bluuebunny/crossref_metadata_2025 huggingface dataset:
Association between vegetables and fruits consumption and depressive symptoms in a middle-aged Chinese population
Authors: Cheng Hai-Ying , Shi Yun-Xia , Yu Feng-Na , Zhao Huan-Zong , Zhang Jian-Hua , Song Mei
Published: May 2019

There is scarce evidence regarding the association between the consumption of vegetables and fruits and depressive symptoms in Chinese population. The purpose of this study was to ascertain the influence of vegetables and fruits consumption on depressive symptoms in a middle-aged Chinese population. This study comprised 1676 Chinese adults aged between 45 and 59 years, who participated in a Health Survey at the time of periodic checkup in the city of Linyi, Shandong Province, China. Dietary intake was assessed using a semi-quantitative food frequency questionnaire (FFQ). Depressive symptoms were assessed using the Center for Epidemiological Studies Depression (CES-D) scale. Log-binomial regression analysis was used to evaluate the association between the consumption of vegetables and fruits and depressive symptoms. A total of 53 participants (3.2%) were classified as having depressive symptoms. After adjustment for confounding variables, participants in the highest quartile of the fruits consumption and vegetables consumption had lower prevalence ratio (PR) for depressive symptoms (PR = 0.76; 95% confidence interval [CI]: 0.603–0.974, P = .042; PR = 0.77; 95% CI: 0.612–0.977, P = .045) than those in the lowest quartile. Moreover, those in the highest quartile of total vegetables and fruits consumption had also a lower PR of depressive symptoms (PR = 0.67; 95% CI: 0.503–0.806, P = .037) than did those in the lowest quartile.

Our findings indicate that higher consumption of vegetables and fruits is significantly associated with a lower risk of depressive symptoms. Further prospective studies are needed to confirm these findings.
Hepatitis B virus prevalence and risk factors in hard-to-reach Turkish population living in Belgium
Authors: Koc Özgür M. , Hens Niel , Bielen Rob , Van Damme Pierre , Robaeys Geert
Published: May 2019

Background:

Hepatitis B virus (HBV) infection is an important public health problem in the Turkish population, that is, one of the largest migrant populations in Europe. With the introduction of cost-effective antiviral treatments in the past decade, there is a need to identify HBV-infected patients who may benefit from treatment. This study describes the design of a study to assess the HBV prevalence in the Turkish population living in Belgium. Additionally, we will determine the risk factors of HBV infection and the uptake of screening, vaccination, and antiviral treatment in this hard-to-reach Turkish population.

Methods:

A longitudinal, epidemiological study will be conducted in the region Middle Limburg Belgium, where the Turkish adult population, 18 years of age and older, will be screened for hepatitis B surface antigen (HBsAg), antibodies against HBsAg (anti-HBs), and antibodies against hepatitis B core antigen (anti-HBc). Educational meetings concerning viral hepatitis B will be organized and there will be 3 ways to be screened for HBV: immediately after the educational meetings, at the Outpatient Hepatology Department of Ziekenhuis Oost-Limburg, and at home visits. Subsequently, participants will be asked to fill in a questionnaire regarding sociodemographic factors, migration history, risk factors for HBV infection (e.g., sharing toothbrushes, HBV-infected family member), and HBV vaccination status. Six months after screening, HBsAg-positive patients will be assessed whether they are under follow-up at the general practitioner or hepatologist. We will also gather information regarding the uptake of vaccination in nonimmunized subjects.

Discussion:

This study will provide information about the HBV prevalence and distribution of the stages of liver disease in the Turkish population in Belgium. By determining the risk factors for HBV infection, subgroups with an increased prevalence of HBV infection can be identified.

Clinical trial number:

This clinical trial is registered at clinicaltrials.gov (NCT03396458).
Respiratory viral infection in early life and development of asthma in childhood
Authors: Hassan Md Zakiul , Chowdhury Muhammad Abdul Baker , Hassan Imran , Chowdhury Fahmida , Schaefer Nancy , Chisti Mohammod Jobayer
Published: May 2019

Background:

Respiratory viruses are the leading cause of early life wheezing that may contribute to the development of childhood asthma leading to increasing morbidity and socioeconomic burden. The aim of this review is to identify whether respiratory viral infections during first year of life were associated with development of childhood asthma.

Methods:

We will search major scientific databases (MEDLINE, CINAHL, Web of Science, Cochrane Library, and ClinicalTrials.gov) using truncated and phrase-searched keywords and relevant subject headings. Observational studies including case–control studies, cohort studies, and randomized control trials published in English will be included in this review. Case reports, qualitative studies, and narrative overviews will be excluded. Exposure will be defined as laboratory-confirmed viral respiratory tract infection in the first year of life and outcome will be defined as development of asthma between ages 5 and 18 years. Effect sizes in bivariate and multivariate analyses will be presented as odds or prevalence ratios. We will explore for heterogeneity of the standard errors across the studies, and if appropriate, we will perform a meta-analysis using a random-effects model to present a summary estimate of the odds or prevalence ratios.

Results:

This review will assess whether respiratory viral infections during first year of life increases the risk of childhood asthma development.

