation with (PA) or without aspirin (PAA) and therapeutic anticoagulation with (TA) or without aspirin (TAA). The average age was highest in the TAA group. Desaturation was highest in the TA and TAA groups. Diabetes, hypertension, dyslipidemia and coronary artery disease were the most prevalent in aspirin groups (PAA and TAA) as was heart failure in the TA and TAA groups and cancer in the TA and PAA groups. Elevated troponin was observed in the PAA and TAA groups. TA and TAA patients received oxygen therapy, needed ICU admission overall, and required invasive ventilation and vasopressors the most. Prophylactic anticoagulation groups (PA and PAA) had the highest patient survival rates. Patients with severe COVID-19 infections were more likely to receive higher, therapeutic, anticoagulation doses. Aspirin was given to patients with preexisting comorbidities, but it had no statistically significant impact on the outcomes of the different groups. Groups receiving prophylactic anticoagulation had the best survival outcomes.
Diagnostic accuracy of high sensitivity troponin and association of electrocardiogram findings for mortality in syncope patients: A retrospective cohort study
Authors: Tatliparmak Ali Cankut , Yilmaz Sarper
Published: June 2023

High-sensitivity cardiac troponin-T (hs-cTnT) and electrocardiogram (ECG) are commonly ordered in daily practice in emergency medicine but their value on long term mortality in syncope patients is unclear. Our aim is to determine the diagnostic accuracy of hs-cTnT and association of ECG findings for 1-year mortality in patients presenting with syncope. In this retrospective cohort study, we included patients presenting with syncope to the emergency department (ED) between May 2020 and May 2021. Patient demographics, vital parameters on admission, ECG findings, hs-cTnT level at admission and 1-year mortality status were recorded. The study included 417 patients (62.4% women) with a mean age of 41.51 (standard deviation [SD] 17.1), 21 of whom were deceased within 1 year after syncope attack (5%). Patients with an abnormal QTc, T-Axis or frontal QRS-T angle had significantly higher 1-year mortality (OR: 9.26, 95% CI: 1.64–52.31; OR: 5.82, 95% CI: 1.69–20.1; 4.94, 95% CI: 1.45–16.84, respectively). The hs-cTnT level was 21.92 pg/mL (95% CI: 3.35–40.51 pg/mL) higher in the mortality group (P = .023). An abnormal QTc, T-Axis and frontal QRS-T angle are associated with a higher 1-year mortality rate and hs-cTnT has good diagnostic accuracy in detecting 1-year mortality for patients presenting with syncope.
Impact of spinal injury on mortality in patients with major trauma: A propensity-matched cohort study
Authors: Lee Han-Dong , Jung KyoungWon , Kang ByungHee , Chung Nam-Su , Jeon Chang-Hoon , Chung Hee-Woong
Published: June 2023

Major trauma is defined as a significant injury or injury that has the potential to be life-threatening and is quantitatively identified as an injury severity score (ISS) >15. Spinal injuries are common in patients with major trauma; however, because spinal injury is not independently included in the ISS calculation, the impact of spinal injury on mortality in patients with major trauma has not been fully elucidated. The purpose of this study is to identify the association between spinal injury and mortality in patients with major trauma. From January 1, 2016, to December 31, 2020, retrospective analysis was conducted on 2893 major trauma adult patients admitted to a level 1 trauma center. There were 781 patients in the spinal injury group and 2112 patients in the group without spinal injury. After matching the 2 groups 1:1, we compared injury mechanism, mortality, cause of death, intensive care unit length of stay (ICU LOS), and duration of ventilator use between spinal injury group and matched cohorts. Falls and traffic accidents were the most common injury mechanisms in the spinal injury group and the matched cohort, respectively. The mortality was significantly lower in the spinal injury group compared with the matched cohort (4.0% vs 7.9%, P = .001), and the ICU LOS was longer than the matched cohort (8.8 ± 17.4 days vs 7.2 ± 11.7 days, P = .028). In the spinal injury group, multiple organ failure (MOF) was the most common cause of death (41.9%), while that in the matched cohort was central nervous system (CNS) damage (61.3%). In patients with major trauma, spinal injury may act as a shock absorber for internal organs, which is thought to lower the mortality rate.
Meta-analysis of the effect of entropy-assisted general anesthesia on the quality of postoperative recovery
Authors: He Bingyuan , Zhang Na , Peng Mingqing
Published: June 2023

Background:

To evaluate the effect of the quality of postoperative anesthetic resuscitation in patients with entropy index monitoring assisted general anesthesia versus standard clinical practice.

