bluuebunny/crossref_metadata_2025 huggingface dataset:
Fulminant Necrotizing Soft-tissue Infection in an Extremely Low Gestational Age Infant
Authors: Viel-Thériault Isabelle , Puthattayil Zakariya B. , Ferretti Emanuela
Published: January 2021

We report a case of rapidly progressive necrotizing skin and soft-tissue infection caused by Bacillus cereus in an extremely low for gestational age infant. This case reminds clinicians to consider this opportunistic pathogen as the etiologic agent in fulminant necrotizing infections in vulnerable hosts, and to institute appropriate therapy in a timely fashion.
Lung-protective ventilation and adjunctive strategies to manage respiratory failure: are they safe in the neurological patient?
Authors: Piran Pirouz , Stevens Robert D.
Published: January 2021

Purpose of review

The coexistence of neurological injury and respiratory failure is common in intensive care. This article provides a contemporary overview of the safety and efficacy of different strategies for mechanical ventilation and adjunctive respiratory approaches in patients with acute brain injury.

Recent findings

Available evidence indicates that lung-protective ventilation (LPV) can be implemented safely in a range of patients with concurrent respiratory failure and brain injury of different etiologies; however, the clinical efficacy of LPV in this setting needs to be established. In patients who have severe acute respiratory distress syndrome (ARDS) and brain injury, adjunctive measures (neuromuscular blocker drug infusions, prone positioning, extracorporeal membrane oxygenation) may be considered, although the neurophysiological impact and safety of these techniques need further investigation. Intracranial pressure and other neuromonitoring techniques may be of value to ensure optimal management of mechanical ventilation and adjunctive measures in this population.

Research is needed to determine the safety, feasibility, and efficacy of LPV and adjunctive approaches for managing patients with concurrent brain injury and respiratory failure.
Postauricular injection in the treatment of all-frequency and high frequency descending sudden hearing loss
Authors: Li Ying , Liang Jiao , Chiang Han-Jen , Liu Yang
Published: January 2021

Background:

Sudden hearing loss (SHL) is a disease, at the same time a symptom, which needs to be treated in a timely manner and counts as an emergency health problem in the Department of Otolaryngology. There are many types of sudden hearing loss and among them, the occurrence of all-frequency descending sudden hearing loss and high frequency sudden hearing loss are high. The conventional treatment for these 2 types of sudden hearing loss sometimes is not as effective as expected. Postauricular injection of glucocorticoids could be the most effective treatment method. However, the effectiveness and safety of postauricular injection of glucocorticoid needs to be assessed systematically.

Methods:

The protocol for the meta-analysis was conducted under the guidance of Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). The aim is to undertake a systematic review and meta-analysis on the effectiveness and safety of postauricular injection of glucocorticoid to treat patient diagnosed with all-frequency and high frequency descending sudden hearing loss. We searched through the following databases: English databases (PubMed, EMBASE, Web of Science) and Chinese databases (CNKI, Wanfang databases, CBM, VIP). The final selected articles will be evaluated using Cochrane RCT evaluation criteria. Revman 5.0 will be used for data analysis. Subgroup analysis, sensitivity analysis, and meta regression will detect sources of heterogeneity. Ethics approval was not required for this protocol. The findings will be disseminated through journal articles or conference presentations.

OSF registration number:

DOI 10.17605/OSF.IO/5Q9NA

Results:

Objectively, evaluate the efficacy and safety of postauricular injection of glucocorticoid in treating all-frequency descending sudden hearing loss and high frequency sudden hearing loss.

Conclusion:

To provide evidence-based medicine for glucocorticoid treatment methods in patients with all-frequency descending sudden hearing loss and high frequency descending hearing loss.
Value of anti-hepatitis B virus in serum tested by enzyme linked immunosorbent assay 3 in diagnosis of hepatitis B
Authors: Fei-fei Shen , Xiao-dan Ren , Hai-qiang Liu , He-wei Zhang
Published: January 2021

Introduction:

This protocol is for a meta analysis that aims to systematically review the diagnostic value of anti-hepatitis B virus in serum tested by the enzyme linked immunosorbent assay in patients with hepatitis B.

Methods and analysis:

The following electronic databases will be searched from inception to Mar 2021: PubMed, Web of Science, ScienceDirect, EMBASE, MEDLINE, Springer, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, VIP Chinese Science and Technology Periodical Database, and Wanfang Database. All study about enzyme linked immunosorbent assay reagents have been published at home and abroad to diagnose hepatitis B virus will be included. MetaDisc 1.4 soft will used to calculate pooled effect size in sensitivity, specifi city, likelihood ratio, diagnostic odds ratio and summary receiver operating characteristic curve, and area under the curve as well.

Ethics and dissemination:

Formal ethical approval is not required, as the data are not individualized. The findings of this systematic review will be disseminated in a peer-reviewed publication and/or presented at relevant conferences.

