bluuebunny/crossref_metadata_2025 huggingface dataset:
Police Accountability in the USA: Gaining Traction or Spinning Wheels?
Authors: Archbold Carol A
Published: May 2021

Police accountability has long been a topic of discussion and debate among police practitioners, politicians, and scholars. This topic re-emerges every time there is highly publicized police shooting or incident of police misconduct. This article provides an overview of the current state of police accountability in the USA. This overview includes several examples of the ways in which police accountability has been enhanced in recent years at the local, state, and federal levels. Next, several obstacles to the progression of police accountability in the USA are discussed including a lack of ‘buy-in’ by some police personnel; limited research on the efficacy of common police accountability tools; lack of financial resources; lack of support and guidance by the federal government in recent years; and police unions. Finally, the article concludes with suggestions for overcoming some of the impediments associated with police accountability in the USA.
Spontaneous slow oscillation—slow spindle features predict induced overnight memory retention
Authors: Dehnavi Fereshteh , Koo-Poeggel Ping Chai , Ghorbani Maryam , Marshall Lisa
Published: May 2021

Study Objectives

Synchronization of neural activity within local networks and between brain regions is a major contributor to rhythmic field potentials such as the EEG. On the other hand, dynamic changes in microstructure and activity are reflected in the EEG, for instance slow oscillation (SO) slope can reflect synaptic strength. SO-spindle coupling is a measure for neural communication. It was previously associated with memory consolidation, but also shown to reveal strong interindividual differences. In studies, weak electric current stimulation has modulated brain rhythms and memory retention. Here, we investigate whether SO-spindle coupling and SO slope during baseline sleep are associated with (predictive of) stimulation efficacy on retention performance.

Methods

Twenty-five healthy subjects participated in three experimental sessions. Sleep-associated memory consolidation was measured in two sessions, in one anodal transcranial direct current stimulation oscillating at subjects individual SO frequency (so-tDCS) was applied during nocturnal sleep. The third session was without a learning task (baseline sleep). The dependence on SO-spindle coupling and SO-slope during baseline sleep of so-tDCS efficacy on retention performance were investigated.

Results

Stimulation efficacy on overnight retention of declarative memories was associated with nesting of slow spindles to SO trough in deep nonrapid eye movement baseline sleep. Steepness and direction of SO slope in baseline sleep were features indicative for stimulation efficacy.

Conclusions

Findings underscore a functional relevance of activity during the SO up-to-down state transition for memory consolidation and provide support for distinct consolidation mechanisms for types of declarative memories.
A Real-Time Loop-Mediated Isothermal Amplification for Detection of the Wheat Dwarf Virus in Wheat and the Insect VectorPsammotettix alienus
Authors: Hao Xingan , Wang Licheng , Zhang Xudong , Zhong Qinrong , Hajano Jamal-U-Ddin , Xu Liangsheng , Wu Yunfeng
Published: May 2021

Wheat dwarf virus (WDV; genus Mastrevirus, family Geminiviridae) is an economically important and widespread pathogen of cereal crops. It causes huge yield loss in wheat because of the unavailability of resistant varieties and rapid transmission by the vector leafhopper, Psammotettix alienus (Dahlb). To monitor and forecast this viral disease, an early diagnosis method is required for WDV detection in both infected plants and the virus vectors. In this study, we developed a real-time loop-mediated isothermal amplification (LAMP) assay for WDV detection. The positive sample could be detected within 28 to 32 min by following a simple, cost-effective procedure. The real-time LAMP assay showed a sensitivity of 2.7 × 105-6copies/μl for detection and a high specificity for WDV amplification, with a similar accuracy to quantitative PCR. Furthermore, a closed-tube dye method facilitates the inspection of the LAMP reaction and avoids cross-contamination in the detection of the virus. This valuable detection assay could serve as an important tool for diagnosis and forecasting wheat dwarf disease intensity in the field.
Attitude of Health Care Professionals Toward Patients With Substance Use Disorders
Authors: Mahmoud Dalia A.M. , El Shiekh Mona M. , Kirolos Amira R. , El Hawary Yomna A.
Published: May 2021

Objectives:

Substance use disorder (SUD) is a chronic relapsing disease with multiple general health and behavior deterioration making it vulnerable to discrimination. As health care professionals play a crucial role in the identification and feasibility of access to treatment of such patients, negative attitudes can reduce the quality of the medical service provided. The purpose of our study is to measure and compare stigma variables toward SUDs among different professions of the health care staff.

Patients and Methods:

In all, 300 participants were enrolled in the study distributed equally into physicians from different specialties, nurses, clerical work employees, manual workers, and early career medical interns. A predesigned semistructured sheet was used to screen the occupation, previous contact SUD cases, family history of substance use problems; they also answered the general health questionnaire, and 4 scales concerning the attitude toward addicts including the level of familiarity, perceived dangerousness, and fear, social distance scales.

Results:

Women showed higher perceived dangerousness and desired social distance from polysubstance use disorder than men. Social distance was significantly more away from polysubstance in staff below the age of 30 years, and from alcohol in the group above 30 years. The level of familiarity with and a desired social distance away from polysubstance abuse among physicians were significant. There was a highly significant fear of benzodiazepine, tramadol, and polysubstance among physicians. Perceived dangerousness for polysubstance among physicians was significantly evident as well as for alcohol among manual workers, for benzodiazepine among house officers, and for heroin among clerical workers.

