bluuebunny/crossref_metadata_2025 huggingface dataset:
Global trends in anal cancer incidence and mortality
Authors: Mignozzi Silvia , Santucci Claudia , Malvezzi Matteo , Levi Fabio , La Vecchia Carlo , Negri Eva
Published: December 2023

Objective

Anal cancer is a rare disease, affecting more frequently women than men, mainly related to human papillomavirus infection (HPV). Rising incidence and mortality have been reported over the past four decades in different countries.

Methods

To provide an up-to-date overview of recent trends in mortality from anal cancer, we analysed death certification data provided by the WHO in selected countries worldwide over the period from 1994 to 2020. We also analysed incidence derived from Cancer Incidence in Five Continents from 1990 to 2012 for all histologies as well as for anal squamous cell carcinoma (SCC).

Results

The highest age-standardised mortality rates around 2020 were registered in Central and Eastern Europe, such as Slovakia (0.9/100 000 men and 0.40/100 000 women), in the UK (0.24/100 000 men and 0.35/100 000 women), and Denmark (0.33/100 000 for both sexes), while the lowest ones were in the Philippines, Mexico, and Japan, with rates below 0.10/100 000 in both sexes. Upwards trends in mortality were reported in most countries for both sexes. Similarly, incidence patterns were upward or stable in most countries considered for both sexes. In 2008–2012, Germany showed the highest incidence rates (1.65/100 000 men and 2.16/100 000 women).

Conclusion

Attention towards vaccination against HPV, increased awareness of risk factors, mainly related to sexual behaviours and advancements in early diagnosis and management are required to control anal cancer incidence and mortality.
LOXL4 Shuttled by Tumor Cells–derived Extracellular Vesicles Promotes Immune Escape in Hepatocellular Carcinoma by Activating the STAT1/PD-L1 Axis
Authors: Zhao Le , Pei Ruifeng , Ding Yiren , Su Zhan , Li Deqiang , Zhu Shuo , Xu Lu , Zhao Hongying , Zhou Wuyuan
Published: December 2023

Emerging evidence has validated that extracellular vesicles (EVs) regulate hepatocellular carcinoma (HCC) progression, while its role in HCC immune escape remains to be elucidated. This study investigates the role of EVs-encapsulated lysyl oxidase like-4 (LOXL4) derived from tumor cells in HCC immune escape. HCC-related microarray data sets GSE36376 and GSE87630 were obtained for differential analysis, followed by identifying the essential genes related to the prognosis of HCC patients. Bone marrow–derived macrophages were treated with EVs derived from mouse Hepa 1–6 cells and cocultured with CD8+ T cells to observe the CD8+ T-cell activity. At last, a mouse HCC orthotopic xenograft model was constructed to verify the effects of HCC cell-derived EVs on the immune escape of HCC cells and tumorigenicity in vivo by delivering LOXL4. It was found that ACAT1, C4BPA, EHHADH, and LOXL4 may be the essential genes related to the prognosis of HCC patients. On the basis of the TIMER database, there was a close correlation between LOXL4 and macrophage infiltration in HCC. Besides, STAT1 was closely related to LOXL4. In vitro experiments demonstrated that LOXL4 could induce programmed death-ligand 1 expression in macrophages and immunosuppression by activating STAT1. In vivo experiments also verified that HCC cell-derived EVs promoted the immune escape of HCC cells and tumorigenicity by delivering LOXL4. LOXL4 was delivered into macrophages via EVs to induce programmed death-ligand 1 by activating STAT1 and inhibiting the killing ability of CD8+ T cells to HCC cells, thus promoting immune escape in HCC.
A secondary aortic graft-enteric fistula: A case report
Authors: Boltuc Paulina Jolanta , Teutonico Paolo , Munaro Daniele , Gentile Linda , Dziugiel Sonia Julia , Sabbatini Sonia , Merlini RN Ilenia , Boltuc-Dziugiel Kamila , Di Saverio Salomone
Published: December 2023

Aortic graft-enteric fistula is an infrequent, severe, and late complication that sometimes follows aortic reconstructive surgery. In this case study, we describe the clinical course of a 62-year-old man with a previous leg amputation due to ischemia and gangrene, aortic bifemoral by-pass, and femoral thromboendarterectomy. In the past, the patient underwent a right inguinal hernia repair procedure and an appendectomy, which was complicated by peritonitis. He was taken to the emergency room in 2017 because of a sudden, sharp pain in the right inguinal region with paleness and sweating.
The optimal dose of pain neuroscience education added to an exercise programme for patients with chronic spinal pain: A systematic review and dose–response meta-analysis
Authors: Núñez-Cortés Rodrigo , Salazar-Méndez Joaquín , Calatayud Joaquín , Malfliet Anneleen , Lluch Enrique , Mendez-Rebolledo Guillermo , Guzmán-Muñoz Eduardo , López-Bueno Rubén , Suso-Martí Luis
Published: December 2023

