bluuebunny/crossref_metadata_2025_split huggingface dataset:
Changes in Sinonasal and Overall Quality of Life Following Endoscopic Endonasal Surgery for Non-functioning Pituitary Adenomas
Authors: Sunil Akhil , Thakar Sumit , Aryan Saritha , Hegde Alangar S 
Published: December 2022

Introduction:
Quality of life (QOL) assessment is increasingly being recognized as an important parameter while evaluating outcomes after endoscopic endonasal transsphenoidal surgery (EETS). There has been no study that has evaluated this in the Indian context.

Objectives:
We aimed to analyze sinonasal and overall QOL before and after EETS for non-functioning pituitary adenomas (NFPAs), and to evaluate possible correlations between changes in QOL and various clinicoradiological, hormonal, and surgical factors.

Methods:
This prospective observational study included 62 patients who underwent EETS for NFPAs. The Anterior Skull Base Nasal Inventory-12 (ASK-12) and Short Form-12 (SF-12) were used to assess QOL. Changes in QOL were recorded at 2 weeks, 3 months, and 1-year follow-up periods.

Results:
While the nasal crusting and nasal discharge components of the ASK-12 worsened 2 weeks after EETS, the headache component demonstrated significant improvement (P < 0.05). The overall ASK-12 score (6.69+/−7.98) did not change significantly at follow-up. The SF-12 physical component summary (PCS) score (42.14+/−8.54) improved progressively after surgery, while the SF-12 mental component summary (MCS) score (42.48+/−7.95) improved 1 year later. The SF-12 PCS correlated with visual field improvement at 3-month follow-up (P = 0.04).

Conclusions:
EETS affects some components of the ASK-12 without affecting the overall sinonasal QOL in patients with NFPAs. These patients demonstrate progressive postoperative improvement in physical well-being, while their mental functioning improves only a year later. Improvement in physical functioning correlates with visual field improvement at a 3-month follow-up. Hormonal dysfunction and surgical factors do not have any impact on QOL in these patients.
Assessment of Relationship between Serum NT-proBNP Levels with Clinical Features and Prognosis in Acute Ischemic Stroke Patients
Authors: Arslan Beyza M. , Cabalar Murat , Isiksacan Nilgün , Yayla Vildan 
Published: December 2022

Background and Aims:
We aimed to assess N-terminal pro brain-type natriuretic peptide (NT-proBNP) levels in acute ischemic stroke (AIS) patients according to clinical and radiological features and to investigate its relationship with short term clinical outcomes.

Methods:
In our study, 107 patients with AIS were evaluated prospectively. Of all, 56 patients had no evidence of atrial fibrillation (AF) (sinus rhythm [SR] group) (52.3%), 24 patients had paroxysmal AF (pAF group) (22.4%), and the other 27 patients had chronic AF (cAF group) (25.3%). Demographic datas, clinical characteristics, laboratory and radiological findings, CHA2DS2 -VASc scores, NIHSS (National Institute of Health Stroke Scale) and modified Rankin Scale (mRS) scores on admission and at the third month evaluations were recorded. Good functional outcome at 3 months was defined as modified Rankin score (mRS) 2 or less. According to the TOAST (Trial of Org 10172 in Acute StrokeTreatment) and OCSP (Oxfordshire Community Stroke Project) study, ischemic stroke subtyping was performed. Serum NT-proBNP levels were estimated in 107 stroke patients and 24 age- and sex-matched control subjects. Venous blood samples were obtained for serum NT-proBNP measurement within the first 48 hours of the patient group.

Results:
Mean age of the 107 AIS patients was 68 ± 15.22 years and 58.9% of them were women. Compared to controls, the SR, pAF and cAF groups had higher plasma NT-proBNP levels (P < 0.001) and also NT-proBNP values were significantly higher in the pAF and cAF group than SR groups (P < 0.001). NT-proBNP values were significantly higher in cardioembolic (CE) (n = 57) group than in large artery atherosclerosis (LAA) (n = 20) and small vessel disease (SVD) (n = 30) groups (P < 0.001). NT-proBNP levels of noncardioembolic SR (n = 49) (P = 0.080), LAA and SVD groups (P = 0.103) were higher than the control group but the difference was not statistically significant. There was a positive correlation between NT-proBNP level and third month mRS scores in CE group (r = 0.491).

