bluuebunny/crossref_metadata_2025_split huggingface dataset:
A comparison of surgical outcomes between robot and laparoscopy-assisted adenomyomectomy
Authors: Shim Jung In , Jo Eun-hye , Kim Miseon , Kim Mi Kyoung , Kim Mi-La , Yun Bo Seoung , Seong Seok Ju , Jung Yong Wook 
Published: May 2019

Abstract
We aimed to investigate the feasibility of robotic adenomyomectomy and compared surgical outcomes between laparoscopic and robotic approaches for adenomyomectomy.
We retrospectively reviewed the data of women who were diagnosed with adenomyosis and underwent adenomyomectomy through a minimally invasive approach between January 2014 and March 2018 at the CHA Gangnam Medical Center, Seoul, Republic of Korea. Patient demographics and operation-related outcomes were compared between the robotic and laparoscopic surgery groups.
We evaluated 43 women who underwent adenomyomectomy through a minimally invasive approach (21 underwent a laparoscopic and 22 underwent a robotic adenomyomectomy). All 22 women who had originally been scheduled to undergo robotic adenomyomectomy could successfully undergo the robotic surgery without requiring conversion to laparotomy and/or serious complications. No statistically significant differences in patient demographics were observed between the robotic and the laparoscopic surgery groups. No significant intergroup difference was observed in the operative time, estimated blood loss, weight of the resected nodule, and length of hospitalization (160.0 vs 212.5 min, P = .106; 500.0 vs 300.0 mL, P = .309; 60.0 vs 70.0 g, P = .932; and 5.0 vs 6.0 days, P = .277). No serious perioperative complications were observed in either group.
Robotic adenomyomectomy is feasible for women with adenomyosis. Surgical outcomes of robotic adenomyomectomy were comparable to those of a laparoscopic approach. There was, however, no superiority of robotic adenomyomectomy in terms of surgical outcomes. Further multicenter prospective studies using standardized surgical procedures are needed to confirm the conclusion of this study.
Association between rs20417 polymorphism in cyclooxygenase-2 and gastric cancer susceptibility
Authors: Chen Shimin , Chen Lu , Tan Yuling , Wang Jiehong 
Published: May 2019

Abstract

Objective:
Previous studies have reported an association between cyclooxygenase-2 (COX-2) polymorphism and gastric cancer (GC) susceptibility, but their results are controversial. This meta-analysis was intended to evaluate the relationship between the COX-2 rs20417 polymorphism and GC susceptibility in different ethnic groups.

Methods:
We searched PubMed, EMBASE, Web of Knowledge, and the Chinese Biomedical Database (CBM) for relevant case-control studies published up to October 6, 2018, which reported an association between the COX-2 rs20417 polymorphism and gastric cancer risk. Odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the strength of this association.

Results:
15 papers detailing case-control studies were included in the analysis, which included a total of 2848 GC cases and 4962 healthy controls. The meta-analysis results indicated that the COX-2 rs20417 polymorphism was associated with increased GC susceptibility under allele (G vs C: OR = 1.67, 95%CI = 1.19–2.35, P = .003), heterozygous (GG vs CG: OR = 1.44, 95%CI = 1.03–2.02, P = .034), dominant (GC+CC vs GG: OR = 1.66, 95%CI = 1.18–2.34, P = .004), homozygous (GG vs CC:OR = 2.20, 95%CI = 1.07–4.54, P = .033), and recessive models (CC vs GG+CG:OR = 2.05, 95%CI = 1.09–3.85, P = .025). An analysis of ethnic subgroups revealed that the COX-2 rs20417 polymorphism was significantly associated with GC susceptibility in Asians under all 5 models (G vs C: OR = 2.22, 95%CI = 1.66–2.96, P < .001; GG vs CC: OR = 4.29, 95%CI = 1.94–9.50, P < .001; GG vs CG: OR = 1.86, 95%CI = 1.34–2.58, P < .001; CC vs GG+CG: OR = 3.73, 95%CI = 1.92–7.24, P < .001; GC+CC vs GG: OR = 2.20, 95%CI = 1.65–2.93, P < .001). Helicobacter pylori positive patients suffered a high risk of GC, compared to H pylori negative patients under the dominant model (OR = 3.09, 95%CI = 1.80–5.32, P < .001).