Conclusions:

This systematic review will evaluate published literature, assessing the link between early life viral infection and childhood asthma. Pooled data may provide evidence that infantile respiratory viral infection results in higher incidence of recurrent wheezing and asthma, thereby stimulating further research into the cost-effectiveness of pharmaceutical interventions such as vaccines and nonpharmaceutical interventions such as hand-washing and respiratory hygiene promotion to young children. Implementing the results of such research may then reduce the burden of acute viral respiratory infections and subsequent recurrent wheezing and asthma.

Systematic review registration:

This systematic review has been registered on PROSPERO (CRD42018105519)
Clinical characteristics and prognosis of nonsurgically treated patients with pneumonic-type adenocarcinoma
Authors: Wei Jia , Tang Dezhu , Nie Ying , Chen Jie , Peng Li
Published: May 2019

Pneumonic-type adenocarcinoma (P-ADC) is a subtype of lung adenocarcinoma with high mortality, which often requires lobectomy surgery. Nonsurgically treated P-ADC patients usually have more advanced or complex conditions, which remain poorly understood and pose a major challenge in clinical management. We aimed to describe the clinical profiles and prognosis of non-surgically treated P-ADC patients. We enrolled 71 patients with pathologically proven P-ADC from a university hospital in China. Clinical and laboratory data were retrieved from medical record. Their median age was 62 years, including 45% men and 35% smokers. Clinical manifestations were dominated by cough, sputum, and dyspnea. Main chest imaging features included nodules, shadow, consolidation, and air bronchogram. Nearly half or more of patients showed higher levels of inflammation and cancer biomarkers including cytokeratin-19-fragment (CYFRA 21-1) and carcinoembryonic antigen (CEA). Majority of patients were classified at the stage IIIB or IV. Palliative care was the most popular treatment option but provided a shorter overall survival compared to tyrosine kinase inhibitor therapy, standard chemotherapy, and sequential therapy while there were no significant differences in the survival among the latter 3 options. Higher serum CEA was associated with longer survival and better prognosis while higher serum CYFRA 21-1 could predict a poor prognosis. Detailed understanding the clinical characteristics and prognostic factors in nonsurgically treated P-ADC may allow the identification of patients with particular risk factors and initiation of early and specific treatment in order to optimize outcomes.
Pectoral nerve block in anesthesia for modified radical mastectomy
Authors: Zhao Jia , Han Fanglei , Yang Yang , Li Hangyu , Li Zinan
Published: May 2019

Background:

Many types of regional nerve blocks have been used during anesthesia for modified radical mastectomy. In recent years, the use of pectoral nerve (PECS) block has gained importance in postoperative analgesia, but there are still controversies regarding its efficacy. There is especially no consensus on the optimal type of PECS block to be used. Herein, we attempt to evaluate the analgesic efficacy of the PECS block after radical mastectomy.

Methods:

We searched PubMed, EMBASE, and the Cochrane library for randomized controlled trials (RCTs) for studies regarding PECS versus general anesthesia (GA) that were published prior to May 31, 2018. Outcome measures such as intra- and postoperative consumption of opioids, postoperative nausea and vomiting (PONV), need for postoperative rescue analgesia, and pain scores were analyzed. After quality evaluation and data extraction, a meta-analysis was performed using Review Manager 5.3 software, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was used for rating the quality of evidence.

Results:

A total of 8 RCTs and 2 cohort studies involving 993 patients were eligible. Compared with the GA group, the PECS block group effectively reduced the intraoperative and postoperative use of opioid drugs, incidence of PONV, need for postoperative rescue analgesia, and pain scores within 0 to 6 hours after surgery. However, subgroup analysis showed that PECS I block did not have a significant advantage in reducing the intra- and postoperative consumption of opioids. Results for each outcome indicator were confirmed as having a high or moderate level of evidence.

Conclusions:

Even considering the limitations (evaluations of efficacy in different age groups and for chronic pain were not carried out) of this meta-analysis, it can be concluded that the PECS II block is an effective anesthetic regimen in modified radical mastectomy that can effectively reduce the intra- and postoperative consumption of opioids, postoperative PONV, and the need for postoperative rescue analgesia and can alleviate early pain (0–6 hours) after surgery.
A case report of hepatitis B related optic neuritis treated with plasma exchange
Authors: Teng Da , Tan Shaoying , Yang Mo , Wang Junqing , Zhao Jie , Xu Quangang , Wei Shihui
Published: May 2019

Introduction:

There are few studies focusing on Binocular hepatitis B related optic neuritis (HB-ON) and associated therapies are still limited. We present a case of HB-ON which has been cured with therapeutic plasma exchange (TPE).

Patient concerns:

The patient was diagnosed as acute hepatitis B in hepatology and got a rapid loss of binocular visual acuity (2/100 in the right eye and no light perception in the left eye) after the onset.

Diagnosis:

Hepatitis B related optic neuritis.

Interventions:

Methylprednisolone and therapeutic plasma exchange.

Outcomes:

The treatment of high dose methylprednisolone was not curative. After 5 TPE sessions, the patient's best corrected visual acuity (BCVA) returned to 20/20 in the right eye and finger counting (FC)/40 cm in the left eye. One month later, the visual acuity increased to 5/100 in the left eye.

