bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neutropenia following intravenous immunoglobulin therapy in adult patients with immune thrombocytopenic purpura
Authors: Oh Sang-Bo , Shin Ho-Jin 
Published: January 2020

Abstract
The purpose of this study was to evaluate neutropenia following intravenous immunoglobulin (IVIG) therapy in adults with immune thrombocytopenic purpura (ITP).
Our analysis included 88 patients with ITP, who received IVIG from January 2006 to March 2016, at Pusan National University Hospital in Korea. Their white blood cell (WBC) count and absolute neutrophil count (ANC) before and after IVIG treatment were analyzed.
Of 88 patients, 24 patients (27.3%) were male, and 64 patients (72.7%) were female. Neutropenia developed in 8 patients (18.7%) after IVIG treatment. In patients with a decrease in WBC count and ANC compared to baseline, median WBC count decreased from 6280/μL to 4530/μL after IVIG therapy, and median ANC decreased from 3840/μL to 2840/μL after IVIG therapy. The neutropenia induced by IVIG had resolved spontaneously after several days, and the mean recovery time was 8.72 days after the completion of the IVIG treatment. During the neutropenic episodes, only one patient developed neutropenic fever, which subsided soon without any treatment.
The results of this study suggest that IVIG may cause neutropenia commonly in adults with ITP, and it seems to be transient and self-limited. This study is meaningful as the first report that not only pediatric ITP patients may develop neutropenia post IVIG administration, but also adult patients suffering ITP.
Fluoroscopic removal of self-expandable metallic airway stent in patients with airway stenosis
Authors: Bi Yonghua , Wu Gang , Yu Zepeng , Han Xinwei , Ren Jianzhuang 
Published: January 2020

Abstract
To study the safety and efficacy of fluoroscopic removal of self-expandable metallic stent for airway stenosis.
We conducted a retrospective analysis of 67 consecutive patients, 39 male and 28 female, who underwent fluoroscopic stent removal from March 2011 to April 2017. The patients ranged in age from 12 to 85 years. Seventy-six airway stents were implanted, 70 covered stents and 6 bare stents, including 9 stents for second stent implantation after removal. All patients underwent chest computed tomography scans with/without bronchoscopy before stent removal. The indication of stent removal and postinterventional complications were analyzed retrospectively.
Seventy-four of 76 airway stents were successfully removed, only 2 stent showed retained struts after removal, for a technical success rate of 97.4%. Two patients died of complications (1 hemorrhage and 1 respiratory failure), resulting in a clinical success rate of 94.7%. Five stents showed strut fracture and the remaining 71 stents were removed in 1 piece. Indications for stent removal include planned removal (n = 40), excessive granulation tissue (n = 15), intolerance of stenting (n = 6), inadequate expansion and deformation (n = 5), stent migration (n = 5), replacement of bare stent (n = 4), and strut fracture (n = 1). There were 17 complications of stent removal: death from massive bleeding (n = 1), restenosis requires stenting (n = 9), strut fracture or residue (n = 5), dyspnea requires mechanical ventilation (n = 2). The survival rates were 83.8%, 82.1%, and 82.1% for 0.5, 3, and 6 years.
Fluoroscopic removal of airway stent is technically feasible and effective. Stents are recommended for removal within 3 months for treating airway stenosis.
Enabling patients to cope with psychotropic medication in mental health care
Authors: Drivenes Karin , Vederhus John-Kåre , Haaland Vegard Øksendal , Ruud Torleif , Hauge Yina Luk , Regevik Hilde , Falk Ragnhild Sørum , Tanum Lars 
Published: January 2020

Abstract
This cross sectional study examined patients’ perceptions of professional support regarding use of psychotropic medication in a specialist mental health care setting. The aims were to evaluate reliability and validity of the MedSupport inventory, and investigate possible associations between MedSupport scores and patient characteristics.
A cross-sectional study was performed. The patients completed the MedSupport, a newly developed self-reported 6 item questionnaire on a Likert scale ranged 1 to 5 (1 = strongly disagree to 5 = strongly agree), and the Beliefs about Medicines Questionnaire. Diagnosis and treatment information were obtained at the clinical visits and from patient records.
Among the 992 patients recruited, 567 patients (57%) used psychotropic medications, and 514 (91%) of these completed the MedSupport and were included in the study. The MedSupport showed an adequate internal consistency (Cronbach alpha.87; 95% CI.86–89) and a convergent validity toward the available variables. The MedSupport mean score was 3.8 (standard deviation.9, median 3.8). Increasing age and the experience of stronger needs for psychotropic medication were associated with perception of more support to cope with medication, whereas higher concern toward use of psychotropic medication was associated with perception of less support. Patients diagnosed with behavioral and emotional disorders, onset in childhood and adolescence perceived more support than patients with Mood disorders.
The MedSupport inventory was suitable for assessing the patients’ perceived support from health care service regarding their medication. Awareness of differences in patients’ perceptions might enable the service to provide special measures for patients who perceive insufficient medication support.
Recurrence of nasal type NK/T cell lymphoma presenting as neurolymphomatosis on 18F-FDG PET/CT
Authors: Pan Qingqing , Luo Yaping 
Published: January 2020

