bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of the value of mesothelin in differentiating between different pleural malignancies by different interventional modalities
Authors: Ahmed Mona M. , El-Assal Gehan M. , Abdel Halim Hesham A. , Mohamed Rasha G.M. 
Published: August 2022

Abstract

Context
Malignant mesothelioma is an insidious neoplasm, with malignant pleural mesothelioma as the most common type, which is characterized by poor prognosis in most patients owing to late presentation. The use of noninvasive markers for early diagnosis of malignant pleural mesothelioma is of great importance in decreasing the incidence of associated morbidity and mortality.

Aims
To evaluate the value of soluble mesothelin level in serum and pleural fluid as a diagnostic marker in patients with pleural malignancies and in differentiation of different causes of pleural effusion.

Patients and methods
We included 48 patients who were classified into three groups: group A (mesothelioma), group B (metastatic malignancy), and group C (transudative effusion). History taking, clinical examination, and laboratory assessment were performed in all groups, in addition to measuring mesothelin level in serum and pleural fluid. Histopathological examination of pleural biopsies was performed in groups A and B.

Results
Mesothelin levels in serum and pleural fluid demonstrated a statistically significant increase in group A as compared with the cases in groups B and C (P<0.001). Moreover, mesothelin levels in serum and pleural fluid demonstrated a statistically significant increase in the samples taken from the cases in group B as compared with the cases in group C (P<0.001).

Conclusion
Soluble mesothelin-related peptides (SMRP) could be used as a valuable marker in diagnosis of different causes of pleural effusion. The diagnostic accuracy of pleural fluid SMRP was higher as compared with the serum SMRP.
Chest ultrasound as a differentiating modality between pneumonia and pulmonary edema
Authors: Elbaz Shata Hanan M.G. , Abdelmaksoud Amina M. , Arram Eman O. , Abumossalam Ahmed M. 
Published: August 2022

Abstract

Background
Chest ultrasound is still impressing physicians with its capabilities in variable lung disorders.

Aim
To assess the effectiveness of chest ultrasound as a diagnostic and a differentiating modality in cases of pneumonia and pulmonary edema. It also evaluates chest sonography effectiveness in follow-up of patients with pneumonia and pulmonary edema.

Patients and methods
Chest ultrasound, chest radiograph, and computed tomography (CT) chest were performed on patients on their arrival, as well as on day 7 and 14 of admission. Patients were divided into group 1, which included 30 patients with clinically consistent signs of pneumonia based on respiratory signs and symptoms in accordance with the American Thoracic Society guidelines 2016, and group 2, which included 15 patients with clinically consistent signs of pulmonary edema.

Results
The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of ultrasound in the follow-up of pneumonia and pulmonary edema were 100% each. The sensitivity, specificity, PPV, NPV, and accuracy of chest radiograph in the follow-up of pneumonia on day 7 were 100, 90, 81.2, 100, and 93.1%, respectively, but for pulmonary edema were 91.7, 66.7, 91.7, 66.7, and 86.7%, respectively. However, the sensitivity, specificity, PPV, NPV, and accuracy of CT chest in the follow-up of pneumonia on day 7 were 88.9, 100, 100, 95.2, and 96.6%, respectively, whereas the sensitivity, specificity, PPV, NPV, and accuracy of CT chest in the follow-up of pulmonary edema on day 7 were 33.3, 100, 85.7, 100, and 86.7%, respectively.

Conclusion
Chest ultrasound might be a dependable method in the diagnosis and follow-up of pneumonia cases as well as differentiating pulmonary edema, both cardiogenic and noncardiogenic.
Is anemia a risk factor in pneumonia progression in covid-19-infected patients?
Authors: Akçiçek Mehmet , Ilgar Mehtap , Ünlü Serkan 
Published: August 2022

Abstract

Background
Determining the factors contributing to the development of severe coronavirus 2019 disease (COVID-19) disease is of great importance for health guidance. In this study, the authors aimed to investigate whether there is a relationship between anemia and progression of COVID-19 pneumonia.

