bluuebunny/crossref_metadata_2025 huggingface dataset:
Design and fabrication of a parasite-inspired, millimeter-scale tissue anchoring mechanism
Authors: Maquignaz Gabriel , Zoll Rachel , Karpelson Michael , Weaver James C , Wood Robert J
Published: December 2024

Optimizing mechanical adhesion to specific human tissue types is a field of research that has gained increasing attention over the past two decades due to its utility for diagnostics, therapeutics, and surgical device design. This is especially relevent for medical devices, which could benefit from the presence of attachment mechanisms in order to better target-specific regions of the gastrointestinal (GI) tract or other soft tissues for sensing, sample collection, and drug release. In this work, and inspired by the tissue anchoring adaptations found in diverse parasitic taxa, we present a design and manufacturing platform for the production of a nonintuitive bioinspired millimeter-scale articulated attachment mechanism using laminate fabrication techniques. The functional design closely mimics the geometry and motions of curved hooks employed by some species of tapeworms to attach to their host’s intestinal walls. Here, we show the feasibility of such a mechanism both in terms of attachment capabilities and manufacturability. Successful attachment of a prototype to tissue-simulating synthetic medical hydrogels is demonstrated with an adhesion force limited only by the ultimate strength of the tissue. These results demonstrate the efficacy of parasite-inspired deployable designs as an alternative to, or complement to, existing tissue attachment mechanisms. We also describe the design and manufacturing process workflow and provide insights for scaling the design for mass-production.
Radiance cascades: a novel high-resolution formal solution for multidimensional non-LTE radiative transfer
Authors: Osborne C M J , Sannikov A
Published: December 2024

Non-LTE radiative transfer is a key tool for modern astrophysics: it is the means by which many key synthetic observables are produced, thus connecting simulations and observations. The default approach for computing the radiation field in multidimensional solar radiative transfer models has long remained the same: a short characteristics, discrete ordinates method, formal solver. In situations with complex atmospheric structure and multiple transitions between optically thick and thin regimes these solvers require prohibitively high angular resolution to correctly resolve the radiation field. Here, we present the theory of radiance cascades, a technique designed to exploit structure inherent to the radiation field, allowing for efficient reuse of calculated samples, thus providing a very high-resolution result at a fraction of the computational cost of existing methods. We additionally describe our implementation of this method in the DexRT code, and present initial results of the synthesis of a snapshot of a magnetohydrodynamic model of a solar prominence formed via levitation-condensation, along with comparison against short characteristics solutions. The approach presented here provides a credible route for routinely performing multidimensional radiative transfer calculations free from so-called ray effects, and scaling high-quality non-LTE models to next-generation high-performance computing systems with GPU accelerators.
CO-loaded hemoglobin/EGCG nanoparticles functional coatings for inflammation modulation of vascular implants
Authors: Wu Sui , Dong Ruichen , Xie Yinhong , Chen Wenhao , Liu Wei , Weng Yajun
Published: December 2024

During the implantation process of cardiovascular implants, vascular damage caused by inflammation occurs, and the inflammatory process is accompanied by oxidative stress. Currently, carbon monoxide (CO) has been demonstrated to exhibit various biological effects including vasodilatation, antithrombotic, anti-inflammatory, apoptosis-inducing and antiproliferative properties. In this study, hemoglobin/epigallocatechin-3-gallate (EGCG) core-shell nanoparticle-containing coating on stainless steel was prepared for CO loading and inflammation modulation. Inspired by strong coordination ability with CO, hemoglobin nanoparticle was first prepared and encapsulated into EGCG metal-phenolic networks. A polydopamine (PDA) linking layer was then coated on 316 stainless steel, and the hemoglobin/EGCG nanoparticles were loaded with the subsequent PDA deposition. It showed that the maximum release amount of CO by the coating was 17.0 nmol/cm2 in 48 h. In vitro evaluations conducted in a simulated inflammatory environment revealed that the coating, which released CO from hemoglobin/EGCG nanoparticles, effectively mitigated the lipopolysaccharide-induced inflammatory response in macrophages. Specifically, it decreased the expression of tumor necrosis factor-α, increased the expression of interleukin-10, suppressed the polarization of macrophages toward the M1 phenotype and reduced intracellular reactive oxygen species (ROS). Furthermore, under simulated oxidative stress conditions, the coating decreased the apoptosis of endothelial cells induced by oxidative stress and down-regulated intracellular ROS levels. In vivo implantation results further confirmed that the coating, with its hemoglobin/EGCG nanoparticles and CO release capabilities, reduced macrophage-mediated inflammatory responses and modulated the polarization phenotype of macrophages.
Sex‐specific cytokine, chemokine, and growth factor signatures in T1D patients and progressors
Authors: Girdhar Khyati , Mine Keiichiro , DaCosta Jeffrey M. , Atkinson Mark A. , Ludvigsson Johnny , Altindis Emrah
Published: December 2024

