bluuebunny/crossref_metadata_2025 huggingface dataset:
Permethrin Cream for the Treatment of Demodex Blepharitis
Authors: Hecht Idan , Melzer-Golik Asia , Sadi Szyper Naava , Kaiserman Igor
Published: June 2019

Purpose:

To evaluate the safety and efficacy of permethrin 5% cream for the treatment of Demodex blepharitis.

Methods:

Patients with confirmed Demodex blepharitis were prospectively recruited and treated with permethrin 5% cream for 6 months. Blepharitis symptoms, ocular examination findings, ocular surface disease index, and ex vivo eyelash Demodex counts were regularly assessed.

Results:

Twenty-three patients were recruited, of which 2 were lost to follow up and 21 entered the analysis. Mean patient age was 57.2 ± 16.8 years (range: 24–82 years), and 13 (62%) were women. Mean Demodex counts improved after treatment from 1.36 ± 1.233 to 0.48 ± 0.6 parasites per eyelash (P = 0.03), and the overall blepharitis symptoms score improved from 42.9 ± 22 to 32.7 ± 21 (P = 0.01). Improvement in disease symptoms (scored on a scale between 0 and 4) was noted including feeling of dry eye (2.85 ± 1.3–1.85 ± 1.7, P = 0.006), discharge (1.86 ± 1.7–1.00 ± 1.1, P = 0.040), and dandruff-like debris (1.69 ± 1.7–0.9 ± 1.6, P = 0.033), as well as clinical findings including a decrease in scaling (on a scale of 1–5; 1.43 ± 0.9–0.86 ± 0.7, P = 0.006) and corneal staining with fluorescein (on a scale of 1–4; 1.29 ± 0.4–1.05 ± 0.2, P = 0.040). No change in the ocular surface disease index score was noted (37.5 ± 24.1–41.63 ± 42.5, P = 0.913), and no adverse events were reported.

Conclusions:

Treatment of Demodex blepharitis with permethrin 5% cream resulted in a decrease in parasite burden and improvement in blepharitis signs and symptoms, with no reported adverse events. Permethrin might be a safe and effective alternative for the treatment of blepharitis associated with Demodex infection.
Are BALB/c Mice Relevant Models for Understanding Sex-Related Differences in Gene Expression in the Human Meibomian Gland?
Authors: Chen Xiaomin , Sullivan Benjamin D. , Darabad Raheleh Rahimi , Liu Shaohui , Kam Wendy R. , Sullivan David A.
Published: June 2019

Background:

A compelling feature of dry eye disease is that it occurs predominantly in women. We hypothesize that this female prevalence is linked to sex-related differences in the meibomian gland (MG). This gland plays a critical role in maintaining the tear film, and its dysfunction is a major cause of dry eye disease. To understand the factors that underlie MG sexual dimorphism and promote dry eye in women, we seek to identify an optimal model for the human MG. Our goal was to determine whether a murine MG is such a model. Toward that end, we examined whether sex differences in MG gene expression are the same in BALB/c mice and humans.

Methods:

Eyelid tissues were collected from humans (n = 5–7/sex) and BALB/c mice (n = 9/sex). MGs were isolated and processed for the evaluation of gene expression by using microarrays and bioinformatics software.

Results:

Our analysis of the 500 most highly expressed genes from human and mouse MGs showed that only 24.4% were the same. Our comparison of 100 genes with the greatest sex-associated differences in human and mouse MGs demonstrated that none were the same. Sex also exerted a significant impact on numerous ontologies, Kyoto Encyclopedia of Genes and Genomes pathways, and chromosomes, but these effects were primarily species-specific.

Conclusions:

Our results indicate that BALB/c mice are not optimal models for understanding sex-related differences in gene expression of the human MG.
Tetanus presenting primarily as periocular discomfort in a patient who underwent surgery for sleep apnea
Authors: Park Donghwi , Kim Jung Soo , Heo Sung Jae
Published: June 2019

Rationale:

Tetanus is caused by a neurotoxin (tetanospasmin) secreted by a spore forming gram-positive, anaerobic rod-shaped motile bacillus, Clostridium tetani. The most common symptoms of tetanus are trismus (100%), dysphagia (70.5%), dysarthria (35.2%), and neck stiffness (29.4%). Respiratory failure, laryngeal spasm, seizure, chest pain, nausea/vomiting, opisthotonus, back pain, and rigid abdominal wall can also be observed during progression of the disease. However, there has been no report of periocular discomfort as an initial manifestation after endoscopic sleep surgery in a patient with tetanus. Here, we report a patient who underwent endoscopic sleep surgery with a concurrent diagnosis of tetanus infection presenting with atypical periocular discomfort as the initial symptom.

Patient concerns:

A 63-year-old man complaining of sleep apnea, snoring, and daytime sleepiness visited our department. He subsequently underwent sleep surgery (anterior pharyngoplasty with tonsillectomy, septoplasty, microdebrider-assisted inferior turbinoplasty, and an endoscopic sinus surgery) for the treatment of his newly diagnosed obstructive sleep apnea. After 3 weeks of surgery, he visited the outpatient clinic of our department with right side periocular discomfort.

Diagnoses:

Four days after presenting with periocular discomfort, he was diagnosed with tetanus by presenting trismus, jaw pain, dysphagia, and ptosis at an emergency department of a different hospital.

Interventions:

Tetanus immunoglobulin and antibiotics were administered.

Outcomes:

His symptoms then resolved after a month without sequelae.

