bluuebunny/crossref_metadata_2025_split huggingface dataset:
Do Early Weight-Bearing and Range of Motion Affect Outcomes in Operatively Treated Ankle Fractures: A Systematic Review and Meta-Analysis
Authors: Sernandez Haley , Riehl John , Fogel Joshua 
Published: January 2021

Objectives:
This systematic review was performed to answer the following questions: (1) Does early weight-bearing (WB) after ankle fracture (AF) open reduction internal fixation (ORIF) affect outcomes? (2) Does early WB after AF ORIF cause an increase in complications? (3) Does early ankle motion after AF ORIF affect outcomes? and (4) Does early ankle motion after AF ORIF cause an increase in complications?

Data Sources:
Articles from 1970 to 2020 were found using the PubMed database.

Study Selection:
Level I studies of adult patients with operatively treated ankle fractures were selected. A total of 1130 cases across 20 studies fit the participant criteria.

Data Extraction:
Studies were reviewed for data pertaining to the current study questions.

Data Synthesis:
The meta-analysis used logistic regression and standardized mean difference.

Results:
Based on the current literature, early WB in operative ankle fractures with stable fixation showed no difference in outcomes when compared with delayed WB protocols. Early WB after ORIF did not significantly increase complications. Early ankle motion after AF ORIF did not have significant standardized mean differences between range of motion and immobilization outcomes. Early range of motion before wound healing may lead to an increase in complications [pooled odds ratio: 3.11, 95% confidence interval (CI): 1.64–5.90] but did not show an increase in infection.

Conclusions:
The authors recommend that early WB at 2 weeks postoperatively can be safely considered for ankle fractures when stable fixation has been obtained. Early ankle motion before wound healing is not recommended due to increased wound complications, without improvement in long-term results.

Level of Evidence:
Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
Is a Low-Cost Drill Cover System Noninferior to Conventional Surgical Drills for Skeletal Traction Pin Placement?
Authors: Selhorst Samantha , O'Toole Robert V. , Slobogean Gerard P. , Harris Matthew , Bhatti Yasser , Enobun Blessing , O'Hara Nathan N. 
Published: January 2021

Summary:
The Drill Cover system was developed as a low-cost alternative to conventional surgical drills with specific applicability to low- and middle-income countries. However, the system may also be useful for the sterile placement of traction pins in the emergency department of high-income country hospitals. In September 2019, a US-based Level-1 trauma center began using the Drill Cover system to apply skeletal traction pins in patients with femoral shaft fractures. With these data, we performed a retrospective interrupted time series study to determine if the Drill Cover system was noninferior to conventional surgical drills in terms of infections at the traction pin site. The study included 205 adult patients with femoral shaft fractures initially placed in skeletal traction using a conventional surgical drill (n = 150, preintervention group) or the Drill Cover system (n = 55, postintervention group). The primary outcome was an infection at the site of skeletal traction pin placement that required surgery or antibiotics, which was compared between groups using a noninferiority test with a 1-sided alpha of 0.05 and a noninferiority margin of 3%. No infections at the site of skeletal traction pin placement were found in either the preintervention or the postintervention group (difference, 0%; 95% confidence interval: 0.0%–1.4%; noninferiority P value < 0.01). The results suggest that the Drill Cover system was noninferior to conventional surgical drills regarding infections at the site of skeletal traction pins. The Drill Cover system may be a safe alternative to the more expensive surgical drills for skeletal traction pin placement in the emergency room environment.
Coronavirus Disease 2019 Immediately Increases Burnout Symptoms in ICU Professionals: A Longitudinal Cohort Study*
Authors: Kok Niek , van Gurp Jelle , Teerenstra Steven , van der Hoeven Hans , Fuchs Malaika , Hoedemaekers Cornelia , Zegers Marieke 
Published: January 2021

OBJECTIVES:
ICU professionals are at risk of developing burnout due to coronavirus disease 2019. This study assesses the prevalence and incidence of burnout symptoms and moral distress in ICU professionals before and during the coronavirus disease 2019 crisis.

DESIGN:
This is a longitudinal open cohort study.

SETTING:
Five ICUs based in a single university medical center plus another adult ICU based on a separate teaching hospital in the Netherlands.

SUBJECTS:
All ICU professionals were sent a baseline survey in October–December 2019 (252 respondents, response rate: 53%), and a follow-up survey was sent in May–June 2020 (233 respondents, response rate: 50%).

