bluuebunny/crossref_metadata_2025 huggingface dataset:
Age and professional experience as determinants of the utilization of psychoneuroimmunological research in clinical practice: An exploratory study
Authors: Mareth Christian , Fetzner Ulrich K. , Saely Christoph H.
Published: August 2023

The immune system is affected by psychosocial stimuli and plays a major role in the development of various diseases. Psychoneuroimmunology (PNI)-based interventions may positively influence the disease course; however, the impact of PNI research findings on clinical practice differs depending on the medical specialties involved. A comprehensive overview of the use of PNI research findings in clinical practice is currently lacking. This exploratory study aimed to provide insight into the dissemination of PNI research findings and their practical applications among clinical practitioners. Data was collected from 50 physicians using an ad hoc online questionnaire. We invited participants to take part in our online survey via an article in the DocCheck Newsletter, a German-language newsletter for physicians. Bivariate nonparametric correlation analysis (Spearman correlation) were used to explore the relationship between independent variables (age, sex, medical specialty, professional experience, and clinical environment) and dependent variables (six questionnaire items concerned with awareness, relevance, and utilization of PNI concepts). While 46% of respondents believed that PNI research findings were relevant to patient treatment, only 22% used PNI-based interventions as part of their therapeutic regimen. Furthermore, 90% of participants could not refer their patients to therapists offering PNI-based interventions. Moderately positive correlations were identified between the increasing age (rs = .48, P < .001) and increasing amount of professional experience (rs = .34, P = .02) of study participants and awareness of the theoretical foundations of PNI research. Although there is some awareness of PNI among medical practitioners, there appears to be a clear barrier inhibiting the implementation of research findings in current treatment practices. Therefore, it is necessary to examine the impact of increasing age and professional experience on the utilization of PNI-based interventions in patient care.
Risk factors and neonatal outcomes of pulmonary air leak syndrome in extremely preterm infants: A nationwide descriptive cohort study
Authors: Oh Seong Hee , Jin Hyun-Seung , Park Chan-Hoo
Published: August 2023

Most extremely preterm infants (EPIs), who were born before 28 weeks of gestation, with pulmonary air leak syndrome (ALS) are symptomatic, often severe, and require drainage. EPIs with severe air leak syndrome (sALS) that require tube drainage or needle aspiration are at high risk of morbidities and mortality. This study aimed to investigate perinatal characteristics, morbidities, and mortality in EPIs with sALS, and to estimate the risk of mortality according to gestational age (GA). A prospective cohort study conducted from 2013 to 2020 compiled the Korean Neonatal Network database to evaluate the incidence, perinatal characteristics, and outcomes of sALS in EPIs born before 28 weeks of gestation. Among 5666 EPIs, the incidence of sALS was 9.4% and inversely related to GA. From this cohort, we compared 532 EPIs with sALS to 1064 EPIs without sALS as controls, matching the subjects by GA and birth weight. Preterm premature rupture of membranes, oligohydramnios, resuscitation after birth, low Apgar scores, repeated surfactant administration, persistent pulmonary hypertension of the newborn, and pulmonary hemorrhage were associated with the development of pneumothorax. The sALS group required a higher fraction of inspired oxygen and more invasive respiratory support at both 28 days of life and 36 weeks of postmenstrual age. The sALS group had a higher incidence of bronchopulmonary dysplasia and major brain injury. The mortality rate was higher in the sALS group than in the control group (55.3% vs 32.5%, P < .001), and the ALS group had a 1.7 times risk of mortality than the control group. More attention should be paid to sALS in EPIs because the frequency of sALS increased as GA decreased, and the risk of mortality was more significant at lower GA.
Differences in clinical outcomes between HER2-negative and HER2-positive luminal B breast cancer
Authors: Kang Byeongju , Lee Jeeyeon , Jung Jin Hyang , Kim Wan Wook , Keum Heejung , Park Ho Yong
Published: August 2023

The clinical features and prognosis of breast cancer can vary widely, depending on the molecular subtype. Luminal B breast cancers are usually either estrogen receptor-positive and/or progesterone receptor-positive with high proliferation of Ki67 index, or HER2 positive (HER2+). The authors compared the clinicopathologic factors and survival rates of different subtypes of luminal B breast cancer according to HER2 status. Between 2009 and 2013, 1131 cases of breast cancer were reviewed and characterized as 1 of 4 different molecular subtypes based on their immunohistochemical results: luminal A, luminal B, HER2+, or triple-negative breast cancer. From these, luminal B breast cancers were extracted and the clinical features and prognosis of the HER2- and the HER2 + subtypes were compared. Survival differed significantly based on the molecular subtype regardless of whether or not the patient received treatment with neoadjuvant chemotherapy. While patients with HER2- luminal B breast cancer who received neoadjuvant chemotherapy had better prognoses, patients with HER2 + luminal B breast cancer who did not receive neoadjuvant chemotherapy had better prognoses. Luminal B breast cancers showed different clinical outcomes and survival rates according to HER2 gene overexpression type. Physicians should consider these results when they establish a treatment strategy.
Homologous platelet gel on radiation-induced dermatitis in a patient receiving head and neck radiotherapy plus cetuximab: A case report
Authors: Guberti Monica , Schiroli Davide , Marraccini Chiara , Mazza Genny , Iotti Cinzia , Baricchi Roberto , Iotti Barbara , Merolle Lucia
Published: August 2023

Introduction:

Acute radiodermatitis is a significant complication of cancer radiotherapy, and platelet-based therapies are emerging as potential new treatments.

