bluuebunny/crossref_metadata_2025_split huggingface dataset:
Noninvasive parameters for assessment of esophageal varices
Authors: Elatty Ehab A. A. , Elshayeb Elsayed I. , Badr Mohammed H. , Mousa Waleed A. E. , El Mansory Mohammed F. 
Published: September 2023

AbstractObjectiveThis study aims to assess esophageal varices (EV) by noninvasive parameters in patients with liver cirrhosis.BackgroundThe current guidelines recommend the screening of all cirrhotic patients by endoscopy for EV, but repeated endoscopic examinations are unpleasant for patients and have a high cost impact and burden on endoscopic units. Therefore, there is a particular need for noninvasive predictors of EV.Patients and methodsA total of 120 cirrhotic patients were enrolled in this study and were divided into three groups: 40 cirrhotic patients with EV and a history of upper gastrointestinal bleeding, 40 cirrhotic patients with EV without a history of upper gastrointestinal bleeding, and 40 cirrhotic patients without EV. All patients in the study were subjected to an assessment of history, clinical examination, routine laboratory investigation, abdominal ultrasound, and upper gastrointestinal endoscopy.ResultsSerum albumin at cut-off less than 3.65 g/dl, platelet count at cut-off less than 99 000/mm3, platelet count/spleen diameter ratio (PC/SD) at cut-off less than 919.6, aspartate aminotransferase-to-platelet ratio index at cut-off greater than 1.14, spleen longitudinal diameter at cut-off more than 140.5 mm, portal vein diameter at cut-off more than 15.2 mm, and prothrombin time at cut-off more than 15.1s are significant in the prediction of EV. North Italian Endoscopy Club Index at cut-off more than 25.4, platelet count at cut-off less than 74 000/mm3, and PC/SD at cut-off 851.6 are significant in the prediction of variceal bleeding risk.ConclusionSerum albumin, platelet count, PC/SD ratio, aspartate aminotransferase-to-platelet ratio index, spleen longitudinal diameter, portal vein diameter, prothrombin time, and Child score can provide information that can help in the prediction of the presence of EVs in patients with liver cirrhosis. North Italian Endoscopy Club Index, platelet count, and PC/SD ratio can provide information that can help in the prediction of variceal bleeding risk in patients with liver cirrhosis.
Prevalence of undiagnosed thyroid dysfunction in correlation with Helicobacter pylori infection: cross-talk between Hashimoto’s thyroiditis and Helicobacter pylori
Authors: Rashad Nearmeen M. , Gomaa Ahmed F. 
Published: September 2023

Abstract
Background
Worldwide, the prevalence of thyroid dysfunction is increasing and it is one of the leading endocrine disorders. The objective of the present study was to assess the prevalence of undiagnosed thyroid dysfunction and its association with Helicobacter pylori (HP) infection and to clarify the association between HP and Hashimoto’s thyroiditis.

Patients and methods
A cross-sectional study was conducted among 300 unrelated patients; 187 patients had normal thyroid function and 113 patients had thyroid dysfunction. The patients were stratified into one of the following five groups based on the reference of the normal thyroid function test; thyroid-stimulating hormone and free thyroxine were used as the screening tests to diagnose thyroid dysfunction. HP antigen in the stool and antibodies against cytotoxin-associated gene A (cag-A), anti-thyroid peroxidase (anti-TPO) antibodies, and anti-thyroglobulin (anti-TG) antibodies were measured.

Results
Our results show that the prevalence of thyroid dysfunction was found in 37.6% of the studied population. The most frequent dysfunction was subclinical hypothyroidism (44.4%), followed by overt hypothyroidism (20.6%). Interestingly, the prevalence was higher in association with HP infection diagnosed by HP antigen and cag-A antibodies. There was statistically significant positive correlation between HP antigen and anti-TPO as well as anti-TG. Regarding cag-A. There were statistically significant positive correlations between antibodies against cag-A and anti-TG as well as anti-TPO. Interestingly, stepwise linear regression analysis showed that serum thyroid-stimulating hormone levels were independently correlated with free thyroxine, HP.

