bluuebunny/crossref_metadata_2025_split huggingface dataset:
Jerking during absences: video‐EEG and polygraphy of epileptic myoclonus associated with two paediatric epilepsy syndromes
Authors: Aoun Marc Abi , Eisermann Monika , Chemaly Nicole , Losito Emma , Desguerre Isabelle , Nabbout Rima , Kaminska Anna 
Published: March 2021

AbstractObjective: Epileptic myoclonus (EM) is reported in many paediatric epilepsies from neonatal period to adolescence. Myoclonus can be the only seizure type or may occur among others, independently or in combination as a single ictal event. We report two children presenting with absences associated with myoclonus, predominating on one side, in a setting of two different types of absence seizures and two different electro‐clinical syndromes.Methods: Patients were explored with long‐duration video‐EEG coupled to surface EMG polygraphy. EEG was visually analysed and complemented by jerk‐locked back‐averaging.Results: Two types of seizure, encompassing myoclonus and absence, were identified: myoclonic absences in the context of epilepsy with myoclonic absences and atypical absences with atonic component (negative myoclonus) in the context of encephalopathy related to status epilepticus during slow sleep (ESES). In the latter case, rhythmic upper limb jerking, mimicking positive myoclonus, corresponded to recovery of muscular tone after each negative myoclonus.Significance: Due to the rhythmic recovery of muscle tone, subsequent rhythmic negative myoclonus may exhibit a similar clinical picture to that of rhythmic positive myoclonus. Video‐EEG recording coupled to EMG polygraphy is essential in order to precisely characterize motor manifestations during seizures with myoclonus [Published with video sequences].
STXBP1 germline mutation and focal cortical dysplasia
Authors: Sharkov Artem , Dulac Olivier , Gataullina Svetlana 
Published: March 2021

AbstractA child with a de novo STXBP1 heterozygous missense mutation, believed to be a pathogenic variant, presented with clustering focal seizures affecting both hemispheres. These had begun at the age of 10 months with a phenotype similar to that of PCDH19 encephalopathy. MRI suggested a similarity to focal cortical dysplasia, though further research is needed. There was no evidence of either suppression‐bursts or infantile spasms. This new case adds to the few other cases of patients with STXBP1 mutation in whom imaging features of focal cortical dysplasia on MRI have been reported, implying a possible role of STXBP1 mutation in neuronal migration disorders. If such a mutation with focal seizures is suspected, the possibility of focal cortical dysplasia should be investigated. [Published with video sequences].
Clinical seizure manifestations in the absence of synaptic connections
Authors: Macdonald‐Laurs Emma , Bailey Catherine A. , Barton Sarah , Yang Joseph Yuan‐Mou , Mandelstam Simone , Macgregor Duncan , Lockhart Paul J. , Leventer Richard J. , Maixner Wirginia J. , Harvey A. Simon 
Published: March 2021

AbstractWe report a child with a history of temporal‐parietal‐occipital disconnection for epilepsy secondary to posterior quadrantic dysplasia who developed recurrent and prolonged bouts of distress and autonomic disturbance associated with EEG and PET evidence of status epilepticus confined to his disconnected cortex. These bouts were refractory to antiseizure medications but resolved following resection of the disconnected cortex. In the absence of synaptic connections, we hypothesise that his seizure‐related symptoms were mediated either by neurochemical transmission in preserved vascular and lymphatic channels or by ephaptic transmission to trigeminal nerve fibres in overlying dura, producing symptoms akin to migraine. The case highlights potential means by which seizures may manifest clinically, without synaptic connections, and adds to the differential for symptoms post‐disconnection surgery.
Thread lifting and single-step facial volumization as an optimum balanced technique of aesthetic correction
Authors: Gribanov I. I. , Starokozheva Natalia Yu. 
Published: March 2021