Conclusion:
This meta-analysis of 15 case-control studies provides strong evidence that the COX-2 rs20417 polymorphism increases the risk of GC susceptibility in general populations, especially in Asians. Helicobacter pylori positive patients and those with the COX-2 rs20417 polymorphism had a higher risk of developing GC.
Glomerulonephritis triggered by chronical aortic graft infection in a male with Loeys–Dietz syndrome
Authors: Zhou Xu-jie , Liu Li-jun , He Pei-xin , Zhou Fu-de 
Published: May 2019

Abstract

Rationale:
Glomerulonephritis triggered by a chronically infected graft is increasingly identified because of widely used implanted device. Removal of the aortic graft and sustained antibiotic therapy is the usual approach to maximize the chance of renal recovery, but as this case shows graft removal is not always possible.

Patient concerns:
A 35-year-old man with intractable and recurrent fever had acute renal failure in sustained antibiotic therapy.

Diagnoses:
Renal biopsy suggested crescentic glomerulonephritis. 18fluorodeoxyglucose/positron emission tomography–computed tomography showed increased metabolic activity at the site of aortic graft, reminding that chronic infection of an implanted graft can lead to severe glomerulonephritis. TGFBR2 c.1133G>T mutation was observed in mutation analysis, which was reported to be associated with Loeys–Dietz syndrome.

Interventions:
Although infection was properly controlled with appropriate antimicrobial treatment, his renal dysfunction did not improve. A short-term inclusion of low-dose corticosteroid significantly benefit without introducing harm.

Outcomes:
He partly recovered from renal injury.

Lessons:
In patients with glomerulonephritis triggered by a long-duration infection, low-dose corticosteroid therapy may be considered when renal dysfunction secondary to nephritis does not improve after appropriate antimicrobial treatment.
Effect of different doses of intravenous oxycodone and fentanyl on intubation-related hemodynamic responses
Authors: Koh Gi-Ho , Jung Ki Tae , So Keum Young , Seo Jong Sik , Kim Sang Hun 
Published: May 2019

Abstract

Background:
Intubation using direct laryngoscopy is a risky and painful procedure that is associated with undesirable hemodynamic changes such as tachycardia, hypertension, and arrhythmia. Recently, intravenous oxycodone was introduced and used for the control of acute postoperative pain and to attenuate intubation-related hemodynamic responses (IRHRs), but there is insufficient information regarding its proper dosage. We investigated the attenuating effects of different doses of oxycodone and fentanyl on IRHRs.

Methods:
For calculating oxycodone effective dose (ED95), which attenuated all IRHR changes to less than 20% over baseline values in 95% of male patients at 1 minute after intubation, oxycodone 0.1 mg/kg was injected for the first patient 1 hour before intubation, and the next dose for each subsequent patient was determined by the response of the previous patient using Dixon up-and-down method with an interval of 0.01 mg/kg. After obtaining the predictive oxycodone ED95, 148 patients were randomly allocated to groups receiving normal saline (group C), oxycodone ED95 (group O1), oxycodone 2 × ED95 (group O2), or fentanyl 2 μg/kg (group F). We recorded the incidence of “success” as a less than 20% change from baseline values in all IRHRs 1 minute after intubation.

Results:
The predictive oxycodone ED95 was 0.091 (0.081–0.149) mg/kg. The incidence of “success” was highest in group O2 (75.7%), followed by group O1 (62.2%) and group F (45.9%) with significant differences between the groups (P < .001). The systolic, diastolic, mean arterial pressure, and heart rate were not significantly different among groups after administration of either oxycodone or fentanyl. The percentage hemodynamic changes of the group O2 were significantly lower than those of groups F and O1, but the absolute percentage hemodynamic changes were not significantly different among groups F, O1, and O2. The recalculated oxycodone ED95 with probit analysis (0.269 mg/kg) was needed to prevent any arterial pressure and heart rate changes.

