bluuebunny/crossref_metadata_2025_split huggingface dataset:
Eficacia y seguridad del Misoprostol frente a Metotrexato más Misoprostol para el manejo médico del aborto en Bogotá (Colombia): estudio clínico aleatorizado
Authors: Arreaza-Graterol Mortimer , Rodríguez-O Jorge A. 
Published: February 2020

Objetivo: evaluar la eficacia y seguridad del misoprostol frente al metotrexato más misoprostol para el manejo médico de pacientes con aborto retenido o embarazo anembrionado.
Materiales y métodos: se realizó un estudio clínico aleatorizado en el que se incluyeron pacientes con embarazo anembrionado o aborto retenido de hasta 63 días y diagnosticado por ecografía. Estas fueron aleatorizadas a metotrexato 50 mg intramuscular más misoprostol 800 mcg intravaginal (grupo 1) u 800 mcg de misoprostol intravaginal (grupo 2). A continuación se evaluó la tasa de aborto completo, incluyendo las pacientes que requirieron un segundo ciclo de rescate con sus respectivas complicaciones.
Resultados: un total de 52 pacientes fueron aleatorizadas al grupo de terapia combinada y 66 al grupo de monoterapia. 92% de las pacientes en el grupo de misoprostol más metotrexato presentaron aborto completo por ecografía frente a 86% de las pacientes en el grupo de misoprostol (p=0,24). Por otro lado, dos de las pacientes del grupo de terapia combinada (6%) requirieron dosis de rescate en comparación con cinco en el grupo de misoprostol (11%), (p=0,348). De igual modo, tres pacientes requirieron legrado uterino obstétrico en el grupo de terapia combinada frente a cinco pacientes en el grupo de monoterapia con misoprostol (p=0,69). En definitiva, los dos esquemas resultaron seguros para las pacientes.
Conclusiones: los resultados permitieron concluir que, en el manejo médico del aborto retenido o embarazo anembrionado menor a 63 días, la monoterapia con una dosis de 800 mcg de misoprostol intravaginal no mostró diferencias significativas en comparación con un esquema de terapia combinada con metotrexato y misoprostol.
Genotipificación del Virus del Papiloma Humano(VPH) en muestras de cepillados cervicales de pacientes de diferentes hospitales de Bogotá y evaluación de la concordancia de dos métodos basados en PCR
Authors: García Dabeiba A. , Schmitt Markus , Cid-Arregui Ángel , Castillo Marcos , Briceño Ignacio , Aristizábal Fabio A. 
Published: February 2020

Objetivo: genotipificar el VPH en muestras de pacientes con diferentes grados histopatológicos de lesión cervical.Materiales y métodos: estudio de corte transversal en muestras de cepillado cervical de mujeres con diferentes grados de lesiones cervicales histopatológicas en la ciudad de Bogotá en el año 2009. Se utilizó Luminex® xMAP® una técnica altamente sensible, reproducible y automatizada, y Reverse Line Blot (RLB).Resultados: las infecciones por los tipos de VPH de 16 y 18 fueron las más frecuentes en todos los tipos de patología del cérvix. Las infecciones mixtas predominaron con un 78,04% de los casos con patología negativa, 85,7% NIC I, 81,25% NIC II, 78,78% NIC III y 71,42% cáncer cervical. La concordancia entre los dos métodos fue del 67%.Conclusión: las infecciones por los tipos de VPH 16 y 18 predominan en la población estudiada.
Menopausia y etnias/razas: ¿hay diferencias en la presentación de los síntomas?
Authors: Romero-Pérez Ivette Marina , Monterrosa-Castro Álvaro , Paternina-Caicedo Ángel 
Published: February 2020

