bluuebunny/crossref_metadata_2025 huggingface dataset:
Demographic and Clinical Characteristics of Familial and Sporadic Multiple Sclerosis Patients
Authors: Mokhtari Shahrzad , Houshi Shakiba , Mirmosayyeb Omid , Barzegar Mahdi , Afshari-Safavi Alireza , Ghasemi Majid , Shaygannejad Vahid
Published: May 2024

Background:

Multiple sclerosis (MS) is a chronic, inflammatory, demyelinating, immune-mediated disease of the central nervous system. It is still unestablished whether heredity correlates with the disease's progression and severity.

Methods:

This study includes the patients with MS seen in the MS clinic of Kashani Hospital, affiliated with Isfahan University of Medical Sciences, from January 2019 to January 2020. We gathered data regarding the demographic and clinical characteristics, such as type of disease and family history of MS. Patients were grouped based on having relatives with MS. We compared demographic and clinical characteristics between those with a family history of MS (familial MS: FMS) and those without a family history of MS (sporadic MS: SMS).

Results:

We included 2,929 MS patients, 523 (17.2%) with FMS and 2,406 (82.8%) with SMS. Patients with FMS were found to have active lesions in the thoracic spine more frequently than those with SMS (P = 0.022). We also found differences in the distribution of gender (P = 0.036) and the frequency of having active brain lesions (P = .024) among patients with FMS and SMS. No difference was found between the demographic/clinical characteristics and the number of affected relatives in the family.

Conclusions:

Significant differences were found among different groups of patients in terms of demographical and clinical characteristics.
An Investigation on the Effect of Exercise on Insomnia Symptoms
Authors: Dadgostar Haleh , Basharkhah Afsaneh , Ghalehbandi Mir Farhad , Kashaninasab Fatemeh
Published: May 2024

Background:

Insomnia affects the daily activities of the sufferers and reduces attention and memory. Cognitive behavioral therapy is an expensive treatment and is not applicable to all patients, and long-term treatment with sleep medication can have side effects such as drug dependency. As an alternative form of non-pharmacological treatments, the effect of exercise therapy on improving the symptoms of insomnia is addressed in the current study.

Methods:

A total of 32 patients diagnosed with insomnia participated in the study, from which 16 received combined resistance-aerobic exercise therapy. The rest of the patients comprised the control group. The intervention group went through a 12-week intervention in the form of aerobic exercise for 3 days a week and resistance training for another 3 days a week. Patients' sleep quality was assessed by the Pittsburgh test before and after the intervention.

Results:

The results showed that combined aerobic-resistance exercise can improve sleep quality in patients with insomnia as well as increase subjective sleep quality and actual sleep duration, and decrease daytime dysfunction due to sleeping problems.

Conclusions:

This study shows that, along with other insomnia treatments, exercise can improve the sleep quality of patients.
Prevalence of Psychological Disorders among Health Workers During the COVID-19 Pandemic: A Systematic Review and Meta-Analysis
Authors: Gheshlagh Reza Ghanei , Hassanpour- Dehkordi Ali , Moradi Yousef , Zahednezhad Hosein , Mazaheri Elaheh , Kurdi Amanj
Published: May 2024

Background:

Repeated contact with patients with COVID-19 and working in quarantine conditions has made health workers vulnerable to psychological distress during the COVID-19 pandemic. The goal of the present systematic review and meta-analysis was to examine the prevalence of the various psychological distresses among health workers during the COVID-19 pandemic.

Methods:

PubMed, Scopus, Web of Science, EMBASE, and Cochrane databases were searched for access to papers examining psychological distress among healthcare workers during the COVID-19 pandemic. Risk of bias was assessed using the Newcastle–Ottawa Scale (NOS). Heterogeneity among the studies was examined using the Cochran's Q test; because heterogeneity was significant, the random effects model was used to examine the prevalence of psychological distress.

Results:

Overall, 12 studies with a total sample size of 5265 were eligible and included in the analysis. Prevalence rates of depression, anxiety, and PTSD were 20% (95% CI: 14–27), 23% (95% CI: 18–27), and 8% (95% CI: 6–9), respectively. The highest prevalence rates of depression and anxiety were related to the SDS and the GAD-7, respectively, and the lowest prevalence rates of the two aforementioned variables were related to the DASS-21.

Conclusions:

The high prevalence of psychological distress among healthcare workers during the COVID-19 epidemic can have negative effects on their health and the quality of services provided. Therefore, training coping strategies for psychological distress in this pandemic seems necessary.
Prevalence and Correlates of Cardiovascular Health Status among Adults in Afghanistan: Results of a National Survey in 2018
Authors: Pengpid Supa , Peltzer Karl
Published: May 2024

Background:

The aim of the study was to assess the prevalence and correlates of cardiovascular health (CVH) status among adults in Afghanistan.

Methods:

In a national cross-sectional household survey 3,447 adults completed CVH measurements in Afghanistan. Criteria for ideal CVH (ICVH) were physical activity, healthy diet, non-smoking, fasting blood glucose (<100 mg/dL), body mass index (<25 kg/m2), total cholesterol (<200 mg/dL), and blood pressure (<120/<80 mmHg).

Results:

More than one-third (34.3%) of participants had 5-7 ICVH, 45.7% 3-4 ICVH, and 20% had 0-2 ICVH. In adjusted logistic regression analysis, secondary or more education (AOR: 1.80, 95% CI: 1.22-2.66) was positively associated, and older age (45-69 years) (AOR: 0.33, 95% CI: 0.26-0.42), and urban residence (AOR: 0.67, 95% CI: 0.51-0.88) were inversely associated with 5-7 ICVH.

