bluuebunny/crossref_metadata_2025_split huggingface dataset:
Decreasing mRNA HMGB1 expression in Klebsiella pneumoniae infection treated by Miana (Coleus scutellarioides (L.) Benth): a cohort experimental study
Authors: Akaputra Risky , Hatta Mochammad , Massi Muhammad N. , Djaharuddin Irawati , Bukhari Agussalim , Aminuddin Aminuddin , Santoso Arif , Natzir Rosdiana , Bahar Burhanudin , Fachri Muhammad , Farsida Farsida , Fathimah Agus , Ubaidah Firda M. , Sridiana Eva , Dwiyanti Ressy , Syukri Ahmad , Junita Ade R. , Febrianti Andini , Primaguna Muhammad R. , Azhar Azhar 
Published: August 2023

Background:
Pneumonia is one of the most common infections caused by the bacterium Klebsiella pneumoniae. During the initiation of an infection, the immune system recognizes the pathogen through the release of high mobility group box 1 (HMGB1), thereby triggering the inflammation process. Miana has demonstrated potent inhibitory effects on the inflammatory process during infection in animal models. The aim of this study was to determine the effect of Miana leaf extract on mRNA HMGB1 expression in Balb/c mice infected with K. pneumoniae.

Methods:
This study comprised a cohort experiment using 20 Balb/c mice divided into four groups. Balb/c mice in each group were intraperitoneally injected with K. pneumoniae. Group 1 was given a placebo; Group 2 was given Miana; Group 3 was given levofloxacin; and Group 4 was given both levofloxacin and Miana. The levels of mRNA HMGB1 expression were measured using real-time PCR before, during, and after the infection as well as after the treatments.

Results:
The initial examination results showed that the average level of mRNA HMGB1 expression was 5.51 fc. The mRNA HMGB1 expression in mice after being challenged with K. pneumoniae was 9.64 fc. Group 1 that was given a placebo had a mean mRNA HMGB1 expression level of 14.99 fc. Group 2 that was given Miana had a mean mRNA HMGB1 expression level of 13.95 fc. Group 3 that was given levofloxacin had an average mRNA HMGB1 expression level of 6.45 fc, and Group 4 that was given levofloxacin and Miana together had an average mRNA HMGB1 expression level of 5.59 fc.

Conclusion:
Miana (Coleus scutellarioides (L.) Benth) increased mRNA HMGB1 expression at the initial administration via regulation of the immune system. Administration of Miana following K. pneumoniae infection inhibited the increase in mRNA HMGB1 expression. Treatment with levofloxacin reduced the level of mRNA HMGB1 expression, and the effect was optimized by the administration of Miana leaf extract as a supplement.
Digestive hemorrhage and fever as a result of a double secondary aortoenteric fistula following the repair of a juxtarenal abdominal aortic aneurysm and an infection of the aortobifemoral bypass graft: a case report
Authors: Abu Jheasha Amal A. , Ashhab Moutasem , Dukmak Osama N. , Maraqa Mohamed , Emar Mohammad , Jubran Fahmi , Alhusseini Rajai 
Published: August 2023

Introduction:
A double secondary aortoenteric fistula (AEF) occurs in a patient who has had significant aortic surgery and is characterized by a direct connection between the gastrointestinal (GI) tract and the aorta at two separate sites.

Importance:
During aortoc reconstructive surgery, the patient may present with a variety of unusual complaints, including fever and GI bleeding. These symptoms are indicative of problems, including the development of an aortoentric fistula, particularly when there is a double secondary fistula.

Case presentation:
The patient was admitted to the hospital due to hematemesis, melena, and high-grade fever after undergoing synthetic grafting aortobifemoral bypass (anatomical reconstruction) and partial resection of the juxtarenal abdominal aortic aneurysm. Pus discharge and a double aortoenteric fistula in unusual sites such as the second-third portion of the duodenum and caecum are visible in upper GI endoscopy and computed tomography angiography. The patient underwent a two-stage open surgery, the first stage involving aortic limb graft exclusion and extra anatomical reconstruction, and the second stage involving graft removal, fistula management, and bowel repair. Then the patient spent a few days in the surgical intensive care unit before being discharged.

Clinical discussion:
Primary and secondary AEF are the two categories of AEF. In patients who underwent aortic reconstruction surgery, the frequency of secondary AEF ranges from 0.36 to 1.6%. Due to the 8:1 injury ratio in the secondery AEF, men suffer more injuries than women.There are two types of fistula depending on whether or not the suture line is involved. The first form is graft enteric erosion, which excludes the suture line, while the second type is entric graft fistula, where the suture line is included. Most common site fistula is third and fourth part of duodenum and least common site is fistula formation in large bowel.