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
Burnout symptoms and moral distress measured with the Maslach Burnout Inventory and the Moral Distress Scale, respectively. The prevalence of burnout symptoms was 23.0% before coronavirus disease 2019 and 36.1% at postpeak time, with higher rates in nurses (38.0%) than in physicians (28.6%). Reversely, the incidence rate of new burnout cases among physicians was higher (26.7%) than nurses (21.9%). Higher prevalence of burnout symptoms was observed in the postpeak coronavirus disease 2019 period (odds ratio, 1.83; 95% CI, 1.32–2.53), for nurses (odds ratio, 1.77; 95% CI, 1.03–3.04), for professionals working overtime (odds ratio 2.11; 95% CI, 1.48–3.02), and for professionals directly engaged with care for coronavirus disease 2019 patients (odds ratio, 1.87; 95% CI, 1.35–2.60). Physicians were more likely than nurses to develop burnout symptoms due to coronavirus disease 2019 (odds ratio, 3.56; 95% CI, 1.06–12.21).

CONCLUSIONS:
This study shows that overburdening of ICU professionals during an extended period of time leads to symptoms of burnout. Working long hours and under conditions of scarcity of staff, time, and resources comes at the price of ICU professionals’ mental health.
SENSITIVITY AND SPECIFICITY OF MULTISPECTRAL IMAGING FOR POLYPOIDAL CHOROIDAL VASCULOPATHY
Authors: Ma Feiyan , Yuan Mingzhen , Kozak Igor , Zhang Qing , Chen Youxin 
Published: January 2021

Purpose:
To evaluate the sensitivity and specificity of multispectral imaging (MSI), a noninvasive imaging technique composed of a series of monochromatic scanning light, for polypoidal choroidal vasculopathy (PCV).

Methods:
This was a prospective observational study. Polypoidal lesions on MSI are defined by oval or lobular hyperreflective oval lesion with dark hyporeflective center. Branching vascular networks on MSI is featured by hyperreflective interlacing signal. Detection sensitivity and specificity of polypoidal lesions was compared with indocyanine green angiography, whereas sensitivity and specificity of branching vascular networks, subretinal fluid, and pigment epithelium detachment were compared with optical coherence tomography.

Results:
Among 67 eyes, 38 eyes (56.7%) were diagnosed with PCV, 7 eyes (10.4%) with neovascular age-related macular degeneration, 13 eyes (19.4%) with central serous chorioretinopathy, 6 eyes (9.0%) with pathological myopia, and 3 eyes (4.5%) with idiopathic choroidal neovascularization. Compared with indocyanine green angiography, the sensitivity and specificity for diagnosing PCV by MSI alone was 84.21% and 93.10%, respectively, and the positive predictive value and the negative predictive value for PCV by MSI was 94.12% and 81.82%, respectively. The sensitivity and specificity for detecting polypoidal lesions were 84.21% and 93.10% compared with indocyanine green angiography. Compared with optical coherence tomography, the sensitivity and specificity for detecting branching vascular networks were 95.83% and 88.37%, for the subretinal fluid were 76.92% and 86.67%, and for the pigment epithelium detachment were 91.11% and 90.91%, respectively.

Conclusion:
Multispectral imaging allowed noninvasive visualization of polypoidal lesions and branching vascular networks and may serve as a new diagnostic option for PCV.
Unveiling the Potential Threat of Bacterial Oral Flora of Snake in Snake Bite Envenomation
Authors: Paul Aby , Joseph Joel Joby , Saijan Sanjo , Sebastian Stelvin , Tom Antriya Annie , Iqbal Thamanna 
Published: January 2021

Abstract
Snakebite is an acute life-threatening and time-limited medical emergency. There is comparatively less evidence regarding the infections caused by pathogens present in the snake's oral flora that induce cellulites secondary to snake bite. Here, we report a case of 15-year-old male patient infected with Acinetobacter baumannii–induced sepsis who underwent hemodialysis posthemotoxic envenomation; inflicted by hemotoxic snake, Russell's viper (Daboia russelii) at right index finger, and he was treated with 20 vials of antisnake venom. He had acute kidney injury and underwent 10 cycles of hemodialysis. He had incidence of cellulites with sepsis, and pus culture showed the presence of A. baumannii isolates with extensive drug resistance. He was treated with piperacillin-tazobactam, vancomycin, imipenem, and colistin for the improvement of his health status. Thus, the management of snake bite–induced sepsis, bacterial susceptibility study of oral flora in local venomous snakes has to be studied.
Short-Course Azithromycin for Lower Respiratory Tract Infection in Adults
Authors: Rattanasuwan Thakul , Ebied Alex , Khoury Adonice 
Published: January 2021

