bluuebunny/crossref_metadata_2025_split huggingface dataset:
Successful rescue of renal transplantation with cardiac arrest after electrical storm: A case report
Authors: Li Hao , Xia Zhiping , Li Ling , Lu Zhongshan , Du Futian , Ye Qifa , Peng Guizhu 
Published: November 2022

Rationale:
Most patients with end-stage chronic kidney disease are associated with complications such as renal hypertension, renal anemia, hyperkalemia, water-sodium retention, and disorders of acid-base balance after long-term renal replacement therapy, which can lead to increased cardiac burden, some degree of myocardial damage, and finally progress to arrhythmia and heart failure. These are the main reasons why patients with chronic kidney disease are prone to cardiovascular events after renal transplantation.

Patient concerns:
We report a case of sudden onset of ventricular fibrillation on the postoperative second day, with repeated electrical storm accompanied by cardiac arrest during resuscitation, a very long cardiopulmonary resuscitation (CPR) process of 5 hours and 14 minutes, and >20 cycles of cardiac defibrillation.

Diagnoses:
According to the patient history and resuscitation process, a diagnosis of ES with cardiac arrest after renal transplantation was formulated.

Intervention:
According to the American Heart Association guidelines for CPR and cardiovascular emergencies, resuscitation measures such as CPR, tracheal intubation, electric defibrillation, symptomatic medication, etc. were performed on the patient.

Outcomes:
Finally, the patient was successfully resuscitated, after which the patient had stable respiratory circulation and no neurological complications. To our knowledge, this is the only reported case in which a patient survived with good neurologic outcomes after a resuscitation that lasted as long as 5 hours and 14 minutes.

Lessons:
This case of adequate resuscitation can provide experience and a basis for CPR of patients with in-hospital complications of cardiovascular events for a long time.
A typical case had rare immediate and delayed red man syndrome multiple times after norvancomycin injection: A case report
Authors: Zang Tianying , Liu Bingyang , Ma Lunkun , Tang Xiaojun 
Published: November 2022

Background:
Red man syndrome (RMS) is an adverse effect of vancomycin that usually occurs within minutes to tens of minutes after infusion. Previous literature reported that RMS rarely occurs again after the infusion speed is controlled.

Methods:
We report a case of immediate and delayed RMS that presented with fever, persistent lower extremity rash, shock, lymphadenopathy and pulmonary edema. This patient subsequently diagnosed with Sjögren's Syndrome, the time from NVCM infusion to RMS onset of this case ranged from 10 minutes to 54 hours, which are all rare in clinic and hard to distinguish severe RMS and IgE-mediated anaphylaxis.

Results:
After multidisciplinary consultation, the patient was diagnosed with RMS based on clinical manifestations and laboratory results. Patients' symptoms, signs, body temperature and disease progress were monitored, and an active search for causes was conducted. After a 20-day treatment, all the symptoms disappeared, the patient was transferred to immunology department to treat SS.

Conclusion subsections:
We reported a patient repeatedly developed fever and even shock when the infusion speed is normal, which was rare and similar as anaphylaxis. Therefore, the progression of RMS and its differentiation from allergy need to be further studied.
The prognostic significance of prognostic nutritional index in gastrointestinal stromal tumors: A systematic review and meta-analysis
Authors: Li Zhenjie , Zhang Dengming , Mo Chunlin , Zhu Peijin , Fan Xiaoxi , Tang Tingyong 
Published: November 2022

Background:
Risk assessment before treatment is important for gastrointestinal stromal tumors (GISTs), which will determine the priority of surgery or preoperative treatment. The prognostic nutritional index (PNI) is an integrated parameter consisting of serum albumin and lymphocyte count. Immunonutritional status defined in this manner is well-known to be closely linked to the prognosis of several other cancers. Nevertheless, the prognostic value of PNI specifically in GISTs has not been well-established. This study aimed to verify the prognostic role of PNI in patients with GISTs.

Methods:
A comprehensive literature search was conducted on medical databases up to June, 2022, and the raw data (hazard ratios and 95% confidence intervals [CIs]) focusing on the prognostic value of PNI in patients with GISTs regarding recurrence-free survival were extracted and synthesized adopting the random-effects model. This review was registered in the PROSPERO database (CRD42022345440).

