bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preoperative single dose versus conventional antibiotic prophylaxis in thyroid surgery
Authors: Islam Mohammad Zahirul , Kamal Mohammad Shah , Hafiz Md Abdul , Hossan Md Mosarraf , Islam Md Saiful , Biswas Supran 
Published: July 2024

Background: Surgical Site Infection (SSI) is the most frequent type of Health care-associated infections (HAI) in low- and middle-income countries and affects up to one-third of patients who have undergone a surgical procedure. SSI incidence is the second most frequent type of HAI in Europe and the United States of America.
Objective: This study aimed to compare the frequency of SSIs after thyroid surgeries with preoperative single dose antibiotic and conventional multi doses prophylaxis antibiotic regimens.
Methods: This randomized clinical trial was carried out in the Department of Otolaryngology and Head Neck Surgery, Chittagong Medical College Hospital from January 2020 to March 2021. Eighty-four patients who underwent elective thyroid surgery were randomly assigned into two equal groups of 42 each. They received either a single dose preoperative injectable antibiotic or a conventional antibiotic regimen for seven days. Patients were followed up till the 30th post-operative day to assess postoperative SSI and other complications.
Results: The majority of the patients were female (90%) and in the age group of 30 to 39 years (33%). Both groups were similar in terms of their demographic characteristics. The most common indication of the surgery was nodular goiter and most of the patients underwent hemithyroidectomy. The mean duration of operation was 120 minutes. No SSI or other major complications were observed in this study.
Conclusion: Preoperative single-dose antibiotic is comparable to conventional multi-dose prophylaxis antibiotic regimens in elective thyroid surgery.
J Bangladesh Coll Phys Surg 2024; 42: 247-252
Self-expandable metallic stenting for advanced GI Tract Malignancy: An effective palliation to relieve obstructions
Authors: Mazumder Suzon Kumar , Das Chittaranjan , Bhuiyan Abul Kheire Mohammad Minhaj Uddin , Bardhan Sushmita , Shakir Washif , Rahman Mohammed Ashrafur 
Published: July 2024

Introduction: Palliative stenting for relieving malignant obstruction of the gastrointestinal tract is routinely practiced in western world. Obstructing advanced GI malignancy requires bypass or exteriorization of proximal gut before NACT or as a bridge to definite surgery. The aim of the study was to review the experience at tertiary cancer hospital and short-term outcome with endoscopic stenting in lieu of palliative bypass surgery for advanced and obstructing GI malignancy.
Materials and Methods: This observation study was carried out in the surgical out-patient department of NICRH where all therapeutic endoscopic facilities were available. All patients treated with stenting in a 2 years period from 2018-2020 were studied.
Results: Fifty-six patients received 60 stents. No case of perforation occurred. In fifteen cases (26.78%) clogging with food occurred; in 5 cases (8.92%) displacement occur. Tumour overgrowth was noted in 7 (12.66%) cases. Four patients (6.72%) received a second stent. Mean survival of patients with esophageal stent was 221 days. Four patients received 4 stents in their colon or rectum. The stents were placed in the sigmoid (n=2), the descending colon (n=1), and the transverse colon (n=1). Mean survival of colonic stent patients was 331 days. No perforation, no clogging by stool and no tumour ingrowth among patients with colonic stent but one (25%) had displacement. Eighteen patients received a total of 18 stents because of obstructing stomach cancer. 12 (61.22%) patients had tumour at cardia. Mean survival after gastric stent placement was 176 days. There was no perforation, one case of clogging (8.33%), and two cases of tumour ingrowth (16.66%). 5 patients underwent duodenal stenting. Remaining one at Billroth II anastomotic site. Single patients (20%) required laparotomy and stent extraction due to duodenal stent migration. Mean survival after duodenal stent placement was 242 days. No perforation, no clogging and no tumour ingrowth.
Conclusions: The present series shows that placement of expandable metallic stents in the obstructing GI tract malignancy as an alternative to bypass surgery is safe, cost effective, low complications, short hospital stay and provides good palliation.
J Bangladesh Coll Phys Surg 2024; 42: 241-246
Caracterização dos fatores clínico-epidemiológicos e das comorbidades neurológicas em pessoas com Epilepsia: Um estudo transversal no Nordeste do Brasil
Authors: Santos Clauhan Williams Soares dos , Araújo Rodrigo André de Souza , Ramos Alana Soares , Andrade Clênia Leite , Santana Hanna Priscila Rodrigues de , Leão Vítor Caron de Souza , Medeiros Fabíola Lys de 
Published: July 2024

