bluuebunny/crossref_metadata_2025 huggingface dataset:
A Comparison of Contiguous Two-level Anterior Cervical Discectomy and Fusion using a Structural Allograft versus a Polyetheretherketone (PEEK) Cage: The Results of a Three-Year Follow-up
Authors: MOO ING HOW , Kam Carmen Jia Wen , Lai Maksim Wen Sheng , Yeo William , Soh Reuben Chee Cheong
Published: March 2020

Background: Allografts and polyetheretherketone (PEEK) cages are the two most commonly used material in anterior cervical discectomy and fusion (ACDF). However, their effectiveness in in two-level ACDF remains controversial. The primary aim of this retrospective study is to compare the clinical and radiological outcomes of two-level ACDF with plate fixation using either a structural allograft or a PEEK cage.
Methods: From 2010 to 2015, 88 consecutive patients underwent a two-level ACDF of which 53 used an allograft and 35 patients with a PEEK cage. All PEEK cages were filled with local autografts. All clinical outcomes were prospectively collected preoperatively, at six months and at two years after surgery. Clinical efficacy was evaluated using visual analogue scale for neck pain and limb pain, the Neck Pain and Disability Score, Neck Disability Index, Neurogenic Symptom Score, and the Japan Orthopedic Association score. Radiological outcomes were assessed preoperatively, immediately after surgery, and at the final follow-up.

Results: A preoperative comparison revealed no difference between the two patient groups in terms of age, gender, body mass index, smoking status, preoperative symptoms, operated levels, and follow-up (mean= 42.8 months). No difference in improvements in the clinical outcome between the two groups was observed. Both groups showed significant improvement in mean disc height, segmental height, and segmental lordosis postoperatively. The fusion rates for PEEK cage was 100% at both levels while the fusion rates for allograft group was 98.1% at cephalad level and 94.2% at caudad level (p>0.05). Subsidence at the cephalad level occurred in 22.9% (8/35) segments in the PEEK group and 7.7% (4/52) segments in the allograft group (p=0.057). At the caudal level, a higher cage subsidence was noted in the PEEK group compared to the allograft group [37.1% (13/35) versus 15.4% (8/52)] (p=0.02). Overall, subsidence was noted in 30% (21/70) of the PEEK group and in 11% (12/104) of the allograft group (p<0.05).
Conclusion: The use of PEEK cages resulted in a higher rate of subsidence in two-level ACDF as compared to allograft. Two-level ACDF using either allografts or PEEK cages resulted in similar clinical outcomes, radiological improvements in alignment and fusion rates.
Incidence and Predictors of Tuberculosis Occurrence among Adults on Antiretroviral Therapy at Debre Markos Referral Hospital, Northwest Ethiopia: Retrospective Follow-up Study
Authors: Aemro Agazhe , Jember Abebaw , Anlay Degefaye Zelalem
Published: March 2020

Background : In resource limited settings, Tuberculosis (TB) is a major cause of morbidity and mortality among patients on antiretroviral treatment. Ethiopia is one of the 30 high TB burden countries. TB causes burden in healthcare system and challenge the effectiveness of HIV care. This study was to assess incidence and predictors of Tuberculosis among adults on antiretroviral therapy at Debre Markos Referral Hospital, Northwest Ethiopia, 2019. Methods : Institution based retrospective follow up study was conducted among adults on ART newly enrolled from 2014 to 2018 at Debre Markos Referral Hospital. Simple random sampling technique was used to select patients chart. Data was entered to EPI- INFO version 7.2.2.6 and analyzed using Stata 14.0. Tuberculosis incidence rate was computed and described using frequency tables. Both bivariable and multivariable Cox proportional hazard models was fitted to identify predictors of TB. Results : Out of the 536 patients chart reviewed, 494 patient records were included in the analysis. A total of 62 patients developed new TB cases during the follow up period of 1000.22 Person Years (PY); which gives an overall incidence rate of 6.19 cases per 100 PY (95% CI: 4.83 - 7.95). The highest rate was seen within the first year of follow up. After adjustment base line Hemoglobin < 10 g/dl (AHR= 5.25; 95% CI: 2.52 - 10.95), ambulatory/bedridden patients at enrolment (AHR = 2.31; 95% CI: 1.13 - 4.73), having fair or poor ART adherence (AHR = 3.22; 95% CI: 1.64 – 6.31) were associated with increased risk of tuberculosis whereas taking Isoniazid Preventive Therapy (IPT) (AHR = 0.33; 95% CI: 0.12 - 0.85) were protective factors of TB occurrence. Conclusion : TB incidence was high among adults on ART especially in the first year of enrollment to ART. Low hemoglobin level, ambulatory or bedridden functional status, non-adherence to ART and IPT usage status were found to be independent predictors. Hence, continuous follow up for ART adherence and provision of IPT has a great importance to reduce the risk of TB.
Adolescents’ Perception Of Dietary Behaviour In A Public School In Chile: A Focus Groups Study
Authors: Vio Fernando , Olaya Marcela , Yañez Marisol , Montenegro Edith
Published: March 2020

