bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association between dementia and hepatitis B and C virus infection
Authors: Choi Hyo Geun , Soh Jae Seung , Lim Jae Sung , Sim Song Yong , Lee Suk Woo 
Published: August 2021

Abstract
Several viral infections are known to increase the risk of dementia through brain cell damage and systemic infection. The association between hepatitis B and C virus (HBV and HCV) infections and dementia was evaluated using a national sample cohort from South Korea. Using the national cohort study from the Korean National Health Insurance Service, we extracted data for patients with HBV or HCV infection and for matched control participants. The controls were matched to the patients according to age, sex, income, region of residence, and past medical histories. The incidence of HCV infection was higher in the dementia group (1.0% [113/11,228]) than in the control group (0.8% [364/44,912], P = .043). However, there was no difference in the incidence of HBV infection in the dementia and control groups. The adjusted odds ratio (OR) for HCV infection was 1.25 (95% confidence interval [CI] = 1.01–1.54, P = .043) in the dementia group. According to the subgroup analysis by sex, the adjusted ORs for HCV infection were 1.04 (95% CI = 072–1.49, P = .851) in men and 1.38 (95% CI = 1.06–1.79, P = .016) in women. We concluded that the incidence of HCV infection was higher (with a higher OR) in women with dementia than in matched control participants in South Korea.
Formula to estimate left atrial volume using antero-posterior diameter in patients with catheter ablation of atrial fibrillation
Authors: Sangsriwong Muktapha , Cismaru Gabriel , Puiu Mihai , Simu Gelu , Istratoaie Sabina , Muresan Lucian , Gusetu Gabriel , Cismaru Andrei , Pop Dana , Zdrenghea Dumitru , Rosu Radu 
Published: August 2021

Abstract
In patients undergoing atrial fibrillation (AF) ablation, an enlarged left atrium (LA) is a predictor of procedural failure as well as AF recurrence on long term. The most used method to assess LA size is echocardiography-measured diameter, but the most accurate remains computed tomography (CT).
The aim of our study was to determine whether there is an association between left atrial diameters measured in echocardiography and the left atrial volume determined by CT in patients who underwent AF ablation.
The study included 93 patients, of whom 60 (64.5%) were men and 64 (68.8%) had paroxysmal AF, who underwent AF catheter ablation between January 2018 and June 2019. Left atrial diameters in echocardiography were measured from the long axis parasternal view and the LA volume in CT was measured on reconstructed three-dimensional images.
The LA in echocardiography had an antero-posterior (AP) diameter of 45.0 ± 6 mm (median 45; Inter Quartile Range [IQR] 41–49, range 25–73 mm), longitudinal diameter of 67.5 ± 9.4 (median 66; IQR 56–88, range 52–100 mm), and transversal diameter of 42 ± 8.9 mm (IQR 30–59, range 23–64.5 mm). The volume in CT was 123 ± 29.4 mL (median 118; IQR 103–160; range 86–194 mL). We found a significant correlation (r = 0.702; P < .05) between the AP diameter and the LA volume. The formula according to which the AP diameter of the LA can predict the volume was: LA volume = AP diam3 + 45 mL.
There is a clear association between the left atrial AP diameter measured on echocardiography and the volume measured on CT. The AP diameter might be sufficient to determine the increase in the volume of the atrium and predict cardiovascular outcomes.
Early use of tocilizumab in patients with severe pneumonia secondary to severe acute respiratory syndrome coronavirus 2 infection and poor prognostic criteria
Authors: Sánchez-Rovira Pedro , Pérez-Chica Gerardo , Ortega-Granados Ana Laura , Aguilar-García Josefa , Díaz-Beltrán Leticia , Gálvez-Montosa Fernando , García-Verdejo Francisco , Luque-Caro Natalia , Quero-Blanco Cristina , Fernández-Navarro Mónica , Rodríguez-Sánchez Agustín , Ruiz-Bailén Manuel , Yaguez-Mateos Luis , Marín-Pozo Juan Francisco , Sierra-Torres María Isabel , Lacárcel-Bautista Celia , Duro-Ruiz Gaspar Jesús , Duro-Fernández María Ángeles , García-Alegría Javier , Herrero-Rodríguez Carmen 
Published: August 2021