Pain neuroscience education (PNE) has shown promising results in the management of patients with chronic spinal pain (CSP). However, no previous review has determined the optimal dose of PNE added to an exercise programme to achieve clinically relevant improvements. The aim was to determine the dose–response association between PNE added to an exercise programme and improvements in pain intensity and disability in patients with CSP. A systematic search of PubMed/MEDLINE, Embase, Web of Science, Scopus, and the Cochrane Library was conducted from inception to April 19, 2023. The exposure variable (dosage) was the total minutes of PNE. Outcome measures included pain intensity, disability, quality of life, pressure pain thresholds, and central sensitization inventory. Data extraction, risk-of-bias assessment, and certainty of evidence were performed by 2 independent reviewers. The dose–response relationship was assessed using a restricted cubic spline model. Twenty-six randomised controlled trials with 1852 patients were included. Meta-analysis revealed a statistically significant effect in favour of PNE on pain intensity and disability. In addition, a dose of 200 and 150 minutes of PNE added to an exercise programme was estimated to exceed the minimum clinically important difference described in the literature for pain intensity (−2.61 points, 95% CI = −3.12 to −2.10) and disability (−6.84 points, 95% CI = −7.98 to −5.70), respectively. The pooled effect of the isolated exercise was small. These findings may be useful in optimising the most appropriate PNE dose to achieve clinically relevant improvements in patients with CSP.
Genomics education for advance practice nurses: Staying cutting edge
Authors: Connors Laurie M. , Wysocki Kenneth
Published: December 2023

As we celebrate the 20th anniversary of sequencing of the human genome and the rapid integration of genetics in health care, we pause to reflect on the status of genomic competency in nursing. The literature provides evidence that nurses do not feel prepared or confident in genomics. Genomic education for nurses and other health care professionals can support access and equity in the integration of genomics into practice. Resources are provided to support genomic education and clinical support.
Comparison of efficacy between tranexamic acid and epsilon-aminocaproic acid for total knee arthroplasty: A meta-analysis of randomized controlled trials
Authors: Li Jun , Guo YuanXue , Li Ming
Published: December 2023

Background:

Tranexamic acid (TXA) and epsilon-aminocaproic acid (EACA) have been demonstrated to reduce blood loss following total knee arthroplasty (TKA). This meta-analysis aimed to compare the efficacy and safety of TXA and EACA in reducing blood loss in primary TKA patients.

Methods:

A search of the PubMed, Embase, and Cochrane Library databases identified all relevant studies published until December 2022. Randomized controlled trials (RCTs) reporting a comparison of TXA and EACA for TKA patients were selected. The main outcomes were total blood loss (TBL), hemoglobin (Hb) drop on postoperative day 3, intraoperative blood loss, operation time and the transfusion rate were evaluated. The weighted mean differences (WMD) and risk ratio (RR) with 95% confidence intervals (CI) were calculated using a fixed-effects or random-effects model. Stata 12.0 software was used for meta-analysis.

Results:

Six studies involving 739 (TXA:372; EACA:367) patients were included in this meta-analysis. There was no significant difference in terms of intraoperative blood loss, Hb drop on postoperative day 3, operation time, tourniquet time (TT), transfusion rate and the occurrence of deep venous thrombosis (DVT) between the 2 treatments groups. However, compared with EACA, TXA significant reduced TBL (WMD, 174.60; 95% CI, −244.09 to −105.11).

Conclusion:

Our research did not demonstrate TXA to be superior to EACA in reducing need for transfusion and Hb drop. TXA was superior than EACA in reducing TBL in TKA patients. More RCTs with identical inclusion criteria and dose and duration of treatment, are required to confirm these findings.
Global trends and hotspots in the application of platelet-rich plasma in knee osteoarthritis: A bibliometric analysis from 2008 to 2022
Authors: Xiao Zipeng , Chen Weijian , Wei Zhihao , Zhang Qian , Tang Gangjian
Published: December 2023

Platelet-rich plasma (PRP) injection therapy holds great promise in improving knee cartilage repair. This bibliometric analysis aimed to explore the research landscape in the application of PRP for knee osteoarthritis (KOA) over the last 15 years. All articles investigating PRP in the application of KOA were retrieved from the web of science core collection. Publications were analyzed using R software, VOS Viewer, CiteSpace, Microsoft Excel, and an online bibliometric platform (https://bibliometric.com/). A total of 815 articles were identified, 6 articles from 2010 had the highest average number of citations in the local database. Filardo G., Kon E., Cole B.J., Marcacci M., and Di Martino A. are the top 5 authors based on the H-index. The “American Journal Of Sports Medicine” is the most authoritative journal in the field of PRP application in KOA. The United States is the global leader in this field, with European countries playing a pivotal role in collaborative exchanges. Taipei Medical University is the most prolific institution and Shahid Beheshti University Medical Sciences in Iran the fastest-rising institution. The keywords “Hyaluronic Acid,” “cartilage,” “growth factors,” “mesenchymal stem cells,” “intra-articular injection,” “pain,” “inflammation,” “double-blind,” “management,” “placebo,” “stromal cells,” “rheumatoid arthritis,” and “pathology” appeared most frequently. “Exercise,” “volume,” and “physical-activity” are the latest hot topics. Future trends in this field include the standardization of injection components, injection sites, and injection methods, the modulation of useful or harmful growth factor receptor expression, sports management, and the validation of contraindications to PRP.
A case report of Mycobacterium fortuitum infection after muscle injection
Authors: Li Hao , Zhang Tao
Published: December 2023

Rationale:

Injection-related abscesses are a common complication in clinical practice, but the identification of infected bacteria might be difficult.

