bluuebunny/crossref_metadata_2025 huggingface dataset:
An Association between Single Nucleotide Polymorphisms of Lys751GlnERCC2Gene and Ovarian Cancer in Polish Women
Authors: Michalska Magdalena M. , Samulak Dariusz , Romanowicz Hanna , Sobkowski Maciej , Smolarz Beata
Published: October 2015

Aim.The aim of this study was to evaluate the role of the Lys751Gln (rs13181)ERCC2gene polymorphism in clinical parameters and the risk for development of ovarian cancer.Material and Methods.The study consisted of 430 patients with ovarian cancer (mean age: 53.2 ± 10.11) and 430 healthy subjects (mean age: 50.31 ± 18.21). Analysis of the gene polymorphisms was performed using the PCR-based restriction fragment length polymorphism (PCR-RFLP). The odds ratios (ORs) and 95% confidence intervals (CIs) for each genotype and allele were calculated.Results.The results obtained indicate that the genotype Gln/Gln is associated with an increased risk of ovarian cancer (OR 5.01; 95% CI 3.37–7.43;p<0.0001). Association of Lys751Gln polymorphism with histological grading showed increasedERCC2Gln/Gln (OR = 6.96; 95% CI 3.41–14.21;p<0.0001) genotype in grading 1 as well as Gln allele overrepresentation (OR = 4.98; 95% CI 3.37–7.40;p<0.0001) in G1 ovarian patients. Finally, with clinical FIGO staging under evaluation, an increase inERCC2Gln/Gln homozygote frequencies in staging I and Gln allele frequencies in SI were observed.Conclusion.On the basis of these results, we conclude thatERCC2gene polymorphism Lys751Gln may be associated with an increased risk of ovarian carcinoma.
The Localization and Characterization of Ischemic Scars in relation to the Infarct Related Coronary Artery Assessed by Cardiac Magnetic Resonance and a Novel Automatic Postprocessing Method
Authors: Woie Leik , Engan Kjersti , Eftestøl Trygve , Larsen Alf Inge , Ørn Stein
Published: October 2015

Aims. The correspondence between the localization and morphology of ischemic scars and the infarct related artery (IRA) by use of cardiac magnetic resonance imaging and a novel automatic postprocessing method.Methods and Results. Thirty-four patients with one-year-old single IRA myocardial infarction were examined. Endocardium, epicardium, and the point where right and left ventricles are coinciding were manually marked. All measurements were automatically assessed by the method. The following are results with manual assessments of scar properties in parenthesis: mean scar size (FWHM criterion): 7.8 ± 5.5 as %LV (17.4 ± 8.6%); mean endocardial extent of infarction: 44 ± 26° (124 ± 47°); mean endocardial extent of infarction as %LV circumference: 9.7 ± 7.0% (34.6 ± 13.0%); and mean transmurality: 52 ± 20% of LV wall thickness (77 ± 23%). Scars located in segments 1, 2, 7, 8, 13, and 14 by use of the automatic method were 96–100% specific for LAD occlusion. The highest specificities of RCA and LCX occlusions were segment 4 with 93% and segment 6 with 64%, respectively. The scar localization assessed automatically or manually was without major differences.Conclusion. The automatic method is applicable and able to assess localization, size, transmurality, and endocardial extent of ischemic scars.
Clinical Use of Anti-Xa Monitoring in Malignancy-Associated Thrombosis
Authors: Yentz Sarah , Onwuemene Oluwatoyosi A. , Stein Brady L. , Cull Elizabeth H. , McMahon Brandon
Published: October 2015

Introduction. Low molecular weight heparin (LMWH) is preferred for malignancy-associated venous thromboembolism (VTE). Many providers monitor LMWH with anti-Xa levels, despite little validation on correspondence with patient outcome. Methods. This is a retrospective, single institution study of anti-Xa measurement in malignancy-associated thrombosis. Cases were identified using the Electronic Data Warehouse, and inclusion was confirmed by two independent reviewers. Malignancy type, thrombotic history, measurement rationale and accuracy, clinical context, and management changes were evaluated. Results. 167 cases met inclusion criteria. There was no clear rationale for anti-Xa testing in 56%. Impaired renal function (10%), documented or suspected recurrent thrombosis despite anticoagulation (9%), and bleeding (6%) were the most common reasons for testing. Incorrect measurement occurred in 44%. Renal impairment was not a significant impetus for testing, as 70% had a GFR > 60. BMI > 30 was present in 40%, and 28% had a BMI < 25. Clinical impact was low, as only 11% of patients had management changes. Conclusions. Provider education in accuracy and rationale for anti-Xa testing is needed. Our study illustrates uncertainty of interpretation and clinical impact of routine anti-Xa testing, as management was affected in few patients. It is not yet clear in which clinical context providers should send anti-Xa levels.
Papillion-Lefèvre Syndrome: Periodontists’ Perspective
Authors: Biraggari Sunil Kumar , Reddy K. Krishna Mohana , Sudhakar J. , Bugude Shiva Shankar , Nichenametla Rajesh , Hakeem Mazher Ahmed , Tiyyagura Swati Reddy
Published: October 2015

