bluuebunny/crossref_metadata_2025 huggingface dataset:
Decisive evidence corroborates a null relationship between MTHFR C677T and chronic kidney disease
Authors: Chang Hsueh-Lu , Chen Guei-Rung , Hsiao Po-Jen , Chiu Chih-Chien , Tai Ming-Cheng , Kao Chung-Cheng , Tsai Dung-Jang , Su Hao , Chen Yu-Hsuan , Chen Wei-Teing , Su Sui-Lung
Published: July 2020

Background:

Previous meta-analyses have explored the association between the C677T polymorphism ofmethyltetrahydrofolate reductase(MTHFR)and chronic kidney disease (CKD) but there were no studies with a decisive conclusion. Furthermore, the high heterogeneity among different populations is not yet interpreted.

Objectives:

This study used trial sequential analysis (TSA) to evaluate whether the nowadays conclusion supported by current cumulative samples. We also applied case-weighted meta-regression to explore the potential gene–environment interactions.

Methods:

For the first stage of this study we conducted a case–control study involving 847 dialysis patients from 7 hemodialysis centers in Taipei during 2015 to 2018 and 755 normal controls from a health center in the Tri-Service General Hospital. The second stage combined the results from the first stage with previous studies. The previous studies were collected from PubMed, EMBASE, and Web of Science databases before January 2018.

Results:

From the case–control study, the T allele ofMTHFRC677T appeared to have a protective effect on end-stage renal disease compared with the C allele [odds ratio (OR): 0.80, 95% CI (confidence interval) = 0.69–0.93]. However, the meta-analysis contradicted the results in Asian (OR = 1.12, 95% CI = 0.96–1.30). The same analysis was also applied in Caucasian and presented similar results from Asian (OR = 1.18, 95% CI = 0.98–1.42). The TSA showed our case–control study to be the decisive sample leading to a null association among Asian population. The high heterogeneity (I2 = 75%) could explain the contradictory results between the case–control study and the meta-analysis. However, further case-weighted meta-regression did not find any significant interaction between measured factors andMTHFRC677T on CKD.

Conclusions:

High heterogeneities were found in both Caucasian and Asian, which caused the null relationship in meta-analysis while there were significant effects in individual studies. Future studies should further explore the high heterogeneity that might be hidden in unmeasured gene–environment interactions, to explain the diverse findings among different populations.
Outcome of lumbar lateral recess stenosis with percutaneous endoscopic transforaminal decompression in patients 65 years of age or older and in younger patients
Authors: Li Xiaoxiang , Liu Tao , Fan Junjun , Zhang Hongtao , Yang Chunbao , Yin Xin , Gao Haoran , Qian Jixian , Sun Siguo
Published: July 2020

Lateral recess stenosis is a common pathology causing clinical syndromes in the elderly population, and there is some concern regarding the number of comorbidities that can occur when performing surgery for this condition in the elderly. However, little research has focused on the issues related to older age, and limited data is available to help the clinician counsel elderly patients undergoing percutaneous endoscopic transforaminal decompression. The present study aimed to explore the safety and efficacy of percutaneous endoscopic transforaminal decompression for lumbar degenerative disease in elderly patients with lumbar lateral recess stenosis and to determine whether age and comorbidity affect the outcome and complication rate.

We identified 117 patients in our patient database who underwent percutaneous endoscopic transforaminal decompression for single-level lumbar lateral recess stenosis. Data regarding the Oswestry Disability Index and visual analog scale for back and leg pain were collected preoperatively, postoperatively, and at the last follow-up. Other data, including preoperative comorbidities, operation time, and intraoperative and postoperative complications, were recorded.

The average follow-up period was 29.9 ± 5.5 months, with a mean age of 69.8 ± 5.4 years in elderly patients (group A) and 50.4 ± 6.4 years in younger patients (group B). Group A had a higher percentage of comorbidity than group B (83.9% vs 18.0%, P < .001). Both visual analog scale scores for leg pain and Oswestry Disability Index were significantly improved in the 2 groups, and no difference was found between the groups regarding both parameters (P >.05). The elderly patients had the same high rate of favorable outcomes as group B (P > .05). Moreover, there was no difference in surgical complications, recurrence, and neurologic deficit recovery rate between both groups. No major complications or perioperative deaths occurred in both groups.

The present study demonstrates that percutaneous endoscopic transforaminal decompression for lateral recess stenosis in elderly patients may be a reasonable treatment associated with substantial benefit.
The effect of dexmedetomidine and remifentanil on the postoperative sore throat after thyroidectomy
Authors: Kim Hyuckgoo , Kwon Hyojin , Jeon Sungmin , Choi Eun Kyung
Published: July 2020

Background:

Postoperative sore throat (POST) is an important concern in surgical patients undergoing endotracheal intubation. Its prevalence after thyroidectomy is up to 80%. The current study aimed to assess the effect of dexmedetomidine and remifentanil on postoperative sore throat.

Methods:

Seventy-four patients who underwent thyroidectomy were randomized to receive either dexmedetomidine (group D) or remifentanil (group R). At anesthesia induction, group D received dexmedetomidine 1 μg/kg over 10 minutes, followed by continuous dexmedetomidine infusion at 0.3 to 0.6 μg/kg/hour during surgery. Group R received remifentanil of 3 to 4 ng/ml during induction, followed by 1.5 to 2.5 ng/ml remifentanil infusion during surgery. POST at rest and swallowing was assessed during the first 24 hours in serial time periods (0–1, 1–6, and 6–24 hours). Hoarseness and postoperative pain score were also assessed.

