bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparative study on the impact of remimazolam and sevoflurane on quality of recovery after transurethral resection of bladder tumor: A randomized controlled noninferiority study
Authors: Ryu Kyoung-Ho , Lee Sung Hyun , Shim Jae-Geum , Park Jiyeon , Ahn Jin Hee , Jeon Suyong , Cho Eunah
Published: August 2024

Background:

Remimazolam is manifested by rapid action, hemodynamic stability, and fast recovery. Our study aimed to investigate whether the quality of recovery (QoR) after remimazolam anesthesia in patients undergoing transurethral resection of bladder tumor, which is predominantly performed in the elderly population, is not inferior to that after conventional anesthesia using sevoflurane.

Methods:

Thirty-four patients were randomly allocated into either of group S (n = 17, receiving sevoflurane anesthesia), or group R (n = 17, receiving remimazolam anesthesia). The QoR was assessed by Korean version of QoR-15 questionnaire, on the day before and after the surgery. Scores acquired for each individual item, QoR-15 scores categorized into 5 dimensions (physical comfort, physical independence, psychological support, emotional state, and pain), and overall global score were subjected to comparative analysis. The primary outcome was postoperative global QoR-15, and a noninferiority delta value of 8.0 was employed.

Results:

The postoperative global QoR-15 in the group S was 141 (134–146), and in the groups R was 133 (128–142) (P = .152). The mean difference of global QoR-15 (group S–group R) was 1.471 (95% confidence interval of −10.204 to 13.146), and the lower 95% confidence interval margin was lower than the noninferiority margin of −8.0. When comparing the QoR-15 sorted by 5 dimensions, pain scored higher in the group S (20 [18–20]) compared to the group R (15 [15–20], P = .032).

Conclusion:

The postoperative QoR following transurethral resection of bladder tumor was found to be lower in patients anesthetized with remimazolam in comparison to those anesthetized with sevoflurane.
Pink urine syndrome in an anuric patient during continuous renal replacement therapy: A case report
Authors: Julien Marie , Saint Gilles David De , Allou Nicolas
Published: August 2024

Introduction:

Pink urine syndrome is a rare, poorly understood condition, often prompted by obesity, insulin resistance, and the drug propofol. It is characterized by pink urine or urine sediment and occurs in the absence of a heme or food-based pigment. The pathophysiology of this syndrome is not yet fully understood but is linked to a uric acid metabolism disorder. Pink urine syndrome is less familiar to anesthesiologists than other propofol infusion complications. Our case report aims to highlight this rarely encountered syndrome, whose both diagnosis and therapeutic may be challenging. We have reported the first case of this syndrome evidenced by the change in color of the effluent bag during continuous veno-venous hemofiltration (CVVHF).

Case presentation:

A 61-year-old woman was admitted to the intensive care unit following a recovered cardiorespiratory arrest due to ventricular arrhythmia. She was placed in hypothermia, sedated with propofol (300 mg/h), and started on CVVHF for oligo-anuric acute kidney injury associated with severe metabolic acidosis. A few hours after initiation of CVVHF, the effluent bag turned bright pink. Given the pink color of the effluent bag and the hypothesis of propofol-induced pink urine syndrome, propofol was replaced by midazolam. After stopping propofol, the color of effluent bag lightened. Unfortunately, the patient died on the third day of hospitalization due to diffuse cerebral edema.

Conclusions:

We report here the first case of pink urine syndrome as revealed by the change in color of the contents of the CVVHF effluent bag in an anuric patient. This syndrome is rare but significant in anesthesia/intensive care settings, where propofol is a frequently used sedative. Knowledge of this syndrome appears to be important to avoid irrelevant additional investigations and to optimize the therapeutic strategy.
A 48-year-old man with fever, nauseous, vomiting, and dizzy: A CARE case report
Authors: Kou Xingbo , An Dinghao
Published: August 2024

Rationale:

Listeria monocytogenes (LM) is an important foodborne bacterium, and LM meningoencephalitis is rare in clinical practice, with poor prognosis in severe patients. It is prone to misdiagnosis in clinical practice. We first reported a case of severe LM meningoencephalitis with muscle lesions and evaluated the comprehensive condition.

Patient concerns:

A 48-year-old man had a fever and was admitted to the neurology department due to dizziness, nausea, and vomiting for 20 days.

Diagnoses:

LM meningoencephalitis complicated with muscle lesions.

Interventions:

We used moxifloxacin 0.4 g, qd, meropenem 2 g, q8h, and dexamethasone 10 mg, qd to reduce exudation and adhesion. Then due to consideration of side effects, we increased the dose of ampicillin by 2 g, q4h, stopped using meropenem and moxifloxacin, and turned to maintenance treatment with dexamethasone and ampicillin. We comprehensively managed his vital signs and physical organ functions, we also controlled some comorbidities. During the hospitalization period thereafter, we used intravenous anti-infection treatment with moxifloxacin 0.4 g, qd, ampicillin 0.5 g, q4h.

Outcomes:

Half a year later, the reexamination showed only protein elevation in cerebrospinal fluid and hydrocephalus in MRI. Afterward, the symptoms did not recur again. The patient recovered well after discharge.

