bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of the interleukine-6 polymorphism with catheter-induced coronary artery spasm in Egyptians
Authors: Abdelaziz Tarek A. , Mohamed Randa H. , Dwedar Ashraf A. , Eldeeb Mohey Eldeen A. , Abdelfattah Abdelrahman A. , Saadawy Sara F. 
Published: February 2024

Background
The role of coronary artery spasm (CAS) was extended beyond variant angina to ischemic heart disease in general, including effort angina, unstable angina, acute myocardial infarction (MI) and sudden death. It is difficult and cumbersome to examine CAS during coronary angiography. Risk factors for CAS include smoking and genetic polymorphisms.

Aim
We aimed to investigate the association of the interleukin-6 (IL-6) polymorphism with catheter-induced CAS in Egyptian patients who undergo coronary angiography.

Methods
This is a case–control study. Two hundred patients with chronic coronary artery disease who underwent elective coronary angiography were included in the study. Patients were divided into two groups: the non-CAS group (100 patients) and the CAS group (100 patients). The subjects were genotyped to the −572 C>G (rs 1800796) polymorphism of the IL-6 gene by PCR-restriction fragment length polymorphism.

Results
We found that patients with CAS have more risk factors for atherosclerosis compared to those without CAS. Smoking, the IL-6 GG genotype, and the G allele were independent risk factors for CAS.

Conclusion
We concluded that the GG genotype and G allele of the IL-6 gene are associated with CAS. Smoking, the GG genotype, and the G allele of the IL-6 gene are independent predictors of catheter-induced CAS.
Age shock index as an early predictor of cardiovascular death in acute coronary syndrome patients
Authors: Carvalho Pedro Rocha , Bernardo Marta Catarina , Carvalho Catarina Ribeiro , Moreira Isabel , Borges Sara , Guimarães José Pedro , Gonçalves Fernando Fonseca , Mateus Pedro , Fontes José Paulo , Moreira Ilídio ,   on Behalf of the ProACS Investigators
Published: February 2024

Background
The shock index (SI), reflecting heart rate (HR) to SBP ratio, is established for predicting adverse outcomes in acute coronary syndrome (ACS) patients. Exploring the age shock index (ASI), obtained by multiplying SI with age, could offer further insights into ACS prognosis.

Objectives
Assess ASI’s effectiveness in predicting in-hospital death in individuals with ACS.

Methods
This study encompassed patients with acute myocardial infarction, drawn from a national registry spanning October 2010 to January 2022. The optimal ASI threshold was established using receiver operating characteristic (ROC) curve analysis. The primary outcome was in-hospital mortality.

Results
A total of 27 312 patients were enrolled, exhibiting a mean age of 66 ± 13 years, with 72.3% being male and 47.5% having ST-elevation myocardial infarction. ROC analysis yielded an area under the curve (AUC) of 0.80, identifying the optimal ASI cutoff as 44. Multivariate regression analysis, adjusting for potential confounders, established ASI ≥ 44 as an independent predictor of in-hospital death [hazard ratio: 3.09, 95% confidence interval: 2.56–3.71, P < 0.001]. Furthermore, ASI emerged as a notably superior predictor of in-hospital death compared to the SI (AUCASI = 0.80 vs. AUCSI = 0.72, P < 0.0001), though it did not outperform the Global Registry of Acute Coronary Events (GRACE) score (AUCASI = 0.80 vs. AUCGRACE = 0.85, P < 0.001) or thrombolysis in myocardial infarction (TIMI) risk index (AUCASI = 0.80 vs. AUCTIMI = 0.84, P < 0.001).

Conclusion
The ASI offers an expedient mean to promptly identify ACS patients at elevated risk of in-hospital death. Its simplicity and effectiveness could render it a valuable tool for early risk stratification in this population.
Deep learning applications for kidney histology analysis
Authors: Pilva Pourya , Bülow Roman , Boor Peter 
Published: February 2024

Purpose of review
Nephropathology is increasingly incorporating computational methods to enhance research and diagnostic accuracy. The widespread adoption of digital pathology, coupled with advancements in deep learning, will likely transform our pathology practices. Here, we discuss basic concepts of deep learning, recent applications in nephropathology, current challenges in implementation and future perspectives.

