bluuebunny/crossref_metadata_2025 huggingface dataset:
IBC Oxford University Oral Abstract 38 - Endrive ZERO: pushing forward efficiency and safety in stapling technology
Authors: Davanzo C , Sirabo A , Schiller M , Zapata A , Muñoz R , Berry M , Gutiérrez L , Sosa M
Published: February 2025

Introduction

Endrive ZERO: Pushing Forward Efficiency and Safety in Stapling Technology Intro: Since their first appearance in 1908 by the Hungarian surgeon Hümér Hültl, Surgical Staplers (SS) have gained massive popularity due to their surprising results, improving surgical safety, complication rates and operative time optimization. Along evolution, SS have been modified according to needs and surgical approaches. From open surgeries to laparoscopy. From manual firing to electric devices. From two rows of staples in each side, to 3-row ones, always divided by the final blade section. To parallel lines, to alternate ones. From linear curling tissue compression to 3D improving innovation. However, there was no such evolution in the staple’s rows disposition. It has always been a simetric stapling, equal amount in each side of the section, even in resective techniques, such as Oncological Surgeries, and among Bariatric Surgery, Sleeve Gastrectomy (SG) particularly. In fact, in these techniques, half of the staples are lost due to specimen extraction, while the exact quantity stays in the remaining tissue, wasting 50% of them. Objective: To assess and to demonstrate the non-inferiority of the new surgical stapling device Endrive ZERO, which provides a 4-row stapling in the remaining tissue, and a 2-row stapling in the resected one.

Methods

From February 2024 to June 2024, 56 patients undergoing SG were recruited with a minimum follow-up of 30 days. 46 were women. There were 6 surgeons participating in this study. Revisional Surgery cases were excluded. All of the procedures were performed with the new Endrive ZERO 60 mm, which provides a 4-row stapling in the remaining tissue, and a 2-row stapling in the resected one. All stapler loads were fired through a 15 mm supra-umbilical trocar, closed posteriorly with EndoClose system. Variables evaluated were Operative Time (OT) (in minutes), 30-day Complication Rate, Hospital Stay (in hours), Total Bleeding Loss (in ml), Analgesia Requirement (in Opiod-Equivalent Consumption) and Pain Management (Visual- Analogical Scale).

Results

Mean initial BMI was 38.7. Mean OT was 41.7 min. Hospital Stay was 24.5. The average of hemostatic clips needed was 1.3. No postoperative complications were reported within 30 days. No hemostatic reinforcement or buttressing material was needed. Average Opioid Consumption (morphine equivalent) was 3.75 mg. No incisional hernia cases were reported in any case. No re-admission nor mortality was registered.

Conclusion

The new Endrive ZERO stapler is safe and effective. Despite the low volume of patients recruited, this stapler seems promising in term of complication and mortality rates enhancement. Further studies with longer follow-up and higher volume are needed to confirm this preliminary report.
IBC Oxford University Oral Abstract 43 - Evaluation of weight loss after single anastomosis sleeve ileal bypass (SASI) and one anastomosis gastric bypass (OAGB): a comparative study
Authors: Ahmed S Salem
Published: February 2025

Introduction

Sleeve Gastrectomy and RYGB are the most frequently performed bariatric procedures world-wide. OAGB is increasing in numbers, SASI bypass is a recently developed procedure, hoping with her to avoid the negative changes happening after the above-mentioned procedures. It is a malabsorptive procedure. One year follow up results obtained in terms of weight loss and the effect on comorbidities were compared between SASI and OAGB patients.

Patients and Methods

We collected our data prospectively from our clinic and formed two groups (Gr) of patients, Gr A: SASI, Gr B: OAGB (no randomization). Analysed variables were baseline and post-operative BMI, excess weight loss (EWL), pre and post-operative comorbidities up to 1 year.

Results

Gr A: between 2019–2022. we have performed 102 SASI operations. 96 (94%) patients available for follow up. GrB: included 120 OAGB patients, 112 P (93%) available for follow up. There were no significant differences in age, gender, comorbidities or anthropometric measurements preoperatively between both groups. follow up of 1 year We observed mild not significant differences in EWL in favor for OAGB, Diarehea, and post prandial abdominal pain less frequent, stool odor less bad in SASI Group. BMI post SASI decreased from 41 kg/m2 to 29 Kg/m2, Post OAGB from 40 kg/m2 to 28 Kg/m2), with EWL of 83%, and 86% respectively Diabetes Miletus type II (DM II), Hyperlipidaemia resolved in similar percentage in both groups. Iron deficiency anaemia and hypoalbuminaemia incidence were higher in Gr B.

Conclusions

SASI Bypass achieve superior results in terms of quality of life and comorbidity and results with significant and comparable EWL to OAGB
IBC Oxford University Oral Abstract 44 - Comparing the accuracy of healthcare professionals’ estimations of their patients’ health numeracy level in the general hospital population to patients attending a metabolic and bariatric surgical (MBS) clinic
Authors: Allen C , Nagri J , Murki R , Byworth C , Beale S , Mojadady A , Ghoora L , Parmar C
Published: February 2025

Background

To support patients in their weight loss journey, it is important that healthcare professionals (HCPs) recognise their patient’s communication needs and adapt to them. This study looks at the health literacy and numeracy (HLN) of patients attending a bariatric outpatient clinic and the accuracy of HCPs’ estimations of patients’ HLN.

Method

Patients completed validated HLN measures—the Medical Term Recognition Test (METER) and General Health Numeracy Test Short Form (GHNT-6) and a demographics survey. HCPs provided an estimation of the patient’s HLN after their consultation based on the scoring categories of each measure. The score from the patient-completed measures and estimations from the HCP were compared.

