bluuebunny/crossref_metadata_2025_split huggingface dataset:
Extreme intraocular pressure and steroid-dependent iritis
Authors: Samuelson Thomas W. , Huang Marshall J. , Larsen Christine L. , Sheybani Arsham , Levin Ariana , Ertel Monica , Pantcheva Mina , Panarelli Joseph F. , Do Anna 
Published: December 2022

A 50-year-old ophthalmic technician was referred by her retina specialist for urgent consultation due to markedly elevated intraocular pressure (IOP) unresponsive to medical therapy. Her history included chronic polyarticular juvenile rheumatoid arthritis and chronic uveitis requiring ongoing topical steroid therapy. She had a sub-Tenon injection of Kenalog (triamcinolone) 18 months prior to referral. Chronic topical anti-inflammatory therapy included nepafenac (Ilevro) and prednisolone acetate 2 times a day. Attempts to discontinue topical steroid resulted in worsening inflammation. The patient was referred when the IOP measured 44 mm Hg in the left eye despite aggressive medical therapy, including acetazolamide. The IOP improved slightly when loteprednol was substituted for prednisolone acetate.
Current medications in the left eye include brimonidine 3 times a day, loteprednol 2 times a day, nepafenac 2 times a day, and fixed combination latanoprost + netarsudil at bedtime. Her only medication in the right eye was travoprost. She is intolerant to dorzolamide. She was also taking acetazolamide 500 mg 2 times a day. She was not taking any anticoagulants. Past surgical history included cataract surgery in each eye. She has not had laser trabeculoplasty in either eye.
Examination revealed uncorrected visual acuity of J1+ in the right eye (near) and 20/30 in the left eye (mini-monovision). There was no afferent pupillary defect. There was mild band keratopathy in each eye while the central cornea was clear in both eyes without keratic precipitates. Here angles were open to gonioscopy without peripheral anterior synechia. There was mild to moderate flare in each eye with trace cells. The IOP was 17 mm Hg in the right eye and 31 mm Hg in the left. Central corneal thickness measured 560 μm and 559 μm in the right and left eye respectively. There was a well-positioned intraocular lens within each capsule with a patent posterior capsulotomy. There was mild vitreous syneresis but no vitreous cell. The cup to disc ratio was 0.5 in each eye with a symmetrical neural rim. The retina was flat without macular edema. Visual field was normal in both eyes (Figures 1 and 2). Optical coherence tomography of retinal nerve fiber layer (RNFL) is shown in Figure 3 and retinal ganglion cell layer is shown in Supplemental Figure 1 (http://links.lww.com/JRS/A756).

JOURNAL/jcrs/04.03/02158034-202301000-00020/figure1/v/2023-08-19T002647Z/r/image-tiff

JOURNAL/jcrs/04.03/02158034-202301000-00020/figure2/v/2023-08-19T002647Z/r/image-tiff

JOURNAL/jcrs/04.03/02158034-202301000-00020/figure3/v/2023-08-19T002647Z/r/image-tiff

Please comment on your management of this patient's left eye.
Current insights into skin lipids and their roles in cutaneous health and disease
Authors: Nicolaou Anna , Kendall Alexandra C. 
Published: December 2022

Purpose of review
The unique and complex array of cutaneous lipids include essential components of the skin structure and signalling molecules mediating homeostasis and inflammation. Understanding skin lipid biology and metabolism can support our comprehension of health and disease, including systemic conditions with cutaneous involvement.

Recent findings
Lipids found on the skin surface, produced by both the host and resident microbes, maintain and regulate the skin microbiome and the epidermal barrier, whilst altered contributions from either source can be detrimental to skin health. The unique lipid composition of the epidermal barrier is essential for its function, and recent studies have expanded our understanding of epidermal ceramide production. This has been supported by improved models available for skin research, including organotypic skin models enabling in-vitro production of complex acylceramides for the first time, and model systems facilitating in-silico exploration of the lipid profile changes observed in clinical samples. Studies have revealed further involvement of lipid mediators such as eicosanoids in cutaneous inflammation, as well as immune regulation in both healthy and diseased skin.

