bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nuances in Visual Rehabilitation After Pituitary Surgery
Authors: Gupta Saksham , Bi Wenya Linda 
Published: January 2025

Abstract
Patients with pituitary lesions often present with visual deficits attributable to mass effect along the optic pathway or on the cranial nerves controlling extraocular muscles. While symptoms often improve after treatment, persistent symptoms negatively impact quality of life. We reviewed the literature on emerging concepts in visual monitoring and recovery during and after pituitary surgery. Rigorous preoperative laboratory testing, neuro-ophthalmologic examination, and imaging abets planning of safe surgery. Intraoperative visual evoked potentials may provide an adjunct to monitor impending damage to vision during surgery, particularly for recurrent tumors that may have scarred onto visual structures. Treatment of persistent visual deficits depends on the physiological cause of the deficit, the duration of symptoms, and the degree and pace of spontaneous recovery. Management ranges from observation to corrective oculoplastic surgery, often in the context of a multidisciplinary team. There are several gaps in knowledge on the reasons why visual deficits remain after adequate decompression during surgery, and further study will reveal new therapies and devices. Postoperative visual deficits following pituitary surgery can cause a considerable reduction in quality of life. Multidisciplinary neurosurgery, neuro-ophthalmologic, and neuro-endocrine teams should work in concert to provide an individualized approach for each patient.
Adjunctive nivolumab in combination with antibiotic therapy for the management of refractory melioidosis in a patient with metastatic breast cancer and chemotherapy-induced pancytopenia
Authors: Tirlangi Praveen Kumar , Kiran Swathi , KE Vandana , Mukhopadhyay C , Kundu Ramit , Pai Ananth , PS Priya , Saravu Kavitha 
Published: January 2025

Abstract
Burkholderia pseudomallei, the causative agent of melioidosis, is intrinsically resistant to multiple classes of antibiotics and primarily affects immunocompromised individuals, such as those with poorly controlled diabetes or malignancies. In this case, a 58-y-old female farmer with poorly controlled diabetes (HbA1c of 11.4%), metastatic breast cancer with chemotherapy-induced pancytopenia and disseminated melioidosis showed no improvement despite receiving antibiotics and supportive care. However, the introduction of adjunctive nivolumab, combined with an antibiotic regimen, resulted in significant therapeutic benefit, suggesting a promising new approach for managing severe and refractory melioidosis.
Extracellular vimentin amplifies inflammation: Perspectives for immune injury and therapeutics for periodontitis
Authors: Yuan Zhiyao , Smith Patricio , McCulloch Christopher A. 
Published: January 2025

AbstractPeriodontitis is an inflammatory disease triggered by microbial biofilms that promote immune dysfunction and tissue destruction of tooth‐supporting tissues. The search for soluble mediators that amplify inflammatory responses and matrix degradation in periodontal tissues has implicated extracellular vimentin (ECV) as a signaling ligand and damage‐associated molecular pattern in the pathogenesis of periodontitis. Intracellular vimentin filaments are essential for the structural integrity of cells and the preservation of matrix homeostasis. These are important determinants of health in the periodontium and many other organs. But in inflamed tissues, intracellular vimentin filaments are disassembled. Vimentin is subsequently released from cells into the extracellular space in a soluble form where it drives immune signaling and tissue destruction. We discuss the role of ECV as a signaling molecule in several tissues. We apply these data to understand how in inflammatory diseases like periodontitis, ECV amplifies immune responses that contribute to disease progression. Arising from these data, we consider novel therapeutic opportunities for limiting tissue destruction by targeting ECV for treatment of inflammatory disorders like periodontitis.
Development and psychometric properties of a quality of life assessment tool for Chinese patients undergoing intravitreal injection (IVI-QoL-23)
Authors: Tan Liangzhang , Linghu Wenrui , Xu Meiqi , Liu Shoukuan , Li Yongtao , Ke Yifeng , Pazo Emmanuel Eric , Ren Xinjun 
Published: January 2025

Purpose:
To develop and assess the psychometric properties of a quality of life (QoL) assessment tool for Chinese patients treated with intravitreal injection (IVI) of anti-vascular endothelial growth factor (anti-VEGF).