Results:

POST incidence at rest (0–1, 1–6, and 6–24 hours) and swallowing (1–6 and 6–24 hours) was lower in group D than in group R. POST severity was significantly lower in group D than in group R during each time period. The incidence of postoperative hoarseness was also lower in group D than in group R at 1 to 6 and 6 to 24 hours. The postoperative pain score was lower in group D than in group R during each time period.

Conclusion:

Intraoperative dexmedetomidine infusion reduced the incidence and severity of POST for 24 hours after thyroidectomy.
Acupotomy for third lumbar vertebrae transverse process syndrome
Authors: Jiao Lin , Xiao Yuanyi , Chi Zhenhai , Zhu Daocheng , Ouyang Xilin , Xu Wei , You Jianyu , Luo Zhaona , Yuan Fuqiang
Published: July 2020

Background:

Acupotomy has been widely used clinically to relieve low back pain. However, the efficacy of acupotomy for the third lumbar vertebrae transverse process syndrome is still uncertain. The aim of this study is to determine the effectiveness and safety of acupotomy therapy for the third lumbar vertebrae transverse process syndrome.

Methods:

Relevant randomized controlled trials will be searched from the databases of PubMed, the Cochrane Library, Embase, the China National Knowledge Infrastructure, Wanfang Database, Chinese Science and Technology Periodical Database, and Chinese Biomedical Literature Database from their inception to May 2020. Two reviewers will independently select studies, collect data, and assess the methodology quality by the Cochrane risk of bias tool. The RevMan V.5.3 will be used for meta-analysis.

Results:

This study will provide an assessment of the current state of acupotomy for the third lumbar vertebrae transverse process syndrome, aiming to show the efficacy and safety of acupotomy treatment.

Conclusion:

This study will provide evidence to judge whether acupotomy is an effective intervention for the third lumbar vertebrae transverse process syndrome.

PROSPERO registration number:

CRD42019134945.
Simulation-based training and assessment of mobile pre-hospital SARS-CoV-2 diagnostic teams in Styria, Austria
Authors: Mileder Lukas P. , Schüttengruber Gerhilde , Prattes Jürgen , Wegscheider Thomas
Published: July 2020

The World Health Organization has declared coronavirus disease 2019 (COVID-19) a pandemic. Polymerase chain reaction testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the diagnostic gold standard of COVID-19. We have developed a simulation-based training program for mobile prehospital diagnostic teams in the province of Styria, Austria, and performed a prospective observational study on its applicability and effectivity.

The 1-day curriculum uses theoretical instruction, technical skills training, and simulator-based algorithm training to teach and train prehospital patient identification and communication, donning the personal protective equipment, collection of naso-/oropharyngeal swabs for SARS-CoV-2 polymerase chain reaction testing, doffing the personal protective equipment, and sample logistics. Trainings were conducted at the SIM CAMPUS simulation hospital, Eisenerz, using high-fidelity patient simulation. To ensure achievement of predefined learning outcomes, participants had to undergo a final simulator-based objective structured clinical examination.

In March 2020, 45 emergency medical assistants and 1 physician of the Austrian Red Cross participated on a voluntary basis. Forty-five of the 46 participants (97.8%) completed the curriculum successfully, with mean objective structured clinical examination ratings of 98.6%.

Using several proven educational concepts, we have successfully drafted and implemented a training program for mobile prehospital SARS-CoV-2 diagnostic teams. Based on simulation-based objective structured examinations, it has prepared participants effectively for preclinical duties.
Prevalence and factors of compassion fatigue among Chinese psychiatric nurses
Authors: Xie Wanqing , Wang Jialin , Okoli Chizimuzo T. C. , He Huijuan , Feng Fen , Zhuang Linli , Tang Ping , Zeng Li , Jin Man
Published: July 2020

Compassion fatigue has emerged as a detrimental consequence of experiencing work-related stress among psychiatric nurses, and affected the job performance, emotional and physical health of psychiatric nurses. However, researches on Chinese psychiatric nurses’ compassion fatigue are dearth. This cross-sectional study aimed to investigate the prevalence and factors of compassion fatigue among Chinese psychiatric nurses.

All participants completed the demographic questionnaire and the Chinese version of Professional Quality of Life Scale (ProQOL-CN). One-way ANOVA, t-tests, Levene test and multiple linear regression analysis were conducted to evaluate factors associated with compassion fatigue.

A total of 352 psychiatric nurses in 9 psychiatric hospitals from the Chengdu, Wuhan, and Hefei were surveyed. The mean scores of compassion satisfaction, burnout and secondary traumatic stress were 32.59 ± 7.124, 26.92 ± 6.003 and 25.97 ± 5.365, respectively. Four variables of job satisfaction, exercise, had children, and age range from 36 to 50 years explained 30.7% of the variance in compassion satisfaction. Job satisfaction, sleeping quality, and marital status accounted for 40.4% variables in burnout. Furthermore, job satisfaction, average sleeping quality, and years of nursing experience remained significantly associated with secondary trauma stress, explaining 10.9% of the variance.

