bluuebunny/crossref_metadata_2025_split huggingface dataset:
Description of the Treatment Course by Pregabalin for Anxiety in Patients With a Major Neurocognitive Disorder
Authors: Novais Teddy , Doutone Audrey , Gombault Caroline , Krolak-Salmon Pierre , Lepetit Alexis , Mouchoux Christelle 
Published: April 2019

Abstract

Background
Anxiety symptoms frequently experienced by patients with a major neurocognitive disorder (NCD) are often treated with long-term benzodiazepines despite known adverse effects. Pregabalin has shown efficacy in generalized anxiety disorders but has not been studied in patients with a major NCD. The objective of this study was to describe the use of pregabalin for anxiety in patient with a major NCD and the impact of its use on the pharmacological treatment change.

Methods
A retrospective study was conducted using data of hospitalized patients in a cognitive-behavioral specialized unit between January 2015 and December 2017. Patients with a major NCD treated by pregabalin were included in this study. Data about the use of pregabalin (initiation and effective dosage, titration duration) and the use of other psychotropics were collected from the patients' medical records.

Results
Thirty-three patients were included (mean age, 79.6 ± 11.7 years; 66.7% women). The mean duration of pregabalin titration was 18.6 ± 1.4 days, and the mean effective dosage was 200.0 ± 130.8 mg/d (range, 50–700 mg/d). At admission (before pregabalin use), 78.8% of patients were treated with a systematic prescription of benzodiazepine. At discharge (with pregabalin use), a significant decrease in patients with systematic prescription of benzodiazepine was observed (78.8% vs 33.3%, P = 0.001). During hospitalizations, no pregabalin treatment has been discontinued for lack of efficacy or for tolerance.

Conclusions
Larger controlled studies are needed to confirm the efficacy and the safety of pregabalin to treat anxiety symptoms associated with neurocognitive disorders.
Systematic Review of Gender Bias in the Clinical Trials of New Long-Acting Antipsychotic Drugs
Authors: Santos-Casado María , García-Avello Adela 
Published: April 2019

Abstract

Purpose/Background
This article evaluates gender bias in the published clinical trials of new long-acting antipsychotics.

Methods/Procedures
We conducted a review of controlled clinical trials of the new prolonged-release antipsychotics (aripiprazole, risperidone, or paliperidone) for the treatment of schizophrenia published in MEDLINE over the last 10 years and available in full text in English. The study followed the corresponding international recommendations.

Results
We identified 132 trials, and of these, 40 met the inclusion and exclusion criteria. We found that only 36.41% of the total patients were women. The separate analysis of the main variable between the subpopulations of men and women was carried out in only 6 of the 40 works included. In contrast, in 15 trials, this analysis was performed on secondary variables, generally related to safety. Only 3 of the 40 trials discussed the results separately according to sex.

Conclusions
The clinical trials of long-acting atypical antipsychotic drugs show a far-from-negligible gender bias. Women are underrepresented, and the main and secondary variables are not analyzed separately according to gender. This is despite international recommendations establishing these criteria as part of a package of minimum requirements for meeting scientific validity and making results apt to extrapolate to the general population of patients.
Concordance of Self- and Clinician-Collected Anal Swabs to Detect Human Papillomavirus in a Sample of HIV-Negative Men
Authors: Yared Nicholas F. , Horvath Keith J. , Baker Jason V. , Thyagarajan Bharat , Waterboer Tim , Kulasingam Shalini 
Published: April 2019

Objective
The aim of this study was to determine the concordance of self- and clinician-collected anorectal swabs for the detection of human papillomavirus (HPV) DNA in a population of HIV-negative men who have sex with men (MSM).

Methods
This cross-sectional study involved recruitment of HIV-negative MSM in a Midwestern US metropolitan area to collect paired sequential self- and clinician-collected anorectal swabs using illustrated instructions. Swabs were tested for type-specific HPV DNA with a comparison of type-specific HPV categories detected by each method. The sensitivity and specificity of self-collection were calculated assuming clinician collection as the criterion standard. McNemar's test and κ statistics were used to determine percent agreement and concordance of self- and clinician-collected swab results.

Results
Seventy-eight participants had paired anorectal swab samples of adequate quality for analyses. The sensitivity and specificity of self-collected swabs for detection of all high-risk HPV DNA types were 69.8% and 91.4%, respectively. Similar degrees of sensitivity and specificity of self-collection were seen for other groups of high-risk HPV types. Percent agreement and κ statistic for self- and clinician-collected swabs for all high-risk HPV types were 80.8% and 0.53, respectively.