Lessons:

LM meningoencephalitis complicated with lower limb muscle lesions is clinically rare. This report focuses on relevant treatment plans, which provide value for the examination and comprehensive management of patients with LM infection in the future.
Effects of Zishen Yutai pills combined with metformin on women with polycystic ovary syndrome undergoing in vitro fertilization
Authors: Zhang Yu , Cao Shan , Liang Jun-xia , Hu Shu-hong , Guo Xu-fang , Chun-jing Shi , Ge Li-na
Published: August 2024

In this study, we analyzed the clinical efficacy of Zishen Yutai pills (ZSYTP) combined with metformin hydrochloride on infertile women diagnosed with polycystic ovary syndrome (PCOS) undergoing in vitro fertilization and embryo transfer (IVF-ET). Patients were assigned into 3 groups: the ZSYTP group (n = 50), the metformin group (n = 50), and the combination group (ZSYTP combined with metformin hydrochloride, n = 50), based on their respective and the indicated treatments before undergoing IVF-ET. Then, their glucose metabolism indices, sex hormone indices, traditional Chinese medicine (TCM) syndrome scores, and outcomes of IVF-ET were compared. Baseline characteristics were not significantly different between the 2 groups. After treatment, various parameters such as body mass index (BMI), fasting plasma glucose (FPG), fasting insulin (FIN), homeostatic model assessment of insulin resistance (HOMA-IR), luteinizing hormone (LH), estradiol (E2), follicle-stimulating hormone (FSH), testosterone (T) levels, and TCM syndrome scores were found to be reduced compared to pretreatment levels in both groups. Moreover, the improvement observed in the treatment group exceeded that of the control group. Specifically, the observation group displayed significantly lower gonadotropin (Gn) dosage and duration, as well as a reduced abortion rate compared to the control group. Furthermore, the observation group had higher numbers of obtained eggs, high-quality embryos, eggs obtained through IVF-ET, average transferred embryos, clinical pregnancy rate, and embryo implantation rate compared to the control group. Pretreatment with ZSYTP combined with metformin before IVF-ET in PCOS patients improves the outcome of IVF-ET.
Acute effects of blood flow restricted aerobic exercise in type 2 diabetes mellitus
Authors: Şahin Elif , Ayaz Teslime , Saglam Melda
Published: August 2024

Background:

This study aimed to compare the acute effects of aerobic exercise performed with blood flow restriction (BFR), a novel method to increase exercise gains, with blood free flow (BFF) conditions in type 2 diabetes mellitus (T2DM).

Methods:

Fifteen individuals with T2DM performed BFF and BFR (40% of arterial occlusion pressure) cycling exercises 48 hours apart, at equal intensity (45% heart rate reserve) and duration (38 minutes). Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), blood glucose, heart rate, and muscle oxygen saturation (SmO2) were assessed before-after and during exercise sessions.

Results:

SBP, DBP, and MAP in the overload phase were higher in the BFR group than in the BFF group (P = .009, 0.031, and 0.013, respectively). Changes in blood pressure (∆SBP and ∆DBP) were similar between the BFF and BFR groups (P > .05), whereas ∆MAP differed (P = .016). Changes in blood glucose levels and heart rates were not significantly different between the groups. Although SmO2baseline was lower in the BFR group (P = .049), SmO2min and SmO2max did not differ significantly between the BFF and BFR groups.

Conclusion:

The similar decrease in blood glucose levels between the groups suggests that BFR exercise is favorable in terms of hypoglycemia. The higher blood pressure observed during the BFR exercise remained within safe limits. These results suggest that people with T2DM can safely perform BFR aerobic exercises; however, further studies are required.
Intensive care of a patient undergoing combined multi-organ cluster (“larynx–trachea–thyroid–hypopharynx–esophagus”) transplantation: A case report
Authors: Shen Jia , Liu Huan , Zhang Yaodan , Xu Yu , Du Aiping , Tian Yongming
Published: August 2024

Objective:

The aim of this study was to summarize the intensive care experience of a patient undergoing combined multi-organ cluster (“larynx–trachea–thyroid–hypopharynx–esophagus”) transplantation.

Methods:

The intensive care management plan for this case was developed by a multidisciplinary team, with focus on 6 aspects: (1) stabilizing the circulation and reducing anastomotic tension by position management to improve the survival chances of transplanted organs, (2) adopting goal-directed analgesia and sedation protocols, as well as preventing anastomotic fistula, (3) implementing a bedside ultrasound-guided nutrition plan, (4) employing “body–mind” synchronous rehabilitation to facilitate functional recovery, (5) taking antirejection treatment and protective isolation measures, (6) monitoring and nursing thyroid function.

Results:

During the intensive care, the patient’s vital signs were stable. The patient was successfully weaned from the ventilator and transferred to the general ward for further treatment at 9 days postoperatively, and discharged upon recovery at 58 days postoperatively. The patient was in good condition during follow-up.

Conclusion:

This study provides reference for the care of patients who undergo similar transplantation in the future.
Acute spontaneous non-hemorrhagic adrenal infarction with systemic lupus erythematosus and antiphospholipid antibody syndrome: A case report
Authors: Liang Chunxiao , Qiu Taichun , Lu Zhongyan , Ming Bing , Xie Dongmei , Wang Fei , Zou Qing
Published: August 2024

Rationale:

Adrenal infarction (AI) is a rare type of adrenal damage, which is relatively common in systemic lupus erythematosus, antiphospholipid antibody syndrome (APS) and pregnancy. The diagnosis of AI is mainly by computed tomography (CT) and magnetic resonance imaging, but is easily confused with other adrenal disease. Hence, this report details a condition of AI with systemic lupus erythematosus, APS and made a differential diagnosis from imaging.

