bluuebunny/crossref_metadata_2025_split huggingface dataset:
Traditional East Asian herbal medicines for the treatment of poststroke constipation
Authors: Jin Chul , Jang Bo-Hyoung , Jeon Jin Pyeong , Lee Ye-Seul , Yang Seung-Bo , Kwon Seungwon 
Published: April 2021

Abstract

Background:
Post-stroke constipation is a major complication of stroke and increases the incidence of poor neurological outcomes and infectious complications and, therefore, warrants active and prompt treatment. In East Asian countries, several types of herbal medicines have been used for the treatment of post-stroke constipation because they are considered safer than existing pharmacotherapies. However, no systematic review has investigated the efficacy and safety of traditional East Asian herbal medicine in the treatment of post-stroke constipation. With this systematic review and meta-analysis, we aimed to evaluate the efficacy and safety of traditional East Asian herbal medicines for the treatment of post-stroke constipation.

Methods and analysis:
Eight electronic databases will be searched for relevant studies published from inception to April 2021. Only randomized controlled trials (RCTs) that assess the efficacy and safety of traditional East Asian herbal medicines for the treatment of post-stroke constipation will be included in this study. The methodological qualities, including the risk of bias, will be evaluated using the Cochrane risk of bias assessment tool. After screening the studies, a meta-analysis of the RCTs will be performed, if possible.

Results:
This study is expected to generate high-quality evidence of the efficacy and safety of herbal medicines to treat post-stroke constipation.

Conclusion:
Our systematic review will provide evidence to determine whether herbal medicines can be effective interventions for patients with post-stroke constipation.

Ethics and dissemination:
Ethical approval is not required, as this study was based on a review of published research. This review will be published in a peer-reviewed journal and disseminated electronically and in print.

Trial registration number:
Research registry reviewregistry1117
Efficacy of cognitive behavioral therapy on mood and quality of life for patients with COVID-19
Authors: Zheng Youxiang , Wang Lu , Zhu Yimei , Zeng Yan 
Published: April 2021

Abstract

Background:
There is no study that has conducted a review or meta-analysis investigating a cognitive behavioral therapy (CBT) intervention to patients with COVID19, with the aim of improving their psychological health. Therefore, in order to provide new evidence-based medical evidence for clinical treatment, we undertook a systematic review and meta-analysis to assess the effectiveness of CBT in relieving patients’ psychological distress and improving quality of life during the COVID-19 epidemic.

Methods:
Seven electronic databases including Web of Science, Embase, PubMed, Wanfang Data, Scopus, Science Direct, Cochrane Library will be searched in April 2021 by 2 independent reviewers. For search on PubMed, the following search terms will be used: “COVID-19, 2019 Coronavirus Disease, 2019-nCoV, cognitive behavioral therapy, CBT, cognitive behavioral treatment.” In order to achieve a consistency (at least 80%) of extracted items, the data extractors will extract data from a sample of eligible studies. The outcomes include any rating scale describing stress, mood, and quality of life. Review Manager software (v 5.4; Cochrane Collaboration) will be used for the meta-analysis. Two independent reviewers will assess the risk of bias of the included studies at study level. Any disagreements will be discussed and resolved in discussion with a third reviewer.

Results:
The results of our review will be reported strictly following the PRISMA criteria.

Conclusions:
The review will add to the existing literature by showing compelling evidence and improved guidance in clinic settings.

OSF registration number:
10.17605/OSF.IO/DCRPJ.

Ethics and dissemination:
Ethical approval and patient consent are not required because this study is a literature-based study. This systematic review and meta-analysis will be published in a peer-reviewed journal.
Successful treatment of cardiac arrest following hysteroscopic surgery using extracorporeal membrane oxygenation
Authors: Chen Ting , Yao Li , Tong Fei , Zhu Chunyan 
Published: April 2021

Abstract

Rationale:
Cardiac arrest caused by water intoxication syndrome following hysteroscopic surgery is a rare but life-threatening occurrence. Extracorporeal membrane oxygenation (ECMO) is rarely used to treat water intoxication syndrome in hysteroscopic surgery. Here, we successfully treated a patient with water intoxication syndrome following hysteroscopic surgery with ECMO.

Patient concerns:
We report a rare case of cardiac arrest during hysteroscopic surgery treated with veno-venous (VV) ECMO.

Diagnosis:
Water poisoning syndrome was diagnosed by electrolyte examination, the lowest value of serum sodium was 110.7 mmol/L.

