bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prolargin serum and tissue expression levels in hypertrophic scars and keloids
Authors: Sorour Neveen E. , Abdeltwab Asmaa O. , Azab Naglaa I. , El Habak Doaa M. 
Published: January 2025

Background
Uncertainty surrounds the exact etiology of hypertrophic scars and keloids. It is generally accepted, nevertheless, that they are caused by reticular dermal chronic inflammation, which typically begins shortly after wounding. Prolonged inflammation increases myofibroblast differentiation and fibroblast proliferation.

Objective
To measure prolargin’s tissue expression and serum level in individuals with keloids and hypertrophic scars to determine how these factors are related to the disease.

Patients and methods
This was a case–control study on 90 patients who were classified into three equal groups. Group I: patients with hypertrophic scars. Group II: patients with keloids. Group III: healthy individuals, age-matched and sex-matched, as controls. Blood samples and tissue biopsies were taken to assess serum and tissue levels of prolargin using the enzyme-linked immunosorbent assay technique.

Results
Serum and tissue prolargin were significantly lower in groups I and II than in group III (P<0.001). Multinomial logistic regression was done for serum prolargin to predict hypertrophic scars and keloids. Group III was used as a reference category. Serum prolargin was a significant predictor for hypertrophic scars (odds ratio=0.933, 95% confidence interval= 0.902–0.965, P<0.001) and keloids (odds ratio=0.946, 95% confidence interval=0.919–0.974, P<0.001).

Conclusion
The current study sheds light on prolargin’s possible role in hypertrophic scars and keloid pathogenesis. The results open up the possibility of investigating prolargin’s intricate pathologic role and its potential as a marker for diagnosis and prognosis for these difficult fibroproliferative skin disorders.
Can lesion volume and prostate-specific antigen density play a role in detecting clinically significant prostate cancer in Prostate Imaging Reporting and Data System-3 lesions on multiparametric magnetic resonance imaging?
Authors: Agrawal Shashank , Prasad Vishnu , Menon Arun Ramadas , Pooleri Ginil Kumar 
Published: January 2025

ABSTRACT

Introduction:
Recently, the Prostate Imaging Reporting and Data System – 3 lesions (PI-RADS 3) have been sub classified into “3a” - lesions with a volume of <0.5 mL and “3b” - lesions exceeding 0.5 mL, whereas the prostate-specific antigen density (PSAD) is an established adjunct tool for predicting clinically significant prostate cancer (csPCa). The objective of this study was to evaluate the association between the volume of PI-RADS 3 lesions and PSAD in diagnosing csPCa and to assess the sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) when PSAD is combined with the lesion volume.

Methods:
This retrospective single-center study reviewed the data of transperineal prostate biopsies performed under transrectal ultrasound guidance from January 2018 to December 2023. csPCa was defined as a Gleason score ≥3 + 4. Patients were divided into two groups based on the PIRADS-3 subclassification and PSAD.

Results:
Out of the 108 PIRADS-3 lesions, 17 patients had csPCa. All the patients with PIRADS-3a (n = 37) had clinically insignificant tumors or benign conditions. Receiver operating characteristic curve analysis for predicting csPCa showed that the (Area under the curve) AUC values of PSAD, prostate volume, and prostate-specific antigen were 0.899, 0.746, and 0.381, respectively. 16 csPCa patients in PIRADS-3b category had PSAD ≥0.29 ng/ml2, whereas 1 patient had PSAD <0.29 ng/ml2. Sensitivity, specificity, PPV, and NPV of PIRADS-3b lesions were 100%, 40.66%, 23.94%, and 100%, respectively, and it became 94.12%, 74.07%, 53.33%, and 97.56%, respectively, when PSAD was added to PIRADS-3b lesions.

Conclusion:
The combination of lesion volume of the PI-RADS 3 lesion and PSAD improved the PPV and specificity of detecting csPCa.
Assessing neoadjuvant chemotherapy’s impact on complications following radical cystectomy
Authors: Nuthalapati Mounish , Menon Arun Ramdas , Patil Vivek Dadasaheb , Sukumaran Sheejamol Velickakathu , Yensani Prashanth Reddy , Agrawal Shashank , Haridas Nikhil Krishna , Nair Haridas , Ganesuni Sohini Chandra , Suresh Nivedita , Rajamma Bindu Mangalath , Pooleri Ginil Kumar 
Published: January 2025

ABSTRACT

Introduction:
Despite level 1 evidence supporting neoadjuvant chemotherapy (NACT) followed by radical cystectomy (RC) for muscle-invasive bladder cancer (MIBC), its adoption is hindered by concerns about toxicity and detrimental impact on post-RC complications. We retrospectively reviewed post-RC complications at a tertiary care hospital, particularly assessing impact of NACT.

