bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnosis, management and prevention of Pediatric Acute Hemolytic Anemia: Egyptian adapted evidence-based clinical practice guidelines
Authors: Mokhtar Galila , Baky Ashraf Abdel , Youssry Ilham , Ragab Iman , Sherief Laila , Zakaria Marwa , Hesham Mervat , Salah Nouran , Abdel-Raouf Rasha , Makkeyah Sara , Shalaby Sherein , Habib Sonia Adolf , Omar Tarek , Amer Yasser , Salama Niveen M. 
Published: October 2023

Abstract
Background
Acute hemolytic anemia (AHA) is a common emergency in pediatric emergency departments, hence the need to adapt pre-existing high-quality practice guidelines for the diagnosis, management, and prevention of AHA to be available for national use.

Methods
The guideline panel used the adapted ADAPTE methodology. The panel prioritized the health questions and recommendations according to their importance for clinicians and patients. The procedure included searching for existing guidelines, quality appraisal, and adaptation of the recommendations to be used in low-resource countries.

Results
The guideline provided approach to a child with AHA: laboratory diagnosis of glucose-6-phosphate dehydrogenase (G6PD) deficiency, autoimmune hemolytic anemia (AIHA), and hemolytic uremic syndrome (HUS); treatment of AHA including indications for red cell transfusion, medical treatment, plasma exchange, and indications of antibiotic in HUS; how to avoid further episodes of hemolysis; and when to refer to a hematologist. Implementation tools included a checklist for history and examination, lists of differential diagnoses, flow charts for the diagnosis of AHA, and a list of medications and food to be avoided in patients with G6PD deficiency.

Conclusion
This adapted guideline will aid decision-making related to the diagnosis, management, and prevention of AHA.
Geospatial distribution of under-five mortality in Alexandria, Egypt: a cross-sectional survey
Authors: Abd ElHafeez Samar , Hassan Mahmoud A. , Hammouda Esraa Abdellatif , Omran Abdelrahman , Esmail Ola Fahmy , Mahboob Amira Saad , Tahoun Mohamed Mostafa , El Malawany Dina Hussein , Eldwiki Mohamed Kamal , El-Meligy Passent Ehab , Elrewany Ehab , Ali Shaimaa Gadelkarim Ebrahim , Elzayat Amira Mahmoud , Ramadan Ahmed , Elshabrawy Abdelhamid , Youssef Naglaa , Ghazy Ramy Mohamed 
Published: October 2023

AbstractBackgroundGlobally, infectious diseases, including pneumonia, diarrhea, and malaria, along with pre-term birth complications, birth asphyxia and trauma, and congenital anomalies remain the leading causes of death for under-five mortality (U5M). This study aimed to identify the geospatial pattern of U5M in Alexandria and its key determinants.MethodologyWe analyzed the geospatial distribution of 3064 deaths registered at 24 health offices reported from January 1, 2018 to June 30, 2019. We adopted two methods of analysis: geospatial analysis and the structural equation model (SEM).ResultNeonates represented 58.7% of U5M, while post-neonates and children were 31.1%, 10.2%respectively. Male deaths were significantly higher compared to females (P = 0.036). The main leading causes of U5M were prematurity (28.32%), pneumonia (11.01%), cardiac arrest (10.57%), congenital malformation (9.95%), and childhood cardiovascular diseases (9.20%). The spatial distribution of U5M (including the most common three causes) tends to be clustered in western parts of Alexandria (El Hawaria, Bahig, Hamlis, and Ketaa Maryiut). SEM showed the total effects of exogenous and intermediate variables on U5M. The U5M proportionately increased by living in rural areas (8.48), followed by crowding rate (8.35), household size (1.36), population size (0.52), and illiteracy average (0.06). On the contrary, the U5M decreased with increasing access to sanitation (-0.17) and access to drinking water (-4.55).ConclusionIlliteracy, and poor locality characteristics (household size, population density, and access to water supply and sanitation) were statistically significant predictors of U5M.
A rare clinical presentation of lung cancer: two cases of solitary digital metastasis on Tc-99m MDP bone scan
Authors: Uslu Biner Inci , Akin Kabalak Pinar , Inal Cengiz Tuba , Yilmaz Ulkü , Kizilgoz Derya , Karaca Metehan , Canbay Fatma , Agackiran Yetkin , Tatci Ebru , Ozmen Ozlem 
Published: October 2023

Abstract
Background
Acrometastases are accounted for a very small proportion of bone metastases. Lung cancer is the most common acrometastasis origin, and it often has a poor prognosis. The aim of the present cases is to describe the probability of an acrometastasis in the differential diagnosis of finger lesions and to emphasize the importance of taking local views of extremity of complaint for proper interpretation in such patients.

