bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk factors for venous thromboembolism following spinal surgery
Authors: Zhang Lu , Cao Hongxin , Chen Yunzhen , Jiao Guangjun 
Published: July 2020

Abstract

Background:
To investigate the risk factors for postoperative venous thromboembolism (VTE) in patients undergoing spinal surgery.

Methods:
Literature published in PubMed, Embase, the Cochrane Library, and Web of Science was systematically reviewed to assess risk factors for VTE following spinal surgery. The data analysis was conducted with STATA 12.0. Data were pooled using fixed-effects or random-effects models according to the heterogeneity among the included studies.

Results:
Twenty-six studies involving 3,216,187 patients were included in this meta-analysis, and the total incidence of VTE after spinal surgery was 0.35% (0.15–29.38%). The pooled analysis suggested that the incidence of VTE after spinal surgery was higher in such aspects as increasing age (weighted mean difference [WMD] 0.55 years, 95% confidence interval [CI] 0.33–0.78, P < .001), female sex (odds ratio [OR] 1.12, 95% CI 1.01–1.25; P = .034), diabetes (OR 1.34, 95% CI 1.29–1.44; P < .001), chronic kidney disease (OR = 8.31, 95% CI 1.98–34.93; P = .004), nonambulatory preoperative activity status (OR 3.67, 95% CI 2.75–4.83; P < .001), D-dimer level (WMD 1.023, 95% CI 0.162–1.884; P = .02), long duration of operation (WMD 0.73, 95% CI 0.21–1.24; P = .006), spine fusion (OR 1.54, 95% CI 1.31–1.82; P < .001), and blood transfusion (OR 2.31, 95% CI 1.73–3.07; P < .001), and the differences were statistically significant. However, there were no significant differences in body mass index, obesity, hypertension, coronary heart disease, spondylolisthesis, intraoperative blood loss, surgical procedures (anterior lumbar interbody fusion vs posterior intervertebral fusion /translaminar lumbar interbody fusion), or surgical site (lumbar vs thoracic) (all P > .05).

Conclusion:
Based on our meta-analysis, we identified several important factors that increased the risk of VTE after spinal surgery. We hope our study provides assistance to spine surgeons so that they can adequately analyze and assess risk factors in patients and then develop preventive measures to reduce the incidence of VTE.
Comparison of arthroscopic single-row and double-row repair in the treatment of rotator cuff tears
Authors: Lin Yanming , Zhao Jiasong , Qiu Heng , Huang Yong 
Published: July 2020

Abstract

Background:
Single-row (SR) and double-row (DR) techniques are 2 kinds of widely used approaches for the arthroscopic repair of rotator cuff. This retrospective clinical trial was performed to address the question of whether a DR rotator cuff anchor repair gives results superior to a SR anchor repair in clinical outcome scores and complication rates.

Methods:
This study was performed and reported in accordance with the Strengthening the Reporting of Observational studies in Epidemiology checklist. We retrospectively reviewed our database, which was collected prospectively. From 2014 to 2017, 264 patients underwent arthroscopic rotator cuff repair by an experienced single shoulder surgeon with the SR and DR techniques. This study was approved by the institutional review board in our hospital and was registered in the Research Registry. Outcome measures included Constant-Murley score, muscle strength, patient satisfaction, passive range of motion, and retear rates.

Results:
The hypothesis was that the DR technique would achieve better functional scores and fewer complications as compared to the SR technique in treatment of rotator cuff tears.
Hearing impairment in young and middle-aged septicemia survivors
Authors: Cheng Chun-Gu , Chien Wu-Chien , Lin Hung-Che , Lin Hui-Chen , Chung Chi-Hsiang , Cheng Chun-An 
Published: July 2020

