bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of radiographic sacroiliitis in anteroposterior lumbar vs conventional pelvic radiographs in axial spondyloarthritis
Authors: Rodriguez Valeria Rios , Llop Maria , Protopopov Mikhail , Sieper Joachim , Haibel Hildren , Proft Fabian , Rudwaleit Martin , Poddubnyy Denis 
Published: April 2020

Abstract

Objective
The aim was to investigate the reliability and validity of radiographic sacroiliitis assessment in anteroposterior (AP) lumbar radiographs compared with conventional pelvic radiographs in patients with axial spondyloarthritis (axSpA).

Methods
Patients from the German Spondyloarthritis Inception Cohort were selected based on the availability of pelvic and AP lumbar radiographs with visible SI joints at baseline and year 2. Two readers scored the images independently in a random order according to the modified New York criteria. The sacroiliitis sum score was calculated as the mean of both readers. Patients were classified as radiographic (r-)axSpA if radiographic sacroiliitis of grade ≥2 bilaterally or grade ≥3 unilaterally was present in the opinion of both readers and as non-radiographic (nr-)axSpA otherwise. The reliability and validity of sacroiliitis assessment in AP lumbar radiographs was assessed using intraclass correlation coefficients (ICCs), absolute agreement and κ statistics.

Results
A total of 226 sets of radiographs were scored from 113 patients included in the study. The ICC for the sacroiliitis sum score was 0.91 at both baseline and year 2. A total of 62 (54.9%) and 55 (48.7%) patients were classified as r-axSpA at baseline and 65 (57.5%) and 60 (53.1%) patients at year 2 based on evaluation of pelvic and AP lumbar radiographs, respectively. The absolute agreement between the methods on the classification was 84.9 and 85.0% at baseline and year 2, respectively, with the κ of 0.70 at both time points.

Conclusion
Radiographic sacroiliitis can be assessed in AP lumbar radiographs with a similar reliability to conventional pelvic radiographs.
Idiopathic multicentric Castleman disease with novel heterozygous Ile729Met mutation in exon 10 of familial Mediterranean fever gene
Authors: Endo Yushiro , Koga Tomohiro , Otaki Hiroki , Sasaki Daisuke , Sumiyoshi Remi , Furukawa Kaori , Tanaka Yoshimasa , Katsunori Yanagihara , Kawakami Atsushi 
Published: April 2020

Abstract

Objective
While the aetiology of idiopathic multicentric Castleman disease (iMCD) remains unclear, the involvement of autoinflammatory mechanisms has been suggested. Herein we report a Japanese patient with iMCD with a novel heterozygous Ile729Met mutation in exon 10 of the Mediterranean fever (MEFV) gene.

Methods
We performed genetic analysis via targeted next-generation sequencing analysis and Sanger sequencing and conducted molecular dynamics simulations to investigate the hydrophobic interactions around the 729th amino acid in human pyrin.

Results
In February 2011, a 59-year-old man was diagnosed with IgG4-related disease at our department based on the findings of cervical and hilar lymphadenopathies, typical lung lesions and cervical lymph node biopsy. The patient was followed up without treatment, as he was asymptomatic. However, he had been experiencing prolonged fatigue and fever with high levels of CRP since June 2017. Axillary lymph node biopsy findings led to the diagnosis of iMCD. He was successfully treated with an IL-6 inhibitor and has been in remission for 12 months. Genetic analyses for hereditary autoinflammatory disease–related genes were performed, revealing a novel heterozygous Ile729Met mutation in exon 10 of the MEFV gene. We identified that this novel mutation significantly altered the local interaction of the human pyrin B30.2 domain by molecular dynamics simulation analysis and experimentally had the potential for inflammasome activation with increased inflammatory cytokines.

Conclusion
The abnormal function of pyrin due to a mutation in the MEFV gene in this patient may have contributed to the development of MCD by inducing IL-6 production via inflammasome signalling.
The Usefulness of Zhukovsky Double Balloon in Obstetric Hemorrhage
Authors: Barinov Sergey V. , Medyannikova Irina V. , Borisova Anna V. , Tyrskaya Yulia I. , Savelieva Irina V. , Shamina Inna V. , Lazareva Oksana V. , Kadtsyna Tatyana V. 
Published: April 2020

Abstract

Objective:
To evaluate the effectiveness of the use of a modified Zhukovsky double (vaginal and uterine) balloon to improve the results of treatment in women with obstetric hemorrhage.

