bluuebunny/crossref_metadata_2025 huggingface dataset:
Temporal Relationship and Clinical Outcomes of Acute Kidney Injury Following Acute Respiratory Distress Syndrome: A Systematic Review and Meta-Analysis
Authors: Charkviani Mariam , Truong Hong Hieu , Nikravangolsefid Nasrin , Ninan Jacob , Prokop Larry J. , Reddy Swetha , Kashani Kianoush B. , Domecq Garces Juan Pablo
Published: February 2024

OBJECTIVES:

Conduct a systematic review and meta-analysis to assess prevalence and timing of acute kidney injury (AKI) development after acute respiratory distress syndrome (ARDS) and its association with mortality.

DATA SOURCES:

Ovid MEDLINE(R), Ovid Embase, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, Ovid PsycINFO database, Scopus, and Web of Science thought April 2023.

STUDY SELECTION:

Titles and abstracts were screened independently and in duplicate to identify eligible studies. Randomized controlled trials and prospective or retrospective cohort studies reporting the development of AKI following ARDS were included.

DATA EXTRACTION:

Two reviewers independently extracted data using a pre piloted abstraction form. We used Review Manager 5.4 software (Cochrane Library, Oxford, United Kingdom) and Open Meta software (Brown University, Providence, RI) for statistical analyses.

DATA SYNTHESIS:

Among the 3646 studies identified and screened, 17 studies comprising 9359 ARDS patients met the eligibility criteria and were included in the meta-analysis. AKI developed in 3287 patients (40%) after the diagnosis of ARDS. The incidence of AKI at least 48 hours after ARDS diagnosis was 20% (95% CI, 0.18–0.21%). The pooled risk ratio (RR) for the hospital (or 30-d) mortality among ARDS patients who developed AKI was 1.93 (95% CI, 1.71–2.18). AKI development after ARDS was identified as an independent risk factor for mortality in ARDS patients, with a pooled odds ratio from multivariable analysis of 3.69 (95% CI, 2.24–6.09). Furthermore, two studies comparing mortality between patients with late vs. early AKI initiation after ARDS revealed higher mortality in late AKI patients with RR of 1.46 (95% CI, 1.19–1.8). However, the certainty of evidence for most outcomes was low to very low.

CONCLUSIONS:

While our findings highlight a significant association between ARDS and subsequent development of AKI, the low to very low certainty of evidence underscores the need for cautious interpretation. This systematic review identified a significant knowledge gap, necessitating further research to establish a more definitive understanding of this relationship and its clinical implications.
Factors Affecting Mortality in Critically Ill Patients With Tuberculosis: A Systematic Review and Meta-Analysis
Authors: Mishra Shivangi , Gala Jinay , Chacko Jose
Published: February 2024

Objectives:

Critically ill patients with tuberculosis carry high mortality. Identification of factors associated with mortality in critically ill tuberculosis patients may enable focused treatment.

Data Sources:

An extensive literature search of PubMed (MEDLINE), Embase, the Cochrane Library, and Google Scholar was performed using Medical Subject Headings terms “tuberculosis,” “critical care,” “critical care outcome,” and “ICU.” We aimed to identify factors affecting mortality in critically ill tuberculosis patients.

Study Selection:

All the studies comparing factors affecting mortality between survivors and nonsurvivors in critically ill tuberculosis patients were included. The database search yielded a total of 3017 records, of which 17 studies were included in the meta-analysis.

Data Extraction:

Data were collected including the name of the author, year and country of publication, duration of the study, number of patients studied, type of tuberculosis, patient demography, smoking history, laboratory parameters, comorbidities, the requirement for mechanical ventilation, duration of ventilation, ICU and hospital length of stay (LOS), type of lung involvement, complications, and outcomes.

Data Synthesis:

The major factors that contributed to mortality in critically ill tuberculosis patients were age, platelet count, albumin, C-reactive protein (CRP), the requirement and duration of invasive mechanical ventilation, Pao
2/Fio
2 ratio, presence of acute respiratory distress syndrome, shock, hospital-acquired infections, renal replacement therapy, and ICU and hospital LOS.

Conclusions:

Patient age, platelet count, albumin and CRP levels, the requirement and duration of invasive mechanical ventilation, Pao
2/Fio
2 ratio, hospital-acquired infections, renal replacement therapy, and ICU LOS were variables associated with mortality.
Disease-Specific Mortality of Dermatofibrosarcoma Protuberans After Mohs Surgery Versus Wide Local Excision: A Systematic Review and Meta-Analysis
Authors: Crum Olivia M. , O'Hern Keegan , Demer Addison M. , Brewer Jerry D.
Published: February 2024

BACKGROUND

Although advances have been made in the understanding of recurrence patterns in dermatofibrosarcoma protuberans, the current understanding of disease-specific mortality after surgical management is limited.

OBJECTIVE

To understand disease-specific mortality rates associated with dermatofibrosarcoma protuberans treated with wide local excision (WLE) versus Mohs micrographic surgery (MMS).

MATERIALS AND METHODS

A systematic literature search was conducted on March 6, 2023, to identify patients treated with MMS or WLE for dermatofibrosarcoma protuberans.

RESULTS

A total of 136 studies met inclusion criteria. Overall, the disease-specific mortality rate was not significantly different after treatment with MMS (0.7%, confidence interval [CI] 0.1–1.2,p: 0.016) versus WLE (0.9%, CI 0.6–1.2,p< .001). For recurrent tumors, the MMS treatment group had a statistically significantly lower disease-specific mortality rate (1.0%, CI 0.0–2.0,p0.046) compared with the WLE treatment group (3.5%, CI 2.0–5.1,p< .001). The mean follow-up for all studies was 57.6 months.

