bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fluoroscopy-guided subclavian vein catheterization in 203 children with hematologic disease
Authors: Pang Huajin , Chen Yong , He Xiaofeng , Zeng Qingle , Ye Peng 
Published: December 2018

Abstract
Subclavian vein catheterization plays an important role in the treatment of children with hematologic disease. However, catheter placement is a difficult and high-risk procedure in children.
Fluoroscopy-guided subclavian vein catheterization was used in 203 children (mean age, 6.99 years ± 3.722 years; range, 1–16 years) with hematologic disease. The number of vein punctures, catheterization success rate, fluoroscopy time, operation time, and surgical complications were recorded.
There was a 100% success rate for fluoroscopy-guided subclavian vein catheterization. A total of 124 cases (61.1%) were successful on the first venipuncture attempt; 171 cases (84.2%) achieved success within 3 attempts. Twenty-five cases had 4 to 6 time venipunctures and the remaining 7 cases underwent ≥7 time venipunctures. All catheter tips were successfully placed at the junction of the superior vena cava and the right atrium. Fluoroscopy times ranged from 16 to 607 seconds (mean, 65.46 ± 85.864 seconds). Operation time ranged between 5 and 25 minutes (mean, 10.38 ± 4.036 minutes). Arterial punctured was happened during surgery in 2 cases. There were 2 cases of catheter-related infection, but no other complications. The mean follow-up time was 35 days; range 20 to 50 days.
Fluoroscopy-guided subclavian vein catheterization in children is a safe procedure, with a high success rate, resulting in a reduced number of venipunctures, optimal catheter placement, and reduced complications.
Pathological fracture of the mandible caused by radicular cyst
Authors: Xiao Xian , Dai Jia-Wei , Li Zhi , Zhang Wei 
Published: December 2018

Abstract

Rationale:
Pathological fracture of the mandible caused by radicular cyst is rare. This report describes a unique case of a mandibular pathological fracture caused by radicular cyst, arising from an endodontically treated molar.

Patient concern:
A 49-year-old female was referred to our department with persistent pain in left mandibular angle, accompanying with restricted mouth opening and malocclusion.

Diagnose:
An orthopantomograph (OPG) showed a unilocular lesion with a relatively well-defined border, and the lesion was associated with a fracture in the inferior border of the mandible.

Intervention:
This patient was treated through curettage of the cyst combined with open reduction and internal fixation of the fracture.

Outcomes:
At the 1-year follow-up visit, the patient did not have any complaints, and the radiographs indicated the consolidation of the fracture without recurrence of cyst.

Lessons:
This case report highlights the routine follow-up of endodontically treated teeth in order to check for apical healing and detect the cystic change at early stages.
Delayed-onset central poststroke pain due to degeneration of the spinothalamic tract following thalamic hemorrhage
Authors: Jang Sung Ho , Kim JongHoon , Lee Han Do 
Published: December 2018

Abstract

Rationale:
Recent studies have used diffusion tensor tractography (DTT) to demonstrate that central poststroke pain (CPSP) was related to spinothalamic tract (STT) injury in patients with stroke. However, few studies have been reported about delayed-onset CPSP due to degeneration of the STT following a stroke.

Patient's concerns:
A 57-year-old female patient presented with right hemiparesis after stroke. Two weeks after onset, she did not report any pain. At approximately 6 months after onset, she reported pain in the right arm and leg, and the pain slowly intensified with the passage of time. At 14 months after onset, the characteristics and severity of her pain were assessed to be continuous pain without allodynia or hyperalgesia; tingling and cold-sensational pain in her right whole arm and leg (visual analog scale score: 5).

Diagnoses:
The patient was diagnosed as the right hemiparesis due to spontaneous thalamic hemorrhage.

Interventions:
Clinical assessment and diffusion tensor imaging (DTI) were performed 2 weeks and 14 months after onset.

