bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictors of early postoperative hypocalcemia in patients with secondary hyperparathyroidism undergoing total parathyroidectomy
Authors: Gong Wei , Lin Yaqi , Xie Yu , Meng Zilu , Wang Yudong 
Published: May 2021

Objective To summarize the clinical features of secondary hyperparathyroidism (SHPT) in patients with chronic renal failure and to explore the predictive factors of postoperative hypocalcemia after total parathyroidectomy in these patients. Methods The clinical data of 87 patients admitted to Guangdong Electric Power Hospital from May 2013 to February 2020 were reviewed. All patients underwent total parathyroid resection and sternocleidomastoid microtransplantation. Age, sex, and the serum calcium, phosphorus, alkaline phosphatase (ALP), and intact parathyroid hormone (iPTH) concentrations were analyzed as predictive factors of postoperative hypocalcemia. Results Bone pain was the most common clinical manifestation in this study population, and all 87 patients experienced relief from their clinical symptoms after the surgical procedure. Age and the preoperative serum calcium, ALP, and iPTH concentrations were determined to be early predictive factors of postoperative hypocalcemia. Conclusions Age and the preoperative calcium, ALP, and iPTH concentrations are independent risk factors for postoperative hypocalcemia in patients with SHPT and renal disease who undergo total parathyroidectomy with sternocleidomastoid microtransplantation. These factors can help identify high-risk patients who can be managed by a multidisciplinary team to improve graft survival and quality of life.
Diagnostic value of pulse oximetry combined with cardiac auscultation in screening congenital heart disease in neonates
Authors: Song Jiajia , Huang Xianping , Zhao Shenzhi , Chen Jiajia , Chen Ruiheng , Wu Guowei , Xu Zhangye 
Published: May 2021

Objective This study aimed to investigate the feasibility and reliability of pulse oximetry combined with cardiac auscultation in screening neonatal congenital heart disease (CHD). Methods This was a retrospective, observational, screening study. All newborns included in the study were at the Second Affiliated Hospital of Wenzhou Medical University from July 2019 to January 2020. Primary screening of CHD was conducted by pulse oximetry combined with cardiac auscultation assays. Indices, including sensitivity, specificity, the positive/negative predictive value, the positive/negative likelihood ratio, and the diagnostic odds ratio, were calculated. The area under the relative operating characteristic curve of the subjects was measured. Results A total of 3327 neonates were enrolled, among whom 139 were diagnosed with CHD and the incidence of CHD was 4.2%. The sensitivity, specificity, diagnostic odds ratio, and area under the relative operating characteristic curve of pulse oximetry combined with cardiac auscultation were 89.9%, 94.7%, 169.0, and 0.923, respectively. Conclusions Pulse oximetry combined with cardiac auscultation is a novel screening method with acceptable accuracy and feasibility for neonatal CHD. This combination method is worth promoting widely.
Rheumatologists’ understanding of refractory gout: a questionnaire survey in China
Authors: Han Xinxin , Yin Yue , Cao Yu , Chu Xiaotian , Han Yingdong , Di Hong , Xu Na , Zhang Yun , Zeng Xuejun 
Published: May 2021

Objective To explore the understanding of refractory gout in Chinese rheumatologists. Methods We conducted an anonymous survey of rheumatologists attending an annual national academic conference on rheumatism. Results Of the 910 rheumatologists who completed the questionnaire, 751 (82.5%) had received relevant continuing medical education (CME). Of these, 140 (18.6%) rheumatologists did not select xanthine oxidase inhibitors as the first treatment for patients with chronic tophaceous gout. Of all respondents, 113 (12.4%), 251 (27.6%) and 324 (35.6%) prescribed incorrect maximum doses of allopurinol, febuxostat and benzbromarone, respectively; this tendency was more pronounced in the non-CME group. Most rheumatologists agreed that complications and comorbidities increased the difficulty of gout management and considered the term refractory gout to describe those cases with uncontrolled symptoms, unmet treatment targets or non-shrinkage of tophi after standardized drug treatment. Moreover, 62.8% (472/751) of specialists considered that a diagnosis of refractory gout was appropriate for patients whose lifestyle and compliance failed to improve despite adequate education and regular urate-lowering therapy. Conclusions Incorrect and inadequate drug therapy may contribute to some cases of refractory gout, especially in physicians without CME. An emphasis on non-drug therapy and the management of comorbidities and complications may reduce cases of refractory gout.
Addition of low-dose sufentanil to ropivacaine for reducing shivering and visceral traction pain during cesarean section
Authors: Chen Xiao-Rong , Gao Tao , Zhang Yin , Peng Ming-Qing 
Published: May 2021

