bluuebunny/crossref_metadata_2025_split huggingface dataset:
Antibiotic-impregnated bone cement for preventing infection in patients receiving primary total hip and knee arthroplasty
Authors: Zhang Jin , Zhang Xiao-Yu , Jiang Feng-Li , Wu Yi-Ping , Yang Bei-Bei , Liu Zi-Yun , Liu Dong 
Published: December 2019

Abstract

Background:
Surgical-site infections after primary total joint arthroplasty (TJA) are a significant issue. Antibiotic-impregnated bone cement (AIBC) has been widely used for the treatment of infected joints, but routine use of AIBC in primary TJA remains controversial. In this systematic review, we evaluated the efficacy of AIBC in reducing surgical-site infections after primary TJA.

Methods:
We systematically searched Pubmed, EMbase, Cochrane Library, CMB, CNKI, and WanFang Data for studies (published until June 1, 2019) evaluating AIBC use in reducing infection rates. Two reviewers independently screened the literature according to inclusion and exclusion criteria, extracted data, and assessed the methodological quality of included studies. Meta-analysis was performed using Review Manager 5.3 software. The registration number is CRD42017078341 in PROSPERO.

Results:
In total, 10 studies were included, resulting in a sample size of 13,909 arthroplasty cases. The overall pooled data demonstrated that, compared with systemic antibiotics, AIBC was more effective in decreasing deep infection rates (odds ratio [OR] = 0.35, 95% confidence interval [CI] = 0.14–0.89, P = .030), although there were higher superficial infection rates with AIBC (OR = 1.53, 95% CI = 1.11–2.11, P = .010). Compared to systemic antibiotics alone, AIBC with systemic antibiotics significantly decreased deep infection rates (OR = 0.55, 95% CI = 0.41–0.75, P = .0001) but there was no difference in superficial infection rates (OR = 1.43, 95% CI = 0.81–2.54, P = .220). In the subgroup analysis, both randomized controlled trials and cohort studies had reduced deep infection rates after primary TJA (OR = 0.61, 95% CI = 0.37–0.99, P = .050 and OR = 0.49, 95% CI = 0.34–0.70, P = .0001, respectively). AIBC decreased deep infection rates in both total hip and knee arthroplasty (OR = 0.25, 95% CI = 0.12–0.52, P = .0002 and OR = 0.62, 95% CI = 0.45–0.87, P = .005, respectively). Deep infection rates were significantly decreased by AIBC with gentamicin (OR = 0.31, 95% CI = 0.20–0.49, P < .00001) but unaffected by AIBC with cefuroxime (OR = 0.35, 95% CI = 0.10–1.20, P = .100). Deep infection rates in the AIBC and control groups were similar when laminar airflow was applied to the operating room (OR = 0.90, 95% CI = 0.60–1.35, P = .620); however, without laminar airflow, the efficacy of AIBC in decreasing deep infection rates was significantly higher than that of control group (OR = 0.21, 95% CI = 0.08–0.59, P = .003).

Conclusions:
AIBC may significantly decrease deep infection rates after primary total hip and knee arthroplasty, with or without systemic antibiotics.
Polymorphism of MPT64 and PstS1 in Mycobacterium tuberculosis is not likely to affect relative immune reaction in human
Authors: Xiao Tongyang , Jiang Yi , Li Guilian , Pang Hui , Zhao Lili , Zhao Xiuqin , Wan Kanglin 
Published: December 2019

Abstract

Background:
MPT64 and PstS1 are the earliest known immune-dominant antigens of Mycobacterium tuberculosis and have been commonly used as candidates in the diagnosis of tuberculosis.

Methods:
We constructed recombinant plasmids pET-32a-Rv0934 and pET-32a-Rv1980c to express both wild and mutant forms of MPT64 and PstS1 and purified them. From November 9 to December 9, 2016, and November 9 to December 10, 2017, 96 patients with tuberculosis, 53 patients without tuberculosis, and 96 healthy volunteers were enrolled in this study. We used the purified proteins as antigens to perform T-spot and enzyme-linked immunosorbent assay (ELISA) for samples obtained from healthy volunteers and tuberculosis patients.

Results:
Regarding T-spot, the area under the curve (AUC) values for MPT64-wild protein (MPT64-H37Rv) and MPT64-mutant protein (MPT64-FJ05395) were 0.723 and 0.750, respectively. The AUC values for PstS1-H37Rv, PstS1-FJ05132, and PstS1-JL06035 were 0.817, 0.796, and 0.745, respectively. With regard to ELISA, the AUC values for MPT64-H37Rv and MPT64-FJ05395 were 0.525 and 0.528, respectively, while those for PstS1-H37Rv, PstS1-FJ05132, PstS1-JL06035 were 0.588, 0.509, and 0.560, respectively. There was no difference between wild and mutant proteins when we used them as antigens to perform T-spot and ELISA assays.