Patient concerns:

We report a case of a 55-year-old woman with pain in her fossa axillaries and inguinal regions. Then CT scan disclosed bilateral adrenal diseases, and the patient was diagnosed with systemic lupus erythematosus, APS and AI after additional autoimmune examinations.

Diagnoses:

The patient was diagnosed as systemic lupus erythematosus with lupus nephritis, hematological damage and oromeningitis, APS, AI and secondary blood coagulation disorders.

Interventions:

The patient was treated with methylprednisolone, hydroxychloroquine and low molecular heparin.

Outcomes:

The patient relieves and remains well 1 year after treatment.

Lessons subsections:

AI can be divided hemorrhagic and non-hemorrhagic, with bilateral lesions more common. In our case, the AI was bilateral, partially involved and non-hemorrhagic, and the “cutoff sign” was first put forward in CT, which might assist the diagnosis.
Analysis of factors influencing pregnancy and its outcomes in women undergoing in vitro fertilization–embryo transfer/frozen embryo transfer cycles: A retrospective study
Authors: Zhang Hao , Zhang Yuan yuan , Cheng Yaping , Yan Hua , Zheng Xi
Published: August 2024

The relationship between clinical outcomes and various factors influencing pregnancy was analyzed to provide reference data for patients and clinicians when selecting embryo transfer protocols. This was a retrospective study of 1309 transfer cycles between June 1, 2018, and May 1, 2023, in the Reproductive Medicine Center. Univariate analysis was performed on various factors that may have affected pregnancy outcomes, and further regression analysis was performed on those factors found by univariate analysis to correlate positively with clinical pregnancy outcomes. Finally, the embryo transfer schemes were compared based on the analysis results. The results showed that the stage of embryonic development significantly affected pregnancy outcomes after transplantation (P < .01, 95% confidence interval: 2.554 [1.958–3.332]). There was no significant difference in the pregnancy rate between 1 high-quality blastocyst transfer and 2 cleavage-stage embryos or blastocyst transfer (64.22% vs 70.11%, P = .439); however, the rate of multiple pregnancies after 1 high-quality blastocyst transfer was close to the rate of natural conception. These data show that the transfer of single high-quality blastocysts can significantly reduce the multiple pregnancy rate while ensuring an ideal pregnancy rate, which can be used as a reference for planning the first transplantation in patients with good prognoses.
Case report: Comprehensive management of painful diabetic neuropathy—Addressing opioid-induced hyperalgesia through multimodal approaches
Authors: Maksymowicz Robert , Strączek Cyprian N. , Matysek Jeremi J. , Lech Dominika M. , Nosek Krzysztof
Published: August 2024

Rationale:

Diabetic neuropathy is a prevalent and debilitating complication of diabetes, necessitating effective pain management strategies. While pharmacological treatments, including opioids, are commonly employed, they pose significant challenges due to the risk of developing opioid-induced hyperalgesia (OIH). This case report aims to illustrate the efficacy of a comprehensive, multidisciplinary approach in managing painful diabetic neuropathy complicated by OIH.

Patient concerns:

A 64-year-old male patient presented to the Pain Treatment Clinic with severe lower limb pain due to diabetic polyneuropathy. He had a history of multiple comorbidities.

Diagnoses:

The patient’s condition and physical examination suggested the presence of opioid-induced hyperalgesia (OIH). Despite the increased dose of opioids, the patient did not report significant constipation or breathing difficulties but experienced drowsiness and dry mouth. A diagnosis of opioid and benzodiazepine dependence was made.

Interventions:

The treatment plan involved the initiation of pregabalin and duloxetine, gradual reduction of opioid use, and psychiatric support for addiction management.

Outcomes:

Over 12 months, the patient experienced significant pain reduction and minimal adverse effects.

Lessons:

Effective management of OIH involves gradual opioid tapering and a multimodal therapeutic approach. However, the optimal treatment strategies and the frequency of OIH occurrence remain areas of uncertainty, relying heavily on clinical expertise and individualized patient care. Further research is needed to refine these treatment strategies and improve patient outcomes.
The value of FPR, FAR, CAR, CPR in the auxiliary diagnosis of colon cancer
Authors: Zhao Shiyu , Ju Ying , Gao Binbin , Chu Fulu , Lu Bingru , Bao Guolin , Ding Shan , Liu Yiqing
Published: August 2024

Chronic malnutrition, abnormal blood clotting, and systemic inflammation contribute to the occurrence and progression of colon cancer. This study aimed to assess the diagnostic utility of the 100fibrinogen-to-prealbumin ratio (FPR), 100fibrinogen-to-albumin ratio (FAR), 100C-reactive protein-to-albumin ratio (CAR), and 100C-reactive protein-to-prealbumin ratio (CPR) in aiding the diagnosis of colon cancer. A total of 129 patients with colon cancer were enrolled between April 2015 and August 2022. While 129 patients with colon adenoma were selected as the control group. The serum levels of FAR, FPR, CAR, CPR, CEA, and CA125 in the colon cancer group were significantly higher than those in the colon adenoma group (P < .05). In Logistic regression analysis, high FAR and high FPR were identified as independent risk factors for colon cancer. Receiver operating characteristic (ROC) curve analysis results showed that Among the combined measures, FAR, FPR, CAR, and CPR had the highest diagnostic efficacy in distinguishing colon cancer from colon adenomas (AUC = 0.886, Sen = 80.62%, Spe = 81.40%). Thus, FAR, FPR, CAR, and CPR may serve as valuable biomarkers for the diagnosis of colon cancer, and the combined detection of FAR, FPR, CAR, and CPR can enhance the diagnostic efficiency for both colon cancer and colon adenoma.
Low molecular weight 35 kDa hyaluronan fragment HA35 in the treatment of bone metastasis pain: A case report
Authors: Zhang Zongchun , Jia Xiaoxiao , Treger Dylan , Hui Mizhou
Published: August 2024