Introdução: A epilepsia é uma doença neurológica crônica que cursa com comorbidades neuropsiquiátricas agravando ainda mais a morbidade e mortalidade de pessoas com epilepsia. Objetivo: Caracterizar o perfil clínico epidemiológico de pacientes com epilepsia correlacionando com as comorbidades associadas. Metodologia: Estudo de corte transversal do tipo analítico. Resultados: Foram analisados 220 prontuários. A idade média da primeira crise foi de 6,6 anos, com predomínio de epilepsia focal (lobo temporal). As alterações focais no exame de neuroimagem ocorreram em 42,2%, assim como as alterações focais no exame do eletroencefalograma em 48,5%. Quanto às comorbidades, 20,8% da população estudada apresenta algum tipo de transtorno do sono. O Déficit intelectual ocorreu em 53,5% (24,9%, nível moderado). As cefaleias em 30,6%. Alterações do comportamento presentes em 20,8% e o Transtorno do espectro Autista em 4,1%. Houve relevâncias estatísticas entre epilepsia de lobo temporal e transtorno do sono, cefaleia e epilepsia parietal, politerapia farmacológica com pior controle de crises e DI. Conclusão: O diagnóstico de epilepsia do lobo temporal foi o mais prevalente. Quanto as etiologias, houve uma relação com explicação congruente, da epilepsia focal com etiologia estrutural, da epilepsia generalizada com etiologia genética, e da epilepsia desconhecida com a etiologia desconhecida. As epilepsias focais apresentaram correlação com eletroencefalogramas com alterações focais, assim como a neuroimagem. A alta prevalência de comorbidades neuropsiquiátricas com relação bidirecional e fatores de riscos compartilhados com a doença de base, contrastando com a visão antiga de que estas comorbidades eram decorrentes do efeito das crises epilépticas.
Teste da Linguinha: Importância para diagnóstico e intervenção precoce da anquiloglossia
Authors: Camargo Daniela Albiero de , Papa Danieli Silva , Silva Heloísa Cogo da , Borgato Gabriell Bonifacio , Carneiro Diego Patrik Alves 
Published: July 2024

A anquiloglossia é uma condição congênita caracterizada pela presença de uma prega de tecido que limita o movimento da língua, podendo afetar funções como a fala, a alimentação e a higiene bucal. Seu diagnóstico precoce é fundamental para garantir um desenvolvimento adequado da fala e da alimentação, prevenindo complicações futuras e promovendo uma melhor qualidade de vida. Assim, o presente estudo teve como objetivo discutir a importância do Teste da Linguinha na identificação da anquiloglossia e sua relevância para a intervenção precoce. Para tal, uma revisão narrativa da literatura realizada nas bases de artigos Scholar Academic e BVS (Biblioteca Virtual de Saúde), através do cruzamento de palavras-chave: anquiloglossia, diagnóstico, tratamento e nutrição. Os critérios de inclusão: estudos epidemiológicos em geral, revisões de literatura, publicados nos últimos 10 anos em português ou inglês e disponíveis para download. Também foram incluídas leis, decretos, notas técnicas e resoluções brasileiras relevantes. Os critérios de exclusão foram estudos laboratoriais, dissertações e teses, cartas ao editor e resumos de congressos. Após as etapas de seleção e análise, foram considerados para a presente revisão da literatura 18 artigos. O Teste da Linguinha, é um exame simples e eficiente que permite a identificação precoce da anquiloglossia ainda na maternidade. O presente estudo evidenciou que o Teste da Linguinha é uma ferramenta crucial para a identificação precoce da anquiloglossia. Essa prática, junto com intervenções apropriadas, podem mitigar significativamente os impactos negativos da condição sobre a saúde do bebê, incluindo-se a nutrição, promovendo um desenvolvimento mais natural e sem complicações.
Análise jurisprudencial de tratamentos especializados no Estado do Ceará
Authors: Gomes Stéfany de Lima , Carneiro Diego Patrik Alves , Alves Regina Maria Aguiar , Meneghim Marcelo de Castro 
Published: July 2024

