bluuebunny/crossref_metadata_2025 huggingface dataset:
Under-five mortality in Sierra Leone and possible associated factors: evidence from the 2019 Demographic and Health Survey
Authors: Koroma Mark Momoh , Kabba John Alimamy , Wanda Jessicah , Yu Jingrong , Zhou Feiyuan , Liang Zhiyan , Tarawally Abu Bakarr , Chigoneka Kuleza , Dai Ying-Chun
Published: September 2022

High under-five mortality rate remains one of the public health challenges, especially in Sub-Saharan Africa, accounting for more than half of all global cases. Sierra Leone was and is still one of the countries with the highest under-five mortality rate. Using the latest 2019 Sierra Leone Demographic and Health Survey data, we investigated factors associated with under-five mortality in Sierra Leone. A total of 9771 mothers aged 15–49 years in the country were interviewed and included in the analysis. The dependent variable is child status (dead = 1; alive = 0). A total of 871 (9%) children died before their fifth birthday. The maternal age of 20–24 years [adjusted odds ratios (AOR) = 0.46; 95% confidence interval (CI) = 0.33–0.64; P < 0.001] up to 40–44 years (AOR = 0.43; CI = 0.27–0.7; P = 0.001), currently breastfeeding (AOR = 0.20; CI = 0.17–0.24; P < 0.001), maternal media exposure and usage of reading newspapers/magazines less than once a week (AOR = 0.48; CI = 0.28–0.85; P = 0.011) were more likely to enhance child survivability through their fifth birthday. Also, the child sex being female (AOR = 0.68; CI = 0.59–0.79) was more likely to survive under-five mortality compared to their male counterpart. On the other hand, mothers who listened to radio at least once a week (AOR = 1.31; CI = 1.08–1.59; P = 0.007) watched television less than once a week (AOR = 1.48; CI = 1.16–1.90), had two (AOR = 3.4, CI = 2.78–4.16; P < 0.001) or three and above birth (AOR = 8.11; CI = 6.07–10.83; P < 0.001) in five years, had multiple birth children (AOR = 1.41; CI = 1.08–1.86) and very small-sized child at birth (AOR= 1.95; CI = 1.41–2.70) were more likely to lose their children below the age of 5 years. The factors contributing to under-five mortality in Sierra Leone are critical to ensuring child survival and improving maternal health. Breastfeeding, maternal age, media exposure, child’s sex, multiple birth type, very small-sized child and the total number of births in 5 years were significant drivers of under-five mortality. The result affirms the need for attention to be focused on enhancing the survival rate of under-five children in Sierra Leone.
A Composite Recombinant Salivary Proteins Biomarker for Phlebotomus argentipes Provides a Surveillance Tool Postelimination of Visceral Leishmaniasis in India
Authors: Iniguez Eva , Saha Samiran , Petrellis Georgios , Menenses Claudio , Herbert Samantha , Gonzalez-Rangel Yvonne , Rowland Tobin , Aronson Naomi E , Rose Clair , Rafuse Haines Lee , Acosta-Serrano Alvaro , Serafim Tiago D , Oliveira Fabiano , Srikantiah Sridhar , Bern Caryn , Valenzuela Jesus G , Kamhawi Shaden
Published: September 2022

Incidence of visceral leishmaniasis (VL) in the Indian subcontinent (ISC) has declined by more than 95% since initiation of the elimination program in 2005. As the ISC transitions to the postelimination surveillance phase, an accurate measurement of human-vector contact is needed to assure long-term success. To develop this tool, we identified PagSP02 and PagSP06 from saliva of Phlebotomus argentipes, the vector of Leishmania donovani in the ISC, as immunodominant proteins in humans. We also established the absence of cross-reactivity with Phlebotomus papatasi saliva, the only other human-biting sand fly in the ISC. Importantly, by combining recombinant rPagSP02 and rPagSP06 we achieved greater antibody recognition and specificity than single salivary proteins. The receiver operating characteristics curve for rPagSP02 + rPagSP06 predicts exposure to Ph. argentipes bites with 90% specificity and 87% sensitivity compared to negative control sera (P >.0001). Overall, rPagSP02 + rPagSP06 provides an effective surveillance tool for monitoring vector control efforts after VL elimination.
(In)Stability of Gender Attitudes in Times of Family Policy Change—A Latent Class Analysis of Germany, Austria, and Sweden
Authors: Sievers Tjorven , Warner Rebecca
Published: September 2022

Assuming a long-term feedback loop between attitudes about gender divisions of labor and family policy, we examine such attitudes in Germany, Austria, and Sweden, between 1994 and 2012. Using a longitudinal, case study approach, we argue that attitudes on the gender division of labor need to be put in relation to both recent family policy changes and a country’s gender regime. Employing latent class analysis, we examine the prevalence of different views on gender division of labor over time and test for measurement invariance to assess whether characteristics of attitudinal groups change across years. Results show increasing support for maternal employment within traditional groups in eastern and western Germany, potentially reflecting shifting policy within a changing gender regime. Simultaneously, intensive mothering and traditional attitudes remain more prevalent in Austria and western Germany than in eastern Germany and Sweden, indicating a persistent maternalist ideal among segments of these historically domestic gender regimes.
The Efficacy and Safety of Radiofrequency Microneedling Versus a Nonablative Fractional 1,550-nm Erbium:Glass Laser for the Rejuvenation of the Neck
Authors: Almukhtar Rawaa , Wood Emily , Goldman Mitchel , Fabi Sabrina G. , Boen Monica
Published: September 2022

BACKGROUND

Radiofrequency microneedling (RFMN) and nonablative fractional 1,550-nm erbium:glass lasers (NAFLs) have been reported to be used with success in neck rejuvenation. There are no head-to-head trials to compare these modalities.

