bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tranexamic acid reduces postoperative blood loss in Chinese pediatric patients undergoing cardiac surgery
Authors: Zou Zhi-yao , He Li-xian , Yao Yun-tai 
Published: March 2022

Abstract

Background:
Tranexamic acid has been increasingly used for blood conservation in cardiac surgery. However, the evidence supporting the routine use of tranexamic acid in Chinese pediatric patients undergoing cardiac surgery remains weak. This meta-analysis aimed to systematically review the efficacy of tranexamic acid when applying to Chinese pediatric patients undergoing cardiac surgery.

Participants:
Chinese pediatric patients undergoing cardiac surgery.

Interventions:
Tranexamic acid or control drugs (saline/blank).

Methods:
PUBMED, Cochrane Library, EMBASE, China National Knowledge Infrastructure (CNKI), Wanfang Data, and VIP Data till May 4, 2021, database search was updated on August 1. Primary outcomes of interest included postoperative bleeding, allogeneic transfusion, and reoperation for bleeding. Secondary outcomes of interest included postoperative recovery. For continuous/dichotomous variables, treatment effects were calculated as weighted mean difference (WMD)/odds ratio and 95% confidence interval.

Results:
A database search yielded 15 randomized controlled trials including 1641 patients, where 8 studies were allocated into non-cyanotic congenital group, 5 were allocated into cyanotic congenital group, and the other 2 were allocated into combined cyanotic/non-cyanotic group. This meta-analysis demonstrate that tranexamic acid administration can reduce the postoperative 24 hours blood loss in non-cyanotic, cyanotic, and combined cyanotic/non-cyanotic patients, the red blood cell transfusion in non-cyanotic and cyanotic patients, and the fresh frozen plasma transfusion in non-cyanotic and combined cyanotic/non-cyanotic patients.

Conclusion:
This meta-analysis demonstrates that tranexamic acid is highly effective in reducing the blood loss in Chinese pediatric cardiac surgery, but it behaves poorly when it comes to the transfusion requirement. To further confirm this, more well-designed and adequately-powered randomized trials are needed.
An improvement on the technique of transosseous tunnels for the fixation of lower pole patella fracture
Authors: Hu Jialang , Guo Xin 
Published: March 2022

Abstract
The technique of transosseous tunnels is widely used in lower pole patella fracture (LPP). Though the extensor mechanism can be restored, distal avulsion fragments are usually unstable. The subsequent fracture gap and nonunion impair the extensor mechanism in turn. Cerclage is a promising method for treating the condition. The aim of this prospective cohort study is to determine if cerclage around the patella combined with the technique of transosseous tunnels stabilizes the avulsion fragments and brings out improved outcomes on LPP.
Twenty two patients with LPP were treated with the hybrid technique. The patients were followed up and evaluated clinically and radiographically. The functional outcome was assessed by the average range of knee movement and Lysholm knee rating system at 6 months after surgery, as well as the final follow-up. Radiologically, Insall-Salvati ratio and the time from surgery to bone union were assessed.
Postoperatively, with a mean followed-up of 12 months. All of the patients regained stability of the knee with an average range of movements of 131.8 degrees at 6 months after operation and 138.2 degrees at the final follow-up. On the Lysholm knee rating system, all cases were classified as excellent. The average score was 93.2 at 6 months after operation and 95.9 at the final follow-up. In radiological assessment, no fracture gap or nonunion occurred. The average Insall-Salvati ratio (I-S ratio) was 1.03.
The hybrid technique offers further stabilization for the avulsion fragments and strengthens attachment of the patellar tendon, which brings forward time of rehabilitation and achieves good clinical outcomes.
A comparative study of a nerve block therapy with and without a deeply inserted acupotomy applied to hyeopcheok points for lumbosacral radiculopathy
Authors: Choi Sooil , Park Sukhee , Lim Young-Soo , Park Tae-Yong , Do Kwang-Sun , Byun Sang Hyun , Yoon Sang-Hoon , Lee Jin-Hyun 
Published: March 2022

