bluuebunny/crossref_metadata_2025 huggingface dataset:
The immunocytokine L19-TNF eradicates sarcomas in combination with chemotherapy agents or with immune check-point inhibitors
Authors: Corbellari Riccardo , Nadal Lisa , Villa Alessandra , Neri Dario , De Luca Roberto
Published: April 2020

Antibody-cytokine fusion proteins (also called ‘immunocytokines’) represent an emerging class of biopharmaceutical products, which are being considered for cancer immunotherapy. When used as single agents, pro-inflammatory immunocytokines are rarely capable of inducing complete and durable cancer regression in mouse models and in patients. However, the combination treatment with conventional chemotherapy or with other immune-stimulatory agents typically increases the therapeutic efficacy of immunocytokines. In this article, we describe combination treatments of a tumor-targeting antibody-cytokine fusion protein based on the L19 antibody (specific to a splice isoform of fibronectin) fused to murine tumor necrosis factor with standard chemotherapy (dacarbazine, trabectedin or melphalan) or with an immune check-point inhibitor (anti-PD-1) in a BALB/c derived immunocompetent murine model of sarcoma (WEHI-164). All combination treatments led to improved tumor remission compared to single-agent treatments, suggesting that these combination partners may be suitable for further clinical development in sarcoma patients.
Unmet needs in the acute treatment of migraine attacks and the emerging role of calcitonin gene–related peptide receptor antagonists: An integrative review
Authors: Mallick-Searle Theresa , Moriarty Maureen
Published: April 2020

Background:

Migraine is a prevalent and chronic disease associated with high rates of disability and significant financial and socioeconomic burden. Current acute treatments for migraine attacks include both migraine-specific (e.g., triptans, ergotamines) and nonspecific (e.g., nonsteroidal anti-inflammatory drugs) medications; however, significant unmet treatment needs remain.

Objectives:

The authors sought to characterize the nature and drivers of unmet treatment needs in the acute treatment of migraine attacks and describe emerging migraine-specific treatments, that is, calcitonin gene–related peptide (CGRP) receptor antagonists.

Data sources:

PubMed searches were conducted using search terms for studies of unmet migraine treatment needs and CGRP receptor antagonists. Additionally, studies presented at recent headache-focused congresses were included.

Conclusions:

Forty percent of people with migraine report at least 1 unmet treatment need. Many people are unable to use migraine-specific or nonspecific agents because of contraindications, precautions, and tolerability issues. Disease burden (disability, headache severity/frequency) remains high even in those receiving migraine-specific medications. The oral CGRP receptor antagonists, ubrogepant and rimegepant, demonstrated efficacy in reducing migraine pain, migraine-associated symptoms, and disability, with a low adverse event profile, similar to placebo.

Implications for practice:

The availability and use of CGRP receptor antagonists may help reduce the extent of unmet needs in the treatment of migraine attacks, resulting in more patients receiving treatment and better outcomes for people with migraine. Nurse practitioners are well positioned to increase rates of migraine diagnosis/treatment (another key unmet need), using consensus guidelines to guide their approach.
Effect of acupoint application on T lymphocyte subsets in patients with chronic obstructive pulmonary disease
Authors: Wu Jian-Jun , Zhang Ying-Xue , Xu Hong-Ri , Li Yi-Xuan , Jiang Liang-Duo , Wang Cheng-Xiang , Han Mei
Published: April 2020

Background:

The development of chronic obstructive pulmonary disease (COPD) is related to the T lymphocyte mediated inflammatory immune response and immune imbalance. The purpose of this systematic review was to evaluate the clinical efficacy and safety of acupoint application on T lymphocyte subsets in patients with COPD.

Methods:

We searched CNKI, Wan fang, Chongqing VIP, China Biology Medicine disc, PubMed, the Cochrane Library, and EMBASE for studies published as of Oct. 31, 2019. All randomized controlled trials of acupoint application on COPD patients that met the inclusion criteria were included. The Cochrane bias risk assessment tool was used for literature evaluation. RevMan5.3 software was used for meta-analysis.

Results:

Eight studies (combined n = 524) qualified based on the inclusion criteria. Compared with routine treatment alone, acupoint application combined with routine treatment can significantly increase the T lymphocyte CD4+/CD8+ ratio (MD 0.12, 95% CI 0.03-0.21, P < .01, I
2 = 49%), reduce CD8+ T-cells (MD-0.99, 95% CI-1.70-0.28, P < .001, I
2 = 37%), reduce the times of acute exacerbations (MD-0.28, 95% CI-0.35-0.21, P < .001, I
2 = 0), and improve the clinical efficacy (MD 1.30, 95% CI 1.14-1.48, P < .001, I
2 = 39%).

Conclusion:

Acupoint application can improve the CD4+/CD8+ ratio and CD8+ T-cells in patients with COPD and has an auxiliary effect in reducing the times of acute exacerbations and improving clinical efficacy.
Relationship between psychological factors and atrial fibrillation
Authors: Fu Yonghui , He Wenfeng , Ma Jianyong , Wei Bo
Published: April 2020

Background:

Although several studies have investigated the role of psychological factors in atrial fibrillation (AF), the results are still under debate. Therefore, we performed a meta-analysis to examine the relationship between psychological factors and the risk of incident AF.

Methods:

We systematically searched the PubMed and EMBASE databases from inception to December 2019 to identify eligible studies. The hazard ratios (HRs) with 95% confidence intervals (CIs) were pooled by using a random-effects model.

