bluuebunny/crossref_metadata_2025 huggingface dataset:
PROGRESSIVE PERIPAPILLARY CHOROID THINNING AND RETINAL NEURODEGENERATION IN PATIENTS WITH DIABETES
Authors: Zhang Shiran , Zhu Zhuoting , Bulloch Gabriella , Guo Xiao , Shang Xianwen , Chen Yifan , Liao Huan , Li Yuting , Huang Wenyong , Wang Wei
Published: November 2022

Purpose:

To investigate longitudinal changes in peripapillary choroidal thickness (pCT) and retinal nerve fiber thickness (pRNFLT) in patients with Type 2 diabetes mellitus.

Methods:

This was a prospective observational cohort study. Patients with Type 2 diabetes mellitus without diabetic retinopathy (DR) at baseline were recruited, followed up for three years, and further divided into an incident DR group and a non-DR group according to the outcome. The pCT and pRNFLT were measured through swept-source optical coherence tomography at 1-year interval, and the mean rates of pCT and pRNFLT thinning were compared between the DR groups.

Results:

A total of 682 patients (682 eyes) were included in the final analysis. After 3-years follow-up, 122 (17.89%) developed DR. Both pCT and pRNFLT progressively thinned (−2.37 [−2.80 to −1.95] µm/year; −0.40 [−0.55 to −0.25] µm/year, respectively, P < 0.05) and accelerated thinning was observed in the incident DR group. The rates of pCT thinning (−3.92 [−4.96 to −2.88] µm/year, −2.03 [−2.49 to −1.57] µm/year, respectively) and pRNFLT loss (−1.03 [−1.31 to −0.76] µm/year, −0.26 [−0.43 to −0.09] µm/year, respectively) in the incident DR group were 1.93 and 3.96 times faster than those in the non-DR group, respectively. In addition, pCT and pRNFLT thinning were negatively related in Type 2 diabetes mellitus population, and faster pCT thinning indicated slower pRNFLT loss.

Conclusion:

Patients with Type 2 diabetes mellitus were at a higher risk of developing DR when accelerated pCT and pRNFLT thinning were present, indicating that heavier choroidal damage and retinal neurodegeneration precede clinical DR. The pCT and pRNFLT have the potential to serve as novel sensitive biomarkers of preclinical and early DR.
Maggot Infestation of Chronic Right Leg Wound Leading to Asymptomatic Bacteremia With Ignatzschineria larvae—A Case Report and Review
Authors: Kling Kendall , Zembower Teresa , Zheng Xiaotian , Qi Chao
Published: November 2022

Ignatzschineria is a genus of Gram-negative bacilli that have been isolated from the gastrointestinal tract of fly larvae of the myiasis-causing species Wohlfahrtia magnifica and Sarcophaga genus that rarely have been associated with invasive infection in humans, typically in setting of maggot-infested wounds. We report a case of an 83-year-old man with a maggot-infested right leg wound who was incidentally found to have bacteremia with Ignatzschineria species with closest match to I. larvae. The isolate was found to be susceptible to all antibiotics tested, consistent with prior case reports. The patient lacked objective findings of systemic infection, suggesting possible low virulence with this organism, but clinicians should be aware that maggot-infested patients may be harboring this bacterium in their bloodstream.
Spinal Infection Secondary to Mycobacterium branderi
Authors: Drakopoulos Michael , Ogbuefi Nonye , Galvin Shannon , Kling Kendall
Published: November 2022

Mycobacterium branderi is a rare, slow-growing, nontuberculous mycobacterium initially identified as a species in 1995. Mycobacterium branderi has previously been reported as the sole pathogen isolated from pulmonary cavitary lesions and from a hand infection. We present a case of M. branderi as the sole pathogen isolated from a spinal epidural abscess associated with discitis, osteomyelitis, and psoas muscle abscesses in an immunocompromised host. The isolate was subjected to DNA hybridization testing and 16S rRNA gene sequencing, with results consistent with M. branderi and Mycobacterium celatum. Subsequent RNA polymerase β subunit gene sequencing identified the organism as M. branderi. The spinal infection is being treated with trimethoprim-sulfamethoxazole, ethambutol, azithromycin, and rifabutin. Repeat spinal cultures after initiation of treatment were negative for growth suggesting eradication of the organism.
Vitamin B12 as a novel risk biomarker of spinal fractures
Authors: Li Zheng , Zheng Rugeng , Xue Hui , Zhu Hao
Published: November 2022

Spinal fractures are common intra-articular fractures. Osteoporosis is a common and frequent disease among the elderly with a poor prognosis and a high risk of spinal fractures. However, the underlying factors for spinal fractures in patients with osteoporosis are unclear. A total of 105 patients with osteoporosis were recruited. Clinical and followed-up information was recorded. And vitamin B12, vitamin B2, vitamin A, and vitamin B9 in the blood were tested. Pearson’s chi-squared and spearman tests were performed to analyze the correlation between spinal fractures and relative parameters. Univariate and multivariate logistic regression, univariate and multivariate Cox proportional hazards regression analysis. There exists strong relation between the expression level of vitamin B12 and spinal fractures. Pearson’s chi-square and Spearman correlation test showed a strong association between vitamin B12 and vitamin B9 and a spinal fracture. Univariate logistic regression analysis showed that vitamin B12 and vitamin B9 were significantly associated with a spinal fracture. Multivariate logistic regression analysis showed that vitamin B12 was associated considerably with a spinal fracture. In addition, Cox regression analysis showed that vitamin B12 expression was significantly associated with maintenance time from recovery to recurrence (MTRR) of spinal fractures in patients with osteoporosis. Enhanced vitamin B12 is significantly correlated with the poor prognosis of patients with osteoporosis and the increasing incidence of a spinal fracture. The higher the vitamin B12, the higher the risk of spinal fracture and the shorter the time to spinal fracture recurrence.
Subgroups in the treatment of nasal polyposis with dupilumab: A retrospective study
Authors: Bertlich Mattis , Freytag Saskia , Dombrowski Tobias , Jurmeister Philipp , Spiegel Jennifer Lee , Bertlich Ines , Ihler Friedrich , Weiss Bernhard G. , Haubner Frank , Gröger Moritz
Published: November 2022

