bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long-term outcomes of EUS-guided lauromacrogol ablation for the treatment of pancreatic cystic neoplasms
Authors: Du Chen , Chai Ningli , Linghu Enqiang , Li Huikai , Feng Xiuxue , Ning Bo , Wang Xiangdong , Tang Ping 
Published: January 2021

Background and Objectives:
We initially reported EUS-guided lauromacrogol ablation (EUS-LA) to treat pancreatic cystic neoplasms (PCNs); however, its long-term effectiveness remains unknown. This study was performed to further determine the effectiveness of EUS-LA in a larger population with a long-term follow-up based on 5 years of experience with EUS-LA.

Materials and Methods:
From April 2015 to April 2020, 279 patients suspected of having PCNs were prospectively enrolled, and seventy patients underwent EUS-guided ablation using lauromacrogol alone. Fifty-five patients underwent follow-up, 35 of whom had a follow-up duration of at least 12 months. The effectiveness of ablation was determined based on volume changes.

Results:
Among the fifty female and twenty male patients with an overall mean age of 50.3 years, cysts were located in the head/neck of the pancreas in 37 patients (52.9%) and in the body/tail of the pancreas in 33 patients (47.1%). The adverse events rate was 3.6% (3/84), with 14 patients undergoing a second ablation. Among the 55 patients who underwent follow-up, the median cystic volume sharply decreased from 11,494.0 mm3 to 523.6 mm3 (P < 0.001), and the mean diameter decreased from 32.0 mm to 11.0 mm (P < 0.001). Postoperative imaging showed complete resolution (CR) in 26 patients (47.3%) and partial resolution (PR) in 15 (27.3%) patients. CR was observed in 18 (51.4%), and PR was observed in 9 (25.7%) patients among the 35 patients followed for at least 12 months.

Conclusions:
EUS-LA was effective and safe for the treatment of PCNs with stable effectiveness based on at least 12 months of follow-up.
Extent of multifocality with corneal manipulation in manual small incision cataract surgery with monofocal posterior chamber intraocular lens implantation
Authors: Bandrakalli Parasappa , Rani Vidya , Yogesh R B , Bagrecha Nirmal Kumar , Pavan G 
Published: January 2021

Purpose:
To compare the visual outcome in terms of multifocality in Manual Small Incision Cataract Surgery (MSICS) with and without intraoperative manipulation of corneal curvature.

Methods:
This was a prospective study on 80 subjects (80 eyes) who underwent MSICS with monofocal posterior chamber intraocular lens (PCIOL) implantation between January 2018 and October 2019. Intraoperative manipulation of corneal curvature using viscoelastics was performed during MSICS in 40 subjects (cases) while this intraoperative manipulation was not performed in the remaining 40 subjects (controls). Uncorrected distance visual acuity (UDVA) and uncorrected near visual acuity (UNVA) were compared at day 1, 7, 30 and 180postoperatively.

Results:
At 1 month and 6 months of follow up, UDVA was comparable in the 2 groups. UNVA was better in cases than controls at 1 month and6 months (P < 0.001). At 6 months of follow up,76% of cases with UDVA of 6/9 or better had UNVA of N8 while only 15% of controls with UDVA of 6/9 or better had UNVA of N8 (P <0.001). Mean near add requirement to achieve a best corrected near vision (BCNV)of N6 at 6 months was significantly lesser (P =0.002) in cases (+2.05 D) compared to controls (+2.43D).

