bluuebunny/crossref_metadata_2025 huggingface dataset:
A systematic review of known interventions for the treatment of chronic nonhypovolaemic hypotonic hyponatraemia and a meta‐analysis of the vaptans
Authors: Bhandari Sunil , Peri Alessandro , Cranston Iain , McCool Rachael , Shaw Alison , Glanville Julie , Petrakova Larisa , O'Reilly Karl
Published: February 2017

International and national guidelines on the treatment of chronic nonhypovolaemic hypotonic hyponatraemia differ; therefore, we have undertaken this systematic review and meta‐analysis to investigate the efficacy and safety of interventions for the treatment of chronic nonhypovolaemic hypotonic hyponatraemia. Following registration of the review protocol with PROSPERO, systematic literature searches were conducted to identify randomized and quasi‐randomized controlled trials assessing any degree of fluid restriction or any drug treatment with the aim of increasing serum sodium concentration in patients with chronic nonhypovolaemic hypotonic hyponatraemia. Where appropriate, outcome data were synthesized in a meta‐analysis. A total of 45 716 bibliographic records were identified from the searches and 18 trials (assessing conivaptan, lixivaptan, tolvaptan and satavaptan) met the eligibility criteria. Results suggest that all four vasopressin receptor agonists (“vaptans”) significantly improve serum sodium concentration. Lixivaptan, satavaptan and tolvaptan were associated with greater rates of response versus placebo. There was no evidence of a difference between each of the vaptans compared with placebo for mortality, discontinuation and rates of hypernatraemia. No RCT evidence of treatments other than the vaptans for hyponatraemia such as oral urea, salt tablets, mannitol, loop diuretics demeclocycline or lithium was identified. Vaptans demonstrated superiority over placebo for outcomes relating to serum sodium correction. Few trials documented the potential benefit of vaptans on change in health‐related quality of life as a result of treatment. There was also a lack of high‐quality RCT evidence on the comparative efficacy of the vaptans and other treatment strategies for the treatment of chronic nonhypovolaemic hypotonic hyponatraemia.
Peripheral blood leucocytes show differential expression of tumour progression‐related genes in colorectal cancer patients who have a postoperative intra‐abdominal infection: a prospective matched cohort study
Authors: Alonso S. , Mayol X. , Nonell L. , Salvans S. , Pascual M. , Pera M. ,   the Colorectal Cancer Research Group (Hospital del Mar Medical Research Institute)
Published: February 2017

Aim

Anastomotic leak is associated with higher rates of recurrence after surgery for colorectal cancer. However, the mechanisms responsible are unknown. We hypothesized that the infection‐induced inflammatory response may induce overexpression of tumour progression‐related genes in immune cells. The aim was to investigate the effect of postoperative intra‐abdominal infection on the gene expression patterns of peripheral blood leucocytes (PBL) after surgery for colorectal cancer.

Method

Prospective matched cohort study. Patients undergoing surgery for colorectal cancer were included. Patients who had anastomotic leak or intra‐abdominal abscess were included in the infection group (n = 23) and matched with patients without complications for the control group (n = 23). PBL were isolated from postoperative blood samples. Total RNA was extracted and hybridized to the Affymetrix Human Gene 1.0 ST microarray.

Results

Patients in the infection group displayed 162 upregulated genes and 146 downregulated genes with respect to the control group. Upregulated genes included examples coding for secreted cytokines involved in tumour growth and invasion (S100P, HGF, MMP8, MMP9, PDGFC, IL1R2). Infection also upregulated some proangiogenic genes (CEP55, TRPS1) and downregulated some inhibitors of angiogenesis (MME, ALOX15, CXCL10). Finally, some inhibitors (HP, ORM1, OLFM4, IRAK3) and activators (GNLY, PRF1, FGFBP2) of antitumour immunity were upregulated and downregulated, respectively, suggesting that the inflammatory environment caused by a postoperative infection favours immune evasion mechanisms of the tumour.

Conclusion

Analysis of PBL shows differential expression of certain tumour progression‐related genes in colorectal cancer patients who have a postoperative intra‐abdominal infection, which in turn may promote the growth of residual cancer cells to become recurrent tumours.
Problem‐Solving Phase Transitions During Team Collaboration
Authors: Wiltshire Travis J. , Butner Jonathan E. , Fiore Stephen M.
Published: February 2017

Multiple theories of problem‐solving hypothesize that there are distinct qualitative phases exhibited during effective problem‐solving. However, limited research has attempted to identify when transitions between phases occur. We integrate theory on collaborative problem‐solving (CPS) with dynamical systems theory suggesting that when a system is undergoing a phase transition it should exhibit a peak in entropy and that entropy levels should also relate to team performance. Communications from 40 teams that collaborated on a complex problem were coded for occurrence of problem‐solving processes. We applied a sliding window entropy technique to each team's communications and specified criteria for (a) identifying data points that qualify as peaks and (b) determining which peaks were robust. We used multilevel modeling, and provide a qualitative example, to evaluate whether phases exhibit distinct distributions of communication processes. We also tested whether there was a relationship between entropy values at transition points and CPS performance. We found that a proportion of entropy peaks was robust and that the relative occurrence of communication codes varied significantly across phases. Peaks in entropy thus corresponded to qualitative shifts in teams’ CPS communications, providing empirical evidence that teams exhibit phase transitions during CPS. Also, lower average levels of entropy at the phase transition points predicted better CPS performance. We specify future directions to improve understanding of phase transitions during CPS, and collaborative cognition, more broadly.
Indocyanine green‐assisted sentinel lymph node biopsy in melanoma using the “FOVIS“ system
Authors: Göppner Daniela , Nekwasil Stephan , Jellestad Anne , Sachse Alexander , Schönborn Karl‐Heinz , Gollnick Harald
Published: February 2017

Background

Metastatic involvement of the sentinel lymph node (SLN) represents a key prognostic factor in melanoma. The combined use of a radiocolloid (technetium‐99m) and blue dye is the gold standard in sentinel lymph node biopsy (SLNB). In this context, near‐infrared (NIR) fluorescence imaging with indocyanine green (ICG) has been suggested as an alternative. The objective of the present study was to examine the potential advantages of fluorescence‐guided SLNB – compared to the conventional method – with respect to the visualization of lymphatic drainage pathways and the SLN. Particular focus was on the impact of the ICG dose used and the body mass index (BMI).

