bluuebunny/crossref_metadata_2025 huggingface dataset:
Epidemiologic study of in-hospital cardiopulmonary resuscitation among pediatric patients: A retrospective, population-based cohort study in South Korea
Authors: Oh Tak Kyu , Choi Chang Won , Song In-Ae
Published: September 2022

We aimed to examine the clinical trends of in-hospital cardiopulmonary resuscitation (ICPR) and factors associated with live discharge following ICPR. As a national population-based cohort study, data were extracted from the South Korean National Inpatient Database. This study included 8992 pediatric patients under 18 years of age who underwent ICPR due to in-hospital cardiac arrest during hospitalization in South Korea between 2010 and 2019 (10 years). The annual prevalence, survival, duration of hospitalization, and total cost of hospitalization at ICPR were examined as clinical trends. In 2010, 7.94 per 100,000 pediatric patients received ICPR; the prevalence increased to 11.51 per 100,000 pediatric patients in 2019. The 10-year survival rates were similar, and the in-hospital, 6-month, and 1-year survival rates over 10 years were 44.0%, 34.0%, and 32.4%, respectively. The mean length of hospital stay at ICPR in 2010 was 20.7 (95% confidence interval [CI]: 19.3–22.2) days; this decreased to 16.6 (95% CI: 15.2–18.0) days in 2019. The mean total cost at ICPR was 11,081.1 (95% CI: 10,216.2–11,946.1) United States Dollars (USD) in 2010; this increased to 22,629.4 (95% CI: 20,588.3–24,670.5) USD in 2019. The prevalence of ICPR increased among pediatric patients in South Korea between 2010 and 2019; however, the survival rates were similar for the 10 years. The length of hospital stay at ICPR gradually decreased from 2010 through 2019, while the total cost of hospitalization at ICPR has gradually increased between 2010 and 2019.
Identification of perioperative neurocognitive dysfunction biomarkers in cerebrospinal fluid with quantitative proteomic approach in patients undergoing transurethral resection of prostate with combined spinal and epidural analgesia
Authors: Luo Tian-Yan , Zhou Wei , Xiang Gui-Fang , Zhang Ying , Liu Qing
Published: September 2022

Background:

This study aimed to identify predictive biomarkers of perioperative neurocognitive dysfunction (PND) in cerebrospinal fluid of elderly male patients undergoing elective transurethral resection of prostate, using an isobaric tags for relative and absolute quantitative-based quantitative proteomic approach.

Methods:

Patients were evaluated with Mini Mental State Examination at −1 and+3 days of operation. Presence of PND was determined with Z-score method. Patients characteristics and quantitative cerebrospinal fluid proteomes detected with isobaric tags for relative and absolute quantitative-were compared between PND and non-PND patients. Gene ontology and Kyoto Encyclopedia of Genes and Genomes analysis were performed to identify pathways potentially involved in PND.

Result:

A total of 229 patients were included in the study and 32 were diagnosed with PND (incidence 14.4%). The age, incidence of hypertension, and diabetes of PND patients were significantly higher than non-PND patients (P < .05). There were 85 differentially expressed proteins identified, among which High Mobility Group Box 1, prostaglandin D synthase, and matrix metalloproteinase inhibitor were considered to be promising candidates as they might play important roles in pathophysiology of PND.

Conclusion:

Proteomic approach identified potential biomarkers for predicting the occurrence of PND. These findings need to be validated in further studies.
Clinical utility of skin perfusion pressure measurement in diabetic foot wounds: An observational study
Authors: Kim Hak Jun , Kim Woo Jong , Lee Hong Seop , Koh Yeong Yoon , Shin Young Bin , Yeo Eui Dong
Published: September 2022

The degree of blood vessel stenosis significantly influences diabetic foot treatment. This study aimed to investigate the association between computed tomography angiography (CTA) stenosis and skin perfusion pressure (SPP), which are noninvasive vascular assessments used to evaluate diabetic foot wounds.

Forty patients who reported diabetic foot wounds between November 2016 and December 2017 were included in the study. SPPand CTA were performed to evaluate the blood flow, and the rate of decrease in wound size was measured for the wounds corresponding to Meggitt–Wagner grade 1 at the first evaluation and 4-week intervals.

The P value of the association between the degree of CTA stenosis and the SPP value was 0.915, and the P value of the association between CTA stenosis and decreasing rate of wound size was .235. There was no statistically significant association between SPP and the decreasing rate of wound size according to the degree of CTA stenosis. The association between SPP value and the decreasing rate of wound size was statistically significant (P < .05).

The decreasing rate in diabetic foot wound size was significantly associated with SPP but not with CTA stenosis.
Relationship between plasma fibrinogen degradation products(FDP) and D-dimer levels and disease activity in rheumatoid arthritis: A STROBE compliant article
Authors: Qiang FuYong , Xu Hui , Sheng Jun
Published: September 2022

In this study, we aimed to investigate whether fibrinogen degradation products(FDP)and D-dimer could be used as serological indicators of rheumatoid arthritis(RA) activity, such as erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and platelets (PLT).

A total of 112 consecutive patients with RA between July 2018 and July 2020 were divided into moderate and high disease activity groups (disease activity score 28(DAS28) > 3.2, n = 60) and low disease activity and remission groups (DAS28≤3.2, n = 52). A total of 50 healthy volunteers were included in the control group, and FDP and D-dimer levels were compared across the three groups. The correlations of FDP and D-dimer levels with ESR, CRP, PLT, and DAS28 were analyzed. Analyses of the receiver operating characteristic(ROC) curves and area under the ROC curve (AUC) of FDP, D-dimer, ESR, CRP, and PLT levels were performed.