Lessons:

Although periocular discomfort is atypical and is not uncommon after nasal and oral surgeries, care should be taken when patients present with periocular pain because it could be a rare initial symptom of tetanus.
Diagnostic usefulness of molecular detection of Coxiella burnetii from blood of patients with suspected acute Q fever
Authors: Bae Moonsuk , Jin Choong Eun , Park Joung Ha , Kim Min Jae , Chong Yong Pil , Lee Sang-Oh , Choi Sang-Ho , Kim Yang Soo , Woo Jun Hee , Shin Yong , Kim Sung-Han
Published: June 2019

Diagnosis of Q fever is difficult due to the lack of distinct clinical features that distinguish it from other febrile diseases. Serologic testing is the gold standard method for diagnosing Q fever, but antibody formation may not be detectable for 2 to 3 weeks from symptom onset, limiting early diagnosis. We thus evaluated the diagnostic utility of polymerase chain reaction (PCR) to detect Coxellia burnetii DNA in serum from patients with suspected acute Q fever.

All adult patients with suspected acute Q fever were prospectively enrolled at a tertiary-care hospital from January 2016 through July 2018. Acute Q fever was diagnosed using clinical and laboratory criteria: fever with at least one other symptoms (myalgia, headache, pneumonia, or hepatitis) and single phase II immunoglobulin G (IgG) antibody titers ≥1:200 or immunoglobulin M (IgM) antibody titer ≥1:50 (probable), or a fourfold increase or seroconversion in phase II IgG antibody titers as measured by indirect immunofluorescence assays between paired samples (confirmed). We performed PCR targeting the transposase gene insertion element IS1111a of C. burnetii.

Of the 35 patients with suspected acute Q fever, 16 (46%) were diagnosed with acute Q fever including 8 probable and 8 confirmed cases; the remaining 19 (54%) were diagnosed with other febrile diseases. The proportion of males diagnosed with Q fever was higher than those diagnosed with other febrile diseases (88% vs 44%, P = .03), but there were no other significant differences in clinical characteristics between the 2 groups. The Q fever PCR sensitivity was 81% (95% confidence interval [CI], 54–96), specificity was 90% (95% CI, 67–99), positive predictive value was 87% (95% CI, 63–96), and negative predictive value was 85% (95% CI, 67–94).

Q fever PCR testing using blood from patients with suspected acute Q fever seems to be a rapid and useful test for early diagnosis of Q fever.
Effects of wine on blood pressure, glucose parameters, and lipid profile in type 2 diabetes mellitus
Authors: Ye Jianhua , Chen Xufeng , Bao Ligang
Published: June 2019

Background:

Previous studies identified conflicting results about the effects of wine intake on glucose parameters and the risk of cardiovascular diseases in type 2 diabetes mellitus (T2DM). The present study further investigated the association between wine digestion and these outcomes in T2DM patients.

Material and methods:

A search of PubMed, Embase, and Scopus databases (up to November 2018) was performed for randomized interventional trials which evaluated the effect of wine on blood pressure (BP), glucose parameters and lipid profiles in T2DM people. We used a variety of tests: fixed and random effects models, Q Cochrane test and I
2 index, Egger and Begg tests, forest plots, and sensitivity analysis in our study.

Results:

A total of 9 randomized interventional studies were included in this meta-analysis. Overall, significant association between wine intake with diastolic BP (weighted mean difference [WMD] = 0.10; 95% confidence interval [95% CI]: −0.01 to 0.20, P = .03 I
2 = 13%) and total cholesterol (TC) (WMD = 0.16, 95% CI: 0.02–0.31, P = .03, I

2
 = 6%), whereas no noticeable differences in glucose parameters, systolic BP, low-density lipoprotein cholesterol (LDLC), triglyceride (TG) and high-density lipoprotein cholesterol (HDLC) were identified between wine and controls groups (fasting glucose [FG],WMD = −0.00, 95% CI: −0.58 to 0.58; fasting insulin [FI], −0.22, −2.09 to 1.65; HbAc1%, −0.16, −0.40 to 0.07; systolic blood pressure, 0.12, −0.05 to 0.28; LDLC, −0.02, −0.25 to 0.21; TG, −0.34, −1.31 to 0.64; HDLC, 0.22, −0.08 to 0.53].

Conclusion:

This meta-analysis revealed that moderate wine consumption among T2DM patients could reduce the level of diastolic blood pressure and TC, but not glucose parameters and other cardiovascular risk factors.
Fetal, neonatal, and infant death in central China (Hubei)
Authors: Deng Yanfei , Wang Rongshuai , Zhou Xiaowei , Ren Liang , Liu Liang
Published: June 2019

Data based on forensic autopsy in neonates and infants in China are rare in the literature. The purpose of this study is to evaluate the characteristics of fetal, neonatal, and infant death and to determine the main cause of death among them.

A retrospective analysis of fetal and infant forensic autopsies referred to the Tongji Forensic Medical Center (TFMC) in Hubei, central China, during a 16-year period between January 1999 and December 2014, was performed.

In this period, there were 1111 males and 543 females; the total male-to-female ratio (MFR) was 2.05:1. There were 173 fetal and infant autopsies conducted, comprised of 43 fetal, 84 neonatal (<28 days) and 46 infant (4 weeks to 1 year) cases. The annual case number ranged from 5 in 2004 to 18 in 2014 (annual mean of 10.8). MFR was 1.75:1. About 94% of these deaths (163/173) resulted from natural causes, 6 cases (3.5%) were accidental deaths, and 4 (2.3%) resulted from homicide (4 abandoned babies). Among fetuses, the most common causes of death were placental and umbilical cord pathologies (28%, 12/43), followed by intrapartum asphyxia resulting from amniotic fluid aspiration (AFA) or meconium aspiration syndrome (MAS) (18.6%, 8/43), congenital malformation (14%, 6/43), and intrapartum infection (9.3%, 4/43). A majority of neonatal deaths (66.7%, 56/84) died within 24 hours of birth. The main causes of neonatal death were asphyxia resulting from AFA, MAS, or hyaline membrane disease, and congenital malformation. The main causes of infant (1–12 months) death were infectious diseases, including pneumonia, meningitis, and viral brainstem encephalitis.

