bluuebunny/crossref_metadata_2025_split huggingface dataset:
Voluminous cervical polyp delivered: a case report
Authors: Marrakchi Salma , Bouanane Rania , Ez-zaky Sara , Taibi Ouiam , Aouadi Salma , Sassi Samia , Lakhdar Khaoula , El Hassouni Fatima , Allali Nazik , Chat Latifa , El Haddad Sihame 
Published: May 2024

Abstract
Cervical polyps are common gynecological findings, typically small and benign. However, larger polyps can mimic malignant neoplasms and pose diagnostic challenges. We present a case of a 40-year-old woman with a large cervical polyp, highlighting the critical role of radiological imaging in diagnosis and management. The lesion was successfully resected, with histological examination confirming a benign nature. This case underscores the necessity for careful evaluation of large cervical polyps to ensure accurate diagnosis and treatment.
Simultaneous surgery for coexisting heart disease and non-cardiac malignancy: assessment of feasibility in case series
Authors: Abdikarimov Anuar , Bekenova Aigerim , Nurmakhan Nazerke , Shayakhmetov Yerzhan , Tuganbekov Turlybek 
Published: May 2024

Abstract
We present case series of simultaneous surgery for coexisting cardiac and non-cardiac pathologies to evaluate the feasibility of the treatment. The retrospective analysis included 27 patients aged between 28 and 74 years. The most often heart diseases were coronary arterial disease and valve defects, and the most often heart surgery was coronary artery bypass grafting. The non-cardiac diseases included neoplasms in the abdominal cavity, urinary system, and chest organs. The average duration of surgery was 277 ± 87 minutes, blood loss 285 ± 182 ml. The in-hospital mortality was 0%, with median stay of 2 and 12 days in the intensive care unit (ICU) and emergency room, respectively. The 1 and 5-year survival rates were 85.7% and 76.2%, respectively. Simultaneous surgeries can be a treatment of choice for patients with cardiac pathology and concomitant neoplasm in abdominal, thoracic, or urinary system. This is the first such study conducted in the Central-Asian region and, in particular, in Kazakhstan.
The significance of a ‘T shaped’ incision for resection of giant mediastinal tumors: a case report
Authors: Pannu Manjinder Kaur , Ehrsam Jonas Peter , Schöb Othmar Markus , Inci Ilhan 
Published: May 2024

Abstract
A 37-year-old male, with a 5-year history of liposarcoma of the right thigh, was incidentally diagnosed with two huge thoracic metastases following a fall. One of these masses, measuring 22 cm, was located in the right chest apex, adjacent to a second 20 cm mass situated in the anterior mediastinum, partially invading the left chest. The patient underwent surgical intervention for mass resection that commenced with a hemi-clamshell incision, but was then extended by completing the lower median sternotomy in order to create a T shaped incision. This type of incision provides ample access for large mediastinal tumors that extensively extend into one side of the thoracic cavity, encompass the anterior mediastinum, and partially reach into the opposite cavity. It enhances visualization, facilitates access to vital organs, allows for precise surgical maneuvers, minimizes the risk of inadvertent tissue damage, and enables thorough oncological resection.
Localized conjunctival amyloidosis clinically presenting as pyogenic granuloma
Authors: Amir Amaar , Amir Baraa , Rabah Rola , Sheikh Salwa 
Published: May 2024

Abstract
Primary amyloidosis of the conjunctiva and eyelid is a rare and often misdiagnosed condition. It is characterized by the deposition of insoluble amyloid fibrils, which are misfolded proteins, in the body. Amyloidosis can be systemic or localized with different types of amyloid fibril proteins identified using mass spectrometry. Ocular involvement in amyloidosis can lead to corneal dystrophies, glaucoma, vitreous opacities, and other symptoms. Diagnosis involves clinical examination and histopathological assessment. Treatment options depend on the extent of involvement and may include surgical excision, glaucoma management, vitrectomy, or liver transplantation in rare cases. We present a rare case of localized conjunctival amyloidosis initially misdiagnosed as pyogenic granuloma, with clinical symptoms of ptosis, periorbital swelling, and conjunctival lesions. The patient underwent excision of the lesions, and subsequent evaluation did not reveal systemic amyloidosis. Ocular amyloidosis requires careful diagnosis and consideration of systemic involvement for appropriate management.
Nonunion after medial malleolar osteotomy in total ankle arthroplasties for severe varus deformity: a report of 3 cases
Authors: Okamura Gensuke , Hirao Makoto , Noguchi Takaaki , Etani Yuki , Ebina Kosuke , Miura Taihei , Tsuboi Hideki , Goshima Atsushi , Okada Seiji , Hashimoto Jun 
Published: May 2024