Conclusions
Self-collected anorectal swab samples showed lower sensitivity but moderate to high specificity for detection of high-risk and vaccine-preventable HPV types compared with clinician-collected swab samples. Self-collection instructional details and the thoroughness of clinician collection of samples may have impacted sensitivity and specificity, suggesting a need to optimize and standardize instructions.
Zao Ren An Shen capsule for chronic insomnia
Authors: Birling Yoann , Bensoussan Alan , Sarris Jerome , Avard Nicole , Zhu Xiaoshu 
Published: April 2019

Abstract

Background:
Zao Ren An Shen (ZRAS), a Chinese Herbal Medicine product, has been proposed as an alternative to recommended treatments for chronic insomnia. There is a lack of strong evidence supporting this proposition.

Aims:
To assess the efficacy and safety of ZRAS capsule for chronic insomnia compared to placebo.

Methods:
A parallel-group, double-blind, randomized-controlled trial will be performed in Western Sydney University, Australia. After a 1-week placebo run-in, adults with chronic insomnia (n = 90) will be randomized in a 1:1 ratio to receive either ZRAS capsule or placebo for 4 weeks. Insomnia severity (Insomnia Severity Scale score), sleep parameters (measured with the Consensus Sleep Diary and actigraphy), fatigue levels (Fatigue Severity Scale score), psychological status (Depression Anxiety Stress Scale score), quality of life (Assessment of Quality of Life score), and adverse events will be assessed at baseline, mid-treatment, post-treatment and at a 1-month follow-up.

Expected outcomes:
We hypothesize that ZRAS capsule will improve insomnia severity, sleep parameters, fatigue levels, psychological status, and quality of life better than placebo at mid-treatment, post-treatment, and follow-up. We also hypothesize that the number of adverse events provoked by ZRAS capsule will be similar to placebo at these time-points.

Trial registration:
Australia New-Zealand Clinical Trial Registry (Registration number ACTRN12619000140156).
A technology-enabled electronic incident report to document and facilitate management of sport concussion
Authors: Linder Susan M. , Cruickshank Jason , Zimmerman Nicole M. , Figler Richard , Alberts Jay L. 
Published: April 2019

AbstractDespite the widespread awareness of concussion across all levels of sport, the management of concussion from youth to college is inconsistent and fragmented. A fundamental gap contributing to inconsistent care is the lack of a scalable, systematic approach to document initial injury characteristics following concussion. The purpose of this study was to determine differences in injury profiles and management of youth, high school, and college athletes using a mobile application for incident report documentation.A cohort study was conducted in which concussion electronic incident report data from 46 high schools and colleges, and Cleveland Clinic ambulatory concussion clinics were gathered and analyzed.In sum, 1421 (N = 88 youth, N = 1171 high school and N = 162 college) athletes with sport-related concussions were included.Despite the relative absence of red flags, youth athletes had a greater probability of being sent to the emergency department than high school and collegiate athletes. Over 60% of athletes were removed from play immediately post-injury. Injury recognition was delayed in 25% of athletes due to delayed symptom reporting (20% of males, 16% of females) or delayed symptom onset (5% of males, 9% of females). A significantly greater incidence of red flags was evident in males, and in high school and collegiate athletes compared to youth athletes.The high frequency of youth athletes sent to the emergency department, despite the absence of red flags, may be a reflection of inadequate medical coverage at youth events, ultimately resulting in unnecessary utilization of emergency medicine services. The relatively high incidence of delayed injury reporting implies that additional educational efforts targeting student-athletes and the utilization of resources to improve injury detection are warranted. The systematic collection of injury-related demographics through the electronic mobile application facilitated interdisciplinary communication and improved the efficiency of managing athletes with concussion.
Risk of Parkinson disease in Sjögren syndrome administered ineffective immunosuppressant therapies
Authors: Ju Uei-Han , Liu Feng-Cheng , Lin Chin-Sheng , Huang Wen-Yen , Lin Te-Yu , Shen Chih-Hao , Chou Yu-Ching , Lin Cheng-Li , Lin Kuen-Tze , Kao Chia-Hung , Chen Chao-Hsien , Yang Tse-Yen 
Published: April 2019

