bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vitamin D supplementation and improvement of pneumonic children at a tertiary pediatric hospital in Egypt
Authors: Labib John Rene , Ibrahem Sally Kamal , Ismail Mohamed M. , Fatah Shaimaa A.M. Abd El , Sedrak Amal Samir , Attia Mona Adel Soliman , El-Hanafi Hadeel Mohammad , Kamel Mai Hamed 
Published: March 2021

Abstract

Background:
Despite the well-recognized effect of vitamin D in metabolism and homeostasis, there is now growing interest in its probable association with pneumonia. This study aims to supply vitamin D3 (Cholecalciferol) (100,000 IU) to pneumonic children to minimize the duration of illness and improve their outcome.

Methods:
A double-blinded, randomized, placebo-controlled trial was conducted in a Pediatric Cairo University affiliated hospital. An intervention arm (93 children) and a control arm (98 children), who had pneumonia with an insufficient or deficient level of vitamin D and whose parental permission was obtained, were enrolled in the trial. All children were treated with antibiotics according to WHO guidelines. Children were given a single injection of 1 mL of 100,000 IU of vitamin D3 or placebo. Clinical data were recorded every eight hours for all children. Outcomes were assessed 7 days after vitamin D injection.
The primary outcome variable was the change in serum level of 25(OH)D, while the secondary outcomes were the medical state of the assigned cases (improvement or death) and duration between enrollment and hospital discharge for improved cases.

Results:
In the supplementation group, the percentage of patients who suffered either deficient (38.7%) or insufficient levels (61.3%) of 25 (OH)D at day one had significantly decreased in the seventh day to (11.8%) and (52.7%), respectively. Kaplan--Meier plots highlighted that the median time to recover of the placebo group was significantly longer than that of the supplementation group (Log Rank P value < .001).

Conclusion:
VDD was detected in pediatric critical care children. In pneumonic children with high VDD, it is illustrated that Vitamin D supplementation is accompanied by lowered mortality risk and pSOFA scores, reduced time to recover, and improved PaO2/FiO2.

Trial registration:
Trial Identifier number: NCT04244474. Registered on 27 January 2020- Retrospectively registered at ClinicalTrials.gov https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S0009JXO&selectaction=Edit&uid=U0004UO8&ts=152&cx=9cceq6
The impact of exercise training for chronic heart failure patients with cardiac resynchronization therapy
Authors: Guo Ran , Wen Yi , Xu Ying , Jia Ruikun , Zou Song , Lu Sijie , Liu Guobin , Cui Kaijun 
Published: March 2021

Abstract

Background and objective:
Systematically review the current published literature on the impact of exercise training (ET) in chronic heart failure (CHF) patients who were conducted cardiac resynchronization therapy (CRT).

Methods:
PubMed, EMBASE, and the Cochrane Library of Controlled Trails databases were searched for trials comparing the additional effects of ET in CHF patients after CRT implantation with no exercise or usual care control up until 2020.03.07. We independently screened the literature, extracted data, employed the tool for the assEssment of Study qualiTy and reporting in EXercise (TESTEX) to evaluate study quality and risk of bias, and performed meta-analysis with Revman 5.3 software.

Results:
Eight trials were identified for qualitative analysis and 7 randomized controlled trails (RCTs) included 235 participants (120 ET; 115 controls) for quantitative analysis. The results showed that the maximal workload (mean difference [MD] 26.32 W, 95% CI 19.41–33.23; P < .00001, I
2 = 0%) and the exercise duration (MD 68.95 seconds, 95% CI 15.41–122.48; P = .01, I
2 = 76%) had significant improvement in the ET group versus control. Subgroup analysis showed that compared with control, the change in peak oxygen uptake (VO2) (MD 3.05 ml/kg/minute, 95% CI 2.53–3.56; P < .00001, I
2 = 0%), left ventricular ejection fraction (LVEF) (MD 4.97%, 95% CI 1.44–8.49; P = .006, I
2 = 59%), and health related quality of life (HRQoL) (the change in Minnesota living with heart failure questionnaire [MLHFQ]: MD −19.96, 95% CI −21.57 to −18.34; P < .00001, I
2 = 0%) were significantly improved in the light to moderate intensity training (non-HIT) group, while there seemed no statistical difference of above endpoints in the high intensity training (HIT) group.

