bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prognostic significance of preoperative albumin to fibrinogen ratio associated nomograms in patients with breast invasive ductal carcinoma
Authors: Zheng Lihua , Zhao Yaheng , Liu Feng , Liu Peng , Li Wei , Yang Yan , Zhang Hongsong , Liu Yunjiang 
Published: June 2020

Abstract
Plasma albumin to fibrinogen ratio is involved in human cancer, but its prognostic significance in breast cancer is controversy. In the context of breast invasive ductal carcinoma, this research aims to retrospectively evaluate by preoperative plasma albumin to fibrinogen ratio (AFR) and forecast oncological outcome and recurrence.
This retrospective study comprised 230 patients with non-metastatic breast invasive ductal carcinoma who underwent surgery between January 2009 and April 2012 in Fourth Hospital of Hebei Medical University. Patients were categorized base on an optimal value of preoperative plasma fibrinogen (Fib) and albumin. Progression-free and cancer-specific survival were assessed using Kaplan–Meier method. The associations between albumin to fibrinogen ratio and clinical outcomes were assessed with univariate and multivariate analysis. A number of risk factors were used to form nomograms to evaluate survival, and Harrell concordance index (C-index) was used to evaluate the predictive accuracy.
Plasma AFR was significantly associated with diminished disease-free survival (DFS) and overall survival (OS). Multivariate analysis revealed that plasma AFR was an independent prognostic indicator for DFS (HR = 1.346; 95% CI: 1.107–1.636; P = .03) and overall survival (OS) (HR = 1.485; 95% CI: 1.106–1.993; P = .008). Two prediction model of 3-, 5-years OS and DFS based on the AFR was developed.
Elevated preoperative plasma AFR is an independent prognostic factor for oncological outcomes in patients with breast invasive ductal carcinoma. The formulated nomogram showed superior predictive accuracy for DFS and OS.
A novel TJP1-ROS1 fusion in malignant peripheral nerve sheath tumor responding to crizotinib
Authors: Li Juming , Liu Lingxiang , Zhang Qi , Huang Yumin , Zhang Yihong , Gan Xiaoyan , Liu Siqin , Yue Zhen , Wei Yongzhong 
Published: June 2020

Abstract

Rationale:
Malignant peripheral nerve sheath tumor (MPNST) is a rare sarcoma. Owing to the lack of specific histological criteria, immunohistochemical, and molecular diagnostic markers, several differential diagnoses must be considered. Advances in molecular testing can provide significant insights for management of rare tumor.

Patient concerns:
The patient was a 50-year-old man with a history of lumpectomy on the right back 30 years ago. He felt a stabbing pain at the right iliac fossa and went to the local hospital.

Diagnosis:
By immunohistochemistry, the tumor cells stained positively for S-100 (focal +), CD34 (strong +++) and Ki-67 (20%), and negatively for smooth muscle actin, pan-cytokeratin, neurofilament, pan-cytokeratin-L, GFAP, CD31, STAT6, ERG, myogenin, and MyoD1. Combined with the histopathology and immunohistochemistry results, our initial diagnosis was solitary fibrous tumor (SFT) or MPNST. The tissue biopsy was sent for next-generation sequencing. neurofibromatosis type 1 Q1395Hfs∗22 somatic mutation, neurofibromatosis type 1 D483Tfs∗15 germline mutation, and amplifications of BTK, MDM2, ATF1, BMPR1A, EBHA2, GNA13, PTPN11, RAD52, RPTOR, and SOX9, as well as TJP1-ROS1 fusion, CDKN2A-IL1RAPL2 fusion and CDKN2A/UBAP1 rearrangement were identified. Given that NAB2-STAT6 fusion, a specific biomarker of SFT, was not identified in our patient's tumor, the SFT was excluded by through genetic testing results. Therefore, our finally diagnosis was a MPNST by 2 or more pathologists.

Interventions and outcomes:
Subsequently, the patient received crizotinib therapy for 2 months and showed stable disease. However, after crizotinib continued treatment for 4 months, the patient's disease progressed. Soon after, the patient stopped crizotinib treatment and died in home.

