bluuebunny/crossref_metadata_2025 huggingface dataset:
Which Surgical Approach Provides Maximum Visualization and Access for Open Reduction and Internal Fixation of Femoral Head Fractures?
Authors: Singh Keerat , Weitlich John D. , Zitsch Bradford P. , Schweser Kyle M. , Cook James L. , Crist Brett D.
Published: January 2022

Objectives:

Femoral head fracture open reduction and internal fixation (ORIF) requires adequate surgical access and visualization. The purpose of this study was to objectively characterize femoral head access associated with commonly used surgical approaches. Our hypothesis was that a surgical hip dislocation (SHD) provides the greatest visualization and access to the femoral head.

Methods:

Ten fresh-frozen cadaveric whole-pelvis specimens (n = 20 hips) were used to compare 4 surgical approaches to the femoral head (n = 5 hips per approach): SHD, Smith-Petersen (with and without rectus release), and Hueter. After surgical exposure, standardized and calibrated digital images were captured and analyzed to determine the percent-area visualized. Three independent investigators assessed each specimen to determine surgical visualization and access to the following femoral head anatomic quadrants: anteromedial, anterolateral, posteromedial, and posterolateral. Data were analyzed for significant (P < 0.05) differences using analysis of variance (ANOVA) and Fisher exact tests.

Results:

The Hueter approach provided the lowest calculated % visualization. For surgeon visualization, SHD demonstrated a significantly (P < 0.001) higher proportion of visualized anatomic landmarks compared with all other approaches. SHD provided significantly (P < 0.049) more access to the femoral head quadrants compared with all other approaches. The Hueter approach had significantly (P = 0.004) lower surgeon access compared with the Smith-Petersen with release.

Conclusions:

SHD provided superior visualization and access to clinically relevant femoral head anatomy compared with the Smith-Petersen with or without rectus release and Hueter approaches.
A Novel Operative Approach to the Treatment of Posterior Malleolus Fractures
Authors: Fahey Eoin J. , Russell Shane P. , Ni Fhoghlu Cliodhna , Curran Niamh , Bayer Thomas , McKenna Johnny
Published: January 2022

Background:

Posterior malleolar fractures are a common subtype of ankle fractures. The management of these fractures remains controversial, though there has been a move toward more operative management in recent years. The operative approach most commonly used to treat these fractures is posterolateral. This method has several drawbacks including the amount of retraction required on already traumatized skin, the risk of damaging the posterior interosseous tibio-fibular ligament, and the difficulty visualizing both the distal fibular and posterior malleolar fractures. We describe a novel operative approach for visualizing and treating these fractures and report on our results.

Method:

This was a retrospective review of prospectively collected data. Data from 2 orthopedic trauma units where this technique is used was analyzed. Demographic and radiographic data was recorded, and a chart review was conducted to identify any noted complications.

Results:

On analysis of medical records, 50 patients were identified who had been operated on using this technique. When classified using the Bartonicek classification, 46% were type II, 36% were type III and 18% were type IV. Analysis of final x-rays showed that there was no incidence of implant failure or loss of reduction in this cohort. There were 2 complications recorded: 1 early wound dehiscence and 1 late infection giving an overall complication rate of 4%.

Discussion:

The technique described in this paper is a novel approach, which we feel offers several benefits. We demonstrated that this technique is safe with an incidence of early complications lower than figures commonly quoted for standard care of this cohort of patients.

Level of Evidence:

Level IV—case series
VE-CAM-S: Visual EEG-Based Grading of Delirium Severity and Associations With Clinical Outcomes
Authors: Tesh Ryan A. , Sun Haoqi , Jing Jin , Westmeijer Mike , Neelagiri Anudeepthi , Rajan Subapriya , Krishnamurthy Parimala V. , Sikka Pooja , Quadri Syed A. , Leone Michael J. , Paixao Luis , Panneerselvam Ezhil , Eckhardt Christine , Struck Aaron F. , Kaplan Peter W. , Akeju Oluwaseun , Jones Daniel , Kimchi Eyal Y. , Westover M. Brandon
Published: January 2022

OBJECTIVES:

To develop a physiologic grading system for the severity of acute encephalopathy manifesting as delirium or coma, based on EEG, and to investigate its association with clinical outcomes.

DESIGN:

This prospective, single-center, observational cohort study was conducted from August 2015 to December 2016 and October 2018 to December 2019.

SETTING:

Academic medical center, all inpatient wards.

PATIENTS/SUBJECTS:

Adult inpatients undergoing a clinical EEG recording; excluded if deaf, severely aphasic, developmentally delayed, non-English speaking (if noncomatose), or if goals of care focused primarily on comfort measures. Four-hundred six subjects were assessed; two were excluded due to technical EEG difficulties.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

A machine learning model, with visually coded EEG features as inputs, was developed to produce scores that correlate with behavioral assessments of delirium severity (Confusion Assessment Method-Severity [CAM-S] Long Form [LF] scores) or coma; evaluated using Spearman R correlation; area under the receiver operating characteristic curve (AUC); and calibration curves. Associations of Visual EEG Confusion Assessment Method Severity (VE-CAM-S) were measured for three outcomes: functional status at discharge (via Glasgow Outcome Score [GOS]), inhospital mortality, and 3-month mortality. Four-hundred four subjects were analyzed (mean [sd] age, 59.8 yr [17.6 yr]; 232 [57%] male; 320 [79%] White; 339 [84%] non-Hispanic); 132 (33%) without delirium or coma, 143 (35%) with delirium, and 129 (32%) with coma. VE-CAM-S scores correlated strongly with CAM-S scores (Spearman correlation 0.67 [0.62–0.73]; p < 0.001) and showed excellent discrimination between levels of delirium (CAM-S LF = 0 vs ≥ 4, AUC 0.85 [0.78–0.92], calibration slope of 1.04 [0.87–1.19] for CAM-S LF ≤ 4 vs ≥ 5). VE-CAM-S scores were strongly associated with important clinical outcomes including inhospital mortality (AUC 0.79 [0.72–0.84]), 3-month mortality (AUC 0.78 [0.71–0.83]), and GOS at discharge (0.76 [0.69–0.82]).