Main symptoms and important clinical findings:

In this report, we present the case of a patient with head and neck cancer undergoing radiotherapy combined with the monoclonal antibody cetuximab. After 4 weeks of this treatment, the patient developed cutaneous radiation dermatitis. Despite receiving standard treatment with corticosteroids and emollient cream, the lesion did not improve.

Main diagnosis:

cutaneous radiation dermatitis on head and neck cancer patient.

Therapeutic interventions:

Topical application of platelet gel was initiated on the wound. From the second week of radiotherapy to the 4th week, homologous platelet-rich plasma was applied on the dermatitis using a bandage, 4 times a day.

Outcomes:

The topical treatment with homologous platelet gel resulted in complete healing of the radiodermatitis, including restoration of the epidermis, reepithelialization, and reduction in associated pain.

Conclusion:

homologous platelet gel might be an alternative to standard treatment of radiation dermatitis.
Soluble suppression of tumorigenicity 2 associated with fulminant myocarditis in children: A retrospective observational study
Authors: Hou Wenquan , Shi Tongtong , Li Yong , Li Wen , Xu Menghua , Peng Feng
Published: August 2023

Fulminant myocarditis (FM) is associated with high mortality, and studies on soluble suppression of tumorigenicity 2 (sST2) and myocarditis are still scarce. The aim of this study was to investigate the relationship between sST2 and FM in children with myocarditis. This was a single-center retrospective clinical observational study. We continuously included patients diagnosed as suspected viral myocarditis from December 2019 to December 2022. A total of 203 patients younger than 11 years old were enrolled in this study, 22 of whom were diagnosed with FM. The level of sST2 was positively correlated with N-terminal B-type natriuretic peptide (NT-proBNP) (R = 0.5588, P < .0001). After including multiple factors, creatinine (odd ratio [OR] 0.911; 95% confidence interval [CI], 0.842–0.986; P = .021), NT-proBNP (OR 1.000; 95% CI, 1.000–1.000; P = .01), left ventricular ejection fraction (OR 1.306; 95% CI, 1.153–1.478; P < .001) and sST2 (OR 0.982; 95% CI, 0.965–0.999; P = .038) were still risk factors for FM. The area under curve values were 0.852 for the NT-proBNP, 0.817 for the creatinine, 0.914 for the left ventricular ejection fraction, and 0.865 for the sST2, which showed good sensitivity and specificity for FM. Elevated level of sST2 was associated with fulminant myocarditis. sST2 might be used as a potential biomarker for the diagnosis of fulminant myocarditis.
Immune-related risk prognostic model for clear cell renal cell carcinoma: Implications for immunotherapy
Authors: Chen Ronghui , Wu Jun , Liu Shan , Sun Yefeng , Liu Guozhi , Zhang Lin , Yu Qing , Xu Juan , Meng Lingxin
Published: August 2023

Clear cell renal cell carcinoma (ccRCC) is associated with complex immune interactions. We conducted a comprehensive analysis of immune-related differentially expressed genes in patients with ccRCC using data from The Cancer Genome Atlas and ImmPort databases. The immune-related differentially expressed genes underwent functional and pathway enrichment analysis, followed by COX regression combined with LASSO regression to construct an immune-related risk prognostic model. The model comprised 4 IRGs: CLDN4, SEMA3G, CAT, and UCN. Patients were stratified into high-risk and low-risk groups based on the median risk score, and the overall survival rate of the high-risk group was significantly lower than that of the low-risk group, confirming the reliability of the model from various perspectives. Further comparison of immune infiltration, tumor mutation load, and immunophenoscore (IPS) comparison between the 2 groups indicates that the high-risk group could potentially demonstrate a heightened sensitivity towards immunotherapy checkpoints PD-1, CTLA-4, IL-6, and LAG3 in ccRCC patients. The proposed model not only applies to ccRCC but also shows potential in developing into a prognostic model for renal cancer, thus introducing a novel approach for personalized immunotherapy in ccRCC.
Application of integrated problem-based learning combined with lecture-based classroom teaching in undergraduate medical education: An effective teaching model in a Medical School in China
Authors: Zhan He-Qin , Zhang Xiao-Xun , Qin Rong , Fei Jun , Dong Gui-Yin , Hao Jia-Hu
Published: August 2023

