bluuebunny/crossref_metadata_2025 huggingface dataset:
Treatment patterns and clinical outcomes in patients with metastatic breast cancer treated with palbociclib-based therapies: real-world data in the Han population
Authors: Mo Hongnan , Ma Fei , Li Qing , Zhang Pin , Yuan Peng , Wang Jiayu , Luo Yang , Cai Ruigang , Li Qiao , Xu Binghe
Published: August 2022

Background:

This study aimed to reveal the treatment patterns and clinical outcomes of diverse palbociclib-based regimens in Han patients with estrogen receptor-positive (ER+) metastatic breast cancer in routine clinical practice.

Methods:

The clinical data of patients with ER+ metastatic breast cancer treated with palbociclib were collected from the National Cancer Center database. The efficacy profile of palbociclib in this Han population was evaluated, especially for various combination regimens. The efficacy of palbociclib-based therapy in patients with prior everolimus treatment was also assessed.

Results:

A total of 186 patients from 89 cities in 18 provinces in China were enrolled. The median progression-free survival (PFS) was similar among different palbociclib-combined groups (P = 0.566): 10.0 months (95% confidence interval [CI] 3.8–16.1) in the +exemestane group, 9.7 months (95% CI 6.3–13.1) in the +letrozole group, 7.8 months (95% CI 5.5–10.2) in the +fulvestrant group, 7.2 months (95% CI 3.2–11.3) in the +toremifene group, and 6.1 months (95% CI 1.2–11.0) in the +anastrozole group. Thirty-four patients (18.3%) had received everolimus for their metastatic disease before the prescription of palbociclib. The disease control rate was significantly lower in patients who had received previous everolimus than in the everolimus-naïve group (50.0% vs. 82.2%, P < 0.001). Patients pre-treated with everolimus had significantly worse PFS than those in the everolimus-naïve group (3.4 months vs. 8.8 months, P 
= 0.001). After propensity score matching, patients pre-treated with everolimus had similar PFS (4.4 months, 95% CI 0.5–8.2) compared with everolimus-naïve patients (6.1 months, 95% CI 4.7–7.5, P 
= 0.439).

Conclusions:

Various palbociclib-based regimens have promising efficacy in ER+ metastatic breast cancer in real-world settings, even in patients who had been pre-treated with everolimus.
Intramedullary Nailing Versus Compound Plate Osteosynthesis in Pathologic Diaphyseal Humerus Fractures
Authors: Koob Sebastian , Plöger Milena M. , Bornemann Rahel , Lehmann Ramona P. , Alex Dana , Placzek Richard
Published: August 2022

Background and Objectives:

Pathologic fractures of the extremities due to carcinoma metastases require individual and patient prognosis-related stabilization procedures. Considering the anatomic features of the humerus, implant material stability is less critical than femoral fractures because of less weight-bearing stress. Therefore, operation length, blood loss, and quick recovery of function are of greater interest. In this retrospective cohort study, we evaluated and compared the outcomes of compound plate osteosynthesis and intramedullary (IM) nailing while managing diaphyseal pathologic fractures of the humerus.

Methods:

We retrospectively reviewed patients treated at our institution for pathologic fractures of the diaphyseal humerus between 2010 and 2021 for group differences (plate osteosynthesis vs. IM nailing) in terms of blood loss, length of operation, implant survival, and upper extremity function.

Results:

We reviewed 42 stabilization procedures due to pathologic diaphyseal humerus fractures, with a mean follow-up of 8.5±15.4  months. IM nailing (n=20) showed a significantly lower blood loss (266.7±23.7 mL) than plate osteosynthesis (n=22, 571.1±92.6 mL). We did not detect statistically significant differences in the complication rate, length of operation, or Musculoskeletal Tumor Society score.

Conclusion:

Our findings suggested that diaphyseal fractures of the humerus should be stabilized using an IM nail rather than plate osteosynthesis due to lower blood loss, while complication rate, implant survival, and length of operation remain indifferent.
Commentary: An Equitable Approach to Serving Structurally Marginalized Communities
Authors: Reid Kaydian S. , Odusanya Anne O. , Lawrence Wayne R. , Hastings Julia F.
Published: August 2022

As the United States grapples with social injustices, greater attention is being placed on the historical lack of equity practices among health and social service organizations that serve marginalized and predominantly racially minoritized communities. We describe strategies health and social service organizations that partner with community-led organizations must take to ensure actionable equitable changes. The opportunity and promise are upon us to resolve health inequities and promote equity-oriented practices, policies, systems, and social-environmental changes.
Polyetheretherketone (PEEK) Implant for the Reconstruction of Severe Destruction in the Maxilla: Case Report
Authors: Hamsho Ramez , Mahardawi Basel , Assi Haider , Alkhatib Haya
Published: August 2022

Polyetheretherketone (PEEK) implants are being increasingly used to reconstruct defects in the oral and maxillofacial region. This article reports a special case of a patient with major destruction in his maxilla due to a war injury. The resultant defect was reconstructed with a 3D-printed, patient-specific, PEEK implant, restoring acceptable function and aesthetics. The patient followed up for 13 months and showed no technical or biological complications, proving the reliability of this treatment option for recreating severe maxillofacial deformities, and benefiting from the advantage they offer, which is eliminating the need for additional surgery to harvest autogenous bone grafts. Thus, when applicable, the use of PEEK implants could be a possible alternative to other treatment modalities.
Military sexual trauma and incident hypertension: a 16-year cohort study of young and middle-aged men and women
Authors: Gaffey Allison E. , Rosman Lindsey , Sico Jason J. , Haskell Sally G. , Brandt Cynthia A. , Bathulapalli Harini , Han Ling , Dziura James , Skanderson Melissa , Burg Matthew M.
Published: August 2022

Objectives:

Veterans, especially women, are three times more to experience sexual harassment and assault [military sexual trauma (MST)] than civilians. As trauma is associated with elevated cardiovascular risk, we investigated whether MST independently contributes to risk for incident hypertension and whether the effects are distinct among women.