CONCLUSION AND RELEVANCE

The authors' meta-analysis suggests there is no substantial difference in disease-specific mortality between MMS and WLE in patients with dermatofibrosarcoma protuberans, except in the case of recurrent tumors, where MMS seems to confer a survival advantage.
TMR Using a Free Rectus Flap after Transhumeral Amputation
Authors: Galbraith Logan G. , Najafali Daniel , Gatherwright James R.
Published: February 2024

Targeted muscle reinnervation offers an approach to regain use of the affected extremity through electronic prosthesis while limiting phantom pain and neuroma limb production or pain. In this case report, we present the first reported case of leveraging the rectus flap for targeted muscle reinnervation. The case herein is of a 28-year-old woman who sustained a severe right upper extremity crush injury while being involved in a vehicular roll-over collision requiring right transhumeral amputation. Plastic surgery, orthopedic surgery, and vascular surgery were consulted to manage the right upper extremity injury.
When Change Chooses You: My Journey With Paralysis
Authors: Hull Dale B.
Published: February 2024

Life sometimes provides unannounced challenges that threaten the structure of our existence. This personal account of an ob-gyn's encounter with paralysis will illustrate the impact of one such experience.
Longitudinal Changes in Choroidal Thickness in Children with a History of Prematurity: An 18-month Prospective Cohort Study
Authors: Lee Yung-Sung , Liu Laura , Wang Nan-Kai , Chen Kuan-Jen , Hwang Yih-Shiou , Lai Chi-Chun , Wu Wei-Chi
Published: February 2024

Purpose:

To evaluate choroidal changes over time in school-aged children with a history of prematurity.

Methods:

A study of 416 eyes, including 88, 190, 36, 56, and 46 eyes in the full-term control, preterm, spontaneously regressed retinopathy of prematurity (ROP), intravitreal bevacizumab (IVB)-treated ROP, and laser-treated ROP groups, respectively. The choroidal thickness was measured 4 times at 6-month intervals by optical coherence tomography.

Results:

Of all the groups, the laser-treated children had the thinnest choroid compared with full-term children (−52.3 μm,P= .04). Preterm children exhibited greater attenuation in choroidal thickness over time than did full-term children (−6.3 ± 26.9 and −1.1 ± 12.8 μm/year,P= .03), whereas no difference was observed between IVB and laser treatments (−4.6 ± 18.9 and −2.0 ± 15.7 μm/year,P= .46). In all groups, the changes in axial length were negatively associated with the changes in choroidal thickness (allP< .05).

Conclusion:

A greater attenuation in choroid thickness over time was observed in preterm children than in full-term children, but this attenuation did not differ between IVB and laser treatments. Axial elongation was associated with choroidal thinning in school-aged children.
Intraocular Straylight and Multifocal Soft Contact Lens Fit With a Myopia Control Approach
Authors: Ritchey Eric R. , Gregory Hannah R. , Nti Augustine N. , Berntsen David A.
Published: February 2024

Objectives:

Center-distance multifocal contact lenses (MFCLs) are used to slow myopia progression. We examined the effect of two MFCLs on intraocular straylight values in myopic individuals.

Methods:

Twenty-five young myopic adults were enrolled and were fit with three contact lenses (Biofinity sphere, Biofinity Multifocal, and NaturalVue Multifocal) in a random order over two study visits. Pupil size (NeurOptics VIP-300, Laguna Hills, CA) and contact lens centration were measured. Right eye intraocular straylight measurements were collected (OCULUS C-Quant; Wetzlar, Germany) and compared with a spectacle trial lens. Log straylight (LogSL) values and straylight residuals were analyzed using repeated-measures analyses of variance with Tukey-corrected post hoc t-tests.

Results:

The mean participant age (±SD) was 24.1±1.5 years, and right eye spherical equivalent refractive error was −3.38±1.53 DS. There was no difference in mesopic pupil size between visits (P=0.68) and no difference in contact lens centration between lenses (P=0.99). LogSL values differed by lens type (P=0.004). LogSL with the spectacle trial lens was significantly greater than with each contact lens type (all P<0.05), but there were no significant differences in LogSL between the three contact lenses (all P>0.05). There was no difference between the three contact lens designs for straylight residuals (P=0.33).

Conclusions:

Measured intraocular straylight for both MFCLs was not different than with a spherical soft contact lens. A significant increase in intraocular straylight with spectacle trial lens correction was observed compared with all contact lenses.
Enacting an “Empowerment Approach” After Sexual Assault: The Views and Beliefs of Forensic Nurse Examiners and Crisis Support Workers
Authors: Driver Mary
Published: February 2024

Background

Sexual violence is a profoundly disempowering experience. It is essential that survivors are offered access to comprehensive medical care, psychological support, and follow-up in a way that offers them a high level of choice and control.

Aims

There has been little research into how practitioners working in the context of immediate postassault understand empowerment and reflect this in their care delivery. This study sought to explore how crisis support workers and forensic nurse examiners conceive how they enact an “empowerment approach” in a sexual assault referral center (SARC) in the United Kingdom.

Methods

A phenomenological approach was taken, and data were gathered through focus groups and interviews.

