bluuebunny/crossref_metadata_2025_split huggingface dataset:
Optimal duration of antiviral treatment in patients with gastrointestinal cytomegalovirus disease at a low and high risk of relapse
Authors: Jung Kyung Hwa , Jung Jiwon , Kim Min Jae , Chong Yong Pil , Lee Sang-Oh , Choi Sang-Ho , Kim Yang Soo , Kim Sung-Han 
Published: January 2022

Abstract
We evaluated the association between antiviral treatment duration and relapse of gastrointestinal (GI) cytomegalovirus (CMV) disease by analyzing the risk factors for relapse.
Patients who were diagnosed with GI CMV disease at a tertiary hospital from January 2008 to April 2019 were retrospectively enrolled. Patients with relapsed disease were those with a recurrence of GI CMV disease at least 4 weeks after the initial antiviral treatment.
Of 238 participants, including 145 (51.9%) with upper and 93 (48.1%) with lower GI CMV diseases, 27 (11.3%) had experienced relapses. The difference in antiviral treatment duration between the relapsed and nonrelapsed GI CMV groups was not significant (median days, 21.0 vs 17.0, P = .13). Multivariate analysis revealed that hematologic malignancy (odds ratio, 3.73; P = .026) and ulcerative colitis (odds ratio, 4.61; P = .003) were independent risk factors for relapse. Participants with at least one of these risk factors and those with no independent risk factors were classified under the high- (relapse rate, 25.9%) and low-risk of relapse groups (relapse rate, 6.7%), respectively. Accordingly, we further stratified 180 (75.6%) and 58 (24.4%) participants under the low- and high-risk of relapse groups, respectively. There was no significant difference in relapse rates between the high- and low-risk groups according to antiviral treatment duration.
Approximately 10% of the participants experienced relapses after antiviral treatment, with hematologic malignancy and ulcerative colitis featuring as risk factors. Therefore, prolonged antiviral treatment might not be helpful in preventing GI CMV disease relapse.
Change in metabolic parameters and reproductive hormones from baseline to 6-month hormone therapy
Authors: Qi Tongyun , Wang Xueqing , Huang Yizhou , Song Yang , Ma Linjuan , Ying Qian , Chatooah Namratta Devi , Lan Yibin , Chen Peiqiong , Xu Wenxian , Chu Ketan , Ruan Fei , Zhou Jianhong 
Published: January 2022

Abstract
Adequate evidence showed hormone therapy (HT) reduces the risk of new-onset diabetes in midlife women by decreasing fasting glucose and insulin. However, the improvement of these diabetic biomarkers varied with each individual in clinical observations. The objective of our study was to investigate potential baseline factors associated with the change of fasting glucose and insulin during HT.
A retrospective cohort study was performed among 263 midlife participants aged 40 to 60 years with menopausal symptoms who have received 6-month individualized HT. Demographic information and laboratory indicators including reproductive hormone, lipid profiles, diabetic indicators were collected and measured at baseline and were followed-up. A series of statistical analyses were performed to confirm the effectiveness of HT and compare the baseline factors between participants with different glycemic or insulinemic response. Multivariable linear regression model with stepwise variable selection was further used to identify the associated factor with the change of fasting glucose and insulin.
Of all participants, fasting glucose (P = .001) and fasting insulin (P < .001) were significantly decreased after individualized HT. Significant differences in baseline reproductive hormones were observed in participants with different glycemic response to HT (P < .001 for both follicle stimulating hormone [FSH] and estradiol). Stepwise linear regression model showed that in addition to baseline fasting glucose levels, baseline FSH was also independently associated with the change of fasting glucose (β = −0.145, P = .019 for baseline FSH) but not fasting insulin. Greater reduction in fasting glucose in women with higher FSH levels was observed even though they have already been in better metabolic conditions (P = .037).
Midlife women with higher baseline FSH levels have greater reduction in fasting glucose but not fasting insulin. FSH could be an independent predictor of glycemic response to HT in peri- and postmenopausal women.
Characteristics of peripheral blood Gamma-glutamyl transferase in different liver diseases
Authors: Xing Mindan , Gao Min , Li Jia , Han Ping , Mei Ling , Zhao Lili 
Published: January 2022

