bluuebunny/crossref_metadata_2025_split huggingface dataset:
EGFR, KRAS, BRAF, ALK, and cMET genetic alterations in 1440 Sardinian patients with lung adenocarcinoma
Authors:   Sardinian Lung Cancer (SLC) Study Group, Colombino Maria , Paliogiannis Panagiotis , Cossu Antonio , Santeufemia Davide Adriano , Sini Maria Cristina , Casula Milena , Palomba Grazia , Manca Antonella , Pisano Marina , Doneddu Valentina , Palmieri Giuseppe 
Published: November 2019

Abstract

Background
Lung cancer is one of the most incident neoplastic diseases, and a leading cause of death for cancer worldwide. Knowledge of the incidence of druggable genetic alterations, their correlation with clinical and pathological features of the disease, and their interplay in cases of co-occurrence is crucial for selecting the best therapeutic strategies of patients with non-small cell lung cancer. In this real-life study, we describe the molecular epidemiology of genetic alterations in five driver genes and their correlations with the demographic and clinical characteristics of Sardinian patients with lung adenocarcinoma.

Methods
Data from 1440 consecutive Sardinian patients with a histologically proven diagnosis of lung adenocarcinoma from January 2011 through July 2016 were prospectively investigated. EGFR mutation analysis was performed for all of them, while KRAS and BRAF mutations were searched in 1047 cases; ALK alterations were determined with fluorescence in situ hybridization in 899 cases, and cMET amplifications in 788 cases.

Results
KRAS mutations were the most common genetic alterations involving 22.1% of the cases and being mutually exclusive with the EGFR mutations, which were found in 12.6% of them. BRAF mutations, ALK rearrangements, and cMET amplifications were detected in 3.2, 5.3, and 2.1% of the cases, respectively. Concomitant mutations were detected only in a few cases.

Conclusions
Almost all the genetic alterations studied showed a similar incidence in comparison with other Caucasian populations. Concomitant mutations were rare, and they probably have a scarce impact on the clinical management of Sardinians with lung adenocarcinoma. The low incidence of concomitant cMET amplifications at diagnosis suggests that these alterations are acquired in subsequent phases of the disease, often during treatment with TKIs.
Spontaneous remission of advanced progressive poorly differentiated non-small cell lung cancer: a case report and review of literature
Authors: Yoon Hee-Young , Park Heae Surng , Cho Min Sun , Shim Sung Shin , Kim Yookyung , Lee Jin Hwa 
Published: November 2019

AbstractBackgroundSpontaneous remission (SR) of cancer is a very rare phenomenon of unknown mechanism. In particular, SR of non-small cell lung cancer (NSCLC) has been scarcely reported. We present the case of a 74-year-old woman with advanced, poorly differentiated NSCLC (highly expressing programmed death ligand-1 [PD-L1]) that progressed despite multiple lines of chemotherapy but then spontaneously remitted.CASE presentationThe patient presented with hemoptysis and was diagnosed with stage IIIA poorly differentiated NSCLC via bronchoscopic biopsy. She had an unremarkable medical history and moderate performance status. The initial treatment plan was surgery after neoadjuvant chemotherapy. Despite conventional chemotherapy, follow-up chest computed tomography (CT) showed gradual tumor progression and she decided against further treatment after fifth-line chemotherapy. However, the size of lung mass was markedly decreased on follow-up chest CT one year after ceasing chemotherapy. Also, follow-up positron emission tomography images showed decreased metabolic activity in the lung mass and a percutaneous biopsy specimen from the diminished lung mass revealed no viable tumor cells. A diagnosis of SR of NSCLC was confirmed, and the patient was without tumor progression on follow-up nine months later. Later, PD-L1 immunostaining revealed high positivity (> 99%) in initial tumor cells.ConclusionOur case showing SR of poorly advanced NSCLC refractory to multiple lines of chemotherapy suggested the association between immunity and tumor regression.
Abdominal cocoon with bilateral cryptorchidism and seminoma in the right testis: a case report and review of literature
Authors: Yue Bingqing , Cui Zilian , Kang Weiting , Wang Hanbo , Xiang Yuzhu , Huang Zhilong , Jin Xunbo 
Published: November 2019

Abstract

Background
Abdominal cocoon is a rare peritoneal lesion and is difficult to diagnose because of its lack of special clinical manifestations. Until now, there is no case report of abdominal cocoon combined with cryptorchidism and seminoma.