The problem-based learning (PBL) is increasingly used in undergraduate education. However, the application of integrated PBL to medical undergraduate education has not been well assessed. An observational study was designed to compare integrated PBL combined with lecture-based classroom (LBC) with traditional LBC teaching in 2 semesters of a Medical School in China. This study was conducted from March 2021 to July 2022. A total of 118 undergraduates majoring in clinical medicine were randomly allocated in 2 groups, 1 group receiving the integrated PBL + LBC teaching (experimental group, n = 60) and another group receiving LBC teaching (control group, n = 58). The experimental group attended the integrated PBL courses for the basic and clinical medicine conducted in the 6th and 8th semesters, respectively, as well as taking the LBC courses. The experimental group was required to preview the course materials before class, make presentations in class and take online feedback questionnaires after class, while the control group was required to preview the textbooks and listen to the traditional LBC courses. The students’ scores of these 2 groups were compared, and feedback questionnaires were performed to evaluate the effectiveness of the experimental group over the control group. Results showed that the experimental group scored significantly higher than the control group in Clinical Skills (95% confidence interval [CI] 4.19–5.89), Internal Medicine I (95% CI: 1.85–9.93), Internal Medicine II (95% CI: 8.07–15.90), Introduction to Surgery (95% CI: 5.08–10.25), Surgery (General Surgery) (95% CI: 7.82–12.72), Surgery (Specialty) (95% CI: 6.47–9.97), and Clinical Medical Level Test (95% CI: 1.60–5.15) (all P < .01). In the feedback questionnaires of integrated PBL, up to 80% and 90% of students were satisfied with the teaching methods and lecturers, respectively. More than 80% of students agreed that the integrated PBL improved their abilities to learn independently, understand knowledge, and to raise, analyze and solve problems. In terms of stress in and out of class, a small number of students, <36.7%, felt stressed. The integrated PBL combined with LBC is an effective teaching approach, which may provide new ideas for teaching research and reform on undergraduate medical education in clinical medicine specialty and other medical majors.
Efficacy of cecal retroflexion observed on adenoma missing of ascending colon during colonoscopy: A prospective, randomized, pilot trial
Authors: Wang Cheng-Long , Zhao Zi-Ye , Wu Jia-Yi , Yan Fei-Hu , Yuan Jie , Xing Jun-Jie , Wang Hao , Yu En-Da
Published: August 2023

Background:

Although colonoscopic retroflexion has been proved effective in reducing missed adenomas, there is still a lack of comprehensive and in-depth research focused on the ascending colon. We aimed to conduct a randomized controlled trial and tandem colonoscopy to investigate whether cecal retroflexion observed during colonoscopy can reduce missed adenomas in the ascending colon.

Methods:

Men and women required to be between 45 and 80 years of age were screened for enrollment in the trial. Patients were randomly assigned according to a 1:1 ratio to either the trial group or control group. Patients in the trial group underwent 2 forward examination and a cecal retroflexion observed in the ascending colon, while patients in the control group underwent only 2 forward examinations in the ascending colon. The primary outcome was adenoma miss rate. The secondary outcomes contained adenoma detection rate, polyp miss rate, polyp detection rate, insertion time and withdrawal time. Differences between groups in the primary outcome and in the other categorical indicators were tested using chi-squared test and Fisher exact test. For the comparison of continuous outcomes, the Student t test was applied.

Results:

A total of 60 subjects were eligible for the study between April to June 2020, of which 55 were randomized and eligible for analysis (26 to the control group and 29 to the trial group). The characteristics of patients were no significant differences statistically between the trial group and the control group. Similarly, the characteristics of the colonoscopy procedures included cecal insertion distance, the length of cecum and ascending colon, insertion time, withdrawal time, quality of bowel preparation, numerical rating scale for pain, polyps detected, and adenomas detected, and there were no significant differences statistically between the 2 groups (P = .864, P = .754, P = .700, P = .974, P = .585, P = .835, P = .373, P = .489). The characteristics of the polyps were also no significant differences statistically between the 2 groups.

Conclusion:

This pilot trial failed to show benefit of cecal retroflexion observed on adenoma missing of ascending colon during colonoscopy; however, further conclusions require a prospective study with a higher level of evidence. (NCT03355443).
Meta-analysis of the efficacy and safety of Xihuang Pills/capsules in adjuvant treatment of uterine cervical neoplasms
Authors: Xu Huirong , Tian Guangyu , Wu Chunli , Sun Xiaowen , Li Kejian
Published: August 2023

Background:

Xihuang Pills/Capsules have a longstanding history of utilization in traditional Chinese medicine (TCM) for treating cancer. Nevertheless, a comprehensive investigation is required regarding the specific impacts and safety of Xihuang Pills/Capsules in individuals with uterine cervical neoplasms. Thus, conducting a meta-analysis is essential to evaluate the clinical effectiveness of combining Xihuang Pills/Capsules with Western medicine in patients with cervical neoplasms.

Methods:

The research involved searching 5 English and 4 Chinese databases for randomized controlled trials (RCTs) investigating the use of Xihuang Pills/Capsules in conjunction with Western medicine for treating uterine cervical neoplasms. Subsequently, statistical analysis was carried out using Review Manager software (version 5.3).

Results:

This research encompassed 10 RCTs involving 937 patients. The findings revealed that the combination of Xihuang Pills/Capsules with Western medicine treatment led to improvements in various aspects of the patients’ condition. Specifically, there was an enhancement in the short-term efficacy rate (risk ratio [RR] = 1.14, 95% confidence interval [CI]: 1.06–1.22, P = .0003), Karnofsky performance score (KPS) (mean difference [MD] = 5.90, 95% CI: 0.54–11.26, P = .03), survival rates, CD3+, CD3 + CD4+, CD3 + CD8+, CD3–CD56 + cells, and immunoglobulin M in patients with uterine cervical neoplasms. Moreover, the combination treatment resulted in a reduction of adverse reactions, including gastrointestinal reactions (RR = 0.52, 95% CI: 0.42–0.64, P < .00001), radiation proctitis (RR = 0.47, 95% CI: 0.33–0.68, P < .0001), myelosuppression (RR = 0.41, 95% CI: 0.26–0.64, P < .0001), as well as carcinoembryonic antigen (CEA) and squamous cell carcinoma antigen (SCC-Ag) levels. Additionally, the treatment exhibited an inhibitory effect on white blood cells (WBCs) and platelets (PLTs).

