bluuebunny/crossref_metadata_2025 huggingface dataset:
Higher Trough Vedolizumab Concentrations During Maintenance Therapy are Associated With Corticosteroid-Free Remission in Inflammatory Bowel Disease
Authors: Ungaro Ryan C , Yarur Andres , Jossen Jacqueline , Phan Becky L , Chefitz Ezra , Sehgal Priya , Kamal Kanika , Bruss Alexandra , Beniwal-Patel Poonam , Fox Caroline , Patel Amir , Bahur Bayda , Jain Anjali , Stein Daniel , Naik Snehal , Dubinsky Marla C
Published: February 2019

Background and Aims

Vedolizumab is an anti-α4β7 biologic approved for ulcerative colitis [UC] and Crohn’s disease [CD]. We aimed to examine the association of maintenance vedolizumab concentrations with remission.

Methods

We performed a cross-sectional multi-centre study of inflammatory bowel disease [IBD] patients on maintenance vedolizumab. A homogeneous mobility shift assay [HMSA] was used to determine trough serum concentrations of vedolizumab and anti-drug antibodies [ATVs]. The primary outcome was corticosteroid-free clinical and biochemical remission defined as a composite of clinical remission, normalized C-reactive protein [CRP] and no corticosteroid use in 4 weeks. Secondary outcomes included corticosteroid-free endoscopic and deep remission. Vedolizumab concentrations were compared between patients in remission and with active disease. Logistic regression, adjusting for confounders, assessed the association between concentrations and remission.

Results

In total, 258 IBD patients were included [55% CD and 45% UC]. Patients in clinical and biochemical remission had significantly higher vedolizumab concentrations [12.7 µg/mL vs 10.1 µg/mL, p = 0.002]. Concentrations were also higher among patients in endoscopic and deep remission [14.2 µg/mL vs 8.5 µg/mL, p = 0.003 and 14.8 µg/mL vs 10.1 µg/mL, p = 0.01, respectively]. After controlling for potential confounders, IBD patients with vedolizumab concentrations >11.5 µg/mL were nearly 2.4 times more likely to be in corticosteroid-free clinical and biochemical remission. Only 1.6% of patients had ATVs.

Conclusions

In a large real-world cohort of vedolizumab maintenance concentrations, IBD patients with remission defined by objective measures [CRP and endoscopy] had significantly higher trough vedolizumab concentrations and immunogenicity was uncommon.
A Third Strike Against Perfect Phylogeny
Authors: Iersel Leo Van , Jones Mark , Kelk Steven
Published: February 2019

Perfect phylogenies are fundamental in the study of evolutionary trees because they capture the situation when each evolutionary trait emerges only once in history; if such events are believed to be rare, then by Occam’s Razor such parsimonious trees are preferable as a hypothesis of evolution. A classical result states that 2-state characters permit a perfect phylogeny precisely if each subset of 2 characters permits one. More recently, it was shown that for 3-state characters the same property holds but for size-3 subsets. A long-standing open problem asked whether such a constant exists for each number of states. More precisely, it has been conjectured that for any fixed number of states $r$ there exists a constant $f(r)$ such that a set of $r$-state characters $C$ has a perfect phylogeny if and only if every subset of at most $f(r)$ characters has a perfect phylogeny. Informally, the conjecture states that checking fixed-size subsets of characters is enough to correctly determine whether input data permits a perfect phylogeny, irrespective of the number of characters in the input. In this article, we show that this conjecture is false. In particular, we show that for any constant $t$, there exists a set $C$ of $8$-state characters such that $C$ has no perfect phylogeny, but there exists a perfect phylogeny for every subset of at most $t$ characters. Moreover, there already exists a perfect phylogeny when ignoring just one of the characters, independent of which character you ignore. This negative result complements the two negative results (“strikes”) of Bodlaender et al. (1992,2000). We reflect on the consequences of this third strike, pointing out that while it does close off some routes for efficient algorithm development, many others remain open.
Genome-Wide CRISPR Screening Identifies the Tumor Suppressor Candidate OVCA2 As a Determinant of Tolerance to Acetaldehyde
Authors: Sobh Amin , Loguinov Alex , Stornetta Alessia , Balbo Silvia , Tagmount Abderrahmane , Zhang Luoping , Vulpe Chris D
Published: February 2019

Acetaldehyde, a metabolite of ethanol, is a cellular toxicant and a human carcinogen. A genome-wide CRISPR-based loss-of-function screen in erythroleukemic K562 cells revealed candidate genetic contributors affecting acetaldehyde cytotoxicity. Secondary screening exposing cells to a lower acetaldehyde dose simultaneously validated multiple candidate genes whose loss results in increased sensitivity to acetaldehyde. Disruption of genes encoding components of various DNA repair pathways increased cellular sensitivity to acetaldehyde. Unexpectedly, the tumor suppressor gene OVCA2, whose function is unknown, was identified in our screen as a determinant of acetaldehyde tolerance. Disruption of the OVCA2 gene resulted in increased acetaldehyde sensitivity and higher accumulation of the acetaldehyde-derived DNA adduct N2-ethylidene-dG. Together these results are consistent with a role for OVCA2 in adduct removal and/or DNA repair.
Evaluating the Concurrent Validity of PROMIS Physical Function in Anterior Cervical Discectomy and Fusion
Authors: Khechen Benjamin , Patel Dil V. , Haws Brittany E. , Cardinal Kaitlyn L. , Guntin Jordan A. , Ahn Junyoung , Singh Kern
Published: February 2019

Study Design:

This study was a retrospective cohort analysis.

