bluuebunny/crossref_metadata_2025 huggingface dataset:
Pediatric Obesity and Sports Medicine: A Narrative Review and Clinical Recommendations
Authors: Confroy Kristen , Miles Christopher , Kaplan Sebastian , Skelton Joseph A.
Published: August 2020

Objective:

To review what is known about sports medicine and pediatric obesity, with a focus on injuries and MSK concerns.

Data Sources:

Systematically searched MEDLINE (PubMed) for all years, using search combinations to best identify potential publications. Manuscripts were reviewed, summarized, and discussed in detail. Experienced clinicians in sports medicine and pediatric obesity reviewed the final searches for substantive content. Inclusion criteria include English language publications, children ≤18 years old, related to the practice of sports medicine and pediatric obesity. Publications excluded that dealt with non-sports medicine aspects of pediatric obesity, such as increasing physical activity or exercise, or the prevention or treatment of obesity.

Main Results:

Twenty-eight publications were included for review. Papers fell into 5 groupings: (1) MSK—increased incidence of MSK injury in children with obesity, hypothesized to be a result of changes in biomechanics; (2) weight management—gradual loss while maintaining proper hydration and nutrition for sports performance; (3) fitness/conditioning—children with overweight/obese showed decreased fitness measures and cardiopulmonary conditioning; (4) exertional heat illness—a concern for adolescent athletes with obesity, specifically in football; and (5) differential diagnoses—3 key differential diagnoses were identified for increased awareness: slipped capital femoral epiphysis, Blount's disease, and pes planus. Clinical topics pertinent to sports medicine and pediatric obesity were discussed.

Conclusions:

Sports medicine clinicians should be aware of the common MSK and sports-related conditions in children with obesity. Few studies have focused investigations on issues related to children with obesity participating in sports and other physical activities.
Worse prognosis in young patients with locally advanced rectal cancer following neoadjuvant chemoradiotherapy
Authors: Zhang Yiyi , Wang Ye , Liu Xing , Chen Bin , Zhuang Jinfu , Li Shoufeng , Yang Yuanfeng , Su Yibin , Guan Guoxian
Published: August 2020

To determine the efficacy of neoadjuvant chemoradiotherapy (NCRT) between young and old patients with locally advanced rectal cancer (LARC) in terms of tumor response and survival outcome.

LARC patients undergoing NCRT and radical surgery from 2011 to 2015 were included and divided into: young (aged ≤50 years) and old group (aged >50 years). Multivariate analyses were performed to identify risk factors for local recurrence. Least absolute shrinkage and selection operator analysis was performed to identify risk factors for overall survival. Predicting nomograms and time-indepent receiver operating characteristic curve analysis were performed to compare the models containing with/withour age groups.

A total of 572 LARC patients were analyzed. The young group was associated with higher pathological TNM stage, poorly differentiated tumors, and higher rate of positive distal resection margin (P = .010; P = .019; P = .023 respectively). Young patients were associated with poorer 5-year disease-free survival and local recurrence rates (P = .023, P = .003 respectively). Cox regression analysis demonstrated that age ≤50 years (Hazard ratio = 2.994, P = .038) and higher pathological TNM stage (Hazard ratio = 3.261, P = .005) were significantly associated with increased risk for local recurrence. Least absolute shrinkage and selection operator analysis and the time-indepent receiver operating characteristic curve analysis demonstrated that including the age group were superior than that without age group.

Young patients were associated with poorer disease free survival (DFS) and a higher risk for local recurrence in LARC following NCRT. The predicting model basing based on the age group had a better predictive ability. More intense adjuvant treatment could be considered to improve DFS and local control for young patients with LARC following NCRT.
Visceral adiposity index is a better predictor of type 2 diabetes than body mass index in Qatari population
Authors: Alkhalaqi Aysha , Al-Naimi Fatima , Qassmi Rouda , Shi Zumin , Ganji Vijay , Salih Reem , Bawadi Hiba
Published: August 2020

The prevalence of type 2 diabetes (T2D) has increased recently in Qatar. Body mass index (BMI) is a predictor of T2D in many populations. However, BMI is based on height and weight measurements and not on body adiposity. Therefore, the utility of BMI for predicting the risk of T2D has been questioned. Visceral adiposity appears to be a better predictor of T2D.

This study aimed to assess the relative effectiveness of visceral adiposity index (VAI) and body adiposity index (BAI), in comparison with BMI, for T2D among Qatari adults.

A random sample of 1103 adult Qatari nationals and long term residents over 20 years old were included in this study. This data were obtained from the Qatar Biobank (QBB). We performed a multivariate logistic regression to examine the association between VAI, BAI, BMI, and T2D, and computed z-scores for VAI, BAI and BMI.

VAI z-scores showed the strongest association with the risk of T2D (OR, 1.44; 95% CI: 1.24–1.68) compared with the z-scores for BAI (OR, 1.15; 95% CI: 0.93–1.43) and BMI (OR, 1.33; 95% CI: 1.11–1.59). ROC curve analysis showed that VAI was a stronger predictor than BAI and BMI (P < .0001). Subgroup analysis indicated that the association was stronger between VAI and T2D in Qatari women than in men.

