bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multifocal head and neck amyloidosis as a diagnostic clue of systemic lupus erythematosus (SLE)
Authors: Chen Chih-Hao , Sun Chuan-Hung 
Published: August 2019

Abstract

Rationale:
Amyloidosis accounts for 2% of head and neck tumors. Amyloidosis that develops in the head and neck region is localized amyloidosis. Multifocal amyloidosis in the head and neck region is extremely rare.

Patient concerns:
The patient presented to the clinic of otolaryngology with nasal obstruction, anosmia and left neck mass for several months.

Diagnosis:
A left nasopharynx tumor was revealed under nasopharyngeal scope. Eosinophilic, proteinaceous material was revealed under a pathology scope in the nasopharynx tissue and neck tumor. Congo red staining demonstrated pale congophilic amorphous material with apple-green birefringence under cross-polarized light, and multifocal amyloidosis was diagnosed. Amyloidosis secondary to systemic lupus erythematosus (SLE) was confirmed after a series of investigations.

Interventions:
The patient underwent local excision for multifocal amyloidosis without following management. To control underlying SLE, the patient accepted steroid pulse therapy and immunosuppressants. The patient eventually achieved disease remission.

Outcomes:
During the 6 months of follow-up in the outpatient department of otolaryngology and rheumatology, complications, recurrence of nasopharyngeal amyloidosis, and SLE flare-up were not observed.

Lessons:
Head and neck amyloidosis involving the nasopharynx is a rare presentation of this disease. Head and neck multifocal amyloidosis should be taken as a hint of systemic disease. In head and neck amyloidosis, a comprehensive survey should be performed to clarify the underlying disease predisposing to amyloidosis and organ involvement.
Prevention, assessment, diagnosis and management of diabetic foot based on clinical practice guidelines
Authors: Pérez-Panero Alberto J. , Ruiz-Muñoz María , Cuesta-Vargas Antonio I. , Gónzalez-Sánchez Manuel 
Published: August 2019

Abstract

Aim:
Diabetic foot complications are the main reason for hospitalization and amputation in people with diabetes and have a prevalence of up to 25%. Clinical practice guidelines are recommendations based on evidence with the aim of improving health care. The main aim of this study was to carry out a systematic review of the levels of the evaluation and treatment strategies that appear in the clinical practice guidelines focus on diabetic foot or diabetes with diabetic foot section. Another objective of this study was to perform an analysis of the levels of evidence in support of the recommendations made by the selected clinical practice guidelines.

Methods:
A systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and a quality assessment by the Appraisal of Guidelines for Research and Evaluation (AGREE II) were performed. The databases checked were “NICE”, “Cinahl”, “Health Guide”, “RNAO”, “Sign”, “PubMed”, “Scopus” and “NCG”. The search terms included were “diabetic foot”, “guideline(s)”, “practice guideline(s)” and “diabetes.”

Results:
Twelve articles were selected after checked inclusion criteria and quality assessment. A summary and classification of the recommendations was completed.

Conclusions:
The heterogeneity of levels of evidence and grades of recommendation of the CPGs included regarding the management, approach and treatment of DF makes it difficult to interpret and assume them in clinical practice in order to select the most correct procedures. Despite this and according to the detailed study of the guidelines included in this work, it can be concluded that the highly recommendable interventions for DF management are debridement (very high level of evidence and strongly recommended), foot evaluation (moderate level of evidence and fairly recommended) and therapeutic footwear (moderate level of evidence and fairly recommended).
“A contemporary description of staphylococcus aureus prosthetic valve endocarditis. Differences according to the time elapsed from surgery”
Authors: Sáez Carmen , Sarriá Cristina , Vilacosta Isidre , Olmos Carmen , López Javier , García-Granja Pablo Elpidio , Fernández Cristina , de las Cuevas Carmen , Reyes Guillermo , Domínguez Lourdes , San Román Jose Alberto 
Published: August 2019

