bluuebunny/crossref_metadata_2025_split huggingface dataset:
Current Concepts in the Management of Neurogenic Thoracic Outlet Syndrome: A Review
Authors: Khabyeh-Hasbani Nathan , Connors Katherine , Buksbaum Joshua R. , Koehler Steven K. 
Published: March 2023

Background:
Thoracic outlet syndrome is a constellation of signs and symptoms due to compression of the neurovascular bundle of the upper limb. In particular, neurogenic thoracic outlet syndrome can present with a wide constellation of clinical manifestations ranging from pain to paresthesia of the upper extremity, resulting in a challenge to correctly diagnose this syndrome. Treatment options range from nonoperative treatment, such as rehabilitation and physical therapy, to surgical correction, such as decompression of the neurovascular bundle.

Methods:
Following a systematic review of the literature, we describe the need for a thorough patient history, physical examination, and radiologic images which have been reported to correctly diagnose neurogenic thoracic outlet syndrome. Additionally, we review the various surgical techniques recommended to treat this syndrome.

Results:
Postoperative functional outcomes have been shown to be more favorable in arterial and venous thoracic outlet syndrome (TOS) patients when compared with neurogenic TOS patients, likely due to the ability to completely remove the site of compression in cases of vascular TOS as compared with incomplete decompression in neurogenic TOS.

Conclusions:
In this review article, we provide an overview of the anatomy, etiology, diagnostic modalities, and current treatment options of correcting neurogenic TOS. Additionally, we offer a detailed step-by-step technique of the supraclavicular approach to the brachial plexus, a preferred approach for decompressing neurogenic TOS.
Oocytes collected from small follicles after a dual trigger with gonadotropin-releasing hormone agonist (Gn-RHa) and human chorionic gonadotropin (hCG) for final oocyte maturation, in poor responder patient do not impact negatively ICSI cycles outcomes
Authors: Barbara Samira , Oumeziane Amina , Nanouche Fatima , Djerroudib Karima , Boucekine Nadjia , Chabane N. , Tazairt Nawal , Lacheheb Ahlem , Chemoul Samia , Bourihane Rachida , Mouhoub Samia , Devroey Paul 
Published: March 2023

Introduction:
Follicles (FOs) of 16–22 mm produce more mature oocytes compared with small FOs as reported. In patients with poor ovarian response, late trigger results in premature luteinization, and an early trigger increases the number of immature oocytes. The purpose of this study was to demonstrate that metaphase II oocytes collected from FO of 11–15 mm results in similar pregnancy outcomes as metaphase II of oocytes collected from FO >16 mm when a dual trigger is used in patients with poor ovarian response.

Materials and method:
This was a prospective cohort study. A total of 122 patients were included according to the Bologna criteria for “poor ovarian responders”. From 2018 to 2020, controlled ovarian stimulation using antagonist protocols was used for ovarian stimulation. Two-dimensional ultrasound combined with hormonal assessment were used to monitor ovarian stimulation. Ovulation was induced with 0.2 mg gonadotropin-releasing hormone agonist and 5000 IU human chorionic gonadotropin when at least 1 FO ≥16 mm; 36 hours later, oocyte retrieval was performed. FO were collected separately. For all laboratory steps, oocytes were treated according to size FO. A single cleavage stage embryo was transferred. The luteal phase was supported with micronized progesterone. Excess embryos were cryopreserved according to FO size. If pregnancy did not occur, a single frozen embryo was replaced. Two groups of punctate FOs were analyzed: group 1 (G1) =246 FO size 11–15 mm, group 2 (G2) =238 FO size ≥16 mm.

Results:
In all, 122 cycles were started, 27 were cancelled. Forty-six fresh embryo transfers in G1 and 49 in G2 were performed, 31 frozen embryo transfers for G1 and 10 for G2. There were no significant differences in fertilization rate, clinical pregnancy rate (CPR), and live birth rate. Logistic regression adjusting the CPR to FO size and other influencing factors revealed no predictors for CPR and live birth rate.

Conclusion:
Study showed similar pregnancy outcomes regardless of FO size.
Primary Retinal Detachment Outcomes Study: summary of reports number 1 to number 18
Authors: Starr Matthew R. , Ryan Edwin H. , Yonekawa Yoshihiro 
Published: March 2023

Purpose of review
To highlight the recent work published from the Primary Retinal Detachment Outcomes (PRO) Study Group.