Summary
Skin lipids offer exciting opportunities as therapeutic targets for many conditions, whether through topical interventions or nutritional supplementation.
A rare case report of iatrogenic Cushing syndrome caused by direct anti-hepatitis C virus therapy with sofosbuvir/velpatasvir
Authors: Ma Bo , Shang Tianling , Huang Jianjie , Tu Zhixin , Wang Yan , Han Yujin , Wang Yang , Wen Xiaoyu , Jin Qinglong 
Published: December 2022

Rationale:
Sofosbuvir/velpatasvir (SOF/VEL) is a combination of direct-acting antivirals with pan-genotypic activity that is used to treat chronic hepatitis C virus infection. This was a fixed-dose regimen. SOF is a nucleotide nonstructural 5B polymerase inhibitor and VEL is an nonstructural 5A inhibitor. Side effects of this agent on the endocrine system, particularly iatrogenic Cushing syndrome (ICS), are uncommon. Here, we present a case of ICS with significantly low serum adrenocorticotropic hormone and cortisol levels caused by SOF/VEL.

Patient concerns:
A 49-year-old Asian woman with chronic hepatitis C and cirrhosis presented with a round face, fat thickening at the clavicle and back of the neck, mild facial edema, facial congestion, skin ulceration on the hands, central obesity, acne, and general status changes after 3 months of treatment with SOF/VEL (400 mg/dose, 1/day).

Diagnoses:
The patient’s serum adrenocorticotropic hormone and cortisol levels dropped significantly, and her normal rhythm vanished, with no visible aberrant lesions on computed tomography or across the abdomen. The patient was diagnosed with ICS.

Outcomes:
Symptoms improved after withdrawing SOF/VEL and taking low-dose oral hydrocortisone. Thus, the SOF/VEL was suspected to be an offender. To our knowledge, this is the first time that SOF/VEL has been linked to ICS.

Lessons:
Hepatologists and primary care physicians treating hepatitis C virus should be more aware of this uncommon adverse event so that direct-acting antiviral therapy can be stopped sooner if it recurs. The findings of this study emphasize the importance of collaboration between hepatologists and endocrinologists in co-management of complications.
The feasibility and efficacy of a community-based multifactorial intervention to improve the cardiovascular risk factor control among patients with type 2 diabetes: A 2-year cluster randomized trial
Authors: Zhao Wenhui , Wang Yanlei , Cao Chenxiang , Zeng Ziqiang , Jin Lixia , Liu Zhaoxiang , Duan Min , Dong Yanan , Zhang Jinpin , Shuai Ying , Wang Na , Zhang Yajing , Deng Guixia , He Jiquan , Zhao Xinghua , Zheng Wenli , Yang Wenying , Xiao Jianzhong 
Published: December 2022

Trial design:
Our study is to investigate the feasibility and effectiveness of multiple cardiovascular factors intervention (MFI) in type 2 diabetes patients in China’s primary care setting.

Methods:
We performed a cluster randomized trial to compare the proportion of patients achieved the targets between usual care group (control, 9 sites, n = 868) and MFI group (8 sites, n = 739) among patients with type 2 diabetes in primary care setting. Logistic regression model with random effects was used to estimate the association of the effect of intervention and the proportion achieved the targets.

Results:
At baseline, the end of 1 year, and 2 years follow-up, the proportion of patients achieved all 3 target goals (HbA1c < 7.0%, blood pressure < 130/80 mm Hg and low-density lipoprotein cholesterol < 2.6 mmol/L) were 5.7%, 5.9%, 5.7% in the control group and 5.9%, 10.6%, 12.3% in the MFI group. After adjusting sex, age, diabetes duration, body mass index, HbA1c, blood pressure, and low-density lipoprotein cholesterol at baseline, there was no difference between the 2 groups (OR (95% CI): 1.27 (0.38–4.27) and 1.86 (0.79–4.38) for the first year and second year, respectively). When stratified by payment method, the patients with medical insurance or public expenses had a higher proportion achieved target goals (6.9% vs 16.4%, OR (95% CI): 2.30 (1.04–5.08)) in the second year.

