bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of Cardiac Rehabilitation on Physical Fitness, Physical Function, and Self-reported Outcomes in Patients ≥80 yr
Authors: Brosved Madeleine , Hirlekar Geir , Philip Wigh Julia , Sundberg Helen , Zidén Lena , Karlsson Thomas , Albertsson Per , Bäck Maria 
Published: March 2022

Purpose:
The beneficial effects of exercise-based cardiac rehabilitation (CR) after an acute coronary syndrome (ACS) are well known, but patients ≥80 yr have been less studied. The aim was to evaluate the effects of CR on patients with ACS ≥80 yr on peak cardiorespiratory fitness (CRF), physical function, and patient-reported outcome measures (PROMs) compared with a control group.

Methods:
A total of 26 patients with ACS, median age 82 (81, 84) yr, were randomized to hospital-based CR combined with a home-based exercise program (CR group) or to a control group (C) for 4 mo. Outcomes were assessed at baseline and 4 mo and included the peak CRF (primary outcome), 6-min walk test (6MWT), muscle endurance, Timed Up and Go (TUG), Short Physical Performance Battery (SPPB), one-leg stand test, and PROMs.

Results:
There were no significant differences between the groups in peak CRF. The CR group improved significantly in terms of the 6MWT (P = .04), isotonic muscle endurance (P < .001), one-leg stand test (P = .001), SPPB total score (P =.03), Activities-specific Balance Confidence (P =.01), and anxiety (P =.03), as compared with C. There were no significant intergroup differences in the TUG, the self-reported health question or depression.

Conclusions:
Patients with ACS ≥80 yr improved in walking distance, muscle endurance, physical function, and PROMs, but not in peak CRF, by participating in a CR program. These results suggest an increased referral to CR for this growing group of patients to enable preserved mobility and independence in daily living, but this needs to be confirmed in larger studies.
Severity of Rotavirus-Vaccine-Associated Intussusception: Prospective Hospital-Based Surveillance, Australia, 2007–2018
Authors: Sheel Meru , Wood Nicholas , Macartney Kristine , Buttery Jim , Dinsmore Nicole , Marshall Helen , Elliott Elizabeth , Kynaston Anne , Richmond Peter , Chateau Dan , McIntyre Peter ,   on behalf of PAEDS Network
Published: April 2022

Background:
Multiple studies have shown an association between intussusception (IS) and receipt of monovalent or pentavalent rotavirus vaccine (RV) in the previous 21 days. Disease severity is an important consideration for risk-benefit evaluations of RV, but no studies have compared the severity of IS within 21 days of vaccination (vaccine-associated, VA) and later (not temporally-associated, VNA).

Methods:
We used active hospital-based surveillance in the Australian Paediatric Active Enhanced Disease Surveillance (PAEDS) network (July 2007 to February 2018) to identify infants ≤9 months of age meeting Brighton level 1 criteria for IS. We used five severity levels: (1) no surgery and length of stay (LOS) ≤1 day, (2) no surgery and LOS ≥2 days, (3) surgery, no bowel resection, (4) bowel resection, and (5) ICU admission.

Results:
Of 323 eligible cases, 87 (26.9%) were VA and 236 (73.1%) VNA. VA-IS cases (median 21 weeks; 24.1% ≤14 weeks) were significantly younger than VNA-IS cases (median 28 weeks, 7.2% ≤14 weeks). Cases 0–≤14 weeks of age were significantly more likely than cases ≥25 weeks to require bowel resection (relative risk ratio 4.6, 95% CI, 1.48–14.3). This effect was not associated with RV. After adjustment for age and sex, VA-IS was not significantly overrepresented in severity levels 2–5; adjusted RRR of 1.37 (95% CI: 0.61–3.11) for bowel resection in cases 0–≤14 weeks of age.

Conclusions:
IS was uncommon but significantly more severe under 14 weeks of age. After adjustment for age and sex, IS severity was not related to RV.
Injury Trends in Special Olympics Athletes From the 2018 USA Games
Authors: Newman Bram , Fudge Jessie , Haskins Amy , Holt Christina , Dexter William 
Published: April 2022

Objective:
To categorize injury types and occurrence among athletes participating in the Special Olympics (SO).

Design:
Retrospective cross-sectional cohort study.

Setting:
2018 SO USA Games.

Participants:
Athletes participating in 14 sports at the 2018 SO USA Games (n = 2251).

Independent Variables:
Individual and team sports.