Abstract

Introduction:
The prevalence of lumbosacral radiculopathy is estimated to be approximately 3% to 5% in patient populations. Lumbosacral radiculopathy is largely caused by a complex interaction between biomechanical and biochemical factors. Nerve block therapy (NBT) mainly treats lumbosacral radiculopathy by improving the biochemical factors, whereas acupotomy mainly focuses on improving the biomechanical factors. Therefore, it is thought that synergistic effects may be obtained for the treatment of lumbosacral radiculopathy when both NBT and acupotomy are combined. However, no study in China and Korea, where acupotomy is majorly provided, has reported the effects of such a combination treatment. Therefore, this study aimed to evaluate the safety, effectiveness, and cost-effectiveness of the concurrent use of a deeply inserted acupotomy and NBT for the treatment of lumbosacral radiculopathy.

Methods/design:
This is an open-label, parallel, assessor-blinded, randomized controlled trial, which will include 50 patients with lumbosacral radiculopathy. After patients voluntarily agree to participate in the study, they will be screened, and will undergo necessary examinations and tests according to the protocol. Those who satisfy the selection criteria will be randomly assigned to either the NBT + acupotomy or NBT groups in a 1:1 ratio. Both groups will undergo 2 NBTs once every 2 weeks from 1 week after the screening test. The treatment group will receive additional acupotomy twice a week for 4 weeks. The primary endpoint is the Oswestry Disability Index, whereas the secondary endpoints are the Numeral Rating Scale, European Quality of Life 5-dimension, McGill pain Questionnaire, Roland-Morris Disability Questionnaire, safety assessment, and economic feasibility evaluation. The measurements will be made at 0, 2, 4, and 8 weeks.

Ethics and dissemination:
This trial has received complete ethical approval from the Ethics Committee of Catholic Kwandong University International St. Mary's Hospital (IS20OISE0085). We intend to submit the results of the trial to a peer-reviewed journal and/or conferences.
Combination therapy of ursodeoxycholic acid and glucocorticoid and (or) immunosuppressant in patients with primary biliary cholangitis
Authors: Wang Zi-Long , Song Kai-Min , Jin Rui , Xie Yan-Di , Wang Yu-Qiong , Liu Zhi-Cheng , Feng Bo 
Published: March 2022

Abstract

Background/objectives:
Primary biliary cholangitis (PBC) is a chronic inflammatory autoimmune cholestasis liver disease. There were many studies comparing a combination of glucocorticoids and/or immunosuppressants to a single UDCA therapy in PBC patients, while the literature demonstrated divergent finds. To evaluate the effectiveness of ursodeoxycholic acid (UDCA) combined with glucocorticoids and (or) immunosuppressants on biochemistry, immunology, histology, clinical symptoms, and adverse reactions of PBC from the perspective of evidence-based medicine.

Materials and methods:
PubMed, web of science, the Cochrane Library, EMBASE databases were searched to collect clinical randomized trials and self-control studies of UDCA combined with glucocorticoids and (or) immunosuppressants and UDCA monotherapy in the treatment of PBC. The retrieval time is from the establishment of the database to August 2020. Two reviewers independently screened literature, extracted data and evaluated the bias of included studies. Revman 5.3 software was used for meta-analysis.

Results:
Six studies including 201 patients were included. The meta-analysis found that the combination therapy can improve some biochemical indexes, immunological indexes, and clinical symptoms of patients with PBC. However, combination therapy has no significant improvement in other biochemical indicators which respond to liver and bile duct damage, such as ALT, GGT, and ALB. Besides, the improvement of liver histology is limited, and the incidence of adverse events is higher.

