bluuebunny/crossref_metadata_2025_split huggingface dataset:
Population level screening for celiac disease: is now the time?
Authors: Shuler Brianne , Liu Edwin , Stahl Marisa G. 
Published: September 2023

Purpose of review
As incidence and prevalence of celiac disease is increasing, subclinical and asymptomatic presentations are more commonly identified through celiac disease screening. However, the United States Preventive Services Task Force released a statement in 2017 maintaining that there is insufficient evidence to recommend general population screening for celiac disease for asymptomatic individuals. This review summarizes the current available evidence on celiac disease screening.

Recent findings
Literature demonstrates that by limiting screening to individuals with recognized symptoms, celiac disease diagnosis is frequently delayed or missed entirely. Most individuals with screening-identified celiac disease have previously unrecognized symptoms that improve through treatment with a gluten-free diet. Screening-identified individuals also demonstrate signs of impaired nutrition, growth, bone health, and quality of life which improve with treatment. Overall, celiac disease screening is viewed favorably by those identified through celiac disease screening programs.

Summary
Individuals with screening-identified celiac disease may still incur complications from untreated disease and receive benefit from treatment with a gluten-free diet. More data is needed to determine the cost effectiveness of different mass screening approaches that incorporate the societal perspective towards screening.
Controversies regarding management of Helicobacter pylori infections
Authors: Price Alyssa , Graham David Y. , Tan Mimi C. 
Published: September 2023

Purpose of review
The recognition that Helicobacter pylori should be considered and treated as an infectious disease has yet to fundamentally change diagnostic and treatment practices and has resulted in many controversies.

Recent findings
We discuss the following controversies: whether the current ‘per-patient’ approach to H. pylori testing based on symptoms should be expanded to include achieving population-level H. pylori eradication, whether H. pylori should be approached as an infectious gastrointestinal disease similar to that of other infectious diseases of similar severity and outcome, whether treatment of H. pylori should be primarily empiric or based on antibiotic susceptibility and locally proven successful therapies as are other infectious diseases, whether it is necessary to obtain confirmation of treatment success in every patient treated for H. pylori, and whether potassium-competitive acid blockers should replace proton pump inhibitors in H. pylori therapy.

Summary
Available guidelines and meta-analyses do not yet address H. pylori as an infectious disease. The diagnosis and management and treatment success of H. pylori infections trails behind that of other important infectious diseases. We provide new insights and propose changes in the traditional understanding required to modernize the management of H. pylori infections.
How to measure human leukocyte antigen-specific B cells
Authors: Kervella Delphine , Torija Alba , Zúñiga Jose M. , Bestard Oriol 
Published: September 2023

Purpose of review
The implementation of highly sensitive immune assays measuring anti-human leukocyte antigen (HLA) antibodies has modified alloimmune risk stratification and diagnosis of rejection. Nonetheless, anti-HLA antibodies represent the downstream effector mechanism of the B-cell response. Better characterizing the cellular components of the humoral immune response (including memory B cells (mBCs) and long-lived plasma cells) could help to further stratify the alloimmune risk stratification and enable discovery of new therapeutic targets. Several tests that characterize HLA-specific mBCs, either functionally or phenotypically, have been developed in the last years, showing promising applications as well as some limitations.

Recent findings
Functional assays involving ex vivo polyclonal activation of mBC have been refined to allow the detection of HLA-specific mBC capable of producing anti-HLA Abs, using different and complementary detection platforms such as multiplex Fluorospot and single antigen bead assay on culture supernatants. Detection of circulating HLA-specific B cells by flow cytometry remains hindered by the very low frequency of HLA-specific mBC.

Summary
Technological refinements have allowed the development of tests detecting HLA-specific mBC. Further evaluation of these assays in clinical trials, both for immune risk stratification and to assess treatment efficacy (desensitization strategies, rescue therapies for ABMR) are now urgently needed.
Detection of urological cancers by the signature of organic volatile compounds in urine, from dogs to electronic noses
Authors: Gaye Oumar , Fall Cheikh Bintou , Jalloh Mohamed , Faye Babacar , Jobin Marc , Cussenot Olivier 
Published: September 2023

Purpose of review
Urine volatile organic compound (VOC) testing for early detection of urological cancers is a minimally invasive and promising method. The objective of this review was to present the results of recently published work on this subject.