Abstract
To determine the incidence and risk of Parkinson disease (PD) in patients with Sjögren syndrome (SS) according to a nationwide population-based database.
In total, 12,640 patients in the SS cohort and 50,560 in the non-SS cohort were enrolled from Taiwan's National Health Insurance Research Database from 2000 to 2010. We used the Cox multivariable proportional hazards model to determine the risk factors for PD in the SS cohort.
We observed an increased incidence of PD in patients with SS, with a crude hazard ratio (HR) of 1.40 and an adjusted HR (aHR) of 1.23. The cumulative incidence of PD was 1.95% higher in the SS cohort than in the non-SS cohort. The SS cohort had an elevated HR under medication use, namely cevimeline and pilocarpine (crude HR, 1.28), hydroxychloroquine (crude HR, 1.43; aHR, 1.46), and methylprednisolone (crude HR, 2.21; aHR, 1.49). Patients receiving other non-hydroxychloroquine immunosuppressant therapies had a lower risk (aHR, 0.86) of PD. Furthermore, patients with SS aged 20 to 49 years had a 1.93-fold higher risk of PD than did those without SS (aHR, 1.93). The risk of PD was higher (aHR, 2.20) in patients with SS without comorbidities than in those with comorbidities. The aHR of PD significantly increased when the follow-up period exceeded 9 years (aHR, 1.93).
We determined an increased risk of PD in patients with SS. Further investigation is warranted to determine the possible underlying mechanisms and the potential role of non-hydroxychloroquine immunosuppressants in ameliorating PD.
Weekly cisplatin for the treatment of patients with ovarian cancer
Authors: Zhang Dan-feng , Dou Peng-hui , Zhao Dong-xu , Li Jing , Hu Yu-hong 
Published: April 2019

Abstract

Background:
Ovarian cancer (OC) is one of the most leading causes of deaths in the Chinese women. The objective of this protocol is to perform a full-scale systematic review on the efficacy of weekly cisplatin (WC) for the treatment of patients with OC.

Methods:
Data sources will comprise of PubMed, PsycINFO, Scopus, Opengrey, Cochrane Central Register of Controlled Trials, Embase, Cumulative Index to Nursing and Allied Health Literature, Web of Science, Allied and Complementary Medicine Database, and Chinese Biomedical Literature Database. All relevant randomized controlled trials from searched databases will be identified from their inception to the present. A defined search strategy will be implemented along with eligibility criteria. Relevant data will be extracted according to the predefined data collection form. Methodologic quality will be assessed by using Cochrane risk of bias tool; and data pooled and meta-analysis will be conducted by using fixed-effects, or random-effects model with RevMan 5.3 software.

Results:
This proposed systematic review will evaluate the efficacy of WC for patients with OC.

Conclusion:
The findings of this study may summarize the latest evidence for the WC on OC.

Ethics and dissemination:
Ethical approval is not required for this study, because it will be based on published studies, and existing sources of literature. The results of this study will be disseminated through peer-reviewed journal.

PROSPERO registration number:
PROSPERO CRD42018120938.
99mTc-SC lymphoscintigraphy and SPECT/CT findings in a case report of Gorham–Stout disease presenting with chylothorax and bone pain
Authors: Jiang Yuanyuan , Hou Guozhu , Cheng Wuying 
Published: April 2019

Abstract

Rationale:
Gorham–Stout disease (GSD) is a rare disorder characterized by multiple osteolytic lesions, sometimes complicated by chylothorax. The aim of this case report is to introduce a very rare case of Gorham–Stout syndrome, which involved several bones along with chylous pericardial and pleural effusions detected by 99mTc-sulfur colloid (SC) lymphoscintigraphy and single photon emission computed tomography/computed tomography (SPECT/CT).

Patient concerns:
A 15-year-old girl presented to our hospital complaining of shortness of breath and bone pain.

Diagnosis:
The CT showed multiple osteolytic lesions, left-sided pleural effusion, and pericardial effusion. 99mTc-SC lymphoscintigraphy showed discontinuation of thoracic duct and tracer accumulation on the left side chest. SPECT/CT revealed increased radioactivity uptake in pleural, pericardial effusions, and some thoracolumbar spines. Diagnostic thoracentesis to identify the nature of pleural effusion and histopathology of biopsy in the right femoral to that of the bone lesion were performed. Based on the clinical information, histopathologic, and radiographic findings, the diagnosis of GSD was made.

Interventions:
The patient received thoracic duct ligation and bisphosphonates treatment.

Outcomes:
After receiving thoracic duct ligation and bisphosphonates treatment, the patient's symptoms of bone pain and dyspnea were relieved, and the pericardial and pleural fluid was diminished dramatically. At the 3-month and 9-month follow-up visit, the patient had nearly complete remission without any complication.

