bluuebunny/crossref_metadata_2025 huggingface dataset:
COVID-19 in Egyptian Children on Regular Hemodialysis: Experience of a Single Center
Authors: Elmoselhy Sawsan Sayed , Ali Said Ragia Marei , Darweish Sallam Dina Ebrahem , Manzour Ayat Farouk , Abdelnabi Hend Hassan , Abozahra Alaa Ali
Published: July 2024

Background

COVID-19 is clinically characterized by high rates of transmission, and pathological abnormalities. Pediatric patients with CKD are at high risk of COVID-19 infection & morbidity.

Aim of the Work

We aimed at studying the rate of infection by COVID-19 in pediatric patients following up at our Pediatric dialysis & Nephrology unit, Ain Shams University.

Patients and Methods

This retrospective study was conducted over 12 months from 1st of March 2020 to end of February 2021 on 70 pediatric patients with chronic kidney disease stage 5 on regular hemodialysis (CDK5d).

Results

The mean age & dialysis duration of our studied patients was 11.89 (±3.01) years & 2.17(±1.2)years respectively, where the incidence of COVID-19 infection confirmed by PCR on nasal swab sampleswas 7%. The younger patients had a higher rate of COVID-19 infection than older ones (p = 0.05). Using public transportation during past 14 days before getting COVID-19 infection was significant in COVID-19 positive patients (p = 0.01). The common associated symptoms in our patients were fever, joint ache, muscle ache, loss of appetite, headache, shortness of breath, fatigue, cough, sore throat, nausea, loss of smell or taste, diarrhea, vomiting.

Conclusion

COVID-19 infection among our CDK5d patients was not uncommon with incidence of 7%, where younger patients were infected more frequently than older patients The common associated symptoms in our patients were fever, joint ache, muscle ache, loss of appetite, headache, shortness of breath, fatigue, cough, sore throat, nausea, loss of smell or taste, diarrhea, vomiting.
COVID-19 Pandemic Effects on Epileptic Children and Interleukin 6 Levels in Recently Diagnosed Epileptic Patients: A Cross Sectional Study
Authors: Zaky Eman Ahmed , Maher Deifalla Shaymaa Ahmed , Ahmed Taher Omnia Mohamed Elnabawy , Shatta Mennatalla Osama , Abdelmageed Reham Ibrahim
Published: July 2024

Background

Epilepsy is a disease with wide range of definitions. It is considered a multifactorial condition that may present at various ages and in many forms, which makes it challenging for physicians. In late 2019, SARS-CoV-2 (COVID-19) emerged as a novel coronavirus. Both epilepsy and COVID-19 can be linked in more than one way.

Aim of the Study

To Determine the effects of COVID-19 pandemic on the health-related quality of life and psychosocial aspects of children with epilepsy & to Determine whether COVID-19 infection is an inflicting cause for epilepsy in newly diagnosed cases.

Patients and Methods

We interviewed 50 patients with Epilepsy and their parents, for the blood tests we sampled 40 and 40 close relatives with no medical condition of similar age and sex.

Results

50 subjects’ results were demonstrated, 28 males and 22 females, median age was 9 years old. Unfortunately, almost all were experiencing depression, data showed that 1 (2%) didn’t have depression, 15 (30%) had mild depression, 27 (54%) had moderate depression and 7 (14%) had been experiencing severe depression, Mostly, all in our study were experiencing anxiety, data showed that 1 (2%) didn’t experience anxiety, 7 (14%) experienced mild anxiety, 16 (32%) experienced moderate anxiety while 26 (52%) experienced severe anxiety. Fair physical, social and emotional health overall, data showed that the average physical health quality of life was 450 (SD 197.65), the average emotional health quality of life was 275 (SD 126.91), the average social health quality of life was 275 (SD 123.61) and the average school performance quality of life was 287.5 (SD 154.31). There were 9 cases newly diagnosed with epilepsy who were COVID IgM. Among subjects with COVID IgM positive, 3 (25%) had no neurological manifestations. Cases had higher levels of IL-6 compared to control children 187.5+/-68.89 and 77.33+/-27.94 respectively with statistically significant difference p < 0.001. However, no significant difference was found upon comparing COVID IgM levels of the 2 relevant groups.

Conclusion

COVID-19 pandemic has major impacts on health-related quality of life, causing depression, anxiety, decreased social and physical activities and poor school performance. COVID-19 can cause new onset seizures and epilepsy, or increase the frequency of seizures, IL-6 is a useful marker for severity of diseases as COVID-19, also for following up the progression of the disease, but not a marker for diagnosing it.
Functional Mobility Scale and Scoliosis Degree before and after Zoledronate Therapy in Children with Osteogenesis Imperfecta
Authors: Elsedfy Heba Hassan , Amr Nermine Hussein , Khalaf Randa Ismail , Aly Baraka Mostafa Mohamed , Fawaz Shereen Ismail , Mohamed Abouelnasr Marwa Abdelhamid
Published: July 2024

Background

Intravenous zoledronate, has been indicated for the treatment of Osteogenesis imperfecta (OI). It is a heritable disorder that causes bone fragility. The purpose of this study was to evaluate its effect on functional mobility scale and scoliosis degree on children with OI.

Methods and Results

This observational study was conducted on 28 OI patients (12 boys & 16 girls) aged 1.3-7.15years. All parameters were evaluated at Pediatric Endocrinology clinic, Children’s Hospital, Ain Shams University. Treatment was started with zoledronate dose 0.05 mg/kg every 6 months. Children less than 3 years of age received intravenous Zoledronate at a dose of 0.025 mg/kg per dose every 6 months with a maximum dose of 2 mg, while children above 3 years old received 0.05 mg/kg/dose every 6 months with a maximum dose of 4 mg. FMS and scoliosis degree using cobb anglewere evaluated before and after zoledronate therapy. Patients showed highly significant improvement in FMS. Patients with mild and moderate degree of scoliosis showed a non significant improvement in the degree of scoliosis while patients with severe scoliosis didn’t show any statistically significant difference.