Conclusions:

The prevalence of ICVH was low in Afghan adults. Population measures may be used to improve CVH targeting identified associated factors.
Iranian Health System Response to the COVID-19 Pandemic
Authors: Shafaghat Tahereh , Rahimi Zarchi Mohammad Kazem , Mousavi Seyed Masood , Askari Roohollah , Ranjbar Mohammad , Ebadi Faezeh
Published: May 2024

Introduction:

The COVID-19 pandemic has created several challenges for countries all over the world. Different countries have taken different measures to fight this pandemic and reduce its challenges depending on their cultural, economic, and social structures. This study aims to understand and explain the Iranian health system's response to fighting the COVID-19 pandemic from the managers' and authorities' perspective.

Method:

This study is a basic applied research performed under a qualitative approach. In the survey, 30 experts including the managers of health centers and deputies and heads of the Ministry of Health and Medical Education and Medical Universities were selected by purposive snowball sampling and participated in semi-structured interviews from March to May 2020. The researchers explained the actions of the Iranian health system in fighting the COVID-19 pandemic in 2020 by content analysis.

Results:

As a result, 14 subthemes were found and classified into four major themes, including the informative and regulative actions (two subthemes), administrative and supportive actions (six subthemes), preventive and curative actions (three subthemes), and resource-related actions (three subthemes).

Conclusions:

Due to its strong health structures, such as urban and rural health networks, various general and specialized hospitals, experienced doctors, and committed health staff, Iran has taken practical actions in fighting the COVID-19 pandemic. However, the findings of this study and its relevant measures can help combat this pandemic in countries with similar social and cultural structures or counter future similar crises.
A Critical Analysis of the World'S Largest Publicly Funded Health Insurance Program: India's Ayushman Bharat
Authors: Kamath Rajesh , Brand Helmut
Published: May 2024

Background:

Launched in September 2018, the ABPMJAY is the world's largest publicly funded health insurance (PFHI) program with population coverage of 500 million. A systematic review was conducted.

Methods:

A comprehensive literature search was conducted in four databases: PubMed, Web of Science, Scopus, and Google Scholar. The literature search was conducted with the search terms: “Ayushman Bharat OR ABPMJAY OR modicare AND RSBY.” The search was set to title and abstract. Gray literature and government websites were also searched for relevant documents. A total of 881 documents were identified (PubMed: 53, Web of Science: 46, Scopus: 97, Google Scholar: 681, government websites: two, and gray literature: two). Fifty-two duplicates were identified. After the elimination of the duplicates, 829 unique documents were identified. These 829 unique citations were then subjected to a review of title and abstract independently by 2 reviewers. Six-hundred and ninety-two articles were rejected after review of title and abstract. One-hundred and thirty-seven articles were screened for full text independently by two reviewers. Sixty-six articles were rejected after review of the full text. Disagreements were resolved by discussion. Seventy-one unique articles were included in the final review. To attain the objective of the study, which is to critically analyze and provide an overview of Ayushman Bharat, a narrative synthesis was performed.

Results:

Seven themes were identified from the review: (1) health and wellness centers (HWCs); (2) out-of-pocket health expenditure (OOPHE); (3) fraud; (4) upcoding and provision of unnecessary medical care; (5) moving focus away from primary care; (6) coverage; and (7) lop-sided access, exclusion at the periphery, and brain drain. There is very little impact evidence of the ABPMJAY available.

Conclusions:

The government could plan impact evaluation studies in every state that the ABPMJAY is functional in. Any high-quality feedback generated might enable the National Health Authority, the government body leading and coordinating the ABPMJAY, to take necessary steps operationally and advice the government on strategy. Another concern is that the ABPMJAY PFHI might negatively impact the ongoing process of continuous strengthening and development of the government health-care system at all levels—primary, secondary, and tertiary. Continual recalibration and course corrections on the basis of high-quality feedback might enable ABPMJAY reduce catastrophic OOPHE for 500 million Indians. This is more than 6% of humanity: the largest block of people served by a single PFHI in history.
Evaluation of Changes in Salivary Lactate Dehydrogenase Level for Detection of Head and Neck Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis Study
Authors: Abedi Niloufar , Maleki Laleh , Tarrahi Mohammad Javad , Khalesi Saeedeh
Published: May 2024

Background:

Research has examined the relationship between salivary lactate dehydrogenase (LDH) levels and head and neck squamous cell carcinoma (HNSCC) screening and prognosis. Due to biochemical changes in cancer cells and increased production of lactate products in the body. The present systematic review aims to evaluate the changes in salivary LDH levels in HNSCC patients.

Methods:

The present study is a systematic review and meta-analysis. The data were collected by searching PubMed, Science Direct, Scopus, Web of Science, and Google Scholar from 2000 to 2021. The heterogeneity of the articles was analyzed using I2 and TAU2.

Results:

After searching the databases, of 988 articles, 665 duplicated articles were excluded by adopting the inclusion and exclusion criteria. So, 25 articles were primarily selected to be reviewed and evaluated for quality. Finally, 19 articles were selected and analyzed according to the Newcastle–Ottawa checklist. A total of 642 HNSCC patients were reviewed. The meta-analysis showed salivary LDH levels in the HNSCC group were higher than the control group (mean difference = 0.675, standard error = 0.058) (P < 0.001).

