bluuebunny/crossref_metadata_2025_split huggingface dataset:
Haemoptysis in a toddler: An uncommon presentation of unusual foreign body ingestion
Authors: Muniandy Sadesvaran , Mohd Shukri Mohd Faiz , Ghazali Nur Izzah , Ishak Mohd Saiful Adli , Mohamad Irfan , Baharuddin Kamarul Aryffin 
Published: July 2020

Introduction:Haemoptysis is uncommon in toddler. Lower respiratory tract infections and foreign body are among the common causes.Case Presentation:We are reporting a case of a child presented to emergency department with complaint of mild haemoptysis, whom was later found to have a piece of broken satay skewer at the tonsillar region. The foreign body was removed during the procedure without any complication.Discussion:Foreign body ingestion, particularly a piece of broken satay skewer, is difficult to suspect without a proper history and eyewitness. Therefore, parent's supervision is important. Emergency residents should have a high index of suspicion of foreign body ingestion in a child with vague symptoms.Conclusion:Foreign body is among the commonest cause of haemoptysis in an afebrile toddler. Acute haemoptysis in otherwise healthy toddler should alert the emergency residents about foreign body ingestion. History of food intake should be more thorough even if trivial.
Effect of hydrocortisone versus methylprednisolone on clinical outcomes in oncology patients with septic shock
Authors: McDonnell Emily , Collins Reagan , Hernandez Mike , Brown Anne Rain T. 
Published: July 2020

Background Corticosteroids are used as adjunctive treatment of critical illness-related corticosteroid insufficiency in patients with septic shock. This study aims to compare the impact of hydrocortisone versus methylprednisolone on duration of septic shock in critically ill oncology patients. Methods Single-center, retrospective cohort study of adult patients receiving hydrocortisone ≥200 mg/day or methylprednisolone ≥40 mg/day with septic shock. The primary outcome was time to shock reversal defined as time to systolic blood pressure ≥90 mmHg without vasopressors for ≥24 h. Results Eighty-eight patients were included, 49 patients received hydrocortisone and 39 patients received methylprednisolone. Solid tumor malignancy was more common in the hydrocortisone group, while hematological malignancy was more common in the methylprednisolone group (p = 0.009). Time to shock reversal was similar between hydrocortisone and methylprednisolone groups (72.4 versus 70.4 h; p = 0.825). Intensive care unit mortality occurred in 51.02% versus 53.85% of patients in hydrocortisone versus methylprednisolone, respectively (p = 0.792). Patients who received methylprednisolone had higher rates of mechanical ventilation (89.74% versus 55.1%, p < 0.001) and longer intensive care unit and hospital lengths of stay (4.2 versus 11.4 days and 14.3 versus 25.7 days; p < 0.001) compared to hydrocortisone. No differences were seen in incidence of steroid-related adverse effects between groups. Conclusions In oncology patients with septic shock, the use of hydrocortisone versus methylprednisolone does not appear to affect time to shock reversal.
LOPH: a novel chemotherapeutic protocol for feline high-grade multicentric or mediastinal lymphoma, developed in an area endemic for feline leukemia virus
Authors: Horta Rodrigo S , Souza Larissa M , Sena Bruna V , Almeida Isabella O , Jaretta Tâmara A , Pimenta Marcela M , Reche Júnior Archivaldo 
Published: July 2020

