bluuebunny/crossref_metadata_2025_split huggingface dataset:
Aldosteronism with mild hypokalemia presenting as life-threatening ventricular arrhythmias
Authors: Shao Dongpu , Wang Shudong , Zhou Shanshan , Cai Qingyuan , Zhang Rangrang , Li Hang , Zheng Yang , Zhang Zhiguo 
Published: December 2018

Abstract

Rationale:
Primary aldosteronism (PA) with hypokalemia increases the risk of life-threatening ventricular arrhythmias. Cases of PA with malignant arrhythmia as the first symptom have been reported. The role of severe hypokalemia in triggering malignant ventricular arrhythmia is well documented. However, few cases of PA with mild hypokalemia that presented with life-threatening ventricular tachycardia have been reported.

Patient concerns:
A 74-year-old man was admitted to our hospital 25 hours after suffering from syncope caused by ventricular tachycardia without chest pain. Electrocardiogram showed ST segment depression and T wave inversion in leads III, avF, V4–V6. Mild QT prolongation was observed during sinus rhythm. Blood tests showed mild hypokalemia and elevated plasma aldosterone level. Abdominal computed tomography showed a nodule in the left adrenal gland. Coronary angiography revealed stenosis in the right coronary artery.

Diagnosis:
Prolonged QT interval, hypokalemia, high level plasma aldosterone, a nodule in the left adrenal gland and right coronary artery stenosis led to a diagnosis of aldosterone hyperplasia and adrenal nodule with ischemic heart disease.

Intervention:
Intravenous potassium and magnesium were administered to correct hypokalemia and a stent was implanted in the right coronary artery for vascularization. A prescription aldosterone receptor antagonist, spironolactone, was prescribed for hyperaldosteronemia.

Outcomes:
During 6 months of follow-up, no episodes of ventricular tachycardia or syncope occurred, and serum potassium level remained normal.

Lessons:
In patients with ventricular tachycardia and mild hypokalemia, physicians need to consider that PA and ischemia heart disease may be one of the possible causes of electrical storm.
Inflammation-based Glasgow Prognostic Score in patients with acute ST-segment elevation myocardial infarction
Authors: Jia Yu , Li Dongze , Cao Yu , Cheng Yisong , Xiao Lei , Gao Yongli , Zhang Lin , Zeng Zhi , Wan Zhi , Zeng Rui 
Published: December 2018

Abstract
The inflammation-based Glasgow Prognostic Score (GPS), which involves C-reactive protein and serum albumin levels, has been reported to be a strong independent predictor of mortality in many cancers. This study aimed to investigate whether the GPS is associated with mortality in patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI).
In this study, 406 consecutive patients with STEMI at our emergency department (ED) who were undergoing pPCI were prospectively enrolled and assigned a GPS of 0, 1, or 2. Kaplan–Meier survival and multivariable Cox regression analyses were used to evaluate the associations between the GPS and long-term mortality.
Twenty-three patients (5.7%) died at the hospital, and 37 (9.7%) died during follow-up (14.4 [9.3–17.6] months). Compared with patients with a lower GPS, those with a higher GPS had significantly higher in-hospital mortality (GPS = 0 vs GPS = 1 vs GPS = 2: 3.3% vs 6.3% vs 28.0%, P < .001), follow-up mortality (4.6% vs 14.3% vs 55.6%, P < .001), and cumulative mortality (9.6% vs 21.1% vs 71.1%, P < .001). Multivariable Cox regression analysis revealed that in patients with a GPS of 1 and 2 (versus 0), the multivariable adjusted hazard ratios (HR) for all-cause mortality were 2.068 (95% CI: 1.082–3.951, P = .028) and 8.305 (95% CI: 4.017–17.171, P < .001), respectively, after controlling for all of the confounding factors. Subgroup analysis showed that a higher GPS was associated with an increased risk of cumulative mortality in the different subgroups.
The GPS on admission may be useful for stratifying the risk of adverse outcomes in patients with STEMI undergoing pPCI in the ED.
The epidemiology of cancer in the United Arab Emirates
Authors: Radwan Hadia , Hasan Hayder , Ballout Rami A. , Rizk Rana 
Published: December 2018

Abstract

Objective:
We conducted a systematic review to explore the United Arab Emirates (UAE)'s cancer-specific epidemiological profiles.