CONCLUSIONS:

VE-CAM-S is a physiologic grading scale for the severity of symptoms in the setting of delirium and coma, based on visually assessed electroencephalography features. VE-CAM-S scores are strongly associated with clinical outcomes.
Association of Nonrecovery of Kidney Function After Pediatric Acute Kidney Injury With 5-Year Kidney and Nonkidney Outcomes
Authors: Ulrich Emma H. , Hessey Erin , Perreault Sylvie , Dorais Marc , Jouvet Philippe , Phan Veronique , Zappitelli Michael
Published: January 2022

IMPORTANCE:

Acute kidney injury is common in critically ill children, but the long-term outcomes are not well defined.

OBJECTIVES:

Evaluated whether nonrecovery of kidney function, following acute kidney injury, was associated with postdischarge mortality, healthcare utilization, and chronic kidney disease.

DESIGN:

Retrospective, two-center, observational study.

SETTING:

Two ICUs at tertiary children’s hospitals in Montreal, QC.

PARTICIPANTS:

Pediatric patients (age ≤ 18 yr) with index admission to intensive care between January 1, 2003, and March 31, 2005. Children were excluded if they 1) died during admission, 2) did not have serum creatinine or urine output measured, 3) did not develop acute kidney injury, 4) could not be linked to administrative health data, and 5) (for chronic kidney disease outcome) had pre-existing renal disease by chart review, baseline estimated glomerular filtration rate measurement, or administrative health data codes.

MAIN OUTCOMES AND MEASURES:

Three-hundred seventy-eight patients’ data were included for long-term mortality and healthcare utilization outcomes; 316 patients for long-term chronic kidney disease outcome. Outcomes were defined using provincial administrative healthcare data diagnosis, procedure, and billing codes.

MAIN RESULTS:

Nonrecovery of kidney function, defined as serum creatinine greater than or equal to 1.5× baseline at ICU discharge, occurred in 51 patients (13%). Nonrecovery of kidney function was not associated with long-term mortality (at 5–7 yr following hospital discharge), increased hospitalizations or emergency department visits (at 30-days, 1-year, and 5-yr follow-up), or increased physician visits (at 1- and 5-yr follow-up). Nonrecovery was associated with increased 30-day physician visits (adjusted relative risk, 1.40; 95% CI, 1.13–1.73) and chronic kidney disease diagnosis within 5 years of discharge (adjusted hazard ratio, 4.92, 95% CI, 1.77–13.70).

CONCLUSIONS AND RELEVANCE:

Nonrecovery of kidney function following an episode of acute kidney injury in critically ill children is associated with nearly five-fold increased risk for long-term chronic kidney disease. Acute kidney injury nonrecovery may be a useful marker to identify patients that are particularly important to follow-up post discharge for chronic kidney disease detection.
Systolic Strain by Speckle-Tracking Echocardiography Is a Feasible and Sensitive Measure of Right Ventricular Dysfunction in Acute Respiratory Failure Patients on Mechanical Ventilation
Authors: Simmons James , Haines Philip , Extein Jonathan , Bashir Zubair , Aliotta Jason , Ventetuolo Corey E.
Published: January 2022

OBJECTIVES:

Right ventricular (RV) dysfunction is common in acute respiratory failure and associated with worse outcomes, but it can be difficult to detect in the ICU setting. Speckle-tracking echocardiography (STE) can identify early changes in RV systolic function and be quantified as systolic strain. We measured the feasibility of RV global longitudinal systolic strain (RV GLS) in respiratory failure patients and its association with clinical outcomes.

DESIGN:

Retrospective cohort.

SETTING:

Two tertiary hospital medical ICUs in Providence, RI, from March 2015 to January 2018.

PATIENTS:

Two hundred twenty-three patients with acute respiratory failure requiring mechanical ventilation (MV) with available echocardiograms.

MEASUREMENTS AND MAIN RESULTS:

Clinical data were extracted from medical records. RV GLS was measured via STE (TOMTEC, Chicago, IL), along with standard echocardiographic measurements by two independent readers blinded to outcomes. The average age was 65 years (range, 21–90 yr), 121 (54%) were men, and the most common etiology of respiratory failure was pneumonia (n = 83, 37%). The average RV GLS was –16% (sd ± 7). The intraobserver correlation coefficients were 0.78 and 0.94, whereas the interobserver correlation coefficient was 0.61 for RV GLS. In the majority of echocardiograms (n = 178, 80%), all wall segments were tracked appropriately by operator visual inspection. Worse RV GLS was associated with greater hospital mortality (odds ratio, 1.03; 95% CI, 1.00–1.07; p = 0.03), such that every 1% decrement in RV GLS was associated with up to a 7% increase in the risk of death. RV GLS was 90% sensitive for the detection of RV dysfunction compared with tricuspid annular plane systolic excursion.

