bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcomes with chemotherapy in carcinoma penis: Experience from a tertiary cancer center
Authors: Mailankody Sharada , Radhakrishnan Venkatraman , Raja Anand , Ganesan Trivadi S. , Dhanushkodi Manikandan , Sagar Tenali Gnana 
Published: September 2023

Background:
Carcinoma penis is more common in India compared to the West. The role of chemotherapy in carcinoma penis is ambiguous. We analyzed the profile and outcomes of patients with carcinoma penis treated with chemotherapy.

Methods:
We analyzed the details of all patients with carcinoma penis treated at our institute between 2012 and 2015. We collected particulars regarding demography, clinical presentation, treatment details, toxicities, and outcomes of these patients. Event-free and overall (OS) survival were calculated from the time of diagnosis until documentation of disease relapse/progression or death for the patients with advanced carcinoma penis who were eligible for chemotherapy.

Results:
There were 171 patients with carcinoma penis treated at our institute during the study period including 54 (31.6%) patients with stage I, 49 (28.7%) patients with stage II, 24 (14.0%) patients with stage III, 25 (14.6%) patients with stage IV, and 19 (11.1%) patients with recurrent disease at presentation. The present study included 68 patients with advanced carcinoma penis (stages III and IV) who were eligible for chemotherapy, with a median age of 55 years (range: 27–79 years). Sixteen patients received paclitaxel and carboplatin (PC) and 26 patients cisplatin and 5-FluoroUracil (CF). Neoadjuvant chemotherapy (NACT) was given to four patients with stage III and nine patients with stage IV disease. Of the 13 patients given NACT, we observed a partial response in five (38.5%), stable disease in two (15.4%), and progressive disease in five (38.5%) evaluable patients. Six (46%) patients underwent surgery after NACT. Only 28/54 (52%) patients received adjuvant chemotherapy. After a median follow-up of 17.2 months, the 2-year OS rates were 95.8, 89, 62.7, 51.9, and 28.6% for stages I, II, III, IV, and recurrent disease, respectively. The 2-year OS of patients who were given chemotherapy versus those who were not given chemotherapy were 52.7 and 63.2%, respectively (P = 0.762).

Conclusions:
We report the real-world outcomes of two chemotherapeutic regimens used in consecutive patients with advanced carcinoma penis. Both PC and CF seemed effective and safe. However, approximately half of patients with advanced carcinoma penis do not receive the planned/indicated chemotherapy. We need further prospective trials regarding the sequencing, protocols and indications of chemotherapy in this malignancy.
Acetic acid versus toluidine blue as screening tools for oral potentially malignant disorders
Authors: Winton Kalluvelil San Rose , Narayanan Veena S. 
Published: September 2023

Background:
Diagnostic adjuncts such as toluidine blue have been investigated as screening tools that improve visual examination of potentially malignant disorders (PMD) and oral cancer. Acetic acid has been reported to be of value in the early detection of cervical cancers. This study assessed the utility of 5% acetic acid as a diagnostic adjunct in oral PMD and compared the accuracy of acetic acid with toluidine blue in the detection of dysplastic PMD and high-risk lesions.

Materials and Methods:
This cross-sectional study was conducted at a dental hospital in a rural setting. Thirty-one patients with oral PMD formed the study group. Five percent acetic acid was applied to the lesions, followed by toluidine blue application and biopsy. Sensitivity, specificity, and positive and negative predictive values were computed considering true positives as stain uptake in dysplastic and high-risk PMD.

Results:
The sensitivity, specificity, and positive and negative predictive values of acetic acid for identifying dysplastic or malignant lesions were 100%, 13.3%, 51.2%, and 100%, respectively, and that for toluidine blue were 75%, 100%, 100%, and 78.9%, respectively. The corresponding values for identifying high-risk PMD (lesions with moderate and severe dysplasia) using acetic acid were 100%, 9.1%, 25.9%, and 100%, respectively, and for toluidine blue were 85.7%, 81.8%, 60%, and 94.7%, respectively.