VAI was a stronger and an independent predictor of T2D compared to BAI and BMI among the Qatari adult population. Therefore, VAI could be a useful tool for predicting the risk of T2D among Qatari adults.
Methylenetetrahydrofolate reductase genetic polymorphism and the risk of diabetic nephropathy in type 2 diabetic patients
Authors: Guan Hui , Xia Meng-Di , Wang Miao , Guan Ying-Jie , Lyu Xiao-Chen
Published: August 2020

Background:

As indicated by numerous studies, there exists a relationship between the polymorphism of methylenetetrahydrofolate reductase (MTHFR) and susceptibility to diabetic nephropathy (DN) in various populations; nonetheless, the findings remain inconsistent. Therefore, we carried out a meta-analysis to determine the relationship between the MTHFR gene polymorphism and DN susceptibility.

Materials and method:

Related studies were identified from PubMed, Cochrane Library, EMBASE, and the China National Knowledge Infrastructure database (time period: from building the library to October 2019). The strength of the association was examined using odds ratios (ORs) with 95% confidence intervals (95% CIs).

Results:

The findings illustrated that the C677T gene polymorphism was significantly associated with an enhanced susceptibility to DN compared to that with diabetes mellitus in allelic (OR = 1.64, 95% CI = 1.34–2.00, P < .001), dominant (OR = 1.85, 95% CI = 1.40–2.46, P < .001), codominant (heterozygote: OR = 1.67, 95% CI = 1.27–2.21, P < .001; homozygote: OR = 2.55, 95% CI = 1.82–3.57, P < .001), and recessive (OR = 1.89, 95% CI = 1.50–2.38, P < .001) models of the overall population. Moreover, as compared with the healthy controls, a significantly augmented susceptibility to DN was found in all 5 genetic comparison models (allelic: OR = 2.06, 95% CI = 1.58–2.67, P < .001; dominant: OR = 2.52, 95% CI = 1.73–3.69, P < .001; codominant: OR = 3.78, 95% CI = 2.50–5.70, P < .001; recessive: OR = 2.41, 95% CI = 1.96–2.97, P < .001). Furthermore, stratifying data by ethnicity revealed substantially augmented vulnerability to DN in not only Caucasian but also Asian populations.

Conclusion:

The present study suggests that the C677T polymorphism was associated with an augmented susceptibility to DN.
Acupuncture and moxibustion therapy for scapulohumeral periarthritis
Authors: Wu Zenan , Yu Xinyu , Xiong Jun , Wu Guoxin , Zuo Zhengyun , Xie Qiongshan
Published: August 2020

Background:

Scapulohumeral periarthritis (SP) is a very common painful shoulder disorder. Several systematic reviews (SRs) and meta-analyses have reported the effectiveness of acupuncture for patients with SP. However, the evidence has not been systematically synthesized. This overview aims to map, synthesize, and assess the reliability of evidence generated from these SRs and meta-analyses of acupuncture for SP.

Methods:

We will electronically search the following databases for literature, regardless of publication status and language: the Cochrane Central Register of Controlled Trials (CENTRAL); PubMed; EMBASE; China National Knowledge Infrastructure (CNKI); Chinese Biomedical Literature Database (CBM); Chinese Scientific Journal Database (VIPdatabase); and Wan-Fang Database. In order to ensure the comprehensiveness and accuracy of the literature retrieval, we will combine the Suggestions of evidence-based medicine experts with the actual situation in the literature retrieval process to formulate the retrieval strategy, and make corresponding records to find the most appropriate retrieval strategy. The reference lists and the citation lists of studies meeting the inclusion criteria and relevant SRs will also be searched to identify further studies for inclusion. Before this review completed, the two reviewers will conduct the searching once again to ensure the latest studies could be included.

Ethics and dissemination:

Ethical approval is not required for overviews. We plan to publish results in peer-reviewed journals and present at international and national academic, clinical, and patient conferences.

Results:

The results will be published in a peer-reviewed journal.

Conclusion:

This overview will provide comprehensive evidence of acupuncture for patients with SP.

INPLASY registration number:

INPLASY202060020.
Cross-sectional study of the prevalence and risk factors of metabolic syndrome in a rural population of the Qianjiang area
Authors: Ling Bing , Zhao Li , Yi Jixiu
Published: August 2020

The prevalence of the metabolic syndrome (MS) is increasing in China, but there are disparities between urban and rural populations, and across different regions.

To examine the prevalence and risk factors of MS in the rural area of Qianjiang (Southwest China).

From March 2016 to June 2018, 6 townships in the Qianjiang District of Chongqing Municipality were selected for a cross-sectional study of the residents in rural areas. Demographics and medical history were collected using a questionnaire. Anthropometry and blood pressure were obtained by physical examination. Blood lipids, fasting plasma glucose, and 2-h postprandial glucose were measured.

A total of 2949 (1067 males and 1882 females) were included. The mean age was 63.8 ± 10.7 years. The prevalence of MS in the study population was 16.8% (496/2949). The prevalence of MS was 7.4% in men, 22.2% in women, 15.7% in Han, 18.1% in Tujia, and 14.8% in Miao. According to age, the prevalence of MS was 10.6%, 17.0%, and 18.3% in the 30–50, 50–69, and ≥ 70 years groups. The multivariable analysis showed that female sex (OR = 33.36, 95%CI: 17.0–65.53), dyslipidemia (OR = 4.71, 95%CI: 1.73–12.82), kidney diseases (OR = 2.32, 95%CI: 1.37–3.94), waistline (OR = 1.39, 95%CI: 1.33–1.46), high-density lipoprotein cholesterol (OR = 0.12, 95%CI: 0.06–0.23), triglycerides (OR = 1.52, 95%CI: 1.31–1.76), alanine aminotransferase (OR = 0.98, 95%CI: 0.97–1.00), γ-glutamyltransferase (OR = 1.00, 95%CI: 1.00–1.01), and glycated hemoglobin (OR = 1.31, 95%CI: 1.08–1.59) were independently associated with MS.