Objective To investigate the efficacy of low-dose sufentanil for preventing shivering and visceral traction pain during cesarean section under spinal anesthesia. Methods This was a prospective, randomized, controlled study. A total of 112 full-term parturients who underwent elective caesarean delivery were randomly divided into two groups. Group R received 0.75% isobaric ropivacaine intrathecally and group RS received 0.75% isobaric ropivacaine plus 5 µg sufentanil intrathecally. Results There were no significant differences in the maximum sensory block time, motor block time, duration of the surgery, and heart rate, mean arterial pressure, and blood oxygen saturation before and 1, 5, and 10 minutes after spinal anesthesia, and at the end of the surgery between the two groups. Shivering was significantly more common in group R (n = 30) than in group RS (n = 8). The incidence of visceral traction pain in group R (46.43%) was significantly higher than that in group RS (14.29%). There was no significant difference in the newborns’ Apgar scores between the groups. Conclusion Adding low-dose sufentanil to ropivacaine can significantly reduce the incidence of shivering and visceral traction pain after spinal anesthesia.
Association of serum irisin concentration with thyroid autoantibody positivity and subclinical hypothyroidism
Authors: Chen Zhengyi , Zhang Qiao , Peng Nianchun , Hu Ying , Li Hong , He Xi , Liu Ruoyi , Xu Shujing , Zhang Miao , Shi Lixin 
Published: May 2021

Objective This study evaluated the association of serum irisin level with thyroid autoantibody (TAA) positivity and subclinical hypothyroidism (SH). Methods In this cross-sectional study, 334 participants were assigned to one of the following four age- and sex-matched groups: TAA plus SH (84 patients), isolated TAA (83 patients), isolated SH (83 patients), or healthy controls (84 individuals). Irisin and creatine kinase (CK) were measured in serum samples. Results Patients with TAA plus SH, isolated TAA, and isolated SH had higher irisin levels compared with the controls. There was a significant increase in the irisin level in the TAA plus SH group compared with the control group. Among all participants, the irisin levels were positively associated with thyroglobulin and thyroid peroxidase antibody titers and high-density lipoprotein cholesterol levels, but negatively associated with waist circumference, glycated hemoglobin levels, and fasting plasma glucose levels. The irisin level was not associated with the thyroid-stimulating hormone, free thyroxine, or CK levels. Irisin levels were independently associated with TAA, with or without SH, but they were not associated with SH alone. Conclusions Irisin level may help to predict the risk of developing TAA with or without SH.
Necrotizing soft tissue infection: clinical characteristics, diagnosis, and management of 32 cases in Beijing
Authors: Cui Zhen , Lu Shuai , Bai Ying , Sun Xu , Tian Peng , Liu Ying , Mao Lu , Jiang Xieyuan 
Published: May 2021

Objective Necrotizing soft tissue infection (NSTI) is a rare but life-threatening bacterial infection. This study was performed to analyze the clinical characteristics of patients with NSTI admitted to the intensive care unit of a trauma and burn center in Beijing and to summarize the treatment experience. Methods This retrospective study involved patients with NSTI admitted to the intensive care unit from January 2010 to January 2020. The clinical manifestations, pathogens, laboratory test results, and prognosis were compared between survivors and nonsurvivors. Results Thirty-two patients were enrolled (28 men, 4 women), including 25 (78.1%) survivors and 7 (21.9%) nonsurvivors. The patients’ median age was 41.5 years (range, 30.0–52.5 years). Mortality was significantly higher in patients with a blood urea nitrogen concentration of ≥11.5 mg/dL, creatinine concentration of <3.4 mg/dL, prothrombin time of ≥15.9 s, and international normalized ratio of ≥1.3. Streptococcus pyogenes and Clostridium perfringens infections were associated with higher mortality. Conclusions More attention should be given to elderly patients and those with hyponatremia, coagulation disorder, and higher blood urea nitrogen or creatinine concentrations. The finding of large gram-positive rods or large numbers of gram-positive cocci in wound secretion smears is a helpful early warning sign of highly lethal NSTI.
Relationship between fasting blood glucose and subsequent vascular events in Chinese patients with mild ischaemic stroke: a cohort study
Authors: Ran Juanjuan , Cui Yu , Wang Yi , Gu Ping 
Published: May 2021

