bluuebunny/crossref_metadata_2025 huggingface dataset:
CD93 maintains endothelial barrier function by limiting the phosphorylation and turnover of VE‐cadherin
Authors: Lugano Roberta , Vemuri Kalyani , Barbera Stefano , Orlandini Maurizio , Dejana Elisabetta , Claesson‐Welsh Lena , Dimberg Anna
Published: March 2023

Regulation of vascular permeability to plasma is essential for tissue and organ homeostasis and is mediated by endothelial cell‐to‐cell junctions that tightly regulate the trafficking of molecules between blood and tissue. The single‐pass transmembrane glycoprotein CD93 is upregulated in endothelial cells during angiogenesis and controls cytoskeletal dynamics. However, its role in maintaining homeostasis by regulating endothelial barrier function has not been elucidated yet. Here, we demonstrate that CD93 interacts with vascular endothelial (VE)‐cadherin and limits its phosphorylation and turnover. CD93 deficiency in vitro and in vivo induces phosphorylation of VE‐cadherin under basal conditions, displacing it from endothelial cell–cell contacts. Consistent with this, endothelial junctions are defective in CD93−/− mice, and the blood–brain barrier permeability is enhanced. Mechanistically, CD93 regulates VE‐cadherin phosphorylation and turnover at endothelial junctions through the Rho/Rho kinase‐dependent pathway. In conclusion, our results identify CD93 as a key regulator of VE‐cadherin stability at endothelial junctions, opening up possibilities for therapeutic strategies directed to control vascular permeability.
Predicting Success of Deformity Correction With Tension Band Plating in Early-Onset Tibia Vara
Authors: Walker Janet L. , Dueber David M. , Stephenson Lindsay P. , Scott Allison C. , Lerman Joel A. , Powell Kenneth P. , Ackman Jeffery D. , Westberry David E. , Nossov Sarah B. , Franklin Corinna C.
Published: March 2023

Background:

Angular deformity correction with tension band plating has not been as successful in early-onset tibia vara (EOTV) as it has been in other conditions. Our hypothesis is that perioperative factors can predict the success of lateral tibial tension band plating (LTTBP) in patients with EOTV.

Methods:

A retrospective review was performed at 7 centers evaluating radiographic outcomes of LTTBP in patients with EOTV (onset <7 y of age). Single-event tibial LTTBP outcome was assessed through medial proximal tibial angle (MPTA). The final limb alignment following comprehensive limb growth modulation (CLGM), which could include multiple procedures, was assessed by mechanical axis zone (MAZone), mechanical tibio-femoral angle (mTFA), and mechanical axis deviation (MAD). Preoperative age, weight, deformity severity, medial physeal slope, and Langenskiöld classification +/- modification were investigated as predictors of outcome. Success was defined as the correction or overcorrection to normal age-adjusted alignment. The minimum follow-up was 2 years except when deformity correction, skeletal maturity, or additional surgery occurred.

Results:

Fifty-two patients with 80 limbs underwent 115 tibial LTTBP procedures at a mean age of 5.3 y, including 78 primary, 21 implant revisions, and 15 reimplantations for recurrence. Tibial LTTBP resulted in a mean change of +8.6o in MPTA and corrected 53% of tibias. CLGM resulted in MAD correction for 54% of limbs.

Univariate analysis showed that success was best predicted by preoperative age, weight, MPTA, and MAD. Multivariate analysis identified that preoperative-MPTA/MAD and preoperative-weight<70 kg were predictive of MPTA and MAD correction, respectively. The probability of success tables are presented for reference.

Conclusion:

Successful correction of MPTA to age-adjusted norms following a single-event LTTBP occurred in 53% of tibias and was best predicted by preoperative-MPTA and preoperative body weight <70 kg. Comprehensive growth modulation corrected limbs in 54%. The probability of correction to age-adjusted MAD is best estimated by preoperative-MAZone 1 or 2 (MAD ≤40 mm). Limbs with preoperative-MAD>80 mm improved, but ultimately all failed to correct completely with CLGM. Osteotomy may need to be considered with these severe deformities. While modified Langenskiöld classification and medial physeal slope have been shown to predict the outcome of osteotomy, they were not predictive for LTTBP. Change in MPTA was common after physeal untethering.

Level of Evidence:

Level—III.
Metagenomic and targeted metabolomic analyses reveal distinct phenotypes of the gut microbiota in patients with colorectal cancer and type 2 diabetes mellitus
Authors: Yang Yong , Han Zihan , Gao Zhaoya , Chen Jiajia , Song Can , Xu Jingxuan , Wang Hanyang , Huang An , Shi Jingyi , Gu Jin
Published: March 2023

Background:

Type 2 diabetes mellitus (T2DM) is an independent risk factor for colorectal cancer (CRC), and the patients with CRC and T2DM have worse survival. The human gut microbiota (GM) is linked to the development of CRC and T2DM, respectively. However, the GM characteristics in patients with CRC and T2DM remain unclear.

Methods:

We performed fecal metagenomic and targeted metabolomics studies on 36 samples from CRC patients with T2DM (DCRC group,n= 12), CRC patients without diabetes (CRC group,n= 12), and healthy controls (Health group,n= 12). We analyzed the fecal microbiomes, characterized the composition and function based on the metagenomics of DCRC patients, and detected the short-chain fatty acids (SCFAs) and bile acids (BAs) levels in all fecal samples. Finally, we performed a correlation analysis of the differential bacteria and metabolites between different groups.

