bluuebunny/crossref_metadata_2025_split huggingface dataset:
Retrospective Study about the Prevalence of (TILs) Tumor Infiltrating Lymphocytes in Non-Metastatic Triple Negative Breast Cancer Patients and its Prognostic Value
Authors: ElGhazaly Hesham Ahmed , El-Mahdy Manal Mohamed , Adel Azza Mohamed , Mostafa Nermeen , Ali Aya Magdy Kamal 
Published: October 2021

Abstract

Background
TNBC comprises a distinct disease entity with a unique microenvironment of TILs, the immunogenic potential of TNBC is derived from its genetic instability and high mutation rate. Tumors from patients with TNBC are more likely than tumors from patients with other subtypes to exhibit chromosomal instability and potential mutations.

Objectives
The study aims to evaluate the prevalence of CD8+ TILs biomarker by IHC in triple negative breast cancer and its prognostic value. TILs are an important prognostic value for the response of patient to chemotherapy the greater number of TILS is associated with higher probability of response to chemotherapy also decrease recurrence. TILS in triple negative breast cancer suggest a likely option for immunotherapy in this disease.

Patients and Methods
This is a retrospective study, which was carried on 30 female patients, Clinical data and paraffin wax block of female patients with triple negative breast cancer are to be collected from the breast cancer unit, department of clinical Oncology and Nuclear medicine Ain Shams university and Matarya teaching hospital.

Results
Several large systematic reviews and meta-analyses have confirmed that high levels of TILs are associated with better disease free survival and overall survival only in triple negative and HER2 positive subtypes, with no significant benefit seen in estrogen receptor positive breast carcinoma. In the Breast International Group (BIG) 02-98 trial shows that for every 10% increase in the intertumoral TILs there was a 17% reduced risk of relapse, and 27% reduced risk of death regardless of chemotherapy type. Also in eastern cooperative oncology group trial (ECOG) 2197, and 1199 showed that for every 10% increase in TILs, a 14% reduction of risk of recurrence, and 19% reduction in risk of death were observed.

Conclusion
Our study showed that All our patients (100%) were positive for CD8+, with a minimum range of 1% and a maximum range of 60%, most of the patients (20 patients) had CD8% between (10% to 20%). High levels of CD8 + TILs are good prognostic indicators in TNBC. our study showed that there were associations of CD8+ TILs infiltrate status with longer progression free survival and better overall survival in triple-negative breast cancer, but were not statistically significant probably due to our small sample size.
Effect of Delay in Initiation of Adjuvant Trastuzumab and Dose Interruptions on Overall Treatment Outcome in Breast Cancer Patients, a Retrospective Study
Authors: Riad Atef Youssef , Alkhateeb Azza Mohammed Adel , Kelany Mohammed Reda , Al-Shater Mohammed Al-Saeed Sakran Ali 
Published: October 2021

Abstract

Background
HER2 amplification or protein over-expression is found in 20% of invasive breast cancers. It’s clearly associated with accelerated cell growth and proliferation and poor clinical outcome. The amplification of HER2 was historically an adverse prognostic factor associated with a higher risk of recurrence, lack of or lower levels of ER expression, and relative resistance to endocrine therapy and CMF based chemotherapy.

Objectives
We aimed in this study to assess the impact of delaying the initiation of adjuvant Trastuzumab for more than three months after the diagnosis of breast cancer and the effect of irregular and interrupted doses of adjuvant Trastuzumab, on progression free Survival, relapse, and overall survival (OS) among patients with breast cancer.

Patients and Methods
A Retrospective cohort study was conducted in Ain Shams University Hospitals. The study included one hundred patients with HER2 positive breast cancer. from January 2011 till December 2016 at the" Department of Clinical Oncology and Nuclear Medicine, Ain Shams University Hospitals".

Results
The median time to progression in group I was 19 months compared to 30 months in group II. There was statistically significant decrease median of group I compared to group II according to PFS.

