bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of Total Donor Endothelial Viability After Endothelium-Inward Versus Endothelium-Outward Loading and Insertion in Descemet Membrane Endothelial Keratoplasty
Authors: Chong Elaine W. , Bandeira Francisco , Finn Prema , Mehta Jodhbir S. , Chan Elsie 
Published: June 2019

Purpose:
This study compares endothelial cell density (ECD) and viability between 2 different techniques used to prepare and insert Descemet membrane endothelial keratoplasty (DMEK) donor tissues. The first technique uses the naturally forming Descemet membrane (DM) scroll where the endothelial cells face outward; in the second technique, the DM is folded into thirds (trifold) with the endothelial cells facing inward.

Methods:
Eighteen cadaveric corneas from 9 donors (matched pairs) were used to compare the 2 tissue-insertion techniques. In the scroll, endothelium-outward technique, standard DMEK preparation was used, and the naturally forming DM scroll was inserted into a Geuder Cartridge. In the trifold, endothelium-inward technique, DMEK preparation was undertaken by folding the donor tissue into thirds before being pulled into the EndoGlide Ultrathin. In each case, the tissue was injected onto a glass slide. Endothelial cell counting was performed using microscopy preinjection and postinjection, and vital staining using calcein acetoxymethyl (AM) was used for quantitative cell viability analysis across the whole tissue.

Results:
Manual ECDs using direct microscopy did not demonstrate a statistically significant difference in ECD between the 2 injection techniques. Using vital staining of the entire 8.0-mm diameter tissue, there was a significantly higher percentage of viable cells using the trifold, endothelium-inward technique (63.1%) compared with the scroll, endothelium-outward technique (41.5%) (P = 0.013). There was no difference in the pattern of cell loss between the 2 groups.

Conclusions:
Greater endothelial cell viability was observed using the trifold, endothelium-inward technique compared with the scroll, endothelium-outward technique.
Syphilis Screening Practices of Family Care Providers
Authors: Pinto Casey N. , Sneeringer Katie , Muller Alison 
Published: June 2019

Background
The incidence of syphilis has doubled since 2000 and continues to increase. Improving syphilis screening practices is an important factor in controlling the spread. The major predictors of syphilis screening among family care providers were investigated.

Methods
A cross-sectional pilot survey consisting of 27 questions was administered electronically to 3 major health systems located in central Pennsylvania. The target population consisted of primary care physicians, nurse practitioners, and physician assistants. Statistical tests were performed to measure the associations between the predictors and the primary outcome variable of syphilis screening rate.

Results
Fifty-two surveys were completed and included. There was no significant association between provider type or provider-patient contact time with syphilis screening rate (P > 0.05). A positive relationship between providers who reported having a standard spoken phrase for sexual health queries and syphilis screening rate trended toward significance (P = 0.07). Qualitative data indicated some provider bias in screening patients only when they are symptomatic or during well woman visits.

Conclusions
Family care providers who have a standard spoken phrase when addressing sexual health are more likely to ask sexual behavior questions and are more likely to screen for syphilis. Biased screening practices are aimed at women, despite higher syphilis prevalence in men, demonstrating a need for increased efforts to educate providers about syphilis, and provide training programs to encourage the assessment of patient risk for exposure to sexually transmitted diseases.
Emergency Colostomy in Craniopagus Conjoined Twins
Authors: Kottappurath Manu , Jeenepalli Srinivasa Kishore , Mandelia Ankur 
Published: June 2019

Abstract
Although nurses plays a vital role in perioperative preparation and management, no nursing literature is available regarding intraoperative preparations for surgery on a conjoined twin. We report the perioperative preparation and nursing management for an emergency nonseparation surgery for a pair of craniopagus conjoined twins.
Exertional Heatstroke in a Marathon Runner Complicated by Concurrent Use of an Antipsychotic Medication Affecting Thermoregulation
Authors: Gessel Trevor , Lin Cindy Y. 
Published: June 2019

Abstract:
We report the case of a half-marathon runner who presented with exertional heatstroke (EHS), whose management was confounded by concurrent treatment of his bipolar disorder with olanzapine. Antipsychotics can have a profound effect on thermoregulation and can cause athletes to present with features of neuroleptic malignant syndrome in the setting of EHS. It is vital for medical providers to consider the thermoregulatory effects of all medications, including antipsychotics, when providing care during sporting events.
Acute cerebral infarction following a Trimeresurus stejnegeri snakebite
Authors: Zeng Xiangxia , Hu Jinlun , Liang Xiaohuan , Wu Yixia , Yan Mei , Zhu Menghuan , Fu Yue 
Published: June 2019

Abstract

Rationale:
Acute cerebral infarction after snake bites is rare. The underlying mechanism causing the thrombotic process remains complex and unknown.

