bluuebunny/crossref_metadata_2025 huggingface dataset:
Simple sugar and caloric contents of soft drinks in Nigeria
Authors: Onyemelukwe G.C. , Bakari A.G. , Ogbadu G.
Published: August 2024

Background: Soft drinks are widely consumed in Nigeria
and it is generally believed that they contain large amounts
of sugars and therefore calories. However, there is as yet no
local study to define the composition of these drinks. This
information is essential in giving dietary advice, especially
in those on special diets. Objective: to study sugar and
caloric contents of soft drinks marketed in Nigeria.
Materials and methods: Six different brands of soft drinks
that are being marketed all over Nigeria were analysed for
their sugar (glucose, fructose and sucrose) and caloric
contents. Results: The sugar content per bottle ranges
between 3.29 to 7.70 grams per bottle with a caloric value
ranging between 13.2 and 30.8 kilocalories per bottle.
Conclusion: The implications of these findings are
discussed and it is proposed that soft drink manufacturers
indicate the caloric value of their products as well as
produce sugar free drinks in African countries. (Int J
Diabetes Metab 14: 110-111, 2006 )
Combined Effects of Type-II Diabetes Mellitus and Cigarette Smoking Increase the Risk of Cardiovascular Complications
Authors: Howlader Zakir H. , Islam Md. Rakibul , Hossain Jahangir , Khan Tanjir A. , Karim Ahmad F. , Kabir Yearul
Published: August 2024

Premature atherosclerosis may result from conditions such as hypercholesterolaemia, diabetes, hypertension and cigarette smoking. Any of these four conditions alone or in combination, stimulates the atherosclerotic process through mechanisms associated with a state of increased vascular oxidative stress. In this study, we investigated the combined effect of type 2 diabetes [DM] and smoking on lipid peroxidation and total antioxidant status, the primary risk factors of atherosclerosis. A total of 85 subjects were included in this study. Out of these, 65 were patients who attended the Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders [BIRDEM] for regular medical check up and 20 were healthy non-smoker volunteers. To investigate the effect of smoking and DM on the risk factors of cardiovascular complications, we divided the study subjects into three groups. Group I consists of healthy non-smoker control subjects, group II was diabetic patients but non-smoker and group III was diabetic and smoker. In group III, the proatherogenic lipid profile [total cholesterol, triglycerides, and LDL cholesterol] increased with a decrease in HDL cholesterol compared to control groups. Thiobarbituric acid reactive substance [TBARS] and lipid hydroperoxide [LHP] increased in group III a sign indicative of increased lipid oxidation. Total antioxidant status [TAS] and antioxidant vitamin [vitamin-C] were significantly lower in group III [p<0.001] compared to other groups
Study on the effect of oral hypoglycaemic agents on arterial stiffness among Malays with type II diabetes mellitus
Authors: Hassan N.H. , Shaaban J. , Abdul Kadir A. , Rehman A. , Abdul Rahman A.R.
Published: August 2024

Objective: To determine the effect of two regimens of oral hypoglycaemic agents: sulphonylurea monotherapy and metformin
in combination with sulphonylurea on arterial stiffness. Methods: A case control study was conducted at the Family Medicine
and Diabetic Clinic, HUSM from May 2004 until May 2005. Sixty subjects receiving sulphonylurea alone and ninety subjects
on combination therapy with metformin participated in this study. A simple random sampling method using a draw lot was
used to select 51 subjects for each group. Augmentation index (AI) was measured using the Sphygmocor apparatus and all
measurements were performed by the investigators after an earlier validation study. The mean augmentation index
measurements were analyzed. Results: The mean AI values of diabetic subjects treated with sulphonylurea monotherapy and
a combination with metformin were 140.51 ± 11.42 vs 140.14 ± 12.86, p= 0.877. AI values were significantly higher in
females compared with males (143.23 ± 10.60 vs 135.82 ± 13.01, 95% CI: -12.07, -2.73, p = 0.002). Duration of diabetes (in
years) was significantly less (3.46 ± 3.16 vs 5.41 ± 3.66, p = 0.005) for sulphonylurea monotherapy patients compared with
combination therapy patients. Conclusion: This study shows that sulphonylurea monotherapy and metformin in combination
with sulphonylurea have similar effects on arterial stiffness in type 2 diabetes subjects. Diabetes is associated with a greater
arterial stiffness in women compared with men.
Carbohydrate -Food knowledge of Emirati and Omani Adults with Diabetes:Results of a pilot study
Authors: Ali Habiba I. , Bernsen Roos M. , Taleb Sara , Al Azzani Basma
Published: August 2024

There is limited research on nutrition knowledge related to diabetes management in persons with diabetes in the United Arab Emirates and other Arabian Gulf countries. Carbohydrate – containing foods have the greatest impact on post-meal blood glucose levels. The purpose of this exploratory study was to determine nutrition knowledge related to carbohydrate- containing foods of adults with diabetes in Oman and the United Arab Emirates. A culturally-appropriate questionnaire was used to assess carbohydrate - food knowledge in a convenience sample of 94 Emirati and Omani men and women with diabetes (age (mean± s.d.): 50 ± 13.5 years) residing in the cities of Al Ain and Al Bureimi. Carbohydrate-food knowledge score (mean± s.d.) was 6.3 ± 2 (maximum 14), reflecting low knowledge of food sources of carbohydrate. Ninety-three percent of the study participants believed that whole wheat bread does not increase their blood glucose levels and 88% of them did not think that unsweetened fruit juices can increase blood glucose levels. Further, scores for the Omani citizens were significantly lower than those of Emirati counterparts, mean difference 2.3 (95% confidence interval:1.5-3.1). Significant (P<0.05) differences in carbohydrate food knowledge scores between the 2 groups were found for 5 of the 14 food items assessed. The results of this study underscore the importance of nutrition education programs for persons with diabetes in these 2 communities.
Maternal BMI and antenatal weight gain as determinants of obstetric outcome
Authors: Savona-Ventura C. , Grima S. , Vella K.
Published: August 2024

