bluuebunny/crossref_metadata_2025_split huggingface dataset:
A case report of acute promyelocytic leukemia with mycosis fungoides
Authors: Dong Shasha , Zhu Yejing , Zhang Fang , Zhao Yongqin , Zhou Hongjing 
Published: January 2024

Rationale:
Acute promyelocytic leukaemia (APL) is a rare subtype of acute myelogenous leukaemia. With advances in treatment regimens, namely, introduction of all-trans-retinoicacid, outcomes have drastically improved, its side effects should not be ignored. Mycosis fungoides is one of the side effects of all-trans-retinoicacid treatment, but it may also be a clinical manifestation before disease progression. However, it rarely appears and is easily overlooked. This leads to being easily misled during the treatment process, affecting the treatment plan, and resulting in adverse consequences. Therefore, early identification and judgment can not only provide appropriate treatment options, but also prevent and treat further disease progression.

Patient concerns:
The patient was hospitalized for pancytopaenia. After completing the examination, the patient was finally diagnosed with acute promyelocytic leukaemia (acute myelogenous leukaemia-M3). We administered tretinoin and arsenous acid. Evaluation of the treatment effect on the 7th day after chemotherapy showed that the bone marrow morphology showed complete remission. After the second course of chemotherapy, the patient developed red miliary macular papules, which gradually worsened. After completing relevant inspections, Considering that the cases was complicated with skin mycosis fungoides, the patient was treated with budesonide ointment and methylprednisolone as chemotherapy.

Diagnoses:
Upon examination, the patient was initially diagnosed with acute promyelocytic leukaemia. Evaluation of the treatment effect on the 7th day after chemotherapy showed that the bone marrow morphology showed complete remission. After the second course of chemotherapy, we discovered the patient was diagnosed with skin mycosis fungoides.

Interventions:
Systemic chemotherapy is first given when a patient was diagnosed with acute promyelocytic leukaemia. After the patient happened skin mycosis fungoides, We have adjusted the treatment plan and supplemented it with other treatment plans based on the original chemotherapy, After 2 months of treatment, his condition gradually improved.

Outcomes:
All-trans-retinoicacid in the treatment of APL must be given attention because mycosis fungoides should not only be distinguished from infectious diseases but also be further assessed with regard to disease progression and metastasis.

Lessons:
Acute promyelocytic leukemia needs to be treated with arsenic trioxide. All-trans-retinoicacid in the treatment of APL must be given attention mycosis fungoides. Early diagnosis can guide accurate treatment, which is of great help in alleviating the pain of patients and improving the cure rate.
Relationship between trimethylamine N-oxide and the risk of hypertension in patients with cardiovascular disease: A meta-analysis and dose-response relationship analysis
Authors: Han Jia-Ming , Guo Lu , Chen Xian-Hui , Xie Qian , Song Xiu-Ying , Ma Yu-Lan 
Published: January 2024

Background:
The gut microbiota-dependent metabolite trimethylamine N-oxide (TMAO) has recently been recognized to be one of the risk factors for cardiovascular disease (CVD). However, there is a scarcity of data on the relationship between circulating TMAO levels and hypertension in patients with CVD. Meta analysis and a dose-response relationship were used in this study to assess the relationship between circulating trimethylamine N-oxide levels and the risk of hypertension in patients with CVD.

Methods:
CNKI, Wanfang Database, Pubmed, Embase, Cochrane Library, and Web of Science were searched up to June 01, 2023. Meta-analysis and dose-response analysis of relative risk data from prospective cohort studies reporting on the relationship between circulating TMAO levels and hypertension risk in patients with CVD were conducted.

Results:
Fifteen studies with a total of 15,498 patients were included in the present meta-analysis. Compared with a lower circulating TMAO level, a higher TMAO level was associated with a higher risk of hypertension in patients with CVD (RR = 1.14,95%CI (1.08, 1.20)). And the higher the TMAO level, the greater the risk of hypertension. The dose-response analysis revealed a linear dose-response relationship between circulating TMAO levels and the risk of hypertension in patients with CVD. The risk of hypertension increased by 1.014% when the circulating TMAO level increased by 1 μ mol/L.

