bluuebunny/crossref_metadata_2025 huggingface dataset:
Keratinous Cyst of the Caruncle Developing From a Sebaceous Gland Duct: Case Report With Immunohistochemical Analysis
Authors: Charles Norman C. , Belinsky Irina
Published: April 2020

An enlarging white caruncular cyst in a 24-year-old woman proved to be a keratinous cyst lined by keratinizing squamous epithelium that lacked a keratohyalin granular layer (trichilemmal keratinization). The cyst most likely originated from a sebaceous gland duct. A panel of immunohistochemical stains was employed that compared and contrasted the cyst lining with the overlying caruncular conjunctival epithelium and further eliminated the likelihood of a conjunctival cyst. The most useful confirmatory stains were the positive trichilemmal marker calretinin, the positive sebaceous ductal marker cytokeratin 17 (suprabasal epithelium), and the negative conjunctival markers cytokeratins 7 and 19. Only one previous report of a very rare similar caruncular cyst is recorded in the literature without an extensive immunohistochemical analysis.
Comparison of clinical outcomes of 3 trifocal IOLs
Authors: Ribeiro Filomena , Ferreira Tiago B.
Published: April 2020

Purpose:

To compare the clinical outcomes obtained after implantation of 1 of 3 models of diffractive trifocal IOLs.

Setting:

Hospital da Luz, Lisbon, Portugal.

Design:

Prospective randomized comparative study.

Methods:

Patients undergoing cataract surgery with bilateral implantation of 1 of 3 models of diffractive trifocal IOLs were enrolled. The IOL models implanted were the FineVision POD F, RayOne Trifocal, or the AcrySof IQ PanOptix IOL (30 eyes of 15 patients in each group). Visual acuity (VA), refraction, defocus curve, and contrast sensitivity outcomes were evaluated during a 3-month follow-up. Furthermore, the Quality of Vision questionnaire (QoV) was used to evaluate the frequency, severity, and discomfort of different visual symptoms.

Results:

A total of 90 eyes of 45 patients were included. No statistically significant differences were found between groups in distance, intermediate, and near VA (P ≥ .112) and postoperative refraction (P ≥ .059). Postoperative binocular uncorrected intermediate VA of 0.10 logarithm of the minimum angle of resolution (logMAR) or better was found in 14 (93.33%) patients in the 3 groups. Postoperative binocular uncorrected near VA of 0.10 logMAR or better was found in 13 (86.67%), 14 (93.33%), and 13 (86.67%) patients in the POD F, RayOne, and PanOptix IOLs groups, respectively. No statistically significant differences were found between groups in scotopic contrast sensitivity with and without glare and in the QoV scores (P ≥ .057), except for the difference between the POD F and RayOne IOLs groups in depth perception severity, which was less in the RayOne IOL group (P = .019).

Conclusions:

The 3 trifocal IOLs evaluated provided a complete visual restoration with good visual quality outcomes.
Validation of semi-automated flow-mediated dilation measurement in healthy volunteers
Authors: Dobbie Laurence J. , Mackin Sharon T. , Hogarth Katrina , Lonergan Frances , Kannenkeril Dennis , Brooksbank Katriona , Delles Christian
Published: April 2020

Background

Flow-mediated dilation (FMD) is a non-invasive imaging modality used to measure endothelial function but has significant intra- and inter-observer variability. The use of semi-automated FMD devices could overcome this limitation. We assessed the reproducibility of same-day semi-automated FMD measurements by investigators who received basic training on the correct use of the device.

Methods

Forty-three healthy volunteers had two brachial artery FMD measurements performed 20 minutes apart using the UNEX EF 38G device, and automated outputs were produced. Images were also manually analysed using edge-detection software. The reproducibility of repeat FMD measurements within individuals was compared for automated and manual readings, and the correlation between analytical techniques was calculated.

Results

Twenty-five percent of scans were of non-diagnostic quality (n = 32). Automated analyses demonstrated sub-optimal reproducibility and measurement variability [intraclass correlation coefficient (ICCC) = 0.334, coefficient of variation (CV) = 45.87%]. In contrast, manually analysed scans had excellent reproducibility and low measurement variance (ICCC = 0.815, CV = 11.40%). FMD values obtained from automated and manual analysis correlated poorly (r = 0.164), whereas resting (r = 0.955) and maximal brachial artery diameters demonstrated excellent correlation (r = 0.867).

Conclusion

Manually evaluated serial UNEX EF readings have good reproducibility and therefore, the optimal FMD workflow involves manual analyses prior to independent automated interrogation. The high non-diagnostic scan rate is most likely the result of insufficient training and indicates that semi-automatic devices such as UNEX EF should be used by experienced investigators to achieve optimal results.
How to assess ventriculoarterial coupling in sepsis
Authors: Pinsky Michael R. , Guarracino Fabio
Published: April 2020

Purpose of review

We will highlight the role of ventriculoarterial coupling in the pathophysiology of sepsis and how to assess it.

Recent findings

Most septic patients show a ventriculoarterial uncoupling at the time of diagnosis with arterial elastance (E
a) greater than left ventricle (LV) end-systolic elastance (E
es), often despite arterial hypotension. Ventriculoarterial coupling levels predict the cardiovascular response to resuscitation in this heterogeneously responding population.