Conclusions:
The controlling of cardiovascular risk factor targets remains suboptimal among patients with type 2 diabetes in primary care setting. MFI in type 2 diabetes improved cardiovascular disease risk profile, especially in the patients with medical insurance.
Adherence to hypertension and dyslipidemia treatment and its implication on control of cardiovascular disease in Vietnam: A semi-systematic review
Authors: Hung Pham Manh , Thanh Vu Huy , Sy Hoang Van , Duc Dang Quy , Tuan Vuong Anh , Tran Anh T Q , Brizuela Grace E , Tran Hieu B 
Published: December 2022

Background:
To understand the prevalent issues and challenges in the provision of care for dyslipidemia and hypertension in Vietnamese adults, quantification of patient journey stages (awareness, screening, diagnosis, treatment, adherence, and control) was performed in this semi-systematic review.

Methods:
The EMBASE and MEDLINE databases were searched for English articles published between 2010 and 2019. Thesis abstracts, letters to the editor, editorials, case studies, and studies on patient subgroups or nationally unrepresentative studies, were excluded. Articles from Google, the Incidence and Prevalence Database, the World Health Organization, Vietnam’s Ministry of Health, and those suggested by the authors were also included. The last search was run on December 10, 2019 for dyslipidemia and hypertension.

Results:
A reviewer independently screened 586 retrievals for dyslipidemia and 177 retrievals for hypertension, and extracted data from 2 articles on dyslipidemia and 6 articles on hypertension that were included in the final synthesis.

Conclusion:
The data generated in this review will help overcome these issues and barriers to patient care in populations with these 2 conditions.
Effectiveness and safety of acupuncture combined with hot compress in the treatment of obese adolescents with insulin resistance: A protocol for systematic review and meta-analysis
Authors: Gang Xiaochao , Tai Yuxing , Xiao Zhenxiang , Jiang Xiaobo , Barat Dilnur , Gao Tianjiao , Han Yiran , Liu Jie , Zhong Chongwen , Chen Shaotao , Liu Mingjun 
Published: December 2022

Background:
In recent years, the incidence of obesity patients has become younger and younger, and adolescents are gradually becoming one of the groups with a high incidence of obesity. Although several systematic reviews and clinical trials suggest that acupuncture and warm compresses may be effective in the treatment of obesity, the effectiveness and safety of acupuncture combined with warm compresses in the treatment of obesity insulin resistance (IR) in adolescents have not been systematically reviewed.

Methods:
The search language of this study is Chinese and English, and the data of Medline, PubMed, Embase, Cochrane Web of Science, China Biomedical Literature Database, Central Controlled Trial Registration Center, and China Scientific Journal Database were searched for this study respectively, from the date of creation of the above data to December 2022. Randomized controlled trials of acupuncture combined with warm compresses in adolescents with obese IR were included in this review. Main outcome measures were body mass index, waist circumference, hip circumference, waist-hip ratio, fasting blood glucose, glycosylated hemoglobin, IR index, body fat content, blood lipid level and blood pressure, etc. In addition, we manually retrieved other resources, including reference lists of identified publications, conference articles and gray literature.

Results:
This study will provide more clinical treatment ideas and options for adolescent obese IR patients.

Conclusion:
The purpose of this study is to summarize and evaluate the efficacy and safety of acupuncture combined with hot compress in treating obesity IR in adolescents from clinical trials.
Efficacy and safety of Yiqi Huoxue Yangxin decoction combined with western medicine in patients with chronic coronary heart disease: A protocol for systematic review and meta-analysis
Authors: Xie Bingxin , Wu Bao , Zhao Mingzhang , Liu Yili , Xu Guolei , Li Qiao 
Published: December 2022

Background:
There is no evidence-based data to confirm the efficacy of Yiqi Huoxue Yangxin Decoction combined with Western medicine in patients with coronary heart disease (CHD). Therefore, in order to provide new medical evidence for clinical treatment, we used this protocol to conduct a systematic review and meta-analysis on the effectiveness and safety of Yiqi Huoxue Yangxin Decoction combined with Western medicine in patients with CHD.

