bluuebunny/crossref_metadata_2025_split huggingface dataset:
The association between rs2476601 polymorphism in PTPN22 gene and risk of alopecia areata
Authors: Lei Zi-Xian , Chen Wen-Jing , Liang Jun-Qin , Wang Yan-Jun , Jin Lan , Xu Chen , Kang Xiao-Jing 
Published: May 2019

Abstract

Background:
The single nucleotide polymorphism (SNP) rs2476601 of the protein tyrosine phosphatase, nonreceptor type 22 (PTPN22) gene has been presented to implicate in the pathogenesis of alopecia areata (AA) in a few association investigations with limited sample size and inconsistent conclusions.

Methods:
The aim of the current meta-analysis was to assess and synthesize the presently available data on the connection between rs2476601 and AA vulnerability. Six electronic databases, including EMBASE, PubMed, Web of Science, the Cochrane Library, Wanfang data, and the China National Knowledge Infrastructure database (CNKI), were systematically retrieved for relevant observational studies published previous to November 2018. Total odds ratios (ORs) and corresponding 95% confidence intervals (95% CIs) were analyzed to evaluate the correlation between PTPN22 polymorphism and AA. Risk of bias was estimated according to the Newcastle–Ottawa Scale (NOS). Sensitivity analyses were carried out using the RevMan 5.3 software.

Results:
In general, 5 case–control studies including 1129 AA patients and 1702 healthy control individuals were obtained for this meta-analysis. The pooled results suggested that rs2476601 SNP was significantly associated with AA susceptibility under allelic model (C vs T, OR = 0.77, 95% CI, 0.64–0.92, P = .003) and recessive model (CC vs CT + TT, OR = 0.73, 95% CI, 0.60–0.88, P = .001).

Conclusion:
On the basis of the results of the current research, the rs2476601 polymorphism of PTPN22 gene is significantly correlated with AA susceptibility. The C-allele and CC-genotype carriers at this locus have a lower risk of AA.
Differences of bleedings after percutaneous coronary intervention using femoral closure and radial compression devices
Authors: Kim Seung-Hyun , Behnes Michael , Baron Sebastian , Shchetynska-Marinova Tetyana , Tekinsoy Melike , Mashayekhi Kambis , Hoffmann Ursula , Borggrefe Martin , Akin Ibrahim 
Published: May 2019

Abstract
Bleedings represent most relevant complications being correlated with significant rates of adverse clinical outcomes in patients undergoing percutaneous coronary intervention (PCI). To reduce bleeding and improve prognosis various types of vascular closure devices (VCD) are frequently applied. This study aims to compare directly one specific femoral closure (FC) to one specific radial compression (RC) device in patients after PCI focusing on overall and access-site bleedings as well as major adverse cardiac events (MACE).
This single-center, prospective, and observational study included consecutive patients either treated by the FC (StarClose SE) or RC (TR Band) device following PCI. The primary outcome was bleeding; the secondary outcomes were MACE at 30 days of follow-up.
Two hundred patients in each group were enrolled following PCI. Access-site bleeding was significantly higher in the FC (43%) compared to the RC (30%) group (P = .001). Most common type of access-site bleeding consisted of hematomas. Of these, small and large hematomas were significantly higher in the FC group (P < .05). No significant differences of MACE were observed in both groups. In multivariable logistic regression models no consistent significant association of any risk factor with bleeding complications was identified.
Despite the use of VCD, transfemoral arterial access is still associated with a higher rates of access site bleeding consisting mostly of hematomas compared to trans-radial access, whereas no differences of MACE were observed between FC and RC patients at 30 days follow-up.
Impact of residential area on the management of rheumatoid arthritis patients initiating their first biologic DMARD
Authors: Movahedi Mohammad , Joshi Raman , Rampakakis Emmanouil , Thorne Carter , Cesta Angela , Sampalis John S. , Bombardier Claire 
Published: May 2019

