bluuebunny/crossref_metadata_2025 huggingface dataset:
Application of high-quality targeted temperature management guided by multimodal brain monitoring in brain protection of patients with cardiac arrest: A case series
Authors: Xia Weiping , Ai Meiling , Ma Xinhua , Hu Chenhuan , Peng Qianyi , Zhao Chunguang , Liu Qi , He Shixiong , Huang Li , Zhang Lina
Published: December 2024

Rationale:

Cardiac arrest (CA) is an acute emergency with high mortality and is closely associated with the risk of brain damage or systemic ischemia–reperfusion injury, post-traumatic stress symptoms.

Patient concerns:

Targeted temperature management in the intensive care unit can improve the neurological outcomes of patients who are comatose after resuscitation from CA. However, there is often a lack of specific evaluation methods for optimal target temperature settings.

Diagnoses:

From November 2021 to October 2022, 9 CA patients received prompt cardiopulmonary resuscitation and return of spontaneous circulation after approximately 10 to 30 minutes of cardiopulmonary resuscitation in Xiangya Hospital, Central South University.

Interventions:

We retrospectively reviewed 9 CA patients’ medical data, including demographic characteristics, hemodynamic change, clinically relevant score, imageological examination, transcranial Doppler ultrasonography, electroencephalogram (EEG), somatosensory-evoked potential, and laboratory data.

Outcomes:

According to the result of each patient’s transcranial Doppler ultrasonography, somatosensory-evoked potential, and EEG to formulate an individualized target temperature. Contrary to the internationally recommended target of hypothermia, we found that not all patients require hypothermia therapy to maintain normal cerebrovascular autonomic regulation function. And neuron-specific enolase and S100β in patients showed a downward trend after hypothermia therapy. Compared with before hypothermia treatment, clinically relevant scores were reduced in patients with good prognosis. Intracranial congestion or ischemia was improved and intracranial pressure was reduced in all patients during hypothermia treatment. For patients with good EEG response, the ratio of gray matter in the brain increased and the neurological prognosis was significantly improved. Finally, after 6 months of follow-up, we found 3 patients died and 1 patient had a long-term vegetative state, the other patients had a good prognosis.

Lessons:

Individualized targeted temperature management under the guidance of multimodal brain monitoring plays an important role in brain protection of patients with CA.
A case of posterior urethral valve diagnosed by ultrasound in antenatal and pathology: A case report
Authors: Gao Jinmei , Guan Yunping , Kang Junling , Zhang Wei
Published: December 2024

Rationale:

Posterior urethral valve is a rare disease, prenatal diagnosis and prognosis evaluation are particularly important.

Patient concerns:

A 25-year-old pregnant woman was found enhanced parenchymal echo in both kidneys, subcapsule urinary cyst formation in both kidneys, bladder enlargement of the fetus during prenatal ultrasonography at 25 W + 4 of gestation. It was accompanied by fetal pericardial effusion and oligohydramnios.

Diagnoses:

Fetal posterior urethral valve.

Interventions:

After detailed prenatal evaluation, labor was induced and fetal autopsy was performed.

Outcomes:

Fetal autopsy pathology confirmed the prenatal judgment.

Lessons:

Prenatal ultrasonography can diagnose posterior urethral valve through typical image manifestations and can make a certain judgment for prognosis evaluation.
Bilateral thalamic infarction with posterior cerebral artery variant (the arcade artery): A case report
Authors: Ling Langping , Xu Lingjia , Zhou Yang
Published: December 2024

Rationale:

Bilateral thalamic infarction is a rare type of posterior circulation stroke, and it often presents with a reduced level of consciousness in the elderly. Arteriosclerosis is the primary etiology of bilateral thalamic infarction, including conditions such as native vessel stenosis or arterial-to-arterial embolism. Cardiogenic or paradoxical embolism can also lead to thrombosis of the perforator branches innervating the thalamus, and these emboli tend to disintegrate and lead to multiple lesions, even in elderly patients.

Patients concerns:

A 69-year-old man presented to our emergency room with sudden onset of drowsiness lasting for 2 days. A computed tomography scan revealed bilateral hypodense thalamic lesions, which resembled artery of Percheron infarcts. Magnetic resonance imaging confirmed cerebral infarction in the posterior circulation. Magnetic resonance angiography and diagnostic digital subtraction angiography suggested a suspicious embolus obstructing the junction between the arcade artery and the left posterior cerebral artery, which had further migrated. Echocardiography, 24-hour Holter monitoring, and deep venous ultrasonography were all negative; however, transesophageal echocardiography revealed a patent foramen ovale.

Diagnosis:

Paradoxical embolism is a rare occurrence in older adults. However, when considering the etiology of stroke in this patient, paradoxical embolism should remain a priority in the diagnostic process following a multifactorial risk assessment.

Intervention:

The patient was treated with antiplatelet, statin therapy, and foramen ovale closure.

Outcome:

He recovered well after the interventional closure surgery and is currently under follow-up.

