Intraductal Papillary Neoplasm of the Bile Duct Posing Diagnostic and Therapeutic Challenges.

Intraductal papillary neoplasms of the bile duct are rare tumors with fibrovascular stalks arising from the bile duct. It is often difficult to diagnose preoperatively, especially from mucinous cystic neoplasms. The incidence is more common in Asian countries and rare in Western countries.

The 2021 US Preventive Services Task Force lung cancer screening eligibility criteria disproportionately exclude younger Black patients with lung cancer.

Background: The 2021 US Preventive Services Task Force (USPSTF) lung cancer screening guideline may continue to exclude many younger Black individuals who have not yet accumulated enough smoking pack-years to be eligible for screening. The objective of this study was to evaluate the proportions of Black and White patients with lung cancer, stratified by age at diagnosis, who would have been eligible for lung cancer screening.

Methods: Incident lung cancer cases among Black and White individuals aged 50-80 years with a smoking history in the Southern Community Cohort Study (SCCS) were identified for analysis.

Primary lung signet-ring cell carcinoma: a national analysis.

Background: Primary lung signet-ring cell carcinoma (LSRCC) is a rare form of aggressive lung cancer whose clinical features remain inadequately discerned. The objective of this study was to evaluate the clinicopathological characteristics and independent prognostic factors of primary LSRCC.

Methods: Overall survival (OS) of patients with LSRCC, lung adenocarcinoma (LAC), and lung mucinous adenocarcinoma (LMAC) in the National Cancer Database from 2004 to 2018 was evaluated using Kaplan-Meier and multivariable Cox proportional hazards modeling.

Comparing Pilates and Gym Ball Exercises for Primary Dysmenorrhea Management: An Empirical Study.

Background: Primary dysmenorrhea, commonly known as menstrual cramps, is a prevalent gynecological issue that impacts many women in their childbearing age. It manifests as reoccurring, cramp-like lower abdominal pain, usually commencing right prior to or during the menstrual period. These painful sensations can be severe, extending to the lower back and upper thighs can greatly disrupt a woman's daily life and overall well-being.

Design and Assessment of Bird-Inspired 3D-Printed Models to Evaluate Grasp Mechanics.

Adapting grasp-specialized biomechanical structures into current research with 3D-printed prostheses may improve robotic dexterity in grasping a wider variety of objects. Claw variations across various bird species lend biomechanical advantages for grasping motions related to perching, climbing, and hunting. Designs inspired by bird claws provide improvements beyond a human-inspired structure for specific grasping applications to offer a solution for mitigating a cause of the high rejection rate for upper-limb prostheses.

Pack-Year Smoking History: An Inadequate and Biased Measure to Determine Lung Cancer Screening Eligibility.

Purpose: Pack-year smoking history is an imperfect and biased measure of cumulative tobacco exposure. The use of pack-year smoking history to determine lung cancer screening eligibility in the current US Preventive Services Task Force (USPSTF) guideline may unintentionally exclude many high-risk individuals, especially those from racial and ethnic minority groups. It is unclear whether using a smoking duration cutoff instead of a smoking pack-year cutoff would improve the selection of individuals for screening.

Long-term Survival After Lung Cancer Resection in the National Lung Screening Trial.

Background: This study sought to evaluate the long-term survival and causes of death after surgery among patients with pathologic stage IA non-small cell lung cancer (NSCLC) in the National Lung Screening Trial (NLST).

Methods: Patients who underwent surgery and who had a diagnosis of pathologic stage IA NSCLC in the NLST were identified for analysis. The 5- and 10-year overall survival and lung cancer-specific survival, stratified by operation type, were evaluated.

Effect of promethazine in cleft surgeries among Indian children.

The use of antihistamine therapy in children for the management of upper respiratory tract infections remains a topic of debate. In this study, we focused on evaluating the effectiveness of promethazine (Phenergan), a first-generation H1 receptor antagonist and sedative, in addressing preoperative and intra-operative sequelae in cleft surgeries. A single-centered, parallel, randomized, double-blinded controlled clinical trial was conducted on 128 children aged 2 to 4 years undergoing cleft palate surgery under general anesthesia.

Persistent race- and sex-based disparities in lung cancer screening eligibility.

