bluuebunny/crossref_metadata_2025_split huggingface dataset:
In-hospital, short-term and long-term adverse clinical outcomes observed in patients with type 2 diabetes mellitus vs non-diabetes mellitus following percutaneous coronary intervention
Authors: Zhuo Xiaojun , Zhang Chuanzeng , Feng Juan , Ouyang Shenyu , Niu Pei , Dai Zhaohui 
Published: February 2019

Abstract

Background:
Several studies have shown that patients with type 2 diabetes mellitus (T2DM) have worse clinical outcomes in comparison to patients without diabetes mellitus (DM) following Percutaneous Coronary Intervention (PCI). However, the adverse clinical outcomes were not similarly reported in all the studies. Therefore, in order to standardize this issue, a meta-analysis including 139,774 patients was carried out to compare the in-hospital, short-term (<1 year) and long-term (≥1 year) adverse clinical outcomes in patients with and without T2DM following PCI.

Methods:
Electronic databases including MEDLINE, EMBASE, and the Cochrane Library were searched for Randomized Controlled Trials (RCTs) and observational studies. The adverse clinical outcomes which were analyzed included mortality, myocardial infarction (MI), major adverse cardiac events (MACEs), stroke, bleeding, target vessel revascularization (TVR), target lesion revascularization (TLR), and stent thrombosis. Risk Ratios (RR) with 95% confidence intervals (CI) were used to express the pooled effect on discontinuous variables and the analysis was carried out by RevMan 5.3 software.

Results:
A total number of 139,774 participants were assessed. Results of this analysis showed that in-hospital mortality and MACEs were significantly higher in patients with T2DM (RR 2.57; 95% CI: 1.95–3.38; P = .00001) and (RR: 1.38; 95% CI: 1.10–1.73; P = .005) respectively. In addition, majority of the short and long-term adverse clinical outcomes were also significantly higher in the DM group as compared to the non-DM group. Stent thrombosis was significantly higher in the DM compared to the non-DM group during the short term follow-up period (RR 1.59; 95% CI: 1.16–2.18;P = .004). However, long-term stent thrombosis was similarly manifested.

Conclusion:
According to this meta-analysis including a total number of 139,774 patients, following PCI, those patients with T2DM suffered more in-hospital, short as well as long-term adverse outcomes as reported by most of the Randomized Controlled Trials and Observational studies, compared to those patients without diabetes mellitus.
Characteristics of the modern-day physician house call
Authors: Fortin Ensign Shannon , Baca-Motes Katie , Steinhubl Steven R. , Topol Eric J. 
Published: February 2019

Abstract
Many barriers to primary healthcare accessibility in the United States exist including an increased opportunity cost associated with seeking primary care. New models of healthcare delivery aimed at addressing these problems are emerging. The potential impact that on-demand primary care physician house calls services can have on healthcare accessibility, patient care, and satisfaction by both patients and physicians is poorly characterized.
We performed a retrospective observational analysis on data from 13,849 patients who utilized Heal, Inc, an application (app)-based, on-demand house calls platform between August 2016 and July 2017. We assessed house call wait time and visit duration, diagnoses by International Classification of Diseases, tenth revision, Inc (ICD10) codes, and house call outcomes by post-visit prescription and lab requests, and patient satisfaction survey.
Patients who utilized this physician house call service had a bimodal age distribution peaking at age 1 year and 36 years. Same day acute sick exams (93.9% of pediatric (Ped) and 66.9% of adult requests) for fever and/or acute upper respiratory infection represented the most common use. The mean wait time for as soon as possible house calls were 96.1 minutes, with an overall mean house call duration of 27.1 minutes. A house call was primarily chosen over an Urgent Care Clinic or Doctor's office (46.2% and 41.6% of respondents, respectively), due to convenience or fastest appointment available (69.6% and 33.8% of respondents, respectively). Most survey respondents (94.2%) would schedule house calls again.
On-demand physician house calls programs can expand access options to primary healthcare, primarily used by younger individuals with acute illness and preference for a smartphone app-based home visit.
A retrospective observational study of early experiences of vedolizumab treatment for inflammatory bowel disease in the UK
Authors: Cummings Fraser , Gaya Daniel R. , Levison Scott , Subramanian Sreedhar , Owen Glynn , Rathmell Anna , Glen Fiona , Demuth Dirk , Meadowcroft Simon , Irving Peter M. 
Published: February 2019

