bluuebunny/crossref_metadata_2025_split huggingface dataset:
Retrospective analysis of brain abscess in 183 patients
Authors: Wu Shenglian , Wei Yiting , Yu Xiaobo , Peng Yucong , He Pingyou , Xu Hangzhe , Qian Cong , Chen Gao 
Published: November 2019

Abstract
This study aims to identify predictive factors related to clinical outcome, reoperation, and complications in patients with brain abscess.
Patients with a diagnosis of brain abscess at discharge at the Second Affiliated Hospital of Zhejiang University School of Medicine between 2008 and 2018 were reviewed. Logistic regression was used to identify predictive factors associated with Glasgow Outcome Scale (GOS) at discharge, GOS at 1 year after discharge, reoperation and complications.
Among 183 patients enrolled into the study, 142 patients had a good outcome at discharge (GOS ≥ 4) and 41 had a poor outcome (GOS ≤ 3). During the follow-up period, 20 additional patients had a good outcome. A total of 156 patients were treated by open craniotomy excision (n = 72) and aspiration (n = 84), 10 of whom underwent reoperation. Complications in surgical patients for brain abscess occurred in 54 patients. Poor outcome was related to Glasgow coma scale (P = .007) and ventricular proximity (P = .001). Surgical method was associated with reoperation (P = .04) and complications (P < .001). Seizure at admission was related to epilepsy (P < .001). Surgical method was related to postoperative intracranial hemorrhage (P = .02).
Glasgow coma scale (GCS) and ventricular proximity were associated with poor outcome. Further, patients who underwent aspiration were more likely to experience reoperation, while open craniotomy excision (OCE) was related to complications. Patients presenting seizure at admission were more likely to develop epilepsy. Patients who underwent OCE tended to experience postoperative intracranial hemorrhage.
Reversible posterior leukoencephalopathy syndrome following apatinib for gastric cancer in an adult
Authors: Lv Yajuan , Zhang Yan , Zhang Jiandong , Liang Ning , Liu Fengjun , Liu Ruixue 
Published: November 2019

Abstract

Rationale:
Reversible posterior leukoencephalopathy syndrome (RPLS) is characterized by rapidly progressive hypertension, headache, and disturbance of consciousness. Moreover, RPLS is rarely reported after apatinib treatment.

Patient concerns:
We present a case of RPLS induced by apatinib in this report. The patient had dizziness and bilateral lower limb weakness after apatinib use for 12 days.

Diagnosis and interventions:
Cranial T2-weighted magnetic resonance imaging (MRI) revealed symmetrical increased signal intensity in bilateral areas of the basal ganglia, radiation crown, frontal lobe, parietal lobe, and occipital lobe, which was suggestive of RPLS. The patient discontinued apatinib use and was administered dexamethasone, mannitol, and antihypertensive drugs.

Outcomes:
The patient's blood pressure returned to normal and neurological symptoms improved after 3 days of discontinuation of apatinib use. Moreover, brain MRI showed complete resolution of previous changes after 44 days of discontinuation of apatinib use.

Lessons:
Increased blood pressure may damage the normal blood-brain barrier, resulting in the extravasation of the fluid into the brain parenchyma. Hypertension is a significant cause of RPLS. It is important to strictly monitor blood pressure during apatinib treatment.
The efficiency and safety of oral tranexamic acid in total hip arthroplasty
Authors: Xu Yipeng , Sun Shaoting , Feng Qing , Zhang Guanfeng , Dong Bin , Wang Xiaoyan , Guo Ming 
Published: November 2019

Abstract

Background:
Intravenous (IV), topical and combination of both application of tranexamic acid (TXA) can reduce blood loss, hemoglobin drop, and transfusion rate in patients following total hip arthroplasty (THA). Lately, published articles reported that oral TXA had as similar blood-saving as IV and topical TXA in THA. The purpose of this meta-analysis is to investigate the efficiency and safety of oral TXA in THA.

Methods:
We systematically searched articles about oral administration of TXA in THA from PubMed, Embase, Scopus, Web of Science, the Cochrane Library, and the Chinese Wanfang database. Study eligibility criteria:
The outcomes were collected and analyzed by the Review Manager 5.3.

