bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cost of illness of patients with small fiber neuropathy in the Netherlands
Authors: Geerts Margot , Hoeijmakers Janneke G.J. , van Eijk-Hustings Yvonne , Brandts Lloyd , Gorissen-Brouwers Carla M.L. , Merkies Ingemar S.J. , Joore Manuela A. , Faber Catharina G. 
Published: August 2023

Abstract
Neuropathic pain is associated with substantial healthcare costs. However, cost-of-illness studies of small fiber neuropathy (SFN) are scarce. Our aim was to estimate the healthcare, patient and family, and productivity costs of patients with SFN in the Netherlands from a healthcare and societal perspective. In addition, the association of costs with age, pain impact on daily life, anxiety, depression, and quality of life (Qol) were examined. Cost questionnaires were completed by 156 patients with confirmed SFN. The average annual total health care and societal cost (€, 2020) was calculated at patient, SFN adult population, and societal level. The average annual healthcare, patient and family, and productivity costs per patient with a Pain Impact Numerical Rating Scale of 0 to 3 (mild), 4 to 6 (moderate), and 7 to 10 (severe) were calculated by using the cost questionnaire data. Quality of life was determined by the EuroQol 5D utility scores. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale. Associations of all costs were analyzed using linear regression analyses. At the patient level, the average annual SFN healthcare and societal cost of SFN was €3614 (95% confidence interval [CI] €3171-€4072) and €17,871 (95% CI €14,395-€21,480). At the SFN population level, the average healthcare costs were €29.8 (CI €26.4-€34.2) million, and on a societal level, these were €147.7 (CI 120.5-176.3) million. Severe pain was associated with significant lower Qol and higher depression scores, higher healthcare, patient and family, and productivity costs (P < 0.001).
Long-term multimodality imaging follow-up of ST-segment elevation myocardial infarction patients treated with bioresorbable vascular scaffold: advantages and challenges
Authors: Eriksen Erlend , Neghabat Omeed , Larsen Terje H. , Saeed Sahrai , Bleie Øyvind 
Published: August 2023

Background:
Multislice computed tomography (MSCT) offers a non-invasive method of imaging bioresorbable scaffolds (BRS).

Objectives:
To investigate the advantages and challenges using MSCT in the follow-up after BRS implantation.

Method:
The BRS cohort consisting of 31 patients in the ‘BRS in STEMI’ trial was examined by multimodality imaging and followed long-term. Minimum lumen area (MLA) and average lumen area (ALA) were examined 12 and 36 months after BRS implantation with MSCT. Optical coherence tomography (OCT) at 12 months was used as a reference.

Results:
Measured by MSCT, the mean MLA was 0.05 ± 1.32 mm² (P = 0.85), but ALA was 1.32 (±2.59 mm², P = 0.015) greater than by OCT. ALA and MLA did not change significantly from 12 to 36 months. MSCT identified all cases of restenosis but missed one patient with massive malapposition.

Conclusion:
Our data support using MSCT in the follow-up after BRS implantation. Invasive investigation should still be considered for patients with unexplained symptoms.
The cardiac preparticipation sports evaluation
Authors: Donovan Denis J. , Nelson Joanna E. , Monaco Michael A. 
Published: August 2023

Purpose of review
Sudden cardiac death (SCD) is the leading cause of death in young athletes during sports participation. Preparticipation cardiovascular screening aims to identify those at an increased risk of SCD. This review aims to provide a background of SCD in young athletes, to discuss the various screening recommendations of major medical societies, and to review recent evidence and current practice.

Recent findings
Numerous studies have evaluated various preparticipation screening practices, particularly regarding the inclusion of ECG as part of an initial evaluation to identify conditions with an increased risk of SCD. Some analyses have shown ECG inclusion to provide increased screening sensitivity and specificity, though others have shown no benefit when compared with evaluation with history and physical examination alone. Furthermore, in countries for which more extensive screening protocols have been employed, postimplementation statistics have not shown a significant decrease in SCD.

