bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gastroenterologische Komplikationen der neuen Immuncheckpoint-Inhibitor-Therapien
Authors: Götze Julian , Bitzer Michael , Malek Nisar Peter 
Published: December 2019

Was ist neu?
Immuncheckpoint-Inhibitoren In den letzten Jahren haben sich Immuncheckpoint-Inhibitoren (ICPI) als fester Bestandteil der medikamentösen Tumortherapie etabliert. Sie gehören zu einer Gruppe von monoklonalen Antikörpern, die eine gegen Krebszellen gerichtete Immunreaktion fördern. Durch Bindung an CTLA-4 und PD-1 bzw. PD-L1 werden hemmende Signalwege unterbrochen, wodurch die Aktivität zytotoxischer T-Lymphozyten gesteigert und die immunologische Toleranz gegenüber Tumorzellen reduziert wird.
Enterokolitis Diarrhöen – als Symptom einer Enterokolitis – stellen nach dermatologischen Phänomenen die häufigste Nebenwirkung unter ICPI-Therapie dar. Unter kombinierter CTLA-4- und PD-1-Blockade können bis zu 44 % der Patienten betroffen sein. Die Klinik der ICPI-assoziierten Kolitis ähnelt dem klinischen Erscheinungsbild chronisch-entzündlicher Darmerkrankungen.
Diagnostik und Therapie der Enterokolitis Das Management betroffener Patienten sollte nach einem standardisierten Vorgehen erfolgen. Sowohl die europäische als auch die amerikanische Fachgesellschaft für Onkologie bieten dezidierte Handlungsempfehlungen zur Diagnostik und Behandlung ICPI-assoziierter Nebenwirkungen. Nach Ausschluss von Differenzialdiagnosen ist eine rasche immunsuppressive Behandlung (u. a. Steroide, Biologika) notwendig, um die Morbidität zu senken. Möglicherweise kann nachfolgend eine Wiederaufnahme der ICPI-Therapie erfolgen.
Hepatitis und Pankreatitis Als weitere relevante Nebenwirkung tritt die immunvermittelte Hepatitis ca. 6–14 Wochen nach Therapiebeginn auf. Meist präsentiert sie sich asymptomatisch und ist gekennzeichnet durch einen Anstieg der Serum-Transaminasen. Die Lipasämie ohne klinische Zeichen einer akuten Pankreatitis ist ein häufiger Laborbefund, der in der Regel keine therapeutische Konsequenz hat.
Medikamentöse Therapie der Herzinsuffizienz mit reduzierter Ejektionsfraktion bei chronischer Nierenerkrankung
Authors: Heine Gunnar Henrik , Rogacev Kyrill Sebastian 
Published: December 2019

Was ist neu?
Etablierte Therapiestrategien Auch wenn die Evidenz für den Einsatz von ACE-Hemmern, Angiotensin-Rezeptorblockern, Betablockern und Mineralokortikoid-Rezeptor-Antagonisten bei HFrEF-Patienten mit schwerer CKD begrenzt ist, macht die schlechte Prognose unbehandelter Patienten einen breiten Einsatz dieser Substanzen oft erforderlich. In den Leitlinien der European Society of Cardiology zur Herzinsuffizienz werden für den klinischen Alltag hilfreiche und konkrete Vorschläge zum Intervall von Laborkontrollen und zu Konsequenzen insbesondere von Hyperkaliämie und Kreatininanstieg unter RAAS-Inhibitoren vorgeschlagen.
Neue Therapiestrategien Neue Therapiestrategien zur Prognoseverbesserung von HFrEF-Patienten lassen sich in unterschiedlicher Weise auf CKD-Patienten übertragen: Der Einsatz von Sacubitril/Valsartan und SGLT-2-Inhibitoren ist bei mittelgradiger CKD (GFR ≥ 30 ml/min/1,73 m²), nicht jedoch bei höhergradiger CKD untersucht. Hingegen liegen für eine hochdosierte intravenöse Eisentherapie Daten aus der PIVOTAL-Studie vor, welche eine Prognoseverbesserung zumindest bei hinsichtlich der Herzfunktion unselektierten Patienten mit dialysepflichtiger CKD suggerieren.
Lungenkrebsscreening – wer, wo und wie?
Authors: Reinmuth Niels 
Published: December 2019

