bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multidimensional Pelvic Fluoroscopy: A New and Novel Technique for Assessing Safety and Accuracy of Percutaneous Iliosacral Screw Fixation
Authors: Shaw James , Gary Joshua , Ambrose Catherine , Routt Milton Chip 
Published: May 2020

Objectives:
Multidimensional fluoroscopy is new imaging technology that generates intraoperative cross sectional imaging. Can this technology be used to assess accuracy and safety of percutaneously placed iliosacral screws intraoperatively?

Design:
Retrospective study.

Setting:
Level 1 academic trauma center.

Patients/Participants:
Fifty-two consecutive patients during a 7-month period with unstable posterior pelvic ring disruptions.

Intervention:
All patients were treated with percutaneous iliosacral and/or transsacral screw fixation by a single experienced surgeon. Traditional triplanar fluoroscopy was performed during guidepin insertion. Intraoperative multidimensional fluoroscopy was used for all patients after iliosacral screw fixation.

Main Outcome Measurements:
Intraoperative multidimensional fluoroscopy and postoperative computed tomography (CT) scans for each patient were retrospectively reviewed by the treating surgeon and another trauma surgeon. Screw position in relation to the sacral neuroforamen was assessed using multidimensional fluoroscopy and compared to postoperative CT scan. Screws were classified as extraforaminal, juxtaforaminal, or intraforaminal.

Results:
No screws were intraforaminally seen on intraoperative multidimensional fluoroscopy or postoperative CT scan. All iliosacral and transsacral screws were considered safe. Intraobserver and interobserver variability existed between reviewers when grading screws as extraforaminal versus juxtaforaminal. This was not clinically significant because both agreed that extraforaminal and juxtaforaminal screw positions are safe. Multidimensional fluoroscopy was used in 3 patients to assess guidepin placement before definitive screw fixation. Two patients underwent a change of fixation after reviewing multidimensional fluoroscopy. No postoperative neurological examination changes occurred.

Conclusions:
Multidimensional fluoroscopy is a novel imaging technology that can safely be used intraoperatively to accurately determine iliosacral and transsacral screw placement.

Levels of Evidence:
Diagnostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Scleral Buckling Using Chandelier and Releasable Suture: A Useful Surgical Variant
Authors: Savastano Alfonso , Weinberg Tamir , Faraldi Francesco , Caporossi Tomaso , Rizzo Stanislao 
Published: May 2020

Purpose:
To describe a surgical variant for scleral buckling technique using a chandelier and scleral releasable suture.

Methods:
We collected retrospectively 20 eyes of 20 patients who underwent to scleral buckling for retinal detachment. In all cases, the surgeons performed the surgical variant of scleral buckling using a 27-gauge (G) chandelier as endoillumination and releasable 7.0 vicryl scleral suture.

Results:
None of the operated eyes developed lens opacity or lens marks at the entrance site of the chandelier used during the surgery, and no cataract development was observed as well, during the follow-up. Retinal reattachment was achieved in 19 out of 20 eyes at the first surgery in the follow-up time of 6 months.

Conclusion:
The association of chandelier and releasable suture was a useful surgical variant when performing scleral buckling technique for retinal detachment. Complications like lens opacity or lens marks at the entrance site of the chandelier due to the use of chandelier itself can be greatly reduced, as well as complications due to vitreous prolapse from the sclerotomy by using releasable scleral suture.
Comparison of intraoperative vs postoperative optical coherence tomography measurement of implantable collamer lens vaulting
Authors: Torbey Julien , Mehanna Carl-Joe , Abdul Fattah Maamoun , Awwad Shady T. 
Published: May 2020

Purpose:
To compare intraoperative vs postoperative optical coherence tomography (OCT) measurements of implantable collamer lens (ICL) vaulting.

Setting:
American University of Beirut Medical Center, Beirut, Lebanon.

Design:
Prospective observational cohort study.

Methods:
Patients with myopia or myopic astigmatism undergoing ICL insertion in which intraoperative OCT measurements were obtained were included. Exclusion criteria included coexisting ocular problems and previous ocular surgery. The outcome measures were ICL vaulting as determined by OCT intraoperatively and postoperatively at 1 day, 1 week, 1 month, and 3 months.