Abstract
Results from clinical trials show that vedolizumab is an efficacious treatment for inflammatory bowel disease, namely Crohn's disease (CD) and ulcerative colitis (UC). However, there is limited evidence from real-world clinical practice, especially on early clinical experiences in the UK.
To describe real-world early experiences of vedolizumab to treat CD and UC in the UK.
A retrospective, chart review study of patients with CD or UC treated with vedolizumab across 5 UK hospitals. All eligible adults (≥18 years at initiation) with a diagnosis of CD and ≥14 weeks of data or UC and ≥10 weeks of data available following vedolizumab initiation were included.
Data were analyzed for 112 patients (CD: 66; UC: 46). Patients with CD had a median of 7.4 (interquartile range 5.7–9.4) months follow-up and patients with UC had a median of 7.4 (5.6–10.2) months follow-up post-vedolizumab initiation. Most patients, 80% (53/66) with CD and 89% (41/46) with UC, remained on vedolizumab treatment at the time of data collection. No new safety signals were identified during the study.
These results add to the body of evidence supporting vedolizumab as an effective and well-tolerated treatment for CD and UC in real-world clinical practice.
Responses of lung cancer survivors undergoing gamma knife surgery to supportive group psychotherapy
Authors: Peng Wanxiu , Zhang Hui , Li Zhongguo 
Published: February 2019

Abstract
An increasingly important concern for clinicians who care for patients with cancers is their psychological problems and quality of life. The present study examined the efficacy of supportive group psychotherapy (SGP) on anxiety, depression and overall quality of life in patients with lung cancer undergoing gamma knife surgery (GKS).
160 patients with lung cancer undergoing GKS were randomly divided into SGP group (n = 82) and care as usual (CAU) group (n = 78). Patients in SGP group received 90 minutes’ group psychotherapy intervention once a week for 8 weeks, while patients in CAU group received usual care. Outcome measures were administered before and after the intervention and at 3-months follow-up. The primary outcome measures were the 14-item Hospital Anxiety and Depression Scale (HADS) and the secondary outcome measures were the 30-item European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30).
Demographic characteristics between SGP and CAU groups showed no difference in sex, age, course of disease, years of education, marital status and profession. Psychological characteristics evaluated by HADS revealed that levels of both depression and anxiety in SGP group were significantly improved compared with that in CAU group at the end of the treatment and the improvement remained at the 3-months follow-up. In addition, EORTC QLQ-C30 demonstrated that functional scales including emotion, cognition and society in SGP group were significantly higher than that in CAU group at the end of the treatment and maintained till 3-months follow-up. EORTC QLQ-C30 also showed that symptom scales including fatigue, nausea/vomiting, pain, syspnea, insomnia, loss of appetite and financial problems in the former group were significantly lower than that in the latter group and maintained till 3-months follow-up. Furthermore, compared with that in SGP group before treatment, these variables in both HADS and EORTC QLQ-C30 showed obvious improvement in the same group after treatment and at the 3-months follow-up.
The results suggested that SGP can alleviate anxiety and depression in patients with lung cancer following GKS and improve the overall quality of life.
Early characteristics of fulminant myocarditis vs non-fulminant myocarditis
Authors: Wang Zicheng , Wang Yanwei , Lin Haiyan , Wang Shengjie , Cai Xianlei , Gao Da 
Published: February 2019

Abstract

Background:
Fulminant myocarditis (FM) is a sub-category myocarditis. Its primary characteristic is a rapidly progressive clinical course that necessitates hemodynamic support. FM can be difficult to predict at the onset of myocarditis. The aim of this meta-analysis was to identify the early characteristics in FM compared to those of non-fulminant myocarditis (NFM).

Methods:
We searched the databases of MEDLINE, EMBASE, CENTRAL, for studies comparing FM with acute NFM from January 1, 2000 to June 1, 2018. The baseline variables were compared in each study. Mean differences (MD) and relative ratios (RR) were calculated.

Results:
Seven studies (158 FM patients and 388 NFM patients) were included in the analysis. The FM group had significantly lower systolic blood pressure (SBP), higher creatine kinase (CK), wider QRS duration, lower left ventricular ejection fraction (LVEF), thicker left ventricular posterior wall diameter (LVPWd), higher incidence of ST depression, ventricular tachycardia/ventricular fibrillation (Vt/Vf) and syncope, less incidence of chest pain than the NFM groups. There was no difference in terms of heart rate (HR), c-reactive protein (CRP), fever, dyspnea, white blood cells (WBC), atrioventricular block (AVB), Q waves, ST elevation, interventricular septum diameter (IVSd), or end-diastolic left ventricular diameter (LVEDd) between FM and NFM.

