bluuebunny/crossref_metadata_2025_split huggingface dataset:
Joint effects of risk factors on adverse events associated with adult blood donations
Authors: Wang Hsuan-Hui , Chen Po-Ming , Lin Chi-Ling , Jau Rong-Chiou , Hsiao Sheng-Mou , Ko Jiunn-Liang 
Published: November 2019

Abstract
The process for blood donation is considered safe, but some adverse events have been reported. Risk factors for adverse events were assessed in this study.
A retrospective case-control study was conducted to investigate the risk factors for adverse events after blood donation between 2010 and 2013. Variables such as gender, age, body mass index (BMI), donation status, donation volume, donation site, pre-donation systolic blood pressure (SBP), and pre-donation diastolic blood pressure were compared between donors with and without adverse events. Multiple logistic regression analysis was performed to assess the joint effects of age, gender, and donation status on adverse events.
The incidence of adverse events among adult blood donations was 1287/1,253,678 (0.1%). On multivariate logistic regression analysis, blood donors aged <35 years (odds ratio [OR], 2.99, 95% confidence interval [CI], 2.57–3.48), of female gender (OR, 3.30, 95% CI, 2.62–4.15), and with first-time donor status (OR, 6.40, 95% CI, 5.17–7.93), donation of 500 mL (OR, 2.22, 95% CI, 1.83–2.69), predonation SBP <124 mm Hg (OR, 1.25, 95% CI,1.05–1.48) and BMI <24 kg/m2 (OR, 1.67, 95% CI, 1.42–1.96) were associated with increased likelihood of adverse event. Further analysis with joint effects method revealed that first-time female donors aged <35 years are associated with the highest odds of adverse events when compared with repeat male donors aged ≧35 years (OR, 100.57, 95% CI, 48.45–208.75).
The findings of our study should prove useful in identifying donors at risk and planning appropriate strategies for the prevention of adverse effects.
Heart rate variability in middle-aged adults
Authors: Oh Hyunjoo , Shin Seungwon , Koh Byung-Hee , Hwang Minwoo 
Published: November 2019

AbstractWhile stress is known to cause many diseases, there is no established method to determine individuals vulnerable to stress. Sasang typology categorizes humans into four Sasang types (So-Eum, Tae-Eum, So-Yang, and Tae-Yang), which have unique pathophysiologies because of their differential susceptibilities to specific stimuli, including stress. The purpose of this study was to determine if Sasang typology can be used identify individuals who are vulnerable to stress by evaluation of heart rate variability (HRV).This was a cross-sectional study. A total of 399 healthy men and women aged 30 to 49 years were recruited. Physical examinations for stress included HRV measurement and blood tests. The subjects also completed questionnaires about psychological stress, self-awareness, and lifestyle. HRV was analyzed using frequency-domain analysis. Subjects were divided into So-Eum (SE) and non-So-Eum (non-SE) groups according to their diagnosis.The weight and body mass index in the SE group were significantly lower than those in the non-SE group (both,P = .000). There were no significant between-group differences in any other demographic variables. In HRV analysis, the normalized high frequency (nHF) was higher (P = .008) while the normalized low frequency (nLF;P = .008) and LF:HF ratio (LF/HF;P = .002) were lower in the SE group than in the non-SE group.Although there was no difference in variables affecting HRV, HRV values were significantly different between groups. The LF/HF value for the SE group was at the lower limit of the normal range, although there were no associated clinical problems. These findings suggest that individuals with the SE type are more susceptible to stress than those with the other types. Thus, middle-aged individuals who are vulnerable to stress can be identified using Sasang typology.
Assessment of TNF-α inhibitors in airway involvement of relapsing polychondritis
Authors: Biya Josette , Dury Sandra , Perotin Jeanne-Marie , Launois Claire , Dewolf Maxime , Deslée Gaëtan , Lebargy François 
Published: November 2019