Case presentation
A case of abdominal cocoon with cryptorchidism and seminoma was diagnosed and treated in our hospital. The patient had no symptoms except occasional abdominal pain. He underwent laparoscopy because of bilateral cryptorchidism and seminoma in the right testis. During the surgery, he was diagnosed with abdominal cocoon due to the thick fibrous tissues which was tightly adhered and encased part of intestine like a cocoon. Enterolysis and bilateral cryptochiectomy were performed after the diagnosis and nutritional and symptomatic support was provided after the surgery. The patient recovered well and was discharged soon. The postoperative pathological examination confirmed the presence of bilateral cryptorchidism and seminoma in the patient’s right testis.

Conclusion
There are only a handful of cases where a patient has both abdominal cocoon and cryptorchidism. Since the etiologies of both diseases remain unknown, further research is required to investigate effective diagnosis and treatment for the diseases and explore the potential connection between the two diseases.
Surgical approaches for treatment of ureteropelvic junction obstruction – a systematic review and network meta-analysis
Authors: Uhlig Annemarie , Uhlig Johannes , Trojan Lutz , Hinterthaner Marc , von Hammerstein-Equord Alexander , Strauss Arne 
Published: November 2019

Abstract

Background
Multiple surgical treatment options are available for the treatment of ureteropelvic junction obstruction (UPJO). The aim of this study is to compare the most frequently used technics in a comprehensive network approach.

Methods
A systematic literature search of the EMBASE, MEDLINE and COCHRANE libraries was conducted in January 2018. Publications were included that evaluated at least two of the following surgical techniques: open pyeloplasty (OP), endopyelotomy (EP), laparoscopic (LP) and robot assisted pyeloplasty (RP). Main outcomes were operative success, complications, urinary leakage, re-operation, transfusion rate, operating time, and length of stay. Network meta-analyses with random effects models simultaneously assessed effectiveness of all surgical techniques.

Results
A total of 26 studies including 3143 patients were analyzed. Compared with RP, EP and LP showed lower operative success rates (EP: OR = 0.09, 95%CI:0.05–0.19; p < 0.001; LP: OR = 0.51, 95%CI:0.31–0.84; p = 0.008). Compared with OP, LP and RP had lower risk for complications (LP: OR = 0.62; 95%CI:0.41–0.95; p = 0.027; RP: OR = 0.41; 95%CI:0.22–0.79; p = 0.007). Compared with RP, no significant differences were detected for urinary leakage or re-operation, transfusion rates. Compared with EP, RP yielded longer operating time (mean = 102.87 min, 95%CI:41.79 min–163.95 min, p = < 0.001). Further significant differences in operating times were detected when comparing LP to EP (mean = 115.13 min, 95%CI:65.63 min–164.63 min, p = < 0.001) and OP to EP (mean = 91.96 min, 95%CI:32.33 min–151.58 min, p = 0.003).

Conclusions
Multiple surgical techniques are available for treatment of UPJO. RP has the highest rates of operative success and as well as LP lower complication rates than OP. Although surgical outcomes are worse for EP, its operating time is shorter than OP, RP, and LP. Surgeons should consider these findings when selecting the optimal treatment method for individual patients.
Agenesis of the dorsal pancreas presenting with diabetic ketoacidosis – a case report and literature review
Authors: Yang Tian , Yang Xudan , Wang Luping , Mo Jun 
Published: November 2019

Abstract

Background
Agenesis of the dorsal pancreas (ADP) is clinically rare, and it is usually accompanied by abdominal pain. Various disorders of glucose metabolism associating with ADP have been reported, but there are only two studies reporting a correlation between ADP and DKA in English literature.

Case presentation
We present a case of a patient with ADP accompanied by abdominal pain and diabetic ketoacidosis as the initial clinical presentation. A 30-year-old man presented with a 3-month history of recurrent onset of persistent mild epigastric pain, which worsen when eating. Laboratory tests revealed metabolic acidosis, hyperglycemia, and ketonuria. Phase contrast CT and MRCP showed the absence of the body and tail of the pancreas, as well as the dorsal pancreatic duct. The C-peptide release test indicated β-cell dysfunction. A combination therapy of insulin, pancreatic enzyme supplements, and mosapride citrate were administrated and the pain gradually resolved.

