bluuebunny/crossref_metadata_2025_split huggingface dataset:
III–3 Low-Intensity Pulsed Ultrasound (LIPUS) for the Treatment of Massive Osteonecrosis Following Carbon Ion Radiotherapy for Malignant Bone Tumor
Authors: Muramatsu Keiichi , Iwanaga Ryuta , Sakai Takashi 
Published: September 2019

Objective:
Carbon ion radiotherapy (CIR) can be applied for unresectable malignant bone tumors, especially arising from the pelvis and spine. The most serious adverse effect of CIR is a massive osteonecrosis of healthy bone surrounding the tumor. We applied LIPUS therapy in 2 cases and report here their clinical courses.

Materials and Methods:
Two cases with the pelvic sarcoma were treated by CIR. Thirteen year-old-male had a metastasis of osteosarcoma at the acetabulum. Seventy three year-old-male had a chondrosarcoma in the pubis, acetabulum and iliac bone.

Results:
Malignant tumors were controlled by CIR only and at present, we find no evidence of disease. Both cases complained of severe hip pain after CIR due to osteonecrosis of the acetabulum. Their pains were well improved at 1 month after LIPUS therapy. Destruction of the hip joint was not observed at the final follow-up.

Discussion:
Until now, positive effect of LIPUS have been reported on osteonecrosis of knee, hip joint and jaw bone. However, there have been, to our knowledge, no report on applying LIPUS for these difficult conditions. LIPUS therapy seems beneficial for pain relief and bone regeneration for massive osteonecrosis after CIR.
Neonatal Antifungal Consumption Is Dominated by Prophylactic Use; Outcomes From The Pediatric Antifungal Stewardship: Optimizing Antifungal Prescription Study
Authors: Ferreras-Antolín Laura , Irwin Adam , Atra Ayad , Dermirjian Alicia , Drysdale Simon B. , Emonts Marieke , McMaster Paddy , Paulus Stephane , Patel Sanjay , Kinsey Sally , Vergnano Stefania , Whittaker Elisabeth , Warris Adilia 
Published: September 2019

Background:
Diagnostic challenges combined with the vulnerability of neonates to develop invasive candidiasis (IC) may lead to antifungal administration in the absence of IC. A modified point-prevalence study was performed to obtain an improved insight and understanding of antifungal prescribing in this specific patient population.

Methods:
Neonates and infants ≤90 days of age receiving systemic antifungals from 12 centers in England were included. Data were collected prospectively during 26 consecutive weeks and entered into an online REDCap database.

Results:
Two hundred eighty neonates and infants were included, the majority ≤1 month of age (68.2%). Prematurity was the commonest underlying condition (68.9%). Antifungals were prescribed for prophylactic reason in 79.6%; of those, 64.6% and 76.3% were extreme low birth weight infants and prematurely born neonates, respectively. Additional risk factors were present in almost all patients, but only 44.7% had ≥3 risk factors rendering them more susceptible to develop IC. Nonpremature and non extremely low birth weight premature infants only scored ≥3 risk factors in 32.6% and 15%, respectively. Fluconazole was the most common antifungal used (76.7% of all prescriptions), and commonly underdosed as treatment. The number of microbiologic proven IC was low, 5.4%.

Conclusions:
Neonatal antifungal prophylaxis is commonly prescribed outside the recommendations based on known risk profiles. Fluconazole is the main antifungal prescribed in neonates and infants, with underdosing frequently observed when prescribed for treatment. Number of proven IC was very low. These observations should be taken into consideration to develop a national pediatric Antifungal Stewardship program aiming to guide rational prescribing.
Characteristics and practice patterns of advanced practice registered nurses caring for older adults: A survey of Gerontological Advanced Practice Nurses Association members
Authors: Clevenger Carolyn , Li Yin , Evans Katherine A. , Cacchione Pamela Z. 
Published: September 2019

ABSTRACT

Background:
Advanced practice registered nurses (APRNs) play a pivotal role in meeting the increasing needs of elder care given the aging population. A good understanding of the characteristics of gerontological APRNs is important for future workforce planning.

Purpose:
To understand the demographic, employment, and practice characteristics of APRNs who provide elder care.

