bluuebunny/crossref_metadata_2025 huggingface dataset:
Mental Health Problems of Female Spouses of Men Living With HIV in Sichuan, China: A Qualitative Study
Authors: Cao Wangnan , Wong Hai Ming , Mo Phoenix Kit-han , Sun Shengzhi , Hu Yanhong Jessika
Published: June 2019

HIV disclosure to spouses can promote HIV prevention and facilitate support from those spouses; it can also cause mental health challenges for the spouses. We conducted a qualitative study of the mental health status and potential contributing factors of mental health challenges of spouses of men living with HIV in Sichuan, China. We interviewed 31 spouses whose husbands were living with HIV. Qualitative data were analyzed using content and thematic analyses. We found that mental health challenges were common among the spouses; leading challenges were themed as hopelessness, depression, and anxiety. Greater HIV knowledge, close relationship with husband, and psychological support may protect spouses from mental health challenges, whereas HIV-related stigma, heavy caregiving burden, and an unsupportive environment might be detrimental to mental health. Spouses of men living with HIV need mental health services, which should take into account a wide spectrum of contributors at individual, couple, and social levels.
Role of ascitic prostaglandin E2 in diagnosis of spontaneous bacterial peritonitis and prediction of in-hospital mortality in patients with decompensated cirrhosis
Authors: Luo Junli , Wu Xianmei , Zhang Yu , Huang Wenxiang , Jia Bei
Published: June 2019

Spontaneous bacterial peritonitis (SBP) is one of the most frequent and severe complications in patients with decompensated cirrhosis. Early antibiotic therapy is extremely important for successful treatment and reducing mortality. Prostaglandin E2 (PGE2) is a regulator of the immune response and infection. This study aimed to explore whether ascitic PGE2 could be used as a marker for diagnosing SBP and predicting in-hospital mortality.

Patients with cirrhosis and ascites undergoing abdominal paracentesis were enrolled in our study. Demographic, clinical, and laboratory parameters were recorded at the time of paracentesis and ascitic PGE2 levels were determined by ELISA. The correlation between ascitic PGE2 level and SBP as well as in-hospital mortality were analyzed.

There were 224 patients enrolled, 29 (13%) patients diagnosed as SBP based on the current guideline criteria. The ascitic PGE2 level of patients with SBP [32.77 (26.5–39.68) pg/mL] was significantly lower than that of patients without SBP [49.72 (37.35–54.72) pg/mL]. In ROC analysis, the AUC of ascitic PGE2 for the diagnosis of SBP was 0.75, and the AUC of ascitic PGE2 combined with WBC and ascitic PGE2 combined with neutrophils were 0.90 and 0.90, respectively, which were significantly higher than that of ascitic PGE2. In multivariate analysis, ascites PGE2≤32.88 pg/mL (OR: 9.39; 95% CI: 1.41–67.44, P = .026), hepatic encephalopathy (OR: 18.39; 95% CI: 3.00–113.13, P = .002) and a higher MELD score (OR: 1.25; 95% CI: 1.05–1.40, P = .009) remained independent predictors of in-hospital mortality.

Ascitic PGE2 level is likely to be a valuable marker in prediction of in-hospital mortality in patients with decompensated cirrhosis, and its value in diagnosis of SBP was not superior to other inflammatory indicators.
A cross-sectional study of the ambulatory central artery stiffness index in patients with hypertension
Authors: Zeng Xuezhai , Jia Na , Liu Deping , Wang Lijuan , Xu Zhujin , Zhang Yan , Wang Hua , Zhang Ruisheng , Zhou Jihong , Pan Chunyu , Gan Yu , Qiao Weiwei
Published: June 2019

The present study aimed to investigate the characteristics of the ambulatory central artery stiffness index (AcASI) and its related factors. The association between AcASI and the left ventricular mass index (LVMI), and other factors related to atherosclerosis were explored.

Patients with primary hypertension were enrolled into this study. Ambulatory central artery blood pressure (CABP) and ambulatory brachial artery blood pressure (BABP) were assessed using a Mobil-O-Graph NG hemomanometer, whereas AcASI and the ambulatory arterial stiffness index (AASI) were determined. LVMI was assessed by echocardiography.

A total of 136 patients with primary hypertension were enrolled from May 2011 to January 2013 in Beijing Hospital. AcASI was significantly associated with AASI (r = 0.879, P < .001). AcASI was significantly lower than AASI (0.422 ± 0.302 vs 0.482 ± 0.270; P < .001). AcASI increased with age, ambulatory brachial mean blood pressure (MBP), and fasting glucose. AcASI was significantly associated with office pulse pressure (PP), ambulatory brachial PP, ambulatory central PP, and pulse wave velocity (PWV). AcASI, but not AASI, was significantly associated with LVMI. Receiver operator characteristic analysis indicated that AcASI and AASI could may be a predictor of left ventricular hypertrophy (LVH). Multiple regression analysis indicated that AcASI, chronic kidney disease, and hypertension course were associated with LVMI, but AASI was not.