Objectives:

This study aims to evaluate the concurrent validity of Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function (PF) domain as compared with legacy measures of patient-reported outcomes (PROs) among patients undergoing anterior cervical discectomy and fusion (ACDF).

Summary of Background Data:

As PROMIS becomes increasingly utilized, it is important to assess its validity among procedure-specific populations.

Methods:

Patients undergoing a primary, 1–3 level ACDF were retrospectively identified from a prospectively maintained surgical registry. PROMIS PF and legacy PRO scores were obtained at preoperative, 6-week, 12-week, and 6-month postoperative visits. Legacy PROs included Neck Disability Index (NDI), Short Form-12 (SF-12) physical composite, Visual Analog Scale (VAS) neck pain, and VAS arm pain. Postoperative improvements in PROs were assessed using paired t tests. Correlations between PROMIS and legacy PROs were tested using Pearson correlation coefficient.

Results:

A total of 57 ACDF patients were analyzed. The mean preoperative PROMIS PF was 40.0±6.4. PROMIS PF significantly improved at 12-week and 6-month follow-up. NDI, VAS neck pain, and VAS arm pain scores demonstrated significant improvement at all postoperative time points. SF-12 scores only exhibited significant improvement at the 6-month follow-up visit. Significant correlations between PROMIS PF, NDI, and SF-12 were identified at all preoperative and postoperative time points. PROMIS PF exhibited strong correlations with VAS neck pain at postoperative time points, and a moderate correlation preoperatively.

Conclusions:

Patients undergoing a primary 1–3 level ACDF experience significant improvements in PROMIS PF scores at 12-week and 6-month follow-up. Furthermore, PROMIS PF exhibits strong correlations to NDI and SF-12 at all preoperative and postoperative time points. These results suggest that PROMIS PF accurately measures PF and may be used in lieu of legacy PF instruments for patients undergoing ACDF.
Metabolic and Endocrine Disorders in Pseudarthrosis
Authors: Hills Jeffrey M. , Khan Inamullah , Archer Kristin R. , Sivaganesan Ahilan , Daryoush Joshua , Hong Daniel Y. , Dahir Kathryn M. , Devin Clinton J. , Stephens Byron
Published: February 2019

Study Design:

Retrospective Cohort.

Objective:

Establish 1-year patient-reported outcomes after spine surgery for symptomatic pseudarthrosis compared with other indications. In the subgroup of pseudarthrosis patients, describe preexisting metabolic and endocrine-related disorders, and identify any new diagnoses or treatments initiated by an endocrine specialist.

Summary of Background:

Despite surgical advances in recent decades, pseudarthrosis remains among the most common complications and indications for revision after fusion spine surgery. A better understanding of the outcomes after revision surgery for pseudarthrosis and risk factors for pseudarthrosis are needed.

Methods:

Using data from our institutional spine registry, we retrospectively reviewed patients undergoing elective spine surgery between October 2010 and November 2016. Patients were stratified by surgical indication (pseudarthrosis vs. not pseudarthrosis), and 1-year outcomes for satisfaction, disability, quality of life, and pain were compared. In a descriptive subgroup analysis of pseudarthrosis patients, we identified preexisting endocrine-related disorders, frequency of endocrinology referral, and any new diagnoses and treatments initiated through the referral.

Results:

Of 2721 patients included, 169 patients underwent surgery for pseudarthrosis. No significant difference was found in 1-year satisfaction between pseudarthrosis and nonpseudarthrosis groups (77.5% vs. 83.6%, respectively). A preexisting endocrine-related disorder was identified in 82% of pseudarthrosis patients. Endocrinology referral resulted in a new diagnosis or treatment modification in 58 of 59 patients referred. The most common diagnoses identified included osteoporosis, vitamin D deficiency, diabetes, hyperlipidemia, sex-hormone deficiency, and hypothyroidism. The most common treatments initiated through endocrinology were anabolic agents (teriparatide and abaloparatide), calcium, and vitamin D supplementation.

Conclusions:

Patients undergoing revision spine surgery for pseudarthrosis had similar 1-year satisfaction rates to other surgical indications. In conjunction with a bone metabolic specialist, our descriptive analysis of endocrine-related disorders among patients with a pseudarthrosis can guide protocols for workup, indications for endocrine referral, and guide prospective studies in this field.
Factors Related to Health Informatics Competencies for Nurses—Results of a National Electronic Health Record Survey
Authors: Kinnunen Ulla-Mari , Heponiemi Tarja , Rajalahti Elina , Ahonen Outi , Korhonen Teija , Hyppönen Hannele
Published: February 2019

In 2015, the Finnish Ministry of Social Affairs and Health published an eHealth and eSocial strategy with key objectives that by 2020 health information systems will be smart and providers will be able to maximize their use. Measures include improving system usability and decision support, involving professionals in system and service development, and increasing professionals' training in information management, electronic documentation, data protection, and data security. The aim of this study was to explore the level of nurses' informatics competencies and sufficiency of in-house training regarding technology-induced changes in work practices. An electronic questionnaire produced by the National Institute of Health and Welfare was sent in February to April 2017 to 29 283 Finnish working-age nurses, community nurses, and midwives; 3607 replies were received. Respondents rated their overall informatics competency relatively high, with the lowest competency scores on terminology-based documentation (Finnish Care Classification) and patient-related digital work. Education, electronic health record system used, experience using electronic health record systems, sufficiency of training, higher levels of technical functionality, ease of use, and usefulness were all associated with competency and remained significant after all adjustments. One-third of the respondents felt that they had not received sufficient training. Age and participation in system development were associated with experiences of sufficiency of training.
Molecular alterations associated with acquired resistance to BRAFV600E targeted therapy in melanoma cells
Authors: Szász István , Koroknai Viktória , Kiss Tímea , Vízkeleti Laura , Ádány Róza , Balázs Margit
Published: February 2019

