bluuebunny/crossref_metadata_2025_split huggingface dataset:
Atrial fibrillation in athletes and general population
Authors: Li Xiangdan , Cui Songbiao , Xuan Dongchun , Xuan Chunhua , Xu Dongyuan 
Published: December 2018

Abstract

Background:
Atrial fibrillation (AF) is the most common type of heart arrhythmia, but the impact of long-term, high-intensity endurance exercise on the risk of AF remains uncertain.

Methods:
PubMed, EMBASE, and Cochrane library databases were searched till Nov 2017 to retrieve the articles. The included studies were summarized, pooled odds ratio (OR) and its 95% confidence interval (CI) were calculated. Both fixed and random effects models were used to combine the data. Stratified and logistic meta-regression analyses were performed to explore the sources of heterogeneity across studies.

Results:
Nine studies including 2308 athletes and 6593 controls were eligible. Our results showed that the risk of AF was significantly higher in athletes than in general population (OR = 2.34, 95% CI = 1.04–5.28, P
heterogeneity<.001, I

2
= 92.3%). Subgroup analysis based on gender and mean age demonstrated a significantly increased risk in men (OR = 4.03, 95% CI = 1.73–9.42, P
heterogeneity<.001, I

2
= 82.7%) and participants with mean age <60 (OR = 3.24, 95% CI = 1.23–8.55, P
heterogeneity<.001, I

2
= 84.3%). Furthermore, subgroup analysis based on type of athletes demonstrated a significantly increased risk of AF in participants with single type of sport (OR = 3.97, 95% CI = 1.16–13.62, P
heterogeneity = .018, I

2
= 70.4%). Results remained unchanged after performing sensitivity analysis. Meta-regression showed that gender, age, type of study, sample size, and sports mode were unrelated to heterogeneity.

Conclusion:
Our study confirmed that the risk of AF was significantly higher in athletes than in general population, especially among men and participants aged <60.
The higher serum endocan levels may be a risk factor for the onset of cardiovascular disease
Authors: Zhao Tianming , Kecheng Yao , Zhao Xuelei , Hu Xuehua , Zhu Jing , Wang Yingnan , Ni Jixiang 
Published: December 2018

Abstract

Objective:
Endothelial dysfunction was widely regarded as the initial lesion in the multifactorial pathogenesis of cardiovascular disease (CVD). Serum endocan, a novel endothelial dysfunction biochemical marker, is involved in the development of CVD. Here, we fulfilled a meta-analysis to evaluate the association between CVD and serum endocan levels.

Method:
The relevant published literature was searched through large literature databases, including PubMed, Embase, Cochrane Library, SinoMed, and Web of Science, up to June 1, 2018. The data were extracted from the studies. Stata software was used to perform a meta-analysis.

Result:
Fifteen original studies with a total of 1839 patients and 1258 controls fulfilled the inclusion criteria and were included in the study dataset. Meta-analysis showed that the levels of serum endocan in patients with hypertension, coronary artery disease, and coronary slow flow were higher than those in the control group. The pooled standardized mean differences and 95% confidence intervals of endocan concentrations in those 3 groups were 0.53 [0.19–0.86], P < .01; 0.99 [0.51–1.39], P < .01; and 0.62 [0.45–0.78], P < .01, respectively. Further analysis showed that the level of serum endocan in hypertension patients with coronary artery disease was higher than that in patients with hypertension (0.61 [0.30–0.92], P < .01). Sensitivity analysis and subgroup analysis were use to confirm the above results.

Conclusions:
In this meta-analysis, we further confirmed that serum endocan level was significantly increased in the CVD population. The high serum endocan level may be one of the risk factors for CVD.
Prognostic impact of the Controlling Nutritional Status score following curative nephrectomy for patients with renal cell carcinoma
Authors: Zheng Yangqin , Bao Lianmin , Wang Wenhan , Wang Qinquan , Pan Yue , Gao Xiaomin 
Published: December 2018