Conclusion

Our study showed that intravenous zoledronate treatment, given once every 6 months, is an effective mode of treatment in OI children. It was associated with improvement in FMS. Longer follow-up is necessary to monitor the effect of treatment on degree of scoliosis by cobb angle.
Assessment of Anthropometric and Pubertal Growth of Children and Adolescents with Type 1 Diabetes Mellitus
Authors: Sherif Eman Monir , Thabet Rasha Adel , Ahmed Mahmoud Rana Abdelhakim , Abd El-aal Ahmed Mohamed Osman
Published: July 2024

Background

Type 1 diabetes mellitus (T1DM) is a wasting disease which is characterized by a severe deficiency or absence of insulin. It can interfere with growth and pubertal development, especially in uncontrolled patients with diabetes.

Aim of the Work

Our primary aim was to assess the anthropometric measures and pubertal growth of children and adolescents with T1DM regularly attending Pediatric and Adolescents Diabetes Unit (PADU), Ain Shams University. Our secondary aim was to detect risk determinants affecting these measures and their link to glycemic control.

Patients and Methods

This cross-sectional observational study was carried out on 200 children and adolescents with T1DM attending the PADU clinic. Patients were assessed using anthropometric measurements, lipid profile (Fasting serum triglycerides, total cholesterol, HDL and LDL) and HbA1c%. Those with short stature were further evaluated using insulin like growth factor1 (IGF1), bone age, lipid profile and thyroid profile. while those with delayed puberty were evaluated using sex hormones.

Results

we found that 12.5% of our patients were short (SD<-2), Cut off point of IGF-1 SDS (≤ -1.2) and GF1( 2ng/ml) was low in72% of them. Diabetic patients with short stature have significantly earlier age of onset of diabetes, earlier age at diagnosis and longer duration of diabetes compared to those with normal stature (P < 0.05). Additionally, patients with short stature and those with delayed puberty have higher HbA1c. Patients with short stature also have higher lipid profile and lower IGF1 compared to those with normal stature (p < 0.05).

Conclusion

Children with uncontrolled T1DM are at risk of being short and had delayed puberty. IGF-1 level can be used as a screening test for short stature in diabetic children.
The Effectiveness of the Single Object Burying Test in Assessing Hypervigilance-like Behavior in the Single Prolonged Stress Model of Post-Traumatic Stress Disorder (PTSD) in Male Sprague Dawley Rats
Authors: Ibrahim Youstina Guirguis , Mohammed Salama Raghda Abd ElAziz , Atalla Boctor Suzi Sobhy , Aziz Bassyouni Lobna Fouad Abdel , Elmelegy Ahmed Abdel-Salam M
Published: July 2024

Introduction

Post-traumatic stress disorder (PTSD) is recognized nowadays as a major public health issue. It arises as a long-term reaction to severe stressors considered to be life-threatening. It’s characterized by intrusive symptoms, avoidance, and hypervigilance. Although its prevalence is rather high, the mechanisms behind this serious condition are little understood, and its treatment is currently challenging. To get insights into this disorder, a variety of PTSD models were developed in the last 15 years as well as several tests have been proposed to assess the PTSD-like behaviors in these animal models. The single object burying test (OBT) was used to examine the hypervigilant behavior in electric shock animal model of PTSD. To the best of our knowledge, no prior studies have utilized the OBT to assess hypervigilance in the traditional single prolonged stress (SPS) animal model of PTSD. Our study aims to compare the behavioral response of the SPS-exposed and SPS-unexposed rats in the OBT.

Methods

This study employed the single prolonged stress (SPS) model to induce PTSD in male Sprague-Dawley rats (n = 12 rats, divided as control group = 6 rats, and SPS group = 6 rats) to investigate whether the single object burying test can detect the hypervigilance like behavior in the SPS rats as compared to control group. Parameters used are the percentage of time spent manipulating the object and the percentage of time spent burying the object.

Results

SPS rats demonstrated decrease in the percentage of time spent manipulating the object and increase in the percentage of time spent burying the object as compared to control group in the OBT. These responses are interpreted as hypervigilance like behavior.

Conclusion

The OBT can be considered a successful test in assessing hypervigilance of the rats exposed to the SPS animal model of PTSD
Protective Role of Caloric Restriction versus L-Carnitine on Aluminium Chloride Induced Cognitive Deficit in Rats
Authors: Wadie C M , Awad H A , Sabaa A R , Mohamed A A , Ali R H , Labib JMW , Abou-Bakr D A
Published: July 2024

Introduction

Alzheimer’s disease (AD) is a worldwide chronic progressive neurodegenerative disease. However, its pathophysiology is still unclear and there is no determined cure for it up till now. Both Acetyl-L-carnitine (ALCAR) and caloric restriction (CR) slow down the aging process.

Hypothesis

To compare the neuroprotective impacts of ALCAR and CR on aluminum chloride (AlCl3) induced AD in adult male rats to explore the pathogenesis and therapeutic strategies of AD.