Conclusion
We concluded that delays in the initiation of adjuvant treatment may be particularly harmful in patients with more aggressive tumor types.
Evaluation of the Clinical Outcomes of Altered Fractionated Radiotherapy in Node Positive Breast Cancer (A Retrospective Study)
Authors: Muhammad Sahar Abdel-Hameed , Gado Nivine Mahmoud Ahmed , El-Lithy Mahmoud Abbas , Saleh Mohammed Essam 
Published: October 2021

Abstract

Background
Hypofractionated radiotherapy schedules provide alternative shorter courses of radiotherapy of more than 2 Gy per fraction and lower total doses compared to the conventionally fractionated schedule of 1.8–2.0 Gy per fraction in 25 fractions.
Hypofractionated radiotherapy offers the advantage of improving patients’ convenience and reducing cost and resource requirements.

Aim
To evaluate the efficacy and toxicity of hypofractionated radiotherapy compared to the conventional schedule.

Methods
In this retrospective study, the clinical data of 140 patients of node positive breast cancer patients were analyzed. Radiation toxicities and locoregional recurrence were compared between patients who received conventionally fractionated radiation schedule and those who received hypofractionated radiation schedules.

Results
After a median follow-up of 48 months, the incidence of loco-regional recurrence was comparable between the conventional and hypofractionated arms; 4% vs
3.1%, respectively (P-value = 0.769). Documented acute skin toxicity with ≥ grade 3 was found in 10.6% of the conventional group and in 5.6% of the hypofractionated group (p = 0.409).
Grade 1 late lung toxicity was manifested in 6.1% of the conventional group and 7.5% of the hypofractionated group and G2 lung toxicity was found in one case only (1.9%) in the hypofractionated group (p = 0.596). Cardiac toxicity was documented in five cases; 9.4% and 5.1% in the conventional group and hypofractionated groups, respectively (pvalue=0.486).

Conclusion
Hypofractionated radiotherapy is comparable to conventional radiotherapy regarding locoregional tumor control and treatment toxicities.
Denervation of the Wrist Joint and Its Long Term Effect
Authors: El-Mahy Mohammed Mostafa , Mohammed Amr Moustafa , Attia Ahmed Reda 
Published: October 2021

Abstract

Background
The wrist joint is a common site of traumatic, degenerative and inflammatory disease that, when symptoms are severe, can be treated by partial or complete arthrodesis, arthroplasty and/or wrist denervation.

Aim of the Work
to review systematically studies about total and partial wrist denervation for chronic painful wrist conditions and meta-analyze the long term improvement.

Materials and Methods
Literature searches was conducted using the following databases: "PubMed, Ovid, Web of Science, Science Direct, Scopus, Cochrane Library, Google Scholar, Medline" using the following key words: wrist joint, total denervation, partial denervation for published studies.

Results
This study provides long-term data regarding the outcomes of partial and total wrist denervation. We have found that this is a reliable motion preserving procedure for patients with chronic wrist pain. In the series, 85% and 70% of patients did not undergo revision surgery at average follow-up of approximately 54.7 months and 47.5 months in total and partial denervation respectively.

Conclusion
Denervation is a relatively quick procedure with low complication rates and does not preclude salvage procedures if pain persists. It has been shown that neurectomy of the articular branches is possible without any injury to the important sensory and motor nerves of the hand. Total denervation of the wrist is a useful method for treating wrist pain when other choices compromise functional capacity or a long period of post-operative recovery is not desired.
Unicompartmental knee arthroplasty versus High tibial osteotomy in treatment of isolated medial compartment Osteoarthritis of knee: A Systematic Review and MetaAnalysis
Authors: El-Ganzoury Ibrahim Mostafa , Zakaria Zeiad Mohamed , Elsayed Ahmed , Elwarwary Abd Ellah 
Published: October 2021

Abstract

Background
Several surgical procedures have been mentioned to treat medial compartment osteoarthritis (OA), as total knee arthroplasty (TKA), unicompartmental knee arthroplasty (UKA) and high tibial osteotomy (HTO).

Objectives
The aim of the study is a systematic review & meta analysis conducted to compare the outcomes between UKA & HTO in different types of patients diagnosed as an isolated medial compartment OA who treated with UKA or HTO and statistically compare between their results of pain, range of motion, complications, and i ncidence of revision to TKA using studies published between 2009 to 2019 from any country.