Numerous studies have reported altered cytokine levels in type 1 diabetes (T1D) patients, yet findings remain inconsistent. In this pilot study, we tested the hypothesis that circulating immune markers exhibit sex‐based differences in T1D, both prior to and after disease onset. We analyzed 47–48 cytokine, chemokine, and growth factor levels in two cohorts. To assess post‐disease differences, we analyzed serum samples from 25 controls and 25 T1D patients. To examine pre‐disease progression, we utilized samples from 21 control children and 16 T1D progressors, collected at age 5 years before disease onset. Across all T1D patients and controls, only macrophage colony‐stimulating factor and interleukin (IL)‐6 showed significant differences. However, we identified notable alterations when comparing sex‐age‐matched controls and T1D samples. Female T1D patients exhibited lower levels of inflammatory cytokines (tumor necrosis factor‐α, IL‐6, IL‐1a), Th2 cytokines (IL‐4, IL‐13), and chemokines (macrophage inflammatory protein (MIP)‐1α, regulated upon activation, normal T cell expressed and secreted, MIP‐3) compared to female controls, differences that were not observed in males. Notably, IL‐22 was lower in female T1D patients compared to female controls, whereas it was higher in male T1D patients compared to male controls. Male T1D patients showed elevated levels of growth factors (epidermal growth factor, platelet‐derived growth factor‐AB/BB) compared to male controls. In T1D progressors, growth‐regulated alpha was lower compared to controls in both sexes. Multiple regression analysis further revealed associations between cytokine levels and factors such as age, BMI, and breastfeeding duration. Overall, our findings serve as a proof of concept, highlighting the importance of sex‐specific differences in T1D pathogenesis. However, follow‐up studies with larger sample sizes are needed to validate and generalize these results.
Before You Tap That: Changes to Paracentesis Management Every Radiologist Should Know
Authors: McNulty Catherine A. , Vuu Kien
Published: December 2024

Paracentesis is a deceivingly simple, ubiquitously performed procedure on the wards and in the interventional suites. Radiologists may be confused about the updated pre- and post-procedural management of patients with cirrhosis and ascites. We review the basics of paracentesis that any performing provider should know, including indications, absolute and relative contraindications, and methods. Updated guidelines for preprocedure laboratory tests, replacement of blood products, and use of albumin are discussed in detail and compared with the previous guidelines.
Pembrolizumab-induced acquired lipodystrophy: a case report and review of the literature
Authors: Marsiglio John , McPherson Jordan , Wahl Matthew , Hu-Lieskovan Siwen
Published: December 2024

Acquired generalized lipodystrophy (AGL) is a rare complication of immune checkpoint inhibitors (ICIs) and is associated with immune-mediated loss of adipose tissue, peripheral resistance to insulin, and serious metabolic complications. Here we report a new case of ICI-induced AGL and provide an updated literature review of published cases. We report a 39-year-old female patient treated with adjuvant pembrolizumab for stage IIIC nevoid melanoma with ICI-induced AGL. After six cycles of pembrolizumab, she developed a 40 lb weight loss with fat wasting, a decreased leptin level, significant liver function abnormalities, hepatic steatosis, hypertriglyceridemia, and subsequently was found to have severe insulin dependence and resistance. No corticosteroids were given and pembrolizumab was discontinued. AGL persists at 3-year follow up and patient remains free of melanoma progression. Literature review identified an additional seven patients who developed ICI-induced acquired lipodystrophy, predominantly female. Of the identified cases, three patients received steroids without resolution of their acquired lipodystrophy, while one patient had resolution without steroid treatment. Five patients and our case were treated with ICIs for melanoma, and all had at least a partial response to treatment. ICI-induced acquired lipodystrophy is an exceedingly rare event with profound clinical consequences. Our case report and literature review better characterized the clinical course and treatment outcomes of these patients. With the increasing utilization of ICIs in treating cancer, further studies to better understand the underlying mechanism and to guide clinical management of the metabolic complications are needed.
Advances in the management of posttraumatic stress disorder after critical illness: a narrative review
Authors: Asimakopoulou Evanthia , Theodosis-Nobelos Panagiotis , Triantis Charalampos
Published: December 2024

Illness requiring critical care can lead to the development of posttraumatic stress disorder (PTSD), a complex mental health condition resulting from exposure to traumatic events. In the intensive care unit (ICU), the nature of interventions often contributes to a high incidence of PTSD, which is a significant component of post-intensive care syndrome (PICS). This article provides a comprehensive overview of the pathophysiological mechanisms underlying PTSD and explores various intervention strategies, emphasizing the importance of a multidisciplinary and holistic approach. Although prevention remains the best therapy, pharmacotherapy is a key component in the management of PTSD symptoms. Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), have demonstrated efficiency in alleviating symptoms. 3,4-Methylenedioxymethamphetamine–assisted therapy is the most promising approach, and the results of the clinical trials are encouraging. Furthermore, medications targeting specific neurotransmission systems involved in fear responses and emotional regulation are being explored, offering promising avenues for future treatment. Nonpharmacological interventions are integral to PTSD treatment. These are often employed alone or in conjunction with pharmacotherapy. Evidence-based psychotherapies, such as cognitive-behavioral therapy and exposure therapies, are effective in addressing maladaptive thought patterns and facilitating trauma processing. Beyond interventions, lifestyle modifications have emerged as significant contributors to resilience and recovery. Regular physical exercise, adequate sleep, and robust social support networks are integral to the overall well-being of patients who have developed PTSD after critical illness. By integrating pharmacological and nonpharmacological approaches within a holistic framework, clinicians and researchers could better address the complex nature of PTSD and enhance the quality of care for individuals affected by this debilitating condition.
Readability of Patient-reported Outcome Measures Used in Plastic Surgery
Authors: Zamore Zachary , Azad Chao Long , Zhu Lily , Lowe Chenery , Giladi Aviram M.
Published: December 2024

Background:

Patient-reported outcomes are essential to understanding success in plastic surgery procedures, many that aim to improve quality of life. Patient-reported outcome measures (PROMs) should be written at or below the sixth-grade reading level recommended by the American Medical Association. This study aimed to evaluate the readability of plastic surgery PROMs.

