bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of Monocyte-to-Lymphocyte and Neutrophil-to-Lymphocyte Ratios With Persistent Critical Illness in Patients With Severe Trauma
Authors: Zhang Beiyuan , Han Yunhong , Chen Xiancheng , Cao Ke , You Yong , Chen Ming , Zhu Zhanghua , Yu Wenkui 
Published: September 2022

BACKGROUND:
Neutrophil-to-lymphocyte ratio and monocyte-to-lymphocyte ratio are reported to reflect the inflammation and immune status in critically ill patients, but their role in severe trauma patients with persistent critical illness remains to be elucidated.

OBJECTIVE:
We aimed to evaluate the relationship of neutrophil-to-lymphocyte ratio and monocyte-to-lymphocyte ratio with persistent critical illness in severe trauma patients.

METHODS:
In a single-center retrospective cohort study, persistent critical illness was defined as intensive care unit length of stay of more than 10 days. Monocyte-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio were computed individually and categorized into 3 tertiles. Logistic regression analysis was used to assess the relationship of monocyte-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio with persistent critical illness. Receiver operating characteristic curves and the Youden index were used to evaluate the discriminatory threshold of persistent critical illness.

RESULTS:
A total of 851 eligible patients were enrolled in the study: 328 patients with persistent critical illness and 523 without. The median levels of maximum neutrophil-to-lymphocyte ratio and monocyte-to-lymphocyte ratio during intensive care unit stay were all higher in patients with persistent critical illness than in those without (11.46 vs. 9.13, p < .001 and 0.62 vs. 0.46, p < .001). Multivariate analysis revealed that the second (≥0.385, <0.693) and third (≥0.693) maximum monocyte-to-lymphocyte ratio tertiles were significantly associated with persistent critical illness after adjusting for confounding factors (odds ratio: 1.89, 95% confidence interval: 1.10–3.26, p = .021 and odds ratio 2.69, 95% confidence interval: 1.44–5.02, p = .002, respectively), whereas maximum neutrophil-to-lymphocyte ratio was not significantly correlated with persistent critical illness. The area under the curve for the maximum monocyte-to-lymphocyte ratio was 0.63 (95% confidence interval: 0.59–0.67), and the optimal cutoff was 0.65 for persistent critical illness.

CONCLUSION:
A high maximum monocyte-to-lymphocyte ratio during intensive care unit stay was independently related to persistent critical illness following severe trauma, although with limited sensitivity and specificity.
Trauma Resuscitation Room Organization Using 5S Methodology: A Quality Improvement Initiative
Authors: Philipose Jency , LaMaina Laura J. , Zapke Jennifer , Sargeant Danielle , Boukas Chris , Bullaro Francesca 
Published: September 2022

BACKGROUND:
Trauma centers are required to have immediate availability of resources to stabilize traumatic injuries. However, maintaining trauma room organization can be challenging in the fast turnaround environment of trauma care. Implementation of 5S methodology has shown success in standardizing processes to maintain organized, efficient workspaces.

OBJECTIVE:
The purpose of this study was to assess the implementation of 5S methodology on trauma resuscitation room organization, efficiency, and cost-effectiveness.

METHODS:
This quality improvement pre- and postintervention study assessed the impact of 5S methodology on trauma resuscitation room organization. A 20-question survey was developed and administered to emergency department technicians before and after a multiphase intervention that included strategies for room reorganization, improved signage, creation of workstations, education, and implementation of a log sheet system. A final cost analysis was evaluated upon completion.

RESULTS:
Emergency department technicians completed n = 26 presurveys and n = 19 postsurveys. Room organization improved from preintervention 31% to postintervention 89%. Restocking with a checklist improved from 46% preintervention to 63% postintervention. A cost analysis summary identified 130 overstocked items equaling a total cost savings of $4,026.82.

CONCLUSION:
The 5S methodology improved trauma bay organization by sorting, organizing, standardizing, labeling, and color coding resuscitation supplies based on the ABCDE (airway, breathing, circulation, disability, and exposure) of the primary survey. Additional strategies included improved signage, workspace reorganization, staff education, and checklist restocking accountability. The 5S implementation resulted in significant cost savings.
Endobronchial Ultrasound-guided Sampling of Centrally Located Intrapulmonary Tumors Provides Suitable Material for Diagnostic and Molecular Testing
Authors: Rai Hem , Graham Emma , Ghoshal Avik , McDill Helen , Hassan Maged , Nicholson Thomas , Taylor Lindsey , Corcoran John , Howell Timothy , Daneshvar Cyrus 
Published: September 2022

Background:
Curvilinear endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA) is a key diagnostic and staging procedure for patients with suspected lung cancer. However, sampling centrally located intrapulmonary tumors is feasible but less well established.