Ventriculoarterial coupling is quantified as the ratio of E
a to E
es. The efficiency of the cardiovascular function is optimal when E
a/E
es is near one. When the hydraulic load of the arterial system is excessive either from increased vasomotor tone, decreased LV contractility or both, E
a/E
es becomes greater than 1 (i.e. ventriculoarterial decoupling), and cardiac efficiency decreases leading to heart failure, loss of volume responsiveness, and if sustained, increased mortality. Noninvasive echocardiographic techniques when linked with arterial pressure monitoring allow for the bedside estimates of both E
a and E
es. Studies using this approach have documented the key role ventriculoarterial coupling has defining initial cardiovascular state, response to therapy and outcome from critical illness. Sequential monitoring of ventriculoarterial coupling at the bedside offers a unique opportunity to assess relevant cardiovascular determinants in septic patients requiring resuscitation.
Carbohydrate composition in breast milk and its effect on infant health
Authors: Berger Paige K. , Plows Jasmine F. , Demerath Ellen W. , Fields David A.
Published: April 2020

Purpose of review

This narrative review presents the current state of available evidence regarding the role of breast milk carbohydrates on infant outcomes, with a primary focus on growth and body composition.

Recent findings

To date, there is a paucity of available data that exists in this realm. The current literature focuses on the role of two carbohydrate fractions in breast milk, and their relationships with infant outcomes in the first six months of life: oligosaccharides and fructose. A small but growing body of research indicates robust associations of both oligosaccharides and fructose in breast milk with infant weight and length, as well as bone, fat, and lean mass. There is also emerging evidence to support the role of these same carbohydrate fractions in breast milk in infant cognitive development.

The present state of the science suggests that oligosaccharides and fructose in breast milk play a role in infant growth and body composition and introduces intriguing associations of these two carbohydrate fractions with infant cognitive development as well.
Radiogenomics of magnetic resonance imaging and a new multi-gene classifier for predicting recurrence prognosis in estrogen receptor-positive breast cancer
Authors: Tokuda Yukiko , Yanagawa Masahiro , Minamitani Kaori , Naoi Yasuto , Noguchi Shinzaburo , Tomiyama Noriyuki
Published: April 2020

To examine the correlation of qualitative and quantitative dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) results with 95-gene classifier or CurebestTM 95-gene classifier Breast (95GC) results for recurrence prediction in estrogen receptor-positive breast cancer (ERPBC).

This retrospective study included 78 ERPBC patients (age range, 24–74 years) classified into high- (n = 33) and low- (n = 45) risk groups for recurrence based on 95GC and who underwent DCE-MRI between July 2006 and November 2012. For qualitative evaluation, mass shape, margin, and internal enhancement based on BI-RADS MRI lexicon and multiplicity were determined by consensus interpretation by 2 breast radiologists. For quantitative evaluation, mass size, volume ratios of the DCE-MRI kinetics, and both the kurtosis and the skewness of the intensity histogram for the whole mass in the initial and delayed phases were determined. Differences between the 2 risk-groups were analyzed using univariate logistic regression analyses and multiple logistic regression analyses. Receiver-operating characteristic curve cut-off values were used to define the groups.

As for the qualitative findings, the difference between the 2 groups was not significant. For the quantitative data, the volume ratio of “medium” in the initial phase differed significantly between the 2 groups (P = .049). The volume ratio of “medium” (P = .006) and of “slow-persistent” (P = .005), and the delayed phase kurtosis (P = .012) in the univariate logistic regression analyses, and in the multiple logistic regression, volume ratio of “medium” >38.9% and delayed phase kurtosis >3.31 were identified as significant high-risk indicators (odds ratio, 5.83 and 3.55; 95% confidence interval, 1.58 to 21.42 and 1.24 to 10.15; P = .008 and P = .018, respectively).

A high volume ratio of “medium” in the initial phase and/or high kurtosis in the delayed phase for quantitative evaluation could predict high ERPBC recurrence risk based on 95GC.
Does Tai Chi Chuan improve psychological well-being and quality of life in patients with breast cancer? Protocol for a systematic review of randomized controlled trials
Authors: Guo Jing , Shen Yifeng , Li Bin , Wang Fei , Jiang Yang , Lin Yi , Chen Jianping
Published: April 2020

Background:

Breast cancer is the most prevalent cancer in women worldwide. Treatment for breast cancer can be expensive, painful and can significantly affect the quality of life, leading to various side effects such as depression and anxiety, fatigue, sleep disorders, and cognitive impairment. Tai Chi Chuan (TCC) is the most prominent manifestation of tai chi in Chinese martial arts. TCC has been reported to be potentially effective for health and well-being of both the sick and the healthy. However, it is still controversial whether TCC benefits breast cancer patients. It is therefore of great value to evaluate the effectiveness of TCC on the psychological well-being and quality of life in people with breast cancer.

Methods:

This review will summarize and meta-analyze all relevant randomized controlled trials on TCC in patients with breast cancer in the light of their anxiety, depression and fatigue level, inflammatory cytokine as well as quality of life, sleep quality, and cognitive function. The following electronic databases will be searched: PubMed, Cochrane Library, EMBASE, Web of Science, China National Knowledge Infrastructure Database, Chinese Biomedical Literature Database, VIP Chinese Science and Technology Periodical Database, and Wan Fang Data. The methodologic quality of randomized controlled trials has been assessed using the Cochrane risk assessment tool. All trials included are analyzed according to the criteria of the Cochrane Handbook. Review Manager 5.3, R-3.5.1 software and grading of recommendations assessment, development, and evaluation pro-GDT online software are used for data synthesis and analysis.