Patients and methods

The study included ten patients who underwent the SLNB procedure using technetium‐99m, blue dye, and ICG. Real‐time fluorescence imaging of lymphatic drainage pathways and the SLN was done using the “FOVIS”‐NIR system. Depending on the quality of the images achieved, ICG was intradermally administered at a dose ranging from 0.25 to 2.5 mg.

Results

Nine SLNs were identified by fluorescence (90 %); (100 %) ten, by gamma probe; eight (80 %), by ICG or blue dye. Transdermal SLN detection was possible in one case (10 %). In correlation to the BMI, higher intradermal ICG doses – up to 2.5 mg overall – proved to be advantageous in the visualization of lymphatic vessels.

Conclusions

Supplementing the technetium‐99m method, fluorescence SLNB using ICG and the “FOVIS”‐NIR system is a safe alternative to the blue‐dye technique. Further studies on the optimal ICG dose and transdermal imaging in correlation to the BMI are required.
Sentinel‐Lymphknoten‐Biopsie des Melanoms mittels Indocyaningrün und „FOVIS“‐System
Authors: Göppner Daniela , Nekwasil Stephan , Jellestad Anne , Sachse Alexander , Schönborn Karl‐Heinz , Gollnick Harald
Published: February 2017

Hintergrund

Der Nachweis metastatischer Infiltrate im Sentinel‐Lymphkoten (SLN) gilt als wesentlicher prognostischer Faktor des Melanoms. Alternativ zur Farbstoffmethode mit Patentblau zum Goldstandard der SLN‐Biopsie (SLNB) mittels Radiokolloid wird die fluoreszenzoptische Darstellung mit Hilfe von Indocyaningrün (ICG) und Nahinfrarot (NIR)‐Kamerasystem kommuniziert. Im Vergleich zur konventionellen Methode wurde die Wertigkeit des ICG‐/NIR‐Verfahrens in Abhängigkeit vom Body‐Mass‐Index (BMI) des Patienten und der Konzentration von ICG bezüglich der Visualisierung des Lymphabstroms und des SLNs untersucht.

Patienten und Methodik

An zehn Patienten wurde die SLNB mittels Technetium‐99m, Patentblau und ICG durchgeführt. Die Fluoreszenz‐Darstellung von Lymphbahnen und SLN erfolgte in Echtzeit mittels der NIR‐Kameratechnik „FOVIS“. Je nach erzielter Bildqualität wurde ICG in einer Dosis von 0,25 mg bis 2,5 mg intrakutan appliziert.

Ergebnisse

Neun der zehn SLN wurden fluoreszenzoptisch identifiziert (90 %), alle zehn radioaktiv (100 %), nur acht (80 %) mittels ICG‐Grünfärbung bzw. Patenblau‐Markierung. Transdermal wurde ein SLN dargestellt (10 %). In Korrelation zum BMI waren höhere ICG‐Mengen, bis zu 2,5 mg intrakutan absolut, in der Darstellung der Lymphbahnen von Vorteil.

Schlussfolgerungen

Die SLN‐Fluoreszenzmarkierung mit dem ICG/NIR‐Kamera‐System „FOVIS“ stellt eine sichere Alternative zur Farbstoffmethode mit Patentblau ergänzend zur Radiokolloidmethode mit Technetium‐99m dar. Weitere Studien zur optimalen Dosierung von ICG und transdermalen Bildgebung in Relation zum BMI sind notwendig.
Clinical course, treatment modalities, and quality of life in patients with congenital melanocytic nevi – data from the German CMN registry
Authors: Wramp Maria Elisabeth , Langenbruch Anna , Augustin Matthias , Zillikens Detlef , Krengel Sven
Published: February 2017

Background

Congenital melanocytic nevi (CMN) are associated with mental stress as well as medical risks for those affected. The German CMN registry was initiated in 2005. Herein, we present results from an interim analysis focusing on disease course, treatment modalities, and quality of life.

Patients and methods

One hundred patients enrolled in the registry between 2005 and 2012 were included in this prospective cohort study, and asked to participate in a follow‐up survey. In addition, standardized questionnaires were used to collect data on quality of life (dermatology life quality index, DLQI) and perceived stigmatization (perceived stigmatization questionnaire, PSQ; social comfort questionnaire, SCQ).

Results

Eighty‐three percent of patients (or their parents) provided answers to the survey questions (mean patient age: 11.2 years, median: 6 years; mean follow‐up: 4.4 years). Overall, four individuals were diagnosed with melanoma, including two pediatric cases with CNS melanoma, one adult with cutaneous melanoma, and one case which later turned out to be a proliferative nodule. Four children were diagnosed with neurocutaneous melanocytosis, three of whom exhibited neurological symptoms. Eighty‐eight percent (73/83) of patients underwent surgery. Seventy‐eight percent reported no or only minor impact of the CMN on quality of life. In general, perceived stigmatization and impairment of social well‐being were also low.

