bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of coronary plaque geometry on plaque vulnerability and its association with the risk of future cardiovascular events in patients with chest pain undergoing coronary computed tomographic angiography—the GEOMETRY study
Authors: Ratiu Mihaela , Chitu Monica , Benedek Imre , Benedek Theodora , Kovacs Istvan , Rat Nora , Rezus Ciprian 
Published: December 2018

Abstract

Introduction:
Coronary computed tomography angiography (CCTA) has emerged as a valuable noninvasive imaging tool for assessing atheromatous plaque morphology and composition, and several CCTA features have been validated as reliable indicators of the plaque-associated risk. However, the role of lesion geometry as a CCTA feature of plaque vulnerability has not been investigated so far.

Material and methods:
Here we present the study protocol of the GEOMETRY trial, a prospective, single center, cohort study in which we aim to investigate the relationship between plaque geometry (as expressed by cross-sectional and longitudinal plaque eccentricity) and the risk for major adverse cardiac events (MACE) during 2 years of follow-up, in order to validate plaque eccentricity as a new CCTA marker of coronary plaque vulnerability. One thousand patients with suspected coronary artery disease (CAD) and pretest probability of CAD between 15% and 85%, who undergo CCTA and in whom CCTA identifies the presence of at least 1 significant coronary plaque (producing a luminal narrowing of at least 50%) will be enrolled in the study. Based on the results of complex image post-processing and plaque analysis, patients will be divided into 2 groups: group 1—patients in whom CCTA analysis identifies only non-eccentric coronary plaque; and group 2—patients in whom CCTA analysis reveals the presence of at least 1 eccentric significant coronary plaque producing a significant luminal narrowing. Study outcomes will consist in the rate of major cardiovascular events and the rate of plaque progression during follow-up.
The study is funded by the Romanian Ministry of European Funds, the Romanian Government and the European Union, as part of the research grant number 103544/2016 – PlaqueIMAGE (contract number 26/01.09.2016).

Conclusion:
In conclusion, GEOMETRY will be the first CCTA-based study that will investigate the impact of geometric distribution of coronary atheromatous plaque on the future risk of cardiovascular events and on the rate of plaque progression, introducing and validating a new potential feature of plaque vulnerability represented by plaque geometry.
Fascia iliaca compartment block versus intravenous analgesic for positioning of femur fracture patients before a spinal block
Authors: Hsu Yuan-Pin , Hsu Chin-Wang , Bai Chyi-Huey , Cheng Sheng-Wei , Chen Chiehfeng 
Published: December 2018

Abstract

Background:
Fascia iliaca compartment block (FICB) provides an analgesic option for positioning before spinal anesthesia in patients suffering from a femur fracture. The evidence supporting FICB is still not well established. The aim of our study is to assess the efficacy and safety of FICB comparing with intravenous analgesic (IVA) on the quality for positioning before spinal anesthesia in participants with a femur fracture.

Methods:
PubMed, Embase, and Scopus databases were interrogated from their inceptions to September 2017. We included randomized controlled studies reported as full text, those published as abstracts only and unpublished data, if available. Data were independently extracted by 2 reviewers and synthesized using a random-effects model.

Main Results:
Three studies comprising 141 participants showed that FICB compared to IVA led to a significant between-group standard mean differences in quality during positioning within 30 minutes before spinal anesthesia (standardized mean difference (SMD) −2.02, 95% confidence interval (CI): −2.43 to −1.61, I
2 = 0%) and time for spinal anesthesia (pooled mean difference (PMD) −2.86 minutes, 95% CI −3.70 to −2.01, I
2 = 0%). Two studies with 101 participants suggested that FICB is superior to IVA on opioid requirements 24 hours postoperatively (pooled odds ratio (POR): 0.11, 95% CI: 0.03 to 0.35, I
2 = 13%). There were no significant differences in complications or hemodynamic effects

Conclusions:
Comparing with IVA, FICB can provide significantly better quality during positioning of femur fracture patients for a spinal block and a shorter time for spinal anesthesia. FICB is safe method.
A case report on complete cure of recurrent primary canaliculitis by 4-snip punctoplasty and canalicular curettage
Authors: Kim Min Ho , Ra Ho 
Published: December 2018

Abstract

Rationale:
For the treatment of primary canaliculitis, 1,2,3-snip punctoplasty and canalicular curettage are commonly used; however, a recurrence rate of 6.6% to 22% has been reported. Herein, we describe a case of recurrent primary canaliculitis that was completely cured by 4-snip punctoplasty and canalicular curettage.

