bluuebunny/crossref_metadata_2025 huggingface dataset:
Central diabetes insipidus caused by a pituitary stalk germinoma resembling infundibuloneurohypophysitis
Authors: Dias Daniela , Vilar Helena , Passos João , Leite Valeriano
Published: September 2020

We report the case of a pituitary stalk germinoma initially misdiagnosed and treated as infundibuloneurohypophysitis (INH). A 27-year-old man presented with a 1-year history of polydipsia, polyuria, nycturia consistent with central diabetes insipidus and a hyperintense pituitary stalk lesion on MRI. A possible INH diagnosis was considered, after excluding other pathologies. Lesion biopsy was discarded at that time on the ground of a small target and the high risk of added morbidity. Oral desmopressin led to initial symptoms resolution but, in the following months, an anterior panhypopituitarism developed, in spite of appropriate treatment and, by that time, the brain MRI also revealed lesion growth, which prompted a biopsy recommendation. The pathology analysis revealed a germinoma. After chemotherapy and radiotherapy, there was complete disappearance of the pituitary lesion, but the panhypopituitarism persisted. In conclusion, this case highlights the importance and difficulty of precise diagnosis in the initial assessment of pituitary stalk lesions and the need for close monitoring of treatment response. Diagnostic reassessment and biopsy in atypical cases is the only path to achieve the correct diagnosis and treatment.
Adult hypophosphatasia manifests in a marathon runner
Authors: Fanous Nada , Barb Diana
Published: September 2020

A 49-year-old woman, previously healthy, presented with recurrent fractures provoked by minimal trauma. She had sustained seven fractures over the previous 2 years. While she was an avid runner, her injuries were determined to be out of proportion to the degree of trauma. Initial evaluation, exploring the more common causes such as low bone density and abnormal vitamin D metabolism, was unremarkable. On repeat of the some of the tests, a low alkaline phosphatase (AP) was noted, which raised suspicion for hypophosphatasia (HPP), a rare cause of recurrent fractures. Subsequent workup revealed a low bone-specific AP and elevated vitamin B6. Subsequently, genetic testing confirmed the diagnosis of adult-onset HPP caused by a heterozygous mutation c.407G>A in the ALPL gene. Asfotase alfa was started; however, the patient developed an allergic reaction leading to the discontinuation of the drug.
Potassium losing, aldosterone producing adrenocortical carcinoma: a rare presentation
Authors: Hussain Zahir S , Rao Smitha S , Hussain Wajith Z , Puzhakkal Shikhil
Published: September 2020

Adrenocortical carcinomas (ACCs) are rare malignancies with an incidence of one to two per million per year. Aldosterone-producing ACCs (APACs) are extremely rare with an incidence less than 1%. We describe a rare case of APAC, presenting with episodic lower-limb weakness and hypertension. Our patient was found to have serum aldosterone levels of 20.8 ng/dL (2.5–15.2) with persistent hypokalaemia and a 9.7×8.3×7.7 cm right adrenal mass, which was suspicious of malignancy on evaluation. He underwent a complete surgical resection which confirmed the diagnosis of ACC and normalised his aldosterone and potassium levels. He was then subjected to postoperative chemotherapy. Postoperative adjuvant chemotherapy with mitotane has a role in preventing recurrence.
Titinopathy, an atypical respiratory failure
Authors: Morais Joana , Oliveira Ana Andrade , Pires Olga , Burmester Inês , Regadas Maria João , Gouveia Paulo
Published: September 2020

Hereditary myopathy with early respiratory failure is a neuromuscular disease with an autosomal dominant inheritance pattern. Clinical presentation is characterised by proximal and distal muscle weakness, exertional dyspnoea and generalised fatigue. There is no disease-modifying therapy and the prognosis is unknown. Herein we present a case of a 40-year-old woman with long-standing asthenia and apathy and, more recently, daytime sleepiness, dyspnoea and difficulty in walking. A hypercapnic respiratory failure with severe acidemia was identified. The muscle biopsy showed the presence of cytoplasmatic bodies and rimmed vacuoles, suggestive of a hereditary myopathy with early respiratory failure disease. The genetic study confirmed this diagnosis identifying a heterozygous mutation on c.95134T>C (p.Cys31712Arg) in exon 343 in the titin gene. The patient was discharged home under supportive treatment with non-invasive ventilation.
Distal phalanx: an unusual site for a gastric adenocarcinoma metastasis
Authors: Harris Holly , Khan Mansoor , Jaunoo Shameen
Published: September 2020

Gastric adenocarcinoma typically metastasises to the liver, peritoneum and lung. Bone metastasises are less frequent and particularly uncommon in the distal extremities. This is an unusual case of metastatic disease in the distal phalanx mimicking the presentation of osteomyelitis. This case highlights the need to remain vigilant in patients with known cancer and to always be mindful of metastatic disease, even if the presentation is atypical.
Association between high blood pressure and long term cardiovascular events in young adults: systematic review and meta-analysis
Authors: Luo Dongling , Cheng Yunjiu , Zhang Haifeng , Ba Mingchuan , Chen Pengyuan , Li Hezhi , Chen Kequan , Sha Weihong , Zhang Caojin , Chen Hao
Published: September 2020

Objective

To evaluate and quantify the future risk of cardiovascular events in young adults with high blood pressure.

Design

Systematic review and meta-analysis.

Data sources

Medline, Embase, and Web of Science were searched from inception to 6 March 2020. Relative risks were pooled using a random effects model and expressed with 95% confidence intervals. Absolute risk difference was calculated. Dose-response relations between blood pressure and individual outcomes were assessed by a restricted cubic spline model.