Objective To characterise the relationship between fasting blood glucose (FBG) and the incidence of subsequent vascular events (SVE) during the 6 months following a mild ischaemic stroke (MIS) in Chinese patients. Methods Data from patients with MIS were retrospectively analysed. The primary endpoint was an SVE during the 6-month follow-up period. The participants were allocated to three groups (tertiles), according to their FBG concentration. Results Of the 260 participants, 51 (19.6%) reported an SVE during the follow-up period. The incidence of SVE significantly differed among the tertiles of FBG. The odds ratio (OR) was 2.361 (95% confidence interval [CI]: 1.551–3.594) for FBG as a continuous variable and that for FBG categorised according to tertile was 13.30 (95% CI: 3.519–50.322) in the fully adjusted model. Curve fitting showed that the incidence of SVE gradually increased with increasing FBG, with the highest tertile showing the highest mean incidence (46.7%; 95% CI: 16.2%–79.9%). In addition, participants with or without diabetes mellitus, hypertension, headache, dizziness, mild cognitive impairment or anterior circulation artery lesion showed similar associations between FBG and the incidence of SVE. Conclusion FBG is an independent predictor of 6-month SVE risk in Chinese patients with MIS.
Efficacy and Safety of Lapatinib in Elderly Egyptian Patients with Her2 neu Positive Metastatic Breast Cancer
Authors: Abozeed WA , Zahi MS , Attia SE 
Published: May 2021

Introduction: The efficacy and safety of the lapatinib based treatment remain challenging in elderly patients with her2neu positive metastatic breast cancer (MBC). Lapatinib exhibits a good overall tolerance, but no study has yet been dedicated to elderly women. The present study is a real-world study that aimed to determine the efficacy and tolerability of the lapatinib-based treatment in the first line setting in Egyptian patients with HER2neu positive MBC who cannot get access to trastuzumab. Patients and Methods: In this retrospective study, 60 elderly patients (⩾ 65 years) with her2neu positive MBC and treatment naïve were included. All patients were treated with the combination of lapatinib (1,250 mg/day, continuously) and chemotherapy (either capecitabine 2,000 mg/m2 on days 1–14 of a 21-day cycle or weekly taxol 80 mg/m2), or lapatinib (1,250 mg/day, continuously) and hormonal treatment. Data on demographics, clinical outcome, and toxicity were collected form the patients’ medical records for descriptive analyses. Results: The median follow-up was 23.5 months (range 11–36 months). Most of the patients were hormone receptor positive (70%). About 28% of the patients had multiple sites of metastasis while 16 patients (26.7%) had bone only metastasis and 11 patients (18.3%) had lung only metastasis. Most of our patients (63.3%) had no associated comorbidities. An overall response rate of 61.7% was achieved, including 2 complete responses (3.3%), and 13 partial responses (21.7%). Median progression-free survival was 15.9 months (95% confidence interval (CI) 13.56- 18.33), and the median overall survival was 19.9 months (95% CI 17.8-21.9). Most common grade 1-2 side effects were diarrhea (43.3%), followed by hand-foot syndrome (35%), and skin rash (13.3%). Grade 3–4 toxicities were identified as hand-foot syndrome (10%), diarrhea (6.6%).There were no symptomatic cardiac events. Tolerability data show that 45% of patients needed a lapatinib dose reduction, and 30% a treatment interruption due to toxicity, while treatment discontinuation occurred in 18.3% of the cases. Conclusion: Lapatinib based therapy in elderly patients with her2neu positive MBC was effective. However, it was not well tolerated especially when combined with chemotherapy.
Verrucous Carcinoma of the Vulva
Authors: Agbanglanon DP , Jaba S , Kietga GG , M’barki I , Elkacemi H , Kebdani T , Elmajjaoui S , Benjaafar N 
Published: May 2021

