bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness of circular external fixator in periprosthetic fractures around the knee
Authors: Nozaka Koji , Miyakoshi Naohisa , Hongo Michio , Kasukawa Yuji , Saito Hidetomo , Kijima Hiroaki , Tsuchie Hiroyuki , Mita Motoki , Shimada Yoichi 
Published: April 2020

Abstract
Background: The incidence of periprosthetic fractures after total joint arthroplasty (TJA) is rising due to an increasing number of TJAs performed annually and the growing elderly population. In many elderly patients with periprosthetic fractures, the bone strength is lowered due to the deterioration of bone quality and a decrease in bone quantity; rigid fixation of the fracture is difficult. It is a challenging operation for orthopedic surgeons. The usefulness of circular external fixation for periprosthetic fractures has been reported in several case studies. The aim of this study was to investigate the rate of union and complications associated with circular external fixation in periprosthetic fractures around the knee. Methods: We included 19 patients with periprosthetic femur and tibial fractures who underwent osteosynthesis using a circular external fixator and had at least 2 years of follow-up. All patients had comorbidities and high risks associated with anesthesia. Tourniquets were not used in any of the patients. There were no cases in which the skin incision was placed, and the closed reduction technique was used in all cases. Results: A 100% union rate was achieved with no serious complications. All fractures healed after a mean time of 14.3±5.2 weeks (range, 8-38 weeks). The walking ability was the same level as before the injury in 13 cases. Discussion: There are many comorbidities associated with periprosthetic fractures in elderly patients. Double-plate or revision surgery were largely invasive and had high risks associated with anesthesia. Circular external fixation is a feasible and effective treatment option because it provides stable fixation, prompt postoperative mobilization, and has no major complications, especially in elderly patients who are treated for periprosthetic fractures Conclusion: Circular external fixation is a safe and reliable method for periprosthetic fractures around the knee in elderly patients. Level of evidence: Level IV, retrospective case series
Effect of toxic trace element detoxification, body fat reduction following four-week intake of the Wellnessup diet: a three-arm, randomized clinical trial
Authors: Jung Su-Jin , Kim Woo-Lim , Park Byung-Hyun , Lee Seung-Ok , Chae Soowan 
Published: April 2020

Abstract
Background: Detox diet are known as a popular dieting strategies that helps toxins elimination and weight manage but there is very little clinical evidence. The Wellnessup diet (WD) used in the present study designed as a healthy meals based on organic plant based diets including various vegetables, fruits, whole grains, nuts and phytonutrients. Methods: To evaluate the effects of 4 week intake of the WD on toxic trace element detoxification, body fat reduction, and safety parameters. Forty-five women with body mass index (BMI) of 23.5-30 kg/m2 were recruited. Thirty of them were assigned 1:1 to the test group (WD, 15 subjects) and control group 1 (calorie-restricted diet, CRD, 15 subjects) in a single blind and randomized, and the remaining 15 subjects were assigned to control group 2 (maintaining regular diet, MRD). The primary outcome were toxic trace element levels in hair (29 types of heavy metals), and the secondary outcomes were changes in anthropometric and urinary organic acids. Results: The levels of four toxic trace elements in hair decreased in the WD group after the diet compared to before the diet. Ni, Rh, Sn, and Ga were significantly lower in the WD group than in the CRD or MRD group (p<0.05). At the end of the trial, both WD and CRD groups had lower BMI, Waist Circumference(WC), Hip Circumference(HC) and WHR compared to the baseline values (p<0.05). Compared to the WD group, the CRD group had a greater mean change (p<0.05) from the baseline for weight loss (-3.22±0.48kg vs -1.88±0.95kg vs) and fat free mass (-2.08 kg vs -1.09 kg). The weight, BMI, body fat mass, fat free mass, WC, and HC of the CRD group were significantly decreased compared to the MRD (p<0.05). No significant changes in any safety parameter were observed. Conclusions: Use of WD might have several beneficial effects and safety such as body fat reduction and improving some the element detoxification through caloric restriction but did not reducing body fat mass more than calorie-restricted diet.
Quality of life in patients with psoriasis seen in the Department of Dermatology, Antananarivo Madagascar.
Authors: Sendrasoa Fandresena Arilala , Volatantely Ratovonjanahary , Harinjara Razanakoto Naina , Onivola Raharolahy , Fifaliana Rakotoarisaona Mendrika , Avotriniaina Rakotonaivo Niriantsoa , Malalaniaina Andrianarison , Moril Sata , Mamisoa Ranaivo Irina , Soavina Ramarozatovo Lala , Fahafahantsoa Rapelanoro Rabenja 
Published: April 2020

