bluuebunny/crossref_metadata_2025_split huggingface dataset:
Venetoclax: A narrative drug review
Authors: Rajendra Akhil , Sengar Manju 
Published: March 2024

ABSTRACT
B cell lymphoma 2 (BCL2) is frequently overexpressed in lymphoid and myeloid malignancies. Targeting BCL2 using venetoclax has significantly improved outcomes in patients with chronic lymphocytic leukemia (CLL) and acute myeloid leukemia (AML), resulting in its approval in the first line in both these diseases. Its role in the management of mantle cell lymphoma, multiple myeloma, and diffuse large B cell lymphoma (DLBCL) is also being explored. This review of venetoclax details the pharmacodynamics, pharmacokinetics, clinical indications, dosing strategies, methods to prevent tumor lysis syndrome, and dose modifications. To prepare this review, we comprehensively searched various websites, including that of the United States Food and Drug Administration (US FDA), European Medicines Agency (EMA) drug manual, PubMed, and UpToDate using the search terms, “Venetoclax,” “AML,” “CLL,” “Pharmacology,” and “hematolymphoid malignancy.” We shortlisted all the full-text articles published in the preceding 10 years. Out of a total of 397 manuscripts identified, we included 57. We also incorporated information from the abstracts and various conference proceedings.
Clinical and demographic profile of lower gastrointestinal malignancies: A retrospective observational study from Eastern India
Authors: Raj Shraddha , Singh Rajesh K. , Kumar Shishir , Devi Seema , Kishor Kunal , Sinha Dinesh K. , Madhawi Richa , Kumar Prince , Choubey Subhadra , Prakash Aman 
Published: March 2024

ABSTRACT

Background:
Lower gastrointestinal (GI) cancers including colorectal and anal cancers are less common in India than in the rest of the world. Literature regarding these malignancies from Eastern India is scarce.

Objectives:
Our primary objective was to determine the clinical and demographic profile of patients with lower GI malignancies reporting to our center.

Materials and Methods:
This observational study was conducted in the Department of Radiation Oncology at State Cancer Institute, Indira Gandhi Institute of Medical Sciences in Patna (Bihar), a tertiary care center in Eastern India. The details of 1191 patients with lower GI cancers were extracted retrospectively from the Hospital-Based Cancer Registry from 2014 to 2021 and analyzed for basic clinical and demographic parameters. The total number of lower GI cancer cases over these consecutive calendar years was calculated. Calculation of annual percentage change (APC) and analysis of the time trend was done using Joinpoint regression software (4.0.1).

Results:
There were 1028 patients with colorectal cancer and 163 patients with anal cancer. The median ages at presentation were 49.5 (range, 12–92) years for colorectal cancer, and 48 (range, 12–85) years for anal cancer, with a male predominance (M:F ratio 1.7 [or 1.7:1 for colorectal cancer] and 2.7 [or 2.7:1 for anal cancer]) patients with colorectal cancer who were younger than 39 years (young colorectal cancer). The rectum (n = 594, 50%) was the commonest site involved. Nearly three-quarter patients (562 with colorectal cancer [74.7%] and 84 with anal cancer [73%]) presented with advanced disease (Stages III and IV). Chemotherapy was the most commonly administered treatment modality (colorectal cancer [n = 383, 37.1%] and anal cancer [n = 70, 43.1%]). There was a rising trend observed in the number of lower GI cancer cases with a significant APC (P < 0.01).

Conclusion:
The number of lower GI cancers is increasing as per the data from our hospital-based cancer registry in Eastern India. Greater frequency of advanced disease coupled with early age at presentation are causes concern. Measures to increase awareness and facilitate early diagnosis are urgently required. Population-based studies are required to validate these findings.
A narrative review of survival analysis in oncology using R
Authors: Pawar Akash , Chowdhury Oindrila R. , Salvi Omkar 
Published: March 2024

