bluuebunny/crossref_metadata_2025 huggingface dataset:
Identifying 5 Common Psychiatric Disorders Associated Chemicals Through Integrative Analysis of Genome-Wide Association Study and Chemical-Gene Interaction Datasets
Authors: Cheng Shiqiang , Wen Yan , Ma Mei , Zhang Lu , Liu Li , Qi Xin , Cheng Bolun , Liang Chujun , Li Ping , Kafle Om Prakash , Zhang Feng
Published: April 2020

Psychiatric disorders are a group of complex psychological syndromes whose etiology remains unknown. Previous study suggested that various chemicals contributed to the development of psychiatric diseases through affecting gene expression. This study aims to systematically explore the potential relationships between 5 major psychiatric disorders and more than 11 000 chemicals. The genome-wide association studies (GWAS) datasets of attention deficiency/hyperactive disorder (ADHD), autism spectrum disorder (ASD), bipolar disorder (BD), major depression disorder (MDD), and schizophrenia (SCZ) were driven from the Psychiatric GWAS Consortium and iPSYCH website. The chemicals related gene sets were obtained from the comparative toxicogenomics database (CTD). First, transcriptome-wide association studies (TWAS) were performed by FUSION to calculate the expression association testing statistics utilizing GWAS summary statistics of the 5 common psychiatric disorders. Chemical-related gene set enrichment analysis (GSEA) was then conducted to explore the relationships between chemicals and each of the psychiatric diseases. We observed several significant correlations between chemicals and each of the psychiatric disorders. We also detected common chemicals between every 4 of the 5 major psychiatric disorders, such as androgen antagonists for ADHD (P value = .0098), ASD (P value = .0330), BD (P value = .0238), and SCZ (P value = .0062), and imipramine for ADHD (P value = .0054), ASD (P value = .0386), MDD (P value = .0438), and SCZ (P value = .0008). Our study results provide new clues for revealing the roles of environmental chemicals in the development of psychiatric disorders.
State-Level Immigration Policy Context and Health: How Are Latinx Immigrant Parents Faring?
Authors: Ayón Cecilia
Published: April 2020

This study examined associations between perceived immigration policy effects and stress among Latinx immigrant parents living in Maricopa County, Arizona, which implemented a series of restrictive immigration policies. Three hundred Latinx immigrant parents participated in the study. A hierarchical regression model was used to examine the relationship between perceived immigration policy effects (that is, subscales include Discrimination, Social Exclusion, Threat to Family, and Children’s Vulnerability) on parents’ stress levels while controlling for demographics. The model also included protective factors (that is, familismo, social support, self-efficacy) and immigrant-specific indicators of health (that is, length of time in the United States and deportation of a family member). Findings revealed that threat to family and children’s vulnerability were associated with heightened stress levels among parents. There were no differences in stress levels by length of time in the United States or deportation of a family member, and protective factors were not associated with reduced stress levels. At a practice level, findings stress the need to work with families to address their fears of family separation and parents’ concerns for how the immigration policy context affects their children. At a policy level, advocacy is needed to secure access to care for immigrants and maintain families together.
Gender Support Disparities in a Majority-Female Profession
Authors: Radey Melissa , Schelbe Lisa
Published: April 2020

Theory and empirical evidence establish gender disparities in work pay and promotion trajectories, particularly in majority-male workplaces. Workplace support’s role, particularly in majority-female workplaces, in facilitating gendered occupational trajectories is less clear. Authors used a statewide sample of child welfare workers (N = 1,501) to examine gender differences in support and analyzed qualitative interviews with a subsample of participants (n = 37) to explore the role of gender in support perceptions. Analyses indicated that men perceived more supervisory and organizational support, whereas gender was not related to coworker support. The qualitative analysis indicated that receiving support required initiative. Men took initiative because they felt entitled. Many women expressed reservations, often warranted from experience, about initiating support to avoid bothering others and to honor workplace hierarchy. Men’s initiative allowed them access to support, thus increasing propensity toward job success. This study indicates that gender differences in workplace support may contribute to producing a self-perpetuating system of structural inequality.
FINSA/FINIA—new regulation for foreign trustees in Switzerland
Authors: Blumenfeld Marc
Published: April 2020

In the light of the international trends to regulate and supervise financial services and their providers (Markets in Financial Instruments Directive (MiFID) II, Prospectus Directive, Packaged Retail and Insurance-based Investment Products (PRIIPs)), the Financial Services Act (FINSA) and the Financial Institutions Act (FINIA) entered into force in Switzerland on 1 January 2020. The new Swiss regulation introduces prudential supervision for asset managers and trustees who have only been subject to Anti-Money Laundering (AML) regulation in Switzerland until now. Foreign trustees will also be affected by the FINSA/FINIA if they engage in activities in Switzerland. This article provides a high-level outline of the new regulatory playing field for foreign trustees in Switzerland.
Intrinsically disordered regions are abundant in simplexvirus proteomes and display signatures of positive selection
Authors: Mozzi Alessandra , Forni Diego , Cagliani Rachele , Clerici Mario , Pozzoli Uberto , Sironi Manuela
Published: April 2020