Patients and Methods
The review will be restricted to Randomized controlled trials (RCTs), clinical trials, and comparative studies, either prospective or retrospective, which studied the outcome of HTO versus UKA of isolated medial compartment osteoarthritis patients, articles published in English &published during 2009 to 2019.

Results
About 150 articles were found using search keywords. By filtration and screening of the title and exclusion of unrelated articles, about 60 articles were found. By applications of all inclusion and exclusion criteria, only 12 articles were fit to undergo this meta-analysis.

Conclusion
In conclusion, there were no significant differences in the pain score, knee score, complication rate and revision rate to TKA between HTO and UKA, while the HTO group manifested superior ROM compared to the UKA group. So, HTO may be convenient for patients with high activity requirements. Over time, both groups exhibited increased revision rates with the deteriorated clinical outcomes. Therefore when deciding on a therapeutic plan, the ability to revise these failed choices of treatment to a total knee arthroplasty should be a major consideration. This may assist surgeons in their choice. Based on the findings of current meta-analysis, it appears that the two groups have the same efficiency and safety in the treatment of medial knee OA.
Dynamic Locked Plating of Distal Femur Fractures
Authors: Thakeb Mootaz Fouad , Elbeshry Shady Samir , Basuony Amr Mostafa Ismaeil 
Published: October 2021

Abstract

Background
Distal femur fractures account for less than 1% of all fractures and 3%– 6% of all femur fractures. Epidemiological studies indicate 2 primary distributions of patients: elderly individuals with low energy mechanisms such as a fall from standing, and younger patients with high-energy mechanisms such as motor vehicle accidents. Fixation of the distal femur fracture with lateral locked plate had a nonunion rate between 0 to 32%. The concept of “Dynamic” Locked Plates, has been proposed to decrease construct stiffness & improve callus formation.

Objective
A systematic review and meta-analysis of literature to assess the outcomes of dynamic locked plate of distal femora fractures.

Data Sources
Medline databases (PubMed, Medscape, ScienceDirect. EMF-Portal) and all materials available in the Internet till 2018.

Data Extraction
If the studies did not fulfill the inclusion criteria, they were excluded. Study quality assessment included whether ethical approval was gained, eligibility criteria specified, appropriate controls, and adequate information and defined assessment measures.

Conclusion
Our systematic review and meta-analysis showed different method of distal femur locked plate dynamyzation. DLP of distal femur increased interfragmentery micro motion, decrease construct stiffness and improve healing & union rate of distal femur fractures. Finally it should be noticed that the orthopedic surgeon should be qualified to utilize either techniques & the choice depends on the preoperative planning & method of fixation available which leads to fracture union on time without complications.
Endoprosthetic Proximal Femoral Hemiarthroplasty Versus Total Hip Endoprosthetic Reconstruction After Proximal Femoral Resections in Young Adults
Authors: Mostafa Mohamed Abdel Rahman , Azmy Sherif Ishak , Rashid Kyrillos Magdy 
Published: October 2021

Abstract

Background
Metastatic tumors are the most common malignant lesion of the proximal femur, with carcinomas being the most frequent. The proximal femur and midfemur are common sites for primary bone sarcomas; approximately16% of Ewing's sarcomas, 13% chondrosarcomas and 10% of osteosarcomas develop at these locations. The major aim in the management of patients who have bone malignancies is prolonging their survival. Primary bone sarcomas that require surgical resection can be treated by either amputation or limb salvage. Most studies which compared both approaches reported that limb salvage had no adverse effect on patients’ survival on long-term.

Objective
This is a systematic review of literature with meta-analysis study that compare the functional outcomes and complications of the methods; proximal femoral hemi versus total arthroplasty after proximal femur resection followed by endoprosthetic reconstruction and provide recommendations by the best available evidence.

Methods
We included Randomized control trails (RCTs), including cluster RCTs, controlled (non-randomized) clinical trials or cluster trials, prospective and retrospective comparative cohort studies, and case-control or nested case-control studies and controlled clinical trials. We excluded cross-sectional studies, case reports, review articles, letters to the editor, meeting abstracts, and technique papers. Search results conducted to systematic review management software and manually screened for eligibility were included. Critical appraisal checklist was used to assess the search results based on the inclusion/exclusion criteria.

