bluuebunny/crossref_metadata_2025 huggingface dataset:
Improving universities’ activities in academic startup support through public interventions: The effectiveness of the German programme ‘EXIST—leverage of potentials’
Authors: Mueller Christoph E
Published: March 2023

Academic startups have a considerable economic impact, which is why public support programmes for them are considered an important component of innovation and technology policy. In this context, university support programmes can be an important part of the policy toolkit by aiming to improve universities’ startup environment and thus promote startup activity at those institutions. Assessing the effectiveness of these programmes is a key evaluation task inasmuch as it provides an evidence base for decision-makers and broadens the discourse on promoting startup culture at universities. This study reports on the background, methodology, and results of the evaluation of the effectiveness of a large university support programme in the academic startup sector in Germany, ‘EXIST—Leverage of potentials’. This programme supports universities which have little experience in building a startup culture and startup-supportive structures. Reliable data are available for two indicators that can be employed to assess intervention effects by means of a difference-in-differences design, namely for the number of applications universities submitted and the number of grants they received in what is Germany’s largest funding programme for prospective startups. The findings indicate that funding by ‘EXIST—Leverage of potentials’ positively affects universities’ activities in the area of startup support.
The global epidemiology of SLE: narrowing the knowledge gaps
Authors: Barber Megan R W , Falasinnu Titilola , Ramsey-Goldman Rosalind , Clarke Ann E
Published: March 2023

SLE is a global health concern that unevenly affects certain ethnic/racial groups. Individuals of Asian, Black, Hispanic and Indigenous ethnicity/race are amongst those who experience increased prevalence, incidence, morbidity and mortality. Population-based surveillance studies from many regions are few and often still in nascent stages. Many of these areas are challenged by restricted access to diagnostics and therapeutics. Without accurately capturing the worldwide burden and distribution of SLE, appropriately dedicating resources to improve global SLE outcomes may be challenging. This review discusses recent SLE epidemiological studies, highlighting the challenges and emerging opportunities in low- and middle-income countries. We suggest means of closing these gaps to better address the global health need in SLE.
Country Guidance, Country of Origin Information, and the International Protection Needs of Persons Fleeing Armed Conflicts
Authors: Querton Christel
Published: March 2023

The article explores whether the European Union Agency for Asylum’s country guidance (CG) reflects the international protection needs of persons fleeing armed conflicts. It uses the Agency’s guidance on Iraq as a case study through the lens of objectivity and relevance. The article highlights the disproportionate reliance on military and State-centric sources which adopt a traditional and narrow concept of security grounded in quantitative approaches. The article argues that the main sources of Country of Origin Information used in CG are inadequate to capture the present-day nature of violence in situations of armed conflict. The article makes the case for a re-balancing of sources to be included in CG that reflects wider security studies perspectives and approaches. The article also suggests that the indicators of indiscriminate violence used by the Agency are grounded in international humanitarian law norms and therefore fail to reflect international protection standards, whilst also being inadequate to capture the nature of violence in situations of contemporary armed conflict. The use of sources of information adopting wider security perspectives and qualitative approaches are encouraged and other factors, such as spheres of control by actors to the conflict, are proposed for inclusion into international protection assessments.
Molecular Mechanisms of Pseudomonas-Assisted Plant Nitrogen Uptake: Opportunities for Modern Agriculture
Authors: Sanow Stefan , Kuang Weiqi , Schaaf Gabriel , Huesgen Pitter , Schurr Ulrich , Roessner Ute , Watt Michelle , Arsova Borjana
Published: March 2023

Pseudomonas spp. make up 1.6% of the bacteria in the soil and are found throughout the world. More than 140 species of this genus have been identified, some beneficial to the plant. Several species in the family Pseudomonadaceae, including Azotobacter vinelandii AvOP, Pseudomonas stutzeri A1501, Pseudomonas stutzeri DSM4166, Pseudomonas szotifigens 6HT33bT, and Pseudomonas sp. strain K1 can fix nitrogen from the air. The genes required for these reactions are organized in a nitrogen fixation island, obtained via horizontal gene transfer from Klebsiella pneumoniae, Pseudomonas stutzeri, and Azotobacter vinelandii. Today, this island is conserved in Pseudomonas spp. from different geographical locations, which, in turn, have evolved to deal with different geo-climatic conditions. Here, we summarize the molecular mechanisms behind Pseudomonas-driven plant growth promotion, with particular focus on improving plant performance at limiting nitrogen (N) and improving plant N content. We describe Pseudomonas-plant interaction strategies in the soil, noting that the mechanisms of denitrification, ammonification, and secondary metabolite signaling are only marginally explored. Plant growth promotion is dependent on the abiotic conditions and differs at sufficient and deficient N. The molecular controls behind different plant responses are not fully elucidated. We suggest that superposition of transcriptome, proteome, and metabolome data and their integration with plant phenotype development through time will help fill these gaps. The aim of this review is to summarize the knowledge behind Pseudomonas-driven nitrogen fixation and to point to possible agricultural solutions.

[Formula: see text] Copyright © 2023 The Author(s). This is an open access article distributed under the CC BY 4.0 International license .
High-Flow Nasal Cannula Compared With Noninvasive Positive Pressure Ventilation in Acute Hypoxic Respiratory Failure: A Systematic Review and Meta-Analysis
Authors: Chaudhuri Dipayan , Trivedi Vatsal , Lewis Kimberley , Rochwerg Bram
Published: March 2023

OBJECTIVES:

To evaluate the efficacy and cost-effectiveness of high-flow nasal cannula (HFNC) when compared with noninvasive positive pressure ventilation (NIPPV) in patients with acute hypoxic respiratory failure (AHRF).

