bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of effects of energy based devices on quality of life after sutureless thyroidectomy
Authors: Arikan Akif Enes , Ozyegin Mustafa Ates 
Published: January 2022

Abstract

Objective:
In current literature, no studies evaluated effect of energy-based vessel-sealing-devices on quality of life after sutureless total thyroidectomies. This study aimed to identify any potential differences between two energy-based vessel-sealing-devices (Harmonic Focus, Ligasure LF1212) in patients with benign thyroid disorders who underwent sutureless total thyroidectomy.

Materials and methods:
Differences in quality of life of patients were evaluated using data obtained by Thy-PRO-39-Tr questionnaire prior to and four-week after surgery. Total and domain-based alterations in quality of life were compared between groups according to energy-based vessel-sealing-devices type (Group L, Group H). Additionally, data including demographics, height, weight, body mass index, neck circumference, sternomental distance were collected.

Results:
Of 1032 patients, 200 were eligible for study, at the end 193 were analysed. There were no differences between groups in terms of age, sex, body mass index, tobacco use. Analysis did not reveal any differences in overall quality of life between groups (P = .42). However, in “eye symptoms” (P < .001) and “cognitive functions” (P = .002) domains, Harmonic provided statistically improved quality of life. Effect on cognitive function was greater in patients of advanced age.

Conclusions:
Especially in elderly patients with worsening eye conditions and cognitive functions, use of Harmonic may enhance patients’ outcome by increasing quality of life in addition to optimizing surgical outcome when compared to Ligasure.
Metastases to duodenum in cervical squamous cell carcinoma
Authors: Chen Yihan , Zhang Hao , Zhou Qingjie , Lu Lijie , Lin Jiejun 
Published: January 2022

Abstract

Rationale:
Metastases to the duodenum in cervical squamous cell carcinoma are extremely rare, with only 7 cases reported in the published English literature.

Patient concerns:
We present the case of a 66-year-old woman with duodenal metastasis of cervical squamous cell carcinoma who presented with nausea and vomiting within the past 12 days.

Diagnosis:
Esophagogastroduodenoscopy revealed a circular narrowed 2nd part of the duodenum with congested and edematous mucosa, which was biopsied for a suspected neoplastic lesion. The pathological diagnosis indicated squamous cell carcinoma identical to the original tumor, confirming duodenal metastasis.

Interventions:
The patient received total parenteral nutrition on admission, but symptoms of jaundice soon appeared in the following week, suggesting infiltration of carcinoma into the common bile duct. After percutaneous transhepatic cholangial drainage was performed, jaundice eased in the following 3 days, and an uncovered self-expandable metallic stent was subsequently inserted into the stenosis of 2nd and 3rd part of the duodenum. Subsequently, the patient's diet quickly resumed.

Outcomes:
The patient refused further intervention and was discharged home to continue palliative care at the local hospital.

Lessons:
Clinicians should be alert to patients’ past medical history to ensure that duodenal metastasis of other tumors is considered in the differential diagnosis. For endoscopists, awareness of such patterns of duodenal stenosis is vital for the accurate recognition of such infrequent diseases.
Low intensity extracorporeal shockwave therapy for chronic pelvic pain syndrome patients with erectile dysfunction
Authors: Daneshwar Datesh , Nordin Abid 
Published: January 2022

Abstract

Introduction:
In this study, the efficacy of low intensity shock wave therapy (LSWT) in improving symptoms of chronic pelvic pain syndrome (CPPS) and erectile dysfunction (ED) was investigated.

Methods:
Men diagnosed with CPPS and ED (n = 50) were prescribed with LSWT. The LSWT was administered in 10 sessions over the course of 5 weeks at 3,000 pulses with .25 mJ/mm2 energy flow and 5 Hz frequency. Outcome parameters were measured before and after LSWT.

Results:
Clinical symptoms related to CPPS and ED were measured using four validated questionnaires namely National Institute of Health Chronic Prostatitis Symptom Index (NIH-CPSI), the International Index of Erectile Function (IIEF), the International Prostate Symptom Score (IPSS), and Sexual Health Inventory for Men (SHIM). The effect of LSWT on each of the three domains of NIH-CPSI, namely Pain, Symptoms, and Quality of Life (QoL) were also analyzed. Uroflowmetry was measured to assess LSWT effect on urine voiding. The mean baseline CPPS symptoms on NIH-CPSI domains of pain, symptoms and QoL were 9.92 ± 5.72 (mean ± SD), 5.14 ± 14.5, and 8.02 ± 3.17, respectively. LSWT resulted in significant reduction of CPPS symptoms on all NIH-CPSI domains (Pain = .9 ± 1.37; Symptoms = .74 ± 1.03; QoL = 1.16 ± 1.78). The baseline means of CPPS symptoms on IIEF, IPSS, and SHIM were 45.42 ± 16.24, 24.68 ± 9.28, and 14.28 ± 6.02, respectively. LSWT significant improved CPPS symptoms on IIEF (49.48 ± 28.30) and IPSS (9.04 ± 7.01) but not on SHIM (16.02 ± 9.85). No statistically significant differences were observed with all uroflowmetry parameters.