Results:

A total of 11 cohort studies were included in this meta-analysis. There were 5, 2, 4, and 5 studies examining the association of anxiety, anger, depression, and psychological stress with AF, respectively. In the pooled analysis by a random-effects model, anxiety (HR = 1.10, 95%CI 0.97–1.24; P = .14), anger (HR = 1.08, 95%CI 0.95–1.23; P = .21), depression (HR = 1.15, 95%CI 0.98–1.35; P = .08), and work stress (HR = 1.14, 95%CI 0.98–1.34; P = .09) were not associated with the risk of AF. These results were not changed when we re-performed the analysis using a fixed-effects model.

Conclusions:

Based on current evidence, no associations were observed for anger, anxiety, and work stress with the risk of AF.
Coats’ disease: characteristics, management, outcome, and scleral external drainage with anterior chamber maintainer for stage 3b disease
Authors: Yousef Yacoub A. , ElRimawi Ahmad H. , Nazzal Rashed M. , Qaroot Ahmad F. , AlAref Adnan H. , Mohammad Mona , Abureesh Omar , Rejdak Robert , Nowomiejska Katarzyna , Avitabile Teresio , Toro Mario Damiano , AlNawaiseh Ibrahim
Published: April 2020

To report on the characteristics and outcome of management of Coats’ disease, and to describe a novel surgical technique for management of stage 3B with total retinal detachment (RD) by scleral external drainage with anterior chamber (AC-maintainer) placement before the drainage without pars plana vitrectomy.

A retrospective study of 26 eyes from 25 Coats’ patients. Outcome measures included: demographics, presentation, laterality, stage, treatment, and outcome.

The median age at diagnosis was 3.5 years. Twenty patients (80%) were males, and all except 1 girl had unilateral disease. The presenting complaint was impaired vision in 13 (50%) eyes, leukocoria in 6 (23%) eyes, and strabismus in 7 (27%) eyes. Based on the Shields classification; 3(12%) eyes were stage 1, 9 (35%) eyes were stage 2, 10 (38%) eyes were stage 3, 2 (8%) eyes were stag e4, and 2 (8%) eyes were stage 5. Primary management included cryotherapy (54%), laser photocoagulation (27%), intravitreal anti-vascular endothelial growth factor (23%), intravitreal steroids (23%), and surgical drainage (12%). The 3 eyes in stage 3B (with total exudative RD) underwent subretinal fluid drainage with AC maintainer, and all had the retina reattached completely for 6 months follow up after the surgery. At mean follow up 21 months, 4 (15%) eyes were enucleated, 19 (73%) eyes had improvement or stabilization in visual acuity.

Coats’ disease usually presents at advanced stage with poor visual prognosis, individualized management with close follow up are mandatory to save the eye. Subretinal fluid drainage with AC maintainer is a safe and useful technique for repairing total RD in eyes with stage 3B Coats’ disease.
Favorable retention rates and safety of conventional anti-rheumatic drugs in older patients with rheumatoid arthritis
Authors: Alpay-Kanitez Nilüfer , Pehlivan Özlem , Omma Ahmet , Can-Sandikçi Sevinç , Girgin Sinem , İçaçan Ozan Cemal , Çelik Selda , Bes Cemal
Published: April 2020

Physicians are challenged by the recognition and treatment of older patients with rheumatoid arthritis (RA). The aim of this case-control study was to evaluate the retention and safety of conventional disease-modifying anti-rheumatic drugs in older patients with RA.

In this observational case-control study, we assessed older patients with RA (≥65 years) who were diagnosed in 3 different rheumatology centers from Turkey. Patients were divided as to those aged ≥65 years (elderly rheumatoid arthritis [ERA]) and those aged <65 years (young rheumatoid arthritis [YRA]) at the time of conventional DMARD treatment initiation. The Mann-Whitney U test was used for the comparison of 2 non-normally distributed groups. The Chi-square (χ2) test was used for categorical variables. Survival analysis were performed using the Kaplan-Meier method.

Four hundred eighteen patients with RA (296 females [71%]) were included from January 2010 to January 2018. The age of treatment onset of 190 (47%) patients was in the elderly period and they were included in the ERA group. In the analysis of drug retention rates, there was no significant difference between the ERA and YRA groups for each conventional DMARD (methotrexate 71.2% in ERA, 62.7% in YRA, P = .817; hydroxychloroquine 82.9% in ERA, 78.8% in YRA, P = .899; leflunomide 81.4% in ERA, 84.4% in YRA, P = .205; sulfasalazine 37.5% in ERA, 40.9% in YRA, P = .380). The adverse event data were also similar in both groups.

The drug retention and adverse effect rates in older patients with RA using conventional DMARDS are similar to the rates in young patients with RA.
The effectiveness of intra-articular vs subacromial corticosteroid injection for frozen shoulder
Authors: Wang Yanbiao , Gong Jing
Published: April 2020

Background:

Intra-articular (IA) corticosteroid injection is a commonly used therapy for frozen shoulder (FS), but controversy still exists regarding the injection site with the best outcome. This randomized controlled trial is designed to determine whether corticosteroid injection into the subacromial space was not inferior to IA injection in patients with FS.

Methods:

This study will be a single-center, randomized, and double-blinded trial. Sixty patients who meet inclusion criteria will be randomized in a ratio of 1:1 to either subacromial injection or IA injection group. The outcome evaluations will be conducted at 4 time points (baseline, 4, 8, and 12 weeks after the injection) by an independent physical therapist. The primary outcome measure is visual analog scale for pain, whereas the secondary outcomes include Constant score, and shoulder passive range of motion including abduction, forward elevation, external rotation at the side, and internal rotation at the side.