Patient concerns:
We herein describe a 49-year-old female who was bitten by a Trimeresurus stejnegeri. After 4 days of biting, she developed acute ischemic infarct.

Diagnosis:
The patient exhibited right side weakness and speech disturbances. Brain computed tomography (CT) scan showed no sign about cerebral hemorrhage symptoms, and brain magnetic resonance imaging (MRI) showed acute ischemic infarct in the left territory. The patient confirmed a diagnosis of acute cerebral infarction following a T. stejnegeri bite.

Interventions:
The patient received an injection of polyvalent anti-snake venom serum, neuroprotective therapy, and anti-platelet aggregate treatment.

Outcomes:
At the 3-month follow-up visit, the patient's left lower extremity swelling disappeared, the right limb muscle strength recovered, and the modified Rankin scale (mRS) score was 4 points.

Lessons:
The patient was diagnosed with acute ischemic infarct interrelated to snake bite; further investigations were needed to ascertain mechanism. The clinicians should pay more attention to identify potential victims of neurologic complications, to reduce the mortality rate of snake bite.
Feasibility of high-resolution manometry for decision of feeding methods in patients with amyotrophic lateral sclerosis
Authors: Suh Jee Hyun , Park Donghwi , Kim In Soo , Kim Hayoung , Shin Cheol Min , Ryu Ju Seok 
Published: June 2019

Abstract
As amyotrophic lateral sclerosis (ALS) progresses, dysphagia gets worse due to the weakening of pharyngeal musculature. As oral feeding becomes more difficult or dangerous due to worsening dysphagia, tracheal aspiration, or undernutrition, the necessity for tube feeding becomes increasingly important. This study aims to establish a standard pressure point by applying pharyngeal pressure using high-resolution manometry (HRM) to start tube feeding in patients with ALS.
This study was designed as a retrospective analysis of prospectively collected data. Forty-one patients with ALS and 20 healthy subjects were participated. Both groups were evaluated using HRM, videofluoroscopic swallowing study (VFSS), and pulmonary function test. The swallowing pressure along the velopharynx (VP), tongue base (TB), pre-upper esophageal sphincter (UES), lower pharynx, and cricopharyngeus, as well as minimal UES pressure were measured using HRM.
There was significantly positive correlation between the pressure of cricopharyngeus and forced expiratory volume in 1 second (FEV1). And there were significant correlations between results of VFSS and FEV1, FEV1%, forced vital capacity (FVC), and FVC%. There was a significant difference in the pressure of TB and cricopharyngeus between the control group and the ALS patient group. The pressures of VP, TB, lower pharynx, and cricopharyngeus have a significant correlation with the recommended feeding type by VFSS.
Because it is possible to use HRM to quantitatively assess pharyngeal and respiratory weaknesses and it is more sensitive than other evaluation tools, the cutoff value of HRM parameters may be used to decide the feeding type in patients with ALS.
Can endoscopists differentiate cytomegalovirus esophagitis from herpes simplex virus esophagitis based on gross endoscopic findings?
Authors: Jung Kyung Hwa , Choi Jonggi , Gong Eun Jeong , Lee Jeong Hoon , Choi Kee Don , Song Ho June , Lee Gin Hyug , Jung Hwoon-Yong , Chong Yong Pil , Lee Sang-Oh , Choi Sang-Ho , Kim Yang Soo , Woo Jun Hee , Kim Do Hoon , Kim Sung-Han 
Published: June 2019