Case presentation
Here we reported two patients with metastases to the fingers with occult primary lung carcinoma and a history of prior lung malignancy, respectively. First case was a 58-year-old man with history of pain and swelling in the fourth finger of his left hand. He underwent an amputation from the metacarpophalangeal level and the pathological diagnosis was metastatic NSCLC. The second case was a 65-year-old ex-smoker man with a history of prior lung cancer (adenocarcinoma) suffered from a swollen, erythematous, painful tip of the right third finger. Phalangectomy was performed and the histological examination of the amputated part revealed the presence of a metastatic differentiated carcinoma of pulmonary origin.

Conclusions
When assessing the masses located at fingers, possibility of a solitary metastatic lung lesion should be considered.
Scaphoid megalourethra associated with congenital urethrocutaneous fistula: a case report of a rare association
Authors: Chrun Lucas Rossato , Egger Paulo Acácio , Toda Lia Yoneka , Henrique Aquiles , Filho Orlando Ribeiro Prado , Costa Larissa Rossato Chrun , Nezo Victor Hugo Silva 
Published: October 2023

Abstract
Background
Congenital megalourethra is a rare male genital malformation, with less than 100 cases reported in literature. Urethrocutaneous fistula, in turn, has only 65 cases described, which what makes the association between these two anomalies an even rarer condition.

Case presentation
The patient was male and born at 37 weeks of gestational age. At birth, the testicles were impalpable, and he had a penile malformation compatible with scaphoid megalourethra associated with congenital urethrocutaneous fistula, with urine output exclusively through a small orifice in the ventral region of the penis. When the child completed 7 months and 22 days, underwent the first surgery, laparoscopically. The first Fowler-Stephens was performed, and the gonadal vessels were ligated, with reconstruction of the penis. Nine months later, the second Fowler-Stephens procedure was performed, with bilateral orchidopexy and penoplasty to improve penis aesthetics. The urethra region was not approached. The postoperative period of the second surgery progressed uneventfully. Nowadays, the patient presents adequate urinary stream.

Conclusion
The scaphoid megalourethra associated with congenital urethrocutaneous fistula is an extremely rare pathology, with very few cases reported in the literature to date. The obstetric USG is important to increasing the chances of early diagnosis and treatment.
The diagnostic role of C2PAC index in cases of sepsis-induced coagulopathy (SIC)
Authors: Mousa Mohamed Shaaban , Ahmed Salwa Hassan , Maksoud Fatma Abdel Wahab Abdel , Soliman Soliman Belal , Tantawy Ahmed A. 
Published: October 2023

Abstract
Background
To study the potential role of the C2PAC index (a ratio of soluble type C lectin-like receptor 2 level sCLEC-2 and platelet count) in sepsis-induced coagulopathy with the possibility of using this index as an early predictor in sepsis and sepsis-induced coagulopathy.

Methods
Our case–control study included a total of 86 participants divided into 2 groups: group I is the case group consisting of 56 patients of sepsis or septic shock and group II (control group) of 30 healthy persons: sex and age-matched healthy individuals. All patients were subjected to assessment of C lectin domain family 2 receptor (sCLEC2), by enzyme-linked immunosorbent assay ELIZA kit, then C2PAC index (a ratio of soluble type C lectin-like receptor 2 level sCLEC-2 and platelet count) was calculated using the platelet count.

Results
Our study demonstrated that sCLEC-2 levels and C2PAC in group I were higher than in group II (p value < 0.001), and Klebsiella was the most common organism detected in ICU septic patients; detected in 25 patients (44.6%), there is a statistical significance (p value 0.045) between sCLEC2 levels and streptococcal infections. It was detected also that the SIC group was 17 patients (30.4%) and the sepsis without coagulopathy group was 39 patients (69.6%). Compared with the sepsis without coagulopathy group, the SIC group was significantly older and had a significantly higher SOFA score, sCLEC-2 levels, and C2PAC index. Lastly, the strong potentiality of using C2PAC as a diagnostic and prognostic marker for sepsis-induced coagulopathy with high statistical significance < 0. 001.