AcASI, which is obtained from ambulatory CABP monitoring, could be a new marker for the evaluation of atherosclerosis. AcASI may be stronger associated with LVH than AASI.
Pleuroparenchymal fibroelastosis in patients affected by systemic sclerosis
Authors: Bargagli Elena , Mazzei Maria Antonietta , Orlandi Martina , Gentili Francesco , Bellisai Francesca , Frediani Bruno , Bergantini Laura , Carobene Loredana , Randone Silvia Bellando , Guiducci Serena , Cameli Paolo , Bruni Cosimo , Cerinic Marco Matucci
Published: June 2019

Pleuroparenchymal fibroelastosis (PPFE) is a rare new interstitial lung disease (ILD) characterized by the fibrotic thickening of the visceral pleura and subadjacent parenchymal areas of the upper lobes This study reveals that patients with ILD-SSc associated with chest HRCT evidence of PPFE require close and recurrent follow-up with periodic evaluation of lung function parameters, DLCO and chest HRCT. Rheumatologists should be aware of this new radiological finding which is accompanied by a negative prognosis, especially when associated with a progressive course. Patients with this radiological pattern need to be monitored with particular attention.
Tai Chi for the treatment of chronic obstructive pulmonary disease
Authors: Gao Longxia , Si Dongxu , Bao Haipeng , Yu MingXia , Sun Huizhuo , Damchaaperenlei Dashzeveg , Yan Yue , Shi Qi , Li Youlin
Published: June 2019

Background:

Chronic obstructive pulmonary disease (COPD) is a common chronic respiratory disease with increasing morbidity and mortality that cause huge social and economic loss. Although recommended by guidelines, pulmonary rehabilitation has not been widely applied in clinics because of its inherent limitations. Free from restrictions of specific training venues and equipment, Tai Chi, as a kind of pulmonary rehabilitation, has been used to cure the COPD, yet the efficacy and safety of Tai Chi remains to be assessed. In this study, we aim to draw up a protocol for systematic review to evaluate the efficacy and safety of Tai Chi for COPD.

Methods:

We will search the following electronic databases from inception to December 31, 2018: PubMed, Web of Science, Medline, Cochrane Central Register of Controlled Trials, Springer, EMBASE, the China National Knowledge Infrastructure Database, Wan Fang Database, the Chinese Scientific Journal Database, and Chinese Biomedical Literature Database. Clinical trial registrations, potential gray literatures, relevant conference abstracts and reference list of identified studies will also be searched. The literature selection, data extraction, and quality assessment will be completed by 2 independent authors. Either the fixed-effects or random-effects model will be used for data synthesis based on the heterogeneity test. Changes in lung function will be evaluated as the primary outcome. Symptom assessment, quality of life (SGRQ), medication usage, exacerbations, and adverse events will be assessed as the secondary outcomes. The RevMan V.5.3.5 will be used for Meta-analysis.

Results:

This study will provide a synthesis of current evidence of Tai Chi for COPD from several aspects, such as lung function, SGRQ, medication usage, exacerbations, and adverse events.

Conclusion:

The conclusion of our study will provide updated evidence to judge whether Tai Chi is an effective solution to COPD patients.

PROSPERO registration number:

PROSPERO CRD42019122791.
Alcohol consumption and risk of dementia
Authors: Li Jing , Hui Xu , Gu Qinghong , Lao Yongfeng , Lu Zhenxing , Hou Lijuan , Jia Bibo , Niu Junqiang , Yao Liang , Yan Peijing
Published: June 2019

Objective:

To investigate the relationship between alcohol consumption and the incidence of dementia.

Method:

We will conduct a systematic search without language and year restrictions to identify all relevant published studies. The following electronic databases will be searched: PubMed, EMBASE, the Cochrane Library, Chinese BioMedical Literature Database (CBM) and China National Knowledge Infrastructure (CNKI), VIP, Wan-Fang. Cohort studies published in Chinese or English are considered for inclusion. Two authors will independently select studies base on inclusion criteria, extract data and assess the quality of included studies using the Newcastle–Ottawa Scale, the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) system will be used to quantify absolute effects and quality of evidence. Any disagreement will be resolved by consensus. We will use the hazard ratio (HR) as the effect indicator, piecewise linear regression model and restricted cubic spline model will be used for linear and nonlinear trend estimation, respectively.

Registration:

The dose-response meta-analysis is registered in the PROSPERO (CRD42019127367) international prospective register of systematic review.

Discussion:

In the previous related dose-response meta-analysis studies, there were some limitations: on the 1 hand, the sex was not taken into account. On the other hand, relative risk (RR) is not the best effect indicator for time-to-event data, but compare with RR, HR is much better. This study intends to use HR as the effect indicator to explore the dose-response relationship and the sex difference between alcohol intake and dementia. Accurate alcohol drinking data can provide high-quality evidence for the prevention of dementia.
Quality of reporting on thoracic radiotherapy technique in prospective lung cancer trials
Authors: Soon Yu Yang , Chen Desiree , Tan Teng Hwee , Seong Tey Jeremy Chee
Published: June 2019

Background:

The aim of this study is to assess the quality of reporting of thoracic (T) RT technique for curative intent treatment in prospective lung cancer trials.

Methods:

We searched MEDLINE for eligible trials published from 1996 to 2016. We assessed the included trials’ reports on whether they reported the RT dose prescription method; RT dose-planning procedures; algorithm for tissue inhomogeneity dose corrections; organs at risk dose constraints; target volume definition, simulation and/or motion management procedures; treatment verification procedures; total RT dose; fractionation schedule; conduct of quality assurance as well as presence or absence of deviations in RT treatment planning and delivery adequately. We performed univariable and multivariable logistic regression to determine the factors that may influence the quality of reporting.

Results:

We found 85 eligible trial reports. Target volume definition, total RT dose, and fractionation schedules were reported adequately in more than 90% of the included trials. Algorithm for tissue inhomogeneity dose corrections, simulation and verification procedures, presence or absence of deviations in RT treatment planning and delivery were reported adequately in less than 20% of the included trials. Twenty-three trials (27%) reported 7 criteria or more adequately. Both univariable and multivariable logistic regression showed that trials with RT focused research question were more likely to have adequate quality in reporting (judged as adequate reporting in 7 criteria or more) than trials with non-RT focused question (odds ratio 4.11, 95% confidence interval 1.10 to 15.43, P value = .04).