Selective inhibition of the mutant BRAF protein is a highly promising therapeutic approach for melanoma patients carrying the BRAF

V600E
mutation. Despite the remarkable clinical response, most patients develop resistance and experience tumour regrowth. To clarify the molecular background of BRAF inhibitor resistance, we generated four drug-resistant melanoma cell lines from paired primary/metastatic cell lines using a vemurafenib analogue PLX4720. Three of the resistant cell lines showed decreased proliferation after drug withdrawal, but the proliferation of one cell line (WM278RES) increased notably. Furthermore, we observed opposite phenomena in which a ‘drug holiday’ could not only be beneficial but also contribute to tumour progression. Using genomic and proteomic approaches, we found significantly different alterations between the sensitive and resistant cell lines, some of which have not been reported previously. In addition to several other changes, copy number gains were observed in all resistant cell lines on 8q24.11–q24.12 and 8q21.2. Gene expression analysis showed that most genes upregulated in the resistant cell lines were associated with cell motility and angiogenesis. Increased expression of six proteins (ANGPLT4, EGFR, Endoglin, FGF2, SerpinE1 and VCAM-1) and decreased expression of two proteins (osteopontin and survivin) were observed consistently in all resistant cell lines. In summary, we identified new genomic alterations and characterized the protein expression patterns associated with the resistant phenotype. Although several proteins have been shown to be associated with BRAF resistance, our study is the first to describe the association of VCAM-1 and osteopontin with BRAF resistance.
The Combined Impact of Sleep and Diet on Adiposity in Infants, Toddlers, and Young Children: A Systematic Review
Authors: Vander Wyst Kiley B. , Whisner Corrie M. , Reifsnider Elizabeth , Petrov Megan E.
Published: February 2019

Objective:

Short sleep duration and poor dietary habits may contribute to increased adiposity; however, the impact of the interaction between these variables on adiposity is less understood. To evaluate research investigating the combined effects of sleep and diet on adiposity in infants, toddlers, and young children.

Methods:

Systematic searches of electronic databases (PubMed, CINAHL, and Web of Science) from inception through April 2017 were conducted. All studies published in English that had at least 1 sleep (e.g., sleep duration and night awakenings), diet (e.g., 24-hour diet recall and breastfeeding duration), and adiposity (e.g., body mass index z-score and weight-for-length) measure were eligible for inclusion. Abstract and full-text article reviews were conducted by 2 independent reviewers. Data were extracted into a standardized spreadsheet.

Results:

Of the 17 full-text articles reviewed, 14 studies were included. Mediation (n = 2) and moderation (n = 2) were seldom used. Investigation of the combined effects of sleep and diet on adiposity demonstrated a substantial lack of evidence. Synthesis of articles suggests that the relationship between sleep and diet may be interactive and their effects additive in their impact when targeted simultaneously within interventions.

Conclusion:

Without consideration of interaction effects among variables of interest, a substantial gap in the literature persists. Both diet and sleep need to be assessed simultaneously and repetitively in future longitudinal research.
Metalworking Fluids and Colon Cancer Risk
Authors: Izano Monika A. , Sofrygin Oleg A. , Picciotto Sally , Bradshaw Patrick T. , Eisen Ellen A.
Published: February 2019

Background:

Metalworking fluids (MWFs) are a class of complex mixtures of chemicals and oils, including several known carcinogens that may pose a cancer hazard to millions of workers. Reports on the relation between MWFs and incident colon cancer have been mixed.

Methods:

We investigated the relation between exposure to straight, soluble, and synthetic MWFs and the incidence of colon cancer in a cohort of automobile manufacturing industry workers, adjusting for time-varying confounding affected by prior exposure to reduce healthy worker survivor bias. We used longitudinal targeted minimum loss-based estimation (TMLE) to estimate the difference in the cumulative incidence of colon cancer comparing counterfactual outcomes if always exposed above to always exposed below an exposure cutoff while at work. Exposure concentration cutoffs were selected a priori at the 90th percentile of total particulate matter for each fluid type: 0.034, 0.400, and 0.003

JOURNAL/enep/04.03/01984727-201902000-00003/inline-graphic1/v/2023-09-08T094221Z/r/image-tiff

for straight, soluble, and synthetic MWFs, respectively.

Results:

The estimated 25-year risk differences were 3.8% (95% confidence interval [CI] = 0.7, 7.0) for straight, 1.3% (95% CI = −2.3, 4.8) for soluble, and 0.2% (95% CI = −3.3, 3.7) for synthetic MWFs, respectively. The corresponding risk ratios were 2.39 (1.12, 5.08), 1.43 (0.67, 3.04), and 1.08 (0.51, 2.30) for straight, soluble, and synthetic MWFs, respectively.

Conclusions:

By controlling for time-varying confounding affected by prior exposure, a key feature of occupational cohorts, we were able to provide evidence for a causal effect of straight MWF exposure on colon cancer risk that was not found using standard analytical techniques in previous reports.
Mediating effect of sleep behaviors when predicting weight-related behaviors in nursing students
Authors: Owens Heather , Polivka Barbara , Christian Becky , King Kristi , Ridner Stanley Lee
Published: February 2019

Background and purpose:

The purpose of this study was to identify whether or not sleep behaviors mediated bioecological predictors of weight-related behaviors among college students.

