bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reporte de caso clínico: Esófago-Gastro-Pexia-Cervical por Estenosis Esofágica Secundaria a Ingesta de Cáusticos
Authors: Villacis Raúl , Aulestia David , Haro Hugo , Arias Grace , Vasconez Nicole 
Published: November 2022

Introducción: La estenosis esofágica causada por la ingesta de sustancias corrosivas o por cáusticos, es la atrofia o estrechez del esófago debido al daño que causan estas sustancias en los tejidos, es considerado intolerable en el paciente y en ciertos casos puede causar hasta la muerte. El daño puede ser reversible o irreversible por lo que realizar un correcto diagnóstico nos conlleva a un tratamiento adecuado y eficaz. La estenosis por esta etiología se produce principalmente en el tercio superior del esófago.
Objetivo: Describir un caso clínico de estenosis esofágica con manejo de esófago gastro pexia cervical.
Material y métodos: Estudio descriptivo retrospectivo presentación de caso clínico.
Resultados: Se presenta al caso de una paciente de 22 años que acude al área de emergencia del Hospital de Especialidades Eugenio Espejo con antecedente de ser portadora de yeyunostomia por estenosis esofágica por ingesta de cáusticos desde hace 3 años que fue sometida a una esófago gastropexia cervical con adecuada evolución post quirúrgica con mejora de su estado nutricional y habilitada completamente la vía oral así como una reinserción pronta a su vida personal y social con buenos resultados.
Conclusiones: Las quemaduras esofágicas por ingesta de cáusticos son frecuentes por lo tanto el galeno debe tener en cuenta que el tratamiento quirúrgico para estenosis esofágica está indicado cuando las dilataciones no son efectivas, cuando se producen perforaciones o cuando el riesgo de perforación es alto y también ante la necesidad de mejorar la calidad de vida de estos pacientes obligados a dilataciones esofágicas periódicas y/o a alimentarse por gastrostomía o yeyunostomia de igual forma con cuadro de desnutrición moderada a grave, hacen un reto el manejo de esta patología como vimos en el presente caso.
No existe un consenso sobre cual técnica quirúrgica es la mejor, ya que tanto la esofagogastroplastia como la esofagocoloplastia tienen sus ventajas y desventajas, sin embargo el galeno deberá estar en la capacidad para decir sobre cuál es la mejor para su paciente. En nuestro caso Se optó por la Esófago gastro pexia cervical con un adecuada evolución post quirúrgica e inserción a su vida cotidiana personal y social con adecuada mejora de su nivel nutricional y sobretodo habilitada la vía oral.
Functional outcome of column specific fixation in the management of complex tibial plateau fractures
Authors: Thapa Bishwamber , Sitoula Prakash , Jha Ranjib , Thapa Santosh 
Published: November 2022

Introduction: Complex tibial plateau fractures usually have complicated intra-articular fracture pattern, often associated with severe soft tissue injury and high risk of wound complications. Single or dual column plating fixation principle based upon conventional x-ray for such fractures may not address multiplanar comminution that often has posterior shearing or coronal fractures. Computed tomography based evaluation of such fractures and column specific approach allow direct fracture visualization and anatomic reduction that results in satisfactory outcome.
Objectives: To assess the clinical and functional outcome and complications of complex tibial plateau fractures fixed with column specific fixation principle.
Methodology: This prospective study was carried out from September 2019 to August 2021 in Orthopaedic department of Nobel Medical College, Biratnagar. Consecutive sampling was used among patient with complex tibial plateau fractures meeting the inclusion criteria. Among 30 patients, with closed and Gustilo grade I or II Schatzker type V-VI fractures or AO type-C injuries to the proximal tibia were operated on column specific approach and followed up for clinico-radiological evaluation.
Results: In this study, most of the patients belonged to 31-40 years of age group with mean age of 40.47 years. Majority of patients were male( 76.7%). Fracture was highly associated with road traffic accident which accounted for 83%. Fourteen patients underwent anteromedial and anterolateral plating(46.67%), 10 patients underwent anterolateral and posteromedial plating(33.33%) and remaining 6 patients underwent triple column plating(20%). The Rasmussen’s functional score at final follow up was 27.17±2.793(range 21-30). 86.7% patients had acceptable clinical outcome. The mean Rasmussen’s radiological score at final follow up was 8.97±1.217(range 6-10). Thus 93.4% patients had acceptable radiological outcome.
Conclusion: Column specific approach addresses all the fracture fragments of complex tibial plateau fractures to achieve acceptable clinical and radiological outcome.
Gestational Trophoblastic Neoplasia: A Clinico-Epidemiological Profile In A Tertiary Care Hospital
Authors: Das Indrani , Mandal Payel , Samanta Sandip , Mistri Pallab Kumar , Kyal Amit , Mukhopadhyay Partha 
Published: November 2022