Materials and Methods

Our study was carried out on 67 adult male albino rats that were allocated into 4 groups: Control, AlCl3, AlCl3-Acetyl-L-Carnitine and AlCl3-Caloric Restriction groups. AlCl3 and ALCAR were taken by gavage in a dose of 100 mg/1ml/kg. B.W. and CR was done by 70% of the daily average caloric intake of the control group for 30 days. All rats were subjected to behavioral assessment; open field test (OFT), Y maze, novel object recognition test (NORT) and passive avoidance test (PAT), biochemical assay of serum phosphorylated tau (pTau), hippocampal homogenate phosphorylated adenosine monophosphate kinase (pAMPK), Beclin-1, Bax (Bcl-2-associated X protein), Bcl2 (B-cell lymphoma-2) and Bax/Bcl2 ratio as well as hippocampal histological studies using H&E, Silver stain and Immunohistochemistry (nuclear protein Ki 67 & glial fibrillary acidic protein GFAP).

Results

The results showed cognitive and behavioral deficits induced by AlCl3 and this were coincident with increased level of serum pTau, aggregated neurofibrillary tangles (NFTs) and senile plaques with increased pAMPK. impaired autophagy and enhanced apoptosis associated with defective neurogenesis and defective astrocyte activation.

Conclusion

ALCAR and CR partially improved the AlCl3 induced behavioral, cognitive, biochemical and histological changes, with more ameliorative effect of ALCAR on hippocampal apoptotic markers, with more obvious behavioral and histological improvement with CR.
Prevalence of Cyberbullying Victimization and its Possible Psychological Outcomes among a Sample of Ain Shams University Students
Authors: Madbouly Elmahdy Hadir Mohamed , Aal Abouseif Hasnaa Abdel , Hassan Azza Mohammed
Published: July 2024

Introduction

Cyberbullying is a form of bullying that uses new technology such as cellphones, hardware systems, and remote tablets. It encompasses all behavior types that include sending continuous aggressive messages using electronic media to hurt or disturb others individually or as a group.

Aim of Work

To measure the prevalence of cyberbullying victimization, and identify factors associated with cyberbullying victimization among a sample of Ain Shams University first-year students.

Materials and Methods

A cross-sectional study was conducted among a convenience sample of first-grade students. A sample size of 529 students showed response to the survey; of them, 266 were from scientific colleges and the remaining were from literary colleges.

Tools

two Arabic self-administered online questionnaires were used to collect data on the demographic characteristics questionnaire and Cyberbullying Scale (C.B.S).

Results

The mean age of the sample is (18.51 ± 0.5 years) and 75.2% of them are females. Most of the studied sample (90.9%) was exposed to CB and 3.7% of them reported high exposure. Moreover, exposure of students to cyberbullying was associated with mother’s occupation (OR = 2.5, 95% CI: 1.02-4.9. p- value= 0.042), the time since students started using social media (OR = 2.7, 95% CI: 1.2-6.1. p-value= 0.01) and using Facebook as their favorite social media app (OR = 2.95, 95% CI: 0.32-11.4. p-value= 0.001).

Conclusion and Recommendations

The majority of adolescents had been exposed to cyberbullying, so intervention techniques and programs to prevent cyberbullying among college students are necessary, and, sharing information on cyberbullying and how to report it to authorities’ families, and student orientations would be beneficial to increasing awareness.
Safety and Efficacy of Mechanical Thrombectomy in Stroke Patients beyond 6 Hours
Authors: Gamal-eldin Mostafa Mahmoud , Farid Mostafa , Eldeen Mostafa Ahmed Mohamed Diaa
Published: July 2024

Background

Stroke is one of the primary causes of death in Egypt. With advances in the stroke imaging and medical care we could extend the window of mechanical thrombectomy beyond 6 hours according to many studies.

Objective

To evaluate the safety and efficacy of endovascular treatment (EVT) of acute large vessel occlusion beyond 6 hours from the onset of the stroke.

Patients and Methods

A retrospective cohort study was conducted that include records for all patients diagnosed with acute ischemic stroke and treated after 6 hours of symptoms onset at Ain shams university hospitals from January 2019 to December 2021 (at least 20 cases) to evaluate the safety and efficacy of endovascular treatment of acute large vessel occlusion beyond 6 hours from the onset of the stroke.

Results

Twenty cases are included in our study with a mean age of 53.7±17, 65% were female, and the median NIHSS score at presentation was 13. Successful recanalization (mTICI 2b to 3) was obtained in 85% of patients and symptomatic ICH rate was 50% mostly in patients who didn’t undergo MRI prior to MT. overall 30% of the patients had good outcome (mRS ≤ 2) at 90 days post thrombectomy.

Conclusion

Mechanical thrombectomy beyond 6 hours is safe and effective with good selection of patients according to MRI and CT perfusion.
Role of MRI in Patellofemoral Pain Syndrome (Anterior Knee Pain)
Authors: Mohamed Ayat Abdullah , Hatem Shalaby Mennat Allah , Naguib Elaassar Maha Mahmoud
Published: July 2024

Background

MRI is a good diagnostic tool in identifying cartilage and soft tissue lesions as well as detecting underlying predisposing anatomical factors of patellar instability, it has a high specification for detecting the grades and the types of some of these diseases or factors that may predispose to them such as trochlear dysplasia and patella alta.

Aim of the Work

The aim of this study was to evaluate the role of MRI in diagnosis of Patellofemoralpain syndrome which is the most common cause of anterior knee pain.

Patients and Methods

This prospective study was done on patients referred from the orthopedic clinic to the department of radiodiagnosis, MRI unit at Ain Shams University hospitals.Thirty patients were included (18 females and 12 males) and their age ranged from 20 to 64 years.

