bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of digestive symptoms with severity and mortality of COVID-19
Authors: Zhang Yufang , Ma Peifen , Zhang Xiu , Pei Zhuoxi , Wang Haixia , Dou Xinman 
Published: October 2020

Abstract

Background:
Gastrointestinal manifestations are common in patients with COVID-19, but the association between specific digestive symptoms and COVID-19 prognosis remains unclear. This study aims to assess whether digestive symptoms are associated with COVID-19 severity and mortality.

Methods:
We will search PubMed, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials up to September, 2020, to identify studies that compared the prevalence of at least one specific digestive symptom between severe and non-severe COVID-19 patients or between non-survivors and survivors. Two independent reviewers will assess the risk of bias of the included cohort studies using the modified Newcastle-Ottawa Scale. Meta-analyses will be conducted to estimate the pooled prevalence of individual symptoms using the inverse variance method with the random-effects model. We will conduct subgroup analyses, sensitivity analyses, and meta-regression analyses to explore the sources of heterogeneity. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach will be used to assess the quality of the evidence.

Results:
The results of this study will be published in a peer-reviewed journal.

Conclusion:
Our meta-analysis will comprehensively evaluate the association between different digestive symptoms and the severity and mortality of patients infected with COVID-19. This study will provide evidence to help determine whether special protective measures and treatment options are needed for patients with digestive system comorbidities during the COVID-19 pandemic.

INPLASY registration number:
INPLASY202090055.
The effect of acupuncture on depression and its correlation with metabolic alterations
Authors: Li Wei , Sun Manqin , Yin Xuan , Lao Lixing , Kuang Zaoyuan , Xu Shifen 
Published: October 2020

Abstract

Background:
Electroacupuncture (EA) treatment has antidepressant effect and when patients were treated with EA and antidepressants, the effect could be maintained for a longer time. However, the effect of EA combined with antidepressants based on metabolism is still in the initial observation stage, which requires further research.

Methods:
A total of 60 patients with moderate depression were assigned into 2 groups at a ratio of 1:1, the EA group (receiving EA and antidepressants) and the control group (taking antidepressants only) in this randomized controlled pilot trial. The EA treatment was performed 3 times a week for 8 consecutive weeks and then follow up for 4 weeks. The patients’ depressive mood was measured by the Hamilton Depression scale (HAMD) at baseline, week 4, week 8 and week 12. Before and after 8-week treatment, morning urine samples from all patients were analyzed by the gas chromatography–mass spectrometry (GC–MS) to find possible metabolic markers of depression and of EA treatment related changes.

Results:
Compared with the control group, the EA group showed more significant improvements in depressive symptoms measured by HAMD at week 4 (16.89 ± 5.74 vs 25.58 ± 7.03, P < .001), week 8 (9.59 ± 5.13 vs 25.04 ± 7.49, P < .001) and week 12 (11.07 ± 6.85 vs 27.25 ± 7.14, P < .001). The significant differences in urinary specific metabolites before and after EA treatment were malonic acid (fatty acid biosynthesis), cysteine (glutamate metabolism), glutathione (glutamate metabolism), tryptophan (tryptophan metabolism), proline (glutamate metabolism), and N-acetyl-5-hydroxytryptamine. These metabolites are involved in tryptophan metabolism, glutamate metabolism, and fatty acid biosynthesis.

Conclusion:
EA treatment combined with antidepressants is more effective in improving depressive symptoms than antidepressants alone. EA may treat depression by acting on tryptophan metabolism, glutamate metabolism, and fatty acid biosynthesis.

Trial registration:
Chinese Clinical Trial Registry: ChiCTR-2000030786.
The adverse effects of novel coronavirus on diabetic foot patients
Authors: Chen Dongqiong , Zhou Hui , Yang Yan , Zhang Yuan , Xie Chunguang 
Published: October 2020

Abstract

Background:
Since the outbreak of novel coronavirus in 2019, the number of new coronavirus infections worldwide has been increasing, there is no effective treatment or vaccine. Novel coronavirus infection is closely related todiabetes, the mortality of diabetes with novel coronavirus pneumonia is significantly higher than that of non diabetic with novel coronavirus pneumonia, Diabetic foot is one of the common and serious complications of diabetes, however, no systematic study on novel coronavirus pneumonia adverse effects on diabetic foot has been found at home and abroad, however, this is a problem that can not be ignored.

