bluuebunny/crossref_metadata_2025 huggingface dataset:
Abordaje y Manejo de la Tbc en el Embarazo
Authors: Guerra Romero María Juliana , Sarmiento Lombana María Valentina , Gómez Rodríguez Rodrigo Alejandro , Sequeda Arroyo Flabio , Sanmartín Ceballos Pedro Rafael , Cortés Benavides Néstor Andrés , Garay Borrero María Paulina , Pérez Nisperuza María José , Martínez Díaz Luisa Fernanda , Serrano Mercado Norela
Published: April 2024

La tuberculosis es una enfermedad infecciosa causada por la bacteria Mycoplasma tuberculosis la cual, inicialmente se aloja a nivel pulmonar, pero tiene la capacidad de provocar afectaciones extrapulmonares conforme avanza la enfermedad. En un paciente contagiado, la tuberculosis puede no manifestarse, pero cuando los síntomas se hacen presente estos pueden ser leves durante varios meses, y posteriormente van aumentando su gravedad.Con frecuencia las manifestaciones clásicas incluyen tos prolongada (a veces con sangre), dolor torácico, astenia, cansancio, pérdida de peso, fiebre, sudores nocturnos, y otros síntomas que dependen de la parte del cuerpo en la que la tuberculosis está activa.Durante el embarazo, la tuberculosis puede presentar complicaciones tanto para la madre como para el feto, lo que resalta la importancia de un diagnóstico precoz y un manejo adecuado. En la gestación, el tratamiento antituberculoso debe ser cuidadosamente seleccionado para garantizar la eficacia y minimizar los riesgos para el feto. Por esta razón y la importancia de estudiar estos escenarios que se pueden presentar en la mujer embarazada con TBC, el objetivo del presente artículo es dar a conocer el abordaje y manejo de la TBC en el embarazo para disminuir el riesgo de morbimortalidad maternofetal.
Augmenting Antioxidative Properties of Cerium Oxide Nanomaterial with Andrographis paniculata Mediated Synthesis and Investigating its Biomedical Potentials.
Authors: Kumaria Sneha , Shivam Pandey, , Manohar Aeshala Leela , Kumar Anuj , Singha Sushant
Published: April 2024

Extensive interest has been poured into the production of sustainable nanomaterials. We report the fabrication of cerium oxide nanomaterial (CNP)utilizing crude extracts of Andrographis paniculata. This synthesis route devises a sustainable approach with the implementation of a less energy-intensive process and avoids hazardous chemicals. The crude extracts of Andrographis paniculata (cAP) act simultaneously as a reducing and stabilizing agent and support the nucleation of CNP leading to unique physiochemical properties. The cAP-CNP conjugate is found in the size range of 150nm with signature UV peaks at 310 nm indicating Ce+4 surface oxidation state. Scanning electron microscope and X-ray diffraction analysis of cAP-CNP conjugate indicates the ultra-structure of dry powder and polycrystalline signature peaks with 111, 200, 220 and 311 crystal planes indicating pure cubic fluorite structure. Further cAP-CNP conjugate also reports high H2O2(80%)and moderate superoxide anion (40%) antioxidative scavenging. The cAP-CNPnanomaterial conjugates exhibit excellent antimicrobial behavior with a reduction of 60% E.colibacterial growth. Similarly,cAP-CNP conjugate exhibits alpha-amylase inhibition (80%) activity indicating its prospects in diabetics’management.In-vitro analysis results the biocompatibility with 85% skin keratinocyte cell growth. Anti-inflammatory assay revealed IL-6 (89%) and TNF-alpha (81%) reduced expression. Overall, cAP-CNP demonstrates a sustainable approach to prospective biomedical applications.
Prevalence of Edwardsiella ictaluri in cage cultured Pangasius spp in Pahang River and their risk factors
Authors: Nordın Amira Syahidah , Mansor Nur Nazifah , Ramly Rimatulhana , Sabuti Asnor , Mohd Ibrahim Mohamad Shafiq
Published: April 2024

Striped catfish, Pangasianodon hypophthalmus is a native species to most Asian countries, including Malaysia which faced series of bacterial disease such as edwardsiellosis caused by E.ictaluri. Edwardsiella ictaluri is a Gram-negative intracellular bacterial pathogen which had caused mortalities in farmed or wild fish in lots of countries and accountable for large economic losses. This study was conducted to determine disease status of Pangasius spp due to Edwardsiella ictaluri and to determine the risk factors of E.ictaluri in striped catfish in Pahang River, Malaysia. Four sampling sites were chosen, two sites in Pekan (Kampung Belimbing and Kampung Tanjung Pulai) and two sites in Temerloh (Kampung Teluk Ira and Kampung Bintang). Thirty samples were collected from each farm for 6 months consecutively and four organ tissues were taken which were liver, spleen, kidney, and brain. External and internal clinical signs were recorded accordingly. DNA was extracted from all tissues and pursued for PCR to detect the presence of Edwardsiella ictaluri. Results show that the infected fish has gross internal clinical signs such as patchy liver, white nodular spleen, and congested kidney. The prevalence rate of E.ictaluri was highest at Kampung Tanjung Pulai in June with 16.67% compared to all farms. No infection of E.ictaluri shown at Kampung Belimbing during the whole sampling session. Spearman’s rho correlation showed that the prevalence of E.ictaluri has strong correlation with temperature in Kampung Tanjung Pulai (ρ > 0.7). Meanwhile those bacteria prevalence have strong relationship with ammonia, sulfide and total suspended solid (TSS) with ρ > 0.5. The susceptible size for this bacterium in striped catfish is between 1 to 50g and 150g to 200g. To our knowledge, this paper is the first report for Edwardsiella ictaluri in cage cultured P.hypophthalmus in Pahang River, Malaysia.
A Knowledg Graph Model for e-Government
Authors: Orji Friday , Nwiabu Nuka , Bennett Okoni , Taylor Onate
Published: April 2024

