bluuebunny/crossref_metadata_2025_split huggingface dataset:
Utilization of the emergency department by kidney transplant recipients: a retrospective cohort study from a high-volume transplant center
Authors: Sabbah Belal Nedal , Alghafees Mohammad , Sabbah Ahmad Nedal , Arabi Tarek Ziad , Abdul Rab Saleha , Alaklabi Abdulaziz Mohammed , Abdalla Hytham Mubarak , Maklad Ahmed Essam , El Sarrag Mazin Ibrahim , Hawari Emad Sameer , Barbour Omar Hussien , Khedr Ahmed , Alrasheed Faisal , Alshalhoub Mohammed , Sayedahmed Ghali , Alshuwaier Khalid , Alkharashi Yasser , Albassam Abdulrahman , Bin Ofisan Salman , Altamimi Abdulrahman 
Published: March 2024

Background:
This study aims to assess the trends of emergency department (ED) visits among kidney transplant recipients in a high-volume transplant centre.

Methods:
This retrospective cohort study targeted patients who underwent renal transplantation at a high-volume transplant centre from 2016 to 2020. The main outcomes of the study were ED visits within 30 days, 31–90 days, 91–180 days, and 181–365 days of transplantation.

Results:
This study included 348 patients. The median (interquartile range) age of patients was 45.0 years (30.8, 58.2). Over half of the patients were male (57.2%). There was a total of 743 ED visits during the first year after discharge. 19% (n=66) were considered high-frequency users. High-volume ED users tended to be admitted more frequently as compared to those with low frequencies of ED visits (65.2% vs. 31.2%, respectively, P<0.001).

Conclusion:
As evident by the large number of ED visits, suitable coordination of management through the ED remains a pivotal component of post-transplant care. Strategies addressing prevention of complications of surgical procedures or medical care and infection control are aspects with potential for enhancement.
Thrombocytopenia with absent radii syndrome with delayed presentation of thrombocytopenic episodes: a case report
Authors: Alassri Riffa , Martini Nafiza , Othman Razan , Kamil Hazem , Mahmoud Jaber 
Published: March 2024

Background:
Bilateral radii aplasia with the presence of both thumbs and episodes of low platelets count are the main characteristics of thrombocytopenia with absent syndrome, which is an unusual birth disorder, with an incidence of 0.42\100 000 population.

Case presentation:
The authors reported a case of a 6-month-old baby girl who experienced thrombocytopenia at the age of 6 months for the first time, as a result of cow’s milk being introduced for 45 days with chronic diarrhea and growth failure. She had a deviation of the axis of the hand laterally, and a bilateral absent of radii with the presence of both thumbs. In addition, she had abnormal psychomotor development, marasmus case manifestations.

Conclusions:
Our aim in publishing the current case report is that clinicians caring for patients with thrombocytopenia with absent syndrome will be aware of the myriad of complications, which may occur in the other organ systems so that they can promptly diagnose and treat any associated abnormalities.
Impact of insufflator/aspirator versus exclusive insufflator during robotic radical prostatectomy: a comparative prospective cohort study
Authors: Otaola-Arca Hugo , Mejías Orlando , Bravo Juan Cristóbal , Pinochet Rodrigo , Bernier Pablo , Muñoz Lorena , Orvieto Marcelo 
Published: March 2024

Background:
New generation devices that combine high-flow insufflation with smoke aspiration using continuous gas recirculation ]so-called Insufflator/aspirator systems (IAS)] have recently been developed to generate pneumoperitoneum. The use of an IAS could have an impact on surgical compared to conventional insufflation systems (CIS). The present study aimed to compare the clinical effectiveness/safety, healthorganizational, and pathological/oncological outcomes of the CIS versus IAS during robot-assisted radical prostatectomy (RARP).

Methods:
Comparative retrospective cohort study including patients with non-metastatic prostate cancer treated with RARP by four expert surgeons at a robotic referral centre between January 2020 and December 2021. A CIS was used until 15 March 2021, and the IAS thereafter. Data were extracted from the Institutional Review Board-approved (#1064) retro and prospective institutional database.

