bluuebunny/crossref_metadata_2025_split huggingface dataset:
Shi's Yi-Qi Bu-Shen Tong-Luo decoction combined with manipulation in the management of wrist stiffness after distal radius fracture
Authors: Wu Hai-Yang , Wang Yi-Ru , Gui Jing , Wen Guo-Wei , Tang Zhen-Yin , Liu Ping , Wu Jun-Hao 
Published: March 2020

Abstract

Introduction:
Wrist stiffness is a common sequela of distal radial fractures. Manipulation is generally used and effective, but problems exist, such as intense pain, swelling during the process of manipulation and long treatment period. Therefore, a combinative therapeutic strategy is necessary to benefit rehabilitation after distal radius fracture. Shi's Yi-Qi Bu-Shen Tong-Luo decoction (BTD) combined with wrist manipulation has been used in the Shanghai Ninth People's Hospital Huangpu Branch in last few decades. BTD has potential therapeutic effects on rehabilitation after distal radius fracture, which should be evaluated by rigorous clinical trial.

Methods/design:
A randomized, double-blind, placebo-controlled clinical trial will be conducted to determine the efficiency of BTD in relief of wrist stiffness and pain and function rehabilitation. A total of 80 wrist stiffness patients with or without pain and edema will be enrolled, and treated with wrist manipulation plus BTD or placebo for 4 weeks. The primary outcome measure is the Cooney wrist score. The second outcome measures include pain numerical rating scale, patient rated wrist evaluation, 36-item short form health survey questionnaire, and side effects.

Discussion:
Although BTD has shown effects on rehabilitation after distal radius fracture in the Shanghai Ninth People's Hospital Huangpu Branch for decades, the universality of this efficacy needs evaluated. The results of this trial will provide a convincing evidence.

Trial registration:
ChiCTR2000029260, January 19, 2020.
Electroacupuncture for post-thoracotomy pain
Authors: Park Sohyeon , Gu Ji-Hyang , Jang Hye-Kyoung , Oh Min-Seok , Lee Eun-Jung , Jung In Chul 
Published: March 2020

Abstract

Background:
Thoracotomy is a common surgical procedure used in cases such as trauma and cancer resection. It is an invasive procedure in which incisions are made in the chest wall to gain access to the chest. Therefore, it often produces intense postoperative pain. Electroacupuncture has been known for its analgesic effects in various conditions, including cases of postoperative pain. This protocol design is for a systematic review and meta-analysis to gather evidence and investigate the analgesic effects of electroacupuncture in pain after thoracotomy.

Methods:
The studies for the systematic review will be searched with keywords on the following 10 databases: PubMed, Cochrane Library (CENTRAL), EMBASE, MEDLINE, Google Scholar, CNKI, KoreaMed, KMBASE, KISS, and OASIS. The search will be done without language restrictions. Only the randomized controlled trials that meet the eligibility criteria will be finally included in the study. The quality of the study will be assessed using the Cochrane Collaborations’ risk-of-bias tool, and Cochrane's software RevMan 5.3 will be used for meta-analysis.

Results:
The designed study will provide a systematic review and meta-analysis of the searched and randomized controlled trials that meet the eligibility criteria. Meta-analysis will be performed with pain scores as the main outcome measure, and they may also be performed with additional outcomes. The qualitative and quantitative data synthesis is expected to provide high quality evidence to judge the pain management effect of electroacupuncture for patients who underwent thoracotomy.

Conclusion:
The conclusion of this systematic review and meta-analysis will provide evidence to judge whether electroacupuncture is an effective analgesic treatment option for patients suffering with post-thoracotomy pain.

PROSPERO registration number:
CRD42019142157.
High C-reactive protein to albumin ratio and the short-term survival prognosis within 30 days in terminal cancer patients receiving palliative care in a hospital setting
Authors: Ju Sang-Yhun , Ma Soo-Jin 
Published: March 2020