Recent findings
Deep learning models have been developed and tested in various areas of nephropathology, for example, predicting kidney disease progression or diagnosing diseases based on imaging and clinical data. Despite their promising potential, challenges remain that hinder a wider adoption, for example, the lack of prospective evidence and testing in real-world scenarios.

Summary
Deep learning offers great opportunities to improve quantitative and qualitative kidney histology analysis for research and clinical nephropathology diagnostics. Although exciting approaches already exist, the potential of deep learning in nephropathology is only at its beginning and we can expect much more to come.
Immunotherapy treatment for sarcomatoid renal cell carcinoma: case report and literature review
Authors: Su Hui , Yu Chao , Ma Xuezhen , Yu Xiao , Sun Guiming 
Published: February 2024

Introduction:
Sarcomatoid renal cell carcinoma (SRCC) is clinically rare, accounting for ~1.0–1.5% of renal parenchymal tumors. Although the concept of SRCC was proposed in 1968, the molecular mechanisms and immunological characteristics of sarcomatoid changes remain unclear. In the era of targeted therapy, the overall survival (OS) of patients with SRCC is typically less than 12 months.

Case presentation:
This article reports a case of SRCC in an 81-year-old male. Progression-free survival (PFS) was as long as 25 months and OS was 30 months after immunotherapy and the effect was significant. This is the first report of successful use toripalimab in the treatment of SRCC.

Clinical discussion:
SRCC is a rare type of renal cancer with no obvious specific clinical manifestations or imaging findings, and the diagnosis of the disease is based on pathological examinations. SRCC has a high degree of malignancy, progresses rapidly, and has a poor prognosis. The effect of traditional treatment is limited, and immune checkpoint inhibitors may have therapeutic potential.

Conclusions:
Toripalimab may be effective and further exploration is anticipated to advance a new period of SRCC.
Septal atrial thrombosis as a primary presentation of antiphospholipid syndrome in a patient with ANA-negative systemic lupus erythematosus: a case report
Authors: Hamsho Suaad , Alaswad Mohammed , Makhlouf Zeina , Alcheikh Salwa 
Published: February 2024

Introduction and importance:
Systemic lupus erythematosus (SLE) predominantly affects young women and is associated with an increased risk of thrombosis. Antiphospholipid antibody syndrome (APS) may complicate the clinical picture, often leading to recurrent arteriovenous thrombosis. This case report underscores the significance of two unique aspects: the rare occurrence of an atrial thrombus and the presence of antinuclear antibody (ANA)-negative SLE.

Case presentation:
A 32-year-old woman presented with a history of symmetric polyarticular joint pain, oral ulcers, significant weight loss, and a history of unprovoked popliteal thrombosis and two unexplained abortions. One week prior to admission, she experienced severe headaches and elevated blood pressure. Clinical evaluation revealed several abnormalities, including a systolic murmur, livedo reticularis, and a transthoracic echocardiogram showing severe mitral regurgitation and an atrial thrombus. A transesophageal echocardiogram confirmed the presence of a pedunculated lesion in the right atria, challenging differential diagnosis.

Clinical discussion:
ANA-negative SLE, though rare, was observed in this patient, highlighting diagnostic complexities. APS compounded the clinical presentation, emphasizing the importance of identifying specific autoantibodies and recurrent thrombotic events. In the case of atrial thrombus, differentiation from other cardiac conditions, such as myxoma or vegetation, is a key.

Conclusions:
This case underscores the critical importance of recognizing and managing atrial thrombus, a rare but life-threatening complication in patients with systemic lupus erythematosus and antiphospholipid syndrome. Additionally, the diagnostic challenge of ANA-negative SLE warrants careful consideration in patients presenting with characteristic features of the disease.
Energy drink consumption among medical students in Jordan – prevalence, attitudes, and associated factors: a cross-sectional study
Authors: Qasem Nuha W. , Al-omoush Omar M. , Al Ammouri Zaid M. , Alnobani Nour M. , Abdallah Mohamed M. , Khateeb Abdullah N. , Habash Michael H. , Hrout Ruba A. 
Published: February 2024

