bluuebunny/crossref_metadata_2025_split huggingface dataset:
Management of lumbar spondylodiscitis developing after laparoscopic sacrohysteropexy with a mesh
Authors: Qu Da-Cheng , Chen Hong-Bin , Yang Mao-Mei , Zhou Hong-Gui 
Published: December 2019

Abstract

Introduction:
Lumbar spondylodiscitis is a rare and severe complication of laparoscopic sacrohysteropexy with a polypropylene mesh. However, a case of lumbar spondylodiscitis following laparoscopic sacrohysteropexy has not been reported so far. We present a case of lumbar spondylodiscitis following laparoscopic sacrohysteropexy with a mesh. We also discuss 33 cases of lumbar spondylodiscitis following sacral colpopexy and (or) rectopexy with a mesh.

Patient concerns:
A 46-year-old woman with 3 previous vaginal deliveries underwent laparoscopic mesh sacrohysteropexy for stage III uterine prolapse. One month after surgery, the patient developed persistent symptoms, such as stiffness of the lumbosacral portion, low back pain (LBP), persistent swelling, pain between the right iliac crest and the buttock, inability to bend down, and pain in the right lower limb. Symptoms were alleviated by a nonsteroidal anti-inflammatory drug. However, in the last 7 days, symptoms worsened and she was unable to stand or walk. The patient had very limited leg mobility.

Diagnosis:
Blood routine examination, erythrocyte sedimentation rate, C-reactive protein, and magnetic resonance imaging (MRI) of the lumbar spine indicated lumbar pyogenic spondylodiscitis.

Interventions:
Removal of mesh and hysterectomy via laparoscopy were performed immediately, and antibiotics were given simultaneously. However, on the basis of MRI findings and persistent symptoms, debridement, laminectomy, spinal canal decompression, bone grafting, and internal fixation via pedicle screw placement were performed 5 months after laparoscopic sacrohysteropexy.

Outcomes:
All symptoms were alleviated 5 days after the operation. The patient could stand in the erect position and raise her lower limbs within 2 weeks. She could resume her normal activities within 2 months after the operation, and her X-ray appeared normal.

Conclusion:
Persistent LBP and radiating pain may be the signals of lumbar spondylodiscitis. MRI is the gold standard diagnostic examination for lumbar spondylodiscitis. Awareness of symptoms, such as LBP and radiating pain symptoms, timely diagnosis, mesh removal, and referral to orthopedists are important to prevent more severe complications. Surgical practice needs to be improved further and any other infections should be treated immediately as the most likely causes of lumbar spondylodiscitis are related to the mesh and other infections.
Reversible cerebral vasoconstriction with thunderclap headache
Authors: Ji Jae Young , Jung Ho Soon , Yoo Sie Hyeon , Son Hee Dong , Kim A. Joo 
Published: December 2019

Abstract

Rationale:
Reversible cerebral vasoconstriction syndrome (RCVS) is often accompanied by thunderclap headaches. Although symptoms usually resolve spontaneously within 2 months, it can cause fatal complications, such as cerebral hemorrhage, and is difficult to differentiate from a migraine and other headaches on the basis of symptoms and Imaging study. In this case report, we explore clinical findings and appropriate treatment methods for RCVS through the case study of a female patient who experienced severe headache upon defecation

Patient concerns:
A 42-year-old female patient complained of a severe throbbing headache with a Numeric Rating Scale (NRS) score of 10 after defecation. The pain subsided temporarily after treatment with diclofenac 75 mg and Tridol 50 mg propacetamol 1 g, but the headache returned upon defecation; soon after, the patient complained again of regular headaches at 4 to 6-hour intervals irrespective of defecation.

Diagnosis:
Brain computed tomography (CT) and head and neck magnetic resonance angiography, performed during a headache episode, revealed no specific neurological findings. Blood analysis was also normal. Head and neck CT angiography, performed one month after the start of the headaches, revealed RCVS.

Interventions:
Treatment commenced with pregabalin (150 mg), oxycodone HCl/naloxone (10/5 mg), Alpram (0.5 mg), milnacipran (25 mg), and frovatriptan 25 mg, but there was no improvement in the headaches. The patient received bilateral trigger point injections (TPI) in the temporal muscles on four occasions at the pain clinic.

Outcomes:
Medication showed no effect, but after the patient received four sessions of bilateral TPI in the temporal muscles her NRS score eventually decreased from 10 to 2. The patient is currently continuing medication while still experiencing headaches at reduced intensities.