Abstract
The ability of sepsis to induce acute phase hearing impairment has been evaluated in septic and sepsis-surviving mice. The relationship between septicemia and long-term hearing impairment remains unknown in humans.
The data were obtained from the Taiwan Longitudinal National Health Insurance Database from 2000 to 2013. We identified patients suffering from septicemia after discharge, excluding those younger than 18 years old and older than 65 years old. The comparison group was matched based on age, sex, and comorbidities. The outcome was hearing impairment occurring after septicemia. The risk factors associated with hearing impairment were established using multivariate Cox proportional hazard regression.
Our study found that septicemia associated with hearing impairment had an adjusted hazard ratio (HR) of 53.11 (95% confidence interval [CI]: 41.74–67.59). The other factors related to hearing impairment in young and middle-aged septicemia survivors included male sex (adjusted HR 1.31 [95% CI: 1.14–1.5]), chronic kidney disease (adjusted HR 1.63 [95% CI: 1.38–1.94]), and otoscleroisis (adjusted HR 231.54 [95% CI: 31.61–1695.8]).
Our study revealed that septicemia was associated with increased development of hearing impairment in young and middle-aged humans in the long term. Clinicians should be aware of long-term septicemia-related hearing impairment and provide prevention strategies for otopathy in septicemia survivors.
Effects of Fusu mixture (Wen-Shen-Qian-Yang Method) on sepsis-induced acute respiratory distress syndrome
Authors: Zhang Li , Long Kunlan , Wang Chunxia , Zhang Xuemei , Yang Hongjing , Chen Jun , Li Xue , Gao Peiyang , Zhang Song 
Published: July 2020

Abstract

Introduction:
Sepsis is the most common etiology of acute lung injury (ALI) or acute respiratory distress syndrome (ARDS). Capillary leakage caused by lung endothelial injury is the central cause of ARDS. The results of research in modern medicine in reducing endothelial damage and restoring endothelial functions are limited. In the previous clinical observations, we found that the Fusu mixture not only improves the clinical symptoms but also reduces the leakage of pulmonary capillaries. Therefore, the purpose of this study is to determine the clinical efficacy of the Fusu mixture combined with Western medicine in the treatment of ARDS caused by sepsis and to explore the mechanism of traditional Chinese medicine.

Methods:
This is a prospective, single-center, randomized, single-blind, and controlled clinical study involving 620 eligible patients. The patients will be randomly divided into 2 groups: the Western medicine treatment group and the combination of Chinese and Western medicine treatment group. After 14 days of intervention, the clinical efficacy and safety of the Fusu mixture on sepsis-induced ARDS patients will be observed. The primary outcome will be measured as 28-day mortality. The secondary outcome indices include inflammatory markers (CRP, PCT, IL-6, TNF - α), APACHE II score, SOFA score, days without a ventilator, blood gas analysis (Lac, PaO2 / FiO2), intensive care unit hospital stay time, intensive care unit mortality. Simultaneously, the analysis of the exploratory results will be carried out to analyze the possible mechanism of Fusu mixture in the treatment of sepsis-induced ARDS by the high-throughput sequencing and bioinformatics.

Discussion:
The purpose of this study is to evaluate the clinical efficacy of Fusu mixture in the treatment of sepsis-induced ARDS and explore its possible mechanism of action. If successful, it will provide evidence-based adjuvant therapy for the clinical treatment of ARDS.
Treatment of acute urticaria with acupuncture
Authors: Zhou Shuai , Zhao Ruirui , Xue Mingxin 
Published: July 2020

Abstract

Rationale:
Urticaria is a refractory dermatosis with long duration and a high recurrence rate. More to the point, medication of acute urticaria always demands high doses, which may cause some adverse effects. Acupuncture, with a history for over 2000 years, has been utilized in clinical practice as an alternative treatment strategy for dermatologic diseases.

Patient concerns:
A 26-year-old male nurse on duty suddenly fell sick during the night-shift in the ward. Wheals began spreading all over his body, but he had no urticaria medicine on hand. The unbearable itching made it extremely difficult for him to resume working.

Diagnosis:
The patient was diagnosed with acute urticaria according to the symptoms.

Interventions:
A 30-minute acupuncture treatment was performed.

Outcomes:
About 5 minutes after needles were inserted into the acupoints, the patient felt significantly relieved of itching sensation; moreover, he could even subjectively control himself from scratching and could calmly wait for gradual disappearance of the wheals. Then 30 minutes later, the wheals almost faded away.

Lessons:
The results suggest that acupuncture may be a promising alternative therapy to treat acute urticaria, especially for patients who cannot receive drug treatment.
Fu's subcutaneous needling for subcutaneous adhesions and scar hyperplasia in the neck region
Authors: Huang Huixia , Liu Jin , Fu Mingquan , Lin I-Wen , Chou Li-Wei 
Published: July 2020

Abstract

Rationale:
Lymphadenectomy for tongue cancer in the neck region is often accompanied by local impaired mobility, gland damage, difficult in swallowing, and postoperative complication and seriously affects patients life quality. We reported a case of subcutaneous adhesions and scar hyperplasia in the neck region after lymphadenectomy for tongue lesions accompanied by impaired neck mobility and difficult in swallowing was treated using Fu's subcutaneous needling (FSN) treatment.