Conclusions:
Oxycodone 0.182 mg/kg is more effective in attenuating all IRHRs than fentanyl 2 μg/kg with safe hemodynamic changes. Further research is required to determine if the recalculated oxycodone ED95 (0.269 mg/kg) is also effective and hemodynamically safe for preventing all IRHRs.
Older menarche age and short reproductive period linked to chronic kidney disease risk
Authors: Noh Ji Hyun , Koo Hoseok 
Published: May 2019

Abstract
This study aimed to investigate the association between reproductive period and menarche age and chronic kidney disease (CKD) in South Korean postmenopausal women.
This was a cross-sectional study of the data for 8510 postmenopausal women using the results of Korean National Health and Nutrition Examination Surveys over the past 6 years.
Of the total 8510 postmenopausal women, 790 (10.23%) were CKD patients. The menarche age in the CKD group was 16.2 ± 1.9 years old, which was higher than that in the non-CKD group (P < .001). The reproductive period of the CKD group was 32.4 ± 5.7 years, which was shorter than 33.3 ± 5.4 years in the non-CKD group (P < .001). The prevalence of CKD was 4.7% at a menarche age of 11 years or younger, which increased with increasing of menarche age, reaching 9.9% at menarche age of 16 years or older. According to the length of the reproductive period, the prevalence of CKD was 13.9% for the group less than 20 years of period and decreased significantly with increasing length of reproductive period. The prevalence of proteinuria was 7.2% in women with reproductive period of less than 20 years and significantly less in women with a reproductive period longer than 45 years (2.3%). The prevalence of CKD and proteinuria increased with increasing of menarche age, and the prevalence of CKD and proteinuria decreased with increasing of reproductive period.
The results suggest that CKD was associated with older menarche age and a short reproductive period. Management of life patterns and medical problems in women with old age at menarche and a short reproductive period should be considered.
The necessity of routine postoperative laboratory tests in enhanced recovery after surgery for primary hip and knee arthroplasty
Authors: Wu Xiang-Dong , Xiao Peng-Cheng , Zhu Zheng-Lin , Liu Jia-Cheng , Li Yu-Jian , Huang Wei 
Published: May 2019

Abstract

Introduction:
Over the last few decades, the concepts of minimally invasive surgery and enhanced recovery after surgery (ERAS) protocols have been introduced into the field of total joint arthroplasty (TJA), and tranexamic acid (TXA) has been widely used in TJA. Modern-day surgical techniques and perioperative care pathways of TJA have experienced unexpected improvements. Recently, the necessity of the practice of ordering routine postoperative laboratory tests for patients undergoing primary TJA has been challenged, especially in the context of implementation of ERAS protocols in TJA. These studies have consistently suggested that routine postoperative laboratory tests are not necessary in modern-day primary, unilateral total hip arthroplasty (THA) or total knee arthroplasty (TKA), and laboratory tests after surgery should only be obtained for patients with risk factors. However, it remains unclear whether routine postoperative laboratory tests after THA and TKA remains justified in the Chinese patient population. Therefore, we developed this study to address this issue.

Methods and analysis:
This retrospective cohort study will include adult patients who underwent primary unilateral THA or TKA and received multimodal perioperative care pathways according to ERAS protocols. The following patient data will be collected from the electronic medical record system: patients’ demographics, preoperative and postoperative laboratory values, operation time, intraoperative blood loss, TXA use, tourniquet use, postoperative length of stay, and any medical intervention directly related to abnormal laboratory values. The main study outcomes are the incidence of acute anemia requiring transfusion and incidence of hypoalbuminemia requiring albumin supplementation. The secondary outcomes are the rates of acute kidney injury, incidence of abnormal serum sodium level, incidence of abnormal serum potassium level, and incidence of abnormal serum calcium level. These clinical data will be analyzed to determine the incidence of abnormal postoperative laboratory values following primary unilateral THA and TKA; to clarify the frequency of any medical intervention directly related to abnormal postoperative laboratory values; and to identify risk factors that predispose patients to have abnormal postoperative laboratory results.

Study registration:
Chinese Clinical Trial Registry (http://www.chictr.org.cn): ChiCTR1900020690.
Retrospective observational analysis of hospital discharge database to characterize primary pulmonary hypertension and its outcomes in Spain from 2004 to 2015
Authors: de-Miguel-Díez Javier , Lopez-de-Andres Ana , Hernandez-Barrera Valentin , Jimenez-Trujillo Isabel , Mendez-Bailon Manuel , de Miguel-Yanes Jose M. , Muñoz-Rivas Nuria , Romero-Maroto Martin , Jimenez-Garcia Rodrigo 
Published: May 2019