Abstract
Differential diagnosis between herpes simplex virus (HSV) esophagitis and cytomegalovirus (CMV) esophagitis is challenging because there are many similarities and overlaps between their endoscopic features. The aims of this study were to investigate the implications of the endoscopic findings for the diagnosis of HSV and CMV esophagitis, and to develop a predictive model for differentiating CMV esophagitis from HSV esophagitis.
Patients who underwent endoscopic examination and had pathologically-confirmed HSV or CMV esophagitis were eligible. Clinical characteristics and endoscopic features were retrospectively reviewed and categorized. A predictive model was developed based on parameters identified by logistic regression analysis.
During the 8-year study period, HSV and CMV esophagitis were diagnosed in 85 and 63 patients, respectively. The endoscopic features of esophagitis were categorized and scored as follows: category 1 (−3 points): discrete ulcers or ulcers with vesicles, bullae, or pseudomembranes, category 2 (−2 points): coalescent or geographic ulcers, category 3 (1 points): ulcers with an uneven base, friability, or with a circumferential distribution, category 4 (2 points): punched-out, serpiginous, or healing ulcers with yellowish exudates. And previous history of transplantation (2 point) was included in the model as a discriminating clinical feature. The optimal cutoff point of the prediction model was 0 (area under receiver operating characteristic curve: 0.967), with positive scores favoring CMV esophagitis. Sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were 96.8%, 89.4%, 92.6%, 87.3%, and 97.5%, respectively.
The predictive model based on endoscopic and clinical findings appears to be accurate and useful in differentiating CMV esophagitis from HSV esophagitis.
Association between salivary amylase enzyme activity and obesity in Saudi Arabia
Authors: Aldossari Norah Mubarak , El Gabry Eman E. , Gawish Gihan E.H. 
Published: June 2019

Abstract
Obesity is a significant public health concern that predisposes individuals to a high risk of premature mortality. Previous studies also reported that low serum concentrations of AMY1 have been associated with obesity. The aimed of the study to assess the relationship between salivary amylase (AMY1) activity and body mass index (BMI) in Saudi male and female adults in Riyadh. This study included a total of 200 (100 individuals who were overweight and obese and 100 who had normal body weight [control individuals]) Saudi participants aged 20 to 50 years old. They were recruited from physical fitness clubs and were school employees in Riyadh City. The dietary food intake was assessed using a 24-hour dietary recall. The activity of the AMY1 was measured using a microplate fluorescence reader. A significant (P ≤ .05) increase was observed in the incidence of hypertension, dyslipidemia, diabetes mellitus (DM), and family history of overweight and obesity in overweight and obese individuals than in the control individuals, and these were in parallel to the significant increase in weight, waist circumference (WC), hip circumference (HC), systolic blood pressure (SBP), diastolic blood pressure (DBP), and BMI. A significant (P ≤ .05) increase was also observed in the carbohydrate and total fat dietary intake of overweight and obese individuals in relation to the respective dietary reference intake (DRI) values. AMY1 activity was significantly lower than the reference values in the overweight and obese group. Furthermore, AMY1 activity was significantly (P ≤ .05) reverse with weight, WC, HC, and BMI in both males and females in the overweight and obese group. In conclusion, the Saudi overweight and obese population seems to be at risk of low AMY1, which correlates with their obesity.
Treatment with verapamil for restoration of sinus rhythm in atrial fibrillation with rapid ventricular response
Authors: Wang Xiaoou , Lin Yanxia , Chen Ling , Liang Dongke , Lin Jie , Qi Guoxian , Tian Wen 
Published: June 2019

Abstract

Rationale:
Atrial fibrillation (AF) is a common arrhythmia disease that can cause thromboembolic disease and/or heart failure, resulting in increased mortality. Propafenone, amiodarone, and flecainide are recommended for converting AF to sinus rhythm. Beta blockers, verapamil, diltiazem, and digoxin are recommended for controlling AF with fast ventricular rate (VR). In this case report, we found that verapamil successfully converted AF into sinus rhythm.

Patient concerns:
A 92-year-old woman presented with fast VR AF with a history of coronary heart disease, hypertension, and diabetes.

Diagnoses:
Verapamil can successfully convert AF into sinus rhythm.

Interventions and Outcomes:
The patient was treated with amiodarone or propafenone, yet still had AF. After stopping amiodarone and propafenone, the patient was given verapamil to control the VR, and following 9 days of treatment the patient switched to sinus rhythm. When verapamil treatment was stopped, the patient experienced AF recurrence. Upon receiving verapamil again, the AF again converted into sinus rhythm.

