bluuebunny/crossref_metadata_2025 huggingface dataset:
Rare case series of congenital adrenal insufficiency in two brothers with NROB1 mutation, presenting with dichotomous pubertal presentation
Authors:   National Institute of Child Health, Karachi, Pakistan., Rai Versha Rani , Shaikh Ikramullah ,   National Institute of Child Health, Karachi, Pakistan., Rahak Karishma ,   National Institute of Child Health, Karachi, Pakistan., Parveen Roshia ,   National Institute of Child Health, Karachi, Pakistan., Raza Jamal ,   National Institute of Child Health, Karachi, Pakistan., Laghari Taj Muhammad ,   National Institute of Child Health, Karachi, Pakistan., Ibrahim Mohsina Noor ,   National Institute of Child Health, Karachi, Pakistan.
Published: April 2022

Congenital Adrenal Hypoplasia (AHC) first described in 1948, characterized by adrenal insufficiency, and hypo-gonadotropic hypogonadism. X linked AHC mainly affects males, it occur mainly due to mutation in NR0B1 gene. In this report, we present two cases of NR0B1 mutation from same family with dichotomous pubertal presentation. An infant diagnosed and being managed as case of adrenal insufficiency, developed precocious puberty at the age of 11 months. His work-up showed increased LH, FSH and Testosterone. Genetic Analysis revealed NR0B1 mutation. He was managed with Gn RH agonist and steroid replacement. His brother 15 years old, treated as primary adrenal insufficiency, presented with arrested puberty, his genetic analysis also showed NR0B1 mutation. Keywords: AHC; adrenal hypoplasia; precocious puberty; hypogonadotropic; hypogonadism.
Left ventricular non-compaction associated with a MYH7 splicing variant (c.818+1G>A)
Authors:   Unidad de Referencia de Cardiopatías Familiares-HUCA, Genética Molecular y Cardiología, Hospital Universitario Central Asturias, Oviedo, Spain., Gómez Juan , Lorca Rebeca ,   Unidad de Referencia de Cardiopatías Familiares-HUCA, Genética Molecular y Cardiología, Hospital Universitario Central Asturias, Oviedo, Spain., Vicente Alejandro Junco ,   Unidad de Referencia de Cardiopatías Familiares-HUCA, Genética Molecular y Cardiología, Hospital Universitario Central Asturias, Oviedo, Spain., Llavona Elías Cuesta ,   Medical Genetics Laboratory, Department of Molecular Medicine, Sapienza University, San Camillo-Forlanini Hospital, Rome, Italy., Reguero Julián R ,   Unidad de Referencia de Cardiopatías Familiares-HUCA, Genética Molecular y Cardiología, Hospital Universitario Central Asturias, Oviedo, Spain., Martín María ,   Unidad de Referencia de Cardiopatías Familiares-HUCA, Genética Molecular y Cardiología, Hospital Universitario Central Asturias, Oviedo, Spain., Calvo Juan ,   Servicio Radiología, Hospital Universitario Central Asturias, Oviedo, Spain., Cigarrán Helena ,   Servicio Radiología, Hospital Universitario Central Asturias, Oviedo, Spain., Corros Cecilia ,   Servicio Radiología, Hospital Universitario Central Asturias, Oviedo, Spain., Coto Eliecer ,   Unidad de Referencia de Cardiopatías Familiares-HUCA, Genética Molecular y Cardiología, Hospital Universitario Central Asturias, Oviedo, Spain.
Published: April 2022

Left Ventricular Noncompaction (LVNC) is a cardiac disease characterized by a trabecular meshwork and deep intertrabecular myocardial recesses that communicate with the left ventricular cavity. MYH7 splicing mutations are very rare, and seem to be restricted to patients with myopathy of LVNC. We characterized at the Cardiac Magnetic Resonance (CRM) and genetic levels in one individual (index case) from a family with LVNC. The patient was heterozygous carrier of a splicing MYH7 intron 8 variant (c.818+1G>A). One of his sons was also mutation carrier but clinically asymptomatic. However, the CRM showed the presence of LVNC. We concluded that the rare MYH7 intron 8 splicing mutation was associated with typical LVNC lesions in the CRM, albeit mutation carriers remain clinically asymptomatic. Keywords: left ventricular non-compaction; MYH7 gene; RNA decay; cardiac magnetic resonance.
Cavography with hydrogen peroxide. Accidental injection of hydrogen peroxide into the inferior vena cava
Authors:   Interventional Radiology, Research Group in Minimally Invasive Technique (GITMI) University of Zaragoza, Spain., Gregorio De , C Bello ,   Interventional Radiology, Research Group in Minimally Invasive Technique (GITMI) University of Zaragoza, Spain., R Bernal ,   Interventional Radiology, Research Group in Minimally Invasive Technique (GITMI) University of Zaragoza, Spain., Casorran Serrano ,   Interventional Radiology, Research Group in Minimally Invasive Technique (GITMI) University of Zaragoza, Spain., C Bonastre ,   Interventional Radiology, Research Group in Minimally Invasive Technique (GITMI) University of Zaragoza, Spain., A Guirola ,   Interventional Radiology, Research Group in Minimally Invasive Technique (GITMI) University of Zaragoza, Spain.
Published: April 2022

Contrast cavography during removal of a vena cava filter in patients treated via thrombectomy for pulmonary embolism is a widely performed procedure, which may involve potentially serious complications if the human factor fails. Accidental injection of hydrogen peroxide (H2O2) after mistaking it for contrast material can have fatal consequences. We present the case of a patient who was accidentally injected with a high quantity of hydrogen peroxide. The preparation of a preoperative checklist, the amount of H2 02 injected and the operator’s skill in aspirating the substance are decisive factors in avoiding such complications.
Brain metastases in anal squamous cell carcinoma: Case report and review of the literature
Authors:   Department of Internal Medicine, Division of Hematology/Oncology, West Virginia University, USA., Malla Midhun , Hatoum Hassan ,   Department of Internal Medicine, Division of Hematology/Oncology, University of Oklahoma Health Sciences, USA., George Sagila ,   Department of Internal Medicine, Division of Hematology/Oncology, University of Oklahoma Health Sciences, USA.
Published: April 2022