Conclusion
The higher prevalence of thyroid dysfunction as observed in the current study was associated with Hashimoto’s thyroiditis. Further future multicenter studies with a bigger sample size are needed to validate our findings.
Role of different direct-acting antiviral drugs on hepatitis C virus-associated mixed cryoglobulinemia in Egyptian patients
Authors: Elshazly Tarek A. , Elrabat Amr M. , Ali Sahar A. M. , Diasty Muhammed , El-Desoky Mohamed 
Published: September 2023

Abstract
Background
Several extrahepatic manifestations have been reported and mixed cryoglobulinemia is a clonal disorder of B cells which is strongly associated with hepatitis C virus (HCV).
New regimens of direct-acting antiviral agents (DAAs) have recently been approved for the treatment of genotype 4 HCV which offer improved results of sustained virologic response (SVR) in the treatment-naive and previously treated patients.

Aim
To assess the prevalence of cryoglobulinemia for evaluating the efficacy of DAA therapy on it.

Patients and methods
Patients received one of the following regimens: sofosbuvir, daclatasvir±ribavirin, or sofosbuvir plus ledipasvir±ribavirin follow-up for 24 weeks after treatment.

Results
A total of 132 patients were involved in our study: 65 men and 67 women. Cryocrit-positive patients clinically presented with clinical manifestations in 32 (53.3%) patients out of the 60 patients. After 12 weeks of DAAs treatment, there was a significant reduction in cryoprecipitate level and rheumatoid factor (RF) level with improvement of glomerular filtration rate, basal C4, and clinical improvement of purpura, Raynaud’s phenomenon, and this was the same when 38 patients continued treatment for 24 weeks. However, comparing 12 and 24-week therapy showed significant improved difference in cryoprecipitate level but improved glomerular filtration rate, basal C4, and decreased level of RF, proteinuria, purpura, and peripheral neuropathy although it did not reach statistical significance

Conclusion
Cryocrit-positive patients were old age, cirrhotics with long duration of HCV. There is significant improvement of both laboratory and clinical parameters of cryoglobulinemia after SVR12 and more significant after SVR24. There is no significant difference in using different DDA regimen with or without ribavirin on the SVR at either 12 or 24 weeks. So, we advise basal laboratory and clinical parameters of mixed cryoglobulinemia before designing treatment regimens of HCV patients in Egypt.
Factors affecting readmitted patients with acute exacerbation of bronchiectasis
Authors: Alduihi Fatima Alhamed , Khoury Abdallah 
Published: September 2023

Abstract
Background
Bronchiectasis is an important cause of morbidity and mortality all over the world. Determining the frequency of actual occurrence is particularly misleading and difficult to determine, especially in patients with multiple respiratory disorders, because it can be a result of any primary pulmonary disease. The objective of this study was to evaluate the effect of readmission with acute exacerbation of bronchiectasis (AEB) on the admissions later on, need of long-term O2 and mechanical ventilation, and mortality.

Patients and methods
This is an observational cohort and prospective study. It was conducted on patients admitted with AEB who achieved modified O’Donnell criteria, and their high-resolution computed tomography showed bronchiectasis on admission at Aleppo University Hospital between September 2017 and January 2019. They were divided into three groups by age. Patients with bronchial asthma, chronic obstructive pulmonary disease, and cystic fibrosis were excluded.

Results
The study included 90 patients (57 males and 33 females) with a mean age of 52.93 ±20.437 years. AEB showed a peak of incidence in the age group 41–65 years. Dyspnea is the most common symptom in exacerbations (88.23%) followed by hemoptysis (80.88%). Wheezing had the least frequency on admission (60.29%). Median survival age was 14±0.214 months. We collected information on 136 exacerbations in 90 patients. A total of 31 (34.44%) patients had at least one readmission and 19 (21%) patients died within 12 months of admission to the hospital. Age, smoking, and need of long-term O2 were statistically significant between the two groups of study (P=0.013, <0.0001, and 0.04, respectively). Sex, radiological changes, mortality, and mechanical ventilation have no significance.

Conclusion
AEB is a common reason for hospitalization, and it correlates with age, smoking, readmission, and need of long-term O2 treatment.
Delirium: a common preventable medical disorder in elderly patients
Authors: Hemeda Afaf 
Published: September 2023

AbstractDelirium is one of commonest unmet medical emergencies in clinical practice however, its role in increasing mortality, hospital admission and institutional placement in very obvious. In addition, a link was found between delirium and development of dementia based on the finding that significant number of delirious patients developed persistent cognitive impairment thereafter. Several factors can lead to delirium or aggravate it and consequently primary care physician should be aware by these factors keeping in mind that delirium is still a treatable condition if identified and managed appropriately and urgently.
Evaluation of the Sabadell noninvasive hepatitis C-related cirrhosis early detection index and right lobe diameter to albumin ratio in the prediction of presence of varices in Egyptian cirrhotic patients
Authors: Kamal Ghada M. , Zaghloul Amr M. , El Aref Rania 
Published: September 2023

