bluuebunny/crossref_metadata_2025_split huggingface dataset:
Methotrexate induced lung diseases in rheumatoid arthritis patients
Authors: Zaki Mohamed Gamal , El Yasaky Ahmad Mohamed , El Hilaly Rana Ahmed , Mostafa Mayada Taha 
Published: October 2021

Abstract

Background
Rheumatoid arthritis (RA) is a progressive, systemic autoimmune disorder characterized by articular and extra-articular manifestations. The lung is commonly a site of extra-articular disease. The lung manifestations of RA vary and may include airways, parenchymal, vascular, and pleural disease. Manifestations of lung disease in RA typically follow the development of articular disease. Methotrexate (MTX)has shown efficacy for the treatment of several diseases, especially RA.
Methotrexate has also been implicated as a causative agent in interstitial lung disease.

Objective
to find any association between MTX intake and lung abnormalities in RA patients.

Patients and Methods
This study included sixty adult RA patients, recruited from Ain Shams University Hospitals. Patients were divided into thirty patients on MTX therapy, and another thirty patients on non-methotrexate therapy. All underwent history, clinical examination, chest examination, evaluation of RA by modified disease activity score 28 (DAS 28) and pulmonary function tests(PFT).

Results
The age of patients receiving MTX ranged from 35-65 years and the non-MTX group was 35-57 years with a mean ±SD of 47.733±5.265 and 40.700 ±5.187, respectively. Male to female ratio of MTX group was about 1:3, while Non MTX group was about 1:9.There was no significant difference regarding age and sex. There was no difference between both group regarding modified DAS score and chest manifestations. There was no difference in PFT findings between patients on high or low dose of MTX therapy .Similarly, no association was found between disease activity score and PFT findings in both groups. On the other hand, a significant association between chest symptoms and PFT, P value&lt;0.05 . Also a strong significant association was found between anticitrullinated protein antibodies (ACPA) status and PFT in both group, p value &lt;0.05.

Conclusion
MTX treatment was not associated with an increased risk of RA-ILD diagnosis. On the contrary, evidence showed that MTX may delay the onset of ILD. There seems no reason to confuse the association of MTX and hypersensitivity pneumonitis with the onset of RAILD.ACPA antibody is considered a major risk factor in RA-ILD, ACPA titers constitute an independent factor associated not only with the presence but also with the severity of RA-ILD
Subclinical Atherosclerosis in Psoriatic Patients: Relation with Vitamin D
Authors: Moussa Shaymaa Ali , Khaled Henaz Farouk , ElShishtawy Heba Fawzy , Elnaggar Heba 
Published: October 2021

Abstract

Background
Psoriasis is a chronic, inflammatory disease that mainly affects skin and nails. Approximately 13%-25% of Psoriasis patients develop Psoriatic arthritis (PsA). Psoriasis and PsA are strongly associated with numerous comorbid diseases and among them, cardiovascular diseases are of particular importance. Low levels of serum vitamin D are associated with increasing risk of metabolic diseases and cardiovascular diseases. Vitamin D deficiency is observed in numerous chronic systemic inflammatory diseases including psoriasis. Carotid intima-media thickness (CIMT) is a marker of arterial vascular disease used to predict a future vascular event. It can serve as a surrogate marker for subclinical atherosclerosis and cardiovascular diseases. Coronary artery calcification score (CACS) is a non-invasive and highly reliable method to measure coronary atherosclerosis through non-contrast cardiac CT.

Objective
To detect subclinical atherosclerosis and study its relation with serum levels of 25hydroxyvitamin D in psoriatic patients with and without arthritis.

Patients and Methods
This study was carried out on 25 Egyptian psoriatic patients and 25 healthy individuals matched as regarding age, sex and BMI as a control group. Patients were classified into 2 groups; Group I: 13 patients with PsA and Group II: 12 patients with psoriatic skin lesion without any arthritic manifestations. All patients were subjected to full medical history taking, thorough clinical examination. Basic laboratory investigations in addition to assessment of serum levels of 25-OH vitamin D were done to all patients and control. carotid duplex for measurement of CIMT in addition to measurement of CACS using coronary CT.

Results
Patients with PsA had lower values of vitamin D than psoriatic patients and controls despite being statistically insignificant (median; 5, 5.5 & 11). CIMT and CACS were statistically higher among PsA patients (CIMT mean; 0.57, 0.52 & 0.44) and (CACS median; 53, 1.5 & 0) respectively. Vitamin D was found to be negatively well correlated with PASI, ALT, AST, serum creatinine and CACS in psoriatic patients. A significant relation between higher PASI and low vitamin D levels in psoriatic patients. CIMT was significantly positively correlated with age, BMI, LEI, ALT, AST, SUA, cholesterol and CACS in psoriatic patients, while CACS was positively correlated with age, ALT, SUA and cholesterol.

