bluuebunny/crossref_metadata_2025_split huggingface dataset:
Characterization of Ciprofloxacin Resistance Levels: Implications for Ototopical Therapy
Authors: Trinh Katherine V. , Ruoff Kathryn L. , Rees Christiaan A. , Ponukumati Aravind S. , Martin Isabella W. , O’Toole George A. , Saunders James E. 
Published: March 2021

Hypothesis:
Ciprofloxacin-resistant pathogens are inhibited by high concentrations of ciprofloxacin found in commercially-available ototopical solutions.

Background:
Ciprofloxacin-resistant pathogens in otitis media are currently treated with ototopical ciprofloxacin suspensions. This is done irrespective of laboratory-reported ciprofloxacin susceptibility, under the assumption that the high concentration of ciprofloxacin applied topically is sufficient to overcome antimicrobial resistance.

Methods:
We evaluated 34 ciprofloxacin-resistant isolates consisting of Staphylococcus aureus, Pseudomonas aeruginosa, Corynebacterium spp., and Turicella otitidis. Ciprofloxacin minimum inhibitory concentration (MIC) assays and clinical ototopical solution minimum bactericidal concentration (CMBC) assays were performed.

Results:
Amongst the ciprofloxacin-resistant isolates, ciprofloxacin MICs ranged from 8 to 256 mcg/ml (mean: 87.1 mcg/ml) and CMBCs ranged from 23.4 to 1500 mcg/ml (mean: 237.0 mcg/ml). There were no significant differences with respect to MIC in comparing P. aeruginosa versus Corynebacterium spp. (mean: 53.3 versus 55.2, p = 0.86), S. aureus versus P. aeruginosa (mean: 128.0 versus 53.3, p = 0.34), and S. aureus versus Corynebacterium spp. (mean: 128.0 versus 55.2, p = 0.09). The correlation between ciprofloxacin MIC and CMBC was poor (Pearson's r = –0.08, p = 0.75).

Conclusions:
Ciprofloxacin-resistant pathogens commonly recovered from otitis media exhibit highly variable ciprofloxacin MIC and CMBC levels. Ciprofloxacin was able to inhibit growth in all isolates tested at MIC levels less than or equal to 256 mcg/ml; however, CMBC's up to 1500 mcg/ml were observed within that same group. The clinical relevance of these in vitro MICs is unclear due in part to higher bactericidal concentrations (CMBC) in several strains. Our results suggest that treatment failures may be due to a combination of factors rather than high-level resistance alone.
Audiologic Outcomes After Oval and Round Window Reinforcement Surgery
Authors: Conway Robert M. , Tu Nathan C. , Pinther Steven , Shareef Zaid , Hong Robert S. , Zappia John J. , Babu Seilesh C. 
Published: March 2021

Introduction:
Oval window (OW) and round window (RW) reinforcement surgery has been used for symptomatic treatment of multiple clinical entities, most commonly perilymphatic fistula and superior semicircular canal dehiscence. Owing to the theoretical acoustically negative effect of stiffening the windows, there has been concern of an unfavorable effect on audiologic outcomes due to the procedure. The purpose of this study is to specifically evaluate audiologic outcomes after OW and RW reinforcement.

Methods:
A retrospective review of patients undergoing transcanal OW or RW reinforcement was completed. Patients were evaluated both as a total group and as two groups separated into “third window” and “two-window” groups based on their specific diagnosis. Primary outcomes included changes in individual pure-tone thresholds, pure-tone average (PTA), air-bone gap, speech reception threshold (SRT), and word recognition scores (WRS) between the preoperative and postoperative groups.

Results:
Seventy-one patients were included in the study. The combined cohort demonstrated a significant postoperative 2.75 dB increase in the air conduction hearing level at 4000 Hz (p < 0.05). This was almost entirely accounted for by a 2.18 dB increase in the air-bone gap at this frequency (p < 0.05). There were no significant changes in PTA, SRT, or WRS between in the combined group or in the subgroup analysis.

Conclusion:
OW and RW tissue reinforcement resulted in a statistically significant but likely clinically insignificant decrease in hearing at the 4000 Hz frequency. There was no worsening of PTA, WRS, or SRT.
Association Between Laryngopharyngeal Reflux and Media Otitis: A Systematic Review
Authors: Lechien Jerome R. , Hans Stéphane , Simon Francois , Horoi Mihaela , Calvo-Henriquez Christian , Chiesa-Estomba Carlos M. , Mayo-Yáñez Miguel , Bartel Ricardo , Piersiala Krzysztof , Nguyen Yann , Saussez Sven 
Published: March 2021

Objectives:
To investigate the relationship between laryngopharyngeal reflux (LPR) and recurrent (ROM) or chronic otitis media with effusion (COME).

