bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of transcatheter closure, mini-invasive closure, and open-heart surgical repair for treatment of perimembranous ventricular septal defects in children
Authors: Yi Kang , You Tao , Ding Zhao-hong , Hou Xiao-dong , Liu Xing-Guang , Wang Xin-Kuan , Tian Jin-hui 
Published: October 2018

Abstract

Objective:
Our study was aimed to comprehensively compare the relative efficacy, safety, and the cost of transcatheter closure, mini-invasive closure, and open-heart surgical repair to treat perimembranous ventricular septal defects (pmVSDs) in children using network meta-analysis method.

Methods:
Five databases were systematically searched including Chinese Biomedical Literature Database, China National Knowledge Infrastructure, PubMed, EMBASE.com, and the Cochrane Central Register of Controlled Trials from the starting date of each database to February 2017. Tools for assessing the risk of bias in nonrandomized studies of interventions (ROBINS-I) were used to evaluate the risk of bias in observational studies and Cochrane Handbook version 5.1.0 was used for randomized controlled trials (RCTs). Data were analyzed using R-3.4.0 software and Review Manager 5.2.

Results:
Three RCTs and 24 observational studies were included in our study. Network meta-analysis result demonstrated that transcatheter closure was the most effective treatment in terms of operative time [standardized mean difference (SMD) = −2.02, 95% confidence interval (CI): −3.92 to −0.12], major complications [odds ratio (OR) = 0.52, 95% CI = 0.30–0.91], ICU stay (SMD = −1.11, 95% CI = −2.13 to −0.08), and hospital stay (SMD = −1.81, 95% CI = −2.24 to −1.39). However, open-heart surgical repair showed a higher success rate of the procedure than transcatheter closure (OR = 0.36, 95% CI = 0.17–0.77).Statistical analysis result demonstrated that transcatheter closure had the best potential to lessen major complications, ICU stay, hospital stay, operative time, and significant residual shunt.

Conclusions:
Transcatheter closure has more benefit than mini-invasive closure and open-heart surgical repair to treat pmVSDs.
Eculizumab in a pregnant patient with laboratory onset of catastrophic antiphospholipid syndrome
Authors: Rovere-Querini Patrizia , Canti Valentina , Erra Roberta , Bianchi Esperia , Slaviero Giorgio , D’Angelo Armando , Rosa Susanna , Candiani Massimo , Castiglioni Maria Teresa 
Published: October 2018

Abstract

Rationale:
Hypercoagulability and pregnancy morbidity are hallmarks of the antiphospholipid syndrome (APS). Catastrophic antiphospholipid syndrome (CAPS) is a potentially life-threatening omplication of APS, with widespread acute thrombotic microangiopathy (TMA) that can be precipitated by pregnancy and delivery and result in multiorgan damage. Unrestrained activation of the complement cascade is involved, favoring endothelial activation, tissue factor expression by leukocytes, and platelet aggregation. The complement block, which interrupts this amplification cycle, could prevent CAPS in patients with early TMA who face precipitating events.

Patient concerns:
We present a nulliparous pregnant woman with APS at the 30+6 week of gestation who has developed thrombocytopenia, intravascular hemolysis, elevated creatinine, proteinuria, and hematuria.

Diagnoses:
These featurs were compatible with the diagnosis of CAPS. Consensually, serum C3 protein levels were rapidly decreasing, reflecting complement consumption.

Interventions:
She was treated with eculizumab, a humanized monoclonal antibody against C5 that prevents the formation of the complement membrane attack complex.

Outcomes:
Laboratory parameters improved and the patient did not develop thrombosis or detectable organ/tissue damage. The patient safely delivered by cesarean section at week 32 of gestation a healthy 1640 g male infant. After 5 days, she received additional eculizumab, with complete resolution of the clinical condition. Low complement activity was detectable in the infant blood for a week after delivery. No infectious complication occurred.

