bluuebunny/crossref_metadata_2025_split huggingface dataset:
On-demand versus half-dose continuous therapy with esomeprazole for maintenance treatment of gastroesophageal reflux disease
Authors: Cho Joon Hyun , Koo Ji Yeon , Kim Kyeong Ok , Lee Si Hyung , Jang Byung Ik , Kim Tae Nyeun 
Published: October 2018

Abstract

Background and aims:
No consensus has been established regarding optimal long-term maintenance therapy in symptomatic gastroesophageal reflux disease (GERD). The aim of this study was to compare the efficacies of on-demand and continuous therapy with esomeprazole as maintenance treatments for GERD.

Methods:
Patients with upper gastrointestinal (GI) endoscopy-proven GERD who received initial proton pump inhibitor (PPI) therapy for 8 weeks were randomized to an on-demand group (esomeprazole 40 mg) or a continuous group (esomeprazole 20 mg). Intensities and frequencies of heartburn and acid regurgitation were assessed using a 6-point Likert scale (0 = no symptoms; 5 = very severe symptoms) and a 6-point frequency scale (0 = none; 5 = symptoms for > 5 days per week) at baseline (start of maintenance treatment) and after 12 weeks of treatment. Alleviation of symptoms was quantified using percentages of patients with a Likert scale or frequency scale of 0 or 1.

Results:
Of the 88 patients enrolled, 8 patients were excluded due to follow-up loss in early period of this study, and finally, 39 in the on-demand group and 41 in the continuous group were analyzed. No significant intergroup difference was found between Likert scale or frequency scale of heartburn or regurgitation at baseline. Percentages of symptom alleviations in the on-demand and continuous groups for intensity of heartburn were 56.4%/48.8% at baseline (P = .523) and 82.1%/87.8% at 12 weeks (P = .471), for frequency of heartburn were 61.5%/46.3% at baseline (P = .173) and 76.9%/87.8% at 12 weeks (P = .200), for intensity of regurgitation was 53.8%/43.9% at baseline (P = .374) and 82.1%/87.8% at 12 weeks (P = .471), and for frequency of regurgitation was 61.5%/56.1% at the baseline (P = .621) and 82.1%/82.9% at 12 weeks (P = .918), respectively. Furthermore, no significant intergroup difference was found for convenience of medication or subjective satisfaction.

Conclusions:
Intensities and frequencies of heartburn and regurgitation responded well to maintenance treatment in patients in the on-demand and continuous groups. On-demand therapy with esomeprazole 40 mg appears to be sufficient for maintenance treatment in GERD patients.
Diagnostic challenges in differentiating intramural gastric abscess from gastric cancer
Authors: Chen Youwei , Han Yong , Du Jing 
Published: October 2018

Abstract

Rationale:
Intramural gastric abscess is a rare clinical condition. It is frequently neglected because of the absence of specific clinical symptoms and misdiagnosed due to the difficulty in differentiating a benign lesion from a malignant one on the gastric wall. Several imaging techniques are helpful for identifying an intramural gastric abscess. Nevertheless, a definite diagnosis is still challenging, and unnecessary surgery is sometimes performed. Therefore, more information regarding case experiences should be shared to help correctly diagnose intramural gastric abscesses.

Patient concerns:
Two patients, a 47-year-old woman and a 31-year-old man, were hospitalized for abdominal pain.

Diagnosis and interventions:
In addition to routine blood tests, either two or three imaging examinations, including esophagogastroduodenoscopy (EGD), computed tomography (CT), and endoscopic ultrasonography (EUS), were performed for these patients. The first patient was diagnosed with gastric cancer metastasized to the gastrocolic ligament, and the other was suspected to have a gastric wall abscess secondary to cancer of unknown origin. Both patients underwent surgery.

Ourcomes:
Surgery revealed a gastric wall abscess involving the colon in the first patient. She recovered after using oral antibiotics for 1 week, and she showed no discomfort or abnormalities during follow-up examinations. The second patient was diagnosed with gastric wall abscess derived from metastasized gastric cancer with a primary tumor located at the splenic flexure of the colon. He was discharged because of intolerance to chemotherapy and died before follow-up.

