bluuebunny/crossref_metadata_2025 huggingface dataset:
A Scoping Review of Implementation Science Studies in the Field of Traumatic Brain Injury: State of the Science and Future Directions
Authors: Hyzak Kathryn A. , Riccardi Jessica , Kinney Adam R. , Esterov Dmitry , Bogdanova Yelena , Bogner Jennifer A.
Published: November 2024

Objective: Implementation research is essential to accelerating the public health benefits of innovations in health settings. However, the US National Academies of Sciences, Engineering, and Medicine 2022 report identified a lag in published implementation research applied to traumatic brain injury (TBI). Our objectives were to characterize implementation science studies published to date in TBI clinical care and rehabilitation and provide recommendations for future directions. Methods: A scoping review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. Articles published between 2011 and 2023 were identified (MEDLINE, PubMed, PsychInfo, and Web of Science), and included if the study focused on the TBI population, measured at least one Proctor (2011) implementation outcome and aligned with implementation research designs. Data were charted using an extraction template. Results: Of the 38 articles, 76% were published between 2018 and 2023. About 37% of articles were in the pre-implementation phase, and 57.9% were in the implementation phase. Over half of articles used a theory, model, or framework to guide the research. Fifteen studies were descriptive, 10 were qualitative, 7 were mixed methods, and 4 were randomized controlled trials. Most studies investigated implementation outcomes regarding national guidelines following TBI or TBI symptom management. Adoption (42.1%) and fidelity (42.1%) were the most commonly studied implementation outcomes, followed by feasibility (18.4%), acceptability (13.2%), and penetration (10.5%). Only 55% of studies used or tested the effectiveness of one or more implementation strategies, with training and education used most commonly, followed by data warehousing techniques. Conclusions: Future research should prioritize the selection and investigation of implementation strategy effectiveness and mechanisms across contexts of care and use implementation research reporting standards to improve study rigor. Additionally, collaborative efforts between researchers, community partners, individuals with TBI, and their care partners could improve the equitable translation of innovations across service contexts.
Methods for Developing Neuroscience Nursing Clinical Practice Guidelines
Authors: Censullo Joan L. , Tran Deborah S. , Starkweather Angela
Published: November 2024

BACKGROUND: Clinical practice guidelines (CPGs) and evidence-based clinical reviews help guide nursing practice. The American Association of Neuroscience Nurses (AANN) has published guidelines for more than 25 years. METHODS: The AANN CPGs are developed using predefined search terms based on PICO (population, intervention, comparison, outcome) questions formulated a priori followed by evaluation of the evidence and creation of recommendations using methodologies of the Grading of Recommendations Assessment, Development, and Evaluation. DISCUSSION: Neuroscience nurses provide care for a specialized population with unique nursing care considerations. The CPG series has been rigorously developed to provide relevant context and practice recommendations to improve this care. CONCLUSION: This article establishes the methodology by which AANN CPGs are developed.
Effectiveness of Delayed First Baths on Transepidermal Water Loss in Late Preterm Infants
Authors: Taşdemir Halil İ. , Efe Emine
Published: November 2024

Purpose: This study evaluates whether delaying the first bath affects late preterm infants’ skin barriers, body temperatures, and comfort. Background: Late preterm infants’ skin is drier and has a limited water retention capacity compared to term infants and adults. It is important to determine timing of care for this population with limited competencies. Methods: A two-arm, three-center, and single- and evaluator-blind randomized controlled trial was conducted. The study is based on the CONSORT guidelines. The participants were recruited from September 2020 to September 2021. The first baths of participants in the intervention group were postponed until 48 hours after birth. Outcomes were measured before bathing and 1, 10, and 30 minutes after bathing. Results: There was a statistically significant interaction between the groups and times for transepidermal water loss, body temperature, and comfort. The intervention group had a lower transepidermal water loss value at follow-up than the control group in the forearm and sternum. The control group had lower mean body temperatures and comfort levels. Conclusion: When the first bathing of a late preterm infant is postponed by a minimum of 48 hours, it reduces damage to the skin barrier, body temperature is maintained, and the experience is more comfortable. Therefore, the first bath should be delayed for at least 48 hours after birth. Implications for practice and research: The study can guide nurses to eliminate the uncertainty of the first bath applied for late preterm infants with a fragile structure in the neonatal intensive care setting and to eliminate the differences between clinics.
The HALP score predicts no-reflow phenomenon and long-term prognosis in patients with ST-segment elevation myocardial infarction after primary percutaneous coronary intervention
Authors: Liu Huiliang , Zhang Feifei , Li Yingxiao , Liu Litian , Song Xuelian , Wang Jiaqi , Dang Yi , Qi Xiaoyong
Published: November 2024

Introduction and objective

Despite recent advances in the management of ST-segment elevation myocardial infarction (STEMI), the clinical outcome of some patients is still unsatisfactory. Therefore, early evaluation to identify high-risk individuals in STEMI patients is essential. The hemoglobin, albumin, lymphocyte, and platelet (HALP) score, as a new indicator that can reflect both nutritional status and inflammatory state of the body, can provide prognostic information. In this context, the present study was designed to investigate the relationship between HALP scores assessed at admission and no-reflow as well as long-term outcomes in patients with STEMI.