Conclusion:
We found that the lower SBP, higher CK, wider QRS duration, lower LVEF, thicker LVPWd, higher incidence of ST depression, Vt/Vf and syncope as well as lower incidence of chest pain were early characteristics of FM.
Effectiveness and safety of Xuefu Zhuyu decoction for treating coronary heart disease angina
Authors: Yang Tao , Li Xiao , Lu Ziwen , Han Xiaowan , Zhao Mingjing 
Published: February 2019

Abstract

Background:
Coronary heart disease angina is a very common cardiovascular disease, which not only causes personal health problems, but also a serious burden on the social economy. Xuefu Zhuyu Decoction (XFZYD) has been widely adapted to clinical practice for people with coronary heart disease angina. At present, it is necessary to update the existing research, re-evaluate the effectiveness and safety of XFZYD, and provide the latest evidence for coronary heart disease angina.

Methods and analysis:
The purpose of this study was to search the electronic database for XFZYD in the treatment of coronary heart disease angina. The database includes PubMed, EMBASE, Cochrane Library, Chinese National Knowledge Infrastructure database (CNKI), Wanfang database, Chinese Biomedical Literature database (CBM), Chinese Scientific Journal database (VIP). In addition, ongoing trials will be retrieved from the WHO ICTRP Search Portal, the Chinese Clinical Trial Register and The Clinical Trials Register. We will assess all the documents from the database establishment to January 31, 2019. The RevMan V.5.3 software will be used to calculate the data synthesis and perform a meta-analysis when the literature is appropriate.

Results:
The study will provide a high-quality synthesis of current evidence of XFZYD for coronary heart disease angina from the various comprehensive assessment, including Significantly effective, Effective, Invalid, Aggravation, which based on the “Guidelines for Clinical Research of New Chinese Medicine”. Adverse events are also included.

Conclusion:
The systematic review will provide evidence for assessing the effectiveness and safety of XFZYD in the treatment of coronary heart disease angina.

PROSPERO registration number:
PROSPERO CRD42019122003.
Circulating uPA as a potential prognostic biomarker for resectable esophageal squamous cell carcinoma
Authors: He Xiao , Xu Xiaoling , Zhu Guanxia , Ye Hong 
Published: February 2019

Abstract
Previous research showed that the 4 genes of matrix metallopeptidase 9 (MMP9), cyto-keratin 20 (CK20), cyto-keratin 19 (CK19) and urokinase type plasminogen activator (uPA) are detectable in the peripheral blood. All the 4 genes are related to tumor invasion and metastasis. However, whether their expression is associated with clinicopathologic factors and the prognosis of patients with esophageal squamous cell carcinoma (ESCC) is still confused. Expression levels of MMP9, CK20, CK19, and uPA were evaluated by quantificational real-time polymerase chain reaction (qRT-PCR) in peripheral blood of 205 ESCC patients who received radical resection. The cut-off value was 1000 copy numbers. Their impacts on clinicopathologic factors and survival were investigated. The uPA expression positively correlated with gender (P
= .046) and tumor size (P = .046). Meanwhile, CK19 expression positively correlated with tumor size (P = .029), vascular invasion (P = .024), and CK20 expression positively correlated with tumor size (P = .035) and degrees of differentiation (P = .032). Moreover, the overexpression of MMP9 has a correlation with postoperative radiotherapy (P = .041) and chemotherapy (P = .012). Among the 4 genes, only uPA is a prognostic indicator for disease-free survival and overall survival both in univariate analysis and multivariate analysis (P = .015). This study suggests that circulating uPA mRNA in peripheral blood can serve as a potential unfavorable prognosis biomarker in ESCC. Further perspective, multi-center and large-scale study is still needed.
The effects of aromatherapy massage on improvement of anxiety among patients receiving palliative care
Authors: Hsu Chia-Hsien , Chi Ching-Chi , Chen Pei-Shih , Wang Shu-Hui , Tung Tao-Hsin , Wu Shih-Chung 
Published: February 2019

Abstract

Background:
Anxiety in patients receiving palliative care is a noteworthy concern because it may affect their quality of life. Aromatherapy has been widely utilized to improve anxiety among patients receiving palliative care.