Methods:
We conducted an observational controlled study including 701 puerperas, which were divided into two groups: The main group consisted of 508 women, who underwent a combined management, that is, traditional (transfusion of fresh frozen plasma, erythrocyte mass, uterotonics, hemostatic agents), surgical hemostasis in cases of caesarean section, and insertion of a double Zhukovsky balloon; while the comparison group included 193 patients, who were managed traditionally. The main group and the comparison group were divided into subgroups according to the main etiology of obstetric hemorrhage: IA and IB—postpartum; IIA and IIB—placenta accreta; IIIA and IIIB—postpartum hysterectomy.

Results:
The most frequent causes of massive obstetric hemorrhage were atony of the uterus (39.2%), placenta previa (29.1%), and placental abruption (11.5%). Of the 508 balloon insertions, 345 (70.7%) were inserted for hemorrhage during cesarean section and 148 (29.3%) for obstetric hemorrhage after spontaneous delivery. Among the obstetric hemorrhage at caesarean section, lower segment bleeding prevailed (78.1%), caused mainly by placenta previa, placenta accreta, placental abruption, polyhydramnios, and uterine scar defects. Combined management, including surgical hemostasis and insertion of vaginal and uterine balloon of Zhukovsky, reduced blood loss by 1.5 times and the number of hysterectomies by 6.72 times compared to controls.

Conclusion:
The use of a modified Zhukovsky double balloon in the management of obstetric hemorrhage may reduce the number of hysterectomies and the amount of blood loss.
Antiphospholipid Antibody Syndrome: Pathogenesis, Diagnosis, and Management in Pregnancy
Authors: Khangura Raminder Kaur , Cooper Shontreal , Luo Guo-Yang 
Published: April 2020

Abstract
Antiphospholipid antibody syndrome is an autoimmune disorder that primarily affects reproductive age women and poses significant obstetric complications. Here we review the pathogenesis, diagnosis, obstetric complications, and management in women with antiphospholipid antibody syndrome.
Role of Ultrasonography in Pregnancies Complicated by Gestational Diabetes: A Review
Authors: Sinno Sara S. Hamze , Nassar Anwar H. 
Published: April 2020

Abstract
This review is to better clarify the role of ultrasonography during pregnancies complicated with gestational diabetes mellitus (GDM). It will focus on the effect of GDM on pregnancy, and the use of ultrasound modality to estimate fetal size and accordingly the mode of delivery. It will also shed light on how this technology can be used to improve our understanding of the pathophysiology of this diagnosis and hopefully improve the maternal-fetal outcome.
Maternal Thyroid-Stimulating Hormone Level and Thyroid Peroxidase Antibody Status in the First and Second Trimester of Pregnancy and Their Relationship with the Risk of Gestational Diabetes Mellitus
Authors: Deng Song-Qing , Chen Hai-Tian , Wang Dong-Yu , Liu Bin , Chen Han-Qing , Wang Zi-Lian 
Published: April 2020

Abstract

Objective:
To investigate thyroid-stimulating hormone (TSH) levels and thyroid peroxidase antibody (TPOAb) in early pregnancy and to estimate the risk of development of gestational diabetes mellitus (GDM).

Methods:
The levels of TSH, free thyroxine, free triiodothyronine, and TPOAb were retrospectively evaluated in 2333 pregnant women. All women recruited were divided into groups of TSH high (H), TSH low (L), TSH (H) TPOAb positive (+), TSH (H)TPOAb negative (−), TSH normal (N)TPOAb (+), TSH (L)TPOAb (+), TSH (L)TPOAb (−), and estimated the risk of GDM.

Results:
TSH level (X
2 = 13.0024, P = 0.0015) and TSH combined TPOAb (X
2 = 20.0038, P = 0.0012) were correlated to development of GDM. The level of TSH in 95 women was increased, and in 216 women were decreased. Of the 2333 pregnant women, 546 patients were diagnosed with GDM, with a prevalence of 23.40%. The prevalence of GDM was 35.78% and 28.70% for the TSH high (H) and TSH low (L) pregnant women, respectively. The increased TSH (P = 0.0013, odds ratio: 2.09, confidence interval:1.34–3.28) was correlated to increase GDM incidence. TSH (H) TPOAb (+) (n = 29), TSH (H) TPOAb (−) (n = 58), TSH normal (N) TPOAb (+) (n = 265), TSH (L) TPOAb (+) (n = 30), TSH (L) TPOAb (−) (n = 154) were in this study. The prevalence of GDM was 51.72%, 29.31%, 23.02%, 26.67%, and 29.87% for the TSH (H) TPOAb (+), TSH (H) TPOAb (−), TSH (N) TPOAb (+), TSH (L) TPOAb (+), and TSH (L) TPOAb (−) pregnant women, respectively. Only the TSH (H) TPOAb (+) pregnant women had a significant higher incidence of GDM (P = 0.0018, odds ratio: 3.63, confidence interval: 1.62–8.16). Trimester specific results showed that only second trimester had higher GDM risk either analyze TSH or the combination of TSH and TPOAb.