Objectives The aim of this study was to establish the safety and efficacy of a novel multidrug lomustine-based chemotherapeutic protocol for cats with high-grade multicentric or mediastinal lymphoma, in an area endemic for feline leukemia virus (FeLV). Methods This prospective study included owned cats, diagnosed (cytologically) with multicentric or mediastinal lymphoma and treated with the LOPH (lomustine, vincristine [Oncovin; Antibióticos do Brasil], prednisolone and hydroxydaunorubicin [doxorubicin]) protocol. A complete blood count was performed before every chemotherapy session and any significant abnormalities recorded as possible related toxicities. Median survival time (MST) and disease-free interval were estimated by Kaplan–Meier curves. Results Twenty-one cats were included in this study. Nineteen (90.5%) tested positive for FeLV and were therefore considered to have persistent viremia. Complete response was reported in 81% (n = 17/21), while three had partial remission and one had no response. Seven cats finished the induction protocol within 20–31 weeks (23.1 ± 4.5; median 20) and all seven received a maintenance protocol. The MST (lymphoma-related survival) for the 21 cats was 214 days. The MST was 214 days for cats with mediastinal lymphoma (n = 13), but it was not reached for multicentric lymphoma (n = 8; P = 0.9). The MST of cats with persistent FeLV antigenemia was 171 days. Grade I anorexia and vomiting occurred in 19% of the cats (n = 4/21). Hematologic toxicity was found in 100% of the cats at some point during their treatment, but it was mostly grade I or II. Neutropenia, thrombocytopenia and anemia occurred in 16/21, 21/21 and 15/21 cats, respectively. Conclusions and relevance The LOPH protocol was well tolerated by cats with lymphoma and persistent FeLV viremia, and resulted in a better MST than similar studies with other protocols. Novel studies and controlled trials are necessary in order to evaluate the efficacy of different protocols according to the lymphoma subtype, anatomic form and FeLV status.
Bone mineralisation adjacent to cemented and uncemented acetabular cups: analysis by [18F]-fluoride-PET in a randomised clinical trial
Authors: Ullmark Gösta , Sörensen Jens , Nilsson Olle , Maripuu Enn 
Published: July 2020

Purpose: We present a randomised clinical trial using F-PET/CT to analyse new bone metabolic mineralisation adjacent to acetabular cups following total hip arthoplasty (THA). Patients and methods: THA was performed on 26 patients (26 cases) with hip OA. Patients with hip osteoarthritis (OA) were randomly assigned to operations with cemented or uncemented acetabular components. The contralateral, healthy acetabulum was used as referent for normal bone metabolism. The patients were analysed with radiography, clinical scoring, and F-PET/CT preoperatively, and at 6 weeks and 6 months postoperatively. Results: No major complications were recorded, and clinical results were good in all patients. Radiography showed all cups to be stable. The bone-forming activity, as measured by F-PET/CT, was quantified as standardised uptake values (SUV). The mean SUV was 4.6 (6 weeks) and 3.5 (6 months) around the uncemented cups, and 4.8 and 4.0, respectively, for the cemented cups. Normal healthy bone metabolism in the referent was 2.8 and 2.7 SUV at 6 weeks and 6 months, respectively. P < 0.01 for the cemented group at 6 weeks and 6 months, for the uncemented group only at 6 weeks. Interpretation: An acetabulum affected by OA has elevated SUV activity. Both cemented and uncemented cups had elevated bone metabolic activity at 6 weeks. The raised activity was interpreted as an effect from bone mineralisation secondary to surgical trauma and healing, and to the OA. At 6 months, activity was more normalised for the uncemented group than for the cemented, suggesting healing may terminate faster in the uncemented group. Postoperative bone metabolic activity can be analysed in detail by F-PET/CT. ClinicalTrials.gov Identifier: NCT01623687
Early myocardial injury biomarkers in diabetic hyperlipidemic rats: Impact of 10-dehydrogingerdione and vitamin D3
Authors: Elseweidy Mohamed M , Aly Sousou I , Hammad Sally K , Shershir Noura I 
Published: July 2020