Conclusion:
MPT64 and PstS1 are likely candidate diagnostic antigens for M tuberculosis T-spot test, at least in combination with other proteins. Polymorphisms of MPT64 and PstS1 had little effect on cell-mediated and humoral immunity in the host.
A rare case of extraluminal gastrointestinal stromal tumor of the ileum presenting with lower urinary tract symptoms
Authors: Yu Chung-Hao , Ting Hui-Kung , Kao Chien-Chang , Tsai Wen-Chiuan , Wu Sheng-Tang , Yu Dah-Shyong 
Published: December 2019

Abstract

Introduction:
Benign prostatic hyperplasia, bladder outlet obstruction, and overactive bladder are major causes of lower urinary tract symptoms (LUTS). Tumor compression of the urinary bladder resulting in LUTS was clinically observed. Gastrointestinal stromal tumors (GISTs) presenting with LUTS have not been reported before. Herein, we report a patient with extraluminal GIST of the ileum who had LUTS without gastrointestinal symptoms during the clinical course.

Patient concerns:
A 68-year-old man visited the genitourinary outpatient department because of frequent urination with mild dysuria. He also complained of poor appetite, fatigue, and body weight loss of 10 kg over 6 months. A large presacral solid mass lesion compressing the bladder and surrounded by the bowel with gas content was identified through abdominal computed tomography.

Diagnosis:
GIST of the ileum with mesenteric invasion was revealed by pathological examination.

Interventions:
Exploratory laparotomy with removal of the pelvic tumor and segmental resection of the ileum was performed.

Outcomes:
Now, he received adjuvant imatinib target therapy for 1 year with stable condition.

Conclusion:
Extravesical compression or invasion of the urinary bladder by a pelvic mass lesion is common but is rarely accompanied by GISTs of the ileum. Specific findings identified through imaging should alert the surgeon to this specific entity and prepare thoroughly before surgical intervention.
Penile resurfacing using a reverse bilateral anterior scrotal artery flap
Authors: Gao Qing-Guo , Qu Wenrui 
Published: December 2019

Abstract

Rationale:
Circumcision is one of the most frequently used surgical procedures worldwide. Extensive penile skin defects, which can occur as a rare but severe complication of circumcision, are serious and frustrating problems for patients who experience them. Procedures for correcting these problems can pose a challenge to plastic surgeons in the clinic.

Patient concerns:
A 31-year-old man was admitted to our care with an extensive defect of the penile skin caused by a circumcision performed 20 days previously.

Primary diagnoses:
Infection, necrosis, and defects of the penile skin.

Interventions:
A reverse bilateral anterior scrotal flap was used to correct complete penile skin loss following debridement of the infected and necrotic tissue.

Outcomes:
The patient experienced no complications during the 10-year follow-up period. The patient reported normal erectile function and the ability to perform intercourse.

Lessons:
The reverse bilateral anterior scrotal artery flap is suitable for repairing skin defects of the penis and allows for satisfactory cosmetic and functional improvement following defects of the penile skin.
Two cases of intrauterine pregnancy with tubal stump pregnancy after in vitro fertilization and embryo transfer following ipsilateral salpingectomy
Authors: Xi Qi , Yu Yang , Zhang Xinyue , Zhang Hongguo , Jiang Yuting , Liu Ruizhi , Zhang Han 
Published: December 2019

Abstract

Rationale:
The recently increased rate of heterotopic pregnancies (HPs) has been largely attributed to the increased use of assisted reproduction technologies (ARTs). HP is a rare and potentially life-threatening condition. It is unusual in natural conception cycles, occurring in 1:10,000 to 1:50,000 pregnancies. However, with the increased use of ART such as in vitro fertilization and embryo transfer (IVF–ET), the incidence has risen to 0.5–1%.

Patient concerns:
Case 1 was a 28-year-old woman who presented to our center complaining of a sudden onset of right-side lower abdominal pain with a small amount of vaginal bleeding. She had undergone IVF–ET and received a thawed embryo transfer with two embryos 23 days previously. She had a history of right salpingectomy for an ectopic pregnancy during the downregulation of her ovulatory cycle 1 year ago. Case 2 was a 25-year-old woman who presented to our center complaining of a sudden onset of right-side lower abdominal pain. She had also undergone thawed embryo transfer following IVF–ET with two embryos 35 days previously. She had a history of right salpingectomy for an ectopic pregnancy 1.5 years previously.

