bluuebunny/crossref_metadata_2025_split huggingface dataset:
Burst spinal cord stimulation for central neuropathic pain
Authors: Yoon Lim-joon , Kim Deok-yeong 
Published: February 2021

Abstract

Introduction:
Central neuropathic pain can result from any type of injury to the central nervous system. Treatment of central neuropathic pain is very challenging. Recently, a novel stimulation paradigm, called burst stimulation, has been presented as an excellent alternative in a group of patients with intractable central neuropathic pain. We report 2 cases where burst spinal cord stimulation (SCS) was applied in patients with neuropathic pain due to spinal cord injury (SCI) or traumatic brain injury.

Patient concerns:
A 52-year-old man who underwent posterolateral fusion surgery for a T12 bursting fracture after a fall 11 years prior developed disabling pain in the anterolateral part of his right thigh. His neuropathic pain following SCI was refractory to various treatment modalities. A 65-year-old man had complained of intractable, cold, throbbing, and shooting pain mainly in his left lower limb during rehabilitation since undergoing a craniotomy 9 years prior for multiple brain injuries caused by a motorcycle accident.

Diagnosis:
Both of these 2 cases were diagnosed with central neuropathic pain syndrome caused by SCI or traumatic brain injury.

Interventions:
Burst SCS were proposed to alleviate the significant refractory pains that were resistant to various medications and stimulation was delivered to the patient in an alternating pattern between traditional tonic and burst waveforms.

Conclusion:
The efficacy of burst SCS in central neuropathic pain is desirable considering the severity of pain in such patients, the refractory nature of their pain, and the paucity of alternative therapeutic options.
CT and MRI characteristic findings of sporadic renal hemangioblastoma
Authors: He Jie , Liu Nan , Liu Wangwang , Zhou Wenli , Wang Qiangfeng , Hu Hongjie 
Published: February 2021

Abstract

Rationale:
Hemangioblastomas in the kidney are rare. Although a few cases of renal hemangioblastoma (RH) have been reported, the content of these articles mainly focused on clinical and pathological research, with minimal descriptions of radiologic findings. Moreover, there are no descriptions of magnetic resonance imaging (MRI) with enhancement of this condition. Herein, we report 2 cases of RH with computed tomography (CT) and MRI findings.

Patient concerns:
Two patients presented to our institution because of dull pain in the left abdomen, and a mass in the left kidney was found by ultrasound examination in each case. The patient had no special family history. Physical examination revealed no obvious tenderness or percussion pain in the renal and ureteral walking areas, and there was no obvious mass. Routine blood and urine tests were normal, and the serum tumor markers were negative. No obvious lesions were found on imaging of the other body parts.

Diagnosis:
Similar radiologic findings were observed in both cases and mimicked those of cavernous hemangiomas of the liver, including peripheral nodular enhancement in the corticomedullary phase, progressive centripetal enhancement in the nephrographic and delayed phases, and occasional complete “filling in” in the delayed phase. We made a radiologic diagnosis of renal clear cell carcinoma for patient 1 and suspected renal clear cell carcinoma for patient 2, but the pathological results showed RH.

Interventions:
Given the suspicion of renal cell carcinoma, both patients underwent partial nephrectomy.

Outcome:
The recovery of the two patients was uneventful, and there was no evidence of local recurrence or metastasis many years after surgery.

Lessons:
RH is a rare benign tumor that can be easily misdiagnosed as clear cell carcinoma. Characteristic CT and MRI manifestations may improve preoperative diagnostic accuracy to avoid surgery or indicate nephron-sparing surgery.
Oral posaconazole and bronchoscopy as a treatment for pulmonary mucormycosis in pediatric acute lymphoblastic leukemia patient
Authors: Liang Yan , Chen Xing , Wang Jinrong , Guo Chunyan , Liu Fengqin , Yang Juan 
Published: February 2021

Abstract

Rationale:
Mucormycosis is a rare fungal infection that typically occurs in immunosuppressed patients following chemotherapy or hematopoietic stem cell transplantation.

Patient concerns:
An 11-year-old child with newly developed acute lymphoblastic leukemia suffered from the paroxysmal left chest pain, fever, and hemoptysis.

Diagnoses:
We made a histopathologic diagnosis aided by bronchoscopy techniques, which indicated invasive fungal hyphae that are characteristic of mucormycosis.