Eligibility criteria for selecting studies

Studies were selected that investigated the adverse outcomes of adults aged 18-45 with raised blood pressure. The primary study outcome was a composite of total cardiovascular events. Coronary heart disease, stroke, and all cause mortality were examined as secondary outcomes.

Results

Seventeen observational cohorts consisting of approximately 4.5 million young adults were included in the analysis. The average follow-up was 14.7 years. Young adults with normal blood pressure had increased risk of cardiovascular events compared with those with optimal blood pressure (relative risk 1.19, 95% confidence interval 1.08 to 1.31; risk difference 0.37, 95% confidence interval 0.16 to 0.61 per 1000 person years). A graded, progressive association was found between blood pressure categories and increased risk of cardiovascular events (high normal blood pressure: relative risk 1.35, 95% confidence interval 1.22 to 1.49; risk difference 0.69, 95% confidence interval 0.43 to 0.97 per 1000 person years; grade 1 hypertension: 1.92, 1.68 to 2.19; 1.81, 1.34 to 2.34; grade 2 hypertension: 3.15, 2.31 to 4.29; 4.24, 2.58 to 6.48). Similar results were observed for coronary heart disease and stroke. Generally, the population attributable fraction for cardiovascular events associated with raised blood pressure was 23.8% (95% confidence interval 17.9% to 28.8%). The number needed to treat for one year to prevent one cardiovascular event was estimated at 2672 (95% confidence interval 1639 to 6250) for participants with normal blood pressure, 1450 (1031 to 2326) for those with high normal blood pressure, 552 (427 to 746) for those with grade 1 hypertension, and 236 (154 to 388) for those with grade 2 hypertension.

Conclusions

Young adults with raised blood pressure might have a slightly increased risk of cardiovascular events in later life. Because the evidence for blood pressure lowering is limited, active interventions should be cautious and warrant further investigation.
Depression among adult patients with primary brain tumour: a cross-sectional study of risk factors in a low–middle-income country
Authors: Pidani Anum Sadruddin , Siddiqui Amna Rehana , Azam Iqbal , shamim Muhammad Shahzad , Jabbar Adnan Abdul , Khan Shameel
Published: September 2020

Objective

The prevalence of depression among patients with primary brain tumour ranges from 15% to 40% globally. Several individual and clinical factors contribute to the development of depression. However, their association with depression in Pakistani setting has not yet been assessed. Thus, we aim to study the factors associated with depression among adult patients with primary brain tumour at a tertiary care hospital in Karachi, Pakistan.

Study design

A prospective cross-sectional study.

Setting

This study was conducted at a tertiary care hospital of Karachi, Pakistan.

Participants

This study included 132 patients with confirmed diagnosis of primary brain tumour (initially diagnosed on MRI of the brain with contrast and later confirmed on histology of surgical specimen) in various stages of treatment.

Primary outcome

The primary outcome of this study was to assess depression and its associated factors among adult patients with primary brain tumour. Depression was assessed using a validated screening tool Patient Health Questionnaire-9 (PHQ-9). Scores of 10–27 on PHQ-9 were indicative of screen positive for depressive symptoms. A set of the structured pre-tested questions was used to evaluate patient-related, tumor-related and treatment-related factors.

Results

Fifty-one (39%, CI: 33.33–46.94) patients in our study screened positive for depressive symptoms on PHQ-9. There was a significant association between depressive symptoms and Karnofsky Performance Scores (KPS) (prevalence ratio: 3.25 and CI: 1.87–5.62) after controlling covariates. Propensity scores predicted a positive association between KPS (functional status) and unemployment, treatment stage, and tumour recurrence. Tumor-related and treatment-related factors including tumour grade, location, type and hemispheric lateralisation were found insignificant.

Conclusion

Depression is common in patients with primary brain tumour. Impaired functional status has a direct impact on depression in these patients. Incorporating the psychosocial domain earlier in the course of treatment needs to be considered for better neuro-oncology management of patients with primary brain tumour.
Study protocol of a multicentre, randomised, controlled trial evaluating the effectiveness of probiotic and peanut oral immunotherapy (PPOIT) in inducing desensitisation or tolerance in children with peanut allergy compared with oral immunotherapy (OIT) alone and with placebo (the PPOIT-003 study)
Authors: Chebar Lozinsky Adriana , Loke Paxton , Orsini Francesca , O’Sullivan Michael , L. Prescott Susan , Gold Michael S , Quinn Patrick , DunnGalvin Audrey , LK Tang Mimi
Published: September 2020

Introduction

Peanut allergy is the the most common cause of life-threatening food-induced anaphylaxis. There is currently no effective long-term treatment. There is a pressing need for definitive treatments that improve the quality of life and prevent fatalities. Allergen oral immunotherapy (OIT) is a promising approach, which is effective at inducing desensitisation; however, OIT has a limited ability to induce sustained unresponsiveness (SU). We have previously shown that a novel treatment comprising a combination of the probiotic Lactobacillus rhamnosus CGMCC 1.3724 with peanut OIT (Probiotic Peanut Oral ImmunoTherapy (PPOIT)) is highly effective at inducing SU, with benefit persisting to 4 years after treatment cessation in the majority of initial treatment responders. Here we describe the protocol for a Phase IIb multicentre, double-blind, randomised, controlled trial (PPOIT-003) with dual primary objectives to evaluate the effectiveness of PPOIT at inducing SU (assessed at 8 weeks after treatment cessation) compared with placebo treatment and peanut OIT alone, in children with peanut allergy.

