bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bile reflux gastritis cystica profunda
Authors: Deng Shenghe , Cao Yinghao , Shen Liming , Wang Jiliang , Tao Kaixiong , Wang Guobin , Li Jiang , Cai Kailin 
Published: April 2019

Abstract

Rationale:
Gastritis cystica profunda (GCP) is a rare gastric lesion involving cystic dilation of the gastric glands extending into the submucosa. It is usually observed at anastomotic sites in the stomach of patients who have undergone gastric procedures. Bile reflux GCP is rare in patients who have not undergone gastric surgery. Here, we report a rare case of a patient with GCP associated with bile reflux, who had no history of gastric surgery.

Patient concerns:
A 50-year-old man presented with intermittent abdominal fullness for 2 years, along with nausea. He had never undergone gastric surgery. Endoscopic ultrasonography (EUS) showed a thickened gastric wall and an echo-poor submucosal layer of the gastric fundus. A 3 cm × 2 cm × 1.5 cm lesion was noted.

Diagnosis:
Bile reflux GCP

Interventions:
Endoscopic retrograde cholangiopancreatography and endoscopic submucosal dissection (ESD) were performed, and the lesion was removed. Conventional pathological examination revealed GCP with glands hyperplasia and a yellow-brown deposit, which was considered bile. The findings were consistent with a diagnosis of GCP without malignancy.

Outcomes:
Upper gastrointestinal barium meal revealed postoperative changes at the gastric fundus. Gastroscopy performed at 6 months after surgical resection showed superficial gastritis with bile reflux.

Lessons:
The findings suggest that GCP etiology varies and that GCP can be caused by bile reflux but without malignancy. Additionally, GCP is not limited to patients who have previously undergone gastric surgery. Moreover, it is difficult to identify. EUS and ESD might be good approaches for the diagnosis and treatment of GCP.
Effect of Fufang Biejia Ruangan Tablet on lowering biochemical and virological parameters of hepatic fibrosis in patients with chronic hepatitis B
Authors: Huang Chaoyuan , Shen Danting , Sun Shuning , Huang Yuancheng , Xin Yijun , Luo Hu , Chen Yinzhen , Zhou Zipu , Liu Fengbin , Chen Xinlin 
Published: April 2019

Abstract

Background:
Liver cirrhosis is one of the end-stage chronic liver diseases. Individuals with chronic hepatitis B (CHB) are at an increased risk of developing liver cirrhosis. Practice guidelines underline that Nucleos(t)ide analogs (NAs) should be the first-line treatment for hepatitis B virus (HBV)-related cirrhosis. However, prolonged use of NAs may lead to drug resistance and kidney impair and does not reverse the fibrosis of liver. Fufang Biejia Ruangan Tablet (RGT), as a traditional Chinese medicine (TCM), has been proved to be effective in the treatment of liver fibrosis. Hence, we will perform meta-analysis in order to evaluate the efficacy and safety of RGT in the treatment of hepatic fibrosis in patients with CHB.

Methods:
To search for relative literatures up to February 2019 by computer from the following databases: PubMed, Embase, Cochrane Library, Chinese National Knowledge Infrastructure, Chinese Science and Technology Periodicals Database, Chinese BioMedical Database and Wanfang Data. Included criteria are randomized controlled trials and cohort studies of hepatic fibrosis in patients with CHB treated by RGT. The primary outcome measures include biochemical and virological parameters. We will use Stata 13.0 software for data synthesis, sensitivity analysis, meta regression, subgroup analysis, and risk of bias assessment. The reporting bias will be assessed by a funnel plot and the funnel plot symmetries will be evaluated by Begg and Egger tests. We will use the Grading of Recommendations Assessment, Development and Evaluation system to assess the quality of evidence.

Results:
This systematic review will provide a synthesis of RGT for hepatic fibrosis in patients with CHB from various evaluation aspects including biochemical and virological parameters, HBV DNA levels HBeAg status and seroconversion, adverse events incidence.

Conclusion:
The systematic review will provide evidence to assess the efficacy and safety of RGT in the treatment of hepatic fibrosis in patients with CHB.