Material and methods

A total of 1040 consecutive STEMI patients undergoing primary PCI were enrolled in this retrospective study. According to the best cutoff value of HALP score of 40.11, the study samples were divided into two groups. The long-term prognosis was followed up by telephone.

Results

Long-term mortality was significantly higher in patients with HALP scores lower than 40.11 than in those higher than 40.11. The optimal cutoff value of HALP score for predicting no-reflow was 41.38, the area under the curve (AUC) was 0.727. The best cutoff value of HALP score for predicting major adverse cardiovascular events (MACE) was 40.11, the AUC was 0.763. The incidence of MACE and all-cause mortality was higher in the HALP score <40.11 group.

Conclusion

HALP score can independently predict the development of no-reflow and long-term mortality in STEMI patients undergoing PCI.
Prevalence and Pathophysiology of Loose Stools and Their Impact on Clinical Severity and Quality of Life in Women With Fecal Incontinence
Authors: Raventós Alba , Carrión Silvia , Españó Daniel , Bascompte Cristina , Karunaratne Tennekoon Buddhika , Clavé Pere , Mundet Lluís
Published: November 2024

Objective:

To compare the impact of fecal consistency with anorectal sphincter dysfunctions on clinical severity and quality of life (QoL) in women with fecal incontinence (FI).

Background:

FI affects up to 24% of middle-aged women, significantly impacting their QoL. Pathophysiological studies have focused more on sphincter and anorectal dysfunctions than on the role of fecal consistency.

Patients and Methods:

A cross-sectional observational study evaluating anorectal physiology, neurophysiology, and fecal consistency with regard to clinical severity and QoL. Patients with a Bristol Stool Chart (BSC) score of 5 or more (BSC ≥5) underwent a breath test to detect bacterial overgrowth (small intestinal bacterial overgrowth), lactose or fructose/sorbitol malabsorption, and/or a cholestyramine test to detect bile acid malabsorption. We compared anorectal physiology, clinical severity, and QoL of those with BSC ≥5 with BSC <5.

Results:

The study included 150 women with an average age of 64.81 ± 11.96. FI types varied: 64.38% had urge FI, 15.06% had passive FI, and 19.18% had both. Among them, 56.2% had BSC ≥5, linked to bile acid malabsorption (20.5%), lactose malabsorption (17.9%), small intestinal bacterial overgrowth (14.3%), and fructose/sorbitol malabsorption (14.3%). Anorectal dysfunctions were highly prevalent, with 49.1% showing external anal sphincter insufficiency, 9.8% internal, and 34.7% both. Those with BSC ≥5 experienced significantly worse clinical severity and QoL (St. Mark 17.3 ± 2.69 vs 12.9 ± 3.27), and more pronounced issues in Fecal Incontinence Quality of Life Scale dimensions of lifestyle, coping, depression, and EuroQol 5-dimension of anxiety/depression and pain/discomfort.

Conclusions:

Fecal consistency of BSC ≥5 significantly worsens clinical severity and QoL in women with FI. Specific diagnostic and therapeutic approaches addressing loose stools are needed before any rehabilitation treatment.
Rigid versus flexible bronchoscopy in interventional pulmonology: perspective from the master clinicians
Authors: Aravena Carlos , Mehta Atul C.
Published: November 2024

Purpose of review

The review explores the evolving roles and comparative effectiveness of rigid versus flexible bronchoscopy in interventional pulmonology. This topic is particularly timely due to recent technological advancements and the growing body of literature highlighting the strengths and limitations of each technique.

Recent findings

Recent literature reveals significant advancements in rigid and flexible bronchoscopy, with studies comparing their efficacy, safety profiles, and clinical outcomes. Key themes include improved diagnostic and therapeutic capabilities, procedural innovations, and patient-centered outcomes.

While rigid and flexible bronchoscopies have distinct advantages, their complementary use can enhance patient care. Future research should focus on developing minimally invasive, high-precision bronchoscopic tools, comparative studies to inform evidence-based practice, exploring hybrid approaches that combine the strengths of both techniques, and enhancing patient-centered outcomes through improved procedural protocols, education, and technologies.
Breast tumor with giant borderline phyllodes: Case report and literature review
Authors: Zhang Gongyin , Zeng Jinsheng , Li Changwang , Wei Changlong
Published: November 2024

Rationale:

Giant phyllodes tumors are rare fibroepithelial neoplasms, accounting for less than 1% of all primary breast tumors. Their main features are a single-round mass, progressive enlargement, and a high rate of local recurrence. A phyllodes tumor measuring more than 10 cm in diameter is usually defined as a “giant” tumor. Surgery remains the primary treatment option, although the efficacy of adjuvant radiotherapy needs to be confirmed by further studies.

Patient concerns:

We report a rare case involving a 38-year-old woman who presented, in May 2022, with a large, borderline lobulated tumor in her left breast, measuring 35 cm × 30 cm. She needed to physically support the mass when performing any activity, and even slight physical activity elevated her heart rate to 130 beats/min. In addition, the patient was unable to lie flat and could only sleep on her left side.

Diagnoses:

Breast B-ultrasound examination and chest computed tomography scans showed the possibility of inflammatory changes. Ultrasound-guided pathologic examination of the mass could not determine the type of mass. Immunofluorescence and bacterial culture of the aspirated fluid were also negative, ruling out the possibility of infection. A mastectomy was then performed to clarify the diagnosis.

