bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mitochondrial-targeted cyclometalated Ir(III)-5,7-dibromo/dichloro-2-methyl-8-hydroxyquinoline complexes and their anticancer efficacy evaluation in Hep-G2 cells
Authors: Meng Ting , Shi Xiongzhi , Chen Hongfen , Xu Zhong , Qin Weirong , Wei Kehua , Yang Xin , Huang Jin , Liao Chuanan 
Published: July 2024

Abstract
Both 8-hydroxyquinoline compounds and iridium (Ir) complexes have emerged as potential novel agents for tumor therapy. In this study, we synthesized and characterized two new Ir(III) complexes, [Ir(L1)(bppy)2] (Br-Ir) and [Ir(L2)(bppy)2] (Cl-Ir), with 5,7-dibromo-2-methyl-8-hydroxyquinoline (HL-1) or 5,7-dichloro-2-methyl-8-hydroxyquinoline as the primary ligand. Complexes Br-Ir and Cl-Ir successfully inhibited antitumor activity in Hep-G2 cells. In addition, complexes Br-Ir and Cl-Ir were localized in the mitochondrial membrane and caused mitochondrial damage, autophagy, and cellular immunity in Hep-G2 cells. We tested the proteins related to mitochondrial and mitophagy by western blot analysis, which showed that they triggered mitophagy-mediated apoptotic cell death. Remarkably, complex Br-Ir showed high in vivo antitumor activity, and the tumor growth inhibition rate was 63.0% (P &lt; 0.05). In summary, our study on complex Br-Ir revealed promising results in in vitro and in vivo antitumor activity assays.
Potential Utility of C-reactive Protein for Tuberculosis Risk Stratification Among Patients With Non-Meningitic Symptoms at HIV Diagnosis in Low- and Middle-income Countries
Authors: Dupnik Kathryn , Rivera Vanessa R , Dorvil Nancy , Duffus Yanique , Akbarnejad Hanane , Gao Yipeng , Liu Jingyi , Apollon Alexandra , Dumont Emelyne , Riviere Cynthia , Severe Patrice , Lavoile Kerlyne , Duran Mendicuti Maria Alejandra , Pierre Samuel , Rouzier Vanessa , Walsh Kathleen F , Byrne Anthony L , Joseph Patrice , Cremieux Pierre-Yves , Pape Jean William , Koenig Serena P 
Published: July 2024

Abstract

Background
The World Health Organization recommends initiating same-day antiretroviral therapy (ART) while tuberculosis (TB) testing is under way for patients with non-meningitic symptoms at HIV diagnosis, though safety data are limited. C-reactive protein (CRP) testing may improve TB risk stratification in this population.

Methods
In this baseline analysis of 498 adults (&gt;18 years) with TB symptoms at HIV diagnosis who were enrolled in a trial of rapid ART initiation in Haiti, we describe test characteristics of varying CRP thresholds in the diagnosis of TB. We also assessed predictors of high CRP as a continuous variable using generalized linear models.

Results
Eighty-seven (17.5%) participants were diagnosed with baseline TB. The median CRP was 33.0 mg/L (interquartile range: 5.1, 85.5) in those with TB, and 2.6 mg/L (interquartile range: 0.8, 11.7) in those without TB. As the CRP threshold increased from ≥1 mg/L to ≥10 mg/L, the positive predictive value for TB increased from 22.4% to 35.4% and negative predictive value decreased from 96.9% to 92.3%. With CRP thresholds varying from &lt;1 to &lt;10 mg/L, a range from 25.5% to 64.9% of the cohort would have been eligible for same-day ART and 0.8% to 5.0% would have untreated TB at ART initiation.

Conclusions
CRP concentrations can be used to improve TB risk stratification, facilitating same-day decisions about ART initiation. Depending on the CRP threshold, one-quarter to two-thirds of patients could be eligible for same-day ART, with a reduction of 3- to 20-fold in the proportion with untreated TB, compared with a strategy of same-day ART while awaiting TB test results.
Molecular tumor board: molecularly adjusted therapy upon identification and functional validation of a novel ALK resistance mutation in a case of lung adenocarcinoma
Authors: Arndt Annette , Neumann Christian , Riecke Armin , Bauer Arthur , Müller Matthias , Wölfle-Guter Manuela , Grunert Michael , Busch Hauke , Künstner Axel , von Bubnoff Nikolas , Fliedner Stephanie , Greinert Dina , Osius Jasmin , Nagarathinam Kumar , Steinestel Konrad , Gorantla Sivahari Prasad , Gebauer Niklas , Witte Hanno M 
Published: July 2024