Introduction: Vulvar verrucous carcinoma (VC) is extremely rare, accounting for less than 1% of vulvar cancer cases. Effectively, it is characterization by a slow growing, no metastasis or lymph node involvement. The aim of this study was to report our experience with this disease Material and Methods: This is a retrospective study of patients with vulvar VC who were treated at National Institute of Oncology between 2013 and 2018. Clinicopathological characteristics, treatment and follow-up were extracted from the medical records. Results: Three cases were identified in the National Institut of Oncology. The average age at diagnosis was 66 years (± 10.02). The average time from the onset of symptoms to diagnosis was 17 months (± 12,7). All patients complained of a vulvar mass or nodule, accompanied by vulvar pruritus and/or pain, which was the reason for consultation. A preliminary pathological diagnosis of squamous cell carcinoma was made in two cases. Surgical treatment included wide local excision, radical vulvectomy with lymph node dissection in the groin. Tumor size and invasion depth ranged from 50 to 105 mm and 17 to 35 mm respectively. In the final histology, VC of the vulva staged IB (2 cases) and staged III (1 case) with marginal limits in two cases. The concurrent radiochemotherapy was performed in one case, exclusive radiotherapy in one case and only surgery in one case. Regarding toxicity after concurrent radiochemotherapy and exclusive radiotherapy we had observed respectely grade 2 proctitis with renal toxicity and grade 2 radiodermatitis. The mean follow-up was 43 months with no recurrence in all cases. The prognosis is good, with low recurrent rate if wide local excision is performed. Conclusions: Vulvar VC is a distinct type of slow-growing, tumor with unclear etiology. Surgery is the most effective treatment. Concurrent radiochemotherapy indicated depending on disease stage and risk factors.
Correlation of Primary Tumor Metabolic Parameters with Clinical, Histopathological and Molecular Characteristics in Breast Cancer Patients at Preoperative Staging FDG-PET/CT Study
Authors: Mohamed AA , Zaher AM , Khalifa MI , AbdElhakem MM , Eloteify* Lamiaa M. 
Published: May 2021

Introduction: The aim of this prospective study was to evaluate the correlation of primary (1ry)tumor metabolic activity parameters maximum standardized uptake value (SUVmax) and tumor SUVmax/liver average SUV ratio (TLR) in initial staging 18F-fluorodeoxyglucose (FDG) positron emission tomography / computerized tomography (PET/CT) scan with clinical, histopathological and molecular characteristics of breast cancer (BC) patients. Material and Methods: Initial staging PET/CT was performed in 40 cases with different stages of BC in the supine position. Tumor FDG uptake was qualitatively evaluated and quantitatively assessed using SUVmax and TLR. Results: Forty female patients with newly diagnosed BC were enrolled in our study, age range from 31-78 (mean 50.5 +/- SD11.7). All the 1ry tumors were detected with mean SUVmax 10.8(+/-SD 7.9). The mean /median SUVmax values of 1ry tumor was higher in premenopausal, stage III& IV, Estrogen Receptors negative(ER-), Progesteron Receptors negative(PR-), Her2neu positive patients, high nuclear grade (GIII), in triple negative molecular subgroup (TN), positive axillary nodal (ALNs)metastases, and (P value = 0.003, 0.017, 0.113, 0.089 0.01,0.002, 0.007 & 0.016 respectively). The mean/median TLR values was higher in premenopausal and Her2neu positive, GIII, TN molecular subtype patients, stage III& IV and in patients with positive ALNs, ER- &PR - patients (P value = 0.002, 0.0476, 0.005, 0.018, 0.039 and 0.022, 0.095 & 0.129 respectively). SUVmax of the 1ry lesion and TLR were moderately negatively correlated with the age of the patients (P value = 0.005 and 0.008 respectively), also they were moderately positively correlated with the size of the1ry tumor (P value = 0.019 and 0.036 respectively). Conclusion: The SUVmax of the 1ry tumor and TLR values had similar significant associations with different prognostic factors in BC
Comparative Study Evaluating Cognitive Functions in Patients Receiving Conventional Whole Brain Radiotherapy vs Hippocampal Avoidance Whole Brain Radiotherapy
Authors: Ramadan Islam , El-Assal Shaaban , Farouk Mohamed , El-zawawy Sherif , El-Deeb Hany 
Published: May 2021