Compassion satisfaction, burnout and secondary traumatic stress among Chinese psychiatric nurses were at the level of moderate. The higher job satisfaction, healthy lifestyle (high sleep quality and regular exercise), and family support (children, stable and harmonious marital status) positively influenced compassion satisfaction and negatively associated with burnout or secondary traumatic stress.
Moxibustion for the side effects of surgical therapy and chemotherapy in patients with gastric cancer
Authors: Li Shuqing , Chen Jianrong , Wang Yanping , Zhou Xu , Zhu Weifeng
Published: July 2020

Background:

Side effects after surgical therapy and chemotherapy of gastric cancer substantially reduce patients’ quality of life. This systematic review aims to investigate whether moxibustion, as a complementary treatment, is effective in alleviating side effects in patients with gastric cancer who underwent surgical therapy or chemotherapy.

Methods:

We will systematically search nine English and Chinese electronic databases to find relevant randomized controlled trials (RCTs) that compare basic treatment with and without moxibustion for treating the side effects induced by surgical therapy or chemotherapy in patients with gastric cancer. The time frame of the search will be from inception to July 1, 2020, and the publication language will not be limited. The literature screening and data extraction will be completed independently by 2 reviewers. The Cochrane risk of bias tool will be used to assess the risk of bias. For the analyses of the side effects of both surgical therapy and chemotherapy, the primary outcomes are defined as the incidence of any side effect, response rate, and quality of life. For the analyses of the side effects of surgical therapy, the secondary outcomes include the incidence of each individual side effect, time to first flatus/defecation/bowel sounds, and length of in-hospital stay. For the analysis of the side effects of chemotherapy, the secondary outcomes include incidence of each individual side effect, white blood cell/red blood cell/platelets counts, and hemoglobin level. R v3.6.2 software will be used to perform the meta-analyses. The quality of evidence will be classified using the Grading of Recommendations Assessment, Development and Evaluation system.

Results:

This study will provide the first systematic review evidence on the efficacy of moxibustion as adjuvant management for gastric cancer by rigorous quality assessment and appropriate data synthesis. The results will be submitted to a peer-reviewed journal for publication.

Conclusion:

The findings of this study will provide currently best evidence on moxibustion for patients with gastric cancer who underwent surgical therapy or chemotherapy and may impact clinical practice.

PROSPERO registration number: CRD42020169511
Injury of photoreceptors and retinal pigment epithelium in macular area of a preterm infant
Authors: Sun Xiantao , Liu Ting , Sun Shuang , Lu Yuebing , Wang Fei , Xie Yuanchun , Li Guanfeng , Wang Hui , Jiang Yu , Huang Yunyun
Published: July 2020

Rational:

Injury of photoreceptors and retinal pigment epithelium (RPE) in macular area of premature infants is very rare.

Patient concerns:

A preterm infant delivered under general anesthesia. The infant was born at 28 weeks’ and 4 days’ gestation, with a birth weight of 1.15 kg and a treatment of oxygen inhalation after birth. According to the related protocol formulated by the Ophthalmology Branch of the Chinese Medical Association in 2014, the infant was regularly checked in our hospital.

Diagnosis:

Optical coherence tomography (OCT) examination showed injuries of the photoreceptors and RPE in macular area.

Interventions:

The fundus screening at 40 weeks’ and 4 days’ gestation (corrected gestational age) showed retinopathy of prematurity in bilateral eyes, with round yellow-white lesions at the macular area of right eye and sub-temporal macular area. OCT examination showed interrupted signals in the external limiting membrane (ELM), inner segment of the photoreceptors (IS)/outer segment of the photoreceptors (OS) layer, interdigitation zone (IZ), and RPE of the central fovea of macula of the right eye, with the area of defect of approximately 184 μm. Enhanced signal reflection was found under the defect area. Interrupted signals were also found in the IS/OS layer of the central fovea of macula of the left eye, with the area of defect of approximately 222 μm. Fundus fluorescence angiography (FFA) examination showed transmitted fluorescence at the macular area of the right eye and sub-temporal macular area of the left eye, suggesting retinopathy of prematurity in bilateral eyes.

Outcomes:

Several factors, such as photic damage, eye injuries, hyperpyrexia, and underlying diseases, could cause macular retinal injuries. However, the baby had not received any radiation from high energy intense light sources, and had no history of hyperpyrexia or trauma. Fundamental screening was performed 1 year and 4 months of age and no obvious change was found in the round yellow-white lesions of the eyes compared with that in earlier stages. We have contacted with the patient for the follow-up OCT and FFA examinations a month later to check the possible structural changes of the macular area.

Lessons:

The retina of a preterm infant is underdeveloped, we speculated that the bilateral retinal injuries in this baby could be caused by various factors.
Therapeutic effects of acupuncture on sensory ataxia after a cerebral hemorrhage
Authors: Lu Kuan-Yu , Yuen Ka-Fai , Luo Jia-Yuan , Hong Chang-Zern , Chou Li-Wei
Published: July 2020

Introduction:

Sensory ataxia is a dysfunction of dynamic balance due to impairment of sensory input into the control of movement. The sequelae of stroke, such as hemiplegia, somatosensory impairment, and impaired balance may cause significant disability and may affect patients’ quality of life. In addition to rehabilitation programs, acupuncture therapy has been applied to stroke patients and is recommended as a complementary therapy in stroke rehabilitation.