Results:

Compared with the CRC group, LefSe analysis showed that there is a specific GM community in DCRC group, including an increased abundance ofEggerthella,Hungatella,Peptostreptococcus, andParvimonas, and decreasedButyricicoccus,Lactobacillus, andParaprevotella. The metabolomics analysis results revealed that the butyric acid level was lower but the deoxycholic acid and 12-keto-lithocholic acid levels were higher in the DCRC group than other groups (P< 0.05). The correlation analysis showed that the dominant bacterial abundance in the DCRC group (Parvimonas,Desulfurispora,Sebaldella, andVeillonellales, among others) was negatively correlated with butyric acid, hyodeoxycholic acid, ursodeoxycholic acid, glycochenodeoxycholic acid, chenodeoxycholic acid, cholic acid and glycocholate. However, the abundance of mostly inferior bacteria was positively correlated with these metabolic acid levels, includingFaecalibacterium,Thermococci, andCellulophaga.

Conclusions:

Unique fecal microbiome signatures exist in CRC patients with T2DM compared to those with non-diabetic CRC. Alterations in GM composition and SCFAs and secondary BAs levels may promote CRC development.
A systematic review of respect between acute care nurses and physicians
Authors: Bransby Derrick P. , Mayo Anna T. , Cronin Matthew A. , Park Katie , Yuan Christina T.
Published: March 2023

Background

Interprofessional collaboration between nurses and physicians has become an essential part of patient care, which, when lacking, can lead to well-known challenges. One possible explanation for ineffective nurse–physician collaboration is a lack of respect.

Purpose

This review aims to enhance our understanding of the role of respect in work between nurses and physicians by synthesizing evidence about the conceptualization of respect, its mechanisms and outcomes, and its origins.

Methods

We performed a PRISMA-guided systematic literature review across five databases and reviewed 28 empirical studies about respect between nurses and physicians in acute care settings.

Findings

Research about respect between nurses and physicians varied in its conceptualization of respect in terms of its nature (as an attitude or behavior), its target (respect for individuals or groups), and its object (respect for task-relevant capabilities or human rights). The greatest convergence was on respect’s object; the majority of studies focused on respect for task-relevant capabilities. The work reviewed offered insights into respect’s potential mechanisms (attention and civility), outcomes (e.g., collaboration, patient outcomes, and provider outcomes such as job satisfaction), and origins (e.g., professional status and competence)—the latter suggesting how respect might be generated, developed, and maintained.

Practice Implications

Our review highlights a need to appreciate how respect for task-relevant capabilities relates to respect for human rights and what fosters each to avoid rewarding only one while hoping for both, allowing leaders to cultivate more effective nurse–physician collaborations and better patient and provider outcomes.
Effects of Aromatherapy Through Inhalation on Work Stress and Job Satisfaction Among Health Professionals
Authors: Amanak Keziban , Gökduman Keleş Mine , Altınkaya Sündüz Özlem
Published: March 2023

The aim of this study was to examine the effects of lavender oil inhalation on work stress and job satisfaction among health professionals. This randomized, experimental study involved 108 health professionals, of whom 36 were randomized into the intervention group, 35 into the placebo group, and 37 into the control group. The intervention was performed during work shifts of the intervention group (8 hours a day during a 5-day period). The intervention group was exposed to lavender oil inhalation through a diffuser and the placebo group was exposed to inhalation of distilled water containing light yellow food dye, but the control group did not receive anything. Data were collected with General Characteristics Form, The Swedish Demand-Control-Support Questionnaire, and The Minnesota Satisfaction Scale. The study was also registered at the Australia-New Zealand Clinical Trials Registry (ACTRN12621000239864). Before the intervention, no significant difference was found in work stress and job satisfaction levels between the intervention, placebo, and control groups. After the intervention, the intervention group had a significantly lower work stress level and a significantly higher job satisfaction level than the placebo and control groups (P < .05). Lavender oil inhalation can decrease work stress and improve job satisfaction.
Repeated Intracameral Amphotericin B: A Safe Approach for Management of Fungal Anterior Chamber Reactivations After Therapeutic Penetrating Keratoplasty
Authors: Okonkwo Arthur , Sethi Kavita , Anand Seema
Published: March 2023

Purpose:

The aim of this study was to describe the safe use of repeated intracameral amphotericin B for anterior chamber reactivations after therapeutic penetrating keratoplasty for Fusarium solani keratitis.

Methods:

A 49-year-old woman monthly soft contact lens wearer with a history of overuse and swimming in her lenses presented with a red painful left eye. Her vision was 0.5 logMAR and there was a poorly demarcated corneal infiltrate. Although corneal scrapes and a corneal biopsy were negative, confocal microscopy showed fungal hyphae. After failure of medical treatment, therapeutic penetrating keratoplasty was performed. Fusarium solani sensitive to amphotericin was isolated. There was pan-azole resistance. The patient was managed with topical amphotericin B, and repeated anterior chamber reactivations were managed with intracameral amphotericin B 5 µg in 0.1 mL on 9 occasions over 5 months after sensitivities were known. Topical cyclosporine was used as the sole immunomodulator postoperatively, with no topical steroid use over the 4-year follow-up period.

