bluuebunny/crossref_metadata_2025_split huggingface dataset:
Safety and efficacy of nivolumab compared with other regimens in patients with melanoma: A network meta-analysis
Authors: Almohideb Mohammad 
Published: September 2022

Background:
Melanoma is a cancerous tumor that develops from melanocytes in the epidermal basal layer of the skin. It is a fatal skin cancer and the third most common kind of cutaneous tumor. We aim to evaluate the effect of nivolumab in melanoma patients compared with other regimens

Methods:
This meta-analysis included only clinical trials, both randomized and nonrandomized. The main outcomes of interest were the response to treatment, overall survival (OS), progression-free survival, and adverse events.

Results:
The overall effect estimates favored nivolumab group over the combination of nivolumab plus ipilimumab (HR 3.06, 95% CI 1.70-5.49) and chemotherapy group (HR 3.58, 95% CI 1.63-7.84) after 1 year. Compared to chemotherapy, nivolumab had lower rates of adverse events.

Conclusion:
Nivolumab monotherapy yields high progression-free survival rates and has the same efficacy when combined with ipilimumab in a 1-year OS. However, after 2 and 3 years of follow-up, the combined regimen has more OS rates.
Acupuncture against the metabolic risk factors for stroke: A systematic review of systematic reviews
Authors: Xu Ying , Zhong Da-yuan , Liao Xiao-qian , Wang Xing-ping , Ge Jin-wen , Xu Wei-hui 
Published: September 2022

Objective:This systematic review (SR) of SRs aims aimed to evaluate the current evidence of rehabilitation interventions in stroke patients after acupuncture treatment.Methods:Full-text SRs published in Chinese and English up to December 15, 2021 were searched in PubMed, Embase, Cochrane Library, CNKI, VIP, and Wanfang databases. The PRISMA statement and the assessment of multiple systematic reviews 2 (AMSTAR 2) scale were used to evaluate the quality of the included articles. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system was employed to assess the outcome indicators for evidence quality evaluation.Results:A number of 42 publications were identified in this study. According to these articles, 4 metabolic areas were identified: systolic blood pressure, weight loss, glycemic index and cholesterol. The acupuncture is beneficial to improve the systolic blood pressure of patients, and the effect of acupuncture on diastolic blood pressure is better than that of sham acupuncture. The weight loss effect of acupuncture is better than that of lifestyle and western medicine. The improvement effect of acupuncture on body mass index (BMI) is also better than that of sham acupuncture. In the study of glycemic index of stroke patients, acupuncture significantly improved glycosylated hemoglobin and insulin sensitivity index compared with western medicine. In cholesterol-related research, acupuncture can effectively improve the content of triglycerides. However, studies on HDL and LDL show that acupuncture can significantly improve HDL, but has no significant effect on LDL.Conclusion:This review summarizes the available evidence and underpins findings of the acupuncture exhibited the therapeutic role in eliminating metabolic risk factors for stroke, including systolic blood pressure, weight loss, glycemic index and cholesterol. Acupuncture could have positive effects on a specific symptom, and the effects depend not only on intervention type but also on how and when the intervention is provided. And more prioritizing high-quality research in this field in the future is conducive to guiding clinical practice.
The Chinese knotting technique assist anatomical anterior cruciate ligament reconstruction for aggressive rehabilitation
Authors: Yu Yang , Yang Xianguang , He Chuan , Wang Guoliang , Liu Dejian , Li Yanlin 
Published: September 2022