Patient concerns:

A 70-year-old male had a sudden onset of conscious loss. The brain computed tomography showed intracerebral hemorrhage with subdural hemorrhage and subarachnoid hemorrhage.

Diagnosis:

Intracerebral hemorrhagic stroke was diagnosed.

Interventions:

He received craniotomy with hematoma evacuation immediately and waked up 3 weeks with bilateral hemiparesis (right side weaker than left), impaired position sensation and tactile perception in the right lower limb. He then began to receive rehabilitation therapy and had significant improvement in muscle strength and static balance, but no improvement in tactile perception of position sense in the right lower limbs and reached plateau. Then he received acupuncture therapies to Yongquan (KI1), Tongtien (BL7) and Houxi (SI3).

Outcomes:

The patient's walking ability recovered after receiving rehabilitation programs for 3 years, but the impairment in proprioception and dynamic balance persisted. The perception and dynamic balance had significantly improved after patient received acupuncture therapy, especially the acupuncture point of Yongquan (KI1).

Conclusion:

The clinical effect of acupuncture in combination with conventional rehabilitation therapy for neurological impairment recovery, improving activity of daily living performance and improving post-stroke imbalance was explored. We hope that this report can facilitate further well controlled quantitative objective studies on a big size of samples.
Iron deficiency is a possible risk factor causing right heart failure in Tibetan children living in high altitude area
Authors: Yu Jiayun , Yu Li , Li Yifei , Hu Fan
Published: July 2020

The aim of the study is to discuss the risk factor of right heart failure (RHF) especially the association of iron deficiency with RHF in Tibetan children who live in high altitude area. In this retrospective study, we collected the data of Tibetan children from January 2011 to December 2018 in our hospital. The patients included in the study had the following data: age, gender, ferritin, echocardiography, hemoglobin, C-reaction protein, and altitude of residence. According to whether RHF was diagnosed, the patients were divided into RHF group and non-RHF group. Totally 133 patients were included with 59 in RHF group and 74 in non-RHF group. In single factor analysis, age (P = .008), altitude of residence (P < .001), ferritin (P < .001), and pulmonary arterial systolic pressure (P < .001) showed significant difference between the 2 groups. Binary logistic regression was performed to further identify the association of the clinical factors with RHF. Higher pulmonary arterial systolic pressure (odds ratio: 29.303, 95% confidence interval: 5.249–163.589, P < .001) and lower ferritin level (odds ratio: 5.849, 95% confidence interval: 1.585–21.593, P = .008) were independent risk factors associated with RHF. In receiver-operating characteristic curve, the optimal cutoff value of ferritin level was 14.6 μg/L with the sensitivity of 81.4% and specificity of 89.2%. As continuous variable, the correlation between ferritin and RHF was not certain (P = .281). Due to the possibility that iron deficiency be a risk factor of RHF in Tibetan children, prevention and treatment of iron deficiency might be a potential way in reducing the incidence of RHF in this high altitude area.
C-reactive protein testing to guide antibiotic prescribing for COPD exacerbations
Authors: An Xing , Zhang Chuantao , Weng Xiangwen , Xiao Wei , Sun Zengtao , Zeng Zhu , Huang Qingsong
Published: July 2020

Background:

The use of antibiotics in the acute exacerbations of chronic obstructive pulmonary disease (COPD) remains controversial. Serum C-reactive protein (CRP), a sensitive biomarker for systemic inflammation and tissue damage, is a good indicator of lower respiratory tract bacterial infection. However, due to the small sample size of the existing studies, the clinical value of CRP in guiding the use of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) antibiotics is insufficient. The aim of this study was to evaluate the value of CRP-guided treatment strategies for AECOPD patients.

Methods:

This review summarizes and meta-analyses randomized controlled trials (RCTs) of CRP guiding antibiotic prescribing for COPD exacerbations. RCTs compare either usual-care or the GOLD strategy have been included. The following electronic databases have been searched: PubMed, Cochrane Library, Embase, CNKI, CBM, VIP, and Wanfang Data. The methodologic quality of RCTs has been assessed using the Cochrane risk assessment tool. All trials included are analyzed according to the criteria of the Cochrane Handbook. Review Manager 5.3, R-3.5.1 software, and GRADE pro GDT web solution are used for data synthesis and analysis.

Results:

This review evaluates the effects of CRP testing on the antibiotic use, CCQ, EQ-5D utility scores and adverse events in patients with COPD exacerbations.

Conclusion:

This review provides clear evidence that CRP testing can reduce the use of antibiotics in patients with AECOPD without causing harm.
Low-level light therapy using a helmet-type device for the treatment of androgenetic alopecia
Authors: Yoon Jung Soo , Ku Won Young , Lee Jang Hyun , Ahn Hee Chang
Published: July 2020

Introduction

Androgenetic alopecia is the most common form of hair loss in both sexes. In recent studies, low-level light therapy (LLLT) has been established as an effective treatment for alopecia. The purpose of this study was to evaluate the safety and efficacy of LLLT using a new helmet-type device for the treatment of androgenetic alopecia.