Introducción: la mayoría de los estudios sobre la sintomatología de la menopausia se han realizado entre mujeres caucásicas de la cultura occidental, lo que lleva a la inquietud de si sus hallazgos son aplicables a mujeres de otros grupos étnicos/raciales. Hay un creciente interés en estudiar el papel de la etnia/raza en los síntomas de la menopausia.
Objetivo: revisar la literatura, identificando estudios que comparen los síntomas menopáusicos en diferentes etnias/razas.
Materiales y métodos: se realizó una búsqueda electrónica en PubMed, Cochrane y SciELO con las palabras clave "menopause", "ethnicity" y "race". Se incluyeron estudios que compararan la presentación de síntomas climatéricos en diferentes etnias. Debido a la dificultad para la comparación de los resultados, no se incluyeron estudios realizados en una sola población étnica.
Resultados: se identificaron 55 estudios, de los cuales 19 cumplieron con los criterios de inclusión. La prevalencia de los síntomas menopáusicos difirió entre los grupos étnicos y se observaron contrastes en la percepción y la experiencia de la menopausia entre las culturas.
Conclusión: los resultados de estos estudios no apoyan un único síndrome menopáusico. El entendimiento de las diferencias entre los grupos étnicos puede mejorar la calidad de la atención en salud que se le brinda a la mujer y promover estilos de vida que contribuyan a disminuir su incidencia y severidad y mejorar la calidad de vida de la mujer.
Embarazo de gemelo acárdico coexistente con gemelo anencefálico, asociado a exposición a varicela en el primer trimestre: reporte de caso y revisión de la literatura
Authors: Saldarriaga-Gil Wilmar , Nieto-Calvache Álbaro José , Pachajoa Harry , Tabares Katherine , Isaza Carolina 
Published: February 2020

Introducción: el gemelo acárdico es una malformación congénita de muy baja prevalencia, 1 en 35.000 nacimientos, y se encuentra aproximadamente en 1 de cada 100 gemelos monocigóticos. La asociación de un gemelo acárdico con un segundo gemelo con malformaciones mayores ocurre aproximadamente en el 10% de los casos. El objetivo de este artículo es el reporte de un caso de muy baja prevalencia y la revisión de la literatura publicada sobre la etiología y fisiopatología asociada a la acardia, así como de las anomalías congénitas asociadas a esta y a la infección por virus de la varicela.Materiales y métodos: se presenta el caso de un embarazo gemelar monocoriónico biamniótico con un gemelo acardius mylacephalus y un segundo gemelo anencefálico, con exposición de la madre a varicela en el primer trimestre del embarazo. Se realizó cariotipo con bandas G, 46 XY sin anormalidades estructurales. Se hace una revisión de la literatura publicada en los últimos 10 años en las bases de datos PubMed, Ovid e HINARI.Conclusión: la importancia de este trabajo radica en que en la literatura revisada sólo se encontró un único reporte de la asociación de gemelo arcádico, coexistente con gemelo anencefálico. Además, sería el primer reporte de la relación entre esta combinación de malformaciones mayores en el embarazo gemelar y la exposición a varicela en el primer trimestre del embarazo.
Studying Canada in Cuba, Studying Cuba in Canada: A Roundtable Discussion
Authors: Kirk Emily , Rein Sandra , Wright Cynthia , Dubinsky Karen , Zarza Zaira 
Published: February 2020

Canada and Cuba have a long historical relationship, in governmental and non-governmental realms alike. While hundreds of Canadian students take part in educational exchanges from a variety of Canadian universities, Canadian/Cuban scholarly ties are not as strong as they are in the US or even the UK. There are a handful of internationally recognized Cuba scholars who have been working in Canada for some decades, among them John M. Kirk, Hal Klepak and Keith Ellis. Cuban scholarship in Canada is still notably scant and it cannot really be classified in generational terms. However it is clear that the work of these senior scholars is bearing fruit, as other scholars located in Canada are increasingly working in Cuban Studies, in both teaching and research.
A few of these scholars came together recently to discuss their experiences. This isn’t an exhaustive or representative group. The participants in this roundtable conversation include those trained as Cubanists, trained in other fields but with more recent research and/or teaching ties to Cuba, and a Cuban educated in Canada. We came together to discuss what we see as the state of the field in Cuban/Canadian studies today and in the future.
A Ação dos EUA na Venezuela: ONGs, Sociedade Civil e Neoliberalismo
Authors: Salgado Tiago Santos 
Published: February 2020