Conclusion:
Elevated TSH level and TPOAb positive in the second trimester of pregnancy were correlated to an increased risk of GDM.
Updates in Long-term Maternal and Fetal Adverse Effects of Gestational Diabetes Mellitus
Authors: Shou Chong , Wei Yu-Mei , Wang Chen , Yang Hui-Xia 
Published: April 2020

Abstract
Gestational diabetes mellitus (GDM) is associated with long-term maternal and fetal adverse outcomes. Recent evidences suggest GDM increases long-term maternal cardiovascular disease, chronic kidney disease, and cancer risks. Maternal hyperglycemia is associated with offspring obesity, overweight, insulin resistance, and neurocognitive development. It remains unclear whether treating mild GDM would reduce long-term maternal and fetal adverse effects.
A Cohort Analysis of Patients with Stage I Twin-to-Twin Transfusion Syndrome from a Major Referral Hospital in Northern China
Authors: Yang Jing , Yuan Peng-Bo , Wei Yuan , Li Hong-Tian , Wang Xue-Ju , Li Lu-Yao , Jiang Yuan-Hui , Wang Jing , Gong Xiao-Li , Zhao Yang-Yu 
Published: April 2020

Abstract

Objective:
To describe the outcomes of Stage I twin-to-twin transfusion syndrome among patients treated with expectant management (EM), amnioreduction (AR), or fetoscopic laser occlusion of chorioangiopagous vessels (FLOC).

Methods:
A cohort of 89 cases was studied. Based on the initial management strategy, patients were classified into three groups: the EM, AR, and FLOC. We assessed perinatal survival to 28 days of age and categorized pregnancy outcomes as good (twin live birth at ≥30.0 weeks), mixed (single fetal demise or delivery between 26.0 and 29.9 weeks), or poor (double fetal demise or delivery at <26.0 weeks).

Results:
26 (29.2%) patients underwent EM, 35 (39.3%) underwent AR, and 28 (31.5%) underwent FLOC therapy. Of those managed expectantly, 19.2% experienced spontaneous abortion, 50% progressed in stage, and 30.8% remained stable or regressed. After adjusting for potential confounders including maternal age, nulliparity, placenta location, and recipient maximum vertical pocket, and so on, FLOC therapy and AR were associated with significantly [odds ratio (OR) = 0.09] and borderline significantly (OR = 0.20) reduced risks of poor pregnancy outcomes and of no survivors to 28 days of age after birth (OR = 0.04 and OR = 0.20, respectively) compared with EM.

Conclusion:
About 70% of those treated with EM progressed in stage or experienced fetal loss. Compared to EM, intervention may decrease the risk of poor pregnancy outcomes and improve the perinatal survival rate.
Frontier Progress in the Establishment of Trophoblast Stem Cell and the Identification of New Cell Subtypes at the Maternal-Fetal Interface
Authors: Zhou Xiao-Bo , Zhou Chan , Sun Yang , Liu Dong , Kong Shuang-Bo , Lu Jin-Hua , Qi Hong-Bo , Wang Hai-Bin 
Published: April 2020

Abstract
Proper development of the human placenta is of vital importance for a successful pregnancy, and a series of pregnancy complications are considered originating from dysfunctional placentas. Like other organ system development, placentation requires large numbers of co-regulators, while the underlying molecular mechanisms orchestrating the placental formation and function are poorly understood. Although we have made many signs of progress in understanding the placental architectures and developments using mouse models, the species-specific differences impede our progress due to the lack of appropriate model systems. In the past few years, major progress has been made by the establishment of novel in-vitro self-renewing stem cell models, as well as identifying the full picture of the cellular organization of the maternal and fetal interface. Providing the tools for the investigation of placentation and reproductive-related regulation mechanism. In this review, we focus on the detailed progress of the human trophoblast stem cells culturing system, and the cellular and molecular terrain at the maternal-fetal interface, respectively, thus providing new insights into placental development.
Application of Modified Cesarean Hysterectomy for Patients with Placenta Previa Complicated with Placenta Percreta
Authors: Zhao Yin , Zou Li , Gao Hui , Wu Di , Zhu Jian-Wen , Liu Xiao-Xia , Zhang Wen , Luo Li-Bo 
Published: April 2020

Abstract

Objective:
To evaluate the efficacy and safety of a modified cesarean hysterectomy (MCH) procedure in controlling hemorrhage in patients with placenta previa complicated with placenta percreta.