Rationale:

Late-stage cancer patients often experience severe pain due to bone metastasis, caused by structural damage and cancer-induced inflammation. Hyaluronan, known to alleviate pain by blocking the TRVP1 calcium channel, faces limitations due to its high molecular weight. However, 35 kDa low molecular weight hyaluronan fragment (HA35) have shown promise in relieving various pains, including cancer-related pain. Nonetheless, evidence regarding their efficacy in bone metastasis pain remains scarce.

Patients concerns:

A 52-year-old female with a rectal malignant tumor and multiple secondary tumors in the sacrum and lungs, accompanied by bone metastasis pain. Despite undergoing radiotherapy, her pain relief was unsatisfactory. Before treatment with HA35, her numerical rating scale score was 10, severely affecting her sleep, appetite, and daily activities.

Diagnoses:

The patient was diagnosed with rectal malignant tumor with multiple metastases, presenting symptoms such as sacral metastasis pain, anal pain, lower limb pain, and anterior abdominal pain. Sacral metastasis pain and lower limb pain indicated a clear diagnosis of bone metastasis pain.

Interventions:

Treatment involved subcutaneous injection into the deep fat tissue layer of the abdomen. A subcutaneous injection of 100 mg/5 mL of HA35 was administered once into the deep fat tissue of the abdomen, with subsequent injections repeated every 3 days.

Outcomes:

Following 1 injection, the patient’s pain score decreased to 6 points within 20 minutes, providing 40% pain relief. After 40 minutes, the score further dropped to 4 points, with 60% pain relief. After 50 injections, pain was consistently controlled at around 3 points.

Lessons subsections:

Subcutaneous injection of HA35 into the abdominal fat tissue effectively alleviates pain in cancer and bone metastasis patients resistant to conventional treatments. Additionally, it helps alleviate anxiety and fatigue, and improves diet and sleep, thereby offering crucial palliative care for advanced cancer patients.
WD repeat domain 43 as a new predictive indicator and its connection with tumor immune cell infiltration in pan-cancer
Authors: Yang Xin , Luo Ting , Liu Zhixin , Liu Jiao , Yang Zhuo
Published: August 2024

Background:

WD repeat domain 43 (WDR43) is a protein component that encodes WD-repeats and is involved in ribosome biogenesis. However, little is known about the role of WDR43 in cancer prognosis and immune modulation.

Methods:

In this study, we analyzed the expression and prognostic significance of WDR43 in pan-cancer using the Cancer Genome Atlas, the Genotype-Tissue Expression, and the Human Protein Atlas. We also examined the differential expression of WDR43 in liver hepatocellular carcinoma (LIHC) and adjacent tissues of 48 patients using immunohistochemistry. Additionally, we investigated the correlation between WDR43 and clinical characteristics, gene alterations, tumor mutation burden, microsatellite instability, mismatch repair, tumor microenvironment, immune infiltrating cells, and immune-related genes using bioinformatics methods. Gene set enrichment analysis was conducted, and potential biological mechanisms were identified.

Results:

Immunohistochemistry staining showed that WDR43 was overexpressed in LIHC among 48 patients. Upregulation of WDR43 was associated with unfavorable prognosis, including overall survival in various types of cancer such as LIHC, uterine corpus endometrial cancer, head and neck squamous cell carcinoma, and pancreatic adenocarcinoma. Differential expression of WDR43 was significantly correlated with microsatellite instability, mismatch repair, and immune cell infiltration. Gene ontology annotation analysis revealed that these genes were significantly enriched in immune-related functions, including immune response, immune regulation, and signaling pathways.

Conclusion:

We conducted a thorough investigation of the clinical features, phases of tumor development, immune infiltration, gene mutation, and functional enrichment analysis of WDR43 in various types of cancer. This research offers valuable insight into the significance and function of WDR43 in clinical therapy.
Current status and factors influencing the work readiness of middle-aged and young postoperative lung cancer patients
Authors: Yin Yuanyuan , Long Xingxia , Zhang Jie , Yang Mei
Published: August 2024

To identify the current status of return-to-work readiness and analyze its influencing factors among middle-aged and young postoperative lung cancer patients. From July 2022 to February 2023, a total of 144 middle-aged and young postoperative lung cancer patients who had been treated in the Department of Thoracic Surgery of West China Hospital, Sichuan University and had not returned to work were selected as the research subjects. A general information questionnaire, the Readiness for Return-To-Work (RRTW) Scale, the General Self-Efficacy Scale (GSES), and the Simplified Coping Style Questionnaire (SCSQ) were used for the survey. Univariate analysis and ordinal logistic regression analysis were used to assess the current status of work readiness and its influencing factors. The distribution of work readiness from high to low was as follows: behavioral preparation-self-assessment stage, intention stage, preintention stage, and behavioral preparation-action stage. Univariate analysis showed that age, place of residence, occupation, nature of work, average family income, scope of surgery, postoperative complications, surgical site, and primary coping strategies were statistically significant (P < .05). The ordinal logistic regression analysis revealed that patients engaged in mentally oriented work (odds ratio [OR] = 13.78, P < .001), with a monthly family income of ≥ 10,000¥ (OR = 6.28, P = .017), proactive coping strategies (OR = 4.84, P = .019), and higher self-efficacy (OR = 1.17, P < .001) had higher work readiness. Patients engaged in other industries (OR = 0.25, P = .028), agricultural, forestry, and fishing labor (OR = 0.08, P < .001), unemployed (OR = 0.12, P = .038), and with a monthly family income of < 1000¥ (OR = 0.07, P = .026) had lower work readiness. In overall, this study suggests that the work readiness of postoperative lung cancer patients needs improvement. Occupation, nature of work, average family income, primary coping strategies, and general self-efficacy are associated with return-to-work readiness among middle-aged and young postoperative lung cancer patients.
Ruptured giant splenic artery aneurysm with an exceptional concurrent gastric and transverse colonic fistula: A rare case report
Authors: Zain Abdo Mohamad , Sires Abdoul Majid , Al-Jawad Mohammad , Alkanj Hussein
Published: August 2024