CONCLUSIONS:

The measurement of RV GLS by STE in subjects on MV is feasible, reproducible, and sensitive for the detection of RV dysfunction. RV GLS may predict poor outcomes in acute respiratory failure.
Long-Term Beta-Blocker Therapy After Myocardial Infarction Without Heart Failure in the Reperfusion Era—Systemic Review and Meta-analysis
Authors: Kim Youngju , Byun Sungwook , Kim Hee-Yeol , Kim Dong-Bin
Published: January 2022

Beta-blockers are recommended as a standard treatment for patients who experience a myocardial infarction (MI). However, the evidence supporting this recommendation is based on the prereperfusion era data. This review aims to evaluate the effectiveness of long-term (≥1 year) beta-blocker therapy in post-MI patients without clinical heart failure (HF) in the reperfusion era. We included observational cohort studies, which compared at least 1 year use of beta-blockers to no beta-blockers in patients with an acute MI, but without HF. The clinical endpoint considered was all-cause mortality, except for cardiovascular death in one study. Five cohort studies and 217,532 patients were included. One study demonstrated a reduction in all-cause mortality with beta-blockers, whereas, in 4 studies, there was no difference in the death rate. The pooled estimate by random effect showed that beta-blocker treatment does not reduce mortality (odds ratio 0.800, 95% confidence interval 0.559–1.145) with high heterogeneity (I2 = 94%). This meta-analysis shows that the use of oral beta-blockers for 1 year or more does not reduce the mortality of MI patients without HF. Large randomized trials need to evaluate beta-blocker discontinuation after an acute MI.
Are High- or Low-dose SGLT2 Inhibitors Associated With Cardiovascular and Respiratory Adverse Events? A Meta-analysis
Authors: Zou Hai-Tao , Yang Guo-Huan , Cai Yu-Jun , Chen Hao , Zheng Xiao-Qin , Hu Rong
Published: January 2022

The association between high-dose or low-dose sodium-glucose cotransporter 2 (SGLT2) inhibitors and various cardiovascular and respiratory serious adverse events (SAE) is unclear. Our meta-analysis aimed to define the association between high-dose or low-dose SGLT2 inhibitors and 86 kinds of cardiovascular SAE and 58 kinds of respiratory SAE. We included large cardiorenal outcome trials of SGLT2 inhibitors. Meta-analysis was conducted and stratified by the dose of SGLT2 inhibitors (high dose or low dose) to synthesize risk ratio (RR) and 95% confidence interval (CI). We included 9 trials. Compared with placebo, SGLT2 inhibitors used at high dose or low dose were associated with the decreased risks of 6 kinds of cardiovascular SAE [eg, bradycardia (RR, 0.60; 95% CI, 0.41–0.89), atrial fibrillation (RR, 0.79; 95% CI, 0.69–0.92), and hypertensive emergency (RR, 0.34; 95% CI, 0.15–0.78)] and 6 kinds of respiratory SAE [eg, asthma (RR, 0.59; 95% CI, 0.37–0.93), chronic obstructive pulmonary disease (RR 0.77, 95% CI 0.62–0.96), and sleep apnea syndrome (RR 0.37, 95% CI 0.17–0.81)]. SGLT2 inhibitors used at high dose or low dose did not show significant associations with 132 other cardiopulmonary SAE. For any outcome of interest, the subgroup difference according to the dose of SGLT2 inhibitors was not significant (P
subgroup > 0.05). SGLT2 inhibitors used at whether high dose or low dose are associated with the decreased risks of 12 cardiopulmonary disorders (eg, bradycardia, atrial fibrillation, hypertensive emergency, asthma, chronic obstructive pulmonary disease, and sleep apnea syndrome). These findings may suggest the potential efficacy of high- or low-dose SGLT2 inhibitors for the prevention and treatment of these cardiopulmonary disorders.
Admission patterns and outcome in a pediatric intensive care unit of the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia: a retrospective study
Authors: Ahmed Seid A.
Published: January 2022

Background:

Intensive care unit is special unit primarily concerned with the care of patients with critical illness. Caring of critically ill children remains one of the most demanding and challenging aspects of the field of pediatrics.

Methods:

A retrospective study design was conducted. All children from 1 month to 14 years of age who were admitted to the pediatric intensive care unit from September 2017 to September 2018 were included. Descriptive statistics was used to describe different characters.

Results:

A total of 305 children were admitted over the study period. Most of patients were males (57.4%) with a male-to-female ratio of 1.3:1. The overall mortality rate was 23.6%. The majority of the children were in the age range of 10–14 years (27.9%). Out of all patients, 23.6% were neurological cases and from these, 22.2% of patients were died. The highest percentages (12.8%) of neurological patients were admitted because of meningitis. Respiratory (19%) and cardiac (11.8%) cases were the second and the third causes of admission, respectively.

Conclusion:

The leading cause of admission and death was neurological causes. Respiratory and cardiac causes were also significant. The mortality rate was very high. Further interventions are recommended to reduce mortality and increase quality of care.
Lipid Keratopathy Management With Therapeutic Scleral Lens Wear
Authors: Gelles John D. , Hillier Kyla E. , Krisa Sydney , Greenstein Steven A. , Hersh Peter S.
Published: January 2022

Purpose:

To report on the use of scleral lens therapy for a patient with lipid keratopathy secondary to rigid gas permeable contact lens wear and ocular surface disease.

Methods:

Case report and literature review.

