bluuebunny/crossref_metadata_2025_split huggingface dataset:
Good pregnancy outcomes in lupus nephritis patients with complete renal remission
Authors: Chen Yinghua , Li Kang , Zhang Haitao , Liu Zhengzhao , Chen Duqun , Yang Liu , Hu Weixin 
Published: October 2021

ABSTRACT

Background
The aim of this study was to investigate pregnancy outcomes and risk factors in patients with lupus nephritis (LN).

Methods
A total of 158 pregnancies in 155 women with LN were divided into a remission group and a control group according to whether they achieved complete renal remission (CRR) prior to pregnancy. The adverse pregnancy outcomes and risk factors were retrospectively analyzed.

Results
In the remission group, 130 LN patients with 133 pregnancies (two twin pregnancies) delivered 127 live births; 25 LN patients with 25 pregnancies delivered 19 live births in the control group. Compared with the control group, the remission group had significantly lower incidence of LN relapse, fetal loss and premature birth. For LN patients in the remission group, a CRR duration &lt;18 months [odds ratio (OR) 11.24, 95% confidence interval (CI) 2.95–42.80, P &lt; 0.001] and anti-C1q antibody positivity before pregnancy (OR 7.2, 95% CI 1.38–37.41, P = 0.019) were independent risk factors for LN relapse; anti-phospholipid antibody positivity (OR 9.32, 95% CI 1.27–68.27, P = 0.028) and prednisone dosage during pregnancy ≥12.5 mg/day (OR 3.88, 95% CI 1.37–10.99, P = 0.011) were independent risk factors for fetal loss and premature birth, respectively; and age &gt;30 years was an independent risk factor for preeclampsia and premature birth.

Conclusion
LN patients with a CRR duration greater than 18 months were associated with good pregnancy outcomes and lower LN relapse. Age, anti-C1q and anti-phospholipid antibodies, and prednisone dosage during pregnancy were risk factors for adverse pregnancy outcomes.
Local Tobacco 21 Policies are Associated With Lower Odds of Tobacco Use Among Adolescents
Authors: Wilhelm April K , Kingsbury John H , Eisenberg Marla E , Shyne Michael , Helgertz Sharrilyn , Borowsky Iris W 
Published: October 2021

Abstract

Introduction
Tobacco 21 (T21) policies have shown promise in reducing cigarette use among adolescents. This study examined whether local T21 policies affected adolescent use of a variety of tobacco products and whether results differed by grade level.

Methods
We used repeated cross-sectional data from eighth, ninth, and eleventh-grade respondents to the 2016 (n = 107 981) and 2019 (n = 102 196) Minnesota Student Surveys. Generalized estimating equations modeled eight adolescent tobacco use outcomes in 2019 (past 30-day use of any tobacco, cigarettes, cigars, e-cigarettes, hookah, chewing tobacco, flavored tobacco, and multiple products) by T21 exposure, defined as respondents’ attendance at a school within a jurisdiction with T21 policy implementation between the two surveys. Models controlled for demographic characteristics and product-specific baseline tobacco use at the school level in 2016 and were stratified by grade.

Results
After adjusting for baseline tobacco use and other demographics, T21-exposed eighth and ninth-grade students had significantly lower odds of tobacco use than unexposed peers in five of eight models, i.e. any tobacco (aOR = 0.80, 95% CI: 0.74, 0.87), cigarettes (aOR = 0.81, 95% CI: 0.67, 0.99), e-cigarettes (aOR = 0.78, 95% CI: 0.71, 0.85), flavored tobacco (aOR = 0.79, CI: 0.70, 0.89), and dual/poly tobacco (aOR = 0.77, 95% CI: 0.65, 0.92). T21-exposed eleventh-grade students did not differ significantly in their odds of any tobacco use outcomes relative to their unexposed peers.

