bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nelarabine-induced rhabdomyolysis in a patient with T-cell acute lymphoblastic leukemia: a case report
Authors: Utsumi Akari , Goto Yuri , Suzuki Takaaki , Imai Chiaki , Matsui Shinichiro , Sakaida Emiko , Ishii Itsuko 
Published: June 2022

Abstract
Background
Nelarabine is an antineoplastic purine analog used for the treatment of refractory or relapsed T-cell acute lymphoblastic leukemia (T-ALL). The most prominent side effect of nelarabine are neurotoxicity and hematologic disorder, which are considered dose-limiting factors. Although clinical studies have reported myopathy due to nelarabine, actual detailed outcomes were not well-known initial approval. The incidence of nelarabine induced rhabdomyolysis has been reported at 2% in study in children. Cases of rhabdomyolysis have been reported in adults from medical facilities in the United Sates with renal dysfunction or severe muscle symptoms after administration of multiple courses of nelarabine. In this report, we discuss a case of rhabdomyolysis diagnosed after a single course of nelarabine. In this case, creatine kinase (CK) level was elevated in grade 4, without renal dysfunction and severe muscle symptoms.

Case presentation
A 46-year-old man from Japan was diagnosed with T-ALL and received a hematopoietic stem cell transplantation in first remission. However, the disease relapsed 6 months after transplantation. Nelarabine was selected as the next-line chemotherapeutic agent. The patient received 1500 mg/m2 of nelarabine on day 1 followed by a dose on days 3 and 5. CK levels, which were baseline before treatment, increased to grade 4 (18,620 IU/L) on the 8th day of treatment. He was diagnosed as rhabdomyolysis due to nelarabine with little possibility of other factors. He complained only of mild pain in his upper extremities and no other symptoms were noticed. The patient was managed with hydration. The pain lasted approximately 7 days, but there were no sequelae secondary to the rhabdomyolysis. Because of the elevation of CK in grade 4, we avoided re-administration.

Conclusion
In the patient administrated nelarabine, CK level was elevated in grade 4, without other symptoms of rhabdomyolysis. The results suggest that CK may be elevated at the onset of rhabdomyolysis caused by nelarabine, even in the absence of other symptoms. Therefore, it was suggested that monitoring CK during nelarabine administration is important for detecting rhabdomyolysis before it becomes severe. We consider that CK should be monitored even in absence of symptoms.
Neuropsychological evaluation and rehabilitation in multiple sclerosis (NEuRoMS): protocol for a mixed-methods, multicentre feasibility randomised controlled trial
Authors: Topcu Gogem , Smith Laura , Mhizha-Murira Jacqueline R. , Goulden Nia , Hoare Zoë , Drummond Avril , Fitzsimmons Deborah , Evangelou Nikos , Schmierer Klaus , Tallantyre Emma C. , Leighton Paul , Allen-Philbey Kimberley , Stennett Andrea , Bradley Paul , Bale Clare , Turton James , das Nair Roshan ,   On behalf of the NEuRoMS Collective
Published: June 2022

Abstract
Background
Cognitive problems affect up to 70% of people with multiple sclerosis (MS), which can negatively impact mood, ability to work, and quality of life. Addressing cognitive problems is a top 10 research priority for people with MS. Our ongoing research has systematically developed a cognitive screening and management pathway (NEuRoMS) tailored for people with MS, involving a brief cognitive evaluation and rehabilitation intervention. The present study aims to assess the feasibility of delivering the pathway and will inform the design of a definitive randomised controlled trial (RCT) to investigate the clinical and cost-effectiveness of the intervention and eventually guide its clinical implementation.

Methods
The feasibility study is in three parts. Part 1 involves an observational study of those who receive screening and support for cognitive problems, using routinely collected clinical data. Part 2 is a two-arm, parallel group, multicentre, feasibility RCT with a nested fidelity evaluation. This part will evaluate the feasibility of undertaking a definitive trial comparing the NEuRoMS intervention plus usual care to usual care only, amongst people with MS with mild cognitive problems (n = 60). In part 3, semi-structured interviews will be undertaken with participants from part 2 (n = 25), clinicians (n = 9), and intervention providers (n = 3) involved in delivering the NEuRoMS cognitive screening and management pathway. MS participants will be recruited from outpatient clinics at three UK National Health Service hospitals.