Findings

Themes were identified under the headings of “indicators of empowerment,” “empowerment as a process,” and “the empowerment approach.”

Conclusion

As part of providing person-centered care that enacts an empowering approach within the SARC setting, professionals need the skills and resources to be able to respond flexibly to their clients. They have a role in addressing victim blaming of those subjected to sexual violence and in promoting the accessibility of SARC services.
Exploiting open source omics data to advance pancreas research
Authors: Swaminathan Gayathri , Saito Toshie , Husain Sohail Z.
Published: February 2024

The “omics” revolution has transformed the biomedical research landscape by equipping scientists with the ability to interrogate complex biological phenomenon and disease processes at an unprecedented level. The volume of “big” data generated by the different omics studies such as genomics, transcriptomics, proteomics, and metabolomics has led to the concurrent development of computational tools to enable in silico analysis and aid data deconvolution. Considering the intensive resources and high costs required to generate and analyze big data, there has been centralized, collaborative efforts to make the data and analysis tools freely available as “Open Source,” to benefit the wider research community. Pancreatology research studies have contributed to this “big data rush” and have additionally benefitted from utilizing the open source data as evidenced by the increasing number of new research findings and publications that stem from such data. In this review, we briefly introduce the evolution of open source omics data, data types, the “FAIR” guiding principles for data management and reuse, and centralized platforms that enable free and fair data accessibility, availability, and provide tools for omics data analysis. We illustrate, through the case study of our own experience in mining pancreatitis omics data, the power of repurposing open source data to answer translationally relevant questions in pancreas research.
Outcome of patients with primary and secondary hemophagocytic lymphohistiocytosis: A retrospective analysis from a tertiary care center
Authors: Abbasi Abdul Muqtadir , Shaikh Mohammad Usman , Shariq Muhammad , Arif Muhammad Salman , Arshad Ainan , Raheem Ahmed , Ali Natasha
Published: February 2024

Hemophagocytic lymphohistiocytosis (HLH) is a progressive and potentially life-threatening disorder. It is classified into primary and secondary HLH. The objective of our study was to determine the outcome of primary and secondary HLH in pediatric and adult patients based on HScore and treatment modality. We conducted a retrospective analysis done from July 2010 to June 2020. Variables analyzed included age, gender and history of death in siblings. HScore was used for disease classification while clinical and laboratory findings which were required to fulfill the HScore diagnostic criteria were also recorded. Continuous variables were summarized as median and categorical variables as frequencies and percentages. Categorical variables were compared using chi-square test and Fisher Exact test. Significance of different variables between primary and secondary HLH was calculated using independent-samples t test. A P value of < .05 was taken as significant. A total of 51 patients were included in the analysis (41 in primary and 10 in secondary HLH group). In primary HLH, 36 patients were in the pediatric age group and 12.2% had a history of death in sibling. All 41 patients had increased ferritin and decreased fibrinogen levels. The overall survival in primary HLH was 44%. In the secondary HLH group, viral infections were the most common etiology and ferritin was increased as well. The overall survival in secondary HLH was 60%. The median survival was 15 ± 4.8 months. The overall survival of both groups combined was 53%. Primary HLH should be considered in pediatric patients who present with pancytopenia and hepatosplenomegaly. In centers where genetic testing is not available, HScore along with serum ferritin and fibrinogen is a good substitute for disease classification.
Accreditation of the handheld 3-dimensional scanner and conventional photo images for area measurement
Authors: Chang Chao-Wei , Hsieh Meng-Chien , Lin I-Wen , Chen Rong-Fu , Kuo Yur-Ren , Lee Su-Shin
Published: February 2024

Accurate assessment of wound areas is crucial in making therapeutic decisions, as the prognosis and changes in the size of the wound over time play a significant role. An ideal assessment method should possess qualities such as speed, affordability, accuracy, user-friendliness for both patients and healthcare professionals, and suitability for daily clinical practice. This study aims to introduce a handheld 3-dimensional (3D) scanner and evaluate its accuracy in measuring wound areas. Engineers from the Industrial Technology Research Institute in Taiwan developed a handheld 3D scanner with the intention of extending its application to the medical field. A project was conducted to validate the accuracy of this 3D scanner. We utilized a smartphone (Asus ZenFone 2 with a 13-million-pixel rear camera), a digital single-lens reflex digital camera (Nikon, D5000, Tokyo, Japan), and the 3D scanner to repeatedly measure square papers of known size that were affixed to the curved surface of life-size facial mask or medical teaching breast models. The “Image J” software was employed for 2-dimensional image measurements, while the “3D Edit” software was used to assess the “area of interest” on 3D objects. By using square papers with predetermined dimensions, the measurement-associated error rate (ER) could be calculated for each image. Three repeated measurements were performed using the “Image J” software for each square paper. The ERs of the 3D scan images were all below 3%, with an average ER of 1.64% in this study. The close-up mode of the smartphone exhibited the highest ER. It was observed that as the area increased, the ER also increased in the digital single-lens reflex camera group. The extension distortion effect caused by the wide-angle lens on the smartphone may increase the ER. However, the definition of a healthy skin edge may vary, and different algorithms for calculating the measurement area are employed in various 3D measurement software. Therefore, further validation of their accuracy for medical purposes is necessary. Effective communication with software engineers and discussions on meeting clinical requirements are crucial steps in enhancing the functionality of the 3D scanner.
Evaluation of different doses of Femoston therapy for incomplete abortion: A prospective observational trial
Authors: Wang Wenrong , Gong Bingchen , Cai Yingying , Huang Xueyao , An Jian
Published: February 2024

