bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pragmatic Evaluation of Growth Hormone Stimulation Tests in Short Stature
Authors: Gupta Rahul , Dabas Aashima , Kohli Shweta , Ramot Rekha , Jyotsna Viveka P. , Goyal Alpesh , Gupta Yashdeep , Khadgawat Rajesh 
Published: April 2024

Abstract

Introduction:
To assess the performance of growth hormone stimulation tests (GHSTs) in the evaluation of short stature.

Methods:
It was a single-centre retrospective study carried out in children evaluated for short stature between January 2005 to March 2020. The clonidine stimulation test (CST) and glucagon stimulation test (GST) were used to assess growth hormone (GH) reserve (GST was performed only when peak GH levels were between 5 to ≤10 ng/mL on CST). A GH level of <5 ng/mL on CST or ≤10 ng/ml on both was used to corroborate GH deficiency.

Results:
A total of 556 children were eligible for this study. The mean (SD) age was 12.9 (3.5) years, and 66.3% were male. The peak GH level [median (IQR)] was 5.50 ng/ml (1.90 – 7.50) on CST (at 60 minutes) and 7.45 ng/ml (2.15 – 10.77) on GST (at 120 minutes). On restricting sampling to two time points, the false positive rate was 13.6% on CST (60, 90 minutes) and 11.5% on GST (120, 150 minutes). Similarly, restricting to three time points was associated with a false positive rate of 8.5% on CST (60, 90, 120 minutes) and 3.8% on GST (90, 120, 150 minutes). Using the treating clinician-determined diagnosis of GHD as a reference standard, the optimal cut-off of peak GH on CST was 7.79 ng/ml (sensitivity: 83.8%; specificity: 89.4%).

Conclusion:
Restricting the GH sampling to fewer time points is associated with an increase in the false positivity rate (FPR).
Type 1 Diabetes in Singapore: Self-Care Challenges, Diabetes Technology Awareness, Current Use, and Satisfaction, an Online Survey
Authors: Chandran Suresh Rama , Ho Cindy , Yeoh Ester , Gardner Daphne 
Published: April 2024

Abstract

Introduction:
To describe the self-care challenges, diabetes technology awareness, current use, and satisfaction among adults with type 1 diabetes and parents of children with type 1 diabetes in Singapore.

Methods:
An anonymous online survey was administered between November 2020 and October 2021. Data are presented as mean (standard deviation) or count (percentages). Comparisons between groups were done using the independent samples T-test.

Results:
251 people (176 adults, 75 parents) participated. The most challenging self-care burdens were carbohydrate counting (24.4%) among adults and insulin dose calculations (28%) among parents. Nocturnal awakenings for diabetes care of their child were a common event (25.3%). Despite high awareness about continuous glucose monitoring devices (77.8% adults, 78.7% parents) the use (24.9% adults, 55% children) remained low. Both adults and parents of children with type 1 diabetes found continuous glucose monitoring to be liberating and less restrictive. Despite overall low insulin pump use (23.9% adults, 29.3% children); satisfaction scores were higher among insulin pump users than insulin pen users (P = 0.02).

Conclusion:
Carbohydrate counting and insulin dose calculations were the most challenging self-care tasks among people with type 1 diabetes in Singapore. Diabetes technology use was relatively low in Singapore. Continuous glucose monitoring and Insulin pump users found them to be beneficial.
Global Warming and Endocrinology: The Hyderabad Declaration of the South Asian Federation of Endocrine Societies
Authors: Bhattacharya Saptarshi , Sahay Rakesh , Afsana Faria , Sheikh Aisha , Widanage Niranjala Meegoda , Maskey Robin , Naseri Mohammad Wali , Murad Moosa , Harikumar K. V. S. , Selim Shahjada , Aamir Azizul Hasan , Muthukuda Dimuthu , Parajuli Naresh , Baheer Mohammed Daud , Latheef Ali , Nagendra Lakshmi , Mondal Sunetra , Kamrul-Hasan A. B. M. , Raza Syed Abbas , Somasundaram Noel , Shrestha Dina , Anne Beatrice , Ramakrishnan Santosh , Kalra Sanjay 
Published: April 2024