Conclusions:
An uncommon complication is double secondary AEF following aortic reconstruction surgery. Since one of the most significant presentations an AEF patient can present with is major GI bleeding and sepsis, A delay in seeking immediate medical treatment could result in the patient’s death. It should be emphasized that one of the mechanisms for AEF formation and a frequent cause of sepsis in patients is recurrent aortic graft infection following aortic reconstruction surgery.
Case report for a patient with an inguinal hernia diagnosed with an Amyand’s hernia during surgery
Authors: AlKwider Hussam A. , Froh Mamon 
Published: August 2023

Introduction and importance:
Amyand’s hernia is rare, occurs when the appendix is located within the hernial sac, is difficult to diagnose prior to surgery, and is considered to be discovered during surgery.

Case presentation:
A 4-year-old child was brought to the medical clinic by her mother with a swelling complaint in the right inguinal region. Following clinical diagnosis and imaging tests, an indirect inguinal hernia was found to be present. It was decided to perform surgery on the child, and he was taken to the operating room and given general anesthesia. An incision was made on the right inguinal side, reaching the spermatic cord and the ostium internum, where a hernia sac was found containing the inflamed appendix. The appendix was removed from the edges of the hernia sac, tied off at its base, and cut. Finally, the hernia sac was closed without the use of a mesh, the surgical incision was closed, and the wound was dressed.

Clinical discussion:
The diagnosis of inguinal hernia is initially made based on the symptoms presented by the patient, as well as through ultrasound imaging. For surgical management, there is a classification called Losanoff and Basson, which discusses the surgical treatment options necessary for different types of Amyand hernias. The hernia is classified into four types based on the clinical presentation of the patient and the condition of the appendix, and each type has its own treatment.

Conclusion:
Amyand’s hernia is an uncommon condition diagnosed during surgery.
Esophageal cancer operation in the COVID-19 era: are the outcomes different from its past in an observational cohort study?
Authors: Shirkhoda Mohammad , Basravi Monem , Jalaeefar Amirmohsen , Farhangian Mehdi , Memari Fereydoun , Meidani Mohsen 
Published: August 2023

Background:
COVID-19 spread rapidly and potentially affected every medical profession, including surgery. This study aims to compare the postoperative outcomes of oesophageal cancer surgeries in COVID-19 age and a year before.

Methods:
This retrospective cohort study was performed as a single-centred study from March 2019 to March 2022 at Cancer institute, Tehran, Iran. Demographic data, cancer type, surgical procedures, and postoperative outcomes and complications were compared between the two groups pre-COVID-19 and during the COVID-19 pandemic.

Results:
Totally, 120 patients enroled in the study, of which 57 underwent surgery before the COVID-19 pandemic, and 63 during the COVID-19 pandemic. The mean age in these groups was 56.9 (±12.49) and 58.11 (±11.43), respectively. Females included 50.9% and 43.5% of individuals who underwent surgery before and during the COVID-19 pandemic. The interval between admission and surgery was significantly shorter in patients underwent surgery during the COVID-19 pandemic (5.17 vs. 7.05; P=0.013). However, there was no significant difference between time interval between surgery and discharge [11.68 (7.81) vs. 12 (6.92); P=0.689]. Aspiration pneumonia was the most common complication in both groups. There was no significant difference between postoperative complications in both groups.

Conclusion:
Outcomes of oesophageal cancer surgeries in COVID-19 age in our institution were comparable with the year before the pandemic. The decrease in the time interval between surgery and discharge did not lead to an increase in postoperative complications and could be noted for post-COVID-19 era policymaking, too. This study suggests not postponing any of the surgical treatments for oesophageal cancer in the COVID-19 era.
Cerebellopontine angle meningioma in a patient presented as acute cerebrovascular accident
Authors: Hassan Mohamed Sheikh , Köksal Ayhan 
Published: August 2023

Introduction and importance:
Cerebellopontine angle (CPA) meningioma is a slowly growing benign tumor of the brain that may compress adjacent neural structures. It has variable clinical presentations that progress very slowly depending on its growth pattern and associated mass effect. A sudden onset clinical presentation is unusual and should prompt consideration of other potential etiologies.

