bluuebunny/crossref_metadata_2025_split huggingface dataset:
Added Value of MRI Knee Cartigram in Assessment of Anterior Knee Pain in Comparison to Conventional Standard MRI
Authors: Ahmed Aya Yassin , Awadallah Shrouk Mohamed , Ali Mohammed Fawzy Mohammed 
Published: August 2023

Background
Osteoarthritis (OA) is a multi-tissue, multi-factorial disease and worldwide a major cause of disability resulting from reduced joint mobility and function. Progressive loss of hyaline cartilage is one of the hallmark features of osteoarthritis, initiated by a loss of proteoglycans and an increase in water content, followed by a loss of type II collagen and a change in collagen fiber orientation.

Objective
To evaluate the role of T2 mapping in detection of degenerative changes in articular cartilage of knee joint as compared to standard clinical magnetic resonance imaging (MRI) at 1.5T.

Patients and Methods
From April 2020 to November 2020, this prospective Study was done to use T2 mapping to visualize the articular cartilage of the knee on 1.5 T MR Scanner using special software to evaluate the efficiency Of T2 mapping to detect cartilage lesions. The material of this study included 380 patients. The study includes all of them come complaining of knee pain and 2 of them had previous minor knee trauma, each patient had a single MRI exanimation including conventional MRI routine protocol and added a single complementary T2 mapping.

Results
there were significant differences between T2 mapping and conventional MRI sequence in the ability to detect cartilage degeneration as T2 mapping was capable of detecting all lesions that were visible on the clinical MRI. Moreover, T2 mapping showed more cartilage lesions than clinical MRI T2 mapping showed more cartilage lesions than clinical MRI, and in T2 maps the lesions appeared generally wider. This proposes that T2 mapping is feasible in the clinical setting and may reveal cartilage lesions not seen on the standard knee MRI.

Conclusion
Our results suggest that T2 mapping is an interesting MRI sequence for the exploration of patients articular cartilage in and should be included in the routine protocol if cartilage pathology is suspecting as it may improve the diagnostic accuracy of MRI for focal chondral lesions, and should help decide whether and MR-arthrography or CT-arthrography is necessary.
Doppler Ultrasound for Fetal Assessment in High Risk Pregnancies
Authors: Labib Sally Makarios , El Shibiny Aida Mohamed , Keriakos Nermeen Nasry 
Published: August 2023

Background
When it comes to the provision of antenatal care or research, pregnant women tend to be divided into low- and high-risk populations; however, the boundaries between the groups are often blurred. For most researchers, ‘high-risk status’ includes maternal conditions associated with increased perinatal mortality and morbidity such as diabetes, hypertensive disorders (chronic hypertension and pre-eclampsia) and cardiac disorders. The waveform analysis of the feto- maternal circulation by Doppler ultrasound has become a quick and a simple way for the assessment of fetal well-being in high-risk pregnancies. It helps identify fetuses at risk of hypoxia and acidaemia, when the results are applied clinically; they contribute to reduced perinatal mortality rates.

Objectives
The main objective of this study is to evaluate Doppler flow indices as an index for assessing fetal wellbeing in high-risk pregnancies.

Methods
A total of 40 pregnant women with singleton pregnancies at a gestational age ≥3234 weeks were included in this study, 30 of them had a high risk factor were selected as 10 preeclampsia patient, 10 gestational diabetes patient, 10 cardiac patient, the remaining 10 women had no obstetric disorder or any risk factor were selected as control. All pregnant women underwent uniform antenatal assessment protocol that includes an Ultrasound examination and Doppler evaluation of fetoplacental circulation: umbilical artery (UA), middle cerebral artery (MCA) and ductus venosus (DV) Doppler ultrasound studies.

Results
Our findings showed no statistically significant difference in the Doppler indices between gestational diabetes group and control group. There was only a considerable change in DV Doppler waveform in this study that is also insignificant. At preeclampsia group, it was found that there was statistically significant difference regarding UA RI, MCA RI, and MCA RI/UA RI ratio compared to control group. In the cardiac group, fetal Doppler indices were comparable to those of the control group.

