bluuebunny/crossref_metadata_2025 huggingface dataset:
Cathepsin E in neutrophils contributes to the generation of neuropathic pain in experimental autoimmune encephalomyelitis
Authors: Harada Yuka , Zhang Jing , Imari Kazuhisa , Yamasaki Ryo , Ni Junjun , Wu Zhou , Yamamoto Kenji , Kira Jun-ichi , Nakanishi Hiroshi , Hayashi Yoshinori
Published: May 2019

Pain is a frequent and disabling symptom in patients with multiple sclerosis (MS); however, the underlying mechanisms of MS-related pain are not fully understood. Here, we demonstrated that cathepsin E (CatE) in neutrophils contributes to the generation of mechanical allodynia in experimental autoimmune encephalomyelitis, an animal model of MS. We showed that CatE-deficient (CatE

−/−
) mice were highly resistant to myelin oligodendrocyte glycoprotein (MOG35-55)-induced mechanical allodynia. After MOG35-55 immunization, neutrophils immediately accumulated in the dorsal root ganglion (DRG). Adoptive transfer of MOG35-55-stimulated wild-type neutrophils into the dorsal root ganglion induced mechanical allodynia in the recipient C57BL/6 mice. However, the pain threshold did not change when MOG35-55-stimulated CatE

−/−
neutrophils were transferred into the recipient C57BL/6 mice. MOG35-55 stimulation caused CatE-dependent secretion of elastase in neutrophils. Behavioral analyses revealed that sivelestat, a selective neutrophil elastase inhibitor, suppressed mechanical allodynia induced by adoptively transferred MOG35-55-stimulated neutrophils. MOG35-55 directly bound to toll-like receptor 4, which led to increased production of CatE in neutrophils. Our findings suggest that inhibition of CatE-dependent elastase production in neutrophil might be a potential therapeutic target for pain in patients with MS.
Events Centrality Moderates the Relationship Between Posttraumatic Growth and Health-Related Quality of Life Among People Living With HIV
Authors: Onu Desmond Uchechukwu , Ugwu Dorothy , Orjiakor Charles Tochukwu
Published: May 2019

HIV diagnosis and treatment are traumatic events, which may translate to positive growth and affect health outcomes of people living with HIV (PLWH). We hypothesized that the pathway between positive growth and health-related quality of life was impacted by event centrality (EC; how much HIV is integrated into self-definition). Two hundred and one PLWH in Nigeria who had been diagnosed/treated for at least 1 year completed measures of posttraumatic growth, EC, and health-related quality of life. Multiple regression analysis was used to investigate relationships between variables of interest. Growth from the trauma of HIV was significantly associated with improved mental health and relationship. Patients who highly centralized identity on HIV had poorer scores for mental health, relationship, and treatment impact and had less traumatic growth. EC moderated the relationship between posttraumatic growth and mental health, social relationship, and treatment impact. Clinicians should ask how PLWH think about events related to diagnosis and treatment when assessing quality of life.
Efficacy and safety of perioperative appliance of sunitinib in patients with metastatic or advanced renal cell carcinoma
Authors: Jin Hongyu , Zhang Jing , Shen Kai , Hao Jianqi , Feng Yuying , Yuan Chi , Zhu Yuqi , Ma Xuelei
Published: May 2019

Background:

The aim of this systematic review and meta-analysis is to comprehensively evaluate the efficacy and safety of the perioperative use of sunitinib in patients with metastatic and advanced renal cell carcinoma (RCC).

Materials and methods:

We searched authenticated databases for related clinical studies. The baseline characteristics, parameters concerning the efficacy and safety of the perioperative use of sunitinib were extracted for subsequent comprehensive analysis. The parameters which reflected the efficacy and safety as overall survival (OS), progression-free survival (PFS), occurrence rate of all-grade and grade ≥3 adverse effects (AEs) were carefully pooled using comprehensive meta-analysis.

Results:

We finally recruited 411 patients from 14 eligible studies. We found proteinuria (75.0%, 95% CI 62.1%–84.6%), anemia (71.6%, 95% CI 60.9%–80.3%), athesia (60.0%, 95% CI 40.3%–77.0%), pause symptoms (59.2%, 95% CI 49.2%–68.4%), arterial hypertension (53.1%, 95% CI 43.2%–62.7%), and thrombocytopenia (52.5%, 95% CI 44.8%–60.0%) to be the most common all-grade AEs. And arterial hypertension, athesia, cutaneous toxicity, hypophosphatemia, leukopenia, pain, pause syndrome, renal dysfunction, and thrombocytopenia were the most common types of grade ≥3 AEs. In addition, objective response rate (ORR) of sunitinib to both the original and metastatic tumor sites increased with the use of sunitinib, so did the OS and PFS.

Conclusion:

Common all-grade and grade ≥3 AEs were carefully monitored. The perioperative use of sunitinib showed superior ORR, OS, and PFS rates. Nevertheless, more studies are required to further verify these findings.
The challenge of the laboratory diagnosis in a confirmed congenital Zika virus syndrome in utero
Authors: Sulleiro Elena , Frick Marie Antoinette , Rodó Carlota , Espasa Mateu , Thorne Claire , Espiau María , Martín-Nalda Andrea , Suy Anna , Giaquinto Carlo , Melendo Susana , Rando Ariadna , Alarcón Ana , Martinón-Torres Federico , Pumarola Tomás , Soler-Palacín Pere , Soriano-Arandes Antoni
Published: May 2019

Introduction:

Zika virus (ZIKV) has caused one of the most challenging global infectious epidemics in recent years because of its causal association with severe microcephaly and other congenital malformations. The diagnosis of viral infections usually relies on the detection of virus proteins or genetic material in clinical samples as well as on the infected host immune responses. Serial serologic testing is required for the diagnosis of congenital infection when diagnostic molecular biology is not possible.