Methods:

This descriptive, quantitative, cross-sectional study, guided by Bronfenbrenner's bioecological model, examined bioecological characteristics and path analysis to assess model fit.

Conclusions:

The fit indices indicated excellent fit of the final model to the data (χ2 (24) = 30.33, p = .17, root-mean-square error approximation = 0.04, comparative fit index = 0.96, standardized root-mean-square residual = 0.03). Sleep duration mediated significant bioecological predictors of weight-related behaviors, but sleep quality did not. Having children significantly predicted increased sugar-sweetened beverage (SSB) consumption and decreased physical activity (PA) among college students. Conversely, eating the majority of meals at home significantly predicted decreased consumption of SSBs and increased PA.

Implications for practice:

Findings support inclusion of sleep duration and use of the bioecological model, when providing patient-centered healthcare focused on weight-related behaviors and weight management in college students.
The incidence of unexpected poor ovarian response in Chinese young women
Authors: Zhuang Jing , Li Hengli , Li Xiaohong , Tian Dongmei , Yang Dan , Zhu Minghui
Published: February 2019

Unexpected poor ovarian response (UPOR) is a problem for both clinicians and infertile couples, because our understanding of this situation is limited. This article investigated incidence of UPOR in women <35 years with normal ovarian reserve function with further analysis.

This is a retrospective study, which included 567 women who accepted their first IVF-ET/ICSI. Based on the number of oocytes retrieved, clinic pregnancy rate of fresh cycle, and cycle cancellation rate of fresh cycle, the included cycles were divided into three groups namely unexpected poor ovarian response (UPOR) (n = 120), for which number of oocytes retrieved was not more than 6; normal ovarian response (NOR) (n = 223), for which number of oocytes retrieved was between 7 and 12; and unexpected high ovarian response (UHOR) (n = 224), for which the number of oocytes retrieved was 13 at least. The comparisons of clinical outcomes and correlated hormones among groups were carried out.

The incidence of UPOR in Chinese women is 21.16%. Patient age (χ
2 = 6.177, P = .0129), basic FSH (χ
2 = 20.585, P < .0001), basic LH (χ
2 = 11.689, P = .0006), and AFC (χ
2 = 8.053, P = .0045) might be helpful for diagnosis of UPOR.

The basic evaluation of ovarian function may no longer be simplified into normal and abnormal ovarian reserve function; rather, by using a detailed numerical analysis, such as basal FSH and LH levels, the ovarian response to ovulation induction may be predicted to some extent.
Comparison of treatments for lumbar disc herniation
Authors: Arts Mark P. , Kuršumović Adisa , Miller Larry E. , Wolfs Jasper F.C. , Perrin Jason M. , Van de Kelft Erik , Heidecke Volkmar
Published: February 2019

Study design:

Systematic review with network meta-analysis.

Objective:

To compare patient outcomes of lumbar discectomy with bone-anchored annular closure (LD + AC), lumbar discectomy (LD), and continuing conservative care (CC) for treatment of lumbar disc herniation refractory to initial conservative management.

Summary of background data:

Several treatment options are available to patients with refractory symptoms of lumbar disc herniation, but their comparative efficacy is unclear.

Methods:

A systematic review was performed to compare efficacy of LD + AC, LD, and CC for treatment of lumbar disc herniation. Outcomes included leg pain, back pain, disability (each reported on a 0–100 scale), reherniation, and reoperation. Data were analyzed using random effects network meta-analysis.

Results:

This review included 14 comparative studies (8 randomized) involving 3947 patients—11 studies of LD versus CC (3232 patients), 3 studies of LD + AC versus LD (715 patients), and no studies of LD + AC versus CC. LD was more effective than CC in reducing leg pain (mean difference [MD] −10, P < .001) and back pain (MD −7, P < .001). LD + AC was more effective than LD in reducing risk of reherniation (odds ratio 0.38, P < .001) and reoperation (odds ratio 0.33, P < .001). There was indirect evidence that LD + AC was more effective than CC in reducing leg pain (MD −25, P = .003), back pain (MD −20, P = .02), and disability (MD −13, P = .02) although the treatment effect was smaller in randomized trials.

Conclusions:

Results of a network meta-analysis show LD is more effective than CC in alleviating symptoms of lumbar disc herniation refractory to initial conservative management. Further, LD + AC lowers risk of reherniation and reoperation versus LD and may improve patient symptoms more than CC.
Correlation of P2RX7 gene rs1718125 polymorphism with postoperative fentanyl analgesia in patients with lung cancer
Authors: Ma Jin , Li Wenyao , Chai Qing , Tan Xiaohong , Zhang Kexian
Published: February 2019

The aim of this study was to investigate the association between purinergic receptor P2X7 (P2RX7) gene rs1718125 polymorphism and analgesic effect of fentanyl after surgery among patients with lung cancer in a Chinese Han population.

A total of 238 patients with lung cancer who received resection were enrolled in our study. The genotype distributions of P2RX7 rs1718125 polymorphism were detected by polymerase chain reaction and direct sequencing. Postoperative analgesia was performed by patient-controlled intravenous analgesia, and the consumption of fentanyl was recorded. The postoperative pain was measured by visual analog scale (VAS). Differences in postoperative VAS score and postoperative fentanyl consumption for analgesia in different genotype groups were analyzed by analysis of variance assay.