Methods:
Data from the institutional bladder cancer database were retrieved for patients aged ≥18 with MIBC (≥American Joint Committee on Cancer Clinical Stage T2), treated with RC between May 2013 and July 2023. Exclusions were nonurothelial histology, salvage cystectomy, and palliative intent. Data abstracted included patient characteristics, NACT administration, surgery, and outcomes. Patients were divided into two groups based on NACT and compared. Complications were categorized as early (≤30 days) or late (31–90 days) and graded. Statistical analysis set significance at P < 0.05.

Results:
Of 154 patients who underwent RC, 33 were excluded due to non-MIBC, nonurothelial histology, or salvage cystectomy. The 121 patients analyzed had a mean age of 64 years and a Charlson Comorbidity Index (CCI) of 4.9. Among them, 61 received NACT and 60 did not. There was no significant difference between the NACT+RC and RC-only groups in overall complication rates (85.3% vs. 75.0%, P = 0.16) or in major complications (50.8% vs. 58.3%, P = 0.41). CCI >5 predicted major complications, while NACT did not.

Conclusion:
In our study of MIBC patients managed at a tertiary care institute in India, NACT administration did not increase postoperative complications.
Shifting tides: A survey analysis of urologists’ evolving attitudes toward focal therapy for prostate cancer
Authors: Koehler Jason , Lazarovich Alon , Tayebi Shima , Viswanath Vijay , George Arvin , Hsu Wei-Wen , Sidana Abhinav 
Published: January 2025

ABSTRACT

Introduction:
Focal therapy (FT) is emerging as an alternative to radical treatment for prostate cancer (CaP). The purpose of this study is to assess the current perceptions of FT amongst urologists.

Methods:
A 22-item questionnaire was e-mailed to members of the American Urological Association. Multivariate logistic regression analysis was used to identify predictors of FT utilization. Results were compared to a previous survey from 2019.

Results:
Two hundred and sixty-four responses were recorded. Less than half (115/264, 43.6%) of respondents utilize FT; among them, 42% perform FT on more than 10 patients/year. Reasons for avoiding FT included: lack of experience (51.8%), belief that CaP is multifocal (46.0%), and lack of infrastructure (43.1%). The most common modalities for FT were high-intensity focused ultrasound (63.4%) and cryoablation (47.3%). Preferred patients for FT were primarily unilateral/anterior only Gleason Grade Group 2 (95/110, 86.4%). A fellowship training in urologic oncology (odds ratio [OR] = 2.86, P = 0.008) and seeing more than 10 CaP patients per month (OR = 2.46, P = 0.002) were associated with greater utilization of FT. Most respondents (85.4%) cited better imaging methods as a factor that has increased FT utilization. Compared to a previous survey, a higher number of respondents (43% vs. 24%) utilize FT and more respondents believe in the “index lesion theory.”

Conclusions:
Less than half of the respondents utilize FT in their practice. Fellowship training in urologic oncology and a higher volume of CaP patients were correlated with FT utilization. As urologists gain more experience, the trend of further utilization of FT for CaP may continue.
Urethral duplication with five openings in anal canal: A novel case report
Authors: Pirzada Faisal Masood , Nayyar Rishi , Yadav Devendra Kumar 
Published: January 2025

ABSTRACT
Urethral duplication is a rare congenital anomaly characterized by more than one urethral channel, with varied course, location of the external opening, and presentation. Presentations can be varied, depending upon individual anatomical dispensation but mostly present as obstruction, recurrent urinary infection, or double urinary stream. Treatment depends on the type of duplication and associated anomalies. Here, we report a case of urethral duplication which did not fit into any known reported type of urethral duplication forms and had five openings at the anal verge.
A retrospective analysis of patients undergoing keratoplasty in a tertiary care center
Authors: Tamboli Nikhat Iqbal , Joshi Rajesh S , Hussain Murtaza , Shilpa  , Husain Bilal , Darade Nikhil Nivritti 
Published: January 2025

Purpose:
The purpose of the study was to study keratoplasty indications and outcomes at a tertiary care center in Western Vidarbha.