Was ist wichtig?
Mögliche Screening-Verfahren Die Notwendigkeit eines Früherkennungsprogramms für Lungenkarzinome gilt als unumstritten. Röntgenübersichtsaufnahmen der Lunge sowie Sputum-Untersuchungen werden nicht empfohlen, jedoch haben jüngst publizierte Daten aus Studien mit Niedrigdosis-CT dieses Thema erneut aufleben lassen. Bei der Bewertung der Daten müssen jedoch verschiedene Besonderheiten dieser Studien berücksichtigt werden. Die aktuelle neue Bewertung stellt eine bedeutsame und notwendige Chance dar, die medizinische Versorgung und Prognose von Patienten mit Lungenkarzinom in Deutschland signifikant zu verbessern.
Implementierung von Lungenkrebsscreening Um ein Screening-Programm möglichst effektiv auszuarbeiten, müssen insbesondere die Einschlusskriterien der Patienten genau definiert sein. Darüber hinaus ist es wichtig, die Zahl der falsch positiven Befunde zum Schutz der Patienten und zur Vermeidung unnötiger Kosten möglichst klein zu halten.
Weitere Ansätze Weitere neue Verfahren zum Lungenkrebsscreening werden derzeit in klinischen Studien untersucht.
Ethanol Ablation of Neck Metastases from Differentiated Thyroid Carcinoma
Authors: Paz-Fumagalli Ricardo , Li Xi , Smallridge Robert C. 
Published: December 2019

AbstractDifferentiated thyroid cancer often metastasizes to cervical lymph nodes, characteristically with slow growth rate and low-level aggressiveness. Cervical lymph node resection is the treatment of choice, but ethanol ablation offers a therapeutic option for patients with few nodes unresponsive to radioiodine therapy and who are poor surgical candidates. The ethanol ablation procedure is minimally invasive, guided sonographically, easily and safely repeated, and easily implemented with minimal technology and cost. Transient nerve injury is infrequent and virtually the only important complication. Current experience indicates that ethanol ablation has the safest therapeutic profile compared to surgery and thermal ablation, and the effectiveness is comparable to thermal ablation and approaches that of surgery. Well-designed clinical trials are lacking.
A study of variations of anterior belly of digastric muscle
Authors: Khona Pratik , Kulkarni Deepali U , Kulkarni Umesh K 
Published: November 2019

Abstract
Aim : To study the anatomical variations of anterior belly of digastric muscle. Materials & Methods: In the present study, 30 human cadavers from the Department of Anatomy, Belagavi Institute of Medical Sciences, Belagavi were examined for the variations of anterior belly of digastric muscle during routine dissections of undergraduate and postgraduate students. The variations found were neatly dissected and photographs taken wherever necessary. Result: Out of 30 cadavers dissected3 specimens presented with variations. Discussion: First variation found had a unilateral accessory belly of digastric muscle on right side. Second variation was unilateral accessory belly of digastric muscle on left side and the third variation was bilateral accessory slips of digastric muscles. The details of these variations will be dealt in the article. Conclusion: As the variations of anterior belly of digastric muscle are common, the radiologists and the surgeons have to watch out for these while dealing with Sub mandibular region.
Correlation between femoral offset and other morphometric parameters
Authors: Jaiswal Pratima , Verma Lakshmi , Ghulyani Tuhin 
Published: November 2019

Abstract
Background and aims: Surgeries involving the femur are quite common. The clinical importance of femur in sports biomechanics and rehabilitation is well known. Therefore, its morphometries has orthopedic implications. The present study aims at establishing interrelationship among various external parameters in adult dried femora including femoral offset (FO), neck shaft angle [NSA], femoral anteversion angle [FNA], Neck width [NW], Anterior Neck length [ANL], Posterior Neck length [PNL], Oblique length [OL] and trochanteric oblique length [TOL], Materials and Methods: A total of 100 [50 right and 50 left] intact, dried adult human femora from department of Anatomy, Government Medical College, Kota were included in this study. The FO, NSA and FNA were measured by digital image analysis in ‘IMAGEJ’ software. OL and TOL were measured using osteometric board. ANL, PNL and NW were recorded using sliding caliper. Statistical analysis was done using SPSS and Microsoft Excel software. The mean values were calculated, relationship between parameters was measured by Pearson's correlation coefficient ‘r’. Multiple regression equations were derived in order to calculate FO by other variables. Results: FO showed strong negative correlation with NSA; strong positive correlation with ANL, PNL, NW; moderate positive correlation with OL, TOL; but no relationship with FNA. NSA had moderate negative correlation with NW and weak negative correlation with PNL. NW & ANL had positive correlation with OL, TOL. Conclusion: In our method we used dried, intact bone and digital photographs with standardised method. Therefore it should provide accurate results; in addition it is cost effective. However studies on larger scale are warranted to design implants for Indian population.
A study on variations of branching patterns of median nerve in the carpal tunnel
Authors: Biswas Krishna Kanta , Baishya Rupak Jyoti , Talukdar Kunjalal 
Published: November 2019