Discussion:

This study has limited inclusion and exclusion criteria and a well-controlled intervention. This clinical trial is expected to provide evidence of proper site of corticosteroid injection for the treatment of FS.

Trial registration:

This study protocol was registered in Research Registry (researchregistry5368).
Traditional Chinese medicine (Liang-Xue-Di-Huang Decoction) for hemorrhoid hemorrhage
Authors: Shi Shuo-Yang , Zhou Qing , He Zong-Qi , Shen Zhao-Feng , Zhang Wei-Xin , Zhang Dan , Xu Cheng-Biao , Geng Ji , Wu Ben-Sheng , Chen Yu-Gen
Published: April 2020

Background:

Hemorrhoidal disease (HD) is one of the commonest proctologic condition in the general population. Medical therapy for HD has not been formally confirmed due to the inconsistent of results. Liang-Xue-Di-Huang Decoction, a kind of ancient Chinese classical prescription, has been used to treat HD from the 19th century in China. However, clinical research of Liang-Xue-Di-Huang Decoction in the treatment of HD was lack. We designed this study to evaluate the efficacy and safety of Liang-Xue-Di-Huang Decoction in the treatment of HD.

Methods/Design:

A randomized, controlled, double blind, double-mimetic agent, and multicenter trial to evaluate the efficacy and safety of Liang-Xue-Di-Huang Decoction is proposed. HD patients (stage I, II, III) will be randomly assigned into experimental group or control group. HD patients will receive a 7-day treatments and a 7-day follow-up. The primary outcome measure is the Hemorrhoid Bleeding Score in 7 and 14 days. The Secondary outcome measures are Goligher prolapse score and quality-of-life score in 7 and 14 days.

Discussion:

This study will provide objective evidences to evaluate the efficacy and safety of Liang-Xue-Di-Huang Decoction in treatment of HD.
Clinical study on post evaluation after listing of Qizhi Weitong granules
Authors: Xu Lin , Zhang Jiaqi , Li Juanjuan , Lv Lin , Zhang Zedan , Wang Fengyun , Tang Xudong
Published: April 2020

Background:

Functional dyspepsia (FD) is a highly prevalent functional gastrointestinal disorder which brings a significant impact on patients’ quality of life. Although there are many available treatments to alleviate dyspepsia symptoms, most of them are far from satisfactory. Traditional Chinese medicine (TCM) has shown good potential in the treatment of FD, especially in terms of improving symptoms and adverse effects of Western medicine. Qizhi Weitong granule (QZWTG), a TCM preparation, has been utilized in treating FD for a long time and has achieved good clinical results. However, the existing evidence of its efficacy and mechanism of action is insufficient. Hence, the purpose of this study is to evaluate the efficacy and safety of QZWTG in the treatment of FD.

Methods:

This study is a multicenter, randomized, double-blinded, double-placebo, positive drug parallel controlled clinical study. The experiment will be carried out in 8 hospitals at the same time, and a total of 384 cases of participants will be randomly assigned to the experimental group and the control group (n = 192). The experimental group will be given QZWTG and Mosapride citrate tablet placebo, and the control group will be given QZWTG placebo and Mosapride citrate tablet. After 4 weeks of intervention and 2 weeks of follow-up, the efficacy and safety of QZWTG in patients with FD will be observed. The primary outcomes are the change in the main symptom score. The secondary outcomes include TCM syndrome evaluation, the change of the Hamilton anxiety scale and the Hamilton depression scale, and advanced events. This study will explore the biological mechanism of QZWTG in the treatment of FD through the results of blood and urine metabolomics.

Discussion:

This trial will provide first-hand evidence on whether QZWTG is noninferior to Mosapride citrate tablet. There will be a new option for the treatment of FD if noninferiority is set up. In addition, the efficacy and safety of QZWTG in the treatment of FD will be evaluated, and the mechanism of QZWTG in the treatment of FD will be explored through the metabolomics of blood and urine. On the other hand, as far as we know, this study may be the largest trial of efficacy and safety of QZWTG in the treatment of FD, which has important application value.
Transcatheter aortic valve implantation in the patients with chronic liver disease
Authors: Ma Xiaochun , Zhao Diming , Li Jinzhang , Wei Dong , Zhang Jianlin , Yuan Peidong , Kong Xiangqian , Ma Jiwei , Ma Huibo , Sun Liangong , Zhang Yuman , Jiao Qiqi , Wang Zhengjun , Zhang Haizhou
Published: April 2020

Background:

Chronic liver disease is traditionally conceived as a risk factor for cardiovascular surgery. Transcatheter aortic valve implantation (TAVI) has recently burgeoned to precede surgical aortic valve replacement (SAVR) in patients with severe aortic stenosis at intermediate to high surgical risk. The evidence regarding TAVI in the patients with chronic liver disease is currently scarce.

Methods:

This article aims to assess the application of TAVI technique in the patients with chronic liver disease.

Results:

TAVI in the patients with chronic liver disease produced acceptable postoperative results. The post-TAVI outcomes were comparable between the patients with or without chronic liver disease, except for a lower rate of pacemaker implantation in the patients with chronic liver disease (OR, 0.49[0.27–0.87], P = .02). In the patients with chronic liver disease, compared to SAVR, TAVI led to a decrease in the in-hospital mortality (OR, 0.43[0.22–0.86], P = .02) and need for transfusion (OR, 0.39[0.25–0.62], P < .0001). The rest outcomes were similar between the 2 groups.