Abstract
Azithromycin, a macrolide antibiotic, has been shown to be effective in community-acquired pneumonia (CAP). The long half-life of azithromycin allows for a shortened treatment course, whereas the drug level is sufficiently maintained in the blood. The objective of this study is to review the body of evidence on the efficacy and safety of azithromycin in CAP treatment given as a regimen of 500 mg daily for 3 days. An English-language literature search was completed through PubMed (1980–2019). Full-text studies conducted in humans to compare a 5-day azithromycin course with a 3-day azithromycin course or azithromycin with other antibiotics for CAP treatment were included. Although the standard recommended CAP treatment regimen of azithromycin is 1500 mg in a total dose divided for 5 days, the efficacy of 1500 mg in a total dose divided for 3 days has been shown to be as effective as the 5-day course and comparable to longer durations of clarithromycin or amoxicillin/clavulanate for CAP treatment in an outpatient setting. Meanwhile, the evidence is less supportive of the use of 3-day azithromycin in patients who require hospitalization. The risk of cardiac death is low and not greater than the risk with other antibiotics.
Association between maternal human immunodeficiency virus infection and preterm birth
Authors: Elenga Narcisse , Djossou F.é.lix , Nacher Mathieu 
Published: January 2021

Abstract
This study aimed to evaluate the relationships between different types of antiretroviral therapy (ART) and preterm birth.
Preterm birth was studied among all singleton pregnancies and compared between human immunodeficiency virus (HIV)-infected and uninfected women.
We performed a matched case-control study from the pregnancy outcome registry of Cayenne Hospital. HIV-infected and uninfected women who delivered in the maternity ward of Cayenne Hospital from January 1, 2013 to December 31, 2015 were studied. We conducted an initial analysis to determine the risk factors for preterm birth among HIV-infected pregnant women. We also evaluated associations between exposure to antiretroviral therapy (ART) and preterm birth.
There were 8682 deliveries; of these, 117 involved HIV-infected women, representing a prevalence of 1.34%. There were 470 controls. The sociodemographic characteristics were comparable. HIV-infected women were more likely to experience preterm birth (adjusted odds ratio [AOR] = 3.9, 95% confidence interval [CI] 1.5–9.9). Overall, 95.73% of the women received antiretroviral therapy before becoming pregnant, and they were in good clinical condition. The median CD4 count at the beginning of pregnancy was 500 cells/mm3 (357–722). Additionally, 53% of HIV-infected women had an undetectable viral load count (<20 copies/mL). Their median haemoglobin level was 120 g/L (100–120). There were 2 human immunodeficiency virus-infected babies. A higher rate of preterm birth was associated with protease inhibitor-based ART than a reverse transcriptase inhibitor-based ART regimen. The sample size being small this result would be considered with caution.
The preterm birth rate among HIV-infected pregnant women was twice that of the general population; this trend was not explained by sociodemographic characteristics. Preterm birth was independently associated with combination ART, especially with ritonavir-boosted protease inhibitor therapy during pregnancy.
Effects of progressive neuromuscular stabilization exercise on the support surface on patients with high obesity with lumbar instability
Authors: Park Sam-Ho , Lee Myung-Mo 
Published: January 2021

Abstract

Background:
Intensive neuromuscular stabilization exercise on highly obese patients with low back pain results in positive effects of body fat decline and prevention of complications. The purpose of this study is to investigate the effects of progressive neuromuscular stabilization exercise on unstable surface on pain, motor function, psychosocial factors, balance, and abdominal contraction with highly obese patients with lumbar instability.

Methods:
This study is a double-blinded randomized controlled trial. A total of 46 highly obese patients (body mass index [BMI] ≥ 30 kg/m2) with lumbar instability were assigned randomly to experimental group (n = 23) and control group (n = 23). The control group performed the intensive progressive exercise on a stable surface and the experimental group on an unstable surface.