Patient concerns:

A 51-year-old female patient was admitted to the hospital due to a lump on her right buttock that emerged after receiving intramuscular injections to treat left shoulder joint pain. The lump gradually enlarged into a 3.0 to 4.5 cm mass at the time of admission with symptoms such as skin redness, itching, and pain.

Diagnoses:

The patient received ultrasonic and other laboratory examinations. Laboratory results from the drainage indicated that the infection was caused by a rapidly growing mycobacteria and was confirmed as Mycobacterium fortuitum by matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry.

Interventions:

The patient was treated with antibiotics for 12 days after incision and drainage of the abscess in the right buttock. Local dressings were changed regularly. A migration lesion that appeared 3 days after treatment was drained and cleaned when it matured.

Outcomes:

The lesion substantially decreased in size and the patient was discharged after 2 months of treatment.

Lessons:

Rapidly growing mycobacteria are rare but important pathogens that should be considered in patients with injection-related abscesses. Early identification and appropriate treatment can result in a favorable prognosis.
Does bore size matter?—A comparison of the subjective perception of patient comfort during low field (0.55 Tesla) and standard (1.5 Tesla) MRI imaging
Authors: Michael Arwed Elias , Heuser Andreas , Moenninghoff Christoph , Surov Alexey , Borggrefe Jan , Kroeger Jan Robert , Niehoff Julius Henning
Published: December 2023

The purpose of the present study was to evaluate the subjectively perceived patient comfort during magnetic resonance imaging (MRI) examinations and to assess potential differences between a recently introduced low field MRI scanner and a standard MRI scanner. Among other characteristics, the low field MRI scanner differs from the standard MRI scanner by offering more space (wider bore size of 80 centimeter diameter) and producing less noise, which may influence the patient comfort. In total, 177 patients were surveyed after MRI scans with either the low field MRI scanner (n = 91, MAGNETOM Free.Max, Siemens Healthineers) or the standard MRI scanner (n = 86, MAGNETOM Avanto Fit, Siemens Healthineers). Patients rated different aspects of comfort on a 5 point Likert scale: (a) claustrophobia, (b) comfort of the scanner table, (c) noise level and (d) vertigo during the scanning procedure. In terms of claustrophobia and comfort of the scanner table, patients rated both MRI scanners similar (e.g., mean ratings for claustrophobia: standard MRI scanner = 4.63 ± 1.04, low field MRI scanner = 4.65 ± 1.02). However, when asked for a comparison, patients did favor the more spacious low field MRI scanner. In terms of noise level, the low field MRI scanner was rated significantly better (mean ratings: standard MRI scanner = 3.72 ± 1.46 [median 4 = “rather not unpleasant”], low field MRI scanner = 4.26 ± 1.22 [median 5 = “not unpleasant at all”]). Patients did not perceive any significant difference in terms of vertigo between both MRI scanners. The newly developed low field MRI scanner offers constructional differences compared to standard MRI scanners that are perceived positively by patients. Worth highlighting is the significantly lower noise level and the innovative bore diameter of 80 centimeter, which offers more space to the patients.
Identification of biomarkers associated with pediatric asthma using machine learning algorithms: A review
Authors: Lin Kexin , Wang Yijie , Li Yongjun , Wang Youpeng
Published: December 2023

Pediatric asthma is a complex disease with a multifactorial etiology. The identification of biomarkers associated with pediatric asthma can provide insights into the pathogenesis of the disease and aid in the development of novel diagnostic and therapeutic strategies. This study aimed to identify potential biomarkers for pediatric asthma using Weighted Gene Co-expression Network Analysis (WGCNA) and machine learning algorithms. We obtained gene expression data from publicly available databases and performed WGCNA to identify gene co-expression modules associated with pediatric asthma. We then used machine learning algorithms, including random forest, lasso regression algorithm, and support vector machine-recursive feature elimination, to classify asthma cases and controls based on the identified gene modules. We also performed functional enrichment analyses to investigate the biological functions of the identified genes.We detected 24,544 genes exhibiting differential expression between controlled and uncontrolled genes from the GSE135192 dataset. In the combined WCGNA analysis, a total of 104 co-expression genes were screened, both controlled and uncontrolled. After screening, 11 hub genes were identified. They were AK2, PDK4, PER3, GZMH, NUMBL, NRL, SCO2, CREBZF, LARP1B, RXFP1, and VDAC3P1. The areas under their receiver operating characteristic curve were above 0.78. Our study identified potential biomarkers for pediatric asthma using WGCNA and machine learning algorithms. Our findings suggest that 11 hub genes could be used as novel diagnostic markers and treatment targets for pediatric asthma. These findings provide new insights into the pathogenesis of pediatric asthma and may aid in the development of novel diagnostic and therapeutic strategies.
The implementation and effect evaluation of AIDET standard communication health education mode under the King theory of goal attainment: A randomized control study
Authors: Yang Hao , Luo Wanying , Du Xue , Guan Yujia , Peng Wentao
Published: December 2023

Background:

This research addresses inadequate understanding of interventional prenatal diagnosis, preoperative anxiety psychological problems in pregnant women undergoing interventional prenatal diagnosis, proposing a health education mode combined AIDET standard communication and King's theory of goal attainment approach to potentially improve health education outcomes, anxiety psychological problems, and patient satisfaction.