Methods:
The systematic review protocol is registered in PROSPERO under registration number CRD42022372800. The systematic literature review will follow PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). The following search terms will be used in PUBMED, Scopus, EMBASE, Cochrane Library, CNKI, Wan Fang, and VIP on December 1, 2022. Two independent authors extract the following descriptive raw information from selected studies: study characteristics such as authors, year of publication, study design; patient demographic information such as number of patients, mean age, body mass index, and sex ratio. The primary outcome of interest is symptom scores. Secondary outcomes include ECG effective rate, improvement of blood lipid index, and adverse events. The Cochrane Bias Risk Tool is used independently by 2 reviewers to assess the risk of bias in included randomized controlled trials. The quality of retrospective studies will be assessed using the Newcastle-Ottawa scale.

Conclusions:
The results of our review will be reported strictly following the PRISMA criteria and the review will add to the existing literature by showing compelling evidence and improved guidance in clinic settings.
Sessile serrated lesion presenting as large pedunculated polyp in the rectum: A case report
Authors: Oh Shin Ju , Kim Jung-Wook , Oh Chi Hyuk 
Published: December 2022

Rationale:
Sessile serrated lesions (SSLs) are serrated polyps (SP) with the typical serrated architecture of the crypt lining epithelium. SSL has an important clinical implication because they are recognized as precursor lesion of sporadic colorectal cancer (CRC) through “serrated pathway.” SSLs usually appear flat to sessile, and are located in the right colon.

Patient concerns:
A 69-year-old man was referred to a tertiary medical center because of intermittent hematochezia for 2 years.

Diagnosis:
Colonoscopy revealed a large, pedunculated polyp in the rectum. The polyp surface was slightly reddish in color and the elongated stalk was covered with almost normal mucosa. Histopathological examination of the resected specimens revealed the typical features of SSL with low-grade dysplasia.

Intervention:
Endoscopic mucosal resection using a detachable snare was performed on the tumor for definite diagnosis and treatment.

Outcomes:
There was no evidence of immediate or delayed bleeding after endoscopic mucosal resection, and the hemoglobin level normalized after a 1-year follow-up.

Lessons:
We report a rare case of a large pedunculated polyp with typical histological features of SSLs in the rectum. Endoscopists should always consider SSLs at any location even with unusual morphological findings.
Efficacy of intense pulsed light and meibomian gland expression treatments in meibomian gland dysfunction: A meta-analysis of randomized controlled trials
Authors: Liu Chao , Zhou Qi , Gao Zi-Qing 
Published: December 2022

Purpose:
This review aimed to evaluate the efficacy and safety of intense pulsed light treatment combined with meibomian gland expression treatments in meibomian gland dysfunction.

Methods:
We conducted a meta-analysis of randomized controlled trials that compared the efficacy of intense pulsed light treatment and meibomian gland expression treatments in the treatment of dry eye disease. The meibomian gland yielding secretion score was the primary outcome, whereas the secondary outcomes included the Meiboscore, tear breakup time in seconds, standard patient evaluation for eye dryness and corneal fluorescein staining.

Results:
This study consisted of 6 trials with 326 patients. Significantly greater improvement was observed in meibomian gland yielding secretion score at 1 month [mean difference (MD): 13.69 (95% CI, 11.98, 15.40)] and at 3 months [MD: 11.03 (95% confidence interval (CI), 10.27, 11.80)], low meibomian gland yielding secretion score at 1 month [MD: 6.92 (95% CI, 5.49, 8.34)] and at 3 months [MD: 6.80 (95% CI, 5.01, 8.59)], up meibomian gland yielding secretion score at 1 month [MD: 6.41 (95% CI, 4.12, 8.70)] and at 3 months [MD: 8.06 (95% CI, 5.70, 10.42)] and tear breakup time at 1 month [MD: 2.38 (95% CI, 1.83, 2.92)] and at 3 months [MD: 1.82 (95% CI, 1.48, 2.19)] in the IPL-MGX group than in the MGX group.

Conclusions:
IPL-MGX is safer and more efficacious as compared to the MGX alone in the treatment of patients with meibomian gland dysfunction-related dry eye. We recommend discussing the decision with the ophthalmologist for an appropriate choice.
Establishment of a prognostic prediction system based on tumor microenvironment of pancreatic cancer
Authors: Feng Yan , Li Pengcheng , Yang Fang , Xu Ke 
Published: December 2022

Background:
Pancreatic cancer (PC) is an inflammatory tumor. Tumor microenvironment (TME) plays an important role in the development of PC. This study aims to explore hub genes of TME and establish a prognostic prediction system for PC.

