bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mediating effect of social support on the associations between health literacy, productive aging, and self-rated health among elderly Chinese adults in a newly urbanized community
Authors: Yang Yikai , Zhang Baiyang , Meng Hongdao , Liu Danping , Sun Min 
Published: April 2019

Abstract
With the growing urbanization of China, which has changed older adults’ living conditions, lifestyle, and the source of support, coupled with rapid population aging, the health status of the elderly should be paid attention to. In addition to objective indicators such as the decline of function, specific factors, such as social support, health literacy, and productive aging, also have an impact on the health outcomes of the elderly. However, the interrelationships among these factors and their potential mechanisms in the context of urbanization remain unclear. Thus, this study was the first to explore the interrelationships among social support, health literacy, productive aging, and self-rated health in older adults living in a newly urbanized community in China.
We aimed to investigate the mediating effect of social support on the associations between health literacy, productive aging, and self-rated health among elderly Chinese adults in a newly urbanized community to provide reference data for future health interventions for the elderly.
This cross-sectional study was conducted between June and August 2013. Questionnaires on social support, health literacy, productive aging, and self-rated health were administered to 992 elderly residents. Structural equation models were used to examine the relationships among these 4 variables. Statistical analyses were performed using IBM SPSS Statistics 21.0 and Mplus 7.0.
The mean scores for social support, health literacy, productive aging, and self-rated health were 34.5 ± 5.8, 13.6 ± 4.4, 11.3 ± 3.0, and 3.4 ± 0.7, respectively. Social support was directly related to self-rated health (β=0.119, 95% confidence interval [CI]: 0.041–0.198), while productive aging and health literacy had indirect associations with self-rated health via social support (β=0.071, 95% CI: 0.054–0.216; β=0.049, 95% CI: 0.066–0.183). Both productive aging (β=0.214, 95% CI: 0.047–0.381) and health literacy had direct associations with social support (β=0.327, 95% CI: 0.175–0.479), while health literacy had a direct association with productive aging (β=0.676, 95% CI: 0.604–0.748). Productive aging mediated the relationship between health literacy and social support.
Overall, improving health outcomes among older adults requires enhancement of social support, along with consideration of productive aging and health literacy.
Atypical case of posterior reversible encephalopathy syndrome related to late onset postpartum eclampsia
Authors: Masai Kaori , Ueda Yayoi , Naito Hiromichi , Tsukahara Kohei , Aokage Toshiyuki , Fujisaki Noritomo , Yamamoto Hirotsugu , Nakao Atsunori 
Published: April 2019

Abstract

Rationale:
Eclampsia, an obstetric emergency frequently seen in pregnant or puerperal women, is a risk factor for posterior reversible encephalopathy syndrome (PRES). Most cases of eclampsia occur postpartum. We report a woman with PRES associated with eclampsia 10 weeks post-delivery, the latest onset ever reported.

Patient concerns:
A 23-year-old healthy woman presented headache and nausea 10 weeks after delivery. Two days later, she generalized tonic-clonic seizure. Her brain MRI presented the foci which is typical of PRES.

Diagnosis:
The patient was diagnosed as PRES associated with eclampsia.

Interventions:
The patient received levetiracetam and edaravone.

Outcomes:
Her clinical course was uneventful and she fully recovered without neurological complications

Lessons:
The possible diagnosis of late onset postpartum eclampsia, even weeks post-delivery, should be considered, since initiation of early treatment averts severe complications and decreases mortality. Sharing our experience may increase awareness of PRES induced by late-onset postpartum eclampsia.
First trimester Doppler velocimetry of the uterine artery ipsilateral to the placenta improves ability to predict early-onset preeclampsia
Authors: Song Wen-Ling , Zhao Yan-Hui , Shi Shu-Jing , Liu Xian-Ying , Zheng Gui-Ying , Morosky Christopher , Jiao Yang , Wang Xiao-Jing 
Published: April 2019