Abstract
Survival estimates are very important to patients with terminal cancer. The C-reactive protein (CRP)/albumin ratio is associated with cancer outcomes. However, few studies have investigated the dose-response association in terminal cancer patients. Therefore, we aimed to evaluate the association between the CRP/albumin ratio and mortality in terminal cancer patients using a longitudinal analysis. We retrospectively investigated the electronic medical records of 435 inpatients with terminal cancer admitted to the palliative care unit of Yeouido St. Mary's Hospital between October 8, 2015, and January 17, 2018. In total, 382 patients with terminal cancer were enrolled in the study. The serum CRP/albumin ratio measured at admission had a linear dose-response relationship with the risk of death among the terminal cancer patients (P for linearity = .011). The multivariate analyses showed that the CRP/albumin ratio was an independent prognostic factor (Model 1, CRP/albumin ratio >48.53 × 10−4: HR = 2.68, 95% CI = 1.82–3.93; Model 2, tertile 2: HR = 1.91, 95% CI = 1.31–2.82 and tertile 3: HR = 3.66, 95% CI = 2.24–5.97). The relationship between a high CRP/albumin ratio and poor survival was a flat L-shape for survival time with an inflection point at approximately 15 days, while the relationship was not significant in terminal cancer patients who survived beyond 30 days. This study demonstrated that high CRP/albumin ratios are significantly and independently associated with the short-term survival prognosis of terminal cancer patients within 30 days.
Vonoprazan vs proton pump inhibitors in treating post-endoscopic submucosal dissection ulcers and preventing bleeding
Authors: Martin  , Zhou Yi , Meng Chun-Xu , Takagi Tatsuya , Tian Yu-Shi 
Published: March 2020

AbstractBackground:Vonoprazan is a potassium-competitive acid blocker (P-CAB) that is frequently used in Japan forHelicobacter pylori (H. pylori) eradication, treatment of gastroesophageal reflux disease, and treatment of post endoscopic submucosal dissection (ESD) complications. We sought to determine if vonoprazan was superior to proton pump inhibitors (PPIs) for treating ESD-induced ulcers (as assessed by ulcer healing and shrinkage ratios) and preventing delayed bleeding over various treatment durations (2, 4, and 8 weeks).Methods:We collected randomized controlled trials (RCTs) and observational studies that discussed the effectiveness of vonoprazan and PPIs on ESD-induced ulcers and bleeding from PubMed, Cochrane Library, ClinicalTrials.gov, and Google Scholar. Studies were selected according to pre-established eligibility criteria and data were extracted separately by 2 researchers with double-check. We used the Cochrane risk of bias tool to assess RCTs and the Newcastle–Ottawa Quality Assessment Scale to assess observational studies. Meta-analyses, based on the random-effects model, were conducted to compare differences in ulcer shrinkage ratios (%) and odds ratios (ORs) for ulcer healing and delayed bleeding. Publication bias was evaluated using funnel plots and Egger regression test. Heterogeneity was assessed usingI2statistics. A sensitivity analysis was conducted to check the robustness of results. The evidential quality of the findings was assessed using the GRADE profiler.Results:Thirteen studies were included in this meta-analysis. The OR effect sizes of vonoprazan relative to PPIs for ulcer healing were 1.33 (P = .13) with a 95% CI (0.33–3.21) at 4 weeks and 1.48 (P = .09) with a 95% CI (0.81–5.20) at 8 weeks. The overall effect size for the shrinkage ratio was 12.24% (P = .16) with a 95% CI (−4.96–29.44) at 2 weeks. The effect size of its subgroup ofH. pylori-positive patients was 19.51% (P < .001) with a 95% CI (11.91–27.12). The overall OR for the occurrence of delayed bleeding was 0.66 (P = .26) with a 95% CI (0.32–1.35). After excluding combination drug studies, the overall ORs between vonoprazan and PPIs on ulcer healing and delayed bleeding were 1.44 and 0.76, respectively.Conclusion:During the first 2 weeks of treatment, vonoprazan was more effective than PPIs for treatingH. pylori-positive patients with ESD-induced gastric ulcers.
Reproductive outcomes of 3 infertile males with XYY syndrome
Authors: Zhang Xinyue , Liu Xiangyin , Xi Qi , Zhu Haibo , Li Linlin , Liu Ruizhi , Yu Yang 
Published: March 2020

