bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transphyseal anterior cruciate ligament reconstruction in adolescents with substantial remaining growth causes temporary growth arrest resulting in subclinical leg-length discrepancy
Authors: Jeon Ji Young , Lee Jaehyung , Kang Michael Seungcheol 
Published: June 2019

Abstract
The purpose of the present study was to investigate the characteristics of growth disturbances in patients with remaining growth after transphyseal anterior cruciate ligament (ACL) reconstruction who were confirmed to have no definite postoperative physeal abnormalities on magnetic resonance imaging (MRI).
Forty adolescents (mean age 15.6 ± 1.0 years [range 12.2–16.8], mean follow-up 2.7 ± 0.7 years [range 2.0–5.5 years]), who underwent transphyseal ACL reconstruction and were confirmed to have no focal physeal disruptions on follow-up MRIs 6 to 12 months after the operation, were retrospectively evaluated. The patients were grouped according to the leg-length growth of the uninjured side, measured on scanograms, obtained before surgery, and at the final follow-up.
Leg-length discrepancies (LLD) at the last follow-up were greater in patients with leg growth ≥4 cm than in those with leg growth <4 cm (5.3 ± 9.0 mm vs −0.3 ± 4.2 mm, P = .033); however, no significant difference was observed between subgroup patients with leg growth of 4 to 6 cm or ≥6 cm (5.6 ± 10.4 mm vs 4.8 ± 7.0 mm, P = .958). On multivariate analysis, leg growth was a significant predictive factor for the final LLD (P = .030).
Adolescents with additional leg-length growth after transphyseal ACL reconstructions presented with greater LLDs (as shown in the <4 cm vs ≥4 cm groups), but they also presented a ceiling effect (as shown in the 4–6 cm vs ≥6 cm subgroups). Transphyseal ACL reconstructions appeared to cause temporary growth arrest/disturbances in patients with substantial remaining growth which then resumed resulting in clinically insignificant LLDs.
Comparison of the aperture and midportion femoral tunnel widening after anterior cruciate ligament reconstruction
Authors: Celik Haluk , Lee Dae-Hee 
Published: June 2019

Abstract

Background:
To identify whether the aperture or the midportion of the femoral tunnel had a larger tunnel widening in patients who undergo ACL reconstruction.

Methods:
PubMed, EMBASE and Cochrane Library were searched for relative studies that evaluated tunnel widening in patients underwent arthroscopic ACL reconstruction. Two reviewers independently recorded data from each study, including the sample size and magnitude of tunnel widening. Random-effects meta-analyses were performed to pool the outcomes of tunnel widening by estimating the standardized mean differences in tunnel widening and their 95% confidence intervals (CIs), Publication bias was assessed using funnel plots and Egger test when the number of included studies was >10.

Results:
Eleven included studies compared tunnel widening between the aperture and the midportion. In these studies, 372 and 92 patients underwent single- and double-bundle ACL reconstructions, respectively. Subgroup analyses in terms of evaluation imaging tool for tunnel widening showed no significant differences in tunnel widening between the aperture and the midportion of the femoral tunnel regardless of plain radiograph (mean difference, 0.02 mm; P = .97), computed tomography (mean difference 0.08 mm; P = .55), and magnetic resonance imaging (mean difference, 0.13 mm; P = .78). Likewise, no significant difference in femoral tunnel widening was found between the aperture and the midportion, irrespective of transtibial (mean difference, 0.18 mm; P = .57), anteromedial (mean difference, 0.02 mm; P = .90), and outside-in techniques (mean difference, 0.01 mm; P = .98).

Conclusion:
No significant difference in femoral tunnel widening was found between the aperture and the midportion in the patients who underwent ACL reconstruction.
Magnetic resonance imaging-guided targeted biopsy in risk classification among patients on active surveillance
Authors: Xue Wenbin , Huang Yu , Li Tao , Tan Ping , Liu Liangren , Yang Lu , Wei Qiang 
Published: June 2019

Abstract

Background:
The aim of this study was to assess the sensitivity and accuracy of magnetic resonance imaging-guided targeted biopsy (MRI-TB) in patients undergoing active surveillance (AS) procedure.

Methods:
We searched databases to identify relevant studies which compared MRI-TB with systemic biopsy for diagnosing prostate cancer in patients on AS. Outcomes included sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), area under the curve (AUC) and publication bias of AS group, confirmatory biopsy group and follow-up biopsy group.

