bluuebunny/crossref_metadata_2025 huggingface dataset:
Relationship Among Clinically Obtained Biomarkers of Inflammation, Hypercoagulability, and Macrophage Activation, and Delirium in Critically Ill Patients With COVID-19
Authors: Khan Sikandar H. , Perkins Anthony J. , Chi Rosalyn , Seyffert Sarah , Conrad Peter , Lindroth Heidi , Wang Sophia , Mulkey Malissa , Gao Sujuan , Khan Babar
Published: January 2023

OBJECTIVES:

Critically ill patients with COVID-19 experience high rates of delirium and coma. Whether delirium occurs through novel mechanisms in COVID-19 is not known. We analyzed the relationship among biomarkers of inflammation (C-reactive protein [CRP]), hypercoagulability (d-dimer), and lung macrophage activation (ferritin), and the primary composite outcome of delirium/coma next day. We also measured associations between biomarkers and next day delirium and coma independently, and delirium severity.

DESIGN:

Retrospective, observational cohort study.

SETTING:

ICUs at two large, urban, academic referral hospitals.

PATIENTS:

All consecutive adult patients admitted to the ICU from March 1, 2020, to June 7, 2020, with COVID-19 with clinical biomarkers and delirium assessments performed.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

Daily concentrations of CRP, d-dimer, and ferritin were obtained. Coma (assessed by Richmond Agitation-Sedation Scale) and delirium (assessed by Confusion Assessment Method for the ICU/Confusion Assessment Method for the ICU-7) were measured bid. A cohort of 197 ICU patients with COVID-19 were included. Higher d-dimer (odds ratio [OR], 1.57; 95% CI, 1.17–2.12; p < 0.01) and ferritin quartiles (OR, 1.36; 95% CI, 1.02–1.81; p < 0.01) were associated with greater odds of the composite outcome of delirium/coma next day. d-dimer was associated with greater odds of next day delirium (OR, 1.49; 95% CI, 1.14–1.94; p < 0.01) and coma independently (OR, 1.52; 95% CI, 1.08–2.14; p = 0.017). Higher ferritin quartiles were associated with greater odds of next day delirium (OR, 1.33; 95% CI, 1.04–1.70; p = 0.026) and coma independently (OR, 1.59; 95% CI, 1.14–2.23; p < 0.01). Higher CRP quartiles were associated with coma (OR, 1.36; 95% CI, 1.03–1.79; p = 0.030) and delirium severity the next day (β = 0.30; se, 0.07; p ≤ 0.01).

CONCLUSIONS:

Our hypothesis-generating study found d-dimer and ferritin were associated with delirium/coma the following day, as well as delirium and coma independently. CRP was associated with next day coma and delirium severity. Larger studies to validate these results are needed.
Therapeutic cancer vaccination against telomerase: clinical developments in melanoma
Authors: Ellingsen Espen Basmo , Bjørheim Jens , Gaudernack Gustav
Published: January 2023

Purpose of review

Checkpoint inhibitors (CPIs) have revolutionized treatment outcomes for patients with malignant melanoma. Long-term follow-up shows that a substantial subset of patients who exhibit clinical responses achieve extended overall survival. Nevertheless, most patients do not achieve durable benefit from CPIs, and improvements are urgently needed. The clinical efficacy of CPIs depends on highly variable preexisting spontaneous T-cell immune responses. Cancer vaccines represent an independent treatment modality uniquely capable of expanding the repertoire of tumor-specific T cells in cancer patients and thus have the capacity to compensate for the variability in spontaneous T-cell responses. Vaccines are, therefore, considered attractive components in a CPI-combination strategy.

Recent findings

Here we discuss recent results obtained through therapeutic vaccination against telomerase human telomerase reverse transcriptase (hTERT). Recent publications on translational research and clinical results from phase I trials indicate that vaccination against telomerase in combination with CPIs provides relevant immune responses, negligible added toxicity, and signals of clinical efficacy.

Conclusion

In the near future, randomized data from clinical trials involving therapeutic cancer vaccines and checkpoint inhibitors will be available. Positive readout may spark broad development and allow cancer vaccines to find their place in the clinic as an important component in multiple future CPI combinations.
Prognostic Value of the Cutoffs for HALP in Endometrial Cancer
Authors: Wang Jinyu , Jiang Peng , Huang Yuzhen , Tu Yuan , Zhou Qian , Li Ning , Kong Wei , Yuan Rui
Published: January 2023

Objectives:

Using preoperative hemoglobin, albumin, lymphocyte, and platelet (HALP) scores, a cutoff value of HALP in endometrial cancer was identified, and the significance of HALP value in endometrial cancer prognosis was evaluated to guide the management of patients.

Materials and Methods:

This study included 626 patients with endometrial cancer who underwent surgery at the First Affiliated Hospital of Chongqing Medical University between June 2015 and June 2020. A Cox regression model was used to analyze the correlation between HALP endometrial cancer recurrence and death, and the receiver operating characteristic curve was used to determine the optimal cutoff value of HALP for predicting the lymph node metastasis (LNM), recurrence, and death of endometrial cancer. Survival analysis was performed using the Kaplan-Meier method and log-rank test.

Results:

Univariate analysis revealed that HALP was associated with a lower risk of recurrence and death of endometrial cancer. Multivariate analysis indicated that HALP was an independent protective factor for predicting recurrence and death in endometrial cancer. The thresholds of HALP for predicting LNM, recurrence, and death in endometrial cancer patients are around 33.8. Kaplan-Meier survival curves showed that the recurrence-free and the overall survival rates were significantly lower in the low-HALP group than that in the high-HALP group (P<0.001).