This study was the 1st retrospective analysis of autopsies of fetal, neonatal, and infant death in TFMC and central China. We delineate the common causes of early demise among cases referred for autopsy, and report a male preponderance in this population. Our data observed that placental and/or umbilical cord pathology, asphyxia due to AFA, and/or MAS, and pneumonia were the leading causes of fetal, neonatal, and infant death, respectively. And it can inform clinical practitioners about the underlying causes of some of the most distressing cases in their practices.
Post-operative giant hiatal hernia
Authors: Felix Valter Nilton , Yogi Ioshiaki , Senday Daniel , Coimbra Fernando Tadeu , Martinez Faria Kauy Victor , Belo Silva Matheus Felipe , Previero Elias da Silva Gabriel
Published: June 2019

To verify the results of the treatment of post-operative giant hiatal hernia (POGH).

The POGH becomes each time more frequent after surgical treatment of the gastroesophageal reflux.

Fifteen patients (6 females and 9 males; 43.66 ± 5.05 years old; BMI 22.13 ± 1.92) were referred to our Service, for surgical treatment of a type III POGH 30.4 ± 1.76 months after treatment of gastroesophageal reflux disease. The need for a reoperation was determined mainly by dysphagia.

Reoperation was completed laparoscopically in all patients and the mean postoperative hospital stay was 3.2 ± 1.2 days (range, 1–6 days). Mortality was 0% and there were not postoperative complications. They became asymptomatic along follow-up of 2.86 ± 1.40 years. Around 1 year from the procedure, patients were submitted to control exams and barium esophagogram revealed well positioned esophago-gastric junction and signs of intact fundoplicature, the same observation having been done at esophageal endoscopy. Esophageal manometry showed preserved peristaltism, increase of resting pressure and extension of the intra-abdominal LES and significant raise of amplitude of deglutition waves at distal third of the esophagus. No reflux was observed at post-operative 24-hour pH testing.

The corrective surgery of POGH can often be completed laparoscopically in experienced hands. Successful results can be obtained performing reduction of the hernia, sac excision, crural repair, anti-reflux procedure and long anterior gastropexy.
Cost-effectiveness analysis of infant feeding modalities for virally suppressed mothers in Canada living with HIV
Authors: Keshmiri Reyhaneh , Coyte Peter C. , Laporte Audrey , Sheth Prameet M. , Loutfy Mona
Published: June 2019

Objective:

The aim of the study was to determine whether exclusive breastfeeding or exclusive formula feeding is more cost-effective when a Canadian mother with HIV is adherent to antiretroviral therapy and has full virologic suppression.

Design:

Current Canadian guidelines recommend that mothers with HIV practice exclusive formula feeding. This contradicts the updated World Health Organization (WHO) guidelines which recommend that mothers with HIV should breastfeed for ≥12 months while receiving support for antiretroviral therapy adherence. Due to the economic and health risks and benefits associated with each modality, there remains expert disagreement on whether the WHO recommendations should be adopted in high-income countries.

Methods:

A microsimulation model was developed to estimate lifetime costs and effectiveness (i.e., infant's quality-adjusted life years) of a hypothetical group of 1,000,000 initially healthy, HIV-negative infants, if the mother with HIV was on antiretroviral therapy with full virologic suppression and either exclusive breastfeeding or exclusive formula feeding. The model was developed from the economic perspective of the Ontario Ministry of Health, taking into account direct costs associated with infant feeding modality as well as related indirect costs born out of the child's lifetime health outcomes. Uncertainties related to model parameters were evaluated using one-way and probabilistic sensitivity analyses.

Results:

In comparison to exclusive formula feeding, exclusive breastfeeding was the dominant feeding modality (i.e., less costly and more effective) yielding cost-savings of $13,812 per additional quality-adjusted life year gained. Neither one-way nor probabilistic sensitivity analyses altered the conclusions.

Conclusions:

Despite the risk of HIV transmission, exclusive breastfeeding was more cost-effective than exclusive formula feeding. These findings merit review of current infant feeding guidelines for mothers with HIV living in high-income countries.
A case report of resected ectopic malignant meningioma with lung metastasis
Authors: Murakami Kotaro , Takahashi Hidenobu , Omori Tomokazu , Uchida Osamu , Hirano Hiroshi , Kawate Norihiko , Ikeda Norihiko
Published: June 2019

Introduction:

Meningioma is mostly a benign tumor, but sometimes it is malignant, and there have been reports of distant metastases.

Patient concerns:

The patient, a woman in her 40s, was under follow-up after resection of an ectopic malignant meningioma originating in the left axilla. She was referred to our department because of a nodule shadow in the right lung on chest computed tomography (CT) 3 years and 5 months postoperatively.

Diagnosis:

Chest CT showed a 1.0 cm nodule shadow in the right S4, which was positive on positron emission tomography-CT; no abnormality was found in any other organ. Therefore, it was considered to be a metastatic lung tumor.

Interventions:

Right middle lobe partial resection was performed using thoracoscopic surgery, and a diagnosis of pulmonary metastasis of ectopic malignant meningioma was made by histopathology and immunohistochemistry.

Outcomes:

In this case, complete resection was possible.

