bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative effectiveness of furosemide vs torasemide in symptomatic therapy in heart failure patients
Authors: Li Yifan , Li Li , Guo Zhipeng , Zhang Shunye 
Published: February 2021

Abstract

Background:
We performed this randomized controlled study protocol to investigate the efficacy and adverse effects of furosemide vs torasemide in patients with heart failure (HF).

Method:
The present study was authorized by the local research ethics committee of Shanxi Cardiovascular Hospital (no. 48736645) and informed consent was obtained from all patients. Patients were enrolled in a consecutive prospective manner on a voluntary basis. Patients who were aged 18 years and older with HF who were eligible to enroll in this randomized trial. All patients had evidence of left ventricular systolic dysfunction, confirmed by echocardiographic or nuclear imaging. The exclusion criteria were left ventricular diastolic dysfunction only, or receipt of medical or pharmaceutical care in other health systems. The primary efficacy end point was the change in procollagen type I carboxyterminal peptide (PICP) serum levels between baseline and final visit. Secondary efficacy variables included parameters related to the clinical course of HF, such as body weight, presence of edema, signs and symptoms of HF, electrocardiogram and echocardiographic evaluation, amino-terminal pro brain-type natriuretic peptide (NT-proBNP) serum levels measured by ELISA method, systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate, and renal function.

Results:
One hundred patients who met the inclusion criteria were included in our study, Table 1

showed the effects of furosemide and torsemide on measures of clinical outcomes.

Discussion:
Fluid overload is the primary cause of hospitalization among patients with HF. Preventing circulatory congestion requires careful control of dietary sodium and chronic administration of loop diuretics. Torasemide and furosemide are representatives of loop diuretics with an identical diuretic mechanism, but different pharmacokinetic properties and additional effects. There is a need for reliable conclusion regarding the comparison of furosemide and torasemide in patients with HF. Several limitation should be noted:
Comparison of airway management without neuromuscular blockers in laparoscopic gynecological surgery
Authors: Ozbilgin Sule , Kuvaki Bahar , Şimşek Hatice Keskin , Saatli Bahadir 
Published: February 2021

Abstract
New generation supraglottic airway devices are suitable for airway management in many laparoscopic surgeries. In this study, we evaluated and compared the ventilation parameters of the laryngeal mask airway-supreme (LM-S) and endotracheal tube (ETT) when a neuromuscular blocker (NMB) agent was not used during laparoscopic gynecological surgery. The second outcome was based on the evaluation of the surgical view because it may affect the surgical procedure.
This was a randomized study that enrolled 100 patients between 18 and 65 years old with an ASA I-II classification. Patients were divided into 2 groups: Group ETT and Group LM-S. Standard anesthesia and ventilation protocols were administered to patients in each group. Ventilation parameters [airway peak pressure (Ppeak), mean airway pressure (Pmean), total volume, and oropharyngeal leak pressure] were recorded before, after, and during peritoneal insufflation and before desufflation, as well as after the removal of the airway device. Perioperative surgical view quality and the adequacy of the pneumoperitoneum were also recorded.
The data of 100 patients were included in the statistical analysis. The Ppeak values in Group ETT were significantly higher in the second minute after airway device insertion. The Ppeak and Pmean values in Group ETT were significantly higher before desufflation and after removal of the airway device. No significant differences were found between the groups in terms of adequacy of the pneumoperitoneum or quality of the surgical view.
The results of this study showed that gynecological laparoscopies can be performed without using a NMB. Satisfactory conditions for ventilation and surgery can be achieved while sparing the use of muscle relaxants in both groups despite the Trendelenburg position and the pneumoperitoneum of the patients, which are typical for laparoscopic gynecological surgery. The results are of clinical significance because they show that the use of a muscle relaxant is unnecessary when supraglottic airways are used for these surgical procedures.
Platelet-rich plasma injection vs corticosteroid injection for conservative treatment of rotator cuff lesions
Authors: Wang Chenglong , Zhang Zhuo , Ma Yihang , Liu Xiangji , Zhu Qingsan 
Published: February 2021

Abstract

Background:
To explore the effectiveness of platelet-rich plasma (PRP) injection regarding functional recovery, pain relief, and range of motion (ROM) of shoulder compared with the corticosteroid injection in patients with rotator cuff lesions treated non-operatively.