Hyperlipidemia represents a major risk factor for cardiovascular diseases leading to myocardial injury. The present study aimed to illustrate the myocardial injury induced in a diabetic hyperlipidemic rat model and the effect of vitamin D3, 10-DHGD intake either individually or in combination form. Male albino rats were selected for the study, received alloxan, hypercholesterolemic diet, and categorized into four groups. The first one (DHC), received hypercholesterolemic diet only and referred to as control. The remaining groups (2, 3, 4) received vitamin D3, 10-DHGD, and combination of both, respectively. Certain biomarkers that were selected for MI evaluation included blood glucose, lipogram pattern, Copeptin, C-reactive protein, myeloperoxidase, heart fatty acid-binding protein, and histopathological changes in myocardium and aorta. Vitamin D3 and 10-DHGD intake induced significant hypoglycemic, hypolipidemic effects, decreased inflammation, and MI biomarkers. Decreased myocardial vacuoles, foam cells, and intimal lesions were also observed compared to DHC. Their combination intake induced more marked reduction in all biomarkers and showed a histopathological pattern similar to normal features of myocardium and aorta. Our findings suggest the therapeutic roles of vitamin D3, 10-DHGD, and their combination against myocardial injury in diabetic hyperlipidemic rats. Impact statement Hyperlipidemia represents a major risk factor for cardiovascular diseases leading to myocardial injury (MI). The present study aimed to illustrate the pattern of myocardial injury induced in diabetic hyperlipidemic rat model and the effect of vitamin D3, 10-dehydrogingerdione (10-DHGD) intake either individually or in combination form.
Lateral Ulnar Collateral Ligament Reconstruction for Posterolateral Rotatory Instability of the Elbow: A Systematic Review
Authors: Fares Austin , Kusnezov Nicholas , Dunn John C. 
Published: July 2020

Background: Posterolateral rotatory instability (PLRI) is a common form of recurrent elbow instability. The aim of this systematic review is to present the outcomes and complications of lateral ulnar collateral ligament (LUCL) reconstruction surgery for PLRI. Methods: A literature search of LUCL reconstructions was performed, identifying 99 potential papers; 11 of which met inclusion/exclusion criteria, accounting for 148 patients. Papers were included if they reviewed cases of PLRI from 1976 to 2016 with reported outcome measures. Data were pooled and analyzed focusing on patient demographics as well as subjective and objective patient outcomes and complications. Results: The average age of patients was 34 years with a mean follow-up time of 49.8 months. The most common mechanism of injury was a traumatic elbow dislocation (66%), followed by cubitus varus deformity (7%), and unknown mechanisms (7%). Overall, 90% of patients achieved elbow stability and 2.7% experienced a failed reconstruction that necessitated an additional surgery. Furthermore, 93% were satisfied with the outcome of the reconstruction, and 83% reported good to excellent outcomes with 11% reporting moderate to severe persistent pain. Nearly half (45%) of reconstructions were done using a palmaris longus tendon graft, 24% with a triceps tendon graft, and 7% with a synthetic graft. Conclusions: Outcomes following LUCL reconstruction for PLRI are excellent and revision rates are low. LUCL reconstruction is a safe and reliable procedure. Level of Evidence: IV Therapeutic
Radiographic Outcomes and Complications of Delayed Fixation of Distal Radius Fractures
Authors: Lee Stella J. , Stenquist Derek S. , Collins Jamie E. , Mora Ariana N. , Teplitz Brett A. , Blazar Philip E. , Earp Brandon E. 
Published: July 2020

Background: Surgeons are sometimes presented with patients with distal radius fractures who present in a delayed fashion or lose reduction after several weeks of attempted closed management. There are limited studies on delayed surgical treatment of distal radius fractures to assist providers in decision-making. Methods: We conducted a matched cohort study to compare radiographic outcomes and complications for patients with a distal radius fracture treated with delayed (3-5 weeks) or early (0-2 weeks) surgical fixation. Patients ages 18+ who underwent open reduction and internal fixation of distal radius fractures by a volar approach at 2 Level I trauma centers between 2003 and 2015 were eligible. We measured radiographic outcomes and reviewed medical records to determine operative approach and complications. Results: There were 25 cases and 50 controls matched for age (18-87), sex, and AO fracture type. The delayed group had surgery at a mean of 24.8 days from injury and the early group at 5.6 days. There was no statistically significant difference between the delayed and early cohorts in radiographic parameters on injury x-rays, in improvement in radiographic parameters on first postoperative x-rays, or in maintenance of radiographic parameters at union. Conclusion: We did not find significant differences in radiographic outcomes or complication rates between patients with delayed versus early surgical treatment for distal radius fracture. Providers treating patients with late presentation or late displacement have the option of surgical fixation beyond the first few weeks after injury. Level of Evidence: III (Retrospective matched cohort study)
Dysfunction of adaptive immunity is related to severity of COVID-19: a retrospective study
Authors: Xie Liang , Wu Qinhan , Lin Qunying , Liu Xuhui , Lin Weihua , Hao Shengyu , Hu Weiping , Xiang Guiling , Lu Hongzhou , Li Shanqun 
Published: July 2020

