bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bronchoscopy for Chronic Unexplained Cough
Authors: Heching Moshe , Rosengarten Dror , Shitenberg Dorit , Shtraichman Osnat , Abdel-Rahman Nader , Unterman Avraham , Kramer Mordechai R. 
Published: October 2019

Background:
Prior studies assessing the diagnostic utility of bronchoscopy for chronic unexplained cough have focused primarily on identifying endobronchial anomalies to determine chronic cough etiology. On the basis of our institutional experience, expanding bronchoscopy to include cultures and biopsies can considerably increase its diagnostic yield for identifying the etiology of chronic unexplained cough.

Materials and Methods:
This retrospective review analyzed bronchoscopies conducted in our institution between 2013 and 2017. Eligibility criteria were bronchoscopies conducted for chronic unexplained cough for which no etiology had been identified before the bronchoscopy. Microbiology, pathology, and cytology results from bronchoscopy were reviewed to identify the etiology of the cough.

Results:
Over the study period, 169 bronchoscopies met the eligibility criteria. The average patient age at bronchoscopy was 59.7±14.8 years; 61% were female individuals. Direct visualization identified anatomic etiologies in 48 (28%) patients, most commonly tracheobronchomalacia, and less common conditions, such as tracheobronchopathia osteochondroplastica. Microbiology cultures were positive in 33 (20%) patients, principally Staphylococcus aureus, Streptococcus pneumoniae, Pseudomonas aeruginosa, and nontuberculosis mycobacterium. Pathology results from endobronchial biopsies identified respiratory conditions associated with cough, primarily eosinophilic bronchitis (n=15), as well as neurofibromatosis (n=1) and amyloidosis (n=1). Cytology results did not reveal alternate diagnoses not previously identified.

Conclusion:
Inclusion of bronchial washings and endobronchial biopsies during bronchoscopy for chronic unexplained cough increased diagnostic yield from 28%, attributable to directly visualized anatomic etiologies, to 41%. The addition of microbiology cultures and pathology analysis significantly increased the diagnostic yield of bronchoscopy in identifying the potential etiology of chronic heretofore unexplained cough.
Periprocedural myocardial and renal injury in patients undergoing elective percutaneous coronary interventions – is there an association?
Authors: Stipinovic Mario , Percin Luka , Radonic Vedran , Jerkic Helena , Jurin Ivana , Letilovic Tomislav 
Published: October 2019

Abstract
Periprocedural myocardial injury (PMI) and contrast-induced nephropathy (CIN) are frequent complications of percutaneous coronary intervention (PCI) associated with early and late major adverse cardiovascular events. Both conditions are associated with similar risk factors, which could imply their possible association. The aim of our study was to assess the correlation of PMI and early postprocedural creatinine shift (ECS) as a marker of renal injury.
A total of 209 hospitalized patients with stable coronary artery disease (CAD) were enrolled, who underwent an elective PCI in a period of 12 months. All patients had their serum high-sensitivity troponin I (hsTnI) measured at baseline and 16 hours after the PCI. PMI was defined according to the elevation of postprocedural hsTnI using criteria provided by both the most recent consensus documents as well as evidence-based data. Renal injury was evaluated using the ECS concept. Serum creatinine (SCr) was also measured at baseline and at 16 hours. ECS was defined as SCr >5% at 16 hours compared to baseline.
Although incidence of both PMI (77.5%) and ECS (44.5%) were high, no association of these 2 conditions could be found. Further analyses of our data showed that diabetes is associated with a higher incidence of ECS, while patients on beta-blocker therapy had a lower incidence of ECS.
In our study, no association between PMI and ECS was found. Additional studies with a larger number of patients and longer patient observation are needed to assess the correlation between PMI and CIN as well as to validate the attractive, but controversial, concept of ECS as an early marker of CIN.
Diffuse pulmonary lymphangiomatosis
Authors: Yu Wencheng , Mi Liyun , Cong Jinpeng , Cheng Wei , Chen Yunqing , Gong Haihong 
Published: October 2019

Abstract

Rationale:
Diffuse pulmonary lymphangiomatos (DPL) is a rare aggressive lymphatic disorder characterized by proliferation of anastomozing lymphatic vessels and extremely rare in adult patients.

Patient concerns:
We report a case of diffuse pulmonary lymphangiomatosis in 59-year-old man presented with cough and sputum for 2 months.

Diagnoses:
Combining clinical manifestations with results of radiological, bronchoscopy, and surgical lung biopsy, it was consistent with the diagnosis of DPL.