Conclusions
T21 exposure is associated with lower odds of multiple forms of tobacco use, particularly among younger adolescent populations, supporting the implementation of T21 policies to reduce tobacco use in this population.
Brucellosis Initially Misidentified as Ochrobactrum anthropi Bacteremia: A Case Report and Review of the Literature
Authors: Gopalsamy Srinivasa Nithin , Ramakrishnan Aditi , Shariff Mustaf M , Gabel Julie , Brennan Skyler , Drenzek Cherie , Farley Monica M , Gaynes Robert P , Cartwright Emily J 
Published: October 2021

Abstract
Automated identification systems may misidentify Brucella, the causative agent of brucellosis, which may be re-emerging in the United States as the result of an expanding feral swine population. We present a case of Brucella suis likely associated with feral swine exposure that was misidentified as Ochrobactrum anthropi, a phylogenetic relative.
An Experimental Study of Trace Element Partitioning between Peridotite Minerals and Alkaline Basaltic Melts at 1250°C and 1 GPa: Crystal and Melt Composition Impacts on Partition Coefficients
Authors: Ma Shuai , Shaw Cliff S J 
Published: October 2021

Abstract
Peridotite–magma interaction is important in establishing magma pathways through the mantle and in metasomatism of the lithospheric mantle. Reactions that consume orthopyroxene and produce olivine and clinopyroxene are of particular interest because these reactions should lead to a redistribution of trace elements between the solid and melt phases at equilibrium. This study examines interaction of a silica-undersaturated alkaline basalt (basanite) with a range of peridotite compositions from dunite, through harzburgite to wehrlite at 1250°C and 1 GPa. Our experiments used the natural concentration of trace elements in the starting materials which allowed us to measure mineral—olivine partition coefficients for Rb, Ca, Co, Sr, Sc, Ct, Y, Ti, V and Zr. For orthopyroxene—and clinopyroxene—melt we additionally measured partitioning of Cs, Ba, all rare earth elements (REE; except Pm), Hf, Th, U, Nb and Ta. We show that there are subtle variations in the partition coefficients, particularly of the REEs that are related to the bulk composition of the system. We also show that with the exception of cations that can have multiple valence states, e.g. vanadium, the lattice strain model and in particular the double fit routine gives excellent agreement between the calculated and experimentally determined partition coefficients. The double fit model allows us to examine the effect of mineral composition on partitioning such that we can show preference of trace elements for the M1 and M2 sites in the pyroxenes. Although our results are similar to those of previous studies, there are two main differences: first we have a complete set of partition coefficients for every trace element that is measurable by LA-ICPMS in our starting material, where previous studies may be missing one or more elements in particular one or more of the middle REE in the pyroxenes Second, we show that although partition coefficients for trace elements in orthopyroxene are comparable between this and previous studies, the REE in clinopyroxene are typically a factor of 2–3 lower in this study. We also note that are correlations between partition coefficient and the composition of olivine, orthopyroxene, clinopyroxene and glass (melt). The relation of partitioning to melt composition suggests that some further development of the lattice strain model is needed. Finally, we show that there is agreement between our measured partition coefficients and those predicted from parameterized models of clinopyroxene–melt partitioning, however, there are unresolved differences that may result from differences in the substitution mechanisms of trace elements in M1 vs. M2 sites in clinopyroxene that are in part related to the composition of the coexisting melt.
Effect of Prenatal Administration of Retinoic Acid on Developing Spinal Cord of Albino Rats
Authors: Sherif MarwaSaad , TawfikKamal Mohamed , Refat Seham , El Gazzar Mona , Hana Gorge , El Sawy Marwa M 
Published: October 2021

Abstract

Background
Vitamin A and its derivatives (Retinoids) are essential for both normal embryonic development and maintenance of differentiation.Retinoids is a well-known teratogen when administered to embryos

Aim
to investigate the structural changes induced by prenatal administration of vitamin A on the developing spinal cord of albino rats.

Material and methods
forty pregnant albino rats were exposed to variable doses of vitamin A (retinylpalmitate) on gd 10.The pregnant albino rats were divided into three groups: Group I (control): rats received sesame oil by oral gavagedaily, till date of delivery. Group II (minimum therapeutic dose): rats were given retinylpalmitate 50 mg/kg daily. Group III (maximum therapeutic dose): rats were givenretinylpalmitate 100 mg/kg daily. The viable offspring of all groups were evaluated for changes in developing spinal cord at PND10. At the end of the experiment, rats offspring were sacrificed, the spinal cord were dissected out, and subjected to histological examination followed by computer image analysis.