Background: The objective of this study was to assess dietary behavior among sixth- to eighth-grade students to inform the delivery and content of nutrition education. Methods: This was a qualitative study through focus groups. Subjects were 57 adolescents 10-14 years old, 30 males and 27 females distributed in six groups. To compare group responses, transcriptions were coded using the original question guide. The information was analyzed using the content analysis technique. Results: The main findings showed that adolescents knew dietary guidelines, but they consumed non-healthy food. They liked to cook but preferred fast food preparations. They increased fast food consumption on weekends and with friends. In utilization of Information Communication Technologies (ICT), all students had access to technology through mobile phones, tablets and computers and were open to have an interactive program with personal information about diet and behavior. Conclusions: Adolescents dietary behavior is not healthy and can be changed with interactive programs considering participation, personal information and utilizing ICT. Keywords: adolescents, community health promotion, dietary behavior, qualitative methods, focus groups
Prevalence of postpartum depression and associated factors among postnatal care attendees in Debre Berhan, Ethiopia, 2018.
Authors: wubetu abate Dargie , Engidaw Nigus Alemnew , Gizachew Kefyalew Dagne
Published: March 2020

Background: Postpartum depression explains various groups of depressive symptoms and syndromes that can take place during the first 6 weeks following birth. The postpartum period is a critical time where both mild and severe mood disorders can occur. The familiar forms are baby blues and postpartum depression. Understanding the prevalence and associated factors of postpartum depression is mandatory for early detection and treatment.
Methods: Institution based cross-sectional study was conducted from 1st May to June 30, 2018. The study participants were eligible women who came to Debre Berhan referral hospital and health centers for postnatal care and vaccination service. The Edinburgh postnatal depression scale was used to assess postpartum depression. A systematic random sampling technique was used to collect the data after determining the skip fraction (k=2). The collected data were coded and entered into Epi-info version 7 and transported to SPSS version 20 for analysis. Both bivariate and multivariate binary logistic regression were done to identify associated factors. During bivariate analysis, variables with p-value < 0.05 were included in multivariate analysis. Odds ratios and their 95% confidence intervals were computed and variables with p-value less than 0.05 were considered to declare significantly associated factors (multivariate analysis).
Putting RFMix and ADMIXTURE to the test in a complex admixed population
Authors: Uren Caitlin , Hoal Eileen G. , Möller Marlo
Published: March 2020

Background
Global and local ancestry inference in admixed human populations can be performed using computational tools implementing distinct algorithms. The development and resulting accuracy of these tools has been tested largely on populations with relatively straightforward admixture histories but little is known about how well they perform in more complex admixture scenarios.
Results
Using simulations, we show that RFMix outperforms ADMIXTURE in determining global ancestry proportions even in a complex 5-way admixed population, in addition to assigning local ancestry with an accuracy of 89%. The ability of RFMix to determine global and local ancestry to a high degree of accuracy, particularly in admixed populations provides the opportunity for more accurate association analyses.
Conclusion
This study highlights the utility of the extension of computational tools to become more compatible to genetically structured populations, as well as the need to expand the sampling of diverse world-wide populations. This is particularly noteworthy as modern-day societies are becoming increasingly genetically complex and some genetic tools and commonly used ancestral populations are less appropriate. Based on these caveats and the results presented here, we suggest that RFMix be used for both global and local ancestry estimation in world-wide complex admixture scenarios particularly when including these estimates in association studies.
Third molar agenesis in modern humans with and without agenesis of other teeth
Authors: Scheiwiller Maya , Oeschger Elias S. , Gkantidis Nikolaos
Published: March 2020

Background The number of teeth in the human dentition is of interest both from developmental and evolutionary aspects. The present case-control study focused on the formation of third molars in modern humans aiming to shed more light on the most variable tooth class in the dentition. Methods For this reason, we investigated third molar formation in a sample of 303 individuals with agenesis of teeth other than third molars (agenesis group) and compared it to a sex and age matched control group of 303 individuals without agenesis of teeth other than third molars. Results The prevalence of third molar agenesis in the agenesis group was 50.8%, which is significantly higher than the 20.5% in the control group (p < 0.001). The chance of a missing third molar in the agenesis group was increased by 38.3% (p < 0.001), after controlling for the agenesis in other teeth factor. When considering the amount of missing third molars per individual, a clear tendency towards more missing third molars was evident in the agenesis group compared to the control group. The frequency of bilaterally missing third molars in the agenesis group was 29% in the maxilla, as well as in the mandible, which is about three times higher than the frequency of unilaterally missing third molars (p < 0.001). In the control group, bilaterally missing third molars occurred in 8.6% in the maxilla and 8.9% in the mandible. Conclusion The present results indicate that genetic factors involved in tooth agenesis affect also the dentition as a whole. Furthermore, the third molars are more vulnerable to factors involved in agenesis of other teeth and they are more often affected as a whole. These findings seem to be associated with the evolutionary trend in humans towards reduced molar number.
Lenticulostriate arteries appearance before thrombectomy predicts good outcome in acute middle cerebral artery occlusion
Authors: Liu Feifeng , Chen Chen , Hong Lan , Shen Hao , Cao Wenjie , Dong Qiang , Yang Xinyi , Guo Mengruo , Li Ying , Xiao Yaping , Cheng Xin , Li Gang
Published: March 2020

