Medical Literature Research Articles

Pseudolipoblastic Perineuroma: A Rare Histologi̇c Subtype.

Pseudolipoblastic perineurioma is a very uncommon variant of extraneural perineurioma, with only a limited number of cases documented in the medical literature. The most remarkable histopathologic characteristic is the existence of vacuolated cells that closely resemble lipoblasts; besides the presence of small, spindle shaped, or epithelioid perineurial cells. In this study, we present another case of pseudolipoblastic perineurioma, predominantly characterized by the presence of vacuolated "pseudolipoblastic" cells. The immunohistochemical expression of EMA, Glut-1, claudin-1, collagen type IV, and laminin as well as S-100 negativity is essential for the diagnosis to support the perineurial origin. Simple excision is the best treatment option for these benign tumors that do not recur or metastasize. It is crucial to recognize this rare entity to differentiate it from many other tumors characterized by prominent intracytoplasmic vacuoles.

Implementation and reception of a semi-structured resident interview to improve equity

Abstract Introduction/Objective To improve equity and inclusion in the residency candidacy interview process, we collaborated with our human resources and graduate medical education colleges to develop standardized interview questions based on best practices reported in corporate and medical literature. These standardized questions were piloted by resident interviewers during the 2023-2024 Pathology residency application cycle in a semi-structured interview format. Methods/Case Report With consultants from the graduate medical education and human resources, we identified favored qualities of expectational candidates (e.g., passion for pathology, interest in program, collaboration, reliability, and compassion) and developed a list of standardized questions with a corresponding answer scoring guide to guide objective assessment of answers for each quality. Residents and fellows (“interviewers”) who volunteer to interview Pathology residency candidates (“candidates”) received training on interviewing best practices, identifying and mitigating bias, and the new semi-structured interview format at the beginning of the interview season. Interviewers were encouraged to use a semi-structured interview format where at least one standardized question is included in addition to their usual ad hoc interview questions and discussions. After the interview season concluded, we surveyed all interviewers (n=39) and candidates (n=90) who participated in this process, for feedback on the semi-structured interview process. Results (if a Case Study enter NA) 31/90 (34%) applicants provided feedback about their interview with 15/29 (52%) applicants agreeing that the semi-structured interview format enhanced their experience. 20/31 (65%) applicants agreed that their impression of Stanford would be positively affected if all interviews were conducted in a semi- structured format. 24/31 (77%) think faculty members should use standardized questions while 17/31 (55%) think residents should use standardized questions in either a semi-structured or structured formats. 17/31 (55%) feel that structured interviews contribute to improving equity. 12/39 (31%) of current residents provided feedback about their interviews. All 12 (100%) respondents used standardized questions in a semi-structured interview format. 10/12 (83%) interviewers think the new format improves our resident interview process. Conclusion Overall, responses from both resident interviewers and applicants support the implementation of semi- structured interviews and the continuation and expansion of this initiative.

Misuse of Neck Restraint Terms Affect Medical Treatment and Public Policy

Misuse of Neck Restraint Terms Affect Medical Treatment and Public Policy

Comparative Study of Air Pollution with Ayurveda and its Management

Background Environmental pollution is increasing day by day and imposing severe and irreversible damage to the world. Air pollution is one of the biggest threats for the environment and affecting humans, animals, crops, cities, forests, aquatic ecosystems. Environmental Toxicology is the science concerned with study of harmful effects of various chemical, biological and physical agents on living organisms. In Ayurveda Charakacharya has briefly described the environmental health in chapter named Janpadodhvansaniyavimanam. Ayurveda has a dedicated branch called Agadatantra which deals with the toxicological aspects of living entities of environment. Aims and objectives We aim to relate and validate this knowledge pertaining to the air pollution. Material and method the references available regarding the air pollution in classical texts were studied and compared with the available information in the contemporary medical literatures. Signs of air pollution given in the text compared and studied with signs of Air pollution. Discussion Ayurveda terms of Vikrut and Prakrut Vayu described in Granthas are found to be relatable with contemporary findings. Conclusion Air pollution described in Ayurveda are very precise and explanatory. Management of air pollution with this ancient science are the new open windows for healthy air breathing for every living organism.