Conclusion:

Meningioma occurs mainly in the cranium, and occurrence in the soft tissue of the extremities is extremely rare. To our knowledge, ours is the first report of a histologically malignant ectopic meningioma with metastasis to the thoracic cavity.
Ischemic stroke in the combined territories of the septum pellucidum and the cingulate gyrus
Authors: Xu Sui-Yi , Xi Fu-Chun , Wu Xiao-Wei , Li Chang-Xin
Published: June 2019

Introduction:

Cases of isolated septum pellucidum infarction have not yet been reported. To date, there are only 2 stroke reports involving septum pellucidum infarction. The etiology of septum pellucidum infarction was subcallosal artery (ScA) injury. The abnormalities were strictly confined to the septum pellucidum and the right cingulated gyrus, making this the first case to report such confined abnormalities.

Patient concerns:

In this report, we present a case of ischemic stroke confined to the septum pellucidum and cingulated gyrus in a 48-year-old male patient who presented with transient ischemic attack-like paroxysmal lower left limb weakness.

Diagnosis:

Even no obvious abnormalities were revealed by an emergency computed tomography, the infarction in the combined territories of the septum pellucidum and the cingulate gyrus was detected on magnetic resonance imaging.

Interventions:

Aspirin with clopidogrel was administered for 3 weeks as a secondary preventive drug. Clopidogrel was selected as a long-term antiplatelet drug based on a thromboelastogram.

Outcomes:

The patient showed no positive signs related to the nervous system in the hospital, and there was no recurrence during the 3-month follow-up.

Conclusions:

Infarction in the septum pellucidum and cingulate gyrus is rare and has atypical clinical manifestations. Physical examination may not yield obvious positive signs. False-negative computed tomography findings of the head may result in misdiagnosis. Thus, it is necessary to perform whole-brain magnetic resonance imaging in time. Moreover, ScA protection should be paid attention to during surgery for anterior communicating artery aneurysm.
Clinicopathologic correlations of renal biopsy findings from northeast China
Authors: Su Sensen , Yu Jinyu , Wang Yue , Wang Yu , Li Jia , Xu Zhonggao
Published: June 2019

Renal biopsy is the cornerstone of diagnostic approaches in nephrology, as they provide invaluable diagnostic information. In this study, we analyzed and reported renal biopsy results from northeast China from the past 10 years to describe the epidemiological trend.

We analyzed clinical features, indications, and histological diagnoses of renal biopsies collected between January 1, 2007, and December 31, 2016.

There were 2725 identified cases (with a mean age of 41.24 ± 15.18 years, 55% male) during the study period. The main clinical indication was nephrotic syndrome (59.9%). Membranous nephropathy (29.1%) was the most common pathological finding in the entire study population, followed by IgA nephropathy (23.4%), minimal change disease (12.7%), and mesangio-proliferative glomerulonephritis (7.4%).

We divided the study period into 2 subperiods: 2007 to 2011 (period 1) and 2012 to 2016 (period 2). Membranous nephropathy and minimal change disease were more frequent in period 2 than in period 1. Conversely, IgAN and non-IgA mesangio-proliferative glomerulonephritis were less frequent in period 2 than in period 1. Cases of Henöch–Schönlein purpura nephritis and lupus nephritis were observed less over time, while cases of nephroangiosclerosis increased significantly over time. Finally, there was a significant increase in the number of tubulointerstitial diseases observed over time, while there was a significant decrease in glomerulosclerosis and unclassified findings over time.

Membranous nephropathy was the most common pathological finding from renal biopsy and the prevalence has increased significantly in recent years in northeast China.
Analysis of the use of upright abdominal radiography for evaluating intestinal perforations in handlebar traumas
Authors: Mehmetoğlu Feride
Published: June 2019

Rationale:

Intestinal perforations due to blunt abdominal handlebar trauma are difficult to diagnose. This report presents a retrospective analysis of 3 patients with intestinal perforations due to abdominal bicycle handlebar trauma who were diagnosed via upright abdominal radiography.

Patients concerns:

All the patients lost their balance while riding a bicycle for leisure and had fallen on the handlebar tip. The patients were initially misdiagnosed at different-level health centers despite various radiologic investigations performed.

Diagnosis:

The patients’ intestinal perforations were diagnosed via plain upright abdominal X-ray radiography (UAXR) in our institution.

Interventions and outcomes:

The children underwent exploratory laparotomy due to intestinal perforations. All the perforations were repaired either with primary closure or bowel resection and anastomosis with successful outcomes.

Lessons:

Pneumoperitoneum due to intestinal perforation can be diagnosed via UAXR with appropriate patient positioning and timing. This case series shows that to accurately diagnose intestinal perforations, upright plain X-ray should be routinely performed, carefully evaluated, and repeated in patients with enduring abdominal complaints.
Moxibustion for rheumatoid arthritis
Authors: Wu Xiao , Zhang Yong , Chen Bailu , Luo Jing , Gan Lu , Chen Guiquan
Published: June 2019

Background:

Rheumatoid Arthritis (RA) is a serious chronic disease which will result in serious syndrome such as joints stiffness, disability, and death. The major medications treating RA usually make sense and side effects, while moxibustion is known as a safe and effective treatment for RA. This review aims to systematically evaluate the effect and safety of moxibustion for treating RA.

Methods:

The following databases will be searched from their inception to March 2019: PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, Wan-Fang Databases, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), Citation Information by National Institute of Informatics, Chinese Scientific Journal Database (VIP Database). Two reviewers will search these databases, select data and measure the quality of studies independently. The methodological quality will be assessed by the Cochrane risk of bias tool. Data will be synthesized by either the fixed-effects or random-effects model according to a heterogeneity test. The primary outcome is symptom evaluation including morning stiffness, pain and joint swelling. The number of joints affected by RA, adverse effects, quality of life, erythrocyte sedimentation rate (ESR), C reactive protein (CRP), and Rheumatoid factor (RF) will be evaluated as secondary outcomes. Risk ratio for dichotomous data and mean differences with a 95% confidence interval for continuous data will be adopted to express the effect and safety of acupuncture for RA.