Results:
Forty-five eyes of 26 patients were included. Mean age was 27.23 ± 6.47 years (range 17 to 48 years), and mean manifest refraction spherical equivalent was −10.20 ± 3.92 diopters (D) (range −20.50 to −4.50 D). Mean ICL vaulting measured 731 ± 215 μm intraoperatively, 648 ± 219 μm at 1 day, 640 ± 204 μm at 1 week, 628 ± 212 μm at 1 month, and 632 ± 210 μm at 3 months postoperatively (P = .0009, with all postoperative vaulting measurements statistically similar to each other, but significantly different from the intraoperative measurement). However, intraoperative ICL vaulting had high predictability of postoperative vaulting at 3 months with r
2 = 0.81 (P < .0001), and Bland–Altman analysis demonstrates a relatively constant difference between the 2 measurements as plotted against their mean with a bias of 98.27 μm and tight 95% limits of agreement range.

Conclusions:
Intraoperative ICL vaulting measured by OCT correlated highly with postoperative OCT vaulting and can be considered a reliable tool to predict the final ICL vault.
Putting on the Same Shoes: Lived Experiences of Women Who Are Reincarcerated
Authors: Blair-Lawton Donna , Mordoch Elaine , Chernomas Wanda 
Published: May 2020

Background
Women are discharged daily from correctional institutions across the world. Many of these women cycle in and out of jail and experience the “revolving door syndrome,” characterized by release, reimprisonment, and subsequent rerelease into the community. Although many factors contribute to this phenomenon, there is limited understanding of its impact on imprisoned women, including their perceptions of returning to community life.

Purpose/Objective
This phenomenological study examined the lived experiences of women who were imprisoned, released to the community, and returned to custody.

Method
Twelve women, nine of whom were Indigenous were interviewed at the Women's Correctional Centre in Manitoba. Individual, face-to-face, in-depth interviews were employed using a woman-centered conversational approach. Qualitative thematic analysis, informed by van Manen's approach, was used to inductively arrive at themes.

Findings
Themes and subthemes organized around van Manen's existentials (temporality, spatiality, relationality, and corporeality) highlight the barriers and challenges women face as they try to sustain change in their lives to avoid the revolving door. Threaded through their accounts are experiences of personal and historical trauma, painful childhoods, difficult relationships, and ineffective or absent personal and systemic supports.

Conclusion
This study highlights the need for trauma-informed comprehensive health care and programing sensitive to women's experience of trauma in their complex lives. Nurses need to partner with service providers and policy makers to address the social/economical inequities that impede the positive life changes these women need to make to prevent reimprisonment.
The effects of green cardamom supplementation on blood pressure and endothelium function in type 2 diabetic patients
Authors: Ghazi Zahedi Shohreh , Koohdani Fariba , Qorbani Mostafa , Siassi Fereydoun , Keshavarz Ali , Nasli-Esfahani Ensieh , Aghasi Mohadeseh , Khoshamal Hoorieh , Sotoudeh Gity 
Published: May 2020

Abstract

Introduction:
Cardamom possesses antioxidant, anti-inflammation, and blood pressure lowering properties, which might improve endothelial function in type 2 diabetic patients. However, no study has examined the effect of cardamom on diabetic patients. The present study aimed to examine the effects of 10-week green cardamom intake on blood pressure, concentrations of inflammatory and endothelial function biomarkers in type 2 diabetes mellitus patients, and its potential mechanisms.

Methods and Analysis Design:
Eighty overweight or obese patients with type 2 diabetes mellitus (aged 30–60 years) will be recruited into the trial and will assign to receive either cardamom (3 g/day, 6 capsules) or placebo (rusk powder, 6 capsules) for a period of 10 weeks. Systolic blood pressure and diastolic blood pressure, asymmetric dimethylarginine, and nitric oxide will be measured. Serum inflammatory markers namely interleukin 6, tumor necrosis factor-α, high-sensitivity C-reactive protein, and factors related to endothelial function including intercellular adhesion molecule-1, vascular cell adhesion molecule 1, CD62 antigen-like family member E, and cluster of differentiation 163 will be measured at baseline and at the end of the trial. Sociodemographic, International Physical Activity Questionnaire, and three 24-hour dietary recall questionnaires will be collected for each participant.

Ethics and dissemination:
The study has been approved by The Ethics Committee of Tehran University of Medical Sciences (IR.TUMS.REC.1395.2700). Each participant will sign a written informed consent at the beginning of the study. At the end of the study, results will be published timely manner.

