bluuebunny/crossref_metadata_2025_split huggingface dataset:
Non-surgical management of tubal ectopic pregnancy
Authors: Xiao Chao , Shi Qingquan , Cheng Qijun , Xu Jianli 
Published: December 2021

Abstract

Background:
Ectopic pregnancy (EP) is a common cause of acute abdominal pain in the field of gynecology. Because the majority of women with EP are hemodynamically stable, non-surgical therapy is a viable option. The goal of this study was to determine the most effective non-surgical therapy for hemodynamically stable EP.

Methods:
We performed a systematic review and meta-analysis. We searched PubMed, LILACS, SciELO, CINAHL, Embase, and the Cochrane library in May 2020, with no starting date restrictions.Studies were restricted to randomized controlled trials, which were included if the target population contained women with tubal EP and the intervention was non-surgical management. The primary outcome measure was treatment success defined by a decrease in serum hCG to a level ranging from five mIU/mL to 50 mIU/mL. Secondary outcome measures were side effects, time needed to treat, number of injections and operative rate.

Results:
We conducted a meta-analysis of 15 studies that included 1573 women who were diagnosed with EP and managed non-surgically. There was no significant difference in treatment success in the matched groups; however, single-dose MTX was associated with fewer side effects than multiple-dose (relative risk 0.48, 95% confidence interval 0.28–0.80, P = .006) and two-dose therapies (relative risk 0.74, 95% confidence interval 0.55–1.00, P = .05).

Conclusions:
We highly recommend that single-dose MTX without mifepristone be used first-line in patients who require conservative therapy due to the inherent negative effects of mifepristone. An EP woman with a low -hCG level that is falling or plateauing should receive expectant treatment to reduce adverse effects.
Identification of prognostic metabolic genes in adrenocortical carcinoma and establishment of a prognostic nomogram
Authors: Chen Qing , Ren Ziyu , Liu Dongfang , Jin Zongrui , Wang Xuan , Zhang Rui , Liu Qicong , Cheng Wei 
Published: December 2021

Abstract
Adrenocortical carcinoma is an invasive malignancy with poor prognosis, high recurrence rate and limited therapeutic options. Therefore, it is necessary to establish an effective method to diagnose and evaluate the prognosis of patients, so as to realize individualized treatment and improve their survival rate.
This study investigated metabolic genes that may be potential therapeutic targets for Adrenocortical carcinoma (ACC). Level 3 gene expression data from the ACC cohort and the relevant clinical information were obtained from The Cancer Genome Atlas (TCGA) database. To verify, other ACC datasets (GSE76021, GSE19750) were downloaded from the Gene Expression Omnibus (GEO) database. The ACC datasets from TCGA and GEO were used to screen metabolic genes through the Molecular Signatures Database using gene set enrichment analysis. Then, the overlapping metabolic genes of the 2 datasets were identified.
A signature of five metabolic genes (CYP11B1, GSTM2, IRF9, RPL31, and UBE2C) was identified in patients with ACC. The signature could be used to divide the patients with ACC into high- and low-risk groups based on their median risk score. Multivariate Cox regression analysis was performed to determine the independent prognostic factors of ACC. Time-dependent receiver operating characteristic (ROC) curve analysis was conducted to assess the prediction accuracy of the prognostic signature. Last, a nomogram was established to assess the individualized prognosis prediction model.
The results indicated that the signature of 5 metabolic genes had excellent predictive value for ACC. These findings might help improve personalized treatment and medical decisions.
Effect of antidepressants in pregnancy outcomes
Authors: Hlongwane Rixile , Phoswa Wendy N. 
Published: December 2021

Abstract

Background:
Depression is much more common in women pre their pregnancies with antidepressants use less common which is caused by when many patients opt to discontinue with the use due to its side effects it causes. But whether depression is treated by antidepressants or not this has the same negative pregnancy outcomes on both the mother and the unborn and even born child from these mothers.

Methods:
Information will be retrieved for this systematic review and meta-analysis study on antidepressants use pregnancy outcomes from PubMed and Google scholar search engines using search medical subjects headings on PubMed and the PICOS framework as the determinant of the research question. All returned articles searched will be stored to Zotero.org and the software RevMan will be used to analyze data.

Ethics and dissemination:
The review and meta-analysis will not require ethical approval and the findings will be published in peer-reviewed journals and presented at local and international conferences. In addition, findings from this study will assist in assessing health related risk outcomes of antidepressants during- and postpregnancy on both the fetal and mother either when used pre- and during-pregnancy.