Method

A randomized, sham device-controlled, double-blind clinical trial was conducted at 2 institutions. Sixty participants diagnosed with androgenetic alopecia aged from 19 to 65 years were recruited. LLLT was performed through a helmet-type device that emitted light with a mean output power of 2.36 mW/cm2 at a wavelength of 655 nm. Participants were divided into 2 groups, which respectively used the experimental device and a sham device. After tattooing at the central point of the vertex, phototrichograms at that point were obtained at 0, 8, and 16 weeks. The primary endpoint of the study was the difference in the rate of change of hair density between the test group and the control group.

Results

Comparing the results at baseline and week 16, the experimental group showed an increase in hair density of 41.90 hairs/cm2 and an increase in hair thickness of 7.50 μm, whereas the control group showed an increase of 0.72 hairs/cm2 and a decrease of 15.03 μm, respectively (P < .001). No adverse events or side effects occurred.

Conclusion

LLLT showed a significant effect on increasing hair density in patients with androgenetic alopecia. LLLT could be a safe and effective treatment for androgenetic alopecia in both sexes.
Intranasal glial heterotopia in a male infant
Authors: Zhang Wei , Tang Lixing , Wang Pengpeng , Ge Wentong , Ni Xin
Published: July 2020

Rationale:

Nasal glial heterotopia is a rare type of neoplasm consisting of meningothelial and/or neuroglial elements.

Patient concerns:

A 2-month-old male was evaluated for treatment of a congenital mass in the right nasal cavity near the pharynx.

Diagnoses:

The patient was preoperatively diagnosed with a congenital intranasal neoplasm.

Interventions:

Nasal endoscopic resection of the nasopharyngeal mass was performed under general anesthesia. Histological examination of the resected tissue provided a diagnosis of intranasal glial heterotopia.

Outcomes:

The surgical outcome was good, with no surgical site infection. After 1 year of follow-up, the boy was asymptomatic with no recurrence.

Lessons:

Excision of a nasopharyngeal mass via nasal endoscopy resulted in no recurrence during 1 year of follow-up. Before any surgical treatment for suspected glial heterotopia, the mass should be differentiated clinically and radiologically from an encephalocele to prevent the risk of cerebrospinal fluid leakage and meningitis.
68Ga-NEB PET/CT can be a new method for diagnosing chylous fistula
Authors: Peng Li , Zhao Jialin , Mao Feng , Sun Qiang
Published: July 2020

Rationale:

We hypothesize that with the determination of lymph fistula location 3-dimensionally, application of appropriate pressure would promote fistula healing, and a secondary surgery may be avoided. 68Ga-labeled 1,4,7-triazacyclononane-N, N’, N”-triacetic acid (NOTA) conjugated with truncated Evan blue (NEB) forms a complex with serum albumin in the interstitial fluid after it is locally injected and allows rapid visualization of the lymphatic system.

Patient concerns:

A 44-year-old woman had a chief complaint of left nipple discharge. A 38-year-old woman came to the hospital after sensing a right breast mass.

Diagnoses:

The 2 patients were diagnosed with chylous fistula after breast cancer surgery based on the findings of a novel method, 68Ga-NOTA-Evans Blue (NEB) positron emission tomography/computed tomography.

Interventions:

We successfully obtained clear images to locate the fistula using 68Ga-NEB positron emission tomography/computed tomography (PET/CT) for both patients. The lymphatic vessels and lymph nodes could be clearly visualized owing to the 68Ga-NEB activity during PET/CT.

Outcomes:

Three-dimensional positioning to locate the fistula could direct the application of the pressure dressing and reduce drainage markedly.

Lessons:

68Ga-NEB PET/CT may be a new method for diagnosing chylous fistula and providing guidance for treatment.
Lefamulin vs moxifloxacin for community-acquired bacterial pneumonia
Authors: Tang Hung-Jen , Wang Jui-Hsiang , Lai Chih-Cheng
Published: July 2020

Lefamulin is a novel pleuromutilin antibiotic with potent in vitro activity against key community-acquired bacterial pneumonia (CABP) pathogens. However, the clinical efficacy and safety of lefamulin for treating CABP remains unclear.

An integrated analysis of 2 phase III trials investigating the clinical efficacy and safety of lefamulin vs moxifloxacin in the treatment of CABP was conducted.

A total of 1289 patients (lefamulin group: 646 and moxifloxacin group: 643) were included in this analysis. The early clinical response rate was 89.3% and 90.5% among lefamulin and moxifloxacin group, respectively. Lefamulin was noninferior to moxifloxacin (89.3% vs 90.5%, RR: 0.99, 95% CI: 0.95–1.02, I

2
 = 0%). In terms of clinical response at test of cure, no significant difference was observed between the lefamulin and moxifloxacin groups (for modified intention to treat population, RR: 0.98, 95% CI: 0.94–1.02, I

2
 = 0%; for clinically evaluable population, RR: 0.96, 95% CI: 0.93–1.00, I

2
 = 0%). In the subgroup analysis, the early clinical response rate at early clinical assessment and clinical response rate at test of cure of lefamulin was similar to that of moxifloxacin across different subgpopulations and all baseline CABP pathogens. Lefamulin was associated with a similar risk of adverse events as moxifloxacin.

Clinical efficacy and tolerability for lefamulin in the treatment of CABP were similar to those for moxifloxacin.
Parenting style during childhood is associated with the development of chronic pain and a patient's need for psychosomatic treatment in adulthood
Authors: Shibata Mao , Ninomiya Toshiharu , Anno Kozo , Kawata Hiroshi , Iwaki Rie , Sawamoto Ryoko , Kubo Chiharu , Kiyohara Yutaka , Sudo Nobuyuki , Hosoi Masako
Published: July 2020

The aim of this study is to investigate the relation between parenting style and chronic pain and the patients’ need for psychosomatic treatment in adulthood.