Conclusion:

Stigma of medical field professionals toward patients with SUDs is common and may contribute to underqualified health care service for these patients, which mandates dissemination of model educational programs starting from college medical curricula to postgraduate ones.
Out of the shadow of interleukin-17A: the role of interleukin-17F and other interleukin-17 family cytokines in spondyloarthritis
Authors: Yeremenko Nataliya
Published: May 2021

Purpose of review

The last decade has witnessed tremendous advances in revealing an important role for the interleukin (IL)-17 cytokine family in the pathogenesis of spondyloarthritis (SpA). Although most attention has been focused on IL-17A, a potential role of other IL-17 family members in inflammation and tissue remodelling is emerging. Herein, I review recent studies covering the role of IL-17B-F cytokines in the pathogenesis of SpA.

Recent findings

Several recent studies provided new insights into the cellular source, regulation and function of IL-17F. IL-17F/IL-17A expression ratio is higher in psoriatic skin compared to SpA synovitis. IL-17F-expressing T cells produce different proinflammatory mediators than IL-17A-expressing cells, and IL-17F and IL-17A signal through different receptor complex. Dual IL-17A and IL-17F neutralization resulted in greater suppression of downstream inflammatory and tissue remodelling responses. Furthermore, there is additional evidence of IL-23-independent IL-17 production. In contrast to IL-17A, IL-17F and IL-17C, which play proinflammatory roles in skin and joint inflammation, an anti-inflammatory function is proposed for IL-17D. An increase in IL-17E is associated with subclinical gut microbiome alterations after anti-IL-17A therapy in SpA patients.

IL-17 family cytokines may act as agonists or antagonists to IL-17A contributing in concert to local inflammatory responses. Understanding their function and identifying their cellular sources, and molecular mechanisms driving their expression will be the key to designing rational therapies in SpA.
A Novel Fluoroscopic Method for Assessing Rotational Malalignment of the Tibia
Authors: Roberts Michael S. , Haimes Mark A. , Vacek Pamela , Blankstein Michael , Schottel Patrick C.
Published: May 2021

Objective:

To evaluate the accuracy and reliability of a novel fluoroscopic technique for assessing tibial rotation and compare it with a previously described fluoroscopic method.

Methods:

A multiplanar circular ring external fixator was secured to the tibial diaphysis of 5 cadaveric lower extremity specimens. Using deformity correction software, the frame and tibia were programed to randomly rotate 5, 10, 15, 20, 25, and 30 degrees of internal and external rotation. After each rotation, 2 blinded, independent observers measured the degree of tibial rotation using 2 different fluoroscopic methods: the previously described “mortise” method and the novel “intermalleolar” method. A total of 65 measurements were made by each observer. Accuracy and interobserver reliability were calculated.

Results:

Both intermalleolar and mortise methods had a mean absolute rotational difference from the true torsion of 3 degrees (standard error 1; range, 0–10 degrees intermalleolar vs. 0–18 degrees mortise). We found that 98.5% (128/130) of measurements using the intermalleolar method were less than 10 degrees from the true rotation compared with 93.8% (122/130) using the mortise method. Both the intermalleolar and the mortise methods had excellent interobserver reliability (intraclass correlation coefficient 0.99 and 0.96, respectively).

Conclusion:

Measuring tibial rotation fluoroscopically using the intermalleolar method is both accurate and reliable. Compared with the previously described mortise method, it has similar accuracy and provides a value that approximates the true tibial rotation. Also, it can be used reliably and effectively intraoperatively to identify tibial malrotation and assist in intraoperative rotational corrections.
A Retrospective Review of Calcaneal Fractures Treated With Minimally Invasive Sinus Tarsi Approach for Open Reduction and Internal Fixation
Authors: Fahey Eoin , Curtin Mark , MacNiocaill Ruairi
Published: May 2021

This study analyses patients that have undergone open reduction and internal fixation of the calcaneus, through a minimally invasive sinus tarsi approach. The primary outcome measure of this study was the degree to which the architecture of the calcaneus was restored, with the secondary outcome measure being the rate of complications attributable to the surgery. Patients were identified retrospectively from theater records. Demographic information was gathered. Outcome measures included: (1) the accuracy of reduction achieved and (2) complication rates. Preoperative and postoperative radiographic measurements, were recorded. Patients’ medical notes were analyzed for any recorded complications. Thirty patients with calcaneal fractures were identified. Of the eligible patients 87% were male, 33% were active smokers, and mean age was 43.5 years. Seventy-six percent of patients had restoration of their Bohler’s Angle to within the normal range. There were no recorded wound complications. This case series shows that a minimally invasive sinus tarsi approach can be used to effectively achieve near anatomic reduction with low rates of complications.

Level of Evidence: Diagnostic Level IV–case series. See Instructions for Authors for a complete description of levels of evidence.
Dual Versus Triple Therapy in Patients with Acute Coronary Syndrome and an Anticoagulation Indication: A Systematic Review with Meta-Analysis and Trial-Sequential Analysis
Authors: Gupta Rahul , Malik Aaqib H. , Gupta Rajiv , Ranchal Purva , Yandrapalli Srikanth , Patel Brijesh , Frishman William H. , Aronow Wilbert S. , Garg Jalaj
Published: May 2021