Results:

There were no episodes of graft rejection and no endothelial, lenticular, or retinal toxicity. The best-corrected visual acuity is −0.1 logMAR and the endothelial cell count is 2160/mm2.

Conclusion:

This report describes the safe and effective use of repeated intracameral amphotericin (cumulative 45 µg) in anterior chamber reactivations after therapeutic penetrating keratoplasty and highlights the role of fungal sensitivity in guiding treatment in refractory cases. It also demonstrated the successful use of topical cyclosporin as the sole postoperative immunomodulatory therapy despite repeated recurrence of infection and consequent increased inflammation in the postoperative period.
Preloaded DMEK With Endothelium Outward: A Multicenter Clinical Study Using DMEK Rapid Device
Authors: Wojcik Gabriela , Parekh Mohit , Romano Vito , Ruzza Alessandro , Scorcia Vincenzo , Viola Pietro , Leon Pia , Franch Antonella , Gadhvi Kunal A. , Ponzin Diego , Ferrari Stefano
Published: March 2023

Purpose:

The objective of this study is to validate Descemet membrane endothelial keratoplasty (DMEK) Rapid device for preloading DMEK grafts with endothelium outward.

Methods:

In this multicenter retrospective clinical study, DMEK tissues (n = 27) were peeled and preloaded (8.25 mm) in a DMEK Rapid device. The device was loaded in a container prefilled with the storage solution and shipped from a single center in Italy to 4 different centers located in Italy and the United Kingdom. Preloaded tissues were delivered by injecting the graft in the anterior chamber. Patients were monitored at days 1 and 15 and at months 1, 3, and 6, as well as at the last follow-up (9–12 months) postoperatively. Main outcome measures included rebubbling rate and graft failure, corrected distance visual acuity, endothelial cell loss (ECL), and central corneal thickness at all time points. A one-way analysis of variance test comparing day 1 with all later time points was followed with significance atP< 0.05.

Results:

The average recorded surgical time was 6 to 25 minutes with no immediate surgical complications. Rebubbling was observed in 7 of 26 cases with one graft failure within 15 days postoperatively. The mean corrected distance visual acuity at day 1 was 0.64 ± 0.49 logMAR, which improved to 0.18 ± 0.43 logMAR at the last follow-up. Endothelial cell density values showed a significant decrease at the last follow-up (1827 ± 565 cells/mm2) (P< 0.001) compared with the preoperative value (2503 ± 128 cells/mm2), with an average endothelial cell loss of 27%. Central corneal thickness significantly dropped from 694 ± 157 μm at day 1 to 502 ± 42 μm at the last follow-up (P< 0.001).

Conclusions:

DMEK Rapid device is quick, easy, and efficient for preloading and shipping DMEK grafts internationally in endothelium-outward orientation.
Alternative Approach for the Treatment of Conjunctivochalasis: Plasma-Based Conjunctivoplasty
Authors: Ucar Fikret
Published: March 2023

Purpose:

The aim of this study was to evaluate the efficacy of plasma-based conjunctivoplasty as a new surgical approach for conjunctivochalasis.

Methods:

This prospective, noncomparative, interventional study included research on 42 eyes of 33 patients who underwent plasma therapy because of conjunctivochalasis between February 2020 and December 2021. Maintaining a 2-mm distance from the limbus, at least 3 lines (approximately 2 mm deep) of plasma therapy were applied to the conjunctiva from the temporal quadrant to the nasal quadrant. Patient symptoms, the fluorescein clearance test, ocular surface integrity with fluorescein staining, the Ocular Surface Disease Index questionnaire, tear breakup time (TBUT), tear meniscus height, and complications were evaluated.

Results:

The mean patient age at the time of surgery was 67.3 ± 7.2 (range: 54–81) years. After surgery, the grades of conjunctivochalasis decreased in all patients. Although epiphora was present in 28 eyes (66.6%) preoperatively, none of the cases had epiphora during the follow-up period. The Ocular Surface Disease Index score improved significantly from 34.7 ± 10.3 preoperatively to 5.0 ± 4.2 3 months postoperatively (P <0.001). Although the preoperative TBUT was 5.1 ± 2.2 seconds, the TBUT increased to 10.0 ± 2.3 seconds 3 months postoperatively (P <0.001). Chemosis developed in only 1 eye (2.3%) and completely regressed with topical steroid treatment in the first postoperative week.

Conclusions:

Plasma-based conjunctivoplasty is a minimally invasive and simple surgery with less intraoperative and postoperative discomfort, a fast recovery, and can be suggested as an alternative approach to other treatment methods.
Disseminated Blastomycosis in a Previously Stable Crohn's Disease Patient on Infliximab Therapy
Authors: Kreines Michael , Newstead Sabrina , Bishop Neil
Published: March 2023

Reactivation of granulomatous diseases is a well-documented risk of biologic therapy. This case highlights a patient well controlled on chronic infliximab therapy, developing symptoms consistent with disease progression. The patient underwent a surgical laparoscopy given concern of small bowel obstruction in which diffuse, peritoneal nodularity was seen. Further staining revealed broad-budding yeast and blastomyces urinary antigen resulted as positive. The patient was treated for disseminated blastomycosis, and his symptoms completely resolved.
A Blue-Enriched Light Intervention Counteracts the Alertness Decrement Among Mine Workers on Extended 12-Hour Night Shift Periods
Authors: Hébert Marc , Lavigne Andrée-Anne , Auclair Julie , Martin Jeanne-Sophie , Francis Kimberley , Gagnon Justine Dumoulin , Dubois Marc-André , Laberge Luc
Published: March 2023

Objective

The aim of the study is to assess whether a blue-enriched light intervention improves nocturnal alertness and daytime sleep of night workers.