The prevalence of MS was 16.8% in Qianjiang. Female sex, kidney diseases, alanine aminotransferase, and γ-glutamyltransferase were independent risk factors for MS.
Association between depressive symptoms and adherence among adolescents living with HIV in the Republic of Congo
Authors: Ekat Martin Herbas , Yotebieng Marcel , Leroy Valériane , Mpody Christian , Diafouka Merlin , Loubaki Gilbert , Nsondé Dominique Mahambou – , Ossibi Ibara Bienvenu Rolland , Bernard Charlotte , Sabin Caroline , Becquet Renaud
Published: August 2020

The increasing availability of antiretroviral therapy (ART) worldwide is yet to result in decreasing HIV-related mortality among adolescents (10–19 years old) living with HIV (ALHIV) in part because of poor adherence. the poor adherence might itself be due to high level of depression. We assess the prevalence of depressive symptomatology and it's associated with adherence among ALHIV receiving ART care in Brazzaville and Pointe Noire, Republic of Congo (RoC).

Adolescents aged 10 to 19 years, on antiretroviral therapy (ART), followed in the two Ambulatory Treatment Centers (ATC) in Brazzaville and Pointe Noire, RoC were included in this cross-sectional study. From April 19 to July 9, 2018, participants were administered face to face interviews using a standardized questionnaire that included the nine-item Patient Health Questionnaire (PHQ-9). Participants who reported failing to take their ART more than twice in the 7 days preceding the interview were classified as non-adherent. Bivariate and multivariable log-binomial models were used to estimate the prevalence ratio (PR) and 95% confidence interval (95%CI) assessing the strength of association between predictors and presence of depressive symptoms (PHQ-9 score ≥9).

Overall, 135 adolescents represented 50% of ALHIV in active care at the 2 clinics were interviewed. Of those, 67 (50%) were male, 81 (60%) were 15 to 19 years old, 124 (95%) had been perinatally infected, and 71 (53%) knew their HIV status. Depressive symptoms were present in 52 (39%) participants and 78 (58%) were adherent. In univariate analyses, the prevalence of depressive symptoms was relative higher among participants who were not adherent compared to those who were (73% vs 33%; PR: 2.20 [95%CI: 1.42–3.41]). In multivariate analysis, after adjustment for report of been sexually active, alcohol drinking, age category (10–14 and 15–19), not in school, loss of both parents, the association between depression and adherence was strengthened (PR: 2.06 [95%CI: 1.23–3.45]).

The prevalence of depressive symptoms in adolescents living with HIV is high and was strongly associated with poor adherence even after adjustment of potential confounders. Efforts to scale-up access to screening and management of depression among ALHIV in sub-Saharan is needed for them to realize the full of ART.
Effects of adductor canal block on pain management compared with epidural analgesia for patients undergoing total knee arthroplasty
Authors: Zhu Lianzhou , Yang Li , Wang Zhengkai , Cui Hanjuan
Published: August 2020

Background:

Total knee arthroplasty (TKA) is known to be a painful orthopedic procedure and moderate to severe pain is common, especially immediately postoperatively and during active motion. The aim of the present study was to compare epidural analgesia (EA) and adductor canal block (ACB) techniques with regard to early period pain levels, need for additional opioids, and ambulation and functional scores in patients who had undergone primary TKA.

Methods:

Approval for the study was granted by the Changji Branch of the First Affiliated Hospital of Xinjiang Medical University. Written informed consent will be obtained from all of the participants. Inclusion criteria included the following: planned unilateral TKA; spinal anesthesia; American Society of Anesthesiologists physical status classification score of I to III. Prospective assessment will be done for 100 patients who are scheduled for unilateral primary TKA surgery in our academic hospital by a single senior surgeon between August 2020 and December 2021. Patients were randomized to ACB treatment or EA treatment by a computer random number generator. The primary outcome was visual analog scale pain scores in the immediate postoperative period. Secondary outcomes included postoperative opioid use, length of hospital stay, activity level during physical therapy, and knee range of motion. Results were evaluated in a confidence interval of 95% and at a significance level of P < .05.

Conclusions:

We hypothesized that standard ACB would be as effective as EA for postoperative pain management following TKA.

Trial registration:

This study protocol was registered in Research Registry (researchregistry5775).
Allopurinol use and type 2 diabetes incidence among patients with gout
Authors: Slobodnick Anastasia , Toprover Michael , Greenberg Jeffrey , Crittenden Daria B. , Pike Virginia C. , Qian Yingzhi , Zhong Hua , Pillinger Michael H.
Published: August 2020

To assess the impact of allopurinol on diabetes in a retrospective cohort of Veterans’ Affairs patients with gout.

The New York Harbor VA computerized patient record system was searched to identify patients with an ICD-9 code for gout meeting at least 4 modified 1977 American Rheumatology Association gout diagnostic criteria. Patients were divided into subgroups based on >30 continuous days of allopurinol, versus no allopurinol. New diagnoses of diabetes, defined according to American Diabetes Association diagnostic criteria or clinical documentation explicitly stating a new diagnosis of diabetes, were identified during an observation period from January 1, 2000 through December 31, 2015.

