bluuebunny/crossref_metadata_2025_split huggingface dataset:
Interpositional Bioresorbable Scaffold-Anchor Appears Non-inferior to a Standard Anchor in the Treatment of Rotator Cuff Tears
Authors: Angerett Nathan , Krasney Leighann , Lutz Rex , Maurer Timothy , Michelitch Scott , Lin Albert , Kelly Matthew 
Published: December 2024

Background
Failure after rotator cuff repair is typically due to a loss of integrity of the bone-tendon interface. The BioWick anchor (Zimmer-Biomet) is an interpositional scaffold-anchor that was developed to improve tendon-bone healing. The purpose of this study was to determine the clinical efficacy of this novel anchor compared with a standard anchor with respect to retear rates and patient outcomes.

Materials and Methods
We enrolled 99 patients in a double-anonymized, prospective, randomized controlled trial who underwent rotator cuff repair. Fifty patients were randomized to the novel anchor group and 49 patients were randomized to the standard anchor group. The primary outcome was rotator cuff repair integrity assessed via ultrasound at 6 months postoperatively. Secondary outcomes included visual analog scale (VAS) pain score, American Shoulder and Elbow Surgeons (ASES) score, Simple Shoulder Test (SST), strength, and active range of motion (AROM) assessed preoperatively and postoperatively at 3 and 6 months.

Results

There were no statistically significant differences in demographic data, mean rotator cuff tear size, tobacco use, workers' compensation status, or operative side between the groups. At 6-month follow-up, the retear rate was 22% (n=9) for the novel anchor group vs 23% (n=10) for the standard anchor group (
P
=.8864). Secondary outcomes, including VAS pain score, ASES score, SST, strength, and AROM measurements, did not differ significantly between the groups at 3- or 6-month follow-up. There were no complications identified in either group.

Conclusion

This study did not demonstrate superior clinical improvements or decreased retear rates with the use of this novel anchor compared with a standard anchor. [
Orthopedics
. 2025;48(1):e33–e39.]
Prevalence and Pattern of Morbidity Triads among the Elderly Population: A Cross-sectional Study in Bankura District, West Bengal
Authors: Das Ujjwal , Kar Nishamani 
Published: December 2024

Background and Aim:
The multi-morbidity in the elderly is a major public health challenge in most of developing countries. The elderly suffer from multiple chronic health conditions due to differential socioeconomic and demographic conditions in the household. The present study examines the prevalence and pattern of triad morbidity among the elderly in the Bankura district of West Bengal.

Materials and Methods:
A cross-sectional study was conducted among elderly men and women aged 55 years and above in five blocks of Bankura district. The multi-stage random sampling designed was developed to select the requisite number of elderly. The blocks were selected in the first stage, and then the village was selected in the second stage, followed by a selection of the target population in the third stage. The pretested, predesigned, and semi-structured questionnaires were developed for collecting the self-reported morbidity information. Descriptive statistics was used to identify the prevalence of disease-specific burden of triad morbidity. Multivariate logistic regression forms of odds ratio with a 95% confidence interval were used to explore the factors associated with morbidities.

Results:
Out of the 462 elderly persons, 222 (48.05%) were males and 240 (51.95%) were females; 360 (77.9%) were affected by more than one disease. The mean age of affecting triad morbidity among the elderly was 61 years. The highest prevalence of triad morbidity among the elderly was arthritis, hypertension, and heart disease (79.6%), followed by diabetes, hypertension, and depression (78%). The overall disease prevalence was more prominent among the female elderly than males. The prevalence of triad morbidities was strongly correlated with key lifestyle factors such as excess intake of alcohol, smoking, and tobacco consumption and higher food choices of nonvegetarians.

Conclusion:
The health problems of the elderly are aggravated by the no education, lack of physical work, poor socioeconomic condition, and Western types of lifestyle. There is an urgent need to develop comprehensive public health strategies to address the high burden of NCDs in Bankura.
Hypoglycaemic, anti-hyperlipidemic, and anti-inflammatory activities of Asparagus africanus (Asparaceae) extract on high-fat diet/streptozotocin-induced diabetes in Wistar rats
Authors: Evans Ngwenah Focham , Mahamat Oumar , Christopher Tume 
Published: December 2024

Objective:
To investigate the toxicity and effect of the extract on some complications of diabetes in Wistar rats.