Methods:

A convenient sampling method was used to select a total of 300 pregnant women who were ready to undergo interventional prenatal diagnosis. They were randomly divided into a implementation group and a control group, with 150 pregnant women in each group. The control group used the communication mode of the traditional process of nurse–patient communication. The implementation group used the AIDET standard communication health education model under the King theory of goal attainment in the process of nurse–patient communication and the interventional prenatal diagnosis health education content questionnaire, the pregnant women’s satisfaction questionnaire, state anxiety scale, and disease uncertainty scale were used for evaluation.

Results:

The results of the interventional prenatal diagnosis health education questionnaire, the results of pregnant women’s anxiety, the results of pregnant women’s disease uncertainty, the results of pregnant women’s satisfaction, the implementation group all were better than the control group (P < .05).

Conclusion:

Using the AIDET standard communication health education model under the King theory of goal attainment in nurse–patient communication is conducive to the rapid establishment of a harmonious and trusting nurse–patient relationship between pregnant women and nurses, helping pregnant women and nurses jointly promote the establishment and implementation of health education goals, helping to improve pregnant women’s acceptance of information related to interventional prenatal diagnosis, health education and the procedure of walking on the day of surgery. It helps enhance the effectiveness of health education and satisfaction, reducing pregnant women’s uncertainty about the disease, their unfamiliarity with the surgery environment and surgery procedure, and their preoperative anxiety.
Oral glucose gel in the prevention of neonatal hypoglycemia: A systematic review and meta-analysis
Authors: Wang Meng-Qin , Zheng Ya-Ning , Zhuang Ying
Published: December 2023

Background:

Neonatal hypoglycemia (NH) is the most prevalent metabolic disorder in neonates and glucose gel in oral solution is a relatively new treatment option for NH. We aimed to determine whether oral glucose gel can prevent NH.

Methods:

We conducted an open literature search using PubMed, Embase, Cochrane Library, and Web of Science. We used relative risk as the statistical data, expressed each outcome effect as a 95% confidence interval, and conducted a heterogeneity test. If heterogeneity statistics indicated that I2 was ≥ 50%, the random effects model analysis was used; otherwise, the fixed effects model analysis was conducted, and sensitivity analyses were conducted for all outcomes.

Results:

In this review, we included a total of 10 studies involving 4801 neonates. Meta-analysis revealed that there were no significant differences between the preventive oral glucose gel group and the control group in terms of blood glucose concentration, glucose concentration 30 minutes after the first breastfeeding, length of stay, Bayley-III composite score, subsequent need for intravenous injection of glucose, 24-hour glucose > 50 mg/dL, separation from mother for treatment of hypoglycemia/admitted to neonatal intensive care unit for hypoglycemia, normoglycemia after 1 to 2 treatments, or normoglycemia after more than 2 treatments, breastfeeding at discharge, delayed feeding, neurosensory impairment, parental satisfaction, developmental delay, and seizure. The subsequent intake was significantly lower in the glucose gel group compared to the control group.

Interpretation:

The use of oral glucose gel as a preventative measure may not reduce the incidence of NH. In order to assess the efficacy of glucose gel in preventing NH, a more high-quality, large-sample, and rigorously designed randomized controlled trial is required.
Metoclopramide-induced acute dystonic reaction: A pediatric case report
Authors: Elendu Chukwuka , Adenikinju Joseph , Ogala Faith , Ologunde Tunde , Adebambo Samuel , Egbunu Emmanuel
Published: December 2023

Introduction:

This case report presents a unique acute dystonic reaction (ADR) induced by metoclopramide in a 6-year-old male patient with pertussis-associated vomiting. The rarity of such a reaction in pediatric patients underscores the significance of this case in contributing to the scientific literature. This report highlights the need for heightened awareness of the potential adverse effects of medications commonly used in pediatrics and emphasizes the importance of tailored interventions for this population.

Main symptoms and important clinical findings:

Following the administration of metoclopramide for vomiting associated with pertussis cough, the patient exhibited distressing symptoms, including torticollis, facial grimacing, and tongue protrusion. These involuntary movements were promptly recognized, leading to the suspicion of an ADR. The clinical findings underscore the importance of vigilant monitoring for extrapyramidal symptoms following medication administration, especially in children.

The main diagnoses, therapeutic interventions, and outcomes:

The primary diagnosis of ADR induced by metoclopramide was confirmed, prompting the cessation of the medication and the initiation of anticholinergic therapy with benztropine. This intervention rapidly resolved the patient’s symptoms, highlighting the importance of tailored and swift therapeutic strategies. The outcome demonstrated the efficacy of timely intervention in managing ADR in pediatric patients.

Conclusion:

The main takeaway lesson from this case lies in the critical need for healthcare practitioners to remain vigilant for potential adverse reactions in pediatric patients, even when prescribing commonly used medications. The successful management of this case underscores the importance of prompt recognition, appropriate interventions, and continuous monitoring. Ultimately, this case contributes to the scientific literature by highlighting the unique manifestation of ADR in a pediatric patient, reinforcing the significance of individualized patient care and medication safety.
Psychosocial challenges of persons with sickle cell anemia: A narrative review
Authors: Essien Emmanuel Aniekan , Winter-Eteng Blessing F. , Onukogu Chinyere Uchechi , Nkangha Dominic Dennis , Daniel Faithful Miebaka
Published: December 2023