Lessons:
To our knowledge, this is the first report of the TJP1-ROS1 fusion, which expands the list of gene fusions and highlights new targets for targeted therapy. Also, our case underlines the value of multi-gene panel next-generation sequencing for diagnosis of MPNST.
A comprehensive evaluation of association between homocysteine levels and single nucleotide polymorphisms with hypertension risk
Authors: Kong Yixuan , Zheng Jinghui , Xu Xiangmei , Chen Xuan , Wang Jie , Lu Liying , Ye Zhuomiao 
Published: June 2020

Abstract

Background:
According to the relevant reports that single nucleotide polymorphisms (SNPs) may contribute to change of homocysteine (HCY) levels and increase the risk of hypertension (HTN). During the inconsistent results, this meta-analysis purpose is systematically review and synthesized relevant data on HCY levels and SNPs in HTN.

Methods:
The systematic search database, from the following database to find out the association studies of SNPs and HTN publications up until March 2020 from the databases of PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), the Chinese Science and Technology Periodical Database (VIP) and Wan fang databases, and Chinese Biomedical Literature Database (CBM). Network meta-analysis and Thakkinstian's algorithm were used to select the most appropriate genetic model, along with false positive report probability (FPRP) for noteworthy associations. All statistical analyses were calculated with STATA software (version 14.0; StataCorp, College Station, TX).

Results:
This meta-analysis will provide high-quality evidence to the effects of SNP on HTN and levels of HCY, and find between SNPs and HTN susceptibility on in all the genetic models, and choose the best one.

Conclusions:
This meta-analysis will research which SNP is the most correlated with HTN risk.

Registration:
INPLASY202050002
Labial adhesion in a postmenopausal female
Authors: Laih Chun-Yo , Huang Chi-Ping , Chou Eric Chieh-Lung 
Published: June 2020

Abstract

Rationale:
Voiding difficulty is more common in males, although it is not uncommon in females. Female voiding difficulty can be caused by iatrogenic, anatomic, and neurogenic factors, and specifically urethra stricture, impaired detrusor contractility, primary bladder neck obstruction, and detrusor-external sphincter dyssynergia. Labial adhesion is a rare cause of female voiding difficulty.
The incidence of labial fusion has been reported to be 0.6% to 1.4% in children; however, the incidence in the elderly has yet to be fully elucidated.

Patient concerns:
We present the case of a postmenopausal and sexually inactive 76-year-old female patient who had nearly total vaginal and urethral occlusion due to labial adhesion. She had no underlying diseases and came to our clinic with a 10-month history of voiding difficulty, postmicturition dribbling, and involuntary urinary leakage when getting up.

Diagnosis:
A genital examination revealed nearly total fusion of the labia minor with only a 3-mm pinhole opening at the posterior end.

Interventions:
Treatment included surgical separation, the local application of estrogen cream, and self-dilatation. She also received an antimuscarinic agent to treat overactive bladder secondary to bladder outlet obstruction which was caused by labial adhesion.

Outcomes:
No surgical complications occurred. Moreover, no labial adhesion or voiding dysfunction was found immediately after the surgery or after 6 months of follow-up.

Lessons subsections:
Genital examinations are a basic but very important noninvasive skill for physicians. This case report highlights that genital examinations should be a priority for patients with gynecological or urological symptoms.
Expectant management and live birth outcomes for male balanced-translocation carriers
Authors: Fan Haitao , Wang Xiuyan , Yang Xiao , Zheng Hongshu , Feng Shuqiang 
Published: June 2020

Abstract

Rationale:
Couples with male balanced-translocation carriers may experience recurrent pregnancy loss (RPL). Although the expectant management of RPL has developed over many years, genetic counseling for RPL couples with male balanced-translocation carriers remains challenging. Here, we describe the expectant management of 2 male carriers of balanced translocations.

Patient concerns:
A 32-year-old and a 28-year-old man presented at the clinic with diagnoses of infertility following spontaneous abortions by their wives.

Diagnosis:
Both patients had normal semen diagnosed by routine semen analysis and underwent cytogenetic diagnoses.

Interventions:
Following genetic counseling and informed consent, both couples voluntarily chose expectant management with natural conception.

Outcomes:
One couple experienced 2 natural pregnancies, the first of which ended in spontaneous abortion and the second produced a phenotypically normal infant. The other couple's first pregnancy resulted in a fetus with a balanced translocation confirmed by amniocentesis and cytogenetic analysis.

