bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cardiac tamponade induced by dabrafenib and trametinib combination therapy for melanoma
Authors: Sundaram Vinita Ruth , Abbas Tahir 
Published: October 2018

Abstract

Rationale:
BRAF and MEK inhibitors (BRAF/MEKi) are targeted therapy for proto-oncogene BRAF mutated metastatic unresectable melanoma. Compared to monotherapy, an increased cardiovascular toxicity is reported with the combination of Dabrafenib and Trametinib. This case report documents Grade 4 cardiac treatment emergent adverse effect of pericardial effusion and cardiac tamponade induced by this combination therapy.

Patient concerns:
A 52 year old man presented with clinical stage II unresectable melanoma with BRAF V600E mutation, was initiated on treatement with Dabrafenib and Trametinib. He complained of generalised edema and increased his weight by 27 kg. This progressed to shortness of breath and he underwent echocardiogram which revealed cardiac tamponade.

Diagnoses:
Emergent pericardiocentesis was performed. No definited pathology was demonstrated in laboratory analysis of pericardial fluid. Re- initiating treatment resulted in cardiac tamponade and pericardiotomy was performed by video-assisted thoracic surgical (VATS). Pericardial biopsy revealed nonspecific chronic inflammation.

Interventions:
Discontinuation of treatment with Dabrafenib and Trametinib and diuretics resolved peripheral edema. Cardiac function normalized after pericardiocentesis and pericardiotomy.

Outcomes:
Treatment with Dabrafenib and Trametinib caused significant peripheral edema and pericardial effusion resulting in cardiac tamponade. Naranjo score suggests probable association of treatment induced pericardial effusion and cardiac tamponade.

Lessons:
This is the first documented report of pericardial effusion and cardiac tamponade induced by Dabrafenib and Trametinib. Cardiac toxicity of BRAF/MEK inhibitors is rare but clinicans must monitor for treatment emergent adverse effects.
A new perspective on perioperative coagulation management in a patient with congenital factor VII deficiency
Authors: Sun Yongliang , Jia Lingling , Yang Zhiying , Chen Wenqian 
Published: October 2018

AbstractRationale:Congenital factor VII (FVII) deficiency is a rare coagulopathy. There are little clinical data for congenital FVII deficiency and no evidence-based medicine guidelines for treatment.Patient concerns:A 48-year-old woman with gallbladder stones suffered from intermittent abdominal pain for 2 months that was accompanied by an abnormally prolonged prothrombin time.Diagnoses:The woman was diagnosed as having cholecystolithiasis with cholecystitis and congenital FVII deficiency.Intervention:Preoperative evaluation confirmed the necessity of recombinant activated factor VII (rFVIIa) replacement therapy. We monitored the plasma factor VII activity (FVII:C) and coagulation function, determined the half-life of rFVIIa in the patient, and administered personalized rFVIIa replacement therapy.Outcomes:Laparoscopic cholecystectomy was performed successfully, and the patient recovered well without any complications.Lessons:The clinical manifestations and severity of bleeding in patients with congenital FVII deficiency can vary widely. The history of massive bleeding and plasma FVII:C are the decisive factors when implementing a replacement therapy. The actual half-life of rFVIIa can be determined from intensive monitoring results of plasma FVII:C at the beginning of replacement therapy, which could further guide the personalization of rFVIIa replacement therapy.
The association between BMI and kidney cancer risk
Authors: Liu Xuezhen , Sun Qi , Hou Haifeng , Zhu Kai , Wang Qian , Liu Huamin , Zhang Qianqian , Ji Long , Li Dong 
Published: October 2018

Abstract

Objective:
Obesity is considered as one of the risk factors of kidney cancer. However, the results are not consistent in reported original studies, as well as in published meta-analysis. This study aims to clarify the relationship between overweight/obesity and kidney cancer by an updated overall and dose-response meta-analysis.

Methods:
This meta-analysis was conducted in accordance with PRISMA guideline. Relevant studies were searched using PubMed, Embase, and Web of Science databases. The studies were limited to human cohort studies in English and Chinese language. Random-effect models and dose-response meta-analysis were used to synthesize the results. Subgroup analyses were also conducted based on the characteristics of participants.

Results:
Twenty-four cohort studies with 8,953,478 participants were included in our meta-analysis. Compared to the normal weight, the pooled RRs of kidney cancer was 1.35 (1.27–1.43) in overweight and 1.76 (1.61–1.91) in obese participants. An increased kidney cancer risk of 1.06 (1.05–1.06) for each 1 kg/m2 increase in BMI was showed in dose-response meta-analysis. No significant heterogeneity was found across studies with I
2 = 39.4% for overweight, and I
2 = 43.3% for obesity.