Conclusions:

This systematic review and meta-analysis supported that TAVI is a reliable therapeutic option for treating severe aortic stenosis in the patients with chronic liver disease. Future large-scale randomized controlled trials investigating the mid-term and long-term prognosis are needed to further verify these results.
The value of clinical parameters combined with magnetic resonance imaging (MRI) features for preoperatively distinguishing different subtypes of uterine sarcomas
Authors: Bi Qiu , Wu Kunhua , Lv Fajin , Xiao Zhibo , Xiong Yulin , Shen Yiqing
Published: April 2020

To investigate clinical parameters combined with magnetic resonance imaging (MRI) features including apparent diffusion coefficient (ADC) values in preoperative identification of different subtypes of uterine sarcomas including uterine leiomyosarcoma (LMS), endometrial stromal sarcoma (ESS), and carcinosarcoma (CS).

Data from 71 patients with uterine sarcoma confirmed by surgery and pathology were collected. The clinical characteristics, conventional MRI features, mean ADC values, minimum ADC values, and lesion-muscle ADC ratio (rADC) values were compared with different subtypes of uterine sarcomas.

Age, clinical manifestation, tumor location, shape, and T1-weighted image (T1WI) signals were significantly different between CS and LMS or ESS (all P < .01). The presence of band sign was significantly higher in ESS than in LMS or CS (both P < .001). The cystic change or necrosis and enhancement could help to differentiate LMS from ESS or CS (both P < .02). Significant differences were observed in T2-weighted image (T2WI) signals of the solid components of LMS compared with CS (P < .001). There was a significant difference between ESS and CS in the rADC values (P = .004).

Clinical parameters combined with MRI features could help narrowing preoperative diagnostic possibilities in distinguishing subtypes of uterine sarcomas. These findings may be beneficial in helping guide operative decisions.
Maternal and fetal complications associated with systemic lupus erythematosus
Authors: He Wen Rong , Wei Hua
Published: April 2020

Background:

Recent guidelines provide better treatment and management of pregnancy in women with systemic lupus erythematosus (SLE). In this analysis, we aimed to systematically assess the maternal and fetal complications associated with SLE using the most recent studies (2017–2019) to obtain an updated result of the present situation.

Methods:

http://www.clinicaltrials.gov, MEDLINE, Cochrane Central, Web of Science, EMBASE, and Google Scholar were searched for English based studies comparing maternal and fetal complications in pregnant women with versus without SLE. Maternal and fetal complications were the endpoints in this analysis. The RevMan software 5.3 (latest version) was the most suitable analytical software for this analysis. Data were represented by risk ratio (RR) with 95% confidence interval (CI).

Results:

A total number of eight million eight hundred and twelve thousand two hundred seventy-two (8,812,272) participants were included in this analysis, consisting of 9696 SLE-associated pregnancy. Based on an analysis of recently published studies (2017–2019), pre-eclampsia/eclampsia was significantly higher in pregnant women with SLE (RR: 3.38, 95% CI: 3.15–3.62; P = .00001). SLE was also associated with an increased risk of stillbirth (RR: 16.49, 95% CI: 2.95–92.13; P = .001) and fetal loss (RR: 7.55, 95% CI: 4.75–11.99; P = .00001). Abortion (RR: 4.70, 95% CI: 3.02–7.29; P = .00001) and the risk for cesarean section due to complications (RR: 1.38, 95% CI: 1.11–1.70; P = .003) were also significantly higher in pregnant women with SLE. In addition, fetal complications including preterm birth (RR: 2.33, 95% CI: 1.78–3.05; P = .00001), infants who were small for gestational age (RR: 2.50, 95% CI: 1.41–4.45; P = .002) and infants with low birth weight (RR: 4.78, 95% CI: 3.65–6.26; P = .00001) were also significantly higher in newborns from mothers with SLE. Moreover, the risk of newborns who were admitted to the neonatal intensive care unit (RR: 2.79, 95% CI: 2.31–3.37; P = .00001), newborns with an APGAR score <7 within 1 minute (RR: 2.47, 95% CI: 1.68–3.62; P = .00001) and 5 minutes (RR: 3.63, 95% CI: 2.04–6.45; P = .0001) respectively, were significantly highly associated with SLE.

Conclusions:

Based on the most recent studies, we could conclude that maternal and fetal complications were significantly higher in SLE-associated pregnancy. Therefore, SLE should still be considered a severe risk factor for pregnancy.
Selective nerve root injection of ozone for the treatment of phantom limb pain
Authors: Li Juanhong , Li Tianzuo , Li Guiying , Liu Hongfu , Zhang Xiaogai
Published: April 2020

Rationale:

Phantom limb pain (PLP) refers to a common complication following amputation, which is characterized by intractable pain in the absent limb, phantom limb sensation, and stump pain. The definitive pathogenesis of PLP has not been fully understood, and the treatment of PLP is still a great challenge. Till now, ozone injection has never been reported for the treatment of PLP.

Patient concerns:

We report 3 cases: a 68-year-old man, a 48-year-old woman, and a 46-year-old man. All of them had an amputation history and presented with stump pain, phantom limb sensation, and sharp pain in the phantom limb. Oral analgesics and local blocking in stump provided no benefits.

Diagnosis:

They were diagnosed with PLP.

Interventions:

We performed selective nerve root ozone injection combined with ozone injection in the stump tenderness points.

Outcomes:

There were no adverse effects. Postoperative, PLP, and stump pain were significantly improved. During the follow-up period, the pain was well controlled.