Results:

This study will provide a high-quality synthesis of current evidence of moxibustion for asthma from several aspects including morning stiffness, pain and joint swelling. The number of joints affected by RA, adverse effects, quality of life, erythrocyte sedimentation rate (ESR), C reactive protein (CRP), and Rheumatoid factor (RF).

Conclusion:

The conclusion of our study will provide updated evidence to judge whether moxibustion is an effective and safe intervention for patients with RA.

Ethics and dissemination:

As individuals will not be involved, the ethical approval will not be required. This review will be published in a peer-reviewed journal or at a relevant conference.

Prospero registration number:

CRD42019126685.
Association between gene variants and the recurrence of atrial fibrillation
Authors: Jiang Tao , Wang Ya-Nan , Qu Qiang , Qi Ting-Ting , Chen Yun-Dai , Qu Jian
Published: June 2019

Background:

Studies showed the controversial results about the effect of common genetic polymorphisms on the atrial fibrillation (AF) recurrence. We performed the systematic review and meta-analysis to qualify the association between common genetic polymorphisms and AF recurrence.

Methods:

Articles were systematically retrieved PubMed, Web of Science, EMBASE, Wanfang, and CNKI database and 9 studies including 3204 patients were enrolled in our meta-analysis.

Results:

Results showed that the associations were significant under rs2200733 3 genetic models (TT vs CC: odds ratio [OR] [confidence interval [CI]] = 1.336 [1.061–1.683], P = .014; CT vs CC: OR [CI] = 0.759 [0.614–0.937], P = .01; TT vs CT + CC: OR [CI] = 2.308 [1.440–3.700], P = .001). The association was significant under rs10033464 genetic model (TT vs GG: OR [CI] = 1.517 [1.165–1.976], P = .002).

Conclusions:

Rs13376333 on chromosome 1q21 (in KCNN3), rs7193343 and rs2106261 on chromosome 16q22 (in ZFHX3) were not associated with AF recurrence in our meta-analysis. In total, our meta-analysis found that rs2200733 and rs10033464 on chromosome 4q25 (near PITX2) were associated with the risk of AF recurrence.
3’UTR polymorphisms in NRAMP1 are associated with the susceptibility to pulmonary tuberculosis: A MOOSE-compliant meta-analysis
Authors: Liu Yang , Zhao Erjiang , Zhu Lin , Zhang Danning , Wang Zhe
Published: June 2019

Many studies have investigated the association between the 3’UTR polymorphism in natural resistance-associated macrophage protein 1 (NRAMP1) and the risk of pulmonary tuberculosis (PTB), Revealing inconclusive results. This study aimed to investigate the correlation between the NRAMP1 3’UTR polymorphism and the risk of PTB.

This meta-analysis included 29 case–control studies to better and comprehensively assess this correlation. Pooled odds ratios (ORs) and 95% confidence interval (95% CIs) were calculated to assess the strength of the association.

These 29 case–control studies included 4672 cases and 6177 controls. The NRAMP1 3’UTR polymorphism displayed a significant positive correlation with the risk of PTB in 3 models (for del/del vs ins/ins: OR = 1.22, 95% CI = 1.01–1.47; for Ins/del vs ins/ins: OR = 1.19, 95% CI 1.08–1.30; for Ins/del + del/del vs ins/ins: OR = 1.25, 95% CI = 1.08–1.45). A stratified analysis by ethnicity revealed that the NRAMP1 3’UTR polymorphism was associated with an increased risk of PTB in the Asian population, but not in Caucasian, African, and South American populations.

The present results indicate that the NRAMP1 3’UTR polymorphism may be considered a risk factor for PTB in the Asian population.
Auriculotherapy in the prevention of postoperative urinary retention in patients with thoracotomy and thoracic epidural analgesia
Authors: Michel-Cherqui Mireille , Szekely Barbara , Lemoyne François , Feliot Elodie , Gayat Etienne , Fischler Marc
Published: June 2019

Background:

Thoracic epidural analgesia is associated with a high rate of postoperative urine retention (POUR). Auriculotherapy can reduce visceral dysfunction and can be helpful in anesthesiology and pain control. The aim of this study was to test the efficacy of preoperative auriculotherapy to decrease the occurrence of POUR.

Methods:

This single-center, double-blinded, 2-arm randomized study was performed between January 2015 and May 2016 in a tertiary care university hospital. Male patients scheduled for an elective lung surgical procedure under combined general anesthesia and thoracic epidural analgesia were included. Auriculotherapy (A group) was performed once the patient was under general anesthesia with 5 semi-permanent needles inserted in both ears at the “Shen Men” “bladder”, “pelvic parasympathetic”, “anterior hypothalamus”, and “frontal lobe” points. Five small round patches of adhesive pads were positioned bilaterally at the same points in the control group (C group). The main outcome measure was the requirement for bladder catheterization during the day and the first night following surgery.

Results:

Fifty-three patients were randomized and 25 analyzed in each group. Requirement for bladder catheterization was different between groups: 24 C group patients (96%) and 18 A group patients (72%) (P = .049, Fisher exact test; Odds Ratio = 0.11 [0.01–0.95]. The number of patients needed to treat with auriculotherapy to avoid 1 case of bladder catheterization was 4. No adverse effect was observed due to auriculotherapy.

