bluuebunny/crossref_metadata_2025_split huggingface dataset:
Do routine blood test results help in the diagnosis of spine tumors? A retrospective study of the significance of pretreatment neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios from 503 spine tumor patients
Authors: Li Yan , Wang Ben , Zhou Siyu , Jiang Liang , Yang Shaomin , Liu Xiaoguang , Wei Feng , Zhang Hua , Wang Yiyuan , Liu Zhongjun 
Published: April 2019

Abstract
The neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) are not fully evaluated for the diagnosis of musculoskeletal tumors, especially spine tumors. The objective of our study was to assess the feasibility of NLR and PLR as indicators for pretreatment diagnosis of spine tumors.
Patients who underwent surgical treatment in our hospital for spine tumors were retrospectively analyzed. Blood test results (neutrophil, lymphocyte, and platelet counts) and final pathological results from surgery or biopsy specimen were collected. Spine tumors were divided into 4 groups. Diagnostic values of NLR and PLR were analyzed using the area under the receiver operating characteristic (ROC) curve (AUC).
There were 503 patients included. The average age of all patients was 46.3 years. Age, NLR, and PLR were significantly different between benign and malignant tumors groups (P < .05), and ROC analysis showed that the AUC was 0.704 and 0.637 for NLR and PLR. Age, location, NLR, and PLR were significantly different between primary and nonprimary tumor groups (P < .05), and ROC analysis showed that the AUC was 0.713 and 0.647 for NLR and PLR. Age, location, NLR, and PLR were significantly different between primary benign and primary malignant tumor groups (P < .05), and ROC analysis showed that the AUC was 0.624 and 0.577 for NLR and PLR.
Pretreatment NLR and PLR had clinical significance in the identification and pretreatment diagnosis of spine tumors. Additionally, NLR and PLR were significantly different between benign and malignant tumors, primary and nonprimary tumors, and primary benign and primary malignant tumors.
Is there agreement between evaluators that used two scoring systems to measure acute radiation dermatitis?
Authors: Fuzissaki Marceila de Andrade , Paiva Carlos Eduardo , Gozzo Thais de Oliveira , Maia Marcelo de Almeida , Canto Paula Philbert Lajolo , Maia Yara Cristina de Paiva 
Published: April 2019

Abstract
To analyze the agreement between the nurses evaluating radiodermatitis that used the Radiation Therapy Oncology Group (RTOG) and the World Health Organization (WHO) scales.
A prospective and longitudinal study conducted in 2016 to 2017, in a university hospital. We analyzed 855 images of irradiated sites of 100 breast cancer women during radiotherapy. In order to evaluate the agreement between 3 observers that evaluated theses irradiated sites Krippendorff's alpha and weighted kappa were obtained and analyzed.
The pairwise agreement among the evaluators was fair and moderate (RTOG scale: 0.408, 95% confidence interval, CI 0.370–0.431; WHO scale: 0.559, 95% CI 0.529–0.590). In addition, the general agreement rates were 10.2% and 29.2%, respectively. When assessing the overall absolute agreement between the evaluators according with different phototypes and types of surgery, there was a fair agreement according to the RTOG scale when evaluating patients with phototype V or VI and mastectomy (3.7% and 8.8%, respectively).
The RTOG and WHO scales should be used with caution in clinical practice to identify the prevalence of radiodermatitis and the severity. Another point of caution is that skin phototype and the type of surgery may influence the analysis outcome. An illustrative scale was designed and proposed, by our group, aiming to improve accuracy and agreement between evaluators that will be tested in subsequent clinical studies.
Impacts of cognitive-behavioral intervention on anxiety and depression among social science education students
Authors: Ezegbe Bernedeth N. , Eseadi Chiedu , Ede Moses Onyemaechi , Igbo Janet N. , Anyanwu Joy I. , Ede Kelechi R. , Egenti Nkechi T. , Nwokeoma Bonaventure N. , Mezieobi Daniel I. , Oforka Theresa O. , Omeje Grace N. , Ugwoezuonu Amanda U. , Nwosu Nneka , Amoke Chijioke V. , Offordile Edmund E. , Ezema Luke C. , Ikechukwu-Ilomuanya Amaka B. , Ozoemena Lilian C. 
Published: April 2019

Abstract

Background:
Anxiety is a common disorder which refers to a significant and persistent fear of one or more social or performance situations. This study investigated the impacts of cognitive-behavioral intervention on anxiety and depression among undergraduate students enrolled in social science education programs at public universities in the Southeast Nigeria.