Conclusion:
The utility of acetic acid in detecting dysplasia and high-risk PMD is severely limited due to its poor specificity. Compared with acetic acid, toluidine blue is a superior screening tool.
Time Spent in Physical Activity by Ambulatory Stroke Patients and its Comparison Based on Gait Speed – A Pilot Study
Authors: Soni Mansi , Muruganantham Balaganapathy 
Published: September 2023

Abstract

Introduction:
Physical activity is proven to have beneficial effects in the prevention and management of stroke. This makes it an important modifiable risk factor Stroke is a condition resulting in various functional deficits. The higher functional ability of stroke patients may result in their higher physical activity. Gait speed is a functional parameter to differentiate between the ability of mobility of patients with stroke. However, if it is reflected in the time spent in an activity needs to be explored.

Objectives:
This pilot study attempts to explore time spent in PA by ambulatory stroke patients and compare time spent in different activity levels based on gait speed.

Subjects and Methods:
This pilot study recruited 26 ambulatory patients with stroke after obtaining informed consent. Their PA was recorded with ActiGraph wGT3X-BT for 1 day. Differences in time spent in the different level of PA were compared between people with gait speed ≤0.49 m/s and >0.49 m/s.

Results:
The result of the study shows that patients with stroke having gait speed ≤0.49 m/s had higher time spent in sedentary (686.02 ± 80.35 min/day) and light activity (612 ± 69.84 min/day) as compared to those with >0.49 m/s (646.42 ± 137.52 min/day and 593.57 ± 119.95 min/day, respectively). While time spent in moderate activity was higher in patients with stroke having gait speed >0.49 m/s (199.73 ± 111.17 min/day) as compared to those whose gait speed was ≤0.49 m/s (141.84 ± 76.75 min/day). However, this difference failed to demonstrate statistical significance.

Conclusion:
Patients with stroke were less physically active as compared to recommendations. Gait speed-based comparison demonstrates a nonsignificant difference between both groups. This suggests that factors other than gait speed may contribute to ambulatory stroke patients’ time spent in PA.
Neglected Locally Advanced Breast Cancer: Ignorance is a Curse
Authors: Tripathi Mayank , Yadav Avadhesh Kumar , Sahu Rajendra Kumar , Pavithira G. J. 
Published: September 2023

Abstract
Breast cancer is the most common cancer worldwide. As per GLOBOCAN 2020, female breast cancer is the most commonly diagnosed cancer (11.7% of total cases). In India, like any other cancer, breast cancer patients present late to the clinic with more than 60% presenting in Stage 3rd and 4th, of these 25% of locally advanced breast cancers develop a fungating breast lesion causing significant distress for the patient, physically, mentally, as well as socially. The subset of patients with locally advanced fungating mass poses a big challenge to the treating surgeon. In this case report, a locally advanced fungating breast cancer weighing 7.5 kg was removed by surgery.
Role of Medical Thoracoscopy in Undiagnosed Exudative Pleural Effusion – An Experience in Tuberculosis and Chest Diseases Center in South India
Authors: Mani Saravanan , Ramesh P. M. , Sagindar S. 
Published: September 2023

Background:
In any exudative pleural effusion, most of the times, the commonly identified etiology could be either tuberculosis or malignancy in our Centre. In our experience, usually pleural effusion diagnosed as probably of tuberculous etiology were straw coloured, exudative effusion with ADA above 45 and those diagnosed as malignancy were exudative, straw colored or hemorrhagic effusion with positive cytology for malignant cells. When this criteria were not met, we looked for additional investigations to find etiology of pleural effusion. So we utilized Medical Thoracoscopy to identify the etiology and presented here our experience with Medical Thoracoscopy in such cases. Aim and

Objective:
The aim of the study was to examine the diagnostic yield of Medical Thoracoscopy in undiagnosed exudative pleural effusion.

Material and Methods:
This retrospective study was carried out at the Govt Thiruvotteeswarar Hospital of Thoracic Medicine in Chennai. we analyzed all the case sheets and Thoracoscopy procedure records of patients with undiagnosed pleural effusion, who were subjected to Medical Thoracoscopy in our Centre from January 2019 to December 2019. It included 25 patients with undiagnosed pleural effusion. We collected demographic details, symptoms, smoking history, CT chest findings and Medical Thoracoscopic findings, brush/biopsy reports from the records. Pleural fluid analysis reports were also analyzed.