Abstract
Of the three ankles after total ankle arthroplasty (TAA) with medial malleolar osteotomy for severe varus deformity (talar varus tilt &gt;10°), two failed in varus migration of the tibial component. In these two cases, tibial osteotomy was performed with varus alignment of 5°and 2°, and with medially shifted placement of tibial component, while one ankle showed no migratoin of prostheses after 5 years, even with nonunion. In this case, tibial osteotomy was performed with a valgus alignment of 4°. Internal fixation after medial malleolar osteotomy should be done for severe varus cases. Medially shifted placement of tibial component should be avoided. Fortunately, the failure did not occur in a case of valgus of the distal tibia. Valgus tibial osteotomy might help to reduce the collision of the talus against the medial malleolus.
Granulocyte colony-stimulating factor-producing lung cancer complicated with antiphospholipid antibody syndrome: a case report
Authors: Yoshino Ryusei , Nakatsubo Masaki , Ujiie Nanami , Yuzawa Sayaka , Ishida Kensuke , Kitada Masahiro 
Published: May 2024

Abstract
No reports on granulocyte colony-stimulating factor-producing lung cancer associated with antiphospholipid antibody syndrome. A 73-year-old man was referred to our department to undergo surgery for lung cancer in the right upper lobe. His examination results suggested that his condition was caused by an elevated white blood cell count and an increased inflammatory response due to granulocyte colony-stimulating factor production. The presence of antiphospholipid antibody syndrome was suspected, and the decrease in coagulation factors was considered to be inhibited by the lupus anticoagulant. Perioperatively, the patient was treated with heparin and steroids, and a thoracoscopically assisted right upper lobectomy was performed. Postoperatively, histopathological examination revealed pleomorphic carcinoma, and the patient tested negative for anticardiolipin IgG antibodies. In lung cancer patients with elevated white blood cell counts, fever, and an inflammatory response, granulocyte colony-stimulating factor-producing lung cancer is an important differential diagnosis. Additionally, when coagulation abnormalities are observed preoperatively, a thorough examination is necessary to prepare for perioperative management.
Phlegmasia cerulea dolens after endovenous cyanoacrylate closure of incompetent small saphenous vein
Authors: Kawatani Yohei , Saitoh Hirofumi , Hori Takaki 
Published: May 2024

Abstract
A previously healthy 70-year-old woman underwent cyanoacrylate closure of an incompetent left small saphenous vein. Six days later, grade 2 treatment-induced thrombosis occurred at the sapheno-popliteal junction. Three days later, the patient presented with pale, cold pain in the left lower extremity. Diffuse thrombosis of the left lower extremity involved the small and great saphenous and deep veins. The patient was admitted and immediately administered heparin with anticoagulant factors, with symptoms began resolving 1 d later. The superficial vein thrombi were resolved. Although a deep venous thrombus remained, symptoms disappeared, and the patient was discharged.
Fixation of a chondral lateral femoral condyle fracture in a 13-year-old boy following patella dislocation using a new suture technique
Authors: Delniotis Ioannis , Leidinger Benedikt 
Published: May 2024

Abstract
Osteochondral or, even more rarely, purely chondral fractures of the lateral femoral condyle following patella dislocation in adolescents are relatively infrequent. Various fixation methods are described in the literature, ranging from traditional screws to bioabsorbable constructs or the use of anchors. Each method possesses its own advantages and limitations. Here, we present a case involving a 13-year-old boy with a large purely chondral fracture of the lateral femoral condyle after patella dislocation, initially overlooked. We introduce a cost-effective suture-bridge technique for the fixation of this fracture, which eliminates the need for a second operation and has yielded favorable outcomes. It is important to know that fractures of this type can be easily overlooked, necessitating a high index of suspicion and the utilization of advanced imaging techniques to prevent potential long-term catastrophic outcomes for the knee joint.
Chest
Authors: Suero Felipe F. , Mundi Gurpreet 
Published: May 2024

