bluuebunny/crossref_metadata_2025_split huggingface dataset:
Direct Cost Related to Stroke
Authors: Pucciarelli Gianluca , Rebora Paola , Arisido Maeregu Woldeyes , Ausili Davide , Simeone Silvio , Vellone Ercole , Alvaro Rosaria 
Published: December 2019

Background
After discharge from a rehabilitation hospital, stroke survivors and their families may face considerable stroke-related direct costs. The total amount could be ascribed to the costs of formal and informal care and to the equipment or materials needed for care.

Objectives
This study aims to describe the direct costs incurred after a stroke by survivors during their first poststroke year and to analyze the basic predictors of these costs.

Methods
Stroke survivors (N = 415) were enrolled for this study during discharge from rehabilitation hospitals (baseline) and interviewed at 3, 6, 9, and 12 months after discharge for a longitudinal study. The trend of the direct costs incurred during the follow-up (from T1 to T4; n = 239) was evaluated using a linear mixed-effects model. The mixed-effects model was used to identify the baseline predictors of the incurred direct costs from the stroke survivors.

Results
During the first year after discharge, stroke survivors spent approximately $3700 on stroke-related direct (ie, medical and nonmedical) costs. The highest direct costs occurred during the first 6 months, although there was not a significant change over time. The higher direct costs incurred were predicted by the linear effect of time, by the educational level (higher vs low), and by the lower Barthel Index score, whereas a higher perceived cost was predicted only by the linear effect of time and by the lower Barthel Index score.

Conclusion
In the first poststroke year, direct costs have remained stable over time and can be predicted by the level of education and physical functioning. The identification of specific direct cost predictors would be helpful for developing more socially and economically tailored interventions for stroke survivors in their first year after their stroke.
Attitudes to Medication—Treatment Among Patients and Caregivers
Authors: Chauhan Nidhi , Chakrabarti Subho , Grover Sandeep 
Published: December 2019

Abstract

Background
Attitudes toward medication treatment are thought to significantly influence adherence in bipolar disorder (BD) and schizophrenia. However, the actual impact of patients' treatment attitudes on adherence and determinants of attitudes is still uncertain.

Methods
A longitudinal examination of treatment attitudes and their correlates was conducted among patients with BD and their caregivers compared with those with schizophrenia. Structured assessments of symptom severity, functioning, insight, medication side effects, knowledge of illness, medication adherence, treatment attitudes, and treatment satisfaction were performed among 176 selected patients (106 with BD and 70 with schizophrenia) and their caregivers. Participants were reassessed on these parameters at 3 and 6 months.

Results
Rates of nonadherence at baseline varied widely between self-reports, clinician ratings, and serum levels. Though symptoms and functioning improved with treatment, overall rates of nonadherence increased in the first 3 months because of early dropouts and remained stable thereafter. However, treatment attitudes and treatment satisfaction remained largely unchanged among patients and caregivers. Both positive and negative attitudes were commonly held and patients' attitudes did not differ between BD and schizophrenia. Patients' attitudes were significantly associated with adherence, insight, knowledge about illness, treatment satisfaction, symptom severity, social disadvantage, and side effects together with caregivers' knowledge, attitudes, and satisfaction. Caregivers of patients with schizophrenia were more knowledgeable and had more positive attitudes than patients.

Conclusions
Patients' attitudes to medication treatment are associated with adherence over time. They are relatively enduring and mainly associated with insight, knowledge of illness, and treatment satisfaction among patients and their caregivers. These findings could inform psychosocial interventions aiming to improve treatment attitudes and adherence in BD and schizophrenia.
The efficacy of celecoxib for pain management of arthroscopy
Authors: Wan Ruijie , Li Pin , Jiang Heng 
Published: December 2019

Abstract

Background:
The efficacy of celecoxib for pain management of arthroscopy remains controversial. We conduct a systematic review and meta-analysis to assess if celecoxib before the surgery decreases postoperative pain intensity of arthroscopy.

Methods:
We search PubMed, Embase, Web of science, EBSCO, and Cochrane library databases for randomized controlled trials (RCTs) assessing the effect of celecoxib versus placebo on pain control of arthroscopy.

