bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of oral calcium supplementation alone or with vitamin D in preventing post-thyroidectomy hypocalcaemia
Authors: Xing Tengfei , Hu Yiyi , Wang Bin , Zhu Jingqiang 
Published: February 2019

AbstractBackground:Thyroidectomy is the main intervention for thyroid malignancies and some benign thyroid diseases. Its most common complication is hypocalcaemia, which requires oral or intravenous calcium therapy. The aim of this meta-analysis was to assess the efficacy of routine calcium supplementation with or without vitamin D in preventing hypocalcaemia post-thyroidectomy.Methods:Systematic searches of the PubMed, EMBASE, and Cochrane Library databases were performed. The qualities of the included articles were assessed using the Cochrane risk of bias tool. The studies’ qualities of outcomes and strengths of evidence were evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool. Data analysis was performed using Review Manager 5.3, and odds ratio (ORs) with their 95% confidence intervals (CIs) were computed for dichotomous data.Results:Ten randomized controlled trials (RCTs) were included. The combined study recruited 1620 patients (343 men and 1277 women) who underwent total thyroidectomy alone or with neck dissection. Calcium supplementation decreased the risk of transient postoperative hypocalcaemia (OR 0.48 [95% CI, 0.31–0.74];P < .001) but did not decrease the demand for intravenous supplementation or the rate of permanent hypocalcaemia compared to no treatment. Calcium and vitamin D supplementation significantly reduced the rate of transient hypocalcaemia and the demand for intravenous supplementation compared to either no treatment (OR 0.21 [95% CI, 0.11–0.40];P < .001 and OR 0.26 [95% CI, 0.10–0.69];P = .007, respectively) or calcium alone (OR 0.39 [95% CI, 0.18–0.84];P = .02 and OR 0.18 [95% CI, 0.07–0.47];P < .001, respectively), but did not decrease the rate of permanent hypocalcaemia. GRADE-based confidence was moderate.Conclusion:Postoperative calcium supplementation is effective for preventing post-thyroidectomy hypocalcaemia. Calcium plus vitamin D was more effective than calcium alone in preventing postoperative hypocalcaemia and decreasing the demand for intravenous calcium supplementation. Further, well-designed RCTs with larger sample sizes are required to validate our findings.
Echocardiographical findings of giant cardiac lipoma
Authors: Liu Liu , Zuo Yangping , Huang Yuwen , Cao Liting 
Published: February 2019

Abstract

Rationale:
Cardiac lipoma is a kind of extremely rare benign tumor. Lipomas can be located in various parts of the pericardium and heart, among which the pericardial lipoma is relatively rare.

Patient concerns:
We report the case of a 59-year-old male with extremely rare cardiac lipoma. The patient was admitted to the hospital because of palpitation and dyspnea for more than one month. Echocardiography examination and the pathological results indicated lipoma.

Diagnoses:
Diagnosed with lipoma.

Interventions:
The patient underwent cardiac lipoma resection successfully.

Outcomes:
There was no obvious cardiac abnormality in the follow-up three months after the surgery.

Lessons:
Echocardiography is of great significance for preoperative evaluation and postoperative follow-up.
Molecular epidemiology and antibiotic resistance of Burkholderia pseudomallei isolates from Hainan, China
Authors: Rao Chenglong , Hu Zhiqiang , Chen Jiangao , Tang Mengling , Chen Hai , Lu Xiaoxue , Cao Liusu , Deng Ling , Mao Xuhu , Li Qian 
Published: February 2019

Abstract

Burkholderia pseudomallei is the causative agent of meliodosis, and the cases in China are gradually increasing. The present retrospective study aimed to surveil the molecular epidemiological characteristics and antibiotic resistance of B pseudomallei isolates. B pseudomallei strains were isolated and verified from meliodosis patients with relevant epidemiological information from 2004 to 2016 in Hainan, China. Pulsed-field gel electrophoresis based on Spe I digestion was carried out, and antimicrobial resistance of B pseudomallei strains was observed against 9 frequently-used antimicrobials. A total of 164 B pseudomallei isolates were successfully divided into 60 pulsed-field gel electrophoresis (PFGE) patterns, including 33 clusters and 27 single types, at an 85% similarity level. The isolates also exhibited a high level of ceftazidime resistance rate (12.8%, 21/164). B pseudomallei strains were mainly heterogenous with no predominant type, but there were some clonal populations, dominate clusters prevalent and the resistance rates of cephems antimicrobial increased significantly between 2004 and 2016 along with the number of melioidosis cases collected in Hainan (cefoperazone-sulbactam [SCF], r
s = 0.96, P = .04; ceftazidime [CAZ], r
s = 0.98, P = .01). In conclusion, this study will help to enhance our understanding of molecular characteristics and antibiotic resistance of B pseudomallei.
Pretransplant C-reactive protein as a prognostic marker in allogeneic stem cell transplantation
Authors: Wu Peilin , Liang Wei , Chen Xianying , Chen Lihong , Yang Xuerong , Yan Zhengwei , Wang Wei 
Published: February 2019