Aggressive rehabilitation after anterior cruciate ligament (ACL) reconstruction may result in better clinical outcomes and fewer complications such as knee stiffness and weakness. We explored the effect of the Chinese knotting technique (CKT) for aggressive rehabilitation after ACL reconstruction.
Ninety-one anatomical ACL reconstruction cases from 2016 to 2020 were retrospectively reviewed. All patients were operated by the same senior physician and his team. According to the reconstruction with or without CKT, the patients were divided into 2 groups. Both groups received aggressive rehabilitation.
The follow-up time of 91 patients was more than 2 years. In total, 43 out of the 91 patients were in the CKT group, and 48 were in the routine group. The knee joint kinematics recorded by Opti_Knee revealed no significant difference among the CKT group, the routine group, and healthy adults at 3, 6, 12, and 24 months after the operation, respectively. The internal and external rotation angle and the anteroposterior displacement at 3 and 6 months after the operation in the CKT group were smaller than in the routine group and were similar to that of the healthy adults. There was no significant difference in flexion and extension angle, varus or valgus angle, proximal–distal displacement, or the internal or external displacement between the 2 groups. In addition, there was no significant difference in 6 degrees of freedom of the knee between the 2 groups at 12 and 24 months after the operation, respectively, which was similar to healthy adults. Compared to the routine group, the International Knee Documentation Committee scores were significantly higher in the CKT group at the 3, 6, and 12 months, respectively, but no difference was observed at 24 months (P = .749). The Lysholm score was significantly higher in the CKT group at the 3 and 6 months postoperatively, while there was no difference at 12 and 24 months, respectively.
In short-term observation, the ACL reconstruction with CKT, which can sustain aggressive rehabilitation and prevent the loosening of ACL graft, can lead to better clinical outcomes and kinematics recovery of the knee compared to routine technique.
Fast pain relief in exercise-induced acute musculoskeletal pain by turmeric-boswellia formulation: A randomized placebo-controlled double-blinded multicentre study
Authors: Rudrappa Girish H. , Murthy Meghana , Saklecha Santosh , Kumar Kare Sanjeev , Gupta Ajay , Basu Indraneel 
Published: September 2022

Background:
Plant extracts with analgesic properties are seldom considered for treatment of acute musculoskeletal pain due to delay in onset of analgesia. Turmeric (Curcuma longa) and boswellia (Boswellia serrata) extracts are well-studied anti-inflammatory compounds gaining in popularity and used as an alternative to conventional treatments for musculoskeletal pain. This study analyzed the analgesic effect of a formulation of turmeric and boswellia extracts in sesame oil (Rhuleave-K, TBF) in reducing exercise-induced acute musculoskeletal pain in healthy participants.

Methods:
In this randomized double-blinded placebo-controlled, single-dose, single-day, multicentre study, a total of 232 participants (TBF n = 116; placebo n = 116) having moderate-to-severe exercise-induced acute musculoskeletal pain were randomized in an allocation concealed 1:1 ratio to receive a single dose of 1000 mg of TBF or placebo. The outcome measures were numerical rating scale (NRS), categorical pain relief scale (PRS), onset of analgesia, and short form of McGill questionnaire (SF-MPQ). NRS and PRS were measured from predose to every 30 minutes interval of postdose up to 6 hours at rest, with movement and applying pressure on the affected part. The onset of analgesia was measured from the time of dosage and censored at 6 hours of postdose. The sum of pain intensity difference (SPID6) and total pain relief (TOTPAR6) at 6 hours was, respectively, analyzed from NRS and PRS scores.

Results:
TBF showed a significant reduction in pain intensity (SPID6rest) with 97.85% improvement in cumulative responder analysis compared with 2.46% in placebo. The onset of pain relief was fast and highly significant in the TBF group with 99% of participants having a mean perceptible pain relief at 68.5 minutes (95% confidence interval, 59.5–77.4) and 96% of participants having a mean meaningful pain relief at 191.6 minutes (95% confidence interval, 176.7–206.4) compared to the placebo group. Highly significant and continuous improvement in pain relief was observed in the TBF group with 93% of participants having ≥ 50% of maximum TOTPAR6 with a number needed to treat of 1.1 at rest.

Conclusion:
Exercise-induced acute musculoskeletal pain can be effectively relieved by TBF (Rhuleave-K) in about 3 hours signifying its strong analgesic activity.
New grading system for post-COVID-19 pulmonary fibrosis based on computed tomography findings
Authors: Demircioglu Ozlem , Kocakaya Derya , Cimsit Canan , Cimsit Nuri Cagatay 
Published: September 2022

Background:
There is currently no objective computed tomography (CT)-defined grading system for coronavirus disease (COVID-19)-related pulmonary fibrosis. We propose a CT-based radiological scale that adapts the histological fibrosis scale to pulmonary fibrosis CT findings, to evaluate possible predictive factors for the degree of fibrosis in these patients.

Methods:
A new radiological fibrosis grading system was created based on existing histological fibrosis scales. One hundred forty-seven COVID-19 patients with any degree of fibrosis on CT were evaluated. Smoking status, the presence of hypertension, the duration of hospital stays, the presence of comorbid diseases, and the levels of prognostic and predictive factors for COVID-19 were evaluated, and how these parameters affected the fibrosis scores was examined.