Abstract
Global warming and endocrine disorders are intertwined issues posing significant challenges. Greenhouse gases emanating from human activities drive global warming, leading to temperature rise and altered weather patterns. South Asia has experienced a noticeable temperature surge over the past century. The sizable population residing in the region heightens the susceptibility to the impact of global warming. In addition to affecting agriculture, water resources, and livelihood, environmental changes interfere with endocrine functioning. Resulting lifestyle changes increase the risk of metabolic and endocrine disorders. Individuals with diabetes face heightened vulnerability to extreme weather due to impaired thermoregulation. A high ambient temperature predisposes to heat-related illnesses, infertility, and nephropathy. Additionally, essential endocrine drugs and medical devices are susceptible to temperature fluctuations. The South Asian Federation of Endocrine Societies (SAFES) calls for collaboration among stakeholders to combat climate change and promote healthy living. Comprehensive approaches, including the establishment of sustainable food systems, promotion of physical activity, and raising awareness about environmental impacts, are imperative. SAFES recommends strategies such as prioritizing plant-based diets, reducing meat consumption, optimizing medical device usage, and enhancing accessibility to endocrine care. Raising awareness and educating caregivers and people living with diabetes on necessary precautions during extreme weather conditions are paramount. The heat sensitivity of insulin, blood glucose monitoring devices, and insulin pumps necessitates proper storage and consideration of environmental conditions for optimal efficacy. The inter-connectedness of global warming and endocrine disorders underscores the necessity of international collaboration guided by national endocrine societies. SAFES urges all stakeholders to actively implement sustainable practices to improve endocrine health in the face of climate change.
A pediatric case of two Nicolau syndrome lesions following leuprolide injection in the upper extremity
Authors: Menteşoğlu Dilek , Elkıran Laden , Kurmuş Gökçe Işıl , Kartal Selda Pelin 
Published: April 2024

Abstract
Nicolau syndrome (NS) is a rare and unpredictable adverse reaction that can occur after the administration of certain medications. A 9-year-old girl, accompanied by her father, visited the outpatient dermatology clinic with complaints of wounds on both upper arms. Upon reviewing her medical history, it was discovered that she had been receiving leuprolide for precocious puberty, and the symptoms began after the last two injections. The patient experienced pain during the leuprolide injection, and redness and swelling were noticed in the injection area on the same day. A few days later, the redness turned into ulcers. The fact that the development of NS cannot be detected in advance and the risk of rapid progression of tissue necrosis make disease management difficult. The prognosis of NS significantly depends on the patient, and when a developing lesion is noticed early, it is crucial to minimize the risk of complications.
Microwave ablation combined with percutaneous vertebroplasty for treating painful non-small cell lung cancer with spinal metastases under real-time temperature monitoring
Authors: Wu Linlin , Hu Miaomiao , Li Peishun , Man Qirong , Yuan Qianqian , Zhang Xusheng , Qiu Yuanyuan , Chen Lili , Fan Jing , Zhang Kaixian 
Published: April 2024

ABSTRACTPurpose:To retrospectively study the therapeutic effect and safety performance of the combination strategies of the computed tomography (CT)-guided microwave ablation (MWA) and percutaneous vertebroplasty (PVP) as a treatment for painful non-small cell lung cancer (NSCLC) with spinal metastases.Materials and Methods:A retrospective review included 71 patients with 109 vertebral metastases who underwent microwave ablation combined with percutaneous vertebroplasty by the image-guided and real-time temperature monitoring. Treatment efficacy was determined by comparing visual analog scale (VAS) scores, daily morphine equivalent opioid consumption, and Oswestry Disability Index (ODI) scores before treatment and during the follow-up period.Results:Technical success was achieved in all patients. The mean pre-procedure VAS score and morphine doses were 6.6 ± 1.8 (4–10) and 137.2 ± 38.7 (40–200) mg, respectively. The mean VAS scores and daily morphine doses at 24 h and 1, 4, 12, and 24 weeks postoperatively were 3.3 ± 1.9 and 73.5 ± 39.4 mg; 2.2 ± 1.5 and 40.2 ± 29.8 mg; 1.7 ± 1.2 and 31.3 ± 23.6 mg; 1.4 ± 1.1 and 27.3 ± 21.4 mg; and 1.3 ± 1.1 and 24.8 ± 21.0 mg, respectively (allP< 0.001). ODI scores significantly decreased (P< 0.05). Minor cement leakage occurred in 51 cases (46.8%), with one patient having a grade 3 neural injury. No local tumor progression was observed by follow-up imaging.Conclusions:MWA combined with PVP can significantly relieve pain and improve patients’ quality of life, which implied this is an effective treatment option for painful NSCLC with spinal metastases. Additionally, its efficacy should be further verified through the mid- and long-term studies.
Efficacy of microwave ablation with parallel acupuncture guided by ultrasound in treating single hepatocellular carcinoma in high-risk areas: A retrospective analysis of 155 patients
Authors: Liu Sheng , Zhou Pingsheng , Shen Qiang , Qian Guojun 
Published: April 2024

ABSTRACT

Objective:
To investigate the safety and short- and long-term efficacy of ultrasound-guided microwave ablation (MWA) with parallel acupuncture for treating single hepatocellular carcinoma (HCC) in high-risk areas.

