bluuebunny/crossref_metadata_2025 huggingface dataset:
Closed reduction evaluation in dysplastic hip with the Ömeroğlu system in children aged 24 to 36 months
Authors: Charles-Lozoya Sergio , Chávez-Valenzuela Salvador , Cobos-Aguilar Héctor , Manilla-Muñoz Edgar , De La Parra-Márquez Miguel Leonardo , Arriaga-Cazares Héctor Eliud , García-Hernández Adrián
Published: March 2023

Closed reduction (CR) as an initial treatment for developmental hip dysplasia of the hip (DDH) in children aged 24 to 36 months is debatable; however, it could have better results than open reduction (OR) or osteotomies, because it is minimally invasive. The purpose of this study was to evaluate the radiological results in children (24–36 months) with DDH initially treated with CR. Initial, subsequent, final anteroposterior pelvic radiological records were retrospectively analyzed. The International Hip Dysplasia Institute was used to classify the initial dislocations. To evaluate the final radiological results after CR (initial treatment) or additional treatment (CR failed), the Ömeroğlu system was used (6 points excellent, 5 good, 4 fair-plus, 3 fair-minus, and ≤2 poor). The degree of acetabular dysplasia was estimated using the initial acetabular index and the final acetabular index, Buchholz–Ogden classification was used to measure avascular necrosis (AVN). A total of 98 radiological records were eligible, including 53 patients (65 hips). Fifteen hips (23.1%) were redislocated, OR with femoral osteotomy and pelvic osteotomy was the preferred surgical treatment 9 (13.8%). The initial acetabular index versus final acetabular index in total population was (38.9º ± 6.8º) and (31.9º ± 6.8º), respectively (t = 6.5, P < .001). The prevalence of AVN was 40%. Overall AVN in OR, femoral osteotomy and pelvic osteotomy were 73.3% versus CR 30%, P = .003. Unsatisfactory results ≤ 4 points on the Ömeroğlu system were observed in hips that required OR with femoral and pelvic osteotomy. Hips with DDH treated with CR initially might had better radiological results than those treated with OR and femoral and pelvic osteotomies. Regular, good, and excellent results, ≥4 points on the Ömeroğlu system, could be estimated in 57% of the cases, in whom CR was successful. AVN is frequently observed in hips with failed CR.
Comparative efficacy and safety of different hemostatic medications during spinal surgery: A network meta-analysis
Authors: Tan Haitao , Pan Songli , Wei Chuanchun , Chen Zhilin , Chen Tao
Published: March 2023

Background:

Significant blood loss is still one of the most frequent issues in spinal surgery. There were different hemostatic methods to prevent blood loss during spinal surgery. However, the optimal hemostatic therapy for spinal surgery is controversial. The purpose of this study was to assess the efficacy and safety of different hemostatic therapies in spinal surgery.

Methods:

Two independent reviewers conducted electronic literature searches in 3 electronic databases (PubMed, Embase, and Cochrane library database) as well as a manual search to identify eligible clinical studies from inception to Nov 2022. Studies that including different hemostatic therapy (tranexamic acid [TXA], epsilon-acetyl aminocaproic acid [EACA], and aprotinin [AP]) for spinal surgery were included. The Bayesian network meta-analysis was performed with a random effects model. The surface under the cumulative ranking curve (SUCRA) analysis was performed to determine the ranking order. All analyses were performed by R software and Stata software. P value less than .05 was identified as statistically significant.

Results:

Finally, a total of 34 randomized controlled trials met the inclusion criteria and finally included in this network meta-analysis. The SUCRA shows that TXA ranked first (SUCRA, 88.4%), AP ranked second (SUCRA, 71.6%), EACA ranked third (SUCRA, 39.9%), and placebo ranked the last (SUCRA, 0.3%) as for total blood loss. The SUCRA shows that TXA ranked first (SUCRA, 97.7%), AP ranked second (SUCRA, 55.8%), EACA ranked third (SUCRA, 46.2%), and placebo ranked the last (SUCRA, 0.2%) for need for transfusion.

Conclusions:

TXA appears optimal in the reduction of perioperative bleeding and blood transfusion during spinal surgery. However, considering the limitations in this study, more large-scale, well-designed randomized controlled trials are needed to confirm these findings.
Diagnostic value of magnetic resonance imaging and magnetic resonance arthrography for assessing acetabular labral tears: A systematic review and meta-analysis
Authors: Huang Zhihao , Liu Wenyu , Li Tianyu , Liu Zhihao , Zhao Pengfei
Published: March 2023

Background:

This study aimed to systematically evaluate the value of magnetic resonance imaging (MRI) and magnetic resonance arthrography (MRA) in the diagnosis of acetabular labral tears.

Methods:

Databases including PubMed, Embase, Cochrane Library, Web of Science, CBM, CNKI, WanFang Data, and VIP were electronically searched to collect relevant studies on magnetic resonance in the diagnosis of acetabular labral tears from inception to September 1, 2021. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias in the included studies by using the Quality Assessment of Diagnostic Accuracy Studies 2 tool. RevMan 5.3, Meta Disc 1.4, and Stata SE 15.0 were used to investigate the diagnostic value of magnetic resonance in patients with acetabular labral tears.

