bluuebunny/crossref_metadata_2025 huggingface dataset:
Hemorrhagic, hypovolemic shock resuscitated with Ringer’s solution using bicarbonate versus lactate: A CONSORT-randomized controlled study comparing patient outcomes and blood inflammatory factors
Authors: Han Sheng-Jin , Zhou Zheng-Wu , Yang Cui , Wei Kun-Peng , Ma Jian-Zhong , Chu Zeng-Fei , Gu Peng
Published: November 2022

Background:

Isotonic crystalloids are the preferred solution for the initial clinical management of patients with multiple trauma, among which lactated Ringer’s solution and normal saline are the most widely used, but both have clinical limitations. Bicarbonated Ringer’s solution (BRS), which provides physiological levels of bicarbonate ions and electrolyte ions, can be used to supplement missing extracellular fluid and correct metabolic acidosis.

Methods:

A prospective, randomized controlled study enrolled 63 patients with traumatic hepatic rupture and hemorrhagic shock. They were randomly assigned to the Bicarbonated group (n = 33) or the Control group (n = 30), which received restrictive fluid resuscitation with sodium bicarbonate Ringer’s solution or sodium lactate Ringer’s solution, respectively. The levels of interleukin (IL)-6, tumor necrosis factor (TNF)-α, arterial blood lactic acid and potential of hydrogen (pH) were measured prior to, 1, 3, 24, and 72 hours following resuscitation. The primary outcomes were patient survival, shock-related complications, and comparison of the inflammatory factors.

Results:

The incidence of complications in the Bicarbonated group was significantly lower than in the Control group (15.15% vs 40.0%; P < .05). The intensive care unit length of stay and mechanical ventilation time in the Bicarbonated group were significantly shorter than in the Control group (all P < .01). The levels of IL-6 and TNF-α in the Bicarbonated group were significantly lower 1 hour following resuscitation than prior to resuscitation (P < .01), whereas these levels in the Control group were increased following 1h of resuscitation as compared with before resuscitation (P < .01). Following resuscitation, the levels of IL-6, TNF-α and lactate in the Bicarbonated group were significantly lower than in the Control group (P < .01). Moreover, in the Bicarbonated group, the lactic acid level decreased and the pH value increased significantly following resuscitation, whereas there was no difference in lactic acid levels and pH value between pre- and 1 hour post-resuscitation in the Control group (P > .05).

Conclusion:

The shock-related complications were dramatically reduced from using BRS in these patients. Additionally, the BRS was found to better inhibit the expression of inflammatory factors in their peripheral blood and could correct acidosis.
A rare case of Takotsubo syndrome with ventricular septal rupture: Case report
Authors: Alsheikh Hamada , Shaheen Nour , Saber Wageih , Meshref Mostafa , Amro Yara , Shaheen Ahmed , Ahmed Mahmoud Galal , Swed Sarya
Published: November 2022

Introduction:

Takotsubo cardiomyopathy (TCM) mimics acute coronary syndrome and is characterized by reversible left ventricular (LV) apical ballooning in the absence of angiographically substantial coronary artery stenosis.

Patient concerns:

A 31-year-old man with acute dejection, physical stress, and psychological strain from the dread of losing his work arrived at the emergency department with chest pain, and discomfort that had lasted 3 hours.

Diagnosis:

Once the coronary angiography revealed normal epicardial coronaries, the case was retroactively diagnosed, and the levels of cardiac enzymes were increased.

Interventions:

The amount of necrotic tissue was so little that the surgeon could only verbally convey it. It is completely closed with the help of a Dacron sheet. The patient received surgical closure of the VSR a few days after having a surgical consultation.

Outcomes:

No postoperative echocardiogram was required, and the patient was sent home in great general condition.

Conclusion:

The presence of TCM with a ruptured LV wall was extremely rare because our patient had neither clinical risk indicators nor a family history of coronary artery disease. As a Takotsubo syndrome severe complication, we underline the significance of identifying, diagnosing, and treating it.
Effects of rosuvastatin/ezetimibe on senescence of CD8+ T-cell in type 2 diabetic patients with hypercholesterolemia: A study protocol
Authors: Ju Sang Hyeon , Ku Bon Jeong
Published: November 2022

Background:

A decade ago, systemic inflammation became widely recognized as an etiology of type 2 diabetes mellitus (T2DM) and complications thereof. Senescent CD8 + T cells of T2DM patients exhibit increased secretion of pro-inflammatory cytokines and enhanced expression of cytotoxic molecules, contributing to systemic inflammation. Recently, many anti-inflammatory roles played by statins and ezetimibe (cholesterol-lowering drugs) have been reported. We will explore the effects of statin/ezetimibe therapy on CD8 + T cell senescence in patients with T2DM and hypercholesterolemia.

Methods:

This 2-group, parallel, randomized, controlled clinical trial will recruit 108 subjects with T2DM and low-density lipoprotein-cholesterol (LDL-C) levels ≥100 mg/dL and randomly assign them to rosuvastatin/ezetimibe and rosuvastatin groups at a 1:1 ratio. Blood samples will be drawn at baseline and after 12 weeks of medication. The primary outcomes will be the LDL-C-lowering effects after 12 weeks. The secondary outcomes will be changes in the senescent (CD28 − CD57+) CD8 + T cell proportions; the levels of circulating pro-inflammatory cytokines, cytotoxic molecules, interleukin-1, transforming growth factor-β, fasting glucose, and HbA1c; and biochemical indices of kidney, liver, and muscle function. Symptoms and signs of predictable adverse events (myopathy and hepatitis) will be routinely monitored.