Background: In December of 2019, coronavirus disease 2019 (Covid-19) was reported in Wuhan, China, and has now rapidly swept around the world. Much research has been carried out since the outbreak, but few studies have focused on the dysfunction of the adaptive immunity. Methods: In this retrospective and multi-center study, 373 patients with laboratory-confirmed COVID-19 from Shanghai Public Health Clinical Center and Affiliated Hospital of Putian University were recruited. Demographic, clinical, radiological features, and laboratory data were recorded and analyzed at admission and at discharge. Results of immunological tests were followed up until the patients were discharged. Results: Of the 373 patients with COVID-19 pneumonia, 322 were in the non-severe group and 51 were in the severe group. Number of T cells, CD4+ and CD8+ T cells, and total lymphocytes declined remarkably upon admission and elevated when the patients were discharged. At admission, counts of total lymphocytes, T cells, CD4+ and CD8+ T cells, and levels of C3 and C4 in the severe group were lower than those in the non-severe group, whereas the neutrophil to lymphocyte ratio (NLR) was higher in the severe group. Counts of T cells, CD4+ and CD8+ T cells, and total lymphocytes were negatively correlated with lactate dehydrogenase and C-reactive protein. Conclusion: COVID-19 might target adaptive immunity and cause a decrease in lymphocytes, especially T cells and subsets. Physicians should pay close attention to the adaptive immunity of patients upon admission. Monitoring NLR, T lymphocytes, and subsets would help physicians with the proper diagnosis and treatment of COVID-19. The reviews of this paper are available via the supplemental material section.
Pulmonary and systemic hemodynamics are associated with myocardial injury in the acute respiratory distress syndrome
Authors: Metkus Thomas S , Mathai Stephen C , Leucker Thorsten , Hassoun Paul M , Tedford Ryan J , Korley Frederick K 
Published: July 2020

BackgroundWhether right and left heart hemodynamics are associated with myocardial injury in the acute respiratory distress syndrome (ARDS) is not known.MethodsWe performed a retrospective cohort study of subjects who had right heart catheterization within the ALVEOLI trial and Fluid and Catheter Treatment Trial. Myocardial injury was assessed using a highly sensitive troponin assay (hsTn; Abbot ARCHITECT). Hemodynamic variables included right atrial pressure, pulmonary artery wedge pressure, cardiac index and stroke volume, pulmonary vascular resistance, pulmonary arterial compliance, and pulmonary effective arterial elastance. We performed linear, logistic, and Cox regression to determine the association of hemodynamic variables with myocardial injury and to determine if hemodynamics mediated the association between myocardial injury and death.ResultsAmong 252 ARDS patients, median day 0 troponin was 65.4 (13.8–397.8) ng/L. Lower cardiac index (β −0.23 SE 0.10; P < 0.001) and stroke volume (β −0.26 SE 0.005; P < 0.001), higher pulmonary vascular resistance (β 0.22 SE 0.11; P < 0.001), lower pulmonary arterial compliance (β −0.24 SE 0.06; P < 0.001), and higher arterial elastance (β 0.27 SE 0.43; P < 0.001) were associated with greater myocardial injury in univariable and adjusted models. Changes in stroke volume, cardiac index, pulmonary arterial compliance, pulmonary vascular resistance, and arterial elastance were all associated with progressive myocardial injury over three days. hsTn levels were associated with mortality; however, the association was attenuated after adjustment for each of stroke volume, pulmonary vascular resistance, pulmonary arterial compliance, and arterial elastance.ConclusionPulmonary vascular hemodynamics are associated with myocardial injury in ARDS, while filling pressures are not. Pulmonary vascular disease may represent a treatable contributor to myocardial injury in ARDS.
Radiological, histopathological findings, and clinical outcome of pulmonary artery sarcoma
Authors: Zhang Shuai , Zhang Yu , Liu Min , Tao Xincao , Xie Wanmu , Wan Jun , Zhai Zhenguo 
Published: July 2020