FDP and D-dimer levels were significantly higher in the high-activity compared to the low-activity and remission (P < .001), and the control (P < .001). No significant differences in FDP and D-dimer were observed between the low-activity and remission and the control (P > .05). FDP and D-dimer levels were positively correlated with ESR, CRP, PLT, and DAS28 (all P < .001). The ROC curves showed that the FDP and D-dimer levels could be used to evaluate the RA activity (all P < .001). The AUC of FDP was significantly larger than that of PLT (P = .047). FDP and D-dimer can be used as supplementary serological indicators to assess RA activity, in addition to ESR, CRP, and PLT.
Visualized analysis of research on helicopter emergency medical service
Authors: Peng Cheng , Su Pan
Published: September 2022

Background:

Numerous studies have confirmed that helicopter emergency medical services (HEMS) play a positive role in prehospital care. However, few studies have used rigorous bibliometric tools to analyze the knowledge structure and distribution of HEMS research.

Objectives:

The purpose of this study was to use bibliometric methods to conduct a quantitative and qualitative analysis of the HEMS-related literature and to determine the research status and hotspots of HEMS research.

Methods:

CiteSpace was used for bibliometric analysis of the HEMS-related literature retrieved from the Web of Science database from 1989 to 2021.

Results:

A total of 1378 HEMS-related literature were included. Collaboration among countries, authors, and institutions needs to be strengthened. The topics in HEMS research have mainly focused on the effectiveness of helicopter emergency medical services for trauma patients and the comparison of transport effectiveness between helicopters and ground emergency medical services on trauma patient transport. Research over the past 10 years has mainly focused on the application of HEMS in patients with trauma, myocardial infarction, cerebral apoplexy, application of tracheal intubation technology in HEMS, and advanced airway management. In recent years, HEMS research trends have mainly included out-of-hospital cardiac arrest, and transport.

Conclusions:

CiteSpace was used to visualize and analyze the HEMS-related literature, which visually reflected the research status and hot spots, providing references for the topic selection and development direction of HEMS research.
Comparison of diagnostic performance between dynamic versus static adenosine-stress myocardial CT perfusion to detect hemodynamically significant coronary artery stenosis: A prospective multicenter study
Authors: Lee Ji Won , Choe Yeon Hyeon , Kim Sung Mok , Choi Jin-Ho , Pak Seongyong , Choo Ki Seok , Kim Jeong Su , Lee Chong Eun , Kim Yun-Hyeon
Published: September 2022

Myocardial computed tomography perfusion (CTP) imaging is a noninvasive method for detecting myocardial ischemia. This study aimed to compare the diagnostic performance of dynamic and static adenosine-stress CTPs for detecting hemodynamically significant coronary stenosis. We prospectively enrolled 42 patients (mean age, 59.7 ± 8.8 years; 31 males) with ≥40% coronary artery stenosis. All patients underwent dynamic CTP for adenosine stress. The static CTP was simulated by choosing the seventh dynamic dataset after the initiation of the contrast injection. Diagnostic performance was compared with invasive fractional flow reserve (FFR) <0.8 as the reference. Of the 125 coronary vessels in 42 patients, 20 (16.0%) in 16 (38.1%) patients were categorized as hemodynamically significant. Dynamic and static CTP yielded similar diagnostic accuracy (90.4% vs 88.8% using visual analysis, P = .558; 77.6% vs 80.8% using quantitative analysis, P = .534; 78.4% vs 82.4% using combined visual and quantitative analyses, P = .426). The diagnostic accuracy of combined coronary computed tomography angiography (CCTA) and dynamic CTP (89.6% using visual analysis, P = .011; 88.8% using quantitative analysis, P = .018; 89.6% using combined visual and quantitative analyses, P = .011) and that of combined CCTA and static CTP (88.8% using visual analysis, P = .018; 90.4% using quantitative analysis, P = .006; 91.2% using combined visual and quantitative analyses, P = .003) were significantly higher than that of CCTA alone (77.6%). Dynamic CTP and static CTP showed similar diagnostic performance in the detection of hemodynamically significant stenosis.
How effective are APRI, FIB-4, FIB-5 scores in predicting liver fibrosis in chronic hepatitis B patients?
Authors: Sapmaz Ferdane Pirincci , Büyükturan Galip , Sakin Yusuf Serdar , Kalkan İsmail Hakki , Atasoy Pinar
Published: September 2022

