bluuebunny/crossref_metadata_2025_split huggingface dataset:
Frequency of dyspnea related to intake of ticagrelor or clopidogrel in patients with chronic coronary syndrome undergoing coronary intervention
Authors: Shnain Dunya Habeeb , Mahmood Ghassan Mohammed , Ahmed Sara Omar 
Published: June 2024

In patients with chronic coronary syndrome, ticagrelor decreases cardiovascular events more efficiently than clopidogrel. In several studies investigating novel P2Y12 inhibitors dyspnea has been detected. A rise of adenosine blood levels is supposed to be one of cases of dyspnea induced by ticagrelor. Dyspnea is a prevalent and complex symptom. It is associated with deterioration of the quality of life and hospital readmission.Aim. To determine the frequency of dyspnea related with ticagrelor or clopidogrel intake in patients with stable coronary artery disease undergoing coronary intervention. Also, to determine which patients could continue ticagrelor intake and which patients couldn’t, and show the causes of ticagrelor discontinuation.Material and methods. Between October 2023 and January 2024, an observational prospective comparative case-control study was conducted at Baghdad Heart Center in Baghdad Teaching Hospital in Medical City. In this study, individuals with stable coronary artery disease who just had therapeutic catheterization and dual antiplatelet therapy were included. The patients from group 1 received aspirin and ticagrelor, while those from group 2 received aspirin and clopidogrel.Results. A total of 120 patients were included. With the ticagrelor intake, the severity of dyspnea was classified as mild 64.2% (77 [120]) and moderate 19.1% (23 [120]). About 16.7% (20 [120]) had no dyspnea at all. The difference between patients who continued ticagrelor intake (16%) and those who stopped using it (84%) was significant. With clopidogrel intake no dyspnea was recorded.Conclusions. According to our findings, the risk or occurrence of dyspnea is only evident in patients who received ticagrelor. When compared to irreversible P2Y12 inhibitors like clopidogrel, the reversible P2Y12 antagonist ticagrelor has a higher incidence of dyspnea in increasing order.
Comparative assessment of long-term survival of patients after primary and recurrent myocardial infarction: a data from the RIMIS registry
Authors: Martsevich S. Yu. , Afonina O. S. , Zagrebelnyy A. V. , Sichinava D. P , Samorodskaya I. V. , Avdeev Yu. V. , Avdeeva I. Yu , Gvindzhilia T. R. , Kuzmina I. M. , Drapkina O. M. 
Published: June 2024

Aim. To compare the long-term prognosis of life of patients after primary and recurrent acute myocardial infarction (MI).Material and methods. The study was based on the RIMIS registry, which included all patients after transmural MI in 2017 in one of the Moscow vascular centers. The prospective part included 191 patients who survived the acute stage of MI, of which 145 suffered a primary acute MI, 46 — a recurrent acute MI. Long-term follow-up data were collected 71 (53;75) months after discharge from the hospital. The primary endpoint was any-cause death.Results. During the follow-up period, 35 (25,2%) patients with a primary MI and 25 (64,1%) patients with a recurrent MI died (p<0,001). It was not possible to establish the fate of 13 (6,81%) patients, of which 7 (4,83%) were people with primary MI and 6 (13,04%) people with recurrent MI. The death risk was significantly higher in patients who had a recurrent MI compared to patients who had a primary MI: hazard ratio (HR)=3,52 (2,09;5,96), p<0,001). An unfavorable prognosis was determined not by the fact of a recurrent MI, but by the complications that resulted from a previous MI, primarily heart failure, as well as age, sex, smoking status, and hospitalizations for cardiovascular diseases in the year before the reference MI, history of angina and following comorbidities: a prior stroke, major bleeding (life-threatening gastrointestinal bleeding requiring complex surgical intervention). Patients who had a recurrent MI were significantly more adherent to follow-up and prescribed therapy.Conclusion. Despite the modern strategy for treating MI both in the acute stage and in the long-term period, the prognosis after recurrent MI remains unfavorable. Signs negatively affecting the prognosis were sex, age, a history of heart failure and angina pectoris, and hospitalizations for cardiovascular diseases one year prior to reference MI.
METTL3-Mediated N6-Methyladenosine mRNA Modification and cGAS-STING Pathway Activity in Kidney Fibrosis
Authors: Tsai Yu-Cheng , Hsieh Tsung-Han , Liao Yuan-Ru , Tsai Ming-Tsun , Lin Tzu-Ping , Lee Der-Yen , Park Jihwan , Kim Donggun , Susztak Katalin , Yang Shang-Feng , Lin Chih-Ching , Li Szu-Yuan 
Published: June 2024