Lessons:
RCVS is difficult to diagnose; moreover, it is difficult differentiate RCVS from other headaches. However, as it can cause fatal complications, it should not be overlooked. It is essential to consider diagnostic treatment for all types of headaches because RCVS can be accompanied by headaches originating from other causes.
Prenatal diagnosis of a 5q35.3 microduplication involving part of the ADAMTS2 locus: a likely benign variant without apparent phenotypic abnormality
Authors: Yue Fagui , Yu Yang , Xi Qi , Zhang Hongguo , Jiang Yuting , Li Shibo , Liu Ruizhi , Wang Ruixue 
Published: December 2019

Abstract

Rationale:
Chromosomal duplications are associated with a series of genetic disorders. However, chromosome 5q duplications, especially pure 5q35.3 microduplications, have rarely been reported in the literature. Clinical phenotypes usually depend on the region of chromosome duplicated, its size, and loci.

Patient concerns:
From 2011 to 2017, prenatal amniotic fluid samples were obtained from 6 pregnant women diagnosed with pure 5q35.3 microduplications following different prenatal indications at our center. We followed up the children of these pregnancies and determined their postnatal health conditions.

Diagnoses:
Cytogenetic studies delineated that all patients had normal karyotypes, except for patient 6 who had 46,XX,inv(9)(p11q13). Single-nucleotide polymorphism array results showed 177–269 kb duplications of 5q35.3 (chr5:178728830–178997692) in these cases. All shared similar localization of ADAMTS2.

Interventions:
All pregnant women chose to continue the pregnancies. Follow-up analysis showed that the children presented normal physical and growth developments.

Outcomes:
We described six prenatal cases with similar 5q35.3 duplications involving part of the ADAMTS2 locus with no apparent postnatal phenotypic abnormalities.

Lessons:
Our research revealed that partial microduplication of ADAMTS2 (chr5:178728830–178997692) might be benign and not correlate with disorders. And there might exist phenotypic diversities of 5q35.3 duplications.
Prognostic and clinical significance of long non-coding RNA HNF1A-AS1 in solid cancers
Authors: Zhou Xi , Fan Yang-Hua , Wang Yan , Liu Yong 
Published: December 2019

Abstract

Background:
LncRNA HNF1A Antisense RNA 1 (HNF1A-AS1) is often dysregulated in cancer. We performed this meta-analysis to clarify the usefulness of HNF1A-AS1 as a prognostic marker in malignant tumors.

Methods:
The PubMed, OVID, and Web of Science databases were searched from inception to January 11, 2018. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated to explore the relationship between HNF1A-AS1 expression and survival. Odds ratios (OR) were calculated to assess the association between HNF1A-AS1 expression and pathological parameters.

Results:
Eight studies with a total of 802 patients were included in the study. The pooled hazard ratio (HR) suggested high HNF1A-AS1 expression correlated with poor overall survival (OS) (HR = 4.85, 95% confidence interval (CI): 2.43–9.68), and disease-free survival (DFS) (HR = 6.34, 95% CI: 1.03–39.12) in cancer patients. High HNF1A-AS1 expression also correlated with poor histological grade (OR = 1.88, 95% CI: 1.27–2.79), high tumor stage (OR = 4.04, 95% CI: 2.53–6.47), lymph node metastasis (LNM) (OR = 4.53, 95% CI: 2.30–8.92), and distant metastasis (OR = 5.99, 95% CI: 2.88–12.48). Begg funnel plot did not show any evidence of obvious asymmetry for high tumor stage (Pr > |z| = 0.368) and LNM (Pr > |z| = 1.000).

Conclusions:
Thus high HNF1A-AS1 expression is predictive of poor OS, DFS, lymph node metastasis, distant metastasis, histological grade, and larger tumor stage, which suggests high HNF1A-AS1 expression may serve as a novel biomarker of poor prognosis in cancer.
Septic shock caused by Rhizobium radiobacter in an elderly woman
Authors: Wang Dong-lian , Zhao Li-dong , Li Li-juan , Zhou Min-jie 
Published: December 2019

Abstract

Rationale:

Rhizobium radiobacter is a Gram-negative pathogen present in soil and plants. Cases of R radiobacter infection in immunocompromised hosts have been sporadically reported. However, septic shock caused by R radiobacter is rarely seen.

