bluuebunny/crossref_metadata_2025_split huggingface dataset:
Peripheral monocyte count is an independent predictor of all-cause mortality in type 2 diabetes with macro-vascular complications
Authors: Yang Lina , Hu Jinbo , Wang Zhihong , Chen Xiangjun , Wang Yue , Yang Shumin , Luo Ting , Mei Mei , Cheng Qingfeng , Xu Zhixin , Du Zhipeng , Gong Lilin , Luo Rong , Li Qifu 
Published: January 2020

Abstract
The relationship between monocyte count and mortality seemed to be varied in different diseases, and it remains unclear in type 2 diabetes (T2D). We conducted a prospective study to investigate whether monocyte count predict all-cause mortality in patients with T2D.
In this prospective study, a total of 1073 patients with T2D were enrolled at baseline and 880 patients completed the follow up. The median follow-up time was 47 months. At baseline, clinical characteristics including height, weight, waist circumference, blood pressure were recorded. Biochemical parameters including counts of white blood cells (WBCC), neutrophil (NC) and monocyte (MC), lipid profiles, glycated hemoglobin (HbA1c), serum creatinine were measured. Charlson comorbidity index (CCI) was calculated based on age and comorbidities. Participants were stratified into low, median, and high tertiles according to the baseline MC. Regression models were used to analyze the associations of peripheral MC and the all-cause mortality.
Compared to the survived subjects, the baseline MC was significantly higher in patients who deceased during the follow-up (0.45 ± 0.16 vs 0.37 ± 0.15 × 109/L, P = .003). In the multivariate Cox hazard models, subjects in higher MC tertile showed higher risks of all-cause mortality (low tertile as the reference, hazard ratio [HR] 95%CI 2.65 [0.84,8.31] and 3.73 [1.14,12.24] for middle and high MC tertile, respectively) after adjusted for gender, body mass index, CCI, duration of T2D, history of hypertension and metabolic syndrome, drugs, levels of high-sensitivity C-reactive protein, systolic blood pressure, HbA1c, WBCC, and NC. In T2D patients with macro-vascular complications at baseline, 1-SD increment of MC resulted in 1.92-fold higher risk of all-cause mortality. However, the relationship disappeared in subjects without macro-vascular complications at baseline (1.13 [0.72, 1.78], P = .591).
Peripheral monocyte count is an independent predictor of all-cause mortality in T2D, especially for subjects with macro-vascular complications.
Orbital myiasis
Authors: Huang Yan-Ling , Liu Lu , Liang Hao , He Jian , Chen Jun , Liang Qiao-Wen , Jiang Zhi-Yuan , He Jian-Feng , Huang Min-Li , Du Yi 
Published: January 2020

Abstract

Rationale:
Myiasis is a parasitic disease caused by fly larvae of the Diptera order that infest human and other vertebrate animal tissues. Orbital myiasis is a potentially destructive infestation of the orbital tissues, which may affect individuals with previous ocular diseases or disorders of consciousness.

Patient concerns:
A 72-year-old man presented with a complaint of repeated pain for two years after trauma to his right eyelid and aggravated symptoms with larvae wriggling out for 2 days. An orbital computed tomography scan revealed right eyeball protrusion and periocular soft tissue edema. Two days later, magnetic resonance imaging showed that the shape of the right eyeball was changed and that the normal structure of the eyeball could not be identified.

Diagnoses:
Due to the patient's symptoms and imaging examination results, the diagnosis of orbital myiasis was made.

Interventions:
The patient was treated by exenteration of the right orbit, and all necrotic tissues and larvae were removed. The defect was repaired via reconstruction with a pedicled musculocutaneous flap from the forehead region. Antibiotics and tetanus toxoid therapy were utilized to prevent potential bacterial infection.

Outcomes:
The patient recovered well postoperatively and was discharged uneventfully. During the 6-month follow-up period, the wound healed well.