Abstract
Access to care and management of Rheumatoid Arthritis (RA) patients may differ based on residential area. We described differences in the profile of patients initiating their first biologic disease modifying antirheumatic drug (bDMARD) based on their residential area type.
Cross-sectional analysis of 793 adult RA patients in the longitudinal Ontario Best Practices Research Initiative (OBRI) registry initiating their first bDMARD <30 days prior to or anytime post-enrolment. Patient residential and clinic areas (rural vs. urban) were classified using 2 methods: postal codes and Statistics Canada population centres. Sociodemographics, disease characteristics, and RA medications (tumor necrosis factor inhibitor [TNFi] vs. non-TNFi, concurrent use of conventional synthetic DMARDs [csDMARDs], and intravenous [IV] vs. subcutaneous [SC] bDMARD) at initiation of first bDMARD were contrasted between residential area types.
Other than marital status, first language, and race (higher proportion of married, English speaking, Caucasian patients in rural areas), no significant differences were observed in the demographic and disease characteristics of patients living in rural and urban areas. In multivariate analysis, there was no association between residential area type and type of bDMARD use, concurrent csDMARD(s) use or route of bDMARD. However, patients living farther from their treating clinic were significantly less likely to initiate IV bDMARD. Female rheumatologist and rural clinic location were independently associated with lower odds of IV bDMARD use.
The use of SC vs. IV bDMARD was associated with being seen in a clinic located in a rural area, being treated by a female rheumatologist, and living farther from treating clinic. These results suggest possible prescription bias in bDMARD selection and/or patient preferences due to convenience.
Development of Alzheimer disease in old major depressive patients based upon their health status
Authors: Tao Ping , Yang Szu-Nian , Tung Yu-Chi , Yang Ming-Chin 
Published: May 2019

Abstract
This study is conducted to investigate the association between major depressive disorder and the subsequent development of Alzheimer disease (AD) in elderly patients with different health statuses using Taiwan's National Health Insurance Research Database (NHIRD).
A retrospective cohort study was performed on subjects over 65 years old from 2002 to 2006 using a random sampling from the 1 million beneficiaries enrolled in the NHI. Patients who were diagnosed with major depressive disorder were selected as the case group. Subjects in the control group were selected from elderly patients who did not have depression during the study period by matching age, sex, and index date of depression with subjects in the case group using a ratio of 1:4 (case:control). Both groups of patients were checked annually over a period of 7 years to observe whether they subsequently developed AD.
A total of 1776 subjects were included in the case group while 7104 subjects were in the control group. After the follow-up period, 59 patients (3.3%) with depression developed AD while 96 patients (1.4%) without depression developed AD. The Kaplan–Meier curves showed that the incidence rate of AD in both groups varied significantly depending on different health statuses (log-rank P < .001). Results of the generalized estimating equation model found that patients with depression (hazard ratio [HR] = 1.898; 95% confidence interval [CI] = 1.451–2.438), very severe health status (HR = 1.630; 95% CI = 1.220–2.177), or artery diseases (HR = 1.692; 95% CI = 1.108–2.584) were at a higher risk of developing AD than other groups.
The association between major depressive disorder and the later development of AD varied depending on the health statuses of elderly patients. Clinicians should exercise caution when diagnosing and treating underlying diseases in elderly depressed patients, and then attempt to improve their health status to reduce the incidence rate of subsequent AD development.
Congenital hepatic fibrosis with polycystic kidney disease
Authors: Jiang Chang , Zhou Qiang , Jin Meishan , Niu Junqi , Gao Yanhang 
Published: May 2019

Abstract

Introduction:
Congenital hepatic fibrosis (CHF) is a rare autosomal recessive disease derived from biliary dysgenesis secondary to ductal plate malformation and is often accompanied by renal cysts or increased renal echogenicity.

Patient concerns:
A 25-year-old woman was admitted to our hospital with splenomegaly and hepatic cirrhosis of a 3-month duration and fever accompanied by abdominal pain for 3 days. The second patient was a 25-year-old male referred to our hospital with hepatomegaly and splenomegaly of 6-year duration who had experienced fever for 3 months and abdominal distension for 1 week. Both 25-year-old patients were found to have CHF with polycystic kidney disease.

Diagnosis:
Radiological imaging, including computed tomography (CT), magnetic resonance imaging (MRI), and sonography, revealed hepatic fibrosis, portal hypertension, splenomegaly, ascites, bile duct malformation, polycystic kidneys, and CHF. For the first patient, a liver biopsy confirmed the pathological features of CHF, and genetic testing revealed three heterozygous missense mutations, which were classified as “undetermined” in the public Wilson's disease/ATP7B and ADPKD/PKD1 databases.