Results:
Nine RCTs and 1 CCT, containing 1305 patients, were ultimately included according to the inclusion criteria and exclusion criteria in the meta-analysis. The effectiveness of oral TXA was as similar as the IV or topical TXA in regard to hemoglobin drop (SMD = −0.14; 95% CI, [−0.28, 0.01]; P = .06), total blood loss (SMD = 0.01; 95% CI, [−0.13, 0.16]; P = .84), transfusion rate (OR = 0.76; 95% CI, [0.38, 1.55]; P = .37). Compared with single oral TXA or blank group, multiple oral TXA effectively reduced hemoglobin drop (SMD = −1.06; 95% CI, [−1.36, −0.77]; P < .05), total blood loss (SMD = −1.30; 95% CI, [−1.66, −0.94]; P < .05), transfusion rate (OR = 0.53; 95% CI, [0.29, 0.95]; P = .03). There were no significant difference in terms of length of stay and complication among all of enrolled studies.

Conclusion:
Oral TXA has favorable effect of blood-saving and do not increase risk of complication in patients following THA. Oral TXA may have no effect in the length of stay. More high quality RCTs are necessary.
Accuracy evaluation of placements of three different alternative C2 screws using the freehand technique in patients with high riding vertebral artery
Authors: Park Jong-Hyeok , Lee Jong Beom , Lee Ho Jin , Kim Il Sup , Hong Jae Taek 
Published: November 2019

Abstract
An observational study.
To evaluate the safeties of placing three different alternative C2 screws using the freehand technique under high riding vertebral artery (HRVA) and to analyze the C2 morphometry in patients with HRVA.
A retrospective analysis of radiologic data was performed on patients that underwent C2 instrumentation from September 2004 to December 2017. Two hundred fifty-one patients were included, and 90 of these patients (35.9%) had a unilateral or bilateral HRVA. We placed three alternative C2 screws including superior pars, inferior pars, and translaminar screws. Computed tomography was used to assess cortical breeches of screw placement and obtain morphometric measurements of C2 pars and lamina, that is, superior pars height/length, inferior pars length, and laminar thickness/length. We used the modification of the all India Institute of Medical Sciences outcome to define cortical breach.
In total, 117 alternative C2 screws were inserted in 90 patients; 7 superior pars screws (6%), 69 inferior pars screws (59.0%), and 41 translaminar (35%) screws. Although cortical breaches occurred during 31 screw placements (26.5%), these were unacceptable in only two cases (1.7%). No symptomatic neurovascular complication was observed after screw placement in any case. Mean height of C2 superior pars was 3.8 ± 1.8 mm and mean thickness of C2 lamina was 5.2 ± 1.1 mm. Mean lengths of superior pars, inferior pars, and lamina were 17.8 ± 3.0 mm, 13.6 ± 2.2 mm, and 26.7 ± 3.3 mm, respectively. Superior pars height and lamina thickness < 3.5 mm that was a minimal diameter of cervical screw were 49.6% and 6.8%, alternative C2 screw was not available in these cases.
Placements of alternative C2 screws using the freehand technique were achieved accurately and safely in patients with HRVA. However, preoperative morphometric evaluation is essential to determine the best option for C2 instrumentation and C2 screw length to avoid neurovascular complications.
Theta burst stimulation for upper limb motor dysfunction in patients with stroke
Authors: Liu Xiao-bo , Zhong Jian-guo , Xiao Xi-li , Li Yu-xi , Huang Yi-jie , Liu Yong-guo , Zhang Chi , Jin Rong-jiang , Liu Tian-yu 
Published: November 2019

Abstract

Background:
Upper limb dysfunction is one of common sequelae of stroke which limits daily activities and decreases quality of life of patients, as well as increasing caregiving burden on families. Theta burst stimulation (TBS) is considered to be a beneficial therapy for post-stroke patients with upper limb motor dysfunction, but there is a lack of a high quality evidence. We aim to investigate the effectiveness and safety of TBS for upper limb motor dysfunction in patients with stroke.

Methods:
The following databases will be searched: PubMed, EMBASE, The Cochrane Library, Web of Science, China Biology Medicine (CBM), China National Knowledge infrastructure (CNKI), Technology Periodical Database (VIP) and WanFang Data from the inception to October 2019. All relevant randomized controlled trials (RCTs) using TBS to treat poststroke patients with upper limb motor dysfunction will be included. The primary outcome is Upper Limb Fugl-Meyer Assessment (UL-FMA). Secondary outcomes will include Action Research Arm Test (ARAT), Box and Block Test (BBT), Wolf Motor Function Test (WMFT), Motor Assessment Scale (MAS), Nine Hole Peg Test (NHPT), Grip strength and other scales evaluating the upper limb motor function. Adverse effects will also be evaluated. Two reviewers will screen studies, extract data and assess the risk of bias of included studies independently. Data analysis will be conducted using Review Manager software (RevMan, version 5.3.5) and R software (version 3.6.1).