Conclusion:

This is the first case in which we used TPE to cure HB-ON. Also, it can demonstrate the relationship between HB-ON and immunopathogenesis. The case may provide an effective method for the treatment of hormone invalid and disabled ON in clinical practice.
Association of p53 expression with poor prognosis in patients with triple-negative breast invasive ductal carcinoma
Authors: Li Jing-ping , Zhang Xiang-mei , Zhang Zhenzhen , Zheng Li-hua , Jindal Sonali , Liu Yun-jiang
Published: May 2019

TP53 gene is mutated in approximately 80% of triple-negative breast cancer (TNBC). However, the prognostic significance of immunohistochemical (IHC)-detected p53 protein expression remains controversial in TNBC. In this study, we retrospectively analyzed the association between IHC-detected p53 expression and the prognosis in a cohort of 278 patients with stage I-III triple-negative breast invasive ductal carcinoma (IDC), who received surgery at the department of breast surgery in the Fourth Hospital of Hebei Medical University from 2010–01 to 2012–12. We found a positive expression ratio of IHC-detected p53 in triple-negative breast IDC of 58.6% (163/278). Furthermore, levels of expression were significantly associated with vessel tumor emboli and higher histologic grade (P = .038, P = .043, respectively), with the highest expression level observed in G3 breast cancer (64.7%). Additionally, Kaplan-Meier analysis showed that p53 expression indicated worse overall survival (OS) in the whole cohort (79.6% vs 89.6%, Log-rank test P = .025) as well as in stratified prognostic stage II patients (90.8% vs 100%, Log-rank test P = .027). The mortality risk of p53 expression patients was 2.22 times higher than that of p53 negative patients (HR: 2.222; 95%CI: 1.147–4.308). In addition, p53 expression was also associated with poor disease-free survival (DFS) (76.7% vs 86.8%, P = .020). Cox proportional hazard ratio model showed p53 expression was an independent risk factor for OS (P = .018) and DFS (P = .018) after controlling for tumor size, lymph node status, and vessel tumor emboli. Altogether, our data showed that IHC-detected p53 expression is a promising prognostic candidate for poor survival in triple-negative breast IDC patients. However, more studies are needed to determine if p53 may be applied to clinical practice as a biomarker and/or novel therapeutic target for TNBC.
The crowd-out effect of a mass casualty incident
Authors: Yang Chih-Jen , Tsai Shih-Hung , Chien Wu-Chien , Chung Chi-Hsiang , Dai Niann-Tzyy , Tzeng Yuan-Sheng , Chen Sy-Jou , Wu Ding-Chung , Chen Cheng-Jueng
Published: May 2019

A mass casualty incident (MCI) can have an enormous impact on an already crowded emergency department (ED), affecting the quality of health care provided to non-MCI ED patients. On June 26, 2015, a burn MCI (BMCI) occurred due to a cornstarch explosion at a party at a water park. The competing needs of the BMCI patients might have crowded out the needs of the non-BMCI patients. Although crowd-out effects have been previously documented in a variety of health care situations, they have not been extensively evaluated during MCIs. We aimed to determine whether the outcomes of the non-MCI patients were compromised during this incident.

We conducted a retrospective observational study comparing several health care parameters and outcomes between non-BMCI patients and historical controls during the designated period using institutional electronic records and the National Health Insurance Research Database.

On the night of the incident, 53 patients were sent to our ED; most of them arrived within 3 hours after the BMCI. There was a significant increase in the wait time for ICU beds among non-BMCI patients compared to the wait times during the corresponding week of the previous year (8.09 ± 4.21 hours vs 3.77 ± 2.15 hours,P = .008). At the hospital level, there was a significantly increased length of hospital stay (LOS) in the ICU after the MCI compared with the LOS in the ICU in the same week of the preceding year (median days: 15 vs 8,P ≤ .001). At the regional level, there were no significant differences between the 2 periods in the LOS in acute care, LOS in the ICU or mortality rates at the involved medical centers.

Crowd-out effects from the MCI occurred in the ED and at the institutional level. Although there was an increased wait time for admission to the ICU and a longer LOS in the ICU, the LOS in acute care beds, treatment of time-sensitive diseases, and mortality rates were not compromised by the current MCI protocol at either the institutional or regional levels.
Real-world database investigating the association between diabetes mellitus and herpes zoster in Taiwan
Authors: Lai Shih-Wei , Lin Cheng-Li , Liao Kuan-Fu
Published: May 2019

Little evidence is available about the correlation between diabetes mellitus and herpes zoster in Taiwan. This study aimed to investigate the correlation between diabetes mellitus and herpes zoster in Taiwan.

A population-based cohort study was conducted using the database of Taiwan National Health Insurance Program. There were 27,369 subjects aged 20 to 84 years with newly diagnosed diabetes mellitus from 2000 to 2012 as the diabetes mellitus group and 107,705 sex- and age-matched subjects without diabetes mellitus as the nondiabetes mellitus group. The incidence of herpes zoster at the end of 2013 was estimated. The multivariable Cox proportional hazards regression model was used to calculate the hazard ratio (HR) and 95% confidence interval (CI) of herpes zoster associated with diabetes mellitus.

The overall incidence of herpes zoster was 1.16-fold higher in the diabetes mellitus group than the nondiabetes mellitus group (7.85 vs 6.75 per 1000 person-years, 95% CI 1.12–1.20). After adjustment for co-variables, the adjusted HR of herpes zoster was 1.17 for subjects with diabetes mellitus (95% CI 1.10–1.23), compared with subjects without diabetes mellitus.