Discussion:

We will evaluate the effects of statin/ezetimibe on CD8 + T cell senescence. Statin/ezetimibe may exert a beneficial immunomodulatory effect.
A pooled analysis of the association between sarcopenia and osteoporosis
Authors: Yu Xiaochao , Sun Shuo , Zhang Shaoxiong , Hao Qinggang , Zhu Boheng , Teng Yirong , Long Qing , Li Shujun , Lv Yan , Yue Qiaoning , Lu Sheng , Teng Zhaowei
Published: November 2022

Background:

Sarcopenia is a progressive generalized skeletal muscle disorder that causes the accelerated loss of muscle mass and function. Osteoporosis is a systemic condition of the skeleton that results in low bone mass and quality. Several studies have suggested that osteoporosis and sarcopenia are interrelated; however, a few studies indicate the lack of a significant association between sarcopenia and osteoporosis. We aimed to evaluate the association between sarcopenia and osteoporosis via a systematic review and pooled analysis.

Methods:

From the inception of the PubMed and Embase databases until September 2022, we conducted a systematic search for studies evaluating the relationship between sarcopenia and osteoporosis. Study appraisal and synthesis methods: We included observational studies that provided 95% confidence intervals (CIs) and risk estimates. Two reviewers independently extracted data and assessed the quality of the research. The random-effects model was applied to the pool analysis, and the odds ratios (ORs) and 95% CIs were finally calculated.

Results:

The primary statistic was the mutual risk between sarcopenia and osteoporosis. According to the inclusion criteria, 56 studies (796,914 participants) were finally included. Sarcopenia was significantly correlative to the risk of osteoporosis (OR, 3.06; 95% CI, 2.30–4.08), and each standard deviation increase in relative appendicular skeletal muscle mass was significantly related to a decreased risk of osteoporosis (OR, 0.65; 95% CI, 0.56–0.75). Osteoporosis observably referred to a higher risk of sarcopenia (OR, 2.63; 95% CI, 1.98–3.49).

Conclusion:

Our research indicated that sarcopenia and osteoporosis are highly positively correlated. Osteoporosis is closely associated with the risk of sarcopenia. Our finding highlights the importance of sarcopenia screening for those at risk of osteoporosis, and vice versa. However, heterogeneity was noted among the studies, and this might have influenced the accuracy of the results. Therefore, the results of our study should be interpreted with caution.
Repetitive transcranial magnetic stimulation in patients with fibromyalgia: A protocol for systematic review and network meta-analysis
Authors: Wang Yangyang , Lei Junfang , Qiao Hong , Tang Jiqin , Fan Xiaohua
Published: November 2022

Background:

Fibromyalgia is a chronic disease characterized by widespread pain. Repetitive transcranial magnetic stimulation (rTMS) effectively relieves pain intensity in patients with fibromyalgia. The frequency and target site of rTMS have significant roles in therapy effectiveness. However, there is disagreement over the best rTMS protocol. Thus, we will conduct a thorough systematic review and network meta-analysis to rank the efficacy of these various rTMS protocols and determine which is most beneficial in lowering pain and enhancing the quality of life.

Methods:

Databases PubMed, Web of Science, Embase, and Cochrane Library will be searched for clinical randomized controlled trials of rTMS in fibromyalgia. The retrieval time is from the inception of the database until October 1, 2022. Following the Cochrane Handbook, 2 reviewers will independently review the literature, extract data, and evaluate the risk of bias of included articles. Pain intensity and quality of daily life are outcome indicators. Stata 17.0 and ADDIS 1.16.8 software will be used for pairwise meta-analysis and network analysis to evaluate the effectiveness of rTMS and the ranking probability of all protocols. The recommended grading assessment, development, and evaluation will be used to assess the overall quality of the evidence.

Results:

The meta-analysis and probability ranking of the network determined the best TMS protocol for fibromyalgia.

Conclusion:

This study will provide systematic support of evidence-based medicine for TMS in fibromyalgia, integrate the results of direct and indirect comparisons of the efficacy of different rTMS protocol, and provide the best one.
Prophylactic antibiotics induce early postcraniotomy seizures in neurosurgery patients: A case series
Authors: Lee Nawon , Jee Dae-Lim , Kim Hyuckgoo
Published: November 2022

Rationale:

Antibiotics can cause central nervous system disturbances, manifesting as dizziness, confusion, headache, and seizures. Seizures due to antibiotic administration are related to increased excitatory neurotransmission because antibiotics act as competitive antagonists of the γ-aminobutyric acid type A receptor.

Patient concerns and clinical findings:

All 5 patients, comprising 4 females and one male and aged 45 to 72 years, underwent open craniotomy with additional surgical maneuvers according to their specific disease. All patients presented American Society of Anesthesiologists Physical Status grades 1 to 2. There were no specific underlying diseases, except hepatitis C and hypertension. However, seizures developed sequentially in the 5 patients after neurosurgery.