Results

Data was collected from 31 patients attending clinic in a single tertiary centre. Based on METER, 80% of patients demonstrated functional health literacy and 7% low health literacy. There was poor agreement between HCPs estimations and measured health literacy (ICC = 0.14; 95% c.i. = -0.19, 0.443), with HCPs more likely to underestimate than overestimate patient’s health literacy (27.8% versus 11.1%). 61.1% of HCPs’ health literacy estimations agreed with METER categories. In the health numeracy measure 3.2% (n = 1) of participants answered all questions correctly, 22.6% of participants scored 0, and 19.4% (n = 6) answered the food label question correctly. There was poor agreement between HCP estimation and measured health numeracy (ICC = -0.196; c.i. = −0.487, 0.1360 P = 0.878), with HCPs more likely to overestimate than underestimate patients’ health numeracy (63.9% versus 22.2%). Only 13.9% of HCP health numeracy estimations agreed with GHNT-6 ratings.

Conclusion

There is poor agreement between HCPs’ perception of their patient’s HLN and patient’s assessed ability through a validated questionnaire. Health numeracy is a known barrier to understanding health-related information and is a demonstrated area for further development in this patient population. HCPs’ identification/appreciation of these is vital in supporting patients’ journeys through the challenging bariatric surgery pathway and postoperative course.
IBC Oxford University Oral Abstract 45 - Postoperative reduced oral feeding is a risk factor for lengthened period of hospital admission and readmission post bariatric surgery
Authors: Alhuniti M
Published: February 2025

Objectives

The revolution of the Laparoscopic bariatric techniques and improved postoperative recovery protocols and regimens have reduced hospital admissions, readmissions and stay; some patients continue to have prolonged admission for various reasons. This paper concentrates and explores whether postoperative oral feeding is a potential risk factor for lengthened hospitalization and readmission.

Methods

A prospective, double blinded, randomized investigation of 450 postoperative patients at King Hussein Hospital, King Hussein Medical City, Amman, Jordan, during the period March 2019–September 2023. Subjects (255 women and 195 men, aged 24–55, with an average of 36 years) were managed for morbid obesity, and were assigned to laparoscopic sleeve gastrectomy (LSG) or laparoscopic Roux-en-Y gastric bypass (LRYGB) groups. Subjects with perioperative hazards and previous bariatric techniques were ruled out. Early oral feeding (oral diet tolerance include solid food and drinking minimum of 1.5 l) with clear fluid on day zero associated with balanced intravenous fluids less than 2.5 l then light hospital diet on the first day after surgery and full hospital diet (solid and fluids) in the second day after surgery were encouraged included subjects with hospital admission (3 days) and group II included subjects with (>3 days) readmission spanned 30days after surgery those are followed the old regimens of reduced oral feedings and full IV fluids from day zero and start clear oral fluids from day one till two weeks post operation (no balanced protocol between IV fluids and when to start clear and solid food time and regimens). Univariate and multivariate logistic regression were used to evaluate effect induced parameters on lengthened hospital admission and readmissions.

Results

The average period of hospitalization was 3 (2–4) days of hospital admission (HD), more days were recorded in 150/450 (33%) subjects: 90/300 (30%) LSG, and 60/150 (40%) LRYGB (P < 0.005). SO, Reduced postoperative oral feeding, the old regimens, lengthened hospitalization, and increased readmission risk. Readmission incidence was 6% (27/450 readmissions): 16/300 (5%) LSG, and 11/150 (7%) LRYGB (P > 0.05).

Conclusion

The old feeding protocols and reduced oral feeding is a risk factor for lengthened hospitalization and readmission. And the early feeding with the new feeding protocols decreases hospital stays postop and decrease re admissions.
IBC Oxford University Poster Abstract 6 - The nutritional effect of SASI: a 5—years’ experience
Authors: Abokhozima A , Zidan M H , Altabbaa H , Elmagd A Abo , Alokl M , El-Masry H , Selim A
Published: February 2025

Introduction

Since the introduction of Single anastomosis Sleeve ileal Bipartition (SASI) many studies have focused on the nutritional malnutrition effect of SASI. Although there is still no consensus on whether SASI causes malnutrition, many studies have disagreed with such claims. In this study, we focused on re-evaluating the malnutritional effects of SASI using the same methodology in the short-term outcome.

Methods

147 cases of SASI were recruited retrospectively from 2018 to 2023 with a 2-year follow-up period. All cases had undergone periodical follow-ups for Cholesterol, LDL, HDL, TG, Serum iron, Ferritin, Calcium, Vitamin D3, and Vitamin B12.

Results

Postoperative Lipid profile significantly reduced (P ≤ 0.001). However, there was no significant reduction in serum iron (P = 0.387), Ferritin (P = 0.061), and serum calcium (P = 0.091). with postoperative supplementation, there was a significant reduction in, Vitamin D3 (P ≤ 0.001), and Vitamin B12 (P ≤ 0.001).

Conclusion

Although there is a rising concern for malnutrition with SASI, unification of the SASI technique, and the usage of the correct postoperative supplementation with regular follow-ups does avoid malnutrition.
IBC Oxford University Poster Abstract 10 - Conversion to laparotomy for laparoscopic sleeve gastrectomy post endoscopic sleeve gastroplasty
Authors: Al Haifi M , Hassan I
Published: February 2025

Introduction

Endoscopic Sleeve Gastroplasty (ESG)is an endoscopic minimally invasive weight loss procedure based on full thickness endoscopic suturing using Apollo’s Overstitch device. In the ESG procedure a series of sutures are placed through the gastric wall reducing the stomach volume by 80%creating a restrictive endoscopic sleeve.