Lessons:
Inhibition of the terminal complement activation is safe and might be effective in patients with APS developing early TMA, enabling safe delivery and preventing thrombotic events both in the mother and in the newborn.
Musculoskeletal complaints in healthcare personnel in hospital
Authors: Koyuncu Nazmiye , Karcioglu Özgür 
Published: October 2018

Abstract
The objective of this study is to investigate musculoskeletal complaints (MSCs) in healthcare workers (HCWs) in 3 community hospital–based departments [internal medicine (IM), general surgery (GS), and emergency department (ED)] and its effects on the quality of work life (QWL) of hospital HCW.
This prospective cross-sectional study was performed in the 700-bed community training hospital. All HCW staffed in 3 departments (IM, GS, ED) of the hospital were asked to respond to items in the study data sheet. Enrolled personnel were inquired about their demographic data, work history and schedule, and medical history. The 16-item Cornell Musculoskeletal Discomfort Questionnaire (CMDQ) Turkish version was applied to evaluate MSC. A total of 216 HCW constituted the study sample and demographic characteristics, history, and clinical findings were analyzed.
Among all, 103 personnel (47.7%) were women (n = 42, 41.1% in physicians, n = 57, 87.6% in nurses and n = 4, 8% in other HCW) (P = .000). A total of 173 personnel (79.7%) reported MSC in some part of their bodies. Female personnel had MSC significantly more commonly than males (chi-square = 40.7, P = .000). Numbers and percentages of the personnel with MSC in 3 departments (IM, GS, ED) were 51/61, 52/65, and 70/90, respectively (P = .67). Total QWL score of those without MSC was significantly higher than others (74.7 + −12 vs 63.2 + −15, respectively; t test, P = .000). Total frequency score of MSC as elicited via CMDQ was significantly higher in those without MSC compared to the others (8.1 + −7.6 vs 0.1 + −0.6, respectively, t test, P = .000).
Female sex, high-income, university graduation, being a nurse or a physician, and older age impose risk for HCW in hospital with respect to having MSC. Presence of MSC affects QWL negatively.
Acupotomy therapy for lumbar disc herniation
Authors: Jiang Cai , Li Yinyan , Guo Miaomiao , Li Xiaomei , Guo Jinhua , Yu Shengxian , Lin Zhonghua 
Published: October 2018

Abstract

Background:
Lumbar disc herniation (LDH) is a clinically common degenerative spinal disease that adversely affects patients’ quality of life and work ability. Although several articles have reported that acupotomy can improve the clinical symptoms of LDH, the efficiency of acupotomy has not been scientifically or methodically evaluated. The primary objective of this study is to evaluate and synthesize evidence on the effectiveness and safety of acupotomy therapy in patients with LDH.

Method:
We plan to search eight English and Chinese electronic databases, including the Web of Science, Cochrane Library, PubMed, EMBASE, SinoMed, Wanfang, China Science and Technology Journal (VIP), and China National Knowledge Infrastructure (CNKI) databases, for potentially eligible studies. Randomized controlled trials (RCTs) on acupotomy treatment in LDH patients will be searched for independently by 2 reviewers in the databases from their inception to August 2018. We will combine data from clinically homogenous studies in a fixed effect meta-analysis using RevManV.5.3.5, and the evidence level will be assessed by using the method for Grading of Recommendations Assessment, Development, and Evaluation (GRADE).

Results:
This systematic review and meta-analysis will use high-quality evidence-based medicine to assess the efficacy and safety of acupotomy therapy in LDH.

Conclusion:
This study protocol will provide strong evidence to determine whether acupotomy therapy is an effective and safe intervention for patients with LDH.
A meta-analysis of safety and efficacy of regorafenib for refractory metastatic colorectal cancer
Authors: Xue Wu-Song , Men Si-Ye , Liu Wei , Liu Reng-Hai 
Published: October 2018

Abstract

Background:
Patients with metastatic colorectal cancer (mCRC) often suffer from progressive disease despite previous therapy. It has been a great challenge for those patients. In 2012, regorafenib was approved for mCRC. In this meta-analysis, we aimed to collect and present existing data to explorethe clinical use of regorafenib.