PROSPERO registration number:
ROSPERO CRD 42018095122.
Questionnaire study on the utility of autopsy case conferences related to emergency medicine practices
Authors: Maeda Hideyuki , Tsujimura Takako , Yoshida Ken-ichi 
Published: April 2019

Abstract
We examined whether and how conferences on cases of medico-legal autopsy after emergency medicine (EM) practices improved the diagnostic accuracy and expertise of emergency medicine practitioners (EMPs) and forensic pathologists (FPs); we also examined the necessity of imaging in autopsy diagnoses. We additionally discuss whether imaging could replace autopsy.
An unsigned, self-administered questionnaire was distributed to the attendees of monthly case conferences during which EMPs and FPs discussed EM-associated autopsy cases. The questionnaire addressed the following 6 questions: was the conference useful for forensic medicine or EM practices, was autopsy necessary for each case, were the autopsy and clinical diagnoses consistent, was imaging necessary for autopsy diagnosis, and should autopsy results be disclosed to the public. Participants were autopsy operators, third-party EMPs, and FPs, primarily from universities in and near Tokyo.
Fifty-two cases were discussed; more than 80% of the attendees acknowledged the usefulness of autopsy and the conferences, and 33.6% corrected their diagnoses by considering autopsy information. Major clinical misdiagnoses were corrected by autopsy in 35.3% of cases, including procedure-related hemorrhage, intoxication, asphyxia, fat embolism, diabetes, organ injuries, and subarachnoid hemorrhage (SAH). Approximately 75% of the attendees recognized the usefulness of imaging for autopsy. However, in a series of four SAH cases, the clinical diagnoses were corrected after the conferences more often by EMPs than by FPs. In a violence-related case, false legal judgment was prevented because the conference discussion corrected the clinical diagnosis from traumatic to natural.
In conclusion, the conference improved the accuracy and expertise of diagnoses provided by EMPs and FPs; conference participation led to the correction of major clinical misdiagnoses as well as that of the first diagnoses issued by attendees in more than one-third cases. The usefulness of imaging for autopsy was acknowledged by two thirds of the attendees. Our results also suggested that imaging cannot replace autopsy in deaths related to procedure or violence and in several categories of deaths such as intoxication and asphyxia.
Effectiveness of advanced nursing care on depression in patients with ovarian cancer
Authors: Lu Zhen-hua , Kang Xiao-qin 
Published: April 2019

Abstract

Background:
This systematic review will assess the effectiveness of advanced nursing care (ANC) on depression in patients with ovarian cancer (OC).

Methods:
We will identify any relevant randomized controlled trial from Cochrane Library, MEDLINE, Embase, Web of Science, Springer, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure from their inceptions to March 5, 2019. The primary outcome includes depression. The secondary outcomes consist of anxiety, quality of life, and adverse events. Data that meets all the eligibility criteria will be extracted, pooled, and analyzed by using RevMan 5.3 software. Methodological quality for each eligible study will be assessed by using Cochrane risk of bias tool.

Results:
This study will analyze depression, anxiety, quality of life, and adverse events of ANC on depression in patients with OC.

Conclusion:
The findings of this study will provide the latest evidence for the effectiveness and adverse events of ANC on depression in patients with OC.

Ethics and dissemination:
No ethic approval is required for this study, because all the data will be extracted from previous published studies. The results of this study will be presented at conference or will be published at a peer-reviewed journal.

PROSPERO registration number:
PROSPERO CRD42019126374.
Indolent T-cell lymphoproliferative disease with synchronous diffuse large B-cell lymphoma
Authors: Guo Linjie , Wen Zhonghui , Su Xueying , Xiao Shuyuan , Wang Yufang 
Published: April 2019

Abstract

Rationale:
Indolent T-cell lymphoproliferative disease (T-LPD) of gastrointestinal tract is a rare recently described disease that seldom progresses. We report a case of T-LPD with synchronous diffuse large B-cell lymphoma (DLBCL) that cause aggravation of disease.

Patient concerns:
A 46-year-old Chinese male presented with intermittent paraumbilical colic pain, bloating, and occasional diarrhea for 10 years. His condition aggravated with partial bowel obstruction recently. The patient was diagnosed as T-LPD initially based on histological result and T-cell receptor-gamma clonal gene rearrangement test. The patient was followed without chemotherapy. His condition stabilized for 1 year and then deteriorated with small intestine perforation.

Diagnosis:
The patient was diagnosed as indolent T-LPD and DLBCL finally.

Interventions:
The patient had surgery for intestine perforation and received chemotherapy for DLBCL and T-LPD afterward.