Discussion
Timely screening and effective management of cognitive problems in MS are urgently needed due to the detrimental consequences of cognitive problems on people with MS, the healthcare system, and wider society. The NEuRoMS intervention is based on previous and extant literature and has been co-constructed with relevant stakeholders. If effective, the NEuRoMS pathway will facilitate timely identification and management of cognitive problems in people with MS.

Trial registration
ISRCTN11203922. Prospectively registered on 09.02.2021.
Peripheral nerve defects repaired with autogenous vein grafts filled with platelet-rich plasma and active nerve microtissues and evaluated by novel multimodal ultrasound techniques
Authors: Zhu Yaqiong , Peng Nan , Wang Jing , Jin Zhuang , Zhu Lianhua , Wang Yu , Chen Siming , Hu Yongqiang , Zhang Tieyuan , Song Qing , Xie Fang , Yan Lin , Li Yingying , Xiao Jing , Li Xinyang , Jiang Bo , Peng Jiang , Wang Yuexiang , Luo Yukun 
Published: June 2022

Abstract

Background
Developing biocompatible nerve conduits that accelerate peripheral nerve regeneration, lengthening and functional recovery remains a challenge. The combined application of nerve microtissues and platelet-rich plasma (PRP) provides abundant Schwann cells (SCs) and various natural growth factors and can compensate for the deficiency of SCs in the nerve bridge, as well as the limitations of applying a single type of growth factor. Multimodal ultrasound evaluation can provide additional information on the stiffness and microvascular flow perfusion of the tissue. This study was designed to investigate the effectiveness of a novel tissue-engineered nerve graft composed of an autogenous vein, nerve microtissues and PRP in reconstructing a 12-mm tibial nerve defect and to explore the value of multimodal ultrasound techniques in evaluating the prognosis of nerve repair.

Methods
In vitro, nerve microtissue activity was first investigated, and the effects on SC proliferation, migration, factor secretion, and axonal regeneration of dorsal root ganglia (DRG) were evaluated by coculture with nerve microtissues and PRP. In vivo, seventy-five rabbits were equally and randomly divided into Hollow, PRP, Micro-T (Microtissues), Micro-T + PRP and Autograft groups. By analysing the neurological function, electrophysiological recovery, and the comparative results of multimodal ultrasound and histological evaluation, we investigated the effect of these new nerve grafts in repairing tibial nerve defects.

Results
Our results showed that the combined application of nerve microtissues and PRP could significantly promote the proliferation, secretion and migration of SCs and the regeneration of axons in the early stage. The Micro-T + PRP group and Autograft groups exhibited the best nerve repair 12 weeks postoperatively. In addition, the changes in target tissue stiffness and microvascular perfusion on multimodal ultrasound (shear wave elastography; contrast-enhanced ultrasonography; Angio PlaneWave UltrasenSitive, AngioPLUS) were significantly correlated with the histological results, such as collagen area percentage and VEGF expression, respectively.

Conclusion
Our novel tissue-engineered nerve graft shows excellent efficacy in repairing 12-mm defects of the tibial nerve in rabbits. Moreover, multimodal ultrasound may provide a clinical reference for prognosis by quantitatively evaluating the stiffness and microvescular flow of nerve grafts and targeted muscles.
Visual acuity after cataract surgery in Macular Telangiectasia Type 2 Stage 3 to 5
Authors: Heng Jacob S. , Arevalo J. Fernando , Handa James T. 
Published: June 2022

Abstract
Background
The purpose of this study was to evaluate visual acuity after cataract surgery in eyes with Macular Telangiectasia (MacTel) Type 2.

Methods
Single-center retrospective cohort study of patients with MacTel Type 2 who underwent cataract surgery and were managed at the same institution. Patients underwent pre-operative assessment by a retinal specialist with examination and optical coherence tomography (OCT) at the same institution. The main outcome measure was the post-operative change in best corrected visual acuity (BCVA). Secondary study outcomes were achieving post-operative BCVA better than Snellen acuity of 20/40 and time to BCVA loss by two lines or more (10 or more ETDRS letters).