Subjects and Methods:
It is a retrospective cross-sectional study in which medical records of all patients undergoing keratoplasty at tertiary care in Western Vidarbha, Maharashtra, India, between October 2021 and October 2023, with a minimum follow-up period of 6 months were reviewed. Data were represented as numbers, percentages, and means.

Study Parameters:
Indications, surgical procedures, and outcomes of all surgeries collected and studied.

Main Outcomes:
Graft survival and visual acuity.

Results:
One hundred cases of keratoplasty were recorded during the study period. Total (33) optical keratoplasties, (41) therapeutic/tectonic keratoplasties, (11) descemet stripping endothelial keratoplasty (DSEK), and (15) deep anterior lamellar keratoplasty (DALK) were included. Out of those, 15 grafts survived and 79 grafts failed. Regrafting was done in six cases.

Conclusion:
Fifteen percent graft survival, visual acuity improved in 30% of patients of optical KP, 28% of patients of DSEK, and 13% of patients of DALK. The most common indication for keratoplasty was a perforated corneal ulcer. Graft failures are seen in infected and rheumatoid arthritis cases commonly. Postoperative complications occurred in 73% of cases. The outcome was better in optical keratoplasty patients than in therapeutic.
Effect of prednisolone acetate eye drops on blood glucose profile in Indian population
Authors: Bhat Archana , Paritekar Prajakta , Umesh Y. 
Published: January 2025

Background:
One of the common indications of topical steroids is to control postoperative inflammation. This study aims to evaluate changes in blood glucose concentrations in diabetic and nondiabetic patients treated with a postoperative regimen of 1% topical prednisolone acetate after cataract surgery.

Materials and Methods:
Prospective, observational cohort study conducted in a tertiary eye care hospital in South India from August 2022 to May 2023. Nondiabetics (Group A) and diabetics with good glycemic control, i.e., glycated hemoglobin (HbA1c) <7% (Group B) undergoing routine uneventful cataract surgery by a single surgeon were included in the study. All patients were prescribed the same regimen of topical corticosteroids after cataract surgery for 2 weeks, i.e., topical prednisolone acetate 1%, 1 drop six times a day for 1 week followed by three times a day for 1 week. All patients underwent capillary fasting blood sugar (FBS) test at the following time points: before the start of surgery, 1-week postoperative, 1-month postoperative, and HbA1c at 3 months postoperative.

Results:
Forty nondiabetic patients (Group A) and 40 well-controlled diabetic patients (Group B) were included in the study. Group A showed a statistically significant increase when 1-week preoperative FBS level (105.9 ± 13.3) was compared with 1-week postoperative (114.42 ± 15.6) which returned to the pretreatment level (102.92 ± 8.9) on 1-month follow-up. In Group B, 1-week preoperative (126.05 ± 31.2) and 1-week postoperative FBS levels (126.37 ± 19.5) were comparable.

Conclusion:
Topical prednisolone acetate can be safely used as a short-term routine postcataract surgery regimen in nondiabetics and diabetics with good glycemic control, without a significant increase in blood sugar levels.
Treatment of Femoral Neck Fractures with Intramedullary Fixation with Integrated Interlocking Lag and Compression Screws
Authors: Lezak Bradley , Hernandez-Irizarry Roberto , Quinnan Stephen 
Published: January 2025

Objectives:
(1) To describe our operative technique for femoral neck fractures using an intramedullary device with integrated compression screws. (2) Retrospective analysis of patients treated with intramedullary fixation with interlocking lag and compression screws for femoral neck fracture (3). To compare our results to published literature on more classic fixation techniques.

Design:
Single-center retrospective cohort.

Setting:
Level 1 trauma center.

Patients/Participants:
Thirty-eight patients with 39 femoral neck fractures were treated with internal fixation. Only patients treated with intramedullary fixation with integrated interlocking lag and compression screws were included; patients treated for femoral neck fractures with a sliding hip screw, screw fixation alone, or intramedullary devices without integrated interlocking screws were excluded. Our final cohort consisted of 19 patients (47% female) with an average age of 50 (27–82) who had 15 (79%) isolated femoral neck fractures and 4 (21%) femoral neck-shaft combined fractures.

Intervention:
Internal fixation with intramedullary fixation using interlocking lag and compression screws for femoral neck fracture.

Outcome Measurements:
Quality of reduction, radiographic healing, and radiographic assessment of nonunion/avascular necrosis (AVN).