Abstract

Background:
Numerous reports have explored the prognostic value of pretransplant serum C-reactive protein (CRP) in patients receiving allogeneic stem cell transplant (ASCT), but the results remain conflicting. Therefore, we performed a meta-analysis to comprehensively assess the prognostic value of pretransplant serum CRP in patients receiving ASCT.

Methods:
We systematically searched eligible studies in PubMed, Embase, and Web of Science from 1999 to September 2018. The pooled hazard ratios (HRs) and their corresponding 95% CIs were used to synthetically assess the prognostic value of pre-ASCT CRP in terms of overall survival (OS), non-relapse mortality (NRM), and acute graft versus host disease (aGVHD).

Results:
A total of 14 articles with 15 studies containing 3458 patients were included in this meta-analysis. The pooled results showed that high pre-ASCT CRP level was significantly related to worse OS (HR = 1.63; 95% CI: 1.34–1.98; P < .05), to an increased risk of NRM (HR = 2.06; 95% CI: 1.62–2.62; P < .05), and aGVHD (HR = 1.35; 95% CI: 1.07–1.71; P < .05). Additionally, sensitivity and subgroup analyses demonstrated that our pooled results were stable and reliable.

Conclusions:
High pre-ASCT serum CRP was significantly associated with worse OS, as well as higher risk of NRM and aGVHD. CRP may be a candidate factor of updating the existing risk scoring systems or establishing a novel risk scoring systems, which has the potential of guiding patient selection for ASCT and proceeding with risk-adapted therapeutic strategies. However, more high-quality clinical studies and basic research are required to further validate our findings in view of several limitations in our meta-analysis.
Subacute stroke physical rehabilitation evidence in activities of daily living outcomes
Authors: García-Rudolph Alejandro , Sánchez-Pinsach David , Salleras Eloy Opisso , Tormos Josep María 
Published: February 2019

Abstract

Background:
Stroke is a leading cause of disabilities worldwide. One of the key disciplines in stroke rehabilitation is physical therapy which is primarily aimed at restoring and maintaining activities of daily living (ADL). Several meta-analyses have found different interventions improving functional capacity and reducing disability.

Objectives:
To systematically evaluate existing evidence, from published systematic reviews of meta-analyses, of subacute physical rehabilitation interventions in (ADLs) for stroke patients.

Methods:
Umbrella review on meta-analyses of RCTs ADLs in MEDLINE, Web of Science, Scopus, Cochrane, and Google Scholar up to April 2018. Two reviewers independently applied inclusion criteria to select potential systematic reviews of meta-analyses of randomized controlled trials (RCTs) of physical rehabilitation interventions (during subacute phase) reporting results in ADLs. Two reviewers independently extracted name of the 1st author, year of publication, physical intervention, outcome(s), total number of participants, and number of studies from each eligible meta-analysis. The number of subjects (intervention and control), ADL outcome, and effect sizes were extracted from each study.

Results:
Fifty-five meta-analyses on 21 subacute rehabilitation interventions presented in 30 different publications involving a total of 314 RCTs for 13,787 subjects were identified. Standardized mean differences (SMDs), 95% confidence intervals (fixed and random effects models), 95% prediction intervals, and statistical heterogeneity (I
2 and Q test) were calculated. Virtual reality, constraint-induced movement, augmented exercises therapy, and transcranial direct current stimulation interventions resulted statistically significant (P < .05) with moderate improvements (0.5 ≤ SMD ≤ 0.8) and no heterogeneity (I
2 = 0%). Moxibustion, Tai Chi, and acupuncture presented best improvements (SMD > 0.8) but with considerable heterogeneity (I2 > 75%). Only acupuncture reached “suggestive” level of evidence.