Methods:
An electronic literature search was performed by 2 authors in the PubMed, Embase, Cochrane Library, and Web of Science databases to identify relevant randomized controlled trial (RCTs) that were published up to July 20, 2020. The quality of the included RCTs was evaluated using the approach recommended by the Cochrane Handbook for Systematic Reviews of Interventions. Standardized mean differences (SMDs) or mean differences (MDs) with 95% confidence intervals (CIs) were applied to calculate the pooled effect sizes.

Results:
Six RCTs were included in this systematic review. Meta-analysis revealed that corticosteroid injection yielded statistically significant superior functional recovery (SMD = −0.80; 95% CI, −1.42 to −0.18; P = .01) and pain relief (MD = 1.59; 95% CI, 0.30–2.89; P = .02) compared with PRP injection for rotator cuff lesions during the short-term follow-up period. However, at the medium-term and long-term follow-up, no statistically significant difference was identified between the 2 groups. Regarding the ROM of shoulder, no statistically significant difference was found between the 2 groups during the whole follow-up period.

Conclusions:
The current clinical evidence revealed short-term efficacy of corticosteroid injection and no significant medium- to long-term difference between corticosteroid and PRP injection in the treatment of rotator cuff lesions. Additional studies with longer follow-ups, larger sample sizes, and more rigorous designs are needed to draw more reliable and accurate conclusions.
The value of caudate lobectomy in hilar cholangiocarcinoma treatment
Authors: Yang Ming , Li Wei Wei , Chen Jian Hua , Cui Miao Hang , Liu Jin Long 
Published: February 2021

Abstract

Purpose:
To discuss the value of caudate lobectomy in hilar cholangiocarcinoma (HCCA) treatment.

Methods:
A systematic review was performed in PubMed, MEDLINE database, EMBASE, and Cochrane Library for trials comparing combined caudate lobectomy with controls from January 1, 1990 to December 2, 2020. The outcomes were postoperative radical cure information, survival condition, morbidity, and mortality.

Result:
Ten studies were included. No difference was observed in the morbidity (odd ratio (OR) 0.93, 95% confidence interval (CI) 0.65–1.33) and mortality (OR 1.16, 95% CI 0.55–2.42) between the combined caudate lobectomy and control groups. Hepatectomy combined with caudate lobectomy was associated with higher incidence of radical resection (OR 3.88, 95% CI 2.18–6.90) and longer survival (hazard ratio 0.45, 95% CI 0.38–0.55).

Conclusion:
Combining caudate lobectomy can significantly increase the incidence of radical resection of HCCA and the postoperative survival time. The morbidity and mortality were not increased after the operation. Thus, caudate lobectomy should be included when performing partial hepatectomy for HCCA.
Impact of blood pressure on the outcomes of inpatients with Subarachnoid hemorrhage
Authors: Saito Naohito , Nishikawa Tetsuo , Ota Tetsuo 
Published: February 2021