Abstract
Gamma-glutamyl transferase (GGT) is a marker of oxidative stress and cholestasis. Because of its low specificity, clinicians usually ignore its diagnostic value.
To compare and analyze the clinical features of GGT in primary biliary cholangitis (PBC), drug-induced liver injury (DILI), alcoholic liver disease (ALD), and non-alcoholic fatty liver disease (NAFLD) from the perspective of different causes instead of the severity of the disease.
We observed the distribution characteristics and the rate of abnormality of GGT in the above 4 diseases. The relationship between GGT and alanine aminotransferase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP), total serum bilirubin, triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol, high-density lipoprotein cholesterol was analyzed using Spearman correlation.
The highest level of GGT was up to 1000.00 to 2000.00 U/L in PBC and DILI, and the highest level of GGT was more than 2000.00 U/L in ALD, yet the difference was not statistically significant (P > .05). The highest level of GGT was only about 200.00 U/L in NAFLD and was the lowest in 4 liver diseases. Also, GGT was positively correlated with ALP, TC in PBC and DILI. Also, in ALD, GGT was positively correlated with ALT, AST, ALP, TG, and TC. In NAFLD, GGT was positively correlated with ALT, AST, and TG.
The abnormal GGT in PBC and cholestasis DILI was associated with cholestasis; in ALD, it was associated with oxidative stress and cholestasis, and in NAFLD, it was associated with oxidative stress. GGT levels had different characteristics in different liver diseases, which were closely related to the pathogenesis of liver diseases.
Anesthetic management of ventricular-peritoneal shunt implantation in osteogenesis imperfecta type IIB
Authors: To Mayumi , Kamizato Kota , Shinzato Hayato , Kakinohana Manabu 
Published: January 2022

Abstract

Introduction:
Osteogenesis imperfecta (OI), a rare congenital disorder, has a risk of bone fracture and progressive bone deformity. OI type II is the most serious subtype, and very few reports on its anesthetic management exist. Patients face several anesthetic difficulties, of which easy fracturing of OI-affected bones is critical. Herein, we report our experience with the anesthetic management of a patient with OI type II.

Patient concerns and diagnoses:
Through genetic testing, a 14-month-old girl (height: 45 cm, weight: 3.9 kg) was diagnosed with OI type IIB due to COL1A gene abnormality. The clinical manifestations included hydrocephalus, blue sclera, dental dysplasia, short stature, limb deformity and shortening, thoracic hypoplasia, rabbit eye, left inguinal hernia, and tricuspid valve regurgitation. Physical examination revealed an enlarged head due to skull dysplasia and hydrocephalus. The pediatrician confirmed that mask ventilation was possible even under spontaneous breathing, and that there was no history of bone fracture during mask holding.

Interventions and outcomes:
The patient was scheduled for gastrostomy and ventriculo-peritoneal shunt implantation. An arterial pressure line was inserted at the neonatal intensive care unit. Propofol and remifentanil were selected for general anesthesia. Confirming that mask-assisted ventilation was possible under sleep, rocuronium was administered. Attentive mask ventilation was performed via the 2-person method to avoid fractures. We were able to intubate successfully using a Macintosh laryngoscope. A microcuff endotracheal tube was used. For ventilation, pressure control ventilation was selected and sedative dosage was adjusted using the patient state index as an indicator. The patient was sedated, intubated, and returned to the neonatal intensive care unit. She was extubated on the sixth postoperative day. No bone fractures were noted.

Conclusion:
OI type II is the most severe subtype with high mortality, and there are few reports on its anesthetic management. Easy fractures can be a problem in airway maintenance, blood pressure measurement, and repositioning. We performed the procedure attentively, avoiding jaw and cervical fractures during mask ventilation and endotracheal intubation. For respiratory management, we chose pressure control ventilation using a cuffed tracheal tube and circulatory control was attained via an arterial line inserted preoperatively. No complications occurred.
Ultrasound evaluation of diaphragm motion in BAG-3 myofibrillar myopathy
Authors: Zhan Liqiong , Lv Lan , Chen Xinyuan , Xu Xiang , Ni Jun 
Published: January 2022

Abstract

Rationale:
Mutations in Bcl-2-associated athanogene-3 (BAG-3) can cause a rare subtype of myofibrillar myopathies (MFMs), characterized by progressive muscle weakness, cardiomyopathy, and severe respiratory insufficiency in childhood. Little is known about diaphragmatic function in BAG-3 MFM. To our knowledge, this is the first case report of detailed evaluation of diaphragmatic function with ultrasound in BAG-3 MFM.

Patient concern:
We describe the case of a 15-year-old girl who complained of fever and shortness of breath. Diaphragmatic sonography revealed bilateral diaphragmatic paralysis. Shortness of breath progressed to respiratory failure approximately 3 months later.