Methods:

We conducted a literature review to identify validated, commonly used PROMs in plastic surgery. We extracted PROMs’ text and instructions and analyzed readability using different approaches that estimate the grade level required to understand. Our primary outcome was the Simple Measure of Gobbledygook (SMOG) index, which detects word complexity and expects 100% comprehension at the grade level rating assigned. We also included the Flesch-Kincaid grade level, Coleman-Liau index, and automated readability index.

Results:

Forty-three PROMs met the inclusion criteria. The mean SMOG index was 8.2 (SD = 1.3), indicating an eighth-grade reading level. Mean reading grade levels measured by the Flesch-Kincaid grade level, Coleman-Liau index, and automated readability index ranged from third to sixth grade, although these may underestimate readability difficulties. Only 6 (14%) PROMs had a SMOG index at or below the sixth-grade level. PROM instructions had significantly higher reading levels than the questions/responses for all readability indexes (P < 0.01).

Conclusions:

PROMs used in plastic surgery, including the instructions, exceed the reading level recommended by the American Medical Association. This may limit comprehension and accurate completion and compromise validity and reliability. PROMs should be written and designed to be accessible to patients of all literacy levels.
Implications of myopia in diagnosis and screening of open angle glaucoma
Authors: Iwase Aiko , Araie Makoto
Published: December 2024

Purpose of review

Rapid increase in the prevalence of myopia has been documented worldwide. Myopia, especially high myopia, is not only an important risk factor for having open angle glaucoma (OAG), but also has a strong linking with the progression of OAG. Since myopic axial length (AXL) elongation is associated with nonglaucomatous optic nerve head (ONH) and visual field abnormalities, myopia poses a challenge in differential diagnosis of OAG. This review provides an overview of literature studying relationships between myopic AXL-elongation and diagnosis and prognosis of OAG, and functional and structural changes in the eye.

Recent findings

Studies using optical coherence tomography (OCT), OCT-angiography, those using standard automated perimetry (SAP), other perimetric or electrophysiological methods showed dose-dependent effects of myopic AXL elongation on the structural changes in the ONH and parapapillary tissues, and functional abnormalities of an eye. Large cohort studies showed approximately one quarter of eyes with nonpathologic high myopia were complicated with various patterns of visual field defects including glaucoma-like ones.

Findings of cross-sectional and longitudinal studies obtained using various fundus imaging devices must be integrated to perimetric results to improve differential diagnosis of OAG in myopic eyes, in which artificial intelligence technology may be useful.
A Novel Surgical Technique Involving Bone Fixation Canthoplasty, Middle Lamellar Recession and Mucograft Spacer in Treating Patients with Euryblepharon
Authors: Samia-Aly Emma , Sorkou Konstantina , Ezra Daniel
Published: December 2024

Purpose:

Euryblepharon is a rare congenital eyelid malformation characterized by symmetrical horizontal enlargement of the palpebral fissure. The eyelid is shortened vertically compared with the horizontal dimension. The lateral canthus is most commonly affected. It can be isolated or associated with other anomalies and it is unclear what causes this appearance. Conservative treatment is the mainstay of treatment; however, in some severe cases, surgery is necessary. Surgery has been reported with varying degrees of success with failure of the resolution of the functional or cosmetic elements.

Methods:

In a retrospective case review, 7 patients were identified with euryblepharon. Some had mild changes and were asymptomatic with no concerns regarding the appearance of their eyelids, while others suffered from ocular irritation and dry eyes and were bothered by the cosmesis. Three opted to go ahead with surgery as they found conservative measures to be unsatisfactory.

Results:

For those patients who opted for surgery, the authors performed lower eyelid bone fixation canthoplasty with septoretractor recession with or without a mucograft spacer. This technique corrected both their functional and cosmetic elements.

Conclusion:

The success in normalizing the lower lid position and contour without skin augmentation suggests that the underlying pathology is related to middle lamellar retraction and lateral canthal dystopia rather than skin deficiency. This new technique corrects both the functional and aesthetic issues without compromising on either element which has been the case in previous studies. It is also tissue-sparing and can be done as a day-case procedure.
Men, masculinities, and mental health: Key issues for nurse practitioners
Authors: Adler Rachel H.
Published: December 2024

Men's mental health is an important topic for nurse practitioners (NPs) because men and women have different epidemiological profiles and clinical presentations when it comes to behavioral health. As clinicians, we must be aware of these differences to better serve diverse patient populations. In this article, four key issues to men's mental health will be discussed in relationship to masculinities: suicide; depression; stigma; and engagement with mental health services. A case study of a male patient is presented, and the article concludes with clinical implications for NPs.
Treatment decision-making process among postmenopausal women with pelvic organ prolapse before gynecological surgery: A qualitative study from Romania
Authors: Badiu Diana , Onuc Silvia , Niculescu Costin , Clinci Daniel , Tica Vlad
Published: December 2024