Methods:
Participants were 55 undergraduate students enrolled in social science education programs at public universities in the Southeast Nigeria. The adequacy of the sample size used was determined using GPower software. Cognitive-behavioral treatment manuals on anxiety and depression were used to deliver the intervention. Data analyses were completed using repeated measures analysis of variance.

Results:
Results indicated a significant positive impact of cognitive-behavioral intervention on anxiety and depression among social science education students exposed to the cognitive-behavioral intervention when compared to the waitlisted group. Results also showed that there was a significant time × group interaction for anxiety and depression. Follow-up tests showed that significant reduction in anxiety and depression persisted after 3 months for the cognitive-behavioral intervention group in comparison to the waitlisted control group.

Conclusion:
We concluded that cognitive-behavioral intervention was a successful intervention which decreased the symptoms of anxiety and depression in social science education students who participated in the study. Additional studies are recommended to further corroborate the influence of cognitive-behavioral intervention in the reduction of anxiety and depressive symptoms in the Nigerian undergraduate student population.
Effects of eplerenone on blood pressure and glucose metabolism in Japanese hypertensives with overweight or obesity
Authors: Adachi Hisashi , Kakuma Tatsuyuki , Kawaguchi Machiko , Kumagai Eita , Fukumoto Yoshihiro 
Published: April 2019

Abstract

Objective:
The impact of aldosterone blockade using eplerenone on hypertensives with obesity has not been clarified. We compared the efficacy and safety between eplerenone and trichlormethiazide in hypertensives with overweight or obesity.

Methods:
A prospective, randomized, open-labeled, blinded-endpoint design, multicenter trial enrolled 204 hypertension-treated outpatients with obesity [body mass index (BMI) ≥25 kg/m2] evaluated by ambulatory blood pressure (BP) measurement. Patients were randomly assigned to receive 50 mg of eplerenone (n = 102) or 1 mg of trichlormethiazide (n = 102), each of which were administered once every morning. Primary efficacy endpoints were systolic and diastolic BPs and biomarkers of glucose metabolism after 6 months of treatment.

Results:
At baseline, BPs were comparable between the two groups. Systolic/diastolic blood pressure (SBP/DBP) were reduced from 153.9 ± 12.6/84.6 ± 11.8 to 129.8 ± 14.2/73.7 ± 12.2 mm Hg by eplerenone therapy and from 152.2 ± 12.5/85.2 ± 10.9 to 133.8 ± 12.6/76.1 ± 8.6 mm Hg by trichlormethiazide therapy (all; P < .001). The efficacy of SBP reduction after adjustment for age, sex, and BMI was significantly greater in the eplerenone group than the trichlormethiazide (P = .034), although the efficacy of DBP reduction was marginally significant (P = .072). Especially, the efficacy of BP reduction was more effective for aged over 65 years than less than 65 years. However, biomarkers of glucose metabolism were not significantly different between these 2 groups.

Conclusion:
The eplerenone therapy was more effective in BP lowering in hypertensives with overweight or obesity than the trichlormethiazide therapy, especially in the elderly.
Practical application of the ATOM study
Authors: Paz Marco A. , Farrerons Monica , Saez Marc , Saurina Carme , Pinto Marc Garcia , Castro Sonia , Sobrino Javier , de Tuero Gabriel Coll 
Published: April 2019

Abstract

Background:
The response to antihypertensive drugs is predictable. The absence of precise prescription recommendations to treat arterial hypertension (HT) lead to use drugs unable to reduce blood pressure (BP) to target values.
We published ATOM study, in which we found significant differences in the ability to reduce BP between the different drugs.
The objective of the study was to determine the expected decrease in blood pressure with the use of commercialized doses of the drugs commonly used in the treatment of HT in clinical practice, to avoid the use of drugs or combinations that even with the best response, are unable to obtain the necessary BP decrease to reach the goal.

Methods:
The analysis was based on the results of the ATOM study. To convert the mean doses of the different drugs and combinations in commercialized doses, the conclusions of the study by Law et al have been applied.