Lessons:

The elderly experiencing a sudden drop in consciousness should be evaluated for thalamic lesions, primarily cerebral infarction in the posterior circulation. Anatomical artery variations may be helpful in attributing multiple and bilateral lesions to a single source of embolism. Digital subtraction angiography and transesophageal echocardiography can help to clarify the etiological categorization and formulate a secondary prevention strategy for cerebral infarction. Paradoxical embolism is a diagnostic dilemma in the elderly population, and treatment principles must be integrated with guidelines, the prospectively validated patent foramen ovale-associated stroke causal likelihood risk stratification system, interdisciplinary collaboration and customized analysis.
High-grade biliary intraepithelial neoplasia localized in the distal bile duct diagnosed via peroral cholangioscopy: A rare case report
Authors: Kato Naohiro , Yamaguchi Atsushi , Kamada Hiroki , Semba Shigeaki , Teraoka Yuji , Mizumoto Takeshi , Tamaru Yuzuru , Hatakeyama Tsuyoshi , Kouno Hirotaka , Shibata Yoshiyuki , Tazuma Sho , Sudo Takeshi , Kuraoka Kazuya , Yoshida Shigeto
Published: December 2024

Rationale:

Biliary intraepithelial neoplasm (BilIN) is characterized by a microscopically identifiable preinvasive neoplasm of the biliary tract. BilIN is rarely diagnosed intentionally and is often detected incidentally in surgical specimens obtained via surgical resection for other types of cancers. Herein, we report a rare case of high-grade BilIN localized in the distal bile duct.

Patient concerns:

A 67-year-old female patient presented with epigastric discomfort approximately 1 month earlier. The patient underwent a blood test on the previous day at a local hospital. Results revealed abnormal liver function. Thus, the patient was referred to our hospital for further examination and treatment.

Diagnoses:

Blood tests showed elevated hepatic and biliary enzyme levels. However, jaundice was not noted, and the patient’s tumor marker levels were normal. Contrast-enhanced computed tomography scan revealed dilatation of the common bile duct and diffuse wall thickening of the bile duct and gallbladder walls. Tissue samples obtained via bile juice cytology showed a poorly differentiated adenocarcinoma. However, the bile duct walls were thick, and the tumor location was unclear. Hence, peroral cholangioscopy was performed. Results revealed an irregular mucosal surface and low papillary protuberances in the lower bile duct. Based on these findings, the patient was diagnosed with distal bile duct carcinoma.

Interventions:

She underwent surgical resection.

Outcomes:

Histological findings showed high-grade BilIN with scattered low-grade BilIN in the surrounding area.

Lessons:

We present a rare case of high-grade BilIN in the lower bile duct that was detected without other types of cancers and diagnosed via peroral cholangioscopy.
Uncovering a lymphoplasmacytic lymphoma/Waldenström macroglobulinemia initially manifesting as dizziness detected through abnormal serum lipemia index: A case report
Authors: Wang Kun , Yi Bin
Published: December 2024

Rationale:

Automated serum index is widely used in biochemical testing, enabling the observation of sample characteristics to a certain extent. The differences between serum lipemia index and sample characteristics can, to a certain extent, facilitate early detection of certain diseases.

Patient concerns:

This is a case report of an elderly patient who was admitted to cardiology outpatient clinic due to dizziness.

Diagnoses:

Basic tests were normal, but hidden lab tests found abnormal serum index. After discussion, further tests showed high immunoglobulin levels.

Interventions:

We performed a lymph node color Doppler ultrasound, blood light chain determination, blood immunization fixed electrophoresis, and urine immunofixation electrophoresis detection. Flow cytometry (lymphoma), FISH (MM + IGH) and MYD88 were detected.

Outcomes:

Consequently, the patient was advised to be transferred to the hematology department and was ultimately diagnosed with Lymphoplasmacytic Lymphoma/Waldenström Macroglobulinemia.

Lessons:

This case was facilitated by the early detection of discrepancies between lipemia indices and sample appearance despite normal examination results. Additionally, close collaboration between clinical laboratory technicians and clinicians facilitated the uncovering of subtle early disease changes, thereby aiding in precise diagnoses.
Expanded phenotypes and pathogenesis of geleophysic dysplasia 3 resulted from a de novo LTBP3 mutation: A case report
Authors: Liang Jie , Han Yu , Tao Huimin , Wang Xuezhen , Zhang Bei , Wu Jiebin , Zhai Jingfang
Published: December 2024

Rationale:

The aim of this study is to investigate the de novo mutation and clinical features of latent transforming growth factor-beta-binding protein 3 (LTBP3) gene-associated geleophysic dysplasia 3, and possible mechanisms of action.

Patient concerns:

A nonconsanguineous couple was recruited for this study due to the presence of intrauterine growth restriction. The pregnant woman and her elder daughter presented with skeletal abnormalities with diabetes. The pregnant woman underwent amniocentesis for cytogenetic analysis and copy number variation sequencing. Furthermore, we employed a combination of pedigree whole exome sequencing and bioinformatics analysis to predict the effects of mutations.

Diagnoses:

The results of karyotyping and copy number variation sequencing were normal. And the whole exome sequencing results indicated that the family carried a de novo mutation c.852_853insAGG (p.L284_P285insR) in the LTBP3 gene (NM_001130144.3) inherited from the mother. The results of bioinformatics prediction demonstrated the mutation influenced the stability of the LTBP3 gene, thereby enhanced the transforming growth factor β signaling pathways.

Interventions:

The couple terminated the pregnancy after comprehensive consideration.