O presente trabalho teve como objetivo associar o tipo de demanda judicial, com as características processuais e da atenção à saúde dos municípios do Estado do Ceará. Estudo transversal constituído por todos os acórdãos no Tribunal de Justiça do Estado do Ceará, no período compreendido entre 2010 e 2018. Os dados foram analisados de forma descritiva e expressos em frequências absolutas. Para a análise foram construídos modelos de regressão logística simples e múltiplo entre a variável de desfecho (tipo de demanda Medicamentos/outros e Leitos UTI/procedimentos cirúrgicos) e as variáveis independentes Índice de Desenvolvimento Humano Municipal (IDH-M), cobertura de ESF e AB e autoria da ação. Foram selecionadas 224 ações para a análise, sendo a maior demanda tendo como réu o Estado do Ceará 147 (65,6%). A cidade de Fortaleza 153 (68,3%) foi a que mais houve demandas. Houve aumento no número de processos de demanda de medicamentos/outros até 2015. Para os processos com demanda de leitos de UTI/procedimentos cirúrgicos nota-se o aumento no número no decorrer do tempo. Houve associação entre a variável IDH-M e o tipo de demanda judicial. Concluiu-se que no estado do Ceará, as demandas judiciais variaram em função do ano e das características da atenção à saúde, com a variável IDH-M, estando associada significativamente com o tipo de demanda judicial entre 2010 e 2018.
Differences in checkpoint-inhibitor-induced hypophysitis: mono- versus combination therapy induced hypophysitis
Authors: van der Leij Stephanie , Suijkerbuijk Karijn P.M. , van den Broek Medard F.M. , Valk Gerlof D. , Dankbaar Jan Willem , van Santen Hanneke M. 
Published: July 2024

ObjectiveImmune checkpoint inhibitors (ICIs) are revolutionary in oncology but may cause immune-related (IR) side effects, such as hypophysitis. Treatment with anti-PD-(L)1, anti-CTLA-4 or anti-CLTA-4/PD-1 may induce hypophysitis, but little is known about the differences in clinical presentation or need for different treatment. We analyzed the differences of anti-PD-(L)1, anti-CTLA-4 and anti-CTLA-4/PD-1 induced hypophysitisMethodsretrospective analysis of 67 patients (27 anti-PD-(L)1, 6 anti-CLTA-4 and 34 anti-CTLA-4/PD-1 induced hypophysitis).ResultsThe median time between starting ICIs and IR-hypophysitis was longer after anti-PD(L)-1) therapy (22 weeks versus 11 and 14 weeks after anti-CTLA-4 and anti-CTLA-4/PD-1 therapy, respectively). The majority of patients (&gt;90%), presented with atypical complaints such as fatigue, nausea, and muscle complaints. Headache, TSH or LH/FSH deficiency were more common in anti-CTLA-4 and anti-CLTA-4/PD-1 versus anti-PD-(L)1 induced hypophysitis (83% and 58% versus 8%, 67% and 41% versus 11%, and 83% and 48% versus 7%, respectively). Pituitary abnormalities on MRI (hypophysitis or secondary empty sella syndrome) were only seen in patients receiving anti-CTLA-4 or anti-CTLA-4/PD-1 therapy. Recovery from TSH, LH/FSH and ACTH deficiency was described in 92%, 70% and 0% of patients after a mean period of 14 and 104 days, respectively, and did not differ between patients who did or did not receive high-dose steroids.ConclusionThe clinical presentation of IR-hypophysitis varies depending on the type of ICIs. MRI abnormalities were only seen in anti-CTLA-4 or anti-CTLA-4/PD-1 induced hypophysitis. Endocrine recovery is seen for LH/FSH and TSH deficiency but not for ACTH deficiency, irrespective of the corticosteroid dose.
Clinical, genomic and immune microenvironmental determinants of nivolumab response in head and neck squamous cell carcinoma
Authors: Tsujikawa Takahiro , Ohno Kazuchika , Morita Kei-ichi , Saburi Sumiyo , Mitsuda Junichi , Yoshimura Kanako , Kimura Alisa , Morimoto Hiroki , Ogi Hiroshi , Shibata Saya , Akashi Takumi , Kurata Morito , Imoto Issei , Shimizu Yasushi , Kano Satoshi , Watanabe Akihito , Yamazaki Tomoko , Asada Yukinori , Hayashi Ryuichi , Saito Yuki , Ozawa Hiroyuki , Tsukahara Kiyoaki , Oridate Nobuhiko , Sano Daisuke , Horii Arata , Ueki Yushi , Maruo Takashi , Mukoyama Nobuaki , Hanai Nobuhiro , Fukusumi Takahito , Iwai Hiroshi , Fujisawa Takuo , Fujii Takashi , Nibu Ken-ichi , Iwae Shigemichi , Ueda Tsutomu , Chikuie Nobuyuki , Yasumatsu Ryuji , Matsuo Mioko , Umeno Hirohito , Ono Takeharu , Masuda Muneyuki , Toh Satoshi , Itoh Kyoko , Hirano Shigeru , Asakage Takahiro 
Published: July 2024