Many governments around the world have invested huge amount of resource to build their e- Government capabilities, to meet government objectives of effective public service delivery and citizens engagement. The increase in size of an e-Government landscape has led to the increase in complexity of the infrastructure. This increasing complex infrastructure presents a challenge for governments to continue to meet its objectives. Knowledge Graph (KG), a constituent AI technology, has shown a lot of promise in helping governments meet its objectives in the midst of the complexity. A major aspect of this complexity is the need to maintain a single view of the world, in the form of a unified meaning of data, within a given e-Government instance, given the heterogeneity in data models used in the different departments within an e-Government instance. In this paper, we present a unique perspective in addressing the problem of deriving semantic meaning from disparate data in an e-Government context, using KG. Our aim is to advance the objectives of effective service delivery and citizens engagement in a complex e- Government instance. We focus on creating a data- centric architectural model that is single, simple and extensible, based on KG. We create a functional model based on architectural view and viewpoints from standards such as The Open Group Architectural Framework (TOGAF). The functional model highlights the various components that underpin the functions. We have developed our model within the context of a Design Science Research (DSR) approach, and we provide evaluation of same model within that context. An e- Government KG model guides the development of KG solutions in e-Government, in order to achieve the e- Government enterprise goals of effective service delivery and citizens engagement.
Beyond Shelters: A Gendered Approach to Disaster Preparedness and Resilience in Urban Centers
Authors: Yarramsetty Rithvik , Sai Prasanna Banothu
Published: April 2024

This research explores the shortcomings of a shelter-centric approach to disaster preparedness and resilience in urban centers, particularly regarding its impact on women. It argues for a gender-integrated approach that acknowledges existing inequalities and vulnerabilities faced by women in disaster situations. The paper begins by examining how socioeconomic factors, social norms, and poorly planned urban infrastructure disproportionately affect women's ability to prepare for and recover from disasters. It then critiques the limitations of traditional disaster response, which often prioritizes immediate shelter needs while neglecting women's long-term safety, security, and economic well- being. Moving forward, the research proposes a framework for building gender-responsive resilience in urban contexts. This framework emphasizes inclusive planning that actively incorporates women's knowledge and perspectives. The paper also highlights the importance of targeted early warning systems and gender-sensitive infrastructure design. Additionally, it proposes strategies like livelihood support programs to foster women's economic recovery after disasters. By exploring case studies and offering specific policy recommendations, this research aims to empower stakeholders - city planners, disaster management agencies, and NGOs - to create more equitable and inclusive practices. These practices will ultimately strengthen the resilience of urban communities by enabling all residents, particularly women, to effectively prepare for, respond to, and recover from disasters.
An improved Mini Antenna Designed at 60GHZ for a New Generation Mobile Phone
Authors: Ahmed Almukhtar , M. Allaghi Walid.
Published: April 2024

Five-generation (5G) communication systems are being required to meet the needs of small, high-speed, and big bandwidth systems [2]. This paper simulates and designs a 60GHZ rectangular micro strip patch antenna. The proposed antenna resonates at 60GHZ with a return loss of -32.126 dB, efficiency of 87.7119%, and gain of 6.96485 dBi. The patch is 2.726 x 2.364 x 0.125 mm. The radiating patch and the 50Ω micro strip feed line are matched using an iset feed transmission line approach. A Roger RT Duroid 5880 substrate, with a height of 0.125mm and a dielectric constant of 2.20 and a loss tangent of 0.0009, was selected in the design. The Advanced Design System (ADS) was used to compute the antenna's parameters and evaluate the results of simulations.
Enhanced Profile Hidden Markov Model for Metamorphic Malware Detection
Authors: D. Javier Ken Carlo , P. Catura Allyza Maureen , C. Morano Jonathan , R. Blanco Mark Christopher
Published: April 2024

Metamorphic malware poses a significant threat to conventional signature-based malware detection since its signature is mutable. Multiple copies can be created from metamorphic malware. As such, signature- based malware detection is impractical and ineffective. Thus, research in recent years has focused on applying machine learning-based approaches to malware detection. Profile Hidden Markov Model is a probabilistic model that uses multiple sequence alignments and a position-based scoring system. An enhanced Profile Hidden Markov Model was constructed with the following modifications: n-gram analysis to determine the best length of n-gram for the dataset, setting frequency threshold to determine which n-gram opcodes will be included in the malware detection, and adding consensus sequences to multiple sequence alignments. 1000 malware executables files and 40 benign executable files were utilized in the study. Results show that n-gram analysis and adding consensus sequence help increase malware detection accuracy. Moreover, setting the frequency threshold based on the average TF-IDF of n-gram opcodes gives the best accuracy in most malware families than just by getting the top 36 most occurring n-grams, as done in previous studies.
Exploring the Clinical Characteristics, Chromosomal Analysis, and Emotional and Social Considerations in Parents of Children with Down Syndrome
Authors: Padman Sachin , Sachin Kusuma , Reddy I. Venugopal
Published: April 2024