Diagnoses, interventions, and outcomes:

Early postcraniotomy seizures (PCS) developed in the patients after neurosurgery. Prophylactic antibiotics were administered in all cases to prevent infection due to open craniotomy. This included the administration of 10 g and 2 g of an antibiotic (cefotiam HCL; Jetiam Intravenous Injection 1g®) an hour before the surgery in the ward and half an hour before the surgery in the operating room, respectively. After surgery, cefotiam HCL 2 g was administered in all patients on the day of surgery. Five patients had myoclonic seizure or generalized tonic–clonic seizure several times at emergence or in the intensive care unit.

Lessons:

Early PCS occurred in every patient when an overdose of the prophylactic antibiotic was administered. This report showed that the preoperative prophylactic antibiotic cefotiam administered in double doses evoked early PCS within a few hours of drug administration. Furthermore, such experiences caution that preoperative intravenous cephalosporins, including cefotiam, should be administered carefully in open craniotomy.
Use self-gravitation traction to treat lumbar disc herniation: Study protocol for a double-center, single-blind randomized controlled trial
Authors: Zhao Xi-Yun , Wang Zhi-Peng , Quan Zhen , Gao Guo-Dong , Zhang Hong-Wei , Zhang Xiao-Gang , Cao Lin-Zhong , Liu Shuo , Li Jin-Feng
Published: November 2022

Background:

Self-gravitation traction is 1 of the most popular treatments for lumbar disc herniation (LDH). This study aims to evaluate the effectiveness and safety of the self-gravitation traction device in the treatment of LDH and to confirm its positive treatment effect.

Methodology:

This trial is designed as a pragmatic double-center, single-blind, and 3-arm (1:1:1 ratio) randomized controlled trial. The recruited patients with LDH will be randomly allocated to the intervention (traction weight is 40% or 60% of its body weight) or control (traction weight is 20% of its body weight) group. Traction will be completed within 6 consecutive weeks (3 times a week), with 10 minutes of traction for the first 3 weeks, 20 minutes of traction for the next 3 weeks. After the experiment is completed, we will establish an experiment-related database. The software of SPSS, version 21 (SPSS Inc. Chicago, IL) will be used for statistical analysis, and measurement data will be expressed via mean and standard deviation (mean ± SD).

Discussion:

Once the trial is completed, we will publish the study in journals in both Chinese and English to promote the dissemination and use of the results. In addition, we also plan to promote the research results at various academic conferences both domestically and internationally.
Prognostic potential of miR-144 in various cancers: A meta-analysis
Authors: Jia Chong-Yang , He Yan , Wu Shi-Nan , He Yan-Ting , Wang Ying
Published: November 2022

Background:

MicrorNA-144 (MiR-144) has been shown to be an attractive prognostic tumor biomarker and play a fundamental role in various cancers, However, the conclusion was inconsistency. The aim of this study was to identify the prognostic role of miR-144 in cancers.

Methods:

Relevant studies were searched in PubMed, EMBASE and Web of Science up to April 20, 2022. Hazard ratios (HR), odds ratio (OR) and 95% confidence intervals were pooled from the selected studies.

Results:

A total of 15 articles involving 1846 participants fulfilled the inclusion criteria. The results revealed that low miR-144 expression was significantly associated with favorable overall survival (HR: 0.68, 95% confidence interval [CI]: 0.53–0.88) in various cancers. Low miR-144 expression had better predictive value in patients with urinary system cancer (HR: 0.48, 95% CI: 0.35–0.64). In addition, low miR-144 expression was associated with tumor diameter (big vs small) (OR: 1.69, 95% CI: 1.08–2.75), tumor stage (III–IV vs I–II) (OR: 2.52, 95% CI: 3.76–8.14) and invasion depth (T3 + T4 vs T2 + T1) (OR: 3.24, 95% CI: 1.72–4.89).

Conclusion:

miR-144 may serve as a prognostic biomarker in cancers.
Ferroptosis-related long non-coding RNA signature predicts the prognosis of hepatocellular carcinoma: A Review
Authors: Bu Fan , Yin Shijie , Guan Ruiqian , Xiao Yao , Zeng ShuLin , Zhao Yonghou
Published: November 2022

Introduction:

Hepatocellular carcinoma (HCC) is a liver cancer. In contrast, ferroptosis is a novel iron-dependent and ROS reliant type of cell death that is observed under various disease conditions.

Methods and analysis:

RNA sequencing data from HCC patients were downloaded from The Cancer Genome Atlas (TCGA) database. Ferroptosis-related long non-coding RNAs (lncRNAs) were screened by Pearson correlation analysis. Patients were randomized into training or testing sets in a 1:1 ratio. They were constructed in the training set using univariate-Lasso and multivariate Cox regression analysis and further tested for prognostic values in the testing set. Four lncRNAs were identified. Kaplan–Meier analysis showed that patients in the high-risk group had a worse prognosis than those in the low-risk group. Following differentially expressed genes analysis of these two groups. Functional analysis showed association with oxidative stress response. Cox regression analyses showed that risk score was an independent prognostic indicator. Receiver operating characteristic curve (ROC) and decision curve analysis demonstrated the accuracy of prediction. Four ferroptosis-related lncRNAs based on differential expression of HCC were screened by bioinformatic methods to construct a prognostic risk model and accurately predict the prognosis of HCC patients. Four lncRNAs may have a potential role in the anti-tumor immune process and serve as therapeutic targets for HCC. To lay the foundation for subsequent studies.
Factors affecting pain and physical functions in patients with knee osteoarthritis: An observational study
Authors: Alghadir Ahmad H. , Khan Masood
Published: November 2022

