bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of Incision Types, Risk Factors, and Complication Rates in Nipple and Skin-Sparing Mastectomy
Authors: Vayvada Haluk , Demirdover Cenk , Geyik Alper , Menderes Adnan 
Published: May 2024

Introduction:
The incidence of breast cancer in the female population of reproductive age is rising. Surgery is the primary approach, and other treatment options can be adopted in certain circumstances. In the surgical field, lately, there has been a growing interest for nipple–skin-sparing mastectomy (NSSM). This study aims to emphasize the effect of incision types and patient characteristics (demographics, concomitant disease, smoking, history of radiotherapy, and chemotherapy) on complication rates.

Patients and Methods:
The subjects included 184 breasts in 92 female patients who underwent the NSSM procedure at our clinic from January 2010 to May 2019. Patients who underwent bilateral NSSM and immediate reconstruction with prosthesis were included in the study.

Results:
The most commonly used incision pattern was the inverted T-scar. Seven patients who had a contralateral prophylactic mastectomy (7.6%) were found to have atypical proliferative lesions or occult breast carcinoma in the clinically healthy contralateral breast on pathological examination. Complications were seen in 36 patients (39.1%). Skin–nipple–areolar complex necrosis was the most frequent complication. A previous history of radiation therapy was associated with higher rates of complications.

Conclusion:
NSSM and immediate single-stage implant reconstruction is a procedure with high morbidity and complication rates. The incision type and smoking have the main effect on complication rates. Although most complications are manageable, the surgical approach and patient-related risk factors should be taken into consideration for avoiding them.
Use of the Superior Breast Border Landmark for Planning Reduction Mammoplasty
Authors: Demir Can Ilker , Yaşar Emrah Kagan , Asadov Mehdi , Alagöz Murat Sahin 
Published: May 2024

Aims:
The aim of this study was to evaluate the reliability of the upper breast border (UBB) in determining the new location of the nipple and to objectively analyze long-term nipple position compared to pre-operative markings.

Patients and Methods:
Thirty-eight patients (76 breasts) patients who underwent superomedial pedicle, reverse-T scar breast reductions and who had long-term (>12 months) follow-up data were included. The sternal notch to the nipple, nipple to inframammarian fold (N-IMF), nipple to chest midline, and areola diameter were measured and recorded at the time of preoperative, markings, and long-term follow-up visit.

Statistical Analysis Used:
The differences in measurements were compared using a paired, two-tailed T-test, and a P < 0.05 was considered statistically significant.

Results:
The average follow-up time was 17.9 months (range 12–41 months). The nipple was located, on average, 0.95 cm lower on postoperative assessment compared to preoperative marking (P = 0.060). The nipple was located, on average, 0.75 cm lateral on postoperative assessment compared to preoperative marking (P < 0.001). The average postoperative increase in the N-IMF distance between marking and the long-term follow-up visit was 1.75 cm (P < 0.001). The areola diameter was increased 0.21 cm on postoperative assessment compared to preoperative marking (P < 0.001).

Conclusions:
The nipple position moved down and the N-IMF distance was greater than planned. However, the nipple was usually located at the area of the greatest projection of the breast due to almost equal elongation of the superior and inferior poles. The outcome of breast reduction procedures in which the postoperative nipple position is planned using the UBB was good.
Forehead Reduction and Hairline Lowering Surgery
Authors: Oreroglu Ali Riza 
Published: May 2024

Background:
Forehead reduction and hairline lowering is an underestimated yet important procedure in facial beautification. Proportions of the forehead to the midface and lower face can be corrected with this surgery as well as addressing changes in hairline positioning.

Objectives:
The aim of this paper was to describe in detail the author's approach to hairline lowering and forehead reduction procedures with emphasis on implications to increase the aesthetic outcome.

Methods:
The procedure was performed under general anesthesia in a single-stage approach with the following algorithm: pretrichial incision, subgaleal dissection and preparation of a parieto-occipital scalp flap, multiple horizontal galeotomies, scalp advancement and fixation, and finally forehead skin excision and closure.

Results:
Forehead reduction and hairline lowering surgery was performed on 17 female patients aged between 19 and 42. Forehead length reduction was measured between 1.7 and 4.2 cm. The patients were followed up for 6 months to 3 years.

