bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of sleep and obesity in adults and children
Authors: Bonanno Lilla , Metro Daniela , Papa Mattia , Finzi Giuseppa , Maviglia Antonia , Sottile Fabrizio , Corallo Francesco , Manasseri Luigi 
Published: November 2019

Abstract
The sleep allows many psychological processes, such as immune system activity, body metabolism and hormonal balance, emotional and mental health, learning, mnemonic processes. The lack of sleep could undermine mental and physical purposes, causing an alteration in cognitive functions or metabolic disorders. In our study, we have examined the irregular sleep effects with the overweight and obesity risk in children and adults.
The sample was composed of 199 subjects, of which 71 adults, (29 males and 42 females), and 128 children (73 males and 55 females). We have measured the weight and height with standard techniques; we also have measured the body mass index dividing the weight in kg with the height square expressed in meters (kg/m2). Subjects were divided into underweight, normal weight, overweight, and obese. Were administered some questionnaires to measure the quantity and quality of sleep, and eating habits and individual consumption of food.
Analysis of demographic variables not showed significant differences between male and female groups but highlighted a significant trend differences in normal-weight score. The clinical condition has a substantial impact on body mass index score and sleep hours were significant predictor on this.
Quantity and quality sleep can also represent a risk factor of overweight and obesity, so sufficient sleep is a factor that influence a normal weight. Adults and children that sleep less, have an increase in obesity and overweight risk with dysfunctional eating behaviors, decreased physical activity, and metabolic changes.
Heart rate variability in people with visual disability
Authors: Moreno Renaldo D. , Abreu Luiz C. , Morais Mauro J.D. , Oliveira Fabiano S. , Bezerra Italla M.P. , Valenti Vitor E. , Sato Monica A. 
Published: November 2019

Abstract

Introduction:
People with visual impairment (VI) have loss of vision that causes impact on their daily living activities. Synonymous of VI are blindness, low vision, subnormal vision, visual incapacity, although there are peculiarities among them. The autonomic nervous system (ANS) provides the body with dynamic adaptation, moment by moment, according to changes in the internal and/or external body environment. As VI is an adverse condition, it is expected to be associated with changes in systemic autonomic activity, such as heart rate (HR) variability.

Objective:
To analyze the blindness stress by monitoring the activity of the ANS in the heart in subjects submitted acutely to low vision and also in subjects with chronic visual deficiency.

Method:
This is a randomized trial experimental study. In this clinical trial, initially, patients will undergo an ophthalmologic medical evaluation, along with monitoring of HR and systolic blood pressure /diastolic blood pressure. Volunteers with normal vision (Group i); and people with VI (Group ii) will be evaluated, all of them inhabitants of Rio Branco City, capital of Acre State, Brazilian Amazon. The intervention will consist of simulating blindness by sealing both eyes of each participant with good eyesight, using a sleep mask and allowing maximum occlusion for 45 minutes, split into 3 periods of 15 minutes each. Still blindfolded, participants will be requested to perform different tasks as walking, serve themselves water and/or cookies, and engaging in playful-pedagogical activity. Identical procedure will be done with the group with VI. The HR will be recorded by the Polar RS800 HR monitor. All findings with a value of P < .05 will be considered statistically significant. As a risk measure the odds ratio will be calculated, adjusted, and not adjusted with their respective 95% confidence intervals. The odds ratio = 1 of lowest risk for the outcome of interest will be considered as the base category for each independent variable.

Ethics and dissemination:
This study will be carried out in accordance with the guidelines that regulate human research in Resolution No. 466/12 of the National Health Council. We obtained the approval of the Research Ethics Committee of the ABC Medical School/Faculdade de Medicina do ABC, with CAAE: 73945017.0.0000.0082, and Opinion No. 2,275,101. All individuals who agreed to participate in the study will sign the free and informed consent form (FICF). The FICF is also available in audio and Braille versions. The results will be disseminated through peer-reviewed journal articles and conferences. This study is registered in the Brazilian Registry of Clinical Trials under the number RBR-9sm9dp.
Treatment of multicentric Castleman disease through combination of tocilizumab, lenalidomide and glucocorticoids
Authors: Cai Sisi , Zhong Zhaodong , Li Xiang , Wang Hong Xiang , Wang Li , Zhang Min 
Published: November 2019

Abstract

Rationale:
Castleman's disease (CD) is a rare lymphoproliferative disease. Compared to unicentric CD, multicentric Castleman disease (MCD) displays poorer prognosis and great variance to different therapies. Though chemotherapy, immunization therapy, and glucocorticoids have been used in the treatment of MCD, its optimal treatment is still controversial.

