bluuebunny/crossref_metadata_2025_split huggingface dataset:
A comparative study of functioning and non-functioning pituitary adenomas
Authors: Qin Jiayin , Li Kai , Wang Xijuan , Bao Yongzhen 
Published: April 2021

Abstract
Pituitary tumors commonly cause visual impairment and the degree of impairment can depend on the size, location, and type of the tumor. However, no studies have been made regarding the differences caused by functioning pituitary adenoma (FPA) and non-functioning pituitary adenoma (NFPA). We aimed to investigate the relationship between clinical characteristics and visual impairment in patients with FPA and NFPA.
This case series study included 73 pituitary adenoma patients. All patients underwent ophthalmic evaluations, and we retrospectively reviewed their medical records. Tumor types were confirmed by histological analysis, and the tumor volume was calculated. Magnetic resonance imaging was used to determine the tumor diameter. The observation indices of the two groups were compared. The correlation between the visual field and tumor volume was analysed using scatter plots.
We enrolled 30 patients in the FPA group and 43 in the NFPA group. The first symptoms presented in the eyes in 23% of FPA patients and 41.9% of NFPA patients. The best-corrected visual acuity of the FPA group was better than that of the NFPA group, and 34 (56.7%) and 73 (84.9%) eyes in these groups had visual field defects, respectively. The visual field defects of the FPA patients were lighter than those of the NFPA patients. Except for the anteroposterior diameter, there were no differences in the other parameters of tumor diameter between the groups. The tumor volume of the FPA group was smaller than that of the NFPA group. The tumor size was positively correlated with the mean deviation and negatively correlated with the mean sensitivity in both groups.
There was a longer delay between the onset of signs and symptoms and treatment in the FPA group than in the NFPA group. Future studies should focus on visual field defects caused by FPA and NFPA.
A rapid clinic-based service for an emergency department of a tertiary teaching hospital during a dengue outbreak
Authors: Shih Hsin-I. , Huang Yi-Ting , Hsieh Chih-Chia , Sung Tzu-Ching 
Published: April 2021

Abstract
The 2015 dengue outbreak in southern Taiwan turned into a public health emergency, resulting in a large-scale mobilization of personnel from the emergency department (ED) services operating in and near full capacity to assist with the outbreak. This study aimed to assess a rapid independent clinic-based service (RCS), which was set up and designed to relieve the overcrowding of the regular ambulatory and emergency services during an epidemic of dengue.
This is a retrospective cross-sectional study.
National Cheng Kung University Hospital, Tainan, Taiwan.
Patients with positive test results were enrolled and reviewed to evaluate the efficacy of RCS implementation between August and October 2015. The case-treatment rates stratified by length of stay (LOS) were used to examine the performance of the RCS that was set up outside the ED and designed to relieve the overcrowding of the regular ambulatory and emergency services.
Patients with dengue-like illnesses may arrive at the hospital and require optimal ED triage and management thereafter. Although the outbreak resulted in a shortage of spare space in the ED, a proper response from the hospital administration would ameliorate the work overload of the staff and would not decrease the quality of care for critical patients.
An early and restrictive intensive intervention was beneficial to health care facilities during a dengue outbreak. Further planning and training of the RCS could be crucial for hospital preparedness for infectious disease outbreaks.
Bandage lens for treatment of corneosclera melting two weeks after pterygium surgery
Authors: Gao Tao , Fan Xiaojing , Wu Yaying , Jin Xiuming 
Published: April 2021

Abstract

Introduction:
Pterygium is a common chronic ocular surface condition in ophthalmology.
At present, the main treatment modality is surgical resection. Although the recurrence rate can be controlled to varying degrees, some patients can still develop serious complications, such as scleral melting, corneal melting, and even corneal perforation.
We report a case of severe corneal and scleral melting after pterygium surgery treated with a bandage lens.

Patient information:
A 60-year-old male who developed corneoscleral melting after pterygium surgery.

Diagnosis:
This patient was diagnosed with corneoscleral melting.

Interventions:
This patient was treated with a bandage lens and eye drops.

Outcomes:
He was treated with a bandage lens, and the tear break-up time (BUT) was prolonged. After 12 days the cornea and sclera were completely cured and the bandage lens was removed after one month.