Conclusion:
Overall, the combination therapy showed no improvement in key biochemical parameters and limited improvement in liver pathology. Besides, the side effects were more serious. Therefore, in the current treatment regimen, it is not recommended for PBC patients.
Personal protective equipment and adverse dermatological reactions among healthcare workers
Authors: Nguyen Chrystie , Young Fletcher Graham , McElroy Doug , Singh Aniruddha 
Published: March 2022

AbstractThe pandemic of the 2019 novel coronavirus disease (COVID-19) has caused an unprecedented mobilization of the United States’ healthcare workforce. In addition to working extended hours under increased duress, healthcare professionals (HCP) of all stations have been making use of various types of personal protective equipment (PPE) with greatly increased frequency and duration. Current data regarding adverse skin reactions as a possible consequence of PPE use are, particularly in the United States, largely insufficient for policy-makers to make informed decisions regarding daily PPE use among HCP.The research vehicle employed by this study is a cross-sectional 25-item survey distributed via email to workers currently employed by a five-hospital system in southcentral Kentucky. This survey was used to collect information from hospital workers of all professional roles about their experiences during the COVID-19 pandemic, focusing on reports of adverse dermatological reactions and associated risk factors.Out of 879 respondents, 54.4% reported some type of skin irritation reaction. Skin irritation was significantly more prevalent among medical and medical support staff than non-medical hospital workers, with the highest prevalence among Certified Nurse Assistant (CNAs). Among clinical workers, those in dedicated COVID-19 units reported the highest prevalence of adverse skin reaction. The most common complaint was dryness/scaling of the skin (306 out of 439, 69.7%), and the most common location was the facial cheeks (305 out of 516, 59.1%). Among those who reported skin irritation, the average self-reported severity of skin reaction (on a scale of 1–5) was 2.00 ± 0.05, and the mean total days of skin reaction per month was 11.70 ± 0.39 days. Total days of irritation per month was found to be significantly related to “total days of PPE use per month,” “hours of PPE use per day,” “frequency of hand washing,” and“use of disinfecting UV irradiation.” Severity of skin reaction was found to be significantly related to “hours per day of PPE use,” “consecutive days of PPE use,” and “female sex.”Clinical workers that put in the most face-to-face time with patients, and those in dedicated COVID-19 units, had the highest risk of adverse skin reaction. Overall, skin reactions were found to be mild, even in those hospital workers with the heaviest PPE use. Because the widespread and consistent use of facial masks in public settings has become a key tool in our protracted struggle with SARS-CoV-2, these findings may help to ameliorate concerns that everyday facial mask and/or other PPE usage contributes to significant dermatologic morbidity among both medical professionals and public citizens.
ANCA-associated vasculitis in idiopathic pulmonary fibrosis
Authors: Traila Daniel , Marc Monica Steluta , Pescaru Camelia , Manolescu Diana , Fira-Mladinescu Ovidiu 
Published: March 2022

Abstract

Rationale:
Idiopathic pulmonary fibrosis (IPF) is a progressive disease with poor prognosis. Patients with IPF represent a heterogeneous population with several described clinical phenotypes. More recently, the development of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis in IPF patients, with an incidence higher than that in the general population, has drawn attention.

Patient concerns:
A 64-year-old woman previously diagnosed with IPF presented to the emergency department with hemoptysis and hypoxemic respiratory failure.

Diagnoses:
High-resolution chest computed tomography revealed bilateral ground-glass opacities associated with areas of consolidation superimposed on the patient's fibrotic background pattern. Diffuse alveolar hemorrhage was confirmed by the presence of hemorrhagic bronchoalveolar lavage fluid. Hematological and biochemical investigations revealed an inflammatory syndrome, moderate anemia, and rapidly progressive glomerulonephritis. Serological analysis revealed perinuclear antineutrophil cytoplasmic antibody positivity and high levels of antimyeloperoxidase antibodies antibodies. The patient underwent kidney biopsy, which revealed necrotizing glomerulonephritis. Clinical and laboratory findings were diagnostic of microscopic polyangiitis with lung and renal involvement.

Interventions:
Cyclophosphamide in combination with methylprednisolone was administered as remission induction therapy. The maintenance therapy consisted of mycophenolate mofetil and prednisone.