Methods:

The randomized controlled trials on the application of entropy index monitoring in general anesthesia were searched in PubMed, Web of Science, Embase, The Cochrane Library, CNKI, Wanfang, VIP, and other databases by computer. The data were collected from inception to January 2022. Two researchers independently screened the retrieved literature according to the inclusion and exclusion criteria and used Cochrane’s risk-of-bias assessment criteria to evaluate the quality of the literature. The evaluation indicators included respiratory recovery time, extubation time, consciousness recovery time, emergence agitation, postoperative nausea and vomiting (PONV), and intraoperative awareness. The RevMan 5.4.1 software was used for the meta-analysis of the data.

Results:

A total of 860 patients from 10 eligible randomized controlled trials were included in this study. The results showed that compared with the control group, the respiratory recovery time (MD = −3.37, 95% CI: −5.09 to −1.85, P < .0001), extubation time (MD = −4.57, 95% CI: −6.08 to −3.95, P < .00001), and consciousness recovery time (MD = −4.95, 95% CI: −7.21 to −2.70, P < .00001) in the entropy index group were significantly shortened. The incidence of emergence agitation in the entropy index group (RR = 0.23, 95% CI: 0.11–0.47, P < .0001) decreased significantly. The incidence of PONV (RR = 0.46, 95% CI: 0.27–0.79, P = .004) was significantly reduced. However, the incidence of intraoperative awareness (RR = 0.33, 95% CI: 0.04–3.16, P = .34) wasn’t significantly different.

Conclusion:

The application of the entropy index can improve the recovery quality of patients under general anesthesia, not only shortening the postoperative recovery time but also reducing the occurrence of agitation and PONV. It does not affect the incidence of intraoperative awareness.
Hyalinising clear cell carcinoma of the lung: A case report and review of literature
Authors: Chen Liqiao , Zhou Ning , Hu Shuya , Wang Fanrong , Xu Tingting , Li Tao , Fu Yangyan , Luo Yiman , Chen Ying
Published: June 2023

Background:

Hyalinising clear cell carcinoma (HCCC) of the lung is a rare tumor, with only 12 reported cases. To improve the differential diagnosis, the aim of this study was to clarify the clinicopathological characteristics, immunophenotype, and molecular characteristics of HCCC of the lung and relate these to prognosis.

Methods:

Sections of HCCC of the lung were collected from a patient for pathological observation, immunohistochemistry, histochemistry, and fluorescence in situ hybridization; the clinical, pathological, and molecular characteristics were compared with those reported in the literature.

Results:

The tumor had a well-demarcated border nodule with a maximal diameter of 2.5 cm. Microscopic findings showed either clear or eosinophilic cytoplasm in the tumor cells. Growth was predominantly in the sheets, nests, and trabeculae in a background of hyalinised, fibrotic stroma, and mucus degeneration. Immunohistochemistry showed that the tumor cells expressed cytokeratin 7, P63, P40, CK5/6, Pan Cytokeratin (PCK), and epithelial membrane antigen, whereas they were negative for thyroid transcription factor-1, napsin A, CD10, vimentin, and smooth muscle actin. The Ki67 proliferation index was 5%. The tumor was positive for both period acid–Schiff (PAS) and Alcian blue–PAS, with a small amount of mucus staining positive for PAS–diastase. Fluorescence in situ hybridization revealed Ewing sarcoma breakpoint region 1 rearrangement and Ewing sarcoma breakpoint region 1-activating transcription factor 1 fusion.