Systematic review registration:
International prospective Register of Systematic Reviews (PROSERO) number: CRD42021232111.
Chinese medicinal herbs for idiopathic membranous nephropathy in adults with nephrotic syndrome
Authors: Liu Meifang , Yang Qianchun , Hua Qiaoli , Liu Jialing , He Weifeng , Niu Di , Liu Xusheng 
Published: December 2021

Abstract
To assess the benefits and harms of Chinese medicinal herbs formulae for the treatment of idiopathic membranous nephropathy in adult patients with primary nephrotic syndrome.
Only randomized controlled trials were included. We searched the Cochrane Central Register of Controlled Trials database, PubMed, EMBASE, Chinese National Knowledge Internet, Chinese Biomedicine Database, and VIP. All studies were analyzed using the criteria of the Cochrane Handbook and were assessed in terms of quality and the risk of bias. Review Manager ver. 5.3.5 software was used for the data analysis, and GRADE profiler software was employed to evaluate quality.
Two studies were included (n = 126 Chinese participants). We found that compared with against conventional treatment, one Chinese medicinal herbs formula plus conventional treatment reduced 24-hours urinary total protein (mean differences –3.16 g/24 h, 95% confidence intervals –4.03 to –2.29), and two Chinese medicinal herbs formulae increased serum albumin levels (mean differences 3.18 g/L, 95% confidence intervals 1.12 to 5.52; I
2 = 0%).
Chinese medicinal herbs formulae may reduce 24-hours urinary total protein and increase serum levels of albumin. However, larger and multicenter studies with high methodological quality are still needed.
Malignant pancreatic tumor other than solid pseudopapillary tumor in pediatric patients
Authors: Kim Duon , Yang Hee-Beom , Kim Hyun-Young 
Published: December 2021

AbstractPancreatic tumors, except solid pseudopapillary tumors (SPTs), are rare in pediatric patients. Herein, we report various types of pancreatic tumors in pediatric patients and review the literature regarding their treatments and prognosis.We retrospectively reviewed the data of pediatric patients who underwent surgery for pancreatic tumors, excluding SPTs, between January 2009 and December 2019 at Seoul National University Children's Hospital. A total of 35 pediatric patients were identified as having undergone surgery for pancreatic tumors. Of these patients, 30 were excluded because the tumor was identified as an SPT.The diagnoses of the five remaining (non-SPT) pancreatic tumors were pancreatic neuroendocrine tumor, mixed acinar neuroendocrine carcinoma, kaposiform hemangioendothelioma, and intraductal papillary mucinous neoplasm. All five patients survived; however, recurrence and liver metastasis were observed in one patient. The detailed demographics, treatments, and prognosis of each patient were reviewed.Despite the rarity and lowincidence of pancreatic tumors in pediatric patients, four types of non-SPT tumors are reported here. Hence, the possibility of these should not be overlooked, especially since the diagnosis and adjuvant treatment differ vastly between the tumor types.
Is there a relationship between body mass index and postoperative pain scores in thoracotomy patients with thoracic epidural analgesia?
Authors: Zengin Musa , Ulger Gulay , Baldemir Ramazan , Sazak Hilal , Alagoz Ali 
Published: December 2021

Abstract
Postoperative efficacy of thoracic epidural analgesia (TEA) following thoracic surgery may vary in patients with different body mass index (BMI) values, regardless of the success of the method. This study aimed to investigate the effects of BMI on postoperative pain scores in patients who underwent thoracotomy with TEA.
After obtaining the ethical committee approval (Date: May 11, 2021, Number: 2012-KEAK-15/2305) the data of 1326 patients, who underwent elective thoracic surgery in high volume tertiary thoracic surgery center between January 2017 and January 2021, were analyzed retrospectively. Patients between the age of 18 and 80 years, who underwent thoracotomy and thoracic epidural catheterization (TEC), and who were assigned American Society of Anesthesiologists I to III physical status were included to the study. Of the 406 patients, who underwent a successful TEC, 378 received postoperative analgesia for 72 hours. Visual analog scale (VAS) scores of these patients were evaluated statistically. Based on BMI, patients were categorized into the following 5 groups: Group I: BMI < 20 kg/m2, Group II: BMI = 20 to 24.9 kg/m2, Group III: BMI = 25 to 29.9 kg/m2, Group IV: BMI = 30 to 34.9 kg/m2, and Group V: BMI ≥ 35 kg/m2.
There were no statistically significant differences in TEC success across different BMI groups (P > .05). Catheter problems and VAS scores significantly increased with higher BMI values in the postoperative 72-hours period (P < .05). Rates of rescue analgesic use were higher in BMI groups of 30 toto 34.9 kg/m2 and ≥35 kg/m2 compared to the other BMI groups.
This study revealed that higher BMI in patients may increase VAS scores, who administered TEA for pain management following thoracotomy. This correlation was supported by the increased need for additional analgesics in patients with high BMI. Therefore, patients with high BMI values would require close monitoring and follow-up.
A meta-analysis of XRCC1 single nucleotide polymorphism and susceptibility to gynecological malignancies
Authors: Zhang Xue Qin , Li Li 
Published: December 2021