Six hundred six gout patients used allopurinol >30 continuous days, and 478 patients never used allopurinol. Over an average 7.9 ± 4.8 years of follow-up, there was no significant difference in diabetes incidence between the allopurinol and non-allopurinol groups (11.7/1000 person-years vs 10.0/1000 person-years, P = .27). A lower diabetes incidence in the longest versus shortest quartiles of allopurinol use (6.3 per 1000 person-years vs 19.4 per 1000 person-years, P<.0001) was attributable to longer duration of medical follow-up.

In this study, allopurinol use was not associated with decreased diabetes incidence. Prospective studies may further elucidate the relationship between hyperuricemia, gout, xanthine oxidase activity, and diabetes, and the potential impact of gout treatments on diabetes incidence.
Comparison of ultrasound-guided and nerve stimulator-guided interscalene blocks as a sole anesthesia in shoulder arthroscopic rotator cuff repair
Authors: Lim Jung A. , Sung Shin Yeung , Lee Ji Hyeon , Lee So Young , Kwak Sang Gyu , Ryu Taeha , Roh Woon Seok
Published: August 2020

Ultrasound-guided interscalene block (US-ISB) and nerve stimulator-guided interscalene block (NS-ISB) have both been commonly used for anesthesia in shoulder arthroscopic surgery.

This study aims to compare which method provides surgical block as a sole anesthesia. In this retrospective study, 1158 patients who underwent shoulder arthroscopic rotator cuff tear repair surgery under ISB between October 2002 and March 2018 were classified into either the US-ISB or NS-ISB anesthesia groups. Demographic and anesthetic characteristics and intraoperative medications were analyzed after propensity score matching and compared between the 2 groups.

There was a 0.5% rate of conversion to general anesthesia in the US-ISB group and a 6.7% rate in the NS-ISB group (P < .001). The volume of local anesthetics used for ISB was 29.7 ± 8.9 mL in the US-ISB group versus 38.1 ± 4.8 mL in the NS-ISB group (P < .001). The intraoperative use of analgesics and sedatives such as fentanyl, midazolam and propofol in combination was significantly lowered in the US-ISB group (P < .001).

US-ISB is a more effective and safer approach for providing intense block to NS-ISB because it can decrease the incidence of conversion to general anesthesia and reduce the use of analgesics and sedatives during arthroscopic shoulder surgery.
Effects of extracorporeal shock wave therapy in patients with knee osteoarthritis
Authors: Xie Xianfei , Zhu Jialing , Zhang Hao
Published: August 2020

Background:

Osteoarthritis is the most common form of arthritis, and is a major cause of disability and chronic pain in adults. However, there is very limited evidence in the scientific literature to support the effectiveness of extracorporeal shockwave therapy (ESWT) in human knee osteoarthritis. This retrospective study aimed to compare the efficacy of ESWT treatment with sham-ESWT on pain, walking speed, physical function, and adverse effects in knee osteoarthritis.

Methods:

This study will be performed and reported in accordance with the Strengthening the Reporting of Observational studies in Epidemiology checklist. We reviewed patients diagnosed with knee osteoarthritis at our academic center from 2016 to 2017. This retrospective cohort study was approved by the institutional review board in Ruijin Hospital. The primary outcome measure was pain on movement measured by a 100-cm visual analog scale. The secondary outcome measures included the Western Ontario and McMaster University Osteoarthritis Index, range of motion, and adverse effects. Statistical analysis was performed using Statistical Package for Social Sciences version 20.0 (IBM Corporation, Armonk, NY). A P-value of <.05 was defined as statistical significance.

Results:

The hypothesis was that ESWT would be an effective treatment for improving pain and physical function in knee osteoarthritis to control symptoms.

Trial registration:

This study protocol was registered in Research Registry (researchregistry5801).
Simultaneous double balloon dilatation using double channel therapeutic endoscope in patients with cricopharyngeal muscle dysfunction
Authors: Jo Yong Seob , Cha Jung Hyun , Kim Yong Kyun , Kim Sun Young , Lee Hong Sub
Published: August 2020

The role of endoscopic balloon dilatation (EBD) using double-balloon catheters in patients with cricopharyngeal muscle dysfunction (CPD) is still unclear. Thus, the aim of this study was to compare the functional outcomes between patients receiving EBD and rehabilitative balloon swallowing (RBS).

A total of 36 patients with CPD, who visited a teaching hospital from February 2014 to June 2017, were included in the study. Among them, 12 patients with severe dysphagia underwent EBD. After propensity score matching, 24 patients who underwent RBS were selected for comparison. We compared the effects of EBD and RBS using 4 functional swallowing parameters: functional dysphagia scale score, penetration-aspiration scale score, pharyngeal transit time, and percentage of pharyngeal remnant (PR) at baseline and after the first and second treatments. Using simple and multiple regression, we examined the associations between EBD/RBS and changes of 4 parameters after the treatments since the baseline

All functional parameters significantly decreased after RBS and EBD (P < .05). After the first therapy session, significant differences in the pharyngeal transit time (P = .034), percentage of PR (P = .008), and penetration-aspiration scale score (P = .014) were observed in the EBD group, compared with those in the RBS group. The regression analysis showed significant improvements in the PR after EBD compared with that after RBS (β = 0.95, SE = 0.31, P = .005).