Methods and analysis

200 children 1 to 10 years of age with current peanut allergy confirmed by failed double-blind placebo-controlled food challenge (DBPCFC) at study screening will be recruited from three tertiary paediatric hospitals in Australia. There are three intervention arms—PPOIT, peanut OIT alone or placebo. Interventions are administered once daily for 18 months. The dual primary outcomes are: (1) the proportion of children who attain 8-week SU in the PPOIT group versus placebo group and (2) the proportion of children who attain 8-week SU in the PPOIT group versus OIT group.

Ethics and dissemination

This study has been approved by the Human Research Ethics Committees at the Royal Children’s Hospital (HREC 35246) and the Child and Adolescent Health Service (RGS 2543). Results will be published in peer-reviewed journals and disseminated via presentations at international conferences.

Trial registration number

ACTRN12616000322437.
Risk factor for intestinal carriage of carbapenem-resistantAcinetobacter baumanniiand the impact on subsequent infection among patients in an intensive care unit: an observational study
Authors: Qiao Fu , Huang Wenzhi , Gao Shan , Cai Lin , Zhu Shichao , Wei Li , Kang Yan , Tao Chuanmin , Zong Zhiyong
Published: September 2020

Objectives

To assess the incidence and the impact of carbapenem-resistantAcinetobacter baumannii(CRAB) intestinal carriage on subsequent CRAB infection and to study risk factors of acquiring CRAB intestinal carriage among patients in intensive care unit (ICU).

Design

Observational study including a case–control study and a retrospective cohort study.

Setting

A 50-bed general ICU of a university hospital, China.

Methods

From May 2017 to April 2018, an observational study was conducted in a 50-bed general ICU of a university hospital in China. Rectal swabs were collected from ICU patients on admission and thereafter weekly. A case–control study was performed to analyse risk factors of the acquisition of CRAB intestinal carriage in ICU using multiple logistic regression. A retrospective cohort study was performed to address whether intestinal CRAB carriage could lead to an increased likelihood of subsequent CRAB infection using subdistribution hazard model regarding death in the ICU as a competing risk event.

Results

CRAB intestinal carriage was detected in 6.87% (66/961; 95% CI 5.27% to 8.47%) of patients on ICU admission, whereas 11.97% (115/961; 95% CI 9.91% to 14.02%) of patients acquired CRAB intestinal carriage during the ICU stay. Pancreatitis (OR 2.16, 95% CI 1.28 to 3.67), haematological disease (OR 2.26, 95% CI 1.42 to 3.58), gastric tube feeding (OR 3.35, 95% CI 2.03 to 5.51) and use of carbapenems (OR 1.84, 95% CI 1.11 to 3.07) were independent risk factors for acquiring CRAB intestinal carriage. The incidence of subsequent CRAB infection was 2.24-fold in patients with CRAB intestinal carriage compared with that in patients without (95% CI 1.48 to 3.39, p<0.001).

Conclusion

More patients acquired CRAB intestinal carriage during their ICU stay than had on admission. Severity of illness, acute pancreatitis, tube feeding and use of carbapenems were independent risk factors of acquisition of CRAB intestinal carriage. Patients with CRAB intestinal carriage are more likely to develop CRAB infection.
Comparative effectiveness of buprenorphine-naloxone versus methadone for treatment of opioid use disorder: a population-based observational study protocol in British Columbia, Canada
Authors: Piske Micah , Thomson Trevor , Krebs Emanuel , Hongdilokkul Natt , Bruneau Julie , Greenland Sander , Gustafson Paul , Karim M Ehsan , McCandless Lawrence C , Maclure Malcolm , Platt Robert W , Siebert Uwe , Socías M Eugenia , Tsui Judith I , Wood Evan , Nosyk Bohdan
Published: September 2020

Introduction

Despite a recent meta-analysis including 31 randomised controlled trials comparing methadone and buprenorphine for the treatment of opioid use disorder, important knowledge gaps remain regarding the long-term effectiveness of different treatment modalities across individuals, including rigorously collected data on retention rates and other treatment outcomes. Evidence from real-world data represents a valuable opportunity to improve personalised treatment and patient-centred guidelines for vulnerable populations and inform strategies to reduce opioid-related mortality. Our objective is to determine the comparative effectiveness of methadone versus buprenorphine/naloxone, both overall and within key populations, in a setting where both medications are simultaneously available in office-based practices and specialised clinics.

Methods and analysis

We propose a retrospective cohort study of all adults living in British Columbia receiving opioid agonist treatment (OAT) with methadone or buprenorphine/naloxone between 1 January 2008 and 30 September 2018. The study will draw on seven linked population-level administrative databases. The primary outcomes include retention in OAT and all-cause mortality. We will determine the effectiveness of buprenorphine/naloxone vs methadone using intention-to-treat and per-protocol analyses—the former emulating flexible-dose trials and the latter focusing on the comparison of the two medication regimens offered at the optimal dose. Sensitivity analyses will be used to assess the robustness of results to heterogeneity in the patient population and threats to internal validity.

Ethics and dissemination

The protocol, cohort creation and analysis plan have been approved and classified as a quality improvement initiative exempt from ethical review (Providence Health Care Research Institute and the Simon Fraser University Office of Research Ethics). Dissemination is planned via conferences and publications, and through direct engagement and collaboration with entities that issue clinical guidelines, such as professional medical societies and public health organisations.
Yorkshire Enhanced Stop Smoking (YESS) study: a protocol for a randomised controlled trial to evaluate the effect of adding a personalised smoking cessation intervention to a lung cancer screening programme
Authors: Murray Rachael L , Brain Kate , Britton John , Quinn-Scoggins Harriet D , Lewis Sarah , McCutchan Grace M , Quaife Samantha L , Wu Qi , Ashurst Alex , Baldwin David , Crosbie Philip A J , Neal Richard D , Parrott Steve , Rogerson Suzanne , Thorley Rebecca , Callister Matthew EJ
Published: September 2020

Introduction

Integration of smoking cessation (SC) into lung cancer screening is essential to optimise clinical and cost effectiveness. The most effective way to use this ‘teachable moment’ is unclear. The Yorkshire Enhanced Stop Smoking study will measure the effectiveness of an SC service integrated within the Yorkshire Lung Screening Trial (YLST) and will test the efficacy of a personalised SC intervention, incorporating incidental findings detected on the low-dose CT scan performed as part of YLST.