Results:

A 40-year-old man with a history of keratoconus and rigid gas permeable contact lens wear, resulting in corneal neovascularization and lipid keratopathy. The patient reported to our clinic with central lipid keratopathy secondary to rigid gas permeable lens wear and ocular surface disease. Given the density, central location, and subsequent visual limitations induced by lipid deposition and topographical irregularity, penetrating keratoplasty and scleral contact lens wear were discussed as possible treatment options. In this case, scleral lens wear provided both visual improvement and resolution of lipid keratopathy. After 3 years, the patient has remained stable, with significant visual improvement and near-complete resolution of lipid keratopathy.

Conclusions:

This case illustrates the use of scleral lens wear in the therapeutic management of lipid keratopathy secondary to rigid gas permeable lens wear and ocular surface disease. For patients limited by lipid keratopathy and topographical irregularity, scleral lens wear may be used to achieve both visual and therapeutic outcomes.
Physical Activity, Sedentary Time, and Cardiometabolic Health in Heavy Goods Vehicle Drivers
Authors: Ruettger Katharina , Varela-Mato Veronica , Chen Yu-Ling , Edwardson Charlotte L. , Guest Amber , Gilson Nicholas D. , Gray Laura J. , Paine Nicola J. , Sherry Aron P. , Sayyah Mohsen , Yates Thomas , King James A. , Clemes Stacy A.
Published: January 2022

Objective:

: Physical inactivity, prolonged sitting, and unhealthy dietary habits are common in Heavy Goods Vehicle (HGV) drivers. These factors increase risk of long-term health conditions

Methods:

: 329 HGV drivers across 25 UK depots completed a health assessment, including questionnaire completion, and objectively measured anthropometrics, blood biomarkers, physical activity (PA), and sedentary behavior.

Results:

: The sample demonstrated a high-risk cardiometabolic health profile. 88.1% were overweight or had obesity, and 11.9% had pre-diabetes or diabetes. 28.3% had hypertension, 83.6% had clinically elevated circulating low-density lipoprotein-cholesterol concentrations (>2mmol/l), and 66.6% had high total cholesterol levels (>4mmol/l). On workdays drivers accumulated 12 hours/day of sitting, 1.7 hours/day of light PA, and 9.8 mins/day of moderate-to-vigorous PA. Associations between light PA and cardiometabolic markers were observed.

Conclusion:

This sample presents high levels of inactivity, overweight, and obesity, and unhealthy cardiometabolic health profiles.
Awareness, Perceptions, and Literacy Surrounding Hearing Loss and Hearing Rehabilitation Among the Adult Population in the United States
Authors: Carlson Matthew L. , Nassiri Ashley M. , Marinelli John P. , Lohse Christine M. , Sydlowski Sarah A.
Published: January 2022

Objective:

To characterize current awareness, perceptions, and literacy surrounding hearing loss among the adult population in the United States.

Study Design:

National cross-sectional survey study.

Setting:

United States.

Patients:

Adults between 50 and 80 years of age in the United States.

Results:

Survey respondents included 1,250 adults between the ages of 50 and 80 years, including 500 who indicated at least moderate hearing loss and were using hearing aids and 750 who denied having hearing loss and were not using hearing aids.

Only 9% of patients were able to correctly identify what constitutes a “normal” or “average” range for hearing. By comparison, a “normal” range of values for vision, blood pressure, and total cholesterol were identified correctly by 93%, 85%, and 52% of the 1,250 surveyed adults, respectively. When asked to rank the importance of addressing hearing loss within the context of 10 other common health conditions, hearing loss was ranked third to least important. When considering annual health maintenance, respondents indicated they were “very likely” to have an annual physical exam (72%), a cholesterol test (70%), an eye exam (66%), and bring their pet to a veterinarian (59%) over twice as frequently as having their hearing evaluated (27%).

When evaluating awareness surrounding associations between hearing loss and other health and social issues, less than one-fourth indicated strong awareness about links between hearing loss and depression, employability and income, fall risk, dementia, and type 2 diabetes. While most patients acknowledge the potential impacts of hearing loss on safety, quality of life, and health, less than half believe that hearing loss is treatable and less than 20% believe that hearing loss is preventable.

Conclusion:

Despite widespread literacy of what constitutes normal vision, blood pressure, and total cholesterol levels, respondents exhibit substantially poorer understanding of “normal” hearing levels. Most adults believe that few treatment options exist for the management of hearing loss. Underlying the uniformly limited literacy surrounding hearing loss and its treatment options is the adult population's lack of appreciation for the long-term health sequelae of untreated hearing loss.
Treating the body to prevent brain injury: lessons learned from the coronavirus disease 2019 pandemic
Authors: Fan Tracey H. , Solnicky Veronika , Cho Sung-Min
Published: January 2022

Purpose of review

We aim to provide the current evidence on utility and application of neuromonitoring tools including electroencephalography (EEG), transcranial Doppler (TCD), pupillometry, optic nerve sheath diameter (ONSD), cerebral near-infrared spectroscopy (cNIRS), somatosensory-evoked potentials (SSEPs), and invasive intracranial monitoring in COVID-19. We also provide recent evidence on management strategy of COVID-19-associated neurological complications.

Recent findings

Despite the common occurrence of neurological complications, we found limited use of standard neurologic monitoring in patients with COVID-19. No specific EEG pattern was identified in COVID-19. Frontal epileptic discharge was proposed to be a potential marker of COVID-19 encephalopathy. TCD, ONSD, and pupillometry can provide real-time data on intracranial pressure. Additionally, TCD may be useful for detection of acute large vessel occlusions, abnormal cerebral hemodynamics, cerebral emboli, and evolving cerebral edema at bedside. cNIRS was under-utilized in COVID-19 population and there are ongoing studies to investigate whether cerebral oxygenation could be a more useful parameter than peripheral oxygen saturation to guide clinical titration of permissive hypoxemia. Limited data exists on SSEPs and invasive intracranial monitoring.