Conclusion:
The current study demonstrated for the first time the safety and efficacy of LSWT administered in 10 sessions over 5 weeks in improving symptoms of CPPS and ED without causing any significant adverse effect to the patient.
Primary spindle cell sarcoma of gallbladder
Authors: Long Xin , Chen Yan , Chen Wei-Xun , Wu Yu , Song Jia , Chen Jin , Zhang Lei 
Published: January 2022

Abstract

Introduction:
Primary spindle cell sarcoma of the gallbladder is a rare condition.

Patient concerns:
A 67-year-old woman was admitted to a local hospital with a chief complaint of abdominal pain in the right upper quadrant for the past 2 months.

Diagnosis and intervention:
Surgical resection was performed following the diagnosis of primary gallbladder sarcoma with local hepatic metastasis. Histological examination confirmed a diagnosis of primary spindle cell sarcoma and hepatic metastasis with simultaneous cholecystolithiasis.

Outcomes:
Adjuvant chemoradiation therapy was not performed because the patient refused treatment. Three months after the surgery, a relapsed lesion was diagnosed. The patient underwent transcatheter arterial chemoembolization.

Conclusions:
The disease should be differentially diagnosed from gallbladder carcinoma or carcinosarcoma with hepatic metastasis. An aggressive surgical approach should be based on a balance between the risk of surgery and the outcome.
Safety of the BNT162b2 mRNA COVID-19 vaccine in oncologic patients undergoing numerous cancer treatment options
Authors: Kian Waleed , Zemel Melanie , Kestenbaum Emily H. , Rouvinov Keren , Alguayn Wafeek , Levitas Dina , Ievko Anna , Michlin Regina , Abod Moataz A. , Massalha Ismaell , Chernomordikov Elena , Sharb Adam A. , Shalata Walid , Levison Esther , Roisman Laila C. , Lavrenkov Konstantin , Peled Nir , Nesher Lior , Yakobson Alexander 
Published: January 2022

Abstract
The COVID-19 pandemic, caused by the SARS-CoV2 virus, has infected millions worldwide with cancer patients demonstrating a higher prevalence for severe disease and poorer outcomes. Recently, the BNT162b2 mRNA COVID-19 vaccine was released as the primary means to combat COVID-19. The currently reported incidence of local and systemic side effects was 27% in the general public. The safety of the BNT162b2 mRNA COVID-19 vaccine has not been studied in patients with an active cancer diagnosis who are either ongoing or plan to undergo oncologic therapy.
This single center study reviewed the charts of 210 patients with active cancer diagnoses that received both doses of the BNT162b2 mRNA COVID-19 vaccine. The development of side effects from the vaccine, hospitalizations or exacerbations from various oncologic treatment were documented. Type of oncologic treatment (immunotherapy, chemotherapy, hormonal, biologic, radiation or mixed) was documented to identify if side effects were related to treatment type. The time at which the vaccine was administered in relation to treatment onset (on long term therapy, within 1 month of therapy or prior to therapy) was also documented to identify any relationships.
Sixty five (31%) participants experienced side effects from the BNT162b2 mRNA COVID-19 vaccine, however most were mild to moderate. Treatment protocol was not linked to the development of vaccine related side effects (P = .202), nor was immunotherapy (P = .942). The timing of vaccine administered in relation to treatment onset was also not related to vaccine related side effects (P = .653). Six (2.9%) participants were hospitalized and 4 (2%) died.
The incidence of side effects in cancer patients is similar to what has been reported for the general public (31% vs 27%). Therefore, we believe that the BNT162b2 mRNA COVID-19 vaccine is safe in oncologic patients undergoing numerous cancer treatments.
Arterial spin labeling signal ratio between the lesion and contralateral sides for evaluation of acute middle cerebral artery infarct
Authors: Lee Junyoung , Park Dong Woo , Kim Young Seo , Kim Hyun Young , Lee Young-Jun 
Published: January 2022