EBD may be an alternative treatment for patients with severe CPD. A significant improvement would be expected in such patients with PR.
Coronavirus disease 2019-associated rapidly progressive organizing pneumonia with fibrotic feature
Authors: Okamori Satoshi , Lee Ho , Kondo Yasushi , Akiyama Yuto , Kabata Hiroki , Kaneko Yuko , Ishii Makoto , Hasegawa Naoki , Fukunaga Koichi
Published: August 2020

Introduction:

Pneumonia is one of the most important characteristics of coronavirus disease 2019 (COVID-19) and imaging findings of COVID-19 pneumonia are diverse and change over disease course. However, the detailed clinical course of organizing pneumonia (OP) caused by COVID-19 has not been clarified.

Patient concerns:

A 60-year-old man and a 61-year-old woman diagnosed with mild COVID-19 were admitted to our hospital. Their respiratory symptoms were deteriorating even after initiating treatment with antiviral drugs.

Diagnosis:

Chest X-rays and computed tomography scan showed a rapid progression of linear consolidation with reversed halo sign, distributed in subpleural and peri-bronchial regions. They also presented with pulmonary fibrosis findings, including traction bronchiectasis and marked lung volume reduction. They were diagnosed with rapidly progressing OP.

Interventions:

They were treated with systemic corticosteroids.

Outcomes:

The patients’ imaging findings and respiratory conditions improved rapidly without any adverse effects.

Conclusion:

Physicians should carefully monitor patients with COVID-19, as they can develop rapidly progressive and fibrotic OP, which respond to corticosteroids.
Efficacy predictors of a second tumor necrosis factor inhibitor in the treatment of rheumatoid arthritis
Authors: Reams Jennifer , Berger Andrea , Denio Alfred
Published: August 2020

To retrospectively evaluate initial tumor necrosis factor inhibitor (TNFi) failure patients for clinical predictors of response to a 2nd TNFi in our 4282 rheumatoid arthritis (RA) patient database.

A cross-sectional retrospective manual chart review of the electronic health record (EHR) was performed on 322 “real world” RA patients who were prescribed 2 TNFis. Response to TNFi was determined by the treating provider who had real time Clinical Disease Activity Index (CDAI) scores to inform treatment decisions. Age, gender, body mass index (BMI), insurance provider, duration of disease, cyclic citrullinated peptide antibody (CCP) and rheumatoid factor (RF) positivity, concomitant disease modifying anti-rheumatic drug therapy, length of time between diagnosis and start of 1st and 2nd TNFi, transient efficacy of 1st TNFi (defined as response to TNFi at 3 months but later lost response), and reason for discontinuation of 1st TNFi were analyzed. A multivariable logistic regression model was used to model response to a 2nd TNFi.

Response proportions to the 2nd TNFi were greater in females (161/223, 72.2% response female vs 41/75, 54.7% male, P < .01), those who began their 1st TNFi within 3 months of their RA diagnosis, and in RF+ patients (123/170, 72.4% response seropositive vs 66/110, 60.0% seronegative, P < .03). The higher female response rate was independent of age, BMI, and seropositivity.

In RA patients who failed an initial TNFi, female patients and patients with RF+ were more likely to have a clinical response to a 2nd TNFi. In the absence of these predictors, stronger consideration for choosing a biologic with an alternative mechanism of action might be given when the 1st TNFi fails.
Acute pancreatitis induced by combination chemotherapy used for the treatment of acute myeloid leukemia
Authors: Yang Qiu-Jin , Zheng Jie , Dang Fu-Tao , Wan Yue-Meng , Yang Jing
Published: August 2020

Rationale:

Drug-induced pancreatitis (DIP) is a kind of acute pancreatitis with a relatively low incidence. There are many cases of acute pancreatitis (AP) caused by chemotherapeutic agents that have been reported. However, few reports focus on the combination of chemotherapeutic agents that induce acute pancreatitis. This article aims to retrospectively analyze a case of DIP and to explore the relationship between chemotherapeutic agents and acute pancreatitis.

Patient concerns:

Here, we report a 35-year-old Chinese female patient who was diagnosed as acute myeloid leukemia with BCR/ABL expression. After induction chemotherapy of daunorubicin and cytarabine, bone marrow aspiration showed: Acute myeloid leukemia-not relieved (AML-NR). Then the regimen of homoharringtonine, cytarabine and dasatinib was started. The patient developed abdominal pain on the 14th day of chemotherapy. Laboratory tests showed elevated serum amylase (AMY) and lipase (LIPA). Computed tomography (CT) of the abdomen revealed a swollen pancreas with blurred edges and thickened left prerenal fascia.

Diagnosis:

The patient was diagnosed as DIP by the symptoms of upper abdominal pain and the change of CT images. Other common causes of AP were excluded meanwhile.

Interventions:

The chemotherapy was stopped immediately. And after fasting, fluid infusion and inhibiting the secretion of the pancreas, the symptoms were relieved.

Outcomes:

DIP relapsed when the regimen of aclacinomycin + cytarabine + G-CSF + dasatinib regimen (G-CSF (400ug/day, day 1 to 15), cytarabine (30 mg/day, day 2 to 15), aclacinomycin (20 mg/day, day 2 to 5)and dasatinib (140 mg/day, continuously)) was given, and was recovered after treatment for AP was performed.

