bluuebunny/crossref_metadata_2025 huggingface dataset:
Medical eponyms versus acronyms: what medical terminology is most beneficial to learn? A question of goals
Authors: Armocida Emanuele , Masciangelo Graziella , Natale Gianfranco
Published: May 2024

Appropriate use of medical terminology is one of the core conditions for successful communication in monolingual and multilingual healthcare communities.

The modern scientific language is based on the descriptive terminology.

However, it is often the case that the advantages of descriptive terminology are at odds with the ability to express complex concepts in just a few words.

To solve this practicality problem it is customary to coin abbreviations and acronyms preferred to traditional eponyms.

Today eponyms are considered ambiguous and non-descriptive, linked to the terminology of the past.

The overview of this study demonstrates that the current habit of using acronyms can increase the scientific descriptive capacity compared to eponyms. On the other hand, acronyms remain ambiguous and more ephemeral than eponyms.

Furthermore, eponyms are not as descriptive as acronyms, but they still carry important information for a medical student.

If you truly believe in the importance of Medical Humanities in the medical curriculum, two aspects cannot be overlooked.

First, eponyms bring students closer in an almost subliminal way to the history of medicine and the non-strictly technical-scientific field of medicine.

Second, medicine is a complex science applied to humans and must strive to keep the patient at the center of its interests. Patients and their families preferably ask us to use eponyms.

Which terminology to choose for medical students? The teachers have the last word.
Glymphatic abnormality in systemic lupus erythematosus detected by diffusion tensor image analysis along the perivascular space
Authors: Mo Jiaying , Han Kai , Deng Kan , Hu Wenjun , Wang Linhui , Wang Jingyi , Xu Yikai , Huang Qin , Tan Xiangliang
Published: May 2024

Objectives

This study aimed to evaluate the activity of the glymphatic system in SLE using a diffusion-based method termed ‘Diffusion Tensor Image Analysis aLong the Perivascular Space (DTI-ALPS)’, and to examine its correlations with morphological changes in the brain.

Methods

In this cross-sectional study, 45 female patients with SLE and 30 healthy controls (HCs) were included. Voxel-based and surface-based morphometric analyses were performed to examine T1-weighted images, and diffusion tensor images were acquired to determine diffusivity along the x-, y- and z-axes in the plane of the lateral ventricle body. The DTI-ALPS index (ALPS index) was calculated for each patient. The differences in values between patients with SLE and the HC group were compared using the independent samples t test or the Mann–Whitney U test. To determine correlations between the ALPS index and brain morphological parameters, partial correlation analysis and Pearson’s correlation analysis were conducted.

Results

Patients with SLE showed lower values for the ALPS index in the left (1.543 ± 0.141 vs 1.713 ± 0.175, P < 0.001), right (1.428 ± 0.142 vs 1.556 ± 0.139, P < 0.001) and whole (1.486 ± 0.121 vs 1.635 ± 0.139, P < 0.001) brain compared with the HC group. Reduced ALPS index showed significant positive correlations with grey matter loss.

Conclusion

The non-invasive ALPS index could serve as a sensitive and effective neuroimaging biomarker for individually quantifying glymphatic activity in patients with SLE. Glymphatic system abnormality may be involved in the pathophysiologic mechanism underlying CNS damage in SLE patients.
A treatment algorithm for familial Mediterranean fever patients with menstruation-associated attacks
Authors: Batu Ezgi Deniz , Bayindir Yagmur , Sener Seher , Balik Zeynep , Aliyev Emil , Kasap Cuceoglu Muserref , Basaran Ozge , Bilginer Yelda , Ozen Seza
Published: May 2024

Objectives

FMF is characterized by febrile polyserositis attacks. Menstruation could be a trigger for attacks. We aimed to analyse the features of adolescent FMF patients with menstruation-associated attacks and propose a management algorithm.

Methods

All female FMF patients who had menarche and visited the Pediatric Rheumatology Unit between January and December 2022, were included into this study. Demographics, general characteristics and the features of menstrual cycle and FMF attacks were noted.

Results

A total of 151 female FMF patients were included. Thirty-five (23.2%) had menstruation-associated attacks. Fever and arthritis were less frequent during the menstruation-associated attacks than the attacks not associated with menstruation in these patients (65.7% vs 88.6%, P = 0.01 and 2.9% vs 20%, P = 0.04, respectively). Patients with menstruation-associated FMF attacks were younger at symptom onset and diagnosis (2.5 vs 5 years, P = 0.004 and 4 vs 7 years, P = 0.01; respectively), had a higher rate of dysmenorrhea (74.3% vs 38.8%, P < 0.001, respectively) and higher pre- and post-menarche attack frequency (4 vs 2 and 10 vs 0, respectively; P < 0.001 for both) than patients whose attacks were not associated with menstruation. The interventions for menstruation-associated attacks included initiating colchicine, increasing the dose of colchicine, switching from coated to compressed colchicine tablets or adding anti-interleukin 1 drugs and initiating on-demand non-steroidal anti-inflammatory drugs, on-demand glucocorticoids and on-demand anakinra. On-demand therapies were beneficial in controlling menstruation-associated attacks.