Patient concerns:
Here, we describe an elderly patient with a rapid progression of watery diarrhea, anorexia, fever, weakness, oliguria, and shock. Blood results showed increased total white blood cell count and C-reactive protein. Arterial blood gas results showed hypoxia and elevated lactate level. The Sequential Organ Failure Assessment score was 11. Blood culture at admission showed Gram-negative bacteria, which were later confirmed as R radiobacter.

Diagnosis:
Septic shock caused by R Radiobacter.

Interventions:
The patient was treated with intravenous cefoperazone/sulbactam and sequential oral levofloxacin.

Outcomes:
The patient recovered completely.

Conclusion:

R radiobacter may be considered as a potential opportunistic pathogen that may cause severe sepsis in elderly patients, especially those with multiple underlying diseases.
Pulmonary and mediastinum metastasis of uterine leiomyoma
Authors: Huang Liqiang , Shi Gaofeng , Wang Qi , Guo Yuwei , Cong Mengdi 
Published: December 2019

Abstract

Rationale:
Pulmonary benign metastasizing leiomyoma (PBML) is rare, usually occurs in women who underwent hysterectomy during the reproductive years, and has no obvious clinical symptoms. A full understanding of the characteristics of PBML is important for its sequential treatment and prognosis.

Patient concerns:
In this report, a 36-year-old female patient with previous uterine leiomyoma who underwent 3 surgical resections of the uterus, bilateral fallopian tubes, and partial omentum was investigated. The physical examination revealed a tumor in the right lower lobe and mediastinum and a solid nodule in the right middle lobe.

Diagnoses:
Chest computed tomography (CT) confirmed a tumor in the right lower lobe and mediastinum and a solid nodule in the right middle lobe. Further positron-emission tomography computed tomography (PET-CT) with 18F-fluorodeoxyglucose (FDG) of the whole body showed mildly intense accumulation of 18F-FDG in the tumor (maximum standardized uptake value [SUV max], 2.6). A pathological examination then confirmed the presence of fibrous and vascular tissue after CT-guided percutaneous biopsy of the tumor in the right lower lobe. Additionally, surgical resection of the tumor and nodule was performed for histological analysis and immunohistochemical assays for estrogen receptor (ER) and progesterone receptor (PR).

Interventions:
The patient underwent complete tumor surgical resection and nodule wedge resection.

Outcomes:
No postoperative complications occurred. No recurrence or other signs of metastasis were found during an 18-month follow-up observation period.

Conclusion:
In this case, lung and mediastinal metastasis of uterine fibroids was observed. However, depending on only a postoperative histological analysis is insufficient for the diagnosis of PBML. Histological analysis combined with an evaluation of the expression levels of ER and PR is crucial for the diagnosis and treatment of PBML.
Multidrug resistant lymph node fistula tracheobronchial tuberculosis
Authors: Liu Jiang , Xie Shouning , Yu Laishun , Su Xiaoling 
Published: December 2019

Abstract

Rationale:
The patient in this case report has been diagnosed with multidrug resistant lymph node fistula tracheobronchial tuberculosis (TBTB). The PubMed was searched using the keywords “Tuberculosis, Multidrug-Resistant”, “Tuberculosis”, and “Bronchial Fistula”, and the results yielded no similar case reports. Therefore, this report helps us to explore more on the causes of multidrug resistance and formation of lymph node fistula, as well as associated treatment strategies.

Patient concerns:
A 15-year old Tibetan girl who was previously treated in the local Hospital for Infectious Diseases for repeated TBTB demonstrated poor treatment outcomes, and so was further diagnosed in our hospital. After standard treatments, the cough and expectoration of the girl showed improvement, and mycobacterium culture showed negative results. Thoracic CT showed local compression of the right bronchus, and disappearance of stenosis. Bronchoscopy showed that the fistula was closed and healed.

Diagnoses:
Multidrug resistant lymph node fistula TBTB.

Interventions:
Antituberculosis drugs such as pyrazinamide (0.75 g/time, twice per day), moxifloxacin (0.4 g per day), protionamide enteric-coated tablets (0.2 g/time, 3 times per day), pasiniazide tablets (0.3 g/time, 3 times per day), and capreomycin (0.75 g per day) were orally administered. The treatment included an 8-month intensive treatment phase and a 12-month consolidation phase. Bronchoscopic local injection combined with cryotherapy was also conducted.