Interventions:
After bronchoalveolar lavage and biopsy, symptom of cough got worse suddenly accompanied by excessive chyloptysis. The patient received an emergency surgical intervention and low fat medium chain fat treatment.

Outcomes:
The patient was discharged with a much better health condition.

Lessons:
This case report is the oldest patient reported in the English literature, to the best of our knowledge. Serious complications of bronchoscopy should be considered, especially in DPL patients with severely enlarged mediastinum or with thin-walled translucent vesicles under endoscopy.
Prognostic value of high stanniocalcin 2 expression in solid cancers
Authors: Hu Lixia , Zha Yanyan , Kong Fanliang , Pan Yueyin 
Published: October 2019

Abstract

Background:
Several studies have explored the prognostic value of stanniocalcin 2 (STC2) in various cancers, but obtained inconsistent results. Therefore, this meta-analysis was performed to determine the prognostic and clinicopathologic significance of STC2 in various cancers.

Methods:
Eligible studies were identified by searching the online databases PubMed, Embase, Web of Science, and the China National Knowledge Infrastructure up to March 2019. Hazard ratios (HRs) with 95% confidence intervals (CIs) and were calculated to clarify the correlation between STC2 expression and prognosis of different cancers. Odds ratios (ORs) with 95% CI were selected to appraise the correlation between STC2 with clinicopathologic characteristics of patients with cancer.

Results:
A total of 16 eligible studies with 4074 patients with cancer were included in our meta-analysis. The results showed that high STC2 expression can predict poor overall survival (OS) for cancer (HR = 1.48, 95% CI: 1.15–1.90, P = .002). Subgroup analysis found that high STC2 expression was associated with worse OS in Asian (HR = 1.85, 95% CI: 1.35–2.55), the reported directly from articles group (HR = 1.39, 95% CI: 1.05–1.84), survival curves group (HR = 1.93, 95% CI: 1.36–2.74), and gastric cancer (HR = 1.43, 95% CI: 1.04–1.95). Furthermore, high STC2 expression was significantly related to advanced T stage (OR = 1.83, 95% CI: 1.17–2.86, P = .008), lymph node metastasis (OR = 2.29, 95% CI: 1.51–3.45, P < .001), lymphatic invasion (OR = 2.15, 95% CI: 1.53–3.02, P < .001), venous invasion (OR = 1.97, 95% CI: 1.30–2.99, P = .001), and more advanced clinical stage (OR = 2.36, 95% CI: 1.74–3.19, P < .001)

Conclusion:
Elevated expression of STC2 suggested a poor prognosis in patients with cancer and may serve as a new tumor marker to monitor cancer development and progression.
Predisposing factors to nonfatal cardiovascular events in women with systemic lupus erythematosus. An observational, cross-sectional, multicenter study in Spain from the risk/systemic lupus erythematosus thematic network
Authors: Fernández-Garcés Mar , Haro Gonzalo , Micó María Luisa 
Published: October 2019

Abstract
Very few studies have been published on cardiovascular morbidity in Spanish patients diagnosed with systemic lupus erythematosus (SLE). Moreover, knowledge of the predictive factors for the occurrence of nonfatal events in this group of patients is scarce.
This was a multicenter, observational, cross-sectional study designed to ascertain the prevalence of nonfatal cardiovascular risk factors and cardiovascular events (CVEs) in 335 Spanish women diagnosed with SLE between 2003 and 2013.
The average patient age was 36.0 years (range: 26.4–45.6); 35 patients (10.7%) experienced at least 1 CVE, which most frequently affected the brain, followed by the heart, and finally, the peripheral vasculature. Both the number of admissions because of SLE (95% confidence interval [CI] odds ratio [OR] = 1.024–1.27, P = .017) and the systemic lupus international collaborating clinics (SLICC) chronicity index score (95% CI OR = 1.479–2.400, P
= .000) resulted in an increase in the OR of these patients presenting a CVE. Regarding the classic risk factors, only the interaction between hypertension (HT) and treatment with antihypertensive drugs influenced the presence of CVEs (95% CI OR = 2.165–10.377, P = .000). The presence of a family history of early cardiovascular disease was also related to CVEs (95% CI OR = 2.355–40.544, P = .002). Binary logistic regression including the above factors resulted in a model in which the 3 main variables in each group persisted, implying that they must be independent of each other. However, the weight of the interaction between the family history of early cardiovascular disease and the interaction between HT and the use of antihypertensives was higher than for the number of admissions for SLE.
The SLE disease activity over time (measured using the SLICC) and the number of hospital admissions due to the disease itself, both increase the risk of women with SLE presenting a CVE. Classic cardiovascular risk factors, especially HT and its treatment, as well as a family history of early CVEs, should be considered when assessing the risk of nonfatal CVEs in women with SLE.
Treatment with the herbal formulation Eefooton slows the progression of chronic kidney disease
Authors: Yao Chien-An , Lin Chih-Hui 
Published: October 2019

Abstract

Rationale:
Patients with end-stage kidney disease (ESKD) receiving maintenance dialysis experience an overall burden of physical and emotional symptoms. However, there were limited alternative treatments to dialysis.