Lessons:

To choose the best treatment plan for patients, clinicians should raise awareness of DIP, and should know that chemotherapeutic agents can induce pancreatitis and the combination of chemotherapeutic agents may increase the risk of drug-induced pancreatitis.
Unicondylar knee arthroplasty versus total knee arthroplasty in adults with isolated medial osteoarthritis
Authors: Yin Zifei , Qian Pingkang , Wu Xiaofeng , Gao Feng , Xu Feng
Published: August 2020

Background:

The choice between unicondylar knee arthroplasty (UKA) and total knee arthroplasty (TKA) is likely to have long-term implications for patient-reported health outcomes. However, high-quality studies that compare the outcomes of TKA and UKA and their effects are still lacking in the literature. Thus, the aim of the present study was to compare the UKA and TKA techniques with regard to functional outcomes and perioperative complications in patients who had isolated medial osteoarthritis.

Methods:

This was a retrospective, single-center, matched-controlled study performed with approval of our hospital (Kunshan hospital of Traditional Chinese Medicine affiliated to Nanjing University of Traditional Chinese Medicine), with the ethics number KZY2020–37. To reduce the effect of selection bias and potential confounding in this observational study, a 1:1 matching algorithm was applied. The groups were split by sex, age to within 6 years, and body mass index within 5 kg/m2. Thus, we retrospectively reviewed the records of 240 consecutively enrolled patients who underwent UKA and 240 patients who underwent TKA from January 2013 to June 2015 from the database of our institution. Written informed consent was obtained from all subjects participating in the trial. Clinical outcomes included range of motion, Short Form 12 score, new Knee Society Score, Western Ontario and McMaster Universities Arthritis Index, and the complications. The outcome measures were evaluated by a physiotherapist and were assessed preoperatively and postoperatively at 6 months and 2 years. The mean follow-up time was 3 years.

Conclusion:

We hypothesized that there was no significant difference between the 2 groups in terms of postoperative outcomes.

Trial registration:

Our study was registered in Research Registry (researchregistry5828).
Global, national and regional prevalence, and associated factors of ocular trauma
Authors: Bian Xiaoyan , Xu Shuang , Song Yuli , Wang Yuye , Zhao Bin , Zhong Yifan , Liu Lei , Hu Yuedong
Published: August 2020

Background:

Ocular trauma is a common eye disease and one of the main causes of blindness. There is a dearth of data on a summary and meta-analysis on the global epidemiology of the disease. Therefore, this systematic review protocol aims to propose the first systematic review and meta-analysis to synthesize existing evidence on the global prevalence and associated factors of ocular trauma worldwide.

Methods:

A systematic search will be performed according to the following databases: PubMed, Web of Science, Chinese National Knowledge Infrastructure (CNKI), Weipu, and Wanfang. Cross-sectional, case-control, and cohort studies reporting on the prevalence and risk factors of ocular trauma will be included. The primary outcome will be the prevalence in global, regional, and national ocular trauma. Study searching, data extraction, and quality evaluation will be performed by 2 reviewers, independently. Appropriate meta-analysis will then be used to pool studies. STATA software package v 12.0 (Stata Corporation, College Station, TX) and R (version 3.4.1; R Foundation for Statistical Computing, Vienna, Austria) software will be used for all statistical analyses.

Results:

This study will provide a high-quality synthesis to examine the prevalence and associated factors of ocular trauma worldwide. Furthermore, current study will project disease estimates in the next 50 years.

Conclusion:

This systematic review and meta-analysis will provide first evidence to evaluate the burden of ocular trauma in the general population.

Ethics and dissemination:

This systematic review and meta-analysis of randomized controlled trials does not require ethical recognition, and the results of this paper will be published in an open access, internationally influential academic journal.

Trial registration number:

CRD42020189166
Preoperative evaluation using external lumbar drainage for patients with posthemorrhagic hydrocephalus
Authors: Sun Tong , Guan Junwen , Yang Jingguo , Yuan Yikai , Zhou Yicheng , You Chao
Published: August 2020

Background:

External lumbar drainage (ELD) remains the most common used methods with a higher sensitivity before lumboperitoneal shunt (LPS) implantation to predict the shunt outcomes in the treatment of idiopathic normal pressure hydrocephalus. However, the benefits of such supplemental test have not been tested in the treatment of post-hemorrhagic hydrocephalus (PHH).

Methods and design:

In the current trial, 100 eligible patients with PHH will be recruited and randomly assigned to the ELD group (study group) and non-ELD group (control group). Lumbar puncture (LP) will be performed for participants in non-ELD group. LP plus ELD will be performed for participants in ELD group, those who will then be investigated the suitability of potential LPS 4 days after ELD. Two independent and practiced assessors will collect the baseline data and evaluate each participant 4 days after ELD or LP, 1 day after LPS, at the time of discharge and 1 month after LPS. The primary outcome is the shunting outcomes 1 month after surgery. The secondary outcomes include the complications related to ELD, complications related to LPS, and Evens index at each evaluation point. Meanwhile, serious adverse events occurring at any time is recorded to determine the safety of this trial.

Discussion:

The results of this trial will demonstrate whether preoperative evaluation using temporary ELD for patients with PHH could attenuate the risk of LPS failure.

Trial registration number

ChiCTR2000034094; Pre-results.
The diagnostic value of miR-92a, -143, and -145 expression levels in patients with colorectal adenocarcinoma from Romania
Authors: Brînzan Costel , Aşchie Mariana , Cozaru Georgeta , Dumitru Eugen , Mitroi Anca
Published: August 2020

MicroRNAs (miRNAs) refers to a small, short non-coding RNA of endogenous class. They have shown to have an increasingly altered expression in many types of cancer, including colorectal cancer (CRC).