Patient concerns:
A 53-year-old woman was admitted to our hospital with chief complaints of epiphora, discharge, eyelid flare up, and swelling near the inferior lacrimal punctum in the left eye, which initially presented 6 months earlier.

Diagnosis:
Based on the aforementioned symptoms, the patient was initially diagnosed with bacterial conjunctivitis at a local ophthalmologic clinic and used antibiotic eye drops for 6 months. However, her symptoms did not improve and they worsened at 2 weeks prior to admission. She was subsequently diagnosed with chronic dacryocystitis and referred to our hospital for surgical treatment. Slit lamp examination results showed conjunctival congestion in the inner corner of the left eye, along with eyelid flare up, swelling near the inferior lacrimal punctum, and yellowish discharge and concretion from the lacrimal punctal orifice. Furthermore, punctal regurgitation was not observed in the lacrimal sac compression test. Thus, the patient was diagnosed with primary canaliculitis on the basis of her clinical symptoms and laboratory findings.

Interventions:
Based on the diagnosis of primary canaliculitis, 1-snip punctoplasty and canalicular curettage were performed, and the patient was prescribed oral antibiotics for 2 weeks together with topical antibiotics for 4 weeks. Overall, the patient's symptoms improved after surgery, but epiphora and yellowish discharge from the lacrimal punctal orifice developed again 2 months after surgery during outpatient follow-up. Based on the diagnosis of recurrent primary canaliculitis, 4-snip punctoplasty and canalicular curettage were performed, and the patient was prescribed oral antibiotics for 2 weeks together with topical antibiotics for 4 weeks.

Outcomes:
Over a 6-month follow-up period, the symptoms disappeared completely and no other findings were observed.

Lessons:
Four-snip punctoplasty and canalicular curettage are simple clinical procedures that can minimize the recurrence rate of primary canaliculitis. Hence, 4-snip punctoplasty and canalicular curettage should be considered as the 1st-line treatment for primary canaliculitis and recurrent cases.
Comparison the efficacy of hemorrhage control of Surgiflo Haemostatic Matrix and absorbable gelatin sponge in posterior lumbar surgery
Authors: Ma Litai , Dai Lijuan , Yang Yi , Liu Hao 
Published: December 2018

Abstract

Objective:
To compare the hemostatic effect of hematostatic agent Surgiflo and absorbable gelatin sponge (AGS) in posterior lumbar surgery.

Methods:
A total of 60 cases were recruited during August 2016 and June 2017 according to the inclusion and exclusion criteria. Patients were randomly allocated to the Surgiflo Haemostatic Matrix (SHM) group or the AGS group (AGS) by computer-generated randomization codes. The success rates of hemostasis for 3 minutes and 5 minutes, the time of operation, the amount of intraoperative bleeding, the volume of autogenously blood transfusion, the amount of blood during hemostasis, the amount of blood transfusion, and BP, RBC, HCT, HB of preoperative, 2 to 3 days, and 5 to 7 days following operation were recorded to compare. Daily drainage and all adverse events after operation were also compared.

Results:
All the patients were followed up for at least 1 month. The RBC and HCT of the AGS group before operation were lower than those in the control group (P = .039, P = .029), but there was no difference after operation (P >.05). In the control group, 19 cases were successfully hemostatic in 3 minutes, 4 cases were successful in 5 minutes, and 7 cases were combined with hemostasis. In the SHM group, it was 22, 3, and 5 cases respectively. There was significant difference in blood loss during hemostatic process between the 2 groups (P <.001). There was no difference in the amount of blood loss and autologous blood transfusion between the 2 groups, and there was no difference in the operation time between the 2 groups. In the AGS group, allogeneic blood was infused in 1 case during operation, and no allogeneic blood was infused in the other patients. The drainage volume on the 1st day and the 2nd to 4th day after operation in the AGS group was less than that in the control group (P = .015, P = .010).