Abstract
The purpose of our study was to differentiate arterial transit artifact from post-recanalization luxury perfusion on arterial spin labeling (ASL) image, and obtain the relationship between ASL signal intensity and clinical outcomes in patients with acute ischemic stroke.
Thirty-five subjects with an acute middle cerebral artery (MCA) infarct were enrolled (18 with recanalized and 17 with non-recanalized MCAs). ASL images were obtained using pseudo-continuous ASL technique with 1600 ms (millisecond) of post-label delay within 3 days from symptom onset. Signal intensities on color ASL images were classified as high, intermediate, and poor grade visually. The ratio of maximum ASL signal between the ischemic area and contralateral side was calculated and compared between patients with and without MCA recanalization. Among patients with non-recanalized MCA, ASL signal ratios were compared between patients with and without hyperintense vessel sign on fluid attenuated inversion recovery (FLAIR). Also, correlation between the ASL signal ratio and National Institutes of Health Stroke Scale (NIHSS) score was evaluated.
High or intermediate grade on color ASL images were more frequently found in patients with recanalized MCA (P < .01). Patients with non-recanalized MCA had higher ASL signal ratio in overall ASL signal grade (P = .010) and intermediate grade (P = .011). Among patients with non-recanalized MCA, those with hyperintense vessel sign on FLAIR had higher ASL signal ratios (P = .049). ASL signal ratio was negatively correlated with both initial (P = .023) and final (P = .003) NIHSS scores.
The ASL signal ratio could help to differentiate between the pial collaterals and post-recanalization luxury perfusion. A higher ASL ratio was related with the hyperintense vessel sign on FLAIR and lower NIHSS score.
Immersive virtual reality (VR) training increases the self-efficacy of in-hospital healthcare providers and patient families regarding tracheostomy-related knowledge and care skills
Authors: Chiang Dung-Hung , Huang Chia-Chang , Cheng Shu-Chuan , Cheng Jui-Chun , Wu Cheng-Hsien , Huang Shiau-Shian , Yang Ying-Ying , Yang Ling-Yu , Kao Shou-Yen , Chen Chen-Huan , Shulruf Boaz , Lee Fa-Yauh 
Published: January 2022

Abstract

Background:
Virtual reality (VR)-based simulation in hospital settings facilitates the acquisition of skills without compromising patient safety. Despite regular text-based training, a baseline survey of randomly selected healthcare providers revealed deficiencies in their knowledge, confidence, comfort, and care skills regarding tracheostomy. This prospective pre–post study compared the effectiveness of regular text- and VR-based intervention modules in training healthcare providers’ self-efficacy in tracheostomy care skills.

Methods:
Between January 2018 and January 2020, 60 healthcare providers, including physicians, nurses, and respiratory therapists, were enrolled. For the intervention, a newly developed head-mounted display (HMD) and web VR materials were implemented in training and clinical services. Subsequently, in-hospital healthcare providers were trained using either text or head-mounted display virtual reality (HMD-VR) materials in the regular and intervention modules, respectively. For tracheostomy care skills, preceptors directly audited the performance of trainees and provided feedback.

Results:
At baseline, the degree of trainees’ agreement with the self-efficacy-related statements, including the aspects of familiarity, confidence, and anxiety about tracheostomy-related knowledge and care skills, were not different between the control and intervention groups. At follow-up stage, compared with the regular group, a higher percentage of intervention group’ trainees reported that they are “strongly agree” or “somewhat agree” that the HMD-VR simulation increases their self-efficacy, including the aspects of familiarity and confidence, and reduced their anxiety about tracheostomy-related knowledge and care skills. After implementation, a higher degree of trainees’ average satisfaction with VR-based training and VR materials was observed in the intervention group than in the regular group. Most reported that VR materials enabled accurate messaging and decreased anxiety. The increasing trend of the average written test and hands-on tracheostomy care skills scores among the intervention group trainees was significant compared to those in the regular group. The benefits of HMD-VR simulations and web-VR material-based clinical services for in-hospital healthcare providers and patient families persisted until 3 to 4 weeks later.

