bluuebunny/crossref_metadata_2025_split huggingface dataset:
Proposal of a new exercise protocol for idiopathic scoliosis
Authors: Ko Jin Young , Suh Jee Hyun , Kim Hayoung , Ryu Ju Seok 
Published: December 2018

Abstract
In clinical practice, we found a unilateral instability in patients with right thoracic scoliosis during asymmetric spinal stabilization exercise (ASSE), which can be an important clue to identify the pathophysiology of idiopathic scoliosis (IS).
We investigated the relationship between unilateral postural instability and weakness of paraspinal muscles according to curve pattern. And finally, we propose the new exercise method based on the curve pattern.
Combined use of prospective and retrospective clinical trials.
Fifteen participants without IS and 10 patients with IS in 1 tertiary referral hospital.
In 15 participants without IS, surface electromyography (sEMG) was used to evaluate the muscular activation patterns in the bilateral erector spinae (ES), rectus abdominis (RA), and external oblique (EO) muscles during ASSE. In addition, to assess the clinical effect of ASSE, Cobb angle and rotation grade were measured from 10 patients with IS.
The most significant findings from the sEMG data were the increased activities of ipsilateral 7th thoracic ES during hand-up motion, ipsilateral 3rd lumbar ES during leg-up motion, and 12th thoracic and 3rd lumbar ES during side-bridging. In a radiographic analysis, specific components of ASSE that activates the concave side muscles were found to be effective for IS.
The paraspinal muscle strengthening of the concave side using ASSE can improve the severity of scoliosis. Based on this research, we could propose a new exercise protocol that can be personalized according to the curve pattern.
An in silico analysis of human sperm genes associated with asthenozoospermia and its implication in male infertility
Authors: Liu Xue Xia , Cai Li , Liu Fu Jun 
Published: December 2018

Abstract
Asthenozoospermia is the most common clinical symptom of male infertility. Molecular markers associated with asthenozoospermia spermatozoa are scarcely identified. The objective of this study was to screen the differentially expressed genes (DEGs) in asthenozoospermia spermatozoa and assess the underlying bioinformatics roles in regulation of sperm quality.
Based on gene expression omnibus (GEO) database, the GSE22331, GSE1133, and GSE4193 expression profile data were downloaded. The DEGs of asthenozoospermia spermatozoa were identified. Germ cell specific genes in DEGs were further screened. Then, gene ontology (GO) and over-representation analysis of DEGs were performed, followed by protein–protein interaction (PPI) network analysis. Expressions of selected genes of TEX11, ADAMTS5, ASRGL1, GMCL1, PGK2, KLHL10 in normozoospermia and asthenozoospermia spermatozoa were identified using real time Reverse Transcription-Polymerase Chain Reaction (RT-PCR).
A total of 1323 DEGs were identified, including 1140 down-regulated genes. Twenty one and 96 down-regulated genes were especially expressed in spermatogonia and round spermatids, suggesting their testicular origins and influences on sperm quality. Bioinformatics analysis showed enriched functions of ubiquitin-like protein transferase or protein binding activities in down-regulated genes. Expressions of selected genes were validated by RT-PCR, which was consistent with bioinformatical results.
The present study provided a novel insight into the understanding of sperm quality, and a potential method and dataset for the diagnosis and assessment of sperm quality in the event of male infertility.
Comparative efficacy and safety of phosphodiesterase-5 inhibitors with selective serotonin reuptake inhibitors in men with premature ejaculation
Authors: Jin Kun , Deng Linghui , Qiu Shi , Tu Xiang , Li Jiakun , Bao Yige , Yang Lu , Wei Qiang 
Published: December 2018

Abstract

Background:
We performed the network meta-analysis (NMA) and systematic review involved all evidence from relevant trials to compare the efficiency and safety of various types of selective serotonin reuptake inhibitors (SSRI) and phosphodiesterase-5 inhibitors (PDE5i) in patients with premature ejaculation (PE).

Methods:
We conducted comprehensive searches of peer-reviewed and grey literature. PubMed, the Cochrane Library Central Register of Controlled Trials, Embase were searched for randomized controlled trials published up to June 1, 2017. The primary outcome was intravaginal ejaculation latency time (IVELT) and adverse effects (AEs). We performed pairwise meta-analyses by random effects model and network meta-analysis by Bayesian model. We used the GRADE framework to assess the quality of evidence contributing to each network estimate.