Abstract
This study sought to investigate the effects of placental laterality on the measurements of uterine artery (UtA) Doppler velocimetry and their application in predicting early-onset preeclampsia (PE).
We conducted a prospective cohort study on all women with singleton, uncomplicated pregnancies scheduled for first-trimester nuchal translucency at our institution. Pulsatility index (PI) for both UtAs was measured by Doppler velocimetry, and placental laterality was determined. Additionally, pregnancy outcome data were abstracted from the medical records. Receiver operating characteristic curves (ROCs) were plotted.
Of the 304 patients enrolled, 247 met the inclusion criteria. Among these patients, 240 had uncomplicated delivery, while 7 had early delivery at <34 weeks due to PE. For the uncomplicated pregnancies, PI measurements of the UtA ipsilateral to the placenta were similar (left versus right UtA: 1.06 ± 0.38 vs. 1.04 ± 0.40; P = .745). However, PI measurements of the UtA contralateral to the placenta differed significantly (left versus right UtA: 1.45 ± 0.51 vs. 1.3 ± 0.47; P = .027). In predicting early-onset PE, the ideal cut-off value for the placental side PI was 1.91, with sensitivity 100% and specificity 96.3%. For nonplacental side PI, the ideal cut-off value for PI was 1.975, with sensitivity 57.1% and specificity 79.2%. Using the mean of the left and right UtA PI, the ideal cut-off value was 1.63, with sensitivity 100% and specificity 74.2%.
ROC analysis confirmed that PI measurements of the UtA on the placental side were significantly lower than those on the contralateral side, PI measurements of the UtA ipsilateral to the placenta were similar.
A case report of cyclosporine-induced myopathy with subacute muscular atrophy as initial presentation
Authors: Ding Hongyun , Li Zhen , Zhang Jianbin 
Published: April 2019

Abstract

Rationale:
Cyclosporine A (CsA) is a potent immunosuppressive agent originally used to prevent rejection after organ transplantation but now more frequently used for treatment of refractory autoimmune diseases. It can induce adverse effects, such as nephrotoxicity, gastrointestinal reactions, and gingival hyperplasia whist myopathy with subacute muscular atrophy are rare.

Patient concerns:
A 55-year-old male patient with idiopathic membranous nephropathy treated with cyclosporine A at 3 mg/kg/d and prednisone at 0.5 mg/kg.d for more than 20 days, gradually developed lower limb weakness, which were progressively aggravated until he was unable to stand or walk. A physical examination show muscle atrophy of both lower extremities, which was more severe in the right thigh muscle than the left, decreased muscular tension of the limbs was also observed.

Diagnoses:
Light microscopy and Transmission electron microscopy of muscle (quadriceps femoris) biopsy revealed drug-induced myopathy rather than neurogenic damage.

Interventions:
Cyclosporine was withdrawn and replaced with cyclophosphamide tablets, prednisone remain unchanged and other symptomatic therapies were also administered.

Outcomes:
His bilateral thigh muscle atrophy showed improvement and lower limb weakness was obviously alleviated and he could stand and walk with the help of others 4 weeks later. Gradually, his thigh muscle atrophy was alleviated so that he was able to walk independently. After follow-up, no similar symptoms were found in the patients.

Lessons:
CsA-induced myopathy with muscular atrophy is rare and serious, which can be identified according to pathological characteristics.
Long-segment central venous occlusion in a hemodialysis patient treated by segmented sharp recanalization strategy
Authors: Zhao Yuliang , Yang Letian , Mai Hongxia , Yu Yang , Fu Ping , Cui Tianlei 
Published: April 2019

Abstract

Introduction:
Among hemodialysis population, central vein occlusion (CVO) is a common complication. Percutaneous transluminal angioplasty has become the mainstay treatment these days. But the treatment of long-segment central venous occlusion remains difficult.

Patient concerns:
We presented a 73-year-old man on maintenance hemodialysis complaining of swelling of the right arm and face for 20 days. The patient underwent maintenance hemodialysis via a right internal jugular vein catheter for first 2 months of dialysis while the initial right radiocephalic wrist arteriovenous fistula (AVF) blood flow had been unsatisfactory (below 180 mL/min) for 1 month.

Diagnosis:
Digital subtraction angiography revealed long-segment CVO extending from the right subclavian vein (SV) to the right innominate vein (IV), forming an obvious included angle at the right jugular angle.

Interventions:
Since conventional guide wire transversal failed, segmented sharp recanalization was performed by separate transversal of the obstructive right SV and right IV, therefore crossing the whole lesion segment by segment, followed by balloon dilation and stent placement.

Outcomes:
No procedure-related complication was recorded during or after the operation. After a follow-up period of 5 months, the patient's AVF maintained satisfactory in blood flow, while the edema in his ipsilateral limb and face also notably ameliorated.