Conclusion:

The amalgamation of Xihuang Pills/Capsules with conventional anti-tumor therapy proves to be both effective and safe in the treatment of cervical neoplasms. However, further validation through high-quality RCTs is necessary to substantiate these findings.
The effect of gender on the clinical outcome of PD-1/PD-L1 inhibitor in advanced lung cancer patients
Authors: Wu Bing , Sun Congcong , Sun Xiaoqin , Li Xue
Published: August 2023

Background:

Programmed death protein-1/ligand-1 (PD-1/L1) inhibitors have widely used in the treatment of lung cancer. Some literatures indicated that different gender might not have equal immune response, but no agreement have reached on the issue. Hence, we performed a systematic review and meta-analysis that examine the effect of gender on the clinical outcome of PD-1/PD-L1 inhibitor in advanced lung cancer patients.

Methods:

Related database and conferences were searched. Studies that reported the relationship between gender and the overall survival (OS) or progression-free survival (PFS) of PD-1/L1 inhibitor were included. Meta-analysis was conducted to obtain pooled hazard ratios (HRs) with 95% CI.

Results:

We included 34 studies with 11,883 lung cancer patients. Meta-analysis showed that PD-1/PD-L1 inhibitors significantly prolonged the OS (males: HR 0.71, 95%CI 0.66–0.77; females: HR 0.72, 95%CI 0.63–0.82) and PFS (males: HR 0.60, 95%CI 0.55–0.66; females: HR 0.72, 95%CI 0.62–0.84) versus chemotherapy. The clinical benefit (OS HR: 0.99; PFS HR: 0.83) was not statistically significant between males and females. In patients treated with cemiplimab, male patients had a better OS (0.53, 95%CI 0.42–0.66) and PFS (OS 1.51, 95%CI 0.80–2.82) compared with female patients, but the small number of female patients precludes us from drawing any firm conclusions in female subpopulations.

Conclusion:

The clinical benefit of PD-1/PD-L1 inhibitors was not statistically significant between males and females during the treatment of lung cancer. In the future, researchers who are designing new immunotherapy studies should ensure a larger inclusion of women in trials, to avoid erroneously extending to women results that are obtained mainly in male patients.
Safety and efficacy of 5-aminolevulinic acid phosphate/iron in mild-to-moderate coronavirus disease 2019: A randomized exploratory phase II trial
Authors: Tanaka Takeshi , Tashiro Masato , Ota Kenji , Fujita Ayumi , Sawai Toyomitsu , Kadota Junichi , Fukuda Yuichi , Sumiyoshi Makoto , Ide Shotaro , Tachikawa Natsuo , Fujii Hiroshi , Hibino Makoto , Shiomi Hisanori , Izumida Mai , Matsui Kohsuke , Yamauchi Momoko , Takahashi Kensuke , Yamanashi Hirotomo , Sugimoto Takashi , Akabame Shogo , Umeda Masataka , Shimizu Masumi , Hosogaya Naoki , Kosai Kosuke , Takeda Kazuaki , Iwanaga Naoki , Ashizawa Nobuyuki , Hirayama Tatsuro , Takazono Takahiro , Yamamoto Kazuko , Imamura Yoshifumi , Miyazaki Taiga , Kobayashi Yusuke , Ariyoshi Koya , Mukae Hiroshi , Yanagihara Katsunori , Kita Kiyoshi , Izumikawa Koichi
Published: August 2023

Background:

5-aminolevulinic acid (5-ALA), a natural amino acid that is marketed alongside sodium ferrous citrate (SFC) as a functional food, blocks severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) proliferation in vitro and exerts anti-inflammatory effects. In this phase II open-label, prospective, parallel-group, randomized trial, we aimed to evaluate the safety and efficacy of 5-ALA in patients with mild-to-moderate coronavirus disease 2019.

Methods:

This trial was conducted in patients receiving 5-ALA/SFC (250/145 mg) orally thrice daily for 7 days, followed by 5-ALA/SFC (150/87 mg) orally thrice daily for 7 days. The primary endpoints were changes in SARS-CoV-2 viral load, clinical symptom scores, and 5-ALA/SFC safety (adverse events [AE] and changes in laboratory values and vital signs).

Results:

A total of 50 patients were enrolled from 8 institutions in Japan. The change in SARS-CoV-2 viral load from baseline was not significantly different between the 5-ALA/SFC (n = 24) and control (n = 26) groups. The duration to improvement was shorter in the 5-ALA/SFC group than in the control group, although the difference was not significant. The 5-ALA/SFC group exhibited faster improvement rates in “taste abnormality,” “cough,” “lethargy,” and “no appetite” than the control group. Eight AEs were observed in the 5-ALA/SFC group, with 22.7% of patients experiencing gastrointestinal symptoms (decreased appetite, constipation, and vomiting). AEs occurred with 750/435 mg/day in 25.0% of patients in the first phase and with 450/261 mg/day of 5-ALA/SFC in 6.3% of patients in the second phase.