Conclusion:
Compared with AGS, SHM could decrease the blood loss during hemostatic process and the postoperative drainage volume in posterior operation of lumbar degenerative disease. SHM is a safe and effective hemostatic agent in lumbar posterior surgery.
Gender specific effect of CETP rs708272 polymorphism on lipid and atherogenic index of plasma levels but not on the risk of coronary artery disease
Authors: Cai Gaojun , Shi Ganwei , Huang Zhiying 
Published: December 2018

Abstract
Numerous studies have shown a relationship between cholesteryl ester transfer protein (CETP) polymorphism in the synthesis of high-density lipoprotein cholesterol (HDL-C) and the coronary artery disease (CAD) susceptibility, but the results have remained inconsistent. In addition, there was no study exploring the relationship between CETP polymorphisms and atherogenic index of plasma (AIP) levels.
We conducted a case-control study to evaluate the relationship between CETP rs708272 polymorphism and CAD risk and lipid levels in Chinese Han population. 556 CAD patients and 414 controls undergoing coronary angiography were consecutively enrolled in the hospital-based study. Polymerase chain reaction-ligase detection reaction (PCR-LDR) method was used to detect the different genotypes at rs708272.
No significant association between CETP rs708272 polymorphism and CAD risk was observed in different genetic models. In the whole population, participants with TT genotype had higher HDL-C levels (1.17 ± 0.31 mmol/L vs 1.09 ± 0.29 mmol/L, P = .001) and lower AIP levels (0.08 ± 0.35 vs 0.16 ± 0.31, P = .004) compared to those with CC genotype, after adjusting for age, gender, smoking, essential hypertension (EH), and DM. The T allele carriers had higher HDL-C levels than the T allele non-carriers (1.13 ± 0.29 mmol/L vs 1.09 ± 0.29 mmol/L, P = .023). Furthermore, subgroup analyses based on gender were carried out. In males, the results showed that participants with TT genotype had significant higher HDL-C levels and lower AIP levels compared with CC genotype (P <.05). In addition, males with CT+TT genotypes had higher HDL-C levels and lower AIP levels than those with CC genotypes (HDL-C: CT+TT 1.11 ± 0.31vs CC 1.06 ± 0.30 mmol/L, P = .041; AIP: CT+TT 0.12 ± 0.32vs CC 0.16 ± 0.31, P = .034, respectively). However, there were no significant associations between lipid levels and CETP rs708272 polymorphism in females, after adjusting for confounders.

CETP rs708272 polymorphism has a gender-specific effect on lipid and AIP levels but not on the risk of CAD.
Hyperamylasemia may indicate the presence of ovarian carcinoma
Authors: Guo Song , Lv Hongtao , Yan Li , Rong Fengnian 
Published: December 2018

Abstract

Rationale:
Reports of malignant ovarian tumor with hyperamylasemia are very rare. We present a patient with hyperamylasemia who was diagnosed with a malignant ovarian tumor.

Patient concerns:
A 46-year-old woman was hospitalized complaining of a 2-day history of abdominal discomfort and fever. On physical examination, she showed abdominal distention and tenderness, with rebound pain. Laboratory evaluation showed significantly elevated serum amylase levels. Computed tomography (CT) revealed a solid mass with uneven density in the pelvis.

Diagnoses:
Based on her clinical symptoms and hyperamylasemia, she was suspected to have acute pancreatitis at first. However, the final pathology showed advanced serous papillary ovarian carcinoma.

Interventions:
She underwent initial therapy for acute pancreatitis, followed by laparotomy once her symptoms had disappeared. A tumor mass with maximum diameter 12 cm was detected originating from the right ovary, and the patient underwent hysterectomy, bilateral salpingo-oophorectomy with omentectomy, and appendectomy. On the 14th day after the surgery, she received 5 courses of chemotherapy with paclitaxel and carboplatin. However, distant metastasis before the 6th course of chemotherapy were detected by CT, she was therefore changed to a chemotherapy regimen containing gemcitabine and capecitabine.

Outcomes:
The final pathology showed advanced serous papillary ovarian carcinoma. On the 14th day after the surgery, she received 5 courses of chemotherapy with paclitaxel and carboplatin. However, her serum CA125 levels rose again before the 6th course of chemotherapy, and CT of the abdomen and pelvis revealed multiple abnormal-density lesions in the peritoneum and pelvic cavity. We considered these to be metastases, and the patient was deemed unresponsive to her previous chemotherapy. She was therefore changed to a chemotherapy regimen containing gemcitabine and capecitabine, and remained on this regimen at the time of writing.

