bluuebunny/crossref_metadata_2025_split huggingface dataset:
Migration of fully covered self-expandable metallic stents used to treat anastomotic strictures after orthotopic liver transplantation
Authors: Ding Songming , Wu Weilin , Lu Jianfang , Zhu Hengkai , Zheng Shusen , Li Qiyong 
Published: January 2022

Abstract
Insertion of a fully covered self-expandable metallic stent (FCEM) through endoscopic retrograde cholangiopancreatography is an effective solution for biliary anastomotic stricture following orthotopic liver transplantation (OLT). However, FCEM migration continues to plague patients. This study aimed to evaluate the FCEM migration rate in our center, and to investigate the factors increasing the migration risk for FCEM.
The study enrolled 43 post-OLT patients with confirmed duct-to-duct AS. The effects of age, gender, albumin, alanine aminotransferase, aspartate aminotransferase (AST), γ-glutamyl transpeptidase, alkaline phosphatase, total bilirubin, direct bilirubin, ABO (blood group system consists of four antigens) incompatibility, stricture length, FCEM brand, FCEM length, donor liver and recipient bile duct diameters, size mismatches between the donor and recipient bile ducts >2 mm, diabetes and/or hypertension status, endoscopic sphincterotomy status, the use of plastic stents or nasobiliary drainage prior to FCEM implantation, duration from OLT to FCEM placement, and OLT etiology on FCEM migration were retrospectively analyzed.
The FCEM migration rate was 48.8% (21/43) at 6 months. The serum AST level was significantly higher in the migration group than that in the nonmigration group (52.48 vs 29.50 U/L, P < .05). A lower serum AST level was associated with a decreased risk of FCEM migration in post-OLT patients with duct-to-duct anastomotic stricture (hazard ratio = 0.968, 95% confidence interval: 0.940–0.996, P = .028).
In this single-center, retrospective cohort study, we showed that an elevated serum AST level was a potential risk factor for FCEM migration.
The influence of empty-nest living on the health of the older people living in the rural areas of Lishui, China
Authors: Hu Naibao , Shi Tala , Xu Lanlan , Pan Guotao , Hu Zhiyong 
Published: January 2022

Abstract
The empty-nest older people are becoming a significant social phenomenon in the rural of China. Most studies on the health of the empty-nest older people contain these older people who have no children or dead children. The emotional experience of the older people with and without children is quite different, our study only chose the empty-nest older people who had children in the rural of Lishui, China. The purpose of this study is to explore the differences of the health conditions between empty-nest and non-empty-nest older people living in the rural areas of China, including items of chronic metabolic diseases, fall injury, and mental health. Our research found that empty-nest older people had higher incidence of fall injury (17.00% vs 6.31%, P = .006) and suffer more severe depression (P = .015) than the non-empty-nest older people. The adjusted odds ratio of fall injury and depression for empty-nest older people compared with the non-empty-nest older people were 2.76 (95% CI, 1.17–6.48) and 2.25 (95% CI, 1.36–3.67), respectively. Our results suggest that empty-nest older people are more likely to suffer from depression and fall injury than non-empty-nest older people living in the rural of China.
Successful subclavian transcatheter aortic valve replacement in a nonagenarian patient
Authors: Oh Seok , Kim Ju Han , Hyun Dae Young , Cho Kyung Hoon , Kim Min Chul , Sim Doo Sun , Hong Young Joon , Ahn Youngkeun , Jeong Myung Ho , Jung Yochun , Lee Kyo Sun 
Published: January 2022

Abstract

Rationale:
In super-aged patients with severe symptomatic aortic stenosis, transcatheter aortic valve replacement (TAVR) is a good treatment option, and the number of TAVR-eligible elderly patients is expected to grow exponentially. We present the case of a nonagenarian woman with severe aortic stenosis who underwent successful subclavian TAVR.

Patient concerns:
A 90-year-old Korean woman was brought to our department with dyspnea. On physical examination, a grade IV systolic murmur was auscultated in both the upper sternal borders and the left lower sternal border.

Diagnosis:
A transthoracic echocardiogram showed heavy calcification of the aortic valve with an increase in both peak velocity (4.36 m/s) and mean pressure (44.8 mm Hg), indicating severe symptomatic aortic stenosis.

Interventions:
After a heart team conference involving interventional cardiologists, cardiac surgeons, and anesthesiologists, subclavian TAVR was performed. Using the left subclavian artery, we successfully deployed a self-expandable valve prosthesis (CoreValveTM Evolut RTM, Medtronic Inc., Minneapolis, MN).