Main Outcome Measures:
Percentage of athletes injured per individual sport, percentage of injury type by sport, rate of injuries per 1000 exposures, and number of injuries per game in team sports.

Results:
In individual sports, the percentage of athletes injured ranged from 38.5% in gymnastics to 12.9% in golf. Musculoskeletal (MSK) injuries occurred in 53.3% of gymnastics injuries and 58.6% of tennis injuries. For stand-up paddleboard, most injuries were non-MSK (66.7%). The highest rate of MSK injuries occurred in gymnastics (25.6/1000 exposures), whereas the highest rates of non-MSK injuries (95.2/1000 exposures) and minor injuries (47.6/1000 exposures) were among stand-up paddleboard athletes. In team sports, the highest number of injuries per game occurred in softball (1.9 per game).

Conclusions:
A high percentage of injuries occurred at the 2018 SO USA Games. The high rate of non-MSK injuries is unique to the SO and should be considered when planning medical coverage for future events.
Efficacy and safety of acupuncture on oligomenorrhea due to polycystic ovary syndrome
Authors: Park Kyoung Sun , Gang Weijuan , Kim Pyung-Wha , Yang Changsop , Jun Purumea , Jung So-Young , Kwon Ojin , Lee Jin Moo , Lee Hye Jeong , Lee Su Jeong , Jing Xianghong , Zhang Ning , Hu Jing , Zhao Jiping , Pang Ran , Jin Chunlan , Lee Jun-Hwan 
Published: April 2022

Abstract

Background:
Polycystic ovary syndrome (PCOS) is one of the most common disorders of reproductive endocrinology affecting women of reproductive age. Our study aims to explore the feasibility of a full-scale trial to evaluate the efficacy and safety of acupuncture for PCOS.

Methods:
This study is a two-armed, parallel, multi-country, multi-center, pilot randomized controlled trial (RCT) for PCOS with oligomenorrhea. We will recruit 60 women aged 20 to 40 years with oligomenorrhea due to PCOS. The participants will be randomly assigned to acupuncture and control groups. The acupuncture group will undergo a total of 40 sessions for 16 weeks with usual care. The control group will be managed with usual care (regular meals, sufficient sleep, and appropriate exercise) only. The primary clinical outcome is mean change in menstrual frequency from baseline to 16 weeks and 32 weeks (follow-up) after the start of the trial. The secondary outcomes are menstrual period, levels of estradiol, luteinizing hormone (LH), follicle-stimulating hormone (FSH), and total testosterone, LH/FSH ratio, antral follicle count and ovarian volume, body mass index, waist hip ratio, acne severity, and health-related quality of life questionnaire scores at 16 and 32 weeks after the start of the trial.

Discussion:
This is the first protocol for multi-country, multi-center RCTs for PCOS in Korea and China. The control group in this study will be subjected to usual care (regular meals, enough sleep, and appropriate exercise). The results of this study will provide evidence for future clinical decisions and guidelines.
This trial has been registered at ClinicalTrials.gov (Identifier: NCT04509817).
Diagnosis of sepsis with inflammatory biomarkers, cytokines, endothelial functional markers from SIRS patients
Authors: Xue Mingming , Xu Feixiang , Yang Yilin , Tao Zhengang , Chen Yumei , Wang Sheng , Yin Jun , Min Min , Shi Dongwei , Yao Chenling , Song Zhenju 
Published: April 2022

Abstract

Background
Sepsis is a life-threatening illness with a challenging diagnosis. Rapid detection is the key to successful treatment of sepsis. To investigate diagnostic value, the plasma protein profiles of inflammatory biomarkers, cytokines, and endothelial functional markers were compared between healthy controls, SIRS, and septic patients.

Methods
The plasma protein profiles were performed by Luminex Assay in a cohort of 50 SIRS patients, 82 septic patients and 25 healthy controls. Fourteen plasma proteins were analyzed in the same cohort: IL-1β, IL-6, IL-8, IL-10, CCL-2, VEGF, VEGF-C, VEGFR2, CD62E, CD62P, MFG-E8, ICAM-1, TFPI, Urokinase.

Result
IL-2R, IL-6, IL-8, IL-10, CCL-2, ICAM-1, and Urokinase were significantly higher in sepsis patients than SIRS patients. VEGF, IL-1β, CD62E, CD62P, MFG-E8, and TFPI have no statistical difference. VEGF-C, VEGFR2 were significantly different in SIRS patients than sepsis patients. Urokinase, ICAM-1, and VEGFR2 were significantly different between sepsis group and SIRS group. The AUCs of Urokinase, ICAM-1, and VEGFR2 and the combination for the diagnosis of sepsis were 0.650, 0.688, 0.643, and 0.741, respectively.