Recent findings
Organic volatile compounds are produced through oxidative stress and peroxidation of cell membranes, and they are eliminated through feces, urine, and sweat. Studies looking for VOCs in urine for the diagnosis of urological cancers have mostly focused on bladder and prostate cancers. However, the number of patients included in the studies was small. The electronic nose was the most widely used means of detecting VOCs in urine for the detection of urological cancers. MOS sensors and pattern recognition machine learning were more used for the composition of electronic noses. Early detection of urological cancers by detection of VOCs in urine is a method with encouraging results with sensitivities ranging from 27 to 100% and specificities ranging from 72 to 94%.

Summary
The olfactory signature of urine from patients with urological cancers is a promising biomarker for the early diagnosis of urological cancers. The electronic nose with its ability to recognize complex odors is an excellent alterative to canine diagnosis and analytical techniques. Nevertheless, additional research improving the technology of Enoses and the methodology of the studies is necessary for its implementation in daily clinical practice.
Efficacy of opioid-free anesthesia in modified radical mastectomy: a cross-sectional observational study
Authors: Assaf Georges R. , Yared Fares , Dib Mary-Joe , Mouawad Tony , Tarabay Oriana , Noujeim Jean-Paul , El-Helou Etienne , Kaady Jean , Abboud Bassam 
Published: September 2023

Introduction:
Perioperative management of female patients undergoing breast surgeries differs from other patients due to chronic pain and postoperative nausea and vomiting. The anesthesia could consist of opioid-free general anesthesia (OFA) or non-opioid-free general anesthesia (NOFA). OFA relies on multimodal analgesia preoperatively and postoperatively. However, it is not yet established whether OFA could replace NOFA as a standard regimen for the management of breast surgeries. The aim of this study is to evaluate the efficacy of OFA for breast surgeries in female patients.

Materials and methods:
Patients undergoing modified radical mastectomy were retrospectively recruited. Two groups were defined: group 1, consisting of treated patients using OFA and group 2, consisting of treated patients using NOFA. Mean time to extubate and mean dose of morphine after recovery were computed. Postoperative morphine and antiemetic use were assessed for up to 24 h. A comparison of the computed data was conducted between both groups.

Results:
A total of 116 patients were included with a mean age of 53±13 years. Group 1 consisted of 56 (mean age was 54±14 years). Group 2 consisted of 60 patients (mean age was 51±12 years). Demographic parameters and time to extubate did not yield significant differences. We noticed morphine sparing at T0 and T12 with statistically significant differences P=0.043 and P=0.006, respectively.

Conclusion:
OFA could be considered in modified radical mastectomy management in female patients; nerve block seemed to act as morphine sparing in operative and postoperative settings by providing significantly less time to extubate with less postoperative morphine requirement.
Thermal necrosis in orthopedic bone tumors: experimental research
Authors: Wang Xue Qi , Brown Jeffrey M. , Lorimer Shannon , Jones Kevin B. , Groundland John S. 
Published: September 2023

Introduction:
The extent of surgical resection in orthopedic oncology differs according to tumor biology. While malignant bone tumors are operatively managed with wide resection, benign bone tumors and metastatic carcinomas are often treated through intralesional excision and adjuvant modalities, including the elimination of residual neoplastic cells through thermal necrosis. This study investigates in vitro temperature thresholds for thermal necrosis in common orthopedic bone tumors.

Methodology:
Eleven cell lines, including metastatic carcinomas to bone (A549, A498, FU-UR-1, PC3, MDA-MB-231, TT, MCF7, and K1), giant cell tumor of bone, osteosarcoma (HG-63), and control non-neoplastic cells (HEK293) were cultured. Cells were exposed to thermal stress at varying times and temperatures and evaluated for survival and viability with crystal violet and MTT assays.