Outcomes:
She suffered continuous pain in her right whole arm and leg (visual analog scale score: 5). On DTT of the 2-week postonset DTI scans, the configuration of the STT was well-preserved in both hemispheres. However, in contrast to those 2-week postonset results, the 14-month postonset DTT results showed partial tearing and thinning in the left STT. Regardless, both the 2-week and 14-month postonset DTT showed that the left STT passed through the vicinity of the thalamic lesion.

Lessons:
Diagnostic importance of performing a DTT-based evaluation of the STT in patients exhibiting delayed-onset CPSP following intracerebral hemorrhage.
The efficiency and regimen choice of adjuvant chemotherapy in biliary tract cancer
Authors: Yin Luxi , Xu Qi , Li Jingjing , Wei Qing , Ying Jieer 
Published: December 2018

Abstract
Biliary tract cancer (BTC) patients have poor prognosis even following radical resection. To improve the current status, more evidence is required clarifying the role of adjuvant chemotherapy. This study aim is to evaluate the efficacy of adjuvant chemotherapy and discuss the regimen choices.
We retrospectively analyzed the clinical data of 80 patients who underwent curative-intent R0 resection from 2008 to 2016. Among them, 40 patients had received adjuvant chemotherapy, and the others in the observation group were 1:1 matched by clinical characteristics including gender, age, tumor stage, and ECOG performance status score. Kaplan–Meier analysis was performed to compare DFS and OS. Potential confounding factors were adjusted by Multivariate analysis.
In the entire patient cohort, the mean disease-free survival (DFS) time of BTC patients with adjuvant chemotherapy and observation was 18.63 ± 3.63 months versus 10.36 ± 1.67 months, respectively (P = .029). There was no significant difference observed in overall survival (OS) time (33.72 ± 5.02 vs 21.05 ± 4.12 months, P = .114). On multivariate analysis, adjuvant chemotherapy and N factor were found to be significant factors for DFS, and sex, age, T factor were found to be significant factors for OS. Besides, subgroup analysis indicated that combination chemotherapy prolonged DFS time of BTC patients than single-agent to some extent, and oral agents showed efficacy to improve OS.
This retrospective study demonstrates that adjuvant chemotherapy contributes to DFS, but is unsatisfactory for improving OS. Combination chemotherapy contained oral agents provides a possibility of therapeutic strategy for improving surgical outcomes of BTC patients.
Perioperative risk assessment with Euroscore and Euroscore II in patients with coronary artery or valvular disease
Authors: Czub Paweł , Cacko Andrzej , Gawałko Monika , Tataj Emanuel , Poliński Jakub , Pawlik Kacper , Cichoń Romuald , Hendzel Piotr 
Published: December 2018

Abstract
Nowadays, both the European System for Cardiac Operative Risk Evaluation (EuroSCORE) logistic (ESL) and EuroSCORE II (ESII) models are used worldwide in predicting in-hospital mortality after cardiac operation. However, these scales are based on different populations and represent different medical approaches. The aim of the study was to assess the effectiveness of the ESL and the ESII risk scores in predicting in-hospital death and prolonged hospitalization in intensive care unit (ICU) after coronary artery bypass grafting (CABG), aortic valve replacement (AVR), and mitral valve replacement (MVR) by comparison of an estimated risk and a real-life observation at a reference cardiac surgery unit.
This retrospective study was based on medical records of patients who underwent a CABG, AVR, or MVR at a reference cardiac surgery unit in a 2-year period. Primary endpoint was defined as in-hospital death. Secondary endpoint was a prolonged hospitalization at the ICU, defined as longer than 3 days.
The study encompassed 586 patients [114 (23.1%) female, mean age 65.8 ± 10.5 years], including 493 patients undergoing CABG, 66 patients undergoing AVR, and 27 patients undergoing MVR. The ESL and ESII risk scores were higher in MVR subgroup (31.7% ± 30.5% and 15.3% ± 19.4%) and AVR subgroup (9.7% ± 11.6% and 3.2% ± 4.2%) than in CABG subgroup (6.9% ± 10.4% and 2.5% ± 4.1%; P < .001). Subgroups of patients were significantly different in terms of clinical, biochemical, and echocardiography factors. Primary endpoint occurred in 36 (6.1%) patients: 21 (4.3%), 7 (10.6%), and 8 (29.7%) in CABG, AVR, and MVR subgroups, respectively. The ESII underestimated the risk of mortality. Secondary endpoint occurred in 210 (35.8%) patients: 172 (34.9%), 22 (33.4%), and 16 (59.3%) in CABG, AVR, and MVR subgroups, respectively.
In the study, the perioperative risk estimated with the ESL and the ESII risk scores was compared with a real-life outcome among over 500 patients. Regardless of the type of surgery, result in the ESL was better correlated with the risk of in-hospital death.
Statins and gastroduodenal endoscopic lesions
Authors: Pantea Monica , Negovan Anca , Voidăzan Septimiu , Macarie Melania , Mocan Simona , Băţagă Simona 
Published: December 2018