Patient concerns:

A 2-year-old girl, born to a mother with confirmed ZIKV infection during pregnancy, with a confirmed ZIKV infection in utero, showed at birth a severe microcephaly and clinical characteristics of fetal brain disruption sequence compatible with a congenital ZIKV syndrome (CZS).

Diagnosis:

ZIKV-RNA and ZIKV-IgM serological response performed at birth and during the follow-up time tested always negative. Serial serologic ZIKV-IgG tests were performed to assess the laboratory ZIKV diagnosis, ZIKV-IgG seroreversion was observed at 21 months of age. ZIKV diagnosis of this baby had to be relied on her clinical and radiological characteristics that were compatible with a CZS.

Interventions:

The patient was followed-up as per protocol at approximately 1, 4, 9, 12, 18–21, and 24 months of age. Neurological, radiological, audiological, and ophthalmological assessment were performed during this period of time. Prompt rehabilitation was initiated to prevent potential adverse long-term neurological outcomes.

Outcomes:

The growth of this girl showed a great restriction at 24 months of age with a weight of 8.5 kg (−2.5 z-score) and a head circumference of 40.5 cm (−4.8 z-score). She also had a great neurodevelopmental delay at the time of this report.

Conclusion:

We presume that as a consequence of prenatal ZIKV infection, the fetal brain and other organs are damaged before birth through direct injury. Following this, active infection ends during intrauterine life, and as a consequence the immune system of the infant is unable to build up a consistent immune response thereafter. Further understanding of the mechanisms taking part in the pathogenesis of ZIKV congenital infection is needed. This finding might change our paradigm regarding serological response in the ZIKV congenital infection.
Diagnostic pitfalls of acute eosinophilic pneumonia in an adolescent boy following cigarette smoking
Authors: Choo Cheryn Yu Wei , Wong Kin-Sun , Lai Shen-Hao , Chiu Chun-Che , Chiu Chih-Yung
Published: May 2019

Rationale:

Acute eosinophilic pneumonia (AEP) is characterized by acute febrile respiratory symptoms, bilateral lung infiltrates, and pulmonary eosinophilia. AEP is closely related to cigarette smoking but is rarely suspected in pediatric cases despite the fact that there is a relatively high incidence of cigarette smoking among adolescents in Taiwan.

Patient concerns:

We report a case of a previously healthy 15-year-old boy who presented with fever and acute progressive dyspnea. Due to lack of awareness of cigarette smoking history in adolescents and the nonspecific signs and symptoms of AEP at early stages, the patient was initially treated as community-acquired pneumonia (CAP) but was unresponsive to antibiotics treatment.

Diagnoses:

A combination of a recent onset smoking history and pulmonary eosinophilia on bronchoalveolar lavage confirmed the diagnosis of cigarette-induced AEP.

Interventions:

Corticosteroid treatment was prescribed.

Outcomes:

The condition improved within 24 hours, with resolution of alveolar infiltrates on chest radiographs.

Lessons:

With the increasing incidence of smoking amongst adolescents in Taiwan, careful history questioning regarding cigarette smoking is necessary. Due to similarities in initial clinical and radiographic features of AEP and CAP, adolescents with suspected CAP who are unresponsive to antibiotic treatment but have a subsequent rise in peripheral eosinophils should raise the clinician's suspicion of AEP related to cigarette smoking.
Effectiveness comparison of a Chinese dicitraditionalmene formula Wuzi Yanzong Pill and its analogous prescriptions for the treatment of oligoasthenozoospermia
Authors: Li Yongqiang , Xue Yahui , Bao Binghao , Wang Jisheng , Dai Hengheng , Gong Xiaoyong , Zheng Wei , Li Yanfeng , Zhang Bao
Published: May 2019

Background:

Among male sterility factors, oligoasthenozoospermia is the most common. As people's lifestyle changes and the population ages, the incidence of oligoasthenozoospermia continues to increase. The studies have shown that about 15% of married couples in the world are affected by infertility, among which infertility caused by male factors alone accounts for about 50%. Many clinical trials have proven that Wuzi Yanzong Pill has a significant effect in the treatment of oligoasthenozoospermia. In this systematic review, we aim to evaluate the effectiveness and safety of Wuzi Yanzong Pill for oligoasthenozoospermia.

Methods:

We will search for PubMed, Cochrane Library, AMED, EMbase, WorldSciNet; Nature, Science online, and China Journal Full-text Database (CNKI), China Biomedical Literature CD-ROM Database (CBM), and related randomized controlled trials included in the China Resources Database. The time is limited from the construction of the library to April 2019. We will use the criteria provided by Cochrane 5.1.0 for quality assessment and risk assessment of the included studies, and use the Revman 5.3 and Stata13.0 software for meta-analysis of the effectiveness, recurrence rate, and symptom scores of oligoasthenozoospermia.

Ethics and dissemination:

This systematic review will evaluate the efficacy and safety of Wuzi Yanzong Pill for treating oligoasthenozoospermia. Because all of the data used in this systematic review and meta-analysis has been published, this review does not require ethical approval. Furthermore, all data will be analyzed anonymously during the review process Trial.

Trial registration number:

PROSPERO CRD42019119170
Risk of silent myocardial ischemia detected by single photon emission computed tomography (SPECT) among asymptomatic Chinese patients with type 2 diabetes
Authors: Xiao-Rong Zhu , Hui-Rong Zhang , Mei Li , Zhen Zhou , Wei Liu , Jing Lu , Guang-Ran Yang , Jian-Bo Zhou , Jin-Kui Yang
Published: May 2019

To explore the prevalence and risk factors of silent myocardial ischemia (SMI) detected by using single photon emission computed tomography (SPECT) in Chinese asymptomatic patients with type 2 diabetes (T2D).