Conclusions
As glucose metabolism disorders can vary across different individuals, we advise clinicians to consider the diagnosis of ADP for a patient who presents with a glucose metabolism disorder accompanied by abdominal pain, pancreatitis or steatorrhea.
Successful management of severe diabetic ketoacidosis in a patient with type 2 diabetes with insulin allergy: a case report
Authors: Nguyen Anh Dat , Luong Chinh Quoc , Chu Hieu Chi , Nguyen Van Khoa Dieu , Nguyen Chi Van , Nguyen Tuan Anh , Nguyen Quan Huu , Mai Ton Duy , Nguyen Dinh Van , Nguyen Bay Quang , Tran Thong Huu , Dao Phuong Viet , Nguyen Dat Tuan , Nguyen Nguyet Nhu , Do Son Ngoc 
Published: November 2019

Abstract

Background
Diabetic ketoacidosis (DKA) is an acute, major, life-threatening complication of diabetes that requires immediate treatment. Allergic reaction to insulin is rare, especially when using recombinant human insulin. The clinical presentation of insulin allergy can range from minor local symptoms to a severe generalized allergic reaction such as anaphylaxis. A limited number of cases have been reported on the treatment of severe DKA in patients with type 2 diabetes with insulin allergy. Here, we describe a patient with type 2 diabetes with insulin allergy in which severe DKA resolved after the initiation of continuous intravenous (IV) recombinant human insulin infusion.

Case presentation
A 58-year-old man with type 2 diabetes initiated subcutaneous insulin administration (SIA) after failure of oral antidiabetic treatment. Symptoms of an allergic reaction developed, including pruritic wheals appearing within 10 min of injection and lasting over 24 h. Both skin prick and intradermal tests were positive with different types of insulin. Two days before admission, he stopped SIA because of allergic symptoms and then experienced weakness and upper abdominal pain. On admission, he was in severe metabolic acidosis with a pH of 6.984 and bicarbonate of 2.5 mmol/litre. The blood glucose level was 20.79 mmol/litre, BUN 4.01 mmol/litre, creatinine 128 μmol/litre, and urinary ketone 11.44 mmol/litre. Over 24 h, metabolic acidosis was refractory to IV fluids, bicarbonate and potassium replacement, as well as haemodialysis. Ultimately, he received continuous IV recombinant human insulin infusion at a rate of 0.1 units/kg/hour, in combination with haemodiafiltration, and no further allergic reactions were observed. On day 5, ketonaemia and metabolic acidosis completely resolved. He had transitioned from IV insulin infusion to SIA on day 14. He was discharged on day 21 with SIA treatment. Three months later, he had good glycaemic control but still had allergic symptoms at the insulin injection sites.

Conclusions
In this patient, SIA caused an allergic reaction, in contrast to continuous IV insulin infusion for which allergic symptoms did not appear. Continuous IV recombinant human insulin infusion in combination with haemodiafiltration could be an option for the treatment of severe DKA in patients with diabetes with insulin allergy.
Follicular lymphoid hyperplasia of the posterior maxillary site presenting as uncommon entity: a case report and review of the literature
Authors: Watanabe Masato , Enomoto Ai , Yoneyama Yuya , Kohno Michihide , Hasegawa On , Kawase-Koga Yoko , Satomi Takafumi , Chikazu Daichi 
Published: November 2019

