bluuebunny/crossref_metadata_2025_split huggingface dataset:
Myasthenia gravis with Castleman disease: A case report with review of literature
Authors: Nandy Sujit , Bhattacharya Debashis , Kundu Somenath , Chatterjee Uttara 
Published: May 2024

ABSTRACT
Myasthenia gravis is an autoimmune disorder caused by the formation of autoantibodies directed against the synapses of neuromuscular junction. It is most commonly associated with other non-thymomatous lesions. Castleman disease is one of them, which is a benign lymphoproliferative disorder of uncertain origin. Only eight cases of myasthenia gravis associated with Castleman disease have been described so far. Here, we take the opportunity to describe a case of myasthenia gravis with Castleman disease simulating thymoma clinically and radiologically along with review of literature of this rare association. Patient developed myasthenic crisis in the immediate post-operative period which is more common in myasthenia gravis with Castleman disease rather than myasthenia gravis with thymoma.
Investigation of Hyaluronan Synthase 2 and CD44 immune reactivity as a biomarker to predict Progesterone-Resistant Endometrial Hyperplasia without atypia: A retrospective case-control study
Authors: Boybay Emine , Atilgan Remzi , Pala Şehmus , Kuloğlu Tuncay , Artaş Gökhan 
Published: May 2024

ABSTRACT

Background/Aims:
In our study, the effect of hyaluronan synthase 2 (HAS2) and CD44 immunoreactivity as a predictive biomarker in the prediction of progesterone-resistant endometrial hyperplasia (EH) cases without atypia was investigated.

Settings and Design:
In this retrospective study, HAS2 and CD44 immunoreactivity in the endometrial tissues of 60 patients diagnosed with EH and treated with progesterone and 20 patients diagnosed with proliferative endometrium (PE) were evaluated.

Materials and Methods:
Eighty patients were divided into four groups. Group 1 (G1) (n = 20) = PE group, G2 (n = 20) = EH group without atypia, G3 (n = 20) = group with continued EH with treatment, G4 (n = 20) = EH with treatment without atypia.

Statistical Analysis:
Intergroup evaluation was done with One-way ANOVA and posthoc tukey test. P < 0.05 values were considered statistically significant.

Results:
The HAS2 immunoreactivity score of G2 and G3 was higher than G1 and G4. On the other hand, there was no difference between G1 and G4. When G2 and G3 were compared, HAS2 immunoreactivity scores were significantly increased in G3. When CD44 immunoreactivity was compared with G1, a significant increase was detected in G2, G3, and G4. However, CD44 immunoreactivity scores were similar in G2, G3, and G4.

Conclusion:
HAS2 immunoreactivity may be an immunohistochemical biomarker in predicting EH cases without atypia resistant to progesterone therapy. Since CD44 immunoreactivity is increased in all EH groups without atypia, it is not effective in predicting treatment resistance.
Bilateral adrenal cortical rests: An interesting innocuous intruder in the fallopian tubes
Authors: Gaffoor Nidha , Shetty Archana , Vidhya V. , Nikhil P. V. , Mysorekar Vijaya 
Published: May 2024

ABSTRACT
Ectopic adrenal rests refer to the presence of adrenal tissue outside its normal anatomical location and are usually discovered incidentally on microscopic examination. Literature suggests its occurrence in diverse extrarenal sites, like the genitourinary system and pelvis. Our case describes the rare occurrence of ectopic adrenal rests in the walls of bilateral fallopian tubes of a 43-year-old female patient who presented with a complaint of heavy menstrual bleeding. A total hysterectomy with bilateral salpingo-oophorectomy was performed. Gross examination revealed adenomyosis with multiple fibroids, and the same was confirmed on microscopy. Additionally, the finding of a well-encapsulated lesion on the walls of both tubes made us relook at the fallopian tubes, which showed a small bright yellow area measuring less than 0.3 cm in the walls, which was consistent with ectopic adrenal rests after ruling out the morphological differentials of Walthard cell nests, aggregates of foamy histiocytes, metastatic renal clear cell carcinoma, displaced ovarian luteinized theca cells, heterotopia of ovarian hilus cells. Immunohistochemistry showed positivity for Melan A and CK7 was negative. The present case helps in investigating the lesser-explored aspect of adrenal rest pathology. It also reiterates need for detailed observation of fallopian tubectomy specimens by pathologists during grossing to avoid overlooking of potentially intriguing entities.
Short-term outcomes of laparoscopic and robotic limited resections of pancreatic neuroendocrine tumours of the uncinate process: Report of six cases and review of the literature
Authors: Lim Teik-Wen , Tan Hwee-Leong , Tan Ek-Khoon , Cheow Peng-Chung , Goh Brian Kim Poh 
Published: May 2024