This study aimed to compare the efficacy of different doses of femoston with expectant management in patients with incomplete abortions. Patients diagnosed with incomplete abortion were included if they chose to continue medical treatment after relevant contraindications were excluded. Participants were divided into 3 groups: the femoston (1/10) and femoston (2/10) groups received different doses of femoston, and patients in the control group received expectant treatment. The success rate of complete abortion and the rate of menstrual recovery among the 3 groups were compared to evaluate the efficacy of different doses of femoston in patients with incomplete abortions. A total of 197 patients were analyzed: 73 in the femoston (1/10) group, 73 in the femoston (2/10) group, and 51 patients were followed up without treatment in the control group. The femoston group was significantly more effective than the control group P < .0001). The adjusted odds ratio (OR) and 95% confidence interval (CI) were 3.103 and 1.153 to 8.350 (P = .025). The success rate of complete abortion in the femoston (2/10) group was significantly higher than that in the femoston (1/10) group (adjusted OR: 0.403, 95% CI: 0.145–1.118, P = .081). In addition, the rate of menstrual recovery in the femoston group was significantly higher than that in the control group (P = .007), and the rate in the femoston (2/10) group was also higher than the femoston (1/10) group with statistically significant (P = .001). Femoston is effective in treating incomplete abortion, with femostons containing 2 mg estrogen being more effective. Patients with incomplete abortion are treated with femoston, and menstrual recovery time may be shortened. Femostons may be a new option for pharmacological treatment of incomplete abortions.
Hemorrhagic retinal arterial macroaneurysm combined with branch retinal artery occlusion treated with intravitreal conbercept injection: A case report
Authors: Xie Pinxue , Feng Wen , Yan Ran , Zhu Siquan , Gao Xinxiao
Published: February 2024

Rationale:

Branch retinal artery occlusion (BRAO) is a rare complication of retinal arterial macroaneurysm (RAM), a low-incidence ocular disease.

Patient concerns:

A 75-year-old woman presented with a chief complaint of blurred vision.

Diagnoses:

The patient for 4 days received a diagnosis of RAM combined with BRAO.

Interventions:

The patient was treated with two successive intravitreal conbercept injections.

Outcomes:

The patient’s best-corrected visual acuity improved, and the RAM diminished.

Lessons:

Administration of conbercept injection might be an effective treatment for complex RAM with BRAO.
Gastrointestinal adverse events of tirzepatide in the treatment of type 2 diabetes mellitus: A meta-analysis and trials sequential analysis
Authors: Tong Keke , Yin Shuang , Yu Yunfeng , Yang Xinyu , Hu Gang , Zhang Fei , Liu Zhenjie
Published: February 2024

Background:

Tirzepatide (TZP) is a novel drug for type 2 diabetes mellitus (T2DM), but the gastrointestinal (GI) adverse events (AEs) is a limiting factor in clinical application. Therefore, this study systematically evaluated the GI AEs of TZP for T2DM.

Methods:

Clinical trials of TZP for T2DM were retrieved from eight databases published only from the establishment of the database to February 2023. Revman5.3 and TSA0.9.5.10 Beta were used for meta-analysis and trials sequential analysis (TSA).

Results:

Meta-analysis showed that compared with placebo, total GI AEs, nausea, decreased appetite, constipation and vomiting were significantly higher in all dose groups of TZP (P < .05), while abdominal pain and abdominal distension were comparable (P > .05). TSA showed that the differences in total GI AEs, nausea, decreased appetite and constipation were conclusive. Compared with insulin, nausea, diarrhea, vomiting and decreased appetite were significantly increased in all doses of TZP (P < .05), and dyspepsia was significantly increased with TZP 15 mg (P < .05). TSA showed that these differences were all conclusive. Compared with GLP-1 RA, decreased appetite was significantly higher with TZP 5 mg, total GI AEs, decreased appetite and diarrhea were significantly higher with TZP 10 mg (P < .05), while nausea, vomiting, dyspepsia and constipation were significantly different in all dose groups, abdominal pain were not significantly different (P < .05) and TSA showed no conclusive results in this group.

Conclusion:

The GI AEs of TZP were significantly higher than those of placebo and insulin, but comparable to GLP-1 RA. Nausea, diarrhea and decreased appetite are very common GI AEs of TZP, and the incidence is positively correlated with dose. GI AEs of TZP decrease gradually over time, so long-term steady medication may be expected to reduce GI AEs.
Expression of MMP-14 and its role in bone destruction in middle ear cholesteatoma: A prospective observational study
Authors: Lei Yu , An Junjun , Ren Qingchun , Wang Minjun , Gao Mingzhu
Published: February 2024