Conclusion:
The overall and dose-response meta-analysis suggested that overweight/obesity increases the risk of kidney cancer both in men and women.
Compound heterozygous mutations in the TH gene in a Chinese family with autosomal-recessive dopa-responsive dystonia
Authors: Feng Bangzhe , Sun Guangfei , Kong Qingxia , Li Qiubo 
Published: October 2018

Abstract

Rationale:
Autosomal-recessive dopa-responsive dystonia (DRD) is a rare clinical disorder presenting as bradykinesia, dystonia, tremor and even severe encephalopathy, and caused by tyrosine hydroxylase deficiency (THD). We report a case of compound heterozygous mutations in the TH gene in a Chinese family with autosomal-recessive DRD herein.

Patient concerns:
A 16-month-old Chinese boy presented with symptoms of movement disorder and growth retardation in his infant period.

Diagnoses:
The genetic test revealed compound heterozygous mutations in the TH gene at c.457C>T and c.698G>A, which are pathogenic of DRD.

Interventions:
The patient was administrated low-dose levodopa.

Outcomes:
The treatment resulted in the substantial improvement of dystonia. His long-term neurological outcome need follow-up for years.

Lessons:
Gene mutation analysis is helpful and necessary to diagnose DRD and has important guiding significance for the subsequent treatment.
Primary Philadelphia chromosome positive acute myeloid leukemia
Authors: Shao Xiaoyan , Chen Dangui , Xu Peipei , Peng Miaoxin , Guan Chaoyang , Xie Pinhao , Yuan Cuiying , Chen Bing 
Published: October 2018

Abstract

Rationale:
Philadelphia chromosome positive acute myeloid leukemia (Ph+ AML) is a rare subtype of AML that is now included as a provisional entity in the 2016 revised WHO classification of myeloid malignancies. However, a clear distinction between de novo Ph+ AML and chronic myeloid leukemia blast crisis is challenging. It is still a matter of debate whether Ph+ AML patients should be treated with chemotherapy or tyrosine kinase inhibitors as first-line therapy.

Patient concerns:
We reported here a case of a 46-year-old man who was diagnosed as Ph+ AML. This diagnosis was confirmed by bone marrow pathology and karyotype analysis of 46, XY, t (9; 22). Further examination, molecular genetic analysis showed BCR/ABL1 (p190) without ABL1 kinase domain mutations, and direct evidence demonstrated in AML by flow cytometry.

Diagnosis:
The diagnosis of Ph+ AML was made on May 2016 according to morphology, immunology, cytogenetic, and molecular criteria, and multiple organ failure was also diagnosed.

Interventions:
The patient was treated with dasatinib as the only medication after experiencing multiple organ failure. Then, he received 2 cycles of chemotherapy with IA (idarubicin 8 mg/m2, day 1–3; cytarabine 100 mg/m2, day 1–7) in August, 2016.

Outcomes:
The patient finally achieved a complete molecular remission.

Lessons:
This case study suggests that dasatinib can be a safe and effective treatment for Ph+ AML patients with poor physical condition.
Value of electrocardiographic left ventricular hypertrophy as a predictor of poor blood pressure control
Authors: Wang Zhenzhen , Zhang Chunyan , Bao Huihui , Huang Xiao , Fan Fangfang , Zhao Yan , Li Juxiang , Chen Jing , Hong Kui , Li Ping , Wu Yanqing , Wu Qinghua , Wang Binyan , Xu Xiping , Li Yigang , Huo Yong , Cheng Xiaoshu 
Published: October 2018