Obesity during pregnancy has been shown to carry significant risk to both mother and child. The role of uncontrolled weight gain during pregnancy has not been fully elucidated. The study analysed the incidence of gestational hypertension and fetal macrosomia in various groups of mothers according to their BMI and antenatal weight gain. A definite statistically significant increased risk of both gestational hypertension and infant macrosomia was demonstrated with increasing BMI. This was compounded by increases in antenatal birth weight in all ranges of maternal BMI suggesting that adverse maternal metabolic parameters may contribute towards promoting the development of maternal and fetal complications. A restricted calorific intake in obese individuals during pregnancy may contribute towards decreasing the relative risks to both mother and child.
Proptosis secondary to rosiglitazone treatment
Authors: Yang Chun Cheng Lin , Chen-Ku Chih Hao , Vagefi Reza M. , Anderson Richard L. , McCann John
Published: August 2024

Objective: To report a case of new onset proptosis secondary to treatment with rosiglitazone. Methods: Case report Results: A patient developed symptomatic bilateral proptosis requiring surgical intervention, two years and a half after treatment with rosiglitazone. Conclusion: Asymptomatic eye protrussion is a frequent finding in patients treated with thiazolidinediones. In a few cases, the proptosis may be clinically significant and may present in patients with or without a previous history of thyroid disease.
ACE Insertion/Deletion gene polymorphism and genomic sequence in Diabetic nephropathy
Authors: Haque S.F. , Mhmad A. , Khan A.U. , Gupta V. , Khan A.S.
Published: August 2024

Insertion/deletion polymorphism of the angiotensin I converting enzyme (ACE) genetically determines most of the plasma ACE activity. Modulation of ACE gene activity might have an important bearing on the rate of progression of renal disease, though its exact role in the nephropathy of type 2 diabetes (T2DM) is far from clear. This prospective, cross-sectional, observational study was designed to study the correlation between insertion/deletion polymorphism of ACE gene in diabetic nephropathy. T2DM cases (n=30) were evaluated, regarding duration, onset and degree of albuminuria, renal insufficiency and hypertension. All patients underwent detailed clinical and biochemical evaluation. Genomic DNA intron 16 of the ACE gene was amplified by polymerase chain reaction (PCR) followed by sequencing. The mean age of this study group was 45.21±2.34 yrs. PCR amplification of ACE gene fragments revealed insertion/insertion (I/I, n =8); insertion/deletion (I/D, n = 18) and deletion/deletion (D/D, n = 4) alleles. All three groups were matched age-wise. Micro- and macro-vascular complications were more prevalent in DD type (p=0.012). The majority (75%) of patients with II allele took a longer time to develop overt albumiuria, having lesser hypertension, renal dysfunction, and dyslipidemia than ID and DD allele (P<0.005). On the other hand, urinary albumin excretion, systemic and diastolic blood pressures, triglycerides, serum creatinine and low density lipoprotein-C were significantly higher (P<0.005), in patients of DD type than II and ID groups. This finding suggests that patients with DD allele of the ACE gene are more likely to have progressive diabetic nephropathy with micro- and macro-vascular complications.
Waist circumfrence is a better predictor than body mass index of insulin resistance in type 2 diabetes
Authors: Liao Ying-Li , Lin Su-Ching , Hsu Chung-Hua
Published: August 2024

Insulin resistance is an important pathogenic factor in type 2 diabetes patents. An easy and efficiency measurement predicting insulin resistance; which can be done easily by type 2 patients is desired. The aim of this study is to examine whether waist circumference is a better predictor of insulin resistance in type 2 diabetes than body mass index (BMI). From a population of 1356 registered diabetic patients, 144 who met (1) aged between 30 and 75 years, (2) being Chinese, (3) having had type 2 diabetes for more than one year, (4) having been taking gliclazide and metformin for more than 6 months were enrolled in this study. The main outcome evaluated is the associations of HOMA insulin resistance index (HOMA index); which were assessed using multiple linear regression analysis. The coefficients of multiple regression analysis with stepwise model showed that waist circumference ( = 0.35, p < 0.001) but not BMI ( = 0.01, p= 0.94), and hemoglobulin A1C% (HbA1C) ( = 0.25, p = 0.01) were the main predictors of HOMA index. These initial findings indicate that waist circumference is a better predictor of insulin resistance in type 2 diabetes than BMI.
Diabetes Mortality and Environmental Heavy Metals in North Carolina Counties:
An Ecological Study
Authors: Spangler J.G.
Published: August 2024

Arsenic, beryllium, cadmium and nickel have been associated with the prevalence of diabetes mellitus in populations exposed to these elements. However, diabetes mortality has not been evaluated. This ecological study correlated airborne concentrations of these metals with diabetes mortality in North Carolina counties. County level data were extracted from the 2000 US Census, the 1999 US Environmental Protection Agency National Air Toxins Assessment, and 2001-2005 diabetes mortality rates by county from the North Carolina State Center for Health Statistics. Multivariable linear regression correlated airborne concentrations of each element with diabetes mellitus mortality rates in all 100 North Carolina counties controlling for county-level characteristics. Airborne concentrations were logarithmically transformed to normalize their distribution. The lowest air concentrations detected were beryllium and cadmium, with nickel showing the highest concentration. Logarithmic concentrations spanned from 3.74 to 4.02 orders of magnitude. County-level diabetes mortality rates were negatively associated with median county income, but positively associated with county-level air concentrations of arsenic, beryllium, cadmium and nickel. These results support diabetes mortality effects of air pollution, and agree with other studies correlating arsenic, beryllium, cadmium and nickel with diabetes prevalence. Policy implications include regulating point source air pollution.
Xanthogranulomatous Pyelonephritis in Peritoneal Dialysis
Authors: Burgos Martín Javier , Almenara Tejederas Marina , Alonso García Fabiola , de la Prada Álvarez Francisco José , Salgueira Lazo Mercedes
Published: August 2024