Methods:
Retrospective analysis was performed on 155 patients with single hepatocellular carcinoma who underwent microwave ablation in our hospital between December 2015 and September 2016. Patients with a tumor distance of ≤5 mm from the risk area were included in the observation group. Patients with a tumor distance of >5 mm from the risk area were placed in the control group. The patients’ preoperative general health status, tumor site, tumor size, follow-up data, disease-free survival rate, overall survival rates, local tumor progression, and intrahepatic distant recurrence rate were collected and analyzed.

Results:
The 1-, 3-, and 5-year overall survival rates for the observation group were 91.8%, 75.5%, and 59.2%, respectively. The 1-, 3-, and 5-year overall survival rates for the control group were 97.2%, 84.0%, and 66.0%, respectively. There were no significant differences between the two groups (P = 0.522). A tumor size of ≤20 mm (HR = 0.488, 95% CI = 0.254–0.940, P = 0.032) was an independent risk factor affecting the overall survival of patients with solitary HCC treated with MWA. The 1-, 3-, and 5-year recurrence-free survival rates for the observation group were 59.2%, 28.6%, and 18.4%, respectively, and those for the control group were 79.2%, 43.4%, and 31.1%, respectively. There was a statistical difference between the two groups (P = 0.007). Tumor size ≤20 mm (HR = 0.468, 95% CI = 0.303–0.723, P = 0.001), tumor location in a risk area (HR = 1.662, 95% CI = 1.121–2.465, P = 0.011), and an α-fetoprotein (AFP) level of <200 ug/L (HR = 0.612, 95% CI = 0.386–0.970, P = 0.036) are independent factors affecting the recurrence-free survival of MWA treatment for HCC.

Conclusion:
Microwave ablation with parallel acupuncture guided by ultrasound is a safe and effective treatment for single hepatocellular carcinoma in high-risk areas.
Evolution of neoadjuvant therapy for breast cancer regimens over 12 years and pathologic response rates according to tumor subtypes and clinical stage: A single-center retrospective study
Authors: Li Zhedong , Wang Yongsheng 
Published: April 2024

ABSTRACT

Background and Purpose:
Given the evolution of neoadjuvant therapy (NAT) for breast cancer, this study aimed to analyze trends in NAT regimens over time and patients’ pathological responses, tumor stages, and subtypes.

Materials and Methods:
Data were analyzed for 548 patients with cT1-4N0-3M0 breast cancer who received NAT at Shandong Cancer Hospital between 2011 and 2022. The 12-year study period was divided into six 2-year periods termed P1 to P6.

Results:
From P1 to P6, the proportion of stage II patients treated with NAT increased from 6.4% to 33.8% compared with same-stage operable breast cancer (r = 0.228, P < 0.001), while the proportion of the full-course group increased from 50.0% to 99.0% (r = 0.354, P < 0.001). The pathologic complete remission (pCR) rate in the full-course group increased from 30.8% to 54.6% (r = 0.248, P < 0.001). In the full-course human epidermal growth factor receptor-2 positive (HER2+) group, the proportion of chemotherapy combined with inhibition therapy increased from 33.3% to 100% (r = 0.530, P < 0.001). Furthermore, dual inhibition therapy increased from 0 to 98.9%. The proportion of the nonanthracycline group (dual inhibition) increased from 56.0% at P5 to 76.6% at P6 (r = 0.190, P = 0.042). In the full-course Triple-Negative Breast Cancer (TNBC) group, the proportion of platinum therapy increased from 0 to 41.9% (r = 0.324, P < 0.001) and immune drugs increased from 0 to 53.2% (r = 0.500, P < 0.001).