Conclusion:

There is significant variability in the quality of reporting on thoracic radiotherapy treatment in prospective lung cancer trials. Future research should focus on developing consensus guidelines to standardize the reporting of radiotherapy technique in clinical trials.
Contrast ultrasound versus ultrasound elastography for diagnosis of breast lumps
Authors: Zhao Wei , Yan Kaituo , Liu Yingying , Zhang Zaibin
Published: June 2019

Chinese women have dense and small breasts. Therefore, in China, contrast ultrasound and ultrasound elastography are commonly used for detection of the breast lumps. Purpose of the study was to compare the sensitivity and accuracy of ultrasound elastography with contrast ultrasound for the diagnosis of the breast lumps.

A total of 1000 women with a damp in breast mass, breast pain, nipple discharge, and/or breast skin discharge were subjected to contrast ultrasound and ultrasound elastography. Women were subjected to stereotactic vacuum-assisted biopsy under B-mode ultrasonography (n = 750). The ultrasound examinations were graded on a 5-points scale method. Data were subjected to the Chi-square Independence test at 99% of confidence level.

Ultrasound elastography was detected the same numbers of benign lesions (648 vs 651, P = .88), malignant lesions (90 vs 99, P = .53), and false positive lesions (5 vs 0, P = .07) as those detected by biopsies. However, diagnostic parameters for contrast ultrasound had a significant difference with those detected by biopsies (P < .0001 for all). For contrast ultrasound and ultrasound elastography, the working area to detect deformation in the image of the breast lesions at least 1 time were 0% to 45% and 5% to 100%.

Ultrasound elastography is the most reliable diagnostic method for detection of the breast lumps.
The usefulness of inflammatory biomarkers in diagnosing child and adolescent's gastritis
Authors: Meliţ Lorena Elena , Mărginean Maria Oana , Mocan Simona , Mărginean Cristina Oana
Published: June 2019

Neutrophil to lymphocyte ratio (NLR) is a simple, noninvasive, inexpensive inflammatory marker that can useful in the assessment of inflammatory activity, especially in pediatric ages. The aim of our study was to establish correlations between the presence of Helicobacter pylori (HP) proved histologically and NLR in children.

A prospective, case–control study was performed on 137 pediatric patients aged between 1 and 18 years, admitted in a Pediatric Tertiary Hospital from Romania, between April 2016 and January 2018. According to the histologic examination, the children were divided into 2 groups: group 1: 50 children with HP infection, and group 2: 87 children without any pathologic findings.

The mean age for the study group was 12.86 ± 3.796 years, whereas for control group, it was 12.10 ± 3.879 years (P = .3001). HP infection was significantly more frequent among children from rural area (P = .0089). Epigastric pain and loss of appetite were significantly associated with HP infection (P = .0350 /P = .0281). We noticed that the leukocyte and neutrophil counts were significantly higher in group 1 (P = .0076/P = .0306). We did not find any significant statistical differences between the 2 groups in terms of lymphocytes, erythrocyte sedimentation rate, and NLR or other assessed laboratory parameters. Regarding the IgA antibodies anti-HP and rapid urease test, they were both significantly associated with histologically confirmed HP infection (P < .0001).

Even though, we did not identify significant differences in term of NLR between HP-induced gastritis children and healthy controls, the mean NLR values were higher HP-positive patients.
Effectiveness of physiotherapy on quality of life in children with asthma
Authors: Zhang Weijian , Liu Lilong , Yang Wenhao , Liu Hanmin
Published: June 2019

Background:

Asthma is the most common chronic lung disease in childhood, leading to a great burden to the healthcare system worldwide. Despite the medication treatment, physiotherapy is now applied for asthmatic children aiming to improve their lung function and life quality. However, the effectiveness of physiotherapy on quality of life (QoL) in children with asthma is not clear. We are aiming to perform this study to provide some evidence to doctors on asthma treatment.

Methods:

PubMed, Embase and the Cochrane Library will be searched from their inception to 31 March 2019 for randomized controlled trials (RCTs) published in English, which investigated the effectiveness of physiotherapy on QoL in children with asthma. Besides, additional studies will be searched by scanning the reference lists of studies and the relevant systematic reviews.

Two authors will select the studies, extract the data, and assess the risk of bias independently. Data synthesis and statistical analysis will be performed in Review manager 5.3. Stata 14.0 will be used to assess the reporting bias. Quality of evidence will be evaluated based on the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system.

Results:

The results will provide information on the effectiveness of physiotherapy on QoL in children with asthma and further demonstrate which physiotherapy is more effective and which domain of QoL could be improved significantly.

Conclusion:

The findings of this study will provide the latest evidence on the effectiveness of physiotherapy on QoL in children with asthma.

Prospero Registration Number:

CRD42019133181.
Thirteen kinds of Chinese medicine injections for acute exacerbation of chronic obstructive pulmonary disease
Authors: Zheng Wenjiang , Gao Tianqi , Huang Huiting , Zhou Zhihui , Yan Qian , Hong Yu , Liao Huili , Zhang Tiange , Liu Xiaohong
Published: June 2019

Background:

Chinese medicine injections (CMIs) are extensively applied to the therapy of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in mainland China. Up to 13 different kinds of CMIs are reportedly often used for treating chronic obstructive pulmonary disease, yet, rarely head to head comparison of tests are used to decide the relative consequent among the distinct CMIs. Network meta-analysis (NMA) will be performed to further compare the effects of 13 different CMI, including direct and indirect comparisons of different CMI.