Conclusion:
MSICS with intra operative manipulation of corneal curvature resulted in better unaided near visual acuity compared to that without intra operative manipulation of corneal curvature, without compromising unaided distant visual acuity.
Pathophysiology of Anemia in HIV-Infected Children Exposed to Malaria
Authors: Moraleda Cinta , Aguilar Ruth , Quintó Llorenç , Nhampossa Tacilta , Renom Montserrat , Nhabomba Augusto , Ruperez María , Aponte John J. , Achtman Ariel H. , Mañú Pereira María del Mar , Schofield Louis , Alonso Pedro L. , Macete Eusebio , Menéndez Clara 
Published: January 2021

ABSTRACTAnemia is a common condition in HIV-infected children; however, its pathophysiology and the contribution of frequent causes of anemia such as iron deficiency (ID) and malaria are poorly understood. We carried out an ancillary study on the effect of HIV on anemia as part of a case–control study on risk factors of anemia among Mozambican children aged 1–59 months with documented HIV status. Of them, 390 children were admitted to the hospital with anemia (hemoglobin [Hb] < 11 g/dL), whereas 272 children without anemia (Hb ≥ 11 g/dL) were recruited in the community. We assessed differences by HIV status in the presentation of anemia etiological factors and the effect of HIV infection on the association of each factor with anemia. Among the 99 HIV-infected and 563 uninfected children included, HIV-infected anemic children had an increased risk of undernutrition (P < 0.0001), Epstein–Barr virus infection (P < 0.0001), bacteremia (P = 0.0060), a decreased risk of malaria (P < 0.0001), and a similar risk of ID (P = 0.7371) compared with anemic-uninfected children. HIV-infected children were significantly less likely to have anemia associated with Plasmodium falciparum hyperparasitemia (P = 0.0444) and had a lower prevalence of parasitemia in the bone marrow (BM) (P < 0.0001) than anemic-uninfected children. Levels of BM erythropoiesis and dyserythropoiesis were comparable between groups. These findings suggest that the pathophysiology of anemia among HIV-infected malaria-exposed children is not related to HIV-specific effects. For unclear reasons, HIV-infected children had reduced risk of malaria infection, whereas ID prevalence was comparable in HIV-infected and uninfected children, suggesting that iron supplementation recommendations should not be different in HIV-infected children.
Utility of Fluorine-18 Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in Patients with Visceral Leishmaniasis: Case Report and Literature Review
Authors: Pinnegar Harriet P. , Sánchez-Montalvá Adrián , Barios Profitos Marta , Bosch-Nicolau Pau , Salvador Fernando , Molina Israel 
Published: January 2021

ABSTRACTThe diagnosis of visceral leishmaniasis (VL) is complicated and often unsuspected. Little is known of the usefulness of nuclear imaging in VL. Our objective was to describe findings seen in fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in cases of VL. We retrospectively reviewed VL cases diagnosed at Vall d’Hebron University Hospital from May 2012 to May 2018 and selected those that had an FDG-PET/CT performed. Information on procedures and details of the FDG-PET/CT features and follow-up were collected. We then systematically reviewed the literature on VL and FDG-PET/CT. Four of 43 patients diagnosed with VL had an FDG-PET/CT performed. All four patients presented diffuse splenic uptake of FDG-PET/CT. Adenopathy was not always present, and bone marrow uptake was found in two patients. A posttreatment FDG-PET/CT in one patient revealed normalization of initial findings. In the literature review, 43 of 50 cases presented similar splenic uptake in the PET/CT, being described as different patterns: “increased metabolism,” “homogeneous,” “diffuse,” “diffuse and multifocal,” “nodular,” “patchy and granular,” “subcortical,” and “compatible with lymphoma.” Other frequent findings were bone marrow uptake and adenopathies. We, therefore, conclude that FDG-PET/CT could become a useful tool for the diagnosis and follow-up of VL and that VL should be taken into account in patients with fever of unknown origin with enhanced splenic uptake in FDG-PET/CT. Differential diagnosis in these cases should be made with splenic primary lymphoma, virus infections, chemotherapy, and colony-stimulating factor therapy. Further structured studies with more cases are needed to define its diagnostic and prognostic value.
Knowledge, Attitude, and Practices regarding Leptospirosis among Visitors to a Recreational Forest in Malaysia
Authors: Shafie Nur Juliani , Abdul Halim Najma Syahmin , Nor Zalipah Mohamed , Mohd Amin Nur Amalin Zahirah , Syed Esa Sharifah Masit’ah , Md-Nor Shukor , Casanovas-Massana Arnau , Ko Albert I. , Palma Fabiana , Neves Souza Fabio , Costa Federico 
Published: January 2021