The Preparation of Future Statistically Oriented Physicians: A Single-Center Experience in Saudi Arabia.

Background and Objectives: Statistics are of paramount significance to physicians as they allow them to critically interpret the medical literature and to contribute to it. However, teaching statistics to medical students and physicians, as well as learning statistics, is nothing short of difficult and anxiety-inducing to a great extent. Materials and Methods: In this study, an example of a novel approach to teaching statistics to medical students is introduced at a single college of medicine in Saudi Arabia. In this retrospective report, a new approach that has been developed and delivered to students is described. Results: The approach, referred to as the personal experience pathway, is part of a major curriculum change to the MBBS program. The track presents statistics to students as a tool, rather than a subject, that students will need to interpret results, either present in the literature or those of the research projects they are conducting. The outcome of this process has been assessed through measuring students' scholarly output through student self-reporting and has been followed up over four student cohorts graduating between the years 2019 and 2022. The approach has successfully equipped students with a solid foundation of statistical understanding that has allowed them to publish in peer-reviewed journals. Such scholarly output has increased significantly over the last two years. Conclusions: The current study presents a framework through which the detailed curriculum plan could be applied to other medical schools, nationally and internationally, which will better prepare future statistically oriented physicians.

Frontiers in Safety and Efficacy: Introduction

There are increasing numbers of people suffering with osteoarthritis and other musculoskeletal disorders. Current treatments for these conditions have significant side effects and comorbidities. Surgery in some cases may be inappropriate or ineffective. The use of regenerative medicine in the form of orthobiologics has been growing. The purpose of these treatments is to treat pain and to possibly enhance the healing of tissue pathology by augmenting the body’s inherent healing capabilities. Orthobiologic products commonly used include platelet rich plasma, adipose and bone marrow derived cellular products and birth tissue products. This review of the current medical literature has been prepared to provide evidence-based information to patients, clinicians, researchers, and regulatory and payer organizations with regard to the safety, efficacy, and cost effectiveness of orthobiologic treatments.

Efetividade e segurança do uso do ar ambiente em comparação ao oxigênio a 100% em prematuros em parada cardiorrespiratória: protocolo de revisão sistemática

Introduction: Cardiorespiratory arrest is a clinical situation characterized by the interruption of blood circulation. It is estimated that 11.1% of all live births in the world are premature, generating short and long-term repercussions. One of the main challenges during cardiacarrest in premature infants is providing sufficient, but not excessive, oxygen during assisted ventilation. Objective: To compare the effectiveness and safety of using room air in relation to 100% oxygen in the resuscitation of premature infants in cardiorespiratory arrest. Methods: To this end, we will carry out a systematic review of randomized clinical trials (RCTs). The study protocol was registered on the Prospero Platform (CRD42024519724). We will include preterm infants with gestational age <37 weeks with CA. The searches were carried out in the following databases: Medical Literature Analysis and Retrieval System Online (MEDLINE) via Pubmed, Excerpta Médica dataBASE (Embase) via Elsevier, Cochrane Central Register of Controlled Trials (CENTRAL) via Cochrane Library, Latin American Literature and the Caribbean Doctor in Health Sciences (LILACS) through the Virtual Health Library Portal, without restrictions on language or year of publication. The selection of studies, transmission of data, assessment of the bias of included studies and assessment of the certainty of the evidence will be carried out by two independent investigators. Expected results: Clarify the transit and safety of using room air compared to 100% oxygen, provide useful information for clinical decision-making, and support future high-quality randomized clinical trials on the topic. Conclusion: This study aims to compile existing research to analyze the effectiveness and safety of application of 100% oxygen in the resuscitation of premature infants. Keywords: Heart arrest; infant premature; systematic review.