AbstractRelapsing polychondritis (RP) is a rare immune-mediated disease affecting cartilaginous structures. Respiratory tract manifestations are frequent and constitute a major cause of morbidity and mortality. The present review of the literature was designed to assess the efficacy of tumor necrosis factor alpha (TNF-α) inhibitors in respiratory tract involvement of RP.A MEDLINE literature search was performed from January 2000 to December 2016 to identify all studies and case reports of anti-TNF-α therapy in RP. Articles published in English or French concerning patients with respiratory tract involvement were eligible. Two authors (JB, FL) independently reviewed and extracted data concerning each patient and 2 personal cases were added. Treatment efficacy was assessed according to systemic and/or respiratory criteria.A total of 28 patients (mean age: 41.6 years; 16 females/12 males) were included in the final analysis. Anti-TNF-α therapy was associated with improved health status and respiratory symptoms in 67.8% and 60.1% of cases, respectively.These results suggest that TNF-α inhibitors could be considered for the treatment of respiratory tract involvement of RP.
Diagnostic challenges in synchronous ovarian metastasis from rectal cancer
Authors: Biolchini Federico , Castro Ruiz Carolina , Pavesi Erica , Musci Giovanni , Zizzo Maurizio , Ugoletti Lara , Annessi Valerio 
Published: November 2019

Abstract

Introduction:
Ovarian metastases from rectal cancer are infrequent; thus it might be hard to diagnose and treat them. Our study introduces a challenging case which highlights our method in addressing such an issue.

Patients concerns:
A 74-year-old woman was admitted to our Unit showing abdominal pain, vomit, and a gross abdominal mass located in the right iliac fossa and mesogastrium. Oncological markers recorded following abnormalities: carbohydrate antigen 19.9 (Ca19.9) = 453.40 U/mL, carbohydrate antigen 125 (Ca125) = 88.3 U/mL.

Diagnosis:
Such a metastatic tumor being difficult to diagnose, we could not achieve a precise preoperative diagnosis. We entered the operating room with a histologic diagnosis that was highly suspicious of colon adenocarcinoma. During surgery, frozen section analysis was positive for primary ovarian cancer. Thanks to the immunohistochemistry test on the histologic specimen, which might be very helpful in diagnosing such metastatic tumor, final pathology report documented ovarian metastasis from rectal cancer.

Interventions:
We performed total hysterectomy with bilateral salpingo-oophorectomy and low anterior resection of the rectum with a terminal colostomy. Adjuvant chemotherapy was administered for 6 months using FOLFOX plus panitumumab in first-line therapy.

Outcome:
At 8 months from surgery, during follow-up, a local pelvic progression of disease was detected, leading to second-line chemotherapy treatment.

Conclusion:
Correct differential diagnosis between primary and metastatic ovarian tumors is paramount in choosing the best treatment which leads to the best possible outcome. In ovarian metastatic tumors, immunohistochemistry could represent an optimal diagnostic tool.
Tube feeding associated postoperative intussusceptions
Authors: Hu Liangshuo , Yin Guozhi , Zhang Dong , Geng Zhimin , Bai Jigang 
Published: November 2019

Abstract

Rationale:
Postoperative intussusception in adults is a rare but serious complication after gastrointestinal anastomosis surgery. Postoperative intussusception in adults caused by tube feeding was rarely been reported before. The aim of the current study was to summarize the clinical data on a group of patients with tube feeding associated postoperative intussusceptions. The possible etiology and preventive measures will also be discussed.

Patient concerns:
During the period from May 2013 to January 2018, patients who received gastrointestinal anastomosis in our center were retrospectively reviewed. Preoperative variables including standard demographic and pathological characteristics as well as the treatment and prognosis were also analyzed.

Diagnoses:
Tube feeding associated postoperative intussusceptions.

Interventions:
7 patients were identified with tube feeding associated postoperative intussusceptions with a prevalence of 0.38%. Intussusceptions occurred from 10 to 69 days (median 25.7 days) postoperatively in an acute form.

Outcomes:
None of the patients had spontaneous reduction and all patients underwent surgery. Antegrade efferent limb intussusceptions were found in all the cases. Intussusception occurred at efferent loop at 23.6 cm (range 15–60) from the gastrointestinal or Braun anastomosis. None of the patients was found recurrence throughout the follow-up period.