Abstract
The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2, keeps spreading globally. Evidence suggests that a subgroup of patients with severe symptomatology might have cytokine storms, which increases mortality. The use of interleukin-6 (IL-6) inhibitors may help in controlling the pathological immune response to the virus. Tocilizumab, a monoclonal antibody against IL-6, stands as an optional treatment for COVID-19 patients presenting this inflammatory hyper-response.
We conducted a retrospective, observational, cohort study including 50 patients affected by COVID-19 with severe pneumonia and poor prognosis criteria, who have also undergone standard treatment; 36 of these patients additionally received tocilizumab in an early stage. The need for intensive care unit (ICU) admission, mortality, recovery of respiratory function, and improvement of biochemical and hematological parameters were compared between cohorts.
Most patients were men, non-smokers and the most frequently reported comorbidities were hypertension and diabetes. Recurrent symptoms were fever, cough, and dyspnoea. 54.8% of patients from the tocilizumab group needed intubation, while in the control group 85.7% needed it. Treatment with tocilizumab significatively increased IL-6 levels, (554.45; CI 95% 186.69, 1032.93; P < .05) while C-reactive protein mean levels were reduced (–108.19; CI 95% –140.15, –75.33; P < .05), but no significant difference was found between cohorts. In comparison with the controls, tocilizumab reduced mortality (25.0% vs 42.9%, P = .021) and the number of ICU admissions (63.9% vs 100.0%, P = .021). 44.1% of patients treated with tocilizumab showed favorable radiological evolution, when compared with 15.4% of patients from the control group.
Tocilizumab may improve clinical symptoms and mitigate deterioration observed in severe COVID-19 patients, and could be considered as an effective therapeutic option in subjects experiencing a significant inflammatory response to the disease.
Usefulness of the capsule endoscopy Crohn's disease activity index in assessing the necessity of early additional treatment in patients with Crohn's disease in clinical remission
Authors: Miyazu Takahiro , Ishida Natsuki , Takano Ryosuke , Tamura Satoshi , Yamade Mihoko , Hamaya Yasushi , Tani Shinya , Iwaizumi Moriya , Osawa Satoshi , Furuta Takahisa , Sugimoto Ken 
Published: August 2021

Abstract
The Capsule Endoscopy Crohn's Disease Activity Index (CECDAI) was recently reported as a new scoring system to evaluate the mucosal lesions of patients with Crohn's disease (CD). We investigated whether CECDAI is useful for assessing the necessity of early additional treatment in patients with CD in clinical remission.
Twenty-one patients with small intestinal CD in clinical remission underwent capsule endoscopy (CE). The CECDAI and Lewis score (LS) were used to evaluate the intestinal lesions. We analyzed the correlations between several biomarkers and CECDAI or LS and examined the changes in therapeutic regimens based on the CECDAI.
CE identified intestinal abnormalities in most CD patients in clinical remission: 81.0% and 85.7%, as assessed using CECDAI and LS, respectively. A significant positive correlation was observed between the CDAI and LS (P = .025), as well as between CDAI and CECDAI (P = .014) in these cases. Compared to LS, CECDAI scores were more evenly distributed. No significant correlations were observed between endoscopic scores and serum markers, including CRP, hemoglobin, and albumin levels. Additional treatment was performed significantly more often in patients with moderate-severe disease activity (CECDAI ≥5.8) (P = .012) than in those with normal (CECDAI <3.5) and mild (3.5≤CECDAI<5.8) disease activity. Resection of the small intestine did not affect the small bowel transit time or CE score.
CECDAI is useful in evaluating mucosal lesions in small bowel CD patients in clinical remission and helps in assessing the requirement for additional treatment for these patients, including those who undergo intestinal resection.
The clinical significance of neutrophil-lymphocyte ratio in patients treated with hemodialysis complicated with lung infection
Authors: Li Ling-Lin , Yang Yu-Qiong , Qiu Min , Wang Li , Yuan Hong-Ling , Zou Ren-Chao 
Published: August 2021