Methods:
We followed the standardized methods for conducting and reporting systematic reviews. We employed a highly sensitive and extensive strategy to identify all studies on the prevalence and incidence of cancer in the UAE, searching electronic databases and the grey literature. We assessed the methodological quality of the studies, summarized them, and qualitatively analyzed their results.

Results:
We included 4 retrospective studies published between 2003 and 2011, reporting data gathered between 1982 and 2004. The majority of the data were collected from national cancer registries and addressed adult Emiratis and certain cancer types. All included studies employed validated procedures for diagnostic confirmation. The overall age-standardized cancer rates were 70.1 and 74.2 per 100,000 in males and females, respectively. Lung, gastric, and prostate cancer ranked as the top 3 types in Emirati males; while breast, cervical, and thyroid cancer were the top 3 types in Emirati females. Men exhibited higher rates of lung and stomach cancers compared with women. The majority of the studies were of acceptable methodological quality.

Conclusions:
Our findings highlight the need for high-quality future research and systematic cancer data collection and registration to provide reliable data on the current incidence of cancer. We hope that our findings guide the tailoring of interventions aimed at curbing cancer rates in the UAE.
The significant impact of age on the clinical outcomes of laparoscopic appendectomy
Authors: Lasek Anna , Pędziwiatr Michał , Kenig Jakub , Walędziak Maciej , Wysocki Michał , Mavrikis Judene , Myśliwiec Piotr , Bobowicz Maciej , Astapczyk Kamil , Burdzel Mateusz , Chruściel Karolina , Cygan Rafał , Czubek Wojciech , Dowgiałło-Wnukiewicz Natalia , Droś Jakub , Franczak Paulina , Hołówko Wacław , Kacprzyk Artur , Karcz Wojciech Konrad , Konrad Paweł , Kopiejć Arkadiusz , Kot Adam , Krakowska Karolina , Kukla Maciej , Leszko Agnieszka , Łozowski Leszek , Major Piotr , Makarewicz Wojciech , Malinowska-Torbicz Paulina , Matyja Maciej , Michalik Maciej , Niekurzak Adam , Nowiński Damian , Ostaszewski Radomir , Pabis Małgorzata , Polańska-Płachta Małgorzata , Rubinkiewicz Mateusz , Stefura Tomasz , Stępień Anna , Szabat Paweł , Śmiechowski Rafał , Tomaszewski Sebastian , von Ehrlich-Treuenstätt Victor , Wasilczuk Maciej , Wojdyła Anna , Wroński Jan Wojciech , Zwolakiewicz Leszek 
Published: December 2018

Abstract
Acute appendicitis (AA) is the most common surgical emergency and can occur at any age. Nearly all of the studies comparing outcomes of appendectomy between younger and older patients set cut-off point at 65 years. In this multicenter observational study, we aimed to compare laparoscopic appendectomy for AA in various groups of patients with particular interest in the elderly and very elderly in comparison to younger adults.
Our multicenter observational study of 18 surgical units assessed the outcomes of 4618 laparoscopic appendectomies for AA. Patients were divided in 4 groups according to their age: Group 1—<40 years old; Group 2—between 40 and 64 years old; Group 3—between 65 and 74 years old; and Group 4—75 years old or older. Groups were compared in terms of peri- and postoperative outcomes.
The ratio of complicated appendicitis grew with age (20.97% vs 37.50% vs 43.97% vs 56.84%, P < .001). Similarly, elderly patients more frequently suffered from perioperative complications (5.06% vs 9.3% vs 10.88% vs 13.68%, P < .001) and had the longest median length of stay (3 [Interquartile Range (IQR) 2–4] vs 3 [IQR 3–5], vs 4 [IQR 3–5], vs 5 [IQR 3–6], P < .001) as well as the rate of patients with prolonged length of hospital stay (LOS) >8 days. Logistic regression models comparing perioperative results of each of the 3 oldest groups compared with the youngest one showed significant differences in odds ratios of symptoms lasting >48 hours, presence of complicated appendicitis, perioperative morbidity, conversion rate, prolonged LOS (>8 days).
The findings of this study confirm that the outcomes of laparoscopic approach to AA in different age groups are not the same regarding outcomes and the clinical picture. Older patients are at high risk both in the preoperative, intraoperative, and postoperative period. The differences are visible already at the age of 40 years old. Since delayed diagnosis and postponed surgery result in the development of complicated appendicitis, more effort should be placed in improving treatment patterns for the elderly and their clinical outcome.
Successful treatment of isolated oral lichen planus on lower lip with traditional Chinese medicine and topical wet dressing
Authors: Yu FeiYan , Xu Na , Zhao Bin , Ren XiuYun , Zhang Fang 
Published: December 2018

Abstract

Rationale:
Biopsy is very important for the diagnosis of oral lichen planus (OLP) on the lips. Traditional Chinese medicine (TCM) can be used to coordinate the whole body, soften and eliminate swellings and masses, and regulate the functions of qi and blood. Therefore, TCM could be an effective and safe treatment for OLP. Wet dressing is particularly important for the treatment of lip diseases. We report on a rare case of OLP on the lower lip.

