bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tobacco treatment in the setting of lung cancer screening
Authors: Verdone James E. , Marciniak Ellen T. , Deepak Janaki 
Published: November 2023

Purpose of review
Lung cancer screening by low-dose CT is an increasingly implemented preventive medicine tool. Screening for lung cancer is incomplete without addressing problematic tobacco use, the greatest modifiable risk factor in the development of lung cancer. This review describes recent work related to lung cancer screening and treatment of tobacco use in that context.

Recent findings
Implementation of lung cancer screening demonstrates socioeconomic disparities in terms of adherence to screening as well as likelihood of successful tobacco dependence treatment. Active tobacco dependence is a common comorbidity for patients undergoing lung cancer screening. The optimal implementation of tobacco dependence treatment in the context of lung cancer screening is still an area of active investigation.

Summary
Treatment of tobacco dependence at time of lung cancer screening is a major opportunity for clinicians to intervene to reduce the major modifiable risk factor for lung cancer, tobacco use. Providing comprehensive tobacco dependence treatment is most effective using combination pharmacologic and behavioral interventions. Practices providing comprehensive treatment will benefit from accurate documentation for billing and coding and supplementing with external resources such as state Quit Lines.
Optimizing the prelung transplant candidate
Authors: Pagteilan John , Atay Scott 
Published: November 2023

Purpose of review
Lung transplant outcomes are impacted by multiple modifiable risk factors. Candidate deterioration on the wait list remains problematic. Innovative technology and strategies to identify and impact pretransplant morbidity have improved short- and long-term outcomes. We focus our review on recent advances in pretransplant recipient assessment and optimization.

Recent findings
Advancements in recipient management have focused on risk factor identification for adverse outcomes and the development of a lung transplant specific frailty assessment. Early surgical correction of gastroesophageal reflux disease (GERD), including the use of partial fundoplication in the setting of esophageal dysmotility, leads to improvements in graft function/longevity. New evidence supports expanding criteria for extracorporeal life support as a bridge to transplant.

Summary
Candidate optimization requires early intervention to limit functional deterioration potentially contributing to adverse outcomes. Frailty can be identified with a transplant specific frailty assessment, and positively impacted with dedicated rehabilitation. Pretransplant frailty is reversible following transplant and should be considered in the context of overall fitness at the time of candidate selection. Invasive support modes including extracorporeal membrane oxygenation (ECMO) are appropriate to preserve strength and mobility, with awake, ambulatory ECMO preferred. The deleterious effect of GERD on graft function can be managed with early fundoplication over medical management alone.
Varicose vein embolization and portal vein stenting in a patient with sinistral portal hypertension-induced gastrointestinal hemorrhage: a case report
Authors: Li Xi , Li Wenbo , Wu Yu , Liu Yuan 
Published: November 2023

Introduction and importance:
Massive gastrointestinal hemorrhage is a severe hemorrhage that occurs in the gastrointestinal tract and is a life-threatening condition. Sinistral portal hypertension is a common etiology for massive gastrointestinal hemorrhage, whose occurrence might be derived from pathological changes induced by obstruction and/or increased blood flow to the portal vein system. However, there is a rare study reporting pancreatic disease-induced sinistral portal hypertension.

Case presentation:
An 80-year-old female pancreatic cancer patient was admitted to our hospital on 22 January 2022 due to a massive gastrointestinal hemorrhage with shock after receiving radio-chemotherapy. Abdominal enhanced computerized tomography showed that the patient presented with pancreatic cancer-causing sinistral portal hypertension with massive collateral circulation, intrahepatic bile duct dilation, and the formation of massive ascites. Subsequent portography interventional procedure revealed the esophageal and gastric varix. Then, the varicose vein was embolized, and the stent was implanted at the lumen of the superior mesenteric vein accessing the portal vein. The patient recovered from pancreatic cancer-causing sinistral portal hypertension, and a normal direction of blood flow was observed in the superior mesenteric vein with a decreasing amount of ascites. In addition, a transfusion was also carried out, and the massive gastrointestinal hemorrhage was alleviated.