Trial registration number:
(http://www.irct.ir, identifier: IRCT-2016042717254N5) Date of registration: 2016-11-23
Treatment of hypothyroidism using Korean medicine: 2 case reports
Authors: Kim Hyongjun , Moon Sun-Young , Han Kyungsun , Lee Jun-Hwan , Im Jong Hwan , Kim Sungha , Yoo Jeong-Eun 
Published: May 2020

Abstract

Introduction:
Hypothyroidism, the most common endocrine disease, comprises a deficiency of thyroid hormone, causing coldness, fatigue, and dysmenorrhea. Here, we report the improvement of hypothyroidism symptoms and thyroid hormone level normalization by using Korean herbal medicine and acupuncture therapy.

Patient concerns:
A 30-year-old woman (Case 1) presented at the clinic with continuous seborrheic dermatitis on the scalp, accompanied by dysmenorrhea. A 55-year-old woman (Case 2) presented with symptoms of coldness of the limbs and fatigue.

Diagnosis:
Both patients were diagnosed with “Yin deficiency and Yang hyperactivity” and hypothyroidism after serum thyroid function tests.

Interventions:
Both patients received herbal medicine decoction, acupuncture, and electroacupuncture therapy.

Outcomes:
Korean medicine improved the symptoms of hypothyroidism and significantly normalized thyroid-stimulating hormone and free-thyroxine levels.

Conclusion:
These outcomes suggest that Korean medicine may be effective for resolution of hypothyroidism; however, further research is needed to confirm these findings.
Clinical characteristics and pregnancy outcomes of atypical hemolysis, elevated liver enzymes, and low platelets syndrome
Authors: Jiang Ruoan , Wang Ting , Li Baohua , He Jing 
Published: May 2020

Abstract

Rationale:
Hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome is a serious and rare disease, which is secondary to preeclampsia in most cases. Hypertension is usually considered as a premonitory symptom of HELLP syndrome. In some patients with HELLP syndrome; however, they develop hypertension very late, even after liver enzymes are elevated or platelet count is decreased. This condition is known as atypical HELLP syndrome.

Patient concerns:
We screened and identified 4 cases of atypical HELLP syndrome in our hospital database from January 2007 to December 2018. All patients had a history of nonspecific symptoms for a few days before hospital admission, such as dizziness, nausea, and vomiting. They developed hypertension after abnormalities were noted in liver enzymes and platelet count.

Diagnoses:
They were diagnosed with atypical HELLP syndrome.

Interventions:
These patients received same treatments as those with HELLP syndrome. Two patients took oral antihypertensive treatment to normalize the blood pressure.

Outcomes:
In our patients, both mothers and neonates had favorable outcomes. In follow-ups, they reported no incidences of high blood pressure after recovery from atypical HELLP syndrome.

Lessons:
These cases provided additional clinical evidences of atypical HELLP syndrome. The incidence of atypical HELLP syndrome is extremely low. Hypertension is not essential for the diagnosis of HELLP syndrome, and can even appear after the onset of laboratory abnormalities. Advanced age, multiple pregnancies, hepatitis B virus infection, and obesity may be potential risk factors for atypical HELLP syndrome. Blood pressure should be monitored closely after delivery.
Transfusion rates and disease spectrum in neonates treated with blood transfusion in China
Authors: Sun Yang , Ma Ting , Wang Wen-hua , Zhang Qin , Jin Zhen-ai , Yang Jiang-Cun 
Published: May 2020

Abstract
This study aimed to investigate blood transfusion rates and spectrum of diseases in hospitalized neonates treated with blood transfusion in China to provide supporting data for future studies on neonatal blood transfusion.
Data on hospitalized neonates were obtained from more than 100 experts from the Department of Neonatology of 55 hospitals in China between January 1, 2012 and December 31, 2016, using a standardized survey. A statistical analysis was conducted to evaluate the data collected, including the blood transfusion rates, blood component transfused, spectrum of diseases, and spectrum of major diseases.
Between 2012 and 2016, 541,128 neonates were hospitalized in the 55 hospitals surveyed. There were 70,433 neonates who received blood transfusion, with an average transfusion rate of 13.02%. The rates of red blood cell transfusion, platelet transfusion, and plasma transfusion were 9.44%, 0.66%, and 4.77%, respectively. The neonatal blood transfusion rate was 17.99% in Northeast China, 9.74% in Northwest China, and between 10.60% and 16.22% in other regions. The neonatal blood transfusion rate was 12.3% in general hospitals and 13.8% in women and children's hospitals. The top 10 diseases identified in hospitalized neonates treated by blood transfusion were, in rank order, as follows:prematurity,pneumonia, hyperbilirubinemia, bacterial sepsis, respiratory distress syndrome, anemia, hemolytic disease, asphyxia, hemorrhage, and necrotizing enterocolitis.
The neonatal blood transfusion rate in China is 13.03%.The rank order in the disease spectrum of the hospitalized neonates and that in hospitalized neonates treated with blood transfusion are different.
Study of efficacy and safety of Jiaotai pill in the treatment of depression
Authors: Zhou Zhihuan , Fu Shufei , Liu Yijia , Wang Yuhan , Bu Huaien , Mei Yan , Tong Yi , Yu Chunquan 
Published: May 2020