Conclusions:
NT-proBNP will contribute to predict cardioembolic and pAF groups and estimate the prognosis.
Autodelineation of organ at risk in head and neck cancer radiotherapy using artificial intelligence
Authors: Bilimagga Ramesh S. , Anchineyan Pichandi , nmugam Murli Shivasha , Thalluri Seshashayi , Goud P. Sudheer Kumar 
Published: December 2022

Aim:
The aim of this study is to check the practical feasibility of artificial intelligence for day-to-day operations and how it generalizes when the data have considerable interobserver variability.

Background:
Automated delineation of organ at risk (OAR) using a deep learning model is reasonably accurate. This will considerably reduce the medical professional time in manually contouring the OAR and also reduce the interobserver variation among radiation oncologists. It allows for quick radiation planning which helps in adaptive radiotherapy planning.

Materials and Methods:
Head and neck (HN) computed tomography (CT) scan data of 113 patients were used in this study. CT scan was done as per the institute protocol. Each patient had about 100–300 slices in Dicom format. A total number of 19,240 images were used as the data set. The OARs were delineated by the radiation oncologist in the contouring system. Of the 113 patient records, 13 records were kept aside as test dataset and the remaining 100 records were used for training the UNet 2D model. The study was performed on the spinal cord and left and right parotids as OARs on HN CT images. The model performance was quantified using the Dice similarity coefficient (DSC) score.

Results:
The trained model is used to predict three OARs, spinal cord and left and right parotids. The DSC score of 84% and above could be achieved using the UNet 2D Convolutional Neural Network.

Conclusion:
This study showed that the accuracy of predicted organs was within acceptable DSC scores, even when the underlying dataset has significant interobserver variability.
Prevalence of oral potentially malignant disorders (OPMD) in adults of Western Maharashtra, India
Authors: Shivakumar K. M. , Raje Vaishali , Kadashetti Vidya 
Published: December 2022

Background:
Oral cavity cancer is estimated to be the third most common malignancy after cancer of cervix and stomach in developing countries.

Objectives:
The objective of this study is to investigate the relationship between smoking, alcoholic consumption, betel quid chewing, and OPMD in a prospective manner.

Materials and Methods:
A descriptive, cross-sectional study was conducted among 35–55-year-old adults of Western Maharashtra, India. Oral cavity examination as recommended by the American Dental Association specification was followed. Data recorded were transferred from precoded survey pro forma to the computer. The prevalence of OPMD was assessed by determining the percentage of the study population affected. Analysis was done to find out the risk of oral premalignant disorders. The Chi-square (x
2) test and adjusted odds ratio (ORs) with 95% confidence interval (CI) were calculated. The Statistical Package for the Social Sciences (SPSS) software version 21.0 was used for the statistical analysis and significance level was set at P < 0.05.

Results:
Odds of having OPMD are five times higher for those who smoke (OR = 5.78; 95% CI, [6.18, 7.82]) as compared to those who do not. The odds of suffering from OPMD are about five times higher among those who chew as compared to those who do not (OR = 4.98; 95%CI, [2.91, 7.28]). The mean frequency of tobacco chewing per day and duration in years in participants with OPMDs was significantly higher as compared with normal oral mucosa (P < 0.05 and P < 0.05), respectively, in the use of different tobacco forms.

Conclusion:
These findings can be used to design case control or cohort studies to further understand the relation between habits and OPMD.
An integrative analysis to enumerate candidate genes for clinical use in oral cancer
Authors: Thakore Vaidehi P. , Patel Kinjal D. , Bhadresha Kinjal P. , Patel Prabhudas S. , Jain Nayan K. 
Published: December 2022

Background:
Oral cancer (OC) is the most pernicious sub-site of head and neck tumours with poor prognostic value that is largely ascribed to the lack of ideal biomarkers and therapeutic targets. This fact highlights an urgent need to identify biomarkers that can further aid in OC management.

Aim:
The aim of this study was to identify a gene panel with a maximum clinical utility for OC.