The frequencies of GG, GA, and AA genotypes were 46.22%, 44.96%, and 8.82%, respectively. After surgery, the postoperative VAS score of GA group was significantly high in the period of analepsia after general anesthesia and at 6 hours after surgery (P = .041 and P = .030, respectively), while AA group exhibited obviously high in the period of analepsia after general anesthesia (P < .001), at postoperative 6 hours (P = .006) and 24 hours (P = .016). Moreover, the patients carrying GA and AA genotypes needed more fentanyl to control pain within 48 hours after surgery (P < .05 for all).

P2RX7 gene rs1718125 polymorphism is significantly associated with postoperative pain and fentanyl consumption in patients with lung cancer.
Comparison of complex regional pain syndrome and fibromyalgia
Authors: Lee Jae-Yeon , Choi Soo-Hee , Park Ki-Soon , Choi Yoo Bin , Jung Hee Kyung , Lee Dasom , Jang Joon Hwan , Moon Jee Youn , Kang Do-Hyung
Published: February 2019

Complex regional pain syndrome (CRPS) and fibromyalgia (FM) share many features. Both can cause severe pain and are considered to have a mechanism of action, including dysfunction of the sympathetic nervous system. However, they have clinical differences in pain range and degree. The present study aimed to find neurophysiologic differences between CRPS and FM using quantitative electroencephalography (QEEG). Thirty-eight patients with CRPS and 33 patients with FM were included in the analysis. Resting-state QEEG data were grouped into frontal, central, and posterior regions to analyze for regional differences. General linear models were utilized to test for group differences in absolute and relative powers. As a result, the CRPS group relative to FM group showed lower total absolute powers in the beta band (F = 5.159, P < .05), high beta (F = 14.120, P < .05), and gamma band (F = 15.034, P < .05). There were no significant differences between 2 groups in the delta, theta, and alpha bands. The present findings show that the CRPS and FM groups differ mainly in the high frequency, which may reflect their distinct pathophysiology and symptomatology. Our study suggests that the QEEG differences can be clinically useful in assessing brain function in patients with CRPS and FM.
Combined intravenous and intra-articular tranexamic acid administration in total knee arthroplasty for preventing blood loss and hyperfibrinolysis
Authors: Zhang Yi-Min , Yang Bo , Sun Xue-Dong , Zhang Zhen
Published: February 2019

Background:

Total knee arthroplasty (TKA) is a surgical procedure to replace the weight-bearing surfaces of the knee joint to relieve pain and disability. However, blood loss and fibrinolytic activity, accounting for a poor prognosis following TKA operation, were relieved by fibrinolytic inhibitor tranexamic acid (TXA). For a better application of TXA function, we explored the effect of intravenous injection (IV) of TXA combined with intra-articular injection (IA) of TXA in patients after TKA.

Methods:

Patients admitted from Weifang People's Hospital from January 2015 to December 2016 who received TKA were injected with 20 mg/kg TXA by IV before TKA (n = 50), 3.0 g TXA by IA after TKA (n = 50), or combination of 20 mg/kg TXA by IV before TKA and 3.0 g TXA by IA after TKA (n = 50). Knee function was assessed using HSS, KSS, NASS, and ROM. In addition, the total blood loss (TBL), hidden blood loss (HBL), maximum hemoglobin (Hb) drop, fibrinolytic activity, as well as incidence of thromboembolism were measured. The patients were followed up for 6 months. The deadline for follow-up was June 2017 and the incidence of thromboembolism events within 6 months after operation was counted.

Results:

HSS, KSS, NASS scores, and ROM were elevated after patients receiving TKA. Patients received IV plus IA TXA has decreased TBL, HBL, and maximum Hb drop than those received IV TXA-alone and IA TXA-alone, with reductions in FDP and D-dimer, indicating that IV plus IA TXA injection is superior to prevent blood loss and hyperfibrinolysis during TKA. Age, sex, type of femoral prosthesis, and the injection method of TXA were risk factors for HBL of patients after receiving TKA.

Conclusions:

The aforementioned results demonstrate that TKA is an effective surgery, and IV plus IA TXA injection functions more effectively in reducing blood loss and fibrinolytic activity in patients, which is a clinical factor of occult hemorrhage.
Increased risk of neurodegenerative dementia in women with migraines
Authors: Lee Sang-Yeon , Lim Jae-Sung , Oh Dong Jun , Kong Il Gyu , Choi Hyo Geun
Published: February 2019

The present study aimed to evaluate the association between migraines and dementia.

Data were collected from 11,438 dementia participants who were 1:4 matched by age, sex, income, region of residence, hypertension, diabetes, and dyslipidemia with 45,752 controls from the Korean National Health Insurance Service-National Sample Cohort from 2002 to 2013. Dementia was diagnosed using the International Classification of Disease-10 (ICD-10) codes (G30 or F00). For the integrity of diagnoses, we included only participants ≥60 years old who had been diagnosed with an ICD-10 code twice or more during ambulatory visits for the same episode. For migraine (ICD-10 code, G43), we included participants who had visited outpatient clinics twice or more for the same episode. In both dementia and control groups, a previous history of migraine was investigated.

Approximately 7.7% (881/11,438) of patients in the dementia group and 6.3% (2888/45,752) of those in the control group had a history of migraine (P < .001). The crude and adjusted odds ratios (ORs) for migraine with dementia was 1.22 (95% confidence interval [CI] = 1.13–1.32, P < .001) and 1.13 (95% CI = 1.05–1.23, P = .002), respectively. In the subgroup analyses according to age and sex, women demonstrated a significantly higher adjusted OR for migraine with dementia, whereas men did not exhibit an association between migraine and dementia.