O presente artigo tem como objetivo demonstrar como se deu a ingerência dos EUA na Venezuela durante o governo de Hugo Chávez através da análise da documentação disponibilizada no site Wikileaks que tornou público o acesso a documentos secretos produzidos pelo Congresso dos EUA e pela embaixada estadunidense em Caracas. Tal análise permite perceber como o governo dos EUA atuou como organizador e financiador da oposição venezuelana ao governo democraticamente eleito de Chávez, em particular através da atuação de ONGs, que atuavam para defender os interesses dos EUA no país e como difusoras do discurso neoliberal dentro das bases chavistas.
Palavras-chave: Hugo Chávez; EUA; Neoliberalismo; Wikileaks
Twin Deliveries: The Prevalence and Perinatal Outcomes in Public Hospitals in Dar es Salaam City, Tanzania
Authors: Benela Zavery , Chibwae Alfred , Jahanpour Ola , Matovelo Dismas 
Published: February 2020

Abstract
Background

The perinatal mortality rates are five times higher in twin pregnancies than singleton pregnancies, therefore antenatal management and safe delivery of twin pregnancies are important issues in obstetrics. This study aimed at providing data on the proportion of twin deliveries in four public hospitals in Dar es Salaam and an insight on the fetal outcomes in relation to their modes of delivery.

Methods

This was a cross sectional study in which all women who delivered twin babies were interviewed and medical records on their delivery summary were obtained in the labour and post-natal wards in four public hospitals in Dar es Salaam between July and December 2011. Post-natal follow up was done on seventh day by contacting women by telephone to establish the neonatal status.

Results

There were 33,638 total deliveries of which 672 were twin deliveries making the prevalence of 2.0% (20 per 1,000 births). Of all twin deliveries analyzed (666 pairs), 373(56.0%) had the diagnosis of twin pregnancy made antenatally. Vaginal delivery was the major mode of delivery (77.3%). whereas combined delivery in which the first twin was delivered vaginally and the second twin by caesarian section accounted for only 2.6%. At birth 1252(94%) of twins were alive, 60(4.5%), were fresh stillbirths and 20(1.5%) were macerated stillbirths. Low Apgar score was more to first twins delivered vaginally compared to first twins (p-value=0.003). Low Apgar score (AS <7) was more amongst second twins delivered vaginally at 30 minutes or longer 27(48.2%) compared to twins delivered in less than 30 minutes 72(15.4%), (p-value=0.001).

Conclusion

There was a significant association between vaginal delivery and low Apgar score at one minute. Long duration of twin to twin delivery interval was associated with low Apgar score of the second twins delivered vaginally. Perinatal mortality rate was also higher in the second twins compared to the first twins. The time delivery interval of the second twin should be made as short as possible by active management of all second twins. Neonatal facilities are required in all hospitals conducting twin deliveries to care for premature babies.
Mining of Subtype Markers for the Prognosis of Ovarian Cancer based on Methylation Data
Authors: Yin Lili , Zhang Ningning , Yang Qing 
Published: February 2020