Conclusions

This is the largest cohort of adolescent FMF patients with menstruation-associated attacks. Severe FMF may cause a tendency to this association. On-demand therapies could be preferred in the management.
Jerks are useful: extracting pulse rate from wrist-placed accelerometry jerk during sleep in children
Authors: Weaver R Glenn , Chandrashekhar M V S , Armstrong Bridget , White III James W , Finnegan Olivia , Cepni Aliye B , Burkart Sarah , Beets Michael , Adams Elizabeth L , de Zambotti Massimiliano , Welk Gregory J , Nelakuditi Srihari , Brown III David , Pate Russ , Wang Yuan , Ghosal Rahul , Zhong Zifei , Yang Hongpeng
Published: May 2024

Study Objectives

Evaluate wrist-placed accelerometry predicted heartrate compared to electrocardiogram (ECG) heartrate in children during sleep.

Methods

Children (n = 82, 61% male, 43.9% black) wore a wrist-placed Apple Watch Series 7 (AWS7) and ActiGraph GT9X during a polysomnogram. Three-Axis accelerometry data was extracted from AWS7 and the GT9X. Accelerometry heartrate estimates were derived from jerk (the rate of acceleration change), computed using the peak magnitude frequency in short time Fourier Transforms of Hilbert transformed jerk computed from acceleration magnitude. Heartrates from ECG traces were estimated from R-R intervals using R-pulse detection. Lin’s concordance correlation coefficient (CCC), mean absolute error (MAE), and mean absolute percent error (MAPE) assessed agreement with ECG estimated heart rate. Secondary analyses explored agreement by polysomnography sleep stage and a signal quality metric.

Results

The developed scripts are available on Github. For the GT9X, CCC was poor at −0.11 and MAE and MAPE were high at 16.8 (SD = 14.2) beats/minute and 20.4% (SD = 18.5%). For AWS7, CCC was moderate at 0.61 while MAE and MAPE were lower at 6.4 (SD = 9.9) beats/minute and 7.3% (SD = 10.3%). Accelerometry estimated heartrate for AWS7 was more closely related to ECG heartrate during N2, N3 and REM sleep than lights on, wake, and N1 and when signal quality was high. These patterns were not evident for the GT9X.

Conclusions

Raw accelerometry data extracted from AWS7, but not the GT9X, can be used to estimate heartrate in children while they sleep. Future work is needed to explore the sources (i.e. hardware, software, etc.) of the GT9X’s poor performance.
Exogenous Indole-3-Acetic Acid Suppresses Rice Infection of Magnaporthe oryzae by Affecting Plant Resistance and Fungal Growth
Authors: Zeng Hongling , He Kaiwei , He Qin , Xu Liting , Zhang Wei , Lu Xiang , Tang Yongyan , Zhu Xiaobo , Yin Junjie , He Min , Chen Xuewei , Li Weitao
Published: May 2024

Auxin is an important phytohormone that regulates diverse biologic processes, including plant growth and immunity. Indole-3-acetic acid (IAA), known as one of the main forms of auxin, is able to activate plant immunity. However, it is unknown whether IAA enhances plant resistance and/or suppresses the growth of the fungal pathogen Magnaporthe oryzae. Here, we found that IAA could induce expression levels of pathogenesis-related genes to enhance disease resistance and could control the development of blast disease through inhibiting M. oryzae infection. Exogenous IAA suppressed mycelial growth and delayed spore germination by inhibiting fungal endogenous IAA biosynthesis and impairing redox homeostasis, respectively. When applied to a field test, two IAA analogues, 1-naphthaleneacetic acid and 2,4-dichlorophenoxy acetic acid, can effectively control rice blast disease. Our study advances the understanding of IAA in controlling rice blast disease through suppressing pathogen growth and enhancing plant resistance.
Residual Acetabular Dysplasia at Walking Age: A Study of 470 Hips Treated With Pavlik Harness
Authors: Bavan Luckshman , Lloyd Thomas , Llewellyn-Stanton Lucy , Mifsud Maximillian , Kothari Alpesh
Published: May 2024

Background:

This study aims to report on the acetabular indices of walking age children following successful DDH treatment with Pavlik harness and investigate risk factors for residual acetabular dysplasia (RAD).

Methods:

We retrospectively reviewed the data for children treated for DDH at a single centre between 2015 and 2020. Acetabular indices (AI) measured on pelvic radiographs taken at 2- and 4-year follow-up visits were referenced against age-matched and sex-matched normal data. Values ≥90th percentile were considered to represent RAD.

Results:

A total of 305 children with 470 hips were suitable for inclusion. The mean age at treatment initiation was 7.0±4.5 weeks and mean treatment duration was 15.9±4.3 weeks. Overall, 27% and 19% of hips were found to have RAD at 2- (n=448) and 4-year (n=206) follow-up, respectively. The χ2 test for independence demonstrated that the difference in the proportion of hips with RAD at both time points was significant (P=0.032). Patients with RAD at 2 years were found to have been treated for longer (P=0.028) and had lower alpha angles on final ultrasound assessment (P<0.001). Patients with RAD at 4 years were older at initiation of treatment (P=0.041), had lower alpha angles on final ultrasound assessment (P<0.001) and were more likely to have had RAD at 2 years (P<0.001). Multivariate analysis identified lower alpha angles on final ultrasound to be predictive for RAD at 2 years (P=0.011), and presence of RAD at 2 years to be predictive for RAD at 4 years (P<0.001).

Conclusions:

The risk of RAD beyond walking age in children successfully treated with Pavlik harness is not negligible. However, we observed that a significant proportion of children with RAD at 2-year follow-up had spontaneously improved without any intervention. This data suggests that routine long-term radiologic follow-up of children treated with Pavlik harness is necessary, and surgical intervention to address RAD should be delayed until at least 4 years of age.