Conclusion:
Despite the range of interventions available for stroke rehabilitation in subacute phase, there is lack of high-quality evidence in meta-analyses, highlighting the need of further research reporting ADL outcomes.
Multiple risks analysis for aplastic anemia in Zhejiang, China
Authors: Wu Li-qiang , Shen Ying-ying , Zhang Ying , Kuang Yue-min , Fang Bing-mu , Wang Zhou-zheng , Fu Li-juan , Shao Ke-ding , Shen Jian-ping , Zhou Yu-hong , Shen Yi-ping , Ye Bao-dong , Zheng Zhi-yin , Chen Jun-fa , Lin Sheng-yun 
Published: February 2019

Abstract
To understand the risks associated with aplastic anemia (AA) in 4 cities of Zhejiang Province, China, with special focus on the joint contributions of multiple risks.
Based on an Electronic Data Capture (EDC), a case control study was carried out. Data regarding socio-demographic, diseases history, living habits, and exposures to toxic substances, etc., were collected through survey questionnaires. t Test, chi-square test, or non-parametric rank sum test, and univariate and multivariate Logistic regression analysis were conducted to analyze data.
The univariate logistic regression analysis results indicated that among all study participants (n = 1802), AA was associated with over 30 risks, in terms of their individual behaviors, daily and environmental exposures, diseases history, and family history. Multivariate logistic regression analysis further confirmed that the independent risks related to AA included presence of chemical factory within 3 km of living residence (odds ratio [OR] = 8.73, 95% CI: 1.42–53.74, P = .019), living in a newly decorated house/apartment (OR = 25.37, 95% CI: 4.44–144.81, P < .001), vegetarian diet (OR = 131.60, 95% CI: 3.45–5020.16, P = .009), preference of sugar (OR = 89.38, 95% CI: 7.22–1106.44, P < .001), preference of oily food (OR = 55.68, 95% CI: 5.12–605.26, P = .001), drinking lake water or pond water (OR = 58.05, 95% CI: 3.21–1049.81, P < .001), habit of staying up late (OR = 11.87, 95% CI: 3.43–41.02, P < .001), infection history (OR = 10.08, 95% CI: 2.75–36.93, P < .001). Result of receiver operating characteristic curve (ROC) analysis on the joint contribution of multiple risks indicated that AA was 13.835 times likely to occur when exposed to ≥1 risks than those exposed to 0 risks (95% CI: 9.995–19.149).
Our study results demonstrated a comprehensive epidemiological pattern, in which the joint contributions of individual inherited health status, environment exposure, and individual behaviors lead to the occurrence of AA.
Prognostic value of serum uric acid in patients with acute heart failure
Authors: Huang Gang , Qin Juan , Deng Xuejun , Luo Guiquan , Yu Dongmei , Zhang Mei , Zhou Shiheng , Wang Lei 
Published: February 2019

Abstract

Background:
Conflicting results have been reported on the prognostic significance of serum uric acid (SUA) in patients with acute heart failure (AHF). This meta-analysis aimed to determine the prognostic significance of SUA level in patients with AHF.

Methods:
We made a comprehensive literature search in Pubmed and Embase databases from inception to April 6, 2018. All available observational studies or post hoc analysis of randomized controlled trial that evaluated the prognostic value of SUA level in patients with AHF were eligible. Outcome of interests were all-cause mortality and the combined endpoint of death or readmission. Prognostic values of SUA level were summarized as higher vs lower SUA category or per 1 mg/ml SUA rise.

Results:
Ten studies involving 12,854 AHF patients were identified and analyzed. AHF patients with the highest SUA level had an increased risk of all-cause mortality (risk ratio [RR] 1.43; 95% confidence intervals [CI] 1.31–1.56) and combined endpoint of death or readmission (RR 1.68; 95% CI 1.33–2.13) after adjusting potential variables. In addition, per 1 mg/ml SUA rise significantly increased by 11% and 12% higher risk all-cause mortality and combined endpoint of death or readmission, respectively. A leave out 1 study sensitivity analysis confirmed the reliability of the pooling effect sizes.