OBJECTIVE

The purpose of the study was to compare the efficacy and safety of radiofrequency microneedling and nonablative fractional 1,550-nm erbium:glass lasers for the rejuvenation of the neck.

METHODS

This was a single-center, randomized, investigator-blinded clinical trial. A total of 21 subjects were randomized into 2 groups, NAFL and RFMN; subjects received 3 treatments 4 weeks apart and were followed up 12 weeks after last treatment.

RESULTS

Subjects in NAFL and RFMN groups showed 42.1% and 8.6% improvement in the Fitzpatrick–Goldman Wrinkling Score, respectively, 41.3% and 16.3% improvement in the elastosis score, respectively. Subjects in the NAFL 1,550-nm erbium:glass group showed significantly better blinded investigator Fitzpatrick–Goldman Wrinkling and Elastosis scores; subjects in the RFMN groups showed a more significant reduction in the Horizontal Neck Wrinkle Severity Score. There was a trend for higher patient satisfaction with the NAFL.

CONCLUSION

This study showed that both treatments resulted in significant improvement in wrinkling and elastosis scores; the NAFL treatment was associated with significantly better blinded investigator Fitzpatrick–Goldman Wrinkling and Elastosis scores and better subject satisfaction.
The Role of Surgery After Remission of Nonsystemic Extensive Periorbital Basal Cell Carcinoma Treated by Vismodegib: A Systematic Review
Authors: Peillex Delphine , Passemard Léa , Magnin Benoit , Rouanet Jacques , Pham Dang Nathalie
Published: September 2022

BACKGROUND

Eyelid basal cell carcinoma (BCC) is usually cured by surgery. However, for a minority of patients, extensive disease progression and recurrence contraindicate surgery or radiotherapy because of severe ocular morbidity. The hedgehog signaling pathway inhibitor vismodegib is becoming the key treatment for this specific form.

OBJECTIVE

The aim of this review was to define the role of surgery after vismodegib treatment.

MATERIALS AND METHODS

A literature search of the PubMed, Cochrane Library, ScienceDirect, and Embase databases was conducted for all articles published up to March 2021 to identify studies that examined treatment of BCC of the eyelid by vismodegib.

RESULTS

Level 1 evidence was found for the use of vismodegib as neoadjuvant therapy in locally advanced eyelid BCC contraindicated to surgery and/or radiotherapy with a rather good tolerance of treatment. Level 3 evidence was found for the role of surgical excision of residual clinically suspicious lesions as for the indication of eyelid reconstruction after mapping or during residual tumoral resection if frozen sections or Mohs surgery were performed.

CONCLUSION

Vismodegib is a well-tolerated treatment for advanced periorbital BCC. The hedgehog signaling pathway inhibitor vismodegib is a potential treatment option in patients with these challenging tumors.
Renal denervation in the antihypertensive arsenal – knowns and known unknowns
Authors: Messerli Franz H. , Bavishi Chirag , Brguljan Jana , Burnier Michel , Dobner Stephan , Elijovich Fernando , Ferdinand Keith C. , Kjeldsen Sverre , Laffer Cheryl L. , S Ram C. Venkata , Rexhaj Emrush , Ruilope Luis M. , Shalaeva Evgeniya V. , Siontis George C.M. , Staessen Jan A. , Textor Stephen C. , Vongpatanasin Wanpen , Vogt Liffert , Volpe Massimo , Wang Jiguang , Williams Bryan
Published: September 2022

Even though it has been more than a decade since renal denervation (RDN) was first used to treat hypertension and an intense effort on researching this therapy has been made, it is still not clear how RDN fits into the antihypertensive arsenal. There is no question that RDN lowers blood pressure (BP), it does so to an extent at best corresponding to one antihypertensive drug. The procedure has an excellent safety record. However, it remains clinically impossible to predict whose BP responds to RDN and whose does not. Long-term efficacy data on BP reduction are still unconvincing despite the recent results in the SPYRAL HTN-ON MED trial; experimental studies indicate that reinnervation is occurring after RDN. Although BP is an acceptable surrogate endpoint, there is complete lack of outcome data with RDN. Clear indications for RDN are lacking although patients with resistant hypertension, those with documented increase in activity of the sympathetic system and perhaps those who desire to take fewest medication may be considered.
Blood pressure response to standing is a strong determinant of masked hypertension in young to middle-age individuals
Authors: Palatini Paolo , Mos Lucio , Rattazzi Marcello , Spinella Paolo , Ermolao Andrea , Vriz Olga , Battista Francesca , Saladini Francesca
Published: September 2022

Objective:

The pathophysiologic mechanisms of masked hypertension are still debated. The aim of this study was to investigate whether the blood pressure response to standing is a determinant of masked hypertension in young individuals.

Design and methods:

We studied 1078 individuals (mean age 33.2 ± 8.5 years) with stage-1 untreated hypertension at baseline. Orthostatic response was defined as the difference between six SBP measurements in the orthostatic and supine postures. People with a response more than 6.5 mmHg (upper decile) were defined as hyperreactors. After 3 months of follow-up, 24-h ambulatory BP was measured and the participants were classified as normotensives (N = 120), white-coat hypertensive individuals (N = 168), masked hypertensive individuals (N = 166) and sustained hypertensive individuals (N = 624). In 591 participants, 24-h urinary epinephrine was also measured.