Abstract
Introduction
Portal hypertension in cirrhosis results from progressive fibrotic remodeling of the liver, which increases the resistance to hepatic sinusoidal blood flow. Increased portal venous pressure causes esophageal and gastric varices, which contribute substantially to cirrhosis-related morbidity and mortality. The gold standard in the diagnosis of varices is esophagogastroduodenoscopy, but identification of noninvasive predictors of esophageal varices (OVs) will allow upper gastrointestinal tract endoscopy to be carried out only in a selected group of patients. Different noninvasive parameters including clinical, laboratory, and sonographic predictors are an alternative approach to perform selective screening endoscopy only in patients at high risk.

Objective
Our objective is to evaluate whether the noninvasive hepatitis C-related cirrhosis early detection (NIHCED) score and the right lobe diameter to albumin ratio can predict the presence of OVs in a group of Egyptian cirrhotic patients.

Patients and methods
Seventy-five patients with liver cirrhosis were enrolled in the study depending on the clinical evidence of stigmata of chronic liver disease (e.g. jaundice, ascites, palmar erythema, spider naevi, etc.) and ultrasonographic features of liver cirrhosis (e.g. coarse echo texture, shrunken liver, etc.).

Results
According to the esophagogastroduodenoscopy results, the patients were categorized into two groups: those with OVs (47 patients, 63%) and those without OVs (28 patients, 37%).
Receiver operating characteristic curve analysis of the NIHCED score was applied to both groups with a cutoff score of more than 45. The estimation cohort study had a sensitivity of 70%, specificity of 78%, and diagnostic accuracy of 74% with an area under the receiver operating characteristic curve of 0.77 (95% confidence interval, 0.66–0.86).
Receiver operating characteristic curve analysis of the right lobe diameter to albumin ratio was applied to both groups with a cutoff score of more than 2.80. The estimation cohort study had a sensitivity of 80%, specificity of 53%, and diagnostic accuracy of 67% with an area under the receiver operating characteristic curve of 0.67 (95% confidence interval, 0.55–0.77).

Conclusion
The NIHCED score and right lobe diameter to albumin ratio are simple noninvasive predictors of the presence of varices in Egyptian patients with liver cirrhosis.
Prognostic value of serum autotaxin in liver cirrhosis and prediction of hepatocellular carcinoma
Authors: Ahmed Nagwa Ramadan , EL-Mazny Ahmed Nabil , Hassan Sarah Ahmed , Rashed Laila Ahmed 
Published: September 2023

Abstract
Background
Autotaxin is a lysophospholipase D related to liver fibrosis; its clinical role in liver cirrhosis is still unknown or limited. In this study we investigate the relation of autotaxin serum levels and prognosis of liver disease and/or prediction of hepatocellular carcinoma (HCC) in hepatitis C virus (HCV) patients.

Patients and methods
This observational, prospective case–control study included 180 participants, 60 patients with HCV-related liver cirrhosis, 60 HCV noncirrhotic patients, and 60 healthy controls. They were enrolled from inpatients and clinics of a tertiary-care hospital. Baseline characteristics, serum autotaxin, Child–Turcotte–Pugh and model of end-stage liver disease scores were determined. Abdominal ultrasound and upper gastrointestinal endoscopy were done at the beginning of the study. Cirrhotic patients were prospectively followed up for 6 months.

Results
Patients with liver cirrhosis had the highest level of autotaxin (106±24 μg/ml) compared with noncirrhotic HCV patients (81.9±21 μg/ml) and healthy controls (42.5±11 μg/ml) using one-way analysis of variance test (P=0.000). Spearman’s correlation analysis showed no significant correlation between autotaxin and Child–Turcotte–Pugh score (r=0.02; P<0.70), and model of end-stage liver disease score (r=0.15; P<0.41). At 6 months of follow-up, patients who developed HCC or encephalopathy had significantly higher baseline autotaxin level (141±55 μg/ml; P=0.02, 117±56.6 μg/ml; P=0.000), respectively, than patients who did not (102±34, 90.7±40 μg/ml). Cutoff values of autotaxin for the prediction of HCC and encephalopathy were 95 and 92μg/ml, respectively, with 91 and 92% sensitivity.

