bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impulse oscillometry to differentiate between chronic obstructive pulmonary disease and bronchial asthma
Authors: Ahmed Mona M. , Kader Maryam A. A. , Mohammed Esraa M. 
Published: September 2023

Abstract
Background
The impulse oscillation system (IOS) yields useful clinical data that predominantly include functional assessment of peripheral airways more than that available from commonly used spirometry. The aim of this study was to differentiate between chronic obstructive pulmonary disease (COPD) and bronchial asthma using IOS.

Patients and methods
This study was carried out on 40 patients; 20 patients were diagnosed with bronchial asthma and the remaining 20 patients had a clinical diagnosis of COPD. All patients underwent baseline IOS and spirometry, and then after 15 min of inhalation of 400 μg salbutamol, spirometry was repeated in all patients.

Results
A highly statistically significant difference was found between asthma patients and COPD patients in R20, whereas no statistically significant difference was found between the two studied groups in R5, X5. There was a statistically significant difference between asthma patients and COPD patients in resistance; 75% of asthmatic patients had increased total airway resistance, mainly proximal, 20% had increased total airway resistance, mainly peripheral, and 5% had normal airway resistance, whereas all COPD patients had increased total airway resistance, mainly peripheral. No significant correlation was found between IOS parameters and spirometric parameters in COPD or asthmatic patients, but in both groups, there was a significant correlation between forced expiratory volume 1 (FEV1) and R5, X5.

Conclusion
IOS provides useful clinical information that prominently includes functional assessment of small, peripheral airway behavior beyond that available from commonly used pulmonary function tests. IOS also aids differentiation between COPD and bronchial asthma. COPD patients had increased airway resistance, mainly in the peripheral airways, whereas asthmatic patients had increased airway resistance, mainly in the proximal airways. R20 is the best IOS parameter to differentiate between these two diseases.
Assessment of ventilator-induced diaphragmatic dysfunction in patients with chronic obstructive pulmonary disease using transthoracic ultrasonography
Authors: Farghaly Shereen , Hasan Ali A. , Makhlouf Hoda A. 
Published: September 2023

Abstract
Background
Mechanical ventilation (MV) can cause progressive thinning of diaphragm muscle and hence progressive decrease in diaphragmatic function. We aimed to assess the rate at which diaphragm thickness (tdi) changed during MV and its effect on weaning outcome using transthoracic ultrasound (TUS) evaluation in patients with chronic obstructive pulmonary disease (COPD).

Patients and methods
Thirty mechanically ventilated patients with COPD were enrolled in this cohort study. Baseline tdi was recorded within 24 h of MV after stoppage of sedation using TUS. The subsequent measurements were recorded on the third, fifth, and seventh day of MV and at the time of initiation of weaning.

Results
There was a significant decrease in tdi at end expiration and at end inspiration by approximately 27.2 and 17% at third day of MV, respectively, and 35.5 and 18.5% at fifth day of MV, respectively, compared with baseline parameters. In the 10 patients who were still on ventilator till the seventh day, tdi were significantly lower compared with baseline recordings. Percentage of decrease of tdi at end inspiration from baseline recordings was significantly higher in patients with difficult weaning than in those with simple weaning. The optimum cutoff value of % of decline of tdi at end inspiration associated with difficult weaning was at least 10.6% giving 88.9% sensitivity and 83.3% specificity.

Conclusion
MV is associated with gradual diaphragmatic atrophy which can be detected by TUS and could predict weaning outcome in mechanically ventilated patients with COPD.
Effect of inspiratory muscle training on weaning from mechanical ventilation in acute respiratory failure
Authors: Ewis Ahmed M. 
Published: September 2023

Abstract
Objective
This study aimed to evaluate the effect of inspiratory muscle training (IMT) on weaning time and success.

Patients and methods
This is a prospective, randomized clinical study conducted in an ICU. A total of 15 patients were trained by inspiratory muscle exercise twice per day and 15 patients did not go under training (control group). Training was conducted through tuning the ventilator sensitivity based on the patients’ maximal inspiratory pressure (MIP). The experimental group received IMT starting with an initial load of 30% of their MIP measured immediately after changing patients to pressure support mode of mechanical ventilation (MV) and increased up to 40% as tolerated by the patient. Training was conducted for 5 min, two sessions per day. In addition, these patients received usual care of MV patients. Sputum culture assessment for aerobic organisms was done immediately after intubation.