Methods

Thirteen miners performing 12-hour night shifts for 12 consecutive nights were exposed to a baseline and a blue-enriched light condition. All subjects wore an actigraph and completed a Psychomotor Vigilance Task at the beginning and at the end of each shift. Data were analyzed with linear mixed models.

Results

In the blue-enriched light condition, the daily increase in median reaction time (RT), mean RT, slowest 10% of RT, and fastest 10% of RT was lower than that observed in the baseline condition between day 1 and 12 (P ≤ 0.05).

Conclusions

The addition of blue-enriched light during a long period of extended night shifts counteracts most of the daily decline in nocturnal alertness observed in the standard lighting condition, irrespectively of sleep duration and sleep efficiency.
Prospective Validation of Tubomanometry in Children With Normal Eustachian Tube Function
Authors: Kuhlmann Götz , Schädelin Sabine , Gürtler Nicolas
Published: March 2023

Objectives

Tubomanometry (TMM), described initially by Estève, is a relatively new manometric method for testing the eustachian tube function (ETF). This study presents the analysis of the measurement of ETF of healthy children by TMM, which has, to date, not been properly evaluated. The objectives of the study were to establish normative data for TMM and to demonstrate TMM as a reliable and valid method for measuring ETF in children.

Design

The evaluation, after initial power analysis, comprised 35 children from 6 to 15 years of age with an intact tympanic membrane, no severe ET dysfunction, and less than three inflammations of the middle ear in their medical history. TMM was performed twice at three pressure levels for both ears. Statistical assessment of the various parameters of TMM was performed with emphasis on the R value and possible age dependency.

Results

The 90th percentile for the R value was calculated to be 1.12. No clinically relevant age effect regarding the use of TMM as a screening method for children was found. Healthy children showed an opening within normal limits for the so-called R value in 88%; a delayed opening was measured in 6%, and rarely no opening was measured in 2%.

Conclusions

TMM is a reliable tool for measuring ETF in children. The normal limit for the R value should be set at 1.12. The proposed measuring algorithm and results can be used to calculate sensitivity and specificity in a future study.
Examining the Spatial Varying Effects of Sociodemographic Factors on Adult Cochlear Implantation Using Geographically Weighted Poisson Regression
Authors: Lee Melissa S. , Lin Vincent Y. , Mei Zhen , Mei Jannis , Chan Emmanuel , Shipp David , Chen Joseph M. , Le Trung N.
Published: March 2023

Objective

To (i) demonstrate the utility of geographically weighted Poisson regression (GWPR) in describing geographical patterns of adult cochlear implant (CI) incidence in relation to sociodemographic factors in a publicly funded healthcare system, and (ii) compare Poisson regression and GWPR to fit the aforementioned relationship.

Study Design

Retrospective study of provincial CI Program database.

Setting

Academic hospital.

Patients

Adults 18 years or older who received a CI from 2020 to 2021.

Intervention(s)

Cochlear implant.

Main Outcome Measure(s)

CI incidence based on income level, education attainment, age at implantation, and distance from center, and spatial autocorrelation across census metropolitan areas.

Results

Adult CI incidence varied spatially across Ontario (Moran's I = 0.04, p < 0.05). Poisson regression demonstrated positive associations between implantation and lower income level (coefficient = 0.0284, p < 0.05) and younger age (coefficient = 0.1075, p < 0.01), and a negative association with distance to CI center (coefficient = −0.0060, p < 0.01). Spatial autocorrelation was significant in Poisson model (Moran's I = 0.13, p < 0.05). GWPR accounted for spatial differences (Moran's I = 0.24, p < 0.690), and similar associations to Poisson were observed. GWPR further identified clusters of implantation in South Central census metropolitan areas with higher education attainment.

Conclusions

Adult CI incidence demonstrated a nonstationary relationship between implantation and the studied sociodemographic factors. GWPR performed better than Poisson regression in accounting for these local spatial variations. These results support the development of targeted interventions to improve access and utilization to CIs in a publicly funded healthcare system.
Distribution of traditional Chinese medicine syndromes and syndrome elements of chronic heart failure based on network analysis and hierarchical cluster analysis
Authors: Zhou Yi , Huang Pinxian , Li Xiaoqian , He Jiancheng
Published: March 2023

Objective:

To explore the distributions of syndromes and syndrome elements of chronic heart failure (CHF), so as to provide a point of reference to the research on diagnosis and treatment of CHF, the study on syndrome standardization, and objective research of TCM diagnosis.

Methods:

The clinical research articles on CHF syndromes in recent 40 years were retrieved from Wanfang Data, CNKI, CqVIP, SinoMed, PubMed, Scopus, Web of Science, and Embase. The cumulative frequencies of CHF syndromes, syndrome elements, and their corresponding cases were counted and compared. The syndrome elements were analyzed by network analysis, and the symptoms were analyzed by hierarchical cluster analysis.