Conclusions:

Preoperative HALP values in patients with endometrial cancer are important in predicting LNM, recurrence, and death of patients. HALP scores combined with traditional pathologic factors can better guide the prognostic management of patients.
Recurrent Periorbital Edema Associated With Retained Foreign Body After Filler Injection
Authors: Shoji Marissa K. , Maeng Michelle M. , Abou Khzam Rayan , Dubovy Sander R. , Johnson Thomas E.
Published: January 2023

A 34-year-old man presented with recurrent bilateral periorbital swelling and pain for 16 years after receiving facial fillers of an unknown substance in a hotel room from a stranger claiming to work in a medical office. Exam demonstrated a firm, mildly tender nodule along the right upper cheek. Imaging revealed a tubular hyperdensity in the right premaxillary soft tissues. Lower eyelid and upper cheek dissection resulted in retrieval of a tubular metallic foreign body consistent with a needle. Histopathology of surrounding tissue demonstrated iron deposition with granulomatous inflammation. Periocular fillers are a common aesthetic procedure. Although generally well-tolerated, complications include inflammatory reactions, infection, necrosis, and vision loss. This case highlights retention of a metallic foreign body, a complication of filler injection that has not been previously reported, emphasizing the importance of careful injection technique by licensed professionals and imaging and surgical exploration if a foreign body is suspected.
A Review of Midface Aging
Authors: Ugradar Shoaib , Kim Jane S. , Massry Guy
Published: January 2023

Purpose:

To review and summarize studies on the anatomy and involutional changes of the midface.

Methods:

A PubMed search was performed searching for studies on the anatomy and involutional changes concerning the midface.

Results:

The anatomy of the midface is complex. Studies of involutional change vary in scientific quality and have conflicting results. However, it appears that among the more common changes, there is a decrease in the maxillary and pyriform angle, with changes to the orbital floor position. Further, there appears to be an inferior migration of the fat compartments of the midface during aging, exacerbating the hollow of the palpebromalar groove and causing a deepening of the nasojugal groove. Changes to the volume of the buccal extension of the buccal fat pad exacerbate these changes and contribute to the gestalt changes associated with facial aging. Here, we review the major characteristics of soft tissue and bony changes on the midface, with special reference to their anatomic relationships.

Conclusions:

The major findings characterizing midface aging are related largely to the soft tissue. However, more robust studies are required to quantify these changes and to appraise their impact on the overall manifestation of aging.
Ectopic Fibrous Dysplasia Presenting As a Well-Circumscribed Orbital Mass
Authors: Lee Tonya C. , Topilow Nicole J. , Ting Michelle A. , Estrella Melanie , Liu Catherine Y. , Korn Bobby S. , Ferguson Cole J. , Kikkawa Don O.
Published: January 2023

The authors present the case of a middle-aged woman with subacute progressive swelling of the OD associated with pain and severely limited duction in all gazes. MRI demonstrated a ~3 cm circumscribed mass in the extraconal space, which displaced and distorted the globe and impinged upon ocular adnexa. She underwent lateral orbitotomy with bone osteotomy to remove the mass, and subsequent histopathologic examination showed woven bone set within a fibrotic background, microscopic features of fibrous dysplasia. Fibrous dysplasia is characterized by abnormal scar-like bony proliferation, typically within a preexisting structure of the skeletal system. To the authors’ knowledge, this represents the first example of fibrous dysplasia presenting as an orbital mass unconnected to the craniofacial skeleton.
Prevalence and Predictors of Hering’s Response in Müller’s Muscle-conjunctival Resection
Authors: Lussier Charlotte , Leung Victoria C. , El-Khazen Dupuis Jessica , Ashraf Davin C. , Idowu Oluwatobi O. , Massicotte Erika , Vagefi M. Reza , Kersten Robert C. , Kalin-Hajdu Evan
Published: January 2023

Purpose:

Determine the prevalence and predictors of Hering’s response following Muller’s muscle-conjunctival resection (MMCR).

Methods:

Seventy-five consecutive patients undergoing unilateral MMCR were recruited in this prospective, multicenter, cohort study. Margin-reflex distance-1 (MRD1) of both eyelids was recorded preoperatively and postoperatively. One hundred forty-three variables were investigated as potential predictors of a late postoperative (≥3 months) Hering’s response using regression analyses. Main outcome measures were Hering’s response (≥0.5 mm descent of the unoperated eyelid from baseline), and a clinically relevant Hering’s response (descent of the unoperated from baseline to a MRD1 ≤ 2.0 mm, or descent from baseline such that the MRD1 of the unoperated eyelid became >1 mm lower than the operated eyelid).

Results:

Twenty-four (32.0%) patients had a late postoperative Hering’s response, but only 6 (8.0%) responses were clinically relevant. A Hering’s response at the immediate (OR 16.24, p = 0.02) and 1-week postoperative (OR 8.94, p = 0.04) timepoints predicted a late postoperative response. However, the presence (OR 7.84, p = 0.07) and amplitude (OR 8.13, p = 0.06) of a preoperative phenylephrine Hering’s response did not predict a late postoperative response. Of the 10 patients with a clinically relevant phenylephrine Hering’s response, only 1 demonstrated a clinically relevant response late postoperatively.