Conclusion:

This study demonstrates that auriculotherapy is a safe and useful technique reducing POUR in thoracotomy patients benefiting from thoracic epidural analgesia.

Trial registration:

Clinicaltrials.gov identifier: NCT 02290054 (November 13, 2014).
Association of serum gastric inhibitory polypeptide and pancreatic polypeptide levels with prolonged esophageal acid exposure time in refractory gastroesophageal reflux disease
Authors: Chen Jing , Guo Baona , Guo Zihao , Li Li , Jiang Jiali , Zhan Yutao , Wu Jixiang , Zhang Chuan
Published: June 2019

Background:

Acid exposure time (AET) prolongation plays an important role in the pathogenesis of gastroesophageal reflux disease (GERD). Gastric inhibitory polypeptide (GIP) and pancreatic polypeptide (PP) participate in the regulation of gastric acid secretion, blood glucose and lipid levels, and food intake. In this study, we evaluated the serum GIP and PP levels in refractory GERD patients and analyzed their metabolic and motility characteristics.

Methods:

Seventy-three refractory GERD patients were enrolled in this study from September 2015 to September 2017. We investigated the clinical characteristics, severity, and duration of GERD symptoms. High-resolution manometry and 24 hours impedance-pH monitoring were performed to assess esophageal motility and reflux parameters. The patients were divided into the AET− group (AET <4.2%) and AET+ group (AET >4.2%). GIP and PP levels were determined in all subjects and their associations with other parameters evaluated.

Results:

Age and GERDQ score were significantly higher (P < .05) and acid reflux and heartburn more frequent in the AET+ group than in the AET− group. The contraction front velocity was increased in the AET− group, while there was no significant difference in the distal contraction integral, peristalsis interruption, distal latency, or resting pressures of the lower and upper esophageal sphincters between the 2 groups (P > .05). The serum levels of GIP (P = .003) and PP (P = .012) were significantly increased in the AET+ group. Increased GIP and PP levels were associated with abnormal upright AET (correlation coefficients 0.307 and 0.233, P = .008 and P = .047). There was a positive correlation between GIP and triglyceride levels (correlation coefficient 0.279, P = .017).

Conclusion:

The serum levels of GIP and PP in refractory GERD patients with prolongation of AET are significantly elevated, mainly in the upright position.
Efficacy of XELOX adjuvant chemotherapy for gastric mixed adenoneuroendocrine carcinoma
Authors: Lin Zhixian , Chen Jiangfeng , Guo Yong
Published: June 2019

Rationale:

Mixed adenoneuroendocrine carcinoma (MANEC) is a rare neoplasm, and consensus on the treatment is unavailable.

Patient concern:

A 60-year-old Chinese man presented with obstructive symptoms while eating and paroxysmal stomach pain for more than a month.

Diagnosis:

MANEC was diagnosed based on clinical manifestations, imaging findings, and pathological examinations.

Interventions:

The patient underwent radical gastrectomy and received XELOX adjuvant chemotherapy (oxaliplatin 200 mg day 1 + capecitabine 1.5 g twice a day) after surgery.

Outcomes:

After 4 cycles of XELOX adjuvant chemotherapy were administered, abdominal computerized tomography and liver magnetic resonance showed liver metastasis.

Lessons:

The therapy of gastric MANEC is based on surgical operation, and adjuvant chemotherapy program has an important influence on its prognosis. Therefore, further studying the effectiveness of XELOX adjuvant chemotherapy for gastric MANEC is necessary.
The clinical result of arterialized venous free flaps for the treatment of soft tissue defect of the fingers
Authors: Lee Malrey , Lee Young-Keun , Kim Dong-Hee
Published: June 2019

The purpose of this study is to report the clinical results of the arterialized venous free flaps in reconstructing soft tissue defects of the finger and to extend the indications for the use of the flaps based on clinical experiences of the authors.

We retrospectively reviewed the records of 35 patients who underwent an arterialized venous free flaps for a finger reconstruction, between May 2007 and August 2015. The mean size of flap was 4.8 ± 1.23 × 3.1 ± 0.84 cm. The donor site was the ipsilateral volar aspect of the distal forearm in all cases. There were 17 (48.6%) cases of venous skin flaps, 9 (25.7%) cases of innervated venous flaps, 7 (20%) cases of tendocu taneous flaps, and 2 (5.7%) case of innervated tendocutaneous flap. The vascularity of recipient beds was good except 8 (22.9%) cases (partial devascularity in 3, more than 50% avascularity [bone cement] in 3, and chronic infected bed in 2).

Of the 35 cases, 29 (82.9%) cases (including 3 cases who had more than 50% avascularity recipient bed) showed complete survival. 3 (8.6%) cases, which had partially devascularity of distal phalanx in recipient bed, showed partial necrosis (P = .015). The mean number of included veins was 2.4 ± 0.5 for a flap.

A forearm arterialized venous free flap is a useful procedure for single-stage reconstructing of a soft tissue or combined defect of a finger, we consider that this technique could be applied to fingers despite an avascular or insufficient vascular recipient bed if the periphery of recipient bed vascularity was good and if the recipient beds were free from infection.
Hypothermic machine perfusion reduces the incidences of early allograft dysfunction and biliary complications and improves 1-year graft survival after human liver transplantation
Authors: Zhang Yili , Zhang Yangmin , Zhang Mei , Ma Zhenhua , Wu Shengli
Published: June 2019

Background:

The worldwide organ shortage continues to be the main limitation of liver transplantation. To bridge the gap between the demand and supply of liver grafts, it becomes necessary to use extended criteria donor livers for transplantation. Hypothermic machine perfusion (HMP) is designed to improve the quality of preserved organs before implantation. In clinical liver transplantation, HMP is still in its infancy.