Results:

A total of 29 articles were included, involving 1385 participants and 1367 hips. The results of the meta-analysis showed that the pooled sensitivity, pooled specificity, pooled positive likelihood ratio, pooled negative likelihood ratio, pooled diagnostic odds ratio, area under the curve of the summary receiver operating characteristic, and Q* of MRI for diagnosing acetabular labral tears were 0.77 (95% confidence interval [CI], 0.75–0.80), 0.74 (95% CI, 0.68–0.80), 2.19 (95% CI, 1.76–2.73), 0.48 (95% CI, 0.36–0.65), 4.86 (95% CI, 3.44–6.86), 0.75, and 0.69, respectively. The pooled sensitivity, pooled specificity, pooled positive likelihood ratio, pooled negative likelihood ratio, pooled diagnostic odds ratio, area under the curve of the summary receiver operating characteristic, and Q* of MRA for diagnosing acetabular labral tears were 0.87 (95% CI, 0.84–0.89), 0.64 (95% CI, 0.57–0.71), 2.23 (95% CI, 1.57–3.16), 0.21 (95% CI, 0.16–0.27), 10.47 (95% CI, 7.09–15.48), 0.89, and 0.82, respectively.

Conclusion:

MRI has high diagnostic efficacy for acetabular labral tears, and MRA has even higher diagnostic efficacy. Due to the limited quality and quantity of the included studies, the above results should be further validated.
Identification of STAT5B as a biomarker associated with prognosis and immune infiltration in breast cancer
Authors: Li Jiaying , Li Li , Mahesutihan Gulijiang , Meng Juanjuan , Chen Yuan , Lv Jingsen
Published: March 2023

Background:

Breast invasive cancer (BRCA) is the most common malignancy and the second leading cause of malignancy death among women. Signal transducers and activators of transcription (STAT) family played a vital role in regulating certain biological processes and could serve as biomarkers for many diseases or cancers.

Methods:

The expression, prognostic value, and clinical functions of STAT family in BRCA were evaluated with several bioinformatics web portals.

Results:

The expression of STAT5A/5B were downregulated in BRCA in subgroup analyses based on race, age, gender, race, subclasses, tumor histology, menopause status, nodal metastasis status, and TP53 mutation. BRCA patients with high STAT5B expression had a better overall survival, relapse free survival, MDFS and post progression survival. STAT5B expression level can impact the prognosis in BRCA patients with positive PR status, negative Her2 status and wild type TP53. Moreover, STAT5B was positively correlated with immune cell infiltration and the level of immune biomarkers. Drug sensitivity revealed that low STAT5B expression was resistant to the many small molecules or drugs. Functional enrichment analysis revealed that STAT5B was involved in adaptive immune response, translational initiation, JAK-STAT signaling pathway, Ribosome, NF-kappa B signaling pathway and Cell adhesion molecules.

Conclusions:

STAT5B was a biomarker associated with prognosis and immune infiltration in breast cancer.
Efficacy comparison of different moxibustion treatments for allergic rhinitis: A systematic review and Bayesian network meta-analysis
Authors: Chen Ke , Hou Chaofeng , Liu Chengjiang , Meng Yong
Published: March 2023

Background:

At present, there are many commonly used moxibustion methods in clinical practice, but it is unclear which moxibustion is more suitable for the treatment of allergic rhinitis (AR), so we used a network meta-analysis to analyze the effectiveness of various moxibustion types in the treatment of AR.

Methods:

We searched 8 databases for comprehensive inclusion of randomized controlled trials (RCTs) for moxibustion in the treatment of allergic rhinitis. The search time was from the beginning of database establishment to January 2022. The Cochrane Risk of Bias tool was used to analyze the risk of bias of the included RCTs. Bayesian network meta-analysis of the included RCT was performed using the R software GEMTC and the RJAGS package.

Results:

A total of 38 RCTs were included, involving 4257 patients and 9 types of moxibustion. The network meta-analysis results revealed that heat-sensitive moxibustion (HSM) not only has the best effect in terms of effective rate (Odd ratio [OR]: 32.77, 95% Credible intervals [CrIs]: 1.86–1360.2) among the nine types of moxibustion, but also has good effect in improving the quality of life score (standard mean differences [SMD]: 0.6, 95% CrIs: 0.07–1.29). In terms of improving IgE and VAS scores, various types of moxibustion were comparable to the efficacy of western medicine.

Conclusion:

The results showed that HSM was the most effective treatment for AR compared with other types of moxibustion. Therefore, it can be regarded as a complementary and alternative therapy for AR patients with poor effects of traditional treatment and patients who are susceptible to adverse reactions of western medicine.
Development and validation of prognostic nomogram for patients with metastatic gastric adenocarcinoma based on the SEER database
Authors: Liu Xianming , Ren Yanyan , Wang Fayan , Bu Yuqing , Peng Lili , Liang Jinlong , Kang Xiyun , Zhang Hongzhen
Published: March 2023