Abstract
The goal of this work was to investigate the potential significance of neutrophil-lymphocyte ratio (NLR) in patients treated with maintenance hemodialysis (MHD).
Herein, we retrospectively reviewed the electronic medical records of 100 patients with end-stage renal failure who were treated with MHD. All patients enrolled in this study met the inclusion criteria and were followed. The differences in each indicator between the two groups were compared using the Wilcoxon rank-sum test. On the other hand, Spearman correlation and logistic regression analysis were used to explore the correlation and risk factors for pulmonary infection between NLR and other indicators. Finally, we determined the optimal cut-off values for NLR, hypersensitive c-reactive protein (hs-CRP), and procalcitonin (PCT) diagnosis of pulmonary infection using the receiver operating characteristic curve.
We found that NLR was positively correlated with age, PCT, hs-CRP, and hospital stay, but negatively correlated with hemoglobin, red blood cell, and Albumin. The expression levels of PCT, hs-CRP, and NLR in the infected group decreased significantly than those before treatment. Multiple regression analysis revealed that NLR is an important independent risk factor for MHD patients with pulmonary infection. Additionally, receiver operating characteristic curve analysis showed that the sensitivity, specificity, and area under the curve were 87.76%, 100%, and 0.920 when using NLR combined with hs-CRP to predict pulmonary infection in MHD patients, whereas that of NLR combined with PCT were 87.76%, 96.08%, and 0.944, respectively.
Findings from this study suggested that NLR is an independent risk factor for MHD patients with pulmonary infection, which can effectively predict pulmonary infection. Moreover, sensitivity and specificity were greatly enhanced when using NLR combined with PCT/hs-CRP to predict pulmonary infection in MHD patients.
Preserved corneal lamellar transplantation for infectious and noninfectious scleral defects
Authors: Jung Young-ho , Yoon Chang Ho , Kim Mee Kum 
Published: August 2021

Abstract

Rationale
: Reinforcement of thinned or necrotizing sclera has been conducted using various materials, including allogeneic sclera, allogenic cornea, amniotic membrane, fascia lata, pericardium, periosteum, and perichondrium. Among them, good outcomes have traditionally been obtained using preserved scleral grafts. However, scleral patch grafts have complications such as graft retraction, thinning, dehiscence, and necrosis. Furthermore, to promote epithelial healing, scleral patch grafting must be accompanied by procedures such as amniotic membrane transplantation (AMT) or grafting using conjunctival flaps or autografts. Recently, acellular preserved human corneas have been used in various ophthalmic surgeries, with emerging evidence supporting its use for treating scleral defects as an option that does not require AMT or conjunctival autografting. We investigated whether corneal patch grafting would show wound healing and tectonic success rate outcomes comparable to those of existing techniques.

Patient presentation
: Three patients presented with intractable ocular pain. Slit-lamp examination showed marked scleral thinning at the nasal side.

Diagnosis
: Scleral thinning progressed with conservative treatment; microbial staining and culturing were performed. Infectious or non-infectious scleritis was diagnosed according to slit-lamp examination and microbial culture results.

Interventions
: A preserved corneal lamellar patch was grafted at the scleral thinning area.

Outcomes
All patients achieved tectonic success with reduction of inflammation following corneal patch grafting. Two patients achieved complete re-epithelialization within 7 days, while 25 days were required for the third patient. No patients experienced graft thinning, rejection, or infection.

Lessons
: Our report suggests the feasibility of using acellular preserved human cornea patch grafts to reinforce inflammatory scleral defects and obtain successful outcomes in terms of wound healing. This technique shows a comparable tectonic success rate and superior effect on scleral defect healing without the need for adjunctive AMT or conjunctival autografting.
Associations of serum soluble klotho and fibroblast growth factor 23 with carotid artery calcification in patients undergoing continuous ambulatory peritoneal dialysis
Authors: Guo Naifeng , Chen Xu , Cao Yingjie , Lu Guoyuan 
Published: August 2021