Abstract
Experimental studies showed a dose-dependent gastroprotective effect of statins on non-steroidal anti-inflammatory drug-induced endoscopic lesions, modulated by increasing endogenous nitric oxide and prostaglandin production.
We investigated the influence of chronic treatment with statins on the occurrence of endoscopic lesions in patients referred for endoscopic evaluation, adjusted for the most important etiologic and risk factors for peptic ulcer disease and its complications.
A consecutive series of 564 patients who underwent upper digestive endoscopy, stratified according to the severity of endoscopic lesions were recruited. Patients with statin therapy were included in the study group (n = 220), while patients without statins in the control group (n = 344). We correlate the influence of chronic statin therapy (at least 6 months) with factors including age up to 50 years, Helicobacter pylori infection, smoking and drinking habits, ulcer history, gastrotoxic drug consumption (low-dose aspirin [ASA], anticoagulants), and comorbidities.

H pylori infection was more frequent in patients with mild/severe endoscopic lesions vs. no lesions, in both groups, but the difference was not statistically significant (P >.05). Male gender represented a risk factor (P <.01) for mild/severe endoscopic lesions only in the statin group. The estimated risk for developing mild/severe endoscopic lesions with ASA intake decreased from 6.26 to 3.40 (P <.01) when statin therapy was associated. Patients without statins and ischemic coronary artery disease (P <.01; odds ratio [OR] = 2.99; 95% confidence interval (CI):1.88–4.73), heart failure (P = .01; OR = 2.13; 95% CI:1.36–3.34), systemic atherosclerosis (P = .04; OR = 2.30; 95% CI:1.44–3.67) had a statistically significant increased risk for developing mild/severe endoscopic lesions in comparison with patients in the statin group. In multivariate regression analysis models, smoking (P <.01; OR = 2.69; 95% CI:1.73–4.16), ASA (P <.01; OR = 4.54; 95% CI:2.83–7.16), and coronary artery diseases (P = .01; OR = 1.80; 95% CI:1.15–2.82) were independent risk factors for mild/severe endoscopic lesions, while chronic statin therapy (P <.01; OR = 0.31; 95% CI:0.19–0.51) was associated with a protective effect in all models.
The results of the present study support a certain protective role of chronic therapy with statins against endoscopic lesions, especially in ASA consumers or patients with cardiovascular diseases.
Anti-N-methyl-D-aspartate receptor encephalitis
Authors: Li Hua , Guo Yan-ke , Cui Ying-lin , Peng Tao 
Published: December 2018

Abstract

Rationale:
Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is an auto-immune and paraneoplastic encephalitis with prominent neuropsychiatric manifestations. The N-methyl-D-aspartate receptor is located in the forebrain and hippocampus and plays a role in learning and memory.