Patient concerns:
A 38-year-old female patient presenting with a history of recurrent erosion, bleeding, and pain on her lower lip for 10 years.

Diagnoses:
Erosive OLP of the lower lip.

Interventions:
The patient was treated for 4 months using TCM comprising “Qingwen Jiedu Kouyankang granules,” total Paeonia glucosides, and a combination of hormones and anti-inflammatory agents applied locally using a wet dressing.

Outcomes:
Lip erosion was improved remarkably after 1 month, and there was no recurrence or aggravation of the condition. The duration of the follow-up period was 5 months.

Lessons:
The therapeutics used here were effective and safe for the treatment of OLP and could improve the quality of life in patients with lip erosion. The therapeutics provide new insight into the treatment of OLP on the lip.
Optimal cutoff value for assessing changes in intrahepatic fat amount by using the controlled attenuation parameter in a longitudinal setting
Authors: Ahn Sang Bong , Jun Dae Won , Kang Bo-kyeong , Kim Mimi , Chang Misoo , Nam Eunwoo 
Published: December 2018

Abstract
The controlled attenuation parameter (CAP) has shown a good correlation with the intrahepatic fat amount in cross-sectional studies. However, there is no study on whether the change of CAP scores can also show good correlation in a longitudinal setting. Therefore, we investigated the correlation between CAP and magnetic resonance imaging-estimated proton density fat fraction (MR PDFF) through serial examination in a longitudinal setting.
Sixty-five patients with nonalcoholic fatty liver disease were evaluated with MR PDFF and transient elastography including CAP at baseline and 3 months later.
The CAP and MR PDFF at baseline showed a strong correlation in assessing hepatic steatosis (r = 0.66, P < .001). After treatment, the correlation between the change in CAP after treatment and the intrahepatic fat change (%) on MR PDFF was not satisfactory (r = 0.37, P = .005) in the longitudinal setting. The optimal cutoff value of the change in CAP for discriminating an improvement or an aggravation in intrahepatic fat percentage (>1% change in MR PDFF) was selected as 38 dB/m (area under the receiver operating characteristic curve = 0.559). For CAP changes > 38 dB/m, the predictive value was 14/16 (87.5%), whereas for changes < 38 dB/m, the predictive value was 12/41 (29.3%). Thereby, the accuracy of the method using the change in CAP was only 26/57 (46%). In addition, Cohen's kappa value was not significant (κ=0.11, P = .186).
Careful interpretation of the steatosis change based on the CAP score is needed when the absolute change value is < 38 dB/m in a longitudinal setting.
Intravoxel incoherent motion and diffusion kurtosis imaging for discriminating soft tissue sarcoma from vascular anomalies
Authors: Wu Gang , Liu Xuanlin , Xiong Yan , Ran Jun , Li Xiaoming 
Published: December 2018

Abstract
To investigate the feasibility of intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) and diffusion kurtosis imaging (DKI) in discriminating soft tissue sarcoma from vascular anomalies.
Twenty-two patients with lower extremity soft tissue sarcoma and 15 patients with lower extremity vascular anomalies underwent IVIM-DWI and DKI. IVIM model generated true diffusion (D), perfusion fraction (f), and pseudo-diffusion coefficient (D∗). DKI model generated mean kurtosis (MK) and mean diffusion (MD). These parameters were measured by 2 radiologists separately through drawing region of interest. Intraclass correlation coefficient (ICC) was calculated to evaluate the inter-reader viability in measurement. The Mann–Whitney test was used to compare the parameters between vascular anomalies and soft tissue sarcoma. Receiver operating characteristic curves were constructed for assessing diagnostic accuracies.
ICC was more than 0.8 for apparent diffusion coefficient (ADC), D, D∗, f, MK, and MD. Mean ADC, D, and MD were significantly lower in soft tissue sarcoma versus vascular anomalies (P < .05). Mean D∗ and f were not significantly different (P > .05). Soft tissue sarcoma had significantly higher MK than vascular anomalies (P < .05). Areas under curve for ADC, D, MK, and MD were 0.876, 0.885, 0.894, and 0.812, respectively.
IVIM and DKI are feasible in discriminating soft tissue sarcoma from vascular anomalies.
Acupuncture for gender differences and similarities in cerebral activity of health volunteers
Authors: Li Ang , Wang Yuan-hong , Zhang Fan , Wang Feng , Zeng Xiang-xin , Yue Jin-huan , Li Xiao-ling , Zhang Qin-hong 
Published: December 2018