Conclusion

This study shows that MRI is useful in detecting various predisposing anatomical factors of patellofemoral instability and associated lesions of knee joint thereby enabling orthopedic surgeons to treat joint pathology as well as correct underlying anatomical abnormality.
Evaluation of the Diagnostic Accuracy of a Computed Tomography-Based Scoring System in the Differentiation between Malignant and Benign Pleural Effusion
Authors: Mohammed Ahmed Moustafa , Hossam El Din Nourhan Mohammed , Kamal Dalia Hesham
Published: July 2024

Background

Pleural effusion in particular is considered a sign of an underlying pathology, so ti is necessary ot search for the cause and determine whether it is a benign cause or a malignant one as they differ in treatment and prognosis.

Aim of the Work

To assess the accuracy of contrast-enhanced CT chest to predict the nature of pleural effusion whether benign or malignant using the CT-based scoring system developed by Porcel et al.'(1)

Patients and Methods

This study was a retrospective study that involved reviewing the contrast-enhanced CT chest done at the radiodiagnosis department in Ain Shams University Hospitals of 30 adult patients (age >18 years old) withunilateral or bilateral pleural effusion, and scoring ti according to hte Porcel et al (" CT scoring system while being blinded to the final diagnosis. The total score was then compared to the biopsy or cytology of the patient to determine its accuracy.

Results

Analyzing the data showed that the highly significant item of the scoring system denoting malignancy was pleural lesion followed by lung masses, liver metastasis, abdominal masses, and absence of pericardial effusion. The cutoff value in our study was found to be total score >7 denoting malignancy with a sensitivity of 94.12%, a specificity of 100%, a PPV (positive predictive value) of 100, a NPV (negative predictive value) of 92.2 and AUC (area under curve) = 0.986. On the other hand, the cutoff value of the study done by Porcel et al ( (27 denotes malignancy) gave a sensitivity of 94.1%, a specificity of 92.3%,a PPV of 94.12, a NPV of 92.31, and an accuracy of 93.33% in our study while in their study gave a sensitivity of 88%, aspecificity of 94%, and AUC = 0.919.

Conclusion

This is a simple chest CT scan scoring system, which includes the evaluation of pleural nodularity or thickening, liver metastases, abdominal masses, lung nodules or masses, pleural loculations, pericardial effusions, and cardiomegaly. It can be used as a reliable tool that helps determine the differential diagnosis ofpleural effusion yet does not replace cytology/biopsy. Further studies assessing this C T scan score are recommended.
Enhanced Recovery after Surgery Protocol (ERAS) versus Standard Protocol for Undergoing Radical Cystectomy in an Egyptian Population
Authors: Osman Tarek , Tawfiq Abdallah Ahmed Mohamed , Attia Elshekhiby Ahmed Saad
Published: July 2024

Background

bladder cancer has been one of the commonest cancer. The gold standard for treatment of muscle invasive bladder cancer is radical cystectomy with pelvic lymphadenectomy and associated with considerable morbidity and mortality and healthcare cost. Enhanced recovery after surgery (ERAS) protocols are multimodal perioperative care pathways designed to achieve early recovery after surgical procedures.

Aim and Objectives

The aim of this study was to compare between the standard preoperative bowel preparation (SP) and ERAS protocol in terms of postoperative length of stay (LOS) and postoperative morbidity.

Subjects and Methods

This was a prospective randomized study was conducted in Ain shams university hospital – Alexandria university hospital involving fifty (50) patients were randomly divided into two equal groups twenty-Five (25) patient in group A follow ERAS protocol and twenty-Five (25) patients in group B following standard protocol. The duration of the study ranged from 6-12 months.

Results

There was statistically significant difference found between group A and group B regarding the studied parameters ( Readmission in 30 days, Ileus, Vomiting, and UTI) while there was no statistically significant difference between them regarding (early mobilization, urine leakage, dehesince and DVT), there was no statistically significant difference found between group A and group B regarding (Length of stay).

Conclusion

In patients undergoing radical cystectomy, enhanced recovery protocol is considered as a safe procedure and not associated with any increase in intraoperative and postoperative complications compared to standard protocol. The length of hospital stay was shorter in ERAS group.
Laparoscopic vs Open Orchiopexy for Palpable Undescended Testis in Children
Authors: Abd El-Magid El-Zayat Tarek Mostafa , Ahmed Tolba Mohamed Kotb , Ahmed Temsah Ahmed Nagi
Published: July 2024

Background

Cryptorchidism is the absence of one or both testes in the scrotum and is generally synonymous with undescended testis. Undescended testis is the most common genital disorder identified at birth. Undescended testes occur in 1–3% of full-term and up to 45% of preterm male neonates. Approximately 80% of undescended testes are clinically palpable and 20% are non-palpable.

Aim of the Work

To compare between laparoscopic and open orchiopexy evaluating final testicular position, success rate, and complications.

Patients and Methods

A prospective comparative study was made in Urology department, Ain Shams University Hospital for Twelve months starting from 1st of June 2021 to 1st of May 2022 on 50 children (aged from 1-18 years) with UDT and were included in the study and divided in to 2 groups 25 for each study group.

Results

In the present study the mean age in group I was 8.1± 0.99 y and in group II was 9.28± 0.91 y with no significant difference. The mean operative time in group I was 63.6 ± 5.56 min, and in group II was 58.44. ± 5.28 min with no statistically significant difference. There was in group I all the studied cases had no testicular atrophy, no testicular ascent, no need for redo-orchiopexy and a hernial sac was detected in all cases. In group II all the studied cases had no testicular atrophy, 92% had negative testicular ascent and 96% had a hernial sac. As regard to complications, only 2 patients presented with wound infection in group I and in group II there were a case with wound infection, a case with hydrocele and 2 cases with scrotal haematoma with no significant difference.