Patient concerns:
A 29-year-old female patient with anti-NMDAR encephalitis, was reported and we also reviewed the literature and summarised the characteristics of the cases.

Diagnoses:
In the present study, we reported 1 patient with anti-NMDAR encephalitis diagnosed by the detection of anti-NMDAR antibodies in serum and cerebrospinal fluid (CSF).

Interventions:
The patient received glucocorticoids and anti-epilepsy treatment as well as human immunoglobulin treatment.

Outcomes:
After treatment, the patient gradually regained consciousness and was discharged after 3 months of rehabilitation. At the follow-up 2 months later, the patient had the sequelae of memory impairment and limb movement disorders.

Lessons:
An accurate early diagnosis and active treatment are crucial to the improvement in the prognosis of patients with anti-NMDAR receptor encephalitis.
Controversy regarding when clinically suspicious thyroid nodules should be subjected to surgery
Authors: Jackson Brandon Spencer 
Published: December 2018

Abstract

Background:
The work-up of a thyroid nodule to diagnose malignancy is not always straightforward. There are various international thyroid societies each with their own guidelines on the approach to a thyroid nodule. The aim is therefore to determine whether a clinically suspicious thyroid nodule should be subjected to surgery.

Method:
A review of various international thyroid society guidelines on their approach to a suspicious thyroid nodule.

Results:
Sixty-two relevant articles were identified of which 4 current international thyroid guidelines, consisting of 6 different international societies, were reviewed. The commonalities of each of the thyroid society guidelines are imaging, with ultrasound, and cytopathology as the main diagnostic investigations. The description and the size of the nodule are the 2 most important factors on ultrasound; however, the guidelines vary in their recommendations whether to biopsy a suspicious thyroid nodule. An indeterminate group exists whereby thyroid nodules cannot be confirmed as malignant even with fine needle aspiration cytology (FNA). Although further investigations (Technetium-99m -sestamethoxyisobutylisonitryl scan, 18F-fluorodeoxyglucose positron emission tomography/computed tomography scan, and molecular testing) may assist in the diagnosis, there are limitations. There are differences in the guidelines whether suspicious nodules should be subjected to surgery.

Conclusion:
Ultrasound and cytopathology are the 2 most appropriate investigations to diagnose whether a suspicious thyroid nodule is benign or malignant. The clinician needs to be aware of the differences between the guidelines from the various international thyroid societies, specifically concerning the indeterminate group of patients where a definitive diagnosis cannot be made. Management decisions should be discussed with a thyroid multidisciplinary team for a consensus decision whether or not to subject a patient with a suspicious thyroid nodule to surgery.
Improvement in renal prognosis with prompt hemodialysis in hyperosmolar hyperglycemic state-related rhabdomyolysis
Authors: Chen I-Wen , Lin Cheng-Wei 
Published: December 2018

Abstract

Rationale:
Acute kidney injury is common and correctable in patients with a hyperosmolar hyperglycemic state (HHS). Nevertheless, hyperglycemic crisis may also contribute to the development of rhabdomyolysis, which can worsen renal function and lead to high mortality in such patients.

Patient concerns:
Herein, we report a case of hyperosmolar hyperglycemic state-related rhabdomyolysis and acute renal failure with an excellent outcome.

Diagnosis:
A 26-year-old Asian female with underlying paranoid schizophrenia presented with newly diagnosed type 2 diabetes mellitus complicated with HHS. Her renal function deteriorated rapidly in spite of standard management for hyperglycemic crisis. Rhabdomyolysis was subsequently diagnosed according to the high levels of serum creatine kinase (CK) (37,710 U/L, normal range: 20–180 U/L) and myoglobin (5167.7 ng/mL, normal range: 14.3–65.8 ng/mL).

Interventions:
After treatment failure of intravenous hydration plus loop diuretic agent for rhabdomyolysis related acute renal failure, temporary hemodialysis was performed 3 times to relieve oligouria and pulmonary edema.