Results:
Of 3046 titles and abstracts initially identified, 17 trials reporting 5739 participants were included. Considering IVELT in the NMA, paroxetine plus sildenafil and sildenafil alone are both superior to placebo (MD: 1.75, 95% CrI: 0.05 to 3.78; MD 1.43, 95% CrI 0.003 to 2.81). Sildenafil is superior to sertraline (MD: 1.63, 95% CrI: 0.10 to 2.79). Considering AEs, placebo demonstrated obviously lower risk comparing to paroxetine, sildenafil and paroxetine plus sildenafil (OR 0.20, 95% CI: 0.05 to 0.52; OR 0.23, 95% CI: 0.04 to 0.80; OR 0.45, 95% CI: 0.01 to 0.92). Compared with tadalafil plus paroxetine, dapoxetine showed significantly less AEs (OR 0.23, 95% CI 0.02 to 0.96).

Conclusions:
Our study concluded that although paroxetine plus sildenafil and sildenafil alone both demonstrated significant IVELT benefit compared with placebo, significant increase of AEs risk was also observed. Furthermore, sildenafil alone was superior to sertraline in efficacy with comparable tolerability.
Complete clinical and functional recovery following low-dose methotrexate related paraparesis in a patient with compound c.1298A>C AND c.677C>T MTHFR polymorphism
Authors: Saviola Gianantonio , Abdi-Ali Lul , Sacco Silvano , Comini Laura , Plewnia Katrin , Rossi Maja , Orrico Alfredo 
Published: December 2018

Abstract

Rationale:
The mechanisms of action of MTX (methotrexate) in the treatment of RA (rheumatoid arthritis) and PsA (psoriatic arthritis) is related to its antifolic activity, due to the high affinity for enzymes that require folate cofactors as dihydrofolate reductase and to the anti-inflammatory activity derivated from the inhibition of thymidylate synthetase that leads to the over-production of adenosine.

Patient concerns:
Our patient was a 41-year-old female, affected by PsA in treatment since 2 years with low-dose methylprednisolone and low-dose subcutaneous MTX. The treatment was effective. The patient subacutely developed a severe paraparesis with impossibility of gait or standing without aid and was admitted to a Neurology Department where the cause of the paraparesis was not clear in spite of accurate radiological neurophysiologic and laboratory tests. Therefore, she was admitted in a rehabilitation unit.

Diagnosis and interventions:
Paraparesis in PsA patient in treatment with methotrexate. MTX toxicity was hypothesized; therefore the drug was discontinued while i.m. folic acid and cyanocobalamin were administered for 20 days. The diagnosis was clinical, based on neurological examination (paraparesis) and on the chronic use of MTX (hypothesis of toxicity).

Outcomes:
The patient obtained a complete resolution of paraparesis. Genetic analyses showed associated a compound heterozygosity for the c.1298A>C and c.677C>T variants of methylenetetrahydrofolate reductase (MTHFR) gene.

Lessons:
Neurological side effects of MTX are uncommon. In literature no previous case of MTX induced paraparesis in patients treated with low-dose MTX for chronic arthritis has been described. The association between the gene polymorphisms of MTHFR (c.1298A>C and c.677C>T) and MTX toxicity in arthritis patients is confirmed. The case also confirms that folates are a precious antidote of MTX toxicity.
Case report of dysregulation of primary bile acid synthesis in a family with X-linked adrenoleukodystrophy
Authors: Płatek Teresa , Orso Evelyn , Zapała Barbara , Polus Anna , Kieć-Wilk Beata , Piwowar Monika , Chojnacka Monika , Ciałowicz Urszula , Malczewska-Malec Małgorzata , Schmitz Gerd , Solnica Bogdan , Dembińska-Kieć Aldona 
Published: December 2018