Conclusions:

As the research results showed, a significant correlation was observed between salivary LDH levels and HNSCCs. So, LDH can be employed as a valuable and minimally invasive biomarker in head and neck cancer screening and prevention.
Identifying Factors Related to Serum Lipids Using Multilevel Quantile Model: Analysis of Nationwide STEPs Survey 2016
Authors: Mohseni Parisa , Khalili Davood , Djalalinia Shirin , Farzadfar Farshad , Mehrabi Yadollah
Published: May 2024

Background:

Lipid disorder is a modifiable risk factor for diseases related to plaque formation in arteries such as heart attack, stroke, and peripheral vascular diseases. Identifying related factors and diagnosis and treatment in time reduces the incidence of non-communicable diseases (NCDs). The aim of this study was to determine factors associated with lipids based on a national survey data.

Methods:

Data of 16757 individuals aged 25–64 years obtained from the Iranian STEPwise approach to NCD risk factor surveillance (STEPs) performed in 2016, through multistage random sampling, were analyzed. Because of clustered, hierarchical, and skewed form of the data, factors related to total holesterol (TC), triglycerides (TG), low-density lipoprotein-cholesterol) (LDL-C), high-density lipoprotein-cholesterol) (HDL-C), TG/HDL-C, TC/HDL-C, and LDL-C/HDL-C were determined applying multilevel quantile mixed model. Parameters of the model were estimated on the basis of random effect of the province as well as urban or rural area for 10th, 25th, 50th, 75th, and 90th quantiles. Statistical analyses were performed by R software version 4.0.2.

Results:

Significant relationship was found between age, body mass index (BMI), waist circumference (WC), diabetes, hypertension, smoking, physical activity, education level, and marital status with TC, LDL-C, HDL-C, LDL-C, and LDL-C/HDL-C. With increasing BMI and WC, subjects had higher levels of serum lipids, especially in higher quantiles of lipid levels. Lipid levels were significantly increased among smokers and those with diabetes or hypertension. The random effects were also significant showing that there is a correlation between the level of lipids in provincial habitants as well as urban and rural areas.

Conclusions:

This study showed that the effect of each factor varies depending on the centiles of the lipids. Significant relationship was found between sociodemographic, behaviors, and anthropometric indices with lipid parameters.
Survey of the Relationship between Extroversion and Transition in Cigarette and Hookah Smoking Stages in High-School Students in Tabriz: A Longitudinal Study
Authors: Pashapour Hadi , madpoorasl Asghar Moham , Dadashzadeh Hossein , Mousavi Saeid
Published: May 2024

Background:

Smoking is a public health problem that affects the adolescent population's health. This study aimed to investigate the relationship between extroversion (compared with introversion) and transition in cigarette and hookah smoking stages in high-school students to use the results in smoking prevention programs.

Methods:

A sample of 2312 students aged 15–16 years in Tabriz were included in the study. Demographic characteristics, cigarette, hookah smoking status, and Eysenck's extroversion questionnaires were completed by all students in the selected schools. Eight months later, cigarette and hookah smoking status were assessed again to determine transition in smoking stages. The marginal homogeneity (MH) test was used to compare the smoking status at the beginning and 8 months later. The generalized estimating equation (GEE) method with the ordinal link was applied to estimate the effect of extroversion on transition in smoking stages.

Results:

The mean (standard deviation) age of the students participating in the study was 15.5 (0.5) years. MH test results showed that, in general, transmission in the stages of both cigarette and hookah smoking in 8 months was significant in students (P-value < 0.0001). Extrovert personality had a significant positive effect on the transition from lower stages to higher cigarette and hookah smoking stages according to the GEE with ordinal link (P = 0.01). In cigarette and hookah smoking, extrovert persons transited to higher stages 1.64 and 1.55 times more than introvert persons.

Conclusions:

Being an extrovert person had a significant effect on the transitioning to higher stages of smoking cigarettes and hookah. In designing cognitive programs to prevent people from smoking or encourage them to quit smoking, considering this dimension of personality trait can be useful in the efficacy of the program.
Protective Effect of Vitamin D Supplementation on Some Hemogram Derived Inflammatory Indices in Normal and High-Fat Diet Fed Male Wistar Rats
Authors: Agh Fahimeh , Mousavi Seyed H. , Aryaeian Naheed , Amiri Fatemehsadat , Jalilvand Mohammad R. , Janani Leila , Hasani Motahareh , Sepahvand Fatemeh , Zamani-Garmsiri Fahimeh
Published: May 2024

Background:

Hematological inflammatory indices are currently suggested to assess systemic inflammation. This study aims to investigate a vitamin D supplementation effect on hematological indices of inflammation in rats.

Method:

Forty-eight middle-aged male rats were allocated into a normal diet (ND) group (10% fat) and a high-fat diet (HFD) group (60% fat). The animals were fed for 26 weeks. After this period, each group was randomly divided into three subgroups, each of 8 rats: Group (1): animals were fed the ND and HFD containing 1 IU/g vitamin D for 4 months, group (2): animals were fed the ND and HFD containing 6 IU/g vitamin D for 4 months and group (3): animals were euthanized to evaluate the HFD effect. Serum 25-hydroxyvitamin D level, white blood cell count (WBCs), platelet count, platelet crit (PCT), mean platelet volume (MPV), platelet distribution width (PDW), platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR) were measured.