Lessons:
For the treatment of AF, nondihydropyridine calcium antagonists can be tried in the absence of antiarrhythmic drugs.
Intrahepatic adrenocortical adenoma arising from adrenohepatic fusion mimicking hepatic malignancy
Authors: Cho Yong Soo , Kim Jin Woong , Seon Hyun Ju , Cho Ju-Yeon , Park Jun-Hee , Kim Hyung Joong , Choi Yoo Duk , Hur Young Hoe 
Published: June 2019

Abstract

Rationale:
Intrahepatic adrenocortical adenoma (IAA) arising from adrenohepatic fusion (AHF) is rare and its imaging findings are not well established. Moreover, it is easily misdiagnosed as malignant hepatic tumor in patients at risk of malignancy. Its key finding is the connection between the tumor and adrenal gland. When IAA from AHF is suspected, biopsy should be considered to avoid unnecessary surgery. Herein, we report 2 cases of IAA from AHF.

Patient concerns:
A 59-year-old woman was admitted due to a 1.5-cm hypoechoic nodule in the right hepatic lobe detected on ultrasound for hepatocellular carcinoma (HCC) surveillance due to chronic hepatitis B. Contrast-enhanced computed tomography (CT) and gadoxetic acid-enhanced magnetic resonance imaging (MRI) were performed to evaluate the hepatic mass. Another 75-year-old woman was admitted due to rectal adenocarcinoma detected on colonoscopy. Contrast-enhanced CT depicted a 2.5-cm mass in the right hepatic lobe.

Diagnosis:
In case 1, CT and MRI showed a 1.5-cm subcapsular mass in the right hepatic lobe with typical findings of HCC in a patient with chronic hepatitis B. The mass was confirmed as IAA from AHF after the laparoscopic surgery. In case 2, CT showed advanced rectal malignancy and a 2.5-cm poorly enhancing mass in the right hepatic lobe. The tentative diagnosis was hepatic metastasis. However, based on the connection between the tumor and adrenal gland during preoperative review, the presumed diagnosis was changed to IAA from AHF, which was confirmed on biopsy.

Interventions:
The hepatic mass connected with the right adrenal gland was laparoscopically resected in case 1. Laparoscopic lower anterior resection for rectal malignancy and percutaneous biopsy for the hepatic mass were performed in case 2.

Outcomes:
The first patient had an uneventful recovery, without recurrence on the 3-year follow-up CT. The second patient had an uneventful postoperative course and has been alive for 12 months postoperatively without pathologically proven IAA changes on follow-up CT.

Lessons:
When hepatic mass is found adjacent to the right adrenal gland on imaging, the connection between the tumor and adrenal gland should be investigated. When IAA arising from AHF is suspected, biopsy should be considered to avoid unnecessary surgery.
Association between genotypes of rs34436714 of NLRP12 and serum tumor necrosis factor-alpha in inflammatory bowel disease
Authors: Dellaporta Erminia , Lazaridis Lazaros-Dimitrios , Koussoulas Vasilleios , Netea Mihai G. , Giamarellos-Bourboulis Evangelos J. , Triantafyllou Konstantinos 
Published: June 2019

AbstractWe aimed to investigate the impact of the single nucleotide polymorphisms of rs34436714 of the NOD-like receptor protein 12 gene on the production of tumor necrosis factor-alpha (TNFα) in patients with inflammatory bowel disease (IBD)In a matched case-control study 90 patients with IBD, 56 with Crohn disease (CD) and 34 with ulcerative colitis, were genotyped and compared to 98 healthy comparators matched for age and gender. Expression level of TNFα, interleukin (IL)-6, IL-12, and soluble triggering receptor expressed on myeloid cells were measured in patients’ sera. Peripheral blood mononuclear cells (PBMCs) were isolated and stimulated for TNFα production.Serum TNFα was greater among carriers of GT/TT genotypes than GG genotypes of rs34436714. Stimulated TNFα production was also higher in carriers of GT/TT genotypes. The frequency of CD with fistulizing behavior and with CD involving the small intestine was greater among carriers of GT/TT genotypes than of the GG genotype. Distribution of the GG, GT, and TT genotypes of rs34436714 were in Hardy–Weinberg equilibrium in both groups. The genotype distribution was the same in both groups.Carriage of minor frequency alleles of rs34436714 was accompanied by greater circulating levels of TNFα and by greater capacity for stimulated TNFα production by PBMCs. These alleles had an impact on the phenotype of patients with CD.
Effect of acupuncture at 3 anti-fatigue acupoints in the treatment of cancer-related fatigue in patients with cancer
Authors: Liao Muxi , Xie Yizi , Yan Jiao , Lin Tong , Ji Shuliang , Li Zongyao , Zhao Wenjing , Yang Yaqin , Lin Lizhu , Lin Jietao 
Published: June 2019