Outcomes:
Her renal function recovered well after temporary renal replacement therapy.

Lessons:
Rhabdomyolysis is a complication of HHS. Delayed detection can be fatal, and timely renal replacement therapy can result in an excellent prognosis. Therefore, it is crucial for clinicians to detect and treat such patients as early as possible to avoid impairing their renal function.
Familial intracranial arachnoid cysts with a missense mutation (c.2576C > T) in RERE
Authors: Wang Yubo , Cui Jiayue , Qin Xiaowei , Hong Xinyu 
Published: December 2018

Abstract

Rationale:
Arachnoid cysts are relatively common intracranial space-occupying lesions; nevertheless, familial intracranial arachnoid cysts are extremely rare, with only a few cases having been reported.

Patient concerns:
The proband was a 7-year-old girl who had experienced generalized tonic-clonic seizures 5 times in the 8 days prior to admission. Nine months later, her 6-year-old younger female cousin presented to us with a 3-day history of headache.

Diagnoses:
Brain magnetic resonance imaging (MRI) confirmed the diagnosis of arachnoid cyst for both of the girls.

Interventions:
A cyst-peritoneal shunting and cyst fenestration were performed for the 7-year-old girl and her cousin separately. Sanger sequencing revealed a heterozygous missense mutation (c.2576C > T) in the Arginine-Glutamic Acid Dipeptide Repeats gene (RERE).

Outcomes:
The outcome was favorable and the follow-up was uneventful.

Lessons:
We hypothesize that the mutation in RERE may be associated with the pathogenesis of familial intracranial arachnoid cysts.
A case report and analysis of hypertrophic obstructive cardiomyopathy causing an illusion of aortic stenosis
Authors: Wang Ying , Zhang Yue Ming , Dong Jing Guang , Cheng Li Jie , Jiang Guan Hua , Zheng Jian Wei , Yu Wen Zhou 
Published: December 2018

Abstract

Rationale:
This study aimed to report a case of hypertrophic obstructive cardiomyopathy causing an illusion of aortic stenosis on imaging.

Patient concerns:
A 71-year-old woman presented with chest tightness after activity for 1 year and coughing for 2 months. A systolic 3/6 grade murmur was found in the third intercostals of the left border of sternum. Transthoracic echocardiography, transesophageal echocardiography, and magnetic resonance imaging (MRI) were all suggestive of aortic stenosis and left ventricular outflow tract stenosis.

Diagnosis:
The patient was diagnosed with “severe aortic stenosis (bicuspid deformity), left ventricular outflow tract stenosis (moderate), and grade II cardiac function.“ She was advised aortic valve replacement and left ventricular outflow tract dredging. However, no aortic valve lesion was found during the operation, and the diagnosis was changed to “hypertrophic obstructive cardiomyopathy.”

Interventions and outcomes:
The morrow procedure was performed, and the patient recovered well after the operation. Hypertrophic obstructive cardiomyopathy was found to cause an illusion of aortic stenosis on imaging.

Lessons:
Special attention and rational treatment should be paid to such patients. In addition, further studies are needed to distinguish between the two diseases to reduce misdiagnosis.
Hearing Status in Survivors of Childhood Acute Myeloid Leukemia Treated With Chemotherapy Only: A NOPHO-AML Study
Authors: Skou Anne-Sofie , Olsen Steen Ø. , Nielsen Lars H. , Glosli Heidi , Jahnukainen Kirsi , Jarfelt Marianne , Jónmundsson Guðmundur K. , Malmros Johan , Nysom Karsten , Hasle Henrik 
Published: December 2018

Background:
As more children survive acute myeloid leukemia (AML) it is increasingly important to assess possible late effects of the intensive treatment. Hearing loss has only sporadically been reported in survivors of childhood AML. We assessed hearing status in survivors of childhood AML treated with chemotherapy alone according to 3 consecutive NOPHO-AML trials.