Materials and Methods:
Eight eligible datasets were downloaded from the Gene Expression Omnibus Database, containing 320OC samples and 173 normal samples. The data were processed by GeneSpring software to reveal differentially expressed genes between OC tissues and normal tissues in eight individual experiments. Functional enrichment and network analysis were performed using PANTHER and STRING databases for concordant genes (fold change >10; P ≤ 0.05). The selected genes were cross-validated in the cancer genome atlas (TCGA), Oncomine, and KaplanMeier (KM) plotter databases.

Results:
Totally, 65 concordant genes were identified, including 37 up-regulated genes and 28 down-regulated genes. A 13-gene panel CXCL8, CXCL10, FN1, GBP1, IFIT3, ISG15, MMP1, MMP3, MMP10, OASL, SERPINE1, SPP1, and PLAU was elected from the lists of functionally enriched genes, hub genes, and genes that showed high alterations for mutation, copy number variation, and mRNA expression status in 'Head and Neck Squamous Cell Carcinoma patients (n = 279; TCGA, Nature 2015)'. Further, validation in Oncomine database demonstrated significant over-expression of all elected genes in OC patients across multiple datasets. In addition, out of 13, six genes (CXCL8, CXCL10, FN1, PLAU, SERPINE1, and SPP1) showed significant association with the prognosis of Head and Neck cancer patients (n = 500) in the KM plotter database.

Conclusions:
Using an integrative analysis, our study investigated and validated a 13-gene panel for OC which can be used to improve current diagnostic, prognostic, and treatment approaches.
Perioperative antimicrobial prophylaxis in clean-contaminated head and neck squamous cell cancer surgeries
Authors: Kohli Pavneet , Penumadu Prasanth , Shukkur Naveeth , Sivasanker M , Balasubramanian Arumugam , Ganapathy Sachit 
Published: December 2022

Introduction:
Judicious use of antibiotics and stringent adherence to practice guidelines is the need of the hour as antibiotic resistance is a rampant problem. Despite several reports in the literature describing the optimal duration of antibiotics, there is no consensus. A “one for all” protocol may be impractical and hence the guidelines need to be tweaked to take into consideration local factors. We designed a protocol for prophylactic antibiotics in clean-contaminated head and neck cancer squamous cell carcinoma (HNSCC) surgeries to prevent unchecked abuse and evaluated its feasibility.

Materials and Methods:
Two hundred consecutive patients who underwent a clean-contaminated surgery for HNSCC between January 2017 and December 2019 were included. Single-dose intravenous amoxicillin-clavulanate at induction followed by three doses of amoxicillin-clavulanate, metronidazole, and amikacin in the postoperative period was used. Adherence to the antibiotic protocol was assessed from a prospectively maintained database.

Results:
The mean age was 55.99 ± 11.71 years. The protocol was effective in 70% of the patients with an acceptable surgical site infection (SSI) rate of 12%. Flap-related complications (9.5%) and oro-cutaneous fistula (5%) were common causes of prolonged antibiotics. On univariate analysis, blood transfusion (P = .014), clinical stage at presentation (P = .028), patients undergoing reconstruction (P = .001), longer operative time (P = .009), and pathological T stage (P = 0.03) were at higher chance of deviating from the protocol. On multivariate analysis, age more than 50 years (OR: 2.14, 95% CI: (1.01, 4.52); P value = 0.047) and reconstruction (OR: 3.36, 95% CI: (1.21, 9.32); P value = 0.020) were found to be significant.

Conclusions:
A three-dose perioperative antibiotic prophylaxis in clean-contaminated HNSCC surgeries is feasible. Similar protocols should be developed and validated at other major centers to limit the unnecessary use of antibiotics and prevent the emergence of antibiotic resistance.
Outcomes of feeding jejunostomy after pancreaticoduodenectomy
Authors: Yamamoto Naoto , Aoyama Toru , Murakawa Masaaki , Kamiya Mariko , Shiozawa Manabu , Rino Yasushi , Masuda Munetaka , Morinaga Soichiro 
Published: December 2022

Aims:
Feeding jejunostomy tube (FJT) is one option for enteral nutrition after pancreaticoduodenectomy (PD); however, controversy regarding its clinical outcome(s) persists. The aim of the present study was to determine the safety and efficacy of FJT management.

Materials and Methods:
Data from 156 consecutive patients, who underwent PD between January 2015 and December 2017, were retrospectively reviewed. Safety was assessed according to postoperative and tube-related complications. Nutritional efficacy was evaluated based on improvement in serum albumin levels.