Conclusion:
After pterygium surgery, various factors affect the occurrence of serious complications of autolysis. Mainly on ocular parts, such as the cornea and sclera, a bandage lens can stabilize the ocular surface tear film and prolong the tear break-up time (BUT), effectively prevent corneoscleral melting and promote corneoscleral cure.
Treatment challenges in patients with early acute massive pulmonary thrombosis embolism (PTE) after lung cancer surgery
Authors: Shen Jian , Zhou Mi , Shao Weihua , Dai Haiyun 
Published: April 2021

Abstract

Introduction:
Early acute massive pulmonary thrombosis embolism (PTE) after lung cancer surgery is one of the most fatal surgical complications. It is often accompanied by shock and hypotension, with high mortality rate. Due to surgical wounds, patients with early acute massive PTE after lung cancer surgery have a high risk of thrombolytic bleeding, which renders treatment more challenging and there is currently no standard protocol on how to safely and effectively treat these patients in the clinic.

Patient concerns:
A 66-year-old woman after video-assisted thoracoscopic surgery for lung cancer, experienced sudden severe dyspnea, shock and hypotension with high D-Dimer, changed electrocardiogram (ECG), right ventricular dilatation, severe tricuspid regurgitation, and raised pulmonary arterial pressure on ultrasonic cardiogram (UCG), thromboses found on Ultrasonography of lower extremity vein.

Diagnosis:
Because of her clinical manifestations and results of bedside auxiliary examinations, the patient was finally diagnosed with acute high-risk PTE after lung cancer surgery.

Interventions:
1.5 hours after onset of symptoms, thrombolysis using a continuous micropump infusion of 20,000 units/kg urokinase into the peripheral vein for 2 hours was initiated for this patient.

Outcomes:
The patient died of massive hemorrhage after thrombolysis.

Lessons:
Treatment for patients with early acute PTE after lung cancer surgery is challenging due to a high risk of thrombolytic bleeding at the surgical site. Real-time monitoring of vital signs during thrombolysis and catheter-directed thrombolysis are recommended for these patients, in order to use the minimum drug dosage for quick curative effects and a low risk of bleeding.
Renal function-adjusted contrast medium volume is a major risk factor in the occurrence of acute kidney injury after endovascular aneurysm repair
Authors: Mun Jin-Ho , Kwon Su-kyung , Park Je-hyung , Chu Wongong , Kim Dong Hyun , Jung Hyuk Jae , Lee Sang Su 
Published: April 2021

Abstract
Acute kidney injury (AKI) is a complication that can occur during endovascular aneurysm repair (EVAR), increasing postoperative mortality and disease-related death. We therefore evaluated the incidence of AKI after elective EVAR, as well as related factors affecting AKI occurrence, investigating the volume of contrast medium (CV)/estimated glomerular filtration rate (eGFR) ratio as a predictive factor.
We retrospectively reviewed the data of patients who underwent EVAR for infrarenal abdominal aorta aneurysm at a single center between April 2011 and December 2018. AKI was defined according to the Kidney Disease: Improving Global Outcomes criteria. We evaluated the occurrence of AKI within the first 7 days postoperatively, comparing serum creatinine levels, eGFR, CV, CV/eGFR ratio, fluid input and output, and morbidity between the AKI and no-AKI groups.
The data of 147 patients were analyzed, of which 131 (89.1%) were males (mean age: 72.10±7.40 years); the incidence of AKI was 4.1% (6/147 patients). The mean dose of contrast agents used was greater in the AKI group than in the no-AKI group (249.17 ± 83.21 mL vs 179.43 ± 84.32 mL, respectively; P = .05). The baseline eGFR was 42.69 ± 22.08 mL/kg/1.73 m2 in the AKI group and 77.96 ± 18.92 mL/kg/1.73 m2 in the no-AKI group (P = .001). The CV/eGFR ratio was significantly higher in the AKI group (8.21 ± 6.13 vs 2.46 ± 1.44; P = 0.003). Baseline eGFR (odds ratio [OR] = 0.922, P = .001) and the CV/eGFR ratio (OR = 2.049, P = .008) were observed to be factors related to the occurrence of AKI in the logistic regression analysis for patients’ characteristics, operation-related factors, and renal outcomes. In the receiver operating characteristic curve analysis, the area under the curve of the CV/eGFR ratio was 0.856, indicating the greatest influence. A CV/eGFR ratio cutoff value of 3.84 was considered the most appropriate, with an 83.3% sensitivity and 83.0% specificity.
The CV/eGFR ratio, rather than the absolute amount of contrast agents, was associated with the development of AKI after EVAR. The CV/eGFR ratio could be used as a possible indicator to limit the amount of contrast media required for the procedure.
Acupuncture for drooling in children with cerebral palsy
Authors: Xiong Wei , Cheng Ling , Tang Genhua , Hou Xinju , Zhu Manhua , Lu Lunbin , Zhong Zhiying 
Published: April 2021