Results:

Orthostatic response was an independent predictor of masked hypertension after 3 months (P = 0.001). In the whole group, the odds ratio for the Hyperreactors was 2.5 [95% confidence interval (95% CI) 1.5–4.0, P < 0.001]. In the participants stratified by orthostatic response and urinary epinephrine, the odds ratio for masked hypertension was 4.2 (95% CI, 1.8–9.9, P = 0.001) in the hyperreactors with epinephrine above the median and was 2.6 (95% CI, 0.9–7.3, P = 0.069) in those with epinephrine below the median. The association between orthostatic response and masked hypertension was confirmed in the cross-sectional analysis after 3 months (P < 0.001).

Conclusion:

The present findings indicate that hyperreactivity to standing is a significant determinant of masked hypertension. The odds ratio for masked hypertension was even quadrupled in people with an orthostatic response more than 6.5 mmHg and high urinary epinephrine suggesting a role of sympathoadrenergic activity in the pathogenesis of masked hypertension.
Differences in Suicidality in Non–Treatment-Seeking and Treatment-Seeking Law Enforcement Officers
Authors: Ponder Warren N. , Beauchamp Alaina M. , Schuman Donna L. , Carbajal Jose , Jetelina Katelyn K. , Galusha Jeanine M.
Published: September 2022

Objective

Law enforcement officers (LEOs) are exposed to high levels of occupational trauma and face added stress from heightened public scrutiny and COVID-19, which may result in suicide. It is crucial to understand differences between LEOs who seek treatment and those who do not.

Method

We compared LEOs from the same greater metropolitan area who sought treatment with those who did not. Participants completed validated measures assessing posttraumatic stress disorder, generalized anxiety, depression, and suicidality.

Results

The treatment-seeking sample scores were higher on all standardized assessments. Bivariate logistic regression results indicated that the non–treatment-seeking sample's odds of experiencing suicidality were 1.76 times the odds for the treatment seeking sample.Conclusions:This suggests that many LEOs experiencing suicidality may not be seeking treatment and highlights the role that posttraumatic stress disorder may play in determining whether LEOs seek treatment or not.
Safety and efficacy of nivolumab compared with other regimens in patients with melanoma: A network meta-analysis
Authors: Almohideb Mohammad
Published: September 2022

Background:

Melanoma is a cancerous tumor that develops from melanocytes in the epidermal basal layer of the skin. It is a fatal skin cancer and the third most common kind of cutaneous tumor. We aim to evaluate the effect of nivolumab in melanoma patients compared with other regimens

Methods:

This meta-analysis included only clinical trials, both randomized and nonrandomized. The main outcomes of interest were the response to treatment, overall survival (OS), progression-free survival, and adverse events.

Results:

The overall effect estimates favored nivolumab group over the combination of nivolumab plus ipilimumab (HR 3.06, 95% CI 1.70-5.49) and chemotherapy group (HR 3.58, 95% CI 1.63-7.84) after 1 year. Compared to chemotherapy, nivolumab had lower rates of adverse events.

Conclusion:

Nivolumab monotherapy yields high progression-free survival rates and has the same efficacy when combined with ipilimumab in a 1-year OS. However, after 2 and 3 years of follow-up, the combined regimen has more OS rates.
Acupuncture against the metabolic risk factors for stroke: A systematic review of systematic reviews
Authors: Xu Ying , Zhong Da-yuan , Liao Xiao-qian , Wang Xing-ping , Ge Jin-wen , Xu Wei-hui
Published: September 2022

Objective:

This systematic review (SR) of SRs aims aimed to evaluate the current evidence of rehabilitation interventions in stroke patients after acupuncture treatment.

Methods:

Full-text SRs published in Chinese and English up to December 15, 2021 were searched in PubMed, Embase, Cochrane Library, CNKI, VIP, and Wanfang databases. The PRISMA statement and the assessment of multiple systematic reviews 2 (AMSTAR 2) scale were used to evaluate the quality of the included articles. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system was employed to assess the outcome indicators for evidence quality evaluation.

Results:

A number of 42 publications were identified in this study. According to these articles, 4 metabolic areas were identified: systolic blood pressure, weight loss, glycemic index and cholesterol. The acupuncture is beneficial to improve the systolic blood pressure of patients, and the effect of acupuncture on diastolic blood pressure is better than that of sham acupuncture. The weight loss effect of acupuncture is better than that of lifestyle and western medicine. The improvement effect of acupuncture on body mass index (BMI) is also better than that of sham acupuncture. In the study of glycemic index of stroke patients, acupuncture significantly improved glycosylated hemoglobin and insulin sensitivity index compared with western medicine. In cholesterol-related research, acupuncture can effectively improve the content of triglycerides. However, studies on HDL and LDL show that acupuncture can significantly improve HDL, but has no significant effect on LDL.

Conclusion:

This review summarizes the available evidence and underpins findings of the acupuncture exhibited the therapeutic role in eliminating metabolic risk factors for stroke, including systolic blood pressure, weight loss, glycemic index and cholesterol. Acupuncture could have positive effects on a specific symptom, and the effects depend not only on intervention type but also on how and when the intervention is provided. And more prioritizing high-quality research in this field in the future is conducive to guiding clinical practice.
The Chinese knotting technique assist anatomical anterior cruciate ligament reconstruction for aggressive rehabilitation
Authors: Yu Yang , Yang Xianguang , He Chuan , Wang Guoliang , Liu Dejian , Li Yanlin
Published: September 2022

Aggressive rehabilitation after anterior cruciate ligament (ACL) reconstruction may result in better clinical outcomes and fewer complications such as knee stiffness and weakness. We explored the effect of the Chinese knotting technique (CKT) for aggressive rehabilitation after ACL reconstruction.