Results:
A total of 8 eligible studies including 2627 patients with GISTs was analyzed and the pooled results confirmed that an elevated PNI was associated with a better recurrence-free survival (hazard ratio: 0.52, 95% CI: 0.40–0.68), with a moderate heterogeneity (I-square, 38%). The findings from subgroup analysis were consistent with the overall pooled results, and a sensitivity analysis, not the subgroup analysis, identified the source of heterogeneity.

Conclusion:
Elevated pretreatment PNI may be a useful indicator for assessing risk of recurrence in patients from China with GISTs. Studies in other countries and regions are needed to further verify the prognostic value of PNI in GISTs.
Biventricular repair of double-outlet left ventricle by handmade trileaflet-valved conduit: A case report
Authors: Alifu Ailixiati , Wang Haifan , Su Yuntian , Chen Renwei 
Published: November 2022

Rationale:
Double-outlet left ventricle (DOLV) is a rare congenital cardiac malformation in which both great arteries arise entirely or predominantly from the left ventricle. An extracardiac conduit is the first surgical option for repairing DOLV, specifically because its placement of the extracardiac conduit can be customized to accommodate all possible anatomical variations. The bovine jugular veins and homograft valves are often used as conduits. There have been no reports on the use of handmade trileaflet-valved conduits for correcting DORV.

Patient concerns:
A 1-year old male was admitted for significant heart murmur and cyanosis, according to the results of transthoracic echocardiography, computed tomography angiography, and cardioangiography, and was diagnosed with DOLV and pulmonary stenosis.

Diagnosis and interventions:
The patient underwent biventricular repair with a handmade trileaflet-valved extracardiac conduit. The postoperative course was uneventful.

Outcome:
Three months after the surgery, TTF indicated mild right ventricular outflow obstruction and pulmonary valve regurgitation.

Lessons:
Correction of the left ventricular double outlet with a handmade trileaflet-valved conduit has been shown to have excellent performance, and long-term outcomes should be followed over time.
Posterior cerebral artery embolism resulting in bilateral paramedian thalamic infarction: A case report
Authors: Xie Shaowei , Han Ning , Chen Xingyu , Yin Kuochang , Xu Guodong , Dong Yanhong , Lv Peiyuan 
Published: November 2022

Rationale:
Bilateral thalamic infarcts are not easily recognized, it have diverse clinical manifestations and relatively severe symptoms. It may leave long-term drowsiness, cognitive impairment, and speech impairment. We report a case of bilateral paramedian thalamic infarction with impaired consciousness as the main symptom. The digital subtraction angiography suggested that the left superior cerebellar artery and posterior cerebral artery (PCA) were occluded.

Patients concern:
A previously 67-year-old man was taken to our hospital after 9.5 hours of acute dizziness and loss of consciousness.

Diagnosis:
The cranial DWI + MRA suggested acute cerebral infarction in bilateral thalamus and bilateral midbrain, and the left posterior cerebral artery was not clearly visualized. The patient was diagnosed with posterior cerebral artery embolism.

Interventions:
A mechanical thrombectomy was performed.

Outcome:
The patient’s symptoms did not completely improve after revascularization, followed by fluctuating consciousness.

Lessons:
Recurrent lethargy in patients after endovascular treatment may be a clinical manifestation of damage to thalamic structures or due to the presence of ineffective recanalization.
A CARE-compliant article: A case report and literature review of IgG4-related lung disease
Authors: Ren Hongmei , Han Zhiqing , Zuo Xiaoming , Wang Jinping , Meng Siming , Zheng Cuixia 
Published: November 2022

Rationale:
IgG4-related lung disease (IgG4-RLD) is an unusual disease, with various clinical manifestations and various chest imaging findings. The patients may have no respiratory symptoms. Therefore, diagnosis is challenging. This can easily cause misdiagnosis and mistreatment.

Patient concerns:
A 71-year-old male presented with chest pain, cough, and shortness of breath. Plain chest computed tomography scans showed multi-locus nodes at the center of the hilum.

Diagnosis:
Percutaneous lung biopsy was performed, and IgG4-RLD was diagnosed.

Interventions:
Prednisone was orally administered daily.