Methods:

From now until April 2019, a systematic and comprehensive literature search will be conducted in both English and Chinese databases, including Medline, Embase, Cochrane library, Chongqing VIP information, Wanfang Database, China national knowledge infrastructure database, and Sino Med. Randomized controlled trials will be included related to CMI therapy for AECOPD. We will assess the quality of the included trials in accordance with the risk of bias tools in Cochrane manual 5.1.0. We will use the grading of recommendations assessment development, and evaluation method to assess the certainty of the estimated evidence from the NMA. STATA 14.0 will be used for data analysis.

Results:

The purpose of this systematic evaluation and NMA was to summarize and rank the direct and indirect evidence for 8 different types of CMI. The NMA's findings will be reported in accordance with preferred reporting items for systematic reviews and meta analyses-NMA statement. Upon completion, NMA results will be submitted to a peer-reviewed journal.

Conclusion:

With NMA, this study will provide evidence for the selection of CMI for patients with AECOPD. The results will provide information to clinicians, bridge the evidence gap and identify promising CMI targets for future trials.

PROSPERO registration number:

PROSPERO CRD 42019132955.
Response to immune complex vaccine in chronic hepatitis B patients is associated with lower baseline level of serum IgG galactosylation
Authors: Han Jing , Gong Guo-Zhong , Lei Jian-Hua , Qin Wen-Jun , Qin Rui-Huan , Wang Xuan-Yi , Gu Jian-Xin , Ren Shi-Fang , Wen Yu-Mei
Published: June 2019

The composition of glycan in immunoglobulin G (IgG) has shown to affect various diseases and can be regulated by drugs and preventive vaccination. A hepatitis B surface antigen (HBsAg)-hepatitis B immunoglobulin (HBIG) immune complex (YIC) therapeutic vaccine for chronic hepatitis B (CHB) patients has undergone clinical trials. To explore for markers of CHB, which could be associated with responsiveness to YIC therapeutic vaccine, serum IgG glycosylation in CHB patients was analyzed.

Kinetic changes of serum galactosylated IgG in 53 hepatitis Be antigen (HBeAg)-positive CHB patients treated with YIC were monitored by matrix-assisted laser desorption/ionization (MALDI) mass spectrometry (MS) analysis. Whole blood cytokines were assayed by cytokine binding assay kits. All samples were back assayed before treatment, during therapy and follow-up for 6 months from a previous completed clinical trial.

During YIC treatment, 26 patients with lower IgG galactosylation level at baseline [galactosylation level (Gal-ratio) = −0.29, 0.18 (mean, SD)] showed sustained increase of serum galactosylated IgG, and responded to YIC treatment by HBeAg seroconversion. While those who did not respond to YIC treatment [Gal-ratio = −0.40, 0.15 (mean, SD)] failed to show similar changes. Furthermore, this kinetic increase of galactosylated IgG correlated with marked up-regulated IL-2 level, confirming that effective cellular immune responses have participated in responsiveness.

For HBeAg-positive CHB patients lower serum IgG galactosylation level may serve as an indicator for selecting a suitable subpopulation of candidates for YIC therapeutic vaccination.
Neutrophil–lymphocyte ratio predicts the outcome of intracerebral hemorrhage
Authors: Liu Shuo , Liu Xiaoqiang , Chen Shuying , Xiao Yingxiu , Zhuang Weiduan
Published: June 2019

Background:

The neutrophil–lymphocyte ratio (NLR) is increasingly recognized as a systemic inflammation factor. It has been used as a predictor for clinical outcomes in cancers. However, its relationship with intracerebral hemorrhage (ICH) is still disputed. We sought to evaluate the prognostic role of NLR in ICH.

Methods:

We searched PubMed, Cochrane Library, Medline, and EMBASE for potentially relevant articles from inception to April 8, 2018. Efficacy outcomes included major disability at 90 days, short-term mortality or in-hospital mortality. Odds ratio (OR) with 95% confidence interval (95% CI) were pooled to assess the association between NLR and ICH.

Results:

A total of 7 trials with 2176 patients were included in this meta-analysis. It revealed that higher NLR had a higher risk of major disability at 90 days (OR: 2.20; 95% CI: 1.27–3.81) and higher mortality at short-term (OR: 1.31; 95% CI: 1.02–1.68) in ICH; without statistically significant association with in-hospital mortality (OR: 1.02; 95% CI: 0.91–1.15).

Conclusions:

Our meta-analysis proved that high NLR was a predictor of major disability and mortality at short term in ICH patients, but not a predictor of in-hospital mortality.
Optic disk hemorrhage and vitreous hemorrhage after phacoemulsification in a normal tension glaucoma patient
Authors: Hu Rongrong , Shen Liping , Wang Xiaoyu
Published: June 2019

Rationale:

Optic disk hemorrhage has been closely correlated with glaucoma for its development and progression. Phacoemulsification surgery results in large intraocular pressure (IOP) fluctuation. We report a case of optic disk hemorrhage and consequently progressive vitreous hemorrhage after an unsuccessful phacoemulsification surgery in an advanced normal tension glaucoma (NTG) patient.

Patient concerns:

An advanced NTG patient of 82 years old with chronic hypertension underwent an unsuccessful phacoemulsification surgery complicated by posterior capsule rupture. During the postoperative 2 weeks, recurrent episodes of fresh hyphema occurred and B ultrasonography scan revealed the progressive vitreous hemorrhage. The IOP went out of control under the maximum tolerable IOP-lowering medications.