Lessons:
In contrast with other postoperative intussusceptions, the tube feeding associated postoperative intussusceptions have special clinical manifestations. It is more likely to occur in early period of time after the surgery and in an acute form. Surgical correction is recommended for most of patients. Several measures have been proposed to prevent such complications after gastrointestinal surgery, however more research and information are still needed.
Compressive peroneal neuropathy by an intraneural ganglion cyst combined with L5 radiculopathy
Authors: Park Se-Heum , Do Hwan-Kwon , Jo Geun-Yeol 
Published: November 2019

Abstract

Rationale:
Most cases of foot drop are known to result from lower motor neuron pathologies, particularly lumbar radiculopathy and peripheral neuropathy, including common peroneal neuropathy. To improve the prognosis of foot drop, it is important to quickly and accurately diagnose the etiology and provide appropriate treatment.

Patient concerns:
A 65-year-old female patient with a history of L4-5 intervertebral disc herniation presented with right foot drop that had developed 1 month previously.

Diagnosis:
Electrodiagnostic examination revealed common peroneal neuropathy combined with L5 radiculopathy, with the former being the main cause of the foot drop. MRI of the right knee was performed to identify the cause of the peroneal nerve lesion, which revealed an intraneural ganglion cyst in the common peroneal nerve.

Interventions:
The patient was treated by ultrasound-guided percutaneous cyst aspiration and corticosteroid injection into the decompressed ganglion, followed by strengthening exercise, electrical stimulation therapy, and prescription of an ankle foot orthosis.

Outcomes:
We confirmed regeneration of the injured peroneal nerve at the follow-up electrodiagnostic examination 12 weeks after the intervention. In addition, the manual motor power test demonstrated an increase in the ankle dorsiflexor function score by one grade.

Lessons:
Diagnosing the cause of foot drop can be difficult with multiple co-existing pathologies, and consideration of various possible etiologies is the key for appropriate diagnosis and treatment. In addition to imaging modalities such as MRI, electrodiagnostic examination can help to improve diagnostic accuracy. Intraneural ganglion cyst of the common peroneal nerve is rare, but should be considered as a possible cause of foot drop.
Changes in the distribution of etiologies of cirrhosis among patients referred for liver transplantation over 11 years in Iran
Authors: Mohagheghi Sina , Khajehahmadi Zohreh , Nikeghbalian Saman , Alavian Seyed Moayed , Doosti-Irani Amin , Khodadadi Iraj , Karimi Jamshid , Sharafi Heidar , Tavilani Heidar 
Published: November 2019

Background and aim:
Cirrhosis is a major public health problem worldwide. The prevalence of cirrhosis is various in different geographical regions. The aim of the present study was to determine the distribution of the etiologies of cirrhosis and their proportional changes through recent 11 years in Iran.

Methods:
In this retrospective, observational study, the data of cirrhotic patients who have been listed for liver transplantation in the Namazi Transplant Center (Shiraz, Iran) between January 2006 and December 2016 were analyzed. Demographic and clinical data of the patients including model for end-stage liver disease score, year of registration, and the etiologic diagnosis for each patient were retrieved.

Results:
The ratio of males to females was the highest (2.6:1) in patients with age over 50 years. Of 4891 patients, hepatitis B virus cirrhosis had the highest frequency (23.53%) and alcoholic cirrhosis had the lowest frequency (1.70%). The percentages of waiting list patients with hepatitis B virus (34.48%–17.48%) (P < 0.001), autoimmune hepatitis (12.64%–8.50%) (P = 0.037), and alcoholic cirrhosis (2.30%–1.10%) were decreased (P = 0.008) and the percentages of waiting list patients with cholestatic (12.64%–25.20%) and nonalcoholic steatohepatitis cirrhosis (0.77%–8.82%) were increased over 11 years (both P < 0.001). Hepatitis B virus and autoimmune hepatitis cirrhosis were the most prevalent in male and female patients, respectively.

Conclusion:
The results of the present study showed an increase in the frequency of cholestasis and nonalcoholic steatohepatitis cirrhosis and therefore it should be considered in the health policy implementation.
A Comparison of Health Risk and Costs Across Private Insurance Markets
Authors: Lissenden Brett , Amin Krutika , Drury Kelly , Pope Gregory C. , Kautter John , Sutton Erin , Peele Yolanda 
Published: November 2019

Background:
The Patient Protection and Affordable Care Act (PPACA) established new parameters for the individual and small group health insurance markets starting in 2014. We study these 2 reformed markets by comparing health risk and costs to the more mature large employer market.

Study Data:
For 2017, claims data for all enrollees in PPACA-compliant individual and small group market plans as well as claims data from a sample of large employer market enrollees.

