bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lymphoblastic lymphoma presenting as soft-tissue swelling – A single-center experience
Authors: Nair Pallavi , Thambi Sugeeth M. , Narayanan Geetha , Vasudevan Jayasudha A. , Pallath Ashwin Mohandas , Nair Sreejith G. 
Published: June 2024

Abstract:BACKGROUND:Lymphoblastic lymphomas (LBL) are a rare, aggressive type of non-Hodgkin lymphomas and constitute 2% of all lymphomas. It is classified as T-lymphoblastic lymphoma (T-LBL) and B lymphoblastic lymphoma (B-LBL) and resembles acute lymphoblastic leukemia (ALL), with no or limited bone-marrow involvement. LBL rarely present as soft-tissue swellings. Soft-tissue involvement is more common in B-LBL than in T-LBL. They occur predominantly in adolescents and young adults and have a prognosis similar to ALL.OBJECTIVE:p>The aim was to study the clinical characteristics, treatment response, and survival of patients with lymphoblastic lymphoma presenting with soft-tissue swelling.SETTINGS AND DESIGN:This was a retrospective study of eight adolescent and adult patients with lymphoblastic lymphoma presenting with soft-tissue swelling conducted in the Department of Medical Oncology at a tertiary cancer center in India.STATISTICAL ANALYSIS:The baseline patient characteristics, treatment details, and response assessment were analyzed using descriptive statistics. Overall survival (OS) and progression-free survival were obtained by the Kaplan–Meier method, using the SPSS version. 11.MATERIALS AND METHODS:We present the clinical features, imaging, diagnosis, treatment, and outcome of eight cases of lymphoblastic lymphoma presenting with soft-tissue swellings. Patients above 14 years of age treated over 12 years were included in the study.RESULTS:There were five males and three females. The median age at diagnosis was 24 years. Common presenting complaints were swelling, pain, and paraparesis. The sites of involvement were the epidural mass, thigh, calf, breast, and anterior chest wall. The diagnosis was confirmed by immunohistochemistry. Seven patients were diagnosed with B-LBL and one with T-LBL. They were treated with intensive chemotherapy (six patients with Berlin–Frankfurt–Munster protocol and two with hyperfractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone). Three patients received consolidation radiotherapy and one received palliative radiotherapy. Seven patients attained remission after induction chemotherapy and four of them are currently alive at a median follow-up of 48 months. The 2-year OS was 71.4%.CONCLUSION:Even though rare, lymphoblastic lymphoma should be considered a differential diagnosis in patients presenting with soft-tissue swelling and should be managed with systemic chemotherapy similar to ALL.
Evaluation of busulfan, cyclophosphamide, and etoposide as a preparation regimen for autologous stem cell transplantation in Hodgkin’s lymphoma patients
Authors: Biçim Soykan , Erkurt Mehmet Ali , Kuku İrfan , Kaya Emin , Berber İlhami , Kaya Ahmet , Hidayet Emine , Uysal Ayşe , Sarıcı Ahmet , Özen İlknur Nizam 
Published: June 2024

Abstract:

BACKGROUND:
Hodgkin’s lymphoma (HL) exhibits a cure rate of 90% in patients diagnosed at an early stage and a cure rate ranging from 70% to 90% in patients diagnosed at an advanced stage. In the case of patients with relapsed/refractory HL (r/rHL), it is recommended to provide salvage chemotherapy initially, followed by autologous stem cell transplantation (ASCT). The ideal conditioning regimen for the transplantation process is still being investigated.

OBJECTIVES:
For individuals with r/rHL, high-dose chemotherapy combined with ASCT (HD-ASCT) is thought to be the most effective method of treatment. The purpose of this research was to evaluate the effectiveness and safety of the busulfan, cyclophosphamide, and etoposide (BuCyE) preparation regimen in r/rHL patients.

MATERIALS AND METHODS:
Retrospective analysis was conducted on the data of 67 lymphoma patients older than 18 years who had HD-ASCT with the BuCyE conditioning regimen between September 2014 and November 2021 (86 months). The research consisted of 34 r/r HL patients among them. A parenteral regimen of 0.8 mg/kg of busulfan every 6 h from day −7 to day −5, 50 mg/kg of cyclophosphamide on days −3 and −2, and 400 mg/m2 of etoposide on days −5 and −4 comprised the patient preparation regimen before ASCT. All data were collected from inpatient files and the Inonu University Turgut Ozal Medical Center Hospital Information System.

