bluuebunny/crossref_metadata_2025_split huggingface dataset:
The contribution of endothelial cells to tissue fibrosis
Authors: Romano Eloisa , Rosa Irene , Fioretto Bianca Saveria , Manetti Mirko 
Published: August 2023

Purpose of reviewTissue fibrosis is an increasingly prevalent condition associated with various diseases and heavily impacting on global morbidity and mortality rates. Growing evidence indicates that common cellular and molecular mechanisms may drive fibrosis of diverse cause and affecting different organs. The scope of this review is to highlight recent findings in support for an important role of vascular endothelial cells in the pathogenesis of fibrosis, with a special focus on systemic sclerosis as a prototypic multisystem fibrotic disorder.Recent findingsAlthough transition of fibroblasts to chronically activated myofibroblasts is widely considered the central profibrotic switch, the endothelial cell involvement in development and progression of fibrosis has been increasingly recognized over the last few years. Endothelial cells can contribute to the fibrotic process either directly by acting as source of myofibroblasts through endothelial-to-myofibroblast transition (EndMT) and concomitant microvascular rarefaction, or indirectly by becoming senescent and/or secreting a variety of profibrotic and proinflammatory mediators with consequent fibroblast activation and recruitment of inflammatory/immune cells that further promote fibrosis.SummaryAn in-depth understanding of the mechanisms underlying EndMT or the acquisition of a profibrotic secretory phenotype by endothelial cells will provide the rationale for novel endothelial cell reprogramming-based therapeutic approaches to prevent and/or treat fibrosis.
Unilateral Biportal Endoscopic Posterior Cervical Foraminotomy
Authors: Zhong Zhuolin , Hu Qingfeng , Huang Leyi , Zhang Shaohua , Zhou Menghui 
Published: August 2023

Study Design:
Retrospective control study.

Objective:
To compare the curative effects of unilateral biportal endoscopic posterior cervical foraminotomy (UBE-PCF) with full-endoscopic posterior cervical foraminotomy (FPCF).

Summary of Background Data:
There are few studies directly comparing outcomes between UBE-PCF and FPCF. The objective of this study was to compare outcomes between UBE-PCF and FPCF.

Methods:
A retrospective control study was conducted for 69 patients of cervical radiculopathy from July 2019 to December 2021. Clinical outcomes scores, including neck disability index, visual analog scale (VAS)-arm, and VAS-neck were evaluated. Serum creatine kinase levels and the size of the operating hole were measured.

Results:
Postoperative neck disability index, VAS-neck, and VAS-arm scores showed statistically significant improvement over preoperative scores (P<0.01). The operating time was significantly shorter in the UBE-PCF group (P<0.001). No significant differences were found in serum creatine kinase levels between the 2 groups (P>0.05). The mean area of the operating hole was 1.47+0.05 cm2 in the FPCF group and 1.79+0.11 cm2 in the UBE-PCF group. The difference was statistically significant (P<0.001).

Conclusions:
Both UBE-PCF and FPCF are safe and effective procedures for cervical radiculopathy. Predictable and sufficient decompression could be achieved by UBE-PCF in a shorter operation time.

Level of Evidence:
Treatment Benefits Level III.
Determining the Effect of Intraoperative TXA on Postoperative Blood Loss in ACDF
Authors: Steinle Anthony M. , Fogel Jessa D. , Chen Jeffrey W. , Chanbour Hani , Vaughan Wilson E. , Karwandyar Ayub , Croft Andrew J. , McDonough Judy , Chandler Philip J. , Gardocki Raymond , Zuckerman Scott L. , Abtahi Amir M. , Stephens Byron F. 
Published: August 2023

Study Design:
Retrospective cohort study using prospectively collected data.

Objective:
To determine the effectiveness of intraoperative tranexamic acid (TXA) in anterior cervical discectomy and fusion (ACDF) on postoperative blood loss.

Summary of Background Data:
TXA has been proven to be a safe and effective agent in reducing blood loss after cervical surgery; however, its efficacy when used intraoperatively for ACDF surgeries had yet to be researched. Currently, there are few studies examining the effects of intraoperative TXA in cervical spinal fusion, and none specifically examining TXA use in ACDF.