Conclusion
The result of the present study suggest that Doppler indices in the third trimester may be useful markers of fetal well-being in high risk pregnancy. Hypertensive disorders with pregnancy can be considered the most important indication for third trimester Doppler examination. Two-vessel examination in these cases seems a good practice.
Role of Contrast Enhanced CT in Assessment of Blunt Abdominal Trauma in Comparison to Ultrasonography
Authors: Hetta Waleed Mohamad Abdelhamid , Kamel Omar Farouk , AL-Jamal Yasmeen Hani Mohamed Ibrahim 
Published: August 2023

Background
Clinical examination fails to accurately diagnose many intraabdominal injuries in blunt abdomen and hence there is a well need for a good imaging technique.US and CT satisfy this to a great extent. With minimum technical limitations and a short time for examination US and CT become extremely useful in guiding the trauma surgeon. CECT is a highly useful imaging modality for diagnosis of blunt abdominal trauma. However US can be used as a useful initial modality. US and CT grading were of not much impact in the management of liver trauma, however extremely useful in the decision making of renal trauma and to a lesser extent in splenic injuries. CT is excellent in picking up clinically unsuspected trauma especially involving liver, kidney and bowel.

Aim of the Work
The aim of this study is to define and compare the role of CE-MDCT and FAST in detection of intraabdominal organs’ injuries and hemoperitoneum. And to highlight the value added by CE- MDCT in hemodynamically stable patients providing an accurate and highly sensitive diagnostic method for blunt abdominal trauma.

Patients and Methods
A prospective study was done in radio diagnosis department in Al Sherouk Police hospitals, and Zagzaig university hospitals-radiology department – ultrasound and CT units. 12 months, from 1/11/2018 to 1/11/2019.

Results
In this study CT detected 18 cases of splenic trauma compared to US which detected only 10 cases. Of the 8 additional cases detected on CT two were of grade IV injury and required surgery. CE-MDCT detected100% of splenic injuries confirmed clinically/surgically thus has been the gold standard method of detecting splenic injuries. CT detected 41 cases of haemoperitoneum which is 91% among all the cases of blunt injury to the abdomen.

Conclusion
CT is a superior diagnositic modality in the diagnosis of abdominal trauma.
Prevelance and Outcome of Liver Function Abnormalities among Egyptian Patients with COVID-19
Authors: Abdelhakam Sara Mahmoud , Hassan Azza Mohammed , Salem Hossam Eldeen Mohamed , Saber Manar Mohamed 
Published: August 2023

Background
In December 2019, a novel corona virus was identified as the pathogen to cause pneumonia in Wuhan, China, which was temporarily named as 2019-nCoV by the World Health Organization, SARS-CoV-2 can be transmitted from person to person through respiratory droplets and close contact, The main manifestations of SARS-CoV-2 infection include fever, dry cough, weakness, and breathing difficulty. Abnormality in liver function tests has been reported; almost one-half of patients experience different degrees of liver test abnormalities, According to a recent study using single-cell RNA sequencing, angiotensin-converting enzyme 2 was highly expressed not only in type II alveolar epithelial cells, but also in bile duct cells. Importantly, recent studies confirmed that angiotensin-converting enzyme 2 receptor is the cell entry receptor of SARS-CoV-2

Objectives
To measure the prevelance of liver function abnormalities among Egyptian patients with COVID -19 and To measure relation between liver function abnormalities and outcome among Egyptian patients with COVID -19.

Patients and Methods
The present study was conducted on 299 patients with covid -19, patients attended to Ain Shams Isolation Hospitals, (retrospective cohort study). Total number of cases during the study period was 299 patients. patients diagnosed with acute hepatitis were excluded from the study, Eventually, 299 patients were enrolled in the study fulfilling the inclusion criteria.

Results
The mean age of our patients is 59.4 years with Male predominance (159 males and 104 females). AST baseline was (55.50%) normal and (5.70%) more than 3 fold, AST after 1 week was (52.5%) normal and (6%) More than 3 fold, AST after 10 days was (54.2%) normal and (6%) More than 3 fold., ALT baseline was (71.2%) normal and (3%) more than 3 fold, ALT after 1 week was (71.9%) normal and (3.3%) More than 3 fold, ALT after 10 days was (74.6%) normal and (3.3%) More than 3 fold.