Cholesteatoma is a noncancerous cystic lesion caused by an abnormal growth of keratinizing squamous epithelium which is invasive and capable of destroying structures. A prospective study on the expression of membrane type1-matrix metalloproteinases (MMP-14) and its related influencing factors in middle ear cholesteatoma was conducted to fully understand the pathogenesis of cholesteatoma in the molecular level. We examined the expression of MMP-14 by immunohistochemical staining 39 middle ear cholesteatoma specimens and 10 external auditory meatus epithelial cell specimens. The cholesteatoma specimens were divided into 4 groups according to the degree of destruction of the ossicles during surgery. The associated factors affecting MMP-14 expression were analyzed using statistical methods; The positive expression of MMP-14 in the epithelium of the external auditory canal was significantly different between middle ear cholesteatoma and normal patients (P < .05); Gender, age, and the degree of hearing loss had no statistically significant effect on MMP-14 expression (P > .05); The expression of MMP-14 was positively correlated with the severity of bone destruction (R = 0.535, P < .05); MMP-14 plays an important role in the pathological development of the epithelium of cholesteatoma; MMP-14 expression in middle ear cholesteatoma tissue was not strongly correlated with the level of hearing loss, age or gender, but was positively correlated with the degree of middle ear bone destruction.
Exploring the protective effects of herbal monomers against diabetic retinopathy based on the regulation of autophagy and apoptosis: A review
Authors: Hu Zhuoyu , Wang Xuan , Hu Qi , Chen Xiangdong
Published: February 2024

Diabetic retinopathy (DR) has become one of the top 3 blinding eye diseases in the world. In spite of recent therapeutic breakthroughs, it is not yet possible to cure DR through pharmacotherapy. Cell death is thought to play a key role in the pathogenesis of DR. Moderate modulation of cellular autophagy and inhibition of apoptosis have been identified as effective targets for the treatment of DR. Numerous phytochemicals have emerged as potential new drugs for the treatment of DR. We collected basic DR research on herbal monomers through keywords such as autophagy and apoptosis, and conducted a systematic search for relevant research articles published in the PubMed database. This review provides the effects and reports of herbal monomers on various DR cellular and animal models in vivo and in vitro in the available literature, and emphasizes the importance of cellular autophagy and apoptosis as current DR therapeutic targets. Based on our review, we believe that herbal monomers that modulate autophagy and inhibit apoptosis may be potentially effective candidates for the development of new drugs in the treatment of DR. It provides a strategy for further development and application of herbal medicines for DR treatment.
Meta-analysis of clinical efficacy of electroacupuncture versus conventional treatment for postoperative urinary retention in cervical cancer
Authors: Tan Jinlang , Gong Rui , Zhang Qian , Zheng Yi , Ma Le , Shi Shuai
Published: February 2024

Background:

To conduct a meta-analysis on the clinical efficacy of electroacupuncture in the treatment of postoperative urinary retention in cervical cancer, and to provide a theoretical basis for the promotion of electroacupuncture in the treatment of this disease.

Methods:

Computer searches of the Cochrane library, Web of science, PubMed, Embase, Chinese Biomedical Literature Database, Wanfang database, Wipu database, and China National Knowledge Infrastructure Database database were conducted to find randomized controlled trials on electroacupuncture for postoperative urinary retention recovery in cervical cancer, all from the time of database creation to October 2022. Two evaluators independently evaluated the quality of the included literature and extracted the data. Data were combined and analyzed using RevMan 5.4.

Results:

A total of 21 Randomized controlled trials with 1532 patients, 789 in the treatment group and 743 in the control group, were included. One descriptive analysis was performed and 20 Meta-analyses were performed. Meta-analysis results showed that: The electroacupuncture group was more effective than the control group in promoting recovery from urinary retention after cervical cancer, with a statistically significant difference [relative risk (RR)] = 1.32, 95% confidence interval (CI 1.26, 1.39),P < .00001; The duration of indwelling catheterization was reduced in the electroacupuncture group compared with the control group, with a statistically significant standard mean difference = −1.43, 95% CI (−1.62, −1.24),P < .00001; The healing rate in the electroacupuncture group was higher than that in the control group, with a statistically significant difference [RR] = 1.92, 95% CI (1.59, 2.30),P < .00001; The rate of urinary tract infection in the electroacupuncture group was lower than that in the control group, with a statistically significant difference [RR] = 0.22, 95% CI (0.10, 0.45),P < .00001. The incidence of urinary retention was lower in the electroacupuncture group than in the control group, and the difference was statistically significant [RR = 0.26, 95% CI (0.18, 0.39),P < .01].

Conclusion:

Electroacupuncture can promote the recovery of urinary retention after cervical cancer surgery, and can improve the healing rate of patients after surgery, reduce the occurrence of urinary tract infection and shorten the duration of indwelling catheterization.
The influence of different sequences of vessel ligation on long-term survival during video-assisted thoracoscopic lobectomy for non-small cell lung cancer: A matched cohort study
Authors: Xiang Zhongtian , Feng Nan , Wu Bo , Zhang Xiang , Zhang Wenxiong
Published: February 2024

In lobectomy of patients with lung cancer, the principle of operation is to cut off the pulmonary vein first, but it is often not taken seriously in clinical practice. We conducted this research to compare the impact of different sequences of pulmonary vessel ligation on the long-term survival of patients. This cohort study included 1239 patients treated surgically with video-assisted thoracoscopic lobectomy from January 2015 to December 2019 at The Second Affiliated Hospital of Nanchang University. Survival and perioperative indicators were compared between a Vein-first group (VF) and an artery-first group. After matching, 364 patients were included in each group for analysis. VF was associated with better overall survival (hazard ratio: 1.96 [1.4~2.74], P < .0001) and disease-free survival (hazard ratio: 1.65 [1.22~2.24], P = .0011). Meanwhile, the survival advantage of VF was achieved in almost all subgroups, particularly in the pathological tumor node metastasis stage I-II group and squamous cell carcinoma group. We obtained no significant differences in perioperative indications (operation time, hospital stay, etc) between VF and artery-first group. With better overall survival and disease-free survival, especially for pathological stage I-II squamous cell carcinoma, vein-first ligation should be strictly observed in lobectomy for patients with non-small cell lung cancer.
Cervical spine Rosai–Dorfman disease: A case report and literature review
Authors: Rao Xianfeng , Kang Zhengwen , Chen Jianwei , Cai Chang , Wang Bo , Zhang Qiusheng
Published: February 2024

Background:

Rosai–Dorfman disease is a benign lymphatic tissue proliferative disease with slow growth and is rarely observed in the clinic. Most of these patients present clinically with enlarged lymph nodes. In patients with spinal extranodal Rosai–Dorfman disease, which is even rare than the disease of lymph nodes, patients may experience numbness and weakness in the extremities.