Dupilumab has been shown to be safe and effective in treating chronic rhinosinusitis with polyposis (CRSwNP). There is to this date no published data whether subgroups like patients with aspirin exacerbated respiratory disease (AERD), increased histologic eosinophilia or elevated blood eosinophil or IgE-levels benefit greater from dupilumab therapy. Moreover, there is no data comparing the efficacy of functional endoscopic sinus surgery (FESS) with dupilumab therapy. We conducted a retrospective chart review of all patients that were treated at a tertiary referral center for CRswNP with dupilumab. We also contacted the patients with a questionnaire to evaluate the efficacy of previous surgeries and dupilumab therapy by visual analogue scale (VAS) and the glasgow benefit inventory (GBI) as well as report on side effects. Overall, 75 patients were included in the study at hand that reported back 138 times. While dupilumab treatment was efficient, we found no systematic evidence of greater efficacy of dupilumab in patients with AERD, histologic eosinophilia or increased blood eosinophil or IgE-levels. All patients showed a considerable decrease in subjective burden of disease, objective smell tests and endoscopic findings. From the patients point of view, dupilumab therapy showed greater efficacy both in the VAS and the GBI overall and all subcategories but “social support.” Dupilumab is efficient in treating CRSwNP; this effect is independent from disease characteristics like AERD, histologic eosinophilia, serum IgE-levels or eosinophil counts. There seems to be a group of patients that benefit greater from dupilumab therapy compared to FESS.
Knowledge mapping of copper-induced cell death: A bibliometric study from 2012 to 2022
Authors: Ren Xue , Pan Ciming , Pan Zimeng , Zhao Shanshan , Wu Chen , Chen Wan , Liu Mengchen , Han Xingyue , Kuang Hongying , Qu Miao
Published: November 2022

Background:

The recent article Copper induces cell death by targeting lipoylated TCA cycle proteins has attracted much attention. Although copper-induced cell death has only recently been formally proposed, it has been studied much earlier. This study aims to undertake a bibliometric analysis of the literature on copper-induced cell death to understand the development of copper-induced cell death better and identify potential new research directions.

Methods:

With the help of Cite Space software, visual analysis is carried out on the annual number of published papers, countries/regions and institutions, journals co-citation, literature co-citation and reference burst, keywords co-occurrence, clustering, and burst.

Results:

A search of 770 articles published in English over the last ten years showed a fluctuating trend of increasing numbers of articles. China had the highest number of articles (190% or 24.68%), followed by the USA and India. Inflammation, biological evaluation, nanoparticle, and cu(ii) have been popular research themes in the last 4 years. The keyword clusters are summarized in 8 categories, including exposure, complexe, er stress, cleavage, paraptosis, cancer, glutamate, reactive oxygen species (ROS), expression. The hot topics are mainly focused on the exploration of mechanisms and related diseases, including induced apoptosis, aggregation, autophagy, endoplasmic reticulum stress, induced oxidative stress, and inflammation. Parkinson’s disease and cancer are 2 diseases that are closely related to copper-induced cell death.

Conclusion:

This study provides a visual analysis of copper-induced cell death trends and provides some hidden potentially useful information for future research directions.
Lung metastases pattern in limb osteosarcoma: A population-based study from 2010 to 2018
Authors: Liu Binbin , Tang Liyuan
Published: November 2022

Osteosarcoma (OS) is one of the most prevalent malignant bone tumors. The proportion of limb OS is relatively high, and lung metastases (LM) are one of the most prevalent metastatic types. A total of 1694 new cases of limb OS were identified in the surveillance, epidemiology and end results (SEER) database from 2010 to 2018. Cox regression analyze was performed to identify prognostic factors for limb OS with LM, and univariate and multivariate logistic regression analyses were used to assess risk factors for LM. Kaplan–Meier analysis was performed to calculate overall survival for LM, and a log-rank test was used for comparison. A total of 287 patients (16.94%) were diagnosed with limb OS with LM. 25 to 59 years old (odds ratio, OR 0.68; 95% confidence interval, CI: 0.46–0.99), larger than 100 mm tumors (OR 3.65, 95% CI: 1.54–8.64), telangiectatic osteosarcoma type (OR 0.24, 95% CI: 0.07–0.81), central osteosarcoma type (OR 0.44, 95% CI: 0.19–0.99), T2 stage (OR 2.59, 95% CI: 1.18–5.69), N1 stage (OR 7.79, 95% CI: 3.90–15.56), presence of bone metastases (OR 4.58, 95% CI: 2.43–8.63) and surgical treatments of primary site (OR 0.22, 95% CI: 0.14–0.33) were significant correlations with lung metastases. Elderly age, black race and absence of surgery were harmful for survival. Age between 25 and 59 years, telangiectatic osteosarcoma and central osteosarcoma were identified as high-risk factors in limb OS patients with LM, and surgical treatment of the primary site significantly increased the survival rate of LM in these patients.
Calcium sulfate in the management of osteomyelitis: A systematic review and meta-analysis of comparative studies
Authors: Sheridan Gerard A. , Falk David P. , Fragomen Austin T. , Rozbruch S. Robert
Published: November 2022

Background:

Calcium sulfate (CS) is used extensively as an antibiotic carrier in the treatment of chronic osteomyelitis, largely due to its biodegradable nature. The aim of this systematic review and meta-analysis is to analyze the comprehensive performance of CS in the literature when compared to other biomaterials or treatments for osteomyelitis. We assess the ability of CS to eradicate infection and achieve other key clinical outcomes.