Conclusion:
During the short term (up to 6 months), non-HIT could improve exercise capacity, cardiac function, and HRQoL in CHF patients with CRT. However, due to the small number of participants, a high-quality large-sample multicenter trial is demanded.
Physical health and emotional and behavioral problems in maltreated children according to family economic status
Authors: Jung Jin Hee , Kwak Young Ho 
Published: March 2021

Abstract
Low family income is a risk factor for child maltreatment. However, there has been no comparative study on the association between child maltreatment and family income. The objective of this study was to investigate the physical health and emotional and behavioral problems of maltreated children according to the economic status of their family.
Cross-sectional nationwide study
Data from 2012 to 2014 was extracted from the Korean National Child Abuse Registry (age <18 years) operated by the National Child Protection Agency (NCPA). Demographic characteristics and 34 physical health and emotional/behavioral problems of maltreated children were compared by family economic status. Family economic status was classified into 2 groups: families receiving the National Basic Livelihood Guarantee (NBLG) and those not receiving the guarantee (non-NBLG group).
A total of 17,128 children were registered in the system. Mean age was 9.3 years (SD 4.8 years), 44.4% were females, and 29.2% were in the NBLG group. Poor hygiene, anxiety, and attention deficit were frequently reported physical and emotional health problems. Common behavioral problems included running away, rebelliousness/impulsivity/aggressiveness, maladjustment in school, learning problems at school, and frequent unauthorized absenteeism and truancy. Physical health problems (7 of 8 items) occurred more often in the NBLG group, and behavioral problems (6 of 17 items) occurred more often in the non-NBLG group.
Children in Korea who are maltreated have different physical health, emotional, and behavioral problems depending on their family income level. These results can be useful in approaching the recognition of and interventions for child maltreatment.
Iron chelators reverse organ damage in type 4B hereditary hemochromatosis
Authors: Wu Ling-yan , Song Zhen-ya , Li Qing-hai , Mou Li-jun , Yu Ying-ying , Shen Si-si , Song Xiao-xiao 
Published: March 2021

Abstract

Rationale:
Hereditary hemochromatosis (HH) is a hereditary disorder of iron metabolism. It is classified into 4 main types depending on the underlying genetic mutation: human hemochromatosis protein (HFE) (type 1), hemojuvelin (HJV) (type 2A), HAMP (type 2B), transferrin receptor-2 (TFER2) (type 3), and ferroportin (type 4). Type 4 HH is divided into 2 subtypes according to different mutations: type 4A (classical ferroportin disease) and type 4B (non-classical ferroportin disease). Type 4B HH is a rare autosomal dominant disease that results from mutations in the Solute Carrier Family 40 member 1 (SLC40A1) gene, which encodes the iron transport protein ferroportin.

Patient concerns:
Here we report 2 elderly Chinese Han men, who were brothers, presented with liver cirrhosis, diabetes mellitus, skin hyperpigmentation, hyperferritinaemia as well as high transferrin saturation.

Diagnosis:
Subsequent genetic analyses identified a heterozygous mutation (p. Cys326Tyr) in the SLC40A1 gene in both patients.

Interventions:
We treated the patient with iron chelator and followed up for 3 years.

Outcomes:
Iron chelator helped to reduce the serum ferritin and improve the condition of target organs, including skin, pancreas, liver as well as pituitary.