Papillion-Lefèvre Syndrome is a very rare disorder of autosomal recessive inheritance distinguished by palmar plantar hyperkeratosis and early onset of periodontitis affecting the dentition. Genetic studies have identified a mutation in the major gene locus of chromosome 11q14 with loss of function. Cathepsin C gene is to be responsible for Papillion-Lefèvre Syndrome. The present case report describes a 13-year-old female, who visited the Department of Periodontology with the chief compliant of bleeding gums and loose teeth. She presented with the signs and symptoms of Papillion-Lefèvre Syndrome. The patient had premature shedding of her deciduous dentition. On clinical examination, extraorally, the patient presented with persistent thickening, flaking, and scaling of the skin of palms and soles. Her intraoral examination revealed gingival inflammation, abscess formation, and periodontal pockets. Her intraoral radiographs showed bone loss involving the central incisors and molars. The patient underwent periodontal therapy and is under maintenance.
No Association ofBDNF,COMT,MAOA,SLC6A3, andSLC6A4Genes and Depressive Symptoms in a Sample of Healthy Colombian Subjects
Authors: González-Giraldo Yeimy , Camargo Andrés , López-León Sandra , Forero Diego A.
Published: October 2015

Background. Major depressive disorder (MDD) is the second cause of years lived with disability around the world. A large number of studies have been carried out to identify genetic risk factors for MDD and related endophenotypes, mainly in populations of European and Asian descent, with conflicting results. The main aim of the current study was to analyze the possible association of five candidate genes and depressive symptoms in a Colombian sample of healthy subjects.Methods and Materials. The Spanish adaptation of the Hospital Anxiety and Depression Scale (HADS) was applied to one hundred eighty-eight healthy Colombian subjects. Five functional polymorphisms were genotyped using PCR-based assays:BDNF-Val66Met (rs6265),COMT-Val158Met (rs4680),SLC6A4-HTTLPR (rs4795541),MAOA-uVNTR, andSLC6A3-VNTR (rs28363170).Result. We did not find significant associations with scores of depressive symptoms, derived from the HADS, for any of the five candidate genes (nominalpvalues >0.05). In addition, we did not find evidence of significant gene-gene interactions.Conclusion. This work is one of the first studies of candidate genes for depressive symptoms in a Latin American sample. Study of additional genetic and epigenetic variants, taking into account other pathophysiological theories, will help to identify novel candidates for MDD in populations around the world.
Prenatal Diagnosis of Cardiac Diverticulum with Pericardial Effusion in the First Trimester of Pregnancy with Resolution after Early Pericardiocentesis
Authors: Garcia Rodriguez Raquel , Rodriguez Guedes Azahara , Garcia Delgado Raquel , Roldan Gutierrez Lourdes , Medina Castellano Margarita , Garcia Hernandez Jose Angel
Published: October 2015

Cardiac diverticulum is a rare anomaly, which may present in association with pericardial effusion. Only few cases diagnosed during fetal life have been published and only in 12 cases pericardiocentesis was made with good postnatal outcomes in 83% of the cases. In the first trimester of pregnancy only 6 cases were reported. We described the largest series of cases published. We describe a case of cardiac diverticulum complicated with pericardial effusion during the first trimester of pregnancy and resolved by intrauterine pericardiocentesis at 17 weeks of pregnancy. We made a systematic review of the literature with the cases reported of cardiac diverticulum, management, and outcomes.
Sound Richness of Music Might Be Mediated by Color Perception: A PET Study
Authors: Satoh Masayuki , Nagata Ken , Tomimoto Hidekazu
Published: October 2015

Objects. We investigated the role of the fusiform cortex in music processing with the use of PET, focusing on the perception of sound richness.Method. Musically naïve subjects listened to familiar melodies with three kinds of accompaniments: (i) an accompaniment composed of only three basic chords (chord condition), (ii) a simple accompaniment typically used in traditional music text books in elementary school (simple condition), and (iii) an accompaniment with rich and flowery sounds composed by a professional composer (complex condition). Using a PET subtraction technique, we studied changes in regional cerebral blood flow (rCBF) in simple minus chord, complex minus simple, and complex minus chord conditions.Results. The simple minus chord, complex minus simple, and complex minus chord conditions regularly showed increases in rCBF at the posterior portion of the inferior temporal gyrus, including the LOC and fusiform gyrus.Conclusions. We may conclude that certain association cortices such as the LOC and the fusiform cortex may represent centers of multisensory integration, with foreground and background segregation occurring at the LOC level and the recognition of richness and floweriness of stimuli occurring in the fusiform cortex, both in terms of vision and audition.
Nonoperative Korean Medicine Combination Therapy for Lumbar Spinal Stenosis: A Retrospective Case-Series Study
Authors: Kim Kiok , Jeong Yongjae , Youn Yousuk , Choi Jeongcheol , Kim Jaehong , Chung Wonseok , Kim Tae-Hun
Published: October 2015

This is a retrospective case series exploring the therapeutic benefits and harm of nonoperative Korean medicine combination therapy for lumbar spinal stenosis (LSS). The medical records of a total of 33 LSS patients, who were treated as inpatients at Mokhuri Neck and Back Hospital, Republic of Korea, from November 2010 to January 2012, were reviewed first and telephone survey on these patients was conducted after one year. Body acupuncture, pharmacoacupuncture, Chuna, and oral administration of herbal medicines were offered to all patients. A Visual analogue scale (VAS) of pain and the walking duration without pain were used to assess the patients during the approximately 1-month treatment period. The average VAS score of pain and the walking duration improved significantly; the VAS score decreased from 9 (SD, 1.15) to 2.75 (2.22) (p<0.01), and the walking duration increased from 5.5 (6.66) to 16.75 (13.00) minutes (p<0.01). No adverse event was reported during the treatment. In addition, the decreased pain level and improved function continued for over one year. Although we did not find definitive evidence, the study results suggest that KM combination therapy may be beneficial for decreasing pain and improving function in LSS patients and may produce comparatively few adverse events.
Condition Monitoring and Fault Diagnosis for an Antifalling Safety Device
Authors: Yang Guangxiang , Liang Hua
Published: October 2015