Abstract

Introduction:
NK/T cell lymphomas seldom involve the peripheral nervous system. We report a case of recurrent nasal type NK/T cell lymphoma presenting as neurolymphomatosis and its manifestation on 18F-FDG PET/CT.

Patient concerns:
A 55-year old man presented with a mass in the right nasal cavity was diagnosed with extranodal NK/T cell lymphoma, nasal type. 18F-FDG PET/CT showed intense FDG uptake within the mass. After radiotherapy the nasal tumor was completely relieved, but the patient experienced numbness and amyosthenia in the right upper extremity one week after completion of radiotherapy.

Diagnosis:
PET/CT showed intense FDG uptake in the brachial plexus, axillary, suprascapular and median nerves, suggestive of recurrence of lymphoma presenting as neurolymphomatosis.

Interventions:
After 1 cycle of chemotherapy, the follow-up PET/CT showed markedly reduced FDG uptake in the previous involved nerves, demonstrating a very good response of neurolymphomatosis to chemotherapy.

Outcomes:
The patient finally had a progression free survival of 8 months after completion of 4 cycles of chemotherapy and autologous stem cell transplantation.

Lessons:
As neurolymphomatosis is a rare neurologic manifestation in recurrence of NK/T cell lymphoma, recognition of its presentation is important for prompt diagnosis and initiating treatment approach.
Weekly versus triweekly cisplatin-based concurrent chemoradiotherapy in the treatment of locally advanced cervical carcinoma
Authors: Zhu Jiahao , Zhang Zheng , Bian Dongyan , Chen Qingqing , Hu Qunchao , Ji Shengjun , Gu Ke 
Published: January 2020

Abstract

Background:
Radiotherapy concurrent with cisplatin is the standard regimen used for treatment of locally advanced cervical carcinoma. In this meta-analysis, survival, recurrence, compliance, and acute adverse effects were compared between weekly and triweekly cisplatin-based concurrent chemoradiotherapy regimens for treatment of cervical cancer.

Methods:
A systematic search for relevant studies was conducted using PubMed, Cochrane Library, EMBASE, and Medline databases. Fixed- or random-effects models were used for pooled analysis. The endpoints were overall survival, recurrence, compliance, and acute adverse effects reported as odds ratios (ORs) and 95% confidence intervals (CIs).

Results:
Eight randomized controlled trials met the inclusion criteria. No significant differences were observed between the 2 arms with respect to recurrence, survival, and acute adverse effects (all P > .05). However, the triweekly cisplatin regimen was associated with significantly lower incidence of local recurrence (OR, 1.72; 95% CI, 1.07–2.78; P = .03), radiotherapy completion (OR, 2.08; 95% CI, 0.99–4.38; P = .05), and anemia (OR, 2.10; 95% CI, 1.01–4.37; P = .05), while a weekly cisplatin regimen was associated with a lower risk of leukopenia (OR, 0.57; 95% CI, 0.42–0.92; P = .00) and thrombocytopenia (OR, 0.55; 95% CI, 0.31–0.97; P = .04).

Conclusions:
Triweekly cisplatin-based chemotherapy significantly reduced local recurrence with tolerable toxicity and might be the optimal regimen in concurrent chemoradiotherapy for locally advanced cervical carcinoma.
Optimal effect-site concentration of propofol for tracheal suctioning during emergence from ophthalmic surgery
Authors: Hung Nan-Kai , Lee Meei-Shyuan , Lai Hou-Chuan , Huang Yi-Hsuan , Lin Bo-Feng , Chan Shun-Ming , Wu Zhi-Fu 
Published: January 2020