DATA SOURCES:

We performed a comprehensive search of MEDLINE, Embase, CINAHL, the Cochrane library, and the international Health Technology Assessment database from inception to September 14, 2022.

STUDY SELECTION:

We included randomized control studies that compared HFNC to NIPPV in adult patients with AHRF. For clinical outcomes, we included only parallel group and crossover randomized control trials (RCTs). For economic outcomes, we included any study design that evaluated cost-effectiveness, cost-utility, or cost benefit analyses.

DATA EXTRACTION:

Clinical outcomes of interest included intubation, mortality, ICU and hospital length of stay (LOS), and patient-reported dyspnea. Economic outcomes of interest included costs, cost-effectiveness, and cost-utility.

DATA SYNTHESIS:

We included nine RCTs (n = 1,539 patients) and one cost-effectiveness study. Compared with NIPPV, HFNC may have no effect on the need for intubation (relative risk [RR], 0.93; 95% CI, 0.69–1.27; low certainty) and an uncertain effect on mortality (RR, 0.84; 95% CI, 0.59–1.21; very low certainty). In subgroup analysis, NIPPV delivered through the helmet interface—as opposed to the facemask interface—may reduce intubation compared with HFNC (p = 0.006; moderate credibility of subgroup effect). There was no difference in ICU or hospital LOS (both low certainty) and an uncertain effect on patient-reported dyspnea (very low certainty). We could make no conclusions regarding the cost-effectiveness of HFNC compared with NIPPV.

CONCLUSIONS:

HFNC and NIPPV may be similarly effective at reducing the need for intubation with an uncertain effect on mortality in hospitalized patients with hypoxemic respiratory failure. More research evaluating different interfaces in varying clinical contexts is needed to improve generalizability and precision of findings.
Long-Term Prognosis Following Early Rehabilitation in the ICU: A Retrospective Cohort Study
Authors: Murooka Yukie , Sasabuchi Yusuke , Takazawa Tomonori , Matsui Hiroki , Yasunaga Hideo , Saito Shigeru
Published: March 2023

OBJECTIVES:

Critically ill patients often have residual functional disabilities. Studies have shown that early rehabilitation improves short-term physical function. However, it remains unknown whether early rehabilitation affects long-term prognosis and healthcare resource utilization.

DESIGN:

Retrospective cohort study.

SETTING:

This study used an administrative claims database in Kumamoto Prefecture, Japan, from April 2012 to February 2017.

PATIENTS:

We identified patients who were admitted to the ICU and received rehabilitation. Eligible patients were divided into those who underwent rehabilitation within 3 days (early rehabilitation group) and after 4 or more days of ICU admission (delayed rehabilitation group). Propensity score matching analyses were conducted to compare the number of outpatient consultations within 1 year and 3 years after discharge from the index hospitalization, total duration of hospitalization after discharge, healthcare costs, and survival.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

A total of 6,679 patients were included in the study. Propensity score matching created 2,245 pairs. No difference was observed in the number of outpatient consultations 1 year after discharge, although there were differences between the groups 3 years after discharge. Long-term observation revealed a shorter overall duration of hospitalization (1.9 vs 2.6 mo; p < 0.001) and lower total costs ($28,159 vs $38,272; p < 0.001), as well as lower average costs per month ($1,690 vs $1,959; p = 0.001) in the early compared with the delayed rehabilitation group. No differences in survival were observed (log-rank test; p = 0.18).

CONCLUSIONS:

Starting rehabilitation within 3 days of ICU admission was associated with shorter durations of future hospitalization and lower healthcare costs. Early rehabilitation for ICU patients might be associated with reduced healthcare resource utilization.
Addressing the Mental Health Needs of Inmates Through Education for Correctional Officers—A Narrative Review
Authors: Darani Shaheen A. , McMaster Robert , Wolff Elena , Bonato Sarah , Simpson Alexander (Sandy) , Glancy Graham , Sandhu Kiren , Quinn Jason
Published: March 2023

Introduction:

People with mental illness are overrepresented in correctional facilities. Correctional officers (COs) lack education to respond to inmates with mental illness. A review was conducted of mental health education programs for COs to identify factors related to effectiveness.

Methods:

Medical and criminal justice databases were searched for articles describing mental health education for COs. Studies including measurable outcomes were analyzed using an inductive analytic approach. The review adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for scoping reviews. Data were synthesized using Moore seven levels of outcomes for continuing professional development education. Findings were grouped by curriculum content and described according to levels of outcome.

Results:

Of 1492 articles, 11 were included in the analysis. Six described mental health programs, two described skill-specific programs, and three described suicide prevention programs. Programs reviewed content about mental illness, practical skills, included didactic and experiential teaching. The programs achieved level 5 on Moore taxonomy. Programs led to improvements in knowledge, skills, and attitudes among officers; however, improvements declined post-training. Officers were receptive to facilitators with correctional or lived mental health experience. Experiential teaching was preferred. Common themes related to programs' effectiveness included applicability to COs, information retention, program facilitators, and teaching methods.