BackgroundIn view of improving biomarkers predicting the efficacy of immunotherapy for head and neck squamous cell carcinoma (R/M HNSCC), this multicenter retrospective study aimed to identify clinical, tumor microenvironmental, and genomic factors that are related to therapeutic response to the anti- Programmed cell death protein 1 (PD-1) antibody, nivolumab, in patients with R/M HNSCC. MethodsThe study compared 53 responders and 47 non-responders, analyzing formalin-fixed paraffin-embedded samples using 14-marker multiplex immunohistochemistry and targeted gene sequencing.ResultsOf 100 patients included, responders had significantly lower smoking and alcohol index, higher incidence of immune related adverse events, and higher PD-1 ligand (PD-L1) expression in immune cells as well as PD-L1 combined positive score (CPS) than non-responders. The frequency of natural killer cells was associated with nivolumab response in patients with prior cetuximab use, but not in cetuximab-naïve status. Age-stratified analysis showed nivolumab response was linked to high CPS and lymphoid-inflamed profiles in patients aged ≥ 65. In contrast, lower NLR in peripheral blood counts was associated with response in patients aged &lt; 65. Notably, TP53 mutation-positive group had lower CPS and T cell densities, suggesting an immune-excluded microenvironment. Patients with altered tumor suppressor gene pathways, including TP53, CDKN2A, and SMAD4 mutations, had lower CPS, higher smoking index, and were associated with poor responses. ConclusionNivolumab treatment efficacy in HNSCC is influenced by a combination of clinical factors, age, prior treatment, immune environmental characteristics, and gene mutation profiles.
Association between inflammatory bowel disease and osteoporosis in European and East Asian populations: exploring causality, mediation by nutritional status, and shared genetic architecture
Authors: Kang Jian , Wu Xize , Li Yue , Zhao Shuangli , Wang Shixuan , Yu Dongdong 
Published: July 2024

BackgroundWhile previous research has established an association between inflammatory bowel disease (IBD) and osteoporosis (OP), the nature of this association in different populations remains unclear.ObjectiveOur study used linkage disequilibrium scores(LDSC) regression analysis and Mendelian randomization(MR) to assess the genetic correlation and causal relationship between IBD and OP in European and East Asian populations.MethodsWe performed separate genetic correlation and causal analyses for IBD and OP in European and East Asian populations, used the product of coefficients method to estimate the mediating effect of nutritional status on the causal relationship, and used multi-trait analysis to explore the biological mechanisms underlying the IBD-nutrition-OP causal pathway.ResultsOur analysis revealed a significant genetic correlation and causal relationship between IBD and OP in the European population. Conversely, no such correlation or causal relationship was observed in the East Asian population. Mediation analysis revealed a significant mediating effect of nutritional status on the causal pathway between IBD and OP in the European population. Multi-trait analysis of the IBD-nutrition-OP causal pathway identified MFAP2, ATP13A2, SERPINA1, FTO and VCAN as deleterious variants.ConclusionOur findings establish a genetic correlation and causal relationship between IBD and OP in the European population, with nutritional status playing a crucial mediating role.
Development and validation of a predictive model assessing the risk of sarcopenia in rheumatoid arthritis patients
Authors: Qu Yuan , Zhang Lili , Liu Yuan , Fu Yang , Wang Mengjie , Liu Chuanguo , Wang Xinyu , Wan Yakun , Xu Bing , Zhang Qian , Li Yancun , Jiang Ping 
Published: July 2024