Conclusion

For the treatment of inguinal cryptorchidism, laparoscopic orchiopexy is a safer and less invasive option than open groin surgery. In children with palpable undescended testis, laparoscopic orchiopexy is linked with improved testicular position and a better success rate as open orchiopexy.
Pseudomonas chlororaphis Metabolites Reduce MfCYP51 Expression and Yield Synergistic Efficacy in Mixture with Reduced Rates of Propiconazole Against DMI-Resistant Monilinia fructicola Isolates
Authors: Wesche Johanna , Zeng Zhezheng , Luo Chao-Xi , Schnabel Guido
Published: July 2024

Brown rot caused by Monilinia fructicola is one of the most important diseases affecting peach production in the southeastern United States. Management often involves the use of demethylation inhibitor (DMI) fungicides, but efficacy can be compromised because of overexpression of the MfCYP51 gene encoding the 14α-demethylase of the ergosterol biosynthesis pathway. This study aimed to investigate the influence of the biorational fungicide Howler EVO containing Pseudomonas chlororaphis ASF009 metabolites on the expression of MfCYP51 in M. fructicola and associated synergy with a DMI fungicide for control of DMI-resistant strains. Mycelia from two DMI-sensitive and three DMI-resistant M. fructicola isolates were exposed or not to propiconazole (0.3 μg/ml), Howler (88.1 μg/ml), or the combination propiconazole + Howler for 6 h prior to RNA extraction. Real-time PCR indicated that Howler reduced the constitutive expression of MfCYP51 in DMI-sensitive and two of three DMI-resistant isolates. Propiconazole-induced expression of the DMI target gene was significantly reduced by Howler and by the mixture of Howler plus propiconazole in all isolates. Detached fruit studies on apple revealed that the combination of Howler plus a reduced label rate of Mentor (50 μg/ml propiconazole) was synergistic against brown rot caused by a DMI-resistant isolate in high and low inoculum spore concentration experiments (synergy values of 40.1 and 4.9, respectively). We hypothesize that the synergistic effects against M. fructicola resistant to DMI fungicides based on MfCYP51 gene overexpression can be attributed to reduced 14α demethylase production due to transcription inhibition, which may necessitate fewer DMI fungicide molecules to arrest fungal growth. The use of Howler/DMI mixtures for brown rot control warrants further investigation because such mixtures could potentially allow for reduced DMI fungicide use rates in the field without compromising yield or increased resistance selection.
Are Surgical Outcomes Different According to Baseline Balance Status in Elderly Patients with Degenerative Sagittal Imbalance?
Authors: Park Se-Jun , Lee Chong-Suh , Park Jin-Sung , Kang Dong-Ho
Published: July 2024

Study Design.

This is a retrospective study.

Objective.

We sought to compare surgical outcomes according to baseline balance statuses in elderly patients with degenerative sagittal imbalance (DSI).

Summary of Background.

Although optimal sagittal correction has been emphasized for good surgical outcomes, the effect of the state of preoperative balance on surgical outcomes has been adequately described at present.

Methods.

Patients aged 60 years and above with DSI who underwent ≥5-level fusion to the sacrum were included. Among them, only those who postoperatively achieved the optimal age-adjusted pelvic incidence (PI) – lumbar lordosis (LL) target were included in this study. Study participants were divided into two groups according to their preoperative sagittal vertical axis (SVA): compensatory balance (SVA <5 cm, group CB) and decompensation (SVA ≥5 cm, group D). Comparisons between the two groups were performed using the χ2 test or Fisher exact test for categorical variables and the independent t-test or Wilcoxon rank-sum test for continuous variables.

Results.

A total of 156 patients whose postoperative sagittal alignment matched the age-adjusted PI-LL target constituted the study cohort. There were 59 patients in group CB and 97 patients in group D. Mean follow-up duration was 50.0 months after surgery. Immediate postoperatively, sacral slope and SVA were significantly greater in group D than in group CB. At the last follow-up, the SVA was significantly greater in group D than in group CB (43.6 vs. 22.7 mm), while no significant differences were found in other sagittal parameters. The Oswestry disability index and Scoliosis Research Society −22 scores at the last follow-up were significantly worse in group D than in group CB.

Conclusion.

The SVA tended to experience less correction postoperatively, with evidence of further deterioration during follow-up in group D than in group CB. This suboptimal correction of SVA may contribute to the inferior clinical outcomes encountered in group D relative to group CB. Therefore, we recommend correction of PI-LL as close as possible to the lower limit of the suggested PI-LL target range in patients with evidence of preoperative decompensation.
Upregulation of Angiomotin-Like 2 Ameliorates Experimental Pulmonary Arterial Hypertension by Inactivating YAP1 Signaling
Authors: Deng Jizhao , Yang Guang , Zhong Nier , Liang Lei , Chen Haichao
Published: July 2024