We compared 4 combinations of 2 parenting style subscales, high and low care and overprotection, among the following 4 age- and sex-matched groups: community-dwelling subjects without chronic pain (n = 100), community-dwelling subjects with chronic pain (n = 100), outpatients with chronic pain (n = 50), and inpatients with chronic pain (n = 50). Parenting style was assessed for both the mother and father by use of the Parental Bonding Instrument questionnaire. The parenting style associated with the worst outcome was defined as both low care and high overprotection, as reported in previous studies.

The frequency of reported adverse parenting style was significantly higher among chronic pain patients than community-dwelling subjects without chronic pain (all P < .05). The odds ratios for an adverse parenting style significantly increased through the categories after adjusting for demographic factors and the pain visual analog scale (P for trend <.01).

These findings suggest that parental low care and high overprotection during childhood contribute to the future risk of chronic pain and the patients’ need for psychosomatic treatment in adulthood.
Effectiveness of niacin supplementation for patients with type 2 diabetes
Authors: Xiang Dan , Zhang Qian , Wang Yang-Tian
Published: July 2020

Background:

Lipid profiles and glycemic control play a critical role in subsequent atherosclerotic cardiovascular disease for patients with type 2 diabetes mellitus (T2DM). This study aimed to evaluate the effectiveness of niacin supplementation on lipid profiles and glycemic control for patients with T2DM.

Methods:

The PubMed, Embase, and the Cochrane Library databases were searched to identify randomized controlled trials (RCTs) that investigated the effects of niacin supplementation for patients with T2DM throughout December 2019. The weighted mean differences (WMDs) with 95% confidence intervals (CIs) were applied to calculate the pooled effect estimates using a random-effects model.

Results:

Eight RCTs comprised a total of 2110 patients with T2DM who were selected for final quantitative analysis. The patients’ niacin supplementation was associated with lower levels of total cholesterol (WMD, −0.28; 95% CI, −0.44 to −0.12; P = .001), triglyceride (WMD, −0.37; 95% CI, −0.52 to −0.21; P < .001), and low-density lipoprotein (WMD, −0.42; 95% CI, −0.50 to −0.34; P < .001). Moreover, the level of high-density lipoprotein was significantly increased when niacin supplementation (WMD, 0.33; 95% CI, 0.21 to 0.44; P < .001) was provided. However, niacin supplementation produced no significant effects on plasma glucose (WMD, 0.18; 95% CI, −0.14 to 0.50; P = .275) and hemoglobin A1c (HbA1c) levels (WMD, 0.39; 95% CI, −0.15 to 0.94; P = .158).

Conclusions:

This study found that niacin supplementation could improve lipid profiles without affecting the glycemic levels for patients with T2DM. Additional large-scale RCTs should be conducted to evaluate the long-term effectiveness of niacin supplementation.
Emergency transfers of home care patients in Fukui Prefecture, Japan
Authors: Kosaka Makoto , Miyatake Hirotomo , Arita Satoshi , Masunaga Hidehisa , Ozaki Akihiko , Nishikawa Yoshitaka , Beniya Hiroyuki
Published: July 2020

Little is known about how emergency transfers take place and what outcomes they lead to in the patients who receive home care in Japan. We aimed to assess outcomes of emergency transfers and factors associated with such outcomes in the Japanese home care setting.

A retrospective analysis of patient data from a home care clinic in Fukui, Japan, included all patients who experienced emergency transfers which were reported to the clinic during 2018 and 2019. We collected data on patients’ sociodemographic and clinical characteristics, as well as the transfer process and its outcome, using patient charts and other administrative records. We first analyzed the overall outcome and then evaluated whether transfer outcomes would differ according to by whom and from where the emergency medical service (EMS) was called, by univariate and multivariate analyses.

We considered 63 patients who experienced emergency transfers during the study period. Of the total, 10 (15.9%) returned to their residences without being admitted or being dead on arrival. Although only 2.6% (1/39) of patients whose transfers were determined by health care professionals (HCPs) returned home without being admitted, a direct return was observed for 37.5% (9/24) of patients whose transfer was determined by those other than HCPs (odds ratio of direct return to residences 22.80, 95% confidence interval 2.65–195.87). There was no other variable which was significantly associated with the outcomes after the emergency transfers, although all the patients who have no available caregivers resulted in hospitalization.

In this preliminary analysis in the Japanese home care setting, only a small proportion of patients returned to their residences without being admitted following emergency transfers. Patients whose EMS transfer was requested by an HCP usually resulted in an admission to the clinic, whereas transfers requested by non-HCPs frequently did not.
Influence of prior hip arthroscopy on outcomes after hip arthroplasty
Authors: Guo Jiankuo , Dou Dongmei
Published: July 2020

Background:

No meta-analysis exists elucidate the impact of prior hip arthroscopy on the outcomes of subsequent hip arthroplasty. The purpose of this study was to systematically review the current evidence in the literature to ascertain if prior hip arthroscopy leads to inferior outcomes after hip arthroplasty.