Results:

The results of this systematic review will be used to summarize and evaluate the evidence available from randomized controlled clinical trials of TCC as supportive and adjuvant therapy for breast cancer.

Conclusion:

This review will provide a detailed summary of the evidence to assess the effectiveness of TCC for breast cancer.

OSF Registration:

DOI 10.17605/OSF.IO/Z2FSA.
Mycobacterium culturing and drug resistance of osteoarticular tuberculosis in Xinjiang, China
Authors: Hajiaheman Yeerzati , Yang Yi , Shayilanbieke Nuerhanati , Jin Gele
Published: April 2020

This study aims to elucidate the strains and drug resistance of mycobacterium isolated from osteoarticular tuberculosis (OATB) patients and provide a reference for the diagnosis and treatment of OATB.

Sixty-nine clinically diagnosed and surgically treated OATB patients were collected in time period of January 2017 to December 2018 at the First Affiliated Hospital of Xinjiang Medical University. The BACTEC MGIT 960 system was used for mycobacteria culturing, strain identification, and drug susceptibility testing, and the mycobacteria culture positive rate, species distribution, and drug resistance were analyzed.

Within 4 weeks, 24 (34.78%) isolates of mycobacteria culture were positive; 40 (57.97%) isolates were positive, when culturing time was expanded to 8 weeks, and the difference was statistically significant (P < .05). Among the 40 isolates, 24 (60%) were identified as mycobacterium tuberculosis (MTB), 10 (25%) were Mycobacterium bovis, and 6 (15%) were non-tuberculous mycobacteria (NTM). Among total 69 isolates, 40 were enrolled in drug sensitivity test, and 15 (37.5%) isolates were confirmed drug resistant strains, in which 5 isolates were MTB, 4 isolates were M. bovis, and 6 isolates of NTM.

The pathogen of clinically diagnosed OATB was mainly MTB. However, M. bovis and NTM also accounted for a considerable proportion, and their drug resistance rate was higher. Extending the culturing time appropriately could improve the culture positive rate. NTM was a drug resistant strain, and mycobacteria culturing, strain identification, and drug resistance analysis should be carried out to serve as a guide for individual treatment.
Comparison of tracheal intubation with controlled ventilation and laryngeal mask airway with spontaneous ventilation for thoracoscopic bullectomy
Authors: Li Xiu-Liang , He Xiang-Bo , Wan Lei , Liu Chun-Quan , Cui Yong
Published: April 2020

General anesthesia with double-lumen endobronchial intubation is considered mandatory for thoracoscopic bullectomy. We assessed the safety and feasibility of thoracoscopic bullectomy for treatment of primary spontaneous pneumothorax (PSP) under intubating laryngeal mask airway (ILMA) with spontaneous breathing sevoflurane anesthesia combined with thoracic paravertebral block (TPB).

From January 2018 to December 2018, some 34 consecutive patients with PSP were treated by thoracoscopic bullectomy under ILMA with spontaneous breathing sevoflurane anesthesia combined with TPB (study group). To evaluate the safety and feasibility of this new technique, these patients were compared with the control group consisting of 34 consecutive patients with PSP who underwent thoracoscopic bullectomy using tracheal intubation with controlled ventilation from January 2017 to December 2017. The demographic characteristics, intraoperative surgical and anesthetic results, and postoperative results were assessed.

The 2 groups had comparable anesthetic time, operation time, chest drainage time, postoperative hospital stays, and hospitalization cost. Visual analogue score (VAS) scores at 3 hours at rest and at coughing were significantly lower in the study group than in the control group (mean, 0.9 vs 2.0 and 1.8 vs 4.0, P = .024 and P = .006, respectively). No differences were seen in PaO2 values between the 2 groups in the intraoperative stage and postoperative stage (P > .05, respectively). The pH value was significantly lower in the intraoperative stage (mean, 7.28 vs 7.40, P = .01) and higher in the postoperative stage (mean, 7.35 vs 7.33, P = .014) in the study group than in the control group. The PaCO2 value was significantly higher in the intraoperative stage in the study group than in the control group (mean, 57.0 mm Hg vs 42.0 mm Hg, P = .015). In the study group, no cough reflex was found, and the level of collapse of the operative lung was excellent in 31 cases and good in 3 cases.

Our study demonstrated that thoracoscopic bullectomy for treatment of PSP can be safely and feasibly performed in highly selected patients under ILMA with spontaneous breathing sevoflurane anesthesia combined with TPB.
Association between hepatitis B virus infection and risk of osteoporosis: a systematic review and meta-analysis
Authors: Xie Xingwen , Huang Rui , Li Xiuxia , Li Ning , Zhang Haijun , Xu Shihong , Li Dingpeng , Xi Shanshan , Yang Kehu
Published: April 2020

Background:

The potential association between hepatitis B virus (HBV) infection and development of osteoporosis has drawn significant attention from clinicians and researchers in recent years due to the increasing prevalence of HBV infection. This study aims to perform a systematic review and meta-analysis of the literature to show whether HBV infection is associated with an increased risk of osteoporosis.