Conclusion:
The segmented sharp recanalization is a practical strategy in treating angled long-segment CVO which is refractory to traditional guide wire transversal in hemodialysis patients.
Diagnostic performance of cytomegalovirus (CMV) immune monitoring with ELISPOT and QuantiFERON-CMV assay in kidney transplantation
Authors: Ruan Yashi , Guo Wei , Liang Sudong , Xu Zhen , Niu Tianli 
Published: April 2019

Abstract

Background:
Cytomegalovirus (CMV) infection is part of major infection complications following kidney transplantation. However, more rapid and low-complexity assays are needed for CMV infection. Our study is to investigate the diagnostic efficacy of 2 novel tests, CMV-ELISPOT and QuantiFERON-CMV tests, in CMV DNA viremia and CMV infection following renal transplant.

Methods:
We searched MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials and the Web of Science. Case–control or cohort study designed to explore the CMV-ELISPOT and/or QuantiFERON-CMV tests in the recipients with CMV infection was considered to be eligible for this study. Sensitivity (SEN), specificity (SPE), diagnostic odds ratio (DOR), and summary receiver-operating characteristic (SROC) curves were calculated.

Results:
We selected a total of 12 articles for systematic review and 11 of them were included in meta-analysis. For CMV-pp65 assay, the pooled SEN, SPE, and DOR were 0.73 (95% confidence interval [CI], 0.67–0.78), 0.61 (95% CI, 0.56–0.65), and 4.46 (95% CI, 3.11–6.39), respectively. For CMV-IE-1 assay, the pooled SEN, SPE, and DOR were 0.84 (95% CI, 0.78–0.88), 0.46 (95% CI, 0.42–0.51), and 5.07 (95% CI, 3.26–7.89), respectively, whereas the pooled SEN, SPE, and DOR of QuantiFERON-CMV test were 0.38 (95% CI, 0.28–0.49), 0.38 (95% CI, 0.32–0.44), and 1.02 (95% CI, 0.17–6.00).

Conclusions:
We reported that CMV-ELISPOT tests, including CMV-pp65 and CMV-IE-1, perform well in the diagnosis and prediction of CMV infection in renal transplant recipients, whereas QuantiFERON-CMV test needs further exploration.
Melioidosis, an emerging infectious disease in the Midwest Brazil
Authors: Volpe-Chaves Cláudia Elizabeth , Rodrigues Ana Cláudia Souza , Lacerda Mara Luci Gonçalves Galiz , Oliveira Caroline Tieppo Flores de , Castilho Suse Barbosa , Franciscato Caroline , Santos Ivson Cassiano de Oliveira , Assef Ana Paula D’alincourt Carvalho , Roever Leonardo , Oliveira Sandra Maria do Valle Leone de , Paniago Anamaria Mello Miranda 
Published: April 2019

Abstract

Rationale:
Melioidosis is an emerging infectious disease in Brazil and caused by Burkholderia pseudomallei, with high morbidity and mortality rates. A total of 28 melioidosis cases were reported in Brazil until 2015. The majority of melioidosis cases were reported in the Northwest region of Brazil and such cases were not previously detected in the Midwest region of Brazil.

Patient concerns:
A 42-year-old man was admitted with a non-productive cough, dyspnea, myalgia, diffuse abdominal pain. Pulmonary auscultation revealed a vesicular murmur, snoring sounds, and the presence of basal crackling rales in the left hemithorax. The patient evolved with several respiratory failures and he was diagnosed as the first case of community-acquired pneumonia with sepsis caused by B pseudomallei in Mato Grosso do Sul, Midwest state of Brazil.

Diagnosis:
The cell isolates were subjected to 16S rRNA gene sequencing to confirm the bacterial species.

Interventions:
Administration of trimethoprim/sulfamethoxazole and meropenem stabilized the clinical condition of the patient. Subsequently upon discharge, the patient was also treated with trimethoprim/sulfametothoxazole for a year.

Outcome:
We reported the first case of community-acquired pneumonia with sepsis caused by B pseudomallei in Mato Grosso do Sul, Midwest state of Brazil and the patient survived.

Lessons:
The emergence of melioidosis in the Midwest region is being neglected and underestimated and melioidosis must be considered of the differential diagnosis in community infections.
Renal cell carcinoma originating in the free wall of simple renal cyst
Authors: Lai Shicong , Jiao Binbin , Wang Xiuhong , Xu Xin , Zhang Meng , Diao Tongxiang , Zhang Guan 
Published: April 2019

Abstract

Rationale:
Simple renal cyst (SRC) is a benign disease. However, rarely renal cell carcinoma (RCC) may be raised at the wall of a preexisting SRC. We herein describe 2 unusual cases of RCC arising from the outer surface of the free wall of the renal cyst.

