bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effectiveness of electrical stimulation for the management of benign prostatic hyperplasia
Authors: Han Wei-jun , Guo Yu-ge , Wang Yun-qi , Wang Jin-wan 
Published: May 2020

Abstract

Background:
This study will aim to assess the effectiveness and safety of electrical stimulation (ES) for the treatment of patients with benign prostatic hyperplasia (BPH).

Methods:
PubMed, EMBASE, Web of science, Springer, Cochrane Library, PsycINFO, Allied and Complementary Medicine Database, CBM, and China National Knowledge Infrastructure will be retrieved from inception to the September 1, 2019. No language limitation will be applied to this study. Randomized controlled trials (RCTs) that assessed the effectiveness and safety of ES for the treatment of patients with BPH will be considered for inclusion. Literature selection, data collection, and risk of bias assessment will be conducted by 2 investigators independently. Statistical analysis will be carried out using RevMan 5.3 Software.

Results:
This study will summarize high quality RCTs based on the present evidence of ES for the treatment of BPH in several aspects, including changes in urological symptoms, changes in prostate size, urodynamic parameters, quality of life, and number and severity of adverse events.

Conclusion:
The findings of this study will provide latest evidence to appraise whether ES is an effective and safety intervention for patients with BPH.

PROSPERO registration number:
PROSPERO CRD42019157241.
Malignant pulmonary embolism associated with renal sarcoma
Authors: Yang Jun Ho , Song Dae Hyun , Lee Chunwoo , Kang Dong Hoon , Jung Jae Jun , Kim Sung Hwan , Byun Joung Hun , Kim Jong Woo , Moon Seong Ho 
Published: May 2020

Abstract

Rationale:
The preoperative diagnosis of massive pulmonary tumor embolism associated with renal neoplasms is relatively rare. In most cases, pulmonary tumor embolism is detected intraoperatively during renal tumor resection. Moreover, primary renal sarcoma is rare, and primary renal sarcoma complicated by pulmonary tumor embolism is extremely rare; accordingly, there is no optimal treatment for such cases. Herein, we report a case of renal sarcoma associated with pulmonary tumor embolism.

Patient concerns:
A 39-year-old man was admitted to the emergency room owing to the sudden onset of dyspnea and palpitation.

Diagnosis:
Contrast-enhanced computed tomography (CT) revealed a large mass in the right kidney involving the infrahepatic inferior vena cava, with massive pulmonary emboli in both the pulmonary arteries.

Interventions:
Emergency pulmonary embolectomy with radical nephrectomy was performed.

Outcomes:
The patient experienced apparent remission of dyspnea, and resolution of right ventricle dysfunction. However, although remnant emboli were detected in the segmental arteries on postoperative CT, complete resolution of pulmonary embolism was observed after adjuvant chemotherapy.

Lessons:
Thus, concomitant cytoreductive nephrectomy with pulmonary embolectomy along with chemotherapy may be effective for patients with renal sarcoma with pulmonary tumor embolism.
Novel β-Lactam/β-Lactamase inhibitor combinations vs alternative antibiotics in the treatment of complicated urinary tract infections
Authors: Lu Li-Chin , Lai Chih-Cheng , Chang Shen-Peng , Lan Shao-Huan , Hung Shun-Hsing , Lin Wei-Ting 
Published: May 2020

Abstract

Objectives:
This meta-analysis assessed the efficacy and safety of novel β-lactam/β-lactamase inhibitor combinations in the treatment of complicated urinary tract infection (cUTI)/acute pyelonephritis (APN).

Methods:
PubMed, Web of Science, EBSCO (Elton B. Stephens Co.), Cochrane Library, Ovid MEDLINE, and Embase databases were accessed until November 21, 2019. In this meta-analysis, only randomized controlled trials comparing the treatment efficacy of novel β-lactam/β-lactamase inhibitor combinations with other antibiotics for cUTI/APN in adult patients were included. The outcomes included the clinical and microbiological responses, and risk of adverse events (AEs).