Outcomes:
Bronchoscopy showed that the fistula was closed and healed, mycobacterium culture showed negative results, and thoracic CT showed local compression of the right bronchus, disappearance of stenosis after treatment.

Lessons:
(1) This girl had a history of long-term oral intake of antituberculosis drugs, but the treatment effectiveness remained poor. Therefore, resistance to tuberculosis can be considered, and also mycobacterium culture and drug sensitivity tests should be considered. After these, the treatment strategies should be adjusted accordingly.
(2) TBTB should be further classified by analyzing under the bronchoscope to decide the best treatment strategy accordingly.
Uterine leiomyoma in a 13-year-old adolescent successfully treated with laparoscopic myomectomy
Authors: Morita Natsuko , Tanaka Tomohito , Hashida Sosuke , Tsunetoh Satoshi , Taniguchi Kohei , Komura Kazumasa , Ohmichi Masahide 
Published: December 2019

Abstract

Rationale:
Uterine leiomyoma, which is very common gynecological tumor in the reproductive years, is extremely rare in adolescence. We herein report a case of a uterine leiomyoma treated with laparoscopic surgery in an adolescent.

Patient concerns:
A 13-year-old girl with no gravida and her first menses at 11 years of age reported feeling bloated. She had a regular menstrual cycle but felt increased abdominal distension.

Diagnosis:
Transabdominal ultrasound and magnetic resonance imaging revealed uterine leiomyoma with a diameter of 10 cm.

Intervention:
Laparoscopic myomectomy was performed.

Outcomes:
The total weight of the leiomyoma removed was 660 g with pathological diagnosis of uterine leiomyoma. The postoperative course was uneventful. The patient was free of disease at the follow-up consultation 18 months after the treatment.

Lessons:
Laparoscopic approach is a very useful and minimally invasive surgery for symptomatic leiomyoma in adolescents.
Safety and feasibility of laparoscopic liver resection for patients with large or multiple intrahepatic cholangiocarcinomas
Authors: Zhu Yunfeng , Song Jiulin , Xu Xi , Tan Yifei , Yang Jiayin 
Published: December 2019

Abstract
Only a few high-volume centers have reported the efficacy of laparoscopic liver resection (LLR) for patients with intrahepatic cholangiocarcinoma (ICC). The minimally invasive approach is still controversial for ICC, especially when dealing with large (≥5 cm) or multiple (≥2) ICCs.
Patients with large and multiple ICCs who underwent LLR or open hepatectomy (OH) between January 2012 and June 2017 were included. Furthermore, 1:2 propensity score matching (PSM) was performed between the LLR group and the OH group. Short- and long-term outcomes were compared between the different techniques.
After PSM, LLR resulted in significantly longer operation time (median 225 minutes vs 190 minutes, P = .006) and pringle maneuver time (median 50 minutes vs 32.5 minutes, P = .001). There was no statistically significant difference in postoperative hospital stay between the different approaches (median 6 days vs 7 days, P = .092). The grade III/IV complication rates were comparable between the groups (5.6% vs 11.1%, P = .868). In the PSM subset, there was no significant difference in terms of overall survival (P = .645) or disease-free survival (P = .827) between patients in the LLR group and in the OH group.
The present study showed that patients who underwent LLR for large or multiple ICCs could obtain similar short- and long-term outcomes compared with those who underwent OH, and lymph node dissection (LND) was technically difficult but feasible during LLR.
Infection Concept Integration and Teaching Strategies in US Baccalaureate Nursing Programs in an Era of Concept-Based Curriculum
Authors: Manning Mary Lou , Pogorzelska-Maziarz Monika , Ward Julia 
Published: December 2019

Background
Health care–associated infections remain a major patient safety problem. Antibiotic resistance and the resurgence of infectious diseases pose an escalating threat to public health. It is essential for nursing students to develop an understanding of the infection concept and the ability to apply their knowledge and skills in all settings.

Purpose
The purpose was to describe the integration of the infection concept and associated teaching strategies in US baccalaureate nursing programs.

Methods
A comprehensive literature review was conducted using multiple online databases.

Results
There is some evidence of infection concept integration within single courses but limited evidence of integration across courses. We were unable to ascertain the degree of infection concept integration throughout a curriculum. Faculty used a blend of creative, innovative strategies to foster active teaching and learning.