Patients and methods
Records of 201 patients whose RT-PCR positivity for COVID-19 was confirmed between August 2020 and October 2020, when admissions and hospitalizations were at their peak, were retrospectively reviewed. The scoring system based on visual evaluation was used for evaluating the severity of the disease on each computed tomography (CT). To determine the progression status of pneumonia, the score difference was calculated by the difference between two CT scores. The patients were divided into two groups according to their hemoglobin levels as anemic and nonanemic patients.

Results
A significant difference was reported between the CT score difference groups in terms of mean age (P<0.001). The mean age of the group that did not show progression was significantly lower than the other groups. Although the mean hemoglobin level of the group that did not show progression was higher than the other groups, no significant difference was reported between the groups (P=0.768). There was no significant difference between the CT score difference groups in terms of the presence or absence of anemia (P=0.791).

Conclusion
No significant relationship was found between hemoglobin levels, anemia, and pneumonia progression in COVID-19-infected patients.
Association of allergen sensitization patterns with clinical outcome of subcutaneous allergen-specific immunotherapy in polysensitized allergic patients
Authors: Abdelwahab Heba W. , El-Maksoud Amina Abd , Farrag Nesrine S. , Fouda Ahmed M. , Ehab Ahmed 
Published: August 2022

Abstract

Introduction
Understanding sensitization patterns helps clinicians tailor care more effectively. Most clinical studies with positive results used single allergens, but many patients are sensitized to multiple allergens.

Aim
This study was planned to assess the correlation between different allergen sensitization patterns (the presence of sensitization to some but not other allergens) and clinical effectiveness of subcutaneous allergen-specific immunotherapy.

Patients and methods
This ex post facto study was conducted on patients with already diagnosed allergic disorders, who were attending our allergy and immunotherapy clinic and receiving subcutaneous allergen-specific immunotherapy. Data collected include patient’s demographic data, diagnosis of allergic disorders, and sensitization pattern duration of subcutaneous immunotherapy. The outcome of subcutaneous allergen-specific immunotherapy was assessed based on symptom score, medication score, and overall clinical outcome.

Results
A total of 100 patients were included. The frequencies of allergens, to which the patients were sensitized, were pollen (1 and 2) (63%), mold (61%), mite (59%), hay dust (41%), and chicken feather (23%). There were no significant association between sensitization patterns and the preimmunotherapy symptom and medication. Apart from cotton pollen, all other allergens were not associated with improvement in symptom score, and apart from chicken feather and dog sensitization all other allergens were not associated with improvement in medication score.

Conclusion
Allergen sensitization pattern could affect clinical outcome of subcutaneous allergen-specific immunotherapy in polysensitized patients. Cotton pollen sensitization is associated with less improvement in symptoms score. Chicken feather sensitization is associated with significant improvement in medication score in contrast to dog hair sensitization. The number of allergens in each patient is not significantly associated with the clinical outcome of subcutaneous immunotherapy.
Predictors of successful weaning
Authors: Sadek Samiaa H. , Hetta Helal F. , Maghrapy Hatem H.M. , Moktar Salma , Tawfek Samir El-Hadidy , Eldeeb Seham M. , Kasem Soheir M. 
Published: August 2022

Abstract

Background
Early release of patients from mechanical ventilation and intubation associated with significant decrease in mortality and morbidities.

Aim
Evaluation of echocardiography and oxidative stress markers in the prediction of weaning failure.

Patients and methods
In all, 120 mechanically ventilated patients were included in the study. Patients were evaluated by tissue Doppler transthoracic echocardiography before and during the spontaneous breathing trial (SBT). In addition to ventilatory parameters, blood samples were obtained for the measurement of lipid peroxidase, glutathione oxidase, and nitric oxide. Different parameters were compared between failed and successful weaning groups.

Results
During SBT, respiratory rate, heart rate, and rapid shallow breathing index (RSBI) were significantly increased compared with before SBT. The serum level of nitric oxide before SBT was significantly decreased in the failed group. All cardiac dimensions significantly increased during SBT compared with before SBT; moreover, the left ventricular dimensions increased significantly in the failed group during SBT. There was significant decrease in right ventricular systolic function during SBT as estimated by tricuspid annular plane systolic excursion (TAPSE) and myocardial performance index. Weaning success was positively correlated with tidal volume, TAPSE, and nitric oxide, while negatively correlated with lipid peroxidase, respiratory rate, left ventricular end-diastolic dimension, and E/E’ of lateral mitral valve annulus. Tidal volume more than or equal to 493 ml before SBT had the highest sensitivity for predicting successful weaning; on the other hand, during SBT left ventricular end-diastolic dimension less than or equal to 5.05 cm had 100% sensitivity and TAPSE more than or equal to 1.65 had 88.9% sensitivity. Respiratory rate less than or equal to 27.5 during SBT had the highest specificity (72.7%).