Abstract
BACKGROUND: Psoriasis is a chronic, inflammatory and multifactorial dermatosis that impairs quality of life (QoL). Health-related QoL has become an important element in medical decision making along with the effectiveness and the harmlessness of the treatments.OBJECTIVE: To assess the impact of psoriasis in the QoL of patients with psoriasis by using the DLQI scales.METHODS: A cross-sectional study, during ten months, was conducted in the Department of Dermatology of the University Hospital Joseph Raseta Befelatanana Antananarivo Madagascar including patients more than 15 years-old with moderate to severe psoriasis. The severity of psoriasis was assessed using the “Psoriasis Area and Severity Index (PASI)”. QoL of patients with psoriasis was evaluated by using the DLQI scales.RESULTS: 80 patients were included, their mean age was 36.52 years and the male to female was 1.5:1. The mean DLQI score was 13.85. Symptoms, feelings and psychic were the most altered dimensions. QoL was impaired in young patients, single, having medium level education. Even though patients with disease duration more than 5 years had higher DLQI score than other patients, the difference was not statistically significant (p=0.36). Furthermore, clinical presentation of psoriasis didn’t influence patient’s QoL (p=0.73). Patients with nail involvement had QoL impaired but the difference with another localization was not statistically significant (p=0.2).The quality of life was influenced by body area involved. The higher the body surface area involved, the more QoL is impaired (p=0.002). Furthermore, the higher the PASI, the more QoL is altered (p=0.002).CONCLUSION: Psoriasis has a negative impact in the quality of life in Malagasy patients with psoriasis, especially in younger and single patients. Worse quality of life is correlated to severity of psoriasis.
Morphological parameters of fourth lumbar spinous process palpation: a three-dimensional reconstruction of computed tomography
Authors: Feng Qi , Zhang Lei , Zhang Mengyao , Wen Youliang , Zhang Ping , Wang Yi , Zeng Yan , Wang Junqiu 
Published: April 2020

Abstract
Background: The localization of lumbar fourth spinous process (L4-SP) is an important anatomical landmark, and identifying its accurate position is essential for the diagnosis and treatment of waist diseases.Methods: Five hundred participants were scanned with positive and lateral computed tomography (CT), which aimed to clarify anatomic characteristics of L4-SP. Anatomical parameters of the surface localization of L4-SP were measured and recorded through a three-dimensional (3D) reconstruction.Results: Five hundred participates were classified into three types according to the position of BC with the iliac spine. There are just 266 that the line between the highest point of the iliac spine on both sides located on L4-SP (type Ⅰ, 53.20%), 16 above L4-SP (type Ⅱ, 3.20%), and 218 below L4-SP (type Ⅲ, 43.60%). BC in type Ⅰ (15.92±1.30 mm) is longer than type Ⅲ (15.56±1.32 mm). While the angle combined with AB and BC are different in the three groups, the angle in type Ⅰ (173.00±4.83°) is larger than that in type Ⅱ (164.69±5.50°) and type Ⅲ (159.45±8.39°). Other measurements were not found any significant differences between above.Conclusion: The traditional palpation for L4-SP is not absolutely exact. The accuracy rate is only 53.20%, and the errors may cause serious consequences.
Curative Effect and Safety of Tolvaptan Combined with Traditional Diuretics in Treatment of Patients with Cirrhotic Ascites and Relevant Research on its Dose: A Systematic Review with Meta-Analysis of Randomized Controlled Trials
Authors: Li Xin , Liu Shidong , Zhang Hui , Liang Fuxiang , Miao Long , Xu Hao , Zhao Zhenjie , Zhou Wence 
Published: April 2020