Results:
Five RCTs are included in the meta-analysis. Celecoxib is administered at 200 mg or 400 mg dosage before the surgery. Overall, compared with control group for arthroscopy, preemptive celecoxib has remarkably positive impact on pain scores at 2 to 6 hours (standard mean difference (SMD) = −0.66; 95% confidence interval (CI) = −0.95 to −0.36; P < .0001) and 24 hours after the surgery (SMD = −1.26; 95% CI = −1.83 to −0.70; P < 0.0001), analgesic consumption (SMD  = −2.73; 95% CI = −5.17 to −0.28; P = .03), as well as the decrease in adverse events (risk ratio (RR) = 0.56; 95% CI = 0.39 to 0.79; P = .001), but shows no obvious effect on first time for analgesic requirement (SMD  = 0.02; 95% CI = −0.22 to 0.26; P = .87), nausea, or vomiting (RR = 0.70; 95% CI = 0.42 to 1.17; P = .18).

Conclusion:
Celecoxib administered at 200 mg or 400 mg dosage before the surgery decreases postoperative pain intensity of arthroscopy.
Aspartate aminotransferase to platelet ratio can reduce the need for transient elastography in Chinese patients with chronic hepatitis B
Authors: Yue Wei , Li Yan , Geng Jiawei , Wang Ping , Zhang Li 
Published: December 2019

Abstract
In the absence of liver biopsy and transient elastography (TE), aspartate aminotransferase to platelet ratio (APRI), fibrosis-4 score (FIB-4), and gammaglutamyl transpeptidase to platelet ratio (GPR) are simple and inexpensive methods for the detection of liver fibrosis. Aims: We compared the performance of APRI, FIB-4, and GPR scores against TE in predicting the presence of liver fibrosis and cirrhosis, determined the optimal cut-off values for fibrosis and cirrhosis prediction, and reviewed the need for further TE assessment in resource-limited areas in China. Methods: TE and basic laboratory tests were performed in 2014 consecutive patients with chronic hepatitis B (CHB), and then compared to APRI, FIB-4, and GPR. Results: For the detection of significant fibrosis, the areas under the receiver operating characteristic (AUROC) curves for APRI, FIB-4, and GPR were 0.83, 0.75, and 0.77, respectively. For the detection of cirrhosis, the AUROC curves for APRI, FIB-4, and GPR were 0.90, 0.84, and 0.84, respectively. The cutoff of APRI was 0.35, with 78% sensitivity and 63% negative predictive value (NPV), to exclude significant fibrosis (F ≥ 2). At an APRI of 0.6, results showed a 94% specificity, 100% positive predictive value (PPV) and 7.9 positive likelihood ratio (PLR) in detecting significant fibrosis. Thus, patients with an APRI of <0.35 or >0.6 demonstrated correct prediction of liver fibrosis. These results translated to 1250 out of the 2014 patients avoiding the need for TE with a diagnostic accuracy of >80%. Conclusions: The APRI score accurately assessed fibrosis and reduced the need for TE in almost two-thirds of Chinese patients with CHB.
A case report of acute fibrinous and organizing pneumonia
Authors: Wang Kaige , Du Xinmiao , Wu Qian , Cheng Deyun 
Published: December 2019

Abstract

Rationale:
Acute fibrinous and organizing pneumonia (AFOP) is a newly evolving rare non-infectious lung pathology, characterized by intra-alveolar fibrin balls on histology. It is usually difficult to be diagnosed and mistaken for other lung diseases.

Patient concerns:
In this article, an interesting case about a male patient with a 15-day history of high-grade fever, chills, and no productive cough was presented. He was misdiagnosed as the lung infection early, but exhibited no response to the antibiotic therapy.

Diagnosis:
The diagnosis of AFOP was determined by the lung biopsy and pathology.

Interventions:
With the diagnosis of AFOP, all antibiotics were discontinued, and 40 mg methylprednisolone daily was given intravenously.

Outcomes:
The patient responded well to the treatment with steroids.