Lessons:
Advanced age and untreated eye trauma are risk factors for orbital myiasis. Timely removal of larvae and elimination of infections are important measures for protecting the eyeball.
A retrospective comparative study of infection control rate and clinical outcome between open debridement using antibiotic-impregnated cement beads and a two-stage revision in acute periprosthetic knee joint infection
Authors: Chang Moon Jong , Lee Seung Ah , Kang Seung-Baik , Hwang Keum Min , Park Hyung Jun , Lee Kyoung Hwan , Seo Jai Gon , Chang Chong Bum 
Published: January 2020

Abstract
The aim of this study was to determine whether the infection control rate of a modified debridement, antibiotics, and implant retention (DAIR) protocol (DAIR with antibiotic-impregnated cement beads) is comparable to that of 2-stage revision for acute periprosthetic joint infection (PJI) after total knee arthroplasty (TKA). We also aimed to determine whether this modified DAIR technique produced better clinical results than those obtained using 2-stage revision in terms of functional outcome, range of motion (ROM), and patient satisfaction at 2 years after surgery.
This retrospective comparative study included patients who underwent modified DAIR (7 patients, 9 knees) or 2-stage revision (8 patients, 9 knees) for acute PJI of the knee joint. Infection control rate, functional outcome measured using Western Ontario and McMaster Universities Arthritis Index (WOMAC) score, ROM and patient satisfaction were compared between the two groups.
There was no difference in infection control rates between the modified DAIR and 2-stage revision groups (78% vs 78%, respectively). In contrast, surgical outcome in the modified DAIR group was tended to be better than 2-stage revision group, but it did not reach statistical significance. Median maximal range of flexion was 103° in the modified DAIR group and it was 90° in the 2-stage group (P = .191). In addition, the median WOMAC function score was 24 in the modified DAIR group and it was 30 in the 2-stage group (P = .076). Median patient satisfaction measured using visual analogue scale was 8 in the modified DAIR group and 5 in the 2-stage group (P = .069).
The infection control rates of the modified DAIR protocol and 2-stage revision protocol were similar for the treatment of acute PJI of the knee joint. However, the modified DAIR protocol could not provide substantially increased functional outcomes and patient satisfaction compared to 2-stage revision. Therefore, the modified DAIR technique should be considered to be of limited use in patients with high surgical morbidity.
Application of point-of-care ultrasound for different types of esophageal foreign bodies: three case reports
Authors: Ahn Jung Hwan , Sohn Youdong 
Published: January 2020

Abstract

Rationale:
Esophageal point-of-care ultrasound (POCUS) has recently been reported as a useful, quick, safe, and simple technique to detect esophageal foreign bodies (FBs). However, case series to detect esophageal FB using POCUS have been rarely reported. Chicken bones and pills, especially, have not yet been reported as esophageal FBs. The objective of this case series was to describe the POCUS findings of 3 different materials—food, pill, and chicken bone.

Patient concerns:
Case 1, a 75-year-old woman with odynophagia and neck pain occurring 30 min after eating chicken porridge; Case 2, a 32-year-old woman with neck discomfort occurring 2 h after taking a pill; Case 3, a 29-year-old woman reporting FB sensation in the neck that occurred 1 h after eating sausage and rice soup.

Diagnosis:
Case 1. Cervical esophageal FB (chicken bone), Case 2. Cervical esophageal FB (oral pill), Case 3. Cervical esophageal FB (food).

Interventions:
Case 1. POCUS, urgent esophagogastroduodenoscopy (EGD) with alligator forceps. POCUS findings; hyperechoic material (suspected FB) that did not disappear by swallowing and esophageal dilatation with pooling of secretions. Case 2. POCUS. POCUS findings; hypoechoic material (suspected FB) that did not disappear by swallowing, and esophageal bulging above the FB, especially observed in the longitudinal view. Case 3. POCUS. POCUS findings; hyperechoic material (suspected FB) with reverberation artifact that did not disappear with swallowing efforts. Prior FB esophageal bulging with persistent air-fluid level was especially observed in the longitudinal view.

Outcomes:
Case 1. FB was removed by EGD with alligator forceps. Case 2. Symptoms disappeared under observation without EGD. Follow-up POCUS revealed normalized bulging esophagus. Case 3. These symptoms improved after vomiting a large piece of food material. Three patients were discharged without complications.