Summary
SCD in young athletes primarily results from underlying cardiac disease. Various preparticipation screening recommendations exist globally, with the common goal of decreasing the rates of SCD by identifying youth at risk during sports participation. Current guidelines in the United States support universal preparticipation evaluation using history and physical examination, with cardiology referral if abnormalities are identified.
Association between hypertension and clinical outcomes in COVID-19 patients: a case-controlled study
Authors: Aslanbeigi Fatemeh , Rahimi Habiballah , Malekipour Adeleh , Pahlevani Hamed , Najafizadeh Maedeh , Ehteram Hassan , Izadpanah Fatemeh , Haddad Kashani Hamed 
Published: August 2023

Background:
The outbreak of coronavirus disease 2019 (COVID-19), which was originated from a severe acute respiratory syndrome-coronavirus-2 (SARS-COV-2) infection, has become an international public health emergency. The aim of this study was to assess the clinical symptoms and physical findings in both hypertensive and nonhypertensive patients infected with COVID-19.

Methods:
A retrospective observational case–control study with diagnosis of COVID-19 by laboratory-confirmed test was conducted on 280 consecutive unselected patients. This was a single-center study. The demographics, laboratory, and clinical findings data were extracted from the hospital registry database.

Results:
Of our 280 patients in the study, there were 149 men (53%) and 138 (50%) were older than 60 years (mean=67.75), and also 50 in-hospital deaths occurred (mortality rate, 17%). Total 19(6.9%) were taking opioid, and smoking. There were no significant differences in the rate of fever, cough, sputum production, gastrointestinal symptoms, myalgia, and headache in the both hypertensive and nonhypertensive groups. The prevalence of underlying diseases was significantly higher in older patients in comparison with younger ones (P=0<0.05), COVID-19 mortality was noticed to be higher among hypertensive patients as compared with nonhypertensive patients (P=0<0.05).

Conclusion:
Hypertension is associated with a poor prognosis and higher mortality among COVID-19 patients. Optimizing blood pressure is essential during the management of COVID-19. Our research implies the importance of early care and education of old patient with hypertension and other comorbidities.
Difference of cardiac rehabilitation in the morning or evening on indexes of left ventricular and N-terminal pro-brain natriuretic peptide: a randomized controlled trial
Authors: Dehghani Mostafa , Cheragi Mostafa , Delfan Bahram , Dehghani Morteza , Shakarami Amir , Bagheri Yagoob , Namdari Parsa , Namdari Mehrdad 
Published: August 2023

Background:
The present study aimed to evaluate the effects a cardiac rehabilitation program (CRP) performed in the morning or evening on left ventricular (LV) filling indices and the level of N-terminal fragment of pro-brain natriuretic peptide (NT-proBNP) in patients undergoing percutaneous coronary angioplasty during the COVID-19 pandemic.

Methods:
This was a randomized controlled single-blinded clinical trial. Ninety-six patients (mean age: 50.2 ± 8.1 years, 36 women and 44 men) with percutaneous coronary angioplasty were divided into two groups of intervention and control. In each group, the CRP was performed in either morning or evening. The CRP included walking and performing push-ups and sit-ups for 8 weeks. The participants of the control groups received routine care. The functional indices of LV, including LV ejection fraction, systolic function, and diastolic function (i.e. the transmitral flow), the E/e’ to left atrium peak strain ratio (as an estimation for LA stiffness), and NT-proBNP level were measured in all participants before starting and at the end of the CRP.

Results:
In the intervention group, the individuals performing the CRP in the evening had significantly higher E-wave (0.76±0.02 vs. 0.75±0.03; P=0.008), ejection fraction (52.5±5.64 vs. 55.5±3.59; P=0.011), and diastolic function velocity (E/A ratio, 1.03±0.06 vs. 1.05±0.03; P=0.014) and significantly lower A-wave (0.72±0.02 vs. 0.71±0.01; P=0.041), E/e’ ratio (6.74±0.29 vs. 6.51±0.38; P=0.038), and NT-proBNP level (2007.9±214.24 vs. 1933.9±253.13; P=0.045) compared with those performing the program in the morning.

Conclusions:
A supervised CRP performed in the evening compared with morning was more effective in improving LV functional indices. Therefore, such home-based interventions are recommended to be performed in the evening during the COVID-19 pandemic.
Laparoscopic training on virtual-reality simulators or live pigs—a randomized controlled trial
Authors: Bian Zhengqian , Zhang Yan , Ye Guangyao , Guo Feng , Mu Yifei , Fan Yinghui , Zhou Xiang , Zheng Qing , Konge Lars , Wang Zheng 
Published: August 2023

Background:
This randomized controlled trial compared the efficacy of virtual-reality (VR) simulator training and surgical training on live pigs to explore the most effective and evidence-based training modality.