Conclusion:
Overall, the results indicate an increasing proportion of patients receiving NAT therapy over time. Furthermore, there were increases in HER2 + patients receiving inhibition therapy (especially dual inhibition) and TNBC patients receiving platinum and immune therapy as part of NAT. Notably, these changes were associated with improved outcomes.
Non-mass-type ductal carcinoma in situ of the breast on ultrasound: Features and pathological analysis
Authors: Zhang Peipei , Kong Peng , Liu Dequan , He Shuqian , Zhang Xuping 
Published: April 2024

ABSTRACT

Aims:
The aims of this study were to investigate the ultrasound features of non-mass-type ductal carcinoma in situ (DCIS) of the breast and conduct a pathological analysis.

Material and Methods:
Ultrasound images of 32 cases of non-mass-type DCIS of the breast, collected between September 2014 and June 2016, were analyzed. The characteristics of the lesions, including border, internal echogenicity, local glandular hyperplasia, micro-calcification, and intra-tumoral blood flow resistance index (RI), were analyzed, and a concurrent pathological analysis was conducted.

Results:
Obvious local glandular hyperplasia was commonly observed in the 32 cases of non-mass-type DCIS of the breast. The internal echogenicity varied in intensity, exhibiting a “leopard pattern” or “zebra pattern.” Color Doppler imaging revealed abundant blood flow signals within the lesion with an RI of >0.7. Isolated duct dilatation and micro-calcifications were occasionally observed within the lesions. High-grade DCIS was the predominant pathological type of non-mass-type DCIS.

Conclusions:
Non-mass-type DCIS of the breast often presents with obvious local glandular hyperplasia and varying internal echogenicity. High-grade DCIS is the frequent pathological type. Color Doppler imaging and RI measurement can assist in diagnosing non-mass-type DCIS of the breast.
Evaluation of stromal myofibroblasts in oral submucous fibrosis and its malignant transformation: An immunohistochemical study
Authors: Liu Ziyi , Hu Wenwu , Shan Zhongyan , Liu Sixuan , Yao Zhigang , Quan Hongzhi 
Published: April 2024

ABSTRACT

Background:
Oral submucous fibrosis (OSF) is a precancerous lesion, with oral squamous cell carcinoma (OSCC) being the most prevalent malignancy affecting the oral mucosa. The malignant transformation of OSF into OSCC is estimated to occur in 7–13% of cases. Myofibroblasts (MFs) play pivotal roles in both physiological and pathological processes, such as wound healing and tumorigenesis, respectively. This study aimed to explore the involvement of MFs in the progression of OSF and its malignant transformation.

Materials and Methods:
In total, 94 formalin-fixed paraffin-embedded tissue blocks were collected, including normal oral mucosa (NOM; n = 10), early-moderate OSF (EMOSF; n = 29), advanced OSF (AOSF; n = 29), paracancerous OSF (POSF; n = 21), and OSCC (n = 5) samples. Alpha-smooth muscle actin was used for the immunohistochemical identification of MFs.

Results:
NOM exhibited infrequent expression of MFs. A higher staining index of MFs was found in AOSF, followed by EMOSF and NOM. Additionally, a significant increase in the staining index of MFs was found from EMOSF to POSF and OSCC. The staining index of MFs in NOM, EMOSF, AOSF, POSF, and OSCC was 0.14 ± 0.2, 1.69 ± 1.4, 2.47 ± 1.2, 3.57 ± 2.6, and 8.86 ± 1.4, respectively. All results were statistically significant (P < 0.05).

Conclusions:
The expression of MFs exhibited a gradual increase as the disease progressed from mild to malignant transformation, indicating the contributory role of MFs in the fibrogenesis and potential tumorigenesis associated with OSF.
Combination low-dose cyclophosphamide with check-point blockade and ionizing radiation promote an abscopal effect in mouse models of melanoma
Authors: Luo Xing , Zeng Ming 
Published: April 2024

ABSTRACT

Purpose:
The complex strategy of hypo-fractionated radiotherapy (HFRT) in combination with an immune checkpoint inhibitor (ICI) can stimulate a potential systemic antitumor response; however, the abscopal effect is always precluded by the tumor microenvironment, which may limit sufficient T-cell infiltration of distant nonirradiated tumors for certain kinds of inhibitory factors, such as regulatory T-cells (Tregs). Additionally, low-dose cyclophosphamide (LD-CYC) can specifically kill regulatory Tregs and strongly synergize antigen-specific immune responses, which could promote an abscopal effect.

Materials and Methods:
We explored whether a triple regimen consisting of HFRT, ICI, and LD-CYC could achieve a better systemic antitumor response in bilateral mouse tumor models.