Conclusions
C2PAC index can be validated as an accurate marker of sepsis-induced coagulopathy with higher sensitivity when using the C2PAC index (82.4%) than using sCLEC-2 (58.8%) and both have the same specificity (89.7%). The C2PAC index is a useful predictor of SIC progression.
Vascular calcification: from the perspective of crosstalk
Authors: Yang Shiqi , Zeng Zhaolin , Yuan Qing , Chen Qian , Wang Zuo , Xie Hui , Liu Jianghua 
Published: October 2023

AbstractVascular calcification (VC) is highly correlated with cardiovascular disease morbidity and mortality, but anti-VC treatment remains an area to be tackled due to the ill-defined molecular mechanisms. Regardless of the type of VC, it does not depend on a single cell but involves multi-cells/organs to form a complex cellular communication network through the vascular microenvironment to participate in the occurrence and development of VC. Therefore, focusing only on the direct effect of pathological factors on vascular smooth muscle cells (VSMCs) tends to overlook the combined effect of other cells and VSMCs, including VSMCs-VSMCs, ECs-VMSCs, Macrophages-VSMCs, etc. Extracellular vesicles (EVs) are a collective term for tiny vesicles with a membrane structure that are actively secreted by cells, and almost all cells secrete EVs. EVs docked on the surface of receptor cells can directly mediate signal transduction or transfer their contents into the cell to elicit a functional response from the receptor cells. They have been proven to participate in the VC process and have also shown attractive therapeutic prospects. Based on the advantages of EVs and the ability to be detected in body fluids, they may become a novel therapeutic agent, drug delivery vehicle, diagnostic and prognostic biomarker, and potential therapeutic target in the future. This review focuses on the new insight into VC molecular mechanisms from the perspective of crosstalk, summarizes how multi-cells/organs interactions communicate via EVs to regulate VC and the emerging potential of EVs as therapeutic methods in VC. We also summarize preclinical experiments on crosstalk-based and the current state of clinical studies on VC-related measures.
Influence of compliance to antithrombotic agents on perioperative morbidity and mortality
Authors: Duranteau Olivier , Hamriti Ayoub , Ickx Brigitte , Tuna Turgay 
Published: October 2023

AbstractFor patients on antithrombotic medication, the outcome of a planned surgery depends on the adjustment of their daily treatment. This study aimed to assess the impact of non-compliance to published recommendations about antithrombotic agents, specifically those provided by the Groupement d'Intérêt pour l'hémostase Peri-opératoire (GIHP), on patient morbidity and mortality.A prospective cohort observational monocentric study was conducted over a 7-month period in 2019 in an academic hospital. The study included patients on antithrombotic agents scheduled for elective surgery, excluding cardiac surgery. The primary endpoints were morbidity and mortality at 1 month according to GIHP guidelines compliance. Blood loss during surgery and length of hospital stay were secondary endpoints.Among the 589 patients included in the study, 87 complications were recorded, resulting in a morbidity rate of 14.8%. Thirty-six patients experienced hemorrhagic events, leading to 8 deaths, while 33 patients suffered from ischemic events, resulting in 3 deaths. Additionally, 18 patients died from causes unrelated to hemorrhage or ischemia. Compliance with GIHP guidelines was observed in 62% of patients. Statistical analysis did not reveal a significant association between adherence to guidelines and morbidity (p value = 0.923), nor between adherence and 1-month survival (p value = 0.698). Similarly, no statistically significant relationships were found between compliance and intraoperative bleeding volume (p value = 0.087), postoperative bleeding (p value = 0.460), or length of hospital stay (p value = 0.339).This study did not identify any substantial associations between non-strict adherence to GIHP recommendations and patient outcomes, including morbidity, mortality, and bleeding. However, it is important to interpret these findings with caution, considering the study’s limitations and the need for further research in this area.
Measuring the impact of therapy on medication use: data-linkage study
Authors: Jordan Julie-Ann , Elliott Adam , Mongan David , Dyer Kevin F. W. 
Published: October 2023