Introduction: Xanthogranulomatous pyelonephritis (XGP) is a rare illness that consists of a destructive chronic inflammatory process of the renal parenchyma associated with recurrent infection and obstructions of the urinary tract. Peritoneal dialysis (PD) is a form of renal replacement therapy used in advanced kidney disease. PD patients demonstrate a systemic inflammatory state, secondary to the increase in uremic toxins, decreased filtration of proinflammatory cytokines, as well as constant exposure to bioincompatible dialysis solutions or a foreign body reaction from the catheter, among other factors, as peritoneal infections. Case Presentation: We present the clinical case of a 74-year-old woman, with a history of recurrent urinary tract infections associated with nephrolithiasis and stage 5D chronic kidney disease, on a PD program. The patient presented a non-specific 3-month state of progressive asthenia, with increased inflammatory parameters in the analytical controls. After presenting multiple negative urine cultures and peritoneal fluid cultures, she was hospitalized to study the constitutional syndrome. The imaging test revealed bilateral staghorn lithiasis with severe dilatation of the right renal pelvis and great cortical thinning. Given the suspicion of XGP, it was decided to perform right renal nephrectomy, which was confirmed after the anatomopathological study. Prior to the intervention, she was transferred to hemodialysis. Over the following months, significant clinical and analytical improvement was observed. Conclusion: The systemic inflammatory state and the risk of infections in PD can mask the diagnosis of XGP in PD patients. There are no reported cases of XGP in patients in PD.
Primary Diffuse Large B-Cell Lymphoma of the Breast with MYC and BCL2 Rearrangements with Terminal Deoxynucleotidyl Transferase Expression: A Case Report
Authors: Matar Bassam , Chbat Maureen , Bitar Houssam Eddine , Rosado Francisco
Published: August 2024

Introduction: Primary breast lymphoma represents only 1% of non-Hodgkin lymphomas. The most common histology is diffuse large B-cell lymphoma. When dual translocations of MYC and BCL2 or BCL6 occur, it is referred to as “high-grade B-cell lymphoma with rearrangements of MYC and BCL2 and/or BCL6” according to the 4th edition of the WHO classification of hematolymphoid tumors. The expression of tdt in this type of malignancy is exceptional. Case Report: This is a case of a 54-year-old woman presenting with a rapidly growing painless mass. Ultrasound-guided core biopsy of the breast mass showed infiltrate of medium-sized neoplastic lymphocytes which stained as CD79a-positive B cells co-expressing CD10, BCL2, tdt, and MYC. Ki-67 is positive in 80%. There was rearrangement of MYC and BCL2 at FISH. Positron emission tomography (PET) scan was negative elsewhere. Final diagnosis was a DLBCL of the breast with tdt expression. She was treated with 6 cycles of R-hyperCVAD/MA (R = rituximab, C = cyclophosphamide, V = vincristine, A = cytarabine, D = dexamethasone, M = methotrexate) and intrathecal chemotherapy (IT CT). Restaging PET shows resolution of all avid uptake. We did a review of literature showing the importance of giving an intensive chemotherapy regimen, high-dose methotrexate, cytarabine, and IT CT for central nervous system (CNS) prophylaxis. Conclusion: Primary DLBCL of the breast with rearrangement of MYC and BCL2 and tdt expression is an aggressive disease not very well studied that needs to be treated with an intensive CT and CNS prophylaxis. Stem cell transplant could be given after first remission.
Immunometabolic Regulation of Bacterial Infection, Biofilms, and Antibiotic Susceptibility
Authors: Chen Ying-Tsun , Lohia Gaurav Kumar , Chen Samantha , Riquelme Sebastián A.
Published: August 2024

Background: Upon infection, mucosal tissues activate a brisk inflammatory response to clear the pathogen, i.e., resistance to disease. Resistance to disease is orchestrated by tissue-resident macrophages, which undergo profound metabolic reprogramming after sensing the pathogen. These metabolically activated macrophages release many inflammatory factors, which promote their bactericidal function. However, in immunocompetent individuals, pathogens like Pseudomonas aeruginosa, Staphylococcus aureus, and Salmonella evade this type of immunity, generating communities that thrive for the long term. Summary: These organisms develop features that render them less susceptible to eradication, such as biofilms and increased tolerance to antibiotics. Furthermore, after antibiotic therapy withdrawal, “persister” cells rapidly upsurge, triggering inflammatory relapses that worsen host health. How these pathogens persisted in inflamed tissues replete with activated macrophages remains poorly understood. Key Messages: In this review, we discuss recent findings indicating that the ability of P. aeruginosa, S. aureus, and Salmonella to evolve biofilms and antibiotic tolerance is promoted by the similar metabolic routes that regulate macrophage metabolic reprogramming.
Comparative Evaluation of Visual Outcomes in Combined Cataract and Vitrectomy for Idiopathic Epiretinal Membrane with an Advanced or Conventional Intraocular Lens
Authors: Choi Se Hyun , Cho In Hwan , Jeon Gang Seok , Chang In Boem , Ma Dae Joong , Hong In Hwan
Published: August 2024