Abstract
It is unclear whether antihypertensive treatment should be indicated after subarachnoid hemorrhage (SAH). Hence, we investigated the impact of blood pressure on inpatient outcomes after SAH rehabilitation.
This retrospective cross-sectional study analyzed data of SAH inpatients, as obtained from the Japan Association of Rehabilitation Database for inpatients undergoing SAH rehabilitation. Inpatients admitted to a conventional ward with a diagnosis of cerebrovascular disease were voluntarily registered in this database between January 2006 and December 2013 from hospitals in Japan. Patients were categorized into hypertensive and non-hypertensive populations and assessed using the Barthel Index (BI) and the total BI score at hospital discharge. We compared the independent population (patients with the highest score for each activity) with its non-independent counterpart. Data on the patients’ age, BI score on admission, total BI score, BI score increase, daily BI score increase, hospitalization duration, BI activities, patients’ sex, and Brunnstrom recovery stage were compared.
Eighty-eight patients with SAH were analyzed; 43 were hypertensive and 45 non-hypertensive. Hypertension was associated with increased non-independence levels (hypertensive versus non-hypertensive patients, transfers [bed to chair and back]: 15 versus 24, P = .03, odds ratio (OR) = 2.532 (95% confidence interval [CI], 1.065–6.024); toilet use: 15 versus 24, P = .03, OR = 2.532 (95% CI, 1.065–6.024); bathing: 23 versus 34, P = .0061, OR = 3.623 (95% CI, 1.414–9.259); stair climbing: 22 versus 31, P = .03, OR = 2.703 (95% CI, 1.114–6.579); and bladder control: 14 versus 24, P = .02, OR = 2.801 (95% CI, 1.170–6.711)). The total BI score of the hypertensive inpatients at discharge was lower than that of their non-hypertensive counterparts (0–75 versus 80–100, 30 versus 19, P = .03). Moreover, the BI score increase per day was significantly lower in the hypertensive group than in the non-hypertensive group (.67 versus 1.8, P = .02). The hypertensive group also had a significantly longer duration of hospitalization than the hypertensive group (52 versus 30 days, P = .02).
Hypertension was associated with longer hospitalization and poorer outcomes post-discharge, suggesting the importance of strict blood pressure control in patients who have experienced SAH.
Cardiovascular syphilis-associated acute myocardial infarction
Authors: Li Xiangdong , Wang Xue , Wang Zhiyuan , Du Beibei , Mao Cuiying , Meng Heyu , Meng Fanbo , Yang Ping 
Published: February 2021

Abstract

Rationale:
In recent decades, the incidence of advanced syphilis has declined due to early recognition and the application of effective antibiotics. Advanced syphilis often manifests in the cardiovascular system as simple aortitis, aortic valve insufficiency, coronary artery stenosis or obstruction, Aortic aneurysm and mucinous myocarditis. In most case reports on the subject, acute myocardial infarction caused by syphilis was reported to be due to aortic valve insufficiency and coronary stenosis as a result of the involvement of the aorta.

Patient concerns:
The patient was a 48-year-old woman. She was admitted to our hospital because of intermittent upper abdominal pain with chest tightness for 3 hours. The patient reported a past syphilis infection, when she was hospitalized for hysteromyoma surgery four years ago, and had no related treatment.

Diagnosis:
According to the characteristics of coronary angiography and results of lab tests and echocardiography, she was finally diagnosed with myocardial infarction associated with syphilis.

Interventions:
At the first diagnosis of syphilis, the patient did not received antibiotics treatment. After the diagnosis of myocardial infarction, she received the percutaneous coronary intervention (PCI) operation assisted by extracorporeal membrane oxygenation (ECMO) technology, successfully got drug -eluted stents in right coronary artery ostium and left main ostium. Then the patient received penicillin to treat the syphilis infection.

Outcomes:
After coronary revascularization, the cardiac function of the patients was gradually improved, and the left ventricular ejection fraction was gradually improved after combined with optimized drug therapy.

Lessons:
The cardiovascular system is often involved in the stages of advanced syphilis with severe complications like myocardial infarction. Standard treatment should be given as soon as syphilis is diagnosis. For stenosis of coronary ostium, the PCI assisted by ECMO technology did not only ensure the effectiveness of the treatment, but also reduce the surgical risk of the patient. This case indicated the effectiveness of ECMO-assisted PCI, and thus may provide a reference for future patient treatment.
Secondary below-knee amputation following open reduction and internal fixation of a closed pilon fracture
Authors: Wei Daiqing , Xu Yangbo , Xiang Feifan , Ye Junwu 
Published: February 2021

Abstract

Rationale:
Despite significant advances in surgical techniques and implants, the clinical outcome of high-energy pilon fractures remains unsatisfactory, which continues to represent numerous challenges for orthopedic trauma surgeons.

Patient concerns:
A 62-year-old man injured his right ankle after falling from a 3 m high place. There were no open wounds or other complications.

Diagnoses:
According to the X-ray and CT scans, the patient was diagnosed with pilon fracture (type AO-43-C2) and lateral malleolus fracture of the right limb.

