bluuebunny/crossref_metadata_2025_split huggingface dataset:
Full recovery of near complete tear of anterior cruciate ligament without surgery: a case report
Authors: Kim Yoo Na , Baek Jungwon , Kim Young Hoon , Hwang Jaewoong , Ko Yu Ri , Lee Min soo , Kim Young chan , Park Hue Jung 
Published: May 2020

Abstract

Introduction:
The anterior cruciate ligament (ACL) is the region where spraining or tearing is most prevalent when the knee is injured. Complete ACL ruptures have a much less favorable outcome without surgical intervention. Polydeoxyribonucleotide (PDRN) is a relatively safe substance widely used for regenerative therapy.

Patient concerns:
A 43-year-old female patient visited our clinic with Rt. knee pain after slipping, which she rated as 7/10 on a numeric rating scale.

Diagnosis:
She was diagnosed as having a near complete tear of the ACL at the femoral attachment, partial tear of the lateral collateral ligament.

Interventions:
Ultrasound-guided PDRN injections were carried out 5 times at intervals of about 2 weeks.

Outcomes:
At 3-month follow-up, the patient demonstrated an improvement in knee symptoms (numeric rating scale 0) and ROM without any complications. Even after 2 years and 5 months since the diagnosis, she has been doing her daily life well without any pain.

Conclusion:
This is the first report of successful PDRN injection for near complete tear of ACL and partial tear of lateral collateral ligament without surgery.
Transesophageal echocardiography (TEE) in the detection of intraoperative cardiac arrest
Authors: Zhang Donghang , Yang Hui , Chen Mingjing , Zheng Zihao , Zhou Wenying , Song Haibo 
Published: May 2020

Abstract

Rationale:
Point-of-care ultrasound is widely used in patients with cardiac arrest, allowing for diagnosing, monitoring, and prognostication as well as assessing the effectiveness of the chest compressions. However, the detection of intraoperative cardiac arrest by Point-of-care ultrasound was rarely reported.

Patient concerns:
A 21-year-old male with Marfan syndrome which manifested Valsalva sinus aneurysms was admitted for aortic valve replacement. After endotracheal intubation, TEE transducer was inserted to evaluate the cardiac structure and function with different views. Severe aortic valve regurgitation was observed in the mid-esophageal aortic valve long and short axis view.

Diagnosis:
TEE showed that cardiac contraction was nearly stopped, the spontaneous echo contrast was obvious in the left ventricular and hardly any blood was pumped out from the heart despite the ECG showing normal sinus rhythm with HR 61 beats/min. Meanwhile, the IBP was dropped to 50/30 mm Hg.

Interventions:
Chest compressions were started immediately and epinephrine 100 μg was given intravenously. After 30 times of chest compressions, TEE showed that cardiac contractility increased and the stroke volume was improved in the TG SAX view.

Outcomes:
The patient was discharged 18 days later in a stable condition.

Lessons:
Continuous echocardiography monitoring may be of particular value in forewarning and detecting cardiac arrest in high-risk patients.
Case report of holocarboxylase synthetase deficiency (late-onset) in 2 Chinese patients
Authors: Xiong Zihong , Zhang Guoying , Luo Xiaoli , Zhang Ning , Zheng Jing 
Published: May 2020

Abstract

Rationale:
Holocarboxylase synthetase (HCLS) deficiency, especially the late-onset type, is a rare disease. Affected patients can present with irreversible metabolic acidosis and may be misdiagnosed with a glucose metabolic disorder. Prompt and correct diagnosis and treatment can reduce mortality to a great extent.

Patient concerns:
We report 2 Chinese patients who were diagnosed with late-onset HCLS deficiency. The age of onset of the 2 patients was approximately 8 months. The 2 patients had skin lesions, severe profound metabolic acidosis, dyspnea, and hyperglycemia.

Diagnoses:
The results of urinary and blood organic acid analysis with gas chromatography/mass spectrometry revealed multiple carboxylase deficiency. Maple syrup urine disease and diabetic ketoacidosis could not be excluded. This finding is different from those of hypoglycemic complications reported in previous reports. Human genetic analysis eventually provided a definite diagnosis.

Interventions:
Prompt oral treatment with biotin dramatically corrected the metabolic imbalances of the 2 patients, and continued oral biotin therapy was essential to the improvement of their prognoses.

Outcomes:
Their metabolic disorders were corrected within 48 hours. During long-term follow-up, the patients achieved developmental milestones.