There is a constant need for the safe operation and reliability of antifalling safety device (AFSD) of an elevator. This paper reports an experimental study on rotation speed and catching torque monitoring and fault diagnosis of an antifalling safety device in a construction elevator. Denoising the signal using wavelet transform is presented in this paper. Based on the denoising effects for several types of wavelets, the sym8 wavelet basis, which introduces the high order approximation and an adaptive threshold, is employed for denoising the signal. The experimental result shows a maximum data error reduction of 7.5% is obtained and SNRs (signal-to-noise ratio) of rotation speed and catching torque are improved for 3.9% and 6.4%, respectively.
RecurrentCandida albicansVentriculitis Treated with Intraventricular Liposomal Amphotericin B
Authors: Toprak Demet , Öcal Demir Sevliya , Kadayifci Eda Kepenekli , Türel Özden , Soysal Ahmet , Bakir Mustafa
Published: October 2015

Central nervous system (CNS) infection withCandidais rare but significant because of its high morbidity and mortality. When present, it is commonly seen among immunocompromised and hospitalized patients. Herein, we describe a case of a four-year-old boy with acute lymphoblastic leukemia (ALL) who experienced recurrentCandida albicansmeningitis. The patient was treated successfully with intravenous liposomal amphotericin B at first attack, but 25 days after discharge he was readmitted to hospital with symptoms of meningitis.Candida albicanswas grown in CFS culture again and cranial magnetic resonance imaging (MRI) showed ventriculitis. We administered liposomal amphotericin B both intravenously and intraventricularly and favorable result was achieved without any adverse effects. Intraventricular amphotericin B may be considered for the treatment of recurrent CNSCandidainfections in addition to intravenous administration.
A Concept Mapping Study of Physicians’ Perceptions of Factors Influencing Management and Control of Hypertension in Sub-Saharan Africa
Authors: Iwelunmor Juliet , Blackstone Sarah , Gyamfi Joyce , Airhihenbuwa Collins , Plange-Rhule Jacob , Tayo Bamidele , Adanu Richard , Ogedegbe Gbenga
Published: October 2015

Hypertension, once a rare problem in Sub-Saharan Africa (SSA), is predicted to be a major cause of death by 2020 with mortality rates as high as 75%. However, comprehensive knowledge of provider-level factors that influence optimal management is limited. The objective of the current study was to discover physicians’ perceptions of factors influencing optimal management and control of hypertension in SSA. Twelve physicians attending the Cardiovascular Research Training (CaRT) Institute at the University of Ghana, College of Health Sciences, were invited to complete a concept mapping process that included brainstorming the factors influencing optimal management and control of hypertension in patients, sorting and organizing the factors into similar domains, and rating the importance and feasibility of efforts to address these factors. The highest ranked important and feasible factors include helping patients accept their condition and availability of adequate equipment to enable the provision of needed care. The findings suggest that patient self-efficacy and support, physician-related factors, policy factors, and economic factors are important aspects that must be addressed to achieve optimal hypertension management. Given the work demands identified by physicians, future research should investigate cost-effective strategies of shifting physician responsibilities to well-trained no-physician clinicians in order to improve hypertension management.
Craniofacial Microsomia: Goldenhar Syndrome in Association with Bilateral Congenital Cataract
Authors: Shrestha U. D. , Adhikari S.
Published: October 2015

Craniofacial microsomia (CFM) includes a spectrum of malformations primarily involving structures derived from the first and second branchial arches. Patients with hemifacial microsomia and epibulbar dermoids are said to have Goldenhar syndrome (GHS). Four-month-old boy with whitish pupillary reflex presented with the features of GHS in pediatric ophthalmology clinic. The child had ocular and auricular manifestations. There were no vertebral anomalies, but he had bilateral congenital cataract. The peculiarity of this case is the presence of the bilateral total congenital cataract, in association with CFM. There is absence of epibulbar dermoid or lipodermoid in the eyes, although the child had features of GHS. In addition to it, anesthetic intubation was smooth in this case. Any case diagnosed with CFM and/or GHS needs treatment through multidisciplinary approach, consultation in ophthalmology department is one of them.
The Effects of Simvastatin on Proteinuria and Renal Function in Patients with Chronic Kidney Disease
Authors: Satirapoj Bancha , Promrattanakun Anan , Supasyndh Ouppatham , Choovichian Panbuppa
Published: October 2015

Current data suggests that statins might have beneficial effects on renal outcomes. Beneficial effects of statin treatment on renal progression in advanced chronic kidney disease (CKD) are obviously controversial. In a retrospective, controlled study, the authors have evaluated the effects of 53-week treatment with simvastatin, versus no treatment on proteinuria and renal function among 51 patients with CKD stages III-IV. By the end of the 53-week treatment, urine protein excretion decreased from 0.96 (IQR 0.54, 2.9) to 0.48 (IQR 0.18, 0.79) g/g creatinine (P<0.001) in patients treated with simvastatin in addition to ACEI and ARBs, while no change was observed among the untreated patients. Moreover, a significantly greater decrease in urine protein excretion was observed in the simvastatin group as compared with the untreated group. The mean changes of serum creatinine and eGFR did not significantly differ in both groups. A significantly greater decrease in total cholesterol and LDL-cholesterol was found in the simvastatin group than in the untreated group. In summary, apart from lipid lowering among CKD patients, ingesting simvastatin was associated with a decrease in proteinuria. These statin effects may become important for supportive therapy in renal damage in the future.
Provider Adherence to National Guidelines for Managing Hypertension in African Americans
Authors: Sessoms Jeanette , Reid Kathryn , Williams Ishan , Hinton Ivora
Published: October 2015