Interventions:

The tumor was completely removed, and the patient did not receive any adjuvant therapy after surgery.

Outcomes:

The patient recovered smoothly. Unfortunately, she experienced a recurrence of the left breast mass six months later, which progressed to malignancy.

Lessons:

The most effective treatment for phyllodes tumors of breast is wide local excision with clean margins greater than 1 cm. Simple mastectomy is recommended for borderline or malignant cases, especially when it is difficult to achieve reliable negative margins. Although adjuvant radiotherapy and chemotherapy after surgery are not generally recommended as first-line treatments, it raises the question of whether the recurrence could have been delayed if the patient had received postoperative radiation therapy.
Role of Charlson comorbidity index in predicting intensive care unit readmission in patients with aortic aneurysm
Authors: Zhan Yu-Fei , Li Feng , Wu Long-Chuan , Chen Lin , Zhu Can-Yan , Han Ming-Shuai , Ma Guo-Fang , Zhong Yong-Hong
Published: November 2024

The purpose of this study was to investigate the value of the Charlson comorbidity index (CCI) in predicting intensive care unit (ICU) readmission in aortic aneurysm (AA) patients. Patient information came from the Medical Information Mart for Intensive Care- IV (MIMIC-IV) database. The relationship between CCI and ICU readmission was analyzed by restricted cubic spline, generalized linear regression, trend analysis, and hierarchical analysis. The clinical value of CCI in predicting ICU readmission was analyzed by receiver operating characteristic curve, decision curve analysis, XGBoost regression, and random forest regression. A total of 523 patients with AA were enrolled in the study. Patients with AA who were readmitted to the ICU had higher width of red blood cell distribution width (RDW) and higher CCI. CCI had better performance and clinical net benefit for predicting ICU readmission than RDW. An independent nonlinear relationship was found between CCI and ICU readmission. The trend analysis suggested that the risk of ICU readmission increased with higher CCI scores. The hierarchical analysis showed that their association was mainly found in surgery requirement populations regardless of AA types. Further, CCI was found to have better clinical value in predicting ICU readmission of thoracic aortic aneurysm (TAA) patients undergoing surgery. Age, renal disease, chronic lung disease, and dementia were important components of CCI in predicting ICU readmission of TAA patients undergoing surgery. CCI was independently associated with the ICU readmission of AA patients in a positive relationship and had more favorable prediction performance in TAA patients who underwent surgery.
Development and validation of a nomogram diagnostic model for coronary slow flow patients: A cross-sectional study
Authors: Tu Guang , Zhao Chen , Cai Zhong-Lan , Huang Xiao-Mi , Tong Sui-Yang , Wang Neng , Qian Jin
Published: November 2024

In this study, risk factors for coronary slow flow (CSF) patients were examined, and a clinical prediction model was created. This study involved 573 patients who underwent coronary angiography at our hospital because of chest pain from January 2020 to April 2022. They were divided into CSF group (249 cases) and noncoronary slow flow (NCF) group (324 cases) according to the coronary blood flow results. According to a 7:3 ratio, the patients were categorized into a training group consisting of 402 cases and a validation group consisting of 171 cases. The outcome was assessed by employing multiple logistic regression analysis to examine the factors that influenced it. The model’s recognizability was assessed by calculating the consistency index and plotting the receiver operating characteristic curve. Its consistency was assessed by calibration curve, decision curve, and Hosmer–Lemeshow testing goodness-of-fit. The multivariate model included factors such as male, BMI, smoking, diabetes, ursolic acid, and high-density lipoprotein cholesterol. The model validation showed that the consistency index was 0.714, and the external validation set had a consistency index of 0.741. The areas under the curve for the training and external validation sets were respectively 0.730 (95% CI: 0.681–0.779) and 0.770 (95%CI: 0.699–0.841). Nomogram calibration curves indicated intense calibration, and the results of the Hosmer–Lemeshow goodness-of-fit test indicated that χ² = 1.118, P = .572. The nomogram combining various risk factors can be used for individualized predictions of CSF patients and then facilitate prompt and specific treatment.
Correlation of thyroid function and sensitivity to thyroid hormone with spinal bone mineral content, bone mineral density, and osteoporotic vertebral fracture: A cross-sectional study based on NHANES
Authors: Wang Qilin , Wang Yueran , Jia Yuhao , Liu Yanhang , Gou Yuwei , Xie Xiansong , Zhang Yingbo
Published: November 2024