Introduction: The aim of this study was to investigate the efficacy of new monofocal intraocular lens (IOL) in comparison with conventional monofocal IOL in patients undergoing combined cataract and vitrectomy surgery for epiretinal membrane (ERM). Methods: This prospective non-randomized comparative study included 65 eyes of 65 patients who underwent combined cataract and vitrectomy for ERM with implantation of advanced monofocal IOL (Eyhance ICB00, 33 patients) and standard monofocal IOL (Tecnis ZCB00, 32 patients). Monocular visual acuities were measured 6 months post-operatively, including corrected and uncorrected distance visual acuity (CDVA, UCDVA), uncorrected intermediate visual acuity (UCIVA), and uncorrected near visual acuity (UCNVA). Furthermore, contrast sensitivity and metamorphopsia were measured. Results: There was no significant difference between two groups regarding operation time, post-operative CDVA, UCDVA, UCNVA, and spherical equivalent (p > 0.05). Monocular UCIVA was significantly higher in the Eyhance IOL group than in the Tecnis IOL group (p = 0.005). The photopic and mesopic contrast sensitivities were comparable between each group for any spatial frequency (p > 0.05). The correlation coefficients from correlations between retinal wrinkling ratio and M score did not differ significantly between groups (p = 0.877), and the degree of metamorphopsia was not significantly related to the type of IOL (p = 0.969). Conclusions: In combined cataract and vitrectomy for ERM, Eyhance IOL provided significant better visual performance at intermediate distance than standard monofocal IOL without compromising operation time, distance vision, contrast sensitivity, and evaluating metamorphopsia. Eyhance IOL can be a useful option for both surgeons and patients.
Lupus Erythematosus Tumidus Misdiagnosed as Erythema Nodosum from Coccidioidomycosis
Authors: Garcia Brianae , Hasnaoui Anis , Ramdass Prakash V.A.K.
Published: August 2024

Introduction: Lupus erythematosus tumidus (LET) is a rare photosensitive dermatosis that is categorized as intermittent cutaneous lupus erythematosus. It shares clinical similarities and histopathological features with other skin disorders, such as erythema nodosum, lymphocytic infiltrate of Jessner, and reticular erythematous mucinosis, thus making diagnosis quite challenging. We present a patient with LET whose diagnosis was confirmed after seeing several doctors. Case Presentation: A 52-year-old Hispanic female presented with tender erythematous nodules on her thighs for approximately 1 month. She was suspected of having erythema nodosum secondary to coccidioidomycosis and was prescribed fluconazole 200 mg for 30 days but showed no improvement. However, histopathological and direct immunofluorescence tests later confirmed a diagnosis of LET. The patient was treated with hydroxychloroquine, and the lesions improved remarkably after 2 weeks. Conclusion: LET is a rare dermatosis that closely resembles other dermatologic conditions such as erythema nodosum, lymphocytic infiltrate of Jessner, and reticular erythematous mucinosis. Diagnosis based on clinical features alone should be avoided, and ideally, treatment should only be initiated after confirmatory histopathological testing.
Pityriasis Lichenoides et Varioliformis Acuta Developing during Pembrolizumab Treatment for Bladder Cancer
Authors: Mizutani Yuki , Noda Ena , Kondo Makoto , Hayashi Akinobu , Yamanaka Keiichi
Published: August 2024

Introduction: Anti-PD-1 immunotherapies enhance T-cell responses against tumor cells by blocking the interaction between PD-1 and its ligand, PD-L1. While these therapies offer significant benefits in treating various malignancies, they can also lead to several immune-related adverse events (irAEs), most notably manifesting in the skin. Lichenoid reactions, eczema, and vitiligo are the three most prevalent forms of cutaneous irAE. Case Presentation: Here, we report a rare case of a pityriasis lichenoides et varioliformis acuta (PLEVA) that developed during pembrolizumab treatment for invasive bladder cancer. A 53-year-old man, receiving pembrolizumab for invasive bladder cancer, developed erythematous papules on his legs after his 11th infusion. The skin lesions gradually spread to his entire trunk and extremities. A punch biopsy revealed several apoptotic keratinocytes and spongiosis, along with perivascular and lichenoid lymphocytic infiltration with vacuolar alteration. Immunohistochemistry showed infiltration of CD4+ and CD8+ T cells in both the epidermis and dermis. Granzyme B-positive inflammatory cells were also slightly present. From these results, he was diagnosed with PLEVA, which might be classified as a lichenoid eruption, especially based on the histological findings. Conclusion: We hypothesize that the anti-PD-1 antibody might lead to epidermal necrosis by amplifying the expression of cytolytic molecules such as granzyme B in CD8+ T cells.
The Importance of Radiation Planning Guidelines in Spinal Stereotactic Body Radiotherapy
Authors: Haisraely Ory , Jaffe Marcia L. , Lawrence Yaacov
Published: August 2024

Introduction: Stereotactic body radiotherapy (SBRT) is a well-established treatment for spinal metastases. Official guidelines for radiation planning were published and revised by several groups. Here, we present real-world data about the importance of adhering to those guidelines. Case Report: A 42-year-old metastatic colon cancer patient presented with oligometastatic disease to L3 vertebra and underwent SBRT treatment. Due to lack of adhering to official guidelines both in dose regiment and in volume definition, he progressed locally and required re-treatment. Conclusions: SBRT is a well-known established choice for oligometastatic spinal lesions. Thorough evaluation of imaging and adherence to clinical guidelines are crucial for achieving a high local control rate and reducing the likelihood of re-irradiation and associated complications.
Primary Peritoneal Mesothelioma Affecting the Greater Omentum That Mimicked an Omental Infarction: A Case Report
Authors: Cravero John Corbyn , Yakubik Taylor , Wahab Laith , Giang Thao , Lopez Lisa M. , Newman Megan G.
Published: August 2024

