bluuebunny/crossref_metadata_2025_split huggingface dataset:
Spontaneous thrombosis in main draining veins of unruptured cerebral arteriovenous malformations
Authors: Chen Xianyi , Lu Xiaoyang , Yan Feng , Xu Weilin , Gao Liansheng , Zheng Jingwei , Yu Jun 
Published: May 2019

Abstract

Rationale:
Spontaneous obliteration of unruptured arteriovenous malformations (AVMs) is rare. It occurs in <1.5% of cerebral AVMs and only 7 cases have been reported so far. This phenomenon, together with the formation and outcome of cerebral AVMs, remains barely understood. In this work, we presented a case that spontaneous venous thrombosis in main draining veins of an unruptured AVM were confirmed, and reviewed the relevant literature in order to discuss the possible mechanisms.

Patient concerns:
Clinical data and treatment of a 33-year-old man with a preliminary diagnosis as right parietal mass with secondary epilepsy.

Diagnoses:
The diagnosis of the mass was a right parietal arteriovenous malformation (AVM) that was 3.5 cm in size and supplied mainly by multiple feeders of right middle cerebral artery (MCA).

Interventions:
An operation was performed with meticulous hemostasis of the extracranial soft tissue and the AVM was resected completely.

Outcomes:
The patient's neurological deficits improved postoperatively and he was subsequently discharged 1 week after surgery.

Lessons:
Thrombosis of the draining veins may be due to venous stagnation. Spontaneous venous thrombosis in an unruptured AVM is rare. Spontaneous obliteration of an AVM can occur by 2 mechanisms: occlusion of the feeding arteries or of the draining veins. Surgical or interventional treatment of an unruptured AVM with thrombosed draining veins is highly controversial now. However, we favor an aggressive treatment strategy.
Impact of text messages in a middle-income country to promote secondary prevention after acute coronary syndrome (IMPACS)
Authors: Passaglia Luiz Guilherme , Brant Luisa Campos Caldeira , Nascimento Bruno Ramos , Ribeiro Antônio Luiz Pinho 
Published: May 2019

Abstract

Background:
Studies that used short message service (SMS) programs as an intervention to promote health care have shown beneficial results in the control of risk factors for ischemic heart disease in patients of high-income countries, but evidence is lacking in low or middle-income countries.

Aims:
The purpose of this study is to evaluate whether the use of SMS increases risk factor control within 6 months after discharge by acute coronary syndrome (ACS) in a middle-income country.

Methods:
It will be a 2-arm, parallel, double-blind, randomized clinical trial of 160 patients discharged after an ACS from a single center with 6 months of follow-up. The intervention group will receive 4 SMS per week offering advice, motivation and information about medication adherence, increase of regular physical activity, adoption of healthy dietary measures, and smoking cessation (if appropriate). The primary outcome is achieving 4 or 5 points in a risk factor control score, which combines the cluster effect of 5 main modifiable risk factors for ACS [low-density lipoprotein cholesterol, LDL-C <70 mg/dL, blood pressure <140/90 mm Hg, regular exercise (≥5 days/week × 30 minutes of moderate exercise per session), nonsmoker status, and body mass index, BMI <25 kg/m2]. Secondary outcomes are plasma LDL-C level, level of physical activity, blood pressure, medication adherence, proportion of nonsmokers, BMI, rehospitalization, cardiovascular death, and death from any cause. This study, as a randomized clinical trial protocol, followed the recommendations of the Standard Protocol Items (SPIRIT).

Expected outcomes:
This study aims to provide evidence of whether SMS interventions are effective in improving cardiovascular disease risk factors control in post-ACS patients in a middle-income country.

ClinicalTrials.gov Identifier:
NCT03414190 (First posted on January 29, 2018; last update on May 14, 2018) - Retrospectively registered
Risk of multiple early gastric cancers in a patient with precursor lesions and endoscopic surveillance for 7 years
Authors: Pan Hui , Fang Chaoying , He Liping , Li Houqiang , Liu Lanzai , Wang Chao , Chen Jiansu 
Published: May 2019

Abstract

Rationale:
Severe mucosal atrophy or intestinal metaplasia is a risk factor for synchronous and metachronous intestinal gastric cancer. Magnifying endoscopy with narrow-band imaging was useful for assessing differentiated early gastric cancer (EGC).

Patient concerns:
A 62-year-old Chinese female was diagnosed with 5 multiple EGCs or high-grade dysplasia (HGD) with endoscopic surveillance for 7 years.

Diagnoses:
Synchronous and metachronous multiple EGCs.