Introduction: Gestational trophoblastic neoplasia (GTN) is a group of interrelated lesions that results from abnormal proliferation of placental trophoblastic cells. Early diagnosis and treatment of GTN results in successful outcomes with fertility preservation.This study was intended to stratify GTN cases using WHO scoring system, to diagnose and manage cases as per protocol and to identify complications of treatment of GTN.
Methodology: This was a single center prospective observational study conducted at Medical college Kolkata from June 2017 to December 2018. All the diagnosed cases of GTN fulfilling the inclusion criteria were incorporated in the study, data were collected from history, clinical examination and investigations. All the data were tabulated and analyzed by standard statistical methods
Results: In this study, primiparous are more prone to have GTN and molar pregnancy was the commonest antecedent event (71.4% of cases). 74.3% (26 out of 35) patients developed disease within four months of previous pregnancy. Anemia and vaginal bleeding were the presenting symptoms in >48.0% cases whereas hemoperitoneum,seizure, hemoptysis and respiratory distress were the rare presenting symptoms.In this study, the cases were diagnosed by histopathology or serial estimation of serum β-hcg. In our study, 91.4% patients were successfully treated with methotrexate and only three cases received EMACO.
Conclusion: To conclude this study established that cases of GTN can be successfully treated by early diagnosis and timely management.
Study of Gastro-Oesophageal Reflux Disease among Patients with Type 2 Diabetes Mellitus presenting to Medicine Department at a Tertiary Care Hospital: A Descriptive Cross-sectional Study
Authors: Mahato Arun Kumar , Shah Madhu , Shrestha Nischal 
Published: November 2022

Introduction: Gastro-oesophageal reflux disease is a chronic condition in which stomach contents regurgitates up into oesophagus causing symptoms like acidic taste in mouth, heart burn, bad breath and chronic cough. There is high prevalence of GERD in patients with Type 2 diabetes mellitus in the western countries, but such related data in our country are just few.
Objectives: To find out the prevalence of gastroesophageal reflux among patients with Type 2 Diabetes Mellitus attending Nobel Medical College Teaching Hospital.
Methodology: This was a descriptive cross-sectional study carried out in Department of Medicine of a tertiary care hospital from July 2020 to June 2021. Ethical approval was taken from Institutional Review Committee of Nobel Medical College Teaching Hospital (Reference number: 464/2020). Convenience sampling was done and data was collected from 191 patients presenting to the department. Collected data was entered, analysed in Statistical Package for the Social Sciences version 21 and documented for study. Point estimate at 95% Confidence Interval and descriptive statistics were interpreted as frequency, percentage, or as mean and standard deviations.
Results: Among 191 patients with type 2 diabetes, gastroesophageal reflux was seen in 78 (40.84%) (33.87-47.81 at 95% Confidence Interval) with more prevalent in male 42 (53.84%) than female 36 (46.15%). Mean duration of type 2 diabetes among reflux cases was 10.20± 5.40 years.
Conclusions: Gastroesophageal reflux was common associated condition among Diabetic patients.
Periprocedural cerebrovascular complications and 30-day outcomes of endovascular treatment for intracranial vertebral artery dissecting aneurysms
Authors: Han Jiangli , Liu Fei , Chen Jigang , Tong Xin , Han Mingyang , Peng Fei , Niu Hao , Liu Lang , Liu Aihua 
Published: November 2022

OBJECTIVE
The authors undertook an evaluation of periprocedural cerebrovascular complications and 30-day outcomes of endovascular treatment for intracranial vertebral artery dissecting aneurysms (IVADAs) and assessed the relevant risk factors.

METHODS
The authors included a series of 195 patients who had undergone endovascular treatment for 198 IVADAs. Clinical data, morphological characteristics, treatment details, and periprocedural cerebrovascular complications including intraprocedural rupture, intraprocedural thrombosis, intracranial hemorrhage (ICH), transient ischemic attack (TIA), and ischemic stroke (IS) were recorded. After evaluation of the 30-day modified Rankin Scale (mRS) scores, the authors applied univariate and multivariate logistic regression analyses to identify the risk factors for complications and 30-day unfavorable clinical outcomes.