Outcomes:
After TAVR, transthoracic echocardiogram showed a decline in both peak velocity (2.06–2.14 m/s) and mean pressure (7.42–7.95 mm Hg) with an increase in the aortic valve area (1.12 cm2). The patient's dyspnea symptoms improved dramatically.

Lessons:
In addition to femoral TAVR, subclavian TAVR may be feasible and safe in super-aged patients.
Quality of evidence supporting the role of Chinese herbal medicine for the treatment of poststroke depression
Authors: Shi Hongshuo , Dong Cengda , Liu Wenbin , Peng Min , Si Guomin , Sun Fengshan 
Published: January 2022

Abstract

Background:
Poststroke depression (PSD) is a syndrome that occurs after stroke. The efficacy of Chinese herbal medicine (CHM) for PSD has also received widespread attention, but there is still a lack of clinical evidence because this overview evaluates the published meta-analyses (MAs)/Systematic reviews (SRs). To provide evidence for the clinical application of CHM in the treatment of PSD

Methods:
Two researchers searched 7 databases for SRs/MAs which are about randomized controlled trials on CHM for PSD. Two investigators use the systematic review assessment tool (AMSTAR-2), the risk of bias in systematic scale, the list of preferred reporting items for systematic reviews and meta-analysis, and the classification of recommended assessments for evaluation, development and evaluation system to assess the included SRs/MAs.

Results:
Our findings will be published in peer-reviewed journals.

Conclusion:
This study provides evidence-based medical evidence for the impact of CHM on PSD.

Registration number:
INPLASY202210001
Delayed gait recovery by resolution of limb-kinetic apraxia in a chronic hemiparetic stroke patient
Authors: Jang Sung Ho , Byun Dong Hyun 
Published: January 2022

Abstract

Rationale:
This paper reports on a chronic hemiparetic stroke patient who showed delayed gait recovery due to resolution of limb-kinetic apraxia (LKA).

Patient concerns:
A 49-year-old man underwent comprehensive rehabilitation at a local rehabilitation hospital since 3 weeks after spontaneous intracerebral haemorrhage. However, he could not walk independently because of severe motor weakness in his right leg until 19 months after the onset.

Diagnosis:
At the beginning of rehabilitation at our hospital (19 months after onset), we thought that he had the neurological potential to walk independently because the unaffected (right) corticospinal tract and corticoreticulospinal tract were closely related to the gait potential, representing intact integrities. As a result, we assumed that the severe motor weakness in the right leg was mainly ascribed to LKA.

Interventions:
At our hospital, he underwent comprehensive rehabilitation including increased doses of dopaminergic drugs (pramipexole, ropinirole, amantadine, and carbidopa/levodopa).

Outcomes:
After 10 days to our hospital, he could walk independently on an even floor with verbal supervision, concurrent with motor recovery of the right leg. After 24 days after hospital admission, he could walk independently on an even floor.

Lessons:
We believe that the resolution of LKA in his right leg by the administration of adequate doses of dopaminergic drugs was the main reason for the delayed gait recovery in this patient. The results suggest the importance of detecting the neurological potential for gait ability of a stroke patient who cannot walk after the gait recovery phase and the causes of gait inability for individual patients.
Successful application of extracorporeal membrane oxygenation treatment in the management of severe respiratory failure caused by primary pulmonary lymphoma
Authors: Yu Chao , Xv Lunbing , Peng Xiaochun , Shao Min 
Published: January 2022

Abstract

Rationale:
Primary pulmonary lymphoma (PPL) is a rare disease, and rapid progression of pulmonary exudation leads to severe respiratory failure. Here, we present the case of a critically ill patient with PPL complicated by refractory hypoxemic respiratory failure. The patient was ultimately cured with a successful combination of extracorporeal membrane oxygenation (ECMO) and chemotherapy.

Patient concerns:
A 36-year-old woman was hospitalized because of a 2-month history of cough with fever and shortness of breath. Computed tomography revealed multiple pulmonary nodules, consolidation, and solid pulmonary opacities. Complications of pneumothorax occurred after computed tomography-guided core needle biopsy, and respiratory failure progressively developed (PaO2/FiO2 65 mm Hg).

Diagnosis:
Primary pulmonary lymphoma, respiratory failure, stress cardiomyopathy, cardiogenic shock.

