bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is routine abdominal drainage necessary for patients undergoing elective hepatectomy? A protocol for systematic review and meta-analysis
Authors: Anweier Nuerzatijiang , Apaer Shadike , Zeng Qi , Wu Jing , Gu Shensen , Li Tao , Zhao Jinming , Tuxun Tuerhongjiang 
Published: February 2021

Abstract

Objectives:
To evaluate comparative outcomes of routine abdominal drainage (RAD) and non-routine abdominal drainage (NRAD) during elective hepatic resection for hepatic neoplasms.

Materials and Methods:
We systematically searched MEDLINE, EMBASE, The Cochrane Library, Web of Science. The searching phrases included “liver resection,” “hepatic resection,” “hepatectomy,” “abdominal drainage,” “surgical drainage,” “prophylactic drainage,” “intraperitoneal drainage,” “drainage tube,” “hepatectomy,” “abdominal drainage” and “drainage tube.” Two independent reviewers critically screened literature, extracted data and assessed the risk of bias. Post-operative morbidity and mortality were the outcome parameters. Combined overall effect sizes were calculated using fixed-effect or random-effect model.

Results:
We have identified 9 RCTs and 3 comparative studies reporting total of 5726 patients undergoing elective hepatectomy under RAD (n = 3084) or NRAD (NRAD group, n = 2642). RAD was associated with significantly higher overall complication rate [odds risk  = 1.79, 95% CI (1.10, 2.93), P = .02] and biliary leakage rate [odds risk  = 2.41, 95% CI (1.48, 3.91), P = .0004] compared with NRAD. Moreover, it significantly increased hospital stays [mean difference  = 0.95, 95% CI (0.02, 1.87), P = .04] compared with NRAD. RAD showed no difference regarding intra-abdominal hemorrhage, wound complications, liver failure, subphrenic complications, pulmonary complications, infectious complications, reoperation and mortality compared with NRAD.

Conclusions:
Although routine abdominal drainage may help surgeons to observe post-operative complication, it seems to be associated with increased post-operative morbidity and longer hospital stays. Non-routine abdominal drainage may be an appropriate option in selected patients undergoing hepatic resection. Higher level of evidence is needed.
Chromobacterium violaceum infection on lower limb skin
Authors: Zhang Peng , Li Jie , Zhang Yan-zhen , Li Xiao-ning 
Published: February 2021

Abstract

Rational:

Chromobacterium violaceum is a motile gram-negative bacterium. This bacterium commonly grows in tropical or subtropical areas in sewage and can cause opportunistic infections.

Patient concerns:
A 50-year-old Chinese man had a skin ulcer in the middle of his left leg in front of the tibia. The diameter of the wound was 3.0 cm, the exudation was obvious, and necrotic tissue was attached to the wound. One week previously, he was working in a field where he accidentally punctured his left leg.

Diagnosis:

C violaceum infection was diagnosed as per the results of pathogen culture from the infection site.

Interventions:
He was treated with piperacillin/tazobactam (3.375 g/12 h iv) and levofloxacin (0.5 g/24 h iv) for 5 days.

Outcomes:
The patient showed good response to therapy and was discharged on day 18 after wound healing.

Lessons:

C violaceum rarely infects humans. When an infection is suspected, samples should be immediately sent for microbial culture. Timely treatment on the basis of drug sensitivity test results can prevent further complications.
Vertebral osteomyelitis as a hidden cause of persistent meningeal irritation in a patient with pneumococcal meningitis
Authors: Hamaguchi Mai , Fujita Hiroaki , Suzuki Keisuke 
Published: February 2021

Abstract

Rationale:
Pneumococcal meningitis generally develops from bacteremia and is often complicated by multiple organ infection.

Patient concerns:
A 62-year-old man with no previous medical history developed progressive disturbance of consciousness preceded by high-grade fever and headache for a few days.

Diagnosis:
The patient was diagnosed with pneumococcal meningitis based on meningeal irritation, polymorphonuclear cell-predominant pleocytosis of the cerebrospinal fluid (CSF) and a positive pneumococcal urinary antigen test at a different hospital. Despite the administration of meropenem and vancomycin, his consciousness worsened, and the patient was transferred to our hospital. Marked nuchal stiffness was noted. The patient showed a disturbance of consciousness, with a Glasgow Coma Scale score of E3V2M5. No significant cranial nerve palsy, motor weakness or sensory impairment was observed. CSF examination showed polynuclear cell-predominant pleocytosis of 755/μL. Transthoracic echocardiography revealed infectious endocarditis.

