bluuebunny/crossref_metadata_2025_split huggingface dataset:
Isolated involvement of corpus callosum in metronidazole-induced encephalopathy with concomitant peripheral neuropathy
Authors: Peng Qing , You Qian , Zhang Jing , Liu Shui 
Published: May 2020

Abstract

Rationale:
Metronidazole is widely used for treating infection of anaerobic bacteria and protozoa. Metronidazole is generally well tolerated, although metronidazole-associated peripheral neuropathy (PN) and metronidazole-induced encephalopathy (MIE) have been reported as rare side effects. The most common sites of MIE involve the bilateral dentate nucleus of the cerebellum. Herein, we present a rare case of MIE with isolated corpus callosum involvement, with concomitant metronidazole-associated PN.

Patient concerns:
A middle-aged man with ulcerative colitis was diagnosed with amoebic dysentery because of unhygienic eating. After receiving metronidazole (1.8 g/d, cumulative dose 61.2 g) for >1 month, he started to complain of continuous paresthesia of the limbs, and intermittent speech problems. Magnetic resonance imaging demonstrated an isolated lesion in the splenium of the corpus callosum.

Diagnosis:
A diagnosis of reversible splenial lesion syndrome and PN was made. Given the patient's medical history, MIE and metronidazole-associated PN were considered.

Interventions:
Metronidazole was stopped. Mecobalamine and vitamin B1 were used for adjuvant treatment.

Outcomes:
At 1.5 months after stopping metronidazole, his symptoms of numbness and hyperesthesia had not improved, although he felt less ill. The isolated lesion disappeared on follow-up magnetic resonance imaging. At 6 months later, the hyperesthesia symptoms remained, and he was unable to resume his previous work.

Conclusions:
Physicians should consider MIE in their differentials for reversible splenial lesion syndrome when encountering a patient with a history of metronidazole medication and symptoms of encephalopathy, especially with concomitant PN. Early identification of this metronidazole-related complication and early cessation of the drug are essential for treatment.
Successful live birth in a woman with resistant ovary syndrome treated with letrozole and HMG
Authors: Mu Zhenni , Song Jingyan , Yu Yi , Sun Zhengao 
Published: May 2020

Abstract

Introduction:
Resistance ovary syndrome (ROS) is a disease characterized by hypergonadotropic amenorrhea but with normal ovarian reserve. Currently, its pathogenesis is still unclear and the treatment methods are complex. Nevertheless, there are evident negative effects of this disease on females’ physical and mental health such as gonadal dysplasia, infertility, anxiety, and depression. This article reports a case of successful ovulation induction and pregnancy with letrozole combined with HMG. This can provide clinical treatment guidelines for the disease.

Patient concerns:
The patient underwent several hormone replacement cycles and ovulation induction cycles. But the dominant follicles were not extracted even after using large doses of gonadotropin.

Diagnosis:
Resistant ovary syndrome; Primary infertility

Interventions:
Larger doses of letrozole combined with HMG were injected to stimulate ovulation and sensitize the ovaries during menstruation. This helped to examine the peripheral effects of letrozole in relation to gonadotropin.

Outcomes:
The patient displayed a dominant follicular growth and notable ovulation which resulted in a full-term pregnancy and successful delivery.

Conclusions:
The resistance ovary syndrome (ROS) can be treated and the findings from this case provides a possible treatment for ROS patients with infertility.
SARS-CoV-2 pneumonia with subcutaneous emphysema, mediastinal emphysema, and pneumothorax
Authors: Xiang Chunlin , Wu Gang 
Published: May 2020

Abstract

Introduction:
Since the end of 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has affected more than 1,000,000 population in the world. Subcutaneous emphysema and pneumothorax are uncommon complications of SARS-CoV-2 pneumonia. Herein, we describe a fatal case of SARS-CoV-2 pneumonia with subcutaneous emphysema and pneumothorax.

Patient concerns:
Subcutaneous emphysema was found in neck, bilateral chest walls, abdomen wall, groin area, and scrotum of a 67-year-old man. Extensive air-space opacities, subcutaneous emphysema and a small amount of pneumothorax were found in his chest X-ray scan. Echocardiography showed left ventricular enlargement with ejection fraction 20%.