Methods:
Type 2 diabetes was induced by a combination of a high-fat diet and streptozotocin (35 mg/kg, i.p.). Aqueous extract of Asparagus africanus (EAA) was prepared and administered (p.o.) for 28 d to groups of diabetic rats as well as to groups of normal rats for toxicity. Fasting blood glucose levels, inflammatory cytokines, and lipid profiles were assessed in diabetic rats. Body and organ weight as well as liver and kidney functions were examined to assess the sub-acute toxicity.

Results:
EAA for 28 d did not affect the body weight, the weight of the liver, kidney, and heart as well as the serum level of aspartate aminotransferase, alanine aminotransferase, urea, uric acid and creatinine in normal rats. In diabetic rats, the administration of EAA significantly lowered hyperglycemia, reduced interleukin (IL)-6, IL-1β, and tumour necrosis factor-α levels, and increased the level of IL-10. EAA also lowered cholesterol, triglyceride, and low-density lipoprotein cholesterol levels and augmented high-density lipoprotein cholesterol in the serum. As a result of the anti-lipidemic effect, EAA reduced the atherogenic index, Castelli indices, and atherogenic coefficient in diabetic rats. EAA showed the presence of flavonoids, alkaloids, tannins, saponins, terpenes, and steroids.

Conclusions:
The findings of this study demonstrated that EAA is safe. It has the potential to reduce the glucose level and the risk of inflammation and atherogenesis in diabetic patients.
Cardioprotective effects of total and anthocyanin-rich extracts of Opuntia ficus-indica fruit on epinephrine-induced cardiac injury in rats
Authors: Safaeian Leila , Sadeghi-Dinani Masoud , Haghighatian Zahra , Fatahian Mohammad-Bagher , Khademizadeh Marjan 
Published: December 2024

Objective:
To examine the effect of fruit extracts of Opuntia ficus-indica on epinephrine-induced myocardial injury in rats.

Methods:
Rats were pre-treated with hydroalcoholic and anthocyanin-rich extracts (250, 500, and 1 000 mg/kg) orally for 16 days. Epinephrine (2 mg/kg) was injected subcutaneously on days 15 and 16. Then ECG, heart rate, RR interval, cardiac histopathology, and serum parameters of cardiac damage and oxidative stress were evaluated.

Results:
Pretreatment with the hydroalcoholic and anthocyanin-rich extracts of Opuntia ficus-indica at doses of 500 and 1 000 mg/kg reversed epinephrine-induced changes in ECG, heart rate, RR interval, and cardiac histopathology, and attenuated creatine phosphokinase-MB activity and malondialdehyde level. The extracts at all doses diminished heart weight, lactate dehydrogenase, and aspartate aminotransferase, and also elevated total antioxidant capacity. However, 1 000 mg/kg of the anthocyanin-rich extract was more effective than the hydroalcoholic extract.

Conclusions:
Supplementation with fruit extracts of Opuntia ficus-indica, especially anthocyanin-rich extract, could protect against epinephrine-induced cardiac injury in rats by alleviating electrocardiographic, biochemical, histopathological, and oxidative stress parameters, and may be used in the treatment of cardiovascular diseases.
Comparing Cisplatin Dosing Schedules in Concurrent Chemoradiotherapy for Locally Advanced Head-and-Neck Cancer: A Comprehensive Review of Weekly Versus 3-Weekly Regimens
Authors: Yang Oscar Chi-Yu , Su Nai-Wen , Leu Yi-Shing , Chang Yi-Fang 
Published: December 2024

Abstract

Objective:
There are approximately 900,000 new cases of head-and-neck cancer (HNC) annually, with a significant proportion presenting as locally advanced head-and-neck cancer (LA-HNC). Cisplatin-based concurrent chemoradiotherapy (CCRT) has become widely accepted, particularly for patients deemed inoperable. The standard regimen is a high-dose 3-weekly cisplatin schedule, however, this can lead to considerable toxicities. This review evaluates the efficacy, safety, and compliance associated with an emerging alternative: a weekly cisplatin dosing schedule.

Data Sources:
The review of current literature included randomized controlled trials, meta-analyses, and retrospective studies within the past decade, comparing weekly, and 3-weekly cisplatin CCRT regimens for LA-HNC.