Background:Energy drinks (ED) are popular beverages that contain high levels of caffeine, sugar, and other supplements, such as vitamins, which are marketed to enhance mental alertness and physical performance. Studies have shown that energy drink consumption is prevalent among medical students. Therefore, this study aimed to assess the prevalence, attitudes, and factors associated with energy drink consumption among medical students in Jordan.Materials and methods:A cross-sectional study was conducted among medical students from six public universities in Jordan. A total of 307 students were included in the study, and data were collected using an expert-validated questionnaire. The collected data were analyzed using SPSS version 25.Results:The study found that 50% of the sample had consumed ED, half of them started consuming them at the age of 16–18, and learned about them from friends. The primary reasons for consuming ED were to stay awake at night and the majority of them increase their consumption during exams to increase alertness. Regular energy drink consumption was significantly associated with being a student at the university located in the south governorate of Jordan (P=0.021), living alone (P=0.000), drinking alcohol (P=0.049), drinking coffee daily (P=0.043), and consuming more than 10 cans of soft drinks weekly (P=0.001). However, sex, age, academic achievement, and smoking status had no significant association with regular energy drink consumption. Students with regular energy drink consumption experienced daytime sleepiness, decreased concentration, fatigue, and reduced performance more than students with no regular energy drink consumption.Conclusion:The prevalence of energy drink consumption among medical students in Jordan is high, with factors such as social influences, lifestyle behaviors, and academic pressure being significant contributors. This study highlights the need for interventions to promote healthy behaviors and raise awareness about the potential harms of ED among medical students.
A rare case of descending colonic volvulus presenting as large bowel obstruction 19 years after sigmoidectomy and descending colorectal anastomosis
Authors: Abebe Temesgen Agegnehu , Berhe Yophtahe Woldegerima , Seid Oumer Ahmed , Sefefe Worku Mekonnen , Lake Leaynadis Kassa 
Published: February 2024

Introduction and importance:
Large bowel obstruction is a common surgical emergency worldwide. Large bowel obstruction secondary to descending colonic volvulus is an extremely rare condition with only few reported cases worldwide. Its extreme rarity is due to its retroperitoneal location and lack of mesentery.

Case presentation:
A 75-year-old male patient with a history of sigmoidectomy and end-to-end descending colorectal anastomosis 19 years previously, presented with failure to pass faeces and flatus of 1 day duration with associated colicky abdominal pain, distension and vomiting. The abdomen was distended but soft and non-tender. Digital rectal examination showed an empty and ballooned rectum. The intraoperative finding was of a 360° counter-clockwise rotated descending colon. Detorsion and extraperitonealization of the descending colon was performed and the patient was successfully discharged.

Clinical discussion:
Volvulus is a twisting of a segment of bowel along its own mesentery. Sigmoid volvulus and caecal volvulus accounts for up to 90% and less than 20% of cases, respectively. Descending colonic volvulus is described in very few case reports. Diagnosis is clinical and confirmed by imaging.

Conclusion:
Descending colonic volvulus is a surgical emergency and an extremely rare cause of large bowel obstruction. Surgical management options include extraperitonealization of the descending colon, diversion colostomy or resection and primary end-to-end anastomosis.
Equipment preparedness for neonatal resuscitation in neonatal intensive care unit in resource limited setting: cross-sectional study
Authors: Hassen Alemayehu Eshetu , Agegnehu Abatneh Feleke , Temesgen Mamaru Mollalign , Admassie Belete Muluadam , Abebe Temesgen Agegnehu , Admass Biruk Adie 
Published: February 2024

Background:
Adverse healthcare’s events are a critical issue worldwide, neonatal intensive care unit adverse events are a considerable issue. It is important that we recognize the basic equipment needed to address these circumstances. The aim of this study is to asses’ equipment preparedness for neonatal resuscitation in the neonatal intensive care unit.

Method:
A hospital-based, cross-sectional study was conducted on 210 neonates admitted to neonatal intensive care unit at comprehensive specialized hospital from 26/03/2022 to 26/05/2022. The data were collected using Checklist prepared from Neonatal resuscitation: current evidence and guidelines. The data obtained were summed up and presented as descriptive statistics using the Microsoft Excel and were analyzed using SPSS version 25. The result reported in text and table form.