Diagnosis:
This resident of Wuhan with laboratory-confirmed SARS-CoV-2 infection had chronic pulmonary and cardiac diseases. Liver dysfunction, myocardial injury, and coagulation disorder were suggested by laboratory findings. Pneumonia, subcutaneous emphysema, and pneumothorax were confirmed with chest X-ray. Heart failure was revealed by echocardiography.

Interventions:
He was transferred to intensive care unit, where invasive ventilation was used for him during the whole hospitalization. Prone position ventilation, vasoconstrictor, antibacteria, and antiviral therapy were given.

Outcomes:
He died on the twelfth day after admission.

Conclusions:
Subcutaneous emphysema and pneumothorax may occur in patients with SARS-CoV-2 pneumonia and chronic pulmonary disease. Chronic cardiac disease might be aggravated by SARS-CoV-2 infection, and develop heart failure.
Neonatal effect of remifentanil in cesarean section with general anesthesia
Authors: Zhang Qi , Kan Hong-Li , Wang Dong-Xin , Fu Dong-Mei 
Published: May 2020

Abstract

Background:
Although several previous studies have reported the efficacy of remifentanil in cesarean section (CS) under general anesthesia, no study has specifically addressed its neonatal effect (NE) in CS under general anesthesia systematically. Thus, this study will systematically investigate the NE of remifentanil in CS under general anesthesia.

Methods:
Electronic databases including MEDLINE, EMBASE, Cochrane Library, Web of Science, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure will be systematically retrieved with the assistance of a specialist librarian to check randomized controlled trials reporting NE in CS under general anesthesia. We will retrieve all electronic databases from their initial time to March 20, 2020 without restrictions of language. All process of study selection, data extraction, and risk of bias evaluation will be carried out by 2 independent authors. We will invite another senior expert to solve the problems that arise between 2 authors. Data will be pooled and analyzed using RevMan V.5.3 software.

Results:
Outcomes consist of assessment of neonatal adaptation, requirements for postoperative respiratory support of neonates, systolic and diastolic noninvasive blood pressure, mean blood pressure, heart rate, electrocardiography, umbilical cord blood gas analysis, and adverse events.

Conclusion:
This study will present evidence of the NE of remifentanil in CS under general anesthesia. This information may inform benefits of intervention to guide the usage of remifentanil in CS under general anesthesia.

Study registration:
INPLASY202040028.
Treatment of cervical spondylotic radiculopathy with posterior percutaneous endoscopic cervical discectomy
Authors: Yao Shudan , Ouyang Beiping , Lu Tingsheng , Chen Qiling , Luo Chunshan 
Published: May 2020

Abstract
To determine the short-term clinical outcomes of single-segment cervical spondylotic radiculopathy treated with posterior percutaneous endoscopic cervical discectomy (PPECD).
Data of a total of 24 patients who underwent PPECD and local anesthesia for single-level segmental cervical spondylotic radiculopathy between March 2016 and December 2017 were reviewed. The Japanese Orthopaedic Association, visual analog scale (VAS), and neck disability index scores at preoperative 1 day, postoperative 1 day, 1 week, 1 month, 3 months, 6 months, and 1 year were recorded. The modified MacNab criteria at the last follow-up were re-recorded for the evaluation of clinical effectiveness.
All operations were successfully completed under endoscopic guidance. No patient showed spinal cord, nerve root, vascular injuries, dural tears or other complications. The postoperative VAS scores of the arm and neck were significantly reduced compared with the preoperative VAS scores (P < .05), while postoperative the Japanese Orthopaedic Association scores were significantly increased (P < .05). The postoperative neck disability index scores were significantly reduced compared with preoperative scores (P < .05). The modified MacNab criteria at the last follow-up showed 16 excellent cases, 8 good cases, 0 fine cases, and 0 poor cases. Postoperative magnetic resonance imaging and cervical 3-dimensional computed tomography reconstruction showed that the intervertebral disc was adequately resected and the nerve root was not under compression.
PPECD is safe and effective for the treatment of single-segment cervical spondylotic radiculopathy.
Refractory adult Coats disease treated with dexamethasone intravitreal implant
Authors: Ding Yu-hua , Yao Bang-tao , Zhao Xiao-gui , Yu Hao , Liu Gang , Wang Xiu-ying 
Published: May 2020

Abstract

Introduction:
Coats disease is a sporadic, retinal vascular abnormality, causing blindness. Several interventional methods, including laser photocoagulation, have been proposed; however, the use of intravitreal dexamethasone in refractory Coats disease is not well described.