Objective: To evaluate race- and sex-based disparities in lung cancer screening eligibility under the 2013 US Preventive Services Task Force, 2021 US Preventive Services Task Force, and National Comprehensive Cancer Network lung cancer screening guidelines.

Methods: Participants in the Southern Community Cohort Study with a smoking history diagnosed with lung cancer from 2002 to 2021 were identified for analysis. Differences in age at lung cancer diagnosis and smoking characteristics were evaluated among 4 groups: Black men, Black women, White men, and White women.

Update on Lung Cancer Screening Guideline.

Lung cancer screening has been shown to reduce lung cancer mortality and is recommended for individuals meeting age and smoking history criteria. Despite the expansion of lung cancer screening guidelines in 2021, racial/ethnic and sex disparities persist. High-risk racial minorities and women are more likely to be diagnosed with lung cancer at younger ages and have lower smoking histories when compared with White and male counterparts, resulting in higher rates of ineligibility for screening.

Primary clear cell adenocarcinoma of the lung: a national analysis.

Background: Primary clear cell adenocarcinoma of the lung (CCAL) is a rare form of lung cancer with poorly understood clinical features. We sought to investigate the clinicopathological characteristics and independent prognostic factors of primary CCAL.

Methods: Overall survival (OS) of patients with CCAL in the National Cancer Database (NCDB) from 2004 to 2017 was compared to lung adenocarcinoma using Kaplan-Meier analysis, multivariable Cox proportional hazards modeling, and propensity score matching.

Epidemiology and preventability of hospital-onset bacteremia and fungemia in 2 hospitals in India.

Objective: Studies evaluating the incidence, source, and preventability of hospital-onset bacteremia and fungemia (HOB), defined as any positive blood culture obtained after 3 calendar days of hospital admission, are lacking in low- and middle-income countries (LMICs).

Design, Setting, And Participants: All consecutive blood cultures performed for 6 months during 2020-2021 in 2 hospitals in India were reviewed to assess HOB and National Healthcare Safety Network (NHSN) reportable central-line-associated bloodstream infection (CLABSI) events. Medical records of a convenience sample of 300 consecutive HOB events were retrospectively reviewed to determine source and preventability.

The Role of Salvage Resection After Definitive Radiation Therapy for Non-small Cell Lung Cancer.

Background: This study evaluated outcomes of patients who undergo extended delay to resection after definitive radiation therapy for non-small cell lung cancer (NSCLC).

Methods: Perioperative outcomes and 5-year overall survival of patients with NSCLC who underwent definitive radiation therapy, followed by resection, from 2004 to 2020 in the National Cancer Database were evaluated. Patients who underwent resection >180 days after the initiation of radiation therapy (including any external beam therapy at a total dose of >60 Gy) were included in the analysis.

Segmentectomy versus lobectomy in the United States: Outcomes after resection for first primary lung cancer and treatment patterns for second primary lung cancers.

Objective: The study objective was to identify whether the results of JCOG0802 could be generalized to US clinical settings.

Methods: Patients diagnosed with clinical stage IA (≤2 cm) non-small cell lung cancer who underwent segmentectomy versus lobectomy (2004-2017) in the National Cancer Database were identified. Overall survival of patients in the National Cancer Database was assessed using propensity score-matched analysis.

Segmentectomy vs Lobectomy for Early Non-Small Cell Lung Cancer With Visceral Pleural Invasion.

Background: Recent prospective trials have demonstrated the noninferiority of segmentectomy to lobectomy in the surgical management of early non-small cell lung cancer (NSCLC). It remains unknown, however, whether segmentectomy is sufficient for treating small tumors with visceral pleural invasion (VPI), a known indicator of aggressive disease biology and poor prognosis in NSCLC.

Methods: Patients in the National Cancer Database (2010-2020) with cT1a-bN0M0 NSCLC and VPI and additional high-risk features who underwent segmentectomy or lobectomy were identified for analysis.

Recurrence After Complete Resection for Non-Small Cell Lung Cancer in the National Lung Screening Trial.

Background: The objective of this study was to evaluate patterns, predictors, and long-term outcomes of recurrent disease after complete resection for early-stage non-small cell lung cancer (NSCLC) using the National Lung Screening Trial (NLST).