Registration number:

INPLASY2020100051.
Prenatal detection of terminal 9p24.3 microduplication encompassing DOCK8 gene
Authors: Yue Fagui , Yu Yang , Zhang Xinyue , Jiang Yuting , Li Leilei , Liu Ruizhi , Zhang Hongguo
Published: January 2021

Trisomy 9p is one of the most common chromosomal partial trisomies in newborns. However, reports on prenatal 9p microduplications are rare in the clinic. This study aimed to examine the genotype–phenotype correlation and assess the clinical significance of 9p24.3 microduplication encompassing the DOCK8 gene. Eight pregnant women underwent amniocentesis for cytogenetic and genetic testing for various indications for prenatal diagnosis from January 2019 to January 2020. Chromosomal karyotypic analysis was performed on G-band metaphases that were prepared from cultured amniotic fluid cells. Chromosomal microarray analysis was carried out to detect chromosomal copy number variations. We also performed a literature review on clinical data on similar 9p24.3 microduplications to determine the genotype–phenotype correlation. We detected 123–248-kb microduplications in the region of 9p24.3 (chr9: 208454–469022), involving part of or the entire DOCK8 gene. The indications for prenatal diagnosis mainly focused on the risk of maternal serum screening for trisomy 21/18, advanced maternal age, and increased nuchal translucency. No evident structural abnormalities were observed for all fetuses, except for case 5 who presented with increased nuchal translucency in prenatal ultrasound findings. Follow-up of postnatal health was performed and showed no apparent abnormalities for cases 1 to 6 after birth. The parents of case 7 chose to terminate the pregnancy while the parents of case 8 chose to continue the pregnancy. We propose that 9p24.3 microduplications that encompass part of or the entire DOCK8 gene are variants that might be benign. However, further large-scale studies are necessary to evaluate the clinical pathogenicity. For prenatal cases with 9p24.3 microduplication, postnatal health and growth should be followed up and assessed regularly from childhood to adulthood.
The benefits of Qigong exercise for symptoms of fatigue
Authors: Wang Rui , Huang Xueyan , Wu Yeqi , Sun Dai
Published: January 2021

Background:

About 5% to 20% of the general population suffers from continuous fatigue, which is also one of the most frequent symptoms seen in primary medical care. Fatigue, if not effectively relieved, may have an adverse effect on the quality of life and treatment of patients. Qigong is a safe and comfortable exercise popular in China and among the Ethnic Chinese, and is a complementary therapy used to treat fatigue, such as cancer related fatigue and chronic fatigue syndrome. It appears promising but lacks convincing evidence; thus, necessitating further investigation.

Methods:

Eight databases (PubMed, Web of Science, Embase, Cochrane Library, China Biology Medicine disc, China National Knowledge Infrastructure, WanFang and VIP Data Knowledge Service Platform) will be searched from inception to November 30, 2020 for randomized controlled trials published in English or Chinese investigating the outcomes of the Qigong exercise (QE) for symptoms of fatigue and quality of life. We will also include additional references of relevant published studies by manually retrieving reference lists of included literature and previous relevant reviews. For articles that meet the inclusion criteria, 2 reviewers will independently conduct the study selection, data extraction, and risk of bias assessment. The results of the outcome measures will be reported in risk ratios for dichotomous data and standard mean differences for continuous data. If necessary, we will also perform subgroup analyses and analyze the causes.

Results:

The results of this review will be submitted to a journal for publication.

Conclusion:

This systematic review protocol aims to analyze whether QE is effective in treating fatigue associated with various disease.

Registration:

INPLASY2020110133.
Clinicopathologic characteristic and prognosis in idiopathic membranous nephropathy patients with focal segmental sclerosis lesion
Authors: Cheng Wenrong , Sun Lijun , Dong Hongrui , Wang Guoqin , Ye Nan , Wang Yanyan , Cheng Hong
Published: January 2021

To explore the clinicopathological characteristics and prognosis of idiopathic membranous nephropathy (IMN) with focal segmental sclerosis lesions (FSL).

A total of 70 IMN patients with FSL (FSL+group) were enrolled in this study, and 140 patients were randomly selected by age and sex matching as disease controls (FSL-group). The clinical and renal histopathological data on renal biopsy and clinical data of patients regularly followed were collected. Serum anti-phospholipase A2 receptor (PLA2R) autoantibody, thrombospondin type-1 domain-containing 7A (7A) autoantibody, glomerular PLA2R and 7A expression, and IgG4 deposition were detected. First, the clinical and pathological significance of IMN combined with the FSL group was analyzed. Whether FSL is a risk factor for renal outcomes was further analyzed.

IMN patients who developed FSL had more severe clinical and pathological characteristics than those without FSL. FSL was an independent risk factor for poorer prognosis. When the appearance of FSL in IMN patients with a high level of serum anti-PLA2R antibody, the treatment needs to be more aggressive to promote remission and to delay the progression of renal function.
CHADS2, CHA2DS2-VASc, ATRIA, and Essen stroke risk scores in stroke with atrial fibrillation
Authors: Yu Inwu , Song Tae-Jin , Kim Bum Joon , Heo Sung Hyuk , Jung Jin-Man , Oh Kyung-Mi , Kim Chi Kyung , Yu Sungwook , Park Kwang Yeol , Kim Jeong-Min , Park Jong-Ho , Choi Jay Chol , Park Man-Seok , Kim Joon-Tae , Hwang Yang-Ha , Chung Jong-Won , Bang Oh Young , Kim Geong-Moon , Kim Yong-Jae , Kim Seonwoo , Woo Sook young , Cho Hyun , Seo Woo-Keun
Published: January 2021

The performance of scoring systems for risk stratification in patients with atrial fibrillation (AF) was not validated well in patients with stroke. The purpose of this study was to evaluate whether the risk scoring systems predict vascular outcomes in stroke patients with AF.