Variables and Methodology:
Risk scores and total (unadjusted and risk-adjusted) per-member-per-month (PMPM) allowed charges. Differences across markets in enrollment duration, age, and geographic distribution are addressed. The analysis is descriptive.

Results:
Compared with large employer market enrollees, health risk was 3% lower among PPACA small group market enrollees and 20% higher among PPACA individual market enrollees. After adjusting for differences in health risk, enrollees in the PPACA individual market had 27% lower PMPM allowed charges than enrollees in the large employer market and enrollees in the PPACA small group market had 12% lower PMPM allowed charges than enrollees in the large employer market.

Conclusions:
On average, the PPACA individual market enrolls sicker individuals than the 2 group markets. But this does not translate to higher health costs; in fact, enrollees in the PPACA individual market accumulate lower allowed charges than enrollees in the large employer market. Lower-income enrollees particularly accumulate lower allowed charges. Narrower networks and increased enrollee cost-sharing among individual market plans, though they may reduce the value of coverage, likely significantly reduce allowed charges.
Comparison of bone scintigraphy and Ga-68 prostate-specific membrane antigen positron emission tomography/computed tomography in the detection of bone metastases of prostate carcinoma
Authors: Soydal Cigdem , Nak Demet , Araz Mine , Akkus Pınar , Urun Yuksel , Ozkan Elgin , Kucuk Nuriye Ozlem , Kir Metin Kemal 
Published: November 2019

Aim
This study aims to assess the diagnostic performance of Ga-68 prostate-specific membrane antigen PET/computed tomography in the comparison of planar bone scintigraphy in the detection of bone metastases. Another purpose is to define the additional benefit of bone scintigraphy subsequent to prostate-specific membrane antigen PET/computed tomography and the role of prostate-specific membrane antigen PET/computed tomography in the treatment planning.

Material and method
Forty-six patients with a median interval of 19 (range: 3–90) days between prostate-specific membrane antigen PET/computed tomography and bone scintigraphy included in the analysis. Diagnostic performance of both modalities was calculated and compared.

Results
Prostate-specific membrane antigen PET/computed tomography and bone scintigraphy were performed for initial staging in 25 (54%), for evaluation of biochemical recurrence in 11 (24%) and metastatic castration-resistant prostate carcinoma in 10 (22%) patients. In the patient-based analysis sensitivity, specificity, accuracy, positive predictive value, and negative predictive value for bone scintigraphy for detection of bone metastases were calculated as 50%, 19–29%, 32–39%, 32–39%, and 33–39%, respectively, based on whether equivocal findings were classified as positive or negative. For prostate-specific membrane antigen PET/computed tomography, these values were found significantly higher as 100%, 95–100%, 98–100%, 96–100%, and 100%, respectively. The diagnostic performance of bone scintigraphy and PET/computed tomography in clinical subgroups was analyzed, prostate-specific membrane antigen PET/computed tomography was superior to bone scintigraphy in three groups.

Conclusion
In this retrospective study, prostate-specific membrane antigen PET/computed tomography was found to be superior to planar bone scintigraphy in the detection of bone metastases. Additional bone scintigraphy seems to be unnecessary in patients who underwent prostate-specific membrane antigen PET/computed tomography within three months period without additional treatment.
Investigation of Fluorodeoxyglucose Positron Emission Tomography for the Diagnosis of Solid Pseudopapillary Neoplasm of the Pancreas
Authors: Kurihara Keisuke , Hanada Keiji , Serikawa Masahiro , Ishii Yasutaka , Tsuboi Tomofumi , Kawamura Ryota , Sekitou Tsuyoshi , Nakamura Shinya , Mori Takeshi , Hirano Tetsuro , Ikemoto Juri , Chayama Kazuaki 
Published: November 2019

Objectives
This study aimed to investigate the utility of fluorodeoxyglucose (FDG) positron emission tomography for solid pseudopapillary neoplasm (SPN) diagnosis.

Methods
The subjects included 53 cases of SPN. We compared the maximal standardized uptake volume (SUVmax) with those of 25 cases of pancreatic duct cancer and 18 cases of pancreatic neuroendocrine neoplasm. In addition, immunopathological testing for SPN with regard to FDG uptake was undertaken.

