bluuebunny/crossref_metadata_2025_split huggingface dataset:
Benzbromarone as a possible cause of acute kidney injury in patients with urolithiasis
Authors: Ye Xiaolan , Wu Jian , Tang Kun , Li Wenge , Xiong Cunquan , Zhuo Li 
Published: April 2019

Abstract

Rationale:
Reports of acute kidney injury (AKI) associated with benzbromarone use in patients with hyperuricemia (HUA) are rare so far.

Patient concerns:
We describe 2 unique clinical patterns in which benzbromarone was a possible cause of AKI following self-medication for HUA. In case 1, a 45-year-old man developed AKI after taking 100 mg of benzbromarone. His serum creatinine (Scr) increased to 2.3 mg/dL on day 2 after benzbromarone administration. Ultrasound showed multiple small stones in both kidneys, and the 24-hour urine uric acid level was 3128 mg. In case 2, a 17-year-old male student presented with AKI after self-administration of 50 mg of benzbromarone. His Scr increased to 6.8 mg/dL on day 3 after benzbromarone administration. Ultrasound showed multiple stones in the left kidney.

Diagnosis:
Both patients underwent renal biopsy, with findings of acute tubular interstitial nephropathy in case 1 and acute tubular damage in case 2. Drug-induced AKI was considered.

Interventions:
Both cases were treated supportively with intravenous hydration only. In both patients, the Scr level recovered within 0.5 months and renal function was normal 3 months after discharge.

Lessons:
Oral benzbromarone is widely used in Asian counties to treat HUA and the adverse effects are mostly mild. However, clinicians should be alert for benzbromarone-induced AKI. Moreover, uricosuric drugs should only be used after exclusion of urolithiasis and other contraindications.
Polymer-free drug-eluting stents versus permanent polymer drug-eluting stents
Authors: Chen Yun-lin , Fan Jinqi , Chen Guozhu , Cao Li , Lu Li , Xu Yanping , Yin Yuehui 
Published: April 2019

Abstract

Background:
Polymer-free drug-eluting stents (PF-DES) have been demonstrated comparable to permanent polymer drug-eluting stents (PP-DES) during long-term follow-up. As a critical component of drug-eluting stents, antiproliferative drugs may be a confounding factor for the results. Thus, we sought to compare the outcomes of these stents during long-term follow-up, especially in consideration of different stent platforms with the same drugs.

Methods:
A systemic search was performed to identify the related randomized controlled trials comparing PF-DES with PP-DES. Primary outcomes included short (≤1 year) and long-term (>1 year) target lesion revascularization (TLR), short-term in-stent late luminal loss (LLL) and diameter stenosis (DS). Subgroup analyses stratified by the different platforms with the same proliferative drugs were conducted in TLR, LLL, and DS. Standardized mean differences (SMDs) and risk ratios (RRs) were estimated using fixed /random effects models

Results:
A total of 6927 patients extracted from 12 RCTs were enrolled in the meta-analysis. No differences were observed in clinical outcomes of short-term and long-term overall mortality, myocardial infarction and stent thrombosis and angiographic outcomes of short-term in-stent LLL and DS between PF-DES and PP-DES for patients with coronary artery lesions. Nevertheless, compared with PP-DES coated with the same proliferative drugs, PF-DES had significantly increased risks of in-stent LLL (SMD, 0.49; 95% confidence interval [CI], 0.25–0.72) and DS (SMD, 0.67; 95% CI, 0.27–1.07), and long-term TLR (RR, 1.64; 95% CI 1.13–2.39). There were no significant differences in other outcomes.

Conclusions:
Under the condition of using same antiproliferative drugs (paclitaxel or sirolimus) in different stent systems, PF-DES are associated with the increased risk of restenosis compared to PP-DES.
Acylcarnitine profile in neonatal hypoxic-ischemic encephalopathy
Authors: López-Suárez Olalla , Concheiro-Guisán Ana , Sánchez-Pintos Paula , Cocho Jose A. , Fernández Lorenzo José R. , Couce María L. 
Published: April 2019