Results:
The final analysis included 299 patients (143 CIS; 156 IAS). We found no statistically significant differences in demographic data and preoperative results, allowing adequate group comparison. The rate of complications of any degree (9.1% and 1.9%, P<0.05) and major complications (4.2% and 0.6%, P<0.05) were lower in the IAS group. Accordingly, the hospital stay was shorter in the IAS group (P<0.05); however, the small size of this statistically significant difference probably lacks clinical value (1.9±1.6 vs. 1.6±0.8 days). There was no significant difference in surgical time, bleeding, pathological findings, or oncological results.

Conclusions:
Data from this large group of patients showed that the rate of overall complications, the rate of major complications, and the length of stay were lower in the IAS group. Implementing the IAS in RARP patients increased the occurrence of SCE and affected our daily practice of transversus abdominis plane block. Interpretation of the results should be made with caution since the design of this study did not allow for the identification of a causal relationship.
Pulmonary embolism complicated by tamponade revealing metastatic lung cancer in a woman pregnant with twin: about a case report
Authors: El Rhalete Abdelilah , Rhazi Inas , Bkiyer Houssam , Housni Brahim 
Published: March 2024

Introduction:
Lung cancer can be revealed by thromboembolic complications. Its association with pregnancy is becoming more frequent due to the increasing number of smoking women. The care of a pregnant woman with cancer is quite delicate because it requires finding a balance between the treatment of the mother and the potential foetal risk.

Case presentation:
The authors report the case of a 38-year-old patient, with a twin pregnancy of 16 weeks, complicated by proximal and distal peripheral venous thrombosis of the left lower limb under low molecular weight heparin therapy at a curative dose. A week later, the patient presented to the emergency room with respiratory distress associated with chest pain and low-abundance metrorrhagia. The obstetrical ultrasound performed confirmed the vitality of only one of the two foetuses. The transthoracic ultrasound objectified a very abundant pericardial effusion producing a tamponade, which was drained percutaneously and whose cytological study revealed a liquid rich in tumour cells. After the unfortunate death of the second twin and an endouterine evacuation, a chest computed tomography angiogram demonstrated a bilateral proximal pulmonary embolism associated with bilateral moderate pulmonary effusion as well as multiple thrombosis and secondary aspect liver lesions with a suspicious parenchymal lymph node of the upper lung lobe. A liver biopsy concluded to a secondary hepatic localization of a moderately differentiated adenocarcinoma whose immunohistochemical complement revealed a pulmonary origin. A multidisciplinary consultation meeting leaned towards treatment with neoadjuvant chemotherapy. The patient died 7 months later.

Discussion:
Venous thromboembolic disease is more common in pregnant women. Delayed diagnosis is common in these cases, resulting in a high rate of locally advanced or metastatic disease. Since the treatment of pregnancy-associated cancer does not rely on a standardized approach, the decision on how to proceed must be made by a multidisciplinary team.

Conclusion:
The cornerstone of management remains to find the balance between treating the mother as well as possible while preventing the foetus from the possible harm of cytotoxic drugs frequently used to treat lung cancer. Because of the delayed diagnosis, the maternal prognosis often remains poor.
Rare diagnosis of coexistent antiphospholipid syndrome and systemic lupus erythematosus in a male patient with successful management: a case report
Authors: Shrateh Oadi N. , Jobran Afnan W.M. , Amoori Azeeza 
Published: March 2024

Introduction:
Antiphospholipid syndrome (APS) and systemic lupus erythematosus (SLE) are two autoimmune disorders that can develop together or separately. Similarities in the pathogenesis have been discovered, including the production of autoantibodies that target subcellular antigens and shared elevated risk of cardiovascular morbidity, which may be caused by common pathologic pathways.

Case presentation:
A 28-year-old male, referred to our hospital for the assessment of chest pain. Past medical history was significant for extensive deep venous thrombosis despite the appropriate management with a therapeutic dose of direct-acting oral anticoagulant. Prolonged partial thromboplastin time was not corrected by mixing study along with positive lupus anticoagulant, anticardiolipin, and B-2 glycoprotein antibodies. In addition, antinuclear antibodies, anti-DNA antibodies, and direct Coombs were positive with decreased levels of C3. The patient was diagnosed with SLE with brain, heart, and kidney involvement in the setting of antiphospholipid antibody syndrome. He was treated successfully with full recovery.

Discussion:
SLE and APS both have sneaky ways of manifestation. Ineffective diagnosis and therapy could cause irreversible organ damage. Clinicians should have a high index of suspicion for APS, particularly in young patients who approach with spontaneous or unprovoked thromboses or unexplained recurrent early or late pregnancy loss. Anticoagulation, modifying cardiovascular risk factors, and identifying and treating any underlying inflammatory diseases are all part of the multidisciplinary care that is needed for management.

