bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Narrative Review of Early Oral Stepdown Therapy for the Treatment of Uncomplicated Staphylococcus aureus Bacteremia: Yay or Nay?
Authors: Dagher Michael , Fowler Vance G , Wright Patty W , Staub Milner B 
Published: May 2020

AbstractHistorically, intravenous (IV) antibiotics have been the cornerstone of treatment for uncomplicated Staphylococcus aureus bacteremia (SAB). However, IV antibiotics are expensive, increase the rates of hospital readmission, and can be associated with catheter-related complications. As a result, the potential role of oral antibiotics in the treatment of uncomplicated SAB has become a subject of interest. This narrative review article aims to summarize key arguments for and against the use of oral antibiotics to complete treatment of uncomplicated SAB and evaluates the available evidence for specific oral regimens. We conclude that evidence suggests that oral step-down therapy can be an alternative for select patients who meet the criteria for uncomplicated SAB and will comply with medical treatment and outpatient follow-up. Of the currently studied regimens discussed in this article, linezolid has the most support, followed by fluoroquinolone plus rifampin.
FLASHING: New high-velocity H2O masers in IRAS 18286−0959
Authors: Imai Hiroshi , Uno Yuri , Maeyama Daichi , Yamaguchi Ryosuke , Amada Kei , Hamae Yuhki , Orosz Gabor , Gómez José F , Tafoya Daniel , Uscanga Lucero , Burns Ross A 
Published: May 2020

Abstract
We discovered new high-velocity components of H2O maser emission in one of the “water fountain” sources, IRAS 18286−0959, which has been monitored using the Nobeyama 45 m telescope in the FLASHING (Finest Legacy Acquisitions of SiO- and H2O-maser Ignitions by Nobeyama Generation) project since 2018 December. The maser spectra show new components with extremely high expansion velocities (&gt;200 km s−1 projected in the line of sight), some of which are located symmetrically in the spectrum with respect to the systemic velocity. They were also mapped with KaVA (KVN and VERA Combined Array) in 2019 March. We located some of these maser components closer to the central stellar system than other high-velocity components (50–200 km s−1) that have been confirmed to be associated with the known bipolar outflow. The new components would have flashed in the fast collimated jet at a speed of over 300 km s−1 (soon) after 2011 when they had not been detected. The fastest of the new components seem to indicate rapid deceleration in these spectra; however, our present monitoring is still too sparse to unambiguously confirm it (up to 50 km s−1 yr−1) and too short to reveal their terminal expansion velocity, which will be equal to the expansion velocity that has been observed ($v$exp ∼ 120 km s−1). Future occurrences of such extreme-velocity components may provide a good opportunity to investigate possible recurrent outflow ignitions. Thus, the sculpture of the parental envelope will be traced by the dense gas that is entrained by the fast jet and exhibits spectacular distributions of the relatively stable maser features.
Tissue Dielectric Constant Measures in Women With and Without Clinical Trunk Lymphedema Following Breast Cancer Surgery: A 78-Week Longitudinal Study
Authors: Koehler Linda A , Mayrovitz Harvey N 
Published: May 2020

Abstract

Objective
Following breast cancer surgery with lymph node removal, women are at risk of developing lymphedema in the upper extremity or trunk. Currently, trunk lymphedema diagnosis relies on a clinical assessment because no quantifiable standard method exists. Tissue dielectric constant (TDC) values are quantifiable measures of localized skin tissue water and may be able to detect trunk lymphedema. The goal of this study was to (1) compare parameters derived from TDC measurements with those derived from clinically accepted criteria for trunk lymphedema in women following breast cancer surgery and (2) explore the potential utility of TDC to detect trunk lymphedema early in its progression.

Methods
This prospective longitudinal study, a secondary analysis from a larger study, observed women with and without clinically determined truncal lymphedema following breast cancer surgery. TDC was measured on the lateral trunk wall at post-surgery weeks 2, 4, 12, and 78 in women who had surgical breast cancer treatment with lymph node removal. Clinical assessment for trunk lymphedema was determined at 78 weeks by a lymphedema expert. Comparison of TDC measurements in women with and without clinical trunk lymphedema was analyzed.