Case presentation:

We report a 32-year-old male patient with multi-segmental spinal Rosai–Dorfman disease. On admission, his left fingers had been numb for 2 months. Over a 2-month period, the limb numbness progressed from the left to the right hand. The patient underwent resection of the lesion and internal fixation of the C2–C7 spine. The postoperative outcomes were satisfied and no recurrence was observed at 1-year follow-up.

Conclusion:

Spinal Rosai–Dorfman disease is a relatively rare tumor of which the pathogenesis is still unclear, and most patients have no specific clinical manifestations. Characteristic imaging findings can indicate this disease, however, a definitive diagnosis still depends on a pathological examination. Currently, total surgical resection of the tumor is a relatively effective and preferred treatment.
Risk factors for recurrence after keloid surgery with electron radiotherapy
Authors: Liu Chunlei
Published: February 2024

The aim of this study was to investigate the effect of postoperative electron radiotherapy (RT) on local control for keloids and to identify risk factors for recurrence. The clinical data of 82 patients treated at our institution from January 2015 to October 2019 were collected. The data included the general condition of the patients, clinical characteristics of the keloids, treatment plan, local control, and treatment side effects. A total of 82 patients (129 keloids) were included. The study included 23 men (28%) and 59 females (72%). The median patient age was 32 years (range, 18–67 years). Twenty-six recurrences were observed, and the 1-, 3-, and 5-year local control rates were 93%, 81%, and 73%, respectively. Univariate analysis revealed that age (P = .03), hypertension (P = .04), scar shape (P < .001), primary site (P = .02), maximum lesion diameter (P < .001), pain and itching (P = .005), local tension (P = .005), and infection (P < .001) were risk factors for local recurrence. Multivariable analysis revealed that maximum lesion diameter (P < .001), infection (P < .001), interval between surgery and RT (P = .02), and previous treatment (P = .02) were independent risk factors. Complete excision of keloids combined with electron RT is safe and seemingly effective. For keloids with a high risk of recurrence, more aggressive treatment should be chosen, and further prospective studies are needed to explore the optimal treatment.
Comparative of the effectiveness and safety of biological agents, small molecule drugs, and microbiome therapies in ulcerative colitis: Systematic review and network meta-analysis
Authors: Gao Jie , Nie Rui , Chen Yalan , Yang Wei , Ren Qian
Published: February 2024

Background:

Biological agents are commonly used for the first-line treatment of ulcerative colitis (UC). However, small-molecule drugs and microbiome therapies are now being used as new treatments for ulcerative colitis. We aimed to compare the relative efficacy and safety of biologics, small-molecule drugs, and microbiome therapies for the treatment of patients with moderate-to-severe ulcerative colitis.

Methods:

We searched the Cochrane, Embase, and PubMed databases from their inception to December 2022. RCTs that recruited patients with moderate-to-severe ulcerative colitis treated with biological agents, small-molecule drugs, and microbiome therapies. Efficacy outcomes were induction of clinical remission and mucosal healing; safety outcomes were adverse events and serious adverse events. A network meta-analysis with multivariate consistency model random-effect meta-regression was done, with rankings based on surface under the cumulative ranking curve (SUCRA) values. Higher SUCRA scores correlate with better efficacy, whereas lower SUCRA scores correlate with better safety.

Results:

A total of 31 RCTs comprising 7933 UC patients were included in our studies. A risk of bias assessment showed a low risk of bias for most of the included studies. Upadacitinib ranked highest for induction of clinical remission (SUCRA, 0.83) and mucosal healing (SUCRA, 0.44). Moreover, no treatments were found to increase the occurrence of adverse events compared with placebos. Ustekinumab ranked lowest for adverse events (SUCRA 0.26) and probiotic ranked lowest for serious adverse events (0·21), whereas tofacitinib ranked highest for adverse events (0·43) and upadacitinib ranked highest for serious adverse events (0·43).

Conclusion:

In this systematic review and network meta-analysis, we found upadacitinib to be ranked highest for the induction of clinical remission and mucosal healing, but the worst performing agent in terms of adverse events in UC patients. Probiotics were the best-performing agent for safety outcomes. More trials of direct comparisons are needed to inform clinical decision-making with greater confidence.
Inadvertent hypothermia in patients undergoing brachytherapy under monitored anesthesia care: A prospective observational cohort study
Authors: Aytac Ismail , Guven Aytac Betül , Postaci Aysun
Published: February 2024