Abstract

Introduction:
Minimally invasive surgery (MIS) for limited resections for pancreatic uncinate lesions is not widely performed but can adequately treat benign or low-grade malignant lesions. The aim of this study was to evaluate the short-term outcomes of MIS-limited pancreatic resections for patients with suspected pancreatic neuroendocrine tumours (PNETs).

Patients and Methods:
This was a retrospective study of six consecutive patients who underwent MIS for PNET within a single institution between 2017 and 2022.

Results:
Six patients underwent limited pancreas-preserving MIS of the uncinate process (uncinectomy or enucleation), of which two were performed through the robotic approach and four through laparoscopic approach. The median operation time was 212.5 (175–338.75) min, and the median blood loss was 50 (50–112.5) ml. The median post-operative hospital length of stay was 5.5 (3.75-11.5) days. Two patients (33.3%) had major post-operative morbidities (Clavien–Dindo ≥Grade 3). There were no open conversions or post-operative mortalities. Five patients had histologically proven Grade 1 neuroendocrine tumours. One was T2 and four were T1.

Conclusions:
This study suggests that limited MIS resections of pancreatic uncinate PNETs are a feasible procedure with good patient outcomes. It offers a safe alternative to radical surgical resections like pancreatoduodenectomies in selected patients with low-grade malignant or benign tumours.
Congenital Single Digit Deformities: Series of Cases in Multiple Families in Remote Villages of Haryana
Authors: Upadhyay Gunjan , Arya Ashish , Anchal Ved Prakash , Munde Santosh Laxmanrao , Singh Ghanapriya , Kapoor Mitali 
Published: May 2024

Abstract

Background and Purpose:
Congenital deformities occur due to abnormal development of limbs in the intrauterine life. The exact cause of this type of defect is not known but can be associated with environmental factors (drug history or exposure of chemical effluents from factory) or genetic predisposition. Cases involving the occurrence of single digits in all four limbs were witnessed, and the aim was to study and trace the cause of such deformities. Knowledge of thalidomide induced phocomelia which has already being published in the literature also contributed to our knowledge and understanding.

Objectives:
(1) Primary objective was to identify the causative agent or genetic factor for the occurrence of single digits in hands and feet in multiple families. (2) Secondary objective was to create awareness among patients and the general public as well as local government authorities regarding such families of “Divyang” patients. We present a case series of multiple families with complete absence of all fingers and toes except one across villages in Haryana.

Materials and Methods:
Clinical setting: (1) Study was based on a detailed questionnaire which was taken from multiple villagers (Tarawari Village, Nilokheri Village, etc.) and (2) phenotypic examination. Five affected patients from multiple families for 1 year were taken for study from March 2022 to March 2023. Their habitus, lifestyle, and environmental status were all studied and compared with other studies. Efforts were taken to study the license and toxic effluent treatment plan of a chemical factory present in the near vicinity.

Results:
A strong genetic association was suggested for the occurrence of single digits in the hands and feet of multiple patients across multiple villages close to a chemical factory. They have well adjusted with writing, eating, riding bikes, and four-wheelers with single fingers and toes.