Purpose.To evaluate provider adherence to national guidelines for the treatment of hypertension in African Americans.Design.A descriptive, preexperimental, quantitative method.Methods.Electronic medical records were reviewed and data were obtained from 62 charts. Clinical data collected included blood pressure readings, medications prescribed, laboratory studies, lifestyle modification, referral to hypertension specialist, and follow-up care.Findings.Overall provider adherence was 75%. Weight loss, sodium restriction, and physical activity recommendations were documented on 82.3% of patients. DASH diet and alcohol consumption were documented in 6.5% of participants. Follow-up was documented in 96.6% of the patients with controlled blood pressure and 9.1% in patients with uncontrolled blood pressure. Adherence in prescribing ACEIs in patients with a comorbidity of DM was documented in 70% of participants. Microalbumin levels were ordered in 15.2% of participants. Laboratory adherence prior to prescribing medications was documented in 0% of the patients and biannual routine labs were documented in 65% of participants.Conclusion.Provider adherence overall was moderate. Despite moderate provider adherence, BP outcomes and provider adherence were not related. Contributing factors that may explain this lack of correlation include patient barriers such as nonadherence to medication and lifestyle modification recommendations and lack of adequate follow-up. Further research is warranted.
Hydrologic Variations and Stochastic Modeling of Runoff in Zoige Wetland in the Eastern Tibetan Plateau
Authors: Qin Guanghua , Li Hongxia , Zhou Zejiang , Song Kechao , Zhang Li
Published: October 2015

Hydrological time series data (1988–2008) of the Hei River, the main water source to Zoige wetland in the Eastern Tibetan Plateau, were investigated. Results showed that the runoff distribution of Hei River varies with the relative change in amplitude (Cm=15.9) and the absolute change in amplitude (ΔQ=37.1 m3/s) during the year. There was a significant decreasing trend since 1988 with annual runoff of 20.0 m3/s (1988–1994), 19.0 m3/s (1995–2000), and 15.2 m3/s (2001–2008). There were double peaks in runoff during the water year: the highest peak in the period of 1988–2000 occurred in July while in the period of 2001–2008 it occurred in October. Shifting peak flow means less water quantity in wetland during growing season. Nearest neighbor bootstrapping regressive method was used to predict daily runoff of the Hei River. Model results show that it was fitted with 94.23% ofR2for daily time series, which can provide a basis for the development and utilization of regional water resources.
Prediction Method of the Fuel Consumption of Wheel Loaders in the V-Type Loading Cycle
Authors: Ma Wenxing , Zhang Yubo , Liu Chunbao , Wang Songlin
Published: October 2015

Wheel loaders in the V-type loading cycle are characterized by complicated loading conditions, nonlinear power-train system, and time-variable engine power distribution. Therefore, it is difficult to predict the fuel consumption of wheel loaders in the V-type loading cycle. The static matching methods cannot provide fuel consumption prediction for the loading cycle. In this paper, the prediction method and model of the fuel consumption for wheel loaders in the V-type loading cycle were proposed. Firstly, the hydraulic system data were tested when a wheel loader loaded three different materials in a typical V-type loading cycle. Secondly, the tested data were filtered by the 8th-order Butterworth filter and the dimensionless power deduction equations of hydraulic power system for loading three different materials were obtained by Gaussian and linear fitting based on the filtered data in the loading cycle. Finally, fuel consumption was obtained with the compiling dynamic calculation program as well as input parameters of tested vehicle speed, throttle parameter, and the dimensionless equation. The simulation results agreed well with experiment results. Dynamic calculation program is applicable to calculate loading economy and can provide academic guidance for wheel loader’s design and optimization.
A Fault-Tolerant Filtering Algorithm for SINS/DVL/MCP Integrated Navigation System
Authors: Xu Xiaosu , Li Peijuan , Liu Jian-juan
Published: October 2015

The Kalman filter (KF), which recursively generates a relatively optimal estimate of underlying system state based upon a series of observed measurements, has been widely used in integrated navigation system. Due to its dependence on the accuracy of system model and reliability of observation data, the precision of KF will degrade or even diverge, when using inaccurate model or trustless data set. In this paper, a fault-tolerant adaptive Kalman filter (FTAKF) algorithm for the integrated navigation system composed of a strapdown inertial navigation system (SINS), a Doppler velocity log (DVL), and a magnetic compass (MCP) is proposed. The evolutionary artificial neural networks (EANN) are used in self-learning and training of the intelligent data fusion algorithm. The proposed algorithm can significantly outperform the traditional KF in providing estimation continuously with higher accuracy and smoothing the KF outputs when observation data are inaccurate or unavailable for a short period. The experiments of the prototype verify the effectiveness of the proposed method.
Global Annual Final AC Yield Comparison between HCPV and c-Si PV
Authors: Ferrer-Rodríguez Juan Pablo , Pérez-Higueras Pedro , Almonacid Florencia , Fernández Eduardo F.
Published: October 2015