Conclusion:

5-ALA/SFC improved some symptoms but did not influence the SARS-CoV-2 viral load or clinical symptom scores over 14 days. The safety of 5-ALA/SFC in this study was acceptable. Further evaluation using a larger sample size or modified method is warranted.
Observational study of effects of pharyngeal stimulation by carbonated solution on repetitive voluntary swallowing in humans
Authors: Tsuchiya Mika , Kubo Yumiko , Maruyama Naomi , Omori Chie , Fukami Hideyuki
Published: August 2023

In this study, we conducted observational study to examine the effects of pharyngeal stimulation by a bolus of carbonated solution on repetitive voluntary swallowing in humans.

Twelve healthy participants had a fine silicone tube inserted into their pharyngeal region, through which various solutions were slowly infused (0.2 mL/minute) to stimulate the pharyngeal mucosa without activating mechanoreceptors. The solutions included 0.3M NaCl (NaCl), carbonated 0.3M NaCl (NaCl + CA), 0.3M NaCl with acetic acid, distilled water, and carbonated distilled water. We used NaCl to inhibit water-sensitive neurons in the pharyngeal mucosa and enable the evaluation of the effects of carbonic acid stimulation on swallowing. Participants were instructed to repeat swallows as rapidly as possible during the infusion, and the swallowing interval (SI) was measured via submental surface electromyographic activity.

SI was significantly shorter during the infusion of NaCl + CA, distilled water, and carbonated distilled water than during the infusion of NaCl. There was a significant positive correlation between SI with NaCl stimulation and the facilitative effects of the other solutions. Longer SIs with NaCl stimulation indicated potent facilitative effects. Thus, stimulation with NaCl + CA facilitated swallowing by reducing SI. Furthermore, the facilitative effects of SI were more pronounced in participants who had difficulty with repetitive voluntary swallowing.

The sensation induced by carbonated solution may enhance the ability for repetitive voluntary swallowing, making it a potentially useful approach for rehabilitating patients with dysphagia.
Risk factors for intraoperative hypothermia in infants during general anesthesia: A retrospective study
Authors: Gao Yi , Fan Jiabin , Zhao Jialian , Hu Yaoqin
Published: August 2023

This study aimed to determine the incidence and evaluate the risk factors and outcomes of intraoperative hypothermia (IH) during general anesthesia in infants. Retrospective analysis of prospectively collected data. A total of 754 infants younger than 1 year old who underwent surgery under general anesthesia were included. Intraoperative body temperature fluctuations, surgical and anesthetic data, postoperative complications, and infant outcomes were recorded. Logistic regression algorithms were used to evaluate potential risk factors. Among the 754 infants, 47.88% developed IH (<36 °C) and 15.4% of them experienced severe hypothermia (<35 °C). The average lowest temperature in hypothermia patients was 35.06 ± 0.69°C with a duration of 82.23 ± 50.59 minutes. Neonates tended to experience hypothermia (37.7% vs 7.6%, P < .001) and prematurity was more common in patients with IH (29.4% vs 16.8%, P < .001). Infants with hypothermia experienced a longer length of stay in the post anesthesia care units and intensive care units, postoperative hospitalizations, and tracheal extubation as well as a higher rate of postoperative hemorrhage than those with normothermia (all P < .05). Several factors were proved to be associated with an increased risk of IH after multivariate analysis: neonate (odds ratio [OR] = 3.685, 95% CI 1.839–7.382), weight (OR = 0.599, 95% CI 0.525–0.683), American society of anesthesiologists (OR = 3.418, 95% CI 2.259–5.170), fluid > 20 mL/kg (OR = 2.380, 95% CI 1.389–4.076), surgery time >60 minutes (OR = 1.785, 95% CI 1.030–3.093), and pre-warming (OR = 0.027, 95% CI 0.014–0.052). This retrospective study found that neonates, lower weight, longer surgery times, more fluid received, higher American society of anesthesiologists stage, and no pre-warming were all significant risk factors for IH during general anesthesia in infants.
A therapy that modulates T lymphocyte subsets in patients infected with Epstein-Barr virus: Ganciclovir combined with interferon atomization inhalation
Authors: Ren Qingguo , Feng Yanli
Published: August 2023

To investigate the effect of ganciclovir combined with interferon atomization inhalation on T lymphocyte subsets in patients with Epstein-Barr virus (EBV) infection and its efficacy. Fifty patients with EBV infection who received ganciclovir combined with interferon atomization inhalation were selected as the observation group, and 50 healthy people were selected as the control group. The changes of T lymphocyte subsets in peripheral blood were detected by flow cytometry before treatment and at the 1st, 2nd, 3rd and 4th cycle after treatment. Before treatment, the CD3+, CD4+, CD4+/CD8+ indexes of the patients were significantly lower than those of the control group (P < .05), and the CD8+ level was significantly increased (P < .05). After one cycle of treatment, there was no significant difference in the changes of T lymphocyte subsets compared with those before treatment. After 2 and 3 cycles of treatment, CD3+, CD4+, CD4+/CD8+ values were higher than those before treatment (P > .05), and CD8+ index was lower than that before treatment (P < .05). After the 4th cycle of treatment, CD3+, CD4+, CD4+/CD8+ values were significantly improved (P < .05), and CD8+ index was significantly decreased (P < .05). Ganciclovir combined with interferon atomization inhalation can regulate the changes of T lymphocyte subsets in patients with EBV infection, improve the patient’s condition, and has no obvious adverse reactions. Monitoring the changes of T lymphocyte subsets during treatment is more meaningful to predict the therapeutic effect of patients with EB virus infection.
Prognostic value of platelet combined with serum procalcitonin in patients with sepsis
Authors: Chen Jianhui , Tu Xiaoyan , Huang Minghuan , Xie Ying , Lin Yanya , Hu Jianxiong
Published: August 2023