Objective:
To investigate the effectiveness of anxiety improvement in patients receiving palliative care by comparing the intervention group (aromatherapy massage) with the control group (common massage alone).

Methods:
A literature search was performed using PubMed, Cochrane Library, Embase, MEDLINE, and CINAHL for all related studies from inception through November 30, 2018 without restriction on language. A quantitative synthesis of randomized controlled trials (RCTs) was conducted to compare the difference in effectiveness scores between the aromatherapy massage and only common massage groups by employing a random-effect model.

Results:
We included three RCTs with a total of 160 participants (81 in the intervention group and 79 in the control group) in our systematic review and conducted a quantitative synthesis. The secondary data from the reviewed trials were then pooled using a random-effect model. Anxiety (mean difference = −2.60 [95% confidence interval: −7.82, 2.63], P = .33) was assessed using anxiety scores from the State-Trait Anxiety Inventory.

Conclusion:
Compared with common massage alone, aromatherapy massage does not provide significant effectiveness of anxiety improvement among patients receiving palliative care.
Spontaneous reduction of an incarcerated gravid uterus after myomectomy in the second trimester
Authors: Tong Chun , Wang Yan , Liu Zhaohui , Zhao Yangyu , Xu Yan , Wang Wei 
Published: February 2019

Abstract

Rationale:
During a normal pregnancy, in the 1st trimester uterus lies in pelvis and enlarges in size as the pregnancy advances. By 14 weeks of gestation, the gravid uterus transforms from a pelvis to an abdominal organ and a retroverted uterus will correct as the fundus rises out of the pelvis and falls forward to its normal anatomical position. If the uterus remains in the pelvic cavity after 14 weeks of gestation, it is referred to as an incarcerated uterus.

Patient concerns:
A 31-year-old gravida 3 para 0 woman was admitted to our obstetrics unit at 20 weeks’ gestation with the complaint of severe persistent upper abdominal pain for over 12 hours.

Diagnosis and interventions:
A diagnosis of fibroid degeneration was made through ultrasound and magnetic resonance imaging. The patient was hospitalized with conservative treatment. An abdominal myomectomy was performed at 22 weeks’ gestation because her condition had deteriorated. Incarcerated uterus was not suspected even at the time of myomectomy. But within 24 hours after myomectomy, diagnosis of incarcerated gravid uterus was made by ultrasound.

Outcomes:
Incarcerated gravid uterus was found spontaneously reduced three weeks after myomectomy by ultrasound. A transverse Cesarean incision was performed at 32 weeks’ gestation. A male infant weighing 2120 g was delivered with Apgar scores of 10 and 10 at 1 and 5 minutes, respectively. Postoperative course was uneventful.

Lessons:
Incarceration of the gravid uterus is relatively rare and it is difficult to diagnose. This patient's findings suggested the incarceration of gravid uterus can be a transient abnormal position. The results of this study indicates that the incarcerated uterus when associated with fibroid is spontaneously reduced after removal of the fibroid.
Preoperative prealbumin and transferrin
Authors: Takemoto Erin , Yoo Jung , Blizzard Sabina R. , Shannon Jackilen , Marshall Lynn M. 
Published: February 2019

Abstract

Summary of Background Data:
There is growing interest in identifying nutritional biomarkers associated with poor outcomes of elective spine surgery. Prealbumin and transferrin are both biomarkers of nutritional status that can be obtained from clinical laboratories. However, associations of preoperative measures of these nutritional biomarkers across their range with risk of complications from spine surgery have not been fully investigated.

Objective:
Determine associations of preoperative prealbumin and transferrin levels with 30-day risk of complication among elective spine surgery patients.

Study Design:
Cohort study with preoperative prealbumin and transferrin collected as standard of care.

Outcome Measures:
30-day risk of medical complication.

Methods:
Data were obtained from medical records of 274 consecutive adult patients ages ≥50 years who underwent elective spine surgery from June 2013 to June 2014. Prealbumin (mg/dL), serum transferrin (mg/dL), and preoperative factors were abstracted from medical records. Prealbumin and transferrin levels were categorized into quartiles and as below versus median or higher. The primary outcome measure was 30-day risk of medical complication, such as renal failure or infections. Associations of the biomarkers with outcome risk were assessed with chi-square tests and with risk ratios (RR) and 95% confidence intervals (CI) estimated with multivariable log-binomial regression.