Methods:

All studies comparing the use of CS to any other surgical technique for the surgical management of osteomyelitis were eligible for analysis. The indication for surgery in each case was chronic osteomyelitis. The minimum dataset required included details regarding infection eradication rates, union rates (in cases of nonunion), all-cause revision surgery and wound leakage. The primary outcome variables of concern were infection eradication and all-cause revision surgery. Secondary outcome variables included union and wound leakage. A random effects meta-analysis was performed.

Results:

Five studies were deemed eligible for inclusion. The CS group had a significantly higher rate of infection eradication (P = .013) and a significantly lower rate of revision for all causes (P < .001) when compared to the comparative group. In total, the CS group had 30 cases of wound leakage compared to 8 in the comparative group (P = .064).

Conclusion:

CS demonstrates superior rates of infection eradication and all-cause revision when compared with alternative treatment methods for chronic osteomyelitis. While the current study reports on differing but nonsignificant rates of wound leakage between CS and other treatments, future studies are required to accurately investigate this clinically important complication.
Weifuchun alters tongue flora and decreases serum trefoil factor I levels in gastric intestinal metaplasia: A CONSORT-compliant article
Authors: Hua Zhaolai , Shen Rui , Lu Bin , Li Meifeng , Zhou Ping , Wu Juan , Dong Wei , Zhou Qihai , Zhang Junfeng
Published: November 2022

Objective:

To explore the molecular mechanisms of Weifuchun in the treatment of gastric intestinal metaplasia (GIM), we designed a preclinical pilot study to examine potential markers of disease progression based on alterations in the tongue flora.

Methods:

Total 27 patients with GIM were treated with Weifuchun for 4 weeks and 26 volunteers as controls. Tongue coating bacteria were profiled using 16S rDNA high-throughput sequencing. Serum pepsinogen I and II levels were detected using the latex immunoturbidimetric assay. The levels of serum trefoil factor I was detected by ELISA. Microplate-based quantification was used to detect serum total bile acid (TBA).

Results:

After treatment, the relative abundance of 4 dominant tongue coating genera (Granulicatella, Gemella, Lachnoanaerobaculum, and Neisseria) increased significantly wheras Alloprevotella, [Eubacterium] nodatum group, Prevotell, and Ruminococcaceae UCG-014 decreased (P < .05). The results showed that Alloprevotella and 3 rare tongue coating genera (Lautropia, Treponema 2, and Aliihoeflea) might be potential markers or target flora for the treatment of GIM. Kyoto encyclopedia of genes and genomes (KEGG) function prediction analysis showed that Weifuchun may regulate bile secretion and folate biosynthesis in patients with GIM. The level of serum trefoil factor I decreased significantly in response to Weifuchun treatment, which was consistent with the decrease in folate biosynthesis predicted by KEGG.

Conclusion:

Weifuchun may restore the balance of tongue flora by decreasing the levels of serum trefoil factor I, thereby providing a new way to measuring the underlying effectiveness and potential mechanisms of action of this traditional Chinese medicinal compound in the treatment of GIM.
Hub gene target of glioblastoma: LOX, SERPINH1 and TGFBI
Authors: Zhang Shuyuan , Zhang Weiwei , Wu Bin , Xia Liang , Li Liwen , Jin Kai , Zou Yangfan , Sun Caixing
Published: November 2022

Glioblastoma (GBM) is a malignant tumor. The long-term prognosis of the patients is poor. Therefore, it is of important clinical value to further explore the pathogenesis and look for molecular markers for early diagnosis and targeted treatment. Two expression profiling datasets [GSE50161 (GPL570 platform), GSE116520 (GPL10558 platform)] were respectively downloaded from the gene expression omnibus database. Volcano diagrams show the Differently expressed genes (DEGs) of GSE50161 and GSE116520. A Venn diagram revealed 467 common DEGs between the 2 datasets. Lysyl oxidase (LOX), serpin family H member 1 (SERPINH1) and transforming growth factor beta induced (TGFBI) were negatively correlated with the overall survival rate in patients with GBM. The hub genes are high in GBM tumor tissues. The relative expression levels of LOX, SERPINH1 and TGFBI were significantly higher in GBM samples, compared with the normal brain tissues groups. Bioinformatics technology could be a useful tool to predict progression of GBM and to explore the mechanism of GBM.LOX, SERPINH1 and TGFBI may be involved in the mechanism of the occurrence and development of GBM, and may be used as molecular targets for early diagnosis and specific treatment.

DEGs identified using GEO2R. Functional annotation of DEGs using Kyoto Encyclopedia of Genes and Genomes and gene body pathway enrichment analysis. Construction of a protein-protein interaction network. The pathway and process enrichment analysis of the hub genes were performed by Metascape. Survival analysis was performed in gene expression profiling interactive analysis. Real-time fluorescent quantitative polymerase chain reaction assay was performed to verify. The animal model was established for western blot test analysis.
L-carbocisteine can cause cholestasis with vanishing bile duct syndrome in children: A case report
Authors: Takaki Yugo , Murahashi Makoto , Honda Kei , Hirai Katsuki
Published: November 2022

Rationale:

Vanishing bile duct syndrome (VBDS) is the acquired progressive destruction and disappearance of intrahepatic interlobular bile ducts in the absence of underlying liver or biliary tract disease, causing chronic cholestasis. Infections, drugs, toxins, malignant diseases, and certain immunological processes are associated with the development of this syndrome. There have been no reports of children developing VBDS as a consequence of the administration of L-carbocisteine.

