bluuebunny/crossref_metadata_2025_split huggingface dataset:
Study of serum sclerostin levels and its role in vascular calcification in patients with chronic kidney disease
Authors: Elarbagy Ahmed R. , Yassein Yassein S. , Emara Mahmoud M. , Sonbol Ahmed A. , Elzorkany Khaled M. A. , El Deen Amera A. Sharaf 
Published: September 2023

AbstractObjectiveThe aim of this work was to study serum sclerostin levels in patients with chronic kidney disease (CKD) not on dialysis and those on regular hemodialysis and its role in vascular calcification.BackgroundCKD, whether starting hemodialysis (HD) or not, is associated with an increase in the risk for vascular calcification, which can only be partially explained by known classical risk factors. Sclerostin is an osteocyte-derived inhibitor of the Wnt pathway and has been shown to play a key role in vascular calcification in patients with CKD.Patients and methodsThis cross-sectional study was carried out on 80 patients with CKD attending Menoufia University Hospital. Patients were classified into 40 patients with CKD who were not on HD (group I) and 40 patients with CKD on regular HD more than 6 months (group II), who were compared with 15 controls (group III). Abdominal aortic calcification (AAC) was assessed using lateral lumbar radiography. Echocardiography was used to assess aortic valve calcification (AVC) calcification. Patient’s basic clinical and biochemical data were recorded. Serum sclerostin level was measured using commercially available enzyme-linked immunosorbent assay kits.ResultsSclerostin levels among the patients with CKD on HD (116.8±0.103.69 Pmol/l) was significantly higher than that of CKD predialysis group (28.63±0.36.26 Pmol/l), which in turn was statistically higher than control group (6.6±0.2.9 Pmol) (P=0.000). AAC was observed in 16 (40%) patients in CKD predialysis group, whereas in CKD on HD group, 26 (65%) patients had AAC. AVC was observed in 14 (35%) patients in CKD predialysis group, whereas in CKD on HD group, 21 (52.5%) patients had AVC. Using binary regression analysis, sclerostin was identified as an independent predictor for the presence of AAC (OR: 1.017;P=0.000) and AVC (OR: 1.013;P=0.001) in patients with CKD.ConclusionPatients with CKD (predialysis and on HD) exhibit an increase in sclerostin levels. Sclerostin expansion correlated positively with vascular and valvular calcification. Sclerostin is an independent risk factor for heart valve calcification and AAC in patients with CKD.
Insulin-like growth factor 1 and insulin-like growth factor binding protein-3 as predictive biomarkers of depression and migraine in obese women
Authors: Rashad Nearmeen M. , Gomaa Ahmed F. , Sabry Hanan M. , Fouad Amira A. , El Shabrawy Shereen M. 
Published: September 2023

Abstract
Introduction
Obesity and its comorbidity, depression and migraine, are highly prevalent conditions and public health problems of enormous scope that are responsible for the significant quality of life impairment and financial cost. Insulin-like growth factor-1 (IGF-1) and its main binding protein, insulin-like growth factor binding protein-3 (IGFBP-3) are related to metabolic diseases such as growth deficiency, obesity, cancer, neurological, and cardiovascular diseases. The objective of this study was to explore IGF-1 and IGFBP-3 in obesity-associated depression and migraine. Also, we aimed to evaluate the association of IGF-1 and IGFBP-3 with clinical features of depression and migraine.

Patients and methods
A cross-sectional controlled study included 50 healthy lean control group and 100 obese women who were subdivided into three subgroups: obese without depression and migraine (n=27), patients with depression (n=24), and patients with migraine (n=49). Clinical, neurological, and psychiatric evaluation of all patients was done. We measured IGF-1 and IGFBP-3 by commercial enzyme-linked immunosorbent assay.

Results
Our study showed a significantly lower level of IGF-1 and IGFBP-3 in obese women compared with lean ones. Even more importantly, obese women with depression as well as migraine had significantly lower IGF-1 and IGFBP-3 than those without depression and migraine. Interestingly, the lower levels of IGF-1 and IGFBP-3 in obese women with depression and migraine were significantly negatively correlated with depression score, BMI, and homeostasis model assessments of insulin resistance. Linear regression analysis test in obese patients showed that BMI and depression scores were independently correlated with serum IGF-1. However, BMI, fasting serum insulin, and depression scores were independently correlated with serum IGFBP-3.