Diagnoses:
Both patients were diagnosed as having a heterotopic pregnancy.

Interventions:
Patient 1 underwent emergency laparoscopy; patient 2 underwent emergency laparotomy and both were treated medically to prevent abortion of the intrauterine pregnancies.

Outcomes:
Patient 1 had an incomplete abortion and underwent uterine curettage on the day 10 after the operation. Patient 2 experienced no further complications during pregnancy and a healthy baby girl was born at the 38th gestational week.

Lessons:
Reproductive physicians need to pay more attention to patients who have received more than one embryo at transfer, especially those with a history of salpingectomy.
Improving the position of resuscitation team leader with simulation (IMPORTS); a pilot cross-sectional randomized intervention study
Authors: Saiboon Ismail M. , Apoo Farah N. , Jamal Shamsuriani M. , Bakar Afliza A. , Yatim Fadzlon M. , Jaafar Johar M. , Berg Benjamin W. 
Published: December 2019

Abstract

Background:
Leadership and teamwork are important contributory factors in determining cardiac resuscitation performance and clinical outcome. We aimed to determine whether fixed positioning of the resuscitation team leader (RTL) relative to the patient influences leadership qualities during cardiac resuscitation using simulation.

Methods:
A cross-sectional randomized intervention study over 12 months’ duration was conducted in university hospital simulation lab. ACLS-certified medical doctors were assigned to run 2 standardized simulated resuscitation code as RTL from a head-end position (HEP) and leg-end position (LEP). They were evaluated on leadership qualities including situational attentiveness (SA), errors detection (ED), and decision making (DM) using a standardized validated resuscitation-code-checklist (RCC). Performance was assessed live by 2 independent raters and was simultaneously recorded. RTL self-perceived performance was compared to measured performance.

Results:
Thirty-four participants completed the study. Mean marks for SA were 3.74 (SD ± 0.96) at HEP and 3.54 (SD ± 0.92) at LEP, P = .48. Mean marks for ED were 2.43 (SD ± 1.24) at HEP and 2.21 (SD ± 1.14) at LEP, P = .40. Mean marks for DM were 4.53 (SD ± 0.98) at HEP and 4.47 (SD ± 0.73) at LEP, P = .70. The mean total marks were 10.69 (SD ± 1.82) versus 10.22 (SD ± 1.93) at HEP and LEP respectively, P = .29 which shows no significance difference in all parameters. Twenty-four participants (71%) preferred LEP for the following reasons, better visualization (75% of participants); more room for movement (12.5% of participants); and better communication (12.5% of participants). RTL's perceived performance did not correlate with actual performance

Conclusion:
The physical position either HEP or LEP appears to have no influence on performance of RTL in simulated cardiac resuscitation. RTL should be aware of the advantages and limitations of each position.
A comparative analysis of physical fitness of children and adolescents with HIV infection
Authors: Medeiros Rafaela Catherine da Silva Cunha de , Santos Isis Kelly dos , Damasceno de Goes Carlos Jean , Vasconcelos de Oliveira Anna Luiza , Medeiros Jason Azevedo de , Cobucci Ricardo Ney , Dantas Paulo Moreira Silva 
Published: December 2019

Abstract

Background:
The impaired physical capacity of children and adolescents with HIV can directly influence their physical performance, activities of daily living and social participation. The purpose of this systematic review protocol is to perform a systematic review and meta-analysis on physical fitness (cardiorespiratory capacity, agility, flexibility, strength, and muscular endurance) in children and adolescents with HIV, compared with healthy controls.

Methods:
We will be following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis protocol (PRISMA-P) statement guidelines. There will be cross-sectional, longitudinal and case-controlled studies, and there will be no restrictions on language and year of publication in the search. The search strategy will be to use databases including: MEDLINE (via PubMed), EMBASE (via Ovid), Web of Science, Scopus, SportDiscus and CINAHL; The MeSH terms will be: physical fitness, fitness trackers, agility, flexibility, physical endurance, muscle strength, aerobic capacity, human immunodeficiency virus, HIV, children, and adolescents, to discuss and compare physical fitness (cardiorespiratory capacity, agility, flexibility, strength, and muscular endurance) in children and adolescents with HIV and healthy control. The reviewers will independently read the articles, extract the data information and analyze the risk of bias using the Cochrane criteria for observational studies. The Cohen's will be used to calculate the agreement between the revisions.

Results:
This study will provide a high-quality synthesis of observational studies on the analysis and comparison of physical fitness in children and adolescents with HIV compared with healthy controls.