Patient concerns:
A 79-year-old woman with chronic kidney disease stage 5 (CKD5) and gout had refused to be on dialysis. She also had hypoglycemia, hypertension, and heart disease.

Diagnoses:
The patient had received the ultrasonography, the renal biopsy and biochemical examinations, confirming the diagnosis of renal impairment, primary hypertension, and chronic nephritic syndrome with unspecified morphologic changes.

Interventions:
She was administered with 20 mL Eefooton (a liquid formula of herbal extracts: Astragalus membranaceus 3 g, Codonopsis pilosula 3 g, Ligustrum lucidum 3 g, Panax quinquefolius 1.3 g, and Rhodiola sacra 1.3 g) orally twice a day for 6 months in addition to her regular medications.

Outcomes:
The patient was followed up for 3 months after the completion of the Eefooton adjuvant treatment. The patient's renal function was improved, and CKD progression was alleviated. After Eefooton treatment, the sizes of both kidneys in the patient increased by 8% while blood urea nitrogen (BUN) and serum creatinine concentrations were decreased. In addition, further reduction in BUN concentration was observed 2 months posttreatment.

Lessons:
This case demonstrated that Eefooton has potential therapeutic significance in patients with CKD5 who chose conservative treatment over dialysis.
Examining the associations among intraocular pressure, hepatic steatosis, and anthropometric parameters
Authors: Chen Ying-Jen , Chen Jiann-Torng , Tai Ming-Cheng , Liang Chang-Min , Chen Yuan-Yuei , Kao Tung-Wei , Fang Wen-Hui , Chen Wei-Liang 
Published: October 2019

Abstract
Emerging evidences had reported the positive relationship between obesity and intraocular pressure (IOP). The aim of the present study was to investigate the association between hepatic steatosis and IOP in an adult Taiwanese population.
Seven thousand seven hundred twelve males and 6325 females who received a health examination at the Tri-Service General Hospital during the period from 2010 to 2016 were included in this study.
IOP was measured by noncontact tonometry. Hepatic steatosis was diagnosed by abdominal ultrasound examination. Multivariate regression analyses were used to assess the associations among various anthropometric parameters and IOP.
After adjusting for pertinent covariables, hepatic steatosis had a closer association with increased IOP than percentage body fat, body mass index, or waist circumference (β = 0.017, 95% confidence interval [CI] = 0.006, 0.028). This relationship remained significant among males in the study population (β = 0.015, 95% CI = 0.001, 0.029). Furthermore, hepatic steatosis was significantly correlated with increased risk of high IOP (odd ratios = 1.235, 95% CI = 1.041–1.465).
Our study highlights that hepatic steatosis is a better index for assessing the relationship with increased IOP than other anthropometric parameters. Underlying pathophysiological mechanisms regulating the association between hepatic steatosis and increasing IOP and even the risk of glaucoma should be examined in further studies.
Successful treatment of a primary thoracic dumb-bell yolk sac tumor presenting with severe spinal cord compression
Authors: Li Zhenfeng , Lv Zhaorui , Yang Qiang , Li Jianmin 
Published: October 2019

Abstract

Rationale:
Primary thoracic dumb-bell yolk sac tumor (YST) with both epidural and extraspinal extension is a rare disease with no standard curative managements yet. The objective of this study is to report a primary thoracic dumb-bell YST presenting with severe spinal cord compression successfully treated with posterior-only approach operation, followed by chemotherapy. The management of these unique cases has not been fully documented.

Patient concerns:
A 26-mounth-old, previously healthy girl presented with progressive numbness and weakness of the lower extremities. Neurological examination revealed paralysis of both lower extremities, sensory disturbance below T-8 and bladder-bowel dysfunction.

Diagnosis:
CT and MRI of spine showed a dumb-bell mass lesion with both epidural and extraspinal extension through enlarged intervertebral foramina and marked spinal cord compression at T7–T9. The AFP level was 13738 ng/ml. Preoperative puncture and Postoperative pathology confirmed the diagnosis of YST.