Methods and analysis

Unless explicitly declined, all smokers enrolled in YLST will see an SC practitioner at baseline and receive SC support over 4 weeks comprising behavioural support, pharmacotherapy and/or a commercially available e-cigarette. Eligible smokers will be randomised (1:1 in permuted blocks of random size up to size 6) to receive either an enhanced, personalised SC support package, including CT scan images, or continued standard best practice. Anticipated recruitment is 1040 smokers (January 2019–December 2020). The primary objective is to measure 7-day point prevalent carbon monoxide (CO) validated SC after 3 months. Secondary outcomes include CO validated cessation at 4 weeks and 12 months, self-reported continuous cessation at 4 weeks, 3 months and 12 months, attempts to quit smoking and changes in psychological variables, including perceived risk of lung cancer, motivation to quit smoking tobacco, confidence and efficacy beliefs (self and response) at all follow-up points. A process evaluation will explore under which circumstances and on which groups the intervention works best, test intervention fidelity and theory test the mechanisms of intervention impact.

Ethics and dissemination

This study has been approved by the East Midlands-Derby Research Ethics Committee (18/EM/0199) and the Health Research Authority/Health and Care Research Wales. Results will be disseminated through publication in peer-reviewed scientific journals, presentation at conferences and via the YLST website.

Trial registration numbers

ISRCTN63825779,NCT03750110.
Changing consumption of resources for respiratory support and short-term outcomes in four consecutive geographical cohorts of infants born extremely preterm over 25 years since the early 1990s
Authors: Cheong Jeanie L Y , Olsen Joy E , Huang Li , Dalziel Kim M , Boland Rosemarie A , Burnett Alice C , Haikerwal Anjali , Spittle Alicia J , Opie Gillian , Stewart Alice E , Hickey Leah M , Anderson Peter J , Doyle Lex W
Published: September 2020

Objectives

It is unclear how newer methods of respiratory support for infants born extremely preterm (EP; 22–27 weeks gestation) have affected in-hospital sequelae. We aimed to determine changes in respiratory support, survival and morbidity in EP infants since the early 1990s.

Design

Prospective longitudinal cohort study.

Setting

The State of Victoria, Australia.

Participants

All EP births offered intensive care in four discrete eras (1991–1992 (24 months): n=332, 1997 (12 months): n=190, 2005 (12 months): n=229, and April 2016–March 2017 (12 months): n=250).

Outcome measures

Consumption of respiratory support, survival and morbidity to discharge home. Cost-effectiveness ratios describing the average additional days of respiratory support associated per additional survivor were calculated.

Results

Median duration of any respiratory support increased from 22 days (1991–1992) to 66 days (2016–2017). The increase occurred in non-invasive respiratory support (2 days (1991–1992) to 51 days (2016–2017)), with high-flow nasal cannulae, unavailable in earlier cohorts, comprising almost one-half of the duration in 2016–2017. Survival to discharge home increased (68% (1991–1992) to 87% (2016–2017)). Cystic periventricular leukomalacia decreased (6.3% (1991–1992) to 1.2% (2016–2017)), whereas retinopathy of prematurity requiring treatment increased (4.0% (1991–1992) to 10.0% (2016–2017)). The average additional costs associated with one additional infant surviving in 2016–2017 were 200 (95% CI 150 to 297) days, 326 (183 to 1127) days and 130 (70 to 267) days compared with 1991–1992, 1997 and 2005, respectively.

Conclusions

Consumption of resources for respiratory support has escalated with improved survival over time. Cystic periventricular leukomalacia reduced in incidence but retinopathy of prematurity requiring treatment increased. How these changes translate into long-term respiratory or neurological function remains to be determined.
East Midlands knee pain multiple randomised controlled trial cohort study: cohort establishment and feasibility study protocol
Authors: Hall Michelle , Fuller Amy , Nomikos Polykarpos Angelos , Millar Bonnie , Ogollah Reuben , Valdes Ana , Greenhaff Paul , das Nair Roshan , Doherty Michael , Walsh David A , Abhishek A
Published: September 2020

Introduction

Knee pain due to osteoarthritis (OA) is a common cause of disability. The UK National Institute for Health and Care Excellence OA guidelines recommend education, exercise and weight loss advice (if overweight) as core interventions before pharmacological adjuncts. However, implementation of these in primary care is often suboptimal. This study aims to develop a complex intervention with non-pharmacological and pharmacological components that can be delivered by nurses. The feasibility and acceptability of the intervention, and feasibility of undertaking a future cohort randomised controlled trial (RCT) will be explored.

Methods and analysis

In phase 1, we will develop a training programme for nurses and evaluate the fidelity and acceptability of the non-pharmacological element of the intervention. Fidelity checklists completed by the nurse will be compared with video analysis of the treatment sessions. Patients and nurses will be interviewed to determine the acceptability of the intervention and explore challenges to intervention delivery. The non-pharmacological component will be modified based on the findings. In phase 2, we will assess the feasibility of conducting a cohort RCT comprising both the pharmacological and modified non-pharmacological components. We will compare three groups: group A will receive the non-pharmacological components delivered before pharmacological components; group B will receive pharmacological components followed by the non-pharmacological components; and group C (control arm) will continue to receive usual care. Study outcomes will be collected at three time points: baseline, 13 and 26 weeks after randomisation. Qualitative interviews will be conducted with a sample of participants from each of the two active intervention arms.