Whereas the majority of herpesviruses co-speciated with their mammalian hosts, human herpes simplex virus 2 (HSV-2, genus Simplexvirus) most likely originated from the cross-species transmission of chimpanzee herpesvirus 1 to an ancestor of modern humans. We exploited the peculiar evolutionary history of HSV-2 to investigate the selective events that drove herpesvirus adaptation to a new host. We show that HSV-2 intrinsically disordered regions (IDRs)—that is, protein domains that do not adopt compact three-dimensional structures—are strongly enriched in positive selection signals. Analysis of viral proteomes indicated that a significantly higher portion of simplexvirus proteins is disordered compared with the proteins of other human herpesviruses. IDR abundance in simplexvirus proteomes was not a consequence of the base composition of their genomes (high G + C content). Conversely, protein function determines the IDR fraction, which is significantly higher in viral proteins that interact with human factors. We also found that the average extent of disorder in herpesvirus proteins tends to parallel that of their human interactors. These data suggest that viruses that interact with fast-evolving, disordered human proteins, in turn, evolve disordered viral interactors poised for innovation. We propose that the high IDR fraction present in simplexvirus proteomes contributes to their wider host range compared with other herpesviruses.
Ecological Assembly Processes of the Bacterial and Fungal Microbiota of Wild and Domesticated Wheat Species
Authors: Hassani M. Amine , Özkurt Ezgi , Franzenburg Sören , Stukenbrock Eva H.
Published: April 2020

Domestication has led to substantial changes in plant physiology. How this anthropogenic intervention has contributed in altering the wheat microbiota is not well understood. Here, we investigated the role of ecological selection, drift, and dispersal in shaping the bacterial and fungal communities associated with domesticated wheat Triticum aestivum and two wild relatives, T. boeoticum and T. urartu. Our study shows that the bacterial and fungal microbiota of wild and domesticated wheat species follow distinct community assembly patterns. Further, we revealed a more prominent role of neutral processes in the assembly of the microbiota of domesticated wheat and propose that domestication has relaxed selective processes in the assembly of the wheat microbiota.

[Formula: see text] Copyright © 2020 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Using Simulation in Training Pediatric Residents on Neonatal Abstinence Syndrome Scoring
Authors: Agana Marisha , Vos Duncan , Williams Mark , Baumgartner Hans , Soares Neelkamal
Published: April 2020

Background:

Neonatal abstinence syndrome (NAS) is characterized by significant physiological and behavioral signs involving multiple-organ systems in neonates following a prenatal exposure to opioids and other nonopioid drugs. Neonatal abstinence syndrome can result in serious morbidity, and even death, if unrecognized and untreated. The purpose of this study was to develop a simulation model of a standard video training of the Finnegan Neonatal Abstinence Scoring System (FNAS) and investigate the perceptions of comfort and competency of pediatric residents undergoing video or simulation training.

Methods:

Thirty-one pediatric and medicine-pediatric residents participated in this single-blinded randomized intervention study. The experimental group completed demonstrated simulation while the control group received the traditional video instruction. Both groups completed FNAS scoring on a case of a neonate with NAS. The FNAS scores of residents were compared with the scores of 2 expert raters. Pre- and posttraining and preference surveys were obtained from all participants.

Results:

Both experimental and control groups scored the FNAS scenario similarly and were also similar to the expert raters. Both groups also reported comparable levels of comfort and competency after the training, though first-year residents reported greater improvement than upper-level residents. The FNAS scores from expert raters were identical for the simulation and video scenarios.

Implications for Practice:

Although this study showed that a simulation training module can be used as a standardized teaching method to administer the FNAS, it can be cost-prohibitive and daunting to produce. Nursing professionals need to be aware of medical education training around FNAS due to the interdisciplinary nature of care for neonates with NAS. Institutions should consider implementing a diversity of practices and models with an interdisciplinary approach to training assessment of the neonate with NAS.

Implications for Research:

A more hands-on, less cost-prohibitive simulation training needs to be developed to teach FNAS administration with a broader range of professionals including interdisciplinary teams of nursing and medical professionals.
Meta-analysis and Trial Sequential Analysis of Randomized Controlled Trials Comparing High and Low Ligation of the Inferior Mesenteric Artery in Rectal Cancer Surgery
Authors: Hajibandeh Shahab , Hajibandeh Shahin , Maw Andrew
Published: April 2020

BACKGROUND:

Despite ongoing debates, there is still no consensus regarding where to divide the inferior mesenteric artery for oncological reasons in rectal cancer: at its origin from the aorta (high ligation) or distal to the origin of the left colic artery (low ligation).

OBJECTIVES:

The purpose of this study was to compare the outcomes of high and low ligation of the inferior mesenteric artery in rectal cancer surgery.

DATA SOURCES:

MEDLINE, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, World Health Organization International Clinical Trials Registry, ClinicalTrials.gov, and ISRCTN Register were searched.

STUDY SELECTION:

andomized controlled trials investigating outcomes of curative anterior resection in patients with cancer of the rectum were included.

INTERVENTIONS:

High ligation of the inferior mesenteric artery was compared with low ligation technique.

MAIN OUTCOME MEASURES:

We measured the total number of lymph nodes harvested, anastomotic leak, postoperative complications, postoperative mortality, operative time, intraoperative blood loss, conversion to open surgery, overall survival, and disease-free survival.