Ninety-one anatomical ACL reconstruction cases from 2016 to 2020 were retrospectively reviewed. All patients were operated by the same senior physician and his team. According to the reconstruction with or without CKT, the patients were divided into 2 groups. Both groups received aggressive rehabilitation.

The follow-up time of 91 patients was more than 2 years. In total, 43 out of the 91 patients were in the CKT group, and 48 were in the routine group. The knee joint kinematics recorded by Opti_Knee revealed no significant difference among the CKT group, the routine group, and healthy adults at 3, 6, 12, and 24 months after the operation, respectively. The internal and external rotation angle and the anteroposterior displacement at 3 and 6 months after the operation in the CKT group were smaller than in the routine group and were similar to that of the healthy adults. There was no significant difference in flexion and extension angle, varus or valgus angle, proximal–distal displacement, or the internal or external displacement between the 2 groups. In addition, there was no significant difference in 6 degrees of freedom of the knee between the 2 groups at 12 and 24 months after the operation, respectively, which was similar to healthy adults. Compared to the routine group, the International Knee Documentation Committee scores were significantly higher in the CKT group at the 3, 6, and 12 months, respectively, but no difference was observed at 24 months (P = .749). The Lysholm score was significantly higher in the CKT group at the 3 and 6 months postoperatively, while there was no difference at 12 and 24 months, respectively.

In short-term observation, the ACL reconstruction with CKT, which can sustain aggressive rehabilitation and prevent the loosening of ACL graft, can lead to better clinical outcomes and kinematics recovery of the knee compared to routine technique.
Bioinformatics analysis identifies potential biomarkers involved in the metastasis of locoregionally advanced nasopharyngeal carcinoma
Authors: Hu Rongrong , Xu Xujun , Mo Lujiao , Chen Mengjie , Liu Yuxiang
Published: September 2022

Nasopharyngeal carcinoma (NPC) is one of the malignant epithelial tumors with a high metastasis rate. This study aimed to screen potential novel biomarkers involved in NPC metastasis. Microarray data of locoregionally advanced NPC (LA-NPC; GSE103611) were obtained from the database of Gene Expression Omnibus. The differentially expressed genes (DEGs) between LA-NPC tissues with and without distant metastasis after radical treatment were screened. Functional analysis was performed and the protein–protein interaction and submodule were analyzed. The univariate Cox regression analysis was performed to identify prognostic genes in NPC in the validation microarray dataset GSE102349. The drug–gene interactions and key genes were identified. Totally, 107 DEGs were identified. The upregulated DEGs and the key nodes in the protein–protein interaction network were associated with pathways or biological processes related to the cell cycle. Four genes including CD44, B2M, PTPN11, and TRIM74 were associated with disease-free survival in NPC. The drug–gene interaction analysis revealed that upregulated genes CXCL10, CD44, B2M, XRCC5, and RPL11 might be potential druggable genes for patients with LA-NPC metastasis by regulating cell cycle, autophagy, and drug resistance. Upregulated CXCL10, CD44, B2M, XRCC5, and RPL11 might play important roles in LA-NPC metastasis by regulating cell cycle-related pathways.
Fast pain relief in exercise-induced acute musculoskeletal pain by turmeric-boswellia formulation: A randomized placebo-controlled double-blinded multicentre study
Authors: Rudrappa Girish H. , Murthy Meghana , Saklecha Santosh , Kumar Kare Sanjeev , Gupta Ajay , Basu Indraneel
Published: September 2022

Background:

Plant extracts with analgesic properties are seldom considered for treatment of acute musculoskeletal pain due to delay in onset of analgesia. Turmeric (Curcuma longa) and boswellia (Boswellia serrata) extracts are well-studied anti-inflammatory compounds gaining in popularity and used as an alternative to conventional treatments for musculoskeletal pain. This study analyzed the analgesic effect of a formulation of turmeric and boswellia extracts in sesame oil (Rhuleave-K, TBF) in reducing exercise-induced acute musculoskeletal pain in healthy participants.

Methods:

In this randomized double-blinded placebo-controlled, single-dose, single-day, multicentre study, a total of 232 participants (TBF n = 116; placebo n = 116) having moderate-to-severe exercise-induced acute musculoskeletal pain were randomized in an allocation concealed 1:1 ratio to receive a single dose of 1000 mg of TBF or placebo. The outcome measures were numerical rating scale (NRS), categorical pain relief scale (PRS), onset of analgesia, and short form of McGill questionnaire (SF-MPQ). NRS and PRS were measured from predose to every 30 minutes interval of postdose up to 6 hours at rest, with movement and applying pressure on the affected part. The onset of analgesia was measured from the time of dosage and censored at 6 hours of postdose. The sum of pain intensity difference (SPID6) and total pain relief (TOTPAR6) at 6 hours was, respectively, analyzed from NRS and PRS scores.

Results:

TBF showed a significant reduction in pain intensity (SPID6rest) with 97.85% improvement in cumulative responder analysis compared with 2.46% in placebo. The onset of pain relief was fast and highly significant in the TBF group with 99% of participants having a mean perceptible pain relief at 68.5 minutes (95% confidence interval, 59.5–77.4) and 96% of participants having a mean meaningful pain relief at 191.6 minutes (95% confidence interval, 176.7–206.4) compared to the placebo group. Highly significant and continuous improvement in pain relief was observed in the TBF group with 93% of participants having ≥ 50% of maximum TOTPAR6 with a number needed to treat of 1.1 at rest.