In this hospital-based retrospective study, 821 T2D patients who were screened for SMI detected by stress myocardial perfusion imaging using SPECT between June 2014 and July 2016 were investigated. Clinical indicators were compared between the patients with SMI and controls without SMI. Risk factors for SMI were evaluated by univariate and multivariate analysis.

In this study, there were 131 patients with SMI in asymptomatic diabetes and the prevalence of SMI was 21.3% of 614 individuals. Logistic regression analysis indicated that diabetic retinopathy (OR = 1.474, 95%CI: 1.113–1.951, P = .007), male gender (OR = 1.805, 95%CI: 1.183–2.747, P = .006), and low-density lipoprotein (LDL) cholesterol (OR = 1.298, 95%CI: 1.042–1.615, P = .02) were risk factors associated with SMI. Besides, the prevalence of SMI increased in associated with the progression of retinopathy (P = .041). The percentage of SMI diagnosed in patients with no diabetic retinopathy (NDR), non-proliferative diabetic retinopathy (NPDR), and proliferative diabetic retinopathy (PDR) were 18.5% (75/405), 25.2% (37/147), and 30.6% (19/62), respectively. The percentage of SMI in male (24.5%, 85/347) was higher than that in female (17.2%, 46/267), P = .029.

Physicians should be aware of these conditions when examining male patients with type 2 diabetes, especially with DR and/or high level of low-density lipoprotein cholesterol (LDL cholesterol), even if otherwise asymptomatic. A routine screening for SMI may thus be considered advisable in these patients.
Hemostatic effect and psychological impact of an oxidized regenerated cellulose patch after transrectal ultrasound-guided prostate biopsy
Authors: Park Ji Woon , Kim Jung Im , Bae Sang Rak , Lee Yong Seok , Han Chang Hee , Kang Sung Hak , Park Bong Hee
Published: May 2019

To investigate the usefulness of the oxidized regenerated cellulose patch (ORCP) for postbiopsy hemostasis, anxiety, and depression in patients undergoing transrectal ultrasound-guided prostate biopsy.

This was a prospective-retrospective study of 300 patients who underwent systematic 12-core prostate biopsy from August 2016 through March 2018. The ORCP was inserted into the rectum immediately after prostate biopsy in the prospective group (n = 150), while the retrospective group (n = 150) underwent prostate biopsy alone. The frequency rate and duration of hematuria, rectal bleeding, and hematospermia were compared between the 2 groups. Anxiety and depression were assessed with the hospital anxiety and depression scale before and after prostate biopsy in the prospective group.

The frequency rates of hematuria and hematospermia showed no significant differences between the prospective versus retrospective groups (64.7% vs 66.7%, P = .881; 18 vs 20%, P = .718; respectively). Frequency of rectal bleeding was significantly lower in the prospective group than in the retrospective group (26.7% vs 42.7%, P = .018). However, there were no significant differences in median duration of rectal bleeding, hematuria, or hematospermia between the 2 groups (2, 5, and 2 days vs 2, 7, and 1 day, P > .05, respectively, for the prospective vs retrospective group). Multivariate analysis found that ORCP insertion was a significant protective factor against postbiopsy rectal bleeding (P = .038, odds ratio 0.52). Only anxiety level in the prospective group before versus after prostate biopsy was significantly reduced (5 vs 4, P = .011).

ORCP insertion after prostate biopsy is an effective and simple method for decreasing rectal bleeding. ORCP insertion may also alleviate anxiety in patients undergoing prostate biopsy.
Percutaneous endoscopic decompression for lumbar spinal stenosis
Authors: Liu Jianjun , Zhang Hongwei , Zhang Xiaogang , He Tao , Zhao Xiyun , Wang Zhipeng
Published: May 2019

Background:

Lumbar spinal stenosis (LSS) is a common and frequently-occurring disease in clinical practice. There are many interventions to treat it, and percutaneous endoscopic decompression (PED) is one of them, but their relative efficacy and safety remains unclear. Hence, the present study aims to synthesize the available direct and indirect evidence on the PED and other treatments for LSS.

Methods:

The following databases will be searched: Cochrane Library, PubMed, Web of Science, Embase and China Biomedical Literature Database (CBM). The search dates will be set from the inception to April 2019. All randomized controlled trials (RCTs) will be included in this network meta-analysis (NMA) and their risk of bias will be assessed using Cochrane handbook tool by 2 independent authors. The efficacy outcomes including: Back and Leg Visual Analog Scale (VAS) score, MacNab criteria, the Oswestry Disability Index (ODI), and Japanese Orthopedic Association (JOA) score. The safety outcomes including: incidence of complications (dura tear, incomplete decompression, reoperation, etc.). A network meta-analysis will be performed using R x64 3.5.1 software and pairwise meta-analysis will be conducted using Stata 12.0 software. Grading of recommendations assessment, development, and evaluation (GRADE) will be used to assess evidence quality.

Results:

The results of NMA will be submitted to a peer-reviewed journal.

Conclusion:

The NMA will provide a comprehensive evidence summary on treatments for patients with LSS.