Discussion:

There is limited, but positive literature suggesting that education programs are beneficial. The decline in improvements suggests need to ensure sustainability of improvements. This review can guide the planning of future education programs for COs based on continuing professional development best practices.
The inhibitory role of microRNA-141-3p in human cutaneous melanoma growth and metastasis through the fibroblast growth factor 13-mediated mitogen-activated protein kinase axis
Authors: Yang Haojan , Zhou Jiateng , Li Dongdong , Zhou Shengbo , Dai Xinyi , Du Xinchao , Mao Hailei , Wang Bin
Published: March 2023

Human cutaneous melanoma (CM) is a highly invasive malignancy arising from melanocytes, and accompanied by ever-increasing incidence and mortality rates worldwide. Interestingly, microRNAs (miRNAs) possess the ability to regulate CM cell biological functions, resulting in the aggressive progression of CM. Nevertheless, a comprehensive understanding of the underlying mechanism remains elusive. Accordingly, the current study sought to elicit the functional role of miR-141-3p in human CM cells in association with fibroblast growth factor 13 (FGF13) and the MAPK pathway. First, miR-141-3p expression patterns were detected in human CM tissues and cell lines, in addition to the validation of the targeting relationship between miR-141-3p and FGF13. Subsequently, loss- and gain-of-function studies of miR-141-3p were performed to elucidate the functional role of miR-141-3p in the malignant features of CM cells. Intriguingly, our findings revealed that FGF13 was highly expressed, whereas miR-141-3p was poorly expressed in the CM tissues and cells. Further analysis highlighted FGF13 as a target gene of miR-141-3p. Meanwhile, overexpression of miR-141-3p inhibited the proliferative, invasive, and migratory abilities of CM cells, while enhancing their apoptosis accompanied by downregulation of FGF13 and the MAPK pathway-related genes. Collectively, our findings highlighted the inhibitory effects of miR-141-3p on CM cell malignant properties via disruption of the FGF13-dependent MAPK pathway, suggesting a potential target for treating human CM.
Factors Influencing General Dermatologists When Referring Patients With Head and Neck Melanoma for Mohs Micrographic Surgery: A Nationwide Cross-Sectional Survey
Authors: Neill Brett C. , Siscos Spyros M. , Bar Anna A. , Seger Edward W. , Latour Emile , Tolkachjov Stanislav N.
Published: March 2023

BACKGROUND

Mohs micrographic surgery (MMS) for cutaneous melanoma has demonstrated higher cure rates, lower local recurrence rates, and improved survival compared with wide local excision (WLE). However, factors affecting referrals by general dermatologists for MMS of head and neck melanoma (HNM) are unknown.

OBJECTIVE

To elucidate referral factors and treatment perspectives of general dermatologists regarding MMS for melanoma in situ (MIS)/lentigo maligna (LM) and early-stage melanoma on the head and neck.

MATERIALS AND METHODS

A cross-sectional analysis was performed using survey responses of general dermatologists with membership in the American Academy of Dermatology.

RESULTS

A total of 231 and 132 of the 402 responding general dermatologists routinely referred melanoma in situ MIS/LM and early invasive melanoma for MMS, respectively. Lack of local access to a Mohs surgeon was the most common deterring reason for MIS/LM referral to MMS, whereas the preference for WLE was the most common deterring reason for early invasive melanoma.

CONCLUSION

Lack of local access to a Mohs surgeon treating HNM with MMS is the primary barrier in referrals to Mohs surgeons for MIS and LM. Among general dermatologists, WLE is preferred for early invasive HNM.
Current Fat Grafting Practices and Preferences: A Survey from Members of ISPRES
Authors: Vizcay Macarena , Saha Shivangi , Mohammad Arbab , Pu Lee L.Q. , Yoshimura Kotaro , Magalon Guy , Khouri Roger , Coleman Sydney , Rigotti Gino , DeFazio Stefania
Published: March 2023

Background:

Fat grafting has established its niche in a wide spectrum of aesthetic and reconstructive procedures. A consensus-based method of harvest, processing, enrichment, injection, and assessment is lacking, despite the rising trends in its application. We conducted a survey among plastic surgeons to evaluate and identify trends of fat grafting practices.

Methods:

We conducted an electronic survey with a 30-item questionnaire of 62 members of the International Society of Plastic Regenerative Surgeons. We collected demographic information, techniques, and experiences related to large volume (100–200 ml) and small-volume (<100 ml) fat grafting.

Results:

The majority of the respondents worked predominantly as aesthetic surgeons. The donor area selection was based on the patient’s fat availability (59.7%). For fat enrichment, platelet-rich-plasma and adipose stem cells were routinely used by 12.9% and 9.7% of respondents, respectively. A 3- to 4-mm cannula with three holes was the most preferred instrument for large-volume fat harvesting (69.5%). For small-volume fat grafting, 2-mm cannulas (75.8%) with Mercedes tip (27.3%) were used most commonly. For processing, decantation of fat was performed by 56.5% of respondents (without exclusivity). For handheld injections (without exclusivity), respondents preferred a 1- to 2-mm cannula with a 1 cm3 syringe. The most popular method of outcome assessment was photographic evaluation.

Conclusions:

The respondents’ tendencies were similar to those reported in the previous literature, with some exceptions, such as the technique for preparing fat and enrichment. A wider cross-sectional survey, involving national delegates and global representatives of plastic surgeons, is anticipated.
Long-term progression pattern of myopic tractional maculopathy: outcomes and risk factors
Authors: Meng Jiaqi , Chen Yuxi , Cheng Kaiwen , Qi Jiao , Du Yu , Yao Yunqian , He Wenwen , Zhang Keke , Lu Yi , Zhu Xiangjia
Published: March 2023

Purpose:

To evaluate the long-term progression pattern of myopic tractional maculopathy (MTM) and the risk factors.