In the present study, miRNA TaqManMGB and qRT-PCR was used to quantify the expression and clinical significance of 3 mature human miRNA in 82 pairs of colorectal adenocarcinoma tissues and normal adjacent tissue samples (NATS) collected from patients of the south-east part of Romania. Differences between CRC and NATS were analyzed using Wilcoxon test, while correlations between miRNAs expression levels and clinicopathological features were examined using non-parametric tests. In addition, the ability of selected miRNAs to function as biomarkers and, as potential indicators in CRC prognosis was also examined.

When the miRNA expression was compared in CRC related NATS, miR-143, and miR-145 were significantly underexpressed (4.99 ± –1.02 vs –5.66 ± –1.66, P < .001; –4.85 ± –0.59 vs –9.27 ± –1.51, P < .001, respectively), while the pattern of miR-92a was significantly overexpressed (–5.55 ± –2.83 vs –4.92 ± –2.44, P < .001). Moreover, the expression levels of selected miRNAs were identified to be correlated with gradual increases in fold change expression with the depth of tumor invasion, lymph node invasion, and maximal increases with distant metastasis. Furthermore, the receiver operating characteristic analysis demonstrated that potential diagnostic of miR-143, miR-145, and miR-92a in discriminating CRC from NATS, with the area under the curve of 0.74, 0.85, and 0.84 respectively. The Kaplan–Meier and the log-rank test showed that a high level of miR-92a and low levels of miR-143 and miR-145 predicted poor survival rate in our cohorts.

In conclusion, we can summarize that miR-145 and miR-143 are decreased, while miR-92 is increased in CRC compared to NATS, and associated with different stages of CRC pathogenesis. Thus, the expression of selected miRNAs can represent potential diagnostic and prognostic tools in patients with CRC from Romania.
Superb microvascular imaging for detecting neovascularization of carotid plaque compared with contrast-enhanced ultrasound
Authors: Zhou Yang , Wang Cong
Published: August 2020

Background:

Superb microvascular imaging (SMI) is a novel Doppler technique that depicts low velocity blood flow without the use of a contrast agent. Studies suggested that SMI may or may not detect neovascularization of carotid plaque with accuracy comparable to contrast-enhanced ultrasound. To gain clarity, a meta-analysis to systematically review and synthesize relevant data on the SMI for the detection of intraplaque neovascularization was undertaken.

Methods:

We will search PubMed, Web of Science, Cochrane Library, and Chinese biomedical databases from their inceptions to the June 31, 2020, without language restrictions. Two authors will independently carry out searching literature records, scanning titles and abstracts, full texts, collecting data, and assessing risk of bias. Review Manager 5.2 and Stata14.0 software will be used for data analysis.

Results:

This systematic review will investigate whether SMI is feasible on the detection of intraplaque neovascularization compared with contrast-enhanced ultrasound.

Conclusion:

Its findings will provide helpful evidence for the feasibility of SMI on the detection of intraplaque neovascularization.

Systematic review registration:

INPLASY202070097.
Factors associated with burnout and job satisfaction in Chinese hospital pharmacists
Authors: Zhao Jie , Zhang Xiaojian , Du Shuzhang
Published: August 2020

Pharmacists with long experience and low personal satisfaction from work are at higher risk of burnout, but the role of specific personality traits is less well understood. In addition, the medical system in China is different from that of other countries, and the characteristics of pharmacist burnout might be different from that of other countries. This study evaluated the roles played by personality, working environment, and work characteristics on burnout and job satisfaction among Chinese hospital pharmacists.

This was a cross-sectional study undertaken between April 28 and 30, 2017. The questionnaires were completed at the “National Academic Conference of the Chinese Society of Clinical Pharmacy”. Questionnaires were handed out to 1786 pharmacists, and 1394 valid questionnaires were analyzed using structural equation modeling techniques.

The final structural model showed that, as expected, personality and working environment factors directly or indirectly predicted burnout dimensions (emotional exhaustion, depersonalization, and reduction of personal accomplishment) and job satisfaction variables. The analyses were consistent with the features of pharmacists’ work characteristics, including job demands, job control, and workload playing mediating roles between antecedent variables (personality and working environment) and emotional outcomes (burnout and job satisfaction). On the other hand, job control and workload did not predict emotional exhaustion.

This study indicates that personality is a negative predictor of 2 dimensions of burnout (emotional exhaustion and depersonalization), while the working environment, especially job demand, is a predictor of burnout and greater emotional exhaustion. Work characteristics are positively related to job satisfaction and play a protective role against burnout.
Moxibustion for treating chronic pelvic inflammatory disease
Authors: Hua Fanghui , Li Honglian , Xiong Jun , Huang Shouqiang , Xiang Jie , Zhou Xiaohong
Published: August 2020

Background:

Chronic pelvic inflammatory disease (CPID) is a difficult-to-treat gynaecological disorder, which has complex etiologies, among married women. In recent years, moxibustion has gradually shown its clinical advantages and been more and more widely used In China. The protocol is try to synthesize and assess the effectiveness and safety of moxibustion for patients with CPID.

Methods:

Seven databases as following: PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, WangFang Database, Chinese Scientific Journal Database, Chinese Biomedical Literatures Database will be searched from their inception to May 2020. No restrictions about language and status. Study selection, data collection, and quality assessment will be respectively conducted by 2 researchers. Based on the heterogeneity test results, the fixed-effects or random-effects model will be selected to synthesize data. The effective rate, Pelvic inflammatory mass diameter and Pelvic fluid depth will be the primary outcomes. Patient reported outcome scale, visual analog scale, C-reactive protein, transforming growth factor β1 =  transforming growth factor β, incidence of any adverse events will be the secondary outcomes. Revman 5.4 software will be implemented for data synthesis. Dichotomous data will be represented by risk ratio for efficacy and safety of CPID treated with moxibustion, while continuous data will be represented by mean difference with a 95% confidence interval.