Introduction:

Splenic artery aneurysm (SAA) is a focal dilation of the splenic artery with varying etiologies including atherosclerosis, arteritis, or trauma. Giant SAAs with a diameter of 10 cm is rare and can lead to severe complications like rupture and fistulas. Therefore, an accurate and timely diagnosis and treatment are important.

Patient concerns:

A 50-year-old male presented with acute epigastric pain and hemorrhagic shock. Considering his symptoms and examination, ultrasound, multi-slice computed tomography and digital subtraction angiography results, a ruptured giant splenic artery aneurysm complicated with an exceptional gastric and transverse colonic fistula was suspected.

Diagnosis:

Ruptured giant splenic artery aneurysm.

Interventions:

Left anterolateral thoracotomy to control the severe aortic bleeding just above the diaphragm, aneurysmectomy, splenectomy, and closing the gastric and transverse colon perforations.

Outcomes:

Multi-slice computed tomography demonstrated the presence of splenic artery aneurysm in the distal third measuring (10 × 12 cm) in diameter with a true lumen measuring (7 × 3.5 cm) and a large hematoma extending to the greater and lesser gastric curvature. Intraoperatively, a large pulsating mass was detected occupying the epigastrium and the left hypochondrium with severe adhesions with the stomach and transverse colon.

Conclusion:

Giant SAA with a diameter of 10 cm is rare and is associated with severe complications. Therefore, successful treatment of splenic artery aneurysms involves prompt diagnosis, immediate surgical intervention to control bleeding, and tailored approaches like thoracotomy to control the thoracic aorta for better hemodynamic stabilization, aiming to eliminate the aneurysm and reduce complications effectively.
Association between obesity and liver cancer from 2012 to 2023: Bibliometric analysis and global trends
Authors: Wang Donghong , Ma Zhibin
Published: August 2024

Incidence rates of liver cancer have increased worldwide in recent decades, making it a major public health problem globally. Obesity can be caused by multiple factors and promotes the development of liver cancer in many ways. Although the research on the association between obesity and liver cancer was previously explored, we first employed bibliometrics to analyze the current research status. From 2012 to 2023, the Web of Science Core Collection database was searched for studies regarding the association between obesity and liver cancer. To evaluate worldwide trends and research hotspots in this topic, bibliometric analysis tools such as VOSviewer, CiteSpace, and R Package were employed. Altogether 233 eligible publications, consisting of 167 articles and 66 reviews, were analyzed. The yearly number of publications and average citation numbers have increased over the last 11 years, particularly the last 6 years. The great majority of published articles on this topic originated from the United States (n = 89, 38.20%), followed by China (n = 60, 25.75%), and England (n = 23, 9.87%). In this subject’s research, American scholars embodied considerable production, great prominence, and high academic influence. The most cited article was Yoshimoto, S et al of Japan Science and Technology Agency published in 2013 with a citation number of 1410. We apply bibliometric analysis for the first time in this field, expecting to help scholars efficiently and effectively retrieve the association between obesity and liver cancer.
A rare case report of splenic infarction in a previously healthy teenager caused by acute infectious mononucleosis
Authors: Ma Lijun
Published: August 2024

Rationale:

Splenic infarction usually occurs in patients with underlying illnesses such as thromboembolic disorders and infiltrative hematologic diseases. Herein, we report a rare case of splenic infarction in a previously healthy boy diagnosed with infectious mononucleosis (IM). Splenic infarction is a rare complication of IM and its incidence is unknown. This case report summarizes the clinical characteristics, treatment options, and anticipated time for recovery from splenic infarction in IM.

Patient concern:

A16-year-old boy presented to our clinic with complaints of fever, sore throat, and general sweakness for 7 days. The patient was diagnosed with IM due to an Epstein–Barr virus infection. Two days later, the patient developed severe abdominal pain in the left upper quadrant and returned to our ER for further evaluation.

Diagnosis:

IM complicated with splenic infarction.

Interventions:

Contrast-enhanced CT confirmed the diagnosis of splenic infarction. This patient was admitted for supportive treatment and close medical monitoring. Surgical

Outcomes:

The patient recovered well with conservative treatment.