A worldwide comparison of the annual yield between conventional c-Si photovoltaic (PV) technology and high concentrated photovoltaic (HCPV) technology is presented. The idea of this paper is to find the most appropriate locations for HCPV systems in terms of the annual energy produced when comparing to fixed tilt PV systems and two-axis oriented PY systems. For estimating the annual energy generation, the method of the Performance Ratio is used. For some locations with high annual direct normal irradiation values, which are distributed around the world, HCPV systems are found to be more advantageous than fixed tilt PV systems. World maps showing this comparison are presented.
Musical Sequence Learning and EEG Correlates of Audiomotor Processing
Authors: Schalles Matt D. , Pineda Jaime A.
Published: October 2015

Our motor and auditory systems are functionally connected during musical performance, and functional imaging suggests that the association is strong enough that passive music listening can engage the motor system. As predictive coding constrains movement sequence selections, could the motor system contribute to sequential processing of musical passages? If this is the case, then we hypothesized that the motor system should respond preferentially to passages of music that contain similar sequential information, even if other aspects of music, such as the absolute pitch, have been altered. We trained piano naive subjects with a learn-to play-by-ear paradigm, to play a simple melodic sequence over five days. After training, we recorded EEG of subjects listening to the song they learned to play, a transposed version of that song, and a control song with different notes and sequence from the learned song. Beta band power over sensorimotor scalp showed increased suppression for the learned song, a moderate level of suppression for the transposed song, and no suppression for the control song. As beta power is associated with attention and motor processing, we interpret this as support of the motor system’s activity during covert perception of music one can play and similar musical sequences.
Intravenous Dexmedetomidine Provides Superior Patient Comfort and Tolerance Compared to Intravenous Midazolam in Patients Undergoing Flexible Bronchoscopy
Authors: Goneppanavar Umesh , Magazine Rahul , Periyadka Janardhana Bhavya , Krishna Achar Shreepathi
Published: October 2015

Dexmedetomidine, anα2agonist, has demonstrated its effectiveness as a sedative during awake intubation, but its utility in fiberoptic bronchoscopy (FOB) is not clear. We evaluated the effects of midazolam and dexmedetomidine on patient’s response to FOB. The patients received either midazolam, 0.02 mg/kg (group M,n=27), or dexmedetomidine, 1 µg/kg (group D,n=27). A composite score of five different parameters and a numerical rating scale (NRS) for pain intensity and distress were used to assess patient response during FOB. Patients rated the quality of sedation and level of discomfort 24 h after the procedure. Ease of bronchoscopy, rescue medication requirement, and haemodynamic variables were noted. Ideal or acceptable composite score was observed in 15 and 26 patients, respectively, in group M (14.48 ± 3.65) and group D (9.41 ± 3.13),p<0.001. NRS showed that 11 patients in group M had severe pain and discomfort as compared to one patient with severe pain and two with severe discomfort in group D during the procedure,p<0.001. Rescue midazolam requirement was significantly higher in group M (p=0.023). We conclude that during FOB, under topical airway anaesthesia, IV dexmedetomidine (1 µg/kg) provides superior patient comfort and tolerance as compared to IV midazolam (0.02 mg/kg).
Correlation between Fine-Needle Aspiration Cytology and Histology for Palpable Breast Masses in a Nigerian Tertiary Health Institution
Authors: Daramola Adetola Olubunmi , Odubanjo Mosebolatan Olatokunboh , Obiajulu Fred John , Ikeri Nzechukwu Zimudo , Banjo Adekunbiola Aina Fehintola
Published: October 2015

Background. Management of breast lumps can be challenging in resource poor settings. Fine-needle aspiration cytology (FNAC) especially when used with cell block can help improve affordability for the patients.Objective. To determine the diagnostic accuracy of FNAC of palpable breast lesions within a 5-year period.Methods. The findings obtained from FNAC of palpable breast lumps seen at the FNAC clinic of our department from January 2007 to December 2011 were retrieved and correlated with findings on histology of excisional biopsies.Results. A total of 1790 patients had FNAC of breast lumps during the 5-year period; 436 of them subsequently had biopsies. Our results compare favourably with the measures of test performance of the UK NHS Breast Screening Programme shown in brackets: absolute sensitivity 95.4% (>70%), complete sensitivity 99.2% (>90%), full specificity 88.9% (>65%), positive predictive value 99.6% (>99%), false-negative rate 0.8% (<4%), false-positive rate 0.4% (<0.5%), inadequate rate 3.2% (<15%), and suspicious rate 10.2% (<15%).Conclusion. Breast FNACs compare very well with histology of excisional biopsies and in experienced hands are extremely useful in the management of breast lumps. Further studies assessing the diagnostic accuracy of FNAC and cell blocks in our setting are recommended.
Testicular Leydig Cell Tumor with Metachronous Lesions: Outcomes after Metastasis Resection and Cryoablation
Authors: Geminiani Julio J. , Marshall Stephen D. , Ho Tammy S. , Brandes Steven B.
Published: October 2015

Leydig cell tumors represent 3% of testicular masses and usually occur in prepubertal boys and men between 30 and 60 years of age. Leydig cell tumors are benign in children but can be malignant in 10% of adults. This case report describes a 41-year-old patient who was diagnosed with a Leydig cell tumor that originated in his right testicle that subsequently metastasized to his liver, lungs, and retroperitoneum. We discuss the patient’s presentation and review the radiographic findings, surgical treatment, surgical pathology, chemotherapeutic treatment, and published literature on this rare pathology.
Inhibitory Effect ofHeracleum persicumandZiziphus jujubaon Activity of Alpha-Amylase
Authors: Afrisham Reza , Aberomand Mohammad , Ghaffari Mohammad Ali , Siahpoosh Amir , Jamalan Mostafa
Published: October 2015