RESULTS
There were no intraprocedural ruptures, but the authors recorded intraprocedural thrombosis (n = 5), ICH (n = 3), TIA (n = 1), and IS (n = 13), comprising an 11.1% (22/198) complication rate. Multivariate logistic regression analysis indicated that hyperlipidemia (odds ratio [OR] 3.17, 95% confidence interval [CI] 1.20–8.41, p = 0.020), IS history (OR 5.55, 95% CI 1.46–21.01, p = 0.012), and subarachnoid hemorrhage (SAH) (OR 4.48, 95% CI 1.52–13.20, p = 0.007) were risk factors for overall complications, whereas aneurysmal height (OR 0.77, 95% CI 0.61–0.98, p = 0.032) was a protective factor. SAH (OR 6.44, 95% CI 1.54–26.89, p = 0.011) and preprocedural mRS score > 2 (OR 5.07, 95% CI 1.01–25.59, p = 0.049) were independent risk factors for perforator occlusion stroke. Periprocedural cerebrovascular complications (OR 32.09, 95% CI 3.00–343.94, p = 0.004) and preprocedural mRS score > 2 (OR 319.92, 95% CI 30.28–3379.98, p < 0.001) were independent risk factors for 30-day unfavorable clinical outcomes.

CONCLUSIONS
Hyperlipidemia, IS history, and SAH were independent predictors for overall periprocedural cerebrovascular complications of endovascular treatment for IVADAs, but aneurysmal height was an independent protective factor. SAH and preprocedural mRS score > 2 were independent risk factors for perforator occlusion stroke. Preprocedural mRS score > 2 and periprocedural complications were independent risk factors for 30-day unfavorable clinical outcomes.
Clinical outcomes of non–small cell lung cancer brain metastases treated with stereotactic radiosurgery and immune checkpoint inhibitors, EGFR tyrosine kinase inhibitors, chemotherapy and immune checkpoint inhibitors, or chemotherapy alone
Authors: Dohm Ammoren E. , Tang Joseph D. , Mills Matthew N. , Liveringhouse Casey L. , Sandoval Maria L. , Perez Bradford A. , Robinson Timothy J. , Creelan Benjamin C. , Gray Jhanelle E. , Etame Arnold B. , Vogelbaum Michael A. , Forsyth Peter , Yu Hsiang-Hsuan Michael , Oliver Daniel E. , Ahmed Kamran A. 
Published: November 2022

OBJECTIVE
Immune checkpoint inhibitors (ICIs) and epidermal growth factor receptor–tyrosine kinase inhibitors (EGFR-TKIs) are commonly used in the systemic management of non–small cell lung cancer (NSCLC) brain metastases (BMs). However, optimizing control of NSCLC BM with stereotactic radiosurgery (SRS) and various systemic therapies remains an area of investigation.

METHODS
Between 2016 and 2019, the authors identified 171 NSCLC BM patients with 646 BMs treated with single-fraction SRS within 3 months of receiving treatment with ICIs (n = 56; 33%), EGFR-TKI (n = 30; 18%), chemotherapy and ICIs (n = 23; 14%), or standard chemotherapy alone (n = 62; 36%). Time-to-event analysis was conducted, and outcomes included distant intracranial control (DIC), local control (LC), and overall survival from SRS.

RESULTS
The median follow-up from BM diagnosis was 8.9 months (range 0.3–127 months). The 12-month Kaplan-Meier DIC rates were 37%, 53%, 41%, and 21% (p = 0.047) for the ICI, EGFR-TKI, ICI and chemotherapy, and chemotherapy-alone groups, respectively. On multivariate analysis, DIC was improved with EGFR-TKI (HR 0.4, 95% CI 0.3–0.8, p = 0.005) compared with conventional chemotherapy and treatment with SRS before systemic therapy (HR 0.5, 95% CI 0.3–0.9, p = 0.03) compared with after; and LC was improved with SRS before (HR 0.4, 95% CI 0.2–0.9, p = 0.03) or concurrently (HR 0.3, 95% CI 0.1–0.6, p = 0.003) compared with after. No differences in radionecrosis were noted by timing or type of systemic therapy.