Liver fibrosis is the most important factor in the prognosis and treatment plan of patients with chronic hepatitis B (CHB). Aspartate aminotransferase (AST)-to-platelet ratio index (APRI), fibrosis index based on 4 factors (FIB-4), and fibrosis index based on 5 factors (FIB-5) scores are noninvasive fibrosis markers, and previous comparative studies have shown that they are as effective as liver biopsy in detecting liver fibrosis in different liver diseases. The aim of our study is to investigate whether existing scoring systems are effective in demonstrating fibrosis in CHB patients and to compare the APRI, FIB 4, and FIB 5 scores in differentiating early and advanced fibrosis in 123 patients who underwent liver biopsy for CHB infection. APRI, FIB-4, and FIB-5 scores of patients who underwent liver biopsy due to CHB were calculated by means of calculators and recorded to be compared with liver biopsies in terms of fibrosis scoring. One hundred twenty-three patients who underwent liver biopsy due to chronic hepatitis B were included in the study. APRI (area under the receiver-operating characteristic [ROC] curve 0.728), FIB-4 (area under the ROC curve 0.693) and FIB-5 (area under the ROC curve 0.643) scores were evaluated as significant predictors of advanced fibrosis. The scoring system with the highest positive and negative predictive value was evaluated as FIB-4. APRI, FIB-4, and FIB-5 scoring systems are appropriate scoring systems in the assessment of advanced fibrosis in patients with CHB. Our study is the first to compare APRI, FIB-4, and FIB-5 values in CHB patients, and more comprehensive studies are needed.
Randomized, direct comparison study of Saccharomyces boulardii CNCM I-745 versus multi-strained Bacillus clausii probiotics for the treatment of pediatric acute gastroenteritis
Authors: Altcheh Jaime , Carosella Mabel V. , Ceballos Ana , D’Andrea Ulises , Jofre Sandra M. , Marotta Carolina , Mugeri Domingo , Sabbaj Liliana , Soto Adriana , Josse Constant , Montestruc Francois , McFarland Lynne V.
Published: September 2022

Background:

The choice of an appropriate probiotic for pediatric acute gastroenteritis (PAGE) can be confusing. Our aim was to compare the efficacy and safety of 2 probiotics (Saccharomyces boulardii CNCM I-745 vs a 4-strain mixture of Bacillus clausii O/C, SIN, N/R, T) for the treatment of PAGE.

Methods:

A 2-arm parallel, randomized trial recruited children (6 months to 5 years old) with mild-moderate acute diarrhea, from 8 centers in Argentina. A total of 317 children were enrolled and blindly randomized to 5 days of either S boulardii CNCM I-745 (n = 159) or a 4-strain mixture of B clausii (n = 158), then followed for 7 days post-probiotic treatment. A stool sample was collected at inclusion for pathogen identification. The primary outcome was duration of diarrhea defined as the time from enrollment to the last loose stool followed by the first 24-hour period with stool consistency improvement. Secondary outcomes included frequency of loose stools/day, severity of diarrhea, number reporting no diarrhea at Day 6, time-to-first formed stool, recurrence of diarrhea by study end (Day 12) and safety outcomes.

Results:

Three hundred twelve (98%) children completed the study. S boulardii CNCM I-745 showed a significant reduction (P = .04) in the mean duration of diarrhea (64.6 hours, 95% confidence interval [CI] 56.5–72.8) compared to those given B clausii (78.0 hours, 95% CI 69.9–86.1). Both probiotics showed improvement in secondary outcomes and were well-tolerated.

Conclusion:

In this study, S boulardii CNCM I-745 demonstrated better efficacy than B clausii mix for reducing the duration of pediatric acute diarrhea.
Preoperative mean platelet volume is a prognostic biomarker for survival in patients with gastric cancer: A cohort study
Authors: An Soomin , Eo Wankyu , Han Ga Young , Park Sukyung , Lee Sookyung
Published: September 2022

This study aimed to evaluate the prognostic potential of mean platelet volume (MPV) in gastric cancer (GC) patients. Patients with stage I–III GC who underwent gastrectomy were enrolled in this study. Cox regression analysis was performed to evaluate the determinants of overall survival (OS) and disease-free survival (DFS). The discriminative capacity of the model was determined using the Harrell concordance index (C-index). The net benefit of the model was validated using decision curve analysis (DCA). Data from 401 patients were analyzed. Multivariate Cox regression analysis revealed that age, stage, serum albumin level (ALB), perineural invasion (PNI) and MPV were determinants of both OS and DFS. The MPV model consisted of 5 covariates (age, stage, ALB, PNI, and MPV level), and the baseline model constituted the same covariates as the MPV model, except for the MPV level. C-indices for OS and DFS were higher in the MPV model than in the baseline model. When the models were validated using DCA, the MPV model showed a greater net benefit than the baseline model for nearly all the threshold probabilities. Age, stage, ALB, PNI, and MPV are prognostic factors for OS and DFS. The discriminative capacities for OS and DFS in the MPV model were higher than those in the baseline model, thus implying the clinical significance of the MPV level as a determinant of survival in GC.
Exploring user perspectives on a robotic arm with brain–machine interface: A qualitative focus group study
Authors: Kim Moon Young , Park Jung Youn , Leigh Ja-Ho , Kim Yoon Jae , Nam Hyung Seok , Seo Han Gil , Oh Byung-Mo , Kim Sungwan , Bang Moon Suk
Published: September 2022

Brain–machine Interface (BMI) is a system that translates neuronal data into an output variable to control external devices such as a robotic arm. A robotic arm can be used as an assistive living device for individuals with tetraplegia. To reflect users’ needs in the development process of the BMI robotic arm, our team followed an interactive approach to system development, human-centered design, and Human Activity Assistive Technology model. This study aims to explore the perspectives of people with tetraplegia about activities they want to participate in, their opinions, and the usability of the BMI robotic arm. Eight people with tetraplegia participated in a focus group interview in a semistructured interview format. A general inductive analysis method was used to analyze the qualitative data. The 3 overarching themes that emerged from this analysis were: 1) activities, 2) acceptance, and 3) usability. Activities that the users wanted to do using the robotic arm were categorized into the following 5 activity domains: activities of daily living (ADL), instrumental ADL, health management, education, and leisure. Participants provided their opinions on the needs and acceptance of the BMI technology. Participants answered usability and expected standards of the BMI robotic arm within 7 categories such as accuracy, setup, cost, etc. Participants with tetraplegia have a strong interest in the robotic arm and BMI technology to restore their mobility and independence. Creating BMI features appropriate to users’ needs, such as safety and high accuracy, will be the key to acceptance. These findings from the perspectives of potential users should be taken into account when developing the BMI robotic arm.
Anti-osteoporosis treatments changed body composition in postmenopausal women: A systematic review and meta-analysis
Authors: Shi Lingfeng , Xu Xiaoli , Xiang Guangda , Duan Shanshan
Published: September 2022

Background:

Whether the widespread anti-osteoporosis treatments in postmenopausal women also benefit the change of body composition (lean body mass [LBM] and body fat mass [FM]) remains controversial. In order to solve this issue and find out the most effective treatment, we conducted this meta-analysis.