Methods:
A tertiary medical center’s prospectively collected spine registry was queried between 1/1/18 and 12/1/21 for all patients who underwent elective ACDF surgery and received a drain postoperatively. Patients were separated into 2 groups; those who had received intraoperative TXA and those who did not. Baseline demographic and operative variables were collected from the registry. The primary outcome was postoperative blood loss over a 24-hour period. Secondary outcomes included total drain output, intraoperative estimated blood loss, operative duration, drain duration, changes in preoperative to postoperative hemoglobin and hematocrit levels, and rate of transfusions, complications, revisions, and reoperations. Univariate and multivariate regression analyses were performed.

Results:
Two hundred eighty-six patients were included. One hundred ninety patients underwent ACDF and did not receive intraoperative TXA, whereas 96 patients underwent ACDF and did receive TXA. There were no differences in any demographic or baseline variables. Multivariate analysis showed intraoperative TXA was associated with shorter drain duration (β=−5.74, 95% CI: −10.9 to −0.53, P=0.031) and reduction in 24-hour drain output (β=−12.2, 95% CI: −19.4 to −4.89, P=0.001) and total drain output (β=−14.0, 95% CI: −22.9 to −5.05, P=0.002).

Conclusions:
TXA use during ACDF procedures leads to a decrease in perioperative blood loss and faster drain removal. TXA is an effective and safe agent for reducing perioperative blood loss in ACDF surgery.

Level of Evidence:
III
Postpartum maternal tachycardia – diagnostic pitfalls!
Authors: Mathur Charlotte , Tohani Arun , Patil Vinod , Khan Ayub , Otigbah Chineze 
Published: August 2023

Purpose of review
Maternal tachycardia is a common sign with a multitude of causes. We attempt to look at the most common sinister ones in the postpartum period.

Recent findings
Current guidelines differ in the definition of maternal tachycardia. It has been associated with adverse outcomes such as increased length of stay as well as higher mortality if there is underlying peripartum cardiomyopathy. Some recent studies look at common investigations and how these apply to peripartum women, such as ECG markers of arrhythmogenesis, reference ranges for PCT and echocardiogram findings during pregnancy prior to diagnosis of peripartum cardiomyopathy.

Summary
Physiological changes make it difficult to interpret maternal tachycardia and thus how best to manage it. We propose the idea of a three-step approach for the assessment of patients, aiming to identify causes including tachyarrhythmias, obstetric haemorrhage, sepsis, venous thromboembolism and peripartum cardiomyopathy.
The first step ‘BEDSIDE’ applies to all patients looking at observations, history and examination. The second step ‘BASIC’, applies to most patients and covers ECG and basic blood tests. The final step ‘EXTRA’ assesses the need for further investigations including additional blood tests and imaging. By using this model, clinicians and healthcare professionals should be able to rationalise the need for more invasive investigations whilst maintain good high-quality care.
Update on gestational diabetes and adverse pregnancy outcomes
Authors: Ugwudike Bryan , Kwok ManHo 
Published: August 2023

Purpose of review
To explore the recent literature concerning the effect of gestational diabetes (GDM) on adverse pregnancy outcomes (APO).

Recent findings
Literature search on PubMed, Medline and British Journal of Obstetrics and Gynaecology was conducted using keywords. Search fields were filtered down to include articles from 2019 onwards. GDM is common during pregnancy and is on the rise because of increasing in obesity rates. GDM tended to show an increased risk of APO compared with non-GDM. Treatment of these pregnancies tended to improve these outcomes, particularly for LGA and macrosomia. Additional factors such as prepregnancy BMI and gestational weight gain (GWG) were shown to influence risk. More studies are needed to determine the true effect on postpartum haemorrhage (PPH) and induction of labour (IOL).

Summary
The review agrees with the findings from previous studies and adds to the current literature. Early intervention to manage glycaemic control and GWG may help improve these outcomes. Public health strategies that tackle obesity rates will help to reduce prepregnancy BMI and, therefore, rates of GDM.
Oral gonadotrophin-releasing hormone (GnRH) antagonists: the continuing search for the ideal nonsurgical therapy of uterine fibroids with a cautionary tale
Authors: Sim-Ifere Ogagaoghene , Aref-Adib Mehrnoosh , Odejinmi Funlayo 
Published: August 2023

Purpose of review
Uterine fibroids are very common with a prevalence of over 70%. They present a significant economic and psychological burden. A variety of nonsurgical treatments exist for its management encompassing hormonal and nonhormonal methods. Gonadotrophin-releasing hormone (GnRH) antagonists are a novel treatment for uterine fibroids. They cause a rapid reduction in endogenous GnRH, leading to a dose-dependent reduction in levels of oestradiol and progesterone, thus reduction in bleeding. The addition of hormones, estrogen, and progesterone, known as add-back therapy, helps curb the menopausal side effects. As such, they pose a potential long-term nonsurgical therapy for management of symptomatic fibroids.