Patient concerns:
A 75-year-old female and a male were admitted to our department because of an asymptomatic renal cystic mass. Although the case history, preoperative imaging, and intraoperative examination of the cyst were carefully evaluated, no concerns were raised with respect to the underlying malignancy.

Diagnosis:
RCC of the clear cell type was diagnosed based on the histology and pathological examination.

Interventions:
With an initial diagnosis of SRC, the retroperitoneal laparoscopic de-roofing of the SRC was performed in both of the patients. When the diagnoses were confirmed 7 days postoperative, both of them were readmitted to our department for a radical nephroureterectomy.

Outcomes:
The postoperative course was uneventful and the two patients did not undergo further chemotherapy. They are currently well and have no clinical or radiological signs of recurrence.

Lessons:
Such cases remind us that seemingly benign renal cysts may harbor underlying neoplasia. Further evaluation and periodical follow-up are also recommended on the management of those seemingly benign renal cysts.
Treatment of adenoid cystic carcinoma of the mobile tongue with anterolateral thigh flap reconstruction
Authors: Tang Xi , Zhang Chengyao , Chen Rui , Zhou Xiaohong , Zhang Yulian 
Published: April 2019

Abstract

Rationale:
Adenoid cystic carcinoma (ACC) is an infrequent malignant neoplasm of the salivary glands. The clinical and pathological characteristics include slow growth, perineural invasion, and local recurrence. ACC of the mobile tongue is rarely reported in the literature.

Patient concerns:
We describe a case of a 43-year-old man patient with numbness and growth in the tongue for 1 month duration. The patient reported a long-term smoking and drinking habit.

Diagnoses:
A biopsy was carried out and histopathological analysis confirmed as diagnosis of adenoid cystic carcinoma. Computed tomography (CT) of the head and neck enhanced scanning revealed an ill-defined high density mass with altered enhanced signal entities involving the anterior 2/3rd of the tongue.

Interventions:
The patient was treated with surgery and adjuvant radiotherapy. Incision was placed over the anteriorly till 2/3rd of tongue and then the femoral anterolateral free flap was used to repair and reconstruct the defect of tongue.

Outcome:
The patient is currently under a postsurgical 29-month regular follow-up, showing good swallowing and speaking function without any recurrence and metastasis.

Lessons:
This case report suggests that surgery and adjuvant radiotherapy are suitable procedures for patients with resectable ACC of the mobile tongue.
Parental knowledge, attitudes, and practices about vocal hygiene for their children in Chengdu, a city from China
Authors: Lu Dan , Yiu Edwin M.-L. , Pu Dai , Yang Hui , Ma Estella P.-M. 
Published: April 2019

Abstract
This study aimed to investigate the knowledge, attitudes, and practices of parents towards vocal hygiene for their children and explore the barriers against implementation of vocal hygiene in Chengdu, a city from mainland China.
An online questionnaire on knowledge, attitudes, and practice was available for parents to complete between March 1 and March 31, 2017. The questionnaire included 5 sections, general demographics; knowledge; attitudes; practices and barriers; and expectation. Scores were calculated for each category of knowledge, attitudes, and practices; and were compared using nonparametric Mann–Whitney U tests between the parents with and without a history of voice disorders. The internal consistency was assessed by Cronbach alpha coefficient. The correlations between vocal hygiene knowledge, attitude, and practice were analyzed using Spearman correlation test.
The questionnaire was completed by 1075 parents. There were certain misconceptions in vocal hygiene knowledge among parents, and the parents had higher level knowledge of positive factors than negative factors about vocal hygiene. Attitudes towards vocal hygiene were positive. Practices of vocal hygiene were poor. The most common barriers to implementation of vocal hygiene practices were related to lack of awareness and knowledge for this topic.
The level of parental vocal hygiene knowledge, practice, and barriers suggest that carry out vocal hygiene programs extremely urgent for school-aged children and their parents.
The efficacy of renal replacement therapy strategies for septic-acute kidney injury
Authors: Zha Junjing , Li Chuan , Cheng Gaoxiang , Huang Lijuan , Bai Zhaoqing , Fang Changtai 
Published: April 2019

Abstract

Background:
Renal replacement therapy (RRT) is the main treatment for patients with sepsis-induced acute kidney injury (SAKI). However, the choice of RRT strategy remains controversial.

Objective:
This study assessed the effectiveness of RRT variants in SAKI patients by a network meta-analysis.