Ureteroscopy and lasertripsy for lower pole stones

To investigate the outcomes of ureteroscopy and lasertripsy in lower pole renal stones <2 cm when treated in situ compared to displacement to the upper pole. Using the Medical Literature Analysis and Retrieval System Online (MEDLINE)/PubMed, the Excerpta Medica dataBASE (EMBASE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Cochrane Library, and Clinicaltrials.gov we identified adult population, English language, studies published until March 2023 comparing surgical outcomes and stone-free rates (SFRs) in relation to lower pole stones <2 cm managed in situ vs those displaced (International Prospective Register of Systematic Reviews [PROSPERO] identifier: CRD42023432750). Analysis was performed using R with the 'meta' package. Bias analysis was performed using the Cochrane Risk of Bias 2 tool for randomised trials and the Newcastle-Ottawa scale for observational studies. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach was used to ascertain the certainty of evidence. A total of five studies were included, comprising two retrospective cohort studies, three randomised trials, with a total of 408 patients. Meta-analysis demonstrated SFRs are significantly higher in those patients undergoing displacement vs those managed in situ (risk ratio 1.21, 95% confidence interval [CI] 1.10-1.34, P < 0.001). There was no significant difference in complication rates. Operative time was significantly longer in the displacement group (mean difference 5.62 min, 95% CI 0.40-10.83 min; P = 0.03). Overall risk of bias was moderate. Certainty of evidence was moderate for stone-free status, and very low for all other outcomes. This systematic review and meta-analysis demonstrates that for lower pole stones <2 cm displacement strategies have significantly higher SFRs than treatment in situ, with no significant difference in complications. There is significantly increased operative time in the displaced group, but an additional 6 min is unlikely to be clinically significant.

Effects of the coronavirus 2019 pandemic on medical publishing: The sacrifice of quality for quantity?

AbstractFacing the coronavirus disease 2019 (COVID‐19) pandemic, medical publishers rose to the occasion, moving to make their full portfolio of COVID‐19–related research available to read for free and expediting peer review and production processes. With such a rapid transition from paper submission to publication, however, concerns also arose regarding whether the quality of the research publication process was being affected. This article seeks to document the transformation of medical publishers' practices in response to the COVID‐19 pandemic and briefly discuss where they may go from here. For this goal, a literature search was performed in PubMed at several points to identify papers that reported early trends in how medical publishers handled COVID‐19 research.

Particularities of a Cardiac Amorphous Left Ventricular Tumor in a Patient with Coronary Artery Disease—Diagnostic and Therapeutic Challenges: A Case Report and Literature Review

Background: Cardiac calcified amorphous tumors (CATs) are rare non-neoplastic formations containing amorphous fibrinous material and calcifications. In our research, we present the case of a 42-year-old male patient who developed, during his 6-months monitoring for coronary artery disease, a left ventricular (LV) CAT raising diagnostic challenges. Methods: To gather additional information on CATs, we researched the international medical literature for scientific articles published with the full text in English, on PubMed, ResearchGate, Clarivate, and Google Scholar between 2020 and 2024. Results: Compared to most described cases, our patient was a young male, without mitral annular calcification or chronic renal disease, but he was suffering from chronic peripheral and coronary artery disease, and genetic testing revealed a higher risk for thromboembolic events. During 6 months, he developed a LV CAT of 4.5/3.5/3 cm. Although we found in the medical literature 16 case reports of patients with CAT, only six authors could specify a precise postoperative evolution of the CAT, most of them sustaining that if completely removed, it would not relapse, an aspect observed also in our patient during 3 years of follow-up. Conclusions: CATs are rare heart tumors with slow growth, but with a high embolization risk that raises diagnostic and therapeutic challenges.

Runners injuries - main types of injuries of the musculoskeletal system of the lower limb and their treatment and prevention

Introduction and purposeRunning is currently one of the most popular physical activities practiced by people around the world, and the number of runners has been growing significantly for many years. The incidence of running-related lower limb injuries in runners ranges between 19.4% and 79.3% [1].The paper presents research results on the main types of injuries of the musculoskeletal system of the lower limb in runners, their risk factors, methods of treatment and prevention. The results indicate a significant relationship between regular training and the occurrence of injuries, and also emphasize the importance of prevention through rest, appropriate running technique and the selection of footwear. The work provides practical tips for runners and coaches that can help reduce the risk of injuries and improve the quality of training. Materials and methods The review was conducted by searching PubMed and other scientific databases focusing on currently available publications. The literature available in the PubMed database was reviewed using the following keywords: “running”, “running injuries”, “tendinopathy”, "running related injuries”, “running biomechanics”, “musculoskeletal injuries”. The analysis of 38 articles published between 2014-2024 was used to write the paper. Conclusions Running has many health benefits, but unfortunately it can also have a negative effect. The development of medical literature regarding appropriate prevention, knowledge of risk factors and treatment methods improves the prognosis of injuries in runners. Evolving diagnostic imaging, body monitoring, prevention, and adequate rest between activities are essential to long-term success in preventing running-related injuries.