Methods:

Case-control, cohort, and cross-sectional studies that report the incidence of osteoporosis, osteoporotic fracture, osteopenia, and bone mineral density level in populations with HBV infection will be selected. Four databases from their inception to October 2019 will be searched. All data were assessed and extracted by 2 authors independently. The Newcastle–Ottawa scale and (Agency for Healthcare Research and Quality) Agency for Healthcare Research and Quality checklist will be used to assess the quality of the selected studies. Stata 15.1 (Stata Corp, College Station, TX) will be used to conduct meta-analysis.

Result:

The results of this systemic review and meta-analysis will be submitted to a recognized journal for publication.

Conclusion:

This systemic review and meta-analysis will determine whether HBV infection is associated with an increased risk of osteoporosis. We hope this review can provide a reliable evidence.

Registration:

PROSPERO (registration number CRD42020140522).
A clinical study of traditional Chinese medicine prolonging the survival of advanced gastric cancer patients by regulating the immunosuppressive cell population
Authors: Pan Xiaoting , Tao Heyun , Nie Mengjun , Liu Yuanjie , Huang Pan , Liu Shenlin , Sun Wei , Wu Jian , Ma Ting , Dai Anwei , Lu Jianwei , Liu Baorui , Zou Xi , Sun Qingmin
Published: April 2020

Background:

Gastric cancer (GC) is a common high-mortality disease, causing a serious social burden. Traditional Chinese medicine has been utilized to prevent and treat GC for many years but its effects remain unclear. The aim of our study is to elucidate the anti-tumor effects and the possible mechanism of Jianpi Yangzheng Xiaozheng decoction.

Methods/design:

This is a prospective, multicenter, randomized controlled trial continuing 1.5 years. Two hundred ten eligible patients will be randomly divided into 2 groups, the chemotherapy alone and the chemotherapy combined with JPYZXZ group at a ratio of 1:2. All patients will receive the treatment for 24 weeks and follow up for 1.5 years. The primary outcomes are one-year survival rate, progression-free survival, and overall survival (OS), while the secondary outcomes are immune related hematology test, objective response rate, tumor makers, traditional Chinese medicine syndrome points, fatigue scale, and quality of life scale. All of these outcomes will be analyzed at the end of the trail.

Discussion:

This study will provide the objective evidence for the efficacy and safety of Jianpi Yangzheng Xiaozheng decoction in advanced GC. Furthermore, it will be helpful to form a therapeutic regimen in advanced GC by the combination of traditional medicine and western medicine.

Trail registration: ChiCTR1900028147
Effect of carotenoid encapsulation on antioxidant activities
Authors: de Queiroz Jaluza Luana Carvalho , Medeiros Isaiane , Piuvezam Grasiela , de França Nunes Ana Clara , Gomes Camila Carvalho , Maciel Bruna Leal Lima , de Araújo Morais Ana Heloneida , Passos Thaís Souza
Published: April 2020

Background:

Carotenoids play essential roles in human health, such as antioxidant activity, and therefore can decrease free radicals oxidation action, preventing numerous diseases. However, these compounds have an unstable nature, turning them susceptible to adverse conditions in food processing and storage. Thereby the search for alternatives that maintain and enhance carotenoid antioxidant function, such as encapsulation, has grown. The objective of this study was to establish a systematic review protocol to evaluate the effect of different encapsulation techniques on the antioxidant action of carotenoids, evaluating which one is the best and safest, and their role in enhancing the antioxidant activity.

Methods:

This protocol was guided by the preferred reporting items for protocols for systematic reviews and meta-analyzes. The databases to be searched are PubMed, EMBASE, Scopus, ScienceDirect, and Web of Science. Experimental studies conducted in rats and mice (in vivo) of both sexes and ages, evaluating the use of encapsulated and crude carotenoids will be included in the systematic review. The characteristics of the studies, the experimental model, and the main results will be described, and the risk of bias assessment will be evaluated. Three independent reviewers will proceed with the selection of studies, data extraction, and methodological quality assessment. A narrative synthesis will be made for the included studies. Besides, if sufficient qualitative data is available, a meta-analysis will be conducted. I2 statistics will be used to assess heterogeneity.

Results:

This protocol will guide the production of a systematic review that can determine the effect of different encapsulation techniques and encapsulating agents on the antioxidant action of carotenoids. Thus, it will enable the determination of the best encapsulation techniques to promote the preservation and increase of the antioxidant activity, contributing to future research that may reproduce the best carotenoid encapsulation technique in an animal model.

Conclusion:

The systematic review to be produced from this protocol will provide support for the construction of research that evaluates the effect of encapsulation on the antioxidant function of carotenoids and its possible application as a nutraceutical, considering that this functionality is directly associated with health promotion.

Record of systematic review:

This review was recorded in the International Register of Prospective Systematic Reviews on January 22, 2020 (registration: CRD42020142065). Available at: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020142065
Wiedemann-steiner syndrome with a de novo mutation in KMT2A
Authors: Jinxiu Liu , Shuimei Liang , Ming Xue , Jonathan Liu CS. , Xiangju Liu , Wenyuan Duan
Published: April 2020

Rationale:

Wiedemann-Steiner syndrome (WDSTS, online mendelian inheritance in man 605130) is a rare autosomal dominant disorder characterized by hypertrichosis cubiti. Here, we report a Chinese boy who do not show the characteristic of hypertrichosis cubiti, and was misdiagnosed as blepharophimosis-ptosis-epicanthus inversus syndrome at first. We found a de novo frameshift mutation (p.Glu390Lysfs∗10) in the KMT2A gene, which was not reported before. Our study increases the cohort of Chinese WDSTS patients, and expand the WDSTS phenotypic and variation spectrum.