Conclusion
Elevated liver function is very common in patients with COVID-19 infection and a significant difference was found between liver function abnormalities and outcome .
Polymorphism Detection of VKORC1 (Vitamin K Epoxide Reductase Complex, Subunit 1) Gene for Warfarin Dose Adjustment in Egyptian Patients with Budd Chiari and/or Portal Vein Thrombosis: A Single Center Experience
Authors: Abdellah Heba Mohamed , Sherif Ahmed Fouad Helmy , Abdel-Wahed Marwa Ali , Sayed Mohamed Osama 
Published: August 2023

Background
Budd–Chiari syndrome is a heterogeneous group of disorders characterized by hepatic venous outflow obstruction at the level of the hepatic venules, the large hepatic veins, the inferior vena cava till its junction with the right atrium.
The classic triad of abdominal pain, ascites, and hepatomegaly is observed in the vast majority of patients with Budd-Chiari syndrome, but it is nonspecific.
Warfarin was introduced into clinical practice in the 1950s, and has been the most widely prescribed oral anti-coagulant for prevention and treatment of thrombotic diseases despite its significant side effects as (bleeding tendency, drug drug interaction).
Vitamin K epoxide reductase complex subunit1 (VKORC1), a membrane protein located in hepatocytes, has an important role in the anabolism of vitamin K, which is essential for blood coagulation.

Objectives
The aim beyond this study is to evaluate effect of the allelic frequency of the VKORC1 (G1639A) polymorphic genes by real time PCR on response of Egyptian patients with Budd–Chiari syndrome or PVT to Warfarin.

Patients and Methods
The studied patients were selected from patients presented to Budd chiari study group clinic.tropical medicine department in Ain Shams University hospitals. Within 6 months from july 2020 to December 2020, total number of cases during the study period was 50 cases fulfilling the inclusion criteria

Results
The mean age of the patients was (32.40 ± 9.69) slightly more common in males. The chronic presentation represented 60% of the patients and the acute represented 32%.The most common cause of budd chiarri syndrome was MTHFRD (52%) followed by FVLM (36%) then Primary ant phospholipid antibody syndrome (26%). Patients with the −1639 promoter polymorphism GG genotype had lower dose requirements, whereas the AG/AA genotypes had higher dose.

Conclusion
Identifying these polymorphisms in patients prior to starting the therapy may help clinicians choose the appropriate warfarin dose & decrease its adverse effects.
Stone Density and Skin to Stone Distance in Non-Contrast Computed Tomography as Prognostic Indicators for the Success of Extra Corporeal Shockwave Lithotripsy in Ureteral Stone Disease
Authors: Abdallah Hany Mostafa , Abdelfattah El-Ghobashy Samir El-Sayed , Badawy Mohamed Hussein , El-Moazen Mohamed Ibrahim , ElShafei Ahmed Mahmoud 
Published: August 2023

Background
Ureteral stones are a major health concern with a worldwide rising prevalence. Ureteral stones formed in the kidney and then descending the ureter commonly manifest themselves as renal colic. Extracorporeal shock wave lithotripsy (ESWL) and ureteroscopy are the two primary treatment modalities for the management of symptomatic ureteral calculi,

Aim of the Work
In this study we tried to assess the prognostic value of patient and stone characteristics in potential candidates for ESWL in ureteral stones.

Patients and Methods
We studied the records of 66 patients with upper ureteral calculi who underwent ESWL. We considered patients being stone free (SF) or when &lt; 4 mm fragments were detected. Age, gender, skin to-stone distance, maximum stone length, stone Hounsfield units (HU) were explored in uni- and multivariate regression analysis.

Results
We found that obesity (BMI &gt; 29.3), high stone density (HU) &gt;935, skin to stone distance &gt;10 and presence of ureteral stent were all factors impeding success of treatment. On the other hand, higher shock intensity and number of shocks per session were positive predictors of treatment success.