Methods:
We retrospectively evaluated the diagnostic utility of EBUS-TBNA in patients who underwent sampling of centrally located intrapulmonary tumors. Diagnostic accuracy, sample suitability for molecular testing, and complications were assessed.

Results:
Between January 2015 and April 2021, 102 EBUS-TBNA procedures sampled centrally located intrapulmonary tumors in 99 patients. The median age was 70 [interquartile range, 63 to 75] years and 51% (51/99) were male. The commonest site was the right upper lobe (n=42/99; 42%). The median tumor size was 29 [interquartile range, 21 to 35] mm. The diagnostic yield was 88/102 (86%) with a false negative rate of 14% (14/102). In addition to intrapulmonary tumor sampling, lymph nodes were sampled in 65/102 procedures and 30/65(46%) were positive for lung cancer. Cancer was diagnosed in 87/99 (88%) cases. When requested, molecular testing was adequate in ≥94% of samples. Complications included minor bleeding in 6/102 (6%) with 2 requiring cold saline instillation, desaturation in 1/102 (1%), and tachycardia in 1/102(1%). One procedure was abandoned due to patient tachycardia. Delayed complications occurred in 1 patient who was hospitalized ≤7 days with pneumonia.

Conclusion:
EBUS-TBNA sampling of centrally located intrapulmonary tumors provides similar diagnostic accuracy to lymph node sampling, provides suitable material for molecular testing, and has a low complication rate.
The relationship of left ventricular outflow tract presystolic wave and 24-h ambulatory blood pressure measurements
Authors: Demiröz Önder , Öztürkeri Burak 
Published: September 2022

Objective
Left ventricular outflow tract (LVOT) presystolic wave is a novel marker for several cardiac conditions. It is shown to be related to several cardiac conditions. The aim of this study is to investigate the relationship between LVOT presystolic wave and 24-h ambulatory blood pressure measurements.

Methods
A total of 194 patients who came to the cardiology outpatient clinic were prospectively enrolled in the study. After demographic and clinical inquiry, blood biochemistry and hemogram tests were performed. Each patient was evaluated with echocardiography and 24-h ambulatory blood pressure measurement. The patients were divided into hypertensive and nonhypertensive groups regarding their ambulatory blood pressure measurements and the LVOT presystolic wave of the groups on echocardiography was compared.

Results
The hypertensive group was significantly older (59.34 ± 11.15 vs. 49.89 ± 15.43; P < 0.001). Presystolic wave presence (96.2 vs. 29.5%; P < 0.001) and velocity (62.23 vs. 29.42; P < 0.001) were higher in patients with hypertension. Blood pressure values and LVOT amplitudes showed a positive correlation (P < 0.001; r = 0.326). In multivariable logistic regression analysis; age, BMI and the presystolic wave were independently associated with hypertension (odds ratio: 8.09; P < 0.001).

Conclusion
LVOT presystolic wave is associated with systemic hypertension and it could be used as a predictor for systemic hypertensive patients.
Validation of Uright model TD 3127AT wireless-portable ambulatory blood pressure monitoring device with timer trigger modification, standard cuff size, in normotensive and mild hypertensive patients of Thailand registry (Thai valid ambulatory blood pressure monitoring)
Authors: Laosanguanek Wanchat , Kaewkanha Ponthakorn , Khowinthaseth Sirhavich , Sirisuth Sirawee , Phanthong Tanattida , Chokesuwattanaskul Ronpichai , Sangwatanaroj Somkiat 
Published: September 2022

Background
Nowadays, automated blood pressure (BP) monitoring devices are commonly used by patients as a part of standard medical care for hypertension. The timer trigger was modified into a wireless automated home BP monitoring (HBPM) device to expand its potential use as ambulatory BP monitoring. However, the BP measurement accuracy in this modified device remains unknown.