Lessons:
AFOP is a rare lung disease characterized by bilateral basilar infiltrates and histological findings of organizing pneumonia and intra-alveolar fibrin in the form of “fibrin balls”. Lung biopsy and histopathology were the most important diagnostic methods for the AFOP. Glucocorticoid was an effective drug for the treatment. Subacute patients of AFOP have excellent prognosis with corticosteroids.
An unusual case report of unilateral parotid gland sarcoidosis with spontaneous remission
Authors: Diamantopoulos Panagiotis T. , Charakopoulos Emmanouil , Viniou Nora-Athina , Diamantopoulou Lydia , Gaggadi Maria 
Published: December 2019

Abstract

Rationale:
Parotid gland sarcoidosis is a well-recognized, but uncommon disease entity. Parotidectomy is most commonly performed to establish the diagnosis and most patients are treated with corticosteroids.

Patient concerns:
A young female patient presented with right parotid enlargement and developed symptoms of facial nerve palsy during diagnostic investigation.

Diagnoses:
A fine-needle aspiration cytology showed granulomatous inflammation. The diagnosis of sarcoidosis was eventually established based on the demonstration of the characteristic lambda and panda signs by a Gallium-67 scintigraphy.

Interventions:
No specific pharmacologic therapy was initiated.

Outcomes:
The patient's symptoms regressed completely over a period of 3 months. Additionally, she remains asymptomatic 2 years later.

Lessons:
This case underlines the importance of not initiating corticosteroids in all patients with parotid gland sarcoidosis and suggests that parotidectomy can be avoided in the presence of characteristic for sarcoidosis imaging findings.
Perioperative outcomes in geriatric patients undergoing hip fracture surgery with different anesthesia techniques
Authors: Chen Dong Xu , Yang Lei , Ding Lin , Li Shi Yue , Qi Ya Na , Li Qian 
Published: December 2019

Abstract

Background:
Previous meta-analyses assessing anesthetic techniques in adult patients undergoing hip fractures surgery are available. However, whether the anesthetic technique is associated with risk of mortality and complications in geriatric patients with hip fractures remains unclear. This study was conducted to assess postoperative outcomes of anesthesia technique in geriatric patients undergoing hip fracture surgery.

Methods:
Cochrane Library, PubMed, EMBASE, MEDLINE, CNKI, and CBM were searched from inception up to May 25, 2018. Observational studies and randomized controlled trials (RCTs) that assessed the perioperative outcomes of technique of anesthesia (general or regional [epidural/spinal/neuraxial]) in geriatric patients (≥60 years old) undergoing hip fracture surgery were included. Two investigators independently screened studies for inclusion and performed data extraction. Heterogeneity was assessed by the I
2 and Chi-square tests. The odds ratio (OR) of the dichotomous data, mean difference (MD) of continuous data, and 95% confidence intervals (CI) were calculated to assess the pooled data.

Results:
Eleven retrospective and 2 RCTs were included. There was no difference in 30-day mortality (OR = 0.96; 95% CI 0.86–1.08; P = .51) between the general and regional anesthesia groups. In-hospital mortality (OR = 1.26; 95% CI 1.17–1.36; P < .001), acute respiratory failure (OR = 2.66; 95% CI 2.34–3.02; P < .001), length of hospital stay (MD = 0.33; 95% CI 0.24–0.42; P < .001), and readmission (OR = 1.09; 95% CI 1.01–1.18; P = .03) were significantly reduced in the regional anesthesia group. Pneumonia (OR = 0.99; 95% CI 0.91–1.07; P = .79), heart failure (OR = 0.97; 95% CI 0.86–1.09; P = .62), acute myocardial infraction (OR = 1.07; 95% CI 0.99–1.16; P = .10), acute renal failure (OR = 1.32; 95% CI 0.97–1.79; P = .07), cerebrovascular accident (OR = 1.08; 95% CI 0.82–1.42; P = .58), postoperative delirium (OR = 1.51; 95% CI 0.16–13.97; P = .72), and deep vein thrombosis/pulmonary embolism (OR = 1.42; 95% CI 0.84–2.38; P = .19) were similar between the two anesthetic techniques.

Conclusion:
General anesthesia is associated with increased risk of in-hospital mortality, acute respiratory failure, longer hospital stays, and higher readmission. There is evidence to suggest that regional anesthesia is associated with improved perioperative outcomes. Large RCTs are needed to explore the most optimal anesthetic techniques for geriatric patients with hip fractures before drawing final conclusions.