Conclusions
Obese women with depression and migraine had significantly lower IGF-1 and IGFBP-3 than those without depression and migraine.
The importance of education and training for noninvasive ventilation: suggestions from the literature
Authors: Elena Barbagelata , Tommaso Perazzo , Gianluca Ferraioli , Mario Santo , Antonello Nicolini 
Published: September 2023

AbstractNoninvasive ventilation (NIV) is a commonly used respiratory support. The use of the NIV is expanding over time and, but its knowledge and skills are very important for the proper use of this life-saving support. This study aims to evaluate the available evidences for the education and training of NIV. There are no clinical trials examining the impact of education and training of the NIV as the primary objective. However, few studies with indirect evidences, and evidence from a simulation-based training, and some reviews were found. Organized training to increase NIV skills is also limited mostly within few developed countries. Education and training in NIV have the potential to increase knowledge and skills of the staff. The development of organized education and training program in NIV appears to be the need in several types of disciplines and care environments.
Association of new obesity indices; visceral adiposity index and body adiposity index, with metabolic syndrome parameters in obese patients with or without type 2 diabetes mellitus
Authors: Rashad Nearmeen M. , Emad George 
Published: September 2023

Abstract
Background
Obesity is the cornerstone of metabolic syndrome (MetS); it is not possible to use BMI to differentiate between lean mass and fat mass. We aimed to investigate, for the first time, the possible association of new obesity indices; visceral adiposity index (VAI) and body adiposity index (BAI), with parameters of MetS in Egyptian obese patients.

Patients and methods
This was a case–control study that included unrelated 150 obese patients and 50 healthy controls. Obese patients were then subdivided into two subgroups, nondiabetic patients (n=85) and 65 patients with type 2 diabetes mellitus. We measured the anthropometric measures; BMI, waist/hip ratio, waist/height ratio, BAI, and VAI.

Results
Among obese patients, we found significant positive correlations between parameters of MetS and obesity indices. Among obesity indiced, the highly significant positive correlations were found between VAI and parameters of MetS. After adjusting for the traditional risk factors, logistic regression analysis test found that the VAI value was the best predictor of type 2 diabetes mellitus in comparison with BMI and BAI. Receiver operating characteristic curve was used to assess the power of obesity indices; the sensitivity and the specificity of BMI were 94.7 and 99.9%, for VAI, they were 74.4 and 99.9%, and, for BAI, they were 83.3 and 58%, respectively.

Conclusion
BMI is still the most powerful diagnostic tool for obesity. Although, in certain conditions, where there are limitations of using BMI, we can use other obesity indices, VAI and BAI could be used to discriminate cardiovascular risk among obese patients.
Effect of vitamin D replacement on cardiometabolic risk factors and electrophysiological pattern of peripheral neuropathy in vitamin D-insufficient or deficient type 2 diabetic patients
Authors: Rashad Nearmeen M. , Sabry Hanan M. , Gomaa Ahmed F. , Ebaid Amany M. , Abomandour Hala G. , Allam Reem M. 
Published: September 2023

Abstract
Background
Diabetic neuropathy is one of the commonest chronic complications of diabetes seen in routine healthcare and considered the most common cause of peripheral neuropathy all over the world. Vitamin D (VD) deficiency is now recognized as a pandemic disease. This study was designed to explore the levels of 25-hydroxycholecalciferol [25(OH) D] in patients with type 2 diabetes mellitus (T2DM) with peripheral neuropathy. We also aimed to clarify the effect of VD supplementation on cardiometabolic status and electrophysiological pattern of peripheral neuropathy.

Patients and methods
This clinical trial enrolled 95 patients with T2DM with peripheral neuropathy. The enrolled patients were divided into three groups according to serum 25(OH) D levels. VD deficiency and insufficiency groups received VD supplements (42,000 IU oral VD per week and 500-mg calcium carbonate per day for 12 weeks). Clinical, electrophysiological pattern, and laboratory parameters were evaluated at baseline and after 12 weeks of intervention. Serum 25(OH) D levels were measured by using a competitive enzyme-linked immunosorbent assay kit.