Objective
We aimed to assess the accuracy of Uright model TD 3127AT, which is an automated HBPM device with a timer trigger modification, following an International Organization for Standardization (ISO) 81060-2:2018 guidelines in the Thai population.

Methods
This cross-sectional study included normotensive and hypertensive Thai participants following the ISO 81060-2:2018 guidelines from August 2021 to February 2022. This study aimed to compare the BP readings from an automated sphygmomanometer, Uright model TD 3127AT, TaiDoc Technology Corporation, with a timer trigger to a standard manual BP measurement.

Result
BPs were measured in 85 participants with a mean age ± SD of 38.39 ± 13.91 years, and 69% were females. The mean SBP ± SD (range) was 117.46 ± 18.63 (84–176) mmHg and the mean DBP ± SD (range) was 74.84 ± 10.70 (42–108) mmHg. The mean BP difference between observers and devices was 0.66 ± 6.81 mmHg for SBP and −0.96 ± 6.33 mmHg for DBP. The SD of the averaged pair determination per individual was ±4.45 mmHg for SBP and ±3.46 mmHg for DBP. The accuracy of the timer-triggered device was found to be acceptable when evaluated according to the ISO 81060-2: 2018 guidelines.

Conclusion
An automated sphygmomanometer, Uright model TD 3127AT, TaiDoc Technology Corporation, with timer trigger modification passed the ISO 81060-2:2018 guidelines.
Black pleural effusion caused by a pancreaticopleural fistula associated with autoimmune pancreatitis: A case report
Authors: Miyadera Keiki , Hisakane Kakeru , Kato Yuki , Atsumi Kenichiro , Ono Hiroki , Tanaka Shu , Kubota Kaoru , Seike Masahiro , Gemma Akihiko , Hirose Takashi 
Published: September 2022

Rationale:
Black pleural effusion is a rare medical condition and a diagnostic marker. Pancreaticopleural fistula is one of the causes of black pleural effusion. Thus far, black pleural effusions caused by pancreaticopleural fistulae have mostly been reported in patients with alcohol-induced chronic pancreatitis. In this report, we present a case of black pleural effusion caused by a pancreaticopleural fistula associated with autoimmune pancreatitis.

Patient concerns and diagnosis:
A 59-year-old female without a history of alcohol drinking presented to our hospital with a chief complaint of dyspnea, as well as chest and back discomfort. She had left pleural effusion, and thoracentesis showed black pleural effusion. Computed tomography revealed the presence of encapsulated fluid from the pancreatic tail to the left pleural cavity, which was diagnosed as a pancreaticopleural fistula. It also showed diffuse pancreatic swelling. Serum testing showed a high IgG4 level (363 mg/dL). These findings led to the diagnosis of autoimmune pancreatitis.

Interventions and outcome:
The patient underwent endoscopic pancreatic sphincterotomy and pancreatic duct stent placement and received treatment with steroids. After treatment, there was no further accumulation of pleural effusion observed.

Conclusion:
This is the first report of black pleural effusion due to a pancreaticopleural fistula associated with autoimmune pancreatitis. The characteristic appearance of black pleural effusion may assist diagnosis. We report this case to emphasize that autoimmune pancreatitis can be a cause of black pleural effusion.
Relative safety and efficacy of topical and oral NSAIDs in the treatment of osteoarthritis: A systematic review and meta-analysis
Authors: Wang Yuhui , Fan Miaozhen , Wang Huideng , You Yi , Wei Chengqiong , Liu Meng , Luo Ailin , Xu Xiaotian , Duan Xiaoqun 
Published: September 2022

Background:
Osteoarthritis (OA) often affects the hands, knees, and hip joints, causing considerable pain and disability, and often affecting the patient’s quality of life. Non-steroidal anti-inflammatory drugs (NSAIDs) are common pain relievers often applied as first line therapies for OA. However, prolonged NSAIDs application can have unwanted side effects. Given this, this study was designed to systematically evaluate the efficacy and safety of topical and oral NSAIDs for the treatment of OA.

Methods:
We searched the PubMed, Embase, Cochrane Library, and Web of Science databases for relevant papers from their inception dates to May 2021. Our study only included randomized controlled trials comparing topical and oral NSAIDs and all data were analyzed using Review Manager version 5.3 (RevMan version 5.3).