Methods:

We assessed 788 161 post-9/11 Veterans (Mage = 32.14 years, 13% women) who were free of hypertension at baseline, using nationwide Veterans Health Administration data collected 2001–2017. Time-varying, multivariate Cox proportional hazard models were used to examine the independent contribution of MST to new cases of hypertension while sequentially adjusting for demographics, lifestyle and cardiovascular risk factors, including baseline blood pressure, and psychiatric disorders including posttraumatic stress disorder. We then tested for effect modification by sex.

Results:

Over 16 years [mean = 10.23 (SD: 3.69)], 35 284 Veterans screened positive for MST (67% were women). In the fully adjusted model, MST was associated with a 15% greater risk of hypertension [95% confidence interval (95% CI) 1.11–1.19]. In sex-specific analyses, men and women with a history of MST showed a 6% (95% CI, 1.00–1.12, P = 0.042) and 20% greater risk of hypertension (95% CI, 1.15–1.26, P < 0.001), respectively.

Conclusion:

In this large prospective cohort of young and middle-aged Veterans, MST was associated with incident hypertension after controlling for established risk factors, including trauma-related psychiatric disorders. Although MST is disproportionately experienced by women, and the negative cardiovascular impact of MST is demonstrated for both sexes, the association with hypertension may be greater for women. Subsequent research should determine if early MST assessment and treatment attenuates this risk.
Skin capillary alterations in patients with acute SarsCoV2 infection
Authors: Rosei Claudia Agabiti , Gaggero Andrea , Famà Francesca , Malerba Paolo , Chiarini Giulia , Nardin Matteo , Brami Valeria , Rossini Claudia , Coschignano Maria Antonietta , Porteri Enzo , Salvetti Massimo , Muiesan Maria Lorenza , Rizzoni Damiano , De Ciuceis Carolina
Published: August 2022

Background:

Acute SarsCov2 infection is associated with endothelial dysfunction and ‘endothelitis’, which might explain systemic microvascular impairment. The presence of endothelial damage may promote vasoconstriction with organ ischemia, inflammation, tissue oedema and a procoagulant state resulting in an increase in the incidence of cardiovascular and cerebrovascular events. Microvascular thrombosis has been demonstrated in postmortem autopsy of COVID-19 patients; however, few data are available about skin capillary alterations in these patients.

Materials and methods:

We evaluated skin microvascular alteration in 22 patients admitted to our hospital with SarsCov2 infection. Capillary density was evaluated by capillaroscopy in the nailfold and the dorsum of the finger in the acute phase of the disease. Capillaroscopy was repeated after 3 months (recovery phase). In addition, blood chemistry parameters and inflammatory markers were obtained during acute infection and at the recovery after 3 months.

Results:

Patients with COVID-19 showed skin microvascular complications, such as thrombosis, microhaemorrhages and neoangiogenesis, which were not detected after 3 months from the discharge. A significant reduction of capillary density in the dorsum was observed after 3 months from the acute infection (97.2 ± 5.3 vs. 75.81 ± 3.9 n/mm2
P < 0.05). A significant inverse correlation between C-reactive protein and capillary density was observed in patients with acute SarsCov2 infection (r = 0.44, P < 0.05). Conversely a direct correlation between capillary density during the acute phase and lymphocyte number was detected (r = 0.49, P < 0.05).

Conclusion:

This is the first in-vivo evidence of skin capillary thrombosis, microhaemorrhages and angiogenesis in patients with acute SarsCov2 infection, which disappeared after 3 months, supporting the presence of endothelial dysfunction and inflammation. Capillary alterations might reflect systemic vascular effects of viral infection.
Association of arterial properties with left ventricular morphology and function in the community
Authors: Mukai Yasuhiro , Nakanishi Koki , Daimon Masao , Sawada Naoko , Hirose Kazutoshi , Iwama Kentaro , Yamamoto Yuko , Yoshida Yuriko , Ishiwata Jumpei , Koyama Katsuhiro , Nakao Tomoko , Morita Hiroyuki , Di Tullio Marco R. , Homma Shunichi , Komuro Issei
Published: August 2022

Objectives:

Arterial structural and functional remodeling is recognized as a key determinant of incident heart failure, although the contribution of arterial properties on left ventricular (LV) remodeling is not fully studied. Aortic dilatation is an early manifestation of arterial remodeling and estimated pulse wave velocity (ePWV) is emerging as a simple measure of arterial stiffness. This study aimed to characterize the association of aortic size and ePWV with LV morphology and function.

Methods:

The study cohort consisted of 539 participants without overt cardiac disease who underwent extensive cardiovascular examination. Aortic root diameter was measured by two-dimensional echocardiography and ePWV was calculated from a regression equation using age and mean blood pressure. LV global longitudinal strain (LVGLS) was obtained by speckle-tracking echocardiography.

Results:

Aortic root diameter and ePWV were correlated with LV mass index and LVGLS, while only ePWV was related to E/e′ ratio. In multivariable analysis, aortic root diameter and ePWV were significantly related to LV mass index and LVGLS (all P < 0.05), and the association of aortic root size and ePWV with LVGLS was independent of LV mass index and E/e′ ratio. Individuals with both aortic root enlargement and increased ePWV had significantly larger LV mass index and reduced LVGLS compared with those either or those with normal aortic size and ePWV (both P < 0.05).