Results:
Based on the results, two tables were drawn, one for systolic BP and the other for diastolic BP, where the doses of the different drugs and combinations are classified according to the BP decrease that can be expected from them. In order to favor the use of the tables in clinical practice, the different drugs have been grouped in intervals of 10 millimeters of mercury (mmHg) for the decrease of the systolic BP and of 5 mmHg for the diastolic BP.

Conclusions:
Recommendations for the use of antihypertensive treatments should not be limited to pharmacological families. They should also consider differences between drugs or specific combinations. From the data of the ATOM study we have implemented tables that express the effect of the drugs commonly used in clinical practice and that should allow the clinicians to choose with care the treatment to use.
Clinical features and genetic analysis of childhood sitosterolemia
Authors: Huang Dan , Zhou Qiong , Chao Yun-Qi , Zou Chao-Chun 
Published: April 2019

Abstract

Rationale:
Sitosterolemia is a rare autosomal recessive disorder of dyslipidemia due to mutations of genes ABCG5 and ABCG8, leading to highly elevated plasma levels of plant sterols and expanded body pools of cholesterol.

Patient concerns:
We present a 9-year-old and a 7-year-old Chinese boy with hypercholesterolemia and xanthomas of sitosterolemia due to ABCG5 gene mutations. We also make a literature review of another 30 sitosterolemic children cases that have been reported with virulence ABCG5 gene mutations.

Diagnosis:
We took peripheral blood samples from 2 patients and their parents to conduct genetic analysis by next-generation sequencing (NGS) technologies.

Interventions:
The 2 patients received dietary modifications without pharmaceuticals treatment.

Outcomes:
A c.1166G>A (Arg389His) homozygosis mutation in exon 9 was observed in case 1, whereas a c.751C>T (Gln251∗) homozygosis mutation in exon 6 was found in case 2. Literature review found another 30 pediatric cases with sitosterolemia due to ABCG5 gene mutation. The lipid profile was normalized and xanthomas got smaller with combined therapy of a combined low-cholesterol and low-phytosterols diet.

Lessons:
These suggested that in patients (especially Asian patients) with multiple xanthomas, severe hypercholesterolemia, or elevated low-density lipoprotein-cholesterol, sitosterolemia should be considered in the differential diagnosis. Early diagnosis is important, and restriction of both cholesterol and phytosterols diet should suggested for these patients.
A case report of Guillain Barré syndrome revealing underlying infective endocarditis due to Cardiobacterium hominis
Authors: Diallo Kévin , Jacquet Caroline , Alauzet Corentine , Beguinot Isabelle , May Thierry , Selton-Suty Christine , Hoen Bruno , Goehringer Francois 
Published: April 2019

Abstract

Rationale:
Guillain-Barré syndrome (GBS) is an acute inflammatory polyradiculoneuropathy presumed to result from an infection-triggered autoimmune reaction.

Patient concerns:
This paper describes a 53-year-old man admitted to hospital for deterioration of his general condition.

Diagnosis:
He developed GBS, confirmed by lumbar puncture and electromyogram, which recovered after intravenous immunoglobulins. A grade 2 aortic regurgitation was detected by transthoracic echocardiography upon diagnosis of GBS, but in the absence of fever, no further investigations were conducted. A few weeks later, the patient presented with fever and infective endocarditis (IE) was diagnosed after the identification of vegetation on the aortic valve with transesophageal echocardiography. The etiologic agent was identified as Cardiobacterium hominis based on 3 positive blood cultures and DNA detection in valvular material.

Interventions:
IE was cured with a 6-week course of antibiotics and aortic valve replacement.

Outcomes:
The patient completely recovered from Guillain-Baré syndrome and IE.

Lessons:
This case of GBS associated with C hominis endocarditis, emphasizes the importance of blood cultures and transesophageal echocardiography for the detection of IE and highlights the insidious nature of C hominis endocarditis which is often diagnosed late.
Parotid ductal stenosis after facial cosmetic surgery (2 case reports)
Authors: Choi Jeong-Seok , Kim Young-Mo , Lim Jae-Yol 
Published: April 2019

Abstract

Rationale:
Facial cosmetic surgery sometimes causes complications involving surrounding tissues. In particular, parotid damage may cause fibrous tissue formation, ductal stenosis, and obstruct salivary flow. Affected patients usually complain of symptoms such as pain and swelling.