Results
A total of 20 eyes (11 patients) underwent cataract surgery and were followed for a median of 25.5 months (IQR 17.5–44.2 months). The median post-operative BCVA improvement was 10.5 letters (IQR 3.50–20.25). Nuclear sclerosis severity [β = 8.99 (95% CI 3.35, 14.6), p = 0.00177] was associated with post-operative change in BCVA and central foveal ellipsoid zone (EZ) breaks [OR 1.33 × 10–9 (95% CI 5.12 × 10–10–3.43 × 10−9), p < 0.001] on OCT was inversely correlated with post-operative BCVA > 20/40 using a multivariate generalized linear model. Central foveal EZ breaks [HR 1.77 × 109 (95% CI 3.86 × 108, 8.11 × 109), p < 0.001] and MacTel Type 2 disease stage [HR 2.83, (95% CI 1.12, 7.12), p = 0.027] were independently associated with shorter time to vision loss of two lines or more in a multivariate Cox regression model.

Conclusions
Visual acuity significant improved after cataract surgery in eyes with MacTel Type 2 regardless of disease severity. The presence of central foveal EZ breaks may predict poorer post-operative visual acuity and subsequent vision loss from disease progression.
Combined intravitreal injection of bevacizumab and a ROCK inhibitor (fasudil) for refractory macular edema secondary to retinal vein occlusion: a pilot study
Authors: Fekri Sahba , Nourinia Ramin , Rahimi-Ardabili Babak , Daneshtalab Arash , Sabbaghi Hamideh , Ahmadieh Hamid , Kheiri Bahareh 
Published: June 2022

AbstractBackgroundTo investigate the adjunctive effect of an intravitreal ROCK inhibitor (fasudil) in combination with intravitreal bevacizumab (IVB) on refractory macular edema secondary to retinal vein occlusion (RVO).MethodsIn this prospective interventional case series, 17 eyes of 17 patients (10 men, 7 women) with refractory RVO-related macular edema underwent three consecutive intravitreal injections of bevacizumab plus fasudil. Monthly evaluation was continued up to 12 months and IVB injection was performed if needed during the follow-up. Changes in the best corrected visual acuity (BCVA) was the primary outcome measure. The secondary outcome measures included central macular thickness (CMT) changes and any adverse events.ResultsBCVA significantly improved (mean change: −0.15 LogMAR; P = 0.017) after 3 consecutive intravitreal injections of fasudil in combination with bevacizumab. CMT significantly decreased (mean change: −206 µm; P = 0.028). The anatomical and functional improvement was maintained during the 12 month follow-up. No adverse effects were noticed.ConclusionIntravitreal ROCK inhibitors may break the resistance to anti-VEGF therapy and improve the RVO induced macular edema via affecting the VEGF-independent pathways.
Do different lipid components accelerate the pathogenesis and severity of Diabetic Retinopathy?
Authors: Mondal Lakshmi Kanta , Pramanik Subhasish , Chowdhury Subhankar , Bose Chiranjit , Bera Debgopal , Saha Ayindrila , Bhattacharjee Koena 
Published: June 2022

Abstract
Background
To assess the association of lipid and lipid-derived toxic molecules in pathogenesis and severity of diabetic retinopathy (DR) in type 2 diabetes mellitus (T2DM).

Methods
The present cross-sectional study included 14 healthy individuals (HC) without T2DM, 22 T2DM subjects without DR (DNR), 24 T2DM subjects with mild non-proliferative DR (MNPDR), and 24 T2DM subjects with high-risk proliferative DR (HRPDR). All subjects underwent plasma and vitreous analysis for estimation of total lipid (TL), free fatty acid (FFA), lipid peroxides (LPOs) like malondialdehyde (MDA), 4-Hydroxy-noneal (HNE), the advanced lipoxidation end product (ALE) like Hexanoyl-lysine (HLY) and vascular endothelial growth factor (VEGF) following standard spectrophotometric and enzyme-linked immunosorbent assay (ELISA) methods respectively.

Results
The concentration of TL, FFA, markers of lipid peroxidation and lipoxidation as well as VEGF in plasma and vitreous were found to be significantly elevated stepwise inT2DM subjects (HRPDR > MNPDR > DNR) compared to healthy controls (HC).Further, plasma conventional lipid components like total cholesterol (TCH), low density lipoprotein cholesterol (LDL-C) and triglycerides (TG), FFA and TL showed their significant positive correlations with vitreous level of different LPOs, ALE and VEGF in the DR group.