Interventions:
VV-ECMO was prescribed as a measure after traditional cardiopulmonary resuscitation.

Results:
ECMO was successfully evacuated on day 5 and the patient was discharged on day 45.

Conclusion:
Mastering the hysteroscopic operative techniques and using a bipolar hysteroscopic generator, isotonic fluid, perfusion pressures less than 100 mm Hg, and local anesthesia may reduce the risk of hysteroscopic water intoxication syndrome. During hysteroscopic surgery, patients may experience cardiac arrest and fatal water intoxication syndrome. Even when traditional cardiopulmonary resuscitation is successful, VV ECMO may contribute to the recovery of brain function if oxygenation is not maintained.
Physiotherapeutic assessment and management of chronic pelvic pain syndrome
Authors: Burzynski Bartlomiej , Jurys Tomasz , Burzynski Kamil , Cempa Katarzyna , Paradysz Andrzej 
Published: April 2021

Abstract

Introduction:
Chronic pelvic pain syndrome is difficult for the diagnosis and therapy and that means the patient attending the physician or physiotherapist may present various symptoms. There are no guidelines concern physiotherapy diagnosis and treatment of chronic pelvic pain syndrome. This study presents the physiotherapeutic assessment and management in men with pelvic pain symptoms.

Patient concerns:
Forty-six-year-old man attended the physiotherapy consulting room due to symptoms of pain in the perineum, lower abdomen, urethra, and scrotum for a year. Earlier, the patient had consulted a urologist who made a diagnosis of cystitis and prescribed medications that did not get results.

Diagnosis:
Ultrasound imaging and manual inspection (per rectum) of the pelvic floor was conducted by physiotherapist. Also, the abdominal and lower extremities muscles were assessed. Patient reported pain symptoms during examination of the musculus ischiocavernosus, puboanalis, pubococcygeus, iliococcygeus, coccygeus, and canalis pudentalis seu Alcocki.

Interventions:
The patient was given physiotherapeutic interventions consisting in the manual therapy of the lumbopelvic hip complex and the manual therapy per rectum.

Outcomes:
During 10th session of the physiotherapeutic treatment, patient reported improvement in pain symptoms. A month later, patient reported total alleviation of the pain symptoms during control visit.

Conclusion:
Therapy of chronic pelvic pain syndrome is a process that involves application of different therapies and different approaches. Functional and structural assessment and also therapy conducted by physiotherapist is becoming an integral part of urology and represents 1 possible conservative treatment form.
Pure erythroid leukemia subsequent to acute myelomonocytic leukemia
Authors: Ji Jiamei , Li Yating , Fan Lei , Lu Hua , Qu Xiaoyan 
Published: April 2021

Abstract

Rationale:
Pure erythroid leukemia is a rare subcategory of acute myeloid leukemia characterized by predominant immature erythroid population. Its occurrence subsequent to acute myelomonocytic leukemia has not been reported before. We reported this rare case to call attention because it may pose a diagnostic challenge.

Patient's concerns:
A 54-year-old female patient presented to our hospital in March 2018 with symptoms of easy fatigability.

Diagnosis:
Bone marrow aspiration was hypercellular showing 67.2% blasts mainly including moderate myeloblasts and monoblasts. There was mild dysplasia with some cells having round, oval, or bizarre nuclei which containing 1 to 3 nucleolus. Erythroid lineage was hypoplasia and mature erythrocytes were generally normal. Conventional cytogenetics of bone marrow cells revealed complex karyotype (44, XX, del (5) (q14q34) del (5) (q14q34), del (14) t (11;14) (q10; q10), −16, del (17), −18[10]).

Interventions:
The patient was treated with second line chemotherapy but did not respond.

Qutcomes:
She died of cardiopulmonary failure 19days after starting of therapy.

Lessons:
This unexpected and relatively uncommon occurrence was associated with a universally rapid and fatal clinical course with survival measured in <2 months despite intensive chemotherapy. We call attention to this rare phenomenon because it may pose a diagnostic challenge.
Analgesic comparison of dezocine plus propofol versus fentanyl plus propofol for gastrointestinal endoscopy
Authors: Zhang Lin , Li Chun , Zhao Chuncheng , Zhao Zhengzhong , Feng Yi 
Published: April 2021

Abstract

Introduction:
As the adjunctive anesthesia to propofol, both dezocine and fentanyl showed some potential for gastrointestinal endoscopy. This meta-analysis aimed to compare their efficacy and safety.