Patient concerns:
A 55-year-old male with tongue cancer received surgical intervention with lymphadenectomy 8 years ago was revealed a 15 cm-long curved surgical incision in the neck region and surrounded by numerous scar tissues.

Diagnosis:
Post-operation subcutaneous adhesions and scar hyperplasia in the neck region after lymphadenectomy was diagnosed.

Interventions:
FSN treatment was performed 2 to 3 times per week for 1 month to sway the affected tightened muscle and dissociate the superficial fascia beneath the scar resulted in a considerable improvement in neck movement.

Outcomes:
The Vancouver Scar Scale (VSS) was as follows: color (M) - 1; vascular distribution (V) - 0, thickness (H) - 2, and flexibility (P) - 4, with a total of 7 points before FSN treatment. The VSS after 1 month of FSN treatment was as follows: M1, V0, H2, and P2, with a total of 5 points. Neck mobility in different directions, i.e., stretching to the back of the neck and laterally bending the neck to the left and/or right side, was improved (P < .05).

Lessons:
At present, treatment of chronic scar hyperplasia has certain side effects and limitations. FSN is safe and convenient, with minimal destruction of the superficial fascia, having evident effects of dissociating tissue adhesion under scars and compensating for deficiencies in scar hyperplasia treatment. It can provide new ideas for future treatments.
Acute fatty liver of pregnancy cases in a maternal and child health hospital of China
Authors: Wang Ling , Gan Quan , Du Shuguo , Zhao Yun , Sun Guoqiang , Lin Ying , Li Ruyan 
Published: July 2020

Abstract

Rationale:
Acute fatty liver of pregnancy (AFLP) is extremely hazardous to pregnant woman in the 3rd trimester of pregnancy. AFLP has an insidious onset and nonspecific experimental indicators, which therefore is difficult to be diagnosed.

Patient concerns:
Case 1 was transferred to our hospital for hypertensive disorders complicating pregnancy at gestation of 38 weeks + 3 days. Case 2 was transferred to our hospital for suspicious fetal heart monitoring response at gestation of 36 weeks + 4 days. Case 3 was transferred to our hospital for prelabor rupture of membranes at gestation of 37 weeks + 1 days.

Diagnosis:
The diagnosis of AFLP was based on the Swansea criteria.

Interventions:
All 3 cases were delivered by cesarean section, and they were all transferred to intensive care unit for further treatment. Cases 2 and 3 were subjected to plasma exchange and continuous renal replacement therapy.

Outcomes:
In this study, all 3 patients were initially diagnosed as gastritis. In addition, case 1 was diagnosed as preeclampsia and her AFLP was misdiagnosed with postpartum hemorrhage after cesarean delivery. Case 2 was admitted to the hospital for intrahepatic cholestasis of pregnancy and fetal distress, but we considered it as AFLP before delivery. Case 3 was treated according to severe intrahepatic cholestasis of pregnancy, but we rediagnosed it as postpartum hemorrhage and disseminated intravascular coagulation after cesarean delivery. Neonatal asphyxia and complications were not found. All of the 3 cases were fully recovered and discharged from our hospital.

Lessons:
If there are multiple risk factors including vomiting, abdominal pain, and fetal distress, AFLP should be highly suspected. Early diagnosis, especially before termination of pregnancy, is the key to successful treatment of AFLP.
Primary anaplastic large cell lymphoma of the central nervous system in a child
Authors: Feng Shuo , Chen Qian , Chen Jinxiao , Zheng Ping , Ma Kangping , Tan Bojing 
Published: July 2020

Abstract

Introduction:
To report the clinical characteristics of primary central nervous system T-cell lymphoma with anaplastic lymphoma kinase-1 (ALK-1) positive in an 8-year-old male.

Patient concerns:
The patient presented cognitive impairment, dizziness, vomiting, fever, and convulsions during the disease, followed by progressive and persistent severe headache, progressive increase of intracranial pressure, indifference, disorder of consciousness, mild increase in white blood cells in cerebrospinal fluid, progressive decrease of sugar, progressive increase of protein, abnormal signal of left parietal-occipital, local meningeal enhancement, and cerebrospinal fluid cytology.

Diagnosis:
He was diagnosed with ALK-1-positive central nervous system T-cell lymphoma.

Interventions:
Meropenem and vancomycin were administered to counter the infection, while dexamethasone alleviated the inflammation.