Abstract
Background & aims: The carpal tunnel, located on the palmar surface of the wrist, is a common site of median nerve compression. The median nerve, on passing through the carpal tunnel, divides into lateral and medial branches. The lateral branch then gives off proper palmar digital branches to the thumb and the radial aspect of the index finger, and a recurrent muscular branch to the thenar muscles. The recurrent muscular branch shows different types of variations of the median nerve. Also, there are other variations of the median nerve in the carpal tunnel. These variations greatly influence the symptoms, as well as the treatment of the carpal tunnel syndrome. So, the present work is carried out to study the variations of branching patterns of median nerve in the carpal tunnel. Materials and methods: 40 wrists [20 right and 20 left] from 20 formaldehyde fixed human perinatal fetuses of 34 - 38 weeks of gestation were dissected in the Department of Anatomy, Gauhati Medical College and Hospital, Guwahati. Due ethical clearance was obtained from the Institutional Ethical Committee, Gauhati Medical College and Hospital, Guwahati. Results: In the present study, 24 [66.7%] hands [11 right and 13 left] showed extraligamentous and 12 [33.3%] hands [8 right and 4 left] showed transligamentous variety of thenar branch of median nerve. Also, 4 [10%] hands showed accessory thenar branch of median nerve, all of which took origin within the flexor retinaculum. The comparisons of numbers of variations of thenar branch of median nerve between right and left hands were found to be statistically non significant [P > 0.05]. Conclusion: A detailed knowledge of the median nerve variations in the carpal tunnel is required for successful diagnosis and treatment of the carpal tunnel syndrome and its complications.
Utility of Web 2.0 tools for self-directed learning among first year MBBS Students
Authors: Shrish Patil , Manjunath S.M , Nidoni Madhumati , Raju G Nagesh 
Published: November 2019

Abstract
Background and aims: To use Web 2.0 tools for learning human histology by First year MBBS students and thus make them aware of the features of these tools. To assess, by way of a feedback, the utility of the web 2.0 tools as instruments for self- directed learning. Materials and Methods:A questionnaire based longitudinal study was administered to sixty students. Their knowledge level about Web 2.0 tools, Self directed learning and Competency based learning were assessed. Then they were asked to participate in online discussions using Web 2.0 tools. Opinion regarding the utility of these Web 2.0 tools was collected using pre-validated questionnaires. Results: Awareness of Web 2.0 tools and Self-Directed Learning [SDL] was low. Even though students found the Web 2.0 tools to be good instruments for learning of that material which was not taught in routine classes, several students preferred their learning to be guided by teachers. Conclusion: Web 2.0 tools are good instruments for Self Directed Learning which leads to better development of competencies required of a professional doctor. Web 2.0 tools need to be integrated into our current curriculum to be fully utilised. These tools are yet to find acceptance by the students.
Morphometrie study of foramen magnum in human dry skulls
Authors: Deshpande Sulabha Hanumant , Nuchhi Ashwini Balasaheb , Bannur Balappa Murigeppa , Patil Babasaheb Gurusiddappagouda 
Published: November 2019