Patient concerns:
A 47-year-old woman was admitted due to poor appetite, general fatigue, puffiness of face, systemic rash, and abdominal distension. On physical examination, the patient displayed as general lymphadenopathy, splenomegaly, hepatomegaly, and shifting dullness.

Diagnoses:
After biopsy of her swollen lymph node and laboratory tests, her initial diagnosis was hyaline vascular-CD.

Interventions:
She was treated with combination of tocilizumab, lenalidomide, and glucocorticoids.

Outcomes:
This patient achieved complete remission (CR) with all her indexes returned to be normal. Her blood routines and biochemical examinations were still normal during the following period.

Lessons:
We reported a case with multicentric Castleman's disease (MCD) which acquired quite good remission after combination treatment with tocilizumab, lenalidomide, and glucocorticoids. Our report provided powerful evidence for displaying the efficiency and safety of target therapy against unicentric Castleman disease.
Traditional Chinese medicine non-pharmaceutical therapies for chronic adult insomnia
Authors: Li Feizhou , Xu Bo , Wang Ping , Liu Ling 
Published: November 2019

Abstract

Background:
Traditional Chinese medicine (TCM) non-pharmaceutical therapies are frequently used for chronic insomnia in China, but in clinical practice, most practitioners choose appropriate treatments based on personal experience. In our study, Bayesian network meta-analysis will be used to identify differences in efficacy and safety between diverse non-pharmaceutical therapies for chronic adult insomnia.

Methods:
The authors will totally retrieve seven electronic databases from their establishment to August 2019 in accordance with relevant strategies. After a series of screening, the 2 researchers will employ the Aggregate Data Drug Information System (ADDIS) and R software to analyze the data extracted from enclosed Randomized Controlled Trials (RCTs). Ultimately, the evidentiary grade of the results will be evaluated.

Results:
This study will provide reliable evidence for different non-pharmaceutical therapies on chronic insomnia in adults.

Conclusions:
The findings will be an available reference to evaluate the efficacy and safety of different non-pharmaceutical therapies on chronic insomnia in adults and may provide decision-making reference on which method to choose for clinicians.

Trial registration number:
PROSPERO CRD42019141496.
Denosumab and Sunitinib in the treatment of giant-cell tumor of bone with pulmonary and bone metastases in an adolescent
Authors: Wang Guannan , Jiang Sujing , Li Zhouqi , Dong Ying 
Published: November 2019

Abstract

Introduction:
Giant cell tumor of bone with pulmonary and bone metastases is exceedingly rare in adolescents. Furthermore, Denosumab and Sunitinib in the treatment of giant cell tumor of bone has never been reported.

Patient concerns:
A 16-year-old boy complained of fever, chest tightness, and shortness of breath and back pain for 5 days.

Diagnosis:
Giant cell tumor of bone with pulmonary and bone metastases.

Interventions:
The patient underwent 2 surgeries for giant cell tumor of bone located in the spine and received Denosumab to reduce local recurrence and control the metastases. Then Sunitinib was added into treatment strategies after the progressing of metastases.

Outcomes:
Within 5 months of Denosumab and Sunitinib, lung metastases were shrinking (stable disease, response evaluation criteria in solid tumors version 1.1). Until now about 4 years into treatment the patient is still survival. Pulmonary and bone metastases are stable.

Conclusions:
This is a case of multi-center giant cell tumor of bone, it does not only provide a reference to the treatment of similar cases of the clinic but also reflects the limitations of the application of Denosumab in the real world.
Cardiovascular outcomes of liraglutide in patients with type 2 diabetes
Authors: Duan Chun-Mei , Wan Teng-Fei , Wang Yue , Yang Qing-Wu 
Published: November 2019

Abstract

Background:
Liraglutide is a novel, long-acting glucagon-like peptide-1 (GLP-1) analogue used to treat type 2 diabetes mellitus. However, the cardiovascular safety and benefits of liraglutide treatment on type 2 diabetes patients remain in debate. In this study, we aimed to examine the overall cardiovascular outcomes of liraglutide in patients with type 2 diabetes.

Methods:
In this systematic review and meta-analysis, we searched the PubMed, Embase, and Web of Knowledge databases up to September 1st, 2017 for randomized trials in which type 2 diabetes patients were assigned to liraglutide and placebo or other comparators groups.