Case presentation:
Here, the authors present a 66-year-old male patient with diabetes, hypertension, and hyperlipidemia who presented to the emergency department of our hospital with sudden onset walking difficulty (ataxia). On examination, the patient was fully conscious. There was no associated cranial nerve deficit, hearing loss, or focal/lateralizing weakness. All sensory modalities were intact. However, the patient had a gait impairment. Romberg and tandem gait tests were positive with the tendency to sway to the left. The patient was admitted with suspicion of acute cerebrovascular disease. The initial noncontrast brain computed tomography and subsequent diffusion MRI were inconclusive. A later brain MRI with contrast revealed a homogeneously contrast enhancing meningioma in the left CPA.

Clinical discussion:
The differential diagnosis of sudden onset ataxia is broad and should include the assessment of a possible CPA lesion. Sudden onset ataxia by a CPA meningioma is very rare as meningiomas grow very slowly. A brain MRI with contrast is essential for its diagnosis.

Conclusion:
Although stroke is the main cause of sudden onset ataxia in a patient with cerebrovascular risk factors, yet other less common causes may be found as in this case of CPA meningioma.
The prevalence of dyslipidemia in patients on hemodialysis: a cross-sectional study from Syria
Authors: Hasan Yasmeen Kamel , Alsultan Mohammad , Anan Mohamed Taher , Hassn Qussai , Basha Kassem 
Published: August 2023

Introduction:Dyslipidemia is an established risk factor for cardiovascular disease (CVD), which is the main cause of mortality among haemodialysis (HD) patients. We investigate the prevalence and characteristics of dyslipidemia in HD patients. Also, we aimed to study the prediction scores; Framingham risk score (FRS), and the atherosclerotic cardiovascular disease risk score; among this population.Methods:One hundred fifty-three HD patients were enroled in this retrospective cross-sectional study from two HD centres in Syria, from March 2021 to March 2022. Dyslipidemia is considered as follows; hyper-total cholesterol (TC) (≥200 mg/dl), hyper-triglycerides (TG), (≥150 mg/dl), hyper-low-density lipoprotein (LDL) (≥100 mg/dl), hypo-high-density lipoprotein (HDL) (<40 mg/dl), hyper-Non-HDL (≥130 mg/dl).Results:The most prevalent dyslipidemic parameter was low HDL (72.50%) followed by increased TGs (37.30%). TC, LDL, HDL, and Non-HDL showed differences between males and females (P=0.001, 0.015, 0.024, and 0.025; respectively). These parameters were higher in females. History of CVD showed associations with TC, LDL, HDL, and non-HDL (P=0.003, 0.007, 0.004, and 0.004; respectively). Additionally, statins showed effects on TC, LDL, and non-HDL (P=0.003, 0.0002, and 0.002; respectively); however, no relation with TG and HDL (P=0.9 and 0.4). HDL level showed differences in low (7.5%) and intermediate (10%) FRS (P=0.01 and 0.028; respectively); however, it did not show a difference in high (20%) FRS (P=0.68). The lipids profile did not show differences in different thresholds of atherosclerotic cardiovascular disease scores.Conclusion:The prevalence of dyslipidemia was high in HD patients in Syria. All lipid parameters except TG showed differences between males and females. Comparisons of lipid parameters with CVD risk stratifications support the need for further studies to prove the benefits of these scores in CVD prediction among the dialysis population.
Not every twist is ovarian torsion: a case report of isolated torsion of the fallopian tube in a child
Authors: Awal Shila , Regmi Pradeep Raj , Prajapati Nabin 
Published: August 2023

Introduction:
Isolated fallopian tube torsion is a rare condition presenting with abdomen pain. The diagnosis is challenging because the clinical findings mimic several other conditions. In this article, we present a case of an adolescent girl who was diagnosed with the condition during laparoscopy.

Presentation of the case:
A 15-year-old girl presented with complaints of sudden onset left lower quadrant pain, nausea, and vomiting. There was tenderness in the left iliac fossa. Ultrasonography revealed inconclusive findings and contrast-enhanced computed tomography of the abdomen and pelvis suggested possible left adnexal torsion. Hence, she underwent a diagnostic laparoscopy which revealed a twisted, edematous, and congested left fallopian tube. The diagnosis of isolated left fallopian tube torsion was made and she was managed with unilateral salpingectomy.