Patient concerns:

A 9-year-old Japanese girl presented with fever, jaundice, and skin rash. Laboratory investigations revealed elevated levels of serum transaminases, γ-glutamyltransferase, and bilirubin. Histopathological features were consistent with a diagnosis of VBDS. Drug-induced lymphocyte stimulation tests (DLST) were positive for L-carbocisteine.

Diagnosis:

VBDS caused by L-carbocisteine.

Interventions:

Ursodeoxycholic acid and discontinuation of L-carbocisteine.

Outcomes:

The patient responded to treatment based upon discontinuation of L-carbocisteine and administration of ursodeoxycholic acid. Her transaminase and bilirubin levels were normalized gradually.

Lessons:

Physicians should be aware of the fact that L-carbocisteine can cause cholestasis with VBDS in children.
Influence of meteorological factors on development of spontaneous pneumothorax
Authors: Lee Suk Hee , Seo Young Woo , Kwak Sang Gyu
Published: November 2022

This study investigated the correlation between spontaneous pneumothorax (SP) and meteorological factors during different seasons. Patients who visited emergency rooms (ERs) in large cities in Korea and were discharged with SP from 2014 to 2016 were included in this study. Data on temperature, air pressure, and wind speed for each region were collected to obtain each factor’s daily maximum, minimum, average, and changes. Days with more than 1 case of SP per million were referred to as pneumothorax days (PD) and those with less than 1 case of SP per million were referred to as non-pneumothorax days (NPD). The environmental factors were assessed on the same day (Day 0), 1 day prior (Day-1), and 2 days prior (Day-2) to PD and NPD per season. A total of 17,846 patients were included in this study. During winter, 4080 patients with SP visited the ERs of large cities with low population densities. The maximum temperature (0.16°C vs 0.76°C, 0.04°C vs 0.87°C, and 0.09°C vs 0.91°C), change in temperature (0.24°C vs 0.90°C, 0.38°C vs 0.81°C, and 0.41°C vs 0.83°C), average atmospheric pressure (0.16 vs 0.52 hPa, 0.25 vs 0.42 hPa, 0.34 vs 0.40 hPa), and maximum atmospheric pressure (0.15 vs 0.53 hPa, 0.28 vs 0.49 hPa, 0.33 vs 0.71 hPa) were greater for Day 0, Day-1, and Day-2, respectively, in PD than in NPD. Meanwhile, the average (0.31 vs 0.48 m/s, 0.28 vs 0.46 m/s, 0.20 vs 0.40 m/s), minimum (0.20 vs 0.31 m/s, 0.18 vs 0.25 m/s, 0.16 vs 0.25 m/s), and maximum (0.44 vs 0.67 m/s, 0.36 vs 0.71 m/s, 0.26 vs 0.58 m/s) wind speeds were slower, and the changes in wind speed (0.44 vs 0.67 m/s, 0.36 vs 0.71 m/s, 0.16 vs 0.25 m/s) were lower for all 3 days in PD than in NPD. High average and change in temperature, slow and unchanging wind speed, and high average and maximum atmospheric pressure were associated with SP. Since many findings of this study were contradictory to previous studies, it is assumed that the interaction of various factors affects SP.
Cirrhosis and hernia repair in a cohort of 6352 patients in a tertiary hospital: Risk assessment and survival analysis
Authors: Pipek Leonardo Zumerkorn , Cortez Vitor Santos , Taba João Victor , Suzuki Milena Oliveira , do Nascimento Fernanda Sayuri , de Mattos Vitoria Carneiro , Moraes Walter Augusto , Iuamoto Leandro Ryuchi , Hsing Wu Tu , Carneiro-D’Albuquerque Luiz Augusto , Meyer Alberto , Andraus Wellington
Published: November 2022

The prevalence of hernias in patient with cirrhosis can reach up to 40%. The pathophysiology of cirrhosis is closely linked to that of the umbilical hernia, but other types are also common in this population. The aim of this study is to evaluate factors that influence in the prognosis after hernia repair in patients with cirrhosis. A historical cohort of 6419 patients submitted to hernia repair was gathered. Clinical, epidemiological data and hernia characteristics were obtained. For patient with cirrhosis, data from exams, surgery and follow-up outcomes were also analyzed. Survival curves were constructed to assess the impact of clinical and surgical variables on survival. 342 of the 6352 herniated patients were cirrhotic. Patient with cirrhosis had a higher prevalence of umbilical hernia (67.5% × 24.2%,P < .001) and a lower prevalence of epigastric (1.8% × 9.0%,P < .001) and lumbar (0% × 0.18%,P = .022). There were no significant differences in relation to inguinal hernia (P = .609). Ascites was present in 70.1% of patient with cirrhosis and its prevalence was different in relation to the type of hernia (P < .001). The survival curve showed higher mortality for emergency surgery, MELD > 14 and ascites (HR 12.6 [3.79–41.65], 4.5 [2.00–10.34], and 6.1 [1.15–20.70], respectively,P < .05). Hernia correction surgery in patient with cirrhosis has a high mortality, especially when performed under urgent conditions associated with more severe clinical conditions of patients, such as the presence of ascites and elevated MELD.
Awareness of postural orthostatic tachycardia syndrome is required in adolescent syncope
Authors: Kim Dong Hyun , Park Ji Young , Kim Su Yeong , Lee Na Mi , Yi Dae Yong , Yun Sin Weon , Lim In Seok , Chae Soo Ahn
Published: November 2022