ABSTRACTLeptospirosis is a zoonotic disease and a worldwide public health problem that affects mainly high-risk groups. Characterizing knowledge, attitude, and practice (KAP) among high-risk groups is important to develop appropriate prevention programs. Here, we performed a cross-sectional study among 300 visitors of a recreational forest in Malaysia to examine leptospirosis KAP and demographics. These variables were integrated to create knowledge and practice scores for each respondent. All respondents had heard about leptospirosis, and 87% of them correctly identified it as a disease. The majority of respondents had high knowledge (63%), positive attitude, and good practice (68%) toward prevention of the disease. However, there were gaps in knowledge, with 78% of the respondents indicating eating without washing hands as the major cause of leptospirosis transmission. Our final model identified that higher knowledge score was associated with higher practice score. Our results indicate that it is important to increase knowledge, especially on transmission routes of leptospirosis, among visitors in recreational areas. Moreover, more attention needs to be paid to promote good practice habits among visitors, targeting those at higher risk of being infected by leptospirosis to prevent potential outbreaks in the recreational areas.
Case Report: Spontaneous Carinal Perforation and Bronchonodal Fistula due to Pulmonary Nocardiosis in an HIV-Infected Patient
Authors: Nakwan Narongwit 
Published: January 2021

ABSTRACTIn clinical practice, nocardial infection is a rare opportunistic infection coexisting with potentially life-threatening condition, particularly in patients with HIV infection. Although the incidence remains low, it is still associated with high morbidity and mortality. The lung is a typical site involved in this organism, and complicating conditions can be resulted from local disruption and or destruction of adjacent structures. To our knowledge, this is the first case of pulmonary nocardiosis in an HIV-infected patient who is complicated with spontaneous carinal perforation, leading to develop bronchonodal fistula.
Morbidity among Arab–Israeli and Palestinian Hajj Pilgrims: A Prospective Study
Authors: Fteiha Bashar , Abul Al-Rub Tawfiq , Schwartz Eli , Lachish Tamar 
Published: January 2021

ABSTRACTThousands of Palestinian and Arab–Israeli pilgrims travel to Mecca each year to complete their pilgrimage. To the best of our knowledge, no previous studies have characterized the infectious and noninfectious morbidity among Arab–Israeli or Palestinian Hajj pilgrims. Thus, we designed and conducted an observational questionnaire-based study to prospectively investigate the occurrence of health problems among these Hajjis who traveled to complete their Pilgrimage during 2019 Hajj season. For the purpose of the study, questionnaires were distributed to Hajj pilgrims at three different time occasions—before travel, inquiring on demographics and medical comorbidities; and 1 and 4 weeks after returning recording any health problems encountered during or after travel. Initial recruitment included 111 Hajjis. The mean age of responders was 49.5 (±9.1) years, with a Male:Female ratio of 1.3:1. The mean travel duration was 18.7 (13–36) days. Altogether, 66.3% of the pilgrims reported at least one health problem during and after the trip, of which 38.6% sought medical attention. Five (4.8%) hajjis were hospitalized, including life-threatening conditions. Cough was the most common complaint (53.8%), and 11.5% also reported fever. Pretravel counseling was associated with reduced outpatient and emergency room visits. We therefore concluded that a high rate of morbidity was reported among this cohort of Hajj pilgrims with a morbidity spectrum similar to pilgrims from other countries. Pretravel consultation with the purpose of educating the pilgrims on the health risks of Hajj may help reduce the morbidity for future Hajj seasons.
Impact of Maternal Periodontitis on Preterm Birth and Low Birth Weight in Babies: Results of a Scoping Review
Authors: Uwambaye Peace , Munyanshongore Cyprien , Rulisa Stephen , Shiau Harlan , Nuhu Assuman , Kerr Michael S. 
Published: January 2021