Down syndrome, also known as trisomy 21, is a common chromosomal disorder that affects one in every 750/1000 live births. It is characterized by delayed milestones and repeated chest infections, with most children having microcephaly, low set ears, flat nasal bridge, simian crease, umbilical hernia, CVS findings, and repeated ear infections. The risk of Down syndrome increases to 1:20 for mothers over 40 years old. A study examined 30 children with phenotype suggestive of Down syndrome, with a male to female ratio of 0.76:1. The median age at presentation was 7 years, with a minimum of 3 years and a maximum of 12 years. The mean maternal age at child birth was 32 years, with 13.3% of the children born out of consanguineous marriage. The study found that none of the mothers had a history of abortions, and 6.7% had complications during pregnancy. The most common complaint was delay in attainment of mile stones (96.7%) followed by recurrent LRTI & URTI (13.2%), with 2 having heart disease and 1 having family history of asthma. Physical characteristics included microcephaly (86.7%), low set ears, a flat nasal bridge (96.7%), half of the children had simian crease and umbilical hernia (50%), excessive skin on the back (76.7%), muscular hypotonia (66.7%), dermatoses (26.7%), and hypothyroidism (10%). Cerebral findings were found in 15 children (50%), with endocardial cushion defects being the most common. ASD (13.04%) was most common in 12 children, followed by VSD (10.86%), and PDA (4.3%) was present in 4.3%.
National MERIT Conference 2024, Manchester, UK
Authors: Ravindran Sai Yuva , Sharma Deepali , Chakravorty Indranil
Published: April 2024

Abstracts selected for publication.
Comparison of the Oral Hygiene Status in Children With and Without Juvenile Diabetes - A Comparative Study
Authors: Govindaraju Lavanya , Gurunathan Deepa
Published: April 2024

Background:

The rise in awareness programs with regard to the maintenance of oral hygiene in children with diabetes has led to a hypothetical question if children with juvenile diabetes are still under the risk of developing dental caries and having poor oral hygiene.

Aim:

To compare the oral hygiene status of the children with and without juvenile diabetes.

Materials and Method:

The study was conducted as age and sex matched case–control study. Sixty-six children diagnosed with juvenile diabetes were compared with the age and sex matched 66 healthy controls with respect to the oral hygiene index, gingival index and DMFT/def index. Mean of the obtained scores of the variables were compared between the groups using Mann–Whitney test with significance level set at 5%.

Results and Conclusion:

No statistically significant differences were noted in the gingival condition and dental caries experience between the children with and without juvenile diabetes (P = 0.820; 0.504; 0.422). However, the overall oral hygiene status was found to be poor in children with juvenile diabetes (P = 0.003). No significant differences were observed in the gingival status and the dental caries prevalence between the two groups.
Intravascular Papillary Endothelial Hyperplasia of Buccal Mucosa Masquerading as Mucocele - A Case Report
Authors: Pandiar Deepak , Krishnan Reshma Poothakulath , Behera Aklesha , Ramani Pratibha
Published: April 2024

Introduction:

Oral intravascular papillary endothelial hyperplasia (IPEH) is a rare entity with only 105 cases reported so far. Labial and buccal mucosa are the commonly affected sites. These sites are coincidently subjected to continuous minor trauma, which led the researchers to opine that IPEH could have a traumatic etiology with a further role of fibroblast growth factors.

Clinical Presentation:

We report a case of IPEH of right buccal mucosa in a 35 years old South Indian male who clinically presented as mucocele. Histopathologically, multiple lesions were found. Immunohistochemical and histochemical findings have also been presented.

Discussion:

The case is supported by a plausible mechanism involved in the pathogenesis. Thus, IPEH must be included in the clinical differential diagnosis of oral mucoceles and hemangioma.

Take-away Lessons:

Being a reactive lesion, it does not require extensive treatment. Clinicians and histopathologists must be aware of this uncommon yet benign condition for appropriate therapy.
Salivary Biomarker Levels in Children with Sleep Problems Before and After Twin Block Therapy
Authors: Bhosale Trupti Balasaheb , Shetty Vabitha
Published: April 2024

Background:

Disturbances in sleep have a wide-ranging effect on a child’s life profoundly impacting the standard of living. The aim of this study was to investigate levels of Salivary Tumor Necrosis Factor-Alpha (TNF-α) and Malondialdehyde (MDA) in a group of children with class II malocclusion and sleep problems before and after twin block appliance therapy.

Materials and Methods:

Eleven children aged 8–12 years with skeletal class II malocclusion and at least one sleep disorder participated in the study. All children were subjected to a recording of their sleep history and a clinical and radiographic examination. Pre-treatment levels of salivary TNF-α and MDA were recorded. A twin block appliance was custom made and delivered to every child. After a minimum follow-up period of 9 months, all children were recalled for a re-evaluation of salivary biomarker levels.

Results:

Levels of salivary biomarkers TNF-α and MDA significantly decreased in children following myofunctional therapy using a twin block appliance.

Conclusion:

The measurement of TNF-α and MDA could be used as an alternative and noninvasive method to evaluate prognosis of twin block therapy for children with sleep-disordered breathing (SDB).
A Variant of Gorlin–Goltz Syndrome with Synchronous Malignant and Multiple Benign Lesions of the Jaws - A Case Report
Authors: John Reena R. , Ashokkumar Pavithran , Gopalakrishnan Kathirvel , Subramanian Mohithan
Published: April 2024

Introduction:

Although numerous syndromic and non-syndromic odontogenic lesions of the jaws have been documented in the literature, there are very few cases of simultaneous benign and malignant jaw lesions.