Pelvic organ prolapse (POP) affects quality of life of many women. This paper aims to identify the experience of postmenopausal women in treatment decision-making process about POP before gynecological surgery. The characteristics of twelve postmenopausal women with stage II, III and IV POP, such as age, body mass index (BMI), physical exercise, education, parity, abortions, comorbidities, previous surgical interventions, and smoker/nonsmoker were evaluated. Each woman was given a semi-structured interview consisted of open-ended questions describing different treatments for POP. Interviews were conducted from January 2022 from May 2022, audio-recorded, transcribed verbatim and analyzed. The mean age was 64 years and most women were obese (BMI ≥ 30, 66.66%) with associated hypertension (58.33%). After constant comparison of the data using qualitative descriptive design, 7 dominant themes were obtained, namely: lack of information about prolapse; the decisive moment for the choice of treatment; the most disturbing symptoms; sources of information on prolapse; decisions regarding the treatment; preferences for conservative treatment; and uncertainty about treatment options. Most of the postmenopausal women stated that treatment decision-making process was mainly influenced by the physician, while supervised pelvic floor muscle (PFM) training was seen as an alternative to surgical treatment (58.33%). Therefore, it is essential to inform in time such women about different treatment options, allowing to decide on their preferred treatment.
Analysis of risk factors for poor healing and long-duration pain in conservative treatment of rib fractures
Authors: Yao Yongzheng , Li Shida , Bi Chao , Duan Jiayu , Jiao Lianjie , Zheng Jie , Wang Lihui , Qian Gaoyang
Published: December 2024

Rib fractures are a common injury following blunt chest trauma, accounting for approximately 10% of all traumatic injuries and up to 50% of blunt chest trauma cases. These fractures are associated with a high risk of complications, such as pneumothorax, hemothorax, and pulmonary infections, and can significantly impact respiratory function. This study analyzes the risk factors for poor healing and long-duration pain in the conservative treatment of rib fractures, providing a reference for clinicians in choosing conservative treatment and formulating treatment plans. A retrospective analysis was conducted on 342 patients who underwent conservative treatment for rib fractures from January 2023 to May 2024. Baseline data, clinical data, and follow-up data were collected. Comparisons were made between the poor healing group and the good healing group, as well as between the long-duration pain group and the short-duration pain group in the conservative treatment of rib fractures. Univariate and multivariate logistic regression analyses were performed to identify risk factors for poor healing and long-duration pain. In patients undergoing conservative treatment for rib fractures, the average duration of pain was 12.18 ± 10.78 days, with an incidence of pulmonary complications of 59.06% (202/342) and poor healing rate of 6.43% (22/342). Significant differences were observed between the good and poor healing groups in terms of age (P = .018), presence of coronary heart disease (CHD, P = .023), chronic obstructive pulmonary disease (COPD, P < .001), blood calcium (P = .007), and alkaline phosphatase (P < .001). Similarly, significant differences were found between the long-duration and short-duration pain groups in age (P = .039), presence of diabetes (P < .001), CHD (P < .001), COPD (P < .001), and alkaline phosphatase (P < .001). Multivariate analysis identified COPD (P = .015), blood calcium (P = .013), and alkaline phosphatase (P = .006) as independent risk factors for poor healing, while diabetes (P = .001), CHD (P = .014), and alkaline phosphatase (P < .001) were independent risk factors for prolonged pain duration. COPD, blood calcium, and alkaline phosphatase are independent risk factors for poor healing in conservative treatment of rib fractures. Diabetes, CHD, and alkaline phosphatase are independent risk factors for long-duration pain in conservative treatment of rib fractures.
Duplicate gallbladders misdiagnosed as residual cholecystitis: A case report and review of the literature
Authors: Ma Xian-Shi , Feng Mei-Fa , Ke Song , Yang Liu
Published: December 2024

Rationale:

Duplication of gallbladder is a rare anomaly in humans, as it is very rare for a duplication of gallbladder to be missed during the first cholecystectomy and thus require a second cholecystectomy.

Patient concerns:

A 42-year-old man came to our hospital with paroxysmal right upper abdominal pain for 10 days. In addition to the pain, he also had transient jaundice. He had undergone laparoscopic cholecystectomy (LC) 1 year ago. Magnetic resonance cholangiopancreatography showed gallstones, intrahepatic bile duct stones with cholangitis, no dilatation of the common bile duct, and a cystic structure was visible in the upper part of common bile duct. The patient underwent LC again, and the intraoperative diagnosis was duplication of gallbladder.

Diagnosis:

The patient was diagnosed with duplication of gallbladder during surgery.

Interventions:

The patient underwent LC again.

Outcomes:

The patient underwent LC again, and was diagnosed with duplicated gallbladder during the operation. The operation was successful and the patient was discharged on the 5th day after the operation without other complications.