Patient concerns:

The patient demonstrated typical craniofacial features of blepharophimosis-ptosis-epicanthus inversus syndrome, including small palpebral fissures, ptosis, telecanthus, and epicanthus inversus, besides he had congenital heart disease (ventricular septal defects), strabismus, hypotonia, amblyopia, delayed speech and language development, delayed psychomotor development, and amblyopia (HP:0000646) which was not reported before.

Diagnosis:

FOXL2 gene was cloned and sequenced, however, there was no mutation detected in this patient. The result of Chromosomal microarray analysis was normal. The patient was diagnosed as WDSTS by whole exome sequencing.

Interventions:

The patient received cardiac surgery, frontalis suspension and regular speech and occupational therapy. He also treated with growth hormone (GH).

Outcomes:

The patient's symptoms are improved after cardiac surgery and frontalis suspension, he can express himself well now and had a 10 cm gain in height.

Lessons:

As the relationship between genotype and phenotype becomes more and more clear, WES is incredibly powerful tool to diagnose the disease of WDSTS.
Colchicine therapy for deep vein thrombosis in a patient with vascular-type Behçet disease
Authors: Nonaka Daishi , Takase Hiroyuki , Machii Masashi , Ohno Kazuto
Published: April 2020

Rationale:

Behçet Disease (BD) is a chronic inflammatory vasculitis with thrombogenicity and multisystem involvement. Deep vein thrombosis (DVT) in the lower extremities is the most frequent manifestation of vascular involvement in BD. The causes of thrombosis vary widely and include congenital predisposition and acquired factors, but of all the thrombosis, the cause is rarely BD. Furthermore, there are few reports of treatment for thrombosis in BD.

Patient concerns:

We herein describe the case of an Asian male patient aged 40 years, admitted to our hospital for left leg pain, edema, and swelling.

Diagnoses:

We confirmed the DVT and pulmonary artery thrombosis (PAT) by contrast computed tomography angiogram. At the same time, the patient developed oral ulcerations and skin lesions consistent with BD.

Interventions:

The patient was initially treated with anticoagulants. However, because the improvement of DVT was inadequate, we added colchicine in anticipation of anti-inflammatory effects. After that, anticoagulation was discontinued, and only colchicine was continuously prescribed.

Outcomes:

We observed an almost complete resolution of DVT and PAT with no recurrence of thrombosis for 6 months after discharge.

Lessons:

This case shows us that we should consider BD as a differential diagnosis of DVT and that colchicine therapy is effective for inflammation-induced thrombosis in BD.
Clinical significance of serum neuron-specific enolase in gastric adenocarcinoma
Authors: Luo Hai , Shen Kexin , Sun Hongyan , Li Ruiqi , Wang Zeming , Xie Zhongshi
Published: April 2020

As a biomarker, neuron-specific enolase (NSE) has been widely recognized in the diagnosis of benign diseases and malignant tumors. This study aimed to investigate the potential diagnostic value of NSE in patients with gastric adenocarcinoma.

Serum levels of the NSE were compared between 219 patients with gastric adenocarcinoma and 298 healthy individuals, NSE and clinicopathological parameters were analyzed. Meanwhile, to evaluate the diagnostic capability of NSE, the receiver operating characteristic (ROC), and area under curve (AUC) was calculated.

In the present study, the median serum NSE level of the patient group was 20.770 ng/mL, which was higher than that of the control group 15.625 ng/mL (P < .05). Serum NSE level in patients group compared with healthy control was statistically significant (P < .05). Serum NSE level was associated with pathological tumor-node-metastasis (pTNM) staging, lymph node metastasis, and distant metastasis in patients with gastric adenocarcinoma. Besides, the AUC of NSE in gastric adenocarcinoma was 0.742, which was higher than those of the other 3 markers (0.573–0.644). Besides, the AUC of the combined 4 markers was higher than any individual marker (0.778).

Serum NSE detecting may have good value for diagnosis of gastric adenocarcinoma. Besides, the combination of NSE, CEA, CA19–9, and CA242 performed even better than any single marker. Thus, the combined detection of the 4 tumor markers may be more useful for the diagnosis of gastric adenocarcinoma.
Effects of hyperbaric oxygen therapy on the expression levels of the inflammatory factors interleukin-12p40, macrophage inflammatory protein-1β, platelet-derived growth factor-BB, and interleukin-1 receptor antagonist in keloids
Authors: Hao Yan , Dong Xinhang , Zhang Mingzi , Liu Hao , Zhu Lin , Wang Youbin
Published: April 2020

Background

: Our study aimed to screen and explore the expression of inflammatory factors in keloid patients and to investigate how hyperbaric oxygen (HBO) therapy affects the expression levels of interleukin-12p40 (IL-12p40), macrophage inflammatory protein-1β (MIP-1β), platelet-derived growth factor-BB (PDGF-BB), and interleukin-1 receptor antagonist (IL-1Ra).

Objective

: 30 patients were randomly selected and divided into the following 3 groups: keloid samples from keloid patients treated with HBO therapy (A), keloid samples from keloid patients treated without HBO therapy (B), and normal control skin samples derived from individuals who had no clear scarring (C). Each group included 10 samples.