Patients with diabetes mellitus are associated with 1.17-fold increased risk for developing herpes zoster.
Spontaneous intracranial hypotension in Hashimoto's thyroiditis
Authors: Liang Hui , Xu Congjie , Liu Tao , Huang Shixiong , Hu Shijun
Published: May 2019

Rationale:

Autoimmune thyroid diseases (ATDs) seldom affect intracranial pressure. Here, we describe a case of spontaneous intracranial hypotension (SIH) related to Hashimoto's thyroiditis (HT), which has never been previously published.

Patient concerns:

A 54-year-old woman was admitted to our hospital due to sudden-onset postural headache, neck pain stiffness, visual blurring, nausea and vomiting. The headache was aggravated when the patient sat or stood up yet rapidly resolved within 1 minute after recumbency.

Diagnosis:

The patient had a grade 1a diffusely palpable thyroid gland and the laboratory report revealed elevated titers of anti-thyroid antibodies, a diagnosis of HT was established. Gadolinium-enhanced magnetic resonance imaging exhibited dilatation of the venous sinuses, obvious diffuse pachymeningeal enhancement, and narrowing of the ventricular system, combined with the lumbar puncture pressure was 60 mmH20 in the lateral recumbent position, and a diagnosis of SIH was eatablished.

Interventions:

The patient was placed on strict bed rest and hydrated for 15 days.

Outcomes:

The headache was gradually relieved, a follow-up at 1 month after discharge revealed that the patient could stand and function normally.

Lessons:

SIH can be related to ATD.
Chronic intestinal pseudo-obstruction with pneumatosis cystoides intestinalis in a patient with systemic sclerosis
Authors: Mitsuyoshi Yuki , Takakura Kazuki , Kobayashi Takashi , Ogawa Nanako , Sakurai Toshiyuki , Nakano Masanori , Ukichi Taro , Ishiuji Yozo , Torisu Yuichi , Saruta Masayuki
Published: May 2019

Rationale:

Chronic intestinal pseudo-obstruction (CIPO) and pneumatosis cystoides intestinalis (PCI) are rare abdominal diseases and the pathological mechanisms have not been fully elucidated. Systemic sclerosis (SSc), which is characterized by the progressive sclerotic changes of skin and internal organs, is a refractory collagen disease and is frequently associated with digestive disorders including CIPO.

Patient concerns:

A 68-year-old woman who has been well managed for SSc over the long term, who presented with abdominal fullness for the first time.

Diagnoses:

Abdominal X-ray and computed tomography (CT) images showed PCI with pneumoperitoneum findings. Based on the diagnosis of CIPO, we evaluated the intestinal peristalsis of the patient by using cine magnetic resonance imaging (MRI).

Interventions:

Oral medications of 15 g/d of Daikenchuto, 750 mg/d of Metronidazole and Sodium Picosulfate were started for improving the bowel peristaltic movement and decreasing intestinal gas production.

Outcomes:

A great improvement of CIPO and PCI by multidrug therapy without any surgical treatments for such an unusual case.

Lessons:

This case indicates that SSc can be accompanied with not only CIPO but also PCI as digestive disorders and that cine MRI, which is a definitely beneficial imaging modality, can intelligibly visualize the peristalsis of the intestines and lead to successful medical control by noninvasive treatment.
Total laparoscopic central pancreatectomy with Roux-Y pancreaticojejunostomy for solid pseudopapillary neoplasm of pancreas
Authors: Liang Bin , Chen Yuanyuan , Li Mengyang , Dong Xiaofeng , Yao Siyang , Liu Tianqi
Published: May 2019

Rationale:

There is controversy regarding the optimal surgical approach for pancreatic lesions in the center of the pancreas. Duodenum-preserving pancreatic cental resection compared with pancreaticoduodenectomy is technically more challenging, but preserves more functional pancreatic tissue.

Patient concerns:

A 34-year-old woman was admitted to our department on March 15, 2017. Computed tomographic's and magnetic resonance cholangiopancreatography's diagnosis was a solitary tumor 3.0 × 2.2-cm lesion located in border between pancreatic neck and body. The patient's condition was good and symptomless, without any disease history. Physical examination and routine blood investigations were normal. All pancreatic malignant tumor biological markers were negative.

Diagnoses:

Solid pseudopapillary neoplasm (SPN) of pancreas.

Interventions:

Total laparoscopic central pancreatectomy with Roux-Y pancreaticojejunostomy was performed, and unscheduled open surgery was done for abdominal pain caused by intraperitoneal bleeding.

Outcomes:

The recovery was smooth after unscheduled open surgery. At the end of 20 months follow-up, she was well and showed no signs of recurrence.