Methods:
PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases were systematically searched. Randomized controlled trials (RCTs) assessing the effect of dezocine versus fentanyl for the anesthesia of patients undergoing gastrointestinal endoscopy were included.

Results:
Five RCTs involving 677 patients were included in the meta-analysis. Overall, compared with fentanyl plus propofol for gastrointestinal endoscopy, dezocine plus propofol resulted in the reduction in propofol dose(mean difference [MD] = −11.72; 95% confidence interval [CI] = −22.83 to −0.61; P = .04), awakening time (std. MD = −1.79; 95% CI = −3.31 to −0.27; P = .02) and hypopnea (risk ratio [RR] = 0.16; 95% CI = 0.06–0.41; P = .0002), but had no remarkable effect on induction time (MD = 1.20; 95% CI = −0.98 to 3.39; P = .28), postoperative pain score (MD = −0.38; 95% CI = −1.00 to 0.24; P = .24), nausea or vomiting (RR = 0.45; 95% CI = 0.10–1.98; P = .29).

Conclusion:
Dezocine plus propofol may be better for the anesthesia of gastrointestinal endoscopy than fentanyl plus propofol.
Role of Imaging in Childhood Arthritis
Authors: Jana Manisha , Mittal Disha , Bagri Neha , Yadav Richa , Parihar Vivek , Bagri Narendra Kumar 
Published: April 2021

Abstract
Imaging plays a pivotal role in the management of various childhood arthritis. Conventional radiography is the most commonly ordered imaging modality for the evaluation of arthritis. Owing to their higher sensitivity for detecting synovitis, magnetic resonance imaging and ultrasonography are increasingly being used to guide clinical management of various forms of arthritis, especially juvenile idiopathic arthritis. Magnetic resonance imaging is a preferred modality for evaluating more complex sites such as the sacroiliac joint. In this review, we have discussed the rational use and the characteristic imaging features of common childhood arthritis.
Epidemiology of Idiopathic Inflammatory Myopathies in Africa
Authors: Essouma Mickael , Noubiap Jean Jacques , Singwe-Ngandeu Madeleine , Hachulla Eric 
Published: April 2021

Background
The epidemiology of idiopathic inflammatory myopathies (IIMs) has been extensively studied in America, Europe, and Asia, but remains unclear in Africa.

Objective
The aim of this review was to summarize available data on the epidemiology of IIMs in Africa.

Methods
We searched MEDLINE, EMBASE, and African Journals Online for studies published up to December 30, 2020, and reporting epidemiological data on IIMs in Africa. Data were combined through narrative synthesis. The review protocol was registered with PROSPERO, CRD42020186781.

Results
We included 39 studies reporting 683 cases (71.7% adults) of IIMs. Incidence rates of ~7.5/1,000,000 person-years and 1.2/1,000,000 person-years were estimated for dermatomyositis (DM), whereas polymyositis (PM) had an incidence rate of 8.8/1,000,000 person-years. Prevalence estimates of 11.49/100,000 and 11/100,000 (95% confidence interval, 0–32) were provided for IIMs and the PM subtype, respectively. Mean age at diagnosis ranged from 7.9 to 57.2 years, and 50% to 100% of the patients were females. Main subtypes of adult-onset IIMs were DM (21%–93%) and PM (12%–79%), whereas the commonest juvenile subtype was juvenile DM (5.8%–9%). Skeletal muscle involvement (56%–100%) was the main disease feature, and esophagus was the most commonly affected internal organ (6%–65.2%). Anti-Jo1/histidyl tRNA synthetase (7%–100%) and anti-Mi2 (17%–45%) antibodies were the most frequent myositis specific antibodies. Early mortality was high (7.8%–45%), and main death causes were infections, cancers and organ damage in respiratory and cardiovascular domains.

Conclusions
Apart from a potential younger age at onset of adult IIMs in Africa, current sparse data mostly suggest a similar epidemiology between Africa and other regions. Further high-quality studies are required to validate these findings.
Features and Clinical Course of Infantile Juvenile Idiopathic Arthritis
Authors: Campbell Julie A. , Shenoi Susan 
Published: April 2021

Background
Juvenile idiopathic arthritis (JIA) is a heterogeneous group of 7 chronic arthritides categories that affects children younger than 16 years. This case series elucidates the characteristics of patients from a single center diagnosed with JIA at younger than 12 months.

