bluuebunny/crossref_metadata_2025_split huggingface dataset:
Words matter: Thoughts after the winter AANP Fellows meeting
Authors: Dirubbo Nancy 
Published: May 2019

ABSTRACT
Critical issues facing nurse practitioners (NPs) today can be influenced by the words used about NPs every day. The words used to describe who and what NPs are can affect efforts to achieve full practice authority throughout the United States. They affect how NPs treat each other and how the public, professional colleagues, and others view them, which can have a profound effect on rules, regulations, and policies that affect NP effectiveness and practice.
A clinical research on the potential pathogenesis of somatic cancer related cerebral venous sinus thrombosis
Authors: Xian Ziqiang , Chen Yicong , Chen Li , Lu Qiuhong , Huang Gelun , Qin Qixiong , Zeng Jinsheng , Liang Zhijian 
Published: May 2019

Abstract
To investigate the pathogenesis of somatic solid cancer-related cerebral venous sinus thrombosis (CVST).
A total of 174 patients with CVST were recruited from the hospital between January 2006 and December 2017 and divided into two groups: (1) somatic cancer-related CVST group, defined as active somatic solid cancer patients with acute CVST; (2) cancer group (CG), defined as active somatic solid cancer patients without CVST. The cancer group patients were age and gender-matched somatic cancer-related CVST group patients. In addition, the types and amount distribution of cancer in cancer group were also matched with somatic cancer-related CVST group patients.
Compared to cancer group patients, somatic cancer-related CVST group patients had more intracranial metastasis, a higher platelet count, higher plasma D-dimer, carcinoembryonic antigen (CEA) and cancer antigen (CA) 125 levels, a greater platelet to lymphocyte ratio (PLR), and a greater platelet to neutrophil ratio (PNR). The risk for CVST in somatic cancer-related CVST group patients increased independently by 0.7% (odds ratio [OR] 1.007; 95% confidence interval [CI] 1.000, 1.015; P = .047) with a 1 ng/ml increase in D-dimer levels, by 4.6% (OR 1.046; 95% CI 1.011, 1.083; P = .010) with a 1 U/ml increase in CEA, by 2.7% (OR 1.027; 95% CI 1.003, 1.051; P = .025) with a 1 U/ml increase in CA125, and by 10.6% (OR 1.106; 95% CI 1.002, 1.220; P = .045) with a 1 unit increase in PNR.
It was suggested that together impacts of elevated plasma D-dimer, CA125, CEA levels, and a greater PNR may lead to hypercoagulability and to trigger the development of cancer-related CVST.
Combined endoscopic submucosal dissection and transanal minimally invasive surgery for the management of lower rectal adenoma extending above the dentate line
Authors: Nepal Pramod , Mori Shinichiro , Kita Yoshiaki , Tanabe Kan , Baba Kenji , Sasaki Fumisato , Nasu Yuichiro , Ido Akio , Uchikado Yasuto , Kurahara Hiroshi , Arigami Takaaki , Sakoda Masahiko , Maemura Kosei , Natsugoe Shoji 
Published: May 2019

Abstract

Rationale:
Minimally invasive surgery is used to treat early colorectal tumors. Endoscopic submucosal dissection (ESD) for resection of tumors extending above the dentate line (particularly those with concomitant hemorrhoids) is technically difficult. We present a case of a patient with a lower rectal adenoma extending above the dentate line, which underwent combined ESD and transanal minimally invasive surgery (TAMIS) to achieve accurate excision and prevent complications.

Patient concerns:
A 68-year-old man with a history of blood in stool over 2 to 3 years underwent colonoscopy, which revealed an adenoma measuring 3 cm in size in the lower rectum extending above the dentate line. The part extending above the dentate line was a type Is lesion and that of oral side was a type IIa lesion. Histopathologically, the lesion was diagnosed as a low-grade intramucosal tubulovillous adenoma.

Diagnosis:
Intramucosal low-grade adenoma with sessile polyp (type Is).

Interventions:
The cranial portion of the lesion was dissected via ESD and the anal portion via TAMIS with minimal bleeding. En bloc resection of the tumor was performed.

Outcomes:
His postoperative period was uneventful, and he was discharged and regularly followed-up.