Abstract

Background:
Gynecological malignant tumor is a serious threat to women's health, cervical cancer, endometrial cancer and ovarian cancer are the most common. The eponymous protein encoded by the XRCC1 (X-ray repair cross complementation 1) gene is an important functional protein in the process of single-stranded DNA damage. Non-synonymous mutations of XRCC1 gene cause amino acid sequence changes that affect protein function and DNA repair ability, and may affect the interaction with other DNA repair proteins, leading to increased risk of tumor development. Many studies have assessed the association between XRCC1 gene polymorphism and the risk of cancer in the female reproductive system, but the results have been inconclusive. In this study, the relationship between XRCC1 Arg399Gln, Arg194Trp, Arg280His single nucleotide polymorphisms and susceptibility to gynecological malignancies was further explored by meta-analysis.

Methods:
English database: Pubmed, Medline, Excerpta Medica Database, Cochrance, etc; Chinese database: China national knowledge infrastructure, Wanfang Database, etc. STATA14 was used for statistical analysis, such as odd ratio (OR) value, subgroup analysis, heterogeneity test, sensitivity analysis, and publication bias.

Results:
In gynecologic cancers, the allele frequency difference of Arg399Gln case control group was statistically significant (GvsA: P = .007). There was no significant difference in allele frequency in the Arg194Trp and Arg280His case control groups (P = .065, 0.198). In different gene models, Arg399Gln was significantly correlated with gynecologic cancers susceptibility (GGvs AA: OR 0.91; 95% confidence interval [CI], 0.85 0.98); Arg194Trp was significantly correlated with gynecologic cancers susceptibility (CCvs TT: OR 0.94; 95% CI 0.88,1.00; CCvs CT: OR 0.97; 95% CI 0.90, 1.05); Arg280His was significantly correlated with gynecologic cancers susceptibility (GGvs AA: OR 0.98; 95% CI 0.94, 1.02; GGvs GA: OR 1.00;95% CI 0.97, 1.04). In the subgroup analysis, Arg399Gln and Arg194Trp were significantly correlated with gynecologic cancers susceptibility in the Asian race (P = .000, 0.049). In the analysis of different cancer subgroups, Arg399Gln and cervical cancer susceptibility were statistically significant (P = .039). Arg194Trp and endometrial cancer susceptibility were statistically significant (P = .033, 0.001).

Conclusions:
XRCC1 Arg399Gln, Arg194Trp, Arg280His single nucleotide polymorphisms were associated with gynecologic cancer susceptibility. Arg399Gln genotype was statistically significant in relation to cervical cancer susceptibility. Arg194Trp genotype was statistically significant in relation to endometrial cancer susceptibility.
Efficacy and safety of colonic dialysis combined with traditional Chinese medicine retention enema in the treatment of chronic renal failure
Authors: Wang Zhilei , Zhang Shoulin , Zheng Xue , Zhang Lili 
Published: December 2021

Abstract

Background:
Chronic renal failure (CRF) is a major public health problem worldwide nowadays. It is characterized by a slow reduction in kidney function identified by an increase of serum creatinine levels and a reduction of urine output. CRF is easier to diagnose than to treat. Clinical evidence shows that colonic dialysis combined with traditional Chinese medicine (TCM) enema can treat CRF by reducing serum creatinine. To assess the therapeutic efficacy and safety of colonic dialysis combined with Traditional Chinese medicine retention enema in CRF, we created a protocol for a systematic review to inform future clinical applications.