Previous studies have demonstrated that thyroid hormone plays an important role in normal bone development, bone metabolism, and establishment of peak bone mass. However, the correlation of thyroid status with bone mineral content (BMC), bone mineral density (BMD), and osteoporotic vertebral fracture (OVF) is rarely discussed. The current study probes into the potential association between thyroid status and spinal BMC, BMD, and OVF from a novel perspective of thyroid function (TF) and sensitivity to thyroid hormone based on the National Health and Nutrition Examination Survey database. A total of 1844 participants were included in this study. The association of thyroid status with outcome variables, like spinal BMC, BMD, and OVF, was analyzed using thyroid function indices and sensitivity to thyroid hormone indices as influence factors. The correlation of them were assessed using univariate and multivariable weighted linear regression, weighted logistic regression models, restricted cubic spline model, and subgroup analyses. The results of this study showed that the association of free triiodothyronine (FT3)/free thyroxine (FT4) with BMC remained negatively associated after adjustment for all covariates. Higher thyroid peroxidase antibody (TPOAb) was significantly associated with an increased risk of developing OVF in both unadjusted and adjusted models. In addition, the results of the restricted cubic spline model were consistent with the weighted multivariate regression analysis after adjustment. The results of this cross-sectional study showed that higher FT3/FT4 and TPOAb were associated with decreased spinal BMC and the increased risk of OVF, indicating a complex link between thyroid status and bone health. Therefore, patients with hyperthyroidism, hypothyroidism, autoimmune thyroid disease, or abnormal peripheral thyroid sensitivity, especially who with elevated TPOAb or FT3/FT4, should focus on the prevention of vertebral osteopenia, osteoporosis, and OVF.
Pancancer analysis of the interactions between CTNNB1 and infiltrating immune cell populations
Authors: Xu Xiaoyuan , Yang Aimin , Han Yan , Li Siran , Hao Guimin , Cui Na
Published: November 2024

Recently, evidence has indicated that CTNNB1 is important in a variety of malignancies. However, how CTNNB1 interacts with immune cell infiltration remains to be further investigated. In this study, we focused on the correlations between CTNNB1 and tumorigenesis, tumor progression, mutation, phosphorylation, and prognosis via gene expression profiling interaction analysis; TIMER 2.0, cBioPortal, GTEx, CPTAC, and GEPIA2 database analyses; and R software. CTNNB1 mutations are most found in uterine endometrioid carcinoma and hepatocellular carcinoma. However, no CTNNB1 mutations were found to be associated with a poor prognosis. In addition, CTNNB1 DNA methylation levels were higher in normal tissues than in tumor tissues in cancer except for breast invasive carcinoma, which had higher methylation levels in tumor tissues. The phosphorylation level of the S675 and S191 sites of CTNNB1 was greater in the primary tumor tissues in the clear cell renal cell carcinoma, liver hepatocellular carcinoma, lung adenocarcinoma, pancreatic adenocarcinoma, and breast cancer datasets but not in the glioblastoma multiform dataset. As for, with respect to immune infiltration, CD8 + T-cell infiltration was negatively correlated with the expression of CTNNB1 in thymoma and uterine corpus endometrial carcinoma. The CTNNB1 level was found to be positively associated with the infiltration index of the corresponding fibroblasts in the TCGA tumors of colon adenocarcinoma, human papillomavirus-negative head and neck squamous cell carcinoma, mesothelioma, testicular germ cell tumor, and thymoma. We also identified the top CTNNB1-correlated genes in the TCGA projects and analyzed the expression correlation between CTNNB1 and selected target genes, including PPP4R2, RHOA, and SPRED1. Additionally, pathway enrichment suggested that NUMB is involved in the Wnt pathway. This study highlights the predictive role of CTNNB1 across cancers, suggesting that CTNNB1 might serve as a potential biomarker for the diagnosis and prognosis evaluation of various malignant tumors.
Effectiveness of refined nursing intervention on postoperative recovery and respiratory function in lung cancer patients after thoracic surgery
Authors: Wang Bin , Qi Fang , Wang Yan , Zhang Jing , Li Wei , Li Xiangnan
Published: November 2024

To evaluate the effectiveness of refined nursing intervention versus routine nursing care in improving respiratory function and facilitating their recovery in lung cancer patients after thoracic surgery. Total 75 primary lung cancer patients (average age: 55.3 ± 10.8 years) who underwent thoracic surgery at Tangshan People’s Hospital from February 2024 to July 2024 were included in the study. According to the different postoperative nursing intervention, patients were randomized into control group (CG) and observational group (OG) for evaluating the effects of refined nursing intervention on pain relief, postoperative recovery and respiratory function. Tidal volume, vital capacity, forced expiratory volume in 1 second, peak expiratory flow, and maximal voluntary ventilation were used to evaluate pulmonary function. The Medical Outcomes Study 36-Item Short-Form Health Survey and Nursing Intensive-Care Satisfaction Scale were administered at the minimum of 30 days of nursing interventions after thoracic surgery to assess quality of life and satisfaction with nursing care respectively. Bivariate correlation analysis and chi-square test (χ
2) were used to analyze significant changes by using SPSS (version 27.0). About 61% (n = 46) of the patients were female. Routine nursing care was conducted in both CG and OG patients, while in OG simultaneously received refined nursing care. After a period of nursing intervention, recovery rate of heart and pulmonary was significantly higher than CG (92.31% vs 72.22%, P = .022) with a lower incidence of postoperative complications (12.82% vs 30.56%, P = .049). Pulmonary function test results revealed a significant improvement in OG patients’ tidal volume (0.43 ± 0.06 vs 0.39 ± 0.07, P = .014), vital capacity (3.53 ± 0.30 vs 3.34 ± 0.32, P = .020), forced expiratory volume in 1 second (4.67 ± 0.67 vs 4.23 ± 0.58, P = .003), peak expiratory flow (4.76 ± 0.51 vs 4.36 ± 0.51, P = .001) and maximal voluntary ventilation (58.22 ± 7.86 vs 53.70 ± 6.89, P = .010) compared to CG. Postoperative moderate-to-worst pain duration in OG was significantly shortened (4.36 ± 1.56 vs 5.81 ± 1.94, P < .001), while health status value was higher (60.87 ± 5.89 vs 56.53 ± 6.22, P = .003). Moreover, OG expressed higher satisfaction with nursing care compared to CG (P = .002). Patients experienced reduced respiratory function after thoracic surgery. Refined nursing intervention might facilitate patients’ postoperative recovery and improve their respiratory function and general well-being, which would be beneficial for achieving patients’ satisfaction and promoting positive interaction between patients and multidisciplinary team members.
Primary pulmonary alveolar soft part sarcoma with ASPSCR1–TFE3 gene fusion: Case report and literature review
Authors: Hu Xijian , Chai Jing , Zhang Bin , Hu Chengguang
Published: November 2024