Outcomes:
The case’s symptoms improved. The patient was discharged from the hospital. After 2 months of reexamination, his symptoms were relieved. Reexamination of the chest computed tomography showed that multi-locus nodes of the lung were obviously absorbed compared with those before.

Lessons:
IgG4-RLD is a rare respiratory disease. It has atypical clinical manifestations and chest images. We report the first case of IgG4-RLD showing multi-locus nodes centered on the hilar, hypertrophic mucosa; as well as a narrow and even occluded lumen.
Once-daily Compared With Twice-daily Enoxaparin Maintenance Therapy Appears Safe and Efficacious in Pediatric Venous Thromboembolism
Authors: Gibson Amber , Montanez Natalie , Addy Katherine , Hashmi S. Shahrukh , Brown Deborah , Rodriguez Nidra , Menon Neethu , Srivaths Lakshmi 
Published: November 2022

Introduction:
Once-daily enoxaparin (ODE), considered standard of care for venous thromboembolism (VTE) treatment in adults, has been infrequently assessed in children. To contribute available data to a limited field, we reviewed our center’s experience with ODE in treating pediatric VTE compared with twice-daily enoxaparin (TDE).

Materials and Methods:
A retrospective analysis of children and adolescents 18 years of age or below diagnosed with VTE and treated at our institution with ODE or TDE maintenance therapy between April 2015 and December 2020 was performed. Patient demographics, clinical and laboratory data pertaining to VTE diagnosis, and management were gathered from electronic medical records and compared between the 2 cohorts.

Results:
Seventy-one children met the eligibility criteria. All patients were initially treated with TDE for 2 weeks before transitioning to ODE maintenance therapy (n=39; 55%) or continuing with TDE dosing (n=32; 45%).
Extremity VTE was more common in ODE (P=0.051) versus pulmonary/intracardiac sites in TDE (P=0.002) when compared with other sites. Median enoxaparin dosing was 1.5 and 1.1 mg/kg/dose in ODE and TDE cohorts, respectively. Bleeding episodes were rare without any difference between the cohorts. Two patients (6%) were lost to follow up in TDE cohort. All evaluable patients in both cohorts had either complete/partial response (ODE n=35 [90%]; TDE n=24 [75%] or stable thrombus ODE n=4 [10%]; TDE n=6 [19%]).

Conclusions:
Our results indicate that ODE, used after the initial TDE treatment period, is as safe and efficacious as TDE maintenance for the treatment of pediatric VTE. The difference in VTE sites may have contributed to the equal efficacy of both the cohorts. Future prospective studies in pediatric VTE are needed to validate these results.
Capgras Syndrome: In the Conscious and the Unconscious Mind
Authors: Chaudhry Serena , Weiss Ashley , Surdis Costandino , Garrett Michael 
Published: November 2022

Abstract
We report the successful psychotherapy and medical treatment of a patient with an atypical presentation of Capgras syndrome, in which the patient not only believed that his parents were impostors but also believed that the entirety of what others would consider consensual reality was in fact an impostor. He insisted that a complex delusional world in which he wished to reside was authentic reality. His delusions of misidentification waxed and waned in response to discernable social stressors, and at times, he seemed to have conscious insight into the delusional nature of his beliefs. This case raises questions about whether Capgras should be considered a stand-alone diagnosis or whether it should be placed within a wider spectrum of psychotic disorders. Excepting our current report, although there are numerous reports of the resolution of Capgras after treatment with neuroleptics, we are unaware of descriptions in the literature of the successful treatment of medication-resistant Capgras with a combination of individual psychotherapy and pharmacological management.
Effects of light on sleep in older adults: a scoping review
Authors: Jiang Lei , Zhou Baibing , Han Han 
Published: November 2022

Abstract
In light of the increase of aging populations, there is a need to focus on how older adults experience sleep disorders. This scoping review aimed to synthesize the features of the light and its effects on sleep in older adults. A total of 25 articles focusing on the effects of light on sleep among older adults were included. We synthesized light intensity, treatment duration, and the spectrum of light therapy as well as features of natural and artificial light that were used to improve sleep outcomes. Literature has shown evidence for the positive effects of light therapy on sleep in older adults. Older adults are, therefore, encouraged to receive frequent sunlight exposure and artificial lighting that accords with the cycle of their circadian rhythms.
Trends of multimorbidity status among the older Chinese population: findings from the Chinese Longitudinal Healthy Longevity Survey 2000 to 2018
Authors: Su Hexuan , Chen Yuming , Xu Huiwen , Wang Kaipeng , Luo Yan , Xu Beibei 
Published: November 2022

Abstract

Objectives:
This paper aimed to assess temporal trends and risk factors of multimorbidity among older Chinese adults from 2000 to 2018.