Lessons:
Type 4B HH is rare but usually tends to cause multiple organ dysfunction and even death. For those patients who have difficulty tolerating phlebotomy, iron chelator might be a good alternative.
Risk factors for postoperative pneumonia and prognosis in lung cancer patients after surgery
Authors: Yao Lijun , Luo Jun , Liu Lu , Wu Qingchen , Zhou Ruiqin , Li Linjun , Zhang Cheng 
Published: March 2021

Abstract
Postoperative pneumonia (POP) is one of the most frequent complications following lung surgery. The aim of this study was to identify the risk factors for developing POP and the prognostic factors in lung cancer patients after lung resection.
We performed a retrospective review of 726 patients who underwent surgery for stages I–III lung cancer at a single institution between August 2017 and July 2018 by conducting logistic regression analysis of the risk factors for POP. The Cox risk model was used to analyze the factors influencing the survival of patients with lung cancer.
We identified 112 patients with POP. Important risk factors for POP included smoking (odds ratio [OR], 2.672; 95% confidence interval [CI], 1.586–4.503; P < .001), diffusing capacity for carbon monoxide (DLCO) (40–59 vs ≥80%, 4.328; 95% CI, 1.976–9.481; P < .001, <40 vs ≥80%, 4.725; 95% CI, 1.352–16.514; P = .015), and the acute physiology and chronic health evaluation (APACHE) II score (OR, 2.304; 95% CI, 1.382–3.842; P = .001). In the Cox risk model, we observed that age (hazard ratios (HR), 1.633; 95% CI, 1.062–2.513; P = .026), smoking (HR, 1.670; 95% CI, 1.027–2.716; P = .039), POP (HR, 1.637; 95% CI, 1.030–2.600; P = .037), etc were predictor variables for patient survival among the factors examined in this study.
The risk factors for POP and the predictive factors affecting overall survival (OS) should be taken into account for effective management of patients with lung cancer undergoing surgery.
Survival analysis and treatment strategies for limb liposarcoma patients with metastasis at presentation
Authors: Wang Shicheng , Zhou Yuanxi , Wang Haifeng , Ling Jing 
Published: March 2021

Abstract
Limited data exist on patients with limb liposarcoma (LLS) with metastasis at presentation Moreover, the potential prognostic factors of this patient population are poorly documented because of its rarity. Therefore, we conducted this study to evaluate the clinicopathologic characteristics and prognostic factors for patients with metastatic LLS.
All patients with LLS with metastasis at presentation from 1975 to 2016 were identified by using the Surveillance, Epidemiology, and End Results (SEER) database. The following clinical data were derived from this clinical database: age, sex, histologic grade, subtype, size of tumor, surgery, radiotherapy, chemotherapy, vital status, cause of death, and survival duration. The Kaplan-Meier method was performed to calculate median survival time and draw survivorship curves. Cox-proportional hazards regression model was used to reveal the statistical independence between various variables.
The present study collected 184 cases from SEER database for survival analysis. Mean age was 57.8 years with 63.6% (n = 117) men. The 3-year overall survival (OS) and cancer-specific survival (CSS) rates of this population were 27.8% and 30.1%, respectively. Univariate analysis revealed that age, tumor grade, and surgery were significantly correlated with survival. Sex and tumor size did not reach significant predictor status of survival. Multivariate analysis revealed that age at diagnosis <60, low tumor grade, and local surgery were significantly correlated with improved OS and CSS.
Patients with LLS with metastasis at diagnosis experienced quite poor prognosis. Currently, surgery for the primary tumor significantly prolonged the survival of those patients, whereas chemotherapy and radiotherapy need to be further confirmed.
Clinical and laboratory features of patients with focal lymphocytic sialadenitis on minor salivary gland biopsy for sicca symptoms
Authors: Ayesha Bibi , Fernandez-Ruiz Ruth , Shrock Devin , Snyder Brittney M. , Lieberman Scott M. , Tuetken Rebecca , Field Elizabeth , Singh Namrata 
Published: March 2021