BACKGROUND: Development and introduction of minimally invasive lifting techniques is considered a demanding and relevant objective of contemporary dermatocosmetology as these techniques result in nonsurgical lifting with minimal disruption of facial harmony due to the activation of a maximal number of key anatomic landmarks following the simultaneous insertion of lifting threads and hyaluronic acid fillers.
AIMS: To study the clinical efficacy and safety of minimally invasive lifting technique and filling up of the tissue volume deficiency with the combination of thread lifting from the temporal approach and hyaluronic acid filler augmentation.
MATERIALS AND METHODS: The study group included 193 female patients (mean age 41.3 8.5 years) with gravitational ptosis of the 1st, 2nd, and 3rd degrees. Group 1 (main) comprised 42 (21.8%) patients who underwent lifting by the method of implantation of 12 threads with shaped polydioxanone spikes DG-Lift and injection of 2 ml of hyaluronic acid biphasic filler. Group 2 (comparison) comprised 64 (33.2%) female patients who underwent lifting using only 1220 polydioxanone DG-Lift threads. Group 3 (comparison) comprised 87 (45%) female patients who received tissue volumization with 48 ml of biphasic hyaluronic acid filler in each case.
RESULTS: A total of 82%, 59%, and 48% of patients in groups 1, 2, and 3, respectively, noted the optimal cosmetic result and full satisfaction with the result according to the Global Aesthetic Improvement Scale. The incidence of complications in group 1 (6.4%) was lower than that in group 2 (9.1%) and group 3 (17.7%). This is due to low invasive nature and lower tissue traumatization with the use of fewer fillers and threads to obtain optimal cosmetic effect.
CONCLUSION: The proposed technique of thread lifting with biodegradable threads DG-Lift from the temporal approach combined with tissue volumization with hyaluronic acid fillers is safe and significantly effective for patients with gravitational ptosis of the 1st, 2nd, and 3rd degrees.
Refractory and Resistant Hypertension in Patients with Type 2 Diabetes Mellitus: Different Response to Renal Denervation
Authors: Falkovskaya A. Yu. , Mordovin V. F. , Pekarskiy S. E. , Manukyan M. A. , Ripp T. M. , Zyubanova I. V. , Lichikaki V. A. , Sitkova E. S. , Gusakova A. M. , Baev A. E. 
Published: March 2021

Aim To compare the antihypertensive effectivity of renal denervation in patients with diabetes mellitus (DM) and associated refractory arterial hypertension (rfAH) (treated with 5 or more classes of antihypertensive drugs, including a thiazide diuretic and a mineralocorticoid receptor antagonist) and uncontrolled resistant AH (ucAH) (treated with 3-4 drugs).Material and methods This interventional study with renal denervation included 18 DM patients with rfAH and 40 DM patients with ucAH; 16 and 36 of them, respectively, completed the study in 6 months. At baseline, patients were sex- and age-matched. Study methods included measurement of office blood pressure (BP; systolic/diastolic BP, SBP/DBP); outpatient BP monitoring; evaluation of kidney function (estimated glomerular filtration rate by the CKD-EPI formula); diurnal diuresis volume; diurnal urinary excretion of albumin, potassium and sodium; diurnal excretion of metanephrines and normetanephrines; and plasma levels of glucose and glycated hemoglobin, aldosterone, and active renin. Patients were instructed about maintaining compliance with their antihypertensive and hypoglycemic therapy throughout the study.Results At baseline, patients of both groups were comparable by BP and major clinical indexes, except for higher values of nocturnal SBP variability (p<0.05) in patients with rfAH. At 6 months following renal denervation, both groups displayed significant decreases in office and average daily SBP and also in the “load” with increased mean diurnal SBP. However, the decrease in average daily SBP was almost 4 times greater in the rfAH group than in the ucAH group ( –19.9 and –5.1 mm Hg, respectively, р=0.02). Moreover, 81 % of patients in the rfAH group responded to the intervention (average daily SBP decrease ≥10 mm Hg) while the number of responders in the ucAH group was considerably smaller (42 %; p=0.02). In patients with rfAH, renal denervation was associated with a significant decrease in pulse BP and nocturnal SBP variability and with the increase in diurnal diuresis. No other alterations were noted in laboratory test results in either group.Conclusion DM patients with rfAH may be the best candidates for the procedure of renal denervation.
Influence of Total Ischemic Time on Clinical Outcomes in Patients with ST-Segment Elevation Myocardial Infarction
Authors: Bessonov I. S. , Kuznetsov V. A. , Gorbatenko E. A. , Dyakova A. O. , Sapozhnikov S. S. 
Published: March 2021