Interventions:
Endoscopic submucosal dissection (ESD) with en bloc resection was performed for all 5 multiple lesions. The ESD specimens were pathologically diagnosed with adenocarcinoma confined to the mucosa or HGD.

Outcomes:
After endoscopy resection, no residual, recurrent, or synchronous lesions were detected by endoscopic surveillance after ESD.

Lessons:
Long-term, meticulous endoscopic surveillance is needed to monitor risk factors associated with multiple EGCs in patients with severe mucosal atrophy or intestinal metaplasia despite successful Helicobacter pylori eradication.
Retroperitoneoscopic nephrectomy for a horseshoe kidney with hydronephrosis and inflammation
Authors: Yang Qing-Tao , Hong Yu-xiang , Hou Gao-ming , Zheng Jun-Hong , Sui Xu-Xia 
Published: May 2019

Abstract

Rationale:
A horseshoe kidney is the most common congenital fusion abnormality in the kidney, occurring in approximately 1 in 400 live births. Several complications including renal malignancies, ureteropelvic junction obstruction, urolithiasis, vesicoureteral reflux, and hydronephrosis can occur in this patient population.

Patient concerns:
A 28-year-old woman was admitted to hospital because of chronic left low back pain. Microscopic hematuria was not seen. Computed tomography showed the horseshoe kidney and left hydronephrosis.

Diagnoses:
On the basis of these findings and clinical manifestations, the final diagnosis was the horseshoe kidney with left renal hydronephrosis and inflammation.

Interventions:
A retroperitoneoscopic nephrectomy on the left kidney was performed.

Outcomes:
Histopathological examination of the specimen confirmed massive dilatation of the pelvicaliceal system and chronic pyelonephritic inflammation. The patient was discharged on the 7th postoperative day with no complications and no back pain. She remained well at 3 months with normal activity and good cosmetic result.

Lessons:
Retroperitoneoscopic nephrectomy can be a safe and minimally invasive surgery for horseshoe kidney treatment.
The prediction value of scoring systems in Mallory-Weiss syndrome patients
Authors: He Li , Li Zheng-Bo , Zhu Hai-Dan , Wu Xiao-Li , Tian De-An , Li Pei-Yuan 
Published: May 2019

Abstract
Mallory-Weiss syndrome (MWS) is a relatively less common cause of nonvariceal upper gastrointestinal bleeding. There is limited data on whether scoring systems could be used to predict the clinical outcomes in patients with bleeding due to MWS. The aim of our study is to evaluate whether the Glasgow-Blatchford score (GBS), AIMS65, and shocking index are effective in predicting the clinical outcomes of MWS.
One hundred twenty-eight patients from January 2010 to January 2017 with MWS in middle China were enrolled. Clinical features such as age, gender, causes of vomiting, endoscopic findings, GBS, AIMS65, and shocking index were recorded. The clinical outcomes including endoscopic treatment and transfusion were analyzed.
MWS accounted for 6.1% of nonvariceal upper gastrointestinal bleeding. Male-to-female ratio was 3.6:1 and median age was 51 years. Patients between 40 and 60 years were more commonly affected; 43.8% of MWS was caused by overdrinking followed by underlying gastric diseases (33.6%). However, for female patients alone, underlying gastric diseases were the leading cause (42.9%). The tears were usually single and most frequently located on the left lateral wall. In receiver-operating characteristic curve analyses, GBS system and shocking index were useful in predicting transfusion (0.856 vs 0.675). But for endoscopic intervention, these scoring systems are not helpful (P > .05).
Apart from drinking, underlying gastric disease is another important cause of MWS especially for female patients and should be paid more attention under endoscopy examination. GBS system and shocking index can be used to predict transfusion.
Clinical and pathological analysis of solitary fibrous tumors with portal vein widening
Authors: Wang Xu-Qing , Yang Han-Qing , Chen Ji-Xiang , Mao Zhen-Fa , Han He , Chen Gong , Fan Xin 
Published: May 2019

Abstract

Rationale:
Solitary fibrous tumors (SFTs) are rare soft-tissue tumors characterized with spindle-cell, which occur more common in the chest and rarely seen in the abdomen. So far as we knew, SFTs accompanied with venopathy of portal vein has rarely been reported.

Patient concerns:
A 36-year-old male presented with left-sided abdominal mass and portal vein expansion on ultrasound.

Diagnoses:
The post-operative histopathology confirmed the diagnosis of Solitary fibrous tumor.

Interventions:
Laparotomy was performed and the mass was completely removed.