Diagnosis:

Vitreous hemorrhage after phacoemulsification in an advanced NTG patient.

Interventions:

Vitrectomy was performed to search for the cause of the progressive vitreous hemorrhage. After removal of the thick vitreous hemorrhage, a fresh spot of optic disk hemorrhage was detected at the nasal margin of the significantly-cupping disk.

Outcomes:

Postoperatively, the hemorrhagic vitreous opacity gradually resolved and the IOP remained stable at 10 ∼13 mmHg with topical prostaglandin analogue drops. Fundus examination revealed the dilated disk vessel with localized angiomatous change at the nasal disk margin.

Lessons:

Severe optic disk hemorrhage may occur after phacoemulsification in advanced glaucoma patients. Systemic vascular factors, such as chronic hypertension and old age, and surgical complications, such as posterior capsule rupture and postoperative IOP elevation, would further increase the risk. For phacoemulsification in advanced glaucoma cases, extra care should be taken to control intraoperative IOP fluctuations and monitor postoperative IOP.
Risk of elevation of serum creatine kinase among HIV-positive individuals receiving dolutegravir-based combination antiretroviral therapy
Authors: Chen Guan-Jhou , Sun Hsin-Yun , Cheng Aristine , Chuang Yu-Chung , Huang Yu-Shan , Lin Kuan-Yin , Huang Yi-Chia , Liu Wen-Chun , Wu Pei-Ying , Hung Chien-Ching , Chang Shan-Chwen
Published: June 2019

We aimed to compare the risks of creatine kinase (CK) elevation between patients receiving dolutegravir-based antiretroviral therapy (ART) and those receiving non-integrase strand transfer inhibitor (InSTI)-based ART.

HIV-positive patients seeking HIV outpatient care between February 2017 and March 2018 were retrospectively reviewed to collect information on ART, practices of vigorous exercise, and laboratory tests including CK level, plasma HIV RNA load, and concurrent medications. The incidences of CK elevation were estimated among patients receiving dolutegravir-based ART and those receiving non-InSTI-based ART.

During the 14-month study period, 1406 patients (mean age 39.4 years and 96.9% being male) were included. The incidence rate of grade 3 or grade 4 CK elevation (>10-fold of the upper limit of normal) was 2.0 per 100 person-years of follow-up (PYFU) and 1.3 per 100 PYFU in the dolutegravir and non-InSTI group, respectively (P = .32). While dolutegravir group had a higher rate of CK elevation of any level than non-InSTI group (22.9 vs 17.4 per 100 PYFU, P = .01), the risk was associated with weight (adjusted odds ratio [aOR], per 10-kg increase, 1.03; 95% CI, 1.02–1.04), duration of exercise (aOR, per 1-hour increase, 1.02; 95% CI 1.01–1.03), but not with dolutegravir-based ART (aOR, 1.00; 95% CI, 0.99–1.06) after adjusting for the testing frequency of serum CK in the multivariate generalized estimating equation model. No patients were hospitalized or switched ART due to CK elevation.

Serum CK elevation was associated with weight and duration of exercise among HIV-positive patients receiving ART, but not with dolutegravir-based ART.
C-reactive protein is a significant predictor of improved survival in patients with advanced non-small cell lung cancer.
Authors: Xiao Xiaoguang , Wang Shujing , Long Guoxian
Published: June 2019

This study tries to evaluate the associations between circulating C-reactive protein (CRP) and the overall survival of patients with non-small cell lung cancer (NSCLC).

One hundred ninety-two patients with advanced NSCLC who treated with chemotherapy were enrolled in this study. The cut-off value of CRP concentration was 5.0 mg/L. The patients were divided into low, intermediate and high 3 groups respectively according to the baseline level of CRP before the treatment. Kaplan–Meier analysis and Cox proportional-hazard models were used to evaluate the relationship between the CRP and overall survival time of patients.

After adjusting for age, gender, smoking history, pathologic type, CRP was a significant independent impact which predicts the survival prognosis of patients with NSCLC. For all patients, the hazard ratio with high CRP levels for NSCLC-specific survival was 1.83 [95%confidenceinterval (CI) = 0.96, 3.48] compared with low CRP levels. The level of CRP was significantly correlated with survival time (hazard ratio = 1.77; 95% CI = 0.73, 4.26) for the patient with first-line chemotherapy. Patients with high level of circulating CRP also responded poorly to chemotherapy.

A high level of circulating CRP was associated with a poor response and worse survival in patients with NSCLC.
Successful treatment of disseminated fusariosis in a patient with acute lymphoblastic leukemia
Authors: Yu Jieni , Chen Yan , Fang Jiabin , Zhang Kejie
Published: June 2019

Rationale:

Fusarium is the second most common cause of fungi infections in the immunocompromised patients with the mortality rate over 80%. Early identification and appropriate selection of antifungal drugs is the key to successful treatment.

Patient concerns:

A 31-year-old female was diagnosed with acute lymphocytic leukemia (pro-B ALL). She developed a high fever and presented with typical painful purple nodules with central necrosis formed on the upper and lower limbs during the induction chemotherapy.

Diagnosis:

Combining clinical manifestations with results of blood culture testing and sequencing methods, it was consistent with the diagnosis of disseminated fusariosis.

Interventions:

The patient was treated with the combination of tigecycline and antifungal agents (Liposomal Amphotericin B and Voriconazole),

Outcomes:

The skin lesions generally healed with some scar left after treating with antifungal agents for 6 weeks. The final date of follow-up was 1.5 years later, and the patient was alive with no diseases.