Clinical discussion and conclusion:
This study emphasizes the successful treatment of massive gastrointestinal hemorrhage induced by pancreatic cancer-causing sinistral portal hypertension by varicose vein embolization and portal vein stenting, which could be considered an alternative opinion for these patients.
Predictive factors for the development of capecitabine-induced hand-foot syndrome: a retrospective observational cohort study
Authors: Chantharakhit Chaichana , Sujaritvanichpong Nantapa 
Published: November 2023

Background:
Capecitabine-induced hand-foot syndrome (HFS) is a common condition that significantly affects patients’ quality of life. The exact underlying mechanisms are currently not clearly understood. Therefore, the study of predictive factors for HFS is of critical importance.

Materials and methods:
This prognostic factor research used a retrospective observational cohort as the study design. Data collected from the medical records of 205 patients treated with capecitabine between January 2019 and June 2022 were subjected to univariable and multivariable regression analysis to determine the predictive factors for the development of grade 2 and grade 3 HFS.

Results:
The incidence of grade 2 and grade 3 HFS was 26.8%. The independent predictive factors, such as age over 60 years (OR 4.80, 95% CI: 2.16–10.68, P<0.001), capecitabine dose greater than 3000 mg/day (OR 2.47, 95% CI: 1.09–5.59, P=0.030), and the number of cycles five or more in the total capecitabine regimen (OR 2.94, 95% CI: 1.29–6.71, P=0.01), were significantly associated with the development of grade 2 and grade 3 HFS.

Conclusions:
Independent predictive factors for the development of grade 2 and grade 3 HFS in patients treated with capecitabine include age over 60, capecitabine dose greater than 3000 mg/day, and patients who plan to undergo five or more cycles in the total capecitabine regimen. This knowledge can be valuable for guiding clinical monitoring and follow-up of patients.
Alcoholic pellagrous encephalopathy: a case report on atypical presentation and diagnostic dilemma in alcohol-related disorders
Authors: Yogi Tek N. , B.C. Pooja , Bhusal Amrit , Limbu Suren , Kafle Rijan 
Published: November 2023

Introduction:
Alcohol use disorder is a global health concern with various complications, including pellagra, often overlooked due to its rarity. This case explores the neurological presentation of pellagra in a long-term alcohol and substance abuser, emphasizing the diagnostic challenges in resource-constrained settings.

Case presentation:
A 36-year-old male with a history of substance abuse presented with multiple symptoms, including hallucinations and neurological deficits. His complex clinical history included alcohol dependence, seizures, and relapses. Physical and neurological examinations revealed characteristic signs of pellagrous encephalopathy. Laboratory findings confirmed anemia and a fatty liver.

Discussion:
Alcoholic pellagrous encephalopathy (APE) presents a diagnostic challenge due to its atypical symptoms, overlapping with other alcohol-related disorders. Niacin deficiency, central to its pathogenesis, affects neurotransmitter synthesis, contributing to neurological symptoms. Diagnosis relies on clinical presentation, but laboratory tests for niacin levels can aid in confirmation. Neuroimaging can exclude alternative causes. This case underscores the importance of considering pellagrous encephalopathy in alcohol-related disorders with neurological symptoms.

Conclusion:
This case underscores the importance of recognizing atypical presentations of APE in chronic alcohol-dependent individuals. Prompt diagnosis, nutritional correction, and addressing alcohol use are vital for successful management. Healthcare providers must be aware of the diagnostic complexities and socioeconomic barriers hindering timely intervention in APE.
Ultrasound-guided continuous erector spinae plane block vs continuous thoracic epidural analgesia for the management of acute and chronic postthoracotomy pain: a randomized, controlled,double-blind trial
Authors: Shaker Ehab Hanafy , Elshal Mamdouh Mahmoud , Gamal Reham Mohamed , Zayed Norma Osama Abdallah , Samy Samuel Fayez , Reyad Raafat M. , Shaaban Mohammed H. , Abd Alrahman Abd Alrahman M. , Abdelgalil Ahmed Salah 
Published: November 2023

Abstract

Introduction:
Postthoracotomy pain (PTP) is a severe pain complicating thoracic surgeries and its good management decreases the risk of PTP syndrome (PTPS).

Objectives:
This randomized controlled study evaluated the efficacy of ultrasound-guided continuous erector spinae plane block (ESPB) with or without dexmedetomidine compared with thoracic epidural analgesia (TEA) in managing acute postoperative pain and the possible emergence of PTPS.