Lessons:
Ovarian carcinoma should be considered as a possibility in patients with hyperamylasemia after ruling out other potential common causes. The final diagnosis depends mainly on the clinical manifestation, laboratory results, and CT examination, though pathology is mandatory to confirm the diagnosis. The main treatment is surgical excision.
Influence of thermal ablation of hepatic metastases from gastric adenocarcinoma on long-term survival
Authors: Tang Kezhong , Liu Yanmo , Dong Linping , Zhang Bo , Wang Lantian , Chen Jian , Chen Guofeng , Tang Zhe 
Published: December 2018

Abstract
The objectives of this systematic review and pooled analysis were to examine long-term survival, morbidity, and mortality following thermal ablation of gastric cancer hepatic metastases and to identify prognostic factors that improve survival.
Patients with hepatic metastases from gastric cancer are traditionally treated with palliative chemotherapy. Surgical resection is an alternative treatment of hepatic metastases. Whether patients can obtain benefit from thermal ablation of hepatic metastases is still controversial.
A systematic literature search was undertaken (1990–2018). Publications were included if they studied more than 7 patients undergoing thermal ablation for hepatic metastasis from gastric cancer in the absence of peritoneal disease or other distant organ involvement. The primary outcome was the hazard ratio (HR) for overall survival. Comparison between thermal ablation and systematic chemotherapy or hepatic resection had been carried out. The influence of liver metastasis-related factors, such as <3 cm versus >3 cm, single versus multiple and metachronous versus synchronous upon survival was also assessed.
The median survival of thermal ablation for the 12 studies included was 22.93[20.45–25.41] months. Procedures were associated with a median 30-day morbidity of 6% (0%–23%) and with no mortality. The median 1-year, 2-year, 3-year, and 5-year survival were 79.14%, 39.79%, 28.45%, and 19.46%, respectively. Thermal ablation of hepatic metastasis was associated with improved overall survival compared with systematic chemotherapy (HR = 2.12; 95% CI 0.77–3.47; P=.000). Meta-analysis confirmed the additional survival benefit of size <3 cm (HR = 1.46; 95% CI 1.03–1.88; P = .002) and receiving chemotherapy after thermal ablation (HR = 2.14; 95% CI 1.05–3.23; P = .000).
A use of RFA/ microwave ablation (MWA) as a liver-directed treatment may provide greater survival benefit than chemotherapy and is an alternative option for the treatment of liver-only metastases from gastric cancer. With the appropriate selection of patients, such as tumors <3 cm in diameter, thermal ablation may provide better prognosis than hepatic resection of hepatic metastasis with lower morbidity and mortality. Postoperation chemotherapy should be provided to patients with GLM who received thermal ablation.
A new scoring model predicting macroscopic vascular invasion of early-intermediate hepatocellular carcinoma
Authors: Liu Yao , Sun Le , Gao Fangyuan , Yang Xue , Li Yuxin , Zhang Qun , Zhu Bingbing , Niu Shuaishuai , Huang Yunyi , Hu Ying , Feng Ying , Jiang Yuyong , Wang Xianbo 
Published: December 2018

Abstract
Macroscopic vascular invasion cannot be properly predicted in advance in hepatocellular carcinoma patients based on clinical characteristics and imaging features.
To develop a predictive scoring model of macroscopic vascular invasion in hepatocellular carcinoma patients after transcatheter arterial chemoembolization combined with radiofrequency ablation based on specific laboratory and tumor indicators.
A predictive scoring model, which estimates the incidence of macroscopic vascular invasion at 1-year follow-up, was constructed based on a derivation cohort of 324 patients with hepatocellular carcinoma; a validation cohort of 120 patients was prospectively included. The prognostic value of the scoring model was determined by concordance index, time-dependent receiver operating characteristics, and calibration curves.
Cox multivariate analysis of the derivation cohort identified prothrombin time, aspartate aminotransferase, and Barcelona clinic liver cancer (BCLC) staging as independent predictive factors of macroscopic vascular invasion. The areas under the receiver operating characteristic curves of the predictive scoring model were 0.832 and 0.785 in the derivation and validation cohorts, respectively, and the calibration curves fitted well. Kaplan–Meier analysis showed that the incidence of macroscopic vascular invasion was significantly higher in the high-risk group (score 0–2) than in the low-risk group (score 3–4) in both the derivation and validation cohorts (P < .0001 and P = .0008, respectively).
The predictive scoring model enables the accurate prediction of macroscopic vascular invasion incidence 1 year in advance in hepatocellular carcinoma patients who undergo transcatheter arterial chemoembolization combined with radiofrequency ablation.
The impact of lymphovascular invasion in patients with prostate cancer following radical prostatectomy and its association with their clinicopathological features
Authors: Jiang Wei , Zhang Lijin , Wu Bin , Zha Zhenlei , Zhao Hu , Jun Yuan , Jiang Yuefang 
Published: December 2018