Discussion:
Women of the reproductive age group are usually affected by this condition. The common presentations are abdominal pain, nausea, and vomiting. The physical examination may reveal abdominal and cervical motion tenderness. Per abdominal ultrasound is the first go-to modality in children. Magnetic resonance imaging, if available, is advised in children if the ultrasound is inconclusive because of the absence of radiation. However, it may require sedation. Therefore, contrast-enhanced computed tomography abdomen gives an added advantage in such scenarios as in our case. This condition is managed by surgery with salpingectomy or tube detorsion with preservation of the tube, depending on the intraoperative findings.

Conclusion:
Clinicians should be aware of the condition given the rarity and challenges in the diagnosis of isolated fallopian tube torsion.
Hemodynamic Characteristics of Intracranial Atherosclerotic Stenosis: A Pilot Study of Contrast Enhancement Time-Density Curves Based on Regions of Interest
Authors: Yu Xiang , Dong Aijing , Zhang Weiguo , Chen Ping 
Published: August 2023

Objective
The present study aimed to analyze the hemodynamic characteristics of occluded vessels responsible for acute ischemic stroke and to diagnose the occlusion types.

Methods
Multimodal computed tomography (CT) was used to accurately identify the range of occlusion of large intracranial vessels. Regions of interest (ROI1–3) were manually delineated at sites 2 mm away from the proximal, middle, and distal portions of each occlusion, generating 3 contrast enhancement time-density curves. The peak CT attenuation values, or Hounsfield units (H1–3), and time-to-peak values (T1–3) were extracted from each curve. H0 and T0 of the time-density curve, based on ROI0 of the automatically recognized input artery, were used as the baseline values with which the odds ratios of each parameter, H1–3/0 and T1–3/0, were obtained. The present study aimed to establish prediction models for intracranial atherosclerotic stenosis (ICAS) based on each ROI's time-density curve.

Results
Among the 33 acutely occluded intracranial vessels, 10 were found to have ICAS, whereas 23 did not, based on the diagnostic criteria. Significant differences were observed in patient sex, neutrophil-to-lymphocyte ratio upon admission, Alberta Stroke Program Early CT Score 24–48 hours after reperfusion therapy, and H1/0, H3/0, and T3/0 between the ICAS and non-ICAS groups (P < 0.05). The prediction model (model 3) based on the ROI3 time-density curve showed the best performance for the diagnosis of ICAS (area under the curve, 0.944; 95% confidence interval, 0.854–1.000). The prediction models based on ROI1 (model 1) and ROI2 (model 2) showed moderate diagnostic performance (area under the curve, 0.817 vs 0.822, respectively). The best visualization for proximal occlusions was in the first phase (arterial phase) of multiphase CT angiography, and in the second phase (early venous phase) for distal occlusions.

Conclusions
The contrast enhancement time-density curves of the ROIs at all evaluated portions of the acute ischemic stroke occlusions provided a visual display of the blood flow characteristics of the responsible vessels. The time-density curve of the ROI placed 2 mm from the distal occlusion was a combined effect of residual blood flow and collateral establishment, thus providing good performance for the diagnosis of ICAS.
Autologous Fat Versus Hydroxyapatite Cement for Use in Frontal Sinus Obliteration
Authors: Martinez O. Parker , Le Paulina B. , Martinez Carlos R. , Chen Elliott 
Published: August 2023

BackgroundFrontal sinus obliteration is a possible terminus for the management of chronic sinusitis, frontal bone trauma, cancer extirpation, or mucocele. The mucosa of the sinus is stripped and space obliterated with either autogenic, allopathic, or synthetic materials. This study aimed to compare the outcomes of autologous fat and hydroxyapatite cement (HAC) for frontal sinus obliteration.MethodsA multidatabase systematic review was conducted to collect outcomes on frontal sinus obliterations with either autologous fat or HAC. Outcomes collected included infection of the frontal sinus or obliteration material, mucocele formation, skin infection at the operative site, hematoma or seroma, cosmetic defect, donor site infection, and need for revision procedure. Prevalence of outcomes was analyzed through meta-analysis of proportions.ResultsTwenty studies were ultimately included in the meta-analysis. Sixteen studies reported outcomes for 667 patients obliterated with autologous fat, and 7 studies reported outcomes for 100 patients obliterated with HAC. Prevalence of infection of the frontal sinus or obliteration material, mucocele formation, skin infection at the operative site, hematoma or seroma, and cosmetic defect did not differ statistically between the cohorts. Donor site infection secondary to fat harvesting for fat obliteration had a prevalence of <0.01. Revision rate was 0.04 (95% confidence interval, 0.01–0.8) for fat obliteration and 0.10 (95% confidence interval, 0.00–0.33) for HAC obliteration.ConclusionsNo statistically significant differences in the studied outcomes were detected between obliterations with autologous fat and HAC, suggesting that either is equally suitable and may be up to the surgeon's preference.
Psychosocial and Behavioral Outcomes for Persons With Cognitive Impairment and Caregivers Following Amyloid-β PET Scan Disclosure
Authors: Couch Elyse , Ashford Miriam T. , Zhang Wenhan , Prina Matthew 
Published: August 2023