Data were obtained from a nationwide multicenter registry for acute stroke with AF from January 1, 2013, to December 31, 2015. We investigated the predictive power of the CHADS2, CHA2DS2-VASc, ATRIA, and Essen stroke scores in stroke patients with AF. The subjects were further stratified into groups according to treatment with or without oral anticoagulants (OACs).

A total of 3112 stroke with AF subjects were included. The rate of recurrent ischemic stroke and any stroke were not associated with the CHADS2, CHA2DS2-VASc, ATRIA, and Essen stroke risk scores. The risks of death and major adverse cerebrovascular and cardiovascular events (MACEs) increased sequentially with the increase of each risk score in OAC group. (the range of C-index 0.544–0.558 for recurrent ischemic stroke; 0.523–0.537 for any stroke; 0.580–0.597 for death; 0.564–0.583 for MACEs). However, in the group treated with OACs, all risk scores were significantly associated with the risk of MACEs. The C-statistics of the 4 scoring systems were 0.544 to 0.558, 0.523 to 0.537, 0.580 to 0.597, 0.564 to 0.583, respectively, for recurrent ischemic stroke, any stroke, death, and MACEs.

The performance of the CHADS2, CHA2DS2-VASc, ATRIA, and Essen stroke risk scores for the prediction of recurrent stroke was unsatisfactory in stroke patients with AF whereas the performance for the prediction of recurrent stroke was not MACEs or death was good. A new risk stratification scheme that is specific for secondary stroke prevention in the AF population is needed.
Prenatal diagnosis of fetal congenital mesoblastic nephroma by ultrasonography combined with MR imaging
Authors: Che Meiling , Yang Fan , Huang Huilin , Zhang Hongyang , Han Cong , Sun Nao
Published: January 2021

Rationale:

Fetal congenital mesoblastic nephroma (CMN) is a rare renal tumor, characterized by polyhydramnios, premature birth, and neonatal hypertension. In the prenatal stage, it is particularly difficult to diagnose CMN either by ultrasonography or magnetic resonance imaging (MRI). Thus, CMN is frequently detected in the third trimester in the clinical scenario.

Patient concerns:

A 29-year-old G2P0 pregnant woman took routine prenatal examinations in our hospital. The fetal right kidney abnormality was not observed after 2 systematical ultrasonic examinations (at 24 and 31 weeks of gestation respectively), and only an increase was noticed in the amniotic fluid index (from 19.3 to 20.8 cm).

Diagnosis:

CMN was detected by antenatal ultrasonography and MRI as a fetal right renal mass at 35 weeks of gestation in our hospital.

Interventions:

The pregnant woman was admitted at a gestational age of 38 weeks and 5 days due to alterations in renal function. Further, the pregnant woman was administered with “oxytocin” to promote delivery, and the neonate underwent a right nephrectomy on the 9th day after birth.

Outcomes:

The pathological examination confirmed a cellular type of right CMN. The neonate recovered well after operation without adjuvant treatment. During 6 months of follow-up, the neonate grew well and showed no signs of recurrence or metastasis.

Conclusion:

Polyhydramnios detected during prenatal examination required attention due to the risk of malformation of fetal urinary system. Prenatal ultrasonography combined with MRI could not only clearly identify the origin of the tumor, but also distinguish the correlation between the tumor and adjacent structures, thereby leading to early diagnosis and favorable prognosis.
The potential impact from glenohumeral internal rotation deficit to the knee kinematics in baseball pitchers
Authors: Cheng Shih-Chung , Lin Shu-Ming , Lin Won-Jean
Published: January 2021

A recent study suggested that baseball pitchers with glenohumeral internal rotation deficit (GIRD) may tend to use trunk rotation as compensation to adjust ball placement, which may lead to subsequent counter movement at the knee of the leading leg.

This study aims to investigate the kinematic characteristics of the counter movements between the femur and the tibia (knee torsion), from the landing of the leading leg until the follow-through phase, during throwing between pitchers with and without GIRD at the dominant arm.

This is a case-control study. Twenty-one senior high school baseball pitchers were recruited in this study. The glenohumeral internal and external rotation, hip internal and external rotation of all participants were measured. Eight pitchers without GIRD and 13 pitchers with GIRD were enrolled into the control group and experiment group, respectively. The maximal angular movement between the femur and the tibia (knee torsion) of the leading leg was measured, using The Zebris 3D (Zebris Medizintechnik GmbH, Isny, Germany) motion analysis system, in the interval from the landing until the follow-through phase during pitching a fastball to the bottom-outside corner with their dominant arm.

The results showed that the maximal knee torsion of the leading leg in the experimental group (13.67 ± 0.9 degrees) was significantly greater than the control group (4.25 ± 1.369 degrees) (P < .05).

Pitchers with GIRD had greater counter movement in the knee joint than pitchers without GIRD.
Nursing effect of ECMO combined with CRRT in the treatment of fulminant myocarditis
Authors: Wu Juan , Zhang Hui , Gao Yongxia , Huang Xihua
Published: January 2021

Background:

Fulminant myocarditis has a sudden onset and rapid progress, which can easily cause multiple organ failure. Acute kidney injury is a common complication. ECMO (extracorporeal membrane oxygenation) and CRRT (continuous renal replacement therapy) have been used in the treatment of fulminant myocarditis, but the combination of the 2 has an impact on the prognosis. There is still a big controversy. Therefore, the purpose of this randomized controlled trial is to evaluate the nursing effect and long-term efficacy and safety of ECMO combined with CRRT in the treatment of fulminant myocarditis.