Level of Evidence:

Level III—case-control study.
Patterns of Multiple Organ Dysfunction and Renal Recovery in Critically Ill Children and Young Adults Receiving Continuous Renal Replacement Therapy
Authors: Thadani Sameer , Fuhrman Dana , Hanson Claire , Park Hyun Jung , Angelo Joseph , Srivaths Poyyapakkam , Typpo Katri , Bell Michael J. , Gist Katja M. , Carcillo Joseph , Akcan-Arikan Ayse
Published: May 2024

OBJECTIVES:

Acute kidney injury requiring dialysis (AKI-D) commonly occurs in the setting of multiple organ dysfunction syndrome (MODS). Continuous renal replacement therapy (CRRT) is the modality of choice for AKI-D. Mid-term outcomes of pediatric AKI-D supported with CRRT are unknown. We aimed to describe the pattern and impact of organ dysfunction on renal outcomes in critically ill children and young adults with AKI-D.

DESIGN:

Retrospective cohort.

SETTING:

Two large quarternary care pediatric hospitals.

PATIENTS:

Patients 26 y old or younger who received CRRT from 2014 to 2020, excluding patients with chronic kidney disease.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

Organ dysfunction was assessed using the Pediatric Logistic Organ Dysfunction-2 (PELOD-2) score. MODS was defined as greater than or equal to two organ dysfunctions. The primary outcome was major adverse kidney events at 30 days (MAKE30) (decrease in estimated glomerular filtration rate greater than or equal to 25% from baseline, need for renal replacement therapy, and death). Three hundred seventy-three patients, 50% female, with a median age of 84 mo (interquartile range [IQR] 16–172) were analyzed. PELOD-2 increased from 6 (IQR 3–9) to 9 (IQR 7–12) between ICU admission and CRRT initiation. Ninety-seven percent of patients developed MODS at CRRT start and 266 patients (71%) had MAKE30. Acute kidney injury (adjusted odds ratio [aOR] 3.55 [IQR 2.13–5.90]), neurologic (aOR 2.07 [IQR 1.15–3.74]), hematologic/oncologic dysfunction (aOR 2.27 [IQR 1.32–3.91]) at CRRT start, and progressive MODS (aOR 1.11 [IQR 1.03–1.19]) were independently associated with MAKE30.

CONCLUSIONS:

Ninety percent of critically ill children and young adults with AKI-D develop MODS by the start of CRRT. Lack of renal recovery is associated with specific extrarenal organ dysfunction and progressive multiple organ dysfunction. Currently available extrarenal organ support strategies, such as therapeutic plasma exchange lung-protective ventilation, and other modifiable risk factors, should be incorporated into clinical trial design when investigating renal recovery.
Summary of Outpatient Visits for Characteristic Nursing in Traditional Chinese Medicine
Authors: Ma Junrui , Zhang Hushan , Wang Jialan , Gao Jie , Fan Dandan , Qian Yanping , Chen Zhuo , Bao Ruifang , Yin Lihua , Xiong Guangyi
Published: May 2024

The aim of this study was to investigate the practical outcomes of traditional Chinese medicine specialty nursing clinics in the clinical setting. Outpatient services have become increasingly popular for seeking medical care. Establishing traditional Chinese medicine specialty nursing clinics can meet the medical needs of the general public, and provide patients with convenient and efficient medical services. This study employed a retrospective cross-sectional observational design to analyze the medical service status of all patients who attended the clinic since its opening. Five qualified traditional Chinese medicine nursing experts identified and implemented 5 categories of traditional Chinese medicine characteristic nursing techniques, including cupping, moxibustion, needle acupuncture, and massage. Nurses and patients evaluated the treatment outcomes for various diseases. Since the establishment of the nursing outpatient department 2 years ago, there have been over 7046 visits, with a satisfaction rate of 97.1%. Currently, 5 nursing experts are nurturing a total of 11 graduate students, conducting 5 free clinics in the nursing outpatient department, and organizing 3 visits by overseas experts. The traditional Chinese medicine specialty nursing outpatient service effectively meets the diverse medical needs of patients, alleviates the outpatient pressure on hospitals, enhances the specialized development of nurses, increases the prominence of traditional Chinese medicine specialty nursing techniques, and promotes traditional Chinese medicine culture.
Protecting Our Own: A Method for Reducing Breast Radiation Exposure in Healthcare Workers
Authors: Westcott Lauren Zammerilla , Ogola Gerald O. , Rees Chet R.
Published: May 2024

Standard lead aprons do not protect the female breast adequately from radiation exposure, which has been associated with breast cancer in healthcare workers. A novel lead shield was designed to reduce radiation to the breast, axilla, and thyroid (BAT). A procedure room was simulated with an anthropomorphic phantom representing the operator. Dosimeters were positioned on the outer quadrant of each breast, the chest, the thyroid, and deep inside of a phantom acrylic female torso with neck and head. Standard lead vest plus a thyroid shield was used as control and compared to standard lead vest plus BAT shield. Three operator and two image receptor positions were tested. The reductions in radiation exposure were calculated. The standard vest plus BAT shield provided significant reductions in radiation exposure for all anatomic locations compared to control. When averaging all operator positions, the BAT provided reductions of 91% (p < 0.0001) for near breast. Reductions for far breast, chest, thyroid, and deep tissues were 76% (p = 0.016), 94% (p < 0.0001), 52% (p = 0.026), and 60% (p = 0.004). With operator 90° to the table using a cross-table lateral beam, the BAT provided a 97.7% reduction in radiation to the near breast and significant reduction in radiation to the chest, thyroid, and deep tissues. The BAT shield reduces radiation exposure to the breast, chest, thyroid and deep hematopoietic tissues. Such shields could benefit healthcare workers to reduce the risk of breast cancer and other radiation-associated cancers.
“They Just Love Me”—An Examination of Social Support Experiences and Values Among People With TBI
Authors: Kersey Jessica , Rice Hannah , Connor Lisa Tabor , Fields Beth , Hammel Joy
Published: May 2024

Objective:

Social support is important for health and functional outcomes after traumatic brain injury (TBI), but many adults with TBI report inadequate social support. Little research has examined the social support priorities of adults with TBI or what an optimal social support network should include. The objective of this study was to describe the social support structures and experiences of adults with TBI.