Results:
Fourteen articles involving 1693 patients were included. In AS group, the sensitivity was 0.62 (95% confidence interval [CI], 0.57−0.68), specificity was 0.89 (95% CI, 0.87−0.90), NLR was 0.43 (0.31−0.60), PLR was 4.90 (3.50−6.86), DOR was 12.75 (7.22−22.51), and AUC was 0.8645. In confirmatory biopsy group, the sensitivity was 0.67 (0.59−0.74), specificity was 0.89 (0.86−0.91), NLR was 0.42 (0.27−0.65), PLR was 4.94 (3.88−6.30), DOR was 14.54 (9.60−22.02), and AUC was 0.8812. In follow-up biopsy group, the sensitivity was 0.35 (0.22−0.51), specificity was 0.88 (0.82−0.92), NLR was 0.76 (0.52−1.11), PLR was 3.06 (1.71−5.50), DOR was 4.41 (2.15−9.03), and AUC was 0.8367.

Conclusion:
MRI-TB has a moderate-to-high diagnostic accuracy for diagnosing and reclassifying patients on AS with high specificity and AUC value under the SROC curve.
The effect of neuromuscular reversal agent on postoperative pain after laparoscopic gastric cancer surgery
Authors: Oh Tak Kyu , Ji Eunjeong , Na Hyo-Seok 
Published: June 2019

Abstract
Use of sugammadex for neuromuscular block reversal is associated with fewer postoperative complications than neostigmine; however, the effects on postoperative pain outcomes are largely unknown. In this retrospective study, we investigated the relationship between neuromuscular reversal agents and postoperative pain-related outcomes following laparoscopic gastric cancer surgery.
We reviewed the electronic health records of patients who underwent laparoscopic gastric cancer surgery between January 2010 and June 2017. Patients were divided into a sugammadex group and a neostigmine group, according to the neuromuscular block reversal agent used. We compared the pain outcomes in the first 3 days postoperatively (POD 0–3), length of hospital stay, and postoperative complications (Clavien-Dindo grade ≥II).
During the study period, 3056 patients received sugammadex (n = 901) or neostigmine (n = 2155) for neuromuscular reversal. After propensity score matching, 1478 patients (739 in each group) were included in regression analysis. In linear regression analysis, intravenous morphine equivalent consumption (mg) during POD 0 to 3 was higher in the sugammadex group than in the neostigmine group [coefficient 103.41, 95% confidence interval (CI): 77.45–129.37; P <.001]. However, hospital stay was shorter (coefficient: −0.60, 95% CI −1.12 to −0.08; P = .025) and postoperative complication rate was lower (odds ratio: 0.20, 95% CI 0.07–0.58; P = .003) in the sugammadex group.
In this retrospective study, patients undergoing laparoscopic gastric cancer surgery who received sugammadex for neuromuscular block reversal exhibited greater postoperative analgesic requirements than those who received neostigmine but had a shorter hospital stay and a lower postoperative complication rate. A randomized and blinded study should be conducted in the future to confirm the findings of the present study.
Delayed endoscopic removal of sharp foreign body in the esophagus increased clinical complications
Authors: Yuan Jingjing , Ma Mengjie , Guo Yang , He Bili , Cai Zhenzhai , Ye Bin , Xu Lei , Liu Jiang , Ding Jin , Zheng Zhongfa , Duan Jianhua , Wang Liangjing 
Published: June 2019

Abstract
Foreign bodies impaction in the esophagus is a common clinical emergency. The aim of this study was to investigate the clinical features of foreign body ingestion, and to analyze the risk factors of complications during the endoscopic procedure.
From 18 general hospitals in Zhejiang Province in China, 595 patients who underwent gastroscopic removal of ingested foreign bodies were prospectively recruited. Patient characteristics, clinical features, foreign body features, clinical outcomes, and complications were documented.
The most common types of foreign body in the esophagus were sharp objects (75.9%), including fish bones (34.0%), chicken bones (22.1%), and fruit nuclei (17.1%). The remaining types were non-sharp objects (24.1%), including food bolus (14.6%). Most objects were lodged in the proximal esophagus (75.9%). Foreign body-related complications occurred in 63 patients (10.5%), including hemorrhage (5.0%), perforation and infection (5.5%). The complication rate was increased by 4.04- and 8.48- fold when endoscopic retrieval was performed after impacted for over 24 and 48 hours, respectively, after impaction, as compared with within 12 hours. Logistic regression analysis revealed that the patients with sharp objects developed more complications than those with non-sharp ones (odds ratio, 2.85; 95% confidence interval, 1.08–7.50; P = .034). However, complications were unrelated with the location in the esophagus or length of foreign bodies (P > .05).
Sharp objects were the most frequently ingested foreign bodies in the esophagus in China. The prevalence of complications was increased in the patients with long foreign body retention time (>24 hours) and sharp objects. Sharp foreign bodies in the esophagus are recommended to be removed within 24 hours.
Fecal microbiota transplantation to treat Parkinson's disease with constipation
Authors: Huang Hongli , Xu Haoming , Luo Qingling , He Jie , Li Mengyan , Chen Huiting , Tang Wenjuan , Nie Yuqiang , Zhou Yongjian 
Published: June 2019