Methods

: Inflammatory factors in the keloid tissues were measured with the MILLIPLEX multiplexed Luminex system. Hematoxylin and eosin staining, immunohistochemical staining, and Western blotting were used to observe the morphological differences in different tissues and the expression levels.

Results

: The expression levels of inflammatory mediators, including IL-12p40, MIP-1β, PDGF-BB, and IL-1Ra, in keloid tissues were significantly different from those in samples of normal skin. Hematoxylin and eosin staining showed significantly greater inflammatory infiltration in keloid tissue. Significantly different expression levels were observed in group A, B, and C.

Conclusion

: Significantly altered levels of inflammatory factors in the samples from keloid patients were observed, suggesting that formation of a keloid is potentially related to inflammatory responses. HBO therapy could significantly affect the expression levels of IL-12p40, MIP-1β, PDGF-BB, and IL-1Ra, indicating that the effects of HBO therapy are associated with the attenuation of inflammatory responses.
A CARE-compliant article: a case report of pleural empyema secondary to Klebsiella pneumoniae liver abscess with a hepatopleural fistula
Authors: Lee Eun Ji , Lee Kyung Hee , Kim Jun Ho , Jeon Yong Sun , Kim Jung Soo
Published: April 2020

Introduction:

Klebsiella pneumoniae liver abscess (KPLA) is often associated with accompanying metastatic complications such as septic pulmonary embolism, brain abscess, and endophthalmitis. Pleural empyema secondary to a KPLA is a very unusual finding, made even more rare with the presence of a hepatopleural fistula.

Patient concerns:

An 81-year-old woman presented with aggravated dyspnea.

Diagnosis:

The patient was diagnosed with KPLA with empyema through computed tomography (CT) scan findings and pleural fluid culture.

Interventions:

The empyema was drained by thoracostomy, and treatment with empirical antibiotics was initiated. After early removal of the chest tube, the liver abscess as well as the empyema increased. An additional liver abscess drainage procedure was performed.

Outcomes:

The fever resolved and dyspnea improved following drainage of effusion. Three days later, the follow-up chest radiograph showed decreased pleural effusion.

Conclusion:

Pleural empyema is a rare but fatal complication secondary to KPLA. Additionally, the discovery of a hepatopleural fistula on a CT scan (multiplanar reconstruction image) made this case even more rare. Both, the liver abscess and pleural empyema, were effectively drained through the fistula tract with drainage procedure, thoracostomy, and additional liver abscess drainage. Prompt diagnostic evaluation, using an imaging modality such as CT, and early drainage management with intravenous antibiotics can improve clinical outcome.
Imaging features and mechanisms of novel coronavirus pneumonia (COVID-19)
Authors: Huang Zixing , Zhao Shuang , Xu Lin , Chen Jianxin , Lin Wei , Zeng Hanjiang , Chen Zhixia , Du Liang , Shi Yujun , Zhang Na , Song Bin
Published: April 2020

Introduction:

A novel coronavirus, tentatively designated as 2019 Novel Coronavirus (2019-nCoV), now called severe acute respiratory syndrome coronavirus 2, emerged in Wuhan, China, at the end of 2019 and which continues to expand. On February 11, 2020, the World Health Organization (WHO) named the disease coronavirus disease 2019 (COVID-19). On February 28, WHO increased our assessment of the risk of spread and the risk of impact of COVID-19 to very high at a global level. The COVID-19 poses significant threats to international health.

Computed tomography (CT) has been an important imaging modality in assisting in the diagnosis and management of patients withCOVID-19. Some retrospective imaging studies have reported chest CT findings of COVID-19 in the past 2 months, suggesting that several CT findings may be characteristic. To our knowledge, there has been no prospective multicentre imaging study of COVID-19 to date.

We proposed a hypothesis: There are some specific CT features on Chest CT of COVID-19 patients. And the mechanism of these CT features is explicable based on pathological findings.

Objective:

To investigate the specific CT features of COVID-19 and the formation mechanism of these CT features.

Method:

This study is a prospective multicenter observational study. We will recruit 100 patients with COVID-19 at 55 hospitals. All patients undergo chest CT examination with the same scan protocol. The distribution and morphology of lesions on chest CT, clinical data will be recorded. A number of patients will be pathologically examined after permission is granted. The data of these three aspects will be analyzed synthetically.

Discussion:

This study will help us to identify the chest CT features of COVID-19 and its mechanism.

Ethics and dissemination:

This retrospective study was approved by the Biomedical Research Ethics Committee of West China Hospital of Sichuan University (No. 2020–140). Written informed consent will be obtained from all study participants prior to enrollment in the study. To protect privacy of participants, all private information were kept anonymous. The results will be published in a peer-reviewed journal and will be disseminated electronically and in print regardless of results.
The Knowledge and Attitudes of Pediatricians in Israel Towards Vegetarianism
Authors: Hamiel Uri , Landau Nitsan , Eshel Fuhrer Audelia , Shalem Tzippora , Goldman Michael
Published: April 2020

Objectives:

Pediatricians have an important role in the dietary education of children, and in the nutritional health of their patients. We aimed to assess nutritional knowledge, familiarity with guidelines, and attitudes of pediatricians regarding vegetarian diets.

Methods:

A cross‐sectional study using a previously implemented questionnaire, distributed amongst a convenience sample of pediatricians in Israel. For each participant, scores of knowledge and of attitudes towards vegetarian diets were calculated. Scores were analyzed and compared between various categorizations of the respondents.