Procedure:
A population-based cohort of children treated according to the NOPHO-AML-84, NOPHO-AML-88, and NOPHO-AML-93 trials included 137 eligible survivors among whom 101 (74%) completed a questionnaire and 99 (72%) had otologic and audiologic examination performed including otoscopy (72%), pure tone audiometry (70%), and tympanometry (60%). Eighty-four of 93 (90%) eligible sibling controls completed a similar questionnaire.

Results:
At a median of 11 years (range, 4 to 25) after diagnosis, hearing disorders were rare in survivors of childhood AML and in sibling controls, with no significant differences. None had severe or profound hearing loss diagnosed at audiometry. Audiometry detected a subclinical hearing loss ranging from slight to moderate in 19% of the survivors, 5% had low-frequency hearing loss, and 17% had high-frequency hearing loss.

Conclusions:
The frequency of hearing disorders was low, and hearing thresholds in survivors of childhood AML were similar to background populations of comparable age.
Randomized Controlled Trial of Symptom Management Patient Education for People With Acute Coronary Syndrome
Authors: Stolic Snezana , Lin Frances , Mitchell Marion 
Published: December 2018

Background:
Poorly managed acute coronary syndrome symptoms increase the risk of subsequent cardiovascular events.

Purpose:
The aim of this study was to evaluate the effectiveness of symptom management patient education on the knowledge of sublingual nitroglycerin for people with acute coronary syndrome.

Methods:
A randomized controlled trial was used to evaluate the 3-resource intervention. The study was conducted in a 448-bed Australian public hospital. The instrument used was the modified Sublingual Nitroglycerin Interview Schedule.

Results:
A total of 169 participants completed the study. The intervention group significantly improved their knowledge of sublingual nitroglycerin when compared with the control group (P = .002).

Conclusion:
This 3-resource symptom management patient education shows promise in improving sublingual nitroglycerin knowledge for people with acute coronary syndrome.
Human Immunodeficiency Virus Diagnosis After a Syphilis, Gonorrhea, or Repeat Diagnosis Among Males Including non–Men Who Have Sex With Men: What Is the Incidence?
Authors: Tilchin Carla , Schumacher Christina M. , Psoter Kevin J. , Humes Elizabeth , Muvva Ravikiran , Chaulk Patrick , Checkley William , Jennings Jacky M. 
Published: December 2018

Background
The release of the first drug for human immunodeficiency virus (HIV) preexposure prophylaxis (PrEP) in 2012 marked the beginning of a new era of HIV prevention. Although PrEP is highly efficacious, identifying and ultimately increasing uptake among the highest risk male subgroups remains a challenge.

Methods
Public health surveillance data from 2009 to 2016 was used to evaluate the risk of an HIV diagnosis after a syphilis (ie, primary, secondary, or early latent), gonorrhea, and repeat diagnoses among urban males, including men who have sex with men (MSM) and non-MSM in Baltimore City.

Results
Of the 1531 males with 898 syphilis diagnoses and 1243 gonorrhea diagnoses, 6.8% (n = 104) were subsequently diagnosed with HIV. Within 2 years, 1 in 10 syphilis or gonorrhea diagnoses were followed by an HIV diagnosis among MSM, and 1 in 50 syphilis or gonorrhea diagnoses were followed by an HIV diagnosis among non-MSM. Among non-MSM with gonorrhea, the rate of HIV incidence was 5.36 (95% confidence interval, 2.37–12.14) times higher in those with (vs. without) a subsequent syphilis diagnosis or gonorrhea diagnosis.

Conclusions
Local health care providers should offer PrEP to MSM diagnosed with syphilis or gonorrhea and to non-MSM with a previous gonorrhea diagnosis at time of a syphilis or gonorrhea diagnosis. The high proportion and short time to an HIV diagnosis among MSM after a syphilis or gonorrhea diagnosis suggest immediate PrEP initiation.