Conclusion:
This systematic review will be very important for the creation of proposals aimed at providing high quality subsidies in the management of HIV during the development phase of children and adolescents.

Ethics and dissemination
Ethics approval is not required because individual patient data and privacy were not involved in this study.

PROSPERO registration number
CRD42019140955.

PROSPERO registration date
23/09/2019.
Evaluating and monitoring bone marrow hypoplasia in adults with aplastic anemia via high-resolution iliac magnetic resonance imaging in the current era
Authors: Yang Xiawan , Bai Yanliang , Guo Huihui , Shi Mingyue , Zhang Wanjun , Pei Yanru , Song Juanjuan , Drokow Emmanuel Kwateng , Huang Gairong , Liu Xiang , Xu Junling , Kai Sun  
Published: December 2019

Abstract
The diagnosis and monitoring of aplastic anemia (AA) rely heavily on a complete blood count (CBC), and multiple-site bone marrow (BM) aspirations and biopsies. However, these approaches have certain limitations. We aimed to assess high-resolution magnetic resonance imaging (MRI) as a complementary approach for evaluating BM hypoplasia and monitoring treatment response in adults with AA in the current era.
Twelve newly diagnosed AA patients and 12 sex- and age-matched healthy controls were enrolled in this study from January 2017 to August 2018. A bilateral iliac 3.0T MRI was used to collect data for each subject, and the signal intensity on the T1-weighted images (T1WIs) were expressed as a contrast-to-noise ratio (CNR). The MRI, CBC, and BM biopsy data were analyzed and compared.
A qualitative analysis identified a significant difference in MRI signal characteristics between the AA group and the healthy control group. The clinical classifications of very severe aplastic anemia (VSAA) and severe aplastic anemia (SAA) corresponded to pattern I and pattern II on the MR images, respectively. However, this imaging classification did not correlate with the biopsy-based BM cellularity measure. A quantitative analysis showed a significantly higher signal intensity in AA patients than in controls. A within-group comparison revealed that more severe types of AA, based on the clinical classification, corresponded to stronger signals. Notably, MRI could detect treatment response earlier than CBC, regardless of whether there were improvements in hematopoiesis.
MRI can be used to predict the therapeutic effects in patients with AA and is an important complementary tool for evaluating and monitoring BM hypoplasia.
Case report of coronary artery fistula
Authors: Punzo Bruna , Forte Ernesto , Salvatore Marco , Cavaliere Carlo , Cademartiri Filippo 
Published: December 2019

Abstract

Rationale:
Unlike invasive coronary angiography and echocardiography, cardiac computed tomography (CCT) and cardiac magnetic resonance (CMR) imaging allow a coronary artery fistula (CAF) comprehensive evaluation focusing on both coronary and myocardial findings.

Patient concerns:
We present the case of an asymptomatic patient suspected for CAF and referred to our structure for cardiovascular evaluation.

Diagnosis:
The patient was diagnosed a CAF without coronary artery disease on the basis of CMR and CCT.

Interventions:
The patient underwent an invasive coronary angiography after which the medical staff decided not to surgically treat the CAF. Therefore, a conservative treatment was chosen with strict temporal monitoring.

Outcomes:
After less than 1 year follow-up, the patient presented stable conditions without complaints.

Lessons:
Multimodal non-invasive imaging has a key role in patient assessment for disease diagnosis providing better understanding for prognosis and treatment.
A rare case of giant synovial osteochondromatosis of the thigh
Authors: Liu Shuzhong , Zhou Xi , Song An , Huo Zhen , Wang Yipeng , Liu Yong 
Published: December 2019

Abstract

Rationale:
Giant synovial osteochondromatosis of the thigh is a highly unusual disease without standard diagnosis and curative managements so far. Our focus is to report a very rare case of giant synovial osteochondromatosis successfully operated by surgical treatment. The management of these unique cases has certain educational significance in clinical practice.

Patient concerns:
A 63-year-old previously healthy man presented to our institution with a 4-year history of continuous progressive hip pain and local numbness of right side in January 2018. One month ago, the patient felt that the above symptoms were aggravated, and the right hip and proximal thigh were significantly swollen.

Diagnosis:
Computed tomography and magnetic resonance imaging of the hip revealed the irregular mass in his right thigh. Post-operative pathology confirmed the diagnosis of synovial osteochondromatosis of the thigh.

Interventions:
Considering the large volume of the mass and possibility of malignancy, the patient underwent surgical exploration and complete tumor resection.

Outcomes:
The patient's neurological deficits and symptoms improved significantly after the surgery, and the postoperative period was uneventful at the 1-year follow-up visit. There were no complications associated with the operation during the follow-up period.