RESULTS:

Analysis of 1102 patients from 8 trials suggested no difference between high and low ligation of the inferior mesenteric artery in terms of total number of lymph nodes harvested (mean difference = –0.87; p = 0.26), anastomotic leak (OR = 1.39; p = 0.15), postoperative complications (OR = 1.39; p = 0.78), postoperative mortality (risk difference = –0.00; p = 0.48), operative time (mean difference = –1.99; p = 0.79), intraoperative blood loss (mean difference = –2.28; p = 0.77), conversion to open surgery (risk difference = 0.01; p = 0.48), 5-year overall survival (OR = 0.76; p = 0.32), 5-year disease-free survival (OR = 0.88; p = 0.58), overall survival at maximum follow up (OR = 0.80; p = 0.43), and disease-free survival at maximum follow-up (OR = 0.83; p = 0.35).

LIMITATIONS:

Limited data were available on functional and long-term survival outcomes.

CONCLUSIONS:

There is no difference between high and low ligation of the inferior mesenteric artery in terms of oncological outcomes or postoperative morbidity and mortality. The available evidence is subject to potential confounding by the use of neoadjuvant therapy, adjuvant therapy, disease stage, location of tumor, and use of protective stoma. Functional outcomes including postoperative bowel, urinary and sexual function, and long-term survival outcomes should be the outcome of study in future trials. PROSPERO registration number: CRD42019148626
Continuous Monitoring of Coronary Care Mortality Using the Global Registry for Acute Coronary Events (GRACE) Score
Authors: Ciambrone Graciana , Higa Claudio C. , Gambarte Jimena , Novo Fedor , Nogues Ignacio , Borracci Raul A.
Published: April 2020

Background:

The aim was to assess the utility of cumulative sum techniques for continuous monitoring of coronary care outcomes, applied to patients with acute coronary syndrome stratified by the Global Registry for Acute Coronary Events (GRACE) risk score.

Methods:

A prospective longitudinal study to assess GRACE score for real-time monitoring of coronary care mortality in a community hospital was conducted between January 2012 and December 2017. An expected-to-observed probability of death chart for individual risk and a variable life-adjusted display were used to monitor the results.

Results:

A total of 1,255 patients undergoing acute coronary syndrome were included in the analysis. GRACE-based variable life-adjusted plots monitoring in-hospital mortality showed that observed death rates remained in general within the expected 95% confidence limit over time, and these behaviors were similar for ST-segment elevation and non-ST-segment elevation myocardial infarction. In-hospital all-cause mortality was 2.6% for the overall population, and 56% of these cases corresponded to unexpected deaths; conversely, unexpected survival occurred in 5.2% of survivors.

Conclusions:

Continuous monitoring of coronary care mortality based on cumulative sum charts and the GRACE score demonstrated the occurrence of series of favorable and unfavorable outcomes on a real-time basis. Additionally, plotting the expected-to-observed probability of death for individual cases was useful to individualize unexpected deaths in low-risk patients. Although overall coronary care performance was adequate according to the GRACE score, we found that there is still some room for improvement, since over half of the deaths occurring in low-risk patients were potentially preventable.
Characterization of Applied Forces and Torques During Rigid Bronchoscopy Intubation
Authors: Barrette Louis-Xavier , Turkseven Melih , De Suvranu , Majid Adnan , Parikh Mihir , Chee Alex
Published: April 2020

Background:

Rigid bronchoscopy intubation poses a significant risk of complication to patients from mechanical trauma. Despite the importance of precision in forces exerted by surgeons during intubation, no prior study has analyzed the overall forces and torques involved in rigid bronchoscopy intubation, and whether existing training modalities accurately replicate them.

Methods:

A bronchoscope was equipped with a 6-axis load sensor to measure forces and torques applied during rigid bronchoscopy intubation. The device was applied to measure intubation forces in low-fidelity manikins and patients by interventional pulmonologists.

Results:

Axial and lateral forces were measured during rigid bronchoscope intubation from the mouth to the mid-trachea. The mean axial/lateral forces recorded during manikin trials were 6.93/18.06 N, whereas those recorded during patient trials were 4.57/9.43 N. Average axial and lateral force application was therefore 51.6% and 92.6% higher in manikin, respectively. Applied axial torque averaged across all human trials was 130.5 N-mm compared with 78.3 N-mm for manikin trials, 40% lower in manikin than in human. Lateral torque application during manikin intubation showed greater variation in between trials and a greater range of SDs within trials.

Conclusion:

This was the first application of a rigid bronchoscope measurement device designed to measure forces applied at the handle. Force and torque discrepancies between manikin training and patient applications were found, indicating a possible mismatch between the haptic feedback received by physicians during rigid training and application. This inconsistency could be resolved via novel haptic training modalities and help increase atraumatic intubations.
Evaluating Yield of 19 Versus 21 G EBUS-TBNA Needles
Authors: Elmufdi Firas S. , Peterson Marissa K. , Niccum David , Asche Stephen , Ham Kealy
Published: April 2020

Background:

Controversy remains regarding the effect of needle size on the diagnostic yield of endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration. We conducted a prospective study comparing the diagnostic yield of 19 and 21 G EBUS needles and hypothesized that the 19 G have a greater EBUS-guided transbronchial needle aspiration diagnostic yield as compared with the 21 G needle.

Methods:

A total of 60 patients undergoing EBUS-guided transbronchial needle aspiration were enrolled with informed consent. Both 19 and 21 G needles were used at each lymph node station in alternating fashion, we randomized which needle, to begin with. Two rapid on-site cytology evaluation stations were present and assigned to one of the 2 needles. They reported sample adequacy and prepared a separate cell block per lymph node sampled for their assigned needle.