Background:
Positron emission tomography (PET) scans for amyloid-β can aid in the early and accurate detection of Alzheimer disease. The results of amyloid PET scans could help people with cognitive impairment and caregivers better understand their diagnosis; however, there are concerns that they could also cause psychological harm.

Methods:
A systematic review of psychosocial and behavioral quantitative outcomes following the disclosure of an amyloid PET scan for persons living with cognitive impairment (subjective cognitive decline, mild cognitive impairment, Alzheimer’s Disease, and other dementias) and caregivers.

Findings:
Ten papers were identified from 7 studies. There was little evidence of an association between disclosure and depression. However, persons with mild cognitive impairment and their caregivers with elevated levels of amyloid had an increased risk of distress or anxiety compared with those without elevated amyloid. Participants correctly recalled the scan results; however, it is unclear whether this led to an increased understanding of their diagnosis. We did not identify any studies measuring behavioral outcomes.

Conclusions:
We found mixed evidence on the relationship between amyloid scans and psychosocial and behavioral outcomes in people with cognitive impairment and caregivers. These findings highlight the need for more methodologically rigorous research on this topic.
Examination of SARS-CoV-2 serological test results from multiple commercial and laboratory platforms with an in-house serum panel
Authors: Lester Sandra N. , Stumpf Megan , Freeman Brandi D. , Mills Lisa , Schiffer Jarad , Semenova Vera , Jia Tao , Desai Rita , Browning Peter , Alston Bailey , Ategbole Muyiwa , Bolcen Shanna , Chen Alexander , David Ebenezer , Manitis Panagiotis , Tatum Heather , Qin Yunlong , Zellner Briana , Drobeniuc Jan , Tejada-Strop Alexandra , Chatterjee Payel , Shrivastava-Ranjan Punya , Jenks M. Harley , McMullan Laura K. , Flint Mike , Spiropoulou Christina F. , Niemeyer Glenn P. , Werner Bonnie J. , Bean Christopher J. , Johnson Jeffrey A. , Hoffmaster Alex R. , Satheshkumar Panayampalli S. , Schuh Amy J. , Owen S. Michele , Thornburg Natalie J. 
Published: August 2023

Severe acute respiratory syndrome (SARS) coronavirus 2 (SARS-CoV-2) is a novel human coronavirus that was identified in 2019. SARS-CoV-2 infection results in an acute, severe respiratory disease called coronavirus disease 2019 (COVID-19). The emergence and rapid spread of SARS-CoV-2 has led to a global public health crisis, which continues to affect populations across the globe. Real time reverse transcription polymerase chain reaction (rRT-PCR) is the reference standard test for COVID-19 diagnosis. Serological tests are valuable tools for serosurveillance programs and establishing correlates of protection from disease. This study evaluated the performance of one in-house enzyme linked immunosorbent assay (ELISA) utilizing the pre-fusion stabilized ectodomain of SARS-CoV-2 spike (S), two commercially available chemiluminescence assays Ortho VITROS Immunodiagnostic Products Anti-SARS-CoV-2 Total Reagent Pack and Abbott SARS-CoV-2 IgG assay and one commercially available Surrogate Virus Neutralization Test (sVNT), GenScript USA Inc., cPass SARS-CoV-2 Neutralization Antibody Detection Kit for the detection of SARS-CoV-2 specific antibodies. Using a panel of rRT-PCR confirmed COVID-19 patients’ sera and a negative control group as a reference standard, all three immunoassays demonstrated high comparable positivity rates and low discordant rates. All three immunoassays were highly sensitive with estimated sensitivities ranging from 95.4%-96.6%. ROC curve analysis indicated that all three immunoassays had high diagnostic accuracies with area under the curve (AUC) values ranging from 0.9698-0.9807. High positive correlation was demonstrated among the conventional microneutralization test (MNT) titers and the sVNT inhibition percent values. Our study indicates that independent evaluations are necessary to optimize the overall utility and the interpretation of the results of serological tests. Overall, we demonstrate that all serological tests evaluated in this study are suitable for the detection of SARS-CoV-2 antibodies.