CONCLUSIONS
The authors’ analysis showed significant differences in DIC based on receipt of systemic therapy and treatment with SRS before systemic therapy improved DIC. Prospective evaluation of the potential synergism between systemic therapy and SRS in NSCLC BM management is warranted.
Intranasal delivery of nanoliposomal SN-38 for treatment of diffuse midline glioma
Authors: Sasaki Takahiro , Watanabe Jun , He Xingyao , Katagi Hiroaki , Suri Amreena , Ishi Yukitomo , Abe Kouki , Natsumeda Manabu , Frey William H. , Zhang Peng , Hashizume Rintaro 
Published: November 2022

OBJECTIVE
Diffuse midline gliomas, including diffuse intrinsic pontine gliomas (DIPGs), are among the most malignant and devastating childhood brain cancers. Despite aggressive treatment, nearly all children with these tumors succumb to their disease within 2 years of diagnosis. Due to the anatomical location of the tumors within the pons, surgery is not a treatment option, and distribution of most systematically administered drugs is limited by the blood-brain barrier (BBB). New drug delivery systems that bypass the BBB are desperately needed to improve outcomes of DIPG patients. Intranasal delivery (IND) is a practical and noninvasive drug delivery system that bypasses the BBB and delivers the drugs to the brain through the olfactory and trigeminal neural pathways. In this study, the authors evaluated the efficacy of nanoliposomal (LS) irinotecan (CPT-11) and an active metabolite of CPT-11, 7-ethyl-10-hydroxycamptothecin (SN-38), using IND in DIPG patient-derived xenograft models.

METHODS
In vitro responses to LS-CPT-11 and LS-SN-38 in DIPG cells were evaluated with cell viability, colony formation, and apoptosis assays. The cellular uptakes of rhodamine-PE (Rhod)–labeled LS-CPT-11 and LS-SN-38 were analyzed with fluorescence microscopy. Mice bearing DIPG patient-derived xenografts were treated with IND of LS-control (empty liposome), LS-CPT-11, or LS-SN-38 by IND for 4 weeks. In vivo responses were measured for tumor growth by serial bioluminescence imaging and animal subject survival. The concentration of SN-38 in the brainstem tumor administered by IND was determined by liquid chromatography–mass spectrometry (LC-MS). Immunohistochemical analyses of the proliferative and apoptotic responses of in vivo tumor cells were performed with Ki-67 and TUNEL staining.

RESULTS
LS-SN-38 inhibited DIPG cell growth and colony formation and increased apoptosis, outperforming LS-CPT-11. Rhod-labeled LS-SN-38 showed intracellular fluorescence signals beginning at 30 minutes and peaking at 24 hours following treatment. LC-MS analysis revealed an SN-38 concentration in the brainstem tumor of 0.66 ± 0.25 ng/ml (5.43% ± 0.31% of serum concentration). IND of LS-SN-38 delayed tumor growth and significantly prolonged animal survival compared with IND of LS-control (p < 0.0001) and LS-CPT-11 (p = 0.003). IND of LS-SN-38 increased the number of TUNEL-positive cells and decreased the Ki-67–positive cells in the brainstem tumor.

CONCLUSIONS
This study demonstrates that IND of LS-SN-38 bypasses the BBB and enables efficient and noninvasive drug delivery to the brainstem tumor, providing a promising therapeutic approach for treating DIPG.
Indications and outcomes of endoscopic transorbital surgery for trigeminal schwannoma based on tumor classification: a multicenter study with 50 cases
Authors: Kong Doo-Sik , Kim Yong Hwy , Lee Won-Jae , Kim Young-Hoon , Hong Chang-Ki 
Published: November 2022

OBJECTIVE
Trigeminal schwannoma is a rare CNS tumor and involves the multicompartmental skull base. Recently, the endoscopic transorbital approach (ETOA) has emerged as a technique for minimally invasive surgery. The objective of this study was to evaluate the optimal indications and clinical outcomes of the ETOA for trigeminal schwannomas based on their tumor classification.

METHODS
Between September 2016 and February 2022, the ETOA was performed in 50 patients with trigeminal schwannoma at four tertiary hospitals. There were 15 men and 35 women in the study, with a mean age of 46.9 years. All tumors were classified as type A (predominantly involving the middle cranial fossa), type B (predominantly involving the posterior cranial fossa), type C (dumbbell-shaped tumors involving the middle and posterior fossa), or type D (involvement of the extracranial compartment). Type D tumors were also subclassified by ophthalmic division (D1), maxillary division (D2), and mandibular division (D3). Clinical outcome was analyzed, including extent of resection and surgical morbidities.