Rationale:

Primary pulmonary alveolar soft part sarcoma (ASPS) is an extremely rare disease characterized by a specific genetic abnormality – the ASPSCR1-TFE3 gene fusion.

Patient concerns:

This study presented a 27-year-old male patient who experienced persistent chest tightness for over 6 months.

Diagnoses:

The computed tomography (CT) scan and enhanced CT scan revealed a mass in the medial segment of the right middle lobe of his lung. The patients then underwent further diagnosis. Pathological examination showed the tumor to be consisting of polygonal cells with abundant eosinophilic or transparent cytoplasm arranged in nests. Next-generation sequencing reported ASPSCR1-TFE3 gene fusion, confirming the final diagnosis of primary pulmonary ASPS. Regular follow-ups of 12 months showed no signs of tumor recurrence.

Interventions:

The patients underwent the medial segment resection of the right middle lobe for treatment.

Outcomes:

A CT examination 3 months after the operation showed that the patient had improved. The last review showed no recurrence or metastasis.

Lessons:

This case report highlights the importance of detailed diagnosis, prompt treatment, and close monitoring of patients with ASPS.
Zolpidem-related euphoria, addiction and detoxification: A case report and review of the literature
Authors: Xie Fangfei , Liu Bo , Yang Liqiu , Huang Junqiang , Li Bin , Li Yuanyuan
Published: November 2024

Rationale:

Zolpidem, a non-benzodiazepine sedative-hypnotic, is considered safer for the treatment of insomnia compared to benzodiazepines. However, in recent years, there have been growing reports of Zolpidem dependence, addiction, and withdrawal symptoms. We reported a case of Zolpidem addiction and successful detoxification, reviewed similar cases in the literature, and proposed a potential mechanism underlying Zolpidem addiction.

Patient concerns:

The patient was a 46-year-old Tibetan woman who had been using Zolpidem intermittently to treat insomnia for at least 8 years. She was overweight, with a BMI of 28.04 kg/m², and had hypertension, diabetes, a 20-year smoking history, and several years of alcohol abuse, often seeking instant gratification. She voluntarily increased both the dosage and frequency of Zolpidem, experiencing euphoria, anxiolysis, and increased appetite at higher doses, which led her to gradually escalate her dosage to 280 mg per day in divided doses. However, upon stopping Zolpidem, she experienced withdrawal symptoms, including insomnia, tension, and palpitations.

Diagnoses:

She was diagnosed with a combination of hypnotic use disorder, anxiety disorder, hypertension, and diabetes.

Interventions:

She underwent diazepam replacement therapy, along with antianxiety medications and mindfulness-based cognitive therapy, to address Zolpidem addiction.

Outcomes:

After 13 days of inpatient treatment, the patient successfully quit Zolpidem. During a 3-month follow-up, she returned to work and remained free from Zolpidem use.

Lessons:

We speculate that Zolpidem addiction is likely linked to the drug’s euphoric effects and certain patient characteristics, such as sensation-seeking behavior. A comprehensive approach, involving both pharmacological and psychological interventions, is essential for an effective detoxification strategy for Zolpidem addiction.
Rescue of a spontaneous subcapsular hepatic hematoma associated with HELLP syndrome: A case report
Authors: Yan Chenze , Jia Zhong , Liu Yuanwei , Zhou Weijiang , Zhou Heshan
Published: November 2024

Rationale:

Spontaneous subcapsular hepatic hematoma (SSHH) is a rare yet severe complication of hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome that can lead to life-threatening situations for both the mother and fetus. Determining an appropriate therapeutic strategy remains challenging, as it involves choosing between surgery, microinvasive percutaneous transhepatic drainage, or conservative treatment alone. Further successful cases are needed to support the optimal option. We retrospectively collected a patient’s clinical record and imaging data to elucidate the natural progression, response to noninvasive treatment, and outcome of SSHH associated with HELLP syndrome.

Patient concerns:

A 34-year-old woman, who underwent a cesarean section due to suspected fetal distress, developed SSHH accompanied by the potential risk of rupture and deteriorated serology within the first 24 hours after delivery.

Diagnoses:

Emergency blood routine examination, serum biochemistry analysis, and computed tomography of the abdomen revealed a SSHH associated with HELLP syndrome.

Interventions:

The main rescue measures included the use of corticosteroids, antihypertensive drugs, and platelet transfusion.

Outcomes:

A positive effect on the patient’s condition was exhibited within 24 to 48 hours. The majority of the subcapsular hepatic hematoma could be absorbed without any sequelae over a period of 7 months.