Patient Concerns:

We present a case of right maxillary squamous cell carcinoma along with several benign odontogenic cystic lesions of the jaws and skeletal abnormalities that meet the criteria for Gorlin-Goltz syndrome.

Take-Away Lessons:

With a review of the literature, the specifics of management and follow-up are discussed.
Expression of CD44, PCNA and E-cadherin in pterygium tissues
Authors: Yıldırım Humeyra , Turan Gulay , Turan Meydan
Published: April 2024

Purpose:

Pterygium is a common ocular surface disease defined by fibrovascular conjunctival growth extending onto the cornea. However, its pathogenesis remains unclear. This study aimed to determine the role of CD44, proliferating cell nuclear antigen (PCNA), and E-cadherin in pterygium formation and recurrence.

Methods:

Sixty patients with pterygium participated in the study, and we collected conjunctival samples from 30 patients to form a control group. CD44, PCNA, and E-cadherin expressions in surgically excised pterygium were compared with tissue samples from the control group.

Results:

We observed that the percentages of CD44 and PCNA were statistically higher in the primary pterygium group and recurrent pterygium group than in the control group (P < 0.001 and P < 0.001, respectively). Conversely, E-cadherin values were statistically higher in the control group than in the primary and recurrent pterygium groups (P = 0.013 and P < 0.001, respectively).

Conclusion:

Cell proliferation and cell adhesion factors may play important roles in the pathogenesis of pterygium.
Adjunctive transseptal corridor: Technique for endoscopic resection of orbital tumor
Authors: Yang Yang , Shen Lifang , Chen Haihong
Published: April 2024

The transnasal endoscopic approach is increasingly used for resection of tumors that are located inferiorly and medially within the orbit. However, this usually requires multiple-handed manipulations, which demand a second corridor for an assistant. Here, we introduce a simple transseptal corridor from the contra-nare, to facilitate assistant instrument maneuverability. This simple, minimally invasive skill greatly improves operation efficiency and deserves greater attention in endoscopic orbital surgery.
Converting LEA to Pelli-Robson contrast sensitivity score in neuro-ophthalmology patients
Authors: Prihatningtias Riski , Hardiyanti Disti , Valencia Lovenia
Published: April 2024

Purpose:

The Pelli-Robson and LEA contrast sensitivity charts are commonly used in clinical settings to measure contrast sensitivity. Although the Pelli-Robson chart is considered the gold standard, it is limited by its bulky size. The LEA chart, on the contrary, offers a more practical and portable option that is still reliable. This has led to questions about whether we can predict Pelli-Robson scores based on LEA scores. This study developed a conversion method to help transition from the LEA chart to the Pelli-Robson chart and validate the conversion score.

Methods:

In this retrospective study, we analyzed the relationship between LEA and the Pelli-Robson contrast sensitivity test. Our study examined a total of 120 eyes. We developed a conversion table through the equipercentile equating method. Subsequently, we assessed the reliability and accuracy of this algorithm for converting LEA results into Pelli-Robson contrast sensitivity scores.

Results:

The study used a conversion table to convert LEA scores to Pelli-Robson scores. The conversion table achieved a reliability of 0.91 based on intraclass correlation, and the algorithm had an accuracy of 81.6% within a 1-point difference from the raw score.

Conclusions:

This study reported a reliable and comparable conversion algorithm for transforming LEA scores into converted estimated Pelli-Robson scores, thereby improving the usefulness of existing data in both clinical and research contexts.
Management of corneal neovascularization: Current and emerging therapeutic approaches
Authors: Wu Duoduo , Chan Kai En , Lim Blanche Xiao Hong , Lim Dawn Ka-Ann , Wong Wendy Meihua , Chai Charmaine , Manotosh Ray , Lim Chris Hong Long
Published: April 2024

Corneal neovascularization (CoNV) is a sight-threatening condition affecting an estimated 1.4 million people per year, and the incidence is expected to rise. It is a complication of corneal pathological diseases such as infective keratitis, chemical burn, corneal limbal stem cell deficiency, mechanical trauma, and immunological rejection after keratoplasties. CoNV occurs due to a disequilibrium in proangiogenic and antiangiogenic mediators, involving a complex system of molecular interactions. Treatment of CoNV is challenging, and no therapy thus far has been curative. Anti-inflammatory agents such as corticosteroids are the mainstay of treatment due to their accessibility and well-studied safety profile. However, they have limited effectiveness and are unable to regress more mature neovascularization. With the advent of advanced imaging modalities and an expanding understanding of its pathogenesis, contemporary treatments targeting a wide array of molecular mechanisms and surgical options are gaining traction. This review aims to summarize evidence regarding conventional and emerging therapeutic options for CoNV.
Single-center retrospective study of the diagnostic value of double-balloon enteroscopy in Meckel’s diverticulum with bleeding
Authors: He Tian , Yang Chao , Wang Jing , Zhong Ji-Sheng , Li Ai-Hua , Yin Ya-Jing , Luo Li-Ling , Rao Chun-Mei , Mao Nian-Fen , Guo Qiang , Zuo Zan , Zhang Wen , Wan Ping
Published: April 2024

BACKGROUND

The study aimed to analyze the characteristic clinical manifestations of patients with intestinal disease Meckel’s diverticulum (MD) complicated by digestive tract hemorrhage. Moreover, we aimed to evaluate the value of double-balloon enteroscopy (DBE) in MD diagnosis and the prognosis after laparoscopic diverticula resection.