Results
This is a prospective randomized control study that collected data on 30 patients with acute respiratory failure. Patients were randomly arranged into two groups (control and experimental). The mean MIP before initiation of weaning in both group was 16cm H2O. There is a significant difference in the final mean MIP between the experimental group (23.27 cm H2O) and the control group (17.40 cm H2O). There is also significant shortening in the weaning time in the experimental group and less frequent likelihood of reintubation, which was recorded in two cases of control group.

Conclusion
The IMT during MV may assist in early weaning off MV among patients with acute respiratory failure, and also it improves the weaning success rate, with less frequent likelihood of reintubation.
Bile carcinoembryonic cell adhesion molecule 6 as a potential diagnostic tool for malignant biliary stenotic lesions
Authors: Mahdy Mohamed Abd-Elhakim , Wahid Lobna Abdel , Abd-Elkader Alaa S. , Hassan Ramy A. , Ahmed Hanan M. 
Published: September 2023

Abstract
Aim
Validate the biliary carcinoembryonic antigen-related cell adhesion molecule 6 in differentiating malignant from benign biliary lesions.

Background
The nature of biliary stenosis needs to be diagnosed early and accurately to give the patient the best chance of therapy. Imaging techniques still lack the high accuracy for this purpose. Different biomarkers were postulated to increase the diagnostic accuracy, and of them, carcinoembryonic cell adhesion molecule 6 (CEAM6) in bile was investigated in this study.

Patients and methods
Forty-four patients with biliary stenosis were enrolled in this prospective study in Assiut University Hospital from 2017 to 2019. CEAM6 concentration in bile and serum was measured using human carcinoembryonic antigen-related cell adhesion molecule 6 ELISA kit from SinoGeneClon Biotech Co. Ltd, and CA19-9 concentration in serum was assessed by the ELISA kit for CA19-9 from USCN Life Science Inc.

Results
The area under the curve, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of bile CEAM6 for diagnosis of stricture type among the study population were 0.841, 83, 74, 77, 82, and 78.5%, respectively, at a cut-off value of 6.15 ng/ml. Multivariate analysis showed age, CEAM6, CA19-9, and alkaline phosphatase as good predictors of malignancy.

Conclusion
CEAM6 in bile could be a good diagnostic tool to detect the nature of biliary stenosis.
Serum visfatin level in prediabetics and its relation to left ventricular function
Authors: Abdel-Hassib Mohammed , Hassabo Abdelhaleem A. , Elashmawy Hossam , Mansour Mostafa I. S. 
Published: September 2023

AbstractIntroductionVisfatin is a molecule of clinical relevance, released mainly from visceral fat (hence it named as such) and could be a promising biomarker with diagnostic and prognostic significance in metabolic syndrome. Very little is known about visfatin and its relation with prediabetes.ObjectiveThe present study was conducted to demonstrate the relationship between serum visfatin level and prediabetes and its relation to left ventricular function.Patients and methodsWe studied 60 prediabetic patients recently diagnosed according to ADA criteria 2014 and classified into two groups according to the BMI. They were compared with 30 healthy matched controls. All groups underwent complete history taking, general examination, laboratory investigations (including homeostasis model assessment-insulin resistance and serum visfatin level), and two-dimensional transthoracic echo Doppler study at baseline and 8 months thereafter only for the patient groups.ResultsThis study showed that there is a positive correlation between serum visfatin level and prediabetes and left ventricular function.ConclusionSerum visfatin is an early and strong predictor of prediabetes and left ventricular dysfunction.
Peripheral blood neutrophils and upregulated surface expression of interleukin-17 and CD177 in patients with bronchial asthma: an association with fungal allergy
Authors: Ahmed Eman E. , Sabry Mohamed K. , Elbadie Hazem E. Abd , Melek Nermine A. Elnour 
Published: September 2023

Abstract
Background
Asthma is a prevalent debilitating airway disease, with a tremendous effect worldwide. Fungi and their spores are identified as major culprits in allergic asthma (AA) etiology. Peripheral blood neutrophils and interleukin 17 (IL-17), which are considered crucial players in both bronchial asthma and host defense mechanisms against fungi, increase concomitantly; moreover, certain subsets of neutrophils express and even release IL-17.