Abstract
This study aimed to assess the associations of serum soluble klotho and fibroblast growth factor 23 (FGF-23) with the occurrence of carotid artery calcification. Peritoneal dialysis patients treated from June 2018 to June 2019 were retrospectively analyzed. They were divided into the carotid artery calcification and non-carotid artery calcification groups according to color Doppler ultrasound findings. Basic indicators in both groups were compared, and the influencing factors of carotid artery calcification were analyzed by logistic regression. Among the 73 continuous ambulatory peritoneal dialysis (CAPD) patients enrolled, 40 (54.8%) had carotid artery calcification. Significant differences were found in age (68.85 ± 7.45 vs 46.62 ± 5.51 years), dialysis time (8.15 ± 1.42 vs 6.02 ± 1.14 months), klotho amounts (325.56 ± 41.15 vs 436.65 ± 45.58 pg/mL) and FGF-23 levels (114.45 ± 15.56 vs 70.15 ± 12.23 pg/mL) between the carotid artery calcification and non-carotid artery calcification groups (all P < .001). The above factors were associated with carotid artery calcification occurrence in univariate analysis. Multivariate analysis showed that elevated age (odds ratio [OR] = 1.55, 95% confidence interval [CI] 1.13–1.74; P = .025) and FGF-23 (OR = 2.16, 95% CI 2.01–2.44; P = .042), and lower klotho (OR = 0.66, 95% CI 0.47–0.85; P = .036) were independent risk factors for carotid artery calcification in CAPD. Serum FGF-23 and age are risk factors for carotid artery calcification in patients with CAPD, whereas klotho is a protective factor.
Durable response to immunotherapy plus chemotherapy in a patient with untreated, brain-metastatic, EGFR exon 20 insertion mutation lung adenocarcinoma
Authors: Nong Jingying , Gu Yanfei , Yao Shuyang , Zhang Yi 
Published: August 2021

Abstract

Rational:
Epidermal growth factor receptor (EGFR) 20 exon insertion is the second most common EGFR aberrations in non-small cell lung cancer (NSCLC). Despite some novel EGFR inhibitors, clinically obtainable management for this subset of patients remains an unmet need. there are no previous reports of upfront combination therapy with immunotherapy and chemotherapy for lung adenocarcinoma with brain metastasis harboring EGFR 20 insertion.

Patient concerns:
A 56-year-old man who sought care for dry cough was diagnosed with lung adenocarcinoma with brain metastases indicating a poor prognosis.

Diagnosis:
Next-generation sequencing of lung biopsied tissue revealed an EGFR exon 20 in-frame insertion (P772_H773insYNP+H773Y).

Interventions:
The patient started treatment of pemetrexed and carboplatin plus programmed cell death-1 inhibitor sintilimab in November 2019.

Outcomes:
The patient achieved partial responses both intra- and extra-cranially. After 6 cycles of treatment, the patient accepted sintilimab plus pemetrexed every 3 weeks as maintenance therapy, which was well-tolerated without any toxicity and is still ongoing after 18 months since initiation of 1st-line treatment.

Lessons:
This is the first case report of the clinical benefit of upfront immune checkpoint inhibitors (ICIs) plus chemotherapy for a brain metastatic NSCLC patient harboring EGFR exon 20 insertion mutation. Further study is needed to validate the predictor involved in responders to ICIs-based therapy with EGFR mutations.
Combined argon laser peripheral iridoplasty and Nd: YAG laser shock wave therapy for recurrent XEN gel stent obstruction due to iris incarceration
Authors: Rho Seungsoo , Lim Su-Ho 
Published: August 2021

Abstract

Introduction:
Despite its proven effectiveness and safety profile, the XEN Gel Stent (Allergan Inc., CA, USA) has a small lumen and is therefore likely to become occluded by fibrin, a blood clot, or even the iris. However, few studies have investigated XEN-iris occlusion and how to manage this condition. We describe the first case report of recurrent XEN gel stent obstruction by iris incarceration, which was resolved following a combined treatment with argon laser peripheral iridoplasty (ALPI) and low-energy neodymium-doped yttrium aluminum garnet (Nd: YAG) laser shock wave treatment.

Patient information:
A 74-year-old Korean male underwent uncomplicated XEN gel stent implantation and presented with low intraocular pressure (IOP) with a well-functioning filtering bleb during the first postoperative week. On postoperative day 10, the XEN lumen was occluded by the iris and demonstrated an IOP spike of 33 mmHg. Despite the use of pilocarpine, the iris incarceration persisted. Therefore, surgery to reposition the XEN stent was attempted using a gonio-prism and intraocular forceps. After the first revision surgery, the IOP and stent position were stable for 2 weeks. However, recurrent partial obstruction of the stent by the iris, pigment dispersion into the intraluminal space, and an elevated IOP of 24 mmHg were observed later.

Diagnosis:
Recurrent XEN gel stent occlusion by the iris and intraluminal pigment dispersion.

Interventions:
Combined ALPI and low energy Nd: YAG laser shock wave therapy.

Outcomes:
IOP dropped from 24 mmHg to 10 mmHg immediately and continued to be well-controlled until 3 months later (range: 8–12 mmHg).