Abstract

Background:
The aim of this study is to provide the methods used to evaluate the effectiveness and safety of acupuncture therapy for treating drooling in children with cerebral palsy.

Methods and analysis:
A comprehensive search of Pubmed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, 4 Chinese databases (China National Knowledge Infrastructure, Chinese Biomedical Literatures database, Wan-Fang Database and Chinese Science and Technology Periodicals will be conducted to identify randomized controlled trials of acupuncture for treating children with cerebral palsy salivation with no restriction on time or language. The primary outcome of this systematic review will be the effective rate. The risk of bias will be implemented according to Cochrane Handbook for Systematic Reviews of Interventions. We will conduct the meta-analysis to synthesize the evidence for each outcome, if possible. The heterogeneity will be evaluated statistically using the χ
2 test and the I
2 statistic. The random-effect model will be used to provide more conservative results, if significant heterogeneity is identified (I
2 > 50% or P < .10).

Ethics/dissemination:
Our findings will be disseminated in a peer-reviewed journal and at conference meetings. It is not necessary for formal ethical approval as no primary data are collected.

Trial registration number:
INPLASY2020110024
Negative-pressure wound therapy combined with artificial dermis (Terudermis) followed by split-thickness skin graft might be an effective treatment option for wounds exposing tendon and bone
Authors: Hsu Kuo-Feng , Chiu Yu-Lung , Chiao Hao Yu , Chen Chun-Yu , Chang Chun-Kai , Wu Chien-Ju , Peng Yi-Jen , Wang Chih-Hsin , Dai Niann-Tzyy , Chen Shyi-gen , Tzeng Yuan-Sheng 
Published: April 2021

Abstract
Skin grafts are not suitable for closing tendon- or bone-exposing wounds, which require flap surgery. Dermal regeneration templates have value for closing such wounds, but the disadvantages of the technique include implantation failures because of infection, hematoma formation, or inappropriate immobilization. Negative-pressure wound therapy was reported to increase graft acceptance in difficult wounds.
This retrospective case series of 65 patients evaluated negative-pressure therapy combined with artificial dermis for the treatment of acute or chronic tendon- or bone-exposing wounds. The artificial dermis was placed after adequate wound-bed preparation, with simultaneous application of a vacuum-assisted closure system. Split-thickness skin grafting was performed after the implanted artificial dermis had become established.
The overall success rate was 88.1% (59/67): 88.6% (39/44) in the chronic wounds group and 87% (20/23) in the acute-trauma group separately. The overall mean survival time of artificial dermis in success cases was 13.24 ± 7.14 days. In separately, the survival time of artificial dermis had no statistically difference in chronic wound group (13.64 ± 7.53 vs 12.60 ± 5.86. P = .943), but had significant statistical difference in acute trauma group (12.45 ± 6.44 days vs 23.33 ± 4.04 days, P = .018). Also, comorbidity of PAOD was found a strong risk factor of failure in chronic wound group (100% vs 23.1%, P < 0.001).
We concluded that artificial dermis combined with negative-pressure therapy followed by split-thickness skin grafting might be a reliable and effective option for surgical reconstruction of tendon- or bone-exposing wounds, and could decreasing waiting periods of autologous skin graft.
Impact of self-decision to stop cancer treatment on advanced genitourinary cancer patients
Authors: Kobayashi Hisato , Tsuchiyama Katsuki , Taga Minekatsu , Tokunaga Takahiro , Ito Hideaki , Yokoyama Osamu 
Published: April 2021

