bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Observational Study of Cutaneous Manifestations in Internal Malignancy at Tertiary Care Centre
Authors: Tandel Jinal , Polra Rutoo , Parmar Dharmesh , Srivastava Priyanka , Panchal Rushikumar , Nair Pragya 
Published: June 2022

Introduction:
Skin is the largest organ in the human body and mirrors the changes in the organism it envelops. Internal malignancies can cause various specific and non-specific cutaneous manifestations along with hair, nail and oral mucosal changes. Some of the changes are detected early indicating a strong association with cancer, while some occur in later stage indicating dissemination or immunosuppression. The present study is an effort to know pattern of dermatosis associated with internal malignancies so that early diagnosis and interventions can be done.

Aim:
To determine the pattern of specific and non-specific dermatosis associated with internal malignancy.

Methods and Material:
Patients of internal malignancies with skin lesions attending dermatology and oncology department during July 2020 to June 2021 were recruited in the study after taking written informed consent. A detailed history of skin lesions and malignancies were taken. Clinical examination (skin/hair/nail) was carried out and photographs were taken. Relevant investigations were carried out. Frequency and percentage of dermographic data and dermatosis associated with internal malignancies were calculated.

Results:
The study included 150 patients with maximum number of patients 78 (52%) in 41-60 years of age group with female: male ratio of 1.2:1. Most common internal malignancy was breast carcinoma in 43 (28.67%) cases. Specific dermatosis were seen in 5 (3.33%) cases and non-specific dermatosis in 121 (80.66%) cases. Specific dermatosis were vasculitis, necrolytic migratory erythema, lymphocytoma cutis, growth and cutaneous metastasis with 1 (0.67%) patient each. Most common non-specific dermatosis was herpes zoster in 17 (11.33%) cases.

Conclusion:
The study was useful in understanding the various specific and non specific dermatosis associated with internal malignancies and thereby helping the physician to manage the conditions.
Survival analysis and predictors of long-term outcomes following radical nephrectomy with inferior vena cava (IVC) thrombectomy in renal cell carcinoma
Authors: Garg Harshit , Nayak Brusabhanu , Kumar Ashish , Singh Prabhjot , Nayyar Rishi , Kaul Aashir , Seth Amlesh 
Published: June 2022

Background:
Renal cell carcinoma (RCC) presents with inferior vena cava (IVC) thrombus in 10%–30% cases and surgical management forms the mainstay of the treatment. The objective of this study is to assess the outcomes of the patients undergoing radical nephrectomy with IVC thrombectomy.

Methods:
A retrospective analysis of patients undergoing open radical nephrectomy with IVC thrombectomy between 2006 till 2018 was done.

Results:
A total of 56 patients were included. The mean (±standard deviation) age was 57.1 (±12.2) years. The number of patients with levels I, II, III, and IV thrombus were 4, 29,10, and 13, respectively. The mean blood loss was 1851.8 mL, and the mean operative time was 303.3 minutes. Overall, the complication rate was 51.7%, while the perioperative mortality rate was 8.9%. The mean duration of hospital stay was 10.6 ± 6.4 days. The majority of the patients had clear cell carcinoma (87.5%). There was a significant association between grade and stage of thrombus (P = 0.011). Using Kaplan–Meier survival analysis, the median overall survival (OS) was 75 (95% confidence interval [CI] = 43.5–106.5) months, and the median recurrence-free survival (RFS) was 48 (95% CI = 33.1–62.3) months. Age (P = 0.03), presence of systemic symptoms (P = 0.01), radiological size (P = 0.04), histopathological grade (P = 0.01), level of thrombus (P = 0.04), and invasion of thrombus into IVC wall (P = 0.01) were found to be significant predictors of OS.