Lessons:
Late-onset HCLS deficiency may present with obvious hyperglycemia. Human genetic analysis eventually provided a definite diagnosis. Prompt treatment with biotin is vital to correct metabolic imbalances, and continued therapy is essential to the improving long-term prognoses. Their mutations were p.R508W and c.1088T > A, and these mutations might represent hot-spot genes in Chinese populations with HCLS deficiency. The variants c.1484T > G(p.L495∗) and c.835G > T(p.E279x) are likely pathogenic, and more studies are needed to confirm these results.
Surgical or nonsurgical treatment for nontraumatic rotator cuff tears
Authors: Huang Ding-gen , Wu Ya-li , Chen Peng-fei , Xia Cui-lan , Lin Ze-jin , Song Jin-qi 
Published: May 2020

Abstract

Background:
The optimal treatment for symptomatic, nontraumatic rotator cuff tear is unknown. The primary aim of this randomized controlled trial is to compare functional improvement after surgical and conservative treatment of nontraumatic rotator cuff tears.

Methods:
This is a single-centre, randomized clinical trial with a follow-up of 12 months. Patients older than 18 years with magnetic resonance imaging – confirmed nontraumatic rotator cuff tears that are suitable for either surgery or nonsurgery treatment is enrolled. The primary outcome is Constant score. Secondary outcome measures include visual analog scale (VAS) score, patient satisfaction, and American Shoulder and Elbow Surgeons (ASES) score. All scores are assessed by an independent observer who is blinded to the allocation of groups.

Results:
The study will provide much needed data on surgical vs nonsurgical treatment for nontraumatic rotator cuff tears. Results of this study may help patients, clinicians, and policy makers assess the pivotal question on comparative effectiveness of surgery vs nonsurgical for rotator cuff tears.

Trial registration:
This study protocol was registered in Research Registry (researchregistry5442).
Risk of venous thromboembolism in elderly patients with vertebral compression fracture
Authors: Huang Ching-Hui , Wang Wei-Hsun , Kor Chew-Teng , Hsiao Ching-Hua , Chang Chia-Chu 
Published: May 2020

Abstract
Vertebral compression fractures (VCFs) are common in elderly and are treated with immobilization. Moreover, immobilization and old age may increase venous thromboembolism (VTE) risk. However, the incidence of VCFs-related VTE is unknown in elderly. The purposes of this study were to determine the incidence of VTE among VCF patients, to explore whether percutaneous vertebroplasty (PV) intervention may reduce VTE risk in VCFs patients.
We conducted a population-based case–control study by using the National Health Insurance Research Database. We identified 1407 patients aged ≥65 with VCF who received PV and 1407 VCFs patients who did not receive PV after developing a 1:1 propensity score-matched study cohort and were followed up for 5 years. Using PV intervention as the exposure factor, a cause-specific Cox's proportional hazards model was used to examine the association between PV and VTE.
After propensity score matching, the mean age of the study participants was 78 years and ∼23% of the analyzed participants were men, incidence of VTE in the PV and control cohorts was 5.77 and 4.19 per 1000 person-years, respectively. Both groups were nonsignificant difference after examination with different adjustment models. Patients with VCF and a history of heart failure, coronary artery disease, receiving antihypertension medication were at a significantly increased VTE risk.
Elderly patients with VCF who received PV had a neutral impact on risk of VTE. VCF patients with heart failure, coronary artery disease, and receiving antihypertension medication were prone to developing VTE should be monitored cautiously.
NKG2C+ natural killer cell function improves the control of HBV replication in individuals with acute HIV infection coinfected with HBV
Authors: Song Ting , Li Li , Su Bin , Liu Lifeng , Liu Yan , Yang Xiaodong , Zhang Qiuyue , Guo Na , Zhang Tong , Sun Guizhen , Wu Hao 
Published: May 2020