Angiomotin-like 2 (AMOTL2) is related to numerous physiological and pathological conditions by affecting signal transduction. However, whether AMOTL2 is linked to pulmonary arterial hypertension (PAH) has not been addressed. This work aimed to investigate the potential role of AMOTL2 in PAH. A decrease in AMOTL2 abundance was observed in the lungs of PAH rats. The upregulation of AMOTL2 significantly decreased right ventricle systolic pressure and right ventricular hypertrophy in PAH rats. Overexpression of AMOTL2 also led to a noteworthy decrease in vascular wall thickness, pulmonary artery area, and collagen deposition in rats with PAH. AMOTL2 was downregulated in hypoxia-stimulated pulmonary arterial smooth muscle cells (PASMCs). Moreover, AMOTL2 overexpression impeded hypoxia-evoked proliferation, migration, and phenotypic transformation in rat PASMCs. Mechanistic investigation revealed that Yes-associated protein 1 (YAP1) activation in PAH rats or hypoxia-stimulated PASMCs was markedly inhibited by AMOTL2 overexpression, which was associated with increased large tumor suppressor 1/2 phosphorylation. The inhibition of large tumor suppressor 1/2 reversed the AMOTL2-mediated inactivation of YAP1. Restoring the activity of YAP1 reversed the inhibitory effect of AMOTL2 on hypoxia-evoked proliferation, migration, and phenotypic transformation of PASMCs. Collectively, these results suggest that AMOTL2 can ameliorate PAH in a rat model by interfering with pulmonary arterial remodeling via the inactivation of YAP1 signaling. Our work indicates that AMOTL2 may be a candidate target for novel drug development for the treatment of PAH.
Fluorescence Intensity between Standard versus Diluted Indocyanine Green to Evaluate Flap Perfusion in Rats
Authors: Atmodiwirjo Parintosa , Ramadan Mohamad R. , Sapphira Elrica , Djohan Michael , Ralena Nadhira A. , Amanda Nadira F.
Published: July 2024

The ideal dose for indocyanine green (ICG) has not been established yet, although 5 mg per mL is widely accepted for free flap evaluation. Due to its high price and rarity in developing countries, this preliminary study aimed to find the lowest concentration of ICG without reducing the fluorescence quality read by near-infrared camera in animal models. An experimental study was conducted on 25 Wistar rats divided into five groups based on the injected ICG, which was in 5 mg per mL, 3.75 mg per mL, 2.5 mg per mL, 1.25 mg per mL, and 0.5 mg per mL concentrations. The epigastric flap was elevated and confirmed to be vital on the fifth day. Upon confirmation, bolus IV injection of ICG was given via the tail, and the flap was read using near-infrared camera. The 25 different videos are randomized and rated individually in a blind manner by five microsurgeons, chosen beforehand. The videos are evaluated with a scoring system ranging from 0 to 4, assessing fluorescence visibility and flap vasculature. Nonetheless, the intraclass correlation coefficient is 0.779. There was no difference between standard and diluted ICG concentrations to evaluate flap perfusion. The 2.5 mg per mL concentration of ICG was the most favorable. This finding is not clinically relevant for application in human subjects yet. However, this study shows promising results for further usage of ICG in daily practice at a lower cost.
The Impact of Prior Obesity Surgery on Bleeding after Abdominal Body Contouring Surgery
Authors: Badran Saif , Braizat Omar , Aljassem Ghanem , Alyazji Zaki , Farsakoury Rana , Iskeirjeh Sara , Asim Mohammad , Glass Graeme E. , Muneer Mohammed
Published: July 2024

Background:

Body contouring surgery removes excess skin and fat, often after massive weight loss. Some reports suggest that patients who have previously undergone obesity (bariatric) surgery are at excess risk of subsequent bleeding, possibly due to complex nutritional and metabolic sequelae of massive weight loss.

Methods:

A retrospective cohort study of intraoperative blood loss and postoperative bleeding indicators were examined for patients who had undergone abdominoplasty. Participants were categorized based on their history of previous obesity surgery, and outcome variables were compared using odds ratio, followed by subgroup comparison between a history of restrictive versus malabsorptive obesity surgery,

Results:

The study included 472 patients, of which 171 (36.2 %) had a history of obesity surgery. Mean age was 40.4 years, and 402 (85.1%) participant were women. Fifty-five (11.6%) patients were smokers whereas 65 (13.7%) were hypertensive. Mean body mass index before surgery was 30.2 kg per m2, and average time between obesity and body contouring surgery (if applicable) was 35.8 months. Patients with a history of obesity surgery exhibited greater intraoperative blood loss (162.2 mL versus 132.1 mL; P = 0.001), drainage volume at 24 h (155 mL versus 135 mL; P = 0.001), and total drainage volume (300ml versus 220 mL; P = 0.001). Postoperative hematoma requiring surgical re-exploration was almost three times higher following a history of obesity surgery (4.7% versus 1.7 %; P = 0.05).

Conclusions:

History of obesity surgery increases intraoperative blood loss, postoperative serosanguinous drainage volumes, and the risk of postoperative hematoma requiring surgical evacuation after abdominal body contouring procedures.
Detoxification as a potential intervention for improving in vitro fertilization outcomes: a comparative analysis of failed cycles before and after detox
Authors: Ogunsola Oluwole I. , Adeyi Atinuke , Ashiru Oladapo A.
Published: July 2024

Objectives:

In vitro fertilization (IVF) success rates vary, posing challenges for patients with repeated failed cycles. Environmental toxins, including endocrine-disrupting chemicals, may contribute to IVF failure. Detoxification has emerged as a potential intervention to improve outcomes, but its efficacy remains uncertain.

Methods:

We conducted a retrospective analysis of data from 65 IVF patients undergoing detoxification at a private fertility clinic in Lagos, Nigeria, between 2020 and 2022. Demographic data, IVF history, and detoxification details were collected. Logistic regression assessed the impact of age and failed IVF cycles on live birth outcomes, with odds ratios calculated.

Results:

Of 65 patients, 33 achieved a positive pregnancy outcome after detoxification. A significant reduction in failed IVF cycles postdetoxification was observed (P < 0.0001). Logistic regression indicated that older age and more failed IVF cycles were associated with decreased odds of live birth. However, detoxification mitigated this effect, reducing the odds of failed IVF cycles, although not significantly.