Case Discussion

52 years old lady with a Body mass index of 39 kg/m2 with previous history of Endoscopic gastroplasty (EGP) done 2 years before with no significant response regarding weight loss. Had been counselled for Laparoscopic Sleeve Gastrectomy (LSG). Preoperative gastroscopy showed loose intragastric sutures and wide stomach. During LSG tense gastric bed adhesions were noticed (suspected sealed old leak) during adhesiolysis a major arterial bleeding at splenic bed noticed that required immediate conversion to laparotomy. Bleeding from splenic artery was controlled by primary repair with proline sutures and sleeve Gastrectomy was performed open. Patient had smooth recovery. Follow up CT was performed 2 days after procedure that revealed patent splenic artery and no gastric tube leakage. Patient was kept for two weeks on low molecular weight heparin to avoid mesenteric vascular occlusion.

Conclusion

EGP can be converted to LSG for non-responders, but extra care should be taken during surgery especially if a sealed leakage is suspected from history or during procedure.
IBC Oxford University Poster Abstract 12 - Naturally banded sleeve gastrectomy (sewefy wrap) versus non-banded sleeve gastrectomy, reporting of early results
Authors: Sewefy A M , Esmaeel T E , Kayed T H
Published: February 2025

Background

Laparoscopic sleeve gastrectomy (LSG) is the most common bariatric procedure, but weight regain remains the main drawback. Banded Sleeve improves the long-term result of LSG on weight loss but, as a foreign body, it has some serious complications. We aimed to test the efficacy of using the round ligament of the liver as a natural band with LSG.

Methods

A prospective randomized controlled trial was conducted from October 2022 to December 2023 at Minia university hospital, included 80 patients. Patients were randomly assigned to 2 equal groups. Group 1: patients were operated by LSG plus banding using the round ligament of the liver. Group 2: patients were operated on by standard LSG without banding. All cases completed one year follow up.

Results

Of the patients, 55 (68.8%) were females, and 25 (31.2%) were male. The mean BMI was 47.6 kg/m2. The mean age was 36.3 years. The operative time was 37 minutes in Group 1 versus 33 minutes in Group 2 (P < .001). The mean gastric volume at one year in Group 1 was 110 ml versus 147 ml in Group 2 (P < .0001). The mean %EWL at one year in Group 1 was 85.8 versus 79.5 in Group 2 (P = 0.002). The mean score of food intolerance after one year was 20.8 in Group 1 versus 21.1 in Group 2 (P = .172).

Conclusion

Naturally banded SG leads to better weight loss than non-banded SG at one year after surgery with minimal sleeve pouch dilatation, but long term follow up is needed.
IBC Oxford University Poster Abstract 14 - The waist-to-hip ratio in bariatric surgery—does a higher ratio mean higher risk?
Authors: Cruz D , Santos-Sousa H , Nogueiro J , Almeida N M , Araújo-Teixeira J P , Lemos J , Peleteiro B , Resende F , Costa-Pinho A , Preto J , Freitas P , Carneiro S , da-Costa E Lima
Published: February 2025

Background

Obesity is rapidly emerging as a significant epidemic in developing countries. Although promising therapeutics are in development, bariatric surgery remains the most effective treatment. To better characterize this disease, waist and hip circumference measurements, and waist-to-hip ratio were developed. These measures provide valuable insights into body fat distribution and its associated health risks, enabling more accurate assessments and targeted interventions.

Methods

A retrospective review of 858 patients submitted to bariatric surgery between 1st January 2019 and 31st December 2023 and comprising waist-to-hip ratio data, was performed. The study’s primary objective was to analyze the correlation between a higher waist-to-hip ratio and perioperative and postoperative complications, as well as surgery duration and conversion rates. Other variables proven to be significantly related to a higher waist-to-hip ratio, namely patients’ comorbidities such as arterial hypertension, dyslipidemia, diabetes mellitus, and obstructive sleep apnea syndrome (OSA) were also included.

Results

There was no significant correlation between waist-to-hip ratio and post-operative complications (M = 0.95; SD = 0.10 versus M = 0.94; SD = 0.09; P = 0.07), neither surgery duration (r = 0.043, P = 0.223), nor conversion rates (due to sample size, n = 0). As a secondary outcome, there was a higher proportion of individuals with diabetes, dyslipidaemia, and OSA among those who had complications and, after adjustment, diabetes remained associated with higher complications (OR = 1.70, 95% c.i. [1.01, 2.87]).

Conclusions

Although there was no significant correlation between a higher waist-to-hip ratio and surgical complications, it was possible to establish a significant relationship between secondary variables, namely the presence of diabetes, and a greater risk of surgical complications. By understanding these relationships, healthcare providers can better identify at-risk patients and tailor surgical approaches to minimize complications and optimize outcomes aiming to enhance patient safety and surgical success.
IBC Oxford University Poster Abstract 16 - In the era of ‘sleeve revision’, what is the perfect algorithm? Suggested algorithm with review of the literature
Authors: Mohamed E
Published: February 2025

Background

Laparoscopic sleeve gastrectomy (LSG) is the mainstream treatment option for patients with morbid obesity due to restrictive and endocrine mechanisms, however it requires modifications for a subset of patients because of weight regain and tough complications, such as gastroesophageal reflux, strictures, gastric leak, and persistent metabolic syndrome. Revision surgeries have become more and more indispensable in bariatric surgery, accounting for 7.4% in 2016.