AIM

To evaluate the value of DBE in the diagnosis and the prognosis after laparoscopic diverticula resection for MD with bleeding.

METHODS

The study retrospectively analyzed relevant data from 84 MD patients treated between January 2015 and March 2022 and recorded their clinical manifestations, auxiliary examination, and follow-up after laparoscopic resection of diverticula.

RESULTS

(1) Among 84 MD patients complicated with hemorrhage, 77 were male, and 7 were female with an average age of 31.31 ± 10.75 years. The incidence was higher in men than in women of different ages; (2) Among the 84 MD patients, 65 (78.40%) had defecated dark red stools, and 50 (58.80%) had no accompanying symptoms during bleeding, indicating that most MD bleeding appeared a dark red stool without accompanying symptoms; (3) The shock index of 71 patients (85.20%) was < 1, suggesting that the blood loss of most MD patients was less than 20%–30%, and only a few patients had a blood loss of > 30%; (4) The DBE-positive rate was 100% (54/54), 99mTc-pertechnetate-positive scanning rate was 78% (35/45) compared with capsule endoscopy (36%) and small intestine computed tomography (19%). These results suggest that DBE and 99mTc-pertechnetate scans had significant advantages in diagnosing MD and bleeding, especially DBE was a highly precise examination method in MD diagnosis; (5) A total of 54 MD patients with hemorrhage underwent DBE examination before surgery. DBE endoscopy revealed many mucosal manifestations including normal appearance, inflammatory changes, ulcerative changes, diverticulum inversion, and nodular hyperplasia, with ulcerative changes being the most common (53.70%). This suggests that diverticular mucosal ulcer was the main cause of MD and bleeding; and (6) Laparoscopic dissection of diverticulae was performed in 76 patients, The patients who underwent postoperative follow-up did not experience any further bleeding. Additionally, follow-up examination of the 8 cases who had declined surgery revealed that 3 of them experienced a recurrence of digestive tract bleeding. These findings indicate that laparoscopic diverticula resection in MD patients complicated by bleeding had a favorable prognosis.

CONCLUSION

Bleeding associated with MD was predominantly observed in male adolescents, particularly at a young age. DBE was a highly precise examination method in MD diagnosis. Laparoscopic diverticula resection effectively prevented MD bleeding and had a good prognosis.
Research on the prognostic value of adjusting intraperitoneal three-dimensional quality evaluation mode in laparoscopic cholecystectomy patients
Authors: Zhou Yuan , Chen Zhan-Qing
Published: April 2024

BACKGROUND

Benign gallbladder diseases have become a high-prevalence condition not only in China but also worldwide. The main types of benign gallbladder diseases include gallbladder polyps, acute and chronic cholecystitis, and gallstones, with gallstones being the most common, accounting for over 70% of cases. Although the mortality rate of benign gallbladder diseases is low, they carry obvious potential risks. Studies have shown that an increased incidence of benign gallbladder diseases can increase the risk of cardiovascular diseases and gallbladder cancer, resulting in a substantial disease burden on patients and their families.

AIM

To assess the medical utility of the Configuration-Procedure-Consequence (CPC) three-dimensional quality evaluation model in modulating the prognosis of laparoscopic cholecystectomy patients.

METHODS

A total of 98 patients who underwent laparoscopic cholecystectomy in our hospital from February 2020 to January 2022 were selected as the subjects. According to the random number table method, they were divided into a study group and a control group, with 49 patients in each group. The control group received routine perioperative care, while the study group had the addition of the CPC three-dimensional quality evaluation. The postoperative recovery-related indicators (time to first flatus, time to oral intake, time to ambulation, hospital stay), stress indicators (cortisol and adrenaline levels), distinctions in anxiety and depression status, and the incidence of perioperative complications were compared.

RESULTS

The time to first flatus, time to oral intake, time to ambulation, and hospital stay of the study group patients were obviously lower than those of the control group patients, with statistical significance (P < 0.05). On the 1st day after admission, there were no obvious distinctions in cortisol and adrenaline levels in blood samples, as well as in the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) scores between the study group and the control group (P > 0.05). However, on the 3rd day after surgery, the cortisol and adrenaline levels, as well as SAS and SDS scores of the study group patients, were obviously lower than those of the control group patients (P < 0.05). The study group had 2 cases of incisional infection and 1 case of pulmonary infection, with a total incidence of complications of 6.12% (3/49), which was obviously lower than the 20.41% (10/49) in the control group (P < 0.05).

CONCLUSION

Implementing the CPC three-dimensional quality evaluation model for patients undergoing laparoscopic cholecystectomy can help accelerate their perioperative recovery process, alleviate perioperative stress symptoms, mitigate anxiety, depression, and other adverse emotions, and to some extent, reduce the incidence of perioperative complications.
Comparative analysis of two digestive tract reconstruction methods in total laparoscopic radical total gastrectomy
Authors: Dong Tian-Xiang , Wang Dong , Zhao Qun , Zhang Zhi-Dong , Zhao Xue-Feng , Tan Bi-Bo , Liu Yu , Liu Qing-Wei , Yang Pei-Gang , Ding Ping-An , Zheng Tao , Li Yong , Liu Zi-Jing
Published: April 2024

BACKGROUND

The incidence of gastric cancer has significantly increased in recent years. Surgical resection is the main treatment, but the method of digestive tract reconstruction after gastric cancer surgery remains controversial. In the current study, we sought to explore a reasonable method of digestive tract reconstruction and improve the quality of life and nutritional status of patients after surgery. To this end, we statistically analyzed the clinical results of patients with gastric cancer who underwent jejunal interposition double-tract reconstruction (DTR) and esophageal jejunum Roux-en-Y reconstruction (RY).