Methods:

We searched the literature, via PubMed, Embase, Scopus, Web of Science, and Cochrane to screen citations from inception to March 26, 2022, for inclusion in this study. Only clinical trials that used anti-osteoporosis treatments in postmenopausal women and displayed the alteration of body composition were included. Stata 14.0 was used for the meta-analysis.

Results:

Our meta-analysis results presented that: compared with placebo, hormone replacement therapy (HRT) was associated with increased LBM (standardized mean differences [SMD] = 0.32, 95% confidence interval [CI] = 0.02–0.61) and reduced FM (SMD = −0.30, 95% CI = −0.51 to −0.09) in postmenopausal women. Compared with placebo, physical exercise training showed an effect of decreasing FM (SMD = −0.66, 95% CI = −0.94 to −0.38) but not significant influence LBM (SMD = 1.31, 95% CI = −0.29 to 2.91). The network meta-analysis of our study showed that oral estrogen and progestogen plus exercise (OEPE) treatment might be the most effective anti-osteoporosis treatment (surface under the cumulative ranking curve 99.9) to reduce FM in postmenopausal women.

Conclusions:

anti-osteoporosis treatments, especially HRT, affect body composition. Furthermore, the combination of HRT and exercise training are the most effective treatment to reduce FM while maintaining LBM.
High expression of ANRIL correlated with the poor prognosis in patients with cancer: A meta-analysis
Authors: Liu Yun , Zhu Linqi , Zhao Wenjun , Zhou Yong , Shao Shihe
Published: September 2022

Background:

ANRIL, also called CDKN2B antisense RNA 1, is an important genetic susceptibility locus for cardiovascular diseases and associated with numerous pathologies, including several human cancers.

Objective:

The relationship between ANRIL and the clinical outcome or prognosis of cancer patients was analyzed in this meta-analysis.

Methods:

One thousand seven hundred eight cancer patients were selected in 23 studies from 3 databases (Pubmed, Cochrane Library, and EMBASE).

Results:

A fixed-effects model indicated that the high expression of ANRIL is obviously linked to poor overall survival (OS) (Hazard ratio [HR] = 1.77, 95% confidence interval [CI] = 1.57–2.00, P < .00001); the random-effects model revealed poor disease-free survival (DFS) (HR = 1.86, 95% CI: 1.46–2.37, P < .00001). A high level of ANRIL expression was also associated with the tumor size (small vs large, odds ratio [OR] = 0.57, 95% CI: 0.39–0.83, P = .003), TNM stage (I + II vs III + IV; OR = 0.40, 95% CI: 0.24–0.69, P = .0008), and lymph node metastasis (LNM) (Yes vs No, OR = 3.66, 95% CI: 1.46–9.17, P = .006). ANRIL was not related significantly to histologic differentiation compared to poor with moderate + well; the OR value is 0.74, 95% CI: 0.26–2.12, P = .58. In addition, evidence suggested that a high level of ANRIL was positively associated with human cancer type, follow-up time, and sample size.

Conclusion:

This meta-analysis demonstrated that ANRIL may be a valuable biomarker for predicting poor prognosis in cancer patients.
SOX2 contributes to invasion and poor prognosis of gastric cancer: A meta-analysis
Authors: Tang Kaifeng , Liu Jingting , Liu Baoqing , Meng Chunyan , Liao Jianhua
Published: September 2022

Background:

The sex-determining region Y-box 2 (SOX2) has been identified to be involved in tumor progression and prognosis in patients with gastric cancer (GC). However, its action is paradoxical. Thus, we conducted the first meta-analysis based on eligible studies to evaluate the clinical utility of SOX2 in GC only.

Methods:

A thorough electronic search was performed to collect eligible studies. The hazard ratios (HRs) or odds ratios (ORs) with 95% confidence intervals (CIs) were generated from included studies to assess the strength of the association between SOX2 and prognosis and clinicopathological characteristics in GC.

Results:

A total of 10 studies comprising 1321 patients with GC were identified for the meta-analysis. The pooled results revealed that high SOX2 expression was significantly associated with poor overall survival compared to low SOX2 expression (pooled HR = 1.485; 95% CI: 1.022–2.160; 𝑃 = .04). The statistical significance between SOX2 expression and overall survival was also established in univariate analysis (pooled HR = 1.606; 95% CI: 1.134–2.274; 𝑃 < .01), as well as recruitment time exceeding 2010 (pooled HR = 1.873; 95% CI: 1.041–3.371; 𝑃 = .04), follow-up time more than 5 years (pooled HR = 1.642; 95% CI: 1.066–2.527; 𝑃 = .02), and cutoff value of more than 5% of cells stained (pooled HR = 1.730; 95% CI: 1.162–2.577; 𝑃 < .01). Moreover, we verified that positive SOX2 expression was correlated with advanced tumor invasion depth (pooled OR = 0.494; 95% CI: 0.362–0.675; 𝑃 < .01) and positive vascular invasion (pooled OR = 1.515; 95% CI: 1.078–2.130; 𝑃 = .02).