Conclusion
It was concluded that the evaluation of patient and stone characteristics pre ESWL can predict the success of treatment for ureteric stones and we recommend thorough evaluation of the parameters before treatment to determine the best treatment modality for each patient. To date there seems to be value in using these variables to aid in better selecting patients for ESWL and thus improving the efficacy of ESWL. Our study was limited by the number of centers and participants. A wider range of participants would probably achieve more efficient results. Further studies on a larger scale would be better to further validate these results.
Association between the initial dose urate-lowering drugs and gout flares in adult males with gout
Authors: Li Xiaoli , Shao Qin , Shen Jingfang , Ren Shaohui , Li Lianju , Lu Hua , Chen Shubo 
Published: August 2023

Abstract

Objectives
Frequent gout attacks in the initial introduction of urate-lowering therapy (ULT) are significant causes of poor drug adherence and ULT discontinuation. Initial low-dose urate-lowering drugs may be effective in reducing gout flares, however robust evidence is sparse. The aim of this study was therefore to assess the association of initial dose urate-lowering drugs with gout flares in adult males with gout during the initial introduction of ULT.

Methods
This cohort study obtained data on consecutive gout patients from a single-centre gout cohort study from August 2017 to October 2020. A standard questionnaire was applied to collect demographic and clinical information, and biochemical parameters were tested on the same day. The primary endpoint was to estimate the association of initial dose febuxostat with gout flares, using Cox hazard models with inverse probability of treatment weighting (IPTW).

Results
A total of 582 gout patients were included in this study. During the 6-week follow-up, 71 (12.2%) patients suffered gout flares. In the main analysis using Cox hazard models with IPTW, compared with colchicine prophylaxis, initial low-dose febuxostat alone had no statistical significance with the increased risk of gout flares [hazard ratio (HR) 1.26; 95% CI 0.58, 2.72], while initial high-dose febuxostat was associated with an increased risk of gout flares (HR 3.08; 95% CI 1.34, 7.07).

Conclusions
This observational study demonstrated that initial low-dose febuxostat was equally effective in preventing gout flares as colchicine prophylaxis, while initial high-dose febuxostat alone was associated with an increased risk of gout flares.
Radon level in groundwater in Kwara State, Nigeria, and the potential radiation dose due to intake
Authors: Jimoh Kabir O , Ademola Janet A 
Published: August 2023

Abstract

Radon in groundwater for domestic purposes contributes to indoor radon and at high concentration levels could be hazardous to inhabitants. Rn-222 concentrations in 101 groundwater samples from some Local Government Areas (LGAs) of Kwara State, Nigeria, were determined by AlphaGUARD portable radon monitor. The mean activity concentrations for the LGAs varied from 4.28 ± 2.29 to 14.59 ± 8.92 Bq.l−1. Radon concentrations were &lt;100 Bq.l−1 guidance level recommended by CEC and WHO. Eighteen percent exceeded the recommended 11.1 Bq.l−1 by the United States Environmental Protection Agency. All the samples exceeded the 0.1 Bq.l−1 Maximum Permitted Level of the Standard Organization of Nigeria for radionuclide contaminant. Mean effective dose from ingestion was estimated for adults, children and infants. Inhalation dose was also estimated. The mean annual effective doses in five LGAs were higher than the 0.1 mSv reference dose level of committed effective dose from the intake of drinking water for 1 y as recommended by the ICRP.

Highlights
Comparison of sensitivity characteristics between GAFCHROMIC LD-V1 and GAFCHROMIC XR-QA2 in mammographic dosimetry
Authors: Gotanda Tatsuhiro , Kawaji Yasuyuki , Yatake Hidetoshi , Imai Shinya , Akagawa Takuya , Gotanda Rumi , Katsuda Toshizo 
Published: August 2023