Methods:
We developed a 31-item IVI-QoL questionnaire using semi- structured patient interviews and expert panel consultation, drawing on a study of the literature. After pretesting on a subset of patients undergoing IVI, the questionnaire was pared down to 23 items. In total, 364 completed questionnaires were received. The IVI-QoL was further developed and evaluated using Rasch analysis.

Results:
The final IVI-QoL version was constructed with 23 items in four dimensions: visual function, emotional subscale, social function, and healthy behavior, based on item reduction and exploratory factor analysis. The person separation indices for the four subscales ranged from 2.05 to 2.60. No items had a differential item functioning (DIF) contrast greater than 0.5 logits. The IVI-QoL-23 scale showed satisfactory internal consistency (Cronbach’s alpha > 0.9).

Conclusions:
The IVI-QoL-23 is reliable and valid for evaluating the QoL of Chinese patients treated with intravitreal injection of anti-VEGF drugs.
Longitudinal changes of macular neurodegenerative and vascular abnormalities on OCTA in sickle cell disease
Authors: Brandsen Rajani P. , Biemond Bart J. , Nur Erfan , Chang-Wolf Jennifer M. , Schlingemann Reinier O. , Diederen Roselie M.H. 
Published: January 2025

Purpose:
To evaluate the presence and progression of maculopathy in patients with sickle cell disease (SCD) using Optical Coherence Tomography (OCT) and OCT-Angiography (OCTA), and to identify clinical/laboratory risk factors for progression during follow-up.

Methods:
Complete ophthalmic examination, including fundoscopy and macular SD-OCT/OCTA scans, was performed in consecutive SCD-patients (HbSS/HbSβ0/HbSβ+/HbSC genotype) during baseline and follow-up visits. SCR stage was based on fundoscopy instead of the Goldberg classification, since fluorescein angiography was not routinely used. Medical/ophthalmological history and hematologic characteristics were retrieved from medical records.

Results:
106 eyes of 60 patients were analyzed. The median follow-up period was 34.5 months (range 8-70, IQR 25-55). Macular thinning was present in 41 eyes (38.7%) at baseline and in 52 eyes (49.1%) at follow-up. Progression of macular thinning was observed in 25.5% (27/106) of the eyes and SCR progression in 15.1% (16/106) of the eyes. Predictors for progression of macular thinning were proliferative retinopathy (adjusted OR (aOR) 3.40, p=0.024), lower vessel density in the superior capillary plexus of the inferior parafoveal subfield (aOR 0.88, p=0.003) and higher vessel density in the deep capillary plexus of the inferior parafoveal subfield (aOR 1.17, p=0.001). No association was found between progression of macular thinning and worsening of other organ damage, SCR progression, ocular complications or laser treatment.

Conclusions:
SCD-related maculopathy progresses in many patients without impairing visual acuity during short-term follow-up. Progression of maculopathy is correlated with proliferative retinopathy and vessel densities in inferior parafoveal subfields. Further research is needed to elucidate functional consequences of macular changes.
Removal of Subretinal Gas After Pneumatic Retinopexy Under Air Using External Manipulation
Authors: Cobbs Lucy , Rodriguez Linnet , Hinkle John , Hsu Jason , Mehta Sonia 
Published: January 2025

Purpose:
To illustrate a technique for the removal of subretinal gas via pars plana vitrectomy (PPV) with air-fluid exchange and simultaneous manipulation with scleral depression.

Methods:
PPV to remove subretinal gas causing persistent macula-off retinal detachment was performed in one eye, and the results were evaluated in this case report. Ports were carefully placed to avoid puncturing the retina, which was significantly displaced anteriorly past the ora serrata due to the buoyancy of the subretinal gas with the patient in a supine position. After vitrectomy was performed, an air-fluid exchange was initiated to flatten the anterior retina and assist in stabilizing the subretinal gas bubble. Simultaneously, a scleral depressor was used to apply external pressure in a sweeping motion to direct the subretinal gas toward the pre-existing retinal break where it was aspirated or moved into the vitreous cavity.