AbstractBackground:Depression is a common affective disorder characterized by marked and lasting melancholia, with corresponding thought and behavior changes. Due to an accelerated pace of life and increased work pressure, the incidence of depression has risen sharply, causing great harm to family and social life. Jiaotai pill (JTP) is a Chinese herbal formula that is commonly prescribed for depression and insomnia in clinical treatment, and exhibits antidepressant effects as shown in animal experimental research. However, there are no standard clinical trials to confirm its efficacy in treating depression.Objective:This study aims to assess the efficacy and safety of JTP in the treatment of depression, so as to tap the clinical efficacy advantages of JTP and provide data support for its clinical application.Methods:A randomized, multicenter clinical trial with parallel groups was designed in this study. A total of 40 patients with depression were included and randomly divided to either the treatment or the control group with a ratio of 1:1. The patients received JTP plus fluoxetine or fluoxetine alone once per day for 8 weeks. The primary outcome included the Hamilton Depression Rating Scale score for patients and brain structure and function by functional magnetic resonance imaging. The secondary outcomes included Traditional Chinese medicine syndrome integral scale scores, Wisconsin Card Sorting Test, blood metabonomics, urine metabonomics.Conclusion:The results of this trial will find changes in brain structure, brain function, and metabolism in patients with depression, and provide critical evidence for JTP in the treatment of depression.
Association between polymorphisms in the XRCC1 gene and male infertility risk
Authors: Liu Zhengsheng , Lin Luqi , Yao Xiongbo , Xing Jinchun 
Published: May 2020

Abstract

Background:
X-ray repair cross-complementing group 1 (XRCC1) single nucleotide polymorphisms (SNPs) might correlate with male infertility susceptibility. This association has been described; however, the findings remain inconsistent. Consequently, this meta-analysis was conducted to characterize the relationship between XRCC1 SNPs and male infertility susceptibility.

Methods/main results:
Studies were systematically searched in databases to evaluate the association between SNPs of XRCC1 and infertility in males. The effect measures chosen were the 95% confidence intervals (95% CIs) and odds ratios (ORs). A total of 7 studies, including 6 case-controlled studies on XRCC1 Arg399Gln and 3 case-controlled studies on XRCC1 Arg194Trp, were included. Ultimately, the results of this analysis revealed that XRCC1 Arg399Gln SNPs were significantly associated with infertility in males in homozygote comparisons (GG vs GA+AA: OR = 0.614, 95% CI: 0.40–0.937, P = .024). This meta-analysis did not demonstrate a relationship between XRCC1 Arg194Trp and male infertility risk.

Conclusions:
Our study indicated that XRCC1 Arg399Gln polymorphism was associated with a significantly decreased male infertility risk, but not XRCC1 Arg194Trp.
Efficacy assessment of acupuncture in improving symptoms of uterine fibroids
Authors: Zheng Min-Qin , Weng Cai , Hu Wei , Shen Chong-Qing , Tao Yun , Pan Zheng-Wei 
Published: May 2020

Abstract

Introduction:
Uterine fibroids are a common benign genital tumor disease in gynecological diseases. It is mainly a change in physical function caused by the growth of smooth muscle cells in the factor uterus. Modern medicine's treatment of this disease is based on the dependence of uterine fibroids on sex hormones. Treatment with antiprogestin and estrogen drugs can reduce the volume of fibroids or slow the rate of increase in volume, thereby achieving the goal of alleviating clinical symptoms. In order to meet the needs of the majority of women of childbearing age and to maintain fertility, acupuncture treatment of uterine fibroids has a broad prospect for development.

Methods/design:
This study plans to select 60 cases that meet the corresponding selection criteria. According to the random principle, they will be divided into intervention group and control group, with 30 cases in each group. The general information, fibroid size, and TCM syndrome scores of the two groups of patients will be compared before treatment. In terms of treatment, the intervention group will be given acupuncture combined therapy; the control group will be given Chinese patent medicine. The treatment cycles in both groups will be three menstrual cycles. After the treatment is completed, the data of the relevant curative effect indicators are analyzed by using SPSS software to draw conclusions.