Result:
Our data demonstrate that LD-CYC combined with HFRT and antiprogrammed cell death ligand 1 (PDL-1) therapy could enhance the abscopal effect than only HFRT/antiPDL-1 or HFRT alone. Surprisingly, repeat CYC doses cannot further restrain tumor proliferation but can prolong murine overall survival, as revealed by the major pathologic responses. These results are associated with increased CD8 + effector T-cell infiltration, although LD-CYC did not upregulate PDL-1 expression in the tumor.

Conclusions:
Compared with traditional strategies, for the first time, we demonstrated that a triple treatment strategy remarkably increased the number of radiation-induced tumor-infiltrating CD8 + T-cells, effectively decreasing infiltrating Tregs, and promoting an abscopal effect. Thus, we describe a novel and effective therapeutic approach by combining multiple strategies to target several tumor-mediated immune inhibitory mechanisms.
A Retrospective Study of Clinical Profile, Management, and Evaluation of Early Outcomes in Endovascular Carotid Artery Stenting for Carotid Artery Stenosis: Our Institutional Experience
Authors: Patil Karansinh Raosaheb Parve , Nadkarni Trimurti D. , Dadla Murtaza Mustafa , Barve Pandurang S. 
Published: April 2024

ABSTRACT

Objective:
The present study was undertaken to evaluate the clinical profile and management of carotid artery stenosis in the Indian population treated by endovascular modalities.

Materials and Methods:
This was a retrospective observational study of 54 patients with carotid artery stenosis treated at a tertiary care centre for 5 years between November 2018 and February 2023. Endovascular carotid artery stenting (CAS) was performed in all patients, and post-procedural imaging was done to assess the extent of restoration of blood flow through the stenosed segment and cerebral blood flow. Patients were followed up to 6 months post-procedure.

Results:
Fifty-four patients underwent carotid stenting. Four (7.4%) patients were asymptomatic and 50 (92.6%) were symptomatic. Total male patients were 39 (72.2%) and female patients were 15 (27.7%). Age of these patients ranged from 37 to 77 years, with the average age being 60.8 years. Hypertension was the most common comorbidity (88.88%), followed by diabetes mellitus (48.14%). Post-procedure brain and carotid angiogram showed no evidence of restenosis. Two patients had developed post-procedure haemorrhagic stroke, and one patient developed a pseudoaneurysm at the access site of the right femoral artery.

Conclusion:
Our study showed CAS is a safe and minimally invasive procedure in patients with severe carotid artery stenosis. Managing comorbidities is equally important. The procedure enabled the patients to have an early discharge and minimal limitation of daily activities.
Lamina Terminalis Fenestration: A Beneficial Approach to Reduce Shunt-dependent Hydrocephalus in Patients with Aneurysmal Subarachnoid Hemorrhage with a Review of Literature
Authors: Jadhav Anil , Katyal Abhishek , Jagetia Anita , Singh Hukum , Srivastava Arvind Kumar , Singh Daljit 
Published: April 2024

ABSTRACT

Objective:
Hydrocephalus requiring shunt placement (12%–20%) is a common complication after aneurysmal subarachnoid hemorrhage (aSAH). Various studies suggest that fenestration of lamina terminalis (LT) during microsurgery for aSAH may be associated with a reduced rate of shunt-dependent hydrocephalus. We report a prospective analysis correlating fenestration of the LT with decreased shunt-dependent hydrocephalus after aSAH managed by microsurgical repair.

Methodology:
A total of 106 patients over a period of 1.5 years with aSAH treated by microsurgical aneurysm repair along with fenestration of LT were analyzed. Patients were treated by same surgical team and those patients where surgical clipping of anterior circulation aneurysms with LT fenestration was performed were included in the study. We compared the rate of shunting in patients operated on by routinely fenestration of the LT with that in cases where LT fenestration was not carried out (taking literature as control). This study design isolates the effect of fenestration of the LT on the incidence of shunt-dependent hydrocephalus.

Results:
There has been significantly lower rate of shunting (2.3%) in the patients where LT fenestration was done, versus 12%–20% in the cases where it was not preformed (P < 0.05). Furthermore, post-aSAH, hydrocephalus is associated with a higher grade of Fischer’s scale (Grade III and IV).

Conclusion:
Fenestration of the LT appears to be associated with a decreased incidence of shunt-dependent hydrocephalus of more than 80% after aSAH. This straightforward microsurgical maneuver should be performed whenever possible during aneurysm surgery.