Lessons:

Selective nerve root injection of ozone is safe and the outcomes were favorable. Ozone injection may be a new promising approach for treating PLP.
COVID-19: guidance for infection prevention and control in nuclear medicine
Authors: Buscombe John R. , Notghi Alp , Croasdale Jilly , Pandit Manish , O’Brien Joseph , Graham Richard , Redman Stewart , Vinjamuri Sobhan
Published: April 2020

This guidance document is a brief consensus document covering the range and breadth of nuclear medicine practice in the UK, and identifies a few steps individual nuclear medicine practitioners and departments can take in the best interests of their patients. This guidance document should be used to inform local practice and does not replace local Trust policies or any relevant legislation. At all times, the best interests of the patients should be paramount. Please read this guidance in conjunction with previous editorial (COVID-19- Nuclear Medicine Departments, be prepared! by Huang HL, Allie R, Gnanasegaran G, Bomanji. J Nucl Med Commun 2020; 41:297–299). Although some aspects of this guidance are time-sensitive due to the nature of the global emergency, we believe that there is still sufficient information to provide some key guiding principles.
Antibody-medicated rejection after heart transplantation: diagnosis and clinical implications
Authors: Nguyen Vidang P. , Kobashigawa Jon A.
Published: April 2020

Purpose of review

The present article will review the diagnosis of antibody-mediated rejection in heart transplant recipients and further explore the clinical implications.

Recent findings

Improved diagnostic techniques have led to increased recognition of antibody-mediated rejection and better understanding of the long-term consequences in heart transplant recipients. Endomyocardial biopsy remains the gold standard for the diagnosis of antibody-medicated ejection; however, several advances in molecular testing have emerged, including the use of gene expression profiling, messenger RNA, and microRNA. Routine surveillance of donor-specific antibodies identifies recipients at high risk for graft compromise. Additionally, new monoclonal antibody therapies have broadened our repertoire in the treatment of rejection.

Advances in molecular testing for antibody-mediated rejection may improve the associated long-term complication, while minimizing risk to the patient.
Endoscopic Retrograde Cholangiopancreatography in Infants
Authors: Koot Bart G.P. , Kelly Deirdre A. , Hadzic Nedim , Gonzales Emmanuel , Hierro Loreto , Davenport Mark , Keil Radan , Fockens Paul , Baumann Ulrich
Published: April 2020

Endoscopic retrograde cholangiopancreatography (ERCP) in infants (younger than 1 year of age) is a highly specialized procedure. Since 2014 opportunities to maintain or purchase duodenoscopes for ERCP in infants have disappeared. In a survey among European hepatology centers (including Israel) we evaluated the availability, need, indications, and practice of ERCP procedures in infants. It shows that infant ERCP is a low‐volume procedure (median 5 procedures/year) in the 14 centers that perform this procedure. Since 2014 several centers no longer have an infant ERCP duodenoscope due to breakdown. In addition, substantial differences exist between centers in indications, types of interventions performed, and practical execution of ERCP procedures in infants. We conclude that a concerted effort by the pediatric hepatology community is needed to secure the future availability of infant ERCP. In addition, consensus on the indications and optimal use of infant ERCP could improve the quality of ERCP care for infants.
Validity of the Wide-range Assessment of Vision-related Essential Skills in Japanese Children with Learning Problems
Authors: Okumura Tomohito , Miura Tomoko , Nakanishi Makoto , Fukui Miho , Toshikawa Mari , Shimakawa Shuichi , Wakamiya Eiji , Tamai Hiroshi , Ashida Akira
Published: April 2020

SIGNIFICANCE

Our study revealed that the validity of a new Japanese visual-perceptual test was acceptable. Visual-perceptual abilities are important to activities of daily living; thus, accurate assessment of visual perception is especially important for children with neurodevelopmental disorders and particularly so for those with learning problems.

PURPOSE

Visual perception refers to the process by which one receives visual information through sensory impulses and then translates those impulses into meaning based on a previously developed view of the environment. A problem in Japan is the paucity of visual perception tests that use normative data from children who are native Japanese. The Wide-range Assessment of Vision-related Essential Skills (WAVES), which measures visual perception and eye-hand coordination skills and is based on Japanese normative data, was recently published in Japan. The validity of this test has not been comprehensively established.

METHODS

To investigate the validity of the WAVES, we used the Pearson correlation coefficient to calculate the degrees of association among WAVES scaled and index scores compared with Developmental Test of Visual Perception, Third Edition, scores from 108 elementary school children with symptoms of learning problems. Participants were recruited at Osaka Medical College Learning Disability Center and Sakai Seikeikai Learning Disability Center.

RESULTS

The concurrent validity of the WAVES was supported by moderate correlation (r = 0.67, P < .01) between the total scores for visual perception and eye-hand coordination index from the WAVES and general visual perception index from the Developmental Test of Visual Perception, Third Edition, even though a correlation analysis of subtests found differences between the two tests.

CONCLUSIONS

Our results showed that the indices from the two tests measured nearly the same underlying visual-perceptual constructs and indicated that the WAVES had acceptable levels of concurrent validity.
Intentional Poisoning in Pediatric Patients
Authors: Tay Elaine Yiling , Tan Grace Fangmin , Yeo Andrea Wei Ching , Tham Elizabeth Huiwen
Published: April 2020

Objectives

Poisonings in children are common reasons for presentation to the emergency department and can potentially have serious complications. Our research aims to review risk factors leading to intentional self-poisoning.