Outcomes:
The patient achieved clinical, radiological, and serological remission within six weeks of treatment.

Lessons:
The association between IPF and ANCA-associated vasculitis may represent a distinct clinical phenotype. Autoimmune testing for ANCAs should be considered part of the diagnostic work-up and follow-up of patients with IPF because of the clinical and therapeutic implications of developing vasculitis in an already vulnerable patient.
Disparities in Comorbidities in Lung Cancer: Findings From the Behavioral Risk Factor Surveillance System
Authors: Johnson Lee Ann , Briley Patrick , Bolin Linda P. , Kitko Lisa , Ellis Charles 
Published: March 2022

Background
In persons with lung cancer, sex and race are independent predictors of comorbidities and are associated survival. It is unclear how comorbidity profiles differ across sex and race.

Objective
The objective was to examine comorbidity differences between men and women and Blacks and Whites.

Methods
Data from the 2014, 2016, 2017, and 2018 Behavioral Risk Factor Surveillance System were analyzed using descriptive statistics, χ
2 test of independence, and multiple logistic regression. Variables included sociodemographics and comorbidities.

Results
Among individuals with lung cancer (N = 594), men were more likely to experience a heart attack (odds ratio [OR], 3.59; 95% confidence interval [CI], 1.62–7.96) and diabetes (OR, 2.83; 95% CI, 1.57–5.10) and less likely to experience depressive disorder (OR, 0.360; 95% CI, 0203–0.637). Black men (OR, 28.57; 95% CI, 9.22–88.55) and women (OR, 2.48; 95% CI, 1.02–6.05) were more likely to have a history of stroke.

Conclusion
Findings show that there may be differences in patterns of comorbidities among individuals with lung cancer. As we continue to move toward individualized medicine in cancer care, future work in this area should examine social determinants of health and how they may influence the patterns of comorbidities.

Implication for Nurses
Although nurses may be aware that certain groups have an increased risk for certain comorbid conditions, this study highlights what groups with lung cancer may be more likely to have certain comorbidities. Nurses can assess individuals for comorbidities and provide education on how to manage comorbidities during cancer treatment.
The Relationship Between Sexual Satisfaction and Marital Satisfaction in Women With Ovarian Cancer and Their Spouses
Authors: Aktaş Demet , Bahar Arzu 
Published: March 2022

Background
Ovarian cancer can have long-term physical and psychosexual effects on survivors. The post–ovarian cancer sexuality concerns of women can cause sadness and anxiety and negatively impact sexual and marital satisfaction in these women and their spouses.

Objective
The aim of this study was to investigate the relationship between sexual satisfaction and marital satisfaction of women with ovarian cancer and their spouses.

Methods
This study was designed retrospectively. This study was conducted with 172 participants: 86 women with ovarian cancer and 86 spouses. Data were collected over 6 months from July 2019 to December 2019. Sexual satisfaction levels were assessed using the Golombok Rust Inventory of Sexual Satisfaction. Marital satisfaction levels were assessed using the Golombok Rust Inventory of Marital State.

Results
Spouses’ sexual satisfaction (mean, 8.10) was worse than that of the women (mean, 5.60). The women’s marital satisfaction (mean, 47.39) was worse than that of their spouses (mean, 40.75).

Conclusions
As the sexual satisfaction of the women increased, the marital satisfaction of the women (r = 0.346, P = .001) and spouses (r = 0.308, P = .001) increased. As the sexual satisfaction of the spouses increased, the marital satisfaction of the women (r = 0.512, P = .001) and spouses (r = 0.409, P = .001) increased.

Implications for Practice
Nurses and healthcare teams need to be aware of post–ovarian cancer sexual and marital satisfaction problems of women and their spouses and organize activities at education and couple counseling on these problems.
Distinct Nausea Profiles Are Associated With Gastrointestinal Symptoms in Oncology Patients Receiving Chemotherapy
Authors: Singh Komal , Pituch Keenan , Zhu Qiyun , Gu Haiwei , Ernst Brenda , Tofthagen Cindy , Brewer Melanie , Kober Kord M. , Cooper Bruce A. , Paul Steven M. , Conley Yvette P. , Hammer Marilyn , Levine Jon D. , Miaskowski Christine 
Published: March 2022

Background
Unrelieved chemotherapy-induced nausea (CIN) occurs 48% of patients undergoing chemotherapy and is one of the most debilitating symptoms that patients report.