Results:

A total of 278 Chinese articles with 71 syndromes and 31 syndrome elements were included after two rounds of screening. The research on CHF syndrome has kept a regular activeness till now, but its development was geographically uneven. The distribution of CHF syndromes gained from the cumulative frequencies of syndromes appeared in the articles were in line with that gained from the cumulative frequencies of the cases corresponding to syndromes. The network analysis found four communities of syndrome elements, indicating the deficiency-excess in complexity of CHF pathology, which can be inferred as some common CHF syndromes. The hierarchical cluster analysis on CHF symptoms showed that the distribution of CHF syndromes included five types.

Conclusion:

The distribution of CHF syndromes includes syndrome of qi deficiency with blood stasis, syndrome of qi and yin deficiency, syndrome of yang deficiency with water retention, syndrome of heart blood stasis obstruction, syndrome of turbid phlegm, and syndrome of collapse due to primordial yang deficiency. The syndrome elements on location of illness are heart, kidney, lung, and spleen, and the syndrome elements on nature of illness are qi deficiency, blood stasis, yang deficiency, yin deficiency, water retention, and turbid phlegm.
Roles of Case Studies and Case Reports in US East Asian Medicine: A Narrative-Medicine Perspective
Authors: Rivkin Sarah E.
Published: March 2023

Recorded stories of the clinical encounter stretch back to ancient times. Throughout their history, these narratives have been called by different names, reflecting changes in format, function, and audience. This paper examines and explains the differences in two related forms of clinical writing as practiced by East Asian Medicine clinicians in the United States today-the case study and the case report. Each has its strengths and weaknesses; each is suited to different roles. The case study is ideal for education and the practice of narrative medicine, whereas the case report has played a vital role in propelling East Asian Medicine into the arena of modern scientific research.
Retraced Lucid Multi-dimensional Chinese Logic System behind Chinese Medicine
Authors: Yu Edwin CL
Published: March 2023

Chinese Logic system is not universally accepted. However, the ancient tacit knowledge behind the logic system permeated the culture and promoted numerous impactful inventions throughout the history. Traditional Chinese medicine with its effectiveness should also have stemmed out from such logic system. This paper aims to rearticulate the underlying lucid multi-dimensional logic system, which faded in obscurity only because of time-out loss of the mid-right concept. Retracing this past tacit but important concept could uncover a multi-dimensional system over a point relating to all matters while capturing the central core of the matter. The seemingly unmanageable multi-dimensional logic was strengthened by verification processes which affirmed its further extensions, and made up the language of the people, the concepts of Yin-Yang, and the development of extensions of Ba Gua derivatives, which furthered the interpretation of the space-time properties and Chinese medicine.
Immune-related adverse events associated with the use of immunotherapy in patients with B-cell lymphoblastic leukemia: A protocol for a systematic review and meta-analysis
Authors: Kanovengi Bianca K. , Nkambule Bongani B. , Hauwanga Edwig , Nyambuya Tawanda M.
Published: March 2023

Background:

B-cell acute lymphoblastic leukemia (B-ALL) is a neoplasm of immature B-cells that is more prevalent in children. Despite successful remission rates in patients with B-ALL on chemotherapy, the risk of relapse is high. This has paved way for highly active immune and cell therapies to be intensively explored. However, the efficacy and immune-related adverse events (AE) associated with the use of immunotherapies remain elusive.

Methods:

This protocol has been prepared in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols 2015 guidelines. Cochrane Central Register of Controlled Trials, MEDLINE, and Embase electronic databases will be searched to retrieve relevant interventional studies. Two reviewers (BKK and EH) will autonomously search and identify relevant studies using a preset inclusion and exclusion criteria. A predefined data extraction sheet will be used to extract relevant data items. The risk of bias will be assessed by 2 reviewers (BKK and BBN) using the Cochrane risk-of-bias tool for randomized controlled trials and the Downs and Black Checklist for nonrandomized controlled trials. A third reviewer (TMN) will be consulted for any discrepancies. The Grading of Recommendations Assessment Development and Evaluation will be used to assess the strengths of evidence by 2 reviewers (BBK and TMN). The I² and Chi-squared statistical tests will be used to investigate statistical heterogeneity across studies. An I² value of > 50% will be considered substantial heterogeneity and a random-effects model will be used. Data analysis will be performed using Review Manager (RevMan V.5.3) statistical software.
Parent/caregiver reported health-related functioning in Chinese children with epilepsy: A cross-sectional, parents-responded, hospital-based study
Authors: He Guoqing , Zhu Jingbo , Li Bin
Published: March 2023