Conclusions:

HCCC is a low-grade carcinoma with excellent prognosis. Tumour necrosis may be a potential risk factor for recurrence and metastasis. Our review of reported cases suggests that regional lymph node dissection combined with lobectomy is a safer treatment than only lobectomy for HCCC of the lung.
Successful percutaneous cannulation of foramen ovale obstructed by completely ossified pterygoalar ligament using the Hartel approach: Two case reports
Authors: Shang Qingqing , Lin Feng , Mu Qingchao , Tan Shuying , Wang Hongyan , Gao Yong
Published: June 2023

Rationale:

Ossification of the pterygoalar ligament, which lies inferolateral to the exocranial opening of the foramen ovale, is traditionally considered to be a bony bar that could obstruct percutaneous needle access to the foramen ovale using the Hartel approach. We herein present two case reports of successfully penetrating the foramen ovale by a needle across the pterygoalar bar. Lack of knowledge of this type of presentation might lead to a change in the surgical approach.

Patient concerns:

A 27-year-old woman had an 11-year history of facial pain because of a space-occupying lesion in the left cerebellopontine angle. Neither open surgery nor drug therapy resolved her facial pain. Another 67-year-old woman developed episodic facial pain because of herpes zoster infection 20 days earlier, and she could not achieve pain relief from drug therapy.

Diagnoses:

Both patients were diagnosed with secondary trigeminal neuralgia.

Interventions:

The patients underwent radiofrequency thermocoagulation of the semilunar ganglion via the foramen ovale.

Outcomes:

The three-dimensional computed tomography scan showed that the ipsilateral foramen ovale was obstructed by the pterygoalar bar. However, percutaneous needle cannulation of the foramen ovale was successful using the anterior approach. The facial pain was immediately and completely resolved without complications except for facial numbness.

Lessons:

During percutaneous radiofrequency thermocoagulation for the treatment of trigeminal neuralgia, the Hartel approach can still be used when the foramen ovale is blocked by a pterygoalar bar. To our knowledge, this is the first report of such a treatment. Moreover, we herein provide specific technical recommendations to assist surgeons who may encounter such cases in the future.
Unpredictable refeeding syndrome with severe hypophosphatemia in borderline personality disorder comorbidity: A case report
Authors: Hamada Kazumasa , Sagiyama Kenichiro , Nishi Ryusei , Fukumoto Takamasa , Kato Ryuichi , Fuku Yuuki , Amitani Haruka , Asakawa Akihiro
Published: June 2023

Rationale:

Refeeding syndrome (RS) is a fatal condition caused by rapid calorie intake during starvation. Self-neglected fasting in psychiatric disorders is associated with RS. However, overeating resulting from circumventing the clinician’s instructions does not have a reportedly high risk of RS.

Patient concerns:

A 47-year-old undernourished woman with borderline personality disorder was hospitalized for nausea, vomiting, and diarrhea.

Clinical findings:

She had not eaten much for 10 days and had lost weight (56.5–51.1 kg) over 3 weeks. No abnormalities were indicated on physical examination and imaging examinations.

Diagnoses, interventions, and outcomes:

Infectious diseases and malignancies were excluded from the differential diagnosis. On the third day of admission, the patient’s serum phosphorus level significantly decreased to 0.7 mg/dL, and additional sodium phosphate was administered intravenously. On the fourth day, despite our instructions, the patient was found to be eating nonhospital food from the first day of admission. In conjunction with her history, a final diagnosis of RS was made. After appropriate treatments, the patient was discharged on the 15th day of hospitalization. The patient’s nausea, vomiting, and diarrhea were improved.

Lessons:

When undernourished patients have psychiatric disorders, including borderline personality disorder or schizophrenia, the occurrence of RS should be considered based on the patients’ poor adherence to physicians’ instructions.
Systematic review and meta-analysis of completely retroperitoneoscopic nephroureterectomy versus traditional retroperitoneoscopic nephroureterectomy in upper tract urothelial carcinoma
Authors: Zhao Yan , Lu Ke , Yin Zhi-Xiang , Peng Yu-Hao , Pei Chang-Song
Published: June 2023

Background:

This systematic review and meta-analysis aim to evaluate the efficacy and safety of completely retroperitoneoscopic nephroureterectomy (CRNU) for the treatment of upper urinary tract urothelial carcinoma (UTUC).