Methods:
A total of 51,326 participants aged 65–105 from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) 2000–2018 were included. Multimorbidity was defined as the co-occurrence of 2 or more (up to 14) chronic conditions in a single person. The adjusted proportion of the number of chronic conditions by follow-up year was examined and described. The generalized estimating equation model including the natural cubic spline was used to predict the prevalence of multimorbidity. Associated factors were identified using generalized estimating equation models from 2000 to 2018. All analyses were conducted separately in 2 age groups: the young-old group (aged 65–79) and the older-old group (aged 80–105).

Results:
The adjusted multimorbidity prevalence for the young-old group increased from 23.9% in 2002 to 72.5% in 2014 and remained high at 46.3% in 2018; the adjusted prevalence for the older-old group increased from 63.4% in 2000 to 87.2% in 2011 and remained at 73.0% in 2018. Being female, having fewer educational years, a professional or technical occupation, and a history of smoking or drinking were associated with an increased risk for multimorbidity in young-old group; while in older-old group, being female, current smoker or drinker, and less engagement in social and leisure activity were associated with an increased risk for multimorbidity.

Conclusion:
The prevalence of multimorbidity first increases and then decreases for both age groups. Management of multimorbidity requires more attention from health policymakers, service providers, and educators of health professionals in China. Health systems should prioritize improving the management of older patients, especially women who have lower education levels.
Sex-specific gut microbiome profiles among preterm infants during the neonatal intensive care hospitalization
Authors: Chen Jie , Li Hongfei , Maas Kendra , Starkweather Angela , Chen Minghui , Cong Xiaomei 
Published: November 2022

Abstract

Objectives:
The gut microbiota among preterm infants is shaped by sex and feeding types. However, sex-specific weekly patterns of gut microbiome profiles among preterm infants during their neonatal intensive care unit (NICU) hospitalization remain unclear. This study aimed to investigate the effect of sex on the weekly development of preterm neonatal gut microbiota in the first 4 weeks of NICU hospitalization.

Methods:
This secondary data analysis included 28 preterm neonates with 261 stool samples collected from January 2014 to February 2015 in the Northeastern United States. The 16S rRNA V4 gene regions of the stool samples were sequenced and aligned against the SILVA 132 database by using Mothur 1.42.3. The sex-specific weekly diversity indexes and relative abundance of bacterial taxonomic composition were generated by Mothur and analyzed by R packages. Sex-specific weekly compositional patterns of the gut microbiome and predicted metabolic functions of gut microbiome profiles were compared, respectively.

Results:
In each week of the NICU hospitalization, preterm females and males had significantly distinguished β-diversity indices and compositions of gut microbiota. Both females and males had significantly enriched Bifidobacterium, a protection feature, in stool samples collected in the third week compared with those in the second week. The predicted metabolic pathways were significantly different between females and males in the second, third, and fourth week of the NICU hospitalization. Both females and males had significantly abundant pathways. Males consistently had more abundance of “lipopolysaccharide biosynthesis” than females in the second, third, and fourth week. Males also had a significant abundance of “membrane and intracellular structural molecules” and “glycan biosynthesis and metabolism” in the second and third week.

Conclusions:
Sex shaped the weekly patterns of preterm neonatal gut microbiome profiles during the first 4 weeks of the NICU hospitalization. Further clinical interventions should consider the distinct gut microbiota compositions and predicted functional profiles between female and male preterm neonates.
A Pediatric Cervical Spine Clearance Guideline Leads to Fewer Unnecessary Computed Tomography Scans and Decreased Radiation Exposure
Authors: Douglas Geoffrey P. , McNickle Allison G. , Jones Stephanie A. , Dugan Mark C. , Kuhls Deborah A. , Fraser Douglas R. , Chestovich Paul J. 
Published: November 2022

Objectives
Physical examination and computed tomography (CT) are useful to rule out cervical spine injury (CSI). Computed tomography scans increase lifetime cancer risk in children from radiation exposure. Most CSI in children occur between the occiput and C4. We developed a cervical spine (C-spine) clearance guideline to reduce unnecessary CTs and radiation exposure in pediatric trauma patients.