Conclusions:
Forehead reduction hairline lowering is an underestimated yet aesthetically important procedure for correcting facial harmony, beautification, and rejuvenative purposes. Following certain planning and technical details can help the surgeon apply the procedure properly, minimizing the risks for major and minor complication and achieving aesthetically successful results.
Evaluation of intermittent tamsulosin in treating symptomatic patients with benign prostatic hyperplasia
Authors: Soliman Mohamed G. , Al-Ghadeer Mohammed R. , Al-Shabaan Hasan R. , Al-Hamrani Amer H. , AlGhadeer Hussain Adil 
Published: May 2024

Purpose:
The purpose of this study is to evaluate and assess the effect of intermittent tamsulosin treatment as a trial to increase the drug safety (in terms of reducing the drug side effects, particularly retrograde ejaculation) while maintaining the effect in reducing the symptoms and assess its impact on the patients’ quality of life.

Materials and Methods:
Patients who enrolled in this study were suffering from lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) and were using 0.4 mg tamsulosin daily to relieve their symptoms but complained of ejaculatory problems. A baseline assessment involves medical history and evaluation of ejaculatory function abdominopelvic ultrasound, postvoid residual volume (PVR) estimation, the International Prostate Symptom Score (IPSS), quality of life assessed using global satisfaction, vital signs, physical examination including digital rectal examination, and renal function. During the study, patients consented to take 0.4 mg tamsulosin intermittently every other day and to proceed with their sexual activities on the days they did not take the drug in. Baseline assessment was repeated and recorded after 3 months from starting the treatment. The adverse effects and compliance were analyzed in all patients.

Results:
Twenty-five patients had a mean baseline IPSS of 6.6 ± 1 and baseline PVR of 87.6 ± 15.1 ml. At the 3rd month, the mean PVR was 100.4 ± 15.1 ml and the mean IPSS was 7.3 ± 1.1. Moreover, 20 out of the total number of 25 patients (80%) reported improvement in their ejaculation. All our 20 patients who showed improvement in their ejaculatory function are either satisfied or very satisfied (4 or 5), in regard to the global satisfaction rate.

Conclusion:
Intermittent tamsulosin therapy (0.4 mg/every other day) is well-tolerated and shows a potential advantage in recovery in patients who suffer from LUTS/BPH and complaining from abnormal ejaculation, especially absent ejaculate. Although there was a significant change in PVR and IPSS after using intermittent tamsulosin therapy. Most patients show a higher overall satisfaction with the treatment compared to the standard dose (0.4 mg/daily). A study on a larger scale is still needed to confirm our results.
Bowel obstruction incidence in urinary diversion patients: A meta-analysis study
Authors: Situmorang Gerhard Reinaldi , Irdam Gampo Alam , Abdullah Aaron 
Published: May 2024

Background:
Bowel obstruction is a common complication that occurs in patient who underwent urinary diversion with an incidence of 0.7%–11%. Although previous studies have published risk factors, prevention and management of postoperative paralytic ileus, and data on urinary postdiversion bowel obstruction in the literature are still scarce and thus require further investigation of the diversion technique which allegedly has differences in pathogenesis, management, and results. To that end, this study conducted a systematic review study to compare two different diversion techniques, namely ileal conduit and continent diversion, especially orthotopic neobladder.

Methods:
This study is a systematic review by searching study in online databases such as PubMed, EBSCOhost, and ProQuest. Inclusion criteria included are full-text articles, English language, and articles of the past 10 years. After searching, we analyzed quantitatively using the RevMan application for meta-analysis.

Results:
From 3403 studies, we got 12 studies that were included in the analysis. In a study conducted from the study of van Hemelrijck et al. stated that intestinal obstruction has an incidence of 50.73–1000, the third-highest when compared with advanced complications such as death (145.07/1000 population) and urinary tract infections (127.03/1000 population). It was found that odds ratio was 0.64 (0.45–0.91).

Conclusion:
The ileal conduit and orthotopic neobladder methods have no significant difference in the incidence of intestinal obstruction.
Evaluation of the accessibility and content of urology residency websites
Authors: Nocera Alexander P , Boudreau Hunter S. , Boyd Carter J , Martin Kimberly D. , Rais-Bahrami Soroush 
Published: May 2024

Introduction:
Students applying for urology residency often have limited resources for obtaining information on prospective programs. Applicants commonly rely on institutional websites to compare program elements. The information on these websites can attract or deter applicants and can have a major impact on application costs, rank lists, and career goals. The objective of this study was to determine the accessibility and content of urology residency program websites.