Abstract
In ophthalmic surgery, coughing during emergence from general anesthesia may have a detrimental effect on intraocular pressure. Tracheal suction during emergence may elicit this reflex. The optimal effect-site concentration (EC) of propofol to prevent triggering of the cough reflex during tracheal suctioning is unknown. The aim of this study is to assess the optimal EC of propofol for tracheal suctioning during emergence in patients undergoing ophthalmic surgery.
Twenty-one patients were enrolled, all of them American Society of Anesthesiologists (ASA) physical status I or II non-smokers undergoing ophthalmic surgery. Anesthesia was induced and maintained under total intravenous anesthesia using target-controlled infusion. During emergence from general anesthesia, tracheal suction was performed at different propofol concentrations as required for Dixon's up-and-down method with a step size of 0.2 μg/ml. A propofol concentration at which the cough reflex was not triggered during tracheal suctioning was considered successful.
The EC50 of propofol for tracheal suction without cough was 1.4 μg/ml and the EC95 was 1.6 μg/ml.
Tracheal suction may be accomplished without triggering the cough reflex when the propofol effect-site concentration is higher than 1.6 μg/ml.
Ultrasonographic findings and prenatal diagnosis of Jacobsen syndrome
Authors: Chen Shuang , Wang Ruixue , Zhang Xinyue , Li Leilei , Jiang Yuting , Liu Ruizhi , Zhang Hongguo 
Published: January 2020

Abstract

Rationale:
Jacobsen syndrome (JBS) is a rare chromosomal disorder with variable phenotypic expressivity, which is usually diagnosed in infancy and childhood based on clinical examination and hematological and cytogenetic findings. Prenatal diagnosis and fetal ultrasonographic findings of JBS are rare.

Patient concerns:
A 38-year-old, gravida 3, para 1, pregnant woman underwent clinical ultrasound examination at 22 weeks of gestation.

Diagnoses:
Ultrasonographic findings indicated an interventricular septal defect, the presence of septal blood flow, dilation of the left renal pelvis, and a single umbilical artery. Amniocentesis was performed to evaluate possible genetic causes of this diagnosis by cytogenetic and single nucleotide polymorphism (SNP) array analysis.

Interventions:
After genetic counseling and informed consent, the couple elected to terminate the pregnancy.

Outcomes:
Karyotype analysis showed that the fetal karyotype was 46,XX,del(11)(q23). The SNP array revealed a 6.118 Mb duplication of 11q23.2q23.3 and a 15.03 Mb deletion of 11q23.3q25.

Lessons:
Ultrasonographic findings of fetal JBS, including an interventricular septal defect, dilation of the left renal pelvis, and a single umbilical artery, may be associated with a 15.03 Mb deletion of 11q23.3q25. Further cases correlating phenotype and genotype are required to predict the postnatal phenotype.
Is insertion of a plastic stent better and safer than epinephrine injection in post sphincterotomy bleeding?
Authors: Schmitz Daniel , Weller Niels , Doll Matthias , Werle Stephan , Mees Claus , Prinz Peter , John Barbara , Schmidt Dorothea , Günther Andreas , Weiß Christel , Rudi Jochen 
Published: January 2020

Objectives
Epinephrine injection is the therapy of first choice in post sphincterotomy bleeding (PSB), but may not be efficient in all cases and can cause postprocedural myocardial infarction. Plastic stent insertion (PSI) may be a better treatment. The aim of this retrospective study was to compare epinephrine injection with PSI with respect to efficacy and safety.

Methods
Clinical success, number of reinterventions and hospital stays after therapy, postprocedural myocardial infarction, bilirubin increase, and pancreatitis as well as factors influencing PSB were analyzed.

Results
Seventy-nine PSBs in 5798 endoscopic retrograde cholangiopancreaticographies (ERCPs) from August 2002 through October 2018 were treated by epinephrine injection, PSI or both (n = 34, 30, 15). Clinical success of PSB therapy showed no difference: 33/34 (97%), 30/30 (100%), 14/15 (93%). Reinterventions were more frequent (n = 30 versus n = 1; P ≤ 0.0001) and hospital stay was longer [median: 3 (2–10) versus 2 (1–3) days; P = 0.0357] in patients who received PSI (versus epinephrine injection). Postprocedural adverse events were very rare: bilirubin increase (1/2/0) and pancreatitis (0/2/1). Intraprocedural episodes of hypertension (≥180 mmHg) were documented in 45–54%.