Recent findings
The PRO database was a large dataset made up of patients with primary rhegmatogenous retinal detachments (RRD) who had surgical repair during 2015. The database was constituted of nearly 3000 eyes from 6 centers across the United States and included 61 vitreoretinal surgeons. Nearly 250 metrics were collected for each patient, creating one of the richest datasets of patients with primary rhegmatogenous detachments and their outcomes. The importance of scleral buckling was demonstrated, particularly for phakic eyes, elderly patients, and those with inferior breaks. 360° laser may result in poorer outcomes. Cystoid macular edema was common, and risk factors were identified. We also found risk factors for vision loss in eyes presenting with good vision. A PRO Score was devised, to predict outcomes based on presenting clinical characteristics. We also identified characteristics of surgeons with the highest single surgery success rates. Overall, there were no major outcome differences between viewing systems, gauges, buckles sutured vs. scleral tunnels, drainage method, and techniques to address proliferative vitreoretinopathy. All incisional techniques were found to be very cost-effective treatment modalities.

Summary
Numerous studies resulted from the PRO database that significantly added to the literature regarding the repair of primary RRDs in the current era of vitreoretinal surgery.
Recent advances in the management of proliferative diabetic retinopathy
Authors: Pandit Saagar , Ho Allen C. , Yonekawa Yoshihiro 
Published: March 2023

Purpose of review
The prevalence of diabetic retinopathy continues to rise. This review highlights advances in imaging, medical, and surgical management of proliferative diabetic retinopathy (PDR) in recent years.

Recent findings
Ultra-widefield fluorescein angiography has been shown to better characterize which patients have predominantly peripheral lesions and who may advance to more advanced forms of diabetic retinopathy. This was well demonstrated in DRCR Retina Network's Protocol AA. Protocol S demonstrated that antivascular endothelial growth factor (VEGF) treatment alone can be useful in the management of select PDR patients – particularly those without high-risk features. However, a growing body of literature highlights how lapse in care is a significant concern in PDR patients, and tailoring one's approach to treatment based on patient needs is recommended. In patients with high-risk features or where there is concern for lost-to-follow-up, incorporation of panretinal photocoagulation in the treatment paradigm is recommended. Protocol AB highlighted how patients with more advanced disease may benefit from earlier surgical intervention for earlier visual recovery but that continued anti-VEGF treatment may result in similar visual outcomes over a longer period. Finally, earlier surgical intervention for PDR without vitreous hemorrhage (VH) or retinal detachment is being considered a potential option to minimize treatment burden.

Summary
Recent advances in imaging, as well as medical and surgical treatment options for PDR, have provided a deeper understanding of PDR management, which can be optimized for the individual patient.
HeartMate-3 Ventricular Assist Devices Versus the Total Artificial Heart for Biventricular Support: A Single-Center Series.
Authors: Satish Mohan , Anyanwu Anelechi , Moss Noah , Lala Anuradha , Itagaki Shinobu , Roldan Julie , Mancini Donna 
Published: March 2023

Introduction:
The SynCardia total artificial heart (TAH) is the only device approved for biventricular support. Continuous flow ventricular assist devices (VAD) in a biventricular configuration (BiVAD) have been used with variable results. The purpose of this report was to examine differences in patient characteristics and outcomes between two HeartMate-3 (HM-3) VADs in comparison with TAH support.

Methods:
All patients who received durable biventricular mechanical support from November 2018 to May 2022 at The Mount Sinai Hospital (New York) were considered. Baseline clinical, echocardiographic, hemodynamic, and outcome data were extracted. Primary outcomes were postoperative survival and successful bridge-to-transplant (BTT).

Results:
A total of 16 patients received durable biventricular mechanical support during the study period, of which 6 (38%) patients received two HM-3 VAD pumps as BiVAD support and 10 (62%) patients received a TAH. Overall, TAH patients had a lower median lactate (p < 0.05) at baseline compared to those on HM-3 BiVAD support yet had higher operative morbidity, lower 6-month survival (p < 0.05), and a higher rate of renal failure (80 vs. 17%; p = 0.03). However, survival declined to the same rate at 1 year (50%) and was largely because of extracardiac adverse events related to underlying comorbidities (particularly, renal failure and diabetes, p < 0.05). Successful BTT was achieved in 3 out of 6 HM-3 BiVAD patients and in 5 out of 10 TAH patients.