Results:

The HFD, significantly increased body weight, PCT, PDW, PLR, NLR, and MLR and significantly reduced serum vitamin D levels compared to the ND (P < 0.05). There was a significant decrease in food intake, MPV, PDW, and NLR after vitamin D supplementation in the ND-fed group (P < 0.05). A significant reduction in platelet count, PCT, and MLR was observed after vitamin D supplementation in HFD-fed rats (P < 0.05).

Conclusions:

In our study, some hemogram-derived inflammatory indices were higher in the HFD-fed group, and vitamin D supplementation lowering effects on some hematological indices were seen in both ND and HFD groups.
Violation of Food Advertising Regulations in Iran: A Systematic Review
Authors: Amini Maryam , Ghodsi Delaram , Zargaraan Azizollaah , Alibeyk Sepideh , Hajigholam-Saryazdi Maryam
Published: May 2024

Background:

The prevalence of non-communicable diseases (NCDs) and the status of nutritionally high-risk behaviors in the country are not promising. Because of undeniable impact of media advertising on food choices, to combat the problem some regulations on food advertisements are developed in the country. However, the high prevalence of NCDs warns of the possibility that either the laws are not given the necessary attention or they are not implemented properly. Therefore in the present review, all studies on how the country's visual and written mass media comply with regulations related to food product advertisement were systematically reviewed.

Methods:

We searched all studies, including Persian and English articles, dissertations, and research projects, published and unpublished reports in eight domestic and international databases and search engines during the years 1996 to December of 2020 (25 years). Then, the content of the eligible studies was extracted, evaluated, and reported.

Results:

A total of 18 eligible studies (articles and reports) were included in the review. The results indicated violations of rules and regulations including displaying food products of low nutritional value and obese people, misleading/exaggerating claims, award offers, induction of gluttony, consumerism, and inconsistency with scientific facts. Most of the studies (55%) had, implicitly or explicitly, targeted children and adolescents.

Conclusions:

The results of this study indicated a violation of the rules and regulations of health policies, mainly in the field of promoting foods of low nutritional value during the study period. Violations of the ban on advertising for children were also reported in more than half of the studies.
The Effectiveness of Silymarin in the Prevention of Anti-Tuberculosis Drug-Induced Hepatotoxicity: A Randomized Controlled Clinical Trial
Authors: Talebi Ali , Soltani Rasool , Khorvash Farzin , Jouabadi Soroush Mohammadi
Published: May 2024

Background:

Several animal studies have shown the protective effect of silymarin (the extract of Silybum marianum seeds) against anti-tuberculosis drug-induced hepatotoxicity (ATDH). However, the knowledge of ATDH of silymarin in humans is scarce. In this study, we aimed to clinically evaluate it.

Methods:

During this randomized controlled clinical trial, 36 new cases of tuberculosis (TB) were enrolled to receive either silymarin 150 mg twice daily for two weeks along with a standard anti-TB therapeutic regimen (experimental group; n = 16) or standard anti-TB therapeutic regimen alone (control group; n = 21). Liver function tests (serum AST, ALT, ALP, and total bilirubin) at the end of weeks 1 and 2 as well as the rate of ATDH during the study were determined and compared between the groups.

Results:

No significant differences between the experimental and control groups were observed at the end of the first week regarding liver function tests; However, at the end of the second week, the mean serum levels of AST (P = 0.03) and ALP (P = 0.04) were significantly lower in the experimental group. ALT (P = 0.016) and ALP (P = 0.027) levels in the experimental group significantly decreased during the study, while the changes in the control group were not significant. Two patients in the control group (9.5%) developed ATDH, while no one in the experimental group manifested this adverse effect.

Conclusions:

Our study suggests that silymarin use has the potential for the reduction of anti-TB drug-induced hepatotoxicity.
Can CBC Profile and Liver Function Test Predict Chronic Kidney Disease among a Normal population?
Authors: Moosazadeh Mahmood , Espahbodi Fatemeh , Afshari Mahdi , Eslami Arman
Published: May 2024

Background:

Kidney disorders are mainly diagnosed after a major decline in the renal function. Chronic kidney disease (CKD) is one of the most common disorders of the urinary system defined by gradual reduction of renal function. Considering the silent nature and late diagnosis of this problem, this study aims to investigate the prevalence of CKD and its association with Complete Blood Count (CBC) profile and liver function tests.

Methods:

Out of the total population enrolled in the Tabari cohort study, 5822 subjects without history of diabetes mellitus, hypertension, cardiac disease, renal failure, cancer, and pathologic obesity were selected. Glomerular filtration rate (GFR) was calculated using creatinine clearance as well as Modification of Diet in Renal Disease (MDRD) equation. CKD was defined as GFR decline less than 60 ml/min/1.73 m2 regardless of its main cause.

Results:

Prevalence of CKD in total population as well as men and women was 20.2%, 16.8%, and 23.1%, respectively. Multivariate models showed the odds ratios for third and fourth quartiles of Mean corpuscular volume (MCV) and also for the fourth quartile of the lymphocyte count as of 0.78 (0.64, 0.95), 0.81 (0.67, 0.99), and 1.22 (1.01, 1.47), respectively. Corresponding odds ratios for the fourth, third, and second quartiles of Blood Urea Nitrogen (BUN) were 1.42 (1.14, 1.77), 1.76 (1.42, 2.19), and 2.79 (2.27, 3.43), respectively.