Conclusion:

Aortic root size and ePWV were independently associated with unfavorable LV remodeling in individuals free of cardiac disease, which might provide useful information into the pathogenesis-linking arterial remodeling and heart failure.
Optimal office blood pressure levels in younger (<50 years old) Korean hypertensive patients: a nationwide cohort study in South Korea
Authors: Kwon Chang Hee , Lee Hae-Young , Lee Jun Hyeok , Kim Minkwan , Sung Ki-Chul
Published: August 2022

Background:

It is unclear what thresholds and targets of office blood pressure (BP) for treatment are appropriate in younger (<50 years old) hypertensive patients. Thus, the aim of this study was to evaluate associations of office BP levels with major cardiovascular events (MACEs) in these patients.

Methods:

Using the Korean National Health Insurance Service database, data of 98 192 younger (<50 years old) hypertensive patients having BP measurements available without any history of cardiovascular events from 2002 to 2011 were extracted. This cohort study evaluated associations of BP levels (<120/<70, 120–129/70–79, 130–139/80–89, 140–149/90–99, and ≥150/≥100 mmHg) with MACEs. The study outcome was MACE, a composite of cardiovascular death, myocardial infarction, stroke, and heart failure.

Results:

In all patients, those treated with antihypertensive medication accounted for 34.7% and those who achieved BP less than 130/80 mmHg accounted for 35.5%. During a mean follow-up of 9.5 ± 2.8 years, 4918 (5%) MACEs were documented in our cohort. The risk of MACE was the lowest [adjusted hazard ratio: 0.77, 95% confidence interval (CI) 0.66–0.89] for those with BP level of less than 120/less than 70 mmHg. It was the highest (hazard ratio 2.0, 95% CI 1.83–2.19) for those with BP level of at least 150/at least 100 mmHg in comparison with those with BP level of 130–139/80–89 mmHg. These results were consistent for all age groups (20–29, 30–39, and 40–49 years) and both sexes.

Conclusion:

Elevated BP level from less than 120 mmHg/less than 70 mmHg is significantly correlated with an increased risk of MACE in younger (<50 years old) Korean hypertensive patients. Lowering BP to less than 120 mmHg/less than 70 mmHg is needed for these patients.
LONGITUDINAL ASSESSMENT OF CHOROIDAL STRUCTURE IN PATIENTS WITH MACULAR NEOVASCULARIZATION
Authors: Lee Kanghoon , Chin Hee Seung
Published: August 2022

Purpose:

To investigate morphologic changes of choroidal structure through chronologic aspect in progression of macular neovascularization (MNV) with pachychoroid features.

Methods:

One hundred seventy-one MNV participants above 50 years old with or without pachychoroid features were included in the analysis. Age-matched 132 normal patients were analyzed as control group. The total choroidal area and ratio of Sattler's layer area to total choroidal area, derived by summing 25 horizontal raster scans of the 30° × 20° scan area on enhanced depth imaging optical coherence tomography, were calculated to compare the difference among the normal eyes and the MNV eyes with/without pachychoroid features.

Results:

The mean ratio of Sattler's layer area to total choroidal area is maintained at around 40% in normal eyes and MNV eyes without pachychoroid features. In MNV with pachychoroid features, the ratio of Sattler's layer area to total choroidal area changes according to the disease activity. Ratio of Sattler's layer area to total choroidal area is 34.1 ± 4.4% at the time of onset, 37.2 ± 4.8% at the time of remission, and decreases during recurrence from 36.8 ± 3.8% to 33.4 ± 3.8% (all P < 0.001).

Conclusion:

MNV with pachychoroid features is a disease whose development and progression are related to a change in the choroidal interlayer area ratio following the relatively larger dilation of Haller's layer vessels.
360 DEGREE ENDOLASER VERSUS FOCAL ENDOLASER IN PRIMARY RHEGMATOGENOUS RETINAL DETACHMENT REPAIR
Authors: Mathai Mariam , Godwin Kristen S. , Albarracin Julio , Levinson Joshua , Broderick Kevin , Melamud Alexander
Published: August 2022

Purpose:

To determine the efficacy of the 360-degree endolaser (360EL) versus focal laser during primary vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD) repair.

Methods:

A single-site retrospective chart review was performed on 241 patients who underwent PPV for primary RRD. Patients were assigned to two groups, PPV with 360EL (n = 183) and PPV without 360EL (n = 59). Only cases where surgeons performed 360EL on all RRDs or surgeons who never perform 360EL on RRDs were included.

Results:

The single surgery anatomical success rate in the 360EL group was 90.2% compared with 86.5% with focal laser (P = 0.619). Epiretinal membrane formation in 360EL group at 1 year was 44.4% versus 37% with focal laser (P = 0.429). Cystoid macular edema formation within 1 year of surgery was 25.8% in 360EL group versus 11.9% with focal laser (P = 0.04).