Methods:
A 34-item survey was distributed to 2,500 current members of the Gerontological Advanced Practice Nurses Association. Three hundred and sixty-four members provided demographic information and employment and practice patterns. To examine the sample representativeness, the survey sample was compared with a sample drawn from the National Sample Survey of Nurse Practitioners 2012. Descriptive statistics were used for analysis.

Results:
Most respondents were older than 55 years, held a master's degree, were certified as a Gerontology APRN, worked in a long-term/elder care setting as an APRN, earned a salary ranging from $105,001 to $125,000, and practiced in urban or suburban areas. Most respondents worked full time, provided care for people who were 55 to 75 years old, and prescribed under a collaborative agreement.

Implications for practice:
The study results suggested that gerontological APRNs have the experience and competence to meet the increasing needs of elder care, practice in a variety of settings, including in rural areas, and spend much time with patients. Future efforts are needed to support APRN practice, such as improving their autonomy and independence.
Kuntai capsules improve glucolipid metabolism in patients with polycystic ovary syndrome
Authors: Liang Ruining , Liu Zhen , Li Peishuang , Fan Pei , Xu Ling , Sun Xueyan , Peng Jiahua , Peng Xuemei , Zhang Meinan 
Published: September 2019

Abstract

Background:
The aim of this study was to observe the effect and safety of Heyan Kuntai Capsule (HYKT) on glucose and lipid metabolism in patients with polycystic ovary syndrome (PCOS).

Methods:
Hundred patients with PCOS were randomly divided into HYKT group (n = 50) and placebo groups (n = 50) in which the individuals were treated with HYKT and its placebo continuously for 6 months. Meanwhile, all participants received health education (such as exercise and diet). The primary outcomes were serum sex hormone levels, a series of blood lipid, fasting and postprandial 2 hours blood glucose. Body mass index (BMI), waist–hip ratio (WHR), insulin, homeostatic model assessment of insulin resistance (HOMA-IR), and insulin-sensitive index (ISI) were also observed. In addition, adverse events were recorded to evaluate the drug safety.

Results:
After treatment, the BMI and WHR of all the patients were decreased. The fasting and postprandial 2 hours blood glucose levels were significantly declined when treated with HYKT, which were not observed in the placebo group. Similarly, serum sex hormones including luteinizing hormone (LH), LH/follicle-stimulating hormone (FSH), and testosterone were lowered after treated with HYKT instead of the placebo. Besides, blood lipids outcomes such as total cholesterol, triglyceride, and low-density lipoprotein cholesterol, as well as insulin and HOMA-IR were decreased with significance in HYKT group when compared with those in the placebo group, whereas high-density lipoprotein cholesterol and ISI increased obviously.

Conclusion:
HYKT showed the effect on ameliorating the glucose and lipid metabolism disorder and improving insulin resistance and increase insulin sensitivity of PCOS patients, which is similar to insulin sensitizing agent.
Reduction of intra-abdominal pain through transcranial direct current stimulation
Authors: Bayer Kian-Elias , Neeb Lars , Bayer Arian , Wiese Jakob Johann , Siegmund Britta , Prüß Magdalena Sarah 
Published: September 2019

Abstract

Background:
Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique to modulate cortical excitability and to induce neuronal plasticity. With a wide range of applications in neurological and psychiatric disorders, the efficiency of tDCS is also studied in the treatment of various pain conditions. Treatment with tDCS might accordingly provide pain relief for patients with acute or chronic pain and thus lead to an increase in quality of life. Moreover, applied as an adjunct therapy, tDCS can reduce help to reduce pain medication intake and accompanying adverse events. To this end, this review examines studies evaluating the efficacy of tDCS in pain relief in patients with intra-abdominal pain.

Methods:
A structured search of the PubMed medical database was carried out to identify possibly relevant studies. Studies were compared in terms of treatment characteristics, general conditions, and results. Jadad scale was applied for quality analyses.

Results:
Out of 289 articles that were found initially, 6 studies were identified that met eligibility criteria. Five out of 6 studies reported significant effects for pain reduction in different types of intra-abdominal pain.