Methods
A pediatric C-spine clearance guideline was implemented in September 2018 at our Level 2 Pediatric Trauma Center. Guidance included CT of C1 to C4 to scan only high-yield regions versus the entire C-spine and decrease radiation dose. A retrospective cohort study was conducted comparing preguideline and postguideline of all pediatric trauma patients younger than 8 years screened for CSI from July 2017 to December 2020. Primary endpoints included the following: number of full C-spine and C1 to C4 CT scans and radiation dose. Secondary endpoints were CSI rate and missed CSI. Results were compared using χ2 and Wilcoxon rank-sum test with P < 0.05 significant.

Results
The review identified 726 patients: 273 preguideline and 453 postguideline. A similar rate of total C-spine CTs were done in both groups (23.1% vs 23.4%, P = 0.92). Full C-spine CTs were more common preguideline (22.7% vs 11.9%, P < 0.001), whereas C1 to C4 CT scans were more common post-guideline (11.5% vs 0.4%, P < 0.001). Magnetic resonance imaging utilization and CSIs identified were similar in both groups. The average radiation dose was lower postguideline (114 vs 265 mGy·cm−1; P < 0.001). There were no missed CSI.

Conclusions
A pediatric C-spine clearance guideline led to increasing CT of C1 to C4 over full C-spine imaging, reducing the radiation dose in children.

Level of Evidence
Level IV, therapeutic.
Ultrasound-Guided Supraclavicular Brachial Plexus Blocks Performed by Pediatric Emergency Medicine Physicians for Painful Orthopedic Procedures in a Pediatric Emergency Department—A Case Series
Authors: Shahar-Nissan Keren , Berant Ron , Ganor Lior , Katzir Yair 
Published: November 2022

Ultrasound-guided brachial plexus blocks are a common pain-reducing technique in the operating room and are also performed in the emergency department, primarily in adults. Performing brachial plexus blocks in the pediatric emergency department by pediatric emergency medicine physicians is yet to become common practice and may pose various challenges.

Objective
The aim of this study was to describe our experience with ultrasound-guided supraclavicular brachial plexus blocks performed by pediatric emergency physicians for the purpose of forearm fracture reductions in the emergency department.

Methods
We present a case series of 15 pediatric patients aged 7 to 17 years undergoing ultrasound-guided supraclavicular blocks.

Results
All blocks resulted in adequate analgesia. No procedural complications were observed.

Conclusions
We conclude that in select pediatric cases ultrasound-guided brachial plexus blocks can be a safe, swift, and efficient means of pain management and procedural analgesia. This approach obviates the need for sedation, thus shortening the time lag between presentation and the reduction procedure, as well as overall length of stay.
Development and Evaluation of the Ally Sexual and Gender Minority Diversity and Inclusion Training at the Centers for Disease Control and Prevention
Authors: Thomas Erin V. , Jennings Melissa A. , Kidder Daniel P. , Fechter-Leggett Ethan D. , Bautista Gregorio J. , Johns Michelle M. ,   Ally Training Committee
Published: November 2022

Context:
The Centers for Disease Control and Prevention (CDC) developed a workforce training on sexual and gender minorities (SGMs).

Objective:
This article describes the evaluation of the training.

Design:
Participants completed pre- and posttest surveys. After the pilot evaluation, some improvements were made to the curriculum and to the pre- and posttest questionnaires. Participants in subsequent (implementation) training were similarly asked to complete pre- and posttest questionnaires.

Setting:
CDC.

Participants:
CDC staff.

Main Outcome Measures:
Participants' knowledge, ally identity, and perceptions of SGMs.

Results:
Pilot and implementation training data showed increases in participant knowledge of 44% and 49%, respectively, increases in ally identity of 11% and 14%, respectively, and increases in positive perceptions of SGM of 25% and 31%, respectively.

Conclusion:
These results suggest that the CDC Ally Training may be a useful tool for improving staff knowledge and perceptions of SGM people.