Results:

Of 270 respondents (60.4% female individuals), 14.1% were following a vegetarian or semi‐vegetarian diet. The overall mean scores for knowledge and attitude were 37.9 ± 16.0% and 38.1 ± 20.7%, respectively. Among pediatricians currently following a vegetarian or semi‐vegetarian diet, mean knowledge and attitude scores were higher by 12.2% (95% confidence interval [CI] 6.8–17.6, P < 0.001) and 17.4% (95% CI 10.5–24.2, P < 0.001), respectively, compared with nonvegetarians. Knowledge scores were found to be positively correlated with attitude scores. Only 13.4% of pediatricians felt that their medical degree studies prepared them well to deal with vegetarian patients. A higher knowledge score was correlated with inquiring of patients eating habits, and counseling on vegetarian diets.

Conclusions:

Pediatricians possess a low average knowledge base in vegetarian nutrition. The majority of pediatricians do not hold positive attitudes concerning vegetarian diets. We show a positive correlation between overall knowledge and overall attitude for individual participants. Increasing the knowledge base of pediatricians regarding vegetarian diets may lead them to conceive meatless diets in a more positive light and better counsel their patients.
Same Anesthesia Endoscopic Retrograde Cholangiopancreatography and Laparoscopic Cholecystectomy
Authors: Fishman Douglas S. , Barth Brad , Mazziotti Mark V. , Lazar David A. , Brandt Mary L. , Fallon Sarah C. , Tsai Cynthia Man‐Wai , Olutoye Oluyinka O. , Giefer Matthew , Martinez Mercedes , Troendle David M.
Published: April 2020

Background:

Successful combined Laparoscopic cholecystectomy and endoscopic retrograde cholangiopancreatography (ERCP) in the Same Session (LESS) has been reported in several studies in adult patients with choledocholithiasis.

Methods:

This was a retrospective analysis of data collected prospectively in the Pediatric ERCP Database Initiative using REDCAP. Adverse events were recorded separately and were reviewed for this study. The primary outcome was the hospitalization days. Secondary outcomes included total duration of anesthesia, morbidity, time from diagnosis to procedure.

Results:

Twenty‐five patients underwent LESS, and 42 underwent the traditional ERCP followed by laparoscopic cholecystectomy. The groups were similar in age, weight, ASA. The median length of stay in the LESS group was 3 days, compared with 4 days (P = .32). Total procedure time was similar between the 2 groups, but anesthesia time was shorter in the LESS group (P = .0401). Morbidity was similarly low between the 2 groups.

Conclusions:

Relative to 2 interventions, a single session combining ERCP and laparoscopic cholecystectomy in pediatric patients is effective with a similar adverse event rate and length of stay. The use of a single sedation and reduced total anesthesia time are potential benefits of this approach. This modality may be considered for pediatric patients with choledocholithiasis with or without hemolytic disease.
Online Survey of Digital Reading by Adults with Low Vision
Authors: Wu Yueh-Hsun , Granquist Christina , Gage Rachel , Crossland Michael D. , Legge Gordon E.
Published: April 2020

SIGNIFICANCE

Access to digital text is increasingly widespread, but its impact on low-vision reading is not well understood.

PURPOSE

We conducted an online survey of people with low vision to determine what assistive technologies they use for visual reading, their preferred text characteristics, and the time they devote to reading digital and hard-copy text.

METHODS

One hundred thirty-three low-vision participants completed an online survey. Participants reported the nature and history of their low vision, their usage of different assistive technologies, and time devoted to five visual reading activities.

RESULTS

The three largest diagnostic categories were albinism (n = 36), retinitis pigmentosa (n = 20), and glaucoma (n = 15). Mean self-reported acuity was 0.93 logMAR (range, 0.1 to 1.6 logMAR). Mean age was 46 years (range, 18 to 98 years). Participants reported on percentage time spent reading using vision, audio, or touch (braille). Seventy-five percent of our participants did more than 50% of their reading visually. Across five categories of reading activities—work or education, news, pleasure, spot reading, and social networking—participants reported more time spent on digital reading than hard-copy reading. Eighty-nine percent of our participants used at least one technology from each of our two major categories of assistive technologies (digital content magnifiers and hard-copy content magnifiers) for visual reading.

CONCLUSIONS

Despite the growing availability of digital text in audio or braille formats, our findings from an online sample of people with low vision indicate the continuing importance of visual reading. Our participants continue to use technology to access both hard-copy and digital text, but more time is devoted to digital reading. Our findings highlight the need for continued research and development of technology to enhance visual reading accessibility.
Predictors of False-Negative Focused Assessment With Sonography for Trauma Examination in Pediatric Blunt Abdominal Trauma
Authors: Quan Grahame E. , Kendall John L. , Bogseth Michael C. , Ruygrok Michael L. , Luoma Kelsey A. , Louderback Reed Z. , Pieracci Fredric , Byyny Richard L.
Published: April 2020

Objectives

This study investigated associations between patient and injury characteristics and false-negative (FN) focused assessment with sonography for trauma (FAST) in pediatric blunt abdominal trauma (BAT). We also evaluated the effects of FN FAST on in-hospital mortality and length of stay (LOS) variables.