Abstract
We report a case of a long-term surviving patient with EML4/ALK translocated non–small cell adenocarcinoma of the lung in UICC8 stage IVA. During recurrence under continuous crizotinib therapy, a hitherto insufficiently characterized missense mutation in the ALK gene (Arg1181His) was identified through targeted sequencing. The aforementioned EML4/ALK translocation could still be detected in this situation. Employing a 3D reconstruction of the ALK tertiary structure, considering its interaction with various ALK inhibitors at the molecular binding site, our analysis indicated the presence of a mutation associated with crizotinib resistance. To validate the biological relevance of this previously unknown mutation, we carried out an in vitro validation approach in cell culture in addition to the molecular diagnostics accompanied by the molecular tumor board. The tumor scenario was mimicked through retroviral transfection. Our comparative in vitro treatment regimen paired with the clinical trajectory of the patient, corroborated our initial clinical and biochemical suspicions. Our approach demonstrates preclinical, in silico, and clinical evidence of a novel crizotinib resistance mutation in ALK as well as sensitivity toward brigatinib and potentially lorlatinib. In future cases, this procedure represents an important contribution to functional diagnostics in the context of molecular tumor boards.
Cisplatin eligibility in the neoadjuvant setting of patients with muscle-invasive bladder cancer undergoing radical cystectomy
Authors: Pichler Renate , Fritz Josef , Mari Andrea , Cadenar Anna , von Deimling Markus , Marcq Gautier , del Giudice Francesco , Leonardo Costantino , Bologna Eugenio , Mori Keiichiro , Tahbaz Rana , De Santis Maria , Klatte Tobias , Erber Barbara , Lackner Felizian , Kronbichler Andreas , Seeber Andreas , Fisch Margit , Moschini Marco , Pradere Benjamin , Mertens Laura S 
Published: July 2024

Abstract

Background
To examine the agreement of different calculated estimated glomerular filtration rate (eGFR) formulas and measured creatinine clearance (CrCI) at the primary diagnosis of muscle-invasive bladder cancer (MIBC).

Materials and Methods
We performed a multicenter analysis of patients with MIBC, treated with cisplatin-based neoadjuvant chemotherapy (NAC) and radical cystectomy (RC), or with RC alone, between 2011 and 2021. Baseline eGFR was computed using 4 calculated serum equations including Cockcroft-Gault (CG), MDRD, CKD-EPI 2009, and race-free CKD-EPI 2021. To examine the association between calculated eGFR and measured CrCI, subgroup analyses were performed among patients in whom measured 24-hour urine CrCl was determined. Cisplatin-ineligibility was defined as CrCI and/or eGFR &lt; 60 mL/minute per 1.73 m2.

Results
Of 956 patients, 30.0%, 33.3%, 31.9%, and 27.7% were found to be cisplatin-ineligible by the CG, MDRD, CKD-EPI, and race-free CKD-EPI equations (P = .052). The concordance between calculated eGFR formulas was rated substantial (Cohen’s kappa (k): 0.66-0.95). Among the subgroup (n = 245) with measured CrCl, 37 (15.1%) patients had a CrCI less than 60 mL/minute. Concordance between measured CrCl and calculated eGFR was poor (ĸ: 0.29-0.40). All calculated eGFR formulas markedly underestimated the measured CrCI. Specifically, 78%-87.5% of patients with a calculated eGFR between 40 and 59 mL/minute exhibited a measured CrCI ≥ 60 mL/minute.

Conclusions
Comparing calculated eGFR formulas, similar percentages of patients with MIBC were deemed cisplatin-ineligible. However, a significant number of patients could be upgraded by being cisplatin-fit based on measured CrCI, particularly when the calculated eGFR was falling within the gray range of 40-59 mL/minute.
Effects of Continuous versus Single Dose Spinal Anesthesia in Octogenarians Undergoing Hip Surgery: Randomized Control Trial
Authors: Mady Eman Z , ELzahaby Hany M , Elsersi Mayar H , Ahmad Aya H 
Published: July 2024

Abstract

Background
Continuous spinal anesthesia (CSA) is an anesthetic technique that offers several clinical advantages for anesthesia and analgesia in elderly patients. The level of sensory blockade can be titrated to the desired dermatomal level with great precision with intrathecal (IT) catheters, allowing better control of the hemodynamic consequences of sympathetic blockade associated with spinal anesthesia compared to epidural or single shot spinal techniques. Octogenarians are expected to suffer more from hemodynamic instability with spinal anesthesia.