Results:

The results of this study will be published in a peer-reviewed journal. This study will provide a comprehensive review of the available evidence for the treatment of moxibustion with CPID.

Conclusions:

This study expects to provide high-quality, evidence-based recommendations on further treatment for clinical guidance of CPID.

Trial registration number:

CRD42020158744 in PROSPERO 2020.
Efficacy and safety of traditional Chinese medicine combined with routine western medicine for the asymptomatic novel coronavirus disease (COVID–19)
Authors: Wang Jiahao , Zhu Xue , Sun Yuying , Zhang Xingcai , Zhang Wei
Published: August 2020

Background:

The number of patients infected with novel coronavirus disease (COVID–19) has exceeded 10 million in 2020, and a large proportion of them are asymptomatic. At present, there is still no effective treatment for this disease. Traditional Chinese medicine (TCM) shows a good therapeutic effect on COVID–19, especially for asymptomatic patients. According to the search results, we found that although there are many studies on COVID–19, there are no studies targeting asymptomatic infections. Therefore, we design a network meta-analysis (NMA) to evaluate the therapeutic effect of TCM on asymptomatic COVID–19.

Methods:

We will search Chinese and English databases to collect all randomized controlled trials (RCTs) of TCM combined with conventional western medicine or using only TCM to treat asymptomatic COVID–19 from December 2019 to July 2020. Then, two investigators will independently filter the articles, extract data, and evaluate the risk of bias. We will conduct a Bayesian NMA to evaluate the effects of different therapies. All data will be processed by Stata 16.0 and WinBUGS.

Results:

This study will evaluate the effectiveness of various treatments for asymptomatic COVID–19. The outcome indicators include the time when the nucleic acid turned negative, the proportion of patients with disease progression, changes in laboratory indicators, and the side effects of drugs.

Conclusion:

This analysis will further improve the treatment of asymptomatic COVID–19.

INPLASY registration number:

INPLASY202070022.
Efficacy and safety of Bacillus Calmette-Guerin for bladder cancer
Authors: Zhang Zhi-hui , Yin Lei , Zhang Ling-ling , Song Jing
Published: August 2020

Background:

This study will systematically assess the efficacy and safety of Bacillus Calmette-Guerin (BCG) for patients with bladder cancer (BC).

Methods:

Literature searches will be performed in multiple electronic databases from inception to present: MEDLINE, EMBASE, CINAHL, Science Direct, Cochrane Library, Web of Science, and China National Knowledge Infrastructure. We will also examine grey literature through identifying conference proceedings, thesis, dissertations, and website of clinical trials registry. Two investigators will independently scan all citation titles, abstracts, and full-text studies. The study quality will be assessed by Cochrane Risk of Bias Tool. If possible, we will perform meta-analysis. Additional analyses will be carried out to test the potential sources of heterogeneity among included trials.

Results:

The present study will summarize high quality trials on investigating the efficacy and safety of BCG for patients with BC.

Conclusion:

The results of this study will supply helpful evidence to determine whether BCG is effective or not for BC.

Study registration number:

INPLASY202070042.
Development of central retinal artery occlusion accompanied by choroidal folds in a patient with antineutrophil cytoplasmic antibody-associated vasculitis
Authors: Takagi Mai , Kobayashi Takatoshi , Kida Teruyo , Takai Nanae , Shoda Hiromi , Maruyama Koichi , Tada Rei , Makino Shigeki , Ikeda Tsunehiko
Published: August 2020

Rationale:

We report a case of central retinal artery occlusion (CRAO) accompanied by choroidal folds in a patient positive for myeloperoxidase (MPO)-antineutrophil cytoplasmic antibody (ANCA).

Patient concerns:

The study involved a 67-year-old female patient who presented at the Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Osaka, Japan on October 24, 2016 after becoming aware of a sudden decrease of visual acuity (VA) in her right eye. Other than suffering with scleritis 6-months previous, there was no obvious past history.

Diagnosis:

Upon examination, the VA in her right eye was hand motion, and the anterior segment of that eye showed thinning of the superior sclera. Macular edema in the inner retina and cherry red spots were observed in the ocular fundus, and optical coherence tomography (OCT) findings showed hyperreflectivity of the inner retina and choroidal folds. Fluorescein angiography (FA) examination of the fundus showed scattered areas of no retinal perfusion, and indocyanine green angiography (IA) findings of the fundus indicated a possible choroidal circulatory disturbance in her right eye. Blood test findings revealed the patient to be positive for MPO-ANCA. Based on the above findings, the patient was diagnosed with CRAO and choroidal circulatory disturbance due to ANCA-associated vasculitis.

Interventions:

For treatment, steroid semi-pulse therapy was initiated.

Outcomes:

Post treatment initiation, the fundus features and choroidal folds gradually improved, and her VA slightly improved to 0.08.

Lessons:

Based on the FA, IA, and OCT findings, the present case was considered to have CRAO accompanied by choroidal circulatory disturbance due to ANCA-associated vasculitis, a rare disease that may be complicated by choroidal circulatory disturbances.