Conclusion:
The management of RCC with IVC thrombus poses a major surgical challenge. Experience of a center along with high-volume and multidisciplinary facility particularly cardiothoracic facility provides better perioperative outcome. Though surgically challenging, it offers good overall-survival and recurrence-free survival.
Point prevalence of delirium among critically ill patients in Saudi Arabia
Authors: Alqadheeb Nada S. , Hashhoush Mai S. , Alharthy Abdulrahman M. , Mahmood Nasir Nasim , Alfardan Zahra A. , Amin Rashid , Maghrabi Khalid A. , Almaani Mohammed A. , Alyamany Mahmoud S. , Alenezi Farhan Zayed , Alruwaili Abdulrahman R. , Alkhatib Kasim H. , Rugaan Asia S. , Eltatar Faisal S. , Algethamy Haifa M. , Abudayah Abdullah M. , Ghabashi Alaa E. , ElRakaiby Galal B. , Alkatheeri Khalid F. , Alarifi Mohammed I. , Al Mubarak Yousef A. , Ismail Nadia H. , Alnajdi Israa H. , Ahmed Mohammed Elrazi I. , Alansari Mariam A. , Alenazi Ahmed O. , Almuslim Osama M. 
Published: June 2022

Background:
Delirium in critically ill patients is independently associated with poor clinical outcomes. There is a scarcity of published data on the prevalence of delirium among critically ill patients in Saudi Arabia. Therefore, we sought to determine, in a multicenter fashion, the prevalence of delirium in critically ill patients in Saudi Arabia and explore associated risk factors.

Methods:
A cross-sectional point prevalence study was conducted on January 28, 2020, at 14 intensive care units (ICUs) across 3 universities and 11 other tertiary care hospitals in Saudi Arabia. Delirium was screened once using the Intensive Care Delirium Screening Checklist. We excluded patients who were unable to participate in a valid delirium assessment, patients admitted with traumatic brain injury, and patients with documented dementia in their medical charts.

Results:
Of the 407 screened ICU patients, 233 patients were enrolled and 45.9% were diagnosed with delirium. The prevalence was higher in mechanically ventilated patients compared to patients not mechanically ventilated (57.5% vs. 33.6%; P < 0.001). In a multivariate model, risk factors independently associated with delirium included age (adjusted odds ratio [AOR], 1.021; 95% confidence interval [CI], 1.01–1.04; P = 0.008), mechanical ventilation (AOR, 2.39; 95% CI, 1.34–4.28; P = 0.003), and higher severity of illness (AOR, 1.01; 95% CI, 1.001–1.021; P = 0.026).

Conclusion:
In our study, delirium remains a prevalent complication, with distinct risk factors. Further studies are necessary to investigate long-term outcomes of delirium in critically ill patients in Saudi Arabia.
Acute kidney injury in critically ill adults
Authors: ElSeirafi Mohamed M. A. , Hasan Hasan M. S. N. , Sridharan Kannan , Toorani Mohamed Qasim , Pasha Sheikh Abdul Azeez , Mohiuddin Zafar , Alkhawaja Sana 
Published: June 2022

Background:
Wide differences in the estimates of acute kidney injury (AKI) have been reported in studies from various parts of the world. Due to dearth of data from the region, we carried out the present study to assess the incidence and the associated factors for AKI in our critically ill population.

Methods:
A prospective, observational study in critically ill adults who developed AKI was carried out. The diagnosis of AKI was attained by AKI Network (AKIN) criteria. The key details collected included details related to demographics, APCAHE score, concomitant diagnoses, whether mechanical ventilation was provided or not, radiological findings, drugs with potential nephrotoxicity, requirement of renal replacement therapy (RRT), whether recovered from AKI and time taken for recovery, duration of stay in the intensive care unit, and outcome (died/alive).

Results:
One hundred patients out of the total 560 with an incidence of 17.9% developed AKI. Forty-five had Stage 1, 22 had Stage 2, and 33 had Stage 3 AKI, and a significantly higher mortality was observed with Stage 3 AKIN Class compared to Stages 1 and 2. Two-thirds of the patients had septic shock, while 29 had contrast-induced nephropathy. Ninety-five patients received at least one drug with potential nephrotoxicity. Sixty-three patients recovered from AKI episodes. Only 29 patients underwent RRT of which 41% died.

Conclusion:
We observed an incidence of 17.9% for AKI in our critically ill patients. The estimates from this study will serve as a baseline for future studies in the region.
Intensive care unit delirium in patients with severe COVID-19
Authors: Smith Ryan J. , Lachner Christian , Singh Vijay P. , Cartin-Ceba Rodrigo 
Published: June 2022

Background:
Delirium is common in patients with severe coronavirus disease-19 (COVID-19). The purpose of our study was to determine whether severe COVID-19 is an independent risk factor for the development of delirium in patients treated in the intensive care unit (ICU).