Results:
Thirty-day morbidity and mortality rates were 61.0% (n = 95) and 1.9% (n = 3), respectively. The rates of clinically relevant postoperative pancreatic fistula and delayed gastric emptying were 30.8% and 9.0%, respectively. In total, nine (5.8%) patients experienced complications directly related to FJT. Eight patients experienced surgical site infection adjacent to the catheter/skin interface. Although all required catheter removal at the bedside or in the office, none required reoperation. The improvement in serum albumin level 1 month after PD was 40.7% compared with 1 week after PD.

Conclusion:
FJT was useful in improving nutritional intake and status. Although FJT was associated with minor self-limiting complications, they could be managed by simple bedside or office treatment. As such, results of this study support the safety and efficacy of the FJT protocol used in the authors' department for nutritional management.
Pretreatment nutritional status, HPV infection, and tumor infiltrating lymphocyte as prognostic predictors in patients with head and neck squamous cell carcinoma after chemotherapy
Authors: Sutandyo Noorwati , Brahma Bayu , Ifandriani Rizky 
Published: December 2022

Background:
The survival rate in head and neck cancer varies among the subtypes, yet, the factors associated with survival between studies are still conflicting. This study aimed to investigate the association between pretreatment nutritional status, human papilloma virus (HPV) infection, tumor infiltrating lymphocyte (TIL), and treatment response after chemotherapy in patients with head and neck squamous cell carcinoma (HNSCC) in Indonesia. Further, factors associated with overall survival were also assessed.

Methods:
This was a retrospective cohort study. Data were collected between January 2015 and January 2018. A total of 30 patients with histopathologically proven squamous cell carcinoma head and neck cancer who had received at least three cycles of chemotherapy were included. Nutritional status was assessed using body mass index (BMI).

Results:
The mean BMI was 21.8 kg/m2 (Standard Deviation 3.98). The underweight patients had a higher risk of progressive disease (OR = 12.1, 95% CI = 1.1-135.6, P = 0.04) compared to patients with higher BMI. Neither HPV infection nor TIL was associated with treatment response and overall survival (P > 0.05). The median survival for the underweight patients was 9 months (95% CI = 3.00-15.00), whereas the median survival for normal and obese patients was 14 months (95% CI = 9.33-18.67).

Conclusion:
Underweight is associated with a significantly higher risk of progressive disease and tends to have shorter overall survival in patients with HNSCC. Yet, neither HPV infection nor TIL was associated with treatment response and overall survival.
Clinicopathologic significance of human epidermal growth factor receptor 2 expression and gene amplification in gastric carcinoma
Authors: Senel Fatma 
Published: December 2022

Aim:
This study is aimed at determining the human epidermal growth factor receptor-2 (HER-2) gene status in gastric cancers using immunohistochemistry (IHC) and silver DNA in situ hybridization (SISH) technique and investigating the relationship between HER-2 status and clinicopathological variables.

Materials and Methods:
We examined 104 gastric carcinoma cases with gastrectomy specimens. The age, sex, histopathological tumor type, tumor differentiation, tumor localization, tumor size, invasion depth, lymph node metastasis status, HER-2 IHC evaluation results, and SISH evaluation results of the cases were recorded.

Results:
In the present study, the SISH-confirmed HER-2 positivity rate (SISH amplification) is 14.4%. A statistically significant relationship was found between HER-2 status and tumor invasion depth (P = 0.03). It was observed that as the depth of invasion increased, HER-2 positivity decreased. No statistically significant relationship was found between HER-2 status and sex, age, tumor size, differentiation, histopathological classification, lymph node metastasis, and tumor localization (P > 0.05). The rate of HER-2 2+ cases was found to be high.

Conclusion:
HER-2 status is negatively correlated with the depth of invasion in gastric cancers, and HER-2 positivity increases as the depth of invasion decreases. HER-2 may be early molecular evidence in oncogenesis. Immunohistochemically, HER-2 2+ cases should be confirmed by the in situ hybridization (ISH) technique.
Dermatofibrosarcoma protuberans
Authors: Dahiya Sakshi , Tomar Reena , Ahuja Manisha , Mallya Varuna , Mandal Shramana , Khurana Nita , Rathi Arun Kumar 
Published: December 2022

Introduction:
Dermatofibrosarcoma protuberans (DFSP) is an uncommon skin tumor with a low-to-intermediate grade of malignancy, characterized by progressive growth and a propensity for local recurrence. In this series, we are analyzing the clinicopathological spectrum of DFSP cases.