Introduction: Malignant peritoneal mesothelioma (MPM) is a rare cancer that is associated with asbestos exposure. The diagnosis can be difficult given the nonspecific nature of presenting symptoms and the presence of concomitant confounding findings. Case Presentation: We report a 71-year-old male who presented with right lower quadrant pain and new-onset ascites. CT imaging of the abdomen/pelvis demonstrated omental stranding concerning for a possible omental infarction. Subsequent imaging showed persistent omental edema but no identifiable soft tissue mass. A biopsy of the omentum showed atypical mesothelial proliferation, but pathology was unable to determine if proliferation was a neoplastic versus reactive process. Surgical oncology performed a diagnostic laparoscopy that showed peritoneal studding of the omentum. Subsequent immunohistochemical staining of the omentum demonstrated preservation of BAP1 expression and loss of MTAP expression, consistent with peritoneal mesothelioma. Conclusion: MPM is a rare and aggressive cancer with an overall poor prognosis. The diagnosis of MPM can be difficult based on the nonspecific clinical presentation, insufficient imaging and laboratory testing, and the presence of concomitant confounding findings, such as with this patient and his admitting diagnosis of omental infarction. This case demonstrates the importance of developing a broad differential while maintaining an awareness of heuristics that can influence clinical decision-making.
Cerebral Venous Sinus Thrombosis with Bilateral Optic Disc Swelling and Bilateral Sixth Nerve Palsies in the Absence of Headache: A Case Report
Authors: Nakata Daisuke , Okada Hiroshi , Ueoka Koji , Shimada Yoshiaki , Tanikawa Atsuhiro , Horiguchi Masayuki , Ito Yasuki
Published: August 2024

Introduction: We report a case of cerebral venous sinus thrombosis (CVST) that presented with bilateral optic disc swelling and diplopia in the absence of headaches. Case Presentation: A 54-year-old woman with no relevant medical history presented with a 2-week history of diplopia and no loss of visual acuity in each eye. Eye movements revealed bilateral abduction deficits, and fundoscopic examination revealed bilateral optic disc swelling. Non-contrast computed tomography of the head showed no abnormalities. Magnetic resonance venography revealed the absence of flow in the superior sagittal and left transverse sinuses as a consequence of thrombosis. The patient was diagnosed with intracranial hypertension associated with abducens nerve palsies secondary to CVST and was initiated on anticoagulant therapy. CVST can lead to stroke even in younger individuals. Conclusion: CVST should be considered in differential diagnosis when bilateral papilledema and abducens nerve palsies are present, even in the absence of headache or other neurological findings.
Successful Treatment of Hemi-Retinal Vein Occlusion with Macular Edema following Spinal Surgery Using Intravitreal Aflibercept and Retinal Photocoagulation: A Case Report
Authors: Nakatake Shunji , Sato Yoshiki , Itotani Maho , Kimoto Kenichi , Kubota Toshiaki , Takeda Atsunobu
Published: August 2024

Introduction: Perioperative visual loss (POVL) owing to hemi-retinal vein occlusion (HRVO) following prone positioning during spinal surgery is rare. Here, we report a case of HRVO with macular edema (ME) after spinal surgery that was successfully treated with intravitreal aflibercept (IVA) injections and retinal photocoagulation (RP). Case Presentation: A 63-year-old Japanese man underwent spinal surgery for lumbar spinal canal stenosis. Surgery was performed with the patient in the prone position under general anesthesia; the operation time was 305 min. No complications were associated with intraoperative anesthesia. On postoperative day 4, the patient noticed decreased visual acuity in his left eye and visited the Department of Ophthalmology on postoperative day 9. The best-corrected visual acuity (BCVA) in the left eye was 0.1. Fundus and optical coherence tomography revealed HRVO and ME in the left eye. IVA injections and RP were performed in the eye, which substantially decreased the ME and improved the patient’s BCVA to 0.8. Conclusions: HRVO can cause POVL after prone positioning during spinal surgery. This is the first case of HRVO with ME after spinal surgery, which was successfully treated with IVA injections and RP.
Leber Hereditary Optic Neuropathy Case Report: Clinical Presentation and Treatment with Idebenone Reinforce the Evidence for m.3866T>C as a Causative Variant
Authors: Jørstad Øystein K. , Skaar Stine , Strand Harald , Røsby Oddveig , Brokstad Ruth Therese , Rønning Pål A.
Published: August 2024