Anal cancer is a rare malignancy and constitutes only 2.5% of all digestive system cancers in the USA. There is an uptrend in the incidence of anal cancers in the general population, which could be attributed to human papilloma virus and human immunodeficiency virus infections, increase in lifetime number of sexual partners, receptive anal intercourse, number of patients on immunosuppressive treatments for organ transplants, cigarette smoking and genital warts [1]. Rate of metastasis from squamous cell cancer (SCC) of the anus is minimal and liver and lungs are the most commonly involved organs [2]. Metastasis to the brain is extremely rare [3]. So, far only 5 cases have been reported in the literature. In this manuscript we report an unusual presentation of brain only metastasis from anal cancer and a review of the literature on this topic. To our knowledge, this case represents the sixth reported case of anal cancer with brain metastasis in the literature. Moreover, this is the first reported case of anal cancer that presented with brain only metastasis within 3 months while in remission after completing treatment with chemoradiotherapy (CRT) for the primary tumor.
New right bundle branch block after selective HIS bundle pacing, Two methods for correction
Authors:   Mansoura University hospitals, Egypt., Sharief Mohamed , Ng G André ,   Department of Cardiovascular Sciences, University of Leicester, NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Groby Road, Leicester, LE3 9QP, UK., Ibrahim Mokhtar ,   University Hospitals of Leicester NHS Trust, Glenfield Hospital, Groby Road, Leicester, LE3 9QP, UK.
Published: April 2022

HIS Bundle Pacing (HBP) is considered the most physiologic pacing technique as it generates a physiological activation of both ventricles through synchronous ventricular depolarization of His bundle– Purkinje conduction system. Permanent HBP and Atrioventricular Node (AVN) ablation in patients with heart failure and atrial fibrillation were found to have an improvement in cardiac function and reduction of left ventricular dimensions [1]. We present case of paroxysmal atrial fibrillation and atypical atrial flutter that underwent HBP and AVN ablation. The patient developed a Right Bundle Branch Block (RBBB) following his AVN ablation with widening of QRS duration to 148 msec. We managed to correct this and restore a narrow QRS by two different mechanisms: 1. Programming the Interventricular (VV) delay to 20 msec (His pacing first followed by septal RV pacing through a back-up lead, 2. Unipolar pacing of the HIS lead with different configuration. By both methods, QRS duration was reduced to 108-110 msec with restoration of physiologic biventricular pacing. To the best of our knowledge, this has not been reported before. Keywords: atrial fibrillation; his bundle pacing; ablate; pace.
Cephalic vein draining directly into external jugular vein: A rare entity
Authors:   Department of Radiology, Skims Soura, J&K, India., Aamir Shah , Omair Shah ,   Department of Radiology, Skims Soura, J&K, India., Tariq Gojwari ,   Department of Radiology, Skims Soura, J&K, India., Shahbaz Qazi ,   Department of Radiology, Skims Soura, J&K, India.
Published: April 2022

Cephalic vein is a superficial vein of upper limb formed by dorsal venous arch on the radial side. It is used for catheterization, insertion of pacemaker and creating an Arteriovenous Fistula (AVF) in patients with Chronic Kidney Disease (CKD) for the purpose of hemodialysis. This is a case report of supraclavicular course of bilateral cephalic veins draining into external jugular veins on their respective sides. Such a case of supraclavicular course of bilateral cephalic veins in a live patient has not been previously reported. Supraclavicular course of cephalic vein increases the risk of complications during the clavicular fractures, cephalic vein catheterization, or head and neck surgery. Hence knowledge of such a variation of cephalic vein is of utmost importance to prevent complications. Keywords: cephalic vein; supraclavicular course; cephalic vein variation.
Metastatic spindle cell sarcoma: A rare type of undifferentiated soft tissue neoplasm
Authors:   Internal Medicine Department, Centro Hospitalar e Universitário de Coimbra EPE, Portugal., Nunes Ana Luísa , Lai Ana ,   Anatomical Pathology Department, Centro Hospitalar e Universitário de Coimbra EPE, Portugal., Oliveira Rui Caetano ,   Anatomical Pathology Department, Centro Hospitalar e Universitário de Coimbra EPE, Portugal., Lima Jandira ,   Internal Medicine Department, Centro Hospitalar e Universitário de Coimbra EPE, Portugal., Santos Rui Marques ,   Internal Medicine Department, Centro Hospitalar e Universitário de Coimbra EPE, Portugal.
Published: April 2022

Sarcomas are rare and characterised by an incidence of approximately 5 cases/100.000 people. Primary spindle cell sarcomas are a subclassification of soft tissue sarcomas, known as uncertain differentiation tumours, based on their unspecific line of differentiation. It might begin in layers of connective tissue under the skin, between muscles or surrounding organs. Diagnosis can be challenging and delayed due to the often-painless nature of these cancers and the common assumption of an underlying benign condition. The presence of distant metastatic disease at the time of the initial diagnosis is not frequent, but is more likely in large, deep and high-grade malignancy sarcomas. Our case describes an elderly patient diagnosed with an asymptomatic undifferentiated spindle cell sarcoma in the lower limb that developed metastatic disease after intentional curative therapy. Keywords: CT/MRI LI-RADS; CEUS LI-RADS; gadolinium contrast; MRI contrast agents; congenital heart disease; contrast enhanced ultrasound.
Encephaloma, neurocysticercosis, angiocavernoma or others: A case report
Authors:   Jiangsu Provincial Key Laboratory of Critical Care Medicine, Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, 210009, Jiangsu, China., Zhi-bao Guo , Yi Yang ,   Jiangsu Provincial Key Laboratory of Critical Care Medicine, Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, 210009, Jiangsu, China.
Published: April 2022