Conclusion:
There is a need to establish genetic analysis so that the cause of such deformities could be known and prevented. There is also a need for general and government awareness toward pollutants released from chemical factories and their effects.
The combined pioglitazone and topiramate therapy for management of pediatric patients with severe MASLD
Authors: Conroy Callen , Radulescu Aurelia , Attia Suzanna L. , Shelman Nathan , Lee James T. , Monticelli Roberto Galuppo , Hall Sara , Kohli Rohit , Softic Samir 
Published: May 2024

Abstract

Background:
Metabolic dysfunction associated steatotic liver disease (MASLD) is the most common cause of chronic hepatitis in adult and pediatric patients. Adolescents with severe MASLD can demonstrate a more aggressive disease phenotype as they more commonly develop liver fibrosis than BMI matched adults. Therefore, MASLD is the fastest growing indication for liver transplants in young adults.

Methods:
Pioglitazone has been shown to improve liver histology in adult patients with MASLD, and in some studies, it attenuated liver fibrosis. Despite its perceived efficacy, pioglitazone is not widely used, likely due to its side effect profile, specifically increased weight gain. Topiramate lowers body weight in adolescents and in combination with phentermine, is one of the few FDA-approved medications for the management of obesity in children over 12 years of age. We performed a retrospective review of the outcomes in pediatric patients with severe MASLD, treated with the combined pioglitazone and topiramate therapy.

Results:
Here, we report a case series of seven adolescents with severe MASLD and ≥F2 liver fibrosis treated with the combined pioglitazone and topiramate therapy. The combined therapy improved mean serum ALT from 165 ± 80 U/L to 89 ± 62 U/L after 12 months mean duration of treatment. One patient who completed 24 months of the combined therapy demonstrated a decrease in liver stiffness from 8.9 kPa to 5.6 kPa, as assessed by FibroScan elastography. There was a significant increase in body weight during this time, however, body mass index as a percentage of the 95th percentile adjusted for age and gender did not increase significantly, 151 ± 29% vs. 152 ± 28%. Moreover, waist circumference, mid-upper arm circumference, percent body fat, and muscle mass were not significantly different before and after treatment. Serum lipid levels and hemoglobin A1c also did not change with the treatment.

Conclusion:
In summary, this case series provides encouraging results about the efficacy of the combined pioglitazone and topiramate therapy for the management of adolescents with severe MASLD, which should be further explored in clinical studies.
Global status and trends of metabolomics in diabetes: A literature visualization knowledge graph study
Authors: Li Hong , Li Liu , Huang Qiu-Qing , Yang Si-Yao , Zou Jun-Ju , Xiao Fan , Xiang Qin , Liu Xiu , Yu Rong 
Published: May 2024

BACKGROUND
Diabetes is a metabolic disease characterized by hyperglycemia, which has increased the global medical burden and is also the main cause of death in most countries.
AIM
To understand the knowledge structure of global development status, research focus, and future trend of the relationship between diabetes and metabolomics in the past 20 years.
METHODS
The articles about the relationship between diabetes and metabolomics in the Web of Science Core Collection were retrieved from 2002 to October 23, 2023, and the relevant information was analyzed using CiteSpace6.2.2R (CiteSpace), VOSviewer6.1.18 (VOSviewer), and Bibliometrix software under R language.
RESULTS
A total of 3123 publications were included from 2002 to 2022. In the past two decades, the number of publications and citations in this field has continued to increase. The United States, China, Germany, the United Kingdom, and other relevant funds, institutions, and authors have significantly contributed to this field. Scientific Reports and PLoS One are the journals with the most publications and the most citations. Through keyword co-occurrence and cluster analysis, the closely related keywords are "insulin resistance", "risk", "obesity", "oxidative stress", "metabolomics", "metabolites" and "biomarkers". Keyword clustering included cardiovascular disease, gut microbiota, metabonomics, diabetic nephropathy, molecular docking, gestational diabetes mellitus, oxidative stress, and insulin resistance. Burst detection analysis of keyword depicted that "Gene", "microbiota", "validation", "kidney disease", "antioxidant activity", "untargeted metabolomics", "management", and "accumulation" are knowledge frontiers in recent years.
CONCLUSION
The relationship between metabolomics and diabetes is receiving extensive attention. Diabetic nephropathy, diabetic cardiovascular disease, and kidney disease are key diseases for future research in this field. Gut microbiota, molecular docking, and untargeted metabolomics are key research directions in the future. Antioxidant activity, gene, validation, mass spectrometry, management, and accumulation are at the forefront of knowledge frontiers in this field.
Phytosomes in herbal formulation: an updated review
Authors: Mehta Gagandeep , Rani Ritu , Singh Ajeet Pal , Singh Amar Pal 
Published: May 2024