Conclusion:

Unilateral MMCR induces a clinically relevant Hering’s response in 8% of patients. A preoperative phenylephrine Hering’s response does not predict a late postoperative Hering’s response. Therefore, when unilateral phenylephrine testing unmasks contralateral blepharoptosis, only the side with blepharoptosis at baseline should be operated.
Orbital Compartment Syndrome in Severe Burns: Predictive Factors, Timing, and Complications of Intervention
Authors: Echalier E. Lacey , Larochelle Ryan D. , Patnaik Jennifer L. , Echalier Benjamin R. , Wagner Anne , Hink Eric M. , Subramanian Prem S. , Liao Sophie D.
Published: January 2023

Purpose:

Severe burn patients require high-volume fluid resuscitation, which increases risk for orbital compartment syndrome (OCS). We aimed to understand surgeons’ practice patterns and to examine risk factors for OCS, timing of lateral canthotomy and cantholysis (LCC), and complications of intervention.

Methods:

A survey of American Society of Ophthalmic Plastic and Reconstructive Surgery and North American Society of Academic Orbital Surgeons’ practice patterns in burn patients was undertaken. In addition, a retrospective analysis was conducted of 107 patients with burns greater than 20% total body surface area at 1 institution from January 1, 2009, to June 1, 2018. Patients with Stevens–Johnson Syndrome or Toxic Epidermal Necrolysis, frostbite, or no ophthalmologic consultation were excluded. Risk factors for OCS, timing of LCC, and complications of the intervention were examined.

Results:

In the survey, 37 of 54 respondents had treated burn patients, of which 29 followed no protocol. Threshold intraocular pressure for intervention varied widely, and nearly all reported having seen complications from LCC in burn patients. For the retrospective analysis, 107 patients met criteria, of which 22 (20.6%) required LCC. Renal failure, inhalation injury, eyelid burns, higher total body surface area, elevated lactate, increased number of escharotomies, and greater total fluid required were significantly associated with the clinical decision that the patient was at risk for OCS requiring LCC. Fluid resuscitation in excess of the Ivy Index (250 ml/kg) increased odds of LCC 8.6 times. Average time of LCC was 15.8 hours after burn. LCC patients experienced higher rates of complications including eyelid retraction, exposure keratopathy, and corneal ulceration.

Conclusions:

Severe burn patients should be monitored closely by an ophthalmologist during the first 48 hours for signs of OCS. Further studies should aim to recommend protocols guiding evaluation and intervention.
SS-OCT–based ocular biometry in an adult Korean population with cataract
Authors: Kim Seonghwan , Oh Richul , Kim Mee Kum , Yoon Chang Ho
Published: January 2023

Purpose:

To evaluate the characteristics of ocular biometric parameters in adult Korean patients with cataract.

Setting:

Department of Ophthalmology, Seoul National University Hospital, Seoul, South Korea.

Design:

Retrospective case series.

Methods:

Ocular biometric values of 5273 eyes of 5273 Korean patients undergoing cataract surgery measured with the IOLMaster 700 at the Seoul National University Hospital between November 2019 and December 2021 were reviewed.

Results:

A total of 5273 eyes of 5273 Korean patients were analyzed. The mean ± SD age was 66.1 ± 12.8 years, and 62% were female. Overall, age and ocular biometric parameters were correlated with each other. Particularly, age showed a negative correlation with anterior chamber depth (ACD; r = −0.357), axial length (AL; r = −0.344), and posterior keratometry (PK; r = −0.054) and a positive correlation with lens thickness (LT; r = 0.484), angle α (r = 0.194), total keratometry (TK; r = 0.137), anterior keratometry (AK; r = 0.129), and angle κ (r = 0.071). AL showed a positive correlation with ACD (r = 0.503) and PK (r = 0.339) and a negative correlation with AK (r = −0.342), TK (r = −0.334), LT (r = −0.288), angle α (r = −0.220), and angle κ (r = −0.040). With age, anterior and total corneal astigmatism changed from with-the-rule (WTR) to against-the-rule (ATR) astigmatism. Posterior corneal astigmatism was ATR regardless of age; however, the magnitude decreased with age.

Conclusions:

Age showed a significant correlation in the order of LT, ACD, and AL. With age, angle α and κ increased, and total corneal astigmatism changes from WTR to ATR, which is mainly affected by changes in anterior corneal astigmatism. AL showed a significant correlation in the order of ACD, AK, PK, and TK. These data are pertinent for improving the result after cataract surgery, especially when using premium intraocular lenses.
Visual outcomes and postoperative complications of eyes with dropped lens fragments during cataract surgery: multicenter database study
Authors: Fouad Yousef A. , Jabbehdari Sayena , Neuhouser Adam , Soliman Mohamed K. , Chandra Aman , Yang Yit C. , Sallam Ahmed B.
Published: January 2023

Purpose:

To analyze the visual outcomes and postoperative complications of phacoemulsification cataract surgery in eyes with posterior capsule rupture (PCR) and dropped lens fragments (DLFs) in comparison with a reference group with uneventful surgery.

Setting:

8 UK National Health Service departments.

Design:

Retrospective comparative nonrandomized study.

Methods:

Demographic, medical history, and ocular examination data were automatically extracted from the electronic records. The main outcome variables were postoperative visual acuity (VA), and the development of postoperative cystoid macular edema (CME) as well as rhegmatogenous retinal detachment (RRD) and epiretinal membrane (ERM) requiring surgery.