Conclusions
Epinephrine injection is better than PSI in PSB. PSI may be an adequate treatment in patients with otherwise indicated stent insertion. Intraprocedural episodes of hypertension may be a risk factor for PSB.
Detection of hepatitis C virus core antigen as an alternative method for diagnosis of hepatitis C virus infection in blood donors negative for hepatitis C virus antibody
Authors: Hassanin Taha M. , Abdelraheem Ehab M. , Abdelhameed Saad , Abdelrazik Mohamed , Fouad Yasser M. 
Published: January 2020

Background
Screening of blood donors in many countries is based on the use of serologic assays to detect specific anti-HCV antibodies (HCV Ab), but it lacks detection sensitivity. So, HCV RNA detection using the current gold standard real-time PCR is a must to rule out HCV infection with the main disadvantage being of high cost. HCV core antigen (HCV-c-Ag) immunoassay is proposed as a more cost efficient alternative to HCV RNA detection with PCR.

Aim
To evaluate the effectiveness of HCV-c-Ag detection as a cheap alternative to HCV RNA (PCR) in diagnosis of HCV infection in blood donors who are HCV Ab negative.

Methods and results
One hundred eighty-six volunteer blood donors who tested negative for HCV Ab were examined for HCV-c-Ag. Seven cases out of these 186 cases were HCV-c-Ag positive (4%). HCV RNA detection (PCR technique) was done to 30 cases (seven cases who test positive for HCV-c-Ag and 23 cases who test negative). Six out of the seven cases who were HCV-c-Ag positive (86%) were HCV RNA positive. Twenty-two cases out of the 23 cases who were HCV-c-Ag negative (96%) were HCV RNA negative.

Conclusion
HCV-c-Ag detection is an efficient method for diagnosis of HCV infection during screening of blood donors with high specificity (95.6%) and high negative predictive value (95.6%).
The success rate of radioactive iodine therapy for Graves’ disease in iodine-replete area and affecting factors: a single-center study
Authors: Park Hyunju , Kim Hye In , Park Jun , Park So Young , Kim Tae Hyuk , Chung Jae Hoon , Choi Joon Young , Kim Sun Wook 
Published: January 2020

Objective
Initial treatment options for Graves’ disease include antithyroid drugs, radioactive iodine (RAI), and surgery. Because of similar effects of three modalities, initial treatment preferences differ by country to country. In Korea, iodine-replete area, RAI was used as a second-line option. For these reasons, the RAI success rate in Korea might differ from other countries.

Methods
A total of 247 patients were enrolled. The primary outcome was cumulative success rate in the first year, and the secondary outcome was factors that affected the success. Delayed response, which included patients who attained successful RAI during the follow-up, after the first year without further RAI, and factors that affected the delayed response were reviewed.

Results
The cumulative success rate in the first year was 62.8%. Higher RAI activity [odds ratio (OR) 2.56, P = 0.02], longer disease duration (OR 0.43, P = 0.01), larger goiter (OR 0.31, P = 0.01), and higher post-RAI fT4 (fT4 between upper normal limit (UNL) to 1.5 × UNL; OR 0.24; P < 0.01, 1.5 × UNL<; OR 0.08; P < 0.01) were associated with RAI success. Twenty-seven patients showed delayed response, and goiter size (P < 0.05), pre-RAI TSH receptor Ab (TRAb) level (P < 0.01) and post-RAI fT4 (P < 0.01) were associated.

Conclusion
The success rate of the first RAI in Korea was lower than that in other countries. Delayed response was observed in patients with smaller goiter, low pre-RAI TRAb, and low post-RAI fT4. In these patients, clinical follow-up with monitoring could be an option, and decision of optimal timing of first RAI is crucial.
Diagnostic performance of 18F-2-fluoro-2-deoxy-D-glucose PET/computerized tomography in identifying bone marrow infiltration in new patients with diffuse large B-cell lymphoma and Hodgkin lymphoma
Authors: Kandeel Ahmed A. , Hussein Mai , Zidan Lamia , Younis Jehan , Edesa Wael , Alsayed Yasser 
Published: January 2020

Objective
To compare between 18F-2-fluoro-2-deoxy-D-glucose PET/computerized tomography (18F-FDG PET/CT) and routine iliac bone marrow biopsy (BMB) in assessment of bone marrow infiltration (BMI) in Hodgkin lymphoma and diffuse large B-cell lymphoma (DLBCL) patients at initial presentation.

Patients and methods
A retrospective analysis of 138 patients (50 Hodgkin lymphomas, 88 DLBCLs). The study included 70 males and 68 females with median age of 43 years. All patients underwent 18F-FDG PET/CT and iliac crest BMB before treatment. Any focal or patchy FDG uptake in the bone marrow, superior-to hepatic uptake was interpreted as abnormal with or without corresponding CT changes. Treatment response was evaluated clinically with each cycle of chemotherapy, radiologically after three cycles and at the end of treatment.