Objective
The aims of this study were to identify subgroups of patients with distinct CIN profiles and determine how these subgroups differed on demographic and clinical characteristics; severity, frequency, and distress of CIN; and the co-occurrence of common gastrointestinal symptoms.

Methods
Patients (n = 1343) completed demographic questionnaire and Memorial Symptom Assessment Scale 6 times over 2 cycles of chemotherapy. Latent class analysis was used to identify subgroups of patients with distinct CIN profiles. Differences among these subgroups were evaluated using parametric and nonparametric statistics.

Results
Four distinct CIN profiles were identified: none (40.8%), increasing-decreasing (21.5%), decreasing (8.9%), and high (28.8%). Compared with the none class, patients in the high class were younger, had a lower annual household income, had child care responsibilities, had a lower Karnofsky Performance Status score and a higher Self-administered Comorbidity Questionnaire score, and were more likely to have received chemotherapy on a 14-day cycle and a highly emetogenic chemotherapy regimen. In addition, patients in the high class reported high occurrence rates for dry mouth, feeling bloated, diarrhea, lack of appetite, abdominal cramps, difficulty swallowing, mouth sores, weight loss, and change in the way food tastes.

Conclusions
That 60% of the patients reported moderate to high CIN occurrence rates confirms that this unrelieved symptom is a significant clinical problem.

Implications for Practice
Nurses need to evaluate patients’ level of adherence to their antiemetic regimen and make appropriate referrals for physical therapy, psychological services, and dietary counseling.
Combining Breast and Ovarian Operations Increases Complications
Authors: Henn Dominic , Barrera Janos A. , Sivaraj Dharshan , Lin John Q. , Rizk Nada M. , Ma Irene , Gurtner Geoffrey C. , Lee Gordon K. , Nazerali Rahim S. 
Published: March 2022

Background:
Breast cancer resulting from a genetic mutations, such as BRCA1 or BRCA2, is seen in 5 to 10 percent of patients. More widespread genetic testing has increased the number of affected women undergoing prophylactic mastectomy and oophorectomy. Recent studies have yielded mixed results regarding complication rates after combined breast and ovarian operations. The authors compared surgical outcomes of breast operations performed in combination with salpingo-oophorectomies or as separate procedures.

Methods:
The authors retrospectively analyzed surgical complications and length of hospital stay in 145 female patients, from which 87 had undergone combined breast surgery and salpingo-oophorectomy, and 58 had undergone these procedures separately. Multivariate logistic regression models were used to calculate odds ratios and 95 percent confidence intervals.

Results:
Patients undergoing combined breast and ovarian operations experienced higher rates of overall complications (46.5 percent versus 19 percent; p < 0.001), infections (22.2 percent versus 8.6 percent; p < 0.05), and delayed wound healing (13.2 percent versus 0 percent; p < 0.05) related to the breast surgery, when compared with patients undergoing separate procedures. Multivariate logistic regression analysis confirmed a significant association between combined surgery and overall postoperative complications (OR, 5.87; 95 percent CI, 2.03 to 16.91; p = 0.02). Patients undergoing tissue expander–based breast reconstruction combined with ovarian surgery had significantly longer hospital stays compared to patients undergoing separate procedures (3.5 days versus 1.8 days; p < 0.001).

Conclusions:
The authors’ data indicate that combining breast and ovarian operations is associated with a higher risk of postoperative complications related to the breast procedure and increases the duration of hospital stay in patients with tissue expander–based reconstructions. The authors’ study provides valuable information for preoperative counseling of patients considering both breast and ovarian surgery.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.