Abstract

Staphylococcus aureus prosthetic valve endocarditis (SAPVE) has a poor prognosis. There are no large series that accurately describe this entity.
This is a retrospective observational study on a prospective cohort from 3 Spanish reference hospitals for cardiac surgery, including 78 definitive episodes of left SAPVE between 1996 and 2016.
Fifty percent had a Charlson Index score >5; 53% were health care-related. Twenty percent did not present fever. Complications at diagnosis included: severe heart failure (HF, 29%), septic shock (SS, 17.9%), central nervous system abnormalities (19%), septic metastasis (4%). Hemorrhagic stroke was not higher in anticoagulated patients. Twenty-seven percent were methicilin-resistant SA (MRSA). Fifteen of 31 had positive valve culture; it was related to surgery within first 24 hours. At diagnosis, 69% had vegetation (>10 mm in 75%), 21.8% perianular extension, and 20% prosthetic dehiscence. Forty-eight percent had persistent bacteremia, related to nonsurgical treatment. Perianular extension progressed in 18%. Surgery was performed in 35 episodes (12 with stroke). Eleven uncomplicated episodes were managed with medical therapy, 8 survived. In-hospital mortality was 55%, higher in episodes with hemorrhagic stroke (77.8% vs 52.2%, odds ratio 3.2 [0.62–16.55]). Early SAPVE was nosocomial (92%), presented as severe HF (54%), patients were diagnosed and operated on early, 38% died. In intermediate SAPVE (9 weeks–1 year) diagnosis was delayed (24%), patients presented with constitutional syndrome (18%), renal failure (41%), and underwent surgery >72 hours after indication; 53% died. Late SAPVE (>1 year) was related with health care, diagnosis delay, and 60% of deceases.
Left SAPVE frequently affected patients with comorbidity and health care contact. Complications at diagnosis and absence of fever were frequent. Presence of MRSA was high. Positive valve culture was related to early surgery. Paravalvular extension was frequent; vegetations were large, but its absence at diagnosis was common. Some uncomplicated SAPVE episodes were safety treated with medical therapy. Surgery was feasible in patients with stroke. Mortality was high. There were differences in some clinical characteristics and in evolution according to the time elapsed from valve replacement. Prognosis was better in early SAPVE.
Apatinib as an optional treatment in metastatic colorectal cancer
Authors: Li Aiyi , Wang Kong , Xu Aiguo , Wang Gang , Miao Yongchang , Sun Zhichao , Zhang Jingyu 
Published: August 2019

Abstract
Antiangiogenic therapy has shown clinical benefit in metastatic colorectal cancer (mCRC). We aimed to evaluate the efficacy and safety of apatinib in patients who failed standard treatment and to explore potential factors related to its efficacy.
A total of 47 patients were enrolled in this retrospective study. Patients who received apatinib therapy after failure of standard therapy from December 2014 and February 2018 were included. Progression-free survival (PFS), overall survival (OS), objective response rate (ORR), and treatment-related adverse events were recorded and evaluated.
The median PFS was 3.717 months (95% confidence interval [CI], 3.198–4.235), and the median OS was 7.335 months (95% CI, 6.738–7.932). The disease control rate was 72.34%, and the ORR was 8.51%. The most common grade 3 to 4 adverse reactions were hypertension, proteinuria, hand-foot syndrome, and diarrhea. Multivariate analysis indicated previous antiangiogenic therapy and baseline elevated neutrophil-to-lymphocyte ratio (NLR) as independent prognostic factors.
Apatinib might be a reasonable treatment option with a controlled safety profile for patients with mCRC who have failed standard therapy. Patients who previously received antiangiogenic therapy and who have baseline elevated NLR are more likely to benefit from apatinib.
Relationships between the femoral neck-preserving ratio and radiologic and clinical outcomes in patients undergoing total-hip arthroplasty with a collum femoris-preserving stem
Authors: Liu Zeming , Hu Hongpeng , Liu Sikai , Huo Jia , Li Mengnan , Han Yongtai 
Published: August 2019