Interventions:
The patient was treated with oral posaconazole and repeated bronchoscopy interventions for 4 months.

Outcomes:
The patient's clinical signs and symptoms and signs were no longer present. The prior lung lesions were also no longer observable using radiologic methods, and a 3-month follow-up with the patient showed no signs of mucormycosis recurrence. Finally, the patient was cured, when the cancer chemotherapy was stopped. Close follow-up for another 2 years showed no evidence of recurrence.

Lessons:
Mucormycosis diagnosis is difficult as clinical and imaging findings vary. This case demonstrates that posaconazole monotherapy combined with bronchoscopy interventions may be a safe and effective treatment option for pediatric pulmonary mucormycosis.
Application of digital practice to improve head movement, visual perception and activities of daily living for subacute stroke patients with unilateral spatial neglect
Authors: Choi Ho-Suk , Shin Won-Seob , Bang Dae-Hyouk 
Published: February 2021

Abstract

Background:
Virtual reality (VR) based digital practice is an attractive way to provide a patient engagement, motivation and adaptable environment for stroke rehabilitation. However, clinical evidence of efficacy with VR-based digital practice is very limited. In this study, we investigated the effects of VR-based digital practice program on unilateral spatial neglect (USN) rehabilitation in patients with subacute stroke.

Methods:
Twenty-four subacute stroke patients with USN were enrolled and randomly assigned to digital practice group (n = 12) and control group (n = 12). Patients in digital practice group received training programs with VR-based applications with leap motion environment. Control group received conventional USN specific training programs. All patients were underwent 4 week practice program (3 sessions/week, a half-hour/session). We analyzed training effects before and after training by assessing the line bisection test, Catherine Bergego Scale, modified Barthel index, Motor-Free Visual Perception Test Vertical Version (MVPT-V), and horizontal head movements (rotation degree and velocity during the VR-based applications), and compared the results between the two groups.

Results:
Compared to control group, digital practice group showed significantly greater improvements in the line bisection test (P = .020), and visual perceptual tasks (MVPT-V, responded more on left visual task, P = .024; correctly respond more on both left and right visual tasks, P = .024 and P = .014, respectively; and faster response time, P = .014). Additionally, horizontal head movement of rotation degree and velocity during the VR based practice in the digital practice group were significantly increased more than control group (P = .007 and P = .001, respectively).

Conclusions:
VR-based digital practice program might be an affordable approach for visual perception and head movement recovery for subacute stroke patients with USN.
A retrospective study of pituitary-thyroid interaction in patients with first-episode of bipolar disorder type I in Mania State
Authors: Han Yi , Zhang Huaihui , Huang Tao , Wang Fang , Zhu Yuncheng 
Published: February 2021

Abstract
Bipolar disorder (BD)-mania is related to the dysfunction of anterior pituitary gland, but the pituitary-thyroid interaction on the acute stage of BD has been controversial. In order to rule out the effects of drugs, we aimed to determine the upstream interaction of first-episode of BD type I in mania state, and tried to find the relationship between thyroid-stimulating-hormone (TSH) and Prolactin (PRL)
This study included 70 real-world patients diagnosed with first-episode BD-mania recuited and 70 healthy controls (HC) matched for age and sex from 2016 to 2017 in the same district of Shanghai. We compared the levels of thyroid hormones and prolactin between the two groups, and linear regression and curve estimation were used for the correlation analysis of TSH and PRL
There were differences in triiodothyronine (TT3), total thyroxin (TT4), and free thyroxine (FT4) concentrations between the groups (P's < .05). After being grouped by sex, higher PRL in the male and female BD-mania subgroup were observed compared to each isosexual HC [(P's < .01, Cohen's d = 0.82/1.08, 95%CI (0.33, 1.31)/(0.58, 1.58)]. Higher FT4 in the male BD-mania group was observed compared to the HC males [(P's
< .01, Cohen's d = 0.90, 95%CI (0.41, 1.39)] while the female BD-mania group showed lower TT3 and TT4 compared to the HC females [(P's
< .01, Cohen's d = 0.93/0.88, 95%CI (0.43, 1.42)/(0.39, 1.37)]. In the female BD-mania group, correlation analysis established an inverse relationship between PRL and TSH (r
2 = 0.25, F = 11.11, P < .01).
The findings demonstrate that sex impacts the concentration of hormones secreted by the anterior pituitary of patients with first-episode BD-mania. The increased PRL may be a putative mechanism that underlies the onset in female patients with a moderate inverse relationship between TSH and PRL. Thyroid hormones and prolactin levels may be developed as potential markers for identifying BD-manic.
Efficiency of red cell distribution width in predicting severity and mortality of patients with acute pancreatitis
Authors: Cheng Tao , Liu Bo-Fu , Han Tian-Yong , Pan Pan , Liu Jun-Zhao , Yu Haifang 
Published: February 2021