Lessons:

For patients with pregnancy-induced hypertension, there is a heightened risk of HELLP syndrome occurrence in subsequent pregnancies. The assessment and treatment of SSHH should be conducted by an experienced multidisciplinary team. In addition to timely delivery, the administration of corticosteroids, usage of antihypertensive medication, and platelet transfusion are necessary, particularly within the first 48 hours if the patient’s condition permits. This approach would provide valuable insights for further therapeutic decisions and facilitate a preliminary prognosis assessment.
Ultrasound-guided popliteal sciatic nerve block for surgical anesthesia in wound care patients with ongoing anticoagulant/antiaggregant therapy: A single-center, prospective study
Authors: Eman Ali , Balaban Onur , Pekşen Özge , Erkin Alper
Published: November 2024

Ultrasound-guided peripheral nerve blocks may be a good alternative in patients under antithrombotic drugs. We evaluated the efficacy of ultrasound-guided popliteal sciatic nerve block in patients undergoing lower extremity wound debridement of whom antithrombotic drugs could not be stopped. We focused on hemorrhagic complications related to sciatic nerve block. Wound care patients followed by Cardiovascular Surgery Department scheduled for lower extremity wound surgery were included in this prospective observational study. Data was collected between March 2021 and September 2022. All patient were under antithrombotic therapy and discontinuation of anticoagulant drugs were not possible. Single-insertion and multiple-injection sciatic nerve block at popliteal region was applied to all patients under ultrasound guidance. Primary outcome was the rate of hemorrhage. Secondary outcomes were block onset times, block success and postoperative analgesia times. Data of 105 patients was evaluated, 87 were male and 18 were female. Mean patient age was 61.92 ± 10.06, mean patient body mass index was 25.68 ± 6.33. All patients were under 1 or more antithrombotic drugs. Only one minor hematoma was detected by postoperative ultrasonography control in 1 patient. Hemorrhage complication rate was 1 of 105 (% 0.95, 95% CI, 0.00024–0.051). Overall block success rate was 99.05%. Mean block onset time was 16.27 ± 5.69 minutes. Mean postoperative analgesia time was 19.5 ± 11.22 hours. Sciatic nerve block under ultrasound guidance using in-plane technique was safe and provided sufficient surgical anesthesia and postoperative analgesia for lower extremity wound debridement surgery in patients on antithrombotic drugs.
Comparison of prognosis after transurethral resection of bladder tumor between solitary and multiple bladder cancers
Authors: Diao Mingxin , Li Yue , Gao Zihui , Wang Chunji , Gu Yaming
Published: November 2024

This study investigates the difference in overall survival rates after transurethral resection of bladder tumor between solitary and multiple bladder cancers, aiming to provide guidance for clinical practitioners. A retrospective analysis was conducted on 133 patients with bladder cancer who underwent transurethral resection of bladder tumor from April 2017 to October 2023, of which 112 patients had complete clinical and follow-up data. Clinical and follow-up data were collected, and the overall survival rates after surgery were compared between solitary and multiple bladder cancers. In this study, the recurrence rate after transurethral resection of bladder tumor was 23.21% (26/112), and the overall survival rate was 80.36% (90/112). The overall survival rate after transurethral resection of bladder tumor was 92.11% (35/38) in the solitary bladder cancer group and 74.32% (55/74) in the multiple bladder cancer group, with a statistically significant difference between the 2 groups (P = .025). The proportion of high-grade pathology was 7.89% (3/38) in the solitary bladder cancer group and 25.68% (19/74) in the multiple bladder cancer group after transurethral resection of bladder tumor, with a statistically significant difference between the 2 groups (P = .025). The mean tumor diameter after transurethral resection of bladder tumor was 2.76 ± 1.66 cm in the solitary bladder cancer group and 4.04 ± 3.17 cm in the multiple bladder cancer group, with a statistically significant difference between the 2 groups (P = .023). Univariate and multivariate regression analyses revealed that the number of bladder tumors is a risk factor for overall survival after bladder cancer surgery (P = .004). Multiple bladder cancers have a higher pathological grade, larger tumor diameter, and poorer prognosis after transurethral resection of bladder tumor compared to solitary bladder cancers. The number of bladder tumors is an independent risk factor for overall survival after bladder cancer surgery.
Preventive measures against HIV among Uganda’s youth: Strategies, implementation, and effectiveness
Authors: Obeagu Emmanuel Ifeanyi , Obeagu Getrude Uzoma
Published: November 2024

Preventing HIV among Uganda’s youth is a critical public health priority due to the high prevalence of HIV/AIDS and the disproportionate burden of new infections among young people. This paper examines the preventive measures implemented to combat HIV/AIDS among Uganda’s youth, focusing on strategies, implementation efforts, and the effectiveness of interventions. Comprehensive sexuality education programs have been implemented in schools and communities to provide young people with accurate information on HIV transmission, prevention methods, and reproductive health. Condom distribution and promotion campaigns target sexually active youth, while HIV testing and counseling services aim to reach youth in various settings, including health facilities and community outreaches. The implementation of HIV prevention strategies involves collaboration among government agencies, NGOs, healthcare providers, educators, and community leaders. Efforts are made to ensure that prevention programs are culturally appropriate, evidence-based, and responsive to the needs of young people. Despite progress in HIV prevention, challenges persist, including knowledge gaps, stigma, gender inequalities, and socio-economic factors. Continuous monitoring and evaluation are essential to assess the impact of interventions and identify areas for improvement. Recommendations include increasing funding for HIV prevention programs, strengthening policy frameworks, enhancing access to youth-friendly health services, integrating comprehensive sexuality education into school curricula, and fostering community engagement. By addressing these recommendations, Uganda can strengthen its HIV prevention efforts and reduce the incidence of HIV/AIDS among its youth population, ultimately contributing to improved health outcomes and well-being.
The association between anemia and sensorineural hearing loss: A review
Authors: Ye Liting , Lai Dong , Tai Junhu
Published: November 2024