Conclusion
In comparison to oxidative stress markers, clinical assessment and bedside transthoracic echocardiography have higher sensitivity, so they can be considered valuable and cheap predictors of successful weaning.
Physical activity status of hookah smokers
Authors: Saad Helmi Ben 
Published: August 2022

Abstract

Background
Studies concerning the effects of hookah use on smokers’ physical activity are few. The main aim of this study was to highlight briefly the main results of studies examining the effects of hookah use on smokers’ physical activity.

Materials and methods
Medline and Scopus were consulted on October 15, 2019, using the following combination: waterpipe and exercise. Only English original articles were retained.

Results
Three studies dealt with the effects of hookah use on smokers’ physical activity. They were performed in the Middle East (n=1), and Tunisia (n=2) and they reported conflicting results.

Conclusion
This report is a request to boost the upcoming investigation to detect the real impacts of hookah use on physical activity.
Risk Factors Associated with Perineal and Vaginal Lacerations and Vaginal Removal in Total Laparoscopic Hysterectomy
Authors: Chikazawa Kenro , Imai Ken , Ko Hiroyoshi , Ichi Naoki , Misawa Masahiro , Kuwata Tomoyuki 
Published: August 2022

Objectives:
This study aimed to identify risk factors associated with perineal and vaginal lacerations related to vaginal removal during total laparoscopic hysterectomy (TLH).

Materials and Methods:
We retrospectively assessed 134 patients who underwent TLH, of whom 44 (32.8%) had vaginal lacerations.

Results:
Univariate analysis revealed that for patients with myomas and adenomyosis, gonadotropin-releasing hormone agonist use and myomas with a transverse diameter of ≥5 cm were significant risk factors, while multiparity (vaginal delivery) was a protective factor for perineal and vaginal lacerations. Moreover, multivariate analysis indicated that multiparity was the only statistically significant protective factor. For cervical intraepithelial neoplasia, endometrial cancer, and endometrial hyperplasia, only a uterine transverse diameter of ≥5 cm was a significant risk factor for perineal or vaginal lacerations.

Conclusion:
For patients with large myomas, multiple vaginal delivery was a protective factor, and in patients with normal-sized uteri, a uterine transverse diameter of ≥5 cm was a risk factor for perineal or vaginal lacerations.
Subclinical Kwashiorkor in Adults
Authors: Kapoor Nitin , Bhattacharya Saptarshi , Agarwal Navneet , Das Sambit , Bantwal Ganapathi , Deshmukh Vaishali , Kalra Sanjay 
Published: August 2022

Abstract
Childhood protein-energy undernutrition (PEU) is a well-recognized problem and therefore a lot of work has been done to identify and manage paediatric PEU. Though there have been several reports of low protein consumption in adults from developing countries, PEU and its subtle forms (subclinical PEU) are not yet recognized as adult disorders. Physicians and public perception do not favour easy recognition and action. In this review, the authors provide a scoping review of the existing literature on this entity providing insights into its recognition, pathogenesis and management. Adult subclinical PEU is an enormous under-recognized challenge that can have detrimental consequences if not recognized and corrected in time. PEU has grave health and economic impact on the patient and society. Therefore, it is important to recognize subclinical PEU and prevent its progression to full-blown form.
Hocus pocus: Breaking the curse of presbyopia
Authors: Israni Neeraj , Kochar Shruti 
Published: August 2022

Background:
Research and awareness on refractive solutions for presbyopia, commonly known as the “Curse of the 40’s,” is essential as a large population in the world suffer from vision impairments. Population-based surveys have shown that one billion people in the world are in presbyopic age.