Methods:
The online electronic databases, such as PubMed, Embase, and the Cochrane library, updated to November 2017 were systematically searched. Trials on the effectiveness of regorafenib in patients who suffer from treatment-refractory metastatic colorectal cancer were included, of which the main outcomes included 3 parameters: overall survival (OS), progression-free survival (PFS), and grade 3/4 AE.

Results:
Totally, 4 trials were included in this meta-analysis. The OD was significantly better with the use of regorafenib (OR = 0.78, 95%CI = 0.65–0.94, I
2 = 69%, P = .008), and PFS (OR = 0.52, 95%CI = 0.34–0.79, I
2 = 97%, P = .002). However, the most common toxicities occurred more frequently in the regorafenib group than the control group (OR = 3.73, 95%CI = 1.68–8.28, I
2 = 79%, P = .001).

Conclusion:
Regorafenib demonstrates better efficacy and has manageable adverse-event profile for treatment-refractory mCRC. Considering the safety feature of regorafenib, further studies and clinical trials are warranted to investigate the dosing of regorafenib and alternative approaches are needed to explore predictive biomarker fortherapy selection.
A case report of Legionella and Mycoplasma pneumonia
Authors: Saladi Lakshmi , Zaidi Bushra , Toolsie Omesh , Vakde Trupti , Adrish Muhammad 
Published: October 2018

Abstract

Rationale:
Concurrent or sequential coinfections of Legionella pneumophila and Mycoplasma pneumoniae have been reported in the past though infrequently. Distinguishing a true co-infection from cross reactivity is often challenging as the diagnosis is mostly dependent on serological testing.

Patient concerns:
A 77-year-old male presented with worsening dyspnea, cough with yellow sputum, diarrhea and fever of 2-days duration. Patient had history of chronic obstructive pulmonary disease (COPD) on home oxygen, bronchiectasis, rheumatoid arthritis (on methotrexate and leflunomide), treated pulmonary tuberculosis and 30-pack-year smoking. Chest X-ray showed bilateral interstitial changes with left lower lobe infiltrate. On day 5, his urine antigen for L pneumophila serogroup 1 was reported positive. The following day his serum M pneumoniae IgM antibody titers were reported elevated at 6647 U/mL. Patient was started on antibiotics and placed on non-invasive positive pressure ventilation.

Diagnosis:
The patient was diagnosed with possible Legionella and Mycoplasma co-infection.

Outcomes:
Sputum Mycoplasma polymerase chain reaction (PCR) and serum cold agglutinins were obtained on day 6 and later reported negative. He was treated with azithromycin for 10 days with clinical improvement.

Lessons:
Serological testing alone is an indirect measure with poor sensitivity and specificity and has its own limitations. Urine antigen detection confirms L pneumophila serogroup 1 infection in a patient with suggestive symptoms. However, diagnosis of M pneumonia should be based on combination of tests including serology and PCR to confirm true co-infection.
Effect of Liuzijue Qigong on patients with chronic obstructive pulmonary disease
Authors: Guo Yu , Xu Mingmin , Ji Meiqi , Zhang Jialei , Hu Qingchuan , Wei Zeren , Yan Jian , Chen Yue , Lyu Jiaxuan , Shao Xiaoqian , Wang Ying , Guo Jiamei , Wei Yulong 
Published: October 2018

Abstract

Background:
Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide with a substantial and increasing social and economic burden. Liuzijue Qigong is a kind of traditional Chinese Qigong exercises that Traditional Chinese Medicine practitioners prescribe to individuals with COPD to strengthen the internal organs’ function. Liuzijue Qigong was recommended for use in COPD rehabilitation, and some clinical trials indicate that Liuzijue Qigong would produce better functional capacity and quality of life of individuals with COPD. The objective of this study is to conduct a systematic review of the existing studies to assess effectiveness and safety of Liuzijue Qigong for the prevention or treatment of COPD in patients.