Lessons:
Expectant management with natural conception may be an alternative to genetic counseling in male balanced-translocation carriers with RPL, especially those who are reluctant to undergo preimplantation diagnosis.
Apatinib plus retinoic acid as maintenance for children with relapsed stage 4 high-risk neuroblastoma
Authors: Jin Mei , Zhang Dawei , Zhao Qian , Zhao Wen , Huang Cheng , Wang Xisi , Duan Chao , Su Yan , Ma Xiaoli 
Published: June 2020

Abstract

Introduction:
Metastatic neuroblastoma (NB) is an aggressive malignancy with a poor prognosis. Many patients present with relapsed high-risk NB after undergoing first-line treatment, and there is no standard therapy available in this setting.

Patient concerns:
The present study aimed to present the cases of 2 patients with recurrent high-risk NB.

Diagnosis:
Two children with International Neuroblastoma Stage System stage 4 high-risk NB chemotherapy. The disease recurrent after finishing the treatment.

Interventions:
Both patients (34 months old and 41 months old) experienced recurrence, received second-line treatment, and then received maintenance treatment using apatinib plus retinoic acid. The apatinib (10 mg/kg per day) and retinoic acid (160 mg/m2 per day) were administered on alternating 2-week cycles, which was continued for 1 year.

Outcomes:
The 2 patients had achieved complete response by the 1-year follow-up after starting apatinib plus retinoic acid, and did not experience any adverse drug reactions.

Conclusion:
The outcomes from these cases suggest that apatinib plus isotretinoin might be an option for maintenance therapy in patients with recurrent high-risk NB.
The efficacy and safety of sulforaphane as an adjuvant in the treatment of bipolar depressive disorder
Authors: Wu Congchong , Chen Xingyang , Lai Jianbo , Xu Yi , Hu Shaohua 
Published: June 2020

Abstract

Background:
Bipolar disorder (BD) is a chronic and disabling psychiatric disorder. The treatment of BD still remains a significant clinical challenge due to the complex nature of the disease. Nutraceutical therapy as adjunctive role is a promising therapy for BD. Sulforaphane (SFN), a broccoli extract, was reported to be effective for emotional problems and cognitive impairment. However, clinical research of SFN in the treatment of BD was rare. Therefore, this study is designed to evaluate the adjuvant role of SFN in the treatment of BD.

Methods:
This is a randomized, double-blinded, placebo-controlled, parallel-group clinical trial. A total of 100 patients who meet inclusion criteria will be assigned to receive quetiapine plus SFN or quetiapine plus placebo in a 1:1 ratio. The total duration of the study will be 12 weeks including 5 follow ups. The primary outcome is in the Montgomery–Asberg depression rating scale. The secondary outcomes are the quick inventory of depressive symptomatology—self report, Hamilton anxiety rating scale, young mania rating scale, cognitive function, inflammatory factors, and intestinal flora. Any adverse events will be recorded throughout the trial.

Discussion:
This trial will provide evidences to evaluate the efficacy and safety of SFN combined with quetiapine in the treatment of BD patients, as well as the adjuvant role of SFN in combination.

Trial registration:
This study protocol was registered at the Chinese clinical trial registry (ChiCTR2000028706).
Case report: An unusual presentation of acute promyelocytic leukemia in a middle aged female mimicking dengue infection
Authors: Yapor Laura , Zahid Maleeha , Shrestha Nikee , Walck Randee , Schreiber Zwi , Adrish Muhammad 
Published: June 2020

Abstract

Rationale:
Acute promyelocytic leukemia (APL) is an uncommon subtype of acute myeloid leukemia (AML). M3v phenotype is a less common presentation of APL and these patients usually present with leukocytosis and abnormal promyelocytes that are characterized by sparse granulation and are less likely to have faggot cells with multiple Auer rods. Distinguishing M3v phenotype from acute febrile illness can be challenging as the diagnosis relies on examination of peripheral smear.

Patient concerns:
Fifty-seven-year-old female who presented after recent trip to Dominican Republic for high grade fever and gum bleeding. She was exposed to patients with Dengue fever during her stay. At presentation, patient had leukocytosis, thrombocytopenia, and urinalysis showing bacteria and white cell. She was started on treatment for urinary tract infection. Patient remained febrile and thrombocytopenia worsened. On day 2, flow cytometry of the peripheral smear showed 43% medium sized blasts. Fluorescence in situ hybridization was positive for promyelocytic leukemia/retinoic acid receptor alpha.

Diagnoses:
The patient was diagnosed with APL.

Interventions:
Patient was started on treatment with all-trans retinoic acid and arsenic trioxide along with supportive care

Outcomes:
Patient had a favorable clinical response and her symptoms subsided.