Conclusion:

Exercise-induced acute musculoskeletal pain can be effectively relieved by TBF (Rhuleave-K) in about 3 hours signifying its strong analgesic activity.
New grading system for post-COVID-19 pulmonary fibrosis based on computed tomography findings
Authors: Demircioglu Ozlem , Kocakaya Derya , Cimsit Canan , Cimsit Nuri Cagatay
Published: September 2022

Background:

There is currently no objective computed tomography (CT)-defined grading system for coronavirus disease (COVID-19)-related pulmonary fibrosis. We propose a CT-based radiological scale that adapts the histological fibrosis scale to pulmonary fibrosis CT findings, to evaluate possible predictive factors for the degree of fibrosis in these patients.

Methods:

A new radiological fibrosis grading system was created based on existing histological fibrosis scales. One hundred forty-seven COVID-19 patients with any degree of fibrosis on CT were evaluated. Smoking status, the presence of hypertension, the duration of hospital stays, the presence of comorbid diseases, and the levels of prognostic and predictive factors for COVID-19 were evaluated, and how these parameters affected the fibrosis scores was examined.

Results:

Of 147 patients, 17.7% had grade 1, 17% had grade 2, 51.7% had grade 3, and 13.6% had grade 4 fibrosis. ANOVA revealed statistically significant relationships between the fibrosis scores and lactate dehydrogenase values, lymphocyte count, C-reactive protein level, and length of hospital stay. Smoking, advanced age, hypertension, and male sex showed significantly higher scores for fibrosis.

Conclusions:

Using our CT-defined lung fibrosis grading system, we could predict the severity of fibrosis as well as the resultant lung pathology in COVID-19 patients. Thus, disease exacerbation and development of permanent severe fibrosis can be prevented using the appropriate treatment methods in high-risk patients.
The frequency and prognostic significance of ABO/Rh blood groups in male breast cancer patients: A multicenter study
Authors: Dogan Izzet , Ayhan Murat , Gurbuz Mustafa , Kucukarda Ahmet , Aydin Esra , Urun Yuksel , Cicin Irfan , Saip Pinar
Published: September 2022

The study evaluated the distributions and prognostic significance of ABO and rhesus (D) groups in male breast cancer (MBC) patients. The data of 137 patients were retrospectively reviewed. Clinical, histopathological data and ABO/Rh blood groups of the patients were recorded. The ABO/Rh blood group distributions were compared to the healthy men control group (n = 120,160) by the chi-square test. Overall distributions of ABO blood groups were different between the patients (17.5% AB, 38% A, 19% B, and 25.5% O) and control group (7.88% AB, 42.06% A, 15.22% B, and 34.84% O) (P < .001). There were significant differences between the patients and control group with respect to AB vs non-AB blood group distributions (P < .001, odds ratio: 2.43, 95% CI) and O vs non-O blood group distributions (P = .016, odds ratio: 0.62, 95% CI). However, A vs non-A and B vs non-B blood group distributions were not significantly different. The distribution of the Rh factor was similar between patients and the control group (P = .93). In univariate analysis, ABO/Rh blood groups were not a prognostic factor on OS (P = .29). The frequency of the AB blood group in MBC patients is increased than in the healthy control group. AB blood group may be a risk factor for MBC, whereas O blood group may be a protective factor.
Early survival after acute myocardial infarction with ST-segment elevation: What could be improved? Insights from France PCI French registry
Authors: Duband Benjamin , Motreff Pascal , Marcollet Pierre , Gamet Alexandre , Decomis Marie-Pascale , Bar Olivier , Saint Etienne Christophe , Hakim Radwan , Canville Alexandre , Viallard Louis , BeyguI Farzin , Lesault Pierre Francois , Bonnet Philippe , Durand Eric , Boiffard Emmanuel , Collet Jean-Philippe , Benamer Hakim , Commeau Philippe , Cayla Guillaume , Pereira Bruno , Koning Rene , Rangé Gregoire
Published: September 2022

Early mortality post-ST-segment elevation myocardial infarction (STEMI) in France remains high. The multicentre France Percutaneous Coronary Intervention Registry includes every patient undergoing coronary angiography in France. We analyzed the prevalence and impact of unmodifiable and modifiable risk factors on 30-day survival in patients experiencing STEMI.

Patients admitted for STEMI between 01/2014 and 12/2016 were included in the analysis. Patients with nonobstructive coronary artery disease, with cardiogenic shock or cardiac arrest without STEMI, were excluded. Prehospital, clinical and procedural data were collected prospectively by the cardiologist in the cath lab using medical reporting software. Information on outcomes, including mortality, was obtained by a dedicated research technician by phone calls or from medical records. Marginal Cox proportional hazards regression was used to test the predictive value for survival at 30 days in a multivariable analysis.

