bluuebunny/crossref_metadata_2025_split huggingface dataset:
Total Thyroidectomy for Benign Thyroid Disorders in an Endemic Region
Authors: Mishra Anjali , Agarwal Amit , Agarwal Gaurav , Mishra S.K. 
Published: August 2002

Abstract.Total thyroidectomy is increasingly being accepted as a treatment of choice for differentiated thyroid cancer. However, because of presumed increased morbidity associated with this procedure, it is still not considered a viable option for management of benign thyroid disorders. To assess the safety and efficacy of total thyroidectomy for management of benign thyroid disorders, we analyzed our data from 127 total thyroidectomies performed for benign thyroid disorders. Demographic details, biochemical findings, indications for operation, specimen weight, and complications were noted. Among these patients, 52 had a toxic goiter and 75 had a nontoxic goiter. The mean duration of the goiters being present was 6.08 ± 6.06 years (0.9–26.0 years), and the mean weight of the specimens was 136.88 ± 120.68 g. The incidence of occult malignancy was 6.3% (n= 8), and those of permanent hypothyroidism and permanent recurrent laryngeal nerve palsy were 1.6% and 0.8%, respectively. Total thyroidectomy should be considered a treatment of choice for multinodular goiter and Graves' disease in a setting of palpable nodule(s) or ophthalmopathy (or both). It is particularly relevant in endemic regions where patients present with a long‐standing, large nodular goiter with virtually no normal thyroid tissue. Reoperation for recurrent goiter in such a setting would be fraught with distressing complications.
Role of the Gut in Multiple Organ Failure: Bacterial Translocation and Permeability Changes
Authors: Swank Gregory M. , Deitch Edwin A. 
Published: August 2002

AbstractIt is clear that increased gut permeability and bacterial translocation play a role in multiple organ failure (MOF). Failure of the gut barrier remains central to the hypothesis that toxins escaping from the gut lumen contribute to activation of the host’s immune inflammatory defense mechanisms, subsequently leading to the autointoxication and tissue destruction seen in the septic response characteristic of MOF. However, the role of the gut is more than that of a sieve, which simply allows passage of bacteria and endotoxin from the gut lumen to the portal or systemic circulation. It appears, in addition, that the translocation of bacteria and endotoxin may lead to local activation of the immune inflammatory system and the local production of cytokines and other immune inflammatory mediators. These intestinally derived mediators may then exacerbate the systemic inflammatory response and potentially lead to a further increase in gut permeability. A vicious cycle of increased intestinal permeability, leading to toxic mediator release, resulting in a further increase in gut permeability is generated. Additionally, the systemic and local inflammatory cells that become activated in the gut contribute to the systemic response characteristic of the sepsis syndrome and MOF. Thus even if the immune inflammatory system, rather than the gut, is the “motor of” MOF, the gut remains one of the major pistons that turns the motor.
Second‐look Surgery after Cytoreduction and Intraperitoneal Chemotherapy for Peritoneal Carcinomatosis from Colorectal Cancer: Analysis of Prognostic Features
Authors: Portilla Alberto Gomez , Sugarbaker Paul H. , Chang David 
Published: August 2002

AbstractAssuming that peritoneal carcinomatosis is a local/regional dissemination of disease, a treatment strategy utilizing cytoreductive surgery and intraperitoneal chemotherapy was developed to treat colon cancer. In an attempt to improve knowledge of the mechanisms controlling abdominal and pelvic recurrences and for better selection of patients for reoperation, we studied those patients who had a second‐look surgery following cytoreduction for peritoneal carcinomatosis from colorectal cancer. A group of 18 patients with symptoms and signs of recurrent peritoneal carcinomatosis were treated with reoperative surgery after definitive cytoreduction and intraperitoneal chemotherapy. An analysis of clinical features of these patients was performed using survival as an endpoint for evaluation of prognosis. The data suggest that the clinical features to be used to select patients for a second‐look procedure after prior cytoreduction were the completeness of resection at the time of initial cytoreduction (p= 0.04) and the completeness of resection at the time of the second look
(p= 0.066). In addition, a limited extent of peritoneal carcinomatosis distribution found at the time of the second look predicted a favorable result. A new objective assessment of peritoneal carcinomatosis, the peritoneal cancer index, was found to be of help during patient selection (p= 0.066). We concluded that second‐look surgery with potential curative intent should be considered in patients who had a complete initial cytoreduction and those in whom total removal of the recurrence is judged possible at the time of the second look. At the time of abdominal exploration, a limited distribution and volume of peritoneal carcinomatosis as defined by the peritoneal cancer index should be considered. Palliative debulking procedures should be used to alleviate symptoms in other patients.RID="" ID="" <E5>Correspondence to:</E5> P.H. Sugarbaker, M.D.
Disasters of Endoscopic Surgery and How to Avoid Them: Error Analysis
Authors: Troidl H. 
Published: August 2002