Methods:
We will search each database from the built-in until April 2021. The English literature mainly searches Cochrane Library, PubMed, EMBASE, and Web of Science, while the Chinese literature comes from CNKI, CBM, VIP, and Wangfang database. Simultaneously we will retrieval clinical registration tests and grey literatures, and he researches related to the adverse effects of novel coronavirus on diabetic foot were collected, The 2 researchers worked independently on literature selection, data extraction, and quality assessment. The dichotomous data is represented by relative risk, and the continuous is expressed by mean difference or standard mean difference, eventually the data is synthesized using a fifixed effect model or a random effect model depending on whether or not heterogeneity exists. The primary outcome was clinical response rate, C-reactive protein and procalcitonin. Secondary outcomes are mainly including mortality, amputation rate, wound healing time and nerve conduction velocity. Finally, meta-analysis was conducted by RevMan software version 5.3.

Results:
The results of our research will be published in a peer-reviewed journal.

INPLASY registration number:
202080113
Survival and prognostic analysis of preoperative indicators in patients undergoing surgical resections with rhabdomyosarcoma
Authors: Jin Hongyu , Zhang Man , Zhou Hui , Zhu Shiyu , Hu Chenggong 
Published: October 2020

Abstract
Several preoperative blood and biochemical parameters are associated with postoperative survival in many kinds of tumors. The aim of this study is to study the predictive value of several routine preoperative blood and biochemical parameters on the prognosis patients with rhabdomyosarcoma (RMS).
We retrospectively recruited 55 patients diagnosed with RMS and had surgery at West China Hospital, Sichuan University between January 2010 and December 2018. Baseline characteristics of the patients, tumor features, surgery details, and values of several examinations were extracted. A long-term follow-up was conducted by phone call. A novel statistical analysis was subsequently carried out to look for the relationship of preoperative parameters and patients’ prognosis.
The ROC analysis showed an area under curve (AUC) of 0.608, 0.620, 0.626, 0.591, and 0.518 for neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), monocyte to lymphocyte ratio (MLR), lactic dehydrogenase (LDH), and alkaline phosphatase (ALP) respectively, and the cut-off value of 2.843, 162.961, and 0.239 for NLR, PLR, and MLR respectively. The survival analysis showed that certain blood and biochemical parameters could cause differences in overall survival (OS) (P = .005 for NLR, P = .005 for PLR, and P = .007 for MLR) and progression free survival (PFS) (P = .029 for NLR, P = .008 for PLR, and P = .013 for MLR).
Several preoperative blood and biochemical parameters are novel prognostic factors in RMS patients. Specifically, a higher NLR, PLR, and MLR value will predict a statistically shorter OS and PFS.
In the future, surgeons should care more about NLR, PLR, and MLR values and several other parameters in patients’ preoperative normal blood and biochemical tests to predict the postoperative conditions.
Continuous adductor canal block provides better performance after total knee arthroplasty compared with the single-shot adductor canal block?
Authors: Yu Rongguo , Wang Haiyang , Zhuo Youguang , Liu Dongxin , Wu Chunling , Zhang Yiyuan 
Published: October 2020