The aim of this study was to investigate the prognostic factors affecting overall survival in patients with metastatic gastric adenocarcinoma and to establish a nomogram prediction model for comprehensive clinical application. Data from 2370 patients with metastatic gastric adenocarcinoma between 2010 and 2017 were retrieved from the surveillance, epidemiology, and end results database. They were randomly divided into a training set (70%) and a validation set (30%), univariate and multivariate Cox proportional hazards regressions were used to screen important variables that may affect overall survival and to establish the nomogram. The nomogram model was evaluated using a receiver operating characteristic curve, calibration plot, and decision curve analysis. Internal validation was performed to test the accuracy and validity of the nomogram. Univariate and multivariate Cox regression analyses revealed that, age, primary site, grade, and American joint committee on cancer. T, bone metastasis, liver metastasis, lung metastasis, tumor Size, and chemotherapy were identified as independent prognostic factors for overall survival and were included in the prognostic model to construct a nomogram. The prognostic nomogram showed good overall survival risk stratification ability for the area under the curve, calibration plots, and decision curve analysis in both the training and validation sets. Kaplan–Meier curves further showed that patients in the low-risk group had better overall survival. This study synthesizes the clinical, pathological, therapeutic characteristics of patients with metastatic gastric adenocarcinoma, establishes a clinically effective prognostic model, and that can help clinicians to better evaluate the patient’s condition and provide accurate treatment.
Elucidating the potential pharmaceutical mechanism of Gyejibokryeong-hwan on rosacea using network analysis
Authors: Kim Jundong , Kim Kyuseok
Published: March 2023

Rosacea is a chronic erythematous disease with telangiectasia that affects the central area of the face. However, because of the ambiguity in the pathophysiology of rosacea, its treatment has not been clearly elucidated; therefore, new therapeutic options need to be developed. Gyejibokryeong-hwan (GBH) is widely used in clinical practice for various blood circulation disorders, including hot flushes. Therefore, we explored the potential pharmaceutical mechanism of GBH on rosacea and investigated the therapeutic points exclusive to GBH through comparative analysis with chemical drugs recommended in 4 guidelines for rosacea based on network analysis. The active compounds in GBH were identified, and the proteins targeted by these compounds and the genes related to rosacea were searched. Additionally, the proteins targeted by the guideline drugs were also searched to compare their effects. And the pathway/term analysis of common genes was conducted. Ten active compounds were obtained for rosacea. There were 14 rosacea-related genes targeted by GBH, with VEGFA, TNF, and IL-4, which were suggested as core genes. The pathway/term analysis of the 14 common genes revealed that GBH could potentially act on rosacea via 2 pathways: the “interleukin 17 signaling pathway” and the “neuroinflammatory response.” Comparison and analysis of the protein targets between GBH and guideline drugs revealed that only GBH separately acts on the “vascular wound healing pathway.” GBH has the potential to act on IL-17 signaling pathway, neuroinflammatory response and vascular wound healing pathway. Further studies are needed to determine the potential mechanism of GBH in rosacea.
Comparative study between histochemical mucus volume, histopathological findings, and endocytoscopic scores in patients with ulcerative colitis
Authors: Kamitani Yu , Kurumi Hiroki , Kanda Tsutomu , Ikebuchi Yuichiro , Yoshida Akira , Kawaguchi Koichiro , Yashima Kazuo , Umekita Yoshihisa , Isomoto Hajime
Published: March 2023

Ulcerative colitis (UC) causes a reduction in goblet cells. However, there have been few reports on the relationship between endoscopic and pathological findings and mucus volume. In this study, we quantitatively evaluated histochemical colonic mucus volume by fixing biopsied tissue sections taken from patients with UC in Carnoy’s solution and compared it with endoscopic and pathological findings to determine whether there is a correlation between them. Observational study. A single-center, university hospital in Japan. Twenty-seven patients with UC (male/female, 16/11; mean age, 48.4 years; disease median duration, 9 years) were included in the study. The colonic mucosa of the most inflamed area and the surrounding less inflamed area were evaluated separately by local MES and endocytoscopic (EC) classification. Two biopsies were taken from each area; one was fixed with formalin for histopathological evaluation, and the other was fixed with Carnoy’s solution for the quantitative evaluation of mucus via histochemical Periodic Acid Schiff and Alcian Blue staining. The relative mucus volume was significantly reduced in the local MES 1–3 groups, with worsening findings in EC-A/B/C and in groups with severe mucosal inflammation, crypt abscess, and severe reduction in goblet cells. The severity of inflammatory findings in UC by EC classification correlated with the relative mucus volume suggesting functional mucosal healing. We found a correlation between the colonic mucus volume and endoscopic and histopathological findings in patients with UC, and a stepwise correlation with disease severity, particularly in EC classification.
Ustekinumab for steroid-refractory pancolitis in a biologically naive child: A case report and literature review
Authors: Alhalabi Marouf
Published: March 2023

Ustekinumab is not recommended for the treatment of children with inflammatory bowel disease, but its off-label use is increasing despite a lack of pediatric pharmacokinetic data. The purpose of this review is to evaluate the therapeutic effects of Ustekinumab on children with inflammatory bowel disease and to recommend the best treatment regimen. Ustekinumab was the first biological treatment for a 10-year-old Syrian boy with steroid-refractory pancolitis who weighed 34 kg. A 260 mg/kg (~6 mg/kg) intravenous dose was followed by 90 mg of subcutaneous Ustekinumab at week 8 (induction). The patient was supposed to receive the first maintenance dose after twelve weeks, but after ten weeks, he developed acute severe ulcerative colitis which was managed according to treatment guidelines, except receiving 90 mg of subcutaneous Ustekinumab when he was discharged. The maintenance dose of 90 mg subcutaneous Ustekinumab was intensified to every 8 weeks. Throughout the treatment period, he achieved and maintained clinical remission. In pediatric inflammatory bowel disease, a dose of intravenous ~6 mg/kg of Ustekinumab is a common induction regimen, while children weighing < 40 kg may require a dose of 9 mg/kg. For maintenance, children may require 90 mg of subcutaneous Ustekinumab every 8 weeks. The outcome of this case report is interesting with improved clinical remission and highlighting the expansion of clinical trials on Ustekinumab for children.
Uniportal video-assisted thoracoscopic (VATS) subtotal parietal pleurectomy for refractory tuberculous pneumothorax: Five case-reports
Authors: Liu Xiaoyu , Wang Xuan , Shen Lei , Wang Bing , Li Li , Dai Xiyong
Published: March 2023

Objective:

This study explored the safety and feasibility of uniportal video-assisted thoracoscopic (VATS) paretal pleurectomy in patients suffering from complex tuberculous pneumothorax. These cases were reported and summarized to present the experience of the authors with this procedure.