Conclusions:
Results indicate that tDCS might be able to reduce intra-abdominal pain. However, more randomized-controlled trials with larger sample size are necessary to define clinically relevant effects as well as treatment characteristics such as duration of stimulation.
Nonoccupational post-exposure prophylaxis for HIV after sexual intercourse among women in Brazil: Risk profiles and predictors of loss to follow-up
Authors: Grangeiro Alexandre , Nascimento Maria Mônica Paulino do , Zucchi Eliana Miura , Ferraz Dulce , Escuder Maria Mercedes , Arruda Érico , Lotufo Denize , Munhoz Rosemeire , Couto Marcia Thereza 
Published: September 2019

Abstract
Access to antiretroviral-based HIV prevention has been marked by sex asymmetries, and its effectiveness has been compromised by low clinical follow-up rates. We investigated risk profiles of women who received nonoccupational post-exposure prophylaxis (nPEP), as well as the rates and predictive factors of loss to follow-up after nPEP initiation.
Retrospective study evaluating 501 women who received nPEP between 2014 and 2015 at 5 HIV centers (testing centers-VCT, outpatient clinics, and infectious diseases hospital). Risk profiles were drawn based on the characteristics of the women and their sexual partners, and then stratified by sociodemographic indicators and previous use of HIV prevention services. Loss to follow-up (LTFU) was defined as not presenting for follow-up visits or for HIV testing after nPEP initiation. Predictors of LTFU were analyzed by calculating adjusted prevalence ratios (aPRs).
Approximately 90% of women had sexual encounters that met the criteria established in the Brazilian guidelines for nPEP. Those who declared to be sex workers (26.5%) or drug users (19.2%) had the highest social vulnerability indicators. In contrast, women who had intercourse with casual partners of unknown HIV risk (42.7%) had higher education and less experience with previous HIV testing (89.3%) or nPEP use (98.6%). Of the women who received nPEP after sexual intercourse with stable partners, 75.8% had HIV-infected partners. LTFU rate was 72.8% and predictors included being Black (aPR = 1.15, 95% confidence interval [CI]: 1.03–1.30), using drugs/alcohol (aPR = 1.15, 95% CI: 1.01–1.32) and having received nPEP at an HIV outpatient clinic (aPR = 1.35, 95% CI: 1.20–1.51) or at an infectious diseases hospital (aPR = 1.37, 95% CI: 1.11–1.69) compared with a VCT. The risk of LTFU declined as age increased (aPR 41–59 years = 0.80, 95% CI: 0.68–0.96).
Most women who used nPEP had higher socioeconomic status and were not part of populations most affected by HIV. In contrast, factors that contribute to loss to follow-up were: having increased social vulnerability; increased vulnerability to HIV infection; and seeking nPEP at HIV treatment services as opposed to at a VCT.
The efficacy and safety of qiming granule in dry eye disease
Authors: Yang Maoyi , Hu Zhipeng , Yue Rensong , Yang Liangjun , Zhang Boxun , Chen Yuan 
Published: September 2019

Abstract

Background:
Dry eye disease is a common eye disease mainly manifests with eye fatigue, foreign body sensation, dry and astringent eyes and other symptoms. Growing evidence shows that qiming granule may have beneficial effects on the clinical treatment of dry eye disease. However, no systematic review and meta-analysis collate and assess these clinical evidences. The purpose of this study protocol is to provide a comprehensive and reliable evaluation of the clinical evidence of qiming granule in the treatment of DED.

Methods and analysis:
Three English database and 4 Chinese databases other sources will be searched. Two methodological trained researchers will read the title, abstract and full texts and independently select the qualified literature according to inclusion and exclusion criteria. After assessment of the risk of bias and data extraction, we will conduct meta-analyses for outcomes including central macular thickness, optimum corrected vision, overall effect rates and adverse effects. The heterogeneity of data will be investigated by Cochrane X2 and I

2
tests. We build 3 hypotheses for subgroup analysis according to the guidance for a credible subgroup effect: Disease status at baseline, duration of intervention, type of concomitant medication. Sensitivity analysis will be conducted to evaluate the stability of the results. Then publication bias assessment will be conducted by funnel plot analysis and Egger test. Finally, we will use the Grading of Recommendations Assessment, Development and Evaluate system to evaluate the quality of evidence.

Results:
The results of our research will be published in a peer-reviewed journal.