Conclusions

Our results provide an overview of the situation of CMN patients in Germany, Austria, and Switzerland. Three percent of patients developed melanoma; 4 % showed CNS involvement.
Efficacy and safety of fumaric acid esters in combination with phototherapy in patients with moderate‐to‐severe plaque psoriasis (FAST)
Authors: Weisenseel Peter , Reich Kristian , Griemberg Wiebke , Merten Katharina , Gröschel Christine , Gomez Natalie Nunez , Taipale Kirsi , Bräu Beate , Zschocke Ina
Published: February 2017

Background

While treatment of patients with moderate‐to‐severe psoriasis using a combination of fumaric acid esters (FAE, Fumaderm®) and phototherapy (UV) is common practice, there have been hardly any studies investigating this regimen. Available information is limited to data from a small pilot study. The objective of the present study was to evaluate FAE/UV combination therapy in a larger patient cohort with moderate‐to‐severe psoriasis.

Patients and methods

In this prospective noninterventional multicenter study, data from patients treated with FAE/UV combination therapy was assessed with regard to efficacy (PGA‚ PASI, DLQI, EQ‐5D), safety, and dosage over a twelve‐month period. The findings were subsequently compared to data from a previous retrospective study on FAE monotherapy.

Results

Data from 363 patients was included in the analysis. Efficacy measures improved substantially on combination therapy. Compared to FAE monotherapy, FAE/UV therapy led to a faster clinical response, however, there was no difference in efficacy after 12 months. Neither the duration nor the type of phototherapy had an impact on efficacy. In general, combination therapy was well tolerated. Seven percent of patients experienced adverse events.

Conclusions

FAE/UV combination therapy is effective and well tolerated in patients with moderate‐to‐severe psoriasis. Such treatment may induce a faster therapeutic response, and appears to be useful, particularly in the first three months of FAE therapy.
Wirksamkeit und Sicherheit von Fumarsäureestern in Kombination mit Phototherapie bei Patienten mit moderater bis schwerer Plaque‐Psoriasis (FAST)
Authors: Weisenseel Peter , Reich Kristian , Griemberg Wiebke , Merten Katharina , Gröschel Christine , Gomez Natalie Nunez , Taipale Kirsi , Bräu Beate , Zschocke Ina
Published: February 2017

Hintergrund

Die Behandlung von Psoriasis‐Patienten mit einer Kombination aus Fumarsäureestern (FSE, Fumaderm®) und Phototherapie (UV) ist verbreitet, wurde aber im Rahmen von Studien wenig untersucht. Bisher liegen lediglich Daten aus einer kleinen Pilotstudie vor. Intention dieser Studie war, eine FSE/UV‐Kombinationsbehandlung an einem größeren Patientenkollektiv mit mittelschwerer bis schwerer Psoriasis zu untersuchen.

Patienten und Methodik

In dieser prospektiven, multizentrischen, nichtinterventionellen Studie wurden Daten von Patienten mit FSE/UV‐Kombinationstherapie hinsichtlich der Wirksamkeit (PGA‚ PASI, DLQI, EQ‐5D), Sicherheit und Dosierung über einen Zeitraum von zwölf Monaten erfasst und mit Daten einer retrospektiven Studie mit FSE‐Monotherapie verglichen.

Ergebnisse

Es wurden Daten von 363 Patienten ausgewertet. Unter der Kombinationstherapie verbesserten sich alle Wirksamkeitsparameter deutlich. Im Vergleich zur Monotherapie mit FSE konnte durch die Kombination mit UV ein schnellerer Wirkeintritt erzielt werden, wobei nach zwölf Monaten kein Unterschied in der Wirksamkeit bestand. Die Dauer und Art der Phototherapie zeigte keinen Einfluss auf die Wirksamkeitsparameter. Allgemein wurde die Kombinationstherapie gut vertragen. Unerwünschte Ereignisse wurden bei 7 % der Patienten berichtet.

Schlussfolgerungen

Die FSE/UV Kombinationstherapie zeigt eine gute Wirksamkeit und Verträglichkeit und kann zu einem schnelleren Wirkeintritt führen. Eine Kombinationstherapie erscheint vor allem in den ersten drei Monaten der FSE Behandlung sinnvoll.
Behandlungspräferenzen für Biologika bei Psoriasis: erfahrene Patienten legen Wert auf Nachhaltigkeit
Authors: Kromer Christian , Peitsch Wiebke K. , Herr Raphael , Schmieder Astrid , Sonntag Diana , Schaarschmidt Marthe‐Lisa
Published: February 2017

Hintergrund und Ziele

Die Therapiezufriedenheit kann durch die Berücksichtigung von Patientenpräferenzen in der gemeinsamen Entscheidungsfindung verbessert werden. Kürzlich untersuchten wir Patientenpräferenzen für Eigenschaften von Biologika und fanden starke Präferenzen für Sicherheit und Wirksamkeit. Die vorliegende Studie hatte das Ziel, Auswirkungen von Therapieerfahrung auf diese Präferenzen zu erheben.

Patienten und Methoden

Präferenzen für Ergebnis‐ (Wahrscheinlichkeit einer 50%igen und 90%igen Verbesserung, Zeit bis zum Ansprechen, Nachhaltigkeit des Erfolgs, Wahrscheinlichkeit von leichten und schweren Nebenwirkungen und Wahrscheinlichkeit eines ACR‐20‐Ansprechens) und Prozesseigenschaften (Behandlungsort, Behandlungshäufigkeit, Zeitaufwand und Applikationsweise) wurden bei 200 Teilnehmern mit mittelschwerer bis schwerer Psoriasis mit Hilfe von Conjoint‐Analyse ermittelt. Der Einfluss aktueller und früherer Therapien, der Krankheitsdauer und der Behandlungszufriedenheit auf die „Relative Importance Scores“ wurde durch Varianz‐analysen, Post‐hoc‐Tests und multivariate Regressionen bestimmt.