Conclusion:
Although male affection is rare, SLE and APS should be considered in male patients as these conditions tend to be more aggressive than in the female.
Surgical management of giant recurrent retroperitoneal liposarcoma: a case report and review of the literature
Authors: Ayoub Madani , Leila Bouzayan , Yassin Mabrouk , Achraf Miry , Rachid Jabi , Mohamed Pr Bouziane 
Published: March 2024

Introduction:
Liposarcoma is a rare, primary, malignant mesenchymal tumor. It represents ∼7% of all mesenchymal sarcomas and 1% of all cancers. Their incidence does not exceed to 2.5 cases/million inhabitants/year. This tumor is locally invasive, diagnosed at a late stage, and can reach a significant size and weight, resulting in a locally advanced tumor.

Case presentation:
A 59-year-old female patient consulting for a large abdominal mass. The abdominal computed tomography showed three retroperitoneal masses, and the surgical exploration revealed a huge process in the retroperitoneal cavity, which takes the left renal compartment, and the left colon. The intervention consisted of a mono-bloc excision of the mass taking the spleen, the left renal compartment, and the left colon with colonic anastomosis. The histological examination concluded the existence of a well-differentiated myxoid liposarcoma of grade I, the postoperative follow-up was simple. One year later, she underwent an excision of a recurrence of the same retroperitoneal location, but of a pleomorphic cell histological type of grade II according to the FNCLCC classification. We review the literature, the pathological, therapeutic, and prognostic aspects of this tumor.

Discussion:
Retroperitoneal liposarcoma is a rare tumor. Its gravity is due to an often-late diagnosis, a complete imaging workup including ultrasound, computed tomography and often MRI is necessary preoperatively to determine the relationship with the different organs. The definitive diagnosis is histological, surgery is the most effective treatment and can be extended to neighboring organs. the frequency of recurrence requires particular surveillance.

Conclusions:
We highlight the importance of radical surgical excision to avoid retroperitoneal liposarcoma tumor complications and to minimize the recurrence risk.
Understanding correlates of infant mortality in Ethiopia using 2019 Ethiopian mini demographic and health survey data
Authors: Adebe Kebede Lulu , Wake Senahara Korsa , Yadata Sagni Daraje , Gondol Ketema Bedane , Mekebo Gizachew Gobebo , Wolde Temesgen Senbeto , Bechera Terefa , Regesa Belema Hailu , Galdassa Agassa , Yadata Kumera Dereje 
Published: March 2024

Background:
Infant mortality is one of the most sensitive and commonly used indicators of the social and economic development of a nation. Ethiopia is among the African countries with high infant mortality rates. This study aimed to understand and identify correlates of infant mortality in Ethiopia.

Methods:
The data, used in this study, were drawn from 2019 Ethiopian Demographic and Health Survey data. The multivariable Cox proportional hazard analysis was done to identify the correlates of infant mortality.

Results:
Infant mortality rate was high in the earlier age of months. Males, higher birth order and rural residences were at higher risk of dying before first birthday compared with respective reference groups whereas health facility deliveries, single births, rich wealth indices and older maternal age were at lower risk of dying before first birthday compared with respective reference groups.

Conclusion:
The study found that age of mother, place of residence, wealth index, birth order, type of birth, child sex and place of delivery were statistically significant in affecting the survival of the infants. Thus, health facility deliveries should be encouraged and multiple birth infants should be given special care. Furthermore, younger mothers should better care of their babies to improve the survival of infants in Ethiopia.
COVID-19 increases a person’s risk of cardiovascular problems: how common is chronic heart failure in SARS-CoV-2 patients? a case report
Authors: Bereda Gudisa 
Published: March 2024

Background and importance:
The coronavirus disease of 2019 (COVID-19) infection typically affects the lungs but can also cause life-threatening heart issues. Heart failure is a common condition that can occur either with an existing heart condition or de novo as part of the clinical course of COVID-19.