Phytosomes, a phospholipid-based self-assembled delivery system, can improve oral bioavailability of polyphenolic compounds. These systems, prepared by reacting polyphenolic phytoconstituents with phospholipid, can enhance the passage of lipophilic herbal constituents across the lipid membrane. Phytosomes are used in various herbal drugs like Ginkgo biloba,Camellia sinensis. Recent advancements in phytosomes technology have led to the development of transdermal routes for delivering phytoconstituents. These products are increasingly used in dietary supplements for homeostatic management of inflammation, toxicities, cancers, and weight loss. This technique increases the hydrophilicity of highly lipophilic drugs, making them suitable for drug delivery and allowing hydrophilic phytoconstituents to cross biological membranes. Researchers are exploring the transdermal route as a potential way to deliver phytoconstituents, which are increasingly being used in dietary supplements for homeostatic management of various diseases. We will explore an updated review of Phytosomes in herbal formulation.
Phytosomes:An Overview
Authors: Mehta Gagandeep , Rani Ritu , Singh Ajeet Pal , Singh Amar Pal 
Published: May 2024

Phytosome is a patented technology that incorporates standardized plant extracts into phospholipids to create lipid-soluble molecular complexes with improved bioavailability and absorption. These phyto-constituents are increasingly important due to their nutritional and medicinal properties, but their bioavailability remains poor. Phytosome drug delivery is a method developed to enhance their bioavailability and is compatible in-vivo. Preparation methods are easy and can be characterized using techniques like FTIR, PXRD, DSC, SEM, TEM, and HNMR. Phytosomes can be used to augment the bioavailability of plant constituents and treat incurable diseases with less side effects. Phytosomes are formed by reacting a stoichiometric amount of phospholipid with standardized herbal extract or polyphenolic constituents in an aprotic solvent. Phosphatidylcholine molecules in phytosomes have hepatoprotective activity and nutritional value. In this article, we are going to keep an eye on Phytosomes Overview.
The effects of vitamin D supplementation on disease activity and fatigue in Libyan rheumatoid arthritis patients
Authors: Elfituri Sarah 
Published: May 2024

ObjectivesThis study aimed to investigate the effect of vitamin D supplementation therapy on disease activity and fatigue in rheumatoid arthritis (RA) patients.Material and methodsA prospective randomized clinical trial was conducted at rheumatology clinics in Tripoli Central Hospital, Libya. The eligible patients received disease-modifying antirheumatic drugs (DMARDs) and were divided into two groups: group A received 50,000 IU of vitamin D once a week; while group B received conventional DMARDs without vitamin D supplementation. The groups were monitored for 12 weeks.ResultsThe study included 68 RA patients, with the majority being female (75%). There were no significant differences in parameters such as age, sex, duration of illness, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), calcium, and vitamin D levels, as well as DAS28 (Disease Activity Score with 28-joint count) and Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) levels between these two groups at baseline. After 12 weeks, group A showed a significant improvement in mean vitamin D levels and FACIT-F scores compared to group B. The increase in vitamin D levels in group A (24.21 ±4.81 nmol/l) was higher than that in group B (5.76 ±3.36 nmol/l). Furthermore, the FACIT-F score in group A was in the normal range (mean: 39.36 ±6.15), whereas group B still exhibited “abnormal” FACIT-F < 27.75 ±4.41. Correlation analysis indicated a positive correlation between FACIT-F and vitamin D levels, suggesting that higher vitamin D levels were associated with improved fatigue. Additionally, a weak inverse correlation was observed between DAS28 and vitamin D levels though the difference was not statistically significant (p > 0.05). Finally, the correlation between DAS28 and FACIT-F was positive (R = 0.557, p = 0.000).ConclusionsThe results of the recent study indicated that vitamin D3 (50,000 IU of cholecalciferol) supplementation had a positive impact in RA patients compared to conventional DMARDs drugs, as was clear from the significant FACIT-F.
ĐẶC ĐIỂM LÂM SÀNG VÀ CẬN LÂM SÀNG BỆNH NHÂN VIÊM KHỚP DẠNG THẤP THỂ HOẠT ĐỘNG NHẸ VÀ VỪA
Authors: Nguyễn Thị Thanh Tú , Đỗ Thị Phương , Nguyễn Thị Ngọc Lan 
Published: May 2024