Anemia affects a third of the world’s population and contributes to increased morbidity and mortality, decreased work productivity, and impaired neurological development. In recent years, many studies have found a possible association between anemia and sensorineural hearing loss (SNHL), especially in various types of nutritional deficiency and hemoglobin disorders anemia. Anemia may affect hearing through various mechanisms, including affecting microcirculation in the ear, causing tissue hypoxia in the ear, and through inflammatory and oxidative stress pathways. This review aims to comprehensively analyze the association between various types of anemia and SNHL, including possible biological mechanisms, clinical features, and treatment strategies, and clarify the importance of anemia treatment and management in preventing SNHL.
Comparison of the effects of video conference and video-based home exercise on physical performance and body composition in older adult individuals
Authors: Elmas Özgün , Cemali Mustafa , Livanelioğlu Ayşe
Published: November 2024

Background:

With the development of technology, remote access exercise interventions are frequently used in older adults. Although different technology methods are used in exercise, studies comparing these methods are limited. Based on this, the aim of the study is to compare the effect of exercise applied with video conference (VC) and video-based home exercise (VBHE) methods on physical performance, skeletal muscle mass, body fat percentage, and body mass index (BMI) in older adults.

Methods:

Thirty older adult individuals between the ages of 65 and 75 years participated in the study. Participants were divided into 2 groups by computer-generated randomization (allocation ratio of 1:1). VC group calisthenic exercises were performed online with the physiotherapist using the WhatsApp program. The VBHE group did the same exercises by watching videos at home. Both programs spanned 6 weeks, 3 times a week. Before and after the intervention, chair sit-stand, 6-minute walk, time up and go, single leg stance, hand grip strength, shoulder flexion strength, and knee extension strength tests were performed on older adults to evaluate their physical performance. For body composition, skeletal muscle mass, body fat percentage, and BMI were assessed using the Inbody device.

Results:

It was observed that in both VC and VBHE groups, physical performance improved statistically significantly compared to the preintervention period (P <.05), while skeletal muscle mass, body fat percentage, and BMI did not change (P ˃.05). When the groups were compared, it was concluded that the exercise program implemented with the VC method improved physical performance better than the VBHE method (P <.05), but there was no difference in skeletal muscle mass, body fat percentage and BMI values (P ˃.05).

Conclusion:

It has been observed that a 6-week calisthenic exercise intervention implemented through technology methods such as VC and VBHE is a useful method for the improvement of the physical performance of older adults. However, it was concluded that the VC method is a more effective method than the VBHE method. It is predicted that the lack of improvement in body composition is due to the intensity and duration of exercise.
Primary intracranial malignant melanomas: A case series with literature review
Authors: Chen Lifeng , Yang Yang , Li Dongmei , Bu Bo
Published: November 2024

Rationale:

There is a high chance of misdiagnosis and limited knowledge regarding therapeutic strategies owing to the rarity of primary intracranial malignant melanoma (PIMM). The objective of the present study was to evaluate the clinical features, treatment modalities, and outcomes of patients with histologically proven PIMM.

Patient concerns:

Data of 15 patients with PIMM admitted to the Chinese People’s Liberation Army General Hospital in a 14-year period between January 2005 and January 2019 were collected. Clinical presentations, pathology, surgical strategies, adjuvant treatment, and prognosis were retrospectively analyzed.

Diagnoses:

CT showed iso- or high-density lesions in 12 cases (80%). MRI revealed short T1 and slightly short T2 in 14 cases (93.3%).The tumors showed mild or no enhancement on enhanced MRI. The patients were eventually diagnosed with PIMM through pathological examination.

Interventions:

The treatment modalities included radical resection followed by conventional radiotherapy (RT, n = 12) and subtotal resection followed by stereotactic radiosurgery (n = 3).

Outcomes:

All 15 patients had either recurrence or metastasis at an average of 14.7 months (range, 6–23 months) after surgery. In total, 14 patients (93.3%) succumbed to disease, with a mean overall survival of 22 months (range, 6–36 months). The median survival time was 23 months. The overall survival rates at 1, 2, and 3 years were 80, 47, and 13%, respectively. Radical resection with RT was associated with longer overall survival (log-rank, P < .05) than subtotal resection followed by stereotactic radiosurgery.