Conclusion
Psoriatic patients especially those with PsA had lower values of vitamin D than controls despite being statistically insignificant. They also suffered from increased risk of CVDs and subclinical atherosclerosis due to increased burden of inflammation and lack of physical activity. Vitamin D was negatively correlated with CACS in psoriatic patients in addition to a strong positive correlation between CIMT and CACS among them.
The Possible Protective Effect of Selenium on Liver Dysfunction in a Rat Model of Extrahepatic Cholestasis
Authors: Lebda Fatma M , El Agaty Sahar M , Nassef Noha A , Aziz Marina A 
Published: October 2021

Abstract

Background
Oxidative stress and inflammation are primarily implicated in the development and progression of liver injury during cholestasis. Selenium, a known essential antioxidant trace element, was found to provide a remarkable antioxidant and anti-inflammatory effects on various diseases.

Aim
This study was planned to evaluate the possible protective effect of selenium supplementation in a rat model of chronic cholestasis.

Design
Experimental study.

Methods
This study was carried out on adult male rats allocated randomly into sham, bile duct ligated (BDL), and BDL-selenium treated (BDL-Se) groups. Sodium selenite was given by gavage daily, in a dose of 100 µg/kg for 6 weeks, starting 2 weeks before the BDL.

Results
BDL group presented a significant increase in serum levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), and liver levels of malondialdehyde (MDA), tumor necrosis factor alpha (TNF-α), and transforming growth factor beta 1(TGF-β1), associated with a significant decrease in serum levels of total proteins (TP) compared to sham group . Selenium supplementation significantly lowered serum levels of AST, ALT, ALP, and liver levels of MDA, TNF-α, and TGF-β1 along with a significant increase in serum TP in BDL-Se group versus BDL rats. Histological analysis of liver showed a significant attenuation of the inflammatory score and a significant decrease in the percentage area of collagen deposition in BDL-Se group versus BDL rats.

Conclusion
Selenium supplementation reduces liver injury and improves liver functions in experimental cholestasis probably by its antioxidant and anti-inflammatory activities, which further alleviate the liver fibrosis.

Abbreviations
BDL: bile duct ligated group, BDL-Se: bile duct ligated-selenium group, MDA: malondialdehyde, TNF-α: tumour necrosis factor-alpha, TGF-β1: transforming growth factor- beta1, ROS: reactive oxygen species, mRNA: messenger RNA, IL-6: interleukin-6, BW: body weight, AST: aspartate aminotransferase, ALT: alanine aminotransferase, ALP: alkaline phosphatase, TP: total proteins, CCl4: carbon tetrachloride, GPx: glutathione peroxidase enzyme, SOD: superoxide dismutase, IL-1: interleukin-1.
Possible Protective Effects of Stem Cells Treatment on Ischemic/Reperfused Hearts in Hypertensive Rats Model
Authors: Hamed Gehane M , Abd-El Hamid Manal S , Nagib Einas M , Amer Hanaa Ahmed , Hussien Nahla Mohamed 
Published: October 2021

Abstract

Back Ground
Hypertension and its cardiovascular complications as myocardial infarction are the leading causes of morbidity and mortality worldwide. Reperfusion strategies are the current standard therapy but they result in cardiac ischemia reperfusion injury. Stem cell transplantation has emerged as a promising therapeutic strategy and showed many beneficial effects in different medical disorders as reno-vascular hypertension.

Aim of Work
To assess the possible protective effects of bone marrow derived mesemchymal stem cells treatment on ischemic/reperfused hearts in hypertensive rats.

Materials & Methods
49 adult female Wistar albino rats, were allocated into three main groups: control group, hypertensive untreated (Ht-u) group and hypertensive stem cells (Ht-SCs) treated group. Body weight, arterial blood pressure, ECG recording, isolated heart study with exposure to ischemia reperfusion injury and fluorescence imaging of labeled MSCs in the heart, aorta and liver were performed. Plasma lipid profile, nitric oxide, MDA and SOD levels and cardiac MDA and SOD levels were estimated. Cardiac tissues were weighed. Heart, aorta and liver were histopathologically assessed.