Outcomes:
At 6 months follow-up, the patient continued to have resolution of his symptoms.

Lessons:
Early detection of high-grade transformation of T-LPD or the coexistence of aggressive lymphoma is essential for the patient. DLBCL may coexist in the indolent course of T-LPD. The diagnosis of T-LPD should be made cautiously in case with progressing symptoms such as intestinal obstruction.
Higher monocyte count with normal white blood cell count is positively associated with 10-year cardiovascular disease risk determined by Framingham risk score among community-dwelling Korean individuals
Authors: Kim Jung-Hwan , Lee Yong-Jae , Park Byoungjin 
Published: April 2019

Abstract
The cardiovascular disease (CVD) has been identified as a leading cause of premature mortality among middle-aged and elderly individuals globally. Inflammation plays an important role in aging and age-related diseases, such as atherosclerosis and CVD. White blood cell (WBC) count is an inexpensive, simple biomarker of systemic inflammations and includes several cell subtype counts, such as neutrophils, monocytes, lymphocytes, basophils, and eosinophils. However, which component of a WBC count has the ability to predict CVD remains controversial. The objective of this study was to assess the association between monocyte counts and 10 year-CVD risk among community-dwelling Korean individuals using the Framingham risk score (FRS). We studied a total of 627 participants aged over 30 years who underwent routine health examinations. The mean age of the study population was 48.1 ± 11.7 years, and 56.9% were male. In the multiple regression analysis, the independent contribution of monocyte count to Framingham 10-year CVD risk was 0.217 ± 0.092 (P = .018) after adjusting for confounding variables. We found that of the various WBCs, monocyte count is an independent predictor of CVD risk. Further larger-scale prospective cohort studies are warranted to determine these associations in the future.
Negative pressure pulmonary edema after general anesthesia
Authors: Liu Ruizhu , Wang Jian , Zhao Guoqing , Su Zhenbo 
Published: April 2019

Abstract

Rationale:
Negative pressure pulmonary edema (NPPE) is a dangerous clinical complication and potentially life-threatening emergency without prompt diagnosis and intervention during recovery period after anesthetic extubation.

Patient concerns:
A 25-year-old woman has undergone endoscopic thyroidectomy. After extubation, the patient developed acute respiratory distress with high airway resistance accompanied with wheezing, oxyhemoglobin saturation (SpO2) decreased to 70%. With positive pressure mask ventilation, her condition was stable, SpO2 99%. However, the patient developed pink frothy sputum with diffuse bilateral rales 30 min later after transported to surgical intensive care unit (SICU).

Diagnoses:
Negative pressure pulmonary edema.

Interventions:
The patient was undergone assisted ventilation with continuous positive airway pressure (CPAP) and furosemide 20 mg was given intravenously.

Outcomes:
Postoperative day (POD) 2 her condition became stable, computed tomography (CT) scan indicated the pulmonary edema disappeared. The patient was discharged 6 days later. No abnormalities were observed during following 4 weeks.

Lessons:
Although usually the onset of NPPE is rapid, with individual differences NPPE is still challenging. Increased vigilance in monitoring, diagnosis, and treatment are essential to prevent aggravation and further complication.
Hypereosinophilic vasculitis
Authors: Alzayer Husam , Hasan Manal Ahmed 
Published: April 2019

Abstract

Introduction:
The Revised International Chapel Hill Consensus Conference 2012 subdivides vasculitides based on combinations of features that separate different forms of vasculitis into definable categories. Hypereosinophilic vasculitis with sparing of the respiratory tract and renal system is a rare presentation that is yet to be described in the Revised International Chapel Hill Consensus Conference 2012 report that addresses nomenclature of vasculitides. This is a condition that involves a vascular injury due to either a primary eosinophilic vasculitis or an underlying connective tissue disease and it predisposes patients to a prothrombotic state.

Patient concerns:
A 39-year-old patient presented with left hand digital ischemia, preceded by Raynaud phenomenon, and vasculitic rash. For 3 months, he was having digital ischemia affecting the left 2nd and 3rd digits in the form of pallor and gangrenous discoloration with a preceding history of a pinpoint pruritic rash affecting his lower limbs that extended to involve the trunk and upper limbs over a short period of time and responded to only a tapering dose of oral steroids. Examination revealed a delayed capillary refill in all left-hand digits and a weak left radial pulse but no bruit. The rest of his peripheral vascular examination was unremarkable.