Methods:

The clinical data of a total of 5 patients with refractory tuberculous pneumothorax having undergone subtotal parietal pleurectomy by uniportal VATS in our institution were hereby collected from November 2021 to February 2022, and regular follow-up was conducted after surgery.

Results:

Parietal pleurectomy via VATS was successfully performed in all these 5 patients, among which, 4 received bullectomy at the same time, with no conversion to open surgery. Among the 4 cases of full lung expansion who were suffering from recurrent tuberculous pneumothorax, the preoperative chest drain duration ranged from 6 days to 12 days; the operation time, from 120 minutes to 165 minutes; intraoperative blood loss, from 100 mL to 200 mL; the drainage volume, from 570 mL to 2000 mL 72 hours after operation; and chest tube duration, from 5 days to 10 days. One rifampicin-resistant case had satisfactory postoperative lung expansion, but left a cavity, the operation time of which was 225 minutes; intraoperative blood loss, 300 mL; the drainage volume, 1820 mL 72 hours after operation; and chest tube duration, 40 days. The follow-up time ranged from 6 months to 9 months, and no recurrence was noted.

Conclusion:

Parietal pleurectomy with preservation of the top pleura via VATS is a safe and satisfactorily effective procedure for patients with refractory tuberculous pneumothorax.
Transcriptome profiling of skeletal muscles from Korean patients with Bethlem myopathy
Authors: Lee Seung-Ah , Hong Ji-Man , Lee Jung Hwan , Choi Young-Chul , Park Hyung Jun
Published: March 2023

Bethlem myopathy is one of the collagens VI-related muscular dystrophies caused by mutations in the collagen VI genes. The study was designed to analyze the gene expression profiles in the skeletal muscle of patients with Bethlem myopathy. Six skeletal muscle samples from 3 patients with Bethlem myopathy and 3 control subjects were analyzed by RNA-sequencing. 187 transcripts were significantly differentially expressed, with 157 upregulated and 30 downregulated transcripts in the Bethlem group. Particularly, 1 (microRNA-133b) was considerably upregulated, and 4 long intergenic non-protein coding RNAs, LINC01854, MBNL1-AS1, LINC02609, and LOC728975, were significantly downregulated. We categorized differentially expressed gene using Gene Ontology and showed that Bethlem myopathy is strongly associated with the organization of extracellular matrix (ECM). Kyoto Encyclopedia of Genes and Genomes pathway enrichment reflected themes with significant enrichment of the ECM-receptor interaction (hsa04512), complement and coagulation cascades (hsa04610), and focal adhesion (hsa04510). We confirmed that Bethlem myopathy is strongly associated with the organization of ECM and the wound healing process. Our results demonstrate transcriptome profiling of Bethlem myopathy, and provide new insights into the path mechanism of Bethlem myopathy associated with non-protein coding RNAs.
Severe blood pressure elevation following ephedrine administration during carotid endarterectomy under general anesthesia: A CARE-compliant case report
Authors: Kim Hyunjee , Kim Jeong Eon , Yu Taeyoung
Published: March 2023

Rationale:

During carotid endarterectomy (CEA) surgery, blood pressure management is particularly important to prevent cerebrovascular and cardiac complications. Ephedrine is a commonly used vasopressor, however, we report the case of a patient with unusually severe blood pressure elevation following intravenous ephedrine administration during CEA.

Patient concerns:

A 72-year-old man diagnosed with right proximal internal carotid artery stenosis underwent CEA under general anesthesia. After declamping the common carotid artery, blood pressure rapidly increased by 125 mm Hg (from 90 to 215 mm Hg) after ephedrine (4 mg) was administered, but the heart rate was stable.

Diagnoses:

There was an ordinal increase in blood pressure after the same small dose of ephedrine was administered at the early stage of the surgery. And the surgical approach was difficult because he had a high location of carotid bifurcation and a prominent mandibular angle. Because of the anatomical proximity of the cervical sympathetic trunk to the carotid bifurcation and the particularly complicated surgical process in the present case, we postulate the reason for this adverse reaction as transient sympathetic denervation supersensitivity.

Interventions:

Perdipine (0.5 mg) was administered repeatedly to reduce blood pressure.

Outcomes:

After surgery, he was diagnosed with right hypoglossal nerve palsy, and no other abnormal signs were found.