Methods:

The prevalence and grade of MTM were assessed with OCT at enrollment and at 2-year follow up. The severity of posterior staphyloma (PS) and presence of dome-shaped macula (DSM) was also evaluated.

Results:

Totally 610 highly myopic eyes of 610 patients were analyzed. The prevalence of epiretinal membrane (ERM), myopic retinoschisis (MS) and macular hole (MH) increased from 26.7%, 12.1% and 4.4% at enrollment to 41.1%, 18.2% and 9.5% at 2-year follow up, respectively. ERM progressed in 21.8% of eyes, but visual acuity (VA) did not decline significantly in these eyes. MS progressed in 6.8% of eyes, and MH progressed in 14.8% of eyes. Significantly greater BCVA reduction was detected in the eyes with MS or MH progression than the rest (p<0.05). Multivariate analysis showed longer axial length (AL), more-severe PS and absence of DSM were associated with MTM progression.

Conclusion:

In highly myopic eyes, long-term VA was relatively stable in those with ERM, but was significantly affected by MS or MH progression. Longer AL, more-severe PS and absence of DSM were risk factors for MTM progression.
Repeatability and Reproducibility of Corneoscleral Topography Measured With Scheimpflug Imaging in Keratoconus and Control Eyes
Authors: Yang Zhengfei , Wang Mengyi , Li Zhouyue , Hu Yin , Jiang Jinyun , Yu Fei , Zeng Junwen , Chen Weiyin , Yang Xiao
Published: March 2023

Objectives:

To determine and compare the repeatability and reproducibility of anterior scleral parameters measured by the corneoscleral profile (CSP) module of Pentacam in keratoconus (KC) and control eyes.

Methods:

This is a prospective observational study. Thirty KC participants (30 eyes) and 24 control participants (24 eyes) were examined three times using the CSP. Sagittal height mean (SHM), sagittal height astigmatism (SHA), and mean bulbar slope (BSM) were measured in 12 mm and 16 mm chord lengths. The repeatability and reproducibility of these measurements were also assessed. Coefficients of variation (CoV), intraclass correlation coefficient (ICC), coefficient of repeatability (CoR1), and coefficient of reproducibility (CoR2) were adopted to assess the reliability.

Results:

In the KC and control groups, SHM showed high repeatability and reproducibility (coefficients of variation [CoVs]≤0.96%, intraclass correlation coefficient [ICCs]≥0.97), and SHM of control eyes showed higher repeatability and reproducibility than that of KC eyes at 12 mm chord length (KC group, CoRs ranged from 35.56 μm to 43.52 μm, control group, ranged from 23.50 μm to 30.31 μm) and 16 mm chord length (KC group, CoRs ranged from 79.54 μm to 81.58 μm, control group, ranged from 48.25 μm to 66.10 μm). Mean bulbar slope also showed high repeatability and reproducibility (CoVs≤3.65%, CoRs≤2.64). Furthermore, the SHA of control eyes showed higher repeatability and reproducibility when compared with KC eyes (control group: CoVs≤29.95%, KC group: CoVs≥32.67%).

Conclusions:

Keratoconus and control eyes demonstrated high repeatability and reproducibility when using CSP measurements, which may prove helpful in fitting contact lenses.
Comparison of Trabeculectomy Outcomes Performed by Residents in Training and Ophthalmologists
Authors: Lima-Fontes Mário , Faria-Pereira Ana , Leuzinger-Dias Mariana , Silva Marta Inês , Barbosa-Breda João , Araújo Joana , Estrela-Silva Sérgio , Benevides-Melo António , Alves Flávio , Tavares-Ferreira João
Published: March 2023

Précis:

Resident-performed trabeculectomies present higher intraocular pressure and lower complete success rate at 1 year.

Purpose:

To compare the 1-year outcomes of ab externo trabeculectomy between residents in training and staff ophthalmologists.

Patients and Methods:

This retrospective study included all consecutive eyes submitted to ab externo trabeculectomy between January 2015 to June 2020. A 1-year complete success rate was considered using all the following criteria: intraocular pressure (IOP)≤21 mm Hg and ≥6mm Hg without ocular hypotensive medications; IOP reduction≥30%; without loss of light perception, phthisis bulbi, and further glaucoma surgery (excluding suture lysis and bleb needling).

Results:

One hundred and ten eyes from 99 patients were included. Thirty percent (n=33) of the trabeculectomies were performed by residents. There were no significant preoperative differences between groups, apart from age at surgery, which was higher in the residents' group (72.39±6.83 vs. 62.00±15.07 years,P<0.001), and visual field index (Humphrey Field Analyzer), which was lower in the ophthalmologists’ group (51.81±34.74% vs. 32.04±33.83%,P=0.013). IOPat 1-, 3-, 6 months, and 1 year after surgery was significantly higher in the resident’s group (P<0.05). Resident-performed trabeculectomies achieved a significantly lower complete success rate when compared with the ophthalmologists’ group (39.39% vs. 64.94%,P=0.013). The overall rate of the postoperative complications and reintervention did not differ between groups, but the occurrence of a shallow anterior chamber was more frequent in the residents’ group (15.15% vs. 4.05%,P=0.037).