Results
Twenty-three studies are included. Quality appraisal demonstrated that all but one study is retrospective. The pooled results from the meta-analysis showed that the rate of aseptic loosening was only 2% when reconstruction occurs with endoprosthetic proximal femoral hemiarthroplasty. There was unimportant heterogeneity in the included studies. The rate of conversion to total hip arthroplasty (THA) is 4.6% to 8% of oncological patients. The rate of periprosthetic fracture was only 1%

Conclusion
Proximal femoral endoprosthesis has definitive benefits in the treatment of primary or metastatic tumors affecting the proximal femur. The implants tend to improve the function and quality of life of patients with metastatic disease and high-grade localized disease. It also provides them with a relatively pain-free limb with good functional capacity. With continuing advances in the surgical and oncological fields, there is a great potential for curative limb salvage surgery in the long term. Reconstruction with endoprosthetic Proximal femoral hemiarthroplasty after proximal femoral resection in young adults can confer additional stability with a reduced dislocation rates and systemic complications as compared to total hip arthroplasty.
Evaluation of the role of platelet gel in promoting healing of phalangeal fractures after fixation by Kirschner wires
Authors: Al Sabbagh Asmaa A , Farid Ashraf M , El Rouby Mohamed A , Abdalmaksoud Sarah A 
Published: October 2021

Abstract

Background
Autologous Platelet gel may become an ideal autologously prepared biologic blood-derived product that can be exogenously applied to a diversity of tissues, in which it releases high concentrations of platelet growth factors that enhance healing.

Aim of the Work
to evaluate the role of platelet gel in promoting healing in phalangeal fractures.

Patients and Methods
This study was conducted on 20 Patients were operated either by general or local anesthesia in a prospective interventional study for: evaluation the role of platelet gel in promoting healing of phalangeal fractures after fixation by Kirschner wires.

Results
In this study: clinical and radiographic signs of healing at 12wks were achieved in 70% of studied patients and 16wks were achieved in 30% of studied patients and early improvement of swelling and tenderness.

Conclusion
The use of Autologous platelet gel in phalangeal fractures after fixation by Kirschner wires gives a significant improvement quickly over the periods according to swelling, tenderness and x-ray healing So decrease recovery time and return to work and activities.
Correlation of Intravenous Vitamin C Injection and Plasma Albumin Level in Burnt Rats (Experimental Animal Study)
Authors: Farid Ashraf Maher , Kamel Ibrahim Hussein , Amin Ebrahim Mohamed , Dief Aya Ibrahim Abdullah Khalifa 
Published: October 2021

Abstract

Background
Burn is tissue injury caused by heat, radiation, electricity, contact with hot objects or chemicals. It’s a global public health problem accounting for an estimated 180000 death annually according to WHO.

Aim of the Work
To detect the efficacy of intravenous vitamin C and plasma albumin level in burnt rats.

Materials and Methods
This study was an experimental study on 14 rats only not including any human and they were divided into two groups: Group A that represented burnt rats that won’t be injected with parenteral vitamin C and Group B represented burnt rats that will be injected with parenteral vitamin C.

Results
There was no statistically significant difference found between two groups regarding albumin level and total proteins level before burn and Post burn 8h. There was highly statistically significant difference between Albumin level and total proteins level before Burn, Post Burn 8h level and Post Burn 24h level.

Conclusion
It is concluded that vitamin C holds potential as a powerful adjunct in burn resuscitation and it may be safe and decreases fluid requirement in the acute phase after burn injury.
The Role of FDG-PET/CT in Staging of Breast Cancer
Authors: Mansour Hesham M , Neyazy Gamal Eldeen M , Abdel Khaleq Yasser I , Elnaggar Ahmed M 
Published: October 2021

Abstract

Background
Breast cancer is the most common non-skin cancer and the second leading cause of cancer related death in women. Breast cancer strikes women of all ages, races, ethnicities, socioeconomic strata, and geographic locales. Once breast cancer is diagnosed, the tumor stage has to be accurately determined before therapy chosen and the prognosis known.