Purpose:
Many structural and physiological changes occur in the eye with the onset of presbyopia, including the decrease in amplitude of accommodation. At present, various static and dynamic techniques have been attempted to give presbyopes good vision at near-, intermediate-, and far-viewing distances. The aim of the video is to familiarize the modern-day ophthalmologists to these modalities.

Synopsis:
In this video, we tried to summarize the indications and contraindications of presbyopic laser. Preoperative investigations like dominance testing and micro monovision testing are described. The role of neuroadaptation and patient counselling is emphasized. Static techniques described in the video include spectacles, contact lenses, surgical options like corneal inlays and onlays, corneal laser ablation, conductive keratoplasty, corneal implant lenses, INTRACOR and IOLs. Dynamic presbyopia correction (accommodative) is always surgical. This is split into lenticular (accommodating IOLs, piggyback, lens refilling, lentotomy) and scleral treatment (laser-assisted presbyopia reversal and scleral expansion bands).

Highlights:
The types of corneal laser ablation, which is otherwise very confusing, is elaborated in a step-wise manner here. The difference in approach of PresbyLasik (Nidek), Presbyond (Zeiss) - Laser Blended Vision, PresbyMax (Schwind), INTRACOR (Technolas) are explained with examples. Each approach has its pros and cons. Our challenge as a surgeon is to identify the best combination for the patient. This video illustrates the treatment options which can help break the curse of presbyopia.

Online Video Link:

https://youtu.be/rTxMIqMrgaw
Pragmatic adjunctive usage of netarsudil: A retrospective chart review from a tertiary care center
Authors: Goergen Nate S , Gagrani Meghal , Gulati Vikas , Ghate Deepta 
Published: August 2022

Purpose:
This retrospective chart review of netarsudil (Rhopressa) characterizes intra-ocular pressure (IOP) reduction, drug tolerance, drug cost, and compliance in a tertiary university Midwest clinic in a variety of glaucoma diagnoses on patients prescribed netarsudil 01/2017 to 5/2020.

Methods:
Patient demographics, primary diagnosis, indication for medication, prescription date, prescription fill status, duration of use, discontinuation reason, and number of IOP-lowering medications were noted. Confounding medication changes were excluded from IOP analysis. The IOP difference between the first visit after starting netarsudil and the baseline (mean before starting netarsudil on the stable medication regimen) was calculated.

Results:
A total of 133 patients were prescribed netarsudil (age 69 ± 20 years, 59% females, 79% white, 86% primary glaucoma) as adjunct glaucoma medication (mean medications 3.2 ± 0.9). Indications were lowering IOP (mean baseline IOP 20.0 ± 6 mmHg) and drug regimen simplification. Prescription was not filled by 22/133 subjects because of the cost (68%) and the need for surgery (23%). No demographic factors were associated with prescription fill status. A total of 101 eyes of 76 patients were used for IOP analysis. The mean change in IOP was –0.8 ± 6.4 mmHg, (IOP decrease in 67%, increase or no change in 33% eyes). Netarsudil was discontinued in 52% (50/96) patients; the reasons include surgery for IOP control (42%), allergies (30%), cost (14%), and paradoxical rise in IOP (12%).

Conclusion:
Netarsudil was used as adjunct third or fourth line medication at a glaucoma practice in Midwestern USA. 17% of prescriptions went unfilled; netarsudil was discontinued in 52% of patients. IOP response was variable in this population with severe complex glaucoma.
Comparison of optical biometry and conventional acoustic biometry in the axial length measurement in silicone oil-filled eyes
Authors: Rajurkar Ketaki , DaCruz Russell , Thakar Meenakshi 
Published: August 2022

Purpose:
To compare the axial length (AL) obtained by A-scan biometry (PAC SCAN 300AP; Sonomed Escalon, USA) and LENSTAR-LS 900 (Haag-Streit, Koeniz, Switzerland) in silicone oil (SiO)-filled eyes.

Methods:
AL measurements were taken in 50 SiO-filled eyes using A-scan and LENSTAR-LS 900 before SiO removal and 1 month following SiO removal. In the subset of patients requiring intraocular lens (IOL) insertion, the predicted refraction and the refraction obtained were compared. IOL power in these patients was calculated using SRK-T formula and the AL obtained by LENSTAR.