Recent findings
There are various uses of GnRH antagonists and the results from the clinical trials are promising. Caution needs to be taken when new treatment options are introduced with audit and data collection tools in place to assess effectiveness as well as any side effects.

Summary
This article highlights the uses of GnRH antagonists in practice and reflects on previous novel treatments for fibroids with a focus on Ulipristal acetate. It states the importance of using audit tools and multiinstitutional databases to prevent and allow early discovery of issues such as those that encumbered Ulipristal.
A comparative analysis of ambulatory blood pressure characteristics in acute stroke and non-stroke Indian patients
Authors: Hegde Subhaschandra B. , Aroor Shivaramakrishna , Anupama Yedabettu Janardana , Hegde Shrikanth N. , Prajapati Hiren , Verberk Willem J. 
Published: August 2023

Objective:
The objective of this study is to identify 24-h blood pressure (BP) characteristics after acute stroke in Indian hospitalized patients.

Methods:
In total, 769 patients [284 women (36.9%)] admitted at a hospital in South India were analyzed. Of these, 364 patients (47.3%) had recently experienced stroke. All patients underwent ambulatory blood pressure measurement (ABPM) so that ABPM patterns and ABPM risk parameters of stroke and non-stroke patients could be compared. Additionally, to investigate the relationship between ABPM parameters and stroke, a stepwise logistic regression analysis was employed.

Results:
Stroke patients had significantly higher BP than non-stroke patients (24-h ABP: 145.0 ± 22.1 vs. 133.7 ± 20.5 mmHg, P < 0.001), with similar dipping status. ABPM parameters mostly associated with stroke (all P < 0.001) were: nighttime [odds ratios (OR): 1.587, 95% confidence interval (95% CI): 1.341–1.885], 24-h (1.584, 1.34–1.881), minimum nighttime (1.582, 1.339–1.879), daytime (1.540, 1.304–1.827), and morning SBP (1.517, 1.287–1.797). Non-dipping status was relatively more common in stroke patients (79% vs. 71%, P < 0.05) but dipping percentage did not show a significant linear relationship with stroke.

Conclusion:
Several ABPM characteristics were strongly associated with stroke in Indian hospitalized patients. Specifically, minimum nighttime and average morning SBP may be considered as important and practical parameters for its relationship with stroke.
Defining optimal blood pressure control for pre-transplant end-stage renal disease patients: scoping review
Authors: Nishimura Yoshito , Khan Mohammad , Lee Benjamin , Arayangkool Chinnawat , Zhang James , Palanisamy Amudha , Banerjee Dipanjan , Izutsu Christie 
Published: August 2023

Background
Strict blood pressure control is essential to prevent cardiovascular disease and is associated with decreased mortality. However, in patients with end-stage renal disease awaiting renal transplantation, the level of optimal blood pressure control is not yet defined.

Methods
Following the PRISMA Extension for Scoping Reviews, we searched MEDLINE and EMBASE for all peer-reviewed articles using keywords including ‘end-stage renal disease’, ‘blood pressure’, and ‘pre-transplant’ from their inception to 7 August 2022.

Results
Seven observational studies, including one population-based study, were included in the review. Most studies investigated factors associated with post-transplant graft failure or mortality. There was considerable heterogeneity in defining optimal pre-transplant blood pressure measurement frequency among studies (average of three measurements vs. single measurement). One study suggested that low pre-transplant diastolic blood pressure (<50 mmHg) was associated with lower odds of delayed graft failure and mortality. Two studies noted that pre-transplant hypertension, or clinical criteria of hypertension that were present prior to transplant, was associated with post-transplant adverse outcomes. In contrast, one study noted that pre-transplant sustained hypotension with mean blood pressure <80 mmHg, was associated with a higher frequency of delayed graft failure.