Results:
Eight studies fulfilled the eligibility criteria for inclusion and 14,608 patients were analyzed in this systematic review and meta-analysis. We found patients in the liraglutide group had a lower risk of major cardiovascular events (MACE) (RR = 0.89, 95% CI: 0.82–0.96, P = .002), acute myocardial infarction (AMI) (RR = 0.85, 95% CI: 0.74–0.99, P = .036), all-cause death (RR = 0.84, 95% CI: 0.74–0.96, P = .009), and cardiovascular death (RR = 0.77, 95% CI: 0.65–0.91, P = .002) than all comparator groups. However, liraglutide treatment did not decrease incidence of stroke (RR = 0.86, 95% CI: 0.70–1.04, P = .124). But among the MACE subgroups analysis, a significant reduction of MACE with liraglutide was only observed in placebo-controlled trials (RR = 0.89, 95% CI: 0.83–0.96, P = .004) but not in studies concerning other comparators (RR = 0.58, 95% CI: 0.29–1.16, P = .122).

Conclusions:
In conclusion, our results suggest that liraglutide treatment decreases the risk of MACE, AMI, all-cause death and cardiovascular death among patients with type 2 diabetes.
Steroids in the treatment of nonarteritic anterior ischemic optic neuropathy
Authors: Chen Jun , Zhu Jie , Chen Li , Hu Chen , Du Yi 
Published: November 2019

Abstract

Background:
Non-arteritic anterior ischemic optic neuropathy (NAION) is the common cause of acute and subacute optic neuropathy in adults over the age of 50. Steroid administration in NAION seems to be in practice and is advised frequently by neurologists. The controversy regarding steroid usage in NAION is far from settled, with strong opinions on both sides. Despite a large amount of articles on this topic, but the results have not always been consistent. To address this gap, we decided to conduct a meta-analysis of all available published studies in order to better understand the effectiveness of steroids in treating NAION.

Objectives:
To identify the effectiveness of steroids in treating NAION.

Methods:
We performed a meta-analysis using databases, including PUBMED EMBASE, and the Cochrane library, to find relevant studies. The weighted mean difference (WMD) was determined for BCVA in steroid and nonsteroid groups.

Results:
Eight studies were included and summarized in this analysis. The studies included 720 eyes (392 NAION eyes and 328 eyes of normal controls). Heterogeneity among these studies was low (I
2 = 0%). Because of the presence of heterogeneity, we conducted a fixed effects model to assess the effect of steroids on visual acuity in patients with NAION. The meta-analysis clearly demonstrated that in NAION, steroids did not significantly improve visual acuity (WMD = −0.02 [95% CI: −0.10 to 0.06], Z = 0.40, P = .69). After sensitivity analysis via the leave-one-out method, WMD was not significantly changed.

Conclusions:
Our meta-analysis found that steroids do not significantly improve visual acuity in NAION. In view of their long list of side effects, attempts at reversing ischemia should not involve the use of steroids.
Acute ischemic stroke in a 7-month-old infant, risk factors, and diagnosis peculiarities
Authors: Meliţ Lorena Elena , Mărginean Cristina Oana , Simu Iunius , Bucur Gabriela 
Published: November 2019

Abstract

Introduction:
Ischemic stroke is an extremely rare disorder in children. The timely diagnosis is essential for the outcome of these children, but unfortunately, delays in diagnosis occur frequently.

Patient concerns:
We report the case of a 7-month-old infant admitted in our clinic for limited movements of the superior and inferior right limbs whose onset was 27 hours before with repeated clonic movements of the right hand associated with the same manifestations in the right oral commissure lasting approximately 10 seconds.

Diagnosis:
The laboratory tests revealed high D-dimers, and positive IgG anti-cardiolipin and anti-beta2 glycoproteins I antibodies, whereas the genetic profile for thrombophilia revealed heterozygote mutation in MTHFR C677T and A1298C genes. Brain imaging established the diagnosis of left frontal ischemic stroke, frontal ischemic stroke, hypoplasia of internal carotid artery, and agenesia of segment M1 of median cerebral artery and segment A1 of left anterior cerebral artery.

Intervention:
We administered low-molecular-weight heparin, antiplatelet therapy along with vasodilators and depletive treatment, wide-spectrum antibiotics, and anticonvulsant therapy.

Outcome:
The neurological deficit was greatly improved, especially in the inferior limb after 6 month from the incident of stroke, and all laboratory parameters were within normal limits including the antibodies mentioned above.