Objective
The primary outcome is to compare the incidence of hypotension (defined as decrease in mean arterial blood pressure &gt; 20% from the base line) in continuous spinal anesthesia CSA versus single dose spinal anesthesia in octogenarians undergoing hip surgery. The secondary outcome is to determine the total use of vasopressor (Ephedrine) and the incidence of spinal complications as nausea, vomiting and post Dural puncture headache.

Methods
This is a randomized controlled clinical trial done at Ain-shams University Hospitals, Cairo, Egypt within a period of 6 months from approval of medical ethics committee. Twenty patients in CSA group received increments of (0.5 ml) of plain bupivacaine 0.5% until T10 level blockade is achieved. Twenty patients in SDA group received single shot of (2.5ml) of bupivacaine 0.5%.

Results
The main finding of this study is that while MAP was significantly lower between 5-35 minutes (&lt;0.001), it was significantly higher between 40-75 minutes in SDA group than CSA group (0.05).Total bupivacaine dose was significantly higher in SDA (12.5±0.8) group than CSA group (7.6±1.3) (p &lt; 0.001). The total ephedrine dose needed was significantly higher in the SDA group (19.5 ±11.3) than in CSA group (4.5±1.7) (p.0.006).

Conclusion
The main finding of this study is that for octogenarians undergoing hip surgery, while MAP was significantly lower between 5-35 minutes, it was significantly higher between 40-75 minutes in single dose spinal anesthesia group than continuous spinal anesthesia group. Episodes of bradycardia were similar in both groups. The bupivacaine dose as well as total ephedrine dose was significantly higher in SDA group than CSA group. Groups were similar in the incidence of postoperative complications related to the neuraxial blockade. The impact of these changes on the overall cardiovascular status and outcome in octogenarians undergoing hip surgery could not be determined from our study design.
Effect of Interleukin-6 Inhibitor (Tocilizumab) in Treatment of Severe Cases of COVID-19 in Intensive Care Unit, Prospective Clinical Trial
Authors: Fahmy Salama George Atef , Mahmoud Hoda Omar , Moris Kerolos Emad , Hussein Wael Reda 
Published: July 2024

Abstract

Background
COVID-19 is a respiratory disease induced by a novel coronavirus (SARS- CoV-2), having already caused more than 2.5 million deaths over the world. Most people with COVID-19 have only mild or uncomplicated symptoms.

Aim of the Work
to study the effect of using Tocilizumab in treatment of severe cases of COVID-19 in ICU.

Patients and Methods
is a clinical trial study (Analytic, Intervention study, single arm, prospective); this study was carried out at Ain shams university hospitals.

Results
The mean Time to death from receiving Tocilizumab was 6.1888 ± 0.6 SD (Days), the mean Hospital length of stay 14.94 ± 1.85 SD (Days), the number of patients required Mechanical Ventilation was 29 Patients, the mean Duration of mechanical ventilation was 15.19 ± 1.094SD (Days), the number of patients who demonstrated clinical improvement was 38 (73%) and the number of patients who discharged alive was 31 (60%).

Conclusion
in critically ill adult patients with Covid-19 receiving organ support in ICUs, treatment with the interleukin-6 receptor antagonists, Tocilizumab improved outcomes, including survival. Many patients achieved clinical improvement and were eventually discharged from the hospital.
Intravenous Dexamethasone versus intrathecal Dexamethasone in Prolonging the Duration of Spinal Anesthesia and Postoperative Analgesia in Elective Cesarean Section
Authors: Mohamed Radwa Tarek , Hammad Raafat Abdelazim , Kamar Noha Mohamed , Mohamed Marwa Mamdouh 
Published: July 2024

Abstract

Background
Spinal anesthesia is the most commonly used technique for cesarean section as it is very economical and easy to administer. The short duration of action of local anesthetic drugs has created a matter of concern for anesthesiologists.

Aim of the Work
To compare the efficacy of intrathecal dexamethasone with intravenous dexamethasone as an adjuvant to prolong the sensory block obtained by spinal anesthesia and postoperative analgesia in cesarean section.

Participants and Methods
66 pregnant women scheduled for cesarean section were randomly allocated to one of three groups including (22) patients each. All the patients received injection of heavy bupivacaine 0.5% 10 mg through spinal anesthesia, with adding 1 mL of 0.9% saline and normal saline 2 mL intravenously (control group), or 0.5 mL (2mg) dexamethasone diluted in 0.5 ml of 0.9% saline intrathecally with normal saline 2 mL intravenously (IT group ), or dexamethasone 2 mL (8mg) intravenously with intrathecal injection of heavy bupivacaine 0.5% 2 mL plus 1 mL of 0.9% saline (IV group ) with overall 3 ml volume intrathecally in each group. Duration of sensory block, postoperative analgesia, visual analog pain scale (VAS) score, time of rescue analgesia in the first 24 h, intra- and post-operative hemodynamics, and side effects if any were recorded.