Protocol registration number:

CRD42019120509.
Three-dimensional navigation (O-arm) versus fluoroscopy in the treatment of thoracic spinal stenosis with ultrasonic bone curette
Authors: Wen Bing-Tao , Chen Zhong-Qiang , Sun Chui-Guo , Jin Kai-Ji , Zhong Jun , Liu Xin , Tan Lei , Yang Peng , le Geri , Luo Man
Published: May 2019

Three-dimensional intraoperative navigation (O-arm) has been used for many years in spinal surgeries and has significantly improved its precision and safety. This retrospective study compared the efficacy and safety of spinal cord decompression surgeries performed with O-arm navigation and fluoroscopy. The clinical data of 56 patients with thoracic spinal stenosis treated from March 2015 to April 2017 were retrospectively analyzed. Spinal decompression was performed with O-arm navigation and ultrasonic bone curette in 29 patients, and with ultrasonic bone curette and fluoroscopy in 27 patients. Patients were followed-up at postoperative 1 month, 3 months, and the last clinic visit. The neurologic functions were assessed using the Japanese Orthopaedic Association (JOA) Back Pain Evaluation Questionnaire. The accuracy of screw placement was examined using three-dimensional computed tomography (CT) on postoperative day 5. There was no significant difference in the incidences of intraoperative dural tear, nerve root injury, and spinal cord injury between the two groups. The two groups showed no significant difference in postoperative JOA scores (P > .05). The O-arm navigation group had significantly higher screw placement accuracy than the fluoroscopy group (P < .05). O-arm navigation is superior to fluoroscopy in the treatment of thoracic spinal stenosis with ultrasonic bone curette in terms of screw placement accuracy. However, the two surgical modes have similar rates of intraoperative complications and postoperative neurologic functions.
A case report of double etiology of ecthyma gangrenosum
Authors: Birlutiu Victoria , Birlutiu Rares Mircea , Baicu Marius , Iancu Gabriela Mariana
Published: May 2019

Rationale:

Ecthyma gangrenosum is a cutaneous infection, most commonly occurring during sepsis evolution with Pseudomonas aeruginosa on an immunocompromised background. There have been rare case reports in previously healthy children and rarer are the cases with double etiology.

Patient concerns:

We present the case of a female Caucasian patient, aged 1 year and 8 months, who developed severe sepsis during flu evolution with predominant respiratory and cerebral manifestations. On admission, at skin level, there was noticed a necrotic coccygeal ulceration (with rapid increasing dimensions 0.5/0.5 cm in 24 hours), and with the transformation from a dry necrosis in a sphacelus at the periphery and progression of necrosis in depth.

Diagnoses:

The patient was diagnosed with ecthyma gangrenosum from which Pseudomonsa aeruginosa and Enterococcus faecalis were isolated from the samples that were harvested intraoperatively, decision that was taken considering the appearance of CT scan and the extremely rapid expansion of necrosis. Excisional debridement with necrectomy, lavage, and dressing being performed. The invasion of the fascia was excluded intraoperatively.

Interventions:

Treatment with Meropenem for 14 days was initiated, as well as amikacin and linezolid, the latter being replaced with teicoplanin for 14 days. Red blood cells transfusion, intravenous immunoglobulins, anticonvulsants were also administered.

Outcomes:

Under treatment the evolution was favorable.

Lessons:

This case brings into discussion a double etiology of ecthyma gangrenosum, in a previously healthy child that occurred in the evolution of influenza. The evolution was favorable under broad-spectrum antibiotic treatment and surgical excision.
Effects of preoperative oral carbohydrates on patients undergoing ESD surgery under general anesthesia
Authors: Wang Yan , Zhu Zhenqiang , Li Hui , Sun Yaqi , Xie Guohao , Cheng Baoli , Ji Feng , Fang Xiangming
Published: May 2019

Background:

Preoperative oral carbohydrate (POC) has been recommended as an important element of the enhanced recovery after surgery (ERAS) protocol, but its effect on patients undergoing endoscopic submucosal dissection (ESD) remains unclear. Our study aims to investigate the effects of POC for ESD surgery, with particular focus on perioperative well-being and gastric peristalsis.

Methods:

A prospective, randomized, and controlled study of patients undergoing ESD was conducted. Seventy-three patients were assigned to 2 groups: experiment (36 patients) and control (37 patients). The experiment group received oral carbohydrate solution 710 mL the night before and 355 mL 2 hours prior to operation. The control group fasted for 10 hours prior to operation. Gastric empty assessment, peristaltic score, and operation score were measured. In addition, visual analogue scale (VAS) scores for 6 parameters (thirst, hunger, mouth dryness, nausea, vomit, and weakness) of wellbeing were compared perioperatively. Preoperative basic conditions of patients, postoperative complications, and their clinical outcomes were also recorded.

Results:

Before anesthesia induction, gastric sonography score was higher in experiment group, while sucked fluid by gastroscopy was similar between 2 groups. And no patient had regurgitation. Moreover, gastric peristaltic score and operation score before operation were both lower in experiment group. Importantly, VAS scores for 3 parameters (thirst, hunger, and mouth dryness) were significantly lower in experiment patients. In addition, clinical outcomes including first time exhaust, first time for drinking water, the usage of hemostasis, postoperative complication, lengths of hospital stay, and in-hospital expense were not significantly different between 2 groups.

Conclusions:

Oral administration of carbohydrates preoperatively instead of fasting improves the feelings of thirst, hunger, and mouth dryness in patients following ESD surgery without enhancing risk of regurgitation. And, avoiding preoperative fasting with POC can decrease the degree of gastric peristalsis that may facilitate the successful completion of ESD surgery.
Efficacy and safety of moxibustion in patients with chronic prostatitis/chronic pelvic pain syndrome
Authors: Cao Qianan , Zhou Xu , Chen Jianrong , Zhong Yuting , Zhang Haifeng , Ao Qi , Liu Meilu , Nie Heyun , Zhu Weifeng , Fu Yong
Published: May 2019

Background:

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common urogenital disease. Moxibustion is a complementary treatment option for CP/CPPS. This systematic review will assess the efficacy and safety of moxibustion as a sole or add-on therapy for CP/CPPS.