Knee osteoarthritis (KOA) is more common as people age and have a higher body mass index (BMI). We must know the role of various factors in pain and physical functions in patients with KOA. Therefore, the present study sought to examine the factors associated with pain and physical functions in individuals with KOA. This cross-sectional observational study included patients with KOA (n = 125; 57 men, 68 women; mean age 52.9 years). Using the visual analogue scale and a reduced version of the Western Ontario McMaster Universities Osteoarthritis Index, pain severity and physical functions were assessed. Demographic factors such as age, BMI, sex, and Kellgren-Lawrence (K/L) radiographic grade of KOA were analyzed. Age (R = 0.263, P < .001), BMI (R = 0.379, P < .001), and K/L grade (R = 0.844, P < .001) were significantly associated with knee pain. Similarly, age (R = 0.310, P < .001), BMI (R = 0.374, P < .001), and K/L grade (R = 0.862, P < .001) were associated with physical functions. No significant association of sex with pain (R = 0.071, P = .440) and physical functions (R = 0.055, P = .545) was observed. Age, BMI, and K/L grade explained 71% and 74% of knee pain and physical functions, respectively. Age, BMI, and radiographic (K/L) grades were associated with pain and physical functions in patients with KOA. K/L grade was the most significant predictor of pain and physical functions in KOA.
Parathyroid adenoma presenting as chronic pancreatitis: A case report and literature review
Authors: Fu Chih-Hsuan , Chen Hua-Fen
Published: November 2022

Background:

Most patients with parathyroid adenomas are asymptomatic and rarely present with chronic pancreatitis (CP). Several studies have reported a positive association between primary hyperparathyroidism (PHPT) and pancreatitis. Parathyroidectomy is the definitive treatment for PHPT. IV bisphosphonates can be considered the drug of choice for bridge to surgery.

Methods:

We reported a 57-year-old female patient was admitted to the emergency room with left upper quadrant abdominal pain and a diagnosis of recurrent pancreatitis. Magnetic Resonance Cholangiopancreatography confirmed the diagnosis of CP. The patient had no common etiology of pancreatitis. Persistent hypercalcemia was noted despite administering intravenous fluids, and Calcitonin. Intravenous Pamidronate, a Bisphosphonate derivative, was also administered. Although calcium levels initially decreased, they were later found to rebound to previous levels.

Results:

A diagnosis of parathyroid adenoma and PHPT was made based on the elevated parathyroid hormone levels and cervical ultrasonography indicated right inferior parathyroid adenoma. Technetium-99m methoxy-isobutyl-isonitrile scintigraphy revealed a focal hot spot of tracer accumulation at the right lower thyroid bed. The patient underwent right lower parathyroidectomy smoothly and successfully. After right lower parathyroidectomy, she had normal serum calcium levels (9.2 mg/dL) and parathyroid hormone (16.1 pg/mL). There was no recurrent abdominal pain after the operation.

Conclusion:

CP is a rare manifestation of parathyroid adenoma. When patients with a history of recurrent pancreatitis, without common causes of pancreatitis, present persistent elevated serum calcium levels, PHPT could be suspected.
Rare presentation in a rare case of pancreatic extraosseous Ewing’s sarcoma: A case report
Authors: Liu Ya-Chih , Yeh Ting-Chi , Wu Pao-Su , Sheu Jin-Cherng , Lee Hung-Chang , Yeung Chun-Yan , Jiang Chuen-Bin , Liu Hsi-Che , Hou Jen-Yin , Chan Wai-Tao
Published: November 2022

Rationale:

Extraosseous Ewing’s sarcoma is a rare tumor which is aggressive with poor prognosis; it can occur anywhere in the body, but scantily in the pancreas. Pancreatic Ewing’s sarcoma is not reported commonly, with inconsistent clinical manifestations. In this regard, early recognition of this disease is very important for the patient’s sake.

Patient concerns:

A 16-year-old boy presented with left lower quadrant abdominal pain for 2 months, and left flank pain with dysuria for 1 month.

Diagnosis:

Abdominal and renal ultrasonography found a mass between the spleen and left kidney as well as left renal pelvic dilatation. Abdominal computed tomography found a heterogenous mass derived from the tail of the pancreas. Serial examinations revealed that the mass was a pancreatic Ewing’s sarcoma. Furthermore, no metastasis was documented.

Interventions:

The tumor was totally excised after 6 months of chemotherapy, which included 10 courses of neoadjuvant chemotherapy with vincristine, epirubicin, and cyclophosphamide, alternating with ifosfamide and etoposide. The patient completed consolidation chemotherapy with vincristine, epirubicin, and cyclophosphamide, alternating with ifosfamide and etoposide for 5 courses. Radiotherapy was applied to the tumor-involved region and tumor bed.

Outcomes:

To date, the malignancy has not recurred since the treatment was completed 4 years ago. There are no complications from the treatment for the patient.