Lessons:
EGD, CT, and EUS/fine-needle aspiration (EUS/FNA) are extremely valuable for differentiating an intramural gastric abscess from gastric cancer, and misdiagnoses can occur if any of these assessments is ignored. Hence, we recommend performing EGD, CT, and EUS/FNA as part of the routine examination when either of these two diseases is suspected clinically.
Bronchobiliary fistula following radiofrequency ablation for liver metastases from breast cancer
Authors: Xi Xue-Jiao , Zhang Yi , Yin Yun-Hong , Li Hao , Ma De-Dong , Qu Yi-Qing 
Published: October 2018

Abstract

Rationale:
Bronchobiliary fistula (BBF) is a rare clinical condition which is characterized by a channel between biliary tract and bronchial tree. BBF can present with fever, dyspnea, and cough. However, it can be easily misdiagnosed as biliary vomiting, dyspnea, or even severe pneumonia.

Patient concerns:
A 53-year-old woman was diagnosed with breast cancer in April 2011 and underwent radical mastectomy and lymph node dissection, chemotherapy, and radiotherapy. Unfortunately, the patient suffered from bone metastasis during the 1st year and liver metastasis during the 2nd year after radical mastectomy. In 2013, the patient underwent transcatheter arterial chemoembolization therapy twice for liver metastasis. The patient was then treated with radiofrequency ablation (RFA) in 2016. Unfortunately, the patient developed a cough with bitter-tasting yellow sputum and chest tightness 2 weeks after the RFA treatment. Approximately 6 months later, the patient still complained of a cough with yellow sputum and persistent chest tightness. The patient was then admitted to our department.

Diagnoses:
The presence of bile in the sputum supported a diagnosis of BBF. Bronchoscopy was performed, and the presence of bile in the lavage fluid confirmed the diagnosis of BBF.

Interventions:
The patient was treated with antibiotics including sulbactam, cefoperazone, levofloxacin and meropenem, was well as hepatoprotectants, nutritional support and other supportive treatments in our department.

Outcomes:
The patient died because of liver failure.

Lessons:
This case demonstrates that we should consider the possibility of BBF when patients experience a recurrent cough with discolored sputum after RFA. In particular, a diagnosis of BBF should be considered in patients who do not respond to antibiotic treatment.
Preliminary study of urinary arsenic concentration and arsenic methylation capacity effects on neurodevelopment in very low birth weight preterm children under 24 months of corrected age
Authors: Jiang Chuen-Bin , Hsueh Yu-Mei , Kuo Guang-Lin , Hsu Chyong-Hsin , Chang Jui-Hsing , Chien Ling-Chu 
Published: October 2018

Abstract
The neurological prognoses of very low birth weight preterm (VLBWP) children during the first 2 years of life will influence their neurodevelopment during subsequent childhood years and adolescence. The objective of this study was to systemic investigate relationships of urinary arsenic (As) concentrations, the As methylation capability, and toenail As concentrations on cognitive, language, and motor development in VLBWP children under 24 months of corrected age.
Participants (n = 60) in our study were recruited from October 2010 to April 2013. Urine and toenail samples were collected for evaluation to assess As exposure. The Bayley scales of infant development III were used to evaluate neurodevelopment at 2 years of corrected age. Concentrations of As species in urine and the As concentration in toenails were, respectively, analyzed using HPLC-HG-AAS and ICP-MS.
The mean concentration of total As was 28.6 μg/g creatinine, and inorganic As was 1.01 μg/L in urine. The urine contained an average of 3% inorganic As, 2% monomethylarsonic acid, and 95% dimethylarsinic acid (DMA). The mean concentration of As in toenails was 225 ng/g. Children with a longer gestational age (≥28 weeks) and higher DMA % levels appeared to have the highest unadjusted cognitive and fine motor scores.
Our study results suggest that gestational age is associated with neurodevelopment in VLBWP children. We recommend that further study simultaneously analyze multiple environmental contaminants that may have adverse effects on neurodevelopment, use biomarkers for the mother–child pair, and determine whether prenatal or postnatal As exposure has a greater influence on the neurological development of VLBWP children.
Remarkable improvement in a very severe chronic obstructive pulmonary disorder patient after use of noninvasive intermittent positive pressure ventilator
Authors: Jung Ji Ho , Lim Young Ho , Lee Jang Woo , Choi Won Ah , Suh Mi Ri , Kang Seong-Woong 
Published: October 2018

Abstract

Rational
Chronic obstructive pulmonary disease (COPD) impairs lung function and induces systemic effects, resulting in impaired quality of life. Skeletal muscle dysfunction—characteristic of advanced COPD patients—limits a patient's ability to perform activities of daily living (ADL). In addition, dysphagia is commonly observed in COPD patients.

Patient concern
This case report documents a 42-year-old man with very severe COPD. He experienced aggravation of the symptoms during standard medical treatment and his ability to perform the ADL was significantly impaired. Furthermore, his dysphagia worsened despite oromotor training.