It is difficult to make a diagnosis for this case. A 38-year-old man suffered from mild cognitive dysfunction for 3 months and intermittent headache for 20 days, and his focal neurological signs were unconspicuous. Cerebrospinal fluid (CSF) showed normal biochemical and negative bacteriologic examinations. Parasitological tests of blood and CSF were negative. Imaging examination showed multiple intracranial lesions, which possessed the characteristics of multidate, fluid levels, bleeding, and without edema zone. The possible diagnosis included metastatic encephaloma, neurocysticercosis and angiocavernoma or other diseases. The patient was treated with dehydration of intracraninal pressure and the neurological symptoms were improved slightly. For this case, with slight abnormal clinical symptoms and complicated imaging findings, it is difficult to diagnose, and brain biopsy may be the only method for the definitive diagnosis.
Laparoscopic management of cholecystoduodenal fistula: A case report
Authors:   Resident, Department of General Surgery, Hinduhridaysamrat Balasaheb Thackeray Medical College and Dr. Rustom Narsi Cooper Municipal General Hospital, Mumbai, India., Prasad Himanshu , Ghag Geeta ,   Professor, Department of General Surgery, Hinduhridaysamrat Balasaheb Thackeray Medical College and Dr. Rustom Narsi Cooper Municipal General Hospital, Mumbai, India., Nandu Vipul ,   Assistant Professor, Department of General Surgery, Hinduhridaysamrat Balasaheb Thackeray Medical College and Dr. Rustom Narsi Cooper Municipal General Hospital, Mumbai, India.
Published: April 2022

Fistula between gall bladder and gastrointestinal tract occurs anywhere for example stomach, duodenum, and colon. Results of inflammatory reaction adhesion may be occur and between two organs and gall stone’s pressure may be contribute this process. Laparoscopic cholecystectomy has been the most widely accepted modality of treatment for patients with gall bladder disease. With time and increasing experience laparoscopic cholecystectomy is now being successfully attempted to treat almost all benign gall bladder pathology and their complications. One such uncommon infrequent complication of cholecystolithiasis is the cholecystoenteric fistula. Management of cholecystoduodenal fistula was traditionally performed by open method. With increasing newer laparoscopic techniques and advancement in the field, cholecystoduodenal fistula, an uncommon clinical entity is now being successfully treated via laparoscopic approach. It is feasible and safer than the conventional open approach in experienced hands, thus decreasing the overall morbidity and mortality attributed to the condition. We report a case of 55yr old female with cholecystoduodenal fistula treated successfully by laparoscopic approach using an Endovascular Gastro-Intestinal Anastomosis (GIA endo) stapler at H.B.T. Medical College & Dr. R.N. Cooper Municipal General Hospital, Juhu, Mumbai. Keywords: cholecystoduodenal fistula; laparoscopic cholecystectomy.
A rare complication of a common disease?
Authors:   Internal Medicine Department, Centro Hospitalar do Baixo Vouga, Aveiro, Portugal., Silva Leal Mariana da , Amado Carolina ,   Internal Medicine Department, Centro Hospitalar do Baixo Vouga, Aveiro, Portugal., Paracana Bárbara ,   Internal Medicine Department, Centro Hospitalar do Baixo Vouga, Aveiro, Portugal., Aguiar Diana ,   Intensive Care Unit, Centro Hospitalar do Baixo Vouga, Aveiro, Portugal., Sousa Mariana ,   Internal Medicine Department, Centro Hospitalar do Baixo Vouga, Aveiro, Portugal.
Published: April 2022

The iliopsoas muscle abscess is a rare condition that may occur by hematological/lymphatic dissemination or secondary to local infections, namely rare situations of kidney infection. Its early identification plays an essential role for an therapeutic and good prognosis. The authors present a rare complication of a very common pathology in the internist’s clinical practice, highlighting the importance to consider the iliopsoas muscle as a possible difficulty in patients with urinary tract infections under targeted therapy who do not show clinical improvement.
46XX testicular DSD SRY-Negative in a child with hypoplastic left heart syndrome
Authors:   Children’s Hospital Los Angeles, Department of Pediatrics, Los Angeles, California, USA., Yamashita Nozomi , Bakhach Marwan ,   Benefis Health System, Great Falls, Montana, USA., Zabinsky Jennifer ,   Children’s Hospital Los Angeles and Keck School of Medicine of USC, Department of Pediatrics, Center for Endocrinology, Diabetes and Metabolism, Los Angeles, California, USA., Takao Cheryl ,   Children’s Hospital Los Angeles, Department of Pediatric Cardiology, Los Angeles, California, Chang Andrew ,   Children’s Hospital Los Angeles, Department of Pediatric Urology, Los Angeles, California, USA., Vidmar Alaina P ,   Children’s Hospital Los Angeles and Keck School of Medicine of USC, Department of Pediatrics, Center for Endocrinology, Diabetes and Metabolism, Los Angeles, California, USA.
Published: April 2022

Disorders of Sex Development (DSD) refers to biological differences between phenotypic sex, gonad morphology and chromosomal material. A full-term infant was born with Hypoplastic Left Heart Syndrome (HLHS) and ambiguous genitalia. Karyotype revealed 46XX with no evidence of Y chromosome or SRY. Biopsy of both gonads revealed testicular tissue. Parents decided to rear the child as male. The child underwent extensive cardiac repair and is currently awaiting decision regarding urological repair. This case emphasizes the need for multidisciplinary care in the management of children with DSD associated with other complex medical conditions to ensure a timely diagnosis and multi-system, patient-centered treatment approach.
Skeletal deformities in a case of digitocutaneous dysplasia
Authors:   University of Arizona College of Medicine, 475 N 5th St., Phoenix, AZ 85004, USA., N Vij , MV Belthur ,   Phoenix Children’s Hospital, Department of Orthopedics, Main Building, Clinic B, 1919 E Thomas Rd, Phoenix, AZ 85016, USA.
Published: April 2022

We present a case of a 2 year old female with digital fibrous lesions, dysmorphic facial features, stridor, sensorineural hearing loss, and scoliosis. The patient surgical history included digital amputations at the interphalangeal joint line bilaterally on the middle, ring, and little finger. Physical exam demonstrated knee and elbow flexion contractures and a left ankle varus contracture. Radiographic evaluation revealed several aggressive fibromas in the proximal femori and tibia (Figure 1) and a mild dextroconvex lumbar scoliosis (Figure 2) [1,2]. Biopsy of a digital lesions revealed a dermal spindle cell proliferation without atypia or necrosis, and perinuclear inclusions on H&E and trichrome stains. Comparative genomic hybridization and single nucleotide polymorphism genotyping revealed two adjacent duplications of the DMD gene (OMIM 400477): a duplication of 83 kb from the cytogenic band Xp21.2 to Xp 21.1 and a duplication of 555 kb within the cytogenetic band of Xp21.2.
Forecasting macroeconomic indicators for Eurozone and Greece: how useful are the oil price assumptions?
Authors: Filis George , Degiannakis Stavros , Bragoudakis Zacharias
Published: April 2022