Methods:

We will retrieve randomized controlled trials (RCTs) of moxibustion for CP/CPPS from the following databases: PubMed, EMBASE, Cochrane Central Register of Controlled Trials, VIP, Chinese Biomedical Database, China National Knowledge Infrastructure Database, Wanfang Data, Chinese Medicine Database System, Google Scholar, Clinicaltrials.gov, and China Clinical Trial Registry from their inception to March 9, 2019, without language restrictions. RCTs comparing moxibustion with active drugs or moxibustion + drugs with these same drugs alone will be included. Primary outcomes will be the change in the total score of the National Institutes of Health's Chronic Prostatic Inflammatory States Index (NIH-CPSI) after moxibustion treatment. Secondary outcomes will include the scores of the individual NIH-CPSI domains, response to treatment of CP/CPPS, leucocyte and phosphatidylcholine corpuscle count in prostatic fluid, incidence of adverse events (AEs), and incidence of moxibustion-related AEs. The Cochrane risk of bias tool will be used for evaluating the risk of bias of individual trials. Heterogeneity will be detected by the Cochran Q test and I-square test. A random-effects model will be used to pool data in the meta-analysis. Risk ratio and weighted or standardized mean difference will be used as the effect measures. Three sets of subgroup analyses will be performed to explore the sources of heterogeneity. Where appropriate, we will assess the likelihood of publication bias based on funnel plots and quantitative tests.

Results:

This study will produce the systematic review evidence regarding moxibustion for treating CP/CPPS based on current RCTs.

Conclusion:

This study will provide a clear basis for understanding the efficacy and adverse reactions of moxibustion treatment for CP/CPPS.

PROSPERO registration number:

CRD42019121338.
Treatment of urinary incontinence after total hysterectomy with acupuncture
Authors: Sun Jiejing , Zhang Xiaoqi , Cao Tiemin , Song Yaohong
Published: May 2019

Rationale:

Acupuncture is a significant feature of traditional Chinese medicine, which can dredge the channels, harmonize qi and blood, replenish deficiency and relieve excess, strengthen the body and remove pathogens to treat urinary incontinence after hysterectomy, and improve the quality of life, which is simple, convenient, inexpensive, and practical.

Patient concerns:

After a total hysterectomy, the catheter was retained every day, causing urinary incontinence and elderly urine wetness for 30 days.

Diagnoses:

Postoperative urinary incontinence for 1 month; type 2 diabetes for 4 years. Hypertension for 2 years.

Interventions:

From the first month after operation, acupuncture on bilateral, Ciliao (BL32), Zhongliao (BL33), and Xialiao (BL34).

Outcomes:

The patient experienced bladder fullness on the 2nd day. On the 3rd day, the patient could arose from bed and urinated on her own. On the 4th day, she could urinate freely. The time and frequency of urination were normal.

Lessons:

acupuncture is safe and effective mode for the treatment of urinary incontinence issues after total hysterectomy. It greatly improves the quality of life and daily wellbeing.
The biomarkers and potential pathogenesis of lung cancer related cerebral hemorrhage
Authors: Qin Kemin , Chen Yicong , Long Haiyin , Chen Jiyun , Wang Dacheng , Chen Li , Liang Zhijian
Published: May 2019

Cerebral hemorrhage is one of the common complications in patients with lung cancer (LC). Although cancer related cerebral hemorrhage was aware, the pathogenesis and biomarkers of lung cancer related cerebral hemorrhage (LCRCH) remained not well known. The aim of this study was to investigate the pathogenesis and plasma biomarkers of LCRCH.

A retrospective review was conducted on acute cerebral hemorrhage patients with active LC who was admitted to the hospital between January 2007 and December 2017. A total of 56 patients with LCRCH (active LC patients with acute cerebral hemorrhage but without conventional vascular risks) was recruited. Meanwhile, 112 patients with active LC alone and gender, age, and subtype of cancer cell matched were recruited as control group.

In LCRCH patients, most of the hemorrhagic lesions were located in lobes. And most of them with adenocarcinoma were in medium to terminal stage with poor prognosis short-term. Moreover, LCRCH patients had a lengthened prothrombin time (PT), elevated plasma carcinoembryonic antigen (CEA), cancer antigen 125 (CA125) and cancer antigen 199 (CA199) levels and decreased platelet (PLT) level than did the patients with LC. Multivariate logistic regression analysis showed that lengthened PT, elevated plasm CEA, and CA199 levels were independent risk factors for LCRCH.

It was suggested that lengthened PT, elevated plasm CEA and CA199 levels associated with the pathogenesis of LCRCH, and that the Index derived from independent risks should be serve as a specific biomarker of LCRCH.
Intranasal lidocaine for acute migraine
Authors: Chi Pei-Wen , Hsieh Kun-Yi , Tsai Chien-Wei , Hsu Chin-Wang , Bai Chyi-Huey , Chen Chiehfeng , Hsu Yuan-Pin
Published: May 2019

Background:

Intranasal lidocaine has been shown to be effective in treating patients with acute migraines; however, its efficacy is still controversial. The aim of our study is to assess the efficacy and safety of intranasal lidocaine compared with a placebo or an active comparator for the treatment of acute migraine.