Conclusion:

This case highlights the need for caution in the use of ephedrine, which is commonly used in CEA surgery, wherein blood pressure management is particularly important. Although it is a rare and unpredictable case, α-agonists are considered safer in situations where sympathetic supersensitivity is possible.
Assessing patiromer utilization and associated serum potassium changes in US veterans with prior sodium polystyrene sulfonate exposure
Authors: Patel Shardool , Pinnell Derek , Qualls Joshua , Rathod Anitha , Chen Wei , Boutin Sylvie , Woods Steven D. , Kovesdy Csaba P. , Tangri Navdeep , Sauer Brian C.
Published: March 2023

Untreated chronic hyperkalemia is associated with an increased risk of mortality. Novel potassium binders (e.g., patiromer) are new additions to the clinician’s armamentarium. Prior to their approval, clinicians often considered trialing sodium polystyrene sulfonate. The study objective was to assess patiromer utilization and associated changes in serum potassium (K+) in US veterans with prior sodium polystyrene sulfonate exposure. This was a real-world observational study of US veterans with chronic kidney disease and a baseline K+ ≥ 5.1 mEq/L, initiated on patiromer between January 1, 2016, and February 28, 2021. The primary endpoints were patiromer utilization (dispensations and treatment courses), and K+ change at 30-, 91-, and 182-day follow-up (FU) intervals. Patiromer utilization was described using Kaplan–Meier probabilities and the proportion of days covered. Descriptive changes in population average K+ were obtained from a pre-post design using single-arm within-patient pre-post lab pairs and paired t tests. Two hundred five veterans met the study criteria. We observed an average of 1.25 (95% CI, 1.19–1.31) treatment courses and a median treatment duration of 64 days. Fifty veterans (24.4%) had >1 course, and 17.6% of patients remained on their initial patiromer treatment course until the end of the 180-day FU. The mean K+ value was 5.73 mEq/L (5.66–5.79) at baseline, 4.95 mEq/L (95% CI, 4.86–5.05) at the 30-day interval, 4.93 mEq/L (95% CI, 4.84–5.03) at the 91-day interval, and 4.9 mEq/L (95% CI, 4.8–4.99) at the 182-day interval. Novel potassium binders (e.g., patiromer) are newer chronic hyperkalemia management tools for clinicians. The average population K+ decreased to <5.1 mEq/L at all follow-up intervals. Patiromer appeared to be well tolerated with nearly 18% of patients remaining on their initial treatment course during the entire 180-day FU period. The median treatment duration was 64 days and approximately 24% of patients initiated a second course during FU.
HLA-A and HLA-B genes are involved in the pathogenesis of IBS
Authors: Liang Huiping , Li Li , Huang Lan , Lu Tingting , Luo Qi , Mao Yanning , Liu Huaying
Published: March 2023

Irritable bowel syndrome (IBS) is the most common functional gastrointestinal disorder. The pathogenesis of IBS has not yet been fully elucidated, and the relationship between human leukocyte antigen (HLA) class I molecules and IBS is not clear. The present case-control study investigated the correlation between HLA-A and HLA-B genes and IBS. Peripheral blood samples were collected from 102 IBS patients and 108 healthy volunteers at Nanning First People’s Hospital. DNA was extracted using a routine procedure, and HLA-A and HLA-B gene polymorphisms were identified by polymerase chain reaction with sequence-specific primers to determine the genotype and distribution frequency of HLA-A and HLA-B in IBS patients and healthy controls. Susceptibility and protective genes for IBS were identified using univariate and multivariate analyses. The frequency of HLA-A11 gene expression in the IBS group was significantly higher than that in the healthy control group, while the frequencies of HLA-A24, 26, and 33 gene expression were significantly higher in the healthy control group than in the IBS group (all P < .05). The frequencies of HLA-B56 and 75 (15) gene expression in the IBS group were significantly higher than those in the healthy control group, while the frequencies of HLA-B46 and 48 gene expression were significantly higher in the healthy control group than in the IBS group (all P < .05). Genes that may be related to the prevalence of IBS were included in the multivariate logistic regression, and the results suggested that the HLA-B75 (15) gene is a susceptibility gene for IBS (P = .031, odds ratio [OR] = 2.625, 95% confidence interval [CI]: 1.093–6.302), while the HLA-A24 (P = .003, OR = 0.308, 95% CI: 0.142–0.666), A26 (P = .009, OR = 0.162, 95% CI: 0.042–0.629), A33 (P = .012, OR = 0.173, 95% CI: 0.044–0.679), and B48 (P = .008, OR = 0.051, 95% CI: 0.006–0.459) genes are protective genes for IBS.
Neoadjuvant immunotherapy versus chemoimmunotherapy in non-small cell lung cancer: A protocol for systematic review and meta-analysis
Authors: Zhu Qunying , Chen Guini , Liu Yunzhong , Zhou Yu
Published: March 2023

Background:

Worldwide, lung cancer is the most common cause of cancer morbidity and mortality. Non-small cell lung cancer (NSCLC) accounts for approximately 80 to 85% of all lung cancers. Recently, a few studies have reported the use of neoadjuvant immunotherapy or chemoimmunotherapy in NSCLC. However, no meta-analysis comparing neoadjuvant immunotherapy with chemoimmunotherapy has yet been reported. We perform a protocol for systematic review and meta-analysis to compare the efficacy and safety of neoadjuvant immunotherapy and chemoimmunotherapy in NSCLC.

Methods:

The statement of preferred reporting items for systematic review and meta-analysis protocols will be used as guidelines for reporting the present review protocol. Original clinical randomized controlled trials assessing the beneficial effects and safety of neoadjuvant immunotherapy and chemoimmunotherapy in NSCLC will be included. Databases searched include China National Knowledge Infrastructure, Chinese Scientific Journals Database, Wanfang Database, China Biological Medicine Database, PubMed, EMBASE Database, and Cochrane Central Register of Controlled Trials. Cochrane Collaboration’s tool is used to assess the risk of bias in included randomized controlled trials. All calculations are carried out with Stata 11.0 (The Cochrane Collaboration, Oxford, UK).