Abstract
Background: Tolvaptan is a receptor antagonist of highly selective vasopressin V2, and it can promote excretion of water without electrolyte. Aims: To evaluated curative effect and safety of Tolvaptan in treatment of cirrhotic ascites, and its relationship with drug dose. Methods: Computer retrieval of PubMed, EMbase and The Cochrane Library was carried out to search the clinical trials of cirrhotic ascites treatment by Tolvaptan. The time limit of retrieval is from the database setup to May 31, 2019. 2 researchers independently screened studies, extracted the data and crosschecked. RevMan 5.3 software was used for Meta-analysis.Results: Finally, 6 articles and 848 patients were included in the study. Meta-analysis indicates that after the intervention for 7 days, serum sodium ion concentration of the combined diuretic group obviously increased, compared with the traditional diuretic group (WMD=2.92mmol/L, 95%CI [2.15, 3.70], P<0.001). In addition, Tolvaptan also can decrease patients’ ascites amount through increasing liquid discharge. However, the drug dose has no obvious correlation with the reduction degree of ascites amount. The rise of blood uric acid is the major adverse event in the treatment of cirrhotic ascites patients by Tolvaptan (OR=6.01, 95%CI [1.11, 32.56], P=0.04). When the dose of Tolvaptan rose to 15mg or 30mg, the total incidence of adverse events was obviously higher than it of traditional diuretic group.Conclusion: Tolvaptan combined with traditional diuretics has good curative effect for the patients with cirrhotic ascites. As its adverse reactions, the recommended dose of Tolvaptan is 7.5mg in the combined therapy.
Acute Superior Mesenteric Artery Embolism treated with Percutaneous Mechanical Thrombectomy: Preliminary application and Experience
Authors: Xu Qiyang , Wang Yi , Wang Di , Hu Songjie , Xu Bin , Yang Leibo , Yu Zuanbiao , Lang Dehai 
Published: April 2020

Abstract
Background: Acute superior mesenteric artery embolism is a life-threatening disease and the prognosis is very poor. Few reports have described the application of Percutaneous Mechanical Thrombectomy in Acute superior mesenteric artery embolism. In the article, we show a series of cases treated with Percutaneous Mechanical Thrombectomy and share our experience. Methods: Review and analyze seven patients with acute superior mesenteric artery embolism treated by Angiojet Ultra thrombectomy system in our institution. Based on the literature, we summarize the diagnosis, treatment and surgical experience of acute superior mesenteric artery embolism. Results: Percutaneous Mechanical Thrombectomy were achieved successfully in all the patients without surgical complication occurred. Five patients’ symptoms relieved significantly and smoothly discharged from the hospital. Two patients still complained of abdominal pain after operation. One patient underwent surgical laparotomy and intestinal resection and the other one abandoned surgical treatment. During the first six months of follow-up, six patients were free of any clinical symptoms or signs and one patient who refused laparotomy died two days later with septic shock. Conclusion: Percutaneous Mechanical Thrombectomy by Angiojet Ultra thrombectomy system is a safe, effective and minimally invasive method in the initial stage of acute superior mesenteric artery embolism. We believe Percutaneous Mechanical Thrombectomy could be a promising alternative in selected cases. Furthermore, large sample data and long term follow-up are needed to verify its effect.
It Was Like Nobody Cared About What I said? Iranian women committed self- immolation: A Qualitative Study
Authors: Aghakhani Nader , Lopez Violeta , Parizad Naser , Baghaei Rahim 
Published: April 2020

Abstract
Background Suicide is a deliberate method initiated with a complete awareness to die. Survivors of self-immolation, a violent suicide method, require long-term emotional and social rehabilitation. This study aimed to explore the influencing factors and experiences of self-immolation in Iranian married women.Methods This study was conducted using a qualitative method. Conventional content analysis was used to analyze data. We purposefully approached 16 married Iranian women [aged 16 to 40 years] in burn centers in Urmia city, located in northwest Iran. Data were collected using an open-ended in-depth face to face interviews at a time and convenient to them.Results Five main themes emerged from data analysis: “Overwhelming family situation and rules”, “Feelings of disappointment, anger, deprivation, depression, shame and grief”, “Choosing self-immolation as a final solution to get rid of the sufferings”, “Accepting own mistake”, and “seeking family support to start a new life. The study highlighted the need for health professionals to focus on the survivors’ and family members’ mental turmoil to help and encourage them to continue a normal life”.Conclusions The qualitative findings suggest that to reduce this social impact, comprehensive supportive programs based on sufferers’ needs to promote their quality of life in all its complexity are recommended.
Is totally laparoscopic gastrectomy without prophylactic drains feasible for patients with distal gastric cancer? The experience of China National Cancer Center
Authors: liu hao , Jin Peng , Xu Quan , Xie Yibin , Ma Fuhai , Ma Shuai , Tian Yantao 
Published: April 2020