AbstractRationale:X-linked adrenoleukodystrophy (X-ALD) is a rare disorder caused by mutations in theABCD1gene, coding for peroxisomal membrane transporter adrenoleukodystrophy (ALD) protein. The disease is characterized by accumulation of very long chain fatty acids (VLCFAs) in tissues. Adult adrenomyeloneuropathy (AMN) and the cerebral inflammatory form of ALD are the main phenotypes presenting various symptoms.Patient concerns:We report a case of 37-year-old patient with diagnosis of X-ALD, confirmed based on elevated VLCFA concentrations and genetic testing ofABCD1gene. The complete clinical picture in the patient indicates AMN phenotype with cerebral involvement.Diagnoses:The reduced synthesis of unconjugated cholic and chenodeoxycholic acids, and the reduction to 28% to 29% of peroxisomal beta-oxidation of behenic acid and normal peroxisomal metabolism of pristanic and palmitic acid were observed in the X-ALD patient. Sanger sequencing of major genes involved in primary bile acid (BA) synthesis failed to identify pathogenic mutations of the investigated set of genes.Interventions:Plasma concentrations of BAs, VLCFAs, and beta-oxidation of C22:0, C16:0, and pristanic acid were studied in primary skin fibroblasts of the patient. In addition, we performed sequencing of theABCD1,ABCD3,CYP7A1,CYP7B1,CYP27A1,HSD3B7, AKR1D1, andSLC27A5genes in the X-ALD family.Outcomes:In the Polish family affected with AMN a dysregulation of the primary BA synthesis pathway was found.Lessons:We have demonstrated the coincidence of the adult form of X-ALD with abnormalities in BA synthesis. We suggest that decreased synthesis of BAs may be an additional dysfunction as a consequence of theABCD1c.659T>C, p.(Leu220Pro) mutation and may be further evidence that disturbed cholesterol metabolism is important in the pathology of ALD.
Relationship between mortality in people with mental disorders and suicide mortality in China during 2000 to 2014
Authors: Liang Yundan , Yang Mengchang , Zhao Gaofeng , Mao Yuanyi , Zhang Lushun , Hu Zeqing 
Published: December 2018

Abstract
Suicide is one of the top 10 causes of death in many countries. Although there are many studies on mental disorders, few studies have examined mortality in suicide population and mentally ill population. This study examined the association between mortality and mental disorders using data on suicides and mental disorders in China. Data from China's Health and Family Planning Statistical Yearbook for 2000 to 2014 were used to analyze the relationship between mortality associated with suicide and mental disorders. The analyses found that mortality among people with mental disorders dropped from 5.42/10 million in 2000 to 2.68/10 million in 2014, decreased more among females than males, and differed between urban and rural areas; that suicide mortality dropped from 10.79/10 million in 2000 to 6.79/10 million in 2014; the decrease was greater in women than in men, with suicide being highest among male residents of cities; and no significant correlation was found between mortality among persons with mental disorders and suicide mortality. There was no correlation between suicide mortality and mental-disorder mortality during 2000 to 2014; however, overall mortality decreased more among females than males during this period.
The relationship between job satisfaction, burnout syndrome and depressive symptoms
Authors: Oliveira Alan Maicon de , Silva Marcus Tolentino , Galvão Taís Freire , Lopes Luciane Cruz 
Published: December 2018

Abstract
Research shows an instability in the way workers in the healthcare field live, and a prevalence of an unhealthy lifestyle. Exhaustion, an overload of obligations and responsibilities and dissatisfaction are all factors that may result in both physical and mental disorders. The aim of our study is to analyze the association between individual and occupational aspects of hospital workers and their job satisfaction, burnout syndrome, and depressive symptoms, as well as the relationship between these 3 factors.
A transversal study was carried out from August to November 2016 in a teaching hospital that is a reference in healthcare to 13 cities in the State of São Paulo, Brazil. Workers with an employment relationship of a period of 3 months or longer were included in the study. Subjects for the study were recruited through random probability sampling. Data were collected using psychometric tools in order to analyze job satisfaction (Job Satisfaction Survey [JSS]), the presence of burnout syndrome (Maslach Burnout Inventory [MBI]) and depressive symptoms (Patient Health Questionnaire-9). Adjusted analyses were conducted and the prevalence ratio (PR) was calculated using Poisson regression. The partial least squares structural equation modeling (PLS-SEM) was used for the analyses.
The final sample of this study comprised 271 professionals. Administrative workers or technical support workers from the hospital showed to be more satisfied in their jobs compared to the healthcare professionals (P = .02). Time of professional activity was also associated with job satisfaction (P = .03). Men displayed burnout syndrome approximately twice as often as women (PR = 1.98; 95% CI: 1.03–3.79; P = .04). Workers who had a low household income presented a predominance twice as high of depressive symptoms (PR = 2.84; 95% CI: 1.24–6.51; P = .01). PLS-SEM confirmed the causal and inverse relationship between burnout syndrome and job satisfaction (P < .001). Depressive symptoms were considered predictors for professional exhaustion (P < .001).
Personal and occupational factors of hospital workers were associated with job satisfaction, burnout syndrome, and depressive symptoms. The absence of burnout was identified as a predictive aspect for job satisfaction, and depressive symptoms as a predictor for professional exhaustion.
Mesalazine treatment causing resolution of intracranial hypertension secondary to ulcerative colitis
Authors: Khanna Raoul Kanav , Hage Rabih , Hage Alexandre , Polin Vanessa , Sené Thomas , Vignal-Clermont Catherine 
Published: December 2018

