bluuebunny/crossref_metadata_2025_split huggingface dataset:
Partial anomalous pulmonary venous connection associated with hemoptysis
Authors: Li ChengCheng , Teng Peng , Yang Yanyan , Ni Yiming , Ma Liang 
Published: June 2019

Abstract

Rationale:
Partial anomalous pulmonary venous connection (PAPVC) is a rare congenital anomaly characterized by the failure of fusion of embryologic pulmonary venous system with left atrium.

Patient Concerns:
A 45-year-old male patient with PAPVC who was hospitalized because of mild hemoptysis. Images showed the anomalous vein originated from the left upper pulmonary vein and flowed into the left brachiocephalic vein. No other underlying causes for hemoptysis were detected.

Diagnosis:
After multi-disciplinary discussion, the patient was diagnosed as PAPVC of left upper pulmonary vein draining into the left brachiocephalic vein with intact atrial septum.

Interventions:
Although surgical correction of PAPVC was feasible, left upper lobectomy was performed as the definitive treatment for both hemoptysis and PAPVC.

Outcomes:
The patient had an uneventful postoperative hospital course and was followed up for nearly 2 years without recurrence of hemoptysis.

Lessons:
PAPVC is associated with atrial septal defect in 80% to 90% of cases while isolated PAPVC with intact atrial septum is an extremely rare entity. We present a rare isolated PAPVC patient with hemoptysis. To our best knowledge, PAPVC associated with hemoptysis has never been reported before.
Variations of plasma D-dimer level at various points of normal pregnancy and its trends in complicated pregnancies
Authors: Baboolall Uttam , Zha Ying , Gong Xun , Deng Dong Rui , Qiao Fuyuan , Liu Haiyi 
Published: June 2019

Abstract
D-Dimer (DD) is the smallest fragment of plasmin-mediated cleavage of fibrin. There is a progressive increase in DD concentration with advancing gestation in normal pregnancies, making the upper limit of 0.5 μg/ml used in non-pregnant population an unfavorable marker during pregnancy. Coagulation and fibrinolysis parameters are also markedly disturbed in pregnancies complicated by various pathologies.
We designed this retrospective observational cohort study to investigate the trimester specific reference range for DD throughout normal pregnancy, and to compare the distribution of DD in third trimester healthy pregnancies and those complicated by preeclampsia (PE), severe preeclampsia (SPE), gestational diabetes mellitus (GDM), premature rupture of membranes (PROM) and preterm premature rupture of membranes (PPROM). In addition, we aimed to determine the diagnostic value of DD in PE and SPE.
In this retrospective observational cohort study, 250 normal and 178 complicated pregnancies were included. Normal pregnancies included 88-first trimester, 101-second trimester and 61-third trimester pregnancies. Complicated pregnancy included 34 PE, 44 SPE, 32 GDM, 33 PROM, and 35 PPROM cases during the third trimester. Predefined exclusion criteria were used.
The period of gestation (POG) accounted for 41.9% of the variance in DD, with strong correlation between the POG and DD. The trimester specific reference intervals were computed. The distribution for severe preeclampsia was statistically different compared to other categories in the third trimester. This exceptional distribution led to the generation of a receiver operating characteristic (ROC) curve with an area under curve of 0.828, attesting its possible role in predicting severe preeclampsia.
We determined trimester specific reference intervals of DD. The role of DD has been explored, and it may be of diagnostic value in severe preeclampsia.
Invasive candidiasis
Authors: Rodrigues Luiza Souza , Motta Fabio Araujo , Picharski Gledson Luiz , Vasconcelos Thaís Muniz , Riccieri Marinei Campos , Dalla-Costa Libera Maria 
Published: June 2019