Early recognition using standardized neuromonitoring and timely intervention is important to reduce morbidity and mortality. The management strategy for neurological complications is similar to those without COVID-19.
Intracranial pressure management: moving beyond guidelines
Authors: Rubiano Andres M. , Figaji Anthony , Hawryluk Gregory W.
Published: January 2022

Purpose of review

The aim of this study was to provide an overview on advances in intracranial pressure (ICP) protocols for care, moving from traditional to more recent concepts.

Recent findings

Deep understanding of mechanics and dynamics of fluids and solids have been introduced for intracranial physiology. The amplitude or the harmonics of the cerebral-spinal fluid and the cerebral blood waves shows more information about ICP than just a numeric threshold. When the ICP overcome the compensatory mechanisms that maintain the compliance within the skull, an intracranial compartment syndrome (ICCS) is defined. Autoregulation monitoring emerge as critical tool to recognize CPP management. Measurement of brain tissue oxygen will be a critical intervention for diagnosing an ICCS. Surgical procedures focused on increasing the physiological compliance and increasing the volume of the compartments of the skull.

ICP management is a complex task, moving far than numeric thresholds for activation of interventions. The interactions of intracranial elements requires new interpretations moving beyond classical theories. Most of the traditional clinical studies supporting ICP management are not generating high class evidence. Recommendations for ICP management requires better designed clinical studies using new concepts to generate interventions according to the new era of personalized medicine.
Factors related to the risk of stroke in the population with type 2 diabetes
Authors: Wang Kai , Lv Zhiguo , Xu Peng , Cui Yabin , Zang Xiaoyu , Zhang DongMei , Wang Jian
Published: January 2022

Background:

Type 2 diabetes is an independent risk factor for stroke. The main role of the current study is to study the mechanism of stroke induced by diabetes, but there is no systematic summary of daily management and stroke prevention for patients with type 2 diabetes. In order to provide a more detailed stroke prevention program for patients with type 2 diabetes, we included in the study and looked forward to analyzing the risk factors that were more in line with the clinical characteristics of type 2 diabetes.

Methods:

We will search the following Chinese and English databases: PubMed, Web of science, Cochrane Library, Medline, and China National Knowledge Infrastructure database. All of the above electronic databases will be searched from inception to June 30, 2021. In addition, we will manually search for conference papers, ongoing experiments, and internal reports to supplement the studies retrieved via electronic search. We will use the STATA 16.0 provided by Cochrane Collaboration Network for statistical analysis.

Results:

The study will prove a collective view on the relationship between related factors and stroke in the type 2 diabetes population.

Conclusion:

We plan to submit this systematic review to a peer-reviewed journal.

INPLASY registration number: INPLASY2021100046
Effectiveness and safety of massage for chronic pain in patients with knee osteoarthritis
Authors: Xu Jianghan , Wu Boyi , Xie Shengji , Wu Guanghui , Zhang Heng , Fu Yangyang , Guo Guangxin
Published: January 2022

Background:

Chronic pain (CP) is a common and debilitating symptom in patients with knee osteoarthritis (KOA). Massage has been supported as a non-pharmacological intervention for the individual symptom relief of CP. However, relevant evidence of using massage for CP in patients with KOA has been lacking.

Methods:

A systematic search will be performed in the following electronic databases for randomized controlled trials to evaluate the effectiveness and safety of massage for CP of KOA: China National Knowledge Infrastructure (CNKI), Wan Fang, PubMed, EMBASE, PsycINFO, and the Cochrane Library databases from their inception to December 2021. The entire process will include study selection, data extraction, risk of bias assessment and meta-analysis.

Results:

This proposed study will evaluate the effectiveness and safety of massage for CP in patients with KOA. Changes in pain relief and adverse effect will be included in our outcomes.

Conclusions:

This systematic review will provide evidence for assessing the credibility of massage for CP in patients with KOA.

Dissemination and ethics:

The results of this review will be disseminated through peer-reviewed publication. This review does not require ethical approval because all of the data used in this systematic review and meta-analysis have already been published. Furthermore, all of these data will be analyzed anonymously during the review process.
Congenital nephrogenic diabetes insipidus presenting as osmotic demyelination syndrome in infancy
Authors: Kobayashi Satoru , Mizuno Nana , Yokoi Kyoko , Mori Takayasu , Sohara Eisei , Uchida Shinichi
Published: January 2022

Rationale:

Almost 90% of congenital nephrogenic diabetes insipidus (NDI) cases are caused by mutations in the arginine vasopressin receptor 2 gene, which has X-linked recessive inheritance. Although NDI is commonly diagnosed in early infancy based on its characteristic findings, clinical diagnosis can be delayed when no other family members have been diagnosed with NDI because several findings of NDI are nonspecific.

Patient concerns:

A 3-month-old boy diagnosed with NDI presenting with osmotic demyelination syndrome (ODS) was admitted for poor weight gain after birth and poor feeding during the week prior to admission.

Diagnosis:

On admission, the initial blood examination showed hypernatremia (158 mmol/L), and treatment with intravenous fluids over the next 2 days further elevated the serum sodium level (171 mmol/L). After admission, polyuria was recognized, and polyuria in his grandmother and mother since childhood without a diagnosis of NDI was found. Magnetic resonance imaging showed multifocal, symmetrical lesions, including the lateral pons, on diffusion- and T2-weighted imaging, which led to a diagnosis of ODS.