Conclusions:

This study showed a high prevalence of CKD among the normal residents (without major underlying diseases and excessive obesity) in the north of Iran, especially among women. In addition, low MCV, low lymphocyte, and high BUN were detected as predictors of this disorder.
Investigation of Intrathoracic Morphology in Computed Tomography Images of Individuals with Anterior Chest Wall Deformity
Authors: Ozturk Mustafa , Ulger Harun , Ozsoy Ibrahim Ethem , Tezcan Mehmet Akif , Savranlar Ahmet
Published: May 2024

Objective:

Morphological determination of the location, position, and level of the intrathoracic organs in relation to the thoracic vertebrae of individuals with anterior chest wall deformity using computed tomography (CT) images.

Study Design:

Retrospective study.

Place and Duration of Study:

Kayseri Health Practice and Research Center, University of Health Sciences Turkey, Kayseri, Turkey, January 2020–January 2022.

Subjects and Methods:

In the study, clinical and morphological measurements of intrathoracic organs were performed on thorax CT images of 80 patients with pectus excavatum (PE) and 70 pectus carinatum (PC) diagnose.

Results:

The mean Haller index (HI) of patients with PE was measured at the highest T11 (Female: 3.79 cm, Male: 3.67 cm) and lowest at T7 (Female: 3.41 cm, Male: 3 cm). The mean HI at all levels (T5-T11) was higher than healthy individuals (P < 0.05). PE severity was higher in women than men. Due to the increase in the severity of PE, it was determined that the heart was displaced in the left anterior, left posterior and downward directions, and the cardiothoracic ratio (CTR) increased. In severe cases, it was seen that the aorta was located on the left side of the corpus vertebrae in the left posterior region. In patients with PC, the most severe HI value was measured at the T7 level (1.54 cm) in women and at the T9 level (1.42 cm) in men. There was no significant difference between the CTRs of patients with PC and healthy individuals.

Conclusion:

We think that knowing the location, position, and levels of the organs in cases with anterior chest wall deformity will shed light on clinical studies.
Morphologic and Morphometric Evaluation of Nutrient Foramina of Tibia
Authors: Ülkir Mehmet , Karaçoban Levend , Günes Burcu Erçakmak
Published: May 2024

Introduction:

The aim of this study is to investigate the morphologic and morphometric characteristics of nutrient foramina on dry tibia bones, as well as the clinical implications.

Materials and Methods:

This study involved 63 tibiae (28 right and 35 left). The length of the tibia, number, direction, size, and location of nutrient foramina in relation to borders, surfaces, and soleal line, the distance between the nutrient foramina and proximal tibial end, the mediolateral, anteroposterior diameter of the tibial shaft at the level of the nutrient foramina, and the foraminal and cnemicus indexes were evaluated. The size of the nutrient foramina was classified using hypodermic needles of 14-16-18-20-22-24 gauge. Nutrient foramina with gauge sizes of 14–16, 18–20, and 22–24 were classified as large, medium, and small, respectively.

Results:

On the tibia, there is usually one nutrient foramina (92.06%), which may locate on the posterior surface (91.18%), lateral to the soleal line (95.17%), and in the upper 1/3 of the tibia (80.9%). The nutrient foramina was primarily 18–20 gauge (72.05%) and directed downward.

Discussion and Conclusion:

The morphological and morphometric features of nutrition foramina are vital to know, especially in surgical procedures and fractures of the upper 1/3 of the tibia. The sizes of NFs were evaluated detail in this study, and it was found that shorter tibiae had smaller NFs that were located more proximal than medium and large NFs. This morphological feature was described in the literature for the first time.
A Comprehensive Case Report on the Fabrication and Rehabilitation with Customized Eye Prosthesis
Authors: Kumar Mempally Hari , Patel Vraj T. , Dev Shruti Vishal , Sindwani Suruchi , Mungara Venkata Saiteja , Rizwana Noorul
Published: May 2024

ABSTRACT

This case report presents the clinical and technical aspects of fabricating and rehabilitating a patient with a custom-designed ocular prosthesis following enucleation due to ocular malignancy. The report details the patient’s history, clinical examination, and the step-by-step process of prosthesis fabrication. The aim is to highlight the importance of a multi-disciplinary approach involving ophthalmologists and maxillofacial prosthodontists in providing optimal esthetic and functional outcomes for patients with ocular defects.
Varicocele and Interventional Radiology: A Comprehensive Case Study on Diagnosis, Therapeutic Intervention, and Implications for Reproductive Health
Authors: Mehakar Saurabh , Anjankar Namrata , Bachate Praful , Jadhao Ritesh , Gajabe Gauri , More Akash , Khemani Shivani
Published: May 2024

ABSTRACT

Male infertility is known to be influenced by varicocele, a common vascular aberration marked by aberrant dilatation of the pampiniform plexus veins within the scrotum. In this instance, a 38-year-old man showed up with scrotal discomfort and swelling, which are clinical signs of varicocele. Scrotal ultrasonography provided diagnostic confirmation, confirming the existence of varicocele and identifying a concomitant minor hemorrhage in the left scrotal sac. Despite the initiation of conservative measures, such as bed rest, cryotherapy, and analgesics, the patient’s clinical course was marked by persistent scrotal swelling and hematoma formation. Subsequently, interventional radiological techniques were employed, specifically coil deployment and varicocele embolization. These interventions demonstrated significant efficacy, leading to a notable reduction in the presenting symptoms. Follow-up assessments, conducted post intervention, indicated a complete resolution of both pain and hematoma. This clinical trajectory underscores the pivotal role of interventional radiology in managing varicocele-related complications. The multi-faceted nature of this case highlights the necessity of a comprehensive, inter-disciplinary approach integrating radiological interventions for the effective management of varicocele-associated symptoms, potentially optimizing reproductive health outcomes.
Sexual and Continence Rehabilitation after Radical Prostatectomy
Authors: Aggarwal Amit , Cahill Declan , Jena Rahul
Published: May 2024