Discussion:
We aim to provide higher evidence-based medical evidence for acupuncture treatment of uterine fibroids.

Trial registration:
ClinicalTrials.gov, ChiCTR2000030438, Registered on March 01, 2020.
Characteristics and outcomes among a hospitalized patient cohort with Streptococcus pneumoniae infection
Authors: Micek Scott T. , Simmons James , Hampton Nicholas , Kollef Marin H. 
Published: May 2020

Abstract
Infection due to Streptococcus pneumoniae (SP) requiring hospitalization is common. However, recent clinical studies describing patient characteristics and outcomes for SP infection in adults requiring hospitalization are lacking. Our goal was to evaluate patient characteristics, contemporary antibiotic resistance, and clinical outcomes among hospitalized adults with SP infections.
A retrospective cohort study was conducted at Barnes-Jewish Hospital (1350 beds) in St. Louis, Missouri, USA for years 2012 through 2016. During the study period, 358 hospitalized adults, excluding those with meningitis, were identified with SP infection. Forty-four patients (12.3%) died within 30 days of the identification of their infection. Among these infections, 99 (27.7%) were assessed to be hospital-acquired and 259 (72.3%) were community-onset infections. The majority of infections involved the respiratory tract (88.5%). Azithromycin resistance was the most common antibiotic resistance at 51.4%, followed by enteral penicillin resistance (45.3%), trimethoprim-sulfamethoxazole (34.1%), second-generation cephalosporin (cefuroxime) (30.7%), and meropenem (22.6%). There were 70 isolates (19.6%) classified as multidrug resistant. Independent predictors of hospital mortality included increasing weight in 1-kilogram increments (adjusted odds ratio [AOR], 1.02; 95% CI, 1.01 – 1.02; P = .048), increasing Charlson Comorbidity Index scores (AOR, 1.31; 95% CI, 1.21 – 1.42; P = .001), and the presence of septic shock (AOR, 3.89; 95% CI, 2.31 – 6.57; P = .009). The median [interquartile range] hospital length of stay was 8.1 days [4.5 days, 16.8 days].
Hospitalized patients with infection attributed to SP have significant 30-day mortality and use of hospital resources. Antibiotic resistance is common among isolates associated with infection. Determinants of mortality are primarily severity of illness, underlying comorbidities and increasing patient weight. Efforts to improve the treatment and prevention of SP infections are needed.
Treatment strategy of unstable atlas fracture
Authors: Guo Wei , Lin Yang , Huang Jingwen , Hu Feng , Ding Zhou , Xiao Zengming 
Published: May 2020

Abstract
At present, the posterior cervical approach with open reduction and internal fixation (ORIF) remains a commonly effective treatment for unstable Atlas fracture. However, the inserted screws into the C1 lateral mass of some unstable atlas fracture are very difficult, so that the operation is forced to change into C0 to C2 fusion. In order to improve the successful rate of lateral mass screw placement, we introduced a method of fixing lateral mass with a towel clamp in posterior transpedicular fixation, and explore the efficacy and feasibility.
Twenty-one consecutive patients with unstable atlas fracture were treated via this method from October 2012 to July 2017. All cases had neck pain and restricted motion of neck movement on admission. Electronic medical records and pre- and postoperative radiographs were reviewed. Screw and rod placement, bone fusion, and spinal cord integrity were assessed via long-term follow-up with anteroposterior and lateral radiographs and computed tomography. Follow-up included clinical assessment of neurological function, assessment of pain using the visual analog scale (VAS), and assessment of the activities of daily living using the neck disability index (NDI).
The mean follow-up duration was 22.1 months (range: 12–54 months). No screw loosening or breakage, plate displacement, neurovascular injury, and severe complications occurred during follow-up. The mean operative time was 112.4 ± 14.9 min (range: 82–135 min), and mean blood loss was 386.2 ± 147.9 mL (range: 210–850 mL). One patient experienced continuous neck pain postoperatively, but this gradually disappeared with analgesic administration. At final follow-up, all patients had bone fusion, the VAS scores and NDI were significantly improved compared with preoperatively.
Fixing the C1 lateral mass with a towel clamp during posterior transpedicular fixation for unstable atlas fracture appears to be a safe and reliable method, with the advantages of being a simple technique with few complications.