Interventions:
The first patient had undergone a splenectomy for anemia 2 months previously. Because there is no radical cure for CHF, and due to economic reasons, neither patient received liver transplantation. Therefore, we administered only anti-fibrotic supportive treatment for symptoms.

Outcomes:
Both patients were discharged after their symptoms improved, and both survived for 2 years of follow-up.

Conclusion:
These cases highlight the value of radiological imaging, pathological examination, and genetic evaluation for the diagnosis of CHF. When an individual with unexplained cirrhosis presents with bile duct dilation and malformation as well as polycystic kidneys, the possibility of CHF should be considered. For individuals found to have polycystic kidneys at a young age, the results of liver function tests and imaging examinations including Fibroscan imaging should be continuously and dynamically monitored to enable early diagnosis of CHF.
An uncommon case of herpetic esophagitis in a small child with allergic rhinitis
Authors: Mărginean Cristina Oana , Meliţ Lorena Elena , Mocan Simona , Mărginean Maria Oana , Mărginean Cristian Dan 
Published: May 2019

Abstract

Rationale:
Herpetic esophagitis (HE) is a common condition in immunosuppressed patients, but a rare entity in immunocompetent patients affecting especially male teenagers and young adults.

Patient concerns:
We report the case of a 5-year-old male patient, with a history of allergic rhinitis admitted in our clinic for acute onset fever refractory to antipyretics, chest pain, anorexia, refusal of solid food, accepting only small amounts of fluids, odynophagia, and epigastric pain. The clinical exam revealed severe malaise, pallor, decreased skin turgor, abdominal epigastric tenderness, heartburn at palpation within the epigastric area. The laboratory tests showed leukocytosis, monocytosis, hypoglycaemia, and elevated inflammatory biomarkers.

Diagnoses:
The serology tests for human immunodeficiency virus (HIV), cytomegalovirus (CMV), Epstein-Barr virus (EBV), and herpes simplex virus (HSV) were negative, except for immunoglobulin G (IgG) anti-EBV which was positive. The chest radiography was normal, and the abdominal ultrasound showed abdominal bloating. The upper digestive endoscopy revealed friable esophageal mucosa, with multiple ulceration on the entire esophagus, and whitish exudates especially on the middle and lower part of the esophagus suggesting a possible eosinophilic esophagitis or caused by Candida. Despite the empirical initiated treatment, the patient's evolution was only slowly favorable. The histological exam established the diagnosis of HE.

Interventions:
We initiated acyclovir therapy with an outstandingly favorable evolution.

Outcomes:
After 1 month, we detected the seroconversion of IgG anti-HSV. The patient's follow-up revealed no additional complaints.

Lessons:
Despite its rarity in immunocompetent individuals, HE must be taken into account even in otherwise healthy small children. Allergic conditions might represent a predisposing factor for HE.
Comparison of arthroscopic suture-bridge technique and double-row technique for treating rotator cuff tears
Authors: Ren Yi-Ming , Zhang Hong-Bin , Duan Yuan-Hui , Sun Yun-Bo , Yang Tao , Tian Meng-Qiang 
Published: May 2019

Abstract

Background:
Rotator cuff tear is a common shoulder disorder in the elderly. Either arthroscopic double-row (DR) or suture-bridge (SB) technique for rotator cuff tear patients is needed to choose. We conducted this systematic review and meta-analysis to compare the clinical outcomes of arthroscopic SB versus DR intervention.

Methods:
The 7 studies were acquired from PubMed, Medline, Embase, CNKI, Google, and Cochrane Library. The data were extracted by 2 of the co-authors independently and were analyzed by RevMan5.3. Mean differences (MDs), odds ratios (ORs), and 95% confidence intervals (CIs) were calculated. Cochrane Collaboration's Risk of Bias Tool and Newcastle–Ottawa scale were used to assess risk of bias.

Results:
Seven studies including 1 randomized controlled trial and 6 observational studies were assessed. The methodological quality of the trials ranged from low to moderate. The pooled results of American Shoulder and Elbow Surgeons score, Constant score, visual analog scale score, and range of motion showed that the differences were not statistically significant between the 2 interventions. The difference of University of California at Los Angeles (UCLA) score was statistically significant between SB and DR intervention, and SB treatment was more effective (MD = −0.95, 95% CI = −1.70 to −0.20, P = .01). The difference of re-tear rate was statistically significant and SB treatment achieved better result than DR treatment (OR = 0.31, 95% CI = 0.15–0.64, P = .001). Sensitivity analysis proved the stability of the pooled results and the publication bias was not apparent.