Lessons:
Taken together, the lesion's clinical features, imaging results, and pathological characteristics are unique. Synovial osteochondromatosis of the thigh, although rare, should be part of the differential diagnosis when the patient presents with local pain, numbness, swelling or other symptoms. We recommend surgical treatment for the occupying lesion when the tumor has caused symptoms or neurological deficits.
Relationship between genetic mutations and clinical phenotypes in patients with Wilson disease
Authors: Zhu Qingwen , Zhu Keyu , Wang Jing , Bian Wenjun , Lu Jianxun 
Published: December 2019

Abstract
To study the relationship between genotype and clinical phenotype of major gene mutation sites in patients with Wilson disease (WD).
Clinical and laboratory data were collected from 40 children with WD admitted to the hospital by high-pass sequencing. The basic clinical data of patients included the following: age, sex, first symptom, K-F ring, clinical classification, serum Ceruloplasmin (CP), 24 hours urine copper. High Frequency Mutations were identified in WD patients: Exon 8, Ar9778Leu, and study the relationship between high frequency mutation and clinical phenotype.
The mutation frequency of 2333G>T(Arg778Leu) in Exon 8 was the highest (48%). The mutation frequency of Exon 13 at 2975C>T site was 29%. The age (t = 0.296, P = .768), sex (χ
2 = 0.005, P = .944), first symptom (χ
2 = 0.480, P = .449), K-F ring (χ
2 = 0.321, P = .17), clinical classification (χ
2 = 20.064, P > .969), serum CP levels (t = 0.007, P = .897) had no significant difference between Arg778Leu mutation group and non-Arg778Leu mutation group. Twenty-four-hour urinary copper levels (t = 12.134, P < .001,) in the Arg778Leu mutation group were higher than those in the Arg778Leu mutation group.
Arg778Leu mutation is associated with 24 hours urinary copper. The study of the association between the type of gene mutation and the clinical phenotype has important implications for the occurrence regularity, pathogenesis, and disease progression in patients with WD.
Successful treatment of fulminant myocarditis in an adult in emergency department
Authors: Liu Danyu , Xu Jun , Yu Xuezhong 
Published: December 2019

Abstract

Rationale:
Fulminant myocarditis (FM) has poor prognosis and the usual treatment is inotropes and symptomatic support. The initiation of extracorporeal membrane oxygenation (ECMO) and intra-aortic balloon pumping (IABP) in the emergency department (ED) is a rare event.

Patient concerns:
We report the case of a 45-year-old man with a complaint of 4 days of high fever and dry cough in the emergency department.

Diagnosis:
Transthoracic echocardiogram and the medical history showed presumptive diagnosis was fulminant myocarditis with cardiogenic shock.

Interventions:
The patient's condition deteriorated drastically and ECMO was initiated immediately after admission. He experienced electrical storm twice during ECMO support and was successfully treated with the combination with IABP.

Outcomes:
ECMO and IABP were continued for 11 and 14 days respectively. The patient was discharged on the 81th day after admission, with all his laboratory tests returned to normal.

Lessons subsections:
The early initiation of ECMO and IABP in the ED is potentially life-saving for suitable patients with FM. It appears promising but has not yet been routinely implemented in underdeveloped and developing countries.
Associations of nutrient intakes with glaucoma among Japanese Americans
Authors: Yoserizal Muhammad , Hirooka Kazuyuki , Yoneda Masayasu , Ohno Haruya , Kobuke Kazuhiro , Kawano Reo , Kiuchi Yoshiaki 
Published: December 2019

Abstract
The aim of this study was to investigate possible associations of nutrient intake on glaucoma in subjects of Japanese descent living in Los Angeles, CA.
In this cross-sectional study, 581 Japanese American participants in Los Angeles underwent an interview, fundus photography, comprehensive physical, and blood examinations, along with determining the body mass index status and any confounding factors. CDSketch was used to measure the cup-disc ratio and rim width of each fundus in the retinal photographs. A multivariate logistic regression test with adjustment for confounding factors was used to assess the association between glaucoma and nutrient intake.
A total of 61 of 581 participants were diagnosed with glaucoma in this study. Multivariate logistic regression analysis showed that a high intake of iron (odds ratio [OR]: 1.303, P = .004), low intake of vitamin A (OR: 0.365, P = .019), and vegetable fat (OR: 0.957, P = .004) were associated with an increased risk of glaucoma.
Current findings showed that high iron intake and low vitamin A and vegetable fat intake appeared to be associated with an increased risk of glaucoma in subjects of Japanese descent living in the Los Angeles populations.