Abstract
Individuals infected with hepatitis B virus (HBV) are often coinfected with human immunodeficiency virus (HIV). However, individuals with chronic HBV infection living with acute HIV infection have a significantly lower HBV viral load, along with higher HBeAg and HBsAg loss than HBV-infected individuals alone. Here, we investigated the possible role of natural killer cells (NK cell) function in this progressive course to explore the relationship between phenotypic/functional changes in NK cells during acute HIV infection and HBV clearance in patients with HIV/HBV coinfection.
Peripheral blood NK cells from 38 patients with primary HIV infection, including 20 with untreated HIV infection and 18 treatment-naïve patients with HIV/HBV coinfection and 16 patients with chronic HBV infection, were enrolled in this study.
We found that the HIV/HBV-coinfected individuals had higher levels of NK cells than the HBV-infected individuals, due to expansion of the CD56neg NK cell population. The proportion of NK cells in CD56dim and CD56bri NK subsets was not found significant difference between HIV/HBV-coinfected and HBV-infected individuals. However, NKG2C levels on NK cells and subsets were significantly higher in HIV/HBV-coinfected individuals than in HBV-infected individuals, whereas NKG2A levels were unaffected or decreased. In addition, the levels of degranulation CD107a, cytotoxicity and IFN-γ production of NK cells were increased in HIV/HBV-coinfected individuals than in HBV-infected individuals. The level of IL-10 production of NK cells was decreased in HIV/HBV-coinfected individuals than in HBV-infected individuals. Furthermore, the level of HBV-DNA was inversely correlated with the proportion of NKG2C+ and NKG2C+NKG2A− NK cells, while positively correlated with the proportion of NKG2A+ and NKG2C-NKG2A+ NK cells. IFN-γ production was inversely correlated with levels of HBV-DNA, but the CD107a expression and IL-10 production of NK cells were not correlated with HBV-DNA levels.
These results demonstrate that the upregulation of NKG2C expression, but not of NKG2A expression on the surface of NK cells increases cytolytic capacity and the amounts of cytokines produced and may play a crucial role in HBV clearance during HIV/HBV-coinfection.
Cemented versus uncemented total knee arthroplasty in younger patients
Authors: Guo Yuning , Ma Shufang , Wang Junbo , Zhang Qin , Wang Shaowei , Du Zhipo 
Published: May 2020

Abstract

Background:
Recently, controversy still exists regarding the clinical effects of cemented or cementless technique in young patients in total knee arthroplasty (TKA). In this context, the present study aimed to determine the functional outcomes and clinical reliability of cementless components versus those of conventional cemented components for young patients in primary TKA.

Methods:
A retrospective review of primary TKAs performed with cementless or cemented fixation between May 2010 and February 2019 was conducted with Institutional Review Board approval. All cases were performed by a single surgeon. Institutional review board approval was obtained prior to conducting chart review and analysis. The primary outcome compared between the 2 fixation groups was the rate of postoperative complications and revision related to TKA, occurring at any point in follow-up. Secondary outcome measures included surgical time, Oxford Knee Score, range of motion, and radiographic outcomes such as progressive radiolucent lines, osteolysis, or component migration.

Results:
We were able to directly compare the outcomes of cemented versus cementless techniques and might reveal a better technique in TKA.

Trial registration:
This study protocol was registered in Research Registry (researchregistry5459).
Intramedullary cervical spinal cord teratoma
Authors: Wang Lishuai , Li Tongxiang , Gong Min , Xing Fei , Li Lang , Xiao Rui , Guan Qing 
Published: May 2020

Abstract

Background:
Intramedullary cervical spinal cord teratomas (ICTs) are extremely rare, and diagnosis and treatment are challenging. We conducted a systematic review of the literature on the diagnosis and treatment of ICT.

Method:
The presentation, imaging manifestations, diagnosis, management, surgery findings, prognosis and histology were reviewed following Preferred Reporting Items for Systematic Reviews and Meta Analyses guidelines. English-language studies and case reports published from inception to 2018 were retrieved. Data on presentation, imaging characteristics, diagnosis, management, surgery findings, outcomes, and histopathology were extracted.

Results:
Ten articles involving 10 patients were selected. The lesions were located in the upper cervical vertebrae in 4 cases, whereas in the lower cervical vertebrae in the remaining 6 cases. In 5 cases, the lesions were located on the dorsal side of the spinal cord, and in the center of the spinal cord in the remaining 5 cases. Quadriparesis (60%), paraplegia (30%), monoplegia (10%), and neck pain (50%) were the main presentations. The lesion appeared as a intramedullary heterogeneous signal during an MRI scan, and the lesion signal would be partially enhanced after the contrast medium was applied. All patients underwent surgical intervention through a posterior approach. Neurological function improved postoperatively in all patients. Two patients with pathology confirmed to be immature teratomas experienced recurrence.