Abstract
The aim of this study is to evaluate the pregnancy outcomes of males with a 47, XYY karyotype following assisted reproductive treatment.
A retrospective study was performed using data from infertile men with 47, XYY at a center for reproductive medicine in 2004 to 2017. Of the 19,842 infertile males treated, a total of 21 showed the 47, XYY karyotype and were included in the present study. Clinical variables were collected. Three men were under treatment with their partner before either in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI).
The incidence of 47, XYY in infertile men is 1/945 (21/19842). Most men are azoospermic or severely oligospermic. Three men and their partners underwent IVF or ICSI treatment with fresh ejaculate samples. The fertilization rate was 52.94% to 83.33%. The embryo cleavage rate was 50% to 90%. One man had abnormal sex hormonal levels and his partner had no clinical pregnancy. The other 2 couples had healthy baby boys.
Live spermatozoa can be gathered and fertility is possible for infertile males with 47, XYY syndrome when IVF or ICSI treatment is used. It is recommended that genetic counseling is provided in such cases.
Immediate effects of noxious and innocuous thermal stimulation on brain activation in patients with stroke
Authors: Chen Sharon Chia-Ju , Hsu Miao-Ju , Kuo Yu-Ting , Lin Ruey-Tay , Lo Sing-Kai , Lin Jau-Hong 
Published: March 2020

Abstract
Case-control studies have shown that noxious thermal stimulation (TS) can improve arm function in patients with stroke. However, the neural mechanisms underlying this improvement are largely unknown. We explored functional neural activation due to noxious and innocuous TS intervention applied to the paretic arm of patients with stroke. Sixteen participants with unilateral cortical infarctions were allocated to one of two groups: noxious TS (8 patients; temperature combination: hot pain 46°C to 47°C, cold pain 7°C–8°C) or innocuous TS (n = 8; temperature combination: hot 40°C–41°C, cold 20°C–21°C). All subjects underwent fMRI scanning before and after 30 min TS intervention and performed a finger tapping task with the affected hand. Immediate brain activation effects were assessed according to thermal type (noxious vs. innocuous TS) and time (pre-TS vs post-TS). Regions activated by noxious TS relative to innocuous TS (P < .05, adjusted for multiple comparisons) were related to motor performance and sensory function in the bilateral primary somatosensory cortices, anterior cingulate cortex, insula, thalamus, hippocampus and unilateral primary motor cortex, secondary somatosensory cortex at the contralateral side of lesion, and unilateral supplementary motor area at the ipsilateral side of lesion. Greater activation responses were observed in the side contralateral to the lesion, suggesting a significant intervention effect. Our preliminary findings suggest that noxious TS may induce neuroplastic changes unconstrained to the local area.
Trial registration: NCT01418404
Morbidity and mortality during hepatitis C treatment using sofosbuvir and daclatasvir with or without ribavirin, in a cohort of Egyptian patients
Authors: Elsadek Hany M. , Abdelbaser Elsayed S. , Emara Mohamed H. , Soliman Hanan H. , Farag Alaa A. 
Published: March 2020

Background
Though direct-acting antiviral agents (DAAs) therapy is associated with a high cure rate of hepatitis C virus infection, a potential risk of serious adverse events (SAEs) exists. The aim of this study was to determine the incidence and predictors of morbidity and mortality related to DAAs therapy.

Methods
This prospective study was conducted on a real word cohort of 1562 treatment naïve chronic hepatitis C (CHC) Egyptian patients, who received 12-weeks therapy with sofosbuvir (SOF) plus daclatasvir (DCV) ± ribavirin (RBV). The incidence and predictors of SAEs and mortality during treatment course and over the following 12 weeks were recorded.

Results
The mean age of study participants was 51.38 ± 9.70 years (55.22%, males). Liver cirrhosis was defined in 72.4% of participants. SAEs were recorded in 120 participants (7.68%), including hepatic decompensation, gastrointestinal bleeding, anemia and hepatocellular carcinoma. Nine patients (0.58%) died and 69 patients (4.42%) discontinued therapy due to SAEs. Severity of cirrhosis was the significant predictor of morbidities and mortality. Hepatic decompensation was predicted by baseline serum albumin [cutoff value: 3.00 g/dL, area under the receiver operating characteristic curve (AUROC): 0.953] and serum bilirubin (cutoff value: 1.75 mg/dL, AUROC: 0.940).

