bluuebunny/crossref_metadata_2025_split huggingface dataset:
Oseltamivir induced Stevens–Johnson syndrome/toxic epidermal necrolysis—case report
Authors: Zuo Wei , Wen Li-Ping , Li Jun , Mei Dan , Fu Qiang , Zhang Bo 
Published: May 2019

Abstract

Rationale:
Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are 2 rare but life-threatening diseases characterized by detachment of epidermis, bullous skin lesions, and mucous membrane erosions. Drugs are highly suspected to be the causative agents. We report a case of SJS/TEN induced by oseltamivir, which is a very rare event.

Patient concerns:
A 9-year-old girl with upper respiratory tract infections presented with generalized maculopapular rash the second day after taking oseltamivir.

Diagnosis:
The diagnosis of SJS/TEN was made based on cytotoxic skin lesions and mucous membrane involvement.

Interventions:
After discontinuing of the drug and combination therapy of corticosteroid and human immunoglobulin initiation, the lesions were improved. Human leukocyte antigen (HLA) gene sequencing was done.

Outcomes:
The girl was followed-up for 1 year. The skin and mucous membranes symptoms were relieved.

Lessons:
We report this case to attract attention to the rare but serious side effect of this antiviral drug.
The ankle brachial index exhibits better association with cardiovascular outcomes than interarm systolic blood pressure difference in patients with type 2 diabetes
Authors: Lin Liang-Yu , Hwu Chii-Min , Chu Chia-Huei , Won Justin G.S. , Chen Harn-Shen , Chang Li-Hsin 
Published: May 2019

Abstract
Increased interarm systolic blood pressure difference (IASBPD) is associated with cardiovascular prognosis in the general population. This study aimed to evaluate whether IASBPD or ankle brachial index (ABI) is strongly associated with cardiovascular outcomes in patients with type 2 diabetes.
Total 446 type 2 diabetes followed up for a mean 5.8 years divided by ABI (<0.9 vs ≥0.9) or IASBPD (<10 vs ≥10 mm Hg). The primary outcome was a composite of all-cause mortality, hospitalization for coronary artery disease, nonfatal stroke, carotid, or peripheral revascularization, amputations, and diabetic foot syndrome. The secondary endpoint was all-cause mortality.
Sixty-four composite events and 17 deaths were identified. The primary and secondary outcomes were higher than those in the group with ABI < 0.9 vs ABI ≥ 0.9 (32.8% vs 11.6%, P < .005 for primary outcome; 14.0% vs 2.3%, P < .005 for all-cause mortality) but IASBPD cannot exhibit a prognostic value. ABI < 0.9 was also the dominant risk factor of both endpoints demonstrated by multivariate Cox proportional analysis (composite events: adjusted hazard ratio [HR], 2.39; 95% confidence interval [CI], 1.26–4.53; P = .007; all-cause mortality: adjusted HR, 3.27: 95% CI, 1.91–5.60; P < .001).
The ABI was more associated with cardiovascular outcomes in patients with diabetes than IASBPD.
Maintenance interferon therapy in chronic hepatitis C patients who failed initial antiviral therapy
Authors: Hung Hung-Chang , Liao Hsien-Hua , Chen Shiuan-Chih , Tsao Shih-Ming , Lee Yuan-Ti 
Published: May 2019

Abstract

Objectives:
To evaluate the effect of pegylated interferon maintenance therapy in patients with chronic hepatitis C who failed initial antiviral therapy.

Methods:
This is a meta-analysis of 6 randomized controlled trials that met the eligibility criteria. In all, 2438 chronic hepatitis C patients who failed to achieve sustained virologic response after initial treatment with pegylated interferon and ribavirin (antiviral therapy nonresponders or relapsers) were enrolled; 1237 patients received maintenance therapy (Maintenance group) and 1201 received no treatment (Observation group).

Results:
The pooled analyses found that patients in the Maintenance group had a significantly higher rate of normal alanine aminotransferase than did patients in the Observation group (pooled odds ratio [OR] 4.436, 95% confidence interval [CI] 1.225–16.064, P = .023), but there was no significant difference between the 2 groups in the incidence of hepatocellular carcinoma (pooled OR 0.872, 95% CI 0.501–1.519, P = .630), or the mortality rate (pooled OR 1.564, 95% CI 0.807–3.032, P = .185).