Abstract
Recent studies have shown that hypertension is poorly controlled in many populations worldwide. Electrocardiographic left ventricular hypertrophy is a common manifestation of preclinical cardiovascular disease that strongly predicts cardiovascular disease morbidity and mortality. However, little information is available regarding the role of left ventricular hypertrophy in blood pressure (BP) control. We aimed to assess the relationship between electrocardiographic left ventricular hypertrophy and BP control in the China Stroke Primary Prevention Trial. The study population included 17,312 hypertensive patients who were selected from a group of 20,702 adults who had participated in the China Stroke Primary Prevention Trial and had undergone electrocardiography at baseline visit. Multivariate analysis identified left ventricular hypertrophy as a predictor of unsatisfactory BP control. The results revealed that 8.1% of hypertensive adults exhibit left ventricular hypertrophy and that the disease is more prevalent in males (12.8%) than in females. Multivariate regression analysis showed that the electrocardiographic left ventricular hypertrophy group had a significantly higher rate of unsatisfactory BP control [odds ratio (OR) 1.42, 95% confidence interval (95% CI) 1.26–1.61, P < .001) than the nonleft ventricular hypertrophy group.
Notable differences in BP control were also observed among males (OR 1.37, 95% CI 1.17–1.60, P < .001) and females (OR 1.45, 95% CI 1.18–1.77, P < .001) and especially among patients with comorbid diabetes (OR 2.32, 95% CI 1.31–4.12, P = .004). In conclusion, the results of this study indicate that electrocardiographic left ventricular hypertrophy appears to be an independent predictive factor for poor BP control, especially in females and patients with comorbid diabetes.
Effect of optimized collagenase digestion on isolated and cultured nucleus pulposus cells in degenerated intervertebral discs
Authors: Feng Xu , Liu Li , Yu Bao-Qing , Huang Jian-Ming , Gu Long-Dian , Xu Da-Feng 
Published: October 2018

Abstract
This study aims to explore the optimized digestive method of collagenase to nucleus pulposus (NP) cells by observing the digestive effects of type I and II collagenase in different concentrations to NP in degenerated intervetebral discs.
NP were collected from 18 human herniated intervertebral disc samples, and digested by type I and II collagenase, which were separated or combined in different concentrations. NP cells were counted using an inverted microscope, and the activities were determined by trypan blue staining at 4, 8, 16, and 24 hours after digestion. The growth of NP cells was also observed.
The amount of NP cells with combined collagenases was greater than that separated in an identical concentration. With the combined collagenases at 4 and 8 hours, the higher concentration, the greater the amount of NP cells became. The amount of cells in extremely low concentrations of collagenase increased after 16 and 24 hours, and its activities remained at a higher level.
The optimized digestion of extremely low concentrations of type I and II collagenase combined could save enzymes, was less harmful to NP cells, and was more adapted to separated and cultured NP cells.
Spontaneous resolution of isolated neurogenic blepharoptosis after blunt trauma
Authors: Kim Tae Gi , Shin Jae Ho 
Published: October 2018

Abstract

Rationale:
Complete isolated neurogenic blepharoptosis caused by blunt trauma is a sporadically reported rare entity and there is no consensus regarding the optimal treatment. We would like to report a rare case of isolated neurogenic blepharoptosis secondary to eyelid trauma with spontaneous recovery occurring within 4 weeks.

Patient concerns:
A previously healthy 47-year-old man presented with blepharoptosis in the right eye after eyelid trauma.

Diagnosis:
At presentation, visual acuity in both eyes was 20/20, and intraocular pressure was within the normal limits. Physical examination showed unilateral ptosis; magnetic resonance imaging (MRI) showed hematoma in the right frontal sinus. No intracranial lesions were observed and the pupillary reactions were normal. The remainder of the examination was unremarkable with full ocular motility. He was diagnosed with an isolated neurogenic blepharoptosis.

Intervention and outcomes:
He was managed conservatively without any specific treatment. Four weeks later, the patient had normal, symmetric lid height, and levator function was completely restored.

Lessons:
Isolated neurogenic blepharoptosis can be caused by blunt trauma, which might cause injury to the terminal branch of the oculomotor nerve. In this case, no special treatment was required, and complete resolution was achieved within 4 weeks.
Application of ultrasonography in monitoring the complications of autologous arteriovenous fistula in hemodialysis patients
Authors: Ren Chong , Chen Jing , Wang Yong , Huang Bihong , Lu Wenwen , Cao Yanpei , Yang Xiaoli 
Published: October 2018