This study evaluates oil price forecasts based on their economic significance for macroeconomic predictions. More specifically, we first use the current state-of-the-art frameworks to forecast monthly oil prices and subsequently we use these forecasts, as oil price assumptions, to predict eurozone and Greek inflation rates and industrial production indices. The macroeconomic predictions are generated by means of regression-based models. We show that when we assess oil price forecasts, based on statistical loss functions, the MIDAS models, as well as the futures-based forecasts outperform those generated by the VAR and BVAR models. By contrast, in terms of their economic significance we show that none of the oil price forecasts are capable of providing predictive gains for the eurozone core inflation rate and the Greek industrial production index, whereas some gains are evident for the eurozone industrial production index and the Greek core inflation rate. However, in all cases the oil price forecasting models, including the random-walk, generate equal macroeconomic predictive accuracy. Thus, overall, we show that it is important to assess oil price forecasting frameworks based on the purpose that they are designed to serve, rather than based on their ability to predict oil prices per se.
Vulnerabilidad al cambio climático del tipo forestal Roble-Raulí-Coihue de la región de Los Ríos. Chile
Authors:   Instituto Forestal (Chile), Bahamondez Carlos , Büchner Carlos , Müller-Using Sabine , Rojas Yasna , Schlegel Bastienne , Vergara Gerardo
Published: April 2022

El propósito de este informe es reportar sobre la vulnerabilidad al cambio climático de las formaciones arbóreas del Tipo Forestal Roble-Raulí-Coihue de la región de los Ríos, haciendo uso de un soporte metodológico que considera no solo los aspectos biofísicos de los bosques, sino también su respuesta ecofisiológica frente a nuevos escenarios climáticos y sus aspectos socioeconómicos. De esta forma, luego de colectar todos los antecedentes metodológicos, los datos e información pertinentes que caracterizan los escenarios futuros permiten contar con información relevante para sustentar propuestas de esquemas silvícolas apropiados para facilitar la adaptación al cambio climático.
Confinamiento y actividad comunicativa en línea de los niños y las niñas en España
Authors: Larrañaga Kepa Paul , Monguí Monsalve Mónica María , Rangel Celia , Núñez-Gómez Patricia
Published: April 2022

Los confinamientos domiciliarios han sido una de las medidas que muchos países han tomado para intentar proteger a las personas del Sars-CoV-2. Al pasar más tiempo en casa, el consumo de dispositivos conectados a internet ha aumentado. En España, los niños y niñas también han sufrido esta situación de confinamiento domiciliario, lo que ha hecho de internet un canal necesario para el aprendizaje y la socialización. De ahí que este trabajo pretenda estudiar cómo se ha construido la actividad comunicativa en internet de los niños y niñas de entre 6 y 12 años durante y después del confinamiento. Las diversas pruebas estadísticas aplicadas arrojaron que la mayor parte de los motivos del incremento del uso de los dispositivos durante el confinamiento están relacionados con los procesos de socialización y las actividades vinculadas al entretenimiento y al juego. Los hallazgos evidencian numerosas tensiones intergeneracionales entre población adulta y los niños/as en el uso de internet.
Evaluation of Attitudes of Students Studying at State and Private Universities towards Distance Education
Authors: Kaya Kaan , Subak Erdem , Agaoglu Ceren , Sadır Yunus , Moghanlou Abdorreza Eghbal
Published: April 2022

With compulsory distance education in Turkey during the pandemic, the positive and negative effects of distance education have been investigated. In this study, the views of 256 students (162 males, 94 females) with a mean age of 21.5±3.457, studying in various departments in the primary field of sports sciences at state (n = 95) and foundation (n = 161) universities, on distance education and face-to-face education. It was taken with the Attitudes towards Distance Education Scale and compared statistically. In addition to frequency and distribution analysis, an Independent Sample T-Test was applied for statistical analysis, and the confidence interval was determined as 95% (p < 0.05). As a result of the research, it was seen that the students found face-to-face education more effective. It was noted that students who found face-to-face teaching more effective than other students agreed with the view that distance education is not engaging with a significant difference (p < 0.05). The same students also stated that they disagreed with the opinions that qualified results can be obtained from distance education applications. According to students ‘ opinions, this study provides educators with information about some of the missing points of distance education compared to face-to-face teaching. The minus points of distance education can be detailed with surveys to be made with more participants.
Cost-utility and cost-consequence analysis of different cervical cancer therapies received by patients in two Nigerian tertiary hospitals
Authors:   Faculty of Pharmaceutical Sciences, Usmanu Danfodiyo University, Sokoto, Sokoto State, Nigeria, Samaila A. , Usman N. ,   Faculty of Pharmaceutical Sciences, Usmanu Danfodiyo University, Sokoto, Sokoto State, Nigeria, Biambo A.A. ,   Faculty of Pharmaceutical Sciences, Usmanu Danfodiyo University, Sokoto, Sokoto State, Nigeria, Adibe M.O. ,   Faculty of Pharmaceutical Sciences, University of Nigeria, Nsukka, Enugu State, Nigeria
Published: April 2022