Interventions:
After the detection of penicillin-susceptible Streptococcus pneumoniae, the antibiotic regimen was changed to aminobenzylpenicillin 12 g/d and ceftriaxone 4 g/d, which improved the patient's consciousness and CSF findings. However, marked neck stiffness and neck pain persisted; we performed a systemic investigation that revealed cervical vertebral osteomyelitis and aortic aneurysm.

Outcomes:
After surgical treatment, the patient achieved complete remission of both conditions.

Lessons:
We should consider vertebral osteomyelitis as a potential complication of meningitis when nuchal stiffness persists despite an improvement in meningitis.
Prognostic value of serum heart-type fatty acid-binding protein in patients with sepsis
Authors: Yang Dagang , Liu Guojuan , Guo Shuang , Ren Huibang , Lu Hongnan , Zhou Lihua , Bao Longtang 
Published: February 2021

Abstract

Background:
Sepsis is commonly acute and critical illness with high morbidity and high mortality, and requires timely diagnosis and treatment. Septic patients had elevated serum H-FABP levels, which may correlate with disease severity and mortality. However, previous studies showed that the association between H-FABP and mortality during the sepsis remains unclear. Thus, we performed a study to analyze this relationship.

Methods:
The electronic databases such as Cochrane Library, PubMed, Embase, Web of Science, Cochrane Clinical Trials Database, Wanfang Database, and China National knowledge Infrastructure (CNKI) were systematically searched to determine the qualified clinical trials. The study language is limited to English or Chinese. The 2 authors used Cochrane Risk of Bias Tool v.2.0 to independently check the quality of papers and extract relevant data. Comprehensive analysis of data extracted in the research using appropriate statistical methods.

Results:
Evaluation of the relationship between the prognosis of patients with sepsis and serum H-FABP is the result of this study.

Conclusion:
The analysis results of this study can infer that H-FABP may be an independent risk factor for the prognosis of patients with sepsis. It is also helpful for clinical workers to make early evaluation and early treatment of patients with sepsis.

Ethics and dissemination:
The conclusions of this meta-analysis study are based on the published evidence. Therefore, moral recognition is unnecessary.

OSF registration number:
DOI: 10.17605/ OSF.IO / 2V4HN.(https://osf.io/2v4hn/).
The effect of transcranial direct current stimulation combined with functional task training on motor recovery in stroke patients
Authors: Al-Hussain Fawaz , Nasim Eman , Iqbal Muhammad , Altwaijri Nouf , Asim Niaz , Yoo Woo-Kyoung , Bashir Shahid 
Published: February 2021

Abstract

Background:
Motor deficits are common after stroke and are a major contributor to stroke-related disability and the potential for long-lasting neurobiological consequences of stroke remains unresolved. There are only a few treatments available for the improvement of motor function in stroke patients. However, the mechanisms underlying stroke recovery remain poorly understood, and effective neurorehabilitation interventions remain insufficiently proven for widespread implementation.

Methods:
Herein, we propose to enhance the effects of brain plasticity using a powerful noninvasive technique for brain modulation consisting of navigated transcranial magnetic stimulation (TMS) priming with transcranial direct current stimulation (tDCS) in combination with motor-training-like constraint-induced movement therapy (CIMT). Our hypothesis is that navigated low-frequency rTMS stimulus priming with precise location provided by neuronavigation on the healthy side of the brain and with anodal tDCS on the affected side combined with CIMT will induce a greater motor function improvement than that obtained with sham tDCS combined with CIMT alone. We predict that the application of this technique will result in a large reduction in cortical excitability and dis-inhibition in the affected hemisphere and lead to improvements in behavioral measures of hand function in stroke patients.

Discussion:
The proposed study, therefore, is important for several reasons. The results could potentially lead to improved stroke therapeutics, and the approach makes use of 2 potential pathways to modulate brain function.

Trial registration:
This study protocol was registered in Clinical Trials Registry (https://clinicaltrials.gov/ct2/show/NCT04646577).