AbstractBackgroundFollicular lymphoid hyperplasia (FLH) is characterized by an increased number and size of lymphoid follicles. In some cases, the etiology of FLH is unclear. FLH in the oral and maxillofacial region is an uncommon benign entity which may resemble malignant lymphoma clinically and histologically.Case presentationWe report the case of a 51-year-old woman who presented with an asymptomatic firm mass in the left posterior maxillary site. Computed tomography scan of her head and neck showed a clear circumscribed solid mass measuring 28 × 23 mm in size. There was no evidence of bone involvement. Incisional biopsy demonstrated benign lymphoid tissue. The patient underwent complete surgical resection. Histologically, the resected specimen showed scattered lymphoid follicles with germinal centers and predominant small lymphocytes in the interfollicular areas. Immunohistochemically, the lymphoid follicles were positive for CD20, CD79a, CD10, CD21, and Bcl6. The germinal centers were negative for Bcl2. Based on these findings, a diagnosis of benign FLH was made. There was no recurrence at 1 year postoperatively.ConclusionsWe diagnosed an extremely rare case of FLH arising from an unusual site and whose onset of entity is unknown. Careful clinical and histopathological evaluations are essential in making a differential diagnosis from a neoplastic lymphoid proliferation with a nodular growth pattern.
Factors influencing incidents of complications while using nickel-titanium rotary instruments for root canal treatment
Authors: Madarati Ahmad A. 
Published: November 2019

AbstractBackgroundTo investigate the complications associated with the use of nickel titanium rotary instruments (NiTi-RIs) for root canal treatments (RCTs), in Saudi Arabia dental practice, and to explore the influencing factors.MethodsAfter obtaining an ethical approval, two pilot studies were conducted to formulate the final questionnaire. The sample size was measured taking into consideration 60% expected response rates and confidence level of 99.9%. The questionnaire was emailed to 600 general dentists (GDs) randomly selected from the dental register and all of the endodontists (175). The email’s introduction clarified objectives of the study and guaranteed that all of the collected information would remain confidential. A reminder was sent after 10 weeks. The data were collected and analyzed using the chi-squared test at a 0.05 significance level.ResultsWith a 51% overall response rate, 71.9% off the respondents used NiTi-RIs. The majority (83.1%) experiencedcomplicationswhile using NiTi-RIs; with theinstruments’ fracturebeing significantly the most common complication (52.7%) (p < 0.001). The majority (87.7%) experiencedNiTi-RIs’ fractureat least once; with more endodontists (94.3%) than GDs (83.3%) (p < 0.001). The greater thenumber of weekly performed RCTsandparticipants’ experiences, the moreNiTi-RIs fracturesand the greater the number offracture incidents(p < 0.001). While 60% of those who performed1–3 RCTsper week experiencedNiTi-RIs fractures, 100% of those who performedmore than 12 RCTsper week did so. The highest percentage of those who experiencedmore than 10fractured NiTi-RIs (60%) was within the group who performedmore than 12 RCTsper week. Althoughfracture incidentsdecreased with a smaller number ofreuses,there was no significant correlation between thenumber of fractured instruments and NiTi-RIsdiscard strategy(p ≥ 0.05).ConclusionFracture incidence was the most common complication while using NiTi-RIs, regardless of the clinicians’ experiences and skills. While the single usemay reduce NiTi-RIs fractures, to some extent, the greaternumber of RCTsperformed per week was the most influential factor.
Age estimation in three distinct east Asian population groups using southern Han Chinese dental reference dataset
Authors: Jayaraman Jayakumar , Wong Hai Ming , Roberts Graham J. , King Nigel M. , Cardoso Hugo F. V. , Velusamy Pavethynath , Vergara Ronaldo G. , Yanagita Keni-ichi , Jorns Teekayu P. 
Published: November 2019

Abstract

Background
Dental age estimation can assist in the identification of victims following natural disasters and it can also help to solve birth date disputes in individuals involved in criminal activities. A reference dataset (RDS) has been developed from the dental development of 2306 subjects of southern Han Chinese origin and subsequently validated. This study aimed to test the applicability of the southern Han Chinese dental maturation RDS on three distinct East Asian population groups.

Methods
A total of 953 dental panoramic radiographs of subjects aged 2 to 24 years were obtained from Philippines, Thailand and Japan. The staging of dental development was conducted according to Anglo-Canadian classification system. The dental age (DA) was calculated using six methods; one un-weighted average and five weighted average (n-tds, sd-tds, se-tds, 1/sd-tds, 1/se-tds) methods based on the scores of the southern Han Chinese RDS. Statistical significance was set at p < 0.05 and the variation between chronological age (CA) and DA was evaluated using paired t-test and Bland & Altman scatter plots.