Patient concerns:
The authors report 2 cases of obstructive parotitis, arising as a complication of facial cosmetic surgery that were treated successfully using sialendoscopic procedures.

Diagnosis:
A diagnosis of parotid ductal stenosis was made based on medical history, clinical manifestations, imaging studies, and sialendoscopic findings for the 2 patients.

Interventions:
The successful sialendoscopic procedures was given to the 2 patients.

Outcomes:
The 2 patients have shown no recurrent symptoms during follow-up.

Lessons:
Surgeons that perform facial cosmetic procedures should attain a thorough knowledge of the surgical anatomy of the parotid region and sialendoscopic procedure may be helpful for the management of obstructive parotitis due to complication of cosmetic surgery.
Sclerosing pneumocytoma
Authors: Khanna Akriti , Alshabani Khaled , Mukhopadhyay Sanjay , Lam Louis , Ghosh Subha 
Published: April 2019

Abstract

Rationale:
Sclerosing pneumocytoma is a rare benign lung neoplasm seen in middle aged adults with a female predominance. Originally thought to be vascular in origin, this rare entity is now understood to be epithelial in nature. On imaging, sclerosing pneumocytoma manifests as a well circumscribed nodule or mass, often juxtapleural in location. On histopathology, sclerosing pneumocytoma is composed of cuboidal “surface cells” and round “stromal cells,” both of which show nuclear staining for thyroid transcription factor-1 (TTF-1). Here we review the existing literature on sclerosing pneumocytoma and present a case of sclerosing pneumocytoma in a highly unusual endobronchial location.

Patient concerns:
This case is a 43 year old woman who presented with chronic cough.

Diagnosis:
Imaging revealed a right upper lobe nodule with an endobronchial component.

Interventions and outcomes:
Endoscopic biopsy was performed, and pathologic diagnosis was confirmed.

Lessons:
Although extremely rare, endobronchial presentation of sclerosing pneumocytoma is possible, and should remain on the differential for patients with endobronchial pulmonary lesions. Pathologic tissue analysis is necessary to confirm this uncommon diagnosis.
Diffuse large B-cell lymphoma involving peripheral nervous system with IgM antibodies against GM1 and GD1b
Authors: Jiang Zhaocai , Ju Weina , Luo Shen , Yang Yu 
Published: April 2019

Abstract

Rationale:
The occurrence of peripheral neuropathy associated with non-Hodgkin's lymphoma (NHL) is uncommon. And autoimmunity may play an important role. We report a case of the patient with NHL, has sensorimotor demyelinating polyneuropathy.

Patient concerns:
The patient presented with a 1-month history of progressive numbness at the distal extremities and motor weakness of the lower limbs. Meanwhile, patient also endorsed a painful lump on her right cheek. And then the enlarged cervical and supra clavicular lymph nodes were observed on admission. Biopsy of the lymph nodes showed NHL. Serum IgM antibodies against GM1 and GD1b were also positive.

Diagnosis:
Biopsy of the lymph nodes showed NHL. Serum IgM antibodies against GM1 and GD1b were also positive. Thus, the patience was diagnosed with lymphoma and sensorimotor polyneuropathy.

Interventions:
Patient refused the further treatment.

Outcomes:
After 11-month follow-up, the weakness of bilateral lower limbs worsens.

Lessons:
We have presented a case of NHL involving peripheral polyneuropathy with IgM antibodies against GM1 and GD1b. Patients may initially present with peripheral nerve complications or develop them during the course of lymphoma, even when in remission. This could complicate the diagnosis of peripheral polyneuropathy secondary to NHL.
Unhealthy changes in eating habits cause acute onset hypertension in the normotensive community-dwelling elderly—3 years cohort study
Authors: Kakamu Takeyasu , Hidaka Tomoo , Kumagai Tomohiro , Masuishi Yusuke , Kasuga Hideaki , Endo Shota , Sato Sei , Takeda Akiko , Koizumi Makoto , Fukushima Tetsuhito 
Published: April 2019