Abstract
The femoral neck-preserving ratio is crucial in arthroplasty with a collum femoris-preserving (CFP) stem. The aim of our study was to analyze the relationships between the neck-preserving ratio and the short-term radiologic and clinical outcomes of patients who underwent total-hip arthroplasty (THA) with a CFP stem.
The data of 325 hips from January 2015 to December 2016 were retrospectively reviewed. The demographic and radiologic data before and after surgery were obtained from patients. The neck-preserving ratio was defined as the ratio of the preserved femoral neck length to the preoperative femoral neck length. Correlations between the neck-preserving ratio and the radiologic and clinical outcomes of patients were analyzed.
The mean neck-preserving ratio was 66.38 ± 6.91% in the current study. We divided patients into 3 groups according to the neck-preserving ratio: group A (neck-preserving ratio ≤60.00%), group B (60.00% < neck-preserving ratio < 70.00%), group C (neck-preserving ratio ≥70.00%). Radiologic features, including the neck-shaft angle ratio (0.96 ± 0.05), canal fill ratio (0.64 ± 0.07), anterior-posterior offset ratio (1.04 ± 0.10), and lateral offset ratio (2.55 ± 1.56) (ratios of the postoperative values to the preoperative values), and the prevalence of complications was significantly different among the groups (χ
2 = 21.173, P < .001). In the correlation analysis, we found a moderate negative correlation between the neck-preserving ratio and neck-shaft angle ratio (r = −0.308, P < .001) and a slight positive correlation of the neck-preserving ratio with the anterior-posterior offset ratio (r = 0.415, P < .001) and the lateral offset ratio (r = 0.164, P = .003). In the linear regression analyses, the neck-preserving ratio was significantly linearly correlated with the neck-shaft angle ratio (B = −0.232, 95% confidence interval [CI] = −0.311 to −0.154, P < .001), anterior-posterior offset ratio (B = 0.589, 95% CI = 0.447–0.730, P < .001), and lateral offset ratio (B = 3.693, 95% CI = 1.256–6.131, P = .003). However, there was no significant linear correlation between the neck-preserving ratio and the canal fill ratio (B = 0.073, 95% CI = −0.033 to 0.180, P = .174). Logistic regression analyses also showed that a sufficient neck-preserving ratio was a protective factor for periprosthetic femoral fractures (odds ratio [OR] = 0.924, 95% CI = 0.859–0.994, P = .035), dislocations (OR = 0.892, 95% CI = 0.796–0.999, P = .048), and thigh pain (OR = 0.886, 95% CI = 0.818–0.960, P = .003).
For CFP stems, an insufficient neck-preserving ratio is significantly correlated with poor radiologic and clinical outcomes. Therefore, surgeons should be cognizant to preserve a sufficient femoral neck length during surgery to improve the outcomes for patients undergoing THA with CFP stems.
Association between miRNA polymorphisms and susceptibility to brain tumors
Authors: Gao Fu’an , Zhu Yuntao 
Published: August 2019

Abstract

Background:
Previous studies have demonstrated that single-nucleotide polymorphisms (SNPs) in miRNAs are related to the susceptibility to brain tumors, but the conclusions remain controversial. This study was to perform a meta-analysis to re-assess the associations between miRNA SNPs and brain tumor risk.

Methods:
Relevant studies were identified in the databases of PubMed and the Cochrane Library databases. Pooled odds ratio (OR) and 95% confidence interval (95% CI) were calculated to assess the relationships between SNPs and the risk of brain tumors under various genetic models by the STATA software.

Results:
Five studies, containing 2275 cases, and 2323 controls, were included, 4 of which evaluated miR-196a2 (rs11614913), 3 for miR-146a (rs2910164) and 2 for miR-499 (rs3746444) and miR-149 (rs2292832), respectively. The meta-analysis indicated that the GG genotype carriers of miR-146a were more susceptible to brain tumors compared with GC genotype carriers (OR = 1.19, 95%CI = 1.01–1.41, P = .036). No significant associations were observed between the SNPs of other miRNAs and the risk of brain tumors. Furthermore, all miRNA polymorphisms did not show significant associations with the risk of glioma subgroup in any genetic models, while meta-analysis of non-glioma subgroup could not be performed due to low statistical power and analysis of only 1 study.

Conclusion:
Our study suggests that miR-146a polymorphism may modify the risk for brain tumors, but which type (glioma or benign non-glioma tumors) should be verified with large sample size.
Physical activity and the risk of frailty among community-dwelling healthy older adults
Authors: Pan Bei , Li Hongli , Wang Yunhua , Sun Min , Cai Hui , Wang Jiancheng 
Published: August 2019

Abstract

Background:
Frailty has become one of the biggest challenges in facilitating healthy aging. Our study aims to investigate the association between physical activity and the risk of frailty, meanwhile, conduct a dose–response to observe the relationship between physical activity volume and frailty.

Method:
We will systematically search six databases to identify cohort studies assessing the association between physical activity and risk of frailty. Risk of bias of individual study will be assessed using the Newcastle–Ottawa Scale. Data will be analyzed by using STATA V.12.0.

Results:
The results of this study will be published in a peer-reviewed journal.

Conclusion:
We will first investigate whether specific-physical activity reduce the risk to onset frailty in healthy older adults. However, predictable heterogeneity may exist in our study because of the inconsistent definitions of frailty.
The effectiveness of exercise on cervical radiculopathy
Authors: Liang Long , Cui Xin , Feng Minshan , Zhou Shuaiqi , Yin Xunlu , He Feng , Sun Kai , Yin He , Xie Rong , Zhang Dian , Zhou You , Wu Yue , Tan Guihong , Wang Zhengdong , Wang Xingyu , Zhang Jianhua , Zhu Liguo , Yu Jie , Wei Xu 
Published: August 2019

Abstract

Background:
Significant functional limitations and disabilities are common presenting complaints for people suffering from cervical radiculopathy. Exercise is a common conservative treatment for this disease. Therefore, we conducted a systematic review and meta-analysis to explore the efficacy of exercise in the treatment of cervical radiculopathy.