Outcomes:

A de novo non-frameshift mutation of the LTBP3 gene might enhance the transforming growth factor β signaling pathways, thereby leading to geleophysic dysplasia 3.

Lessons:

As a rare multi-system musculoskeletal disorder, geleophysic dysplasia 3 necessitates early prenatal diagnosis and multidisciplinary consultation in order to facilitate further diagnosis and evaluation of the patient and the fetus.
Injection of an allodermal matrix and leukocyte-rich platelet-rich plasma mixture improved the tendon integrity in cases of full-thickness common extensor tendon tears of the elbow: Two case reports
Authors: Yoon Eun-Ji , Lee Jung-Woo , Kim Jong-Ho
Published: December 2024

Rationale:

Lateral epicondylitis, commonly known as tennis elbow, is a chronic condition characterized by tendinosis at the insertion site of the lateral epicondyle. Various treatment methods are available, ranging from conservative to surgical options for refractory lateral epicondylitis. Recently, platelet-rich plasma (PRP) injections have shown effectiveness for treating this condition. This study aimed to evaluate the effectiveness of injecting a mixture of allodermal matrix (ADM) and leukocyte-rich PRP (LRPRP) for tendon regeneration.

Patient concerns:

A 59-year-old man and a 62-year-old man, both with full-thickness tears in the common extensor tendon, presented persistent elbow pain despite undergoing several conservative treatments, including steroid injections, extracorporeal shock wave therapy, physical therapy, and medication previously.

Diagnoses:

The patients were diagnosed with refractory lateral epicondylitis using ultrasonography and magnetic resonance imaging (MRI).

Interventions:

We performed injections of a mixture of ADM and LRPRP into the full-thickness tear of the common extensor tendon.

Outcomes:

One year after the procedure, visual analogue scale pain scores, patient-rated tennis elbow evaluation scores, quick disabilities of the arm, shoulder, and hand scores, and Nirschl scores had all improved significantly from baseline. In case 1, MRI scans obtained at 6 and 12 months postinjection demonstrated improved tendon integrity in full-thickness tear of the common extensor tendon. In case 2, similar improvements were observed on the 6-month postinjection MRI.

Lessons:

Injection of a mixture of ADM and LRPRP at the site of full-thickness tears in the common extensor tendon of the elbow can enhance tendon integrity. This treatment also improves functional status in cases of recalcitrant lateral epicondylitis.
Risk factors for deep surgical site infection following open posterior lumbar fusion: A retrospective case–control study
Authors: Han Xiangdong , An Chao , Wang Qi
Published: December 2024

This study aimed to identify risk factors for deep surgical site infection (SSI) following open posterior lumbar fusion (OPLF). We retrospectively analyzed the clinical data of patients who underwent OPLF between January 2014 and December 2022. Patients were divided into SSI and non-SSI groups according to whether deep SSI occurred following OPLF. Patient’s sex, age, body mass index (BMI), history of diabetes mellitus and smoking, American Society of Anesthesiologists score, surgical segment, surgical time, preoperative albumin level, local use of vancomycin, and cerebrospinal fluid (CSF) leakage were compared between the 2 groups. Univariate and multivariate logistic regression analyses were used to identify risk factors for postoperative deep SSI. The deep SSI rate was 5.0% (63/1256). Among them, age (P < .001), BMI (P = .008), surgical segment (P < .001), surgical time (P < .001), prevalence of diabetes mellitus (P = .036), and CSF leakage (P < .001) were significantly higher in the SSI group, whereas the preoperative albumin level (P < .001) and proportion of local use of vancomycin (P = .046) were significantly lower in the SSI group than those in the non-SSI group. Multivariate analysis indicated that higher age (P = .046, odds ratio [OR]: 1.036, 95% confidence interval [CI]: 1.001–1.073), BMI (P = .038, OR: 1.113, 95% CI: 1.006–1.232), lower preoperative albumin level (P = .041, OR: 0.880, 95% CI: 0.778–0.995), higher surgical segment (P = .004, OR: 2.241, 95% CI: 1.297n3.871), and CSF leakage (P = .046, OR: 2.372, 95% CI: 1.015–5.545) were risk factors, and the local use of vancomycin (P < .001, OR: 0.093, 95% CI: 0.036–0.245) was the protective factor for deep SSI following OPLF. We identified 5 risk factors (older age and BMI, lower preoperative albumin level, higher surgical segment, and CSF leakage) and 1 protective factor (local use of vancomycin powder) for deep SSI following OPLF. To address these risk and protective factors, comprehensive evaluations and recommendations should be provided to patients to reduce SSI rates.
Incidence of acute angle closure in patients with primary angle closure without prophylactic iridotomy during pharmacological mydriasis for cataract surgery
Authors: Kitnarong Naris , Phongsuphan Theerajate , Tanratanavong Tanapath
Published: December 2024