Methods:

This is a prospective randomized controlled trial to study the effectiveness and safety of ECMO combined with CRRT in the treatment of fulminant myocarditis. Approved by the clinical research ethics committee of our hospital. Patients were randomly assigned to 1 of 2 treatment options:

Observation indicators include: basic vital signs, laboratory indicators, echocardiographic changes, complications, and outcomes. SPSS 25.0 (Chicago, IL) version statistical software package was used to analyze the data.

Discussion:

This study will evaluate the nursing effect and long-term efficacy and safety of ECMO combined with CRRT in the treatment of fulminant myocarditis. The results of this experiment will provide clinical evidence for the treatment of fulminant myocarditis with ECMO and CRRT.

Ethics and dissemination:

Private information from individuals will not be published. This systematic review also does not involve endangering participant rights. Ethical approval was not required. The results may be published in a peer-reviewed journal or disseminated at relevant conferences.

OSF Registration number:

DOI 10.17605/OSF.IO/PAQBZ.
Clinical acupuncture therapy for children with allergic rhinitis
Authors: Li Jun , Liu Lanhua , Jiao Lin , Liao Kai , Xu LingnLing , Zhou Xiaohong , Xiong Jun
Published: January 2021

Background:

Allergic rhinitis (AR) in children has become a common clinical allergic disease, the incidence of which is increasing in pediatric. The side effects of the drug cause parents to worry about the health of their child. However, a large number of current clinical studies have shown that acupuncture therapy is effective in treating children with AR. Therefore, this systematic review aims to explore the safety and effectiveness of acupuncture in the treatment of AR in children.

Methods:

We will conduct a comprehensive literature search in Medline, PubMed, Cochrane Database of Systematic Reviews, Embase, Chinese Biomedical Literatures Database (CBM), China National Knowledge Infrastructure (CNKI), Wang Fang Database (WF), Chinese Scientific Journal Database (VIP) from inception to November 2020 without any language restriction. In addition, we will retrieve the unpublished studies and the references of initially included literature manually. Reviewers will identify studies, extract data, and assess the quality independently. The outcomes of interest include: total effective rate; the total nasal symptom score; Rhinitis quality of life questionnaire (RQLQ); Visual Analog Scale (VAS); Laboratory inspection indicators: the level of IgE, IL6, IL10 or TNF-α; Recurrence rate; adverse events. Randomized clinical trials will be collected, methodological quality will be evaluated using the Cochrane risk-of-bias assessment tool, and the level of evidence will be rated using the Grading of Recommendations, Assessment, Development and Evaluation approach. Meta-analysis will be performed using RevMan 5.4.0 software. The heterogeneity test will be conducted between the studies, P < .1 and I
2 > 50% are the thresholds for the tests. We will utilize the fixed effects model or the random effects model according to the size of heterogeneity.

Results:

The results of this systematic review will provide a synthesis of current evidence of AR in children. We will report this result shortly.

Conclusion:

This study will explore whether or not acupuncture therapy can be used as one of the non drug therapies to prevent or treat allergic rhinitis in children.

Trial registration number:

INPLASY2020110053.
Chinese herbal medicine injections (CHMIs) for chronic pulmonary heart disease
Authors: Lei Yuping , Wang Meili , Sun Guiqiang , Liu Yong , Yang Yapei , Hao Dong
Published: January 2021

Background:

Chinese herbal medicine injections (CHMIs) are frequently used for various refractory diseases including chronic pulmonary heart disease (CPHD). However, due to the diversity of CHMIs treatments, its relative effectiveness and safety remain unclear. In our study, Bayesian network meta-analysis will be used to identify differences in efficacy and safety between diverse CHMI for CPHD.

Methods:

Relevant randomized controlled trials (RCTs) and prospective controlled clinical trials published in PubMed, Google Scholar, Excerpt Medica Database, Medline, Cochrane Library, Web of Science, China Scientific Journal Database, China National Knowledge Infrastructure, Chinese Biomedical Literature Database and Wanfang Database will be systematic searched to identify eligible studies from their establishment to December 2020. The methodological qualities, including the risk of bias, will be evaluated using the Cochrane risk of bias assessment tool. Stata14.2 and WinBUGS 1.4.3 software were used for data synthesis. The evidentiary grade of the results will be also evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.

Results:

The results of this study will be published in a peer-reviewed journal, and provide reliable evidence for different CHMIs on CPHD.

Conclusions:

The findings will provide reference for evaluating the efficacy and safety of different CHMIs for CPHD, and provide a helpful evidence for clinicians to formulate the best adjuvant treatment strategy for CPHD patients.

Trial registration number:

INPLASY2020120004.
Comparison of the ductal carcinoma in situ between White Americans and Chinese Americans
Authors: Kuang Xin-Wen , Sun Zhi-Hong , Song Jun-Long , Zhu Zhanyong , Chen Chuang
Published: January 2021

Currently, the wide-spread use of screening mammography has led to dramatic increases in ductal carcinoma in situ (DCIS). However, DCIS of Chinese Americans, the largest Asian subgroup in American, has rarely been comprehensively studied over the past decade. This work compared the DCIS characteristics and prognosis of Chinese American patients with White Americans in the USA to determine the characteristics and prognosis of DCIS patients of Chinese Americans.