Interventions:
By needle biopsy, we identified the pathological diagnosis is YST. Subsequently, the patient was treated with one-stage posterior-only approach operation, followed by 9 courses of chemotherapy based on cisplatin, bleomycin, etoposide.

Outcomes:
The patient has a complete neurologic recovery and remains recurrence free as of more than 2 years after the completion of operation. There were no other complications associated with the operation during the follow-up period.

Lessons:
YST should be considered in the range of children with thoracic dumb-bell tumor presenting with spinal cord compression. Needle biopsy is valuable for preoperative diagnosis and design of the treatment strategy. If there is no evidence of CSF spread, metastasis or multiple diseases, it is effective to remove tumors as thoroughly as possible immediately, avoid further nerve injury and conduct enough chemotherapy. This case suggests that this treatment strategy is an effective option for primary YST with both epidural and extraspinal extension and severe spinal cord compression.
Effectiveness of high-frequency oscillatory ventilation for the treatment of neonatal meconium aspiration syndrome
Authors: Hao Li-xia , Wang Fei 
Published: October 2019

Abstract

Background:
The purpose of this study is to raise nonjudgmental awareness and attention to current experience of high-frequency oscillatory ventilation (HFOV) for the treatment of neonatal meconium aspiration syndrome (NMAS).

Methods:
We will comprehensively search literature from the databases of Cochrane Library, PubMed, Embase, Web of Science, WorldSciNet, PsycINFO, Allied and Complementary Medicine Database, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure from inception until July 1, 2019 without language limitation. We will also handle searching the bibliographies of all relevant studies found for unpublished literatures. Statistical analysis will be conducted using RevMan 5.3 software.

Results:
The outcomes include function inhaled oxygen concentration, oxygenation index, arterial oxygen tension/alveolar arterial oxygen tension, partial pressure of oxygen, partial pressure of carbon dioxide, transcutaneous arterial oxygen saturation, duration of hospitalization, and adverse events.

Conclusion:
This study will provide an exhaustive view of HFOV for treating infants with NMAS.

PROSPERO registration number:
PROSPERO CRD42019140520.
Radiotherapy combined with cytokine-induced killer cell therapy for liver metastasis from rectal cancer
Authors: Dang Yazheng , Qi Tao , Gao Hongxiang , Huang Shigao 
Published: October 2019

Abstract

Rationale:
Colorectal cancer is the most common type of cancer leading to death; approximately 10% to 25% of rectal cancer patients present with synchronous colorectal liver metastases. However, the management of synchronous colorectal liver metastases is difficult, especially for patients unable to tolerate chemotherapy or surgery. To date, the optimum treatment of colorectal liver metastasis patients remains controversial, and the curative effect is unsatisfactory. Therefore, we established a novel therapeutic approach to treat colorectal liver metastases employing radiotherapy plus immunotherapy.

Patient concerns:
A 56-year-old man presented with mucous bloody defecation occurring >20 times a day and accompanied by fatigue and poor appetite. After 4 months, he was admitted to the hospital due to increased fecal blood volume.

Diagnosis:
Highly differentiated adenocarcinoma was diagnosed based on rectal biopsy, and abdominal computed tomography (CT) showed multiple metastatic tumors in the liver.

Interventions:
The patient underwent 1 cycle of chemotherapy, which was terminated owing to severe gastrointestinal reactions. Several days later, he was administered cytokine-induced killer (CIK) cell therapy plus adjuvant radiotherapy.

Outcomes:
Dynamic changes in the patient's tumor markers returned to normal levels, and abdominal CT and abdominal magnetic resonance imaging (MRI) revealed no metastatic liver tumors.

Lessons:
Sequent therapy provided a curative effect for liver metastasis in a rectal cancer patient. Radiation may have activated the body to produce distant effects, eliminating the live metastasis. CIK cell-immunotherapy and radiotherapy may have synergistic therapeutic effects and could be combined for successful treatment of liver metastasis from rectal cancer.
Acute onset of orofacial dystonia from promethazine treatment
Authors: Zhang Ruili , Lai Jianbo , Huang Jinwen 
Published: October 2019

Abstract

Rationale:
Promethazine is an antihistamine agent used commonly for nausea and allergy. Along with its anticholinergic and antidopaminergic functions, promethazine is also used for psychiatric symptoms, such as troubling sleep, anxiety, and agitation. Previous studies have reported that promethazine may occasionally elicit acute dystonia in some individuals, especially for young children and pregnant women.