Abstract

Background:
Previous studies have showed that red cell distribution width (RDW) may be an inflammatory status, and it may be used to predict prognosis of acute pancreatitis (AP). However, there are no systematic reviews for the evidence, and the association between RDW and AP is still not completely understood. Therefore, we will undertake a systematic review of the literature to summarize previous evidence regarding this topic, in order to clarify the value of RDW predicting prognosis of patients with AP.

Methods:
We will search EMBASE, Web of Knowledge, PubMed, ClinicalTrials.gov and Cochrane Library from their inception to Mar 2021 to retrieve relevant studies. Two authors independently judged study eligibility and extracted data. Heterogeneity will be examined by computing the Q statistic and I2 statistic.

Results:
This study proved the Efficiency of RDW in predicting mortality and severity of patients with AP. And provided easy method for clinical evaluation for AP patients.

Conclusions:
The findings of this systematic review will show the value of RDW predicting prognosis of patients with AP.

Ethics and dissemination:
Ethical approval is unnecessary as this protocol is only for systematic review and does not involve privacy data. The findings of this study will be disseminated electronically through a peer-review publication or presented at a relevant conference.
The incidence of prostate cancer is increased in patients with obstructive sleep apnea
Authors: Lee Eun Jung , Suh Jeffrey D. , Cho Jae Hoon 
Published: February 2021

Abstract
Some studies have demonstrated an increased risk of prostate cancer in patients with obstructive sleep apnea (OSA). However, the relationship is unclear and the results are conflicting. This study aims to investigate associations between OSA and prostate cancer using the Korea National Health Insurance Service database.
A total of 152,801 men (≥ 20 years of age) newly diagnosed with OSA between 2007 and 2014 were included. A control group of 764,005 subjects was selected using propensity score matching by age and sex. The mean follow-up time was 4.6 years (range 2.3–6.9). The primary endpoint was newly diagnosed prostate cancer. The prostate cancer hazard ratio (95% confidence interval) was calculated for patients with OSA and compared to the control group.
The incidence of prostate cancer among patients with OSA was significantly higher than that in controls (1.34 [1.23–1.49]). In particular, the incidence of prostate cancer was highest in patients aged 40–65 years (1.51 [1.32–1.72]).
This study provides additional evidence for a link between OSA and prostate cancer.
Postoperative spinal epidural hematoma in a biportal endoscopic spine surgery
Authors: Ahn Dong Ki , Lee Jung Soo , Shin Won Shik , Kim San , Jung Jin 
Published: February 2021

Abstract
Biportal endoscopic spine surgery (BESS) is extending its application to most kind of spine surgeries. Postoperative spinal epidural hematoma (POSEH) is one of the major concerns of this emerging technique. Through this study we aim to investigate the incidence of POSEH in BESS comparing to a conventional spine surgery (CSS).
The patients who underwent a non-fusion decompressive spine surgery due to degenerative lumbar spinal stenosis (LSS) or herniated lumbar disc (HLD) or both between January 2015 and March 2019 were reviewed retrospectively. The incidence of clinical POSEH that demanded a revision surgery for hematoma evacuation was compared between CSS and BESS. As a second endpoint, the morphometric degree of POSEH was compared between the two groups. The maximal compression of cauda equina by POSEH was measured by 4 grade scale at the T2 axial image and the neurological state was evaluated by 5 grade scale. The indication of hematoma evacuation was more than hG3 with more than nG1. As a subgroup analysis, risk factors of POSEH in BESS were investigated.
The 2 groups were homogenous in age, sex, number and level of operated segments. There was significant difference in the incidence of symptomatic POSEH as 2/142 (1.4%) in CSS and 8/95 (8.4%) in BESS (P = .016). The radiological thecal sac compression by hematoma was hG1 65 (61.3%), hG2 35 (33.0%), hG3 5 (4.7%), hG4 1 (0.9%) cases in CSS and hG1 33 (39.8%), hG2 25 (30.1%), hG3 22 (26.5%), hG4 3 cases (3.6%) in BESS. The difference was significant (P < .001). In BESS subgroup analysis, the risk factor of high grade POSEH was bilateral laminectomy (OR = 8.893, P = .023).
The incidence of clinical and morphometric POSEH was higher in BESS. In BESS, POSEH developed more frequently in bilateral laminectomy than unilateral laminectomy.
Current indications for adjuvant treatment following transoral laser microsurgery of early and intermediate laryngeal cancer
Authors: Vander Poorten Vincent , Meulemans Jeroen , Van Lierde Charlotte , Nuyts Sandra , Delaere Pierre 
Published: February 2021