Diagnosis
He was diagnosed as very severe COPD have a problem with swallowing and respiratory function.

Intervention
Upon NIPPV treatment, the patient's ability to perform the ADL, as well as his dysphagia, showed improvement.

Outcomes
Thus, we report the remarkable improvement of physical function, as well as dysphagia, in a very severe COPD patient after NIPPV treatment.

Lessons
NIPPV may be useful as a treatment option for such patients.
The association between TNF-α 238A/G and 308A/G polymorphisms and juvenile idiopathic arthritis
Authors: Li Xing-yan , Liang Chun-hua , Parkman Virginia , Lv Zheng-tao 
Published: October 2018

Abstract

Objective:
A previous meta-analysis concluded that TNF-α 238A/G and TNF-α 308A/G polymorphisms were not associated with the risk of juvenile idiopathic arthritis (JIA) in the overall population or Caucasian subjects. With the publication of a fair number of studies on the association between TNF-α polymorphisms and JIA in recent years, we conducted this updated meta-analysis to make a more accurate evaluation of such relationship.

Methods:
We adopted PubMed, EMBASE, ISI Web of Science and CNKI to identify observational studies that addressed the association between TNF-α polymorphisms and risk for JIA. The allelic effect of variant A for the risk of JIA was expressed as odds ratio (OR) along with the associated 95% confidence interval (95% CI). Meta-analyses were performed by pooling ORs and 95%CI from included studies using RevMan 5.3 software. The stratified-analysis based on ethnicity was performed to confirm the ethnicity-dependent effect on the relationship.

Results:
A total of 15 case-control studies including 2845 patients in JIA groups and 4771 patients in control groups were included in our study. The findings indicated a statistically significant association between the A allele of the TNF-alpha 238A/G polymorphism and the decreased JIA risk in Caucasians (P = .0002). The study in Iranian showed similar results (P = .0002) whereas the studies in other ethnicities failed to replicate this finding: Han (P = .29), Mexican (P = .64) and Turkish population (P = .32). TNF-α 308A/G was not statistically associated with JIA in overall subjects or Caucasians.

Conclusion:
Our study confirmed the protective role of the A allele in TNF-α 238A/G but not TNF-α 308A/G against the occurrence of JIA in the Caucasian population. To exactly validate the correlation between TNF-α polymorphisms and JIA in other ethnic backgrounds, additional studies are required.
The genetic association between apolipoprotein E gene polymorphism and Parkinson disease
Authors: Li Jianming , Luo Jia , Liu Li , Fu Hui , Tang Liang 
Published: October 2018

Abstract

Objective:
Although the relationship between apolipoprotein E (ApoE) gene polymorphisms and the risk of Parkinson disease (PD) has been established, the results were inconsistent and inconclusive.

Methods:
A comprehensive search examining the association between APOE polymorphisms and PD through PubMed, Embase, Chinese National Knowledge Infrastructure (CNKI), and Cochrane Library databases was performed without published year limited.

Results:
A total of 47 studies with 7533 cases and 14442 controls were included in present study. The results showed statistically significant association between risk factor ApoE ε4 allele and PD in Asian population (P = .003, odds ratio, OR [95% confidence interval, CI] = 1.43 [1.13,1.80]). Genotype ε2ε4 have significantly associated with PD in Asian population (P = .004, OR [95% CI] = 4.43 [1.62,12.10]). Genotype ε3ε4 was significantly associated with PD in Latin-American population (P = .01, OR [95% CI] = 1.44 [1.08,1.91]). In addition, the frequency of the genotype ε3ε4 is lower in PD group than that in the control group in Caucasian population, and the difference of genotype ε3ε4 is also statistically significant (P = .006, OR [95% CI] = 0.86 [0.77,0.96]). Although significant heterogeneity was observed among all studies, the results were shown to be stabilized by sensitive analysis. No publish bias was observed.

Conclusions:
This meta-analysis suggests that the APOE ε4, but no ε2, might be a risk factor for PD in Asian population. Furthermore, the genotype ε2ε4 may be a susceptible factor for PD in Asian population, and the genotype ε3ε4 may be a susceptible factor for PD in both Caucasian and Latin-American populations.
The impact of perioperative allogeneic blood transfusion on prognosis of hepatocellular carcinoma after radical hepatectomy
Authors: Xun Yangqin , Tian Hongwei , Hu Lidong , Yan Peijing , Yang Kehu , Guo Tiankang 
Published: October 2018