Lessons:

IM is most often seen in adolescents and young adults. Splenic infarction is a rare complication of IM, particularly in patients who do not usually have any underlying predisposing medical conditions. Contrast-enhanced CT is the imaging modality of choice in suspected cases. Early recognition and treatment of splenic infarction in patients with IM can help prevent potentially life-threatening events. Patients should be advised to avoid sports that may precipitate splenic rupture. However it is still unknown when it is safe for patients to resume sports. In our case, 6 weeks after the splenic infarction, the patient generally felt well with complete resolution of objective symptoms and splenomegaly, and resumed sports without experiencing any adverse events.
Chronic abdominal distention caused by diffuse nodular ileal and mesenteric lipomatosis: A case report
Authors: Zhang Li-xiao , Wang Yong-fei , Hu Xiao-jie , Qi Jie , Liang Wei
Published: August 2024

Rationale:

Diffuse intestinal and mesenteric lipomatosis is a rare condition characterized by the overgrowth of adipose tissue in the intestines and mesentery. This case report aims to highlight the rare occurrence of chronic abdominal distention caused by this disease and its unique invasion into the muscle layer, which has not been previously reported.

Patient concerns:

A 36-year-old woman with a 7-year history of abdominal distension was admitted to our hospital’s Department of Gastrointestinal Surgery.

Diagnose:

Abdominal and pelvic computed tomography revealed diffuse small intestinal lipomatosis.

Interventions:

The patient underwent surgery. We performed an open-field ilectomy involving removal of all lipomatous intestines (250 cm).

Outcomes:

During the surgery, diffuse nodular ileal and mesenteric lipomatosis was confirmed, characterized by the presence of multiple nodular lipomas within the submucosal and muscular layers. The surgical intervention involved the resection of 250 cm of the affected ileum, followed by jejunoileal anastomosis. Postoperative pathology confirmed the diagnosis, with lesions observed in both the submucosa and muscle layers. The patient showed significant improvement in symptoms, with normal intestinal function and weight gain observed over a 10-month follow-up period, and no signs of recurrence.

Lessons:

Diffuse intestinal and mesenteric lipomatosis can lead to long-term abdominal distension. Additionally, it may be involved in the muscle layer of the intestinal wall. Surgery is the primary treatment option for symptomatic intestinal lipomatosis.
A comparative cross-platform analysis of cuproptosis-related genes in human nonobstructive azoospermia: An observational study
Authors: Jiang Silin , Wei Yong , Li Yongshan , Liu Wei , Wang Zhenzhong , Meng Xuhui , Zhu Qingyi , Shen Luming
Published: August 2024

This study aimed to identify novel biomarkers associated with cuproptosis in human nonobstructive azoospermia (NOA). We obtained 4 NOA microarray datasets (GSE145467, GSE9210, GSE108886, and GSE45885) from the NCBI Gene Expression Omnibus database and merged them into training set. Another NOA dataset (GSE45887) was used as validation set. Differentially expressed cuproptosis-related genes were identified from training set. Gene Ontology function and Kyoto Encyclopedia of Genes and Genomes pathway analyses were conducted. Least absolute shrinkage and selection operator regression and support vector machine-recursive feature elimination were used to identify hub cuproptosis-related genes. We calculated the expression of the hub cuproptosis-related genes in both validation set and patients with NOA. Gene set variation analysis was used to explore their potential biological functions. The risk prediction model was built by logistic regression analysis and was evaluated in the validation set. Finally, we constructed a competing endogenous RNA network. The training set included 29 patents in the control group and 92 in the NOA group, and 10 cuproptosis-related differentially expressed genes were identified. Subsequently, we screened 6 hub cuproptosis-related genes (DBT, GCSH, NFE2L2, NLRP3, PDHA1, and SLC31A1) by least absolute shrinkage and selection operator regression and support vector machine-recursive feature elimination. GCSH, NFE2L2, NLRP3, and SLC31A1 expressed higher in NOA group than in control group (P < .05) in the validation set (4 patients in control and 16 in NOA groups), while the expression levels of GCSH, NFE2L2, NLRP3, PDHA1, and SLC31A1 were higher in NOA group than in control group (P < .05) in our patients (3 patients in control and 4 in NOA groups). The model based on the 6-gene signature showed superior performance with an AUC value of 0.970 in training set, while 1.0 in validation set. Gene set variation analysis revealed a higher enrichment score of “homologous recombination” in the high expression groups of the 6 hub genes. Finally, we constructed a competing endogenous RNA network and found hsa-miR-335-3p and hsa-miR-1-3p were the most frequently related to the 6 hub genes. DBT, GCSH, NFE2L2, NLRP3, PDHA1, and SLC31A1 may serve as predictors of cuproptosis and play important roles in the NOA pathogenesis.
A real-world analysis of roxadustat effectiveness and safety in managing renal anemia among patients on maintenance hemodialysis: An observational study
Authors: Zhang Yuan , Chen Minyue , Tang Lian , Chen Xiangfan , Meng Yajing , Feng Sujuan
Published: August 2024