The data were obtained using the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) data. The diagnosis and treatment variables between the two groups were compared by means of Chi-square tests. Survival was determined with the use of the Kaplan–Meier method and the multivariable Cox proportional hazard regression model.

From 1975 to 2016, 81,745 White Americans and 2069 Chinese Americans were diagnosed with ductal carcinoma in situ. Compared with the white patients, the Chinese Americans were younger (P < .001) with smaller tumors (P < .001) and higher family income (P < .001). DCIS patients of Chinese American group accounted for a higher percentage of all breast cancers than the whites (P < .001). In the multivariable Cox proportional hazard regression analysis, Chinese American was an independent favorable prognostic factor in terms of overall survival (OS) (HR, 0.684; 95% CI, 0.593–0.789; P < .001) compared with the white group.

In conclusion, DCIS characteristics of the Chinese group, which exhibited a higher proportion of younger age, a higher DCIS ratio, and a better prognosis, were distinct from those of the White Americans.
Plasma rich in growth factors versus Mitomycin C in photorefractive keratectomy
Authors: Sanchez-Avila Ronald M. , Uribe-Badillo Edmar E. , Sanz Javier Fernández-Vega , Muruzabal Francisco , Jurado Nancy , Alfonso-Bartolozzi Belén , Alfonso Jose F. , Baamonde Begoña , Anitua Eduardo , Merayo-Lloves Jesus
Published: January 2021

To evaluate the efficacy and safety of plasma rich in growth factors (PRGF) in photorefractive keratectomy (PRK) versus Mitomycin C (MMC).

This is a comparative, longitudinal and retrospective case-control study (MMC vs PRGF), in patients with a spherical correction from −0.25 to −8.00 D and cylinder correction from −0.25 to −3.00. The uncorrected distance visual acuity (UDVA), refractive efficacy and safety indices, and changes in endothelial cell density were evaluated. The predictability was assessed with the postoperative manifest spherical equivalent.

Forty-four patients (72 eyes) were treated with MMC and twenty-five patients (45 eyes) with PRGF. The final UDVA (LogMar) in MMC was 0.029 ± 0.065 and in PRGF it was 0.028 ± 0.048 (p = 0.383). The efficacy index for MMC was 0.98 ± 0.10 and 1.10 ± 0.46 for patients treated with PRGF (p = 0.062). The safety index for MMC was 1.03 ± 0.11 and 1.12 ± 0.46 (p = 0.158) for PRGF group. The change percentage of endothelial cell density was 0.9 ± 11.6 for MMC and 4.3 ± 13.1 for PRGF (p = 0.593). The predictability for MMC was 92.1% and for the PRGF was 91.9% (p = 0.976). Hyperemia, eye pain and superficial keratitis were observed in 11.1% of the MMC group; no adverse events were observed with the PRGF.

The use of PRGF in PRK surgery is as effective as MMC. The PRGF shows a better safety profile than MMC for its intraoperative use in PRK.
Tuina therapy for temporomandibular joint disorder syndrome
Authors: Chen Jing , Li Yongchao , Zeng Lirong , Sun Wei , Wei Ni , Xie Hui , He Wenjuan
Published: January 2021

Background:

Temporomandibular joint disorders (TMD) is common in clinic at present, which seriously affects the mental health and quality of life of patients. With the development of society, the incidence of TMD is gradually increasing. At present, there are many treatment methods, Tuina as a characteristic traditional Chinese medicine therapy, clinical treatment of TMD has a significant effect. In recent years, there are many clinical studies on Tuina in the treatment of TMD, but the clinical efficacy of Tuina in the treatment of TMD has not been systematically evaluated. In this study, we systematically evaluated the relevant literature of Tuina in the treatment of TMD by using the method of evidence-based medicine, in order to provide reference for clinical research in this direction in the future.

Methods:

VIP Chinese database, China knowledge Network, Wanfang, China Biomedical Database, PubMed, Embase, Cochrane Library and Web of Science were searched for clinical randomized controlled trials of Tuina in the treatment of TMD from the establishment of the database to December 2020. The 2 researchers independently screened the literature and carried out quality assessment and data extraction for the included study, and used RevMan5.3 software for risk assessment and Meta analysis.

Results:

In this study, the efficacy and safety of Tuina in the treatment of TMD were evaluated by effective rate, visual analog score (VAS) of temporomandibular joint pain, dysfunction index ((DI), palpation index (PI), craniomandibular index (CMI), maximum mouth opening (MMO), incidence of adverse reactions and so on.

Conclusion:

This protocol can provide evidence-based basis for the treatment of TMD, with Tuina to significantly improve the symptoms and function of patients with TMD.

OSF Registration number:

DOI 10.17605/OSF.IO/J75A8.
Dexamethasone for the treatment of traumatic brain injured patients with brain contusions and pericontusional edema
Authors: Pérez-Bárcena Jon , Castaño-León Ana María , Lagares Gómez-Abascal Alfonso , Barea-Mendoza Jesús Abelardo , Navarro Maín Blanca , Pomar Pons Jaume , Periañez Párraga Leonor del Mar , Ibáñez Domínguez Javier , Chico-Fernández Mario , Llompart-Pou Juan Antonio , Frontera Juan Guillem
Published: January 2021

Background:

Traumatic brain injury (TBI) constitutes a leading cause of death and disability. Patients with TBI and cerebral contusions developing pericontusional edema are occasionally given dexamethasone on the belief that this edema is similar to that of tumors, in which the beneficial effect of dexamethasone has been demonstrated.