Methods
We included patients who presented to the rheumatology clinic for JIA with symptom onset at younger than 1 year. Chart review was conducted to complete case report forms that included demographics, historical features, examination features, laboratory results, imaging results, and treatment courses.

Results
We identified 12 patients who met our inclusion criteria. Eight of our patients were diagnosed with oligoarticular JIA, 3 had polyarticular JIA, and 1 was diagnosed with systemic JIA. Overall, 58% (7/12) of patients had joint contractures at their initial visit. Of the patients with oligoarticular JIA, 50% (4/8) required a disease-modifying antirheumatic drug to achieve disease remission; 12.5% (1/8) required biologic therapy. All of the polyarticular JIA patients had highly positive antinuclear antibodies, as well as elevated inflammatory markers.

Conclusions
Children with infantile JIA are overall similar to the larger population of patients with JIA. Disease severity may not be different compared with that of older children with JIA; however, there is likely a larger delay in diagnosis and the presence of contractures, which occurred in more than half of our patients.
Textbook Outcome
Authors: Halpern Samantha E. , Moris Dimitrios , Gloria Jared N. , Shaw Brian I. , Haney John C. , Klapper Jacob A. , Barbas Andrew S. , Hartwig Matthew G. 
Published: April 2021

Objective:
To define textbook outcome (TO) for lung transplantation (LTx) using a contemporary cohort from a high-volume institution.

Summary Background Data:
TO is a standardized, composite quality measure based on multiple postoperative endpoints representing the ideal “textbook” hospitalization.

Methods:
Adult patients who underwent LTx at our institution between 2016 and 2019 were included. TO was defined as freedom from intraoperative complication, postoperative reintervention, 30-day intensive care unit or hospital readmission, length of stay >75th percentile of LTx patients, 90 day mortality, 30-day acute rejection, grade 3 primary graft dysfunction at 48 or 72 hours, postoperative extracorporeal membrane oxygenation, tracheostomy within 7 days, inpatient dialysis, reintubation, and extubation >48 hours post-transplant. Recipient, operative, financial characteristics, and post-transplant outcomes were recorded from institutional data and compared between TO and non-TO groups.

Results:
Of 401 LTx recipients, 97 (24.2%) achieved TO. The most common reason for TO failure was extubation >48 hours post-transplant (N = 119, 39.1%); the least common was mortality (N = 15, 4.9%). Patient and graft survival were improved among patients who achieved versus failed TO (patient survival: log-rank P < 0.01; graft survival: log-rank P < 0.01). Rejection-free and chronic lung allograft dysfunction-free survival were similar between TO and non-TO groups (rejection-free survival: log-rank P = 0.07; chronic lung allograft dysfunction-free survival: log-rank P = 0.3). On average, patients who achieved TO incurred approximately $638,000 less in total inpatient charges compared to those who failed TO.

Conclusions:
TO in LTx was associated with favorable post-transplant outcomes and significant cost-savings. TO may offer providers and patients new insight into transplant center quality of care and highlight areas for improvement.
Nisin- and ripcin-derived hybrid lanthipeptides display selective antimicrobial activity againstStaphylococcus aureus
Authors: Zhao Xinghong , Kuipers Oscar P. 
Published: April 2021

ABSTRACTLanthipeptides are (methyl)lanthionine ring-containing ribosomally synthesized and post-translationally modified peptides (RiPPs). Many lanthipeptides show strong antimicrobial activity against bacterial pathogens, including antibiotic-resistant bacterial pathogens. The group of disulfide bond-containing antimicrobial peptides (AMPs) is well known in nature and forms a rich source of templates for the production of novel peptides with corresponding (methyl)lanthionine analogues instead of disulfides. Here, we show that novel macrocyclic lanthipeptides (termed thanacin and ripcin) can be synthesized using the known antimicrobials thanatin and rip-thanatin as templates. Notably, the synthesized nisin(1-20)-ripcin hybrid lanthipeptides (ripcin B-G) showed selective antimicrobial activity againstS. aureus, including an antibiotic-resistant MRSA strain. Interestingly, ripcin B-G, which are hybrid peptides of nisin(1-20) and ripcin, respectively, that are each inactive against Gram-negative pathogens, showed substantial antimicrobial activity against the tested Gram-negative pathogens. Moreover, ripcin B-G was highly resistant against the nisin resistance protein (NSR; a protease could cleave nisin and strongly reduce its activity), opposed to nisin itself. Mode of action studies show that ripcin C exerts its antimicrobial activity against Gram-positive pathogens by binding to the cell wall synthesis precursor lipid II and thereafter arrests cell growth. In addition, ripcin C exerts its antimicrobial activity against Gram-negative pathogens by binding to LPS and the cell wall synthesis precursor lipid II. This study provides an example of converting disulfide bond-based AMPs into (methyl)lanthionine-based macrocyclic hybrid lanthipeptides and can yield antimicrobial peptides with selective antimicrobial activity againstS. aureus.For Table of Contents Use Only
Resistance training rejuvenates the mitochondrial methylome in aged human skeletal muscle
Authors: Ruple Bradley A. , Godwin Joshua S. , Mesquita Paulo H. C. , Osburn Shelby C. , Vann Christopher G. , Lamb Donald A. , Sexton Casey L. , Candow Darren G. , Forbes Scott C. , Frugé Andrew D. , Kavazis Andreas N. , Young Kaelin C. , Seaborne Robert A. , Sharples Adam P. , Roberts Michael D. 
Published: April 2021