Results
The overall diagnostic performance showed significant higher sensitivity of 18F-FDG PET/CT than that of BMB (73.9 versus 62.5%, P = 0.046), while the specificity was higher in BMB than in 18F-FDG PET/CT (100% in BMB versus 93.5% in 18F-FDG PET/CT). In Hodgkin lymphoma, sensitivity, negative predictive value (NPV) and accuracy were significantly higher in 18F-FDG PET/CT compared with BMB, being 87.5, 94.4 and 96% versus 50, 81 and 84% (P = 0.02, 0.03, 0.04, respectively). However, for DLBCL patients, almost comparable results were found between both tests in terms of sensitivity, NPV and accuracy (66.7, 83.9 and 81.8% versus 68.8, 84.9 and 88.6%, respectively). After PET/CT scan, 12 patients (8.6%) were upstaged to stage IV, eight of them were negative by BMB.

Conclusion

18F-FDG PET/CT seemed to be an excellent diagnostic test in assessment of BMI at initial assessment and staging of Hodgkin lymphoma and DLBCL patients.
Future treatments for hyperoxaluria
Authors: Burns Zachary , Knight John , Fargue Sonia , Holmes Ross , Assimos Dean , Wood Kyle 
Published: January 2020

Purpose of review
The review of potential therapies in the treatment of hyperoxaluria is timely, given the current excitement with clinical trials and the mounting evidence of the importance of oxalate in both kidney stone and chronic kidney disease.

Recent findings
Given the significant contribution of both endogenous and dietary oxalate to urinary oxalate excretions, it is not surprising therapeutic targets are being studied in both pathways. This article covers the existing data on endogenous and dietary oxalate and the current targets in these pathways.

Summary
In the near future, there will likely be therapies targeting both endogenous and dietary oxalate, especially in subsets of kidney stone formers.
New devices for kidney stone management
Authors: Terry Russell S. , Whelan Patrick S. , Lipkin Michael E. 
Published: January 2020

Purpose of review
The purpose of this review is to summarize recent developments in the array of devices which are commonly used by urologists in the surgical management of kidney stones. To accomplish this goal, an extensive review of recent endourology literature, conference abstracts, and publicly available documents from manufacturers and the United States Food and Drug Administration was collected and reviewed.

Recent findings
Recent developments in the holmium:yttrium-aluminum-garnet (Ho:YAG) laser lithotripsy include the introduction of pulse modulation. This technique delivers the laser energy in an asymmetric manner such that an initial bubble is created (the ‘Moses effect’) through which the remainder of the energy can then travel through without being absorbed by surrounding water. Even more novel is the thulium fiber laser, which is produced in a fundamentally different way than traditional Ho:YAG lasers and is not yet available for clinical use. Finally, novel mechanical lithotrites which effectively combine ultrasonic energy, ballistic energy, and suction capability appear to be highly effective for stone clearance in recent benchtop and clinical studies.

Summary
With the introduction of both new modifications of time-tested technologies as well as completely novel modalities, the practicing urologist's armamentarium of devices for the surgical management of kidney stones continues to grow. As the popularity of ‘mini’ procedures continues to grow, the adaptability of these technologies to these procedures will be critical to maintain maximum relevance.
Is Nasal Septal Body Size Associated With Inferior Turbinate Hypertrophy and Allergic Rhinitis?
Authors: Hizli Omer , Kayabasi Serkan , Ozkan Deniz 
Published: January 2020

Abstract
Nasal septal body is a thickened mucosal area of nasal septum with an unknown certain role. In this study, the authors aimed to investigate the association between the area, length, and width of the nasal septal body with inferior turbinate hypertrophy (ITH) and allergic rhinitis (AR). A total of 106 patients with ITH (54 with AR and 52 without AR), and 49 patients without ITH and AR (control group) were included in this study. Using axial and coronal paranasal computed tomography scans, the area, length, and width of nasal septal body were measured, and the mean values between the groups were compared. Mean area, length, and width of nasal septal body significantly differed among 3 groups (P < 0.001). Septal body area was significantly greater in ITH with AR group, compared to ITH without AR group (P < 0.001) and the control group (P < 0.001). Also, it was significantly greater in ITH without AR group compared to the control group (P < 0.001). Septal body width was significantly greater in ITH with AR group, compared to ITH without AR group (P < 0.001) and the control group (P < 0.001). Also, it was significantly greater in ITH without AR group compared to the control group (P < 0.001). Patients with ITH had a greater nasal septal body area, length, and width, compared to the patients without. Moreover, AR had an additional increasing effect on the area and width of the nasal septal body.