Methods:
A systematic literature search for studies will be performed in 7 databases, including PubMed, Web of Science, Embase, the Cochrane Library, the Chinese National Knowledge Infrastructure Database (CNKI), Wanfang database, and VIP database. The methodological quality of the included studies using the risk bias assessment tool of Cochrane and the level of evidence for results are assessed by the GRADE method. Statistical analysis is conducted with Revman 5.3.

Results:
This systematic review and meta-analysis will provide a synthesis of existed evidences for exercise on cervical radiculopathy.

Conclusion:
The conclusion of this study will provide evidence to assess effectiveness of exercise on cervical radiculopathy, which can further guide clinical decision-making.

PROSPERO registration number:
CRD42019121886
Bleeding with negative coagulation screening test as initial presentation of chronic myelogenous leukemia managed by fresh frozen plasma
Authors: Wang Yanzhi , Wang Lina , Xi Yaming , Li Zijian 
Published: August 2019

Abstract

Introduction:
Chronic myelogenous leukemia (CML), a clonal disorder of pluripotent stem cell, rarely presents with bleeding in chronic phase due to the function preservation of the platelets. Factor (F) XIII deficiency, an extremely rare hemorrhagic disease, can cause fatal bleeding, which has been previously described in autoimmune disorders and leukemias.

Patient concerns:
A 38-year-old woman with a 20-day history of spontaneous subcutaneous hemorrhage visited our hospital, who presented with intracranial hemorrhage, hematuria, and delayed hematoma after a bone marrow puncture. Initial management included cytogenetics analysis, molecular analysis, and coagulation evaluation.

Diagnosis:
Bone marrow puncture, cytogenetics, and molecular analysis indicated the diagnosis of CML. With the normal results of clotting screening tests and platelet counting, as well as the relief of bleeding after infusion of fresh frozen plasma (FFP), acquired rare bleeding disorder probably associated with factor XIII (FXIII) deficiency.

Interventions:
Management with anti-hyperleukocytosis and chemotherapy, hydration, alkalization, diuresis, uric acid-lowering, molecular targeted drugs, and freshly frozen plasma transfusion therapy resolved the bleeding diathesis.

Outcomes:
The patient survived from the initial bleeding, however, she died. Twenty six months later due to the progression of CML.

Lessons:
CML can initially present as unusual bleeding, possibly related to FXIII defect. It is essential to screen coagulopathy including FXIII activity and to supplement plasma for CML patients who present initially as bleeding, which cannot be deciphered by the routine clotting screening test.
Fulminant bilateral acute retinal necrosis complicated with secondary herpes simplex type-1 viral encephalitis
Authors: Ye Lingqi , Ding Xiansan , Shen Shanshan , Wang Jing , Wu Jimin , Chen Yanxing 
Published: August 2019

Abstract

Rationale:
Acute retinal necrosis (ARN), which is characterized by peripheral necrotizing retinitis, severe retinal arteritis, and progressive inflammatory reaction in the vitreous and anterior chambers, has been reported in cases with herpes simplex encephalitis (HSE). It is a relatively rare complication secondary to HSE. However, cases presented with viral encephalitis following ARN were seldom reported.

Patient concerns:
A 43-year-old immunocompetent male patient manifested the aforesaid reverse situation. He developed HSE following 3-day systemic steroid therapy for abrupt ocular pain and rapidly decreased visual acuity, which was later diagnosed as ARN. Polymerase chain reaction (PCR) analysis of vitreous specimen verified herpes simplex virus-1 (HSV-1) infection.

Diagnosis:
HSE associated with ARN.

Interventions:
The patient was treated with intravenous acyclovir (500 mg every 8 h) for 21 days. A pulse of intravenous methylprednisolone, 500 mg/d for 5 days was given as an anti-inflammatory therapy, followed by prednisone taper.

Outcomes:
The patient's neurological symptoms got improved very soon after the therapy, but his vision acuity remained no perception of light in both eyes.