Lessons:
Combined ESD and TAMIS is effective in patients with benign and early neoplastic lesions of the anorectum extending above the dentate line with concomitant hemorrhoids and can prevent complications.
Validation of an individualized reduction of falls intervention program among wheelchair and scooter users with multiple sclerosis
Authors: Rice Laura A. , Peterson Elizabeth W. , Backus Deborah , Sung JongHun , Yarnot Rebecca , Abou Libak , Van Denend Toni , Shen Sa , Sosnoff Jacob J. 
Published: May 2019

Abstract

Introduction:
Falls are a serious concern for wheelchair and scooter users with multiple sclerosis (MS). Approximately, 75% of the population reports at least one fall in a 6-month period and nearly half report frequent falls. Falls can result in physical injuries and contribute to activity curtailment. Despite the negative consequences, limited evidenced-based fall prevention programs designed specifically for wheelchair and scooter users with MS exist.

Purpose:
Recognizing the threat falls pose to health and well-being and the dearth of fall prevention programs, the purpose of this study is to perform a structured process evaluation and examine the feasibility and efficacy of a community-based intervention specifically designed to reduce fall incidence among wheelchair and scooter users with MS. Secondary aims of the intervention are to improve functional mobility skills associated with fall risk (e.g., transfer and wheelchair skills, balance), increase knowledge of fall risk factors, decrease fear of falling, and enhance quality of life and community participation.

Methods:
To evaluate our specific aims, a clinical trial will be performed with 160 wheelchair and scooter users with MS. (ClinicalTrials.gov Identifier: NCT03705364). Participants will be recruited to participate in a small group-style community-based program. The content of the program will be based on factors found to be associated with falls among wheelchair and scooter users with MS. These factors include but are not limited to, wheelchair/scooter related characteristics, transfer activities, impaired seated balance, and environmental factors. A physical or occupational therapist, will implement the intervention, which is comprised of 6 sessions that occur once weekly. The incidence of falls, along with an examination of wheelchair/scooter and transfer skills, seated postural control and knowledge of fall related risk factors will be compared between intervention and control participants, with assessment periods occurring prior to the intervention, 1 to 2 weeks after completion of the 6-week intervention session, and 12 weeks after the intervention period is complete.

Conclusion:
Results from this study will guide the refinement of the intervention program and inform future research among a large and diverse group of wheelchair and scooter users living with MS.
Relationship between efficacy of sunitinib and KIT mutation of patients with advanced gastrointestinal stromal tumors after failure of imatinib
Authors: Xie Fuming , Xiao Weidong , Jiang Yahui , Xia Xiao , Wang Yaxu 
Published: May 2019

Abstract

Background:
A large number of studies have shown that KIT mutations are closely related to the prognosis of gastrointestinal stromal tumors (GISTs). At the same time, sunitinib (SU) has become the second-line recommended drug for GISTs because of its efficacy. We initiated a systematic review to compare the efficacy of SU after failure of Imatinib (IM) in different KIT mutations.

Methods:
We searched for SU-treated patients with advanced GISTs after failed IM treatment by using databases such as PubMed, EMBASE, and the Cochrane Library, up to March 2018. We conducted statistical analyses to calculate the odds ratio (OR), hazard ratio (HR), and 95% confidence interval (CI) using fixed-effects and random-effects models by Review Manager 5.3 software.

Results:
We included a total of 474 patients from 3 retrospective studies and 2 cohort studies. Patients with exon 9 mutations had higher clinical benefit (OR = 2.61, 95% CIs = 1.32–5.18, P = .006) rates and longer progression-free survival (progressive disease, HR = 0.51, 95% CIs = 0.36–0.72, P = .0001) compared with exon 11, but there was no statistically significant difference in overall survival (OS, HR = 0.93, 95% CIs = 0.34–2.55, P = .89) and there was greater heterogeneity (Tau2 = 0.72, Chi2 = 21.45, df = 3, P < .001, I
2 = 86%). Subgroup analysis suggests that race may be one of the sources of heterogeneity.