Abstract
Aims: Ovarian cancer is one of three major malignancies involving the female reproductive system, and its morbidity and mortality are ranked number 3 and number 1 among gynecological tumors, respectively. DNA methylation (MET), as one of the main epigenetic modes, is closely related to the occurrence and development of ovarian cancer. To guide individualized treatment and improve the prognosis in ovarian cancer patients, it is of great significance to elucidate effective MET subtype markers. Methods: A total of 571 ovarian cancer MET samples were downloaded from the Cancer Genome Atlas (TCGA), and a COX proportional hazards model was established using the MET spectrum and clinically pathological parameters. Subsequently, the consensus clustering of CpG loci with a significant difference in both univariate and multivariate analyses was performed to screen the molecular subtypes, and these CpG loci were subjected to gene function annotation. Finally, CpG MET loci associated with poor prognosis in ovarian cancer patients were further screened by constructing a weighted gene co-expression network analysis (WGCNA). Results: A total of 250 prognosis-related MET loci were obtained by COX regression and 6 molecular subtypes were screened by clustering. There was a remarkable MET difference between most subtypes, of which Cluster 2 had the highest MET level and demonstrated the best prognosis in patients, while Cluster 4 and Cluster 5 had a MET level significantly lower than that of the other subtypes and demonstrated a very poor prognosis. All Cluster 5 samples were at a high grade, while the percentage of Stage IV samples in Cluster 4 was evidently greater than that in the other subtypes. Using the co-expression network, 5 CpG loci were eventually obtained: cg27625732, cg00431050, cg22197830, cg03152385, and cg22809047. The clustering analysis shows that the prognosis in patients with hypomethylation was significantly worse than that in patients with hypermethylation. Conclusions: These MET molecular subtypes can be used not only to evaluate the prognosis in ovarian cancer patients but also to fully distinguish the tumor stage and histological grade in these patients. Prognosis-related CpG loci can be applied as biomarkers for individualized treatment in ovarian cancer patients.
Two-week global trends on 2019-nCoV fatality and virulence rates: a cross-sectional study
Authors: Arroz Jorge 
Published: February 2020

Abstract
BackgroundThe recent Public Health Emergency of International Concern, caused by a novel coronavirus (2019-nCoV) is fast spreading, and contribution for the increase of knowledge about this outbreak is desired. The aim of this study is to analyse the global trend of 2019-nCoV fatality and virulence rates from 24 January to 06 February 2020.MethodsA cross-sectional study was carried out. Data from 2019-nCoV, Severe Acute Respiratory Syndrome coronavirus (SARS-CoV) and Middle East Respiratory Syndrome coronavirus (MERS CoV) were obtained from World Health Organization. Only confirmed cases and deaths directly attributed to these viruses were considered. For 2019-nCoV, severe illness was also considered. Two endpoints of interest were analysed: trends in fatality rate (death among confirmed cases x 100) and virulence rate (severe illness among confirmed cases x 100).ResultsThe 2019-nCoV fatality and virulence rate decreased 1.0 and 7.3 percent points during the analysed time-frame, respectively. The SARS-CoV and MERS-CoV fatality rate are five and 17 times higher than the current 2019-nCoV fatality rate. The current cumulative 2019-nCoV confirmed cases exceeded 3.5 and 11.3 times the SARS-CoV and MERS-CoV confirmed cases, respectivelly.ConclusionsA reduction in fatality and virulence rate associated with the novel coronavirus was observed in the analyzed time-frame. The novel coronavirus is spreading at higher rates than SARS-CoV and MERS-CoV, although with comparative lower fatality rates. Continuous surveillance using additional indicators such as virulence rate (in addition to the fatality rate) may contribute to broaden and deepen the knowledge about the novel coronavirus.
Bench investigation of the accuracy of the dynamic approach in respiratory mechanics during noninvasive ventilation with different pressure support levels
Authors: Chen Yuqing , Yuan Yueyang , Zhang Hai , Li Feng , Zhou Xin 
Published: February 2020