Lessons:

Our case and literature review showed that there are no specific signs of duplicated gallbladders, and ultrasound has a low sensitivity for the diagnosis of double gallbladders, so double gallbladders are easily missed. Patients with double gallbladders may have multiple missed diagnoses during diagnosis and treatment, as in this case. When patients experience upper abdominal pain again after gallbladder removal, we should be alert and consider the possibility of duplicated gallbladders.
Comparison of clinical results between transpulmonary thermodilution monitoring and conventional methods in cardiac surgery: An observational study
Authors: Ertugay Serkan , Kahraman Ümit , Oğuz Emrah , Demir Emre , Öztürk Esin , Kocabaş Nüzhet Seden , Tuncer Osman Nuri , Öztürk Pelin , Özbaran Mustafa
Published: December 2024

The Pulse Index Contour Continuous Cardiac Output (PICCO) module provides advanced and continuous monitoring of cardiac output through the use of arterial pulse contour analysis and transpulmonary thermodilution. The objective of this study was to compare the early postoperative outcomes of patients who were monitored using the conventional method and the pulse contour analysis method. A prospective observational study was conducted involving 45 patients who underwent cardiac surgery between 2020 and 2022. Patients were randomly assigned to either Group P (PICCO) or Group C (conventional). In the PICCO cohort, a femoral artery cannula was inserted for the continuous recording and management of hemodynamic data, in accordance with the decision-making algorithm of the module. In the conventional group, cannulation of the radial artery and jugular vein was performed. The postoperative hemodynamic and clinical data are subjected to analysis. The utilization of dopamine was markedly diminished in Group P at both the 0- and 6-hour postoperative intervals, whereas the administration of dobutamine was observed to be elevated (P = .008). The frequency of red packed cell transfusions was higher in Group C at postoperative hour 0. Hemodynamic data indicated a 42% increase in cardiac index and a 33% decrease in systemic vascular resistance, along with a 33% increase in global ejection fraction in patients monitored with PICCO. The mortality rates observed in the 2 groups were not statistically different. The implementation of advanced monitoring techniques, specifically the PICCO module, led to notable enhancements in hemodynamic parameters. The utilization of this technique may prove advantageous in guiding inotrope selection and transfusion decisions during the initial postoperative period. However, it is important to note that morbidity and mortality rates remain comparable.
Lipid accumulation product mediating the association between uranium and cerebrovascular diseases mortality: Evidence from National Health and Nutrition Examination Survey
Authors: Zou Qu , Tian Xinling , Mao Qingsong , Zhu Xiaoyi , Kong Yuzhe
Published: December 2024

This study investigated the potential association between uranium exposure and mortality from cerebrovascular diseases, with a focus on the mediating effects of lipid indicators. Employing recommended sampling weights to account for National Health and Nutrition Examination Survey’ complex survey design, this analysis drew from data collected between 2005 and 2016. The study examined the impact of uranium on mortality from cerebrovascular diseases using various statistical approaches, including Cox regression to assess linear relationships within metal mixtures. It also evaluated the role of lipid-adjusted plutonium (LAP) as a mediator and verified the persistence of associations across different subgroups. The study encompassed 4312 participants and established a significant direct link between uranium levels and mortality from cerebrovascular diseases (hazard ratio (95%CI) = 20.4243 (20.1347–20.7181), P = .0266). It also identified LAP as a mediating factor in the relationship, accounting for a mediated proportion of 1.35%. The findings highlight a pivotal connection between uranium exposure and increased mortality due to cerebrovascular diseases, with LAP playing a significant intermediary role.
Relationship between hypothyroidism and chronic kidney disease: Results from the National Health and Nutrition Examination Survey 2007 to 2012 and Mendelian randomization study
Authors: Xu Yin , Wang Xinmei , Wang Guofeng , Wei Wei , Li Ning
Published: December 2024

Chronic kidney disease (CKD) and hypothyroidism are prevalent chronic conditions with a generally believed correlation between them. However, large-scale population studies and investigations into causation are lacking. This study analyzed CKD and thyroid function data from the National Health and Nutrition Examination Survey database spanning 2007 to 2012 using multiple regression analyses to examine the correlation between CKD and hypothyroidism. Bidirectional Mendelian randomization analysis was employed to investigate the causal association between the two conditions. As CKD stages deteriorated, there was a significant decrease in total triiodothyronine (TT3) and free triiodothyronine (P < .05). However, no significant decrease was observed in total thyroxine and free thyroxine. Notably, there was a significant increase in thyroid-stimulating hormone levels (P < .05). However, no significant changes were observed in thyroglobulin, thyroglobulin antibody, and thyroid peroxidase antibody levels. A causal relationship between CKD and reduced thyroid function was observed (odds ratio [OR] = 1.0041, 95% confidence interval [CI]: 1.0007–1.0075, P = .0186). Conversely, reverse causality was not statistically significant (OR = 2.540, 95%CI: 0.8680–4.8603, P = .1014). As CKD progressed, the risk of hypothyroidism increased. A causal correlation was observed between CKD and reduced thyroid function. Chronic kidney disease (CKD) and hypothyroidism are prevalent chronic conditions with a generally believed correlation between them. There is no large-scale population studies and the causation relationship between CKD and hypothyroidism are lacking. The finding of the causal relationship between CKD and hypothyroidism may be beneficial to the prevention of the disease and the prognosis of the patients.
Primary pulmonary plasmacytoma: A case report
Authors: Jin Cong , Yan Lina , Zhang Jing , Cao Lihua , Zhang Dan
Published: December 2024

Rationale:

Extramedullary plasmacytoma is an extremely rare malignant clonal plasmacytoma, which can occur in any tissue or organ of the body other than bone marrow hematopoietic tissue. Lesions mostly occur in the head and neck or upper respiratory tract, and rarely in the lower respiratory tract. Primary plasmacytoma of the lung, also known as primary pulmonary plasmacytoma (PPP), is rarer and is mainly diagnosed on the basis of the histopathology of biopsy tissue. In this report, we present a case of PPP.