Abstract
This study aims to evaluate the application of color Doppler ultrasound in monitoring the complications of autologous arteriovenous fistula in hemodialysis patients.
Patients with maintenance hemodialysis who underwent autologous arteriovenous fistula were enrolled in this cross-sectional study. Ultrasound was used to detect fistula complications (stenosis and thrombosis), brachial artery diameter, and hemodynamic parameters. The ultrasound parameters were analyzed and screened to identify the most important indicator for monitoring complications.
In all, 89 patients were included. Ultrasound showed 72 cases (80.90%) had normal fistula structure, and 17 cases (19.10%) had complications. The diameter, time-averaged mean velocity, flow volume, and diastolic peak velocity of brachial artery in complication group were significantly lower than those of noncomplication group (P < .05). The brachial artery pulsatility index and resistance index of complication group were significantly higher than those of noncomplication group (P < .05). There was no significant difference in peak flow velocity between complication and noncomplication group (P > .05). Indicators showed statistical significance were grouped based on quantiles. The incidence of complications was higher when the brachial artery diameter was ≤5.40 mm, or brachial artery flow was ≤460 mL/ min, or brachial artery pulsatility index was >1.04, or brachial artery resistance index was >0.60.
Ultrasound monitoring of brachial artery diameter and hemodynamic parameters can help early detection of fistula complications. When the brachial artery diameter was ≤5.40 mm, or brachial artery flow was ≤460 mL/min, or brachial artery pulsatility index was >1.04, or brachial artery resistance index >0.60, stenosis or thrombosis should be checked to prevent fistula failure.
Prevention of depression in first-year university students with high harm avoidance
Authors: Saigo Tatsuo , Hayashida Masaki , Tayama Jun , Ogawa Sayaka , Bernick Peter , Takeoka Atsushi , Shirabe Susumu 
Published: October 2018

Abstract
High harm avoidance (HA) scores on the temperament and character inventory appear to be a risk factor for depressive disorders and suicide. Since 2012, we have conducted group cognitive behavioral therapy (G-CBT) interventions for students at Nagasaki University with high HA and without depressive disorders, with the aim of preventing depression. Here, we report on the effects of the G-CBT at 1-year follow-up for the 2012 to 2015 period.
Forty-two participants with high HA were included in the final analysis. Outcomes were measured with the Beck Depression Inventory II, Manifest Anxiety Scale, 28-item General Health Questionnaire, and Brief Core Schema Scales at baseline, and at 6-month, and 1-year follow-ups.
Repeated-measures analyses of variance revealed a significant decrease in mean depressive symptom scores at the 6-month follow-up point; this decrease was maintained at 1 year. Improvements in cognitive schemas were also seen at 6 months and 1 year.
We observed improvements in cognitive schemas associated with depression as a result of the G-CBT intervention, with effects maintained at 1 year post-intervention. This intervention may be effective in positively modifying the cognitions of students with HA and preventing future depression.
Concurrent versus sequential whole brain radiotherapy and TKI in EGFR-mutated NSCLC patients with brain metastasis
Authors: Chen Hualin , Wu Aibing , Tao Hua , Yang Donghong , Luo Yiping , Li Shujun , Yang Zhixiong , Chen Ming 
Published: October 2018

Abstract
To examine the outcomes of concurrent versus sequential whole-brain radiotherapy (WBRT) and epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) in nonsmall cell lung cancer (NSCLC) patients with EGFR mutation.
Retrospectively 105 patients with NSCLC, brain metastasis, and EGFR mutation (Affiliated Hospital of Guangdong Medical University, 01/2011 to 12/2014) were grouped as: EGFR-TKIs alone (n = 39, group A), EGFR-TKIs + concurrent radiotherapy (n = 34, group B), and radiotherapy followed by EGFR-TKIs (n = 32, group C).
The intracranial objective response rates of groups A, B, and C were 66.7%, 85.3%, and 75%, respectively (P < .05). The median intracranial progression-free survival of groups A, B, and C were 6.8, 12.4, and 9.1 months, respectively (P < .05). The median extracranial progression-free survival of groups A, B, and C were 7.8, 9.4, and 8.3 months, respectively (P > .05).
EGFR-TKIs and WBRT by simultaneous application improved the short- and long-term benefits to patients with NSCLC brain metastasis carrying EGFR mutation compared to concurrent application or EGFR-TKIs alone without additional adverse events.
Association between the HLA-DQA1 rs2187668 polymorphism and risk of idiopathic membranous nephropathy
Authors: Bao Liping , Li Jushuang , Hu Shuang , Wu Xiaoyan 
Published: October 2018

Abstract

Objective:
Numerous studies have evaluated the association between the rs2187668 polymorphism in the human leucocyte antigen (HLA) complex class II HLA-DQ a-chain 1 (HLA-DQA1) gene and idiopathic membranous nephropathy (iMN) risk, which provided new insight into potential new targets for the treatment of iMN. However, this relationship remains inconclusive. Our aim was to evaluate the relationship between this polymorphism and iMN susceptibility by performing a meta-analysis.