Conclusion
Autotaxin is a sensitive predictor for the development of HCC and encephalopathy in HCV-related cirrhotic patients. However, it was not related to disease severity.
Extracellular vesicles and systemic lupus erythromatosus
Authors: Omran Rasha N. , El Shebini Emad M. , Zahran Enas S. , Shoeib Sabry A. 
Published: September 2023

AbstractIntroductionExtracellular vesicles (EV) have emerged as important ‘nanoshuttles’ of information between cells, carrying proteins, genetic information, and bioactive lipids to modify the phenotype and function of recipient cells. EVs are potential regulators in autoimmune disorders, playing a determinant role in the appearance and maintenance of inflammation.ObjectiveThis study aimed to carry out an up-to-date review of the EVs and their relationship with systemic lupus erythromatosus.Data sourcesMedline databases (PubMed, Medscape, ScienceDirect, EMF-Portal) and all materials available in the Internet till 2018.Study selectionThis search yielded 275 articles. The articles were studied to perform an up-to-date review of the extracellular vesicles and their relationship with systemic lupus erythromatosus.Data extractionIf the studies did not fulfill the inclusion criteria, they were excluded. Study quality assessment included whether ethical approval was obtained, the eligibility criteria specified, appropriate controls, and adequate information and defined assessment measures.Data synthesisComparisons were made by a structured review, with the results tabulated.ConclusionWe can safely conclude that EVs play an important role in the complex pathogenesis and management of systemic lupus erythematosus.
Current characteristics of chronic hepatitis B in Egypt
Authors: Elsabaawy Maha M. , Elsherefy Mohammed E. , Sakr Haitham E. , Elsabaawy Dalia , Elshazly Helmy , Elezaawy Hossam , Al Azab Gasser I. , Eltahawy Mahmoud 
Published: September 2023

Abstract
Background and aim
In the era of hepatitis C virus eradication, Egypt had to pay attention to the two million infected with chronic hepatitis B. This study aimed to observe the current characteristics of chronic hepatitis B virus (HBV) infection in Egypt.

Patients and methods
This cross-sectional study was conducted on 183 patients with chronic HBV infection. The demographic, epidemiologic, clinical, laboratory, and treatment data were collected from patient registries.

Results
Positive hepatitis B e-antigen (HBeAg) cases represented 18.04%. They were younger (31.09±8.542–38.22±10.6 years) (P<0.05), with higher alanine aminotransferase (84.91±67.855–53.75±55.575 U/l) (P<0.05) and viral loads (3.58×108±16.49×108–1.74×106±10.1×106 IU/ml) (P<0.05), particularly in chronic active carrier states. Unsafe hygienic procedures (sharing toothbrushes and razors) were the main infective routes (73.7%). Coinfection with hepatitis C virus was documented in 14.7%, along with 16.3% with schistosomal infestation. HBV and hepatitis D virus coinfection was reported in 8.9% of the studied cohort. Radiologically, liver cirrhosis was detected in 44% of cases, with associated splenomegaly in 20.7%. Histologically, 40.2% were found to have significant pathology (A2, F2>2). Thirty (16.3%) cases were outside international guidelines of treatment, only for follow-up. Overall, 70.5% were subjected to lamidine therapy, with unfair responses mainly detected in the HBeAg-positive group (71.4%), who responded marvelously to interferon finite regimens. HBeAg-positive status and schistosomiasis were found to be associated with poor response to oral antivirals by multivariate analysis (P<0.05).

Conclusion
More classified governmental censorship efforts, notably on private organizations, along with awareness levitation are promptly mandated. Additionally, the poor response to oral antivirals in HBeAg-positive patients signifies sticking to interferon as a first-line treatment option.
Achieving euthyroidism in hypothyroid patients using levothyroxine improves depressivity and impaired daily life scores using ThyPRO questionnaire
Authors: Elsherbiny Tamer M. 
Published: September 2023

Abstract
Background
Levothyroxine is the recommended treatment to achieve euthyroidism in hypothyroid patients. Achieving euthyroidism was found to improve quality of life in some studies but failed to do so in other studies. Thyroid patient reported outcomes (ThyPRO) is a thyroid-specific health-related quality of life measure. This study aims to assess patient-reported outcomes in levothyroxine-treated hypothyroid patients using ThyPRO.

Patients and methods
The study included 194 patients, divided into two groups: group 1 included 141 hypothyroid patients with benign thyroid disease treated with l-thyroxine, stable in euthyroidism for at least 6 months, and group 2 included 53 patients with euthyroid benign thyroid disease. All patients completed a professionally translated, carefully revised version of the ThyPRO questionnaire into Arabic language. All patients had their Thyroid stimulating hormone (TSH) measured at inclusion. Anti-thyroperoxidase and/or anti-thyroglobulin antibodies were recorded for each patient where available.