Lessons:

The pancreas is a very rare extraosseous location for Ewing’s sarcoma. Pancreatic extraosseous Ewing’s sarcoma should be regarded as a differential diagnosis of non-urinary originated left flank pain with dysuria in adolescents.
The status of TKI/acid-suppressant concomitant use in 44 hospitals in China: A cross-sectional descriptive study
Authors: Chen Fangting , Yao Wendong , Wu Fan , Xie Rui , Wang Jianping , Shi Zheng
Published: November 2022

The irrational use of tyrosine kinase inhibitors (TKIs) has attracted increasing attention, especially because of drug–drug interactions. The objective of this study was to analyze TKI prescriptions and evaluate the rationality of concomitant use of TKIs and acid-suppressants. TKI prescriptions from 2016 to 2018 were collected from hospitals in Beijing, Guangzhou, Hangzhou, and Zhengzhou for 40 d/yr. Focusing on the data in 2018, we analyzed the pharmacoeconomic indicators of TKIs and the number and proportion of different coprescriptions. The evaluation criteria for coprescriptions were based on clinical literature and package inserts. A total of 41,738 TKI prescriptions were assessed. The total dose and sales of imatinib were the highest, the medication days and defined daily doses of gefitinib were the highest, and the highest defined daily cost was sunitinib. Meanwhile, there were 17 TKIs with drug utilization indices of ≤ 1.0. The irrational combination rate of prescriptions of non-cancer-related departments was high in 3 cities, but not Hangzhou. The irrational combination rate of prescription of inpatient prescriptions was > 23% in the 4 cities. The combined use of TKIs and acid-suppressants is common in China and may have a clear or potential impact on the pharmacokinetics, pharmacodynamics, and adverse drug reactions of TKIs. Therefore, it is urgent to implement necessary interventions to stop such irrational use or if the combined use is necessary, to correct adverse consequences. The aims should be to achieve safe and effective use of TKIs and reduce unnecessary costs.
Risk factors and SCN5A-H558R polymorphism for atrial fibrillation in Tibetans living at different altitudes
Authors: An Renfang , Liu Jiang , Zhang Jinwei , Yao Fengcai , Tian Dekuan , Liang Fuli , Li Wenqiang , Li Delian , Wang Yiqi , Yan Sai , Yang Qijuan , Zhang Yajie , Su Xiaoling
Published: November 2022

Several studies have found associations of genes with atrial fibrillation (AF), including SCN5A-H558R. However, there are limited data of these associations among populations living at different altitudes. We investigated the relationship between the SCN5A-H558R polymorphism and AF in Tibetans living at different altitudes in Qinghai, China. General clinical and genotype data were obtained from 72 patients with AF and 109 non-AF (NAF) individuals at middle altitudes, and from 102 patients with AF and 143 NAF individuals at high altitudes. Multifactor logistic regression was performed to determine associations and AF risk factors. SCN5A-H558R genotypes differed significantly between the AF and NAF groups (P < .0125) and the G allele was an independent AF risk factor (P < .05) at both altitudes, with no significant differences according to altitude (P > .0125). At middle altitudes, age, red blood cell distribution width (RDW-SD), left atrial internal diameter (LAD), and G allele were independent AF risk factors. At high altitudes, age, smoking, hypertension, RDW-SD, free triiodothyronine, LAD, and G allele were independent AF risk factors (P < .05). The G allele of SCN5A-H558R might be an independent risk factor of AF both high and middle altitude, but there are some differences in other clinical risk factors of AF.
Content validity of the comprehensive home fall hazard checklist, an observational study
Authors: Ziebart Christina , Dewan Neha , MacDermid Joy
Published: November 2022

One strategy to reduce the number of falls in older adults is through home hazards assessment checklists. The comprehensive home fall hazard checklist (CHFHC) was designed to guide individuals through their home, assessing fall hazards. The checklist systematically prompts the individuals to check 10 general locations in the house The purpose of this study was to assess the content validity of the comprehensive home fall hazard checklist. A 4-point ordinal Likert rating scale was used to evaluate the content validity of each of the 74 items on the checklist. The relevance and clarity of each item was assessed. Nine experts rated the content validity of each test in relation to the 5 tasks in the rating protocol. The item content validity index, and the scale content validity index were determined, and a kappa rating was calculated. Three of the 74 items on the CHFHC were determined to be not relevant receiving a content validity index of 0.78 or less. All of the items were ranked as being quite clear or highly clear, with all items receiving at least 0.78 on the content validity index. The Kappa score indicates expert agreement. The content validity index was determined to be excellent, with high ratings for both relevance and clarity for 71 of 74 items on the CHFHC.
Latent tuberculosis in adult hematopoietic stem cell transplantation recipients: Clinical experience from a previously endemic population
Authors: Mert Duygu , Ozer Muhammet , Merdin Alparslan , İskender Gülşen , Uncu Ulu Bahar , Kizil Çakar Merih , Dal Mehmet Sinan , Altuntaş Fevzi , Ertek Mustafa
Published: November 2022