Methods:
Articles were identified in the PubMed, Google Scholar, EMBASE, Cochran Library databases. Meta-analyses were performed for rs2187668 allele frequency, genotypes, and the association with iMN susceptibility. Subgroup analyses, publication bias and sensitivity analyses were also conducted.

Results:
11 eligible studies (3209 cases and 7358 controls) from 7 articles were included. Statistical analyses were carried out using Stata 12.0, combining data from all the relevant studies. The pooled odds ratios (ORs) regarding the association between the HLA-DQA1 rs2187668 polymorphism and iMN risk were statistically significant [A vs G: OR = 3.34, 95% confidence interval (CI) = 2.70–4.13; AA vs GA + GG: OR = 8.69, 95% CI = 6.64–11.36; GG vs GA + AA: OR = 0.25, 95% CI = 0.19–0.33;AA vs GG: OR = 12.61, 95% CI = 8.02–19.81; GA vs GG: OR = 3.45, 95% CI = 2.79–4.25].

Conclusions:
Our pooled analysis showed a significant association between rs2187668—(A) allele and iMN susceptibility, and the intervention of this mutation might bring new therapeutic strategy for iMN. However, further studies should be performed to confirm this finding.
A case report of recurrent Merkel cell carcinoma with synchronous metastases to the heart and stomach
Authors: Ha Joo Young , Park Song Ee , Kim Hee Sung , Won Hoyoun , Kim Beom Jin , Hwang In Gyu 
Published: October 2018

Abstract

Rationale:
Merkel cell carcinoma (MCC) is an aggressive, rare neuroendocrine skin cancer. MCC metastasis to the heart is exceedingly rare and gastric metastases from MCC have rarely been reported.

Patient concerns:
We described the case of an 82-year-old man diagnosed with recurrent MCC with cardiac and gastric metastasis who presented with poor oral intake and severe weight loss. The patient was diagnosed with MCC 3 years ago and treated with surgical resection and radiation.

Interventions:
We performed stomach biopsy in edematous lesion. And fluoroscopy and ultrasound guided biopsy of the cardiac mass was performed.

Diagnoses:
MCC with synchronous metastases to the heart and stomach.

Outcomes:
The primary lesion had complete resolution and the patient remained disease free on regular follow-up every 6 months for 2 and half years. After MCC recurred, palliative anti-cancer therapy was considered but could not be performed due to the patient's poor performance status involved elderly, combined recurrent pneumonia.

Lessons:
To our best knowledge, this is the first report of synchronous cardiac and gastric metastasis from cutaneous MCC worldwide. Although uncommon, MCC should be considered in clinical cases of synchronous metastasis.
Autopsy diagnosis of acupuncture-induced bilateral tension pneumothorax using whole-body postmortem computed tomography
Authors: Jian Junqi , Shao Yu , Wan Lei , Zhang Min , Liu Ningguo , Zhang Jianhua , Chen Yijiu 
Published: October 2018

Abstract

Rationale:
Acupuncture, a component of traditional Chinese medicine, is also a well-known form of complementary and alternative medicine. Serious adverse events of acupuncture have been reported, including the acupuncture-related pneumothorax which is a rare but fatal condition sometimes. The pneumothorax was related to needle insertion in the upper back or paraspinal area and the reported victims suffered from either unilateral or bilateral pneumothorax. Postmortem computed tomography has advantages in the detection of pathologic gas and is being considered as a useful visualization tool for diagnosing the cause of death.

Patient concerns:
A 52-year-old man underwent acupuncture and cupping treatment at an illegal Chinese medicine clinic for neck and back discomfort and was admitted to the hospital with severe gasp and dyspnea about 30 hours later. The patient suddenly became unconscious with heart rate and blood pressure lost and died after cardiopulmonary resuscitation. Diagnosis, interventions and outcomes: Whole-body postmortem computed tomography of the victim revealed collapse of the both lungs and mediastinal compression, which was also confirmed by autopsy. More than 20 pinprick injuries were found on the skin of the upper and lower back in which multiple pinpricks were located on the body surface projection of the lungs. The cause of death was concluded as acute respiratory and circulatory failure due to acupuncture-induced bilateral tension pneumothorax.

Lessons:
Acupuncture-induced tension pneumothorax is rare and should be recognized by forensic pathologists. Postmortem computed tomography can be used to detect and accurately evaluate the severity of pneumothorax before autopsy and can play a supporting role in determining the cause of death.