Interventions:
The patient was treated with veno-venous ECMO and chemotherapy.

Outcomes:
The patient was successfully weaned off ECMO after chemotherapy and transferred out of the intensive care unit on day 9. After regular chemotherapy, no obvious lesions were observed in either lung tissue.

Conclusion:
ECMO can be selected as an important salvage treatment for patients with severe cardiopulmonary dysfunction caused by PPL and other malignant tumors that may be cured or transferred to a stable stage.
SARS-CoV-2 (COVID-19) pneumonia patient treated with two doses of infliximab within 2 weeks for acute severe ulcerative colitis
Authors: Alhalabi Marouf , Eddin Kamal Alaa , Ali Fadwa , Abbas Ahmad 
Published: January 2022

Abstract

Rationale:
The ongoing coronavirus pandemic has caused severe acute respiratory syndrome, posing a significant challenge for patients receiving immunotherapy for immune-mediated inflammatory diseases. As of January 2022, immunosuppressants such as tumor necrosis factor inhibitors (anti-TNFα) and azathioprine are inadvisable for an infectious disease caused by the SARS-CoV-2 virus (COVID-19). We continued infliximab as a second induction dose nine days after the onset of COVID-19 symptoms in a patient with acute severe ulcerative colitis.

Patient concerns:
We report the case of a 34-year-old male with 6 to 8 times bloody diarrhea, fever, and cramping abdominal pain. Ulcerative colitis was diagnosed 6 months earlier and treated with mesalamine 80 mg/kg/day and azathioprine 2.5 mg/kg/day. The patient had never undergone surgery before. Sigmoidoscopy revealed multiple ulcerations and spontaneous bleeding, and the colon samples tested negative for cytomegalovirus and Clostridium difficile. However, intravenous corticosteroids did not induce remission. A nasopharyngeal swab tested positive for SARS-CoV-2.

Diagnosis:
Acute severe ulcerative colitis and SARS-CoV-2 (COVID-19) pneumonia.

Interventions:
The second loading dose of infliximab was administered nine days after the diagnosis of COVID-19.

Outcome:
The patient completed infliximab induction at a dose of 5 mg/kg at weeks 0, 2, and 6, with no complications.

Lessons:
It is unclear whether anti-TNF-α treatment improves or deteriorates COVID-19 patient outcomes, and this case demonstrates that infliximab can be used safely. Current guidelines make a weak recommendation to avoid using anti-TNFα agents in the presence of acute COVID-19 infection. There is an urgent need for research on biologics therapy.
Intubation difficulty scale contributors and time delay in clinical practice
Authors: Kang Ting-Wei , Wang Jung-Der , Tsai Yi-Seng , Lin Chung-Ren , Tseng Chia-Chih Alex 
Published: January 2022

Abstract
The intubation difficulty scale (IDS) includes 7 contributors that provide a comprehensive assessment of difficult intubation. However, the effect of each contributor is unclear, and the scale has not been revalidated recently and has not been validated in orient. This study determined the duration of successful intubation (DSI) for each of these 7 contributors.
The patients were intubated by attending anesthesiologists. The duration and other data were recorded by 2 research assistants. Anaesthesiologists reported the IDS and their perceptions. A linear mixed-effects model with a DSI was constructed using IDS factors.
In total, 1095 patients were enrolled. The average DSI was 23.9 ± 21.8 seconds (37.1% IDS = 0). All 7 factors were independently associated with duration, with the exception of vocal cord adduction. The best model was as follows: DSI (in seconds) = 15.2 + 31.1 (number of additional attempts) + 26.2 (number of additional operators) + 11.4 (number of alternative techniques) + 7.9 (increased lift force) + 4.9 (external laryngeal pressure) + 3.5 (Cormack grade 1). The mixed models were similar except for the regression coefficient for the number of alternative techniques that decreased from 11.4 to 6.9 seconds.
We confirmed that each IDS contributor affects the DSI and validated a prediction model with 6 IDS contributors. This prediction model may facilitate the development of strategic plans for critical airway management. Furthermore, it could improve simulations and monitor learning progress and help provide valuable feedback.
Acupuncture plus massage for cervicogenic headache
Authors: Ding Fangfang , Liu Zhen , Li Rui , Wang Chenying , Lu Yan 
Published: January 2022

Abstract

Background:
Cervicogenic headache (CGH), one of the most common headaches. It is characterized by pain starting from the neck and gradually involving the eyes, frontal and temporal regions. Acupuncture and massage therapy has been widely used in the treatment of CGH, the purpose of this study was to evaluate the effectiveness and safety of acupuncture combined with massage in the treatment of CGH.