Results:

The results of this systematic review and meta-analysis will be publicly available and published in a peer-reviewed journal.

Conclusion:

This evidence will be useful to practitioners, patients, and health policy-makers regarding the use of neoadjuvant chemoimmunotherapy in NSCLC.
Postpartum urinary incontinence of nulliparous women: A prospective cohort study
Authors: Elbiss Hassan M. , Abu-Zidan Fikri M.
Published: March 2023

Postpartum urinary incontinence affects women’s quality of life. It is associated with different risk factors during pregnancy and childbirth. We evaluated the persistence of postpartum urinary incontinence and associated risk factors among recently delivered nulliparous women with incontinence during pregnancy. This was a prospective cohort study, which followed up all nulliparous women recruited antenatally from 2012 to 2014 in Al-Ain Hospital, Al-Ain, United Arab Emirates, who developed urinary incontinence for the first time during pregnancy. Three months after giving birth they were interviewed face-to-face, using a structured and pre-tested questionnaire, and divided into 2 groups: those who had urinary incontinence and those without it. Risk factors were compared between the 2 groups. Of the 101 participants interviewed, postpartum urinary incontinence continued in 14 (13.7%) while 87 (86.3%) recovered from it. The comparative analysis did not show any statistically significant difference between the 2 groups for sociodemographic risk factors nor for antenatal risk factors. Childbirth-related risk factors were also not statistically significant. Recovery from incontinence during pregnancy in nulliparous women was over 85% as postpartum urinary incontinence affected only a small proportion at 3 months following delivery. Expectant management is advised instead of invasive interventions in these patients.
Percutaneous management of caliceal diverticula: a narrative review
Authors: Dean Nicholas S. , Guo Jenny N. , Krambeck Amy E.
Published: March 2023

Purpose of review

Caliceal diverticula are relatively uncommon within urologic practice and may be difficult to diagnose and treat. We aim to highlight contemporary studies examining surgical interventions for patients with caliceal diverticula, with a focus on percutaneous intervention, and provide updated practical recommendations for the management of these patients.

Recent findings

Studies within the last 3 years examining surgical treatment options for caliceal diverticular calculi are limited. When flexible ureteroscopy (f-URS) and percutaneous nephrolithotomy (PCNL) are examined within the same observational cohorts, PCNL is associated with improved stone-free rates (SFRs), lower requirement for re-intervention, and longer lengths of stay (LOS). Retrograde f-URS for the treatment of caliceal diverticula and diverticular calculi is associated with satisfactory safety and efficacy outcomes. There are no studies in the last 3 years that provide supporting evidence to use shock wave lithotripsy to treat caliceal diverticular calculi.

Recent studies examining surgical interventions for patients with caliceal diverticula are limited to small observational studies. Heterogeneity in LOS and follow-up protocol limits comparisons between series. Despite technological advancements in f-URS, PCNL appears to be associated with more favorable and definitive outcomes. PCNL continues to be the preferred treatment strategy for patients with symptomatic caliceal diverticula when deemed technically feasible.
Neisseria elongata–mediated peritonitis in an end-stage renal disease patient on automated peritoneal dialysis: a case report and literature review
Authors: Alsayed Ahmed , Abdalla El Mustafa , Ali Bashir , Hatem Ahmed , Albsheer Khalid , Elhadi Mohamed , Makawi Amna
Published: March 2023

Introduction:

Peritoneal dialysis (PD) can result in peritonitis, which frequently causes severe and near-fatal clinical implications if left untreated. Usually, gram-positive bacteria are the most common organisms involved. Uncommonly recognized as the cause of peritonitis in PD patients, Neisseria elongata is a gram-negative nasal and oropharyngeal normal flora organism.

Case presentation:

We report a rare case of a 29-year-old man who had received automated PD for 6 years and had N. elongata peritonitis.

Discussion:

Several case reports of Neisseria-related peritonitis may point to the potential pathogenicity of such organisms and suggest that many cases of culture-negative peritonitis may have been misdiagnosed. Poor nutrition and chronic kidney disease have been suggested as potential risk factors for N. elongata peritonitis, both of which are present in our patient. With appropriate antibiotic use, most of the cases respond well to empirical treatment.

Conclusion:

Although rare, N. elongata can lead to PD catheter. peritonitis that, in some cases, require changing to hemodialysis.
Case report: a rare presentation of typhoid fever due to eating over-ripened pineapple
Authors: Bereda Gudisa
Published: March 2023

Background and Importance:

Typhoid fever is an acute infection caused by Salmonella typhi, especially when it is waterborne or foodborne. Overripe pineapple causes typhoid fever because overripe pineapple is a desirable host for the survival of S. typhi. The importance of typhoid fever as a public health burden is reduced by early detection and appropriate antibiotic treatment.