Setting:

Community-based rehabilitation program.

Participants:

Community-dwelling adults with TBI, predominantly from racial and ethnic minority groups.

Design:

Cross-sectional collection of quantitative and qualitative data.

Main Measures:

Number of close social contacts and total social contacts, along with a report of the frequency of social support using the Medical Outcomes Study Social Support Survey. Qualitative interviews were used to examine the quality of social support and participant values and priorities.

Results:

Participants had an average of 4.3 close contacts (median 3.5, range 1-10), an average of 8.5 total social contacts (median 7, range 2-28), and a low frequency of social support (mean 28.4, SD = 24.7). Interview themes fell under 2 grand themes: structure of social networks (social networks are made up of families; proximity influences the type of support) and quality of social support (commitment vs indifference; doing things with and for others adds meaning; and “they just love me”).

Conclusion:

Participants in this study had small social networks and a low frequency of social support. Findings suggest that people with TBI value committed support partners, social inclusion, bidirectional relationships, and emotional connection, yet experience lower support in these areas compared to tangible support. Future research should examine how to adapt existing models of social support to more closely align with participant values. Rehabilitation services may need to focus more heavily on individual and family training, addressing strategies to develop and maintain relationships, emotional connection, and communication to enhance relationship and social support quality.
Nontraditional approaches to sedation for anterior segment surgery: a narrative review
Authors: Shapiro Jeremy N. , Mian Shahzad I.
Published: May 2024

Purpose of review

Surgical and anesthetic technological advancement have made both cataract and noncataract anterior segment surgery significantly less invasive and time-intensive, facilitating the transition of some of these procedures from the operating room under monitored anesthesia care (MAC) to the office-based setting without MAC. This transition has been aided by the popularization of nonintravenous approaches to achieving patient sedation for these procedures. In this review, we discuss the literature surrounding traditional and nontraditional methods of achieving patient sedation for anterior segment surgery.

Recent findings

Our survey of the literature suggests that nonintravenous (IV) approaches to sedation for these procedures may be just as safe, effective, and satisfactory to patients as traditional IV approaches.

As anterior segment surgery becomes less invasive and less time-intensive, providers considering transitioning their cataract and anterior segment surgery out of the operating room and into the office-based setting without MAC anesthesia should consider the non-IV sedation options outlined in this review to achieve adequate patient sedation and comfort.
Intense pulsed light treatment for the management of meibomian gland dysfunction
Authors: Gupta Angela Satya , Massaro Mina , Bunya Vatinee Y.
Published: May 2024

Purpose of review

Meibomian gland dysfunction (MGD) is one of the most common disorders encountered by ophthalmologists, and its management can prove challenging for both clinicians and patients. Intense pulsed light (IPL), which has been historically used in the field of dermatology, has emerged as a tool to help improve meibomian gland function. The goal of this review is to assess the clinical efficacy, utility, and safety of IPL for the treatment of MGD.

Recent findings

In recent randomized controlled trials, IPL has been shown to improve meibomian gland function, and subsequently tear film quality and dry eye symptoms. The mechanism of action still remains unclear. Recent literature suggests that IPL may also be used in conjunction with other therapies, such as meibomian gland expression, low-level light therapy, and thermal pulsation. Careful attention should be placed on each patient's Fitzpatrick skin type, as well as protecting the ocular structures to reduce the risk of adverse effects. Cost, accessibility, as well as a limited duration of efficacy may be drawbacks.

There is significant evidence supporting that IPL may be used as a potential well tolerated and effective treatment for MGD, though there are certain caveats regarding its long-term efficacy, accessibility, and cost.
Femtosecond laser-assisted in situ keratomileusis versus small-incision lenticule extraction: current approach based on evidence
Authors: Teo Zhen Ling , Ang Marcus
Published: May 2024

Purpose of review

Laser keratorefractive surgery achieves excellent visual outcomes for refractive error correction. With femtosecond laser, small incision lenticule extraction (SMILE) is an increasingly viable alternative to laser-assisted in situ keratomileusis (LASIK). Comparative studies demonstrate similar efficacy and predictability between SMILE and LASIK, making it difficult for clinicians to choose which to use. This review thus compares femtosecond-LASIK (FS-LASK) and SMILE in various scenarios, to assist clinicians in deciding which refractive surgery procedure to recommend.

Recent findings

SMILE may be superior for highly myopic eyes due to a smaller decrease in functional optical zone. SMILE further induces less spherical aberration and less overall higher order aberrations in mesopic conditions. SMIILE also has less postoperative dry eye, making it suitable those with preexisting dry eye. For low to moderate myopic astigmatism correction, FS-LASIK has less undercorrection compared to SMILE. Lastly, SMILE has not yet received Food and Drug Administration or Conformité Européenne approval for hyperopic correction, rendering FS-LASIK the choice of procedure for hyperopic correction.