Aim To evaluate the effect of the total time of myocardial ischemia on results of the treatment of patients with ST segment elevation acute myocardial infarction (STEMI) who underwent percutaneous coronary interventions (PCI).Material and methods This study used data from a hospital register for PCI in STEMI from 2006 through 2017. 1649 patients were included. Group 1 consisted of 604 (36.6 %) patients with a total time of myocardial ischemia not exceeding 1880 min; group 2 included 531 (32.2 %) patients with a duration of myocardial ischemia from 180 to 360 min; and group 3 included 514 (31.2 %) patients with a duration of myocardial ischemia longer than 360 min.Results Mortality was lower in group 1 (2.3 %) than in groups 2 and 3 (6.2 and 7.2 %, respectively; p1–2=0.001; p1–3<0.001; p2–3=0.520). The incidence of major cardiac complications (“adverse cardiac events”, MACE) was lower in group 1 (4.1 %) than in groups 2 and 3 (7.3 and 9.5 %, respectively, p1–2=0.020; p1–3<0.001; p2–3=0.200). The incidence of no-reflow phenomenon was higher in group 3 (9.7 %) than in groups 2 and 3 (4.5 and 5.3 %, respectively (p1–2=0.539; p1–3=0.001; p2–3=0.005). The major factors associated with the increased total time of myocardial ischemia >180 min were age (odd ratio, OR, 1.01 at 95 % confidence interval, CI, 1.0 to 1.02; р=0.044), female gender (OR, 1.64 at 95 % CI 1.26 to 2.13; р<0.001), chronic kidney disease (OR 1.82 at 95 % CI 1.21 to 2.74; р=0.004). Performing prehospital thrombolysis was associated with a decrease in the total time of myocardial ischemia (OR 0.4 at 95 % CI 0.31 to 0.51; р<0.001). A strong direct correlation was observed between the total time of myocardial ischemia and the time from the onset of pain syndrome to hospitalization (r=0.759; р<0.001).Conclusion The total time of myocardial ischemia >180 min was associated with increased mortality and development of MACE. The total time of myocardial ischemia > 360 min was associated with increased incidence of the no-reflow phenomenon. The major predictors for the time of myocardial ischemia >180 min included age, female gender, and chronic kidney disease. The use of pharmacoinvasive strategy was associated with an increased number of patients with a total duration of myocardial ischemia <180 min. The contribution of the time of prehospital delay to the total time of myocardial ischemia was greater than the contribution of the “door-to-balloon” time. The time of prehospital delay showed a strong direct correlation with the total time of myocardial ischemia.
Shortness of Breath on Exertion: Diagnostic Possibilities of Stress Echocardiography
Authors: Karev E. A. , Malev E. G. , Verbilo S. L. , Prokudina M. N. 
Published: March 2021

Aim To determine diagnostic capabilities of the expanded protocol for stress echocardiography (stress-EchoCG) with comprehensive evaluation of clinical and echocardiographic indexes in differential diagnosis of dyspnea.Material and methods This study included 243 patients (123 women and 120 men) who were referred to outpatient stress-EchoCG during one calendar month. For 80 patients complaining about shortness of breath, the expanded stress-EchoCG protocol with treadmill exercise was performed. During the exercise, E / e’ and tricuspid regurgitation velocity were determined, and clinical features and possible nature of dyspnea were evaluated.Results Shortness of breath had an ischemic origin in 17.5 % of 80 patients; 13.8 % had criteria of elevated left ventricular end-diastolic pressure; 17.5 % of patients had clinical signs of bronco-pulmonary pathology; 5.0 % had moderate and severe mitral regurgitation; 20 % displayed signs of chronotropic insufficiency during exercise including on the background of beta-blocker therapy; 15.0 % of patients displayed a hypertensive response to exercise, which was associated with signs of chronotropic insufficiency in 50 % of them; and 1.3 % had signs of hyperventilation syndrome. In addition to diagnosis of transient ischemia, additional information about the nature of shortness of breath was obtained for 72.5 % of patients. Based on results of the test, objective causes for dyspnea were not identified for 10.0 % of patients.Conclusion The expanded stress-EchoCG protocol with exercise allows obtaining information about the nature of dyspnea for most patients with shortness of breath of a non-ischemic origin. For this patient category, expanding the stress-EchoCG protocol does not increase duration of the study and is economically beneficial for diagnosis of chronic heart failure and other causes for shortness of breath.
Ultrasound guided quadratus lumborum block and transversus abdominis plane block for postoperative analgesia after lower segment caesarean section under spinal anesthesia: A prospective observational study
Authors: Benazir Kouser , Parihar Anju , Ashraf Shazia , Rafiq Wasim 
Published: March 2021