Purpose Endovascular therapy is widely used in acute large vessel occlusion. This study investigated whether imaging of lateral lenticulostriate arteries(LSAs) before thrombectomy would potentially be helpful for predicting prognosis of patients with acute M1 segment of middle cerebral artery occlusion(MCAO). Methods 59 consecutive patients with acute M1 segment of MCAO treated with mechanical thrombectomy at two comprehensive stroke center were analyzed. Patients were categorized into LSA+ (appearing of lateral LSAs) and LSA- (sparing of lateral LSAs) group according to preprocedural digital substraction angiography (DSA).Baseline data and clinical outcomes were compared. A good clinical outcome was defined as a modified Rankin Scale score of 0 to 2 at 3 months. The association between clinical and imaging parameters and functional outcome was evaluated with logistic regression analysis. Results LSA+ was shown in 36 patients (61%). LSA+ group had a significantly higher proportion of good outcome (72.2% vs. 8.7%, OR 27.3,95% CI 5.38-138.4, P <0.001), lower risk of symptomatic intracranial haemorrhages (sICH) (8.3% vs. 47.8%,OR 0.10,95% CI 0.02-0.42, P =0.001) and lower mortality in hospital (5.6% vs. 34.8%, OR 0.11,95% CI 0.02 -0.58, P <0.004) compared with LSA- group. Patients in LSA+ group had lower baseline NIHSS score( P <0.01) and NIHSS score at 14 days( P <0.01) and smaller infarct core volume( P =0.016) on computed tomography perfusion imaging (CTP) compared to the LSA- group. Multivariate logistic regression analysis showed that a small infarct core volume (OR 6.74,95% CI 1.148-39.569, P =0.035) and LSA+(OR 22.114,95% CI 3.339-146.470, P =0.001) were associated with a good clinical outcome. Conclusions Our data suggest that appearance of lateral LSAs before mechanical thrombectomy would be potentially helpful for predicting favorable prognosis of patients with acute M1 segment of MCAO.
Urinary continence outcomes of four years of follow-up and predictors of early and late urinary continence in patients undergoing robot-assisted radical prostatectomy
Authors: Li Xing , Zhang Huan , Jia Zhuo , Wang Yunpeng , Song Yong , Liao Limin , Zhang Xu
Published: March 2020

Background: The robot-assisted radical prostatectomy (RARP) has been widely applied in recent years; however, only a few studies are reported about long-term urinary continence after surgery. The present study aimed to examine the outcomes of continence rates (CRs) and determine the risk and protective factors of urinary continence in patients with prostate cancer (PCa) undergoing RARP. Methods: This retrospective study included 650 patients treated with RARP with perioperative data and at least one year of follow-up from January 2009 to November 2017. Also, the preoperative, intraoperative, and postoperative parameters of the patients were analyzed. Continence was defined as no pad use. Early and late continence was defined as the return of urinary continence within 3 months and beyond 12 months post-surgery, respectively. CRs were examined from 1–48 months postoperatively. Logistic regression analysis evaluated the association between the predictive factors and urinary continence in the early and late stages. Results: No significant difference was detected in the CR from 12–48 months postoperatively (P=0.766). Logistic regression analysis proved that pelvic lymph node dissection (PLND) was a significant risk factor of urinary continence at 1 month. Nerve-sparing (NS) was a significant protective factor of urinary continence at 1, 3, and 6 months. Advanced age was an independent risk factor of urinary continence at 6, 12, and 24 months. Other variables were not statistically significant predictors of urinary continence. Conclusions: The current results demonstrated that CR gradually improved with time within 1 year and stabilized 1 year after the surgery. PLND, NS, and age were significant determinants of continence in the early and late stages, respectively. These parameters could be used for preoperative identification of patients at high risk and counseling about postoperative expectations for urinary continence.
LncRNA MALAT1 exhibits positive effects on nucleus pulposus cell biology in vivo and in vitro by sponging miR-503
Authors: Zheng Hongyu , Wang Tingting , Li Xiangmin , He Wei , Gong Zhiqiang , Lou Zhenkai , Wang Bing , Li Xingguo
Published: March 2020

Background: Intervertebral disc degeneration (IDD) is characterized by the loss of nucleus pulposus cells (NPCs) and phenotypic abnormalities. Accumulating evidence suggests that long noncoding RNAs (lncRNAs) are involved in the pathogenesis of IDD. In this study, we aimed to investigate the functional effects of lncRNA MALAT1 on NPCs in IDD and the possible mechanism governing these effects. Results: We validated the decreased expression of MALAT1 in the IDD tissues, which was associated with decreased Collagen II and Aggrecan expression. In vitro, overexpressed MALAT1 could attenuate the effect of IL-1β on NPC proliferation, apoptosis, and Aggrecan degradation. In vivo, MALAT1 overexpression attenuated the severity of disc degeneration in IDD model rats. Our molecular study further demonstrated that MALAT1 could sponge miR-503, modulate the expression of miR-503, and activate downstream MAPK signaling pathways. The effects of MALAT1 on NPCs were partially reversed/aggregated by miR-503 mimics/inhibitor treatment. Conclusion: Our data suggested that the MALAT1-miR-503-MAPK pathway plays a critical role in NPCs, which may be a potential strategy for alleviating IDD.
Cone Beam Computed Tomography (CBCT) in Periodontal Diseases: A Systematic Review Based on the Efficacy Model
Authors: Assiri Hassan , Dwasaz Ali , Alahmari Ahmad AA , Asiri Zuhair A
Published: March 2020