Brachytherapy, which is often performed under anesthesia, is one of the main treatment options for cervical cancer. It is unclear whether hypothermia and its associated negative outcomes are encountered during this procedure. This prospective observational cohort study aimed to investigate the prevalence and adverse effects of hypothermia during serial brachytherapies under deep sedation for cervical cancer. Female patients over the aged > of 18 years who underwent were taken to serial brachytherapy sessions under deep sedation on alternate dates at most twice a week for the treatment of cervical cancer were included. A total of 23 female were screened for initial and post-procedural hypothermia using infrared thermometers without contact to the skin at forehead between July and October 2022 at tertiary education and research hospital. Hypothermia was detected in 2 2 (8.7%) of the 23 patients and 5 5 (5.4%) of the 92 sessions. A negative correlation was found between the anesthesia time and post-procedural body temperature values (r = −0.385, P < .001). It was observed that there was a decrease in body temperature of at most −1.3 degrees and at least −0.1 degrees during the sessions. A decrease of ≥ 0.4°C was detected in any session in 16 (69.9%) of the 23 patients. A decrease of ≥ 0.4°C was detected in 34 (37%) of the 92 sessions. Involuntary hypothermia may occur during brachytherapy sessions performed under sedation. Institutions should encourage routine temperature monitoring and active warming to prevent hypothermia and adverse outcomes.
Prognostic factors of cirrhotic patients with invasive fungal infections
Authors: Hung Tsung-Hsing , Ko Ping-Hung , Tsai Chih-Chun , Wang Chih-Ying , Lee Hsing-Feng
Published: February 2024

Fungal infection (FI) is a life-threatening condition in cirrhotic patients. However, a population-based study is required to determine the short-term mortality of these patients. The Taiwan National Health Insurance Database was used to enroll 1214 cirrhotic patients with FIs who were hospitalized between January 1, 2010 and December 31, 2013. Among them, 165 were diagnosed with invasive FIs. The overall 30-day and 90-day mortality rates for patients with invasive FIs were 25.7% and 49.9%, respectively (P < .001). After adjusting for sex, age, and other comorbidities, the following 90-day mortality prognostic factors were statistically different: renal function impairment (hazard ratio = 1.98, 95% confidence interval = 1.05–3.70, P = .034), concurrent with bacterial infections (hazard ratio = 1.75, 95% CI = 1.07–2.88, P = .027). Half of the cirrhotic patients died within 90-daysdue to invasive FIs, highlighting the importance of renal function impairment and concurrent with bacterial infections as an important prognostic factor.
Calcium dobesilate-induced hyperpyrexia: A case report
Authors: Yang Hui , Yuan Hong-Ling , Zhang Zhi-Ping , Zhang Hong-Kui , Liu Ming-Wei
Published: February 2024

Rationale:

Calcium dobesilate, a vasoprotective and antioxidant agent, is gradually being used for the treatment of chronic kidney disease. Calcium dobesilate-induced hyperpyrexia is a rare clinical event, and few studies have reported it.

Patient concerns:

The patient took calcium dobesilate, which caused high fever. After stopping calcium dobesilate, his body temperature returned to normal.

Diagnoses:

Based on the medical history, symptoms and signs, the patient was diagnosed with drug fever caused by calcium dobesilate.

Interventions:

Calcium dobesilate was stopped, and supportive treatment was given at the same time.

Outcomes:

The present case was initially misdiagnosed as a fever caused by a bacterial infection, but treatment with the antibiotic moxifloxacin was ineffective. Based on the patient’s medical history, laboratory and examination results, body temperature changes, and Naranjo Advanced Drug Response Scale, calcium dobesilate-induced hyperpyrexia was diagnosed. After discontinuation of calcium dobesilate, the patient’s body temperature normalized, and no additional episode of fever was observed at follow-up.

Lesson:

Moreover, misdiagnosis and mistreatment of this condition can deteriorate the patient’s condition. Herein, we report a case of calcium dobesilate-induced hyperpyrexia that occurred during the treatment of chronic renal insufficiency. Subsequently, a systematic analysis of the patient’s diagnosis and treatment was reviewed. If unexplained high fever develops during the use of calcium dobesilate, calcium dobesilate-induced hyperpyrexia should be considered. Accordingly, calcium dobesilate should be discontinued.
Exploring the impact of cognitive impairments on treatment compliance and quality of life in patients with Continuous Ambulatory Peritoneal Dialysis (CAPD)
Authors: Wu Caixia , Yu Ran , Li Qingju , Chen Jiajia , Wang Wanpeng
Published: February 2024

The aim of this study is to investigate the impact of cognitive impairments on treatment compliance and quality of life in patients with Continuous Ambulatory Peritoneal Dialysis (CAPD). A cross-sectional study was conducted among patients with CAPD at the Department of Nephrology, Lianshui People’s Hospital from October 2021 to May 2022. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), and the End-Stage Renal Disease Adherence Questionnaire was used to evaluate treatment compliance. Quality of life was assessed using the SF-36 questionnaire. Scores from all the questionnaires and demographic data were recorded. A total of 98 patients were enrolled, and the prevalence of cognitive impairment among CAPD patients was 69.39% (MoCA score < 26). Patients were divided into 2 groups: one group with normal cognitive function (MoCA score ≥ 26) and the other with cognitive impairments. There were statistically significant differences in age, dialysis age, education, urea clearance index, history of high blood pressure, and diabetes between the 2 groups (all P < .05). Patients with cognitive impairments had lower compliance levels in terms of diet fluid restriction, medication therapeutic regimens, and dialysis regimen (all P < .05). Patients with cognitive impairments also had lower quality of life scores in the dimensions of physical function, general health, social function, emotional function, and mental health (all P < .05). Cognitive impairment appears to be common among CAPD patients and may adversely affect both their treatment adherence and overall quality of life. A more comprehensive understanding of the underlying mechanisms necessitates further study.
Nitrous oxide induced subacute combined degeneration of the spine cord: A case report
Authors: Wang Shuo , Li Zhe , Shi Yuanyuan , Wang Tianjun , Jin Wei
Published: February 2024

Rationale:

In recent years, recreational use of inhaled nitrous oxide (N2O) is on the increase among young people, accompanied by a corresponding rise in reports about its toxicity. Subacute combined degeneration of the spine cord (SCD) is the typical clinical picture of the nervous system disorder caused by N2O intoxication, as a result of metabolic disturbance of vitamin B12.