Patient concerns:
The 68-year-old female patient was admitted to our hospital because of feeling anxious and intermittent palpitation for over 1 year. She developed acute orofacial dystonia following promethazine treatment.

Diagnoses:
Her diagnoses was generalized anxiety disorder.

Interventions:
Discontinuation of the offending agent, promethazine, and injection of Botulinum toxin.

Outcomes:
The acute orofacial dystonia was finally alleviated by local injection of Botulinum toxin.

Lessons:
Careful assessment of the risk of developing acute dystonia is also needed in old patients when initiating the promethazine treatment.
Sarcopenia feature selection and risk prediction using machine learning
Authors: Kang Yang-Jae , Yoo Jun-Il , Ha Yong-chan 
Published: October 2019

Abstract
The purpose of this study was to verify the usefulness of machine learning (ML) for selection of risk factors and development of predictive models for patients with sarcopenia.
We collected medical records from Korean postmenopausal women based on Korea National Health and Nutrition Examination Surveys. A training data set compiled from simple survey data was used to construct models based on popular ML algorithms (e.g., support vector machine, random forest [RF], and logistic regression).
A total of 4020 patients ≥65 years of age were enrolled in this study. The study population consisted of 1698 (42.2%) male and 2322 (57.8%) female patients. The 10 most important risk factors in men were body mass index (BMI), red blood cell (RBC) count, blood urea nitrogen (BUN), vitamin D, ferritin, fiber intake (g/d), primary diastolic blood pressure, white blood cell (WBC) count, fat intake (g/d), age, glutamic-pyruvic transaminase, niacin intake (mg/d), protein intake (g/d), fasting blood sugar, and water intake (g/d). The 10 most important risk factors in women were BMI, water intake (g/d), WBC, RBC count, iron intake (mg/d), BUN, high-density lipoprotein, protein intake (g/d), fiber consumption (g/d), vitamin C intake (mg/d), parathyroid hormone, niacin intake (mg/d), carotene intake (μg/d), potassium intake (mg/d), calcium intake (mg/d), sodium intake (mg/d), retinol intake (μg/d), and age. A receiver operating characteristic (ROC) curve analysis found that the area under the ROC curve for each ML model was not significantly different within a gender.
The most cost-effective method in clinical practice is to make feature selection using RF models and expert knowledge and to make disease prediction using verification by several ML models. However, the developed prediction model should be validated using additional studies.
Osimertinib or EGFR-TKIs/chemotherapy in patients with EGFR-mutated advanced nonsmall cell lung cancer
Authors: Huang Lei , Huang Hao , Zhou Xiao-Ping , Liu Jin-Feng , Li Chun-Rong , Fang Min , Wu Jun-Rong 
Published: October 2019

Abstract

Background:
The aim of this meta-analysis is to investigate the impact of Osimertinib on treatment efficacy in advanced nonsmall cell lung cancer (NSCLC).

Methods:
Trials comparing Osimertinib against epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs)/chemotherapy in patients with NSCLC with an epidermal growth factor receptor (EGFR) mutation were included, and the pooled data for progression-free survival (PFS), overall survival (OS), overall response rate (ORR), disease control rate (DCR), and adverse events (AEs) were analyzed.

Results:
Analysis results based on 6 eligible trials showed that Osimertinib significantly improved the overall PFS (hazard ratio [HR] = 0.38, 95% confidence interval [CI] = 0.29–0.50), improved the OS (HR = 0.66, 95% CI = 0.48–0.89), increased the ORR (odds ratio [OR] = 1.76, 95% CI = 1.14–2.72), increased the overall DCR (OR = 1.18, 95% CI = 1.02–1.37), and reduced the grade 3 or greater AEs (relative ratio [RR] = 0.50, 95% CI = 0.33–0.75) in all subgroups except in the ORR in the Exon 19 deletion (Ex19del) and/or L858R subgroup. Compared to patients with Ex19del and/or L858R mutation, patients with the T790M mutation had the benefits of a greater PFS (41.7%), a greater ORR (80.0%), a greater DCR (71.2%), and fewer grade 3 or greater AEs (70.7%) (each P < .05). Race, sex, age, EGFR mutation, and smoking history may significantly predict additional benefits from Osimertinib, but there were no significant differences between subgroups stratified by these clinical characteristics.

Conclusions:
Osimertinib showed greater treatment benefit for patients with NSCLC with EGFR mutation than EGFR-TKIs/chemotherapy, especially for T790M mutation-positive patients.