Results
PDN10 neonates of mothers received minimum dose of vitamin A (subgroup II) revealed few immature irregular dorsal horn neurons with relatively decreased cellular density in anterior horn neurons. Meanwhile, the PDN10 neonates of mothers received daily maximum therapeutic dose of vitamin A (subgroup III) exhibited dark,pyknotic nucleiand packed dorsal horn cells while anterior horn cells were shrunkenandkaryoliticnuclei.

Conclusion
minimum and maximum doses of vitamin A in pregnant rats attributed to morphological changes in spinal cord of their young neonates and in long term follow up which was more obvious in maximum dose than low intake. Therefore, it might be assumed that neither minimum nor maximum dose could be used as a safe drug for their serious side effects on spinal cord morphology and consequently its functions.
Intrathecal Nalbuphine versus Intrathecal fentanyl as adjuvant to 0.5% bupivacaine for caesarian section surgery under subarachnoid block
Authors: Hameed Amr Essam El-Din Abdel , Hussien Noha Sayed , Mohamed Marwa Mamdouh , El Kenawy Abdelrahman Mostafa Mohamed 
Published: October 2021

Abstract

Background
One of the main objectives of anesthesia is to relieve the patient’s pain and agony, by ensuring the performance of surgical procedures without any discomfort. Elimination of postoperative pain is indispensable due to the central, peripheral and immunological stress response to tissue injury. So there is a need for extended analgesia without any side effects to achieve this goal.

Aim of the Work
To compare the post-operative analgesic effect of intrathecal-nalbuphine and fentanyl as adjuvant to bupivacaine during cesarean delivery. The secondary aim is to compare side effects between using nalbuphine and fentanyl as adjuvants to bupivacaine.

Patients and Methods
After Approval is obtained from the research Medical Ethical Committee of Faculty of Medicine, Ain Shams University. The study was conducted on 60 patients that were randomly selected. Randomly divided into 2 groups 30 patients each. Group F which received fentanyl as adjuvant while group N received nalbuphine as adjuvant.

Results
The addition of a small dose of nalbuphine or fentanyl to bupivacaine in spinal anesthesia prolonged the time of postoperative analgesia. In this study, there was no significant difference regarding the age, height, weight, and duration of operation, maximum sensory level, and maximum motor blockade level. The duration of the postoperative analgesia was prolonged with Nalbuphine group in comparison to the fentanyl group, the results were highly significant.

Conclusion
We concluded that either intrathecal nalbuphine (0.8 mg) or intrathecal fentanyl (25 µg) combined with Bupivacaine improves intraoperative analgesia and prolongs early post-operative analgesia in cesarean section. There was no significant difference with regard to: Peak sensory block level, Maximum motor block level, systolic blood pressure, diastolic blood pressure, oxygen saturation, and heart rate.
Effect of phosphate level on the outcome of COPD patients in the Intensive Care Unit
Authors: Mohamed Gihan S , El Shebiny Ahmed A , Maarouf Mohammed M , Heikal Ahmed M 
Published: October 2021

Abstract

Background
Chronic Obstructive Pulmonary Disease (COPD) is a preventable ano treatable oisease with some sienificant extra pulmonary effects that may contribute to the severity in inoivioual patients. Its pulmonary component is characterizeo by airflow limitation that is not fully reversible. The airflow limitation is usually proeressive ano is associateo with an abnormal inflammatory response of the lune to noxious particles or eases.

Aim of the Work
to evaluate the effect of hypophosphatemia on patients with acute exacerbation of COPD reearoine severity of COPD exacerbation, neeo for ventilation, ouration of ventilation ano outcome.

Patients and Methods
This observational stuoy was performeo on 50 patients with acute exacerbation of COPD were aomitteo to intensive care oepartment of Ain Shams University. Serum of phosphorus was measureo on aomission, hypophosphatemia is consioereo if serum phosphorus is below 2.5me/ol. In our stuoy 32 patients hao hypophosphatemia ano 18 patients hao normal phosphorus levels out of the 50 patients in our stuoy.