Results:
The present study included 14 men and 11 women patients, with a mean age of 54.4 ± 16.16 years. Dyspnea was the most common presenting symptom (96%) followed by cough (84%) among the studied patients. Seventeen (70.8%) patients had right-sided pleural effusion. The diagnostic yield of Medical Thoracoscopy among the studied patients was 68 %. The histopathological yield of Thoracoscopic pleural biopsies was as follows: 10 (40%) malignant cases and 7 (28%) patients with tuberculous pleural effusion. There were eight (32%) patients who were not diagnosed. The post-thoracoscopic complications in this study occurred only in seven (28%) patients, which were pain, surgical emphysema and trapped lung.

Conclusion:
Medical Thoracoscopy is an additional diagnostic procedure which can improve our diagnostic yield in undiagnosed pleural effusions. It is a safe procedure which can be done under conscious sedation and local anaesthesia. Wherever the facility is available, it can be utilized to find out etiology of pleural effusion.
Electrodiagnostic Features of Sciatic Neuropathy: Six-year Referral Center Experience
Authors: Yildiz Fatma Gokcem , Uzuncakmak-Uyanik Handan , Aghamirzayeva Khayala , Temucin Cagri Mesut 
Published: September 2023

ABSTRACT

Introduction:
Sciatic neuropathy is one of the most important neuropathies of the lower extremity. Although electromyography (EMG) is useful for detecting and localizing neurologic damage, assessing the severity of neuropathy, determining prognoses, and detecting confounding or accompanying neurologic pathologies, electrodiagnostic analyses of sciatic neuropathy are rare in the literature.

Methods:
The EMG database between 2017 and 2022 was reviewed. Neurophysiologic data of 58 patients who were electrophysiologically diagnosed as having sciatic neuropathy were included in the study. The adult patient group was divided into three groups, injection trauma, noninjection trauma, and other etiologies for subgroup analyze. Pediatric patients were not divided into subgroups because of their limited number.

Results:
Sciatic neuropathy was found in nine patients in the pediatric group, and 48 patients in the adult group. Sciatic neuropathy was left sided in six (66.7%) pediatric patients and 25 (52%) adult patients. It was bilateral in one adult patient. There was no significant difference between the groups in terms of nerve conduction studies. No statistically significant difference was found in the needle EMG of the gastrocnemius medialis, tibialis anterior (TA), and biceps femoris short-head muscles (P = 0.78, P = 0.32, and P = 0.14, respectively). In both injection and noninjection trauma patients, the most common needle EMG findings in the gastrocnemius medialis muscle were detected as grade 2. Grades 3 and 4 findings were observed predominantly in peroneal division innervated TA and biceps femoris short-head muscles.

Conclusion:
The most common etiology of sciatic neuropathy in adults was injection-related trauma. The peroneal division is more prone to injury in sciatic neuropathy in the context of sciatic variations. Consequently, we considered that the degree of damage in noninjection traumas might be higher in both distal and proximal segments compared with injection traumas.
Tuberculosis Knowledge among Persons Living with HIV Attending a Tertiary Hospital in Lima, Peru
Authors: Paredes Jose Luis , Navarro Rafaella , Echevarria Juan , Seas Carlos , Prochazka Mateo , Otero Larissa 
Published: October 2023

ABSTRACT.
Tuberculosis (TB) is the leading cause of death among people living with HIV (PLWH). Limited TB knowledge has been associated with delayed TB diagnosis and low adherence to TB treatment. A cross-sectional study was conducted among PLWH at the largest HIV-referral center in Lima, Peru, to describe TB knowledge among PLWH and potential associated sociodemographic factors. Participants answered a self-administered survey on TB knowledge, which consisted of five questions about TB cure, transmission, treatment, symptoms, and prevention. Of 179 PLWH enrolled, most participants did not know that isoniazid (85%) and antiretrovirals (78%) are preventive measures for TB, and 56 (31.3%) knew that TB can be asymptomatic in PLWH. We did not find statistical differences in TB knowledge based on gender, education, marital status, and time on HIV care. We identified important gaps in TB knowledge among PLWH. Addressing these gaps could empower PLWH to reduce their TB risk.
Engagement with Traditional Healers for Early Detection of Plague in Uganda
Authors: Apangu Titus , Candini Gordian , Abaru Janet , Candia Bosco , Okoth Felix J. , Atiku Linda A. , Griffith Kevin S. , Hayden Mary H. , Zielinski-Gutiérrez Emily , Schwartz Amy M. , McCormick David W. , Mead Paul S. , Kugeler Kiersten J. 
Published: October 2023