Conclusion:

The use of 360EL in PPV for RRD repair does not improve single-surgery anatomical success in routine RRDs when compared with PPV with focal laser.
Mechanisms of chronic pain in inflammatory rheumatism: the role of descending modulation
Authors: Trouvin Anne-Priscille , Simunek Arielle , Coste Joël , Medkour Terkia , Carvès Sandrine , Bouhassira Didier , Perrot Serge
Published: August 2022

Persistent pain despite satisfactory disease treatment is frequent in rheumatoid arthritis (RA) and spondyloarthritis (Spa) and may result from specific changes in central pain processing. We assessed these mechanisms further by systematically comparing thermal pain thresholds and conditioned pain modulation (CPM) between patients with active RA or Spa and healthy controls. We included 50 patients with RA and 50 patients with Spa and 100 age-matched and sex-matched controls. Heat and cold pain thresholds (HPT-CPT) were measured on the dominant forearm, and CPM was assessed by applying conditioning stimuli (immersion in a cold-water bath) to one foot and the nondominant hand in 2 successive randomized sequences. Descending pain modulation was assessed as the difference in HPTs (in °C) before and after conditioning. Larger HPT differences (ie, a larger CPM effect) reflected more efficient descending inhibition. Potential associations between changes in CPM and clinical data, including disease activity, pain intensity, and psychological and functional variables, were systematically assessed. Heat pain threshold and cold pain threshold were similar in patients and controls. The mean CPM effect was significantly weaker in patients than that in controls for conditioning applied to either the foot (0.25°C ±2.57 vs 2.79°C ±2.31; P < 0.001) or the nondominant hand (0.57°C ±2.74 vs 2.68°C ±2.12; P < 0.001). The smaller CPM effect in patients was correlated with average pain intensity, but not with disease activity or other clinical characteristics, suggesting a significant pathophysiological role for changes in endogenous pain modulation in the mechanisms of chronic pain associated with inflammatory rheumatism.
Professional Behavior and Value Erosion: A Qualitative Study of Physicians and the Electronic Health Record
Authors: Skeff Kelley M. , Brown-Johnson Cati G. , Asch Steven M. , Zionts Dani L. , Winget Marcy , Kerem Yaniv
Published: August 2022

Goal:

Occurrences of physician burnout have reached epidemic numbers, and the electronic health record (EHR) is a commonly cited cause of the distress. To enhance current understanding of the relationship between burnout and the EHR, we explored the connections between physicians' distress and the EHR.

Methods:

In this qualitative study, physicians and graduate medical trainees from two healthcare organizations in California were interviewed about EHR-related distressing events and the impact on their emotions and actions. We analyzed physician responses to identify themes regarding the negative impact of the EHR on physician experience and actions. EHR “distressing events” were categorized using the Accreditation Council for Graduate Medical Education (ACGME) Physician Professional Competencies.

Principal Findings:

Every participating physician reported EHR-related distress affecting professional activities. Five main themes emerged from our analysis: system blocks to patient care; poor implementation, design, and functionality of the EHR; billing priorities conflicting with ideal workflow and best-practice care; lack of efficiency; and poor teamwork function. When mapped to the ACGME competencies, physician distress frequently stemmed from situations where physicians prioritized systems-based practice above other desired professional actions and behaviors. Physicians also reported a climate of silence in which physicians would not share problems due to fear of retribution or lack of confidence that the problems would be addressed.

Practical Applications:

Physicians and administrators need to address the hierarchy of values that prioritizes system requirements such as those required by the EHR above physicians' other desired professional actions and behaviors. Balancing the importance of competing competencies may help to address rising burnout. We also recommend that administrators consider qualitative anonymous interviews as an effective method to uncover and understand physician distress in light of physicians' reported climate of silence.
Assessing Professional Fulfillment and Burnout Among CEOs and Other Healthcare Administrative Leaders in the United States
Authors: Shanafelt Tait , Trockel Mickey , Wang Hanhan , Mayer Thom , Athey Leslie
Published: August 2022

Goal:

The objective of this study was to evaluate the prevalence of burnout and professional fulfillment among healthcare administrative leaders and examine the association between burnout and professional fulfillment and personal and professional characteristics.

Methods:

Between June 7 and June 30, 2021, we performed a national survey of CEOs and other senior operational leaders to evaluate their personal work experience. Burnout and professional fulfillment—as well as a sleep-related impairment and self-valuation—were assessed using standardized instruments.

Principle Findings:

Of the 5,994 members of the American College of Healthcare Executives who were sent an invitation to participate, 1,269 (21.2%), including 279 CEOs, submitted usable responses. The mean overall burnout score was 2.71 (range: 0–10), and 33% of participants had burnout scores that fell in the high range (unfavorable). Mean professional fulfillment score was 7.29 (range: 0–10), with 56.6% scoring in the high range (favorable). Burnout and professional fulfillment scores varied by role. On multivariable analysis, sleep-related impairment (OR for each 1-point increase = 1.29, 95% CI [1.19–1.41]; p < .001) and self-valuation (OR for each 1-point increase = 0.63, 95% CI [0.57–0.68]; p < .001) were independently associated with burnout after adjusting for all other variables.

Applications to Practice:

Results of this study suggest that healthcare leaders had lower burnout and professional fulfillment scores than clinicians. Nonetheless, one-third of healthcare leaders had burnout scores that fell in the high range. At the individual level, sleep health and self-valuation appear to reduce risk of burnout and promote professional fulfillment.
Can malocclusion provide clinicians with information for differential diagnosis of temporomandibular joint diseases?: A review
Authors: Matsuda Shinpei , Yamaguchi Taihiko , Mikami Saki , Yoshimura Hitoshi , Gotouda Akihito
Published: August 2022