Diagnosis:
A neurologist was consulted and genetic sequencing identified a p.Pro209Leu mutation in BAG-3, yielding diagnosis of BAG-3 MFM leading to bilateral diaphragmatic paralysis.

Interventions:
Respiratory muscle training and long-term mechanical ventilation.

Outcomes:
It is quite unfortunate for this patient to have a poor prognosis due to the lack of effective treatment for this genetic disorder.

Lessons:
This case provides more clinical information for this rare disease which may cause severe diaphragm pathological damage leading to respiratory failure in BAG3 MFM and a future study with a systematic evaluation of a greater number of patients will be necessary to characterize this population.
Dabrafenib- and trametinib-associated glomerular toxicity
Authors: Jo Eunmi , Rhee Harin 
Published: January 2022

Abstract

Rationale:
Combined treatment with dabrafenib, a B-RAF inhibitor, and trametinib, a mitogen-activated protein kinase inhibitor, is an effective option for patients with metastatic melanoma. A few cases of acute kidney injury associated with tubulointerstitial nephritis and 1 case of nephrotic syndrome have been reported in patients on this drug combination; however, progressive renal injury has not been reported. In this case study, we report a patient with metastatic melanoma who developed glomerular capillary endothelial toxicity and progressive glomerular sclerosis during combination therapy.

Patient concern:
Our patient was an 80-year-old woman with a history of type 2 diabetes and chronic kidney disease.

Diagnosis and intervention:
She was diagnosed with metastatic melanoma and commenced combination therapy with dabrafenib and trametinib.

Outcomes:
Her renal function progressively deteriorated; by month 20 after treatment commencement, her serum creatinine level had increased from 1.59 to 3.74 mg/dL. The first kidney biopsy revealed marked glomerular and endothelial cell damage. Her medication was stopped, but no improvement was evident. At 5 months after the first biopsy, her serum creatinine level had increased to 5.46 mg/dL; a second kidney biopsy revealed focal segmental glomerular sclerosis and marked tubulointerstitial fibrosis. She was started on hemodialysis.

Lessons:
We describe a patient with a metastatic melanoma who developed progressive kidney failure during treatment with dabrafenib and trametinib. The most prominent microscopy findings were glomerular endothelial damage in the initial kidney biopsy and accelerated glomerular sclerosis and tubulointerstitial fibrosis in the follow-up biopsy. We hypothesize that a decreased renal reserve and impairment of kidney repair capacity caused by inhibition of B-RAF, a downstream mediator of vascular endothelial growth factor, may explain the progressive kidney injury.
Acupuncture and electroacupuncture for stroke
Authors: Choi Tae-Young , Ang Lin , Jun Ji Hee , Lee Hye Won , Yun Jong-Min , Kim JiHee , Moon Byung Soon , Joo Min Cheol , Lee Myeong Soo 
Published: January 2022

Abstract

Background:
The aim of this study was to undertake a systematic overview of meta-analyses and published systematic reviews to identify whether and when acupunctureand electroacupuncture are deemed efficacious treatment options for stroke and stroke-related disorders.

Methods:
Four databases, namely, PubMed, AMED, EMBASE, and the Cochrane Library will be searched from their inception. Two reviewers will independently perform study selection, data extraction, and assessment. This will be followed by an assessment of the methodological and report quality using the Assessment of Multiple Systematic Reviews-2 tool. Finally, the study will entail the assessment of evidence quality by employing the Grading of Recommendations Assessment, Development, and Evaluation system.

Results:
This overview is expected to provide data on using acupuncture for stroke and stroke-related disorders on the basis of the included systematic reviews’ qualitative and quantitative syntheses.

Conclusion:
This overview will assess the benefits as well as hazards of acupuncture for stroke, subsequently providing patients and practitioners with useful information and have implications for future studies on the topic.