Materials and Methods:
A list of accredited urology residency programs was obtained from the American Urological Association residency directory in 2020. A total of 141 program websites were evaluated for the presence of 53 criteria, which were categorized into five groups: Personnel information, applicant information, program information, training/research, and resident benefits. Residencies lacking an available website or functional links were excluded from the study.

Results:
Of the 53 criteria analyzed, only 24 were featured on more than 50% of the websites. Less than 10% of the programs had available information regarding resident contact information (5.67%), alumni contact information (2.84%), frequently asked questions (9.22%), electives (9.93%), night float (5.67%), and board pass rates (5.67%). The three factors most commonly available included program description (100%), coordinator contact information (88.65%), and clinical sites (87.94%). None of the 141 programs had all 53 criteria available on their website.

Conclusions:
The majority of current urology residency websites may lack the accessibility and content necessary for candidates to make application decisions for desired programs. Residency programs should consider revising their websites to enhance resident recruitment and facilitate applicants’ decision-making process.
Thulium laser en bloc resection versus conventional transurethral resection of urinary bladder tumor: A comparative prospective study
Authors: Badawy Atef , Sultan Sultan Mohamed , Marzouk Asem , El-Sherif Eid 
Published: May 2024

Background:
Transurethral resection of bladder tumors (TURBT) is the standard management for urinary bladder tumors; however, new techniques as Thulium laser en bloc resection of bladder tumors (TmLRBT) have been introduced as a substitute to TURBT.

Objectives:
In this study safety, efficacy, and tumor recurrence after TmLRBT and TURBT were prospectively compared in patients with primary (<4 cm) bladder tumors.

Patients and Methods:
Between August 2019 and May 2021, patients with primary (<4 cm) bladder tumors were enrolled. Patients were randomized between the two procedures. All perioperative data were collected prospectively. Pathological specimen findings and recurrence rates were reported during follow-up visits.

Results:
Sixty patients underwent TURBT, and another 60 had TmLRBT. No significant differences were detected in patient demographics or preoperative tumor characteristics between the two groups. Operation time was less (28.2 vs. 38.9 min, P < 0.001), and rate of bladder perforation was lower with TmLRBT compared to TURBT (3.3% vs. 15.0%, P = 0.027). In the TmLRBT group, higher rate of muscle detection (95.0% vs. 78.3%, P < 0.001) in the pathological specimen, and lower rate of tissue destruction (0.0% vs. 21.6%, P < 0.001) were obtained compared to TURBT. Recurrence rate in cases of nonmuscle invasive bladder cancer was lower with TmLRBT (6.7% vs. 33.0%, P < 0.001).

Conclusion:
In this study, TmLRBT showed reduced operative time with lower perforation rates. Higher detection of detrusor muscle and less tissue destruction in the pathological specimen were obtained with TmLRBT, as well as lower rates of tumor recurrence. These findings suggest that TmLRBT is a safe and efficacious substitute to TURBT in tumors <4 cm.
The study of miRNA-200c expression and epithelial-to-mesenchymal transition-related transcription factors in the primary bladder urothelial carcinoma
Authors: Narwal Anubhav , Kumari Kalpana , Kaushal Seema , Seth Amlesh , Nayak Brusabhanu , Rustagi Yashika , Dinda Amit Kumar 
Published: May 2024

Background:
Epithelial-mesenchymal transition (EMT) plays an important role in bladder carcinoma (BC) invasiveness and metastasis. Studies have shown that muscle-invasive BC (MIBC) and non-MIBC (NMIBC) are different at the molecular level owing to different EMT-related programming. Recent studies suggest that dysregulation of specific miRNAs is linked to EMT in BC. With this background, we aimed to study the immunoexpression of EMT-markers and its correlation with miRNA-200c expression in a series of MIBCs and NMIBCs.

Materials and Methods:
Quantitative real-time-polymerase chain reaction for the quantification of miR-200c expression was performed on 50 cases of urinary BC obtained from transurethral resection of bladder tumor (TURBT), cystectomy specimens, and ten peritumoral bladder tissue. Immunohistochemistry for ZEB1, ZEB2, TWIST, E-cadherin, and β-catenin was performed on tumor and peritumoral bladder tissue.