Included were 2590 patients (74% men) aged 63 ± 14 years. During the first month, 174 patients (6.7%) died. After adjustment, unmodifiable variables significantly associated with reduced 30-day survival were: age > 80 years (prevalence 15%; hazard ratio [HR] 2.7; 95% confidence interval [CI] 1.5–4.7), chronic kidney disease (2%; HR 5.3; 95% CI 2.6–11.1), diabetes mellitus (14%; HR 1.6; 95% CI 1.0–2.5), anterior or circumferential electrical localization (39%; HR 2.0; 95% CI 1.4–2.9), and Killip class 2, 3, or 4 (7%; HR 3.4; 95% CI 1.9–5.9; 2%; HR 10.1; 95% CI 5.3–19.4; 4%; HR 18; 95% CI 10.8–29.8, respectively). Among modifiable variables, total ischemic time > 3 hours (68%; HR 1.8; 95% CI 1.1–3.0), lack of appropriate premedication (18%; HR 2.2; 95% CI 1.5–3.3), and post-PCI TIMI < 3 (6%; HR 4.9; 95% CI 3.2–7.6) were significantly associated with reduced 30-day survival.

Most predictors of 30-day survival post-STEMI are unmodifiable, but outcomes might be improved by optimizing modifiable factors, most importantly ischemic time and appropriate premedication.
Differences in the thalamocortical tract of the ascending reticular activating system in disorders of consciousness after hypoxic-ischemic brain injury: A pilot study
Authors: Jang Sung Ho , Choi Eun Bi
Published: September 2022

This study purposed to investigate differences in the thalamocortical tract of the ascending reticular activating system between vegetative state (VS) and minimally conscious state (MCS) patients with hypoxic-ischemic brain injury (HI-BI). Fourteen patients with disorders of consciousness following HI-BI (VS group: 7 patients, MCS group: 7 patients) and 12 normal subjects were recruited. The 5 parts of reconstructed thalamocortical tract were prefrontal cortex (PFC), premotor cortex, primary motor cortex (M1), primary somatosensory cortex (S1), and posterior parietal cortex (PPC). The fractional anisotropy (FA) value and tract volume (TV) in each part of the thalamocortical tract were estimated. The FA values and TV of all parts of the thalamocortical tract in the VS group and the FA values of all parts and TV of PFC, premotor cortex, and PPC parts in the MCS group were lower than the control group (P < .05). In addition, the FA values of PFC and PPC parts were significantly lower in the VS group than the MCS group (P < .05). The results of our pilot study indicate that PFC and PPC parts of the thalamocortical tract are important areas to assess for differentiation of VS and MCS after HI-BI.
Risk factors of anaphylaxis in Korea: Identifying drug-induced anaphylaxis culprits using big data
Authors: Ahn Kyung-Min , Kim Byung-Keun , Yang Min-Suk
Published: September 2022

Drug-induced anaphylaxis is a fatal medical condition whose incidence has been increasing continuously. Due to differences between genetic backgrounds and health care systems, different populations may be prone to various causative drugs. Using the Health Insurance Service and Assessment Service database, we investigated culprit drugs for drug-induced anaphylaxis and common medication risk factors in the Korean general population. We collected medical prescription histories within 3 days prior to anaphylaxis between January 2011 and December 2019 from the HIRA database. Designed as a case-crossover study, the attributable visits (case visits) were matched to medical visits (control visits) with the drug sets for each visit. We collected a list of medication risk factors for anaphylaxis and calculated the risk ratio of each agent using the chi-square test and conditional logistic regression analysis. A total of 159,473 individuals were listed in the database with a diagnosis of anaphylaxis in the HIRA from 2011 to 2019. After evaluating the suitability of control visits for matching with a case visit, 8168 subjects and 767 drugs were analyzed. The chi-square analysis identified 31 drugs as potential risk factors for drug-induced anaphylaxis in Korea. After applying a conditional logistic regression analysis for each agent, 5 drugs were found to be the common medication risk factors for drug-induced anaphylaxis: cefaclor, iopromide, iohexol, iomeprol, and tolperisone. We found 5 medication risk factors that showed the highest risk of drug-induced anaphylaxis and their degree of risk using an objective methodology in the Korean general population.
Effectiveness of calamine lotion as an adjunctive therapy to mometasone furoate ointment in the treatment of infant eczema: A retrospective study
Authors: Meng Yuan-Cui , Fan Jin-Chao , Bian Wei-Ni
Published: September 2022

This retrospective study investigated the effectiveness of calamine lotion (CL) as an adjunctive therapy to mometasone furoate ointment (MFO) in the treatment of infant eczema (IE).

This retrospective study analyzed the electronic medical records of 50 IE infants. They were allocated to a treatment group or a control group, with 25 subjects in each group. All infants in both groups received MFO. In addition, infants in the treatment group underwent CL. The outcomes were effectiveness based on the eczema area and severity index, lesion area, and pruritus severity. We analyzed the outcomes before and after treatment.

The results of this study showed that infants in the treatment group had more effective in effectiveness based on eczema area and severity index (P < .01), lesion area (P < .01), and pruritus severity (P = .01) than those in the control group. However, no medical records reported any adverse events in either group.

The results of this study showed that CL added to MFO was more effective than MFO alone in the treatment of infants with IE.
Daily life difficulties among patients with ulcerative colitis in Japan and the United Kingdom: A comparative study
Authors: Kawakami Aki , Tanaka Makoto , Sakagami Kayoko , Choong Lee Meng , Kunisaki Reiko , Maeda Shin , Bjarnason Ingvar , Ito Hiroaki , Hayee Bu’Hussain
Published: September 2022