Results:
The 274 adults studied had a median prealbumin level of 27.4 mg/dL and a median transferrin level of 265.0 mg/dL. The 30-day risk of complication was 12.8% (95% CI: 8.8%–16.7%). Risk of complication did not vary by quartile for either prealbumin (P = .26) or transferrin (P = .49) and was not associated either with prealbumin (below median, RR = 1.1, 95% CI: 0.8, 1.5) or transferrin (below median, RR = 1.1, 95% CI: 0.8, 1.6).

Conclusions:
Among adults undergoing elective spine surgery, the 30-day risk of complication was not associated with prealbumin or transferrin. Nutrition status, as measured by prealbumin and transferrin, does not appear to be associated with complication risk.

Level of evidence: Level III.
Solvent-based paclitaxel or nab-paclitaxel for heavily treated relapsed/refractory small cell lung cancer
Authors: Sugiyama Keiji , Kogure Yoshihito , Torii Atsushi , Shiraishi Kazuhiro , Yamada Arisa , Ishida Akane , Shigematsu Fumie , Nozawa Kazuki , Niwa Hideyuki , Oka Saori , Nakahata Masashi , Kitagawa Chiyoe , Oki Masahide , Saka Hideo 
Published: February 2019

Abstract
Treatment options for patients with relapsed/refractory small cell lung cancer (R/R SCLC) are limited, and the efficacy of salvage therapies for heavily treated patients should be assessed. Here, we evaluated the efficacy of paclitaxel (PTX) in R/R SCLC patients.
A single-institute retrospective chart review was conducted. The primary endpoint was overall survival (OS), whereas the secondary endpoints were progression-free survival (PFS), overall response rate, disease control rate (DCR), and safety.
Thirty-one patients (median age, 69 [range, 56–80] years) were analyzed. The median follow-up period was 122 (range, 28–1121) days. The median OS and PFS were 4.4 and 2.2 months, respectively. Adverse events of grade 3 or higher, other than hematological toxicity, were febrile neutropenia and neuropathy. Multivariate analyses identified the following independent predictors of poor OS: performance status and lactate dehydrogenase at the upper limit of normal.
PTX monotherapy showed moderate efficacy with acceptable toxicity in heavily treated patients with R/R SCLC patients.
Clown Intervention on Psychological Stress and Fatigue in Pediatric Patients With Cancer Undergoing Chemotherapy
Authors: Lopes-Junior Luis C. , Silveira Denise S. C. , Olson Karin , Bomfim Emiliana O. , Veronez Luciana C. , Santos Jéssica C. , Alonso Jonas B. , Nascimento Lucila C. , Pereira-da-Silva Gabriela , Lima Regina A. G. 
Published: February 2019

BackgroundClown intervention has been shown to enhance emotional and behavioral processes, but few studies have comprehensively examined the effectiveness of this practice using biomarkers.ObjectiveThe aim of this study was to evaluate the effect of a clown intervention on the levels of psychological stress and cancer-related fatigue in pediatric patients with cancer undergoing chemotherapy.MethodsSixteen patients who met all criteria from a pediatric oncology inpatient unit in a Brazilian comprehensive cancer care hospital participated in this quasi-experimental study. Eight saliva samples were collected, comprising 4 at baseline and 4 after clown intervention (+1, +4, +9, and +13 hours after awakening). Salivary cortisol and α-amylase levels were determined using high-sensitivity enzyme-linked immunosorbent assay kits. Stress and fatigue were measured by the Child Stress Scale-ESI and the PedsQL Multidimensional Fatigue Scale, respectively. Relationships among stress, fatigue, and biomarker levels were investigated using nonparametric statistics.ResultsIn comparison with baseline measurements, the total psychological stress and fatigue levels improved after the clown intervention at the collection time point +4 hours (P= .003 andP= .04, respectively). Salivary cortisol showed a significant decrease after clown intervention at the collection time points +1, +9, and +13 hours (P< .05); however, α-amylase levels remained unchanged.ConclusionThese findings provide preliminary evidence that clown intervention merits further study as a way to reduce stress and fatigue in pediatric cancer inpatients, and that self-report and biomarker measures are feasible to collect in this patient group.Implications for PracticeClown intervention as a nonpharmacological intervention may improve stress and fatigue levels in pediatric inpatients with cancer undergoing chemotherapy.