Results:

The analysis included 175 589 eyes in the reference group, 2751 eyes in the PCR group, and 519 eyes in the DLF group. During all postoperative intervals, the mean VA in the DLF and PCR groups was significantly worse than the reference group (P < .001). On multivariate analysis, the odds of having a VA ≤0.3 logMAR at 4 to 12 weeks postoperatively among eyes with DLF and PCR were 88% and 73% lower than the reference group (P < .001). More eyes developed CME in the DLF and PCR groups (P < .001). The odds of requiring RRD and ERM surgery were 3.6 and 2.1 times higher in the DLF group, and 1.8 and 1.3 times higher in the PCR group, respectively, as compared with the reference group.

Conclusions:

Eyes undergoing phacoemulsification complicated by PCR, and more so with DLF, have worse visual outcomes and higher chances of CME, ERM, and RRD when compared with uneventful surgery.
Evaluation of implantable collamer lens sizing developed by reviewing the horizontal compression-vault coefficient
Authors: Nakamura Tomoaki , Nishida Tomoya , Isogai Naoki , Kojima Takashi , Sugiyama Yasuo , Yoshida Yoko
Published: January 2023

Purpose:

To evaluate the implantable collamer lens (ICL)–sizing method using the partial regression coefficient of the implanted ICL size to review the conventional horizontal compression coefficient and match the results of clinical observation.

Setting:

Nagoya Eye Clinic, Nagoya, Japan.

Design:

Interventional case series.

Methods:

Patients who underwent ICL V4c implantation to correct myopia and myopic astigmatism were enrolled. The stepwise multiple regression analysis used achieved vault as a dependent variable and preoperative biometric parameters as explanatory variables. The partial regression coefficient of the implanted ICL size was obtained to develop the optimal ICL-sizing formula, the Nakamura-Kojima formula version 3 (NK-formula V3). 85 eyes of 45 patients were implanted with an ICL size recommended by the NK-formula V3. At 3 months postoperatively, the achieved vault was measured using anterior segment optical coherence tomography to validate the NK-formula V3.

Results:

The study enrolled 174 patients (174 eyes). The partial regression coefficient of the implanted ICL size adopted as the compression-vault coefficient in the multiple regression equation predicting the vault was 0.729. To validate the NK-formula V3, 77 (90.6%), 7 (8.2%), and 1 (1.2%) eyes were in the moderate-vault, low-vault, and high-vault categories, respectively. The mean difference between the achieved and predicted vaults was 0.064 ± 0.190 (range: −0.264 to 0.742) mm for the NK-formula V3 and 0.176 ± 0.217 (range: −0.254 to 0.907) mm for the NK-formula V2.

Conclusions:

As in vivo coefficient measurement experiments are not possible, the partial regression coefficient is the best option for developing a formula to predict the optimal ICL size.
Efficacy and safety of the eight-chop technique in phacoemulsification for patients with cataract
Authors: Sato Tsuyoshi
Published: January 2023

Purpose:

The aim of this study was to estimate the efficacy of the 8-chop technique in phacoemulsification surgeries of patients with cataract.

Setting:

Sato Eye Clinic, Chiba-ken, Japan.

Design:

Prospective study.

Methods:

Patients were classified into 3 groups (Grade II, Grade III, and Grade IV; n = 50 each) according to the firmness of their lens nuclei. The Eight-chopper I was used for Grade II, Eight-chopper II for Grade III, and Lance-chopper for Grade IV. The best-corrected visual acuity, intraocular pressure (IOP), and endothelial cell density were evaluated at 7 and 19 weeks postoperatively. The primary outcome measures were the mean operative time, mean phaco time, cumulative dissipated energy (CDE), and volume of fluid used.

Results:

150 cataract surgeries were performed. The operative time (minutes), phaco time (seconds), CDE, and volume of fluid used (milliliters) differed significantly among the 3 groups, increasing in the following order: Grade II, Grade III, and Grade IV (P < .01). The corneal endothelial cell density did not decrease significantly in the 3 groups at 19 weeks postoperatively (P = .09). The rate of endothelial cell loss was 0.9% ± 5.9%, 1.0% ± 10.3%, and 5.3% ± 11.1% in the Grade II, III, and IV groups at 19 weeks postoperatively, respectively. There were significant reductions in the IOP at 7 and 19 weeks postoperatively compared with the preoperative IOP in the 3 groups (P < .01).

Conclusions:

The 8-chop technique was effective and safe in phacoemulsification for patients with cataracts with lens nuclei of varying hardness.
Two-surgeon, two-center evaluation of a new combined EDOF intraocular lens approach
Authors: Mastropasqua Leonardo , Pedrotti Emilio , Ruggeri Maria Ludovica , Vecchiarino Luca , Bonacci Erika , Guarini Daniele , Falconio Gennaro , Toto Lisa , Marchini Giorgio
Published: January 2023

Purpose:

To evaluate visual performance and quality of life after bilateral implantation of 2 extended depth-of-focus intraocular lenses (EDOF IOLs).

Setting:

Ophthalmology Clinic, Department of Medicine and Science of Ageing, University “G. d'Annunzio” Chieti-Pescara, Italy, and Ophthalmic Unit, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy.

Design:

Prospective clinical study.

Methods:

60 eyes of 30 patients with senile cataract were enrolled in this study. Patients underwent phacoemulsification and bilateral implantation of the Mini WELL IOL in the dominant eye and the Mini WELL PROXA IOL in the nondominant eye within a month. The main outcome measures over a 3-month follow-up period were uncorrected and corrected visual acuity at different distances (33 cm, 60 cm, and 4 m), defocus curve, contrast sensitivity, and patient satisfaction (evaluated by mean of the National Eye Institute Refractive Error Quality-of-Life instrument-42 questionnaire).