Methods

A systematic literature search was performed in PubMed, Embase and Cochrane library. Data were collected and analysed.

Results

Revisional bariatric surgeries after LSG include Roux-en-Y gastric bypass, repeated sleeve gastrectomy, biliopancreatic diversion, duodenal switch, duodenal-jejunal bypass, one-anastomosis gastric bypass (MGB), single anastomosis duodeno-ileal bypass (SADI) and transit bipartition. The overall revision rate was 10.4%, but for patients with ≥10-year follow-up, the rate was 22.6%. European studies had a higher revision rate (14.4%) than other studies. The most common reason for revision was failure in weight loss, and the most frequent revisional procedure was gastric bypass.

Conclusion

Reaching a clear algorithm for revisional bariatric surgery is still debated. However, we assume that it depends mainly on pre-revisional BMI and presence of GERD symptoms as follows: patients with BMI> 40 kg/m2 should receive Standard R-Y gastric bypass, those with BMI <40 kg/m2 with GERD should have R-Y gastric bypass with long biliopancreatic limb or MGB with RY configuration. Patients with BMI <40 kg/m2 without GERD may benefit from MGB or SADI.
Automated Scoliosis Cobb Angle Classification in Biplanar Radiograph Imaging with Explainable Machine Learning Models
Authors: Yu Jennifer , Lahoti Yash , McCandless Kyle C. , Namiri Nikan K. , Miyasaka Matthew S. , Ahmed Hamza , Song Junho , Corvi John J. , Berman Daniel C. , Cho Samuel K. , Kim Jun S.
Published: February 2025

Study Design.

Retrospective Cohort Study

Objective.

To quantify the pathology of the spine in patients with scoliosis through one-dimensional feature analysis.

Summary of Background Data.

Biplanar radiograph (EOS) imaging is a low-dose technology offering high-resolution spinal curvature measurement, crucial for assessing scoliosis severity and guiding treatment decisions. Machine learning (ML) algorithms, utilizing one-dimensional image features, can enable automated Cobb angle classification, improving accuracy and efficiency in scoliosis evaluation while reducing the need for manual measurements, thus supporting clinical decision-making.

Methods.

This study used 816 annotated AP EOS spinal images with a spine segmentation mask and a 10-degree polynomial to represent curvature. Engineered features included the first and second derivatives, Fourier transform, and curve energy, normalized for robustness. XGBoost selected the top 32 features. The models classified scoliosis into multiple groups based on curvature degree, measured through Cobb angle. To address class imbalance, stratified sampling, undersampling, and oversampling techniques were employed, with 10-fold stratified K-fold cross-validation for generalization. An automatic grid search was used for hyperparameter optimization, with K-fold cross-validation (K=3).

Results.

The top-performing model was Random Forest, achieving an ROC AUC of 91.8%. An accuracy of 86.1%, precision of 86.0%, recall of 86.0%, and an F1 score of 85.1% were also achieved. Of the three techniques employed to address class imbalance, stratified sampling produced the best out-of-sample results. SHAP values were generated for the top 20 features, including spine curve length and linear regression error, with the most predictive features ranked at the top, enhancing model explainability.

Conclusions.

Feature engineering with classical ML methods offers an effective approach for classifying scoliosis severity based on Cobb angle ranges. The high interpretability of features in representing spinal pathology, along with the ease of use of classical ML techniques, makes this an attractive solution for developing automated tools to manage complex spinal measurements.
Risk Factors for Postoperative Non-Satisfaction despite ODI Improvement in Patients undergoing Elective Lumbar Surgery
Authors: Hambrecht Jan , Köhli Paul , Chiapparelli Erika , Lan Ranqing , Burkhard Marco D. , Altorfer Franziska C. S. , Evangelisti Gisberto , Guven Ali E. , Tsuchiya Koki , Duculan Roland , Shue Jennifer , Sama Andrew A. , Cammisa Frank P. , Girardi Federico P. , Mancuso Carol A. , Hughes Alexander P.
Published: February 2025

Study design.

Secondary analysis of prospective study.

Objective.

To assess the risk factors for postoperative non-satisfaction despite improvement in the Oswestry Disability Index (ODI) two years after elective lumbar surgery.

Background.

The ODI and postoperative satisfaction are important markers of postoperative success. While ODI improvement is expected to correlate with satisfaction, their exact relationship remains unclear. Additionally, some patients may achieve functional improvement yet report non-satisfaction postoperatively.

Methods.

A secondary analysis was performed on a prospective study of patients undergoing lumbar surgery for degenerative conditions. Patients with a 2-year ODI and satisfaction follow-up were included. Risk factors for non-satisfaction despite ODI improvement were investigated using t-tests, Wilcoxon-tests, and Fisher’s-exact-tests. Significant variables were analyzed with multivariable logistic regression, adjusting for covariates.

Results.

355 patients (65±10 y, 58% female) were included. Non-satisfied patients showed significantly higher scores in pre- (64[52-76], P<0.001) and postoperative (36[20-44], P<0.001) ODI and lower absolute (18[8-30], P<0.001) and percentage (30[17-52], P<0.001) improvement rates from pre- to postoperatively. Higher baseline (OR1.03, 95%CI 1.01-1.05, P<0.001) and postoperative (OR1.08, 95%CI 1.06-1.10, P<0.001) ODI scores, and lower absolute (OR0.94, 95%CI 0.92-0.96, P<0.001) and percentage (OR0.95, 95%CI 0.94-0.97, P<0.001) improvement rates, were significant risk factors for experiencing non-satisfaction, despite ODI improvement. Higher fat infiltration (FI) of the multifidus (MF) (OR1.03, 95%CI 1.00–1.06, P=0.042) or the erector spinae (ES) (OR1.06, 95%CI 1.03–1.09, P<0.001) were significantly correlated with postoperative non-satisfaction, after adjusting for covariates.