Conclusion:

SOX2 could not only be an independent prognostic marker in GC but might also be a novel target for cancer therapy.
The race coefficient in glomerular filtration rate-estimating equations and its removal
Authors: Hsu Chi-yuan , Go Alan S.
Published: September 2022

Purpose of review

To review new publications about the use of the race coefficient in glomerular filtration rate (GFR)-estimating equations since this topic was last reviewed a year ago in Current Opinion in Nephrology and Hypertension.

Recent findings

Accounting for race (or genetic ancestry) does improve the performance of GFR-estimating equations when serum creatinine (SCr) is used as the filtration marker but not when cystatin C is used. The National Kidney Foundation (NKF)–American Society of Nephrology (ASN) Task Force on Reassessing the Inclusion of Race in Diagnosing Kidney Disease recommended immediate adoption of a new refitted SCr-based equation without race and increased use of cystatin C. This report has created consensus but the endorsed new SCr equation without race underestimates GFR in Black Americans and overestimates GFR in non-Black Americans, which may result in diminished ability to detect racial disparities.

The approach recommended by the NKF–ASN Task Force represents a compromise attempting to balance a number of competing values, including racial justice, benefit of classifying more Black Americans as having (more severe) chronic kidney disease, accuracy compared with measured GFR, and financial cost. The full implications of adopting the race-free refitted CKD-EPI SCr equation are yet to be known.
Prenatal genetic testing 2: diagnostic tests
Authors: Jenkins Morgan , Seasely Angela R. , Subramaniam Akila
Published: September 2022

Purpose of review

Prenatal genetic testing can be divided into two categories: screening and diagnosis. Prenatal genetic screening tests are used to assess carrier status or as a fetal risk assessment for a particular genetic disorder [1]. Prenatal genetic diagnostic testing is used to diagnose particular genetic conditions with as much certainty as possible [1,2]. This review will focus on the diagnostic side of prenatal genetic testing.

Recent findings

Next generation sequencing (NGS) has revolutionized prenatal genetic diagnostic testing. NGS methods are becoming more advanced and accurate as more genetic information is being linked to genetic conditions.

Prenatal genetic diagnostic testing involves clinicians invasively obtaining tissue via amniocentesis or chorionic villus sampling to identify if a fetus has a genetic condition. This testing has traditionally been done through fluorescence in-situ hybridization, karyotype, or chromosomal microarray analysis. However, genetic testing is in a time of rapid technologic expansion and new methods like NGS, which includes targeted gene panels, whole exome sequencing, and whole genome sequencing are being used too. In this time of growth, it is important that providers educate themselves on the research support and indication behind each type of genetic diagnostic test.
Reaffirming Adverse Events Related to Lung Cancer Survivors’ Target Therapies and Their Apparent Effects on Fear of Cancer Progression, Anxiety, and Depression
Authors: Yu Chu-Chun , Chu Chia-Yu , Lai Yeur-Hur , Hung Chia-Tai , Chan Jui-Chun , Chen Yen-Ju , Hsu Hui-Te , Lee Yun-Hsiang
Published: September 2022

Background

Most advanced non–small-cell lung cancer (NSCLC) patients received targeted therapies of epidermal growth factor receptor tyrosine kinase inhibitors. However, few studies reported the relationships between adverse events (AEs) and psychological distress.

Objectives

The aims of this study were to (1) examine the differences in the incidence of AEs, fear of progression (FoP), anxiety, and depression among 3 generations of epidermal growth factor receptor tyrosine kinase inhibitors (first, gefitinib and erlotinib; second, afatinib; third, osimertinib) and (2) examine the difference in levels of FoP, anxiety, and depression between the presence and absence of AEs in NSCLC patients.

Methods

This study used a cross-sectional study design. Patients with NSCLC (N = 120) were recruited from a medical center in northern Taiwan. Adverse events, FoP, anxiety, and depression were assessed by questionnaires.

Results

The incidence rates of photosensitivity, mouth and throat sores, and diarrhea were significantly high in the gefitinib, erlotinib, and afatinib groups, respectively. A lesser proportion of patients experienced AEs in the osimertinib group, compared with those in the gefitinib and erlotinib, and afatinib groups. The incidence rates of FoP, anxiety, and depression were 13.8% to 26.0%, 24.1% to 40.4%, and 17.6% to 40.0%, respectively. Patients with photosensitivity, paronychia, and alopecia had significantly higher levels of FoP, anxiety, and depression.

Conclusion

This study confirmed the priorities of care among 3 generations of epidermal growth factor receptor tyrosine kinase inhibitors in NSCLC patients, using both the Common Terminology Criteria for Adverse Events (CTCAE 4.03) and PRO-CTCAE 1.0. Photosensitivity, paronychia, and alopecia were associated with higher levels of FoP, anxiety, and depression. Therefore, these AEs require further management.

Implications for Practice

Our study suggests a follow-up to address AEs and psychological distress.
Factors Affecting Family Management Among Chinese Parents of Children With Leukemia
Authors: Lin Nan , Jin Chendi , Zhu Jihua , Xu Hongzhen , Zhou Hongqin
Published: September 2022

Background

Effective family management can improve the ability of children’s families to cope with the disease. However, the family management styles of children with leukemia are unknown.

Objective

This study used a family management style framework and structural equation model to determine the direct and indirect predictors of family management of children with leukemia.