Study Selection:
Studies comparing 3-weekly and weekly cisplatin-based CCRT were included.

Results:
Weekly cisplatin regimens demonstrated comparable efficacy to the traditional 3-weekly schedule, with lower toxicity and improved compliance. Key studies suggested that weekly cisplatin may have a more favorable safety profile, with reduced risks of neutropenia, renal impairment, and ototoxicity. However, the potential for slightly better locoregional control with the 3-weekly regimen remains a point of ongoing investigation. Novel agents including immune checkpoint inhibitors, xevinapant, and berzosertib are being actively investigated as combinational therapies with cisplatin-based CCRT.

Conclusion:
Weekly cisplatin-based CCRT is a viable alternative to the traditional 3-weekly regimen for treating LA-HNC, particularly in patients at higher risk of toxicities. Further randomized controlled trials are required to confirm the optimal cisplatin schedule and efficacy of combinational therapies with novel agents. These findings underline the importance of exploring treatment protocols that balance therapeutic benefits with reduced adverse effects and improved compliance.
Adult-onset Renal Neuroblastoma: Case Report and Literature Review
Authors: Yang Yao-Ren , Huang Cih-En 
Published: December 2024

Abstract
Neuroblastoma is an extremely rare neoplasm in adults, with a poorer prognosis compared to pediatric neuroblastoma. Due to its rarity, there are no specific treatment guidelines for adult neuroblastoma. Here, we report a case of adult renal neuroblastoma presenting initially with painless and gross hematuria. Enhanced computed tomography revealed an infiltrative, heterogeneously enhanced renal mass at the lower pole of the right kidney, accompanied by regional lymphadenopathies. The initial impression was renal cell carcinoma, and a right nephroureterectomy with regional lymph node dissection was performed. Pathologic examination confirmed the diagnosis of primary renal neuroblastoma with a differentiating subtype. The patient was classified as having International Neuroblastoma Staging System stage 2B or International Neuroblastoma Risk Group Staging System stage L2. The patient underwent six courses of adjuvant chemotherapy, and no disease recurrence was observed during a 7-year follow-up period.
5-Fluorouracil, Leucovorin, Oxaliplatin, and Irinotecan as a Potential Standard for Second-line Therapy in Extrapulmonary Neuroendocrine Carcinomas
Authors: Ho I-Wei , Chiang Nai-Jung , Lai Jiun-I , Chang Peter Mu-Hsin , Chen San-Chi , Hung Yi-Ping , Chen Ming-Huang 
Published: December 2024

Abstract

Background:
Neuroendocrine carcinomas (NECs) are classified by the World Health Organization as poorly differentiated, aggressive Grade 3 tumors with high proliferative indices and frequent lung involvement. While initial treatment for advanced NEC typically involves etoposide and platinum-based therapies, standardized options for subsequent lines of treatment are lacking. This study evaluates the efficacy and outcomes of various second-line treatments for NECs following progression after initial therapy.

Materials and Methods:
A retrospective cohort study was conducted at Taipei Veterans General Hospital, Taiwan, from January 2016 to June 2023. The study included patients aged 18 years or older diagnosed with extrapulmonary NEC who had progressed following initial platinum and etoposide therapy. Treatment response and survival outcomes were assessed.

Results:
The study analyzed 34 patients across four treatment regimens: 5-fluorouracil, leucovorin, oxaliplatin, and irinotecan (FOLFOXIRI), 5-fluorouracil, leucovorin, and irinotecan, 5-fluorouracil, leucovorin, and Nivolumab + Ipilimumab. The FOLFOXIRI regimen demonstrated the highest objective response rate of 33.3% and a disease control rate of 66.7%, compared to the other groups, with a median progression-free survival of 4.1 months and median overall survival of 9.7 months.