Conclusion.

Higher pre- and postoperative ODI scores and lower ODI improvement were linked to postoperative non-satisfaction. Higher FI in the MF or ES was also a significant risk factor for postoperative non-satisfaction, despite ODI improvement. The findings highlight that postoperative satisfaction is influenced by various factors affected by ODI-measured disability. Additionally, paraspinal muscle health greatly affects postoperative outcomes and should guide preoperative planning and postoperative care.
Impact of Short-Acting Beta-Blockers on the Outcomes of Patients With Septic Shock: A Systematic Review and Meta-Analysis
Authors: McChesney Chris , Orozco Nicolas , Fiorini Kyle , Wong Michelle Yee Suet , Slessarev Marat , Prager Ross , Kao Raymond , Leligdowicz Aleksandra , Sharif Sameer , Lewis Kimberley , Rochwerg Bram , Honarmand Kimia , Ball Ian M. , Arntfield Robert , Houlton Rachael , VanNynatten Logan , Basmaji John
Published: February 2025

Objectives:

To determine the impact of short-acting beta-blocker therapy on outcomes in adult patients with septic shock.

Data Sources:

We searched MEDLINE, Embase, and unpublished sources from inception to April 19, 2024.

Study Selection:

We included randomized controlled trials (RCTs) that evaluated short-acting beta-blockers compared with usual care in patients with septic shock.

Data Extraction:

We collected data regarding study and patient characteristics, beta-blocker administration, and clinical, hemodynamic, and biomarker outcomes.

Data Synthesis:

Twelve RCTs proved eligible (n = 1170 patients). Short-acting beta-blockers may reduce 28-day mortality (relative risk [RR], 0.76; 95% CI, 0.62–0.93; low certainty) and probably reduce new-onset tachyarrhythmias (RR, 0.37; 95% CI, 0.18–0.78; moderate certainty) but may increase the duration of vasopressors (mean difference [MD], 1.04 d; 95% CI, 0.37–1.72; low certainty). Furthermore, there is an uncertain effect as to whether short-acting beta blockers impact 90-day mortality (RR, 0.98; 95% CI, 0.73–1.31), ICU length of stay (MD, –0.75 d; 95% CI, –3.43 to 1.93 d), hospital length of stay (MD, 1.03 d; 95% CI, –1.92 to 3.98 d), duration of mechanical ventilation (MD, –0.10 d; 95% CI, –1.25 to 1.05 d) (all very low certainty), bradycardia episodes (RR, 3.14; 95% CI, 0.91–14.01), and hypotension episodes (RR, 4.74; 95% CI, 1.62–14.01) (all very low certainty).

Conclusions:

In patients with septic shock, short-acting beta-blockers may improve survival and reduce new-onset tachyarrhythmias. However, these findings were based on low certainty evidence and given ongoing concerns regarding adverse effects and the increase duration of vasopressor use, we need larger and more rigorous RCTs to evaluate this intervention.
Risk factors of lower urinary tract symptoms measured by the International Consultation on Incontinence Modular Questionnaire in females with lupus cystitis: A case-control study
Authors: Faddan Amr Abou , Gadelkareem Rabea Ahmed , Hassanien Manal , Abolella Hassan Abdellatif , Talaat Esraa Ahmed
Published: February 2025

Background

Lupus cystitis may cause significant lower urinary tract symptoms (LUTS). This study aimed to evaluate LUTS and identify potential risk factors in female patients with systemic lupus erythematosus (SLE).

Materials and methods

In this case-control study, 46 female patients with SLE were assessed for LUTS using the International Consultation on Incontinence Modular Questionnaire on Female Lower Urinary Tract Symptoms (ICIQ-FLUTS). The findings were compared with a control group of 20 women.

Results

The total incidence rates of LUTS in the SLE and control groups were 82.6% and 55%, respectively (p = 0.022). Statistically significant differences were observed between the 2 groups in symptom duration (p < 0.001), filling (p < 0.001), voiding (p = 0.001), incontinence (p < 0.001), and total LUTS scores (p < 0.001) as measured by ICIQ-FLUTS. Additional significant differences included renal echogenicity (p = 0.003), bladder wall thickness (p = 0.045), and the presence of pus cells in urine (p = 0.045). The possible risk factors for the occurrence of LUTS in patients with lupus cystitis included rapid weight loss (p = 0.025), easy fatigability (p = 0.006), fever (p = 0.046), psychosis (p = 0.033), and both renal (p = 0.025) and clinical (p = 0.047) SLE disease activity indices. The Spearman correlation between the total ICIQ-FLUTS score and the SLE Disease Activity Index was not significant (r = −0.203; p = 0.181). However, a statistically significant but weak correlation was observed between the ICIQ-FLUTS score and easy fatigability (r = 0.381; p = 0.013).