Patient concerns:

A 65-year-old woman with repeated episodes of cough and sputum for many years was hospitalized for an acute episode of chest pain and shortness of breath. Chest computed tomography revealed bilateral inflammation of multiple lobes, accompanied by slight bronchial dilatation.

Diagnoses:

The results of pathology of the electronic bronchoscopy sample were different from those of common infections but were consistent with plasmacytoma.

Interventions and outcomes:

The patient was discharged after hormone anti-inflammatory therapy. As patients lose contact, further follow-up of the patient was not possible.

Lessons:

PPP is a rare lung tumor, and diagnosis of this lesion on the basis of bronchoscopic biopsy is even rarer. With this case report, we seek to enhance the awareness and understanding of PPP. We recommend that in cases wherein chest imaging findings suggest multiple lung lesions, the possibility of pulmonary plasmacytoma should also be considered, and biopsy should be actively performed to confirm the diagnosis and guide treatment. This report provides valuable insights and guidance for clinicians in the management and diagnosis of patients with PPP.
Leptospirosis manifested with severe pulmonary hemorrhagic syndrome successfully treated with veno-venous extracorporeal membrane oxygenation: A case report and literature review
Authors: Zhang Xing-Cheng , Lei Xi-Qun , Sun Yun , Shan Nan-Bing
Published: December 2024

Rationale:

The mortality rate associated with pulmonary hemorrhage induced by leptospirosis is notably high. Available treatment modalities are limited, and their efficacy has not been fully demonstrated. Here, we present the case report of a patient with leptospirosis-induced pulmonary hemorrhagic syndrome. A 49-year-old male patient was admitted to the Surgical Ward of the Department of Intensive Care Medicine of Fuyang Infectious Disease Clinical College of Anhui Medical University. The patient had initially sought medical attention at a local hospital due to symptoms of fever persisting for 4 days and chest tightness accompanied by hemoptysis for 1 day.

Patient concerns:

We present the case report of a patient with leptospirosis-induced pulmonary hemorrhagic syndrome. Hemoptysis persisted in our patient during VV-ECMO, although we adjusted the heparin regimen to maintain an activated partial thromboplastin time target value of 50 to 55 seconds.

Diagnoses:

Leptospirosis-induced pulmonary hemorrhagic syndrome.

Interventions:

He was immediately intubated and mechanically ventilated and then transferred to our hospital for further medical intervention. Upon arrival at our hospital, he was treated with veno-venous extracorporeal membrane oxygenation (VV-ECMO). Consequently, he was administered penicillin and omacycline for anti-infective therapy. Anti-inflammatory agents, high-dose vasoactive drugs to enhance blood pressure, continuous renal replacement therapy, tracheal sputum aspiration, and ventilator-assisted ventilation were also administered as part of the treatment protocol.

Outcomes:

After treatment, his inflammation index was significantly decreased, the amount of pulmonary bleeding was reduced, his oxygenation ratio was improved, and the pulmonary lesions were absorbed. Consequently, he was discharged on the 34th day of hospitalization.

Lessons:

We successfully treated a case of leptospirosis pulmonary hemorrhagic syndrome using VV-ECMO combined with prudent anticoagulant therapy.
Causal relationship between 731 immune cells and the risk of myeloproliferative neoplasms: A 2-sample bidirectional Mendelian randomization study
Authors: Wang Yao , Fei Yang
Published: December 2024

Myeloproliferative neoplasms (MPN) are chronic hematological disorders marked by the abnormal proliferation of bone marrow cells. The most commonly encountered forms are polycythemia vera (PV), primary myelofibrosis (PMF), and essential thrombocythemia (ET). These disorders are generally associated with increases in blood components, which can lead to conditions like splenomegaly, thrombosis, bleeding tendencies, and a heightened risk of progressing to acute leukemia. Previous research has indicated a possible link between immune cells and MPN, yet this association is still poorly understood. This study seeks to elucidate the causal relationship between immune cell characteristics and the development of MPN. In this study, we employed Mendelian randomization (MR) to investigate potential causal links between 731 immune cell traits and the risk of developing MPN, leveraging data from genome-wide association studies (GWAS). To ensure the robustness of our findings, we conducted extensive sensitivity analyses to assess heterogeneity and detect any pleiotropic effects. Moreover, we implemented a false discovery rate (FDR) correction to mitigate the risk of false positives that may result from the multiple hypothesis testing, thereby adjusting for any statistical biases due to multiple comparisons. The immune phenotype IgD on IgD+ CD24- B cells demonstrated a statistically significant protective effect against MPN (PFDR = 0.047). Upon adjusting the significance threshold to PFDR < 0.20, 16 immune cell phenotypes were significantly associated with MPN. Among these, 11 were found to exert a protective effect against MPN, 5 phenotypes were associated with an elevated risk of MPN. This research highlights a significant association between various immune cell phenotypes and the risk of developing MPN, thereby advancing our understanding of the intricate interplay between immune cell traits and the progression of MPN.
Bibliometric and visual analysis of medication therapy management from 2003 to 2023
Authors: Guo Zhiye , Fu Lianhao , Chu Zhijun , Gao Shuojun , Lu Lin , Jiao Wanli
Published: December 2024