Choosing an antithrombotic regime in patients with acute coronary syndrome (ACS) and a concomitant indication for anticoagulation is a challenge commonly encountered by clinicians. Our aim in this article is to evaluate the safety and efficacy of triple antithrombotic therapy (TT, anticoagulant plus dual antiplatelet) versus dual antithrombotic therapy [dual therapy (DT), anticoagulant plus single antiplatelet] in patients with ACS. We included all randomized trials comparing the outcomes of single versus dual antiplatelet therapy in patients with ACS on anticoagulants. The primary outcome was major adverse cardiac events (MACE). Other outcomes studied were all-cause mortality, cardiovascular mortality, myocardial infarction (MI), stroke, stent thrombosis (ST), and major bleeding. The Mantel-Haenszel risk ratio (RR) random-effects model was used to summarize data. Six studies, with a total of 11,437 patients, met our selection criteria. With a follow-up duration of 9–14 months, there was no significant difference between DT and TT in terms of MACE [RR 0.96; 95% confidence interval (CI), 0.79–1.17], all-cause mortality (RR 1.00; 95% CI, 0.77–1.29), cardiovascular mortality (RR 1.03; 95% CI, 0.79–1.34), MI (RR 1.14; 95% CI, 0.90–1.45), stroke (RR 0.83; 95% CI, 0.56–1.23), and ST (RR 1.32; 95% CI, 0.87–2.01). Compared with TT, DT was associated with significant reductions in major bleeding 4.1% versus 6.5% (RR 0.61; 95% CI, 0.45–0.81; number needed to treat = 42), clinically significant bleeding 10.5% versus 16.4% (RR 0.62; 95% CI, 0.48–0.80) and intracranial hemorrhage 0.4% versus 0.8% (RR 0.43; 95% CI, 0.24–0.77). In patients on anticoagulant therapy, the strategy of single antiplatelet therapy (DT) confers a benefit of less major bleeding with no difference in MACE, all-cause mortality, cardiovascular mortality, MI, stroke, and ST.
Invasive Coronary Physiology Assessment for Patients With Stable Coronary Disease
Authors: Elgendy Islam Y. , Denktas Ali , Johnson Nils P. , Jaffer Farouc A. , Jneid Hani
Published: May 2021

Visual assessment of coronary stenosis severity using conventional coronary angiography is associated with wide interoperator variability and a weak relationship with hemodynamics. Invasive coronary physiology assessment using fractional flow reserve (FFR) has been shown to be safe and beneficial. Large multicenter randomized trials have demonstrated the superiority of FFR-guided percutaneous coronary intervention in reducing the risk of major cardiac adverse events, number of stents used, and total cost in patients with multivessel coronary disease. FFR requires vasodilatory agents for the microvasculature to induce maximal hyperemia, which carry a slight risk, cost, and effort. Nonhyperemic pressure ratios provide a physiologic metric without vasodilator medications but with more limited clinical outcomes data. The transition from anatomy to physiology for coronary artery disease decision-making represents a cultural sea change in the cardiac catheterization laboratory that requires time and retooling.
Term Birth Weight and Neurodevelopmental Outcomes
Authors: Cortese Marianna , Moster Dag , Wilcox Allen J.
Published: May 2021

Background:

Preterm birth is an important risk factor for neurodevelopmental disabilities. The vast majority of these disabilities occur, however, among term births. The role of fetal growth restriction specifically among term babies has been incompletely described.

Methods:

We conducted a population-based study of term birth weight and its link to a range of neurodevelopmental outcomes using Norwegian health registries. To remove the influence of preterm birth, we restricted our analyses to 1.8 million singleton babies born during a narrow range of term gestational age (39–41 weeks). Babies with malformations were excluded. We adjusted analyses simply for year of birth, as further adjustments for sex, parity, maternal age, smoking, marital status, immigrant status, and parental education had trivial influence. An additional sibling analysis controlled for unmeasured family-based confounding.

Results:

The risk of neurodevelopmental disabilities at term steadily increased at birth weights lower than 3.5 kg. Using the category of 3.5–3.9 kg as the reference, the odds reached 25-fold for cerebral palsy at the smallest weights (95% confidence interval 8.0, 79), 16-fold for vision/hearing disability (4.0, 65), 11-fold for intellectual impairment (6.9, 17), 7-fold for schizophrenia (1.0, 50), 5.4-fold for epilepsy (2.6, 12), and 3.5-fold for autism spectrum (1.3, 9.4) and behavioral disorders including attention-deficit hyperactivity disorder (2.1, 5.4). Associations remained robust with sibling controls.

Conclusions:

Reduced fetal growth is a powerful predictor of a wide variety of neurodevelopmental disabilities independent of preterm delivery.
Efficacy and airway complications of Parker Flex-Tip tubes and standard endotracheal tubes during airway manipulation
Authors: Hung Kuo-Chuan , Chen Jen-Yin , Feng I-Jung , Chiang Min-Hsien , Wu Shao-Chun , Chen I-Wen , Lin Yao-Tsung , Chang Ying-Jen , Wu Zhi-Fu , Lu Hsiao-Feng , Sun Cheuk-Kwan
Published: May 2021

BACKGROUND

Despite reported superior intubation outcomes associated with Parker Flex-Tip (PFT) tubes compared with those associated with standard polyvinylchloride tubes, the efficacy and safety of PFT tubes remain uncertain.

OBJECTIVES

To compare the intubation outcomes between PFT and conventional standard polyvinylchloride tubes.

DESIGN

Meta-analysis of randomised controlled trials.

DATA SOURCES

Embase, Medline, Google Scholar, PubMed and the Cochrane controlled trials register from inception until 3 January 2021.

ELIGIBILITY CRITERIA

All randomised trials comparing intubation outcomes between PFT (PFT group) and standard polyvinylchloride (standard polyvinylchloride group) tubes.