Abstract

Rationale:
Fecal microbiota transplantation (FMT) is recognized as an emerging treatment through reconstruction of gut microbiota. Parkinson's disease is a neurodegenerative disorder, which is accompanied by constipation. Here we first reported a patient with Parkinson's disease and constipation that were obviously relieved after FMT.

Patient concerns:
A 71-year-old male patient presented with 7 years of resting tremor, bradykinesia (first inflicted the upper limbs and subsequently spread to lower limbs), and intractable constipation (defecation needing more than 30 minutes).

Diagnoses:
Parkinson's disease for 7 years; constipation >3 years.

Interventions:
The patient had used madopar, pramipexole, and amantadine for anti-Parkinson and showed partially mitigation while laxative therapy for constipation failed. Finally FMT was performed.

Outcomes:
The patient successfully defecated within 5 minutes and maintained daily unobstructed defecation until the end of follow-up. The patient's tremor in legs almost disappeared at 1 week after FMT but recurred in the right lower extremity at 2 months after FMT.

Lessons:
Gut microbiota reconstruction may have therapeutic effects for Parkinson's disease patients, especially those who have gastrointestinal symptoms and limited treatment choices.
Placenta membranacea: an anormaly of the placenta
Authors: Tang Lu , Xu Liangzhi , Hu Ying , Zhang Li , Wei Qiang , Wu Lin 
Published: June 2019

Abstract

Rationale:
The placenta membranacea (PM) is a rare type of placental abnormality, which is associated with placenta previa, antepartum hemorrhage (APH), postpartum hemorrhage (PPH), chorioamnionitis, fetal growth restriction (FGR), preterm birth even stillbirth. The purpose of this case report is to summarize the characteristics and analyze the relevant factors of PM.

Patients concerns:
Repetitive B-ultrasound of the first patient demonstrated a thin placenta covering the most part of uterine wall, which completely covers the internal cervical ostium for 22 weeks. B-ultrasound of the second patient showed placenta partially covering the internal cervical ostium and fetus small for gestation age for 23 days. The third patient complained of abdominal pain and vaginal discharge for 1 day.

Diagnoses:
Diagnosis of PM is based on Doppler ultrasound apparatus, and confirmed by pathology.

Interventions and Outcomes:
In the first patient, elective cesarean section was performed. The second patient required termination of pregnancy due to poor postnatal outcome. The third patient underwent intrauterine fetal death. Of these 3 cases, one delivered a term fetus by cesarean section complicated with placenta previa and placenta accreta, one terminated the pregnancy because of serious fetal growth retardation, and the other underwent intrauterine fetal death.

Lessons:
High-resolution color Doppler ultrasound apparatus can improve the diagnostic accuracy, and close antenatal surveillance followed by proper arrangement of delivery may improve neonatal outcomes.
Investigation of candidate genes of non-syndromic cleft lip with or without cleft palate, using both case–control and family-based association studies
Authors: Ge Xing , Hong Jia-Wei , Shen Jun-Yu , Li Zheng , Zhang Rui , Wang Qi , Ding Zhen , Chen Gang , Xu Li-Chun 
Published: June 2019

Abstract

Objective:
Non-syndromic cleft of the lip and/or palate (NSCL/P) is one of the most common polygenic diseases. In this study, both case–control and family-based association study were used to confirm whether the Single Nucleotide Polymorphisms (SNPs) were associated with NSCL/P.

Methods:
A total of 37 nuclear families and 189 controls were recruited, whose blood DNA was extracted and subjected to genotyping of SNPs of 27 candidate genes by polymerase chain reaction-improved multiple ligase detection reaction technology (PCR-iMLDR). Case–control statistical analysis was performed using the SPSS 19.0. Haplotype Relative Risk (HRR), transmission disequilibrium test (TDT), and Family-Based Association Test (FBAT) were used to test for over-transmission of the target alleles in case-parent trios. The gene–gene interactions on NSCL/P were analyzed by Unphased-3.1.4.

Results:
In case–control statistical analysis, only C14orf49 chr14_95932477 had statistically significant on genotype model (P = .03) and allele model (P = .03). Seven SNPs had statistically significant on TDT. None of 26 alleles has association with NSCL/P on FBAT. Some SNPs had haplotype-haplotype interactions and genotype-genotype interactions.