Abstract
Minor salivary gland biopsy (MSGB) is often used in patients lacking specific autoantibodies (seronegative patients) to confirm the presence of focal lymphocytic sialadenitis (FLS), which would suggest a diagnosis of Sjogren syndrome. There are no current guidelines indicating when to refer patients for MSGB. The objective of our study was to ascertain distinguishing clinical and laboratory features among individuals with sicca symptoms based on their serologic and histopathologic status, and to identify factors associated with FLS.
Using a cross-sectional study design, patients ages 18 years or older with sicca symptoms who had MSGB performed at the University of Iowa from January 2000 to December 2016 were selected for chart reviews. The clinical and laboratory features of patients with and without FLS were analyzed using exact univariate and multivariable logistic regression, with Bonferroni correction for multiple comparisons.
We identified 177 patients who had MSGB performed and available clinical data. A total of 133 patients had FLS, 37 (27.8%) were seropositive (positive-anti-Sjogren syndrome type A [SSA] and/or anti-Sjogren syndrome type B) and 96 (72.2%) were seronegative. Dry eyes (unadjusted odds ratio [OR]: 5.17, 95% confidence interval [CI]: 1.16–26.30; adjusted odds ratio [aOR]: 12.58, 95% CI: 1.70–167.77) and the presence of anti-SSA (OR: 7.16, 95% CI: 1.70–64.24; aOR: 8.82, 95% CI: 1.73–93.93) were associated with FLS. Smoking (aOR 0.27, 95% CI: 0.11–0.63) and antihistamine use (aOR 0.23, 95% CI: 0.08–0.63) were associated with lower odds of FLS.
Our study suggests that dry eyes and anti-SSA positivity are associated with FLS. Smoking and antihistamine use were associated with lower odds of FLS. In the appropriate clinical context, seronegative patients with sicca symptoms and no smoking history could be considered for MSGB. A thorough medication and smoking history should be performed in all patients before referral for MSGB.
A comparison of double single suture-button fixation, suture-button fixation, and screw fixation for ankle syndesmosis injury
Authors: Kurtoglu Alper , Kochai Alauddin , Inanmaz Mustafa Erkan , Sukur Erhan , Keskin Dogan , Türker Mehmet , Uysal Mustafa , Sen Zafer , Daldal Ismail 
Published: March 2021

Abstract
Different methods have been used throughout the years for syndesmotic injury but there is no consensus on the ideal treatment. Some methods are expensive and some have more complications. The aim of this study is to compare single suture endobutton with double suture endobutton and screw fixation for syndesmotic injury.
Sixty nine patients with syndesmotic injury with fibular fractures whom were treated with a single interosseous suture endobutton system (ZipTightTM, Zimmer Biomet), a double interosseous suture endobutton system (ZipTightTM, Zimmer Biomet) and 1 syndesmotic screw (TST, Istanbul, Turkey) were included in this study. Functional and radiological results from patient records between 2015 and 2018 were retrospectively evaluated.
Twenty patients were treated with the double interosseous suture endobutton, 23 were treated with the single interosseous suture endobutton, and 26 were treated with traditional AO screw fixation. Three patients from the screw fixation group (11.5%) required revision surgery (P < .05). All the radiologic and clinical outcomes were statistical similar in all 3 groups.
Our findings showed that the interosseous suture endobutton system is at least as safe as the screw fixation technique for treatment of syndesmosis joint injuries and can be used as an alternative to the screw method. The interosseous suture endobutton system eliminates the need for a second surgery to remove the hardware, which minimizes the probability of re-diastasis. Since our results showed no statistical difference between single and double interosseous suture endobutton systems, the less costly single endobutton system may be the better alternative.
High L1CAM expression predicts poor prognosis of patients with endometrial cancer
Authors: Guo Min , Gong Han , Nie Dan , Li Zhengyu 
Published: March 2021

Abstract

Backgroud:
Previous studies have reported that the levels of L1 cell adhesion molecule (L1CAM) indicate poor prognosis of patients with various solid tumors. However, the prognostic significance of L1CAM in endometrial cancer has remained controversial. Herein, we conducted a systematic review and meta-analysis to evaluate the prognostic value of L1CAM in endometrial cancer.

Methods:
All studies related to the association between L1CAM expression and clinical characteristics of endometrial cancer were identified by searching the PubMed, MEDLINE, EMBASE, and Web of Science databases. Primary outcomes of the meta-analysis were the hazard ratios (HRs) for overall survival (OS) and disease-free survival (DFS). Secondary outcomes were odds ratios (ORs) for clinicopathological characteristics. Publication bias and sensitivity analysis were conducted to ensure reliability of the results.