Abstract
Background: Under the dynamic conditions of non-invasive mechanical ventilation, respiratory system mechanics parameters, including compliance (Crs) and airway resistance (Rrs), are affected by systemic and ventilator parameters. We evaluated the accuracy of respiratory mechanics in the dynamic approach in different lung disease models during pressure support ventilation (PSV).Methods: A Respironics V60 ventilator was connected to an active lung simulator for modeling four profiles of respiratory mechanics: normal, restrictive, obstructive and mixed obstructive/restrictive. PSV and positive end-expiration pressure (PEEP) were 2-25 cmH2O and 5 cmH2O, respectively. Measurements were performed with an air leak of 25-28 L/min. Ventilator performance and patient-ventilator asynchrony were evaluated by measuring flow, airway pressure, and volume. Crs and inspiratory/expiratory resistance (Rinsp/Rexp) were calculated by dynamic approach. Results: Crs was overestimated with pressure support (PS) at 5 cmH2O. Peak inspiratory/expiratory flow (PIF/PEF) and tidal volume (VT) was increased with PS level, while calculated Crs was decreased. At PS 10-15 cmH2O, the difference between calculated and preset Crs was ≤20% in higher resistance models (obstructive and mixed). In normal resistance conditions (restrictive and normal), the calculated Crs was always larger than the preset value significantly regardless of PS. Underestimations of Rinsp and Rexp were observed at PS 5-10 cmH2O. The calculation error might be controlled within 10% when PS above 15 cmH2O in higher resistance models. Conclusion: Higher gas flow is beneficial for Rrs estimation by using dynamic approach, whereas the calculation of Crs is always overestimated in normal resistance conditions.
Medical Chest Drain Insertion – Considerations for a Pleural Service
Authors: Liu Ying-Tung , Goh Zi Wei , Beckert Lutz 
Published: February 2020

Abstract
Aim:
To review local chest drain insertions, the indications, use of fibrinolytics, and the success rate of talc pleurodesis in a tertiary hospital in New Zealand.

Methods:
This is an observational study of all patients requiring chest drain insertion in the respiratory unit in Christchurch Hospital from January 2015 to December 2016. We analysed patient characteristics, type of drain inserted, and the nature of pleural fluid. We report the success of fibrinolytic therapy for empyema and pleurodesis for malignant pleural effusions.

Results:
A total of 486 chest drains were inserted for 333 patients, with a median age of 69 years. The majority of patients were male (60%) and 259 drains (53.3%) were inserted on the right. The main indications for chest drain insertion were malignant pleural effusions (50.5%), non-malignant pleural fluid (33.6%) and pneumothorax (17.7%). Most drains inserted were of small caliber; they were 12 French (Fr) (62.4%), central venous catheters to drain the pleural space (14.2%), and indwelling pleural catheters (10.9%). Talc slurry pleurodesis for malignant pleural effusions was used in 40 cases with a success rate of 75%.
In the 41 cases of empyema and complicated parapneumonic effusions (CPE), 29 organisms were cultured. The majority of organisms identified were Streptococcus and Staphylococcus species. Fibrinolytics were used in 26 cases (52%) of empyema and CPE. Of the 22 patients who required surgical intervention, only two had prior fibrinolytic therapy for empyema / CPE.

Conclusion:
Small bore catheters were used in Christchurch in keeping with international guidelines. The success rate of talc slurry pleurodesis and fibrinolytic therapy was in keeping with international experience.
miR-367-3p enhanced gastric cancer progression by targeting Smad7 to regulate the transforming growth factor-1/Smad3 pathway
Authors: Jing Yuan-ming , Zhang Lin , Zhang Yu , Wei guo Jian , Yang hui Jian , Huang liang Zong 
Published: February 2020