Objectives The aim of this study was to address the diagnostic efficacy of cone beam computed tomographic (CBCT) imaging in periodontics based on a systematic search and analysis of the literature using the hierarchical efficacy model. Methods A systematic search of the electronic databases such as PubMed, Scopus, Web of Science, and Cochrane was conducted until February 2019 to identify studies addressing the efficacy of CBCT imaging in Periodontics. The identified studies were subjected to pre-identified inclusion criteria followed by an analysis using a hierarchical model of efficacy (model) designed for an appraisal of the literature on a diagnostic imaging modality. Two examiners performed the eligibility and quality assessment of relevant studies, and consensus was reached where disagreement was found. Results The search resulted in 64 studies. Of these, 35 publications were allocated to the relevant level of efficacy and quality assessments wherever applicable. The overall diagnostic accuracy studies showed the risk of bias and applicability concerns in the use of CBCT to be low to moderate. In addition, CBCT is accurate in identifying periodontal defects when compared to other modalities. The studies on the level of patient outcomes agreed that CBCT is a reliable tool for the assessment of the outcomes after the treatment of periodontal defects. Conclusion CBCT was found to be beneficial and accurate in cases of infra-bony defects and furcation involvements.
Dietary patterns of Brazilian farmers and their relation with sociodemographic, labor, and lifestyle conditions
Authors: Cattafesta Monica , Petarli Glenda Blaser , Luz Tamires Conceição da , Zandonade Eliana , Bezerra Olívia Maria de Paula Alves , Salaroli Luciane Bresciani
Published: March 2020

Background: The eating habits have changed in the last few decades, but few studies prioritize the food consumption of farmers and the rural population. In this scenario, the objective of this paper was to define the dietary patterns of farmers in a Brazilian municipality and explore the sociodemographic, occupational and lifestyle factors to the high adherence these dietary patterns.
Methods: This is a cross-sectional epidemiological study of 740 farmers (51.5%, n=381 males; 48.5%, n=359 females) from a municipality in Southeastern Brazil. Food intake data were obtained by applying multipass 24-hour recall and dietary intake was presented in dietary patterns determined by Principal Component Analysis with varimax orthogonal rotation.Results: Three dietary patterns were identified. The first pattern, “local traditional”, was associated with sociodemographic and labor variables, being considered typical of the region's farmer as white race/color (p=0.003), not extra-physical activity (p=0.014) and cultivating 5 or more crops (p=0.005). The permanence of a “traditional Brazilian” pattern and the occurrence of an “industrialized” pattern were also observed. Farmers working in non-conventional agriculture were 54% less adhere to “traditional Brazilian” pattern (OR 0.46, 95% CI 0.25–0.86, p=0.014). Individuals aged 50 and over years were 82% less likely (OR 0.18, 95% CI 0.10–0.30) to adhere to “industrialized” pattern. Still, individuals of lower socioeconomic class were 52% less likely to adhere to this pattern (OR 0.48, 95% CI 0.24–0.96). Farmers who spent R$ 200 or more per capita to buy food were more than twice as likely to adhere to this food pattern (95% CI 1.32–3.73), and who had the habit of frequently eating out were 1.62 as likely adhere to “industrialized” pattern (95% CI 1.11–2.36).
Conclusion: The findings indicate changes in dietary patterns in rural areas of the country, maintaining a traditional Brazilian pattern, as well as a local and an industrialized pattern. This last pattern demonstrates that the contemporary rural population also opts for a diet with ultra-processed products, being associated with the characteristic habits of a more urbanized rural region.
Associations of CXCL1 gene 5’UTR variations with ovarian cancer
Authors: Guo Man , Xu Chao , Chen Yan-Zhe , Sun Qi-Wen , Zhao Xin-Ying , Liu Xin , Yang Yi , Hu Yi-Yan , Li Fei-Feng , Liu Shu-Lin
Published: March 2020

Background: There are about 2.4 hundred thousand new cases and 1.5 hundred thousand deaths of ovarian cancer (OC) annually in the world. Chronic inflammation is a risk factor for OC. C-X-C motif chemokine ligand 1 (CXCL1) defects may facilitate inflammation and transactivate EGFR in ovarian cancer, but the precise haplotypes associated with the potential diseases remained largely unknown. In this work, we characterized CXCL1 gene variations to elucidate their possible associations with OC.
Methods: We analyzed the CXCL1 gene for 300 OC patients with 400 healthy participants as controls. The statistical analyses and Hardy-Weinberg equilibrium tests of the patients and control populations were conducted using the SPSS software (version 19.0) and Plink (version 1.9).
Results: The variants rs11547681, rs201090116, rs199791199, rs181868085, rs4074 and rs1814092 within or near the CXCL1 gene were characterized. The genetic heterozygosity of rs11547681 and rs4074 was very high. Statistical analysis showed that the variant rs11547681 in the gene was closely associated with the risk of OC in the Chinese Han population, although this variant was not associated with FIGO stages or pathological grades of the patients.
Conclusions: Rs11547681 in CXCL1 gene was associated with the risk of OC in the Chinese Han population.
Influence of genetic polymorphisms in homocysteine and lipid metabolism systems on antidepressant drug response
Authors: Yuan Baoyu , Sun Xiaoyan , Xu Zhi , Pu Mengjia , Yuan Yonggui , Zhang Zhijun
Published: March 2020