Results:

Binocular uncorrected visual acuity at 90 days was 0.03 ± 0.11 logMAR for long distance, 0.05 ± 0.10 logMAR for intermediate distance, 0.03 ± 0.08 logMAR at 40 cm, and 0.06 ± 0.08 logMAR at 33 cm. Statistically significant differences between the 2 EDOF IOLs in favor of Mini WELL PROXA IOL were observed for uncorrected near visual acuity at 40 and 33 cm (P < .001 and P < .001, respectively) and for distance-corrected near visual acuity at 40 cm (P < .001). Significant differences between the 2 IOLs in the defocus curves were reported.

Conclusions:

In this small pilot study, bilateral implantation of Mini WELL IOL and Mini WELL PROXA IOL achieved good quantity and quality of vision.
Acupuncture for cancer patients with nausea and vomiting: A protocol for systematic review and meta-analysis
Authors: Kim Sung-A , Lim Sabina , Won Tiana , Yeo Sujung
Published: January 2023

Background:

Nausea and vomiting are among the most common adverse effects experienced by cancer patients undergoing treatment worldwide. Their treatment with pharmacologic therapy can often be complicated by medication interactions and other unwanted side effects. The aim of this systematic review and meta-analysis protocol is to assess the effectiveness and safety of acupuncture therapy for treating nausea and vomiting in patients with cancer.

Methods:

Three electronic databases and 2 clinical registry platforms will be searched from inception to May 2022: the MEDLINE via PubMed, Embase via Ovid, the Cochrane Central Register of Controlled Trials via the Cochrane Library, the World Health Organisation International Clinical Trials Registry Platform, and National Institutes of Health Clinical trials.gov. Search terms will include nausea, vomiting, cancer, and acupuncture. Two researchers will independently select studies, extract data and assess the risk of bias. The primary outcome will be the incidence of nausea and/or vomiting or other validated outcome measures. Meta-analysis will be carried out using RevMan V.5.4. The quality of evidence from randomized clinical trials will be evaluated with the Grading of Recommendations Assessment, Development and Evaluation System tool.

Results:

The results will provide a high-quality synthesis of evidence for clinicians in the field of oncology.

Conclusion:

The conclusion is expected to provide evidence to determine whether acupuncture is an effective and safe treatment for cancer patients with nausea and vomiting.
Effects of traditional Chinese exercise on vascular function in patients with Alzheimer’s disease: A protocol for systematic review and network meta-analysis of randomized controlled trials
Authors: Li Jin , Wang Chen , Zhang Peizhen
Published: January 2023

Background:

Alzheimer’s disease (AD) is a progressive neurodegenerative disorder with an insidious onset, usually characterized by memory impairment, visual-spatial skill impairment, executive dysfunction and personality behavioral changes. Studies have confirmed that vascular dysfunction may precede AD pathological changes and can present as vascular malformations, atherosclerosis, and impaired self-regulation, and can affect oxidative stress and amyloidosis. Therefore, it is important to improve or prevent vascular dysfunction in AD patients. Regular exercise can effectively inhibit the production of reactive oxygen species during the occurrence of AD and can improve the reduction of cerebral blood flow due to AD. Previous studies have shown that exercise can achieve superior clinical results in improving vascular function in AD patients. Therefore, we hypothesize that traditional Chinese exercises (TCEs) may have a good clinical effect in improving vascular function in patients with AD.

Methods:

We will search “PubMed,” “the Cochrane Library,” “Embase,” “Web of Science,” “CINAHL,” “ProQuest Dissertations and Theses,” and “ProQuest-Health & Medical Collection,” “CNKI,” “SinoMed,” “VIP,” and “Wanfang Data” to find randomized controlled trials of the effects of TCEs on AD vascular function from the creation of the database to the present, including at least 1 indicator in carotid intima-media thickness (cIMT), middle cerebral artery mean flow velocity (MFV), blood indicators [Heme Oxidase-1 (HO-1), angiopoietin I (Ang I), vascular endothelial growth factor (VEGF), brain-derived neurotrophic factor, matrix metalloproteinase-9 (MMP-9)], and arterial stiffness [(Ankle Brachial Index (ABI), pulse wave velocity (PWV)]. For the included literature, Excel 2019 will be used for data extraction and collection. For the indicators that can be netted for network meta-analysis, Surface Under the Cumulative Ranking for each exercise modality will be calculated with the help of Stata 16.0 and rank, where the higher the SUCRA score, the higher the ranking. For the indicators that cannot be netted, Review Manager 5.4 will be used for meta-analysis will be performed to evaluate the improvement effect of TCEs on AD patients.

Results:

This meta-analysis will further determine the efficacy and safety of TCEs on vascular function in AD patients.

Conclusion:

In this study, randomized controlled trials of the effects of TCEs on vascular function in AD patients will be selected to provide evidence-based medical evidence for promoting the application of TCEs by observing the order of advantages and disadvantages of various exercise modalities through network meta-analysis.
Blood glucose control with different treatment regimens in type 2 diabetes patients hospitalized with COVID-19 infection: A retrospective study
Authors: Chertok Shacham Elena , Maman Nimra , Ishay Avraham
Published: January 2023

Coronavirus disease (COVID-19) is closely associated with hyperglycemia and a worse prognosis in patients with a previous diagnosis of type 2 diabetes mellitus. A few studies investigated the effects of diabetes treatment regimens in these patients during hospitalization. Here, we evaluate the impact of insulin and non-insulin therapy on glucose control in patients with type 2 diabetes admitted with COVID-19.