Results
Clinical assessment identified trunk lymphedema in 15 out of 32 women at 78 weeks. These women had TDC ratios statistically higher than women without truncal lymphedema.

Conclusion
The overall findings indicate that TDC has the ability to quantify trunk lymphedema and might be valuable in early detection.

Impact
TDC may be a beneficial tool in the early detection of breast cancer–related trunk lymphedema, which could trigger intervention.

Lay Summary
A new device may help recognize trunk lymphedema in patients with breast cancer so they could receive appropriate treatment.
COVID-19 response in northwest Syria: innovation and community engagement in a complex conflict
Authors: Ekzayez Abdulkarim , al-Khalil Munzer , Jasiem Mohamad , Al Saleh Raed , Alzoubi Zedoun , Meagher Kristen , Patel Preeti 
Published: May 2020

ABSTRACTDespite lacking capacity and resources, the health system in the northwest Syria is using innovative approaches for the containment of COVID-19. Lessons drawn from previous outbreaks in the region, such as the polio outbreak in 2013 and the annual seasonal influenza, have enabled the Early Warning and Response Network, a surveillance system to develop mechanisms of predicting risk and strengthening surveillance for the new pandemic. Social media tools such as WhatsApp are effectively collecting health information and communicating health messaging about COVID-19. Community engagement has also been scaled up, mobilizing local resources and encouraging thousands of volunteers to join the ‘Volunteers against Corona’ campaign. Bottom-up local governance technical entities, such as Idleb Health Directorate and the White Helmets, have played key leadership role in the response. These efforts need to be scaled up to prevent the transmission of COVID-19 in a region chronically affected by a complex armed conflict.
A comparison between Sevoflurane Volatile Induction/Maintenance Anesthesia and Propofol Total Intra-venous Anesthesia for Rigid Bronchoscopy under Spontaneous Breathing for Tracheal/Bronchial Foreign Body Removal in Children
Authors: Al-Safty O M T , Youssef O R , Kamaleldin D M , Youssef M K M 
Published: May 2020

Abstract

Background
Foreign body aspiration is a life-threatening condition. Asphyxiation from inhaled foreign bodies is a leading cause of accidental death among children younger than 4 years. While early clinicians used topical anesthesia, general anesthesia became common place for the removal of aspirated objects with increased experience with the rigid bronchoscope and advances in anesthetic delivery. Inhaled anesthesia and total intravenous anesthesia are widely used for rigid bronchoscopy in children.

Objective
In this study, we compared sevoflurane VIMA and propofol TIVA, when used for both induction and maintenance of anesthesia in children undergoing rigid bronchoscopy for tracheal or bronchial foreign body removal.

Methods
This is a prospective double – blinded, randomized controlled Trial, After Approval is obtained from the research ethics committee of anaesthesia and intensive care department, Ain Shams University. Patients were randomly divided into two groups (n = 30 each). In Group VIMA, anesthesia was induced with inhalation of sevoflurane. Before induction, a closed circuit with a 1-l reservoir bag was overflowed by 8 vol % sevoflurane with 0.3 l/min fresh oxygen flow for 3 min. In Group TIVA, a bolus of 2.5 mg/kg propofol was administered over 30 seconds. Additional propofol 0.5–1 mg/kg was given as needed to deepen anesthesia.

Results
Our results demonstrate that compared with propofol TIVA, sevoflurane VIMA provides more stable haemo-dynamics and respiration, faster induction and recovery and higher incidence of excitement in paediatric patients undergoing tracheal/bronchial foreign body removal.

Conclusion
Foreign body aspiration is a life-threatening condition. Anesthetic management can be challenging, as the airway is shared with the surgeon and adequate ventilation must be maintained despite airway manipulation.
A Comparison of the Analgesic Effect between Magnesium Sulphate and Fentanyl as Adjuvants to Epidural Levobupivacaine in Patients Undergoing Open Reduction and Internal Fixation of Pott's Fracture
Authors: Ibrahim S F , Samir G M , Alawady D S M , Kodous M A A H 
Published: May 2020

Abstract

Background
The use of opioids in epidural anesthesia has become popular to optimize postoperative analgesia. The present study was designed to compare the analgesic efficiency of epidural infusion of (magnesium sulfate added to levobupivacaine) compared to (fentanyl added to levobupivacaine) and (levobupivacaine) alone.