Sickle cell anemia (SCA) is a severe form of sickle cell disease that primarily affects black populations and individuals in tropical countries. This condition causes significant morbidity and mortality and leads to a range of psychosocial challenges. A preliminary search was conducted on Ovid Medline and public databases with a combination of Medical Subject Headings keywords, resulting in 368 articles. The articles were screened based on the selection criteria in a nonsystematic method by 3 researchers, and a narrative synthesis was done to analyze extracted data from selected peer-reviewed article. Mental disorders, sleep disturbances, interpersonal relationship challenges, stigmatization, and workplace discrimination were identified as significant contributors to the psychosocial distress experienced by individuals with SCA and their families. Depression and anxiety were prevalent among individuals with SCA, leading to poor treatment adherence, increased pain, and disruptions in various aspects of life. Sleep disturbances, including sleep-disordered breathing and sleepwalking, were also identified as significant contributors to poor sleep quality in SCA patients. Families of individuals with SCA also face challenges, including psychological stress, financial strain, and social disruption. Stigmatization is common, leading to misconceptions and discrimination. Workplace discrimination is prevalent, with a high unemployment rate among adult SCA patients. Comprehensive care is crucial to address these psychosocial issues. Early identification and intervention, comprehensive support programs, patient and family education, enhanced pain management strategies, and integration of mental health into clinical care are recommended. School-based support, research and advocacy, and community support groups are also important. By addressing these challenges through comprehensive care and support, healthcare professionals, policymakers, and society can reduce psychosocial distress and improve the lives of individuals with SCA.
Factors influencing self-quantification for patients with hypertension: A cross-sectional Study
Authors: Ma Guiyue , Fang Haiyan , Wang Xiang , Meng Yahui , Zhu Yu , Zhang Chuanying
Published: December 2023

This study aimed to investigate the level of self-quantification among patients with hypertension and identify the factors influencing this behavior. This study aimed to investigate self-quantification levels and identify influencing factors among 400 patients diagnosed with hypertension. Employing a convenience sampling method, the research was conducted across diverse healthcare settings, including a tertiary hospital, 2 community hospitals, 2 pension institutions, and 5 residential areas. Participants underwent assessment using a self-quantification scale. The collected data underwent thorough analysis using various statistical methods, including descriptive analysis for an overview, 2 independent samples t test for mean comparisons, one-way analysis of variance for variations among groups, and multiple linear regression analysis to identify influential factors. This robust methodology was applied to gain comprehensive insights into the self-quantification behaviors of patients with hypertension. The total self-quantification score for patients with hypertension was found to be (96.64 ± 14.16). The average value for all dimensions was (3.22 ± 0.47). Notably, medical insurance type, education level, age, and complications were identified as significant factors influencing self-quantification among patients with hypertension. The study concludes that patients without medical insurance, with lower education levels, older age, and no complications tended to have lower levels of self-quantification. These findings underscore the necessity for targeted interventions to improve self-quantification in these specific patient groups. By addressing the identified influencing factors, healthcare providers can implement measures to enhance self-quantification among patients with hypertension.
Circulating tumor DNA predicts recurrence and assesses prognosis in operable gastric cancer: A systematic review and meta-analysis
Authors: Mi Junjie , Wang Rong , Han Xiaofang , Ma Ruijun , Li Huiying
Published: December 2023

Background:

Selecting the appropriate patient for further treatment after surgery for gastric cancer can improve the patient prognosis. Circulating tumor DNA (ctDNA) has the potential to predict recurrence and prognosis after gastric cancer surgery, but the results are still inconclusive. As the completed studies had small sample sizes and were inconsistent, a meta-analysis was conducted to assess the effect of ctDNA on recurrence and prognosis after gastric cancer surgery.

Methods:

PubMed, Embase, Scopus, and the Web of Science were searched for potentially eligible studies published up to April 7, 2023. Pooled relative risk (RR) and pooled hazard ratio (HR) were calculated to evaluate recurrence, recurrence-free survival (RFS), and overall survival (OS) following gastric cancer surgery.

Results:

A pooled analysis revealed that patients who were ctDNA positive before and after surgery were at a high risk of gastric cancer recurrence (RR = 1.79, 95% CI: 1.19–2.71; RR = 3.17, 95% CI: 2.36–4.25). The pooled data revealed that ctDNA-positive patients had a poorer RFS and OS (HR = 6.37, 95% CI: 2.70–15.01; HR = 4.58, 95% CI: 1.68–12.49).

Conclusions:

ctDNA-positive patients were at a high risk of recurrence after gastric cancer surgery and had a poorer prognosis. Hence, ctDNA-positive patients needed close follow-up and further treatment.
Bilateral late hematomas after breast augmentation mimicking anaplastic large cell lymphoma: A case report
Authors: Ma I Zhen , Chung Jee Hyeok , Kim Jinhyun , Hong Ki Yong
Published: December 2023

Rationale:

Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is rare, but its incidence has recently increased. It is characterized by a sudden onset of seroma collection after implantation of textured breast implants. However, BIA-ALCL may be confused with late hematoma, which is also a rare finding in aesthetic breast surgery. The cause of late hematoma is mostly unknown, and patients rarely present with specific symptoms.

Patient concerns:

We presented a case of late hematoma that occurred in a patient who underwent augmentation mammoplasty 25 years ago and was on anticoagulants for 7 years.

Diagnoses:

Ultrasonography and magnetic resonance imaging could not rule out the possibility of BIA-ALCL.