Conclusions

The ICIQ-FLUTS demonstrated acceptable content validity and consistency in evaluating LUTS in patients with lupus cystitis. Rapid weight loss, easy fatigability, fever, psychosis, and elevated renal and clinical SLE Disease Activity Index scores were significantly associated with the occurrence of LUTS in these patients.
Selective genetic inactivation of Caspase 8 in hepatocytes ameliorates progression of MASH following Jnk deficiency
Authors: Volkert Ines , Grube Julia , Woitok Marius Maximilian , Mohamed Mohamed Ramadan , Edlund Karolina , Duda Julia Christin , Dietrich Jana , Schneider Ursula , Yin Guo , Lin Cheng , Erschfeld Stephanie , Berger Hilmar , Candels Lena , Davis Roger J. , Bartneck Matthias , Kühnel Mark Phillip , Guillot Adrien , Schneider Kai Markus , Schneider Carolin Victoria , Jonigk Danny , Rahnenführer Jörg , Tacke Frank , Hengstler Jan , Trautwein Christian
Published: February 2025

Background and Aims:

Metabolic dysfunction-associated steatohepatitis (MASH) is associated with c-Jun N-terminal kinases (JNK) activation across various cell types, but its hepatocyte-specific function in steatotic liver disease remains unclear. Our study investigates the role of JNK1/JNK2 during MASH progression and dissect its hepatocyte-specific function.

Approach and Results:

We showed that UK biobank patients with a predicted-loss-of-function (pLOF) variant of JNK1 presented an increased prevalence of MASLD and liver damage. Analysis of a pathology cohort of patients with steatotic liver disease revealed increased oxidative stress response and apoptosis. After subjecting mice deficient for Jnk1 and Jnk2 in hepatocytes (Jnk1/2
Δhepa) to two different MASH models, we observed enhanced liver injury, fibrosis and oxidative stress. RNA sequencing revealed highly up-regulated pathways in Jnk1/2
Δhepa livers, including inflammatory signals and apoptotic pathways. Additional blocking of Caspase 8 signaling improved HFD-induced liver damage, fibrogenesis and oxidative stress. Ultimately, a therapeutic approach using lipid nanoparticles containing small interfering RNA (siRNA) targeting Caspase 8 during MASH progression attenuated liver injury and cell death in mice.

Conclusions:

Our findings define a protective role of JNK1/JNK2 in hepatocytes during the oxidative stress response driving progression of MASH. This process is mainly mediated by Caspase 8-dependent apoptosis, thereby discovering that Caspase 8 is a downstream target of JNK1/2. Caspase 8 directed therapy in hepatocytes might be a promising treatment for patients with an increased oxidative stress response and MASH.
Discrete Bayesian Dose-response Analysis under Dose Uncertainty
Authors: Hofer Eduard
Published: February 2025

Establishing a relationship between disease and dose requires each individual in the population under investigation to be known by disease status and by the value of the dose received. Frequently, the dose values are reconstructed using a dose assessment model containing imprecisely known parameter values, model formulations, and input data (epistemic uncertainties). As a consequence, the state of knowledge of the assessed dose values needs to be expressed by a joint subjective probability distribution thereby accounting for state of knowledge dependence due to uncertainties shared by the assessed dose values of several individuals. Dose-response analysis must apply this joint state of knowledge in obtaining a subjective probability distribution for the parameters of the dose-response model. This is achieved by drawing a random sample of dose vectors according to the joint distribution, by applying Bayes’ theorem for each vector, and by averaging the posterior parameter distributions (Bayesian model averaging). If the dose response is quantified by a binary variable, a logistic regression model is embedded in the likelihood function. This paper presents a new, computationally efficient Bayesian model averaging method that operates over the discretized parameter space and thereby does away with the computational complexities of Bayesian methods. It corrects for the attenuation effect that is due to the application of dose vectors other than the true vector. Results obtained for a sample of dose vectors are compared to those obtained with the standard discrete Bayesian method using the true dose vector.
Application of ultrawide-field ss-OCTA in the precise diagnosis of diabetic retinopathy
Authors: Zou Chen , Liu Wei , Chang Qing , Xuan Yi , Zhou Yao , Tang Nuo , Wang Min
Published: February 2025

Purpose:

To study the imaging findings of ultrawide-field swept source optical coherence tomography angiography (ss-OCTA) and its advantages with respect to ultrawide-field fundus photography (FP) in the precise diagnosis of diabetic retinopathy (DR), and to reveal its applications in DR.

Methods:

The imaging findings of microangiopathy in ultrawide-field ss-OCTA and ultrawide-field FP from DR patients were retrospectively analyzed, and the differences between the two methods were assessed. In addition, the grade of DR based on the imaging findings of the two modalities was determined and compared.

Results:

Ultra-widefield ss-OCTA clearly revealed various occult retinal microvascular lesions in DR patients over a detection range which was similar to ultrawide-field FP. Significantly more retinal microangiopathy were detected and more eyes were given a worse DR grade with ultrawide-field ss-OCTA than those with ultrawide-field FP.

Conclusion:

Ultrawide-field ss-OCTA is more able to detect retinal microangiopathy compared with ultrawide-field FP and is contributive in the precise diagnosis of DR. Ultrawide-field ss-OCTA has substantial applicability in the precise diagnosis of DR, especially when ultrawide-field fundus fluorescence angiography (FFA) is unavailable.
Epstein-Barr Virus Associated Frosted Branch Angiitis
Authors: Xia Julia L. , Lai Jennifer M. , Palestine Alan G. , Reddy Amit K.
Published: February 2025

Purpose:

To describe two cases of frosted branch angiitis (FBA) in the setting of Epstein-Barr virus (EBV) infection.

Methods:

Retrospective case series of two patients at the University of Colorado Sue Anschutz-Rodgers Eye Center.