Conclusion:
The current study suggests that VR materials significantly enhance trainees’ self-efficacy (increased familiarity, increased confidence, and reduced anxiety) and their satisfaction with the training, while motivating them to use acquired knowledge and skills in clinical practice.
Efficacy and safety of nitrate supplementation on exercise tolerance in chronic obstructive pulmonary disease
Authors: Yang Hongkuan , He Shuifeng , Chen Fang , Liang Linbao , Pan Junjie 
Published: January 2022

Abstract

Background:
Exercise intolerance was prevalent in people with chronic obstructive pulmonary disease (COPD) and had a detrimental effect on the quality of life. We aimed to evaluate the efficacy and safety of nitrate supplementation in exercise tolerance of people with COPD.

Methods:
We searched medical databases including Cochrane Library, EMBASE, and PubMed from inception to October 2020 for randomized control trials in treating COPD with nitrate supplementation.

Results:
Nine trials were identified. Compared with placebo, nitrate supplementation has no significant effect on the following variables: exercise endurance time (standard mean difference [SMD]: 0.06; 95% confidence interval [CI]: –0.39 to 0.52; P = .79), exercise capacity (SMD: 0.30; 95% CI: –0.21 to 0.80; P = .25), oxygen consumption (SMD: –0.04; 95% CI: –0.33 to 0.25; P = .80), resting systolic blood pressure (MD: –2.84; 95% CI: –8.46 to 2.78; P = .32), systolic blood pressure after exercise (MD: –4.66; 95% CI –15.66 to 6.34; P = .41), resting diastolic blood pressure (MD: 0.89; 95% CI: –4.41 to 6.19; P = .74), diastolic blood pressure after exercise (MD: –0.21; 95% CI: –5.51 to 5.10; P = .94), heart rate (MD: –2.52; 95% CI: –7.76 to 2.73; P = .35), and arterial oxygen saturation (MD: –0.44; 95% CI: –2.38 to 1.49; P = .65). No severe adverse effects from nitrate supplementation were reported in the included trails.

Conclusion:
Current evidence suggests that nitrate supplementation may be safe but ineffective for improving exercise tolerance in people with COPD.
Congenital soft tissue Ewing's sarcoma
Authors: Yang Chaoxiang , Chen Wenjun , Han Penghui 
Published: January 2022

Abstract

Rationale:
Most congenital soft tissue masses are benign. Ewing's sarcoma (ES) is a highly malignant tumor that commonly occurs in children and adolescents and rarely occurs during the fetal period. Cases of congenital soft tissue ES with magnetic resonance imaging (MRI) findings are scarce. To the best of our knowledge, no previous reports have described the pre- and postnatal MRI findings of ES.

Patient concerns:
We present a case of congenital soft tissue ES arising in the body wall, which was examined using MRI during the prenatal and neonatal periods.

Diagnoses:
Malignancy was suspected by diffusion-weighted imaging, which demonstrated restricted diffusion within the mass even during the fetal period. ES was confirmed via histopathological examination after birth.

Interventions:
The patient initially underwent conservative treatment for suspected hemangioma. Tumorrectomy was undergone after three weeks based on previously dissatisfied therapeutic effects.

Outcomes:
The patient died of multiple distant metastases despite undergoing postoperative chemotherapy and metastasectomies.

Lessons:
Fetal or neonatal soft tissue ES may be clinically misdiagnosed as a hemangioma. It is important to suspect this through an imaging approach such as diffusion-weighted imaging.
Vitamin D deficiency osteomalacia triggered by long-term social withdrawal and unbalanced diet in a Japanese middle-aged subject
Authors: Iwamoto Yuichiro , Tatsumi Fuminori , Dan Kazunori , Katakura Yukino , Shimoda Masashi , Kimura Tomohiko , Nakanishi Shuhei , Mune Tomoatsu , Kaku Kohei , Kaneto Hideaki 
Published: January 2022

Abstract

Introduction:
Osteomalacia is caused by an increase in the number of osteoids owing to mineralization failure. There are various causes of osteomalacia, such as hypophosphatemia due to excess production of fibroblast growth factor 23, vitamin D deficiency, insufficient vitamin D action, and renal tubular disorders.

Patient concerns:
A 53-year-old man with bone pain and gait disturbance was referred to our institution. At the age of 35, he developed atopic dermatitis. He had eyesight deterioration due to atopic cataracts when he was 37 years old. Subsequently, he stayed home all the time, and his eating habits were unbalanced for a long period of time. Although he had atopic dermatitis, he did not take allergen-free diets, and he did not use sunscreen. Furthermore, when he was 43 years old, he failed to flex his legs and suffered gait disturbance.