Materials and methods:
Thirty-six novice surgical residents without independent laparoscopic experience were randomly paired with a peer and randomized into three groups: VR simulator group (dyad training on LapSim VR simulators), pig surgery group (training on live, anesthetized pigs) and control group (training by a lecture on laparoscopic surgery, surgical videos and textbooks). After 6 h of training, all participants performed a simulated cholecystectomy procedure using a pig liver with adherent gallbladder working in pairs. All procedures were video-recorded and the recordings were saved on USB-sticks in a blinded fashion identifiable only by the unique participant number. All video-recordings were scored blindly and independently by two expert raters using the Global Operative Assessment of Laparoscopic Skills (GOALS) assessment instrument.

Results:
The performances in the three groups were significantly different, P less than 0.001. Both the VR simulation training group and the live pigs training group performed significantly better than the control group, both P values less than 0.001. However, there was no significant difference in the performance of the two simulation-based training groups, P=0.66.

Conclusion:
Novice surgical trainees can benefit from both VR simulator training and pig surgery simulation compared with traditional studying and there was no significant difference between the two modalities. The authors recommend that VR simulators should be used for basic training of laparoscopic skills and surgery on live animals should be reserved for higher-level surgical training.
Clinical characteristics and management outcomes of Guillain-Barré syndrome: eight-year experience at a tertiary center in jordan – a retrospective cohort study
Authors: Al-Hayk Kefah , Aqaileh Suha , Smadi Mahmoud M. , Yassin Ahmed , Aldabbour Belal , Al Qawasmeh Majdi , Kofahi Raid , Elamassie Samah , El-Salem Khalid 
Published: August 2023

Background:
Guillain-Barré syndrome (GBS) is a major cause of acute flaccid paralysis that is encountered in all geographical areas. Very limited data about this syndrome has been reported from the Arab countries. This study is the first one trying to describe the clinical features and management outcomes of GBS in the Jordanian population.

Methods:
This retrospective study looks at adult patients admitted to a major tertiary referral hospital in the north of Jordan between 2013 and 2021.

Results:
A total of 30 patients met the inclusion/exclusion criteria. Males were predominantly affected (70%) with a male-to-female ratio of 2.33. Acute inflammatory demyelinating polyradiculoneuropathy variant was encountered in 60% of cases, whereas axonal variants, namely, acute motor axonal neuropathy and acute motor axonal and sensory neuropathy variants were seen in about 23% of cases. ICU admission was reported in 37% of patients and 6.7% required mechanical ventilation. Most patients had a favorable outcome with a GBS disability score of three or better at out-patient follow-up visits.

Conclusion:
Our cohort of patients showed a significant deviation in disease expression from that reported in other parts of the globe. This deviation was obvious in more prominent male predominance, frequencies of different GBS variants, and more favorable short-term morbidity/mortality outcomes. However, larger multicenter prospective studies are needed for confirmation of these results.
Case report peripheral ulcerative keratitis with nodular scleritis, presents as the primary manifestation of granulomatosis with polyangiitis
Authors: Bohara Dikshya , Sitaula Ranju Kharel , Sitaula Sanjeeta , Jha Saket 
Published: August 2023

Introduction and importance:
Granulomatosis with polyangiitis (GPA) is an ANCA-associated autoimmune disorder that typically affects small and/or medium-sized blood vessels. Being a life-threatening disease, with timely suspicion, targeted laboratory investigations, and collaborative management from the ophthalmologist and rheumatologist led to long-term remission of the disease.

Case:
A 38-year-old female complaining of recurrent deep boring pain with redness in her left eye for many years, which was diagnosed as nodular scleritis with peripheral ulcerative keratitis. The patient also has recurrent bouts of epistaxis and in suspicion of GPA laboratory investigations were carried out and later diagnosed. She was started on cyclophosphamide and is currently under maintenance with rituximab.

Case discussion:
Ocular involvement has been shown to occur in 20–50% of the population in several studies. It causes conjunctivitis, episcleritis, scleritis, necrotizing keratitis, corneoscleral perforation, posterior uveitis, and optic neuritis. The positive C-ANCA and high PR3 autoantibody have high sensitivity and association with GPA. Cyclophosphamide has been shown to be an effective treatment in multiple studies whereas rituximab has been emerging as a new treatment modality for maintenance, which in turn helps in the remission and relapse of GPA cases.