Abstract
This chapter discusses the anatomy of the lung, cardiac landmarks, and vascular anatomy of the chest. Murmurs indicate abnormal blood flow through the heart valves and can be detected by auscultation at specific precordial locations. Understanding the vascular anatomy of the chest is important for the anesthetic management of specific thoracic procedures.
Dermatome Anatomy
Authors: Shirey Derek , Matusic Bryan 
Published: May 2024

Abstract
Dermatomes, areas of skin in which a single spinal nerve root provides distinct sensory information, are critical anatomical regions which serve as a foundational aspect for anesthetic procedures. Detailed mapping of dermatomal anatomy allows for focused therapy involved in neuraxial anesthesia, interventional pain procedures, and regional nerve blocks. Additionally, a full understanding of dermatomal anatomy provides with the anesthesiologist a road map of the specific spinal nerve levels associated with anatomical landmarks throughout the body when delivering regional anesthesia to reduce pain in the operative and outpatient setting. Spinal nerve levels also define specific motor functions which are termed myotomes. Observation of specific muscle actions allows for identification of the spinal nerve level responsible for the production of the movement.
Brain and Skull
Authors: Liu Nathan , Malik Tariq M. 
Published: May 2024

Abstract
The chapter includes a brief overview of bones, vasculature, and general neuroanatomy. Anesthetic considerations of variability in skull or brain are included where appropriate. The term skull includes the cranium and mandible. The top of the cranium is called the cranial cavity, and the floor is the base of the skull. The facial skeleton includes the front of the skull with the mandible. The skull is composed of many flat bones connected by fibrous joints, which have many foramens for the entry and exit of vessels or nerves and many ridges which are from attachments from different muscles or ligamentous structures. The skull contains the brain along with an extensive network of vessels around it. The medulla becomes spinal cord once it leaves the foramen magnum. The cerebrospinal fluid (CSF) fills the space around the brain, and is mainly produced by the ventricles. The driving force for the circulation of the CSF is the pulsation of arteries within and around the brain. The CSF movement is more oscillatory in nature, rather than free-flowing.
Flow Velocity
Authors: Lennertz Richard 
Published: May 2024

Abstract
This chapter reviews basic concepts in fluid dynamics that are useful to the practice of anesthesiology. Laminar flow occurs when fluids flow in an orderly fashion without mixing. Turbulent flow involves mixing within the fluid and creates additional resistance to flow. The Reynolds number equation describes factors that promote turbulent versus laminar flow. Pouiselle’s Law describes factors that contribute to resistance regardless of the type of flow. Path diameter is the most important determinant of resistance. Increasing path diameter reduces resistance and increases flow. Increasing path length or fluid viscosity increases resistance and reduces flow. These concepts are particularly relevant in managing fluid resuscitation and partial airway obstruction.
Flowmeters
Authors: Mahboobi Sohail K. , Germani Mark L. 
Published: May 2024

Abstract
A traditional flowmeter is a glass tube, also called a Thorpe tube, with variable orifice and a flow measurement scale (graduations) marked on it. Inside there is a floating device, a ball or bobbin, to indicate the flow of gases. The function of the flowmeter is based primarily on physical principles. The annular space around the bobbin is tubular at low flow rates with laminar flow, and viscosity determining the gas flow, as described by Poiseuille’s law. At high flow rates, the annular space simulates an orifice, creating turbulent gas flow. This turbulent flow depends primarily on the density of the gas, as described by Graham’s law. Flow across the annular space results in a constant pressure drop which equilibrates with gravitational force, allowing quantification of the flow, since increasing flows cause the pressure drop to occur over increasing cross-sectional areas. Safety systems include color and touch coding and a hypoxic guard system, which prevents administration of hypoxic mixtures either electronically, mechanically, or pneumatically. Limitations include faulty connections and pipeline crossovers.
Uptake and Elimination Curves
Authors: Levin Lora B. 
Published: May 2024