Methods:
This study searched the literature in the PubMed, EmBase, and Cochrane Library databases up to August 18, 2018. The outcomes of the analysis were the survival rate, renal recovery rate, intensive care unit (ICU) duration, and hospital duration.

Results:
Twenty-two articles were included in the analysis. The results showed that only the negative control was inferior to the regimens of RRT with polymyxin B-immobilized fiber (PMXF), PMXF alone, continuous venovenous hemofiltration (CVVH), CVVH plus alkaline phosphatase (AP), continuous venovenous hemodialysis (CVVHD), high-volume CVVH, and extra high-volume CVVH in terms of the survival rate. According to the surface under the cumulative ranking , RRT with PMXF (84.4%) and PMXF (84.3%) were the treatments most likely to improve the survival rate among SAKI patients, followed by CVVH plus AP (69%). Continuous venovenous hemodiafiltration (CVVHDF), extra high-volume CVVHDF, intermittent venovenous hemodiafiltration (IVVHDF), and low-volume CVVHDF resulted in very similar survival rates. CVVH plus AP conferred relative advantages in the renal recovery rate and ICU duration.

Conclusion:
CVVH, CVVHD, and their derived RRT strategies can improve survival rates in SAKI patients, but there is no significant difference among the RRT strategies. There was also no significant difference in the survival rate among CVVHDF, IVVHDF, and their derived strategies. More high-quality randomized controlled trials with large sample sizes are needed for further research.
Spontaneous rotational dislocation of the lumbar spine in type 1 neurofibromatosis
Authors: Jia Fei , Cui Xingang , Wang Guodong , Liu Xiaoyang , Sun Jianmin 
Published: April 2019

Abstract

Rationale:
Scoliosis is the most common form of dystrophic spinal deformities in type 1 neurofibromatosis, whereas a spontaneous rotational dislocation of the lumbar spine is a rare entity. Former researchers had advocated the use of circumferential fusion performed through combined anterior-posterior approaches as the mode of treatment of this situation, but we managed to achieve a solid circumferential fusion equally using posterior approach alone.

Patient concerns:
A 51-year-old lady presented with severe back pain and no history of trauma, fever, or loss of weight. On examination, she showed several café-au-lait spots on her body and no neurologic deficit.

Diagnoses:
The imageology revealed a rotational dislocation of the L2 to L3. The diagnosis of neurofibroma was confirmed by biopsy.

Interventions:
The patient underwent posterior reduction, combined intervertebral-posterolateral fusion, and internal fixation with screws and rods.

Outcomes:
The patient was satisfied with the back pain relief after surgery and able to live a normal life at follow-up. The imageology showed a good correction of the deformity with a solid bony fusion.

Lessons:
Special attention must be paid to patients who have neurofibromatosis and unexplained back pain for early diagnosis. Early circumferential fusion to reconstruct a stable spine is the key to treatment. Given the result of this case, the prognosis is promising following posterior surgery alone.
Diagnostic challenges of spinal gout
Authors: Ma Shaolong , Zhao Jianhui , Jiang Rui , An Quanming , Gu Rui 
Published: April 2019

Abstract

Introduction:
Spinal gout is rarely encountered in clinical practice, is easily misdiagnosed, and often remains undiagnosed. This paper aims to provide some clues that are the salient diagnostic features of spinal gout, particularly axial pain, radiculopathy, and myelopathy, as determined on the basis of our experience with a few cases as well as a literature review.

Methods:
We retrospectively reviewed the clinical data of 5 patients that were treated for axial pain and neurological symptoms associated with spinal gout between 2014 and 2017 in our hospital. Herein, we systematically describe the clinical characteristics of 5 patients with spinal gout. The 5 patients included 4 men and 1 woman, aged between 24 and 75 years. The most common clinical presentation included spinal pain, radiculopathy, and myelopathy. Four of the 5 patients had a history of gout and elevated serum uric acid levels.

Results:
Four patients underwent surgery, while the remaining patient underwent conservative treatment and biopsy due to poor general condition. Pathological examination of the surgical samples in the 4 surgical cases and the biopsy sample in the remaining case confirmed the presence of spinal gout tophi. The neurological symptoms of all 5 patients were relieved after treatment.

Conclusion:
Due to its rarity and lack of typical defining criteria, the diagnosis of spinal gout is quite difficult. We recommend that patients presenting with axial pain; radicular pain or myelopathy; and especially high uric acid levels, with or without a history of gout, should be evaluated for spinal gout. Timely pathological examination of surgical or biopsy samples would help confirm the diagnosis and enable practitioners to provide the appropriate treatment to prevent disease progression.