Patient concerns, diagnoses, interventions and outcomes:

We report a 28-year-old female of SCD due to prolonged use of N2O, presented with paresthesia and unsteady in walking progressing within 1 month. Symptoms gradually improved with the treatment of intramuscular injections of hydroxocobalamin combined with N2O abstinence, and the patient recovered completely with normal neurological examination after 4 months of follow-up.

Lessons:

Clinicians should be aware of the clinical features and pathogenesis of SCD caused by N2O intoxication in order to lead effective treatment as soon as possible. Recreational N2O use should always be considered as an etiology when dealing with patients presented with myelopathy and/or neuropathy suspected of vitamin B12 deficiency.
Development of a novel predictive model for interstitial lung disease in ANCA-associated vasculitis prognostications within the Chinese population
Authors: Fan Mingwei , Li Pengfei , Wang Yu , Li Yue , Zhao Wenjing , Wu Ruhao , Tian Xiaoying , Zhang Mengting , Cheng Zhe
Published: February 2024

Antineutrophil cytoplasmic antibody vasculitis-associated interstitial lung disease (AAV-ILD) is a potentially life-threatening disease. However, very little research has been done on the condition’s mortality risk. Hence, our objective is to find out the factors influencing the prognosis of AAV-ILD and employ these findings to create a nomogram model. Patients with AAV-ILD who received treatment at the First Affiliated Hospital of Zhengzhou University during the period from March 1, 2011, to April 1, 2022 were selected for this research. The development of nomogram entailed a synergistic integration of univariate, Lasso, and multivariate Cox regression analyses. Internal validation ensued through bootstrap techniques involving 1000 re-sampling iterations. Discrimination and calibration were assessed utilizing Harrell’s C-index, receiver operating characteristic (ROC) curve, and calibration curve. Model performance was evaluated through integrated discrimination improvement (IDI), net reclassification improvement (NRI), and likelihood ratio test. The net benefit of the model was evaluated using decision curve analysis (DCA). A cohort comprising 192 patients was enrolled for analysis. Throughout observation period, 32.29% of the population died. Key factors such as cardiac involvement, albumin, smoking history, and age displayed substantial prognostic relevance in AAV-ILD. These factors were incorporated to craft a predictive nomogram. Impressively, the model exhibited robust performance, boasting a Harrell’s C index of 0.826 and an AUC of 0.940 (95% CI 0.904–0.976). The calibration curves depicted a high degree of harmony between predicted outcomes and actual observations. Significantly enhancing discriminative ability compared to the ILD-GAP model, the nomogram was validated through the IDI, NRI, and likelihood ratio test. DCA underscored the superior predictive value of the predictive model over the ILD-GAP model. The internal validation further affirmed this efficacy, with a mean Harrell’s C-index of 0.815 for the predictive model. The nomogram model can be employed to predict the prognosis of patients with AAV-ILD. Moreover, the model performance is satisfactory. In the future, external datasets could be utilized for external validation.
Prognostic implication of novel immune-related signature in breast cancer
Authors: Chen Bingfeng , Wu Haoming , Fang Yutong , Huang Guangsheng , Guo Cuiping , Chen Chunfa , He Lifang , Chen Zexiao , Hou Xiangling , Li Cheukfai , Wu Jundong
Published: February 2024

Checkpoint inhibitor therapy has become increasingly important and has been endorsed as a treatment regimen in breast cancer. But benefits were limited to a small proportion of patients. We aimed to develop an improved signature on the basis of immune genes for detection of potential benefit from immunotherapy. Gene expression data of patients with breast cancer initially extracted from The Cancer Genome Atlas were analyzed. Ten genes were selected from the interaction of differentially expressed genes as well as immune-related genes to develop a survival signature. We compared the high-risk and low-risk groups by gene set enrichment analysis, immune infiltration, checkpoint molecule expression and immunophenoscore. Ten genes were extracted from interactions of differentially expressed and immune-related genes. The immune risk score was determined on the basis of the Cox regression coefficient of hub genes and validated with the GSE96058 dataset. Immune cell infiltrates, including CD8 + T cells, plasma cells, follicular helper T cells, CD4 + memory T cells, M1 macrophages, regulatory T cells and resting NK cells, were more highly infiltrated in the high-risk group as compared to the low-risk group. Checkpoint molecules, including CTLA-4, PD-L1, TIM-3, VISTA, ICOS, PD-1, and PD-L2, were expressed at markedly lower levels in the high-risk group as compared to the low-risk group. Immunophenoscores, as a surrogate of response to immune checkpoint therapy, was observed significant lower in the high-risk group. The 10-gene prognostic signature could identify patients’ survival and was correlated with the biomarkers of immune checkpoint inhibitor therapy, which may guide precise therapeutic decisions in clinical practice.