Abstract
Optimal prognostic markers evaluating early neuroprotective interventions in neonatal hypoxic-ischemic encephalopathy (HIE) are lacking. This study was designed to assess the prognostic value of acylcarnitines in neonatal HIE.
An observational cohort study was conducted over 10 years in 67 HIE. Variables analyzed included sex, blood cord pH, Apgar score, hypothermia treatment (yes/no), neuron-specific enolase (NSE) levels, and clinical outcome (neurological examination, brain magnetic resonance imaging [MRI], and electroencephalogram) before discharge and at 6 months. Acylcarnitine profiles were analyzed by tandem-mass spectrometry on dried-blood spots collected on day 3 for newborn screening. A cohort of healthy newborns was used as control group.
HIE patients had significantly increased C4, C5, C5:1, C6, C6-OH, C8 levels (all P < .01) and decreased long-chain acylcarnitine levels (P < .03). Hypothermia treatment was associated with a decrease in C4 levels (p = 0.005) and an increase in most long-chain acylcarnitine levels (P < .01). A significant association was found between C4 levels and NSE on day 1 of hypothermia treatment (P = .002) and abnormal brain magnetic resonance imaging (MRI) at discharge (P = .037). In the hypothermia group, C4 levels decreased in patients with favorable outcomes but remained high in those who progressed unfavorably.
C4 appears to be a good prognostic marker in HIE, as blood levels correlated with NSE levels and abnormal MRI findings. Furthermore, hypothermia did not lead to decreased levels in patients with adverse outcomes.
Predictive value of early molecular response for deep molecular response in chronic phase of chronic myeloid leukemia
Authors: Wang Rui , Cong Yue , Li Caili , Zhang Chen , Lin Hai 
Published: April 2019

Abstract
To investigate the association of 3- and 6-month BCR-ABL transcript levels on the international scale (BCR-ABLIS) and other factors with deep molecular response (DMR) achievement in chronic myeloid leukemia (CML)-chronic phase (CP) patients receiving tyrosine kinase inhibitor (TKI) therapy.
We retrospectively analyzed the clinical data of 206 patients enrolled in our hospital between January 2010 and July 2018. These patients were initially diagnosed with CML-CP and received imatinib or nilotinib therapy. Early molecular response (EMR) was assessed based on BCR-ABLIS (IS: on the international scale) transcript level at 3 and 6 months. Potential factors impacting DMR achievement were identified using Cox proportional hazard regression models. The effects of EMR achievement on the cumulative incidence of MR4.0 were investigated via Kaplan–Meier analysis.
Multivariate Cox regression analysis showed that a BCR-ABLIS transcript level at 3 and 6 months of TKI therapy was an independent factor for the achievement of MR4.0, which was nevertheless not related to age, gender, Sokal score, hemoglobin level, or white blood cell (WBC) count at the initial time of diagnosis. Patients achieving an EMR (EMR: 3-month BCR-ABLIS ≤10%, 6-month BCR-ABLIS <1%) were more likely to reach MR4.0 than patients failing to achieve EMR (P
1 <.001, P
2 <.001). Patients who had 3-month BCR-ABLIS ≤1% were more likely to reach MR4.0 than those who had 3-month BCR-ABLIS of 1% to 10% or >10% (P
1 = .001, P
2 <.001). Similarly, patients who had 6-month BCR-ABLIS ≤0.1% were more likely to achieve MR4.0 than those in the 0.1% to 1% and ≥1% groups (P
1 <.001, P
2 <.001). Also, a higher percentage of patients on nilotinib therapy achieved EMR compared with patients on imatinib therapy (93.3% vs 63.6% on 3-month nilotinib therapy, P = .001; 88.9% vs 59.9% on 6-month nilotinib therapy, P = .004).
This study demonstrates that EMR, especially a 3-month BCR-ABLIS ≤1% and 6-month BCR-ABLIS ≤0.1%, have predictive value for DMR achievement. In addition, there is a higher percentage of patients receiving nilotinib therapy achieved EMR than that of those receiving imatinib therapy.
Effects of physical therapy on lung function in children with asthma
Authors: Wang Qiu , Zhang Weijian , Liu Lilong , Yang Wenhao , Liu Hanmin 
Published: April 2019

Abstract

Background:
Morbidity of asthma in children is increasing, which is significantly affecting children's life quality. Despite the medication therapy, physical therapies, including breathing exercises, inspiratory muscle training and physical training, are widely used to improve children's condition. However, the effectiveness of physical therapy remains unclear. This systematic review and meta-analysis is aiming to evaluate the effects of physical therapy on lung function in children with asthma and to assess which physical therapy is more effective.

