bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of Bone Microarchitecture by Trabecular Bone Score (TBS) to Evaluate Osteoporosis Independent of Bone Density
Authors: Saeed Alaa Ibrahim , Abd Elmohdy Mohamed Adel , Sweed Hala Samir , Elsaid Salma M S , Safwat El Araby Mennat-ullah 
Published: November 2024

Abstract

Background
Osteoporosis (OP) is defined as low bone mineral density caused by altered bone microstructure, ultimately predisposing patients to low-impact, fragility fractures. Trabecular bone score (TBS) is an indicator of bone quality that has been used to assess bone microarchitecture and can predict fragility fracture. The objective of the current study is to evaluate the ability of lumbar spine TBS to assess osteoporosis independent of bone mineral density.

Patients and Methods
a cross sectional study was conducted on patients coming to Geriatric inpatient and outpatient clinic of Mansoura University Hospitals in Mansoura, Egypt, from January 1, 2021, to July 1, 2022. Our inclusion criteria included elderly male (60 years and above) and Postmenopausal females aged 50 years or above. DXA scan, TBS and QCT were done for patients presented to Geriatric inpatient and outpatient clinic.

Results
During the study period 45 persons, TBS significantly associated with bone micro- architecture, diagnose osteoporosis independent of BMD and helpful for early detection of fragility fracture.

Conclusion
TBS is significantly associated with direct measurements of bone micro-architecture, diagnose primary osteoporosis, and may be a useful adjunct to BMD for fracture detection and prediction.
Prevalence and Risk Factors of Cardiotoxicity in Elderly Cancer Patients
Authors: Ali Maha A , Sweed Hala S , Alsadany Mohamad A , Kazamel Ghada , Tolba Mohammad F 
Published: November 2024

Abstract

Background
Heart disease and cancer are the leading causes of death in older adults. Concerns regarding cardiotoxicity of anticancer agents may lead to under-treatment, resulting in suboptimal outcomes.

Aim
to assess the prevalence and risk factors of cardiotoxicity in elderly patients with cancer.

Patients and Methods
The study sample comprised one hundred (100) elderly participants, men and women, sixty years and above. All participants included in the study were subjected to: comprehensive geriatric assessment (CGA), laboratory investigations (including: lipid profile, fasting blood glucose, C-reactive protein), echocardiography (ECHO) and electrocardiogram (ECG).

Results
In the current study, the prevalence of cardiotoxicity was 57%. Participants who experienced cardiotoxicity were older, had higher smoking index, lower body mass index, and longer cancer duration. They had higher prevalence of diabetes, hypertension and dyslipidemia and had higher mean value of C-reactive protein. Participants who had received certain chemotherapy agents (Anthracycline, 5-Fluorouracil, Capecitabine, Arsenic trioxide, and Lapatinib), certain targeted therapy agents (Pertuzumab and Trastuzumab); and those who received radiotherapy (most commonly radiotherapy to the chest) were more liable for cardiotoxicity. Cardiotoxicity was associated with depression, malnutrition, and functional decline of the affected patients.

Conclusion
Cardiotoxicity is common in elderly cancer patients. It is associated with risk factors as older age, higher smoking index, longer cancer duration, higher prevalence of hypertension, diabetes and dyslipidemia, and treatment with certain anticancer agents. Comprehensive geriatric assessment is essential in elderly cancer patients.
Proportion of Hip Fracture and the Associated Risk Factors among Egyptian Females
Authors: Abd el Rahman Ali Mohamed Azzam , Sweed Hala Samir , Allam Mohamed Farouk , Aly Walaa Wessam , Matter Abeer Hassan Mohamed , El Aliem El Shabrawy Walid El Sayed Abd 
Published: November 2024

Abstract

Background
Fragility fractures caused by osteoporosis are well-known to increase the risk of further fragility fractures; a history of the wrist, vertebral body, or hip fractures increases the risk of further fractures accordingly. Fragility fractures induce lower activities of daily living, and repeated fractures further reduce mobility.

Aim of the Work
The objective of this study was to identify the proportion of hip fracture among Egyptian females and its associated risk factors, and also to identify the proportion of hidden vertebral fractures among those with fragility hip fractures.