Introduction: Leber hereditary optic neuropathy (LHON) is a mitochondrial disorder that typically presents with painless, central visual loss, hyperaemia of the optic nerve head, and peripapillary telangiectasias. Most LHON cases are due to one of three variants, but several less common variants also exist. We describe a clinical case of LHON associated with the variant m.3866T>C, which is possibly linked to LHON. Case Presentation: A 59-year-old Caucasian woman experienced acute, bilateral, and painless visual loss. She reported cigarette smoking, and elevated phosphatidylethanol suggested harmful alcohol consumption. Her best-corrected visual acuity (BCVA) was 20/100 for the right eye and 20/50 for the left eye. She could only read the Ishihara demonstration plate, and threshold perimetry demonstrated reduced central sensitivity bilaterally. Her optic nerve heads were hyperaemic, with peripapillary telangiectasias. The visual symptoms and clinical findings suggested LHON. Magnetic resonance imaging demonstrated a tuberculum sella meningioma and two cerebral aneurysms, which we regarded as incidental findings. Genetic testing did not identify common LHON variants but a rare homoplasmic variant, m.3866T>C, which studies suggest might cause LHON or act in synergy with other variants to increase the disease penetrance. After initiating test-of-treatment with idebenone 900 mg per day, the patient’s BCVA improved to 20/32 for both eyes and then stabilized. Conclusion: This case strengthens the evidence for m.3866T>C as a causative LHON variant. The case also raises the question as to whether this particular variant can respond favourably to treatment with idebenone.
Hedgehog Pathway and Programmed Cell Death Protein-1 Inhibitors for Advanced Basal Cell Carcinoma
Authors: Verkouteren Babette J.A. , Reyners An K.L. , Aarts Maureen J.B. , Mosterd Klara
Published: August 2024

Introduction: Basal cell carcinoma (BCC) is treated with local surgery or noninvasive treatment modalities. If a BCC remains untreated, it can develop into a locally advanced BCC or a metastatic BCC. Case Presentation: Here we report in detail the management of three complex advanced BCC (aBCC) after treatment failure with vismodegib. On all tumors, next generation DNA sequencing in the Center for Personalized Cancer Treatment-02 (CPCT-02) study was performed; subsequently, patients were included in the Drug Rediscovery Protocol (DRUP) trial, in which treatment was started with commercially available targeted anticancer drugs based on the molecular tumor profile. All patients showed partial response or stable disease following treatment with second line PD-1 inhibitors with an average duration of response of 12.3 months. Discussion/Conclusion: Immunotherapy can be a treatment option for aBCC resistant to hedgehog pathway inhibitor treatment. However, despite the high tumor mutational burden of aBCCs, immunotherapy does not always lead to a long response. Rechallenge or combining treatment of hedgehog inhibitors and PD-1 inhibitors by parallel or alternating cycles may be a strategy to lengthen the treatment response.
Preoperative Diagnostic Dilemma in Rapidly Progressive Mixed Neuroendocrine-Nonendocrine Neoplasm of the Ascending Colon: A Case Report
Authors: Kawakami Masayo , Nakazato Hidetsugu , Tokisawa Hiromi , Tomiyama Takeshi , Miyagi Jun , Nagayoshi Seiji , Tamashiro Koichi , Yoshimi Naoki , Ohmine Yasushi
Published: August 2024

Introduction: Mixed neuroendocrine-nonendocrine neoplasms (MiNENs) of the digestive tract are rare. They contain both neuroendocrine and nonendocrine components. We here report a rare case of a metastatic MiNEN originating in the ascending colon. Case Presentation: An 80-year-old man presented with abdominal pain and vomiting. Colonoscopy showed an obstructing mass in the ascending colon, and a biopsy resulted in diagnosis of an adenocarcinoma. A CT scan revealed multiple liver metastases. Thus, our diagnosis was stage IV colon adenocarcinoma (cT4aN1bM1a according to TNM Classification of Malignant Tumors). The primary lesion was resected to alleviate symptoms. Histopathological and immunohistochemical examination revealed a well-differentiated adenocarcinoma and a small-cell neuroendocrine carcinoma, leading to the diagnosis of a MiNEN. The patient declined postoperative treatment and died approximately 2 months after the surgery. Conclusion: The incidence of MiNENs may be underestimated because they lack typical symptoms or imaging features and are therefore often only diagnosed after resection. Awareness of colonic MiNENs and further accumulation of cases are necessary to improve the outcomes.
Case Report of Complete Response to Olaparib in a Patient with Breast Cancer Brain Metastases
Authors: Asazuma Kazuki , Shimomura Akihiko , Kawamura Yukino , Taniyama Tomoko , Shimizu Chikako
Published: August 2024

Introduction: Breast cancer is the second most common cause of central nervous system (CNS) metastases. It has been shown that the median time from breast cancer diagnosis to CNS metastasis is 30.9 months and that the overall median survival after metastasis is extremely poor at 6.8 months. Although treatment options for ErbB2 Receptor Tyrosine Kinase 2 (ERBB2)-positive breast cancer brain metastasis (BCBM) have been reported, effective treatment options for ERBB2-negative BCBM, which has one of the worst prognoses, are limited. Olaparib is one of the standard treatments for germline BRCA1/2 mutated (gBRCA1/2mt), ERBB2-negative, metastatic, or recurrent breast cancer. However, there is minimal existing evidence to evaluate the efficacy of olaparib in BCBM. Case Presentation: In our report, we assessed the case of a Japanese woman in her early 30s, ERBB2-negative, gBRAC2mt-positive BCBM, who achieved a complete response and prolonged progression-free survival of 9 months after the initiation of treatment with olaparib. Conclusions: Thus, our case report demonstrated the significant efficacy of olaparib in BCBM treatment. Furthermore, we highlighted the need for more studies to investigate the efficacy of olaparib and explore the efficacy of poly ADP ribose polymerase inhibitors in BCBM.
Spontaneous Retinal Reattachment following Multiple Vitreoretinal Interventions: Case Report
Authors: Wise Nathan Nash , Chin Eric K. , Almeida David R.P.
Published: August 2024