Results
The study groups, There was significantly higher post-operative analgesic duration (8.73 ± 2.64) hours compared to addition of Intravenous Dexamethasone (4.91 ± 1.02) hours or using hyperbaric bupivacaine alone (3.43 ± 0.71) hours with p-value &lt;0.001. There was no effect on the time of onset of sensory block with no significant complications were detected.

Conclusion
The addition of 2mg dexamethasone intrathecally as an adjuvant to spinal anesthesia during cesarean section prolong the duration of sensory block and postoperative analgesia.
A Comparative Study Between Ultrasound-Guided Ilioingunial/Iliohypogastric Nerve Block versus Transverse Abdominis Plane Block in Patients Undergoing Oblique Inguinal Hernia Repair
Authors: Fahmy Adel Mikhael , Kamal Karim Youssef , Abdallah Abdelaziz , Ashour Abdelrahman Hassan 
Published: July 2024

Abstract

Background
Poorly controlled acute pain after abdominal surgery is related to somatic pain signals derived from the abdominal wall and is associated with a variety of unwanted post-operative consequences, including patient suffering, distress, respiratory complications, delirium, myocardial ischemia and prolonged hospital stay.

Objective
Regional anesthesia by (Ultrasound guided (US) Transversus abdominis plane block (TAP) or Ultrasound guided ilioinguinal and iliohypogastric nerves (IIN+IHN) block may be used as components of multimodal anesthesia with a comparable effect. In the present study, Bupivacaine is used to compare between them following inguinal hernia repair.

Patients and Methods
The study was conducted on 60 randomly chosen patients aged above 18 years, American Society of Anesthesiologists (ASA) class I or II scheduled for elective unilateral open inguinal hernia repair under general anesthesia, in Ain Shams University Hospitals after approval of the medical ethical committee. They were allocated in two groups. TAP block Group: received general anesthesia and (0.2 mL/kg of 0.25% bupivacaine per side), by midaxillary approach, under ultrasound guidance, the probe was placed transversely between the iliac crest and costal margin. Ilioinguinal/ iliohypogastric nerves block group: received general anesthesia, with (0.2 mL/kg of 0.25% bupivacaine per side). The inferior portion of linear ultrasound transducer will be placed over the anterior superior iliac spine with the superior margin of the transducer pointed directly in an oblique plane toward the umbilicus. The superior margin of the ultrasound transducer was slowly rotated superiorly and inferiorly until the fascial plane between the internal oblique and transverse abdominis muscle is identified.

Results
The results of the study revealed that patients received IIN+IHN block had significantly lower pain scores at 8, 12, 16, 20, and 24 hrs after operation, delayed time for rescue analgesia and decreased total need of analgesic in the first 24hrs post-operative compared to patients who received TAP nerves block.

Conclusion
IIN+IHN block was effective in reducing postoperative pain scores for 4-6 hours, lowering total 24-h postoperative opioid and analgesic consumption and delaying the need for rescue analgesia after inguinal hernia repair under general anesthesia, compared to TAP nerves block. It will be more useful to study in high-risk hypertensive and cardiac patients and to correlate with plasma catecholamine levels, which reflect the stress response and it is necessary to evaluate postoperative pain on movement in farther studies.
Bupivacaine/Dexmedetomidine versus Bupivacaine Alone in Caudal Block for Toddlers Undergoing Unilateral Open Inguinal Hernia Repair
Authors: Ahmed Ahmed Ali Fawaz , Nasr El Din Dalia Abdel Hamid Mohamed , Abd-Elfattah Ghoneim Mohamed Mohamed , Elsayed Khalil Mona Mohamed Magdy 
Published: July 2024

Abstract

Background
Unilateral open inguinal hernia repair surgeries are one of the most frequently performed operations in the pediatric population. Regional anesthetic techniques are commonly used for better control of pain in pediatrics. the most widely used technique of regional anaesthesia in pediatrics is the caudal block.

Objective
To evaluate the analgesic and sedative effect of dexmedetomedine when given caudally as an adjuvant to bupivacaine in caudal block vs bupivacaine alone in toddlers undergoing unilateral Open inguinal hernia repair surgeries.

Patients and Methods
The study was conducted on 50 randomly chosen patients in Ain Shams University Hospitals after approval of the medical ethical committee. Patients were divided randomly into two groups; each group consisted of 25 patients. After preoperative assessment and obtaining baseline vital data, all patients received general anesthesia.