Interventions:
The patient was initially treated with calcaneal traction upon admission to a primary hospital. Five days after the injury, the patient underwent open reduction and internal fixation (ORIF) of the fracture and vacuum sealing drainage (VSD) for wound closure.

Outcomes:
The patient presented to our hospital on the 9th day after the first ORIF operation because of critical ischemia of the affected foot and distal lower leg. Blood circulation did not improve after a series of salvage treatments, and below-knee amputation was ultimately performed.

Lessons:
This is a rare case of complete ischemic necrosis following ORIF surgery of a closed pilon fracture due to iatrogenic damage. Standardized treatment that strictly follows the guidelines, instructions, or expert consensus should be promoted in this kind of complicated pilon fracture.
Survival outcomes in esophageal cancer patients with a prior cancer
Authors: Pan Deqiang , Xu Wenbo , Gao Xingcai , Yiyang Feng , Wei Shuai , Zhu Guang 
Published: February 2021

Abstract
To achieve a deeper understanding of patients who developed esophageal cancer (EC) as a second primary malignancy, which may help guide in clinical practice for these patients in the future.
In the primary cohort, EC patients with a prior malignancy were identified from the surveillance, epidemiology, and end result 18 database. The 5 most common types of prior cancers were picked out based on the frequency of occurrence. In addition, Kaplan–Meier and log-rank tests were performed to investigate the survival impacts of prior cancers on EC patients. Besides, a competing-risk model was constructed to explore the relationship between EC-treatment and EC-specific mortality. In the secondary cohort, patients with stage I–III (N0M0) EC from 2004 to 2014 were enrolled. After propensity score matching, univariate and multivariate Cox analyses were developed to determine the prognostic factors for EC patients.
A total of 1199 EC patients with a prior cancer were identified in the primary cohort. The 5 most common sites of prior cancers were prostate, female breast, bladder, lung and bronchus, and larynx. Kaplan–Meier analyses revealed that EC patients with prior prostate cancer and bladder cancer had the best overall survival (OS), while those with prior cancers of larynx and lung and bronchus had the worst OS. Fine and Gray competing risks analysis indicated that the administration of surgery was closely associated with better EC-specific survival (P < .001). In the secondary cohort, multivariate Cox analyses found that age at diagnosis, race, tumor grade, tumor extent, nodal status and metastasis stage, histology, and the administration of surgery were prognostic factors for OS and cancer-specific survival in EC patients. Besides, the existence of a prior cancer was an independent prognostic factor for cancer-specific survival.
EC remains to be the most important cause of death in EC patients with a prior cancer. EC related treatment should be actively adopted in patients with a prior cancer, as they were more likely to die from EC than the prior cancer. EC patients with a prior cancer had comparable OS than those without.
Comparative efficacy and safety of complementary and alternative therapies for tubal obstructive infertility
Authors: Dong Shuang-Qian , Zhao Xing-Long , Sun Ying , Zhang Jian-Wei 
Published: February 2021

Abstract

Background:
Infertility is a kind of global disease. Fallopian tubal obstruction is one of the most important causes of female infertility. Complementary and alternative therapies are effective in treating tubal obstructive infertility, but there is no study on a comprehensive comparison among them. So, the purpose of this paper is to evaluate the efficacy and safety of different complementary and alternative therapies for tubal obstructive infertility.

Methods:
We will search for randomized controlled trials (RCTs) from the following databases: PubMed, Cochrane Library, EMBASE, Web of Science, Chinese Biomedical Literature Database (SinoMed), Chinese National Knowledge Infrastructure (CNKI), Wanfang database, and VIP database. We will assess the risk of bias of the included studies with the Cochrane tool, and the strength of evidence with the GRADE approach. Both pairwise meta-analyses and network meta-analyses will be performed to examine the relative efficacy and safety of complementary and alternative therapies in the treatment of tubal obstructive infertility.

Conclusion:
Our findings will provide clear evidence based on current available studies, which may lead to some proposals for both patients and researchers.