Case presentation:
On 11 October 2022, a 60-year-old middle-aged black African woman widow was admitted with a history of muscular weakness for 2 days, a lack of appetite, and occasional vomiting for 1 day. She arrived at the emergency room after complaining for 2 days of peeing less than usual, a fast heartbeat, swelling in the feet, pink blood-tinged mucus, fever, headache, dehydration, a nonproductive cough, and shortness of breath. The left ventricular ejection fraction was 43% on the echocardiogram. Routine reverse transcription polymerase chain reaction testing was performed in the emergency room; she tested COVID-19 positive. To treat her proven COVID-19 infection, she received subcutaneous enoxaparin 80 mg every 12 h as prophylaxis for deep venous thromboembolism.

Clinical discussion:
A COVID-19 infection can induce cardiac failure and arrhythmias, as well as cause direct harm to the heart. This study explains how enoxaparin has dual benefits in this case report: it reduces the risk of venous thromboembolism in the COVID-19 hospitalized case and prevents death and cardiac ischemia in myocardial infarction.

Conclusion:
Higher mortality and more frequent acute decompensation may be caused by the capacity of severe acute respiratory syndrome associated coronavirus 2 to cause myocardial injury, as well as by patients with chronic heart failure’s lower baseline features, decreased cardiopulmonary reserve, and susceptibility for myocardial injury.
Standford type A aortic dissection in a patient with situs inversus totalis, with critical clinical presentation: a case report
Authors: De Masi De Luca Gabriele , Nicolardi Salvatore , Mangia Federica , Zaccaria Salvatore , Palamà Zefferino , Tridici Maurizio , Papadia Paola , De Masi De Luca Giuseppe , Accogli Michele 
Published: March 2024

Introduction and importance:
The association of Standford type A acute aortic dissection with situs inversus totalis (SIT) is extremely rare and only a few cases are reported in the literature to date. Due to the particular rarity, this unusual condition, if not diagnosed quickly and correctly, can generate both clinical and surgical difficulties.

Case presentation:
We describe the case of a male Caucasian patient with SIT and aortic dissection type A, who occurred to our Emergency Department with a severe clinical condition of shock. Using the fast diagnostic approach with chest X-Ray and echocardiography followed by computed tomography investigation, a Standford type A acute aortic dissection and the presence of SIT were detected. The patient was subjected to surgical treatment with optimal results in a short time.

Clinical discussion and conclusion:
The event of aortic dissection is an extremely serious condition and the simultaneous presence of a critical clinical presentation with an unusual congenital anomaly could condition a correct and rapid diagnostic process. Only an accurate diagnostic investigation can give a quick diagnosis and useful elements for a correct therapeutic approach.
Current status and future perspectives of wilms tumor treatment in Iran
Authors: Zahir Mazyar , Alidousti Arash , Kajbafzadeh Abdol-Mohammad , Arshadi Hamid , Kompani Farzad , Hajivalizadeh Sepideh , Zolbin Masoumeh Majidi , Ghohestani Seyed Mohammad , Amirzargar Hossein , Hekmati Pooya 
Published: March 2024

Background:
Wilms tumor (WT) is among the most common pediatric malignancies. In this study, the authors tried to evaluate the adherence to internationally-approved WT treatment protocols in our tertiary medical center in Iran.

Methods:
In this retrospective study, the medical records of 72 pathologically confirmed WT patients who underwent treatment from April 2014 to February 2020 were evaluated. Demographic characteristics, histologic features of the tumors and metastases, utilized treatments, and survival rates were subsequently investigated.

Results:
From the total of 72 patients, 31 (43.1%) and 41 (56.9%) were males and females, respectively. The median age at the time of diagnosis was 44.0 (interquartile range: 18.5, 72.0) months. Among the patients, favorable histology was observed in 68 (94.6%) patients, while 4 (5.4%) patients had unfavorable histology. Regarding chemotherapy, 34/56 (60.7%), 4/56 (7.1%), and 18/56 (32.2%) received adjuvant, neoadjuvant, and combined chemotherapy, respectively. The mean numbers of neoadjuvant and adjuvant chemotherapy sessions were 9.4±5.6 and 14.5±11.1, respectively. 32/72 (44.4%) of the patients received adjuvant radiotherapy with a mean number of 7.3±3.6 sessions. Overall survival rates were 86% at 1-year, 74% at 3-year, and 62% at 5-year.