Results
Ht-SCs treated group demonstrated significant increase in body weight gain %, significant decrease in R voltage, SBP, DBP and MAP sixth week values compared to HT-u group, with DBP and MAP showing non-significance from the control. Significant increase in heart rate basal and all reperfusion values and non-significant increase in basal PT/LVW were detected compared to HT-u group. Basal TPT and HRT were significantly shortened and MFR/LVW was significantly increased than HT-u group, being non-significantly changed from the control denoting systolic and diastolic function improvement.TPT and HRT prolongation and MFR/LVW decrease after IR injury was significantly lower in HT-SC group than HT-u group. This was accompanied by significant decrease in atherogenic index, plasma and cardiac MDA and significant increase in plasma nitrites, SOD and cardiac SOD. BM-MScs were detected in cardiac and aortic tissues.

Conclusion
Single injection of BM-MScs exerted anti-hypertensive and anti-hypertrophic effects, reduced systolic and diastolic dysfunction after ischemia reperfusion injury and improved coronary flow in hypertensive rats, through homing into aortic tissues mitigating endothelial dysfunction and exerting angiogenic effects and homing into cardiac tissues exerting anti-oxidant, anti-inflammatory and anti-apoptotic effects.
Incidence and Association of Patient Safety Indicator 9 (Perioperative hemorrhage or hematoma) and clinical outcomes in Cardio-thoracic surgery hospital, Ain Shams University, Egypt
Authors: Al-Tehewy Mahi M , Abd AlRazak Sara E. M , Wahdan Maha M , Hikal Tamer S. F 
Published: October 2021

Abstract

Background
Patient Safety Indicators (PSIs) were developed as a tool for hospitals to identify potentially preventable complications and improve patient safety performance.

Aim
the study aimed to measure the association between the AHRQ patient safety indicator PSI9 (Perioperative hemorrhage or hematoma) and the clinical outcome including death, readmission within 30 days and length of stay at the cardiothoracic surgery hospital Ain Shams University.

Methods
exploratory prospective cohort study was conducted to follow up patients from admission till 1 month after discharge at the cardiothoracic surgery hospital who fulfills the inclusion criteria. Data were collected for 330 patients through basic information sheet and follow-up sheet.

Results
the incidence rate of PSI9 was 49.54 per 1000 discharges. Demographic data was not significantly associated with increased incidence of PSI9. The risk of development of PSI9 was significantly higher in patients admitted directly to ICU [relative risk (RR) =5.6]. The risk of death and readmission was higher in cases developed PSI9 than the cases without PSI9 [RR = 2.40 (0.60-9.55) and 2.43 (0.636 - 9.48) respectively].

Conclusion
high incidence rate of PSI9 and the incidence is higher in male gender and 60 years old and more patients. Those patients developed PSI9 were at high risk for readmission and death.

Recommendations
the hospital administration should consider strategies and policies to decrease the rate of PSI9 and subsequent unfavorable clinical outcomes.
Evaluation of Hepatitis C Patients' Satisfaction Regarding Care and Treatment in Different Hospitals in Cairo, Egypt, 2020
Authors: Yousef Shaimaa S , Al Bagoury Lamyaa S , Dewedar Sahar A , Sabbour Sahar M , Anwar Wagida A 
Published: October 2021

Abstract

Background
Patient satisfaction can be considered as an indirect measure of health outcomes and quality of provided services.

Objectives
To compare HCV patients' satisfaction regarding care and treatment in different selected Viral Hepatitis Outpatients Clinics in Cairo. Method: The current study is a cross sectional study. It recruited 300 HCV patients from Viral Hepatitis Outpatients Clinics in University, Ministry of Health (MOH) and Insurance Hospitals (100 HCV patients from each clinic). Recruited HCV patients attended at least 2 visits to the Viral Hepatitis Clinics. They completed an interview questionnaire about socio- demographic data, history of diagnosis of HCV, onset and type of treatment and Hepatitis Patients Satisfaction Questionnaire (HPSQ).

Results
Mean age of HCV patients were (48.9 ±13.5), (50.4 ± 10.4), and (54.8 ± 10.9) from University, MOH and Insurance Hospitals, respectively. Females accounted for (63%) of HCV patients in University Hospital sample however, males were (54%) and (57%) in MOH and Insurance Hospitals, respectively. Most of studied HCV patients were referred by specialists; (59%), (86%) and (87%) from University, MOH, and Insurance Hospitals, respectively. A statistically significant difference was found between the 3 Clinics as regards rating the quality of received HCV services, meeting patients’ needs, coping with HCV disease, and helping patients access to specialist services (p &lt; 0.01). The study revealed that the majority of health providers in the 3 Viral Hepatitis Clinics didn't involve HCV patients in making decisions about their treatment.