Results:
Overall, the experimental group treated with a novel β-lactam/β-lactamase inhibitor combination and the control group comprised 1346 and 1376 patients, respectively. No significant difference in the clinical response rate at test-of-cure was observed between the novel β-lactam/β-lactamase inhibitor combination and comparators among the microbiological modified intent-to-treat population (89.1% vs 88.3%, OR, 1.04; 95% confidence interval [CI], 0.76–1.42; I

2
= 28%) and the microbiologically evaluable population (95.2% vs 94.7%, OR, 1.12; 95% CI, 0.68–1.84; I

2
= 0%). Additionally, the novel β-lactam/β-lactamase inhibitor combination was associated with a better microbiological response at test-of-cure than the comparators among the microbiological modified intent-to-treat population (74.4% vs 68.5%, OR, 1.34; 95% CI, 1.04–1.72; I

2
= 45%) and microbiologically evaluable population (80.1% vs 72.5%, OR, 1.49; 95% CI, 1.06–2.10; I

2
= 58%). Finally, the risk of AEs associated with the novel β-lactam/β-lactamase inhibitor combination was similar to that associated with the comparators (treatment-emergent adverse events [TEAE], OR, 1.04; 95% CI, 0.87–1.23; I

2
= 19%; serious AEs, OR, 1.21; 95% CI, 0.82–1.76; I

2
= 0%; treatment discontinuation for drug-related TEAE, OR, 077; 95% CI, 0.38–1.56, I

2
= 5%). The all-cause mortality did not differ between the novel β-lactam/β-lactamase inhibitor combination and comparators (OR, 1.19; 95% CI, 0.37–3.81; I

2
= 0%).

Conclusions:
The clinical and microbiological responses of novel β-lactam/β-lactamase inhibitor combinations in the treatment of cUTI/APN are similar to those of other available antibiotics. These combinations also share a safety profile similar to that of other antibiotics.
Acute spinal subdural hematoma
Authors: Yokota Kazuya , Kawano Osamu , Kaneyama Hironari , Maeda Takeshi , Nakashima Yasuharu 
Published: May 2020

Abstract

Rationale:
Spontaneous spinal subdural hematoma (SSDH) is a rare disease that can cause severe permanent neurological dysfunction. Here we present a case of spontaneous SSDH, in which a series of magnetic resonance images (MRIs) taken through the course of the disease facilitated understanding of the resolution process of the hematoma and the diagnosis of SSDH.

Patient concerns:
A 59-year-old male presented with sudden severe back pain and rapid onset of paraplegia. This symptom had continued developing while he was transferred to the emergency department. Initial physical examination showed flaccid paralysis of both lower limbs with areflexia and loss of all sensation below T6 bilaterally. MRI images showed an anterior subdural hematoma from C7 to T7 with spinal cord compression.

Diagnosis:
Based on MRI findings, the diagnosis was SSDH.

Interventions:
We chose conservative treatment of 1-week bed rest and intensive rehabilitation for the patient due to the presence of sacral sparing and the slight motor recovery at 24 hours after the onset.

Outcomes:
Frequent MRI images demonstrated that the spinal cord compression was surprisingly mitigated only 2 days and mostly absorbed 4 days after the onset. The patient's motor function was recovered completely and he was discharged after 8 weeks of hospitalization.

Lessons:
Our chronological MRI findings provide crucial information for diagnosing SSDH and also suggest that spinal surgeons should consider the potential option of a conservative approach for treating SSDH. Although prompt selection of a therapeutic strategy for SSDH could be challenging, the surgeons could observe the course of the patient's neurological status for a few days to detect signs of spontaneous recovery.
Acute cerebral infarction with acute myocardial infarction due to patent foramen ovale
Authors: Chen Jinghong , Li Rui , Chen Jingjing , Zhao Jingru , Li Na , Sun Sujuan , Yang Baoming 
Published: May 2020

Abstract

Rationale:
Patent foramen ovale (PFO) is not considered to be the main cause of stroke and is classified as the infarction of undetermined cause. The relationship between PFO and cerebral embolism is still unclear and cerebral embolism accompanied with coronary artery embolization in PFO patient is rare. In this case, we reported a patient with PFO suffered acute cerebral and myocardial infarction simultaneously, and analyzed the source of emboli and potential pathogenesis.

Patient concerns:
A 53-year-old female presented with chief complaints of intermittent palpitations and chest tightness for 6 years, aggravated for 3 days.

Diagnoses:
During the hospitalization, acute cerebral infarction and acute myocardial infarction occurred at the same time in the patient. The patient felt paroxysmal abdominal pain repeatedly. Finally, we detected PFO in the patient

Interventions:
Double antiplatelet therapy was given to the patient of acute cerebral and myocardial infarction with PFO.

Outcomes:
Two weeks after the onset of the disease, the condition was relatively stable. But after 2 months, the patient experienced repeated heart failure, transthoracic echocardiography manifested no significant change in the PFO gap but significant cardiac function reduction.