We investigated head-up tilt test (HUTT) results across age-groups in syncope/presyncope patients to establish pediatric postural orthostatic tachycardia syndrome (POTS) characteristics. We retrospectively reviewed syncope patients’ medical records. Adolescents were defined as 10 to 19 years old, adults as 20 to 59 years old, and older individuals as ≥60 years old. From HUTT results, we determined POTS prevalence and differences among the age-groups. We included 147 adolescents, 269 adults, and 123 older patients. Seventy (13.0%) patients (61.4% females; median age: 20 [17–25] years) were diagnosed with POTS. The syndrome was more prevalent among adolescents (33 [22.4%]) than adults (37 [13.8%]), and was absent among older individuals. Affected adolescents had significantly lower resting diastolic blood pressure (DBP) and heart rate (HR), and converted to maximum HR more rapidly than adolescents without the syndrome during the passive phase. Adolescents with POTS demonstrated several unique characteristics compared to adults with and adolescents without this syndrome. POTS may be underrecognized among syncope and presyncope patients, among which 22.4% of adolescents were diagnosed with the syndrome. POTS should be considered when evaluating syncope patients.
Comparison of the synergistic effects of sevoflurane and desflurane on muscle relaxant vecuronium in laparoscopic colon cancer surgery
Authors: Song Qianqian , Zhao Xiujie , Wang Yewen , Zhang Quanyi
Published: November 2022

Sevoflurane and desflurane are commonly used inhalation anesthetics in clinical practice. This study compared the synergistic effects of sevoflurane and desflurane on the muscarinic agent vecuronium in laparoscopic colon cancer surgery. The aim of this study was to compare sevoflurane and desflurane in a synergistic effect on the muscle relaxant vecuronium in laparoscopic colon cancer surgery. Sixty patients undergoing elective laparoscopic radical resection of colon cancer were randomly divided into sevoflurane (n = 30) and desflurane (n = 30) groups. After anesthesia and successful tracheal intubation, patients in both groups were maintained with combined remifentanil. Muscle relaxant effects were monitored in both groups using a muscle relaxant monitor (train of stimuli-Watch), the onset time, T1 and T2 recovery time, and muscle relaxant dosage of vecuronium were observed. Hemodynamic changes were observed in both groups, and the dosage of vasoactive drugs was recorded. The quality of recovery of the patients was evaluated using the Mini-Mental State Examination (MMSE) and the discharge from the Aldrete score criteria. There was no significant difference in the onset time of vecuronium between the two groups (P > .05). The desflurane group’s T1 and T2 recovery times were later than that of the sevoflurane group. The dosage of vecuronium was statistically significantly less than that in the sevoflurane group (P < .05); the extubation time in the desflurane group was statistically significantly longer than that in the sevoflurane group (P < .05). There were no significant differences in preoperative and intraoperative mean arterial pressure, heart rate, ephedrine and atropine dosage, MMSE score, and Aldrete score between the 2 groups (P > .05). Compared with sevoflurane, desflurane has a stronger synergistic effect on the muscle relaxant of vecuronium without increasing the incidence of cardiovascular adverse reactions and affecting patient recovery.
Early Lyme neuroborreliosis manifesting as brachial plexopathy and meningitis in Northwestern Ontario, Canada: A case report
Authors: Gu Kaien , Boodman Carl , Orr Pamela , Wuerz Terence
Published: November 2022

Rationale:

Lyme disease is a tick-borne disease caused by the spirochete B. burgdorferi, and patients often present with symptoms comparable to a viral-like illness. The diagnosis can be challenging given its wide range of manifestations and diagnostic testing can take days or longer. Here, we present a case of Lyme disease presenting as brachial plexopathy and meningitis.

Patient concerns:

A 76-years-old male presented to a tertiary-care hospital with left arm weakness and neck pain.

Diagnosis:

Our patient was diagnosed with Lyme neuroborreliosis and had positive serology, including enzyme immunoassay and Western blot.

Interventions:

Our patient received 17 days of ceftriaxone (2g IV daily) followed by oral doxycycline (100mg bid).

Outcomes:

Over the subsequent year, our patient had eventual complete recovery in muscle strength and sensation, with slower improvement to the cervical neck and left arm pain.

Lessons:

Incidence of Lyme disease is increasing in North America, and the disease has a wide range of symptoms. Lyme neuroborreliosis (LNB) is 1 presentation and can present with early or late manifestations; clinicians should maintain a high index of suspicion and begin empiric treatment in individuals with a clinical syndrome consistent with LNB. Early LNB manifestations have onset within 6 months of infection and include cranial and peripheral neuropathy, radiculitis, and aseptic meningitis; late LNB encompasses a chronic encephalomyelitis.
Comparison of the geriatric nutritional risk index and the prognostic nutritional index in determining survival outcome in patients with non-small cell lung cancer undergoing surgical resection: A cohort study
Authors: An Soomin , Han Ga Young , Eo Wankyu , Kim Dae Hyun , Lee Sookyung
Published: November 2022