Methods

A retrospective medical record review of all intentional pediatric poisoning cases presenting to the Children's Emergency at National University Hospital, Singapore between January 2014 and December 2015 was performed.

Results

Eighty-seven cases of intentional poisonings were identified, 31 (36.5%) of which were with suicidal intent. The majority of cases were female (85.1%) and adolescents older than 16 years (93.1%). A known psychiatric history was present in 57.5% and 62 (71.3%) had a history of deliberate self-harm. Being diagnosed with a new psychiatric illness during that presentation was associated with a history of self-harm (adjusted odds ratio [Adj OR], 6.74; 95% confidence interval [CI]; 1.04–43.62; P = 0.045). Twenty-seven (31.0%) patients had a history of intentional poisoning, and 15 (17.2%) went on to have subsequent presentations for poisoning. Recurrent poisoning attempts were strongly associated with a known psychiatric history (Adj OR, 5.91; 95% CI, 1.62–21.58; P = 0.007) and a history of deliberate self-harm (Adj OR, 7.49; 95% CI, 1.38–40.66; P = 0.02). Deliberate overdosing on personal long-term medication was seen in 15 (35.7%) of 42, of which 12 (80%) of 15 were psychiatric medications.

Conclusions

Known psychiatric history or a history of deliberate self-harm are risk factors for intentional poisoning. Appropriate risk stratification and preemptive interventions involving closer surveillance or cognitive behavioral programs are possible measures to prevent intentional self-poisoning, especially in these at-risk groups.
Compensation of Ipsilateral Motor and Sensory Functions by Contralateral Uncrossed Pathway in a Stroke Patient With Half Brain
Authors: Shi Yu , Wan Chunxiao
Published: April 2020

This study reports a case of motor and sensory function recovery after massive left cerebral infarction in a young man, along with preserved function of the injured hemisphere. He received early rehabilitation therapy in a nerval care unit within 1 wk of surgery, and the rehabilitation lasted for more than 3 yrs. When he gradually recovered from coma, his motor, sensory, and speech functions improved significantly. Two years later, he was able to live independently and returned to work. The findings of functional magnetic resonance imaging, diffusion tensor imaging, somatosensory evoked potential, and motor evoked potential confirmed that there was a strong connection between his right brain and the right limbs. Thus, early rehabilitation is a promising approach for restoring motor and sensory function after massive brain injury or extensive brain tissue damage.
Anatomical site-specific immunomodulation by bacterial biofilms
Authors: Morra Christina N. , Orihuela Carlos J.
Published: April 2020

Purpose of review

The human body plays host to bacterial biofilms across diverse anatomical sites. The treatment of pathogenic biofilm infection is confounded by their high rate of antibiotic resistance. Therefore, it is critical to understand the interplay between these biofilms and the host immune system to develop new tactics to combat these infections.

Recent findings

Bacterial biofilms and the components they produce affect and are affected by the host immune system. Host anatomical sites represent distinct niches in which defined bacterial biofilms are able to form and interact with the host immune system. For persistent colonization to occur, the bacteria must either avoid or suppress the host immune system, or induce an immune response that facilitates their perpetuation.

Commensal bacterial biofilms form a protective barrier against colonization by pathogens. Using similar mechanisms, bacteria modulate the immune system to orchestrate persistence and sometimes disease. Clinicians must balance the need to avoid disturbing beneficial commensal biofilms with the difficulty in preventing or treating pathogenic bacterial biofilms such as those that develop on medical implants and open wounds.
What Patients Want During Follow-Up After Cosmetic Plastic Surgeries
Authors: Miao Xiaoteng , Miao Xiaolin , Wang Jiaqi
Published: April 2020

Background:

High follow-up rates are essential to minimize bias in clinical researches. And, now, social media is widely used in various fields of plastic surgeries. However, there are no reports about its usage in the follow-up after cosmetic plastic surgeries.

Purpose:

The authors conducted a survey based on interview and questionnaires to get an insight into social media's usage in improving the retention among patients seeking cosmetic plastic surgery and what the patients want during the follow-up in China.

Methods:

The authors reviewed the works of literature and interviewed the surgeons who have rich experiences with the follow-up procedure with patients seeking cosmetic plastic surgery. And come up with the potential elements that may influence the retention, then they recruited the participants through both the new social media and the traditional way, then gathered the participants’ preferences and opinions about the elements through questionnaires. Then the data were analyzed with SPSS.

Results:

The choices which make the follow-up more convenient to attend are usually more welcomed among the participants than those making the follow-up more costly and time-consuming. However, those choices that make the patients feel less concerned are less appreciated even they are easy to practice and time-saving.

Conclusion:

Patients have preferences during the follow-up after cosmetic plastic surgeries. Clinicians should always consider such preferences and try to use appropriate follow-up approaches that are more acceptable to the patients. Other studies list out “tips to improve the retention.” However, the authors believe that patients’ need is the core to improve retention.
Changes of Stress Distributions Around Pterygomaxillary Junction With Different Osteotome Angulations
Authors: Dilaver Emrah , Suzen Muazzez , Demir Oguzhan , Iric Sedat , Ayhan Ali O. , Uckan Sina
Published: April 2020