Abstract
Background

Prophylactic drains have been used to remove intraperitoneal collections and to detect complications early in open surgery. In the last decades, Gastric cancer minimally invasive surgery has been widely carried out throughout the world. However, little has been reported on routine prophylactic abdominal drainage after totally laparoscopic distal gastrectomy. To evaluate the feasibility of without prophylactic drains in totally laparoscopic distal gastrectomy in selective patients.
Methods

Data of distal gastric cancer patients underwent totally laparoscopic distal gastrectomy with and without prophylactic drainage at China National Cancer Center/Cancer Hospital from February 2018 to August 2019 were reviewed. The outcomes of patients with and without a prophylactic drainage were compared.
Results

A total of 420 patients who underwent surgery for gastric cancer were identified; of these, 88 patients who received totally lapaoscopic distal gastrectomy were included. The incidence of concurrent illness was higher in the drain group, (48.8% vs. 27.7%, p = 0.041). The overall postoperative complication rate was 19.5% in the drain group (n = 47), and 10.6% in the no-drain group (n = 41), there were no significant differences between two groups (p > 0.05). The need for percutaneous catheter drainage (PCD) was also not significantly different between groups (9.8% vs. 6.4%, p = 0.700). However, patients with larger BMI (≥ 29) are prone to postoperative complications (p = 0.042). In addition, more operating time cost in the drain group than in the no-drain group (188.10 ± 38.89 min vs. 164.30 ± 36.97 min, p < 0.05). The number of days after surgery until the initiation of soft diet (5.34 ± 2.27 days vs. 4.17 ± 2.13 days, p < 0.05) and first flatus (4.29 ± 1.45 days vs. 3.55 ± 1.83 days, p = 0.041) were greater in the drain group.
Conclusions

Without prophylactic drainage may reduce surgery time and result in faster recovery. Routine prophylactic drains are not necessary in selective patients. A prophylactic drain may be useful in patients at higher risk.
Comparison of clinical outcomes with proximal femoral nail anti-rotation versus InterTAN nail for intertrochanteric femoral fractures: A meta-analysis
Authors: Liu Wei , Ji Guangrong , Liu Jie 
Published: April 2020

Abstract
Objective: To access the efficacy and safety of proximal femoral nail anti-rotation (PFNA) and InterTAN nail for intertrochanteric femoral fractures.Methods: According to the Cochrane systemic analysis method, randomized control trials (RCTs) and retrospective comparative observational studies which were related to the comparison of PFNA and InterTAN nail in the treatment of the elderly with intertrochanteric fractures were retrieved. Data were independently extracted from the included studies by two reviewers and analyzed using RevMan 5.3 , and the quality of the studies was assessed.Results: Two RCTs and seven observational studies were recruited, which consisted of 681 patients with PFNA and 651 patients with InterTAN nail. The meta-analyses showed no significant differences between the two approaches on Harris Hip Score, operation time, blood loss, time to union, mean hospital stay, union problems, intraoperative complications, hematoma, infection, other complication in both RCTs and observational studies. In terms of other outcomes, for the RCTs, results showed that there were shorter tip–apex distance, reduced pain at thigh or hip in InterTAN nail than in PFNA; however, InterTAN nail was not superior to PFNA in cutout, reoperation, and femoral shaft fracture; for observational studies, the risk of the screw migration (RR=5.13, 95%CI: [1.33,19.75], P=0.02), cutout (RR=3.26, 95%CI: [1.64,6.47], P=0.0008), the varus collapse of the femoral head (RR=7.19, 95%CI: [2.18,23.76], P=0.001), femoral shaft fracture (RR=5.73, 95%CI: [2.24,14.65], P=0.0003) treated by InterTAN nail were significantly decreased, compared with those by PFNA; however, no significant differences was observed in the aspects of tip–apex distance and pain at thigh or hip between these two groups.Conclusion: Analysis of a large number of relevant clinical indicators available shows that InterTAN nail has better clinical manifestation than PFNA in treating unstable femoral intertrochanteric fractures.
Health Technology Assessment and priority setting for Universal Health Coverage: A qualitative study of stakeholders capacity, needs, policy areas of demand and perspectives in Nigeria
Authors: Uzochukwu Benjamin Sunday , Okeke Chinyere Cecilia , O’Brien Niki , Ruiz Francis , Sombie Issiaka , Hollingworth Samantha 
Published: April 2020