Conclusion
Total lipid and lipid-derived detrimental biomolecules ultimately result in increased secretion of VEGF and thus not only add as associated mediators in the pathogenesis of DR, these also accelerate the severity of microangiopathy in T2DM.
An exploratory clinical trial on the efficacy and safety of glucagon-like peptide-1 receptor agonist dulaglutide in patients with type 2 diabetes on maintenance hemodialysis
Authors: Ugamura Daisuke , Hosojima Michihiro , Kabasawa Hideyuki , Tanabe Naohito , Yoshizawa Yuta , Suzuki Yoshiki , Saito Akihiko , Narita Ichiei 
Published: June 2022

Abstract
Background
Dulaglutide is a once-weekly glucagon-like peptide-1 (GLP-1) receptor agonist approved for the treatment of type 2 diabetes mellitus (T2DM). However, the efficacy and safety of dulaglutide remain unclear in insulin-treated patients with T2DM on maintenance hemodialysis (HD).

Methods
Dulaglutide treatment was initiated, and the insulin dose was adjusted according to the needs of individual participants. Primary outcomes were changes in the mean and standard deviation (SD) of blood glucose (BG) levels and mean amplitude of glycemic excursions (MAGE) evaluated by continuous glucose monitoring (CGM) for six days, glycated albumin (GA), glycated hemoglobin (HbA1c), pre-dialysis blood glucose levels, and daily total insulin dose from the baseline over 24 weeks. Secondary outcomes were changes in treatment satisfaction and QOL levels from the baseline, measured by using the Diabetes Treatment Satisfaction Questionnaire (DTSQ) and the Diabetes Therapy-Related Quality of Life questionnaire (DTR-QOL) scores.

Results
The analysis was performed on the 12 participants who completed the study. The GA level (median − 1.8 [interquartile range − 6.6, − 0.3] %; p = 0.026) and daily total insulin dose (− 15.0 [− 24.5, − 9.4] U/day; p = 0.002) significantly decreased without increasing hypoglycemia (area over the glucose curve < 70 mg/dL: 0.0 [− 0.2, 0.0] mg·24 h/dl; p = 0.917). Four patients successfully withdrew from insulin therapy. The levels of HbA1c, SD of BG, and MAGE showed a decreasing tendency, but no significant improvement. Regarding treatment satisfaction and QOL, the total scores of DTSQ (8.0 [0.3, 12.5]; p = 0.041) and DTR-QOL (15.5 [− 1.8, 42.0]; p = 0.023) significantly improved.

Conclusion
Dulaglutide may help improve glycemic control, treatment satisfaction, and QOL without increasing hypoglycemia in insulin-treated patients with T2DM on maintenance HD.
Trial registration This study was registered with the University Hospital Medical Information Network-Clinical Trials Registry (UMIN-CTR) on October 11, 2016 (registration ID, UMIN000024283).
Depression, sexual dysfunction, life satisfaction and marriage satisfaction in women with multiple sclerosis
Authors: Aydın Tuba , Onger Mehmet Emin 
Published: June 2022

Abstract
Background
Marriage satisfaction is one of the factors that affects life satisfaction in healthy people and patients. In the current literature, it is found there is a positive correlation between marriage and life satisfaction. Many factors such as sexual dysfunction, depression and neurological disorders affect negatively marriage and life satisfactions. However, there is not enough research dealing with how multiple sclerosis (MS) affects women's marital and life satisfaction. This study aimed to examine marital satisfaction and life satisfaction of female patients with MS (pwMS) in relation to sexual dysfunction and depression. A total of 139 married women (MS Group: 81, Control Group: 58) were recruited in the study. Then both groups’ participants were requested to fill the relevant documentary; Demographic Information Form, Marital Life Scale (MLS), Life Satisfaction Scale (LSS), Arizona Sexual Experiences Scale (ASEX), and Beck Depression Inventory (BDI).

Results
Regarding the percentages of the relevant parameters; it was examined that 60.96% of pwMS and 62.07% of control group have depression, respectively. In addition, 89.16% of pwMS and 86.21% of control group have sexual dysfunction, respectively. Furthermore, 55.52% of pwMS and 44.83% of control group have high life satisfaction, whereas 60.24% of pwMS and 56.90% of control group have high marriage satisfaction, respectively. There was a strong positive correlation between marriage satisfaction and life satisfaction (p < 0.001) and there was a weak negative correlation between marriage satisfaction and sexual dysfunction (p < 0.001). In addition, there were weak negative correlations between marriage satisfaction and depression level (p < 0.001) and between life satisfaction and sexual dysfunction (p < 0.001), respectively. Similarly, there was a weak negative correlation between life satisfaction and depression level (p < 0.001), whereas there was a weak positive correlation between depression level and sexual dysfunction (p < 0.001). Finally, while there was no significant difference in the marriage satisfaction and sexual dysfunction between the groups in points of life satisfaction and depression level (p > 0.05).