Conclusion
This systematic review summarizes the current evidence regarding the relationship between pre-transplant blood pressure control and post-transplant outcomes in end-stage renal disease patients. While the results from the included studies are mixed, more stringent blood pressure control than currently practiced may be beneficial to decrease graft failure and mortality in this patient population.
Rural-Urban Differences in Health Care Unaffordability During the Postpartum Period
Authors: MacDougall Hannah , Hanson Stephanie , Interrante Julia D. , Eliason Erica 
Published: August 2023

Objective:
The objective of this study was to examine health care unaffordability for rural and urban residents and by postpartum status.

Methods:
We used cross-sectional survey data on female-identifying respondents ages 18–44 (n=17,800) from the 2019 to 2021 National Health Interview Study. Outcomes of interest were 3 measures of health care unaffordability. We conducted bivariate and multivariable regression models to assess the association between health care unaffordability, rurality, and postpartum status.

Results:
Bivariate analyses showed postpartum people reported statistically significantly higher rates of being unable to pay medical bills and having problems medical paying bills, as compared with nonpostpartum people. Rural residents also reported statistically significantly higher rates of being unable to pay their medical bills and having problems paying medical bills as compared with urban residents. In adjusted models, the predicted probability of being unable to pay medical bills among postpartum respondents was 12.8% (CI, 10.1–15.5), which was statistically significantly higher than among nonpostpartum respondents. Similarly, postpartum respondents had statistically significantly higher predicted probabilities of reporting problems paying medical bills (18.4%, CI, 15.4–21.4) as compared with nonpostpartum respondents. The rural residency was not significantly associated with the health care unaffordability outcome measures in adjusted models.

Conclusions:
Both postpartum and rural respondents reported higher rates of being unable to pay medical bills and having problems paying medical bills; however, after adjusting for covariates, only postpartum respondents reported statistically significantly higher rates of these outcomes. These results suggest that postpartum status may present challenges to health care affordability that span the urban/rural context.
Established and potential cardiovascular risk factors in metabolic syndrome: Effect of bariatric surgery
Authors: Bashir Bilal , Adam Safwaan , Ho Jan H. , Linn Zara , Durrington Paul N. , Soran Handrean 
Published: August 2023

Purpose of review
The aim of this review was to provide an overview of the role of novel biomarkers in metabolic syndrome, their association with cardiovascular risk and the impact of bariatric surgery on these biomarkers.

Recent findings
Metabolic syndrome encompasses an intricate network of health problems, and its constituents extend beyond the components of its operational definition. Obesity-related dyslipidaemia not only leads to quantitative changes in lipoprotein concentration but also alteration in qualitative composition of various lipoprotein subfractions, including HDL particles, rendering them proatherogenic. This is compounded by the concurrent existence of obstructive sleep apnoea (OSA) and nonalcoholic fatty liver disease (NAFLD), which pave the common pathway to inflammation and oxidative stress culminating in heightened atherosclerotic cardiovascular disease (ASCVD) risk. Bariatric surgery is an exceptional modality to reverse both conventional and less recognised aspects of metabolic syndrome. It reduces the burden of atherosclerosis by ameliorating the impact of obesity and its related complications (OSA, NAFLD) on quantitative and qualitative composition of lipoproteins, ultimately improving endothelial function and cardiovascular morbidity and mortality.

Summary
Several novel biomarkers, which are not traditionally considered as components of metabolic syndrome play a crucial role in determining ASCVD risk in metabolic syndrome. Due to their independent association with ASCVD, it is imperative that these are addressed. Bariatric surgery is a widely recognized intervention to improve the conventional risk factors associated with metabolic syndrome; however, it also serves as an effective treatment to optimize novel biomarkers.
Management of the sensitized heart transplant candidate
Authors: Kittleson Michelle M. 
Published: August 2023

Purpose of review
For sensitized heart transplant candidates who have antibodies to human leukocyte antigens (HLA), finding a suitable donor can be challenging and can lead to adverse waitlist outcomes. In recent years, the number of sensitized patients awaiting heart transplantation has increased likely due to the use of durable and mechanical circulatory support as well as increasing number of candidates with underlying congenital heart disease.

Recent findings
Advances in the assessment of HLA antibodies allow for identification of heart transplant candidates who may benefit from desensitization strategies to widen the donor pool and mitigate the risk of adverse posttransplant outcomes.