Diagnosis:
Hypocalcemia and hypophosphatemia were observed as follow: calcium, 5.5 mg/dL; adjusted calcium, 6.9 mg/dL; inorganic phosphorous, 1.9 mg/dL. In addition, intact parathyroid hormone levels were as high as 277.4 pg/mL, and 1, 25-(OH)2 vitamin D and 25-(OH) vitamin D levels were markedly reduced: 1, 25-(OH)2 vitamin D, ≤4 pg/mL; 25-(OH) vitamin D, 11.0 ng/mL. Fibroblast growth factor 23 levels did not increase. Alkaline phosphatase (ALP) and bone-type ALP (BAP) levels were high: ALP, 784 U/L; BAP, 159.2 μg/L (reference range: 3.7–20.9 μg/L). Based on these findings, we diagnosed this patient with vitamin D-deficient osteomalacia triggered by long-term social withdrawal and an unbalanced diet.

Interventions and outcomes:
After hospitalization, to treat vitamin D-deficient osteomalacia, we started to administer 1 μg/day of alfacalcidol and 3 g/day of calcium lactate. Approximately one month later, 1,25-(OH)2 vitamin D levels increased to 214 pg/mL. Consequently, calcium and inorganic phosphorus were also increased up to 7.8 mg/dL and 3.9 mg/dL, respectively, and intact parathyroid hormone was decreased to 132.0 pg/mL.

Conclusions:
We should bear in mind the possibility of osteomalacia triggered by social withdrawal and vitamin D deficiency even in middle-aged subjects.
Acupuncture for nasal congestion in COVID-19
Authors: Dong Zhibin , Guo Jinyun , Deng Tingting , Zhang Jingwen , Lv Xinwei , Zhang Kaixin , Ma Yuxia , Ma Yuning 
Published: January 2022

Abstract

Background:
From the end of 2019 to now, coronavirus disease 2019 (COVID-19) has put enormous strain on the world's health systems, causing significant deaths and economic losses worldwide. Nasal congestion, one of the symptoms of COVID-19, poses considerable problems for patients. In China, acupuncture has been widely used to treat nasal congestion caused by COVID-19, but there is still a lack of evidence-based medical evaluation.

Methods:
According to the retrieval strategies, randomized controlled trials on the acupuncture for COVID-19 nasal congestion were obtained from China National Knowledge Infrastructure, WanFang, VIP, PubMed, Embase, and Cochrane Library, regardless of publication date, or language. Studies were screened based on inclusion and exclusion criteria, and the Cochrane risk bias assessment tool was used to evaluate the quality of the studies. The meta-analysis was performed using Review Manager (RevMan 5.3) and STATA 14.2 software. Ultimately, the evidentiary grade for the results will be evaluated.

Results:
The study will provide a high-quality and convincing assessment of the efficacy and safety of acupuncture in the treatment of COVID-19's nasal congestion and will be published in peer-reviewed journals.

Conclusion:
Our findings will provide references for future clinical decision and guidance development.

PROSPERO registration number:
NO.CRD42021299482.
Dramatic recovery without steroid therapy and withdrawal from insulin therapy in a subject with hyperglycemic and hyperosmolar syndrome and depletion of insulin secretory capacity induced by type 2 autoimmune pancreatitis
Authors: Iwamoto Yuichiro , Tatsumi Fuminori , Kohara Kenji , Shimoda Masashi , Nakanishi Shuhei , Mune Tomoatsu , Kaku Kohei , Kaneto Hideaki 
Published: January 2022

Abstract

Introduction:
Autoimmune pancreatitis (AIP) is characterized by the involvement of autoimmune mechanisms and is classified as type 1, together with infiltration of IgG4-positive cells, and type 2 with poor serological abnormal findings. In clinical practice, AIP is often treated with steroid therapy.

Patient concerns:
An 81-year-old Japanese woman had thirst and appetite loss in the previous 5 days; thus, she visited a local doctor. The patient had no abdominal or back pain. She had no history of diabetes mellitus, but at that time blood glucose level and HbA1c were as high as 633 mg/dL and 9.7%, respectively, and she was referred to our institution.

Diagnosis:
Based on various clinical findings in this patient, we diagnosed her with hyperglycemic and hyperosmolar syndrome and depletion of insulin secretory capacity induced by type 2 AIP.

Interventions and outcomes:
The patient completely recovered without steroid therapy and was withdrawn from insulin therapy.

Conclusions:
We should bear in mind the possibility of AIP when the sudden onset of hyperglycemia together with enlargement of the pancreas are observed in subjects without a history of diabetes mellitus.