Methods

A total of 496 parents of children with leukemia completed the Family Management Measure, the Feetham Family Functioning Survey, the Social Support Rating Scale, and a demographic family information form. We used structural equation modeling to explore the direct and indirect effects of the study variables on family management styles.

Results

Family functioning, family income, parental education level, and geographic location affect family management directly, among which family functioning has the most significant coefficient in the model (0.53). Siblings and social support can affect family management through the mediating effect of family functioning. Employment change can directly affect family management (−0.27) and indirectly affect family functioning (−0.08).

Conclusions

Our results support the family management style framework. Individual and family factors such as family income, parental education level, geographic location, employment change, siblings, and social support contribute to the ease or difficulty of family management. In addition, family functioning can also mediate between contextual influences and family management styles.

Implications for Practice

Family functioning plays a vital role in relationships between contextual influences and family management. We can construct family management interventions according to family management influencing factors.
Posttraumatic Stress Disorder, Anxiety, and Depression Symptoms After Potentially Traumatic Events
Authors: Marqueses José M. S. , Sanz Jesús , García-Vera María Paz , Morán Noelia , Eisma Maarten C.
Published: September 2022

People exposed to potentially traumatic events (PTEs) may develop distinct symptom patterns, which may require different therapeutic approaches. We aimed to identify classes of people exposed to PTEs based on the presence of posttraumatic stress disorder (PTSD) clusters, anxiety, and depression and to explore which cognitive factors (rumination, worry, and negative cognitions) are associated with class membership. Latent class analyses were conducted to identify subgroups of 258 PTE-exposed Spanish adults. A three-class solution emerged: a resilient class with low odds of all symptoms (n = 188); a partial PTSD class, characterized by partial PTSD clusters, moderate anxiety, and low depression (n = 36); and a high symptom class, characterized by high PTSD, moderate anxiety, and low depression (n = 34). These classes related meaningfully to rumination, worry, and negative cognitions. Distinct symptom patterns of PTSD clusters, anxiety, and depression can be distinguished in people exposed to PTEs and relate to cognitive risk factors of psychopathology.
Characterization of a Novel Frameshift Mutation Within the TRPS1 Gene Causing Trichorhinophalangeal Syndrome Type 1 in a Kindred Cypriot Family
Authors: Ergoren Mahmut Cerkez , Akcan Nese , Manara Elena , Paolacci Stefano , Fahrioğlu Umut , Betmezoglu Meryem , Bundak Ruveyde , Mocan Gamze , Temel Sehime Gulsun , Bertelli Matteo
Published: September 2022

Trichorhinophalangeal syndrome (TRPS) is an extremely rare autosomal dominant multisystem disorder characterized by craniofacial and skeletal abnormalities. Three subtypes of TRPS have been described: TRPS type I, TRPS type II, and TRPS type III. Mutations in the TRPS1 gene can cause both TRPS type I and TRPS type III. Therefore, the genotype-phenotype correlation is crucial to determine the subtype. The current family study from Cyprus involves affected patients from 4 generations who presented with alopecia, unoperated umbilical hernia, caput quadratum, long philtrum, depressed nasal bridge, frontal bossing, pes planus, beaked nose, and some deformities in hands and feet. Sequence analysis of the TRPS1 gene revealed a novel c.2854_2858del (p.Asn952ArgfsTer2) frameshift variant leading to a premature stop codon. To the best of our knowledge, we report here the first case of a Turkish Cypriot family of 4 generations with a novel frameshift mutation leading to truncated protein in the TRPS1 gene causing TRPS type I clinical phenotype. Overall, as the genotype and phenotype correlation in TRPSI is still uncertain and complex, the present outcome can enhance our knowledge of this complicated, rare, and severe genetic disorder.
Tumor Genomic Profiling to Determine Tissue Origin of Cancers of Unknown Primary: A Single Institute Experience With its Utility and Impact on Patient Management
Authors: Saeed Omer A.M. , Armutlu Ayşe , Cheng Liang , Longe Harold O. , Saxena Romil
Published: September 2022

Tumor genomic profiling represents a promising tool in diagnosis and management of cancer of unknown primary. We report our experience on the impact of genomic profiling in elucidating primary tumor site, correlation with pathologic findings and patient management. Tissue or cytology specimens from 22 cancers of unknown primary were referred for genomic profiling. Reports were available to review in 18 cases; 3 samples were inadequate for analysis. Of the remaining 15 cases, primary tumor site was suggested in 12 cases (80%), whereas it remained indeterminate in 3 (20%). Of the 12 cases, molecular profiling was concordant with light microscopy findings in 3 patients, whereas in 2 cases molecular testing identified a sarcoma, contradicting light microscopy and immunohistochemistry findings. The suggested primary was confirmed by additional immunohistochemistry in 1 case and by endoscopic biopsy in another. In 5 cases, follow-up biopsy or additional testing were not considered necessary for patient management. Three patients received palliative care and 12 received various chemotherapy regimens. Five patients died within a year, whereas 9 were alive more than a year after diagnosis, 3 of who were alive >3 years after diagnosis. In conclusion, genomic profiling helped confirm the original diagnosis and suggested primary sites in two third of our cases. Although many patients may be at a disease stage too advanced to withstand further investigations or underg aggressive therapy, molecular testing improves diagnostic accuracy and may thus assist in selection of the most appropriate therapy.
Sinonasal Bacteroma/Bacteria-related Concretions
Authors: Holliday Dean , Mehrad Mitra , Ely Kim A. , Lewis James S.
Published: September 2022