Ethics and dissemination

This protocol was approved by the East Midlands-Derby Research Ethics Committee (18/EM/0288) and registered at ClinicalTrials.gov (protocol v4.0, 10/02/2020). The study will be reported in accordance with the Consolidated Standards of Reporting Trials guidance and standards. The results will be submitted for publication in peer-reviewed academic journals.

Trial registration number

NCT03670706
Association of serum uric acid, morning home blood pressure and cardiovascular risk factors in a population with previous prehypertension: a cross-sectional study
Authors: Bawazier Lucky Aziza , Sja'bani Mochammad , Irijanto Fredie , Zulaela Zulaela , Widiatmoko Agus , Kholiq Abdul , Tomino Yasuhiko
Published: September 2020

Objective

To observe the changes in blood pressure (BP) over 10 years and to investigate current BP association to serum uric acid (SUA) levels and cardiovascular risk factors in the epidemiological data of a target group of patients with prehypertension in 2007.

Design

Cross-sectional study.

Setting

Mlati Subdistrict, Sleman District, Yogyakarta Province, Indonesia.

Participants

A total of 733 patients from ‘Mlati Study Database’ in 2007 were selected by simple random sampling using statistical software. Subjects had both physical and laboratory examinations.

Outcome measures

Morning home BP and laboratory examination of urine (uric acid excretion and creatinine) and blood samples (SUA, blood urea nitrogen, creatinine, a lipid profile and fasting blood glucose levels).

Results

About 31.1% of 733 subjects with prehypertension became hypertensive after 10 years, 24.6% returned to normal tension and the rest of it remained in prehypertensive state. Mean (SD) of SUA levels in 2017 was significantly higher in men than in women (5.78 (1.25) mg/dL vs 4.52 (1.10) mg/dL, p<0.001). Furthermore, men tended to have high-normal (5–7 mg/dL) or high SUA levels (≥7 mg/dL) compared with women (p<0.001, Relative Risk (RR)=2.60). High-normal and high SUA levels in population with a history of prehypertension were significantly associated with current prehypertension and hypertension only in women (p=0.001, RR=1.21). Age and body mass index was found to be significantly associated with both systolic and diastolic BP in men, but only with systolic BP in women. Fasting blood glucose and SUA levels were significantly associated with systolic and diastolic BP only in women.

Conclusion

We concluded that after 10 years, of 733 subjects with prehypertension, 31.1% became hypertensive. The SUA levels in men are significantly higher than those in women. Moreover, high-normal and high SUA levels were significantly associated with prehypertension and hypertension in women but not in men.
Use of real-world data to study health services utilisation and comorbidities in long-term breast cancer survivors (the SURBCAN study): study protocol for a longitudinal population-based cohort study
Authors: Jansana Anna , Del Cura Isabel , Prados-Torres Alexandra , Sanz Cuesta Teresa , Poblador-Plou Beatriz , Gimeno Miguel A , Lanzuela Manuela , Ibañez Berta , Tamayo Ibai , Moreno-Iribas Conchi , Padilla-Ruiz María , Redondo Maximino , Comas Mercè , Domingo Laia , Díaz-Holgado Antonio , Salamanca Francisco Javier , Castells Xavier , Sala Maria
Published: September 2020

Introduction

Breast cancer has become a chronic disease due to survival improvement and the need to monitor the side effects of treatment and the disease itself. The aim of the SURBCAN study is to describe comorbidity, healthcare services use and adherence to preventive recommendations in long-term breast cancer survivors and to compare them with those in women without this diagnosis in order to improve and adapt the care response to this group of survivors.

Methods and analysis

Population-based retrospective cohort study using real-world data from cancer registries and linked electronic medical records in five Spanish regions. Long-term breast cancer survivors diagnosed between 2000 and 2006 will be identified and matched by age and administrative health area with women without this diagnosis. Sociodemographic and clinical variables including comorbidities and variables on the use of health services between 2012 and 2016 will be obtained from databases in primary and hospital care. Health services use will be assessed through the annual number of visits to primary care professionals and to specialists and through annual imaging and laboratory tests. Factors associated with healthcare utilisation and comorbidities will be analysed using multilevel logistic regression models. Recruitment started in December 2018.

Ethics and dissemination

This study was approved by the Ethics Committee of Parc de Salut Mar. The results of the study will be published in a peer-reviewed journal and will be presented at national and international scientific conferences and at patient associations.

Trial registration number

This protocol is registered in Clinical Trials.gov (identifier: NCT03846999).
Vimentin as a target for the treatment of COVID-19
Authors: Li Zhenlin , Paulin Denise , Lacolley Patrick , Coletti Dario , Agbulut Onnik
Published: September 2020

We and others propose vimentin as a possible cellular target for the treatment of COVID-19. This innovative idea is so recent that it requires further attention and debate. The significant role played by vimentin in virus-induced infection however is well established: (1) vimentin has been reported as a co-receptor and/or attachment site for SARS-CoV; (2) vimentin is involved in viral replication in cells; (3) vimentin plays a fundamental role in both the viral infection and the consequent explosive immune-inflammatory response and (4) a lower vimentin expression is associated with the inhibition of epithelial to mesenchymal transition and fibrosis. Moreover, the absence of vimentin in mice makes them resistant to lung injury. Since vimentin has a twofold role in the disease, not only being involved in the viral infection but also in the associated life-threatening lung inflammation, the use of vimentin-targeted drugs may offer a synergistic advantage as compared with other treatments not targeting vimentin. Consequently, we speculate here that drugs which decrease the expression of vimentin can be used for the treatment of patients with COVID-19 and advise that several Food and Drug Administration-approved drugs be immediately tested in clinical trials against SARS-CoV-2, thus broadening therapeutic options for this type of viral infection.
The dedicated iron deficiency anaemia clinic: a 15-year experience
Authors: Stone Helen , Almilaji Orouba , John Christopher , Smith Carla , Surgenor Susan L , Ayres Lachlan , Williams Elizabeth J , Snook Jonathon
Published: September 2020