Case Presentation:

A 26-year-old black African male health care worker was admitted to the clinic on 21 July 2022, with a significant chief complaint of headache, loss of appetite, and watery diarrhea. The admitted patient presented with a 2-day history of hyperthermia, headache, loss of appetite, and watery diarrhea, as well as back pain, joint weakness, and insomnia. The H antigen titer was positive, which was 1 : 189 greater than the normal range and showed the past history of S. typhi infection. The O antigen titer value detected was a false negative result because it was done before the 7-day onset of fever. On admission, ciprofloxacillin 500 mg was given orally twice a day for 7 days to treat typhoid by inhibiting the deoxyribonucleic acid replication of S. typhi by preventing S. typhi deoxyribonucleic acid topoisomerase and deoxyribonucleic acid gyrase.

Clinical Discussion:

Typhoid fever pathogenesis is based on pathogenic factors, infecting species, and host immunity. By using the agglutination biochemical test, the Widal test was able to identify the patient’s bloodstream as carrying the S. typhi bacteria that causes typhoid fever.

Conclusion:

Due to contaminated food or unsafe drinking water sources, typhoid fever is associated with travel to developing nations.
Diagnostic implications of neuroimaging in epilepsy and other seizure disorders
Authors: Nieto-Salazar Maria A. , Velasquez-Botero Felipe , Toro-Velandia Adriana C. , Saldana-Rodriguez Ericka A. , Rodriguez-Rodriguez Miguel E. , Gupta Aditi , Cheeti Srinidhi , Huerta-Rengifo Claudia , Pavón-Enamorado Fredy R. , Rodezno Carmen M. C. , Medina Patrick S. D. , De-Sario-Velasquez Gioacchino D. M. S. , Sah Biki K. , Shaheen Fatima , Shree Anagha , Sah Rajan K.
Published: March 2023

Epilepsy is the most common neurological disorder that affects ~1–2% of the global population, leading to presentation in the emergency room. The neuroimaging modalities have an important application in diagnosing new onset unprovoked seizures and epilepsy. This article discusses the various neuroimaging modalities for diagnosing seizures and epilepsy and addresses that the MRI is the investigation of choice, and urgent imaging is more commonly done by computed tomography in patients with new-onset seizures. The goal of the article was to diagnose seizures and epilepsy for early intervention to prevent complications or damage to the brain. MRI detects even small cortical epileptogenic lesions, whereas computed tomography is used in screening, diagnosis, evaluation, and monitoring of the prognosis of seizures in children. Magnetic resonance spectroscopy provides biochemical measurements of reduced N-acetyl aspartate and increased creatinine and choline in dysfunctioning epileptic zones. Volumetric MRI is very sensitive and specific in determining seizures originating in extratemporal and extrahippocampal sites. Even though diffusion tensor magnetic resonance imaging has a limited role, it is used in specific pediatric patient groups with temporal lobe epilepsy. Functional radionuclide imaging modalities (positron emission tomography and single-photon emission computerized tomography) are increasingly significant for the identification of the epileptic region. Furthermore, the authors recommend the use of artificial intelligence and further research on imaging modalities for early diagnosis of seizures and epilepsy.
Laparoscopic sleeve gastrectomy in situs inversus totalis: a case report
Authors: Ortiz Gómez Jesús E. , Arellanes Herrera Paloma S. , Guzmán Barba José A. , Esparza Estrada Isaac , Orozco Álvarez Malo José O.
Published: March 2023

Introduction and Importance:

Obesity and being overweight are defined as abnormal and excessive fat accumulation, respectively. Obesity is defined as a BMI of 30 or higher. Sleeve gastrectomy, the most commonly performed bariatric surgery worldwide, is an effective treatment for obesity and its comorbidities. However, some cases, such as situs inversus, may present additional challenges for surgeons.

Case Presentation:

The authors present the case of a 28-year-old female scheduled for gastric sleeve surgery with a BMI of 49. During the preoperative evaluation, dextrocardia was evident, and a diagnosis of situs inversus totalis was made. The surgery was performed without complications in a high-volume hospital specializing in bariatric surgery.

Clinical Discussion:

Gastric sleeve surgery should be considered an effective and safe procedure in such patients as long as the surgeon is prepared, makes technical adjustments with their team, and has the necessary experience.

Conclusion:

Laparoscopic gastric sleeve surgery is a safe procedure in patients with situs inversus, as long as it is performed by an experienced surgeon.
The study of human monkeypox disease in 2022 using the epidemic models: herd immunity and the basic reproduction number case
Authors: Al-Raeei Marwan
Published: March 2023

As of May 2022, a new outbreak of the human monkeypox (MPOX) disease appeared in multiple countries, where the 2022 human MPOX disease spread to more than 109 cases, excluding the suspected cases up to the end of 2022. The deaths of the 2022 human MPOX exceeded 200 cases up to the same date. The human MPOX is not a new disease, this disease was once endemic in some countries on the African continent. Despite this, this disease began to spread in a number of countries around the world in 2022. The first case of the 2022 human MPOX was recorded in the United Kingdom in May. After that date, this disease began to become a pandemic in a number of other countries, such as the United States, Spain, and Brazil. The 2022 human MPOX is a type of viral disease caused by a viral virus, the MPOX virus, and this virus causes rashes and lesions over the skin of the patient, as well as in the mouth of the patient. Multiple effective indicators are employed for the study of the 2022 of the human MPOX, such as the herd immunity of the human MPOX (HIhMPOX), the basic reproduction number of the human MPOX (BRNhMPOX), and the infection period of the human MPOX. This study focuses on the study of the herd immunity of, and the basic reproduction number of the 2022 outbreak of human MPOX in multiple countries around the world. This study employed the semianalytical method of the Susceptible compartment S, Infectious compartment I, Recovered compartment R (SIR) pandemic model including the mortality for the study of the herd immunity, and the basic reproduction number of the 2022 human MPOX disease. It is found that the average value of the herd immunity for the human MPOX disease in 2022 equals to 0.2194, that is, 21.94% for multiple countries, and equals to 35.52% for the United States, and 30.99% for Spain. Also, it is found that the average value of the basic reproduction number of the 2022 human MPOX disease equals to 1.2810 for multiple countries. It is concluded from these values that 21.94% of the total susceptible population has to be immunized in an effective way to prevent the spreading of the disease. Also, based on the previous values, it is concluded that the status of the 2022 MPOX disease is spreading as a pandemic.
Optimizing the Role of the Hospital-Based Nurse Scientist in a Changing Nursing Environment
Authors: Chipps Esther , Zadvinskis Inga M.
Published: March 2023