Hematopoietic stem cell transplantation (HSCT) recipients may be at an elevated risk of developing active tuberculosis infection due to suppression in the cellular immune system. Herein, we aimed to evaluate the prevalence of latent tuberculosis and active tuberculosis in patients with allogeneic and autologous HSCT. In this cohort, data were obtained retrospectively from patients’ records. The patients who were followed up in the bone marrow transplantation unit of the University of Health Sciences Dr Abdurrahman Yurtaslan Ankara Oncology Education and Research Hospital between January 2016 and December 2019 were screened for the study. And the HSCT recipients who had tuberculin skin test and/or QuantiFERON-TB gold (QFT-GIT) test results were included in the study. A total of 361 patients were included in the study, 227 patients had autologous HSCT, and 134 patients had allogeneic HSCT. QFT-GIT was performed in 10 patients with allogeneic HSCT, and it was found positive in only 1 patient. Tuberculin skin test ≥5 mm was accepted as positive and was accepted to have latent tuberculosis, and it was positive in 18.2% (41) of the patients with autologous HSCT and was positive in 21.6% (29) of the patients with allogeneic HSCT. There was no significant difference between the 2 groups (P = .429). Isoniazid (INH) prophylaxis was started in 16.7% of patients with autologous HSCT and 22.4% of patients with allogeneic HSCT. During follow-up, active tuberculosis did not develop in any patients in both groups. There was no statistically significant difference found between allogeneic and autologous HSCT recipients regarding the prevalence of latent tuberculosis. Active tuberculosis infection did not develop in any of the patients who started INH prophylaxis. INH prophylaxis seems to be very efficient in preventing the reactivation of latent tuberculosis in patients going through allogeneic HSCT and/or autologous HSCT.
Exploring the relationship between novel Coronavirus pneumonia and Parkinson’s disease
Authors: Xi Xiaoming , Han Liang
Published: November 2022

The hypothesis is that there is 0a relationship between Parkinson’s disease and coronavirus disease 2019 (COVID-19). By summarizing the pathogenesis of Parkinson’s disease and COVID-19 and the impact of COVID-19 on the central nervous system, the relationship between Parkinson’s disease and COVID-19 was analyzed, including whether Parkinson’s disease is a predisposition factor for COVID-19 and whether COVID-19 causes the occurrence of Parkinson’s disease. Discuss the impact of COVID-19 on patients with Parkinson’s disease, including symptoms and life impact. To summarize the principles, goals and methods of home rehabilitation for Parkinson’s disease patients during COVID-19. Through the analysis of this paper, it is believed that COVID-19 may cause Parkinson’s disease. Parkinson’s disease has the condition of susceptibility to COVID-19, but this conclusion is still controversial.
Safety and efficacy of acupuncture for anxiety and depression in patients with heart failure: A protocol for systematic review and meta-analysis
Authors: Wang Cheng , Wang Jia , Shi Rui , Yu Keying , Zhang Miao , Lu Ruozhu , Shi Mingpeng , Deng Yue
Published: November 2022

Background:

In recent years, with the increase of patients with coronary heart disease, the number of patients with heart failure (HF) has also gradually increased. Coronary heart disease is one of the most common causes of HF. Anxiety and depression are frequent psychological disorders in patients with HF. Studies have shown that anxiety and depression can affect the quality of life of patients with HF, and can increase hospitalization and mortality. Conventional pharmacotherapy and psychotherapy have certain limitations. Acupuncture has therapeutic effects on heart disease, anxiety and depression, and has been widely used to relieve symptoms in patients with HF. This protocol aims to evaluate the safety and efficacy of acupuncture for anxiety and depression in patients with HF.

Methods:

We will search the following databases: PubMed, Web of Science, Springer Cochrane Library, EMBASE, MEDLINE, WHO international clinical trials registry platform, China National Knowledge Infrastructure database, Wan Fang database, Chinese scientific journal database and Chinese Biomedical Literature Database. The databases will be searched from initiate to October 1, 2022. Two reviewers will screen and document eligible studies based on inclusion and exclusion criteria. Two reviewers will independently perform data analysis and bias risk assessment. Review Manager version 5.4 software will be used for meta-analysis.

Results:

This study will explore the efficacy and safety of acupuncture for anxiety and depression in patients with HF.

Conclusion:

The results of this study will provide high-quality evidence for evaluating the safety and efficacy of acupuncture for anxiety and depression in patients with HF.
Comparative effectiveness of acupuncture and pharmacological interventions in treating diabetic stroke: A protocol for a systematic review and network meta-analysis
Authors: Zhang Ao , Han Fangda , Piao Chunli
Published: November 2022

Background:

There is a close and causative correlation between stroke and diabetes, and the complication of the 2 diseases seriously harms human health and currently becomes a topic of clinical importance. To date, the common methods of treating diabetic stroke include acupuncture and pharmacological interventions. However, there is no high-quality or direct evidence of their comparative effectiveness. This review aims to provide a network meta-analysis to compare the efficacy of acupuncture and pharmacological interventions in treating diabetic stroke.

Methods:

Databases such as PubMed, Cochrane Central Register of Controlled Trials, EMBASE, China National Knowledge Infrastructure, China Biology Medicine Disc will be searched for relevant randomized controlled trials to obtain literatures on the treatment of diabetic stroke, and clinical randomized controlled trials will be screened out from their inception to December 30, 2022. The participant intervention comparator outcomes of this study are as flowing: P, patients with diabetic stroke; I, acupuncture and pharmacological interventions; C, no treatment, pharmacological placebo, or sham acupuncture groups; O, primary outcome will be blood glucose levels, glycosylated hemoglobin levels, and the rate of stroke recurrence; secondary outcomes will include fasting and post-load blood glucose levels, cholesterol, triglycerides, and quality of life scale scores. Cochrane Risk of Bias Tool will be used in assessing literature’s quality. Review Manager software 5.3 and Stata 15.1 will be used in data analysis.