RESULTS:
The median age of the patients was 43 years, and 67.6% were males. The most common type of HL was nodular sclerosis, which was followed by mixed cellularity. The median time for platelet and neutrophil engraftment was 14 and 11 days, respectively. 5.0 × 106/kg was the median transplanted dose of CD34+ cells (2.1–13.55). Liver toxicity was observed in 6 (17.6%) patients. Eight patients suffered from pulmonary side effects. The median number of previous chemotherapies was 2 (2–4). In all lymphoma patients, the complete response rate was 61.8% (n = 21), whereas the disease progression rate was 32.3% (n = 11). Transplantation-related mortality on the 100th day was 8.8% (n = 3). Three-year overall survival was 57.17%.

CONCLUSION:
When the literature was reviewed, the studies with the BuCyE preparation regimen in patients with r/rHL were limited. This conditioning regimen was found to have fewer side effects and a lower cost. It can be preferable when compared to carmustine (BCNU), etoposide, cytarabine (ARA-C), and melphalan (known as BEAM) in r/rHL.
Safety and efficacy of bronchoscopy with transbronchial lung biopsy in interstitial lung diseases: our experience
Authors: N Neenu , MK Kanmani , Utpat Ketaki , Desai Unnati 
Published: June 2024

BackgroundInterstitial lung diseases (ILDs) are a heterogeneous group of disorders with wide spectrum whose accurate diagnosis and proper treatment pose a great challenge. Our study is focused on safety and efficacy of bronchoscopy with transbronchial lung biopsy (TBLB) in patients with ILD.MethodologyA prospective observational study of 68 patients was conducted in our tertiary care center. Diagnostic role, yield, and safety of TBLB in ILD were studied by comparing with high-resolution computed tomography (HRCT) patterns and histopathology.ResultsA total of 136 cases of ILD were referred to us in the said period. Of these, 75 patients underwent bronchoscopy and 68 underwent bronchoscopy with TBLB. Among them, the most common HRCT pattern was chronic hypersensitivity pneumonitis (HP) 47.06%. ILDs were subdivided as, with known cause (13.24%), 64.71% granulomatous ILDs (17.65% sarcoidosis and 47.06% chronic HP) and 22.06% idiopathic interstitial pneumonitis IIP). Pathological diagnosis of ILD was obtained in 54.41%. Based on etiological classification, pathological diagnosis was obtained in 46.67% IIP, 11.11% ILD with known cause, and 65.9% granulomatous ILD. A total of 16.2% patients had complications with no mortality. Complications associated with TBLB in IIP with non-IIP cases as well as usual interstitial pneumonia (UIP) with non-UIP cases were statistically significant.ConclusionBronchoscopy was safe and well tolerated. Most important limiting factor was awareness about bronchoscopy and unwillingness for the procedure on understanding the risks of the same in ILD. TBLB is a useful diagnostic procedure for our ILDs as a part of multidisciplinary approach with total yield of 54.41% and more yield in chronic HP and sarcoidosis. We experienced a low rate of complications.
Knowledge, attitude, and practices regarding COVID-19 among the postgraduate medical students of a government medical college in Gujarat (India)
Authors: Parekh Aneri , Dave Jigna , Singhal Sanjay , Deokar Kunal 
Published: June 2024

Objective:
To assess postgraduate students’ knowledge, attitude, and practices regarding COVID-19.

Methods:
A self-designed online questionnaire was circulated to the postgraduate students. Mean knowledge, attitude, and practice scores were calculated and compared among different study groups with the ANOVA test.

Results:
Out of 254 postgraduate students approached, 220 responses were received, so the final sample size was 220. Out of 220 students enrolled, 159 (72.27%) students had good knowledge and 61 (27.73%) students had poor knowledge; 167 (75.90%) students had a positive attitude, 51 (23.18%) students had a neutral attitude, and only two (0.92%) students had a negative attitude; 196 (89.09%) students observed good practices whereas 24 (10.91%) students observed poor practices.

Conclusion:
Most students had good knowledge, a positive attitude, and good practices.
Impact of Coronary Microvascular Dysfunction on Myocardial Strain in Patients with Heart Failure and Preserved Ejection Fraction
Authors: Yahia Mohamed , Emara Ahmed , Abdou Waleed , Ewis Mohamed Fouad 
Published: June 2024

Abstract

Background:
This research aimed to evaluate the role of coronary microvascular dysfunction in alteration of left ventricular (LV) myocardial deformation.