Abstract
To examine trends in the incidence, characteristics and outcomes, and to identify factors associated with in-hospital mortality (IHM) of patients hospitalized for primary pulmonary hypertension (PPH) in Spain (2004–2015).
We included all patients hospitalized with PPH and included in the Spanish National Hospital Discharge Database.
We analyzed 46,883 discharges of patients (7.14% with PPH as their primary diagnosis). Incidence rates decreased from 6.15 cases per 100,000 inhabitants in 2004–06 to 3.40 in 2013–15 (P < .001). Mean age rose from 66.43 ± 21.28 to 69.73 ± 21.12 years (P < .001) and the proportion of females increased over the study period (58.44% vs 60.71%; P < .001). Comorbidity using the Charlson Comorbidity Index (CCI) also increased with 16.07% having CCI ≥3 in 2004–06 vs 21.795 in 2013–15. Median length of hospital stay (LOHS) was 1 day longer in period 2004–06, than in 2013–15 (9 vs 8 days; P < .001). The proportion of patients who were considered a readmission and the mean costs increased from 15.7% and 3712.46€ in the first period to 17.14% and 4040.28€ in 2013–15 (P < .001). IHM increased from 8.2% in 2004–06 to 9.93% in 2013–15 (P < .001). The predictors’ of IHM among PPH patients included comorbidity and use of mechanical ventilation. Primary diagnosis of PPH did not predict higher IHM (OR 1.07; 95%CI 09–1.26).
Our data indicates that the incidence of hospitalizations decreased in Spain between 2004 and 2015. Parallel, LOHS also decreased during this period. By contrast, comorbidity increased over time in PPH patients, as well as readmission rates, costs and IHM.
Intracranial Rosai-Dorfman disease with the petroclival and parasellar involvement mimicking multiple meningiomas
Authors: Wang Chao , Kuang Pingding , Xu Fangfang , Hu Ling 
Published: May 2019

Abstract

Rationale:
Rosai-Dorfman disease (RDD) is a rare non-Langerhans cell histiocytosis. Petroclival RDD is extremely rare. To the best of our knowledge, only 7 cases of petroclival RDD have been reported so far. Herein, we present the 8th case of intracranial RDD with the petroclival and parasellar involvement mimicking multiple meningiomas.

Patient concerns:
A 57-year-old woman presented with a 1-year history of vision diminution and 1-month hearing loss in her right ear.

Diagnoses:
Contrast-enhanced Magnetic resonance imaging (MRI) of the brain demonstrated multiple well-defined, homogenous mass which closely related to the dura mater in the bilateral parasellar and petroclival regions range from the basement of anterior to posterior cranial fossa. The lesions were T1 isointense, T2 hypointense, and homogeneously enhanced. Initial diagnosis of multiple meningiomas was made according to MRI findings. Final diagnosis of RDD was confirmed by histopathological and immunohistochemical examinations after subtotal surgical resection.

Interventions:
The patient received subtotal resection because multiple lesions were extensive.

Outcomes:
The vision diminution recovered well after the surgery but the hearing loss in her right ear was still persisted.

Lessons:
Although rare, a standard RDD typically are dural-based, extra-axial, well-circumscribed masses mimicking meningioma, and presenting with characterized hypo to isointense on T1-weighted images, hypo to isointense on T2-weighted images, and obvious enhancement. Resection of the intracranial lesion is the most effective treatment. In case of subtotal resection, the application of adjunctive radiotherapy and/or steroid agents should be advised. Final diagnosis of RDD should be confirmed by histopathological and immunohistochemical examinations.
p53 involvement in clonal hematopoiesis of indeterminate potential
Authors: Chen Sisi , Liu Yan 
Published: May 2019

Purpose of review
Clonal hematopoiesis of indeterminate potential (CHIP) increases with age and occurs when a single mutant hematopoietic stem cell (HSC) contributes to a significant clonal proportion of mature blood lineages. Somatic mutations in the TP53 gene, which encodes the tumor suppressor protein p53, rank in the top five among genes that were mutated in CHIP. This review focuses on mechanisms by which mutant p53 promotes CHIP progression and drives the pathogenesis of hematological malignancies, including myelodysplastic syndromes, and acute myeloid leukemia.