Patients and Methods
To assess the proportion of fragility hip fractures among males aging 40 years and older we collected the cases of fragility hip fractures presented to orthopedic emergency room during the period from January 1, 2019 to December 31, 2020, excluding those with high impact fractures or pathological fractures.

Results
Assessment of the anthropometric measures revealed groups differed significantly in the BMI. Assessment of the geriatric depression scale (GDS), mini mental state examination (MMSE), and mini nutritional assessment (MNA) in the two groups demonstrated that the patient's group had significantly higher score in GDS suggestive of depression, and significantly lower score in MMSE and MNA suggestive of associated dementia and malnuitrition respectively. Also evaluation of the prevalence of chronic diseases revealed that patient's group had significantly higher prevalence of diabetes mellitus, higher intake of oral antidiabetics, higher prevalence of dementia, chronic kidney disease. Medical history assessment demonstrated that patient's group were more prevalently using steroid and antiepileptics. GDS, MMSE, and MNA had a diagnostic value for hip fractures predictors of hip fractures highlighted that significant predictors were older age, marital status, low BMI, smoking, depression, poor nutritional status, DM, dementia, CKD, and oral steroids intake.

Conclusion
Osteoporosis is a complex and costly disease, osteoporotic fractures may be largely preventable, as environmental factors are open to intervention, and effective pharmacological agents are available. From both clinical and economic perspectives, aggressive measures to detect osteoporosis at earlier stages may be warranted.
Prevalence of Cognitive Impairment in Post Stroke Patients
Authors: Sayed Sara Abdelaziz , Hamza Sarah Ahmed , Adly Nermien Naim , Tawfik Heba Mohamed 
Published: November 2024

Abstract

Background
Stroke is a leading cause of vascular dementia. Cognitive dysfunction strongly contributes to disability and loss in quality of life.

Objective
Our study aimed to detect post stroke cognitive impairment in a sample of Egyptian people with stroke, six months after the last cerebrovascular accident.

Methods
A cross sectional study was conducted on 120 patients with stroke, six months after the last cerebro vascular accident. Comprehensive Geriatric Assessment was performed. Cognitive assessment was done using MMSE(Mini Mental State Examination) test, functional evaluation using Modified Rankin Scale and Barthel index, Diagnosis of vascular dementia by NINDS AIREN criteria (National Institute of Neurological Disorders and Stroke (NINDS) and the Association Internationale pour la Recherche et l’Enseignement en Neurosciences (AIREN)), Hachiniski ischemic scale and radiological evidence of vascular insult

Results
Mean age of the patients was 69.17. Prevalence of cognitive impairment assessed by MMSE was 33.3%. Age was the only factor associated with poststroke cognitive impairment in regression analysis (p value 0.01). NINDSAIREN criteria is positive in 80% of patients diagnosed to have cognitive impairment (dementia) by MMSE. Patients with cognitive impairment had depression (p value 0.03), no satisfactory sleep (p value 0.01), longer post-stroke duration (p value 0.04), higher scores in Hachiniski ischemic score (p value 0.002), more than one infarction (p value 0.03) and impaired function by Barthel Index (p value 0.01). Pre stroke cognitive impairment was significantly higher in (patients with post stroke cognitive impairment (p value 0.003

Conclusion
Cognitive impairment is prevalent in stroke patients. Age was the only factor associated with poststroke cognitive impairment in regression analysis. NINDSAIREN criteria is positive in 80% of patients diagnosed to have cognitive impairment (dementia) by MMSE. Patients with cognitive impairment had depression, no satisfactory sleep, longer post-stroke duration, higher scores in Hachiniski ischemic score, more than one infarction and impaired function by Barthel Index. Pre stroke cognitive impairment was significantly higher in patients with post stroke cognitive impairment
Impact of Serum Albumin & Pre-albumin as well as Anthropometric Measurements on Long Term Survival Outcomes after Allogeneic Stem Cell Transplantation
Authors: El Afifi Amal Mostafa , El-Ghammaz Amro Mohammed Sedky , Ahmed Alia Mohammed Saeed , Hussien Abdallah Nour El Hoda , Ali Saad Ahmed ELsayed Mahmoud 
Published: November 2024

Abstract

Background
Allogeneic HSCT is the treatment of choice for treatment of patients with high risk features of acute leukemia or those who are relapsed after standard treatment. By now, there are few studies on nutritional assessment of hematological patients before and after HSCT, and additionally, most rely on one single assessment method.