Conclusion:
Our study is the first meta-analysis to evaluate the clinical efficacy and safety of qiming granule in the treatment of DED. It will provide more options for clinical treatment of the disease.

PROSPERO registration number:
CRD42018109183.
Mucocele of the appendix presenting as an exacerbated chronic tubo-ovarian abscess
Authors: Cubro Hajrunisa , Cengic Vesna , Burina Nina , Kravic Zlatko , Beciragic Esad , Vranic Semir 
Published: September 2019

Abstract

Rationale:
Appendiceal mucocele is a rare entity of mucinous cystic dilatation of the appendix. It has no typical clinical presentation and is considered a potentially premalignant condition.

Patient concerns:
We present a case of accidental intraoperative finding of an appendiceal mucocele in a 54-year old woman that clinically presented with an exacerbated chronic tubo-ovarian abscess.

Diagnoses:
Trans-vaginal ultrasonography showed an encapsulated, oval, unilocular mass above the uterus with a heteroechogenic structure, homogeneous fluid content, and smooth regular walls without inner proliferation. The histopathologic diagnosis was consistent with an appendiceal cystadenoma.

Interventions:
The patient underwent a simple appendectomy.

Outcomes:
There were no clinical, biochemical or imaging signs of the disease recurrence at 6 months follow up.

Lessons:
To our knowledge, this is the only well-documented case of appendiceal mucocele mimicking exacerbated chronic tubo-ovarian abscess reported in the literature. Awareness of a rare entity such as an appendiceal mucocele, which is frequently misdiagnosed as a potential cause of acute abdomen, is necessary for the appropriate management strategy in order to prevent complications.
Expression and clinical significance of latent-transforming growth factor beta-binding protein 2 in primary hepatocellular carcinoma
Authors: Chen Jinchun , Gao Guosheng , Wang Hui , Ye Xingtao , Zhou Jun , Lin Jianjun 
Published: September 2019

Abstract
The present study aimed to explore the expression of latent transforming growth factor β binding protein 2 (LTBP2) in patients with hepatocellular carcinoma (HCC) and their correlation to clinicopathologial features.
Serum levels of LTBP2 in 60 patients with HCC, 35 patients with hepatocellular benign tumors, 60 patients with precancerous lesions of HCC, and 60 healthy volunteers were determined by enzyme-linked immunosorbent assay. The expression levels of LTBP2 at messenger RNA (mRNA) and protein levels in 60 cases of HCC and adjacent tissues were detected by quantitative real-time polymerase chain reaction and immunohisochemistry. Statistical analysis was used to analyze the relationship between LTBP2 and clinical characteristics of patients with HCC.
The mRNA and protein levels of LTBP2 were significantly upregulated in HCC tissues compared to adjacent tissues. Additionally, higher serum LTBP2 level was also observed in HCC patients relative to normal controls. Further investigation demonstrated that LTBP2 expression was associated with malignant degree of tumor, tumor progression, tumor differentiation, tumor size, tumor stage and hepatitis virus infection, and has prognostic implications in HCC patients.
LTBP2 might be served as a potential biomarker in diagnosis and treatment of HCC.
Endobronchial ultrasound-guided transbronchial needle aspiration versus mediastinoscopy for mediastinal staging of lung cancer
Authors: Steinhauser Motta João Pedro , Lapa e Silva José Roberto , Samary Lobato Caroliny , Mendonça Vanessa Souza , Steffen Ricardo E. 
Published: September 2019

Abstract

Background:
Lung cancer is a major health problem, with estimates of 1.6 million tumor-related deaths annually worldwide. The emergence of endobronchial ultrasound (EBUS), a minimally invasive procedure capable of providing valuable information for primary tumor diagnosis and mediastinal staging, significantly changed the approach of pulmonary cancer, becoming part of the routine mediastinal evaluation of lung cancer in developed countries. Some economic evaluation studies published in the last 10 years have already analyzed the incorporation of the EBUS technique in different health systems. The aim of this systematic review is to synthesize the relevant information brought by these studies to better understand the economic effect of the implementation of this staging tool.