Results:

A total of 141 lymph nodes were analyzed. Diagnosis included 69 benign lymph nodes, 47 malignant lymph nodes, 22 noncaseating granulomas, and 3 infected lymph nodes. Five hundred seventy-three passes (average: 4.1 passes/lymph node) were done with 19 G and 581 passes with 21 G needles (average: 4.1 passes/lymph node). Diagnostic yield was similar between 19 and 21 G needles overall (89.4% vs. 88.7%, P=0.71). The 19 G needles showed higher smear cellularity (32.6% vs. 13.0%, P=0.05), and rapid on-site cytology evaluation adequacy (84.8% vs. 63.0%, P=0.004) in lymph nodes with cancer diagnosis. In 7 of the 141 lymph nodes, samples from only one of the needles provided the final diagnosis.

Conclusion:

There is no difference in the overall diagnostic yield between 19 and 21 G needles. Further studies are needed to confirm the trend of the superiority of 19 G in cancerous lymph nodes.
Incorporating Stakeholder Feedback in Guidelines Development for the Management of Abnormal Cervical Cancer Screening Tests
Authors: Perkins Rebecca B. , Fuzzell Lindsay N. , Lake Paige , McIntyre McKenzie , Nayar Ritu , Saraiya Mona , Loukissas Jennifer , Felder Tamika , Guido Richard S. , Vadaparampil Susan T.
Published: April 2020

Objective

The 2019 ASCCP Risk-Based Management Consensus Guidelines present a paradigm shift from results- to risk-based management. Patient and provider factors can affect guideline adoption. We sought feedback from stakeholders to inform guideline development.

Materials and Methods

To solicit provider feedback, we surveyed attendees at the 2019 ASCCP annual meeting regarding readiness to adopt proposed changes and used a web-based public comment period to gauge agreement/disagreement with preliminary guidelines. We elicited patient feedback via a brief survey on preferences around proposed recommendations for treatment without biopsy. Surveys and public comment included both closed-ended and free-text items. Quantitative results were analyzed using descriptive statistics; qualitative results were analyzed using content analysis. Results were incorporated into guideline development in real time.

Results

Surveys indicated that 98% of providers currently evaluate their patients' past results to determine management; 88% felt formally incorporating history into management would represent an improvement in care. Most providers supported expedited treatment without biopsy: 22% currently perform expedited treatment and 60% were willing to do so. Among patients, 41% preferred expedited treatment, 32% preferred biopsy before treatment, and the remainder were undecided. Responses from the public comment period included agreement/disagreement with preliminary guidelines, reasons for disagreement, and suggestions for improvement.

Conclusions

Stakeholder feedback was incorporated into the development of the 2019 ASCCP Risk-Based Management Consensus Guidelines. Proposed recommendations with less than two-thirds agreement in the public comment period were considered for revision. Findings underscore the importance of stakeholder feedback in developing guidelines that meet the needs of patients and providers.
Extracorporeal Membrane Oxygenation for Coronavirus Disease 2019 in Shanghai, China
Authors: Li Xin , Guo Zhen , Li Bailing , Zhang Xiaolin , Tian Rui , Wu Wei , Zhang Zhongwei , Lu Yunfei , Chen Nan , Clifford Sean P. , Huang Jiapeng
Published: April 2020

Severe cases of coronavirus disease 2019 (COVID-19) cannot be adequately managed with mechanical ventilation alone. The role and outcome of extracorporeal membrane oxygenation (ECMO) in the management of COVID-19 is currently unclear. Eight COVID-19 patients have received ECMO support in Shanghai with seven with venovenous (VV) ECMO support and one veno arterial (VA) ECMO during cardiopulmonary resuscitation. As of March 25, 2020, four patients died (50% mortality), three patients (37.5%) were successfully weaned off ECMO after 22, 40, and 47 days support, respectively, but remain on mechanical ventilation. One patient is still on VV ECMO with mechanical ventilation. The partial pressure of oxygen/fractional of inspired oxygen ratio before ECMO initiation was between 54 and 76, and all were well below 100. The duration of mechanical ventilation before ECMO ranged from 4 to 21 days. Except the one emergent VA ECMO during cardiopulmonary resuscitation, other patients were on ECMO support for between 18 and 47 days. In conclusion, ensuring effective, timely, and safe ECMO support in COVID-19 is key to improving clinical outcomes. Extracorporeal membrane oxygenation support might be an integral part of the critical care provided for COVID-19 patients in centers with advanced ECMO expertise.
Hiccups triggered by bladder filling after bilateral pontine hemorrhage
Authors: Chon Jinmann , Yoo Seung Don , Lee Seung Ah
Published: April 2020

Introduction:

A hiccup is myoclonus of a sudden involuntary contraction of the diaphragm. Hiccups have various causes, and brain stem stroke is one of the causes of central hiccups. Certain types of hiccups are caused by diseases that can be fatal. Therefore, it is beneficial for physicians to be familiar with the various cases of unusual hiccups. We report a case of hiccups triggered by urinary bladder filling in a brain stem stroke patient. To the best of our knowledge, previous reports have not described a similar case.

Patient concerns:

We describe the case of a 54-year-old patient who had acute bilateral pontine hemorrhage. The patient had intermittent hiccups in the early stages of the stroke onset. The hiccups ceased by the administration of medication or stimulation of the pharyngeal or tracheal wall. Two months after the onset, the Foley catheter was removed to check if the patient could void the bladder voluntarily. Hiccups occurred whenever the bladder was filled with some amount of urine.