Outcomes:
Patients had no symptoms, recovered well without recurrence; the portal vein and splenic vein dilatation were alleviated and the symptoms of portal hypertension were relieved.

Lessons:
SFTs presents with few symptoms in the early stage of the disease. A rich arteriovenous shunt is beneficial to the diagnosis of SFTs by B-ultrasound and computed tomography (CT) examinations. However, the diagnosis of SFTs must depend on histopathology.
A case of palatine tonsillar metastasis of lung adenocarcinoma
Authors: Chen Chia-Chun , Lee Chin-Tse , Chang Shih-Lun , Tsai Meng-Chen 
Published: May 2019

Abstract

Rationale:
Palatine tonsil is an extremely rare site for metastatic disease, accounting for 0.8% of malignant tonsillar neoplasms. To the best of our knowledge, this is the first report of metastatic adenocarcinoma in the tonsil treated with wide excision and targeted therapy, with no local recurrence 6 months postoperatively.

Patient concerns:
A 75-year-old man presented hemoptysis and mild productive cough for 2 weeks.

Diagnoses:
Palatine tonsil metastasis from lung adenocarcinoma, pT2bN0M1b, stage IVA, was confirmed.

Interventions:
Wide excision of primary lung tumor and metastatic tonsil carcinoma has been performed, and the patient was undergoing targeted therapy with the epidermal growth factor receptor inhibitor afatinib.

Outcomes:
There was no local recurrence in the oropharynx 6 months postoperatively.

Lessons:
We aim at highlighting the importance of a thorough evaluation for suspicion of tonsillar enlargement, which might be a sign of a primary malignancy elsewhere.
Effect of Qigong on self-rating depression and anxiety scale scores of COPD patients
Authors: Wu Jian-jun , Zhang Ying-xue , Du Wei-sha , Jiang Liang-duo , Jin Rui-feng , Yu Hui-yong , Liu Jin-min , Han Mei 
Published: May 2019

Abstract

Objective:
To explore the clinical efficacy and safety of Qigong in reducing the self-rating depression scale (SDS) and self-rating anxiety scale (SAS) scores of patients with chronic obstructive pulmonary disease (COPD).

Methods:
We searched CNKI, Wan fang, Chongqing VIP, China Biology Medicine disc, PubMed, Cochrane Library, and EMBASE for studies published as of Dec 31, 2018. All randomized controlled trials of Qigong in COPD patients, which met the inclusion criteria were included. The Cochrane bias risk assessment tool was used for literature evaluation. RevMan 5.3 software was used for meta-analysis.

Results:
Six studies (combined n = 415 patients) met the inclusion criteria. Compared with conventional therapy alone, Qigong in combination with conventional therapy significantly improved the following outcome measures: SDS score [mean difference (MD) −3.99, 95% CI (−6.17, −1.82), P < .001, I
2 = 69%]; SAS score[MD −4.57, 95% CI (−5.67, −3.48), P
< .001, I
2 = 15%]; forced expiratory volume in one second/prediction (FEV1% pred) [MD 3.77, 95% CI (0.97,6.58), P < .01, I
2 = 0]; forced expiratory volume in one second (FEV1) [MD 0.21, 95% CI (0.13, 0.30), P
< .001, I
2 = 0%]; forced vital capacity (FVC) [MD 0.28, 95% CI (0.16, 0.40), P
< .001, I
2 = 0]; 6-minute walk test (6MWT) distance [MD 39.31, 95% CI (18.27, 60.34), P
< .001, I
2 = 32%]; and St. George's Respiratory Questionnaire (SGRQ) total score [MD −11.42, 95% CI (−21.80, −1.03), P
< .05, I
2 = 72%].

Conclusion:
Qigong can improve the SDS and SAS scores of COPD patients, and has auxiliary effects on improving lung function, 6MWT distance, and SGRQ score.
Comparative cardiovascular safety of selective serotonin reuptake inhibitors (SSRIs) among Chinese senile depression patients
Authors: Guo Shengyu , Chen Ling , Cheng Sixiang , Xu Huilan 
Published: May 2019

Abstract

Background:
Senile depression patients in China usually present with a higher risk of coronary heart disease that may trigger cardiac death. Selective serotonin reuptake inhibitors (SSRIs) were the most prescribed antidepressants in China; the cardiovascular safety of SSRIs when used in Chinese senile depression patients has not been evaluated.