Background: High treatment costs pose a lot of economic burden on cervical cancer (CC) patients and their family members. Studies on cost-utility and cost-consequences analysis of CC therapies are lacking in Nigeria. Objective: To evaluate the cost-utility and cost-consequence of different CC therapies received by patients in two Nigerian tertiary hospitals. Method: This study employed a prospective longitudinal design with a 12-month patient follow- up. It was conducted at Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto and Ahmadu Bello University Teaching Hospital (ABUTH), Zaria, North-Western Nigeria. Data of all the 157 eligible CC patients were collected at baseline, after therapy and at 12 months follow up. Data analysis was done with appropriate descriptive and inferential statistics using SPSS V. 20 for windows. P<0.05 was considered statistically significant. Results: The mean total cost of therapy per patient for adjuvant chemoradiation therapy (CRTS) was the highest (₦663,497±164,690). The incremental cost-utility ratio (ICUR) for adjuvant chemotherapy (CTS) was the lowest (₦529,042 per QALY), while CRT had the highest ICUR, ₦9,511,087 per QALY. Adjuvant radiotherapy (RTS) had ₦452,009±10,619 mean total cost per patient against best symptoms’ resolution and survival; unfortunately, fertility not preserved. Conclusion: Adjuvant chemotherapy (CTS) was found to be the most cost-effective therapy option, while CRT was found to be least cost-effective therapy option received by the patients. Adjuvant radiotherapy (RTS) had a moderate mean total cost per patient with the best symptoms’ resolution and survival; unfortunately, fertility not preserved.
Trianon következményei a Magyar Természettudományi Múzeum Ásvány- és Kőzettárának szemszögéből
Authors: Papp Gábor , Topa Boglárka Anna , Kis Annamária , Jánosi Melinda
Published: April 2022

A cikk a trianoni békeszerződés aláírásának 100. évfordulóján az Ásvány- és Kőzettár szemszögéből vizsgálja a korabeli Magyarország valamennyi állampolgárának és intézményének életét különböző mértékben, de gyakran drasztikusan megváltoztató történelmi esemény következményeit. A közvetlenül a tár személyi állományát, illetve gyűjtési és kutatási lehetőségeit érintő hatások tárgyalása mellett leltárszerűen áttekintjük a tárhoz kapcsolódó tudományterületeket (ásványtan, kőzettan, meteoritika, teleptan) a gyűjtési és kutatási területeik elcsatolása miatt érő veszteségeket és a Trianonhoz való hivatalos viszony változásainak tükröződését az ásványtári publikációkban.
新冠肺炎疫情下的慢性疼痛處置考量
Authors: 林旺生 林旺生 , Wang-Sheng Lin 蘇府蔚 , Fu-Wei Su 張祜銘 , Hu-Ming Chang 王偉全 , Wei-Chuan Wang 楊振亞
Published: April 2022

新冠肺炎疫情自2019年末以來，自中國武漢地區迅速蔓延至世界各地，對各國的公衛和醫療量能造成巨大威脅。醫療資源的整合和重新分配成為公共衛生的一大課題，所以許多慢性疾病的處置，在疫情之下有著不同的面貌。保持社交距離和減少不必要的外出，在疫情期間是許多國家廣泛採取的防疫措施，也因此，病人因非急迫性醫療至醫院就診的意願大幅下降。慢性疼痛為一普遍的健康問題，在處理上往往需要長期的使用藥物及非藥物的治療方式，且必須定期地監控各項治療所帶來的療效和潛在副作用。疫情席捲各國的當下，就面對慢性疼痛病人的第一線醫護人員而言，是一個全新的挑戰。本篇旨在藉由文獻回顧，協助醫師和健康相關從業人員能在疫情期間，讓慢性疼痛病人持續地得到適切且有效的治療和追蹤。

 

Chronic pain is a major public health concern which not only results in impaired quality of life on the individual level but also poses a tremendous burden on the healthcare system and economy on a national scale. As the COVID-19 pandemic has greatly impacted the world since 2019, the operation of healthcare systems has changed to accommodate non-pharmacologic interventions against the COVID-19 outbreak. As a result, chronic conditions have been managed differently since the medical resources are less accessible. Chronic pain requires continuous and concerted medical attention to carefully assess the possible adverse events associated with pharmacologic interventions and to adjust the regimen accordingly. The indication for procedural interventions should also be evaluated since the pain is often fluctuating. In this article, we aim to review updated evidence-based practices of pharmacologic and non-pharmacologic interventions with a focus on clinical considerations for chronic pain management. A feasible framework is proposed for telemedicine and interdisciplinary teamwork to help facilitate continuous care during this trying time.

 
社區醫學訓練與試辦偏遠衛生所訓練計畫調查
Authors: 蘇致軒 蘇致軒 , Chih-Hsuan Su 吳家鈞 , Jia-Jyun Wu 許碧珊
Published: April 2022

目的：根據衛生福利部調查醫療區域醫師人力密度，部份次醫療區域醫師人力仍低於世界衛生組織所定最低醫療基本需求之每萬人口醫師數10位，因此衛生福利部提出優化偏鄉醫療精進計畫，其中教育方面規範家庭醫學科於專科訓練期間得前往偏遠地區衛生所進行輪訓。為完善規劃偏遠衛生所輪訓試辦之事宜，因此進行本研究。

方法：於2020年6月對全台68所符合家庭醫學科訓練資格醫院之部科主任或家庭醫學專科醫師訓練計畫主持人行問卷調查，後續召集有參加試辦計畫意願之醫療院所進行會談與二次調查。

結果：問卷回收率100%。全台約60.3%之教學訓練醫院有大於一個月以上的衛生所訓練計畫，且大部分的訓練醫院同意衛生所是具備教學功能之院外基層醫療訓練場所。然而安排偏遠地區衛生所訓練的主要障礙是工作分配困難與和不符合醫院組織的方向與需求，此外工作場所安全、學習和工作間的平衡也是一大考量。儘管如此，多數醫院仍認為偏遠地區衛生所之訓練能有助住院醫師的責任感訓練及不同制度下之工作與溝通訓練。

結論：此計畫執行立意良善，然衛福部需考慮增加家庭醫學科總訓練容額、補助交通經費、補助相關保險、偏遠執業風險及教學訓練之平衡。以期於住院醫師訓練、醫療院所家庭醫學科成長及國家偏遠醫療精進之間達成多贏局面。

 

Purpose: According to a MOHW (the Ministry of Health and Welfare) survey, several sub-regions (mainly rural and remote areas) in Taiwan fail to meet the WHO minimum requirement for health workforce (ten physicians per ten thousands residents). The MOHW had accordingly developed and implemented a program requiring all family medicine doctors-in-training to spend a part of their residency at rural health centers (RHCs). To promote the quality and efficacy of the training program and the safety of the training environment, the following research was conducted.

Methods: A questionnaire was issued in June 2020 to the branch chiefs and training program organizers of the 68 hospitals qualified for family medicine training in Taiwan. A symposium was subsequently held and a survey conducted to learn and analyze the responses of all the participating hospitals and public health centers.