Trial registration number:
Reviewregistry1263
Overview of the mortality from external causes of reproductive-age women in Brazil
Authors: de Souza Ana Mayara Gomes , Costa Ketyllem Tayanne da Silva , de Morais Thiffany Nayara Bento , de Andrade Fábia Barbosa 
Published: January 2022

Abstract
Studies have shown that a new demographic and epidemiological profile has been emerging in women of childbearing age, mainly due to the increase in life expectancy, reduction in infant mortality, higher survival in old age, and the drop in fertility rate.
To evaluate the external (violence) causes of mortality among women in Brazil from 2007 to 2016.
This is a quantitative, ecological study of temporal trends and correlations of the main causes of mortality of women of childbearing age and their association with age, from 2007 to 2016 in Brazil. The collected data were extracted from the Departamento de Informática do Sistema Único de Saúde database called the Mortality Information System.
It was possible to identify a considerable increase among the Brazilian states, with the highest coefficient of mortality from external causes, especially the northern regions. The highest coefficient identified among the evaluated states was 3.57 per 10,000, and in the northeast and southeast, external causes mainly affected young women aged 10 to 29 years.
It is necessary for managers and health professionals to be more aware of the diseases that affect this population.
Evaluation of the relationship between the spleen volume and the disease activity in ulcerative colitis and Crohn disease
Authors: Kawashima Kazumasa , Onizawa Michio , Fujiwara Tatsuo , Gunji Naohiko , Imamura Hidemichi , Katakura Kyoko , Ohira Hiromasa 
Published: January 2022

Abstract
Inflammatory bowel disease (IBD) is caused by the activation of an abnormal immune response in the intestinal mucosa; the spleen is involved in the main immune response. Ulcerative colitis (UC) and Crohn disease (CD) have different inflammatory mechanisms; this study aimed to quantitatively measure and compare the spleen volumes between patients with UC and CD and examine the relationship between spleen volume and disease activity in both.
We retrospectively analyzed 44 patients with IBD aged 30–60 years (UC group, n = 24; CD group, n = 20). The control group comprised 19 patients with pancreatic cysts that did not affect the spleen volume. All patients underwent computed tomography (CT) between April 2014 and March 2019. Using the Image J software, spleen volumes in the UC, CD, and control groups were measured accurately from the CT images and adjusted for the body weight.
No significant differences in the sex, age, or body weight were noted between the UC and CD groups and the control group. The spleen volumes, adjusted for the body weight, were 2.2 ± 1.0 cm3/kg, 2.0 ± 1.0 cm3/kg, and 3.6 ± 1.7 cm3/kg in the control, UC, and CD groups, respectively. The volumes differed significantly between the CD and control groups (P = .01), but not between the UC and control groups (P = .43). Furthermore, a significant strong correlation was found between the disease activity and the body weight-adjusted spleen volume in patients with CD (P < .01).
The spleen volume, adjusted for the body weight, was significantly larger in patients with CD than in the controls and was also strongly correlated with the CD activity. These results suggest that the immune response in CD may affect the spleen volume.
Difference between bone age at the hand and elbow at the onset of puberty
Authors: Jang Woo Young , Ahn Kyung-Sik , Oh Saelin , Lee Ji Eun , Choi Jimi , Kang Chang Ho , Kang Woo Young , Hong Suk-Joo , Shim Eddeum , Kim Baek Hyun , Je Bo-Kyung , Jung Hae Woon , Lee Soon Hyuck 
Published: January 2022

Abstract
In the pubertal period, bone age advances rapidly in conjunction with growth spurts. Precise bone-age assessments in this period are important, but results from the hand and elbow can be different. We aimed to compare the bone age between the hand and elbow around puberty onset and to elucidate the chronological age confirming puberty onset according to elbow-based bone age.
A total of 211 peripubertal subjects (127 boys and 84 girls) who underwent hand and elbow radiographs within 2 months was enrolled. Two radiologists and a pediatric orthopedic surgeon assessed bone age. Hand bone age was graded using the Greulich–Pyle (GP) method, and elbow bone age was determined using the Sauvegrain method. The correlation of 2 methods was evaluated by Demining regression analysis, and the mean absolute difference (MAD) with chronological age was compared between pre-pubertal and pubertal subjects. Receiver-operating characteristic curve analysis was performed to determine the chronological age confirming puberty onset.
There was a statistically significant difference in bone age revealed by the GP and Sauvegrain methods in the pubertal group. In the pubertal group, the MAD was 1.26 ± 0.90 years with the GP method and 0.61 ± 0.47 years with the Sauvegrain method in boys (P < .001), while in girls, the MAD was 0.84 ± 0.60 years and 0.53 ± 0.36 years with the same 2 methods (P = .033). The chronological age for confirming puberty onset using the elbow was 12.2 years in boys and 10.3 years in girls.
The bone ages of hand and elbow were different at puberty, and the elbow was a more reliable location for bone-age assessment at puberty. Puberty onset according to elbow occurred slightly earlier than expected.
Diagnostic method for malignant pleural effusion distinguishing malignant mesothelioma from lung cancer using pleural carcinoembryonic antigen and hyaluronic acid levels
Authors: Saraya Takeshi , Ohkuma Kosuke , Fujiwara Masachika , Ishii Haruyuki 
Published: January 2022