Introduction: The aim of the study was to document and analyze a rare case of spontaneous retinal reattachment in a patient after successive unsuccessful vitreoretinal surgeries and to explore potential mechanisms contributing to this unexpected outcome. Case Presentation: A 61-year-old patient with a history of high myopia presented with a rhegmatogenous retinal detachment. After undergoing multiple vitreoretinal procedures, including pars plana vitrectomy with silicone oil tamponade, anatomical reattachment was not achieved, and the patient developed complex retinal detachment associated with myopic foveoschisis. Surprisingly, spontaneous reattachment of the retina was observed during routine follow-up. Comprehensive ocular examination, optical coherence tomography (OCT), and fundus autofluorescence imaging were utilized to confirm and document the retinal status. A thorough review of patient history, surgical reports, and postoperative imaging was performed to discern potential contributory factors. The patient’s retina remained attached for 12 months after the last intervention without additional surgical or medical treatment. OCT images revealed normalization of retinal architecture with reestablishment of the foveal contour and partial recovery of visual acuity. No signs of proliferative vitreoretinopathy or other commonly associated complications were observed. Immunological assays and genetic testing ruled out systemic conditions that could predispose to spontaneous reattachment. Conclusion: This case represents a remarkable instance of spontaneous retinal reattachment without surgical intervention after multiple failed procedures. The mechanisms underlying this phenomenon remain speculative; however, they may involve delayed postoperative cellular proliferation and migration, subtle intraocular pressure changes, or unrecognized vitreous traction resolution. Further investigation into similar cases may provide insights into the natural history of retinal detachment and potential self-resolving dynamics, which could inform future therapeutic strategies.
Giant Cell Temporal Arteritis Followed by Severe Encephalopathy Induced by Immunotherapy in a Patient with Metastatic Renal Cell Carcinoma Achieving Durable Partial Response: A Case Report
Authors: Fiala Ondřej , Tkadlecová Michaela , Pivovarčíková Kristýna , Baxa Jan , Stránský Petr , Šiková Dominika , Hora Milan , Fínek Jindřich
Published: August 2024

Introduction: Combined immuno-oncology (IO) regimens are the cornerstone of the current front-line systemic therapy for metastatic renal cell carcinoma (mRCC). Despite the fact that combined IO regimens show high efficacy, they are often accompanied by a wide spectrum of immune-related adverse effects (irAEs). Case Presentation: We describe a case of rare irAEs manifested as giant cell temporal arteritis (GCA) followed by severe encephalopathy occurring after continuing immunotherapy in a 66-year-old man with mRCC receiving a combination of ipilimumab and nivolumab in the first line of systemic therapy. GCA occurred 4 months after the initiation of IO and responded promptly to the low-dose prednisone therapy. Four months after the continuation of nivolumab maintenance, the patient was hospitalized due to severe irAE encephalopathy which presented as psycho-behavioral abnormalities and progressive cognitive decline. He was treated with high-dose methylprednisolone which led to complete resolution of the symptoms and IO was permanently discontinued. The patient achieved a durable partial response. Conclusion: Both GCA and the subsequent encephalopathy in our patient responded well to the corticosteroid therapy, leading to the complete resolution of the symptoms and the patient achieved a durable partial response. Although the risk of severe neurologic irAEs affecting the central nervous system induced by IO re-administration, following previous discontinuation due to irAE, is not well-defined because of their rarity, this case highlights the need for caution, particularly in cases with a history of previous irAE-associated GCA.
Expert Opinions on Uveal Melanoma: Insights from the 58th Ophthalmic Oncology Group Meeting
Authors: Stålhammar Gustav , Vishnevskia-Dai Vicktoria , Verdijk Robert M. , Moulin Alexandre
Published: August 2024

Introduction: Clear evidence for the best clinical management of uveal melanoma is lacking in some areas. Therefore, reports on expert opinions in the field can be valuable. Methods: A questionnaire comprising 10 questions was distributed to potential participants of the 58th Ophthalmic Oncology Group Meeting in Stockholm, Sweden, in June 2024. Results: Among 34 respondents, 13 (38%) had >20 years of postresidency experience in ophthalmic oncology. The maximum recommended tumor thickness for ruthenium-106 plaque brachytherapy was 5.7 mm (SD 1.1). Twenty-three respondents (68%) indicated that radiological surveillance for metastatic disease should be conducted irrespective of primary tumor characteristics. A majority (74%) would treat a lesion with a 6 mm diameter and 1.5 mm thickness without waiting for evidence of growth if sufficient risk factors were present. Most experts did not currently recommend sampling of circulating tumor DNA or circulating tumor cells. There were no significant differences in responses based on the experience of respondents (≤20 vs. >20 years) or their annual volume of new cases (≤50 vs. >50). Conclusion: This article reports the opinions of 34 experts in ophthalmic oncology on various contemporary topics in uveal melanoma. The responses illustrate both agreements and differences in opinions among experts.
Diagnostic Accuracy of Papanicolaou Society of Cytopathology System for Reporting Respiratory Cytology: A Systematic Review and Meta-Analysis
Authors: Ahuja Sana , Fattahi-Darghlou Marzieh , Zaheer Sufian , Ahuja Rhea
Published: August 2024