AbstractFor every innovation there are two sides to consider. For endoscopic surgery the positive side is more comfort for the patient, and the negative side is new complications, even disasters, such as injuries to organs (e.g., the bowel), vessels, and the common bile duct. These disasters are rare and seldom reported in the scientific world, as at conferences, at symposiums, and in publications. Today there are many methods for testing an innovation (controlled clinical trials, consensus conferences, audits, and confidential inquiries). Reporting “complications,” however, does not help to avoid them. We need real methods for avoiding negative failures. The failure analysis is the method of choice in industry. If an airplane crashes, error analysis starts immediately. Humans make errors, and making errors means punishment. Failure analysis means rigorously and objectively investigating a clinical situation to find clinical relevant information for avoiding these negative events in the future. Error analysis has four important steps: (1) What was the clinical situation? (2) What has happened? (3) Most important: Why did it happen? (4) How do we avoid the negative event or disaster in the future. Error analysis has decisive advantages. It is easy to perform; it supplies clinically relevant information to help avoid it; and there is no need for money. It can be done everywhere; and the information is available in a short time. The other side of the coin is that error analysis is of course retrospective, it may not be objective, and most important it will probably have legal consequences. To be more effective in medicine and surgery we must handle our errors using a different approach. According to Sir Karl Popper: “The consituation is that we have to learn from our errors. To cover up failure is therefore the biggest intellectual sin.”
Strategy for Surgical Management of Ileocolonic Anastomotic Recurrence in Crohn's Disease
Authors: Yamamoto Takayuki , Allan Robert N. , Keighley Michael R.B. 
Published: August 2002

Abstract.After resection for ileocecal or ileocolonic Crohn's disease anastomotic recurrence is common, and many patients require further surgery. This study reviews our overall experience of surgery for ileocolonic anastomotic recurrence of Crohn's disease so we can propose a strategy for management. A series of 109 patients who underwent surgery for anastomotic recurrence after ileocecal or ileocolonic resection for Crohn's disease between 1984 and 1997 were reviewed. Ileocolonic recurrence was treated by strictureplasty in 39 patients and resection in 70 (with sutured end‐to‐end anastomosis, 48; stapled side‐to‐side anastomosis, 22). Stapled anastomosis has been frequently used between 1995 and 1997. Short recurrence was mainly treated by strictureplasty, and long or perforating disease was resected. Coexisting small bowel disease was more common in the patients having strictureplasty. Septic complications (leak/fistula/abscess) related to the ileocolonic procedure occurred in 1 of 39 patients (3%) after strictureplasty, in 6 of 48 (13%) after resection with sutured anastomosis, and in none of 22 after resection with stapled anastomosis. The median duration of follow‐up was 90 months after strictureplasty, 105 months after resection with sutured anastomosis, and 22 months after resection with stapled anastomosis. Altogether 18 of 39 patients (46%) after strictureplasty, 22 of 48 (46%) after resection with sutured anastomosis, and none of 22 after resection with stapled anastomosis required further surgery for suture line recurrence. In conclusion, strictureplasty is useful for short ileocolonic recurrence in patients with multifocal small bowel disease or previous extensive resection. Stapled side‐to‐side anastomosis was associated with a low incidence of complications, and early recurrence was not observed, although the duration of follow‐up was short.
Tumors of the Stomach
Authors: Davis Gregory B. , Blanchard D. Kay , Hatch George F. , Wertheimer‐Hatch Laura , Hatch Kathryn F. , Foster Roger S. , Skandalakis John E. 
Published: August 2002