Conclusions:
Both arthroscopic SB and DR interventions had benefits in rotator cuff tear. SB treatment was more effective in UCLA score and had lower re-tear rate than DR treatment. The arthroscopic SB technique is recommended as the optical choice for rotator cuff tear.
Exploring the survival prognosis of lung adenocarcinoma based on the cancer genome atlas database using artificial neural network
Authors: Jiang Na , Xu Xianrong 
Published: May 2019

Abstract
The aim of this study was to investigate the clinical factors affecting the survival prognosis of lung adenocarcinoma, and to establish a predictive model of survival prognosis of lung adenocarcinoma by artificial neural network.
Download the cancer genome atlas (TCGA) database for lung adenocarcinoma research data, perform cox regression analysis and descriptive statistics on the obtained clinical data, draw the survival curve by Kaplan–Meier method, select the independent variables that are statistically significant for constructing the artificial neural networks (ANN) model, and establish artificial neural network model.
The number of valid cases included in the study was 524, including 280 men and 244 women, with an age range of 33 to 88 years, mean age 66.87 years, and median progression-free survival (PFS) was 37.7 months. The median overall survival time (OS) was 41.1 months. Cox multivariate analysis showed that smoking history, tumor stage, and surgical margin resection status were independently associated with PFS, and tumor stage and surgical margin resection status were independently associated with OS. The accuracy of the established ANN model itself was predicted to be 65.8%. The accuracy of correctly predicting the prognosis of the predicted samples was 75.0%, and the area under the receiver operating characteristic curve was 0.712.
The clinical prognostic factors of lung adenocarcinoma include: smoking history, tumor stage, and surgical margin resection status. The established ANN model can be used to predict the prognosis of lung adenocarcinoma.
Template matching for benchmarking hospital performance in the veterans affairs healthcare system
Authors: Vincent Brenda M. , Wiitala Wyndy L. , Luginbill Kaitlyn A. , Molling Daniel J. , Hofer Timothy P. , Ryan Andrew M. , Prescott Hallie C. 
Published: May 2019

Abstract
Comparing hospital performance in a health system is traditionally done with multilevel regression models that adjust for differences in hospitals’ patient case-mix. In contrast, “template matching” compares outcomes of similar patients at different hospitals but has been used only in limited patient settings.
Our objective was to test a basic template matching approach in the nationwide Veterans Affairs healthcare system (VA), compared with a more standard regression approach.
We performed various simulations using observational data from VA electronic health records whereby we randomly assigned patients to “pseudo hospitals,” eliminating true hospital level effects. We randomly selected a representative template of 240 patients and matched 240 patients on demographic and physiological factors from each pseudo hospital to the template. We varied hospital performance for different simulations such that some pseudo hospitals negatively impacted patient mortality.
Electronic health record data of 460,213 hospitalizations at 111 VA hospitals across the United States in 2015.
We assessed 30-day mortality at each pseudo hospital and identified lowest quintile hospitals by template matching and regression. The regression model adjusted for predicted 30-day mortality (as a measure of illness severity).
Regression identified the lowest quintile hospitals with 100% accuracy compared with 80.3% to 82.0% for template matching when systematic differences in 30-day mortality existed.
The current standard practice of risk-adjusted regression incorporating patient-level illness severity was better able to identify lower-performing hospitals than the simplistic template matching algorithm.
First successful combination of extracorporeal membrane oxygenation (ECMO) with video-assisted thoracic surgery (VATS) of pulmonary bullae resection in the management of refractory pneumothorax in a critically ill patient with H7N9 pneumonia and acute respiratory distress syndrome
Authors: Huang Jinbao , Li Hongyan , Chen Shuxing , Lan Changqing , Lin Qinghua , Weng Heng 
Published: May 2019