Methods:
Eligible random controlled trials were collected from 8 bibliographic databases (PubMed, EMBASE, Web of Science, The Cochrane Library, Chinese Biomedical Literature Database, Chinese National Knowledge Infrastructure, Chinese Science and Technology Periodical Database, Wanfang Database), completed before October 2021. The primary outcome is the serum creatinine, Urea nitrogen, total effective rate, uric acid, creatinine clearance. Secondary outcome: TCM syndrome score, glomerular filtration rate, hemoglobin, adverse reactions, and adverse events. Data extraction and quality assessment were independently conducted by 2 researchers. The quality and bias of the data were assessed using RevMan5.4 software.

Results:
This study will provide a clinical basis for colonic dialysis combined with TCM retention enema in the treatment of CRF.

Conclusion:
Colonic dialysis combined with TCM retention enema in the treatment of CRF can delay the progression of renal disease, proving its effectiveness and safety.

INPLASY Registration number:
INPLASY2021100116
Neurologic deficit due to vertebral body osteophytes after oblique lumbar interbody fusion
Authors: Lee Tae-Kyu , Kim Jae-Young , Han Moon-Soo , Lee Jung-Kil , Moon Bong Ju 
Published: December 2021

Abstract

Rationale:
In recent years, oblique lumbar interbody fusion (OLIF), which uses a window between the peritoneum and the iliopsoas muscle to split the muscle to access the lumbar spine, is known as an effective and safe treatment for spinal diseases, such as degenerative disc disease, spondylolisthesis, recurrent disc herniation, and spinal deformity. Despite this fast and useful surgical method, there were often cases of new neurological symptoms or worsening of symptoms after surgery. We analyzed the preoperative risk factors in a patient with neurologic symptoms, such as motor weakness and exacerbation of radiating pain, after OLIF.

Patient concerns:
A 78-year-old man presented with complaints of numbness in the soles of both feet. L4–5 stenosis was diagnosed on MRI. We performed bilateral L4 laminotomy and L4–5 percutaneous posterior screw fixation after L4–5 OLIF. Postoperatively, his radiating pain improved, and there were no other neurologic symptoms. In the 6th week after surgery, he complained of pain in both ankles, while in the 10th week, the pain progressively worsened, and there was a decrease in motor performance of the right ankle.

Diagnosis:
Magnetic resonance imaging findings indicated that L4–5 stenosis was resolved. On the basis of the computed tomography findings, the cage was well inserted, the disc height and foramen height increased, and the alignment was good. However, a nerve root injury due to the protruding osteophyte from the inferior endplate of the L4 body was suspected, necessitating exploration of both L4 nerve roots by focusing on the right side.

Interventions:
We performed right facetectomy and right foraminotomy. During surgery, it was confirmed that the right L4 nerve root was entrapped by the osteophyte.

Outcomes:
Postoperatively, his radiating pain improved, and motor performance of his right ankle was restored.

Lessons:
A prominently protruding osteophyte is assessed as a possible risk factor for the development of new neurologic deficits after OLIF. In patients with confirmed osteophytes, surgery should be planned taking into consideration the shape of the osteophytes and their relationship to the nerve root.
Prevalence of SARS-CoV-2 amongst ophthalmologists throughout the first and second waves of the pandemic
Authors: Sacchi Matteo , Lizzio Rosario Alfio Umberto , Villani Edoardo , Tagliabue Elena , Monsellato Gianluca , Pajardi Giorgio , Luccarelli Saverio , Nucci Paolo 
Published: December 2021

Abstract
The study aims to investigate the prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among ophthalmology unit staff throughout the first and second waves of the outbreak, in order to verify the effectiveness of the measures adopted in containing the contagion.
A retrospective observational study was conducted involving staff members, who received a naso/oropharyngeal swab when complaining of SARS-CoV-2 symptoms and once a month as a screening measure. They were tested for SARS-CoV-2 antibodies as a screening measure during the first and the second wave. Clinical activities performed during the outbreak were compared with those performed during the same period in 2019 and correlated with the number of coronavirus disease-2019 eye care workers.
Analysis included 25 workers. Clinical infection was 0% and 12% whereas the prevalence of SARS-CoV-2 antibodies ranged from 4% to 8% in the first and second wave, respectively. The increase in the prevalence of SARS-CoV-2 infection between the first and the second wave was not significant (1/25 vs 3/25, P = .6092). Clinical activities significantly decreased during the first wave compared with the same period in 2019 (3256 vs 10,075, P < .0001, –68% to 2019), but increased during the second wave (8208 vs 3256, P < .0001, +152% to the first wave).
Despite the increase in routine activities during the second wave, we did not observe a significant increase in SARS-CoV-2 prevalence. Strict protection measures seemed to contain the rate of contagion among the ophthalmology unit members even in a high-volume clinical setting in one of the most affected area by the coronavirus disease-2019 outbreak.
Development and validation of a nomogram for predicting prostate cancer in patients with PSA ≤ 20 ng/mL at initial biopsy
Authors: Wu Qiang , Li Fanglong , Yin Xiaotao , Gao Jiangping , Zhang Xu 
Published: December 2021