In a nested case–control study using a national sample cohort, migraine increased the risk of dementia in women.
Intravascular large B-cell lymphoma presenting with hearing loss and dizziness
Authors: Miyake Zenshi , Tomidokoro Yasushi , Tsurubuchi Takao , Matsumura Akira , Sakamoto Noriaki , Noguchi Masayuki , Tamaoka Akira
Published: February 2019

Rationale:

Intravascular large B-cell lymphoma (IVLBCL) is a type of malignant lymphoma in which neoplastic B cells proliferate selectively within the lumina of small- and medium-sized vessels. Patients with IVLBCL frequently develop neurological manifestations during their disease course. Patients are known to often develop various neurological manifestations, but there are only a few reports of IVLBCL whose initial symptoms are deafness and/or disequilibrium.

Patient concerns:

A 66-year-old Japanese man was provisionally diagnosed with sudden sensorineural hearing loss. Administration of prednisolone did not improve his symptoms, and then he experienced amaurosis fugax. Magnetic resonance imaging (MRI) showed multiple brain infarcts, so he was administered antithrombotic drugs. Nevertheless, he experienced recurrent strokes, became irritable, and had visual hallucinations. He was emergently admitted to our hospital with disturbance of consciousness.

Diagnosis:

Blood tests showed elevation of lactose dehydrogenase and soluble interleukin-2 receptor. Cranial MR diffusion-weighted imaging showed multiple lesions bilaterally in the cerebral white matter and cortex, posterior limbs of the internal capsule, and cerebellar hemispheres, which were hypointense on apparent diffusion coefficient maps. Hyperintense lesions were detected bilaterally in the cerebral white matter and basal ganglia on both T2-weighted imaging and fluid-attenuated inversion recovery imaging. Contrast-enhanced brain MRI demonstrated contrast-enhancing high-signal lesions along the cerebral cortex. Brain biopsy revealed a diagnosis of IVLBCL.

Interventions:

The patient could not receive chemotherapy because of his poor general condition. Therefore, we administered high-dose methylprednisolone (mPSL) pulse therapy.

Outcomes:

There was little improvement in consciousness levels after the high-dose mPSL pulse therapy. On the forty-ninth day of hospitalization, he was transferred to another hospital to receive supportive care.

Lessons:

IVLBCL should be regarded as an important differential diagnosis of hearing loss and dizziness. Most importantly, if the symptoms are fluctuant and steroid therapy is not effective, biopsy should be considered as early as possible.
Effectiveness and safety of fluoxetine for premature ejaculation
Authors: Li Xiao , Li Juntao , Li Xianrui , Wang Jisheng , Dai Hengheng , Wang Jingshang
Published: February 2019

Background:

Premature ejaculation (PE) is one of the most common male sexual dysfunctions, which can directly harm men's self-esteem and affect the stability of the relationship between husband and wife. To some extent, PE even affects the harmony and stability of society. So, men's health has gained more and more attention. As one of the long-acting selective serotonin reuptake inhibitors (SSRIs), fluoxetine has been proven to be effective in the treatment of PE by many trails. In this study, we aim to evaluate the effectiveness and safety of fluoxetine for PE to provide the newest evidence for clinical use.

Methods and analysis:

Literature research will be divided into 2 parts: electronic search and manual search. We will search PubMed, EMBASE, The Cochrane Library, the China National Knowledge Infrastructure (CNKI), China Biology Medicine disc (CBMdisc), the China Science and Technology Journal database (VIP), and the Wanfang database online. We will select the eligible studies published up to December 31, 2018. Manual searches mainly retrieve dissertations, ongoing trails, internal reports, and so on. We use intravaginal ejaculatory latency time (IELT) as the primary outcome of PE and we also care about the following indexes: PE Diagnostic Tool (PEDT); Arabic index of PE (AIPE); Index of PE (IPE). In addition, we will carefully observe the patient's adverse reactions during the medication. Two reviewers will read the articles, extract the data information, and assess the risk of bias independently. Data analysis will be used the software such as RevMan V.5.3.5; EndNote X7 and Stata 13.0.

Results:

This study will provide a high-quality synthesis of current evidence of fluoxetine for PE from several aspects, including IELT, PEDT, AIPE, IPE, and adverse events.

Conclusion:

This systematic review will provide evidence to assess the effectiveness and safety of fluoxetine in the treatment of PE.

Trial registration number:

PROSPERO CRD42018109722.
Anticoagulation in atrial fibrillation and cognitive decline
Authors: Zeng Decai , Jiang ChunLan , Su Chunxiao , Tan Ying , Wu Ji
Published: February 2019

Background:

It is well known that atrial fibrillation (AF) carried a high risk of cognitive decline, which is independent of stroke or transient ischemic attack (TIA). Whether anticoagulation is associated with reduced risk of cognitive decline in participants with AF still remains controversial. We conducted a systematic review and meta-analysis to explore the effect of anticoagulation on the risk of cognitive decline in patients with AF.

Methods:

We systematically searched the PubMed, Embase and the Cochrane Database for eligible studies published up to January 2018. Risk ratios (RR) with 95% confidence interval (CI) for cognitive decline were extracted, and pooled estimations were calculated using the fixed effects model. Subgroup analyses were further performed.