Results:

Case 1 is a 17-year-old female who presented with bilateral floaters and blurry vision two weeks after a diagnosis of mononucleosis. Visual acuity was 20/20 in both eyes and exam was significant for vitreous cell and FBA appearance to the retinal vasculature in both eyes. Treatment with oral prednisone and valacyclovir was initiated with improvement in vitritis and vascular sheathing. One month after all treatment was discontinued, there was a recurrence of vitritis that was treated with bilateral sub-Tenon’s triamcinolone acetonide injections. Final visual acuity was 20/20 in both eyes with resolved vitritis. Case 2 is a 20-year-old male who presented with headache and acute bilateral vision loss. He was found to have a meningoencephalitis with cerebrospinal fluid positive for EBV that was treated with intravenous methylprednisolone and acyclovir. Visual acuity was count fingers in both eyes. Exam was significant for diffuse bilateral frosted branch angiitis which the subsequent development of bilateral bacillary detachments and neuroretinitis that required treatment with oral prednisone, oral acyclovir, and bilateral intravitreal dexamethasone implants, which resolved all ocular inflammation. Final visual acuity was 20/30 right eye and 20/25 left eye.

Conclusion:

Bilateral FBA may present following EBV infection and responds well to corticosteroids and antiviral therapy.
The Interaction of Shock Waves With Biological Tissue - Momentum Transfer, the Key for Tissue Stimulation and Fragmentation
Authors: Wess Othmar , Mayer Juergen
Published: February 2025

Background:

Shock waves in medicine have gained enormous importance and have spread since 1980, and the first kidney stone was successfully fragmented in a patient in Munich. Meanwhile, the spectrum of medical applications of shock waves ranges from powerful fragmentation of kidney stones to diverse indications such as wound healing, chronic pelvic pain, spasticity, erectile dysfunction, and others, to neuro-stimulation in the context of Alzheimer’s disease. A comprehensive working mechanism for this diverse field of medical indications are still missing.

Objective:

Investigation of the physical basis of the working mechanism of shock waves in medical applications.

Methods:

We developed a model based on the mechanical forces generated by the momentum transfer at the acoustic interfaces of different layers of biological tissue. The generated forces are strong enough to crash brittle material and provide an adequate mechanical stimulus to activate mechano-transduction and mechano-sensory-transduction with nerve stimulation, thereby affecting the neural memory function of the central nervous system.

Results:

The key to generating appropriate forces in the millisecond range is the mechanism of momentum transfer at the interfaces between tissue layers with different acoustic impedances. According to Newton´s laws of motion, a change in momentum (momentum transfer) generates force F = dP/dt. The inherent shear forces can stretch biological membranes to release biomolecules such as VEGF and NO. A most favourable feature of this mechanism is the selective effect on soft tissue interfaces and small tissue inhomogeneities to generate small forces in the range of few (≤ 10) Newton to stimulate tissue and nerve cells, while the same shock wave can generate forces ≥ 200 Newton and more on hard tissue interfaces such as bones or stones.

Conclusion:

The mechanism of momentum transfer is the basis for mechano-transduction and mechano-sensory transduction. It offers the opportunity to stimulate peripheral nerves and modify the motor reflex patterns of “pathologic” reflexes by hyper stimulation. The new technique of transcranial pulse stimulation (TPS) may be based on direct stimulation and reactivation of neurons in the brain. Momentum transfer is the basic physical mechanism and the initiator for successive biological processes in medical shock wave therapy.
Intracorporeal versus extracorporeal anastomosis in laparoscopic total gastrectomy: a systematic review and meta-analysis
Authors: Zaman Shafquat , Hussain Mohammad Iqbal , Kausar Maria , Mostafa Omar E.S. , Mohamedahmed Ali Yasen , Hajibandeh Shahab , Hajibandeh Shahin , Camprodon Ricardo , Sellahewa Chaminda
Published: February 2025

Background:

To evaluate outcomes of intracorporeal (IOJ) versus extracorporeal (EOJ) oesophagojejunostomy following laparoscopic total gastrectomy (LTG) for the treatment of gastric cancer.

Methods:

A comprehensive search of various electronic databases was conducted. Comparative studies of IOJ versus EOJ following LTG in patients with gastric malignancy were included. Primary outcomes were anastomotic leak, anastomotic bleeding, and anastomotic stricture formation. Secondary outcomes included operative time, length of hospital stay (LOS), volume of intra-operative haemorrhage, number of harvested lymph nodes, time to flatus, time to soft diet, intra-abdominal infection, pulmonary infection, surgical site infection (SSI), duodenal stump leak, pancreatic fistula occurrence, postoperative ileus, re-operation, and mortality. Combined overall effect sizes were calculated using the random-effects model, and the Newcastle-Ottawa Scale was used to assess risk of bias.

Results:

Seventeen non-randomised studies enrolling 2,960 patients divided between an IOJ (n = 1430) and EOJ (n = 1530) group were included. IOJ was associated with significantly lower risk of anastomotic stricture (P = 0.01), volume of intra-operative bleeding (P = < 0.001), and SSI (P = 0.04) compared to EOJ. No difference was found in anastomotic leak (P = 0.93); anastomotic bleeding (P = 0.35); operative time (P = 0.63); LOS (P = 0.30); lymph node yield (P = 0.17); time to first flatus (P = 0.77); time to resumption of soft diet (P = 0.32); intra-abdominal infection (P = 0.22); pulmonary infection (P = 0.45); duodenal stump leak (P = 0.46); pancreatic fistula occurrence (P = 0.16); and paralytic ileus (P = 0.59), re-operation (P = 0.50), and mortality (P = 0.23) between the two groups.