AbstractBackground:Invasive candidiasis (IC) is a major cause of morbimortality in children. Previous studies described the clinical characteristics and risk factors for this infection; however, limited data are available on the predictors of mortality in these patients. In this context, we evaluated the risk factors associated with death due to IC in a pediatric tertiary care hospital in South of Brazil.Methods:This is a retrospective, cross-sectional, observational, and analytical study of a series of pediatric patients with clinical and laboratory diagnosis of IC from March 2014 to September 2017. Univariate and multivariate analysis were performed to estimate the association between the characteristics of the patients and death.Results:A total of 94 cases of IC were included. The incidence was 1.13 cases per 1000 patients/d, with a mortality rate of 14%. There was a predominance of non-albicansCandida(71.3%) in IC cases and, although there is no species difference in mortality rates, biofilm formation was associated with increased mortality. Clinical characteristics such as male sex, stay in the intensive care unit, and thrombocytopenia; comorbidities such as cardiological disease and renal insufficiency; and risks such as mechanical ventilation and dialysis were associated with increased mortality.Conclusion:Data from this study suggest that biofilm formation byCandidasp. is associated with increased mortality, and this is the first study to correlate the male sex and cardiological disease as risk factors for death in pediatric IC patients.
Multivariate analysis of incision infection after posterior lumbar surgery in diabetic patients
Authors: Peng Wang , Liang Yan , Lu Tao , Li Miao , Li Dong-Sheng , Du Kai-Hui , Wu Jian-Huang 
Published: June 2019

Abstract

Background:
Patients requiring posterior lumbar surgery have increased annually. Incision infection after lumbar surgery has serious consequences for patients. However, data on the related factors of incision infection after lumbar surgery in diabetic patients are limited. Therefore, this study aimed to analyze diabetic patients who underwent lumbar surgery and to explore the risk factors of perioperative incision infection to provide a scientific basis for perioperative intervention of lumbar spine surgery and reduce risk of incision infection in such patients.

Methods:
We retrospectively reviewed data of diabetic patients who underwent posterior lumbar surgery from 2011 to 2016. A total of 523 diabetic patients undergoing posterior lumbar surgery were analyzed for the influence of various risk factors on postoperative incision infection. Univariate and multivariate logistic regression was performed. The test level was α=.05, and P < .05 was considered statistically significant.

Results:
In the past 6 years, among the 523 diabetic patients, the incidence of incision infection after posterior lumbar surgery was approximately 7.1%, of which the shallow incision infection rate was 4.2% and the deep incision infection rate was 2.9%. Incision infection of posterior lumbar surgery in diabetic patients is related to smoking, preoperative glycosylated hemoglobin A1c, postoperative albumin (Alb), surgical segment, operation time, and intraoperative blood loss, especially on postoperative fasting blood glucose, postoperative postprandial blood glucose, local subcutaneous fat thickness, and operation sequence (odds ratio >5.00). Meanwhile, sex, age, body mass index (BMI), preoperative Alb, and newly diagnosed diabetes were not highly correlated with incision infection after posterior lumbar surgery.

Conclusion:
Local subcutaneous fat thickness is a better indicator for predicting incision infection compared with BMI. In diabetic patients undergoing lumbar surgery, actively controlling blood glucose fluctuations, restoring normal diet early after surgery, and optimizing surgical procedures to reduce trauma and operative time can effectively reduce the risk of infection after posterior lumbar surgery.
Therapeutic effect of minimally invasive catheter drainage and local chemotherapy for the lumbosacral tuberculosis without neural symptoms
Authors: Li Tian-qing , Ma Zhen-sheng , Zhang Yang , Xu Hui-fa , Lei Wei 
Published: June 2019

Abstract
Increasing number of studies have shown growing incidence of lumbosacral tuberculosis and its complications. However, the treatment options for this disorder are still limited.
To evaluate the long-term therapeutic effect and prognosis of minimally invasive puncture catheter drainage and Isoniazid local chemotherapy for the treatment of lumbosacral tuberculosis without neural symptoms under the guidance of computed tomography (CT).
A total of 45 patients with asymptomatic lumbosacral tuberculosis were treated by minimally invasive catheter drainage under CT guidance. Forty-two cases had been followed up, which included 22 women and 20 men with an average age of 36.45 years old. Isoniazid was injected locally and antituberculotic drugs were administered for postoperative treatment. Oswestry Disability Index (ODI), visual analogue scale (VAS) evaluation and Cobb angle were recorded before and after operation.
Forty-two patients had been followed up and the follow-up term was from 1.2 to 8.5 years (average 60 months). All patients were healed without recurrent cases. The ODI were improved from 14.86 ± 2.02 before operation to 1.48 ± 1.55 after operation. The post-operative (4.19 ± 1.17) VAS score was improved compared to the pre-operative VAS score (0.55 ± 0.55). The post-operative Cobb angle (6.19° ± 3.85°) was also improved relatively to the preoperative Cobb angle (5.90° ± 3.71°).
Minimally invasive puncture catheter drainage combined with Isoniazid local chemotherapy is an effective method for lumbosacral tuberculosis without neural symptom. Meanwhile, it can be applied for the treatment of spinal tuberculosis before open surgery.
Epidemiologic characteristics and risk factors in patients with ketamine-associated lower urinary tract symptoms accompanied by urinary tract infection
Authors: Liu Weihua , Wu Weiwei , Wei Yongbao , Wu Jinfeng , Li Tao , Zhu Qingguo , Ye Liefu , Hong Fuyuan , Gao Yunliang , Yang Jinrui 
Published: June 2019