Abstract
In recent years, radiochromic films have begun to be used for dosimetry in mammography; however, the most sensitive GAFCHROMIC XR-QA2 (XR-QA2) film is no longer available owing to its discontinuation. In this study, we evaluated the sensitivity characteristics of GAFCHROMIC LD-V1 (LD-V1) as an alternative to XR-QA2 in the field of mammography, at a low dose and low energy. Our results show that the average ratio of the concentration change of LD-V1 divided by the concentration change of XR-QA2 at each absorbed dose was 53.7%, indicating the sensitivity of LD-V1 to be approximately half of XR-QA2. In addition, the linearity of the concentration change is sufficient even within a dose range of 0.59–14.52 mGy, which is lower than the manufacturer's recommended dose range. Therefore, the LD-V1 is capable of accurate dose assessment even with a low dose and the low level of energy used in mammography.
Perioperative Team-Based Morbidity and Mortality Conferences: A Systematic Review of the Literature
Authors: Samost-Williams Aubrey , Rosen Roni , Hannenberg Alexander , Lydston Melis , Nash Garrett M. , Brindle Mary 
Published: August 2023

Objective:
This systematic review aimed to identify key elements of perioperative team-based morbidity and mortality conferences (TBMMs) and their impact on patient safety, education, and quality improvement outcomes.

Background:
Patient safety in the perioperative period is influenced by system, team, and individual behaviors. However, despite this recognition, single-discipline morbidity and mortality conferences remain a mainstay of educational and quality improvement efforts.

Methods:
A structured search was conducted in MEDLINE Complete, Embase, Web of Science, ClinicalTrials.gov, Cochrane CENTRAL, and ProQuest Dissertations and Theses Global in July 2022. Search results were screened, and the articles meeting inclusion criteria were abstracted.

Results:
Seven studies were identified. Key TBMM elements were identified, including activities done before the conference—case selection and case investigation; during the conference—standardized presentation formats and formal moderators; and after the conference—follow-up emails and quality improvement projects. The impacts of TBMMs on educational, safety, and quality improvement outcomes were heterogeneous, and no meta-analysis could be conducted; however, improvement was typically shown in each of these domains where comparisons were made.

Conclusions:
Recommendations for key TBMM elements can be drawn from the reports of successful perioperative TBMMs. Possible benefits of structured TBMMs over single-discipline conferences were identified for further exploration, including opportunities for rich educational contributions for trainees, improved patient safety, and the potential for system-wide quality improvement. Design and implementation of TBMM should address meticulous preparation of cases, standardized presentation format, and effective facilitation to increase the likelihood of realizing the potential benefits.
Completion Total Mesorectal Excision: A Case-Matched Comparison With Primary Resection
Authors: Burghgraef Thijs A. , Rutgers Marieke L. , Leijtens Jeroen W. A. , Tuyman Jurriaan B. , Consten Esther C. J. , Hompes Roel ,   on behalf of the MIRECA working group.
Published: August 2023

Objectives:
The aim of this study was to compare the perioperative and oncological results of completion total mesorectal excision (cTME) versus primary total mesorectal excision (pTME).

Background:
Early-stage rectal cancer can be treated by local excision alone, which is associated with less surgical morbidity and improved functional outcomes compared with radical surgery. When high-risk histological features are present, cTME is indicated, with possible worse clinical and oncological outcomes compared to pTME.

Methods:
This retrospective cohort study included all patients that underwent TME surgery for rectal cancer performed in 11 centers in the Netherlands between 2015 and 2017. After case-matching, we compared cTME with pTME. The primary outcome was major postoperative morbidity. Secondary outcomes included the rate of restorative procedures and 3-year oncological outcomes.

Results:
In total 1069 patients were included, of which 35 underwent cTME. After matching (1:2 ratio), 29 cTME and 58 pTME were analyzed. No differences were found for major morbidity (27.6% vs 19.0%; P = 0.28) and abdominoperineal excision rate (31.0% vs 32.8%; P = 0.85) between cTME and pTME, respectively. Local recurrence (3.4% vs 8.6%; P = 0.43), systemic recurrence (3.4% vs 12.1%; P = 0.25), overall survival (93.1% vs 94.8%; P = 0.71), and disease-free survival (89.7% vs 81.0%; P = 0.43) were comparable between cTME and pTME.

Conclusions:
cTME is not associated with higher major morbidity, whereas the abdominoperineal excision rate and 3-year oncological outcomes are similar compared to pTME. Local excision as a diagnostic tool followed by completion surgery for early rectal cancer does not compromise outcomes and should still be considered as the treatment of early-stage rectal cancer.