Ethics and dissemination:
The study has been reviewed and approved by the Human Research Ethics Committee of the King Fahad Specialist Hospital Dammam. The results will be actively disseminated through peer-reviewed journals, conference presentations, social media, broadcast media, print media, the internet and various community/stakeholder engagement activities.
Infliximab therapy intensification based on endoscopic activity is related to suppress treatment discontinuation in patients with Crohn disease
Authors: Komaki Yuga , Kanmura Shuji , Yutsudo Kazuki , Kuwazuru Kosuke , Komaki Fukiko , Tanaka Akihito , Nishimata Nobuaki , Sameshima Yoichi , Sasaki Fumisato , Ohi Hidehisa , Nakamura Yuichi , Tokushige Koichi , Sameshima Yukinori , Ido Akio 
Published: February 2021

Abstract
Administering double doses of infliximab or shortening its dosing interval for patients with Crohn disease who experience a loss of response to treatment is an accepted treatment method; however, the effectiveness and appropriate timing of treatment intensification remain unclear. We examined the treatment outcomes of patients with Crohn disease receiving infliximab therapy intensification.
Among 430 patients with Crohn disease who were seen at our related facilities from July 2002 to July 2018, 46 patients (30 men and 16 women) who were followed up for diminished infliximab effects for >1 year after therapy intensification were included in this study. The relationship between patient background and continuation of therapy intensification was retrospectively examined through a logistic regression analysis.
Among the 46 patients, 67.4% (31 cases) continued therapy intensification for 12 months. The treatment discontinuation rate after 12 months (7.1% vs 43.8%, P = .015) and the C-reactive protein levels at the start of therapy intensification (P = .0050) were significantly lower in the group in which treatment was strengthened due to remaining endoscopic findings (n = 14) than that due to clinical symptoms (n = 32). There was no significant difference in the rates of treatment discontinuation after 12 months of treatment strengthening between patients receiving double doses (n = 34) and those with shortened dosing intervals (n = 12).
Infliximab treatment discontinuation seems to be less likely to occur in patients with Crohn disease who are receiving infliximab treatment intensification based on endoscopic findings of exacerbations than in patients whose treatment is based on clinical symptoms.
Uncovered stent insertion for isolated superior mesenteric artery dissection
Authors: Yang Zhi-Qing , Sun Lu-Bin , Li Gui-Rong , Yuan Fu-Kang , Xia Feng-Fei 
Published: February 2021

Abstract
The aim of this study is to describe our clinical outcomes in isolated superior mesenteric artery dissection (SMAD) patients that underwent uncovered stent insertion.
Between January 2016 and August 2019, consecutive isolated SMAD patients at our center were treated via uncovered stent insertion. Both short- and long-term outcomes in these patients were analyzed.
Over the course of the study period, 11 total isolated SMAD patients meeting the criteria for stent insertion at our hospital were treated via uncovered stent insertion. Stent placement across the SMAD site was successful in all patients, with 1 stent being used per patient. There were no instances of procedure-related complications, and the median operative duration was 60 minutes. Patency of the distal superior mesenteric artery and branches thereof was achieved in all cases. Patients experienced progressive SMAD-related symptom relief and were followed for 6 to 49 months (median: 22 months). Over this follow-up period, the obliteration of the dissection was observed within 3 months in all patients. We did not detect any instances of stent occlusion, bowel ischemia, or anti-platelet-related bleeding during the follow-up period.
Uncovered stent insertion can achieve favorable short- and long-term outcomes in isolated SMAD patients.
Efficacy of an inpatient smoking cessation program at a single regional cancer center
Authors: Park Ha-Young , Choe Yu-Ri , Oh In-Jae , Kim Min-Seok , Kho Bo Gun , Shin Hong-Joon , Park Cheol Kyu , Kim Yu-Il , Kim Young-Chul , Ahn Hye-Ran , Kweon Sun-Seog 
Published: February 2021