Abstract
Young adults with longstanding ketamine abuse present with lower urinary tract symptoms (LUTSs), which may be accompanied by urinary tract infection (UTI). However, the morbidity and risk factors for ketamine-associated LUTS accompanied by UTI (KALAUTI) are still unknown. To ascertain these, we surveyed patients with a history of ketamine abuse and LUTS at the time of their initial presentation.
One hundred untreated patients with ketamine-associated LUTS were initially surveyed at 3 medical institutions. The patients’ basic demographic and clinical information, KALAUTI status, and possible risk factors were obtained via a questionnaire and analyzed.
Eighty-one patients were finally enrolled. Eight patients (9.88%) had a definitive diagnosis of KALAUTI and 16 (19.75%) had suspected KALAUTI. The diagnosis of KALAUTI was ruled out in the remaining 57 patients (70.37%). Patients with upper urinary tract involvement, longer duration of drug use, or more severe LUTS (P < .05), were more prone to KALAUTI. Frequent urine culture and a higher voiding symptom score (VSS) were risk factors for KALAUTI (P < .05), increasing the risk of KALAUTI by 44.241- and 1.923-fold, respectively.
The study indicates that frequent urine culture and severe VSS are risk factors for KALAUTI. The possibility of UTI should be considered in ketamine abusers with LUTS in the clinical setting.
Perceived stress and psychological distress among chinese physicians
Authors: Wang Yan , Wang Ping 
Published: June 2019

Abstract
Although the association between perceived stress and psychological distress has been demonstrated, the mechanism behind the association is not well understood in physicians. The purpose of this study was to examine how coping styles (positive and negative) mediated the association between perceived stress and psychological distress among Chinese physicians.
A cross-sectional survey was conducted in Liaoning Province, China, between October and December 2017. Self-administered questionnaires, including the General Health Questionnaire to assess psychological distress, the Stress Reaction Questionnaire to assess perceived stress, and the Trait Coping Style Questionnaire to assess coping style, as well as surveys of demographic and occupational characteristics, were distributed to 1120 physicians employed in large general hospitals. The final sample consisted of 1051 participants. Asymptotic and resampling strategies were used to examine how coping style mediated the association between perceived stress and psychological distress.
Perceived stress was significantly and positively associated with psychological distress among physicians. Both positive and negative coping significantly mediated the association between perceived stress and psychological distress. For psychological distress and its 3 dimensions (depression, anxiety, and reduced self-affirmation), the proportions of mediating roles of coping styles were 26.1%, 29.9%, 24.8%, and 22.7%, respectively.
Perceived stress had positive effects on psychological distress, and coping style was a mediator in this relationship among Chinese physicians. In addition to reducing stress in clinical practice, appropriate coping styles should be adopted in psychological distress prevention and treatment strategies.
Three-dimensional pseudocontinuous arterial spin labeling and susceptibility-weighted imaging associated with clinical progression in amnestic mild cognitive impairment and Alzheimer's disease
Authors: Huang Qingling , Cao Xuan , Chai Xue , Wang Xiao , Xu Ligang , Xiao Chaoyong 
Published: June 2019

Abstract

Background:
This study aimed to evaluate the value of 3-dimensional pseudocontinuous arterial spin labeling (3D-pcASL) and susceptibility-weighted imaging (SWI) for the early disease-sensitive markers of conversion from amnestic MCI (aMCI) to Alzheimer disease (AD) in this process.

Methods:
Forty patients with aMCI and AD respectively were recruited in the study, and 40 healthy subjects were taken as controls. Data were recorded using 3T MR scanner. We assessed the cerebral blood flow (CBF) in 11 different regions of interest, and counted number of microhemorrhages (MB) in 3 regions of brain lobes, bilateral basal ganglia/thalamus, and brain stem/cerebellum, and then investigated correlations between Montreal Cognitive Assessment (MoCA) scores, CBF, and susceptibility-weighted imaging (SWI) features in these 3 groups.