Abstract
Malignant mesothelioma (MM) is difficult to diagnose because of the lack of parenchymal opacities, often revealing minimal or absent pleural thickening. Furthermore, pleural effusion has diverse differential diagnoses, including malignancies, infections, as well as collagen vascular and other benign diseases. In general practice, lung cancer (LC) is the most common malignancy causing pleural effusion; therefore, a simple method using pleural diagnostic markers to differentiate between LC and mesothelioma is crucial.
We retrospectively reviewed the data of 530 adult patients diagnosed with pleural effusion between January 2010 and December 2020 in an outpatient or inpatient setting. Patients with pathologically diagnosed MM or LC with cytologically positive (class IV or V) pleural effusion were analyzed, and the characteristics of these 2 diseases were compared.
During the study period, 27 patients diagnosed with MM and 100 patients diagnosed with LC were enrolled. Receiver operating characteristic curve analysis demonstrated that pleural carcinoembryonic antigen (CEA) and hyaluronic acid (HA) could discriminate MM from LC with an area under the curve of 0.925 (95% confidence interval [CI]: 0.879–0.972, P < .001) and 0.815 (95% CI: 0.686–0.943, P < .001), respectively. To diagnose MM, the accuracy of pleural HA >30,000 ng/mL revealed a sensitivity of 75.0%, specificity of 72.6%, and odds ratio of 7.94 (95% CI: 2.5–25.2, P = .001); pleural CEA <6.0 ng/mL revealed a sensitivity of 95.2%, specificity of 84.9%, smaller negative likelihood ratio of 0.06, and odds ratio of 112.5% (95% CI: 14.4–878.1, P < .001). Multiple logistic regression analysis revealed that these 2 parameters could discriminate MM from LC, with a hazard ratio of 23.6 (95% CI: 2.437–228.1, P = .006) and 252.3 (95% Cl: 16.4–3888.1, P < .001), respectively, and their combination had a high specificity of 98.3%.
Pleural CEA (≥6.0 ng/mL) can rule out MM with a high degree of certainty, and the positive results for combination of pleural CEA <6.0 ng/mL and HA >30,000 ng/mL can confirm MM with high specificity, prior to cytological or pathological examinations.
Global and regional prevalence and burden for premenstrual syndrome and premenstrual dysphoric disorder
Authors: Gao Mingzhou , Zhang Hao , Gao Zhan , Cheng Xunshu , Sun Ya , Qiao Mingqi , Gao Dongmei 
Published: January 2022

Abstract

Introduction:
Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) are becoming common mental diseases in women impairing daily functioning. Estimation of the epidemiological burden of PMS/PMDD can serve as scientific basis for prevention and management of premenstrual disorders. Herein, we firstly provide a protocol to perform estimation on the prevalence and risk factors for PMS/PMDD in the general population globally and regionally.

Methods/design:
The PubMed, Web of Science, Chinese National Knowledge Infrastructure, the Cochrane Central Register of Controlled Trials (Cochrane Library), Chinese VIP Information, EMBASE, Wanfang Database, as well as the Chinese Biomedical Literature Database will be queried to find related studies containing information on the prevalence of PMDD (2011–2021). Two independent reviewers will comb the literature and abstract the data characteristics. Disparities will be reconciled via consents. The primary outcome will be the global prevalence. The random-effect model will be employed to pool the assessments. The standard χ
2 tests, as well as the I
2 statistic will be used to determine heterogeneity. Furthermore, the meta-regression analysis will be employed to estimate the differences in study-level characteristics. All the statistical analyses will be carried out in the software Stata v 15.0 (Stata Corporation, College Station, TX), as well as the R (v R 3.5.1, R Foundation for Statistical Computing, Vienna, Austria) software.

Discussion:
Based on existing evidence, our study will offer a high-quality synthesis for global and regional prevalence, burden, and risk factors of PMS/PMDD. Effective strategies will be made for prevention and management of epidemiological burden on the PMS/PMDD, even premenstrual disorders.

Ethics and dissemination:
This study does not involve the specific patients, and all research data comes from publicly available professional literature, so an ethics committee is not required to conduct an ethical review and approval of the study.

INPLASY registration number:
INPLASY2021120065.