Conclusion:
In patients with CVD, the level of circulating TMAO is significantly related to the risk of hypertension. The risk of hypertension increased by 1.014% for every 1 μ mol/L increase in circulating TMAO levels.
Factors associated with the use of traditional doses of amitriptyline for chronic pain management: A cross-sectional study
Authors: Koo Hyunji , Jeong Kyeong Hye , Jeon Nakyung , Jung Sun-Young 
Published: January 2024

There are studies on the effect of low-dose amitriptyline on pain control, but there is a lack of studies on the use of amitriptyline for chronic pain and the factors associated with the prescription of traditional doses. We used a national sample cohort of patients aged ≥ 18 years who were prescribed amitriptyline along with chronic pain, without psychiatric disorders, between 2002 to 2015. We categorized the prescriptions into 2 groups according to the daily dose: low doses (≤25 mg) and traditional doses (>25 mg). Multivariable logistic regression models were used to identify factors associated with traditional dose prescriptions.
Among 177,769 prescriptions for amitriptyline, 15,119 (8.5%) were prescribed for chronic pain. The prevalence of prescriptions and proportion of traditional doses of amitriptyline tended to decrease during the study period. Male sex (odds ratio [OR] 1.09, 95% confidence interval [CI] 1.05–1.13); age 65–80 years (OR 1.12, 95% CI 1.08–1.16), especially ≥ 80 years (OR 1.55, 95% CI 1.45–1.65); headaches (OR 1.18, 95% CI 1.10–1.27), receiving medical aids (OR 2.58, 95% CI 2.46–2.71); and being prescribed benzodiazepines or zolpidem concomitantly (OR 1.10, 95% CI 1.06–1.15) were significantly associated with traditional dose prescriptions of amitriptyline.
Although traditional dose prescriptions of amitriptyline have been declining, close monitoring is still required in the presence of the above-mentioned factors.
Exploration of kiwi root on non-small cell lung cancer based on network pharmacology and molecular docking
Authors: Li Ruochen , Wang Mingxiao , Tian Jin , Liu Minghui , Li Gaigai , Zhou Xun 
Published: January 2024

Background:
Kiwi root is a Chinese herb clinically used in the treatment of lung neoplasm; however, the multi-target mechanism of kiwi root in the treatment of non-small cell lung cancer (NSCLC) remains to be elucidated. Thus, this study aimed to investigate the molecular mechanisms of kiwi root in the treatment of NSCLC through network pharmacology and molecular docking techniques.

Methods:
The active components and targets of kiwi root were obtained from the TCMSP database, and NSCLC-related targets were obtained from the GeneCards, OMIM, and DrugBank databases. The intersection targets of NSCLC and kiwi root were obtained from VENNY 2.1.0. Then, the common targets were imported into the STRING database, and by using the Cytoscape 3.7.1 software, drug-disease network diagrams were created. Afterwards, the DAVID database was utilized to perform bioinformatic annotation. Finally, molecular docking of key components and key targets was performed by Autodock Tools.

Results:
A total of 4083 NSCLC-related disease genes were collected from the GeneCards, OMIM,and DrugBank databases, and 177 non-duplicated drug targets were acquired from the TCMSP database. A total of 138 intersection target genes were obtained, in which TP53, AKT1, and TNF were the key targets.

Conclusion:
Through network pharmacology techniques, the mechanism of kiwi root in the treatment of NSCLC has been uncovered and provides a theoretical basis for the clinical treatment of NSCLC with kiwi root, which requires further experimental validation.
The safety and feasibility of using a 5-Fr guiding catheter with a 0.035-inch guidewire in place for cerebral angiography
Authors: Huang Xianchen , Li Guanqiang , Hu Bo , Zhang Xicheng , Sun Yuan 
Published: January 2024

Background:
This study aimed to evaluate the safety and efficacy of performing diagnostic cerebral angiography using a 5-Fr guiding catheter with a 0.035-inch guidewire in place.

Methods:
Actual flow rates at different pressures using the 5-Fr guiding catheter with a 0.035-inch guidewire in place were measured in vitro. Integrity of the guidewire surface after high-pressure injection was determined by examination under a light microscope and scanning electron microscope. Injected and unused contrast medium were collected and analyzed using a particle detector. Furthermore, a prospective randomized controlled study was conducted to compare safety and efficacy between the guided (guidewire in place) and conventional methods.

Results:
The maximum injection pressure at a flow rate of 5 mL/s for the various types of commonly used contrast medium was approximately 350 psi, which is below the pressure limit for cerebral angiography. The guidewire surface remained relatively intact after multiple high-pressure injections. Procedure success and primary success rates did not significantly differ between the guided and conventional methods. However, procedure time (25.93 ± 4.07 vs 31.55 ± 5.49 minutes) and radiation exposure time (12.16 ± 3.82 vs 17.27 ± 6.12 minutes) were significantly shorter in the guided method group.