Results: The response rate of the questionnaire was 100%. Around 63% of the responding hospitals had a RHC training program more than one month long, and most of the hospitals found public health center a good training venue. A major difficulty was that sending residents specializing in family medicine to RHCs seldom met the needs and goals of those hospitals. In addition, safety of the working environment and balance between learning and working were identified as issues demanding further consideration. Nevertheless, most participating hospitals believed that training at RHCs did help promote residents’ sense of responsibility, as well as their ability to work under different systems.

Discussion: The program has great humanitarian potential. However, the MOHW may need to consider increasing the allowed number of trainees in family medicine each year, subsidizing trainee’s travel and insurance expenses, and assessing and addressing the risks of practicing in remote and rural areas so both the quality and efficacy of the training program can be improved to create win-win outcomes for all parties involved.

 
工時規範對家庭醫學住院醫師訓練影響—住院醫師觀點
Authors: 盧奐廷 盧奐廷 , Huan-Ting Lu 林名男 , Ming-Nan Lin 吳晉祥 , Jin-Shang Wu 黃信彰 , Shinn-Jang Hwang 林偉瑄 , Wei-Hsuan Lin 林季緯
Published: April 2022

目的：本研究探討家庭醫學科住院醫師自2019年適用勞動基準法規定後，對工時規範之滿意度、健康影響、學習成效、醫療品質與病人安全層面進行調查，並進一步比較不同訓練職級、不同醫院訓練容額、與不同醫院層級住院醫師在工時規定影響看法上的差異。

方法：以2017至2019訓練年度進入家庭醫學專科醫師訓練計畫的住院醫師為對象，以問卷調查工時限制所造成的影響。結果：共有286位家庭醫學住院醫師參與研究，其中有近九成滿意目前工時限制規定，且普遍認為工時限制不會降低訓練品質。其中第一年住院醫師超時的比例較高，較資深住院醫師同意工時規定會減少教學指導與學習體驗的比例較高，但多數還是認為並不影響教學品質。超過半數第一年住院醫師認為醫療錯誤發生率會降低，資深住院醫師則多認為不變。雖然所有醫院層級的住院醫師都認為工作時疲勞情況與嗜睡程度有所改善，但地區與區域級醫院仍有少部分住院醫師認為工作時疲勞及嗜睡程度更明顯。

結論：實施工時限制後，大部分家庭醫學科住院醫師滿意目前工時限制規定，認為工時限制不會降低訓練品質，也不需要延長受訓年限。學員普遍認為對於工時限制對住院醫師的身心健康有正向影響，對於病人受到的醫療品質與病人安全則不受影響。

 

Objective: The study assessed family medicine residents’ overall satisfaction with the resident duty hour restriction implemented in 2019 and explored their perceptions of the impacts of the restriction on their well-being, education, and patient safety. The study further compared the differences in residents’ perceptions based on the level of residency training, size of residency training program, and level of training hospital.

Methods: Residents admitted to the family medicine residency training program by the Taiwan Association of Family Medicine from 2017 to 2019 were selected to participate in this study. A prospective anonymous questionnaire survey was administered to family medicine residents nationwide to gather their opinions and suggestions regarding the newly implemented resident duty hour reform.

Results: A total of 286 family medicine residents responded to the questionnaire survey. Nearly 90% of the residents were satisfied with the current duty hour regulations and found the restriction unlikely to compromise the quality of residency training. First-year residents reported a greater frequency of working overtime, compared to residents of other levels. The more senior the residents, the stronger the belief that duty hour restriction reduced time for learning and faculty guidance; however, the majority of the responding residents were of the opinion that the restriction did not affect the overall quality of residence training. Over 50% of the first-year residents felt the restriction helped reduced the likelihood of medical error, while more senior residents found the likelihood unchanged. Regardless of the levels of their training hospitals, a great part of the residents found the problems of fatigue and daytime sleepiness alleviated, yet there was still a minority of residents in regional and district hospitals felt the problems aggravated.

Conclusion: After the implementation of duty hour restriction, most family medicine residents are satisfied with the current regulations and feel no significant impact of the restriction on the quality of residency training. In their opinion, there is no need to extend the length of residency training. The duty hour reform does exert positive influences on their physical and mental health and bring about no impact on patients’ safety and quality of care.

 
人芽囊原蟲感染肝臟囊腫之案例報告
Authors: 張益華 張益華 , Yi-Hua Chang 葉俊濬 , Jun-Jun Yeh 陳啟益
Published: April 2022

人芽囊原蟲(Blastocystis hominis)是常見於人類胃腸道的單細胞寄生蟲。它的致病性仍未知。一位78歲女性，為腎臟癌合併肺部轉移，抱怨右上腹疼痛。腹部超音波及電腦斷層顯示肝臟右葉一個巨大囊腫，囊液檢測顯示許多人芽囊原蟲。之後接受首次metronidazole 14天療程。一年後，因囊腫引流導致囊內出血及橫膈下腔血腫，接受手術切除肝臟囊腫。囊液檢測再次顯示許多人芽囊原蟲。在metronidazole 20天療程後的45天糞便檢查呈現陰性。據我們所知，這是第一個肝臟囊腫感染人芽囊原蟲的案例報告。對於此受感染肝臟囊腫足夠抗生素療程的確認及其引流或切除的必要性，仍待未來進一步的研究探討。

 

Blastocystis hominis is a unicellular parasitic microorganism commonly found in the gastrointestinal tracts of humans. Its pathogenicity remains uncertain. A 78-year-old female patient with renal cell carcinoma and lung metastasis complained of right upper quadrant pain. Abdominal ultrasonography and computed tomography scan showed a huge liver cyst in which a plethora of Blastocystis hominis was identified through cyst fluid analysis. The patient then received her first course of metronidazole treatment for 14 days. One year later, she underwent resection of the liver cyst due to internal bleeding and subphrenic hematoma induced by cyst drainage procedure. Cyst fluid analysis again revealed a profusion of Blastocystis hominis. Stool examination showed a negative result 45 days after a course of metronidazole for 20 days. To the best of our knowledge, this is the first case of the presence of Blastocystis hominis in liver cyst. However, further studies are required to determine the adequate course of antibiotic treatment and necessity of drainage or resection of the infected liver cyst.