Results:
Of 147 patients, 17.7% had grade 1, 17% had grade 2, 51.7% had grade 3, and 13.6% had grade 4 fibrosis. ANOVA revealed statistically significant relationships between the fibrosis scores and lactate dehydrogenase values, lymphocyte count, C-reactive protein level, and length of hospital stay. Smoking, advanced age, hypertension, and male sex showed significantly higher scores for fibrosis.

Conclusions:
Using our CT-defined lung fibrosis grading system, we could predict the severity of fibrosis as well as the resultant lung pathology in COVID-19 patients. Thus, disease exacerbation and development of permanent severe fibrosis can be prevented using the appropriate treatment methods in high-risk patients.
Early survival after acute myocardial infarction with ST-segment elevation: What could be improved? Insights from France PCI French registry
Authors: Duband Benjamin , Motreff Pascal , Marcollet Pierre , Gamet Alexandre , Decomis Marie-Pascale , Bar Olivier , Saint Etienne Christophe , Hakim Radwan , Canville Alexandre , Viallard Louis , BeyguI Farzin , Lesault Pierre Francois , Bonnet Philippe , Durand Eric , Boiffard Emmanuel , Collet Jean-Philippe , Benamer Hakim , Commeau Philippe , Cayla Guillaume , Pereira Bruno , Koning Rene , Rangé Gregoire 
Published: September 2022

Early mortality post-ST-segment elevation myocardial infarction (STEMI) in France remains high. The multicentre France Percutaneous Coronary Intervention Registry includes every patient undergoing coronary angiography in France. We analyzed the prevalence and impact of unmodifiable and modifiable risk factors on 30-day survival in patients experiencing STEMI.
Patients admitted for STEMI between 01/2014 and 12/2016 were included in the analysis. Patients with nonobstructive coronary artery disease, with cardiogenic shock or cardiac arrest without STEMI, were excluded. Prehospital, clinical and procedural data were collected prospectively by the cardiologist in the cath lab using medical reporting software. Information on outcomes, including mortality, was obtained by a dedicated research technician by phone calls or from medical records. Marginal Cox proportional hazards regression was used to test the predictive value for survival at 30 days in a multivariable analysis.
Included were 2590 patients (74% men) aged 63 ± 14 years. During the first month, 174 patients (6.7%) died. After adjustment, unmodifiable variables significantly associated with reduced 30-day survival were: age > 80 years (prevalence 15%; hazard ratio [HR] 2.7; 95% confidence interval [CI] 1.5–4.7), chronic kidney disease (2%; HR 5.3; 95% CI 2.6–11.1), diabetes mellitus (14%; HR 1.6; 95% CI 1.0–2.5), anterior or circumferential electrical localization (39%; HR 2.0; 95% CI 1.4–2.9), and Killip class 2, 3, or 4 (7%; HR 3.4; 95% CI 1.9–5.9; 2%; HR 10.1; 95% CI 5.3–19.4; 4%; HR 18; 95% CI 10.8–29.8, respectively). Among modifiable variables, total ischemic time > 3 hours (68%; HR 1.8; 95% CI 1.1–3.0), lack of appropriate premedication (18%; HR 2.2; 95% CI 1.5–3.3), and post-PCI TIMI < 3 (6%; HR 4.9; 95% CI 3.2–7.6) were significantly associated with reduced 30-day survival.
Most predictors of 30-day survival post-STEMI are unmodifiable, but outcomes might be improved by optimizing modifiable factors, most importantly ischemic time and appropriate premedication.
Effectiveness of calamine lotion as an adjunctive therapy to mometasone furoate ointment in the treatment of infant eczema: A retrospective study
Authors: Meng Yuan-Cui , Fan Jin-Chao , Bian Wei-Ni 
Published: September 2022