INPLASY registration number:
INPLASY202110076.
Association between Alpha B-crystallin expression and prognosis in patients with solid tumors
Authors: Yang Minglan , Li Yufan , Tian Feng 
Published: February 2021

Abstract

Background:
Alpha B-crystallin (CRYAB), as a small heat shock protein, may play critical roles in the tumorigenesis and progression of several kinds of human cancers. However, the prognostic value of CRYAB in solid malignancies remains controversial. The aim of the present study was to investigate the association between CRYAB expression and clinicopathology and prognosis of solid tumor patients.

Methods:
PubMed, Web of Science, EMBASE, Chinese National Knowledge Infrastructure, and WanFang databases were systematically searched to retrieve studies that investigated the prognostic value of CRYAB expression in various solid tumors. Hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated to determine the strength of association between CRYAB expression and survival in patients with solid tumors. Odds ratios (ORs) with 95% CIs were pooled to assess the correlation between CRYAB expression and clinicopathological characteristics of patients with solid tumors.

Results:
A total of 17 studies, including 18 cohorts with 6000 patients, were included in this meta-analysis. Our results showed that increased CRYAB expression could predict poor overall survival (HR = 1.81, 95% CI: 1.50–2.19, P < .001), disease-free survival (HR = 1.47, 95% CI: 1.16–1.86, P = .001), and disease-specific survival (HR = 1.40, 95% CI: 1.19–1.63, P < .001) in patients with cancer. Furthermore, the high expression level of CRYAB was associated with certain phenotypes of tumor aggressiveness, such as lymph node metastasis (OR = 2.46, 95% CI: 1.48–4.11, P = .001), distant metastasis (OR = 3.34, 95% CI: 1.96–5.70, P < .001), advanced clinical stage (OR = 2.24, 95% CI: 1.24–4.08, P = .008), low OS rate (OR = 4.81, 95% CI: 2.82–8.19, P < .001), and high recurrence rate (OR = 1.38, 95% CI: 1.11–1.72, P = .004).

Conclusions:
CRYAB may serve as a valuable prognostic biomarker and therapeutic target in human solid tumors.
Prognostic value of lactate levels and lactate clearance in sepsis and septic shock with initial hyperlactatemia
Authors: Lee Seong Geun , Song Juhyun , Park Dae Won , Moon Sungwoo , Cho Han-jin , Kim Joo Yeong , Park Jonghak , Cha Jae Hyung 
Published: February 2021

Abstract
The 2016 Surviving Sepsis Campaign guidelines suggest guiding resuscitation to normalize lactate levels in patients with sepsis-associated hyperlactatemia as a marker of tissue hypoperfusion. This study evaluated the prognostic value of lactate levels and lactate clearance for 30-day mortality in patients with sepsis and septic shock diagnosed in the emergency department.
We performed a retrospective cohort study of sepsis patients with initial lactate levels of ≥2 mmol/L. All patients met the Sepsis-3 definitions. The prognostic value of 6-hour lactate levels, 6-hour lactate clearance, 6-hour lactate metrics (≥2 mmol/L), and lactate clearance metrics (<10%, <20%, and <30%) was evaluated. We compared the sensitivity and specificity between metrics.
Of the 363 sepsis and septic shock patients, 148 died (30-day mortality: 40.8%). Nonsurvivors had significantly higher 6-hour lactate levels and lower 6-hour lactate clearance than those of survivors. Six-hour lactate levels and 6-hour lactate clearance were associated with 30-day mortality after adjusting for potential confounders (odds ratio, 1.191 [95% confidence interval (CI), 1.097–1.294] and 0.989 [0.983–0.995], respectively). Six-hour lactate levels had better prognostic value than 6-hour lactate clearance (area under the curve, 0.720 [95% CI, 0.670–0.765] vs 0.656 [0.605–0.705]; P = .02). Six-hour lactate levels of ≥3.5 mmol/L and 6-hour lactate clearance of <24.4% were the optimal cut-off value in predicting the 30-day mortality. The prognostic value of 6-hour lactate metrics and 6-hour lactate clearance metrics did not differ. Six-hour lactate levels (≥2 mmol/L) had the highest sensitivity (89.2%).
Six-hour lactate levels proved to be more accurate in predicting 30-day mortality than 6-hour lactate clearance and initial lactate levels.