 
Environmental Rights and Case of Climate Justice in Pakistan
Authors: Adeel Mukhtar Mirza
Published: April 2022

Pakistan’s efforts for environmental protection and climate justice offers a striking story. Pakistan not only proved to be an astral leader as Chair of G77 at the Earth Summit in Rio de Janeiro, Brazil in 1992, but its judiciary has also been playing a critical role in providing direction for dispensation of climate justice with the help of innovative interpretation of fundamental rights in country’s constitution. In this context, the case of Leghari v. Federation of Pakistan was a step in the right direction for climate justice in Pakistan since it argued that the government’s inability to take timely actions affected the petitioner’s fundamental rights. The decree, too, is a cardinal achievement in the domain of climate justice and climate change litigation process. This paper presents the ground analysis of this case law by combining the previous studies on the subject and overwhelming implication of climate change on human rights. Moreover, it attempts to discuss the cases, which were recently resolved and some of the pending ones which through logical reasoning address climate injustice.
DIGITALISASI ADMINISTRASI PERTANAHAN UNTUK MEWUJUDKAN PERCEPATAN PEMBANGUNAN NASIONAL PERSPEKTIF KEBIJAKAN HUKUM (LEGAL POLICY)
Authors: Erfa Riswan
Published: April 2022

Digitalisasi administrasi pertanahan merupakan salah satu pelaksanaan tugas pemerintahan ditujukan untuk mewujudkantujuan pembangunan nasional. Administrasi pertanahan yang masih berbasis konvensional harus digeser ke arahadministrasi pertanahan yang berbasis digital. Layanan administrasi pertanahan seperti pendaftaran tanah sistematislengkap yang belum berbasis digital harus diarahkan menuju digitalisasi, terlebih di era semakin cepatnya perkembanganilmu pengetahuan dan teknologi. Hal tersebut untuk mempercepat pelayanan, mempermudah masuknya investasi, integrasidata antar sektor pembangunan, dan mempercepat terwujudnya tujuan nasional. Namun demikian diperlukan landasandan pedoman bagi Badan atau Pejabat Pemerintahan dalam menjalankan tugas penyelenggaraan digitalisasi pertanahan.Landasan dan pedoman tersebut saat ini belum diformulasi dengan baik dalam sebuah produk hukum. Paper ini menjelaskandua hal yang menjadi fokus permasalahan dengan menggunakan metode penelitian hukum normatif. Pertama paper iniberupaya untuk menjelaskan landasan filosofis, teoritis, dan yuridis urgensi membentuk ketentuan hukum yang mengaturtentang digitalisasi administrasi pertanahan. Kedua menjelaskan konsep kebijakan digitalisasi administrasi pertanahan kedepan dalam konteks hukum. Permasalahan yang dikemukakan tersebut dianalisis dengan dengan beberapa teori, sepertiteori tujuan hukum dan teori politik hukum. Landasan filosofis digitalisasi tidak lepas dari tujuan nasional yang merupakancerminan dari basis ideologis bangsa. Landasan teoritis didasarkan pada tujuan hukum untuk menciptakan kepastian,kemanfaatan, dan keadilan. Landasan yuridis didasarkan pada peraturan perundang-undangan yang berkaitan denganaspek pertanahan dan administrasi pemerintahan. Selanjutnya konsep kebijakan digitalisasi administrasi pertahanan yangditujukan untuk mempercepat pembangunan nasional selain memperhatikan aspek kemanfaatan bagi pembangunan jugamesti memperhatikan asas-asas pembentukan peraturan perundang-undangan.
MENINJAU EFEKTIVITAS PENEGAKAN HUKUM PENATAAN RUANG DALAM RANGKA MEWUJUDKAN TERTIB TATA RUANG
Authors: Pramuji Stevanus Eko , Putri Viorizza Suciani
Published: April 2022

Upaya penegakan hukum yang tegas merupakan salah satu cara mewujudkan tertib tata ruang sehingga menciptakan ruangnasional yang aman, nyaman, produktif dan berkelanjutan. Instrumen hukum penataan ruang dibuat untuk ditegakan danmencegah terjadinya pelanggaran pemanfaatan ruang. Meskipun telah ada instrumen hukum yang mengatur terkait penataanruang, pada pelaksanaannya pengaturan tersebut sulit diaplikasikan dalam kondisi faktual di lapangan bilamana terjadipelanggaran pemanfaatan ruang sehingga berpengaruh terhadap efektivitas penegakan hukum penataan ruang. Melaluimetode penelitian normatif yang bersifat deskriptif analitis, penelitian ini mencoba menjawab: (1) apakah faktor-faktor yangmempengaruhi efektivitas penegakan hukum penataan ruang, (2) apakah penegakan hukum penataan ruang yang sudahberjalan dapat dinilai efektif, (3) bagaimana solusi untuk mencapai efektivitas penegakan hukum tersebut. Hasil penelitianmenunjukan bahwa faktor-faktor yang mempengaruhi penegakan hukum penataan ruang adalah faktor hukum, penegakhukum, sarana/fasilitas penunjang, masyarakat dan kebudayaan. Dari kelima faktor tersebut dapat diketahui penegakanhukum penataan ruang belum efektif. Solusi agar penegakan hukum penataan ruang dapat efektif yakni dengan perbaikankualitas perencanaan tata ruang, penerapan asas ultimum remedium, membuat aturan pelaksanaan yang menunjang prosespenegakan hukum dan memperbaiki skema kelembagaan bagi penegak hukum tata ruang.
Kesesuaian Penggunaan Lahan Terhadap Rencana Tata Ruang Wilayah Kabupaten Pringsewu
Authors: Lubis Andi Dermawan , Arismawati Novia , Pratama Wahyu Hidayat
Published: April 2022