Results:
The one-year postoperative visual acuity without correction was 20/25 with normal intraocular pressure and attached retina. There were no intraoperative or postoperative complications.

Conclusion:
Our technique used a partial air-fluid exchange to stabilize the subretinal gas and external manipulation with a scleral depressor to manually extrude subretinal gas. This maneuver was previously described in the 1980s, and we include a surgical video of its execution with modern vitrectomy equipment and the benefit of excellent control of the subretinal gas without the need to create a retinotomy.
Comparison of “Lung and Large Intestine being Exterior-Interior” and “Gut-Lung Crosstalk” Based on COVID-19
Authors: Wang Yunliang , Zhang Yan 
Published: January 2025

Abstract
The infection of SARS-CoV-2 has triggered Covid-19 pandemic. In addition to the fever and respiratory symptoms in the process of coronavirus infections, gastrointestinal symptoms, especially diarrhea, are prominent features of its acute infection and long COVID. The associations between lung and large intestine have been demonstrated by Western medicine at the aspects such as tissue origin, microflora homeostasis, mucosal immunity, renin-angiotensin system (RAS) and autonomic nervous system as well, which are considered as the evidence of material basis and potential regulatory mechanisms for “gut-lung crosstalk” in COVID-19. We have noticed that probiotics and other preparations can regulate the intestines, and further treat COVID-19 with effective and gratifying results. In the system of traditional Chinese medicine (TCM), there’s a term of “lung and large intestine standing in exterior-interior relationship (肺与大肠相表里)”, showing an interconnection of lung and bowel. “lung and large intestine standing in exterior-interior relationship” is an important part of the theory of visceral activities proposed by ancient physicians through a long-term observation and practice. It’s considered that "lung" and "large intestine" are interconnected and mutually exterior-interior in the normal physical activities and the disease development, providing a theoretical basis for treating lung diseases and bowel diseases from the perspective of overall concept. Here, we intend to compare the term of “lung and large intestine standing in exterior-interior relationship” in TCM and “gut-lung crosstalk” in Western medicine regarding the development of COVID-19 and its intestinal symptoms, and provide more ideas for diagnosing and treating lung and bowel related diseases.
Traditional Chinese Medicine Recorded by Missionaries (1887-1932): A Study Centered on the China Medical Missionary Journal
Authors: LI YanRan , YAN Na 
Published: January 2025

Abstract:
It was in The China Medical Missionary Journal (CMMJ) that traditional Chinese medicine (TCM) made her academic international debut, which was first published in Shanghai in 1887. Originally, It integrated medical evangelism, hospital reports and world medical development, and it was transformed into a purely academic journal in 1907. There are many records related to TCM in it, such TCM diagnosis, treatment methods and clinical practices. These records show the process of how the missionaries observed, understood, learned, and used TCM. They also reflect the attitudes of medical missionaries towards TCM after experiencing it in its homeland - China at that time. The writings of missionaries on TCM represent a confluence of Eastern and Western medical research and cultural interactions, contributing significantly to the study of modern Chinese medical advancements and Sino-Western cultural exchanges.
Performance of Ulcer Features in Predicting Malignancy Among Gastric Ulcers Diagnosed on Upper Endoscopy
Authors: Patel Ankur P. , Gandle Cassandra , Baerman Elliot , Lill Isaac , Pecha Robert L. , Nguyen Wenker Theresa H. , El-Serag Hashem B. , Ketwaroo Gyanprakash A. , Tan Mimi C. 
Published: January 2025

Objective:
Even though the prevalence of malignancy within gastric ulcers is low, surveillance endoscopy is routinely performed after gastric ulcer diagnosis resulting in unnecessary costs and risks. Endoscopic appearance may be used to identify ulcers with malignant features and guide decisions regarding the need for surveillance endoscopy. Our aim was to assess the predictive value of several endoscopic ulcer features with the risk of prevalent malignancy in patients diagnosed with gastric ulcers.