RESULTS

Analysis of the 13 eligible trials showed no significant difference in successful first-attempt intubation rate [risk ratio (RR) 1.20, 95% confidence interval (CI) 0.99 to 1.44] (6 trials, 568 participants), trauma risk (RR 0.83, 95% CI 0.67 to 1.03) (5 trials, 501 participants) as well as the overall risks of epistaxis (RR 0.58, 95% CI 0.26 to 1.31) (3 trials, 262 participants), sore throat (RR 0.90, 95% CI 0.70 to 1.17) (4 trials, 451 participants) and hoarseness (RR 0.71, 95% CI 0.44 to 1.14) (4 trials, 451 participants) between the two groups. However, the intubation time was slightly shorter (weighted mean difference −4.2 s, 95% CI −7.4 to −1.0 s) (8 trials, 759 participants) and the risks of severe epistaxis (RR 0.15, 95% CI 0.03 to 0.84) (3 trials, 262 participants) and overall difficulty in airway manipulation (RR 0.48, 95% CI 0.29 to 0.80) (8 trials, 647 participants) were lower in the PFT group than those in the standard polyvinylchloride group. Trial sequential analysis conclusively confirmed a shorter intubation time with PFT tubes than with standard polyvinylchloride tubes, whereas other intubation outcomes were inconclusive.

CONCLUSION

The use of PFT tubes for airway manipulation was associated with a shorter intubation time compared with the standard polyvinylchloride tubes. The results of trial sequential analysis suggest the need for further trials and meta-analysis to compare other intubation outcomes associated with the two devices.

TRIAL REGISTRATION

PROSPERO CRD42020197670.
Submuscular Gluteal Augmentation and Lipoplasty for Buttock Beautification
Authors: Aytaç Selçuk
Published: May 2021

Background:

The number of gluteal augmentation procedures with implants has increased in the last years. However, due to high complication rates related to the placement of the implants, surgeons have started to avoid using implants. The objective of the present study was to describe the details of the submuscular gluteal augmentation technique together with lipoplasty techniques and to increase the prevalence of its use.

Methods:

All methods are complementary to each other rather than being superior to each other. That is why the author has used submuscular gluteal augmentation with implant technique and lipoplasty together during the surgeries. The complication rates are lower with this easy-to-learn technique described in this article. Eighty-six patients aged 20–46 underwent surgery. The follow-up period was 6–24 months. The implants used consisted of round cohesive silicone, with the most commonly used size being 330 cm3. The average volume of infiltrated fat was 514 cm3.

Results:

The sciatic nerve is well protected by the surrounding anatomical structures, indicating that submuscular technique can be used safely. Partial wound dehiscence was noted in 1 patient, implant malposition in 5 patients, and seroma in 2 patients. All patients reported that they are highly satisfied with the results of the procedure.

Conclusions:

The author advocates that the combination of lipoplasty with the submuscular technique described is safe, easy to perform, has a short operative time and low complication rates. It can be preferred in buttock beautification as a simple and safe technique.
A Case of Systemic Inflammatory Response Syndrome after Liposuction-assisted Abdominoplasty
Authors: Riesmeijer Sophie A. , van der Lei Berend
Published: May 2021

A 51-year-old woman underwent liposuction-abdominoplasty. After surgery, she developed hypotension and bradycardia, attributed to iatrogenic opioid-intoxication. After discontinuing opioids, the patient had several episodes of hypotension and tachycardia, responding well to fluid resuscitation. The initial differential diagnosis of postoperative bleeding was ruled out with a CT-scan. Other potential causes of hemodynamic instability, such as pulmonary embolism and fat embolism, were considered unlikely in absence of corresponding symptoms. Based on leukocytosis and tachycardia, the patient was diagnosed with systemic inflammatory response syndrome, a disproportional inflammatory reaction to surgery. The patient was managed expectantly with intravenous fluid administration and recovered without further treatment or complications.
Association of central arterial stiffness with hippocampal blood flow and N-acetyl aspartate concentration in hypertensive adult Dahl salt sensitive rats
Authors: Ajamu Samuel O. , Fenner Rachel C. , Grigorova Yulia N. , Cezayirli Defne , Morrell Christopher H. , Lakatta Edward G. , Bouhrara Mustapha , Spencer Richard G. , Fedorova Olga V. , Fishbein Kenneth W.
Published: May 2021

Background:

Central arterial stiffness (CAS) is associated with elevated arterial blood pressure (BP) and is likely associated with stiffening of cerebral artery walls, with attendant cerebral hypoperfusion, neuronal density loss and cognitive decline. Dahl salt-sensitive (Dahl-S) rats exhibit age-associated hypertension and memory loss, even on a normal salt intake.

Method:

We sought to explore whether central arterial pulse wave velocity (PWV), a marker of CAS, is associated with hippocampal cerebral blood flow (CBF) and neuronal density in hypertensive Dahl-S rats. We measured systolic BP (by tail-cuff plethysmography), aortic PWV (by echocardiography) and CBF andN-acetyl aspartate (NAA) (by magnetic resonance imaging) in 6 month-old male Dahl-S rats (n = 12).

Results:

Greater PWV was significantly associated with lower CBF and lower NAA concentration in the hippocampus, supporting a role of CAS in cerebrovascular dysfunction and decline in cognitive performance with aging.

Conclusion:

These findings implicate increased CAS in cerebral hypoperfusion and loss of neuronal density and function in the Dahl-S model of age-associated cardiovascular dysfunction.
SURGICAL FAILURES AFTER PRIMARY SCLERAL BUCKLING FOR RHEGMATOGENOUS RETINAL DETACHMENT
Authors: Patel Samir N. , Salabati Mirataollah , Mahmoudzadeh Raziyeh , Obeid Anthony , Kuriyan Ajay E. , Yonekawa Yoshihiro , Klufas Michael A. , Garg Sunir J. , Hsu Jason , Khan M. Ali
Published: May 2021

Purpose:

To compare proliferative vitreoretinopathy (PVR)-related surgical failure and non-PVR–associated failure after scleral buckling for primary rhegmatogenous retinal detachment.