AIM

To explore the application effect of DTR in total laparoscopic radical total gastrectomy (TLTG) and evaluate its safety and efficacy.

METHODS

We collected the relevant data of 77 patients who underwent TLTG at the Fourth Hospital of Hebei Medical University from October 2021 to January 2023. Among them, 35 cases were treated with DTR, and the remaining 42 cases were treated with traditional RY. After 1:1 propensity score matching, the cases were grouped into 31 cases per group, with evenly distributed data. The clinical characteristics and short- and long-term clinical outcomes of the two groups were statistically analyzed.

RESULTS

The two groups showed no significant differences in basic data, intraoperative blood loss, number of lymph node dissections, first defecation time after operation, postoperative hospital stay, postoperative complications, and laboratory examination results on the 1st, 3rd, and 5th days after operation. The operation time of the DTR group was longer than that of the RY group [(307.58 ± 65.14) min vs (272.45 ± 62.09) min, P = 0.016], but the first intake of liquid food in the DTR group was shorter than that in the RY group [(4.45 ± 1.18) d vs (6.0 ± 5.18) d, P = 0.028]. The incidence of reflux heartburn (Visick grade) and postoperative gallbladder disease in the DTR group was lower than that in the RY group (P = 0.033 and P = 0.038). Although there was no significant difference in body weight, hemoglobin, prealbumin, and albumin between the two groups at 1,3 and 6 months after surgery, the diet of patients in the DTR group was better than that in the RY group (P = 0.031).

CONCLUSION

The clinical effect of DTR in TLTG is better than that of RY, indicating that it is a more valuable digestive tract reconstruction method in laparoscopic gastric cancer surgery.
Incidence of surgical site infection in minimally invasive colorectal surgery
Authors: Ni Lu-Ting , Zhao Ru , Ye Yi-Ru , Ouyang Yi-Ming , Chen Xin
Published: April 2024

BACKGROUND

Surgical site infection (SSI) is a common complication of colorectal surgery. Minimally invasive surgery notably reduces the incidence of SSI. This study aimed to compare the incidences of SSI after robot-assisted colorectal surgery (RACS) vs that after laparoscopic assisted colorectal surgery (LACS) and to analyze associated risk factors for SSI in minimally invasive colorectal surgery.

AIM

To compare the incidences of SSI after RACS and LACS, and to analyze the risk factors associated with SSI after minimally invasive colorectal surgery.

METHODS

Clinical data derived from patients who underwent minimally invasive colorectal surgery between October 2020 and October 2022 at the First Affiliated Hospital of Soochow University were collated. Differences in clinical characteristics and surgeryrelated information associated with RACS and LACS were compared, and possible risk factors for SSI were identified.

RESULTS

A total of 246 patients (112 LACS and 134 RACS) were included in the study. Fortythree (17.5%) developed SSI. The proportions of patients who developed SSI were similar in the two groups (17.9% vs 17.2%, P = 0.887). Diabetes mellitus, intraoperative blood loss ≥ 100 mL, and incision length were independent risk factors for SSI. Possible additional risk factors included neoadjuvant therapy, lesion site, and operation time.

CONCLUSION

There was no difference in SSI incidence in the RACS and LACS groups. Diabetes mellitus, intraoperative blood loss ≥ 100 mL, and incision length were independent risk factors for postoperative SSI.
Burden of gallstone disease in the United States population: Prepandemic rates and trends
Authors: Unalp-Arida Aynur , Ruhl Constance E
Published: April 2024

BACKGROUND

Gallstone disease is one of the most common digestive disorders in the United States and leads to significant morbidity, mortality, and health care utilization.

AIM

To expand on earlier findings and investigate prepandemic rates and trends in the gallstone disease burden in the United States using national survey and claims databases.

METHODS

The National Ambulatory Medical Care Survey, National Inpatient Sample, Nationwide Emergency Department Sample, Nationwide Ambulatory Surgery Sample, Vital Statistics of the United States, Optum Clinformatics® Data Mart, and Centers for Medicare and Medicaid Services Medicare 5% Sample and Medicaid files were used to estimate claims-based prevalence, medical care including cholecystectomy, and mortality with a primary or other gallstone diagnosis. Rates were age-adjusted (for national databases) and shown per 100000 population.

RESULTS

Gallstone disease prevalence ( claims-based, 2019) was 0.70% among commercial insurance enrollees, 1.03% among Medicaid beneficiaries, and 2.09% among Medicare beneficiaries and rose over the previous decade. Recently, in the United States population, gallstone disease contributed to approximately 2.2 million ambulatory care visits, 1.2 million emergency department visits, 625000 hospital discharges, and 2000 deaths annually. Women had higher medical care rates with a gallstone disease diagnosis, but mortality rates were higher among men. Hispanics had higher ambulatory care visit and hospital discharge rates compared with Whites, but not mortality rates. Blacks had lower ambulatory care visit and mortality rates, but similar hospital discharge rates compared with whites. During the study period, ambulatory care and emergency department visit rates with a gallstone disease diagnosis rose, while hospital discharge and mortality rates declined. Among commercial insurance enrollees, rates were higher compared with national data for ambulatory care visits and hospitalizations, but lower for emergency department visits. Cholecystectomies performed in the United States included 605000 ambulatory laparoscopic, 280000 inpatient laparoscopic, and 49000 inpatient open procedures annually. Among commercial insurance enrollees, rates were higher compared with national data for laparoscopic procedures.