BackgroundThe psychological therapies service (PTS) in the Northern Health and Social Care Trust, in Northern Ireland, provides therapies to adults with moderate or severe mental health difficulties. Psychometric outcomes data are routinely collected to assess if a patient demonstrates significant improvement in their main presenting problem area following therapy. The wider impact of therapy is not fully measured in the outcomes database as this would be disproportionately burdensome for both patient and therapist. The present study, to our knowledge, is the first to use data linkage to link patient therapy outcomes data with prescriptions data.AimsTo widen our understanding of patient medication use before and after therapy.MethodUsing Health and Care Number as a unique identifier, the Psychological Therapies Service – Routine Outcome Measurement Database (n = 3625) and data from 72 500 controls were linked with data from the Enhanced Prescribing Database (EPD). The EPD data were sourced from the Honest Broker Service.ResultsKey findings from the study were: (a) the odds of PTS clients using antipsychotics in the year before therapy were 25 times greater compared with controls (odds ratio (OR) = 24.53, 95% CI 20.16–29.84); (b) in the 1st year post discharge, PTS clients who clinically improved post therapy discharge were more likely than ‘non-engagers’ and ‘non-improvers’ to come off antianxiety medication (OR = 0.61, 95%, CI 0.38–0.98); and (c) therapy did not have an impact on antidepressant use.ConclusionsThe results highlight the need for discussion between therapy services, GPs and psychiatry about whether more engagement and collaboration is needed to plan phased reduction in medication.
From awareness to action: an urgent call to reduce mortality and improve outcomes in eating disorders
Authors: Ayton Agnes , Ibrahim Ali , Downs James , Baker Suzanne , Kumar Ashish , Virgo Hope , Breen Gerome 
Published: October 2023

SummaryHigh mortality rates and poor outcomes from eating disorders, especially anorexia nervosa, are largely preventable and require urgent action. A national strategy to address this should include prevention; early detection; timely access to integrated physical and psychological treatments; safe management of emergencies; suicide prevention; and investment in training, services and research.
Localization and Diagnostic Evaluation of Peripheral Nerve Disorders
Authors: Jin Peter H. 
Published: October 2023

ABSTRACT

OBJECTIVE
This article provides a framework for the initial evaluation of patients with suspected peripheral nerve disease. The key clinical elements of peripheral nerve diseases can help the practicing neurologist differentiate among peripheral neuropathies with similar presentations.

LATEST DEVELOPMENTS
The wide range of peripheral nerve diseases with similar clinical presentations can pose a diagnostic challenge. The large array of available testing modalities (including imaging and electrodiagnostic, autonomic, laboratory, biopsy, and genetic testing) further complicates clinical decision making. Recent developments (eg, discovery of new autoantibodies, genetic variations, and histopathologic techniques) across the peripheral neuropathy spectrum have resulted in an increased need to evaluate patients logically and with a tailored diagnostic approach.

ESSENTIAL POINTS
A careful approach that focuses on key clinical elements combined with an understanding of purposeful diagnostic testing can lead to a successful diagnosis of peripheral nerve diseases.
Spinal Muscular Atrophy
Authors: Oskoui Maryam , Servais Laurent 
Published: October 2023

ABSTRACT

OBJECTIVE
This article provides a comprehensive overview of the diagnostic assessment and treatment of individuals with spinal muscular atrophy (SMA) due to homozygous deletions of SMN1.

LATEST DEVELOPMENTS
In recent years, most states have incorporated SMA in their newborn screening panel. To provide the earliest diagnosis possible after symptom onset, vigilance is needed for births in states without newborn screening for SMA and when compound heterozygotes are missed by newborn screening programs. Supportive care for respiratory, nutritional, and orthopedic health impacts outcomes and is the cornerstone of care. Adaptive equipment, including assistive home technology, enables affected individuals to gain autonomy in their daily activities. Pharmacologic treatments approved by the US Food and Drug Administration (FDA) include three drugs that increase deficient survival motor neuron protein levels through SMN1- or SMN2- directed pathways: nusinersen, onasemnogene abeparvovec, and risdiplam. Efficacy for these trials was measured in event-free survival (survival without the need for permanent ventilation) and gains in functional motor outcomes. Earlier treatment is most effective across all treatments.

ESSENTIAL POINTS
The diagnostic and therapeutic landscapes for SMA have seen dramatic advancements in recent years, improving prognosis. Optimized supportive care remains essential, and vigilance is needed to define the new natural history of this disease.
Toxic Neuropathies
Authors: McNeish Brendan L. , Kolb Noah 
Published: October 2023

ABSTRACT

Objective
The purpose of this article is to provide an overview and update on the most clinically relevant toxic neuropathies.