Key Points

METTL3 was upregulated in CKD, leading to increased m6A modification levels.M6A modifications were enriched in genes related to the cyclic guanosine monophosphate–AMP synthase-stimulator of IFN genes pathway in CKD.Normalizing heightened METTL3 and m6A modification levels showed promise as a strategy to combat kidney disease.

Background
Chemical modifications on RNA profoundly affect RNA function and regulation. m6A, the most abundant RNA modification in eukaryotes, plays a pivotal role in diverse cellular processes and disease mechanisms. However, its importance is understudied in human CKD samples regarding its influence on pathological mechanisms.

Methods
Liquid chromatography–tandem mass spectrometry and methylated RNA immunoprecipitation sequencing were used to examine alterations in m6A levels and patterns in CKD samples. Overexpression of the m6A writer METTL3 in cultured kidney tubular cells was performed to confirm the effect of m6A in tubular cells and explore the biological functions of m6A modification on target genes. In addition, tubule-specific deletion of Mettl3 (Ksp-Cre Mettl3f/f) mice and antisense oligonucleotides inhibiting Mettl3 expression were used to reduce m6A modification in an animal kidney disease model.

Results
By examining 127 human CKD samples, we observed a significant increase in m6A modification and METTL3 expression in diseased kidneys. Epitranscriptomic analysis unveiled an enrichment of m6A modifications in transcripts associated with the activation of inflammatory signaling pathways, particularly the cyclic guanosine monophosphate–AMP synthase (cGAS)-stimulator of IFN genes (STING) pathway. m6A hypermethylation increased mRNA stability in cGAS and STING1 as well as elevated the expression of key proteins within the cGAS-STING pathway. Both the tubule-specific deletion of Mettl3 and the use of antisense oligonucleotides to inhibit Mettl3 expression protected mice from inflammation, reduced cytokine expression, decreased immune cell recruitment, and attenuated kidney fibrosis.

Conclusions
Our research revealed heightened METTL3-mediated m6A modification in fibrotic kidneys, particularly enriching the cGAS-STING pathway. This hypermethylation increased mRNA stability for cGAS and STING1, leading to sterile inflammation and fibrosis.
Teacher's attitude towards the use of Differentiated Instruciton (DI) and its impact in teaching
Authors: Kumar Kharka Deo , Kinley  
Published: June 2024

A single-paced method of instruction does not benefit diverse learners, which is why "one size fits all" teaching has been severely criticized. Thus, it is essential to differentiate instruction to meet the diverse needs of learners. Using mixed methods, this study examines teachers’ use of DI and their attitudes towards using DI in the classroom. Additionally, the study examined the impact of teachers’ attitudes on the practice of DI and the challenges associated with it. Surveys, classroom observations, self-administered open-ended questionnaires, and student feedback were used to collect data. Teacher attitudes toward DI seem positive, and they understand it well. In the classroom, content, process, and product are typically differentiated, with product being the least differentiated. Teachers’ attitudes and DI implementation also exhibit a statistically significant positive correlation (rs (22) =.75, p ≤ .001). In addition, teachers’ attitudes influence DI implementation. Moreover, DI implementation is hampered by crowding, high student-teacher ratios, time constraints, and a rule forbidding student from using their mobile phones. This study raises awareness about DI in the school system in order to meet the needs of diverse learners, who may not benefit from a single-paced teaching approach.
Semyon Ivanovich Shumakov (1913–1995) – founder of the neurosurgical service of the Penza region (to the 110th anniversary of birth)
Authors: Shalin V. V. 
Published: June 2024