Methods:
Patients with gastric ulcers were identified using endoscopic reporting software in 2 hospitals in Houston, TX, from February 2019 to July 2021. Malignant and benign gastric ulcers were defined using ulcer biopsy histopathology, and ulcers that had healed on surveillance endoscopy were also classified as benign ulcers. Potential endoscopy-related predictors of malignant ulcers included: Forrest classification, location, size, elevated border, irregular border, and background gastric atrophy.

Results:
We identified 338 patients with gastric ulcers, and 150 (44%) had at least one surveillance endoscopy. Malignant ulcers were found in 41 patients (12%). The strongest predictors of malignancy were irregular border [area under receiver operating characteristic (AUROC): 0.89, 95% CI: 0.80-0.97], gastric atrophy on histopathology (AUROC: 0.87, 95% CI: 0.78-0.96), and elevated border (AUROC: 0.84, 95% CI: 0.73-0.95). A multivariate model including corpus/cardia location, irregular border, elevated border, and gastric atrophy on histopathology had the best discrimination for predicting malignant ulcers (AUROC: 0.96, 95% CI: 0.93-0.98) with low false negatives (0.4%).

Conclusions:
A model combining corpus/cardia location, irregular border, elevated border, and gastric atrophy on histopathology best-predicted malignancy in gastric ulcers and may identify patients with the most benefit from surveillance endoscopy.
A Systematic Critical Appraisal of Clinical Practice Guidelines in Barrett’s Esophagus Using the AGREE II Tool
Authors: Dayto Denisse C. , Sephien Andrew , Reljic Tea , Klocksieben Farina , Slone Samuel , Kumar Ambuj , Blonski Wojciech 
Published: January 2025

Background:
Several clinical practice guidelines (CPGs) exist for managing Barrett’s esophagus (BE). However, the methodological quality of these CPGs is not known. To summarize the methodological quality of CPGs, we performed a critical appraisal of all available CPGs for the management of BE published from January 2018 to February 2023.

Methods:
A comprehensive search of EMBASE and PubMed was conducted to identify eligible CPGs published from January 1, 2018, until February 24, 2023, addressing the management of BE. The Canadian Agency for Drugs and Technologies broad filter was also utilized in the search. The quality of the CPGs was independently assessed and evaluated by 2 reviewers using the Appraisal of Guidelines for Research & Evaluation II (AGREE II) instrument, with domain scores showing good quality being >80% and sufficient quality being >60%. The search yielded 652 citations, of which 5 CPGs met eligibility.

Results:
Three CPGs were published by gastroenterology societies in the United States and 2 in Europe. The overall median score for the AGREE II domain was 100% for scope and purpose, 93% for stakeholder involvement, 93% for rigor of development, 93% for clarity of presentation, 75% for applicability, and 75% for editorial independence.

Conclusion:
The findings from our study show that there is significant variability in the methodological quality of the CPGs for the management of BE across different domains. The application of the AGREE II tool can help CPG developers in improving the methodological rigor and applicability of CPGs.
Complete mesocolic excision versus D2 lymphadenectomy in right hemicolectomy: a meta-analysis of propensity score matched studies and randomized controlled trials
Authors: Pompeu Bernardo Fontel , Pasqualotto Eric , Marcolin Patrícia , Delgado Lucas Monteiro , Pigossi Beatriz D’Andrea , Figueiredo Sergio Mazzola Poli de , Formiga Fernanda Bellotti 
Published: January 2025

Introduction:
The complete mesocolic excision (CME) in right-sided hemicolectomy could result in higher lymph node yield and decreased local recurrence. However, this approach could increase intraoperative and postoperative complications. Therefore, our meta-analysis aims to demonstrate the outcomes of CME versus D2 conventional lymphadenectomy in right-side colon cancer.

Methods:
We searched MEDLINE, Cochrane Central Register of Clinical Trials, and Scopus for studies published until April 2024. Odds ratios (OR) with 95% confidence intervals (CIs) were pooled using a random-effects model. Heterogeneity was assessed using the Cochran Q test and I
2 statistics, with P values <0.10 and I
2 >25% considered significant. Statistical analysis was performed using R Software, version 4.1.2.