Conclusions:

Resident-performed trabeculectomies present significantly higher postoperative IOP levels and a lower complete success rate when compared with staff ophthalmologists. It is, therefore, fundamental to adopt strategies to change this gap, improve patient safety, and strengthen resident confidence.
Assessing the Diagnostic Accuracy of SD BIOLINE for Detection of Hepatitis C Virus: A Systematic Review and Meta-analysis
Authors: Weng Shu-Chang , Zhou Jie , Zhong Xiao-Ying , Xin Qing , Mai Yue-Xue , Ji Li-Qin , Li Ya-Ping , Cao Xun-Jie , Yang Wen-Hui , Chen Hao-Kai , Guo Xu-Guang
Published: March 2023

Hepatitis C virus (HCV) is a globally widespread ribonucleic acid virus that transmits through blood and sexual contact. Its morbidity and mortality are particularly higher in economically underdeveloped areas. Therefore, an economical and effective diagnostic method for detection of HCV is urgently needed. In this study, we evaluated the diagnostic accuracy of the SD BIOLINE rapid diagnostic test for HCV detection. We searched for studies related to SD BIOLINE and HCV in PubMed, Embase, Web of Science, and the Cochrane Library and then designed inclusion and exclusion criteria. After extracting valid data, the included literature was evaluated with the quality assessment tool Quality Assessment of Diagnostic Accuracy Studies. After our data analysis, the sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic accuracy, summary receiver operating characteristic curve, funnel plot, box plot, and Fagan plot of the diagnostic method were determined. Nine articles with nine sets of data were finally included. The sensitivity and specificity were 0.94 and 0.98, respectively, the positive likelihood ratio was 79.53, the negative likelihood ratio was 0.05, the diagnostic odds ratio was 1590.32, and the summary receiver operating characteristic curve was 0.9958. The SD BIOLINE test has the advantages of high sensitivity, high specificity, low cost, and easy operation for diagnosing HCV. Therefore, we recommend using SD BIOLINE for rapid and effective screening of HCV, which is especially applicable for economically underdeveloped areas.
Podiatric assessment in children and adults with epidermolysis bullosa: are foot and ankle patient-reported outcome measures (PROMs) able to measure the severity of podiatric involvement among EB patients?
Authors: Wong Joy Lynn , Khan Mohammed Tariq , Cowan Timothy L. , Murrell Dedée F.
Published: March 2023

Epidermolysis bullosa (EB) represents a group of rare genetic skin fragility disorders characterized by (muco) cutaneous blistering upon minimal mechanical trauma. Ninety percent of EB patients experience podiatric symptoms which may affect physical functioning and emotional well-being. To date, an EB-specific podiatric assessment has not been outlined to guide clinicians in the assessment of EB podiatric involvement. This review describes the podiatric involvement of patients with EB and assesses the relevance of validated foot and ankle patient-reported outcome measures (PROMs) in measuring podiatric severity among EB patients. A literature review was conducted to identify systematic reviews and clinical studies investigating foot health and podiatric manifestations using validated foot health PROMs across foot and ankle conditions. Limited studies have documented the significance of podiatric involvement among EB patients. Existing EB-specific PROMs are not region-specific for assessing podiatric involvement. Among the foot and ankle PROMs, the Foot Health Status Questionnaire, Foot Function Index, and Manchester Oxford Foot Questionnaire were identified as potentially appropriate for assessing podiatric severity among EB patients, each with its strengths and limitations in assessment. However, they have not been widely validated for assessing dermatology-related diseases. An evaluation of the relevance of each identified PROM to EB podiatric assessment would enable future development of an appropriate EB-specific podiatric assessment tool that would guide management.
Rare case of horseshoe lung associated with scimitar syndrome in Palestine: a case report
Authors: Shrateh Oadi N. , Rajab Amjad , Issawi Mohammed , Owienah Haneen , Sulaiman Sa’d , Sweileh Thaer , Taqa Mohammad A. , Hijjeh Nizar , Asbeh Yousef A.
Published: March 2023

Introduction:

The caudal and basal parts of the lungs are fused together in a rare congenital bronchopulmonary anomaly known as horseshoe lung. The majority of horseshoe lung cases are associated with scimitar syndrome. Most patients present with nonspecific symptoms. Multidetector pneumoangiography can be used to diagnose horseshoe lung, which shows that the isthmus of the pulmonary parenchyma traverses the midline, connecting the two lungs together. Treatment and prognosis are usually determined depending on the presence of other concomitant anomalies and the degree of symptom severity.

Case Presentation:

A 3-month-old-male patient presented with respiratory symptoms and a history of chest infection. Chest imaging revealed anomalous venous drainage from the right lower lobe of the lung, right lung hypoplasia with mediastinal shift, and a parenchymal isthmus extending between the two lungs. The patient was diagnosed with horseshoe lungs associated with scimitar syndrome. He was also found to have extralobar sequestration to the right lower lobe of the lung. The patient underwent surgical management in the form of tunneling of the anomalous vein into the left atrium using pericardium autograft ligation of the sequestration artery.

Clinical Discussion:

Because of its common association with other congenital malformations such as scimitar syndrome and cardiovascular defects, clinicians should be meticulous in the investigation and workup process of patients with horseshoe lung in order not to miss any of these associated abnormalities.