Background: Variation in genes implicated in homocysteine and lipid metabolism systems may influence antidepressant response. This study was aimed to investigate how the MTHFR, ApoE and ApoA4 polymorphisms determine this response to treatment. Methods: A total of 281 Han Chinese patients received a single antidepressant drug (SSRI or SNRI) for at least 6 weeks. The Hamilton Depression Rating Scale (HDRS-17) was used to evaluate the severity of depressive symptoms and the therapeutic effects of the drug administered. Eight single nucleotide polymorphisms (SNPs) of MTHFR, ApoE and ApoA4 genes were detected using gene chips. Differences in clinical variables between the responders and non-responders, as well as between remission and non-remission groups, were examined using the independent samples t test and Pearson’s χ2 test. In addition, the associations of single loci and haplotypes with treatment response were analyzed. Results: Haplotype (C-A) in MTHFR (rsl801133 and rs1801131) was significantly associated with better antidepressant response in the 8-week antidepressant group overall (P = 0.0007), and in the male subgroup (P = 0.003), and SNRI subgroup (P = 0.001). The ApoE rs405509 C allele was significantly associated with worse antidepressant response in the 6-week male subgroup (P = 0.004), while the 405509 AA genotype was associated with better antidepressant efficacy in the 6-week group overall (P = 0.006) and male subgroup (P = 0.002). Haplotype (G-A) in APOE (rs7412 and rs405509) was significantly associated with better antidepressant response in 6-week male subgroup (P = 0.003), G-C haplotype was associated with better response in 6-week SNRI subgroup；APOA4 rs5092 G allele was associated with worse antidepressant response in 6-weeks male subgroup (P = 0.037), SNRIs subgroup (P = 0.097) and 8-weeks female subgroup (P = 0.045)；APOA4 rs5092 GG genotype was associated with worse antidepressant efficacy in 6-week SNRI subgroup (P = 0.008). Conclusions: The haplotype in MTHFR (rs1801131-rs1801133) C-A type was associated with better antidepressant efficacy, especially in males and in patients using SNRIs. The efficacy of antidepressants may be better in ApoE rs405509 A allele and AA genotype carriers, but worse in ApoA4 rs5092 G allele and GG genotype carriers.
Hypophosphataemia after ferric carboxymaltose is unrelated to symptoms, intestinal inflammation or vitamin D status
Authors: Fang Wendy , Kenny Rachel , Rizvi Qurat-ul-Ain , McMahon Lawrence P. , Garg Mayur
Published: March 2020

Background
Intravenous iron replacement is recommended for iron-deficient patients with inflammatory bowel disease (IBD), but may be associated with hypophosphataemia, predisposing to osteomalacia and fractures. This study aimed to evaluate the incidence and risk factors for hypophosphataemia following intravenous ferric carboxymaltose (FCM) in patients with IBD.

Methods
This prospective observational study of patients with and without IBD evaluated serum phosphate for 28 days following intravenous FCM, and assessed associations with symptoms, markers of inflammation and vitamin D status.

Results
24 patients with IBD (11 with Crohn’s disease [CD], 13 with ulcerative colitis [UC], mean age 45 years [range 19-90], 7 female), and 20 patients without IBD (mean age 56 [22-88]y, 11 female), were included. Overall, serum phosphate declined by a mean of 36% at Day 7, with a mean fall of 42% (SD 19%) at some time point over 28 days (p<0.001). Twenty-four of 44 (55%) patients developed moderate to severe hypophosphataemia (serum phosphate <0.6 mmol/L). No differences between patients with and without IBD were seen, but patients with CD had greater decline in phosphate than those with UC. There was no association between hypophosphataemia and symptomatic adverse events, faecal calprotectin, C-reactive protein, albumin, platelet count, 25(OH) vitamin D, or 1,25(di-OH) vitamin D. Serum phosphate <1.05mmol/L on Day 2 predicted susceptibility to moderate-severe hypophosphataemia (OR 7.0).

Conclusions
Hypophosphataemia following FCM is common, unrelated to symptomatic adverse events, baseline intestinal or systemic inflammation, or vitamin D status.
The outcome for surgical fixation of distal radial fractures in patients with Idiopathic Parkinson’s Disease: a cohort study
Authors: Chou Te-Feng , Chang Chun Yao , Huang Chun-Ching , Chang Ming-Chau , Chen Wei-Ming , Huang Tung-Fu
Published: March 2020

Introduction : Idiopathic Parkinson’s Disease (PD) is a progressive neurologic disorder causing postural instability and unsteady gait. These patients are at increased risk for fractures and have inferior outcomes after treatment. Several studies have evaluated the incidence and outcome of PD patients after hip fractures. However, there are limited studies assessing the outcome of upper extremity fractures in these patients. In this study, we evaluated the outcome of PD patients that received surgical intervention for distal radial fractures (DRF). We hypothesize that these patients have an inferior outcome after surgery in comparison with non-PD patients. Methods : Between May 2005 through May 2017, we retrospectively reviewed all of the patients with DRF and subsequently underwent open reduction and internal fixation (ORIF) at a level 1 trauma center. All of the surgeries were performed by fellowship trained orthopedic surgeons. The inclusion criteria include patients with a definitive diagnosis of PD, non-pathological DRF and a minimum follow-up of 1 year or up until the time of treatment failure was noted. Each PD patient was matched for age and gender to 3 non-PD patients. The primary objective was to determine the failure rate after surgical fixation for DRF. The secondary outcomes include time to treatment failure, reoperation rate, readmission rate, length of hospital stay, and postoperative complications. Results : A total of 88 patients were included in this study (23 PD, 65 non-PD patients). All underwent ORIF and received standard postoperative follow-ups. The overall treatment failure rate in PD was 39.1% vs. 4.6% in the non-PD group (p<0.05). The time to treatment failure were 9.11 ± 3.86 weeks and 14.67 ± 5.8 weeks for PD and non-PD, respectively (p<0.05). PD patients had a significantly higher rate of failure when k-wires and ESF were used (p<0.05), while loss of reduction was the most common mode of failure in PD (44.4%) The length of hospital stay for PD was 5.3 ± 4.69 days compared with 3.78 ± 0.96 days for non-PD (p=0.01). There were 3 PD patients readmitted within 30 days after surgery, and 1 patient had pneumonia after the surgery. Conclusion: This study revealed that patients with PD have a high treatment failure rate despite surgical intervention for DRF. PD patients had a longer hospital stay and had a shorter time to treatment failure. In treating PD patients complicated with DRF, the surgeon must take into consideration the complex disease course of PD and the associated comorbidities such as osteoporosis, frail status, and frequent falls. Rehabilitation and disposition plans should be discussed in advance and longer hospital stays should be expected. Level of evidence: Level IV, Retrospective Cohort Study Keywords: Parkinson’s disease, distal radial fractures, osteoporosis, fracture nonunion Disclosure: We do not have any disclosures or conflicts of interest
Effect of Gum Arabic (Acacia Senegal )on C-reactive protein level among Sickle Cell Anemia patients
Authors: Kaddam Lamis AbdelGadir , Kaddam Anas Suliman
Published: March 2020