Interventions:

Bilateral implant removal was performed, and massive amounts of late hematoma and organizing tissues were removed.

Outcomes:

The pathologists confirmed the biopsy results as late hematoma with organizing tissues. Capsules from both sides were confirmed as fibrous capsules with chronic inflammation and foamy macrophage infiltration.

Lessons:

Although malignancy needs to be primarily ruled out, late hematoma can occur beyond expectations, especially in anticoagulated patients, and must be included in the differential diagnosis.
Laparoscopic radical surgery for locally advanced T4 transverse colon cancer and prognostic factors analysis: Evidence from multi-center databases
Authors: Xie Feng , Lu Pingfan , Chen Yuming , Liu Xiangjun , Zou Zhenhong , Gan Jinheng
Published: December 2023

The safety and efficacies of laparoscopic radical procedures are still controversial for locally advanced pathological T4 (pT4) TCC (transverse colon cancer). Therefore, the aim of this study is to evaluate the oncologic and perioperative outcomes and to recognize the prognostic factors in radical resection for pT4 TCC derived from multi-center databases. 314 patients with TCC who underwent radical resection between January 2004 and May 2017, including 139 laparoscopic resections and 175 open resections, were extracted from multicenter databases. Oncological as well as perioperative outcomes were investigated. The baseline characteristics of the 2 groups did not differ significantly. Nevertheless, the laparoscopic technique was found to be linked with a significantly longer duration of surgery (208.96 vs 172.89 minutes, P = .044) and a significantly shorter postoperative hospital stay (12.23 vs 14.48 days, P = .014) when compared to the conventional open approach. In terms of oncological outcomes, lymph node resection (16.10 vs 13.66, P = .886), 5-year overall survival (84.7% vs 82.7%, P = .393), and disease-free survival (82.7% vs 83.9%, P = .803) were similar between the 2 approaches. Based on multivariate analysis, it was determined that differentiation and N classification were both independent prognostic factors for overall survival. However, it was found that only N classification was an independent prognostic factor for disease-free survival. These findings underscore the significance of differentiation and N classification as key determinants of patient outcomes in this context. Overall, the laparoscopic approach may offer advantages in terms of shorter hospital stays, while maintaining comparable oncological outcomes. Laparoscopic radical procedure can gain a couple of short-term benefits without reducing long-term oncological survival for patients with pT4 TCC.
Case report: A pregnant woman with Crohn disease who used ustekinumab to the 3rd trimester developed severe infection
Authors: Guo Peng , Cao Wulan
Published: December 2023

Rationale:

Crohn disease (CD) and pregnancy often impact each other, which poses challenges for women with CD to successfully give birth to a healthy baby. The latest guideline recommends that patients with active inflammatory bowel disease delay pregnancy to induce remission and optimize disease control. Research data has showed that the incidence of infection and severe infection in patients treated with ustekinumab (UST) did not increase compared to those treated with a placebo.

Patient concerns:

This report describes the entire process of a pregnant woman with CD who has undergone ileostomy and long-term enteral nutrition and requires biological agents to control the disease, from conception to delivery. This case was pregnant during CD period and regularly treated with UST to the third trimester, with the onset of sepsis and septic shock at 38 weeks gestation.

Diagnoses:

The patient was pathologically diagnosed with CD 16 years ago and admitted to our department at 38 weeks gestation.

Interventions:

After admission to our department, fetal heart monitoring indicated fetal distress, so we immediately terminated the pregnancy by cesarean section. After the diagnosis of septic shock, the patient was transferred to intensive care unit for active anti-infection and symptomatic supportive treatment.

Outcomes:

The mother only experienced an infection in the third trimester, and cured by active treatment. The newborn was delivered at full term and confirmed to be low birth weight.

Lessons:

Her experience suggests that although pregnant during Crohn active period, a good outcome can be achieved through positively controlling with medication and closely monitoring it. The use of UST during pregnancy appears to be safe for both the mother and fetus but may be associated with severe infections.
Electronic visualized double-lumen endobronchial tube for situs inversus totalis: A case report and literature review
Authors: Li Zhi , Wang Youyu , Liu Zhiheng , Luo Nanbo
Published: December 2023

Rationale:

Using an electronic visualized double-lumen endobronchial tube (E-visual DLT) allows for excellent surgical visualization during one-lung ventilation. Situs inversus totalis (SIT) is a rare autosomal recessive genetic condition wherein the bronchial and pulmonary lobar structures on the left and right sides of individuals are reversed compared to those of the general population. In the case of SIT, placing a left-sided E-visual DLT into the right bronchus might offer more advantageous one-lung ventilation. However, there have been no reported instances of using E-visual DLT single-lung ventilation anesthesia techniques for SIT.

Patients concerns:

We present a case report detailing the effective implementation of a visualized single-lung ventilation technique under general anesthesia in a 36-year-old male diagnosed with SIT. The patient had a mediastinal mass and underwent thoracoscopic resection of the mediastinal mass using a left-sided approach.

Diagnoses:

Based on the findings from the contrast-enhanced chest computed tomography (CT) results, the patient was diagnosed with SIT along with a mediastinal mass. Surgical intervention was proposed to alleviate the cardiac compression caused by the mass. Nevertheless, the administration and handling of anesthesia posed a notable challenge since clinical anesthesiologists encounter contradictory data and a limited number of evidence-based guidelines.