ABSTRACT
Clinical trials in oncology largely include survival analysis, that is, the time to the occurrence of an event of interest as the primary outcome of the study. Survival analysis can be performed using non-parametric methods. In this review, we have provided the details of the statistical model for the probability of an individual surviving until time t. We have also discussed the use of the Cox proportional model to obtain the hazard or risk of occurrence of an event at a certain time while enrolled in the study. Hazard ratios and their confidence intervals are discussed and interpreted. We have also discussed the reporting of various survival endpoints, including the median recurrence-free and overall survival (in days and months), and the five-year recurrence-free and overall survival probability with 95% confidence intervals (CIs). We have discussed the P values obtained through the comparison of the survivals between various groups of patients and the methods of graphically representing the survival curves. To prepare this review, we searched the internet using Google for packages available for survival analysis on the Comprehensive R Archive Network (CRAN). We selected the Survival package and used the latest version 3.4-0. As an example, to demonstrate the methodology and applications, we used the rotterdam data set on primary breast cancer patients available in the Survival package, and the survminer package version 0.4.9 to visualize the survival curves. We have thus attempted to provide an easily understandable process for analyzing survival data using RStudio in the oncology setup. The results obtained by the listed procedure are accurate and highly dependable.
Randomized study assessing the cardiopulmonary toxicities from postoperative conventional versus hypofractionated radiotherapy in locally advanced left breast carcinoma
Authors: Saha Subhayan , Chatterjee Koushik , Mukherjee Pratyusha , Mondal Santu , Pal Santanu , Mitra Debabrata 
Published: March 2024

ABSTRACT

Background:
Radiotherapy plays an important role in decreasing the risk of locoregional recurrence in patients with locally advanced breast carcinoma. However, radiotherapy can lead to late side-effects in the normal tissues.

Objectives:
We aimed to assess and compare the late toxicities in the heart and lungs in patients with left breast carcinoma who were treated with adjuvant conventional versus hypofractionated radiotherapy.

Materials and Methods:
This was a randomized study conducted between February 2019 and August 2021 in the Department of Radiotherapy at the Institute of Postgraduate Medical Education and Research and SSKM Hospital, Kolkata. Patients with histopathologically proven locally advanced left breast carcinoma who had undergone surgical resection were randomized to receive either hypofractionated radiation (39 Gy in 13 fractions) or conventional radiation (50 Gy in 25 fractions). Pulmonary toxicities were assessed through pulmonary function tests performed at baseline and every 6 mo, with measurement of the forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), and the diffusion capacity of the lung for carbon monoxide (DLCO). Cardiac toxicity was assessed by measuring the left ventricular ejection fraction (LVEF) on echocardiography at baseline and every 6 mo after the completion of radiotherapy.

Results:
We analyzed the data of 51 patients, 27 on the hypofractionated arm and 24 on the conventional radiation arm. At 6 mo of follow-up, there were no statistically significant differences in the cardiopulmonary toxicities between the patients treated with either conventional or hypofractionated radiation. The mean reductions in the LVEF [1.48% (95% CI, 0.7–2.26) vs. 1.13% (95% CI, 0.49–1.77), P = 0.49], FVC [2.19% (95% CI, 1.21– 3.17) vs. 1.92% (95% CI, 1.18–2.66), P = 0.67], FEV1 [1.36% (95% CI, 0.44–2.28) vs. 0.96% (95% CI, 0.34 –1.58), P = 0.49], DLCO [2.96% (95% CI, 1.38–4.54) vs. 2% (95% CI, 0.92–3.08), P = 0.33] were similar between the hypofractionated and conventional radiation arms, respectively. Similarly, at 12 and 18 mo of follow-up, there were no statistically significant differences between the mean reductions in all the four parameters, and no differences in the 2-year survivals of the patients treated with the two radiation techniques.