Objective
The aim of this study was to assess the post-operative analgesic efficiency of Magnesium Sulphate as an additive to Levobupivacaine in comparison with either Levobupivacaine alone or the combination of Levobupivacaine and Fentanyl.

Patients and Methods
Ain Shams university hospitals. After obtaining an informed consent; 45 patients admitted for open reduction and internal fixation of Pott's fracture, were blindly randomized into three groups; group N, group M or group F. Group N receive levobupivacaine, group M receive levobupivacaine and magnesium, and group F receive levobupivacaine and fentanyl.

Results
The study showed that the onset of both sensory and motor blocks was significantly faster in the group receiving magnesium and levobupivacaine in comparison with the other two groups. In addition, heart rate was significantly lower in the 2 groups receiving magnesium and fentanyl as adjuvant to levobupivacaine compared to the third group.

Conclusion
It was concluded that using magnesium sulphate as an additive to epidural levobupivacaine infusion produces good analgesia without side effects; it proved to fasten the epidural block in comparison to both the levobupivacaine and the levobupivacaine and fentanyl groups, besides it increased the duration of post operative analgesia in comparison with levobupivacaine group.
Evaluating the effect of calcium chloride in combination with neostagmine and atropine against residual neuromuscular blockade at the end of general anesthesia
Authors: Marzouk M M , Shoukry R A , Refaat S A , Fathi A M 
Published: May 2020

Abstract

Background
Muscle relaxants used in general anesthesia during the insertion of an endotracheal tube (ETT) to relax the muscles of the neck and throat, which reduces the risk of injury. They also are used to relax the chest muscles when an endotracheal tube is used to aid mechanical ventilation.

Objective
The aim of this study has been to evaluate the effect of calcium chloride coadministered with neostigmine and atropine on neuromuscular blockade recovery time at the end of general anesthesia. And compare it’s effect against usual neuromuscular reverse of neostigmine and atropine.

Patients and Methods
In this present study we use Double blind prospective randomized Clinical trial study, 30 patients were enrolled. They were divided in two groups each of which contains 15 patients: Group (A): received 5 mg/kg of calcium chloride coadministered with 25 μg/kg of neostigmine and 15 μg/kg of atropine at the end of surgery. Group (B): received the same volume of normal saline coadministered with 25 μg kg of neostigmine and 15 μg / kg of atropine at the end of surgery.

Results
Comparison between calcium and neostigmine groups according TOF at 5 minutes and 10 minutes using Independent t-test, P- value was less than 0.01 which means that there is high significant difference between 2 groups. On the other hand, TOF at 20 minutes in calcium and neostigmine groups shows no difference at all.

Conclusion
So Calcium chloride elevate serum calcium level, calcium has antineuromuscular blockade effect, therefore calcium chloride increase TOF and enhance neuromuscular recovery and decrease the PORC after neostigmine administration.
Impact of Thyroid Dysfunction in Correlation to Mortality Rate of the Critically ILL ICU Patients (Prospective Observational Study)
Authors: Mohammed A E , Saied A M , Selima W Z , Ibrahim W S 
Published: May 2020

Abstract

Background
during critical illness, changes in circulating hormonal levels are a common phenomenon. These alterations are correlated with the severity and outcome of patients in intensive care unit (ICU). Thyroid hormone stays a key role in the maintenance of the body growth. Modulating metabolism and the immune system.

Aim of the Work
is to access the relation between thyroid dysfunction and mortality in critically ill patients and to access the strength of thyroid dysfunction as a predictor of mortality against APACHE II score and CRP, also to assess the additive effect of low FT3 and high APACHE II score as a predictor of mortality.

Patients and Methods
the study population (n = 40) included 21 males (52.2%) and 19 females (47.5). their age range from (21 years) to (91 years) were selected from critically ill patients admitted to El Demerdash hospital general ICU in the period from March 2017 to March 2018. Patients were divided into 2 groups according to 7th day thyroid profile:

Group 1
Normal thyroid function group (24 patients).