Abstract
We aimed to evaluate the prognostic significance of the preoperative Controlling Nutritional Status (CONUT) score in patients with renal cell carcinoma (RCC), and then compared its accuracy of the prognostic nutritional index (PNI), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) as predictors of survival.
We included 635 patients who underwent nephrectomy for RCC from January 2004 to July 2014. The X-tile program was used to determine the optimal cut-off values for CONUT score, PNI, NLR, and PLR.
The median follow-up duration after surgery was 48.40 (29.30–80.10) months. The optimal cutoff values were 2 for CONUT score, 48 for PNI, 3.5 for NLR and 204.7 for PLR by X-tile program with cancer-specific survival (CSS) as end-point. Higher CONUT score, NLR and PLR, and lower PNI were statistically associated with worse OS and CSS in the univariate analysis. Multivariate analysis showed that higher CONUT score was an independent predictor for OS (HR = 3.012; 95% CI, 1.525–5.948; P = .001) and CSS (HR = 3.001; 95% CI, 1.290–6.984; P = .011), and CONUT score was superior to PNI, NLR, and PLR according to the HR.
Therefore, preoperative CONUT score can be a strong independent predictor in RCC patients after nephrectomy.
Baseline 18F-FDG PET/CT as predictor of the pathological response to neoadjuvant therapy in esophageal cancer
Authors: Domachevsky Liran , Kashtan Hanoch , Brenner Baruch , Nidam Meital , Morgenstern Sara , Kundel Yulia , Groshar David , Bernstine Hanna 
Published: December 2018

Abstract
The type of pathological response to neoadjuvant chemoradiation in patients with locally advanced esophageal cancer predicts overall survival (OS).
We aimed to assess early 18F-FDG positron emission tomography/computed tomography parameters in predicting the pathological response to neoadjuvant treatment.
The cohort included consecutive patients with locally advanced esophageal cancer who underwent baseline 18F-FDG positron emission tomography/computed tomography between September 2006 and February 2015. Positron emission tomography variables of maximum and average standardized uptake values (SUVmax, SUVaverage), metabolic tumor volume (MTV), and total lesion glycolysis were recorded in addition to computed tomography volume. MTV was calculated using cut-off values of 42%, 50% and 60% (MTV 0.42, 0.5, and 0.6) of the tumoral SUVmax. Receiver operating characteristic (ROC) analysis was used to determine sensitivity and specificity.
Sixty-one patients (44 male, 17 female) fulfilled the inclusion criteria. Only MTV values of 13.6 mL (MTV 0.42) and 7.4 mL (MTV 0.5) remained significant on ROC analysis, with an area under the curve of 0.690 (confidence interval 0.557–0.823, p = .02] and 0.664 (confidence interval 0.527–0.802, P = .048), respectively in differentiating patients with a complete (n = 44) or incomplete (n = 17) pathological response.
MTV at presentation is associated with the pathological response to neoadjuvant chemoradiation in patients with locally advanced esophageal cancer.
Obstructive ileus caused by metal staples 6 years after the initial surgery
Authors: Lee Chul Seung , Kim Min Ki 
Published: December 2018

Abstract

Rationale:
Complete small bowel obstruction (SBO) is a common surgical emergency often resulting from adhesive bands installed after a surgical procedure. However, SBO caused by surgical staples used in a previous operation is unusual. Herein, we report a rare case of adhesive ileus induced by surgical staples.

Patient's concerns:
A 58-year-old woman visited our Emergency Department with right lower quadrant (RLQ) pain and vomiting. The patient had undergone laparoscopic total hysterectomy with the Endo GIA stapler for uterine myoma 6 years prior.

Diagnoses:
Computed tomography (CT) revealed a closed-loop obstruction with volvulus involving the distal ileum.

Interventions:
After suspected failure of conservative therapy with fluid resuscitation and Levin tube decompression, emergency laparoscopic surgery was performed. A fibrous band around the surgical staples considered to have been used in a previous operation was observed which extended to the greater omentum, through which a segment of the bowel formed a closed-loop obstruction around the right ovary.

Outcomes:
The patient's symptoms resolved and a follow-up on post-operative day 14 showed no symptoms.