PROSPERO registration number:
CRD42018093582.
Compound danshen dripping pills combined with trimetazidine in treating unstable angina pectoris
Authors: Yao Dongfeng , Wang Chuan , Han Lihua , Zhang Pan , Liu Jiping , Wang Bin , Zhang Enhu 
Published: December 2019

Abstract

Background:
Compound danshen dripping pills (CDDP) and trimetazidine (TMZ) are commonly used in the treatment of unstable angina pectoris (UAP). Currently, the combination of CDDP and TMZ has been widely used for UAP. However, the clinical evidence CDDP combined with TMZ for treating UAP is not sufficient.

Methods:
We searched for randomized controlled trials testing CDDP combined with TMZ for the treatment of UAP in Chinese National Knowledge Infrastructure database, VIP database, Chinese Biological and Medicine database, Wangfang database, MEDLINE, EMBASE, Cochrane Library, and Web of Science. Extracted data are analyzed using Review Manager 5.3 software. The quality evaluation, forest plots and funnel plots will be conducted by RevMan5.3 software. Moreover, subgroup analysis and sensitivity analysis will also be completed by RevMan5.3.

Results:
This systematic review will provide powerful clinical evidence of combination CDDP and TMZ for treating UAP.

Conclusions:
This systematic review will be provided up-to-date clinical evidence to evaluate the effectiveness and safety of CDDP combined with TMZ for the treatment of parents with UAP.

Registration Number: PROSPERO CRD42019143100
Correlation between FAS single nucleotide polymorphisms and breast carcinoma susceptibility in Asia
Authors: Chen Ying , Wang Hanfei , Yan Yunwen , Ren Min , Yan Cunye , Wang Benzhong 
Published: December 2019

Abstract

Background:
FAS cell surface death receptor (FAS) gene has 2 common single nucleotide polymorphisms (SNPs) in its promoter, FAS-1377G > A (rs2234767) and FAS-670A > G (rs1800682). Several studies have investigated the role of these 2 polymorphisms in etiology of breast cancer in Asian population while the outcomes are inconsistent. To derive a more precise assessment of the association between breast cancer susceptibility with FAS gene promoter SNPs, a meta-analysis of published studies was performed.

Material and methods:
We systematically searched PubMed, Embase, Web of Science, and the Chinese biomedical database (CBM) for papers published until November 1, 2018. Odds ratio (OR) with 95% confidential interval (95%CI) was conducted to evaluate the associations. Statistical analysis was conducted using Stata13.0 software. A total of 8 studies covering 2564 cases and 2633 controls were included.

Results:
The integrated results suggest the following: For the FAS-1377G/A polymorphism, we only found significant associations for allele G vs allele A (OR = 1.100, 95%CI = 1.004–1.206, P = .040). After stratification by ethnicity, a significant association was observed only for the AA+GA vs GG genotype in East Asian populations (OR = 1.177, 95% CI = 1.010–1.371, P = .037). The association was not found in West Asian populations. For the FAS -670A/G polymorphism, no association with cancer risk was found in any comparison model. Sensitivity analysis suggests that the meta-analysis results obtained after excluding any single study were similar to the original ones, suggesting that the meta-analysis results were not significantly affected by any single study.

Conclusion:
These results indicated that FAS-1377G/A polymorphism may contribute to the increased breast cancer susceptibility and could be a promising target for cancer risk prediction. Further studies are needed to determine if the FAS gene confers a risk of breast cancer in other ethnic groups, such as Africans and Latin Americans.
Spinal rosette-forming glioneuronal tumor
Authors: Hamauchi Shuji , Tanino Mishie , Hida Kazutoshi , Sasamori Toru , Yano Shunsuke , Tanaka Shinya 
Published: December 2019

Abstract

Rationale:
Rosette-forming glioneuronal tumor (RGNT) is a rare tumor which has been first reported as the fourth ventricle tumor by Komori et al and is classified as a distinct clinicopathological entity by the WHO Classification of Tumors of the Central Nervous System as in 2007. Although RGNTs were reported to occur in both supratentorial and inflatentorial sites, only 4 case reports of spinal RGNT have been demonstrated.

Patient concerns:
A 37-year-old female presenting with slowly progressing right-sided clumsiness. Cervical magnetic resonance imaging revealed a spinal intramedullary tumor between the C2 and C5 levels.