Result:
Significant differences were shown for BMI, QVAS, K-ODI, FABQ, and balance ability for both groups before and after the intervention (P < .05), and only the experimental group showed significant difference for transverse abdominis muscle thickness in contraction and contraction rate (P < .05). Compared to the control group, the experimental group showed significant difference (P < .05) in the amount of changes for QVAS, K-ODI, balance ability, transverse abdominis muscle thickness in contraction, and contraction rate.

Conclusion:
Progressive neuromuscular stabilization exercise program on unstable surfaces demonstrated to be an effective and clinically useful method to decrease pain level, increase motor function, balance, and transverse abdominis muscle thickness in contraction and contraction rate for highly obese patients with lumbar instability.
Diagnostic accuracy of ultrasound superb microvascular imaging for parotid tumors
Authors: Zhang Jili , Wu Jialing , Hou Xiukun 
Published: January 2021

Abstract

Background:
As a novel ultrasound technique, superb microvascular imaging (SMI) can quickly, simply, and noninvasively study the microvascular distribution in the tumor and evaluate the microvascular perfusion. Studies suggested that SMI is helpful for the differentiation between benign and malignant parotid tumors. However, the results of these studies have been contradictory. Therefore, the present meta-analysis aimed at determining the accuracy of SMI in the differential diagnosis between benign and malignant parotid tumors.

Methods:
We will search PubMed, Web of Science, Cochrane Library, and Chinese biomedical databases from their inceptions to September 30, 2020, without language restrictions. Two authors will independently carry out searching literature records, scanning titles and abstracts, full texts, collecting data, and assessing risk of bias. Review Manager 5.2 and Stata14.0 software will be used for data analysis.

Results:
This systematic review will determine the accuracy of SMI in the differential diagnosis between benign and malignant parotid tumors.

Conclusion:
Its findings will provide helpful evidence for the accuracy of SMI in the differential diagnosis between benign and malignant parotid tumors.

Systematic review registration:
INPLASY2020100093
Utility and safety of low-concentration nitrous oxide anesthesia in ptosis surgery
Authors: Noguchi Santaro , Nakakura Shunsuke , Noguchi Asuka , Nakama Sayuri , Tastukawa Yoko , Kashima Tomoyuki , Tabuchi Hitoshi 
Published: January 2021

Abstract
To evaluate the utility of low-concentration nitrous oxide (N2O) anesthesia in ptosis surgery
This study was a retrospective consecutive case series that included 54 successive patients with blepharoptosis who underwent bilateral levator aponeurosis advancement and on whom skin resection performed by the same surgeon between August 2016 and July 2017. Among these patients, 27 were operated with a local anesthesia injection (air group) and 27 with a local anesthesia injection and low-concentration N2O anesthesia (N2O group). All N2O cases used a total of 6 L of gas comprising 70% oxygen and 30% N2O. Preoperative and postoperative blood pressure (BP) and heart rate (HR) and intraoperative pain, anxiety, nausea, and memory were measured immediately after surgery using visual analog scale score (VASS). Additionally, perioperative side effects were examined.
There was no significant difference in age, sex, and preoperative and postoperative margin reflex distance (MRD) between the 2 groups (all P > .05). The intraoperative mean peripheral oxygen saturation was significantly higher (97.5% ± 1.6% vs 99.5% ± .6%, P < .001), intraoperative HR was significantly lower (78.2 ± 12.8 vs 70.7 ± 11.6 bpm, P = .02), and operation time was significantly shorter (33.1 ± 8.1 vs 29.4 ± 10.3 minutes, P = .03) in the N2O group than in the air group.
Difference between intraoperative and preoperative systolic BP (BPs) (+15.8 ± 18.0 vs + 3.1 ± 21.7 mm Hg, P = .02), diastolic BP (BPd) (+7.0 ± 17.4 vs −2.3 ± 13.6 mm Hg, P = .04), and HR (3.2 ± 8.5 vs −3.9 ± 9.4 bpm, P = .01) was significantly lower in the N2O group than in the air group.
VASS of intraoperative pain was significantly lower in the N2O group than in the air group (49.5 ± 24.7 vs 22.6 ± 14.9, P < .001), whereas intraoperative anxiety and memory did not present significant differences between the groups (P = .09 and P = .45, respectively). Intraoperative nausea score was 0 for all cases in both groups. There was no other side effect.
Ptosis surgery with anesthesia using 30% N2O may effectively suppress intraoperative BP and HR along with pain and shorten the operation time without side effects such as nausea.
Clinical therapeutic effects of probiotics in combination with antibiotics on periodontitis
Authors: Luo Wenping , Li Hao , Ye Fei 
Published: January 2021

Abstract

Background:
Dental pain can have a detrimental effect on quality of life. Symptomatic apical periodontitis is the most common cause of dental pain and arise from an inflamed or necrotic dental pulp. There is growing evidence to support the effectiveness of probiotics in combination with antibiotics on periodontitis. We therefor will conduct this study to evaluate the clinical therapeutic effects of probiotics in combination with antibiotics on periodontitis.