Abstract
Volatile anesthetic uptake and elimination curves graphically demonstrate the speed of induction and emergence from anesthesia. Changes in the alveolar concentration of volatile anesthetics as compared to the inspired concentration (FA/FI) plotted against time demonstrate relative anesthestic uptake. Changes in alveolar concentration of anesthetics as compated to the inspired concentration when gases are discontinued (FA/FA0) plotted against time demonstrate the elimination of anesthetic gases. Changes in the uptake and elimination curves demonstrate how different volatile anesthetic factors, as well as physical and physiologic factors, can speed up or slow down induction and emergence.
Nitrous Oxides and Closed Spaces
Authors: Ahmed Muhammad Fayyaz , Chuba Emuejevoke 
Published: May 2024

Abstract
Nitrous oxide is a colorless, sweet-smelling, tasteless gas used as an adjunct to other volatile or intravenous anesthetic for balanced general anesthesia. It has a very high MAC of 104% and hence it cannot be used as a sole anesthetic. It is commonly used as a supplement for analgesia. Nitrous oxide is 30 times more soluble than nitrogen in blood, and it can diffuse to closed spaces and can lead to detrimental effects. It is vital to understand the properties of nitrous oxide and the potential effect on certain surgeries to ensure safe application.
Neuromuscular Function
Authors: Shah Nimit K. , Gwam Chike 
Published: May 2024

Abstract
Postoperative residual neuromuscular blockade remains a frequent occurrence after administration of neuromuscular blocking agent (NMBA), even after a single dose of intermediate-acting NMBA. There is increasing evidence that these can lead to postoperative pulmonary complications and increased postoperative morbidity and mortality. Several anesthesia societies now recommend quantitative neuromuscular function monitoring during anesthesia when NMBA is used to decrease the incidence of postop residual neuromuscular blockade. Neuromuscular function is monitored in 3 ways: (1) clinical evaluation for performing tests such as 5 s head lift, ability to cough, good grip strength, etc. (2) qualitative monitoring in which the strength of a muscle contraction following a nerve stimulus given by a peripheral nerve stimulator is subjectively evaluated visually or tactilely, and (3) quantitative neuromuscular monitoring in which neuromuscular function is objectively assessed by monitors which give a numerical value of the evoked response following a nerve stimulation. Several studies have shown that the clinical evaluation and qualitative monitoring are both unreliable in excluding residual neuromuscular block (NMB) completely. A TOFR &gt;0.9 should be obtained by quantitative monitoring before tracheal extubation, as this is the only way of assuring adequate recovery of neuromuscular function. A peripheral nerve stimulator uses single twitch, TOF, tetanic stimulation, PTC, and DBS patterns of stimulation. A quantitative monitor employs electromyography, acceleromyography, and other techniques and most commonly gives TOFR as a measure of residual blockade.
Statistics and Simple Math in Anesthesia Practice
Authors: Scott Stayner R. , Ferguson Kris 
Published: May 2024

Abstract
Statistical methods are used to help validate the conclusions drawn by authors who report on studies published in medical and scientific journals. An understanding of basic statistical methods is necessary to independently assess the quality of research data and conclusions presented at conferences, in journal articles, and in independent research. Basic understanding of the types of data that can be analyzed, the types of statistical tests that can be used for data analysis, how to determine the quality of the data, and conclusions that can be made based on the data collected are necessary to effectively incorporate new medical and scientific findings into medical practice.
Termination of Drug Action
Authors: Parker Nicholas M. 
Published: May 2024

Abstract
Termination of a drug’s action usually depends on the drug being pulled from the site of action down a concentration gradient into the blood. Drug clearance from the blood may then occur via biotransformation (enzymatic chemical change to the drug molecule), active efflux, passive elimination, or any combination of the three. Lipophilic drugs can accumulate significantly in peripheral tissues, creating a reservoir that can shorten or lengthen the duration of action depending on the context. A multitude of factors in the operating room may affect the duration of drug action, including hypotension, drug interactions, fluid shifts, and the length of surgery.
Impact of Hepatic Disease
Authors: Zubair Muhammad Haseeb , Ranieri Aladino De 
Published: May 2024