Conclusion:
The results show that efficacy of SU is closely associated with KIT genotypes in GISTs. Moreover, racial factor also directly affects the prognosis of different KIT mutational status, so GISTs patients of different genotypes might also consider the use of targeted drugs in consideration of ethnic differences.
Isolated injury to the tibial division of sciatic nerve after self-massage of the gluteal muscle with massage ball
Authors: Cho Ju Young , Moon Hyunseok , Park Sungwon , Lee Byung Joo , Park Donghwi 
Published: May 2019

Abstract

Introduction:
An isolated injury to the tibial division is rare among compressive sciatic neuropathy. To date, isolated injury to the tibial division of the sciatic nerve after self-massage of the gluteal muscle has not been reported. Here, we report a case of compressive sciatic neuropathy diagnosed after self-massage of the gluteal muscle using magnetic resonance image (MRI) and ultrasound images and its associated therapeutic process.

Patient concerns:
A 50-year-old woman presented right lower extremity pain for the past 7 days.

Diagnosis:
Electrophysiological findings were consistent with right tibial neuropathy proximal to the branch to hamstring muscles. However, T2-weighted MRI showed high signal intensity and swelling in the right sciatic nerves from the superior gemellus level to the quadratus femoris level. After considering both radiologic and electrophysiological findings, the patient was diagnosed with an isolated injury to the tibial division of the right sciatic nerve.

Interventions:
The patient agreed to an ultrasound-guided perineural steroid injection upon receiving detailed explanation of the procedure.

Outcomes:
After the injection, there was significant improvement in pain.

Conclusion:
Therefore, in making a diagnosis of sciatic neuropathy, it may be important to find the lesion via MRI than relying solely on the patient's history or electrophysiologic study.
Ultrastructural findings in graft failure after Descemet membrane endothelial keratoplasty (DMEK) and new triple procedure
Authors: Schmidt Isabell , Schlötzer-Schrehardt Ursula , Langenbucher Achim , Eppig Timo , Hager Tobias , Zimpfer Annette , Seitz Berthold 
Published: May 2019

Abstract
To investigate factors that influence graft failure after Descemet membrane endothelial keratoplasty (DMEK) based on transmission electron microscopy results.
Retrospective observational case series.
This single center study included 16 eyes of 16 patients with penetrating keratoplasty (n = 14) or repeat DMEK (n = 2) following graft failure after DMEK. The main outcome measures were ultrastructural changes in the explanted graft on transmission electron microscopy, best-corrected visual acuity, and central corneal thickness.
The mean preoperative and postoperative best-corrected visual acuity was 1.01 ± 0.54 logMAR and 0.56 ± 0.37 logMAR. The mean central corneal preoperative and postoperative thickness was 667 ± 187 μm and 511 ± 42 μm. Visual acuity and central corneal thickness improved significantly (P = .001/P = .003) after repeat surgery. Electron microscopy showed that 3 of 14 corneas showed upside down transplantation, and 3 corneas had pigmented cells or pigment granules at the Descemet–stroma interface. Further, 9 of 16 specimens showed a posterior collagenous layer deposited onto the Descemet membrane (average thickness 5.1 ± 6.2 μm; ranged 0.65–20 μm); this did not correlate significantly with the time between the original and repeat keratoplasty. Of 16 original grafts, 7 showed ultrastructural anomalies of the Descemet membrane, but one excised cornea showed no Descemet membrane pathologies.
The majority of eyes with graft failure after DMEK showed ultrastructural changes in the Descemet membrane. It is crucial to assess donor tissue quality and to conduct graft marking before surgery to avoid immediate or delayed graft failure after DMEK. Nevertheless, repeat keratoplasty provided significant improvement in central corneal thickness and visual acuity.
Interdigitating dendritic cell sarcoma of the spleen with hepatic failure after chemotherapy
Authors: Zhao Chengchen , Xie Xiaohui , Gai Dong Zheng , Wu Dengshu , Xin Hongya , Yang Tianlun 
Published: May 2019

Abstract

Rationale:
Interdigitating dendritic cell sarcoma (IDCS) is an extremely rare disease originating from dendritic cells (DCs). There are few cases report interdigitating dendritic cell sarcoma of spleen along with their pathological characteristics and treatment.

Patient concerns:
Here we report a case of IDCS in 53-year-old female who presented spleen enlargement and thrombocytopenia.

Diagnoses:
The patient underwent surgical resection of spleen, and the pathology confirmed IDCS.

Interventions:
She received surgical resection of spleen and one cycle of chemotherapy (ABVD with ifosfamide and oxaliplatin) after surgery.

Outcomes:
She died of severe hepatic failure caused by chemotherapy.