Medication therapy management (MTM) includes various clinical pharmacy services that greatly influence society and economy. Despite extensive research in recent years, there is currently a lack of bibliometric analysis on this subject. Articles and reviews on MTM published from 2003 to 2023 were identified and selected from the Web of Science Core Collection. CiteSpace, VoSviewer, Bibliometrix, and Microsoft Excel were used to conduct bibliometric analysis and knowledge mapping. The bibliometric analysis encompassed 3255 publications on MTM. The United States and the United Kingdom emerged as the most influential countries in this particular domain, whereas Brigham and Women’s Hospital and Harvard Medical School were the most active institutions. Elizabeth Manias published the largest number of papers, whereas Jeffrey L. Schnipper published the largest number of co-citations. The American Pharmacists Association has been identified as the most prolific journal in this field. Optimizing medication and ensuring drug safety in elderly patients are current research frontiers. Topics such as “polypharmacy,” “dementia,” “oncology,” and “anticholinergic burden” were identified as potential research priorities in the future. This study is the first to utilize bibliometric analysis to uncover the global status, research hotspots, and future development trends of MTM for scholars, thereby providing valuable guidance for future research endeavors.
Case report of antifungal drug-induced phlebitis in a patient with myelodysplastic syndrome
Authors: Wen Jia-Quan , Guo Xing-Yu , Xie Yan-Qun , Zhang Jun-Jun , Mei Jun-Hui
Published: December 2024

Rationale:

This article summarized the nursing experience of phlebitis caused by intravenous infusion of amphotericin B cholesterol sulfate complex in a patient with myelodysplastic syndrome.

Patient concerns:

A 59-year-old man with myelodysplastic syndrome complicated with fungal infection was treated with antifungal therapy.

Diagnoses:

Patient with myelodysplastic syndrome was diagnosed with secondary phlebitis caused by liposomal amphotericin B.

Interventions:

The focus of nursing care was to use infrared rays of a specific electromagnetic wave therapy device to treat the patient’s phlebitis.

Outcomes:

After 30 minutes each time, twice a day, the patient’s phlebitis was cured after 6 days of continuous use.

Lessons:

The specific electromagnetic wave therapy can make the phlebitis caused by amphotericin B quickly heal, which is helpful for the smooth implementation of the antifungal treatment program.
Association between cathepsins and cardiomyopathy: A Mendelian randomization study
Authors: Chen Qiuyun , Yang Xiuming , Zhang Qingyu , Yu Zongliang
Published: December 2024

Research suggests that cathepsins, due to their extensive mechanisms of action, may play a crucial role in cardiomyopathies. However, further studies are necessary to establish causality. This study aims to investigate the causal relationship between cathepsins and various types of cardiomyopathies. This study investigated causal associations between 9 cathepsins and cardiomyopathies, including their subtypes: hypertrophic cardiomyopathy (HCM), dilated cardiomyopathy, and restrictive cardiomyopathy, using pooled data from genome-wide association studies. The analyses employed inverse variance weighted (IVW), Mendelian randomization (MR)-Egger, and weighted median methods for univariable MR, reverse MR, and multivariable MR to estimate causality. For sensitivity analyses, we applied Cochran Q test, MR-PRESSO, MR-Egger intercept test, and the leave-one-out method to ensure the robustness and reliability of our findings. Univariable MR analyses indicated that elevated levels of cathepsin E were associated with an increased risk of overall cardiomyopathy (IVW: P = .045, odds ratio [OR] = 1.078, 95% confidence interval [CI] = 1.002–1.160). Conversely, higher levels of cathepsin B were linked to a reduced risk of HCM (IVW: P = .037, OR = 0.856, 95% CI = 0.740–0.990), and higher cathepsin O levels were causally related to a reduced risk of HCM (IVW: P = .04, OR = 0.810, 95% CI = 0.662–0.991). Reverse MR analyses indicated that a higher risk of HCM was causally related to increased levels of cathepsin E (IVW: P = .038, OR = 1.024, 95% CI = 1.001–1.047). Multivariable MR analyses showed that increased cathepsin E levels still correlated with increased overall cardiomyopathy, even after the addition of other types of cathepsins (IVW: P = .0165, OR = 1.005, 95% CI = 1.0176–1.1901), while cathepsin O levels remained causally related to a reduced risk of HCM (IVW: P = .0053, OR = 0.7183, 95% CI = 0.5692–0.9065). Cathepsin L2 was also found to be associated with an increased risk of restrictive cardiomyopathy (IVW: P = .0374, OR = 2.1337, 95% CI = 1.0450–4.3565). This study demonstrates the causal relationship between cathepsins E, B, L2, O and the development of cardiomyopathy. The findings may be crucial for early diagnosis, prognosis prediction, molecular classification, and identifying potential therapeutic targets for cardiomyopathy.
Bacterial meningitis in a quaternary NICU: A multiyear retrospective study
Authors: O’Hearn Olivia , Srinivasan Lakshmi , Devine Matthew , Harris Mary Catherine
Published: December 2024