Methods:

In this single-center, retrospective, consecutive case series, eyes with surgical failure after scleral buckling for primary rhegmatogenous retinal detachment were identified. Eyes with surgical failure were categorized as PVR-associated and non-PVR–associated failure, and these groups were compared.

Results:

Of the 530 scleral buckling procedures performed, 69 were surgical failures (13%), of which 27 of the 530 (5%) were due to PVR and 42 of the 530 (8%) were from non-PVR causes. Patients with PVR-associated failure were more likely to be smokers (P < 0.001), have a delayed presentation after symptoms (P = 0.011), have preoperative vitreous hemorrhage (P = 0.004), and have preoperative PVR (P = 0.002). Multivariate logistic regression models showed that the odds of PVR-associated failure were greater in eyes with preoperative vitreous hemorrhage (odds ratio, 8.2; P = 0.048), preoperative PVR (odds ratio, 22.7; P = 0.023), and among previous smokers (odds ratio, 28.8; P < 0.001). Thirty-two of 69 patients (46%) required one additional surgical intervention, and 37 of the 69 patients (53%) required two or more additional interventions to achieve final reattachment.

Conclusion:

Proliferative vitreoretinopathy–related surgical failure after primary scleral buckling was 5%. Risk factors for PVR-associated failure parallel those commonly referenced for pars plan vitrectomy, including smoking history, preoperative vitreous hemorrhage, and preoperative PVR.
TWENTY-THREE–GAUGE HYPERSONIC VITRECTOMY
Authors: Romano Mario R. , Caretti Luigi , Ferrara Mariantonia , La Gloria Valerio Alvise , Fallico Matteo , Repetto Rodolfo , Avitabile Teresio
Published: May 2021

Purpose:

To evaluate the safety, effectiveness, and the best parameters setup of hypersonic vitrectomy.

Methods:

A prospective, multicentric, interventional study on 50 eyes that had undergone hypersonic vitrectomy because of various vitreoretinal diseases. We primarily assessed the effectiveness of vitreous removal, intraoperative complications, and surgical setup. Secondarily, we evaluated single-surgery anatomical success and postoperative best-corrected visual acuity.

Results:

Intraoperative complications occurred in 5 eyes (10%), whereas technical problems were detected in 23 eyes (46%), resulting in conversion to guillotine vitrectomy in 15 cases. The most common finding related to the technical problems was an inadequate vitreous liquefaction with the formation of vitreous strands and consequent inadequate vitreous outflow, sometimes complicated by vitreous incarceration in the vitrectomy probe. The best settings were considered a stroke of 60 µm and vacuum of 40 mmHg for both core and peripheral vitrectomy. At 3-month follow-up, primary anatomical success was achieved in 49 eyes (98%) and the mean best-corrected visual acuity overall improved.

Conclusion:

The availability of hypersonic vitrectomy in the current surgical practice opens a new era in vitreoretinal surgery. Despite the potential advantages in fluidics, the performance of hypersonic vitrectomy system needs to be further optimized, mainly for the occurrence of inadequate vitreous liquefaction and vitreous strands formation.
CHORIORETINITIS SCLOPETARIA AND ORBITAL EMPHYSEMA CAUSED BY A HIGH-VELOCITY LIQUID MISSILE
Authors: Kamboj Alisha , Hwang Christopher J. , Kulenkamp J. Erik , Mundae Rusdeep S. , Mokhtarzadeh Ali , Harrison Andrew R. , Montezuma Sandra R.
Published: May 2021

Purpose:

To highlight a case of chorioretinitis sclopetaria, with concomitant macular hole formation and orbital emphysema, caused by a commercial-grade pressure washer.

Methods:

This is a retrospective case report.

Results:

A 19-year-old man presented to the emergency department with a left eye injury, incurred after being sprayed with a commercial-grade pressure washer. He endorsed ipsilateral blurred vision, pain, and linear floaters. Left eye visual acuity was 20/40. Dilated fundus examination showed inferior vitreous hemorrhage, retinal whitening, and preretinal, intraretinal, and subretinal hemorrhages, consistent with chorioretinitis sclopetaria. Optical coherence tomography revealed a full-thickness macular hole. Computed tomography scan of the orbits showed subcutaneous and postseptal orbital emphysema. Two months after injury, vitreous and retinal hemorrhages and macular hole resolved. Five months after injury, visual acuity improved to 20/20.

Conclusion:

Chorioretinitis sclopetaria is defined as a full-thickness chorioretinal disruption resulting from a high-velocity projectile passing adjacent to or into the orbit without penetrating the globe. Chorioretinal deformation and ocular comorbidities are influenced by the velocity of the missile and its spatial relationship to the orbit. Although this pattern of injury is typically associated with indirect trauma to the globe by a BB or a bullet, this is the first report of chorioretinitis sclopetaria precipitated by a high-velocity liquid missile.
Sex differences in the antihypertensive treatment and risk of uncontrolled hypertension in 5308 hypertensive patients in the United Arab Emirates
Authors: Shehab Abdulla , Bhagavathula Akshaya Srikanth , AlHajri Noora
Published: May 2021

Background

Sex differences in the antihypertensive medications used to control blood pressure and risk factor control in hypertensive patients is poorly understood.