Diagnoses:
Pathological analysis showed unique biphasic cellular architecture consisting of perivascular pseudorosettes dominantly with few neurocytic rosettes and diffuse astrocytoma component. The tumor cells composed of perivascular pseudorosettes showed positivity for both synaptophysin and glial markers such as GFAP and Olig2. Therefore, the diagnosis of RGNT was made.

Interventions:
Gross total resection of the tumor was achieved. No adjuvant chemotherapy nor radiotherapy was conducted after operation.

Outcomes:
At 2 years after the operation, no recurrence was observed.

Lessons:
Although RGNT arising from the spinal cord is extremely rare, we need to consider the tumor as a differential diagnosis for intramedullary spinal cord tumors.
Secondary lower limbs lymphedema in patients with Chikungunya fever
Authors: Almeida Catarina Coelho , Lins Esdras Marques , Soares Brandão Simone Cristina , Pinto Flavia Cristina Morone , de Andrade Aguiar José Lamartine , de Lima Filho José Luiz , Rocha Fernanda Appolônio 
Published: December 2019

Abstract
Chikungunya fever (CHIKF) is an arbovirus characterized by acute fever, myalgia and polyarthralgia. Lymphedema in the lower limbs (LL) was observed in several patients during an outbreak of CHIKF in the state of Pernambuco (Brazil) in 2016. No reports on lymphatic vessels disease due to CHIKF have been described. The aim of the study was to follow lymphatic abnormalities in the LL of 16 patients with CHIKF, using lymphoscintigraphy.
An observational, prospective study with patients in the acute phase of CHIKF (confirmed serological diagnosis) with LL edema submitted to clinical evaluation and lymphoscintigraphy at baseline and after 90 days.
Sixteen patients (81% females) participated in this study. All patients presented with lower limb lymphedema, being 15 (94%) bilateral. Of the 31 limbs affected by lymphedema, 24 (77%) presented abnormalities in lymphatic drainage by lymphoscintigraphy. The delay to visualize pelvic lymph nodes was the most frequent lymphoscintigraphic abnormality, observed in 16 (51,6%) LL. Nine (56%) patients were clinically reevaluated after 90 days, and all 18 LL remained with lymphedema. A second lymphoscintigraphy showed persistent abnormalities in 13 (72%) of the 18 LL.
CHIKF can lead to lymphedema, and lymphedema may persist or progress after 3 months of the acute phases of the disease.
Five Year Follow-up of a Randomized Controlled Trial of Laparoscopic Repair of Very Large Hiatus Hernia With Sutures Versus Absorbable Versus Nonabsorbable Mesh
Authors: Watson David I. , Thompson Sarah K. , Devitt Peter G. , Aly Ahmad , Irvine Tanya , Woods Simon D. , Gan Susan , Game Philip A. , Jamieson Glyn G. 
Published: December 2019

Objective:
To determine whether absorbable or nonabsorbable mesh repair of large hiatus hernias is followed by less recurrences at late follow-up compared to sutured repair.

Summary of Background Data:
Radiological recurrences have been reported in up to 30% of patients after repair of large hiatus hernias, and mesh repair has been proposed as a solution. Earlier trials have revealed mixed outcomes and early outcomes from a trial reported previously revealed no short-term advantages for mesh repair.

Methods:
Multicentre prospective double-blind randomized controlled trial of 3 methods of hiatus hernia repair; sutures versus absorbable mesh versus nonabsorbable mesh. Primary outcome – hernia recurrence assessed by barium meal X-ray and endoscopy at 3–4 years. Secondary outcomes – clinical symptom scores at 2, 3, and 5 years.

Results:
126 patients were enrolled – 43 sutures, 41 absorbable mesh, and 42 nonabsorbable mesh. Clinical outcomes were obtained at 5 years in 89.9%, and objective follow-up was obtained in 72.3%. A recurrent hernia (any size) was identified in 39.3% after suture repair, 56.7% – absorbable mesh, and 42.9% – nonabsorbable mesh (P = 0.371). Clinical outcomes were similar at 5 years, except chest pain, diarrhea, and bloat symptoms which were more common after repair with absorbable mesh.

Conclusions:
No advantages were demonstrated for mesh repair at up to 5 years follow-up, and symptom outcomes were worse after repair with absorbable mesh. The longer-term results from this trial do not support mesh repair for large hiatus hernias.