The objective was to study the incidence of acute primary angle closure (acute PAC) during pharmacologic mydriasis before cataract surgery and changes in anterior chamber angle parameters in patients with primary angle closure diseases (PACD) with and without prophylaxis laser peripheral iridotomy (LPI). This was a prospective, comparative study of cataract patients with PACD with and without prophylaxis LPI presented at the Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand during June 2022 to December 2023. The incidence of acute PAC during pharmacologic mydriasis prior to cataract surgery was recorded. Changes in anterior chamber depth (ACD) and anterior chamber angle parameters measured with anterior segment optical coherence tomography before and after cataract surgery were compared between groups using Student t test. There were 195 eyes of 116 patients with a mean age of 70 years enrolled in the study. Eighty patients were women and 36 were men. There were 99 eyes without prophylaxis LPI and 96 eyes with LPI. There was significantly more angle-closure glaucoma in the non-LPI group than in the LPI group. Preoperatively, all anterior chamber angle parameters were significantly greater in the LPI group than in the non-LPI group (P < .001 all parameters), except ACD (P = .83) and anterior chamber width (ACW) (P = .30). All participants underwent uneventful cataract surgery. Postoperatively, all parameters of the anterior chamber angle and ACD increased significantly in both groups. When comparing between groups, all postoperative anterior chamber angle parameters were not significantly different between the groups, but ACD was significantly greater (P = .036) and ACW was lower in the LPI group (P = .008). There was no incidence of acute PAC occurring during pharmacological mydriasis before cataract surgery in both groups. There was no incidence of acute PAC in patients with and without prophylaxis LPI during pharmacological mydriasis in the preoperative preparation for cataract surgery. Eyes without LPI showed significantly lower preoperative anterior chamber angle parameters compared to eyes with previous LPI, but not significantly different postoperatively. The benefits of prophylactic LPI for PACD scheduled for cataract surgery must be further investigated.
Pancreaticopleural fistula causing recurrent bilateral pleural effusions: A case report
Authors: Liu Rixiang , Su Ruolin , Yan Haiyu , Zhu Huangxin , Zhang Nuobei
Published: December 2024

Rationale:

Pancreaticopleural fistula (PPF) is an infrequent etiology of pleural effusion, characterized by nonspecific thoracic symptoms, which often leads to misdiagnosis and subsequent severe complications. Consequently, early diagnosis is crucial for effective management and the prevention of adverse outcomes. This report presents a rare case of PPF causing bilateral pleural effusions, aiming to enhance clinical recognition of this condition.

Patient concerns:

A 51-year-old male with a history of hepatitis B, pulmonary tuberculosis, and chronic pancreatitis presented with recurrent chest tightness, dyspnea, and significant weight loss. He had undergone multiple hospitalizations for pleural effusions with no definitive diagnosis.

Diagnoses:

The patient exhibited a marked increase in amylase levels within the pleural effusion, and magnetic resonance cholangiopancreatography revealed a pancreatic pseudocyst herniating into the mediastinum. Endoscopic retrograde cholangiopancreatography (ERCP) demonstrated mild dilation of the pancreatic duct, leading to a definitive diagnosis of PPF.

Interventions:

Despite initial conservative measures, including thoracentesis, antimicrobial therapy, and somatostatin analogs, the patient continued to experience persistent pleural effusion. Ultimately, ERCP with pancreatic duct stent placement was performed, leading to a significant improvement in the patient’s condition.

Outcomes:

Re-evaluation 2 months postdischarge using a thoracoabdominal computed tomography scan confirmed near-complete resolution of the pancreatic pseudocyst, absence of pleural effusion, and normalization of pancreatic function.

Lessons:

This case underscores the importance of a multidisciplinary approach in diagnosing and managing PPF. It highlights the utility of ERCP in both diagnosing and treating PPF and the need for early recognition to prevent diagnostic delays and improve patient outcomes.
Immunochemotherapy for small cell lung cancer with paraneoplastic Cushing syndrome: A case report and literature review
Authors: Yu Ling , Li Yanlong , Li Caiyu , Qi Xiangjun , Lin Yeding , Li Yuanliang , Chen Hanrui , Lin Lizhu
Published: December 2024

Rationale:

Paraneoplastic Cushing syndrome (PCS) is an adverse prognostic factor for small cell lung cancer (SCLC) patients. Retrospective studies have shown that the median survival of SCLC complicated with PCS was <7 months. No immunochemotherapy has been recorded in the treatment of SCLC with PCS. Previous preclinical and clinical studies have suggested glucocorticoid exposure may affect the efficacy of immunotherapy.

Patient concerns and diagnosis:

A 60-year-old man was admitted for his irritability and palpitation. During hospitalization, a chest computed tomography scan revealed a lobar soft tissue shadow in his left lower lung. He was diagnosed as limited-stage SCLC (T2bN1M0 IIB) with PCS, ultimately.

Interventions and outcome:

The patient received 4 courses of immunochemotherapy of etoposide plus platinum with durvalumab and 1 adjuvant radiotherapy alone in 2022 for his limited-stage SCLC, and underwent 5 courses of immunochemotherapy of irinotecan plus platinum with serplulimab in 2023 for his extensive-stage SCLC. The patient achieved a long survival of 20 months.