Conclusion:

Detoxification shows promise as an intervention to improve IVF outcomes in patients with repeated failed cycles. By reducing failed IVF cycles and enhancing live birth rates, detoxification may optimize reproductive success. Further research with larger sample sizes is needed to confirm these findings and elucidate underlying mechanisms. Nonetheless, our study highlights the importance of considering environmental factors and adopting holistic approaches to enhance IVF success.
Are For-Profit Eye Banks a Good Idea?
Authors: Van Meter Woodford S.
Published: July 2024

For-profit eye banks have been advocated because they stimulate innovation and improve the quantity and quality of corneal tissue. The claims of for-profit eye banks do not stand up to scrutiny and promote discord in the recovery and distribution field. Commercialization can adversely affect public perception of corneal donation.
Analysis of intraocular lens packaging weight and waste
Authors: Keyser Andrew , Chang David F. , Thiel Cassandra , Hovanesian John
Published: July 2024

Purpose:

To analyze waste from intraocular lens (IOL) packaging across a variety of brands.

Setting:

Private clinical practice.

Design:

Prospective weight and composition analysis of all elements of unopened packages of IOLs sold in the United States—both preloaded and non-preloaded.

Methods:

Samples were collected from multiple IOL companies in 2023. The primary end point for comparison was the total weight of each IOL package, because this generally correlates with the carbon footprint. The percentage of total weight contributed by paper, plastic, Tyvek, foil, sterile saline solution (fluid), metal, or glossy paper material was also calculated.

Results:

The non-preloaded IOL package weights ranged from 29 g (Zeiss Lucia) to 80 g (RxSIGHT LAL). Most of the weight was attributable to paper, including the box and instructions for use (IFUs) pamphlet. The latter was generally the largest component within the box. The weights of preloaded IOL packages were generally higher than those of their non-preloaded counterparts and ranged from 67 g (Hoya iSert) to 116 g (Rayner RayOne Spheric).

Conclusions:

Meaningful differences in IOL packaging weight and waste were noted across different models and manufacturers. Electronic IFUs linked to QR codes could replace the need for an IFU pamphlet within every box, significantly reducing the box's size, weight, and carbon footprint. Pairing preloaded IOL cartridges with autoclavable injectors could reduce associated waste. Because of the enormous global volume of IOL implantation, these waste-reducing strategies should be prioritized by IOL manufacturers.
Costs of Presenteeism and Absenteeism Associated With Psychological Distress Among Male and Female Older Workers
Authors: Gilbert-Ouimet Mahée , Sultan-Taïeb Hélène , Aubé Karine , Matteau Léonie , Trudel Xavier , Brisson Chantal , Guertin Jason Robert
Published: July 2024

Objective

We estimated, for women and men (1) the associations between psychological distress and the prevalences of presenteeism and absenteeism, (2) average hours lost annually per person, and (3) costs from the employers' economic perspective.

Methods

Participants were 1292 Canadian white-collar workers. Psychological distress, presenteeism, and absenteeism were assessed with validated questionnaires. The average annual hours of productivity loss and related costs were estimated using generalized linear models with a negative binomial distribution and a log link.

Results

High psychological distress in women and men was associated with presenteeism costs ($6944 and $8432) and absenteeism costs ($2337 and $2796 per person). The association between psychological distress and annual hours lost to presenteeism was twice stronger for men than women.

Conclusions

Productivity losses associated with psychological distress are high in women and men older workers.
Tenfold Increase: Acute Pediatric Mastoiditis Before, During, and After COVID-19 Restrictions
Authors: Draut Sarah , Müller Joachim , Hempel John-Martin , Schrötzlmair Florian , Simon Florian
Published: July 2024

Introduction

Acute mastoiditis (AM) is a relatively rare complication arising from acute otitis media, a common condition among children. The COVID-19 pandemic has significantly impacted AM cases. We noted a surge in pediatric AM cases in Germany after COVID-19 restrictions were lifted in 2022. This study assesses AM incidence and the clinical course in children before, during, and after the pandemic. The study also explores complication rates and microbial changes.

Methods

Participants: We included children (0–18 yr) diagnosed with AM who underwent mastoidectomy at a tertiary-care university hospital from January 2012 to June 2023.

Objectives: We aimed to evaluate AM incidence during pre-COVID, COVID, and post-COVID periods; assess complications; and analyze the microbial spectrum.

Data Analysis: Incidence and complication rates were compared between periods, along with the microbial spectrum.

Results

Population: 75 children were included (median age, 3.3 yr).

Incidence: Significant increases in AM cases occurred in the post-COVID period compared to pre-COVID and COVID periods. No significant difference was observed between pre-COVID and COVID periods.

Complications: Complication rates increased notably in the post-COVID period compared to pre-COVID and COVID periods with respect to more sensitive imaging methods being used in the post-COVID period. No significant difference was observed between pre-COVID and COVID periods.

Spectrum of Pathogens: No significant differences were found in pathogen distribution between periods. Streptococcus pyogenes and Streptococcus pneumoniae were common throughout.

Discussion

The study highlights a substantial rise in AM cases and complications after COVID-19 restrictions were lifted in Germany. This underscores the importance of monitoring infectious diseases and their complications during health crises. Additionally, the study highlights the importance of contrast-enhanced imaging. Further research is needed to explore the mechanisms behind this trend.