Lessons:
The 99mTc-SC lymphoscintigraphy and SPECT/CT could provide significant value assessing the lymphatic abnormity and evaluating the extent of disease, therefore aiding to guide decision making in the clinic.
Prognostic significance of tumor length in patients with esophageal cancer undergoing radical resection
Authors: Yang Jianbao , Liu Yahong , Li Bin , Jiang Peng , Wang Cheng 
Published: April 2019

Abstract

Background:
The prognostic significance of tumor length in esophageal cancer (EC) remains controversial. Hence, we conducted a meta-analysis to quantitatively assess the prognostic significance of tumor length in EC patients.

Method:
A systematic literature search was conducted in the PubMed, EMBASE, and Web of Science. Hazard ratios (HRs) with their 95% confidence intervals (CIs) were used to assess the prognostic significance of tumor length for overall survival (OS), and disease-free survival (DFS) in EC patients.

Results:
A total of 21 articles with 22 eligible studies involving 9271 patients were included in this meta-analysis. The results of our pooling analyses demonstrated that tumor length was an independent prognostic parameter for OS (HR = 1.38, 95% CI: 1.24–1.54, P < .01) and DFS (HR = 1.29, 95% CI: 1.11–1.50, P < .01) in EC patients. Moreover, our subgroup analysis and sensitivity analysis showed that the pooled HRs assessing the prognostic significance of tumor length did not significantly fluctuated, suggesting our pooling analyses were stable and reliable.

Conclusion:
The results of this meta-analysis demonstrated that long tumor is an independent risk of poor OS and DFS in EC patients, suggesting that it may provide additional prognostic information and thus contribute to a better stratification of EC patients, especially for those with no lymph node metastasis. However, more well-designed prospective clinical studies with large sample size are needed to strength our conclusion due to several limitations in this meta-analysis.
Impact of antimalarial (AM) on serum lipids in systemic lupus erythematosus (SLE) patients
Authors: Tao Chen-Yang , Shang Jin , Chen Tao , Yu Dahai , Jiang Yu-Min , Liu Dong , Cheng Gen-Yang , Xiao Jing , Zhao Zhan-Zheng 
Published: April 2019

Abstract

Background:
Dyslipidemia is a common disorder in systemic lupus erythematosus (SLE) patients. It is still inconclusive whether antimalarial drugs could affect the serum lipids in SLE patients, therefore we conducted a systematic review and meta-analysis of available data to address this issue.

Methods:
We comprehensively searched the databases of PubMed, EMBASE and Cochrane Library from date of inception to Sep 2018 for both randomized controlled trials (RCTs) and observational studies. Review Manager 5.3 software was used for analysis. We performed meta-analysis using random-effects model and weighted the mean difference (WMD) and its 95% confidence interval (CI). The Q test was used to assess the presence of heterogeneity and the I

2
index was used to quantify the extent of heterogeneity.

Results:
In total, 8 studies met our selection criteria including 2 RCTs, 2 cohort studies, and 4 case-control studies. There were 717 patients (336 patients in CQ (chloroquine) or HCQ (hydroxychloroquine) group, and 381 patients in control group (SLE patients without the therapy of AM)). Compared with the control group, TC, TG, LDL-C, VLDL-C were associated with a significant decrease, respectively (WMD = −21.40 mg/dL, 95% CI −27.62 to −15.18, P < .00001), (WMD = −29.07 mg/dL, 95% CI −45.28 to −12.86, P = .0004), (WMD = −16.25 mg/dL, 95% CI −28.82 to −3.68, P = .01), (WMD = −6.41 mg/dL, 95% CI −12.39 to 0.44, P = .04), however the change of HDL-C did not reach statistically significance (WMD = 4.42 mg/dL, 95% CI −1.21 to 10.06, P = .12).

Conclusions:
CQ or HCQ can infect the serum lipids in SLE patients. However, these results should be interpreted with cautions since lacking sufficient RCTs.
Primary pulmonary hepatoid adenocarcinoma
Authors: Yang Kun , Jiang Huifeng , Li Qiuyao 
Published: April 2019

Abstract

Rationale:
Hepatoid adenocarcinoma of lung (HAL) is a rare malignant tumor, which can be defined as a primary alpha-fetoprotein (AFP)-producing lung carcinoma. The majority of hepatoid adenocarcinoma (HAC) expressed AFP in tumor cells, but AFP expression is not required for its diagnosis according to the modified diagnostic criteria. Despite that HAC exhibits a poor prognosis and ineffective treatment options, early diagnosis and aggressive treatment can result in long-term survival.