Objective

To report our cumulative experience from a dedicated iron deficiency anaemia (IDA) clinic over the last 15 years—with particular emphasis on referral rate, uptake of investigation, impact on endoscopy services, diagnostic yield of gastrointestinal (GI) investigation and the issue of recurrent IDA.

Method

A series of analyses of a register of 2808 referrals to the Poole IDA clinic between 2004 and 2018.

Results

The study population of 2808 had a sex ratio of 1.9 (female/male ratio) and a median age of 72 years (IQR: 60–79). A rising referral rate over the study period appears to be plateauing at around 2 cases per 1000 population per annum. On the basis of a snapshot audit, investigation of IDA may now account for over 20% of all diagnostic endoscopies.

Overall, 86% of cases underwent examination of the upper and lower GI tract. Significant GI pathology was identified in 27% of the investigated cohort. Adenocarcinoma of the upper or lower GI tract was found in 8.3%, the majority in the right colon. The prevalence of recurrent IDA was estimated at 12.4%, and the results of investigation of this subgroup are reported.

Conclusion

Unexplained IDA is common, particularly in those over 60 years, and may be the first indication of underlying GI malignancy in over 8% of cases. Unresolved challenges include accommodating the resulting endoscopy workload, establishing a risk/benefit ratio for investigating those with major comorbidities and the management of recurrent IDA.
BCL2andBCL6atypical/unbalanced gene rearrangements in diffuse large B-cell lymphoma are indicators of an aggressive clinical course
Authors: Tourneret Alicia , Alame Melissa , Rigau Valerie , Bauchet Luc , Fabbro Michel , De Oliveira Laura , Cacheux Valere , Costes Valerie , Lacheretz-Szablewski Vanessa
Published: September 2020

Aims

Diffuse large B-cell lymphoma (DLBCL) is the most common type of aggressive non-Hodgkin's lymphoma that represents a heterogeneous group of disease that is differentially characterised by clinical, molecular and cytogenetic features.MYC,BCL2andBCL6gene rearrangements have been identified as prognostic factors in DLBCL, especially forMYC. Nevertheless the frequency and effect of atypical/unbalancedBCL6, BCL2andMYCtranslocations in DLBCL is not fully documented. Here, we aimed to analyse those atypical/unbalanced rearrangements in DLBCL and to assess their prognostic impact.

Methods

We collected tumour tissue and clinical data from 97 DLBCL and used interphase fluorescence in situ hybridisation (FISH) with break-apart probe to characteriseBCL6, BCL2andMYCgene pattern.

Results

19 of 97 (19,6%) cases of DLBCL had atypical/ unbalanced gene rearrangements (14 involvingBCL6gene, 5 involvingBCL2gene and none involvingMYCgene). Compared with patients with simple gene rearrangement and patients without cytogenetic abnormality, patients with atypical/unbalanced gene rearrangement were in an unfavourable risk group by the International Prognostic Index (p=0039), died of disease (p=0012), harboured relapse or progression (p=0011) and had shorter overall (p=0,04), relapse free (p=0029) and event free (p=0026) survival.

Conclusions

We showed that patients with DLBCL withBCL2orBCL6atypical/unbalanced rearrangements constituted a group of patients with poor outcome. We also underlined the importance of FISH analyses, easily feasible in routine practise, at diagnosis of DLBCL to detect the rather frequent and clinically significant atypical/unbalanced aberrations of these genes.
Effectiveness of providing university students with a mindfulness-based intervention to increase resilience to stress: 1-year follow-up of a pragmatic randomised controlled trial
Authors: Galante Julieta , Stochl Jan , Dufour Géraldine , Vainre Maris , Wagner Adam Peter , Jones Peter Brian
Published: September 2020

Background

There is concern that increasing demand for student mental health services reflects deteriorating student well-being. We designed a pragmatic, parallel, single-blinded randomised controlled trial hypothesising that providing mindfulness courses to university students would promote their resilience to stress up to a year later. Here we present 1-year follow-up outcomes.

Methods

University of Cambridge students without severe mental illness or crisis were randomised (1:1, remote software-generated random numbers), to join an 8-week mindfulness course adapted for university students (Mindfulness Skills for Students (MSS)), or to mental health support as usual (SAU).

Results

We randomised 616 students; 53% completed the 1-year follow-up questionnaire. Self-reported psychological distress and mental well-being improved in the MSS arm for up to 1 year compared to SAU (p<0.001). Effects were smaller than during the examination period. No significant differences between arms were detected in the use of University Counselling Service and other support resources, but there was a trend for MSS participants having milder needs. There were no differences in students’ workload management; MSS participants made more donations. Home practice had positive dose–response effects; few participants meditated. No adverse effects related to self-harm, suicidality or harm to others were detected.

Conclusion

Loss to follow-up is a limitation, but evidence suggests beneficial effects on students’ average psychological distress that last for at least a year. Effects are on average larger at stressful times, consistent with the hypothesis that this type of mindfulness training increases resilience to stress.