Results:
Follow-up time was on average 50 months (range: 34–84), with a median of 50 months (interquartile range: 42–56). Nineteen patients (100%) had successful healing without further intervention. There were no nonunions, and 2 (10%) patients developed AVN leading to conversion to total hip arthroplasty.

Conclusion:
Femoral neck fractures are challenging to manage due to their intracapsular location and the tenuous blood supply to the femoral head. The use of intramedullary devices with integrated lag and compression screws is an effective method for the operative fixation of femoral neck fractures. Level of evidence: Level IV therapeutic.
Anterior Opening Wedge High Tibial Osteotomy for Recurvatum Deformity of the Proximal Tibia Secondary to Physeal Arrest: A Dual Site Study
Authors: Bartoletta John J. , Schmale Gregory A. , Mattioli-Lewis Tressa M. , Bouchard Maryse 
Published: January 2025

Context:
Injury to the anterior proximal tibial physis or tibial tubercle can result in recurvatum deformity of the tibia. Anterior opening wedge high tibial osteotomy (AHTO) with and without tibial tubercle osteotomy (TTO) can restore posterior tibial slope, improving patient symptoms and function.

Aims:
Review radiographic and surgical outcomes of patients that undergo AHTO for recurvatum deformity of the proximal tibia.

Settings and Design:
Patients from two tertiary pediatric institutions with proximal tibial recurvatum treated with an AHTO between 2002 and 2017 were retrospectively reviewed.

Materials and Methods:
Deformity was assessed radiographically using the posterior proximal tibial angle (PPTA), medial proximal tibial angle, and Caton–Deschamps index (CDI). Surgical techniques and complications were recorded.

Statistical Analysis Used:
Descriptive statistics were expressed as means and standard deviations.

Results:
Twelve patients with a mean age of 13.1 years (10–15 years) were included in this study. Acute AHTO proximal to the tibial tubercle was performed in nine cases. Two patients had concurrent TTO. Three patients underwent AHTO with gradual correction with a Circular external fixator with the corticotomy distal to the tibial tubercle. Mean postsurgical follow-up was 6.1 months (1.3–15.6 months). Mean preoperative PPTA improved to within normal for all surgical techniques (AHTO 98.7° to 82.6°, AHTO + TTO 102° to 80.9°, and gradual AHTO 104° to 76.9°). Three patients had residual radiographic hyperextension deformity at last follow-up (PPTA: 85.0°, 87.9°, 94.0°). No clinically significant secondary coronal plane deformities occurred. One patient who underwent acute AHTO had postoperative radiographic patella baja (CDI 0.51). Ten complications (7 Grade I and 3 Grade II) occurred in seven cases.

Conclusions:
Opening wedge AHTO with acute and gradual techniques corrects the sagittal plane deformity of recurvatum without inducing clinically significant coronal plane deformities, but minor complications are frequent.
Factors Thought to Cause and Aggravate Acne Vulgaris as Perceived by Adolescent High School Students in an Urban City and the Effect of Acne on their Quality of Life
Authors: Villanueva Marie Antoinette O. , Carpio Carolina A. , Coo Elisa Rae L. 
Published: January 2025

Background:
Acne vulgaris is a common disorder of the pilosebaceous unit seen primarily in adolescents. There is still a paucity on understanding about acne. Although nonlife-threatening, acne has a significant impact on social, psychological, and emotional well-being.

Materials and Methods:
Ananalytical cross-sectional study was conducted among high school students using constructed, self-administered questionnaires adapted from previous studies.

Results:
Among 416 respondents, 340 (81.73%) have acne. Acne is not considered contagious which was believed by 154 (45.26%) students with acne and 28/76 (36.84%) of those without. Despite controversial findings, diet, hormones, genetics, emotional stress, lifestyle, menstruation, and cosmetics are thought to play roles in acne. Students believed lack of sleep, hormones, stress, oily/fatty foods, menstruation, cosmetics, sunlight, and poor hygiene aggravate acne. There were significant differences in responses of those with and without acne to food/diet and hormones (P 0.000 and 0.006, respectively). There were also significant differences in the distribution of answers between those with and without acne on sweets (P 0.002) and heat/sun exposure (P 0.004). The students’ quality of life (QOL) assessed using teenagers’ QOL and Cardiff Acne Disability Index showed weak positive and statistically significant correlation between scores and acne severity indicating that as the severity of acne increases, the greater the impairment in their QOL.