Conclusion:
In our single center experience, similar outcomes were observed among patients BTT with HM-3 BiVAD compared to those BTT on TAH support despite lower Interagency Registry for Mechanically Assisted Circulatory Support level.
An update on corticosteroid treatment for IgA nephropathy
Authors: Ghaddar Malak , Barratt Jonathan , Barbour Sean J. 
Published: March 2023

Purpose of review
The use of corticosteroids to treat IgA nephropathy (IgAN) has been limited by many controversies related to uncertain benefit and safety concerns. Recent trials have tried to address these limitations.

Recent findings
After being paused because of an excess of adverse events in the full-dose steroid arm, the TESTING trial compared a reduced dose of methylprednisolone to placebo in patients with IgAN after optimization of supportive therapy. Steroid treatment was associated with a significant reduction in the risk of a 40% decline in estimated glomerular filtration rate (eGFR), kidney failure and kidney death as well as a sustained decrease in proteinuria compared with placebo. Serious adverse events were more frequent with the full dose regimen but less common in the reduced dose regimen. A phase III trial evaluating a new formulation of targeted-release budesonide showed a significant reduction in short-term proteinuria and has resulted in accelerated FDA approval for use in the United States. In a subgroup analysis of DAPA-CKD trial, sodium-glucose transport protein 2 inhibitors reduced the risk of kidney function decline in patients who have completed or are not eligible for immunosuppression.

Summary
Both reduced-dose corticosteroids and targeted-release budesonide are new therapeutic options that can be used in patients with high-risk disease. More novel-targeted therapies with a better safety profile are currently under investigations.
Pontine and bilateral cerebellar lesion in osmotic demyelination syndrome associated with uncontrolled type II diabetes mellitus: a case report
Authors: Shrestha Suraj , Kharel Sanjeev , Gautam Sandesh , Poddar Elisha , Adhikari Sugat , Acharya Suman , Pant Samriddha Raj , Jha Anamika , Ojha Rajeev 
Published: March 2023

Introduction and importance:
Osmotic demyelination syndrome (ODS) as a result of the hyperosmolar hyperglycemic state is rare and can present with variable neurological manifestation due to lysis of myelin sheath.

Case presentation:
A 44-year diabetic male presented with complaints of sudden onset, progressive bilateral weakness in lower limbs, and slurring of speech for the past 1.5 months. Cerebellar examination showed a bilaterally impaired finger nose test, dysdiadochokinesia, impaired heel shin test, and an impaired tandem gait. MRI brain (T2 and fluid-attenuated inversion recovery sequences) showed high signal intensity in the central pons and bilateral cerebellum. With a diagnosis of ODS with poorly controlled diabetes, he was treated with insulin, metformin, and supportive measures following which his symptoms subsided gradually.

Clinical discussion:
A rapid correction of hyponatremia is considered the most common cause of ODS. Variations in plasma glucose levels, a rare cause of ODS, can cause an abrupt osmolality change causing pontine and extrapontine myelinolysis. Prevention of rapid correction of hyponatremia and rapid changes in plasma osmolality in vulnerable patients is the mainstay of treatment.

Conclusions:
Clinical features, imaging studies, and monitoring of serum osmolality, serum glucose, and electrolytes aid in diagnosis and favorable outcomes for the patient.
Partial Sheehan’s syndrome with abdominal tuberculosis presented with pancytopenia and fluctuating thyroid profile: a case report
Authors: Yadav Prashant , Bari Md Anwarul , Saha Akash , Yadav Sushmita , Khan Amzad H. 
Published: March 2023