Abstract.This collective review includes all available case reports of smooth muscle (stromal) tumors of the stomach in the world literature from 1762 to 1996. It updates our previous review from 1767 to 1959. Overall, we identified 2189 patients with leiomyoma (LM) and 1594 with leiomyosarcoma (LMS). The peak age of incidence of LM was 50 to 59 years, while LMS was most frequently seen between ages 60 and 69. Women were more likely to develop LM, and men more commonly presented with malignant smooth muscle tumors of the stomach. Concerning the patterns of growth, LMs were more likely to grow intraluminally (endogastric), whereas LMSs were predominantly exogastric. The most common site of LMs was on the anterior or posterior wall of the body of the stomach; LMSs were most likely found along the greater curve. The presenting symptoms of both types of smooth muscle tumors were similar; in decreasing order of frequency they were bleeding, pain, palpable mass, and weight loss. Interestingly, there was no correlation between the size of the tumor and signs or symptoms of bleeding, pain, weight loss, or ulceration, although patients with LMSs were more likely to report weight loss than patients with benign tumors. For LMS, there seemed to be no correlation between tumor size or location and rate of metastasis, although the tumors that grew in a dumbbell shape (i.e., both intraluminally and extraluminally) had a higher frequency of metastasis than other growth patterns. Overall, the rate of metastasis at diagnosis was 35.4%, with the liver, spleen, and regional lymph nodes the most common sites.
In Vitro Elution of Gentamicin, Amikacin, and Ceftiofur From Polymethylmethacrylate and Hydroxyapatite Cement
Authors: Ethell Mark T. , Bennett R. Avery , Brown Murray P. , Merritt Kelly , Davidson Jeffrey S. , Tran Thang 
Published: August 2002

Objective—To compare the elution characteristics of ceftiofur and liquid and powdered gentamicin and amikacin from polymethylmethacrylate (PMMA) and from hydroxyapatite cement (HAC).Methods—PMMA and HAC beads in triplicate were impregnated with various amounts and formulations of antibiotics. Beads were immersed in 5 mL of phosphate buffered saline that was replaced at 1, 3, 6, and 12 hours, and 1, 2, 3, 5, 7, 10, 14, 18, 22, 26, and 30 days. The eluent was stored at −70°C until assayed within 2 weeks by microbiological assay (gentamicin and amikacin) or capillary electrophoresis (ceftiofur).Results—Rate of elution for all beads was greatest within the first 24 hours. Cumulative release of total antibiotic dose from beads over 30 days was significantly greater from HAC than PMMA. Antibiotic elution was directly related to the amount of antibiotic incorporated into the cement. Powdered and liquid forms of gentamicin had similar elution rates from PMMA. Elution of amikacin from PMMA beads was greater when the powdered form was used compared with liquid amikacin. Eluent concentrations of ceftiofur were similar to those of the aminoglycosides during the first 3 to 7 days but then decreased precipitously by comparison.Conclusions—Elution of antibiotics from HAC was greater than from PMMA. Gentamicin‐ and amikacin‐impregnated PMMA and HAC released bactericidal concentrations of antibiotic for at least 30 days. Ceftiofur‐impregnated PMMA or HAC is unlikely to provide long‐term bactericidal concentrations.Clinical Relevance—Gentamicin and amikacin elute effectively from PMMA and HAC.
Surgical Management of Intrathoracic Tracheal Avulsion in Cats: Long‐Term Results in 9 Consecutive Cases
Authors: White Robert N. , Burton Carolyn A. 
Published: August 2002

Objective— To evaluate the outcomes and complications in a consecutive series of cats undergoing surgical repair of intrathoracic tracheal avulsion injuries.Study Design— Retrospective clinical study.Animals— Nine client‐owned cats.Methods— The medical records of all cats undergoing surgical repair of intrathoracic tracheal avulsion injuries from 1994 to 1997 were reviewed. The results of physical examination, laboratory evaluations, radiography, tracheoscopy, surgery, and patient follow‐up were reviewed. Complications that arose and long‐term outcome were noted.Results— Long‐term resolution of clinical signs was achieved in all cats after resection of the damaged trachea and its repair by end‐to‐end anastomosis. Follow‐up periods ranged from 12 months to 2.9 years. One cat developed unilateral left‐sided laryngeal paralysis 2 to 3 months after surgery; however, this was transient and resolved without intervention within 6 months of surgery.Conclusions— Surgical management of intrathoracic tracheal avulsion injuries in cats can be accomplished via a right lateral thoracotomy. Careful anesthetic technique is an integral part of the surgical procedure if a successful outcome is to be achieved. The incidence of both short‐term and long‐term complications was low. Care should be exercised to visualize and protect the left recurrent laryngeal nerve if postoperative iatrogenic unilateral left‐sided laryngeal paralysis is to be prevented.Clinical Relevance— This retrospective study documents the successful surgical correction of a series of clinical cases of intrathoracic tracheal avulsion in cats.
Measures to Prevent and Control COVID-19 in Skilled Nursing Facilities
Authors: Canter Benjamin E. , Ulyte Agne , McGarry Brian E. , Barnett Michael L. 
Published: January 2025