Objective
Evaluating nutritional indicators as well as anthropometric measurements in long term survivors post-transplant, identifying their relationship on transplant outcomes.

Methods
The present work included 30 patients with two or more years after allogeneic stem cell transplantation who were following up at Bone Marrow Transplantation Unit, Ain Shams University Hospitals, during the Jan-2019 till Jan- 2023. We assessed nutritional lab parameters including albumin, prealbumin as well as anthropometric measurements including BMI, waist, circumference, waist hip ratio and body fat percentage using bioelectric impendence in long term survivors as well as assessment of quality of life using FACT-BMT questionnaire.

Results
We found statistically significant association between nutritional lab parameters as well as anthropometric measurements with late transplant outcome including incidence of chronic GVHD, disease relapse and transplant related mortality as well as post-transplant quality of life.

Conclusion
Nutritional lab biomarkers and anthropometric measurements in long term survivors post-allogeneic stem cell transplantation were a low cost, non- invasive biomarkers for early and late transplant complications, patients’ survival and quality of life.
Association between Hyperparathyrodism and Intradialytic Hypertension in Prevalent Hemodialysis Patients
Authors: Saeed Saeed Abdelwahaab , Abdelwahaab Sanad Khaled Gouda , Ezzat Mohamed Ali , Mahmoud Henna Amira Mahmoud 
Published: November 2024

Abstract

Background
Intradialytic hypertension is a recognized short-term risk marker associated with increased 30-day morbidity and mortality in end-stage kidney disease (ESKD) patients undergoing hemodialysis. Biomarker dynamics, reflecting changes over time, have gained importance in predicting clinical outcomes. This study investigated the relationship between hyperparathyroidism and intradialytic hypertension in prevalent hemodialysis patients, focusing on dynamic changes in intact parathyroid hormone (iPTH) levels.

Aim of the Work
This study aimed to investigate the association between hyperparathyrodism and intradialytic hypertension in prevalent hemodialysis patients.

Patients and Methods
A cross-sectional study was conducted at El Dakahlia Governorate Hospital, involving 70 ESKD patients on regular hemodialysis. Patient demographics, comorbidities, medication use, and dialysis-related parameters were recorded. Blood pressure, body mass index (BMI), and laboratory results, including iPTH, were measured pre- and post-dialysis.

Results
The mean age of the study cohort was 41.24 years, with 54.3% males. Half of the patients were on beta-blockers, 40% on ACE inhibitors/ARBs, and calcium channel blockers, reflecting the prevalence of comorbid hypertension. Patients with intradialytic hypertension (14.3%) exhibited significantly higher post-dialytic BMI and systolic blood pressure (p &lt; 0.001), while diastolic blood pressure decreased post-dialysis (p &lt; 0.001). No significant differences were observed in age, gender, smoking, comorbidities, or antihypertensive drug usage between patients with and without intradialytic hypertension.

Conclusion
From this study we found that the prevalence of iHTN was (14.3%). Intradialytic hypertension was significantly associated with metabolic disorders including anemia, low iPTH level. There were significant indirect moderate correlations between iPTH and SBP pre, intra and postdialytic. There was significant indirect moderate correlation between iPTH and serum creatinine. Also, there were significant indirect weak correlations between iPTH with serum BUN, serum potassium and serum phosphorus.
Evaluation the Role of Serum Epidermal Growth Factor Like Domain 7 as a New Non-Invasive Diagnostic Marker for Hepatocellular Carcinoma in Egyptian Cirrhotic Patients
Authors: Ibrahim El-Baz Hossam Samir , Mostafa Elsayed Mohamed Abdelmoghny , Fahmy Abdelmeged Mohamed Lotfy , Hassan Abdullah Amr Salah 
Published: November 2024

Abstract

Background
Hepatocellular carcinoma (HCC) is a significant global health concern, ranking as the sixth most common cancer worldwide. In Egypt, it is the fourth most prevalent malignancy. The rising incidence of HCC has been attributed to advancements in screening programs, improved diagnostic tools, increased survival rates in cirrhotic patients, and a higher prevalence of hepatitis C virus (HCV) infections.