Conclusions:
Interferon-based maintenance therapy in patients with chronic hepatitis C who failed initial antiviral therapy improved liver inflammation as indicated by blood chemistry (alanine aminotransferase).
Finding the best effective way of treatment for rapid I-131 turnover Graves’ disease patients
Authors: Thamcharoenvipas Siwaporn , Kerr Stephen J. , Tepmongkol Supatporn 
Published: May 2019

Abstract

Background:
Rapid I-131 turnover Graves’ disease patients have low cure rate. We aimed to compare cure percentage at 12 months among 3 treatment doses of I-131 with or without lithium carbonate (LiCO3) in rapid turnover Graves’ disease patients.

Methods:
Sixty Graves’ disease patients referred for radioactive iodine treatment were randomised into three arms of treatment: Group A, 3.7 MBq I-131/g thyroid plus 600 mg/day LiCO3, Group B, 5.55 MBq I-131/g plus 600 mg/day LiCO3, and Group C, 7.4 MBq I-131/g without LiCO3. Data were collected at baseline, 3, 6, 9, and 12 months. The primary endpoint were cure rates (percentage of euthyroid or hypothyroid) at 12 months. Pairwise comparisons were made across 3 groups using an equality of proportions test. The secondary endpoint, the odds of cure over the total follow-up for group B and C versus group A, was analyzed using generalized estimating equation (GEE). Side effects of I-131 and LiCO3 treatment were evaluated at 1 to 2 weeks after treatment.

Results:
The cure rate at 12 months was 45% (9/20) for group A, 60% (12/20) for group B and 80% (16/20) for group C. The mean difference in proportion cured at 12 months between group C and group A was 35 (7.0 to 66.8)%; P-value = .02. There was a statistically significant difference between cure rates over all follow-up of group C and A after adjustment for sex (adjusted OR = 3.09; 95%CI = 1.32–7.20; P-value = .009), but no significant difference was found between group B and A or C and B in the primary and/or secondary efficacy endpoints. Side effects from the treatment were found in 12% (7/60); 2 in group A, 4 in group B, and 1 in group C. Four of these were likely due to LiCO3 side effects.

Conclusions:
Treatment of rapid turnover Graves’ disease patients with high dose I-131 (7.4 MBq/g) provides significantly higher cure rates at 12 months, and 3 times odds of cure than 3.7 MBq/g I-131 plus LiCO3 with lesser side effects. We thus recommend 7.4 MBq I-131/g for treatment in these patients.
Reduced rate of dehiscence after implementation of a novel technique for creating colonic anastomosis in pediatric patients undergoing intestinal anastomosis in a single institute
Authors: Yang Yang , Chen Bailin , Xiang Li , Guo Chunbao 
Published: May 2019

Abstract
We aimed to investigate the new continuous horizontal mattress anastomosis for pediatric patients who underwent emergency or electively laparotomy.
From June 2012 to June 2017, 858 patients undergoing intestinal anastomosis were reviewed retrospectively, including 369 patients with the new continuous horizontal mattress anastomosis and 489 patients with traditional 2 layer interrupted anastomosis, served as control. Propensity score matching was performed to adjust for selected baseline variables. The primary outcome, anastomosis complications and clinical outcomes, including postoperative gastrointestinal function recovery, overall expenditure, and postoperative hospital stay were compared between the 2 groups.
Patients with the new manual anastomosis had advantageous postoperative outcomes than those with the traditional 2 layer interrupted anastomosis. A mean of 11.4 minutes was required to construct the new manual single-layer anastomosis versus 18.5 minutes for the traditional anastomosis (P < .001). A reduction trend for postoperative anastomotic complications was indicated in patients receiving horizontal mattress anastomosis (odds ratio [OD] (95% confidence interval [CI]), 0.56 (0.37–0.84); P = .004), including peritonitis or abscess (OD [95% CI], 0.56 (0.32–0.98); P = .026), anastomotic leakage (OD [95% CI], 0.39 [0.12–1.27]; P = .088), and anastomotic strictures (P = .26). Mean length of stay was 10.9 ± 2.9 days for the new manual anastomosis group and 11.3 ± 3.5 days for traditional 2-layer anastomosis patients (P = .12).
Beneficial effects of the new manual anastomosis were demonstrated in terms of anastomotic complications, and length of hospital stay in the pediatric patients. Furthermore, it is a novel, feasible and safe method that may simplify the surgical procedure in anastomoses.
Based on arterial spin labeling helps to differentiate high-grade gliomas from brain solitary metastasis
Authors: Fu Min , Han Fang , Feng Changchao , Chen Tao , Feng Xiaobo 
Published: May 2019

Abstract

Background:
We first introduced this meta-analysis was to assess the accuracy of arterial spin labeling (ASL) in the differentiating high-grade gliomas (HGG) from brain solitary metastases (BSM).