Result:
In this study there was 12.72% complete equipment preparation (without defect) in 210 cases. From the total, there was minor defect in 52.8% cases, and 34.45% cases had serious defect. Serious defects were more frequently detected in the equipment preparation (42.46%), resuscitation medications (12.5%), and radiant warmer set-up (40%).

Conclusion and recommendation:
Overall equipment preparation for neonatal resuscitation was insufficient, and quality of equipment preparation for neonatal resuscitation and stabilization needs to be improved. To enhance equipment preparedness in the neonatal intensive care unit staff should establish uniform guidelines.
Single breath count test and its applications in clinical practice: A systematic review
Authors: Bhandari Samikchhya Keshary , Bist Anil , Ghimire Anup 
Published: February 2024

Background:Single breath count test (SBCT) may be a reproducible, rapid, easy to perform and easy to interpret substitute to spirometry especially in low resource settings for certain conditions. Its interest has been rekindled with the recent COVID-19 pandemic and it can be done as a part of tele-medicine as well.Objectives:The Objective of this review was to summarize the evidence of single breath count test in clinical practice.Methods:We searched EMBASE, PubMed and Google Scholar for all the relevant articles as per exclusion and inclusion criteria. Two authors independently screened all the studies. Newcastle Ottawa Scale was used to assess the quality of the studies. The systematic review was carried following the PRISMA guidelines.Results:After the rigorous process of screening, a total of 13 articles qualified for the systematic review. Single breath count test (SBCT) >25 had sensitivity of >80% in diagnosing Myasthenia Gravis exacerbation and SBCT <=5 predicted the need for mechanical ventilation in Guillain–Barre syndrome (GBS) patients with 95.2% specificity. Also, Single breath count correlated significantly with Forced Expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) in children with pulmonary pathology and in patients with COVID 19 it was used to rule out the need for Noninvasive Respiratory Support.Conclusion:Single breath count test will undoubtedly be an asset in low resource settings and in telemedicine to assess the prognosis and guide management of different respiratory and neuromuscular diseases.
A case report of coexisting breast cancer with peritoneal, cutaneous tuberculosis, and potential Pott’s disease: therapeutic and diagnostic challenges
Authors: Hassan Bassam , Alshehabi Zuheir 
Published: February 2024

Introduction:
Breast cancer affects one in eight women during their lifetime; it may coincide with other diseases due to its high prevalence. Different pathologies that occur simultaneously with breast cancer, or later during its course, lead to multiple interactions with cancer and have a significant impact on its management.

Presentation of case:
A 58-year-old Syrian female was admitted to our hospital for compliant of abdominal distension. Following complete examination, obtained biopsies confirmed the diagnosis of peritoneal tuberculosis. At a subsequent time, she suffered back pain and the computed tomography showed vertebral lesion with breast mass that was diagnosed as invasive lobular carcinoma (ILC) of the left breast. Vertebral lesion that appeared on radiologic assessment was diagnosed as cancer metastasis. However, the interaction of this metastasis with the proposed management diverted the attention towards its non-cancerous entity. Five months after completing the chemotherapy, biopsies revealed the recurrence of triple-negative (ER−, PR−, HER2− neu−) ILC of the breast. Ultimately, the patient was followed up for an overall duration of 4 years.

Discussion:
Latent tuberculosis infections may be activated by chemotherapy regimens that suppress immunity. Therefore, initial management of tuberculous infection is preferred when it coexists with cancer.