Background
Periodontitis has been documented as public health concern but its association with preterm and low birth weight remains uncertain, thus the objective of this scoping review is to summarize the most recent published evidence related to the impact of periodontitis on preterm birth and low birth weight in order to improve public awareness and to inform policies for oral health during pregnancy.
Methods
Hinari, PubMed, and Google Scholar were searched to acquire the published literature. The retrieved studies included cross-sectional, case control studies and randomized controlled trials with available full text published in English from 2008 to 2019.
Results
After combining the key words, 333 articles were identified with only 133 eligible articles published from 2008 to 2019. After reviewing the available 50 full text articles, duplicates were removed and 15 studies fully met the inclusion criteria. There were 13 articles that supported the association between maternal periodontitis and preterm low birth weight while 2 found no evidence to support the association.
Conclusion
The results of this scoping review contribute to an increasing body of evidence to support the hypothesis that maternal periodontal disease may be a risk factor for preterm delivery and low birth weight.
Rwanda J Med Health Sci 2020;3(3):372-386
Low-dose aspirin promotes osteogenic differentiation and osteogenic activity in osteoporotic rats by regulating Opg/Rankl/Rank Axis
Authors: Zhao Haijiao , Zhao Lei 
Published: January 2021

Purpose: To investigate the effect of low-dose aspirin (ASP) on osteogenic differentiation and osteogenic effects in osteoporotic rats, and the associated mechanism.Methods: The bone marrow mesenchymal stem cells were randomly divided into 4 groups: control group and 3 drug groups treated with graded doses of ASP i.e. 0.5, 1 and 2 mmol/L, with 4 wells in each group. The OPG, RANKL protein expression levels, OPG/RANKL ratio, alkaline phosphatase (ALP) level, and ALP secretion at days 3, 5 and 7 were compared amongst the groups.Results: ALP secretion in BMSCs was markedly higher in the 1 mmol/L ASP group than in control (p < 0.05). The OPG protein concentration and OPG/RANKL ratio were markedly higher in ASP-treated BMSCs than in control, while RANKL protein expression level was significantly lower than that in control (p < 0.05). In BMSCs treated with ASP at doses of 0.5 and 2 mmol/L, OPG protein expression levels and ratio of OPG/RANKL were markedly lower than those in 1 mmol/L ASP group, while the mean level of RANKL protein expression was markedly higher than that in 1 mmol/L ASP group (p < 0.05).Conclusion: Low-dose aspirin increases the expression of ALP, and promotes calcification which relates to upregulation of OPG and inhibition of the OPG/RANKL/RANK axis. This provides new leads for the development of new anti-osteoporosis drugs.
Keywords: Aspirin, OPG, RANKL, RANK, Osteoporosis
Effect of extracts from selected Kenyan plants on traits of metabolic syndrom in Wistar rats fed a high-fat high fructose diet
Authors: Kiage-Mokua Beatrice N. , De Vrese Michael , Kraus-Stojanowic Ina , Nielsen Annegret , Kareru Patrick , Kenji Gaston , Onyango Christine , Roos Nils , Ghadimi Darab , Schrezenmeir Jürgen 
Published: January 2021