Lessons:
Surgeons using surgical staples should be aware that adhesion may occur when the staples are exposed to the abdominal cavity, which can lead to the risk of SBO several years after surgery. Thus, staples should not be exposed to the abdominal cavity, or anti-adherent substances should be used to minimize the possibility of such complications.
Dark chocolate modulates platelet function with a mechanism mediated by flavan-3-ol metabolites
Authors: Montagnana Martina , Danese Elisa , Angelino Donato , Mena Pedro , Rosi Alice , Benati Marco , Gelati Matteo , Salvagno Gian Luca , Favaloro Emmanuel J. , Del Rio Daniele , Lippi Giuseppe 
Published: December 2018

Abstract
Cocoa is a rich source bioactive compounds, i.e., flavan-3-ols, and its consumption has been associated with several beneficial effects, such as the positive modulation of the hemostasis targeted by the platelet function. However, these phenolic compounds have a very low bioavailability and extensively undergo phase I and II metabolism, with the appearing into the bloodstream of (epi)catechin conjugates and phenyl-γ-valerolactones and their conjugates, at different times.
The aims of this study were to explore the effect of dark chocolate on platelet function and to investigate the relationship between this interplay and flavan-3-ol derived metabolites.
Eighteen healthy male volunteers ingested 50 g of 90% cocoa chocolate within 5 minutes. Blood samples were collected immediately before chocolate ingestion (T0) and 4 hours afterwards (T1). Platelet function analyzer (PFA)-100 closure time was assessed using collagen/adenosine-5′-diphosphate (COL/ADP) and collagen/epinephrine (COL/EPI) cartridges. Plasma flavan-3-ol metabolites were identified and quantified by means of liquid chromatography coupled to a triple quadrupole mass spectrometer (UHPLC-ESI-MS/MS).
Results evidenced a significant increase of COL/ADP-induced PFA-100 closure time, but not COL/EPI, 4 hours after ingestion of dark chocolate. Total plasma structurally-related (epi)catechin metabolite (SREM) concentration significantly increased at T1, together with 4 out of the 6 detected metabolites. Total phenyl-γ-valerolactone concentrations remained unchanged. Spearman correlations evidenced a strong correlation between COL/ADP closure time and SREMs, mainly led by (epi)catechin-sulfate isomers.
These data confirm that the potential beneficial effect of dark chocolate on primary hemostasis may be mediated by flavan-3-ol circulating metabolites.
Impact of hospital care volume on clinical outcomes of laparoscopic radical hysterectomy for cervical cancer
Authors: Lee Banghyun , Kim Kidong , Park Youngmi , Lim Myong Cheol , Bristow Robert E. 
Published: December 2018

Abstract

Background:
In cervical cancer, the impact of hospital volume of laparoscopic radical hysterectomy (LRH) has not been investigated systematically as in ovarian cancer.
The aim of this study was to investigate the impact of hospital care volume of LRH on treatment outcomes of patients with cervical cancer.

Methods:
The PubMed, Embase, and Cochrane Library databases were searched with the terms “cervical cancer,” “radical hysterectomy,” and “laparoscopy.” The selection criteria included studies presenting operative outcomes and/or perioperative complications of LRH from high-volume hospitals (HVHs) (≥15 cases/year) and low-volume hospitals (LVHs) (<15 cases/year). Fifty-nine studies including 4367 cases were selected. Linear regression analysis weighted by the average annual case number in each study was performed to evaluate differences between the groups.

Results:
In HVH, a higher number of lymph nodes (24.5 vs 21.1; P = .037) were retrieved by LRH in older women (48.4 vs 44.5 years; P = .010) with tendencies of shorter operation time (224.4 vs 256.4 minutes; P = .096) and less blood loss (253.1 vs 322.2 mL; P = .080). Compared with LVH, HVH had fewer patients with stage IA disease (13.8 vs 24.4%; P = .003) and more patients with stage IIA disease (15.3 vs 7.1%; P = .052) with comparable 5-year overall survival (93.1 vs 88.6%; P = .112).

Conclusion:
HVH is a prognostic factor for operative outcome and perioperative complications in patients with cervical cancer undergoing LRH. The exact effect of hospital volume on survival outcome needs to be evaluated.
Perforation of small intestine secondary to metastatic lung adenocarcinoma
Authors: Wang Jian , Chen Yimeng , Zhang Sisi , Chen Qingyong 
Published: December 2018

Abstract

Rationale:
About 50% of patients with a diagnosis of nonsmall cell lung carcinoma exhibit metastatic disease at the time of diagnosis. The preferential sites of extrapulmonary spread are the lymph nodes, liver, brain, adrenal glands, and bones; gastrointestinal tract perforation secondary to metastatic lung cancer is extremely rare.