Frank’s Sign which is a Marker of Coronary Heart Disease

In today's clinical practice, the importance of a thorough clinical examination of the patient is emphasised in the article. There are 2 real-world instances of diagonal earlobe creases, commonly referred to as Frank's sign. The patients in both cases have ischemic heart disease, however they differ in terms of age and Frank's sign severity. Data from the literature are presented regarding the frequency of Frank's disease in various population groups, as well as its clinical importance and potential underlying pathophysiological causes. In the medical literature, the diagonal ear lobe crease (DELC) is termed as a substitute sign that can detect high-risk individuals with hidden atherosclerosis. However, there hasn't been any research on this subject in the dentistry or medical literature. Most clinical, angiography, and postmortem data are in favour of the idea that DELC is a useful extravascular physical marker that can determine individuals who are at risk of dying from coronary artery atherosclerosis. Some research findings have failed to support the theory linking DELC to certain health conditions. However, recent studies utilizing B mode ultrasonography have indicated a connection between DELC and the development of carotid artery atherosclerosis. Another study has also associated DELC with the existence of calcified carotid artery atheromas visible on panoramic radiographs. Notably, DELC is highly noticeable on head and neck oncology screening examinations. When the patient's vital signs, medical examination, and panoramic radiograph are combined, the results are DELC can aid to assess the patient's risk of atherosclerosis.

Time to Publication in Medical Education Journals: An Analysis of Publication Timelines During COVID-19 (2019-2022).

COVID-19 changed scholarly publishing. Yet, its impact on medical education publishing is unstudied. Because journal articles and their corresponding publication timelines can influence academic success, the field needs updated publication timelines to set evidence-based expectations for academic productivity. This study attempts to answer the following research questions: did publication timelines significantly change around the time of COVID-19 and, if so, how? We conducted a bibliometric study; our sample included articles published between January 2018, and December 2022, that appeared in the Medical Education Journals List-24 (MEJ-24). We clustered articles into three time-based groups (pre-COVID, COVID-overlap, and COVID-endemic), and two subject-based groups (about COVID-19 and not about COVID-19). We downloaded each article's metadata from the National Library of Medicine and analyzed data using descriptive statistics, analysis of variance, and post-hoc tests to compare mean time differences across groups. Overall, time to publish averaged 300.8 days (SD = 200.8). One-way between-groups ANOVA showed significant differences between the three time-based groups F (2, 7473) = 2150.7, p < .001. The post-hoc comparisons indicated that COVID-overlap articles took significantly longer (n = 1470, M= 539; SD = 210.6) as compared to pre-COVID (n = 1281; M = 302; SD = 172.5) and COVID-endemic articles (n = 4725; M = 226; SD = 136.5). Notably, COVID-endemic articles were published in significantly less time than pre-pandemic articles, p < .001. Longer publication time was most pronounced for COVID-overlap articles. Publication timelines for COVID-endemic articles have shortened. Future research should explore how the shift in publication timelines has shaped medical education scholarship.

Effects of self-management education integrated nursing on cancer patients with PICC placement: a systematic review and meta-analysis