Methods:
The databases of PubMed, Embase, Cochrane library, Medicine, Web of Science, China National Knowledge Infrastructure, Wan-Fang Database, China Biomedical Literature Service System, and Chongqing VIP Chinese Science will be searched. This study will include randomized controlled trials of acupuncture combined with massage in the treatment of CGH published before November 2021. The primary outcomes included the overall efficiency, visual simulation score, neck activity score, quality of life score, and adverse reactions as secondary outcomes were assessed. Cochrane bias risk assessment tool will be used for literature data screening and quality evaluation, and using RevMan5.4 to collect data for statistical analysis. We then will use the Grading of Recommendations Assessment, Development, and Evaluation approach to assess the overall quality of evidence supporting the primary outcomes.

Results:
This systematic review will provide a high-quality synthesis to evaluate the efficacy and safety of acupuncture combined with massage therapy in the treatment of CGH, providing a reference for the safe and effective treatment plan.

Conclusion:
This study provides evidence that acupuncture combined with massage is effective and safe for patients with CGH.

Systematic review registration:
INPLASY2021120049U1.
Uncontrolled blood pressure among hypertensive adults with rheumatoid arthritis in Saudi Arabia
Authors: Almalki Ziyad S. , AlOmari Bedor Abdullah , Alshammari Tahani , Alshlowi Areej , Khan Mohd Faiyaz , Hazazi Ali , Alruwaily Maha , Alsubaie Sarah , Alanazi Faten , Aldossary Norah , Albahkali Raseel 
Published: January 2022

Abstract
Despite the availability and advancement of diagnostic and treatments with demonstrated benefits in minimizing cardiovascular morbidity and mortality, hypertension control rates remain suboptimal. Therefore, this research aimed to determine the prevalence of uncontrolled BP in rheumatoid arthritis (RA) patients and understand all potential risk factors for uncontrolled BP.
We conducted a cross-sectional study on RA patients in 2 rheumatology clinics in 2 public hospitals in Riyadh. Patients’ information such as demographics, comorbidities, drug use, and other clinical data were captured through a review of medical records and supplemented by patient interviews. Multivariate logistic regression was utilized for the analysis to identify the significant factors of uncontrolled BP (systolic BP ≥140 mm Hg or diastolic BP ≥90 mm Hg).
In total, 834 subjects with RA and concomitant BP were involved in this cross-sectional study. The prevalence of uncontrolled BP was found to be 31.65% among all the study population. Multivariate analysis showed that males, subjects above 60 years of age, and smokers had a distinctly higher occurrence of uncontrolled BP. Among the patients with comorbid conditions, those with obesity, hyperlipidemia, diabetes, anemia, cancer, and reflex or gastroesophageal reflux disease also showed a significantly higher risk of uncontrolled BP (P < .05).
The rate of uncontrolled BP was found to be alarmingly high in the study population. Age, gender, smoking, diabetes, obesity, hyperlipidemia, cancer, gastroesophageal reflux disease, and osteoporosis are independently linked with lack of BP control.
Modified DIVA Score
Authors: Rizvi Munaza Batool , Silver Ellen J. , Khine Hnin , Sellinger Catherine 
Published: January 2022

ObjectiveThis study aims to validate the DIVA (Difficult Intravenous Access) score in our population and to identify any additional patient characteristics that may be associated with difficult access in children.MethodsThis was a cross-sectional study in an urban quaternary pediatric emergency department with patients younger than 21 years and Emergency Severity Index ≥2 who require intravenous (IV) access for their management. In addition to patient characteristics comprising the DIVA score, data were collected on patient “history of difficult access,” hydration status, skin shade, history of sickle cell disease or diabetes, technology dependence, and body mass index. The number of IV cannulation attempts and total time taken were recorded for each patient. “Difficult access” was defined as ≥2 or more attempts or time >30 minutes to achieve successful IV cannulation.ResultsA convenience sample of 300 pediatric patients was enrolled. The DIVA score had a sensitivity of 51% (95% confidence interval [CI], 40.8%–61.14%) and a specificity of 82.99% (95% CI, 76.95%–87.99%) for predicting “difficult access” in our population. Among all patient characteristics examined in this study, only “history of difficult access” improved the identification of “difficult access” patients. The “history of difficult access” variable had a sensitivity of 61% (95% CI, 50.7%–70.6%) and a specificity of 75.7% (95% 95% CI, 69.12%–81.62%) in predicting “difficult access.” With the addition of “history of difficult access” to the original DIVA score, we developed a “modified DIVA score (m-DIVA).” The m-DIVA score had a sensitivity of 78% (95% CI, 68.6%–85.6%) and specificity of 67% (95% CI, 59.9%–73.58%), representing a 52.9% improvement in correctly identifying “difficult access” patients over the original DIVA score.ConclusionsThe m-DIVA score, which incorporates prior history, increases the screening test's sensitivity in identifying “difficult access” patients and should be further investigated as clinical tool.
Association of Increased Fluvoxamine Use with Reports of Benefit for COVID
Authors: Kojima N , Qato Dima M , Klausner JD 
Published: January 2022