Patient concerns:
A 60-year-old male nonsmoker patient presented with a 20-day history of facial, neck, and right upper limb edema. Physical examination revealed a 3.5 cm mass in his right chest. Computed tomography (CT) revealed a 4 cm mass near the right lung hilum.

Diagnosis:
Biopsy of the right chest wall mass revealed low differentiated lung adenocarcinoma. Additionally, retroperitoneal lymphadenopathy, pericardial effusion, metastases in the mediastinum, bilateral adrenal gland, and right thoracic wall nodule, as well as multiple bone metastases were also found.

Interventions:
Since the patient was diagnosed with multiple metastatic lung cancer, chemotherapy was started. One week after chemotherapy, he experienced a sudden acute abdominal pain. Abdominal CT examination indicated the possibility of intestinal perforation. Hence, the patient underwent an emergency operation. During the surgical procedure, 2 perforations of size 1×1 cm2 were discovered at 110 cm and 140 cm of the jejunum from Treitz's ligament. Then, an intestinal resection and end-to-end anastomosis were performed. The pathological diagnosis of the resected specimen revealed that it was a metastatic lung adenocarcinoma of small intestine.

Outcomes:
The patient died 10 days after operation and 19 days following the cancer diagnosis due to septic shock.

Lessons:
Gastrointestinal tract metastasis from the lung is uncommon, but the survival rate is extremely low; therefore, it should be considered as a possibility in patients who present with any of the gastrointestinal symptoms.
Anaplastic pancreatic cancer diagnosed with endoscopic ultrasound guided fine needle aspiration showing hypervascular tumor
Authors: Fujimoto Takehide , Inatomi Osamu , Mizuno Ryo , Shintani Shuhei , Nishida Atsushi , Bamba Shigeki , Sugimoto Mitsushige , Andoh Akira 
Published: December 2018

Abstract

Rationale:
Pancreatic ductal carcinoma is a hypovascular tumor, and characteristic findings are observed on imaging modalities, such as computed tomography (CT) and magnetic resonance imaging (MRI), in most cases.

Patient concerns:
Here we report a case of anaplastic carcinoma of the pancreas (ACP) with characteristics of hypervascular tumor diagnosed by endoscopic ultrasound guided fine needle aspiration (EUS-FNA). A 70-year-old woman was admitted to hospital because of exacerbation of diabetes. Contrast-enhanced CT revealed a hypervascular tumor at the head of the pancreas.

Diagnosis:
EUS-FNA was performed. Osteoclast-like giant cells and tumor cells with polymorphic nuclei were found on pathological examination and she was diagnosed with ACP.

Interventions:
Although it was a surgical indication at the time of diagnosis, the tumor rapidly worsened. Oral administration of TS-1 (tegafur/gimeracil/oteracil) was initiated. Chemotherapy was discontinued after the end of 2 courses because the tumor had increased prominently on CT.

Outcomes:
She died approximately a year since the onset of the illness.

Lessons:
ACP occasionally exhibits the characteristics of a hypervascular tumor and may require differentiation from other pancreatic tumors, such as neuroendocrine tumor. Therefore, pathological diagnosis by EUS-FNA at an early stage is important to determine treatment strategies.
Dazhu Hongjingtian (Herba Rhodiolae) for unstable angina pectoris
Authors: Fan Yu , Gu Xuyu , Zhang Heng 
Published: December 2018

Abstract

Background
Dazhu Hongjingtian (DZHJT), also named Herba Rhodiolae, has been frequently introduced for patients with angina pectoris in China. However, the add-on effect of DZHJT in unstable angina pectoris (UAP) has not been systematically evaluated. The purpose of this protocol is to provide the methods used to assess the efficacy and safety of DZHJT as adjuvant therapy for management of UAP.

Methods
We will extensively search for eligible studies in PubMed, Emase, Cochrane Library, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, Wanfang, and VIP databases up to October 2018. Only randomized controlled trials comparing DZHJT in combination with Western medicine vs Western medicine alone were selected.
The primary outcomes are above 50% reduction in frequency of angina attacks and weekly frequency of angina attacks reduction. The secondary outcomes are the blood rheology parameters (whole-blood viscosity, plasma viscosity, and fibrinogen) and adverse events. We will use RevMan V.5.0 software to perform meta-analysis.