BackgroundSarcopenia is linked to an unfavorable prognosis in individuals with rheumatoid arthritis (RA). Early identification and treatment of sarcopenia are clinically significant. This study aimed to create and validate a nomogram for predicting sarcopenia risk in RA patients, providing clinicians with a reliable tool for the early identification of high-risk patients.MethodsPatients with RA diagnosed between August 2022 and January 2024 were included and randomized into training and validation sets in a 7:3 ratio. Least Absolute Shrinkage and Selection Operator (LASSO) regression analysis and multifactorial logistic regression analysis were used to screen the risk variables for RA-associated muscle loss and to create an RA sarcopenia risk score. The predictive performance and clinical utility of the risk model were evaluated by plotting the receiver operating characteristic curve and calculating the area under the curve (AUC), along with the calibration curve and clinical decision curve (DCA).ResultsA total of 480 patients with RA were included in the study (90% female, with the largest number in the 45–59 age group, about 50%). In this study, four variables (body mass index, disease duration, hemoglobin, and grip strength) were included to construct a nomogram for predicting RA sarcopenia. The training and validation set AUCs were 0.915 (95% CI: 0.8795–0.9498) and 0.907 (95% CI: 0.8552–0.9597), respectively, proving that the predictive model was well discriminated. The calibration curve showed that the predicted values of the model were basically in line with the actual values, demonstrating good calibration. The DCA indicated that almost the entire range of patients with RA can benefit from this novel prediction model, suggesting good clinical utility.ConclusionThis study developed and validated a nomogram prediction model to predict the risk of sarcopenia in RA patients. The model can assist clinicians in enhancing their ability to screen for RA sarcopenia, assess patient prognosis, make early decisions, and improve the quality of life for RA patients.
A dose–response correlation between smoking and severity of acute pancreatitis: a propensity score-matched study
Authors: Li Runzhuo , Tang Wanyun , Yan Sun , Yu Xiaohan , Hu Lian 
Published: July 2024

BackgroundAcute pancreatitis, among the most prevalent gastrointestinal disorders, exhibits a continual rise in its incidence recent years. This study endeavor to explore the correlation between smoking exposure and the severity of acute pancreatitis (AP).MethodsFive hundred and eight patients diagnosed as acute pancreatitis (AP) were included in our data analysis. Patients were categorized based on their smoking pack-years into four groups: light, moderate, heavy, and non-smokers. Outcomes were classified as two: “mild acute pancreatitis (MAP)” and “moderately severe acute pancreatitis (MSAP) or severe acute pancreatitis (SAP)”. We conducted propensity score matching (PSM) to adjust confounding factors and multivariable logistic regression analysis to determine adjusted odds ratios and 95% confidence intervals. Additionally, a dose-dependent association analysis between smoking exposure and the incidence rate of “MSAP or SAP” was performed.ResultsSmokers exhibited a higher risk of “MSAP or SAP” compared to non-smokers, both before (17.1 vs. 54.9%, p &lt; 0.001) and after (9.4 vs. 24.7%, p &lt; 0.001) PSM. With an area under the ROC curve of 0.708, smoking showed a moderate level of predictive ability. Furthermore, propensity score matching analysis showed that patients who smoked compared to non-smokers had significantly higher risks of “MSAP or SAP” for light smoking (OR 3.76, 95% CI 1.40–10.07, p = 0.008), moderate smoking (OR 4.94, 95% CI 2.23–10.92, p &lt; 0.001), and heavy smoking (OR 8.08, 95% CI 3.39–19.25, p &lt; 0.001).ConclusionSmoking is an independent risk factor that can raise the severity of pancreatitis. Moreover, the severity of acute pancreatitis escalates in tandem with the accumulation of pack-years of smoking.
Exosomes: a significant medium for regulating drug resistance through cargo delivery
Authors: Ren Bixuan , Li Xiaoqing , Zhang Zhihua , Tai Sheng , Yu Shan 
Published: July 2024

Exosomes are small lipid nanovesicles with a diameter of 30–150 nm. They are present in all body fluids and are actively secreted by the majority of cells through the process of exocytosis. Exosomes play an essential role in intercellular communication and act as significant molecular carriers in regulating various physiological and pathological processes, such as the emergence of drug resistance in tumors. Tumor-associated exosomes transfer drug resistance to other tumor cells by releasing substances such as multidrug resistance proteins and miRNAs through exosomes. These substances change the cell phenotype, making it resistant to drugs. Tumor-associated exosomes also play a role in impacting drug resistance in other cells, like immune cells and stromal cells. Exosomes alter the behavior and function of these cells to help tumor cells evade immune surveillance and form a tumor niche. In addition, exosomes also export substances such as tumoricidal drugs and neutralizing antibody drugs to help tumor cells resist drug therapy. In this review, we summarize the mechanisms of exosomes in promoting drug resistance by delivering cargo in the context of the tumor microenvironment (TME).