Nurses and nurse leaders directing clinical organizations can elevate scholarly inquiry by employing a PhD-prepared hospital-based nurse scientist (HBNS). This individual will shape the culture of clinical inquiry, leading and driving efforts to close the gap between knowledge and practice. As the nursing workforce struggles to recover from the COVID-19 pandemic, now more than ever, collaborations between HBNSs and nurse leaders are essential to explore and test new nursing care delivery systems. Given the national shortage in the PhD-prepared nurse scientist talent pool, attracting and hiring the right candidate is critical. The purpose of this article is to provide practical recommendations for nurse leaders to introduce an HBNS into an organization as an important building block for nursing science and improved clinical practice. The role of the HBNS has evolved in tandem with increased education in the nursing workforce, evidence-based practice, and the explosion of implementation science. Before recruiting an HBNS, the organization must create a job description that outlines responsibilities, paying attention to the HBNS position within the organizational structure. Additionally, leaders must consider the candidate's characteristics for interacting with clinical staff. The senior nursing leadership team must recognize and appreciate the HBNS as a scholar and advisor.
Creating a Business Case for Success
Authors: Welch Teresa D. , Smith Todd B. , Niklinski Erin
Published: March 2023

Health care is a highly competitive environment where managers must compete for finite resources. The Centers for Medicare & Medicaid Services–directed reimbursement models such as value-based purchasing and pay-for-performance heavily focused on quality improvement and nursing excellence are having a major impact on financial reimbursement for health care services in the United States. As such, nurse leaders must function in a business-focused environment where decisions regarding resource allocation are driven by quantifiable data, the potential return on investment, and the organization's ability to provide quality patient care in an efficient manner. It is imperative for nurse leaders to recognize the financial impact of potential additional revenue streams, as well as avoidable costs. Nurse leaders must also be skilled at translating the return on investment for nursing-centric programs and initiatives, often hidden in anecdotal terms and cost avoidance rather than revenue generation, to ensure appropriate resource allocation and budgetary assumptions. This article uses a case study framed within the business case to review a structured approach to operationalizing nursing-centric programs and highlights key strategies for success.
The Relationship Between Directly Observed Therapy for Chlamydia Infections and Retesting Rates in an Adolescent Population
Authors: Nightingale Kira J. , Makeneni Spandana , Bonett Stephen , Wood Sarah M.
Published: March 2023

Background

Chlamydia trachomatis is the most common reportable sexually transmitted infection in the United States, with >60% of reported cases occurring in individuals aged 15 to 24 years. US practice guidelines recommend directly observed therapy (DOT) for the treatment of chlamydia in adolescents, but almost no research has been done to evaluate whether DOT results in improved outcomes.

Methods

We conducted a retrospective cohort study of adolescents who sought care at 1 of 3 clinics within a large academic pediatric health system for a chlamydia infection. The study outcome was return for retesting within 6 months. Unadjusted analyses were performed using χ
2, Mann-Whitney U, and t tests, and adjusted analyses were performed using multivariable logistic regression.

Results

Of the 1970 individuals included in the analysis, 1660 (84.3%) received DOT and 310 (15.7%) had a prescription sent to a pharmacy. The population was primarily Black/African American (95.7%) and female (78.2%). After controlling for confounders, individuals who had a prescription sent to a pharmacy were 49% (95% confidence interval, 31%–62%) less likely than individuals who received DOT to return for retesting within 6 months.

Conclusions

Despite clinical guidelines recommending the use of DOT for chlamydia treatment in adolescents, this is the first study to describe the association between DOT and an increase in the number of adolescents and young adults who return for sexually transmitted infection retesting within 6 months. Further research is needed to confirm this finding in diverse populations and explore nontraditional settings for the provision of DOT.
Healthy vaccinee bias and MenB-FHbp vaccine effectiveness against gonorrhea
Authors: Abara Winston E. , Bernstein Kyle T. , Lewis Felicia M.T. , Pathela Preeti , Islam Aras , Eberhart Michael , Cheng Iris , Ternier Alexandra , Sanderson Slutsker Jennifer , Madera Robbie , Kirkcaldy Robert
Published: March 2023

Observational studies demonstrated 30–40% effectiveness of OMV meningococcal serogroup-B vaccines against gonorrhea. To explore whether healthy vaccinee bias influenced such findings, we examined effectiveness of MenB-FHbp, a non-OMV vaccine that is not protective against gonorrhea. MenB-FHbp was ineffective against gonorrhea. Healthy vaccinee bias likely did not confound earlier studies of OMV vaccines.