Methods

We conducted a retrospective review of the patients newly diagnosed with hypertension registered for treatment in 52 outpatient settings across Abu Dhabi province between 1 January and 31 December 2017. We explored sex differences in risk factors and treatment management over 6 months of the follow-up period of each patient. Multiple logistic regression models were used to identify factors associated with poor BP control.

Results

A total of 5308 patients (2559 men and 2849 women) were identified. We observed an increase in SBP and DBP levels in men (1.72/1.13 mmHg) and only SBP in women (0.87/-0.021 mmHg) with increased incidence of comorbidities overtime. The overall BP control was suboptimal (65%) (<140/90 mmHg) with no significant difference between women (65.3%) and men (64.2%). In men with dyslipidemia, use of angiotensin-converting enzyme inhibitor or angiotensin receptor blocker with diuretics and in women, only calcium channel blockers showed higher for BP control. Factors significantly associated with poor BP control in men are being overweight and obese, and dyslipidemia in men. After the age of 50, women in contrast to men, with dyslipidemia and heart rate >80 beats per minute are less likely to maintain hypertension control.

Conclusion

Sex-specific analysis indicated that BP control among United Arab Emirates men and women was suboptimal (65%). Interventions aiming to achieve better control of BP in hypertensive patients with metabolic syndrome should be emphasized.
Comparative efficacy and safety of intravenous ferric carboxymaltose and iron sucrose for iron deficiency anemia in obstetric and gynecologic patients
Authors: Shin Hye Won , Go Doo Yeon , Lee Suk Woo , Choi Yoon Ji , Ko Eun Ji , You Hae Sun , Jang Yoo Kyung
Published: May 2021

Introduction:

Iron deficiency anemia (IDA) is common among obstetric and gynecologic patients. This systematic review aimed to assess the comparative efficacy and safety of commonly used intravenous (IV) iron formulations, ferric carboxymaltose (FCM), and iron sucrose (IS) in the treatment of IDA in obstetric and gynecologic patients.

Methods:

We systematically searched PubMed, EMBASE, Cochrane CENTRAL, and Google Scholar for eligible randomized controlled trials (RCTs) comparing IV iron replacement using FCM and IS up to October 2019. The primary outcome was to compare the efficacy of FCM and IS, assessed by measuring serum hemoglobin (Hb) and ferritin levels before and after iron replacement. The secondary outcome was to compare the safety of FCM and IS, assessed by the incidence of adverse events during iron replacement. The meta-analysis was performed using RevMan 5.3.

Results:

We identified 9 RCTs with 910 patients (FCM group, n = 456; IS group, n = 454). Before iron replacement, FCM and IS group patients had similar baseline Hb (mean difference [MD], 0.04 g/dL; 95% confidence interval [CI], −0.07 to 015; I
2 = 0%; P = 0.48) and ferritin levels (MD, −0.42 ng/mL; 95% CI, −1.61 to 0.78; I
2 = 45%; P = 0.49). Following iron replacement, patients who received FCM had higher Hb (MD, 0.67; 95% CI, 0.25–1.08; I
2 = 92%; P = 0.002) and ferritin levels (MD, 24.41; 95% CI, 12.06–36.76; I
2 = 75%; P = 0.0001) than patients who received IS. FCM group showed a lower incidence of adverse events following iron replacement than IS group (risk ratio, 0.53; 95% CI, 0.35–0.80; I
2 = 0%; P = 0.003). Serious adverse events were not reported in any group.

Conclusion:

FCM group showed better efficacy in increasing Hb and ferritin levels and a favorable safety profile with fewer adverse events compared with IS group for IDA treatment among obstetric and gynecologic patients. However, this meta-analysis was limited by the small number of RCTs and high heterogeneity.

Trial registration:

The review was prospectively registered with the International Prospective Registry of Systematic Reviews (https://www.crd.york.ac.uk/prospero/, registration number CRD42019148905).
Study on the preventive effect of intravenous esomeprazole in the management of nonvarices upper gastrointestinal bleeding
Authors: Sun Xing-cheng , Yuan Wei-feng , Ma Wen-jie , Zhang Wen-jun , Xu Shuo-gui
Published: May 2021

This retrospective study investigated the preventive effect of intravenous esomeprazole (IVEO) in the prevention of nonvarices upper gastrointestinal bleeding (NUGIB).

This study enrolled 130 patients with NUGIB and all of them underwent successful endoscopic hemostasis, of which 65 cases received routine management and IVEO (Group A) and the other 65 cases received routine management alone (Group B). The primary outcome (recurrent bleeding rate within 72-hour, 7-day, and 30-day), and secondary outcomes ((all-cause mortality, bleeding-related mortality, blood transfused, hospital stay (day), and incidence of adverse events)) were compared between 2 groups.

Patients in the group A showed lower recurrent bleeding rate within 72-hour(P < .05), 7-day (P < .05), and 30-day (P < .05), than that of patients in the group B. However, no significant differences were identified in all-cause mortality(P = .26), bleeding-related mortality (P = .57), blood transfused (P = .33), and hospital stay (P = .74) between 2 groups. In addition, both groups had similar safety profile.

This study found that routine management and IVEO was superior to the routine management alone for preventing the recurrent bleeding rate after successful endoscopic hemostasis in patients with NUGIB.
COVID19 infection in a patient with paroxysmal nocturnal hemoglobinuria
Authors: Sokol Juraj , Nehaj Frantisek , Mokan Michal , Lisa Lenka , Stasko Jan
Published: May 2021

Introduction:

Paroxysmal nocturnal hemoglobinuria (PNH) is an acquired, life-threatening hemopoietic stem cell disorder characterized by the triad of hemolytic anemia, thrombosis, and impaired bone marrow function. Evidence suggests that severe outcomes in COVID19 infection are attributed to the excessive activation of the complement cascade leading to acute lung injury and associated is with an increased prothrombotic state.