Materials and Methods:
This observational study involved 50 patients with LV ejection fraction (LVEF) >50% and coronary microvascular dysfunction (diagnosed by coronary angiography). TIMI frame count (TFC) was calculated for each patient. They were classified into 2 groups: 30 patients with heart failure and preserved ejection fraction (HFpEF) (cases group) and 20 patients without HF (control group). Speckle tracking echocardiography was used to evaluate LV deformation.

Results:
The mean age of the studied patients was 58.8 ± 8 years. The frequency of diabetes mellitus, hypertension, and dyslipidemia were significantly higher in cases than controls. Cases had significant higher BMI (30 ± 4.48 vs. 27.3 ± 3.94 kg/m2, P=0.029). The total TFC in cases was 97.1 ± 22.9 and in controls was 79 ± 18.5, and this difference was statistically significant (P=0.005). Significantly decreased LV global strain was observed in HFpEF cases than in controls (−17.6 ± 2.14 % versus −19.5 ± 1.98%, P < 0.001). In cases with a higher TFC, the LV global strain decrease was more pronounced. There was a significant correlation between the LV global strain and total TFC (r=-0.470 and P=0.009).

Conclusion:
Patients with HFpEF exhibited higher total TFC reflecting more affected coronary microvasculature. Those patients had reduced LV global strain. Coronary microvascular dysfunction probably leads to alteration of myocardial performance.
Chest Shape Influences Ventricular-Arterial Coupling Parameters in Infants with Pectus Excavatum
Authors: Sonaglioni Andrea , Nicolosi Gian Luigi , Braga Marta , Villa Maria Cristina , Migliori Claudio , Lombardo Michele 
Published: June 2024

Background:
The present study was designed to investigate the possible influence of chest shape, noninvasively assessed by modified Haller index (MHI), on ventricular-arterial coupling (VAC) parameters in a population of term infants with pectus excavatum (PE).

Methods:
Sixteen consecutive PE infants (MHI >2.5) and 44 infants with normal chest shape (MHI ≤2.5) were prospectively analyzed. All infants underwent evaluation by a neonatologist, transthoracic echocardiography, and MHI assessment (ratio of chest transverse diameter over the distance between sternum and spine) within 3 days of life. Arterial elastance index (EaI) was determined as end-systolic pressure (ESP)/stroke volume index, whereas end-systolic elastance index (EesI) was measured as ESP/left ventricular end-systolic volume index. Finally, VAC was derived by the Ea/Ees ratio.

Results:
At 2.1 ± 1 days after birth, compared to controls (MHI = 2.01 ± 0.2), PE infants (MHI = 2.76 ± 0.2) were diagnosed with significantly smaller size of all cardiac chambers. Biventricular systolic function, left ventricular filling pressures, and pulmonary hemodynamics were similar in both the groups of infants. Both EaI (4.4 ± 1.0 mmHg/ml/m2 vs. 3.4 ± 0.6 mmHg/ml/m2, P < 0.001) and EesI (15.1 ± 3.0 mmHg/ml/m2 vs. 12.7 ± 2.5 mmHg/ml/m2, P = 0.003) were significantly increased in PE infants than controls. The resultant VAC (0.30 ± 0.10 vs. 0.30 ± 0.08, P > 0.99) was similar in both the groups of infants. Both EaI (r = 0.93) and EesI (r = 0.87) were linearly correlated with MHI in PE infants, but not in controls. On the other hand, no correlation was found between MHI and VAC in both the groups of infants.

Conclusions:
Chest deformity strongly influences both Ea and Ees in PE infants, due to extrinsic cardiac compression, in the absence of any intrinsic cardiovascular dysfunction.
Approach to the Patient with Acute Aortic Syndromes in Light of the New Consensus Statement on Multimodality Imaging in Thoracic Aortic Diseases
Authors: Muratori Manuela , Mancini Maria Elisabetta , Tamborini Gloria , Mushtaq Saima , Annoni Andrea , Fusini Laura , Celeste Fabrizio , Baggiano Andrea , Fazzari Fabio , Mantegazza Valentina , Pontone Gianluca , Pepi Mauro 
Published: June 2024

Abstract
Acute aortic syndromes comprise a range of interrelated conditions including aortic dissection, intramural hematoma, penetrating atherosclerotic ulcer, and contained or not contained aortic aneurysm rupture. These syndromes are potentially life threatening; therefore, a rapid and accurate diagnosis is crucial. A new Clinical Consensus Statement on Aortic and Peripheral Vascular Disease has recently been published, and we will try to highlight the main innovations in the document.
Unveiling the Hidden Chamber: Exploring the Importance of Left Atrial Function and Filling Pressure in Cardiovascular Health
Authors: Pergola Valeria , D’Andrea Antonello , Galzerano Domenico , Mantovani Francesca , Rizzo Massimiliano , Giannuario Giovanna Di , Khoury Georgette , Polizzi Vincenzo , Rabia Granit , Gimelli Alessia , Campana Marco 
Published: June 2024