Results
The pooled results will provide a high-quality of evidence of DZHJT as adjuvant therapy in patients with UAP.

Conclusion
This systematic review and meta-analysis will provide up-to-date evidence to evaluate DZHJT as adjuvant therapy in patients with UAP.

PROSPERO registration number
PROSPERO CRD42018111885.
Increased nerve twigs in small intestinal mucosa with programmed cell death-ligand 1 and somatostatin receptor type 2A expression in recurrent Crohn disease
Authors: Caruso Maria Lucia , Di Pinto Federica , Ignazzi Antonia , Coletta Sergio , Valentini Anna Maria , Cavalcanti Elisabetta , De Michele Francesco 
Published: December 2018

Abstract

Rationale:
Inflammatory bowel disease (IBD) patients manifest symptoms of disturbed gut function, such as neural sensory-motor changes. Programmed cell death-ligand 1 (PD-L1), normally present in neural tissue, exists in close apposition to the mucosal immune system and intestinal epithelium, and a bi-directional communication is known to occur at these interfaces. Somatostatin has been shown to suppress the inflammatory reaction, and has been used in several clinical trials to treat inflammatory disorders, such rheumatoid arthritis. Recently, somatostatin receptor type 2A, that regulates neurotransmission, proliferation, and apoptosis, has been recognized in IBD. Although prominent abnormalities in the morphology of the enteric nervous system have been observed in idiopathic IBD, they are more marked in Crohn disease.

Patient concerns:
A 55-year-old woman with recurrent Crohn disease, just surgically treated for ileal resection, have a stenotic complication.

Interventions:
At surgery 5 cm of preterminal ileum with stenosis and anastomotic ileocolic block was removed.

Diagnoses:
The histopathology showed a recurrent Crohn in fistulo-stenotic phase; the stenosis was mainly sustained by mass-forming, ganglioneuromatous hyperplasia. Normally very rare, fine nerve twigs extend up into mucosa but we found a new-formed fibrillary network, extending into the inflammation area at the subepithelial luminal site of the mucosa, that was positive to PD-L1 and somatostatin receptor type 2A (SSTR2A) immunostaining but not visualized in routinary stained slides.

Outcomes:
After surgery the patient was semestrally followed with clinical endoscopic evaluation that results uneventfully.

Lessons:
Our case shows that before surgery neuromatous abnormalities can be predicted by immunostained new-formed twigs in the mucosa.
Associations between DNAH1 gene polymorphisms and male infertility
Authors: Yang Xiao , Zhu Dongliang , Zhang Hongguo , Jiang Yuting , Hu Xiaonan , Geng Dongfeng , Wang Ruixue , Liu Ruizhi 
Published: December 2018

Abstract
Genetic abnormalities could account for 10% to 15% of male infertility cases, so increasing attention is being paid to gene mutations in this context. DNAH1 gene polymorphisms are highly correlated with astheno-teratozoospermia, but limited information has been reported on pathogenic variations in DNAH1 in the Chinese population. We explored 4 novel variations of the DNAH1 gene in Chinese infertile patients. Mutation screening of the DNAH1 gene was performed on 87 cases of asthenozoospermia with targeted high-throughput sequencing technology; another 200 nonobstructive azoospermia cases were further analyzed to investigate the prevalence of DNAH1 variations. The effects of the variations on protein function were further assessed by bioinformatic prediction. For carriers of DNAH1 variations, genetic counseling should be considered. Assisted reproductive technologies should be performed for these individuals and microsurgery should be considered for patients with azoospermia. DNAH1 variations were identified in 6 of 287 patients. These included 8 heterozygous variations in exons and a splicing site. Among these, 4 variations (g.52400764G>C, g.52409336C>T, g.52430999_52431000del, g.52412624C>A) had already been registered in the 1000 Genomes and Exome Aggregation Consortium databases. The other 4 novel variations (g.52418050del, g.52404762T>G, g.52430536del, g.52412620del) were all predicted to be pathogenic by in silico analysis. The variations g.52418050del and g.52430999_52431000del were detected in 1 patient who was more severe than another patient with the variation g.52430999_52431000del. Physicians should be aware of genetic variants in male infertility patients and DNAH1 mutations should be considered in patients with asthenospermia or azoospermia.