Conclusion:
Scleritis and peripheral ulcerative keratitis can be the manifestation of a GPA. Careful evaluation, diagnosis, and management with a multidisciplinary medical team, early start of cyclophosphamide, and rituximab have a huge role in decreasing the disease activity and is life-saving.
Cytomegalovirus viremia in an 11-year-old child with sickle cell disease manifested only with fever: a case report
Authors: EID Mahfoud , Ghanem Abd , Saloum Elias 
Published: August 2023

Introduction and importance:
Cytomegalovirus (CMV) is a widespread virus, and it affects people of all ages. Infection with this virus causes severe life-threatening disease in immunocompromised patients and newborns. While CMV infection is asymptomatic or present as a mild illness in most cases of immunocompetent patient, it may cause severe diseases in 10% of cases.

Case presentation:
Here, the authors describe the case of an 11-year-old male presented with an ischemic stroke due to sickle cell disease; who, during hospitalization, developed a prolonged fever. After excluding bacterial infections, infiltrating diseases, rheumatologic diseases, malignancies, and other possible causes, he was diagnosed with CMV infection, which not checked initially, because most cases are asymptomatic.

Conclusion:
This case highlights the need to consider CMV infection in the differential diagnosis of every case of fever of unknown origin, regardless of the patient’s immune status.
Magnitude of opportunistic infections and associated factors among adult people living with human immune deficient virus on art at selected public hospital, mogadishu somalia: cross-sectional study
Authors: Mohamud Abdirahman Khalif , Ahmed Omar Abdullahi , Mohamud Abdulrahman Ahmed , Dirie Najib Isse 
Published: August 2023

Introduction:
Opportunistic infections (OIs) remain the leading cause of death among people living with Human immune deficient virus and OIs-related mortality in Africa is estimated at 310 000 cases. Besides, Somalia has scant data about OIs since a high burden of tuberculosis and HIV co-infection has been reported. Hence, up-to-date information is vital for better treatment and interventions and may support national and international HIV strategies and eradication programs. Therefore, this study aims to estimate the magnitude of OIs and determine factors associated with among people living with HIV/AIDs on anti-retroviral therapy (ART) in a selected public hospital in Mogadishu, Somalia.

Materials and methods:
A hospital-based cross-sectional study was conducted between 1 June and 30 August 2022 by interviewing HIV patients and reviewing case record files using a validated questionnaire containing sociodemographic, clinical, OIs history, behavioural and environmental characteristics. Logistic regression was used to determine factors associated with OIs at the significance level of a=0.05.

Result:
The magnitude of OIs among people living with HIV was 37.1% (95% CI=31.6–42.2); major identified OIs were pulmonary tuberculosis 8.2%, Diarrhoea 7.9%, and Pneumonia 4.3%. Based on Multivariable logistic regression drinking non-sterilized water [adjusted odds ratio (AOR)=2.395, 95% CI: 2.010–4.168], living with domestic animals (AOR=4.012, 95% CI: 1.651–4.123), Co-morbidity of chronic disease (AOR=2.910, 95% CI: 1.761–3.450), and poor ART adherence (AOR=3.121, 95% CI: 1.532–6.309) were factors associated with OIs.

Conclusion:
Human immune deficient virus patients in Mogadishu, Somalia, suffer from OIs. The OIs reduction strategies should improve drinking water sanitation, provide special consideration for those living with domestic animals and those with a co-morbid chronic disease, and improve ART adherence.
Amyotrophic lateral sclerosis with respiratory failure and dysautonomia: a case report
Authors: Chapagain Subodh , Khati Nirajan , Lama Roshani , Karki Rikesh , Aryal Roshan , Pangyani Binaya , Koirala Anupam 
Published: August 2023

Introduction and importance:
Amyotrophic lateral sclerosis (ALS) is a disease that affects both upper and lower motor neurons, causing a range of symptoms beyond the motor system. Recent research has shown that the autonomic nervous system can also be affected, with symptoms such as orthostatic hypotension, fluctuations in blood pressure, and dizziness being reported.