Methods:

A systematic review of PubMed and Web of Science databases was conducted to identify trials comparing the outcomes of CRNU and other surgical procedures. A total of 6 case-control studies were selected for analysis. The efficacy and safety of CRNU were evaluated using mean difference or hazard ratio (HR) with 95% CIs, employing continuous or dichotomous method with a random or fixed-effect model. Meta-analysis was performed using STATA 11.0 software.

Results:

The meta-analysis indicated that CRNU in subjects with UTUC was significantly associated with a shorter operation time (standardized mean difference, −1.36; 95% CI, −1.61 to −1.11, P < .001) and lower blood loss (standardized mean difference, −0.54; 95% CI, −0.77 to −0.31, P < .001) when compared to traditionally retroperitoneoscopic nephroureterectomy (TRNU). No significant difference was observed in the occurrence of grade I & II complications (HR, 1.04; 95% CI, 0.49–2.2, P = .915) and total complications (HR, 0.69; 95% CI, 0.38–1.27, P = .238) between CRNU and TRNU.

Conclusion:

The findings suggest that CRNU is an advanced surgical technique that is safe and effective for the treatment of UTUC. We recommend that CRNU be further employed for patients with UTUC. Further randomized, multicenter trials are needed to validate these results, given the limitations of this study.
The role of 3-dimensional preoperative planning for primary total hip arthroplasty based on artificial intelligence technology to different surgeons: A retrospective cohort study
Authors: Zhang Bingshi , Li Wenao , Li Mengnan , Ding Xuzhuang , Huo Jia , Wu Tao , Han Yongtai
Published: June 2023

Preoperative planning with computed tomography (CT)-based 3-dimensiona (3D) templating has been achieved precise placement of hip components. This study investigated the role of the software (3-dimensional preoperative planning for primary total hip arthroplasty [THA] based on artificial intelligence technology, artificial intelligence hip [AIHIP]) for surgeons with different experience levels in primary THA. In this retrospective cohort study, we included patients, who had undergone THA with the help of the AIHIP, and matched to patients, who had undergone THA without the help of the AIHIP, by age and the doctor who operated on them. The subjects were divided into 4 groups, senior surgeon (Chief of Surgery) with AIHIP group, senior surgeon without AIHIP group, junior surgeon (Associate Chief of Surgery) with AIHIP group and junior surgeon without AIHIP group. The general data, imaging index, clinical outcomes and accuracy of stem size prediction and cup size prediction were retrospectively documented for all patients. There was a significant difference in discrepancy in leg length (P = .010), neck-shaft angle (P = .025) and femoral offset (P = .031) between the healthy side and the affected side, operation duration (P < .001), decrease in hemoglobin (Hb) per 24 hours (P = .046), intraoperative radiation exposure frequency (P < .050) and postoperative complications (overall P = .035) among the patients in junior surgeon group. No significant differences were found between senior surgeon groups with respect to discrepancy in leg length (P = .793), neck-shaft angle (P = .088)and femoral offset (P = .946) between the healthy side and the affected side, operation duration (P = .085), decrease in Hb per 24 hours (P = .952), intraoperative radiation exposure frequency (P = .094) and postoperative complications (overall P = .378). The stem sizes of 95% were accurately estimated to be within 1 stem size, and 97% of the cup size estimates were accurate to within 1 cup size in senior surgeon group with AIHIP. A total of 87% stem sizes were accurately estimated to be within 1 stem size, and 85% cup sizes were accurate to within 1 cup size in junior surgeon group with AIHIP. In conclusion, our study suggests that an AI-based preoperative 3D planning system for THA is a valuable adjunctive tool for junior doctor and should routinely be performed preoperatively.
Absolute monocyte count has a diagnostic role in distinguishing tumor marker-negative TGCT from benign testicular tumor via CCL2 regulation
Authors: Cao Li , Chang Qinzheng , Sun Jiajia , Pang Shuo , Fan Yidong , Liu Jikai
Published: June 2023