Abstract
This study aimed to explore the feasible gender differences and similarities in cerebral activity response to the acupuncture at local acupoints around knee.
Fifteen male and 15 female healthy adults were recruited and included in this study. Functional magnetic resonance imaging (fMRI) was applied to measure cerebral activity response to acupuncture at Liangqiu (ST34), Xuehai (SP-10), Neixiyan (EX-LE4), and Dubi (ST-35).
Acupuncture activated the postcentral gyrus, precuneus, temporal, posterior lobe, and occipital lobe in both males and females. When compared with females, males showed brain activation in the right middle frontal gyrus, inferior frontal gyrus, right precuneus, right superior parietal lobule, left cerebellum anterior lobe; and brain deactivation in the right frontal. When compared with males, females were observed brain activation in the right frontal lobe, right parietal lobe, and right middle temporal gyrus; and brain deactivation in the left and right medial frontal gyrus.
The results of this study demonstrated that the neural effects of local acupoints around knee might be different between male and female subjects. Further clinical trials should take this gender effect into account in their design of studies.
Acquired renal glucosuria in an undifferentiated connective tissue disease patient with a SLC5A2 heterozygous mutation
Authors: Gu Xiangchen , Chen Min , Xu Yanqiu , Wang Yi 
Published: December 2018

Abstract

Introduction:
Renal glucosuria is a renal tubular disorder caused by genetic conditions, drugs, and poisons. Mutations in the SLC5A2 gene are recently found to be responsible for the inherited renal glucosuria, while undifferentiated connective tissue disease (UCTD) was not considered pathogenic for renal glucosuria. Here, we present a case of acquired renal glucosuria in a UCTD patient.

Patient concerns:
A 30-year-old woman was seen in the outpatient clinic for complaints of frequent urination and dysuria. Laboratory tests showed a urinary tract infection (UTI) and persistent renal glucosuria. After antibiotic treatment, the UTI symptoms were relieved, but the renal glucosuria remained.

Diagnosis:
Laboratory tests ruled out renal tubular acidosis and diabetes mellitus. Genetic analysis showed a heterozygous mutations in the SLC5A2 gene. Meanwhile, immunological tests showed a high antinuclear antibody titer (1:160) and an elevated anti-Rho/SSA antibody level. Schirmer test, tear breakup time, and lip biopsy results were all negative. The patient did not meet the criteria for any known connective diseases. Therefore, she was diagnosed with UCTD. Interventions: The patient was started with the treatment of Hydroxychloroquine.

Outcomes:
Hydroxychloroquine treatment resolved the renal glucosuria. The patient's follow- up urinalysis showed no glucosuria at all.

Lessons:
This is the first case report to demonstrate that UCTD may induce renal glucosuria in a patient with a heterozygous mutation in SLC5A2. This case suggests that during the process of diagnosing renal glucosuria, in addition to familial renal glucosuria (FRG), autoimmune diseases, though rare, should also be taken into consideration.
Spontaneous vaginal cuff dehiscence and evisceration of multiple organs
Authors: Zhou Yan , Zhang Yichao , Liu Weicheng , Zhang Wei , Wang Xiwen , Yu Xueqiao , Ding Zhao , Gong Zhilin , Jiang Congqing , Qian Qun 
Published: December 2018

Abstract

Rationale:
Vaginal cuff dehiscence and evisceration constitute a rare but potentially life-threatening event that usually occurs in postmenopausal patients who have undergone hysterectomy. This is a valuable case of spontaneous transvaginal evisceration without pelvic surgery history.

Patient concerns:
A 74-year-old postmenopausal woman with an obstetric history of 7 full term vaginal deliveries, experienced sudden evisceration when she attempted to defecate.