The aim of this literature review was to summarize the clinical characteristics and symptoms of temporomandibular joint diseases, and to discuss the associations between temporomandibular joint diseases and categorization of malocclusion. Electronic literature searches were performed using the PubMed database. The authors established a differential diagnostic method for temporomandibular joint diseases related to malocclusion. A literature search using PubMed yielded 213 texts, of which based on exclusion criteria, 28 were included in this study. Malocclusions were categorized into 5 types. The authors suggested a diagnostic tree of temporomandibular joint diseases based on the types of malocclusion and 4 variables in clinical characteristics and symptoms. Clinicians treating malocclusions must attempt to clarify the cause of the occlusal condition. If caused by temporomandibular joint disease, it is important to make a proper differential diagnosis at first, and not to overlook the causative disease. Further clinical knowledge of associations between temporomandibular joint diseases and malocclusions should be accumulated, and the diagnostic tree should be improved based on new information.
Identification and validation of miR-509-5p as a prognosticator for favorable survival in osteosarcoma
Authors: Guo Jiekun , Fang Xiang , Zhou Jun , Zeng LingGuo , Yu Bin
Published: August 2022

Osteosarcoma (OS) is the most common primary bone cancer diagnosed in children. This study aims to explore the aberrantly expressed miRNAs that are prognostically related and to provide potential biomarkers for the prognosis prediction of OS. The miRNA profiles of OS and adjacent normal controls were obtained from 2 gene expression omnibus cohorts (i.e., GSE28423 and GSE65071). GSE39058 and Therapeutically Applicable Research to Generate Effective Treatments cohorts, which respectively contained 91 and 85 OS samples with both miRNA expression and clinical characteristics, were employed to perform survival and multivariate Cox regression analyses. Lymphocyte infiltration abundance between distinct subgroups was evaluated with the CIBERSORT algorithm and a previously proposed method. Gene set enrichment analysis was used to infer the dysregulated signaling pathways within each subgroup. Of the 31 differentially expressed miRNAs, miR-509-5p (miR-509) was the most significantly prognostic miRNA in the GSE39058 cohort and its high expression was associated with the better OS prognosis (Log-rank P = .008). In the Therapeutically Applicable Research to Generate Effective Treatments validation cohort, the association of high miR-509 expression with favorable survival was also observed (Log-rank P = .014). The results remained still significant even adjusted for clinical confounding factors in multivariate Cox regression models. Further immunology analyses demonstrated that elevated infiltration of lymphocytes, decreased infiltration of immune-suppressive cells, and immune response-related pathways were significantly enriched in patients with miR-509 high expression. Our study suggests that miR-509 may serve as a potential biomarker for evaluating OS prognosis and provides clues for tailoring OS immunotherapy strategies.
Bone densitometry in children with idiopathic nephrotic syndrome on prolonged steroid therapy: A tertiary multicenter study
Authors: Soliman Ahmed S.A. , Abukhatwah Mohamed W. , Kamal Naglaa M. , Sweed Enas M.M. , Alelyani Abdullah M. , Althobaiti Sami D. , Alzaedi Mazen A , El-Rebigi Amany M. , Besher Nehad T. , Abukhatwah Omar M.W. , Alharbi Abdullah O. , Afifi Wesam E.
Published: August 2022

Long-term glucocorticoids administration inhibits bone mineralization and has a negative impact on basic cellular mechanisms that are critical in the development and maintenance of bone strength. Steroids can cause osteoporosis in children and have a negative impact on bone mineral content (BMC) and bone mineral density (BMD).

We aim to determine the BMD of children with idiopathic nephrotic syndrome (INS) who are on corticosteroids therapy.

This cross-sectional study included 90 patients on corticosteroids therapy and 50 apparently healthy age and sex-matched children served as a control group. Renal functions, bone biochemistry, and parathyroid hormone (PTH) were measured in patients and controls. BMD was measured at the lumbar spinal region (L2–L4) using Dual-energy X-ray absorptiometry (DEXA) scan in both patients and controls groups.

Serum PTH, phosphorous, and alkaline phosphatase levels were significantly higher in patients than in controls. There was a statistically significant reduction in blood calcium levels in patients compared to controls. Osteopenia was diagnosed by DEXA scan in 24 patients (26.7%) and osteoporosis in 12 patients (13.3 %). There was a statistically significant decline in BMD-z score, BMD, and BMC in patients compared to the healthy group.

Patients with INS on corticosteroids treatment have a lower BMD than their peers. Pediatric INS patients had a high prevalence of osteopenia and osteoporosis as measured by DEXA. Steroid therapy has a deleterious impact on bone mineralization in children with INS.
Assessing the general health, increase in mental and physical workload among administrative staff of the University of Nigeria due to the COVID-19 pandemic
Authors: Edikpa Edith C , Chigbu Baptista C. , Onu Amaka E , Ogakwu Veronica N. , Aneke Mary C. , Nwafor Bernadette N. , Diara Chinwe F. , Chibuko Honorius , Oguejiofor Chidumebi N. , Anigbogu Grace N. , Adepoju Esther B. , Igbokwe Chiawa I.
Published: August 2022

The coronavirus disease 2019 (COVID-19) pandemic has changed the global workloads and general well-being of employees, especially in the university system. The object of this study is to evaluate the mental health and effect of increase in workload on the general well-being of the administrative staff of the University of Nigeria, Nsukka, on the resumption of academic activities after the lockdown due to COVID-19. A total of 73 randomly selected administrative staff were involved in the study. Three sets of instruments, the demographic questionnaire, National Aeronautics and Space Administration-Task Load Index, and General Health Questionnaire, were used to obtain information on the demographic characteristics, workload, and level of mental disorder among the respondents due to COVID-19. The generalized linear regression model, 1-way analysis of variance, independent samples t test, and contingency coefficient were used to analyze the data. The results revealed that high workload is significantly associated with high risk of mental and general health disorders among the respondents. The married, divorced, widowed, older, and females staff with >2 children are the most vulnerable to mental disorder, physical workload, frustration, and general health challenges. The younger staff, those with at most 2 children, and those who are still single experience lower mental and general health disorder and are more resilient. Significant and comprehensive health and administrative support should be provided for the overall well-being of the staff.
Effect of COVID-19 on quality of life of persons aged >70 years with adult spinal deformity: A cross-sectional case-control study
Authors: Suárez-Huerta María Luz , Gomez-Rice Alejandro , Carvajal Alvarez Miguel , Vazquez Vecilla Iria Carla , Izquierdo-Nuñez Enrique , Fernandez-Gonzalez Manuel , Zuñiga-Gómez Lorenzo , Betegon-Nicolas Jesus , Sanchez-Campos Sonia
Published: August 2022