Results:
Our SR will be conducted according to AMSTAR 2.0 and reported in compliance with PRISMA. The findings of this SR will be disseminated through peer-reviewed publications or conference presentations.

Conclusion:
Our study will provide evidence for the effectiveness and safety of theta burst stimulation for upper limb motor dysfunction in patients with stroke.

Ethics and dissemination:
This systematic review (SR) does not require formal ethical approval since no privacy health information will be included. The findings of this SR will be disseminated through peer-reviewed publications or conference presentations.

PROSPERO registration number:
CRD42019142462.
Efficacy of horizontal muscle augmentation combined inferior oblique muscle shortening for pediatric strabismus
Authors: Du Xiu-Mei 
Published: November 2019

Abstract

Background:
This study will explore the efficacy and safety of horizontal muscle augmentation (HMA) combined inferior oblique muscle shortening (IOMS) for the treatment of pediatric strabismus (PS).

Methods:
Literature search for studies will be carried out in the following databases: Cochrane Library, MEDILINE, EMBASE, CINAHL, Web of Science, PsycINFO, CBM, and CNKI. We will search all these databases without language and publication status restrictions. Two independent authors will perform selection of studies, data collection and management, risk of bias evaluation. A third author will be consulted with the help of discrepancies.

Results:
This study will provide a synthesis of existed evidence for HMA combined IOMS for the treatment of PS.

Conclusion:
The results of this study will provide evidence to evaluate the efficacy and safety of HMA combined IOMS for the treatment of PS, which can help to guide clinical decision-making.

Systematic review registration:
PROSPERO CRD42019149716.
Intravoxel incoherent motion diffusion-weighted imaging evaluated the response to concurrent chemoradiotherapy in patients with cervical cancer
Authors: Bian Hao , Liu Fenghai , Chen Sha , Li Guoce , Song Yancheng , Sun Min , Dong Honghuan 
Published: November 2019

Abstract
To evaluate the application of multiple b values diffusion-weighted imaging based on biexponential signal decay model to predict the response to concurrent chemoradiotherapy in cervical cancer patients.
This prospective study enrolled 28 patients (mean age: 50.89 ± 10.70 years) with cervical cancer confirmed by biopsy who received concurrent chemoradiotherapy. Pelvic magnetic resonance scans were performed 2 weeks before, 7 days and 21 days after the initiation of therapy, and 1 month after the end of the treatment. Diffusion-weighted imaging with b values of 0, 50, 450, and 850 s/mm2 were performed, and tumor volume, means of tumor apparent diffusion coefficient (ADC)min, ADCmean, ADCslow, ADCfast, and Ffast were measured.
Pretreatment ADCmin and ADCslow of good outcome group were significantly higher than those of poor outcome group (P < .05). At the 7th day of the treatment, Ffast and its change rate of good outcome group were significantly higher than those of poor outcome group (P < .05). At the 7th day and 21st day of the treatment, Ffast showed a slowly increasing tendency with no significant difference compared with pretreatment value in poor outcome group (P < .05). One month post-treatment, only ADCslow change rate was significantly higher in good outcome group than that in poor outcome group.
Intravoxel incoherent motion-related ADC values could be utilized to better predict the outcome of cervical cancer chemoradiotherapy.
The prognostic values of estrogen receptor alpha and beta in patients with gastroesophageal cancer
Authors: Zhang Dongyun , Ku Jianwei , Yi Yingjie , Zhang Junhui , Liu Rongzhi , Tang Nianya 
Published: November 2019

Abstract

Background:
Published studies have investigated the prognostic roles of estrogen receptor alpha (ERα) and estrogen receptor beta (ERβ) in gastroesophageal cancer patients with the controversial results. The aim of the study was to systematically evaluate the impacts of ERα and ERβ on the overall survival (OS) in patients.

Method:
Relevant eligible studies were extracted from PubMed, Embase, Web of Science, CNKI and Wanfang databases (from the start date to November 2018) following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. HR (hazard ratio) with 95% confidence intervals (CIs) were used to assess the prognostic values of ERα and ERβ for OS in patients.