Postprandial hyperglycemia plays an important role in the development of type 2 diabetes. Inhibition of alpha-amylase was led to a delay in breaks down of starch and glycogen and prevented a rapid rise in blood sugar. Alpha-amylase was isolated by gel filtration chromatography Sephadex G-75 from bovine pancreas. Then, total methanolic extracts of plants were prepared and IC50values of extracts on alpha-amylase were obtained and compared with acarbose IC50. The polyphenolic content of extracts and antioxidant capacity were determined by Folin-Ciocalteu test and DPPH test, respectively. The specific activity of alpha-amylase was 48.2 U/mg. For inhibition of alpha-amylase, IC50values ofH. persicum,Z. jujuba, and acarbose were 307, 827, and 113 μg/ml, respectively. For inhibition of DPPH radical, IC50values of extracts were 235 and 701 μg/ml. Total phenolic contents of methanol extracts were73.8±3.2and44.2±1.8 μg tannic acid equivalent/mg extract. Acarbose causes gastrointestinal symptoms and liver toxicity, butH. persicumandZ. jujubadecrease these side effects and prevent gastrointestinal disorders. Due to the high polyphenolic content and antioxidant capacity of these plants and significant inhibitory effect of the plants on alpha-amylase, these plants can be proposed for treatment of diabetic patients.
Bisphosphonate-Mediated Oral Ulcers: A Rare Differential Diagnosis of Erosive Oral Lesions
Authors: Lengfeld Julia , Buder-Bakhaya Kristina , Goebeler Matthias , Wobser Marion
Published: October 2015

Oral bisphosphonates are widely used drugs for the treatment of various indications such as postmenopausal osteoporosis. Ulcerations of the upper gastrointestinal tract, predominantly reported for alendronate, are common side effects. The occurrence of ulcerations within the oral cavity is less well known and probably underreported. Especially in cases of incorrect mode of intake, oral bisphosphonates are prone to induce oral ulcerations by as yet incompletely delineated mechanisms. We herein report on 2 elderly female patients suffering from oral ulcerations, which could be attributed to inadequate ingestion of alendronate. Possible ways to cause damage to the oral mucosa include non-specific toxic and pro-apoptotic effects, partly via bisphosphonate-mediated interference with intracellular signalling such as the mevalonate downstream pathway. Adequate patient advice in terms of correct use of oral bisphosphonates is crucial in order to prevent mucosal damage. Otherwise, prompt treatment cessation or a switch to an intravenously administered bisphosphonate is likely to achieve complete healing.
Hemorrhagic Transformation in Patients with Cerebral Infarction Referred to a Rehabilitation Hospital
Authors: Maeshima Shinichiro , Okamoto Sayaka , Okazaki Hideto , Mizuno Shiho , Asano Naoki , Tsunoda Tetsuya , Maeda Hirofumi , Masaki Mitsuko , Sonoda Shigeru
Published: October 2015

Purpose: The aim of our study was to investigate the presenting conditions of patients with hemorrhagic transformation (HT), the frequency of HT and its treatments at a rehabilitation hospital. Subjects and Methods: 165 patients with cerebral infarctions transferred to our rehabilitation hospital during the study period were enrolled. HT was diagnosed by two stroke specialists using computed tomography (CT) at the time of transfer to our rehabilitation hospital and other imaging data from previous consultations. Neurological status, activities of daily living, administered agents, patient age, duration from stroke onset to transfer and length of hospital stay were examined. Results: 30 of the 165 patients (18.2%) were diagnosed with HT. Decreased activities of daily living at admission and discharge as well as longer hospitalization stays were more prevalent in HT patients than in those without HT. We did not change antiplatelet or anticoagulant agents, but continued rehabilitation over a defined period while monitoring blood pressure; we confirmed with CT that the patients' physical conditions did not deteriorate. Conclusion: With careful symptom and CT monitoring over a defined period, rehabilitation can be continued in patients who develop HT at the time of transfer to a rehabilitation hospital in the acute phase of cerebral infarction.
Clinical Spectrum, Therapeutic Options, and Outcome of Advanced Heart Failure in Hypertrophic Cardiomyopathy
Authors: Pasqualucci Daniele , Fornaro Alessandra , Castelli Gabriele , Rossi Alessandra , Arretini Anna , Chiriatti Chiara , Targetti Mattia , Girolami Francesca , Corda Marco , Orrù Pierpaolo , Matta Gildo , Stefàno Pierluigi , Cecchi Franco , Porcu Maurizio , Olivotto Iacopo
Published: October 2015

Background—

The clinical course of patients with hypertrophic cardiomyopathy and advanced heart failure (HF) subtended by progressive left ventricular dysfunction has received limited attention. Our aim was to assess the outcome of HF and impact of treatment options including the implantable cardioverter-defibrillator and heart transplantation (HT) in patients with hypertrophic cardiomyopathy evaluated at 2 Italian referral centers >3 decades.

Methods and Results—

All-cause mortality and a combined end point including death, HT, or appropriate implantable cardioverter-defibrillator shock were assessed in 71 consecutive patients with HF not related to outflow obstruction (7% of the entire hypertrophic cardiomyopathy cohort) followed up for 6.1±6.9 years after development of New York Heart Association class III to IV symptoms. At enrollment, left ventricular ejection fraction was <50% in 55 patients and >50% in 16; all had restrictive left ventricular filling. During follow-up, 35 patients died (49%%; 5-year rate, 49%) and 53 met the combined end point (75%; 5-year rate, 62%). Most events occurred in the 3 years after HF onset (17% per year compared with only 3% per year subsequently). Appropriate implantable cardioverter-defibrillator shocks occurred in 11 of 34 implanted patients. Of 37 patients evaluated for HT, 14 were transplanted, 10 listed, and 13 excluded; 2 early post-HT deaths occurred in patients with elevated pulmonary vascular resistance. Eleven of the 14 HT patients were alive at 10±8 years.