Methods:
The PubMed, Web of Knowledge, and Cochrane Libraries and China National Knowledge Infrastructure databases were searched up to August 31, 2018. The pooled weighted sensitivity and specificity, summary receiver operating characteristic curve (SROC), sensitivity analysis, and threshold effect analysis were performed on Stata version 12.0 and Meta-Disc version 1.4. Deeks’ funnel plot asymmetry test was performed to assess publication bias.

Results:
Of 5 eligible articles, of the 346 lesions from 346 patients, 274 were HGG, and 72 were BSM. The forest pooled sensitivity of 0.88 (95% confidence interval [CI]: 0.65, 0.96) and specificity of 0.85 (95% CI: 0.74, 0.92) of ASL were reported in this meta-analysis. The pooled area under the curve of SROC was 0.92 (95% CI: 0.89, 0.94). Sensitivity analysis demonstrated that the pooled estimates were reliable. No evident publication bias was obtained (P = .38).

Conclusion:
The parameters derived from ASL with high accuracy in differentiating HGG from BSM. However, results must be interpreted with caution due to the small sample size considered. Large sample prospective studies were necessary to assess and confirm its clinical value.
Characteristics of chondroid lipoma
Authors: Huang Chao , Guo Wenlai , Qu Wenrui , Zhu Zhe , Li Rui 
Published: May 2019

AbstractRationale:Chondroid lipoma (CL) is a rare benign tumor. No relevant epidemiological reports have been published on CL, and there is a lack of uniform diagnostic and treatment criteria for the tumor.Patient concerns:Here, we report a case of CL with a mass on the left buttock for 2 weeks, and further illuminate its diagnosis and treatment.Diagnosis:The diagnosis of CL was rendered according to the pathological indices.Interventions:The tumor was resected completely under spinal anesthesia.Outcomes:The patient was followed-up for 6 months and showed no tumor recurrence or metastasis and there was resolution of the patient's lower-limb numbness and pain.Lessons:The case study presented here provides evidence that CL could be effectively diagnosed by using ultrasound, puncture or biopsy, and/or magnetic resonance imaging. Furthermore, the patient recovered without any complications after completely resecting the tumor.
Magnetic resonance imaging features predictive of an incomplete response to transarterial chemoembolization in patients with hepatocellular carcinoma
Authors: Kim Yeun Jeong , Lee Min Hee , Choi Seo Youn , Yi Boem Ha , Lee Hae Kyung 
Published: May 2019

Abstract
To identify pretreatment magnetic resonance imaging (MRI) features associated with an incomplete response (IR) to transarterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC).
The medical records of 89 patients with HCC who had undergone a first TACE were reviewed retrospectively. The size, visual attenuation in the arterial phase, signal intensity (SI) on T1-, T2-, and diffusion-weighted images, and apparent diffusion coefficient (ADC) values of each lesion were evaluated on pretreatment images. The response to TACE was routinely assessed at 4 weeks post-treatment by 4-phase computed tomography. The HCC patients were classified as complete or incomplete responders based on the arterial–phase enhancement of the target lesion.
In multivariate analysis, larger lesion diameter (P = .004, OR = 1.06 per millimeter, 95% CI = 1.02–1.11), faint enhancement on arterial phase (P = .021, OR = 3.24, 95% CI = 1.22–9.14), and non-low SI on T1-weighted images (P = .016, OR = 3.36, 95% CI = 1.29–9.32) were significantly associated with increased odds of an IR to TACE in HCC patients.
An iso-to-high T1-weighted SI by pretreatment MRI was an independent predictor of an incomplete response to TACE in patients with HCC, in addition to faint arterial enhancement and lesion size.
Obesity and metabolic syndrome in children in Brazil
Authors: Sentalin Priscilla Bueno Rocha , Pinheiro Andreia de Oliveira , Oliveira Robson Rocha de , Zângaro Renato Amaro , Campos Luciana Aparecida , Baltatu Ovidiu Constantin 
Published: May 2019