Results:
In SiO-filled eyes, a significant difference was noted between the AL values obtained using the two methods (P = 0.0002). No significant difference was noted after SiO removal (P = 0.634). In the subset of patients needing IOL insertion, no significant difference (P = 0.07) was seen between target refractive error and postoperative refractive error (mean deviation from the target being 0.176 diopter). AL of an SiO-filled eye is more accurately measured using optical low coherence reflectometry (OLCR)-based biometry (LENSTAR) than with conventional acoustic biometry (A-scan).

Conclusion:
We conclude that LENSTAR gives more accurate biometry in an SiO-filled eye. The AL obtained after SiO removal was comparable and showed no significant difference.
The effectiveness of laser vitreolysis for vitreous floaters in posterior vitreous detachment
Authors: Goh Wan Ni , Mustapha Mushawiahti , Zakaria Syed Z S , Bastion Mae-Lynn C 
Published: August 2022

Purpose:
To determine the effectiveness of laser vitreolysis in terms of contrast sensitivity function (CSF) and vision-related quality of life (VRQol) for symptomatic floaters due to posterior vitreous detachment (PVD).

Materials:
This is an interventional study that involved 57 eyes of 45 patients with symptomatic floaters for more than 3 months. Patients underwent one to three sessions of vitreolysis via Neodymiun-doped Yttrium Aluminum Garnet (Nd:YAG) laser. We examined the CSF using the computer programs Freiburg Acuity and Contrast Test (FrACT) and VRQoL survey using the National Eye Institute Visual Function Questionnaire-25 (NEI VFQ-25) before, and 1 month after, vitreolysis.

Results:
Twelve patients had both eyes lasered and 33 patients had one eye lasered. The mean CSF improved from 3.20 ± 0.85%W to 2.64 ± 0.63%W 1 month after vitreolysis. Each use of the laser showed a significant mean difference in CSF (%W) as analyzed by paired t-test before and after the first laser (0.29 ± 0.49%W [P ≤ 0.001]); after the first and second laser (0.35 ± 0.53%W [P = 0.01]); and after second and third laser (0.21 ± 0.31%W [P = 0.02]). There was improvement in the median of four subscales in NEI VFQ-25 scores post treatment: general vision (z = −3.30, P = 0.001), near activity (z = 3.396, P = 0.001, distance activity (z = −2.788, P = 0.005), and mental health (z = −2.219, P = 0.026). The mean scores increased to 79.55 ± 9.45 from the baseline 75.06 ± 9.69 (P ≤ 0.001). No adverse events were recorded 1 month after the laser treatments.

Conclusion:
Vitreolysis by Nd:YAG laser improved the CFS and VRQoL in symptomatic PVD patients.
Choroidal vascularity index changes with phacovitrectomy for vitreoretinal interface disorders
Authors: Ercan Zeynep Eylul , Gokgoz Gulsah , Yilmaz Gursel 
Published: August 2022

Purpose:
Vitreomacular interface disorders have long been argued to change choroidal structure. The aim of this study was to determine the choroidal vascularity index (CVI) changes following internal limiting membrane peeling for epiretinal membrane (ERM) and full thickness macular hole (FTMH).

Methods:
Fifty-nine patients with unilateral ERM and 56 with unilateral FTMH were included in the study. Axial length, pre- and post-surgery intraocular pressure, baseline and post-phacovitrectomy CVI were calculated and compared with the normal fellow eyes. To compare the baseline and the final measurements, Wilcoxon test was used. Mann–Whitney U test was used for independent data comparisons. Median and standard deviations were compared.

Results:
Axial length, pre- and post-surgery intraocular pressure differences were insignificant between study and fellow eyes within all groups. CVI were significantly lower in post-vitrectomy study eyes of all groups compared with pre-surgery (P < 0.001). There were no significant changes before and after the surgeries in fellow eyes. Baseline CVI of ERM study eyes (median 65.90%) and FTHM study eyes (median 65.59%) did not differ significantly between groups (U = 1336, P = 0.07, r = 0.16).

Conclusion:
There are conflicting results of vitreoretinal interface disorders CVI in the literature. In this study, both FTMH and ERM eyes showed reduced CVI postoperatively compared with the baseline. Preoperatively, there were no difference between study eyes and the fellow eyes.