Databases:
PubMed, Scopus, and Cochrane Library.

Methods:
Three authors searched articles published between January 1980 and September 2020 about the association between LPR and the development of recurrent or chronic otitis media. Inclusion, exclusion, diagnostic criteria, and clinical outcome evaluation of included studies were analyzed using PRISMA criteria. The bias analysis of included studies was evaluated with the Tool to assess Risk of Bias of the CLARITY group.

Results:
Twenty-six clinical and three experimental articles met our inclusion criteria, accounting for 1,624 children and 144 adults with COME or ROM. According to the pH study type, the prevalence of LPR and gastroesophageal reflux disease (GERD) in OM patients were 28.7% (range, 8–100%) and 40.7 (range, 18–64%), respectively. The majority of studies identified pepsin or pepsinogen in middle ear effusion, with a range of mean concentrations depending on the technique used to measure pepsin. There was an important heterogeneity between studies regarding definition of COME, ROM, and LPR, exclusion criteria, methods used to measure pepsin/pepsinogen in middle ear secretions and outcome assessments.

Conclusion:
The association between LPR and OM is still unclear. Future clinical and experimental studies are needed to investigate the association between LPR and OM in both children and adults through extensive gastric content analysis in middle ear suppurations and impedance-pH monitoring considering acid, weakly acid, and alkaline reflux events.
Extended Middle Cranial Fossa Approach for Placement of Auditory Brainstem Implants
Authors: Shapiro Scott B. , Lipschitz Noga , Hammer Theresa , Wenstrup Lisa , Zuccarello Mario , Samy Ravi N. 
Published: March 2021

Objective:
Traditionally, auditory brainstem implants (ABIs) have been placed via the translabyrinthine or retrosigmoid approaches. In select patients, a modified extended middle cranial fossa (xMCF) approach with tentorial ligation may be advantageous for vestibular schwannoma (VS) resection and auditory rehabilitation. This manuscript describes the application of this modification of the MCF approach for simultaneous VS resection and ABI placement.

Patients:
Patients with neurofibromatosis type 2, profound bilateral sensorineural hearing loss, single functioning sigmoid/jugular venous system, and giant (>4 cm) VS.

Interventions:
Simultaneous VS resection and ABI placement via a modified xMCF approach with tentorial ligation.

Main Outcome Measures:
Extent of tumor removal and brainstem decompression, access to lateral recess of the fourth ventricle, functional hearing improvement, surgical complications.

Results:
Two patients met indications and underwent surgery. There were no immediate or delayed surgical complications. Both had subtotal tumor removal with significant decompression of the brainstem and ABI placement. One patient achieved voice and environmental sound awareness at 35 to 55 dbHL across frequencies. The second patient presented with failure to thrive and multiple lower cranial neuropathies in addition to the above-listed indications. She was hospitalized multiple times after surgery due to failure to thrive and recurrent aspiration pneumonia. Her device was never activated, and she expired 1 year after surgery.

Conclusions:
The xMCF with tentorial ligation is an additional approach for tumor resection and ABI placement in selected patients with neurofibromatosis type 2. Future studies will further define when this approach is most applicable as well as the challenges and pitfalls.
Hemoperitoneum associated with uterine fibroids
Authors: Daimon Atsushi , Tanaka Tomohito , Kogata Yuhei , Tanaka Yoshimichi , Fujita Daisuke , Ohmichi Masahide 
Published: March 2021

Abstract

Introduction:
Uterine fibroids, which are common benign tumors, rarely cause acute complications. We herein report a case of hemoperitoneum associated with uterine fibroid that could be diagnosed preoperatively with contrast-enhanced computerized tomography (CT).

Patient concerns:
A 48-year-old woman with uterine fibroid developed extremely severe lower abdominal pain on the first day of her menstrual period.

Diagnosis:
Ultrasonography and contrast-enhanced CT revealed a uterine fibroid and extravasation from the dilated vessels of the uterine fibroid.

Intervention:
Emergent abdominal hysterectomy was performed.

Outcomes:
The total amount of bleeding was 4,600 mL. Intraoperative blood salvage (1,357 mL), 6 units of red blood cells, 4 units of fresh frozen plasma, and 20 units of platelet concentrates were transfused. The postoperative course was uneventful. Pathological examination confirmed a benign uterine fibroid.