Diagnosis:
Investigations revealed an absolute eosinophilic count of 4.34 K/μL and erythrocyte sedimentation rate of 44 mm/h. A magnetic resonance angiogram showed a beaded appearance of the left ulnar artery distally and the radial artery branches in the left hand and subsequently was diagnosed with hypereosinophilic vasculitis.

Interventions:
He was started on oral prednisone of 1 mg/kg daily orally tapering done as well as azathioprine for maintenance.

Outcomes:
Two weeks postdischarge, the patient was seen in the outpatient department where his ischemic symptoms improved, and his skin rash healed. Noticed improvement in his splinter hemorrhages was also detected. He continued to do well on 2 years follow-up

Conclusion:
This case reflects the importance of frequent reevaluation for vasculitic diseases criteria and nomenclature. Hypereosinophilic vasculitis with absent respiratory and renal involvement is a rare presentation with scarce evidence to guide treatment.
Efficacy of ranibizumab for the treatment of diabetic retinopathy
Authors: Ren Yong-bo , Su Xing-jie , Qi Yan-xiu , Luan He-qun , Sun Qi 
Published: April 2019

Abstract

Background:
Previous clinical trials have reported that ranibizumab can be used to treat diabetic retinopathy (DR) effectively. However, no study has been conducted to evaluate its efficacy for patients with DR systematically. Thus, this study will specifically and systematically assess the efficacy and safety of ranibizumab for DR.

Methods:
Cochrane Library, EMBASE, PUBMED, Web of Science, Google Scholar, Cumulative Index to Nursing and Allied Health Literature, China National Knowledge Infrastructure, and Chinese Biomedical Literature Database will be searched from inceptions to the March 20, 2019 for studies related to the topic. This study will only consider publicly released randomized controlled trials for evaluating the effect and safety of ranibizumab for DR. No language restrictions will be imposed for all databases search. Methodological quality of each included trial will be assessed by Cochrane risk of bias tool. Statistical analysis will be performed by Stata 12.0 software.

Results:
This study will provide recent summary evidence of ranibizumab for DR. Primary outcomes include percentages with retinopathy improvement, and cumulative probabilities for retinopathy worsening. Secondary outcome consist of visual function, best-corrected visual acuities, central subfield thickness, total macular volume, peripheral visual field loss, retinal neovascularization, and adverse events.

Conclusion:
The findings of this study may provide theoretical basis for clinical practice refer and may benefit more patients with DR.
Massive abscess with prolonged respiratory failure due to newly diagnosed myotonic dystrophy
Authors: Ota Koshi , Nakamura Yoshitsugu , Nakamura Eriko , Takashima Shogo , Oka Masahiro , Ota Kanna , Sakaue Masahide , Sano Yohei , Takasu Akira 
Published: April 2019

Abstract

Rationale:
Myotonic dystrophy is a progressive multisystem genetic heterogeneous disorder. General anesthesia with opioids increases the risk of prolonged postanesthetic respiratory recovery in myotonic dystrophy patients.

Patient concerns:
A 20-year-old previously healthy woman was transferred to our emergency department for further workup of respiratory failure, and massive ascites with abscess caused by endometriosis. Hypercapnic respiratory failure persisted under intensive care unit (ICU) management, but finally improved after cessation of fentanyl as a sedative agent.

Diagnosis:
Myotonic dystrophy type 1.

Interventions:
Massive ascites with abscess was accordingly managed by drainage, antibiotics, and an antifungal agent. Myotonic dystrophy type 1 was confirmed after molecular genetic testing revealed a cytosine-thymine-guanine repeat length of 400 to 450 in the DMPK gene.

Outcomes:
The patient was discharged without complications on hospital day 69.

Lessons:
Myotonic dystrophy should be considered when hypercapnic respiratory failure persists in sedated ICU patients. Opioids should not be used for perioperative management of patients with myotonic dystrophy.
Can Changes in Service Delivery Models Improve Program Quality and Efficiency? A Closer Look at HIV Programs in Kenya and Uganda
Authors: Kandasami Stephanie , Shobiye Hezekiah , Fakoya Ade , Asiimwe Sarah , Inimah Maureen , Etukoit Michael , Morrison Linden , Johnson Michael , Dybul Mark 
Published: April 2019

Background:
With the scale-up of antiretroviral treatment, many health facilities in low- and middle-income countries have implemented innovative practices targeted at overcoming operational challenges and delivering efficient quality HIV services. However, many of these practices remain largely unexplored as a means to better reach the global 90-90-90 targets.