Abstract
The purpose of this observational study was to examine the prevalence of obesity in children of 6 to 8 years of age from primary public schools over a period of 6 years and the associated environmental and metabolic health risk factors.
This was a cohort observational study to investigate the prevalence of obesity in children from 14 state primary schools in Vinhedo, Sao Paulo state. Environmental and metabolic health risk factors for obesity were investigated in a cross-sectional survey.
This present study revealed 74.0% of children with obesity consumed fried foods and sweets at school, and 84.0% consumed snacks and soft drinks at home. This cohort reported to have engaged in physical activity for less than 3 hours per week at school (93.0%) and at home (85.0%). There was a high prevalence of increased waist circumference and insulin resistance among children with obesity (84.9% and 84.5%, respectively). The body mass index had a significant Spearman correlation with waist circumference, insulin resistance, and triglycerides.
Childhood obesity was associated with a high prevalence of both environmental and metabolic risk factors. Also, the authors conclude that the lack of parents’ awareness of childhood obesity and its risk factors represents a substantial barrier to lifestyle counseling.
Small bowel capsule endoscopy in ulcerative colitis: the capcolitis study: a prospective observational study
Authors: Bokemeyer Bernd , Luehr Doreen , Helwig Ulf , Maaser Christian , Jessen Petra , Schreiber Stefan 
Published: May 2019

Background
Clinical phenotypes in inflammatory bowel disease (IBD) patients include ulcerative colitis (UC) and Crohn’s disease (CD). Moreover, genetic aetiology studies suggest a continuum of phenotypes from exclusively ileal to left-sided colonic disease.

Patients and methods
A nationwide registry (BioColitis Registry) prospectively recorded ∼900 UC-patients in Germany and in the CapColitis substudy, small bowel capsule endoscopy (SBCE) was consecutively offered at participating centres. The primary objective was to investigate the presence of small bowel lesions. In total, 127 UC-patients were included.

Results
SBCE was evaluable in 125 of 127 UC-patients. Small bowel lesions were found in 16/125 (13%) patients, of which nine were classified as clinically significant [backwash ileitis (n=4) or lesions suggestive of CD (n=5)], and seven were not significant [biopsy-induced lesions (n=3) or single small bowel lesions (n=4)]. The SBCE results prompted diagnostic workups in all patients with clinically relevant lesions, and all patients with lesions suggestive for CD (4%) were re-classified as CD by the treating physicians.

Conclusion
Systematic examination of 125 consecutive UC-patients failed to confirm a clinically important phenotype overlap with CD, as suggested by genetic aetiology studies. In five patients (4%) with small bowel lesions, the diagnosis was changed to CD.
Cognitive Effects of Combined Amisulpride and Quetiapine Treatment in Patients With Refractory Schizophrenia: A Naturalistic, Prospective Study
Authors: Molina Juan de Dios , Quintero Javier , García-Laredo Eduardo , López-Muñoz Francisco , Correas-Lauffer Javier , Barbudo Eduardo , Ceverino Antonio , Mur Carlos , Garcia-Resa E. 
Published: May 2019

Background:
Regarding the treatment of patients with resistant schizophrenia, different options exit, although they are supported by limited evidence. In this study, antipsychotic polypharmacy, comprising 1200 mg of amisulpride and 600 mg of quetiapine, was used. Clinical change evaluation was performed using neurocognitive evaluations.

Study Question:
The use of amisulpride and quetiapine will imply a clinical improvement in patients affected by schizophrenia, which will be specially reflected in a cognitive improvement.

Study Design:
Naturalistic and prospective study. Twenty-six patients were applied and assessed by a battery of neurocognitive evaluations since the pretreatment baseline until 6-month treatment. The patients had no biological response to medication, high social maladjustment, and a long clinical history of the disease. Kane and Brenner criteria for treatment-resistant schizophrenia were applied to choose the subjects.

Measures and Outcomes:
The cognitive improvement will imply a significant betterment, from the pretreatment baseline until 6-month treatment, in the following cognitive tests: Stroop Test, WAIS Coding Subtest, and Comprehensive Trail Making Test (CTMT). An improvement in the Calgary Depression Scale, Simpson–Angus Scale, and Visual Analogue Scale (EVA) will also be observed. This scales were been used during the baseline, 3 months after, and then, 6 months.