Ergebnisse

Teilnehmer, die aktuell eine topische Therapie (p = 0,02) oder eine Phototherapie (p = 0,032) erhielten, hielten den Zeitaufwand der Behandlung für wichtiger als andere. Diejenigen, denen zuvor traditionelle Systemtherapien (p = 0,028) oder Biologika (p = 0,044) verordnet worden waren, legten mehr Wert auf die Nachhaltigkeit als andere. Diese Eigenschaft gewann mit steigender Anzahl zuvor verabreichter systemischer Therapien (p = 0,045) und längerer Krankheitsdauer (p = 0,018) an Bedeutung.

Fazit

Patientenpräferenzen für Biologika variieren abhängig von der Therapieerfahrung und Krankheitsdauer. Diese Aspekte sollten bei der gemeinsamen Entscheidungsfindung berücksichtigt werden.
Europäische Leitlinien (S1) für die Anwendung von hochdosierten intravenösen Immunglobulinen in der Dermatologie
Authors: Enk Alexander , Hadaschik Eva , Eming Rüdiger , Fierlbeck Gerhard , French Lars , Girolomoni Giampiero , Hertl Michael , Jolles Stephen , Karpati Sarolta , Steinbrink Kerstin , Stingl Georg , Volc‐Platzer Beatrix , Zillikens Detlef
Published: February 2017

Hintergrund und Ziele

Die Behandlung schwerer dermatologischer Autoimmunerkrankungen und der toxischen epidermalen Nekrolyse (TEN) mit hochdosierten intravenösen Immunglobulinen (IVIg) ist ein bewährtes therapeutisches Verfahren in der Dermatologie. Da eine IVIg‐Therapie in der Regel nur bei seltenen Erkrankungen oder bei schweren Fällen in Betracht gezogen wird, stützt sich die Anwendung von Immunglobulinen zumeist nicht auf Daten aus randomisierten kontrollierten Studien, wie sie in der evidenzbasierten Medizin erforderlich sind. Da Indikationen für die Anwendung von IVIg selten sind, ist es unwahrscheinlich, dass solche Studien in absehbarer Zeit durchgeführt werden. Wegen der hohen Kosten für IVIg im First‐Line‐Einsatz wurden die ersten klinischen Leitlinien für die Anwendung von IVIg bei dermatologischen Erkrankungen im Jahr 2008 herausgegeben und im Jahr 2011 überarbeitet.

Methoden

Diese europäischen Leitlinien wurden von einer Gruppe durch das EDF und die EADV benannter Experten erarbeitet. Die Leitlinien wurden erstellt, um die derzeit als wirksam erachteten Behandlungsindikationen zu aktualisieren und die für die Anwendung von IVIg bei dermatologischen Autoimmunerkrankungen und TEN vorliegenden Daten zusammenzufassen.

Ergebnisse und Schlussfolgerung

Die vorliegenden Leitlinien repräsentieren die einvernehmlichen Meinungen und Definitionen von Experten zur Anwendung von IVIg, die die aktuell publizierten Daten widerspiegeln, und sollen als Entscheidungshilfe für den Einsatz von IVIg bei dermatologischen Erkrankungen dienen.
Pre‐ and perioperative aspects of dermatosurgery
Authors: Müller Cornelia S. L. , Hubner Wakiko , Thieme‐Ruffing Sigrid , Pföhler Claudia , Vogt Thomas , Volk Thomas , Gärtner Barbara C. , Bialas Patric
Published: February 2017

Dermatosurgery occupies an exceptional position among all surgical disciplines. Above all, this includes the fact that, with very few exceptions, the vast majority of surgical interventions can be performed under local or regional anesthesia, usually in smaller procedure rooms that are spatially separated from larger operating suites. Thus, peri‐ and postinterventional patient monitoring is the responsibility of the dermatosurgeon and his team. Though inherently smaller, this team still has to observe numerous perioperative requirements that – in larger surgical specialties – would be attended to by a host of various specialists working in concert. Said requirements include hygienic aspects, knowledge concerning pre‐ and intraoperative patient monitoring, managing surgical site infections, adequate postsurgical pain management, as well as detailed pharmacological knowledge with respect to common local anesthetics and the toxic and allergic reactions associated therewith. Not only does this require interdisciplinary collaboration and shared responsibility for the patient. It also necessitates the development and implementation of quality‐oriented and evidence‐based guidelines that, in the dermatosurgical setting, usually extend far beyond the scope of the specialty per se. The objective of the present CME article is the condensed presentation of interdisciplinary aspects relating to the most important perioperative issues.
Update: Therapie der Necrobiosis lipoidica
Authors: Peckruhn Melanie , Tittelbach Jörg , Elsner Peter
Published: February 2017

Die Necrobiosis lipoidica ist eine seltene granulomatöse Erkrankung von bisher unzureichend geklärter Ätiologie. Häufig stellt die bei Diabetikern gehäuft zu beobachtende und zur Ulzeration neigende Dermatose eine starke Belastung für die Patienten dar. Bezüglich der Therapie existieren aktuell keine deutschen oder europäischen Leitlinien. Gleichzeitig lässt sich unter der aktuellen Standardtherapie, der lokalen oder intraläsionalen Anwendung von Glukokortikoiden, nicht immer ein zufriedenstellendes Ansprechen beobachten. Daher wurde untersucht, ob seit dem Jahr 2000 publizierte Therapiemodalitäten das Therapiespektrum relevant und erfolgversprechend erweitern. Es erfolgte eine Betrachtung aller Arbeiten im oben genannten Zeitraum, bei denen mehr als ein Einzelfallbericht je Therapiemodalität publiziert wurde. Insgesamt wurden in einem systematischen Review die Daten von 16 verschiedenen, seit 2000 publizierten Therapieverfahren in 49 Publikationen analysiert.