The article is devoted to Semyon Ivanovich Shumakov (1913–1995), an outstanding doctor, the founder of the neurosurgical service of the Penza region.The formation of the neurosurgical service in the Penza region occurred in the middle of the XX century. S.I. Shumakov is exactly the man who stood at the origins. The development of neurosurgery as a separate branch of clinical medicine in the Penza region became possible thanks to his work. During the work of S.I. Shumakov, the neurosurgical service underwent great changes – new methods of diagnosis and treatment were introduced, as well as complex surgical interventions were carried out, which are now becoming commonplace. Thanks to his dedication and dedication to his work, modern neurosurgery is currently developing in the Penza region.The data of the biography and the main directions of S.I. Shumakov’s work are considered. The data of the materials of the State Archive of the Penza region, the available literature data, as well as the archive of relatives, friends and students were analyzed.
Endovascular treatment of patients with distal aneurysms of cerebellar arteries
Authors: Kolomin E. G. , Goroshchenko S. A. , Bobinov V. V. , Petrov A. E. , Rozhchenko L. V. , Samochernykh K. A. 
Published: June 2024

Aim. To evaluate short- and long‑term angiographic and clinical outcomes of endovascular treatment of patients with distal aneurysms of cerebellar arteries.Materials and methods. The outcomes of endovascular treatment of 6 patients with distal aneurysms of cerebellar arteries who underwent surgery at the Neurosurgical Division No. 3 of the Polenov Russian Research Institute of Neurosurgery between January 1 of 2017 and March 31 of 2023 were analyzed.Results. The following endovascular methods were used: occlusion of the aneurysm sac using only detachable coils (n = 2); occlusion using stent‑assisted coiling (n = 3); deconstructive intervention with occlusion of the main artery (n = 1). In 1 of 2 cases of coil‑only aneurysm occlusion, additional stent‑assisted occlusion was performed due to recurrence. Among 6 aneurysms, 1 (16.65 %) aneurysm was radically excluded from the blood flow (class А); 4 (66.7 %) were excluded subtotally (class B); 1 (16.65 %) was excluded partially (class С). Control angiography at least 6 months after showed radical exclusion of the aneurysm from the blood flow (class A) in 5 (83.3 %) patients, subtotal exclusion (class В) in 1 (16.7 %) patient. Clinical outcome was excellent in 5 (83.3 %) patients (0 points per the modified Rankin scale); in 1 patient after deconstructive surgery, augmentation of neurological symptoms with following partial regression was observed (2 points per the modified Rankin scale). Complications during deconstructive surgery were observed in 1 (16.7 %) patient.Conclusion. Deconstructive surgery of the distal aneurysms of cerebellar arteries can be associated with high risk of postoperative ischemic complications with development of persisting neurological deficit. Surgical interventions with preservation of the artery lumen (including reconstructive surgeries) should be the method of choice in endovascular treatment of distal aneurysms of cerebellar arteries due to minimal risk of ischemic complications and improved clinical outcomes of surgical treatment.
Postoperative outcomes of tumor-associated epileptic seizures in glioma patients
Authors: Chizhova K. A. , Gulyaev D. A. , Korepanov I. I. , Belov I. Yu. , Kurnosov I. A. , Chirkin V. Yu. , Sulin K. A. , Chistova I. V. , Yakovenko I. V. 
Published: June 2024