Abstract
The aim of this study was to construct a nomogram for predicting prostate cancer (PCa) in patients with PSA ≤ 20 ng/mL at initial biopsy.
The patients with PSA ≤ 20 ng/mL who underwent prostate biopsy were retrospectively included in this study. The nomogram was developed based on predictors for PCa, which were assessed by multivariable logistic regression analysis. The receiver operating characteristic curve, calibration plots and decision curve analysis (DCA) were used to evaluate the performance of the nomogram.
This retrospective study included 691 patients, who were divided into training set (505 patients) and validation set (186 patients). The nomogram was developed based on the multivariable logistic regression model, including age, total PSA, free PSA, and prostate volume. It had a high area under the curve of 0.857, and was well verified in validation set. Calibration plots and DCA further validated its discrimination and potential clinical benefits. Applying the cut-off value of 15%, our nomogram would avoid 42.5% of unnecessary biopsies while miss only 4.4% of PCa patients.
The nomogram provided high predictive accuracy for PCa in patients with PSA ≤ 20 ng/mL at initial biopsy, which could be used to avoid the unnecessary biopsies in clinical practice.
Case report of gastric syphilis in Korea
Authors: Yu Hyung-Joo , Kim Seong-Jung , Oh Hyung-Hoon , Im Chan-Mook , Han Bora , Myung Eun , Yun Sook-Jung , Lee Kyung-Hwa , Joo Young-Eun 
Published: December 2021

Abstract

Rationale:
Syphilis is a contagious infectious disease caused by Treponema pallidum. Gastric involvement of syphilis is rare and has nonspecific gastrointestinal symptoms and endoscopic findings. To date, 16 cases have been reported in Korea. Here, we report 2 additional cases of gastric syphilis in men in their 30 second.

Patients concerns:
Two 35- and 33-year-old men presented with epigastric pain.

Diagnosis:
The serum venereal disease research laboratory and fluorescent treponemal antibody absorption tests were positive. Esophagogastroduodenoscopy showed multiple variable-sized flat elevated lesions and geographic ulcers with whitish exudates in the antrum and body. Warthin–Starry silver staining of endoscopic biopsy specimens confirmed gastric syphilis.

Interventions:
The patients were treated with an intramuscular injection of 2.4 million units of benzathine penicillin once a week for 3 weeks.

Outcomes:
Clinical symptoms and gastric lesions were completely resolved.

Lessons:
First, gastric syphilis, despite its rarity and nonspecific symptoms and endoscopic findings, should be considered in a rare extracutaneous presentation of syphilis. Second, a high index of clinical suspicion and an accurate diagnosis based on a combination of clinical, radiological, endoscopic, serologic, and histopathologic findings provide an opportunity to identify and treat patients with gastric syphilis.
Recurrent pulmonary cryptococcosis during chronic HBV infection
Authors: Liu Huan , Shen Shu , Wang Qiuhui 
Published: December 2021

AbstractRationale:Pulmonary cryptococcosis is one of the important opportunistic infections and has a wide range of symptoms depending on the underlying conditions. Here, we reported a case living with chronic hepatitis B virus infection who had a recurrent pulmonary cryptococcosis.Patient concerns:A 51-year-old male patient was admitted to our center because of cough, fatigue, and shortness of breath for 2 weeks.Diagnosis:Pulmonary infection was suggested by chest computed tomography. Most lab examinations for infection were negative and only cryptococcal antigen testing was positive. Therefore, a clinical diagnosis of pulmonary cryptococcosis was made.Interventions:Fluconazole (200 mg/day) and bicyclol (50 mg/day) was given orally.Outcomes:During the follow-up of 3 and 6 months, his conditions improved, and he recovered fully. Moreover, cryptococcal antigen level was 12.57 ng/mL. During the 2-year follow-up, no recurrence occurred.Lessons:This case highlights the importance of the awareness of opportunistic infections during chronic hepatitis B virus infection, especially the potential of recurrence.