Objective
Point this study is to assess job serum epidermal development factor like space 7 as a demonstrative marker in HCC Egyptian cirrhotic patients.

Methods
A total of 90 subjects were enrolled in this study, categorized into two groups: Group A (HCC), comprising 45 patients with Hepatocellular carcinoma, and Group B (Cirrhotic), comprising 45 patients with liver cirrhosis without HCC. The study subjects underwent history taking, physical examination, routine laboratory tests, measurement of AFP and EGFL7 levels, and radiological evaluations.

Results
EGFL7, a molecule with signaling and EGF-like domains, was significantly upregulated in HCC tissues compared to cirrhotic tissues. High EGFL7 expression was associated with adverse clinicopathological features and poor prognosis in HCC patients. The study demonstrated that EGFL7 exhibited higher diagnostic performance in distinguishing between cirrhosis and HCC compared to AFP. Moreover, EGFL7 levels were positively correlated with the Child-Pugh score and the size of hepatic lesions in the HCC group.

Conclusion
This research highlights that serum EGFL7 is substantially elevated in HCC patients, particularly those with co-existing conditions such as diabetes, hypertension, or viral markers. EGFL7 emerges as a more sensitive and accurate marker than AFP for early HCC detection. Incorporating EGFL7 into diagnostic algorithms could enhance the effectiveness of surveillance programs for early HCC detection, ultimately leading to improved clinical outcomes and patient management.
Effect of Pentoxifylline on Inflammatory Marker in Non-Diabetic Chronic Kidney Disease Patients
Authors: Mohamed Basant Abdelkarim Eid , Hebah Hayam Ahmed , AbdelMobdy Ashraf Hassan , Ahmed Fatma Abdelrahman , Ezzat Mohamed Ali 
Published: November 2024

Abstract

Background
Chronic kidney disease is a progressive condition that affects &gt;10% of the general population worldwide, amounting to &gt; 800 million individuals in 2017. CKD has emerged as one of the most prominent causes of death and suffering in the 21st century.

Aim of the Work
To assess the effect of pentoxifylline on inflammatory marker and Chronic Kidney Disease progression in non- diabetic chronic kidney disease.

Patients and Methods
The current study design was a prospective, interventional, open- label, randomized controlled clinical trial conducted on adult patients with Chronic Kidney Disease at the outpatient clinics of AinShams University hospital, Cairo, Egypt, from the start of February (2023) to the end of July (2023).

Results
TNF-alpha, CRP, UPCR, and GFR were measured at baseline and after a six-month follow-up period. TNF-alpha and CRP levels were determined using enzyme-linked immunosorbent assay (ELISA) kits, while UPCR was calculated by dividing the urinary protein concentration by the urinary creatinine concentration. GFR was estimated using CKD-EPI. The results of this study showed a significant decrease in CRP levels in group 2 compared to group 1, indicating a greater reduction in systemic inflammation with the addition of Pentoxifylline. Similarly, UPCR decreased significantly in group 2, suggesting a beneficial effect of Pentoxifylline on proteinuria. In contrast, there was no statistical difference in the reduction of TNF-alpha levels between the two groups, although both groups exhibited a significant decrease in TNF-alpha. Furthermore, there was no significant difference in GFR changes between the two groups.

Conclusion
The addition of pentoxifylline to the standard therapy in non-diabetic CKD patients resulted in a significant reduction in CRP levels and proteinuria, indicating its potential as an adjunctive treatment to mitigate inflammation and proteinuria. However, no significant difference was observed in the reduction of TNF-alpha levels or GFR changes between the two groups. These findings suggest that pentoxifylline's anti-inflammatory effects may be mediated through pathways other than TNF-alpha inhibition. Further research is warranted to explore the underlying mechanisms and optimize the use of pentoxifylline in the management of CKD patients.
Musculoskeletal Ultrasound Findings in First Degree Relatives of Rheumatoid Arthritis Patients
Authors: Ibrahim Hassanien Bassant Megahed , EL Hefny Abdelazim Mohamed , Morad Caroline Samy , Aly Hussein Safaa Abdelsalam , Mohamed Abdelkader Mohamed Rizk 
Published: November 2024

Abstract

Background
Rheumatoid arthritis (RA) is an autoimmune inflammatory disease that primarily targets synovial joints. Retrospective analysis of individuals who ultimately developed RA have shown RA autoantibodies such as rheumatoid factor (RF) and anticitrullinated protein antibodies (ACPA) develop months to years prior to the onset of clinically evident synovitis. So there has been increasing interest in identifying individuals at risk for future development of RA, with the hope of intervening to prevent the onset of disease.