Lessons:

This case highlights the importance of the typical cutaneous lesions for early diagnosis and proper treatment to decrease the mortality rate of this severe infection. This patient was successfully treated with the combination of tigecycline and antifungal agents, which may be the first clinical confirmation of tigecycline that improved the effectiveness of antifungal agents against fusariosis, but it requires more studies to verify. We reviewed 62 cases from literature and analyzed using logistic regression and recognized the high-risk factor for fusariosis mortality in patients with acute leukemia was non-remission of underlying disease.
Is there still a place for vinorelbine in advanced metastatic castration resistant prostate cancer?
Authors: Roviello Giandomenico , Corona Silvia Paola , Conca Raffaele , Petrioli Roberto , Rosellini Pietro , Bonetta Alberto , Aieta Michele
Published: June 2019

The aim of this paper was to evaluate the activity and tolerability of oral vinorelbine in patients with advanced castration resistant prostate cancer (CRPC) who progressed after a minimum of three lines including: abiraterone acetate, docetaxel, cabazitaxel, and enzalutamide.

Treatment consisted of weekly oral vinorelbine 60 mg/m2. Chemotherapy was administered until disease progression or unacceptable toxicity.

Twenty-six patients received vinorelbine: their median age was 74 years (range 58–84 years). Twenty-four (92.3%) patients had bone metastases. A decrease in PSA levels ≥50% was observed in 2 patients (7.7%). Among the subjects who were symptomatic at baseline, pain was reduced in 3 patients (13.6%) with a significant decrease in analgesic use. Median progression-free survival was 9 weeks (95% CI: 7 to 11) and median overall survival was 17 weeks (95% CI: 12 to 22). Treatment was well tolerated, and no grade 4 toxicities were observed.

Our findings do not suggest the use of oral vinorelbine on a weekly schedule, in CRPC heavily pre-treated.
Improving the detection rate of prostate cancer in the gray zone of PI-RADS v2 and serum tPSA by using prostate-specific antigen–age volume
Authors: Lu Yuan-Fei , Zhang Qian , Chen Hai-Yan , Chen Jie-Yu , Pan Yao , Xu Cong-Cong , Xu Jian-Xia , Yu Ri-Sheng
Published: June 2019

To improve the detection of prostate cancer (PCa) by combining the Prostate Imaging Reporting and Data System version 2 (PI-RADS v2) and prostate-specific antigen–age volume (PSA–AV), especially among those in gray zone with PI-RADS v2 score 3 or serum total prostate-specific antigen (tPSA) 4 to 10 ng/mL.

The 357 patients were enrolled in this study. The PI-RADS v2 scoring system was used to represent characteristics on multiparametric magnetic resonance imaging (mpMRI). PI-RADS v2 score 3 or tPSA 4 to 10 ng/mL were defined as the gray zone in detecting PCa. The formula equates to the patient age multiplied by the prostate volume, which is divided by the tPSA level. Univariate and multivariate analyses were done to ascertain significant predictors of prostate cancer.

In all, 174 (48.7%) were benign prostatic hyperplasia, 183 (51.3%) had PCa. The results showed that PI-RADS v2, tPSA, and PSA–AV were significant independent predictors of prostate cancer. PI-RADS v2 score ≥4 could detect PCa with rate of 82.1%. Serum tPSA ≥10 ng/mL could detect PCa with rate of 66.2%, PSA density (PSAD) ≥0.15 ng/mL/cc with rate of 62.8%, and PSA–AV ≤250 with rate of 83.5%. Combining with PSA–AV ≤250, patients those with tPSA 4 to 10 ng/mL could improve the detection from 36.0% up to 81%, those with PI-RADS v2 score 3 from 28.6% up to 60.0%.

PI-RADS v2 and PSA–AV are faithful variables for detecting PCa. And for patients, those in gray zones of PI-RADS v2 and tPSA, PSA–AV can improve detection rate of PCa.
Performance of Interferon‐Gamma Release Assays for Tuberculosis Screening in Pediatric Inflammatory Bowel Disease
Authors: Stevens James P. , Ballengee Cortney R. , Chandradevan Raguraj , Thompson Amelia B. , Schoen Bess T. , Kugathasan Subra , Sauer Cary G.
Published: June 2019

Objectives:

The aim of the study was to analyze the diagnostic accuracy and utility of QuantiFERON‐TB Gold In‐Tube, an interferon‐gamma release assay (IGRA), as a screening tool for latent tuberculosis infection (LTBI) in pediatric patients with inflammatory bowel disease (IBD) undergoing treatment with anti‐tumor necrosis factor (anti‐TNF) medications. To describe cases of tuberculosis in the pediatric IBD population, TB treatment courses, outcomes, and their effect on IBD management.

Methods:

A single‐center, retrospective cohort study of pediatric IBD patients who underwent tuberculosis screening. IGRA testing from 2011 to 2017 were analyzed to determine result rates, characteristics, and outcomes.

Results:

One thousand seven hundred fifty‐four (1,754) tests were performed on 859 patients. One thousand six hundred thirty‐four (1,634) tests were negative, 9 were positive, and 111 were indeterminate. Eight of 9 positive tests resulted during repeat annual screening while receiving IBD treatment. Five patients were treated for latent tuberculosis infection (LTBI), and 4 were false‐positives. IBD therapy was interrupted in 3 patients, with no negative long‐term outcomes. We report 1 known false‐negative, in a patient who developed disseminated TB on anti‐TNF therapy. Indeterminate testing rates were higher at IBD diagnosis than during treatment (10.3% vs 5.3%, P < 0.001). Follow‐up testing of indeterminate results was negative in all patients retested, with 14 patients lost to follow‐up. No patient with indeterminate testing developed TB.