Methods:

PUBMED, Scopus, EMBASE, and Cochrane Library databases were searched on May 20, 2019. Only English publications were included. The primary outcomes were postoperative complication, revision, and reoperation. Secondary outcomes included Harris Hip Score (HHS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), operative time, and estimated blood loss.

Results:

Eleven studies with a total of 1227 patients were included. The pooled data revealed that patients with prior hip arthroscopy were associated with higher risks for any postoperative complication (P < .00001), dislocation (P = .03), revision (P = .03), and reoperation (P = .02) following subsequent hip arthroplasty. However, there were no significant differences in infection rate (P = .22), HHS (P = .09), WOMAC (P = .19), operative time (P = .52), and estimated blood loss (P = .17) between the groups.

Conclusions:

Patients with prior hip arthroscopy are at increased risks for any postoperative complication, dislocation, revision, and reoperation following subsequent hip arthroplasty. However, prior hip arthroscopy does not appear to have an impact on the functional outcomes and intraoperative outcomes.
Efficacy and safety of Zuojin Pill for chronic gastritis
Authors: Shi Jianglong , Liu Liyun , Li Jian , Ma Xiaoju , Qiu Hairong , Shen Tao
Published: July 2020

Background:

Chronic gastritis (CG), as the highest incidence of gastrointestinal diseases, has been gradually increasing around globally. With the obvious disadvantages of standard treatment, more and more people ask the traditional Chinese medicine for help in the treatment of CG. As a traditional Chinese medicine compound, Zuojin Pill (ZJP) has a long history of clinical application in the treatment of digestive system diseases. Whereas, neither systematic nor meta-analysis of randomized controlled trials explain the efficacy and safety of ZJP in treating CG. Thus, we provide a protocol to evaluate the efficacy and safety of ZJP for CG.

Methods:

From the beginning to December 2019, the following electronic databases will be searched for studies in English or Chinese: the Cochrane Library, Embase, PubMed, Web of Science, the Chinese National Knowledge Infrastructure, the Chinese Biomedical Literature Database, the Chinese Scientific Journal Database, and the Wanfang Database. Clinical efficiency, helicobacter pylori infection clearance rate, quality of life and symptom scores will be measured as primary outcomes. Meta-analysis will be performed using the Stata 15.

Outcomes:

This study will provide the current evidence of CG treated with ZJP from the several aspects including clinical efficiency, helicobacter pylori infection clearance rate, quality of life, symptom scores, the 1-year recurrent rate, efficacy under endoscopy and number of reported adverse events associated with the use of ZJP.

Conclusion:

The outcomes of this review will be served as a proof to evaluate if ZJP is effective in the treatment of CG.

PROSPERO registration number:

PROSPERO CRD42020155036.
Effects of herb-partitioned moxibustion for primary dysmenorrhea
Authors: Ma Fengjun , Yan Xiao , Yu Yanpu , Du Dongqing , Li Shujing , Chen Chen , Zhang Xiaobin , Dong Zhibin , Ma Yuxia , Ma Yuning
Published: July 2020

Background:

Primary dysmenorrhea (PD) is a cyclic cramp in pelvic which affects the quality of life. Herb-partitioned moxibustion (HPM), a critical component of moxibustion therapy in traditional Chinese medicine, has been used to treat PD. However, there is still a lack of high-quality evidence to support the effectiveness and safety of HPM on patients with PD. The object of this work is to evaluate the efficacy and safety of HPM in the management of PD.

Methods:

The Embase, MEDLINE, PubMed, Cochrane Library Central Register of Controlled Trials, China national knowledge infrastructure database, Wan fang database, Chongqing VIP information, and SinoMed will be searched from their inception to Jun 2020. All randomized controlled trials of HPM for the treatment of PD will be included. We will operate article retrieval, duplication removing, screening, quality evaluation, and data analyses by RevMan 5.3 (The Cochrane Collaboration, Oxford, England).

Results:

This study will provide a high-quality comprehensive evaluation of the efficacy and safety of HPM for the treatment of PD.

Conclusion:

The conclusion of our systematic review will give more convincing evidence to assist clinicians during the decision-making process when dealing with PD.

Trial registration number:

10.17605/OSF.IO/UFKNP
Viral shedding in patients with hand, foot and mouth disease induced by EV71, CA16, or CA6
Authors: Li Xianzhi , Wang Qiuxia , Chen Zhenhua , Duan Xiaoxia , Han Yutong , Luan Rongsheng , Long Lu
Published: July 2020

Introduction:

Hand, foot, and mouth disease (HFMD) has been an important public health concern worldwide, especially in the Asia-Pacific region. Unfortunately, the effect of current measures on preventing and controlling HFMD may be limited. Isolation of infectious sources is reported as an important way to prevent and control this disease. The isolation period is determined on the basis of duration of viral shedding in patients with HFMD. However, the results of previous researches on duration of viral shedding remain controversial. Here, we present a protocol of a systematic review and single-arm meta-analysis for assessing the duration of viral shedding in patients with HFMD induced by Enterovirus 71 (EV71), Coxsackievirus A16 (CA16), or Coxsackievirus A6 (CA6).