Results:
High ERα expression was associated with poor OS (HR = 1.58, 95% CI = 1.29–1.94, P < .001) and ERβ with better OS (HR = 0.56, 95% CI = 0.37–0.83, P = .004) in gastroesophageal cancer. Furthermore, unfavorable OS was found in Chinese gastroesophageal patients with higher ERα expression (HR = 1.57, 95% CI = 1.25–1.96, P < .001) and better OS with higher ERβ expression (HR = 0.51, 95% CI = 0.31–0.83, P < .01) in our subgroup analysis. Meanwhile, worse OS was found in esophageal squamous cell carcinoma (ESCC) patients with high ERα expression (HR = 1.74, 95% CI = 1.33–2.26, P < .001), and favorable OS in ESCC with ERβ overexpression (HR = 0.40, 95% CI = 0.31–0.52, P < .001). Besides, high ERα expression was associated with lower tumor differentiation in ESCC (OR = 1.64; 95% CI = 1.02–2.64, P = .04) and ERβ was linked with better tumor differentiation in gastric adenocarcinoma (GCA) (OR = 0.49; 95% CI = 0.26–0.94, P = .03).

Conclusions:
ERα and ERβ might serve as potential prognostic biomarkers for gastroesophageal cancer patients. ERα overexpression predicted poor OS and lower tumor differentiation, and ERβ suggested favorable OS and better tumor differentiation. Further related studies should be performed to test these results.
The burden of health conditions across race and ethnicity for aging Americans
Authors: McGrath Ryan P. , Snih Soham Al , Markides Kyriakos S. , Faul Jessica D. , Vincent Brenda M. , Hall Orman T. , Peterson Mark D. 
Published: November 2019

Abstract
Despite evidence suggesting race and ethnicity are important factors in responses to environmental exposures, drug therapies, and disease risk, few studies focus on the health needs of racially- and ethnically-diverse aging adults.
The objective of this study was to determine the burden of 10 health conditions across race and ethnicity for a nationally-representative sample of aging Americans.
Data from the 1998 to 2014 waves of the Health and Retirement Study, an ongoing longitudinal-panel study, were analyzed.
Those aged over 50 years who identified as Black, Hispanic, or White were included. There were 5510 Blacks, 3423 Hispanics, and 21,168 Whites in the study.
At each wave, participants reported if they had cancer, chronic obstructive pulmonary disease, congestive heart failure, diabetes, back pain, hypertension, a fractured hip, myocardial infarction, rheumatism or arthritis, and a stroke. Disability-adjusted life years (DALYs) were calculated for each health condition by race and ethnicity. Ranked DALYs determined how race and ethnicity was differentially impacted by the burden of each health condition. Sample weights were utilized to make DALY estimates nationally-representative.
Weighted DALY estimates (in thousands) ranged from 1405 to 55,631 for Blacks, 931 to 28,442 for Hispanics, and 15,313 to 295,623 for Whites. Although the health conditions affected each race and ethnicity differently, hypertension had the largest number of DALYs, and hip fractures had the fewest across race and ethnicity. In total, there were an estimated 198,621, 101,462, and 1,187,725 DALYs for older Black, Hispanic, and White aging adults.
Our findings indicate that race and ethnicity may be influential on health and disease for aging adults in the United States. Monitoring DALYs may help guide the flow of health-related expenditures, improve the impact of health interventions, advance inclusive health care for diverse aging adult populations, and prepare healthcare providers for serving the health needs of aging adults.
Pediatric pancreatic teratoma
Authors: Wang Jian , Yin Yuan , Cai Zhaolun , Shen Chaoyong , Yin Xiaonan , Chen Xin , Zhao Zhou , Zhang Bo 
Published: November 2019

Abstract

Rationale:
Pediatric pancreatic teratoma (PPT) is a rare tumor with unclear clinicopathologic features and treatment strategy.

Patient concerns:
A 13-month-old boy was admitted to the hospital with a complaint of a palpable epigastric mass.

Diagnoses:
The lesion was diagnosed as benign mature cyst teratoma via postoperative pathological examination.

Interventions:
Pylorus-preserving pancreaticoduodenectomy (PPPD) was performed on the patient. The entire mass was resected from the head of the pancreas and sent to the laboratory for frozen section evaluation.

Outcomes:
The patient was followed up for 15 months. He did not undergo recurrence or PPPD-related complications.