Diagnosis:

Pontine hemorrhage, neurogenic bladder, and quadriplegia.

Interventions:

When the hiccups occurred, the amount of urine in the bladder was checked using a transabdominal bladder ultrasonography scanner. After clean intermittent catheterization for bladder emptying, the hiccups subsided.

Outcomes:

The hiccups occurred 5 or 6 times a day, as often as the bladder was filling. He was unable to void the urine voluntarily for 5 days after the removal of the Foley catheter. Percutaneous suprapubic cystostomy was performed finally to remove the stimulation of bladder filling and the hiccups disappeared.

Conclusion:

Bladder filling is suspected to increase the sympathetic tone and cause a hiccup reflex. Bladder filling could be a factor triggering hiccups in pontine hemorrhage.
ABO blood type, smoking status, other risk factors and prognosis of pancreatic ductal adenocarcinoma
Authors: Li Shuang-Shuang , Zhou Cong-Ya , Liao Rong , Xiong Lai , Weng Ning-Na , Zhao Ya-Qin , Mason Clifford , Gou Hong-Feng , Yi Cheng , Zhu Qing
Published: April 2020

The aim of this observational study was to test whether ABO blood type was a prognostic factor for pancreatic ductal adenocarcinoma (PDAC) patients and whether other risk factors could influence pancreatic cancer patients’ survival. This study included 610 patients who were diagnosed as pancreatic cancer and had undergone radical surgery. Patients’ characteristics included age, gender, tumor stage, tumor grade, adenosquamous carcinoma (ASC) status, preoperative serum carbohydrate antigen 19-9 (CA19-9) levels, preoperative serum carcinoembryonic antigen (CEA) levels, ABO blood type, smoking status, and drinking status were analyzed in this study. Cox proportional hazards regression model and Kaplan–Meier method were used to evaluate the role of prognostic factors. For pancreatic cancer patients undergoing radical surgery, the overall survival was worse for ASC patients than PDAC patients (Log-rank = 11.315, P < .001). Compared with ASC patients (Log-rank < 0.001, P = .996), PDAC patients can benefit from chemotherapy (Log-rank = 17.665, P < .001). For PDAC patients, O blood type had better overall survival than non-O blood type (Log-rank = 4.153, P = .042). Moreover, the group with higher serum levels of CA19-9 had poor prognosis compared to another group with low serum CA19-9 (Log-rank = 4.122, P = .042). Higher CEA levels indicated poor prognosis (Log-rank = 13.618, P < .001). In conclusion, ASC status was associated with overall survival of pancreatic cancer patients and cannot benefit from postoperative chemotherapy. Non-O blood type was a prognostic factor for PDAC patients.
Ultrasonographic measurement of femoral cartilage thickness in type II diabetic patients
Authors: Bedewi Mohamed A. , Elsifey Ayman A. , Naguib Moheyeldeen F. , Saleh Ayman K. , Al-Ghamdi Sameer , Alhariqi Bader A. , Aldossary Nasser M. , Gould Elaine S.
Published: April 2020

The aim of this study is to compare the distal femoral cartilage thickness of patients with type II diabetes mellitus with those of healthy subjects using ultrasonography. The study comprised 34 patients and 36 healthy subjects. Demographic characteristics of all the participants were recorded. The thickness of the femoral articular cartilage was measured using a 5-18MHzlinearprobe.Measurements were performed bilaterally from three points (intercondylar area, medial condyle, and lateral condyle). No significant difference could be found between patients and healthy subjects. Two demographic characteristics correlated positively with diabetic patients.
Obstructive jaundice in a patient with polycystic liver disease complicated with polycystic kidney and polycystic lung
Authors: Zhang Liling , Gan Linwang , Liu Qi , Li Ying , Lin Jiaru , Ou Santao
Published: April 2020

Rationale:

Polycystic liver disease (PLD) is an autosomal-dominant disorder that is commonly associated with autosomal-dominant polycystic kidney disease (PKD) but rarely complicated with polycystic lung. Here, we report the first case of severe obstructive jaundice caused by multiple liver cysts in a patient with PLD complicated by PKD and polycystic lung.

Patient concerns:

A 72-year-old man with a history of PLD complicated with polycystic kidney presented with progressive jaundice, hematuria, poor appetite, nausea, and weight loss since 3 months.

Diagnosis:

PLD complicated with PKD and polycystic lung was identified using computed tomography, and obstructive jaundice was identified using magnetic resonance imaging and magnetic resonance cholangiopancreatography.

Interventions:

The patient could not undergo surgery, and was therefore treated with combined bilirubin adsorption and continuous veno-venous hemofiltration.

Outcomes:

The patient's symptoms and laboratory findings improved after bilirubin adsorption and continuous veno-venous hemofiltration. Unfortunately, the patient was unable to continue the treatment due to financial reasons, and died of shock most likely due to cyst rupture.