Aim of the Work
to highlight the role of PET-CT imaging in staging of patients with breast cancer.

Patients and Methods
This study was carried out on a total of 51 female patients biopsy-proved to have cancer breast coming to perform PET/CT scans for staging, pre-operative or pre-therapeutic assessment with ages ranging from 27 to 78 years, in specialized private center in Cairo using combined PET-CT machine (Phillips Ingenuity TF PET/CT 128 Slice) from October 2017 to June 2019.

Results
Combined PET/CT staged 3 patients as stage IA, 10 patients as stage IIA, 6 patients as stage IIB, 2 patients as stage IIIA, 3 patients as stage IIIB, 2 patients as stage IIIC and 25 patients as stage IV. Out of 51 patients, combined PET/CT upgraded the staging of 13 patients compared to initial CT staging.

Conclusion
PET/CT is the technique of choice and indispensable tool for evaluation of the patients with breast cancer.
Ultrasound predictive criteria for short term benign thyroid nodular volume reduction after ultrasound guided radiofrequency ablation
Authors: Shehab Khaled Fikry Tawfik , Hussein Ahmed Mohamed , Khattab Rasha Tolba 
Published: October 2021

Abstract

Purpose
This study evaluates the outcome of patients complaining of compressive& cosmetic problems due to benign thyroid nodules after recieving RF ablation with correlation between some ultrasound features of the nodules and their shrinkage and volume reduction.

Methods and material
fifteen patients with benign thyroid nodules causing compressive symptoms (foreign body sensation,neck discomfort or pain) and cosmetic problems.

Results
A total of 15 patients were included with the age rangmg from 22-82 years old the mean was 52.73 years old (SD + 14.37).Among them 12 patients (800 0)were females and 3 patients(20%) were males. There was statistically significant difference between volume of nodules before the procedure with mean volume was 21.13±5.13 and I month after with mean volume I I .96±3.08 and 3 months after the procedure with mean volume 7.70±2.82 with noticeable improvement in nodules with peri and intranodular vascularity showing mean reduction ratio 69.88% after 3 months vs 59.93% and 64 12% of weak peripheral vascularity and intense intra-nodular vasculanty respectively as well as US structure with spongiform nodules showing mean reduction ratio 68.48% at 3 months vs 59.87% and 62.14% for solid &mixed nodules respectively.Mean symptoms and cosmetic score were significantly reduced. Conclusion: This study validated the efficacy and safety of RFA for treatment of benign thyroid nodules and showed correlation between shrinkage and some common US findings.
Knee pain: Ultrasound and MRI correlation
Authors: Eldin Mahmoud Mustafa Mohamed Kamal , HamdyNasef Hana , Shalaby Mennatallah Hatem 
Published: October 2021

Abstract

Background
Knee pain incidence is increasing among the community which has different multiple pathologies. Magnetic Resonance Imaging (MRI) is considered the gold standard imaging modality in diagnosing knee soft tissue injury. Ultrasound (US) is another modality which can be used in diagnosing soft tissue injury.

Aim of the Work
is to detect the reliability of US in diagnosing cases with knee pain as compared to MRI.

Patients and Methods
A prospective study was conducted on 20 patients with knee pain. They were referred from the Orthopedic and/or Rheumatology Department to Radiology department at Ain Shams University hospitals for MRI and US examination of the knee.The age group were from 19 to 59 years.

Results
In this study, 20 patients were examined with majority being males (75%). US was tested against MRI for different soft tissue pathologies.including knee effusion, meniscal pathology (tear, degeneration and extrusion), medial collateral ligament sprain, lateral collateral ligament sprain and Baker’s cyst. There was good agreement between US and MRI in most of these pathologies. US showed an overall sensitivity of 61.7% and specificity of 92.7% with accuracy of 86.9%. The overall PPV and NPV were 66.1% and 91.3% respectively.

Conclusion
Ultrasound can be considered a reliable screening imaging modality in cases of knee pain.