Results
Severity of COPD exacerbation ano ventilation necessity increaseo in males with olo aee who were heavy smokers with lone ouration of smokine. Hieh levels of PaCO2 increaseo the neeo for ventilation. Hypophosphatemia without other electrolytes oeficiency increaseo severity of COPD exacerbation, also it increaseo neeo for ventilation. Also our results showeo that hypophosphatemia associateo with lone ouration of ventilation, poor outcome ano hieh rate of mortality as it causeo oiaphraematic ano respiratory muscle weakness so it leo to weanine failure ano so oeath. Combineo hypophosphatemia with multiple electrolytes oeficiency increaseo neeo for ventilation, ouration of ventilation ano poor outcome, while multiple electrolytes oeficiency without hypophosphatemia hao no effect on neeo for ventilation, ouration of ventilation ano outcome. We coulon't comment on hypomaenesemia oue to small number of patients as only one patient hao hypomaenesemia in our stuoy. Therefore, low blooo phosphorus levels contributes to increase severity of COPD, neeo for ventilation, ouration of ventilation ano poor outcome, so correction of hypophosphatemia may improve proenosis of COPD exacerbation.

Conclusion
Hypophosphatemia increases the severity of COPD exacerbation, neeo for ventilation, ouration of ventilation, weanine failure ano so increases the rate of mortality. Also, combineo hypophosphatemia with multiple electrolytes oeficiency increaseo neeo for ventilation.
Hypophosphatemia and weaning of Mechanically Ventilated patients with Chronic Obstructive Pulmonary Disease during acute exacerbations
Authors: Elkad Galal Adel Abdelrheem , Khalil Mustafa Mansour Hussien , Armanious Simone Halem , Adawy Ali Ragab Ahmed 
Published: October 2021

Abstract

Background
Chronic obstructive pulmonary disease (COPD) is a common pulmonary disease. It is currently the third leading cause of death in the United State and is predicted to be the third leading cause of death worldwide by 2020

Objectives
The aim of this study is to evaluate the predictive value of serum phosphorus level on weaning of mechanically ventilated chronic obstructive pulmonary disease (COPD) patients with acute exacerbation (AECOPD).

Patients and Methods
After approval of the medical ethics committee of Faculty of medicine, Ain Shams University, informed consents were taken from the patient’s next of kin to include their data in this study.

Results
In this prospective cohort study, 116 patients were assessed for enrollment. 26 patients were excluded due to very early mortality at day 1, administration of total parentral nutrition containing phosphorous and very low phosphorus level (less than 1.5 mg/dL or who needs correction).

Conclusion
In the light of the previous results Hypophosphatemia (1.5 - 2.5 mg/dL) was associated with poor prognosis in terms of longer durations of mechanical ventilations and higher ICU mortality rates in mechanically ventilated patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD), Hypophosphatemia should be included in initial assessment of such patients to stratify them.
Impact of dexamethasone added to intra-articular morphine and bupivaciane for post-operative analgesia after knee arthroscopy
Authors: Hammad Raafat Abdelazim , Abd El- Haq Ahmed Abd El-Daeem , El-Aziz Toulan HebaFouadAbd , Talaat Amr Mohammed 
Published: October 2021

Abstract

Background
Pain relief after knee arthroscopy is very important for early recovery and rehabilitation. Many drugs were used intra-articularly to prolong postoperative analgesia and diminish post-operative pain. The present study studies the effects of adding dexamethasone to intra-articular morphine and bupivacaine combination on postoperative pain after knee arthroscopy.

Aim of the Work
The aim of the study is to evaluate the effect of adding dexamethasone (8mg) to intra-articular morphine (10mg) and bupivacaine (25mg) injection on postoperative pain after knee arthroscopy.

Patients and Methods
A randomized double-blinded clinical trial was carried out on 40 patients undergoing knee arthroscopy. Patients were divided randomly into two equal groups. All drugs used were injected intra-articularly at the end of arthroscopy. In the control group, patients were administered 10mg morphine added to bupivacaine 25mg. In the study group, patients were administered 10mg morphine and 8mg dexamethasone added to bupivacaine 25mg. Visual analog score for pain at rest and movement, time to first analgesic request, total analgesic consumption, duration of analgesia and adverse effects were recorded.