Objectives
In this study, we sought to determine the peripheral frequency of certain neutrophil subpopulations, expressing both CD177 and IL-17, among AA patients, particularly those with fungal allergy.

Methods
This observational study comprised 40 patients with AA (age range 19–60 years) and 20 age-matched and sex-matched healthy controls (age range 20–55 years). All patients had positive allergy skin prick test results, and accordingly, they were further subdivided into two groups (18 reactive to fungal allergens and 22 to other aeroallergens). The frequency of IL-17+CD177+ neutrophils in the peripheral blood was assessed by flow cytometry in all studied participants.

Results
The authors observed significantly increased frequency of circulating IL-17+CD177+ neutrophils among AA patients (especially mild to moderate cases) compared with healthy controls (43.3±13.9 vs 15.3±4.8). On the contrary, and surprisingly, patients with fungal allergy and those without did not show any difference with respect to this neutrophil subpopulation (44.6±14.4 vs 42.2±13.7).

Conclusion
Despite limited sample size, we reported elevated IL-17+CD177+ neutrophil proportion in all AA, regardless of fungal aeroallergenicity. This observation points to a role played by this neutrophil subpopulation in asthma pathophysiology, especially the allergic phenotype, and hopefully offer a new therapeutic approach in asthma management.
Serum retinol-binding protein 4 and the risk of ischemic stroke in Egyptian patients with hypothyroidism
Authors: Rashad Nearmeen M. , Sabry Hanan M. , Afifi Samir A. , Fathy Maha A. , El-Helaly Amira M. , Mohamed Haitham E. 
Published: September 2023

Abstract
Objective
Ischemic stroke (IS) is one of the major causes of disability and death worldwide. Effective prevention remains the best approach to reduce the burden of stroke. Adipokines can serve as a key messenger to central energy homeostasis and metabolic homeostasis. Retinol-binding protein 4 (RBP4), a retinol transporter, is elevated in insulin resistance. Controversy exists regarding the role of RBP4 in thyroid diseases. The objective of this study was to evaluate serum RBP4 in patients with hypothyroidism and to assess the association of serum RBP4 with susceptibility of IS.

Patients and methods
This case–control study included 50 healthy individuals as a control group and 90 patients with hypothyroidism, who were stratified into two subgroups: patients with IS and patients without IS. All participants were subjected to history taking and clinical, laboratory, and radiological evaluation.

Results
Serum RBP4 levels were significantly higher in hypothyroid patient, especially patients with IS, compared with the nonstroke group. Interestingly, serum RBP4 level was positively correlated with vascular and metabolic risk factors. Moreover, diastolic and systolic blood pressures, triglyceride, free T3, as well as thyroid-stimulating hormone, were independently correlated with serum RBP4 by linear regression analysis test. The diagnostic power of serum RBP4 level in differentiating hypothyroidism from controls was revealed at the cutoff value of 12.25, with area under the curve of 0.909 (95% confidence interval: 0.861–0.957). However, the diagnostic power of serum RBP4 level in differentiating hypothyroid patient with IS from those without stroke was revealed at the cutoff values of 11.4, with area under the curve of 0.822 (95% confidence interval: 0.737–0.906). In conclusion, the higher levels of serum RBP4 in hypothyroidism, especially in patients with IS, were associated with metabolic and glucose abnormalities, and thus, it could be used as a promising predictive biomarker of IS in hypothyroidism.
Association of serum visfatin and its mRNA expression levels with cognitive function and idiopathic intracranial hypertension in obese Egyptian women
Authors: Rashad Nearmeen M. , Sabry Hanan M. , Fouad Amira A. , Afifi Samir A. , Fathy Maha A. , El-Helaly Amira M. 
Published: September 2023

Abstract
Background
An epidemic of obesity has spread across the globe. Obesity has numerous comorbidities, including airway disease, insulin resistance, type 2 diabetes, cardiovascular disease, atherosclerosis, degenerative neurological disease, cognitive dysfunction, and cancer. Inflammatory cytokine is suggested to play a role in obesity and its complications. The current study aimed to estimate the expression and serum visfatin concentrations in obese Egyptian women. Moreover, we aimed to evaluate the possible association of visfatin gene expression and its serum levels with idiopathic intracranial hypertension (IIH) and cognitive dysfunction

Participants and methods
This cross-sectional study enrolled 60 obese women and 40 lean healthy women as controls. Obese women were classified according to grades of obesity into three groups. All participants underwent full clinical, neurological, and psychiatric examination. IIH group included patients with intracranial pressure greater than 25 cm H2O (opening pressure measured during lumber puncture in lateral decubitus position). Cognitive function was evaluated by using Montreal Cognitive Assessment scale (MoCA), Arabic version. Estimation of visfatin expression levels was determined by real-time PCR, and serum visfatin concentrations were measured using enzyme-linked immunosorbent assay.