Abstract
Smoking is the leading cause of preventable death and a risk factor for cancer, but smoking cessation is difficult even in patients who need hospitalization. This study aimed to investigate the usefulness of an inpatient smoking cessation consultation program and to analyze the clinical factors associated with abstinence. In this observational study, patients received regular counseling for 6 months, and abstinence was objectively assessed via urine and exhaled carbon monoxide testing. Cessation rates were assessed at 4 weeks and 6 months, and clinical characteristics associated with cessation success were investigated. Of the 571 patients referred to participate in the program, 170 (29.8%) were enrolled, and only 2 (1.2%) used smoking cessation drugs in addition to counseling. The smoking cessation rate was 77.6% after 4 weeks and 59.1% after 6 months. The cessation rates were significantly higher in patients with cancer than in those without cancer at both timepoints (63.8% vs 21.9%, P < .001, 53.6% vs 12.5%, P < .001), and they were also higher in the first admission group than in the re-admission group (87.4% vs 74.7%, P = .033, 88.5% vs 76.1%, P = .037). In patients with lung cancer, progression-free survival and overall survival tended to be better in those enrolled in the program (P = .158, P = .183). In conclusion, the inpatient smoking cessation program was associated with a high abstinence rate. Most patients maintained cessation without medication, suggesting that initial admission, along with a cancer diagnosis, can provide enough motivation to abstain from smoking. In addition, the smoking cessation effort showed potential to improve survival during lung cancer treatment.
Evaluation of Empiric Vancomycin for Fevers During High-dose Cytarabine Administration
Authors: Hoover Alex , Zimmerman Jessica A.O. , Wiese Sawyer , Modi Arunkumar 
Published: February 2021

Background:
Cytarabine is a nucleoside analog used in chemotherapy regimens for the treatment of multiple hematologic malignancies. One of the known adverse effects of cytarabine, particularly in patients receiving high-dose cytarabine (HDAC), is drug-induced fever. Multiple studies have demonstrated an increased risk of viridans group streptococcal bacteremia in patients who have received HDAC. For this reason, our institution and several other institutions across the country routinely include vancomycin as empiric coverage for patients who develop fever during HDAC, due to concern for resistance to cephalosporin monotherapy.

Materials and Methods:
Patient demographic, diagnosis, treatment, and outcome information was collected by electronic chart review for each HDAC infusion from 2007 to August 2018 at the University of Iowa Stead Family Children’s Hospital. If fever was documented during or within 24 hours of HDAC, additional information was collected regarding patient outcome and diagnostic testing.

Results:
Of 208 HDAC administrations documented, patients developed fevers during the course on 82 occasions (39.4%). A median of 3 blood cultures per febrile period were obtained from time of fever onset during HDAC administration through >24 hours afebrile. One blood culture was positive for an oral flora organism determined by the microbiology lab report to be a likely contaminant. There were no other positive blood cultures in non-neutropenic or neutropenic patients.

Conclusion:
Fever due to HDAC is relatively common but appears to frequently lack association with bacteremia during the time of HDAC administration. Broad-spectrum empiric antibiotic regimens including vancomycin may be unnecessary for these patients, particularly before they become neutropenic.
Political uncertainty moderates neural evaluation of incongruent policy positions
Authors: Haas Ingrid J. , Baker Melissa N. , Gonzalez Frank J. 
Published: February 2021

Uncertainty has been shown to impact political evaluation, yet the exact mechanisms by which uncertainty affects the minds of citizens remain unclear. This experiment examines the neural underpinnings of uncertainty in political evaluation using functional magnetic resonance imaging (fMRI). During fMRI, participants completed an experimental task where they evaluated policy positions attributed to hypothetical political candidates. Policy positions were either congruent or incongruent with candidates' political party affiliation and presented with varying levels of certainty. Neural activity was modelled as a function of uncertainty and incongruence. Analyses suggest that neural activity in brain regions previously implicated in affective and evaluative processing (anterior cingulate cortex, insular cortex) differed as a function of the interaction between uncertainty and incongruence, such that activation in these areas was greatest when information was both certain and incongruent, and uncertainty influenced processing differently as a function of the valence of the attached information. These findings suggest that individuals are attuned to uncertainty in the stated issue positions of politicians, and that the neural processing of this uncertainty is dependent on congruence of these positions with expectations based on political party identification. Implications for the study of emotion and politics and political cognition are discussed.
This article is part of the theme issue ‘The political brain: neurocognitive and computational mechanisms’.
Demographic benchmarks for equitable coverage of the COVID-19 vaccination program among priority populations
Authors: Vashist Kushagra , Akintobi Tabia , Bednarczyk Robert A. , Narayan KM Venkat , Patel Shivani A. 
Published: February 2021