Patient concerns:
We report a 70-year-old Chinese male patient with alcoholic intake over 30 years and smoking history of 60 cigarettes per day for 40 years. He sought medical consultation for productive cough and hemoptysis sputum.

Diagnoses and interventions:
Chest CT scan revealed a mass (6.4 × 5.5 cm) in the left lower lobe of the lung. The patient underwent curative surgical resection, and subsequently diagnosed as HAL.

Outcomes:
Eighteen months after primary diagnosis, the patient died of multiple organ failure caused by distant metastases.

Lessons:
Familiarizing with the clinical features and modified diagnostic criteria of this rare tumor may increase awareness of the disease among clinicians and pathologists, thereby avoiding misdiagnosis and mistreatment.
Long-term compliance of vaginal pessaries
Authors: Hsieh Ming-Fang , Tsai Hsiao-Wen , Liou Wen-Shiung , Lo Ching-Chuan , Lin Zi-Han , An Ya-Fen , Lin Hsin-Yin 
Published: April 2019

Abstract
Vaginal pessary treatment for pelvic organ prolapse (POP) is relatively safe and cost-effective. Since long-term use is an important key to keep the benefit of pessary treatment, we would like to investigate the factors which might affect the compliance of vaginal pessaries. In this retrospective study, 65 women were included, and we found poor compliance in women with severe stress urinary incontinence (SUI) after reduction (1-hour pad test >10 gm vs ≦10 gm, 57.1% vs. 84.3%, P = .027). Besides, women younger than 60 years-old also had poor compliance (age ≦60-year-old vs >60-year-old, 58.3% vs 83.0%, P = .04). Other factors such as POP stage, history of hysterectomy, and types of pessaries, did not show significant influence on the long-term compliance in this study. Therefore, to evaluate the severity of SUI after reduction before providing pessary treatment is important to predict long-term compliance. Meanwhile, long-term pessary treatment seems to be more acceptable to elderly patients.
Reproducibility of normalized apparent diffusion coefficient measurements on 3.0-T diffusion-weighted imaging of normal pancreas in a healthy population
Authors: Ding Xun , Xu Haibo , Zhou Jun , Xu Jia , Mei Hao , Long Qingyun , Wang Yaxun 
Published: April 2019

Abstract
To prospectively compare the reproducibility of normal pancreas-normalized apparent diffusion coefficient (ADC) measurements for the normal pancreas and mean normalized ADCs at different pancreas anatomic locations.
In total, 22 healthy volunteers underwent pancreatic 3.0-T magnetic resonance (MR) imaging, including axial diffusion-weighted (DW) imaging with 3 b values used (0, 400, and 800 s/mm2) and with the respiratory-triggered (RT) technique. The mean ADCs from 3 regions of interest (ROIs) in 5 anatomic locations (head [H], body [B], and tail [T] of pancreas and spleen [S] and erector spinae muscles [M]) were calculated. The pancreas-normalized ADC was defined as the ratio of the ADC for the pancreas to the ADC for the spleen or erector spinae muscle. Reproducibility of ADCs and normalized ADCs was assessed by the Bland–Altman method. The ADC and normalized ADC data were analyzed by repeated-measures ANOVA.
Mean ADC and normalized ADC values did not differ (P >.05) with repeated measurements at the different pancreas anatomic locations. Reproducibility of pancreas-normalized ADC measurements in each of the 3 pancreatic anatomic locations was better with the erector spinae muscle rather than the spleen used as a reference. Mean ADC and normalized ADC values significantly differed between the 3 pancreatic segments (H: 1.36 × 10−3 mm2/s, B: 1.38 × 10−3 mm2/s, T: 1.25 × 10−3 mm2/s, P = .022; H/S: 1.75, B/S: 1.78, T/S: 1.59, P = .009; H/M: 0.91, B/M: 0.95, T/M: 0.85, P = .008). Mean ADC values and normalized ADC values showed a trend to decrease from the pancreatic head to tail.
Our preliminary results suggest that normalized ADC measurements for the pancreas show good intra- and interobserver reproducibility, the erector spinae muscle is a better choice than the spleen for calculating normalized ADC values for the pancreas, and the normalized ADC values are lower for the pancreatic tail than other pancreatic segments.