Caesarean section being a major surgical procedure is associated with substantial postoperative discomfort and moderate to severe pain for 48 hours postoperatively. This prospective study was undertaken to observe the ultrasound guided quadratus lumborum block and transversus abdominis plane block for postoperative analgesia after lower segment caesarean section under spinal anesthesia. Hundred patients belonging to ASA class I & II and a normal singleton pregnancy with a gestation of at least 37 weeks posted for elective caesarean delivery under spinal anesthesia were selected. The patients who had received either TAP block or QL block were assigned two groups. The patients who had received TAP block were assigned group A and the patients who had received QL block were assigned group B. : The overall VAS score in group B was lower than in group A. The duration of analgesia in Group A ranged from 6-12 hours with a mean duration of 8.5±1.998 hours. In Group B the duration ranged from 9-24 hours with a mean duration of 16.5±3.096 hours. The difference in duration of analgesia between the two groups was statistically significant. In group A the mean analgesic consumption dose was 1.07±0.264 grams at 12 hours, 2.11±0.317 grams at 24 hours and 2.67±0.673 at 48 hours. In group B it was 0.43±0.501 grams at 12 hours, 1.35±0.567 grams at 24 hours and 1.65±0.604 grams at 48 hours. The difference was statistically significant It can be concluded that Ultrasound Guided nerve blocks (TAP block and QL block) can be used as a part of multimodal analgesia for better postoperative pain relief in lower abdominal surgeries like LSCS especially when given before the resolution of spinal anaesthesia. Further it was observed that QLB was superior to TAP block in terms of better pain control (duration and quality) as shown by lower VAS score, demand for the first rescue analgesia which was delayed and total consumption of rescue analgesia was less in the first 48 hours.
Differentiating transudative and exudative pleural effusion by pleural fluid cholesterol
Authors: A Shilpa , Ambresh Ayyali 
Published: March 2021

Pleural effusion is one of the common condition encountered in day to day practise. A correct diagnosis of the underlying disease is essential to rational management. Today there are a number of laboratory tests available to differentiate exudates and transudates which are considered cost effective to the patients, so this study was designed for the measurement of pleural fluid cholesterol to differentiate transudative and exudative pleural effusions (sensitivity-97.8%, specificity-100%) with the advantage that a contemporary blood sample is not required, thereby lowering cost of diagnostic procedure. To study the diagnostic value of Pleural fluid Cholesterol in differentiating transudative and exudative pleural effusions. This cross sectional descriptive study was conducted on patients of pleural effusion (n=60) age &#62;18 years patients with definitive clinical diagnosis and evidenced by radiological diagnosis of pleural effusion were taken as inclusion criteria. The results showed majority of the patients were males (63.3%) and females (36.7%). According to lights criteria 46 patients were exudates and 14 patients were transudates and according to Pleural fluid Cholesterol criteria 45 patients were exudates and 15 patients were transudates with sensitivity of 97.8% and specificity of 100% and accuracy of 98.3%. The pleural fluid cholesterol criteria were found to be the most efficient criteria. Since this parameter involves the measurement of only pleural fluid values of cholesterol, it has following advantages-Economically it reduces number of biochemical tests and Simpler as there is no need to take simultaneous blood sample at the time of thoracocentesis.
COVID-19 Associated Pneumonia
Authors: Al-Umairi Rashid S. , Al-Kalbani Joukha , Al-Tai Saqar , Al-Abri Ahmed , Al-Kindi Faiza , Kamona Atheel 
Published: March 2021

Medical imaging, including chest radiography and computed tomography, plays a major role in the diagnosis and follow-up of patients with COVID-19 associated pneumonia. This review aims to summarise current information on this topic based on the existing literature. A search of the Google Scholar (Google LLC, Mountain View, California, USA) and MEDLINE® (National Library of Medicine, Bethesda, Maryland, USA) databases was conducted for articles published until April 2020. A total of 30 articles involving 4,002 patients were identified. The most frequently reported imaging findings were bilateral ground glass and consolidative pulmonary opacities with a predominant lower lobe and peripheral subpleural distribution.

KEYWORDS
COVID-19; Viral Pneumonia; Diagnostic Imaging; X-Ray Computed Tomography; Radiography;Review.
Clinical Practice Guidelines for the Evaluation and Diagnosis of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents
Authors: Abdul Razzak Hira , Ghader Nariman , Qureshi Ateeq A. , Zafar Mehnaz , Shaijan Jeena F. , Al Kuwari Muna 
Published: March 2021