Results:
We identified 8 RCTs (2096 patients with OA), for evaluation and revealed that, in general, topical and oral NSAIDs presented with similar efficacies for the treatment of OA. The Western Ontario and McMaster Osteoarthritis Index for assessing pain relief in OA patients was (standardized mean difference [SMD] 0.07; 95%CI −0.02, 0.17) and visual analog scale was (SMD −0.01; 95%CI −0.02, 0.18), and improved stiffness in OA patients (SMD 0.09; 95%Cl 0.03, 0.20).

Conclusions:
Topical NSAIDs are as effective as oral NSAIDs for the treatment of OA and both topical and oral NSAIDs are equally effective in reducing pain and improving physical function in OA patients. In terms of safety, a larger number of samples are still needed to determine if there are any differences in the safety profile of topical or oral NSAIDs.

Registration number:
INPLASY 2021110009.
Laboratory characteristics of IgG4-related disease: A retrospective study from a single tertiary medical center
Authors: Cho Hanwool , Lee Jeong Joong , Kim Myungshin , Oh Eun-Jee , Kim Yonggoo , Chae Hyojin 
Published: September 2022

Immunoglobulin G4-related disease (IgG4-RD) is an immune-mediated fibroinflammatory condition with unique histopathological features that can affect most organs, making diagnosis challenging. This study characterized detailed laboratory characteristics of IgG4-RD.
Baseline clinical and laboratory features of 33 patients with IgG4-RD were reviewed, including serum IgG4 concentrations, serum free light chains (sFLCs), IgGĸ- and IgGλ-heavy/light chains (HLCs), capillary serum protein electrophoresis (SPE), and immunofixation electrophoresis (IFE) of IgG4 subclass.
The cohort of 33 patients showed male predominance (94%), with 8 (24%) exhibiting multiple organ involvement. Most patients (88%) had an elevated IgG4 concentration, and 67% had elevated erythrocyte sedimentation rate and IgE levels. Median IgG4 concentration at baseline was significantly higher in patients with >2 organs involved than those with ≤2. Furthermore, erythrocyte sedimentation rate was significantly correlated with serum IgG4 concentrations at baseline. SPE results demonstrated polyclonal gammopathy in most patients. Half of the patients had an increased κ/λ sFLC ratio, 42% had an increased IgGκ/IgGλ HLC ratio. Most patients exhibited hypergammaglobulinemia in the anodal end of the ɤ region on SPE.
This study describes detailed laboratory features of IgG4-RD. Although none of these tests are considered diagnostically sufficient by itself, the provided laboratory characteristics can increase awareness of this disorder and help distinguish it from other IgG4-RD mimics.
Effectiveness of educational interventions for quality of life of parents and children with food allergy: A systematic review
Authors: Cheon Jooyoung , Cho Chung Min , Kim Hyo Jin , Kim Dong Hee 
Published: September 2022

Background:
Educational intervention along with medical treatment is important to improve the quality of life of children with food allergies and their parents. This systematic review was designed to investigate the effects of education programs for parents and children with food allergies to provide a direction for developing an intervention program to improve their quality of life.

Methods:
A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Relevant studies published between January 2010 and August 2021 were identified through a systematic search of 5 databases (PubMed, EMBASE, CINAHL, Cochrane Central Register of Controlled Trial, and Psycho Info).

Results:
A total of 2351 articles were identified. Of these, 9 met the inclusion criteria after duplicates were removed. Among these, only 2 studies, using the support and handbook provided, showed significant results on quality of life.

Discussion:
There is a lack of educational interventions for children with food allergies and their parents. Educational intervention, an essential intervention, can maximize medical treatment and improve overall quality of life. Hence, these interventions should be actively developed and applied in the future.
Immunosuppressive therapy versus supportive care in IgA nephropathy patients with stage 3 and 4 chronic kidney disease
Authors: Ștefan Gabriel , Stancu Simona , Zugravu Adrian , Petre Nicoleta , Secăreanu Silviu , Popa Otilia , Capusa Cristina 
Published: September 2022