Methods

This retrospective cohort studied children younger than 18 years between January 1, 2002, and December 31, 2013, with BAT, documented FAST, and pathologic fluid on computed tomography, surgery, or autopsy. Multivariable and bivariate analyses were used to assess associations between FN FAST and patient injury characteristics, mortality, and hospital LOS.

Results

A total of 141 pediatric BAT patients with pathologic free fluid were included. There were no patient or injury characteristics, which conferred increased odds of an FN FAST. Splenic and bladder injury were negatively associated with FN FAST odds ratio of 0.4 (95% confidence interval [CI], 0.2–0.8) and 0.1 (95% CI, 0–0.8). Abbreviated Injury Scale score of 4 or greater to the abdomen and extremity was negatively associated with FN FAST odds ratio of 0.1 (95% CI, 0–0.3) and 0.3 (95% CI, 0.1–0.9). There was no association between FN FAST and mortality. Patients with an FN FAST had increased hospital LOS after controlling for sex, age, and Injury Severity Score.

Conclusions

Clinicians need to be cautious applying a single initial FAST to patients with minor abdominal trauma or with suspected injuries to organs other than the spleen or bladder. Formalized studies to develop risk stratification tools could allow clinicians to integrate FAST into the pediatric patient population in the safest manner possible.
Social Impacts Among Participants in HIV Vaccine Trial Network (HVTN) Preventive HIV Vaccine Trials
Authors: Andrasik Michele P. , Sesay Fredericka Albertina , Isaacs Abby , Oseso Linda , Allen Mary
Published: April 2020

Background:

Given the persistent stigma and discrimination against HIV worldwide, preventive HIV vaccine trials face unique challenges. Negative social impacts (NSIs)—problems that HIV vaccine trial participants face in many different spheres of their lives related to trial participation—have received a great deal of attention. Beneficial social impacts (BSIs)—perceived benefits experienced by a participant and resulting from their trial participation—are a critical component of participants' experiences, yet they have received little attention.

Setting:

All HIV Vaccine Trials Network trial participants for whom social impact data were available—8347 participants in 13 countries who enrolled in 48 phase 1, 2a, and 2b trials.

Methods:

A cross-protocol analysis to assess self-reported BSIs and NSIs related to participating in a preventive HIV vaccine trial. Data were obtained from 48 completed HIV Vaccine Trials Network vaccine trials from December 2000 to September 2017.

Results:

Overall, 6572 participants (81%) reported at least one BSI, and 686 participants (8%) reported 819 NSI events. Altruism/feeling good helping others was the BSI most often endorsed by study participants (43%), followed by receiving risk-reduction counseling (30%). Most NSI events (81%) were reported by US/Swiss participants, and most (79%) trial-related NSIs were negative reactions from friends, family, and partners. Of the NSIs reported, 7% were considered to have a major impact on the participant's quality of life.

Conclusion:

Our results underscore the relatively common experiences of BSIs among preventive HIV vaccine trial participants and mirror the results of other studies that find infrequent reports of NSIs.
Managing childhood cancer pain into survivorship: recognition and emerging principles
Authors: Anderson Anna-Karenia , Woods Simon
Published: April 2020

Purpose of review

Continual refinement and further stratification of childhood cancer treatment has led to increased survivorship with recognized improvements in many long-term health outcomes. Despite this progress, persisting pain prevalence in childhood cancer survivors is increasing and emerging as a significant long-term health concern.

Recent findings

Currently, there is no guidance on how to approach and manage persisting pain in survivors of childhood cancer.

Clinicians should work with children and young people to optimize the management of pain and other symptoms on treatment. Focusing on an early post treatment screening for pain and other symptoms (including sleep and fatigue), and the role of on-going analgesic use. Follow-up should offer a multidisciplinary approach, aimed at lessening reliance on pharmacological approaches to pain management, addressing psychological concerns and promoting increased physical activity. The onus is on clinicians to mitigate the long-term risk of pharmacological reliance, particularly opioid dependency, in patients leaving their care and heading into adulthood. In this article, we highlight the emerging evidence of persisting pain in survivors of childhood cancer as a significant long-term health outcome and consider some initial principles of management.
Alternatives to Traditional Language Sample Measures With Emergent Bilingual Preschoolers
Authors: Guiberson Mark
Published: April 2020

The aim of this article was to evaluate the use of alternatives to traditional language sample analysis (LSA) measures with bilingual preschool-aged children. A database of 184 bilingual preschool children, including children with developmental language disorder (DLD), was used in this study. The goals of the study were to establish the convergent validity between traditional language sample measures and alternative measures of clinician-observed and parent-reported longest utterance, compare groups across traditional and alternative measures, and establish to what extent alternative measures predict language status (typical or DLD). Results indicated that alternative measures may be useful in describing the language of preschool bilingual children, but none of the measures alone would provide adequate diagnostic information to make a determination of DLD status.
Using General Language Performance Measures to Assess Grammar Learning
Authors: Eisenberg Sarita L.
Published: April 2020

Grammar is an important goal area for children with language impairment. The current article considers the use of General Language Performance Measures (GLPMs) to assess outcomes for this basic goal area and for 3 intermediate grammar goals that contribute to children's developing ability to construct increasingly longer and more complex sentences: production of word combinations, production of sentences with required and optional constituents, and production of complex sentences. These goals are very important because they address a significant deficit area for children with language impairment and enable these children to increase the informativeness of their utterances. Using GLPMs in addition to session data and probes enables speech–language pathologists to determine whether these forms are being incorporated into conversational speech.