Methods:
Ninety patients with chest malignancies planned for thoracotomy were randomly allocated into 3 equal groups. Group 1: TEA (20 mL of levobupivacaine 0.25% bolus, then 0.1 mL/kg/h of levobupivacaine 0.1%), group 2: ESPB (20 mL of levobupivacaine only 0.1% bolus every 6 hours), and group 3: ESPB (20 mL of levobupivacaine 0.25% and 0.5 μg/kg of dexmedetomidine Hcl bolus every 6 hours).

Results:
Resting and dynamic visual analog scales were higher in group 2 compared with groups 1 and 3 at 6, 24, and 36 hours and at 8 and 12 weeks. Postthoracotomy pain syndrome incidence was higher in group 2 compared with groups 1 and 3 at 8 and 12 weeks, whereas it was indifferent between groups 1 and 3. The grading system for neuropathic pain score was higher in group 2 compared with groups 1 and 3 at 8 and 12 weeks, whereas it was indifferent between groups 1 and 3. Itching, pruritis, and urine retention were higher in group 1 than in ESPB groups.

Conclusion:
Ultrasound-guided ESPB with dexmedetomidine is as potent as TEA in relieving acute PTP and reducing the possible emergence of chronic PTPS. However, the 2 techniques were superior to ESPB without dexmedetomidine. Erector spinae plane block has fewer side effects compared with TEA.
Oral Manganese Chloride Tetrahydrate: A Novel Magnetic Resonance Liver Imaging Agent for Patients With Renal Impairment
Authors: Brismar Torkel B. , Geisel Dominik , Kartalis Nikolaos , Madrazo Beatrice L. , Persson Hedman Hanna , Norlin Andreas 
Published: November 2023

Abstract
Manganese-based contrast agents (MBCAs) show promise to complement gadolinium-based contrast agents (GBCAs) in magnetic resonance imaging (MRI) of the liver. Management of patients with focal liver lesions and severely impaired renal function uses unenhanced liver MRI or GBCA-enhanced MRI. However, unenhanced MRI risks reducing patient's survival.
Gadolinium-based contrast agents, which help to detect and visualize liver lesions, are associated with increased risk of nephrogenic systemic fibrosis in renally impaired patients, a severe adverse event (AE) with potentially fatal outcome. Therefore, use of GBCA in patients with impaired renal function requires careful consideration. Other concerns are related to tissue deposition in the brain and other organs due to lack of gadolinium clearance, which could lead to concerns also for other patient populations, for example, those exposed to multiple procedures with GBCA. Of particular concern are the linear chelates that remain available for liver MRI, where there is no replacement technology. This has highlighted the urgency for safer alternatives.
An alternative may be the drug candidate Ascelia-MBCA (ACE-MBCA, Orviglance), oral manganese chloride tetrahydrate. This candidate effectively visualizes and detects focal liver lesions, as demonstrated in 8 clinical studies on 201 adults (healthy or with known or suspected focal liver lesions). ACE-MBCA has a low and transient systemic exposure, which is likely the reason for its beneficial safety profile. The AEs were primarily mild and transient, and related to the gastrointestinal tract. This new, orally administered product may offer a simple imaging approach, allowing appropriate patient management in renally impaired patients when use of GBCA requires careful consideration.
In this review, we highlight the clinical development of ACE-MBCA—a novel, liver-specific contrast agent. We begin with a brief overview of manganese properties, addressing the need for MBCAs and describing their optimal properties. We then review key findings on the novel agent and how this allows high-quality MRIs that are comparable to GBCA and superior to unenhanced MRI. Lastly, we provide our view of future perspectives that could advance the field of liver imaging, addressing the medical needs of patients with focal liver lesions and severe renal impairment.
Our review suggests that ACE-MBCA is a promising, effective, and well-tolerated new tool in the radiologist's toolbox.
A Novel Approach to Reduce Lid Weight in the Upper Eyelid Blepharoplasty: Split-Thickness Excision of the Palpebral Part of Orbicularis Oculi Muscle
Authors: Demir Ahmet , Ünverdi Ömer Faruk , Orhan Abdullah Erkan 
Published: November 2023

Objectives:
With the effect of advancing age and environmental factors, excess skin and muscle start to weigh on the eyelids and cause a tired facial expression. The prevailing opinion is that by partially excising muscle in surgical treatment, this load on the eyelid will be reduced, and more successful results will be obtained. Using a classic strip orbicularis oculi excision, the integrity of the muscle is disrupted, and morbidities such as lagophthalmos and edema increase. In this paper, we share our clinical experiences regarding the split excision of the palpebral part of the orbicularis oculi muscle and the subsequent process.