Im Ergebnis zeigte sich, dass die meisten Erfahrungen bezüglich der topischen PUVA‐Therapie, der photodynamischen Therapie (PDT) und der systemischen Therapie mit Fumarsäureestern vorliegen. Allerdings ist auffällig, dass mit steigender Zahl der pro Behandlungsmodalität behandelten Patienten der Anteil der Patienten, bei denen eine Abheilung bzw. eine teilweise Abheilung berichtet wurde, sinkt. Wir interpretieren diese Beobachtung als Publikationsbias. Daher kann für keines der besprochenen Verfahren eine klare Empfehlung als Therapie der zweiten Wahl nach Versagen der lokalen bzw. intraläsionalen Steroidtherapie gegeben werden.
Hourglass‐shaped right ventricle and localized constrictive pericarditis
Authors: Karakus Alper , Ari Hasan , Camci Sencer , Ari Selma , Tutuncu Ahmet , Melek Mehmet
Published: February 2017

Constrictive pericarditis is characterized by thick pericardial fibrosis and frequent calcification that progressively impairs diastolic filling of the heart. The diagnosis of constrictive pericarditis has been challenging even though multiple diagnostic modalities have been developed. The diagnosis of constructive pericarditis is especially difficult in localized constrictive pericarditis which is extremely rare. We report a case of localized constrictive pericarditis with a 3D multislice cardiac computed tomography (CT) finding of the constrictive band causing strangulation and hourglass shaping of the right ventricle.
Diagnostic paradox: Ruptured aneurysm of sinus of Valsalva simulating tricuspid valve endocarditis
Authors: Hoda Mehar , Verma Arushi , Alapati Sridevi , Alapati Srilatha , Yarrabolu Tharakanatha R.
Published: February 2017

Rupture of aneurysm of sinus of Valsalva into the right atrium mimicking tricuspid valve endocarditis is a rare presentation. We review a case of spontaneous rupture of aneurysm of sinus of Valsalva into the right atrium presenting as a murmur. Transthoracic echocardiogram showed a mobile mass that appeared to be attached to the tricuspid valve leaflet with moderate tricuspid regurgitation suggestive of tricuspid valve endocarditis. The diagnosis was confirmed as spontaneous rupture of noncoronary sinus in to the right atrium by transesophageal echocardiogram. Patient recovered completely after surgical repair.
Evaluation of vegetation size and its relationship with septic pulmonary embolism in tricuspid valve infective endocarditis: A real time 3DTEE study
Authors: Utsunomiya Hiroto , Berdejo Javier , Kobayashi Sayuki , Mihara Hirotsugu , Itabashi Yuji , Shiota Takahiro
Published: February 2017

Background

Tricuspid valve infective endocarditis (TVIE) causes septic pulmonary embolism (PE). However, the impact of vegetation size on PE is not fully elucidated.

Methods

In 26 consecutive patients with definite TVIE according to Duke criteria, we tested clinical, microbiological, and echocardiographic data including real time three‐dimensional transesophageal echocardiography (3DTEE) as potential predictors of PE. 3DTEE measurement of maximum length of vegetation (MLV) was obtained with Advanced QLAB Quantification Software by cropping the 3D volume with the appropriate 2D plane to obtain the largest value. The standard two‐dimensional transesophageal echocardiography (2DTEE) images were also evaluated to determine the MLV.

Results

Pulmonary embolism occurred after TVIE diagnosis with 3DTEE assessment and initiation of antibiotic therapy in 12 patients (46.2%). The 3DTEE MLV was larger than the 2DTEE value with a mean difference of 3.6 mm (95% CI, 2.5–4.6 mm). The best cutoff value for prediction of PE was MLV ≥16.4 mm with 3DTEE and MLV ≥9.5 mm with 2DTEE. The positive predictive value increased from 76.9% to 90% when 3DTEE was used. The accuracy of classification of patients with PE increased from 80.6% to 84.9% with 3DTEE. On multivariate analysis, 3DTEE MLV ≥16.4 mm (odds ratio 20.5; 95% confidence interval 1.31–322; P=.031) was independently associated with the occurrence of PE after adjustment for age, sex, complex vegetation, and the number of vegetation‐attached leaflets.

Conclusions

In TVIE, vegetation length is a strong predictor of the occurrence of PE. In combination with 2DTEE, 3DTEE may identify high‐risk patients who will need a more aggressive therapeutic strategy.
Effect of a one‐step self‐etch adhesive on endogenous dentin matrix metalloproteinases
Authors: Apolonio Fabianni M. , Mazzoni Annalisa , Angeloni Valeria , Scaffa Polliana M. C. , Santi Spartaco , Saboia Vicente de Paulo A. , Tay Franklin R. , Pashley David H. , Breschi Lorenzo
Published: February 2017

Degradation of the hybrid layer created in dentin by dentin adhesives is caused by enzyme activities present within the dentin matrix that destroy unprotected collagen fibrils. The aim of the present study was to evaluate the effect of a one‐step self‐etch adhesive system on dentinal matrix metalloproteinases 2 and 4 (MMP‐2 and MMP‐9, respectively) using in situ zymography and an enzymatic activity assay. The null hypothesis tested was that there are no differences in the activities of dentinal MMPs before and after treatment with a one‐step adhesive system. The MMP‐2 and MMP‐9 activities in dentin treated with the one‐step adhesive, Adper Easy Bond, were quantified using an enzymatic activity assay system. The MMP activities within the hybrid layer created by the one‐step adhesive tested were also evaluated using in situ zymography. The enzymatic assay revealed an increase in MMP‐2 and MMP‐9 activities after treatment with adhesive. In situ zymography indicated that gelatinolytic activity is present within the hybrid layer created with the one‐step self‐etch adhesive. The host‐derived gelatinases were localized within the hybrid layer and remained active after the bonding procedure. It is concluded that the one‐step self‐etch adhesive investigated activates endogenous MMP‐2 and MMP‐9 with the dentin matrix, which may cause collagen degradation over time.
Glass: The eye of science
Authors: Bolt Marvin
Published: February 2017