Lessons:

The case preliminarily demonstrated the efficacy of immunochemotherapy in the management of SCLC complicated with PCS. The regime of serplulimab with irinotecan-based chemotherapy also indicated its satisfactory efficacy as a second-line treatment for extensive-stage SCLC. Furthermore, the case has highlighted that the management of hypercortisolism, the improvement of myelosuppression, and the prophylaxis against infection were 3 hinges for the continuation of immunochemotherapy and the holistic management of SCLC with PCS.
A case report of adenomyosis-induced spontaneous rupture in an unscarred and unpregnant uterus
Authors: Liu Yan , Hu Xiaoling , Lv Wen , Xu Yingzi
Published: December 2024

Rationale:

Spontaneous uterine rupture, although rare, is a life-threatening obstetric emergency with a high maternal and fetal mortality rate. It can occur without warning, leading to severe complications, including hemorrhage, shock, and fetal demise. The risk factors contributing to uterine rupture are diverse and include a history of uterine surgery (such as cesarean section), trauma to the uterus, abnormal uterine contractions during labor, and underlying conditions like adenomyosis. Identifying and understanding these risk factors are crucial for early detection, timely intervention, and improved outcomes in affected pregnancies.

Patient concerns:

Here, we report an exceptionally rare case of spontaneous uterine rupture triggered by adenomyosis in a 34-year-old unmarried and nulliparous woman with no prior scarring or pregnancy. Physical examination revealed abdominal distension, with the uterine fundus at the level of the umbilicus, exhibiting hardness, tenderness upon palpation, and rebound tenderness. Ultrasonography and computerized tomography scans suggested adenomyosis and uterine rupture. During surgery, a rupture was discovered in the left basal layer of the uterus, with a rupture diameter of approximately 3 cm. Additionally, there were multiple internal endometrial lesions in the uterorectal pouch.

Diagnoses:

Adenomyosis-induced spontaneous uterine rupture.

Interventions:

The procedures performed included excision of adenomyotic lesions, repair of the uterine rupture, and electrocoagulation of endometriotic lesions in the pelvic cavity.

Outcomes:

At the 1-month post-surgery follow-up examination, the patient showed good recovery, with no signs of complications. She was able to resume normal daily activities without difficulty. The surgical site was healing well, with no signs of infection or abnormal scarring. Ultrasound and clinical assessments confirmed the resolution of pelvic fluid accumulation, and uterine function appeared to be intact. The patient was advised to continue regular follow-up visits to monitor her recovery and ensure long-term well-being.

Lessons:

First, uterine rupture caused by adenomyosis in a nonpregnant, scarless uterus is extremely rare but still possible. When patients with severe adenomyosis present with abdominal pain and pelvic fluid, obstetricians and gynecologists should consider the possibility of uterine rupture. Second, ultrasound examination can quickly and accurately diagnose both adenomyosis and uterine rupture.
The assessment of the relationship between the development of cardiovascular diseases and SCUBE-1 level in individuals exposed to loud noise
Authors: Fedai Halil , Toprak Kenan , Cetin Mustafa , Elmas Ali Nizami , Tosun Veysel , Demirbag Recep
Published: December 2024

Development of industry in the modern world, the number of individuals working in noisy environments is increasing with each passing day. Noise causes an increase in the incidence of cardioembolic events, yet the relevant underlying pathophysiology remains unclear. In this study, we aimed to investigate the relationship between signal peptide and complement C1r/C1s, Uegf, and Bmp1-epidermal growth factor domain-containing protein-1 (SCUBE-1) in the pathophysiology of cardioembolic events in individuals exposed to noisy environments. The study sample consisted of 99 textile factory workers who were exposed to loud noise and 56 volunteer office workers who were not exposed to loud noise. Hemogram values, basic biochemical parameters, and SCUBE-1 levels were measured for all participants. When the SCUBE-1 level of the group exposed to loud noise was compared with the control group, SCUBE-1 level was found to be significantly higher in the group exposed to loud noise (P < .001). The group exposed to loud noise was divided into 2 subgroups based on the duration of exposure to loud noise. The SCUBE-1 levels were significantly higher in the group exposed to loud noise for >10 years than in the group exposed to loud noise for <10 years (P < .001). In this study, we found that noise significantly increased the serum SCUBE-1 levels. Noise was also an independent predictor of serum signal peptide-complement C1r/C1s, Uegf, and Bmp1-epidermal growth factor domain-containing protein-1 levels. Therefore, it should be noted that individuals exposed to noise may be more prone to embolic events.
Living with sickle cell in Uganda: A comprehensive perspective on challenges, coping strategies, and health interventions
Authors: Obeagu Emmanuel Ifeanyi , Obeagu Getrude Uzoma
Published: December 2024

Sickle cell anemia (SCA) is a hereditary blood disorder with profound implications for affected individuals, particularly in resource-limited settings such as Uganda. This review explores the multifaceted aspects of SCA in Uganda, focusing on epidemiology, challenges faced by individuals, coping strategies, healthcare disparities, and community support. The study incorporates a thorough examination of the genetic landscape, prevalence, and the impact of SCA on the quality of life in Uganda. Coping strategies and resilience play a pivotal role in mitigating the impact of SCA on affected individuals. This review critically evaluates the various coping mechanisms employed by individuals in Uganda and the resilience demonstrated in the face of chronic illness. It explores the psychological, social, and cultural dimensions of coping and resilience, shedding light on adaptive strategies that contribute to improved quality of life. This article aims to contribute valuable insights into the specific challenges faced by individuals with SCA in Uganda, offering a foundation for targeted interventions, improved healthcare policies, and increased awareness within both the medical community and the broader society.
Assessing the timing of amniotomy after Foley balloon catheter removal in women with labor induction: The role of Bishop score: An observational study
Authors: He Yun , Tao Yu , Ni Qin , Li Zhuoyue , Huang Ying , Liu Lanhua
Published: December 2024