Case presentation:
A 58-year-old male presented with left lower limb limping, difficulty climbing stairs, and left foot weakness, followed by right upper limb weakness and was diagnosed with ALS and received edaravone and riluzole treatment. He presented again with right lower limb weakness, shortness of breath, and wide fluctuations in blood pressure, leading to ICU admission with new diagnosis of ALS with dysautonomia with respiratory failure and was managed with non-invasive ventilation, physiotherapy, and gait training exercises.

Clinical discussion:
ALS is a progressive neurodegenerative disease affecting motor neurons but non-motor symptoms can also occur, including dysautonomia, which can result in blood pressure fluctuations. Dysautonomia in ALS is caused by several mechanisms such as severe muscle atrophy, prolonged ventilatory support, and upper and lower motor neuron lesions. Management of ALS involves giving a definitive diagnosis, providing nutritional support, using disease-modifying drugs such as riluzole and non-invasive ventilation to improve survival and quality of life. Early diagnosis is essential for effective management of the disease.

Conclusion:
Early diagnosis, use of disease-modifying drugs, non-invasive ventilation, and maintaining the patient’s nutritional status are crucial for managing ALS which can have non-motor symptoms as well.
Frosted branched angiitis due to viral meningo-encephalitis and ocular toxoplasmosis; a rare case report from Nepal
Authors: Sitaula Ranju Kharel , Shah Chiranjiwi Prasad , Shrestha Saurav Man 
Published: August 2023

Introduction:
Frosted branched angiitis (FBA) is characteristic florid translucent retinal perivascular sheathing of both arterioles and venules in association with variable uveitis and vasculitis affecting the entire retina. The vascular sheathing is supposed to be an immune-mediated reaction, possibly due to immune complex deposition in vessel walls secondary to various underlying etiologies. The authors aim to report a case of FBA secondary to herpes simplex virus and Toxoplasma gondii infection causing the diagnostic dilemma. This is the first case report on FBA from Nepal.

Case report:
An 18-year-old young boy hospitalized with the diagnosis of acute viral meningo-encephalitis presented with the complaint of diminution of vision and floaters in both eyes for a week. Herpetic infection was confirmed with the cerebro-spinal fluid analysis and was under antiviral drugs. His presenting visual acuity was 20/80 in both eyes and ocular features were suggestive of FBA. The vitreous sample analysis revealed raised toxoplasma titre so intravitreal clindamycin was administered twice. The ocular features resolved in the subsequent follow ups with intravenous antiviral treatment and intravitreal antitoxoplasma treatment.

Conclusions:
FBA is a very rare clinical syndrome secondary to many immunological or pathological causes. So, possible etiologies must be ruled out for timely management and good visual prognosis.
Relationship of microvascular density on histological and immunohistochemical features in endometrioid adenocarcinomas of the uterus: experimental study
Authors: Lуndіn Mykola , Kravtsova Olga , Sikora Kateryna , Lуndіna Yulia , Sikora Yana , Awuah Wireko Andrew , Hasan Mohammad M. , Abdul-Rahman Toufik , Sikora Vladyslav , Hyriavenko Nataliia , Romaniuk Anatolii 
Published: August 2023

Background:
The most common malignant tumors of the uterus are endometrioid adenocarcinomas (EA). Their prognosis depends on the qualitative characteristics of the neoplastic cells and their stroma. The neovascularization of EA tissues and level of microvascular density (MVD) influence tumor progression. Our study aims to establish the relationship between MVD in EA tissue and the histological and immunohistochemical features of tumors.

Materials and methods:
The authors studied 30 cases of endometrial ЕА and compared their histological and immunohistochemical characteristics with the MVD of tumor tissues.

Results:
Our study indicated that MVD in EA tissue depends on the grade of the tumors and their FIGO stage. Increased MVD was correlated with a depression of E-cadherin and PR expression and enhanced expression of VEGF and Ki-67. MVD enhancement during VEGF overexpression is a manifestation of the functional activity of these proteins. The increase in MVD was accompanied by more frequent metastasis of the EA to the lymph nodes.

Conclusion:
EA progression is accompanied by qualitative and quantitative variations of parenchymal and stromal patterns of tumors. Dedifferentiation of EA leads to overexpression of VEGF, which becomes diffuse in tumors cells, resulting in an increase of adenocarcinomas’ MVD and their metastatic potential. Correlations between histological and immunohistochemical features of EAs indicate the synchronicity of the occurrence and progression of morphological and immunological anaplasia, which can be used in predicting the course of the disease.