Conclusion:
Hypofractionated radiation post-mastectomy does not lead to an increase in the late cardiopulmonary toxicities and may be considered a reasonable alternative to conventional fractionation in breast carcinoma.
A narrative review of the role of cross-sectional imaging in the management of thyroid carcinoma: Imaging guidelines and T-CIRADS
Authors: Mahajan Abhishek , Agarwal Ujjwal , Padashetty Shubham , Shukla Shreya , Smriti Vasundhara , Rastogi Shivam , Vaish Richa , Kumar Suman , D’Cruz Anil 
Published: March 2024

ABSTRACT
Thyroid cancer is the most common endocrine malignancy and cross-sectional imaging plays an increasing role in management, especially for pre-surgical staging. It is important for the radiologist to know about the invasive nature of thyroid carcinoma and to highlight key imaging findings in the report thus permitting better surgical planning and improving surgical outcomes. For this review, we performed a comprehensive search of abstracts regarding the pre-operative markers in thyroid carcinoma and their key implications. We searched in PubMed, Cochrane CENTRAL, MEDLINE, Embase, and Google Scholar. This review article focuses on the major changes and key pre-surgical cross-sectional imaging findings mentioned in the 8th edition of the American Joint Committee on Cancer staging and the manner in which these changes should be incorporated in radiology reports. We conclude that the behavior and appearance of locally invasive thyroid cancer on computed tomography are crucial for the pre-operative evaluation of thyroid carcinoma. We also discuss synoptic reporting for thyroid malignancies, that is, T-CIRADS. Total thyroidectomy with possible removal of adjacent infiltrated critical structures along with neck dissection and post-operative risk stratification according to the American Thyroid Association is essential for an optimal curative result and survival.
Esophageal cancer imaging - reporting and data system (ECI-RADS) and post-therapy ECI-RADS (pECI-RADS): Comprehensive synoptic reporting formats for esophageal cancer imaging: A narrative review
Authors: Chakrabarty Nivedita , Mahajan Abhishek 
Published: March 2024

ABSTRACT
Using a comprehensive synoptic reporting format effectively conveys the imaging findings from the radiologist to the treating physician/surgeon, relaying maximum relevant information in a standardized manner without missing any pertinent findings. We believe that two separate reporting templates are required for cancer image reporting: one for conveying baseline imaging findings on initial staging and the other for recording post-treatment findings. As no such reporting format is available for esophageal cancer on the American College of Radiology website, we have prepared two structured reporting templates: Pretreatment Esophageal Cancer Imaging–Reporting and Data System and Post-therapy Esophageal Cancer Imaging–Reporting and Data System to enable the radiologist to convey important findings pertaining to staging and post-therapy assessment of esophageal cancer. For this, we searched the internet using Google and referred to all the relevant articles and their references published in the preceding 25 years; we also included an article from 1984 because of relevance. In addition, we referred to the management guidelines of the National Comprehensive Cancer Network version 2.2022 for formulating the synoptic reporting formats.
Programmed death ligand (PD-L1) expression in invasive squamous cell carcinoma of the uterine cervix: A cross-sectional observational study
Authors: Chaudhary Nikhil , Raju Kalyani , Sheela SR , Sakalecha Anil Kumar , Manjunath G N 
Published: March 2024

ABSTRACT

Background:
Normal cervical epithelium does not express programmed death ligand-1 (PD-L1) protein. Expression of PD-L1 has been reported in 50% cells of cervical carcinoma. Approximately 17% of adenocarcinomas and 35% of squamous cell carcinomas (SCC) of the cervix express PD-L1.

Objectives:
To determine the expression of PD-L1 in invasive SCC of the cervix and to correlate the expression with various clinicopathological parameters.

Materials and Methods:
This was a cross-sectional study conducted between July 2016 and June 2021 in the Department of Pathology, in collaboration with the Department of Obstetrics and Gynecology at the R. L. Jalappa Hospital and Research Center, Kolar, in South India. proportion of PD-L1 expression was evaluated on the biopsy specimens by immunohistochemistry (PD-L1 Antibody Biogenex AN921-M) and based on the PD-L1 positive cells, was scored as 0 (<5%), 1 (5–29%), 2 (30–59%), and 3 (>60%). We evaluated the association of PD-L1 expression with the clinicopathological parameters.

Results:
We included 90 cases of SCC of the cervix. The median age was 52.5 years (range, 30–74), with the majority of patients between the ages of 40–49 years. Overall, PD-L1 expression was noted in 66.7% cases of SCC of the cervix. PD-L1 marker expression increased with age, from 40–49 years (n = 14/28, 50%) to 70–79 years (n = 10/12, 83.3%); P = 0.037. PD-L1 expression was maximum (n = 40/47, 85.1%) in moderately differentiated SCC; there was a significant correlation between histological grade and PD-L1 expression; P < 0.001. There were no significant correlations between the PD-L1 expression and other clinicopathological parameters such as parity, clinical findings, disease stage, size of lesion, lymph node status, and overall survival.