Purpose: To examine the potential of extracts from selected herbs used in African traditional medicine in diabetes patients, and to determine their effect on traits of metabolic syndrome in rats fed a high-fat and high-fructose diet.Methods: Ethanol and aqueous extracts were prepared from Mangifera indica (MI), Lonchocarpus eriocalyx (LE), Urtica massaica (UM), Schkuhria pinnata (SP) and Launaea cornuta (LC). Ethanol extracts (1:100 dilution) were examined for inhibition of pancreatic lipase and α-glucosidase activity invitro. Furthermore, aqueous extracts were administered for 74 days to male Wistar rats fed a high-fat and high-fructose diet to assess their effect on traits of metabolic syndrome.Results: Ethanol extracts showed at least 30 % inhibition of pancreatic lipase in vitro but no effect on α- glucosidase activity. Administration of the aqueous extracts caused significant reduction in liver triglycerides (except for LE). Muscle triglycerides and fat were also reduced, with the most pronounced effect elicited by LE. Urinary glucose excretion and plasma triglycerides, but not hyperinsulinemia and insulin resistance, were reduced by UM compared to control.Conclusion: This exploratory study indicates that UM may be considered a candidate for the prevention and management of type 2 diabetes.
Keywords: Kenyan traditional medicine, High-fat diet, High fructose, Insulin resistance, Triglycerides, Diabetes, Liver steatosis
Medication Adherence and Health Status in HIV Positive Patients in Akwa Ibom State, Nigeria
Authors: Jackson Idongesit L. , Umoh Samuel S. , Erah Patrick O. 
Published: January 2021

Purpose: To assess medication adherence and health status in ambulatory HIV positive patients in Akwa Ibom State, Nigeria.Methods: The 7-item Adherence to Refills and Medication Scale (ARMS-7) was used to assess medication adherence among 500 HIV positive patients in three secondary health facilities in Akwa Ibom State, Nigeria. A single-item question (measuring self-rated health) and depression (CESD-R) questionnaire were also used to evaluate the patients. Recent CD4 count and viral load were obtained from the patients’ folders. The association between independent and dependent variables was evaluated using logistic regression analysis.Results: Only 56 (11.7%) respondents reported 100% adherence to their medications; 190 (39.7%) rated their health as being ‘very good’ and 51 (10.7%) reported being depressed. Respondents who were single were more likely to be nonadherent (aOR = 2.665, 95% CI = 1.336 - 5.318; p = 0.005), and the nonadherent patients were more likely to have lower CD4 cell counts (aOR = 0.998, CI = 0.996 – 0.999; p = 0.007). Those who rated their health as ‘fair’ or ‘poor’ were more likely to be nonadherent (aOR= 11.380, CI = 1.527 – 84.785; p=0.018) and depressed (aOR = 2.748, CI = 1.469 – 5.141; p = 0.002). Patients who were unemployed were more likely to rate their health as fair/poor (aOR = 1.890, CI = 1.197 – 2.985; p=0.006).Conclusion: This work has shown that even though most of the HIV positive patients perceive their health as being very good, their adherence to medications was poor which is directly related to their unemployment status. Intervention to improve adherence directed at socio-economic status of the individual patient is recommended.
Keywords: Medication adherence; Depression; Self-rated health; Nigeria
Protective effect of Salvia miltiorrhiza in rheumatoid arthritis patients: A randomized, single-blind, placebocontrolled trial
Authors: Yuan Zheng , Zhao Changsong , Zhang Qiang , Gao Zhengrong 
Published: January 2021

Purpose: To study the protective effect of Salvia miltiorrhiza (SM) against rheumatoid arthritis (RA) in RA patients.Methods: Sixty RA patients were divided into two groups: SM (n = 30) and placebo (n =30) groups given SM at a dose of 250 mg/kg (3 capsules/day), and placebo (3 capsule/day), respectively, for 12 weeks. Patient responses based on American College of Rheumatology (ACR), health assessmentquestionnaire (HAQ) score, and global assessment of disease (GAD) were recorded. Moreover, Disease Activity Score (DAS) 28, pain score (visual analogue score, VAS), rheumatoid factor (Rh factor), and inflammatory cytokines (markers) were determined.Results: After 12 weeks of intervention with SM, ACR20 (30 %)/ACR50 patient response (13.3%, i.e., score for swelling and tenderness of joints), was significantly improved. There were considerable reductions in GAD, HAQ, DAS 28, pain score (VAS), and levels of erythrocyte sedimentation rate(ESR), acute phase reaction protein (CRP), Rh factor (IgM) and inflammatory cytokines (IL-1β, IL-6 and TNF-α), when compared to placebo (p < 0.01). Treatment with SM produced milder adverse effects than treatment with placebo (p < 0.01).Conclusion: Overall, SM produces better anti-RA effect than placebo by significantly altering ACR patient response, reducing GAD, HAQ, DAS 28 scores, Rh factor, ESR, CRP and inflammatory cytokines in RA patients. However, a large-scale clinical trial is needed before SM can be recommended for combating RA and its related symptoms.
Keywords: Salvia miltiorrhiza, Rheumatoid arthritis, DAS 28, Adverse effect
Characterization and evaluation of the performance of starch and cellulose as excipients for direct compression technique
Authors: Alyami Hamad S. , Abu-Alrub Samer S. , Mahnashi Mater H. , Alyami Mohammad H. , Al Meanazel Osaid T. 
Published: January 2021