Patients can be seen where “fungal debris,” “mycetoma,” or “mass-like obstruction” of the sinonasal tract is suspected clinically but lack fungus and instead have granular, eosinophilic debris and bacterial colonies. We report and characterize 15 such cases, tentatively termed “bacteromas,” compared with randomly selected cases of mycetoma and allergic fungal sinusitis (AFS). Pathology reports from 2016 to 2021 were searched. All candidate cases were examined microscopically and included if they had granular, amorphous debris with negative Grocott methenamine silver staining and lacked diagnostic features of other entities. The 7 males and 8 females ranged from 21 to 78 years old. Imaging frequently revealed opacification of the paranasal sinuses. Operative reports showed all to have paranasal sinus involvement. Most were unilateral (13/15, 87%). The maxillary sinus was involved in 11/15 (73%) cases, sphenoid sinus in 2/15 (13%), and frontal and ethmoid sinuses in 1/15 (7%), each. Bacteroma patients frequently had a history of allergic rhinitis (8/15, 53%), more than mycetomas (1/15, 7%) and AFS (5/15, 33%) (P=0.0142). Facial pain was a common presenting symptom (13/15, 87%) in bacteromas compared with mycetomas (5/15, 33%) or AFS (1/15, 7%). Morphologically, cases consisted of large aggregates of paucicellular to acellular debris with a characteristic densely eosinophilic granular appearance, commonly associated with bacteria. Four of the 10 cultured patients grew Pseudomonas aeruginosa. Course posttreatment ranged from symptom resolution 1 week postoperatively to recurrent infections and symptoms 23 months from the initial operation. In summary, “bacteroma” is a heretofore undescribed pathologic entity of the sinuses that appears to be related to chronic bacterial infection and is distinct from mycetoma, AFS, and rhinolithiasis.
Fluid Accumulation in Mechanically Ventilated, Critically Ill Children: Retrospective Cohort Study of Prevalence and Outcome
Authors: Gelbart Ben , Serpa Neto Ary , Stephens David , Thompson Jenny , Bellomo Rinaldo , Butt Warwick , Duke Trevor
Published: September 2022

OBJECTIVES:

To describe the prevalence, patterns, explanatory variables, and outcomes associated with fluid accumulation (FA) in mechanically ventilated children.

DESIGN:

Retrospective cohort study.

SETTING:

Tertiary PICU.

PATIENTS:

Children mechanically ventilated for greater than or equal to 24 hours.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

Between July 2016 and July 2021, 1,636 children met eligibility criteria. Median age was 5.5 months (interquartile range [IQR], 0.7–46.5 mo), and congenital heart disease was the most common diagnosis. Overall, by day 7 of admission, the median maximum cumulative FA, as a percentage of estimated admission weight, was 7.5% (IQR, 3.3–15.1) occurring at a median of 4 days after admission. Overall, higher FA was associated with greater duration of mechanical ventilation (MV) (mean difference, 1.17 [95% CI, 1.13–1.22]; p < 0.001]), longer intensive care length of stay (LOS) (mean difference, 1.16 [95% CI, 1.12–1.21]; p < 0.001]), longer hospital LOS (mean difference, 1.19 [95% CI, 1.13–1.26]; p < 0.001]), and increased mortality (odds ratio, 1.31 [95% CI, 1.08–1.59]; p = 0.005). However, these associations depended on the effects of children with extreme values, and there was no increase in risk up to 20% FA, overall, in children following cardiopulmonary bypass and in children in the general ICU. When excluding children with maximum FA of >10%, there was no association with duration of MV (mean difference, 0.99 [95% CI, 0.94–1.04]; p = 0.64) and intensive care or hospital LOS (mean difference, 1.01 [95% CI, 0.96–1.06]; p = 0.70 and 1.01 [95% CI, 0.95–1.08]; 0.79, respectively) but an association with reduced mortality 0.71 (95% CI, 0.53–0.97; p = 0.03).

CONCLUSIONS:

In mechanically ventilated critically ill children, greater maximum FA was associated with longer duration of MV, intensive care LOS, hospital LOS, and mortality. However, these findings were driven by extreme values of FA of greater than 20%, and up to 10%, there was reduced mortality and no signal of harm.
Opioid Utility and Hospital Outcomes among Inpatients admitted with Osteoarthritis and Spine Disorders
Authors: Lee Se Won , Werner Bryan , Nguyen Dan , Wang Charles , Kang Mingon , Ayutyanont Napatkamon , Lee Soohyoung
Published: September 2022

Objective

To evaluate opioid analgesic utilization and predictors for adverse events during hospitalization and discharge disposition among patients admitted with osteoarthritis (OA) or spine disorders.

Design

This is a retrospective study of 12,747 adult patients admitted to 6 private community hospitals from 2017 to 2020. Opioid use during hospitalization and risk factors for hospital-acquired adverse events and non-home discharge were investigated.

Results

The total number of patients using opioids decreased, however, the daily morphine milligram equivalent (MME) use for patients on opioids increased from 2017 to 2020. Increased odds of non-home discharge were associated with older age, Medicaid, Medicare insurance, and increased lengths of stay (LOS), increased body mass index, daily MME, and electrolyte replacement in the OA group. In the spine group, older age, black race, Medicaid, Medicare, no insurance, increased Charlson comorbidity index (CCI), LOS, polypharmacy, and heparin use were associated with non-home discharge. Adverse events were associated with increased age, LOS, Medicare, polypharmacy, antiemetic, and benzodiazepine use in the OA group and increased CCI, LOS, and electrolyte replacement in the spine group.