Due to epilepsy, children have faced several difficulties and challenges. Epilepsy shows an impact on a person quality of life (QoL) which can be associated with psychological, physical, and social aspects and can have a greater impact on the QoL of the person than that do through another chronic disease(s). Health-related quality of life (HRQoL) is a multidimensional concept that includes emotional, mental, physical, behavioral, and social aspects of the well-being and functioning of the patients. The objective of the study was to assess the level of HRQoL for childhood epilepsy in Chinese children under treatment for epilepsy. Also, to identify factors that can affect QoL. A descriptive, cross-sectional, parents-responded questionnaire-based study was performed on 382, 4 to 18 years old hospitalized and outpatient units’ children from various backgrounds, varying socio-economic status, and of varying intellectual capability with the most recent epilepsy. The clinical and socio-demographic parameters were collected from medical records and by an interview with parents of children. The quality of life in the children with epilepsy (QoLCE) questionnaire-91 was used to access HRQoL. The average age of children was 10.4 ± 3.2 years. The duration of epilepsy in children was 3.90 ± 2.80 years. Among the enrolled children, 153 (40%) children were girls, and 229 (60%) individuals were boys. The overall QoLCE questionnaire-91 score was 69.40 ± 16.40 (minimum scores: 27.80, maximum scores: 87.80). A total of 324 (84%), 41 (11%), and 17 (5%) children were from urban, suburban, and rural types, respectively. The generalized seizure (198 (52%)) is the most common type of existing seizure followed by focal seizure (152 (40%)). Male (P = .015), older children (12–14 years, P = .019), those residing in urban areas (P = .021), and those with focal seizures (P = .049) had higher QoL scores. The overall QoL of Chinese CWE is affected by sex, age, urbanization, and seizure type but not with education or economic status of the families. The study provides helpful insight for the clinicians in the management of chronic childhood epileptic conditions (Level of Evidence: II; Technical Efficacy Stage: 5).
Primary central nervous system diffuse large B-cell lymphoma in fourth ventricle: Case report and literature review
Authors: Zhao Jiahui , Zou Cunyi , Guo Zongze , Cheng Peng , Lu Weicheng
Published: March 2023

Rationale:

Primary central nervous system lymphoma (PCNSL) is rare, especially lymphoma arising in the fourth ventricle. Only a few cases have been reported. We report a case of fourth ventricular lymphoma and review the relevant literature. Characterizing these cases can provide a basis for optimizing the diagnosis and management of fourth ventricle lymphoma.

Patient concerns:

A 48-year-old male with blurred vision, dizziness, staggering persisting for 2 months was admitted.

Diagnosis:

Preoperative magnetic resonance imaging revealed a space occupying lesion of the fourth ventricle. The patient presented with symptoms of hydrocephalus before surgery, such as memory loss and slurred speech. Pathological analysis following complete resection confirmed the lesion as PCNSL.

Intervention:

The patient underwent a midline posterior fossa craniotomy.

Outcomes:

The patient symptoms were relieved after surgery. Postoperative chemotherapy was administered with our regular follow-up. Follow-up 9 months after operation indicated a good prognosis.

Lessons:

According to the literature, biopsy surgery and subsequent chemotherapy are generally considered as the best treatment options for PCNSL. We believe that for the special location of the fourth ventricle, lymphomas in this site are suitable for the combination of complete resection and subsequent chemotherapy. This approach facilitates tumor resection and reduces possibility of obstructive hydrocephalus.
Primary ovarian endometrial stromal sarcoma after hysterectomy associated with multiple organ invasion: A case report
Authors: Chen Ningxin , Gong Min , Lai Wen , Ling Ling , Liu Qiaoling
Published: March 2023

Rationale:

Endometrial stromal sarcoma (ESS) is a rare disease in patients with uterine malignancies, accounting for <1%. Low-grade endometrial stromal sarcoma (LGESS) accounts merely 0.2% of gynecologic malignant tumor. Primary low-grade extrauterine endometrioid stromal sarcomas (LGEESS) is even more uncommon, with only a few documented case reports. We report a case of primary LGEESS exhibiting widely invasion in multiple organs after hysterectomy, which is the first case reported in Jiangsu Province of China.

Patient concerns:

A 42-year-old nulliparous female with dysgnosia presented with a moderate amount of irregular vaginal bleeding, abdominal pain and distension, and frequent urination for 2 days. Her surgical history included a total hysterectomy and bilateral salpingectomy for uterine fibroids 6 years ago. Ultrasonography and the abdominal and pelvic computed tomography scan detected some solid polycystic masses in the pelvic and abdominal cavities.

Diagnoses:

The histopathology of the specimen confirmed the diagnosis of LESS in the absence of florid endometriosis. The patient was diagnosed with primary extrauterine endometrial stromal sarcoma at FIGO stage III.

Interventions:

Surgery and histopathology were performed.

Outcome:

After surgery, the patient was maintained on leuprorelin acetate microspheres with sustained release for injection at 3.75 mg once every 4 weeks while refusing further radiotherapy.

Lessons:

The diagnosis of primary LGEESS is challenging mainly because of their unforeseen location and nongynecologic signs and symptoms. Total hysterectomy and bilateral salpingo-oophorectomy are recommended to LGESS, while additional resection for extrauterine disease depends on disease extent and resectability.
TCM as adjunctive therapy improves risks of respiratory hospitalizations in persons with type 2 diabetes: A retrospective cohort study
Authors: Lin Pei-Chun , Lin Cheng-Chieh , Li Chia-Ing , Wang Tang-Chuan , Peng Yi-Hao , Chang Tung-Ti , Lin Chin-Yi , Li Tsai-Chung , Hsieh Ching-Liang
Published: March 2023