ABSTRACT.
In rural Uganda, many people who are ill consult traditional healers prior to visiting the formal healthcare system. Traditional healers provide supportive care for common illnesses, but their care may delay diagnosis and management of illnesses that can increase morbidity and mortality, hinder early detection of epidemic-prone diseases, and increase occupational risk to traditional healers. We conducted open-ended, semi-structured interviews with a convenience sample of 11 traditional healers in the plague-endemic West Nile region of northwestern Uganda to assess their knowledge, practices, and attitudes regarding plague and the local healthcare system. Most were generally knowledgeable about plague transmission and its clinical presentation and expressed willingness to refer patients to the formal healthcare system. We initiated a public health outreach program to further improve engagement between traditional healers and local health centers to foster trust in the formal healthcare system and improve early identification and referral of patients with plaguelike symptoms, which can reflect numerous other infectious and noninfectious conditions. During 2010–2019, 65 traditional healers were involved in the outreach program; 52 traditional healers referred 788 patients to area health centers. The diagnosis was available for 775 patients; malaria (37%) and respiratory tract infections (23%) were the most common diagnoses. One patient had confirmed bubonic plague. Outreach to improve communication and trust between traditional healers and local healthcare settings may result in improved early case detection and intervention not only for plague but also for other serious conditions.
Vaccination of Rabbits with a Cholera Conjugate Vaccine Comprising O-Specific Polysaccharide and a Recombinant Fragment of Tetanus Toxin Heavy Chain Induces Protective Immune Responses against Vibrio cholerae O1
Authors: Kelly Meagan , Jeon Suhi , Yun Jeesun , Lee Byungman , Park Minchul , Whang Yoonhee , Lee Chankyu , Charles Richelle C. , Bhuiyan Taufiqur R. , Qadri Firdausi , Kamruzzaman Mohammad , Cho Somyoung , Vann Willie F. , Xu Peng , Kováč Pavol , Ganapathy Ravi , Lynch Julia , Ryan Edward T. 
Published: October 2023

ABSTRACT.
There is a need for next-generation cholera vaccines that provide high-level and durable protection in young children in cholera-endemic areas. A cholera conjugate vaccine (CCV) is in development to address this need. This vaccine contains the O-specific polysaccharide (OSP) of Vibrio cholerae O1 conjugated via squaric acid chemistry to a recombinant fragment of the tetanus toxin heavy chain (OSP:rTTHc). This vaccine has been shown previously to be immunogenic and protective in mice and found to be safe in a recent preclinical toxicological analysis in rabbits. We took advantage of excess serum samples collected as part of the toxicological study and assessed the immunogenicity of CCV OSP:rTTHc in rabbits. We found that vaccination with CCV induced OSP-, lipopolysaccharide (LPS)-, and rTTHc-specific immune responses in rabbits, that immune responses were functional as assessed by vibriocidal activity, and that immune responses were protective against death in an established virulent challenge assay. CCV OSP:rTTHc immunogenicity in two animal model systems (mice and rabbits) is encouraging and supports further development of this vaccine for evaluation in humans.
Approach to a Child with Bilateral Proptosis as a Rare Presentation of Acute Myeloid Leukemia
Authors: Tanveer Shafiq , Khilji Maryum , Hassan Rao , Tanveer Safina , Khilji Ayesha 
Published: October 2023

A 6-year-old girl presented with a 2-month history of sudden onset, painless, progressively increasing bilateral proptosis, palpable lymphadenopathy and skin pallor. A full blood count showed bicytopenia and the erythrocyte sedimentation rate (ESR) was raised. Computerized tomography (CT) scan showed bilateral lacrimal gland enlargement. The bone marrow biopsy was consistent with M2 acute myeloid leukemia (AML). The patient received symptomatic treatment and was sent to pediatric oncologist for induction chemotherapy and tumor lysis syndrome (TLS) protocol. Bilateral proptosis is a rare manifestation of several diseases. This case report emphasizes on the low threshold for hematological malignancies in the presentation of bilateral proptosis. Ophthalmologists should be cognizant of the unusual ophthalmic manifestations of haematological malignancies, as they are a diagnostic challenge but knowledge about the rare extramedullary manifestations of AML facilitates early diagnosis and thereby improves prognosis.
Categories: Ophthalmology, Pediatrics, Hematology
Skateboarding
Authors: Beal Becky 
Published: October 2023