Lessons:

The anatomy of the operation is clearer and easier than open surgery because of the magnification effect of laparoscopy. Total laparoscopic central pancreatectomy is safe, effective, feasible for SPN of pancreas, and it should be equally applicable to some other pancreatic cystic neoplasms and neuro-endocrine tumors. Suture is the best measure to prevent postoperative angiorhagia of intraperitoneal cavity.
Clinical and diagnostic outcomes in arthroscopic treatment for posterolateral plicae impingement within the radiocapitellar joint
Authors: Park Kun-Bo , Kim Sung-Jae , Chun Yong-Min , Yoon Tae-Hwan , Choi Yun Seok , Jung Min
Published: May 2019

Synovial plica is rarely diagnosed as cause of elbow pain. Impingemnt of posterolateral plicae in the radiocapitellar joint tends to be usually overlooked. The purpose of this study was to present outcomes of arthroscopic treatment in relatively large number of cases and propose reliable diagnostic test for posterolateral plicae of the radiocapitellar joint.

From January 2000 to December 2010, 24 cases diagnosed with pathologic posterolateral radiocapitellar plica on arthroscopic finding were retrospectively reviewed. Magnetic resonance imaging (MRI) evaluation and preoperative physical examination were performed. The posterolateral radiocapitellar plica test newly proposed by the present study was also conducted. To measure postoperative clinical outcomes, the disabilities of the arm, shoulder, and hand (DASH) score and Mayo elbow performance score (MEPS) were employed. Minimum duration of follow up was 24 months.

According to the preoperative MRI, pathologic radiocapitellar plica was identified in 17 cases (70.8%). Preoperatively, maximal tender point was present on the radiocapitellar joint line in 20 cases (83.3%) and mechanical symptoms were observed in 9 cases (37.5%). 6 cases (25%) demonstrated pain at terminal extension and limitation of extension. 20 (83.3%) cases tested positive for posterolateral radiocapitellar plica test. The sensitivity and specificity of the posterolateral radiocapitellar plica test were 83.3% and 87.5%, respectively. The accuracy value was 86.3%. Arthroscopic debridement of pathologic plica in the radiocapitellar joint demonstrated clinical improvements: DASH score was from 36.6 to 8.9 and MEPS was from 56.9 to 95.6 at the latest follow-up.

Symptomatic impingement by the pathologic posterolateral plica of the radiocapitellar joint should be considered when posterolateral elbow pain which is refractory to conservative treatment, and other prevalent diseases are excluded. The posterolateral radiocapitellar plica test and radiocapitellar joint line tenderness could be recommended as reliable examination maneuvers to obtain accurate diagnosis. Arthroscopic debridement was an effective method for treating symptomatic plicae.
Pathway-based network analyses and candidate genes associated with Kashin-Beck disease
Authors: Zhang Rongqiang , Guo Hao , Yang Xiaoli , Zhang Dandan , Li Baorong , Li Zhaofang , Xiong Yongmin
Published: May 2019

To perform a comprehensive analysis focusing on the biological functions and interactions of Kashin-Beck disease (KBD)-related genes to provide information towards understanding the pathogenesis of KBD.

A retrospective, integrated bioinformatics analysis was designed and conducted. First, by reviewing the literature deposited in PubMed, we identified 922 genes genetically associated with KBD. Then, biological function and network analyses were conducted with Cytoscape software. Moreover, KBD specific molecular network analysis was conducted by Cytocluster using the Molecular Complex Detection Algorithm (MCODE).

The biological function enrichment analysis suggested that collagen catabolic process, protein activation cascade, cellular response to growth factor stimulus, skeletal system development, and extrinsic apoptosis played important roles in KBD development. The apoptosis pathway, NF-kappa B signaling pathway, and the glutathione metabolism pathway were significantly enriched in the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway network, suggesting that these pathways may play key roles in KBD occurrence and development. MCODE clusters showed that in top 3 clusters, 54 of KBD-related genes were included in the network and 110 candidate genes were discovered might be potentially related to KBD.

The 110 candidate genes discovered in the current study may be related to the development of KBD. The expression changes of apoptosis and oxidative stress-related genes might serve as biomarkers for early diagnosis and treatment of KBD.
Nasal colonization with methicillin-resistant Staphylococcus aureus associated with elevated homocysteine levels in the general US adults
Authors: Min Kyoung-Bok , Min Jin-Young
Published: May 2019

Given the emergence of community-acquired methicillin-resistant Staphylococcus aureus (MRSA) as a global health threat, understanding the risk factors for MRSA infection in the community may be a reasonable strategy to prevent it. We investigated the associations between serum homocysteine levels and prevalence of nasal colonization with S aureus and MRSA among United States adults. We conducted a cross-sectional analysis of a nationally representative sample of 7832 adults (20 years or older). The main outcome variables were nasal colonization with S aureus and MRSA. Percentages of colonization with S aureus and MRSA were calculated by the quartiles of serum homocysteine. A total of 7832 of 2051 subjects (26.2%) were culture positive for S aureus, 98 (4.8%) of whom had nasal colonization with MRSA. In comparison with subjects having the lowest serum homocysteine, the odds of nasal colonization with MRSA were significantly higher in those with the highest homocysteine (odds ratio, 3.09; 95% confidence interval, 1.11–8.61) in multivariate analysis, adjusted for all confounding variables. By contrast, homocysteine elevation was not significantly associated with S aureus colonization. Nasal colonization with MRSA in the general community was significantly associated with increases in serum homocysteine levels.
The effects of statins on benign prostatic hyperplasia and the lower urinary tract symptoms
Authors: Yang Xuesong , Zhang Qiang , Jiang Guo , Liu Junbo , Xie Chaofan , Cui Shu , Wu Tao
Published: May 2019

Background:

The aim of this meta-analysis was to understand the relationship between statin with benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS).