Results:
The results revealed that for AD patients, the MoCA scores and CBF values in frontal gray matter (FGM), occipital gray matter (OGM), temporal gray matter (TGM), parietal gray matter (PGM), hippocampus, anterior cingulate cortex (ACC), precuneus, posterior cingulate cortex (PCC), precuneus, basal ganglia and thalamus decreased compared with aMCI patients and control group, and significant difference was revealed among the 3 groups. While in cerebellum, statistical significance was only found between AD patients and control group. On SWI, the average numbers of hemorrhage in regions of lobes for AD patients were significantly higher than aMCI patients and control group. The same results occurred in the bilateral basal ganglia/thalamus. We further found the MoCA score was positively correlated with CBF, but negatively correlated with hypointense signal on SWI.

Conclusion:
3D-pCASL and SWI have promising potential to be biomarkers for conversion from aMCI to AD in this process.
Quality of life in patients who undergo conventional or robotic-assisted total laparoscopic hysterectomy
Authors: Rodrigues Rodrigo Corvino , Rodrigues Meline Rossetto Kron , Freitas Noélle de Oliveira , Rudge Marilza Vieira Cunha , Lima Silvana Andréa Molina 
Published: June 2019

Abstract

Background:
Hysterectomy for benign gynecologic diseases, especially dysfunctional uterine bleeding, is one of the most common gynecologic interventions. The uterus can be removed using abdominal, vaginal, laparoscopic, or robotic-assisted laparoscopic hysterectomy. In a robotic-assisted procedure, the surgeon directs the robot while seated at a console in the operating room. This differs from laparoscopic hysterectomy because a “robot” performs the operation, while the surgeon watches a monitor. This systematic review will compare quality of life (QOL) in patients who undergo total robotic-assisted laparoscopic hysterectomy for benign indications and those who undergo conventional laparoscopic surgery.

Methods:
We will perform a systematic review according to the Cochrane Methodology for randomized controlled trials. The review will include studies reporting use of QOL metrics to assess patients who undergo total hysterectomy for benign indications using robotic-assisted technique or conventional laparoscopic surgery. QOL will be the primary outcome and will be measured using validated instruments. An overall search strategy will be developed and adapted for Embase, MEDLINE, LILACS, and CENTRAL databases. Two reviewers will independently select the eligible studies, assess the risk of bias, and extract the data from included studies. Similar outcomes measured in at least 2 trials will be plotted in the meta-analysis using Review Manager 5.3. The quality of evidence will be determined using the GRADE approach.

Results:
This systematic review is designed to provide high quality evidence on QOL in patients undergoing total hysterectomy for benign indications using either robotic-assisted or conventional laparoscopic surgery.

Conclusion:
It is expected that high-quality evidence on QOL can be used to guide decision-making by institutions and clinicians to improve health care; the evidence can also be used in future studies.

PROSPERO registration number:
PROSPERO CRD 42019129913
A retrospective study of patients with systemic lupus erythematosus combined with Pneumocystis jiroveci pneumonia treated with caspofungin and trimethoprim/sulfamethoxazole
Authors: Wang Zhi-Guo , Liu Xue-Ming , Wang Qian , Chen Nan-Fang , Tong Sheng-Quan 
Published: June 2019

Abstract
Systemic lupus erythematosus (SLE) complicated with Pneumocystis jiroveci pneumonia (PCP) is a clinical complex with unsatisfying treatment efficacy and poor prognosis which is difficult to be diagnosed at early stage. The present study aimed to investigate the clinical features of SLE with PCP, recognize the early onset indicating factors, and evaluate the treatment efficacy of combined caspofungin and trimethoprim/sulfamethoxazole (coSMZ).
We reviewed data of 9 patients admitted with SLE-PCP and treated with caspofungin combined with coSMZ at Tangshan Gongren Hospital from January 2013 to December 2017. Patients’ clinical manifestation and laboratory data [leucocyte, lymphocyte, cluster of differentiation 4 (CD4)+T cell, lactate dehydrogenase (LDH), blood gas, etc] were compared before and after treatments. And the early onset factors of SLE-PCP, treatment efficacy of combined caspofungin and CoSMZ were analyzed.
Among these 9 patients, 8 patients suffered renal impairment, and all of them had been taking prednisone in the past 3 months at an average dose of 29.4 ± 13.6 mg/day. In addition, they had taken at least one kind of immunosuppressants. Laboratory data (leucocyte, lymphocyte, CD4+T cell, PaO2, LDH) were remarkably abnormal at hospital admission, but they were improved significantly after 2 weeks of treatment, which is also statistically significant (P < .05), except that leukocyte had no significance change to the value at admission (P = .973). In addition, none of the studied patients died.
The results of the study indicated that long-term use of glucocorticoids and immunosuppressants, low CD4+T cell count, and renal impairment are the early-onset factors for SLE-PCP, caspofungin, when combined with CoSMZ, it could be a promising and effective strategy to treat SLE with PCP.
Efficacy and safety assessment of S-1-based regimens comparing to intravenous fluorouracil-based ones in Asian patients with metastatic colorectal carcinoma
Authors: Chen Jianxin , Wang Junhui 
Published: June 2019