Abstract
Background : Anthropologists are often faced with the task of assigning sex to remains that are incomplete, fragmented or damaged as may result from incidents such as mass disasters, airplane crashes, fire, explosions or physical violence. The size of foramen magnum does not change after puberty, not related to age then after. It is this part of the cranial base which can withstand fire explosions as the area is covered by large amount of soft tissue. Hence the foramen magnum was considered for studying the sexual differences in skull. Aims : To analyse the morphology and morphometry of foramen magnum, and the impact of these variables on sex determination of skull. Materials and Methods : 68 male and 68 female adult dry skulls were used for the study. The shapes of foramen magnum were studied. Results : In total, oval was the most common shape comprising of 61.76%, 16.17% arrow head, 11.76% irregular and 10.29% round. The sagittal diameter was 33.0 [28-40] mm in males and 33.0 [28-43] in females and transverse diameters of foramen magnum were 27[21-31] in males and 26.0[23-33]mm in females. Area of foramen magnum was calculated using Radinsky and Teixeria formulae and foramen magnum index was calculated. Mean, standard deviation and median [where ever required] were calculated. Student t test and Mann Whitney U test/ T test were applied. We did not find significant difference between male and female values. Conclusion : Our study did not demonstrate statistically significant difference in expression of sexual differences in the foramen magnum. However if detailed analysis is done with greater sample size by discriminant function analysis, it may prove useful in predicting sex in severely fragmented cranial bases.
Extra coeliac axis origin of cystic artery: a cadaveric study
Authors:   Vinitha G,   Rajeshwari M S
Published: November 2019

Abstract
Background: A thorough knowledge of extra hepatic biliary system vasculature is very important for surgeons to avoid iatrogenic bleeding during upper abdominal surgeries. Aim: Cystic artery usually a branch of right hepatic artery rarely has anomalous origin from coeliac trunk or from its branches. Very rarely it has an extracoeliac origin. The aim is to study the incidence of origin of cystic artery other than coeliac trunk. Material and method: The study was done on 50 formalin fixed cadavers [32male, 18 female] in the department of anatomy, Bangalore medical college and research institute during 2014-17. During routine dissection of coeliac trunk, cystic artery was traced and observed for its origin. Results: Cystic artery took its origin from right hepatic artery in 37 [74%], left hepatic artery in 9[18%], hepatic artery in 3[6%] and superior mesenteric artery ini [2%] cadaver. Conclusion: The incidence of extra coeliac axis origin of cystic artery is 2% which arose from superior mesenteric artery. Prior knowledge of these variations is important for surgeons and interventional radiologists during pancreatobiliary surgeries, angiogram and arterial embolization.
Morphometry relevant to Anterior Petrosectomy with special reference to Kawase’s Triangle
Authors: Siddiqui Abu Ubaida , Satapathy Bikash Chandra , Gill Sukhjeet Singh 
Published: November 2019

Abstract
Background and aims :The petrous apex and the middle cranial fossa is a commonly explored area in neurosurgeries and hence require a holistic approach which should include the possibility of anatomical variants and morphometric dissimilarities. Material and Methods:This morphometric study was undertaken on 91 dry adult skulls [182 petrosal apices] to analyze a number of parameters relevant to Anterior Petrosectomy [AP] via the Kawase’s Triangle [KT]. The anatomical landmarks most pertinent to Anterior Petrosectomy [Kawase's approach] were defined, recorded and validated. The findings of the study were compared with earlier workers who have employed other means of investigation viz. dry bones/CT scans or cadaveric studies . Results : The parameters undertaken for the study presented with variable values and moresoever for the surface area of the KT. This can be very logically attributed to the variant anatomy amongst races and also to the physiological status of the individual Conclusions : AP has evolved as a preferred method for approaching petroclival region and thus requires an in depth understanding. The present analysis throws significant light on certain parameters that would be helpful in making anterior petrosectomy safer. Surgeries of the skull base demand for high end precision and proficiency and thus our findings provide enhanced alertness for a better and safe procedure. A methodical approach to the area with the background knowledge of these parameters shall culminate in desired neurosurgical outcomes.
Boosting anatomy teaching of MBBS first year students using a quality circle module-A personalized perspective
Authors: Agnihotri Gaurav 
Published: November 2019