Abstract
The left atrium (LA) is a vital component of the cardiovascular system, playing a crucial role in cardiac function. It acts as a reservoir, conduit, and contractile chamber, contributing to optimal left ventricle (LV) filling and cardiac output. Abnormalities in LA function have been associated with various cardiovascular conditions, including heart failure, atrial fibrillation, valvular heart disease, and hypertension. Elevated left ventricular filling pressures resulting from impaired LA function can lead to diastolic dysfunction and increase the risk of adverse cardiovascular events. Understanding the relationship between LA function and LV filling pressures is crucial for comprehending the pathophysiology of cardiovascular diseases and guiding clinical management strategies. This article provides an overview of the anatomy and physiology of the LA, discusses the role of LA mechanics in maintaining normal cardiac function, highlights the clinical implications of elevated filling pressures, and explores diagnostic methods for assessing LA function and filling pressures. Furthermore, it discusses the prognostic implications and potential therapeutic approaches for managing patients with abnormal LA function and elevated filling pressure. Continued research and clinical focus on left atrial function are necessary to improve diagnostic accuracy, prognostic assessment, and treatment strategies in cardiovascular diseases. It will explore the importance of assessing LA function as a marker of cardiac performance and evaluate its implications for clinical practice. In accordance with rigorous scientific methodology, our search encompassed PubMed database. We selected articles deemed pertinent to our subject matter. Subsequently, we extracted and synthesized the salient contents, capturing the essence of each selected article.
Sensitivity and Reproducibility of Inferior Vena Cava Diameter and Superior Vena Cava Flow Velocity Measurements to Changes in Cardiac Preload in Subjects with Hypertension
Authors: Mcnally Ryan John , Farukh Bushra , Chowienczyk Phil J. , Faconti Luca 
Published: June 2024

Objectives:
We investigated the sensitivity and reproducibility of inferior vena cava (IVC) diameters and superior vena cava (SVC) flow velocities in detecting changes in cardiac preload in clinically euvolemic subjects with hypertension.

Methods:
Measurements were obtained during passive leg raising (PLR) and lower limb venous occlusion (LVO), interventions which respectively transiently increase and decrease cardiac preload. Measurements were made in 36 subjects and repeated on two separate occasions to examine reproducibility.

Results:
During PLR, there was no significant change in IVC diameters, but peak flow velocity of the SVC S wave increased by 6.5 (95% confidence interval 1.6–11.3) cm/s (P = 0.01). During LVO, IVC diameter in expiration decreased by 3.2 (1.7–4.7) mm and the SVC S wave decreased by 9.7 (4.4–14.7) cm/s (P < 0.001). Venae cavae-derived indices can be used to assess changes in preload within the physiological range in euvolemia.

Conclusions:
Despite suboptimal reproducibility of baseline measurements, high agreeability between the changes in IVC diameter and SVC flow after LVO suggests that these indices can be used to monitor changes in cardiac preload.
Impact of Chest Wall Conformation on the Outcome of Primary Mitral Regurgitation due to Mitral Valve Prolapse
Authors: Sonaglioni Andrea , Nicolosi Gian Luigi , Rigamonti Elisabetta , Lombardo Michele 
Published: June 2024

Background:
The possible influence of chest wall conformation on cardiovascular (CV) outcome of patients with mitral regurgitation (MR) due to mitral valve prolapse (MVP) has never been previously investigated.

Methods:
This retrospective study included all consecutive symptomatic patients with MVP and moderate MR who underwent exercise stress echocardiography at our institution between February 2014 and February 2021. Modified Haller Index (MHI; chest transverse diameter over the distance between sternum and spine) was noninvasively assessed. During the follow-up, we evaluated the occurrence of any of the following: (1) CV hospitalization, (2) mitral valve (MV) surgery, and (3) cardiac death or sudden death.