Patient concerns:
A 38-year-old man presented with a painless reduction in visual acuity in his right eye, commencing 15 days prior to initial assessment.

Diagnosis:
Clinical manifestations and multimodal imaging indicated Coats disease.

Interventions:
Retinal laser photocoagulation was performed in the nonperfused areas, 15 months later, the exudative retinal detachment, and macular edema remained, the patient was then treated with an intravitreal slow-release dexamethasone implant.

Outcomes:
The exudative retinal detachment and macular edema had resolved, and the BCVA had also improved.

Conclusion:
Dexamethasone intravitreal implantation was effective in treating refractory Coats disease.
Effect of intraoperative pressure ulcer preventive nursing on inflammatory markers in patients with high-risk pressure ulcers
Authors: Jin Feng , Fu Yan-jun , Zhang Yang , Yan Jing-ling , Zhou Kui-chen , Liu Hong-wei 
Published: May 2020

Abstract

Background:
This study will be designed to appraise the effects of intraoperative pressure ulcer preventive nursing (IPUPN) on inflammatory markers (IMs) in patients with high-risk pressure ulcers (HRPU) based on high quality randomized controlled trials (RCTs).

Methods:
In this study, we will perform a rigorous literature search from the following electronic databases: Cochrane Library, MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine Database, and Chinese Biomedical Literature Database. All electronic databases will be retrieved from their initial time to March 1, 2020 without limitations of language and publication status. We will only consider high quality RCTs that explored the effects of IPUPN on IMs in patients with HRPU. Two investigators will identify relevant trials, extract data, and appraise risk of bias in each eligible trial. Data will be pooled by either a fixed-effects model or a random-effects model according to the results of heterogeneity identification. The primary outcomes include IMs, and incidence of new pressure ulcers. The secondary outcomes are time to ulcer development, quality of life, length of hospital stay, and adverse events. Statistical analysis will be undertaken using RevMan 5.3 software.

Results:
This study will summarize high quality clinical evidence of RCTs to evaluate the effects of IPUPN on IMs in patients with HRPU.

Conclusion:
The expected findings may provide helpful evidence to determine whether IPUPN is an effective intervention on IMs in patients with HRPU.

INPLASY Registration Number:
INPLASY202040029.
Clinical efficacy and safety of somatostatin in the treatment of early postoperative inflammatory small bowel obstruction
Authors: Wu Zhongyong , Wang Suibiao , Yuan Shaofei , Lin Ming 
Published: May 2020

Abstract

Background:
As one of the complications after abdominal operation, early postoperative inflammatory small bowel obstruction (EPISBO) is a great trouble for many patients. The use of somatostatin in treating this disease had been widely reported, but its efficacy and safety were controversial. Therefore, the present research carried out a systematic review of the clinical efficacy and safety of somatostatin in treating EPISBO.

Methods:
Computer retrieval was conducted in foreign databases (including PubMed, The Cochrane Library, and Embase) and Chinese database (including Sino Med, CNKI, VIP, and WangFang Data), supplementary search for the literatures included was performed, and manual retrieval was performed in abstracts, books, and non-electronic magazines related to the present research to ensure the recall rate. Among all republished relevant experimental studies in Chinese and English from January 1, 1996 to February 1, 2020, randomized controlled trials on the curative efficacy of somatostatin for EPISBO were collected. The evaluation measures included patients’ total effective rate, peristaltic sound recovery time, time of disappearance of abdominal pain, time of first defecation after operation, drainage of gastrointestinal decompression and length of stay after treatment. The literatures were selected by two investigators independently to extract data according to the inclusion and exclusion criteria, Bias Risk Assessment Tool recommended by Cochrane Review Hand book 5.2 was used to assess literature quality, and meta-analysis was carried out by using soft Stata 12.0.

Results:
This study will scientifically and effectively analyze the clinical efficacy and safety of somatostatin in the treatment of EPISBO through systematic review and meta-analysis.

Ethics and dissemination:
The results of this study will be published in a peer-reviewed SCI journal to provide evidence-based medical evidence for the clinical treatment of early postoperative inflammatory bowel obstruction.