Conclusion:
Two-thirds of cervical SCC cases express PD-L1. The PD-L1 expression is significantly associated with the patient’s age and the grade of the disease. Evaluation of PD-L1 expression in SCC of the cervix is important as anti-PD-L1/PD-1 immunotherapies can be used in PD-L1 positive cervical cancer.
Clinical Presentations of Melioidosis and Antibiogram of Burkholderia pseudomallei: An 8-year Study in a Tertiary Care Center, South India
Authors: Suseela Kundoly Velayudhan , Alex Aiswariya , Das Subi 
Published: March 2024

Abstract

Background:
Melioidosis, an infectious disease caused by Burkholderia pseudomallei, is endemic in tropical countries. In nonendemic areas, the disease is rarely suspected because of varying clinical presentations and only a few attempts are made to isolate the pathogen. Many cases are left underdiagnosed or underreported in geographical areas where the disease is not endemic. This study aimed to analyze the clinical presentations, comorbidities, and antibiotic susceptibility patterns in patients with melioidosis in a tertiary care center.

Materials and Methods:
A retrospective study was done on culture-confirmed melioidosis patients admitted to a tertiary care center, from January 2015 to December 2022. Relevant information on clinical presentations, mortality rate, comorbidities, and antibiogram was collected from hospital medical records.

Results:
A total of 73 culture-confirmed cases of melioidosis were included in the study. Common clinical presentations were pneumonia (n = 35, 47.9%), septicemia (n = 13, 17.8%), and deep abscesses (n = 9, 12.3%). The mortality rate from melioidosis was 15.1% (n = 11). No significant difference was found in the mortality rate between pneumonia and septicemia groups (P = 0.716). Diabetes mellitus (DM) was the major comorbidity detected (n = 56, 76.7%). Isolates were susceptible to ceftazidime (n = 71, 97.3%), meropenem (n = 71, 97.3%), and co-trimoxazole (n = 60, 82.2%).

Conclusions:
Common clinical presentations of melioidosis in our setting were pneumonia and septicemia. DM was the major comorbidity. Nearly one in six patients died. Ceftazidime and meropenem were the effective antibiotics. These findings may help physicians to make an early microbiological diagnosis which is essential to reduce mortality.
A Cross-sectional Study of Cutaneous Manifestations in Overweight and Obese Children
Authors: Thomas Ann Willie , Bhatia Anuradha , Sharma Monika 
Published: March 2024

Abstract

Background:
Overweight and obesity are a major public health problem and are now considered to be a global epidemic. The skin is one of the main organs to be affected due to metabolic abnormalities in obesity. The various cutaneous manifestations of obesity are directly related to the age of onset, duration, and severity of the underlying disease.

Aims:
The aim of this study is to determine the frequency and pattern of cutaneous manifestations in overweight and obese children.

Materials and Methods:
The present study was a cross-sectional study conducted among 150 overweight and obese children (according to the World Health Organization definition), of age group 5–19 years (school-going children) attending the dermatology and pediatrics outpatient department. The study utilized a prestructured pro forma to record demographic profile, weight, height, and body mass index; the different cutaneous manifestations were noted in overweight and obese children. Relevant investigations such as pus culture, potassium hydroxide (KOH) preparation, and skin biopsy were done wherever indicated.

Results:
Most of the patients were overweight (82%). Males (61.33%) outnumbered females (38.67%) in our study. Majority of the patients had acanthosis nigricans (74.67%), followed by striae distensae (32.67%), acne vulgaris (20%), and dermatophytosis (17.33%). Hidradenitis suppurativa was found in two children, and cellulite in one child.