Interventions:

Convened a multidisciplinary meeting prior to the initiation of anesthesia to formulate a comprehensive strategy. Throughout the anesthetic management, our team ensured meticulous monitoring, delivered sufficient oxygenation, and established hemodynamic equilibrium. The anesthesia team deliberated and devised a plan to employ a left-sided E-visual DLT placement through the right bronchus for right-sided one-lung ventilation in the patient with SIT. The process of anesthesia induction was subjected to repeated simulations to guarantee patient safety.

Outcomes:

Due to the meticulous and effective administration and supervision of anesthesia, the surgery was completed as planned. Subsequently, the removal of the E-visual DLT was executed without any complications.

Lessons:

Data and literature about SIT are scarce, necessitating thorough pre-planning and preparation.
Safety profiles and adverse reactions of azithromycin in the treatment of pediatric respiratory diseases: A systematic review and meta-analysis
Authors: Sun Ying-wen , Cen Yuan-hua , Chen Mu-heng , Yan Xu-ke , Jin Xiao-fen
Published: December 2023

Background:

Azithromycin (AZM) is an antimicrobial agent and frequently used in the treatment of pediatric respiratory diseases due to its well-recognized clinical efficacy. Despite some favorable findings from many studies, there is a lack of research reports focusing on the safety profiles and adverse reactions.

Methods:

The randomized controlled trials of AZM in the treatment of pediatric respiratory diseases on internet databases were searched. The search databases included Chinese CNKI, Wanfang, VIP, PubMed, EMBASE, and Cochrane Library. Two researchers of this study independently assessed the eligibility, risk of bias, and extracted the data. The included literature was meta-analyzed and subgroup analyzed by revman 5.1 software.

Results:

A total of 14 eligible studies were included. The results of meta-analysis showed that the incidence of adverse reactions after AZM treatment was 24.20%, which was lower than 48.05% in the control group (OR = 0.42, 95% CI 0.12–0.72, P < .001). In the subgroup of sequential therapy, AZM had a lower incidence of adverse reactions in sequential therapy (OR = 0.29, 95% CI 0.09–0.60, P < .001). In the subgroup of intravenous administration, AZM had a lower the incidence of adverse reactions (OR = 0.57, 95% CI 0.12–0.84, P = .003). In the subgroup of oral administration, AZM had a lower the incidence of adverse reactions (OR = 0.45, 95% CI 0.13–0.69 P < .001). Overall, it was also found that the incidence of adverse reactions in the AZM subgroup was significantly lower than that in other treatment subgroup.

Conclusion:

AZM has fewer adverse reactions and better safety profiles, which make AZM a more attractive option in the treatment of pediatric respiratory diseases.
The potential role of serum lipoprotein in children with sepsis
Authors: Wu Jiabo , Su Chang , Jiang Junsheng , Mao Yueyan
Published: December 2023

To determine whether serum lipoprotein is correlated with sepsis on the day of admission and help with early warning, identification, and intervention for sepsis. This retrospective study involved all children admitted to our pediatric intensive care unit from January 2021 to June 2023. Clinical data of involved patients were collected via inquiring databases of our hospital. The Pediatric Risk of Mortality and Pediatric Index of Mortality II scores were calculated, multivariate analysis was conducted to evaluate the independence of the association between serum lipoprotein and the risk of sepsis on the day of admission. This study involved 88 children (48 with sepsis, 40 non-sepsis). The sepsis group had a lower level of high-density lipoprotein (HDL), total cholesterol, and low-density lipoprotein (LDL). The CRP, white blood cell, and procalcitonin (PCT) were considerably higher than the non-sepsis group. After adjusting for covariates, logistic regression analysis suggested that the CRP, PCT, HDL, Pediatric Risk of Mortality score, Pediatric Index of Mortality II score and LDL were independent risk factors for sepsis. Moreover, the AUC of CRP, PCT, HDL, and LDL were 0.58, 0.76, 0.82, and 0.86, respectively. Our results may indicate that serum lipoprotein is correlated with sepsis on the day of admission and may help with early warning, identification, and intervention for sepsis.
A rare case of hypertensive urgency caused by linezolid was reported: A case report
Authors: Luo Jingjing , Wu Xinan , Liu Yiming
Published: December 2023

Rationale:

Linezolid itself is rarely reported to cause blood pressure elevation, and it is rare to report that linezolid causes hypertensive urgency.

Patients concerns:

This case report describes a 38-year-old man who developed acute hypertension after a postoperative foot infection that was treated with linezolid antitherapy. Hypertensive urgency occurred without obvious potential interaction between linezolid and drugs. After receiving appropriate treatment and stopping medication, the patient’s blood pressure returned to normal and did not recur.

Diagnoses:

Hypertensive crises occurred during the treatment of linezolid.

Interventions:

After stopping linezolid, the patient’s blood pressure gradually returned to normal.

Outcomes:

The patient’s blood pressure returned to normal on the 26th day after stopping linezolid, and no abnormal blood pressure was found in the follow-up 2 months after discharge.