Conclusions:

IGRAs are a useful tool to screen for LTBI, both before anti‐TNF therapy and during treatment. Results should be used in concert with detailed history and examination. Positive and indeterminate results should be promptly repeated for timely TB diagnosis and to minimize interruptions in IBD therapy.
Nanobody and aptamer as targeting moiety against bacterial toxins: therapeutic and diagnostic applications
Authors: Ganji Ali , Islami Maryam , Ejtehadifar Mostafa , Zarei-Mehrvarz Ehsan , Darvish Maryam
Published: June 2019

Infectious diseases are common life-threatening problems mediated by pathogen micro-organisms that cause morbidity and mortality worldwide. Currently, there is an increasing rate of the bacterial infections and emergence of the new antibiotic resistance in human societies. On the other hand, early detection of the bacterial infection present in biological samples suffers from extended time, high cost, and laborious methods. Therefore, there is a permanent need for robust diagnostic and therapeutic tools against bacterial agents. Recently, specific targeting bio-molecules, such as aptamer and nanobody have been appeared as specific and effective tools for biomedical application. They have excellent physicochemical parameters that make them superior to diagnosis and treatment of infectious agents achievable from diverse large libraries through systematic evolution of ligands by exponential enrichment (SELEX) or phage display process, respectively. The present study provides an overview of nanobody and aptamer and their method description. Main contexts of article focus on the application of nanobody and aptamer as an inhibiting moiety for some bacterial toxins.
A Replicable Model of Recruitment for Longitudinal Research of Preterm Infants
Authors: Gordon Jessica M. , Proschold Kaitlyn , Harville Cedric , Dutra Samia , Groer Maureen
Published: June 2019

Background

Recruitment and retention in longitudinal studies can be challenging because the numbers of participants may not adequately reflect the targeted population.

Objectives

The aim of the study was to present a replicable pathway model of recruitment via retrospective chart review and describe outcomes of the recruitment methods used in the model on enrollment, scheduling, and attrition.

Methods

This retrospective chart review included recruitment data from participants of a parent grant (n = 99) that met chart review inclusion criteria (n = 47) for a follow-up study measuring microbiome data of preterm infants at toddler and preschool age.

Results

Over a 3-year recruitment period, 25 of the 47 participants eligible for recruitment were enrolled in the follow-up study. Initial contact was more likely to be performed via mail and e-mail for first time points and via phone for subsequent contact and second time points. For scheduling, phone contact was the method utilized most frequently for both groups, with online scheduling second when introduced in the preschool group. Two participants were lost to follow-up, resulting in an attrition rate of 8%.

Discussion

This recruitment pathway model offers researchers multiple recruitment methods for initial contact and scheduling that may be useful in contacting more participants to positively affect enrollment and reduce attrition rates for longitudinal cohorts. The innovation of recruitment methods via Facebook for initial contact and online scheduling are new methods with promise and multiple benefits for the research staff and participants.
Lack of Association Between the S83I ParC Mutation in Mycoplasma genitalium and Treatment Outcomes Among Men Who Have Sex With Men with Nongonococcal Urethritis
Authors: Chambers Laura C. , Jensen Jørgen S. , Morgan Jennifer L. , Lowens M. Sylvan , Romano Sarah S. , Totten Patricia A. , Soge Olusegun O. , Hughes James P. , Golden Matthew R. , Manhart Lisa E.
Published: June 2019

From February 2015 to October 2017, among 20 men who have sex with men with Mycoplasma genitalium-associated nongonococcal urethritis, 15% had macrolide resistance and S83I ParC mutations. Azithromycin followed by moxifloxacin cleared Mycoplasma genitalium in 2 of 2 with and 11 of 13 without S83I mutations. Dual failures were cleared after doxycycline. S83I mutations were not associated with moxifloxacin failure.
Cervical and Oropharyngeal Lymphogranuloma Venereum: Case Report and Literature Review
Authors: Galeano-Valle Francisco , Pérez-Latorre Leire , Díez-Romero Cristina , Fanciulli Chiara , Aldamiz-Echeverria-Lois Teresa , Tejerina-Picado Francisco
Published: June 2019

Lymphogranuloma venereum (LGV) is a sexually transmitted infection caused by invasive serovars of Chlamydia trachomatis. There have been only a few case reports of oropharyngeal C. trachomatis infection complicated with cervical LGV. We report a case of a HIV-positive male patient with cervical LGV that presented a poor evolution despite appropriate treatment.
The experiences and needs of people seeking primary care for low-back pain in Australia
Authors: Ahern Malene , Dean Catherine Mary , Dear Blake Farran , Willcock Simon Mark , Hush Julia Margaret
Published: June 2019

Introduction:

There is a knowledge gap about the current experiences and needs of people with low back pain (LBP) seeking primary care in Australia.

Objectives:

The aim of this study was to understand the experiences and needs of Australians who have received treatment for LBP in primary care.

Methods:

This was a prospective, cross-sectional internet survey conducted between July 2017 and September 2017. Participants were adults who had experienced an episode of LBP in the past year, had sought primary care in Australia, and were proficient in English. Outcomes were patient-reported experiences about primary care treatment, including reasons for seeking care, health care practitioners consulted, components of care received, and patients' evaluations of the importance and helpfulness of treatment.

Results:

A total of 426 Australians completed the survey. The response rate of survey completion was 50%. Participants reported seeking primary care for LBP not only for pain relief, but for difficulties with activities and participation with usual social roles as well as quality of life and mood. Participants consulted multiple health care practitioners and used numerous treatment modalities. Only half reported they received education and a very low proportion were aware of receiving guideline-based advice. The level of satisfaction with care was below moderate for 42% of respondents. Participants reported that they want LBP care to be more person-centred and better tailored to their needs; they also reported wanting more education, particularly about prevention of future episodes and self-management.