Methods:
Twenty-seven patients who applied to our clinic to undergo blepharoplasty were operated on under local anesthesia. The orbicularis oculi muscle was split-excised together with the skin from the marked areas.

Results:
The split excision of the orbicularis oculi muscle did not cause prolonged edema. The general appearance of the eyelid and face of the patients was observed to have significantly improved in the third month after surgery compared with the preoperative period. No complications such as wound healing, hypertrophic scar, asymmetry, or infection were observed during the follow-up period.

Conclusions:
The split excision of the orbicularis oculi muscle can be considered a new and effective method in cases in which a muscle excision is planned as part of blepharoplasty. Prolonged edema due to the strip muscle excision is not observed clinically. This technique can eliminate the negative effects of excess muscle tissue on the eyelid without disrupting the integrity of the muscle.

Level of Evidence:
Evidence Based Medicine Level V
Therapeutic effects of Naohuan Dan combined with idebenone in treating mild cognitive impairment with kidney deficiency and phlegm stasis: A retrospective study
Authors: Ye Jiaxi , Zhu Min , Fan Shengnuo , Huang Qihui 
Published: November 2023

Abstract

Background
Naohuan Dan is a prescription used to treat dementia. This study aims to assess the effectiveness and safety of Naohuan Dan combined with idebenone in treating mild cognitive impairment (MCI) with kidney deficiency and phlegm stasis.

Materials and methods
This retrospective, observational clinical trial enrolled 64 MCI patients treated in the Sun Yat-sen Memorial Hospital, Zhongshan University, from May 1, 2019, to April 30, 2022. The 32 patients in the treatment group received Naohuan Dan combined with idebenone, whereas the 32 patients in the control group were treated with idebenone alone. The observation lasted for 12 weeks. The primary outcomes were the Mini-Mental State Examination (MMSE) score and clinical efficacy, whereas secondary outcomes included the Montreal Cognitive Assessment (MCS) score, the activities of daily living (ADL) score, the Geriatric Depression Scale (GDS) score, the traditional Chinese medicine (TCM) syndrome score, and changes in serum markers. Neuron-specific enolase (NSE), interleukin 8 (IL-8), and tumor necrosis factor α (TNF-α) were taken as the serological indicators for evaluating cognitive function. Adverse events in both groups were recorded during the treatment period.

Results
The treatment group demonstrated higher MMSE scores and clinical efficacy than the control group, specifically in the scores of spatial orientation, attention and calculation, and language proficiency in the MMSE scale. The treatment group outperformed the control group in MCS, ADLs, GDS, and TCM syndrome scores. Furthermore, the treatment group was superior to the control group in recovering the levels of NSE, IL-8, and TNF-α. In addition, the treatment group had lower incidence of adverse reactions such as nausea and poor appetite than the control group.

Conclusions
The 12-week treatment with Naohuan Dan combined with idebenone significantly improved the cognitive function and daily life abilities, lowered the depression levels, and reduced the occurrence of adverse events among patients with MCI. These findings offer valuable insights into the efficacy of integrating TCM with Western medicine in the clinical management of MCI.
(ClinicalTrials.gov ID: NCT05931029; https://clinicaltrials.gov/study/NCT05931029?cond=Naohuan%20Dan&rank=1)
A Murine Polytrauma Model for the Study of Thromboinflammation
Authors: MacArthur Taleen A. , Goswami Julie , Navarro Sergio M. , Spears Grant M. , Bailey Kent R. , Thompson Riley , Dong Jing-Fei , Kozar Rosemary A. , Auton Matthew T. , Knight Jason , Park Myung S. 
Published: November 2023

ABSTRACT

INTRODUCTION
Neutrophil Extracellular Traps (NETs) contribute to trauma-induced coagulopathy. We aimed to develop a murine polytrauma model that induces thrombo-inflammatory response i.e., NETosis and accelerated thrombin generation.