Sepsis, a common and life-threatening condition in critically ill patients, is a leading cause of death in intensive care units. Over the past few decades, there has been significant improvement in the understanding and management of sepsis. However, the mortality rate remains unacceptably high, posing a prominent challenge in modern medicine and a significant global disease burden. A total of 295 patients with sepsis admitted to the hospital from January 2021 to December 2022 were collected and divided into survival group and death group according to their 28-day survival status. The differences in general clinical data and laboratory indicators between the 2 groups were compared. Receiver operating characteristic curve analysis was used to evaluate the predictive value of platelet (PLT) and procalcitonin (PCT) for the prognosis of sepsis patients within 28 days. A total of 295 patients were diagnosed with sepsis, and 79 died, with a mortality rate of 26.78%. The PLT level in the death group was lower than that in the survival group; the PCT level in the death group was higher than that in the survival group. The receiver operating characteristic curve showed that the area under the curve of PCT and PLT for evaluating the prognosis of sepsis patients were 0.808 and 0.804, respectively. Kaplan–Meier survival analysis showed that the 28-day survival rate of the low PLT level group was 19.0% and that of the high PLT level group was 93.1% at the node of 214.97 × 109/L, and the difference between the 2 groups was statistically significant (χ2 = 216.538, P < .001). The 28-day survival rate of the low PCT level group was 93.4% and that of the high PCT level group was 51.7% at the node of 2.85 ng/mL, and the difference between the 2 groups was statistically significant (χ2 = 63.437, P < .001). There was a negative correlation between PCT level and PLT level (r = −0.412, P < .001). Platelet combined with serum procalcitonin detection has high predictive value for judging the 28-day prognosis of sepsis, and it can be used as an index for evaluating the patient’s condition and prognosis, and is worthy of clinical promotion and application.
Comparison and validation of the Japanese score and other scoring systems in patients with peptic ulcer bleeding: A retrospective study
Authors: Kim Seong Hoon , Moon Hee Seok , Choi Seong Woo , Kang Sun Hyung , Sung Jae Kyu , Jeong Hyun Yong
Published: August 2023

Acute upper gastrointestinal bleeding (UGIB) is one of the most urgent medical conditions, with peptic ulcer bleeding (PUB) accounting for most gastrointestinal bleeding cases. The Japanese scoring system was developed to predict the probability of intervention in patients with UGIB, and it is more effective than other scoring systems, according to several studies. This study aimed to verify whether the Japanese scoring system is better than other scoring systems in predicting the probability of intervention when limited to PUB in patients with UGIB. We enrolled patients who presented with symptoms of UGIB and were diagnosed with peptic ulcers using endoscopy. The performances of the scoring systems in predicting patient outcomes were validated and compared using the receiver-operating characteristic curve analysis. Additionally, we used the chi-square test, Fisher exact test, and the t test to analyze the association between the patients characteristics and clinical outcomes. Of the 1228 patients diagnosed with peptic ulcers, 90.6% underwent endoscopy. rebleeding occurred in 12.5% of the patients, and 2.5% of the patients died within 30 days. The Japanese score was the most effective in predicting the need for endoscopic intervention for PUB. Sex, systolic blood pressure, hematemesis, syncope, blood urea nitrogen level, and the American Society of Anesthesiologists score were predictive factors for the probability of endoscopic intervention in patients with PUB. The Japanese score is an effective predictor of the probability of endoscopic intervention in patients with PUB.
Transurethral 1470 nm diode laser vaporization versus plasma kinetic enucleation of the prostate for the treatment of benign prostatic hyperplasia: A retrospective study
Authors: Huang Jiaguo , Fan Yi , Wang Kai , Ding Hongxiang , Mao Dikai , Zhao Liwei , Tai Shengcheng
Published: August 2023

To compare the efficacy, safety, and complications of transurethral 1470 nm diode laser vaporization and plasma kinetic enucleation of prostate (PKEP) in benign prostatic hyperplasia treatment. A retrospective matched-paired comparison of patients treated using transurethral 1470 nm diode laser vaporization (n = 40) or PKEP (n = 40) was conducted. Baseline characteristics, preoperative data, and postoperative outcomes at the 24-month follow-up of the patients were recorded. The present study found no significant preoperative differences between the 2 treatment groups. Compared with PKEP, 1470 nm diode laser vaporization had a significantly shorter operation time and less intraoperative blood loss, but there were no marked differences between the 2 groups in terms of postoperative bladder irrigation time, catheterization time, and hospital stay. Moreover, at the 24-month follow-up postoperatively, there were no marked differences in the International Prostatic Symptomatic Score (IPSS), quality of life (QOL), maximum urinary flow rate (Qmax), and post-void residual urine volume (PVR) between the 2 groups. IPSS, QOL, Qmax, and PVR had improved significantly compared to preoperative assessment at 24-month follow-up in both groups and there was no significant difference in the variation of IPSS, QOL, Qmax and PVR before and after the operation. Furthermore, complications were comparable between the 2 treatment groups. Transurethral 1470 nm diode laser vaporization and PKEP are effective strategies in the treatment of benign prostatic hyperplasia. However, 1470 nm diode laser vaporization offers advantages over PKEP in terms of shortening operation time and reducing intraoperative bleeding. Nonetheless, further research with a larger number of patients and long-term follow-up is necessary to confirm and validate these findings.
Urinary continence in high-risk prostate cancer after robot-assisted radical prostatectomy
Authors: Wu Xiaobo , Wong Chris Ho-Ming , Gandaglia Giorgio , Chiu Peter Ka-Fung
Published: August 2023