Both FS-LASIK and SMILE demonstrate good efficacy and predictability. Understanding specific clinical scenarios where one may be superior to the other will aid clinicians in choosing the most suitable procedure for personalized care.
Outcomes of Gonioscopy-Assisted Transluminal Trabeculotomy in Eyes With Prior Failed Glaucoma Surgery
Authors: Siddhartha Srihari , Krishnamurthy Rashmi , Dikshit Siddharth , Garudadri Chandrasekar , Ali Md Hasnat , Senthil Sirisha
Published: May 2024

Précis:

This study concludes that GATT can be an effective and safe surgical alternative for managing IOP in eyes with prior failed glaucoma surgeries, associated with minimal complications.

Purpose:

To report outcomes of gonioscopy-assisted transluminal trabeculotomy (GATT) in eyes with prior failed glaucoma surgery.

Patients and Methods:

A retrospective study involving 30 eyes of 30 patients, all of whom had open angles on gonioscopy, experienced prior glaucoma surgery failures, and subsequently underwent GATT. The primary outcome measure was success defined as complete when the intraocular pressure (IOP) was >5 and ≤21/16 mm Hg without glaucoma medications and qualified with medications.

Results:

The mean age was 51.8±16.1 years. Twenty-one eyes underwent GATT and 9 eyes underwent phaco-GATT. Twenty-seven eyes had failed trabeculectomy and 3 eyes had failed glaucoma drainage device. Post-GATT, the IOP decreased from 27.1±7 to 16.9±6 mm Hg (P<0.001) at the end of 15 months, with a mean drop in AGM from 4.9±1.0 to 2±1.6. At postoperative 1 year, the probability of complete success was 20% (95% CI: 9–43) for an IOP criterion of both 21 and 16 mm Hg. The qualified success probability at 1 year was 82% (67–100) for an IOP criterion of 21 mm Hg and 57% (38–84) for an IOP criterion of 16 mm Hg. Risk factor for failure was older age [hazard ratio (HR): 1.03, 95% CI: 1.01–1.06]. The complications noted were hyphema in 14 eyes (46%), majority resolved within 1 week and all by 2 weeks. None needed any intervention.

Conclusions:

This study concludes that GATT can be an effective and safe surgical alternative for managing IOP in eyes with prior failed glaucoma surgeries, associated with minimal complications.
Efficacy of Ab Interno Revision for Trabeculectomy Bleb Failure Using a Minimally Invasive Approach: A Prospective Study
Authors: Snehi Sagarika , Thattaruthody Faisal , Singh Jyoti , Singh Ashok , Pandav Surinder S. , Kaushik Sushmita
Published: May 2024

Précis:

Ab interno bleb revision using the Grover and Fellman spatula offers potential benefits in improved intraocular pressure control and spares the conjunctiva for enhanced bleb management.

Purpose:

This study aimed to evaluate the safety and effectiveness of Ab-Interno Bleb Revision (AIBR) for treating failed trabeculectomy blebs.

Methods:

This noncomparative case series enrolled glaucoma patients with failed trabeculectomy blebs who underwent AIBR and were followed up for 1 year. Eligible patients received subconjunctival Mitomycin C 0.1 mL of 0.2 mg/mL (20 μg) 5 days before the AIBR, performed using the Grover and Fellman spatula. The primary outcome measures were intraocular pressure (IOP) and the usage of IOP-lowering medications 1 year after the procedure. Secondary outcomes included the procedure’s failure rate and complications. Complete success was defined as achieving an IOP between 5 and 21 mm Hg without medication, while qualified success required additional medical treatment.

Results:

The study comprised 23 eyes from 23 patients, having a mean age of 59.66±14.93 years. Preoperatively, the mean IOP was 23.54±10.7 mm Hg, and the mean antiglaucoma medication requirement was 3.99±0.65, both significantly reduced to 15.7±6.9 mm Hg (P=0.009) and 1.26±1.2 (P <0.001) at 1 year, respectively. Overall, 19 eyes (82.6%) achieved success (complete success: 39.2%, qualified success: 43.4%), while in 4 (17.4%) patients, the procedure failed (IOP >21 mm Hg). 5 patients had transient hyphema, but there were no sight-threatening complications such as hypotony or choroidal detachment.

Conclusions:

Ab-Interno Bleb Revision (AIBR) is a safe, effective, and minimally invasive intervention for managing failed trabeculectomy blebs. By eliminating the need to reopen the conjunctiva, this technique offers a promising alternative for the treatment of this challenging condition.
Risk Factors Associated With Open Fracture Complications Following Antibiotic Prophylaxis
Authors: Costanzo Elizabeth , Maynard Kaylee , Louie Ted , Shulder Stephanie , Gorczyca John , Jones Courtney MC , Croix Michael , Alpizar-Rivas Rodolfo , Escaler Patricia , Lipof Jason , Acquisto Nicole M.
Published: May 2024

Background

The Eastern Association for the Surgery of Trauma guidelines provide antibiotic selection recommendations based on open fracture type. However, risk factors for open fracture complications (eg, infection, acute kidney injury [AKI], multi-drug resistant organisms, or Clostridioides infection [C. difficile]) and overall antibiotic prophylaxis guideline adherence are unclear at our institution.

Methods

This is a retrospective, observational study of patients who received antibiotic prophylaxis between March 2011 and October 2020 at a level 1 trauma center. We sought to identify open fracture injury complications and assess adherence to institution antibiotic prophylaxis guidelines. Descriptive data and bivariate analyses are reported. Multivariable logistic regression was performed to identify independent risk factors associated with infectious complications.