AbstractBackground:Adductor canal block (ACB) has emerged as an attractive alternative for femoral nerve blocks (FNB) as the peripheral nerve block of choice for total knee arthroplasty (TKA), preserving quadriceps motor function while providing analgesia comparable to FNB. However, its optimal application for TKA remains controversial. The objective of this meta-analysis was to compare continuous-injection ACB (CACB) vs single-injection ACB (SACB) for postoperative pain control in patients undergoing TKA.Methods:This study attempts to identify the available and relevant randomized controlled trials (RCTs) regarding the analgesic effects of CACB compared to SACB in patients undergoing TKA according to electronic databases, including PubMed, Medline, Web of Science, EMbase, and the Cochrane Library, up to September 2019. Primary outcomes in this regard included the use of a visual analogue scale (VAS) pain score with rest or activity, while secondary outcomes were cumulative opioid consumption, length of hospital stay (LOS), complications of vomiting and nausea, and rescue analgesia. The corresponding data were analyzed using RevMan v5.3.Ethical review:Because all of the data used in this systematic review and meta-analysis has been published, the ethical approval was not necessaryResults:This research included 9 studies comprised of 739 patients. The analyzed outcomes demonstrated that patients who received CACB had a better at rest-VAS scores at 4 hours (P = .007), 8 hors (P < .0001), 12 hours (P < .0001), 24 hours (P = .02), mobilization-VAS score at 48 hours (P < .0001), and rescue analgesia (P = .03) than those who underwent SACB. Nevertheless, no significant differences were present between the 2 strategies in terms of pain VAS scores 48 hours at rest (P = .23) and 24 hours at mobilization (P = .10), complications of vomiting and nausea (P = .42), and length of hospital stay (P = .09).Conclusion:This meta-analysis indicated that CACB is superior to SACB in regard to analgesic effect following TKA. However, due to the variation of the included studies, no firm conclusions can be drawn. Further investigations into RCT are required for verification.
Outcomes of patients with a non-diagnostic initial bronchoscopy for suspected thoracic malignancy
Authors: Gaddam Maneesh , Paff Stephen , Venkatram Sindhaghatta , Diaz-Fuentes Gilda 
Published: October 2020

Abstract
Lung cancer is 1 of the leading causes of cancer-related deaths and bronchoscopy is an essential tool for the diagnosis. The diagnostic yield varies based on the characteristics of the lesion and bronchoscopic techniques employed. There is limited data regarding outcomes of patients suspected of thoracic malignancies with a non-diagnostic initial bronchoscopy. The goal of the study was to evaluate the outcomes of patients with a non-diagnostic bronchoscopy for suspected thoracic malignancies and to evaluate variables predictive of a diagnostic bronchoscopy.
Retrospective analysis of adult patients at BronxCare Hospital Center who underwent bronchoscopy for suspected thoracic malignancy. The study period was January 2012 to February 2019. Exclusion criteria included patients who underwent only inspection bronchoscopy or bronchoalveolar lavage as the diagnostic yield for malignancy with these techniques is low. All other bronchoscopic procedures were included that is, endobronchial biopsies, transbronchial biopsies, and endobronchial ultrasound guided-transbronchial needle aspiration. Bronchoscopy was considered diagnostic when a specific histopathological diagnosis was established.
311 patients underwent bronchoscopy to rule out malignancy. A diagnosis was obtained in 153 (49.2%) patients, 81 (52.9%) had primary lung cancer and 14 (9.15%) other malignancies. 158 (50.8%) patients had initial non-diagnostic bronchoscopy; 86 (54.43%) were lost to follow up. Of the remaining 72 (45.57%) patients, radiological resolution or stability was observed in 51 (70.8%) patients. Primary lung cancer was found in 13 (18.05%) patients and other malignancies in 5 (6.94%). Predictive of a diagnostic bronchoscopy was the performance of endobronchial biopsies and endobronchial ultrasound guided-transbronchial needle aspiration.
This study highlights some of the barriers to the timely diagnosis of thoracic malignancies. Following patients with a non-diagnostic procedure as well as all those patients with diagnosed malignancies it of the utmost importance. In patients available for follow up, close to 25% of additional cases with treatable malignancy could be identified and patients diagnosed with cancer could receive timely treatment.
Schmorl node induced multiple radiculopathy
Authors: Chen Yongjie , Wei Guojun , Li Zongguang , Yu Naichun , Gong Fengqing , Ji Guangrong 
Published: October 2020

Abstract

Rationale:
We report a case of Schmorl node induced multiple radiculopathy.

Patient concerns:
A 70-year-old female patient complained of lower back pain in the left leg accompanied by numbness and weakness.

Diagnosis:
Radiographs showed obvious osteoporosis in the lumbar vertebrae. Computed tomography demonstrated a hole in the upper posterior half of the L2 vertebral body. Magnetic resonance imaging of the lumbar spine revealed a herniated disc involving a protrusion at the posterior wall of the L2 vertebral body, which was present in the left lateral and dorsal epidural spaces. There was significant lumbar stenosis at the L2 vertebral body secondary to dural sac compression due to the mass.