AbstractIntroductionSeveral recent studies have found that fluvoxamine decreases the risk of serious disease progression among people with early SARS-CoV-2 infection. In this study, we examined changes in the total number of fluvoxamine tablets dispensed across retail pharmacies in the U.S.MethodsWe hypothesized that fluvoxamine prescriptions would increase substantially since March 2021 as an option for the early treatment of SARS-CoV-2 infection. We used the IQVIA National Prescription Audit (NPA) Weekly nationally projected data for prescriptions dispensed from retail pharmacies for fluvoxamine from 27 December 2019 to 31 December 2021. We performed an interrupted-time series analyses on frequency of dispensing fluvoxamine tablets.ResultsThe weekly rate of dispensed tablets of fluvoxamine increased throughout the study period. The weekly number of dispensed tablets of fluvoxamine increased (11.1%) from a baseline of 1,586,154 (95% confidence interval [CI]: 1,563,960 – 1,608,348) to 1,762,381 (95% CI: 1,735,682 – 1,789,080) by December 2021.ConclusionOur findings are consistent with a modest increase in the use of fluvoxamine for the treatment of COVID-19 associated with the discovery and media dissemination of the potential clinical benefit of fluvoxamine use.
A re-examination of the impact of COVD-19 deaths on the computation of average life expectancy
Authors: Rao Arni S.R. Srinivasa , Krantz Steven G. , Swanson David A. 
Published: January 2022

AbstractIt is natural to question the impact of COVID-19 on life expectancy. However, a newborn during the 2020-2021 period need not experience the same level of adult mortality found in 2020-2021 because there may be zero COVID-19 related deaths when the newborn reaches adulthood. Thus, life expectancy lost due to COVID-19 cannot be found simply by incorporating excess deaths due to COVID-19 and re-doing the life table computations because: (1) we know that the COVID-19 deaths need not occur every year for the next 20-25 years; and (2) once an adult, a newborn in 2021/2022 need not experience the same mortality rate that current middle and older aged COVID-19 patients experience. Using U.S. data as an example, we estimate an average of 29.68 years of life was lost to those aged 18-64 who died from COVID-19 in the U.S., noting that 74 % of the reported deaths of 18-64 occurred among 50-64 years and 10 % below 40 years. Instead of computing life expectancy years lost due to COVID-19, we recommend computing life years lost due to COVID-19.
Do self-management interventions improve self-efficacy and quality of life in stroke survivors? A literarture review
Authors: Septianingrum Yurike , Nurjanah Siti , Rumambo Pandin Moses Glorino 
Published: January 2022

ABSTRACTObjectiveThe aim of this review was to assess the effectiveness of self-management interventions on the self-efficacy and quality of life of stroke survivors compared to usual care.MethodArticle searches were performed using the same keywords in the Pubmed, CINAHL, Scopus and Science Direct databases published from January 2020 to October 16, 2021. A total of 8 articles in randomized controlled trials were identified in this study.FindingsEight studies were taken, of which six discussed the effectiveness of self-management interventions on self-efficacy and two literatures measured the quality of life of stroke patients. Almost all participatory studies reported an increase in self-efficacy and quality of life after receiving the self-management intervention. The heterogeneity in this study is reported regarding the form of intervention, duration of implementation, instruments used, and outcomesConclusionsThere are various self-management interventions, which can be in the form of education, support, coaching, or empowerment. Self-management interventions are reported to improve self-efficacy and quality of life of stroke patients. Future studies are expected to measure the perceived burden of self and self-care in stroke patients