Abstract
Introduction Health technology assessment (HTA) is an effective tool to support priority setting and generate evidence for decision making especially en route to achieving universal health coverage (UHC). We assessed the capacity needs, policy areas of demand, and perspectives of key stakeholders for evidence-informed decision making in Nigeria where HTA is still new. Methods We surveyed 31 participants including decision makers, policy makers, academic researchers, civil society organizations, community-based organizations, development partners, health professional organizations. We revised an existing survey to examine the need, policy areas of demand, and perspectives of stakeholders on HTA. We then analyzed responses and explored key themes. Results Most respondents were associated with organizations that generated or facilitated health services research. Research institutes highlighted their ability to provide expertise and skills for HTA research but some respondents noted a lack of human capacity for HTA. HTA was considered an important and valuable priority-setting tool with a key role in the design of health benefits packages, clinical guideline development, and service improvement. Public health programs, medicines and vaccineswere the three main technology types that would especially benefit from the application of HTA. The perceived availability and accessibility of suitable local data to support HTA varied widely but was mostly considered inadequate and limited. Respondents needed evidence on health system financing, health service provision, burden of disease and noted a need for training support in research methodology, HTA and data management Conclusion The use of HTA by policymakers and communities in Nigeria is very limited mainly due to inadequate and insufficient capacity to produce and use HTA. Developing sustainable and institutionalized HTA systems requires in-country expertise and active participation from a range of stakeholders. Stakeholder participation in identifying HTA topics and conducting relevant research will enhance the use of HTA evidence produced for decision making. Therefore, the identified training needs for HTA and possible research topics should be considereda priority in establishing HTA for evidence-informed policy making for achieving UHC particularly among the most vulnerable people in Nigeria.
Evaluate the correlation of electrolytes with biochemical parameters in biological samples of Parkinson’s disease patients at different stages
Authors: Afridi Hassan Imran , Rajput Kanwal , Kazi Tasneem Gul , Talpur Farah Naz , Baig Jameel Ahmed 
Published: April 2020

Abstract

Background: Neurodegeneration is complex and multifaceted leading to many chronic diseases like Parkinson’s disorder. Electrolytes imbalance have significant role in the pathophysiology of neurological disorders, which might be serve as a bio-indicator of the neurological problems. In present study, the disturbances of electrolytes (calcium, magnesium, sodium and potassium) and its correlation with biochemical parameters in patients with Parkinson’s at different stages with related to referent were studied. Methods: The biological samples were collected from patients recently diagnosed for mild Parkinson disease (MPD) (n=95) as well as chronic PD (CPD) patients, diagnosed for last 5 to 10 years (n=125).The Precision of digestion method was verified by applying matrixes matched certified reference materials of biological samples. The recovery of electrolytes was obtained in the range of 98.4–99.1 % of certified reference materials. The electrolytes concentrations were measured by acid digested biological samples preliminary analysis through flame atomic absorption spectrometry. Results: The experimental data indicated the content of Calcium and Magnesium were found to be higher in scalp hair samples of both patients while Sodium and Potassium showed inverse relation (p<0.05 for both groups). Electrolytes levels in blood serum and plasma was found to be lower in both types of patient groups than healthy groups (p<0.01). Conclusions: These results suggest a disturbance in the elemental homeostasis during the diseases of PD at different stages. In spite of, additional work is proposed to study the actual correlation among micro elemental level and the grade of diseases in neurological sick person.