Methods:
We will systematically search the following databases: PubMed, the Cochrane Library, EMBASE, Web of Science, China National Knowledge Infrastructure (CNKI), Chinese BioMedical Literature Database (CBM), and WanFang database. A grey literature search will be conducted using ZETOC Conference Proceedings and Open Grey. Only randomized controlled trials (RCTs) related to research on probiotics in combination with antibiotics to treatment patients with periodontitis will be included. All sources have to be searched from their inception to October 2020. Two authors will independently select studies, extract study data, and evaluate the quality of the included studies. We will use Review Manager Software (RevMan 5.3) to analyze data.

Results:
This study will systematically evaluate the clinical therapeutic effects of probiotics in combination with antibiotics on periodontitis.

Conclusions:
This study will generate evidence for a better clinical decision of patients with periodontitis.

Registration number:
DOI 10.17605/OSF.IO/QZ6SB (https://osf.io/qz6sb/).
Multiple simple cystic metastases in the lateral neck at presentation with papillary thyroid microcarcinoma
Authors: Zhu Lei , Zhu Xi , Zhou Bin , Mao Wei bo , Wu Yong , Cheng Feng 
Published: January 2021

Abstract

Introduction:
Metastasis of a papillary thyroid microcarcinoma (PTMC) in the lateral neck is characterized primarily by solid lymphadenopathy, although some cases may rarely present with a cervical cystic mass. We report a case of lateral cervical lymph node metastases of PTMC that appeared as a cystic lymphangioma of the lateral neck.

Patient concerns:
A 55-year-old man with a painless egg-sized mass in the right side of the neck that had been present for 1 month underwent physical examination, ultrasonography, computed tomography (CT), fine needle aspiration biopsy (FNAB), and intraoperative fast-frozen pathological examination, which indicated that the cystic masses in the neck were benign. However, the final pathology report identified the lateral neck masses as lymph node metastases of thyroid carcinoma.

Diagnosis:
The patient was diagnosed with PTMC of the right lobe of the thyroid gland with lateral neck metastases.

Interventions:
The patient underwent right cervical neck dissection together with a right thyroidectomy, followed by levothyroxine therapy and routine follow-up.

Outcomes:
No postoperative complications were reported, and the thyroid-stimulating hormone inhibition target was <0.1 mmol/L; there was no detectable tumor recurrence on routine clinical follow-up for up to 16 months.

Conclusions:
This case report emphasizes the need to consider cervical lymph node metastases of thyroid carcinoma in the differential diagnosis for patients with large, multiple, simple cystic neck masses.
Music-based intervention to reduce aggressive behavior in children and adolescents
Authors: Ye Peijie , Huang Zhaohui , Zhou Huan , Tang Qishou 
Published: January 2021

Abstract

Background:
We aimed to evaluate the effect of music-based intervention on the aggressive behavior in children and adolescents, and made a comparison of music medicine and music therapy.

Methods:
We searched PubMed (MEDLINE), Ovid-Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) to identify relevant studies. Standardized mean differences (SMDs) were estimated with random-effect model.

Results:
We included 10 studies and found a significant decrease of aggressive behavior (SMD = −0.99; 95% CI = −1.42 to −0.56) and a significant increase of self-control (SMD = 0.56; 95% CI: 0.19 to 0.93) in the music-based intervention group compared with the control group. The aggressive behavior was significantly decreased in the music therapy group compared with the control group (SMD = −1.79; 95% CI = −3.23 to −0.35); while, no difference was observed between music medicine group and control group. Sub-group analyses exhibited a more efficacious in reducing aggressive behavior in the children received ≥2 sessions per week, the children with a mean age > 10 years, the children whose behavior were reported by teachers, and the children with aggressive behavior before intervention. Sensitivity analyses yielded similar results.

Conclusion:
Music-based intervention seemed to be more efficacious for reducing aggression and increasing self-control in children and adolescents, especially music therapy.