Result:

This systematic review and network meta-analysis will provide evidence of the efficacy of different therapeutic methods in treating diabetic stroke, to show which forms of therapy are more commonly used with higher effectiveness.

Conclusion:

The results will systematically provide suggestions for medical practitioners to choose the effective, time-saving and economical therapeutic strategy for diabetic stroke.
The efficacy and safety of several interventions of corticosteroids for CRSwNP patients after endoscope sinus surgery: A protocol for systematic review and network meta-analysis
Authors: Zhang Lan , Zhu Baohua , Zhang Rong , Liu Huixia , Li Peishan , Liao Jie , Shen Hanchao , Tian Li
Published: November 2022

Background:

Corticosteroid has been a mainstay of chronic rhinosinusitis with nasal polyps (CRSwNP) medical therapy. While endoscopic sinus surgery (ESS) will be performed when patients had failed to respond to maximal medical therapy. Many studies shown that several corticosteroids of interventions (e.g., nasal spray, oral, atomization/nebulization, nasal irrigation, direct infiltration, and steroid-eluting stent, etc) have each demonstrated significant efficacy compared with placebo or no corticosteroids intervention except intranasal corticosteroids for the treatment of CRSwNP after ESS. The aim of this systematic review and network meta-analysis is to answer the following question: which 1 is the best corticosteroid of intervention for CRSwNP patients after ESS?

Methods:

A systematic review will be conducted to identify studies involving randomized controlled trials which compared several different interventions of corticosteroids (e.g., nasal spray, oral, atomization/nebulization, nasal irrigation, direct infiltration, steroid-eluting stent, etc) for CRSwNP patients after ESS. The primary outcomes are efficacy (e.g., effective rate or cure rate), visual analogic scale of symptom severity, Lund-Kennedy endoscopic score, adverse events, and so on. We will comprehensively search PubMed, Embase, Cochrane Library, ClinicalTrials.gov, Web of Science, Chinese National Knowledge Infrastructure, Wangfang and VIP journal database from inception to July, 2022. For studies which meet our inclusion criteria, 2 reviewers will extract data independently and assess the quality of literature using a revision of version 2 of the Cochrane risk of bias tool (RoB 2.0). A random effects model will be used for all pairwise meta-analyses (with a 95% confidence interval). Network meta-analyses will be conducted to generate estimates of comparative effectiveness of each intervention class and rankings of their effectiveness.

Results:

The results of this study expect to provide a high-quality, evidence-based recommendation on which 1 is the best corticosteroid of intervention for CRSwNP patients after ESS?

Discussion:

This study will provide evidence regarding the comparability of several interventions of corticosteroids for CRSwNP patients after ESS. Also, the data generated from this review will provide health-care providers with a clear evidence synthesis of CRSwNP patients after ESS management strategies. These data will be incorporated into the development of a patient decision aid to assist patients and clinicians in making a preference-based decision when faced with a CRSwNP patients after ESS as well.
Acupuncture for shoulder-hand syndrome after stroke: An overview of systematic reviews
Authors: Lei Siyuan , Dai Fangran , Xue Fei , Hu Guanyu , Zhang Ye , Xu Xiaohong , Wang Rui , Zhang Xiaolin , Cong Deyu , Wang Yufeng
Published: November 2022

Background:

To provide evidence, this review evaluated the methodological quality, risk of bias, and reporting quality of SRs/MAs in the treatment of shoulder-hand syndrome after stroke with acupuncture.

Methods:

Systematic reviews and Meta analyses (SRs/MAs) of acupuncture for shoulder and hand syndromes after stroke were retrieved from 6 databases from inception to May 1, 2022. Two reviewers independently screened the literature and extracted the data, then used Assessment of Multiple Systematic Reviews-2 (AMSTAR-2), Bias Risk in Systematic Review (ROBIS), and Preferred Report Item for Systematic review and Meta–analysis (PRISMA), Grading of Recommendations, Assessment, Development and Evaluation (GRADE) to assess methodological quality, risk of bias, quality of reporting, and quality of evidence.

Results:

We included 7 SRs/MAs, of which all SRs/MAs had very low AMSTAR-2 assessment quality and one study had a very low assessment bias risk. According to the PRISMA checklist, Protocol and registration, Synthesis of results, Summary of evidence, Conclusions and Funding were the main reporting limitations. GRADE evaluation showed a total of 37 results, but no high-quality evidence results, 6 results (16.22%) of the evidence quality were moderate, and supported acupuncture combined with exercise rehabilitation and drug therapy was better than exercise joint drug rehabilitation and rehabilitation, we also found that the result of limitations were the main factors that influence the evidence of low quality, followed by imprecision, inconsistency, and publication bias.

Conclusions:

Acupuncture is a relatively safe and effective adjuvant therapy for shoulder and hand syndromes after stroke. However, because of the low quality of SRs/MAs evidence supporting these findings, high-quality randomized controlled trials should be conducted, and the quality of relevant SRs should be improved to provide evidence for clinical application.
Automated identification and quantification of traumatic brain injury from CT scans: Are we there yet?
Authors: Hibi Atsuhiro , Jaberipour Majid , Cusimano Michael D. , Bilbily Alexander , Krishnan Rahul G. , Aviv Richard I. , Tyrrell Pascal N.
Published: November 2022

Background:

The purpose of this study was to conduct a systematic review for understanding the availability and limitations of artificial intelligence (AI) approaches that could automatically identify and quantify computed tomography (CT) findings in traumatic brain injury (TBI).