Conclusion:
CT could be useful to determine a diagnosis for bleeding from ruptured subserosal uterine fibroid.
Rare malignant spindle cell sarcoma of the left atrium diagnosed with TEE
Authors: Sun Yuan-Yuan , Wang Xin-yu , Zhang Guo-Ming , Chen Xu , Jing Bo , Wu Yuan , Song Yu , Su Mao-Long 
Published: March 2021

Abstract

Introduction:
One of the purposes of echocardiography is to determine the nature of a space-occupying lesion. The conventional transthoracic echocardiogram (TTE) is the preferred method for the diagnosis of cardiac space-occupying lesions as it can reveal the baseline information. For patients with poor conditions, however, TTE cannot clearly display the boundary, it has a limited role in determining the nature of the lesions.

Patient concerns:
A 47-year-old woman presented with intermittent fever for 7 days and chest distress/shortness of breath for 5 days.

Diagnosis:
In our current case, we inferred the nature of space-occupying lesions in the left atrium more accurately using transesophageal echocardiography (TEE) than TTE, which may offer diagnostic evidence for surgical treatment.

Interventions:
The patient underwent surgical resection of the left atrial tumor and reconstruction of the left atrial wall. However, the patient's posterior lobe of the mitral valve was infiltrated by tumor, which was difficult to completely remove.

Outcomes:
Echocardiography was performed 3 months after surgery and the tumor recurred in the posterior lobe of the mitral valve. Although almost all tumors have been removed by surgery, the average survival time is often less than 1 year, as it is difficult to completely remove and easy to relapse with poor prognosis.

Conclusion:
Transesophageal echocardiography (TEE) plays a relatively more important role in the determination and differential diagnosis of cardiac space-occupying lesions
Effectiveness of home visiting on patients with hypertension
Authors: Ma Yuxia , Lu Hongmei , Zhang Yuanyuan , Wang Yutan , Li Sijun , Yan Fanghong , Han Lin 
Published: March 2021

Abstract

Background:
Blood pressure lowering treatments can help prevent cardiovascular disease. However, little is known about the possibility of home visiting programs for hypertension. This study aims to evaluate the effectiveness of home visiting programs on hypertensive patients.

Methods:
We systematically reviewed the medical literature and performed a meta-analysis. Five electronic databases were systematically searched from their inception to September 2019. Two reviewers independently assessed the risk of bias of the studies included in the review using tools developed by the Cochrane Collaboration. The meta-analysis was performed using Review Manager software (version 5.3).

Results:
Thirteen RCTs with 2674 participants were identified. The home visiting program demonstrated a greater reduction in systolic blood pressure (MD = −5.63, 95% confidence interval (CI): −8.32 to −2.94), diastolic blood pressure (MD = −4.14, 95% CI: −6.72 to −1.56) and waist circumference (MD = −2.61, 95% CI: −3.5, −1.72) during a 6 month intervention. However, there were no significant differences between the groups in terms of body mass index, weight, or blood lipids.

Conclusion:
Home visiting programs were associated with improved BP control and reduced blood pressure, which indicate that it might be an effective method for management of hypertension.
Gene diagnosis and pedigree analysis of two Han ethnicity families with propionic acidemia in Fujian
Authors: Chen Yao , Lin Xuehua , Lin Qingying , Zeng Yinglin , Qiu Xiaolong , Liu Guanghua , Zhu Wenbin 
Published: March 2021

Abstract
Propionic acidemia is associated with pathogenic variants in PCCA or PCCB gene. We investigated the potential pathogenic variants in PCCA or PCCB genes in Fujian Han population.
Two probands and their families of Han ethnicity containing two generations were subject to newborn screening using tandem mass spectrometry, followed by diagnosis using urine gas chromatography mass spectrometry. Sanger sequencing was used to identify potential mutations in PCCA and PCCB genes.
Compound heterozygous variants were identified in PCCB gene in two siblings of the first family, the youngest girl showed a novel missense variant c.1381G>C (p.Ala461Pro) in exon 13 and a heterozygous missense variant c.1301C>T (p.Ala434Val) in exon 13, which were inherited respectively from their parents. The oldest boy is a carrier with a novel missense variant c.1381G>C (p.Ala461Pro) in exon 13 which were inherited from his father. In the second family, c.1535G>A homozygous mutations were identified in the baby girl, which were inherited respectively from their parents. In silico analysis, several different types of bioinformatic software were utilized, which predicted that the novel variant c.1381G>C in PCCB gene was damaged. According to ACMG principle, the missense variant c.1381G>C (p.Ala461Pro) in exon 13 was a Variant of Undetermined Significance (VUS).
One novel missense variant and two missense variants in PCCB gene were identified in the study. The novel variant of PCCB gene identified VUS was identified for the first time in the Chinese population, which enriched the mutational spectrum of PCCB gene.
Liberal blood transfusion strategies and associated infection in orthopedic patients
Authors: Wang Ying , Chen Junli , Yang Zhitang , Liu Yugang 
Published: March 2021

Abstract

Objective:
It remains unclear whether transfusion strategies during orthopedic surgery and infection are related. The purpose of this study is to evaluate whether liberal blood transfusion strategies contribute to infection risk in orthopedic patients by analyzing randomized controlled trials (RCTs).