Conclusion:
Cerebral vascular malformation, excessive weight, and altered lipid profiles contributed to the development of acute ischemic stroke in our patient.
Uncommon erythema multiforme in small children: experience of a single Romanian pediatric unit
Authors: Mocanu Adriana , Ivanov Anca , Alecsa Mirabela , Lupu Vasile Valeriu , Lupu Ancuta , Starcea Iuliana Magdalena , Miron Oana Tatiana , Gavrilovici Cristina , Miron Ingrith Crenguta 
Published: November 2019

Abstract

Rationale:
Erythema multiforme (EM) is an immune-mediated disease with mucocutaneous localization and plurietiologic determinism. The term “multiforme” refers to the variety of aspects that the lesions can take from patient to patient and during evolution in a single patient.

Patient concerns:
We have selected 2 cases of small children diagnosed with different etiology of EM to illustrate the importance of a correct and fast diagnosis. Case 1 involves a 2-year-old girl from a rural area who presented with fever and pruritic erythematous papular eruption. The onset of the symptoms was 3 days before presentation with fever and ulcerative lesions on the oral and labial mucosa, followed by the appearance of erythematous macular lesions, with progressive confluence to intense pruritic patches. The 2nd involves a 2-year-old boy with fever, loss of appetite, productive cough, and petechiae. He had corticosensible immune thrombocytopenia from the age of 6 months, with many recurrences. The patient received treatment with ampicillin/sulbactam and symptomatics for an erythemato-pultaceous angina. During the 2nd day of treatment the patient developed an erythematous macular eruption on the face, scalp, trunk, and limbs, with bullae formation.

Diagnoses:
The 1st patient was diagnosed based on biologic findings: positive inflammatory syndrome, elevated level of anti-Mycoplasma pneumoniae immunoglobulin M antibodies and immunoglobulin E. Histopathologic examination described papillary dermal edema, inflammatory infiltrate, and lymphocyte exocytosis. In the 2nd case, the hemoleucogram identified 12,000/mm3 platelets and the medulogram aspect was normal. Serology for Epstein–Barr virus was negative. The diagnosis was EM secondary to M pneumoniae infection in case 1 and secondary to administration of ampicillin/sulbactam in case 2.

Interventions:
In both cases, etiopathogenic treatment consisting of steroidal antiinflammatory drugs, antihistamines was administered. Because of specific etiology, the 1st case received antibiotics.

Outcomes:
The evolution was favorable in 10 to 14 days; the patients were discharged after etiopathogenic treatment consisting of steroidal antiinflammatory drugs, antihistamines, and/or antibiotics.

Lessons:
Performing a detailed clinical examination, medical history of drug use, infection or general diseases can establish a good diagnosis of EM. Histopathologic examination can help. The treatment is etiologic, pathogenic, and symptomatic. EM usually has a self-limited evolution.
Childhood adrenocortical tumor
Authors: Wu Xiaohui , Xu Jun , Wang Jinhu , Gu Weizhong , Zou Chaochun 
Published: November 2019

Abstract
The aim of the study was to investigate the molecular mechanisms in childhood adrenocortical tumors (ACTs), which is still unclear.
A total of 9 girls and 4 boys with ACTs were enrolled. Relevant clinical features were obtained from records. Immunohistochemistry of vimentin, chromogranin A, S100, synaptophysin, cytokeratin (CK), type 2 3β-hydroxysteroid dehydrogenase (3βHSD), cytochrome P45017α, p53, p21, p27, cyclin D1, Ki-67, insulin growth facter-2 (IGF-2), and β-catenin were undertaken for 13 tumors and 3 adjacent normal tissues. TP53 mutations in exon 2-11 were analyzed for 6 tumors and 3 blood samples.
Virilization was the most common presentation (8/13, 61.5%). Immunohistochemically, p53 was positive in 8 of 13 ACTs and none in controls while p21 was positive in 12 of 13 ACTs and none in controls (P = .0036). Ki-67 was positive in 10 of 13 ACTs, but not in normal tissues (P = .0089). Although the expression of p27, cyclin D1, IGF-2 and β-catenin were similar between the ACTs and controls, β-catenin was noted in nuclear of 3 ACTs but not in controls. The difference of type 2 3βHSD and P450c17α was not significant (P > .05, respectively). Four variants of TP53 were identified in the 6 tumors. C215G variant was found in 5 of 6 while A701G and G743A variants were found in 1 case, respectively. A novel C680G variant was also noted in 1 case. It was notable that C215G variant was found in the blood mononuclear cell of 3 patients.
In conclusion, p53 variant and p21 overexpression, and abnormal β-catenin distribution may be involved in the etiology and mechanism of childhood ACTs.
Autologous platelet-rich gel and continuous vacuum sealing drainage for the treatment of patients with diabetic foot ulcer
Authors: Xu Jie , Wang Qiao-Yun , Li Wei 
Published: November 2019