Trial registration number

ACTRN12615001160527.
Occupational physical activity, not leisure-time physical activity, is associated with increased high-sensitivity C reactive protein levels
Authors: Lee Jongin , Kim Hyoung-Ryoul , Jang Tae-Won , Lee Dong-Wook , Lee Yu Min , Kang Mo-Yeol
Published: September 2020

Objective

This study aims to explore the association between physical activity and high-sensitivity C reactive protein, based on different types of physical activity—occupational and leisure time.

Methods

Using cross-sectional data from the Korea National Health and Nutrition Examination Survey 2015–2018, we explored the association between different types of self-reported physical activity and high levels of high-sensitivity C reactive protein (>3 mg/L). We estimated the ORs for high-level high-sensitivity C reactive protein using multiple logistic regression models after adjusting for covariates from 12 970 eligible subjects (mean age 44.8).

Results

Compared with subjects who did not engage in moderate-to-vigorous level of occupational physical activity (OPA), the group that engaged in moderate-to-vigorous level of OPA showed a significantly high OR (1.32, 95% CI (1.03 to 1.69)), whereas the group that engaged in moderate-to-vigorous level of leisure-time physical activity (LPA) yielded a low OR (0.84, 95% CI (0.69 to 1.01)). The group that engaged in moderate-to-vigorous level of OPA but not LPA showed a significantly high OR (1.76, 95% CI (1.27 to 2.45)) compared with subjects who engaged in moderate-to-vigorous level of LPA but not in OPA.

Conclusions

OPA is directly associated with high C reactive protein levels, suggesting that it increases the risk of inflammation.
Cryogenic characterization of a $$\hbox {LiAlO}_{2}$$ crystal and new results on spin-dependent dark matter interactions with ordinary matter
Authors: Abdelhameed A. H. , Angloher G. , Bauer P. , Bento A. , Bertoldo E. , Breier R. , Bucci C. , Canonica L. , D’Addabbo A. , Di Lorenzo S. , Erb A. , Feilitzsch F. V. , Iachellini N. Ferreiro , Fichtinger S. , Fuchs D. , Fuss A. , Ghete V. M. , Garai A. , Gorla P. , Hauff D. , Ješkovský M. , Jochum J. , Kaizer J. , Kaznacheeva M. , Kinast A. , Kluck H. , Kraus H. , Langenkämper A. , Mancuso M. , Mokina V. , Mondragon E. , Olmi M. , Ortmann T. , Pagliarone C. , Palušová V. , Pattavina L. , Petricca F. , Potzel W. , Povinec P. , Pröbst F. , Reindl F. , Rothe J. , Schäffner K. , Schieck J. , Schipperges V. , Schmiedmayer D. , Schönert S. , Schwertner C. , Stahlberg M. , Stodolsky L. , Strandhagen C. , Strauss R. , Usherov I. , Wagner F. , Willers M. , Zema V. , Zeman J. , Brützam M. , Ganschow S.
Published: September 2020

In this work, a first cryogenic characterization of a scintillating $$\hbox {LiAlO}_{2}$$

LiAlO
2

single crystal is presented. The results achieved show that this material holds great potential as a target for direct dark matter search experiments. Three different detector modules obtained from one crystal grown at the Leibniz-Institut für Kristallzüchtung (IKZ) have been tested to study different properties at cryogenic temperatures. Firstly, two 2.8 g twin crystals were used to build different detector modules which were operated in an above-ground laboratory at the Max Planck Institute for Physics (MPP) in Munich, Germany. The first detector module was used to study the scintillation properties of $$\hbox {LiAlO}_{2}$$

LiAlO
2

at cryogenic temperatures. The second achieved an energy threshold of ($$213.02\pm 1.48$$

213.02
±
1.48

) eV which allows setting a competitive limit on the spin-dependent dark matter particle-proton scattering cross section for dark matter particle masses between $$350\,\hbox {MeV/c}^{2}$$