Conclusions—

In hypertrophic cardiomyopathy, advanced HF not associated with outflow obstruction portends a severely unfavorable prognosis, particularly in the first 3 years after onset of symptoms, despite frequently preserved systolic function in about one quarter of the patients. Outcome of HT is favorable but requires early consideration, as the window of opportunity may be short.
The Gut Microbiome Contributes to a Substantial Proportion of the Variation in Blood Lipids
Authors: Fu Jingyuan , Bonder Marc Jan , Cenit María Carmen , Tigchelaar Ettje F. , Maatman Astrid , Dekens Jackie A.M. , Brandsma Eelke , Marczynska Joanna , Imhann Floris , Weersma Rinse K. , Franke Lude , Poon Tiffany W. , Xavier Ramnik J. , Gevers Dirk , Hofker Marten H. , Wijmenga Cisca , Zhernakova Alexandra
Published: October 2015

Rationale:

Evidence suggests that the gut microbiome is involved in the development of cardiovascular disease, with the host–microbe interaction regulating immune and metabolic pathways. However, there was no firm evidence for associations between microbiota and metabolic risk factors for cardiovascular disease from large-scale studies in humans. In particular, there was no strong evidence for association between cardiovascular disease and aberrant blood lipid levels.

Objectives:

To identify intestinal bacteria taxa, whose proportions correlate with body mass index and lipid levels, and to determine whether lipid variance can be explained by microbiota relative to age, sex, and host genetics.

Methods and Results:

We studied 893 subjects from the LifeLines-DEEP population cohort. After correcting for age and sex, we identified 34 bacterial taxa associated with body mass index and blood lipids; most are novel associations. Cross-validation analysis revealed that microbiota explain 4.5% of the variance in body mass index, 6% in triglycerides, and 4% in high-density lipoproteins, independent of age, sex, and genetic risk factors. A novel risk model, including the gut microbiome explained ≤25.9% of high-density lipoprotein variance, significantly outperforming the risk model without microbiome. Strikingly, the microbiome had little effect on low-density lipoproteins or total cholesterol.

Conclusions:

Our studies suggest that the gut microbiome may play an important role in the variation in body mass index and blood lipid levels, independent of age, sex, and host genetics. Our findings support the potential of therapies altering the gut microbiome to control body mass, triglycerides, and high-density lipoproteins.
Drug-Coated Balloon Versus Standard Balloon for Superficial Femoral Artery In-Stent Restenosis
Authors: Krankenberg Hans , Tübler Thilo , Ingwersen Maja , Schlüter Michael , Scheinert Dierk , Blessing Erwin , Sixt Sebastian , Kieback Arne , Beschorner Ulrich , Zeller Thomas
Published: October 2015

Background—

Drug-coated balloon angioplasty (DCBA) was shown to be superior to standard balloon angioplasty (POBA) in terms of restenosis prevention for de novo superficial femoral artery disease. For in-stent restenosis, the benefit of DCBA over POBA remains uncertain.

Methods and Results—

One hundred nineteen patients with superficial femoral artery in-stent restenosis and chronic limb ischemia were recruited over 34 months at 5 German clinical sites and prospectively randomized to either DCBA (n=62) or POBA (n=57). Mean lesion length was 82.2±68.4 mm. Thirty-four (28.6%) lesions were totally occluded; 30 (25.2%) were moderately or heavily calcified. Clinical and duplex ultrasound follow-up was conducted at 6 and 12 months. The primary end point of recurrent in-stent restenosis assessed by ultrasound at 6 months was 15.4% (8 of 52) in the DCBA and 44.7% (21 of 47) in the POBA group (
P
=0.002). Freedom from target lesion revascularization was 96.4% versus 81.0% (
P
=0.0117) at 6 months and 90.8% versus 52.6% (
P
<0.0001) at 12 months, respectively. At 12 months, clinical improvement by ≥1 Rutherford category without the need for target lesion revascularization was observed in 35 of 45 DCBA patients (77.8%) and 23 of 44 POBA patients (52.3%;
P
=0.015). No major amputation was needed. Two patients in the DCBA and 3 patients in the POBA group died. No death was procedure related.

Conclusions—

DCBA for superficial femoral artery in-stent restenosis is associated with less recurrent restenosis and a better clinical outcome than POBA without an apparent difference in safety.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT01305070.
Effect of Mineralocorticoid Receptor Antagonists on Cardiac Structure and Function in Patients With Diastolic Dysfunction and Heart Failure With Preserved Ejection Fraction: A Meta‐Analysis and Systematic Review
Authors: Pandey Ambarish , Garg Sushil , Matulevicius Susan A. , Shah Amil M. , Garg Jalaj , Drazner Mark H. , Amin Alpesh , Berry Jarett D. , Marwick Thomas H. , Marso Steven P. , de Lemos James A. , Kumbhani Dharam J.
Published: October 2015

Background

There has been an increasing interest in use of mineralocorticoid receptor antagonists (
MRA
s) in patients with heart failure with preserved ejection fraction (
HFPEF
). However, a comprehensive evaluation of
MRA
effects on left ventricular (
LV
) structure and function in these patients is lacking. In this meta‐analysis, we evaluated the effects of
MRA
s on
LV
structure and function among patients with diastolic dysfunction or
HFPEF
.