Methods:
Three main databases (PubMed, Embase, and the Cochrane Library) will be searched from inception to November 30, 2018 for randomized controlled trials investigating the effects of physical therapy on lung function in children (age < 18 years old) with asthma published in English. In addition, a manual search of the references of relevant published studies in English will also be considered.
Two independent reviewers will conduct studies selection, data extraction, and risk of bias assessment. Outcome measures will be the Peak Expiratory Flow (PEF), the Forced Expiratory Volume in the first second (FEV1), and the Forced Vital Capacity (FVC). Subgroup analyses will be performed according to the physical therapy (breathing exercises, inspiratory muscle training, and physical training) and the outcome (PEF, FEV1, FVC).

Results:
The results will provide useful information about the effect of physical therapy on lung function in children with asthma and demonstrate which physical therapy is more effective.

Conclusion:
The findings of this study will be published in a peer-reviewed journal.

Prospero registration number:
CRD42019121627
A systematic review and meta-analysis of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) versus traditional staged hepatectomy
Authors: Liu Yanmo , Yang Yingxin , Gu Shenglong , Tang Kezhong 
Published: April 2019

Abstract
It is still controversial whether associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) or traditional staged hepatectomy such as portal vein embolization (PVE) and 2-staged hepatectomy (TSH) is better. The aim of this study was to compare these 3 available strategies in extended hepatectomy.
Trials were identified by searching MEDLINE, PubMed, the Cochrane Library, and Embase and additional articles were identified by hand searching. Comparative clinical studies reporting volumetric changes, mortality, morbidity, and feasibility of the second stage about ALPPS versus PVE or ALPPS versus TSH were included.
Nine studies involving 557 patients met the inclusion criteria. Five studies reported on comparison of ALPPS and PVE, and the other 4 reported about ALPPS and TSH. In the comparison of ALPPS versus traditional staged hepatectomy (PVE and TSH), ALPPS was associated with a greater increase in the future liver remnant (FLR) (RR: 4.87; 95%CI, 3.41–6.33) and more frequent completion of stage 2 resection (RR: 1.32; 95%CI, 1.21–1.44). Compared with the traditional staged hepatectomy, ALPPS had a trend toward higher morbidity (RR: 1.19, 95%CI, 0.96–1.47) and mortality (RR: 2.11, 95%CI, 1.02–4.33) after stage 2 resection.
ALPPS is associated with greater future liver remnant hypertrophy and a higher rate of completion of stage 2, but this may be at the price of greater morbidity and mortality.
Calcineurin B1 subunit in human peripheral blood mononuclear cells and its role in idiopathic membranous nephropathy
Authors: Zhu Ying , Zhang Min , Wang Fan , Sun Jing , Lu Jianda , Chen Ruiying , Xie Qionghong , Xue Jun , Hao Chuanming , Lin Shanyan 
Published: April 2019

Abstract
The immune responses involved in the pathogenesis of idiopathic membranous nephropathy (IMN) have not been fully understood. Calcineurin, a key signaling enzyme in T-cell activation, may be implicated in IMN. The present study aimed to investigate the role of calcineurin B1 subunit (CnB1) in IMN and the potential mechanism.
A total of 59 biopsy-proven IMN patients and 28 healthy controls were recruited. The CnB1 expression in human peripheral blood mononuclear cells (PBMCs) was assessed by Western blotting. Knockdown and overexpression of CnB1 in Jurkat T cell line were achieved by small interference RNA (siRNA) transfection and lentiviral transduction, respectively.
It was found that PBMCs CnB1 expression was significantly increased in IMN patients (P = .002), but unrelated to the severity and prognosis of IMN. Knockdown of CnB1 in Jurkat cells inhibited the nuclear factor of activated T cells (NFAT)-regulated gene expression required for T-cell activation.
Our study suggested the potential role of CnB1 in the occurrence of IMN. The mechanism maybe involved the effect of CnB1 on the T-cell activation mediated by calcineurin-NFAT signaling.
Solitary adrenal metastasis from advanced gastric cancer invading duodenal bulb with situs inversus totalis
Authors: Xue Wangsheng , Li Yongbo , Zhao Zeyun , Li Wei , Wang Shuang , Zhang Mingwei , Liu Tongjun , Wang Min 
Published: April 2019