Abstract

Background:
Research focusing on the efficacy of autologous platelet-rich gel (APRG) and continuous vacuum sealing drainage (CVSD) for diabetic foot ulcer (DFU) is increasing. Despite increasing knowledge on this theme, its results remain inconsistent. Thus, we will provide insight into the efficacy of APRG and CVSD for patients with DFU.

Methods:
We will search electronic databases of MEDILINE, EMBASE, Cochrane Library, CINAHL, AMED, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure from inception to October 1, 2019. No language limitation is utilized to these databases. Two authors will independently perform study selection, data extraction, and risk of bias assessment. Disagreements between 2 authors will be solved through discussion with a third author.

Results:
The efficacy and safety of APRG and CVSD for patients with DFU will be assessed by the time to complete healing, proportion of ulcers healed within trial period, change of size of ulcer, health-related quality of life, patient length of hospital stay, and adverse events.

Conclusion:
The results of this study will provide helpful evidence of APRG and CVSD for patients with DFU.

Systematic review registration:
PROSPERO CRD42019153289.
The treatment modalities of masticatory muscle pain a network meta-analysis
Authors: Feng Jie , Luo Mengqi , Ma Jianbin , Tian Ye , Han Xianglong , Bai Ding 
Published: November 2019

Abstract

Background:
Numerous treatment modalities have been attempted for masticatory muscle pain in patients with temporomandibular disorders (TMD). To compare the treatment efficacy of more than 2 competing treatments, a network meta-analysis (NMA) was conducted.

Methods:
This study was reported with reference to the extended Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement for reporting of systematic reviews incorporating network meta-analyses. Medline via Pubmed, Embase via OVID, and Cochrane Library Central were searched (up to February 11, 2019). Axis I protocol of Diagnostic Criteria or Research Diagnostic Criteria for Temporomandibular Disorders (DC/TMD, RDC/TMD) were chosen as diagnostic standards. The PICOS (Problem/patient, Intervention, Comparison, Outcome, Study design) method was used to screen trials under eligibility criteria. And the NMA was performed with mvmeta commands in Stata (StataCorp, Tex).

Results:
Of 766 studies searched, 12 randomized clinical trials (RCTs) were finally included. Nineteen different therapies were found and further categorized into 9 treatment modalities. The general heterogeneity was not found among included trials. But predictive intervals (PrIs) were conspicuously wider than confidential intervals (CIs) of all pairwise comparisons, indicating that heterogeneity may exist between studies. Complementary therapy showed the greatest probability (42.7%) to be the best intervention. It also had the highest mean rank (2.3) in the rankogram and the biggest value of surface under the cumulative ranking (SUCRA, 84.1%).

Conclusions:
Based on the limited evidence of available trials, complementary therapy seemed to be slightly more effective than remaining treatment modalities for pain reduction in TMD patients with masticatory muscle pain. High-quality randomized controlled trials are expected to validate the findings.
Efficacy of resveratrol for the treatment in patients with ulcerative colitis
Authors: Chen Yan-hui , Xiang Yi 
Published: November 2019

Abstract

Background:
This study will aim to systematically explore the efficacy of resveratrol for the treatment of patients with ulcerative colitis (UC).

Methods:
We will search the electronic databases of MEDLINE, EMBASE, Cochrane Library, Web of Science, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure up to the September 1, 2019 for randomized controlled trials (RCTs) that report on UC who have undergone resveratrol compared with other interventions. All electronic databases will be searched without restrictions of language. Two authors will independently conduct study screen, data extraction, and risk of bias assessment. Any disagreements between 2 authors will be resolved with a third author by discussion or consultation if it is necessary. RevMan 5.3 software will be applied for statistical analysis.

Results:
Outcomes include clinical remission, improvement of clinical symptoms, maintenance of remission, relapse rate, endoscopic assessment, histological assessment, quality of life, and adverse events.

Conclusion:
This study will provide most recent evidence of resveratrol for the treatment of patients with UC.

PROSPERO registration number:
PROSPERO CRD42019150849.