To assess the clinical feasibility of the geriatric nutritional risk index (GNRI) and prognostic nutritional index (PNI) as determinants of survival in patients with stage I to III non-small cell lung cancer (NSCLC). This retrospective study included patients with stage I to III NSCLC from all age groups. Hazard ratios (HRs) for overall survival (OS), cancer-specific survival (CSS), and relapse-free survival (RFS) were calculated using the Cox regression analysis. The concordance index (C-index) of the models was evaluated following the establishment of the prognostic models for survival. The median patient age was 69 years, and 64.6% of the patients were male. In total, 172 (65.4%) patients were classified as having stage I disease, 52 (19.8%) as stage II disease, and 39 (14.8%) as stage III disease. Using multivariate Cox regression analysis, the HRs of GNRI for OS, CSS, and RFS were 0.37 (P = .003), 0.47 (P = .041), and 0.38 (P < .001), respectively. However, the HRs of the PNI for survival outcomes were not statistically significant. Overall, age, sex, tumor-node-metastasis (TNM) stage, pleural invasion (PI), and GNRI were significant determinants of OS and constituted the OS model (concordance index [C-index], 0.824). In addition, age, TNM stage, PI, and GNRI were significant determinants of CSS and constituted the CSS model (C-index, 0.828). Finally, TNM stage, PI, lymphatic invasion, and GNRI were significant determinants of RFS and constituted the RFS model (C-index, 0.783). Our study showed that GNRI, but not PNI, was a predictor of OS, CSS, and RFS in patients with stage I–III NSCLC across all age groups. Excellent discriminant power was observed for OS, CSS, and RFS models.
Factors affecting patient safety culture in a university hospital under the universal health insurance system: A cross-sectional study from Japan
Authors: Hata Takeo , Murao Hitoshi , Nakagami-Yamaguchi Etsuko , Yamaguchi Yoko , Eguchi Hiromi , Nishihara Masami , Nitta Masahiko , Ueda Eiichiro , Uchiyama Kazuhisa , Katsumata Takahiro
Published: November 2022

We conducted a cross-sectional study of patient safety culture aimed at examining the factors that influence patient safety culture in university hospitals under a universal health insurance system. The Hospital Survey on Patient Safety Culture developed by the Agency for Healthcare Research and Quality was used. The survey was distributed to 1066 hospital employees, and 864 responded. The confirmatory factor analysis showed a good fit of the results to the 12-composites model. The highest positive response rates were for “(1) Teamwork within units” (81%) and “(2) Supervisor/manager expectations and actions promoting patient safety” (80%), and the lowest was for “(10) Staffing” (36%). Hayashi’s quantification theory type 2 revealed that working hours per week had the greatest negative impact on patient safety culture. Under a universal health insurance system, workload and human resources might have a significant impact on the patient safety culture.
Phase angle is a useful bioelectrical marker for skeletal muscle quantity and quality in hospitalized elderly patients
Authors: Geng Jiaxu , Wei Yanan , Xue Qian , Deng Lihua , Wang Jingtong
Published: November 2022

To analyze whether phase angle (PhA) can be a useful bioelectrical marker for skeletal muscle quantity and quality in hospitalized elderly patients. Two hundred hospitalized elderly patients were included in this retrospective observational study. PhA was obtained by Bioelectrical Impedance Analysis, skeletal muscle area index (SMI) and skeletal muscle density (SMD) were measured at the third lumbar vertebra level in computed tomography images using SliceOmatic software. PhA was positively associated with SMD and SMI, with correlation coefficients of 0.629 and 0.674, respectively. Multiple logistic regression analysis showed that 1° reduction of PhA was significantly associated with low SMI [odds ratio (OR) = 4.331 (1.681–11.161)] and low SMD [OR = 6.418 (2.963–13.899)]. Receiver operating characteristic curve analysis showed that the area under the curve (AUC) for PhA to identify patients with low SMI was 0.772 for male and 0.784 for female; the AUC for PhA to identify low SMD patients was 0.829 for male and 0.812 for female; the AUC for PhA to identify low SMD combined with low SMD patients was 0.801 for male and 0.773 for female. The results of this study showed that PhA was highly related to SMI, which can indicate the quantity of skeletal muscle in the entire body, and was highly related to SMD, which can be used to assess skeletal muscle quality. Therefore, PhA may be a useful bioelectrical marker for skeletal muscle quantity and quality.
Steroid treatment response combined with serological mark in differentiating type-1 autoimmune pancreatitis from pancreatic cancer
Authors: Liu Bingqian , Tang Ning , Yao Yuan , Li Hua , Xu Lishan , Zhou Bin , Liu Bin
Published: November 2022

Autoimmune pancreatitis (AIP) and pancreatic cancer (PC) are two different diseases. Their diagnosis, treatment and prognosis are different, and it is difficult to differentiate them. This study aimed to explore the role of steroid treatment response combined with serological mark in distinguishing type-1 AIP from PC. Clinical data were collected and compared from 50 cases of AIP (group 1) and 100 cases of PC (group 2). The diagnostic value of serum IgG4, CA19-9, globulin (GLB) and eosinophil cell (EC) were evaluated. The response of steroid treatment of 28 patients with atypical imaging in group 1 was analyzed. After 2 weeks, the patients were classified as positive and negative steroid response according to the manifestations and/or the radiological changes. The positive response cases (n = 20) were confirmed as AIP, whereas negative ones (n = 8) were finally diagnosed as PC after complete resection. Serum GLB, IgG4 and EC levels in group 1 were significantly higher than those in group 2 (P < .01), and CA19-9 levels were distinctly lower in group 1 (P < .01). The level of serum IgG4 was related to the accuracy of diagnosis of AIP on the basis of the result of logistic regression analysis. Two-weeks steroid therapy response combined with serum IgG4 levels contribute to the differential diagnosis AIP and PC. However, regular and long-term follow-up were importance for the differential diagnosis. There was an urgent need to explore the specific markers that distinguish these 2 entities.
Health utility measurement for people living with HIV/AIDS under combined antiretroviral therapy: A comparison of EQ-5D-5L and SF-6D
Authors: Wang Xiaowen , Luo Hongbing , Yao Enlong , Tang Renhai , Dong Wenbing , Liu Fuyong , Liang Jun , Xiao Minyang , Zhang Zuyang , Niu Jin , Song Lijun , Fu Liru , Li Xuehua , Qian Shicong , Guo Qing , Song Zhizhong
Published: November 2022