Setting:
A study was conducted on selected facilities in districts of country programs supported by The Global Fund to Fight AIDS, Tuberculosis, and Malaria. The aims of the study were to understand how facilities seek to improve the delivery and uptake of HIV services and to examine what innovative practices might be contributing to their success.

Methods:
The study used a qualitative approach through observations, document reviews, and semistructured interviews with site management and clinical staff to identify service delivery innovations in 30 health facilities in Kenya and Uganda.

Results:
Eleven innovative practices were observed along the HIV care cascade. These practices led to improvements in the quality of testing, treatment, and retention across the facilities. Effective human resource and data management processes also enabled the implementation of these innovative practices.

Conclusions:
Many facilities use innovative practices along the HIV care cascade to address bottlenecks and challenges. These have the potential to improve the quality and efficiency of service delivery and support the attainment of the 90-90-90 treatment targets. Replicating these practices would require further implementation research and a mind shift of donors, governments, and implementers from a metric of coverage to a stronger focus on efficiency and impact.
Immune-mediated encephalitis for the infectious disease specialist
Authors: Venkatesan Arun 
Published: April 2019

Purpose of review
Autoimmune encephalitis is increasingly recognized and must be distinguished from infectious forms of encephalitis. Moreover, physicians should be aware of infectious triggers of autoimmune encephalitis and of infectious complications associated with treatment.

Recent findings
Recent epidemiological studies suggest that the incidence of autoimmune encephalitis may rival that of infectious encephalitis. Although distinguishing autoimmune from infectious forms of encephalitis on clinical grounds can be challenging, recently proposed diagnostic criteria can provide some assistance. There has been an explosion in our knowledge of autoimmune encephalitis associated with antibodies to neuronal cell surface antigens, and two of the most common forms, anti-NMDA receptor encephalitis and anti-LGI1 encephalitis, are typically associated with distinctive clinical features. Although tumors have long been known to trigger autoimmune encephalitis, it has been recently recognized that herpes simplex encephalitis may trigger the generation of antineuronal autoantibodies resulting in an autoimmune neurologic relapse. Both first and second-line therapies for autoimmune encephalitis are associated with infectious complications, whereas emerging treatments, including anakinra and tocilizumab, may also result in increased susceptibility to certain infections.

Summary
The diagnosis and management of autoimmune encephalitis is complex, and awareness of diagnostic criteria and modalities, typical clinical syndromes, infectious triggers of disease, and infectious complications of therapies is critical in optimizing care for affected patients.
Titanium Three-Dimensional Printed Cranioplasty for Fronto-Nasal Bone Defect
Authors: Champeaux Charles , Froelich Sébastien , Caudron Yohan 
Published: April 2019

Objective:
To analyze the characteristics and outcome of patients who underwent the insertion of a 3-dimensional (3D) printed titanium (Materialise) cranioplasty.

Methods:
Surgical and clinical data of patients who underwent 3D printed titanium cranioplasty insertion at our institution were retrospectively reviewed.

Results:
A retrospective search identified 19 cases of titanium cranioplasty insertion between 2012 and 2018. 12 patients were male (63.2%) and mean age at cranioplasty was 47.4 ± 11.3 years. 9 patients had the cranioplasty inserted during the very same procedure of the craniectomy and 10 at a separate surgical stage from the craniectomy. Median delay from the craniectomy until the prosthesis insertion was 0.6 years, interquartile range (IQR) [0.4, 0.9]. Side of cranioplasty insertion was right in 6 cases and in the midline frontal in 9. Median surface of the implant was 68.1 cm2, IQR [53, 125.4]. Median follow-up since the cranioplasty insertion was 1.2 year, IQR [0.4, 2.1]. At data collection, 1 patient was lost to follow-up, 1 had its cranioplasty taken out but, none was reported dead. 6 patients (31.6%) experienced early post-operative complications following the cranioplasty insertion. One patient had its cranioplasty removed 2.5 years after the insertion for tumoral recurrence (hemagiopericytoma) and skin necrosis leading to the plate exposure.

Conclusion:
3D printed titanium cranioplasty are useful for complex craniofacial reconstruction regardless the etiology of the skull defect. This device is not associated with a higher rate of complication.