Conclusion:
The FOLFOXIRI regimen shows potential as an effective second-line treatment for patients with extrapulmonary NEC who have progressed after first-line therapy with platinum/etoposide.
The pivotal image findings of progressive multifocal leukoencephalopathy: A case report
Authors: Ma Shou-De , Wei Chih-Wei , Huang Tai-Lin , Wu Chao-Hsin , Chang Shiang-Yu 
Published: December 2024

Abstract
Progressive multifocal leukoencephalopathy (PML) is a rare disease associated with the reactivation of the JC virus, particularly in immunocompromised patients. A 60-year-old woman, who was on immunosuppressive therapy, presented with a sudden seizure and was diagnosed with PML based on magnetic resonance imaging (MRI) findings. Typically, PML appears on computed tomography scans as asymmetric focal zones of low attenuation in the periventricular and subcortical white matter, while MRI findings usually show multifocal demyelination in these areas. The imaging results in this case are consistent with the typical presentation of PML.
Antifungal Susceptibility of Dermatophyte Isolates from Patients with Chronic and Recurrent Dermatophytosis
Authors: Amin Nikhitha , Shenoy Manjunath M. , Pai Vidya 
Published: December 2024

Abstract

Background:
The widespread occurrence of chronic and recurrent dermatophytosis has significantly affected the quality of life for patients in India and beyond. Identifying the causative dermatophytes and understanding their antifungal susceptibility can aid clinicians in tailoring effective antifungal therapies.

Materials and Methods:
Patients with chronic and recurrent dermatophytosis were enrolled, and conventional fungal cultures were conducted on skin scrapings. Identified isolates underwent antifungal susceptibility testing using the Clinical and Laboratory Standards Institute broth microdilution method (CLSI M38-A2) for common systemic antifungals, determining the minimum inhibitory concentration (MIC) range and calculating MIC 50 and MIC 90.

Results:
Sixty samples were tested. Tinea corporis was the most common presentation (66.6%). Trichophyton mentagrophyte species complex was the prevalent species (45, 75%), followed by Trichophyton rubrum (7, 11.7%). In Trichophyton mentagrophytes species complex, MIC range was 8-64 μg/mL for fluconazole, 0.06-0.25 μg/mL for terbinafine, and 0.125-0.5 μg/mL for griseofulvin. For Trichophyton rubrum, the MIC range was 8-64 μg/mL for fluconazole, 0.06-0.25 μg/mL for terbinafine, and 0.125-0.5 μg/mL for griseofulvin. For all species, itraconazole MIC was ≤0.125 μg/mL. Hence, itraconazole and terbinafine had the best MIC range against tested isolates in our study.

Limitations:
Absence of genotyping of isolate and not compared the results with studies where sequence-based identification to species level was done.

Conclusion:

In vitro, resistance to itraconazole for any of the four isolated agents was not seen. Terbinafine resistance appears to be an uncommon occurrence in South India. In vitro susceptibility tests shall be regularly done to design the epidemiological cutoff values.
Prospective Study of Dobutamine Stress Echocardiography in Comparison with 18F-fluorodeoxyglucose Positron Emission Tomography for Myocardial Viability in Ischemic Cardiomyopathy
Authors: Kumari Nuthalapati Rama , Sunitha Arumulla , Rajashekhar Sama 
Published: December 2024

Abstract

Background:
Myocardial viability is utilized in the decision-making process for suitability of revascularization in patients with coronary artery disease and depressed left ventricular (LV) function.

Aims:
The aim of this study was to compare the accuracy of dobutamine stress echocardiography (DSE) with the 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) for the identification of viable myocardium in patients with previous myocardial infarction and LV dysfunction.

Settings and Design:
This was a prospective observational study done at Nizam’s Institute of Medical Sciences.

Materials and Methods:
Patients with coronary artery disease with previous myocardial infarction with significant LV dysfunction were included in the study.

Statistical Analysis:
Categorical variables were presented in number and percentage (%), and continuous variables were presented as mean ± standard deviation. Student’s paired t-test was applied to test the difference between the outcomes of 18F-FDG PET and dobutamine stress echo. The statistical software SPSS 17.0 version was used in the analysis of the data.

Results:
In our study population, the mean LV ejection fraction was 35.1%. A total of 800 myocardial segments were evaluated with resting two-dimensional echocardiography examination, of which 250 (31.2%) were normal and 550 (68.8%) were abnormal segments. The dysfunctional 550 segments were further assessed with DSE followed by 18F-FDG PET. In our study, 453 segments were viable on 18F-FDG PET and 407 segments viable on DSE (P = 0.001). Viability was detected by both modalities in 88.1% and discordance in 11.9% of segments. These results yielded a positive predictive value of 97.8% and negative predictive value of 61.1% of DSE.