Pulmonary artery sarcoma is a rare malignancy with poor prognosis. Lack of specific clinical manifestations, some patients are even confirmed postoperatively or at autopsy, that leads to the delay in treatment. Early diagnosis and radical surgical resection provide the possibility of prolonged survival. We retrospectively enrolled 13 patients diagnosed with pulmonary artery sarcoma at our hospital between 2015 and 2019. Their clinical, laboratory, radiological, and histopathological data were collected and analyzed. Published case series were also reviewed. Results show that, the median age of the patients was 53 years, with 6 (46.2%) males. The most common symptom is exertional dyspnea. Erythrocyte sedimentation rate and C‐reactive protein were increased in 76.9% and 69.2% of these patients, while D‐Dimer remained normal or elevated slightly. Metastasis was present at diagnosis in eight (61.5%) patients. Ten patients were diagnosed histologically: three were diagnosed after pulmonary endarterectomy, four by endobronchial ultrasound‐guided transbronchial needle aspiration, two by percutaneous lung biopsy, and one by endovascular aspiration biopsy. Four patients underwent surgery and one is waiting for surgery. Nine patients received chemotherapy; and three of them received targeted therapy with anlotinib after chemotherapy. Two patients received anti‐PD‐1 monoclonal antibody. One patient died during endobronchial ultrasound‐guided transbronchial needle aspiration. Two patients died 9 and 13 months after diagnosis, respectively; one refused invasive diagnostic procedures and died three months after clinical diagnosis. In conclusion, the most appropriate approach to get tissue specimen needs to be tailored to every pulmonary artery sarcoma patient. Pulmonary endarterectomy combined with chemotherapy and targeted therapy has prolonged their survival time.
Epidemiological factors associated with health knowledge of three common eye diseases: A community-based pilot survey in Hong Kong
Authors: Wong Perseus WF , Lau Jordy KP , Choy Bonnie NK , Shih Kendrick C , Ng Alex LK , Chan Jonathan CH , Wong Ian YH 
Published: July 2020

Objectives: To assess the proportions of respondents in the general community having heard or awareness, and their knowledge level, of three common eye diseases: age-related macular degeneration, cataract, and glaucoma. We also attempted to assess for risk factors that may be associated with any variations, which will help identify the areas of inadequate knowledge and demographics of potential audiences for focused health education. Methods: We conducted a community-based pilot survey for the residents from a southern suburb of Hong Kong in early 2016, by inviting all aged 50 or above to complete a standardized questionnaire in the local community hall. Results: Most of the 222 respondents have heard, or awareness, of cataract (92.79% or 81.98%, respectively), followed by glaucoma (86.94% or 52.70%, respectively), and age-related macular degeneration (51.35% or 29.28%, respectively). The results of Cronbach’s alpha (α > 0.7) and Spearman’s correlation coefficient (p < 0.01) suggested that the internal consistency, convergent and discriminant validities of the questionnaire were acceptable for the study population. Compared to a previous Hong Kong survey in 2002, the proportions of having heard of the three eye diseases were greater, but the overall knowledge remained limited. From a maximum knowledge score of 29, the median scores for age-related macular degeneration, cataract, and glaucoma were 9, 13, and 14, respectively. Except for the treatment of cataract, the knowledge level in most areas was low. Sociodemographic factors and medical history, rather than behavioral factors, were more likely to be associated with having a higher knowledge level. Subjects with family or friends with a history of glaucoma or age-related macular degeneration were more aware and knowledgeable, but not for subjects who were current and past smokers or alcohol drinkers. For age-related macular degeneration, gender modified the effect between age and knowledge level, while age was a confounder of having medical history, and having heard or awareness, of the disease. Conclusion: Despite a larger proportion of the community having heard or awareness since 15 years ago, much effort remains for improving health knowledge of these three eye diseases in Hong Kong. We recommend targeting respondents with higher lifestyle risks, such as current and past smokers or alcohol drinkers, as a focused audience, and utilizing family members, relatives, or friends as another way of distributing health information.