Materials and Methods:
A retrospective study of 12 patients with DFSP who were diagnosed at our institute over the last 2 years (2018–2020) was performed.

Results:
The clinicopathological spectrum and immunohistochemistry of DFSP cases were studied with one case with lymph node metastasis, which is a rare entity, and two cases of the fibrosarcomatous DFSP were also diagnosed and warrant a special mention.

Conclusion:
Pathologists should be aware of metastasis and unusual variants while reporting dermatofibrosarcoma.
Personalized dendritic cell vaccination in cancer therapy: An evidence-based research study
Authors: Hatzidaki Eleana , Papasotiriou Ioannis 
Published: December 2022

ABSTRACT

Background:
Although chemotherapy is considered to be the golden standard, it does not come without a price. Toxicities and resistance are frequently limiting its effectiveness. Immunotherapy has emerged as a safer therapeutic alternative but still has a long way until it has proven to be of equal efficacy. A type of immunotherapy is dendritic cell (DC) vaccination.

Aims and Objectives:
We have developed a novel platform for the generation of autologous DCs that have been activated against peptides that are personalized for each patient individually. The aim of the study was to clinically evaluate this platform.

Materials and Methods:
Our platform and our algorithm for the determination of the immunogenic peptides has been tested. DC generation was verified both morphologically and by CD80/86 expression. Peptide antigenicity was determined using a number of T-cell epitope prediction algorithms. Response to therapy was evaluated using response evaluation criteria in solid tumors (RECIST) criteria by the doctors involved. Immune status was also evaluated before and after DC vaccination and correlated with circulated tumor cell count.

Results:
It was found that DC vaccine increased immune activation while correlated with decreased circulating tumor cell counts. Clinical evaluation by the determination of immune markers may be a superior tool than using RECIST criteria.

Conclusion:
Dendritic cell therapies could prove to be a valuable tool in cancer treatment.
A prospective clinical study to assess primary hypothyroidism in head and neck cancer patients treated with external beam radiotherapy
Authors: Shewalkar Balaji K. , Balachandran Roopa , Pant Punita , Patel Jitendra 
Published: December 2022

ABSTRACTS

Purpose:
Head and neck cancers are treated by multimodality methods like surgery, radiotherapy, and chemotherapy. Hypothyroidism is one of the late side effects of radiation to the neck. The main aim of the study was to assess the incidence of primary hypothyroidism in patients with head and neck cancers, who received therapeutic external beam radiation; to evaluate the time duration and the total dose of radiation for the development of hypothyroidism.

Materials and Methods:
A prospective observational study was conducted in our institute on 200 patients from December 2018 to April 2020 with head and neck cancers, which were proven histopathologically. They received external beam radiation using Cobalt 60 or Linear accelerator. A thyroid function test was done in patients after 3 months and 6 months of completion of radiotherapy.

Results:
The incidence of hypothyroidism was 8% after 3 months (P value = 0.0088) post radiation and increased to 14% after 6 months (P value = 0.0024). Of the patients who developed hypothyroidism, a maximum number of cases (24; 86%) were given 60 Gy radiation dose, three (10%) were given 40–59 Gy, and one (3%) was given up to 40 Gy as the mean dose of radiation to the lower neck. A P value of 0.750 was not significant; hence, a dose of radiation was not a significant factor. The patients treated with the two-dimensional (2-D) technique (50%) had a higher incidence of hypothyroidism than the patients treated with three-dimensional conformal radiation therapy (3D-CRT) (14.8%) and intensity-modulated radiation therapy (IMRT) (9%). The use of concurrent cisplatin was not a significant factor for hypothyroidism (P value = 1).

Conclusion:
Thyroid function test should be done in patients who received therapeutic external beam radiation to the neck at baseline and periodically. The early detection and treatment can prevent complications of long-term thyroid hypofunction like hypercholesterolemia, cardiovascular side effects, menstrual irregularities, infertility, peripheral neuropathy, depression, and myxoedema.