Intervention:

The infusion was stopped, and the patient was fed milk diluted 2-fold with water.

Outcomes:

The serum sodium level gradually decreased to 148 mmol/L over the course of 1 week. Low-sodium milk was started at 4 months of age and maintained a serum sodium level of approximately 140 mmol/L, which was within the normal range. The developmental quotient was 94 at 4 years of age.

Lessons:

ODS is an encephalopathy resulting from extreme fluctuations in serum sodium concentration and plasma osmolality. ODS due to hypernatremia has been reported in several patients, although it usually occurs during rapid correction of hyponatremia. Consequences of the central nervous system are a critical complication of NDI that affects prognosis. These consequences can be avoided with treatment. Early blood examination or polyuria in the patient, mother, or another family member and hypernatremic dehydration with good urine output should lead to an early diagnosis and prevent central nervous system consequences.
Shoulder impingement: various risk factors for supraspinatus tendon tear
Authors: Ahmad Rani G.
Published: January 2022

A total of 680 cases of monolateral shoulder pain and functional impairment were included, and Chi-Squared tests was incorporated to test for possible associations.

No relation between impingement syndrome and potential risk factors was found, such as presence of down slopping (P = .083), presence of ossification acromiale (P 
= .102), presence of calcific tendinitis (P 
= .144), types of acromion (I [P = .600], II [P = .536], III [P = .633] and IV [P = .832]) and grade of acromioclavicular degenerative changes (mild [P = .077], moderate [P = .111], and severe [P = .700]). However, a significant relationship was uncovered between impingement syndrome and risk factors such as gender (X2 = 7.004, df = 1, P = .08) (where females were more prone), history of shoulder dislocation (X2 = 19.440, df = 1, P = .001), presence of supraspinatus tendon tear or tendinopathy (X2 = 69.344, df = 1, P = .001) and supraspinatus complete tear (X2 = 13.593, df = 1, P = .001). A significant relationship was found between the type of supraspinatus pathology and factors such as gender (female more prone) (X2 = 34.719, df = 3, P = .01), presence of down slopping (X2 = 57.765, df = 3, P = .01), history of shoulder dislocation (X2 = 148.880, df = 3, P = .001), type III of the acromion (X2 = 12.979, df = 3, P = .005), presence of acromioclavicular generative changes mild (X2 = 76.408, df = 3, P = .001) and moderate (X2 = 29.697, df = 3, P = .001), and acromiohumeral distance of ≤3 mm (X2 = 18.915, df = 3, P = .001), 3.1 to 6 mm (X2 = 13.212, df = 3, P = .004), and 9.1–12 mm (X2 = 15.066, df = 3, P = .002). Overall, the Magnetic Resonance Imaging results yielded high sensitivity for detecting full-thickness supraspinatus tears.

Considering the findings, this study may help radiologists understand the salient risk factors and identify which factors are mainly responsible for supraspinatus tendon tears and the respective grade of tear (articular partial, bursal partial, complete, or tendinopathy).
Bipolar clavicle fractures treatment using medial and lateral double plates
Authors: Xing Haiyang , Cao Changpeng , Chen Xinxiao , Gao Yang , Huang Guanning , Zhu Jiajing , Wang Gang
Published: January 2022

Rationale:

Clavicle fractures are common, accounting for 2.6 to 4% of all fractures, which typically result from direct injuries, including direct force on the shoulder after falling. However, bipolar clavicle fractures are rare, accounting for only 2.8% of all clavicle fractures, and their injury mechanism is speculated to evolve from two independent and continuous forces affecting the clavicle. Due to its low incidence, there is great controversy regarding the treatment of this fracture, as there is no relevant treatment standard or guideline to date.

Patient concerns:

In this case report, we describe a rare case of bipolar clavicle fracture in a 76-year-old man with multiple systemic fracture complications due to a traffic injury. He presented with limited shoulder function and movement upon arrival in the emergency room.

Diagnosis:

Bipolar clavicle fracture in the right shoulder (Robinson type 1B2, Robinson type 3B2)

Interventions:

We performed trans-sternoclavicular locking plate and lateral clavicular hook plate treatments and instructed patients to perform reasonable postoperative functional exercises.

Outcomes:

Three months postoperatively, the pain was almost completely relieved with a DASH score of 40.0. Furthermore, radiographic examination of the clavicle showed satisfactory fracture healing. The patient had no further demands for shoulder function and no irritative symptoms of internal fixation and refused to undergo a second operation. The patient had a satisfactory prognosis after the treatment.

Lessons:

The treatment of bipolar clavicle fractures remains controversial. This study provides evidence of a feasible method to treat bipolar clavicle fractures: trans-sternoclavicular locking plate and lateral clavicular hook plate treatment.
The efficacy of parenteral nutrition (PN) and enteral nutrition (EN) supports in cirrhosis
Authors: Yu Bin , Wang Jiting
Published: January 2022

Importance:

Multiple nutritional therapies are currently available for patients with liver cirrhosis, yet many interventions have not been compared head-to-head within randomized clinical trials.

Objective:

To evaluate the improvement of nutritional indicators and liver function indexes of liver cirrhosis treated with different nutrition intervention.

Data source:

We searched PubMed, Embase. com and Cochrane Library database from construction to April 3, 2020. After eliminating the duplicated or overlapping reports, 6 studies were included. We performed a Bayesian network meta-analysis by Stata 12.0 and GeMTC 0.14.3 in order to compare different nutritional interventions with consistency model.

Study selection:

Randomized clinical trials comparing 2 or more therapies in patients with cirrhosis were evaluated. Six randomized clinical trials met the selection criteria.