ABSTRACTResistance training (RT) alters skeletal muscle nuclear DNA methylation patterns (or the methylome). However, no study has examined if RT affects the mitochondrial DNA (mtDNA) methylome. Herein, ten older untrained males (65±7 years old) performed six weeks of full-body RT (twice weekly). Body composition and knee extensor torque were assessed prior to and 72 hours following the last RT session. Vastus lateralis (VL) biopsies were also obtained. VL DNA was subjected to reduced representation bisulfite sequencing providing excellent coverage across the ~16-kilobase mtDNA methylome (254 CpG sites). Various biochemical assays were also performed, and older male data were compared to younger trained males (22±2 years old, n=7). RT increased whole-body lean tissue mass (p=0.017), VL thickness (p=0.012), and knee extensor torque (p=0.029) in older males. RT also profoundly affected the mtDNA methylome in older males, as 63% (159/254) of the CpG sites demonstrated reduced methylation (p<0.05). Notably, several mtDNA sites presented a more “youthful” signature after RT in older males when comparisons were made to younger males. The 1.12 kilobase D-loop/control region on mtDNA, which regulates mtDNA replication and transcription, possessed enriched hypomethylation in older males following RT. Enhanced expression of mitochondrial H- and L-strand genes and increases in mitochondrial complex III and IV protein levels were also observed (p<0.05). This is the first study to show RT alters the mtDNA methylome in skeletal muscle. Observed methylome alterations may enhance mitochondrial transcription, and RT remarkably evokes mitochondrial methylome profiles to mimic a more youthful signature in older males.
Combined Inhibition of AKT and KIT Restores Expression of Programmed Cell Death 4 (PDCD4) in Gastrointestinal Stromal Tumor
Authors: Kozinova Marya , Joshi Shalina , Ye Shuai , Belinsky Martin G. , Sharipova Dinara , Farma Jeffrey M. , Reddy Sanjay , Litwin Samuel , Devarajan Karthik , Campos Alex Rosa , Yu Yi , Schwartz Brian , von Mehren Margaret , Rink Lori 
Published: April 2021

AbstractThe majority of gastrointestinal stromal tumor (GIST) patients develop resistance to the first-line KIT inhibitor, imatinib mesylate (IM), through acquisition of secondary mutations inKITor bypass signaling pathway activation. AKT is a relevant target for inhibition, in addition to KIT, since the PI3K/AKT pathway is crucial for IM-resistant GIST survival. We evaluated the activity of a novel pan-AKT inhibitor, MK-4440 (formerly ARQ 751), as monotherapy and in combination with IM in GIST cell lines and preclinical models with varying IM sensitivities. Dual inhibition of KIT and AKT demonstrated significant synergistic effects in IM-sensitive and -resistant GIST cell lines. Proteomic analyses revealed upregulation of the tumor suppressor, PDCD4, in combination treated cells. Enhanced PDCD4 expression correlated to cell cycle arrest and cell death.In vivostudies revealed superior efficacy of MK-4440/IM combination in an IM-sensitive preclinical model of GIST compared with either single agent. The combination demonstrated limited efficacy in two IM-resistant models, including a GIST patient-derived xenograft model possessing an exon 9KITmutation. These studies provide strong rationale for further use of AKT inhibition in combination with IM in primary GIST; however, alternative agents will need to be tested in combination with AKT inhibition in the resistant setting.