Conclusions:

LTG for gastric malignancy with IOJ may be associated with lower risk of anastomotic stricture and SSI compared to the extracorporeal approach. However, future adequately powered randomized studies are needed to compare the two techniques.
Wild honey grayanotoxin intoxication in rural Himalayan region of Nepal: a case report
Authors: Adhikari Aayush , Aryal Roshan , Baral Pratik , Acharya Baburam , Neupane Peter , Paudel Aadesh , Yadav Sushil Kumar
Published: February 2025

Introduction and importance:

Wild honey from Nepal’s Himalayas contains grayanotoxin, derived from rhododendron flowers, and is used in alternative medicine. However, it can cause severe side effects like vomiting, hypotension, and bradycardia.

Case presentation:

A 52-year-old baker from Chame, Manang, Nepal experienced dizziness, vomiting, sweating, and hypersalivation 30 minutes after consuming a teaspoon of wild honey for mild abdominal pain. In the emergency department, he had severe dizziness, low blood pressure of 48/32 mm Hg, heart rate of 49 beats per minute, and oxygen saturation of 90%. Electrocardiogram showed sinus bradycardia. He received IV fluids, oxygen, ondansetron, and atropine, with low-dose vasopressor support. His condition gradually improved, and he was discharged with stable vitals follow-up showed stable vitals and no symptoms.

Clinical discussion:

Consumption of honey containing grayanotoxins, derived from rhododendron plants, can lead to wild honey intoxication, prevalent in regions such as Turkey, South Korea, and Nepal. Symptoms include dizziness, hypotension, bradycardia, and cardiac disturbances. Diagnosis is clinical with use of laboratory tests to rule out other differentials if available and treatment involves symptomatic care with fluids, atropine, and monitoring. Distinguishing mad honey intoxication from conditions like acute coronary syndromes and organophosphate poisoning is crucial.

Conclusion:

Wild honey intoxication from rhododendron grayanotoxins causes symptoms such as dizziness, hypotension, and bradycardia, requiring clinical diagnosis and management with symptomatic care, fluids, and atropine, along with close monitoring for recovery.
Exploring the evolution of evidence synthesis: a bibliographic analysis of umbrella reviews
Authors: Nayak Sandeep Samethadka , Amini-Salehi Ehsan , Ulrich Michael T. , Sahli Yasmin , Fleischman Micah , Patel Masum , Naeiji Mahdi , Maghsoodifar Hasan , Sadeghi Douki Seyed Amir Hossein , Alroqi Hadi , Faraji Niloofar , Hassanipour Soheil , Hashemi Mohammad , Keivanlou Mohammad-Hossein
Published: February 2025

Background:

Umbrella review studies have become increasingly vital in evidence synthesis, offering a comprehensive overview by analyzing multiple systematic reviews and meta-analyses. This bibliometric study aimed to delineate the growth and thematic evolution of umbrella reviews within evidence-based medicine, illuminating their integral role in synthesizing high-level evidence.

Methods:

Utilizing the Web of Science Core Collection, we performed a search for publications on umbrella reviews, identifying relevant articles through a refined strategy. Analytical tools including VOS Viewer and CiteSpace were employed to visualize connections and trends among the gathered data, converting intricate bibliometric information into comprehensible visual maps.

Results:

Our search yielded 2965 pertinent publications, highlighting a marked growth in research output, particularly from 2010 to 2023. The United States, United Kingdom, and China were predominant in this field, with leading institutions like King’s College London and the University of Toronto at the forefront. The analysis identified major journals such as BMJ Open and PLOS One as key publishers. Co-citation and keyword analysis revealed current research focuses, with recent trends emphasizing COVID-19 and mental health. The study also uncovered a robust international collaboration network, underscoring the global impact of umbrella reviews.

Conclusion:

This bibliometric analysis confirms the expanding influence and utility of umbrella reviews in medical research and decision-making. By charting the evolution and current trends in this field, our study not only showcases the geographical and institutional distribution of research but also guides future scholarly efforts to advance evidence synthesis methodologies.
Effectiveness of virtual reality-based cognitive behavioral group therapy on reducing anxiety and depression in Parkinson’s patients: a randomized controlled trial
Authors: Asadiof Farnaz , Gharehtapeh Zhaleh Hasanpour , Naeim Mahdi , Mirzai Fatemeh , Mohammadi Yasaman
Published: February 2025

Introduction/objective:

This study aimed to evaluate the impact of virtual reality-based cognitive behavioral group therapy (VR-CBGT) on reducing anxiety and depression in patients with Parkinson’s disease.

Methods:

A randomized clinical trial with a pretest and posttest design was conducted involving 90 Parkinson’s patients, from Roozbeh Hospital, Tehran in 2023. Participants were randomly assigned to an experimental group receiving 12 sessions of VR-CBGT over 3 months or a control group with no psychological intervention. Both groups completed the Beck Depression Inventory and Beck Anxiety Inventory before and after the intervention. Data were analyzed using multivariate analysis of covariance in SPSS-25.

Results:

The experimental group showed significant reductions in depression and anxiety compared to the control group. VR-CBGT explained 15% of the variance in depression (F = 6.148, P < 0.0005) and 31% in anxiety (F = 17.800, P < 0.0005).

Conclusion:

VR-CBGT effectively alleviates depression and anxiety in Parkinson’s patients, offering a promising therapeutic approach. Integrating VR into CBT enhances engagement and real-life skill application, supporting its use as a complementary intervention.