Abstract

Rationale:
Situs invsersus totalis (SIT) is a rare anomaly featured by complete inversion of abdominal and thoracic organs. Adrenal metastasis is often encountered as part of advanced systemic dissemination, which is usually unresectable. Few published cases reported the adrenal metastasis from gastric cancer with SIT and the treatment of gastrectomy combined with adrenalectomy, especially with intraoperative radiotherapy (IORT).

Patient concerns:
A 61-year-old SIT man found a mass on the right clavicle and the biopsy revealed a metastatic cancer. Around 14 years ago, he had a rectal cancer resection surgery and no sign of occurrence. Five months later, the patient had a pain in his right low abdomen and abdominal CT found a right adrenal mass.

Diagnoses:
Gastroscopy and the pathology revealed the gastric antrum cancer invading the duodenal bulb. Abdominal enhanced CT suspected the adrenal mass as a hematoma, but positron emission tomography computed tomography suspected it as the metastases of gastric cancer which is consistent with the pathology results. Finally, the SIT patient was diagnosed with primary gastric cancer invading duodenal bulb with solitary right adrenal metastasis.

Interventions:
The patient was treated with curative distal gastrectomy and Billroth-II anastomosis with D2 lymphadenectomy. A total 18 Gy intraoperative radiotherapy (IORT) using low energy x-rays by Intrabeam were given after resection.

Outcomes:
The patient had liver metastasis in the seventh month after surgery but there is no sign of local recurrence until now.

Lessons:
Gastric cancer with adrenal metastasis, especially with SIT is rare and intractable. The result suggested that active surgical treatment for resectable gastric cancer and solitary adrenal metastatic tumor, especially in combination with IORT may be an option in controlling local relapse and prolonging survival in selected patients.
Efficacy of acyclovir for herpes simplex encephalitis
Authors: Wang Wei , Ji Meng 
Published: April 2019

Abstract

Background:
Clinical researches indicate that acyclovir can be used to herpes simplex encephalitis (HSE). However, no systematic review has explored its efficacy for the treatment of HSE. Therefore, this study systematically will investigate the efficacy and safety of acyclovir for patients with HSE.

Methods:
We will search the following databases from inceptions to March 1, 2019 without any language restrictions: Cochrane Library, Embase, MEDICINE, PsycINFO, Web of Science, Allied and Complementary Medicine Database, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure. This study will include randomized controlled trials that assess the efficacy and safety of acyclovir for patients with HSE. Two authors will independently carry out the study selection, data extraction, and risk of bias assessment. Cochrane risk of bias tool will be used to assess the risk of bias assessment.

Results:
This study will systematically assess the efficacy and safety of acyclovir for HSE. The primary outcome is mortality rate, which is measured by Glasgow coma score, or other instruments. The secondary outcomes include quality of life, as assessed by 36-Item Short Form Health Survey or relevant scales; overall survival, the number of patient who died; the number of patient who had severe sequelae, and adverse events.

Conclusions:
The findings of this study may provide the existing evidence on the efficacy and safety of acyclovir for HSE.

PROSPERO registration number:
PROSPERO CRD42019125999.
Options for the Interpretation of and Recommendations for Acting on Different PROMs in Daily Clinical Practice Using KLIK
Authors: Haverman Lotte , van Oers Hedy A. , van Muilekom Maud M. , Grootenhuis Martha A. 
Published: April 2019

Introduction:
This paper describes the different ways in which information is being fed back to health care providers (HCPs) using the Dutch evidence-based KLIK Patient-Reported Outcome Measures (PROMs) portal (www.hetklikt.nu). KLIK was initially developed for children with a chronic illness and their parents, and recently expanded for use in adult health care. Patients complete online PROMs at home about their health-related quality of life (HRQOL), symptoms and/or psychosocial functioning before an outpatient consultation with their HCP. PROMs are subsequently converted into an individual KLIK electronic (e)PROfile and discussed during the consultation to facilitate systematic attention for HRQOL.