Conclusion

The study reveals a significant increase in pediatric AM cases and complications following the COVID-19 pandemic in Germany. Adequate computed tomographic or magnetic resonance imaging, including contrast enhancement, is shown to be a very important parameter beside clinical symptoms in deciding for the right therapy. Thus, surgical treatment became more important. Continuous monitoring and adaptive healthcare strategies during health crises are vital for optimal patient care. Further research is warranted to understand the reasons behind these trends and to inform future pandemic preparedness efforts.
Long-term blood pressure variability and risk of cardiovascular diseases in populations with different blood pressure status: an ambispective cohort study
Authors: Li Jinnan , Qu Ting , Li Ying , Li Pengcheng , Luo Benmai , Yi Yue , Shi Aibin , Pang Zhixin , Chu Yuting , Zhao Yuxin , Yang Li , Xu Shaopeng , Xie Juan , Zhu Hong
Published: July 2024

Objective

We aimed to investigate the correlation between long-term blood pressure variability (BPV) and the risk of cardiovascular diseases (CVDs) among population with different blood pressure statuses (normotension, well-controlled hypertension, and uncontrolled hypertension).

Methods

In this ambispective cohort study, CVD-free residents aged over 50 years were consecutively enrolled from two community health service centers (CHCs) in Tianjin, China from April 2017 to May 2017. Information on blood pressure was retrospectively extracted from electronic medical records of CHCs between January 2010 and May 2017, and the occurrence of new-onset CVDs was prospectively observed during follow-up until September 2019. Long-term variation of SBP and DBP was assessed using four indicators: SD, coefficient of variation (CV), average successive variability (ASV), and average real variability (ARV). Cox proportional hazards regression model was developed to identify the potential impact of BPV on the incidence of CVDs. The receiver operating characteristic curve (ROC) was utilized to evaluate the predictive value of BPV indicators for the occurrence of CVDs.

Results

Of 1275 participants included, 412 (32.3%) experienced new CVD events during the median 7.7 years of follow-up, with an incidence density of 499/10 000 person-year in the whole cohort. Cox regression analysis revealed that almost all SBP and DBP variability indicators (except for SBP-SD) were significantly related to the risk of CVDs, especially among individuals with well-controlled hypertension. A trend toward an increased risk of CVDs across BPV quartiles was also observed. Moderate predictive abilities of BPV were observed, with the area under ROC curves ranging between 0.649 and 0.736. For SBP variability, SD had the lowest predictive ability, whereas for DBP variability, ARV had the lowest predictive ability. No significant association of CVDs with SBP-SD was found in all analyses, no matter as a continuous or categorical variable.

Conclusion

Elevated long-term BPV is associated with an increased risk of CVDs, especially among individuals with well-controlled hypertension. CV and ASV had higher predictive values than SD and ARV.
The prognostic relevance of exercise pulmonary hypertension in cardiac and pulmonary diseases
Authors: Zeder Katarina , Douschan Philipp , Foris Vasile , Sassmann Teresa , Maron Bradley A. , Olschewski Horst , Kovacs Gabor
Published: July 2024

Purpose of review

In this review, we provide an overview of the prognostic implications of exPH in patients with various common cardiac and pulmonary diseases.

Recent findings

Exercise pulmonary hypertension (exPH) has been recently re-introduced in the current European Society of Cardiology/European Respiratory Society pulmonary hypertension guidelines. Accordingly, exPH is defined as a mean pulmonary arterial pressure (mPAP)/cardiac output (CO) slope greater than 3 mmHg/l/min. Key considerations for this re-introduction included increasing understanding on normal pulmonary hemodynamics during exercise and the broadly available evidence on the association of an abnormal mPAP/CO slope with poor survival in the general population and in different disease entities.

Exercise (patho-)physiology has opened a new field for clinical research facilitating recognition of cardiovascular and pulmonary vascular diseases in an early stage. Such early recognition with significant prognostic and possibly therapeutic relevance, but being undetectable at rest, makes exercise pulmonary hemodynamics particularly interesting for common diseases, such as valvular heart disease, left heart disease, and chronic pulmonary disease.
Cardiac sarcoidosis and neurosarcoidosis – multidisciplinary approach for diagnosis
Authors: Kouranos Vasileios , Sharma Rakesh , Wells Athol , Singh-Curry Victoria
Published: July 2024

Purpose of review

The current review aims to highlight the role of multidisciplinary approach in the diagnosis of patients with cardiac and neurosarcoidosis. Multidisciplinary approach integrates the available clinical information, imaging and histopathological results aiming to reach a definite or at least provisional diagnosis and allow appropriate management. Multidisciplinary approach is the reference standard for diagnosis of interstitial lung disease and should be strongly considered in complex clinical conditions such as cardiac sarcoidosis (CS) and neurosarcoidosis.

Recent findings

Histopathological confirmation of noncaseating granulomatous inflammation provides a definite diagnosis of sarcoidosis involving any organ. However, a provisional high confidence or even definite clinical diagnosis can be reached using multidisciplinary evaluation of all available evidence. The diagnosis of cardiac sarcoidosis and neurosarcoidosis requires the integration of different expertise based on the current diagnostic criteria sets. Identifying typical or at least compatible patterns on advanced imaging modalities (CMR and Fluro-Deoxy-Glucose Positron Emission Tomography (FDG-PET)) seems key for the diagnosis of CS, while a confident diagnosis of extra-cardiac disease supports an at least provisional diagnosis. Similarly, in neurosarcoidosis integrating compatible MRI appearances and cerebrospinal fluid results in patients with systemic sarcoidosis allows an at least provisional diagnosis. Exclusion of alternative differential diagnoses is crucial and requires high clinical suspicion, imaging review expertise and appropriate tests performance.

There have been considerable advances in the diagnostic approach of patients with cardiac and neurosarcoidosis. Multidisciplinary approach for both diagnosis and management is required to reach a confident clinical diagnosis and should be applied when possible.