Data extraction and synthesis:

Two investigators independently reviewed the full manuscripts of eligible studies and extracted information into an electronic database: patients’ characteristics study design, interventions, the number of events of interest in each group.

Main outcomes and measures:

Body mass index, Child-Pugh score, model for end-stage liver disease score, total bilirubin, alanine transaminase, aspartate transaminase, total protein, Triceps skinfold, Midarm Muscle Circumference, Fischer ratio, overall survival.

Results:

There are 6 studies enrolling a total of 1148 patients who received different nutrition supports including parenteral nutrition (PN), enteral nutrition (EN), EN (without branched-chain amino acids), EN + intestinal probiotics, PN + EN, late evening snacks (LES), EN + LES, noLES. The direct comparisons showed that the effect of EN was better than EN (without branched-chain amino acids); EN + intestinal probiotics was better than EN and PN; PN + EN was better than them alone; EN + LES was better than LES and EN; LES was better than noLES. Although the difference of indirect comparisons between the included regimens was not statistically significant, the results showed that EN + intestinal probiotics appeared to be superior to PN + EN. While LES and EN + LES seemed to rank behind them and the difference between them was extremely small.

Conclusion and relevance:

Available evidence suggests that EN + intestinal probiotics appear to be the most effective strategy for patients with cirrhosis compared with other interventions.
Clinical differentiation of inflammatory bowel disease (IBD) in Latin America and the Caribbean
Authors: Yamamoto-Furusho Jesús K. , Parra-Holguín Norma N. , Juliao-Baños Fabián , Puentes Fabián , López Rocio , Bosques-Padilla Francisco , Torres Esther A. , Nieves-Jimenéz Humberto , Veitia-Velásquez Guillermo R. , Jara-Alba Maria L. , Bautista Sócrates , Piñol-Jimenez Felipe N. , Salgado-Rosado Pablo , Villa-Ovalles Keyla C. , Abreu-Martinez Yudelka A. , Borges Zunilda , Davila-Bedoya Santiago , Otoya-Moreno Guillermo , Iadé-Vergara Beatriz
Published: January 2022

The aim of the present study was to describe the epidemiological and clinical characteristics of inflammatory bowel disease (IBD), including medical and surgical treatments, in several countries in Latin America and the Caribbean.

IBD is recognized as a global health problem because its incidence and prevalence have increased significantly over the last few years.

This multicenter retrospective cohort study included 4714 patients with IBD diagnosed from 9 countries in Latin America and the Caribbean: Colombia, Cuba, Dominican Republic, Ecuador, Mexico, Peru, Puerto Rico, Uruguay, and Venezuela.

Crohn disease (CD) was more frequent in Puerto Rico (71.9%), the Dominican Republic (61.0%), and Peru (53.1%). Ulcerative colitis was more frequent in Colombia (78.6%), Venezuela (78.2%), Mexico (75.5%), Cuba (69.9%), Ecuador (64.1%), and Uruguay (60.9%). The following clinical characteristics were more frequent in the Caribbean: penetrating behavior in CD, steroid dependence, steroid resistance, intolerance to thiopurines, extraintestinal manifestations, surgeries, hospitalizations due to IBD, and family history of IBD. The factors associated with the use of biological therapy were pancolitis in ulcerative colitis, penetrating behavior in CD, steroid resistance and dependence, presence of extraintestinal manifestations, and the need for surgery.

This study from Latin America and the Caribbean demonstrated the different epidemiological and clinical characteristics of IBD.
Effectiveness and safety of acupuncture for treating trigeminal neuralgia associated anxiety and depression
Authors: Luo Ning , Li Rongrong , Wang Yiyi , Xia Yunfan , Sun Jing , Zhao Linfang , Sun Chao , Sun Jiemin , Fang Jianqiao
Published: January 2022

Background:

Patients with trigeminal neuralgia (TN) often develop a terrible fear of triggering pain, which may lead to anxiety and depression, exerting a negative effect on their quality of life. This protocol is carried out to comprehensively explore the effectiveness and safety of acupuncture for treating anxiety and depression induced by TN.

Methods:

Randomized control trials involving acupuncture for treating patients with anxiety and depression caused by TN will be searched in eight electric databases, including PubMed, Web of Science, EMBASE, Cochrane Central Register of Controlled Trials, Chinese National Knowledge Infrastructure, Chinese Biomedical Literature Database, Wanfang Database and Technology Periodical Database (VIP). In addition, studies that were reported in Chinese or English will be considered. Studies selection, data extraction and risk of bias assessment of the included studies will be conducted independently by two reviewers. Quality of the included studies will be performed according to the Cochrane Risk of Bias tool. Meanwhile, the level of evidence for results will be assessed by using the Grading of Recommendations Assessment, Development, and Evaluation method. The primary outcomes will be the Hamilton Anxiety/Depression Scale or Zung Self-Rating Anxiety/Depression Scale, secondary outcomes will be the visual analog score, numerical rating score, SF-36, and adverse events. All analyses will be conducted by using the RevMan software V5.3.

Results:

A high-quality synthesis of current evidence of acupuncture for TN patients associated with anxiety and depression will be provided in this study.

Conclusion:

This systematic review will offer comprehensive evidence of acupuncture on specific outcomes induced by TN and TN-related anxiety and depression.