Discussion:
IDCS is a rare disease with insufficient treatment guidelines. We adopted chemotherapy of ABVD with ifosfamide and oxaliplatin which showed no improvement but led to life-threatening liver damage.
A case report on the acute and late complications associated with carbon monoxide poisoning
Authors: Kim Seong Gyu , Woo Jungmin , Kang Gun Woo 
Published: May 2019

Abstract

Rationale:
Acute kidney injury (AKI), rhabdomyolysis, and delayed leukoencephalopathy after carbon monoxide (CO) poisoning are very rare. We report a case presenting with AKI, rhabdomyolysis, and delayed leukoencephalopathy after CO poisoning.

Patient concerns:
The patient was admitted to our emergency department due to loss of consciousness after CO exposure during a suicide attempt.

Diagnoses:
Laboratory findings revealed elevated carboxyhemoglobin, serum creatinine, and serum muscle enzyme levels. Initially, this patient was diagnosed with AKI and rhabdomyolysis due to CO poisoning. A month after the CO poisoning, she showed neuropsychiatric symptoms. Brain magnetic resonance imaging showed white-matter hyperintensity on the T2 flair image. Therefore, she was diagnosed with delayed leukoencephalopathy after CO poisoning.

Interventions:
At the same time as diagnosis of AKI and rhabdomyolysis, the normobaric oxygen and hydration therapies were performed. A month later, rehabilitation was started due to delayed leukoencephalopathy.

Outcomes:
Her renal function and muscle enzyme levels were completely restored with alert mental status. She could walk with the aid of a walker at last visit.

Lessons:
This case shows that we should consider about rare acute and late complications such as AKI, rhabdomyolysis, and delayed leukoencephalopathy after CO poisoning.
A comparison of the efficacy and safety of complementary and alternative therapies for the primary dysmenorrhea
Authors: Zhai Fengting , Wang Dongmei , Hua Zhen , Jiang Yuting , Wang Dandan 
Published: May 2019

Abstract

Background:
There are a number of complementary and alternative therapies for the primary dysmenorrhea (PD) and their efficacy has been assessed by several systematic reviews. But only pair-wised drugs have been evaluated in the traditional meta-analyses and conflicting interpretation of results also existed among different studies. Here, a protocol for a network meta-analysis will be presented aimed to compare the efficacy and safety of different complementary and alternative therapies for PD.

Methods:
All randomized controlled trials of complementary and alternative therapies for the PD will be included. The primary outcomes of our interest are pain intensity and pain duration and the secondary outcomes are quality of life, clinical effective rate, and adverse events. We will search relevant database, the ongoing trial, previous relevant reviews and reference lists, and so on. The identification and selection of studies and data extraction will be conducted by two independent reviewers. We will perform a battery of pairwise meta-analyses and Bayesian network meta-analyses to assess the relative outcomes of different complementary and alternative therapies. We will use the surface under the cumulative ranking curve values and the mean ranks to get the treatment hierarchy, and then use the node-splitting method to evaluate consistency. The softwares WinBUGS 1.4.3 and STATA will be selected and the quality of the evidence will be evaluated using the Grading of Recommendations Assessment, Development and Evaluation instrument.

Ethics and dissemination:
This review does not require ethical approval.

PROSPERO registration number:
PROSPERO CRD42018107763.
Plasma C-terminal agrin fragment and rapid kidney function decline in chronic kidney disease patients
Authors: Lorenz Georg , Hettwer Stefan , McCallum Wendy , Angermann Susanne , Wen Ming , Schmaderer Christoph , Heemann Uwe , Roos Marcel , Renders Lutz , Steubl Dominik 
Published: May 2019