Methods:
We will perform the comprehensive literature search in English and Chinese electronic database. The publication period will be from inception to the search date. In addition, the clinical trial registries, dissertations, informal publication, grey literature, reference lists of studies, systematic reviews, and conference abstracts will also be collected. Two reviewers will identify relevant studies, extract data information, and then assess the methodical quality by the Cochrane risk of bias assessment tool. Only randomized controlled trials comparing Liuzijue Qigong against other intervention or nonintervention will be included. Data will be synthesized by either fixed-effect or random-effect model regarding to a heterogeneity test. The routine lung function, arterial blood gas tensions, partial pressure of carbon dioxide, functional capacity, 30 seconds sit-to-stand test, respiratory function, maximal inspiration pressure, maximal expiratory pressure, airway resistance, and specific airway conductance will be assessed as primary outcomes. The secondary outcomes involved dyspnea, and fatigue levels, respiratory muscle strength, upper and lower limb muscle strength, handgrip strength test, and health-related quality of life and safety. Meta-analysis will be performed by using Cochrane's Review Manager software (version 5.3.5).

Results:
This systematic review and meta-analysis will provide a high-quality synthesis and evaluate the efficacy and safety based on current relevant literature evidence of Liuzijue Qigong intervention for COPD patient.

Conclusion:
Our systematic review will provide evidence to determine whether Liuzijue Qigong is an effective and safe approach to prevention and treatment of COPD patients.
Fecal microbiota transplantation for patients with irritable bowel syndrome
Authors: Wen Wenting , Zhang Haibo , Shen Junlong , Wei Luxia , Shen Shunong 
Published: October 2018

Abstract
Irritable bowel syndrome (IBS) is a common functional bowel disease characterized by chronic or recurrent abdominal pain, bloating, constipation, and diarrhea. Many patients with IBS have a poor quality of life due to abdominal discomfort, diarrhea, constipation, and the presence of other diseases. At present, intestinal motility inhibitors, adsorbents, astringents, intestinal mucosal protective agents, and antidepressants have been combined to treat IBS, but the treatment process is long, which results in a large economic burden to patients. Fecal microbiota transplantation (FMT) is a treatment involving the transplantation of functional bacteria from healthy human feces into the gastrointestinal tract of patients; thus, replacing the intestinal flora and modulating intestinal and extra-intestinal diseases. In recent years, the efficacy and economic benefits of FMT in the treatment of IBS have received increasing attention from researchers.
A search for randomized controlled trials (RCTs) on treating IBS with FMT will be performed using 9 databases, including PubMed, the Cochrane Library, Embase, ClinicalTrails, China National Knowledge Infrastructure, Sino Med, ScienceDirect, VIP, and Wanfang Data. Two reviewers will independently screen data extraction studies and assess study quality and risk of bias. The risk of bias for each RCT will be assessed against the Cochrane Handbook standards to assess methodological quality. RevMan V.5.3 software will be used to calculate data synthesis when meta-analysis is allowed.
This study will provide a high-quality synthesis of existing evidence on the effectiveness and safety of FMT in the treatment of IBS.
This study will determine if FMT is an effective and safe intervention for IBS.
PROSPERO registration number is PROSPERO CRD42018108080.
Bystander cardiopulmonary resuscitation training in primary and secondary school children in China and the impact of neighborhood socioeconomic status
Authors: Li Hui , Shen Xu , Xu Xia , Wang Yan , Chu Lihua , Zhao Jialian , Wang Ya , Wang Haihong , Xie Guohao , Cheng Baoli , Ye Hui , Sun Yaqi , Fang Xiangming 
Published: October 2018

Abstract

Background:
The World Health Organization (WHO) has endorsed school bystander cardiopulmonary resuscitation (CPR) training programs. But related researches in China are limited. Therefore, we conducted this study to assess bystander CPR training in school children in China and the impact of neighborhood socio-economic status (SES) on.