Methods:

The DEXCON TBI trial is a multicenter, pragmatic, randomized, triple-blind, placebo controlled trial to quantify the effects of dexamethasone on the prognosis of TBI patients with brain contusions and pericontusional edema. Adult patients who fulfill the elegibility criteria will be randomized to dexamethasone/placebo in a short and descending course: 4 mg/6 h (2 days); 4 mg/8 hours (2 days); 2 mg/6 hours (2 days); 2 mg/8 hours (2 days); 1 mg/8 hours (2 days); 1 mg/12 hours (2 days). The primary outcome is the Glasgow Scale Outcome Extended (GOSE) performed 1 month and 6 months after TBI. Secondary outcomes are: number of episodes of neurological deterioration; symptoms associated with TBI; adverse events; volume of pericontusional edema before and after 12 days of treatment; results of the neuropsychological tests one month and 6 months after TBI. The main analysis will be on an “intention-to-treat” basis. Logistic regression will estimate the effect of dexamethasone/placebo on GOSE at one month and at 6 months, dichotomized in unfavorable outcome (GOSE 1–6) and favorable outcome (GOSE 7–8). Efficacy will also be analyzed using the 'sliding dichotomy’. An interim and safety analysis will be performed including patients recruited during the first year to calculate the conditional power. A study with 600 patients would have 80% power (2 sided alpha = 5%) to detect a 12% absolute increase (from 50% to 62%) in good recovery.

Discussion:

This is a confirmative trial to elucidate the therapeutic efficacy of dexamethasone in a very specific group of TBI patients: patients with brain contusions and pericontusional edema. This trial could become an important milestone for TBI patients as nowadays there is no effective treatment in this type of patients.

Trial Registration:

eudraCT: 2019–004038–41; Clinical Trials.gov: NCT04303065.
Efficacy of minimally invasive surgery for the treatment of hypertensive intracerebral hemorrhage
Authors: Liu Jiang , Cheng Jing , Zhou Hongjun , Deng Chunyan , Wang Zhengxin
Published: January 2021

Introduction:

Hypertensive intracerebral hemorrhage (HICH) is the most serious complication of hypertension. Clearing intracranial hematoma as soon as possible, reducing brain cell edema, and controlling intracranial pressure could effectively reduce neuron damage, lower patient mortality, and improve patient prognosis. At present, minimally invasive surgery (MIS) has been widely used and plays an important role in the treatment of HICH. However, it is still in controversies about the choice of surgical treatment and medication treatment for HICH. Therefore, we try to conduct a randomized, controlled, prospective trial to observe the efficacy of MIS treatment against HICH compared with medication treatment.

Methods:

Patients will be randomly divided into treatment group and control group in a 1:1 ratio using the random number generator in Microsoft Excel. Stereotactic soft channel minimally invasive intracranial hematoma puncture and drainage treatment and medication treatment will be applied respectively. The outcomes of intracerebral hemorrhage volume, Glasgow coma scale, National Institutes of Health Stroke Scale will be recorded.

Conclusions:

The findings of the study will be helpful for the choice of MIS and conservative treatment when treating HICH patients.

Trial registration:

OSF Registration number: DOI 10.17605/OSF.IO/ME6Y5.
Acupuncture for polycystic ovary syndrome
Authors: Liao Zaibo , Fan Huaying , Fan Huayu , Chen Xiaohua
Published: January 2021

Background:

As the results of previous systematic reviews and meta-analyses on acupuncture for polycystic ovary syndrome (PCOS) have provided inconsistent evidence. This overview of systematic reviews (SRs) and meta-analyses will aim to critically appraise the methodology and reporting quality of the relevant SRs and meta-analyses with the aim of identifying whether acupuncture could provide an effective treatment for patients with PCOS or not.

Methods:

Electronic databases including MEDLINE via Ovid, EMBASE, PubMed, Cochrane library, China National Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP database), and Wanfang Database will be searched for related SRs and meta-analyses from inceptions to the search date without language restrictions. Two reviewers will independently select SRs and meta-analyses and collect related data, and a third reviewer will be introduced if any disagreement happened during the assessing. The Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) and the latest Assessment of Multiple Systematic Reviews 2 (AMSTAR2) checklists will be employed to evaluate the reporting and methodology quality.

Results:

This overview will be published in a peer-reviewed journal.

Conclusion:

This overview will identify related SRs and meta-analyses of acupuncture for treating PCOS.