Results

A total of 401 patients met study criteria; median age of 48 ± 20 years, 62% male. Fracture classifications were similar: 30% type I, 39% type II, and 30% type III. Infection occurred in 18.5% of patients, AKI in 20.3%, multi-drug resistant organism in 3%, and no patients developed C. difficile. Eighty-one percent received guideline adherent antibiotics. In bivariate analysis, fracture classification (P = 0.02) and antibiotic choice (P = 0.004) were associated with infection. Receiving a concomitant nephrotoxic medication was associated with AKI (P = 0.01). In logistic regression, only fracture classification was reliably and independently associated with occurrence of infection.

Conclusions

Appropriate fracture classification and antibiotic choice is important to reduce infection following open fracture. Reducing concomitant exposure to nephrotoxic agents may reduce the risk of AKI.
The associations of opioid and benzodiazepine prescriptions with injuries among US military service members
Authors: Kelber Marija S. , Smolenski Derek J. , Belsher Bradley E. , O'Gallagher Kevin , Issa Fuad , Stewart Lindsay Thonsen , Evatt Daniel P.
Published: May 2024

Given the high rates of physical trauma and pain among service members, opioid-prescribing practices and use patterns have significant implications for the well-being of service members and can affect military medicine and personnel readiness. This study measured the association between prescribed opioid and benzodiazepine medications and subsequently reported injuries (accidental, alcohol and drug related, self-inflicted, and violence related) among active duty military members. Participants were service members who entered the military between January 1, 2005, and June 30, 2010. In a nested case–control design, we compared individuals with injuries to individuals without injuries with respect to their opioid and benzodiazepine prescriptions in the 30 days before the injury of an index case. We used a multiintercept, logistic regression model to compare coefficient estimates by injury type. Overall, approximately 17% of individuals with an injury and 4% of individuals without an injury had a recorded opioid prescription. Individuals with an injury of any type had greater odds of prior exposure to opioid prescriptions than controls. Although a dose–response effect was observed for all injury types, it reached a plateau sooner for natural or environmental accidents and self-inflicted injuries relative to alcohol-related and drug-related injuries, violence-related injuries, vehicle accidents, accidental falls, and other accidents. Benzodiazepine prescriptions were found in 3.5% of individuals with an injury and 0.5% of individuals without an injury. The association between benzodiazepine prescriptions and injuries was strongest for natural and environmental accidents.
Small graft size and hepatocellular carcinoma outcomes in living donor liver transplantation: a retrospective multicentric cohort study
Authors: Kim Deok-Gie , Hwang Shin , Lee Kwang-Woong , Kim Jong Man , You Young Kyoung , Choi Donglak , Ryu Je Ho , Kim Bong-Wan , Kim Dong-Sik , Cho Jai Young , Nah Yang Won , Ju Man ki , Kim Tae-Seok , Lee Jae Geun , Kim Myoung Soo , Parente Alessandro , Kim Ki-Hun , Schlegel Andrea , Choi Soo Jin Na , Joo Dong Jin ,   the Korean Organ Transplantation Registry Study Group
Published: May 2024

Introduction:

This study examined associations between the graft-to-recipient weight ratio (GRWR) for adult-to-adult living donor liver transplantation (LDLT) and hepatocellular carcinoma (HCC) outcomes.

Materials and Methods:

Data from patients in the Korean Organ Transplantation Registry who underwent LDLT for HCC from 2014 to 2021 were retrospectively reviewed. Patients were categorized using the cutoff GRWR for HCC recurrence determined by an adjusted cubic spline (GRWR <0.7% vs. GRWR ≥0.7%). Recurrence-free survival (RFS) and HCC recurrence were analyzed in the entire and a 1:5 propensity-matched cohort.

Results:

The eligible cohort consisted of 2005 LDLT recipients [GRWR <0.7 (n=59) vs. GRWR ≥0.7 (n=1946)]. In the entire cohort, 5-year RFS was significantly lower in the GRWR <0.7 than in the GRWR ≥0.7 group (66.7% vs. 76.7%, P=0.019), although HCC recurrence was not different between groups (77.1% vs. 80.7%, P=0.234). This trend was similar in the matched cohort (P=0.014 for RFS and P=0.096 for HCC recurrence). In multivariable analyses, GRWR <0.7 was an independent risk factor for RFS [adjusted hazard ratio (aHR) 1.89, P=0.012], but the result was marginal for HCC recurrence (aHR 1.61, P=0.066). In the pretransplant tumor burden subgroup analysis, GRWR <0.7 was a significant risk factor for both RFS and HCC recurrence only for tumors exceeding the Milan criteria (aHR 3.10, P<0.001 for RFS; aHR 2.92, P=0.003 for HCC recurrence) or with MoRAL scores in the fourth quartile (aHR 3.33, P<0.001 for RFS; aHR 2.61, P=0.019 for HCC recurrence).

Conclusions:

A GRWR <0.7 potentially leads to lower RFS and higher HCC recurrence after LDLT when the pretransplant tumor burden is high.
CXCR6 expression correlates with radiotherapy response and immune context in triple-negative breast cancer–experimental studies
Authors: Meng Jin , Yang Yilan , Lv Jiaojie , Lv Hong , Zhao Xu , Zhang Li , Shi Wei , Yang Zhaozhi , Mei Xin , Chen Xingxing , Ma Jinli , Zhang Zhen , Shao Zhimin , Yu Xiaoli , Guo Xiaomao
Published: May 2024

Background:

The chemokine receptor CXCR6 is critical for sustained tumor control mediated by CD8+ cytotoxic T cells (CTLs) in tumors. Previous studies have shown that ionizing radiation induces an inflamed immune contexture by upregulating CXCR6. However, the clinical significance of CXCR6 expression in triple-negative breast cancer (TNBC) and its correlation with radiotherapy remains unknown. This study aimed to clarify the prognostic value of CXCR6 and its role in the breast tumor microenvironment (TME).