Latest Developments
Broadly, toxic neuropathies were previously quite rare with the notable exception of neuropathy from alcohol or older chemotherapeutics. The development of newer therapies, particularly immunotherapy to treat malignancy, has resulted in a substantial increase in the occurrence of toxic neuropathies that require timely recognition and treatment. The understanding of other toxic neuropathies continues to evolve, such as statin-induced neuropathy, which new evidence suggests is much less common than previously suspected.

Essential Points
Toxic neuropathies can be caused by medications, supplements, and recreational substances that injure peripheral nerves. Medications have evolved in the past 2 decades, as have the types of neuropathies that can be seen as related toxicities. In some areas of medicine, new classes and generations of drugs are associated with a lower incidence of toxic neuropathy.
Adjusting Acute Kidney Injury Kidney Disease: Improving Global Outcomes Urine Output Criterion for Predicted Body Weight Improves Prediction of Hospital Mortality
Authors: Hessler Michael , Arnemann Philip-Helge , Jentzsch Imke , Görlich Dennis , Morelli Andrea , Rehberg Sebastian W. , Ertmer Christian , Kampmeier Tim-Gerald 
Published: October 2023

BACKGROUND:
Based on the Kidney Disease: Improving Global Outcomes (KDIGO) definitions, urine output, serum creatinine, and need for kidney replacement therapy are used for staging acute kidney injury (AKI). Currently, AKI staging correlates strongly with mortality and can be used as a predictive tool. However, factors associated with the development of AKI may affect its predictive ability. We tested whether adjustment for predicted (versus actual) body weight improved the ability of AKI staging to predict hospital mortality.

METHODS:
A total of 3279 patients who had undergone cardiac surgery in a university hospital were retrospectively analyzed. AKI was staged according to KDIGO criteria (standard staging) and after adjustment for hourly urine output adjusted by predicted body weight for each patient and each day of their hospital stay.

RESULTS:
The incidence of AKI (all stages) was 43% (predicted body weight adjusted) and 50% (standard staging), respectively (P < .001). In sensitivity-specificity analyses for predicting hospital mortality, the area under the curve was significantly higher after adjustment for predicted body weight than with standard staging (P = .002).

CONCLUSIONS:
Compared to standard staging, adjustment of urine output for predicted body weight increases the specificity and improves prediction of hospital mortality in patients undergoing cardiac surgery.
Transperineal laser ablation (TPLA) with ultrasound/MRI fusion guidance in the treatment of localized radiotherapy-resistant prostate cancer
Authors: Manenti Guglielmo , Nezzo Marco , Ryan Colleen Patricia , Fraioli Federico Romeo , Carreri Beatrice , Gigliotti Paola Elda , Angeloni Cecilia , Di Pietro Francesca , De Angeli Martina , Perretta Tommaso , D'Angelillo Rolando Maria , Garaci Francesco Giuseppe 
Published: October 2023

Objective The objective of this study was to assess the technical feasibility, safety, and efficacy of transperineal laser ablation (TPLA) guided by ultrasound/magnetic resonance (MR) fusion as a salvage treatment for refractory focal prostate cancer. Methods A total of five patients who had undergone radiation therapy (RT) for prostate carcinoma and biochemical recurrence, confirmed by both prostate-specific antigen (PSA) levels and MRI (3T mpMRI), were enrolled in this study. Focal ablation was performed using a 1064 nm diode laser. Post-ablation follow-up was conducted for a duration of 18 months, which included regular PSA sampling, 3T mpMRI, and ultrasound/MR fusion-guided biopsies systematic and targeted at the site of the focal treatment. Results The focal ablation procedure was carried out in an outpatient setting regimen with optimal clinical and biochemical outcomes. No recurrence was detected throughout the follow-up period. Conclusion TPLA focal treatment effectively manages local recurrences of RT refractory prostate cancer without side-effects or complications. Preservation of quality of life and functional outcomes, along with a >70% reduction in PSA, were achieved. Advances in knowledge Our study investigated TPLA as a salvage treatment for low-risk recurrent prostate cancer after RT, demonstrating its tolerability, feasibility, and effectiveness.