Conclusion:
As obesity and its effects on the skin in school-going children are understudied by dermatologists and pediatricians, a proper examination and diagnosis of different cutaneous manifestations of obesity in children will further help in preventing multiple comorbidities in future.
A Case Report of Giant Tuberous Xanthoma with Type IIa Familial Hypercholesterolemia
Authors: Sharanya Bommakanti Sai , Logeshwari J. , Pinjala Padmaja , Thakur Rajeev Singh 
Published: March 2024

Abstract
Tuberous xanthomas are nontender, yellow to red papules to nodules that occur on the extensor surface, and trauma-prone areas such as the elbows, knees, Achilles tendon, and buttocks. A 10-year-old female child born out of second-degree consanguineous marriage presented with multiple skin-colored nodular lesions on axillary folds, both elbows, cubital fossa, medial side of the wrist, interphalangeal joints, buttocks, knees, popliteal fossa, and Achilles tendons. After complete evaluation, diagnosis of familial hypercholesterolemia type IIa with tuberous xanthoma was made. Tuberous xanthoma usually presents in combined type III dyslipidemias, but in our case, it is presented in type IIa familial hypercholesterolemia. Early diagnosis and treatment of familial hypercholesterolemia are important for preventing complications.
Eruptive Syringoma in a Case of Mucopolysaccharidosis Type IIIB-Sanfilippo B
Authors: Rajendran Arthi , Raviprakash Divya , Priyadarshini Anuradha , Adikrishnan S. 
Published: March 2024

Abstract
Eruptive syringoma is a rare clinical variant of syringomas and is commonly described in the setting of Down’s syndrome. Hereby, we report the case of a 22-year-old female presenting with multiple, small, skin-yellow-hyperpigmented, round-ovoid papules over the face, forearms, hands, lower abdomen, and thighs associated with facial dysmorphism, hepatomegaly, macular dystrophy, and behavioral disturbances. Histopathology of the cutaneous lesion revealed ductal epithelial cells forming tadpole structures suggestive of syringomas and whole exome sequencing confirmed the underlying genetic defect: mucopolysaccharidosis Type IIIB-Sanfillipo B syndrome. Hence, we present this rare case of eruptive syringomas associated with mucopolysaccharidosis.
Carbon Baby Syndrome: A Case Report with Review of Literature
Authors: Kumari Sandhya , Verma G. K. , Gulati Anchana , Negi Ajeet 
Published: March 2024

Abstract
Carbon baby syndrome also known as universal acquired melanosis is one of the rare causes of diffuse and progressive hyperpigmentation of the skin. A case of a 9-year-old Nepali child was reported in whom darkening of the skin began at the age of 5 months. At presentation, generalized hyperpigmentation was observed with characteristic sparing of pressure areas over the palms and soles. The diagnosis was established by histopathological evidence of epidermal and dermal melanization after the exclusion of all cutaneous and systemic causes for such hyperpigmentation. This case is reported for its rarity and unusual clinicohistopathological features.
Insulin-induced Panniculitis in a Child: A Rare Entity
Authors: Mendiratta Vibhu , Meena Amit Kumar , Verma Bharati , Bhattacharya Jenna 
Published: March 2024

Abstract
Insulin-induced panniculitis is a rare entity. It represents the early stage of development of lipoatrophy. The complex of insulin and insulin antibodies leads to the activation of macrophages, which is responsible for the initiation of autoimmune process and leading to panniculitis followed by subsequent development of lipoatrophy. Here, we report the case of insulin-induced panniculitis with lipoatrophy associated with Type 1 diabetes mellitus in an 11-year-old female child.
Cerebriform Intradermal Nevus Presenting as Cutis Verticis Gyrata: A Rare Presentation
Authors: Jaiswal Prashansa , Shukla Akhilesh , Rana Shiwangi , Shloka Shilpi 
Published: March 2024

Abstract
Cerebriform intradermal nevus (CIN) is one of the causes for secondary cutis verticis gyrata (CVG). Here, we report a 9-year-old boy with well-demarcated swelling over the left temporal area of his scalp since birth. The swelling was about 15 cm × 10 cm in size with cerebriform folds. It was soft in consistency and loss of hair was present. Histopathology confirmed CIN. This report serves as an example of a rare case of secondary CVG due to a CIN.