Summary
Antibody sensitization is a barrier to successful heart transplantation and strategies to identify sensitized patients, stratify their risk, and mitigate this risk through desensitization is crucial to optimize the quality of life and survival of HT recipients.
Association of aortic dissection and lipoprotein (a): a meta-analysis
Authors: Motawea Karam R. , Elhalag Rowan H. , Rouzan Samah S. , Talat Nesreen E. , Reyad Sarraa M. , Chébl Pensée , Mohamed Mai S. , Shah Jaffer 
Published: August 2023

Background and Aim:
Some studies reported a positive relation between aortic dissection (AD) and increased lipoprotein (a) (LP(a)), while other studies reported no association, so the authors aimed to do a meta-analysis to establish the relation between AD and high levels of LP(a).

Methods:
PubMed, Scopus, Web of Science, SAGE, EMBASE, Science Direct, and Cochrane Library were searched. The inclusion criteria were any randomized control trials or observational studies that measured the levels of LP(a) in AD patients and healthy controls. The authors excluded case reports, case series, noncontrolled studies, reviews, editorials, and animal studies.

Results:
After a search of the literature, four studies were included in the meta-analysis with 678 patients included in the analysis. The pooled analysis showed a statistically significant association between the AD group and increased levels of LP(a), decreased levels of TG, low-density lipoprotein cholesterol, and TC compared with the control group (MD=11.71, 95% CI=4.11–19.32, P-value=0.003), (MD=−0,32, 95% CI=−0.48 to −0.16, P-value<0.0001 ), (MD=−0,21, 95% CI=−0.42 to −0.1, P-value=0.04), (MD=−0,58, 95% CI=−0.62 to −0.54, P-value<0.00001), respectively.

Conclusion:
Our study showed that AD is significantly associated with increased levels of LP(a). The significant increase in LP(a) in AD was associated with decreased levels of TG, low-density lipoprotein cholesterol, and TC. Future clinical trials testing Lp (a) targeting medications could be useful in the primary, or secondary prevention of AD in high risk patients.
Prevalence of hypercholesterolaemia in outpatient children aged 9–11 years
Authors: Ibrahim Nour , Chreitah Ahmad , Zreik Youssef 
Published: August 2023

Background:
Hypercholesterolaemia is a silent disease that is considered to be one of the main risk factors for cardiovascular disease, often beginning in childhood, and early diagnosis and management may reduce the risk of developing atherosclerosis and early cardiovascular disease in early adulthood.

Objectives:
The purpose of this study was to evaluate the importance of universal screening for dyslipidemia in children aged 9–11 years.

Methods:
An observational, descriptive, cross-sectional study was conducted from July 2021 to June 2022. A total of 532 children (279 girls and 253 boys) aged 9–11 years were enroled, and non-fasting blood samples were obtained to measure total cholesterol (TC) levels in the blood.

Results:
The mean serum TC was 136.4±28.1 mg/dl. Thirty-two children (6%) of the screened participants had abnormal TC levels; those were tested subsequently by fasting serum TC, and 19 children were confirmed as dyslipidemic (3.5%). The prevalence of borderline blood cholesterol levels (TC between 170 and 199 mg/dl) was 2.6% CI 95% (2.2–3.2), and the prevalence of hypercholesterolaemia (TC ≥200 mg/dl) was 0.9% CI 95% (0.5–1.4). A positive correlation was found between body mass index and blood cholesterol level. (r = 0.55, P =0.002).

Conclusions:
Universal non-fasting TC screening in children aged 9–11 years old is effective in detecting hypercholesterolaemia. Since the authors found that the positive family history as the sole basis for selective examination in children is insufficient.
Immunoglobulin A nephropathy in remission: a case report
Authors: Mahat Asim , Lageju Nimesh , Neupane Durga , Mishra Upama , Koirala Sefali 
Published: August 2023

Introduction:
Immunoglobulin A nephropathy is the most prevalent form of primary glomerulonephritis.

Case presentation:
A 33-year-old military male presented with complaints of fever, headache, myalgia, chills, and haematuria for 10 years. His lab results showed elevated serum creatinine levels and proteinuria. A renal biopsy was done which was consistent with a diagnosis of immunoglobulin A nephropathy. He was managed with antihypertensive, including angiotensin-converting enzyme inhibitors, steroids and immunosuppressants, and Omega-3 fatty acids. There was remission of the symptoms and the patient’s serum creatinine and sonogram findings returned to baseline.

Conclusion:
Routine follow-up along with the appropriate use of medications can limit disease complications and progression.