Lessons:
Although a growing number of people are aware that PFO is a risk factor for arterial embolization especially when coexisting with atrial septal aneurysm, a significant proportion of patients have paradoxical embolism after PFO closure. Therefore, transesophageal echocardiography should be routinely performed to find the possible cause of embolism when infarction of undetermined cause occurs, and PFO closure and anti-platelet aggregation or anticoagulant therapy should be given at the same time in order to reduce the occurrence of arterial thrombosis.
Omega-3 PUFA intake and the risk of digestive system cancers
Authors: Wang Jian , Zhang Yueyang , Zhao Long 
Published: May 2020

Abstract

Background:
A growing number of epidemiological studies have suggested a possible association between long-chain omega-3 polyunsaturated fatty acid (PUFA) intake and the risk of cancers, but the results have been inconsistent. We aimed to conduct a meta-analysis to assess the association of omega-3 PUFA consumption with digestive system cancers.

Methods:
Relevant observational studies were identified through a comprehensive search of PubMed, Embase, and the Web of Science through December 2019 and by reviewing the references of the retrieved articles. The relative risks (RRs) of digestive system cancers associated with omega-3 PUFA intake were estimated using a random-effect model and were stratified by region, sex, study design, type of omega-3 PUFAs, smoking status, alcohol consumption, BMI, and physical activity.

Results:
Twenty-five studies (8 case–control studies and 17 cohort studies) involving 1,247,271 participants and 23,173 patients with digestive system cancers were included in this analysis. The risk of digestive system cancers decreased by 17% in individuals who consumed omega-3 PUFAs (RR = 0.83, 95% confidence interval (CI), 0.76–0.91). The risk estimates of digestive system cancers varied by cancer sites, study location, study design, type of omega-3 PUFAs, and other confounders (smoking, alcohol consumption, body mass index, and physical activity). Visual inspection of funnel plots and the Begg's and Egger's tests revealed no evidence of publication bias.

Conclusion:
The findings show that omega-3 PUFAs should be as a healthy dietary component for the prevention of digestive system cancers. Cancer incidence decreases with increasing omega-3 PUFAs intake for most digestive system cancer sites. The relation between omega-3 PUFAs and digestive system cancers RR is similar among different populations.
Efficacy of neural stem cell transplantation for the treatment of patients with spinal cord injury
Authors: Tang Hua-yu , Li Yu-zhi , Tang Zhao-chen , Wang Lu-yao , Wang Tian-shu , Araujo Fernando 
Published: May 2020

Abstract

Background:
The aim of this study is to evaluate the efficacy of neural stem cell transplantation (NSCT) for the treatment of patients with spinal cord injury (SCI).

Methods:
All potential randomized controlled trials (RCTs) on NSCT in the treatment of patients with SCI will be searched from the following electronic databases: Cochrane Library, MEDILINE, EMBASE, Web of Science, Scopus, CBM, WANGFANG, and CNKI. We will search all electronic databases from their initiation to the January 31, 2020 in spite of language and publication date. Two contributors will independently select studies from all searched literatures, extract data from included trials, and evaluate study quality for all eligible RCTs using Cochrane risk of bias tool, respectively. Any confusion will be resolved by consulting contributor and a consensus will be reached. We will utilize RevMan 5.3 software to pool the data and to conduct the data analysis.

Results:
This study will summarize the most recent RCTs to investigate the efficacy and safety of NSCT in the treatment of patients with SCI.

Conclusion:
This study will provide evidence to assess the efficacy and safety of NSCT in the treatment of patients with SCI at evidence-based medicine level.

Systematic review registration:
PROSPERO CRD42020173792.
Sodium–Glucose Cotransporter-2 Inhibitors and the Risk of Amputation: What Is Currently Known?
Authors: Misher Anne , Ampuero Andrea , Phan Rebecca , Aziz Soma , Ebong Eti , Braich Judy , Dyches Kristin , Southwood Robin 
Published: May 2020

Background:
Diabetes mellitus is a major cause of morbidity and mortality in the United States. Twelve medication classes on the market reduce serum glucose including sodium–glucose cotransporter-2 (SGLT2) inhibitors. Potential benefits of these agents include improved glycemic control, weight loss, reduction in blood pressure, and possible reduction in cardiovascular events in patients with elevated cardiovascular risk.

Areas of Uncertainty:
Recently, several adverse events have been identified including increased possible risk of amputation associated with SGLT2 inhibitor therapy.

Data Source:
We conducted a review of published literature and identified 32 trials reviewing incidence of SGLT2 inhibitor-related amputation.