Objectives: Inflammation is ongoing process among sickle cell anemia even during steady state. C reactive protein (CRP) is cardinal marker that utilized widely as inflammatory indicator. Gum Arabic (GA) is gummy exudates from Acacia Senegal tree. Fermentation by colonic bacteria increases serum butyrate concentrations, so considered as prebiotic agent. Gum Arabic (GA) has anti-inflammatory activity through butyrate. Earlier we proved that regular intake of GA increased fetal hemoglobin and anti-oxidant capacity most likely through raised level of butyrate, which would ameliorate symptoms of sickle cell anemia. Best of our knowledge this is the first study conducted to investigate GA intake on inflammatory markers among sickle patients. Results : This was a retrospective study conducted on stored samples from trial of Gum Arabic and sickle cell anemia. Quantitative CRP was measured by Mindray BS 200 before and after Gum Arabic consumption for 12 weeks. Daily intake of GA significantly decreased C reactive protein level (P.V=001) (95% CI, 0.943 -3.098). No correlation between CRP and age, fetal hemoglobin, hemolysis markers and white blood cells. Our findings revealed novel effect of GA as anti-inflammatory agent can be consumed as natural dietary supplement to modulate disease severity and downregulate inflammatory process.
The effect of using awake craniotomy combined with multimodal techniques intraoperatively on the survival of patients with glioblastoma: A retrospective single-centre study
Authors: zhou hui , Yang Li , Lu Ming , Deng Xqing , Yang Mming
Published: March 2020

Background :We analysed outcomes of cerebral glioblastoma patients undergoing awake craniotomies combined with multimodal techniques for tumour resection, with regards to the extent of resection, functional preservation, and prognosis.
Methods : A retrospective analysis was conducted on adult glioblastoma patients who underwent an awake craniotomy from September 2010 to August 2018 under anaesthesia combined with multimodal techniques.
Results: In total, 81 glioblastoma patient charts were analysed. The most common lesion sites were the frontal lobe (n=36), temporal lobe (n=17), and parietal lobe (n=6). The main symptoms were headache (n=51), dyskinesia (n=11), speech disorder (n=9), and epilepsy (n=10). The extent of resection was gross total for 91.36% patients, subtotal for 7.41%, and partial for 1.23%. No deaths occurred 30 days post-operation. Intracranial haemorrhage occurred in 2 patients, seizures in 5 patients, and intracranial infections in 3 patients. There was no significant difference between preoperative and postoperative Karnofsky Performance Status scores (P>0.05). There were no significant changes in postoperative neurological function in 50 patients. Symptoms improved in 24 patients. Three patients exhibited motor dysfunction, 2 exhibited speech deficits, and 2 exhibited sensory deficits. The average duration of hospitalization was 6.89±2.66 days. The shortest survival time was 4 months, the longest survival time was 26 months, and the median survival time was 12 months.
Conclusions: Awake craniotomy using multimodal techniques such as neuronavigation, intraoperative ultrasound, electrophysiology, and tumour fluorescence during an operation can maximize safety during the cerebral glioblastoma resection, thus protecting brain function and improving surgical efficacy and patients’ postoperative quality of life.
Antimicrobial Sensitivity pattern of Bacteria Causing Urinary Tract Infection among Diabetic Patients
Authors: Thapa Pratima , Sunar Anita , Lamichanne Dipendra , K.C Apeksha , Dhungana Arjan , Paudel Rajan , Jaiswal Suresh , Tiwari Bishnu Raj
Published: March 2020

Urinary tract infection is the presence and active multiplication of microorganism within the urinary tract. UTIs are group of infections that affects any part of urinary tract. The cross sectional descriptive study was conducted to determine the antibiotic sensitivity pattern of bacteria causing urinary tract infection in diabetic and non-diabetic patient from February 2016 to March 2016. Among the total 601 urine sample, 250 were diabetics and 351 were non diabetics. All samples were investigated by standard laboratory procedures. Out of diabetic patient 111(44.4%) were female and 139(55.6%) were male and among non-diabetic, 234(66.7%) were female and 117(33.3%) were male. The UTI prevalence rate was found to be 78 (13%) was statistically significant (p = 0.02), among the significant growth 6.8% diabetic and 6.2% non-diabetic. Escherichia coli (54) was the most predominant organism (42.5% in diabetic and 57.5% non-diabetic) followed by Staphylococcus aureus (8). Amikacin, Cotrimoxazole and Nitrofurantoin were most sensitive to E. coli isolated in diabetic and non-diabetic patients among the tested antimicrobials. High rate of resistance was observed with Norfloxacin and Nalidixic acid. Gentamicin, Cefotaxime, Cotrimoxazole and Ciprofloxacin were highly sensitive to S. aureus in diabetic patients while Oxacillin and Azithromycin were resistance and in non-diabetic patient highly sensitive antimicrobials were Azithromycin, Gentamicin, Cefotaxime, Cotrimoxazole, Vancomycin and Ofloxacin while Oxacillin was resistance. The antimicrobial susceptibility testing of bacterial isolates should be performed before the treatment of UTI. Key words : Diabetic, Urinary tract infection, Antimicrobial sensitivity.
The whole blood phagocytosis assay: a clinically relevant test of neutrophil function and dysfunction in community-acquired pneumonia
Authors: Reiné Jesús , Rylance Jamie , Ferreira Daniela , Pennington Shaun , Welters Ingeborg Dorothea , Parker Robert , Morton Ben
Published: March 2020