Methods:

A systematic literature search was conducted using PubMed, Embase, Cochrane Library, Chinese Medical and Biological Literature Database, China HowNet, Vip, and Wanfang. We calculated pooled odds ratios (OR) and 95% CI and standardized mean difference (SMD). Using Stata 12.0 and Review 5.3 for meta-analysis.

Results:

This meta-analysis included 11 articles and 49,128 participants. Results show statins could not reduce the incidence of BPH [OR = 0.77 (0.57, 1.03, P = .08]. For patients over 60 years old, statins could reduce the incidence of BPH [OR = 0.35 (0.22, 0.55), P < .0001]. Statins can slow down the progression of LUTS in BPH [SMD = −0.32 (−0.54, −0.10), P = .004], but there is no significant correlation between them in patients taking drugs for less than 1 year.

Conclusion:

Statins have no significant effect on the incidence of BPH, but statins can reduce the risk of BPH for patients over 60 years old. For patients with hyperlipidemia, the duration of medication is more than 1 year, which can slow down the progression of LUTS. However, more high-quality and large sample size studies are needed to further improve and verify.
Child and adolescent chronic fatigue syndrome/myalgic encephalomyelitis: where are we now?
Authors: Gregorowski Anna , Simpson Jane , Segal Terry Y.
Published: May 2019

Purpose of review

The current review aims to determine the recent evidence regarding cause, impact, effective treatment and prognosis of children and young people (CYP) affected by chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) at a time when the National Institute for Clinical Excellence guidelines in the United Kingdom are being reviewed and more research is called for worldwide.

Recent findings

CFS/ME is a debilitating illness with no clear cause. This review describes the heterogeneous clinical picture and the effects on the young person and family. Comorbidities such as mood disorders and pain are discussed including evidence for treatment. The various aetiological hypotheses are discussed and the precipitating factors identified. The evidence base is limited regarding effective treatment for CYP with CFS/ME, particularly the severely affected group. A large trial of online cognitive behavioural therapy with teenagers is being explored in the United Kingdom. The Lightning Process has been shown to be effective when added to medical care.

Current evidence is hampered by different diagnostic criteria, the heterogeneous nature of the condition, and limited number of small studies. There is a clear need for more research and larger studies exploring the cause of and most effective treatment for CYP with CFS/ME.
Uncontrolled donation after circulatory death: ethics of implementation
Authors: Molina María , Domínguez-Gil Beatriz , Pérez-Villares José M. , Andrés Amado
Published: May 2019

Purpose of review

Despite its potential to increase the donor pool, uncontrolled donation after circulatory death (uDCD) is available in a limited number of countries. Ethical concerns may preclude the expansion of this program. This article addresses the ethical concerns that arise in the implementation of uDCD.

Recent findings

The first ethical concern is that associated with the determination of an irreversible cardiac arrest. Professionals must strictly adhere to local protocols and international standards on advanced cardiopulmonary resuscitation, independent of their participation in an uDCD program. Cardiac compression and mechanical ventilation are extended beyond futility during the transportation of potential uDCD donors to the hospital with the sole purpose of preserving organs. Importantly, potential donors remain monitored while being transferred to the hospital, which allows the identification of any return of spontaneous circulation. Moreover, this procedure allows the determination of death to be undertaken in the hospital by an independent health care provider who reassesses that no other therapeutic interventions are indicated and observes a period of the complete absence of circulation and respiration. Extracorporeal-assisted cardiopulmonary resuscitation programs can successfully coexist with uDCD programs. The use of normothermic regional perfusion with ECMO devices for the in-situ preservation of organs is considered appropriate in a setting in which the brain is subject to profound and prolonged ischemic damage. Finally, communication with relatives must be transparent and accurate, and the information should be provided respecting the time imposed by the family's needs and emotions.

uDCD can help increase the availability of organs for transplantation while giving more patients the opportunity to donate organs after death. The procedures should be designed to confront the ethical challenges that this practice poses and respect the values of all those involved.
Outcome of Relapsed Pediatric Patients After Second Allogeneic Hematopoetic Stem Cell Transplantation: A Retrospective Study From a Single Institution
Authors: Berger Massimo , Pessolano Rosanna , Carraro Francesca , Saglio Francesco , Vassallo Elena E. , Fagioli Franca
Published: May 2019

Prognosis of relapsed leukemia patients after second allogeneic hematopoietic stem cell transplantation (HSCT2) is historically considered very poor. We report the outcome of 18 pediatric patients after failure of HSCT2. The 2-year overall survival was 26% (95% confidence interval [CI], 6-47). The lymphoid malignancies were associated with better survival (40% [95% CI, 12-68]) than myeloid malignancies (0%, P=0.002), together with time to relapse after the HSCT2 (≥5 mo: 44% [95% CI, 12-76] vs. 0% for patients who relapsed within 5 mo from HSCT2, P=0.005), other factors such as sex, donor type, conditioning regimen, and graft versus host disease prophylaxis did not have statistical significance. When the multivariate analysis was carried out, 2 independent protective factors were identified: the lymphoid malignancies and the graft versus host disease 0 to I after HSCT2. When we look at the treatments, patients receiving blinatumomab after relapse got benefit in terms of overall survival and, more importantly, with a long-term control of acute lymphoblastic leukemia.
Development of a Bidimensional Simpatía Scale for Use With Mexican American, Puerto Rican, and Cuban American Adults
Authors: Davis Rachel E. , Lee Sunghee , Johnson Timothy P. , Rothschild Steven K.
Published: May 2019

Background

Through its influence on social interactions, simpatía may have a wide-ranging influence on Latinx health. Simpatía—which does not have a direct English translation—refers to being perceived as likeable, pleasant, and easygoing. Research to investigate the influence simpatía on Latinx health is limited, likely due to a lack of options for measuring simpatía among diverse Latinx populations.