Conclusion:

C14orf49 chr14_95932477 was significantly different between cases and controls on genotype model and allele model by case–control design. Seven SNPs were significantly different on HRR. Four SNPs were significantly different on TDT.
Health education strategies targeting maternal and child health
Authors: Herval Álex Moreira , Oliveira Danielle Peruzzo Dumont , Gomes Viviane Elisângela , Vargas Andrea Maria Duarte 
Published: June 2019

Abstract

Background:
Health education during pregnancy is important to improve maternal and children outcomes. However, the strategies must be specifically designed for each context and demographic characteristics. Our objective was identify health education strategies targeting pregnant women with the intention of improving results of pregnancy at an urban level.

Methods:
We conducted a scoping review of the literature to answer the question: “what health education strategies targeting pregnant women were reported by primary healthcare teams or the community promoting health in pregnancy, childbirth, postpartum and childhood?” Potential eligible studies were selected using PubMed, Web of Science, LILACS and SciELO by 2 reviewers.

Results:
From a total of 3105 articles, 23 were deemed eligible. We identified 9 educational methodologies focusing on different outcomes of pregnancy, birth or maternal wellbeing.

Conclusions:
It is important that health education strategies continue after childbirth, independent of the strategy. All the strategies presented in this review are suitable for transfer with a moderate chance of success of implementation or improvement of current education methodologies. Further research is required on health education, including a higher number of patients.
The incidence of spondyloarthritis in Slovenia
Authors: Hočevar Alojzija , Potočnik Pucelj Nataša , Ješe Rok , Pavič-Nikolič Milena , Tomšič Matija , Rotar Ziga 
Published: June 2019

Abstract
Epidemiological studies of spondyloarthritides (SpA) are rare and data for our country are lacking. We aimed to determine the incidence of SpA in a well-defined region in Slovenia.
We performed a retrospective chart review of adults diagnosed with SpA between January 2014 and December 2016 at an integrated secondary/tertiary medical center, which provides rheumatology services to almost a half of the adult national population, that is, 700,000 adults. Potential cases were ascertained by searching the electronic medical records for ICD-10 codes M02∗, M07∗, M13∗, M45∗, M 46.1, K50∗, K51∗, and L40∗. SpA cases were stratified as axial and peripheral SpA and then the annual incidence rates of SpA overall and both subsets were estimated.
During the 3-year period we identified 302 SpA cases (55.0% males, median [interquartile range] age 46.7 [35.0–57.5] years). 98 (32.5%) of them had predominantly axial SpA and the remainder peripheral SpA. The estimated annual incidence rate per 100,000 adults in our region was 14.3 (95% confidence interval [CI] 12.8–16.0) for SpA overall, 4.6 (95% CI 3.8–5.6) for axial SpA, and 9.6 (95% CI 8.4–11.1) for peripheral SpA.
The estimated annual incidence rate of 14.3 cases per 100,000 adults in SpA overall was comparable to that of rheumatoid arthritis in our population. The peripheral SpA was twice as common as axial SpA.
Hypothalamic sydrome as an initial presentation of Wernicke encephalopathy
Authors: Zhu Sha , Qiang Jun , Xia Qing , Wang Yanshu , Zhang Jun , Liu Xianzeng 
Published: June 2019

Abstract

Rationale:
Wernicke encephalopathy (WE) is a syndrome characterized by an acute or subacute onset of ataxia, ophthalmoplegia, and mental status changes. To our knowledge, hypothalamic syndrome is rare in WE.

Patient concerns:
A 73-year-old female patient with acute cerebral infarct, who showed initial symptoms of vomiting, nausea, ataxia, and subsequent anorexia, was treated with parenteral nutritional supplement for 20 days. Nevertheless, the patient still developed refractory hyponatremia despite the appropriate sodium supplement given for a week following parenteral nutritional supplement. In fact, after 14 days of parenteral nutritional supplement, the patient gradually showed hypotension and apathy. Hyponatremia, hypotension, anorexia and apathy were signs of hypothalamic syndrome.

Diagnoses:
Finally, the patient was diagnosed as WE by head magnetic resonance imaging, which showed symmetrical lesions in T2-weighted imaging images and FLAIR high signal intensity in the periaqueduct, hypothalamus, thalamus, mammiliary bodies, medulla oblongata, and vermis cerebelli.

Interventions:
The patient was given thiamine supplementation.

Outcomes:
The patient regained consciousness within 3 days. The sings of hyponatremia, hypotension, and apathy were relieved subsequently.