Conclusions:

The needs of people currently seeking primary care for LBP in Australia do not seem to be adequately met. Improving patients' experiences and outcomes may require better integration of health care across providers and delivery of more person-centred care.
Impact of Demographics, Education, and Stress on Body Mass Index Among Jordanian University Students
Authors: Amr Rula A. , Al-Smadi Ahmed M. , Akasheh Rand T. , Dababneh Basem F. , Qatatsheh Alaa A. , Mayyas Amal H. , Hamad Islam M.
Published: June 2019

Obesity prevalence increased dramatically and impacted negatively on developing chronic diseases. The main objective of this study is to examine the association between body mass index (BMI) and demographic factors, stress, dietary intakes, and physical activity levels among Jordanian university students. A convenience sample was chosen from 3 universities. Data were analyzed based on questionnaires about BMI, dietary intakes, and demographics. The χ2 and Kruskal-Wallis tests were used to examine the association between BMI and the studied variables. The results showed that 20.6% of participants were overweight and 8.4% were obese. The results indicate a significant association between BMI and students' gender, nationality, and age; males compared with females and Jordanian participants compared with non-Jordanian students had significantly higher obesity. There was a significant association between stress, general health, and BMI. The results indicate that students who had normal weight perceived their health more as excellent and had less stress compared with students who were overweight or obese. This study indicates a relatively high prevalence of obesity among university students, especially males, Jordanians, and participants who felt stressed.
Machine Perfusion of Liver Grafts With Implantable Oxygen Biosensors: Proof of Concept Study in a Rodent Model
Authors: Scheuermann Uwe , Ibrahim Mohamed M. , Yerxa John , Parker William , Hartwig Matthew G. , Klitzman Bruce , Barbas Andrew S.
Published: June 2019

Background.

Normothermic machine perfusion (NMP) is emerging as a novel preservation strategy in liver transplantation, but the optimal methods for assessing liver grafts during this period have not been determined. The aim of this study was to investigate whether implantable oxygen biosensors can be used to monitor tissue oxygen tension in liver grafts undergoing NMP.

Methods.

Implantable phosphorescence-based oxygen sensors were tested in 3 different experimental groups: (1) in vivo during laparotomy, (2) during NMP of liver grafts with an acellular perfusate (NMP-acellular), and (3) during NMP with perfusate containing red blood cells (NMP-RBC). During in vivo experiments, intrahepatic oxygen tension was measured before and after occlusion of the portal vein (PV). In NMP experiments, intrahepatic oxygen tension was measured as a function of different PV pressure settings (3 vs 5 vs 8 mm Hg) and inflow oxygen concentration (95% O2 vs 6% O2).

Results.

In vivo, intrahepatic oxygen tension decreased significantly within 2 minutes of clamping the PV (P < 0.05). In NMP experiments, intrahepatic oxygen tension correlated directly with PV pressure when high inflow oxygen concentration (95%) was used. Intrahepatic oxygen tension was significantly higher in the NMP-RBC group compared with the NMP-acellular group for all conditions tested (P < 0.05).

Conclusions.

Implantable oxygen biosensors have potential utility as a tool for real-time monitoring of intrahepatic oxygen tension during NMP of liver grafts. Further investigation is required to determine how intrahepatic oxygen tension during NMP correlates with posttransplant graft function.
Association Between Peripheral Blood CD19-Positive Rate and Antibody-Mediated Rejection Following Rituximab Administration in Kidney Transplant Recipients
Authors: Nanmoku Koji , Shinzato Takahiro , Kubo Taro , Shimizu Toshihiro , Yagisawa Takashi
Published: June 2019

Background.

Rituximab is used widely for desensitization in ABO-incompatible and donor-specific antibody-positive kidney transplantation. However, data about the effects of individual differences in rituximab-induced B-cell suppression on antibody-mediated rejection (AMR) remain unknown. We aimed to assess the association between CD19-positive rate and AMR following rituximab administration after kidney transplantation.

Methods.

Overall, 42 patients who underwent rituximab therapy for pretransplant desensitization in ABO-incompatible (n = 33) and donor-specific antibody-positive (n = 15) kidney transplantation were observed retrospectively. To predict AMR incidence, the peripheral blood CD19-positive rate was determined and classified into short- and long-acting groups. AMR incidence, allograft function, complications, and rituximab dose were compared.

Results.

Eight patients (19%) had AMR within 39.2 months after transplantation. The CD19-positive rate cutoff value to predict AMR incidence was 4.4%, 6.4%, and 7.7% at 6, 12, and 18 months after transplantation, respectively. When comparing the short- and long-acting groups stratified according to the CD19-positive rate cutoff value, AMR incidence was significantly higher in the short-acting group than in the long-acting group at 6 (71.4% vs 8.6%), 12 (70.0% vs 3.1%), and 18 (58.3% vs 3.3%) months after transplantation. The CD19-positive rate for all patients with AMR exceeded the cutoff value 6, 12, or 18 months. Conversely, serum creatinine level, tacrolimus trough-level, cytomegalovirus antigenemia-positive rate, neutropenia incidence rate, and total dose of rituximab before transplantation showed no significant differences between the 2 groups.

Conclusions.

The risk of AMR was higher in patients with short-term B-cell suppression following rituximab administration. Additional rituximab administration after transplantation may prevent AMR in patients with a CD19-positive rate higher than the cutoff value.