Results
Our results revealed that obese women had higher values of visfatin expression (1.44±0.29) and serum levels (124.1±) compared with lean women (1.01±0.3 and 46.1±33.8, respectively). The visfatin expression and serum levels were significantly positively correlated with obesity indices, metabolic risks, MoCA, cerebrospinal fluid opening pressure, and cognitive dysfunction. Linear regression test showed that BMI, cerebrospinal fluid opening pressure, and MoCA were the main predictors of both serum and expression levels of visfatin in obese women. The receiver operating characteristic curve analysis revealed that the power of serum visfatin levels was higher than visfatin expression in differentiating obese women from lean ones.

Conclusion
There was a strong independent association between both higher visfatin expression and serum levels and obesity indices, metabolic risks, IIH, and cognitive dysfunction in obese Egyptian women.
Updated ACR Thyroid Imaging Reporting and Data Systems in risk stratification of thyroid nodules: 1-year experience at a Tertiary Care Hospital in Al-Qassim
Authors: Ewid Mohammed , Naguib Mervat , Alamer Ali , El Saka Hala , Alduraibi Sharifa , AlGoblan Abdullah , Ahmed Elzaki 
Published: September 2023

Abstract
Background
Thyroid imaging reporting and data system (TI-RADS) is assessment of risk stratification of thyroid nodules, using a score. A novel ACR (American College of Radiology) TI-RADS has been recently suggested by American College of Radiology. But, the utility of ACR TI-RADS in risk stratification for thyroid lesion needs further evaluation.

Aim
Of this study was to evaluate ACR TI-RADS classification in discriminating benign and from other thyroid lesions as detected by fine needle aspiration cytology (FNAC).

Methods
This retrospective study included all patients referred to our institute for FNAC of a thyroid nodule over 1 year. Thyroid nodules were categorized according to the 2017 ACR TI-RADS. Ultimately, efficacy of ACR TI-RADS in differentiating benign from non-benign nodules was assessed using ROC curve, cross-tabulation, and Chisquare tests. According to the results of FNAC, nodules were classified into 2 groups; benign lesions (Bethesda II) and malignant lesions (Bethesda IV, V).

Results
The percentages of Bethesda IV and V lesions defined in our ACR-TIRADS were as follows: ACR TI-RADS 1, 2 (0%), ACR TI-RADS 3 (4%), ACR TI-RADS 4 (6.6%), and ACR TI-RADS 5 (22.6%). ROC curve analysis for ACR TI-RADS to differentiate benign from non-benign pathology showed (AUC 0.60, 95% CI: 0.505–0.713). ACR TI-RADS had sensitivity, specificity, positive predictive value and negative predictive value 75%, 62.35 %, 15.7%, 96.3% respectively.

Conclusion
Differentiation between benign and malignant thyroid lesion can be suggested from the ultrasound based ACR TI-RADS system. FNAC might be deferred in patients having ACR TI-RADS 1 and 2.
Role of endoscopic colonic stent insertion in patients with colonic obstructing malignancy: a single-center study
Authors: Marie Mohammad S. , Behairy Gad M. 
Published: September 2023

Abstract
Background
Left-sided colonic malignant lesions have the potential of acute bowel obstruction. Emergency surgery with stoma construction is considered the standard of management. Insertion of colonic stent to allow bowel decompression, primary resection, and re-anastomosis, avoiding the need of colostomy formation, can be an alternative. We describe our experience with the use of colonic stent in left-sided malignant obstruction as a step to relieve the obstruction before definitive surgical intervention.

Patients and methods
A total of 30 patients with left-sided colonic malignant obstruction were included; 15 patients were offered colonic self-expandable metal stent insertion, and the other fifteen patients were offered emergent surgery.