Protocol and registration:
Open Science Framework (https://osf.io, OSF), registration number: ryd2g.
Effectiveness of respiratory muscle training for patients with obstructive sleep apnea
Authors: Xue Shi-Min , Jia Juan , Fan Ping , He Shi-Wei 
Published: May 2020

Abstract

Background:
This study will evaluate the effectiveness and safety of respiratory muscle training (RMT) for patients with obstructive sleep apnea (OSA).

Methods:
Randomized controlled trials will be retrieved through electronic database searches from MEDLINE, EMBASE, Cochrane Library, CINAHL, Scopus, CBM, and CNKI from the beginning to the present. All electronic databases will be searched without any language limitation. Two researchers will independently select studies, collect data, and assess study quality, respectively. RevMan 5.3 software will be used for statistical analysis.

Results:
The primary outcome is severity of OSA, as measured by polysomnography or any relevant tools. The secondary outcomes are hypopnea index, apnea index, respiratory event index, respiratory disturbance index, sleep-related quality of life, and any expected or unexpected adverse events.

Conclusion:
The results of this study will summarize current evidence of RMT for the treatment of patients with OSA.

Systematic review registration:
INPLASY202040051.
Risk of carpal tunnel syndrome after parathyroidectomy in patients with end-stage renal disease
Authors: Wang Jie-Sian , Chen Wei-Shan , Lin Cheng-Li , Wang I-Kuan , Shen Ming-Yi 
Published: May 2020

Abstract
Carpal tunnel syndrome (CTS) is the most common mononeuropathy in clinical practice. Some patients with end-stage renal disease (ESRD) often associate with tertiary hyperparathyroidism, and ultimately need parathyroidectomy (PTX). However, no studies have definitively demonstrated an effect of PTX on ESRD patients’ quality of life. We selected 1686 patients who underwent PTX and 1686 patients who did not receive PTX between 2000 and 2010. These patients were propensity-matched with others by age, sex, and comorbidities at a ratio of 1:1. We used single and multivariable cox proportional hazard models to estimate hazard ratios (HRs) and corresponding 95% confidence intervals (CIs). In this study, 116 ESRD patients developed CTS, and the CTS incidences were 7.33 and 12.5 per 1000 person-years for the non-PTX and PTX group. The results reveal that the incidence curve for the PTX group was significantly higher than that for the non-PTX group (log-rank test, P = .004). After adjustments were made for sex, age, and baseline comorbidities, the PTX group had a 1.70-fold higher risk of CTS (hazard ratio (HR) = 1.70, 95% confidence intervals (CI) = 1.17–2.47) than the non-PTX group. The results also demonstrated that female patients (HR = 1.60, 95% CI = 1.06–2.42) and patients with one or more comorbidities (HR = 1.79, 95% CI = 1.23–2.60) might have an increased risk of CTS. The subhazard ratio for CTS risk was 1.62 (95% CI = 1.12–2.36) for the PTX group compared with the non-PTX group in the competing risk of death. In conclusion, we revealed that ESRD patients who had undergone PTX may have an increased risk of CTS.
Is septal deviation associated with headache?
Authors: Kwon Sam Hyun , Lee Eun Jung , Yeo Cha Dong , Kim Min Gul , Kim Jong Seung , Noh Sang Jae , Kim Eun Ji , Kim Su Geun , Lee Jong-Hwan , Yoo Ji Seob , Koh Ji hoon , Kim Byeong Jin 
Published: May 2020

Abstract
To investigate the potential relationship between septal deviation (SD) and headache using nationwide representative cohort sample data.
This study used a nationwide cohort sample from the Korean National Health Insurance Service database. The cohort sample was composed of 1 million patients, which is obtained by propensity score matching from 2002 to 2013. There were 9171 individuals in the SD group and 28243 in the control or no SD group. The Kaplan–Meier survival analysis, the log-rank test, and Cox proportional hazard regression analysis were used to calculate the incidence, survival curve, and hazard ratio of headache for each group.
There were no statistically significant differences in sex (P = .7708), age (P = .991), residential area (P = .9626), or socioeconomic status (P = .9982) between the 2 groups. The survival curve between SD and control or no SD showed a statistically significant difference. The adjusted hazard ratio for headache incidence during the 10-year follow-up period of the SD group was 1.37 (95% CI: 1.31-1.43).
This cohort study suggests that SD is associated with headache. Therefore, these findings suggest that septoplasty can be considered as 1 of the treatment option in SD patients with headache.
Genetic variants of mineral metabolism in health and disease
Authors: Robinson-Cohen Cassianne 
Published: May 2020

Purpose of review
Disturbances in mineral metabolism are common among individuals with chronic kidney disease and have consistently been associated with cardiovascular and bone disease. The current review aims to describe the current knowledge of the genetic aspects of mineral metabolism disturbances and to suggest directions for future studies to uncover the cause and pathogenesis of chronic kidney disease – mineral bone disorder.