Conclusion
The concept of infection and the related teaching strategies used to help students organize infection-related knowledge, skills, and attitudes to form logical connections needs greater attention.
Neuroimaging Methods for Nursing Science
Authors: Atalla Sebastian W. , Kalvas Laura Beth , Campbell Jenna L. , Anderson Alison R. , Cowan Ronald L. , Wright Kathy , Humbel Angela C. , Monroe Todd B. 
Published: December 2019

Background
Since the inception of magnetic resonance imaging, thousands of studies have appeared in the literature reporting on multiple imaging techniques. However, there is a paucity of neuroimaging research programs developed by nurse scientists.

Objectives
The purpose of this article is to introduce the nurse scientist to complex neuroimaging methods with the ultimate goal of creating impetus for future use of brain imaging in nursing research.

Methods
This article reviews common neuroimaging methods, presents vocabulary frequently used in neuroimaging work, provides information on access to resources in neuroimaging education, and discusses considerations for use of neuroimaging in research.

Results
Ten imaging modalities are reviewed, including structural and functional magnetic resonance imaging, computed tomography, positron emission tomography, and encephalography.

Discussion
Choosing an imaging modality for research depends on the nature of the research question, needs of the patient population of interest, and resources available to the novice and seasoned nurse scientist. Neuroimaging has the potential to innovate the study of symptom science and encourage interdisciplinary collaboration in research.
Two Methods for Calculating Symptom Cluster Scores
Authors: Salomon Rebecca E. , Crandell Jamie , Muscatell Keely A. , Santos Hudson P. , Anderson Ruth A. , Beeber Linda S. 
Published: December 2019

Background
Symptom clusters are conventionally distilled into a single score using composite scoring, which is based on the mathematical assumption that all symptoms are equivalently related to outcomes of interest; this may lead to a loss of important variation in the data.

Objectives
This article compares two ways of calculating a single score for a symptom cluster: a conventional, hypothesis-driven composite score versus a data-driven, reduced rank regression score that weights the symptoms based on their individual relationships with key outcomes.

Methods
We conducted a secondary analysis of psychoneurological symptoms from a sample of 356 low-income mothers. Four of the psychoneurological symptoms (fatigue, cognitive dysfunction, sleep disturbance, and depressed mood) were measured with the Center for Epidemiological Studies Depression Scale; the fifth (pain) was measured using an item from the Medical Outcomes Study 12-item Short Form Health Survey (SF-12). Mothers’ function was measured using the 12-item Short Form Health Survey. The composite score was calculated by summing standardized scores for each individual psychoneurological symptom. In contrast, reduced rank regression weighted the individual symptoms using their respective associations with mothers’ function; the weighted individual symptom scores were summed into the reduced rank regression symptom score.

Results
The composite score and reduced rank regression score were highly correlated at .93. The cluster of psychoneurological symptoms accounted for 53.7% of the variation in the mothers’ function. Depressed mood and pain accounted for almost all the explained variation in mothers’ function at 37.2% and 15.0%, respectively.

Discussion
The composite score approach was simpler to calculate, and the high correlation with the reduced rank regression score indicates that the composite score reflected most of the variation explained by the reduced rank regression approach in this data set. However, the reduced rank regression analysis provided additional information by identifying pain and depressed mood as having the strongest association with a mother’s function, which has implications for understanding which symptoms to target in future interventions. Future studies should also explore composite versus reduced rank regression approaches given that reduced rank regression may yield different insights in other data sets.
Computed Tomography Perfusion Data for Acute Ischemic Stroke Evaluation Using Rapid Software: Pitfalls of Automated Postprocessing
Authors: Kauw Frans , Heit Jeremy J. , Martin Blake W. , van Ommen Fasco , Kappelle L. Jaap , Velthuis Birgitta K. , de Jong Hugo W.A.M. , Dankbaar Jan W. , Wintermark Max 
Published: December 2019

Abstract
Computed tomography perfusion (CTP) is increasingly used to determine treatment eligibility for acute ischemic stroke patients. Automated postprocessing of raw CTP data is routinely used, but it can fail. In reviewing 176 consecutive acute ischemic stroke patients, failures occurred in 20 patients (11%) during automated postprocessing by the RAPID software. Failures were caused by motion (n = 11, 73%), streak artifacts (n = 2, 13%), and poor contrast bolus arrival (n = 2, 13%). Stroke physicians should review CTP results with care before they are being integrated in their decision-making process.