Results
Of the 15 patients, 10 (66.6%) had successful stent insertion (technical and clinical). We failed to insert stent in four (26%) patients, and one (6.6%) patient had colonic perforation. All patients with successful colonic stent insertion underwent one-step resection and primary anastomosis.

Conclusion
Colonic stent for left-sided colonic malignant obstruction represents a valuable procedure for one-step resection and primary anastomosis without the need for colostomy.
Serum osteoprotegerin as an early marker of chronic kidney disease in hypertensive patients
Authors: Elhefnawy Khaled A. , Mohamed Ezzat M. , Abou Yousef Athar M. , Fikry Abeer A. , Allam Hala M. 
Published: September 2023

Abstract
Background
Serum osteoprotegerin (OPG) is a marker of cardiovascular disease. The deterioration of renal function in diabetic patients could be predicted by OPG concentrations, and it was suggested that OPG could be used as a risk marker for chronic kidney disease (CKD) in patients with hypertension.

Objective
The aim was to investigate the role of serum OPG as an early marker of CKD in hypertensive patients.

Patients and methods
A total of 144 hypertensive patients were included and classified into two main groups: group I, which included 72 hypertensive patients without CKD [estimated glomerular filtration rate (eGFR) ≥60 ml/min/1.73 m2], and group II, which included 72 hypertensive patients with CKD (eGFR<60 ml/min/1.73 m2). All participants of the study were subjected to detail clinical examination and investigations including complete blood count, fasting and random blood glucose, glycosylated hemoglobin, urine analysis, serum creatinine, liver function tests, eGFR, and serum OPG assays.

Results
Serum OPG levels were significantly higher in hypertensive group with CKD than in hypertensive group without CKD. A significant positive correlation was found between OPG and diastolic blood pressure, duration of hypertension, serum creatinine, and albumin creatinine ratio, whereas there is a negative correlation between OPG and both weight and eGFR. The best cutoff value of serum OPG in prediction of CKD among hypertensive patients is greater than 1.9 ng/ml with sensitivity of 100% and specificity of 100%.

Conclusion
Serum OPG can serve as an early marker for CKD in hypertensive patients.
Assessment of serum and urinary levels of neutrophil gelatinase-associated lipocalin in correlation with albuminuria in nondiabetic obese patients
Authors: Rashad Nearmeen M. , Said Nora M. , Emad George , Gomaa Ahmed F. , Kadry Heba M. 
Published: September 2023

Abstract
Background
Obesity, a new pandemic, is associated with an increased risk of death and morbidity. Obesity-related glomerulopathy is an increasing cause of end-stage renal disease. Neutrophil gelatinase-associated lipocalin (NGAL) is a neutrophil-expressed inflammatory protein that is increased in different diseases. The objective of the current study was to evaluate the predictive performance of serum and urinary NGAL in obese patients and to clarify its possible relationship with different stages of albuminuria in nondiabetic patients.

Patients and methods
This cross-sectional study was conducted on 55 obese patients and 40 healthy individuals as a control group. The enrolled patients were divided into three groups according to the level of albuminuria. Serum and urinary NGAL (ng/ml) were measured by enzyme-linked immunosorbent assay kits.

Results
Serum and urinary NGAL levels were significantly higher in obese (354.44±121.2 and 213.22±10.8, respectively) compared with healthy controls (44.21±11.2 and 13.9±6.3, respectively; P<0.001). Moreover, there were higher significant values of serum NGAL in patients with macroalbuminuria (488.65±44.53) and microalbuminuria (264.33±25.53) compared with patients with normoalbuminuria (122.48±4.53, P<0.001) and higher significant values of urinary NGAL in patients with macroalbuminuria (363.84±32.53) and microalbuminuria (112.19±26.53) compared with patients with normoalbuminuria (32.17±10.53, P<0.001). Serum and urinary NGAL levels were statistically significant predictors of albuminuria among obese patients. In addition, our results observed that BMI, waist/hip ratio, urinary albumin, estimated glomerular filtration rate, and urinary albumin-creatinine ratio were independently correlated with serum NGAL, whereas BMI, waist/hip ratio, and urinary albumin were the only variables that were independently correlated with urinary NGAL.

Conclusion
The higher levels of serum and urinary NGAL in obese patients compared with healthy group were strongly correlated with urinary albumin-creatinine ratio and cardiometabolic risk factors.