Results:
Both the MTT and crystal violet assay demonstrated statistically superior rates of viability and survival for A549 (lung carcinoma), FU-UR-1 (renal carcinoma), K1 (thyroid carcinoma), and MG-63 (osteosarcoma) cell lines compared to control (HEK293 cells) at 60°C. Additionally, the MTT assay demonstrated superior viability for PC3 (prostate carcinoma), MCF7 (breast carcinoma), and A498 (renal carcinoma) compared to control. All cell lines demonstrated significantly decreased survival and viability in temperatures more than 90°C.

Conclusion:
This study demonstrated in vitro thresholds for thermal necrosis for cell lines of common orthopedic tumors of bone. The A549 (lung carcinoma), K1 (thyroid carcinoma), and FU-UR-1 (renal carcinoma) cell lines demonstrated greater resistance to heat stress compared to non-neoplastic control cells. Temperatures in excess of 90°C are necessary to reliably reduce cell survival and viability to less than 10%.
Pulmonary alveolar microlithiasis: a rare case report from Syria
Authors: Batesh Duaa , Habash Roaa , Alhaffar Mhd Nabih , Almani Imad 
Published: September 2023

Introduction and importance:
This report presents a case of pulmonary alveolar microlithiasis (PAM), a rare disease characterized by dry cough, dyspnea, and chest pain. Most reported cases are from Turkey, with a frequency of 1.85 in 1 million, and there are no documented cases from Syria in the medical literature. Here, we present the first case report from Syria.

Case presentation:
A 56-year-old male patient complained of a dry cough that began 4 years ago and had worsened over the last 3 months, along with a grade I dyspnea. Chest radiograph showed a ‘sandstorm-like’ appearance, and a computed tomography scan revealed diffuse ground-glass opacities. To confirm the diagnosis, we performed a transbronchial lung biopsy and bronchial washing. Histopathology results revealed interalveolar calcification consistent with PAM. The diagnosis was based on radiological and lung biopsy findings. The patient received oxygen therapy, resulting in significant improvement. We recommended the use of a home oxygen machine for episodes of shortness of breath.

Clinical discussion:
PAM is an autosomal recessive disease caused by a mutation in the SLC34A2 gene (solute carrier family 34, member 2 gene), characterized by intra-alveolar airspace microliths called calcospherites. Miliary tuberculosis should be considered a differential diagnosis.

Conclusions:
The disease progresses slowly and is often diagnosed incidentally. Lung transplantation remains the only effective treatment.
Effect of laparoscopic mini-gastric bypass versus laparoscopic sleeve gastrectomy on hypertension and dyslipidemia in obese type 2 diabetes mellitus patients
Authors: Ahmad Wassim B. , Al Shalabi Abdul Ghani , Kabalan Younes 
Published: September 2023

Objective:
The aim of the research was to compare the effect of the laparoscopic mini-gastric bypass (LMGB) technique with the laparoscopic sleeve gastrectomy (LSG) technique in bariatric surgery on type 2 diabetes mellitus (T2DM), hypertension (HTN), and dyslipidemia in obese T2DM patients.

Materials and methods:
A prospective, cross-sectional study, conducted in Surgery Department at Al-Mouwasat and Al-Assad University Hospitals in Damascus, and included T2DM obese patients who would undergo bariatric surgery using the LMGB or LSG technique.

Results:
The research included two groups: the LSG group (92 patients, 60.9% female, age 44.6 year, BMI 41.85 kg/m2) and the LMGB group (137 patients, 59.1% female, age 47.1 year, BMI 43 kg/m2). Before surgery, the prevalence of HTN and dyslipidemia were similar in the two groups. After one year: T2DM improvement and remission rate in the LMGB group (13.9, 80.3%) were greater than in the LSG group (13, 62%), the difference was statistically significant. The HTN improvement and remission rate in the LMGB group (52.9, 41.4%) were greater than in the LSG group (47.5, 39%), the difference was not statistically significant. The dyslipidemia improvement rate was greater in LSG group (47.2 vs. 32.7%), while the dyslipidemia remission rate was greater in LMGB group (67.3 vs. 52.8%), the difference was statistically significant.