Lessons:
In this case series, the impacted materials were chicken bone, pill, and food. However, POCUS findings were similar (esophageal dilation, hyperechoic or hypoechoic lesion with mixed echogenic contents in food or secretion, and no change with swallowing efforts). A longitudinal view was useful to assume the presence of cervical esophageal FB in all three cases. Thus, POCUS findings could be indirect signs of a FB in the esophagus.
Moxibustion for the treatment of primary dysmenorrhea
Authors: Wang Xue , Xiong Jun , Yang Jun , Yuan Ting , Fan Hao , Jiang Yunfeng , Zhou Xiaohong , Liao Kai , Xu Lingling 
Published: January 2020

Abstract

Background:
Primary dysmenorrhea (PD) is a common gynecological disease, it refers to spasmodic pain in the lower abdomen before, after or during menstruation, accompanied by general discomfort, In severe cases, fainting may occur due to severe pain, reducing the quality of patients’ life and imposing a heavy burden on social medical security system. There are many ways to treat primary dysmenorrhea, including western medicine and traditional Chinese medicine. Moxibustion is one of the traditional Chinese medicine treatments for primary dysmenorrhea, especially popular in China. Therefore, our overview aims at evaluating the methodological bias and the reliability of the conclusions of systematic reviews (SRs) about moxibustion for primary dysmenorrhoea, and help clinical decision makers translate this research into clinical policy and practice.

Methods:
We will search electronic databases including PubMed, Embase, Cochrane Library, Chinese Biomedical Literatures Database (CBM), China National Knowledge Infrastructure (CNKI), WangFang Database (WF), Chinese Scientific Journal Database (VIP) from inception to February 2017. We will consider systematic reviews and meta-analysis of randomized controlled trials evaluating the effect of moxibustion for PD. Two reviewers will identify relevant studies, extract data information, and then assess the methodological quality by Assessment of Multiple Systematic Reviews-2 (AMSTAR-2) tool. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) report checklist to assess the quality of reports included in the study. We will use the evaluations of the Classification of Recommendations, Evaluation, Development and Evaluation (GRADE) of the authors of the included systematic reviews. The screening of systematic reviews, eligibility evaluation, data extraction, methodological quality, and quality of evidence will be conducted by independent reviewers in pairs. The outcomes of interest include: total effective rate, visual analog scale scores (VAS), Cox Menstrual Symptom Scale (CMSS), Dysmenorrhea symptom score and adverse events outcomes prioritized in the individual reviews. We will extract data onto a predefined form designed to summarize the key characteristics of each review. The evidence will be a narrative synthesis organized around the type and content of the intervention and the results reported.

Results:
The results of this study will be published in a peer-reviewed journal.

Conclusions:
We expect to compile evidence from multiple systematic reviews of symptomatic improvement in patients with primary dysmenorrhea in an accessible and useful document.

Registration number PROSPERO:
CRD42019141130
Is high tibial osteotomy better than proximal fibula osteotomy for treating knee osteoarthritis? A protocol for a systematic review and meta-analysis of clinical controlled trials
Authors: Huang Hetao , Huang Sicong , Liang Guihong , Zeng Lingfeng , Pan Jianke , Yang Weiyi , Chen Hongyun , Liu Jun , Pan Biqi 
Published: January 2020

Abstract

Background:
Knee osteoarthritis (KOA) is a common disease in the elderly, which seriously reduces the quality of life of patients and increases the social burden. proximal fibula osteotomy (PFO) and high tibial osteotomy (HTO) are effective methods to treat KOA. However, it is not entirely clear which method has the advantage. Therefore, we evaluated the efficacy and safety of HTO and PFO in the treatment of KOA.

Methods:
Randomized controlled trials from online databases including PubMed, Embase, the Cochrane Library, China National Knowledge Infrastructure, Chinese Scientific Journal Database, Wanfang Data and Chinese Biomedical Literature Database that compared the efficacy of HTO and PFO in the treatment of KOA were retrieved. The main outcomes included hospital for special surgery (HSS) knee scores, knee society knee scoring system (KSS) score, visual analog scale (VAS) knee pain scores, western ontario and McMaster universities osteoarthritis index score, operation time, intraoperative bleeding volume, hospitalization time, complications. The Cochrane risk of bias tool was used to assess methodological quality.

Results:
The literature will provide a high-quality analysis of the current evidence supporting HTO for KOA based on various comprehensive assessments including HSS scores, KSS score, VAS scores, western Ontario and McMaster universities osteoarthritis index score, operation time, intraoperative bleeding volume, hospitalization time, and complications.