Ethics and dissemination:

Ethics approval and patient consent are not required as this study is an overview based on published systematic reviews and meta-analyses.
CTPA pulmonary artery distensibility in assessment of severity of acute pulmonary embolism and right ventricular function
Authors: Wang Dawei , Yang Fei , Zhu Xiaolong , Cui Shujun , Dong Shanglin , Zhang Zhenming , Zhang Yujiao
Published: January 2021

To investigate the characteristics of pulmonary artery distensibility (PAD) in patients with acute pulmonary embolism (APE) and to assess the correlation of PAD with APE severity and right ventricular function. A total of 33 patients who underwent retrospective electrocardiogram (ECG)-gated computed tomography pulmonary angiography (CTPA) with a definite diagnosis of APE were included in the study. According to APE severity, the patients were divided into severe (SPE) and non-severe (NSPE) groups. Data from a control group without APE matching the basic demographics of the APE patients were collected. Pulmonary artery distensibility (PAD) and right ventricular function parameters were compared among the 3 groups, their relationships were investigated, and receiver operating characteristic (ROC) curves were used to determine the sensitivity and specificity of the above parameters for the diagnosis of APE severity. The PAD values of the control, NSPE, and SPE groups were (7.877 ± 2.637) × 10−3 mm/Hg, (6.050 ± 2.011) × 10−3 mm/Hg, (4.321 ± 1.717) × 10−3 mm/Hg, respectively (P < .01). There were statistically significant differences in right ventricular function parameters among the 3 groups (P < .05). The correlation analysis between PAD and right ventricular function parameters showed a weak negative correlation (r = −0.281–−0.392). The area under the ROC curve of PAD was 0.743, the critical value was 4.200, and the sensitivity and specificity were 62.5% and 94.1%, respectively. The PAD obtained by retrospective ECG-gated CTPA could accurately evaluate APE severity and right ventricular function. As the severity of APE increases, PAD decreases, which is helpful to identify patients at high risk of APE.
Pediatric Acute B-Cell Lymphoblastic Leukemia Developing Following Recent SARS-CoV-2 Infection
Authors: Leclercq Charlotte , Toutain Fabienne , Baleydier Frederic , L’Huillier Arnaud G. , Wagner Noemie , Lironi Céline , Calza Anne-Marie , Ansari Marc , Blanchard-Rohner Geraldine
Published: January 2021

Coronavirus disease-2019 in children has been linked to various clinical presentation, from paucisymptomatic cutaneous eruptions, to multisystemic inflammatory syndrome. We report the case of an 8-year-old boy who presented with persistent fever and pancytopenia, associated to a skin rash. An extensive etiological workup showed a positive serology for severe acute respiratory syndrome coronavirus 2 and Epstein-Barr virus. A few weeks later, type B acute lymphocytic leukemia was diagnosed. This case underlines the polymorphic appearance of coronavirus disease-2019 and the need for critical appraisal.
The 2020 WHO Classification of Tumors of Bone: An Updated Review
Authors: Choi Joon Hyuk , Ro Jae Y.
Published: January 2021

Bone tumors are a rare and heterogeneous group of neoplasms that occur in the bone. The diversity and considerable morphologic overlap of bone tumors with other mesenchymal and nonmesenchymal bone lesions can complicate diagnosis. Accurate histologic diagnosis is crucial for appropriate management and prognostication. Since the publication of the fourth edition of the World Health Organization (WHO) classification of tumors of soft tissue and bone in 2013, significant advances have been made in our understanding of bone tumor molecular biology, classification, prognostication, and treatment. Detection of tumor-specific molecular alterations can facilitate the accurate diagnosis of histologically challenging cases. The fifth edition of the 2020 WHO classification of tumors of soft tissue and bone tumors provides an updated classification scheme and essential diagnostic criteria for bone tumors. Herein, we summarize these updates, focusing on major changes in each category of bone tumor, the newly described tumor entities and subtypes of existing tumor types, and newly described molecular and genetic data.
Influence of Comorbidities on Short-Term Functional Outcomes After Unilateral Total Knee Arthroplasty
Authors: Kim Youn Ji , Kim Bo Ryun , Kim Sang Rim , Nam Kwang Woo , Lee So Young , Choi Jun Hwan , Kim Won Bin , Kim Beom Su
Published: January 2021

Objective

The aim of the study was to determine the effect of comorbidities on physical function and quality of life of patients at 3 mos after total knee arthroplasty.

Design

Data from 140 patients who underwent a primary unilateral total knee arthroplasty were examined retrospectively. Comorbidities were osteoporosis, presarcopenia, degenerative spine disease, diabetes, and hypertension. All patients completed the following: range of motion, stair climbing test, 6-min walk test, Timed Up and Go Test, peak torque of the knee extensor and flexor, instrumental gait analysis, Western Ontario McMaster Universities Osteoarthritis Index, and EuroQoL five-dimension questionnaire.

Results

Univariate analyses revealed that osteoporosis led to a significantly longer time to complete the stair climbing test–ascent, stair climbing test–descent, and Timed Up and Go Test and to lower scores for the 6-min walk test and peak torque of the knee extensor. Patients with degenerative spine disease showed significant negative scores for knee extension range of motion. Diabetes showed a negative correlation with peak torque of the knee extensor and knee flexion range of motion, as well as a higher Western Ontario McMaster Universities Osteoarthritis Index–stiffness score. Multivariable linear regression analysis showed that Western Ontario McMaster Universities Osteoarthritis Index–stiffness remained independently associated with diabetes. Six-minute walk test, Timed Up and Go Test, stair climbing test–ascent, and peak torque of the knee extensors showed a significant association with osteoporosis.

Conclusions

Comorbidities, particularly osteoporosis and diabetes, affect short-term functional outcomes 3 mos after total knee arthroplasty.
Implementation and Sequencing of Practice Transformation in Urban Practices with Underserved Patients
Authors: Quigley Denise D. , Predmore Zachary S. , Chen Alex Y. , Hays Ron D.
Published: January 2021

Background:

Patient-centered medical home (PCMH) has gained momentum as a model for primary-care health services reform.