Clinically, for testicular tumor patients with negative tumor markers, how to distinguish the malignant from the benign is a difficult problem. This study aimed to assess the clinical significance of the absolute monocyte count (AMC) in differential diagnosis of testicular germ cell tumor with stage S0 (TGCTS0) and benign testicular tumor. In this retrospective single-center study, a total of 90 patients newly diagnosed with benign testicular tumor or TGCTS0 were reviewed. All patients received surgical intervention as the primary treatment method. AMC and other clinicopathological parameters were analyzed. Receiver operating characteristic (ROC) curves were constructed to assess the diagnostic power of investigated parameters, and to determine the optimal cutoff values. Kaplan–Meier curve analysis was used to study the survival of patients with TGCTS0. qRT-PCR and immunohistochemistry (IHC) were performed to examine the expression of C-C motif chemokine ligand 2 (CCL2) mRNA and protein respectively. Differential gene expression and functional enrichment analysis were performed using Gene Expression Omnibus and the Cancer Genome Atlas databases. The mean preoperative AMC in patients with TGCTS0 was significantly higher than that in patients with benign testicular tumor (P = .020). AMC > 0.485*10^9/L was identified to be associated with the presence of TGCTS0 (hazard ratio [HR] = 3.074, P = .026), and patients with higher AMC level had worse progression free survival (PFS) (P = .047). Furthermore, AMC combined with lactate dehydrogenase (LDH) achieved a better diagnostic efficacy for TGCTS0 (area under curve [AUC] = 0.695). Tumor-associated macrophages (TAMs) signature gene CCL2 was highly expressed in TGCT compared with normal testicular tissue. Functional enrichment analysis showed that CCL2 is closely involved in the Extracellular Matrix Organization pathway and positively correlated with the expression of various matrix metalloproteinases (MMPs). Elevated AMC may serve as a predictor of higher risk of TGCTS0, and CCL2 mediated TAMs infiltration and MMPs secretion is essential for the tumorigenesis of TGCT.
Could initial CT chest manifestation in patients hospitalized with COVID 19 pneumonia predict outcome on short term basis
Authors: Dola Eman F. , Nakhla Osama Lamie , Alkaphoury Mona Gamalludin
Published: June 2023

Chest computed tomography (CT) can be used to monitor the course of the disease or response to therapy. Therefore, our study was designed to identify chest CT manifestations that can predict the outcome of patients on short term follow-up. This was a retrospective study wherein we reviewed chest CT scans of 112 real-time reverse transcription polymerase chain reaction positive patients admitted to our hospital. All 112 patients underwent follow-up chest CT at a time interval of 4 to 42 days. Our study included 83 male and 29 female who were positive for COVID 19 infection and admitted to the hospital with positive chest CT findings. All patients underwent follow-up chest CT, and the outcomes were categorized as resolution, regression, residual fibrosis, progression, or death. These proportions were 5.4%, 48.2%, 24.1%, 14.3%, and 8%, respectively. The only significant factor in determining the complete resolution of chest CT was oligo-segmental affection (P = .0001). The main CT feature that significantly affected the regression of chest CT manifestations was diffuse nodular shadows (P = .039). The CT features noted in patients with residual fibrosis were interstitial thickening, with a P value of .017. The mono-segmental process significantly affected progression (P = .044). The significant factors for fatality were diffuse crazy paving, pleural effusion, and extra-thoracic complications (P = .033, .029, and .007, respectively). The prognostic value of the first admission CT can help assess disease outcomes in the earliest phases of onset. This can improve resource distribution.
“…with the third eye we can detect mistakes and correct them…’’ Supportive supervision and the management of Clubfoot by Ponseti method: Qualitative experiences from Mwanza, Tanzania
Authors: Kowero Emmanuel , Burengelo Dorica , Philbert Doreen , Sirili Nathanael
Published: June 2023