Recent findings
The most severe disorders of mineral metabolism are caused by highly penetrant, rare, single-gene disruptive mutations. More recently, genome-wide association studies (GWAS) have made an important contribution to our understanding of the genetic determinants of circulating levels of 25-hydroxyvitamin D, calcium, phosphorus, fibroblast growth factor-23, parathyroid hormone, fetuin-A and osteoprotegerin. Although the majority of these genes are known members of mineral homeostasis pathways, GWAS with larger sample sizes have enabled the discovery of many genes not known to be involved in the regulation of mineral metabolism.

Summary
GWAS have enabled remarkable developments in our ability to discover the genetic basis of mineral metabolism disturbances. Although we are far from using these findings to inform clinical practice, we are gaining understanding of novel biological mechanisms and providing insight into ethnic variation in these traits.
Real-world experience of the role of 18F FDG PET-computed tomography in chronic spinal implant infection
Authors: Brown Philip H. , Carter Joseph R. , Moyade Pamela , Mohammed Mohammed , De Matas Marcus , Vinjamuri Sobhan 
Published: May 2020

Objectives
The presence of postinstrumentation back pain in patients after undergoing spinal surgery is a well established phenomenon. So too is the presence of infection, both overt and subclinical which can be a source of pain. The accurate assessment of infection in patients with spinal implants in situ and no overt radiological or biochemical abnormalities frequently presents a diagnostic challenge. We present our experience spanning 5 years of using 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography (18F FDG PET)-computed tomography (CT) scans to aid the diagnostic process in treating presumed low-grade chronic implant infection.

Methods
We undertook a retrospective analysis of all patients with spinal implants in place who were referred for 18F FDG PET-CT imaging over a 5-year period. All available images, case notes and laboratory results were reviewed.

Results
Data pertaining to 49 patients were analysed, with infection diagnosed on 18F FDG PET-CT in 24 (45%) of those sent for scanning. Fifteen patients in the cohort underwent revision surgery, and 11 of whom had been diagnosed as infected on PET-CT. Confirmation of infection with positive microbiological sampling occurred in 8/11 giving a positive predictive value of 0.72 in our series.

Conclusion
We present a real-world experience of using 18F FDG PET-CT as a diagnostic tool in the evaluation of patients with chronic pain after undergoing spinal implantation. We have found PET-CT to be a promising modality and would recommend multicentre collaboration to ensure reproducibility across more centres.
Bladder sparing landscape for bacillus Calmette-Guérin unresponsive bladder cancer
Authors: Soria Francesco , Giordano Andrea , Shariat Shahrokh F. , Gontero Paolo 
Published: May 2020

Purpose of review
The treatment of bacillus Calmette-Guérin (BCG) unresponsive disease remains a challenge for urooncologists. The search for effective conservative treatments is ongoing and several new agents have been recently tested for this purpose. The aim of this manuscript was to review the last developments in this interesting field.

Recent findings
The advent of systemic immunotherapy in the nonmuscle invasive setting promise to revolutionize the paradigm of treatment of BCG unresponsive disease. The preliminary results of the Keynote-057 trial (3 months complete response of 41% in carcinoma-in-situ patients) have led to the rapid approval of pembrolizumab from the Food and Drug Administration. Interesting results have been reported for gene therapies such as those with CG0700 and Adstiladrin, nonreplicating adenovirus able to increase the ‘in situ’ antitumor activity. However, larger prospective trials with longer follow-up are needed to confirm the initial findings.

Summary
In summary, early radical cystectomy remains the standard treatment for BCG unresponsive patients. However, in case of patients unfit for or refusing radical cystectomy, the bladder-sparing options are continuously increasing. Although BCG-reinduction (with or without interferon) and traditional intravesical chemotherapy may represent the past, the present and the future are characterized by device-assisted therapies, systemic immunotherapy, and gene therapy.