Abstract
The liver is the predominant site of metabolism for nearly all drugs absorbed from the gastrointestinal tract, and the role of hepatic system is not limited to glucose metabolism, protein synthesis, and functioning as a blood reservoir, but also functions to metabolically transform various drugs into either active and inactive forms. The hepatic system is connected to the heart via the hepatic arteries, which draws two-third of the blood from the spleen, pancreas, and stomach. Phase I and phase II reactions govern most drug metabolism. The substrates of the cytochrome enzyme system, along with their inducers and inhibitors, can aid in anesthetic management of patients with liver disease. Thus an understanding of hepatic physiology and pathology is critical to the anesthetic management of the patient.
Drug-Drug Binding
Authors: Ozinga John , Knezevic Nebojsa Nick 
Published: May 2024

Abstract
This chapter discusses the main concept of drug-drug binding, defining the key elements of drug-drug interaction such as affinity, potency, different types of dose-response curves, etc. Knowledge of whether the drug is a full or partial agonist, and whether antagonism is competitive or noncompetitive is requisite prior to drug administration. Furthermore, the pharmacodynamic profile of a drug is an important variable when evaluating concentration-dependent effects of that drug. Being aware of pharmacodynamic drug-drug interactions, based on drug-drug binding and different types of synergism and antagonism, is an essential part of anesthesia practice.
Dexmedetomidine
Authors: Ferguson Kris , Stayner R. Scott 
Published: May 2024

Abstract
Dexmedetomidine is unique as it produces “cooperative sedation.” It has axiolytic, sedative and analgesic properties. Dexmedetomidine acts as an alpha2-adrenergic receptor agonist in a similar way to clonidine. It decreases the dose requirement of inhaled and intravenous anesthetics as well as opioids and benzodiazepines. Dexmedetomidine maintains the airway and spontaneous ventilation, thereby enhancing the safety of awake fiberoptic intubation. There is blunting of the sympathetic response to noxious stimuli, making for stable hemodynamics throughout a surgical case. Emergence delirium is minimized compared with other sedatives, and dexmedetomidine has a sparing effect on postoperative opioids. Dexmedetomidine can facilitate a balances anesthetic technique when combined with other sedatives such as benzodiazepines, opioids and propofol. It is not recommended for long term sedation.
Nitroglycerin and Sodium Nitroprusside
Authors: Sprowell Andrew , Sharma Archit 
Published: May 2024

Abstract
Nitrates are widely used as vasodilators for the treatment of ischemic heart disease and heart failure. Nitrates dilate veins, arteries, and coronary arteries by relaxing vascular smooth muscle. Even though they find extensive use in treatment of acute angina symptoms, they are prone to side effects ranging from flushing and headache to hypotension, and hence deserve care during administration as well as knowledge of potential interactions with other drug classes. This chapter discusses the different types of nitrates and their potential utility, as well as the various categories of patients in which these drugs should be restricted or used with caution.
Muscle Relaxants
Authors: Papapetrou Peter , Ferguson Kris 
Published: May 2024

Abstract
Muscle relaxants have been a key component among the armamentarium of anesthetic drugs as they allow for optimal intubating conditions as well as muscle paralysis during surgery. They are classified as either depolarizing or nondepolarizing muscle relaxants. Succinylcholine is currently the only depolarizing muscle relaxant and has a rapid onset, though it carries risk of malignant hyperthermia, hyperkalemia, as well as prolonged paralysis in genetic variants of plasma cholinesterase. Nondepolarizing muscle relaxants have been developed to avoid the side effects of succinylcholine and carry an alternative mechanism of action. They are metabolized via various pathways depending on the drug, and each drug has unique considerations in terms of onset, duration of action, and side effects.
Interaction with Chronic Drug Therapy
Authors: Pinkert Vincent , Rose Sydney E. 
Published: May 2024

Abstract
Medication management is an essential component of patient optimization prior to surgery. Many patients are on complicated regimens of prescription and nonprescription medications. While continuing most medication regimens is tolerated, certain medications put patients at elevated risk for perioperative complications, and should be stopped. Likewise, stopping certain medications places patients at increased risk of acute decompensation, disease progression, and/or withdrawal, and should be continued. Lack of large randomized controlled trials accounts for the variations in recommendations. Nonetheless, there are medications known to interact with anesthetic agents, cause morbidity if abruptly stopped, or have potential perioperative issues. An awareness of these, in addition to a broad understanding of the basic principles of relevant chronic drug-anesthetic interactions, is essential to avoiding dangerous combinations, and keeping patients safe.