Background: Chemotherapy plays an important role in cancer treatment. Peripherally inserted central catheter (PICC) is an important vascular access device used in cancer patients undergoing chemotherapy. Objective: This review entailed an evaluation of the effects of self-management education on the occurrence of complications in patients with PICC placement. Methods: PubMed, Embase, the Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Database, VIP database and Chinese Biomedical Literature database were searched for randomised controlled trials on the effects of self-management education on patients with PICC placement. Meta-analysis was performed on the studies meeting the inclusion criteria using RevMan5.4 software. Results: A total of 12 quantitative studies were included in the meta-analysis and the results showed that self-management education reduced the incidence of total catheter-related complications (95% CI (0.17, 0.32), p &lt; 0.00001); catheter dislodgement (95% CI (0.07, 0.40), p &lt; 0.0001); catheter-associated infections (95% CI (0.11,0.41), p &lt; 0.00001); catheter obstruction (95% CI (0.14,0.53), p = 0.0002); phlebitis (95% CI (0.11,0.47), p &lt; 0.0001) and thrombosis (95% CI (0.07,0.57), p &lt; 0.0001) in patients with PICC placement. Conclusion: Available research evidence suggests that self-management education is effective in reducing PICC catheter-related complications in patients with PICC placement. However, more high-quality studies need to be included for analysis.

Predictive value of prognostic nutritional index in patients undergoing gastrectomy for gastric cancer: A systematic review and meta-analysis.

The value of prognostic nutritional index (PNI) in gastrectomy remains controversial. This meta-analysis aimed to evaluate the predictive value of PNI in patients undergoing gastrectomy for malignancy. We retrieved studies from medical literature databases to analyze the endpoints of overall survival, cancer-specific survival, recurrence-free survival, and clinicopathologic features. The hazard ratio (HR) and 95% confidence interval (CI) were used to access the survival prognostic value of PNI in patients after gastrectomy. Odds ratio and mean difference were used to evaluate the relationship between the low PNI and clinicopathologic features. In total, we included 38 articles (39 trial comparisons) which contained 23,756 gastrectomy patients. The results showed that low PNI was associated with shorter overall survival (HR: 1.82, 95% CI 1.62-2.03), shorter cancer-specific survival (HR: 1.44, 95% CI 1.24-1.67), and shorter recurrence-free survival (HR: 2.52, 95% CI 1.41-4.47). Besides, patients with low PNI had a higher risk of postoperative complications compared with high PNI (HR: 1.65, 95% CI 1.30-2.09). And low PNI group was found to be related to older, lower BMI, larger tumor size, deeper tumor invasion, poorer differentiation, more advanced tumor stage, total gastrectomy, and the presence of lymph node metastasis, lymphatic invasion, and vessel invasion. PNI was significantly associated with survival and postoperative complications of gastric cancer patients undergoing gastrectomy. Therefore PNI has the potential to be a prognostic predictor for gastrectomy.

Pulmonary hyalinizing granuloma: literature review and case presentation

Pulmonary hyalinizing granuloma (PHG) is an extremely rare condition. Only 170-200 cases have been described until now all over the world. There have been no reports in the Russian medical literature. Etiology of the disease is unknown. The X-ray picture is very unspecific. Tumors of lungs and pleura and infectious diseases are included in the differential line. Patients with pulmonary hyalinizing granuloma have long stabile progression of the disease, and the treatment with glucocorticoids can lead to the long lasting remission.The aim of the review was to inform pulmonologists, general practitioners, infectious disease specialists, thoracic surgeons, and oncologists about the existence of pulmonary hyalinizing granuloma, its diagnosis, clinical course, and treatment. Also we present one clinical case of patient with pulmonary hyalinizing granuloma.Conclusion. Because of very low incidence of PHG, an internist or a pulmonologist can never encounter it in their professional life. However it is worth keeping this condition in mind and including it into the diagnostic process when focal and focused shadows are identified in the lungs during chest X-ray. Probably, the disease is caused by different immune-mediatory processes, but the exact pathogenesis is still unknown. Biopsy of the lung tissue by means of lung resection is crucial for the morphological verification of the diagnosis. The prognosis of the disease is favorable. The timely initiation of treatment can sufficiently prolong the remission.