Results
Our results revealed that, among 95 patients with T2DM with peripheral neuropathy, 32 patients had VD insufficiency [20 ng/ml <25(OH) D <30 ng/ml], 50 patients had VD deficiency [25(OH) D < 20 ng/ml], and 13 patients had VD sufficiency [25(OH) D >30 ng/ml]. Our results reported that 25(OH) D levels were negatively correlated with cardiometabolic risk factors and Toronto Clinical Scoring System. On the contrary, 25(OH) D levels were positively correlated with nerve conduction velocities (NCV). Stepwise multiple linear regression analysis revealed that glycated hemoglobin and Toronto Clinical Scoring System were the main predictors of 25(OH) D levels among other clinical and laboratory biomarkers. Logistic regression analysis observed that motor NCV and sensory NCV of median nerve and glycated hemoglobin were independent predictors of response to VD supplementation. NCV in studied groups showed that motor NCV and sensory NCV in the median, posterior tibial, and ulnar nerves were significantly decreased in both VD deficiency and insufficiency groups compared with VD sufficiency groups, and supplementation with 42 000 IU oral VD per week and 500-mg calcium carbonate per day for 12 weeks improved cardiometabolic risk factors and electrophysiological pattern of peripheral neuropathy.

Conclusion
The supplementation of VD for 12 weeks to VD deficiency and insufficiency groups improved the cardiometabolic and electrophysiological pattern of peripheral neuropathy.
Association between 25-hydroxyvitamin D and hemoglobin A1c levels in patients with type 2 diabetic kidney disease
Authors: Azeem Haitham A. , Mohammed Arafa I. , Hashim Alaa M. 
Published: September 2023

Abstract
Introduction
Vitamin D is suggested to influence glucose homeostasis. An inverse relationship between serum 25-hydroxyvitamin D (25(OH)D) and glycemic control in non-chronic kidney disease (CKD) patients with type 2 diabetes was reported. We aimed to examine this association among type 2 diabetes patients with CKD.

Objectives
To examine the relation between plasma 25-hydroxyvitamin D3 (25(OH)D3) levels and glycemic state in diabetic patients at various stages of CKD.

Patients and methods
A total of 70 participants (40 men and 30 women) with a mean age of 65.3±11.5 years suffering from type 2 diabetes mellitus with various stages of CKD were recruited. Blood for glycated hemoglobin (HbA1c), serum 25(OH)D3, renal profile, and estimated glomerular filtration rate was drawn at enrollment. Correlation and regression analyses were carried out to assess the relationship of serum 25(OH)D, HbA1c, and other metabolic traits.

Results
Our study shows the following results:
Most of the participants are urban with age range from 50 to 70 years.
Forty percent of the participants are with good glycemic control, 30% with moderate control, and 30% with bad control.
Fifty percent of the patients were at CKD stage 3. Stage 5 patients differed significantly from stages 1 to 4 patients where they were younger, with lowest mean HbA1C value and a much higher mean 25(OH)D level (around twice of stage 1 patients).
Half of the cases are vitamin D deficient, nearly a third of them are insufficient, and about 20% are sufficient.
The level of 25(OH)D3 correlates inversely with the level of HbA1C irrespective of estimated glomerular filtration rate or the age of the patients.

Conclusion
The present study reported a significant inverse relationship between serum 25 (OH)D3 and HbA1c levels in type 2 diabetics with suboptimal glycemic control and concomitant different stages of CKD.
A review of bone marrow niche cellular spectrum
Authors: Shoieb Sabry A. , Abdel Hafez Mohammad A. , Abd El-Hamid Alaa E. , Ezz Walaa Hamdy 
Published: September 2023

AbstractTo perform a narrative review on the role of bone marrow (BM) niche in normal hematopoiesis.MEDLINE databases and Ovid database were searched. The search was performed on 10 October 2018 and included articles published from 2015 to 2018 in English language.The initial search presented 45 articles, which were included in the study.Hematopoietic stem cells which produce a variety of hematopoietic lineage cells throughout the life are located in a specialized microenvironment called the ‘niche’ in the BM where they are governed. Several types of cells in the BM have been suggested to contribute to hematopoietic stem cell niche activity.
Predictors of myocardial injury in patients with cirrhosis presenting with upper gastrointestinal bleeding
Authors: Shaheen Rehab , Gouda Tarek , Bahgat Monir , Selim Tarek , El-Menshawy Hazem Hakim El-Beltagy , Awad Elsayed 
Published: September 2023

Abstract
Background
Myocardial injury in conditions other than coronary artery disease (CAD), known as type 2 myocardial infarction, is mostly related to mismatch between myocardial oxygen supply and demand. Cirrhotic patients with acute upper gastrointestinal bleeding (UGIB) are usually hemodynamically unstable. Hypovolemia, hypotension, and decreased oxygen-carrying capacity as consequences of UGIB may precipitate subclinical heart failure and myocardial injury.