Methods: The frequency of recurrence in patients with pathologic stage I-II NSCLC who underwent complete resection (lobectomy or bilobectomy) in the NLST was evaluated. Predictors of increased risk of recurrence were assessed by Fine-Gray competing risks regression.

Effects of Anesthetic Agents on Blood Brain Barrier Integrity: A Systematic Review.

Background: The blood brain barrier (BBB) is a highly selective permeable barrier that separates the blood and the central nervous system. Anesthesia is an integral part of surgery, and there is little known about the impact of anesthetics on the BBB. Therefore, it is imperative to explore reversible or modifiable variables such as anesthetic agents that influence BBB integrity.

The normative values for resting length of pectoralis minor muscle among individuals with asymptomatic shoulder in South Bengaluru: a cross-sectional pilot study.

Objective: The aim of the study was to determine the normative values for resting length of pectoralis minor muscle among males and females with an asymptomatic shoulder in South Bengaluru.

Patients And Methods: Two hundred and forty-six subjects with asymptomatic shoulders were taken by convenience sampling. The subjects were divided into two groups: Group A (123 males) and Group B (123 females).

The Increasing Adoption of Minimally Invasive Lobectomy in the United States.

Background: The objective of this study is to evaluate the trends of and outcomes associated with the use of minimally invasive lobectomy for stage I and II non-small cell lung cancer (NSCLC) in the United States.

Methods: The use of and outcomes associated with open and minimally invasive lobectomy for clinical stage I and stage II NSCLC from 2010 to 2017 in the National Cancer Database were assessed by multivariable logistic regression and propensity score matching.

Results: From 2010 to 2017, use of minimally invasive lobectomies increased for stage I NSCLC (multivariable-adjusted odds ratio [aOR] 4.

Effective Evaluation of Medical Images Using Artificial Intelligence Techniques.

This work is implemented for the management of patients with epilepsy, and methods based on electroencephalography (EEG) analysis have been proposed for the timely prediction of its occurrence. The proposed system is used for crisis detection and prediction system; it is useful for both patients and medical staff to know their status easily and more accurately. In the treatment of Parkinson's disease, the affected patients with Parkinson's disease can assess the prognostic risk factors, and the symptoms are evaluated to predict rapid progression in the early stages after diagnosis.

Neurocognitive Rehabilitation in COVID-19 Patients: A Clinical Review.

: COVID-19 has affected many people all around the world for more than two years now have suffered many long-term consequences which is commonly referred to as long-haulers. Despite multiorgan complaints in long haulers, symptoms related to cognitive functions commonly referred as brain fog are seen in the high risk covid patients with age more than 50, women more than men, obesity, asthma and those who experienced more than five symptoms during the first week of covid illness. Long term isolation has certainly contributed to high level of anxiety and stress calling for an empathetic response to this group of covid patients as there is no specific test to detect long haulers and no specific cognitive rehabilitation techniques available as of today.

Exploring Changes in Patient Safety Incidents During the COVID-19 Pandemic in a Canadian Regional Hospital System: A Retrospective Time Series Analysis.

Objectives: The COVID-19 pandemic has placed unprecedented strain on healthcare systems and may have consequential impacts on patient safety incidents (PSIs). The primary objective of this study was to examine the impact of the COVID-19 pandemic on PSIs reported in Niagara Health.

Methods: Flexible Farrington models were used to retrospectively detect weeks from January to September 2020 where PSI counts were significantly above expected counts.

Central Pancreatectomy for Central Pancreatic Lesions: A Single-Institution Experience.

Background Pancreaticoduodenectomy and distal pancreatectomy are radical procedures for pancreatic lesions with high postoperative morbidity and mortality even in experienced hands. Central pancreatectomy is an alternative less radical procedure for centrally located pancreatic lesions that are benign or have a low malignant potential. It involves removing the central portion of the pancreas and has the advantage of preserving the pancreatic parenchyma, thereby decreasing the postoperative endocrine and exocrine insufficiencies.

Efficacy of corrective exercise strategy in subjects with hyperkyphosis.

Background: Age-related hyperkyphosis causes deleterious effects on health, physical function, and quality of life. Recently, health care providers recognized it as a major health concern.

Objective: To identify the effect of corrective exercise strategy on hyperkyphosis and compare it with that of conventional exercise.