Results
There were no significant differences between the two studied groups regarding age, sex, and TSH. Anti-thyroperoxidase antibodies were significantly higher in treatment group versus group 2, but anti-thyroglobulin antibodies did not differ among the two studied groups. Group 1, l-thyroxine treatment group, showed significantly lower scores in the goiter symptoms, depressivity, impaired daily life, and hyperthyroid symptom scales compared with group 2. No significant differences were found regarding the remaining symptom scales.

Conclusion
Hypothyroid patients of different etiologies rendered euthyroid for at least 6 months compared with euthyroid patients with benign thyroid disease have significantly better depression, goiter, impaired daily life scores using a thyroid-specific questionnaire, the ThyPRO, compared with euthyroid benign thyroid disease.
Effects of interleukin-12 gene polymorphism on response to hepatitis B vaccination among hemodialysis Egyptian patients
Authors: Abdel-Moniem Sawsan M. , Mohammed Mohammed A. , Essam El-Deen Ziyad M. , Mostafa Hanan M. 
Published: September 2023

Abstract
Background
Hepatitis B virus (HBV) infection is a major health problem among hemodialysis (HD) patients. Interleukin (IL)-12 gene polymorphisms may be associated with immune response variability to recombinant HBV vaccines. The aim was to determine the correlation between IL-12 gene polymorphism and hepatitis B surface-antibody (HBs-Ab) titer in response to HBV vaccine among HD Egyptian patients.

Patients and methods
Seventy patients receiving long-term HD and 20 age-matched and sex-matched healthy controls were enrolled. All participants were non-HBV vaccinated and seronegative for HBV and HIV. Recombinant HBV vaccine was given (three-dose scheduled). Thereafter, HBs-Ab titer and IL-12 gene polymorphism were evaluated 8 weeks after the last vaccination dose.

Results
There was no response (HBs-Ab<10 μIU/ml) in 20% of HD patients and 10% of the controls. HBs-Ab titers showed no significant correlation with duration of HD, BMI, serum albumin, hemoglobin, leucocytic count, parathyroid hormone level, or IL-12 gene polymorphism. Responders to vaccination had significantly lower transferrin saturation and significantly higher levels of urea reduction ratio, Kt/V and lymphopenia. IL-12B genotype frequency was as follows: AA (58.3 vs. 55.6%), AC (37.5%) and CC (4.2 vs. 0%) in responders of either HD or control participants, respectively (P>0.05 for all).

Conclusion
There was no significant association between IL-12B gene polymorphism and HBs-Ab response in Egyptian HD patients. In HD patients, lymphocytopnea, diabetes mellitus (DM), high transferrin saturation and inefficient HD were associated with HBV vaccine hyporesponsiveness.
Study of the relationship of thyroid status and frailty in older Egyptian men
Authors: El Din Ibrahim Maha H. , Alsebaie Mohamed M. , Elbendary Haidy I. , Yousief Elham M. 
Published: September 2023

Abstract
Background
This study was conducted in Endocrine and Diabetes Clinic (Cairo University) and National Institute of Diabetes and Endocrinal Glands from 2016 to 2017.

Aim
To recognize the relationship between thyroid status and frailty in older Egyptian men, as distinguishing proof of contrasts in thyroid function as a hazard factor for frailty gives added chances to recognize men in danger of more unfortunate well-being results.

Methods
The study included 100 geriatric Egyptians men without overt thyroid disorder. All patients were subjected to medical history and physical measurement including assessment of frailty by using FRAIL scale (Fatigue, Résistance, Ambulation, Illnesses and Loss of weight, with frailty represented by the presence of three or more of these elements), free thyroxine level and thyroid-stimulating hormone.

Results
The average age of the patients was 67.34±3.42 years. of 100 men, four patients were classified as having overt hyperthyroidism, two patients having overt hypothyroidism (2.0%), 10 patients having subclinical hyperthyroidism (10%), one patient with subclinical hypothyroidism (1.0%), and 83 patients were euthyroid (83%), and 40 men were classified as being frail. The authors found a positive correlation of frailty with age (P<0.001).

Conclusion
There is a statistically significant association of frailty with smoking (P=0.014) and hypertension (P=0.003). There was no factually noteworthy relationship between frailty and thyroid-stimulating hormone, free T4, and free T3, and no measurably statistically significant difference between frailty and change in thyroid function (P=0.592).