For 400 years, telescopes and microscopes have provided us with access to distant and tiny worlds. We note significant moments in the evolution of the glass used in both devices from their first appearance until the present, relate those moments to key discoveries, and reflect about what it means to extend our sense of vision using glass, the eye of science.
Accelerated Leach Testing of GLASS (ALTGLASS): I. Informatics approach to high level waste glass gel formation and aging
Authors: Jantzen Carol M. , Trivelpiece Cory L. , Crawford Charles L. , Pareizs John M. , Pickett John B.
Published: February 2017

Glass corrosion data from the ALTGLASS™ database were used to determine if gel compositions, which evolve as glass systems corrode, are correlated with the generation of zeolites and subsequent increase in the glass dissolution rate at long times. The gel compositions were estimated based on the difference between the elemental glass starting compositions and the measured elemental leachate concentrations from the long‐term product consistency tests (ASTM C1285) at various stages of dissolution, ie, reaction progress. A well‐characterized subset of high level waste glasses from the database was selected: these glasses had been leached for 15‐20 years at reaction progresses up to ~80%. The gel composition data, at various reaction progresses, were subjected to a step‐wise regression, which demonstrated that hydrogel compositions with Si*/Al* ratios of <1.0 did not generate zeolites and maintained low dissolution rates for the duration of the experiments. Glasses that formed hydrogel compositions with Si^*/Al^* ratios ≥1, generated zeolites accompanied by a resumption in the glass dissolution rate. The role of the gel Si/Al ratio, and the interactions with the leachate, provides the fundamental understanding needed to predict if and when the glass dissolution rate will increase due to zeolitization.
Accelerated Leach Testing of Glass (ALTGLASS): II. Mineralization of hydrogels by leachate strong bases
Authors: Jantzen Carol M. , Trivelpiece Cory L. , Crawford Charles L. , Pareizs John M. , Pickett John B.
Published: February 2017

The durability of high level nuclear waste glasses must be predicted on geological time scales. Waste glass surfaces form hydrogels when in contact with water for varying test durations. As the glass hydrogels age, some exhibit an undesirable resumption of dissolution at long times while others exhibit near steady‐state dissolution, that is, nonresumption of dissolution. Resumption of dissolution is associated with the formation of zeolitic phases while nonresumption of dissolution is associated with the formation of clay minerals. Hydrogels with a stoichiometry close to that of imogolite, (Al2O3·Si(OH)4), with ferrihydrite (Fe2O3·0.5H2O), have been shown to be associated with waste glasses that resume dissolution. Aluminosilicate hydrogels with a stoichiometry of allophane‐hisingerite ((Al,Fe)2O3·1.3‐2Si(OH)4) have been shown to be associated with waste glasses that exhibit near steady‐state dissolution at long times. These phases are all amorphous and poorly crystalline and are also found on natural weathered basalt glasses. Interaction of these hydrogels with excess alkali andOH−(strong base) in the leachates, causes the Al2O3·nSiO2(where n=1‐2) hydrogels to mineralize to zeolites. Excess alkali in the leachate is generated by alkali in the glass. Preliminary rate‐determining leach layer forming exchange reactions are hypothesized based on these findings.
Use of behavioral reasoning theory to examine the role of social responsibility in attitudes toward apparel donation
Authors: Park MinJung , Cho Hyojung , Johnson Kim K. P. , Yurchisin Jennifer
Published: February 2017

Drawing on behavioral reasoning theory, this study investigated drivers of young consumers’ apparel donation behavior. By examining the impact of values (i.e., benevolence and power) and reasons (i.e., other‐oriented reasons and self‐oriented reasons) on attitudes, this study highlights the different motivations individuals have for donating clothing. As predicted, benevolence was positively related to other‐oriented reasons for donations and power was positively related to self‐oriented reasons for donations. Both other‐ and self‐oriented reasons for donating influenced attitudes related to apparel donation behavior. These findings offer an overarching explanation for the seemingly disparate reasons for apparel donation previously identified.
Laparoscopic implantation of artificial urinary sphincter in women with intrinsic sphincter deficiency: Mid‐term outcomes
Authors: Ferreira Carlos , Brychaert Pierre‐Emannuel , Menard Johann , Mandron Eric
Published: February 2017

Objectives

To analyze the safety and the mid‐term continence rates of laparoscopic implantation of artificial urinary sphincter in women.

Methods

A total of 52 women with intrinsic sphincter deficiency underwent a laparoscopic artificial urinary sphincter implantation from 2005 to 2015 at Surgical Clinic Du Pré, Le Mans, France. The artificial urinary sphincter was implanted around the bladder neck by a transperitoneal laparoscopic approach to the Retzius space. Urodynamic assessment was carried out. Postoperative functional outcome was defined as success (no leaking, no pad use), improvement (>50% decrease in number of leakages, >50% decrease in number of pads used or use of light protection) or failure (<50% improvement, persistent or increased leaking). Outcome measures also included perioperative and long‐term complications.

Results

The mean age of the patients was 69.1 years (range 64–82 years). After a mean follow up of 37.5 months (median 24 months; range 1–125 months), 38 (77.6%) patients were considered to be continent (no leakage, no pads), and eight (16.3%) improved their grade of incontinence. Three patients abandoned the follow‐up schedule and were excluded. There was no perioperative severe complication. Artificial urinary sphincter revision was needed in 11 (22.4%) patients, requiring a total of seven redo procedures and four permanent sphincter removals. The main reasons for redo procedures were six (11.2%) mechanical problems and one vaginal erosion (2%).