Results
The study group showed lower visual analog score at rest and movement, prolonged postoperative analgesia, and decreased total analgesic consumption compared with the control group.

Conclusion
Adding dexamethasone to intra-articular combination of morphine and bupivacaine after knee arthroscopy prolongs the duration of analgesia, lowers pain scores, and decreases total analgesic consumption with no detected adverse effects.
Evaluation of the effect of diastolic function on prognosis of patient with septic shock
Authors: El zawawy Aya Abdel Khalek , Lateef Samia Abdel Mohsen Abdel , Hakim Karim Youssef Kamal , Refaat Sameh Ahmed 
Published: October 2021

Abstract

Background
Septic shock remains the leading cause of death in the intensive care unit (ICU), with an increasing incidence and a current mortality rate of approximately 30 %. Sepsis was defined by the presence of at least two criteria of systemic inflammatory response syndrome associated with a clinically or microbiologically documented, or a highly suspected infection. Severe sepsis was defined as a sepsis associated with at least one organ failure different from that responsible for the infection. Septic shock was defined as a severe sepsis associated with low blood pressure despite adequate vascular filling which required a vasopressor support. Cardiac dysfunction in sepsis is driven primarily by release of cytokines, mitochondrial dysfunction, and tissue hypoxia that leads to cardiac myocyte injury and death.

Aim of the Work
The aim of this study was to evaluate the effect of diastolic function on prognosis of septic shock in patients admitted to an intensive care unit (ICU).

Patient and Methods
This study was conducted on (50) patients with septic shock admitted to an intensive care unit (ICU) from November 2017 to November 2018.

Results
These patients was divided according to cardiac echocardiography findings into two groups:-Group 1:- 25 patients with preserved diastolic function and diastolic dysfunction grade I; 12 Male and 13 Female were included in the study, the average age was 43.44±13.69.Group 2:- Another 25 patients with diastolic dysfunction grade II and grade III; 11 Males and 14 Females were included in the study, the average age was 47.28±15.7.

Conclusion
We recommend assessment of patients admitted to the ICU with septic shock via echocardiography to determine the grade of diastolic dysfunction and using diastolic dysfunction as a predictive risk factor in various score assessment of ICU patients. Our study was limited by decreased sample size and we recommend further studies with increased sample size..
A Comparative Study between Ultrasound Guided Bilateral Transversus Abdominis Plane block Versus Opioids (Nalbuphine) Analgesia after Abdominoplasty
Authors: Elsafty Omar Mohammed Taha , Awad Hanan Mahmoud Farag , Mahran Mostafa Gamal Eldin , Sadek Haidy Atef Fekry 
Published: October 2021

Abstract

Background
Poorly controlled acute pain after abdominoplasty is associated with a variety of unwanted post-operative consequences, including patient suffering, distress, respiratory complications, prolonged hospital stay and an increased likelihood of chronic pain.

Objectives
The aim of this study is to assess the analgesic efficacy and hemodynamic effects of bilateral ultrasound guided single injection Transversus Abdominis Plane (TAP) Block compared with intravenous nalbuphine after abdominoplasty. Each of them combined with general anesthesia in patients undergoing abdominoplasty.

Patients and Methods
The study was conducted on 70 randomly chosen patients in Ain Shams University Hospitals after approval of the medical ethical committee. They were allocated in two groups of 35 patients each: Group TAP: bilateral ultrasound guided TAP block was performed before extubation of patients using 20 ml of 0.25% bupivacaine in each side, Group N: received intravenous nalbuphine as post operative analgesia after abdominoplasty.

Results
The results of the study revealed that single injection tansversus abdominis plane block has more analgesic efficacy than intravenous nalbuphine. The first call for rescue analgesia (nalbuphine), total nalbuphine consumption and pain scores (visual analog score) indicated that the superiority of the analgesic technique (TAP Block) was attributed to their opioid sparing effect.

Conclusion
An ultrasound-guided TAP block technique allows for direct visualization of all anatomical structures, the needle, and the spread of local anesthetic, thereby increasing the safety margin, optimizing block qualities, decreasing systemic analgesia requirements and sparing its side effects.