Conclusion:

Although it is very rare, horseshoe lung should be considered in the differential diagnosis of respiratory distress symptoms, especially in children younger than 1 year.
Acute hemorrhagic edema of infancy: a rare case report from Syria
Authors: Ataya Jamal , Hanifa Hamdah , Alsoud Eman
Published: March 2023

Introduction and Importance:

Acute hemorrhagic edema of infancy (AHEI) is a rare leukocytoclastic vasculitis clinically characterized by the classic triad (palpable purpuric skin lesions, edema, and fever) and is commonly misdiagnosed as Henoch–Schönlein purpura. AHEI frequently occurs after infections, drug treatment, or vaccination, even though its etiology is undetermined. Besides having a sudden onset, AHEI is also characterized by a self-limiting course with complete and spontaneous recovery within 1–3 weeks.

Case Presentation:

We report a rare case of a 1-year-old Syrian infant who presented to the clinic with an abnormal rash covering his entire body following a viral respiratory infection. On physical examination, he had many purpuric lesions across his body, and laboratory tests revealed that they were within the normal range. AHEI was determined based on clinical evaluation and laboratory analysis.

Discussion and Conclusion:

The authors focus on this entity as a differential diagnosis of his Henoch–Schönlein purpura. To prevent potentially serious complications, doctors should recognize purpura lesions in children exposed to respiratory infections, which received particular drugs or were given vaccinations. Furthermore, there is no danger associated with this disease, and it is benign.
Posterior cruciate ligament avulsion associated with an epiphyseal fracture of the proximal fibula: a case report of a 13-year-old child
Authors: Toumia Mohamed L. , Zairi Mohamed , Msakni Ahmed , Mohsni Ahmed A. , Saied Walid , Bouchoucha Sami , Boussetta Rim , Nessib Mohamed N.
Published: March 2023

Introduction and importance:

Posterior cruciate ligament (PCL) avulsion fractures are rare among the pediatric population. Reported PCL injury incidence varies from 1 to 40% depending on the study population. PCL lesions can be isolated or associated with other ligamentous lesions, which makes their management challenging. Knee ligament reconstruction is essential to restore knee stability and, thus, prevent future menisci and cartilage degeneration. However, surgical management of these injuries can lead to subsequent iatrogenic growth disturbances.

Case presentation:

The authors describe the case of a 13-year-old child involved in a sports accident causing a PCL avulsion fracture associated with an epiphyseal fracture of the proximal fibula resulting from an incomplete peel-off injury of the lateral collateral ligament. The patient was scheduled for open reduction and internal fixation on the same day of the presentation. A long-leg cast was then applied for 6 weeks. By 3 months postoperatively, the patient regained full range of motion, and return to sport was possible 6 months after the surgery.

Conclusion:

In children and adolescents, PCL avulsion fractures are often associated with other occult lesions. Although good functional and clinical outcomes using operative management for these lesions are reported, specific treatment recommendations are lacking in skeletally immature patients.
Control of diabetes, hypertension, and dyslipidemia in Jordan: a cross-sectional study
Authors: Hyassat Dana , Abu Noor Nancy , AlAjlouni Qais , Jarrar Yazan , Qarajeh Raed , Mahasneh Awn , Elzoubi Zaid , Khader Yousef , Farahid Oraib , El-Khateeb Mohammed , Ajlouni Kamel
Published: March 2023

Aims:

To determine the level of glycemic, blood pressure (BP), and lipids control among patients with type 2 diabetes mellitus (DM) attending the National Center for Diabetes, Endocrinology and Genetics and to determine factors associated with poor control.

Methods:

A cross-sectional study of 1200 Jordanian type 2 DM patients was included in this study during the period of December 2017–December 2018. We reviewed the charts of these patients until January 2020. Data obtained from medical records included information about sociodemographic variables, anthropometric measurements, glycated hemoglobin (HbA1c), BP, low-density lipoprotein (LDL), the presence of DM complications, and treatment.

Results:

The percentage of subjects who had HbA1c values of less than 7% was 41.7%. BP targets (<140/90 and 130/80 mmHg) were achieved in 61.9 and 22% of our patients, respectively. LDL targets less than 100 and 70 mg/dl or less were achieved in 52.2 and 15.9% of our studied population. Only 15.4% of our patients could have simultaneous control of HbA1c less than 7%, BP less than 140/90 mmHg, and LDL less than 100 mg/dl. Factors associated with poor glycemic control were obesity [odds ratio (OR)=1.9], DM duration between 5 and 10 years or more than 10 years (OR=1.8 and 2.5, respectively), and the use of a combination of oral hypoglycemic agent plus insulin or insulin alone (OR=2.4 and 6.2, respectively). Moreover, factors associated with uncontrolled BP (≥140/90) were male gender (OR=1.4), age 50–59 years or at least 60 years (OR=3.3 and 6.6, respectively), overweight and obesity (OR=1.6 and 1.4, respectively), insulin use (OR=1.6), and LDL at least 100 mg/dl (OR=1.4).

Conclusion:

The overall prevalence of poor glycemic control was high and alarming. Future research should focus on capturing all variables that may impact glycemic, BP, and dyslipidemia control, with special emphasis on a healthy lifestyle that would be of great benefit in this control.
Giant hydronephrosis masquerading as ovarian tumor: a case report
Authors: Kurniadi Andi , Kurniaputra Muhamad P. , Yulianti Herry , Kireina Jessica
Published: March 2023

Introduction and importance:

Giant hydronephrosis is defined as the accumulation of more than 1 l of fluid in the kidney’s collecting system. Its presentation can mimic other conditions including ovarian tumor. Herein, the authors report a case of giant hydronephrosis caused by urolithiasis that mimics the presentation of an ovarian tumor. The authors also highlight the challenges in diagnosing this rare entity and the management options available.