Results:
The potential increased risk for amputation is mostly of the lower extremities. Of the SGLT2 inhibitors currently available, canagliflozin has the highest association with an increased risk of lower extremity amputation and is the only agent with a Food and drug Administration Black Box Warning. Most canagliflozin amputation occurred in a single study. Risk factors for amputation with SGLT2 inhibitors may include those who have a history of amputations, susceptible to foot ulcers and those with baseline cardiovascular disease.

Conclusions:
For at-risk patients who desire an agent from this drug class, empagliflozin or dapagliflozin should be considered, as studies have not found a significant increase in amputations when compared with placebo or in retrospective reviews. Despite the increased risk of amputation found with canagliflozin, providers can use SGLT2 inhibitors with frequent monitoring to safely manage diabetes in low-risk patients. Patient education on associated risks is warranted. Diabetes educators can inform patients of risk factors to assist with monitoring.
Improved Outcome of Intestinal Failure in Preterm Infants
Authors: Fredriksson Fanny , Nyström Niklas , Waldenvik Kajsa , Ördén Helene , Lindblom Maja , Paulsson Mattias , Finkel Yigael , Lilja Helene Engstrand 
Published: May 2020

ABSTRACTObjective:The aim of the study was to evaluate the outcome and to identify predictors for survival and enteral autonomy in neonatal intestinal failure (IF).Methods:A retrospective observational study in a Swedish tertiary centre of children born between 1995 and 2016 with neonatal IF, defined as dependency on parenteral nutrition (PN) ≥60 days, starting with PN before the age of 44 gestational weeks. Data were extracted from medical records and predictors for survival and enteral autonomy were identified by the Cox regression model. Time to death and weaning off PN analysis were performed with Kaplan‐Meier curves including log rank test.Results:In total, 105 children were included. Median gestational age was 28 weeks (22–42), 50% were born extremely preterm (<28 gestational weeks). PN started at a median age of 2 days (0–147) with a median duration of 196 days (60–3091). Necrotizing enterocolitis was the dominating cause of IF (61%). Overall survival was 88%, 5 children died of sepsis and 4 of intestinal failure‐associated liver disease. Survival increased from 75% during 1995 to 2008 to 96% during 2009 to 2016 (P = 0.0040). Age‐adjusted small bowel length of >50% and birth 2009 to 2016 were predictors for survival. Enteral autonomy was achieved in 87%, with positive prediction by small bowel length of >25% of expected for gestational age and remaining ileocecal valve.Conclusions:Preterm neonates with IF, at high risk of IF‐associated morbidity, showed a high overall survival rate. Small‐bowel length and being born 2009 to 2016 were predictors for survival and remaining ICV and small‐bowel length were predictors for enteral autonomy.
Sudden Death Due to a Cerebellopontine Angle Epidermoid Cyst
Authors: Bel Hadj Mariem , Ben Jomâa Sami , Njima Manel , Ben Abdeljelil Nouha , Chadly Ali 
Published: May 2020

Abstract
Epidermoid cyst of the brain is a rare benign embryonal tumor. It has an excellent prognosis because of its slow-growing nature. Clinically, symptoms are variable and depend on the location of the cyst. Sudden death may occur as a result of lethal complications because of the tumor growth, but it is still rare. In this article, we present a rare case of sudden unexpected death of a 58-year-old man, with no neurologic history, due to an epidermoid cyst of the brain diagnosed at autopsy.
The Utility of a Travel Screen at Triage in Pediatric Emergency Medicine
Authors: Greenky David , Gillespie Scott , Levine Aly , Murray Brittany 
Published: May 2020

Background
The travel screen was implemented by emergency departments (EDs) across the country in 2014 to detect patients exposed to Ebola early and prevent local outbreaks. It remains part of the triage protocol in many EDs to detect communicable disease from abroad and has become a defacto screen for other travel-related illness. Its utility has not been studied in the pediatric ED.

Methods
This was a retrospective review of electronic medical records across 3 EDs from January 1, 2016, to December 31, 2016. The screening question reads, “Has the child or a close contact of the child traveled outside the United States in the past 21 days?” A follow-up question requesting travel details is included for positive screens. We compared length of stay, return-visit rates, and differences in disposition between patients with positive and negative travel screens using generalized linear regression. Matched regression estimates, 95% confidence intervals, and P values were reported.