This is a retrospective study including 359 COVID-19 patients with type 2 diabetes. Patients were divided into 2 groups according to diabetes treatment during hospitalization. The first group included patients treated with insulin only, and the second group patients treated with other antidiabetic agents with or without insulin. Average blood glucose was higher in the insulin-only treatment group (201 ± 66 mg/dL vs 180 ± 71 mg/dL, P = .004), even after excluding mechanically ventilated patients (192 ± 69 vs 169 ± 59 mg/dL, P = .003). In patients with moderate severity of COVID-19, average blood glucose was also significantly higher in the insulin-only treated group (197 ± 76 vs 168 ± 51 mg/dL, P = .001). Most patients (80%) in the combination treatment group received metformin. Moderately affected COVID-19 patients with type 2 diabetes could safely be treated with antihyperglycemic medications with or without insulin.
Monochorea after acute contralateral pontine infarction: A case report
Authors: Hwang Yun Su , Shin Byoung-Soo , Ryu Han Uk , Kang Hyun Goo
Published: January 2023

Rationale:

Chorea is a hyperkinetic movement characterized by random, brief, and involuntary muscle contractions. In stroke, a common cause of chorea, basal ganglia are anatomical locations that can cause chorea when a stroke occurs, and chorea is less frequently triggered by a stroke in other anatomical brain regions. Herein, we report a rare case of monochorea after acute contralateral pontine infarction.

Patient concerns:

A 32-year-old man visited the emergency room due to dysarthria and right hemiparesis that occurred approximately 6 hours and 30 minutes before the visit. A brain magnetic resonance image confirmed a diffusion restriction lesion in the left pons. The patient was initially diagnosed with acute infarction at the left pons and began to receive medical treatment with an antiplatelet agent and statin with admission.

Diagnosis:

Approximately 14 hours after the onset of the initial stroke symptoms, the patient complained of involuntary movement in the right arm for the first time. Intermittent, irregular involuntary movements were observed in the distal part of the right arm. This symptom was unpredictable and random, and a similar symptom was not observed in other parts of the patient’s body. Clinically, post-stroke monochorea was suspected.

Interventions and outcomes:

The symptom improved from day 5 without specific medical treatment for chorea.

Lessons:

The monochorea caused by the pontine lesion in this case was triggered by the direct lesions of the corticospinal tract, and its underlying pathophysiology remains unclear. However, abnormal movements can occur due to inadequate downstream activation or inhibition of the corticospinal tract, which is induced by functional abnormalities of the motor cortex. This case suggests that further investigation is needed on the mechanisms of direct corticospinal tract lesions for chorea.
The impact of wearing powered air purifying respirators or N95 masks on the olfactory function in healthcare workers: A randomized controlled trial
Authors: Xia Xiao , Liu Shixu , Xia Kun , Liu Yanyi , Zhang Jinzhi , Liu Xiaohong , Yao Yuhao , Li Guangxi
Published: January 2023

Background:

With the Coronavirus disease 2019 epidemic, wearing a mask has become routine to prevent and control the virus’s spread, especially for healthcare workers. However, the impact of long-term mask wear on the human body has not been adequately investigated. This study aimed to investigate whether Powered Air Purifying Respirators and N95 masks impact the olfaction in healthcare workers.

Methods:

We recruited fifty-six healthcare workers and randomly divided them into 2 groups, wearing a powered air purifying respirator (PAPR) (experiment group, N = 28) and an N95 mask (control group, N = 28). Olfactory discrimination and threshold tests were performed before and after wearing the masks. SPSS 26.0 (SPSS Inc., Chicago, Illinois) software was used for the statistical analyses.

Results:

There was a statistical difference in the olfactory threshold test after wearing the mask in both PAPR Group (Z = –2.595, P = .009) and N95 Group (Z = –2.120, P = .034), with no significant difference between the 2 (χ
2 = 0.29, P = .589). There was no statistical difference in the discrimination test scores in both 2 groups after wearing the masks.

Conclusion:

Wearing a mask affects the healthcare workers’ olfaction, especially odor sensitivity. Healthcare workers have a higher olfactory threshold after long-term mask wear, whether wearing PAPRs or N95 masks.
The role of closed-loop management of fever patients in a county-level medical community for the prevention and control of the post-coronavirus disease 2019 pandemic
Authors: Ding Yajun , Xu Chunxia , Zhang Xingguo , He Yanzhen , Wang Fang , Zhang Libo , Yu Yaner , Zhou Yachun , Zhang Youping , Ye Dongxian
Published: January 2023