CONCLUSION

The gallstone disease burden in the United States is substantial and increasing, particularly among women, Hispanics, and older adults with laparoscopic cholecystectomy as the mainstay treatment. Current practice patterns should be monitored for better health care access.
Kuicolong-yu enema decoction retains traditional Chinese medicine enema attenuates inflammatory response ulcerative colitis through TLR4/NF-κB signaling pathway
Authors: Han Li , Tang Kun , Fang Xiao-Li , Xu Jing-Xi , Mao Xi-Yun , Li Ming
Published: April 2024

BACKGROUND

Ulcer colitis (UC) is a chronic, nonspecific, and noninfectious inflammatory bowel disease. Recently, Toll-like receptors (TLRs) have been found to be closely associated with clinical inflammatory diseases. Achieving complete remission in patients with intermittent periods of activity followed by dormancy is challenging. Moreover, no study has explored the mechanism by which Kuicolong-yu enema decoction retains traditional Chinese medicine enemas to attenuate the inflammatory response in UC.

AIM

To explore the mechanism by which Kuicolong-yu enema decoction retains traditional Chinese medicine enemas to attenuate the inflammatory response in UC.

METHODS

This prospective clinical study included patients who met the exclusion criteria in 2020 and 2021. The patients with UC were divided into two groups (control and experimental). The peripheral blood of the experimental and control groups were collected under aseptic conditions. The expression of TLR4 protein, NF-κB, IL-6, and IL-17 was detected in the peripheral blood of patients in the experimental group and control group before and 1 month after taking the drug. Linear correlation analysis was used to analyze the relationship between the expression level of TLR4 protein and the expression levels of downstream signal NF-κB and inflammatory factors IL-6 and IL-17, and P < 0.05 was considered statistically significant.

RESULTS

There were no significant differences in the patient characteristics between the control and experimental groups. The results showed that the expression levels of TLR4 and NF-κB in the experimental group were significantly lower than those in the control group (P < 0.05). The levels of IL-6 and IL-17 in the experimental group were significantly lower than those in the control group (P < 0.05). The TLR4 protein expression in the experimental group was positively correlated with the expression level of downstream signal NF-κB and was positively correlated with the levels of downstream inflammatory cytokines IL-6 and IL-17 (r = 0.823, P < 0.05).

CONCLUSION

Kuicolong-yu enema decoction retains traditional Chinese medicine enema attenuates the inflammatory response of UC through the TLR4/NF-κB signaling pathway.
Quality-adjusted life years and surgical waiting list: Systematic review of the literature
Authors: de la Plaza Llamas Roberto , Ortega Azor Lorena , Hernández Yuste Marina , Gorini Ludovica , Latorre-Fragua Raquel Aránzazu , Díaz Candelas Daniel Alejandro , Al Shwely Abduljabar Farah , Gemio del Rey Ignacio Antonio
Published: April 2024

BACKGROUND

The quality-adjusted life year (QALY) is a metric that is increasingly used today in the field of health economics to evaluate the value of different medical treatments and procedures. Surgical waiting lists (SWLs) represent a pressing problem in public healthcare. The QALY measure has rarely been used in the context of surgery. It would be interesting to know how many QALYs are lost by patients on SWLs.

AIM

To investigate the relationship between QALYs and SWLs in a systematic review of the scientific literature.

METHODS

The study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement. An unlimited search was carried out in PubMed, updated on January 19, 2024. Data on the following variables were investigated and analyzed: Specialty, country of study, procedure under study, scale used to measure QALYs, the use of a theoretical or real-life model, objectives of the study and items measured, the economic value assigned to the QALY in the country in question, and the results and conclusions published.

RESULTS

Forty-eight articles were selected for the study. No data were found regarding QALYs lost on SWLs. The specialties in which QALYs were studied the most in relation to the waiting list were urology and general surgery, with 15 articles each. The country in which the most studies of QALYs were carried out was the United States (n = 21), followed by the United Kingdom (n = 9) and Canada (n = 7). The most studied procedure was organ transplantation (n = 39), including 15 kidney, 14 liver, 5 heart, 4 lung, and 1 intestinal. Arthroplasty (n = 4), cataract surgery (n = 2), bariatric surgery (n = 1), mosaicplasty (n = 1), and septoplasty (n = 1) completed the surgical interventions included. Thirty-nine of the models used were theoretical (the most frequently applied being the Markov model, n = 34), and nine were real-life. The survey used to measure quality of life in 11 articles was the European Quality of Life-5 dimensions, but in 32 articles the survey was not specified. The willingness-to-pay per QALY gained ranged from $100000 in the United States to €20000 in Spain.

CONCLUSION

The relationship between QALYs and SWLs has only rarely been studied in the literature. The rate of QALYs lost on SWLs has not been determined. Future research is warranted to address this issue.
Successful splenic artery embolization in a patient with Behçet’s syndrome-associated splenic rupture: A case report
Authors: Zhu Guang-Zhao , Ji Dong-Hua
Published: April 2024

BACKGROUND

Splenic rupture associated with Behçet’s syndrome (BS) is extremely rare, and there is no consensus on its management. In this case report, a patient with BS-associated splenic rupture was successfully treated with splenic artery embolization (SAE) and had a good prognosis after the intervention.