Incontinence and Erectile-Dysfunction (ED) is a reality for many men post-Radical Prostatectomy. Urologists undertaking this procedure should prioritize minimizing postoperative incontinence and sexual dysfunctions. One major obstacle in the rehabilitation process is the lack of a standardized, objective, universal definition to accurately define post-operative incontinence and ED. This makes it challenging to tailor treatment, manage expectations, and also monitor progress in patients who suffer from post-RP incontinence and ED. Nevertheless, treatment always remains undoubtedly superior to leaving the issues without intervention. This chapter describes in details about the complete rehabilitation process to be followed in each and every patient undergoing Radical Prostatectomy.
Future Landscape in High-risk Prostate Cancer and Metastatic Prostate Cancer
Authors: Garg Harshit , Kaushik Dharam , Liss Michael Andre
Published: May 2024

The management of high-risk and advanced prostate cancer had a major paradigm shift over the past decade. From the Huggins’ era of sole androgen deprivation therapy (ADT), the management has evolved to novel androgen receptor signaling inhibitors (ARSI), chemotherapy, targeted molecular, immunotherapy, and radiotheranostics. The management of advanced prostate cancer is broadly studied under metastatic hormone or castration-sensitive prostate cancer (mCSPC) or metastatic castration-resistant prostate cancer (mCRPC). The mCSPC has evolved from mere ADT to the use of abiraterone, enzalutamide, and docetaxel-based chemotherapy and the burning conflict of treatment intensification with triplet therapy. Various novel agents, such as poly (ADP-ribose) polymerase inhibitors (PARPIs) and radiotheranostics, are being explored in the management of mCSPC. The management of mCRPC has evolved from mitoxantrone to docetaxel-based therapy, novel ARSI therapy, PARPI, 177 lutetium-prostate-specific membrane antigen-617, or novel-targeted therapy.
Pathology of Prostate Cancer: What Urologist Should Know and Future Directions
Authors: Singh Nikhil , Rane Swapnil , Menon Santosh
Published: May 2024

Prostate cancer is the second-most common malignancy in men. Risk factors include age, family history, and genetic predisposition. Gleason grading remains one of the strongest prognostic factors in prostate cancer which has been modified multiple times with the most recent modifications brought in ISUP 2019 consensus conference and by GUPS. This chapter aims to familiarize the urologist with the nuances of pathology reporting, especially the Gleason scoring system in a simplified manner with some practical updates. It also brings forth the latest upcoming trends in areas of the utility of artificial intelligence in the field of prostate pathology.
Artificial Intelligence Applications in Prostate Cancer Management: Success Stories and Future Ahead
Authors: Khanna Raghav , Martinez Alejandro Granados , Raison Nicholas , Ourselin Sebastien , Briganti Alberto , Montorsi Francesco , Dasgupta Prokar
Published: May 2024

This review summarizes and provides an outlook for developments around the use of artificial intelligence (AI) in the diagnosis and treatment of prostate cancer. We searched existing literature on the design and development of new AI-based systems using a non-systematic approach. Areas targeted by AI include the diagnosis, Gleason scoring, biomarker identification, and prognosis of prostate cancer (PCa) from digitised histopathology, segmentation, detection, and classification of PCa from magnetic resonance imaging, AI applications for prostate ultrasound, AI in radiotherapy for PCa including synthetic computed tomography generation and treatment planning and AI in measuring and improving surgical outcomes and education. Recent work has focused on deep learning techniques. Algorithms have achieved results that outperform or are similar to those of experts. However, few proposed algorithms are clinically oriented and can be practically deployed. Future progress needs to be made in data availability, prospective evaluation, regulation, responsible AI, explainability, and practical aspects of clinical deployment.
The Illustrative Case of Aspirin: Making Sense of Evidence When Weighing Risk and Benefit
Authors: Alderman Chris
Published: May 2024

In this edition of the journal, we publish discussion of the use of aspirin–an old drug, reborn with new purpose, and then apparently in decline because of a change in the status of evidence in relation to some of the indications for it. Just as the situation appears clearer, along comes new information that creates more confusion about where we currently stand with this medicine.
Evaluation of Aspirin Prescribing and Gastrointestinal Bleeding in Adults 60 Years of Age and Older in a Large, Academic Health System
Authors: Potthast Kristin L. , Billups Sarah J. , Fixen Danielle R. , Titus Oliver , Saseen Joseph J. , Linnebur Sunny A.
Published: May 2024