Conclusion:
ICTs are extremely rare entities that are mainly located in the center or dorsal part of the spinal cord which mainly manifest as quadriplegia and neck pain. MRI is a useful modality that provides diagnostic clues. Surgery from a posterior approach is the primary treatment, and the effect of adjuvant therapy remains uncertain. The prognosis is mainly related to the pathological nature of the tumor and not the method of resection.
Membranous nephropathy and thymoma in a patient with ankylosing spondylitis
Authors: Lin Lirong , Zhao Lei , Huo Bengang , Zheng Luquan , Yu Rongjie , Li Weibing , Yang Jurong 
Published: May 2020

Abstract

Rationale:
We report a rare case with ankylosing spondylitis (AS), thymoma, and membranous glomerulonephritis. The pathogenic mechanisms of these 3 diseases may be associated with each other. Here, we discuss the course of diagnosis and treatment.

Patient concerns:
A 64-year-old woman with bilateral pain of the sacroiliac joints for 10 years and anasarca for 10 days.

Diagnoses:
A diagnosis of AS by HLA-B27 and pelvic X-ray tests, thymoma based on computed tomography and pathological diagnosis, and membranous glomerulonephritis based on renal biopsy.

Interventions:
We administered methylprednisolone 500 mg/d for 3 consecutive days, followed by methylprednisolone 40 mg oral QD, for a month.

Outcomes:
The patient was followed up once a month. In the sixth month, the patient's serum creatinine had decreased to 0.96 mg/dL, urine microalbumin/creatinine decreased to 173.3 mg/g, and albumin had risen to 33.1 g/L. Pain and morning stiffness were relieved, and the Bath Ankylosing Spondylitis Disease Activity Index score dropped to 4.0.

Lessons:
Although the causal relationship between AS, thymoma, and membranous nephropathy in this patient still needs to be established, the pathogenesis between the 3 diseases may have some association. In clinical practice, patients with AS need to be screened for tumors and renal complications.
The American College of Nuclear Medicine Guidance on Operating Procedures for a Nuclear Medicine Facility During COVID-19 Pandemic
Authors: Tulchinsky Mark , Osmany Saabry 
Published: May 2020

Abstract
The novel coronavirus 2 pandemic is causing widespread disruption in everyday life necessitating urgent and radical adaptations in operating procedures at nuclear medicine facilities. The potential for causing severe illness, COVID-19, calls for strict observance of preventive measures aimed to mitigate the spread of the virus. The threat of COVID-19 is particularly serious as there is no vaccine and no specific antiviral therapy. Further complications are introduced by shortages of personal protective equipment for healthcare workers who have direct contact with patients and effective testing to identify infected patients, raising the need for delaying some testing and therapies. Certain vulnerable segments of the general population have been identified (advanced age and certain comorbidities), which should heighten further their preventive efforts. Therefore, this guidance is intended to be operationalized depending on a facility’s specific needs and local disease prevalence.
Optic Neuropathy Due to Compression by an Ectatic Internal Carotid Artery Within the Orbital Apex
Authors: Caton Michael T. , Zamani Amir A. , Du Rose , Prasad Sashank 
Published: May 2020

Abstract:
Neurovascular compression is a rare but potentially treatable cause of optic neuropathy. Although incidental contact of the cisternal optic nerve and internal carotid artery (ICA) is common, compressive optic neuropathy occurring within the orbital apex has not been comprehensively described. We report a case of intra-orbital and intracanalicular optic nerve compression due to an ectatic ICA in a patient with congenital absence of the contralateral ICA. This report describes the complementary roles of advanced neuroimaging and neuro-ophthalmologic examination in rendering the diagnosis.
Relative fat mass is a better predictor of dyslipidemia and metabolic syndrome than body mass index
Authors: Kobo Ofer , Leiba Ronit , Avizohar Ophir , Karban Amir 
Published: May 2020

Background
Relative fat mass (RFM) had been recently developed. We aimed to examine RFM predictability to various cardiometabolic risk factors, compared to BMI.

Methods
Observational, cohort study, among patients who visited the Rambam Periodic Examinations Institute (RPEI). We compared the correlation of BMI and RFM to hypertension, impaired fasting glucose, high LDL, low HDL and metabolic syndrome, by gender.