The aim of this study was to investigate how the alteration of the angulation of osteotome at pterygomaxillary junction affects lateral pterygoid plate, maxillary tuberosity, palatal surface of maxilla, palatine bone and body of sphenoid bone. Following reconstruction of 3D modelling of maxilla, Osteotomes’ tip was angulated 45° and 90° to sagittal plane to simulate pterygomaxillary osteotomy. Finite element analyses (FEA) was performed and Von Misses stress distributions were analyzed for two different angulations. Independent sample t test was used to compare differences between 45° and 90° angulations. Von Misses stress values on lateral pterygoid plate were higher in 45° angulation (0.71 ± 0.21 MPa) than 90° angulation (0.54 ± 0.28 MPa). This difference was statistically significant (P < 0.01). Placement of osteotome's tip with 90° angulation had higher stress value than 45° angulation on maxillary tuberosity region. However; difference wasn’t significant (P = 0.44). Stress values on body of sphenoid bone were 0.45 ± 0.17MPa for the case of 90° angulation and 0.19 ± 0.09MPa for 45° angulation. Difference between these values were statistically significant (P < 0.01). Possible risk of unfavourable lateral pterygoid plate fracture and complications related with body of sphenoid bone during pterygomaxillary osteotomy was remarkably increased in case of narrow angulation (45°). Keeping osteotome at right angle with sagittal plane may avoid these complications.
Association of Mandibular Dysplasia With Maxillary Volumetric and Linear Measurements in Children With Hemifacial Microsomia
Authors: Xu Xi , Tang Xiao-Jun , Zhang Zhi-Yong , Li Bing-Hang , Yin Lin , Feng Shi , Liu Wei
Published: April 2020

In hemifacial microsomia (HFM), the correlations between mandibular dysplasia and maxillary deformities in HFM patients have not yet been assessed. The objective of the present study was to examine the association of maxillary volumetric and linear measurements with mandibular ramus height or corpus length on the affected side in children with unilateral HFM.

In this retrospective research, a total of 70 children with unilateral HFM were enrolled at our department from 2010 to 2019. Demographic information was recorded, and computed tomographic scan were reconstructed and analyzed by segmentation, volumetric, and cephalometric measurements. Analyses involved independent sample t-test, univariable, and multivariable linear regression.

In the overall population, mandibular ramus height (MRH) was positively associated with the maxillary bone volume (MBV) (r = 0.484, P < 0.001) and maxillary total volume (MTV) (r = 0.520, P < 0.001). Similarly, mandibular corpus length (MCL) was significantly associated with the MBV (r = 0.467, P < 0.001) and MTV (r = 0.520, P < 0.001). Multivariate regression analysis revealed that the MRH or MCL were significantly and independently associated with MBV or MTV (MRH/MBV β = 0.420, P < 0.001; MRH/MTV β = 0.391, P < 0.001; MCL/MBV β = 0.403, P < 0.001; MCL/MTV β = 0.307, P < 0.01).

These results demonstrated that the MBV and MTV are independently associated with MRH or MCL on the affected side in children with unilateral HFM, suggesting a potential interaction between mandibular dysplasia and maxillary deformities.
Evaluation of Surgical and Audiological Outcomes of Push-Through Myringoplasty and Underlay Cartilage Tympanoplasty in Repairing Anterior Tympanic Membrane Perforations
Authors: Erden Burak , Gülşen Secaattin
Published: April 2020

Introduction:

Endoscopic push-through myringoplasty (PTM) that could be performed by the endoscopic transcanal approach is a minimally invasive procedure in repairing anterior quadrant perforations of the tympanic membrane. Push-through myringoplasty does not require any skin incision rather than graft harvesting and also does not require tympanomeatal flap elevation.

Objective:

The purpose of the current study was to compare the surgical and audiological outcomes of PTM and conventional retroauricular underlay cartilage tympanoplasty (UCT) in the treatment of patients with anterior tympanic membrane (TM) perforation.

Methods:

This clinical trial was conducted on total of 71 subjects with anterior TM perforation who underwent PTM (n = 32) and UCT (n = 39). Graft uptake rates, audiological outcomes, duration of surgery (DoS), and complications were analyzed and compared between groups.

Results:

Graft uptake rates of the PTM and UCT group were 90.6% and 89.7%, respectively (P = 0.512). According to pure tone audiometry measurements at postoperative month 6, the air-bone gap (ABG) values remarkably improved in both PTM and UCT groups without any significant difference (P = 0.654). The average DoS was shorter in the PTM (29.7 ± 5.7 minutes) group relative to the UCT (48.7 ± 11.3 minutes) group, and the difference was extremely significant (P < 0.0001).

Conclusions:

Push-through myringoplasty yielding shorter DoS and fewer postoperative complication and morbidity may serve as an efficient alternative to conventional microscopic UCT in treatment of anterior TM perforations, with comparable graft uptake rates and audiological outcomes.
Modified Endoscopic Dacryocystorhinostomy Using the Middle Uncinate Process Approach
Authors: Yang Jing , Cao Zhiwei , Gu Zhaowei
Published: April 2020

Purpose:

Endoscopic dacryocystorhinostomy (EDCR) is advantageous in that it avoids facial scar formation, does not damage the medial canthus ligament, and recovers quickly. The main purpose of EDCR is to establish a fistula large enough to completely expose the lacrimal sac and avoid complications. Accurate location of lacrimal sac and complete opening of lacrimal sac are the keys to successful operation. However, due to the individual differences in the size of the lacrimal sac and the anatomical structure of the nasal cavity, it is difficult to determine the location of the lacrimal sac during the operation. Most patients need to place dilatation tubes after operation, which may lead to some defects. To explore the clinical effects of modified dacryocystorhinostomy using nasal endoscopy through the middle uncinate process approach for the treatment of chronic dacryocystitis and nasolacrimal duct obstruction.