Patient concerns:

A 27-year-old Caucasian man with PNH presented to the Emergency Department of our hospital with acute onset shortness of breath, cough and blood in urine.

Diagnosis:

The patient was diagnosed with acute hemolytic exacerbation of PNH complicated with moderate COVID19 pneumonia.

Outcomes:

The patient was initiated with an anticoagulant unfractionated heparin, dexamethasone, and cefuroxime injection. His symptoms quickly resolved, and he was discharged after 5 days.

Conclusion:

The complement system activation is a critical component in the sequalae of COVID19 infection. Evidence suggests that severe outcomes in COVID19 infection are attributed to the excessive activation of the complement cascade leading to acute lung injury and associated is with an increased prothrombotic state. Notably, C5a concentration was noted to be higher in patients with COVID19 infection. The use of complement inhibitors to attenuate immune mediated damage in COVID19 nevertheless represents a very interesting theoretical approach. However, careful consideration as to which patients may benefit will be required and the outcome of clinical trials needed.
Bailing Capsule combined with α-ketoacid tablets for stage 3 chronic kidney disease
Authors: Hu Xiuhong , Wang Jing , Yang Hongjuan , Ji Suhua , Li Yuhong , Xu Baozhen , Cui Hongrui
Published: May 2021

Background:

Chronic kidney disease (CKD) is a progressive and irreversible loss of kidney function. After stage 3, there will be increased risks of hypertension, heart failure, bone disease, anemia, gastrointestinal symptoms, and progression to end-stage kidney failure without proper intervention and treatment. Compound α-ketoacid tablets (KA) administration plays an important role in clinical CKD adjunctive therapy for patients with restricted protein intake. Bailing Capsule (BC), a commonly used Chinese patent medicine for renal diseases, could regulate human immune function, repair renal tubular epithelial cells, prevent renal tubular atrophy, and reduce kidney damage to improve renal function. In this study, we try to conduct a double-blinded, randomized, controlled trial to observe the efficacy and safety of BC combined with KA in treating patients with stage 3 CKD.

Methods:

This is a double-blinded, randomized, controlled trial. Patients will be randomly divided into treatment group (BC and KT) and control group (BC-simulation and KT) in a 1:1 ratio according to random number table. The treatment course will be 8 weeks, and the changes of subjective symptoms, patient global assessment (PGA) scale, serum creatinine, cystatin C, and estimated glomerular filtration rate, all related adverse events, vital sign measurements, and physical examinations will be recorded. SPSS 21.0 will be used for data analysis.

Conclusions:

The results will show whether BC combined with KA could alleviate the symptoms of fatigue, anorexia, halitosis, nausea, itching, and edema, improve kidney function in patients with CKD at stage 3.

Trial registration:

OSF Registration number: DOI 10.17605/OSF.IO/24AJ7.
Effects of overactive bladder syndrome on female sexual function
Authors: Lin Xiao-Dan , Lin Ning , Ke Zhi-Bin , Xu Ning , Jiang Ping , Li Hong
Published: May 2021

This study was to evaluate the impact of the symptoms of overactive bladder (OAB) syndrome on female sexual function. Seventy nine patients with OAB (OAB group) and 79 healthy women (control group) underwent physical examination at our center, and had their sexual function evaluated using the female sexual function index (FSFI). In accordance with the presence or absence of urge incontinence, the OAB group was further divided into the wet and dry groups. The sexual function was evaluated again after 3 months of pharmacotherapy. We investigate the difference of sexual function between OAB and control group. The effect of OAB severity and OAB pharmacotherapy on sexual function was also explored. There were no significant differences between OAB group and control group, including age, body mass index (BMI), education, occupation, fertility, parity, childbirth, and menopause. Compared with the control group, the OAB group had significantly lower FSFI scores. The respective mean ± standard error FSFI scores in the control group and the OAB group were 2.98 ± 1.07 and 2.27 ± 0.96 for desire, 3.48 ± 1.16 and 2.32 ± 1.44 for arousal, 4.60 ± 1.13 and 3.10 ± 1.95 for lubrication, 3.37 ± 0.87 and 2.63 ± 1.04 for orgasm, 3.58 ± 1.02 and 2.41 ± 1.35 for sexual satisfaction, 3.58 ± 1.02 and 2.41 ± 1.35 for sexual pain, and 22.24 ± 5.29 and 15.59 ± 7.47 for the total score (P < .05 for all comparisons). The scores for desire, lubrication, orgasm, sexual satisfaction, pain, and total FSFI between the OAB-dry and OAB-wet subgroup were similar while score of arousal in OAB-wet subgroup was significantly increased compared with that of OAB-dry. OABSS score was commonly used in the assessment of OAB severity. The difference of the FSFI scores among mild OAB group, moderate OAB group, and severe OAB group was statistically significant (P < .05). Female FSFI sexual function scores were significantly improved after OAB pharmacotherapy (P < .05). Women with OAB syndrome have poorer sexual function than healthy women. Patients with more serious OAB experience more disturbing sexual dysfunction. Female sexual function scores were significantly improved after OAB pharmacotherapy.
Efficacy of Bi Qi Capsules in combination with methotrexate in the treatment of rheumatoid arthritis
Authors: Ding Weizhong , Chen Shirong , Shi Xuexiang , Zhao Yang
Published: May 2021

Background:

It is known that Bi Qi Capsules (BQC) have synergistic effects when combined with Methotrexate, but there is a lack of clinical studies on the long-term efficacy and safety of the combination of the 2 in the treatment of rheumatoid arthritis (RA). Therefore, the purpose of this randomized controlled trial was to evaluate the long-term efficacy and safety of this treatment.