Abstract
This meta-analysis aims to clarify the clinical impacts of allogeneic blood transfusion (ABT) on hepatectomy outcome in hepatocellular carcinoma (HCC) patients. A systematic literature search was performed for relevant articles in international and Chinese databases up to May 2018. Random- or fixed-effect meta-analysis was used to pool the effect estimates. Publication bias was assessed by Egger's and Peters's test. Heterogeneity was assessed using the I
2 statistic. The strength of evidence was rated by the Grading of Recommendations Assessment, Development, and Evaluation system. A total of 29 studies met the eligibility criteria. Meta-analysis showed HCC patients in ABT group had lower survival rate at 1, 3, 5, and 10 years after radical hepatectomy than those in no blood transfusion (NBT) group (RR = 0.9, 95%CI: 0.87–0.93, P < .05; RR = 0.83, 95%CI: 0.77–0.89, P < .05; RR = 0.7, 95%CI: 0.65–0.74, P < .05; RR = 0.64, 95%CI: 0.54–0.75, P < .05). Similar results were observed in disease-free survival (DFS) (respectively: RR = 0.86, 95%CI: 0.82–0.91, P < .05; RR = 0.77, 95%CI: 0.67–0.79, P < .05; RR = 0.71, 95%CI: 0.64–0.79, P < .05; RR = 0.62, 95%CI: 0.48-0.8, P < .05). Cancer recurrence rate was higher for the patients in ABT group at 1 and 3 years (RR = 1.5, 95%CI: 1–2.24, P < .05; RR = 1.27, 95%CI: 1.09–1.49, P < .05, respectively), but not statistically significant at 5years (RR = 1.08, 95%CI: 0.98–1.19, P = .512). The HCC patients in ABT group increased postoperative complications occurrence compared with those in NBT group (RR = 1.87, 95%CI: 1.42–2.45, P < .05). This meta-analysis demonstrated that ABT was associated with adverse clinical outcomes for HCC patients undergoing radical hepatectomy, including poor survival, DFS, and complications. Surgeons should reduce blood loss during hepatectomy and avoid perioperative allogenic blood transfusion.
Muscle oxygenation during hybrid arm and functional electrical stimulation–evoked leg cycling after spinal cord injury
Authors: Hasnan Nazirah , Mohamad Saadon Nurul Salwani , Hamzaid Nur Azah , Teoh Mira Xiao-Hui , Ahmadi Sirous , Davis Glen M. 
Published: October 2018

Abstract
This study compared muscle oxygenation (StO2) during arm cranking (ACE), functional electrical stimulation–evoked leg cycling (FES-LCE), and hybrid (ACE+FES-LCE) exercise in spinal cord injury individuals. Eight subjects with C7-T12 lesions performed exercises at 3 submaximal intensities. StO2 was measured during rest and exercise at 40%, 60%, and 80% of subjects’ oxygen uptake (VO2) peak using near-infrared spectroscopy. StO2 of ACE showed a decrease whereas in ACE+FES-LCE, the arm muscles demonstrated increasing StO2 from rest in all of VO2) peak respectively. StO2 of FES-LCE displayed a decrease at 40% VO2 peak and steady increase for 60% and 80%, whereas ACE+FES-LCE revealed a steady increase from rest at all VO2 peak. ACE+FES-LCE elicited greater StO2 in both limbs which suggested that during this exercise, upper- and lower-limb muscles have higher blood flow and improved oxygenation compared to ACE or FES-LCE performed alone.
Hypothyroidism induced by phenytoin and gabapentin
Authors: Miyake Zenshi , Ishii Kazuhiro , Tamaoka Akira 
Published: October 2018

Abstract

Rationale:
Antiepileptic drugs (AEDs) are one of the causative drugs of drug-induced hypothyroidism. In most cases, AED-induced hypothyroidism is subclinical and indicated only by abnormalities of free thyroxine (T4) and/or thyroid-stimulating hormone (TSH) levels. Severe symptomatic hypothyroidism following AEDs is rarely reported in the literature.

Patient concerns:
A 75-year-old man experienced neurologic symptoms including memory impairment, ataxic gait, sensory polyneuropathy and myopathy, lethargy, and edema of the face and lower extremities. He had been administered phenytoin and gabapentin for the treatment of symptomatic traumatic epilepsy 8 years before.

Diagnoses:
The patient had low free T4 (0.21 ng/dL) and high TSH (113.2 μIU/mL), which indicated hypothyroidism. Negative thyroid-related autoantibody tests and the lack of goiter excluded the possibility of Hashimoto disease. Phenytoin and/or gabapentin were strongly suspected as causing his hypothyroidism.