Lessons:
The differential diagnosis of retroperitoneal occupying lesions among children must consider mature cystic teratomas. Compete surgical resection combined with subsequent postoperative outpatient follow-up remains the primary choice for the management of PPTs.
PPTs are extremely rare tumors with unclear clinicopathologic features and treatment strategy. This study aims to explore the clinical characteristics of and treatment strategy for these tumors. We reported a 13-month-old patient with pancreatic teratoma who underwent pylorus-preserving PPPD. The operation lasted approximately 6 hours. The mass was completely removed, and the patient recovered uneventfully. Complete surgical resection combined with outpatient follow-up is the primary choice for the management of PPTs.
Continuous irrigation and suction with a triple-cavity drainage tube in combination with sequential somatostatin–somatotropin administration for the management of postoperative high-output enterocutaneous fistulas
Authors: Kong Xiangheng , Cao Yuning , Yang Daogui , Zhang Xiangyang 
Published: November 2019

Abstract

Introduction:
Enterocutaneous fistula is considered one of the most serious complications in general surgery and is associated with high morbidity and mortality. Although various treatments are reported to have varying success, high-output enterocutaneous fistulas (output over 500 ml/day) continue to be associated with high mortality, and few papers on this topic exist in the literature. The aim of this study is to describe an effective multidisciplinary treatment method for postoperative high-output enterocutaneous fistula and discuss the clinical development of the therapeutic strategy.

Patient concerns:
Three patients suffered high-output enterocutaneous fistulas, in which case 1 presented with duodenal fistula, case 2 with ileal fistula, and case 3 with small bowel fistula.

Diagnosis
: All 3 cases were diagnosed with high-output enterocutaneous fistulas by drainage of intestinal contents.

Interventions:
With the exception of routine treatment including fluid resuscitation, correction of the electrolyte balance, control of infection, and optimal nutrition, all the cases accepted continuous irrigation and suction with triple-cavity drainage tubes in combination with sequential somatostatin–somatotropin administration were given. With regard to establishing effective drainage, the triple-cavity tube placement was performed by insertion through the initial drainage channel in case 1, percutaneous puncture with dilation by graduated dilators in case 2, and tract reconstruction in case 3. The technical details of the approach are described and clinical characteristics including fistula location, defect size, output volume, approach of triple-cavity tube placement, length of fistula tract, somatostatin and somatotropin administration time, and fistula healing time were recorded and compared. In addition, other various techniques reported in the literature are reviewed and discussed.

Outcomes:
All the patients were cured by the multidisciplinary treatments and were followed up without fistula recurrence and other relevant complications at 1 week, 1 month, and 3 months after the treatments.

Conclusion:
The strategy involving continuous irrigation and suction with a triple-cavity drainage tube in combination with sequential somatostatin–somatotropin administration may be a safe and effective alternative treatment for postoperative high-output enterocutaneous fistula and a more practical method that is easy to execute to manage this problem. Long-term studies, involving more patients, are still necessary to confirm this suggestion.
Immediate and short-term radiological changes after combining static stretching and transcutaneous electrical stimulation in adults with cavus foot
Authors: Fernández-Seguín Lourdes María , Heredia-Rizo Alberto Marcos , Díaz-Mancha Juan Antonio , González-García Paula , Ramos-Ortega Javier , Munuera-Martínez Pedro V. 
Published: November 2019

AbstractBackground:Cavus foot is a deformity represented by an increased and rigid medial longitudinal arch, and it is often associated with persistent pain and gait disturbances. None of the conservative conventional treatments for cavus foot have shown conclusive evidence of effectiveness, and so further is research needed to understand how to manage this condition better. This study aimed to assess the immediate and short-term radiological changes after combining static stretching and transcutaneous electrical stimulation of the plantar fascia in adults with idiopathic cavus foot.Methods:A randomized, single-blinded clinical trial was conducted. Sixty-eight participants with idiopathic cavus foot, as determined by an internal Moreau–Costa–Bertani angle (MCBA) less than 125° in a lateral weight-bearing foot radiograph, were equally distributed into a neuromuscular stretching group (NSG) or a control group (no intervention). The NSG underwent a single session, combining transcutaneous electrical nerve stimulation with static stretching of the plantar fascia. Primary measurements of 3 angles were taken using a lateral weight-bearing foot radiograph: the internal MCBA; the calcaneal pitch angle (CPA); and the first metatarsal declination angle (FMDA). Outcomes were collected at baseline, immediately postintervention, and 1 week after intervention.Results:Analysis of variance revealed a significant group effect for all angles (all,P < .05). NSG participants showed a significant increase in the internal MCBA (P = .03), and a significant decrease in the CPA (P = .01) and FMDA (P = .04) from baseline to immediately postintervention. These changes remained statistically significant 1 week after the intervention (all,P < .05).Conclusion:The combination of static stretching and transcutaneous electrical stimulation of the plantar fascia, compared with no treatment, achieved immediate and short-term changes in the internal MCBA, the CPA, and the FMDA, which resulted in flattening the medial longitudinal plantar arch in adults with idiopathic cavus foot.