Results:

Eight relevant articles involved 454,273 patients were ultimately included in this meta-analysis. We found that anticoagulation was associated with reduced risk of cognitive impairment as compared with nonanticoagulation (RR 0.72, 95% CI 0.69–0.75, I

2
11.5%). This reduction was still significant after adjustment for stroke and TIA (RR 0.72, 95% CI 0.69–0.74, I

2
0.0%). In the subgroup analyses, the incidence of cognitive decline was significantly decreased in those treated with anticoagulation compared to no treatment (RR 0.72, 95% CI 0.69–0.75, I

2
0.0%), but the cognitive benefit showed no significant difference between anticoagulant and antiplatelet treatment (RR 1.01, 95% CI 0.68–1.50, I

2
46.8%).

Conclusion:

Anticoagulation is associated with cognitive benefit in participants with AF independent of stroke and TIA, but it was not superior to antiplatelet drugs in reducing the risk of cognitive decline.
Efficacy of Duohuojisheng decoction monotherapy for the treatment of knee osteoarthritis
Authors: Hou Zhi-ling , Yuan Bo-yang , Huo Ming-xia , Ni Lei , Bao Qiang
Published: February 2019

Background:

This systematic review investigates the efficacy and safety of Duohuojisheng decoction (DHJSD) monotherapy for the treatment of patients with knee osteoarthritis (KOA).

Methods:

We searched relevant studies on DHJSD monotherapy for KOA from the databases of CENTRAL, EMBASE, MEDLINE, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine Database, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, VIP Information, and Wanfang Data from the inception to January 1, 2019. Two researchers independently selected studies, collected data, and assessed the methodology quality by using Cochrane risk of bias tool.

Results:

This study evaluates the efficacy and safety of DHJSD monotherapy for KOA by assessing the pain intensity, stiffness, and disability of affected knee joints, and quality of life, as well as the adverse events.

Conclusion:

The results of this study provide latest updated evidence of DHJSD monotherapy alone for KOA.

Ethics and dissemination:

No ethical approval is required for this systematic review, because it is based on the published data, and not on individual patient data. Its findings is published in a peer-reviewed journal.

PROSPERO registration number:

PROSPERO CRD42019120405.
Predictive factors of chemotherapy use in stage II nasopharyngeal carcinoma
Authors: Pan Xin-Bin , Huang Shi-Ting , Chen Kai-Hua , Jiang Yan-Ming , Zhu Xiao-Dong
Published: February 2019

Identification of predictive factors of chemotherapy use and assessment of the roles of these factors in prognosis will aid therapeutic decision-making in stage II nasopharyngeal carcinoma (NPC).

Using logistic regression, we retrospectively assessed factors predicting chemotherapy use in 251 stage II (2010  UICC/AJCC staging system) NPC patients. Five-year overall survival (OS), locoregional-free survival (LRFS), and distant metastasis-free survival (DMFS) were analyzed based on the predictive factors.

Logistic regression found that N1 stage was an independent factor predicting chemotherapy use in stage II NPC patients. However, 5-year OS (96.5% vs 94.9%, P = .564), LRFS (98.2% vs 96.9%, P = .652), and DMFS (95.9% vs 97.6%, P = .560) did not differ between N0 and N1 stage patients. Moreover, addition of chemotherapy use did not improve treatment outcomes in N1 stage compared with radiotherapy alone.

N1 stage predicted chemotherapy use in stage II NPC patients. But, the addition of chemotherapy did not provide a survival benefit.
Biochip detection of BP180 autoantibodies in blister fluid for the serodiagnosis of bullous pemphigoid
Authors: Sernicola Alvise , Russo Irene , Saponeri Andrea , Alaibac Mauro
Published: February 2019

Bullous pemphigoid is an autoimmune subepidermal blistering skin disease immunologically defined by autoantibodies directed against basement membrane zone antigens, the main of which is BP180. Laboratory tests are essential for diagnosis and include direct immunofluorescence and serologic assessments with indirect immunofluorescence and ELISA. Serology may be performed on blister fluid, in alternative to blood serum. This study investigated the use of a Biochip-based indirect immunofluorescence approach for the serum diagnosis of bullous pemphigoid on blister fluid. We compared the results using the Biochip-method with the ELISA detection of bullous pemphigoid-180 autoantibodies in blister fluid and observed a perfect correlation between these 2 methods in our group of 13 patients with clinical and direct immunofluorescence diagnosis of bullous pemphigoid. The Biochip is a simple, standardized and inexpensive diagnostic tool and its use on blister fluid may facilitate the diagnosis of this and other autoimmune bullous disorders. Our results suggest that the Biochip assay on serum of bullae is a non-invasive screening technique for the early diagnosis of bullous pemphigoid that is practical for fragile elderly patients and achievable even in small laboratory settings.
Amiodarone and acupuncture for cardiac arrhythmia
Authors: Meng Xiang-Dong , Gao Wei-Qin , Sun Ze
Published: February 2019

Background:

Amiodarone and acupuncture (AA) are commonly used to treat cardiac arrhythmia (CA). The objective of this systematic review is to assess the efficacy and safety of AA for patients with CA.

Methods:

Randomized controlled trials (RCTs) of AA for CC will be searched from 9 databases including PubMed, EMBASE, Cochrane Library, Web of Science, Scopus, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, VIP Information, and Wanfang Data from inception to February 1, 2019 without any limitations. Two reviewers will independently screen the relevant papers, extract data, and evaluate the risk of bias for each included study. RevMan 5.3 software will be used for meta-analysis. The primary outcome includes arrhythmic episodes (including time and frequency domain parameters). The secondary outcomes consist of health-related quality of life, oxygen saturation, and safety.

Results:

The protocol of this proposed study will provide evidence to judge whether AA is an effective treatment for patients with CA.

Conclusion:

The findings of this proposed study will summarize the up-to-date evidence of AA for CA.