Purpose of review

Urinary incontinence is common postoperative complication following robot-assisted radical prostatectomy (RARP) in patients with prostate cancer (PCa). Despite the increasing adoption of RARP in the treatment of high-risk PCa (HRPC), concerns persist regarding the adequacy of reported continence outcomes in this subgroup. This review aims to illuminate the state of continence recovery in HRPC patients post-RARP.

Recent findings

Urinary continence (UC) recovery rates in HRPC was reported to be lower than the intermediate/low-risk counterparts from 6 to 24 months post-RARP. Predictive models showed that age, obesity, race, disease status, and surgical approaches represent predictors of continence recovery. Special techniques like NeuroSAFE technique and Retzius-Sparing approach also play a role in reducing incontinence also in the high-risk scenario.

RARP for HRPC appears to be associated with worse continence compared with other risk groups. A multimodality approach for prediction and prevention of incontinence after RARP is vital. Further research into this area is necessary to enhance continence recovery outcomes in HRPC patients undergoing RARP.
Addressing Diversity, Equity, and Inclusivity Contributions in Academic Review
Authors: Noone Joanne , Murray Teri A.
Published: August 2023

Background:

The nursing profession and academic environments are increasingly calling for nurse educators to incorporate diversity, equity, and inclusion (DEI) goals and actions into their professional practice. Such work aligns with institutional and professional missions of social justice and antiracism.

Problem:

Historically, there has been an undervaluing and lack of recognition in academia of DEI contributions and qualitative or community-based research focused on health equity. This lack of recognition may disproportionately impact faculty who focus their scholarship and research on marginalized communities.

Approach:

The current state of the academic review of DEI contributions for appointment, promotion, and tenure is presented. Examples for teaching, research and scholarship, practice, and service are provided.

Outcomes:

Recommendations include expanding recognition and evaluation of academic scholarship and advocacy against efforts to dismantle social justice and antiracism advances within academia.

Conclusion:

Examining hegemonic norms is vital to promote more equitable power structures in academic environments.
Effects of an Interactive e-Book on Enhancing Nursing Students' Knowledge, Confidence, and Learning Self-efficacy of Nursing Skills
Authors: Yu Tzu-Yuan , Huang Tsai-Wei , Huang Hui-Chuan , Li Siao-Yun , Chuang Yeu-Hui
Published: August 2023

Background:

Interactive e-books offer multimedia and interactive features that make them particularly suitable for learning nursing skills and also allow for easy content updating, ensuring that students learn the most current skills based on the latest clinical guidelines.

Purpose:

To examine the effectiveness of an interactive e-book in increasing nursing students' knowledge, confidence, and learning self-efficacy of performing nasogastric tube feeding.

Methods:

A randomized controlled trial was conducted with 62 nursing students, with the experimental group using an interactive e-book for learning whereas the comparison group using a printed textbook.

Results:

The experimental group demonstrated significantly greater knowledge and confidence improvements than the comparison group, but no significant difference was found in learning self-efficacy. The experimental group was significantly more satisfied with the learning materials than the comparison group.

Conclusions:

Interactive e-books are more effective in enhancing nursing students' knowledge and confidence in performing nursing skills than printed textbooks.
“Make-up” Examinations
Authors: Bultas Margaret W. , Schmuke Ashley , Armstrong Kathleen , Rubbelke Cynthia , Alnawman Mohammed , Moran Vicki , Fuller Kelli , Cole Briauna , Lovan-Gold Kelly
Published: August 2023

Background:

Nursing faculty may have concerns about unfair advantages and inflated examination grades when students take an examination late.

Purpose:

The purpose of the study was to compare make-up examination scores with on-time examination scores to determine whether scores were higher in students who took an examination late.

Methods:

A descriptive, comparative study using retrospective examination scores from a large nursing program was analyzed. Late examination scores were compared with the student's individual on-time examination average and the class's average of on-time examination scores.

Results:

A total of 156 examinations were taken late. There were no statistically significant differences between students’ late examination scores when compared with the student's on-time examinations or the class average of the examination.

Conclusion:

Students do not appear to gain an advantage when taking an examination late. Findings may assist faculty in developing policies for taking make-up examinations.
Designing and delivering public engagement activities together with patient partners: The experience of Public Conference on Cancer
Authors: Savas Sevtap , Follett Alicia , Bishop Derrick , King John , Taylor-Cutting Janine , Bilash Tristan , Etchegary Holly , Whitten Cindy , Stuckless Teri
Published: August 2023