Abstract
C-terminal agrin fragment (tCAF) is a promising biomarker for glomerular filtration. Data regarding biomarkers that have the ability to predict rapid progression of chronic kidney disease (CKD) are sparse but necessary in order to identify patients at high risk for rapid progression. This study addresses the value of tCAF as a predictor of rapid kidney function decline in CKD patients.
We measured plasma tCAF in a retrospective observational cohort study of 277 prevalent CKD patients stage I-V. Using multivariable Cox proportional hazards regression analysis, we evaluated the association of tCAF with end-stage-renal-disease (ESRD), ≥30%-decline of estimated glomerular filtration rate (eGFR) and the composite endpoint of both, adjusting for eGFR, age, systolic blood pressure, proteinuria and diabetes.
The median age was 58 [interquartile range 47, 71] years, 36% were female. Median tCAF level was 822 [594, 1232] pM, eGFR was 32 [19, 48] ml/min/1.73 m2. tCAF was correlated to eGFR and proteinuria (r = −0.76 and r = 0.49, P < .001 resp.). During a follow-up of 57.1 [42.9, 71.9] weeks, 36 (13%) patients developed ESRD and 13 (5%) had an eGFR decline of ≥30% (composite endpoint: 49 (18%)). In multivariable analysis, each 100 pM higher tCAF was independently associated with ESRD (hazard ratio (HR) 1.05 (95%-CI 1.02-1.08)), ≥30% eGFR decline (HR 1.10 (1.03–1.18)) and the composite endpoint (HR 1.07 (1.04–1.1)).
Plasma tCAF may identify CKD patients at risk for rapid kidney function decline independent of eGFR and other risk factors for eGFR loss such as proteinuria.
Combined intracoronary assessment and treatment of a patient with coronary plaque rapid progression prior to acute myocardial infarction
Authors: Si Daoyuan , Du Beibei , Zhao Yanan , Li Xiangdong , Wang Xingtong , Liu Kun , He Yuquan , Yang Ping 
Published: May 2019

Abstract

Rational:
Plaque rapid progression prior to acute myocardial infarction is not a common phenomenon, and its mechanism remains unknown. Intracoronary imaging may help to assess the plaque characteristics and progression.

Patient concern:
A 37-year-old male patient suffered an acute myocardial infarction (AMI) 1 month after the diagnosis of a mildly stenosed coronary artery. Intracoronary imaging was done to seek the underlying causes and guide further treatment.

Diagnosis:
Two coronary angiograms in 1 month showed plaque rapid progressing prior to the AMI. Intracoronary optical coherence tomography (OCT) post-AMI showed plaque erosion and heavy burden of thrombus.

Intervention:
The patient was advised to defer stent deployment. The patient was then given intensified antithrombotic therapy. Three weeks later, OCT imaging revealed sufficient lumen area and the intact endothelium without remaining thrombus. Fractional flow reverse (FFR) showed no functional ischemia. Dual-antiplatelet therapy without stenting was recommended for 12 months.

Outcomes:
The 6-month follow-up showed good recovery and normal cardiac function.

Lessons:
First, for patients with mild coronary stenosis and typical angina symptoms, further intracoronary assessment should be performed. Second, OCT can not only help to determine the plaque characteristics but can also help to develop patient-tailored strategies for AMI patients.
The effectiveness of air-free warming systems on perioperative hypothermia in total hip and knee arthroplasty
Authors: Liu Shuyan , Pan Yu , Zhao Qiancong , Feng Wendy , Han Hongyu , Pan Zhenxiang , Sun Qianchuang 
Published: May 2019

Abstract

Background:
Perioperative hypothermia is a common and serious complication during surgery. Different warming systems are used to prevent perioperative hypothermia. However, there have been no previous meta-analyses of the effectiveness of air-free warming systems on perioperative hypothermia in patients undergoing joint arthroplasty.

Methods:
We systematically searched PubMed, EMBASE, Cochrane Library, and China National Knowledge Infrastructure (CNKI) databases to collect randomized controlled trials (RCTs) from inception to August 2018. These RCTs compared the effects of air-free warming with forced-air (FA) warming system in patients undergoing joint arthroplasty. Postoperative temperature, core temperature during surgery, thermal comfort, blood loss and incidence of shivering and hypothermia were analyzed.

Results:
A total of 287 patients from 6 clinical studies were included in the analysis. In summary, there was no significant difference in the postoperative temperature (WMD −0.043, 95% CI −0.32 to 0.23, P = .758) between the air-free warming and FA warming groups. No statistical difference (WMD 0.058, 95% CI −0.10 to 0.22, P = .475) was found in core temperatures at 0 minutes during surgery between the air-free warming and FA warming groups. Furthermore, there was no statistical difference in thermal comfort, blood loss or incidence of shivering and hypothermia between the air-free warming and FA warming groups.

Conclusions:
Air-free warming system was as effective as FA warming system in patients undergoing joint arthroplasty.