The difficulty of life scale (DLS) instrument is used to measure specific life problems in patients with ulcerative colitis (UC). Importantly, health care providers should consider the characteristics of the country in which they support patients with UC. This cross-cultural comparison study investigated DLS among patients with UC in Japan and the United Kingdom (UK). Outpatients attending one hospital in London and one in Osaka were included. We collected patient information using the DLS questionnaire, which comprises 18 items in three domains. Mean differences between Japan and the UK were compared for the total score and each domain of the DLS. Variables with P < .05 in univariate analysis were entered into a multiple regression model. We included 142 patients from Japan and 100 patients from the UK in the analysis. Univariate results showed that UK patients had more difficulties than Japanese patients in all three domains. Multivariate results showed that only “decline of vitality or vigor” showed significantly lower difficulty scores in Japanese patients. Having four or more bowel movements per day, visible bleeding, and being a homemaker or unemployed were significantly associated with greater difficulty according to the DLS total score. The level of daily life difficulties assessed using the DLS was greater among patients in the UK than among Japanese patients. This comparative study between patients with UC in Japan and the UK demonstrated certain country-related features for domain 3, “decline of vitality or vigor,” of the DLS. The reasons why UK patients felt greater decline in vitality or vigor may be that these patients may have symptoms other than bowel symptoms; also, Japanese patients are more hesitant to express discomfort. The findings of this study might lead to a better understanding of culturally sensitive perceptions of daily life difficulties in UC.
Clinical impact of surgical treatment for the spontaneously ruptured resectable hepatocellular carcinoma: A single institution experience
Authors: Xu KangHe , Ryu Dong Hee , Choi Jae-Woon , Choi Hanlim , Kim Dae Hoon , Lee Taek-Gu , Kim Myung Jo , Park Sungmin , Yoo Kwon Cheol
Published: September 2022

Spontaneously ruptured hepatocellular carcinoma (srHCC) is a fatal complication of hepatocellular carcinoma (HCC). In addition, emergency treatment is frequently fraught with difficulties. This study aimed to investigate the prognosis and recurrence pattern in patients undergoing hepatectomy for the srHCC. This retrospective study included 11 patients with srHCC treated using either emergency hepatectomy or emergency transarterial embolization (TAE) followed by staged hepatectomy between January 2015 and December 2019. The patients visited the emergency room because of a sudden rupture of HCC without being diagnosed with HCC. We analyzed the prognosis, recurrence rate, and survival in these patients after hepatectomy. Four of the 11 patients in this study were classified as Child–Pugh class A and 7 as Child–Pugh class B. Nine patients visited for sudden onset of abdominal pain, and 2 for sudden onset of shock. The median hemoglobin level at the time of the visit was 11.5 g/dL (interquartile range: 9.8–12.7). Five patients underwent one-stage hepatectomy and 6 underwent emergency TAE hemostasis followed by staged hepatectomy. Median overall survival and recurrence-free survivals were 23 and 15 months, respectively. Recurrence occurred in 7 patients (4 in the one-stage group and 3 in the staged group). Among patients with recurrence, 6 had intrahepatic recurrence and 3 peritoneal metastases. Patients with srHCC who undergo staged hepatectomy can achieve a relatively good prognosis. The most common sites of recurrence after hepatectomy are intrahepatic and peritoneal. Peritoneal metastases are more likely to occur after one-stage hepatectomy.
Successful treatment through staged laparoscopic transgastric endoscopic retrograde cholangiopancreatography for postoperative bile leakage: A case report
Authors: Jeong Chi-Young , Choi Jung Woo , Kim Jae-Ri , Jang Jae Yool , Cho Jin-Kyu
Published: September 2022

Introduction:

Therapeutic laparoscopic-assisted transgastric endoscopic retrograde cholangiopancreatography (LA-ERCP) is a safe and effective technique for patient who are unable to receive endoscopic or percutaneous transhepatic treatment. This procedure shows a high overall success rate in managing pancreaticobiliary complications, comparable to that of ERCP.

Patient concerns:

A 51-year-old man had abdominal pain for 2 days. The patient showed acute calculous cholecystitis and acute cholangitis with distal common bile duct (CBD) stones. We performed laparoscopic cholecystectomy and removed the distal CBD stones through CBD exploration.

On the fourth day after the surgery, bile leakage was observed through the surgical drain.

Diagnosis:

The patient was diagnosed with postoperative bile leakage based on clinical findings.

Interventions:

The patient could not receive ERCP or percutaneous transhepatic biliary drainage because he had severe trismus and limb stiffness after suffering from poliomyelitis. So, we performed LA-ERCP, sphincterotomy, and biliary stent insertion. The fully covered self-expanding metal stent was implanted within the percutaneous gastrostomy site around, and 4 weeks later, the stent was removed during re-ERCP.

Outcomes:

The patient was discharged without any complications. There were no long-term complications noted during the 12-month follow-up.

Conclusion/Lessons:

Staged LA-ERCP represents a practical strategy for managing bile leakage and offers a novel solution for patients for whom transoral and transhepatic approaches are unsuitable. As a result, clinicians must know techniques for gaining access to the biliary system, such as LA-ERCP.
Evaluation of the efficacy of 1 L polyethylene glycol plus ascorbic acid and an oral sodium sulfate solution: A multi-center, prospective randomized controlled trial
Authors: Woo Jung Hun , Koo Hoon Sup , Kim Dae Sung , Shin Jeong Eun , Jung Yunho , Huh Kyu Chan
Published: September 2022

Introduction:

Low-volume bowel preparation has been developed to increase patient compliance. We compared 1 L of polyethylene glycol/ascorbic acid (PEG/Asc) and oral sodium sulfate (OSS) with respect to bowel preparation efficacy, compliance, and safety.