Case presentation:

The authors present a case of a 65-year-old P5A0 woman with an abdominal tumor of 1-year duration that progressively increased in size. She also complained of mild left flank pain since a year ago. Ultrasonography revealed a large cystic mass in the lower to middle abdomen. Ovarian tumor was suspected and laparotomy was performed. Surgical exploration revealed a left giant hydronephrosis with normal gynecological organs. The postoperative course was uneventful, and she was discharged in satisfactory condition.

Clinical discussion:

Giant hydronephrosis should always be considered as a differential diagnosis when presented with a large abdominal cystic lesion.

Conclusion:

Routine screening for bilateral kidneys during gynecological ultrasonography will help detect giant hydronephrosis and prevent unplanned surgical interventions.
A minireview of cholera outbreak in Lebanon – a rising public health concern
Authors: Berjaoui Christin , Akoum Nourhane Al , El Nouiri Ahmad , Khayat Saadeddine , Abbass Mortada , Mousawi AlHareth Al , Wellington Jack , Uwishema Olivier
Published: March 2023

Cholera is a highly contagious illness that can cause severe, acute, watery diarrhea. The WHO and the Lebanese Ministry of Health announced on the 10 October 2022 the re-emergence of Cholera in Lebanon. Data was collected from the Ministry of Public Health in Lebanon, the WHO, news announcements, as well as from online databases such as PubMed, Science Direct, news, conferences, and press releases on the current cholera outbreak. More than 669 confirmed cholera cases and 23 deaths have been reported in Lebanon up until 29 December 2022. The Ministry of Public Health is providing cooperation and support in containing the disease and covering the hospital and treatment expenses for cholera patients. This paper aims to study the epidemiology of cholera, focusing on the most recent cholera outbreak in Lebanon, and to suggest some recommendations that can be followed to fight off this outbreak.
A rare presentation of urolithiasis in a child with urine retention from a nonendemic area: a case report and literature review
Authors: Muhumuza Joshua , Musinguzi Brian , Bukyana Sedrick , Kajoba Dickson , Kithinji Stephen M. , Molen Selamo F.
Published: March 2023

Introduction and Importance:

Even though urolithiasis in general is not uncommon, urethral stones have an incidence of less than 0.3% and are 20 times less common in children. Though cases of urethral stones have been reported in children from endemic areas, they are even rarer in countries like Uganda that are not endemic for urolithiasis.

Case Presentation:

The authors present a 7-year-old male who presented with acute urine retention. Though the diagnosis of retention was made in a lower-level health facility, the cause of the retention was not determined till the patient arrived at a general hospital. Diagnosis of an obstructing stone in the penile urethra was made clinically. Meatotomy and stone extraction were done, and a urethral catheter was passed.

Clinical Discussion and Conclusion:

When attending to children with acute urine retention, urolithiasis should be kept among the differential diagnoses, even in areas that are not endemic for urinary tract stones. A thorough clinical evaluation may be all that is needed to make a diagnosis.
A mesenteric cystic lymphangioma with no cysts’ radiological findings on X-ray in a 16-month-old boy
Authors: Shbani Abdulrahman , Toufan Ebrahim , Martini Nafiza , Yousif Mayas A.
Published: March 2023

Background:

Mesenteric cystic lymphangiomas (MCLs) are uncommon benign tumors that arise from the lymphatic vessels. These tumors represent 5–6% of all pediatric benign tumors.

Presentation:

Herein, we present a case of MCL in a 16-month-old child with an unusual report of symptoms. We used abdominal X-rays, ultrasonography, laboratory tests, and histopathological examination. Exploratory laparotomy confirmed the diagnosis of the MCL along with histopathological examination.

Conclusion:

The main message of this report is not to ignore the cases of intestinal obstruction, even if they were transient, and the operation choice should always be in mind, even in the absence of any surgical precedents. In addition, the X-ray may not tell us the whole story about MCL’s existence. These cases must be carefully dealt with and studied, which gives a remarkable level of uniqueness in this case.
Coronary ostial stenosis after coronary artery bypass graft and combined aortic valve replacement: case report
Authors: Nadeem Abdullah , Bilal Wajeeha
Published: March 2023

Introduction and Importance:

A 65-year-old patient with the left anterior descending artery (LAD) ostial stenosis proved by coronary angiography is presented. LAD ostial stenosis is an uncommon condition whose etiology is unknown. The patient also had a coronary artery bypass graft combined with aortic valve replacement 13 years ago. The clinical and angiographic profiles of the patient are discussed here, supported by the literature.

Case Presentation:

A 65-year-old female patient with a medical history of hypertension and dyslipidemia came to the outpatient department with a complaint of chest pain and shortness of breath. Coronary angiography was carried out in 2008, which revealed triple vessel coronary artery disease, valvular heart disease, and ostial stenosis. In 2009, the patient underwent coronary artery bypass graft surgery combined with aortic valve replacement and remained asymptomatic thereafter. In 2022, transthoracic echocardiography and a Doppler study were conducted, which revealed normal size left ventricle, an ejection fraction of 55%, and diastolic dysfunction grade I. A graft study was done, which revealed left main and right coronary artery were normal, and the left circumflex artery with mild stenosis and obtuse marginal with subtotal stenosis and severe ostial stenosis of the LAD was observed.