METHODS
Wild-type male mice (n = 10, age 8 – 12 weeks) underwent polytrauma (gastrocnemius crush, femur fracture, and laparotomy) and were compared to an uninjured control group (n = 10). Mice were euthanized by cardiac puncture performed 3 hours after injury. Whole blood samples were immediately processed to platelet poor plasma for thrombin generation kinetics (Calibrated Automated Thrombogram), myeloperoxidase (MPO), and von Willebrand Factor (vWF) quantification. Immunohistochemistry of lung tissue was performed to assess for Citruillinated H3 (Cit H3) and MPO. A NETosis cluster was defined as 3+ neutrophils staining for Cit H3 at 400 X magnification (CitH3 cluster). Data presented either as mean (SD) or median [IQR] with p < 0.05 significant. Sham and trauma treated animals were compared by the 2-sample Wilcoxon ranksum test.

RESULTS
Animals subjected to polytrauma had accelerated thrombin generation compared to controls with greater peak height (nM) (61.3 [41.2, 73.2] vs. 28.4 [19.5, 37.5], p = 0.035) and shorter time to peak (min) (3.37 [2.81, 3.81] vs. 4.5 [4.08, 4.75], p = 0.046). Markers of neutrophil activation were greater following polytrauma than in controls (MPO (ng/ml) 961.1 [858.1, 1116.8] vs. 481.3 [438.0, 648.9], p = 0.004). NETosis, as evidenced by the above defined number of CitH3 clusters in the lung, was greater in polytrauma than in controls (mean 3 [2.9] vs. 0.2 [0.7], p = 0.009).

CONCLUSIONS
This is the first study to demonstrate that NETosis and accelerated thrombin generation can be induced using a murine polytrauma model, as early as three hours following injury.

STUDY TYPE
Animal study

LEVEL OF EVIDENCE
NA
Dimethyl malonate protects the lung in a murine model of acute respiratory distress syndrome
Authors: Taghavi Sharven , Campbell Alexandra , Engelhardt David , Duchesne Juan , Shaheen Farhana , Pociask Derek , Kolls Jay , Jackson-Weaver Olan 
Published: November 2023

BACKGROUND
Succinate is a proinflammatory citric acid cycle metabolite that accumulates in tissues during pathophysiological states. Oxidation of succinate after ischemia-reperfusion leads to reversal of the electron transport chain and generation of reactive oxygen species. Dimethyl malonate (DMM) is a competitive inhibitor of succinate dehydrogenase, which has been shown to reduce succinate accumulation. We hypothesized that DMM would protect against inflammation in a murine model of ARDS.

METHODS
C57BL/6 mice were given ARDS via 67.7 μg of intratracheally administered lipopolysaccharide. Dimethyl malonate (50 mg/kg) was administered via tail vein injection 30 minutes after injury, then daily for 3 days. The animals were sacrificed on day 4 after bronchoalveolar lavage (BAL). Bronchoalveolar lavage cell counts were performed to examine cellular influx. Supernatant protein was quantified via Bradford protein assay. Animals receiving DMM (n = 8) were compared with those receiving sham injection (n = 8). Cells were fixed and stained with FITC-labeled wheat germ agglutinin to quantify the endothelial glycocalyx (EGX).

RESULTS
Total cell counts in BAL was less for animals receiving DMM (6.93 × 106 vs. 2.46 × 106, p = 0.04). The DMM group had less BAL macrophages (168.6 vs. 85.1, p = 0.04) and lymphocytes (527.7 vs. 248.3; p = 0.04). Dimethyl malonate–treated animals had less protein leak in BAL than sham treated (1.48 vs. 1.15 μg/μl, p = 0.03). Treatment with DMM resulted in greater staining intensity of the EGX in the lung when compared with sham (12,016 vs. 15,186 arbitrary units, p = 0.03). Untreated animals had a greater degree of weight loss than treated animals (3.7% vs. 1.1%, p = 0.04). Dimethyl malonate prevented the upregulation of monocyte chemoattractant protein-1 (1.66 vs. 0.92 RE, p = 0.02) and ICAM-1 (1.40 vs. 1.01 RE, p = 0.05).

CONCLUSION
Dimethyl malonate reduces lung inflammation and capillary leak in ARDS. This may be mediated by protection of the EGX and inhibition of monocyte chemoattractant protein-1 and ICAM-1. Dimethyl malonate may be a novel therapeutic for ARDS.