Recent findings

TP53 was frequently mutated in individuals with CHIP. Although clinical studies suggest that expansion of HSCs with TP53 mutations predisposes the elderly to hematological neoplasms, there is a significant gap in knowledge regarding the mechanisms by which TP53 mutations promote HSC expansion. Recent findings suggest that several cellular stressors, including hematopoietic transplantation, genotoxic stress, and inflammation, promote the expansion of HSCs with TP53 mutations. Further, TP53 mutations identified in CHIP cooperate with genetic and/or epigenetic changes in leukemogenesis.

Summary

TP53 mutations identified in CHIP are associated with increased risks of de novo and therapy-related hematological neoplasms. Thus, targeting mutant p53 and related pathways holds great potential in preventing CHIP progression and treating hematological malignancies.
Growing old in the age of heterogeneity: the perils of shifting clonality
Authors: Gustafsson Karin , Scadden David T. 
Published: May 2019

Purpose of review
Hematopoietic stem cells (HSC) are functionally heterogeneous in a clone-specific manner. The complexity of that heterogeneous mix of cells is progressively lost with age as a myeloid-dominant hematopoietic system is established. Yet, the function of this diversity, as well as the consequences of its loss, remains unknown. This review will bring together recent advances in HSC diversity and novel insights into myeloid heterogeneity and specification in order to bring focus on how this may affect the ageing individual.

Recent findings
The ageing haematopoietic system is dominated by a low number of active HSC clones that produce an excess of myeloid cells. In addition, individual myeloid progenitors and their mature progeny are proving to be more functionally restricted than previously recognized. The presence or absence of a particular type of myeloid cell can greatly affect the outcome of various pathological processes.

Summary
Myeloid cells are important drivers of many ageing-associated diseases. The loss of HSC heterogeneity, with a possible concomitant restriction of myeloid cell diversity, could significantly impact health during ageing.
Rural health, telemedicine and access for pediatric surgery
Authors: Kohler Jonathan E. , Falcone Richard A. , Fallat Mary E. 
Published: May 2019

Purpose of review
Access to care for children requiring pediatric general or specialty surgery or trauma care who live in rural areas remains a challenge in the United States.

Recent findings
The expertise of specialists in tertiary centers can be extended to rural and underserved areas using telemedicine. There are challenges to making these resources available that need to be methodically approached to facilitate appropriate relationships between hospitals and providers. Programs, such as the National Pediatric Readiness Project and the HRSA Emergency Medical Services for Children Program enhance the capability of the emergency care system to function optimally, keep children at the home hospital if resources are available, facilitate transfer of patients and relationship building, and develop necessary transfer protocols and guidelines between hospitals.

Summary
Telehealth services have the potential to enhance the reach of tertiary care for children in rural and underserved areas where surgical and trauma specialty care is not readily available, particularly when used to augment the objectives of national programs.
Progress in Pharmacological and Surgical Management of Tourette Syndrome and Other Chronic Tic Disorders
Authors: Pandey Sanjay , Dash Deepa 
Published: May 2019

Background:
Tourette syndrome (TS) and other chronic tic disorders are clinically heterogenous and cause physical discomfort, social difficulties, and emotional distress. In addition to tics, TS patients have a variety of behavioral comorbidities, including obsessive-compulsive disorders and attention-deficit hyperactivity disorders. TS treatment is multidisciplinary, involving behavioral therapy, oral medications, and botulinum toxin injections.

Methods:
Relevant studies on pharmacological and surgical treatment options for TS and other chronic tic disorders, their limitations and current recommendations were reviewed using the PubMed search till April 2, 2018. Besides, the reference lists of the retrieved publications were manually searched to explore other relevant studies. This review aims to discuss the progress in pharmacological and surgical treatment options for TS and other chronic tic disorders.

Results and Conclusions:
Both typical and atypical antipsychotic agents are mainstays of pharmacological treatment of TS and other chronic tic disorder patients; however, their use is limited by serious side effects considering their potential of dopamine blockade. Because of the phenotypic variability, no medication has proven effective for all persons with TS and other chronic tic disorders. Botulinum toxin has emerged as a good therapeutic option, especially for focal and dystonic tics. But, their uses are limited by lack of sufficient evidence and high cost. Surgical treatment is considered in medically refractory and severely disabled tics patients. Deep brain stimulation has replaced lesional surgeries; however, there is uncertainty regarding the selection of patients and target of stimulation.