We built a closed-loop management model for patients with fever in a county-level medical community and explored the role of this model in post-coronavirus disease 2019 (COVID-19) epidemic prevention and control. The subjects included 83,791 patients with fever treated in designated hospitals between February 2020 and April 2021. A pre-hospital, in-hospital, and post-hospital management system for patients with fever in the county-level medical community was established to allow the closed-loop management of these patients. SPSS software (version 13.0) was used to analyze the methods of visiting the hospital, nucleic acid detection in the hospital, and location of the patients after the hospital visit. Chi-square tests were used to compare the methods of visiting and location after hospital visits between patients with and without an epidemiological history. The number of patients with fever in the fever clinic showed a logarithm change (R
2 = 0.4710), accompanied by seasonal changes. The number of fever patients with an epidemiological history decreased logarithmically monthly (R
2 = 0.8876). Among patients with fever, 99.64% sought medical treatment on their own, with relatively low proportions undergoing home quarantine and requiring centralized quarantine special vehicles. After visiting the fever clinics, 98.56% of patients isolated at home or were monitored, with small proportions of patients requiring hospital admission or centralized isolation. However, the proportions of patients with home and centralized isolation with epidemiology were relatively high, accounting for 20.55% and 27.40% of cases, respectively. Compared to the overall population of patients with fever, the difference was statistically significant (χ
2 = 48.881, P = .000). The establishment of a closed-loop management model for patients with fever in a county-level medical community strengthened the management of these patients. No local cases occurred in Beilun District between March 2020 and April 2021. In the post-COVID-19 era, all medical institutions in the county-level medical community strengthened infectious disease pre-examination and triage and promoted the formation of a strategic pattern of initial diagnosis at the grassroots level, 2-way referral, upper and lower linkage, and joint epidemic prevention. This management was more conducive to COVID prevention and control by hierarchical management according to the presence or absence of an epidemiological history.
Exploration of Fuzheng Yugan Mixture on COVID-19 based on network pharmacology and molecular docking
Authors: Jiang Xinyu , Zhou Jie , Yu Zhongming , Gu Xueya , Lu Ying , Ruan Yanmin , Wang Tianyue
Published: January 2023

After the World Health Organization declared coronavirus disease 2019 (COVID-19), as a global pandemic, global health workers have been facing an unprecedented and severe challenge. Currently, a mixturetion to inhibit the exacerbation of pulmonary inflammation caused by COVID-19, Fuzheng Yugan Mixture (FZYGM), has been approved for medical institution mixturetion notification. However, the mechanism of FZYGM remains poorly defined. This study aimed to elucidate the molecular and related physiological pathways of FZYGM as a potential therapeutic agent for COVID-19. Active molecules of FZYGM were obtained from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP), while potential target genes of COVID-19 were identified by DrugBank and GeneCards. Compound-target networks and protein-protein interactions (PPI) were established by Cytoscape_v3.8.2 and String databases, respectively. The gene ontology (GO) analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis were performed. Finally, a more in-depth study was performed using molecular docking. Our study identified 7 active compounds and 3 corresponding core targets. The main potentially acting signaling pathways include the interleukin (IL)-17 signaling pathway, tumor necrosis factor (TNF) signaling pathway, Toll-like receptor signaling pathway, Th17 cell differentiation, and coronavirus disease-COVID-19. This study shows that FZYGM can exhibit anti-COVID-19 effects through multiple targets and pathways. Therefore, FZYGM can be considered a drug candidate for the treatment of COVID-19, and it provides good theoretical support for subsequent experiments and clinical applications of COVID-19.
Synchronous cutaneous malignant peripheral nerve sheath tumor and jejunal gastrointestinal stromal tumor and submucosal angiomyolipoma in type 1 neurofibromatosis: A case report and literature review
Authors: Kim Kyung Jong , Kim Min Sung , Hong Ran , Lim Sung-Chul
Published: January 2023

Rationale:

Type 1 neurofibromatosis (NF1) is one of the most prevalent genetic conditions. NF1 is characterized by cutaneous plexiform neurofibromas and café au lait skin pigmentation, and is inherited in an autosomal dominant trait with mutation in the neurofibromin 1 gene on chromosome 17. Neurofibromin is involved in Ras proto-oncogene regulation. Accordingly, NF1 may lead to malignancies, with a lifetime cancer risk of 60%. Malignant peripheral nerve sheath tumor (MPNST) is the leading cause of mortality due to NF1. The relevance of gastrointestinal stromal tumor (GIST) in NF1 is increasingly being reported in the literature and NF1-associated GIST has been identified to have an alternative molecular pathogenesis.

Patient concerns:

A 62-years-old female had a 7 × 5 cm growing back mass in the background of various sized cutaneous neurofibromas with café au lait spots. Computed tomography performed in the workup revealed a 4.1 cm enhancing mass near the ileal mesentery.

Diagnoses:

NF1 affected by cutaneous MPNST of the back, and synchronous GIST and submucosal angiomyolipoma (AML) of the jejunum.

Interventions:

The patient underwent laparoscopic jejunal mass excision, and excision and flap coverage for the back mass owing to the suspicion of multiple MPNSTs. However, the abdominal masses were diagnosed as GIST and AML following confirmation of the immunohistochemical profiles. Accordingly, the patient was administered adjuvant radiotherapy to the MPNST after surgery.

Outcomes:

Symptomatic improvements were achieved, and no subsequent relapses were observed.

Lessons:

Although MPNST and GIST are not rare neoplasm in NF1, only 2 case reports have been published on the synchronous occurrence of these tumors. Moreover, no case report has been published on AML in NF1, except 1 renal AML in segmental neurofibromatosis. Identifying the clinical and pathologic significances of the NF1 is important to achieve improved diagnostic accuracy.
Modulated electrohyperthermia in locally advanced cervical cancer: Results of an observational study of 95 patients
Authors: Lee Sun Young , Lee Dong Hyun , Cho Dong-Hyu
Published: January 2023