Lessons:
When patients develop unexplained hypothalamic syndrome, we should think of the possibility of WE. The concomitant presence of hyponatremia, hypotension, anorexia, and apathy in WE is rare. Therefore, this case is reported here for discussion.
Net clinical benefit analysis of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation and chronic kidney disease
Authors: Shen Nan-Nan , Zhang Xue-Min , Le Ke-Jia , Wei An-Hua , Wu Yue , Gu Zhi-Chun 
Published: June 2019

Abstract

Background:
Atrial fibrillation (AF) is increasingly prevalent in chronic kidney disease (CKD) patients. The efficacy and safety of non-vitamin K antagonist oral anticoagulants (NOACs) in AF and CKD patients remains unknown. This systematic review and meta-analysis will mainly assess net clinical benefit (NCB) property of NOACs versus warfarin in patients with AF and CKD by a pooled-analysis.

Methods:
We will search Medline, Embase, Cochrane Library, and Clinical Trials.gov Website comprehensively for eligible randomized controlled trials that report the efficacy and safety outcomes according to renal function of NOACs. Relative risks and their 95% confidence intervals will be calculated using fixed- and random-effects models. Subgroup, sensitivity, and regression analyses will be performed to evaluate intertrial heterogeneity and bias of the results. NCB that balance stroke/systemic embolism (SSE) and major bleeding will be calculated using Singer's method.

Results:
This systemic review and meta-analysis will evaluate the NCB of NOACs versus warfarin via SSE, major bleeding and all-cause death in patients with CKD.

Conclusions:
This study will provide new evidence for clinical profile of NOACs on SSE, major bleeding, all-cause death, and NCB in CKD patients.

PROSPERO registration number:
CRD42019116940.
Efficacy of Houttuynia eye drops for the treatment of vernal keratoconjunctivitis
Authors: Yu Lingyan , Chen Xueying , Yu Zhenwei 
Published: June 2019

Abstract

Background:
Vernal keratoconjunctivitis (VKC) is a common eye disease and can result in permanent decrease or loss of vision. Houttuynia eye drops (HED) is used for the treatment of VKC. However, the clinical evidence of HED has not been well concluded. Herein, we described a proposed systemic review and meta-analysis to evaluate the clinical efficacy of HED for the treatment of VKC.

Methods:
Six electronic databases (Medline, Embase, the Cochrane database, Chinese National Knowledge Infrastructure, Wanfang database, and Chinese Biology and Medicine database) will be searched for randomized controlled trials (RCTs) which evaluating the clinical efficacy of HED for the treatment of VKC. Studies meet the eligibility criteria will be included. Data of the included studies will be extracted and the quality will also be evaluated. Data synthesis will be performed using RevMan software. Sensitivity analysis and publication bias will also be investigated.

Results:
This study will provide high-quality systemic review and synthesis of RCTs on efficacy of HED for the treatment of VKC.

Conclusion:
This systemic review and meta-analysis will conclude the efficacy of HED for the treatment of VKC.

Registration:
PROSPERO CRD42019124737
Concomitant pulmonary sarcoidosis and HIV infection
Authors: Yang Yan , Cheng Yusheng , Wang Chenghui 
Published: June 2019

Abstract

Rationale:
Sarcoidosis is an immune-mediated systemic disease, and the increase in CD4+ T lymphocyte cells is considered as a key factor for the development of sarcoidosis. The acquired immune deficiency syndrome (AIDS) is well known as the impaired immune system and characterized by relative lack of CD4+ T lymphocytes. Thus, the coexistence of sarcoidosis and HIV infection has rarely been reported.

Patient concerns:
A 65-year-old female patient was admitted to our respiratory ward complained of fatigue, chest distress, and a persistent dry cough for 2 months.

Diagnoses:
The chest computed tomography scan showed diffuse reticulonodular infiltrates and mediastinal and hilar lymphadenopathy. Fibreoptic bronchoscopy along with transbronchial biopsy and transbronchial needle aspiration was performed. The pathological findings revealed noncaseating granulomas, and the patient was found to be HIV-seropositive through enzyme-linked immunosorbent assay and confirmed as HIV by the centers for disease control and prevention.

Interventions:
The patient was administered oral methylprednisolone 20 mg/day for pulmonary sarcoidosis and then referred to the hospital for infectious diseases receiving subsequent treatment for HIV.

Outcomes:
clinical symptoms relieved 3 months later after treatment.

Lessons:
The coexistence of sarcoidosis and HIV infection is rare because of paradoxical roles of CD4-positive T cells in the pathogenesis of AIDS and sarcoidosis.