Conclusions
Most patients have the higher level of several cytokines and developed endothelial cell injury in the initial phase of sepsis, Urokinase, ICAM-1, and VEGFR2 may be useful to evaluate severity and prognosis of sepsis patients.
A case of crescentic glomerulonephritis in a patient with COVID-19 infection
Authors: Alawad Mouhammad J. , Subahi Eihab A. , Al-Ani Haneen A. , Taha Noheir M. , Kamal Ijaz 
Published: April 2022

Abstract

Rationale:
Kidney involvement with COVID-19 infection is a well-known complication, and the majority of kidney involvement is related to ischemic injury/acute tubular injury. However, there are some cases of glomerulonephritis, the etiology of which is not yet known, but an immune process is likely to be the trigger.

Patient concerns:
A 27-year-old man presented to our hospital with facial puffiness and lower-limb swelling.

Diagnosis:
Laboratory assessment revealed features of impaired kidney function with proteinuria and hematuria; COVID-19 polymerase chain reaction was positive, which was consistent with pauci-immune crescentic focal segmental glomerulonephritis.

Intervention:
After renal biopsy, the patient was started on methylprednisolone and rituximab. Due to worsening kidney parameters, he underwent intermittent hemodialysis as needed.

Outcome:
Kidney function tests partially improved; he was discharged on oral steroids with follow-up in the nephrology clinic to observe for the need for further hemodialysis.

Lessons:
We conducted a literature review of cases of glomerulonephritis associated with COVID-19 and described numerous types of glomerulonephritis. This report highlights the importance of recognizing emerging glomerulonephritis with COVID-19, the different pathological patterns of renal biopsies, and management interventions and responses.
Radiologic placement of Hickman catheters using intravenous sedation in pediatric patients under 20 kg
Authors: Kim Jin Hyeok , Jeon Ung Bae , Jang Joo Yeon , Kim Yong-Woo , Hwang Jae-Yeon , Lim Young Tak , Yang Eu Jeen 
Published: April 2022

Abstract
Surgeons generally perform Hickman catheter insertion in children under general anesthesia. At times, it is difficult to perform procedures with an anesthesiologist for an interventional radiologist. Several diagnostic and therapeutic procedures are efficiently and safely conducted using intravenous (IV) sedation in children with a pediatrician. This study aims to evaluate the efficacy and safety of radiologically placed Hickman catheters using IV sedation in children under 20 kg.
Fifty-nine catheters were inserted in 45 children under IV sedation. With continuous monitoring of vital signs, IV midazolam and ketamine were slowly infused by a pediatrician. Mean age and body weights were 3.2 years and 15.2 kg, respectively. Acute leukemia was the most common disease for the procedure (72.9%). The location of the catheter tip was evaluated by measuring the height of the thoracic vertebra.
Technical success rate was 100%, and IV sedation-related complications did not occur. The right internal jugular vein was accessed for 51 catheters (86.4%), and the mean procedure time was 21.5 minutes. The 2 vertebral body units below the carina were the cavoatrial junction on a fluoroscopy image. Mean catheter life was 285 days, and catheters were removed post-treatment (35.6%). During follow-up, complications occurred in 29 cases (1.72 per 1000 catheter-days). Catheter-related infections were suspected in 4 patients (6.8%), with 1 positive result.
Radiological Hickman catheter placement in children under 20 kg using IV sedation by pediatricians is effective and safe, with minimal complications. The carina is a landmark to estimate the cavoatrial junction in pediatric patients.
Anticipating VA/non-VA care coordination demand for Veterans at high risk for hospitalization
Authors: Vanneman Megan E. , Yoon Jean , Singer Sara J. , Wagner Todd H. , Goldstein Mary K. , Hu Jiaqi , Boothroyd Derek , Greene Liberty , Zulman Donna M. 
Published: April 2022