Results
During study years, 20 167 patients visited the RPEI and included in the trial. Compared to BMI, RFM showed significantly better predictability (odds ratio [OR], [95% confidence interval (CI), P value]) of high LDL [1.618 (1.441–1.816, P < 0.001) vs. 0.732 (0.67–0.8, P < 0.001) in men; 1.572 (1.377–1.794, P < 0.001) vs. 0.938 (0.849–1.163, P = 0.94) in women], low HDL [2.944 (2.569–3.373, P < 0.001) vs. 2.177 (2–2.369, P < 0.001) in men, 2.947 (2.519–3.448, P < 0.001) vs. 1.9 (1.658–2.176, P < 0.001) in women], high triglycerides [4.019 (3.332–4.847, P < 0.001) vs. 1.994 (1.823–2.181, P < 0.001) in men, 3.93 (2.943–5.247, P < 0.001) vs. 2.24 (1.887–2.62, P < 0.001) in women] and metabolic syndrome [7.479, (4.876–11.47, P < 0.001) vs. 3.263 (2.944–3.616, P < 0.001) in men, 16.247 (8.348–31.619, P < 0.001) vs. 5.995 (5.099–7.048, P < 0.001) in women]. There was no significant difference in the predictability of BMI and RFM to hypertension and diabetes mellitus.

Conclusion
RFM provides high predictability for dyslipidemias and metabolic syndrome.
Acute hyperglycemia and contrast-induced nephropathy in patients with non-ST elevation myocardial infarction
Authors: Baydar Onur , Kilic Alparslan 
Published: May 2020

Introduction
Acute hyperglycemia and contrast-induced nephropathy (CIN) are frequently observed in non-ST elevation myocardial infarction (NSTEMI) patients undergoing percutaneous coronary intervention (PCI), and both are associated with an increased mortality rate. We investigated the possible association between acute hyperglycemia and CIN in patients with NSTEMI undergoing PCI.

Materials and methods
We retrospectively enrolled 281(149, 53% men) NSTEMI patients undergoing PCI. For each patient, plasma glucose levels were secreened at hospital admission. Acute hyperglycemia was defined as glucose levels > 198 mg/dl. CIN was defined as an increase in serum creatinine 25% or 0.5 mg/dl from baseline in the first 48–72 hours.

Results
Overall, 44 (15.7%) patients had acute hyperglycemia. Patients with acute hyperglycemia had higher incidence of CIN than those without acute hyperglycemia (29.5 vs 5.1%, P < 0.001). Also, in-hospital mortality, length of hospital stay, major bleeding, requirement of mechanical ventilation and dialysis were observed significantly higher in patients with hyperglycemia. Patients were then reallocated to two groups according to the presence or absence of CIN. Overall, 25 cases (8.9%) of CIN were diagnosed. Diabetes mellitus, weight, age, glucose level and estimated glomerular filtration rate (eGFR) were detected as independent risk factors of CIN. Additionally, admission glucose levels were significantly correlated with creatinine levels after PCI, eGFR and contrast volume/eGFR ratio.

Conclusion
In NSTEMI patients undergoing primary PCI, acute hyperglycemia may be associated with an increased risk for CIN and in-hospital mortality and morbidity.
Individual variation in susceptibility or exposure to SARS-CoV-2 lowers the herd immunity threshold
Authors: Gomes M. Gabriela M. , Ferreira Marcelo U. , Corder Rodrigo M. , King Jessica G. , Souto-Maior Caetano , Penha-Gonçalves Carlos , Gonçalves Guilherme , Chikina Maria , Pegden Wesley , Aguas Ricardo 
Published: May 2020

AbstractIndividual variation in susceptibility and exposure is subject to selection by natural infection, accelerating the acquisition of immunity, and reducing herd immunity thresholds and epidemic final sizes. This is a manifestation of a wider population phenomenon known as “frailty variation”. Despite theoretical understanding, public health policies continue to be guided by mathematical models that leave out considerable variation and as a result inflate projected disease burdens and overestimate the impact of interventions. Here we focus on trajectories of the coronavirus disease (COVID-19) pandemic in England and Scotland until November 2021. We fit models to series of daily deaths and infer relevant epidemiological parameters, including coefficients of variation and effects of non-pharmaceutical interventions which we find in agreement with independent empirical estimates based on contact surveys. Our estimates are robust to whether the analysed data series encompass one or two pandemic waves and enable projections compatible with subsequent dynamics. We conclude that vaccination programmes may have contributed modestly to the acquisition of herd immunity in populations with high levels of pre-existing naturally acquired immunity, while being critical to protect vulnerable individuals from severe outcomes as the virus becomes endemic.Graphical AbstractHighlightsVariation in susceptibility/exposure responds to selection by natural infectionSelection on susceptibility/exposure flattens epidemic curvesModels with incomplete heterogeneity overestimate intervention impactsIndividual variation lowered the natural herd immunity threshold for SARS-CoV-2