Conclusion:
Beliefs and perceptions about acne play an important part in management and compliance. The results generally equate from evidence-based data. Few misconceptions may be brought by misleading information and different opinions. The physical, social, and psychological morbidity associated with acne can be profound and the QOL can be impaired.
Management of Nail Disease by Philippine Dermatologists: A Cross-sectional Study
Authors: Erfe Ma. Georgina Victoria De Guzman , Pineda Raphaela Martina Canga , Dim-Jamora Krisinda Clare Cuyong 
Published: January 2025

Background:
Nail disorders, comprising around 10% of dermatological cases, can arise at any age. There is no current data on the management patterns of Filipino dermatologists regarding nail diseases in the Philippines.

Aims:
This study aims to identify the management patterns of board-certified Filipino dermatologists categorized as private practice dermatologist, public government dermatologist, and combined practice dermatologist for common nail diseases and assess whether their approaches align with current clinical guidelines.

Settings and Design:
A cross-sectional analytic design was employed, with data collected through a validated online questionnaire distributed to Philippine Dermatological Society board-certified dermatologists.

Materials and Methods:
A structured questionnaire was electronically distributed to Filipino dermatologists, gathering data on the types of nail conditions encountered and the treatment modalities employed, from July to October 2022.

Statistical Analysis Used:
Sample size was calculated with a 95% confidence level and an 8% margin of error, yielding 159 participants. Descriptive statistics using frequency and percentage were used to summarize the data. STATA 15.0 was utilized for analysis.

Results:
There were 221 dermatologists who participated; 65.2% are in private practice, 5.4% work exclusively for the government, and 29.4% are in both private and public practice. The most common nail disorders managed were onychomycosis, periungual warts, and nail psoriasis. Management approaches varied by practice setting. Discrepancies between practice habits and guidelines, particularly in treating conditions such as paronychia and antifungal use, highlight the need for updated information and access to advanced treatments, especially in resource-limited settings.

Conclusions:
Filipino dermatologists generally follow global guidelines for managing nail diseases, but treatment choices are influenced by factors such as clinical presentation and resource availability, which differ between private, government, and combined practices. While private practitioners often refer to surgical cases such as onychocryptosis, government dermatologists tend to handle them themselves. Despite these challenges, dermatologists adapt pragmatically to provide effective care.
Comparison of oxygen supplementation by nasal cannula with suction versus air insufflation without suction under drapes during monitored anesthesia care in adult cataract surgery-A randomized non-inferiority trial
Authors: Arivazhakan Subramaniam Shanmugam , Balachander Hemavathi , Panneerselvam Sakthirajan , Govindaraj Kirthiha , Rudingwa Priya 
Published: January 2025

Background:
Patients with multiple co-morbidities undergoing cataract surgery are at risk of hypoxia and hypercarbia secondary to the rebreathing of the accumulated carbon dioxide under the surgical drapes. They are also at risk of fire accidents due to the hyperoxic condition secondary to oxygen supplementation.

Objectives:
The main aim of the study was to determine the lowest level of hemoglobin oxygen saturation while providing medical air in comparison with oxygen. Our hypothesis is that providing medical air will be non-inferior to oxygen administration in preventing hypoxia and rebreathing in these patients.

Methods:
This randomized non-inferiority trial was conducted in a single center Tertiary care hospital, over a study period of March 2020 to February 2021. Fifty-six adult patients with equal gender distribution undergoing cataract surgery with multiple comorbid conditions without sedative premedications were included in the study and randomized into either Group “O” (n = 28) who received oxygen @ 4 l min-1 through a nasal cannula with suction, and Group “A” (n = 28) who received medical air @10 l min-1 through the circle breathing system under the drapes. The main outcome measured was the lowest hemoglobin oxygen saturation (SPO2), the highest end-tidal carbon dioxide (hETCO2), and the highest fraction of inspired carbon dioxide levels (hFiCO2).

Results:
The lowest mean SPO2 measured was found to be similar between Group O and Group A with 98.8 ± 0.7 and 98.4 ± 0.9 (P = 0.081), respectively. The highest mean ETCO2 and mean FiCO2 values were also comparable between the Group O versus Group A with 32.8 ± 2.1 versus 33.3 ± 2.2 (P = 0.464), and 4.5 ± 1.4 versus 4.8 ± 1.8 (P = 0.464) respectively.

Conclusion:
We conclude that the supplementation of compressed medical air under surgical drapes is non-inferior to nasal oxygen supplementation under regional anesthesia without causing hypoxia and hypercarbia by conserving valuable hospital resources.