RESULTS
In this study, overall gross-total resection (GTR) was performed in 35 (70.0%) of 50 patients and near-total resection (NTR) in 9 patients (18.0%). The mean follow-up period was 21.9 (range 1–61.7) months. There was no tumor regrowth or recurrence during the follow-up period. Based on the classification, there were 17 type A tumors, 20 type C, and 13 type D. There were no type B tumors. Of the 13 type D tumors, 7 were D1, 1 D2, and 5 D3. For type A tumors, GTR or NTR was achieved using an ETOA in 16 (94.1%) of 17 patients. Eighteen (90.0%) of 20 patients with type C tumors attained GTR or NTR. Ten (76.9%) of 13 patients with type D tumors underwent GTR. Statistical analysis showed that there was no significant difference in the extent of resection among the tumor subtypes. Surgical complications included transient partial ptosis (n = 4), permanent ptosis (n = 1), transient diplopia (n = 7), permanent diplopia (n = 1), corneal keratopathy (n = 7), difficulties in mastication (n = 5), and neuralgic pain or paresthesia (n = 14). There were no postoperative CSF leaks or enophthalmos during follow-up.

CONCLUSIONS
This study showed that trigeminal schwannomas can be effectively treated with a minimally invasive ETOA in all tumor types, except those predominantly involving the posterior fossa (type B). For the extracranial compartments, D2 or D3 tumor types often require an ETOA combined with the endoscopic endonasal approach, while D1 tumor types can be treated using an ETOA alone.
ANALISIS KONSEP-KONSEP FISIKA BERBASIS KEARIFAN LOKAL PADA JAJANAN TRADISIONAL DAWET DAN KLEPON
Authors: Elisa Eti , Prabandi Audri Mely , Istighfarini Elma Tri , Alivia Haniyah , Inayah H. Latifa Widi , Nuraini Lailatul 
Published: November 2022

ABSTRAKKearifan lokal adalah identitas atau sebuah bentuk dari pengetahuan, wawasan, pemahaman maupun keyakinan serta adat yang dimiliki sebuah bangsa yang memiliki fungsi sebagai penutun manusia dalam berperilaku, mengelola kebudayaan dalam kehidupan di dalam komunitas ekologis. Kearifan lokal yang dekat dengan kehidupan masyarakat diharapkan dapat menjadi sumber belajar bagi siswa termasuk dalam proses pembelajaran fisika. Salah satu bentuk kearifan lokal yaitu adanya jajanan tradisional. Dawet dan Klepon merupakan salah satu jajanan tradisional yang sudah lama dikenal masyarakat secara turun menurun. Penelitian ini bertujuan untuk menganalisis konsep fisika yang ada pada jajanan tradisional yaitu dawet dan klepon. Penelitian ini merupakan penelitian kualitatif. Teknik pengumpulan data menggunakan observasi, wawancara dan dokumentasi. Data dianalisis secara deskriptif. Hasil penelitian ini diperoleh dari proses pengolahan Dawet dan Klepon dengan mengidentifikasi konsep–konsep fisika terutama pada konsep tekanan, suhu dan kalor, koagulasi, dan hukum Archimedes. Dengan demikian, analisis konsep fisika pada pembuatan jajanan tradisional dapat dijadikan alternatif sumber belajar yang menarik bagi siswa. Kata kunci: kearifan lokal; konsep fisika; kalor; tekanan; koagulasi ABSTRACTLocal wisdom is an identity or a form of knowledge, insight, understanding as well as beliefs and customs of a nation that has a function as a human guide in behavior, managing culture in life in an ecological community. Learning about local wisdom will help physics learning in understanding its application in everyday life. Dawet and Klepon are traditional snacks that have long been known to the Javanese for generations. This study aims to analyze the physical concepts that exist in traditional snacks, namely dawet and klepon. This research is a phenomenological qualitative research, where this research uses triangulation techniques, namely by using observations and interviews accompanied by documentation. The results of this study were obtained from the processing of Dawet and Klepon by identifying the concepts of physics, especially on pressure, temperature and heat, coagulation, precipitation and Archimides' Law. keywords: local culture; physics concepts; heat; pressure; coagulation