Results
An increase in SUVmax was observed in all tumors with increased tumor diameter. Among tumors of 20 mm or smaller, the SUVmax of SPN was significantly higher than those of pancreatic duct cancer and pancreatic neuroendocrine neoplasm. The results of a pathological study of FDG uptake in SPN revealed increased glucose transporter protein type 1 expression with tumor enlargement. Furthermore, increased hypoxia-inducible factor-1 and vascular endothelial growth factor expression under hypoxic conditions were observed in the areas of necrosis.

Conclusions
In cases in which high FDG uptake is observed in small pancreatic tumors, FDG positron emission tomography is potentially useful for SPN differentiation. The factors involved in FDG uptake in SPN include cell density and glucose transporter protein expression, as well as hypoxia-inducible factor and vascular endothelia growth factor expression in the hypoxic environment of necrotic areas.
Expression of Epithelial-Mesenchymal Transition Markers in Treated Pancreatic Ductal Adenocarcinoma
Authors: Wang Minhua , Estrella Jeannelyn S. , Katz Matthew H. , Kim Michael , Rashid Asif , Lee Jeffrey E. , Maitra Anirban , Wistuba Ignacio I. , Wolff Robert A. , Varadhachary Gauri R. , Wang Huamin 
Published: November 2019

ObjectivesEpithelial-mesenchymal transition (EMT) plays an important role in the progression, metastasis, and chemoresistance of pancreatic duct adenocarcinoma (PDAC); however, the expression of EMT markers and their clinical significance in PDAC patients who received neoadjuvant therapy (NAT) are unclear.MethodsWe examined the expression of EMT markers, including Zeb-1 (zinc finger E-box-binding homeobox 1), E-cadherin, and vimentin by immunohistochemistry in 120 PDAC patients who received NAT and pancreatectomy from 1999 to 2007. The results were correlated with clinicopathologic parameters and survival.ResultsAmong 120 cases, 45 (37.5%) and 14 (11.7%) were positive for Zeb-1 and vimentin, respectively, and 25 (20.8%) were E-cadherin-low. The median overall survival and disease-free survival were 35.3 (standard deviation [SD], 2.8) and 15.9 (SD, 3.6) months, respectively, in vimentin-negative group compared with 16.1 (SD, 1.1) (P= 0.03) and 7.0 (SD, 1.1) months (P= 0.02) in the vimentin-positive group. In multivariate analysis, vimentin expression was an independent predictor of shorter disease-free survival (hazard ratio, 2.50; 95% confidence interval, 1.31–4.78;P= 0.016) and overall survival (hazard ratio, 2.55; 95% confidence interval, 1.33–4.89;P= 0.01).ConclusionsEpithelial-mesenchymal transition markers are frequently expressed in treated PDAC. Vimentin expression is a prognostic biomarker for survival in PDAC patients who received NAT.
Systemic Chemotherapy in Metastasis-Induced Acute Pancreatitis Patients With Small Cell Lung Cancer
Authors: Yu Min , Zheng Lingnan , Han Deqian , Wang Yongsheng , Ren Li , Lu You , Zhang Shuang 
Published: November 2019

Objectives
Small cell lung carcinoma (SCLC) is a highly malignant tumor characterized by early metastasis even at the time of diagnosis. Although pancreatic metastasis occurring in SCLC is a common observation in the literatures, there is currently very limited experience with the metastasis-induced acute pancreatitis in SCLC patients.

Methods
Here we retrospectively analyzed patients with metastasis-induced acute pancreatitis and SCLC in West China Hospital between 2009 and 2017. The patients were diagnosed as having SCLC by bronchoscopic biopsy or computed tomography–guided percutaneous biopsy. Metastasis-induced pancreatitis was established by clinical symptoms, radiologic surveillance, serum amylase, and lipase level. The series included 14 patients, 4 women and 10 men, with a mean age of 54 years (range, 29–76 years). The patients underwent chemotherapy plus palliative treatment (n = 8) or palliative care alone (n = 6).

Results
Compared with patients receiving palliative treatment alone, a trend toward improved survival was observed in patients who underwent chemotherapy.

Conclusion
Our personal experience indicated that chemotherapy might provide a survival benefit in SCLC patients with metastasis-induced pancreatitis, especially those with good performance status.