We aimed to compare the clinical efficacy and safety of roxadustat with erythropoiesis-stimulating agents, particularly erythropoietin (EPO), in the treatment of maintenance hemodialysis patients with renal anemia. A prospective cohort study was carried out at the Nephrology Department of the Nantong First People’s Hospital and Nantong University Affiliated Hospital from December 2020 to December 2021. We compared hemoglobin (Hb) levels, serum ferritin (SF) levels, and adverse cardiovascular events between the roxadustat and EPO groups at 1, 3, and 6 months into the treatment. A total of 209 patients participated in the study, with 112 in the roxadustat group and 97 in the EPO group. At baseline, no statistically significant differences were observed between the 2 groups in terms of age, gender, weight, dialysis modality and duration, previous EPO dosage, Hb levels, SF levels, transferrin saturation, heart function classification, and blood pressure levels (P > .05). After 1 month, Hb levels in the roxadustat group were significantly higher than those in the EPO group (P < .05). However, no statistically significant differences were found between the 2 groups at 3 and 6 months (P > .05). Additionally, there were no significant differences in SF levels and the occurrence of adverse cardiovascular events between the 2 groups after treatment (P > .05). Roxadustat was superior to EPO in the initial treatment phase, while its cardiovascular safety was comparable to that of EPO.
Long-term impacts of COVID-19 in patients with prior heart failure in Korea: A nationwide cohort study using the common data model
Authors: Lee Seunghwa , Lim Kyoung Ree , Chun Kwang Jin , Kim Bum Sung
Published: August 2024

Limited data are available on the long-term prognosis and monitoring period after coronavirus disease 2019 (COVID-19) infection in the population with prior heart failure (HF). We aimed to exam the association of COVID-19 with clinical prognosis in populations with prior HF and evaluate prognosis within 30 days and 30 days to 1 year after infection. Based on insurance benefit claims sent to the Health Insurance Review and Assessment Service of Korea from January 2018 to April 2022, 9,822,577 patients were selected and converted to the Observational Medical Outcomes Partnership-common data model by the Big Data Department of Health Insurance Review and Assessment Service of Korea. In the dataset, 1,565,274 patients exhibited diagnosis of HF based on the International Statistical Classification of Diseases and Related Health Problems 10 codes. They were divided into 2 groups according to COVID-19 infection, and propensity-score-matching analysis was performed. The clinical outcome was all-cause mortality. Among the 1,565,274 patients with an HF diagnosis, 1,152,975 patients were classified into the HF with the COVID-19 group and 412,299 patients in the HF without COVID-19 group. We created 200,780 matched pairs by propensity-score-matching analysis. Within 30 days of COVID-19, the HF with COVID-19 group had a higher risk of all-cause death compared with the HF without COVID-19 group (hazard ratio [HR]: 2.19, 95% confidence interval [CI]: 2.04–2.36, P < .01). Thirty days to 1 year after COVID-19 infection, the HF with COVID-19 group exhibited a higher risk of all-cause death (HR: 2.04, 95% CI: 1.83–2.27, P < .01). In populations with prior HF, COVID-19 is associated with a higher risk of all-cause mortality within 30 days and this risk remains augmented up to 1 year after the acute phase of COVID-19. Our findings suggest that greater attention may be crucial in populations with prior HF for a prolonged period after COVID-19 infection.
Ethical Dilemmas and Coping Experiences of Nurses Caring for Patients With Hematologic Cancer
Authors: Uzun Sevda
Published: August 2024

The study aimed to evaluate the ethical dilemmas faced by nurses who provide care to patients with hematologic cancer and determine their coping mechanisms using a phenomenological approach. This qualitative study was conducted with 35 nurses employed in clinics specializing in hematologic cancer patient care, living in diverse regions of Turkey, using semistructured, in-depth interviews through the WhatsApp mobile application. The snowball sampling technique was utilized to identify participants, and interviews continued until data saturation was achieved. All interviews were recorded and subsequently transcribed. Data analysis was conducted using Colaizzi’s phenomenological analysis method, with the study adhering to the COREQ (Consolidated Criteria for Reporting Qualitative Research) checklist for reporting. In the analysis of the data, 2 categories (ethical dilemma situations and coping experiences) and 6 subthemes (treatment, care, professional values and beliefs, emotions, struggling with emotional burdens, and psychosocial approach) emerged. According to the results, nurses responsible for hematologic cancer patients struggle with ethical dilemmas in healthcare delivery and face challenges in effectively addressing them, which could potentially impact the quality of healthcare provided by nurses.
Sexual Disorders in Men
Authors: Spytska Liana
Published: August 2024

The aim is to identify the causes of physical and emotional health disorders in men in terms of intimate interaction with partners, as well as how they can be prevented. The research used comparison, analysis, statistical methods, and surveys. The need for people to discover and study sexual health issues in the modern world in order to support not only the physical, but also the psychological aspects of their body, as well as the impact of lifestyle on this process, is shown. The research was conducted to better understand all diseases that are based on the deterioration of the psycho-emotional state of men, which leads to sexual disorders. A more detailed study of this topic will allow to better select treatment for patients and find different approaches to the problem in the future.
Addressing Barriers to Autopsy and Genetic Testing in Stillbirth Workup
Authors: Gibbins Karen J. , Vora Neeta L. , Subramaniam Akila , Page Jessica M. , Riches Naomi O. , Rothwell Erin
Published: August 2024

The cause of death in many stillbirths remains unexplained, in part because of systematic barriers to complete workup. We review the importance of placental pathology, fetal autopsy, and genetic testing in stillbirth workup. Placental pathology is useful in 65% of stillbirths, and fetal autopsy is useful in 42%. Currently, only 21% of stillbirths in the United States undergo autopsy. Barriers to complete stillbirth workup include cost of autopsy and genetic testing, availability of perinatal pathology expertise, health care professional knowledge about workup, and availability of skilled counseling to support bereaved parents in making decisions about autopsy and genetic workup. We propose solutions to overcome these barriers, including policy changes to expand access and a framework for high-quality patient counseling and decision support.
Clinical Associations of E148Q Heterozygosity
Authors: Küçükali Batuhan , Bayraktar Elif Özlem , Yıldız Çisem , Gönen Sevim , Kutlar Merve , Karaçayır Nihal , Belder Nuran , Acun Büşra , Esmeray Şenol Pelin , Sunar Yayla Emine Nur , Gezgin Yıldırım Deniz , Bakkaloğlu Sevcan A.
Published: August 2024

Objective

The exact effects of MEFV variants on inflammation are still under investigation, and reports on variants of unknown significance, particularly the E148Q variant, have been conflicting. Therefore, this study aims to investigate patients exhibiting E148Q heterozygosity, focusing on diagnoses and disease courses to assist physicians in interpreting the variant.