Abstract
U.S. Veterans Affairs (VA) patients’ multi-system use can create challenges for VA clinicians who are responsible for coordinating Veterans’ use of non-VA care, including VA-purchased care (“Community Care”) and Medicare.
To examine the relationship between drive distance and time—key eligibility criteria for Community Care—and VA reliance (proportion of care received in VA versus Medicare and Community Care) among Veterans at high risk for hospitalization. We used prepolicy data to anticipate the impact of the 2014 Choice Act and 2018 Maintaining Internal Systems and Strengthening Integrated Outside Networks Act (MISSION Act), which expanded access to Community Care.
Cross-sectional analysis using fractional logistic regressions to examine the relationship between a Veteran's reliance on VA for outpatient primary, mental health, and other specialty care and their drive distance/time to a VA facility.
Thirteen thousand seven hundred three Veterans over the age of 65 years enrolled in VA and fee-for-service Medicare in federal fiscal year 2014 who were in the top 10th percentile for hospitalization risk.
Key explanatory variables were patients’ drive distance to VA > 40 miles (Choice Act criteria) and drive time to VA ≥ 30 minutes for primary and mental health care and ≥60 minutes for specialty care (MISSION Act criteria).
Veterans at high risk for hospitalization with drive distance eligibility had increased odds of an outpatient specialty care visit taking place in VA when compared to Veterans who did not meet Choice Act eligibility criteria (odds ratio = 1.10, 95% confidence interval 1.05–1.15). However, drive time eligibility (MISSION Act criteria) was associated with significantly lower odds of an outpatient specialty care visit taking place in VA (odds ratio = 0.69, 95% confidence interval 0.67, 0.71). Neither drive distance nor drive time were associated with reliance for outpatient primary care or mental health care.
VA patients who are at high risk for hospitalization may continue to rely on VA for outpatient primary care and mental health care despite access to outside services, but may increase use of outpatient specialty care in the community in the MISSION era, increasing demand for multi-system care coordination.
Impact of 2 different posterior screw fixation techniques on primary stability in a cervical translational injury model
Authors: Oberkircher Ludwig , Riemenschneider Julia , Bäumlein Martin , Knauf Tom , Bliemel Christopher , Ruchholtz Steffen , Krüger Antonio 
Published: April 2022

Abstract

Background:
In case of injuries to the subaxial cervical spine, especially in osteoporotic bone, the question of the most stable operative technique arises. There are several techniques of screw fixation available regarding dorsal stabilization. This study investigates 2 techniques (lateral mass screws (LMS) vs cervical pedicle screws (CPS)) in the subaxial cervical spine regarding primary stability in a biomechanical testing using a translational injury model.

Methods:
A total of 10 human formalin fixed and 10 human fresh-frozen specimens (C 4 - T 1) were investigated. Specimens were randomized in 2 groups. Fracture generation of a luxation injury between C 5 and C 6 was created by a transection of all ligamentous structures as well as the intervertebral disc and a resection of the facet joints.
Dorsal stabilization of C 4/C 5 to C 6/C 7 was performed in group A by lateral mass screws, in group B by pedicle screws. In the biomechanical testing, the specimens were loaded at 2 N/s in translation direction until implant failure.

Results:
Formalin fixed specimen: Mean load failure was 513.8 (±86.74) Newton (N) for group A (LMS) and 570.4 (±156.5) N for group B (CPS). There was no significant difference (P = .6905).
Fresh frozen specimen: Mean load failure was 402.3 (±96.4) N for group A (LMS) and 500.7 (±190.3) N for group B (CPS). There was no significant difference (P = .4206).

Conclusion:
In our loading model respecting the translational injury pattern and a flexion movement we could not verify statistically significant differences between lateral mass screws and cervical pedicle screws. Mean loading failure was slightly higher in the CPS group though.
A novel NOTCH3 mutation and its clinical, neuroimaging and pathological presentation in a Chinese patient with CADASIL
Authors: Dang Jing , Lei Shengsuo , Xia Mingwan , Chen Jihua 
Published: April 2022

Abstract

Rationale:
Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is the most common form of familial cerebral small vessel disease in adults, and is caused by NOTCH3 mutations. However, individual symptom types, onset, and disease severity span a wide range.

Patient concerns:
Herein, we report a case of chronic neurological symptoms including slurring of speech, recurrent weakness in both limbs and legs, and progressive memory loss. Cranial magnetic resonance imaging revealed recurrent acute lacunar subcortical infarction and extensive white matter hyperintensities. Skin biopsy revealed granular osmiophilic materials close to the cell surface of smooth muscle cells in an arteriolar vessel. The patient's genomic DNA showed a mutation c.635G>C[p.(Cys212Ser)] in exon 4.

Diagnosis:
The patient was finally diagnosed with CADASIL.

Interventions:
The patient was treated with antiplatelet therapy and extremity rehabilitation.

Outcomes:
There was no improvement in speech, extremity function, or memory.