Conclusion:
This meta-analysis indicates that elevated SUA level independently predicts all-cause mortality and the combined endpoint of death or readmission in AHF patients. Measurement of SUA level may improve risk stratification of adverse outcomes in these patients.
Prolonged stabilization of platinum-refractory ovarian cancer in a single patient undergoing long-term Mistletoe extract treatment
Authors: Hwang Woo Yeon , Kang Mi Hyun , Lee Seul Ki , Yeom Ji Su , Jung Min Hyung 
Published: February 2019

Abstract

Rationale:
Advanced ovarian malignancies are associated with poor overall survival; thus, patients often turn to alternative treatments, despite the controversy surrounding their use. Mistletoe extract has been commonly used as complementary medicine to treat patients with cancer for several decades, and has proven benefits in integrative oncology.

Patient concerns:
A 47-year-old woman with stage IVB ovarian cancer who underwent optimal surgical cytoreduction, but whose disease persisted after adjuvant platinum-based combination chemotherapy and 2nd-line chemotherapy.

Diagnosis and interventions:
The patient discontinued chemotherapy due to her septic condition and acute kidney injury accompanied by acute pyelonephritis, and opted for adjuvant treatment with mistletoe extract.

Outcomes:
The patient has achieved good health without progression of cancer or ascites over the 42 months since the 1st diagnosis and 24 months since the last relapse.

Lessions:
Our case suggests that mistletoe extract can produce favorable outcomes in patients with platinum-refractory ovarian cancer.
Pancreatic progenitor cell differentiation and proliferation factor predicts poor prognosis in heptaocellular carcinoma
Authors: Mao Zhengfa , Li Xi , Ma Xiaoyan , Wang Xuqing , Zhang Jiangxin , Fan Xin 
Published: February 2019

Abstract
The aim of this study is to investigate the expression of pancreatic progenitor cell differentiation and proliferation factor (PPDPF) and its relationship with clinicopathological factors in hepatocellular carcinoma (HCC).
A total of 135 patients diagnosed with HCC who underwent curative surgery were enrolled in this study. The expression of PPDPF was examined by real time-polymerase chain reaction (RT-PCR), western blot, and immunohistochemistry. The prognostic value for each sample was explored.
Both RT-PCR and western blot revealed PPDPF expression was upregulated in HCC. Higher PPDPF expression was also observed in HCC (54.07%) detected by immunohistochemistry (IHC), which was significantly associated with tumors size (P = .003), Edmondson-Steiner Grading (P = .021), recurrence (P = .010), and Diolame complete (P = .023). Patients with higher PPDPF expression had increased cancer progression and poorer prognosis than those with lower expression (P = .043). Multivariate analysis indicated PPDPF as an independent prognostic factor (P = .014).
Aberrance PPDPF expression might be a useful predictor and could serve as a potential therapeutic target for HCC.
Prognostic factors in patients with advanced extrahepatic cholangiocarcinoma
Authors: Aktas Gokmen , Kus Tulay , Balkan Ayhan , Metin Taylan , Gulsen Murat Taner , Abali Huseyin 
Published: February 2019

Abstract
Extrahepatic cholangiocarcinoma (ECC) is an aggressive malignancy causing a lot of fatalities and comorbidities. Endoscopic biliary stenting (EBS) is mostly needed for ECC. In this study, we aimed to investigate the prognostic factors for the overall survival (OS) and the factors predicting the patients eligible for chemotherapy after EBS in ECC.
We retrospectively screened 153 advanced ECC patients who underwent EBS for jaundice to make the patients eligible for chemotherapy. Patient's clinical and laboratory parameters were recorded. OS was estimated by the Kaplan–Meier method. All parameters were assessed by binary logistic regression analysis to predict which patients are eligible for chemotherapy.
The median OS of all patients was 12.0 months (10.1–13.8). The median OS of the patients treated with chemotherapy was 13.0 months (12.0–14.0), while it was 4.0 months (2.3–5.7) for patients unable for chemotherapy after EBS. Albumin, aspartate aminotransferase (ALT) and carbohydrate antigen 19-9 (CA 19-9) values were independent prognostic factors for OS. Higher albumin and lower prothrombin time (PT) levels were independent parameters to predict the patients eligible for chemotherapy after EBS.
Being suitable for chemotherapy was the main determinant for prolonged survival and albumin and PT levels were independent predictors for chemotherapy eligibility after EBS. Albumin, ALT, and CA 19-9 values were independent prognostic factors for OS in ECC.
Doughnut sign of hepatic alveolar echinococcosis on FDG PET/CT
Authors: Shen Guohua , Kou Ying , Kuang Anren 
Published: February 2019

Abstract

Rationale:
A characteristic metabolic finding of hepatic alveolar echinococcosis (HAE) on positron emission tomography/computed tomography (PET/CT) correlates with morphologic features on CT and magnetic resonance imaging (MRI).