Clinical Discussion:

Recognizing this complication early can prevent life-threatening complications and is then of the utmost importance. Coronary ostial stenosis is an uncommon but potentially dangerous consequence of aortic valve replacement whose etiology is not well understood in the literature. Rapid clinical identification is therefore essential. Coronary angiography needs to be done right away if coronary ostial stenosis is suspected. The mainstay of treatment for ostial stenosis is coronary artery bypass surgery or percutaneous coronary angioplasty. Since the patient has already undergone a coronary artery bypass graft (CABG) surgery, there is a significant risk of redoing CABG, as it is associated with considerable morbidity, which has a negative effect on long-term quality of life.

Conclusion:

Despite the fact that CABG is the most common form of therapy, percutaneous coronary intervention has demonstrated good short-term outcomes. To assess the effectiveness of CABG with drug-eluting stents for the treatment of coronary ostial stenosis, further information on long-term outcomes is required.
Intra-abdominal ectopic breast tissue in male patient presenting as a fibroadenoma: a case report
Authors: Baset Zekrullah , Arafat Yaser , Amini Jawad , Rezaie Fatema , Mohammady Nooria , Mousavi Sayed H.
Published: March 2023

Introduction:

Fibroadenoma (FA) in ectopic male breast tissue is extremely rare. The ectopic breast tissue (EBT) is mostly appearing along the milk line; however, uncommon locations are also seen, such as the present case.

Case Presentation:

The authors report a 19-year-old male presenting with intestinal obstruction. The patient underwent laparoscopic surgery, and an excisional biopsy of the lesion was done. The histopathologic result confirms FA arising from EBT. This case is reported for its rarity. It indicates that FA should always be considered when there is an intra-abdominal suspicious mass.

Discussion:

EBT presenting as FA is also reported in the face, posterior neck, chest, middle back, buttocks, vulvar, and thighs. In this case, the authors present a EBT presented as a FA in the intra-abdomen of a young male patient, causing intestinal obstruction. FA in the male breast is rare; however, benign breast parenchyma showing FA in the intra-abdomen of a male patient is extremely rare.

Conclusion:

When a tumor is palpated in the milk line, the existence of FA should be taken into consideration. FA of the male EBT in the intra-abdomen is extremely rare. However, a close follow-up of the patient is strongly recommended, as the carcinoma arising from FA has a very poor prognosis.
The outcome of concomitant cholecystectomy with bariatric surgery: a retrospective cohort study
Authors: Yildirim Kadir , Karabicak Ilhan , Gursel Mahmut F. , Karabicak Can , Malazgirt Zafer
Published: March 2023

Background:

Gallstones are more common in obese individuals than in healthy individuals. They are diagnosed during the preoperative evaluation for bariatric surgery (BS). However, simultaneous cholecystectomy with BS is still controversial in patients with asymptomatic gallstones in the same session. In this study, the authors aimed to present an analysis of these operations performed with BS in the hospital.

Materials and Methods:

The records of 396 patients who underwent BS at Samsun VM Medicalpark Hospital between September 2017 and October 2021 were retrospectively reviewed. The length of hospital stay, operation time, complications, and safety of patients who underwent simultaneous cholecystectomy and BS only were examined.

Results:

Of 396 patients, 262 (66.1%) underwent laparoscopic sleeve gastrectomy and 134 (33.8%) underwent laparoscopic gastric bypass surgery. Gallstones were detected during the preoperative examination in 72 (18.1%) of the 396 patients who underwent BS. It was observed that 11 of them had symptoms. No major complications occurred during or after surgery in patients who underwent simultaneous cholecystectomy and only in those who underwent BS.

Conclusion:

Simultaneous cholecystectomy with BS does not burden the patient, and complication rates are very low. The procedure is also cost-effective, as patients do not require a second surgery.
Combined personalized therapy for the treatment of multiple giant keloids: a case report and literature review
Authors: Niraula Himalaya , Timilsina Sujan , Joshi Surya P. , Lamichhane Rajan , Yadav Rupesh K. , Sharma Samit , Shrestha Jayan M. , Lohani Ishwar
Published: March 2023

Introduction:

Keloids are the result of an abnormal wound-healing process and are associated with various risk factors. The majority of diagnoses are clinical. Successful treatment of keloid is challenging due to its nonregressing and recurring nature.

Case presentation:

We discuss the case of a 30-year-old mongoloid male who had multiple swellings over his body for the past 10 years. More striking are the giant keloids that are present over his bilateral scapulae. Diagnosis of keloid was made clinically. Smaller sessile lesions over his shoulder and upper limbs were subjected to intralesional 5-fluorouracil and triamcinolone injections, whereas the giant bilateral scapular keloids underwent excision and split skin grafting.

Clinical discussion:

Keloids usually present with firm and rubbery masses that extend beyond the site of the previous wound/injury. Keloids are diagnosed and evaluated clinically. Its differentiation from the hypertrophic scar is done based on the presence of multiple lesions beyond the site of the previous wound/injury.

Conclusion:

Treatment of keloids is difficult due to their nonregressing and recurring nature. Hence, the main goal of treatment is to tailor the therapy to the patient’s needs such that the benefits outweigh the risks.