Methods:
A network of meta-analysis was conducted to fill the objectives. PubMed, Embase databases, and 2 Chinese language electronic databases WANFANG and CNKI were searched for the related articles. The primary outcome of the present study was the number of cardiovascular reactions when each SSRI drug was used among senile depression patients in China. Odds ratios (ORs) and corresponding 95% confidence intervals (95% CIs) were calculated within pairwise and network meta-analysis.

Results:
Fifteen trials were identified, including 1432 patients; the network meta-analysis showed that Chinese senile depression patients treated by Escitalopram were associated with a lower risk of cardiovascular reaction (CDR) than Paroxetine (ORs 0.37, 95% CI 0.14–0.37). Escitalopram also exhibited distinct advantages compared with other SSRIs. The rank of SSRIs with respect to cardiovascular safety was Escitalopram > Sertraline > Citalopram > Paroxetine > Fluoxetine, respectively.

Conclusion:
Escitalopram exhibited distinct advantages compared with other SSRIs, while Fluoxetine had the biggest cardiovascular reaction probability.
Plate-prosthesis composite reconstruction after large segmental resection of proximal humeral tumors
Authors: Wei Ran , Guo Wei , Yang Rongli , Tang Xiaodong , Yang Yi , Ji Tao 
Published: May 2019

Abstract
Since the standard reconstructive option after large segmental resection of proximal humeral tumors remained controversial, we designed and applied plate-prosthesis composite (PPC) for this circumstance. The purposes of the study were to: compare the functional outcome, implant survival (IS), surgical risk of PPC with those of conventional proximal humeral prosthesis (PHP); and describe the design and reconstructive procedure of PPC.
Twenty patients (11 males, 9 females), who received intraarticular proximal humeral resection without preservation of abductor mechanism, were included in this study, with a mean resection length accounting for 72.5% (range, 61.9–81.8%) of whole humeral length. According to the reconstructive options, we categorized patients into PPC group (9 patients) and PHP group (11 patients). PPC was a semi-custom-made endoprosthesis, with modular proximal part same as PHP and custom-made distal part including dumpy stem and composite lateral anatomic plate for distal humerus. The mechanical prosthetic complication was defined as the imaging evidence regardless of reoperation. The IS was defined as the time from surgery to the occurrence of mechanical prosthetic complication.
The mean follow-up time was 40.1 months (range, 14–129). The Musculoskeletal Tumor Society 93 scores of PPC and PHP group showed no significant difference (73.3% vs 70.0%, P = .46). Compared to PHP group, PPC group showed significantly lower mechanical prosthetic complication rates (0 vs 45.4%, P = .03) and better IS (86.0 vs 59.3 ± 21.7 months, P = .028). Moreover, the comparison of surgical time (3.2 vs 3.3 hours, P = .60), blood loss (288.9 vs 376.4 mL, P = .15) and perioperative complication rates (11.1% vs 18.2%, P = .58) between 2 groups showed no differences.
For reconstruction after large segmental resection of proximal humeral tumors, PPC achieved better IS while maintained similar functional outcome compared to conventional PHP without influencing the complexity and safety of surgery.
Meta-analysis of the effects of drug-coated balloons among patients with small-vessel coronary artery disease
Authors: Yang Jing-qi , Peng Jin-hua , Xu Ting , Liu Li-yun , Tu Jie-hong , Li Shun-hui , Chen Hui 
Published: May 2019

Abstract

Objective:
This study evaluated the clinical value of drug-coated balloons for patients with small-vessel coronary artery disease (SVD).

Methods:
A computerized literature search was performed using the databases to conduct a meta-analysis and evaluate the clinical value of drug-coated balloons among patients with SVD.

Results:
This review enrolling 1545 patients receiving drug-coated balloons and 1010 patients receiving stents (including drug-eluting stents and bare-metal stents). The meta-analysis results showed that the incidence of major adverse cardiovascular events among patients with SVD did not significantly differ between the drug-coated balloon group and the stent group within 1 postoperative year (odds ratio = 0.81, P = .5). A subgroup analysis showed that the incidence of myocardial infarction among the drug-coated balloon group was significantly lower than that among the stent group (odds ratio = 0.58, P = .04). Nevertheless, the late lumen loss of the drug-coated balloon group was significantly lower than that of the stent group (mean difference = 0.31, P = .01).

Conclusions:
Drug-coated balloons can be used to effectively reduce the incidence of myocardial infarction in patients with SVD within 1 year and decrease the extent of late lumen loss without increasing the incidence of major adverse cardiovascular events.
A case report of infant with gastric perforation caused by Candida albicans infection
Authors: Zhang Min 
Published: May 2019

Abstract

Rationale:
Spontaneous gastric perforation in young children is rare, and gastric perforation caused by Candida albicans infection is even rarer.