Aim of work
Assessment of the prevalence and potential risk factors of myocardial injury in patients with liver cirrhosis with acute UGIB.

Patients and methods
The study was conducted on 132 patients diagnosed with liver cirrhosis presenting by UGIT bleeding at Mansoura University Hospitals during one year. Patients were divided into 2 groups: group 1 (76 patients) with myocardial injury or ischemic heart disease and group 2 (60 patients) without.

Results
The incidence of myocardial injury in this study (elevated troponin levels above cutoff value and/or ECG changes) was 55% of patients. Troponin I was positive in 25% of patients. ECG ischemic changes were found in 36.3% of patients in the form of ST-segment deviation or T-wave inversion. On univariate analysis, predictors of myocardial injury in patients with UGIB included MELD score and variceal source of GI bleeding. On multivariate analysis variceal source of GI bleeding is an independent predictor of myocardial injury. Variceal bleeding was found in 95 % of the ischemic group versus 63% in the other group.

Conclusion
More than half of the study patients presented with UGIB have suffered from unnoticed subclinical myocardial injury. Variceal source of GI bleeding was found to be an independent predictor of myocardial injury.
Serum omentin-1 as a predictor of activity in Crohn’s disease
Authors: Mohammed Mohammed A. , Omar Nesreen M. 
Published: September 2023

Abstract
Background and aim
Crohn’s disease (CD) is associated with alterations in fat mass and fat distributions, with changed productions of adipokines, including omentin-1. Omentin-1 may be involved in the pathogenesis of inflammatory bowel disease. The aim was to determine the serum and mucosal omentin-1 levels in CD patients and to evaluate its potential as a marker for disease activity.

Patients and methods
Seventy-five adult consecutive outpatients, with a confirmed diagnosis of CD, and 45 age-matched, sex-matched, and BMI-matched healthy volunteers were enrolled in this study after written conscious consent and approval by the Institutional Review Board of Mansoura University. CD was diagnosed by conventional clinical, radiological, endoscopic, and histopathological criteria. Serum levels and mucosal mRNA expression of omentin-1 were measured by commercially available kits according to the manufacturer’s protocols.

Results
Serum omentin-1 and its mucosal gene expression were significantly lower in patients with CD (53.3±12.8) than in healthy controls (72.7±16.8, P<0.0001). Moreover, serum omentin-1 levels were significantly lower in patients with active CD (36.2±9.6) than in patients in remission (69.2±14.4, P≤0.0001). No significant differences were demonstrated between patients in remission and healthy controls (P>0.05). In CD patients, the decrease in serum omentin-1 was associated with a significantly higher BMI, C-reactive protein, erythrocyte sedimentation rate, Crohn’s disease activity index, simplified endoscopic score for CD and inflammation scores (P≤0.05). Moreover, omentin-1 was much superior to C-reactive protein in predicting CD activity and severity.

Conclusion
Serum and mucosal expression of omentin-1 might be a reliable surrogate noninvasive marker of disease activity in CD with significantly high sensitivity, specificity, and diagnostic accuracy.
Early addition of rituximab in the management of myositis associated with systemic lupus erythematosus
Authors: Behiry Mervat E. , Shaker Ahmed , Shohdy Kyrillus , Nagy Fadi 
Published: September 2023

AbstractTargeting B-cell in systemic lupus erythematosus (SLE) seems to be a promising approach. Although rituximab failed to show efficacy in refractory SLE in clinical trial setting, real-world experience still shows some efficacy in certain situations. A 20-year-old woman was diagnosed with SLE with coexistent myositis. The patient’s muscular condition did not improve on corticosteroids, addition of rituximab could achieve complete response. Introducing rituximab early for the nonrenal manifestations of SLE merits further investigation.
Can hepatitis C virus core antigen replace quantitative RNA in the assessment of a sustained virologic response?
Authors: Musa Nevine I. , Safwat Eslam , Ghait Ramy S. , Aly Heba , Abdelhamid Dalia H. 
Published: September 2023

Abstract
Background
The widespread use of direct-acting antivirals (DAAs) in the treatment of hepatitis C virus (HCV) infection has reduced the need for monitoring HCV-RNA levels because viral kinetics do not predict a sustained virologic response (SVR). However, the performance of cheaper tests, such as the assay to quantify hepatitis C virus core antigen (HCV Ag), has not been determined. Our aim was to assess the accuracy of the HCV core Ag test in predicting the achievement of SVR and its predictive value as a monitoring test in the course of treatment.