Intervention:
Left-sided hemilaminectomy was performed at L2 with screw fixation at L1–3. Intraoperatively, the severely ruptured disc compression in the dural sac and nerve root was removed.

Outcomes:
The patient's leg pain was immediately resolved, and her back pain was reduced. The patient recovered normal motor function at 20 days after surgery.

Lessons:
A Schmorl node can progress and break through the lumbar vertebral body, resulting in nerve compression. A large proximal herniated mass can cause distal multiple radiculopathy. Therefore, this special case of Schmorl node with multiple radiculopathy should be treated by removing the proximal herniated nucleus pulposus from the vertebral body.
Scalp acupuncture for patients with vascular dementia
Authors: Li Jie , Man Qiuhong , Wang Wenchun , Pang Rizhao , Liu Jiancheng , Zhang Feng , Zhang Anren 
Published: October 2020

AbstractBackground:Vascular dementia (VD) is a kind of acquired intelligence impairment syndrome caused by a series of cerebrovascular factors leading to brain tissue damage. Scalp acupuncture is widely used to treating VD. However, there is no a systematic review has been used to assess the efficacy and safety of scalp acupuncture therapy for VD. Therefore, the purpose of this paper is to systematically evaluate the effects of scalp acupuncture on VD.Methods:We will search the following databases from their inception to July 2020: PubMed, Chinese National Knowledge Infrastructure (CNKI), Wan Fang Database, Embase, Medline, Chinese Biomedical Literature Database (CBM), EBSCO, Web of Science, Technology Periodical Database (VIP), the Chongqing VIP Chinese Science and Cochrane Library. At the same time, we will retrieve other resources including conference articles, and gray literature. The randomized controlled trials (RCTs) in English or Chinese associated with scalp acupuncture for VD will be included. Our study data collection and analysis will be conducted independently by 2 reviewers, and Rev Man V.5.3.5 statistical software will be used to performing meta-analysis.Results:This review research will provide a high-quality synthesis to evaluate the efficacy and safety of scalp acupuncture for patients with VD.Conclusion:This study will provide available evidence to judge whether scalp acupuncture is an effective and safe intervention for patients with VD. It also will provide reliable evidence for its widespread application.Ethics and dissemination:This systematic review will provide convincing evidence for both patients and clinicians. It does not require ethical approval and the results will be published in a peer-reviewed journal.OSF Registration number:DOI 10.17605/OSF.IO/7CYZR.
Myositis ossificans of the thigh causing external compression of the superficial femoral artery and vein
Authors: Wang Sung Il , Park Eun Hae , Hwang Hong Pil , Kim Jung Ryul 
Published: October 2020

Abstract

Rationale:
Myositis ossificans (MO) is a benign condition characterized by heterotopic bone formation in the skeletal muscle of extremities. Marked variation can occur in the incidence and location of the bone formed as well as resulting complications. Femoral vessel obstruction caused by MO is an extremely rare but disabling complication. Arterial occlusion may aggravate ischemic conditions, resulting in necrosis in the lower extremity.

Patient concerns:
We report a 41-year-old female with progressive pain and swelling of the right thigh region for 1 year.

Diagnoses:
We diagnosed it as obstruction of the superficial femoral artery and vein caused by external compression of the MO between the sartorius and vastus medialis of the thigh.

Interventions and outcomes:
Adherent tissues and mass were excised with care without damaging the femoral artery or the vein. However, normal morphology did not recover due to loss of elasticity of femoral vessels. Therefore, after resection of the narrowed region of the femoral artery, a femoral-to-femoral graft interposition using the greater saphenous vein was performed. At 12 months after the surgery, vessel reconstruction computed tomography images confirmed normal continuous flow of the femoral artery.