CASE SUMMARY

The patient was admitted for pain in the left upper abdominal quadrant. He was diagnosed with splenic rupture. Multiple oral and genital aphthous ulcers were observed, and acne scars were found on his back. He had a 2-year history of BS diagnosis, with symptoms of oral and genital ulcers. At that time, he was treated with oral corticosteroids for 1 month, but the symptoms did not alleviate. He underwent SAE to treat the rupture. On the first day after SAE, the patient reported a complete resolution of abdominal pain and was discharged 5 d later. Three months after the intervention, a computed tomography examination showed that the splenic hematoma had formed a stable cystic effusion, suggesting a good prognosis.

CONCLUSION

SAE might be a good choice for BS-associated splenic rupture based on good surgical practice and material selection.
Endoscopic treatment of bleeding gastric ulcer causing gastric wall necrosis: A case report
Authors: Li Wei-Feng , Gao Ruo-Yu , Xu Jing-Wen , Yu Xi-Qiu
Published: April 2024

BACKGROUND

Gastric wall necrosis is a rare complication of endoscopic treatment for bleeding gastric ulcer, which may exacerbate the patient’s condition once it occurs and may even require surgical intervention for treatment.

CASE SUMMARY

A 59-year-old man was admitted to our department with melena. Endoscopy revealed a giant ulcer in the gastric antrum with a visible vessel in its center, which was treated with sclerosants and tissue glue injection and resulted in necrosis of the gastric wall.

CONCLUSION

Injection of sclerosants and tissue glue may lead to gastric wall necrosis, which is a serious complication. Therefore, before administering this treatment to patients, we should consider other more effective methods of hemostasis to avoid gastric wall necrosis.
Intermittent melena and refractory anemia due to jejunal cavernous lymphangioma: A case report
Authors: Liu Kai-Rui , Zhang Sheng , Chen Wei-Run , Huang You-Xing , Li Xu-Guang
Published: April 2024

BACKGROUND

Lymphangiomas in the gastrointestinal tract are extremely rare in adults. As a benign lesion, small intestine lymphangiomas often remain asymptomatic and pose challenges for definitive diagnosis. However, lymphangiomas can give rise to complications such as abdominal pain, bleeding, volvulus, and intussusception. Here, we report a case of jejunal cavernous lymphangioma that presented with intermittent melena and refractory anemia in a male adult.

CASE SUMMARY

A 66-year-old man presented with intermittent melena, fatigue and refractory anemia nine months prior. Esophagogastroduodenoscopy and colonoscopy were performed many times and revealed no apparent bleeding. Conservative management, including transfusion, hemostasis, gastric acid secretion inhibition and symptomatic treatment, was performed, but the lesions tended to recur shortly after surgery. Ultimately, the patient underwent capsule endoscopy, which revealed a more than 10 cm lesion accompanied by active bleeding. After single-balloon enteroscopy and biopsy, a diagnosis of jejunal cavernous lymphangioma was confirmed, and the patient underwent surgical resection. No complications or recurrences were observed postoperatively.

CONCLUSION

Jejunal cavernous lymphangioma should be considered a cause of obscure gastrointestinal bleeding. Capsule endoscopy and single-balloon enteroscopy can facilitate diagnosis. Surgical resection is an effective management method.
New frontiers in ectopic pancreatic tissue management
Authors: Covantsev Serghei
Published: April 2024

The pancreatic development variations are relatively frequent but are often overlooked in clinical practice. This is due to the fact that they do not present with a distinct clinical picture and are usually asymptomatic. It also refers to the ectopic pancreatic tissue in the stomach. This anomaly can be diagnosed in any part of the digestive system, but it is mostly seen in the upper gastrointestinal tract, especially in the stomach, duodenum and jejunum. The management of this condition has evolved due to the development of minimally invasive procedures.
How to identify early complications in patients undergoing distal gastrectomy?
Authors: Tropeano Giuseppe , Chiarello Maria Michela , Fico Valeria , Brisinda Giuseppe
Published: April 2024

In this editorial we comment on the article by Zhang et al published in a recent issue of the World Journal of Gastrointestinal Surgery . Gastrectomy with appropriate lymph node dissection is still standard curative treatment in locally advanced gastric cancer. Several studies point out that gastric cancer surgery is a complex procedure that leads to a high risk of morbidity and mortality. Many factors can contribute to the onset of complications with consequent effects on prognosis and increased mortality. The complications can be divided in complications related to anastomosis, to motility and to surgical site infection. The study presented by Zhang B et al represent an interesting analysis on the possibility to prevent postoperative morbidity. The study was performed on 131 patients with distal gastric cancer who underwent gastrectomy with D2 lymph node dissection. Of these patients, 16% developed early postoperative complications. The univariate analysis showed that prealbumin level, hypertension, diabetes, history of abdominal surgery, R0 resection, and blood transfusion were factors influencing early postoperative complications after distal gastrectomy. Moreover, the inclusion of the above significant variables in the logistic regression analysis revealed that hypertension, diabetes, a history of abdominal surgery, and blood transfusion were independent predictors of postoperative complications. In conclusion, preoperative and intraoperative factors can be used to establish an early postoperative nomogram model. The results of the study presented by Zhang et al suggest that the prediction model can be used to guide the detection of postoperative complications and has clinical reference value.