From skateboarding's distant origins in the 1940s to the heyday of the Z-Boys to Tony Hawk's lifelong and lucrative career as a professional skateboarding icon, this book showcases what skateboarding was in the past and what it's now evolved into.
In the last half century, skateboarding has evolved from a simple, idyllic child's pastime that originated in southern California to becoming a worldwide youth culture phenomenon. This now-mainstream action sport has spawned a multi-billion-dollar commercial market for skateboarding equipment, skateboard-related media and entertainment, as well as skate-inspired softgoods like clothing, shoes, and accessories; and it is likely to soon become an Olympic sport.
Skateboarding: The Ultimate Guide is brimming with fascinating history and engaging stories from skateboarding's 60-odd year existence and evolution. Covering the action sport's origins, myriad breakthrough developments, pioneering heroes, both "street style" and "vert" or ramp skating, unique popular culture, and likely future, this book will delight anyone with an interest in this individualistic and compelling athletic pursuit.
Sonia Sotomayor
Authors: Greene Meg 
Published: October 2023

This insightful biography introduces readers to Justice Sonia Sotomayor, a remarkable woman with a single-minded pursuit of educational excellence, who rose from poverty in a Bronx housing project to a seat on the U.S. Supreme Court.
Sonia Sotomayor: A Biography is an overview of Justice Sotomayor’s life and career from her childhood to her ascent to the Supreme Court. It is also an early assessment of her performance on the court, her relationships with her colleagues, and the particular influence she is likely to exert on future decisions.
Sharing an inspirational, rags-to-riches story, the book begins with Sotomayor’s childhood in an East Bronx housing project. It follows her to Princeton, where she was a student activist, and to Yale Law School. Equally important to an understanding of this influential judge is the discussion of her career as a prosecutor for the City of New York and as a judge in the District Court for the Southern District of New York and the Second Circuit Court. Examining her reputation as a tough but fair jurist, the book explores the influence of these years which, at the time of her appointment, established her as the only Supreme Court justice with experience as a trial judge.
Transgender Health Issues
Authors: Boslaugh Sarah 
Published: October 2023

Although transgender individuals have always existed, their fight for acceptance and equal rights is just beginning. Within this larger context, one area of emerging concern is their health—physical, psychological, and social. From legislation determining public restroom access to insurance coverage of hormone therapy for transitioning individuals to harassment and discrimination, transgender people face a number of challenges that can negatively affect their well-being.
A part of Greenwood's Health and Medical Issues Today series, Part I of this book explores definitions of sex and gender, the history of transgender awareness and activism, physical and psychological health concerns specific to transgender individuals, and how identifying as transgender can have different effects on individuals' health at different stages in their life. Part II examines issues and controversies related to the health and well-being of transgender individuals. Part III provides a variety of useful materials, including case studies, a timeline of critical events, a glossary, and a directory of resources.
Vaccines
Authors: Davidson Tish 
Published: October 2023

What is a vaccine and how does it work? How are vaccines made? Who discovered vaccines? What diseases do vaccines prevent, are these vaccines effective, and are they safe? Presenting comprehensive information on a topic that remains the focus of considerable controversy, Vaccines: History, Science, and Issues provides readers with a single-volume examination of vaccines and their history, production, uses, and limitations.
Written in language that avoids intimidating medical jargon, this latest addition to Greenwood's Story of a Drug series looks at different types of vaccines and documents the value of vaccination to society. It explains the process of developing a vaccine, the testing required before it can be distributed to the public, and the challenges that arise in manufacturing and distribution, along with potential solutions to some of these problems. Readers will gain insight into vaccination-related topics such as the legal issues surrounding mandatory vaccination, the relationship between vaccines and adverse events, and the government's role in adjudicating claims of damage. The book also includes international recommendations from the World Health Organization and information on vaccines that are available and used outside the United States.