Most federation of gynecology and obstetrics stage II or higher locally advanced cervical cancer (LACC) patients are treated with concurrent chemoradiotherapy (CCRT); however, recurrence is high, and the prognosis is poor. In this observational retrospective study, data from LACC patients treated with CCRT alone or combined with modulated electrohyperthermia (mEHT) were collected from 2011 to 2018. Ninety-five LACC patients, including 53 (%) treated with CCRT alone and 42 (%) treated with CCRT + mEHT, were enrolled. The complete remission rate significantly increased with CCRT + mEHT compared with CCRT alone among LACC cases with lymph node metastasis (45% vs 71%, P = .0377). Additionally, at the last follow-up point, the no-evidence-of-disease rate significantly improved with CCRT + mEHT compared with CCRT (58% vs 82%, P = .0315). Disease-free survival increased in the CCRT + mEHT group with lymph node metastasis (P = .04). The addition of mEHT to CCRT led to a better therapeutic response in LACC with regional lymph node metastasis without severe complications.
Sleep quality and sleep patterns among recovered individuals during post-COVID-19 among Jordanian: A cross-sectional national study
Authors: Abuhammad Sawsan , Alzoubi Karem H , Khabour Omar F , Hamaideh Shaher , Khasawneh Basheer
Published: January 2023

This study aims to investigate sleep patterns and quality in patients who had SARS-CoV-2 (COVID-19) infection and to determine the sleep quality and pattern among patients. A cross-sectional design was used to assess sleeping patterns during the post-COVID-19 era for recovered individuals from April 1st, 2022, to June 1st, 2022. The participants had to meet the following requirements: both genders, ages 18 to 70, and previously infected with COVID-19. The prevalence of low sleep quality among the recovered individuals during post-COVID-19 era was 834 (40.6%), and the prevalence of disturbance in sleep quality was 1308 (63.6%). Lower economic status and younger ages in twenties and thirties experienced more disturbances in sleep patterns than other older ages. Many predictors were determined the quality of sleep. These predictors were age (B = .105, P = .00), income (B = .05, P = .035) and educational level (B = .20, P = .006). To sum up, our study found that the prevalence of low sleep quality among the recovered individuals during post-COVID-19 era was moderate, and the prevalence of disturbance in sleep quality was high. The predictors of quality of sleep were age, income, and educational level. Practitioners should be trained to evaluate and manage sleep disturbances, as this comprehensive approach has the potential to reduce mental distress and prevent the consequences of sleep disturbances.
Prosthesis for bilateral equinus foot: A case study
Authors: Cotinat Maëva , Leroy Vincent , Bensoussan Laurent , Viton Jean-Michel
Published: January 2023

Background:

Although surgical treatment for equinus foot has been widely described in the literature, less attention has been paid to orthopedic treatment with prostheses, which constitutes an interesting alternative approach. It has been described in the literature for treating lower-limb inequality, but not for equinus foot. The aim of this article is to report that the use of prosthetics can be a valid means of managing bilateral equinus foot.

Case description and methods:

In the present case report, we describe the management of an irreducible bilateral equinus in a 45-year-old patient with poliomyelitis sequelae, starting with orthoses and orthopedic shoes, followed by prostheses. We measured the evolution of the patient's spatiotemporal gait parameters, his autonomy, and his satisfaction with a QUEST score.

Findings and outcomes:

Despite the deterioration of the patient's physical abilities due to the onset of a postpoliomyelitis syndrome, his gait parameters and his autonomy were maintained while using the prostheses. His tolerance of the prostheses improved even more greatly, as shown by his QUEST score, which increased from 2.95 to 4.67 of 5.

Conclusion:

The use of prostheses was at least as effective and even better tolerated than orthoses and orthopedic shoes by this patient. Despite the occurrence of a postpoliomyelitis syndrome, the prostheses helped to maintain his walking performances, while improving his satisfaction.
Association Between Enlarged Genital Hiatus and Composite Surgical Failure After Vaginal Hysterectomy With Uterosacral Ligament Suspension
Authors: Bradley Megan S. , Sridhar Amaanti , Ferrante Kimberly , Andy Uduak U. , Visco Anthony G. , Florian-Rodriguez Maria E. , Myers Deborah , Varner Edward , Mazloomdoost Donna , Gantz Marie G. ,   for the NICHD Pelvic Floor Disorders Network
Published: January 2023

Importance

The impact of a persistently enlarged genital hiatus (GH) after vaginal hysterectomy with uterosacral ligament suspension on prolapse outcomes is currently unclear.

Objectives

This secondary analysis of the Study of Uterine Prolapse Procedures Randomized trial was conducted among participants who underwent vaginal hysterectomy with uterosacral ligament suspension. We hypothesized that women with a persistently enlarged GH size would have a higher proportion of prolapse recurrence.

Study Design

Women who underwent vaginal hysterectomy with uterosacral ligament suspension as part of the Study of Uterine Prolapse Procedures Randomized trial (NCT01802281) were divided into 3 groups based on change in their preoperative to 4- to 6-week postoperative GH measurements: (1) persistently enlarged GH, 2) improved GH, or (3) stably normal GH. Baseline characteristics and 2-year surgical outcomes were compared across groups. A logistic regression model for composite surgical failure controlling for advanced anterior wall prolapse and GH group was fitted.

Results

This secondary analysis included 81 women. The proportion with composite surgical failure was significantly higher among those with a persistently enlarged GH (50%) compared with a stably normal GH (12%) with an unadjusted risk difference of 38% (95% confidence interval, 4%–68%). When adjusted for advanced prolapse in the anterior compartment at baseline, the odds of composite surgical failure was 6 times higher in the persistently enlarged GH group compared with the stably normal group (95% confidence interval, 1.0–37.5; P = 0.06).

Conclusion

A persistently enlarged GH after vaginal hysterectomy with uterosacral ligament suspension for pelvic organ prolapse may be a risk factor for recurrent prolapse.