Methods:

A systematic search of the PubMed, EMBASE, Springer, and Cochrane Library databases was performed to identify studies comparing the outcomes in patients with HMP versus static cold storage (SCS) of liver grafts. The parameters analyzed included the incidences of primary nonfunction (PNF), early allograft dysfunction (EAD), vascular complications, biliary complications, length of hospital stay, and 1-year graft survival.

Results:

A total of 6 studies qualified for the review, involving 144 and 178 liver grafts with HMP or SCS preservation, respectively. The incidences of EAD and biliary complications were significantly reduced with an odds ratio (OR) of 0.36 (95% confidence interval [CI] 0.17–0.77, P = .008) and 0.47 (95% CI 0.28–0.76, P = .003), respectively, and 1-year graft survival was significantly increased with an OR of 2.19 (95% CI 1.14–4.20, P = .02) in HMP preservation compared to SCS. However, there was no difference in the incidence of PNF (OR 0.30, 95% CI 0.06–1.47, P = .14), vascular complications (OR 0.69, 95% CI 0.29–1.66, P = .41), and the length of hospital stay (mean difference −0.30, 95% CI −4.10 to 3.50, P = .88) between HMP and SCS preservation.

Conclusions:

HMP was associated with a reduced incidence of EAD and biliary complications, as well as an increased 1-year graft survival, but it was not associated with the incidence of PNF, vascular complications, and the length of hospital stay.
The evolving roles of computer-based technology and smartphone applications in facial plastic surgery
Authors: Kayastha Darpan , Vakharia Kalpesh T.
Published: June 2019

Purpose of review

This article aims to provide a comprehensive review of the established and emerging applications of various computer-based technologies and smartphone applications in the field of facial plastic surgery.

Recent findings

Computer-based technologies and smartphone applications have widespread utility across various domains of facial plastic surgery; these include preoperative consultation, surgical planning, intraoperative navigation, custom implant creation, postoperative assessment, physician productivity, communication, and education. Smartphone applications are being utilized for assessment of patients such as those with facial paralysis. Three-dimensional (3D) imaging and 3D printing has influenced preoperative counseling, surgical planning, and execution. The incorporation of intraoperative navigation has the potential to improve the accuracy and precision of facial reconstruction.

Current advances in computer-based technology have made a significant impact on the practice of facial plastic and reconstructive surgery. These technological advances have influenced how we counsel patients, perform procedures, assess outcomes, and learn new techniques.
Metabolic syndrome and inflammatory skin conditions
Authors: Steele Chelsea Elizabeth , Morrell Dean , Evans Megan
Published: June 2019

Purpose of review

Several chronic inflammatory skin disorders have been linked to metabolic syndrome (MetS) and an increased risk for cardiovascular disease. In this review, we will summarize the recent evidence on the association between psoriasis, hidradenitis suppurativa (HS), and atopic dermatitis (AD) and metabolic syndrome with careful attention to this association among the pediatric population.

Recent findings

Historically, psoriasis has exhibited the most robust association with MetS in the literature. Recent studies show that the prevalence of MetS appears to be higher among patients with HS and can be associated with MetS even in mild disease. A relationship between AD and MetS is still under debate, but research has shown a clear link between pediatric AD and being overweight or obese.

There are no current consensus guidelines for metabolic syndrome in the pediatric population, and its clinical implications in children are still unclear. Nevertheless, providers should be aware of the shared underlying inflammatory state and link between several cutaneous disorders and metabolic syndrome. Early diagnosis and proper disease management of these at risk populations has the potential to assist in disease control and mitigate future cardiovascular disease.
Altered Bile Transporter Expression and Cholesterol Metabolism in Children With Cholesterol and Pigment Gallstones
Authors: Koivusalo Antti , Mutanen Annika , Nissinen Markku , Gylling Helena , Pakarinen Mikko
Published: June 2019

Objectives:

We elucidated pathophysiology of pediatric gallstone disease by assessing liver expression of bile transporters in relation to bile acids and surrogates of cholesterol absorption and synthesis in serum and gallstones.

Methods:

RNA expression of canalicular bile transporters in liver biopsies from 32 pediatric gallstone patients and from 6 liver donors (controls) was measured by qRT‐PCR (quantitative real‐time reverse transcription polymerase chain reaction). Concentrations of cholesterol and precursors, plant sterols and bile acids in gallstones, and in serum of the patients and 82 healthy children were measured. Primary outcomes were the difference in RNA expressions and serum sterol profiles between patients and controls.

Results:

Cholesterol stones (CS; n = 15) contained cholesterol >42% and pigment stones (PS; n = 17) <9% of weight. CS patients had markedly lower serum plant sterols (absorption) and higher cholesterol precursors (synthesis) than PS patients or healthy controls. CS contained several times more cholesterol precursors and less plant sterols relative to cholesterol than PS, which were enriched by primary bile acids (12–5.2‐fold, P < 0.001). Liver RNA expression of ABCG5/G8 was similarly increased 2.5‐ to 1.8‐fold (P < 0.002) in CS and PS patients, whereas PS patients had higher ABCB11 expression (P < 0.05). In PS bile acid concentration correlated with gallstone plant sterols (R2 = 0.83, P < 0.0001), and ABCG5 expression with ABCB11 expression (R2 = 0.27, P = 0.03).