Abstract

Background:
Cancer-related fatigue (CRF), is a common distressing symptom of cancer. What's more, “Three anti-fatigue acupoints” is one of the most important components of “Jin's 3-needle therapy” created by Rui Jin, a professor of Guangzhou University of Chinese Medicine, which can be used in the treatment of CRF. In this article, researchers will assess the safety and effect of acupuncture at 3 anti-fatigue acupoints on CRF in patients with cancer.

Methods:
Literature search for relevant articles up to October 2018 will be carried out in 9 databases: Cochrane Library, Embase, PubMed, VIP, CBM, CNKI, Wanfang Database, CiNii, and OASIS. The included literatures will be randomized controlled trials of acupuncture at 3 anti-fatigue acupoints on CRF in patients with cancer. The certain common scales, which reflect the patients’ fatigue degree or life quality will be the primary outcome measures. The secondary outcome measures will be defined with the blood index. After collecting the data, we will utilize Stata V.13.0. to perform data synthesis, subgroup analysis, partial sequence analysis, sensitivity analysis, and so on. A funnel plot will be used to assess reporting biases. And the funnel plot will be evaluated by the Egger and Begg tests. The quality of evidence will be judged by the grading of recommendations assessment, development, and evaluation.

Results:
The results of this systematic review and meta-analysis will be published in a peer-reviewed journal.

Conclusion:
Our study will provide the evidence for the clinical efficacy and safety of acupuncture at 3 anti-fatigue acupoints in the treatment of CRF.
IGF-1 polymorphisms modulate the susceptibility to osteonecrosis of the femoral head among Chinese Han population
Authors: Wang Jun , Liu Hongyun , Zhang Qiliang 
Published: June 2019

Abstract
The study was performed to investigate the genetic associations of IGF-1 polymorphisms rs35767, rs5742714, and rs972936 with susceptibility to osteonecrosis of the femoral head (ONFH) among Chinese Han population.
Totally, 101 ONFH patients and 128 healthy controls were enrolled. Hardy–Weinberg equilibrium (HWE) was detected with chi-square test in control group. Odds ratios (ORs) with 95% confidence intervals (95% CIs) were calculated to estimate the relationship between IGF-1 polymorphisms and ONFH risk. Besides, hyplotype analysis was performed to examine linkage disequilibrium between the studied polymorphisms.
Genotype AA and allele A of polymorphism rs35767 were more frequent in control group, and offered protection for ONFH onset (AA: OR = 0.382, 95% CI = 0.158-0.923; A: OR = 0.650, 95% CI = 0.442–0.956). Furthermore, the negative relationship was also observed between ONFH risk and polymorphism rs5742714 under the comparisons CG vs CC, and G vs C (OR = 0.395, 95%CI = 0.199–0.787; OR = 0.346, 95%CI = 0.191–0.627). While the polymorphism rs972936 significantly enhanced the disease risk (CT vs CC: OR = 2.434, 95% CI = 1.184–5.003; TT vs CC: OR = 2.497, 95% CI = 1.040–5.990). Furthermore, haplotype analysis demonstrated that C-T (rs5742714–rs972936) could increase ONFH risk (OR = 2.177, 95% CI = 1.444–3.283), while G-T might be a protective factor for ONFH (OR = 0.472, 95% CI = 0.254–0.878).

IGF-1 polymorphisms rs35767, rs5742714, and rs972936 show significant association with ONFH risk.