ImportanceSkilled nursing facilities (SNFs) experienced high mortality during the COVID-19 pandemic, leading them to adopt preventive measures to counteract viral spread. A critical appraisal of these measures is essential to support SNFs in managing future infectious disease outbreaks.ObjectiveTo perform a scoping review of data and evidence on the use and effectiveness of preventive measures implemented from 2020 to 2024 to prevent COVID-19 infection in SNFs in the US.Evidence ReviewTwo analyses were performed. First, an analysis of the federal COVID-19 SNF Database was conducted to describe time trends in COVID-19 incidence, deaths, testing, vaccination, and treatment among SNF residents and staff, as well as shortages in staff and personal protective equipment (PPE). Then, a comprehensive literature search was conducted from May 2023 to April 2024 to identify high-quality evidence on the use and effectiveness of modifiable preventive measures used among SNF residents. Both nonpharmacologic (facility characteristics, PPE, cohorting, and isolation, visitation, staffing, testing) and pharmacologic (vaccination, treatment) measures were reviewed.FindingsNationwide data indicated early shortages of PPE, infrequent testing, and persistent staff shortages in SNFs. Other nonpharmacologic measures, such as visitor restrictions or ventilation modifications, were widely adopted but there were no available national data to quantify their effectiveness. These nonpharmacologic measures lacked high-quality studies to verify effectiveness. In contrast, the effectiveness of vaccination and antiviral treatment was shown in multiple studies. Evidence also showed associations between COVID-19 outcomes in residents and crowding, staff size, hours per residents and networks, and surveillance testing of residents and staff. Despite high initial uptake, up-to-date vaccination status was suboptimal in residents and staff from 2022 to 2024. Only a minority of infected residents received antiviral treatment.Conclusions and RelevanceThis scoping review found that although many preventive measures were implemented in SNFs in the US throughout the COVID-19 pandemic, few were based on clear evidence of their effectiveness. Pharmacologic measures, such as vaccination and antiviral treatment, had more robust evidence supporting their efficacy than nonpharmacologic interventions. Using the scarce resources and staff of SNFs on measures of questionable effectiveness could distract from known effective ones such as vaccination and antiviral treatment. When possible, implementation efforts should be commensurate with the demonstrated effectiveness of available preventive measures.
Survival Among Patients With ERBB2-Positive Metastatic Breast Cancer and Central Nervous System Disease
Authors: Ferraro Emanuela , Reiner Anne S. , Bou Nassif Rabih , Tosi Umberto , Brown Samantha , Zeller Sabrina , Dang Chau T. , Seidman Andrew D. , Moss Nelson S. 
Published: January 2025