Supportive supervision is the key to health programs in the provision of quality care. Clubfoot or Congenital Talipes Equinovarus remains among the prevalent congenital musculoskeletal birth defects in Tanzania. In 2015, Tanzania introduced supportive supervision guidelines for clubfoot treatment. However, little is known about how supportive supervision helps maintain the skills of providers. To analyze the supportive supervision in maintaining the clinical skills of healthcare workers in clubfoot management in Mwanza, Tanzania. An exploratory qualitative case study employing in-depth interviews (IDIs) with healthcare providers, supervisors, and parents of children with clubfoot was conducted in Mwanza, Tanzania. Data were collected from 3 purposefully selected hospitals and 32 IDI were conducted with the selected participants between April and May 2021. A semi-structured interview guide was used to conduct the IDIs. Qualitative content analysis was used to analyze the data. Two categories were identified in this study. First “the contribution of supportive supervision” attributed by its purpose and the success brought by the supportive supervision. Second, “the maintenance of healthcare workers’ skills was attributed to their willingness to learn and actively engage in supportive supervision, cooperation with clinics and clubfoot programmes, and material support. The findings of this study underscore the contribution of supportive supervision to maintaining skills in the management of clubfoot in Tanzania. The findings of this study highlight the importance of joint efforts to maintain quality service skills.
Prognostic value of pretreatment systemic immune-inflammation index in Chinese esophageal squamous cell carcinoma patients receiving radical radiotherapy: A meta-analysis
Authors: Zeng Xiaoxiao , Ye Ling , Luo Mingying , Zeng Danli , Chen Yang
Published: June 2023

Background:

The association between pretreatment systemic immune-inflammation index (SII) and long-term survival among Chinese esophageal squamous cell carcinoma (ESCC) patients who received radical radiotherapy remains unclear. The aim of this study was to identify the prognostic role of pretreatment SII in Chinese ESCC patients receiving radical radiotherapy based on current evidence.

Methods:

The PubMed, EMBASE, Web of Science and CNKI databases were searched up to March 18, 2023. Primary and secondary outcomes were overall survival (OS) and progression-free survival (PFS), respectively. The hazard ratios (HRs) with corresponding 95% confidence intervals (CIs) were combined to assess the predictive role of pretreatment SII for long-term survival of Chinese ESCC patients receiving radiotherapy. All statistical analyses were conducted by STATA 15.0 software.

Results:

A total of 8 eligibility studies involving 2101 cases were included in this meta-analysis. The pooled results demonstrated that elevated pretreatment SII was significantly related to worse OS (HR = 1.59, 95% CI: 1.24–2.02, P < .001) and PFS (HR = 1.33, 95% CI: 1.13–1.57, P < .001). Besides, subgroup based on TNM stage showed similar results.

Conclusion:

Pretreatment SII could serve as a novel prognostic factor in Chinese ESCC patients receiving definitive radiotherapy and patients with an elevated SII may experience poorer survival.
Prenatal ultrasound diagnosis of fetal giant pericardial cyst: A case report
Authors: Wang Xiaoqing , Zhang Weixia , Wang Mijie , Jiao Ronghong
Published: June 2023

Rationale:

We describe 1 case of fetal giant pericardial cyst was diagnosed by fetal echocardiography in the second trimester, and the changes of the cyst were recorded by follow-up observation in the late trimester and after birth. We then review and discuss the knowledge about its diagnosis and treatment.

Patient concerns:

A 34-year-old pregnant woman was referred to our hospital because of a diagnosis of a fetal pericardial effusion at 22 5/7 weeks at another hospital.

Diagnosis:

Fetal echocardiography revealed an irregular anechoic area in the right side of the fetal right atrium and right ventricle that was closely related to but not communicated with the pericardiumis and suggested fetal pericardial cyst. Fetal cardiothoracic magnetic resonance imaging showed cystic FIESTA signal in the right lung region, with clear boundary, and a seemingly line-like low signal shadow within.

Interventions:

Since fetal pericardial cysts keep decreasing in size during maternal pregnancy, follow-up observation measures are taken.

Outcomes:

Fetal pericardial cysts disappear on their own 4 months after delivery.

Lessons:

Asymptomatic pericardial cysts in the fetal period can be followed up and observed, and intervention is performed only when the cyst rapidly enlarges or ruptures and becomes infected in the fetal or neonatal period. Echocardiography can be used as a first-line detection method for their initial detection and follow-up.