Aim of the Work
To detect the presence of early synovitis (preclinical stage of RA) among healthy first degree relatives of RA patients by MSUS and its correlation to serological markers.

Patients and Methods
This was a cross sectional study which was conducted on 60 subjects with high risk of developing arthritis; healthy first degree relatives (FDR) of RA patients classified according to ACR/EULAR 2010 criteria. It was carried out at Ain Shams University Hospital. All patients were recruited from Rheumatology outpatient clinic and the inpatient department of Ain Shams University Hospital.

Results
The study included subjects aged 16 to 55 years, predominantly female, with a mean BMI of 26.44 kg/m². Rheumatoid arthritis (RA) duration ranged from 1 month to 30 years, averaging 6.96 years. Among familial disease relatives (FDRs), 78.3% were nonsmokers. Arthralgia was common (58.3%), with varied joint involvement. Laboratory findings showed elevated ESR and CRP levels. Wrist and MTP-II joints were most frequently affected on ultrasound. A 7-joint ultrasound score (US7) was developed for efficient rheumatological evaluation.

Conclusion
This cross-sectional study aimed to assess preclinical synovitis by musculoskeletal ultrasound (MSUS) in first-degree relatives (FDRs) of rheumatoid arthritis (RA) patients and its correlation with laboratory findings. We found a prevalence of 51.6% for MSUS positive findings, primarily synovitis. ESR was significantly higher in FDRs with positive MSUS findings. RF showed the highest positive predictive value (75%) for MSUS positivity. Clinical arthralgia exhibited the highest sensitivity (58%). Our study underscores the potential of combining RF, Anti-CCP, and clinical arthralgia in predicting preclinical synovitis in at-risk populations, facilitating early intervention strategies.
Study the Role of Cadherin-11 as a Novel Biomarker of Kidney Fibrosis
Authors: Gaafar Ghada M , Abdelwahab Saeed , Aref Hayam , Salman Manal , Khedr Abdelrahman , Elbraky Abdelrahman 
Published: November 2024

Abstract

Introduction
Kidney fibrosis constitutes the shared final pathway of all chronic nephropathies and it is attributed to the pathologic deposition of ECM components in response to chronic injury. Biopsy is the gold standard diagnostic tool but it is invasive and has some limitations. CDH-11 is an excellent non- invasive biomarker of kidney fibrosis.

Objectives
To measure serum CDH-11 among patients indicated for native kidney biopsy correlating its levels with IFTA score of kidney biopsy to investigate its sensitivity and specificity as a biomarker of kidney fibrosis.

Patients and Methods
This cross sectional study comprised 100 patients clinically indicated for native kidney biopsy. All of them were subjected to measurement of serum CDH-11 on the day of biopsy. This study was carried out in Ain Shams university and Ain Shams university specialized hospitals.

Results
Median of CDH-11 was 3.9 (2.2–7.6), it was significantly higher in cases with Arteriosclerosis with p-value &lt;0.001, also it was highest in grade -3 followed by 2 fo1lowed by 1 then zero of all chronicity grading scale points (Global and segmental, Tubular atrophy and interstitial fibrosis) with p-value &lt;0.001, Consequently it was highest in severe, followed by moderate, then mild, and lowest in minimal IFTA with (Median 12.0 (7.6–16.0), 6.1 (4.4–7.7), 3.5 (2.2–4.6), 1.2 (0.5–2.6) respectively. The area under the curve was 0.645 and the best cut-off level was ≥5.6 ng/dl (90.9% sensitivity, 71.8% % specificity).

Conclusion
CDH-11 is highly sensitive and specific marker in patients with kidney fibrosis and its level can predict degree of fibrosis in different causes of kidney disease.