Purpose of review
This review summarizes the information in the literature on the indications for adjuvant therapy after transoral laser microsurgery (TLM) for early/intermediate stage laryngeal cancer.

Recent findings
A high rate of ‘nonevaluable’ margins after TLM significantly complicates decision-making concerning adjuvant therapy. However, consensus grows that second-look TLM in patients with multiple superficial and deep positive margins is more sensible than sending these patients systematically for adjuvant radiotherapy (RT).

Summary
The classical adagium: ‘Failure to achieve negative margins indicates need for adjuvant RT’ does not translate automatically to patients with glottic cancer treated by TLM. Rather, specifically patients with multiple superficial positive margins and positive deep margins after TLM need careful judging what constitutes the best additional adjuvant treatment. Second-look resection is nowadays regarded as the preferred adjuvant treatment for many of these patients whereas RT is reserved for those in whom a second look TLM is judged unlikely to result in ‘true negative margins.’ Additionally, when the pathology of the re-resection reveals multiple foci of residual disease or suggests again a resection with positive margins, adjuvant postoperative RT is likely to result in a better local control. If this strict selection of patients for adjuvant RT is adhered to carefully, oncological and functional results will be optimal.
Continuous Glucose Monitoring in Patients With Insulinoma Treated by Endoscopic Ultrasound-Guided Ethanol Injection
Authors: Yuan Tao , Liu Shixuan , Zhu Cheng , Dong Yingyue , Zhu Huijuan , Wu Xi , Tang Yan , Zhao Weigang 
Published: February 2021

Objectives
The aims of this study were to analyze the continuous glucose monitoring (CGM) profiles of patients with insulinoma before and after treatment with endoscopic ultrasound–guided ethanol injection and assess the value of CGM in curative effect evaluating.

Methods
We included 8 patients, and CGM was performed for 3 to 5 days before and after treatment.

Results
The proportion of monitoring points at which the glucose level was lower than 3.9 mmol/L after treatment decreased in patient 5 (from 4% to 3%) and patient 8 (from 30% to 12%), whereas the proportion increased in patient 1 (from 1% to 16%), patient 3 (from 5% to 23%), and patient 7 (from 7% to 63%). There was no mean significant difference between CGM values (5.75 [standard deviation, 2.49] mmol/L) and self-monitoring of blood glucose values (5.76 [standard deviation, 2.32] mmol/L) (P > 0.05). Pearson correlation analysis showed positive correlation between CGM values and self-monitoring of blood glucose values (r = 0.88, P < 0.05). Clarke Error Grid Analysis showed that 91.5% of pairs were located in areas A and B.

Conclusions
Continuous glucose monitoring is useful for detecting hypoglycemia and evaluating curative effect, but the correction of fingertip blood glucose is necessary when the blood glucose is relatively low.
Does the Implementation of a Clinical Care Pathway Have an Impact on Early Intravenous Fluid Therapy of Acute Pancreatitis?
Authors: Di Mauro Davide , Smith Radford , Wijesurendere Chinthaka , Hubble Sheena , Manzelli Antonio 
Published: February 2021

Objectives
Early intravenous fluid (IVF) resuscitation is crucial in the management of acute pancreatitis; variation in IVF prescription practice had been demonstrated. This pilot study aims to assess whether the implementation of an Acute Pancreatitis Care Pathway (APCP) produces a change toward a more adequate IVF regimen in the first 24 hours.