ImportanceApproximately one-third of patients with ERBB2 (formerly HER2 or HER2/neu)–positive (ERBB2+) metastatic breast cancer (MBC) develop brain metastasis. It is unclear whether patients with disease limited to the central nervous system (CNS) have different outcomes and causes of death compared with those with concomitant extracranial metastasis.ObjectiveTo assess overall survival (OS) and CNS-related mortality among patients with ERBB2+ breast cancer and a diagnosis of CNS disease by disease distribution (CNS only vs CNS plus extracranial metastasis).Design, Setting, and ParticipantsThis single-center, retrospective cohort study included patients with ERBB2+ MBC and CNS disease, including parenchymal brain metastasis, leptomeningeal disease (LMD), or dural metastasis, who were treated between August 2010 and April 2022 at Memorial Sloan Kettering Cancer Center. Data were analyzed between December 2023 and August 2024.Main Outcomes and MeasuresOverall survival, estimated with the Kaplan-Meier method, and CNS-related mortality with cumulative incidence.ResultsThe cohort included 274 patients (272 [99.3%] female). The median age was 53.7 years (range, 28.7-87.4 years); 125 patients (45.6%) presented with de novo MBC. At CNS metastasis diagnosis, 73 (26.6%) presented with CNS-only disease. There was a median follow-up of 3.7 years (range, 0.2-12.0 years) from CNS disease diagnosis among those alive at the end of follow-up. Both OS and CNS-related death were significantly correlated with the pattern of presentation: OS was shortest among patients with LMD (1.24 years; 95% CI, 0.89-2.08 years) followed by those with extracranial metastasis (2.16 years; 95% CI, 1.87-2.58 years) and was longest among patients with parenchymal or dural CNS disease only (3.57 years; 95% CI, 2.10-5.63 years) (P = .001). Of 192 patients (70.1%) who died, 106 (55.2%) died of a CNS-related cause. The group with CNS-only disease remained at high risk of death from CNS causes, with a 3-year CNS-related death rate of 33.98% (95% CI, 22.84%-45.43%) and a 3-year death rate from other causes of 6.07% (95% CI, 1.93%-13.69%). On multivariable modeling for CNS-related death, LMD (hazard ratio, 1.87; 95% CI, 1.19-2.93; P = .007) and treatment with whole-brain radiotherapy (hazard ratio, 1.71; 95% CI, 1.13-2.58; P = .01) were associated with CNS-related death.Conclusions and RelevanceIn this cohort study, 55.2% of deaths among patients with ERBB2+ breast cancer and brain metastasis were due to CNS-related causes, with the greatest risk among patients with LMD. CNS-only presentation was associated with improved survival but a higher rate of CNS-related death, supporting an approach of aggressive local therapy for select patients.
Inorganic Nanoscintillators: Current Trends and Future Perspectives
Authors: Dujardin Christophe , Bessière Aurélie , Bulin Anne‐Laure , Chaput Frédéric , Mahler Benoit 
Published: January 2025

AbstractThis review explores the potential of inorganic nanoscintillators for applications in detection, imaging, and therapy. It begins by comparing scintillation mechanisms in bulk materials versus nanocrystals, highlighting key differences related to characteristic interaction distances. The review then focuses on the synthesis and preparation of doped insulators, including oxides and fluorides, as well as semiconductor quantum dots. Finally, the last section discusses various applications where scintillating nanocrystals can offer significant advantages.
Stimuli‐Responsive Core‐Shell Electrospun Nanofibers for Drug Delivery: A Mini‐Review
Authors: Xie Songpei , Zhang Jing , Orf Chase , Byars Allison , Zhu Mengfan 
Published: January 2025

ABSTRACTCore‐shell nanofibers have the potential to surpass traditional monolithic electrospun nanofibers in drug delivery, due to their ability to encapsulate sensitive therapeutics within the core, protect them from degradation, and enable controlled release profiles through the shell. When designed to be stimuli‐responsive, these nanofibers evolve to “smart” drug delivery platforms for advanced therapeutic applications. This mini‐review examines recent advancements in the fabrication and applications of stimuli‐responsive core‐shell nanofibers. Key fabrication techniques, such as coaxial electrospinning, single‐nozzle electrospinning using water‐in‐oil or oil‐in‐water emulsions or using immiscible blends (e.g., polyethylene oxide and chitosan; polyvinylpyrrolidone and polyvinylidene), needleless electrospinning, and post‐fabrication coating methods, are discussed along with their respective advantages and limitations. Additionally, the review also explores how these nanofibers can be engineered to respond to stimuli like near‐infrared (NIR) light, ultrasound, temperature, and pH changes. Representative examples illustrate their ability to reduce initial burst release, enable on‐demand chemodrug delivery, and implement photothermal therapy against cancer cells. At the end, we offer perspectives on the challenges, opportunities, and new directions for future development.
Open‐Source Tools for Assessing Cytoskeleton Properties in Pathological Conditions From Microscopy Images: An Application Note
Authors: Petrou Magdalini , Stylianou Andreas 
Published: January 2025

ABSTRACTThe cytoskeleton is a multiplex network of different proteins and filaments and is involved in a variety of important functions. Nevertheless, its deregulation leads to various diseases. Cells' cytoskeleton characteristics and structures can be accessed with image analysis tools. Our purpose, therefore, was to identify relevant freeware tools that can be used for assessing cytoskeleton characteristics from microscopy images and create an application note for them. The tools covered in this application note are the ImageJ/Fiji, FilamentSensor, and Ilastik software. These three softwares are presented and described regarding their uses, features and other characteristics, and examples of using this software for analyzing the cell cytoskeleton are provided. These tools might contribute to the advancement of biological research and the enhancement of therapeutic outcomes, particularly regarding pathological conditions, suggesting further development and adoption of open‐source tools in the scientific community.