This observational, cross-sectional case-control study evaluates the impact of coronavirus disease 2019 (COVID-19) on health-related quality of life (HRQoL) in elderly persons who have undergone surgery for adult spinal deformity (ASD). On December 31, 2019, the Chinese authorities first reported severe acute respiratory syndrome coronavirus 2, and on March 11, 2020, it was declared a pandemic. The pandemic seems to have had a negative effect on elderly patients who underwent ASD, in terms of functional and psychological quality of life. We selected patients with ASD aged > 70 years who had undergone surgery between 2010 and 2015 and compared them with age- and sex-matched patients who did not have ASD. We recorded sociodemographic variables, type of surgery, levels of spinal fusion, HRQoL (Scoliosis Research Society-22, Short Form 12 Health Survey, EuroQol-5D [EQ-5], Geriatric Depression Scale [Yesavage] [GDS], Modified Frailty Index-11, and Barthel index), fear of visiting a health center, fear of leaving one’s house, and adherence to preventive measures. The study population comprised 174 patients (mean [standard deviation] age, 77.3 [5.9] years; 86% women), of whom 87 had undergone surgery for ASD. The incidence of COVID-19 was higher in patients aged > 85 years (P = .041), urban areas (P = .047), and in patients in long-term care (P = .03). Similarly, no differences were observed for the ability to cope with the pandemic (P > .05). Patients who underwent surgery also had a higher risk of depression (GDS, 6.7 [P = .02]), a lower EQ-5 score (P = .001), a higher body mass index (P = .004), greater consumption of drugs (P < .001), especially opiates (P < .001). Patients who underwent surgery constitute a vulnerable population during the COVID-19 pandemic, with poorer quality of life and had a much higher risk of depression. They are also polymedicated and prefrail, adhere well to COVID-19 preventive measures, and do not seem to fear visiting health centers.
Diagnosis and treatment of primary hyperparathyroidism with pathological fracture of the limbs: A retrospective observational study
Authors: Liu Huijiang , Luo Kai , Liao Shijie , Tang Haijun , Mo Jianming , Xie Tianyu , Li Chong , Li Boxiang , Liu Yun , Zhan Xinli
Published: August 2022

Primary hyperparathyroidism (PHPT) with pathological fracture is rare, and the early symptoms of PHPT lack specificity, leading to misdiagnosis. Therefore, this study aimed to summarize the clinical characteristics and treatment of PHPT patients with pathological fractures and to improve the attention of orthopedic clinicians to PHPT.

It is a retrospective study, 2226 patients with hyperparathyroidism in our hospital from 2009 to 2019 were screened, excluding secondary hyperparathyroidism and patients without limb fracture, and the remaining 20 patients with PHPT accompanied by pathological fractures were finally analyzed. Parathyroid hormone (PTH) and calcium levels were compared on the first postoperative day, and the prognosis of the patients was assessed by bone mineral density and Visual Analogue Scale scores at 3 and 12 months postoperatively.

The early symptoms of PHPT patients in this study included urinary calculi (80%), bone pain (30%), and digestive tract symptoms (25%). Fourteen (70%) cases were misdiagnosed at the initial diagnosis. After parathyroidectomy, the blood calcium and PTH levels decreased significantly in all patients (P < .05). For the treatment of fracture, 9 of the patients underwent surgical treatment of the fracture, while the remaining patients received splint external fixation. The follow-up time was 4.60 ± 0.62 years (1–10 years). All patients recovered well from the fracture, the symptoms of systemic bone pain were markedly improved, and bone mineral density was significantly improved after surgery.

Orthopedic surgeons need to avoid misdiagnosis and pay attention to the early symptoms in PHPT patients with pathological fracture, and better therapeutic effects can be obtained by combining parathyroidectomy with fractures fixation.
Analysis of the impact of noninvasive prenatal testing for trisomies 21 and 18 in twin pregnancies undergoing artificial reproductive technology
Authors: Yang Cuiyu , Hu Linhua , Jiang Shudan , Liang Fengbing , Zhang Songying
Published: August 2022

Purpose:

The purpose of this study was to evaluate the performance and impact of noninvasive prenatal screening (NIPS) on twin pregnancies.

Patients and methods:

Twin pregnancies after artificial reproductive technology(ART) were tested by NIPS for screening trisomy 21, 18, and 13 in a single medical center in Hangzhou. Positive NIPS results were confirmed by karyotyping, while negative results were interviewed after delivery.

Results:

From January 2019 to December 2020, 474 twin pregnancies were tested by NIPS for screening trisomy 21, 18, and 13 in a single medical center in Hangzhou. The performance of NIPS had been evaluated compared to the invasive diagnostic results. The positive predictive value (PPV) of NIPS for chromosome 21 and 18 aneuploidies is 80% (95CI, 36.09–96.59) and 100%, respectively. The incidence of trisomy 21, and 18 chromosome aneuploidies among the twin pregnancies undergoing ART was 0.84% and 0.21%, respectively.