Introduction:Sheehan’s syndrome is a well-recognized cause of panhypopituitarism secondary to pituitary apoplexy, followed by postpartum hemorrhage. Depending upon the degree of ischemic injury, it can be either partial or complete.Case presentation:We report an interesting case of a 35-year-old woman admitted to our hospital with complaints of abdominal distension, which was later presumed to be due to disseminated tuberculosis (TB) after excluding the possible differentials. During the treatment course, she was going through repeated attacks of hypovolemic shock and hypoglycemia due to adrenocortical insufficiency. This, along with the history of prolonged amenorrhea 4 years back due to severe postpartum hemorrhage in her last pregnancy, has led us to our diagnosis of partial Sheehan’s syndrome. After 1 month of starting steroid and anti-TB therapy, it was quite surprising when she presented with features of pancytopenia and antitubercular drug-induced hepatitis.Discussion:Sheehan’s syndrome may have a varying degree of presentation depending upon the degree of damage to the pituitary gland, which includes amenorrhea, lactation failure, adrenocortical insufficiency, hyponatremia, hypoglycemia, as well as pancytopenia in some rare instances The hormone panel especially the thyroid profile should be monitored carefully. Such cases are often challenging to deal with because of their varying degrees of presentation and the delay in diagnosis due to a lack of clinical suspicion.Conclusion:Therefore, we believe that this rare presentation of pancytopenia in Sheehan’s syndrome with fluctuating thyroid profile and abdominal TB in the background will let clinicians approach such a rare disease differently.
Idiopathic recurrent pyoderma gangrenosum with cobalamin deficiency in a 62-year-old male: a case report
Authors: Sitaula Seema , Kharel Sanjeev , Sherpali Aakash , Shrees Vijay , Mainali Atul 
Published: March 2023

Introduction:
Pyoderma gangrenosum (PG) is a rare, neither infectious nor gangrenous, neutrophil-mediated inflammatory dermatosis. In 50–70% of cases, systemic disease is the underlying cause, and the remaining is idiopathic.

Case Presentation:
The authors here present a case of a 62-year-old male with a history of recurrent ulcer over the dorsum of hand diagnosed with recurrent PG with cobalamin deficiency treated with intralesional steroid injection and topical antibiotics along with intramuscular vitamin B12 injections. The patient returned after a year with a history of swelling in the left hand for 1 week, which was managed with intravenous antibiotics.

Clinical Discussion:
The most common kind of PG is ulcerative, which accounts for around 85% of cases that have been found. Ulcerative PG begins as small, painful erythematous or violaceous papules and pustules that quickly develop into ulcers with an exudative, mucopurulent, hemorrhagic base or with areas of necrosis and high, well-defined, serpiginous, violet-blue, or metallic grey borders, which are its defining feature. Glucocorticoids, along with a wide range of additional systemic immunomodulatory medication as alternatives and antibiotics to prevent infection are used for treatment.

Conclusion:
PG is a rare form of neutrophilic dermatosis that can be difficult to diagnose and treat. PG has a mixed nutritional deficiency and a history of ulcers. It is crucial to have a high degree of suspicion when making a diagnosis, as well as to look for associated diseases and start treatment as soon as possible.
Adult-onset Still’s disease as the first manifestation of acute myeloid leukemia: a case report
Authors: Ibrahim Ranim , Drie Tasneem , Shahada Zienab , Al Halabi Hayat , Kudsi Maysoun 
Published: March 2023

Introduction and importance:
The association between adult-onset Still’s disease (AOSD) and malignancy has previously been observed. However, only a limited number of cases described a combination of AOSD and leukemia, none of which reported AOSD-related symptoms as the first manifestation of acute myeloid leukemia (AML). This presentation might represent a paraneoplastic syndrome or leukemic arthritis mimicking AOSD.

Case presentation:
Here the authors report a case of a 23-year-old female who fulfilled the Yamaguchi criteria for an AOSD diagnosis. She presented with complaints of polyarthritis, sore throat, and daily fever spikes with the appearance of a nonpruritic maculopapular salmon-colored rash. Her laboratory work showed marked pancytopenia, which led to a bone marrow examination and an AML diagnosis. The patient started receiving chemotherapy with considerable improvement in the AOSD-related symptoms.

Clinical discussion:
Patients with underlying malignancies could present with systemic features compatible with AOSD, which necessitates excluding malignancy in any patient with this presentation, specifically in light of some warning signs like pancytopenia.

Conclusion:
This case interprets a rare association between AOSD and AML. In addition, it highlights how crucial it is to be aware of the signs that should warn the clinician of a possible underlying malignancy in any patient presenting with AOSD-related symptoms.
Knowledge and attitude of organ donation in the Eastern region of Saudi Arabia and the influence of social media campaigns: a cross-sectional study
Authors: Alessa Mohammed Y. , Albedaiwi Maryam S. , Al Mousa Ali M. , Alhassan Ghadeer M. , Alnefaie Bayan T. 
Published: March 2023

Background:
Previous studies showed organ donation to be less common in Arabic countries, and since there are not many studies exploring the perception toward organ donation, especially in the Eastern region of Saudi Arabia, this study aimed to assess the knowledge, attitude, and influence of social media campaigns on the willingness of organ donation.