This article presents a comprehensive review of clinical practice guidelines (CPGs) for the evaluation and/or diagnosis of attention deficit/hyperactivity disorder (ADHD) in children and adolescents. A systematic review was undertaken to summarise the recommendations reported in CPGs. MEDLINE® (National Library of Medicine, Bethesda, Maryland, USA), Cumulative Index to Nursing and Allied Health Literature® (EBSCO Information Services, Ipswich, Massachusetts, USA) and other databases were searched to retrieve CPGs. A total of five guidelines were included for analysis. The selected CPGs were appraised independently by five reviewers using the AGREE II instrument. The highest total score was achieved by the National Institute for Health and Care Excellence guidelines (91.4%) followed by the CPGs from the Scottish Intercollegiate Guidelines Network, Canadian Attention Deficit Hyperactivity Disorder Resource Alliance, British Association of Psychopharmacology and the American Academy of Paediatrics. By appraising current ADHD guidelines, clinicians cannot only identify CPGs related to ADHD but can also determine which guidelines should be considered of high quality and trustworthy to follow during clinical practice. The researchers recommend using the AGREE II instrument for CPG appraisal in healthcare professional education and training. Improvements in the applicability of guidelines are warranted in the future to enhance its clinical use and relevance.

KEYWORDS
Attention Deficit Hyperactivity Disorder; Practice Guidelines; Adolescents; Children; Diagnosis.
Emerging and Novel Therapies for Keloids
Authors: Memariani Hamed , Memariani Mojtaba , Moravvej Hamideh , Shahidi-Dadras Mohammad 
Published: March 2021

Keloids are abnormal fibroproliferative scars with aggressive dermal growth expanding beyond the borders of the original injury. Different therapeutic modalities, such as corticosteroids, surgical excision, topical silicone gel sheeting, laser therapy, cryotherapy, photodynamic therapy and radiotherapy, have been used to treat keloids; however, none of these modalities has proven completely effective. Recently, researchers have devised several promising anti-keloid therapies including anti-hypertensive pharmaceuticals, calcineurin inhibitors, electrical stimulation, mesenchymal stem cell therapy, microneedle physical contact and ribonucleic acid-based therapies. The present review summarises emerging and novel treatments for keloids. PubMed® (National Library of Medicine, Bethesda, Maryland, USA), EMBASE (Elsevier, Amsterdam, Netherlands) and Web of Science (Clarivate Analytics, Philadelphia, Pennsylvania, USA) were searched for relevant literature published between January 1987 to June 2020. A total of 118 articles were included in this review. A deeper understanding of the molecular mechanisms underlying keloid scarring pathogenesis would open further avenues for developing innovative treatments.

KEYWORDS
Keloid; Treatment; Fibroblast; Scar; Dermatology.
Changes in Self-Efficacy and Social Support after an Intervention to Increase Physical Activity Among Adults with Type 2 Diabetes in Oman
Authors: Al-Ghafri Thamra S. , Al-Harthi Suad , Al-Farsi Yahya , Craigie Angela M. , Bannerman Elaine , Anderson Annie S. 
Published: March 2021

Objectives: This study aimed to describe changes in self-efficacy (SE) and social support (SS) 12 months after the MOVEdiabetes trial, an intervention designed to increase physical activity (PA) among adults with type 2 diabetes mellitus in Oman. Methods: The original MOVEdiabetes trial was conducted between April 2016 and June 2017 in Muscat, Oman. The intervention group (IG) received personalised PA consultations, pedometers and monthly messages using a web-based application, while the comparison group received usual care. Self-reported SE and SS from family and friends were assessed using validated psychosocial scales. Results: Of the 232 original participants in the trial, a total of 174 completed the 12 months follow-up study period (response rate: 75%). However, based on intention-to-treat analysis with several imputation procedures for missing data at 3 and/or 12 months, there was a significant increase in SE scores in the IG (+10.3, 95% confidence interval [CI]: 7.1–13.5; P <0.001); however, the correlation with PA levels was weak (+4.2, 95% CI: 2.7–5.7; P <0.001). Higher SE scores were noted in those without comorbidities (+12.2, 95% CI: 6.8–17.6; P <0.001) and with high income levels (+9.7, 95% CI: 5.2–14.2; P <0.001). Additionally, SS scores increased significantly among those in the IG who received support from friends (+2.3, 95% CI: 1.1–3.7; P <0.001), but not family (+1.2, 95% CI: −0.4–2.8; P = 0.110). The reliability of the scales was acceptable for SE and SS from family, but poor for SS from friends (Cronbach’s alpha coefficients = 0.82, 0.82 and 0.40, respectively). Conclusion: The PA intervention was associated with positive changes in SE and SS from friends. However, further tools for assessing psychosocial influences on PA are needed in Arab countries.

KEYWORDS
Physical Activity; Type 2 Diabetes Mellitus; Self-Management; Health Behaviors; Social Support, Self-Efficacy; Primary Healthcare; Oman.