The timing of amniotomy after the Foley balloon catheter removal is crucial for successful labor induction. This study aimed to assess the effects of the Bishop score on the timing of amniotomy in patients undergoing labor induction after the Foley balloon catheter removal. This was a retrospective cohort study based on electronic medical records. We performed a Chester sampling in patients with singleton-term pregnancies who initially underwent cervical ripening using a Foley balloon catheter at the Obstetrical Department of Taixing People’s Hospital from January 2023 to July 2023. A total of 889 patients were admitted to the study. After excluding 330 patients according to the exclusion criteria, 103 patients were included. Following the Foley balloon removal, an amniotomy with a Bishop score < 6 was defined as an amniotomy with an unfavorable Bishop score (n = 62), and an amniotomy with a Bishop score ≥ 6 was defined as an amniotomy with a favorable Bishop score (n = 41). The primary outcome was the incidence of cesarean delivery and the interval from induction to delivery. The secondary outcomes included the incidence of operative vaginal delivery, intrapartum hemorrhage, postpartum hemorrhage, infection, thrombosis, and neonatal outcomes. All statistical comparisons were analyzed by GraphPad Prism 9. All data were presented as the mean ± SD or percentage. Statistical analysis comparing both groups was performed using the t test, chi-square test, or Fisher exact test where appropriate. The baseline data, operative vaginal delivery rate, postpartum hemorrhage rate, infection rate, thrombosis rate, intrapartum and postpartum hemorrhage volume, and neonatal outcomes showed no significant differences between the 2 groups. However, the cesarean delivery rate, interval from induction to delivery, and hemoglobin postdelivery decline were significantly decreased in the favorable Bishop score group. Amniotomy with a favorable Bishop score after Foley balloon catheter removal is linked to lower cesarean delivery rates, shorter induction-to-delivery intervals, and less postdelivery hemoglobin decline without increasing adverse maternal or neonatal outcomes.
Inflammatory proteins and vestibular neuronitis: A Mendelian randomization study
Authors: He Yu , Guo Tao , Dai Tianrong , Zhou Bin , Xie Hui
Published: December 2024

Previous studies have highlighted the correlation between inflammatory responses and vestibular neuritis (VN). The aim of Mendelian randomization was to assess the causal associations between 91 inflammatory proteins and vestibular neuritis comprehensively. By leveraging publicly accessible genetic datasets, we probed whether 91 inflammatory proteins serve as upstream determinants of vestibular neuritis. We conducted a comprehensive sensitivity analysis to assess the robustness, heterogeneity, and polygenicity of our findings. Three inflammatory proteins were found to exert a significant causal effect on the VN: eotaxin levels are associated with a reduced risk of VN (inverse variance weighting [IVW]: odds ratio [OR] = 0.7113, 95% confidence intervals [CI] = 0.5199–0.9731, P = .0331). Similarly, the measurement of monocyte chemotactic protein-2 is linked to a decreased risk of VN (IVW: OR = 0.8535, 95% CI = 0.7328–0.9942, P = .0418). Conversely, an increase in the level of the T-cell surface glycoprotein CD5 is correlated with an increased risk of VN (IVW: OR = 1.3969, 95% CI = 1.0095–1.9331, P = .0437). This study suggested that eotaxin, monocyte chemotactic protein-2, and the T-cell surface glycoprotein CD5 may play crucial roles in the pathogenesis of VN. The potential use of these inflammatory proteins for diagnosing VN or as therapeutic targets has significant clinical implications.
Evaluating private hospital performance from intellectual capital and digital perspective
Authors: Chen Xiaoming , Shan Xin , Xu Jian
Published: December 2024

The objective of this study is to examine the impact of intellectual capital (IC) and its elements on private hospital performance. In addition, this study explores the moderating role of digital transformation in the relationship between IC and its elements and private hospital performance. This study selects 13 private listed hospitals from 2012 to 2022 as the sample. IC is assessed by the modified value added intellectual coefficient model, hospital performance is measured by financial performance and sustainable growth, and digital transformation is measured using text analysis. Multiple regression analysis is used to do the analyses. The results show that IC and only one element (structural capital) have a positive impact on private hospital performance, while human and relational capitals have no significant impact. Surprisingly, digital transformation negatively moderates the relationship between IC and private hospital performance. This study underscores the pivotal role of IC in enhancing the performance of private hospitals, and hospital managers should accelerate hospital digital transformation in the digital era.
Surgical management of testicular cancer with limited retroperitoneal disease
Authors: Sigg Silvan , Rothermundt Christian , Fankhauser Christian Daniel
Published: December 2024

Purpose of review

Chemotherapy offers excellent long-term survival rates for men with clinical stage II germ cell tumours. However, in this predominantly younger population, chemotherapy is associated with long-term adverse effects. Primary retroperitoneal lymph node dissection (RPLND) may serve as an alternative treatment option, preserving oncological safety while potentially reducing adverse effects in men with limited retroperitoneal disease.