Abstract
The aim of this study was to determine what lifestyle changes can predict acute onset hypertension in the normotensive community-dwelling elderly.
This study targeted elderly people enrolled in National Health Insurance in Fukushima Prefecture, Japan. The subjects were 24,490 people who took all of the specific health examination conducted by National Health Insurance in fiscal years 2013, 2014, and 2015 continuously and had a recorded systolic blood pressure (BP) <130 mm Hg and diastolic BP <85 mm Hg in the first 2 fiscal years. We examined their lifestyle changes for the first 2 fiscal years using the questionnaires given at the health examination. Multivariate Poisson regression analysis was conducted to examine the relationship between new-onset hypertension observed at the last examination and unhealthy lifestyle changes.
The mean age of the subjects was 61.5 ± 8.2 years old at baseline. We observed new-onset hypertension in 1.062 subjects at the last examination. Of the study subjects, 12,027 (49.1%) answered to having at least one of the items of unhealthy lifestyle change in the questionnaire. In the multivariate logistic regression, eating supper before bedtime showed a significant increase in the risk ratio for acute onset hypertension (risk ratio 1.27, 95% confidence interval, 1.01–1.58).
This study indicated that eating before bedtime is a risk factor of new-onset hypertension in the normotensive community-dwelling elderly. Adequate health guidance to avoid unhealthy lifestyle changes is required even in normotensive people as this hypertension is preventable.
Effectiveness of a multi-faceted intervention among elementary school children
Authors: Chuang Hai-Hua , Lin Rong-Ho , Chen Jau-Yuan , Yeh Wei-Chung , Lin Hsiu-Fong , Ueng Steve Wen-Neng , Hsu Kuang-Hung 
Published: April 2019

Abstract
Childhood obesity has been shown to be closely related to future obesity and comorbidities. As its prevalence and impact has increased significantly worldwide, researchers have focused on prevention and intervention. This study assessed a multifaceted intervention for elementary school children.
A retrospective data collection with a cohort analysis was employed. A 16-week school-based intervention with nutritional intervention, physical activity, and behavioral education was designed and conducted by a multidisciplinary team for 1860 children aged 6 to 13 years. Basic information, anthropometrics, and physical fitness (PF) were recorded before and after the intervention. The differences compared with a reference group, and compared between subgroups, were analyzed.
Significant favorable changes in body weight and composition were found. Children's height, weight, and muscle weight increased, whereas BMI, BMI z-score (zBMI), waist circumference, hip circumference, waist-hip ratio, waist-height ratio, body fat percentage, and visceral fat area decreased. Sit-ups and 800-m run time significantly improved. Girls exhibited a greater reduction in body weight outcomes; boys improved more in body composition and PF. Students with higher zBMI had a greater reduction in all anthropometrics; students with lower zBMI showed greater PF improvement, except for the 800-m run.
The intervention improved weight measures, body composition, and PF. Subgroup differences suggested the need for sex- and weight-specific interventions.
Prevalence of extracranial carotid atherosclerosis in the patients with coronary artery disease in a tertiary hospital in Malaysia
Authors: Sahadevan Mahavishnu , Chee Kok Han , Tai Mei-Ling Sharon 
Published: April 2019

Abstract
There is limited information regarding the prevalence of extracranial carotid atherosclerosis in the patients with coronary artery disease (CAD) undergoing coronary artery bypass graft (CABG) surgery in South East Asia. The primary objective was to assess the prevalence of extracranial carotid stenosis, raised carotid intima media thickness (CIMT), and plaques in the patients with CAD undergoing elective CABG. The secondary objective was to evaluate the risk factors for extracranial carotid atherosclerosis.
A total of 119 consecutive patients with CAD undergoing elective CABG in a tertiary hospital in Malaysia were recruited. Data on the demographic characteristics and risk factors were collected. The ultrasound carotid Doppler findings comprising of raised CIMT, plaques, and stenosis in the extracranial carotid vessels were recorded.
The mean age of the patients was 64.26 ± 10.12 (range 42–89). Most of the patients were men (73.1%). The patients consisted of 44 (37%) Malays, 26 (21.8%) Chinese, and 49 (41.2%) Indians.
A total of 67 (56.3%) patients had raised CIMT, 89 (74.8%) patients had plaques, and 10 (8.4%) patients had stenosis in the internal and common carotid arteries. The mean age of patients with plaques was higher compared to those without plaques (66.00 ± 9.63 vs 59.10 ± 9.92, P = .001). The body mass index (BMI) of patients with stenosis was higher compared to those without stenosis (28.35 ± 4.92 vs 25.75 ± 3.16, P = .02).
The patients with plaques were more likely to be older, whereas the patients with carotid stenosis were more likely to have higher BMI.