ABSTRAK
Penggunaan lahan perlu diatur dalam suatu sistem yang dapat memberikan manfaat sebesar-besar kemakmuran bagirakyat tanpa merusak fungsi lahan sebagai sumber kehidupan. Oleh karena itu, penggunaan lahan diarahkan agar dapatdimanfaatkan dengan optimal secara berkelanjutan bagi kesejahteraan masyarakat. Lingkup studi pada penelitian iniadalah di Kabupaten Pringsewu dengan studi kasus di Kecamatan Pringsewu, Kecamatan Ambarawa, dan KecamatanPagelaran. Penelitian ini bertujuan untuk menggambarkan kondisi penggunaan lahan di Kabupaten Pringsewu terutamaterkait kesesuaian penggunaan lahan saat ini terhadap rencana tata ruang wilayah (RTRW) Kabupaten Pringsewu. Hal iniberguna untuk mengetahui wilayah yang pembangunannya telah sesuai dengan arahan RTRW, wilayah yang berpotensiuntuk dikembangkan pembangunannya sesuai arahan RTRW, serta wilayah yang pembangunannya saat ini tidak sesuaidengan RTRW. Metode analisis yang digunakan adalah dengan melakukan analisis spasial yaitu dengan melakukan overlayantara peta penggunaan tanah saat ini dan peta rencana pola ruang RTRW Kabupaten Pringsewu Tahun 2011-2031. Hasilpenelitian menunjukkan bahwa sebesar ± 11.015,21 ha lahan atau 86,95% dari luas wilayah studi pembangunannya telahsesuai dengan arahan kebijakan RTRW, sebesar ± 994,3 ha atau 7,85% dari luas wilayah studi dapat dikembangkan sesuaiarahan, dan ± 659,52 ha atau 5,20% dari luas wilayah studi tidak sesuai dengan arahan RTRW.
Kata kunci : penggunaan lahan, pencana tata ruang wilayah, kesesuaian, Kabupaten Pringsewu
ABSTRACTLand use needs to be regulated in a system that can provide the maximum benefit to the community without destroying thefunction of land as a source of life. For this reason, land needs to be regulated and directed for its development so that itcan be used optimally for the community to obtain sustainable benefits for welfare. The scope of the study in this researchis in Pringsewu Regency with case studies in Pringsewu District, Ambarawa District, and Pagelaran District. This study aimsto describe the condition of land use in Pringsewu Regency, especially related to the existing land use of the Rencana TataRuang Wilayah (RTRW). This study is used for knowing areas whose development is in accordance with the RTRW Directive,areas that may be developed for development in accordance with the RTRW Directive, as well as areas whose currentdevelopment is not in accordance with the RTRW. The analytical method used is to perform a spatial analysis which is doneby overlaying the existing land use map with the spatial plan map of the Pringsewu Regency RTRW 2011-2031. The resultsshowed that ± 11,015.21 hectares or 86.95% of the area of the study area was in accordance with the RTRW Directive policy, ± 994.3 hectares or 7.85% of the study area could be developed according to the Directive, and ± 659.52 hectares or 5.20%of the study area is not in accordance with the RTRW Directive.
Keywords : land use, spatial planning, suitability, Pringsewu Regency
Faktor yang berhubungan dengan Kelelahan Kerja pada Psikososial Karyawan bagian Rotary 9 Feet di PT Sumber Graha Sejahtera Luwu Tahun 2021
Authors: Lestari S Andi Dewi , Batara Andi Surahman , Mutthalib Nurul Ulfah
Published: April 2022

Data from the ILO states that almost every year as many as two million workers die due to work accidents caused by fatigue. The study stated that from 58115 samples, 32.8% of them or 18828 samples suffered from fatigue. Surveys in developed countries report that 10-50% of the population experience fatigue. The prevalence of fatigue is about 20% among patients who come in need of health services. The purpose of the study was to determine the psychosocial relationship with the incidence of work burnout at PT Sumber Graha Sejahtera, Luwu Regency in 2021. The type of research was quantitative research using the Cross-Sectional Study method. The research sample was 85 people. The data was taken using a questionnaire and then analyzed using the Chi-square test at a 95% confidence level (?=0.05). The results showed that there was a relationship between psychosocial and work fatigue (? = 0.016).
Determinan Beban Kerja Fisik Dan Mental Perawat Dengan Penerapan Pasien Safety Pada Masa Pandemi Covid 19 di RSUD Labuang Baji Makassar
Authors: Riski Aulia , Razak Amran , Ahri Reza Aril
Published: April 2022

Nurses have a very big responsibility in carrying out their duties both to patients and their families. During the current Covid-19 pandemic  the number of patients received by hospitals is not proportional to the number of nurses so that it will have an impact on increasing physical and mental workloads. This study aims to determine the relationship between the determinants of the physical and mental workload of nurses with the application of patient safety during the COVID-19 pandemic at Labuang Baji Hospital Makassar.This type of research is a quantitative research with a cross sectional study approach. The sampling technique used total sampling with a total sample of 53 people. Data analysis was carried out univariate, bivariate with chi-square test. The results showed that there was an influence between physical workload (p value = 0.001) mental workload (p value 0.017) on the Application of Patient Safety during the Covid 19 Pandemic Period at Labuang Baji Hospital Makassar. It is recommended for nurses to perform stress management and adequate rest so that their workload is reduced so that the application of patient safety can be carried out properly.
Comparison of conventional incision and drainage versus ultrasound guided minimally invasive techniques in management of the breast abscess
Authors: Singh Shailendra Pal , Kumar Anil , Chaudhary Shakti Kumar , Kumaran Ranjith
Published: April 2022

Background: The feasibility of ultrasound guided minimally invasive techniques in management of breast abscess has been a topic of concern from a long time thus, resulting in many studies. Objectives: To assess the feasibility and to compare ultrasound guided minimally invasive techniques with conventional incision and drainage in breast abscess management Materials and Methods: Patients admitted in Surgery Department / OPD with BREAST ABSCESS (total 60 patients) were divided into two random groups of 30 patients each using random number tables. Group 1 was treated by conventional incision and drainage, Group 2 was treated by ultrasound guided minimally invasive techniques. Chi-square test was used. Results: For group 2, the average pain(VAS) score was 4.7 with minimal bleeding during the procedure, no need of dressing, average duration of stay 0.47 days, average days required for complete recovery is 13 days and excellent cosmesis as compared to group 1 where average pain score was 7, mild bleeding occurred in all cases with requiring an average of 10 days of dressing, all healed leaving a scar, average days required for complete recovery is 28 days and thus only satisfactory cosmesis with average 3.1 days of hospital stay.