Conclusions:

In CS, upregulation of ABCG5/G8 expression associates with low absorption and high gallstone content of cholesterol. In PS, activation of bile acid transport by ACBC11 interconnects with hepatic upregulation of ABCG5/G8 enriching PS with bile acids and plant sterols.
Long‐term Effects of Cholestatic Liver Disease in Childhood on Neuropsychological Outcomes and Neurochemistry
Authors: Talcott Joel B. , Beath Sue V. , Patel Tulpesh , Griffiths Gareth , Kelly Deirdre A.
Published: June 2019

Objectives:

Children with liver disease have increased risk of long‐term cognitive deficits. We differentiated between the effects of chronic liver disease from that associated with transplantation by recruiting children with cholestatic liver disease (CLD) with and without transplantation.

Methods:

Psychometric measures and magnetic resonance spectroscopy were obtained for 3 groups of children: stable liver disease without transplantation; CLD from birth with transplantation; and individuals healthy to 18 months of age, before transplantation for acute liver failure.

Results:

Cognitive outcomes between children with different disease histories were significantly associated with the duration of liver disease but not the effects of transplantation, including that of immunosuppression. Lower intellectual ability was most frequently observed in the CLD group, whereas all of the acute liver failure group scored within the normal range. Myoinositol and glutamate/glutamine concentrations in cortex were significantly associated with disease duration across the cohort. Neurometabolite profiles in stable liver disease were consistent with subclinical encephalopathy. Impaired growth in early childhood was associated with later cognitive performance.

Conclusion:

Children with prolonged liver disease had the poorest cognitive outcomes despite successful transplantation, suggesting that prolonged cholestasis before transplantation adversely affects neurodevelopment, and reinforces the need for timely interventions.
Correlates of Gut Function in Children Hospitalized for Severe Acute Malnutrition, a Cross‐sectional Study in Uganda
Authors: Lanyero Betty , Grenov Benedikte , Barungi Nicolette N. , Namusoke Hanifa , Michaelsen Kim F. , Mupere Ezekiel , Mølgaard Christian , Jiang Pingping , Frøkiær Hanne , Wiese Maria , Muhammed Musemma K. , Pesu Hannah , Nielsen Dennis S. , Friis Henrik , Rytter Maren JH. , Christensen Vibeke B.
Published: June 2019

Objective:

Children with severe acute malnutrition (SAM) may have impaired intestinal function, which can result in malabsorption, diarrhoea, and poor growth. This study evaluated the gut function of children with SAM using fecal and blood biomarkers and assessed their correlates.

Methods:

A cross‐sectional study, nested in a randomized trial (www.isrctn.com, ISRCTN 16454889), was conducted at Mulago hospital, Uganda among subgroups of 400 children with complicated SAM and 30 community controls. Gut function was evaluated by 5 biomarkers: plasma citrulline, fecal myeloperoxidase and fecal neopterin, bacterially derived 16S rRNA gene and internal transcribed Spacer region (ITS) specific for Candida spp. in blood.

Results:

Compared with controls, children with SAM had lower median plasma citrulline (5.14 vs 27.4 μmol/L, P < 0.001), higher median fecal myeloperoxidase (18083 vs 7482 ng/mL, P = 0.001), and fecal neopterin (541 vs 210 nmol/L, P < 0.001). A higher blood concentration of 16S rRNA gene copy numbers was observed among children with SAM (95 vs 28 copies/μl, P = 0.05), whereas there was no difference in the blood concentration of Candida‐specific ITS fragment.

Among those with SAM, plasma citrulline was lower in children with edema, diarrhoea, dermatosis, and plasma C‐reactive protein (CRP) >10 mg/L. Fecal neopterin was positively correlated with symptoms of fever and cough whereas it was negatively correlated with mid‐upper arm circumference (MUAC), weight‐for‐height z score (WHZ), edema, and dermatosis.

Conclusions:

Children with complicated SAM seem to have impaired gut function characterized by reduced enterocyte mass, intestinal inflammation, and increased bacterial translocation.
Innovation During Orientation
Authors: Wendler Andrew J. , Wendler Zoe Ann , Wendler M. Cecilia
Published: June 2019

Modern health care demands knowledge, swift action, and critical thinking from nurses. New and experienced registered nurses are better able to provide excellent care when they are supported by documents that drive consistent nursing action. The process of developing these documents is critically important. Technical writers can improve the adoption of carefully designed forms that help newly licensed registered nurses develop a foundation in critical thinking as they move through orientation.
A test of psychological and electrodermal changes immediately after the delivery of 3 analgesic treatment messages
Authors: Geers Andrew L. , Fowler Stephanie L. , Helfer Suzanne G. , Murray Ashley B.
Published: June 2019

Introduction:

Placebo analgesia often results when a pain reduction treatment message is delivered to a patient or research participant. Little information exists regarding the psychological changes that are immediately triggered by the delivery of a treatment message.

Objectives:

This experiment tested the impact of 3 different analgesic treatment messages on the expectations, feelings, and electrodermal activity of participants anticipating a pain stimulus.

Methods:

In laboratory sessions, healthy participants (N = 138) were randomly assigned to 1 of 4 conditions in a between-subject design. The design included a no treatment message control condition and 3 treatment message conditions: a standard analgesic message, an analgesic treatment with side-effect message, and a double-blind analgesic message. After the treatment message manipulation, measures were taken of: treatment efficacy expectations, pain experience expectations, pretask anxiety, positive affect, negative affect, and electrodermal activity.

Results:

Overall, the dependent measures showed relatively few correlations. Furthermore, across all 3 message conditions, treatment-specific expectations were greatly increased compared with the control condition. Finally, participants in the double-blind message condition displayed elevated negative affect.

Conclusion:

All 3 analgesic treatment messages produced a stronger immediate influence on treatment efficacy expectations than on the other dependent measures. Treatment messages can alter negative affect along with expectancies. The low correlations found between dependent measures suggest that different patterns of psychological responses may emerge from analgesic treatment messages depending on contextual factors.