Conclusion:
The guided catheterization method is safe and feasible for cerebral angiography and has several advantages over the conventional method.
Adult congenital heart diseases: systematic review/meta-analysis
Authors: Mahmod Ahmdelmukashfi M.Elmustfa A.Azem , Koko Shima Hassan Mohammed 
Published: January 2024

Background:
Congenital heart disease (CHD) is a gross structural abnormality of the heart that has functional significance. The impact of CHD on the patients’ quality of life (QOL) is a topic of considerable interest and importance to both researchers and clinician. However, there is a lack of systematic reviews investigating and identifying the QOL of congenital heart disease patients.

Aim:
To assess the QOL of adult patients with congenital heart disease by reviewing the previous studies conducted on this subject.

Methods:
The PubMed and Google Scholar databases were explored for studies published between 2020 and 2022. The keywords used for the searching process included “QOL, Adults, CHD, Outcomes, Impact, Effects, Life of CHD Patients.” The inclusion criteria were original English articles and full-text articles conducted on adult patients with congenital heart disease and reported quality of life.

Results:
A total of 5455 articles were obtained, but only seven articles were eligible for the inclusion criteria. The included studies involved a total of 8549 participants; 104 were healthy, and 8445 were adult patients with congenital heart disease. The investigated items of the studies included quality of life, health-related QOL, including physical and psychological dimensions, sense of coherence, mental health, physical functioning, physiological wellbeing, psychological resilience, anxiety, depression, illness perception, and health status.

Conclusion:
Patients with congenital heart disease experience low QOL across all dimensions. The risk factors for poor QOL included age, depression, anxiety, and female gender.
Acute hypothermia in a patient with COVID-19: a case report and summary of the evidence
Authors: Jyoti Avijit Sarker , Kamrul-Hasan A.B.M , Rahman Monjur , Hasan Mohammad Jahid 
Published: January 2024

Introduction and importance:
SARS-COV-2 has many presenting signs including a number of typical and atypical symptoms. However, having the enormous capacity of mutation, the virus is changing its genetic pattern continuously, giving rise to newer and rarer manifestations. Here, the authors report a case of adult COVID-19 along with features of hypothermia which is relatively rare and has future implications in clinical perspective.

Case presentation:
The patient presented with hypothermia and indicative symptoms of COVID-19 during admission. Comorbidities were assessed, potential differentials were ruled out thorough appropriate clinical examination and investigations. Insulation with a blanket and room heater was used to stabilize the normal body temperature (98.6°F) in the hospital setting, during this period vitals (Blood pressure, Pulse rate and oxygen saturation) were assessed regularly. On the sixth day of hospital admission, he was discharged from the hospital with advice.

Clinical discussion:
COVID-19 virus can enter into brain through olfactory tract and may cause dysfunction in the medial preoptic area of the hypothalamus containing warm sensitive neurons directly or via cytokine-induced release of prostaglandin E2 from endothelial cells, which acts through a paracrine mechanism that may provoke hypothermia in our case.

Conclusions:
This case highlights a rare presentation of COVID-19 infection that has not been thoroughly explored. The authors believe the case report holds particular importance especially in dealing with COVID-19 cases in both clinical and home settings.
Surgical stabilization of rib fractures for flail chest: Analysis of center-based variability in practice and outcomes
Authors: Hylands Mathieu , Gomez David , Tillmann Bourke , Haas Barbara , Nathens Avery 
Published: January 2024

BACKGROUND
Given the lack of high-quality data on patient selection for surgical stabilization of rib fractures (SSRF), significant variability in practice likely exists across trauma centers. We aimed to determine whether centers with a more liberal approach to SSRF had improved outcomes.

METHODS
We performed a retrospective cohort study of adult patients with flail chest admitted to Level I or II trauma centers participating in the American College of Surgeons’ Trauma Quality Improvement Program. The primary outcome was hospital mortality; secondary outcomes included discharge status, tracheostomy, duration of mechanical ventilation, and hospital length of stay. Logistic regression was performed to calculate center-level observed/expected rates of SSRF and centers were grouped into quintiles from “most liberal” to “most restrictive.” Multivariable regression was used to determine the association between these quintiles and outcomes. We also used an instrumental variable analysis to evaluate the association between SSRF and mortality at the patient level.