Patients with type 2 diabetes are at a higher risk of chronic obstructive pulmonary disease (COPD) and asthma than the general population. In addition, emerging evidence suggests that traditional Chinese medicine (TCM) might be beneficial for patients with type 2 diabetes. We investigated whether TCM use was associated with a reduced risk of respiratory hospitalizations in patients with type 2 diabetes. Conducting a retrospective cohort study, we used data retrieved from the NDCMP database. Among 56,035 patients, 5226 were classified as TCM users; 50,809 were classified as TCM nonusers. Both groups were analyzed until the end of 2011 to examine the incidence of respiratory hospitalizations by using a Cox proportional hazards model to evaluate effects of TCM use on respiratory hospitalizations. During the 6-year study follow-up period, the incidence density rates of COPD- and asthma-related hospitalization were estimated to be 13.03 and 4.47 per 10,000 patient-years for TCM nonusers and 10.08 and 3.28 per 10,000 patient-years for TCM users, respectively. The HR of COPD-related hospitalization in TCM users was 0.88 (95% CI = 0.79–0.99); and the HR of asthma-related hospitalization in TCM users was 0.81 (95% CI = 0.66–1.00). Stratified analyses revealed that effects of TCM use were stronger among individuals who had diabetes for <3 years. As a part of Integrative Medicine, our study results demonstrate that TCM use was associated with a significant reduced risk of respiratory hospitalizations, especially in patients with diabetes for <3 years.
Exploring the mechanism of action of Hedyotis diffusa Willd on acne using network analysis
Authors: Seo Gwangyeel , Kim Kyuseok
Published: March 2023

In this study, we used a network pharmacological method to explore the active ingredients of Hedyotis diffusa Willd (HDW) in the treatment of acne and elucidated the physiological mechanisms in the human body in which they are involved. We identified the active compounds of HDW that are expected to act effectively in the human body using the Traditional Chinese Medicine Systems Pharmacology database and analysis platform and extracted potential interacting proteins for each active compound using the Swiss Target Prediction platform. Next, we analyzed the potential mechanisms of action of the protein targets shared by HDW and each standard drug on acne and assessed the possibility of spontaneous occurrence of the binding between proteins and active compounds through the molecular docking process. Seven active compounds were selected according to the oral bioavailability and drug-likeness criteria of the Traditional Chinese Medicine Systems Pharmacology database and analysis platform. Subsequently, 300 protein targets were collected from the Swiss Target Prediction. Using the Search Tool for the Retrieval of Interacting Genes/Proteins database, a protein-protein interaction network was constructed by analyzing the relationship between HDW, acne, and each standard drug. By analyzing the gene ontology terms and Kyoto Encyclopedia of Genes and Genomes pathway, the “positive regulation of lipid metabolic process” was found to be the most involved pathway shared by HDW, acne, and isotretinoin. An analysis of the protein targets shared by the antibiotic agents with HDW and acne found that “cholesterol storage” in tetracycline, “icosacoid transport” in azithromycin, “steroid hydroxylase activity” in erythromycin, “positive regulation of leukocyte tethering or rolling” in clindamycin, “response to UV-A” in minocycline, “steroid 11-beta-monooxygenase activity” in doxycycline, and “neutrophil-mediated immunity” in trimethoprim were the most involved. Virtual molecular docking analysis showed that all proteins spontaneously bound to their corresponding active compounds. Our analysis suggests that HDW can, directly and indirectly, suppress sebum secretion and exert antiinflammatory effects on acne. Further, HDW may regulate free radicals and suppress apoptosis. Therefore, HDW can be used as an alternative or supplement to standard drugs for acne treatment in patients who cannot use standard treatments due to side effects.
Pleomorphic adenoma of the tongue: A case report
Authors: Liang Yuanzi , Bai Dong , Liu Wenting , Wang Zhiqun
Published: March 2023

Rationale:

Salivary gland tumors account for approximately 3% of all tumors, most of which are benign, with pleomorphic adenomas being the most common, occurring mostly in middle-aged women, mostly originating from the major salivary glands and, to a lesser extent, from the minor salivary glands, with the tongue being a very rare site of occurrence. To date, case reports of pleomorphic adenoma at the root of the tongue are also rare.

Patient concerns:

A 56-year-old male patient with no obvious cause of foreign body sensation in the pharynx, sputum, no pain, no blood in the sputum, no dysphagia, and no difficulty in swallowing and breathing, which was significantly aggravated in the past 2 weeks, with difficulty in swallowing, breath-holding on lying down.

Diagnoses:

computed tomography and magnetic resonance imaging revealed a soft tissue mass at the root of the left tongue, which involved the tongue body in the forward direction. Electronic laryngopharyngoscopy showed a left-sided tongue root mass with a poorly smooth mucosa, covered with a mucous white pseudomembrane and a localized brownish-black crust without active bleeding. The final pathological findings showed a pleomorphic adenoma.

Interventions:

Postoperative symptomatic treatment was given, and the patient recovered well. Eight days after surgery, the patient was discharged from the hospital, and the pharyngeal pain basically subsided at the time of discharge, with no fever and no pharyngeal discomfort. Postoperative laryngoscopy showed smooth mucosa of the pharyngeal cavity, good pseudomembrane formation in the operated area, no active bleeding, no purulent secretions, and normal blood routine on recheck. The medical advice after discharge was firstly, full rest for 1 week, secondly, continue the oral anti-inflammatory treatment, 1 week after the operation need to review the outpatient clinic, finally, if there are any uncomfortable symptoms, seek medical attention in time.

Outcomes:

At present, the patient has been followed up for half a year and has recovered well from the operation without any discomfort.