Abstract
Decision-making to stop cancer treatment in patients with advanced cancer is stressful, and it significantly influences subsequent end-of-life palliative treatment. However, little is known about the extent to which the patient's self-decisions influenced the prognostic period. This study focused on the patient's self-decision and investigated the impact of the self-decision to stop cancer treatment on their post-cancer treatment survival period and place of death.
We retrospectively analyzed 167 cases of advanced genitourinary cancer patients (kidney cancer: 42; bladder cancer: 68; prostate cancer: 57) treated at the University of Fukui Hospital (UFH), who later died because of cancer. Of these, 100 patients decided to stop cancer treatment by themselves (self-decision group), while the families of the remaining 67 patients (family's decision group) decided to stop treatment on their behalf because the patient's decision-making ability was already impaired. Differences in the post-cancer-treatment survival period and place of death between the 2 groups were examined. The association between place of death and survival period was also analyzed.
The median survival period after terminating cancer treatment was approximately 6 times longer in the self-decision group (145.5 days in self-decision group vs 23.0 days in family's decision group, P < .001). Proportions for places of death were as follows: among the self-decision group, 42.0% of patients died at UFH, 45.0% at other medical institutions, and 13.0% at home; among the family's decision group, 62.7% died at UFH, 32.8% at other medical institutions, and 4.5% at home. The proportion of patients who died at UFH was significantly higher among the family's decision group (P = .011). The median survival period was significantly shorter for patients who died at UFH (UFH: 30.0 days; other institutions/home: 161.0 days; P < .001).
Significantly longer post-cancer-treatment survival period and higher home death rate were observed among patients whose cancer treatment was terminated based on their self-decision. Our results provide clinical evidence, especially in terms of prognostic period and place of death that support the importance of discussing bad news, such as stopping cancer treatment with patients.
The efficacy and safety of gemcitabine-based induction chemotherapy for locally advanced nasopharyngeal carcinoma treated with concurrent chemoradiation
Authors: Fei Qian , Chen Han-Bo , Zhang Chun-Mei , Xu Jia-Jun , He Xia , Chen Song-Wang 
Published: April 2021

Abstract

Objectives:
To assess the efficacy and toxicity of gemcitabine-based induction chemotherapy followed by concurrent chemoradiotherapy (CCRT) in locally advanced nasopharyngeal carcinoma (LA-NPC).

Methods:
Both observational studies (OBS) and randomized controlled trials (RCT) were included in the meta-analysis. Systematic online searches were conducted in Web of Sciences, PubMed, Embase, meeting proceedings and ClinicalTrials.gov from the inception to May 25, 2020. The primary endpoint of interest was overall survival.

Results:
five OBSs and 2 RCTs including 1680 patients were incorporated in the analysis. The evidence from the RCTs showed that adding gemcitabine-based induction chemotherapy to CCRT significantly improved progression free survival (hazard ratio (HR): 0.60, 95% confidence interval (CI): 0.40–0.88; P = .010; chi square P = .25; I
2 = 24%) and overall survival (HR: 0.47; 95% CI: 0.28–0.80; P = 0.005; chi square P = .49, I
2 = 0%) and was related to a higher risk of hematological toxicities. Furthermore, based on the data of OBSs, overall survival (HR: 0.52; 95% CI: 0.31–0.88; P = .02; chi square P = .37, I
2 = 6%) was significantly improved in patients treated with gemcitabine-based induction chemotherapy compared to those treated with taxane-based induction chemotherapy. However, the progression free survival (HR: 0.67; 95% CI: 0.45–1.01; P = .06; chi square P = .74; I
2 = 0%) showed no significant difference.

Conclusions:
For LA-NPC patients, adding gemcitabine-based induction chemotherapy to CCRT significantly improved overall survival and progression free survival with a higher risk of hematological toxicities when compared to CCRT alone. Also, gemcitabine-based regimen could be used as an alternative induction chemotherapy regimen to taxane-based regimen in the treatment of LA-NPC.
A novel 125I seeds fixed on gastric tube for treatment of inoperable esophageal carcinoma
Authors: Jin Jing , Yu Yang , Jia Weikun , Li Wei 
Published: April 2021