Conclusion:
Our results suggested that while the demographic characteristics of WT patients in Iran resemble those in other countries, abidance to internationally recommended protocols is relatively low. Moreover, survival rates were rather dismal in our study compared to those from other developing countries, further signifying the need for the development of a nation-specific treatment protocol for WT.
Autoimmune hemolytic anemia, a rare disease in newborns: a case report
Authors: Kukreja Sandhaya , Baker Saadia Abu , Ochani Sidhant , Lohana Sapna , Kalwar Asifa , Memon Kainat , Kumari Sadhna , Faraz Muhammad , Hasibuzzaman Md. Al 
Published: March 2024

Introduction and importance:
Autoimmune hemolytic anemia (AIHA) is a type of hemolytic anemia in which autoantibodies attack the membrane antigens of red blood cells, causing cell rupture (lysis). Hemolysis stimulates compensatory RBC production by boosting erythropoietin levels; however, this response is often insufficient to restore normal hemoglobin blood levels, resulting in anemia. It is a rare disease, with an annual incidence of one case in every 80 000 live births. Infants of any age can be affected, though neonatal incidence is unusual. Here, the authors report a rare case of AIHA in the neonatal period with concomitant atrial septal defect, ventricular septal defect, and patent ductus arteriosus.

Case presentation:
A one-hour-old male neonate weighing 3 kg who was born at 38 weeks of gestation presented to the pediatric department with the complaint of respiratory distress. Examination revealed obvious respiratory distress with subcostal and intercostal recessions and a continuous grade 2 murmur at the left upper chest; the liver was palpable 1 cm below the right subcostal margin with a palpable splenic tip. Laboratory investigations were ordered, which showed hemoglobin was decreasing continuously and bilirubin was raised, suspecting AIHA. A positive blood culture, tachycardia, tachypnea, and a raised leukocyte count showed that the baby was in sepsis. The baby improved clinically, and the complete blood count showed improved Hb. Cardiac examination findings and a second-grade continuous murmur at the left upper chest were further investigated through echocardiography, which showed a grade 2 atrial septal defect, a muscular ventricular septal defect, and a patent ductus arteriosus.

Clinical discussion:
Childhood AIHA is a rare and underrated disease that differs from the adult form. The disease’s initial manifestation and subsequent course are both poorly understood. It affects mostly young children, and a high prevalence (21%) is found in infants. In some patients, there is a genetic predisposition to the development of this disease, and there is underlying immune deregulation in more than half of the cases, necessitating long-term homogeneous multidisciplinary follow-up. It is of two types, primary and secondary, and according to the study conducted in France, AIHA is associated not only with other autoimmune diseases but with some systemic diseases as well, like neurological, digestive, chromosomal abnormalities, and cardiac diseases, as in our case.

Conclusion:
There is a scarcity of data on clinical management and treatment strategies. More research should be done to know the environmental factors that can trigger the immune response against red blood cells. Moreover, a therapeutic trial is essential for a better outcome and helps prevent serious complications.
Drug reaction with eosinophilia and systemic symptoms syndrome secondary to isoniazid and ethambutol: a case report and literature review
Authors: Adhikari Yagya Raj , Bhattarai Madhur , Baral Bikash , Jha Supriya , Subedi Prativa , Karki Ruchi , Baral Amrita , Sharma Prakash , Kharel Arun , Paudel Basanta Sharma 
Published: March 2024

Introduction:
Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a severe, potentially life-threatening condition precipitated by reaction of therapeutic drugs. The prevalence of potential antitubercular therapy (ATT)-induced DRESS is 1.2%.

Case presentation:
A 71-year-old female patient after 5 weeks of starting ATT complaints of fever, vomiting, dizziness, and generalized itchy maculopapular rash over the body. It was associated with marked eosinophilia (absolute eosinophil count 3094 cell/mm3, 36% in peripheral blood smear).

Discussion:
Fever, rash, lymphadenopathy, and internal organ involvement with marked eosinophilia constitute the major clinical manifestations of DRESS. RegiSCAR scoring system is usually used to diagnose DRESS. Identification of the culprit drug is based on the temporal correlation of symptoms with drug exposure and rechallenge test, patch test and lymphocytic transformation tests may be valuable adjunctive tools. Treatment includes withdrawal of offending agent and use of topical or systemic corticosteroids, antihistamines, cyclosporin or JAK inhibitor with clinical judgement.

Conclusion:
Clinicians from the tuberculosis burden region must be aware of DRESS associated with ATT and they must counsel the patient properly before prescription and manage them without delay if DRESS ensues.