Conclusions

Herein we report one of the largest series with the longest follow up evaluating the outcomes of laparoscopic artificial urinary sphincter implantation in female patients. This approach seems to be a safe and effective treatment option for patients with intrinsic sphincter deficiency.
(Pro)renin receptor (ATP6AP2) depletion arrests As4.1 cells in the G0/G1 phase thereby increasing formation of primary cilia
Authors: Wanka Heike , Lutze Philipp , Staar Doreen , Peters Barbara , Morch Anica , Vogel Lukas , Chilukoti Ravi Kumar , Homuth Georg , Sczodrok Jaroslaw , Bäumgen Inga , Peters Jörg
Published: February 2017

The (pro)renin receptor [(P)RR, ATP6AP2] is a multifunctional transmembrane protein that activates local renin–angiotensin systems, but also interacts with Wnt pathways and vacuolar H+‐ATPase (V‐ATPase) during organogenesis. The aim of this study was to characterize the role of ATP6AP2 in the cell cycle in more detail.ATP6AP2down‐regulation by siRNA in renal As4.1 cells resulted in a reduction in the rate of proliferation and a G0/G1 phase cell cycle arrest. We identified a number of novel target genes downstream ofATP6AP2knock‐down that were related to the primary cilium (Bbs‐1, Bbs‐3, Bbs‐7, Rabl5, Ttc26, Mks‐11, Mks‐5, Mks‐2, Tctn2, Nme7) and the cell cycle (Pierce1, Clock, Ppif). Accordingly, the number of cells expressing the primary cilium was markedly increased. We found no indication that these effects were dependent of V‐ATPase activity, asATP6AP2knock‐down did not affect lysosomal pH and bafilomycin A neither influenced the ciliary expression pattern nor the percentage of ciliated cells. Furthermore, ATP6AP2 appears to be essential for mitosis. ATP6AP2 translocated from the endoplasmatic reticulum to mitotic spindle poles (pro‐, meta‐ and anaphase) and the central spindle bundle (telophase) andATP6AP2knock‐down results in markedly deformed spindles. We conclude that ATP6AP2 is necessary for cell division, cell cycle progression and mitosis. ATP6AP2 also inhibits ciliogenesis, thus promoting proliferation and preventing differentiation.
Filaggrin loss‐of‐function mutations, atopic dermatitis and risk of actinic keratosis: results from two cross‐sectional studies
Authors: Andersen Y.M.F. , Egeberg A. , Balslev E. , Jørgensen C.L.T. , Szecsi P.B. , Stender S. , Kaae J. , Linneberg A. , Gislason G. , Skov L. , Elias P.M. , Thyssen J.P.
Published: February 2017

Background

Common loss‐of‐function mutations in filaggrin gene (FLG) represent a strong genetic risk factor for atopic dermatitis (AD). Homozygous mutation carriers typically display ichthyosis vulgaris (IV) and many have concomitant AD. Previously, homozygous, but not heterozygous, filaggrin gene mutations have been associated with squamous cell carcinomas.

Objective

The first objective was to examine the association between FLG mutations and actinic keratosis (AK). The second objective was to investigate the occurrence of AK in patients with IV and AD, respectively.

Methods

FLG mutation status in patients with AK was compared with controls from the general population. Furthermore, based on nationwide data from Danish registers, we compared the risk of AK in patients with IV, AD and psoriasis, respectively.

Results

The prevalence of homozygous FLG mutations was significantly higher in the AK group (n = 4, 0.8%) in comparison with the control group (n = 18, 0.2%), whereas the prevalence of heterozygous FLG mutations was lower. In hospital registry data, patients with AD exhibited an increased risk of AK than did psoriasis controls (adjusted OR 1.46; [95% CI 1.12–1.90]), whereas no difference in risk was observed between patients with IV and AD.

Conclusions

This study indicates an increased susceptibility to AK in individuals with homozygous, but not heterozygous, FLG mutations and in patients with AD compared to psoriasis. Whether a reduction or absence of epidermal filaggrin could contribute to the susceptibility to AK in patients with IV and AD is unknown and additional research is needed to further explore this relationship.
The risk of depression, suicidal ideation and suicide attempt in patients with psoriasis, psoriatic arthritis or ankylosing spondylitis
Authors: Wu J.J. , Penfold R.B. , Primatesta P. , Fox T.K. , Stewart C. , Reddy S.P. , Egeberg A. , Liu J. , Simon G.
Published: February 2017

Background

Sparse information is available concerning mental health issues in psoriasis, psoriatic arthritis (PsA) and ankylosing spondylitis (AS) patients.

Objective

To estimate risk of depression, suicidal ideation and suicide attempt in patients with psoriasis, PsA and AS, respectively, compared with the general population.

Methods

This population‐based cohort study analysed 36 214 psoriasis patients, 5138 PsA patients and 1878 AS patients who were frequency‐matched with a general population cohort. Annual incidence rate of depression, suicidal ideation and suicide attempt was calculated separately for psoriasis, PsA and AS.

Results

There was an increased risk of depression in the three cohorts; adjusted IRR: psoriasis, 1.14 (95% CI, 1.11, 1.17); PsA, 1.22 (95% CI, 1.16, 1.29); AS, 1.34 (95% CI, 1.23, 1.47). There was no significantly increased risk for suicidal ideations or suicide attempt among psoriasis, PsA or AS patients.

Limitations

Patients were not excluded if previously diagnosed with depression, suicidal ideation or suicide attempt. Suicide attempt and completed suicide analyses were not adjusted for presence of depression. Use of systemic psoriasis treatment to measure severe psoriasis could lead to psoriasis severity misclassification.