Results:
Thirty-five TURBT and 15 cystectomy specimens were assessed. Among MIBC, loss of expression of E-cadherin (72.3%), β-catenin (66.7%), and ZEB1, ZEB2, and TWIST2 immunoreactivity was noted in 53.3%, 86.7%, and 73.3% of cases, respectively. Among NMIBC, loss of expression of E-cadherin (22.5%), β-catenin (17.1%) and ZEB1, ZEB2, and TWIST immunoreactivity was noted in 11.5%, 51.4%, and 91.4% of cases, respectively. Upregulation of miRNA-200c was noted in cases with retained E-cadherin and negative TWIST expression. Downregulation of miRNA-200c expression was noted in all the cases showing loss of E-cadherin, β-catenin, and in cases immunoreactive for ZEB1, ZEB2, and TWIST in MIBC. Downregulation of miRNA-200c expression was also noted in cases of MIBC with retained β-catenin and those immunonegative for ZEB1 and ZEB2. A similar trend was noted in NMIBC. Median miRNA-200c expression was low in both high-grade and low-grade NMIBC compared to peritumoral bladder tissue and was not statistically significant.

Conclusion:
This study for the first time explores the relation of miR200C with E-cadherin, b-catenin, and its direct transcriptional regulators, namely Zeb1, Zeb2, and Twist in the same cohort of BC. We observed that miRNA-200c is downregulated in both MIBC and NMIBC. We identified novel expression of TWIST in cases of BC showing downregulation of miR200Cs suggesting that it is one of the protein targets of altered miRNA-200c expression contributing to EMT and can serve as a promising diagnostic marker and therapeutic target. Loss of E-cadherin and ZEB1 immunoexpression in high-grade NMIBC suggests an aggressive clinical behavior. However, ZEB2 heterogeneous expression in BC limits its diagnostic and prognostic utility.
Role of videourodynamics in the identification of causes of lower urinary tract symptoms and low uroflow in young men
Authors: Gupta Naveen Kumar , Gaur Shantanu , Pal Dilip Kumar 
Published: May 2024

Introduction:
The etiology of lower urinary tract symptoms (LUTS) is multifactorial with causes attributed either to the dysfunction of the bladder or its outlet. Although the etiologies are well studied in aged men, very limited research trials are available in young men with LUTS. Most of the time young men presenting with chronic irritative or obstructive symptoms are labeled with chronic prostatitis or prostatodynia and are treated empirically. In this study using videourodynamics, we prospectively investigated the etiologies of LUTS and low uroflow in young men.

Materials and Methods:
Fifty male patients, 18–50 years of age attending the urology outpatient department at a tertiary care center from January 2021 to December 2021 with symptoms suggestive of chronic LUTS and low uroflow (maximum urinary flow rate [Qmax] <15 ml/s at a voided volume >150 ml) were included in the study and underwent multichannel videourodynamic study (VUDS). Clinical characteristics and urodynamic results in different diagnostic groups were tabulated and analyzed. The P ≤ 0.05 was considered statistically significant.

Results:
Out of 50 enrolled patients, primary bladder neck obstruction was seen in 21 patients (42%), dysfunctional voiding in 14 (28%), impaired detrusor contractility (IDC) in 9 (18%), and benign prostatic obstruction (BPO) was noted in 6 patients (12%). The mean age and size of the prostate of patients with BPO were greater than those in the remaining groups and patients with IDC had lower Qmax and Pdet at Qmax than those in the remaining patients.

Conclusion:
Chronic LUTS in young men has a variety of underlying etiologies and VUDS in this population is helpful in attaining an accurate diagnosis and thus may guide toward efficient management.
Evaluation of a nitinol stone retrieval basket as an alternative to biopsy forceps for biopsy of suspected upper tract genitourinary malignancies
Authors: McClelland Daniel J. , Spencer Raven D. , McArdle Ian W. , Luchey Adam M. , Barnard John T. , Hajiran Ali J. , Crigger Chad B. , Agarwal Gautum , Morley Chad E. 
Published: May 2024

Background:
The anatomical nature of the ureteroscopic approach for biopsy of upper urothelial tract tumors requires the utilization of small instruments, often limiting biopsy specimen quality. This leads to lower-than-desired tumor grading accuracy and malignancy detection capabilities on the initial evaluation of upper tract tumor specimens. This is problematic because optimal treatment of upper tract urothelial carcinoma (UTUC) depends on early disease detection and subsequent accurate diagnosis.

Objective:
The objective of our study was to compare the biopsy capabilities of two ureteroscopic biopsy instruments – biopsy forceps and the nitinol stone retrieval basket.

Methods:
We performed a retrospective analysis of ten patients who underwent biopsy of an upper tract mass with either instrument. Average specimen size, muscularis propria presence, and malignancy detection sensitivity were the variables of interest.