Background National guidelines no longer recommend adults 60 years of age and older to begin treatment with low-dose daily aspirin for primary prevention of atherosclerotic cardiovascular disease (CVD) due to a lack of proven net benefit and a higher risk of bleeding.
Objective The objective of this cross-sectional retrospective analysis was to evaluate the appropriateness of low-dose aspirin prescribing and subsequent gastrointestinal bleeding in older persons receiving primary care in a large academic health system. Setting
Large, academic health system within Colorado. Patients Patients with an active order for daily low-dose aspirin as of July 1, 2021, were assessed for appropriateness based on indication (primary vs secondary prevention) and use of a concomitant proton-pump inhibitor
(PPI). Incident gastrointestinal bleeds (GIBs) in the subsequent 12 months and GIB risk factors were also evaluated. Results A total of 19,525 patients were included in the analysis. Eighty-nine percent of patients identified as White and 54% identified as male. Of the
total cohort, 44% had CVD and 19% were co-prescribed a PPI. GIB occurred in 247 patients (1.27%) within the subsequent year. Risk factors significantly associated with a GIB within 1 year included: history of GIB, history of peptic ulcer disease, other esophageal issue (esophagitis, Barrett’s
esophagus, Mallory Weiss tears, etc.), 75 years of age or older, and history of gastroesophageal reflux disease. Conclusion This evaluation found that many older persons at this institution may be inappropriately prescribed aspirin, providing opportunities for pharmacists
to improve medication safety by deprescribing aspirin among primary prevention patients or potentially co-prescribing a PPI in secondary prevention patients.
Distinct Characteristics and Changes in Liver Function of Patients with Hepatocellular Carcinoma Treated with Atezolizumab Plus Bevacizumab for More Than 1 Year
Authors: Kim Youngun , Kim Jung Sun , Kang Beodeul , Kim Ilhwan , Kim Hyeyeong , Lee Won Suk , Sang Yun Beom , Jung Sanghoon , An Chansik , Kim Chan , Chon Hong Jae
Published: May 2024

Purpose Since 2020, atezolizumab plus bevacizumab (Ate/Bev) has been the standard first-line therapy for unresectable hepatocellular carcinoma (HCC), but long-term treatment studies are limited. This study evaluated the clinical characteristics and effects of Ate/Bev for over 1 year.Materials and Methods This study included patients with unresectable HCC treated with first-line Ate/Bev between May 2020 and April 2022. Those receiving Ate/Bev for 1 year or more were classified as the long-term treatment group.Results Of 246 patients, 69 (28.0%) were in the long-term treatment group, which comprised more proportions of intrahepatic tumor burden < 25%, Eastern Cooperative Oncology Group 0, and a lower proportion of portal vein tumor thrombosis than the short-term treatment group. The long-term treatment group had a higher incidence of atezolizumab-related thyroid dysfunction (31.9% vs. 10.7%, p < 0.001; median time to onset [mTTO], 2.8 months), dermatologic toxicity (29.0% vs. 14.7%, p=0.017; mTTO, 3.3 months), bevacizumab-related hypertension (44.9% vs. 22.0%, p=0.001; mTTO, 4.2 months), and proteinuria (69.6% vs. 38.4%, p < 0.001; mTTO, 6.8 months), compared to the short-term treatment group. Regarding liver function in the long-term treatment group, patients initially classified as Child-Pugh class A decreased from 87.0% to 75.4%, and albumin-bilirubin grade 1 decreased from 68.1% to 50.7% after 1 year of treatment.Conclusion The Ate/Bev long-term treatment group had a lower intrahepatic tumor burden, less portal vein tumor thrombosis, and better performance status and liver function at baseline. Atezolizumab-related immunological adverse events emerged relatively early in treatment compared to the bevacizumab-related. Additionally, some patients demonstrated liver function deterioration during long-term Ate/Bev treatment.
Transport-entropy and functional forms of Blaschke–Santaló inequalities
Authors: Fradelizi Matthieu , Gozlan Nathaël , Sadovsky Shay , Zugmeyer Simon
Published: May 2024

We explore alternative functional or transport-entropy formulations of the Blaschke–Santaló inequality. In particular, we obtain new Blaschke–Santaló inequalities for

s

-concave functions. We also obtain new sharp symmetrized transport-entropy inequalities for a large class of spherically invariant probability measures, including the uniform measure on the unit Euclidean sphere and generalized Cauchy and Barenblatt distributions.
Moment analysis on channel eigenvalue for DAS‐to‐DAS system
Authors: Gwak Donghyuk , Jeon Youngil , Lee Jemin , Na Jee‐Hyeon
Published: May 2024

In this paper, we study on channel eigenvalue distribution of MIMO system, namely, DAS‐to‐DAS system, of which transmit and receive nodes are geometrically distributed in unplanned manner. It offers key to performance upper bound analysis of collaborative transmission in unplanned network and multi‐user transmission of distributed antenna system. Previous studies on stochastic geometry have analyzed performance of single typical receiver, while transmitters are geometrically distributed. And random matrix theory has unveiled probabilistic behavior of MIMO channel eigenvalues, while transmit and receive antennas are collocated. Our study integrates knowledge from the two different research fields to extend the applicability to analysis on channel eigenvalue distribution of DAS‐to‐DAS system. As a preliminary research on such channel eigenvalue distribution, its first few moments are derived in analytic form. And its coherency of the analysis results with Monte‐Carlo simulation results has examined.
IgG, IgM, and Nonstructural Protein 1 Response Profiles after Receipt of Tetravalent Dengue Vaccine TAK-003 in a Phase 2 Randomized Controlled Trial
Authors: Low Jenny G. , Oh Helen M. , Leo Yee-Sin , Kalimuddin Shirin , Wijaya Limin , Pang Junxiong , Lee Tau Hong , Moss Kelley J. , Brose Manja , Tricou Vianney
Published: May 2024