Patients and methods
This prospective study was carried out on 90 patients, chronically infected with HCV, who received DAA therapy. Blood samples were collected and the levels of HCV core Ag and HCV-RNA were measured at baseline and at 12 weeks after the end of treatment. We compared the ability of these assays to predict which patients would achieve SVR12.

Results
The baseline level of HCV-RNA was 1 688 529.6±994 697.3 IU/ml (range: 312 700–3 491 100 IU/ml) and HCV core Ag was 179.2±83.5 pg/ml (range: 33.5–315.6 pg/ml). HCV Ag became undetectable in 92.2% 12 weeks after the end of treatment, whereas HCV-RNA became undetectable in 87.8% at the end of treatment (P<0001). Seventy-nine out of 90 (87.8%) patients achieved SVR12; the test for HCV Ag identified 63.6% of these patients.

Conclusion
Measurement of HCV core Ag can monitor the efficacy of DAA therapy for HCV infection. Thus, it can be applied in clinical practice.
Endoscopic endonasal prelacrimal recess approach for antrochoanal polyp
Authors: Ismaeil Wael F. , Abdelazim Mohamed H. 
Published: September 2023

AbstractBackgroundThe purpose of this study was to assess the effectiveness of endoscopic transnasal prelacrimal recess approach (ETPRA) in preventing the recurrence of antrochoanal polyps.Patients and methodsA total of 32 patients with antrochoanal polyp were divided into two equal groups: group 1 included 16 patients who underwent endoscopic middle meatal antrostomy (EMMA), and group 2 included 16 patients who underwent a combined surgical technique using EMMA together with ETPRA. They were followed up from 24 to 36 months. Success rates for visualization of the origin of the polyps, surgical complications, and recurrence were evaluated.ResultsThe most common symptoms were nasal obstruction (100%), snoring (75%), rhinorrhea (59.38%), headache (96.88%), and hyposmia (53.13%). The study found that postoperative complications varied between both groups. Recurrence was found in 18.75% in EMMA group and 0% in ETPRA group. They were statistically significant (P<0.05). However, nasolacrimal duct injury was found in two patients in ETPRA group, and postoperative lacrimation presented in only one (6.25%) patient of the same group. They were statistically insignificant (P>0.05).ConclusionRecurrence rate of antrochoanal polyp has been reduced with the usage of ETPRA in comparison with EMMA alone.
An unusual presentation of cervical necrotizing fasciitis in an immunocompetent adult patient: a case report and literature review
Authors: Bhati Jyan M. , Al-Shwareb Abdulmonem M. , AlKhunaizi Shahd M. , AlQudehy Zeinab A. 
Published: September 2023

AbstractNecrotizing fasciitis is a sever and potentially fatal soft tissue infection, but its presentation in head and neck region is rare. Few reported cases of cervical necrotizing fasciitis secondary to tonsil infection were found in literature, which were proven to be dangerous life threatening condition.In this short communication, we are presenting a 35-year-old, immune-competent Saudi female patient. She was presented to our hospital with ill looking picture of right peritonsillar abscess with mild degree of trismus. Patient was admitted, IV antibiotic was started and CT scan neck showed pus in the left tonsil parenchyma and in right peritonsillar region, with cellulitis in right parapharyngeal region with no clear collection noticed within the neck spaces. Patient was taken to OR where pus in the left tonsil surface was noted and cleaned, and incision and drainage of right peritonsillar fossae was done, pus came out and gas bubbles noted along with necrotic fleshy tissue in the lower pole of the right tonsil from which multiple biopsies were taken. Patient had postoperative bleeding after 24 hours. CT scan was repeated and patient was taken for OR for debridement of necrotic tissue from right tonsil, and right neck exploration and debridement. Necrotic tissues medial to the right submandibular gland was seen and removed. The cultured swab and aspirated pus showed coagulase-negative staphylococcus, antibiotic was changed based on sensitivity results and she responded very well. She was discharged home post operatively in stable condition and was followed up for 18 months with no history of recurrent tonsillitis.