Results:
The nitinol stone retrieval basket obtained larger biopsy samples than the biopsy forceps, with average biopsy volumes being 0.0674 cm3 and 0.0075 cm3, respectively (P = 0.00017); this was the only statistically significant result of our study. Muscularis propria was present in 31% (4/13) of the biopsies with the nitinol stone retrieval basket, whereas 0% (0/5) of the biopsy forceps biopsies contained muscularis propria (P = 0.2778). Regarding malignancy detection sensitivity, the nitinol stone retrieval basket biopsies identified malignancy in 100% of the specimens that had confirmed malignancy; the biopsy forceps only detected malignancy 40% of the time (P = 0.4134).

Conclusion:
These findings suggest that the nitinol stone retrieval basket is a useful diagnostic tool for UTUC, although further investigation is warranted to determine its superiority compared to biopsy forceps.
Synergistic Effects of Cinnamomum verum and Stingless Bee Honey on Isoproterenol-induced Cardiac Hypertrophic Murine Model
Authors: Padmanabhan Arul Mozhi , Doss Victor Arokia 
Published: May 2024

Abstract

Objective:
This study aimed to validate the synergistic effects of Cinnamomum verum (C. verum) barks and stingless bee honey (SBH) against cardiac hypertrophy (CH).

Materials and Methods:
Isoproterenol (ISO-group II-30 mg/kg)-induced cardiac hypertrophic Wistar rats were used in this study. Hypertrophic rats were treated using the reference drug losartan (LOS Group III: 50 mg/kg) and aqueous extracts of C. verum barks and SBH (ACH Group IV: 250 mg/kg and 250 mg/kg). CH was characterized by electrocardiography, hypertrophic indices, and biochemical estimations such as total glucose, protein, albumin, lipid profiles, cardiac marker enzymes, and histopathological studies.

Results:
Rats received ISO had increased levels of glucose, protein, cholesterol, triglycerides, very low-density lipoprotein, and low-density lipoprotein, coupled with decreased levels of albumin and high-density lipoprotein. These levels were restored to near normal when treated with ACH extracts of the standard drugs. Contrary to the ISO-induced myocardial damaged hearts, ACH extracts had a profound effect compared to LOS, which was also reflected in histopathological studies.

Conclusion:
These data explicitly reveal that the ACH have a synergistic cardioprotective (antihypertrophic) effect.
Protective Effect of Shenfu Injection against Sepsis-induced Acute Lung Injury by Suppressing Inflammation and Apoptosis Through the Regulation of the Janus Kinase 2/Signal Transducer and Activator of Transcription 3 Pathway
Authors: Cao Li-Juan , Xie Hai-Tang , Chu Zhong-Xia , Ma Yue , Wang Ming-Ming , Zhuang Shi 
Published: May 2024

Abstract

Objective:
Sepsis-induced acute lung injury (ALI) is a clinically critical condition with a high mortality rate. Shenfu injection (SFI) is a Chinese herbal medicine extracted from red ginseng and Aconite, Radix Aconiti, with various pharmacological activities. This study aimed to investigate the potential mechanism of action of SFI in preventing sepsis-induced ALI.

Materials and Methods:
We established a mouse model of sepsis-induced ALI by cecal ligation and puncture (CLP). The mice were randomly divided into three groups (n = 8): Sham, CLP, and SFI (10 mL/kg). Bronchoalveolar lavage fluid (BALF) and lung tissue were collected for pathological analysis, enzyme-linked immunosorbent assay, immunohistochemistry (IHC), and protein detection.

Results:
Our results showed that SFI significantly ameliorated pathological damage caused by CLP-induced ALI. SFI treatment significantly decreased the lung wet-to-dry weight ratio. In addition, SFI treatment significantly reduced the protein levels and cell numbers in the BALF. SFI could significantly reduce the levels of tumor necrosis factor-α, interleukin-6 (IL-6), and IL-1β in plasma and BALF. SFI significantly reduced the protein expression of Bax and cleaved caspase-3 and increased the protein levels of Bcl-2. Western blotting and IHC results showed that SFI reduced the phosphorylation of Janus kinase 2 (JAK2) and signal transducer and activator of transcription 3 (STAT3).

Conclusions:
In a septic ALI mouse model, SFI inhibited apoptosis and inflammation through the JAK2/STAT3 pathway, providing a candidate drug for the treatment of septic ALI.