Intervention:
The patient was treated with replacement therapy (levothyroxine 25 μg/day).

Outcomes:
His symptoms markedly and promptly improved alongside continued antiepileptic therapy.

Lessons:
In this case, the patient's hypothyroidism was assumed to result from different mechanisms of the 2 AEDs leading to thyroid hormone reduction. AEDs can not only cause asymptomatic thyroid hormone abnormalities but also clinically observable hypothyroidism. Therefore, clinicians should be aware of the association between anticonvulsants and symptomatic hypothyroidism.
Oriental herbal medicine and moxibustion for polycystic ovary syndrome
Authors: Kwon Chan-Young , Lee Boram , Park Kyoung Sun 
Published: October 2018

Abstract

Background:
Polycystic ovary syndrome (PCOS) is one of the most common disorders of reproductive endocrinology in women of reproductive age. Lifestyle intervention and oral contraceptives are the first-line treatments for PCOS. Recent studies have suggested that complementary and alternative medicine (CAM) therapies including acupuncture, herbal medicine, and mind–body therapy have the potential to alleviate the symptoms and/or pathology of PCOS and to improve the quality of life of women with PCOS. This meta-analysis aimed to quantitatively summarize the efficacy and safety of moxibustion combined with oriental herbal medicine (OHM), common CAM therapies, for treating PCOS.

Methods:
Four databases were searched from their inception to June 22, 2018. Randomized controlled trials (RCTs) and quasi-RCTs using both OHM and moxibustion as experimental intervention, and western medication (WM) as control intervention were included. Studies involving OHM plus moxibustion combined with WM as the experimental intervention were also included. The quality of included studies was assessed using risk of bias tool.

Results:
Owing to the heterogeneity of reporting, meta-analysis was only performed for pregnancy rate, rate of normal biphasic basal body temperature (BBT), and total effective rate (TER). The results showed that compared to the WM group, the OHM combined with moxibustion group was associated with significantly higher pregnancy rate (risk ratio [RR] 1.95, 95% confidence interval [CI] 1.55–2.47; I2 = 0%), normal biphasic BBT rate (RR 1.66, 95% CI 1.34–2.05; I2 = 0%), and TER (RR 1.19, 95% CI 1.08–1.31; I2 = 0%). When OHM combined with moxibustion was used as an adjunctive therapy to WM, pregnancy rate (RR 1.65, 95% CI 1.29–2.11; I2 = 0%), and TER (RR 1.35, 95% CI 1.13–1.61; I2 = 43%) were significantly higher than those of the WM group.

Conclusion:
According to current evidence, OHM combined with moxibustion might be beneficial for treating PCOS. Moreover, the treatment might improve the therapeutic effects of conventional WMs including clomiphene citrate, oral contraceptives, and/or metformin. However, the findings should be interpreted with caution, owing to poor methodological quality of the included studies. Further larger, high-quality, rigorous RCTs should be conducted in this regard.
Tpeak-Tend/QT interval predicts ST-segment resolution and major adverse cardiac events in acute ST-segment elevation myocardial infarction patients undergoing percutaneous coronary intervention
Authors: Wang Xianpei , Zhang Lu , Gao Chuanyu , Zhu Jialu , Yang Xiaohang 
Published: October 2018

Abstract
Elevated ST-segment and increased Tpeak-Tend interval (Tp-e) were prognostic predictors in major adverse cardiac events (MACEs) in ST-segment elevation myocardial infarction (STEMI). The electrophysiologic relationship between them during percutaneous coronary intervention (PCI) needs to elucidate.
Patients with STEMI admitted to hospital were prospectively evaluated. ST-segment resolution (STR) (defined as ≥50% reduction as the complete-STR [CSTR] group, <50% as incomplete-STR [ISTR] group), Tp-e interval, and ratio of Tp-e to QT interval (Tp-e/QT) were measured, calculated and analyzed with MACEs.
Tp-ec interval (corrected Tp-e interval, P < .001) and Tp-e/QT ratio (P < .001) were significantly increased by myocardial infarction and partly recovered post-PCI. Patients with ISTR showed more increased Tp-ec interval (P < .001) and Tp-e/QT ratio (P < .001) than those in CSTR groups post-PCI. In multivariate analysis and receiver operating characteristic curves analysis, Tp-e/QT was an independent and strongest predictor for STR. STR and electrocardiogram parameters with a cutoff value for predicting STR showed prognostic value for MACE in STEMI in Kaplan–Meier survival analysis.
Both STR and change of Tp-e parameters were not only predictors of arrhythmia, but also prognostic factors of MACE in patients with STEMI after PCI.