Methods:
A total of 1,093 students from seven schools in Zhejiang province participated in this study. Theoretical and practical bystander CPR training were conducted in instructor-led classes. Students completed a 10-statement questionnaire before and after training, and then underwent a skills assessment during a simulated basic life support (BLS) scenario. Subgroup analyses were stratified according to neighborhood SES.

Results:
Before training, most students (72.83%) had a strong desire to learn bystander CPR and share with others. After training, bystander CPR theory was significantly improved (P < .01), and 92.64% students reached an 85-100% performance rate in a simulated BLS scenario. Students from low-SES neighborhoods had less pre-training knowledge of bystander CPR (P < .01). However, their performance was similar with students from higher-SES neighborhoods on the post-training questionnaire and the skills assessment, and better among students aged 13–14 years.

Conclusion:
School children in China have a poor pre-training knowledge of bystander CPR. However, with training, there was a significant improvement in the basic theory and skills of CPR. Bystander CPR training efforts should be targeted to Chinese primary and secondary school children, especially in low-SES neighborhoods.
Factors influencing class agreement and medical expenditure by age in South Korea
Authors: Choi Ryoung , Kang Hyun Goo 
Published: October 2018

Abstract

Background:
There are not many studies evaluating the factors affecting medical expenditure for different age groups, income classes, and subjective social classes. Therefore, this study evaluates the agreement between income class, objective class, and subjective social class and analyzes the factors that affect medical expenditure by age group.

Methods:
Multiple regression analysis and χ
2 test were conducted to evaluate the compatibility between income quintiles and subjective social classes and to identify the factors influencing medical expenditure by subjective social class and age using raw data from the 2013 Korea Health Panel (n = 9,385) of the Korea Institute for Health and Social Affairs and the National Health Insurance Service.

Results:
When the class compatibility between income quintiles and subjective social classes was analyzed by age group, young people in the first, second, and third income quintiles considered themselves to be in the second subjective social class while and those in the fourth and fifth income quintiles considered themselves to be in the third subjective social class. Moreover, middle-aged and old people in the first, second, third, and fourth income quintile considered themselves to be in the second subjective social class while those in the fifth income quintile considered themselves to be in the third subjective social class.

Conclusion:
Social support, public health approaches, and medical treatment service models are needed to eliminate comparative deprivation among individuals.
Young male breast cancer, a small crowd, the survival, and prognosis?
Authors: Li Naikun , Wang Xiaohui , Zhang Hongju , Wang Haiyong 
Published: October 2018

Abstract
Women diagnosed with breast cancer at young age often have poorprognoses. Yet, few studies have focused on the prognoses of young men with breast cancer. We therefore used Surveillance, Epidemiology, and End Results (SEER) population-based data and identified 151 male patients with breast cancer aged <40 years between 1988 and 2012. Propensity score matching analysis was used to balance the clinical variables among different groups. Kaplan–Meier curves were applied to compare the survival differences. The subgroup variables on cancer-specific survival (CSS) and overall survival (OS) were analyzed by the Cox proportional hazard model. Results showed that male patients with breast cancer aged <40 had a significant OS benefit compared with those aged ≥40 years (P < .001). The significant difference of the CSS was not found (P > .05). Compared with the male patients with breast cancer aged ≥40, those aged <40 had significant OS benefit in most subgroups (P < .05). Compared with the female patients with breast cancer aged <40, the male patients with breast cancer aged <40 had worse OS and CSS benefit only in the subgroup with progesterone receptor and estrogen receptor positive (P < .05). In conclusion, we demonstrated that young male patients with breast cancer had better OS compared with elder male patients with breast cancer. However, the survival benefit was not found compared with young female patients with breast cancer.