Background. Epileptic seizures occur in 50–90 % of patients with low‑grade glioma and in 20–60 % of patients with glioblastoma. The presence of tumor‑associated epilepsy is one of the leading criteria affecting the quality of life of this cohort of patients. The study of risk factors for the formation and persistence of tumor‑associated epilepsy after surgical resection can contribute to the most adequate care for such patients in terms of freedom from seizures and the duration of the relapse‑free period.Aim. To study the features of epileptic seizures before surgical treatment, in remote cases of the postoperative period in patients with glioma.Materials and methods. Patients (n = 184) with histologically verified gliomas underwent total or non‑total microsur‑ gical removal of the tumor. The radicality of resection was assessed 1 month after the operation. The observation was carried out for 5 years.Results. All patients were divided into 4 groups. The 1st group consisted of 102 (55.42 %) patients whose seizures regressed after surgery; the 2nd group included 2 patients with the first seizures after surgery – 1 (0.54 %) in the early and 1 (0.54 %) in the late postoperative period; the 3rd group – 23 (12.5 %) patients with seizures both before and after surgery; the 4th group – 57 (31 %) patients without seizures. Total resection was performed significantly more often in the group with regressed seizures – in 79 (77.4 %) patients. The dynamics of the course of seizures did not depend on their initial nature and frequency. Twenty four (70,6 %) patients with new seizures had tumor recurrence, of which 15 (62.5 %) patients had seizure recurrence earlier than tumor recurrence based on RANO criteria.Conclusion. Tumor‑associated epilepsy is most common in low‑grade gliomas. Total resection allows to increase life expectancy and improve its quality by controlling seizures. The effectiveness of adjuvant treatment of this cohort of patients is directly related to the results of treatment of tumor‑associated epilepsy.
Surgical treatment of gangliogliomas in functional areas of the brain in child: a literature review and clinical cases
Authors: Nizolin D. V. , Kim A. V. , Zueva Yu. A. , Shmeleva O. O. , Maslov N. E. , Efimtsev A. Yu. , Nazaralieva E. T. , Samochernykh K. A. 
Published: June 2024

Surgical treatment of tumors located near functional areas involves the use of technologies such as awake craniotomy, cortical and subcortical stimulation. The introduction of these and other technologies makes it possible to achieve maximum resection of the tumor without compromising the functional status of the patient. The use of this technologies has been well studied in adults, but this not about pediatric patients.Aim of the work is to present two clinical cases of successful treatment of low‑grade gliomas of functional areas of the brain in children and literature review.In clinical cases, damage of functionally significant areas were noted: the sensory speech cortex and the corticospinal tract. The involving speech cortex in the first case was also confirmed by functional magnetic resonance imaging. In the first case, an operation was performed with awake craniotomy, using cortical and subcortical mapping, in the second, using subcortical mapping and metabolic navigation. Total tumor resection was achieved in both clinical cases with a good functional outcome.Achieving an optimal balance of functional outcome and the degree of radical removal of low‑grade tumors of functional areas is possible using an integrated approach based on the analysis of multimodal data.
Primary abscess of the sella turcica of odontogenic nature (observation from practice)
Authors: Bogdanova O. Yu. , Grigoriev A. Yu. , Pilnikov V. G. , Melikov E. A. 
Published: June 2024

Abscess of the sella turcica is an extremely rare disease of the chiasm and sellar region which often clinically and radiologically imitates other lesions in this area complicating the diagnosis.The article presents a clinical case of a 42‑year‑old female patient with primary abscess of the sella turcica which at first was considered to be pituitary adenoma. The patient underwent surgery through endoscopic transnasal access with good postoperative outcome. Additional postoperative examination revealed a possible source of hematogenic advancement of infectious process into the sella turcica cavity – pericoronitis of tooth 4.8. The article also presents review of publications on the topic.
Surgical treatment of cerebellar hemangioblastoma during pregnancy: a clinical case and literature review
Authors: Zayachkovsky N. A. , Paltsev A. A. , Tastanbekov M. M. , Li O. A. 
Published: June 2024

Among all primary brain tumors with localization in the posterior cranial fossa, hemangioblastoma is the most common among the adult population. In some patients, the manifestation of a brain tumor may occur during pregnancy.This article describes a clinical case of pregnancy complicated by hypertensive‑hydrocephalic symptoms against the background of cerebellar hemangioblastoma and developed occlusive hydrocephalus. The result of the work of a team of neurosurgeons, obstetricians and anesthesiologists was successful surgical treatment against the background of pregnancy prolongation. Five months after tumor resection, no recurrence of hemangioblastoma was observed, the patient gave birth to a healthy baby naturally.
Acute back pain: clinical and radiological diagnosis. Guidelines of the WFNS Spine Committee
Authors: Gushcha A. O. , Yusupova A. R. , Kartavykh R. A. 
Published: June 2024