Methods:

We will use PubMed, EMBASE, Cochrane library, and Scopus databases to search for articles from their inceptions to November 2018. We will only include randomized controlled studies. Data were independently will be extracted by 2 reviewers. Data analysis and synthesis will be analyzed by the Revman 5.3 software. We will conduct the study in accordance with the guideline of the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols.

Results:

This review will evaluate the efficacy and safety of intranasal lidocaine for acute migraine. The primary outcome is pain intensity measured by visual analogue, numerical rating scale, or verbal rating scale. Secondary outcomes are success rate, requirement of rescue medicine, relapse, and adverse events.

Conclusion:

The findings of this systematic review will summarize the latest evidence of intranasal lidocaine for acute migraine. The results will provide implications for clinical practice and further research.

Prospero registration number: CRD42018116226
Platelet–lymphocyte ratio is not a prognostic predictor for acute paraquat-intoxicated patients
Authors: Wang Wen Jie , Cao Zong Xun , Feng Shun Yi , Song Ya Qi , Zhang Su Li , Bai Wen Jing , Li Yong
Published: May 2019

This study aimed to investigate the prognostic predictive value of the platelet–lymphocyte ratio (PLR) in patients with acute paraquat (PQ) intoxication.

A total of 107 patients with acute PQ intoxication via oral ingestion were admitted in Cangzhou Central Hospital from May 2012 to September 2018. Valuable detection indices were screened out by using Cox proportional hazard regression and receiver operating characteristic (ROC) curve analyses, and their diagnostic efficiency was evaluated by using Kaplan–Meier curve.

The 90-day mortality was 58.9% (63/107). The Kaplan–Meier curve showed that PLR was not associated with 90-day survival (log-rank test; P = .661). In Cox proportional hazard regression analyses, PLR was not an independent risk factor. Meanwhile, the ROC curves showed that PLR had an AUC value of 0.569 (95% confidence interval: 0.459–0.679, P = .227) in predicting 90-day survival.

PLR is not a prognostic predictor for patients with acute PQ intoxication.
Systematic reviews of pharmacological and nonpharmacological treatments for patients with chronic urticaria
Authors: Shi Yunzhou , Zhou Siyuan , Zheng Qianhua , Huang Ying , Hao Pingsheng , Xu Mingmin , Zhang Leixiao , Xiao Xianjun , Zheng Hui , Li Ying
Published: May 2019

A wide range of pharmacological and nonpharmacological interventions for chronic urticaria (CU) have been evaluated in systematic reviews (SRs). We conducted an umbrella review of SRs of the effectiveness and safety of pharmacological and nonpharmacological interventions for CU, which allow the findings of separate reviews to be compared and contrasted and thereby provide decision makers in healthcare with the evidence they need.

We included SRs evaluating pharmacological and nonpharmacological interventions for CU. Comprehensive searches were conducted in 7 bibliographic databases, relevant journals up to July 2018. Two reviewers independently assessed the studies’ relevance and quality. The assessment of multiple systematic reviews tool and grading of recommendations assessment, development and evaluation method was used to assess the methodological quality of the SRs and classify the quality of the outcomes.

In total, 41 SRs were included. Thirty-seven reviews performed quantitative research syntheses, and 4 reviews performed qualitative research syntheses. The majority of SRs evaluated interventions based on combination therapies, antihistamines, traditional Chinese medicines, autohemotherapy, omalizumab, acupuncture, cyclosporine, and leukotriene receptor antagonist. Positive intervention outcomes were reported in the majority (75.32%) of the reviews. However, the methodological quality and evidence quality of the reviews were generally poor.

There is some evidence to support a variety of interventions for CU. However, there was much heterogeneity in evidence quality among SRs. Many of the SRs had methodological weaknesses that make them vulnerable to bias. Moreover, there remained little information on the relative effectiveness of one intervention compared with another. Therefore, further SRs that adherence to strict scientific methods are necessary, and primary studies make comparisons between the different treatment options directly.
Safety and efficacy of combined use of propofol and etomidate for sedation during gastroscopy
Authors: Chen Lingyuan , Liang Xueyan , Tan Xinmei , Wen Haibin , Jiang Junsong , Li Yan
Published: May 2019

Background:

Sedation with etomidate or propofol alone during gastroscopy has many side effects. A systematic review and meta-analysis were conducted to evaluate the safety and efficacy of the combined use of propofol and etomidate for sedation during gastroscopy.

Methods:

PubMed, Embase, Medline (via Ovid SP), Cochrane library databases, CINAHL (via EBSCO), China Biology Medicine disc (CBMdisc), Wanfang, VIP, and China National Knowledge Infrastructure (CNKI) databases were systematically searched. We included randomized controlled trials (RCTs) comparing the combined use of propofol and etomidate vs etomidate or propofol alone for sedation during gastroscopy. Data were pooled using the random-effects models or fixed-effect model based on heterogeneity.

Results:

Fifteen studies with 2973 participants were included in the analysis. Compared to propofol alone, the combined use of propofol and etomidate possibly increased recovery time (SMD = 0.14, 95% CI = 0.04–0.24; P = .005), and the risk for myoclonus (OR = 3.07, 95% CI = 1.73–5.44; P < .001), injection pain, and nausea and vomiting. Furthermore, compared to propofol alone, the combination of propofol and etomidate produced an apparent beneficial effect for mean arterial pressure (MAP) after anesthesia (SMD = 1.32, 95% CI = 0.38–2.26; P = .006), SPO2 after anesthesia (SMD = 0.99, 95% CI = 0.43–1.55; P < .001), apnea or hypoxemia (OR = 0.16, 95% CI = 0.08–0.33; P < .001), injection pain, and body movement. Further, compared to etomidate alone, the combination of propofol and etomidate reduced the risk for myoclonus (OR = 0.15, 95% CI = 0.11–0.22; P < .001), body movement, and nausea and vomiting.