Results:
Four hundred and twenty-four consecutive patients (66.8 ± 11.5 years, 48.3% men) were retrospectively analyzed. Overall, MVP patients had concave-shaped chest wall (MHI = 2.55 ± 0.34) and were found with small cardiac chamber dimensions. During a mean follow-up time of 3.2 ± 1.7 years, no patients died, 55 patients were hospitalized due to CV events, and 20 patients underwent MV surgery. On multivariate Cox analysis, age (heart rate [HR] 1.05, 95% confidence interval [CI] 1.03–1.06), diabetes mellitus (HR 3.26, 95% CI 2.04–5.20), peak exercise-E/e' ratio (HR 1.07, 95%CI 1.05–1.09), and peak exercise-effective regurgitant orifice area (HR 2.53, 95% CI 1.83–3.51) were directly associated to outcome, whereas MHI (HR 0.15, 95%CI 0.07-0.33) and beta-blocker therapy (HR 0.26, 95% CI 0.19–0.36) showed strong inverse correlation. An MHI ≥2.7 showed 80% sensitivity and 100% specificity for predicting event-free survival (area under the curve = 0.98).

Conclusions:
Symptomatic patients with moderate MR due to MVP and MHI ≥2.7 have an excellent prognosis over a medium-term follow-up. Noninvasive chest wall shape assessment should be encouraged in clinical practice.
Severe Rheumatic Mitral Stenosis, Worse Left Atrial Mechanics is Closely Associated with Echo Criteria for Intervention
Authors: Vriz Olga , Feras Khaliel , Alamri Mohammed , Blassy Benny , Almozel Anwar , Smith Matthew , Kinsara Abdulhalim Jamal , Galzerano Domenico , Alsomali Afrah , Veldtman Gruschen R 
Published: June 2024

Background:
Rheumatic mitral valve (MV) stenosis is associated with progressive left atrial (LA) fibrosis and functional impairment, Pulmonary artery systolic pressure (PASP) and right ventricular (RV) dysfunction. The aims of the study were to determine in those patients with severe MV stenosis if LA mechanical function as assessed by speckle tracking echocardiography could identify those with increased PASP, atrial fibrillation (AFib), and RV dysfunction.

Subjects and Methods:
Patients with severe MV stenosis were identified from the institutional echo database. Echocardiograms were read off line and measurements included atrial and ventricular strain. Patients were divided into tertiles of LA reservoir strain (LASr) values and data compared between the groups.

Results:
Ninety-seven patients, 67 females, mean age 47.4 ± 11.9 years, had MV mean gradient of 8.3 ± 5.1 mmHg, MV area by pressure half time of 1.3 ± 0.3 cm2 and LASr of 11.18% ± 6.4%. Those patients in the lowest LASr tertile had more AFib (72%, P = 0.0001), PASP >50 mm Hg (39%, P = 0.005), and worst RV impairment. In multivariable logistic regression analysis, LASr, age, and mean MV gradient were the independent predictors of AFib and PASP >50 mm Hg. Cutoffs, determined by receiver operating characteristic curve analysis had high specificity for the composite outcome of Afib and PASP >50 mmHg (85% for LASr <7.7%).

Conclusion:
In severe MV stenosis LASr, age and mean MV gradient, are independent predictors of Afib and PASP >50 mmHg. LASr <7.7% has high sensitivity and specificity in identifying those who meet ESC guideline 2017 criteria for valve intervention, suggesting its potentially helpful addendum to the surveillance of patients with MV stenosis.
A practical approach of leech therapy: Insight from the Unani system of medicine
Authors: Ahmer S. M. , Fahad Ataullah , Khan Mohammad Saad Ahmad 
Published: June 2024

Abstract
Leech therapy is an effective mode of treatment from time immemorial. However, our Indian System of Medicine has given a new platform to this practice of treating patients suffering from various diseases such as skin diseases, joint pain, inflammation, wounds, nonhealing ulcers, lumps, hemorrhoids, varicose veins, deep-vein thrombosis, and plastic and reconstructive surgeries. The objective of this study was to construct the standard operating procedures (SOPs) for leech therapy and to raise awareness among AYUSH practitioners and other health-care providers. This review study of SOP for leech therapy was carried out through the Unani classical textbooks and the recent research on leech therapy from sources such as PubMed, Scopus, AYUSH portal, Google Scholar, and ResearchGate. The collected material was studied in detail and analyzed for the development of standard operating procedures (SOPs) for leech therapy. This paper focused on the practical application and handling of leech during the procedure of leech therapy, and to some extent, an attempt to construct SOPs of leech therapy has been made with the help of some Unani experts, ancient Unani literature, and recent studies on leech therapy. Leech therapy is an effective, safe, feasible, beneficial, and economical treatment modality. Hence, the development of standard operative procedures (SOPs) considering leech therapy is the need of the hour. This paper is an initiative to develop an SOP for this practical procedure and hope it will be beneficial for all traditional healers.