Bacterial meningitis causes significant morbidity and mortality in infants. Lumbar punctures are often deferred until the results of blood cultures are known and sometimes not considered, making this population susceptible to a missed diagnosis. There are few studies describing the epidemiology of neonatal meningitis in quaternary neonatal intensive care unit settings. We describe the epidemiology of meningitis in a level IV neonatal intensive care unit; compare pathogens and rates of concordant bacteremia between infants with and without neurosurgical (NS) devices. Retrospective review of infants < 1 year of age in the Children’s Hospital of Philadelphia neonatal intensive care unit with bacterial meningitis (June 2007–October 2021). Analysis included summary statistics, Wilcoxon rank sum, Chi square, and Fisher exact tests. We identified 101 episodes of bacterial meningitis (95 infants). 9 infants died. At diagnosis, 26 infants (27%) had NS devices. Group B streptococcus (GBS) and Escherichia coli (E coli) were most common pathogens, however, coagulase-negative staphylococci and Staphylococcus aureus (S aureus) predominated among infants with NS devices. While 86% had positive blood cultures in the absence of a NS device, only 14% of episodes with NS devices had concomitant bacteremia (P < .0001). Although Group B streptococcus and E coli remain most prevalent overall, coagulase-negative staphylococci and S aureus were common pathogens in NS patients. Infants with NS devices rarely had concomitant bacteremia. Meningitis was diagnosed in the absence of a positive blood culture in 36% of episodes, underscoring the importance of developing guidance for lumbar punctures in infants evaluated for sepsis.
The effect of lidocaine infusion in oncologic surgery: A bibliometric analysis based on CiteSpace
Authors: Lv Ranxu , Wang Yong , Sun Jing , Kang Yuqing , Mou Chunyan , Chen Yujing , Feng Zhaoming , Xue Xing
Published: December 2024

Background:

Over the past 2 decades, lidocaine’s application in oncologic surgery has received significant attention. It has potential antitumor effects and acts as a chemosensitizer. The aim of this study is to analyze the process and frontiers of lidocaine application in oncologic surgery over the past 20 years.

Methods:

A bibliometric analysis was performed and CiteSpace software was used to conduct metrology, co-occurrence, and cluster analysis. Articles retrieved from the Web of Science database from January 1, 2004 to May 27, 2024. Inclusion criteria comprised peer-reviewed original articles or reviews on lidocaine and cancer, excluding conference abstracts, corrigenda, repeated publications, and unrelated articles.

Results:

A total of 956 articles were included in this study. Two hundred seventeen were selected for detailed analysis. The annual publication count showed an overall increasing trend, peaking in 2022. The United States emerged as the leading country in terms of publication frequency and centrality. Major research themes included lidocaine’s antiproliferative effects, enhancement of chemotherapy efficacy, and various administration methods.

Conclusion:

Based on the above results, we draw a conclusion that the relationship between lidocaine and cancer has garnered increasing attention, with research in this area rapidly developing. Lidocaine exhibits significant antitumor effects and potential as a chemosensitizer, enhancing the efficacy of traditional chemotherapy. These findings underscore the importance of further research to fully elucidate lidocaine’s mechanisms and its potential clinical applications in oncology.
Comparing the safety of a single balloon catheter to dinoprostone for inducing labor in pregnant women with group B Streptococcus vaginal colonization: An observational study
Authors: Ying Xia , Chen Lin , Wang Danxiao , Yi Songjia , Yang Xiaofu , Wang Xiaomin , Yu Leiyuan , Chen Yuan , Luo Qiong
Published: December 2024

Group B Streptococcus is a bacterium that colonizes in approximately 20% of pregnant women and can be vertically transmitted to newborns, leading to maternal-neonatal adverse outcomes, such as chorioamnionitis, neonatal sepsis, and pneumonia. However, there is currently no agreement on the optimal induction method for this specific population. This study aims to evaluate the safety of a single balloon catheter (BC) in comparison to dinoprostone for labor induction in term pregnant women with group B Streptococcus colonization. In this retrospective cohort study, a total of 321 term pregnancies with positive group B Streptococcus requiring Induction of labor (IOL) were included. Out of these, 80 pregnancies were induced with a single BC, while the remaining 241 were induced with dinoprostone. The study compared the safety outcomes between the 2 groups, specifically focusing on maternal and neonatal adverse events. It is important to note that all women in the study received prophylactic antibiotics. When prophylactic antibiotics were administered, no significant differences were observed in terms of mode of delivery, clinical chorioamnionitis, puerperal infection, fetal distress, neonatal asphyxia, neonatal infection, neonatal sepsis, NICU admission, and neonatal pneumonia between the 2 induction methods (all P > .05). Additionally, there were no reported cases of neonatal group B Streptococcus infection following balloon induction in pregnant women with vaginal GBS colonization. In relation to maternal and neonatal adverse events, the study findings indicated that labor induction using a BC was deemed safe for women who were colonized with group B Streptococcus, provided that prophylactic antibiotics were administered either at the onset of labor or when the membranes ruptured.