Conclusions

Despite the decreasing number of patients using opioids over the years, patients on opioids had an increased daily MME over the same time period.
Higher Risk of Dyslipidemia With Coformulated Elvitegravir, Cobicistat, Emtricitabine, and Tenofovir Alafenamide than Efavirenz, Lamivudine, and Tenofovir Disoproxil Fumarate Among Antiretroviral-Naive People Living With HIV in China
Authors: Sun Liqin , He Yun , Xu Liumei , Zhao Fang , Zhou Yang , Zhang Lukun , Peng Qiaoli , Zhang Haitao , Zhang Qiuyue , Cao Tingzhi , Song Ying , Wang Siyuan , Rao Man , Jia Xinyun , Liu Xiaoning , Zhou Jing , Ju Bin , Wang Hui , Liu Jiaye
Published: September 2022

Background:

We aimed to examine the evolution of blood lipids and compare the risk of dyslipidemia between antiretroviral-naive people living with HIV who received tenofovir disoproxil fumarate (TDF), lamivudine (3TC), and efavirenz (EFV) (TDF + 3TC + EFV) and those who received coformulated elvitegravir, cobicistat, emtricitabine, and tenofovir alafenamide (E/C/F/TAF).

Methods:

We retrospectively reviewed the medical records of 2343 antiretroviral-naive people living with HIV who initiated TDF + 3TC + EFV or E/C/F/TAF. A propensity score matching method was used to compare longitudinal changes of blood lipids between the 2 groups.

Results:

By using 1:3 matching ratio, we included 253 and 91 matched patients in TDF + 3TC + EFV group and E/C/F/TAF group, respectively. The levels of total cholesterol, triglyceride, low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol were higher in E/C/F/TAF group than those in TDF + 3TC + EFV group at 3, 6, 9, and 12 months (Wilcoxon test, all Ps < 0.05), except for high-density lipoprotein cholesterol at 9 and 12 months. The cumulative rates of hypercholesterolemia, hypertriglyceridemia, and high LDL-C in PLWH with normal lipid levels in E/C/F/TAF group were higher than those in TDF + 3TC + EFV group (hypercholesterolemia, 59.7% vs 21.5%, P < 0.001; hypertriglyceridemia, 69.5% vs 46.3%, P < 00.001; and high LDL-C, 41.5% vs 14.2%, P < 0.001). Multivariate analysis showed treatment with E/C/F/TAF was associated with a significantly higher risk of hypercholesterolemia [adjusted hazard ratio (HR), 4.12; 95% confidence interval (CI): 2.65 to 6.41], hypertriglyceridemia (adjusted HR, 1.69; 95% CI: 1.18 to 2.43), and high LDL-C (adjusted HR, 4.60; 95% CI: 2.66 to 7.97).

Conclusions:

We concluded that treatment with E/C/F/TAF resulted in higher risks of dyslipidemia compared with TDF + 3TC + EFV.
Long COVID in children and adolescents
Authors: Stephenson Terence , Shafran Roz , Ladhani Shamez N.
Published: September 2022

Purpose of review

Although acute COVID-19 has been milder in children and young people compared with adults, there is a concern that they may suffer persistent symptoms. There is a need to define the clinical phenotype, determine those most at risk, the natural course of the condition and evaluate preventive and therapeutic strategies for both mental health and physical symptoms.

Recent findings

More recent studies with control groups reported a lower prevalence of persistent symptoms in children and young people exposed to SARS-CoV-2. A systematic review and meta-analysis found that the frequency of the majority of reported persistent symptoms is similar in SARS-CoV-2 positive cases and controls. Children and young people infected with SARS-COV-2 had small but significant increases in persisting cognitive difficulties, headache and loss of smell. Factors associated with persisting, impairing symptoms include increased number of symptoms at the time of testing, female sex, older age, worse self-rated physical and mental health, and feelings of loneliness preinfection.

This review highlights the importance of a control group in studies following SARS-CoV-2 infection, the need for case definitions and research to understand the outcomes of long COVID in children and young people.
Three-Dimensional Evaluation of Upper Airway Changes After Bimaxillary Surgery of Skeletal Class 3 Patients
Authors: Karaaslan Seyhan , Tüz Hakan H. , El Hakan , Süslü Ahmet Emre , Göktürk Tuğçe
Published: September 2022

The aim of this study was to evaluate the 3-dimensional changes in upper airway space of class 3 patients after surgery with sleep-related breathing disturbance. This is a retrospective cohort study included 25 patients who had undergone bimaxillary orthognathic surgery with maxillary advancement and mandibular setback for skeletal class 3 deformity. The changes in minimum axial area, nasopharyngeal and oropharyngeal airway volume were determined by cone-beam computed tomography images, as well as the sleep parameters by polysomnography preoperatively and postoperatively. The impacts of mandibular setback and maxillary advancement amounts on the airway structures were evaluated and compared with other parameters. The results show that pharyngeal volume measurement means were found to be significantly increased postoperatively (P<0.05). No significant difference was observed in the mean values of minimum axial area and sleep parameters after the operation (P>0.05). A positive relationship was determined between the oropharyngeal volume and minimum axial area changes at a rate of 60% (r: 0.600). No relationship was revealed between airway volume changes and polysomnographic parameters. An increase in the total airway volume and no postoperative sleep-related disturbance symptoms were observed in the patients treated by maxillary advancement and mandibular setback surgery.