We compared the discriminative validity, agreement and sensitivity of EQ-5D-5L and SF-6D utility scores in people living with HIV/AIDS (PLWHIV). We conducted a cross-sectional survey among PLWHIV aged more than 18 years old in 9 municipalities in Yunnan Province, China. A convenience sample was enrolled. We administered the SF-12 and EQ-5D-5L to measure health-related quality of life. The utility index of the SF-6D was derived from the SF-12. We calculate correlation coefficients to evaluate the relationship and agreement of 2 instruments. To evaluate the homogeneity of the EQ-5D-5L and SF-6D, intraclass correlation coefficients, scatter plots, and Bland–Altman plots were computed and drawn. We also used receiver operating characteristic curves to compare the discriminative properties and sensitivity of the econometric index. A total of 1797 respondents, with a mean age of 45.6 ± 11.7 years, was interviewed. The distribution of EQ-5D-5L scores skewed towards full health with a skewness of −3.316. The overall correlation between EQ-5D-5L and SF-6D index scores was 0.46 (P < .001). The association of the 2 scales appeared stronger at the upper end. An intraclass correlation coefficient of 0.59 between the EQ-5D-5L and SF-6D meant a moderate correlation and indicated general agreement. The Bland–Altman plot displayed the same results as the scatter plot. The receiver operating characteristic curve showed that the AUC for the SF-6D was 0.776 (95% CI: 0.757, 0.796) and that for the EQ-5D-5L was 0.732 (95% CI: 0.712, 0.752) by the PCS-12, and it was 0.782 (95% CI: 0.763, 0.802) for the SF-6D and 0.690 (95% CI: 0.669, 0.711) for the EQ-5D-5L by the MCS-12. Our study demonstrated evidence of the performance of EQ-5D-5L and SF-6D index scores to measure health utility in people living with HIV/AIDS. There were significant differences in their performance. We preferred to apply the SF-6D to measure the health utility of PLWHIV during the combined antiretroviral therapy period. Our study has demonstrated evidence for instrument choice and preference measurements in PLWHIV under combined antiretroviral therapy.
Comparison of programmed intermittent epidural bolus injection and continuous epidural injection in controlling nighttime pain and improving sleep quality after thoracotomy
Authors: Lee Su-Sung , Baek Ji-Hye , Park Soon-Ji , Kim Hye-Jin , Kim Hee-Young , Byeon Gyeong-Jo
Published: November 2022

Background:

Postoperative pain after open thoracotomy is known to be very severe and affects sleep quality. This study aimed to investigate the effects of a programmed intermittent epidural bolus injection versus continuous epidural injection for controlling nighttime pain and improving sleep quality after thoracotomy.

Methods:

Seventy-six patients scheduled for open thoracotomy for lung cancer or other lung diseases were enrolled. The participants were divided into 2 groups. Group A was continuously injected with 0.2% levobupivacaine at 1.1 mL/h, and group B was injected intermittently with 3 mL 0.2% levobupivacaine at 3 hours intervals through a thoracic epidural catheter via a programmed infusion pump. Within 48 hours after surgery, the degree of pain control using visual analog scale and the patients’ sleep conditions on postoperative day (POD) 0 and 1 were evaluated, and other adverse events were investigated.

Results:

On POD 1 night, the visual analog scale in group B showed lower than group A (P = .009). Comparison of time to fall asleep showed no differences between 2 groups. Total sleep time was no difference on POD 0 but was longer in group B than that in group A on POD 1 (P = .042). Awakening from sleep on POD 0 was lower in group B than that in group A (P = .033), and satisfaction with sleep quality on POD 0 was superior in group B compared to group A (P = .005). Postoperative nausea and vomiting occurred more frequently in group B than in group A (P = .018).

Conclusion:

The programmed intermittent epidural bolus technique of patient-controlled epidural analgesia reduces postoperative nighttime pain and improves sleep quality in patients undergoing thoracotomy for lung cancer or other lung diseases.
Sixty cases of refractory allergic rhinitis treated by vidian trunk or branch neurectomy: A single-center observational study
Authors: Chu Shidong
Published: November 2022

To investigate the effect of vidian trunk neurectomy and selective vidian branch neurectomy on treating moderate-to-severe persistent allergic rhinitis. Sixty patients with moderate-to-severe persistent allergic rhinitis treated at Zhejiang Hospital of Integrative Medicine participated in this study from June 2018 to June 2020. The patients in the observation group (n = 40) underwent a vidian trunk neurectomy. The patients in the control group (n = 20) underwent a vidian branch neurectomy. The patients in both groups were followed up after 6 months, 1 year, and 2 years of surgery. The efficacy was evaluated based on the AR diagnostic and the efficacy assessment criteria. The 4 symptoms of sneezing, runny nose, nasal congestion, and nasal itch were scored as efficacy indices before and 6 months, 1 year, and 2 years after surgery. Nasal endoscopy or sinus CT was performed to assess the postoperative inferior turbinate swelling. The postoperative tear secretion was followed up in both groups, and patients with dry eyes were counted in combination with ocular symptoms. The data recorded before and after surgery and between the 2 groups were analyzed statistically. The observation group had signs of 2.73 ± 0.452 before surgery, 1.20 ± 0.405 6 months after surgery, 1.25 ± 0.494 1 year after surgery, and 1.30 ± 0.564 2 years after surgery. The control group had signs of 2.75 ± 0.444 before surgery, 1.45 ± 0.686 6 months after surgery, 1.75 ± 0.716 1 year after surgery, and 1.90 ± 0.852 2 years after surgery. The between-subjects effect test between the groups showed an overall significant difference (P < .05). The overall effective rate 2 years postoperatively was 38/40 (95.0%) in the observation group and 10/20 (50%) in the control group. Fisher’s exact test showed a significant difference between the groups. No patient in either group had dry eyes 1.5 years after surgery. Both vidian trunk neurectomy and selective vidian branch neurectomy have good immediate therapeutic effects, and vidian trunk neurectomy has higher long-term efficacy than selective vidian branch neurectomy.
LncRNA PVT1 regulates biological function of osteoarthritis cells by regulating miR-497/AKT3 axis
Authors: Xu Jinming , Fang Xiang , Qin Ling , Wu Qiang , Zhan Xinli
Published: November 2022