Conclusion:
This proposed systematic review will provide up-to-date evidence to assess the effect of HTO in the treatment for patients with KOA.
Moxibustion as an adjunct for lower urinary tract symptoms associated with benign prostate enlargement
Authors: Lee Hye-Yoon , Bae Go-Eun , Lee Sang-Don , Nam Jong-Kil , Yun Young-Ju , Han Ji-Yeon , Lee Dong-Hoon , Choi Jun-Young , Park Seong-Ha , Kwon Jung-Nam 
Published: January 2020

Abstract

Background:
Benign prostatic enlargement (BPE) causes discomfort in daily life, including lower urinary tract symptoms (LUTSs) caused by the enlarged prostate, and requires long-term management as a chronic, irreversible disease. To improve LUTS, certain complementary therapies have been used with or without doctors’ directions. Conventional treatments and complementary therapies tend to be combined unsystematically, depending on patient preference; thus, research for safe and efficient combination therapy is warranted.

Methods:
Twenty-nine participants were randomly assigned to an integrative group (IG, n = 15) or a conventional group (CG, n = 14). The IG received moxibustion (twice weekly for 4 weeks, at the acupuncture points SP6, LR3, and CV4) and conventional medication for 4 weeks, followed by conventional medication alone for 8 weeks. The CG received conventional medication alone for 12 weeks. The outcome measures were International Prostate Symptom Score (IPSS), patient's global impression of changes (PGIC), maximum urinary flow rate (Q
max), postvoid residual urine volume (PVR), and frequency-volume chart.

Results:
Total IPSS (IG, −2.4 ± 4.2; CG, 0.9 ± 4.0; P = .039), PGIC-A (IG, 3.5 ± 1.0; CG, 2.2 ± 1.0; P = .001), and PGIC-B (IG, 3.5 ± 0.1; CG, 4.7 ± 0.6; P = .004) were significantly improved in the IG compared with the CG, 4 weeks after baseline. Among the IPSS items, incomplete emptying (IG, −0.6 ± 0.7; CG, 0.4 ± 1.2; P = .019), straining (IG, −0.6 ± 0.8; CG, 0.2 ± 1.2; P = .046), and nocturia (IG, −0.8 ± 1.4; CG, 0.1 ± 1.0; P = .045) showed significant differences. The Q
max and PVR volume did not differ significantly at 12 weeks after the baseline.

Conclusion:
Moxibustion can be considered an adjunct therapy to improve LUTS in BPE patients. A full-sized randomized controlled trial would be feasible with comparator modifications and an extended study period. The study design should include a placebo group and narrow the eligibility to subjects who do not respond well to conventional treatments.
Depressed sympathovagal modulation indicates sepsis in patients with suspected infection
Authors: Hsu Ching-Tang , Tai Henry Chih-Hung , Chung Jui-Yuan , Chen Jiann-Hwa , Chen Wei-Lung 
Published: January 2020

Abstract
This study explored whether sympathovagal modulation assessed through frequency domains of heart rate variability (HRV) can indicate sepsis in patients with suspected infection.
In total, 370 consecutive adult patients with suspected infection admitted to the emergency department were enrolled in this single-center cohort study. A continuous 10-minute electrocardiography for HRV analysis was recorded immediately for these patients after inclusion. Patients were stratified into non-sepsis and sepsis groups based on a sepsis-related organ failure assessment score of ≥2 that met the Third International Consensus Definitions for Sepsis. Seven frequency domains of HRV were compared between these 2 groups.
Compared with the non-sepsis group (n = 98), the sepsis group (n = 272) had a significantly lower incidence of respiratory tract infection, higher total power, higher very-low-frequency component, higher high-frequency (HF) component, higher normalized HF component, lower normalized low-frequency (LF) component, and lower LF component/HF component ratio (LF/HF). Multiple logistic regression model identified HF component (odds ratio [OR] = 0.994; 95% confidence interval [CI], 0.990–0.999) and LF/HF (OR = 0.494; 95% CI, 0.423–0.578) as significant variables associated with sepsis. The area under receiver operating characteristic curves of HF component and LF/HF was 0.741 (95% CI, 0.685–0.797) and 0.930 (95% CI, 0.900–0.960), respectively, in identifying sepsis in patients with suspected infection.
Tilted sympathovagal balance toward increased vagal activity and depressed sympathetic modulation, assessed by the HF component and LF/HF, may indicate sepsis in patients with suspected infection.
Epidural anesthesia for emergency cesarean section in a woman with Fontan circulation
Authors: Wu Pin , Zhu Sheng-Mei , Yao Yong-Xing 
Published: January 2020

Abstract

Rationale:
Anesthetic management of pregnant women with Fontan circulation remains challenging. There are few reports that describe the anesthetic management of cesarean section after Fontan surgery. Here, we present a case of successful epidural anesthesia in a woman with Fontan circulation who required emergency cesarean section.