Methods:
A retrospective analysis was conducted on 23 patients with placenta previa complicated with placenta percreta from January 2016 to December 2018 in the Union Hospital. The patients’ age ranged from 24 to 41 years, and had gestational durations of 32–38 weeks. Nine of them underwent MCH and 14 underwent conventional cesarean hysterectomy (CCH). In the MCH group, the bladder was not mobilized, deliberately. The uterus was excised horizontally above the tourniquet level. Placental tissue around the cervical os was cleaned thoroughly, and hemostatic suturing was performed under direct vision. In the CCH group, the uterus was removed gradually after programmed hemostasis and dissection of adhesions of the vesicouterine peritoneal fold and mobilization of the bladder.

Results:
There were no significant differences in general conditions between the two groups. The blood loss was significantly less in the MCH group (P < 0.05). The operation time was also decreased dramatically and hospital stay (in days) was shorter than in the CCH group (P < 0.05). There were no bladder or ureter injuries in the MCH group, compared with three cases in the CCH group. There were no statistically significant differences in neonatal birth weight, Apgar score, or intensive care unit admittance rates between the two groups (P > 0.05).

Conclusion:
This MCH procedure reduced blood loss, avoided bladder injury, and had no long-term complications. It is a safe, rapid, and effective way to control fetal hemorrhage during surgery for women with placenta previa complicated with placenta percreta.
Diagnostic Value of Magnetic Resonance Imaging in Fetal Lateral Ventriculomegaly and the Relationship Between the Degree of Isolated Lateral Ventriculomegaly and Neonatal Prognosis
Authors: Zhao Xiao-Min , Li Xing , Li Wen , Li Shan-Shan , Chang Ying 
Published: April 2020

Abstract

Objective:
To assess the value of magnetic resonance imaging (MRI) in fetal lateral ventriculomegaly diagnosed with ultrasound, and to study the relationship between the degree of isolated lateral ventriculomegaly and neonatal prognosis.

Methods:
The pregnancy information and outcomes of 97 cases of fetal ventriculomegaly were retrospectively reviewed in the Tianjin Central Hospital of Gynecology Obstetrics from January 2016 to December 2017. The maternal age was 18–42 years, and the fetal gestational age at diagnosis was 19+4 to 37+3 weeks. MRI and ultrasound were used to compared the diagnosis of fetal lateral ventriculomegaly and evaluated the development of the nervous system after birth.

Results:
Among 97 pregnancy cases, associated central nervous system malformations were observed in 36 cases on ultrasound or ultrasound + MRI. Central nervous system malformations were diagnosed with ultrasound in 15 cases (15/36, 41.7%) and with ultrasound + MRI in 25 cases (25/36, 69.4%). Pearson χ
2 test was used to compare the detection rates between the groups, and the difference was statistically significant (P < 0.05). We followed up 61 cases of isolated lateral ventriculomegaly for 1–3 years after birth. According to the width of the lateral ventricle of the fetus in middle pregnancy, the subjects were grouped as follows: mild 33 cases (lateral ventricle width 10.0–12.0 mm), moderate 23 cases (lateral ventricle width 12.1–15.0 mm), and severe 5 cases (lateral ventricle width >15.0 mm). The rate of normal growth and development in the mild group was 90.9% (30/33), that in the moderate group was 69.6% (16/23), and that in the severe group was 40.0% (2/5), and the difference between groups was statistically significant (P < 0.05).

Conclusion:
Ultrasound combined with MRI can detect more central nervous system malformations, and the degree of isolated lateral ventriculomegaly is closely related to fetal prognosis.
Sex Hormone-binding Globulin, Cardiometabolic Biomarkers, and Gestational Diabetes: A Longitudinal Study and Meta-analysis
Authors: Li Meng-Ying , Rawal Shristi , Hinkle Stefanie N. , Zhu Ye-Yi , Tekola-Ayele Fasil , Tsai Michael Y. , Liu Si-Min , Zhang Cui-Lin 
Published: April 2020

Abstract

Objective:
This study investigated the prospective associations of circulating levels of sex hormone-binding globulin (SHBG) levels with cardiometabolic biomarkers and risk of gestational diabetes (GDM) during pregnancy. It also examines the longitudinal trajectory of SHBG in women with and without GDM.