Objectives

The goal of this research was to develop a bilingual, survey-based simpatía scale for use among ethnically diverse Latinx adults in health-related settings.

Methods

Data were obtained through a telephone survey data of 1,296 Mexican American, Puerto Rican, and Cuban American adults living in the United States. Interviews were conducted in English and Spanish. Exploratory factor analysis, item response theory analysis, confirmatory factor analysis, and computation of estimates of internal consistency reliability were conducted to inform the development of the final simpatía scale.

Results

Results indicate that the final, nine-item, simpatía scale has high internal consistency (α = .83) and measurement invariance among Mexican American, Puerto Rican, and Cuban American adults. Two dimensions were identified, as indicated by a perceptions subscale and a behavior subscale. Cuban Americans were found to have the highest simpatía scores, followed by Puerto Ricans and Mexican Americans.

Discussion

Culture is often identified as a powerful potential influence on health-related behaviors, but measures are often not available to assess specific cultural traits. By developing a new tool for measuring simpatía, this research advances opportunities for understanding and promoting Latinx health.
A Novel Approach to Helping People with Glaucoma Use Their Drops Routinely
Authors: McDonald John E. , Dickinson Jane K.
Published: May 2019

Pharmacy data reveal that 70% of patients were missing one or more days worth of drops out of five. Adopting approaches to behavior change and management skills used for people with diabetes may provide insight to improve self-management of glaucoma. Every person who is diagnosed with a chronic health condition such as glaucoma has unique life circumstances that may present barriers to behavior change. An accurate diagnosis and a treatment plan are useless if patients do not use their prescribed eye drops. Active listening and effective communication can result in persons who are more engaged in their self-care behaviors. Collaborative communication using person-centered and strengths-based messages could help eye care providers identify challenges and concerns for people with glaucoma who are experiencing inconsistencies with their eye drops. In an atmosphere where patients can discuss their challenges with treatment recommendations without judgment or fear, they are more likely to trust their provider and therefore share their situation openly and honestly. This is accomplished by choosing language that communicates mutually-agreed-upon self-management goals and addresses and strengthens individual and clinical outcomes. The eye care professional is then seen by the patient as a resource who can empathize when setbacks occur and reinforce the patient's self-management goals. Open-ended questions and tell-ask-tell approaches for identifying barriers to care are keys to more effective communication and trusting relationships. This includes recognizing that glaucoma is associated with increased rates of anxiety or depression that may be an overlooked barrier to self-management. By adopting language recommendations from diabetes care and education, eye care practitioners may be better equipped to help people with glaucoma improve their self-care.
The Audibility of Low Vision Devices with Speech Output Used by Older Adults with Dual Sensory Impairment
Authors: St-Amour Lorie , Jarry Jonathan , Wittich Walter
Published: May 2019

SIGNIFICANCE

The successful uptake, integration, and use of vision rehabilitation devices with speech output depend to a large part on their audibility. However, individuals with combined vision and hearing impairments are at a disadvantage when using devices that do not consider multiple impairments.

PURPOSE

Sensory rehabilitation for individuals with combined vision and hearing impairment often relies on the use of assistive technology devices that use speech outputs (e.g., talking clock), but in individuals with dual impairment, their use is likely compromised by a concurrent hearing loss. The goal of this study was to evaluate the audibility of these devices in a population of individuals with acquired dual sensory impairment.

METHODS

We measured the ability to correctly repeat speech output presented by three assistive technology devices (talking watch, calculator, scanner) and confidence levels in response accuracy in 24 participants with visual impairment only and in 22 individuals with dual sensory loss. Stimuli were presented at three volumes that were repeated one or four times. Participants were placed at a fixed distance of 74 cm from the sound source.

RESULTS

The pattern of results was similar across the different devices, whereby an interaction of volume and repetition indicated that participants' accuracy to repeat a phrase and their confidence in their response improved with increasing volume, but more so at higher numbers of repetition (P < .05; ω2, from 0.005 to 0.298). Participants with dual sensory loss generally had lower accuracy and confidence.