Diagnoses:
Spontaneous vaginal cuff dehiscence and multiorgan evisceration.

Interventions:
After physical examination and fluid resuscitation, the patient had underwent the Hartmann's procedure, total hysterosalpingo-oophorectomy, sacrocolpopexy, and posterior colporrhaphy.

Outcomes:
The patient recovered well and the constipation symptoms have significantly improved. One-year follow-ups examination revealed complete healing of the vaginal cuff, and there was no evidence of prolapse.

Lessons:
We report a case of spontaneous vaginal cuff evisceration without pelvic surgery history but with constipation and redundant sigmoid colon. After resecting the necrotic sigmoid colon, the patient's constipation symptoms significantly improved. It is reasonable to speculate that the etiology was related to severe sigmoidocoele.
Chinese herbal medicine for recurrent aphthous stomatitis: a protocol for systematic review and meta-analysis
Authors: Zhang Ying , Ng Kwan-him , Kuo Chih-yu , Wu Dong-jie 
Published: December 2018

Abstract

Background:
Recurrent aphthous stomatitis (RAS) is the most frequent form of oral ulceration, characterized by recurrent oral mucosal ulceration in an otherwise healthy individual. This study was designed to evaluate the efficacy and safety of Chinese herbal medicine for recurrent aphthous stomatitis.

Methods:
Five databases will be searched from inception to date, including PubMed, Cochrane Library, EMBASE,CNKI, and CBM. The researchers will comprehensively screen clinical randomized trials of Chinese herbal medicine for recurrent aphthous stomatitis. The review will be conducted by 2 independent authors without time and language limitation. The risk of bias will be assessed by the Cochrane risk of bias tool.

Results:
Ethical approval is not required because this study is based on published papers. After peer-review, the study will be disseminated in scientific journals and conferences.

Conclusion:
This systematic review will provide evidence for the efficacy and safety of Chinese medicine for recurrent aphthous stomatitis.

PROSPERO registration:
CRD42018111955.
Clinical research on the efficacy and safety of Bosinji for low back pain with radiculopathy caused by herniated intervertebral disc of the lumbar spine
Authors: Goo Bonhyuk , Kim Sung-Jin , Kim Eun-Jung , Nam Dongwoo , Lee Hyun-Jong , Kim Jae-Soo , Park Yeon-Cheol , Baek Yong-Hyeon , Nam Sang-Soo , Seo Byung-Kwan 
Published: December 2018

Abstract

Background:
A lumbar herniated intervertebral disc (LHIVD) is a common problem that usually causes low back pain and radiating pain. The effectiveness of Bosinji, one of the herbal medicines used for low back pain and radiating pain in patient with LHIVD, has been reported in several studies; however, little clinical evidence is available owing to the methodological limitations in previous studies. Hence, the present study aims to establish the clinical evidence regarding the efficacy and safety of Bosinji in improving pain, function, and quality of life in LHIVD patients.

Method/design:
This is a multicenter, open-label, randomized, controlled, and equivalence trial with 2 parallel arms. A total of 74 patients who have low back pain and radiating pain due to LHIVD will be recruited and randomly allocated to the experimental group and control group. The patients in the experimental group and control group will take 2.5 g of Bosinji granule (1.523 g of Bosinji extract) or Loxonin tablet (60 mg of loxoprofen) 3 times a day for 6 weeks. Additionally, both groups will receive the same acupuncture treatment once a week for 6 weeks as a concurrent treatment. Changes in the 100-mm visual analogue scale (VAS) for low back pain after 6 weeks from baseline will be assessed as the primary outcome. Furthermore, the 100-mm VAS for radiating pain, Oswestry disability index (ODI), Roland–Morris disability questionnaire (RMDQ), EuroQol 5 Dimensions 5 Levels (EQ-5D-5L), global perceived effect (GPE), and deficiency syndrome of kidney index (DSKI) will be used to evaluate secondary outcomes. Outcomes will be assessed at baseline and at 3, 6, and 10 weeks after screening. For the safety evaluation, laboratory examinations including complete blood count, liver function test, renal function test, blood coagulation test, inflammation test, and urine analysis will be conducted before and after taking the medications.

Discussion:
The results of this trial will be used to establish clinical evidence regarding the use of Bosinji with acupuncture treatment in the treatment of patients with LHIVD.

Trial registration number:
NCT03386149 (clinicaltrials.gov) and KCT0002848 (Clinical Research Information Service of the Republic of Korea).