Methods:
RCTs with liberal versus restrictive red blood cell (RBC) transfusion strategies were identified by searching PubMed, Embase, the Cochrane Central Register of Controlled Trials from their inception to July 2019. Ten studies with infections as outcomes were included in the final analysis. According to the Jadad scale, all studies were considered to be of high quality.

Results:
Ten trials involving 3938 participants were included in this study. The pooled risk ratio (RR) for the association between liberal transfusion strategy and infection was 1.34 (95% confidence intervals [CI], 0.94–1.90; P = .106). The sensitivity analysis indicated unstable results, and no significant publication bias was observed.

Conclusion:
This pooled analysis of RCTs demonstrates that liberal transfusion strategies in orthopedic patients result in a nonsignificant increase in infections compared with more restrictive strategies. The conclusions are mainly based on retrospective studies and should not be considered as recommendation before they are supported by larger scale and well-designed RCTs.
Trimetazidine reduces contrast-induced nephropathy in patients with renal insufficiency undergoing coronary angiography and angioplasty
Authors: Heshmatzadeh Behzadi Ashkan , Amoozgar Behzad , Jain Shalini , Velasco Noel , Zahid Umar , Abbasi Hamidreza , Alasadi Lutfi , Prince Martin R. 
Published: March 2021

Abstract

Objectives:
This systematic review and meta-analysis assesses the utility of trimetazidine (TMZ) to prevent contrast induced nephropathy (CIN) in patients with renal insufficiency undergoing coronary angiography and angioplasty.

Materials and methods:
This meta-analysis was formulated and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A search of databases was conducted by 2 researchers independently for clinical trials, comparing hydration plus TMZ vs conventional hydration alone for prevention of CIN through January 2020. All patients had renal insufficiency (defined as GFR < 89 ml/minute/1.73 m2) and the outcome of interest was the incidence of contrast induced acute kidney injury. The odds ratio (OR) was estimated with 95% confidence interval (CI). Heterogeneity was reported with the I
2 statistic, using a fixed-effects model, and >50% of I
2 was considered to be statistically significant.

Results:
Eleven studies, 1611 patients, met the inclusion/exclusion criteria: 797 patients comprised the TMZ plus hydration group and the remaining 814 patients comprised the control (hydration only) group. Heterogeneity was low I
2 = 0%, P = .84, and the heterogeneity of each study was also low. The incidence of CIN in the TMZ plus hydration group was 6.6% (53/797), while the incidence of CIN in the control (hydration only) group was 20% (165/814). Pooled analysis of all studies showed TMZ reduced incidence of CIN compared to saline hydration alone (OR risk 0.30, 95% CI 0.21, 0.42, P < .0001).

Conclusion:
TMZ added to hydration reduces CIN in renal insufficiency patients undergoing coronary angiography.
TuYou-County Pediatric Eye (TYPE) study, design issues, baseline demographic characteristics, and implications
Authors: Zhang Xiaoli , Yang Yajun , Zhang Song , Zhang Han , Yao Litong , Liu Lei , Li Huixia , Zhang Xiaoguang , Guo Shixuan , Qi Lao , Zhou Lili , She Jie , Zhao Bin , Bian Xiaoyan , Zhang Guisen 
Published: March 2021

Abstract
To report the rationale, design, and baseline demographic characteristics of TuYou-County Pediatric Eye study, which mainly aimed to determine the retinal microvascular changes with optical coherence tomography angiography (OCTA) and its association with eye abnormalities in school aged children and adolescents at suburban location in Northern China.
TuYou-County Pediatric Eye study was a school-based survey conducted in TuYou-County. Multi-ethnic (Mongol, Han, and Hui) participants will be followed up for 5 years. Standardized ophthalmological examinations include visual acuity, ocular biometry, retinal photography, and OCTA. A questionnaire survey was conducted to collect variables regarding to eye disease such as parental history of eye diseases, near work, outdoor activities, living and eating habits, etc.
After sampling, 687 participants were eligible for investigation, and 20 students did not attend the investigation, living 667 (response rate, 97.1%) students completed questionnaires and all ocular examinations. The average age of all participants was 14.9 ± 5.11.
TYPE study is the first large-scale school-based multi-ethnic survey in suburban site of Northern China. Continuous identification of retinal microvascular changes with eye diseases will provide new insights into the control related diseases in school-age children and adolescents.
Low FOXJ2 expression is associated with unfavorable postoperative prognosis of patients with epithelial ovarian cancer
Authors: Li Yong , Zhu Xinghua , Liu Chunhua , Han Qing , Chen Xiaojing , Liu Yushan , Yin Yi , He Aiqin , Xia Fei 
Published: March 2021