CONCLUSIONS

Scores and confidence levels being very low across devices and users suggest that even participants with normal hearing for their age experienced a certain level of difficulty understanding speech output, confirming the need for better assistive technology device design.
Secretory Carcinoma of the Skin
Authors: Kastnerova Liubov , Luzar Boštjan , Goto Keisuke , Grishakov Viktor , Gatalica Zoran , Kamarachev Jivko , Martinek Petr , Hájková Veronika , Grossmann Petr , Imai Hiroshi , Fukui Hideaki , Michal Michal , Kazakov Dmitry V.
Published: May 2019

Secretory carcinoma of the skin is a rare adnexal carcinoma, which is morphologically and immunohistochemically identical to secretory carcinoma of the breast and is associated with the presence of t (12;15) translocation, resulting in the ETV6-NTRK3 gene fusion. Nineteen cases of primary cutaneous secretory carcinoma have been previously published in the literature. In this study, we describe 6 new cases of secretory carcinoma of the skin. The study group consisted of 5 female patients and 1 male patient, ranging in age from 57 to 98 years (mean: 74.2, median: 74). Locations included the axilla (2), neck, eyelid, thigh, and nipple base, each one. Microscopically, all but 1 tumor were well circumscribed and nonencapsulated and exhibited characteristic abundant secretions within the microcystic and tubular spaces comprised by bland oval, round to cuboidal neoplastic cells. In addition, solid areas and focal pseudopapillae were seen, and, in 1 case, a focal mucinous component with small lakes of mucin containing small tumor nests or tubules of the neoplastic cells was present. The remaining neoplasm was mostly solid and papillary, with only few characteristic lumina containing secretions. Immunohistochemically, all cases expressed S-100 protein, mammaglobin, STAT5, GATA3, and NTRK. ETV6-NTRK3 gene fusion was detected in 5 cases, whereas, in the remaining tumor, a novel NFIX-PKN1 gene fusion was found.
CD5-negative Mantle Cell Lymphoma
Authors: Miao Yuan , Lin Pei , Saksena Annapurna , Xu Jie , Wang Michael , Romaguera Jorge , Yin C. Cameron , Medeiros L. Jeffrey , Li Shaoying
Published: May 2019

Mantle cell lymphoma (MCL) represents 4% to 9% of all non-Hodgkin lymphomas and is characterized by CD5 and cyclin D1 expression and t(11;14)(q13;q32). However, about 5% of MCL lack CD5 expression and is poorly characterized. Here, we present 58 patients with CD5 negative (CD5−) MCL and compared them with a group of 212 typical CD5 positive (CD5+) MCL cases. There were 39 men and 19 women with a median age of 66 years (range, 36 to 88). Compared with CD5 positive (CD5+) MCL patients, patients with CD5− MCL showed a lower male-to-female ratio (P=0.006) and a higher frequency of “bone marrow non-nodal” presentation (P=0.01). All other clinicopathologic features, including the frequency of SOX11 expression, were similar between the 2 groups. Treated with similar regimens, patients with CD5− MCL showed a significantly longer progression-free survival (PFS) (P=0.01) and a tendency for longer overall survival (OS; P=0.078) than CD5 positive (CD5+) MCL patients. Univariate analysis showed of the well-known poor prognostic factors, only Mantle Cell Lymphoma International Prognostic Index was an inferior prognostic factor and blastoid/pleomorphic morphology and high Ki67 were not associated with prognosis in CD5− MCL patients. Multivariate Cox regression analysis showed CD5 expression was an independent prognostic factor for PFS (P=0.031) but not OS in MCL patients. In conclusion, the results suggest that patients with CD5− MCL have a more favorable prognosis than CD5+ MCL patients, although the clinicopathologic features of both groups are largely similar. CD5− MCL may represent a distinct variant of MCL and needs to be included in the differential diagnosis of CD5− small B-cell lymphomas.
Palmitoylation controls the stability of 190 kDa Ankyrin-G in dendritic spines and is regulated by ZDHHC8 and lithium
Authors: Piguel Nicolas H. , Shaun S. Sanders , DeSimone Francesca I. , Martin-de-Saavedra Maria D. , McCoig Emmarose , Dionisio Leonardo E. , Smith Katharine R. , Thomas Gareth M. , Penzes Peter
Published: May 2019

AnkG, encoded by theANK3gene, is a multifunctional scaffold protein with complex isoform expression: the 480 kDa and 270 kDa isoforms have roles at the axon initial segment and node of Ranvier, whereas the 190 kDa isoform (AnkG-190) has an emerging role in the dendritic shaft and spine heads. All isoforms of AnkG undergo palmitoylation, a post-translational modification regulating protein attachment to lipid membranes. However, palmitoylation of AnkG-190 has not been investigated in dendritic spines. TheANK3gene and altered expression of AnkG proteins are associated with a variety of neuropsychiatric and neurodevelopmental disorders including bipolar disorders and are implicated in the lithium response, a commonly used mood stabilizer for bipolar disorder patients, although the precise mechanisms involved are unknown. Here, we showed that Cys70 palmitoylation stabilizes the localization of AnkG-190 in spine heads and at dendritic plasma membrane nanodomains. Mutation of Cys70 impairs AnkG-190 function in dendritic spines and alters PSD-95 scaffolding. Interestingly, we find that lithium reduces AnkG-190 palmitoylation thereby increasing its mobility in dendritic spines. Finally, we demonstrate that the palmitoyl acyl transferase ZDHHC8, but not ZDHHC5, increases AnkG-190 stability in spine heads and is inhibited by lithium. Together, our data reveal that palmitoylation is critical for AnkG-190 localization and function and a potential ZDDHC8/AnkG-190 mechanism linking AnkG-190 mobility to the neuronal effects of lithium.