Conclusion:

The performance of NIPS was substantially accurate among the twin pregnancies after ART in this study, and NIPS potentially avoided a considerable part of aneuploidies liveborn in twin pregnancies in Hangzhou.
Comparison of video-stylet and conventional laryngoscope for endotracheal intubation in adults with cervical spine immobilization: A PRISMA-compliant meta-analysis
Authors: Chen I-Wen , Li Yu-Yu , Hung Kuo-Chuan , Chang Ying-Jen , Chen Jen-Yin , Lin Ming-Chung , Wang Kuei-Fen , Lin Chien-Ming , Huang Ping-Wen , Sun Cheuk-Kwan
Published: August 2022

Background:

Although minimization of cervical spine motion by using a neck collar or manual in-line stabilization is recommended for urgent tracheal intubation (TI) in patients with known or suspected cervical spine injury (CSI), it may worsen glottic visualization. The overall performance of video-stylets during TI in patients with neck immobilization remains unclear. The current meta-analysis aimed at comparing the intubation outcomes of different video-stylets with those of conventional laryngoscopes in patients with cervical immobilization.

Method:

The databases of Embase, Medline, and the Cochrane Central Register of Controlled Trials were searched from inception to June 2021 to identify trials comparing intubation outcomes between video-stylets and conventional laryngoscopes. The primary outcome was first-pass success rate, while secondary outcomes included overall success rate, time to intubation, the risk of intubation-associated sore throat, or tissue damage.

Results:

Five randomized controlled trials published between 2007 and 2013 involving 487 participants, all in an operating room setting, were analyzed. The video-stylets investigated included Bonfils intubation fiberscope, Levitan FPS Scope, and Shikani optical stylet. There was no difference in first-pass success rate (risk ratio [RR] =1.08, 95% confidence interval [CI]: 0.89–1.31, P = .46], overall success rate (RR = 1.06, 95% CI: 0.93–1.22, P = .4), intubation time [mean difference = 4.53 seconds, 95% CI: –8.45 to 17.51, P = .49), and risk of tissue damage (RR = 0.46, 95% CI: 0.16–1.3, P = .14) between the 2 groups. The risk of sore throat was lower with video-stylets compared to that with laryngoscopes (RR = 0.45, 95% CI: 0.23–0.9, P = .02).

Conclusion:

Our results did not support the use of video-stylets as the first choice for patients with neck immobilization. Further studies are required to verify the efficacy of video-stylets in the nonoperating room setting.
Role of noncoding RNAs and untranslated regions in cancer: A review
Authors: Zhang Yiping , Yang Meiwen , Yang Shulong , Hong Fenfang
Published: August 2022

Cancer is one of the most prevalent diseases worldwide, and poses a threat to human health. Noncoding RNAs (ncRNAs) constitute most transcripts, but they cannot be translated into proteins. Studies have shown that ncRNAs can act as tumor suppressors or oncogenes. This review describes the role of several ncRNAs in various cancers, including microRNAs (miRNAs) such as the miR-34 family, let-7, miR-17-92 cluster, miR-210, and long noncoding RNAs (lncRNAs) such as HOX transcript antisense intergenic RNA (HOTAIR), Metastasis associated lung adenocarcinoma transcript 1 (MALAT1), H19, NF-κB-interacting lncRNA (NKILA), as well as circular RNAs (circRNAs) and untranslated regions (UTRs), highlighting their effects on cancer growth, invasion, metastasis, angiogenesis, and apoptosis. They function as tumor suppressors or oncogenes that interfere with different axes and pathways, including p53 and IL-6, which are involved in the progression of cancer. The characteristic expression of some ncRNAs in cancer also allows them to be used as biomarkers for early diagnosis and therapeutic candidates. There is a complex network of interactions between ncRNAs, with some lncRNAs and circRNAs acting as competitive endogenous RNAs (ceRNAs) to decoy miRNAs and repress their expression. The ceRNA network is a part of the ncRNA network and numerous ncRNAs work as nodes or hubs in the network, and disruption of their interactions can cause cancer development. Therefore, the balance and stabilization of this network are important for cancer diagnosis and treatment.
The efficacy and safety of oxycodone in treating the uterine contraction pain after negative pressure aspiration: A randomized, compared, multicenter clinical study
Authors: Wang Yi-Nan , Xu Ming-Jun , Feng Ying , Chen Xin-Zhong , Yao Fei , Shen Ming-Kun , Zou Lu-Wen , Feng Hua , Zhao Lei , Xu Jian-Guo
Published: August 2022

This study aims to evaluate the efficacy and safety of oxycodone hydrochloride in treating postoperative uterine contraction pain in dysmenorrhea patients undergoing negative pressure aspiration.

This study is a multicenter randomized controlled clinical trial. Two hundred patients with history of moderate or severe dysmenorrhea for negative pressure aspiration were divided into 4 groups evenly (n = 50): the control group (group P, isotonic saline), the low-dose oxycodone group (group O1), the medium-dose oxycodone group (group O2), and the high-dose oxycodone group (group O3). All the 4 groups were followed by slow (45–60 seconds) static push of propofol until eyelash reflex disappeared (a maximum dose of 2.5 mg/kg). Additional propofol (0.6–1 mg/kg) was added if body movement occurred during operation.