Conclusions:
The authors found that the LMGB technique was more effective than the LSG technique in controlling cardiovascular risk factors of obesity, T2DM, HTN, and dyslipidemia.
Efficacy and complications of hyaluronic acid and polylactic acid for penile augmentation: a systematic review and meta-analysis
Authors: Kusumaputra Ahmad , Setiawan Muhammad R. , Soebadi Mohammad A. , Wirjopranoto Soetojo 
Published: September 2023

Background:
Penile size is considered a symbol of manhood and is a subjective problem for men, especially those with small penis syndrome. Penile augmentation was introduced to correct penile size problems from a medical, psychological, or esthetic point of view. Hyaluronic acid (HA) and polylactic acid (PLA) are two types of augmentation agents that are popularly used today. However, no systematic studies and meta-analyses have compared these two modalities as penile augmentation agents. This study aimed to analyze the efficacy and safety of penile filler injections with HA compared to PLA.

Methods:
This study was based on the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Articles examining the differences in efficacy and adverse events of the administration of HA and PLA in patients undergoing penile augmentation were systematically reviewed from the PubMed, Proquest, Web of Science, and Scopus databases. An odds ratio with a 95% CI was applied to measure the study outcome. The analysis was performed with RevMan 5.4 software. The risk of bias for each study was evaluated using the Risk of Bias v2 instrument from Cochrane. This research protocol is registered in the International Prospective Register of Systematic Reviews (PROSPERO) registry.

Result:
Four articles consisting of 283 research subjects were included in this study. The meta-analysis for penile girth enhancement after penile augmentation found significant results in the HA group compared to the PLA group (P=0.01). There was no difference in the level of satisfaction with penile appearance 4 weeks after penile augmentation in the HA group compared to the PLA group (P=0.79). HA was significantly superior in sexual satisfaction 12 weeks postpenile augmentation (P=0.0004). There was no difference in the incidence of pain after penile augmentation in the HA group compared to the PLA group (P=0.33). In the postaugmentation penile inflammation, there was no difference (P=0.98) in the HA group compared to the PLA group.

Conclusion:
There are differences in the efficacy of penile augmentation with the superiority of HA in increasing penile diameter and postaugmentation sexual satisfaction compared to PLA. There was no difference in the incidence of complications between using HA and PLA.
Giant right atrial myxoma presented with symptoms of Budd–Chiari syndrome: a case report
Authors: Med Sidi El Moctar Echreiva , El Hadj Sidi Chighaly , Abdulrazzak Mohammed , Ahmed Kamal Manar , Mohamed Ahmed Mohamed Feissal , Boye Khaled 
Published: September 2023

Introduction and importance:
Right atrial myxoma is rarely associated with Budd–Chiari syndrome (BCS). In this paper, we present a case of a young patient with a giant right atrial myxoma complicated by the development of BCS.

Case presentation:
A 26-year-old female presented to the emergency room with persistent abdominal pain, ascites, lower limb edema, and an acute episode of dyspnea. Abdominal computed tomography revealed a lesion in the right cardiac cavity that resembled an intracardiac thrombus. Transthoracic echocardiography showed a large heterogeneous mass in the right atrium protruding into the right ventricle and a large thrombus interfering with inferior vena cava flow. The patient underwent cardiac surgery to remove the atrial mass, and histopathologic examinations confirmed the diagnosis of atrial myxoma.

Clinical discussion:
The right atrial myxoma is relatively rare, especially the giant ones. Rarely have intracardiac tumors such as giant right atrial myxoma been identified as a risk factor for the onset of BCS.

Conclusion:
In the differential diagnosis of BCS, right atrial tumors, including myxomas, should be considered, especially when other explanations are absent.
A new modified limited incision for superficial parotidectomy compared to modified Blair’s incision
Authors: Alomar Omar Salem Khattab 
Published: September 2023

Background:
Many incisions have been used to perform parotidectomy, but they result in a visible scar on the neck and may cause patient dissatisfaction by producing disfigurement sometimes.