Methods:
The systematic review will be reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guidelines. Eletronic databases (Medline, Lilacs, Embase, Cochrane Library of Trials, Web of Science, Scopus, National Health System Economic Evaluation Database) will be searched for full economic analyses regarding the use of EBUS-guided transbronchial needle aspiration (EBUS-TBNA) compared to the surgical technique of mediastinoscopy for the mediastinal staging of lung cancer. Two authors will perform the selection of studies, data extraction, and the assessment of risk of bias. Occasionally, a senior reviewer will participate, if necessary, on study selection or data extraction.

Results:
Results will be published in a peer-reviewed journal.

Conclusion:
This review may influence a more cost-effective mediastinal staging approach for patients with lung cancer around the world and help health decision makers decide whether the EBUS-TBNA technique should be incorporated into their health systems and how to do it efficiently.

Protocol Registry:
PROSPERO 42019107901.
Diagnostic accuracy of digital X-ray radiogrammetry on hand bone loss for patients with rheumatoid arthritis
Authors: An Hong-Jian , Zhang Jun 
Published: September 2019

Abstract

Background:
This study will aim to evaluate the diagnostic accuracy of digital X-ray radiogrammetry (DXR) on hand bone loss (HBL) for rheumatoid arthritis (RA).

Methods:
In this study, we will search the literature from PubMed, EMBASE, Cochrane Library, PsycINFO, Web of Science, Google Scholar, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine Database, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, and WANFANG from the inception to June 1, 2019 without language restrictions. All case–controlled studies on assessing diagnostic accuracy of DXR on HBL for diagnosis of RA will be included. Quality Assessment of Diagnostic Accuracy Studies tool will be used for eligible studies. We will apply RevMan V.5.3 software and Stata V.12.0 software for statistical analysis.

Results:
We will evaluate diagnostic accuracy of DXR on HBL in patients with RA by assessing the sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio.

Conclusion:
This study will detect the diagnostic accuracy of DXR evaluation on HBL in patients with RA.

Systematic review registration:
PROSPERO CRD42019139489.
Efficacy and safety of lactulose for the treatment of irritable bowel syndrome
Authors: Chen Hong-Bin , Su Xiao-Ying 
Published: September 2019

Abstract

Background:
In this study, investigators will evaluate the efficacy and safety of lactulose for the treatment of irritable bowel syndrome (IBS).

Methods:
Literature search for relevant studies up to present will be conducted in MEDICINE, EMBASE, Google Scholar, Web of Science, Cochrane Library, Wangfang, Allied and Complementary Medicine Database, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure. The included studies are randomized controlled trials of lactulose in patients with IBS. We will use RevMan 5.3 software using statistical analysis.

Results:
This study will provide a high-quality integration of current evidence of lactulose for treating IBS on several aspects including global IBS symptoms, abdominal pain, defecation urgency, stool frequency, stool consistency, quality of life, and adverse events.

Conclusions:
This study will provide the evidence for the clinical efficacy and safety of lactulose for the treatment of IBS.

PROSPERO registration number:
PROSPERO CRD42019140639.
Circulating miR-21 levels in hypertensive patients with asymptomatic organ damage
Authors: Yildirim Erkan , Ermis Emrah , Allahverdiyev Samir , Ucar Hakan , Yavuzer Serap , Cengiz Mahir 
Published: September 2019

Abstract
As a modifiable risk factor for cardiovascular disease, presence of hypertension (HT) necessitates the awareness of asymptomatic organ damage (AOD). The aim of this study was to measure plasma micro RNA-21 (miR-21) and the parameters that reflect AOD such as carotid intima-media thickness (CIMT), microalbuminuria (MAU) in hypertensive patients compared with healthy controls. In addition, the aim of this study was to evaluate plasma miR-21 levels in HT patients with AOD.
This study was designed as a cross-sectional observational study. The study includes 2 groups: 32 patients with HT and 32 healthy controls. First, we compared these 2 groups. Then, to underline the relationship between plasma miR-21 and HT, hypertensive patients were divided into 2 groups: with AOD and without AOD.
Sixteen patients with HT had AOD. MiR-21 levels significantly correlated with clinical systolic and diastolic blood pressure, MAU, C-reactive protein, and CIMT. CIMT, miR-21, and MAU levels were significantly higher in patients with AOD.
Our study showed increased miR-21 levels in HT patients with AOD.