Conclusion
HPSQ findings identified University Hospital's patients more satisfied about their HCV treatment management than MOH and Insurance Hospitals' patients except for involvement of HCV patients in making decisions which was lacking in the 3 hospitals.
IMPACT OF COLLIMATION ON RADIATION EXPOSURE IN ADULT AND PAEDIATRIC DIGITAL X-RAY IMAGING
Authors: Satharasinghe Duminda , Jeyasugiththan J , Jeyasuthan M , Amalaraj T , Abeyweera A L , Wanninayake W M N M B , Pallewatte A S 
Published: October 2021

AbstractThis study aimed to evaluate the collimation practices and quantify the overexposure due to extensive X-ray field area. The study was carried out in four digital X-ray units (including one paediatric X-ray unit). A total of 749 X-ray projections (555 adult and 194 paediatric) were evaluated. In adult X-ray units, the radiation field size was two times larger than the electronically collimated field. In the paediatric unit, the radiation field was 3.7 times larger than the electronic collimated field. The average additional entrance surface dose due to the excess radiation field used in a paediatric X-ray unit varied between 9.3 (2.5%) and 201.4 $\mu $Gy (10.9%). Therefore, proper pre-patient collimation should be applied whenever feasible, which reduces the patient radiation dose considerably.
Subcutaneous Peripheral Nerve Stimulation for Treatment of Acute/Subacute Herpes Zoster-related Trigeminal Neuralgia
Authors: Liu Dong-Yang , Chen Jin-Sheng , Lin Chu-Yan , Gong Qing-Juan , Zhao Qing , Wan Li 
Published: October 2021

Objectives:
The purpose of this study was to observe the effect of subcutaneous stimulation of the peripheral nerve on acute or subacute zoster occurring in trigeminal nerve branches, and to evaluate the preventive effect of prior temporary implant of a peripheral stimulation electrode in the acute or subacute phase of herpes zoster (HZ) (from 30 to 90 d after zoster onset) before postherpetic neuralgia (PHN) presents.

Methods and Materials:
A total of 26 patients’ medical records were analyzed. All of patients had received temporary subcutaneous peripheral nerve stimulation (PNS). The clinical efficacy of treatment was evaluated on a visual analog scale (VAS), and dosages of pain medication were recorded before and at 1 to 6 months after the temporary stimulation. The rate of PHN was reevaluated at a 6 months follow-up.

Results:
There was a significant decrease in VAS values after PNS. Medication doses decreased significantly after TPNS. The rate of clinically meaningful PHN (VAS >3) dropped below 4%.

Discussion:
This study revealed that PNS is an effective treatment for trigeminal herpetic neuralgia following acute or subacute HZ. As a extend neuromodulation method, subcutaneous peripheral nerve-field stimulation might be a useful option to reduce the progression of neuropathic changes caused by persistent transmission of pain signals in the trigeminal nerve branches after the acute or subacute phase of HZ.
Positive Expiratory Pressure Therapy on Oxygen Saturation and Ventilation After Abdominal Surgery
Authors: Spyckerelle Iris , Jonsson Fagerlund Malin , Holmgren Erik , Johansson Göran , Sahlin Carin , Thunberg Johan , Franklin Karl A. 
Published: October 2021

Objective:
To evaluate the immediate effects of positive expiratory pressure therapy on oxygen saturation and ventilation after abdominal surgery.

Background:
Positive expiratory pressure therapy to treat postoperative hypoxia is widespread, despite a lack of evidence of effect.

Methods:
This randomized, sham-controlled, crossover trial investigated adults 1–2 days after abdominal surgery at Umeå University Hospital, Sweden. The intervention was positive expiratory pressure of 10–15 cm H2O. The control was a sham device. The investigations were ended with deep-breathing maneuvers. Outcomes were the gradient of changes in peripheral oxygen saturation and transcutaneous carbon-dioxide partial pressure (PtcCO2).

Results:
Eighty patients were included and randomized and 76 patients were analyzed. Oxygen saturation increased from a baseline mean of 92% to 95%, P < 0.001, during positive expiratory pressure breathing, while PtcCO2 decreased from a mean of 36 to 33 mm Hg, P < 0.001. This was followed by apnea, oxygen desaturations to a mean of 89%, P < 0.001, and increased PtcCO2 before returning to baseline values. The changes in oxygen saturation and PtcCO2 did not differ from sham breathing or deep-breathing maneuvers.