Abstract
Several studies have shown that miR-367-3p can function so as to promote or suppress the development of many forms of cancer, but its specific role in gastric cancer (GC) is not fully characterized. In this study, we found that patient GC samples exhibited significantly elevated miR-367-3p expression relative to healthy para-cancerous tissues, and the expression of this miRNA was positively correlated with features of more aggressive disease lymph node metastasis (p=0.025) and depth of invasion (p = 0.047). When miR-367-3p was overexpressed, this led to increased growth, migration, and epithelial-mesenchymal transformation of GC cells, whereas inhibiting this miRNA resulted in the opposite phenotype. Luciferase reporter assays further confirmed the ability of miR-367-3p to target Smad7 and to inhibit its expression. As Smad7 functions to suppress TGF-β1/Smad3 signaling, this miRNA is thus able to enhance TGF-β1/Smad3 signaling, which in turn drives GC progression and feed forward enhancement of this signaling pathway. Together these findings thus offer valuable new insight into the role of miR-367-3p in GC.
The fate of ARCO stage-II femur head necrosis with ring-shaped hardening zone: forty-one hips followed for average of nine years
Authors: Wu Zhong-Shu , Yang Peng , Yang Fan , Chen Xiao-Jun , Chen Zhen-Qiu , He Wei , Wei Qiu-Shi 
Published: February 2020

Abstract
Purpose The goal of this retrospective study is to report the lower collapse risk and good prognosis of the ARCO stage-II femur head necrosis with ring-shaped hardening zone. Methods We retrospectively recruited 30 patients (41 hips) with ring-shaped hardening zone from the ARCO stage II femur head necrosis. In these 41 hips with ring-shaped hardened bands, we found two subtypes which named type A and type B by us respectively. These hips were followed for a minimum of 5 years after the diagnosis. (average 9 years). Results 20 (48.8%) of the 41 hips suffered from hip pain, 18 (43.9%) of the them were painlessness, and 3 (7.3%) of the them were discomfort. Without special treatment, 9 (22.0%) of the 41 hips collapsed, 8 of them were type B and one was type A. At the last follow-up, the collapse of the nine hips were without apparent progress. At the most recent follow-up, the thirty patients had good daily hip function, 39 (95.1%) of the 41 hips were asymptomatic and only 2 (4.9%) of them were discomfort. ConclusionsThis study demonstrates that the ARCO stage II femur head necrosis with ring-shaped hardening zone at the middle of femoral head (stay away from the weight-bearing area) which called type A by our team have a low frequency of collapse. Surprisingly, we found that regardless of type A or type B, whether or not collapse occurred, the stage-II femur head necrosis with ring-shaped hardening zone has a good prognosis without special treatment.
Clinical assessment of three-dimensional printing assisted osteotomy guide plates in precise osteotomy of adult talipes equinovarus
Authors: Zhang Yuan-Wei , Xiong Liang-Yu , Huang Zu-Tai , Gao Wen-Cheng , Xiao Xin , Zhang Su-Li , Ni Wen-Yan , Deng Liang 
Published: February 2020

Abstract
Objectives: This current research is aimed to assess clinical efficacy and prognosis of three-dimensional (3D) printing assisted osteotomy guide plate in precise osteotomy of adult talipes equinovarus (ATE). Materials and Methods: We included a total of 27 patients of ATE malformation (including 12 males and 15 females) from January 2014 to June 2018 in current research. The patients were divided into the routine group (n=12) and 3D printing group (n=15) based on different operative methods. The parameters, including the operative time, intraoperative blood loss, complications, time to obtain bony fusion, functional outcomes based on American Orthopedic Foot and Ankle Society (AOFAS) and International Congenital Clubfoot Study group (ICFSG) scoring systems between the two groups were observed and recorded regularly. Results: The 3D printing group exhibits superiorities in shorter operative time, less intraoperative blood loss, higher rate of excellent and good outcomes presented by ICFSG score at last follow-up (P< 0.001, P< 0.001, P =0.019) than the routine group. However, there was no significant difference exhibited in AOFAS score at last follow-up and total rate of complications between the two groups (P=0.136, P =0.291). Conclusions: Operation assisted by 3D printing osteotomy guide plates for correcting the ATE malformation is novel and feasible, which might be an effective method to polish up the precise osteotomy of ATE malformation and enhance the clinical efficacy.