Results:
Subjects, after 6-month treatment with amisulpride and quetiapine, did show statistically significant differences in the assessed areas: WAIS Coding Subtest (P < 0.001), CTMT A and B (CTMT A P < 0.034; CTMT B P < 0.000), and Stroop Tests: Word (P < 0.001), Word-Color (P < 0.007), and Interference (P < 0.039). Furthermore, they showed a statistically significant difference in the Calgary Depression Scale (P < 0.002), Simpson–Angus Scale (P < 0.019), and EVA (P < 0.001).

Conclusions:
The results of this report show a cognitive and clinical improvement in refractory patients after the administration of amisulpride and quetiapine.
The future of cell-free DNA testing to guide therapeutic decisions in B-cell lymphomas
Authors: Condoluci Adalgisa , Rossi Davide 
Published: May 2019

Purpose of review
Tissue biopsy is the current gold standard technique for diagnosis and molecular profiling of lymphomas, but it carries several disadvantages in terms of procedural risks (infectious and haemorrhagic complications, anaesthesiologic risks) and analytic aspects (heterogeneity of tumors, low representation of tumor cells in the tissue). Noninvasive genotyping of B-cell lymphomas through circulating tumor DNA (ctDNA) is emerging as a practical tool to monitor the genetics and course of the disease from diagnosis to eventual relapse.
This review will explore recent advances in the field of liquid biopsy in lymphomas, highlighting their clinical implications.

Recent findings
ctDNA has been recently proposed an alternative source of tumor DNA for genotyping purposes, especially for those samples having low tumor representation or when longitudinal genetic monitoring is limited by the inaccessibility of relapsed tumor tissues. Also, ctDNA has been recently proposed radiation-free tool for the early identification of chemorefractory lymphoma patients.

Summary
The detection of ctDNA circulating in the bloodstream of lymphoma patients can inform about the genetics of the disease at diagnosis identifying druggable alterations, detect the onset of mutation of resistance during treatment, anticipate about relapse earlier than standard methods [e.g. PET associated with computed tomography (PET/CT)] during follow-up.
Simple Schizophrenia
Authors: Lally John , Maloudi Sarah , Krivoy Amir , Murphy Kieran C. 
Published: May 2019

Abstract
Clustering of symptoms to characterize simple schizophrenia is still debated, and support is needed for the characterization of simple schizophrenia as a syndrome. We conducted a systematic review to identify all cases of simple schizophrenia published until December 2017. We identified 42 cases of simple schizophrenia, 57% of which met all three diagnostic criteria (ICD-10, DSM-4 research criteria, and Black and Boffeli's criteria for simple schizophrenia). The mean age at first contact with clinical services was 30.1 (SD = 11.6) years, with a mean delay of 7.4 (SD = 6.8) years from symptom onset to first presentation. An insidious onset and negative symptoms were characteristic features in all cases. Social withdrawal, alogia, blunted affect, lack of initiative/interest, and functional impairment were found in more than 85% of cases. Our findings contribute to greater awareness and understanding of simple schizophrenia, and have the potential to reawaken interest in this clinically distinct subgroup.
Characteristics of Adolescent Psychiatric Inpatients in Relation to Their History of Preceding Child Psychiatric Inpatient Care
Authors: Lukkari Sari H. , Hakko Helinä H. , Partanen Marja A. , Riala Kaisa R. , Riipinen Pirkko K. 
Published: May 2019

AbstractAmong psychiatric inpatients aged 13 to 17, various familial and clinical characteristics were compared between those with and without a previous history of specialized child psychiatric care (CPSY versus non-CPSY). CPSY adolescents were younger (boys: odds ratio [OR], 0.7; girls: OR, 0.4) at admission to adolescent psychiatric inpatient care, and they more likely had mothers with psychiatric problems (boys: OR, 4.0; girls: OR, 4.8) and child welfare placement background (boys: OR, 2.8; girls: OR, 6.7) compared with non-CPSY adolescents. CPSY girls were also characterized as having unemployed mothers (OR, 3.1) and engaging in nonsuicidal self-injury (OR, 3.1), whereas CPSY boys were diagnosed with anxiety (OR, 2.7) or conduct disorder (OR, 2.8). Based on our study, family-focused care and intervention services are required to prevent continuity of psychiatric disorders from childhood into adolescence.