The use of immunosuppressive therapy for immunoglobulin A nephropathy (IgAN) patients with stage 3 or 4 chronic kidney disease (CKD) is controversial. We performed a monocentric retrospective study on 83 consecutive IgAN patients with stage 3 or 4 CKD and proteinuria ≥0.75 g/d (age 41 [33–56] years, 72% male, estimated glomerular filtration rate 36.1 [25.4–47.5] mL/min/1.73 m2) who received uncontrolled supportive care (Supp) (n = 36), corticosteroids/corticotherapy (CS) (n = 14), or CS combined with monthly pulses of cyclophosphamide (CS + CFM) (n = 33) between 2010 and 2017. Patients were followed until composite endpoint (doubling of serum creatinine, end-stage kidney disease (dialysis or kidney transplant) or death, whichever came first) or end of study (January 2020). Patients were followed for a median of 29 (95% confidence interval = 25.2–32.7) months, and 12 (15%) patients experienced the composite endpoint. Within the limitation of a retrospective study, our results suggest no benefit from immunosuppressive therapy in patients with IgAN with stage 3 and 4 CKD as compared with supportive care.
There were no differences between the 3 studied groups regarding age, estimated glomerular filtration rate, proteinuria, Oxford classification score, arterial hypertension, and therapy with renin-angiotensin system inhibitors.
Mean kidney survival time for the entire cohort was 81.0 (95% confidence interval = 73.1–89.0) months, without significant differences between the 3 groups.
In univariate and multivariate Cox regression analysis adjusted for IgAN progression factors, immunosuppressive therapy was not associated with better kidney survival when compared with supportive therapy.
Ultrasonographic misdiagnosis of multicystic mesothelioma of the omentum: A case report
Authors: Diao Yuhong , Chen Li , Liu Zhixing 
Published: September 2022

Rationale:
Multicystic Mesothelioma (MM) is very rare and preoperative diagnosis is difficult.

Patient concerns:
We report a case of a 34-year-old man with solid abdominal cystic echo mass. Physical examination showed that the patient had a flat and soft abdomen without tenderness or rebound pain, no fluid wave tremor, and no obvious abdominal mass was touched. The patient complained of repeated abdominal distention with nausea for 5 days. Sonographic examination suspected pseudomyxoma peritoneum.

Diagnosis:
Conventional ultrasound examination showed a cystic solid echo mass in the right abdominal cavity of the patient, with uneven internal echo and honeycomb change, and clear boundary with surrounding organs. Color Doppler suggested that the blood flow in the mass was not obvious. Contrast-enhanced computed tomography of the abdomen revealed hypodensity foci in hepatic and renal crypts and right paracolic sulcus.

Interventions:
Laparoscopic resection of the mass was performed, and the postoperative pathological findings were polycystic mesothelioma (greater omentum).

Outcomes:
After mass resection, all laboratory tests and abdominal ultrasound were normal, and abdominal distension and nausea disappeared.

Lessons:
Improved ultrasound diagnosis of MM is useful for clinical decision-making.
Identification of perioperative neurocognitive dysfunction biomarkers in cerebrospinal fluid with quantitative proteomic approach in patients undergoing transurethral resection of prostate with combined spinal and epidural analgesia
Authors: Luo Tian-Yan , Zhou Wei , Xiang Gui-Fang , Zhang Ying , Liu Qing 
Published: September 2022

Background:
This study aimed to identify predictive biomarkers of perioperative neurocognitive dysfunction (PND) in cerebrospinal fluid of elderly male patients undergoing elective transurethral resection of prostate, using an isobaric tags for relative and absolute quantitative-based quantitative proteomic approach.

Methods:
Patients were evaluated with Mini Mental State Examination at −1 and+3 days of operation. Presence of PND was determined with Z-score method. Patients characteristics and quantitative cerebrospinal fluid proteomes detected with isobaric tags for relative and absolute quantitative-were compared between PND and non-PND patients. Gene ontology and Kyoto Encyclopedia of Genes and Genomes analysis were performed to identify pathways potentially involved in PND.

Result:
A total of 229 patients were included in the study and 32 were diagnosed with PND (incidence 14.4%). The age, incidence of hypertension, and diabetes of PND patients were significantly higher than non-PND patients (P < .05). There were 85 differentially expressed proteins identified, among which High Mobility Group Box 1, prostaglandin D synthase, and matrix metalloproteinase inhibitor were considered to be promising candidates as they might play important roles in pathophysiology of PND.

Conclusion:
Proteomic approach identified potential biomarkers for predicting the occurrence of PND. These findings need to be validated in further studies.