RESULTS
Among 23,619 patients with flail chest across 354 centers, 22% underwent SSRF. Center rates of fixation ranged from 0% to 88%. Higher rates of SSRF were not associated with lower mortality overall (highest vs. lowest quintile: odds ratio, 0.86; 95% confidence interval, 0.63–1.17). However, centers with a more liberal approach to SSRF had lower rates of independent status at discharge, higher tracheostomy rates, longer duration of mechanical ventilation, and longer hospital and ICU length of stay. The patient level analysis demonstrated that SSRF as was associated with a 25% lower risk of death.

CONCLUSION
Overall, centers with a liberal approach to SSRF do not show improved outcomes among patients with a flail chest, but have higher resource utilization. Results at the patient level suggest that there is a population likely to benefit but these patients remain to be identified through further research.

LEVEL OF EVIDENCE
Prognostic and Epidemiological; Level III.
DOES FRAILTY IMPACT FAILURE-TO-RESCUE IN GERIATRIC TRAUMA PATIENTS?
Authors: Kojima Mitsuaki , Morishita Koji , Shoko Tomohisa , Zakhary Bishoy , Costantini Todd , Haines Laura , Coimbra Raul 
Published: January 2024

AbstractBackgroundFailure-to-rescue (FTR), defined as death following a major complication, is a metric of trauma quality. The impact of patient frailty on FTR has not been fully investigated, especially in geriatric trauma patients. This study hypothesized that frailty increased the risk of FTR in geriatric patients with severe injury.MethodsA retrospective cohort study was conducted using the TQIP database between 2015 and 2019, including geriatric patients with trauma (age ≥ 65 years) and an Injury Severity Score (ISS) > 15, who survived ≥48 h post-admission. Frailty was assessed using the modified 5-item frailty index (mFI). Patients were categorized into frail (mFI ≥ 2) and non-frail (mFI < 2) groups. Logistic regression analysis and a generalized additive model (GAM) were used to examine the association between FTR and patient frailty after controlling for age, sex, type of injury, trauma center level, ISS, and vital signs on admission.ResultsAmong 52,312 geriatric trauma patients, 34.6% were frail (mean mFI: frail: 2.3 vs. non-frail: 0.9, p < 0.001). Frail patients were older (age 77 vs. 74 years, p < 0.001), had a lower ISS (19 vs. 21, p < 0.001), and had a higher incidence of FTR compared to non-frail patients (8.7% vs. 8.0%, p = 0.006). Logistic regression analysis revealed that frailty was an independent predictor of FTR (odds ratio [CI]: 1.32 [1.23-1.44], p < 0.001). The GAM plots showed a linear increase in FTR incidence with increasing mFI after adjusting for confounders.ConclusionThis study demonstrated that frailty independently contributes to an increased risk of FTR in geriatric trauma patients. The impact of patient frailty should be considered when using FTR to measure the quality of trauma care.Level of EvidenceLevel IV, therapeutic/care management
Diverse and weakly immunogenicvargene expression facilitates malaria infection
Authors: Bhardwaj Inayat , Nyarko Prince B. , Ashn Asrar Ba , Cohen Camille , Ceesay Sukai , Achan Jane , Dabira Edgard , Nakajima Rike , Jain Aarti , Taghavian Omid , Jasinskas Algis , Felgner Philip L. , D’Alessandro Umberto , Bousema Teun , Travassos Mark , Radulescu Ovidiu , Claessens Antoine 
Published: January 2024

AbstractPlasmodium falciparumis believed to escape immunity via antigenic variation, mediated in part by 60vargenes. These genes undergo mutually exclusive expression and encode the PfEMP1 surface antigen. The frequency ofvarswitching and the immunogenicity of each expressed PfEMP1 remain unclear. To this end, we carried out a Controlled Human Malaria Infection (CHMI) study with 19 adult African volunteers in The Gambia to gain insight into the effect of naturally acquired immunity on the expressedvargene repertoire during early phase of an infection. Our findings demonstrated a strong correlation between the diversity ofvarexpression, quantified through entropy, and infection outcome. Low-immunity individuals were characterised by highvarentropy profiles, higher parasitaemia, and lower sero-recognised PfEMP1 domains compared to high-immunity individuals. For the first time we recorded the probability ofvargene switchingin vitroand of turnoverin vivo, enabling us to estimate both intrinsic switching and negative-selection effects. These processes are rapid, resulting in estimated turnover/switching probabilities of 69% - 97% and 7% - 57% per generation,in vivoandin vitro, respectively.Var(PfEMP1) expression triggered time-dependent humoral immune responses in low immunity individuals, with many PfEMP1 domains remaining weakly immunogenic. We conclude that the role of intrinsicvarswitching is to reset and maintain a diversevarrepertoire. The highvarswitching rates and weak PfEMP1 immunogenicity benefit parasite survival during the CHMI.
Surgical diagnoses and post-operative outcomes of intestinal obstruction among adults at regional referral hospitals in Dar-es-Salaam, Tanzania: a prospective, observational hospital-based study
Authors: Mponzi Shadrack Samwel , Wandwi Wambura Boniphace , Mbembati Naboth Almasi , Leshabari Kelvin Melkizedeck 
Published: January 2024