Purpose: To investigate the influence of two often-used excipients (starch and microcrystalline cellulose) on the physical properties of powder blends and tablets that contain mannitol as diluent.Methods: Powder and powder mixtures of three commonly used excipients (starch, mannitol and microcrystalline cellulose) were thoroughly examined using the angle of repose for flowability, particle size analyzer to determine the diameter of the particles, scanning electron microscopy (SEM) for morphological assessment, and x-ray diffraction to determine crystalline/amorphous characteristics. Tablets were prepared by direct compression technique and were evaluated for mechanical strength and disintegration behavior as part of quality control test.Results: The results showed that increase in MCC concentration of the mixture leads to significantly enhanced flowability (p < 0.05) when compared to starch. The angle of repose for mannitol/MCC powder mixture with 70 % w/w MCC was approximately 29°, indicating good flow properties of thepowder mix. Moreover, starch tablets containing MCC exhibited better mechanical strength and longer disintegration time, while, at 1:1 ratio of MCC and mannitol, tablet disintegration was faster (33.0 ± 5.2s)Conclusion: MCC (at 30 %w/w in the blend) produces optimal flow of the powder blend and superior mechanical strength,
Keywords: Tablet disintegration, Flowability, Starch, Hardness, Mechanical strength
Down-modulation of endoplasmic reticulum stressinitiated apoptosis by huperzine A in isoproterenolprovoked myocardial infarction rat model: Role of Nrf2/HO- 1 signaling axis
Authors: Li Zhongkui , Gao Lufang , Xiang Daokang , Liu Wenbo 
Published: January 2021

Purpose: To investigate the myocardial protective effect of huperzine A (HPA), a sesquiterpene alkaloid, in a rat model of isoproterenol (ISP)- provoked MI and ER stress.Methods: Three groups of rats were used: control, ISP and ISP+HPA groups. The following indices were assayed using standard protocols: oxidative stress parameters, including NADPH oxidase 4 (NOX4), reactive oxygen species (ROS), nuclear factor erythroid 2-related factor 2 (Nrf2), and heme oxygenase-1 (HO-1); indices of calcium homeostasis, namely, sarcoplasmic and endoplasmic reticulum calcium ATPase isoform 2a (SERCA2a); ER stress parameters, viz, protein kinase R (PKR)-like endoplasmic reticulum kinase (PERK), glucose-regulated protein 78 (GRP78), and C/EBP homologous protein (CHOP); and indices of apoptosis, i.e., B-cell lymphoma 2 (Bcl-2), Bcl-2-associated X protein (Bax) and caspase-12].Results: Oxidative/ER stress and cardiomyocyte apoptosis were up-modulated (p < 0.05), while SERCA2a, a key calcium handling channel, was downmodulated in the ISP group (p < 0.05). In contrast, HPA treatment ameliorated these ISP-induced myocardial aberrations. (p < 0.05).Conclusion: These results indicate that HPA might be a potential therapeutic candidate for MI and associated cardiac problems.
Keywords: Caspase-12, ER stress, Huperzine A, Myocardial infarction, SERCA2a