Methods:
This prospective observational cohort study involved 162 critically ill patients admitted to a multidisciplinary ICU during 2019 and 2020. A validated screening tool was used to diagnose delirium. Multiple delirium risk factors were collected daily including clinical characteristics, hospital course, lab values, vital signs, surgical exposure, drug exposure, and COVID-19 characteristics. After univariate analysis, a multivariate logistic regression analysis was performed to determine independent risk factors associated with the development of delirium.

Results:
In our study population, 50 (31%) patients developed delirium. A total of 39 (24.1%) tested positive for COVID-19. Initial analysis showed COVID-19 to be more prevalent in those patients that developed delirium (40% vs. 17%; P = 0.003). Multivariate analysis showed opioid use (odds ratio [OR]: 24 [95% confidence intervals (CI): 16–27]; P ≤ 0.001), benzodiazepine use (OR: 23 [95% CI: 16–63] P = 0.001), and estimated mortality based on acute physiology and chronic health evaluation IV score (OR: 1.04 [95% CI: 1.01–1.07] P = 0.002) to be independently associated with delirium development. COVID-19 (OR: 1.44 [95% CI: 0.13–10.6]; P = 0.7) was not found to be associated with delirium.

Conclusion:
Delirium is prevalent in critically ill patients admitted to the ICU, including those with COVID-19. However, after adjustment for important covariates, we found in this cohort that COVID-19 was not an independent risk factor for delirium.
Evaluation of Clinical and Biochemical Parameters of Trinidadian Patients with Coronary Artery Disease for Predicting the Revascularization Strategy
Authors: Monplaisir Tamika Kachada , Nayak Shivananda B , Bhaktha Geetha , Ali Ronan , Mohan Surapaneni Krishna , Ambrose Jenifer Mallavarapu 
Published: June 2022

Background:
In recent times, optimal revascularization approaches have been used for treating multi-vessel obstructive coronary artery disease (CAD) patients. Based on the disease severity, making the decision to perform a suitable revascularization intervention in the patients is of paramount importance.

Aim:
This study aimed to evaluate the biochemical parameters of patients with suspected CAD in Trinidad and assess their clinical significance for predicting revascularization strategy.

Materials and Methods:
One hundred and twenty-four patients referred for angiography were recruited for the study. Biochemical parameters such as fasting blood sugar (FBS), lipid profile, cardiac enzymes, creatinine, uric acid, N-terminal probrain natriuretic peptide (NT-proBNP), soluble ST2, interleukin 6, and hemoglobin A1C (HbA1c) were explored. Similarly, we examined clinical parameters such as age, the presence of chronic conditions, and ethnicity.

Results:
With respect to revascularization strategies, FBS, NT-proBNP, HbA1c, and soluble ST2 correlated moderately with coronary artery bypass grafting (CABG) by Point-Biserial correlations: FBS-r = 0.196, P = 0.029, NT-proBNP-r = 0.208, P = 0.020, soluble ST2-r = 0.178, P = 0.048, and HbA1c-r = 0.282, P = 0.001. The presence of Type 2 diabetes (T2D) at baseline and ethnicity also formed statistically significant associations with CABG-ethnicity (χ2 (1) =7.267, P = 0.007) and T2D at baseline (χ2 (1) =12.858, P < 0.001).

Conclusion:
Ethnicity and presence of T2D were also significantly associated with both CAD severity and revascularization decision-making and should be taken into consideration for further study. Further investigation of these parameters might prove to be useful to predict the revascularization strategy required for treating CAD patients.
Evolution of SARS-CoV-2 variants: a mini-review
Authors: Musa-Booth T.O. , Adegboro B. , Medugu N. 
Published: June 2022