Methods
Patients with confirmed diagnosis of acute pancreatitis, from July 2015 to February 2016 (group 1) and from September 2017 to March 2018 (group 2), were considered. The APCP was developed between March 2016 and August 2017. Median IVF rate, volume, and type infused in the first 24 hours, were compared between groups. Nonparametric data were analyzed with the Mann-Whitney U test, differences in frequencies with the McNemar test; significance was set at P < 0.05.

Results
Seventy-two patients were included, 36 in each group. In the first 24 hours, the median IVF rate was 177 mL/h vs 225 mL/h (P = 0.004); Ringer lactate infusion was 30% vs 77.8% (P = 0.0003). The median total IVF volume did not differ between groups.

Conclusions
The implementation of the APCP has the potential to lead to a successful change in early IVF resuscitation practice.
Platinum-Based Treatment for Well- and Poorly Differentiated Pancreatic Neuroendocrine Neoplasms
Authors: Pulvirenti Alessandra , Raj Nitya , Cingarlini Sara , Pea Antonio , Tang Laura H. , Luchini Claudio , Chou Joanne F. , Grego Elisabetta , Marinova Ioana , Capanu Marinela , Landoni Luca , Scarpa Aldo , Allen Peter J. , Klimstra David S. , Reidy-Lagunes Diane L. 
Published: February 2021

Objectives
Pancreatic neuroendocrine neoplasms include well-differentiated tumors (PanNETs) and poorly differentiated carcinomas (PanNECs). Previous reports suggested a role for platinum-based therapy largely in PanNEC. We sought to investigate the role of platinum-based therapy in pancreatic neuroendocrine neoplasms regardless of tumor grade and differentiation.

Methods
Patients with pancreatic neuroendocrine neoplasms treated with platinum-based therapy at Memorial Sloan Kettering (1994–2016) and Verona University Hospital (2008–2016) were retrospectively identified. Response to treatment by RECIST v1.1, overall survival, and progression-free survival were defined. Among patients with available tissue, DAXX, ATRX, Rb, and p53 expression was evaluated to support the histologic grade of differentiation.

Results
Fifty PanNETs, 29 PanNECs, and 22 high-grade tumors with undeterminable differentiation were included. No patients achieved complete response. Overall rate of partial response was 31%, 41% for PanNEC, and 20% for PanNETs. Among PanNETs, partial response was achieved in 33% of G1 (2/6), 10% of G2 (2/19), and 24% of G3 (6/25) tumors. Median overall survival was 29.3 months for PanNETs and 10.9 months for PanNEC (P < 0.001). There was no significant difference in median progression-free survival (P = 0.2).

Conclusions
Platinum-based therapies demonstrated increased activity in PanNEC; however, promising efficacy was also observed in PanNETs, irrespective of grade.
Epidemiology of Sjögren Syndrome in Africa
Authors: Essouma Mickael , Noubiap Jean Jacques , Singwe-Ngandeu Madeleine , Hachulla Eric 
Published: February 2021

Background
The epidemiology of Sjögren syndrome (SS) has been extensively studied in America, Europe, and Asia.

Objective
To summarize available data on the epidemiology of SS in Africa.

Methods
MEDLINE, EMBASE, and African Journals Online were searched from inception up to May 17, 2020, to identify relevant articles. Data gleaned from these reports have been summarized narratively in this review.

Results
Twenty-one hospital-based studies were included. These studies reported 744 cases of SS. The mean age at diagnosis varied between 28 and 73.6 years, and the female proportion ranged from 83.3% to 100%. There was no population-based incidence or prevalence. Among people with autoimmune and other rheumatic conditions, the frequency of primary SS was in the range 1.9% to 47.6%, whereas that of rheumatoid arthritis–associated secondary SS was in the range 4.3% to 100%. Sicca symptoms were the commonest features, with most frequently involved organs being joints, lungs, and neurological structures. Main autoantibodies were anti-Ro/SS antigen A, anti-La/SS antigen B, and antinuclear antibodies.

Conclusions
The epidemiology of SS is poorly characterized in Africa. Available data are broadly consistent with those from other populations. Extensive and high-quality research is urgently needed.