Aim. To propose the list of guidelines of the World Federation of Neurosurgical Societies (WFNS) Spine Committee on clinical and radiological diagnosis of acute back pain.Materials and methods. Systematic literature search in the PubMed and Google Scholar databases between 2012 and 2022 using keywords “acute back pain AND clinical diagnosis” and “acute back pain AND radiologic diagnosis” was performed. In total, 97 articles were analyzed, and the WFNS Spine Committee organized 2 consensus meetings to propose specific guidelines. The first meeting took place in May of 2022 in Karachi (Pakistan), the second during the Congress of the Middle East Spine Society in September of 2022 in Istanbul (Turkey). To formulate the guidelines, both meetings used the Delphi method of voting on the preliminary statements proposed based on the evidence level‑stratified literature search.Results and discussion. In total, 10 statements were put to vote. Clinical characteristics allowing to distinguish between acute and chronic pain were indicated. A trend towards instrumental hyperdiagnosis of back pain was observed but routine neuroimaging does not have clinical benefit in acute back pain, it can even have a negative effect.Conclusion. Acute back pain is hard to diagnose both clinically and radiologically. A patient with primary acute back pain should not be prescribed radiological exams in the absence of “red flags”. There are specific indications for specific radiological exams. The gold standard of diagnosis is magnetic resonance imaging which is confirmed by high‑quality studies.
Evaluation of effectiveness and safety of manual anastomosis use of its own modernization in the rectum anterior resection
Authors: Gaydarov S. G. , Mamedli Z. Z. , Dudaev Z. A. , Pugaev D. M. , Mongush Ch. M. 
Published: June 2024

Aim. The choice of optimal method of colorectal anastomosis formation remains a matter of debate. The purpose of this study is to assess safety of an original method of forming a manual colorectal anastomosis.Materials and methods. The retrospective study included patients having rectal cancer with tumor localization above 5 cm from the anocutaneous line, who underwent anterior resection of the rectum with formation of a manual “side-to-end” anastomosis of own modification. The main parameter evaluated was frequency of anastomotic failure and the additional one was overall incidence of postoperative complications.Results. The study included 31 patients, among them were 15 (48.4 %) men, 18 (58.1 %) of them were older than 50 years, 9 (29 %) were smokers, 17 (54.8 %) had a body mass index greater than 25 kg/m2 . Anastomosis failure developed n 2 (6.5 %) patients and only 1 (3.2 %) patient required a second surgery.Conclusion. Preliminary analysis data indicate safety of the proposed method of colorectal anastomosis formation. It is necessary to conduct comparative studies to evaluate possibility of wider implementation of this technique in clinical practice.
Efficacy and safety of different chemotherapy regimens in patients with disseminated pancreatic cancer over 65 years old
Authors: Manukyan M. Sh. , Chikhareva Ya. E. , Bazin I. S. , Pokataev I. A. , Tryakin A. A. 
Published: June 2024

Aim. To evaluate the effectiveness and tolerability of systemic chemotherapy in elderly patients with metastatic pancreatic cancer (mPC) in real clinical practice.Materials and methods. The study included patients with mPC over 65 years of age who received first-line chemotherapy at the N. N. Blokhin National Medical Research Center of Oncology for the period from 2004 to 2023. Any previous antitumor chemotherapy for mPC was an exclusion criterion. The primary endpoint was 1-year overall survival (OS), and the secondary endpoints were ORR, median progression-free survival, median OS, chemotherapy tolerability.Results. The study included 148 patients aged 65 to 86 years with mPC who received first-line chemotherapy. Median progression-free survival among the entire population was 5.2 months. One-year OS among all patients was 32 %. The 1-year OS in mFOLFIRINOX group was 43.4 % and in gemcitabine group – 19.6 %. In a subgroup analysis, median OS with combination treatment was higher than in the gemcitabine monotherapy group (median OS 8.4 months vs. 6.8 months, p = 0.009). Patients with ECOG 2–3 also benefited from combination chemotherapy. Median OS was 8.9 months versus 3.9 months in gemcitabine (p = 0.008). The frequency of an objective response with triple chemotherapy was 66.1 %. In 30.8 % of cases, grade 3–4 neutropenia developed with mFOLFIRINOX, but febrile neutropenia developed only in three patients (5.8 %). The incidence of grade 3–4 adverse events was low, and these chemotherapy regimens were well tolerated.Conclusion. Conducting a triple chemotherapy regimen in elderly patients with mPC is an effective treatment option with an acceptable range of toxicity.