Patient concerns:
A 4-month-old infant presented with frequent retching. The results of X-rays showed obvious pneumoperitoneum but gastric vacuole was not seen.

Diagnosis:
The infant was diagnosed as spontaneous gastric perforation caused by C albicans infection based on blood culture, peritoneal fluid culture, and postoperative histopathology.

Interventions:
An emergency exploratory laparotomy was performed and a gastric perforation repair was done. The infant received antishock, antiinfection, and intravenous nutrition treatment.

Outcomes:
After operation and antiinfective symptomatic treatment, the infant recovered.

Lessons:
This case emphasized the rare C albicans infection as a cause of the gastric perforation in infant. The C albicans infection should always be thought of as an etiology for the gastric perforation in infant, to reduce the significant mortality. The early detection is necessary to treat Candida infections.
Effect of sagittal split ramus osteotomy on morphologic parameters of temporomandibular joint in patients with mandibular prognathism
Authors: Ma He-Di , Shu Jing-Heng , Deng Xu-Zhao , Liu Zhan 
Published: May 2019

Abstract
The purpose of this study was to evaluate the change in three-dimensional morphology and clinical symptoms of temporomandibular joint (TMJ) in class III dentofacial deformity patients postoperatively for 6 months after sagittal split ramus osteotomy (SSRO).
Seventeen patients with skeletal Class III malocclusion and 10 asymptomatic volunteers (classified as Control group) were recruited for the study and underwent cone-beam computed tomography scanning. The geometries of the maxilla and mandible were reconstructed using MIMICS (Materialise, Leuven, Belgium). The morphologic measurements of the patients’ TMJs were done before surgery and at 6-month follow-up – named as Pre and Post groups, respectively.
The joint spaces (medial joint space, superior joint space, lateral joint space, anterior joint space, and posterior joint space) of the Control group were significantly greater than those of the Pre and Post groups (P < .05), and SSRO did not significantly change the TMJ morphology parameters. Five patients were found to have preoperative temporomandibular disorder (TMD) symptoms, and 3 of them were relieved at 6 months after surgery. Postoperative TMD symptom was observed in 1 patient without preoperative TMD symptom.
SSRO did not markedly alter the TMJ morphology of the patients with mandibular prognathism. The effects of SSRO on TMD symptoms should be related to the type of deformity.
Medical resource utilization patterns and mortality rates according to age among critically ill patients admitted to a medical intensive care unit
Authors: Oh Dong Kyu , Na Wonjun , Park Yu Rang , Hong Sang-Bum , Lim Chae-Man , Koh Younsuck , Huh Jin-Won 
Published: May 2019

Abstract
There is ongoing controversy about how to address the growing demand for intensive care for critically ill elderly patients. We investigated resource utilization patterns and mortality rates according to age among critically ill patients.
We retrospectively analyzed the medical records of patients admitted to a medical intensive care unit (ICU) in a tertiary referral teaching hospital between July 2006 and June 2015. Patients were categorized into non-elderly (age <65 years, n = 4140), young-elderly (age 65–74 years, n = 2306), and old-elderly (age ≥75 years, n = 1508) groups.
Among 7954 admissions, the mean age was 61.5 years, and 5061 (63.6%) were of male patients. The proportion of comorbidities increased with age (64.6% in the non-elderly vs 81.4% in the young-elderly vs 82.8% in the old-elderly, P < .001 and P for trend <.001), whereas the baseline Sequential Organ Failure Assessment (SOFA) score decreased with age (8.1 in the non-elderly vs 7.2 in the young-elderly vs 7.2 in the old-elderly, P < .001, R = −.092 and P for trend <.001). Utilization rates of mechanical ventilation (48.6% in the non-elderly vs 48.3% in the young-elderly vs 45.5% in the old-elderly, P = .11) and renal replacement therapy (27.5% in the non-elderly vs 25.5% in the young-elderly vs 24.8% in the old-elderly, P = .069) were comparable between the age groups. The 28-day ICU mortality rates were lower in the young-elderly and the old-elderly groups than in the non-elderly group (35.6% in the non-elderly vs 34.2% in the young-elderly, P = .011; and vs 32.6% in the old-elderly, P = .002).
A substantial number of critically ill elderly patients used medical resources as non-elderly patients and showed favorable clinical outcomes. Our results support that underlying medical conditions rather than age per se need to be considered for determining intensive care.