Conclusion
Sexual dysfunction and depression are important problems that affect women’s marriage and life satisfaction. Sexual dysfunction is a common problem for women, regardless of MS.
Serum sclerostin and sympathetic skin response: relationship with myeloma bone disease
Authors: Omran Alaa A. , Nageeb Rania S. , Waley Ahmad Barakat , Nageeb Ghada S. , Eisa Mohamad 
Published: June 2022

AbstractBackgroundMyeloma bone disease (MBD) is a common complication that significantly contributes to morbidity and mortality in multiple myeloma (MM). Serum sclerostin level and sympathetic activity can affect MBD. The purpose of this study is evaluation of serum sclerostin level and sympathetic activity (using sympathetic skin response “SSR”) in MM patients, and studying the relationship between both of them as well as their relationship with MBD. 35 smoldering myeloma patients (group I) and 35 newly diagnosed MM (group II) and 35 controls (group III) were included in the study. All the participants were subjected to complete history taking, and clinical examination. Assessment of serum sclerostin level, SSR, MM stages [by the international staging system (ISS)], MBD grading (according to the Durie–Salmon staging system) were done for all patients within 7 days from the diagnosis.ResultsUndetectable and decreased SSR amplitude are significantly more detected in group I and II (compared with group III). Autonomic manifestations, and loss of SSR is significantly more detected in group II than group I. Autonomic manifestations were absent in group III. SSR amplitude of median and tibial nerves is significantly decreased in group II than group I and III. MBD was detected in all patients of group II. Serum sclerostin and LDH were significantly increased in group II than group I. Group I and II had significantly higher levels of sclerostin when compared with group III. Group II had significantly higher levels of sclerostin and lower levels of ALP in comparison with group I. Serum sclerostin level was correlated positively with LDH and negatively with ALP and SSR amplitude. MBD was significantly affected by ISS stage III, LDH level, SSR affection and serum sclerostin level ≥ 0.40 ng/ml. SSR response affection was the most significant risk factor for advanced MBD followed by increased sclerostin level.ConclusionsSerum sclerostin level was significantly increased and sympathetic activity was significantly decreased in MBD. Loss of the SSR response was the most significant risk factor for advanced MBD followed by increased sclerostin level.RecommendationsPotentially validating the use of bone-turnover markers in larger studies, in addition to electrophysiological examination of SSR to stratify patients who are at high-risk for progressive MBD, as the use of newer agents with anabolic effects such as anti-sclerostin antibodies have shown potential in repair of MBD. These newer agents could potentially change the treatment landscape in patients with MBD.
Factors affecting anxiety and depression during the first wave of the COVID-19 pandemic: a cross-sectional study of three different populations
Authors: Ayhan-Balik Cemile Hurrem , Karakaya Seda , Kutlu Fatma Yasemin 
Published: June 2022

Abstract
Background
This paper was the first study comparing levels of anxiety and depression and assessing the affecting factors among the general population, frontline healthcare workers, and COVID-19 inpatients in Turkey during the first wave of the COVID-19 pandemic. We collected data from the general population (n = 162), frontline healthcare workers (n = 131), and COVID-19 inpatients (n = 86) using Individual Characteristics Form, Generalised Anxiety Disorder Scale, and Beck Depression Inventory in this cross-sectional study.

Results
An increased prevalence of depression and anxiety were found predominantly in frontline healthcare workers (p < 0.001). COVID-19 inpatients and frontline healthcare workers were more likely to demonstrate anxiety (p < 0.001) than the general population. In the regression analysis, while fear of infecting relatives was a significant predictor of anxiety and depression in the general population, gender and experiencing important life events were associated with anxiety. Fear of infecting relatives and lack of personal protective equipment while providing care were predictors of anxiety and depression in healthcare workers (p < 0.001). Furthermore, the fear of being re-hospitalised due to re-infection was a predictor of depression and anxiety levels of the COVID-19 inpatients.

Conclusion
Policymakers and mental health providers are advised to continuously monitor psychological outcomes and provide necessary health support during this pandemic.