Lessons:
Accurate early diagnosis and appropriate treatment are crucial to improve the prognosis of patients with CADASIL.
Stenosing tenosynovitis with rice bodies formation diagnosed by ultrasound
Authors: Ge Lei , Zhang Lei , Lu Libin 
Published: April 2022

Abstract

Rationale:
Rice bodies are usually found in several nonspecific chronic inflammatory diseases that are symptomatically dominated by primary disease and local compression symptoms. Rice bodies are usually detected by magnetic resonance imaging; however, some remote areas and areas with poor economic conditions do not have access to magnetic resonance imaging examination, which leads to delayed diagnosis of the disease.

Patient concerns:
We report the case of a 62-year-old man with pain in the metacarpophalangeal joint of his right middle finger and limited flexion activity of his middle finger.

Diagnoses:
The mass was 1 cm, well-circumscribed, soft, and painless. Ultrasound showed stenosing tenosynovitis with rice body formation.

Interventions:
The patient underwent tenosynovectomy with synovectomy of the right middle finger tendon sheath under plexus block anesthesia.

Outcomes:
No postoperative complications were noted. A 6-month follow-up showed no recurrence. The activity of the patient's middle finger improved significantly.

Lessons:
Stenosing tenosynovitis with rice body formation is a very rare condition, and we use ultrasound for diagnosis. Ultrasound is convenient, rapid, inexpensive, and can obtain blood flow information, facilitate disease follow-up, and even allow ultrasound localization in advance for guided needle biopsy.
Japanese pediatric patient with moderately active ulcerative colitis successfully treated with ustekinumab
Authors: Kakiuchi Toshihiko , Yoshiura Masato 
Published: April 2022

Abstract

Rationale:
Ustekinumab is effective in the treatment of adult Crohn disease (CD) and ulcerative colitis (UC). However, data on its efficacy and safety in pediatric CD and UC are limited. To the best of our knowledge, there are no reports of Japanese children with UC treated with ustekinumab in the long-term.

Patient concerns:
A 14-year-old man with diarrhea and bloody stools was referred to our hospital. Colonoscopy revealed total colitis-type UC. His pediatric UC activity index score was 50, indicating moderately active UC.

Diagnoses:
Ulcerative colitis.

Interventions:
Infliximab was introduced because of steroid-resistant refractory UC; however, secondary ineffectiveness was observed 17 months later. Therefore, ustekinumab was administered along with prednisolone (16 years of age).

Outcomes:
The patient achieved UC remission after ustekinumab treatment, leading to maintained remission without side effects.

Lessons:
To the best of our knowledge, this is the first pediatric case of moderately active UC successfully treated with ustekinumab in Japan. Ustekinumab combined with steroids is an effective and safe induction therapy for UC.
Congenital aphallia associated with congenital urethrorectal fistula
Authors: Luo Si-Si , Yang Zhe , Ma Ning , Wang Wei-Xin , Chen Sen , Wu Qi , Qu Si-Wei , Li Yang-Qun 
Published: April 2022

Abstract

Rationale:
Aphallia is an extremely rare congenital malformation of unknown cause, with few reports in the literature. It is usually associated with other urogenital and gastrointestinal anomalies and is believed to be a result of either the absence of a genital tubercle or chromosome polymorphism. Herein, we describe an extremely rare case of congenital aphallia with congenital urethrorectal fistula and describe our treatment for this patient.

Patient concerns:
An 8-year-old boy was brought to our hospital by his parents because of congenital absence of the penis. The child was male per karyotype and had excess heterochromatin on chromosome 9 (46 XY with 9 qh+). No urethral orifice was identified, and urine passed rectally since birth; thus, urinary tract outlet obstruction led to urine reflux from the anus to the epididymis for a long time. The boy had to be placed on prophylactic antibiotics because he developed urinary tract infection and epididymitis almost every day.

Diagnosis:
Congenital aphallia (46 XY normal male karyotype) associated with congenital urethroretal fistula.

Interventions:
We performed urethral exteriorization via perineal urethroplasty and urethrorectal fistula repair. The parents approved for phallic reconstruction when the boy reached puberty.

Outcome:
A new external urethral orifice was created on the lower scrotum. The urinary reflux was corrected, and the epididymitis symptoms disappeared. The urethral fistula was then closed. At 8 months follow up, the patient was no longer on antibiotics and had no symptoms of urinary tract infection or epididymitis.

Conclusions:
Compatible treatment should be adopted to address urinary tract drainage and infection. Management requires a stepwise approach to address needs as they arise. Neophalloplasty should be performed by an experienced team in early adolescence.