Mục tiêu: Nghiên cứu được thực hiện nhằm khảo sát đặc điểm lâm sàng và cận lâm sàng của bệnh nhân viêm khớp dạng thấp thể hoạt động nhẹ và vừa. Đối tượng: 72 bệnh nhân viêm khớp dạng thấp được điều trị tại bệnh viện Đại học Y Hà Nội. Phương pháp: nghiên cứu tiến cứu, mô tả cắt ngang trên 2 nhóm bệnh nhân: nhóm I gồm 36 bệnh nhân được dùng Methotrexat kết hợp viên nang Hoàng kinh; nhóm II gồm 36 bệnh nhân được dùng Methotrexat kết hợp Mobic, Kết quả: Đa số bệnh nhân viêm khớp dạng thấp trong nghiên cứu có độ tuổi trên 50 (tuổi trung bình nhóm I là 56,50 ± 9,43 (tuổi), nhóm II là 59,00 ± 11,12 (tuổi); nữ giới chiếm đa số (88,89% ở nhóm I và 94,44% ở nhóm II). Thời gian cứng khớp buổi sáng ở nhóm I là 44,31 ± 22,04 (phút), ở nhóm II là 45,83 ± 35,65 (phút). Chỉ số Ritchie ở nhóm I là 11,47 ± 2,21 (điểm), ở nhóm II là 12,81 ± 4,31 (điểm). Mức độ hoạt động bệnh theo DAS 28 ở nhóm I là 4,06 ± 0,6, ở nhóm II là 4,07 ± 0,71. Yếu tố dạng thấp RF định lượng ở nhóm I là 168, 03 ± 212,24 (u/l), ở nhóm II là 166,07 ± 174,86 (u/l).
ĐÁNH GIÁ TÁC DỤNG CỦA ĐIỆN CHÂM HỖ TRỢ ĐIỀU TRỊ NGƯỜI BỆNH BIẾN CHỨNG THẦN KINH NGOẠI VI DO ĐÁI THÁO ĐƯỜNG TYPE II TẠI BỆNH VIỆN NỘI TIẾT TRUNG ƯƠNG
Authors: Bùi Chiến Thắng , Phạm Văn Giáp , Trần Thị Hồng Ngãi 
Published: May 2024

Mục tiêu: Đánh giá tác dụng của điện châm hỗ trợ điều trị người bệnh biến chứng thần kinh ngoại vi chi dưới (thể huyết ứ) do đái tháo đường type 2 và mô tả một số yếu tố liên quan đến biến chứng thần kinh ngoại vi thể huyết ứ do đái tháo đường type 2. Đối tượng và phương pháp nghiên cứu: 60 bệnh nhân đái tháo đường type 2 có biến chứng thần kinh ngoại vi. Kết quả: Độ tuổi trung bình là 67,95 ± 7,43 (tuổi); thời gian mắc bệnh đa số > 5 năm (50%). Triệu chứng lâm sàng thường gặp là tê bì, nóng rát, kim châm (76,7%). Mức độ kiểm soát đường huyết kém (HbA1c từ 8.5% đến 11%) tại thời điểm khám chiếm 43,3%. Bệnh nhân kiểm soát tốt đường huyết thì cho hiệu quả điều trị tốt cao hơn ở những nhóm bệnh nhân không kiểm soát được đường huyết.
HIỆU QUẢ ĐIỀU TRỊ VIÊM LỢI CỦA KEM ĐÁNH RĂNG LACALUT AKTIV
Authors: Dương Đức Long , Vũ Mạnh Tuấn , Vũ Lê Hà , Vũ Việt Hà , Trịnh Minh Báu , Hoàng Thị Hà Phương , Phạm Lê Hương Linh 
Published: May 2024