Outcomes:
The patient died of cerebral hernia due to intracranial hypertension in the eighth week of the disease.

Conclusions:
PCNS ALK-1-positive anaplastic large cell lymphoma is extremely rare. Also, it is difficult to distinguish from central meningeal lymphoma and central nervous system infection, which might lead to delayed diagnosis. However, early diagnosis depends on the pathological diagnosis of brain tissue biopsy.
Traditional Chinese herbal bath therapy for insomnia
Authors: Wen Qiao , Dong Xiaohui , Lan Lei , Liu Lizhou , Tumilty Steve , Yan Bohua , Chen Yabing , Wang Xing , Zhang Yonggang , Feng Fen 
Published: July 2020

Abstract

Introduction:
Insomnia is a major public health problem. Due to the side effects of pharmacological therapy, people are seeking to choose complementary and alternative therapies for insomnia disorder. Traditional Chinese herbal bath therapy is an important complementary therapy which combines advantages of Chinese herbs and bathing therapy. This protocol describes the methodology of a systematic review assessing the effectiveness and safety of traditional Chinese herbal bath therapy for insomnia.

Methods and analysis:
Reporting of this review will be adherent to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. We will electronically search the following seven databases from inception to January 23, 2020: PubMed, Cochrane database (CENTRAL), EMBASE, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), VIP Database, and Wanfang Database. Parallel randomized controlled trials evaluating the effectiveness and safety of traditional Chinese herbal bath therapy for insomnia will be included. Study selection, data extraction and assessment of risk of bias will be performed independently by two researchers. The sleep quality will be assessed as the primary outcome. Global symptom improvement, anxiety and depression, and adverse events will be evaluated as secondary outcomes. The Cochrane's risk of bias tool will be utilized for assessing the methodological quality of included studies. Revman software (v.5.3) will be used for data synthesis and statistical analysis. Data will be synthesized by either fixed-effects or random-effects model according to a heterogeneity test. If it is not appropriate for a meta-analysis, a descriptive analysis will be conducted. GRADE system will be used to assess the quality of evidence.

PROSPERO registration number:
CRD42020168507
Multiple limb compartment syndrome as a manifestation of capillary leak syndrome secondary to metformin and dipeptidyl peptidase IV inhibitor overdose
Authors: Kasugai Daisuke , Tajima Kosuke , Jingushi Naruhiro , Uenishi Norimichi , Hirakawa Akihiko 
Published: July 2020

Abstract

Rationale:
Capillary leak syndrome is a condition that increases systemic capillary permeability and causes characteristic manifestations such as recurrent hypovolemia, systemic edema, and hemoconcentration. Acute limb compartment syndrome is a possible complication of severe capillary leak syndrome. However, timely diagnosis and prompt treatment are challenging because of atypical presentation.

Patient concerns:
An 18-year-old woman with a history of clinical depression was admitted to our intensive care unit (ICU) because of metformin and vildagliptin overdose. She developed marked vasodilatory shock with recurrent severe hypovolemia and disseminated intravascular coagulation. After urgent hemodialysis and plasma exchange, she started to stabilize hemodynamically. However, her limbs became stone-hard with massive edema. Her serum creatinine kinase level increased to an extremely high level.

Diagnosis:
Extremities were distended, and her skin developed pallor with blistering. Intramuscular pressure in both forearms and lower legs was significantly elevated.

Interventions:
Decompressive fasciotomy was performed. Hemodialysis was continued because of rhabdomyolyses-induced acute kidney injury.

Outcomes:
The patient was finally able to walk by herself at the time of hospital discharge on day 109.

Lessons:
The possibility of acute compartment syndrome should be considered in patients with marked capillary leakage, especially after aggressive fluid resuscitation. It is important to be aware of the compartment syndrome in an ICU setting because communication barriers often mask typical symptoms and make diagnosis difficult.
Very late relapse of high-grade osteosarcoma
Authors: Kaneuchi Yoichi , Hakozaki Michiyuki , Yamada Hitoshi , Hasegawa Osamu , Yamada Shoki , Oka Yuka , Watanabe Kazuo , Konno Shinichi 
Published: July 2020

Abstract

Rationale:
Osteosarcoma is the most common primary malignant bone tumor in children. The prognosis of osteosarcoma has improved with the use of aggressive systemic chemotherapy in addition to surgery. The relapse of osteosarcomas is usually as lung metastasis observed within 2 to 3 years after the initial treatment. A relapse is rarely observed at >10 years.