Abstract

Background:
We performed the present systematic review and meta-analysis to evaluate the efficacy and safety for S-1-based regimens comparing to intravenous fluorouracil-based ones in Asian patients with metastatic colorectal carcinoma (mCRC).

Methods:
Eligible prospective and controlled randomized clinical trials (RCT) were included, of which data were extracted by inclusion criteria and exclusion ones. Odds ratio (OR) and Hazard ratio (HR) of outcomes including objective response rate (ORR), disease control rate (DCR), progressive-free survival (PFS), overall survival (OS), and adverse events (AEs) were explored for the final analysis between the 2 groups.

Results:
A total of 23 eligible prospective, controlled RCTs including 2269 patients were enrolled for the pooled analysis. With the meta-analysis of available data, the results of the present research showed that there was no statistical difference on short-term efficacy including ORR (HR = 0.85, 95% CI: 0.71–1.01; P = .07) or DCR (HR = 0.88, 95% CI: 0.69–1.11; P = .27), as well as long-term efficacy including PFS (HR = 1.00, 95% CI: 0.90–1.11; P
= .98) or OS (HR = 0.95, 95% CI: 0.82–1.10; P
= .50). In addition, the incidences of AEs including leucopenia, neutropenia, and vomiting were statistically lower in S-1-based regimens comparing to intravenous fluorouracil-based ones, regardless of all grade or high grade (all P <.05). However, there were no significant differences detected among other AEs including anemia, thrombocytopenia, increased alanine aminotransferase concentration, stomatitis, anorexia, diarrhea, hand–foot syndrome (HFS), or sensory neuropathy among the 2 groups (all P >.05).

Conclusions:
The present meta-analysis revealed that S-1-based regimens might be associated with comparable efficacy, as well as lower risk of leucopenia, neutropenia, and vomiting at all/high grade comparing to intravenous fluorouracil-based ones in Asian patients with mCRC.
Implementation of a Weight-Based Protocol for the Management of Steroid-Induced Hyperglycemia
Authors: Myers Alyson K. , Khan Mahmuda , Choi Sebastian , Garnica Patricia , Stoffels Guillaume , Lin Amanda 
Published: June 2019

Background:
Hyperglycemia is a recognized complication of supraphysiological steroid dosing. There are no consensus guidelines on optimal treatment of steroid-induced hyperglycemia. We assessed the safety of a weight-based insulin protocol for persons treated with supraphysiological doses of steroids to examine the efficacy of using this protocol in patients with diabetes treated with prednisone or methylprednisolone.

Areas of Uncertainty:
There is uncertainty about the optimal dosing of insulin to manage steroid-induced hyperglycemia; thus, a weight-based protocol was created with the goal of reaching euglycemia faster than current practice in persons with diabetes. Variables such as steroid dosing, baseline glycemic control, and duration of steroid use further complicated the ability to manage these patients.

Innovations:
The interdisciplinary team of diabetes providers and pharmacists worked together to devise a protocol to manage steroid-induced hyperglycemia with the goal of reducing hyperglycemia while avoiding hypoglycemia, as well as to allow for less reliance on endocrine consultation. The protocol used weight, insulin naivety, renal function, blood glucose measurements, and steroid dosing to determine the insulin dose. There was some evidence to suggest the proportion of blood glucose levels more than 200 mg/dL was lower after protocol initiation compared with before protocol initiation (P = 0.053). Several factors decreased the rate of successful outcomes, including minimal primary team participation, accurate completion of calculations based on the protocol, and initiation of the protocol after several days of hyperglycemia.