Lessons:

Imaging examination of the lungs is necessary for patients with PLD. Although infrequent, jaundice can occur in these patients and cause severe hyperbilirubinemia. When surgery is contraindicated, blood purification may serve as an alternative treatment for patients with PLD-related obstructive jaundice.
The effectiveness of a novel surgical approach for the treatment of congenital muscular torticollis
Authors: Shan Jianlin , Jiang Heng , Zhang Yang , Zhang Zhicheng , Ren Dajiang , Zhu Bing
Published: April 2020

The outcomes of surgical treatment for congenital muscular torticollis (CMT) are poor in many cases, primarily from surgeon's fear of damage to important blood vessels in the carotid sheath. The current research aimed to establish a novel, safer and more effective surgical approach for the treatment of CMT based on the anatomic relationship between the fascial sheath of the sternocleidomastoid muscle and the carotid sheath.

A total of 12 formalin-fixed cadaveric specimens (including 9 males and 3 females with average age of 48.1 years at the time of death) were used to observe the anatomical integrity and the compactness of the sternocleidomastoid fascial sheath and its relationship with the carotid sheath. From January 2013 to December 2015, 22 patients with CMT were treated surgically, including 12 males and 10 females with an average age of 13 years (range: 6–28 years). All patients underwent surgical treatment using the novel approach designed by the author, that is, separation of the fascial sheath of the sternocleidomastoid and the carotid sheath was performed.

The fascial sheath of the sternocleidomastoid muscle is easily isolated from the carotid sheath in all specimens. All procedures were successfully completed. The space between the fascial sheath of the sternocleidomastoid muscle and the carotid sheath can be accessed in all patients. Carotid sheath contracture was identified in 1 patient and divided successfully. The average follow-up period was 19 months (range: 5 to 43 months). No postoperative lateral band was noted in the neck in any of the patients. Satisfaction regarding cosmetic and functional outcomes was considered excellent in 13 patients, good in 7 patients, and fair in 2 patients.

The fascial sheath of the sternocleidomastoid muscle is easily isolated from the carotid sheath. This anatomical feature is the basis of division of the sternocleidomastoid muscle and can improve the safety and effectiveness of surgical treatment for CMT in patients older than 6 years old.
Effects of body weight support and gait velocity via antigravity treadmill on cardiovascular responses early after total knee arthroplasty
Authors: Kim Bo Ryun , Kim Sang Rim , Nam Kwang Woo , Lee So Young , Park Yong Geun , Suh Min Ji , Jeon Young Tae
Published: April 2020

To investigate the effects of body weight support (BWS) and gait velocity on cardiovascular responses during walking on an antigravity treadmill early after unilateral and bilateral total knee arthroplasty (TKA).

This study was a cross-sectional study design. Fifty patients (7 males and 43 females; average age, 72.0 ± 5.1 years) at 4 weeks after unilateral (n = 25) and bilateral (n = 25) primary TKA were enrolled in the study. Subjects walked on an antigravity treadmill at speeds of 2.5 km/hour and 3.5 km/hour with 3 levels (50%, 25%, and 0%) of BWS. Cardiovascular responses were monitored by measuring oxygen consumption (VO2), heart rate (HR), systolic and diastolic blood pressure (SBP/DBP), the respiratory exchange ratio (RER), and rate pressure product (RPP). Borg rating of perceived exertion (RPE) and a visual analog scale (VAS) of knee pain were recorded immediately after each trial.

There were no significant differences in cardiovascular responses between the unilateral and bilateral TKA groups. In the repeated measures Analysis of Variance, VO2 levels, HR, RPP, RPE, RER, and VAS were significantly increased in proportion to 3 levels (50%, 25%, and 0%) of BWS for unilateral and bilateral TKA groups, respectively. Meanwhile, SBP and DBP were unaffected by differences in BWS. At 3.5 km/hour, VO2, RPE, and RER values were statistically greater than those at 2.5 km/hour under the same BWS conditions.

We found that the reduction in the metabolic demand of activity, coupled with positive pressure on the lower extremities, reduced VO2 and HR values as BWS increased.

Cardiovascular responses vary according to BWS and gait velocity during antigravity treadmill walking. BWS rather than gait velocity had the greatest effect on cardiovascular responses and knee pain.
The microcirculatory characteristics of the heart and lung meridians
Authors: Hu Hantong , Jiang Yongliang , Li Xiaoyu , Lou Jiali , Zhang Yajun , He Xiaofen , Fang Junfan , Wu Yuanyuan , Shao Xiaomei , Fang Jianqiao
Published: April 2020

Introduction:

The aim of the present study is to compare the microcirculatory difference of different meridians by using laser doppler flowmetry and investigate the specificity for the meridian-visceral association and site-to-site association between 2 specific meridians.

Methods and analysis:

The Lung and Heart meridians are chosen as 2 specific studied meridians. 120 participants will be enrolled and divided into the healthy control group, chronic stable angina pectoris group and healthy intervention group. Laser doppler flowmetry will be used to assess the blood perfusion of the Heart and Lung meridians. The specificity for the meridian-visceral association will be investigated by comparing the microcirculatory difference between the Heart and Lung meridians in the healthy control group and chronic stable angina pectoris group. Besides, participants in the healthy intervention group will receive 2 sessions of moxibustion in the Heart meridian and Lung meridian, respectively, to explore the specificity for the site-to-site association on the body surface. Primary outcomes will be blood flow curve and blood perfusion units of relevant sites along the Heart and Lung meridians. Statistical analysis will be conducted by third party statisticians.

Ethics and dissemination:

Ethics approval (approval No: ZSLL-KY-2019-001A-01) has been obtained from the Ethics Committee of the Third Affiliated Hospital of Zhejiang Chinese Medical University. The study findings will be disseminated through presentation at peer-reviewed medical journals.