Methods:

The messenger RNA and protein expression of CXCR6 in human TNBC and their association with survival were analyzed. The role of CXCR6 in the immune context was investigated using a combination of single-cell RNA sequencing, bulk transcriptome sequencing data, and fluorescence-based multiplex immunohistochemistry (mIHC) techniques.

Results:

Elevated CXCR6 expression correlated with better clinical outcomes and superior response to adjuvant radiotherapy and immunotherapy in TNBC. CXCR6 fostered an immunostimulatory microenvironment characterized by upregulated cytotoxic markers. We also found that CXCR6 plays a crucial role in regulating the differentiation of CD8+ T cells and the intercellular communication of immune cell subtypes, thus shaping the TME.

Conclusions:

This study highlights the emerging role of CXCR6 in shaping the TME and targeting CXCR6 may be a promising strategy for improving the effectiveness of radiotherapy and immunotherapy in TNBC.
How Effective Is Ureteroscopic Irrigation at Evacuating Stone Dust?
Authors: Yang Bingyuan , Ray Aditi , Zhang James , Turney Ben
Published: May 2024

Ureteroscopic laser lithotripsy results in the formation of small and numerous stone fragments. These have the potential to act as a nidus for stone recurrence, and the effectiveness of irrigation via the ureteroscope at clearing them is not well understood. Using an in vitro quartz-based model, fragments of known sizes from <63 µm to 2mm are irrigated at rates of 15 mL/min, 30 mL/min and 120 mL/min. Clinically achievable rates of 15-30 mL/min are unable to wash out larger particles >500 µm, and even 120 mL/min irrigation was able to wash out less than half of these larger particles. Complete stone clearance is unlikely to be achievable by intraoperative irrigation alone and requires additional technologies such as suction.
Factors Associated With Recent Decline in Anal Health Among Older Gay and Bisexual Men: A Cross-sectional Analysis
Authors: Goddard Sian L. , Poynten I. Mary , Petoumenos Kathy , Jin Fengyi , Hillman Richard J. , Fairley Christopher K. , Garland Suzanne M. , Grulich Andrew E. , Templeton David J. ,   on behalf of the Study for the Prevention of Anal Cancer (SPANC) Research Team
Published: May 2024

We investigated factors associated with “worse than usual” anal health among gay and bisexual men aged ≥35 years recruited to a longitudinal study of anal human papillomavirus infection/lesions from September 2010 to August 2015.

Among 616 participants (median age 49 years; 36% HIV-positive), 42 (6.8%) reported worse than usual anal health in the last 4 weeks. Associated factors included spending less time with gay friends (odds ratio [OR] = 2.25, 95% CI = 1.06–4.77), most time “feeling down”(OR = 9.17, 95% CI = 2.94–28.59), reduced libido (OR = 2.90, 95% CI = 1.52–5.52), current anal symptoms (OR = 6.55, 95% CI = 2.54–16.90), recent anal wart diagnosis (OR = 4.33, 95% CI = 1.98–9.49), and fear of developing anal cancer (OR = 9.34, 95% CI = 4.52–19.28).

Concerns regarding anal health should be routinely discussed by clinicians, and potentially associated psychosocial, physical, and sexual issues further explored.
Analysis of the detection rate and clinical characteristics of early gastric cancer by painless gastroscopy and ordinary gastroscopy
Authors: Qiu Lei , Yao Linhua , Hu Piwei , He Tongyun
Published: May 2024

Objective:

To investigate the difference of early gastric cancer (EGC) detection rate and endoscopic characteristics between painless and ordinary electronic gastroscopy, and summarize the clinical data of gastric cancer (GC) patients.

Methods:

Clinical data of 72,000 patients who underwent gastroscopy in the First People Hospital of Huzhou (Zhejiang, China) from January 2016 to December 2021 were retrospectively analyzed. The patients were divided into painless gastroscopy group (observation group, 36,000 cases) and ordinary gastroscopy group (control group, 36,000 cases) according to the examination methods. The detection rate of EGC between the 2 groups and the endoscopic characteristics of EGC lesions between the 2 groups were compared, and the clinical data of GC were summarized.

Results:

Painless gastroscopy is safer than ordinary gastroscopy. The detection rate of GC and EGC in the observation group was significantly higher than that in the control group (P < .05); the difference between the 2 groups in the detection rate of advanced GC was not statistically significant. The average length of EGC lesions in the observation group was significantly shorter than that in the control group (P < .05). The proportion of EGC with lesion length <2.0 cm in the observation group was significantly higher than that in the control group (P < .05). The proportion of EGC lesions with type II morphology, normal or pallor mucosal color, and no rupture in mucosa in the control group were significantly lower than that in the observation group, respectively (P < .05). The proportion of EGC distributed in the cardia, fundus and corpus was higher in the observation group than in the control group (P < .05). The incidence of helicobacter pylori (HP) infection, precancerous diseases, first-degree relatives of GC patients, and risk factors in patients with GC was significantly higher than that in non-GC patients (P < .05), multivariate logistic regression analysis showed that these were independent influencing factors for the occurrence of GC.