Growing evidence indicates that lncRNAs are involved in the progression of several diseases, including osteoarthritis (OA). However, the role of the lncRNA PVT1 in OA is still unclear. The present study was aimed at exploring the impact of PVT1 on OA progression, along with potential underlying mechanisms. PVT1 expression levels in articular cartilage tissue of OA patients and non-OA patients were evaluated. To assess the proliferation and apoptosis of chondrocytes subject to treatment, PVT1, miR-497, and AKT3 were either knocked down or upregulated in IL-1β-induced chondrocytes. The variables detected were changes in levels of AKT3 and extracellular matrix (ECM)-related factors (including aggrecan, collagen Type II, and MMP-9). Elevated PVT1 levels were found in cartilage tissue of OA patients and IL-1β-induced chondrocytes. It was also observed that PVT1 knockdown and miR-497 upregulation led to enhanced cell proliferation and suppressed apoptosis. In addition, a decrease in aggrecan and collagen type II levels and an increase in MMP-9 levels were observed in IL-1β-induced chondrocytes. A dual luciferase reporter assay was performed to identify the factors that interacted with miR-497, PVT1, and AKT3. It was observed through rescue experiments that enhancing AKT3 expression or knocking down miR-497 could reverse the impacts of PVT1 knockdown in IL-1β-induced chondrocytes. An upregulation of PVT1 is observed in OA patients. On the other hand, PVT1 knockdown can decrease the effects of IL-1β on the proliferation, apoptosis, and expression of ECM-related proteins of chondrocytes through the regulation of the miR-497/AKT3 axis. PVT1 levels are elevated in the cartilage tissue of OA patients and IL-1β-induced chondrocytes. PVT1 knockdown alleviates the effects of IL-1β treatment on the proliferation and apoptosis of chondrocytes and ECM degradation in chondrocytes by regulating the miR-497/AKT3 axis.
Brachial-ankle pulse wave velocity as a predictor of long-term cardiovascular events in 2174 subjects with type 2 diabetes mellitus: A retrospective cohort study
Authors: Kim Hack-Lyoung , Jeon Won Kyeong , Joh Hyun Sung , Lim Woo-Hyun , Seo Jae-Bin , Kim Sang-Hyun , Zo Joo-Hee , Kim Myung-A
Published: November 2022

The prognostic value of arterial stiffness in patients with diabetes mellitus (DM) remains unclear. The aim of this study was to investigate the association between brachial-ankle pulse wave velocity (baPWV) and the occurrence of cardiovascular events in people with DM. A total of 2714 subjects (mean age, 63.6 years; males, 59.3%) with type 2 DM and without documented cardiovascular disease and stroke were analyzed. The primary end-point of this study was composite cardiovascular events of cardiac death, non-fatal myocardial infarction, coronary revascularization and stroke. There were 118 composite events (4.3%) during a median follow-up period of 3.84 years (interquartile range, 1.60–5.52 years). In multivariable Cox regression analysis, higher baPWV (≥1672 cm/s) was associated with composite events even after controlling for potential confounders (hazard ratio [HR], 2.00; 95% confidence interval [CI], 1.31–3.07; P = .001). Compared to the lowest baPWV tertile, both middle (HR, 1.84; 95% CI, 1.03–3.27; P = .037) and the highest (HR, 2.97; 95% CI, 1.69–5.22; P < .001) tertile of baPWV were associated with increased risk of cardiovascular events in the same multivariable model. In conclusion, the baPWV was associated with cardiovascular events in people with type 2 DM. Considering the simplicity and convenience of baPWV measurement, baPWV may be useful for risk stratification of people with type 2 DM.
Effectiveness of exercise in reducing cerebral stroke risk factors: A systematic review and meta-analysis
Authors: Men Jie , Wang Wenjuan , Zhao Jian , Wen Jie , Hao Qingqing , Li Shufeng , Zou Shuangling
Published: November 2022

Objectives:

This study aimed to explore the relationship between exercise and cerebral stroke and provide evidence for the prevention of cerebral stroke.

Materials/Methods:

All clinical trials of exercise intervention for atherosclerosis were systematically reviewed. Five major databases were searched to retrieve relevant studies from their inception to May 2022. According to the magnitude of heterogeneity, the random and fixed-effect models were used to test reasonably.

Results:

According to the inclusion and exclusion criteria, 1341 articles were screened and 13 articles involving 825 patients were identified. The result showed that in the randomized controlled trials carotid intima-media thickness index was lower in the exercise group (−0.04 mm, 95% confidence interval: −0.07 to −0.01). All were statistically significant (P < .005) and subgroup analysis showed that the intervention period and paper quality are sources of heterogeneity.

Conclusions:

The results of this systematic review suggest that exercise is associated with a slow increase in carotid intima-media thickness, which may provide evidence that exercise helps reduce cerebral stroke.