Abstract

Objective:
Numerous studies have shown that lymphovascular invasion (LVI) is linked to biochemical recurrence (BCR) in prostate cancer (PCa) patients following radical prostatectomy (RP). However, the actual clinicopathological impacts of LVI remain unclear. Thus, we performed a meta-analysis to evaluate the pathologic and prognostic impacts of LVI in PCa patients.

Methods:
Following the guidance of the PRISMA statement, relevant studies were collected systematically from the PubMed, EMBASE, and Web of Science databases to identify relevant studies published before June 2018. The hazard ratios (HRs) and 95% confidence intervals (95% CIs) were calculated to investigate the association of LVI with BCR and clinicopathological features.

Results:
A total of 20 studies including 25,570 patients (106–6678 per study) with PCa were incorporated into this meta-analysis. Overall pooled analysis suggested that LVI was associated with a higher BCR risk both in univariate (pooled HR=1.50, 95% CI: 1.34–1.68, P <.001) and multivariate analyses (pooled HR=1.25, 95% CI: 1.17–1.34, P <.001). In addition, LVI was closely correlated with extraprostatic extension (yes vs no: OR = 4.23, 95% CI: 1.86–9.61, P <.001), pathological GS (≥7 vs <7: OR = 5.46, 95% CI: 2.25–13.27, P <.001), lymph node metastases (yes vs no: OR = 18.56, 95% CI: 7.82–44.06, P <.001), higher pathological stage (≥ T3 vs < T2: OR = 6.75, 95% CI: 5.46–8.36, P <.001), positive surgical margin (positive vs negative: OR = 2.42, 95% CI: 1.57–3.72, P <.001) and seminal vesicle invasion (yes vs no: OR = 5.72, 95% CI: 2.45–13.36, P <.001).

Conclusions:
This study suggests that LVI in histopathology is associated with a higher risk of BCR and advanced clinicopathological features in PCa patients and could serve as a poor prognostic factor in patients who underwent RP.
Association between MDM2 rs2279744, MDM2 rs937283, and p21 rs1801270 polymorphisms and retinoblastoma susceptibility
Authors: Cao Qixin , Wang Yun , Song Xiaohui , Yang Weihua 
Published: December 2018

Abstract
Retinoblastoma (Rb) is the most common intra-ocular malignancy in children. The association of rs2279744, and rs937283 in MDM2 gene, and p21 rs1801270 polymorphism and RB development have been demonstrated. To provide a comprehensive assessment of and to clarify associations between the 3 SNPs (MDM2 rs2279744, MDM2 rs937283, and p21 rs1801270) and the risk of RB, we performed a meta-analysis of all the eligible case-control studies. We searched English databases include PubMed, Embase, Google Scholar, and Cochrane Library, using an upper date limit of January 1, 2018. The association between MDM2 rs2279744, MDM2 rs937283, and p21 rs1801270 polymorphisms and the risk of RB were estimated by calculating a pooled OR and 95% CI under a homozygote comparison, heterozygote comparison, dominant model, and recessive model. The statistical power analysis was performed using G∗Power. Our meta-analysis showed a significant association between RB susceptibility and MDM2 rs2279744 recessive model (OR = 1.427, 95%CI: 1.107-1.840, P = .006, I2 = 0%). Moreover, a significant link was observed between RB risk and MDM2 rs937283 homozygote comparison (OR = 0.471, 95%CI: 0.259-0.858, P = .014, I2 = 0%) and recessive model (OR = 0.587, 95%CI: 0.410-0.840, P = .004, I2 = 0%). However, no significant relationship between the p21 rs1801270 polymorphism and RB susceptibility was detected in any of the 4 models (P > .05). In conclusion, we found that significant association between the MDM2 rs2279744 polymorphism and increased RB risk, while MDM2 rs937283 polymorphism was associated with significantly decreased RB risk. However, as to the P21 rs1801270 polymorphism, a statistically significant association was not identified for RB.