Conclusion:
Breast cancer is common and may co-present with other diseases, which, in some cases, produce mimicking lesions that alter its diagnosis. Pott’s disease, albeit a rare entity, has shown a resurgence in developed countries and should be considered in the differential diagnosis of vertebral lesions in patients with breast cancer.
Pilot Application of SEM/EDX Analysis on Suspected Cigarette Burns in a Forensic Autopsy Case of Child Abuse
Authors: Tambuzzi Stefano , Gentile Guendalina , Primavera Riccardo , Muccino Enrico , Zoja Riccardo 
Published: February 2024

Abstract
Cigarette burn lesions present forensic scenarios that are often difficult to investigate, both from a morphological diagnostic point of view and with regard to the mode of infliction, especially if the victim is unable to speak or has died. Although there may be the suspicion for a lesion to be produced by a lit cigarette, to date one can only rely on the morphological aspects that characterize it, and there is a lack of tools to reach the most evidence-based diagnosis possible. This limitation arose when managing a forensic autopsy case of possible child abuse that resulted in the death of the child, characterized by the presence of 3 suspicious cigarette burn lesions. We therefore decided to perform scanning electron microscopy/energy-dispersive x-ray (SEM/EDX) spectrometry analysis on these lesions and on the cigarette butt found at the crime scene. At the same time, SEM/EDX was applied to the analysis of an unlit cigarette in its entirety (obtained from the same source package as the cigarette butt), a positive control skin sample with an iatrogenic cigarette burn injury, and a negative control skin sample. Among the various compounds highlighted on compositional analysis, only sulfuric anhydride (SO3) and phosphoric anhydride (P2O5) showed a highly significant distribution pattern by being found in the autopsy samples, the cigarette butt, the tobacco of the unlit cigarette, and the positive skin control. Considering this, cigarette burns appear to follow Locard's principle as well, and similarly to other lesions, SEM/EDX allowed the diagnosis of cigarette burn lesions, already suspected morphologically, to be corroborated. Therefore, SEM/EDX is confirmed as a helpful tool in forensic pathology investigations.
Long-Acting Reversible Contraception Knowledge Among Female Adolescents Presenting to a Pediatric Emergency Department
Authors: Bowling Morgan S. , Yao Meizhen , Mazzaferro Natale , Greenberg Patricia , George Ellen , Sivitz Adam , Tejani Cena 
Published: February 2024

Abstract

Objectives
The objective of this study was to assess awareness and use of long-acting reversible contraception (LARC) among female adolescents presenting to a pediatric emergency department (PED).

Study Design
During routine presentation to an urban PED in New Jersey, female adolescents, aged 15–19 years, were asked to voluntarily complete an electronic survey about sexual practices and contraception. The PED is in an urban teaching hospital, treating 35,000 children annually. Patients could schedule a follow-up appointment at the hospital's obstetrics/gynecology clinic. Data were collected over 13 months, and follow-up was monitored to determine if they attended an outpatient appointment, and if so, what the outcome was.

Results
Data for 199 participants were analyzed. The median age of participants was 18 years, whereas 79% self-identified as Black, and 17.6% self-identified as Latina. Twenty-one percent of participants used a form of birth control during their first sexual encounter, the largest percentage being condoms (77.8%). Forty percent of participants reported some prior knowledge about contraceptive implants, and 20% had knowledge about intrauterine devices, whereas only 3 (1.5%) intrauterine devices and 2 (1%) arm implants had been previously used. Of the 78 participants that requested a follow-up, 14 (17.9%) completed their appointment. Of those, 2 (14%) were prescribed contraception (Depo-Provera shot and oral contraceptive pills).

Conclusions
Knowledge about LARC remains low in our PED, despite it being the most effective method of contraception. Even when interventions were made to link interested respondents to outpatient women's health services, follow-up attendance was poor, and no patients obtained LARC. There is a significant discrepancy between the consensus standard of contraception care across all relevant medical specialties and current utilization by high-risk populations. Future efforts must focus on how to close this gap, and the ED could be pivotal for improving both reproductive health education and intervention among adolescent patients.
68Ga-PSMA Uptake in the Testis
Authors: Calderon Tobar Merve Nida , Önner Hasan 
Published: February 2024

Abstract
Although abnormal 68Ga-PSMA uptake in the prostate and its metastases can be seen in a variety of diseases, it is rare to see in the testis. In these 2 cases, 68Ga-PSMA PET/CT revealed unilateral 68Ga-PSMA uptake in the testis of 2 patients. One of these patients was diagnosed with testis metastases from prostate cancer after an orchiectomy. The other patient was diagnosed with an orchitis. 68Ga-PSMA uptake should be considered as an infection, as well as a malignancy in the initial differential diagnosis.