Patient concerns:
A 29-year-old woman at gestational week 28 was scheduled for emergency cesarean section because of fetal distress. Her past medical history was significant for congenital transposition of the great arteries that had been treated by Fontan surgery 26 years earlier. Her postoperative course had been uneventful and she had reached a near normal level of activity with no arrhythmias or thrombotic complications. On presentation, her oxygen saturation was approximately 84% and she had digital clubbing. Arterial blood gas analysis showed a PCO2 of 35 mmHg, PO2 of 55.5 mmHg, and hemoglobin of 16.3 g/dL. Her blood coagulation parameters were within normal limits except for a high fibrinogen concentration (4.55 g/L).

Diagnosis:
The diagnosis was pregnancy requiring emergency cesarean section because of fetal distress.

Interventions:
Before anesthesia, a radial artery line was established for continuous measurement of blood pressure. An air pressure pump was placed on the patient's lower limbs and a low-dose dobutamine infusion was started. Next, epidural anesthesia was successfully performed at L2–3. Five milliliters of 2% lidocaine followed by 10 mL of 0.75% ropivacaine were injected. Dobutamine was infused to maintain a target blood pressure of 100–120/60–70 mmHg.

Outcomes:
The procedure was uneventful with the patient maintaining a stable heart rate of 80 to 90 beats/min and an oxygen saturation of 90% to 94%. A male infant weighing 840 g was delivered. The Apgar score was 9 at 1 and 5 minutes. The patient was transferred to the intensive care unit for 20 hours of monitoring and discharged 9 days later. The neonate was discharged after 2 months of specialist neonatal treatment.

Lessons:
Epidural anesthesia may be used in women with Fontan circulation undergoing emergency cesarean section. Knowledge of the physiology of the heart lesion and that of pregnancy are critical to the outcome.
Kangaroo Care for Hospitalized Infants with Congenital Heart Disease
Authors: Lisanti Amy Jo , Buoni Alessandra , Steigerwalt Megan , Daly Michelle , McNelis Stephanie , Spatz Diane L. 
Published: January 2020

Abstract

Background:
Kangaroo care (KC), or skin-to-skin care, occurs when an infant is dressed in a diaper and held to a parent's bare chest. This form of holding has been shown to have many benefits for hospitalized infants and has been shown to be a safe and feasible intervention to support infants with congenital heart disease. Despite known benefits, KC was not implemented routinely and consistently in our cardiac center for infants with congenital heart disease. The purpose of this project was to support use of KC as a nursing intervention for hospitalized infants with congenital heart disease and their parents.

Methods:
A KC quality improvement committee formed to develop strategies to increase frequency of KC, including the creation of a new nursing policy and procedure on KC for infants, adaptation of the electronic health record to facilitate KC documentation, education, and supporting translation of KC into practice through the cardiac center's first Kangaroo-A-Thon.

Results:
Twenty-six nurses initiated KC 43 times with 14 patients over the 8-week period for the Kangaroo-A-Thon. No adverse events were reported as a result of infants being held by their parents in KC.

Conclusion:
Our local initiative provided preliminary evidence that KC can be safely integrated into standard care for hospitalized infants with congenital heart disease. Formal standards and procedures, along with creative initiatives such as a Kangaroo-A-Thon, can be a first step toward fostering the translation of KC into practice.
The (Slow) Depathologizing of Gender Incongruence
Authors: Davies Robert D. , Davies Madeline E. 
Published: January 2020

Abstract
Psychiatric nosology has at times mirrored cultural mores and societal values, pathologizing behaviors seen at the time to be either immoral or outside the norm. This has been particularly true when it comes to issues related to sexuality and gender. Such pathologizing has resulted in further stigmatization and discrimination in society. Gender incongruence, the experience of an individual whose internal sense of gender is at odds with the sex they were assigned at birth, has long been pathologized. This article will compare the history of the psychiatric depathologizing of homosexuality to the current process of depathologizing gender incongruence.