Conclusion

The risk of depression, but not suicidal ideation or suicide attempt, was significantly increased in patients with psoriasis, PsA and AS.
Firm Age, Investment Opportunities, and Job Creation
Authors: ADELINO MANUEL , MA SONG , ROBINSON DAVID
Published: February 2017

New firms are an important source of job creation, but the underlying economic mechanisms for why this is so are not well understood. Using an identification strategy that links shocks to local income to job creation in the nontradable sector, we ask whether job creation arises more through new firm creation or through the expansion of existing firms. We find that new firms account for the bulk of net employment creation in response to local investment opportunities. We also find significant gross job creation and destruction by existing firms, suggesting that positive local shocks accelerate churn.
Skeletal and dental effects of Class III orthopaedic treatment: a systematic review and meta‐analysis
Authors: Rongo R. , D'Antò V. , Bucci R. , Polito I. , Martina R. , Michelotti A.
Published: February 2017

To summarise the skeletal, dental and soft tissue effects of orthopaedic treatment on growing skeletal class III patients compared with a concurrent untreated similar control group and to evaluate whether the design of the primary studies may affect the results. A literature search was performed up to the end of February 2016. No restrictions were applied concerning language and appliances. Once the quality score was assessed, a meta‐analysis was performed for the appliances used in more than three studies. A moderator analysis for study design was performed. The level of evidence was evaluated by means of the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) tool. The search resulted in 21 papers. The quality of most of the studies was medium. Each study reported skeletal sagittal improvement and overjet correction. Fourteen studies reported a significant increase in lower facial height. Follow‐up data showed slight relapses in about 15% of patients. Meta‐analyses were performed for the facemask and chin cup. The two appliances were efficient for correcting the sagittal discrepancy, increasing the divergence. In the analysis for study design, the retrospective studies showed a more efficient appliance than RCTs for 6 of 13 variables. The level of evidence was between very low and moderate. There is very low to low evidence that orthopaedic treatment is effective in the correction of Class III skeletal discrepancies and moderate evidence for the correction of the overjet. A common side effect is mandibular clockwise rotation in older subjects.
Grief, Death, and Longing in Stoic and Christian Ethics
Authors: Scherz Paul
Published: February 2017

The Stoic rejection of the passion of grief strikes many ethicists writing on dying as inhuman, selfish, or lacking appreciation for the world. This essay argues that Stoics rejected grief and the fear of death because these passions alienated one from the present through sorrow or anxiety for the future, disrupting one's ability to fulfill obligations of care for others and to feel gratitude for the gift of loved ones. Early Christian writers on death, such as Ambrose, maintained much of the substance of Stoic doctrine but transformed it through their belief in the resurrection and their corresponding revaluation of the future. While these writers rejected grief as an affective response to death, they affirmed longing for lost loved ones. These authors provide an example of how contemporary religious ethicists can use Stoic insights for recovering the tradition of the art of dying.
Can Isaac Forgive Abraham?
Authors: Gauvin Mitchell J.
Published: February 2017

Forgiveness is an expression that befits agents who are at heart morally frail and imperfect. There is strong disagreement regarding its structure, conditions, and permissibility. Søren Kierkegaard's pseudonymously authored Fear and Trembling—already well understood as a challenge to our understanding of faith, religion, and the moral law through its focus on the biblical tale of Abraham's binding of Isaac—offers an indirect challenge to our understanding of forgiveness. Isaac is too often overlooked as characterless and philosophically uninteresting. What such a reading ignores is his potential expression for what Kierkegaard understood as forgiveness: a dutiful commitment to love equally. Rather than dispelling traditional accounts of forgiveness, Isaac's binding reveals the extent of its diverse expressions.
Christian Supersessionism, Zionism, and the Contemporary Scene
Authors: Magid Shaul
Published: February 2017

Postliberal theology has been a topic of considerable theological debate over the past few decades. In his 2011 book Another Reformation, Peter Ochs deploys a postliberal theological model for the purpose of developing a sophisticated understanding of the future of interreligious relations. Ochs argues that postliberal theology is a reparative theology focusing on alleviating human suffering. He argues that the Christian idea of supersessionism may be the most challenging for Christians to confront as they explore avenues for making interreligious dialogue more effective. Ochs critiques the Mennonite theologian John Howard Yoder's understanding of Zionism as Jewish Constantianism for being an instance of an ostensibly postliberal theology losing its way. In this essay, I offer a critique of Ochs's reading of Yoder, claiming that Yoder's view actually mirrors an important intra‐Jewish debate about the relationship between political power and piety, and retrieves an ingenious contribution of both early Judaism and early Christianity that is effaced in today's growing Constantinian approach to Christian imperialism and Jewish nationalism.
A Hermeneutics of Intimacy
Authors: Wesselhoeft Kirsten
Published: February 2017

All four of the volumes discussed here integrate erudite historical and textual scholarship in Islamic studies with clearly articulated ethical and theological projects of gender justice, which are in turn rooted in the authors’ engagements in Muslim communities worldwide. This combination is a hallmark of recent work on gender and sexuality in Islamic contexts, where scholars foreground the complex intersection of their own ethical standpoints, their historically and linguistically grounded exegesis of classical sources, and their hopes for gender justice in contemporary Muslim communities. In the process, they offer a range of evocative models for how to combine descriptive and constructive work in religious ethics. Further, this cluster of works contributes to an ongoing conversation in religious ethics about the concept of tradition. This review draws out a focus on the relational intimacy of the hermeneutical project that I argue constitutes an overarching theoretical intervention in the concept of an ethical tradition.
One Good Turn Deserves Another
Authors: Barbieri William A.
Published: February 2017

Elizabeth Bucar has provided a service to the guild with her introduction to the emergent field of visual ethics. In this comment I undertake to expand the picture she presents. I argue that the visual dimension of ethics includes a “dark side” not addressed in her piece, and go on to consider a number of current avenues of inquiry in which religious ethics intersects with visual studies. After briefly considering some of the distinctive methodological challenges attending the visual turn in ethics, I conclude my survey of this new field with some comments on the moral qualities of cinema.