Results:
Overall, 17 studies encompassing 7146 patients were eligible for the meta-analysis. Results showed L1CAM overexpression to be significantly associated with decreased overall survival (HR = 2.87, 95% CI; 1.81–4.55, P < .001) and disease-free survival (HR = 3.32, 95% CI; 1.99–5.55, P < .001) in patients with endometrial cancer. High L1CAM expression was also related to adverse clinicopathological characteristics.

Conclusion:
This systematic review demonstrated that high L1CAM expression is correlated with poor survival outcomes and adverse clinicopathological parameters in patients with endometrial cancer.
Conservative treatment and outcome of upper cervical spine fractures in young children
Authors: Tomaszewski Ryszard , Sesia Sergio B. , Studer Daniel , Rutz Erich , Mayr Johannes M. 
Published: March 2021

Abstract
Cervical spine (C-spine) fractures in young children are very rare, and little information on treatment modalities and functional, radiographic, and patient-reported outcome exists. In this 2-center, retrospective case series, we assessed subjective and functional mid-term outcomes in children aged ≤5 years whose C-spine fractures were treated nonoperatively.
Between 2000 and 2018, 6 children (median age at injury: 23.5 months; range: 16–31 months) with C1 or C2 injuries were treated with Minerva cast/brace or soft collar brace at 1 of the 2 study centers. Two patients suffered C1 fractures, and 4 patients had lysis of the odontoid synchondrosis. Overall, 3 children had sustained polytrauma. One child died due to the consequences of massive head injury.
For the primary outcome parameter, we recorded subjective symptoms such as pain and functional restrictions due to the sequelae of C-spine injuries at follow-up.
Based on medical records, we also assessed the causes of injury, diagnostic procedures, treatments and complications, and time to fracture consolidation.
Median follow-up of the 5 surviving children was 51 months (range: 36–160 months). At the latest follow-up, 4 of 5 children did not complain of any pain. One child who sustained an open head injury in combination with a subluxation of the odontoid and undisplaced fracture of the massa lateralis reported occasional headache. All patients experienced complete fracture healing and normal range of motion of the cervical spine.
Median duration of cast/brace treatment was 8.5 weeks. Fracture healing was confirmed by computed tomography in all patients.
All C-spine injuries were managed with either Minerva cast/Halo brace or soft collar brace without complications.
In our retrospective case series, nonoperative treatment of atlas fractures and dislocations or subluxations of the odontoid in young children using Minerva casts or prefabricated Halo braces resulted in good subjective and functional outcomes at mid-term. We observed no complications of conservative treatment of C1 and C2 injuries in young children.
Arterial only anastomosis associated with modified Baudet technique in ear replantation
Authors: Pertea Mihaela , Ciobanu Petru , Poroch Vladimir , Velenciuc Natalia , Lunca Sorinel , Anghelina Florin , Palade Dragos Octavian 
Published: March 2021

Abstract

Background:
Total ear amputation is a relatively rare trauma with an absolute indication for surgical treatment. Numerous techniques for auricular reconstruction have been described. When local and general conditions allow microsurgical replantation, this must be the first choice. We propose the association of microsurgical techniques with some modification (modified Baudet technique) to obtain higher survival rate of the reimplanted stump.

Methods:
This study included cases of 3 male patients with total ear amputation, the injuries and their mechanism (workplace accident) being identical. Chief complaints were pain, bleeding, important emotional impact due by an unaesthetic appearance. The established diagnosis was traumatic complete ear amputation (grade IV auricular injury according to Weerda classification). Microsurgical replantation was performed only with arteriorraphy, and no vein anastomosis. Cartilage incisions and skin excisions were made to enlarge the cartilage-recipient site contact area. Medicinal leeches were used to treat venous congestion, to which systemic anticoagulant therapy was added.

Results:
The results showed the survival of the entire replanted segment in all cases, with good function and esthetical appearance. Patients were fully satisfied with the final outcome.

Conclusion:
Microsurgical replantation is the gold standard, for the surgical treatment of total ear amputation. We believe that cartilage incisions and the increased surface of contact between cartilage and recipient site has an adjuvant role in revascularization of the amputated stump (with only arterial anastomosis) and the use of hirudotherapy helps to relieve early venous congestion.