Methods:

We conducted interviews at 14 primary care practices undergoing PCMH transformation in a large urban federally qualified health center in California and used grounded theory to identify common themes and patterns.

Results:

We found clinics pursued a common sequence of changes in PCMH transformation: Clinics began with National Committee for Quality Assurance (NCQA) level 3 recognition, adding care coordination staff, reorganizing data flow among teams, and integrating with a centralized quality improvement and accountability infrastructure. Next, they realigned to support continuity of care. Then, clinics improved access by adding urgent care, patient portals, or extending hours. Most then improved planning and management of patient visits. Only a handful worked explicitly on improving access with same day slots, scheduling processes, and test result communication. The clinics' changes align with specific NCQA PCMH standards but also include adding physicians and services, culture changes, and improved communication with patients.

Conclusions:

NCQA PCMH level 3 recognition is only the beginning of a continuous improvement process to become patient centered. Full PCMH transformation took time and effort and relied on a sequential approach, with an early focus on foundational changes that included use of a robust quality improvement strategy before changes to delivery of and access to care.
Fighting Frailty in Underserved Communities
Authors: Migliarese Sara , Smith Nancy , Annas Austin , Healy Catherine
Published: January 2021

Methods:

Participants older than 50 years were recruited for frailty screenings and a 6-week exercise intervention. Participants were screened using grip strength, Functional Assessment of Chronic Illness Therapy Fatigue Scale, and the Short Physical Performance Battery.

Results:

Seventy-six adults were screened, with 62 meeting criteria for frailty (81.6%). Thirty-four adults (mean age = 64.9, range 50-104, 26% < 65) received exercise intervention. Significant increases in Functional Assessment of Chronic Illness Therapy Fatigue Scale (P = .042), grip strength (P < .001), and Short Physical Performance Battery (P < .001) were found.

Conclusion(s):

Medically underserved individuals may have a higher prevalence and earlier onset of frailty and respond favorably to exercise.
Filling the Breast Cancer Survivor Gap of Care Through Pilates-Based Exercise
Authors: Martin Suzanne
Published: January 2021

Women have a 1 in 8 chance of contracting breast cancer at some time in their lifetime and this risk increases with age. There is currently a lack of information regarding the amount of specific physical therapy or functional education resources for patients undergoing treatment after the stages of initial occurrence of diagnosis and medical treatment. In addition, depending on diagnosis and subsequent treatment protocols, patients experience a variety of side effects that limit functional ability. The Pilates Method can help bridge the care gap. The Pilates Method promotes body awareness and sensory reintegration and, depending on the level of expertise of the practitioner, can focus on specific corrective remedial exercises specifically designed to address limitations, weakness, and imbalance. As a result, the Pilates Method can be a valuable adjunct care facilitator in establishing a “new normal” of physical ability and integration for breast cancer survivors.
Management of Gait Impairments in Older Adults
Authors: Lamb Carrie A.
Published: January 2021

The aim of this article is to highlight the versatility of CoreAlign as it relates to gait in the aging population. Declines in strength, flexibility, and balance can lead to falls, injuries, and even hospitalizations. CoreAlign is uniquely suited to address these areas of dysfunction efficiently by allowing patients to train functional movement patterns. Early clinical experience shows this is a tool that is applicable to a wide range of physical abilities and diagnoses.
Performance of National and Foreign Models for Predicting the 6-Minute Walk Distance for Assessment of Functional Exercise Capacity of Brazilian Elderly Women
Authors: Marques Neysa Laila Xavier Rangel , de Sá Ferreira Arthur , da Silva Débora Pedroza Guedes , de Menezes Sara Lúcia Silveira , Guimarães Fernando Silva , Dias Cristina Márcia
Published: January 2021

Objectives:

To compare the results of the 6-Minute Walk Test (6MWT) with those estimated using national and foreign predictive equations of the six-minute walked distance (6MWD) in Brazilian elderly women.

Methods:

Fifty healthy elderly women (72 ± 5 years, 29.4 ± 4.7 kg/m2) performed the 6-Minute Walk Test.

Results:

Predicted distances using different equations showed significant differences and the percentage of predicted 6MWD varied between 71 ± 7% and 112 ± 12%. Correlations between predicted distances were all significant (P < .05). The classification of normal-reduced 6MWD was significantly different among equations.

Conclusion:

National or foreign equations failed to accurately predict functional exercise capacity in healthy elderly women, highlighting the need to recalibrate those equations before clinical use in this population.
Bladder Control Is a Fitness Issue
Authors: Crawford Bruce
Published: January 2021

With regard to urinary incontinence, the Cochran Review states that there is support for the recommendation of pelvic floor muscle exercise as first-line conservative therapy for women with stress incontinence, urge incontinence, and mixed incontinence. Despite all of this, most patients with pelvic floor disorders are generally not offered, and consequently do not participate in, an organized program of pelvic floor rehabilitation before using medication and/or surgery to address these problem. As we confront mounting, and unsustainable, health care costs, we should make an effort to examine the possibility that some human conditions previously thought to be medical conditions may in fact, at least initially, be best addressed outside the medial arena. The data that support pelvic floor exercise as an effective preventive, and first-line therapeutic, strategy for pelvic floor disorders certainly suggest that there is a fitness issue at hand.