Conclusion:

The combination of propofol and etomidate might increase recovery time vs that associated with propofol, but it had fewer side effects on circulation and respiration in patients undergoing gastroscopy. The combined use of propofol and etomidate can improve and produce an apparent beneficial effect on the adverse effects of propofol or etomidate alone, and it was safer and more effective than propofol or etomidate alone.
Top-100 highest-cited original articles in inflammatory bowel disease
Authors: Chen Xinrong , Yang Kun , Xu Yujie , Li Ka
Published: May 2019

Objectives:

The use of citation analysis to identify the first 100 papers in inflammatory bowel disease (IBD) provides unique insights into advances in disease understanding and subsequent follow-up treatment innovations over time.

Methods:

The Thomson Reuters Web of Science database with the search terms “inflammatory bowel disease” or “Crohn disease” or “ulcerative colitis” or “colitis” was used to identify all English language full manuscripts for the study. Title, first and senior authors, institution and department of first author, journal, country of origin, year, and topic of each manuscript were analyzed.

Results:

The top 100 manuscripts were published between 1955 and 2013. 224,809 eligible papers were returned and the median (range) citation number was 1028.5 (719–3957). The country and year with the greatest number of publications were the USA (n = 47), and 2007 (n = 11). Gastroenterology published the highest number of papers (n = 18, 21,083 citations) and The New England Journal of Medicine had the most citations (n = 13, 25,035 citations).

Conclusions:

This highly cited list of papers identifies the subjects and authors who have had the greatest impact on IBD research in the last decades, which serves as a reference for researchers and clinicians “highly citable” manuscripts.
Diagnostic accuracy of intestinal ultrasound and magnetic resonance enterography for the detection of endoscopy-based disease activity in ileocolonic Crohn’s disease
Authors: Yuksel Ilhami , Kilincalp Serta , Coskun Yusuf , Akinci Hakan , Hamamci Mevlut , Alkan Afra
Published: May 2019

Background

Crohn’s disease (CD) is characterised by chronic gastrointestinal inflammation with relapsing–remitting behaviour and often requires endoscopic and/or radiologic assessment.

Objective

The objective of this study was to compare the diagnostic accuracy of intestinal ultrasound (IUS) and magnetic resonance enterography (MRE) for the assessment of disease activity in CD using a simple endoscopic score for CD as a reference standard.

Patients and methods

A prospective observational study was carried out in 71 consecutive adult patients with known CD, attending our tertiary inflammatory bowel disease clinic, between November 2014 and July 2016. Ileocolonoscopy, IUS and MRE were performed within 1 month prospectively. The simple endoscopic score-CD 0–2 was accepted as remission.

Results

The sensitivity of IUS and MRE for detecting endoscopic activity was found similar with regard to bowel wall thickening and mesenteric fibrofatty proliferation (P>0.05). The overall accuracy for detecting mural lesions was similar between IUS and MRE. When mural lesions were analysed, the sensitivity of MRE in detecting the loss of wall stratification and stenosis was significantly higher than IUS (P<0.001 for both). IUS showed higher specificity for bowel wall thickening, loss of wall stratification and stenosis (P=0.009, P<0.001 and P<0.001, respectively). Sensitivity and accuracy of IUS were higher in detecting ascites in active disease (P=0.002).

Discussion

Our results showed that IUS and MRE were equally accurate in detecting endoscopic activity. IUS may be the preferred technique for the evaluation of disease activity and for the follow-up of CD.
Combining Natural Language Processing of Electronic Medical Notes With Administrative Data to Determine Racial/Ethnic Differences in the Disclosure and Documentation of Military Sexual Trauma in Veterans
Authors: Gundlapalli Adi V. , Jones Audrey L. , Redd Andrew , Divita Guy , Brignone Emily , Pettey Warren B.P. , Carter Marjorie E. , Samore Matthew H. , Blais Rebecca K. , Fargo Jamison D.
Published: May 2019

Background:

Despite national screening efforts, military sexual trauma (MST) is underreported. Little is known of racial/ethnic differences in MST reporting in the Veterans Health Administration (VHA).

Objective:

This study aimed to compare patterns of MST disclosure in VHA by race/ethnicity.

Research Design:

Retrospective cohort study of MST disclosures in a national, random sample of Veterans who served in Afghanistan and Iraq and completed MST screens from October 2009 to 2014. We used natural language processing (NLP) to extract MST concepts from electronic medical notes in the year following Veterans’ first MST screen.

Measure(s):

Any evidence of MST (positive MST screen or NLP concepts) and late MST disclosure (NLP concepts following a negative MST screen). Multivariable logistic regressions, stratified by sex, tested racial/ethnic differences in any MST evidence, and late disclosure.

Results:

Of 6618 male and 6716 female Veterans with MST screen results, 1473 had a positive screen (68 male, 1%; 1405 female, 21%). Of those with a negative screen, 257 evidenced late MST disclosure by NLP (44 male, 39%; 213 female, 13%). Late MST disclosure was usually documented during mental health visits. There were no significant racial/ethnic differences in MST disclosure among men. Among women, blacks were less likely than whites to have any MST evidence (adjusted odds ratio=0.75). In the subsample with any MST evidence, black and Hispanic women were more likely than whites to disclose MST late (adjusted odds ratio=1.89 and 1.59, respectively).

Conclusions:

Combining NLP results with MST screen data facilitated the identification of under-reported sexual trauma experiences among men and racial/ethnic minority women.
Privacy in Health Disparity Research
Authors: Xu Heng , Zhang Nan
Published: May 2019

Background:

Most research on identifying and understanding health disparities focused on measurement strategies and analytics design over administrative and survey data. What has received less attention, however, is the complex interplay between privacy concerns and the needs of health disparity research.