Methods:

This was a prospective, double-blind, single-simulation, randomized controlled trial investigating the efficacy and safety of BQC in combination with Methotrexate in the treatment of RA, and was approved by the Clinical Research Ethics Committee of the hospital. Patients were randomized in a 1:1 ratio to either the observation or control group and were respectively followed up for 6 months after receiving 12 weeks of treatment. The observation indexes included: total effective rate, DAS-28 score, inflammatory indexes, and adverse reactions. Finally, the collected data was statistically analyzed by SPSS version 18.0.

Discussion:

This study evaluated the long-term efficacy of BQC in combination with Methotrexate in the treatment of RA. The trial results of this study will provide new ideas for choosing a combination of Chinese and Western medicine protocols for the treatment of RA.

Trial registration:

OSF Registration number: DOI 10.17605/OSF.IO/U85GX.
Usefulness of triggered non-contrast-enhanced magnetic resonance angiography in assessing lower extremity venous disease
Authors: Chen Chien-Wei , Ting Hua , Chen Pang-Yen , Weng Jun-Cheng , Hsu Yin-Chen , Wang Shih-Chung , Tseng Yuan-Hsi , Huang Yao-Kuang
Published: May 2021

Although venous duplex ultrasonography (USG) is reliable for diagnosing lower extremity venous disease (LEVD), cross-sectional imaging studies were usually required before intervention or surgery. Patients of LEVD with renal insufficiency usually restrict the use of contrast-enhanced imaging modalities. In seeking an alternative imaging solution for these patients, we explore the clinical utility of triggered angiography non-contrast-enhanced magnetic resonance imaging (TRANCE-MRI) in the assessment of LEVD.

We collected data from patients presenting to a tertiary wound-care center with symptoms of LEVD from April 2017–November 2019. Each participant underwent baseline USG followed by TRANCE-MRI on a 1.5T MR scanner (Philips Ingenia, Philips Healthcare, Best, The Netherlands). Inter-rater reliability was measured using Cohen's kappa (κ).

All 80 participants (mean age, 61.9 ± 14.8 years; 35 males, 45 females) were assessed and were classified into one of five disease groups, deep vein thrombosis (n = 38), venous static ulcer (n = 16), symptomatic varicose veins (n = 18), recurrent varicose veins (n = 3), and lymphoedema (n = 5). The inter-rater reliability between TRANCE-MRI and doppler USG showed substantial agreement (κ, 0.73). The sensitivity, specificity, and accuracy of TRANCE-MRI were 90.5%, 88.1%, and 88.8%, respectively. In 59 (73.8%) USG-negative patients, we were able to diagnose positive findings (deep venous thrombosis, n = 7; varicose veins, n = 15; lymphedema, n = 10; iliac vein compression with thrombosis, n = 6; external venous compression, n = 5; vena cava anomaly, n = 2; occult peripheral artery disease, n = 5; ccluded bypass graft, n = 1) by using TRANCE-MRI. Of these, 9 (15.3%) patients underwent additional vascular surgery based on positive TRANCE-MRI findings.

TRANCE technique provides the limb's entire venous drainage in clear images without background contamination by associated arterial imaging. Additionally, simultaneous evaluation of bilateral lower extremities can help determine the lesion's exact site. Although TRANCE-MRI can provide MR arteriography and MR venography, we recommend performing only MR venography in symptomatic LEVD patients because the incidence of occult arterial disease is low.
miRNA-34a-5p regulates progression of neuroblastoma via modulating the Wnt/β-catenin signaling pathway by targeting SOX4
Authors: Wang Yue , Guan Enqing , Li Dehua , Sun Lirong
Published: May 2021

Neuroblastoma is an embryonal tumor of the autonomic nervous system with poor prognosis in children. In present study, we demonstrated the relationship of miRNA-34a-5p in the regulating of the Wnt/β-catenin signaling pathway by targeting SRY-related HMG-box (SOX4)

Reverse transcription-quantitative PCR was used to detect the expression levels of miRNA-34a-5p and SoX4. Western blotting was performed to assess the protein expression levels of SoX4, Wnt, MMP9, Bax, and Bcl-2. The proliferation, apoptosis, migration and invasion of neuroblastoma cells were determined using MTT, flow cytometry and Transwell assays.

In this study, we sought to investigate the role of miRNA-34a-5p on neuroblastoma and the possible molecular mechanism. We had performed in-vitro and in-vivo experiments to evaluate the effects of miRNA-34a-5p on neuroblastoma cell proliferation and invasion by altering its expression level via cell transfection. On the basis of our study, miRNA-34a-5p showed decreased expression levels in neuroblastoma. Subsequently, we manipulated miRNA-34a-5p expression through cell transfection and observed abnormal expression of β-catenin as well as the downstream targets of the Wnt/β-catenin pathway in neuroblastoma cells. With all these evidences, we determined that miRNA-34a-5p regulated Wnt/β-catenin pathway by targeting SOX4.

In conclusion, our study demonstrates that miRNA-34a-5p can inhibit the over-activation of the Wnt/β-catenin signaling pathway via targeting SOX4 and further regulate proliferation, invasion of neuroblastoma cells.