Abstract
To explore the treatment benefit of 125I seeds fixed on a gastric tube in the early inoperable esophageal carcinoma (EC).
Three senile patients with early inoperable EC who were treated with brachytherapy between October 2017 and February 2019 were included in this study. 125I seeds were fixed on the gastric tube, which was then inserted on the surface of the EC. One patient suffered from severe pulmonary insufficiency; 1 patient underwent colon cancer surgery one week before treatment and suffered from liver dysfunction and esophageal varices; 1 patient suffered from venous embolism of lower extremities and pulmonary artery embolism.
All three patients were successfully operated and completed treatment. During the operation, no displacement and shedding of 125I seed gastric tube occurred. After surgery, the discomfort while swallowing and pain after eating were significantly improved. Moreover, dysphagia was relieved in patient 3. In addition, no complications, such as perforation or bleeding, occurred. Local lesions were effectively controlled.
Gastric tube with 125I seeds provides a new treatment protocol for inoperable EC and malignant obstruction of esophageal carcinoma.
Comparison of single and double dorsal wires in the extension block technique for mallet fractures
Authors: Polat Oktay , Bombaci Hasan , Kibar Birkan , Toy Serdar 
Published: April 2021

Abstract
Mallet fractures are avulsion fractures of the extensor tendon from the distal phalanx base and often occur due to sudden flexion or axial loading. In this study, we aimed to compare the clinical and radiological results of patients treated with single and double dorsal wires from the dorsal in the extension block method.
Patients to whom a single wire from dorsal was applied were assigned to Group 1 (n: 22), and those to whom double wires were applied were assigned to Group 2 (n: 23). Surgical treatment was decided for patients with more than 1/3 of the fracture fragment containing the joint surface and volar subluxation. The range of motion of the distal interphalangeal (DIP) joint was measured with a goniometer. The displacement of the fragment was measured before and after surgery on lateral radiographs. The presence of bridging callus formation on anterior-posterior and lateral radiographs was evaluated for a union.
There were 30 male (66.7%) and 15 (33.3%) female patients. The mean age of the patients was 32 years. Radiographic union was obtained in all patients. Pseudoarthrosis was not observed in any patient. The Crawford score was excellent in 13 (28.9%) cases, the score was good in 18 (40%) cases, the scores were moderate in 13 (28.9%) cases, and the score was poor in 1 case (2.2%). There were no complications in 35 (77.8%) cases, dorsal bump complications occurred in 9 cases (20%), and osteoarthritis and dorsal bump complications occurred in 1 (2.2%) case. We did not observe nail deformity, skin necrosis, infection, or fingertip sensitivity. We found similar functional and clinical results between the groups.
We recommend using single dorsal wire, as using double dorsal wires requires extra operation time, effort, and fluoroscopy.
Study on the effect of education for insulin injection in diabetic patients with new simulation tools
Authors: Liang Kaiyong , Xie Qiao , Nie Jieping , Deng Jieqing 
Published: April 2021

Abstract

Background:
Insulin is an essential therapy for treating diabetes, but many patients lack standard insulin injection skills.

Purpose:
We developed a standard training procedure based on a new simulation tool. Then we conducted a study to investigate the effect of this standard training on the ability of diabetic patients to inject themselves with insulin.

Methods:
After follow-up, a total of 120 patients with diabetes mellitus were included. These patients needed insulin therapy depending on their condition and had not previously learned insulin injection. We randomly divided them into the intervention group (60 cases) and the control group (60 cases). The control group was trained on insulin injection before being discharged according to the traditional method, and the intervention group was trained based on an improved simulation tool. All participants were trained as individuals or groups. Finally, we evaluated the learning effects of both groups.

Results:
The time spent at the training stage in the intervention group was shorter than the control group. We found that after applying simulation devices to mimic operations, the learning time for patients was reduced.
The first subcutaneous injection success rate was 73.33% in the intervention group, which was significantly higher than that in the control group by 46.67%. The score of the first subcutaneous injection and pre-discharge score in the test group was significantly higher than that of the control group. One month later, the score for injection skills in the 2 groups was higher than that before discharge, and the score in the trial group was still higher than that in the control group. The incidence of subcutaneous fat hyperplasia in the trial group was lower than that in the control group (3.3% vs 15%, P < .05). Moreover, the incidence of hypoglycemia (16.7% vs. 26.7%) was higher in the control group, but the difference was not statistically significant (P = .184).

Conclusions/implications for practice:
After applying simulation tools plus operating video and guideline as the standard procedure to train diabetic patients on insulin injection, all patients had a good grasp of using the insulin injection technique. This education method is safe, efficient, and worth promoting worldly.