Lessons:
Vascular compression and peripheral inflammatory response due to MO can cause loss of normal vascular morphology. Surgical excision of the mass and the involved femoral artery segment followed by femoral arterial reconstruction should be considered for lesions that do not spontaneously regress to prevent functional impairment and secondary complications in extremities.
Mast cells activation and high blood tryptase levels due to paclitaxel administration. Is Cremophor EL the culprit?
Authors: D’Errico Stefano , Baldari Benedetta , Arcangeli Mauro , Santurro Alessandro , Frati Paola , Fineschi Vittorio 
Published: October 2020

Abstract

Rationale:
Although the cancer incidence continues to rise, cancer mortality has declined over the past decade, in large part due to more efficacious chemotherapeutic regimens thus, the ability to use first-line chemotherapeutic agents in the treatment of patients with cancer is crucial. Antineoplastic agents can potentially cause toxic and/or hypersensitivity reactions, that can have serious consequences. Anaphylaxis is a big pitfall in oncological patients; the most important aspect in diagnosing anaphylaxis is to precisely identify the offending agent to prevent future events. Paclitaxel (Taxol) is widely used as antitumor medication in the ovarian, breast, non-small-cell lung, and other cancers. Paclitaxel hypersensitivity reactions are frequently described in the literature, but fatalities are rarely reported. Due to the low solubility of paclitaxel, the compound requires dissolution in Cremophor EL, a derivative of castor oil.

Patient concerns:
A 79-year-old man was affected by high-grade non-papillary urothelial carcinoma and underwent a radical cystectomy and prostatectomy with locoregional lymphadenectomy.

Diagnosis:
Eight months later, relapse was detected, and penis amputation and left nephrostomy were performed. Multiple metastases to lymph nodes were detected.

Interventions:
Palliative chemotherapy was started with Paclitaxel (110 mg) infused at a rate of 50 mL/h. Despite premedication with cetirizine dihydrochloride, dexamethasone, ondansetron, ranitidine, 20 min after Paclitaxel infusion starts, the patient developed general distress, followed by cardiac arrest.

Outcomes:
The mechanism of fatal paclitaxel-associated hypersensitivity reaction is uncertain and its solvent vehicle Cremophor EL may be involved. Several mechanisms have been postulated: an IgE-mediated mast cell degranulation induced by paclitaxel or Cremophor EL, a non-IgE-mediated idiosyncratic mast cell degranulation by paclitaxel or by Cremophor EL, and complement activation. Severe hypersensitivity reactions with fatal outcome are considered rare.

Lessons:
The unpredictability and often dramatic reactions of Taxol cause substantial anxiety for doctors and caretakers. They also represent a significant logistic and financial burden on hospitals. Despite premedication, skin testing, and desensitization protocols administration of taxane-based, chemotherapy cannot be considered safe and severe to fatal hypersensitivity reactions cannot be prevented.
COVID-19 presenting as fulminant hepatic failure
Authors: Melquist Stephanie , Estepp Kayla , Aleksandrovich Yauheni , Lee Angela , Beiseker Andrea , Hamedani Farid Saei , Bassett John 
Published: October 2020

Abstract
Introduction: Severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) responsible for the COVID-19 pandemic has spread from Wuhan, China in December, 2019 to 216 countries and territories as of September 10, 2020 with 27.74 million cases and 899,911 confirmed deaths. The spectrum of disease is most commonly seen as a viral pneumonia with high grade fevers, shortness of breath, dry cough, and chest pain with radiologic evidence of bilateral, interstitial, ground glass opacities, and peripheral lung consolidation. Liver chemistries are frequently abnormal, with transaminases shown to be one-two times the upper limit of normal in most instances. The full spectrum of gastrointestinal involvement of the SARS-CoV-2 infection has yet to be fully seen.
Patient concerns: We present a case of a young woman with SLE who developed severe abdominal pain, nausea and vomiting, rapidly progressing to acute hepatic failure and tested positive for SARS-CoV-2 infection. She had no respiratory symptoms.
Diagnosis: A thorough work-up of acute liver failure including liver biopsy confirmed acute hepatitis with viral like changes. Common viral causes of liver failure were ruled out. The patient had no recent travel history.
Interventions: The patient was started on hydroxychloroquine due to SLE, treated with N-Acetyl-Cysteine, and methylprednisolone.
Outcomes: The patient improved with resolution of encephalopathy and normalization of her liver chemistries without any development of respiratory illness.
Conclusion: This case details a unique presentation of likely SARS-CoV-2 infection. Until now, the literature has primarily described a respiratory illness and liver injury with mild transaminase elevations. Significant liver injury progressing to acute liver failure should be considered in those with SARS-CoV-2 infection.