Methods:
High throughput RNA-sequencing and clinical data of PC were downloaded from The Cancer Genome Atlas and International Cancer Genome Consortium database, respectively. PC patients were divided into high- and low-score group by using stromal, immune scores system based on ESTIMATE. Differentially expressed genes between high- and low-score patients were screened and survival-related differentially expressed genes were identified as candidate genes by univariate Cox regression analysis. Final variables for establishment of the prognostic prediction system were determined by LASSO analysis and multivariate Cox regression analysis. The predictive power of the prognostic system was evaluated by internal and external validation.

Results:
A total of 210 candidate genes were identified by stromal, immune scores system, and survival analyses. Finally, the prognostic risk score system was constructed by the following genes: FAM57B, HTRA3, CXCL10, GABRP, SPRR1B, FAM83A, and LY6D. In process of internal validation, Harrell concordance index (C-index) of this prognostic risk score system was 0.73, and the area under the receiver operating characteristic curve value of 1-year, 2-year, and 3-year overall survival period was 0.67, 0.76 and 0.86, respectively. In the external validation set, the survival prediction C-index was 0.71, and the area under the curve was 0.81, 0.72, and 0.78 at 1-year, 2-year, and 3-year, respectively.

Conclusion:
This prognostic risk score system based on TME demonstrated a good predictive capacity to the prognosis of PC. It may provide information for the treatment strategy and follow-up for patients with PC.
Complementary and alternative therapies for generalized anxiety disorder: A protocol for systematic review and network meta-analysis
Authors: Song Kai , Wang Yating , Shen Li , Wang Jinwei , Zhang Rong 
Published: December 2022

Background:
Generalized anxiety disorder (GAD) is a prevalent and impairing psychiatric disorder, which is a great threat to people’s mental health, and imposes a major burden on individuals, families and society. Complementary and alternative medicine (CAM) therapies is a potential treatment for GAD, however, the selection strategies of different CAM therapies in clinical practice is still unclear, and the purpose of this study is to evaluate the efficacy and acceptability of different CAM interventions using systematic review and network meta-analysis (NMA).

Methods:
Based on the strategy, the authors will retrieve a total of 9 electronic databases by January 2023. After a series of screening, the 2 researchers will use Aggregate Data Drug Information System (ADDIS) and Stata software to analyze the data extracted from randomized controlled trials (RCTs) of CAM therapies for the GAD. Finally, the evidence grade of the results will be evaluated.

Results:
This study will provide a reliable evidence for the selection of CAM therapies for GAD.

Conclusion:
The results of this study will provide references for evaluating the influence of different CAM therapies for GAD, and provide a choice basis for clinical decision-making.
Multiple recurrent aneurysms with angiitis of the central nervous system in a girl: A case report
Authors: Wen Jiayu , Ye Shengda , Yang Bin , Liu Xi , Chen JinCao 
Published: December 2022

Introduction:
Primary central nervous system (CNS) vasculitis is a rare immune inflammatory disease confined to the blood vessels of the brain and spinal cord. The total number reported in the world is about 500[1]. Most are negative in cerebral angiography or vascular stenosis and only 1 case of aortic aneurysms reported.

Patient concerns:
A 12-year-old female experienced sudden headache and vomiting. Previous findings of vascular stenosis. Diagnosed as a ruptured aneurysm bleeding. The aneurysm recurred a short time after treatment.

Diagnosis:
Multiple recurrent aneurysms with angiitis of the central nervous system

Interventions:
The patient underwent 2 aneurysm clipping operations, both of which completely clipped the aneurysm.

Outcomes:
The patient recovered well after surgery. Three months after discharge, DSA reexamination in our hospital showed that the aneurysm was completely clipped without recurrence.

Conclusion:
Subarachnoid hemorrhage after acute cerebral infarction is rare. In addition, the patient had recurrent aneurysms after the first aneurysm clipping, which emphasized the importance of postoperative drug therapy and blood pressure control.