Patient concerns:
A young man from an endemic area was admitted to our hospital due to right upper quadrant pain for 2 months.

Diagnosis:
CT and MRI revealed a heterogeneous mass with calcification, consisting of central necrosis and peripheral solid inflammatory tissues. Accordingly, FDG PET/CT demonstrated a characteristic metabolic finding of doughnut sign. Combining the above characteristic imaging features with positive serologic findings, the patient was diagnosed as HAE.

Interventions:
He then underwent extracorporeal hepatectomy and liver autotransplantation followed by medical treatment of benzimidazoles.

Outcomes:
He remained asymptomatic without evidence of recurrence at 2-year follow-up.

Lessons:
The characteristic metabolic appearance of HAE on FDG PET/CT, correlated with its morphologic features of CT and MRI, may allow to make accurate diagnoses.
Single- versus 2-stage reconstruction for chronic post-radiation chest wall ulcer
Authors: Zhou Yaodong , Zhang Yixin 
Published: February 2019

Abstract
Radiation therapy can have adverse effects on normal tissue and cause chronic ulcers. The purpose of this study was to compare breast cancer patients who underwent single-stage reconstruction with patients who underwent 2-stage reconstruction for chronic radiation-induced necrotic ulcers of the chest wall.
This retrospective study comprised of 50 patients with chronic radiation-induced chest wall ulcers who underwent chest wall reconstruction in our hospital between January 2002 and January 2016. All patients developed ulcers after undergoing breast cancer surgery, followed by radiation therapy. These patients were divided into 2 groups: group A, patients who underwent debridement and reconstruction with tissue flaps simultaneously in a single-stage procedure; group B, patients who underwent debridement and omentum majus tamping in the 1st stage, followed by surgical reconstruction with skin grafting or flap transfer 2 weeks later. The postoperative complications and outcomes were evaluated and compared.
These patients were followed up for 48 to 55 months (mean: 50 months), and overall survival was 98%. One patient in group A died of septicemia 5 days after the operation. Six patients in group A developed flap infection, among which 4 patients progressed to flap necrosis (group A: 6/25 vs group B: 0/25; P = .000).
Compared to single-stage reconstruction, surgical reconstruction in 2 stages was safer and more effective in treating chronic radiation-induced ulcers of the chest wall, and is associated with fewer postoperative complications. The omentum majus flap was the most ideal tissue for the repair of these defects.
Peritoneal lymphoma with ascites mimicking portal hypertensive ascites
Authors: Liu En-Shao , Wang Jyh-Seng , Yang Wen-Chi 
Published: February 2019

Abstract

Rationale:
Lymphoma with an initial manifestation of ascites and peritoneal invasion is rare.

Patient concerns:
A 65-year-old woman presented to the emergency department with a 3-week history of abdominal distention, anorexia, and night sweating, and a 2-week history of melena. She was a silent hepatitis B virus carrier. Abdominal ultrasound showed massive ascites without cirrhosis. Abdominal computed tomography revealed ascites, infiltrative peritoneal lesions with omental cake appearance, and lymphadenopathies.

Diagnosis:
We performed paracentesis and the ascites cytology was obtained. The patient also underwent esophagogastroduodenoscopy, which showed ulcerative tumors in the stomach. Both ascites cytology and pathology of the gastric tumors confirmed the diagnosis of B-cell lymphoma.

Interventions:
This patient received 7 cycles of chemotherapy.

Outcomes:
Follow-up imaging studies revealed partial remission of lymphoma, but an enlargement of residual tumors in omentum and mesentery, which resulted in intractable ascites and rapid deterioration of performance status. Despite a change of regimen of chemotherapy, this patient expired 10 months after diagnosis.

Lessons:
Lymphoma should be one of the differential diagnoses in patients with intractable ascites not attributable to other comorbidities.