Methods:
A cross-sectional study was conducted between September 2021 and April 2022 among social media users through an Arabic online survey exploring the population’s knowledge and attitude regarding organ donation and their willingness to donate. A total of 443 Saudi residents participated in the survey, with 376 of them meeting the required criteria.

Results:
In all, 85% of participants of the study’s calculated response rate were eligible to be included. One hundred ninety-eight of them (52.7%) were female, with age ranges between 18 and 29 years old (76.9%). The majority of the participants (63%) showed unwillingness to donate organs, with the highest rate among males (70.2%), aged above 30 (78.1%), and employees/students out of the healthcare sectors (69.5%). Inadequate knowledge was reported as the most common reason behind their rejection. Next to fears of operation and losing life, and the desire to donate to relatives only. Almost half of the participants (51.6%) agreed on the effect of social media on their behavior toward organ donation, with 187 of them (96.4%) referring to it as a positive effect which was significantly associated with the willingness to donate organs (P=0.006).

Conclusion:
The study results showed that most of the participants have neither proper knowledge nor willingness toward organ donation. Therefore, more strategies could be developed to increase the rate of donation in the Eastern region.
Preliminary results of laparoscopic cholecystectomy using real-time indocyanine green fluorescence: a cross-sectional study
Authors: Vu Van Quang , Le Van Thanh , Nguyen Hoang Ngoc Anh , Dang Kim Khue , Luong Mong Vu Anh 
Published: March 2023

Objective:
Evaluating the results of laparoscopic cholecystectomy (LC) using indocyanine green (ICG) fluorescence.

Materials and methods:
This is a cross-sectional study of patients with LC using real-time fluorescent ICG to treat gallbladder disease from May 2021 to May 2022 in the 108 Military Central Hospital.

Results:
There were 68 patients who underwent LC using intraoperative ICG fluorescence for bile duct visualization. The mean age of the patients was 55.4±16.2, and the male/female ratio was 1.52. Chronic cholecystitis caused by stones accounted for the majority (51.47%). The authors detected 7.35% of cases with anatomical changes of the extrahepatic biliary tract using ICG fluorescence and clearly identified the anatomy of the common bile duct and the cystic duct at 100 and 92.65%, respectively. The average surgical time was 42.8±14.6 min. There were no postoperative complications or side effects from ICG; the average hospital stay was 2.8±1.5 days.

Conclusions:
ICG fluorescence cholangiography allows surgeons to easily identify critical anatomical landmarks in the LC. Thereby helping the surgery to be performed safely, avoiding severe complications due to damage to the biliary tract.
Efficacy of Propolis in the Prevention of Oral Mucositis in Patients Undergoing High-Dose Chemotherapy
Authors: Çakmak Seher , Nural Nesrin 
Published: March 2023

Background
Oral mucositis is one of the most common symptoms in adults with a hematological cancer who are receiving high-dose chemotherapy. Propolis is a complementary and alternative method used to prevent oral mucositis in these patients.

Objective
The aim of this study was to determine the efficacy of propolis in the prevention of oral mucositis in patients receiving high-dose chemotherapy and/or hematopoietic stem cell transplantation.

Methods
A total of 64 patients, 32 in the propolis group and 32 in the control group, were enrolled in this prospective randomized controlled experimental study. Whereas the standard oral care treatment protocol was administered to the control group, aqueous propolis extract was applied to the propolis intervention group in addition to the standard oral care treatment protocol. Data collection forms included a Descriptive Information Form, the Karnofsky Performance Scale, the Cumulative Illness Rating Scale-Geriatric, Patient Follow-up Form, the World Health Organization Oral Toxicity Scale, and the National Cancer Institute Common Terminology Criteria for Adverse Events.

Results
The incidence and duration of oral mucositis were statistically significantly lower in the propolis intervention group than the control group, and the onset of oral mucositis and grade 2 to 3 oral mucositis occurred later (P < .05).

Conclusion
Propolis mouthwash combined with standard oral care treatment delayed the onset of oral mucositis and decreased its incidence and the number of days it lasted.

Implications for Practice
Mouthwash with propolis can be used as a nursing intervention to decrease oral mucositis and its symptoms in hematological cancer patients receiving high-dose chemotherapy.