ABSTRACTBackgroundThere is limited available published information regarding surgical diagnoses and post-operative outcomes of intestinal obstruction among adult patients in East African hospitals. The observation is despite available anecdotal evidence of the condition to be among the commonest surgical emergencies in the area.ObjectiveTo assess the surgical diagnoses and outcomes of intestinal obstruction among adult patients treated at the regional referral hospitals in Dar-es-salaam - Tanzania.Methods & FindingsThis was a prospective, observational, hospital-based study. Data were collected using a pre-validated Clinical Research Form (CRF). All adult patients with post-operative surgical diagnoses of intestinal obstruction at Amana, Mwananyamala and Temeke hospitals in Dar es Salaam were the target population. Data were analyzed using a generalized linear model via SAS version 9.7. Multivariable logistic regression model was the final fitted model. Intra-operative findings (surgical diagnoses) of intestinal obstruction was an outcome variable. Unless otherwise stated, an α-level of 5% was used as a limit of type 1 error in findings. The study analysed an average of 1411 patients-days of follow-up. Participants’ median age and duration of hospital stay were 47 (IQR: 35-67) years and 4 (IQR: 3-6) days respectively. Intra-operative findings included adhesions (aOR=5.66), abdominal tumors (aOR=1.028), hernia (aOR=2.04) and volvulus (aOR=4.2). Moreover, 12 (5.26%) clients died and 20 (9%) had surgical sites infection. No statistically significant difference of hospital on surgical outcomes (χ2test value = 4.992; df = 10).ConclusionAdhesions was the commonest intraoperative cause of intestinal obstruction in this study population. One-in-twenty of all followed-up clients died. Significant proportion of patients had evidence of post-operative complications.
Cardiac Troponin T is a Serum Biomarker of Respiratory Dysfunction in Amyotrophic Lateral Sclerosis
Authors: Koch Teresa , Fabian Rachel , Weinhold Leonie , Koch Franz-W. , Barakat Saman , Castro-Gomez Sergio , Grehl Torsten , Bernsen Sarah , Weydt Patrick 
Published: January 2024

AbstractObjectiveInformative biomarkers are an urgent need in management and therapy development of amyotrophic lateral sclerosis. Serum cardiac troponin T is elevated in most amyotrophic lateral sclerosis patients and not correlated with neurofilaments. We sought to delineate the functional implications and the informative value of serum troponin T with regard to respiratory function, a major prognostic factor in amyotrophic lateral sclerosis.MethodsWe analyzed two independent hospital-based amyotrophic lateral sclerosis cohorts (d=discovery cohort; v= validation cohort) with data available on serum cardiac troponin T levels (nd=297; nv=49), serum neurofilament light chain levels (nd=116; nv=17), and routine respiratory test results (nd=86; nv=49).ResultsSerum cardiac troponin T levels, unlike serum neurofilaments, were strongly associated with the respiratory domain of the revised amyotrophic lateral sclerosis functional rating score (rd= - 0.29, pd= 0.001; rv= - 0.48, pv= 0.007) and with relevant pulmonary function parameters (nd), namely SVC% (r = - 0.45; p = 0.001), FVC% (r = - 0.43; p = 0.001), FEV1% (r = −0.37, p = 0.007), and PEF (r = - 0.34, p = 0.027).Serum cardiac Troponin T reliably discriminated benchmarks of SVC% < 80%: (AUC 0.75, p = 0.003), FVC % < 80%: (AUC 0.72, p = 0.011) and PEF% <75%: (AUC 0.72, p = 0.015).InterpretationOur findings confirm cardiac Troponin T as an informative serum biomarker in amyotrophic lateral sclerosis, complementing neurofilaments. Serum Troponin T can flag compromised respiratory function in amyotrophic lateral sclerosis and might prove useful as a proxy of respiratory impairment with prognostic implications.