When Giant Lymphangioma Meets Hydrops Fetalis: An Uncommon Case Report of Lower Extremity Involvement

Abstract Approximately 75% of lymphangiomas manifest in the head and neck region, with limb and bone involvement observed in only 2% of cases. This case report presents a rare instance of fetal lymphangioma associated with hydrops fetalis, affecting the left lower extremity and abdomen. A 22-year-old secundigravida woman was referred to the gynecology department at 31.2 weeks of gestation. Initial fetal ultrasound revealed a live fetus with a large lymphangioma involving the left lower extremity, gluteal region, and abdomen. Additional ultrasound findings included subcutaneous edema, pericardial effusion, ascites, placentomegaly, and tricuspid regurgitation. Postnatal clinical examination confirmed the diagnosis of lymphatic malformation. Notably, only one other similar case has been reported in the English-language PubMed database. This report adds to the medical literature as a rare instance of prenatally diagnosed lymphangioma-associated hydrops fetalis.

PubMed-indexed Research Productivity of Urology Applicants and Residents: Does Medical Student Research Productivity Predict Resident Research or Pursuit of an Academic Career?

ObjectivesTo assess the research output of urology residents at top programs and investigate the correlation between medical school research productivity (MRP), research during residency (RRP), and pursuit of academic practice. Further, to characterize trends in MRP before and after the transition to pass/fail scoring of USMLE Step 1. MethodsOur team previously reported on the PubMed-indexed research productivity of applicants matching into top 50 urology programs. Here, we used the same list of residents, recorded their publications during residency, and noted their career paths, including fellowships, academic roles, or private practice. We then highlight the relationship between MRP, RRP, and pursuit of an academic career. We also highlight trends in MRP of applicants matching to top residency programs before and after the transition to pass/fail Step 1 exams. ResultsWe collected data on 727 residents. On multivariate logistic regression, total medical school publications (OR 1.07, 95% CI 0.97, 1.19), total urology publications (OR 1.05, 95% CI 0.92, 1.21), and total first author publications (OR 1.10, 95% CI 0.91, 1.33) were not associated with academic appointment after residency. On the other hand, RRP was correlated with pursuit of academics (1.08, 95% 1.03,1.14). MRP was significantly higher amongst applicants who applied with a pass/fail exam compared to those who did not. ConclusionMRP is not predictive of pursuing an academic career, but RRP is. There is a significant increase in average MRP of those matching to top urology programs after the transition to a pass/fail scoring system for Step 1.

Two-faced Janus: on the 150th anniversary of the discovery of DDT

One of the factors associated with increased morbidity of malignant neoplasms is environmental pollution with cancerogenic compounds including pesticides. Until recently, stable organic pollutant insecticide dichlorodiphenyltrichloroethane (DDT) was the single tool for fighting malaria carriers. Despite vast evidence of its negative effect on human health, DDT is still used in some countries.Aim. To perform a comprehensive analysis of the dynamics of DDT pesticide use and the consequences of its use on the global healthcare as well as to investigate the mechanism of its action on the human body including the endocrine system and cancerogenic effects.The review was composed using the PubMed (2853 publications), Elsevier (3139 publications), eLibrary (784 publications) biomedical literature databases. Full-text articles were retrieved through PubMed Central (PMC), Science Direct, Research Gate, CyberLeninka electronic resources.

Missing History: Anarcha, Betsey, and Lucy’s Legacy in Gynecologic Textbooks

Abstract The legacy of J. Marion Sims as the “father of gynecology” has become widely controversial among medical professionals and lay public because of ethical concerns surrounding the development of his surgical techniques and his exploitation of enslaved women for his experiments. Notably, in April 2018, the City of New York relocated a commemorative statue of Sims from Central Park following an art commission’s investigation of his controversial practices. The relocation was viewed by many as a public acknowledgement of the contributions of Anarcha, Betsey, Lucy, and the other enslaved women to the advancement of gynecologic surgery. However, despite the increased public awareness of the women’s sacrifices in recent years medical literature has not kept pace. We compared the portrayal of Sims and these enslaved women within current gynecology textbooks, prior editions, and historical medical literature. We found that gynecologic textbooks more often mention J. Marion Sims by name (74%) compared to the enslaved women he experimented on (24%). Neither current gynecologic surgery textbooks nor primary historical sources contain significant references to these women, meaning much of their story has been lost to history. While there has been increased public knowledge of the sacrifices of Anarcha, Betsey, and Lucy and other enslaved women, lay recognition is not enough. Full acknowledgment of their contributions necessitates crediting their roles in Sims’ experiments and stating their names in medical literature.