Conclusions:
Positive expiratory pressure breathing after abdominal surgery improves oxygen saturation during the maneuver because of hyperventilation, but it is followed by apnea, hypoventilation, and oxygen desaturation. The effect is not different from the expiration to a sham device or hyperventilation. It is time to stop positive expiratory pressure therapy after abdominal surgery, as there is no evidence of effect in previous trials, apart from the adverse effects reported here.
Optimizing Parameters for Using the Parallel Auditory Brainstem Response to Quickly Estimate Hearing Thresholds
Authors: Polonenko Melissa J. , Maddox Ross K. 
Published: October 2021

Objectives:
Timely assessments are critical to providing early intervention and better hearing and spoken language outcomes for children with hearing loss. To facilitate faster diagnostic hearing assessments in infants, the authors developed the parallel auditory brainstem response (pABR), which presents randomly timed trains of tone pips at five frequencies to each ear simultaneously. The pABR yields high-quality waveforms that are similar to the standard, single-frequency serial ABR but in a fraction of the recording time. While well-documented for standard ABRs, it is yet unknown how presentation rate and level interact to affect responses collected in parallel. Furthermore, the stimuli are yet to be calibrated to perceptual thresholds. Therefore, this study aimed to determine the optimal range of parameters for the pABR and to establish the normative stimulus level correction values for the ABR stimuli.

Design:
Two experiments were completed, each with a group of 20 adults (18–35 years old) with normal-hearing thresholds (≤20 dB HL) from 250 to 8000 Hz. First, pABR electroencephalographic (EEG) responses were recorded for six stimulation rates and two intensities. The changes in component wave V amplitude and latency were analyzed, as well as the time required for all responses to reach a criterion signal-to-noise ratio of 0 dB. Second, behavioral thresholds were measured for pure tones and for the pABR stimuli at each rate to determine the correction factors that relate the stimulus level in dB peSPL to perceptual thresholds in dB nHL.

Results:
The pABR showed some adaptation with increased stimulation rate. A wide range of rates yielded robust responses in under 15 minutes, but 40 Hz was the optimal singular presentation rate. Extending the analysis window to include later components of the response offered further time-saving advantages for the temporally broader responses to low-frequency tone pips. The perceptual thresholds to pABR stimuli changed subtly with rate, giving a relatively similar set of correction factors to convert the level of the pABR stimuli from dB peSPL to dB nHL.

Conclusions:
The optimal stimulation rate for the pABR is 40 Hz but using multiple rates may prove useful. Perceptual thresholds that subtly change across rate allow for a testing paradigm that easily transitions between rates, which may be useful for quickly estimating thresholds for different configurations of hearing loss. These optimized parameters facilitate expediency and effectiveness of the pABR to estimate hearing thresholds in a clinical setting.
Risk Factors for Development of a Recalcitrant Femoral Nonunion: A Single Surgeon Experience in 122 Patients
Authors: Wiss Donald A. , Garlich John , Hashmi Sohaib , Neustein Adam 
Published: October 2021

Objectives:
The goals of the study were (1) to document the healing rates of femoral nonunions stratified by those that healed as intended, healed after a subsequent intervention, and those that did not heal; (2) to report the prevalence of recalcitrant femoral nonunions and (3) to identify specific demographic, injury, and treatment-related risk factors for the development of a recalcitrant nonunion.

Design:
Longitudinal observational cohort study.

Setting:
Academic Level 1 trauma center.

Patients/Participants:
One hundred twenty-two femoral nonunions treated with either a plate or intramedullary nail by a single surgeon between 1991 and 2018.

Intervention:
Bivariate and multivariate regression analysis were performed to identify specific demographic, injury, and treatment factors in patients who developed a recalcitrant nonunion.

Results:
Although 83.6% of the femoral nonunions eventually healed, only 66% “healed as intended” with 17.2% requiring 1 or more additional procedures to consolidate and 16.4% of nonunions failing to unite. There were no statistically significant differences in the recalcitrance rate when we compared treatment with conventional versus locked plates or primary versus exchange nailing. Risk factors for developing a recalcitrant nonunion were deep infection, current smokers, metabolic bone disease, and patients who had undergone 3 or more prior surgical procedures.

Conclusions:
The use of both intramedullary nails and modern plates were associated with a high rate of recalcitrance. Infection, current smokers, metabolic bone disease, and 3 or more prior surgical procedures were predictors for the development of a recalcitrant nonunion.

Level of Evidence:
Therapeutic Leve IV. See Instructions for Authors for a complete description of levels of evidence.