Group 2
thyroid dysfunction group (16 patients).

Results
the most significant abnormality between the 2 groups was TT3 and FT3. The patients in thyroid dysfunction group showed significantly higher APACHE II score and CRP but lower GCS. They also needed more mechanical ventilation with longer duration. There was no significant difference between the 2 study groups as regard cardiovascular complication.

Conclusion
our study also showed highly significant correlation between thyroid dysfunction and mortality. FT3 appeared to be better predictor of mortality among critically ill patients with AUC 83% and p value &lt; 0.001 with sensitivity 99% and specificity 61%. The predictive value of FT3 for mortality increased by the addition of APACHE II score &gt; 25.
Prevalence of Peripheral Arterial Disease among End Stage Renal Disease Patients
Authors: Morkos R R W , Shahan A M , Elserafy A S , Hanna H F 
Published: May 2020

Abstract

Background
Patients with End Stage Renal Disease are more susceptible to develop Peripheral Arterial Disease. So, screening is helpful for early diagnosis.

Objectives
The aim of this study is to screen and calculate the prevalence of asymptomatic patients on regular hemodialysis for presence of PAD.

Methods
The study included 100 asymptomatic patients on regular hemodialysis and below 60 years old to be screened for presence of PAD. All selected patients have been subjected to ABI assessment using the Doppler. It was found that the prevalence of PAD among ESRD patients is 26% of which 80.8% had bilateral PAD and 19.2% had unilateral disease. The results showed that females had statistically significant higher risk of developing PAD than males. The study showed also that A1C level in patients who have no diabetes carries statistically significant results. The mean A1C level for the study group was 5.56 ± 0.70 and the control group was 4.92 ± 0.73. The p value was 0.000. The A1C level cut off value was &gt; 5.3.

Conclusion
Renal impairment is an important risk factor for developing PAD in absence of traditional risk factors such as DM, hypertension, or dyslipidemia. Prevalence of PAD was 26% in our study. ABI is a simple non-invasive modality of screening for PAD. Females are at higher risk to develop PAD than males by ∼ 2.7 fold. Although diabetes is absent, A1C level &gt; 5.3 is significantly correlating with the risk of PAD.
Right Ventricular Function Assessment in patients with chronic stable angina with Type II DM Versus Non Diabetic Patients by TAPSE and TDI Echocardiography
Authors: Kamal M , Shabana A , Thabet S , Wadie B 
Published: May 2020

Abstract

Background
In patients with documented right coronary artery (RCA) lesions, right ventricular function could be affected. In addition, the presence of diabetes mellitus is found to be a risk factor for cardiomyopathy.

Objective
The aim of the study is to assess the effect of type II DM on RV function in patients with chronic stable angina who have significant RCA lesion, using TAPSE and TDI by echocardiography

Patients and Methods
One hundred patients who underwent elective coronary angiography for suspected coronary artery disease and were found to have significant RCA lesion were divided into two groups according to presence of Type II DM. Echocardiography was done for all patients and RV function assessment by TAPSE and TDI was done.

Results
In our study 100 patients were included; 73 of patients were males and 27 were females with mean age of 56.70 ± 8.51 years. almost one fourth of the candidates were smokers, 23% were ex-smokers and about half of the candidates were non-smokers (51%).About half of the patients were known hypertensive (48%) while the rest were not. As regarding LVEF it ranged between 35-73% with a Mean ± SD of 54.10 ± 8.94, TAPSE ranged between 17-30 mm with a mean ± SD of 22.81 ± 3.08 and S ‘was ranged between 9-19cm/s with a mean ± SD of 13.50 ± 2.24. Comparison between both groups showed that control group (Group I) had a mean age of (57.34 ± 8.74) and 86% were males . All Diabetic patients (Group II) had a mean age of (56.06 ± 8.30) years, (60%) were males. There was no significant difference between the two groups with respect to age and gender. As regarding smoking status in Group II (20%) were smokers and for Group I (32%) . As regarding hypertension, in Group II (72%) were hypertensive and for the Group I (32%) were hypertensive which was significantly different in both groups.The presence of associated significant LAD lesions was found in 52% of Group II and only 32% in Group I, which was significantly differenct between 2 groups. (p = 0.043).As regarding Echocardiographic data, there was no significant difference in both groups regarding TAPSE (P value .629) and S’(P value .247).