Abstract
The forkhead box (FOX) family is a large and diverse group of transcription factors. Forkhead box J2 (FOXJ2) is a member of the FOX family that is aberrantly expressed in a variety of cancers. However, its role in epithelial ovarian cancer (EOC) remains elusive. The purpose of this study was to evaluate the prognostic value of FOXJ2 expression in patients with epithelial ovarian cancer.
The current study retrospectively included 151 patients with EOC from January 2013 to September 2016. FOXJ2 expression was analyzed by immunohistochemistry based on tissue microarrays. Then, the prognostic value of FOXJ2 expression and clinical outcomes were evaluated by Kaplan–Meier and cox regression analysis.
Low FOXJ2 expression was associated with high International Federation of Gynecology and Obstetrics (FIGO) stage. Kaplan–Meier curves showed that high FOXJ2 expression was associated with improved median overall survival (OS, 57.9 vs 31.9 months; P = .037) and longer median progression-free survival (PFS, 31.8 vs 18.1 months; P = .012). Univariate analysis demonstrated that FOXJ2 expression was significantly correlated with OS and PFS in patients with epithelial ovarian cancer. Multivariate analysis revealed FOXJ2 expression as an independent prognostic factor of progression-free survival of epithelial ovarian cancer patients.
Low FOXJ2 expression is a novel adverse prognostic factor of clinical outcome in epithelial ovarian cancer.
Prevalence and correlates of dyslipidemia in HIV positive and negative adults in Western Kenya
Authors: Tilahun Hailu , Masyuko Sarah J. , Mogaka Jerusha N. , Temu Tecla , Kinuthia John , Osoti Alfred O. , Nakanjako Damalie , Farquhar Carey , Page Stephanie T. 
Published: March 2021

Abstract
There is increasing morbidity and mortality from cardiovascular diseases (CVD) in sub-Saharan Africa (SSA). Dyslipidemia is a well-known CVD risk factor which has been associated with human immunodeficiency virus (HIV) infection and its treatment in high-income countries. Studies in SSA that have examined the relationship between HIV and dyslipidemia have reported mixed results. In this study, we sought to determine the prevalence of dyslipidemia in HIV positive and negative adults (>=30 years old) and evaluate for association in Western Kenya with a higher prevalence expected among HIV positive individuals.
HIV positive adults receiving antiretroviral therapy (ART) and HIV negative individuals seeking HIV testing and counseling services were recruited into a cross-sectional study. Demographic and behavioral data and fasting blood samples were collected. Dyslipidemia was defined according to the National Cholesterol Education Program Adult Treatment Panel III. Associations between baseline demographic and clinical variables and dyslipidemia were analyzed using logistic regression.
A total of 598 participants, 300 HIV positive and 298 HIV negative adults were enrolled. Dyslipidemia data was available for 564 (94%) participants. In total, 267 (47%) had dyslipidemia. This was not significantly different between HIV positive and HIV negative individuals (46% vs 49%, P = .4). In a multivariate analysis including both HIV positive and negative individuals, adults 50 to 59 years of age had a 2-fold increased risk of dyslipidemia (Odds ratio [OR] 2.1, 95% confidence interval (1.2–3.5) when compared to 30 to 39-years-old participants. Abdominal obesity (OR 2.5), being overweight (OR 1.9), and low fruit and vegetable intake (OR 2.2) were significantly associated with dyslipidemia. Among HIV positive participants, time since HIV diagnosis, ART duration, use of (PI) protease inhibitor-based ART, viral load suppression, current cluster of differentiation (CD4) count and nadir CD4 did not have significant associations with dyslipidemia.
The prevalence of dyslipidemia is high in Western Kenya, with nearly half of all participants with lipid abnormalities. Dyslipidemia was not significantly associated with HIV status, or with HIV-specific factors. Older age, being overweight, abdominal obesity, and low fruit and vegetable intake were associated with dyslipidemia and may be targets for public health interventions to lower the prevalence of dyslipidemia and CVD risk in sub-Saharan Africa.