Lessons:
Flow cytometry of the peripheral smear is key to diagnosis of suspected APL. One must maintain high suspicion for this life-threatening condition as early diagnosis saves lives.
Patterns of Prior and Subsequent Neoplasms in Children and Adolescents With Soft Tissue Sarcomas
Authors: Uckunkaya Oliver , Nöllke Peter , Hallmen Erika , Becker Cornelia , Stegmaier Sabine , Sparber-Sauer Monika , Vokuhl Christian , Koscielniak Ewa , Hettmer Simone 
Published: June 2020

Background:
The occurrence of prior, concurrent and subsequent neoplasms (SN) represents a serious problem in children and adolescents with soft tissue sarcomas. Pathogenic germline variants contribute to the diagnosis of multiple neoplasms in sarcoma survivors.

Materials and Methods:
The records of 748 children and adolescents, diagnosed with soft tissue sarcomas and registered in trials/registries by the cooperative soft tissue sarcoma (Cooperative Weichteilsarkom Studie) group, were reviewed for the occurrence of SNs. Reference histology review was available for all cases; the presence of oncogenic fusions known at the time of diagnosis was confirmed for fusion-positive (F+) entities.

Results:
Concurrent or subsequent SNs developed in 13 of 473 survivors of fusion-negative (F−) sarcomas, for an 8-year cumulative SN incidence of 5% in survivors of F− sarcomas. In contrast, only 1 of 278 survivors of F+ sarcoma developed an SN. Twenty of 748 patients with soft tissue sarcomas had a history of prior neoplasms. Six of 14 patients who developed SNs after their index sarcomas met Chompret criteria for Li-Fraumeni syndrome. Nine of 20 patients who had tumors before their index sarcoma diagnosis had neurofibromatosis type 1 or neurofibromatosis type 1 spectrum tumors.

Conclusion:
Sarcoma phenotype/genotype and the sequence and nature of prior and subsequent neoplasms provide a window into underlying germline genetic susceptibilities in children and adolescents with soft tissue sarcomas.
Adverse Events Related to Accidental Unintentional Ingestions From Cough and Cold Medications in Children
Authors: Wang George Sam , Reynolds Kate M. , Banner William , Bond G. Randall , Kauffman Ralph E. , Palmer Robert B. , Paul Ian M. , Rapp-Olsson Malin , Green Jody L. , Dart Richard C. 
Published: June 2020

Objectives
Previous research has demonstrated that accidental unsupervised ingestions (AUIs) were responsible for the majority of cough and cold medication (CCM) ingestions leading to significant adverse events (AEs) in children. The objective of this analysis was to characterize the role of AUIs in the morbidity associated with CCM exposure in children.

Methods
This surveillance study collected data from 5 United States data sources from 2009 to 2016, in children younger than 6 years with an AE from an AUI involving at least 1 CCM over-the-counter pharmaceutical ingredient. An expert panel reviewed each case to determine causality.

Results
From 4756 total cases reviewed, 3134 (65.9%) had an AE from an AUI determined to be at least potentially related to a CCM ingredient. The majority (61.3%) of cases occurred in children aged 2 to younger than 4 years. Most exposures occurred in the child's own residence (94.9%), and 43.8% were admitted to a health care facility (22.0% to a critical care unit). Dextromethorphan and diphenhydramine, when packaged alone or in combination products, contributed to 96.0% of AUIs. The most common specific products involved were single-ingredient pediatric liquid diphenhydramine (30.1%) and single-ingredient pediatric liquid dextromethorphan (21.4%). There were 3 deaths from solid diphenhydramine formulations.

Conclusions
There continues to be opportunities for the implementation of interventions to prevent AUIs of CCM in children. Additional emphasis on engineering controls, such as flow restrictors for liquid formulations targeting diphenhydramine and dextromethorphan products, represent additional opportunities to further reduce AEs from AUIs of CCM.
Digital Phenotyping to Quantify Psychosocial Well-Being Trajectories After Spinal Cord Injury
Authors: Mercier Hannah W. , Hamner Jason W. , Torous John , Onnela Jukka Pekka , Taylor J. Andrew 
Published: June 2020

Objective
The aim of the study was to explore feasibility of smartphone-based digital phenotyping methods to examine depression and its relation to psychosocial well-being indicators after spinal cord injury.