Objectives:

The main objective of the paper is to illustrate the fundamental challenges facing the reconciliation of privacy needs and health disparity research.

Research Design:

We investigated whether privacy disparity exists over raw, unprocessed, public health data, and then examined the effect of a state-of-the-practice data anonymization process and a state-of-the-art privacy-preserving data sharing technique on both privacy disparity and the efficacy of health disparity research.

Results:

We demonstrate that the essential elements for health disparity research, for example, the integration of demographics attributes such as race in public health datasets, could indeed lead to privacy disparity if not carefully treated.

Discussions and Policy Implications:

The findings in this paper indicate that regulators must carefully study the privacy implications before mandating the inclusion of certain attributes like race and geolocation in a released dataset. For example, the Affordable Care Act requires all federally supported public health programs to collect data on race, ethnicity, sex, geographic location, etc., to the extent feasible. Although doing so could help identify health disparities, if the collected data are directly released without proper sanitization, the released data may introduce privacy disparities, causing further harm to underserved populations.
Effective Use of Sirolimus and Zoledronic Acid for Multiosteotic Pseudomyogenic Hemangioendothelioma of the Bone in a Child: Case Report and Review of Literature
Authors: Danforth Olivia M. , Tamulonis Karen , Vavra Kimberly , Oh Caleb , Brickman Arlen , Ebersole John , Cameron James , Mahon Brett , Kent Paul
Published: May 2019

Pseudomyogenic hemangioendothelioma (PMH) is a rare neoplasm with vascular and sarcomatous elements, unpredictable course, and uncommon metastatic or fatal potential. Although systemic chemotherapy has been reported with variable success, generally accepted treatment is aggressive surgery with wide margins. Evidence-based treatment options are lacking, and lack of clear prognostic features poses a risk of undertreatment or overtreatment with associated morbidity and mortality. We report the use of initial systemic therapy with oral sirolimus (SIR) and IV zoledronic acid (ZA) to induce a sustained clinical response and avoidance of amputation in a 6-year-old boy. At 37 months after diagnosis, our patient remains in sustained clinical remission as documented by x-ray, MRI, and PET-CT with return of normal mobility/activity and resolution of swelling and pain. Literature review identified 20 cases of pediatric and young adult patients with PMH, of which 7 received some form of systemic therapy. To the best of our knowledge, our patient represents the youngest reported case of PMH and the first successful and limb-sparing utilization of systemic chemotherapy as primary treatment for PMH.
MYCN Amplified Relapse Following Resolution of MYCN Nonamplified 4S Neuroblastoma With Placental Involvement: A Case Report and Review of the Literature
Authors: Langenberg-Ververgaert Karin P.S. , Renzi Samuele , Chung Catherine T. , Shago Mary , Lo Winnie , Davidson Scott , Villani Anita , Baruchel Sylvain , Irwin Meredith S. , Morgenstern Daniel A.
Published: May 2019

Congenital neuroblastoma with placental involvement is exceptionally rare, but mortality is high. Detailed examination of placenta including MYCN amplification and segmental chromosomal aberrations should be performed in all suspected cases, as it is noninvasive and readily available. Maternal dissemination has not been reported. In this manuscript, we describe an infant with placental diagnosis of MYCN nonamplified congenital neuroblastoma. This is the first report of a recurrence of congenital 4S neuroblastoma following resolution in which MYCN amplification is only detected in the recurrence. Germline sequencing using a large comprehensive cancer panel did not reveal variants in candidate cancer predisposition genes.
A Multicenter Study of the Prognostic Value of Desmoplastic Reaction Categorization in Stage II Colorectal Cancer
Authors: Ueno Hideki , Kanemitsu Yukihide , Sekine Shigeki , Ishiguro Megumi , Ito Eisaku , Hashiguchi Yojiro , Kondo Fukuo , Shimazaki Hideyuki , Kajiwara Yoshiki , Okamoto Koichi , Mochizuki Satsuki , Tsujimoto Hironori , Shinto Eiji
Published: May 2019

Highly accurate risk assessment of recurrence may improve adjuvant treatment practice in stage II colorectal cancer (CRC), which lacks definite prognostic factors. Recent studies indicate the importance of stroma in determining cancer behavior, although there are few histopathologic criteria for its evaluation. A pathology review of 679 stage II CRC patients (1980-2005) was conducted at an institution. Desmoplastic reaction (DR) results were classified as mature, intermediate, or immature depending on the presence of hyalinized collagen bundles and myxoid stroma observed at the extramural desmoplastic front on hematoxylin–eosin-stained slides. Pathologically, 430, 180, and 69 tumors were classified into the mature, intermediate, and immature groups, respectively. On the basis of the DR results, 5-year recurrence rate was found to have a wide range of 9.1% to 30.7%; 5-year relapse-free survival (RFS) rates were highest in the mature group (85.2%), followed by the intermediate (77.1%), and immature (60.9%) groups. Multivariate analyses revealed an independent effect of DR pattern on RFS. In addition, 446 patients treated at 4 independent institutions (2007-2008) were examined as a second cohort for result validation, revealing an adverse prognostic impact of unfavorable DR and identifying DR categorization as an independent prognostic factor. In both cohorts, Harrell’s concordance index for RFS was higher than the other conventional factors in the DR including T stage. Categorizing DR pattern based on the histologic products of fibroblasts at the desmoplastic front help elucidate their important biological role in cancer development, thus providing clinically useful prognostic information regarding stage II CRC.