Conclusions:
To the best of our knowledge, this is the first case report of the efficacy of combined laser treatment for relieving recurrent XEN implant occlusion by the iris. This combination laser treatment might be a relatively safe rescue treatment to restore the patency of a XEN gel stent occluded by the iris, even in cases with recurrent XEN stent obstruction after surgical repositioning.
Case Report/Case Series: Rare case of anti-LGI1 limbic encephalitis with rapidly progressive dementia, psychiatric symptoms, and frequently seizures
Authors: Wu Haiyan , Mei Fan , Liu Lixin , Zhang Li , Hao Hongjun , Zhang Shouzi 
Published: August 2021

Abstract

Rationale:
Anti leucine-rich glioma inactivated 1 (LGI1) limbic encephalitis (LE) is rare autoimmune encephalitis, characterized by acute or subacute cognitive impairment, faciobrachial dystonic seizures, mental disorders, and refractory hyponatremia. As a type of treatable rapidly progressive dementia with a good prognosis, early, and accurate diagnosis is essential. We present a case of anti-LGI1 LE who was initially misdiagnosed with Alzheimer disease because his clinical manifestations were similar to Alzheimer disease.

Patient concerns:
A male patient presenting with rapidly progressive dementia, faciobrachial dystonic seizures, psychiatric disturbance, and refractory hyponatremia was admitted. The scores of Mini-Mental State Examination, Montreal Cognitive Assessment, and Neuropsychiatric Inventory were 19/30, 16/30, and 91/144, respectively. Brain magnetic resonance images indicated moderate atrophy of the hippocampus and abnormally hyperintensities in the left medial temporal and hippocampus.

Diagnosis:
The patient was diagnosed with anti-LGI1 LE based on the presence of LGI-1 antibodies in the cerebrospinal fluid and serum and clinical manifestations.

Interventions:
Patient was treated with glucocorticoid against LGI1, antiepileptic drug, cholinesterase inhibitors, and other adjuvant therapy.

Outcomes:
The patient showed marked improvement on immunotherapy. Clinical symptoms were disappeared and the LGI-1 antibodies in cerebrospinal fluid and serum were both negative at the time of discharge.

Conclusions:
Recognition of the specific symptoms and LGI-1 antibody test will be helpful for the early diagnosis, prompt immunotherapy, and good prognosis. This case raises the awareness that rapidly progressive dementia with frequent seizures could be caused by immunoreactions.
Association between human immunodeficiency virus serostatus and the prevalence of atrial fibrillation
Authors: Osuji Ngozi , Haberlen Sabina A. , Ashikaga Hiroshi , Brown Todd T. , Feinstein Matthew J. , Witt Mallory D. , Magnani Jared W. , Soliman Elsayed Z. , Wu Katherine C. , Post Wendy S. 
Published: August 2021

Abstract
Atrial fibrillation (AF) leads to increased risk for stroke. Human immunodeficiency virus (HIV) is associated with cardiovascular disease (CVD), although it is unclear if HIV is associated with AF. The purpose of this study was to evaluate the association between HIV serostatus and the prevalence of AF in the Multicenter AIDS Cohort Study.
A cross sectional study was conducted among 1674 HIV-infected (HIV+) and uninfected (HIV–) men who completed resting 12-lead electrocardiograms, and/or ambulatory electrocardiogram monitoring. Multivariable logistic regression was used to evaluate the association between AF, defined as the presence of either AF or atrial flutter, and HIV+ serostatus. Associations were adjusted for demographic variables, and then also for CVD risk factors.
HIV+ men were younger than HIV– men (median 55.5 vs 61.7 years, P < .001) and were more frequently African-American (30.5% vs 17.8%, P < .001). Most HIV+ men (81%) had undetectable viral load. The age and race adjusted prevalence of AF was 3.0% in HIV+ and 3.3% in HIV– men. There was only 1 case of AF among African-American men. There were no associations between AF and HIV serostatus after adjusting for demographic factors (odds ratio 0.76; 95% CI 0.37 to –1.58; P = .47) or after further adjustment for CVD risk factors (odds ratio 0.84; 95% CI 0.39 to –1.81; P = .66).
We found no association between HIV and AF in this cohort in which viral replication among the HIV+ men is generally suppressed. The overall prevalence of AF was low and was rare in African-American men.