Results:
Three randomized controlled trials and four observational studies comprising 2296 patients were included, of whom 1138 (49.6%) were submitted to the CME and 1158 (50.4%) to the conventional D2 lymphadenectomy. CME was associated with decreased local recurrence rates (OR 0.07; 95% CI 0.001 to 0.36; P = 0.002). There were no significant differences between groups in overall complications, severe complications, intraoperative complications, blood loss, and 30-day mortality. No difference between groups was observed in distance metastasis and 3-year disease-free survival.

Conclusion:
In this meta-analysis, CME significantly decreases local recurrence rates compared with D2 conventional lymphadenectomy in patients with right-side colon cancer. No significant difference was observed between groups in rates of overall complications, severe complications, intraoperative complications, blood loss, and 30-day mortality.
A bleeding sword: Scimitar syndrome in a child with hematemesis due to esophageal varices – a case report
Authors: Elawad Aida , Arabi Ali M. E. , Yousif Rayan , Ganim Mohammed , Rafei Ahmed , Bedab Rawan A. , Salah Reem , Abdo Abdelmounem E. 
Published: January 2025

Introduction:
Scimitar syndrome, or congenital venolobar syndrome, is a rare congenital heart condition that typically involves partial anomalous pulmonary venous drainage (PAPVD) of the right lung, right lung hypoplasia, and dextroposition of the heart. The incidence is estimated to be between 1 and 3 cases per 100 000 live births. Most patients present with cardiopulmonary symptoms, though rare cases may involve gastrointestinal (GI) complications. We report a unique case of Scimitar syndrome in a 10-year-old boy presenting with hematemesis due to esophageal varices.

Case Presentation:
A 10-year-old boy presented with massive hematemesis, losing approximately 1 liter of fresh blood. After stabilization, an upper GI endoscopy revealed grade IV esophageal varices, which were ligated successfully. Abdominal ultrasound showed mild portal hypertension, and a unique vessel, identified as the Scimitar vein, was found draining into the left portal vein. Subsequent imaging confirmed right lung hypoplasia, dextroposition of the heart, and PAPVD, leading to the diagnosis of Scimitar syndrome. The patient was transferred abroad for specialized care due to limited medical facilities in Sudan.

Clinical Discussion:
Scimitar syndrome is often associated with severe symptoms in children, such as respiratory failure and pulmonary hypertension. Upper GI bleeding in this syndrome is rare, likely resulting from portal hypertension caused by the anomalous drainage of the Scimitar vein into the left portal vein.

Conclusion:
This case underscores the importance of recognizing the diverse complications of Scimitar syndrome, including its rare association with upper GI bleeding. Timely diagnosis and intervention, especially in resource-limited settings, are critical to managing complex congenital conditions.
Mad (wild) honey poisoning: a case series of eleven cases
Authors: Subedi Bhusan Kumar , Homagain Sushan , Ghimire Jeevan , Subedi Shova , Paudel Suruchi , Pandeya Govinda , Jha Saroj Kumar , Shrestha Nishan , Twanabasu Sajal , Devkota Sadina 
Published: January 2025

Introduction:
Mad (Wild) honey, used as alternative medicine in some countries where cases of poisoning are reported, got its name due to its intoxicating effects. Poisoning due to mad honey mostly presents as bradycardia and hypotension.

Case reports:
We report 11 cases involving 6 females and 5 males, of mad honey poisoning used for medicinal purposes. All patients were young adults (average age 43.9 years) except for one. Lightheadedness, dizziness and nausea were the most common complaints. All presented in bradycardia ranging from 35 to 60 beats per minute. All cases were managed conservatively while one required vasopressors support. All patients improved with a couple of days of supportive care.

Discussion:
Mad honey poisoning seems to be a geographically restricted entity as the majority of cases are reported from a particular region. Because of its use as an alternative medicine for various purposes, cases of intoxication occur year around. Although the signs and symptoms of mad honey can be life threatening including nausea, dizziness, bradycardia, and hypotension, the prognosis is generally good

Conclusion:
Although the prognosis is fairly good, mad honey intoxication has significant morbidity. Lack of awareness about the potential complications of consuming mad honey seems to be the cause of cases of poisoning seen annually.