Methods:

Sixty-nine patients (71 eyes) with chronic dacryocystitis and nasolacrimal duct obstruction underwent modified dacryocystorhinostomy using nasal endoscopy. Modified methods included changes in surgical approach, incision of the anterior wall of the lacrimal sac, and treatment of adherent mucosa.

Results:

In all 71 eyes, no serious complications occurred. The anatomical success rate was 93.0% (66/71) and the symptomatic success rate was 97.2% (69/71). None of the patients underwent conversion to an open method.

Conclusion:

Modified dacryocystorhinostomy using nasal endoscopy is advantageous in terms of shorter operation time, accurate dacryocystorhinostomy location, less bleeding, relatively simple operation, no requirement for dilation tube insertion, and better effects than conventional dacryocystorhinostomy using nasal endoscopy. Modified dacryocystorhinostomy is a safer and more effective method to treat chronic dacryocystitis-nasolacrimal duct obstruction.
Language Sample Analysis of Writing in Children and Adolescents
Authors: Scott Cheryl M.
Published: April 2020

Competent writing eludes many school children and adolescents, especially those with developmental language and reading disorders. Language sample analysis (LSA) of writing is a powerful but underused assessment tool that can also inform instruction. Similar to LSA of oral language, writing has been analyzed at word, sentence, and text levels using measures that include lexical diversity, sentence length, clause density, grammaticality, productivity, and text organization and content. Unique observations of writing include spelling and literate semantic and syntactic features. This article offers a review of analytic writing measures in the LSA literature from perspectives that include developmental change, language ability differences, relation to quality ratings, practical utility, and effects of genre and task. Writing samples from two 12-year-old students, with and without a language disorder, are used to illustrate application of these measures and suggest potential instruction targets.
The Utility of the National Alzheimer’s Coordinating Center’s Database for the Rapid Assessment of Evolving Neuropathologic Conditions
Authors: Mock Charles , Teylan Merilee , Beecham Gary , Besser Lilah , Cairns Nigel J. , Crary John F. , Katsumata Yuriko , Nelson Peter T. , Kukull Walter
Published: April 2020

The field of dementia research is rapidly evolving, especially with regards to our understanding of the diversity of neuropathologic changes that underlie cognitive decline. Definitions and criteria for known conditions are being periodically revised and refined, and new findings are being made about neuropathologic features associated with dementia status. The database maintained by the National Alzheimer’s Coordinating Center (NACC) offer researchers a robust, rapid, and statistically well-powered method to evaluate the implications of newly identified neuropathologic conditions with regards to comorbidities, demographic associations, cognitive status, neuropsychologic tests, radiographic findings, and genetics. NACC data derive from dozens of excellent US Alzheimer disease research centers, which collectively follow thousands of research volunteers longitudinally. Many of the research participants are autopsied using state-of-the-art methods. In this article, we describe the NACC database and give examples of its use in evaluating recently revised neuropathologic diagnoses, including primary age-related tauopathy (PART), limbic predominant age-related TDP-43 encephalopathy (LATE), and the preclinical stage of Alzheimer disease neuropathologic change, based on the National Institute on Aging—Alzheimer’s Association consensus guidelines. The dementia research community is encouraged to make use of this readily available database as new neuropathologic changes are recognized and defined in this rapidly evolving field.
A 26-Year-Old Woman With Diplopia and Nystagmus
Authors: Anderson William J. , Sharma Aseem , Guzman Miguel A. , Chung Sophia M.
Published: April 2020

A 26-year-old woman presented for a routine contact lens evaluation but was found to have a subtle right sixth nerve paresis and adducting nystagmus of the left eye. She reported horizontal diplopia on far right gaze as well as subjective right-sided weakness and poor balance for 1 year. Brain and spinal MRI revealed multiple cystic lesions with variable enhancement throughout the posterior fossa and cervical spinal cord. These MRI findings were highly suspicious for an infectious central nervous system process, such as neurocysticercosis; however, primary or metastatic tumors were also important considerations. Tumor location and imaging characteristics were most helpful in differentiating among these etiologies. A brain biopsy ultimately established the diagnosis of a rosette-forming glioneuronal tumor.
Optic Neuropathy in Charcot–Marie–Tooth Disease
Authors: Hamedani Ali G. , Wilson James A. , Avery Robert A. , Scherer Steven S.
Published: April 2020

Background:

Charcot–Marie–Tooth disease Type 2A (CMT2A) presents with optic atrophy in a subset of patients, but the prevalence and severity of optic nerve involvement in relation to other CMT subtypes has not been explored.

Methods:

Patients with genetically confirmed CMT2A (n = 5), CMT1A (n = 9) and CMTX1 (n = 10) underwent high- and low-contrast acuity testing using Sloan letter charts, and circumpapillary retinal nerve fiber layer (RNFL) and macular total retinal, RNFL, and ganglion cell layer/inner plexiform layer thickness was measured using spectral domain optical coherence tomography (OCT). We used age- and gender-adjusted linear regression to compare contrast acuity and retinal thickness between CMT groups.

Results:

One of 5 patients with CMT2A had optic nerve atrophy (binocular high-contrast acuity equivalent 20/160, mean circumpapillary RNFL 47.5 μm). The other patients with CMT2A had normal high- and low-contrast acuity and retinal thickness, and there were no significant differences between patients with CMT2A, CMT1A, and CMTX1.

Conclusions:

Optic atrophy occurs in some patients with CMT2A, but in others, there is no discernible optic nerve involvement. This suggests that optic neuropathy is specific to certain MFN2 mutations in CMT2A and that low-contrast acuity or OCT is of limited value as a disease-wide biomarker.