The postoperative VAS scores in different groups showed that there was no statistical difference between groups P and O1, while there were statistical differences when groups O2 and O3 were compared with group P (P < .01), and when group O3 compared with O1 (P < .01). Furthermore, there was no significant differences in HR and BP among the 4 groups, but the intraoperative respiratory frequency in groups O1, O2, and O3 was significantly higher than in group P (P < .01). The SPO2 after operation in groups O2 and O3 was higher than in group P (P < .05). There was a significant difference in the VAS ≥ 4 between group O2 or O3 and Group P (P < .01). The incidence of respiratory depression in P group was significantly higher than in O1, O2, and O3 groups (P < .01). The dilatation time and the number of dilatation bar used in group O3 is lower than that of group P and group O1 (P < .01). The difficulty of dilatation in group P was 26% as assessed by clinicians, with significant differences with groups O1, O2, and O3 (P < .01).

Conclusion:

Oxycodone hydrochloride injection could be safely and effectively applied to negative pressure aspiration, and a 0.08 mg/kg dose could significantly reduce postoperative uterine contraction pain of patients with dysmenorrhea.
PAK4 expression is associated with the prognosis in non-small cell lung cancer
Authors: Li Chenghui , Ji Dongdong , Duan Aixiong , Jiang Qian
Published: August 2022

This study attempted to determine the expression of p21-activated kinase 4 (PAK4) in non-small cell lung cancer (NSCLC) tissues and the normal lung tissues. The correlation between PAK4 expression and prognosis of NSCLC patients was also evaluated in the present study. The expression level of PAK4 was measured by high-performance liquid chromatography method. Chi-square test was adopted to explore the relationship of PAK4 expression and clinical features. Kaplan-Meier survival curves were plotted to delineate the overall survival rate of NSCLC patients. Cox regression analysis was performed to evaluate the prognostic significance of PAK4 expression in NSCLC. The PAK4 expression in NSCLC tissue samples was significantly higher than that in normal lung tissues (P<0.001) and shared significant correlation with Eastern Cooperative Oncology Group score, histological type, and distant metastasis (P<0.05). Survival curve revealed that NSCLC patients with high PAK4 expression had relatively higher mortality than those with low PAK4 expression (P = .001). Cox regression analysis explained that PAK4 expression was associated with the prognosis of NSCLC patients (P = .024; HR, 3.104; 95% CI, 1.164–8.278). In a word, PAK4 was highly expressed in NSCLC tissues and could act as a prognostic factor for NSCLC patients.
Monocyte to high-density lipoprotein ratio predict long-term clinical outcomes in patients with coronary heart disease: A meta-analysis of 9 studies
Authors: Liu Hong-Tao , Jiang Zhong-Hui , Yang Zhong-Bin , Quan Xiao-Qing
Published: August 2022

Background:

A novel inflammation-related biomarker, the monocyte to high-density lipoprotein cholesterol ratio (MHR), had a great relation to the development and prognosis of coronary atherosclerotic heart disease. Current study was to investigate whether the MHR was a potential tool in predicting the mortality and major adverse cardiac events (MACEs) in patients suffering coronary heart disease (CHD) by meta-analysis.

Methods:

The Cochrane Library, PubMed, MEDLINE, Scopus, EMBASE, and Web of science were searched for relevant cohort studies published prior to February 10, 2022. The association between MHR and mortality/MACEs was analyzed in patients with CHD. Hazard ratios (HR) with 95% confidence interval (CI) were calculated to estimate the strength of association.

Results:

In the meta-analysis, a total of 9 studies of 11,345 patients with CHD were included. Compared with the low level of MHR group, the high MHR value was associated with higher long-term MACEs (HR = 1.72 95% CI 1.36–2.18, P < .001), long-term mortality (HR = 1.71, 95% CI 1.10–2.66, P = .017), and in-hospital mortality/MACEs (HR = 2.82, 95% CI = 1.07–7.41, P = .036).

Conclusions:

This study suggested that increased MHR value might be associated with higher long-term mortality and long-term MACEs in CHD patients. MHR might serve as a potential prognostic indicator for risk stratification in patients with CHD.
A cavernous hemangioma of infundibulopelvic vessels presenting as an adnexal tumor: A rare case report and literature review
Authors: Ma Hongwei , Tang Huiyun , Chen Qian , Zheng Wen , Tan Xin
Published: August 2022

Rationale:

Female reproductive organ angiomas are rarely reported and are accidentally found during surgery. Angiomas arising from infundibulopelvic vessels presenting as adnexal masses are even rarer, and a few doctors have experience in their management.

Patient’s main concerns and important clinical findings:

Herein, we report the case of a 40-year-old woman who was admitted after a physical examination revealed an ovarian mass. The physical examination revealed a palpable adnexal mass in the right pelvic cavity. Ultrasound showed a 4.5 × 4.0 × 5.0 cm space-occupying lesion close to the right ovary, which had many echogenic lines and calcifications in its cystic cavity.

Primary diagnosis:

Right adnexal mass.

Interventions:

Laparoscopic surgery was performed in all the patients. During the surgery, the mass was found to be a retroperitoneal hemangioma with distorted and dilated vessels. We separated the right infundibulopelvic vessels and performed tumor resection with minimal blood loss.

Outcomes:

The patient recovered well, and no abnormalities were observed during the following 2 years. Pathological results showed that this adnexal mass was a type of cavernous hemangioma arising from the infundibulopelvic vessels.

Lessons:

Surgical removal of the affected tissues is an aggressive treatment of choice for cavernous hemangiomas. Laparoscopic resection of infundibulopelvic hemangioma is feasible, and gynecologists are qualified for this operation, as long as damage to the iliac vessels is avoided.