AbstractRationale:At present, data regarding refractory pneumothorax treated with video-assisted thoracic surgery (VATS) in combination with extracorporeal membrane oxygenation (ECMO) in critically ill patients with H7N9 pneumonia have never been reported.Patient concerns:A laboratory-confirmed case of human infection with avian influenza A (H7N9) virus was treated in our hospital. Acute respiratory distress syndrome (ARDS) developed and the patient was oxygenated via veno-venous ECMO due to the failure of mechanical ventilation. Unfortunately, a right refractory pneumothorax occurred. Despite treatment with pleural drainage and select bronchial occlusion, the patient still failed to improve.Diagnosis:Fatal H7N9 pneumonia complicated with severe ARDS, pulmonary bullae, and refractory pneumothorax.Interventions:Successful combination of ECMO with VATS of pulmonary bullae resection was performed and pneumothorax was cured.Outcomes:One week after the operation, ECMO was removed. However, the patient finally developed multiorgan failure (MOF) complicated by refractory hypoxemia due to progressive lung fibrosis and died 36 days after admission.Lessons:Although the patient died of MOF triggered by severe lung fibrosis at last, the successful treatment of refractory pneumothorax by combination of ECMO with VATS is encouraging. Thus, when refractory pneumothorax in a patient with severe pulmonary dysfunction fails to improve through routine therapy, the treatment of pneumothorax by VATS based on ECMO support can be considered as a feasible selection.
Extensive intravesical benign hyperplasia induced by an extravesical migrated intrauterine device
Authors: Zhang Peng , Wang Ting , Yang Lu 
Published: May 2019

Abstract

Rationale:
Intravesical migrated intrauterine devices (IUDs) have been reported to cause bladder perforation, stone formation, or malignant transition. However, such extensive intravesical benign hyperplasia caused by an extravesical migrated IUD is firstly reported.

Patient concerns:
A 38-year-old woman suffered from recurrent urinary urgency and dysuria and without macroscopic hematuria for about 1 month.

Diagnoses:
Urinary ultrasound and abdominal contrast-enhanced computed tomography (CT) revealed thickening of the bladder walls. Diagnostic transurethral resection and pathology initially misdiagnosed the intravesical lesions as non-invasive urothelial carcinoma. Further diagnostic and therapeutic transurethral resections and pathology confirmed the intravesical lesions to be extensive benign hyperplasia, which was extremely likely caused by the extravesical migrated IUD.

Interventions:
The intravesical lesions received therapeutic transurethral resections. Then the migrated IUD was removed by open surgery.

Outcomes:
After above treatments, the patient's lower urinary tract symptoms gradually disappeared. No recurrent lesion was found in the bladder through CT 3 months later.

Lessons:
Even an extravesical migrated IUD could silently cause extensive intravesical lesions. Whether symptomatic or not, any migrated IUD including extravesical and intravesical ones should be treated seriously, if possible, removed as soon as possible.
Efficacy of Xianling Gubao capsule in treating sarco-osteopenia
Authors: Chen Qunqun , Zeng Junxiang , Chen Yi , Yang Yalan , Zhang Tian , Luo Tao , Huang Hongxing 
Published: May 2019

Abstract

Background:
Sarco-osteopenia (SOP) is a new type of geriatric syndrome, resulting from the combination of sarcopenia (SP) and osteoporosis (OP). Xianling Gubao capsule (XLGBC), made from several traditional Chinese medicine, is reported to have a therapeutic effect on diseases of bones and joints. This protocol will be designed to assess the efficacy of XLGBC in the treatment of SOP.

Methods:
Relevant randomized controlled trial literatures evaluating the effect of XLGBC on patients with SOP will be obtained by searching the following 7 electronic databases: Cochrane Library, PubMed, Embase, Chinese National Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP), Chinese Biomedical and Medical Database (CBM), and Wanfang Database, from inception to March 2019. The primary outcomes will be bone mineral density, skeletal muscle mass index, handgrip strength, and gait speed. Stata V.13.0 software will be used for data synthesis and analysis, sensitivity analysis, subgroup analysis, and risk of bias assessment. Reporting bias will be evaluated utilizing a funnel, with Egger tests assessing funnel plot symmetries. Quality of evidence will be evaluated according to guidance of the Recommendations Assessment, Development, and Evaluation guideline.

Result:
This study will provide a rational synthesis of current evidences for XLGBC on SOP.

Conclusion:
The conclusion of this study will provide evidence to judge the effectiveness and safety of XLGBC on SOP.

Ethics and dissemination:
This systematic review will be contributed to peer-reviewed publications, aiming to provide evidence about efficacy of XLGBC on SOP.

Trial registration number:
CRD42019128223.