Public outreach and engagement activities can greatly benefit from collaborating with patient partners in planning and execution. Here, we describe and reflect on our experience regarding the organization and delivery of the Public Conference on Cancer, a virtual public event that aimed to exchange knowledge on cancer, cancer lived experiences, and cancer services and support in Newfoundland and Labrador, Canada. The Public Interest Group on Cancer Research, including 12 cancer-affected members, four scientists, as well as a clinician and a research assistant formed the conference organizing team. The team's experiences and reflections and the feedback received after the Conference were used to distill perspectives gained, lessons learned, and opportunities identified. The Public Conference on Cancer was a successful public engagement event. It reached out to the general public, initiated new or strengthened existing connections among stakeholders, disseminated important clinical and social knowledge on cancer, and gave us further ideas and expertise to use in future public outreach activities. We also realized challenges remaining, such as the need to improve accessibility and recruitment, and unique considerations for patient speakers and speakers from special/vulnerable communities. While there are considerations that need to be further elaborated and integrated for widely accessible public engagement activities, partnering with cancer patients and family members in designing and delivering public outreach activities is effective in knowledge dissemination, personal and professional growth, and forming connections with stakeholders.
Evidence-Based Practices in Facial Reanimation Surgery
Authors: Aronson Sofia , Applebaum Sarah A. , Kelsey Lauren J. , Gosain Arun K.
Published: August 2023

Learning Objectives:

After studying this article, the participant should be able to: 1. Describe the causes and preoperative evaluation of facial paralysis. 2. Discuss techniques to restore corneal sensation and eyelid closure, elevation of the upper lip for smile, and depression of the lower lip for lip symmetry. 3. Outline treatment goals, surgical treatment options, timing of repair, and other patient-specific considerations in appropriate technique selection.

Congenital facial paralysis affects 2.7 per 100,000 children; Bell palsy affects 23 per 100,000 people annually; and even more people are affected when considering all other causes. Conditions that impair facial mimetics impact patients’ social functioning and emotional well-being. Dynamic and static reconstructive methods may be used individually or in concert to achieve adequate blink restoration, smile strength and spontaneity, and lower lip depression. Timing of injury and repair, patient characteristics such as age, and cause of facial paralysis are all considered in selecting the most appropriate reconstructive approach. This article describes evidence-based management of facial paralysis.
Immediate Prepectoral Implant-Based Breast Reconstruction after J-Pattern Skin-Reducing Mastectomy
Authors: Caputo Glenda Giorgia , Pisano Gaetano , Albanese Roberta , Mura Sebastiano , Scarabosio Anna , Contessi Negrini Filippo , Parodi Pier Camillo
Published: August 2023

Skin-reducing mastectomy for single-stage reconstruction is an oncologically safe procedure used in women with large and ptotic breasts. This study describes a new technique, the J-pattern skin-reducing breast reconstruction with prepectoral implant and acellular dermal matrix (Braxon fast), which is indicated for patients with large and ptotic breasts who would benefit from a breast reduction and need a mastectomy for curative or prophylactic purposes. The authors present a case series of 35 breasts of 19 women who underwent this procedure from January of 2021 through December of 2022 at the Plastic and Reconstructive Surgery Department of the University Hospital Santa Maria della Misericordia, in Udine, Italy, with a median follow-up of 15 months. The advantages of the J scar consist of a reduced risk of skin necrosis, a reduced bottoming-out rate, simplification of the surgical design, and lower impact of scars not involving the medial quadrants of the breast. Patients were administered the BREAST-Q 2.0 postoperative questionnaire at 3 months postoperatively, which showed a high average level of satisfaction with the reconstruction. This surgical technique is a valid option for patients who have voluminous breasts and adequate pinch test results who wish to undergo immediate heterologous reconstruction along with curative or prophylactic mastectomy.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, IV.
Patient-Reported Satisfaction and Health-Related Quality of Life in Patients with Breast Augmentation: A Follow-Up of 6 Months
Authors: Luong Kim Phi , Peters Magdalena , Slijper Harm P. , Hummelink Stefan , Ulrich Dietmar J. O.
Published: August 2023

Background:

To evaluate the success of a breast augmentation, it is essential to measure outcomes from the patient perspective, because a successful aesthetic result is, in particular, determined by the patient. This study aimed to evaluate patient-reported satisfaction with their breasts, and psychosocial, physical, and sexual well-being in patients undergoing breast augmentation using validated questionnaires.

Methods:

This is a multicenter cohort study based on ongoing routinely collected data. Patient-reported satisfaction and health-related quality of life were assessed with the BREAST-Q augmentation module at intake and 6 months postoperatively.

Results:

A total of 1405 patients were included. Large changes in BREAST-Q scores (range, 0 to 100) between intake and 6 months postoperatively were seen in satisfaction with breasts (mean, effect size: +57, 3.8), psychosocial well-being (mean, effect size: +38, 2.1), physical well-being (mean, effect size: −14, −1.2), and sexual well-being (mean, effect size: +44, 2.4). Moreover, improvements in all four scales were not dependent on their intake scores, and all postoperative scores reached similar levels. A decreased physical well-being of the chest was measured after surgery. The satisfaction with breasts scale correlated moderately to strongly with the psychosocial and sexual well-being scale 6 months after surgery. Subgroup analysis based on patient characteristics found no differences in outcomes, except for body mass index.

Conclusions:

Significant improvement in patient-reported satisfaction with breasts, psychosocial well-being, and sexual well-being can be seen 6 months after breast augmentation, despite a decline in physical well-being after treatment. Postoperative satisfaction levels did not depend on preoperative scores. These insights can contribute to improving preoperative communication between surgeon and patient regarding the expected outcomes.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, IV.