SARS-CoV-2 has evolved over time with several mutations, especially on the spike protein, which has led to emergence of various variants. With the evolution of SARS-CoV-2 come new challenges in surveillance, effectiveness of preventive and treatment strategies, and outcome of the disease. Despite the lockdowns, mask mandates and other preventive measures put in place, in addition to over 10 million vaccine doses that have been administered globally as of February 2022, COVID-19 cases have risen to over 435 million and resulted in over 5.9 million deaths, largely as a result of the evolution of SARS-CoV-2 variants. To review the evolution of these variants, we searched different online database sources using keywords such as “source of SARS-CoV-2”, “SARS-CoV-2 origin”, “evolution of SARS-CoV-2”, “SARS-CoV-2 variants”, “variants of concern”, “variants of interest”, and “variants of high consequence”. This was to enable us give a good report about the various variants of SARS-CoV-2 that have emerged so far, and the public health challenges posed by them.
Assessment of microbial quality and detection of extended spectrum β-lactamase genes in Gram-negative bacterial isolates of herbal mixtures commonly hawked in Sagamu metropolis, Ogun State, Nigeria
Authors: Olaniran O.B. , Ajayi S.E. , Oluwatobi O.B. , Adeleke O.E. 
Published: June 2022

Background: The use of herbal mixtures in the treatment of diseases is on the rise. Many of these herbal drugs are not produced under hygienic conditions and safety issues associated with herbal medicines may have an exacerbated impact in immunocompromised and elderly individuals. This study aimed to determine the microbial loads of locally prepared herbal mixtures and detect extended spectrum beta-lactamase (ESBL) genes in any isolated Gram-negative bacteria pathogen.
Methodology: Fifty local herbal mixtures were purchased randomly from three locations in Sagamu town (Sagamu market, Ita-Oba Road and Isale Oko) in Ogun State, Nigeria. The mean total viable bacterial (MTVB), mean total coliform (MTC), and mean total fungal (MTF) counts were determined by the plate count method. The bacterial isolates were streaked on differential bacteriological media while the fungi isolates were grown on potato dextrose agar. The isolates were identified upon growth on culture media using conventional biochemical tests. Antibiotic susceptibility pattern of the isolates was determined using Kirby-Bauer disk diffusion technique. Phenotypic detection of ESBL was done by the modified double disc synergy test followed by amplification detection of blaTEM, blaCTX-M and blaSHV genes with polymerase chain reaction (PCR) assay.
Results: Bacteria and fungi were isolated from 38 (76.0%) and 25 (50.0%) of the herbal samples respectively. Ten (20.0%) and 14 (28.0%) of the samples had mean bacterial and fungal load that exceeded 105CFU/mL or g, respectively. Nineteen (38.0%) of the herbal samples analyzed had total coliforms. Fifty-one isolates belonging to eight bacterial genera and 28 fungi isolates belonging to four fungal genera were obtained. Thirty- two (62.7%) of the bacterial isolates were Gram-negative while 19 (37.3%) isolates were Gram-positive. Staphylococcus aureus was the most common bacterial isolate (33.3%) while Aspergillus species was the most prevalent fungus (60.7%). Sixteen (84.2%) S. aureus and 26 (81.3%) Gram- negative isolates were multidrug resistant, and 6 (18.8%) of 32 Gram-negative isolates were ESBL producers. ESBL-encoding genes were detected in 7 (27%) of the 26 multidrug resistant Gram-negative bacteria with TEM and SHV being the most prevalent 4 (14.8%) while CTX-M was identified in only one isolate.
Conclusion: This study reported the presence of microbial contaminants which exceeded the safety limits of 105 CFU/g according to World Health Organization. The use of locally prepared herbal medicines poses a major health risk due to the lack of microbial quality standards.
Investigation of rodent reservoirs of emerging pathogens in Côte d'Ivoire, West Africa
Authors: Meite S. , Koffi K.S. , Kouassi K.S. , Coulibaly K.J. , Koffi K.E. , Sylla A. , Sylla Y. , Faye-Ketté H. , Dosso M. 
Published: June 2022