OBJECTIVE: To refine and validate a neutrophil function assay with clinical relevance for patients with community-acquired pneumonia (CAP). Design: Two phase cross-sectional study to standardise and refine the assay in blood from healthy volunteers and test neutrophil phagocytic function in hospital patients with CAP. Participants : Phase one: Healthy adult volunteers (n=30). Phase two: Critical care patients with severe CAP (n=16), ward-level patients with moderate CAP (n=15) and respiratory outpatients (no acute disease, n=15). RESULTS: Our full standard operating procedure for the assay is provided. Patients with severe CAP had significantly decreased neutrophil function compared to moderate severity disease (median phagocytic index 2.8 vs. 18.0, p=0.014). Moderate severity pneumonia neutrophil function was significantly higher than control samples (median 18.0 vs. 1.6, p=0.015). There was no significant difference between critical care and control neutrophil function (median 2.8 vs. 1.6, p=0.752). Conclusions: Our whole blood neutrophil assay is simple, reproducible and clinically relevant. Changes in neutrophil function measured in this pneumonia cohort is in agreement with previous studies. The assay has potential to be used to identify individuals for clinical trials of immunomodulatory therapies, to risk-stratify patients with pneumonia, and to refine our understanding of ‘normal’ neutrophil function in infection.
Mathematical model of blood glucose dynamics by emulating the pathophysiology of glucose metabolism in type 2 diabetes mellitus
Authors: López-Palau Nelida Elizabeth , Olais-Govea José Manuel
Published: March 2020

This work addresses a physiological-based mathematical model of blood glucose dynamics in Type 2 Diabetes Mellitus (T2DM). The model emulates the pathophysiology of the T2DM metabolism including the gastric emptying effect and the enhancing effect on insulin due to the incretin hormones. Its mathematical structure considers a model of blood glucose dynamics of healthy humans developed with a physiological-based pharmacokinetic-pharmacodynamic approach. Then, the mathematical functions, representing the metabolic rates with a relevant contribution to hyperglycemia, are individually fitted to clinical data of T2DM patients. Methodologically, it allows emulating the pathophysiology of the T2DM condition. Numerically, the resulting model simulates successfully a programmed graduated intravenous glucose test and different-doses oral glucose tolerance tests. The comparison between simulations and clinical data shows a good agreement description of the blood glucose dynamics in T2DM and, it opens the likelihood of using this model to develop model-based controllers for blood glucose regulation in T2DM.
Mechanisms of Ranolazine Pretreatment in Preventing Ventricular Tachyarrhythmias in Diabetic db/db Mice with Acute Regional Ischemia-Reperfusion Injury
Authors: Chou Chung-Chuan , Lee Hui-Ling , Chang Gwo-Jyh , Wo Hung-Ta , Yen Tzung-Hai , Wen Ming-Shien , Chu Yen , Liu Hao-Tien , Chang Po-Cheng
Published: March 2020

Background: Studies have demonstrated that db/db mice have increased susceptibility to myocardial ischemia-reperfusion (IR) injury and ventricular tachyarrhythmias (VA). We aimed to investigate the antiarrhythmic and molecular mechanisms of ranolazine in db/db mouse hearts with acute IR injury.Methods: Ranolazine was administered for 1 week before coronary artery ligation. Diabetic db/db and control db/+ mice were divided into ranolazine-given and -nongiven groups. IR model was created by 15-min left coronary artery ligation and 10-min reperfusion. In vivo electrophysiological studies and optical mapping to simultaneously record intracellular Ca2+ (Cai) and membrane voltage in Langendorff-perfused hearts were performed. Western blotting and whole-cell patch clamp study were performed to evaluate the effect of ranolazine in the non-IR and IR zones. Results: The severity of VA inducibility by burst pacing was higher in db/db mice than db/+ mice with acute IR injury. Ranolazine suppressed VA inducibility and severity in db/db and db/+ mice. Optical mapping studies showed that ranolazine significantly shortened action potential duration (APD80), Cai transient duration (CaiTD80), Cai decay time, ameliorated conduction inhomogeneity, and suppressed arrhythmogenic alternans induction. The expression of pThr17-phospholamban, calsequestrin 2 and SCN5A in the IR zone was significantly downregulated in db/db mice, which was ameliorated by ranolazine. Conclusions: Ranolazine pretreatment shortens APD80 and CaiTD80, reduces Cai decay time, and ameliorates conduction velocity inhomogeneity to suppress induction of arrhythmogenic alternans and VA; and amelioration of downregulation of pThr17-phospholamban, calsequestrin 2 and SCN5A may partly underlie the anti-arrhythmic molecular mechanisms of ranolazine in db/db mouse hearts with IR injury.
Effect of 1,5-anhydroglucitol levels on culprit plaque rupture in diabetic patients with non-ST segment elevation acute coronary syndrome
Authors: Su Gong , Gao Ming-Xi , Yao Wei-Feng , Dai Xi-Xi , Shi Gen-Ling , Zhang Tao , Zhuang Shao-Wei
Published: March 2020