Methods

Data of pediatric patients presenting to the Pediatric Rheumatology clinic between November 2016 and September 2023, exhibiting only E148Q heterozygosity in MEFV gene analysis, were extracted. Patients who were lost before 9 months of follow-up have been excluded to ensure the completion of initial diagnostic tests and evaluations.

Results

Among the 119 patients with E148Q variant, the diagnoses were as follows: healthy, 51.3%; IgA vasculitis, 10.1%; Familial Mediterranean Fever (FMF), 7.6%; Periodic fever, Aphtous stomatitis, Pharyngitis, Adenitis (PFAPA), 6.7%; and other diagnoses, 19.3%. IgA vasculitis patients experienced articular, gastrointestinal, and renal involvement at rates of 91.7%, 58.3%, and 16.7%, respectively. Complete response, partial response, and no response to colchicine were 37.5%, 12.5%, and 50%, respectively, in PFAPA patients. All FMF patients responded to colchicine treatment resulting in reduced mean FMF episode counts in 6 months from 3.22 ± 0.92 to 0.56 ± 0.52.

Conclusions

The E148Q variant may amplify inflammation and modify disease courses. Patients with the E148Q variant experiencing typical FMF episodes should receive colchicine, but clinicians should exercise caution regarding alternative diagnoses. Additionally, the E148Q variant may increase acute phase reactants and disease severity in IgA vasculitis. However, to reach definitive conclusions on its treatment-modifying role in PFAPA, universal diagnosis and treatment response criteria should be adopted.
Apparently Benign 131I Adrenal Uptake
Authors: Travaglio Morales Daniela , Kreissl Michael C. , Fischer Florian , Heinzel Alexander
Published: August 2024

A 60-year-old man suffering from papillary thyroid cancer (pT2 pN0(0/21) cM0) underwent diagnostic 131I whole-body scintigraphy with recombinant thyroid-stimulating hormone for follow-up after thyroidectomy and adjuvant 131I therapy with 4.2 GBq. A focal uptake of radioiodine was found in the right adrenal gland, which had not been seen on the initial posttherapeutic images; therefore, an adrenal metastasis was suspected. However, the diagnostic workup including contrast-enhanced MRI as well as endocrine laboratory tests indicated a benign etiology showcasing a very rare case of false-positive radioiodine uptake in the adrenal gland. The imaging follow-up after 1 year showed no significant changes.
Mirogabalin: a novel gabapentinoid or another false dawn?
Authors: Craig Thomas J. , Farquhar-Smith Paul
Published: August 2024

Purpose of review

Mirogabalin is a novel gabapentinoid medication for the treatment of neuropathic pain. The purpose of this review is to discuss current evidence for its use. Gabapentinoids are widely prescribed for neuropathic pain. Mirogabalin offers theoretical advantages over traditional gabapentinoids due to its specificity for the α2δ-1 subunit of voltage-gated calcium channels. It is theorised that this specificity may reduce adverse drug reactions by minimising binding to the α2δ-2 subunit which is responsible for many of the gabapentinoid side effects.

Recent findings

Mirogabalin’s slower dissociation from the α2δ-1 compared with α2δ-2, and its higher potency may also impart an efficacy benefit over traditional gabapentinoids. These theoretical advantages of mirogabalin remain inconclusive in clinical practice, with mixed evidence regarding mirogabalin versus traditional gabapentinoids. Some studies suggest a reduced side effect profile yet, others fail to demonstrate significant differences. Regarding efficacy, mirogabalin may be superior to placebo for several neuropathic pain syndromes, but evidence of widespread benefit over traditional gabapentinoids is currently lacking.

Mirogabalin offers theoretical promise, but large, independent studies are required to further assess its performance versus traditional gabapentinoids.
A traffic light approach for treatment and supportive care stratification in lung cancer
Authors: Phillips Iain , Nottelmann Lise , Stares Mark
Published: August 2024

Purpose of review

Comprehensive supportive care interventions for patients with lung cancer are being investigated in a range of ways, including: early palliative care, prehabilitation and rehabilitation. We review recent literature on supportive care and propose a traffic light system to individualise comprehensive supportive care. Green for those very likely to receive anti-cancer treatment, red for those very unlikely to receive anti-cancer treatment and orange where the chance of accessing treatment is uncertain. Comprehensive supportive care can be individualised based on the group a particular patient is in.

Recent findings

Lung cancer outcomes are improving with the availability of increasingly efficacious treatments; however, treatment rates for advanced disease remain low. In this review, we discuss how person-centred outcomes could be improved, how outcomes can be prognosticated and how the ‘host’ can be staged as well as the cancer. Recent data suggests that early comprehensive supportive care improves quality of life, reduces time spent in hospital and may affect survival.

Comprehensive supportive care is likely to improve quality of life in patients with advanced lung cancer. Further work is needed to see if it can improve treatment rates and survival.