Methods for PRO Score Interpretation:
KLIK includes a variety of different PROMs. The KLIK ePROfile initially consisted of literal representations of the individual PROM items in the European traffic light colors (red, orange, green) and only one graph. Over the years, the KLIK ePROfile evolved into a broader spectrum of feedback options; (1) literal representation of individual items, (2) summary scores, and (3) graphic representations (4 options).

Developing Recommendations for Acting on PRO Results:
The primary goal of KLIK is to longitudinally monitor patient and parent self-reported or proxy-reported health outcomes, which means that the focus of KLIK is not mainly on recommending actions for PRO results. However, there are several aids that help interpretation of the KLIK ePROfile and recommendations are given for actions based on PROM scores. The main aid is the KLIK training, which includes a theoretical and a practical part. In the training, 2 tools—a decision tree and a summary of information about the KLIK ePROfile—are given to the HCPs to assist them in using KLIK.

Discussion:
Customization of a PROM portal is needed for each different patient group and clinical setting. Because the KLIK website is flexible, every PROM (with good psychometric qualities and permission of the publisher) can be built in. However, implementing and feeding back PROMs in pediatric health care encompasses different challenges, because different versions of the same PROM are needed for children of different ages, as well as proxy and self-report versions.
A Decade in Review
Authors: Barbera Lisa , Moody Lesley 
Published: April 2019

Background:
In 2007 Cancer Care Ontario (CCO) implemented standardized systematic symptom evaluation in all cancer patients in Ontario using the Edmonton Symptom Assessment System. The initial implementation did not include symptom management guidance and this limited the success of the implementation. Within a short time, the need for guidance on how to respond to symptoms became apparent.

Objective:
To describe how CCO has approached electronic symptom monitoring and related clinical response to symptom scores.

Results:
CCO’s approach to symptom management includes acknowledgment, assessment, and intervention steps. In partnership with the Program in Evidence Based Care, CCO developed guidance documents for management of each of the symptoms assessed with Edmonton Symptom Assessment System. These materials included an in-depth document similar to the full guidelines created by Program in Evidence Based Care for cancer treatment topics, a shorter pocket guide, and a 1-page algorithm. The guidance was aligned with symptom score severity. The 1-page algorithm was the most popular format of these materials. When time for revisions came, only this document was revised. When additional PRO measures were implemented, the plan ensured that the launch included a bundle of clinician-facing and patient-facing guidance materials together with the measure. All resources are accessible from a mobile-friendly website.

Conclusions:
Providing clear guidance for symptom management is an important part of successful PRO measure implementation. Involving a wide range of stakeholders early in the creation of such resources facilitates implementation and team building.
Interpreting and Acting on PRO Results in Clinical Practice
Authors: Blackford Amanda L. , Wu Albert W. , Snyder Claire 
Published: April 2019

Introduction:
We have used several methods to aid in the interpretation of patient-reported outcome (PRO) scores, and to suggest recommendations for acting on them, both within the PatientViewpoint system and in work done since.

Methods for Interpreting PRO Scores:
For identifying possibly concerning change scores, PatientViewpoint uses questionnaires’ minimally important differences or score worsening >½ SD. For poor scores in absolute terms, PatientViewpoint primarily uses distributions based on normative data (eg, worst quartile, >2 SD from the mean). To advance methods for score interpretation, we explored using needs assessments to identify health-related quality-of-life scores associated with unmet needs and requiring follow-up. We also investigated the ability of PRO scores to predict patients’ most bothersome issues.

Methods for Addressing PRO Results:
To develop suggestions for addressing issues identified by PRO questionnaires, we conducted a targeted literature review, interviewed experts from different disciplines, developed draft recommendations based on the literature and interviews, and finalized the recommendations in a consensus meeting with all experts.

Discussion:
The needs assessment method requires strongly correlated content in the needs assessment and health-related quality-of-life questionnaire. Additional research is needed to explore using the worst scores in absolute terms to identify patients’ most bothersome issues. The approach described for developing suggestions for addressing PRO results focuses on local resources and is best-suited for a local context.

Key Points:
A combination of pragmatic solutions and exploratory research can inform interpreting and acting on PRO scores.