Patient concerns:
We report the case of a 51-year-old Japanese man who was treated for high-grade osteosarcoma of the femur at 13 years old. He was referred to our hospital with a suspicion of primary lung cancer based on back pain, respiratory distress, and an abnormal mass on chest radiograph.

Diagnoses:
Computed tomography-guided biopsy confirmed the lung lesion as a metastatic recurrence of high-grade osteosarcoma without local recurrence.

Interventions:
Chemotherapy was planned, but the patient's general condition rapidly deteriorated and thus palliative therapy was provided.

Outcomes:
The patient died 2 months after the initial consultation.

Lessons:
The survival durations of osteosarcoma patients have been prolonged by recent progress in multimodality therapy, and thus clinicians as well as osteosarcoma patients should always keep in mind the possibility of very late relapse.
Penile metastasis in rectal cancer with pathologic complete response after neoadjuvant chemoradiotherapy
Authors: Lee Taek-Gu , Son Seung-Myoung , Kim Myung Jo , Lee Sang-Jeon 
Published: July 2020

Abstract

Rationale:
Penile metastasis in rectal cancer is very rare and often originates from prostatic or bladder cancer. The prognosis of penile metastasis is poor and its treatments are more often palliative than curative due to association with disseminated metastases. Pathologic complete response (pCR) in rectal cancer with neoadjuvant chemoradiotherapy (CRT) has been shown to be surrogate marker of favorable long-term outcomes and currently has no report of penile metastasis. Here, we first report isolated penile metastasis in rectal cancer with pCR after neoadjuvant CRT.

Patient concern:
The patient was a 74-year-old male with metastasis to the glans penis from rectal cancer diagnosed 9 months after abdominoperineal resection. Physical examination revealed palpable multiple nodules on the glans penis.

Diagnosis:
Penile biopsy revealed metastatic carcinoma from the rectal cancer.

Intervention:
Chemotherapy was started as soon as possible, because patient suffered urinary discomfort by rapid growing metastatic lesions. He is currently receiving palliative chemotherapy with modified FOLFOX-6 (mFOLFOX-6; oxaliplatin with 5-fluorouracil and folinic acid) plus bevacizumab.

Outcome:
The patient is still alive 4 months after diagnosis with markedly decreased metastatic lesions.

Lesson:
We propose that although penile metastasis in rectal cancer with pCR after preoperative neoadjuvant CRT is extremely rare, it might help to start early palliative chemotherapy and clinicians should be aware of this possibility.
Clinical outcomes following polymer-free sirolimus-eluting stent implantations in unselected patients
Authors: Krackhardt Florian , Waliszewski Matthias W. , Kherad Behrouz , Barth Claudia , Marcelli Daniele 
Published: July 2020

Abstract
Patients with chronic kidney disease (CKD are frequently excluded from coronary artery disease trials. The aim of this assessment was to study the clinical outcomes of polymer-free sirolimus-eluting stent implantations in patients with impaired renal function.
Large-scale, international, single-armed, multicenter, ‘all comers’ observational studies (ClinicalTrials.gov Identifier: NCT02629575 and NCT02905214) were used for this post-hoc subgroup analysis to compare the clinical outcomes in patients with normal renal function (NRF) to those with renal insufficiency (CKD, dialysis dependence). The accumulated target lesion revascularization rate was the primary endpoint at 9 to 12 months whereas the accumulated major adverse cardiac event, stent thrombosis (ST) and procedural success rates were part of the secondary endpoints.
There were 6791 patients with NRF, whereas 369 patients had CKD and 83 patients were dialysis dependent. The target lesion revascularization rate at 9 to 12 months was significantly higher in dialysis patients (2.1% vs 3.3% vs 6.7%, P = .011). The accumulated major adverse cardiac events rates in the dialysis and in the CKD group were significantly higher as compared to patients with NRF (13.3% vs 4.0%, P < .001; 6.5% vs 4.0%, P = .024). Finally, ST rates (NRF: 0.7%, CKD: 0.6%, dialysis: 1.3%) were not statistically different between subgroups (P = .768). All-cause cumulative mortality rates were 3.3% (CKD) and 4.0% (dialysis) respectively.
Percutaneous coronary interventions with polymer-free, ultra-thin strut sirolimus-eluting stents have comparable revascularization rates in CKD and dialysis dependent patients as compared to percutaneous coronary interventions with other 2nd generation drug-eluting stents. ST and all-cause mortality rates were low as compared to available literature references.