PROSPERO registration number:

PROSPERO CRD42019120962.
The effectiveness and safety of cervus and cucumis polypeptide injection in promoting fracture healing after bone fracture surgeries
Authors: Yang Xia , Niu Kecheng , Zhang Xiaoyan , Gao Baiqing , Feng Bo , Si Ha
Published: February 2019

Background:

Bone fractures are a common occurrence, and, according to clinical investigations, approximately 5% to 10% of patients with fractures will suffer from delayed healing or even non-healing. The high efficacy of traditional Chinese medicine in promoting fracture healing has been fully verified over a long history of diagnosis and treatment. Traditional Chinese medicine has a long history of applying Chinese herbs to treat fractures. Cervus and cucumis polypeptide injection has been widely used to promote fracture healing after fracture surgery in clinic, but its efficacy and safety are controversial. For the above reasons, the purpose of this study is to systematically evaluate the efficacy and safety of cervus and cucumis polypeptide injection in promoting fracture healing after bone fracture surgeries and to provide a theoretical basis for the selection of appropriate treatment measures for delayed healing of patients with fractures.

Methods:

A total of 8 databases were searched, including the non-Chinese-language databases PubMed, The Cochrane Library, Web of Science, and Embase and the Chinese databases Chongqing VIP Chinese Journal Service Platform (VIP), Wanfang Data Knowledge Service Platform (Wanfang Data), SinoMed and Chinese National Knowledge Infrastructure (CNKI). The databases were queried for publicly released randomized controlled trials of the effectiveness and safety of Cervus and Cucumis polypeptide injection for fracture healing after surgical treatment, and no language restrictions were imposed. The software Review Manager 5.3 was used to evaluate the quality of the selected documents, and Stata 12.0 software was used for statistical analysis.

Results:

This review will be to assess the efficacy and safety of cervus and cucumis polypeptide injection in promoting fracture healing after bone fracture surgeries.

Conclusion:

Our study will use systematic evaluation to objectively evaluate the efficacy and safety of cervus and cucumis polypeptide injection in promoting fracture healing after fracture surgery. It will provide theoretical basis for guiding clinical practice and benefit more patients.

Ethics and dissemination:

This study is a systematic review that does not require ethical approval and meets the requirements of protocol for a systematic review and meta-analysis. At the same time, this study does not involve the recruitment of patients. All data are from published academic papers.

Protocol and registration:

A protocol had been registered for this systematic review and meta-analysis in PROSPERO. (registration number: CRD42019120965).
The telomere length of peripheral blood cells is associated with the risk of ischemic stroke in Han population of northern China
Authors: Xiao Jianhao , Yuan Qian , Zhang Simiao , Li Xiaodong , Bai Hongying , Wang Yunliang , Duan Shiwei
Published: February 2019

Background:

Telomere length is closely related to the onset and prognosis of ischemic stroke. This study was to investigate the relationship between telomere length and the incidence of ischemic stroke in Han population of northern China.

Methods:

In the present study, 152 patients with ischemic stroke were selected as the case group, and 152 healthy persons were used as the control group. Detection of telomere length was done by real-time polymerase chain reaction after extraction of genomic DNA from peripheral venous blood.

Results:

Our results showed that the telomere length of the patients in the case group was significantly lower than that of the control group (Z = −11.843, P < .0001). Further analysis found that the telomere length of the control group was inversely correlated with age (r = −0.234, P = .004), and the telomere length and homocysteine (HCY) were inversely correlated in the case group (r = −0.176, P = .03), especially in women (r = −0.357, P = .024). Multivariate regression analysis showed that telomere length was a protective factor for ischemic stroke (odds ratio [OR] 95% confidence interval [95% CI] = 0.748 [0.681–0.823], β = −0.29, P < .0001). The receiver operating characteristic curve showed that telomere length was a good diagnostic biomarker of ischemic stroke (area under the curve: 0.894, sensitivity: 84.7%, specificity: 93.4%).

Conclusion:

Our results indicate that shorter telomere length has some connection with the risk of ischemic stroke in the northern Chinese Han population. Telomere length might serve as a potential candidate biomarker for ischemic stroke. This requires a large sample to be further verified.
Electrical stimulation on adverse events caused by chemotherapy in patients with cervical cancer
Authors: Dou Peng-Hui , Zhang Dan-Feng , Su Cui-Hong , Zhang Xiao-Li , Wu Ying-Jie
Published: February 2019

Background:

This protocol of systematic review aims to investigate the effectiveness of electrical stimulation (ES) on adverse events (AEs) caused by chemotherapy in patients with cervical cancer (CC).

Methods:

This systematic review of randomized controlled trials will be identified through searchers of PUBMED, PsycINFO, Scopus, Opengrey, Cochrane Central Register of Controlled Trials, EMBASE, Cumulative Index to Nursing and Allied Health Literature, Web of Science, Allied and Complementary Medicine Database, and Chinese Biomedical Literature Database. All the sources will be searched from the inception to the date of study search ran. Additionally, websites of clinical trials registry and reference lists provided in relevant studies and reviews will also be searched. Two independent reviewers will evaluate the eligibility criteria of all potential literature, extract the data, and determine the risk of bias for each included study. RevMan 5.3 software will be used to pool the data and to conduct a meta-analysis.

Results:

This systematic review will assess the effectiveness of ES on AEs caused by chemotherapy in patients with CC.

Conclusion:

The findings of this study may summarize the latest evidence for the ES on AEs following chemotherapy for CC.

PROSPERO registration number:

PROSPERO CRD42019120191.