AbstractWe report the demographic distribution of non-institutionalized populations in the US who are prioritized for COVID-19 vaccination by ethnicity, age and sex and region. The composition of non-institutionalized priority populations was estimated using a nationally representative sample of 25,417 adults interviewed in the National Health Interview Survey (NHIS) in 2018. A relatively large fraction of individuals prioritized for the earliest distribution of the vaccine are women, non-Hispanic Black, and young to middle aged adults. Overall, the study provides a platform to track equity in vaccine coverage and to better tailor health communication strategies.
Diagnostic accuracy of RT-PCR for detection of SARS-CoV-2 compared to a “composite reference standard” in hospitalized patients
Authors: Reich Noah , Lowe Christopher F. , Puddicombe David , Matic Nancy , Greiner Jesse , Simons Janet , Leung Victor , Chu Terry , Naik Hiten , Myles Nick , Burns Laura , Romney Marc G. , Ritchie Gordon , Champagne Sylvie , Dooley Kent , Sekirov Inna , Stefanovic Aleksandra 
Published: February 2021

AbstractBackgroundCOVID-19 caused by the novel coronavirus SARS-CoV-2 has caused the greatest public health emergency of our time. Accurate laboratory detection of the virus is critical in order to contain the spread. Although real-time polymerase chain reaction (PCR) has been the cornerstone of laboratory diagnosis, there have been conflicting reports on the diagnostic accuracy of this method.MethodsA retrospective review was performed on all hospitalized patients tested for SARS-CoV-2 (at St. Pauls Hospital in Vancouver, BC) from March 13 – April 12, 2020. Diagnostic accuracy of initial PCR on nasopharyngeal (NP) swabs was determined against a composite reference standard which included a clinical assessment of the likelihood of COVID-19 by medical experts, initial and repeat PCR, and post-hoc serological testing.ResultsA total of 323 patients were included in the study, 33 (10.2%) tested positive and 290 (89.8%) tested negative by initial PCR. Patients testing positive were more likely to exhibit features of cough (66.7% vs 39.3%), shortness of breath (63.6% vs 35.9%), fever (72.7% vs 27.6%), radiographic findings (83.3% vs 39.6%) and severe outcomes including ICU admission (24.2% vs 9.7%) and mortality (21.2% vs 6.2%) compared to patients testing negative. Serology was performed on 90 patients and correlation between serology and PCR was 98.9%. There were 90 patients included in the composite reference standard. Compared to the composite reference standard, initial PCR had sensitivity of 94.7% (95% CI 74.0 to 99.9%), specificity of 100% (95% CI 94.9 to 100%), positive predictive value of 100% (95% CI 81.5 to 100%) and a negative predictive value of 98.6% (95% CI 92.5 to 100%).DiscussionOur study showed high sensitivity of PCR on NP swab specimens when compared to composite reference standard in hospitalized patients. High correlation of PCR with serological testing further increased confidence in the diagnostic reliability of properly collected NP swabs.
Central diabetes insipidus induced by temozolomide: A literature Review
Authors: Hossain Mohammad D. , Siddik Abu Bakar , Pinky Susmita Dey , Sauda Tonazzina Hossain , Nasreen Fahtiha , Sarker Pallab , Rahman Masum 
Published: February 2021

AbstractTemozolomide has been the most used chemotherapeutic drug for glioblastoma and various CNS malignancies. Although myelosuppression has the most severe adverse effect, central diabetes insipidus (CDI) has been found as an infrequent side effect. CDI is characterized by decreased antidiuretic hormone secretion from posterior pituitary, thereby the inability to concentrate the urine with variable degrees of polyuria and compensatory polydipsia. Following a comprehensive literature search of several databases from 1990 to October 2020, which were limited to the English language, patient data were analyzed to demonstrate the risk factors, severity, reversibility of the disease, and overall survival. Total nine cases found who developed CDI following TMZ treatment. All patients manifest hyperosmolar symptoms like polyuria and polydipsia within 3 to 12 weeks following temozolomide initiation. Clinical and laboratory features, therapeutic response to exogenous desmopressin, and clinical course have been summarized.