Lessons:

It is very rare to find a pleomorphic adenoma of the tongue, and it occurs mostly in middle-aged women. In clinical diagnosis, it is sometimes difficult to distinguish it from malignant tumor of the tongue.
Multiple traditional Chinese medicinal approaches in collaboration with conservative conventional medicine for lumbar herniated intervertebral discs: A systematic review and meta-analysis
Authors: Kim Taeoh , Kim Hyungsuk , Shin Woo-Chul , Cho Jae-Heung , Song Mi-Yeon , Chung Won-Seok
Published: March 2023

Background:

This review aimed to verify the clinical effects of traditional Chinese medicine in collaboration with conservative conventional medicine for lumbar herniated intervertebral discs (LHIVD).

Methods:

The CENTRAL, EMBASE, MEDLINE/PubMed, JMAS, CNKI, and seven Korean databases were searched using pre-planned strategies. The risk of bias was assessed using the Cochrane Collaboration tool and a meta-analysis was conducted accordingly.

Results:

Twenty-eight randomized controlled trials (RCTs) were included in this systematic review and meta-analysis. All RCTs included 2746 participants. The experimental group showed more significant improvements in VAS (Mean differences (MD) −1.61, 95% Confidence Intervals (CI) [−2.44, −0.79]; I
2 = 98%), Oswestry Disability Index (ODI) (MD −8.52, 95% CI [−11.71, −5.34]; I
2 = 96%), and Japanese Orthopaedic Association (JOA) scores (MD 4.83, 95% CI [3.49, 6.17]; I
2 = 85%) than the control group. However, the difference in the incidence of adverse events between the experimental and control groups was not significant (Relative Risk (RR) 0.05, 95% CI [0.23, 1.10]; I
2 = 46%).

Conclusion:

Traditional Chinese medicine in collaboration with conservative conventional medicine can be used to relieve pain and facilitate better function of the lumbar spine in lumbar herniated intervertebral disc cases. However, this conclusion should be applied with caution in clinical practice owing to the low quality of the included studies.
Exploring the relationship between intestinal flora and the pathological mechanism of myopia in adolescents from the perspective of Chinese and Western medicine: A review
Authors: Xi Xiaoming , Han Liang , Ding Mengmeng , Li Jinglu , Qiao Chenye , Liu Zongjian , Qie Shuyan
Published: March 2023

The etiology of adolescent myopia involves genetic and environmental factors. The pathological mechanism of modern medicine includes blood perfusion, changes in blood molecules, neurotransmitters, and sclera remodeling. Chinese medicine believes that myopia is mainly related to the deficiency of liver blood and spleen and stomach disorders. The prevention and treatment of myopia in adolescents are very important, but in terms of the current incidence of myopia in adolescents and the level of clinical diagnosis and treatment, its prevention and treatment are insufficient. Modern medicine and traditional Chinese medicine both pay attention to integrity, so adolescent myopia should not only pay attention to eye changes but also pay attention to other body systems and other aspects of change. Intestinal flora has become a research hotspot in recent years, and it has been found that it is closely associated with multi-system and multi-type diseases. No studies have directly investigated the link between Intestinal flora and myopia in adolescents. Therefore, by summarizing the pathological mechanism of adolescent myopia and the connection between intestinal flora and the pathological mechanism of adolescent myopia, this paper analyzes the possible pathological mechanism of the influence of intestinal flora on adolescent myopia, providing a theoretical basis for future studies on the correlation between changes of intestinal flora and its metabolites and the incidence of adolescent myopia, which is of great significance for the study on the risk prediction of adolescent myopia.
Biofeedback Training to Increase PCO2 in Asthma with Elevated Anxiety: A One-Stop Treatment for Both Conditions?
Authors: Meuret Alicia E. , Rosenfield David , Millard Mark M. , Ritz Thomas
Published: March 2023

Objective

Anxiety is highly prevalent in individuals with asthma. Asthma symptoms and medication can exacerbate anxiety, and vice versa. Unfortunately, treatments for comorbid anxiety and asthma are largely lacking. A problematic feature common to both conditions is hyperventilation. It adversely affects lung function and symptoms in asthma and anxiety. We examined whether a treatment to reduce hyperventilation, shown to improve asthma symptoms, also improves anxiety in asthma patients with high anxiety.

Method

One-hundred-twenty English- or Spanish-speaking adult patients with asthma were randomly assigned to either capnometry-assisted respiratory training (CART) to raise PCO2 or feedback to slow respiratory rate (SLOW). Although anxiety was not an inclusion criterion, 21.7% met clinically-relevant anxiety levels on the Hospital Anxiety and Depression scale. Anxiety (HADS-A) and depression (HADS-D) scales, anxiety sensitivity (ASI), and negative affect (PANAS-N) were assessed at baseline, posttreatment,1-month follow-up, and 6-month follow-up.

Results

In this secondary analysis, asthma patients with high baseline anxiety showed greater reductions in ASI and PANAS-N in CART than in SLOW (ps ≤ .005, Cohen's ds ≥ .58). Further, at 6-month follow-up, these patients also had lower ASI, PANAS-N, and HADS-D in CART than in SLOW (ps ≤ .012, Cohen's ds ≥ .54). Patients with low baseline anxiety did not have differential outcomes in CART than in SLOW.

Conclusions

For asthma patients with high anxiety, our brief training designed to raise PCO2 resulted in significant and sustained reductions in anxiety sensitivity and negative affect compared to slow-breathing training. The findings lend support for PCO2 as a potential physiological target for anxiety reduction in asthma.

Trial Registration:
clinicaltrials.gov Identifier: NCT00975273.