Design
Smartphone research platform obtained smartphone sensor and survey data among community-living adult wheelchair users with spinal cord injury. Weekly measurements for 4 mos included Patient Health Questionnaire 8, Spinal Cord Injury–Quality of Life Satisfaction with and ability to participate in social roles and activities, global positioning system–derived community mobility metrics, health conditions, and physical activity.

Results
Forty-three individuals were enrolled. Study retention was higher among individuals offered financial incentives (78%) compared with participants enrolled before incentives (50%). Participants who dropped out more commonly had nontraumatic or acute spinal cord injury, were older, and had less satisfaction and lower participation in social roles and activities. Among 15 individuals with complete data, half had 1 wk or more of mild depression. Those with depression had frequent health issues, less satisfaction, and lower participation in social roles and activities. Those without depression experienced increased social engagement over time. Average community mobility was similar across depression groups. Relationships were typically in-phase but also varied by individual.

Conclusions
Smartphone-based digital phenotyping of psychosocial well-being after spinal cord injury is feasible but not without attrition challenges. Individual differences in depression patterns highlight clinical utility of scaling these methods.
Public Perceptions on Breast Implant–Associated Anaplastic Large Cell Lymphoma
Authors: Lee Erica , Khavanin Nima , He Waverley , Darrach Halley , Kraenzlin Franca , Jenny Hillary , Yang Robin , Sacks Justin M. 
Published: June 2020

Background:
Breast implant–associated anaplastic large cell lymphoma (BIA-ALCL) has entered the spotlight, as several high-profile media outlets have begun to relay the evolving science to the public. This study aimed to gauge the baseline knowledge and concern regarding BIA-ALCL among adult laywomen within the United States.

Methods:
Mechanical Turk was used to survey 500 American women on self-reported demographics, prior experience with breast implants, and 11 questions regarding their knowledge and concern regarding BIA-ALCL. Responses were reviewed for quality control before study inclusion.

Results:
Overall, 12 percent of respondents had received breast implants and 73 percent knew someone with implants; 13.6 percent of respondents (including 51.7 percent of respondents with implants) had previously heard of BIA-ALCL. After providing information about its risk, 58.4 percent of respondents were still willing to receive a reconstructive implant and 45.8 percent a cosmetic implant; 35.8 percent reported they would be less likely to receive an implant. Of the respondents with breast implants, 66.7 percent reported some degree of concern regarding BIA-ALCL and 35.0 percent are strongly considering removing their implants. Those who had heard of BIA-ALCL consumed information from several sources, predominantly health professionals or media/health care blogs. Different sources of information were not associated with a respondent’s degree of concern.

Conclusions:
Only a minority of American women have heard of BIA-ALCL and understand its association with breast implants. As plastic surgeons who perform breast reconstruction, we can promote the spread of information through the popular media and health care blogs to address this growing concern, particularly among women with existing breast implants.
Nonaesthetic Applications for Botulinum Toxin in Plastic Surgery
Authors: Freeman Matthew D. , Margulies Ilana G. , Sanati-Mehrizy Paymon , Burish Nikki , Taub Peter J. 
Published: June 2020

Background:
Since their introduction to clinical medicine in 1989, botulinum toxin injections have been used for many indications. First used for nonsurgical management of strabismus, botulinum toxin injections are now widely used in plastic and reconstructive surgery for aesthetic indications; however, nonaesthetic indications of botulinum toxin have grown tremendously over the past two decades and span numerous specialties, including urology, dermatology, ophthalmology, otolaryngology, gynecology, plastic surgery, general surgery, and neurology. The present review aims to highlight nonaesthetic indications of botulinum toxin that are most relevant to the plastic surgeon with an emphasis on evidence-based practice.

Methods:
A PubMed search with manual reference checking was conducted to find the most relevant and influential articles on the nonaesthetic uses of botulinum toxin within the realm of adult plastic surgery. Studies were then categorized into areas of use, and quality of evidence for each category was highlighted.

Results:
Botulinum toxin has numerous nonaesthetic indications in plastic surgery, including for select pain-related disorders, skeletal muscle activity disorders, exocrine gland hyperfunction, wound healing, Raynaud phenomenon, abdominal wall reconstruction, and prosthetic breast reconstruction and augmentation. Although these indications have been widely reported, high-quality evidence supporting efficacy, optimal dose, and injection protocol with randomized controlled trials is lacking in many areas.

Conclusions:
Botulinum toxin is widely used in plastic surgery for a variety of nonaesthetic indications. Future studies should focus on investigating efficacy and best practice with high level of evidence research.