Background: One of the main health problems in West Africa remains upsurge of emerging pathogens. Ebola virus disease outbreak occurred in 2014 in Liberia, Guinea and Sierra Leone, Monkeypox virus in Nigeria in 2017 and most recently Lassa virus in Nigeria, Togo and Benin in 2018. These pathogens have animal reservoirs as vectors for transmission. Proper investigation of the pathogens in their rodent vectors could help reduce and manage their emergence and spread.
Methodology: This study was conducted with an approval from the Côte d’Ivoire Bioethics Community. Small mammal trappings were carried out in 9 sites within three zones namely, peri-urban, peri-rural and protected areas. Liver, lung and kidney tissues from trapped small mammals were sampled in accordance with the recommended conditions of biosafety and bioethics. The organs were transported in liquid nitrogen to the laboratory. Molecular tests were used to detect pathogens. Orthopoxviruses and Monkeypox virus were detected in the organs by PCR using consensus primers targeting the virus surface membrane haemagglutinin (HA) genes, while Leptospira species were detected by PCR using primers targeting the rrs and lfb1 genes.
Results: Out of 4930 night-traps, 256 (5.19%) small mammals were trapped including Crocidura, Rattus, Lophuromys, Praomys, Mus and Mastomys. Leptospira species were detected in 6 genera from 7 study sites and the infected small mammals accounted for 13.3%. Leptospira sp was detected mainly in the rodent vector genera Rattus (32.3%), Lophuromys (29.0%), and Praomys (16.1%). Three species of Leptospira were detected and Leptospira interrogans was the most common frequent species (74.2%). Monkeypox virus was not detected from studied small mammals.
Conclusion: The initial data from our investigation indicates the presence of Leptospira sp in rodent vectors, Rattus, Lophuromys and Praomys, which are the potential small mammalian reservoirs of this pathogen in Cote d’Ivoire.
Prediction of Liquid Accumulation in Gas Wells to Forecast the Critical Flowrate and the Loading Status of Individual Wells
Authors: Joseph A. , Bassey I. 
Published: June 2022

Liquid accumulation is a major problem in gas wells. The inability of gas to lift coproduced liquids to the surface imposes back pressure on the reservoir, limits the ultimate recovery and ultimately kills the well if improperly managed. Therefore, accurate prediction of its occurrence and reliable monitoring strategy is key to effectively handling liquid accumulation in gas wells. In this study, machine learning algorithms were used to develop regression and classification models to accurately predict the critical flowrate and the loading status of individual wells. The regression models used are the feed-forward neural network and a least squares support vector machine models while the decision trees model was used as the classification model to characterize the loading status of the wells investigated. These models were validated using actual published data and it was observed that the feed-forward neural network performed better in predicting the critical rate compared to the least squares support vector machine model with an R2 value of 0.9833, and thus was adopted. The feed-forward neural network model was further compared with other critical rate models; and a consistent result with least percent error of 5.571% was also observed. Form this study, it is obvious that the neural network model provide benefits and good prospects in investigating liquid loading phenomena in gas wells compared to empirical models that apply so many simplifying assumptions.
“A MORTE PEDE CARONA”: Klebsiella pneumoniae COMO AGRAVANTE NA INFECÇÃO POR Strongyloides stercoralis
Authors: Moreno Brenda de S. , Nascimento Letícia de A. , Azevedo Pedro Ricardo G. , Brandão Fabiana 
Published: June 2022

Introdução: Durante o ciclo evolutivo alguns helmintos realizam Ciclo de Loss, fenômeno que pode estar relacionado a um intrigante mecanismo de “carona” translocando bactérias intestinais para o pulmão. Neste contexto, há a associação entre Gram-negativa Klebsiella pneumoniae e o parasito nematódeo Strongyloides stercoralis, um evento mais comum que o documentado. K. pneumoniae está “intimamente” relacionada a elevadas taxas de sepse neonatal, infecção intestinal. Por outro lado, o geohelminto S. stercoralis causa a verminose com maior fator de risco para imunocomprometidos. Objetivo: Discutir a interação entre patógenos de domínios distintos, que quando presentes no mesmo hospedeiro agravam o desfecho clínico. Metodologia: Trata-se de uma revisão integrativa baseada no modelo PRISMA, evidenciando aspectos como epidemiologia, fatores de virulência e resistência, bem como relatos de casos de co-infecção entre S. stercoralis e K. pneumoniae. Resultado: A análise dos dados sugere que a translocação intestinal bacteriana é agravante em casos de estrongiloidíase, relacionada a quadros graves de coinfecções. Estudos apontam K. pneumoniae como uma das principais bactérias intestinais realocada por S. stercoralis. Considerações finais: São escassas as fontes de inquérito da coinfecção por esses organismos, o que pode prejudicar a interpretação dos desfechos clínicos, do controle e vigilância, além de limitar abordagens terapêuticas mais eficientes.