Lessons:
The present case indicates that ARN can also be a risk factor for HSE. Once ARN was suspected, corticosteroid should be applied with caution and in combination with antiviral treatment to avoid progressive duplication of virus and its spread to the brain.
Chinese Herbal Medicine Versus Placebo for the Treatment Of Chronic Obstructive Pulmonary Disease
Authors: Xiong Chan , Li Yu , Zeng Yan , Wei Hua , Zhuang Guang-tong , Li Lin , Zhao Li-hong , Li Chen-yi , Qin Er-qi , Fu Juan-juan 
Published: August 2019

Abstract

Background:
Chinese herbal medicine (CHM) has been shown to be effective in the treatment of stable chronic obstructive pulmonary disease (COPD) by published meta-analyses. However, disease outcomes were inconsistent and heterogeneity was observed attributed to placebo-controlled studies. We present a protocol for a systematic review aiming to evaluate the clinical efficacy and safety of CHM comparing to placebo in the treatment of stable COPD, to provide robust evidence for the use of CHM in COPD.

Methods:
We will comprehensively search the following 9 databases from inception to March 2019: Web of Science, PubMed, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), Chinese National Knowledge Infrastructure (CNKI), WANFANG Database, Chinese Scientific and Technological Periodical Database (VIP) and Chinese Biomedical Database (CBM), and the Cochrane Library database. All clinical randomized controlled trials comparing CHM to placebo for the treatment of stable COPD in English or Chinese will be included. The primary outcome will be quality of life, symptom score and exacerbation frequency, and the secondary outcomes include traditional Chinese medicine syndrome score and effective rate, lung function, 6-minute walk distance, and adverse events. Data extraction and quality assessment will be performed independently by 2 reviewers. Data synthesis and risk of bias will be assessed using the Review Manager software. This protocol will be conducted according to the Preferred Reporting Item for Systematic Review and Meta-analysis Protocols (PRISMA-P) guidance.

Results:
This systematic review and meta-analysis will provide a high-quality comprehensive evaluation of the efficacy and safety based on current literature evidence of CHM intervention for stable COPD.

Conclusion:
The conclusion of this study will present the evidence of whether CHM is an effective and safe intervention for stable COPD patients.
Efficacy and safety of acupuncture therapy for chronic atrophic gastritis
Authors: Li Yuan , Zhang Yili , Meng Han , Liao Mengting , Su Zeqi , Zhai Mengyin , Jiang Lingling , Li Ping , Ding Xia 
Published: August 2019

Abstract

Background:
The proportion of application of acupuncture for chronic atrophic gastritis (CAG) is increasing over time. We will conduct this study to explore the efficacy and safety of acupuncture as a treatment method for CAG.

Methods:
We will go through domestic and foreign databases until July 2019 to identify related randomized controlled trials that explored the effectiveness of acupuncture for CAG. RevMan (V.5.3) and test sequential analysis (V.0.9) will be used for mata-analysis and trial sequential analysis.

Results:
This study will update previous evidence summaries of acupuncture and determine the efficacy and safety of acupuncture for CAG based on clinical effectiveness rate, clearance of Helicobacter pylori (H pylori) infection, and quality of life and symptom scores.

Conclusion:
This study will determine the evidence for judging whether acupuncture provides benefits in the treatment of CAG, and will support the application of acupuncture in the recovery of patients with CAG.

Registration number:
CRD42019127916.
Impact of bedside percutaneous dilational and open surgical tracheostomy on intracranial pressure, pulmonary gas exchange, and hemodynamics in neurocritical care patients
Authors: Kieninger Martin , Windorfer Martin , Eissnert Christoph , Zech Nina , Bele Sylvia , Zeman Florian , Bründl Elisabeth , Graf Bernhard , Künzig Holger 
Published: August 2019

Abstract
Aim was to compare the impact of bedside percutaneous dilational tracheostomy (PDT) and open surgical technique (ST) on intracranial pressure (ICP), pulmonary gas exchange and hemodynamics.
We retrospectively analyzed data of 92 neurocritical care patients with invasive ICP monitoring during either PDT (43 patients) or ST (49 patients).
Peak ICP levels were higher during PDT (22 [17–38] mm Hg vs 19 [13–27] mm Hg, P = .029). Mean oxygen saturation (SpO2) and end-tidal carbon dioxide partial pressure (etCO2) did not differ. Episodes with relevant desaturation (SpO2 < 90%) or hypercapnia (etCO2 > 50 mm Hg) occurred rarely (5/49 during ST vs 3/43 during PDT for SpO2 < 90%; 2/49 during ST vs 5/43 during PDT for hypercapnia). Drops in mean arterial pressure (MAP) below 60 mm Hg were seen more often during PDT (8/43 vs 2/49, P = .026). Mean infusion rate of norepinephrine did not differ (0.52 mg/h during ST vs 0.45 mg/h during PDT). No fatal complications were observed.
Tracheostomy can be performed as ST and PDT safely in neurocritical care patients. The impact on ICP, pulmonary gas exchange and hemodynamics remains within an unproblematic range.