Methods:
We conducted a nested case-control study of 107 incident GDM cases and 214 matched controls within the Eunice Kennedy Shriver National Institute of Child Health and Human Development Fetal Growth Studies-Singleton Cohort. The cohort enrolled non-obese and obese women aged 18–40 years with a singleton pregnancy between 8 and 13 weeks of gestation from 2009 to 2013. GDM was ascertained via medical records review. Blood samples were drawn four times at gestational weeks 10–14, 15–26, 23–31, and 33–39. The prospective associations between SHBG levels and cardiometabolic biomarkers were examined using the Spearman partial correlation among the controls. The longitudinal trajectories of SHBG levels were examined among the cases and the controls. Meta-analysis of prospective studies were performed to examine the association between SHBG levels and GDM risk.

Results:
SHBG levels at gestational weeks 10–14 were significantly inversely associated with fasting insulin (r = −0.17, P = 0.01) and insulin resistance as measured by HOMA-IR (r = −0.17, P = 0.01) at gestational week 15–26. SHBG at gestational weeks 10–14 and 15–26 was lower in cases than controls (mean ± standard deviation: (204.0 ± 97.6) vs. (220.9 ± 102.5) nmol/L, P = 0.16 and (305.6 ± 124.3) vs. (322.7 ± 105.1) nmol/L, P = 0.14, respectively), yet the differences were not significant. In the meta-analysis, SHBG was 41.5 nmol/L (95% confidence interval: 23.9, 59.1, P < 0.01) significantly lower among women with GDM than without, and each 50 nmol/L increase in SHBG was significantly associated with an odds ratio of 0.85 (95% confidence interval: 0.76–0.95, P = 0.01) for GDM.

Conclusion:
Lower SHBG levels in early pregnancy were prospectively associated with higher high insulin levels and insulin resistance in mid-pregnancy and subsequent risk of GDM, independent of adiposity. SHBG may serve as a marker for the identification of high-risk pregnancies during early pregnancy.
Risk Assessment and Prevention of Spontaneous Preterm Birth
Authors: Li Chao 
Published: April 2020

Abstract
Preterm parturition is the consequence of pathological signals that activate the common pathway of parturition and considered as a syndrome. Many risk factors for spontaneous preterm birth (sPTB) have been identified. Two significant risk factors for sPTB are history of prior sPTB and short cervical length at midtrimester. 17 hydroxyprogesterone caproate, vaginal progesterone, cerclage, and pessary have all been studied for prevention of sPTB. Difference in patient populations likely contributes to the conflicting study results. Further studies are needed to establish strategies in prevention of sPTB in singleton as well as multiple pregnancies.
Efficacy of Nonsteroidal Anti-inflammatory Drugs for Treatment of Uncomplicated Lower Urinary Tract Infections in Women: A Meta-analysis
Authors: Zhang Yu , Wu Jian-Guo , Zhou Hong-Ji , Huang Wen-Xiang , Jia Bei 
Published: April 2020

Abstract
Urinary tract infections (UTIs) are among the most frequent causes for antibiotic prescription and; therefore, alternative treatment options for UTIs can potentially reduce antibiotic usage and development of resistance. To evaluate the efficacy of nonsteroidal anti-inflammatory drugs (NSAIDS) for the treatment of uncomplicated lower UTIs in women, this study implemented a meta-analytic approach to evaluate the results of available randomized clinical studies from online databases. A total of four trials involving 1144 patients with uncomplicated lower UTIs were included in the final evaluation. Results showed that symptom resolution at Day 3–4 in the NSAIDs group was significantly lower than that in the antibiotics group [pooled odds ratio (OR) = 0.41, 95% confidence interval (CI): 0.23–0.74, P < 0.05]. However, there was no significant difference between the NSAIDs and antibiotics groups in symptom resolution at Day 7 (pooled OR = 0.43, 95% CI: 0.17–1.06, P = 0.07), secondary antibiotic treatment rate at Day 28–30 (pooled OR = 1.15, 95% CI: 0.16–7.98, P = 0.89) and adverse events rate (pooled OR = 1.09, 95% CI: 0.61–1.96, P = 0.77). Therefore, this meta-analysis suggests that, although inferior to antibiotics in fast symptom resolution, symptomatic treatment with NSAIDs can be considered as an alternative treatment option for uncomplicated lower UTIs in women. However, given the low number of randomized controlled trials that met inclusion criteria in this meta-analysis, efficacy of NSAIDs for treatment of uncomplicated lower UTIs should be further evaluated in more comprehensive clinical studies.