350

MeV/c
2

and $$1.50\,\hbox {GeV/c}^{2}$$

1.50

GeV/c
2

. Secondly, a detector module with a 373 g $$\hbox {LiAlO}_{2}$$

LiAlO
2

crystal as the main absorber was tested in an underground facility at the Laboratori Nazionali del Gran Sasso (LNGS): from this measurement it was possible to determine the radiopurity of the crystal and study the feasibility of using this material as a neutron flux monitor for low-background experiments.
Measurements of $${\Xi }{^-} $$ and $$\overline{\Xi }{^+} $$ production in proton–proton interactions at $$\sqrt{s_{NN}}$$ = 17.3 $$\hbox {Ge}\hbox {V}$$ in the NA61/SHINE experiment
Authors: Aduszkiewicz A. , Andronov E. V. , Antićić T. , Babkin V. , Baszczyk M. , Bhosale S. , Blondel A. , Bogomilov M. , Brandin A. , Bravar A. , Bryliński W. , Brzychczyk J. , Buryakov M. , Busygina O. , Bzdak A. , Cherif H. , Ćirković M. , Csanad M. , Cybowska J. , Czopowicz T. , Damyanova A. , Davis N. , Deliyergiyev M. , Deveaux M. , Dmitriev A. , Dominik W. , Dorosz P. , Dumarchez J. , Engel R. , Feofilov G. A. , Fields L. , Fodor Z. , Garibov A. , Gaździcki M. , Golosov O. , Golovatyuk V. , Golubeva M. , Grebieszkow K. , Guber F. , Haesler A. , Igolkin S. N. , Ilieva S. , Ivashkin A. , Johnson S. R. , Kadija K. , Kargin N. , Kashirin E. , Kiełbowicz M. , Kireyeu V. A. , Klochkov V. , Kolesnikov V. I. , Kolev D. , Korzenev A. , Kovalenko V. N. , Kowalski S. , Koziel M. , Krasnoperov A. , Kucewicz W. , Kuich M. , Kurepin A. , Larsen D. , László A. , Lazareva T. V. , Lewicki M. , Łojek K. , Lyubushkin V. V. , Maćkowiak-Pawłowska M. , Majka Z. , Maksiak B. , Malakhov A. I. , Marcinek A. , Marino A. D. , Marton K. , Mathes H.-J. , Matulewicz T. , Matveev V. , Melkumov G. L. , Merzlaya A. O. , Messerly B. , Mik Ł. , Morozov S. , Mrówczyński S. , Nagai Y. , Naskręt M. , Ozvenchuk V. , Paolone V. , Petukhov O. , Płaneta R. , Podlaski P. , Popov B. A. , Porfy B. , Posiadała-Zezula M. , Prokhorova D. S. , Pszczel D. , Puławski S. , Puzović J. , Ravonel M. , Renfordt R. , Röhrich D. , Rondio E. , Roth M. , Rumberger B. T. , Rumyantsev M. , Rustamov A. , Rybczynski M. , Rybicki A. , Sadovsky A. , Schmidt K. , Selyuzhenkov I. , Seryakov A. Yu. , Seyboth P. , Słodkowski M. , Staszel P. , Stefanek G. , Stepaniak J. , Strikhanov M. , Ströbele H. , Šuša T. , Taranenko A. , Tefelska A. , Tefelski D. , Tereshchenko V. , Toia A. , Tsenov R. , Turko L. , Ulrich R. , Unger M. , Uzhva D. , Valiev F. F. , Veberič D. , Vechernin V. V. , Wickremasinghe A. , Włodarczyk Z. , Wojcik K. , Wyszyński O. , Zimmerman E. D. , Zwaska R.
Published: September 2020

The production of $$\Xi (1321)^{-}$$

Ξ

(
1321
)

-

and $$\overline{\Xi }(1321)^{+}$$

Ξ
¯

(
1321
)

+

hyperons in inelastic p+p interactions is studied in a fixed target experiment at a beam momentum of 158 $$\hbox {Ge}\hbox {V}\!/\!c$$

Ge

/

c

. Double differential distributions in rapidity $${y}$$
y
and transverse momentum $$p_{T}$$

p
T

are obtained from a sample of 33M inelastic events. They allow to extrapolate the spectra to full phase space and to determine the mean multiplicity of both $${\Xi }{^-} $$

Ξ

-

and $$\overline{\Xi }{^+} $$

Ξ
¯

+

. The rapidity and transverse momentum spectra are compared to transport model predictions. The $${\Xi }{^-} $$

Ξ

-

mean multiplicity in inelastic p+p interactions at 158 $$\hbox {Ge}\hbox {V}\!/\!c$$

Ge

/

c

is used to quantify the strangeness enhancement in A+A collisions at the same centre-of-mass energy per nucleon pair.
Gravitational deflection of massive particles in Schwarzschild-de Sitter spacetime
Authors: He Guansheng , Zhou Xia , Feng Zhongwen , Mu Xueling , Wang Hui , Li Weijun , Pan Chaohong , Lin Wenbin
Published: September 2020

In this paper, the gravitational deflection of a relativistic massive neutral particle in the Schwarzschild-de Sitter spacetime is studied via the Rindler–Ishak method in the weak-field limit. When the initial velocity$$v_0$$v0of the particle tends to the speed of light, the result is consistent with that obtained in the previous work for the light-bending case. Our result is reduced to the Schwarzschild deflection angle of massive particles up to the second order, if the contributions from the cosmological constant$$\varLambda $$Λare dropped. The observable correctional effects due to the deviation of$$v_0$$v0from light speed on the$$\varLambda $$Λ-induced contributions to the deflection angle of light are also analyzed.
Strong decays of the $$\varXi (1620)^0$$ as a $$\varLambda {\bar{K}}$$ and $$\varSigma {\bar{K}}$$ molecule
Authors: Huang Yin , Geng Lisheng
Published: September 2020

In this work, we study the strong decays of the newly observed $$\varXi (1620)^0$$

Ξ

(
1620
)

0

assuming that it is a meson-baryon molecular state of $$\varLambda {\bar{K}}$$

Λ

K

¯

and $$\varSigma {\bar{K}}$$

Σ

K

¯

. We consider four possible spin-parity assignments $$J^P=1/2^{\pm }$$

J
P

=
1
/

2
±

and $$3/2^{\pm }$$

3
/

2
±

for the $$\varXi (1620)^0$$

Ξ

(
1620
)

0

, and evaluate its partial decay width into $$\varXi \pi $$

Ξ
π

and $$\varXi \pi \pi $$

Ξ
π
π

via hadronic loops with the help of effective Lagrangians. In comparison with the Belle data, the calculated decay width favors the spin-party assignment $$1/2^-$$

1
/

2
-

while the other spin-parity assignments do not yield a decay width consistent with data in the molecule picture. We find that about 52–68% of the total width comes from the $${\bar{K}}\varLambda $$

K

¯

Λ

channel, while the rest is provided by the $${\bar{K}}\varSigma $$

K

¯

Σ

channel. As a result, both channels are important in explaining the strong decay of the $$\varXi (1620)^0$$

Ξ

(
1620
)

0

. In addition, the transition $$\varXi (1620)^0\rightarrow \pi \varXi $$

Ξ

(
1620
)

0

→
π
Ξ

is the main decay channel in the $$J^{P}=1/2^{-}$$

J
P

=
1
/

2
-

case, which almost saturates the total width. These information are helpful to further understand the nature of the $$\varXi (1620)^0$$

Ξ

(
1620
)

0

.