Abstract
Background and aims : In Medical education scenario, a ‘quality circle’ comprises of a small group of individuals who perfonn voluntarily quality control activity. The present study aims to implement the ‘quality circle concept’ in anatomy teaching of first year MBBS students and gauge the effects. The study also assesses the success of the quality circle module based on student satisfaction levels at the end of the course. Materials and methods: A quality circle was fonnulated at the beginning of the MBBS first year course in the anatomy department at Government medical college, Amritsar and a problem pool was identified based on inputs from the class and the author. Using this problem pool a questionnaire was circulated to all students at beginning of course and then again at end of course to assess student satisfaction levels after implementation of the quality circle. The student responses based on a five point Likert scale were tabulated and statistically analyzed. Results: The means for items in questionnaire as determined at beginning and end of course were compared and they came out to be statistically significant [p<0.001]. The responses indicated that there was a statistically significant impact of the ‘quality circle’ on student satisfaction levels. Conclusion: The quality circle module should be utilized for effective achievement of goals in medical institutions. The author advocates that the concept should be tried in all professionals during the MBBS course. Though the results are subtle and limitations are there, it provides opportunities of personality development for the students. The quality circle creates a platfonn wherein the students and facu1ty/authorities can interact and act cohesively and in an unidirectional manner for effective achievement of academic goals and environment.
A study ofthe morphogenesis & mitral cell population of human fetal olfactory bulbs
Authors: Roy Sagoik , Roy Nivedita 
Published: November 2019

Abstract
Background and Aims: Human fetal olfactory bulbs have a six layered laminar architecture where mitral cells are the largest neurons. Volume of the bulbs is considered as an indicator of olfactory function. Fetal bulb cell transplants are used to treat many diseases of the central nervous system. The present study aims to trace the development of the fetal bulbs with respect to it’s gross appearance, volume, arrangement and the number of mitral cells. Materials and Methods: Sixty two normal fresh aborted fetuses were collected from Obstetrics and Gynaecology department of Regional Institute of Medical Sciences, Imphal. The fetuses were dissected and olfactory bulbs were gently taken out and fixed in 10& formal saline. Once fixed, the volume of the bulbs were measured using a measuring cylinder and insulin syringe. This was followed by tissue processing and staining with Toluidine Blue and Cresyl Violet. Stained slides were photographed and number of mitral cells were counted using Image J software. The correlation of bulb volume with fetal age, crown rump length [CRL 1 and fetal body weight was analysed using SPSS software. Similar analysis was also done between mitral cell number and fetal age. Result: Fetal bulbs attained adult morphology at 20 weeks. Bulb volume was found to rise significantly with advancing fetal age until it slowed down 32 weeks onwards. Mitral cells were identifiable at 16 weeks and maintained a laminar arrangement and showed progressive increase in number until 28 weeks. There after the orderly arrangement of cells as well their number declined. Conclusion: Very few studies have been conducted so far regarding the fetal olfactory bulbs in India. The present study is expected to supplement known data and knowledge regarding the development of the fetal bulbs and the mitral cell population and help in the diagnosis and treatment of central nervous system diseases.
Morphological and morphometric features of cuboid bone
Authors: Kumar Suja S ,   Viveka S
Published: November 2019

Abstract
Background and aims : Morphological and morphometric data of cuboid is of significance in creating 3D model of midfoot alignment and in understanding pathologies and instabilities in the region. There is minimal data on biometric values of cuboid. The objective of the study was to evaluate morphological variations in calcaneal articulating facet and metatarsal articulating facet. The other objective was to report morphometric data of cuboid. Methodology: This descriptive study was conducted in the department of Anatomy, using 24 dry cuboid bones. Each bone was observed for pattern of articular surfaces. Articular surface of each bone was photographed and categorized. Presence of navicular facet was noted. Results: Pattern of calcaneal articular facet was classified into four types: IA – concavo-convex facet with posteromedial projection and overall oval or reniform shaped; 1B – concavo-convex facet without posteromedial projection and rectangular shaped; 2A – plane facet with posteromedial projection and oval or reniform shaped; 2B – plane facet without posteromedial projection and rectangular shaped. Type I was the most common. Pattern of metatarsal articulating facet was classified into three groups: Concave – the edges of metatarsal articulating facet projected anteriorly making a depression for articulation of 4th and 5th metatarsal bones; Plane – articulating facet is flat; Convex – the articulating surface slopes posteriorly. Concave pattern was most common. Mean medial length of cuboid was 33.9 [°3.3] mm, lateral length was 17.9[ °1.6]mm, height was 22[°1.5] mm, length index was 188.8, area of calcaneal articular facet was 124.9 [°10.9] mm2, area of metatarsal articulating facet was 91.9[°5.7]mm2, depth of peroneal groove was 1.83 [°1.3]mm. Conclusion: Morphological characterization of articular surfaces of cuboid, especially the calcaneal facet helps to understand the degree of movement at calcaneocuboid joint and also joint pathologies.