Conclusion
The risk of morbidity and mortality related to SOF/DCV ± RBV therapy in CHC patients is small and is significantly linked to advanced cirrhosis.
Narrow band imaging characteristics of gastric polypoid lesions: a single-center prospective pilot study
Authors: Esposito Gianluca , Angeletti Stefano , Cazzato Maria , Galli Gloria , Conti Laura , Di Giulio Emilio , Annibale Bruno , Lahner Edith 
Published: March 2020

Introduction:
Gastric polypoid lesions (GPL) are endoscopic findings whose histological nature is difficult to determine with white-light endoscopy. Hyperplastic polyps (HP), type-1 gastric carcinoids (T1-GC) and adenomas are the most frequent GPL needing different management. Narrow-band imaging (NBI) has high accuracy for gastric malignant lesions but few studies assessed whether GPL display specific NBI characteristics. We aimed to investigate the endoscopic NBI appearances of GPL.

Materials and methods:
During gastroscopies, images of GPL were recorded, and lesions were removed for histological evaluation. Two endoscopists blindly reviewed the digital images and registered the endoscopic NBI appearances on a specific check-list. GPL were categorized in HP, adenomas and T1-GC using histology as gold standard.

Results:
Overall 52 GPL, observed in 40 patients [F55%; age 63 (36–85) years], were included: 29 (55.8%) HP; 18 (34.6%) T1-GC; 5 (9.6%) adenomas. The median size was seven (2–35) mm. A regular circular mucosal pattern was more frequently observed in HP and T1-GC compared to adenomas (P < 0.001). T1-GC showed a central erosion in 77.8% (P < 0.001 versus HP) with a clear demarcation line in 33.3%. Adenomas had tubule-villous mucosal pattern in 80% (P = 0.01 versus other lesions).

Conclusion:
NBI analysis of the mucosal pattern seems to be effective to endoscopically discriminate between adenomas and HP while the main characteristic of T1-GC seems to be the presence of a central erosion, sometimes with demarcation line. The endoscopic NBI characterization of GPL may contribute to optimize the management of these lesions.
Antiretroviral Prophylaxis
Authors: Lemoine Anaïs , Michot Joëlle , Viala Jérôme , Tounian Patrick , Dollfus Catherine 
Published: March 2020

Abstract
An 8-year-old child experienced abdominal pain and melena due to duodenal and ileal ulcerations throughout antiretroviral prophylactic treatment after a needlestick injury. Mild to moderate adverse effects often occur with lamivudine and zidovudine, but more severe adverse effects such as intestinal ulcers resulting in melena after a prophylactic antiretroviral treatment may question the safety of the current guidelines.
Point-of-Care Ultrasound in United States Pediatric Emergency Medicine Fellowship Programs
Authors: Acuña Josie , Rubin Marina , Hahn Barry , Das Devjani , Kapoor Monica , Adhikari Srikar , Greenstein Joshua 
Published: March 2020

Objectives
In 2015, the American Academy of Pediatrics (AAP) released a policy statement regarding point-of-care ultrasonography (POCUS) by pediatric emergency physicians, which included recommendations on education and training. In the 3 years since the AAP policy statement and its accompanying technical report were published, it is unclear which aspects of the recommendations set forth by this policy have been instituted by POCUS programs throughout the country. The objective of this study was to conduct a survey of pediatric emergency medicine (PEM) fellowship directors throughout the United States regarding the current state of education and training of POCUS in their department.

Methods
We conducted an online survey of all PEM fellowship program directors in the United States between April 1, 2018, and July 31, 2018.

Results
Of the 78 PEM fellowship program directors contacted, 62 (79.5%) responded. The majority reported having an ultrasound curriculum in place to educate their fellows (77%). Fellows are being taught using a variety of educational strategies. The most commonly reported barriers were lack of qualified faculty available for training (62.9%), lack of confidence or comfort in using the existing ultrasound machine(s) in their department (54.8%), and physician resistance to using new technology (50%). The majority of programs reported having processes in place for credentialing (56%) and quality assurance (72.6%). Whereas 77.4% have a system for archiving POCUS studies after they are performed, only half of the programs report utilization of middleware for their archival system. Compliance with documentation varied significantly between programs.

Conclusions
Our survey results demonstrate that, although there is still room for improvement, POCUS programs have succeeded in many of the goals set forth by the 2015 AAP policy statement, such as establishing and growing an ultrasound curriculum and using various strategies to educate PEM fellows.
The Utility of Ultrasound in Detecting Skull Fractures After Pediatric Blunt Head Trauma
Authors: Gordon Isaac , Sinert Richard , Chao Jennifer 
Published: March 2020

Background
Head trauma is a common reason for evaluation in the emergency department. The evaluation for traumatic brain injury involves computed tomography, exposing children to ionizing radiation. Skull fractures are associated with intracranial bleed. Point-of-care ultrasound (POCUS) can diagnose skull fractures.