Conclusions
The results of this study shows that TAPSE and S’ showed normal values in patients with chronic stable angina and there was no additional effect for type II D.M.
Knowledge, Attitude and Practice towards vitamin D importance and supplementation among mothers of under five children in a primary health care center in Cairo
Authors: Selim N S S , Wahdan M M , Aboulezz N F , Sabbour S M 
Published: May 2020

Abstract

Background
The world is currently facing a pandemic of vitamin D deficiency especially women in child bearing age, during pregnancy and nursing mothers. One of the major reasons for the worldwide spread of this nutritional disorder has been lack of awareness about the importance of vitamin D and prevention of deficient states across populations.

Objectives
To assess the knowledge and attitude of mothers attending primary health care center in Cairo towards vitamin D importance, to identify mothers' practices towards vitamin D, its supplementation & sun light exposure.

Subjects & Methods
A cross sectional study was conducted among mothers attending “100 meters” primary health care center in El-Sherouk city in Cairo. A sample of 195 mothers were interviewed using structured questionnaire to collect data including socio-demographic characteristics, mother’s knowledge about the importance of Vitamin D, mother’s attitude and practices towards taking vitamin D, its supplementation and sun light exposure for herself and her child. Scoring system was designed for knowledge, attitude and practice of mothers. A short targeted health education message was given to the participating mothers about vitamin D importance in the form of flyers.

Results
Less than one quarter of the mothers (22.6%) had a good knowledge towards vitamin D and its supplementation (total knowledge score percentage &gt; 50%) . The highest knowledge about benefits of vitamin D was “bone health” and the least knowledge recalled by mothers were “prevention of depression and obesity”. Thirty six percent of mothers had a positive attitude towards vitamin D and its supplementation (total attitude score percentage ≥75%) & forty six percent of mothers had a good practice towards vitamin D and its supplementation ( total practice score percentage ≥75%) . More than half of mothers (53.5%) were exposed to the sun from 10 am to 3 pm. The majority of mothers (91.1%) were exposed to the sun more than one hour per week. Only (48.7%) of the mothers gave their children vitamin D supplementation & about half of them (52%) started giving vitamin D supplement to her children since birth. Highly educated mothers had better knowledge and practice score than others (P value &lt; 0.05).

Conclusion & Recommendation
Less than one quarter of the mothers had a good knowledge towards vitamin D and its supplementation while about three fifths of the mothers had a positive attitude regarding vitamin D and its supplementation & less than half of the mothers had a good practice towards vitamin D and its supplementation. Implementing awareness campaigns and future health education programs may help in building more awareness about the vitamin D importance.
Evaluation of Superficial Electrocautery in the Treatment of Localized Vitiligo
Authors: Rasheed A I , Abdelfattah N S , Abdallah A G M 
Published: May 2020

Abstract

Background
Vitiligo is a disease that causes the loss of skin color. The extent and rate of color loss from vitiligo is unpredictable. It can affect the skin on any part of your body. It may also affect hair and the inside of the mouth.

Aim of the Work
Aiming for treating localized stable vitiligo by a simple, old technique. This study was based on a minimal burn, insufficient to develop scar, might activate the repairing processes which would enhance in the same time the MCs proliferation.

Patients and Methods
The study was done on 30 patients presented with localized stable vitiligo. Superficial electrocautery was done every month for 4 months with application of daily closed wound care using combined fusidic acid and betamethasone valerate cream followed by herbal β sitosterol containing cream then occlusion with Vasline gauze for 10 days or till complete wound healing. Other patch in the same patient is treated only by the above mentioned topical treatment as a control.

Results
In our study of total 30 patients, 8 patients (27%) showed marked repigmentation after treatment, 16 patients (53%) showed moderate response and the remaining 6 patients (20%) showed mild or no response to treatment.

Conclusion
No significant side effects were noticed during the course of treatment. Just mild, transient erythema and burning sensation were detected.