Trial registration:

ClinicalTrials.gov NCT04244812.
Single-center experience in the treatment of extremely medial clavicle fractures with vertical fixation of double-plate
Authors: Liu He , Peng Chuangang , Zhang Ziyan , Yuan Baoming , Ren Guangkai , Yu Junlong , Wu Dankai
Published: April 2020

Patients suffering from extremely medial clavicle fractures combined with distinct displacement generally need surgical intervention. Double-plate fixation is a widely applied technique in the treatment of distal radius fracture, which has been reported to fix lateral clavicle fracture as well. This study reveals the effect of double-plate fixation as an innovative procedure in the treatment of extremely medial clavicle fractures for the first time.

Nine patients complaint of extremely medial clavicle fracture were enrolled in this research from May 2017 to March 2019. Patients were operated with an open reduction and internal fixation using the double-plate technique. Postoperative x-ray was taken regularly to observe the fracture healing at each visit, and the related complications were also recorded. The rating score systems of Constant Murley score of treated shoulder and contralateral shoulder, ROWE score as well as American Shoulder and Elbow Surgeons (ASES) were evaluated to comment on the postoperative shoulder joint function.

All patients achieved postoperative fracture healing with no complications. Only 1 patient complained of slight restriction, 2 patients complained of pain during overhead work, and another patient was found with plate breakage. Meanwhile, the Constant Murley scores of treated and contralateral shoulder were 94.1 and 98.5 points, respectively, indicating the similar shoulder function. Furthermore, the ROWE and ASES scores of the involved shoulder were 96.7 and 96.3 points at average, respectively.

It is the first time to introduce the surgical technique of vertical double-plate fixation implied in stable fixation of extremely medial clavicle fractures, which could provide the surgeons with an alternative method for this type of fracture.
Individualized management of giant anterior meningoceles-case series
Authors: Wang YueLong , He Bin , Yang Jinhao , Xu Jianguo , Liu Jiagang , Huang Siqing
Published: April 2020

Rationale:

Anterior spinal meningoceles are rare neuroanatomic abnormality formed by protrusion of the spinal meninges through a defect in the vertebral column. Presently, therapeutic options for anterior spinal meningoceles are still controversial. The objective of this study is to discuss the individualized management of giant anterior spinal meningoceles.

Patient concerns and Diagnoses:

We analyzed 4 patients with anterior spinal meningoceles between 2007 and 2014 in our department by retrospective chart review, two of whom were anterior sacral meningoceles (ASMs), and another2 were intrathoracic meningoceles (ITMs).

Interventions and outcomes:

Patients mainly presented with compressive symptoms including rectal irritation, dyspnea (patient 3) and fixed neurologic deficits (patient 4). Three out of 4 patients received surgical treatment, one of which underwent reoperation. After surgery, meningoceles in 1 patient completely disappeared. Two patients acquired the stability of the size of the meningoceles.

Lessons:

Management of anterior spinal meningoceles often requires precise treatment based on the different conditions of each patient. Surgical intervention has been proposed for the treatment of symptomatic anterior spinal meningoceles. The goal of surgery is to safely disconnect the linkage between the cyst and CSF from subarachnoid space to prevent further enlargement of the cyst or reaccumulating of cystic fluid.
Laparoscopic drainage as a minimally invasive treatment for a psoas abscess
Authors: Hong Chang Hwa , Hong Yong Cheol , Bae Sang Ho , Son Myoung Won , Won Sung Hun , Ryu Aeli , Kim Chang Hyun , Chang Hee Jun , Kim Woo Jong
Published: April 2020

A psoas abscess is a rare but potentially devastating condition that is associated with risks of neurological deficits, septic shock, and even death. The current first-line treatment is percutaneous catheter drainage (PCD) under imaging guidance, combined with broad-spectrum antibiotics. Surgical drainage should be considered if PCD fails or is impossible.

Although many studies on PCD and open surgical drainage have appeared, the outcomes of laparoscopic drainage have rarely been reported. Thus, we laparoscopically drained the psoas abscesses of 6 patients; drainage was complete and we encountered no recurrence or complication. All patients were evaluated by plain radiography, contrast-enhanced computed tomography, and laboratory tests; all were followed-up for 1 year. Laparoscopic drainage is a good treatment option when PCD fails, affording all the advantages of open surgery (complete drainage, resection of infected tissue, and contermporaneous treatment of concomitant lesions). Also, laparoscopic drainage is minimally invasive, requires a smaller incision, and allows rapid recovery.
The association of hepatitis B virus screening and antiviral prophylaxis with adverse liver outcomes in Chinese cancer patients undergoing chemotherapy
Authors: He Lan-Ying , Wang Yu-Lan , Tian Xu , Chen Wei-Qing
Published: April 2020

Currently, the association of the initiation time of hepatitis B virus (HBV) screening and antiviral prophylaxis with adverse liver outcomes in cancer patients undergoing chemotherapy remains conflicting.

This retrospective study was designed to determine the association of HBV screening and antiviral prophylaxis with adverse liver outcomes, and then proposed optimal management strategies on HBV screening and antiviral prophylaxis.

We analyzed the medical data of Chinese cancer patients undergoing chemotherapy between 2000 and 2015. Descriptive statistics and Chi square tests were performed to analyze the basic characteristics of patients. Time-to-event analysis was used to determine incidence, and competing risk analysis was used to determine the hazard ratios (HRs) for outcomes.