This retrospective study investigated the effectiveness of calamine lotion (CL) as an adjunctive therapy to mometasone furoate ointment (MFO) in the treatment of infant eczema (IE).
This retrospective study analyzed the electronic medical records of 50 IE infants. They were allocated to a treatment group or a control group, with 25 subjects in each group. All infants in both groups received MFO. In addition, infants in the treatment group underwent CL. The outcomes were effectiveness based on the eczema area and severity index, lesion area, and pruritus severity. We analyzed the outcomes before and after treatment.
The results of this study showed that infants in the treatment group had more effective in effectiveness based on eczema area and severity index (P < .01), lesion area (P < .01), and pruritus severity (P = .01) than those in the control group. However, no medical records reported any adverse events in either group.
The results of this study showed that CL added to MFO was more effective than MFO alone in the treatment of infants with IE.
Successful treatment through staged laparoscopic transgastric endoscopic retrograde cholangiopancreatography for postoperative bile leakage: A case report
Authors: Jeong Chi-Young , Choi Jung Woo , Kim Jae-Ri , Jang Jae Yool , Cho Jin-Kyu 
Published: September 2022

Introduction:
Therapeutic laparoscopic-assisted transgastric endoscopic retrograde cholangiopancreatography (LA-ERCP) is a safe and effective technique for patient who are unable to receive endoscopic or percutaneous transhepatic treatment. This procedure shows a high overall success rate in managing pancreaticobiliary complications, comparable to that of ERCP.

Patient concerns:
A 51-year-old man had abdominal pain for 2 days. The patient showed acute calculous cholecystitis and acute cholangitis with distal common bile duct (CBD) stones. We performed laparoscopic cholecystectomy and removed the distal CBD stones through CBD exploration.
On the fourth day after the surgery, bile leakage was observed through the surgical drain.

Diagnosis:
The patient was diagnosed with postoperative bile leakage based on clinical findings.

Interventions:
The patient could not receive ERCP or percutaneous transhepatic biliary drainage because he had severe trismus and limb stiffness after suffering from poliomyelitis. So, we performed LA-ERCP, sphincterotomy, and biliary stent insertion. The fully covered self-expanding metal stent was implanted within the percutaneous gastrostomy site around, and 4 weeks later, the stent was removed during re-ERCP.

Outcomes:
The patient was discharged without any complications. There were no long-term complications noted during the 12-month follow-up.

Conclusion/Lessons:
Staged LA-ERCP represents a practical strategy for managing bile leakage and offers a novel solution for patients for whom transoral and transhepatic approaches are unsuitable. As a result, clinicians must know techniques for gaining access to the biliary system, such as LA-ERCP.
Evaluation of the efficacy of 1 L polyethylene glycol plus ascorbic acid and an oral sodium sulfate solution: A multi-center, prospective randomized controlled trial
Authors: Woo Jung Hun , Koo Hoon Sup , Kim Dae Sung , Shin Jeong Eun , Jung Yunho , Huh Kyu Chan 
Published: September 2022

Introduction:
Low-volume bowel preparation has been developed to increase patient compliance. We compared 1 L of polyethylene glycol/ascorbic acid (PEG/Asc) and oral sodium sulfate (OSS) with respect to bowel preparation efficacy, compliance, and safety.

Methods:
A multicenter, prospective, randomized, single-blinded, non-inferiority trial was conducted in 3 hospitals. Patients were randomized to receive a bowel-cleansing agent. Bowel-cleansing efficacy was evaluated using the Boston Bowel Preparation Scale (BBPS). Satisfaction, feeling, taste of the bowel cleanser, and adverse events after taking the bowel cleanser were investigated through a questionnaire. Additionally, blood samples were analyzed before and after bowel cleansing.

Results:
In total, 172 patients were analyzed (85 with 1 L PEG/Asc and 87 with OSS), and the mean BBPS scores were comparable between agents. The 1L PEG/Asc group tended to have a higher BBPS score in the right colon (2.22 vs 2.02; P = .08). The compliance of 1 L of PEG/Asc was comparable to that of OSS. Patients taking 1 L PEG/Asc reported greater thirst and dizziness (P = .04 and P = .047, respectively) than the OSS cohort. On the other hand, gastrointestinal symptoms such as vomiting and abdominal distension were more common in the OSS group, without statistical significance. In terms of laboratory adverse events, elevation of serum creatinine was found in both groups after taking the bowel cleansing agent (P < .001 for the 1L PEG/Asc group; P = .04 for the OSS group). However, most of the increased values were within the normal ranges.

Discussion:
The 1L PEG/Asc treatment was comparable to OSS in terms of bowel preparation efficacy, compliance, and safety.
An unusual case of subacute combined degeneration due to nitrous oxide abuse, which relapsed after bariatric surgery: A case report
Authors: Chen Wei , Si Zhihua , Bi Yanping , Yang Bing 
Published: September 2022

Rationale:
Several studies have reported subacute combined degeneration (SCD) induced by nitrous oxide (N2O) abuse. However, few studies have reported that N2O-induced SCD recurred because of sleeve gastrectomy after neurological symptoms improved.