Trial registration:

PROSPERO registration number: CRD42020219775.
Enhancing parental knowledge of childhood and adolescence safety
Authors: Temsah Mohamad-Hani , Aljamaan Fadi , Alhaboob Ali , Almosned Badr , Alsebail Raghad , Temsah Reem , Senjab Abdulrahman , Alarfaj Abdulrahman , Aljudi Talal , Jamal Amr , Habash Alia , Alsohime Fahad , Almazyad Mohammed , Alabdulhafid Majed , Hasan Gamal , Assiri Raghad Asaad , Alqahtani Wa’ad Massoud Almunassir , Alherbish Adi , Alhasan Khalid , Al-Eyadhy Ayman
Published: January 2022

Background:

Safeguarding children and adolescents from unintentional injuries is a significant concern for parents and caregivers. With them staying more at home during the coronavirus disease 2019 pandemic, more educational tools and valid educational programs are warranted to improve parental knowledge and awareness about childhood and adolescences’ safety. This study aims to explore the effectiveness of childhood and adolescence safety campaigns on parents’ knowledge and attitude toward preventable injuries.

Methods:

This was a pre–post experimental study, in which the predesigned assessments were used as an evaluation tool before and after attending a childhood and adolescence safety campaign. The pre–post assessment question included questions to evaluate the socio-demographic status, followed by knowledge questions in line with the current childhood and adolescence safety campaign. The outcomes of interest were assessed before and after attending the campaign's stations.

Results:

Three hundred eight parents volunteered to participate in this study. Their knowledge score improved from 36.2 [standard deviation (SD) 17.7] to 79.3 (SD 15.6) after attending the Campaign (t value = 34.6,P < .001). Both, perceptions on the preventability of accidents and the parents’ perceived usefulness of educational campaigns showed improvements, with (t value = 6.3,P < .001) and (t value = 3.097,P < .001), respectively.

Conclusion:

The educational childhood and adolescence safety campaign for caregivers in Saudi Arabia resulted in a significant increase in the overall knowledge and attitudes toward childhood and adolescence's safety. As children and adolescents are currently staying at home more, additional educational tools and programs are warranted to promote safe practices among parents and caregivers.
Capitalizing Upon Graduate Student Projects to Sustain Clinical Outcomes
Authors: Hulett Becky , Uremovich Inga , Oesterle Mary
Published: January 2022

As part of a clinical-academic partnership, graduate nursing students initiated evidence-based quality improvement projects in a large, metropolitan, 5-time Magnet®-designated pediatric hospital to encourage continuous innovation and evidence-based practice. This article describes the evolution and strategies used by leadership and staff to sustain the projects over time. Data collected by the organization report trended outcomes, highlight themes for success from graduate nursing students from 2017 through 2020, and report the implications for nurse executives.
The Academic Partnership Unit
Authors: Aull Michael , Nobles Patrick M.
Published: January 2022

Recruitment and retention of BSN-prepared nurses are a primary goal of many hospitals as they attempt to meet the challenges of high patient acuities and increased turnover among bedside nurses. In this article, the authors describe the Academic Partnership Unit, an evidence-based clinical education program designed to train, recruit, and retain BSN-prepared nurses.
Relationship Between Body Temperature and Heart Rate in Children With No Other Apparent Cause of Tachycardia
Authors: Matsumura Osamu , Morikawa Yoshihiko , Kaneko Tetsuji , Sakakibara Hiroshi , Hagiwara Yusuke
Published: January 2022

Objective

The aim of the study was to investigate the normal heart rate range for each body temperature in patients visiting the emergency department (ED) with no other, apparent, coexisting factors causing tachycardia.

Methods

This was an observational study conducted in the ED at a single children's hospital between April 1, 2014, and March 31, 2017. Data on all visits were extracted from the electronic triage system and were excluded if they indicated the presence of factors other than body temperature potentially increasing the heart rate. We created age-dependent heart rate percentile curves for body temperature in 6 age categories: 0 to younger than 3 months, 3 to younger than 12 months, 1 to younger than 2 years, 2 to younger than 5 years, 5 to younger than 10 years, and 10 years or older. The curves were created for the body temperatures of 36.0°C to 38.0°C for the 0 to younger than 3 months age group and for body temperatures of 36.0°C to 40.5°C for the other age groups.

Results

Of the 113,242 patients included, 61,321 were analyzed. The percentile curves across all age groups were similar despite differences in the baseline heart rate. Heart rate increase was steepest between 37.0°C and 38.0°C at a rate of approximately 20 beats per minute per degree Celsius for all groups. Compared with previous studies in the outpatient setting, including the ED, heart rate was lower in younger patients and was similar among older patients.

Conclusions

We created new, age-dependent heart rate percentile curves for body temperature for use in the ED setting. In outpatients, the effect of coexisting factors affecting heart rate, such as crying, may be higher among younger patients.
Measurable Residual Disease Assessment as a Surrogate Marker in New Drug Development in Acute Myeloid Leukemia
Authors: Gui Gege , Hourigan Christopher S.
Published: January 2022

Response criteria for patients treated for acute myeloid leukemia (AML) based on cytomorphology are inadequate. Many patients achieving a complete remission by such criteria will later relapse. Patients with AML in such remissions who test negative using higher sensitivity measures of residual disease burden (measurable residual disease [MRD]) have on average lower relapse rates and better survival than those testing positive. This association has raised the possibility that these technological advances in measurement of tumor burden could be used to optimize the drug development and regulatory approval processes in AML. The heterogeneous genetic etiology, diverse immunophenotypic profiles, related precursor states and polyclonal architecture however combine to make the development of standardized and validated MRD assessments for AML challenging. Current and future methods to measure residual disease in AML, performance characteristics of testing currently in use, and potential uses for optimized AML MRD tests including as a surrogate endpoint are discussed.