Methods:

A multicenter, prospective, randomized, single-blinded, non-inferiority trial was conducted in 3 hospitals. Patients were randomized to receive a bowel-cleansing agent. Bowel-cleansing efficacy was evaluated using the Boston Bowel Preparation Scale (BBPS). Satisfaction, feeling, taste of the bowel cleanser, and adverse events after taking the bowel cleanser were investigated through a questionnaire. Additionally, blood samples were analyzed before and after bowel cleansing.

Results:

In total, 172 patients were analyzed (85 with 1 L PEG/Asc and 87 with OSS), and the mean BBPS scores were comparable between agents. The 1L PEG/Asc group tended to have a higher BBPS score in the right colon (2.22 vs 2.02; P = .08). The compliance of 1 L of PEG/Asc was comparable to that of OSS. Patients taking 1 L PEG/Asc reported greater thirst and dizziness (P = .04 and P = .047, respectively) than the OSS cohort. On the other hand, gastrointestinal symptoms such as vomiting and abdominal distension were more common in the OSS group, without statistical significance. In terms of laboratory adverse events, elevation of serum creatinine was found in both groups after taking the bowel cleansing agent (P < .001 for the 1L PEG/Asc group; P = .04 for the OSS group). However, most of the increased values were within the normal ranges.

Discussion:

The 1L PEG/Asc treatment was comparable to OSS in terms of bowel preparation efficacy, compliance, and safety.
Human monkeypox virus: An updated review
Authors: Adnan Nawal , Haq Zargham ul , Malik Asmara , Mehmood Asim , Ishaq Uzma , Faraz Maria , Malik Jahanzeb , Mehmoodi Amin
Published: September 2022

The human monkeypox is an emerging zoonotic orthopoxvirus with a clinical presentation similar to that of smallpox. It is difficult to differentiate monkeypox from other orthopedic infections, and laboratory diagnosis is the primary component of disease identification and monitoring. However, current diagnostics are time-consuming, and new tests are needed for rapid and precise diagnosis. Most cases have been reported in Central Africa; however, an increasing number of cases have been reported in Europe, the United States of America (USA), Australia, and the United Arab Emirates. Although investigation of the current global outbreak is still ongoing, viral transmission seems to have occurred during crowded events in Spain and Belgium. New therapeutics and vaccines are being deployed for the treatment and prevention of monkeypox, and more research on the epidemiology, biology, and ecology of the virus in endemic areas is required to understand and prevent further global outbreaks.
An unusual case of subacute combined degeneration due to nitrous oxide abuse, which relapsed after bariatric surgery: A case report
Authors: Chen Wei , Si Zhihua , Bi Yanping , Yang Bing
Published: September 2022

Rationale:

Several studies have reported subacute combined degeneration (SCD) induced by nitrous oxide (N2O) abuse. However, few studies have reported that N2O-induced SCD recurred because of sleeve gastrectomy after neurological symptoms improved.

Patient concerns:

We report the case of an 18-year-old woman who developed paresthesia, weakness in 4 limbs, and an unstable gait after frequent, excessive N2O inhalation.

Diagnosis:

The patient was diagnosed as having SCD.

Interventions and outcomes:

Nineteen days after intravenous mecobalamin and supplementation with other kinds of vitamin B, her weakness and paresthesia resolved. However, 7 months after discharge, the patient experienced recurrence following sleeve gastrectomy. Blood biochemistry revealed low vitamin B12 levels. After a 22-day treatment, similar to the first hospitalization, her residual numbness and unsteady gait improved.

Lessons:

This case highlights that patients, especially those at high risk of vitamin B12 deficiency, undergoing sleeve gastrectomy require careful nutritional follow-up and routine monitoring of micronutrients such as vitamin B12 and homocysteine. Continuous vigilance is essential for patients with common and rare neurological complications.
Efficacy and safety of biologic therapy in microscopic colitis: systematic review and meta-analysis
Authors: Taneja Vikas , El-Dallal Mohammed , Anand Rajsavi S. , Haq Zadid , Mishkin Brooke , Feuerstein Joseph D.
Published: September 2022

Background

This systematic review and meta-analysis sought to evaluate the effectiveness and safety of biologic therapy in the treatment of steroid-refractory microscopic colitis (MC).

Methods

We searched MEDLINE, Embase, Web of Science, and Cochrane Central to identify articles and abstracts reporting efficacy or safety data on biologic use (infliximab, adalimumab, certolizumab, golimumab, vedolizumab, ustekinumab, and tofacitinib) for induction and maintenance of remission in MC. We assessed clinical remission and response rates and all reported adverse events (AEs).

Results

A total of 376 studies were screened yielding 13 articles (including four abstracts) with a combined information on 78 patients for efficacy and safety outcomes. Most studies were case series. Vedolizumab was used in five studies, adalimumab in three, and a combination of infliximab and adalimumab in five studies. The rates of remission were 66.08% (95% CI, 36.79–95.37%; I
2, 71%) at weeks 3–6 and 54.20% (95% CI, 39.39–69.01%; I
2, 0%) at weeks 12–16. Clinical response rates were 100% (95% CI, 88.04–100%; I
2, 0%) at weeks 3–6 and 67.20% (95% CI, 47.72–86.69%; I
2, 52%) at weeks 12–16. Most frequent AE was medication discontinuation with a pooled incidence of 16.1% (95% CI, 5.9–37.5%). No deaths attributable to biologic use were reported. The overall quality of evidence was very low due to the high risk of biases.

Conclusion

Low-quality evidence supports the short-term efficacy of biologics in budesonide refractory MC. While our findings represent the most comprehensive evaluation of biologic therapy in severe MC, further research including randomized clinical trials is needed to better define the role of specific agents and long-term therapy.