Patient concerns:
We report the case of an 18-year-old woman who developed paresthesia, weakness in 4 limbs, and an unstable gait after frequent, excessive N2O inhalation.

Diagnosis:
The patient was diagnosed as having SCD.

Interventions and outcomes:
Nineteen days after intravenous mecobalamin and supplementation with other kinds of vitamin B, her weakness and paresthesia resolved. However, 7 months after discharge, the patient experienced recurrence following sleeve gastrectomy. Blood biochemistry revealed low vitamin B12 levels. After a 22-day treatment, similar to the first hospitalization, her residual numbness and unsteady gait improved.

Lessons:
This case highlights that patients, especially those at high risk of vitamin B12 deficiency, undergoing sleeve gastrectomy require careful nutritional follow-up and routine monitoring of micronutrients such as vitamin B12 and homocysteine. Continuous vigilance is essential for patients with common and rare neurological complications.
Efficacy and safety of biologic therapy in microscopic colitis: systematic review and meta-analysis
Authors: Taneja Vikas , El-Dallal Mohammed , Anand Rajsavi S. , Haq Zadid , Mishkin Brooke , Feuerstein Joseph D. 
Published: September 2022

Background
This systematic review and meta-analysis sought to evaluate the effectiveness and safety of biologic therapy in the treatment of steroid-refractory microscopic colitis (MC).

Methods
We searched MEDLINE, Embase, Web of Science, and Cochrane Central to identify articles and abstracts reporting efficacy or safety data on biologic use (infliximab, adalimumab, certolizumab, golimumab, vedolizumab, ustekinumab, and tofacitinib) for induction and maintenance of remission in MC. We assessed clinical remission and response rates and all reported adverse events (AEs).

Results
A total of 376 studies were screened yielding 13 articles (including four abstracts) with a combined information on 78 patients for efficacy and safety outcomes. Most studies were case series. Vedolizumab was used in five studies, adalimumab in three, and a combination of infliximab and adalimumab in five studies. The rates of remission were 66.08% (95% CI, 36.79–95.37%; I
2, 71%) at weeks 3–6 and 54.20% (95% CI, 39.39–69.01%; I
2, 0%) at weeks 12–16. Clinical response rates were 100% (95% CI, 88.04–100%; I
2, 0%) at weeks 3–6 and 67.20% (95% CI, 47.72–86.69%; I
2, 52%) at weeks 12–16. Most frequent AE was medication discontinuation with a pooled incidence of 16.1% (95% CI, 5.9–37.5%). No deaths attributable to biologic use were reported. The overall quality of evidence was very low due to the high risk of biases.

Conclusion
Low-quality evidence supports the short-term efficacy of biologics in budesonide refractory MC. While our findings represent the most comprehensive evaluation of biologic therapy in severe MC, further research including randomized clinical trials is needed to better define the role of specific agents and long-term therapy.
Medications for Chronic Conditions and Mortality in Older Adults
Authors: Hsu Hui-Fen , Tu Hung-Pin , Chen Kuei-Min , Belcastro Frank 
Published: September 2022

Abstract

Background
With the population aging, examining the relationship between polypharmacy and mortality based on population data sources is important for clinical management and policy direction.

Objectives
This study aimed to examine the association between number of chronic medications and risk of mortality in older adults.

Methods
This population-based retrospective cohort study used data from the National Health Insurance Research Database in Taiwan for information regarding chronic medication use (over 4 years) in older adults aged 65 and older. The association between medication use and mortality numbers was analyzed using Cox proportional hazards regression models adjusted for demographic variables and comorbidity.

Results
The number of medications was significantly associated with high mortality risk. Within polypharmacy, being 65–74 years old, male, living in northern Taiwan, having one type of comorbid disease, and receiving <84 days of refillable chronic prescription were associated with greater mortality risk. Subgroup analyses’ results regarding comorbidity showed significant positive associations between number of medications and mortality in most comorbid diseases except for mental disorders and diseases of the skin and subcutaneous tissue.

Discussion
General practitioners should know that chronic polypharmacy is associated with increased mortality risk. Recognizing the possible adverse effects of multiple medication use could help physicians optimize drug regimens in the future.