Introduction: This study conducts the first meta-analysis to evaluate the diagnostic accuracy and the aggregated risk of malignancy associated with each category of the Papanicolaou Society of Cytopathology (PSC) system for reporting respiratory cytology. Methods: A systematic search was conducted in PubMed, Scopus, and Web of Science using the keywords “(Lung, Respiratory specimens) AND (Papanicolaou Society of Cytopathology System).” Articles were assessed for risk of bias using the QUADAS-2 tool. After excluding inadequate samples, sensitivity and specificity for various cut-off points. Summary receiver operating characteristic curves and diagnostic odds ratios were pooled to assess diagnostic accuracy. Results: Five studies, totaling 3,489 cases, were included. Sensitivity and specificity for the “Atypical and higher risk categories” considered positive were 60% (95% CI, 51–68%) and 87% (95% CI, 81–92%), respectively. For the “Suspicious for malignancy and higher risk categories” considered positive, sensitivity and specificity were 49% (95% CI, 40–58%) and 95% (95% CI, 92–97%), respectively. Sensitivity and specificity for the “Malignant” category considered positive for malignancy were 42% (95% CI, 33–52%) and 97% (95% CI, 92–99%), respectively. The pooled area under the curve ranged from 68 to 75% for each cut-off. Conclusion: This meta-analysis underscores the PSC system’s accuracy in reporting respiratory cytology. It highlights the diagnostic importance of the “Suspicious” and “Malignant” categories in identifying malignancy, and the utility of the “Atypical” category for initial screening. These findings support the PSC system’s role in enhancing diagnostic accuracy and clinical decision-making in respiratory cytology.
Olhar decolonial no arquivo especular de Jonathas de Andrade
Authors: Novaes Bárbara Bergamaschi
Published: August 2024

El trabajo de Jonathas de Andrade explora los ecos del pasado colonialista, especialmente en la población y los imaginarios del nordeste de Brasil, así como la herencia cultural del proyecto modernista que marcó la arquitectura y el urbanismo brasileños en la segunda mitad del siglo XX. Sus obras crean un cortocircuito de enunciados y de temporalidades, engendran una imbricación entre el cuerpo de la imagen y la imagen de los cuerpos, poniendo en funcionamiento la cartografía de las ciudades y el mapeo de las subjetividades. En este artículo presentamos un breve panorama de las obras del artista, deteniéndose en: Amor e Felicidade no Casamento (2007), Educação para Adultos (2010), 4000 disparos (2010), Tombamento (2013), ABC da cana (2014), O caseiro (2016) y O Peixe (2016). Para eso, se vale del aporte teórico de Rancière, Foster, Bosi, entre otros.
Um ensaio sobre ensaios visuais
Authors: Cadôr Amir Brito
Published: August 2024

Os ensaios visuais têm ganhado cada vez mais espaço em revistas acadêmicas e até mesmo em revistas comerciais. Este ensaio procura trazer um pouco do contexto histórico dos ensaios visuais no campo das publicações de artista, com destaque para as revistas brasileiras publicadas a partir dos anos 1970. As reflexões sobre o ensaio visual foram realizadas ao analisar alguns exemplos selecionados e po- dem auxiliar no estabelecimento de critérios para a avaliação dos ensaios visuais, de modo que um dia sejam reconhecidos como produção intelectual com o mesmo peso de um artigo acadêmico.
The World as Image and the Image of the World: Photographing Google Street View
Authors: Schellini Marcelo , Eskinazi Lucas
Published: August 2024

Este ensayo se centra en obras de arte creadas mediante la reproducción y apropiación de imágenes disponibles en la interfaz de GSV. Reflejo de la creciente proliferación de imágenes producidas por cámaras automáticas, independientemente de la percepción y la cognición humanas, estas obras provocan una reconsideración del acto fotográfico, del papel del artista como comentador  y curador de imágenes, la sublimación de la autoría y la ontología de la imagen fotográfica. El hecho de que de que tales obras de arte sean creadas extrayendo imágenes de la interfaz GSV puede ser interpretado como una implicación de su redundancia visual. Este artículo defiende, por el contrario, que las obras fotográficas en cuestión implican técnicas creativas y modos de apropiación estética específicos.
Prognostic Value of Resting Left Ventricular Sphericity Indexes in Coronary Artery Disease With Preserved Ejection Fraction
Authors: Wu Ping , Zhao Yuting , Guo Xiaoshan , Liu Xia , Hu Yingqi , Xiao Yuxin , Xu Li , Huang Nan , Li Yuanyuan , Wang Yanhui , Ren Tailin , Wu Qiuyan , Wang Ruonan , Zhang Xiaoli , Wu Zhifang , Li Sijin
Published: August 2024

Background

Adverse left ventricular remodeling is a significant cardiovascular predictor for patients with coronary artery disease and preserved left ventricular ejection fraction (LVEF). However, the remodeling indexes reflecting left ventricular spherization by myocardial perfusion imaging are underexplored.

Methods and Results

727 patients (mean age 59.8±13.5 years, 329 women) diagnosed or suspected coronary artery disease with preserved LVEF who underwent resting myocardial perfusion imaging were retrospectively enrolled. The myocardial perfusion imaging findings including the total perfusion deficit and sphericity indexes (shape index (SI) and eccentricity index (EI) obtained from gated (QGS) and non‐gated (QPS) images) were collected. Major adverse cardiovascular events (MACE) were followed up for 45.1±22.0 months. All patients were divided into 4 subgroups based on total perfusion deficit at 10% and LVEF at 65%. Univariable comparative analyses were performed in 5 cohorts (all patients and 4 subgroups). Patients who experienced MACE displayed higher SI and/or lower EI (all
P
<0.05). Kaplan–Meier survival analyses suggested significant differences for SI
QPS
in all 5 cohorts, for EI
QPS
and EI
QGS
in 4 cohorts, and for end‐systolic and end‐diastolic SI
QGS
in 3 cohorts (all 
P
<0.05). Multivariate Cox analysis showed that abnormal SI and EI remained statistically significant predictors for MACE after adjusting for total perfusion deficit, LVEF, and other confounding factors.

Conclusions

For patients diagnosed or suspected of coronary artery disease with preserved or supra‐normal LVEF, resting sphericity indexes by myocardial perfusion imaging displayed incremental long‐term prognostic value. Among these indicators, SI
QPS
is particularly promising across different perfusion or preserved functional conditions.