Background Postprandial hyperglycemia was reported to play a key role in established risk factors of coronary artery diseases (CAD) and cardiovascular events. Serum 1,5-anhydroglucitol (1,5-AG) levels are known to be a clinical marker of short-term postprandial glucose (PPG) excursions. Low serum 1,5-AG levels have been associated with occurrence of CAD; however, the relationship between 1,5-AG levels and coronary plaque rupture has not been fully elucidated. The aim of this study was to evaluate 1,5-AG as a predictor of coronary plaque rupture in diabetic patients with non-ST segment elevation acute coronary syndrome (NSTE-ACS).Methods A total of 132 diabetic patients with NSTE-ACS were included in this study. All patients underwent intravascular ultrasound examination, which revealed 38 patients with plaque rupture and 94 patients without plaque rupture in the culprit lesion. Fasting blood glucose (FBS), hemoglobin A1c (HbA1c) and 1,5-AG levels were measured before coronary angiography. Fasting urinary 8-iso-prostaglandin F2α (8-iso-PGF2α) level was measured and corrected by creatinine clearance. Results Patients with ruptured plaque had significantly lower serum 1,5-AG levels and a tendency of higher HbA1c levels than patients without ruptured plaque in our study population. In multivariate analysis, low 1,5-AG levels were an independent predictor of plaque rupture (odds ratio 3.3; p = 0.006) in diabetic patients with NSTE-ACS, but HbA1c was not. The area under the receiver-operating characteristic curve for 1,5-AG (0.678, p = 0.001) to predict plaque rupture was superior to that for HbA1c (0.618, p = 0.034). Levels of 1,5-AG were significantly correlated with urinary 8-iso-PGF2α levels (r=-0.224, p = 0.010).Conclusions Serum 1,5-AG may identify high risk for coronary plaque rupture in diabetic patients with NSTE-ACS, which suggests PPG excursions are related to the pathogenesis of plaque rupture in diabetes.
Microcirculatory effects of norepinephrine in patients with septic shock: a microdialysis study
Authors: Fatnassi Amira , Romdhani Chihebeddine , Kaabi Widd , Labbene Iheb , Hajjej Zied , Sellami Walid , Ferjani Mustapha
Published: March 2020

Background: The management of septic shock requires the administration of an alpha-adrenergic drug such as norepinephrine, after optimization of the patient’s preload, to maintain adequate mean arterial pressure. Nevertheless, with optimal macrocirculatory parameters, alterations of tissue perfusion can occur. This study aimed to investigate the effect of norepinephrine dosage on microcirculation parameters, studied by microdialysis, in patients with septic shock. Methods: We conducted a retrospective study. We included all patients aged over 16 years in septic shock. We studied three groups (levosimendan, dobutamine, and control group). We administrated norepinephrine before inclusion, at stable flow for more than an hour. We performed hemodynamic monitoring of macrocirculation by echocardiography. We analyzed microcirculation parameters (lactate, pyruvate, and lactate/pyruvate ratio) every six hours during the first three days, by muscle microdialysis (CMA 600, CMA microdialysis AB, Stockholm, Sweden). We studied correlations between microcirculation parameters and norepinephrine doses.Results: We included thirty patients in the study (ten patients in each group). Demographic characteristics and mortality were comparable across the three groups. In total, we analyzed 390 samples of interstitial muscle fluid. We did not find any correlation between norepinephrine doses and the lactate concentration in the muscle, as well as the ratio of lactate/ pyruvate concentration in the muscle (p > 0.05) for all groups. We found a weak inverse correlation between norepinephrine doses and muscle pyruvate levels (p < 0.05) for the dobutamine group and the control group and but not for the levosimendan group.Conclusions: Noradrenaline dose has little effect on microcirculation when administered for hemodynamic optimization, as recommended by the Surviving Sepsis Campaign.
Pathogenic factors of Cognitive Dysfunction after liver transplantation: An observational study
Authors: Zhou Yongpeng , Huang Jun , Si Zhongzhou , Luo Sumei , Zhou Qin , Li Liwen
Published: March 2020

Background Neurocognitive complications seriously affect long-term health-related quality of life in patients after liver transplantation, but what was it like during the transplant? There has been little related research,so it is very necessary to understand the changes in cognition during the perioperative period. Methods This observational study included patients with end-stage liver disease who are waiting for liver transplantation in our center. We performed the individual cognitive function investigation before and one week after successful surgery,then analyze the changes between them and further explore possible ones that cause perioperative cognitive dysfunction among several factors. Results From December 2018 to November 2019, there are 70 patients completed all the investgation. Compared with preoperative cognitive performance, 29 patients experienced deterioration, 14 patients showed significant improvement, and 27 patients remained unchanged. Multi-factor analysis results showed that, a mean arterial pressure <80 mmHg (p=0.035) during the reperfusion phase, sufentanil dosage <1.5 µg kg -1 (p=0.027), and blood transfusion volume >70 ml kg -1 (p=0.047) were closely related to early postoperative cognitive dysfunction. Conclusions The incidences of deterioration, maintenance, and improvement in cognitive function were 41.6%, 38.4%, and 20%, respectively. Massive blood transfusion, hypotension during the reperfusion phase, insufficient intra-operative analgesia, and lower anesthesia depth may be the independent pathogenic factors for deteriorated cognitive function.