Aim of Study:
The aim of this study is to use a modified limited incision for superficial parotidectomy as an alternative to the classical incision, with no obvious scarring and without affecting the identification of the facial nerve, resulting in better cosmesis.

Patients and Methods:
A prospective comparative study on 100 patients has undergone superficial parotidectomy using a modified limited incision and another 100 patients who have undergone superficial parotidectomy using the modified Blair’s incision (control group) for variant benign pathologies. The surgeries were conducted in four hospitals (three private and one public) in Baghdad, Iraq, from January 2016 to September 2022. In both groups, the patients were followed up through outpatient visits to assess the cosmetic result of the incision and detect postoperative complications.

Results:
All tumors were removed with no need for extending the skin incision. The cosmetic result of the incision was very satisfactory and only a nominal scar could be seen 6 months after surgery. Five percent of patients only developed postoperative complications.

Conclusion:
A modified limited incision for superficial parotidectomy provides better patient satisfaction compared to a modified Blair’s incision. The modified limited incision can be performed safely with a better cosmetic appearance of the surgical scar compared to the standard incision.
Establishment of hospital-based surgical residency programs as a health policy for surgical needs provision: an Indonesian perspective
Authors: Lukman Kiki 
Published: September 2023

Objective:
One of the health interventions that can be implemented cost-effectively in developing countries is the provision of basic surgical procedures. One way to increase access to surgical services is to increase the production of surgeons, in this case through increasing the surgical residency program. There are similarities between university-based surgical residency programs and hospital-based surgical residency programs. However, in Indonesia, the differences between them are stark; the establishment of hospital-based surgical residency programs is challenging and requires collaboration between the government, university, college of surgery, and private sector.

Design:
The author reviewed the literature on post-graduate medical education for surgical programs and the contrast between university-based and hospital-based surgical residency programs.

Setting:
Information collected from the Indonesian Health Education Independent Accreditation Institution and varied literature was included.

Participants:
Not applicable.

Result:
In Indonesia, the implementation of an academic surgery environment in the hospital-based surgical residency program is challenging, and the implementation of the academic health system can increase student intake and provide more both from the university and the hospital-based surgical residency program.
Negotiated Rates for Surgical Cancer Care in the Era of Price Transparency—Prices Reflect Market Competition
Authors: Rochlin Danielle H. , Rizk Nada M. , Matros Evan , Wagner Todd H. , Sheckter Clifford C. 
Published: September 2023

Objective:
To measure commercial price variation for cancer surgery within and across hospitals.

Summary Background Data:
Surgical care for solid organ tumors is costly and negotiated commercial rates have been hidden from public view. The Hospital Price Transparency Rule, enacted in 2021, requires all hospitals list their negotiated rates on their website, thus opening the door for an examination of pricing for cancer surgery.

Methods:
This was a cross-sectional study using 2021 negotiated price data disclosed US hospitals for the ten most common cancers treated with surgery. Price variation was measured using within- and across-hospital ratios. Commercial rates relative to cancer center designation and the Herfindahl-Hirschman Index at the facility level were evaluated with mixed effects linear regression with random intercepts per procedural code.

Results:
495,200 unique commercial rates from 2,232 hospitals resulted for the ten most common solid-organ tumor cancers. Gynecologic cancer operations had the highest median rates at $6,035.8/operation compared to bladder cancer surgery at $3,431.0/operation. Compared to competitive markets, moderately and highly concentrated markets were associated with significantly higher rates (HHI 1501-2500, coefficient $513.6, 95% CI, $295.5 - $731.7; HHI >2500, coefficient $1,115.5, 95% CI, $913.7–$1,317.2). National Cancer Institute designation was associated with higher rates, coefficient $3,451.9 (95% CI, -$2,853.2–$4,050.7).

Conclusions:
Commercial payer-negotiated prices for the surgical management of 10 common, solid-tumor malignancies varied widely both within and across hospitals. Higher rates were observed in less competitive markets. Future efforts should facilitate price competition and limit health market concentration.