Background: Whole brain radiotherapy is the treatment of choice for patients with brain metastases. However, neurocognitive functions decline due to impaired hippocampal neurogenesis might occur thereafter. It is hypothesized that conformal hippocampal avoidance during the course of WBRT might provide meaningful neurocognitive functions preservation. Our study aims to demonstrate the impact of delivering HA‑WBRT on NCF changes in patients receiving WBRT. Methods: fifty patients who were referred for cranial irradiation were enrolled in the study. Before the HA‑WBRT course and randomly assigned to two equal groups, the first group will receive conventional whole brain palliative radiotherapy and the second group will receive hippocampal sparing whole brain radiotherapy, assigned to 30 Gy over 10 fractions over two weeks, all participants should receive baseline neurocognitive assessment, including memory, executive functions, and psychomotor speed,the primary endpoint was delayed recall, as determined by the change/decline in Hopkins Verbal Learning Test (HVLT-R) and The One Card Learning Test (OCLT) from the baseline assessment to 4 months after the start of HA‑WBRT. Results: Regarding neurocognitive outcomes, no statistically significant differences were found between various NCF scores obtained at baseline and at post‑radiotherapy intervals, in immediate verbal memory and non‑verbal memory, except for delayed recall memory on HVLT-R Hopkins Verbal Learning Test -Revised for delayed recall Learning, p =0.008. Conclusions: Functional preservation by hippocampal sparing during WBRT could largely be achieved in this study, which also suggests that HA‑WBRT should be a feasible technique preserving neurocognitive functions while maintaining intracranial control.
Prognostic role of standard uptake value according to pathologic features of lung adenocarcinoma
Authors: Bertoglio Pietro , Ventura Luigi , Aprile Vittorio , Cattoni Maria Angela , Nachira Dania , Lococo Filippo , Rodriguez Perez Maria , Guerrera Francesco , Minervini Fabrizio , Gnetti Letizia , Bacchin Diana , Franzi Francesca , Querzoli Giulia , Rindi Guido , Bellafiore Salvatore , Femia Federico , Viti Andrea , Kestenholz Peter , Ruffini Enrico , Paci Massimiliano , Margaritora Stefano , Imperatori Andrea Selenito , Lucchi Marco , Carbognani Paolo , Terzi Alberto Claudio 
Published: May 2021

Objective: To evaluate the influence of lung adenocarcinoma second predominant pattern on the maximal standard uptake value (SUVmax) and its prognostic effect in different histologic groups. Methods: We retrospectively collected surgically resected pathologic stage I and II lung adenocarcinoma from nine European institutions. Only patients who underwent preoperative PET-CT and with available information regarding SUVmax of T (SUVmaxT) and N1 (SUVmaxN1) component were included. Results: We enrolled 344 patients with lung adenocarcinoma. SUVmaxT did not show any significant relation according to the second predominant pattern ( p = 0.139); this relationship remained nonsignificant in patients with similar predominant pattern. SUVmaxT influenced the disease-free survival in the whole cohort ( p = 0.002) and in low- and intermediate-grade predominant pattern groups ( p = 0.040 and p = 0.008, respectively). In the high-grade predominant pattern cohort and in the pathologic N1 cases, SUVmaxT lost its prognostic power. SUVmaxN1 did not show any significant correlation with predominant and second predominant patterns and did not have any prognostic impact on DFS. Conclusions: SUVmaxT is influenced only by the adenocarcinoma predominant pattern, but not by second predominant pattern. Concurrently, in high-grade predominant pattern and pN1 group the prognostic power of SUVmaxT becomes nonsignificant.
Adult attachment, stress-coping, and resilience in first-generation immigrants in the United States
Authors: Fang Chiao-Ju , Tong Nenette , Villa Rosely J , Flores Ana M , Lim Elaine , Tu Alexandria 
Published: May 2021

Introduction Previous studies have shown correlations between adult attachment, stress-coping, and resilience, but little is known about how attachment and stress-coping affect resilience, particularly among first-generation immigrants. This study explored relationships among adult attachment, stress-coping, and resilience for first-generation immigrants. Method A quantitative cross-sectional design was used to assess associations between adult attachment and stress-coping with resilience among first-generation immigrants. Thirty-five participants answered an online Qualtrics survey. A simple linear regression analysis was conducted to analyze the results. Results The results indicated statistically significant correlations between avoidance scores and annual household income but not between resilience and education, resilience and income, and stress-coping scores and education and income. Positive reinterpretation growth was positively correlated with resilience, while denial and behavioral disengagement were negatively correlated. Adult attachment and number of years in the United States were not significantly statistically related to resilience. Conclusion The findings indicate high income may be associated with attachment avoidance, and increases in positive coping strategies and decreases in negative coping strategies are associated with resilience among first-generation immigrants. Understanding influences on first-generation immigrants to engage in stress-coping skills may inform the development and implementation of occupational therapy, including programs and interventions for successful client-centered outcomes.