Methods & Results

Randomized, controlled clinical trials evaluating the efficacy of
MRA
s in patients with diastolic dysfunction or
HFPEF
were included. The primary outcome was change in E/e’, a specific measure of diastolic function. Secondary outcomes included changes in other measures of diastolic function,
LV
structure, surrogate markers for myocardial fibrosis (carboxy‐terminal peptide of procollagen type I [
PICP
] and amino‐terminal peptide of pro‐collagen type‐
II
[
PIIINP
]), blood pressure, and exercise tolerance. In the pooled analysis,
MRA
use was associated with significant reduction in E/e’ (weighted mean difference [
WMD
] [95% confidence interval {
CI
}]: −1.68 [−2.03 to −1.33];
P
<0.0001) and deceleration time (
WMD
[95%
CI
]: −12.0 ms [−23.3 to −0.7];
P
=0.04) as compared with control, suggesting and improvement in diastolic function. Furthermore, blood pressure and levels of
PIIINP
and
PICP
were also significantly reduced with
MRA
therapy with no significant change in
LV
mass or dimensions.

Conclusion

MRA
therapy in patients with asymptomatic diastolic dysfunction or
HFPEF
is associated with significant improvement in diastolic function and markers of cardiac fibrosis without a significant change in
LV
mass or dimensions.
Investment Promotion as Progressive Realization of Economic and Social Rights
Authors: Lorenzo Johanna Aleria P.
Published: October 2015

Faced with the reality of finite and scarce resources, and the fact that realization of most economic and social rights requires resources, can a State comply with its icescr obligations, particularly Article 2(1) thereof, when it engages in investment promotion activities? This paper examines the conditions under which the pursuit of foreign direct investment (fdi) can be deemed consistent with State obligation to fulfill socioeconomic rights. It is posited that investment promotion activities potentially augment the limited national income of many developing countries, thereby creating conditions that make more possible the enjoyment of socio-economic rights. This relationship is premised on the caveat that, as part of the State’s duty to protect, it should ensure the pre-existence of a set of institutions that sufficiently regulates the behavior of foreign businesses and a certain level of human capital and physical infrastructure conducive to knowledge and technology transfer.
A Theology of Christ as Act: A Response to Oliver Davies
Authors: Macchia Frank D.
Published: October 2015

This article is a theological response to the Christological perspective of Oliver Davies’ provocative book, Theology of Transformation. More specifically, Macchia addresses Davies’ argument that transformation theology is a theology of the act, of Christ who acts, an argument that is explicated in three points of emphasis: 1. The living Christ is exalted and present among us. 2. The act is not an abstract concept but is real and embodied. 3. This is act as Christologically formed, meaning as resembling self-sacrificial love. While Macchia offers several critiques of the book, he notes in agreement with Davies that Jesus as the living Lord powerfully present in the church and beyond as the source of new life in the Spirit has always been a Pentecostal point of emphasis.
Transformation Theology and Pentecostalism
Authors: Davies Oliver
Published: October 2015

In this article, in dialogue with Pentecostal theologians, I argue that our contemporary science allows us to return to a transformational account of the embodied self and the material world, with implications in particular for both Christology and pneumatology and their relation. On the basis of a reading of Acts 2.32–36, in which Christ in heaven ‘pours forth’ the Holy Spirit upon the first Church, I argue that the reality of the living Christ for us is itself the work of the Holy Spirit and itself communicates the work of the Spirit. This suggests the possibility of a Trinitarian koinonia which points to the unity of the Spirit-filled doxology and devotion of the worshipping Church on the one hand, and to the active life of discipleship through our acts of following Christ on the other.
‘Let Me Hear Your Voice’: Re-hearing the Song of Songs through Pentecostal Hermeneutics
Authors: Redick Caroline
Published: October 2015

The Song of Songs has inspired numerous interpretations throughout history, ranging from mystical visions of God’s union with his people, to practical guidelines for marriage. This article examines the text from the perspective of Pentecostal hermeneutics, following the insights of early Pentecostal preachers and contemporary Charismatic leaders to showcase the Song of Songs as a story about the pathos-filled relationship of God and humanity. Through dialogue with these sources, biblical scholarship, and the philosophical hermeneutic of Ernesto Grassi, this article takes an inter-disciplinary approach to argue that the Song exists as a space within Scripture for prayerful dialogue. It will focus on the way that Scripture facilitates communion with God. Thus, the purpose of this article is not only to explore Spirit-filled interpretation of the Song of Songs, but through these interpretations, to theologize about the nature of the Bible itself.
Mourning, Melancholy and Hexis: Towards a Context for Fritz Yshaq Baer
Authors: Gutwirth Eleazar
Published: October 2015

An examination, annotation and translation of the hitherto unpublished correspondence with Baer in the Baron papers lead to a re-contextualization. Intensified after his demise in 1980, a large stream of publications attempted to contextualize the work of the historian of the Jews of Christian Spain, Fritz Yshaq Baer, against the background of broadly known events of the twentieth century, identifying him with a “School” of Jewish history. Here this notion is traced to the early 1970s and alternative possibilities are explored. First, attention is paid to the role of institutions, networks and models in the production of knowledge without restricting this solely to the universities or to Germany. This leads to valuing the role of Spanish institutions and their intellectual presuppositions and practices. The history of reading raises questions as to the role of intended public, history of the book and genre in his publications. Finally, taking the ethics of reading into consideration, we ask who the participants in the dialogues he was constructing were. This includes his correspondence with Baron which is published as an appendix.