Lessons:

Linezolid is rarely reported to cause elevated blood pressure, even though it may occur in the absence of obvious drug interactions. Case reported fewer reasons may be for clinicians statistically insignificant or notice, and hypertensive urgency often lead to clinical risk, should be given enough attention to clinical. Pay attention to blood pressure monitoring during use, when there is abnormal increase in blood pressure, should consider adverse drug reactions, give timely discontinuation and give symptomatic treatment.
Hsa_circ_0124554 may serve as a biomarker for the diagnosis of colorectal cancer: An observational study
Authors: Li Kexin , Li Tong , Yu Zhuocheng , Yuan Qingqing , Qing Yanping
Published: December 2023

Circular RNAs (circRNAs) play important roles in the occurrence and development of cancer, and have been shown with diagnostic values in various cancers. The latest research showed that hsa_circ_0124554 is closely related to liver metastasis and vascular invasion in colorectal cancer (CRC). This study aimed to investigate whether hsa_circ_0124554 can be used as a diagnostic marker for CRC. In this study, quantitative reverse transcriptase polymerase chain reaction (qRT-PCR) was used to detect hsa_circ_0124554 expression levels in 40 pairs of CRC tissues and adjacent non-tumor intestinal tissues derived from CRC patients and 32 paired plasma specimens. The relationship between the expression of hsa_circ_0124554 and the clinicopathological features of CRC patients was analyzed by t-test and chi-square test. Receiver operating characteristic (ROC) curve analysis was established to explore the diagnostic value of hsa_circ_0124554 in CRC. The results showed that hsa_circ_0124554 was substantially expressed in CRC tissues (P < .001) and that there were variations in pathological differentiation, perineural invasion and invasion. The expression of hsa_circ_0124554 in CRC patients was considerably higher than healthy controls (P < .001). The area under the receiver operating characteristic (ROC) curve (AUC) of tissue and plasma hsa_circ_0124554 was 0.703 and 0.742. The AUC of the expression combined hsa_circ_0124554, carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) had the best diagnostic performance (AUC = 0.899) in the CRC groups, and the sensitivity and specificity were 0.844 and 0.844. The expression of hsa_circ_0124554 was up-regulated in the tissues and plasma in CRC patients, which may be a new biomarker for the diagnosis of CRC. The combination hsa_circ_0124554, CEA and CA199 has the best diagnostic efficacy in CRC.
Breakthrough of chemiluminescence-based LAM urine test beyond HIV-positive individuals: Clinical diagnostic value of pulmonary tuberculosis in the general population
Authors: Zhang Yingxuan , Chen Shihao , Wei Hongxia , Zhong Qianhong , Yuan Yiwu , Wang Yongping , Lou Jianrong , Zhang Xilin
Published: December 2023

To investigate the diagnostic value of a novel high-sensitivity urine lipoarabinomannan (LAM) test (chemiluminescence-based) for active tuberculosis in the general population. A retrospective study was conducted on 250 clinical suspected tuberculosis patients who were HIV-negative and visited the Fourth People’s Hospital of Foshan from January 2022 to December 2022. Among them, there were 135 cases of pulmonary tuberculosis, 34 cases of extrapulmonary tuberculosis, and 81 cases of non-tuberculosis. Urine samples were collected for LAM antigen detection before treatment, and laboratory data of sputum smear acid-fast staining (smear method), sputum culture, and GeneXpert method were collected. Using clinical diagnosis as the reference standard, the diagnostic efficacy of 4 methods for detecting active tuberculosis was evaluated. For the 135 cases of pulmonary tuberculosis, the sensitivity of sputum smears, sputm culture, sputm GeneXpert method, and urine LAM were 29.6% (40/135), 45.9% (62/135), 59.3% (80/135), and 51.9% (70/135), respectively. The combination of LAM + GeneXpert and LAM + culture had the highest sensitivity for detecting active pulmonary tuberculosis, which were 71.0% and 78.2%, respectively. For the detection of sputum culture-negative pulmonary tuberculosis, the positive rates of smear, GeneXpert, and LAM were 0.0% (0/73), 53.4% (39/73), and 52.1% (38/73), respectively. LAM + smear and LAM + Genexpert could detect 52.1% and 68.5% of sputum culture-negative patients, respectively. The high-sensitivity urine LAM test holds promise for tuberculosis diagnosis in the general population. It demonstrates high-sensitivity, enabling the detection of sputum culture-negative pulmonary tuberculosis patients. Furthermore, when combined with existing methods, it can enhance the overall detection rate.
Treatment of aneurysmal artery with PED: A case report
Authors: Li Da , Jiang Yunxia , Zhuge Chengjun , Wu An
Published: December 2023

Rationale:

Pipeline embolization devices are a new treatment for intracranial aneurysms, especially irregular, giant aneurysms.

Patient concerns:

A 48-year-old female patient presented with a headache in the frontal part for 3 weeks.

Diagnoses:

Cerebral computed tomographic angiography and magnetic resonance angiography showed a saccular aneurysm in the right internal carotid artery that wrapped the parent artery. Digital subtraction angiography provided images with 1 large saccular internal carotid aneurysm.

Interventions:

The patient was treated by flow diverter stent and coil embolization and dual antiplatelet therapy with aspirin and ticagrelor in the ICU and was discharged after 10 days without complications.

Outcomes:

One year after interventional therapy, repeated digital subtraction angiography showed no recurrence of aneurysm and embolization well, and the patient reported improvement in neurological symptoms.

Lessons:

Aneurysmal parent artery is a rare phenomenon. The combination of flow diverter stents and coil embolization to treat cases with large saccular aneurysms has important clinical significance and this may provide a reference for clinical treatment of aneurysmal parent artery.