Mục tiêu: Đánh giá và so sánh hiệu quả điều trị viêm lợi của kem đánh răng Lacalut Aktiv có chứa Aluminum Lactate với kem đánh răng giả dược ở nhóm sinh viên trường Đại học Y Hà Nội. Phương pháp: Nghiên cứu thử nghiệm lâm sàng ngẫu nhiên có đối chứng được thực hiện trên 80 đối tượng nghiên cứu có chẩn đoán viêm lợi do cao răng, mảng bám. Bệnh nhân được ngẫu nhiên phân vào 2 nhóm: nhóm sử dụng kem đánh răng Lacalut Aktiv và nhóm sử dụng kem đánh răng giả dược. Các chỉ số OHI-S và GI của cả hai nhóm được ghi nhận và so sánh tại thời điểm trước khi can thiệp; tái khám sau 2 tuần và sau 4 tuần. Kết quả: Nhóm có sử dụng kem đánh răng Lacalut Aktiv có cải thiện về chỉ số lợi GI và chỉ số OHI-S vượt trội hơn so với kem đánh răng được chọn đưa vào nhóm chứng, tuy nhiên sự khác biệt không có ý nghĩa thống kê. Kết luận: Kem đánh răng Lacalut Aktiv có hiệu quả tốt trong điều trị viêm lợi trên đối tượng là sinh viên trường Đại học Y Hà Nội. Cần nghiên cứu tiếp tục với cỡ mẫu lớn hơn để có kết luận chắc chắn
AS PROPOSTAS TERAPÊUTICAS OFERTADAS NO TRATAMENTO DO TEA NO BRASIL
Authors: Roberto Tiago Moreno Lopes , Landi Jian Carlos , Seixas Lara Cristina Moreira , Cunha Thalita , Oliveira Elimeire Alves de , Maria Filho Gerardo 
Published: May 2024

O Transtorno do Espectro Autista (TEA) é uma condição neurobiológica que afeta o desenvolvimento e a interação social da pessoa. No Brasil, existem inúmeras propostas terapêuticas para o tratamento do TEA, que têm como objetivo melhorar a qualidade de vida dos indivíduos e promover sua inclusão na sociedade. A presente pesquisa bibliográfica teve como objetivo explorar e evidenciar as propostas terapêuticas ofertadas para TEA no contexto brasileiro, as intervenções utilizadas para ampliar as habilidades sociais nos serviços públicos e privados. Trata-se de uma pesquisa bibliográfica exploratória e descritiva, que envolveu a coleta, seleção e análise de fontes bibliográficas por meio de buscas nas plataformas virtuais Lilacs, Google Acadêmico e Scielo, em que foram utilizadas as palavras chaves, “Terapia And Autismo, “Propostas Terapêuticas And Autismo” e “Tratamentos And Tea”. Diante do levantamento realizado, podemos concluir que as pessoas enfrentam dificuldade para o acesso às linhas de cuidados ofertadas nos serviços públicos e privados, que há uma variedade de abordagens e práticas, mas as intervenções que possuem maiores evidências e eficácias científicas nas redes de cuidado pública e privada têm como prioridade o atendimento multiprofissional, ampliando, desta forma, as possibilidades de estimulação para o melhor desenvolvimento do paciente.