Objectives
We performed a systematic review/meta-analysis to determine operating characteristics of POCUS skull studies in the diagnosis of fractures in pediatric head trauma patients.

Methods
We searched PubMed, EMBASE, and Web of Science for studies of emergency department pediatric head trauma patients. Quality Assessment Tool for Diagnostic Accuracy Studies 2 was used to evaluate risk of bias. Point-of-care ultrasound skull study operating characteristics were calculated and pooled using Meta-DiSc.

Results
Six studies of 393 patients were selected with a weighted prevalence of 30.84%. Most studies were at low risk of bias. The pooled sensitivity (91%) and specificity (96%) resulted in pooled positive likelihood ratio (14.4) and negative likelihood ratio (0.14). Using the weighted prevalence of skull fractures across the studies as a pretest probability (31%), a positive skull ultrasound would increase the probability to 87%, whereas a negative test would decrease the probability of a skull fracture to 6%. To achieve a posttest probability of a skull fracture of ~2% would require a negative skull ultrasound in a patient with only a pretest probability of ~15%.

Conclusions
A POCUS skull study significantly increases the probability of skull fracture, whereas a negative study markedly decreases the probability if the pretest probability is very low.
Analysis of Scars and Keloids by Focused Ion Beam/Scanning Electron Microscopy
Authors: Migita Hisashi , Rikimaru Hideaki , Rikimaru-Nishi Yukiko , Koga Noriyuki , Watanabe Koichi , Ohta Keisuke , Nakamura Kei-ichiro , Kiyokawa Kensuke 
Published: March 2020

Background
Histological differentiation between hypertrophic scars (HSs) and keloids has been considered difficult. In this study, we analyzed differences in the 3-dimensional tissue architecture between HSs and keloids using focused ion beam/scanning electron microscopy (FIB/SEM).

Methods
Five specimens each of normal skin, normotrophic scars (NSs), HSs, and keloids were investigated. Three sites in each specimen were observed by FIB/SEM tomography, resulting in an observation of 15 sites per tissue type. We identified fibroblasts and macrophages and assessed the contact ratio and the mode of intercellular contact (planar contact or point contact). The significance of differences among the 4 tissue types was determined by Fisher exact test.

Results
In normal skin, contact between fibroblasts and macrophages was observed at all 15 sites, and the mode of contact was always planar. There was contact at 87% of the NS sites (planar: point = 80%: 7%). In HSs, contact was seen at 80% of the sites (planar: point = 20%: 60%). In keloids, contact was found at only 15% of the sites (planar: point = 7.5%: 7.5%). The intercellular contact ratio showed no significant differences among normal skin, NSs, and HSs; however, a significant difference was noted between these tissues and keloids. The intercellular contact mode also showed no significant difference between normal skin and NSs, but a significant difference between these tissues and HSs.

Conclusions
These histopathologic findings suggest that FIB/SEM tomography is useful for distinguishing between HSs and keloids and can provide important knowledge for understanding the pathogenesis of keloids.
Surgical Treatment of Dacryocystitis by Using a Venous Catheter
Authors: Meduri Alessandro , Inferrera Leandro , Tumminello Giuseppe , Cicciù Marco , Aragona Pasquale 
Published: March 2020

Purpose:
Aim of this work is to highlight the advantages of a new surgical technique performed over 15 patients affected dacryocystitis and treated by using a venous catheter.
The arrangement of a 30 mm venous catheter used at the end of a dacryocystectomy (DCT) was performed in 15 patients with dacryocystitis. The venous catheter was removed at 30 days after the surgery.
The use of the venous catheter allows washing the lacrimal drainage system, reducing the risk of postoperative infections and supports the recanalization of the lacrimal drainage system 30 days after surgery.
The presented cases demonstrated how the technique is easy and it reduces the possibility of the post-operative infection. It could be performed under regional anesthesia. Furthermore, after the surgery the recanalization of the lacrimal drainage system with a significant reduction of the epiphora in 6 months after surgery has been observed.