Methods:

Systematic review, in accordance with PRISMA 2020 and SPIRIT-AI extension guidelines, with a search of 4 databases (Medline, Embase, IEEE Xplore, and Web of Science) was performed to find AI studies that automated the clinical tasks for identifying and quantifying CT findings of TBI-related abnormalities.

Results:

A total of 531 unique publications were reviewed, which resulted in 66 articles that met our inclusion criteria. The following components for identification and quantification regarding TBI were covered and automated by existing AI studies: identification of TBI-related abnormalities; classification of intracranial hemorrhage types; slice-, pixel-, and voxel-level localization of hemorrhage; measurement of midline shift; and measurement of hematoma volume. Automated identification of obliterated basal cisterns was not investigated in the existing AI studies. Most of the AI algorithms were based on deep neural networks that were trained on 2- or 3-dimensional CT imaging datasets.

Conclusion:

We identified several important TBI-related CT findings that can be automatically identified and quantified with AI. A combination of these techniques may provide useful tools to enhance reproducibility of TBI identification and quantification by supporting radiologists and clinicians in their TBI assessments and reducing subjective human factors.
Observations on the kinematic characteristics of the healthy side of the knee in stroke patients: A cross-sectional study
Authors: Yu JunWu , Wang Chen , Yang FaMing
Published: November 2022

The abnormal gait of stroke patients not only severely limits the recovery of their walking ability, but also seriously affects their quality of daily life. Previous observational studies have focused too much on the observation of single degree of freedom and axial knee motion angles in stroke patients. Changes in the multi-degree of freedom and multi-axial joint angles of the knee have been less frequently observed, leading to somewhat limited conclusions. Therefore, the aim of this study was to use the Opti-knee motion test to analyze in real time the motion of the knee in all directions on the healthy side of stroke patients and to compare it with normal gait to provide a clinical basis for subsequent rehabilitation. In a cross-sectional study, 120 subjects (60 stroke patients were as the observation group and 60 healthy subjects as the control group) were studied. Both groups of subjects were tested for Opti-Knee tri-axial angles of motion of the healthy side of the knee, including flexion and extension, internal and external rotation, internal and external turning, anterior and posterior displacement, superior and inferior displacement, left and right displacement, maximum extension angle and maximum flexion angle. Compared with the control group, there were significant changes in the joint angles of flexion and extension, internal and external rotation, internal and external turning, maximum extension and maximum flexion of the knee on the healthy side in the observation group, and the differences were statistically significant [95%(37.22, 45.13), P = .01], [95%(9.51,13.67), P = .018], [95%(4.82,7.57), P = .049], [95%(4.12, 8.63), P = .019], [95%(51.68, 57.28), P = .0001]. However, there was no significant change in the angle of motion of the healthy side of the knee for anterior-posterior displacement, superior-inferior displacement and internal-external displacement in either group and the differences were not statistically significant [95%(1.16, 1.78), P = .72], [95%(0.85,1.32), P = .32], [95%(0.57, 0.88), P = .36]. This study confirms the importance of changes in the angle of motion of the knee on the side of the stroke patient in maintaining the stability of the knee joint. Therefore, their bilateral lower limb symmetry training should be paid attention to in the subsequent rehabilitation treatment.
Application of improved Glasgow coma scale score as switching point for sequential invasive-noninvasive mechanical ventilation on chronic obstructive pulmonary disease (COPD) with respiratory failure
Authors: Zhang Jin-Bo , Li Li-Hong , Zhu Jin-Qiang , Zhou Shi-Fang , Ma Ji-Hong , Li Zhi-Qiang , Jin Xiao-Hong , Lin Xiao-Qin
Published: November 2022

Background:

To compare the efficacy and feasibility of using a modified Glasgow coma scale (GCS) score of 13 or 15 as the criterion for switching chronic obstructive pulmonary disease (COPD) patients with respiratory failure to sequential invasive-noninvasive ventilation.

Methods:

COPD patients with respiratory failure who had undergone endotracheal intubation and invasive mechanical ventilation (IMV) between June 2017 and June 2020 at 4 different hospitals in China were included. A total of 296 patients were randomly divided into 2 groups. In group A, the patients were extubated and immediately placed on noninvasive ventilation (NIV) when the modified GCS score reached 13. In group B, the same was done when the modified GCS score reached 15.

Results:

No significant differences in the mean blood pressure, oxygenation index, arterial partial pressure of oxygen, and arterial partial pressure of carbon dioxide were seen between groups A and B before extubation and 3 hours after NIV. The re-intubation times were also similar in the 2 groups. Compared to group B, the length of hospital stay, incidence of ventilator associated pneumonia, and time of invasive ventilation were all significantly lower in group A (P = .041, .001, <.001).

Conclusion:

Using a modified GCS score of 13 as the criterion for switching from IMV to NIV can significantly reduce the duration of IMV, length of hospital stay, and incidence of ventilator associated pneumonia in COPD patients with respiratory failure.