Lessons:

PIMM is an extremely rare tumor with a poor prognosis. Radical resection with RT may result in a longer overall survival rate. Targeted immunotherapy may be a promising treatment option for PIMM.
Lymphocyte subsets in pediatric acute lymphoblastic leukemia and their prognostic value
Authors: Peng Luyun , Dai Qingkai , Wang Yuefang , Yang Hao , Shi Rui , Zhang Ge , Jiang Yongmei , Ye Lei
Published: November 2024

To study the changes of lymphocyte subsets in children with acute lymphoblastic leukemia (ALL) at initial diagnosis and compare them with those of healthy children and patients who have achieved complete remission (CR). Furthermore, we aim to analyze the prognostic significance of lymphocyte subsets in these patients. From May 2011 to December 2015, 405 children with ALL were enrolled in this study. Peripheral blood was collected at the time of diagnosis, and lymphocyte subsets were detected by flow cytometry. Then, the percentages of lymphocyte subsets in each group were compared. In addition, survival and prognostic factor analyses were performed to determine the prognostic value of lymphocyte subsets. Lymphocyte subsets in children with ALL were dramatically different from those in healthy children and patients achieving CR. Additionally, lymphocyte subsets were correlated with different minimal residual disease and risk parameters. Furthermore, percentages of CD3+ T cells and CD4+ T cells and the ratio of CD4/CD8 were associated with different clinical outcomes. Multivariate analysis demonstrated the percentage of CD4+ T cell as an independent predictor for clinical prognosis. Lymphocyte subsets in pediatric ALL undergo dramatic changes and were related to prognosis, especially CD4+ T cells.
Day napping and metabolic-associated fatty liver disease: A systematic review and meta-analysis of observational studies
Authors: Gao Linxiao , Gong Jianping , Zhong Guochao , Qin Yajun
Published: November 2024

Background:

Napping inevitably affects human health, and the association between napping and metabolism-related diseases is being more seriously considered. However, the conclusions of studies on the relationship between napping and fatty liver disease (NAFLD)/metabolic-associated fatty liver disease (MAFLD) remain controversial.

Methods:

We performed a systematical search to identify eligible studies up to July 31, 2024. The fixed effects model was used to calculate the pooled odds ratio (OR). Subgroup were performed. Sensitivity analyses and meta-regression analysis were carried to explore the heterogeneity. Publication bias was assessed by funnel plot and Egger’s test.

Results:

48,248 participants from 13 studies were included in this meta-analysis. The pooled analysis found napping to have an association between the incidence of NAFLD/MAFLD (OR, 1.13; 95% confidence interval (CI), 1.08–1.19; P < .001). The robustness of this study was confirmed using a sensitivity analysis. No apparent heterogeneity or publication bias was observed. Further meta-analysis revealed that short nap duration did not greatly affect the incidence of the disease (OR, 1.01; 95% CI, 0.91–1.12; P = .80). However, long nap duration was significantly linked to high risk of the disease (OR, 1.21; 95% CI, 1.02–1.44; P = .03).

Conclusion:

Patients with NAFLD/MAFLD may had higher prevalence of napping habit. Future research is warranted to conduct a dose-response analysis, measure the effects of confounding factors, and explore the causal relationships between NAFLD/MAFLD. The research protocol was registered and approved in PROSPERO (registration no: CRD42023439507).
Quantifying thermoplastic mask quality for precision radiotherapy in head and neck cancer: A 3D stress test and 6D-axis error analysis
Authors: You Weirchiang , Chen Chienchih , Chu Hsiushan , Yau Yuchen , Liu Tingyang , Lai Peishuan , Chen Yungcheng , Chen Niwei , Tsai Chefu , Hsieh Heyuan
Published: November 2024

Patients with head and neck cancers often require radiotherapy, where immobilization devices like thermoplastic masks ensure precise radiation delivery by minimizing movement. However, the quality of these masks lacks standard reference data. This study aimed to establish institutional acceptance criteria for thermoplastic mask quality and quantify their effectiveness using a 3 dimensional stress test and verified the setup errors using daily megavoltage computed tomography (MVCT). Between April and June 2022, 30 patients underwent radiotherapy with thermoplastic masks. Four key facial points (forehead, bilateral cheekbones, and chin) were tested for supporting force. Mean forces ranged from 3.97 N to 8.8 N. MVCT was used to assess 6 dimensional-axis errors, with mean translational errors (x, y, z) of 0.32 mm, −1.09 mm, and 2.24 mm, respectively, and rotational errors (yaw, pitch, roll) of −0.12°, 0.22°, and 0.35°, respectively. The results demonstrated that the thermoplastic masks provided precise immobilization, minimizing setup errors in 6 dimensions. Our findings offer a quantifiable method to ensure high-quality immobilization during radiotherapy for patients with head and neck cancers.
Homoharringtonine in the treatment of acute myeloid leukemia: A review
Authors: Shen Siyu , Zhuang Haifeng
Published: November 2024

Acute myeloid leukemia (AML) is a hematological malignancy characterized by the accumulation of immature myeloid precursor cells. Over half of AML patients fail to achieve long-term disease-free survival under existing therapy, and the overall prognosis is poor, necessitating the urgent development of novel therapeutic approaches. The plant alkaloid homoharringtonine (HHT), which has anticancer properties, was first identified more than 40 years ago. It works in a novel method of action that prevents the early elongation phase of protein synthesis. HHT has been widely utilized in the treatment of AML, with strong therapeutic effects, few toxic side effects, and the ability to enhance AML patients’ prognoses. In AML, HHT can induce cell apoptosis through multiple pathways, exerting synergistic antitumor effects, according to clinical and pharmacological research. About its modes of action, some findings have been made recently. This paper reviews the development of research on the mechanisms of HHT in treating AML to offer insights for further research and clinical therapy.