The profiles of vaccine-induced dengue antibodies may differ from those produced following natural infection and could potentially interfere with the interpretation of diagnostic tests. We assessed anti-dengue IgG and IgM antibodies, and nonstructural protein 1 antigen profiles in the serum of adults who received a single dose of the tetravalent dengue vaccine TAK-003 as either an initially developed high-dose formulation or the standard approved formulation in a phase 2 study in Singapore (#NCT02425098). Immunoglobulin G and IgM profiles during the first 30 days postvaccination varied by baseline serostatus (microneutralization assay). Nonstructural protein 1 antigen was not detected in the serum of any participants. Vaccine-induced IgG and IgM antibodies can affect serological confirmation of subsequent dengue infection in vaccinees. These results highlight the limitations of using serological tests for dengue diagnosis, particularly in a postvaccination setting, and emphasize the need for more sensitive antigen- and molecular-based testing for accurate dengue diagnosis.
Automating the Generation of Notifiable Bacterial Disease Reports: Proof-of-Concept Study and Implementation in Six Hospitals in Thailand
Authors: Lim Cherry , Klaytong Preeyarach , Hantrakun Viriya , Rangsiwutisak Chalida , Phiancharoen Chadaporn , Tangwangvivat Ratanaporn , Kripattanapong Somkid , Jitpeera Charuttaporn , Poldech Wiratya , Jiramahasan Punya , Laosatiankit Bangon , Photivet Orawan , Sukbut Punchawee , Thongsri Warintorn , Kosasaeng Kailas , Chiwehanyon Bongkoch , Leesahud Nutjamee , Ritthong Preecha , Linreung Wandee , Aramrueang Panatda , Bhunyakitikorn Wichan , Iamsirithaworn Sopon , Limmathurotsakul Direk
Published: May 2024

Information on notifiable bacterial diseases (NBD) in low- and middle-income countries (LMICs) is frequently incomplete. We developed the AutoMated tool for the Antimicrobial resistance Surveillance System plus (AMASSplus), which can support hospitals to analyze their microbiology and hospital data files automatically (in CSV or Excel format) and promptly generate antimicrobial resistance surveillance and NBD reports (in PDF and CSV formats). The NBD reports included the total number of cases and deaths after Brucella spp., Burkholderia pseudomallei, Corynebacterium diphtheriae, Neisseria gonorrhoeae, Neisseria meningitidis, nontyphoidal Salmonella spp., Salmonella enterica serovar Paratyphi, Salmonella enterica serovar Typhi, Shigella spp., Streptococcus suis, and Vibrio spp. infections. We tested the tool in six hospitals in Thailand in 2022. The total number of deaths identified by the AMASSplus was higher than those reported to the national notifiable disease surveillance system (NNDSS); particularly for B. pseudomallei infection (134 versus 2 deaths). This tool could support the NNDSS in LMICs.
Clinical Characteristics and Outcomes of Disseminated Strongyloidiasis in the United States—A Multicenter Network Analysis
Authors: Henao-Martínez Andrés F. , Olivo Freites Christian , Agudelo Higuita Nelson I. , Marcos Luis A. , Chastain Daniel B. , Mohareb Amir M. , Tuells Jose , Villalpando-Carrion Salvador , Franco-Paredes Carlos
Published: May 2024

Human strongyloidiasis is a potentially life-threatening parasitic disease among immunocompromised hosts. We aim to determine the factors and mortality associated with disseminated strongyloidiasis. We conducted a U.S.-based multicenter retrospective cohort study to determine 90-day clinical outcomes for people diagnosed with Strongyloides infection in the TriNetX patient database. We identified adult patients with the International Classification of Diseases (10th revision, clinical modification) code for Strongyloides infection (B78) or a positive Strongyloides IgG antibody test and captured outcomes at 90 days. We identified 5,434 patients with strongyloidiasis, of whom 48 had disseminated strongyloidiasis for 0.9% prevalence of disseminated disease. Systemic connective tissue disorders, pulmonary eosinophilia, liver cirrhosis, blood disorders (monoclonal gammopathy, aplastic anemia, and lymphoid malignancy), malnutrition, alcohol use disorder, and transplantation status were frequent in patients with disseminated disease. Mortality was significantly higher in people with disseminated disease at 30 days (21%). The 90-day risk of hospitalization, bacteremia, and acute respiratory distress syndrome (ARDS) was higher in those with disseminated infection. People with disseminated strongyloidiasis had a heightened risk of hospitalization, bacteremia, acute respiratory distress syndrome, and mortality. The population at risk for severe strongyloidiasis infection is evolving, reflecting conditions in which glucocorticoids or additional immunosuppressive medications are commonly used for treatment.
Melioidosis and Activation from Latency: The “Time Bomb” Has Not Occurred
Authors: Howes Matthew , Currie Bart J.
Published: May 2024

Burkholderia pseudomallei, the causative agent of melioidosis has long been considered able to exist in a latent form. Seropositivity among U.S. soldiers returning from the Vietnam conflict led to melioidosis being dubbed “the Vietnamese time bomb.” Cases assigned to “(re)activation from latency” over 30 years of the Darwin Prospective Melioidosis Study (DPMS) were reviewed and reassessed and additional cases from DPMS years 31–34 were added. Historical reports of melioidosis attributed to activation from latency were reviewed. Some earlier DPMS cases and most historical cases described as activation from latency more accurately reflect undiagnosed chronic melioidosis, often with relapsing–remitting courses, rather than truly latent, asymptomatic infection. Such protracted disease should now be diagnosable much earlier, provided melioidosis is considered and laboratory facilities are available. The longest plausible duration of asymptomatic latency remains 29 years. In conclusion, activation from latency is a rare event in melioidosis, accounting in our analysis for under 3% of DPMS cases, consistent with why the Vietnamese time bomb never eventuated.