Results
The study population included 152,945 patients with a total of 322,229 encounters in 2016, of which 232,787 encounters had a travel screen documented during triage. There were 2258 patient encounters that had positive travel screens. Only 201 (8.9%) of these encounters had further description of the travel in the comments box. The odds of hospital admission for patients with positive travel screens were 1.76 (95% confidence interval, 1.54–2.01; P < 0.001) times the odds of hospital admission for patients screened negative. The significance of this finding was largely driven by general hospital admission. Other metrics did not differ significantly between the groups.

Conclusions
Although a positive travel screen was mildly predictive of inpatient admission, information is not available to providers about travel-related risk. Recent literature suggests integrating a travel history with presenting symptoms and region of travel and could produce a more specific travel screen. A revised travel screen should be implemented and studied in the pediatric ED.
Trends in Time From HIV Diagnosis to First Viral Suppression Following Revised US HIV Treatment Guidelines, 2012–2017
Authors: Crepaz Nicole , Song Ruiguang , Lyss Sheryl , Hall H. Irene 
Published: May 2020

Background:
Since 2012, treatment guidelines have recommended initiating antiretroviral therapy for all persons as soon as possible after HIV diagnosis, irrespective of CD4 counts. If clinicians adopted the treatment guidelines, a shortened interval between diagnosis and first viral suppression (Dx-to-VS) would be expected, with greater declines among those with CD4 counts ≥500 cells/µL at diagnosis.

Methods:
Using the National HIV Surveillance System data, we examined Dx-to-VS intervals among persons aged ≥13 years with HIV infection diagnosed during 2012–2017. Analyses were stratified by the first CD4 count: CD4 ≥500 cells/µL, 200–499 cells/µL, <200 cells/µL, and no CD4 value reported within 3 months after diagnosis.

Results:
During 2012–2017 in the 27 US jurisdictions with complete laboratory reporting, 138,759 HIV diagnoses occurred. The median Dx-to-VS interval shortened overall for persons with HIV diagnosed in 2012 vs. 2017 from 9 to 5 months, a 12.3% annual decrease (P < 0.001) and in all CD4 groups. In 2012, the Dx-to-VS interval was longer for persons with CD4 ≥500 cells/µL than 200–499 cells/µL and <200 cells/µL (median, 9, 7, and 6 months, respectively). By 2017, the median interval was 4 months for these groups, compared with 25 months for those without a CD4 value within 3 months after diagnosis.

Conclusion:
Decreases in Dx-to-VS intervals across all CD4 groups with a greater decrease among those with CD4 ≥500 cells/µL are consistent with the implementation of treatment recommendations. The Dx-to-VS interval was longest among persons not linked to care within 3 months after diagnosis, underscoring the importance of addressing barriers to linkage to care for ending the HIV epidemic.
Associations Between Physician Prescribing Behavior and Persistent Postoperative Opioid Use Among Cancer Patients Undergoing Curative-intent Surgery
Authors: Xu Yuan , Cuthbert Colleen A. , Karim Safiya , Kong Shiying , Dort Joseph C. , Quan May Lynn , Hinther Ashley V. , Quan Hude , Hemmelgarn Brenda R. , Cheung Winson Y. 
Published: May 2020

Objective:
This study aimed to evaluate the association between prescribers’ opioid prescribing history and persistent postoperative opioid use in cancer patients undergoing curative-intent surgery.

Background:
Study has shown that patients may be over-prescribed analgesics after surgery. However, whether and how the prescriber's opioid prescribing behavior impacts persistent opioid use is unclear.

Methods:
All adults with a diagnosis of solid cancers who underwent surgery during the study period (2009–2015) in Alberta, Canada and were opioid-naïve were included. The key exposure was the historical opioid-prescribing pattern of a patient's most responsible prescriber. The primary outcome was “new persistent postoperative opioid user,” was defined as a patient who was opioid-naïve before surgery and subsequently filled at least 1 opioid prescription between 60 and 180 days after surgery.

Results:
We identified 24,500 patients. Of these, 2106 (8.6%) patients became a new persistent opioid user after surgery. Multivariate analysis demonstrated that patients with most responsible prescribers that historically prescribed higher daily doses of opioids (≥50 vs <50 mg oral morphine equivalent) had an increased risk of new persistent opioid use after surgery (odds ratio = 2.41, P < 0.0001). In addition to the provider's prescribing pattern, other factors including younger age, comorbidities, presurgical opioid use, chemotherapy, type of tumor/surgical procedure were also found to be independently associated with new persistent postoperative opioid use.

Conclusions:
Our results suggest that prescriber with a history of prescribing a higher opioid dose is an important predictor of persistent postoperative opioid use among cancer patients undergoing curative-intent surgery.