A total of 12,158 patients (81.1% with solid tumors) were analyzed. Among solid tumors patients, late screening and late antiviral therapy of chronic HBV were associated with higher incidence of hepatitis flare (HR 3.29, 95% confidence interval [CI] 2.26–4.79; HR 6.79, 95% CI 4.42–10.41), hepatic impairment (HR 2.96, 95% CI 2.03–4.32; HR 8.03, 95% CI 4.78–13.48), liver failure (HR 2.19, 95% CI 1.41–3.40; HR 14.81, 95% CI 6.57–33.42), and HBV-related death (HR 3.29, 95% CI 2.26–4.79; HR 8.30, 95% CI 4.95–13.91) in comparison with early screening and early therapy.

Early HBV screening and antiviral therapy could reduce the risk of adverse liver outcomes among chronic HBV patients receiving chemotherapy. Hepatitis B surface antibody-positivity was associated with a decreased risk of liver failure and chronic HBV, late screening or late antiviral therapy were predictors of liver failure for patients with anti-tumor therapy. However, it should be applied cautiously into each types of solid tumors and hematologic malignancies because subgroup analysis according to type of cancer was not designed.
Positron emission tomography/computed tomography dual imaging using 18-fluorine flurodeoxyglucose and 11C-labeled 2-β-carbomethoxy-3-β-(4-fluorophenyl) tropane for the severity assessment of Parkinson disease
Authors: Li Xiaohong , Zhang Qizhou , Qin Yongde , Li Yubin , Mutaerbieke Nazimuguli , Zhao Xiaojia , Yibulayin Amina
Published: April 2020

The value of dual imaging mode for the severity assessment of Parkinson disease (PD) is explored by conducting positron emission tomography computed tomography (PET/CT) double imaging using combined 18-fluorine flurodeoxyglucose (18F-FDG) brain metabolism and 11C-2β-carbomethoxy-3β-(4-fluorophenyl) tropane (11C-CFT) brain dopamine transporter (DAT).

A total of 102 patients with PD and 50 healthy people in the control group are enrolled for the PET/CT dual imaging of 18F-FDG brain metabolism and 11C-CFT brain DAT. The characteristics of 18F-FDG PET/CT and 11C-CFT PET/CT imaging are analyzed by delineating the region of interest. Differences in the glucose metabolism and DAT distribution in the basal ganglia of patients with PD and healthy control group in the PET/CT imaging and the radioactive distribution characteristics of cerebral cortex in glucose metabolism imaging are compared. The characteristics of PET/CT imaging of 11C-CFT brain DAT in the ganglion region in absorbing 11C-CFT in different PD groups are analyzed.

Compared with the healthy control group, changes in the cerebral glucose metabolism in the PD group mainly occur due to the increased symmetry metabolism of the nucleus of bilateral basal ganglia and the decreased metabolism of the cerebral cortex as shown in the 18F-FDG PET/CT images. With disease progression, the bilateral parietal, frontal, temporal, and occipital leaves showed different degrees of FDG metabolism. Statistically significant difference is observed for the11C-CFT absorption among the caudate nucleus and the anterior, middle, and posterior nuclei of the bilateral basal ganglia of the PD and healthy control groups. In the PD group, the bilateral caudate nucleus and the anterior, middle, and posterior parts of the putamen show decreased DAT distribution. Regardless of unilateral or bilateral symptoms, the DAT distribution in the nucleus of the contralateral basal ganglia and in the posterior part of the nucleus is substantially reduced.

PET/CT dual imaging by 18F-FDG PET/CT combined with 11C-CFT PET/CT features high application value for the severity assessment of PD.
The effects of the wenyang huoxue method on coronary heart disease heart failure
Authors: Han Wenbo , Zhao Yong , Wang Yahong , Dai Yanyan , Hao Jinhong , Li Tianli , Wang Xian
Published: April 2020

Background:

Coronary heart disease (CHD) has become the primary cause of heart failure (HF). Wenyang Huoxue method can significantly improve cardiac function in patients with CHD complicated with HF, but it has not been systematically evaluated for efficacy and safety.

Methods:

We will search China National Knowledge Infrastructure Database, Wanfang database, China Biomedical Literature Database, China Science Journal Database PubMed, Excerpt Medica Database, and Cochrane library. Clinical trial registrations, potential grey literature, related conference abstracts, and reference lists of identified studies will also be retrieved. The electronic database will be searched for literatures published from January 2000 to September 2019. Based on the heterogeneity test, data integration is performed using a fixed effect model or a random effects model. Changes in total effective rate in cardiac function will be assessed as primary outcome. 6-minute walk test, left ventricular ejection fraction, and plasma brain natriuretic peptide will be assessed as secondary outcomes. RevMan 5.3.5 will be used for meta-analysis.

Results:

This study will provide a high-quality comprehensive evaluation of the efficacy and safety of Wenyang Huoxue method for treating patients with CHD complicated with HF.

Conclusions:

This systematic review will determine whether Wenyang Huoxue method provides evidence for effective intervention in patients with CHD complicated with HF.

Ethics and dissemination:

This systematic review and meta-analysis of randomized controlled trials does not require ethical recognition, and the results of this paper will be published in an open access, internationally influential academic journal.

Trial registration number:

CRD42016025957