Abstract

Rationale:
The association between intracranial hypertension (ICH) and ulcerative colitis (UC) is rare. We report the unusual case of a male patient with UC and ICH in whom both conditions resolved with mesalazine therapy.

Patient concerns:
A 48-year-old Caucasian man presented to our department in June 2016 for decreased vision, transient visual obscuration, pulsatile tinnitus and headaches of 7 months duration. Bilateral optic disc swelling was found at fundus examination. Brain MRI excluded any brain tumor and lumbar puncture showed cerebrospinal fluid (CSF) opening pressure of 26 cm of water with normal CSF contents.

Diagnoses:
Idiopathic ICH was suspected.

Interventions:
The patient was managed with oral acetazolamide. Headaches initially improved but the dosage could not be decreased under 750 mg a day without recurrence of the symptoms. Extensive review of systems showed that the patient had active UC. He was given oral mesalazine, 2000 mg a day.

Outcomes:
The symptoms of UC and ICH quickly resolved. Acetazolamide was progressively tapered over the course of the 9 subsequent months and the patient did not show any worsening of his symptoms or papilledema.

Lessons:
UC should be added to the list of disorders associated with ICH. In case of atypical ICH with drug dependency, investigations should seek for UC. Treating efficiently UC with mesalazine may improve ICH, suggesting an underlying inflammatory process.
Apatinib for treating advanced intrahepatic cholangiocarcinoma after failed chemotherapy
Authors: Wang Li-Ye , Gong Shuai , Gao Li-Ping , Hou Li-Xia , He Wei 
Published: December 2018

Abstract

Rationale:
Intrahepatic cholangiocarcinoma (ICC) originates from the secondary branch of the bile duct and the intrahepatic bile duct epithelial cells, and is a rare pathological type of primary liver cancer. Recently, apatinib has been successfully used for a variety of malignancies.

Patient concerns:
A 23-year-old female was noted with intermittent right upper abdominal distension, abdominal pain, and vomiting after eating for more than 1 month. The enhanced CT scan revealed multiple intrahepatic lesions, portal vein and right branch tumor emboli were present.

Diagnosis:
Combined with the patient's medical history and pathology and immunohistochemistry, the diagnosis was confirmed as locally advanced unresectable ICC (cT4N1M1, Stage IVB).

Interventions:
The disease progressed after six cycles of gemcitabine plus capecitabine chemotherapy. She received oral apatinib treatment since September 30, 2017. Due to related adverse reactions, the patient could not tolerate the treatment, and the subsequent reduction therapy was given.

Outcomes:
On April 11, 2018, the review of CT evaluation suggested that the disease was progressed. Hence, in this patient, apatinib as second-line treatment for advanced ICC showed a progression-free survival with 6 months.

Lessons:
Apatinib as second-line treatment for advanced ICC is effective, and the adverse effects are tolerable. However, the efficacy and safety of apatinib in the treatment of ICC need to be further confirmed by large sample of prospective randomized controlled trials.
Comparison of analgesic efficacy of oxycodone and fentanyl after total hip replacement surgery
Authors: Kim Mi Kyeong , Ahn Sang Eun , Shin Eunsil , Park Sung Wook , Choi Jeong-Hyun , Kang Hee Yong 
Published: December 2018

Abstract

Background:
Total hip replacement (THR) is often accompanied by severe postoperative pain. We aimed to study whether oxycodone can be an effective alternative for fentanyl in the management of early postoperative pain after total hip replacement.