Recent findings

The rate of negative surgical specimens (pN0) in primary RPLND series varies between 4% and 16% in seminoma and 12–29% in nonseminoma, respectively. This suggests that early restaging, novel biomarkers, and/or percutaneous biopsies should be considered to minimize overtreatment. In stage II seminoma, three prospective RPLND series with follow-up periods ranging from 22 to 51 months report recurrence rates between 6% and 30%. In contrast, only retrospective data are available for stage II nonseminoma, with follow-up periods and recurrence rates yet to be fully defined. Following primary RPLND with confirmed viable cancer, adjuvant chemotherapy reduces recurrence risk. In cases of recurrence after primary RPLND, first-line chemotherapy remains a highly effective salvage option. Ongoing research is needed to identify risk factors for contralateral retroperitoneal disease to refine surgical templates and to determine predictors of recurrence, allowing for more personalized decisions regarding the use of adjuvant chemotherapy and follow-up strategies.

Men with clinical stage II germ cell tumours may benefit from RPLND due to its lower risk of long-term side effects. Chemotherapy is an effective salvage treatment if needed. Although RPLND is a safe and promising option, further studies are required to better understand relapse risks and to tailor treatment plans based on individual patient factors.
Haemophilus influenzae-induced epididymitis: a rare case report
Authors: Patel Dev , Walker Luke , Patel Nalini , Patel Tirath , Kaithamanakallam Rajesh Perumbilavil
Published: December 2024

Introduction and importance:

Epididymitis is a common urological condition typically caused by Chlamydia trachomatis or Neisseria gonorrhoeae, with rare complications like abscess formation. Haemophilus influenzae, usually linked to respiratory infections, is an uncommon cause. This report discusses a 33-year-old male with H. influenzae epididymitis, bacteremia, and a positive NAAT for Chlamydia, presenting a rare and complex clinical scenario. His history of vasectomy adds further intricacy to the case. This highlights the importance of recognizing atypical pathogens, conducting thorough diagnostic evaluations, and tailoring management strategies for unusual presentations of epididymitis.

Case presentation:

A 33-year-old male with GERD and a history of vasectomy presented with 1 day of fevers, chills, and worsening left-sided scrotal pain. Examination showed localized scrotal tenderness and a temperature of 100.9°F. Blood cultures revealed H. influenzae, and NAAT confirmed Chlamydia with negative Gonorrhea testing. Ultrasound suggested epididymitis with a possible abscess, while CT showed scrotal edema without a drainable collection. Follow-up imaging maintained concerns for an abscess. Treated with Rocephin and Doxycycline, the patient showed clinical improvement, with plans for serial imaging to monitor resolution and ensure full recovery.

Clinical discussion:

This case highlights the challenges of managing epididymitis caused by the atypical pathogen H. influenzae. Rare in genitourinary infections, its detection raises questions about pathogenesis, possibly linked to the patient’s vasectomy altering local immunity. Co-infection with Chlamydia may have exacerbated localized inflammation. Serial imaging, particularly ultrasound, proved critical in identifying an abscess overlooked by CT. Management involved targeted antibiotics, careful monitoring of blood cultures, and follow-up imaging to prevent complications. The case underscores the importance of a broad differential diagnosis and tailored treatment in managing rare presentations of epididymitis.

Conclusion:

This report highlights a rare case of H. influenzae-induced epididymitis with bacteremia and co-existing Chlamydia infection in a post-vasectomy patient. It underscores the importance of recognizing uncommon pathogens, especially in patients with unique risk factors like vasectomy. Serial imaging was crucial for identifying complications such as abscess formation. Early diagnosis and targeted therapy were essential in preventing serious outcomes like chronic inflammation or abscess rupture. This case contributes to the limited literature on atypical epididymitis, emphasizing the need for a multidisciplinary approach in managing complex infections effectively.
Short-term mortality and readmission rate prediction by the sequential organ failure assessment score in acute decompensated heart failure
Authors: Hoang Van , Tran Van Dong , Tran Thanh Hoa , Nguyen Van Dan , Nguyen Van Thuc , Vu Quynh Nga , Tran Tra Giang
Published: December 2024

Background:

Data on the use of sequential organ failure assessment (SOFA) in patients with cardiovascular disease are increasing. Several studies demonstrated that the SOFA score can identify short-term mortality in patients with acute decompensated heart failure (ADHF). This study was conducted to determine the prognostic value of the admission SOFA score in patients hospitalized for ADHF and to assess its ability in predicting the 30-day readmission rate.

Materials and methods:

This study was conducted from July 2022 to August 2023 at our institution. A total of 216 patients were included in the study, and the SOFA score was calculated for all patients.

Results:

The average SOFA score is 3.14 ± 2.67, of which SOFA scores of ≤1, 2–3, and ≥4 account for 34.3%, 27.8%, and 37.9% of the total score, respectively. During the 30-day follow-up period, there were 22 cases of death from all causes (10.2%), of which in-hospital mortality accounted for 9.7%. Patients with all-cause mortality had higher SOFA scores than the survivors (7.32 ± 2.93 and 2.66 ± 2.12, respectively). The area under the receiver operating characteristic curve (AUC) for the SOFA score is 0.897 [95% confidence interval (CI) = 0.830–0.964] for 30-day mortality. The SOFA score was also compared with other validated risk scores, namely, the Get With the Guidelines-Heart Failure (GWTG-HF) risk score and the Acute Decompensated Heart Failure National Registry (ADHERE) score. In this study cohort, the SOFA score demonstrates superior predictive accuracy to the GWTG-HF and ADHERE scores [the AUCs when predicting 30-day mortality are 0.769 (95% CI = 0.676–0.862) and 0.789 (95% CI = 0.705–0.873), respectively].