Methods and analysis:

A comprehensive literature search will be performed in PubMed, EMBASE, the Cochrane library, Chinese National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), and Wanfang Database, covering the period from inception to May 1, 2019. Point estimate of positive rate with corresponding 95% confidence intervals (CIs) of EV71, CA16, or CA6 in HFMD patients’ fecal or throat samples will be carried out using STATA 14.0. Subgroup analyses will be performed for mild cases, severe cases, and close contacts. Sensitive analysis will also be performed to evaluate the influences of individual studies on the final effect by exclusion of a few articles of poor quality. We will assess the risk of bias for the final studies included in our meta-analysis using previously available tools and the modified risk of bias tool.

Results:

The results of this systematic review and meta-analysis will be published in a peer-reviewed journal.

Conclusion:

To the best of our knowledge, this paper will be the first systematic review and meta-analysis for assessing the duration of viral shedding in patients with HFMD induced by EV71, CA16, or CA6. The conclusions drawn from this review will provide the scientific basis to formulate the isolation period of HFMD.

Ethics and dissemination:

Ethical review is not required as this article is for a systematic review since there is no direct involvement of patients in the whole process. We will publish the results of this systematic review and meta-analysis of single-arm studies in a peer-reviewed journal.

Registration number:

Prospero CRD42020139999.
A randomized controlled trial to evaluate the effectiveness and safety of electro acupuncture and transcranial direct current stimulation with computerized cognitive rehabilitation in patients with vascular cognitive impairment
Authors: Park Hyeng Kyu , Song Min Keun , Kim Jae Hong , Han Jae Young
Published: July 2020

Background:

Vascular cognitive impairment (VCI) refers to all cognitive disorders caused by cerebrovascular disorders. For the treatment, many types of pharmacologic and nonpharmacologic treatments are used but their underlying mechanisms and effects are unclear. Regarding nonpharmacologic treatment, electroacupuncture (EA), transcranial direct current stimulation (tDCS), and computerized cognitive rehabilitation treatment (CCRT) are effective. Here, we report the protocol for a randomized controlled trial of the effect and safety of combination therapy of EA or tDCS and CCRT in patients with VCI.

Methods:

This study will be a prospective, outcome assessor-blinded, parallel-arm, randomized controlled clinical trial. Participants with cognitive impairment caused by stroke after 3 months of onset (n = 45) will be randomly assigned to a CCRT, combination therapy with EA and computerized cognitive rehabilitation treatment, or combination therapy with tDCS and computerized cognitive rehabilitation treatment group. All groups will receive treatment 3 times per week for 8 weeks, giving a total of 24 treatments. The CCRT group will perform a training task like shopping, calculating, and others and involving computerized cognitive assessment and brain training system (RehaCom) for 30 minutes. The combination therapy with EA and computerized cognitive rehabilitation treatment group will receive EA using 8 acupuncture points – baekhoe, sinjeong, both sides of pungji, 4 sites of sishencong – and will be applied using an EA stimulator and receive CCRT for 30 minutes at the same time. The combination therapy with tDCS and computerized cognitive rehabilitation treatment group will receive tDCS treatment and receive CCRT for 30 minutes at the same time. The primary outcome will be evaluated using the Lowenstein occupational therapy cognitive assessment, while other scales assessing walking ability, activities of daily living, and quality of life are considered secondary outcome measures. Outcomes will be evaluated before intervention, at the end of intervention 8 weeks after the first intervention, and 4 weeks after completion of the intervention program.

Discussion:

This study aims to examine the effect and safety of combination therapy with EA or tDCS and CCRT in patients with VCI. This study can be useful in developing new treatment technologies using collaborative research with combined traditional Korean and conventional medicines.

Trial registration:

This trial has been registered with cris.nih.go.kr (registration number, KCT 0003644 Registered 01 April 2019, http://cris.nih.go.kr).
A randomized interventional parallel study to evaluate the effect of pelvic floor muscle training with stabilization exercises of high and low intensity in women with stress urinary incontinence
Authors: Hagovská Magdaléna , Urdzík Peter , Švihra Ján
Published: July 2020

Introduction:

The effect of different intensities of pelvic floor muscle training (PFMT) assessed by 2D/3D ultrasound (USG) have not been sufficiently monitored in the literature. The objective of the study will be to evaluate the effect of this intervention by assessing the change in incontinence episode frequency, hiatal area (HA) and hiatal diameter by 2D/3D USG and quality of life over 12 weeks of treatment.

Methods:

Using a randomized interventional parallel study, patients will be assigned to groups A and B using simple software randomization according to odd and even patient sequence numbers. The following methods will be used for evaluation: change in incontinence episode frequency, power and endurance of pelvic floor muscles assessed by perineometer (in cmH2O), HA (in cm2) during contraction, Valsalva manoeuvre assessed by 3D USG, hiatal diameter assessed by 2D USG, the Incontinence Quality of Life scale (I-QoL) and the Patient Global Impression of Improvement score (PGI-I). Interventions: Group A, high-intensity PFMT 5 times a week for 30 minutes per day. Group B, low-intensity PFMT twice a week for 15 minutes per day. The duration of the intervention will be 12 weeks.

Discussion:

The study protocol presents the starting points, design, and methods of the PELSTAB Study. We expect that, after 12 weeks of high-intensity PFMT, women with stress urinary incontinence will have significantly less incontinence episode frequency, better reduction of HA during contraction and Valsalva manoeuvre, higher power and endurance of pelvic floor muscles and better quality of life compared to the group with low-intensity PFMT.

Registration:

This study was registered in the ClinicalTrials.govNCT04340323.