Conclusion:

Painless gastroscopy can effectively improve the screening and diagnostic efficiency of EGC, especially for EGC lesions that are not easy to expose the site, small in size, superficial, without obvious mucosal color change or without mucosal breakage. Therefore, the value of painless gastroscopy in EGC screening is worth further promotion and research.
Taurolidine and Heparin as Catheter Lock Solution for Central Venous Catheters in Hemodialysis
Authors: Nguyen Timothy , Camins Bernard C. , Butler David A.
Published: May 2024

Background:

Chronic kidney disease can lead to end-stage renal disease, and the prevalence is increasing. Many patients starting hemodialysis require central venous catheters (CVCs). Catheter-related bloodstream infections (CRBSIs) are a common complication and lead to significant morbidity and mortality. Interventions to prevent CRBSI include antimicrobial lock therapy but concern for the development of antimicrobial resistance and adverse effects. Nonantimicrobial antiseptics as catheter lock solutions have also been used. Taurolidine and heparin catheter lock solution is first approved by the Food and Drug Administration for the prevention of CRBSI in patients on hemodialysis. Taurolidine has a unique mechanism of action and favorable safety profile.

Mechanism of Action, Pharmacodynamics, and Pharmacokinetics:

Taurolidine and heparin catheter lock solution have both antimicrobial and anticoagulant properties. Taurolidine is derivative of the amino acid taurine, and heparin is derived from porcine intestinal mucosa. Taurolidine not only damages microbial cell walls but also prevents the adherence of microorganisms to biological surfaces, preventing biofilm formation. Taurolidine and heparin catheter lock solution is intended to be used intraluminally within the catheter and should be aspirated. Because it is used locally, limited pharmacokinetic and pharmacodynamic data are available.

Clinical Trials:

The LOCK-IT-100 trial is a randomized, double-blind, phase 3 study, which included 795 end-stage renal disease patients on hemodialysis with CVC. Taurolidine and heparin was compared with the control heparin alone. The results of the study showed a 71% risk reduction in CRBSI for taurolidine and heparin arm (95% confident interval, 38%–86%, P = 0.0006). Other studies have also shown that taurolidine lock solution leads to decreased CRBSI episodes. Several systematic reviews and meta-analysis consisted of taurolidine in adult, and pediatric populations also showed reduction in the incidence of CRBSIs.

Therapeutic Advance:

Taurolidine and heparin lock solution represents a novel preventive strategy for those undergoing hemodialysis through a CVC by reducing the risk of CRBSI. This is significant progress because there are no other similar options available for patients for whom catheters are the only options for their life-saving treatment.
Safe Fall Recovery Education for Older Adults
Authors: Arena Sara K. , Wilson Christopher M. , Boright Lori , Cassidy Brant , Fedorow Sarah , Hallman Sheilah , Rager Hannah
Published: May 2024

High fall rates among older adults in combination with prolonged time on the floor after a fall have created an urgent need to preventatively address fall recovery strategies. The purpose of this study is to describe the outcomes of a novel safe fall recovery (SFR) educational module provided by physical therapists to older adults in their homes. A pre- and post-test descriptive study used a convenience sample to recruit 30 adults (≥65 years). A baseline assessment and SFR in-home education were provided. Pre- and post-education measures included the Steps for Safe Fall Recovery (Steps for SFR) tool, the Activity Specific Balance Confidence (ABC) scale, and a fall confidence survey. The Wilcoxon matched-pairs signed-rank test determined significance (P < .05). Participants were age 77.2 (6.8) years and 20 females. Eight reported a fall during the prior year. Statistically significant improvements were identified in the Steps to SFR tool (P = .001), the ABC scale (P = .004), and the fall recovery confidence survey (P = .001). Integration of an SFR educational intervention delivered to an older adult population in their home demonstrated improved safety and confidence to recover from a fall.
Neuromuscular Electrical Stimulation of Peroneal Longus Improve Balance Control Ability in Young Adults With Chronic Ankle Instability
Authors: Wang Yueping , Zheng Huifen , Wang Jiangna , Xu Peiming , Sun Wei
Published: May 2024

Objective

This study aimed to investigate the effects of 6 wks of peroneal longus neuromuscular electrical stimulation on the balance control ability in young adults with chronic ankle instability.

Design

This study is a double-blind randomized controlled trial. Six weeks of neuromuscular electrical stimulation and placebo intervention were conducted in the neuromuscular electrical stimulation and control groups for 20 mins, three times a week, respectively. Thirty-eight participants successfully completed the whole intervention and single-leg standing tests. The kinetics data of the center of pressure trajectory during static single-leg stance were measured using a Kistler force platform. Two-way repeated measures analysis of variance was used to analyze the electrical stimulation effects.

Results

Significant interactions were detected in Cumberland Ankle Instability Tool scores and all balance parameters including displacement X, displacement Y, 95% confidence ellipse area, root-mean-square, and center of pressure mean displacement velocity (P < 0.05, 0.103 ≤ η2 ≤ 0.201). Significant between-group differences were found in Cumberland Ankle Instability Tool scores (P = 0.003, Cohen’s d = 0.215), displacement X (P = 0.045, Cohen’s d = 0.107), root-mean-square ml (P = 0.019, Cohen’s d = 0.143), and 95% confidence ellipse area (P = 0.031, Cohen’s d = 0.123) after the 6-wk interventions.

Conclusions

Six weeks of neuromuscular electrical stimulation on the peroneus longus can improve static balance control ability in young adults with chronic ankle instability, especially the stability of ankle frontal plane.