Conclusions:
On considering 18F-FDG PET a gold standard for detection of viable myocardial segments, DSE has shown a sensitivity of 87.6% and specificity of 90.7%. Thus, DSE can be used as a good alternate to 18F-FDG PET where facility for FDG PET is not available. However, patients detected to have nonviable dysfunctional segments on DSE can be evaluated further with 18F-FDG PET for confirmation of viability.
Benign paroxysmal positional vertigo
Authors: Swain Santosh Kumar 
Published: December 2024

Abstract
Benign paroxysmal positional vertigo (BPPV) is the leading etiology of peripheral vertigo. It manifests with transient, recurring bouts of vertigo brought on by movements of the head. BPPV happens when particles known as otoliths, which can either float freely (canalithiasis) or become attached to the cupula (cupulolithiasis), stimulate semicircular canals abnormally. The clinical symptoms of the BPPV are triggered when the head changes position so that the involved semicircular canal aligns vertically with gravity. During the Dix–Hallpike maneuver (used to diagnose posterior canal BPPV) and the supine roll test (used to diagnose horizontal canal BPPV), patients typically experience a brief delay followed by acute vertigo and nystagmus. Reversing the head position often causes the nystagmus to change direction. The location of otolith debris and the semicircular canal that is affected determine the severity, frequency, and length of symptoms in BPPV. There may be a spontaneous recovery of the BPPV with the help of conservative treatments. However, an important treatment option such as the canalith repositioning maneuver is helpful for giving an immediate resolution of the symptoms by clearing otolithic debris from the semicircular canal into the vestibule. This review article will discuss the prevalence, etiopathology, clinical features, differential diagnosis, and management of different types of BPPV including medical and surgical treatment and rehabilitation for BPPV.
An unanticipated failure of nasogastric tube placement due to peripancreatic collection: A case report
Authors: Gautam Pooja , Tarafdar Yashashvi , Sanjeev Om P. , Sundar Shyam 
Published: December 2024

Abstract
Nasogastric tube (NGT) placement is a very common clinical procedure in the emergency department (ED). The procedure is very simple, yet difficulties and catastrophes of misplacement are much more than reported. We hereby report a case of failure of the NGT placement in a patient with acute pancreatitis with a huge abdominal collection and its interesting solution. A 33-year-old male presented to ED with severe pain abdomen, abdominal distension, and shortness of breath. Abdominal examination showed a tense swelling in the upper abdomen with a grossly distended abdomen. Respiratory distress and fatigue were detected, warranting quick interventions. The reason for respiratory fatigue was figured out to be increased abdominal pressure resisting diaphragmatic pull down. As the abdomen was tense, NGT placement was to be done as part of routine care. Placement of the NGT was challenging, and multiple attempts failed to negotiate it beyond 35–40 cm, even with the best hands. An upper abdomen scan with ultrasonography (USG) point of care ultrasonography revealed hypoechoic images, likely a huge collection. A percutaneous drainage was planned immediately, a USG-guided pigtail catheter of 10 F was placed, and almost 2000 ml of fluid was aspirated. It was decided to push Ryle’s Tube (RT), and surprisingly, it was easily negotiable by now. After confirmation by the auscultation method, it was fixed at the 60 cm mark. In our case, there was compression of the stomach by the huge peripancreatic collection to the extent that there was no patent lumen to pass on anything.
Rathke’s cleft cyst: A case report
Authors: Swain Santosh Kumar 
Published: December 2024

Abstract
A Rathke cleft cyst (RCC) is a nonmalignant growth originating from Rathke’s pouch, which is the precursor to the anterior pituitary gland during early development. Most RCCs are asymptomatic and are typically discovered incidentally during computed tomography scans or magnetic resonance imaging (MRI). The progressive enlargement of the RCC is often symptomatic due to compression of the adjacent structures. The clinical presentations of the RCC are headache, visual disturbances, pituitary dysfunction causing hypogonadism, hyperprolactinemia, deficits of growth hormones, hypothyroidism, and diabetes insipidus. The conventional treatment of the symptomatic RCC is surgical excision through a transsphenoidal approach. Here, we are presenting a patient of Rathke’s cleft cyst presenting severe headache that was relieved after endoscopic transsphenoidal decompression of the cyst.