Conclusion:

The SOFA score might be used to screen high-risk patients for optimization strategy in the treatment of ADHF.
A Randomized Controlled Feasibility Study to Evaluate the Online Delivery of Storytelling Through Music With Oncology Nurses
Authors: Phillips Carolyn S. , Morris Sue E. , Woods Heather , Mazzola Emanuele , Xiong Niya , Young Cara , Stuifbergen Alexa , Hammer Marilyn , Ligibel Jennifer
Published: December 2024

Background

Oncology nurses frequently contend with intense work-related emotions stemming from their roles, which include bearing witness to suffering, managing end-of-life care, and navigating ethical dilemmas. These emotional challenges can lead to burnout, compassion fatigue, and overall psychological distress.

Objective

To determine the feasibility, acceptability, and preliminary effect of implementing Storytelling Through Music (STM) online with oncology nurses.

Intervention/Methods

This study (trial registration: NCT04775524) was a 2-group, randomized wait-list controlled trial, utilizing quantitative and qualitative methods. STM is a 6-week intervention that combines storytelling, reflective writing, songwriting, and psychoeducation. Data were collected in both groups at 3 timepoints and analyzed with descriptive statistics, conventional content analysis, and nonparametric tests.

Results

The oncology nurses (n = 24) were primarily female (96%) and White (79%), with an average of 15.98 (range, 2-51) years of nursing experience. All STM participants completed the intervention and found it acceptable. STM participants had greater improvements in burnout, secondary traumatic stress, anxiety, depression, and posttraumatic growth.

Conclusion

The online delivery of STM proved feasible and acceptable, demonstrating potential scalability across diverse geographic locations, and showed promise in reducing psychological distress and burnout. Future research should consider larger-scale studies with diverse participant demographics and settings to validate these findings further.

Implications for Practice

Results highlight the potential value of integrating expressive arts into comprehensive support programs for nurses. By implementing interventions that acknowledge and support the emotional demands of their work, healthcare organizations can better equip oncology nurses to navigate the complexities of their roles while maintaining their well-being.
Improving quality of life for patients with systemic sclerosis
Authors: Armstrong Faith
Published: December 2024

Systemic sclerosis is often misdiagnosed because its symptoms are similar to those of other autoimmune diseases. Nurses must have a comprehensive understanding of the disease process and interventions so they can positively impact patient outcomes.
Trauma-informed care: The nurse's role in recognizing and responding to pediatric sexual abuse
Authors: Betters Erin , Driscoll Brittany , Kapps Amanda , McCracken Angela , Murphy Danielle
Published: December 2024

Trauma-informed care is essential in pediatric nursing, particularly for addressing the needs of children who have experienced sexual abuse. By fostering therapeutic relationships and maintaining a supportive environment, nurses can help promote healing while advocating for specialized training in trauma-informed care.
Gastric cancer
Authors: Coffman Tammie J.
Published: December 2024

Patients with gastric cancer experience symptoms that impact adequate nutritional intake. Delayed diagnosis may result in advanced disease. Surgery, chemotherapy, biologic therapy, and radiotherapy comprise interventions. This article discusses gastric cancer incidence and risks, treatment approaches, and nursing management of patients with gastric cancer, including advanced care planning for patients with terminal diagnoses.
When Auditing Is Not Enough: Analysis of a Central Line Bundle Audit Program
Authors: Linke Christopher A. , Hodges Paul , Edgerton Megan E. , Bjorgaard Johannah D.
Published: December 2024

Background:

Bundled interventions and auditing have been recommended to reduce central line-associated bloodstream infection (CLABSI) events at acute care hospitals. We review the outcomes of a bundle audit program at an adult and pediatric academic medical center from April 1, 2021, to May 31, 2022.

Objectives:

To analyze the impact on CLABSI rates following the introduction of a central line maintenance bundle audit process.

Methods:

All audit survey data, CLABSI event rates, and line days were collected. Statistical relationships were evaluated for CLABSI bundle performance with CLABSI rates and audit volume with CLABSI rates. Analyses were conducted at the hospital and unit level.

Result:

No correlation is found between CLABSI rates and audit performance at the hospital level (adult units, P = .619, r-sq = 2.13%; peds/NICU, P = .825, r-sq = 0.43%) or at the unit level (n = 7; P = .8-.896, r-sq = 0.15%-18.2%). There was no correlation in CLABSI rates when reviewing performance by audit volume at the hospital level (adult, P = .65, r-sq = 1.7%; peds/NICU, P = .677, r-sq = 1.5%) or at the unit level (n = 7; P = .25-.8, r-sq = 1.2%-8.5%). By contrast, a single unit that did not participate in the audit program during the sample period reported a lower CLABSI rate than comparable participating units (P = .008).

Conclusion:

During the sample period, there was no relationship found between this CLABSI bundle audit program and improvement in CLABSI performance.