Methods:
We conducted a randomized controlled trial on 46 patients scheduled to undergo THR. We followed a standard general anesthetic technique, with endotracheal intubation. Twenty minutes before the end of surgery, single bolus injection of fentanyl, 50 μg (fentanyl group [group F], n = 23) or oxycodone, 4 mg (oxycodone group [group O], n = 23) was administered intravenously. Numeric rating scale (NRS) was used to assess pain in the post-anesthesia care unit (PACU). All patients had intravenous patient-controlled analgesia (PCA) with 10 μg/kg of fentanyl for 48 hours. Intravenous boluses of 50 μg were administered for breakthrough pain. The cumulative opioid dose administered at 6, 12, 24, and 48 h after surgery were recorded. A P value of less than .05 was considered statistically significant.

Results:
The NRS of group O in the PACU was significantly lower (P <.05); fewer patients in group O required additional fentanyl boluses in the PACU (P <.05). The cumulative opioid requirement was significantly less in group O at 6, 12, 24, and 48 hours after surgery. (P <.05)

Conclusions:
A single bolus injection of oxycodone is more effective than that of fentanyl in the acute phase of postoperative pain after THR. It may be used as an alternative drug for fentanyl in pain control after orthopedic surgery.
Hyponatremia: Prevalence and characteristics in internal medicine patients in northeast of China
Authors: Gang Xiaokun , Zhang Yumin , Pan Xin , Guo Weiying , Li Zhuo , Wang Yao , Wang Guixia 
Published: December 2018

Abstract
To determine the incidence, clinical features, etiology, risk factors, and mortality in internal medicine patients with hyponatremia (P-Na).
A prospective survey was conducted in patients with P-Na, diagnosed at admission in an Internal Medicine Department. 692 patients were then selected and subsequently divided into 3 groups based on the severity of P-Na. Multivariate linear regression analysis was used to explore the factors associated with levels of P-Na.
The prevalence of P-Na was 3.37%. Euvolemia P-Na was the predominant subtype in 3 types of P-Na (49.42%). Gastrointestinal and neurological manifestations were common hyponatremic symptoms. The leading 5 underlying diagnoses were chest infection (31.94%), malignancy (10.84%), cardiac disease (6.36%), liver cirrhosis (6.07%), and neurological disease (5.20%). Moderate and severe P-Na had higher mortalities than mild P-Na (P <.05). For the levels of serum Na, Age, and serum Cl were positively correlated while serum K, blood urea nitrogen (BUN), and Glu were negatively correlated (P <.05).
P-Na is common in internal medicine and accompanied by other electrolyte disturbances, various symptoms/diagnoses, and increased mortalities with decreasing Na, which requires special attention in clinical practice.
Bee venom acupuncture for circumscribed morphea in a patient with systemic sclerosis
Authors: Hwang Ji Hye , Kim Kyung-Ho 
Published: December 2018

Abstract

Rationale:
Bee venom has been reported to demonstrate antinociceptive and anti-inflammatory effects in experimental studies, but there remain questions regarding the clinical use of bee venom, especially for scleroderma. This case report shows the successful outcome of bee venom acupuncture for circumscribed morphea in a patient with systemic sclerosis, which is considered to be a rare condition.

Patient concerns:
A 64-year-old Korean woman had circular white areas (3 and 1 cm diameter) with severe itch in the right lateral iliac crest. Based on an initial diagnosis of systemic sclerosis (1 year prior to presentation at our clinic), she had been treated with painkillers, steroids, antitussive expectorants, and aspirin, with minimal effect on her recent skin symptoms.

Diagnoses:
In this study, the diagnosis of circumscribed morphea was based on localized skin symptoms of the patient with systemic sclerosis.

Interventions:
The patient visited Gachon University Korean Medical Hospital for treatment of topical skin symptoms. After being evaluated for bee venom compatibility, she was administered subcutaneous bee venom acupuncture along the margins of the patches (superficial circumscribed lesions) using the shallow surround needling method twice per week for 1 week and then once per week for the following 3 weeks.

Outcomes:
Itch levels were evaluated before each treatment session: by her second visit, her itch had decreased from 8 to 3 on a 10-point numerical rating scale; by her sixth visit, her itch had decreased from 3 to 0. She did not experience adverse effects, and these improvements were maintained until the 2-month follow-up evaluation.

Lessons:
Bee venom treatment demonstrates the potential to serve as an effective localized therapy for circumscribed morphea.