Results
The result of the study reveals that the addition of dexmedetomedine at 1μg/kg to bupivacaine 0.25% in caudal blocks can effectively prolong the duration of postoperative analgesia and causes better sedation than using bupivacaine alone in caudal blocks at similar doses in pediatrics.

Conclusion
From our study we can conclude that the addition of dexmedetomedine at 1μg/kg to bupivacaine 0.25% in caudal blocks can effectively prolong the duration of postoperative analgesia and causes better sedation in the toddlers undergoing unilateral open inguinal hernia repair surgeries. It is better than using bupivacaine alone in caudal blocks at similar doses.
Prognostic Value of C-Reactive Protein in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease Admitted to Intensive Care Unit
Authors: Ali Sultan Sherif Sayed , Ali Elshebiny Ahmed , Khamis Ahmed Mohamed , Mounir Ramy Wahba , Masoud Ali Khedr Masoud Mostafa 
Published: July 2024

Abstract

Background
Chronic obstructive pulmonary disease (COPD) is a leading and increasing cause of worldwide morbidity and mortality. Recently, COPD has gained interest as a major public health concern and is currently the focus of intense research because of its persistently increasing prevalence, mortality, and disease burden. COPD is the third leading cause of death in the world, and further increases in its prevalence and mortality can be predicted in the coming decades.

Aim of the Work
The aim of the present work was to detect the possible role of CRP levels in predicting the prognosis of ICU admitted patients with AECOPD.

Patients and Methods
This prospective Cross sectional study was conducted on 66 adult patients of both sexes admitted to the ICUs of Al-Mabarra governmental hospital in Port Said and Ain Shams University Hospitals.

Results
In our study, it was noticed that duration of NIMV (Days) ranged from 2 h - 11 days in low group and ranged from 1 day - 14 days in high group, While Duration of IMV (Days) ranged from 2 h – 7 days in low group and ranged from 3 day - 18 days in high group. In the present study, we found that 33patients were discharged after improvement (100%) from low group (it reflects the benefit of grouping our study cases), while 26patients were discharged after improvement (78.79%), and 7 patients (21.21%) unfortunately were dead from high group. In the current study, as regards the correlation between CRP with MV, ICU stay and hospital stay, it was noticed that the serum CRP level was significantly elevated in relation to increased period of IMV days (r = 0.714, p = &lt;0.001), NIMV days (r = 0.491, p = &lt;0.001), ICU stay (r = 0.690, p = &lt;0.001) and hospital stay (r = 0.686, p = &lt;0.001).

Conclusion
The following conclusion was obtained from the current study: CRP as biological marker was noticed to be elevated in patients with AECOPD who needed ICU admission. CRP is good indicator of future increase of MV days, hospital stay and ICU stay. There was a significant relation between CRP level and mortality. 100% of our study cases of low group discharged on improvement it reflects the benefit of grouping our study cases. There was no significant relation between CRP level and development of acute heart failure regarding the inclusion criteria in the study.
Comparative Study between High Caloric Nutrition and Net Caloric Nutrition and Their Correlation with Organs Failure and Mortality in Acute Respiratory Distress Syndrome Patients
Authors: Sabri Hussein Hassan , Sultan Sherif Sayed , Taeimah Mohamed Osman , Ramzy Tadrous Rafik Alfy , Abdel-Ghaffar Ahmed Elsaid 
Published: July 2024

Abstract

Background
Acute respiratory distress syndrome (ARDS) is an acute life threatening inflammatory lung injury manifested by hypoxia and stiff lungs due to increased pulmonary vascular permeability and almost always requiring mechanical ventilation support. ARDS represents an acute response to diverse provoking trigger factors and etiologies, resulting in bilateral lung opacities on radiography and hypoxemia.

Objective
To compare between high caloric nutrition and net caloric nutrition in ARDS patients regarding the mortality rates and the incidence of multiple organ failure.

Patients and Methods
This was a prospective, cohort, randomized, comparative study that was conducted on include adults’ patients with ARDS who was admitted to ICU Units in El Galaa Military Hospitals throughout 6 months.

Results
Regarding our primary outcomes, we found that there was no difference found between two groups regarding Hospital mortality, and there was statistically significant difference found between two groups regarding Survival at 60 days. While for the secondary outcomes in our study, we found that there was no difference found between two groups regarding infections, ICU mortality, ICU duration of stay and duration of hospital stay.

Conclusion
No difference was found between high caloric nutrition and net caloric nutrition in terms of the mortality rates and the incidence of multiple organ failure among ARDS patients.