Results
From six dental age calculations, all methods of DA accurately estimated the age of Japanese and few methods in Filipino subjects (n-tds, 1/sd-tds, 1/se-tds). There was consistent overestimation of age for all the methods for Thai females (p < 0.05).

Conclusions
The southern Han Chinese dental reference dataset was shown to be most accurate for Japanese, followed by Thai males and it was particularly ineffective for Filipinos and Thai females.
The exploration of the knowledge, attitudes and practice behaviors of advanced care planning and its related predictors among Taiwanese nurses
Authors: Hsieh Chiu-Chu , Huang Hsiang-Ping , Tung Tao-Hsin , Chen I-Chien , Beaton Randal D. , Jane Sui-Whi 
Published: November 2019

AbstractBackgroundDespite the documented and well known patient benefits of ACP, the completion of ACP, only a minority of patients, during the advanced or EOL stage of their illnesses, receive such care. The misconceptions about ACP for healthcare providers, such as nurses, might become potential barriers to the effective implication of ACP. Also, from the transcultural perspective, it is evident essential to explore Taiwanese nurses’ attitudes, knowledge, and actions of ACP. The purposes of this study were to explore the implication of ACP or hospice care for nurses caring for non-cancer chronic illness patients at a regional teaching hospital in Taiwan; and, to identify predictors of those nurses’ knowledge, attitudes, and actions toward ACP.MethodsThis cross-sectional study with a purposive sample of 218 nurses was conducted at a teaching hospital in southern Taiwan. Structured questionnaires were employed and data were analyzed with descriptive statistics, t-test, one-way ANOVAs, Pearson’s correlation and multiple regressions.Results16.1% of Taiwanese physicians actively initiated ACP issues or conversations with patients or their family members. Nurses’ attitudes toward ACP were fairly positive but their knowledge about ACP was insufficient and actions of ACP were not positively executed. The predictors of ACP-Knowledge (ACP-K) included position title, education hours and lacking of educational training. The predictors of ACP-Attitude (ACP-A) included ACP-K and “fear of patient or family member not accepting”, whereas ACP-A, position title, “patients do not feel necessary” and “not sure physician’s concern” were the predictors of ACP-Act.ConclusionContinuous education and training for nurses regarding ACP needs to be improved by taking those predictors found in this current study into account, and more studies on the nurse’s role in ACP also should be further examined.Trial registrationKAFGH 106–012. Date of registration 1 May 2017.
Development and internal validation of a Nomogram for preoperative prediction of surgical treatment effect on cesarean section diverticulum
Authors: Wang Yizhi , Zhu Qinyi , Lin Feikai , Xie Li , Li Jiarui , Wang Xipeng 
Published: November 2019

Abstract

Background
The aim of this study was to develop and validate an individualized score based on preoperative parameters to predict patient outcomes after vaginal repair of cesarean section diverticulum.

Methods
This is a retrospective cohort study (Canadian Task Force classification II-2). Patients were enrolled between Jun 11, 2012, to May 27, 2016. Multivariable logistic regression analyses were used to construct the predictive model. Then, we generated a nomogram to assess the individualized risk of poor prognosis after operation. This prediction model included information from 167 eligible patients diagnosed with cesarean section diverticulum who underwent vaginal repair. Class-A healing group was defined as CSD patients who had menstruation duration of no more than 7 days and a thickness of the remaining muscular layer of no less than 5.8 mm after vaginal repair according to conferences. Others were included in the non-class-A healing group. A final nomogram was computed using a multivariable logistic regression model.

Results
The factors contained in the individualized prediction nomogram included the depth/ the thickness of the remaining muscular layer ratio, number of menstruation days before surgery, White blood cell and fibrinogen. This model demonstrated adequate discrimination and calibration (C-index = 0.718). There was a significant difference in the number of postmenstrual spotting days (12.98 ± 3.86 VS 14.46 ± 2.86, P = 0.022) and depth/ the thickness of the remaining muscular layer ratio (2.81 ± 1.54 VS 4.00 ± 3.09, P = 0.001) between two groups. Decision curve analysis showed that this nomogram was clinically useful.

Conclusions
This cesarean section diverticulum score can predict the outcomes of cesarean section diverticulum and can be useful for counseling patients who are making treatment decisions.