bluuebunny/crossref_metadata_2025 huggingface dataset:
Results of a Phase II Study to Determine the Efficacy and Safety of Genetically Engineered Allogeneic Human Chondrocytes Expressing TGF-β1
Authors: Lee Bumsup , Parvizi Javad , Bramlet Dale , Romness David W. , Guermazi Ali , Noh Moon , Sodhi Nipun , Khlopas Anton , Mont Michael A.
Published: January 2019

Genetically engineered chondrocytes virally transduced with a transforming growth factor (TGF)-β1 (TG-C [TissueGene-C]) expression vector have been shown to have potential benefits in the nonoperative management of knee osteoarthritis. Previous literature has reported on safe dosages of TG-C. Therefore, the purpose of this study was to evaluate the Phase II results and a 24-month efficacy of this injectable mixture compared with placebo in patients with Kellgren–Lawrence (K–L) grade III knee osteoarthritis. Specifically, we assessed (1) functional outcomes, (2) pain scores, (3) adverse events (AEs), and (4) magnetic resonance imaging (MRIs) findings. We performed a multicenter, double-blinded, placebo-controlled, and randomized study of adults who had K–L grade III knee osteoarthritis. A total of 102 patients were 2:1 randomized to TG-C at a dose of 3.0 × 107 cells, or placebo injections between May 1, 2011 and October 31, 2012. Outcomes analyzed were knee joint function, pain, quality of life, adverse events, and MRI findings using the whole-organ magnetic resonance imaging score (WORMS) system. There were significant improvements in the International Knee Documentation Committee (IKDC) and visual analogue scale (VAS) scores in the TG-C cohort, when compared with the placebo cohort at weeks 12, 52, 72, and 104 (p < 0.05). No severe AEs were observed. Common AEs were arthralgia, joint inflammation, and joint effusion which were similar between both cohorts. Whole-knee MRIs at 12 months showed less progression of cartilage damage, infrapatellar fat pad-synovitis, and effusion-synovitis in the TG-C cohort. Patients who received TG-C had significant improvements in IKDC and VAS scores. These patients also reported less severe and frequent pain. Additionally, fewer patients treated with TG-C showed progression of cartilage damage, as well as less progression of infrapatellar fat pad synovitis and effusion-synovitis. Furthermore, treatment with TG-C was generally well tolerated with minor AEs. Therefore, based on these results, TG-C appears to be a safe and effective modality for the management of K–L grade III osteoarthritis.
Chest X-Ray Not Routinely Indicated Prior to the YEARS Algorithm in the Diagnostic Management of Suspected Pulmonary Embolism
Authors: van der Pol Liselotte , Tromeur Cecile , Faber Laura , van der Hulle Tom , Kroft Lucia , Mairuhu Albert , de Roos Albert , Huisman Menno , Klok Frederikus
Published: January 2019

Background The YEARS algorithm was designed to simplify the diagnostic process of suspected pulmonary embolism (PE) and to reduce the number of required computed tomography pulmonary angiography (CTPA) scans. Chest X-ray (CXR) is often used as initial imaging test in patients suspected for PE.

Aim To determine if CXR results differ between patients with confirmed PE and with PE ruled out, and to investigate whether CXR provides incremental diagnostic value to the YEARS criteria that is used for selecting patients with CTPA indication.

Methods This post-hoc analysis concerned 1,473 consecutive patients with suspected PE who were managed according to YEARS and were subjected to CXR as part of routine care. The prevalence and likelihood ratios of seven main CXR findings for a final diagnosis of PE were calculated.

Results A total of 214 patients were diagnosed with PE at baseline (15%). Abnormal CXR occurred more often in patients with confirmed PE (36%, 77/214) than in patients without PE (26%; 327/1,259), for an odds ratio of 1.60 (95% confidence interval: 1.18–2.18). Only the unexpected finding of a (rib)fracture or pneumothorax, present in as few as six patients (0.4%), significantly lowered the post-test probability of PE to an extent that CTPA could have been avoided.

Conclusion The incremental diagnostic value of CXR to the YEARS algorithm to rule out PE was limited. CXR was more frequently abnormal in patients with PE than in those in whom PE was ruled out. These data do not support to perform CXR routinely in all patients with suspected PE, prior to CTPA imaging.
Hypertrophic Cardiomyopathy in Patients with Atrial Fibrillation: Prevalence and Associated Stroke Risks in a Nationwide Cohort Study
Authors: Jung Hyunjean , Yang Pil-Sung , Sung Jung-Hoon , Jang Eunsun , Yu Hee , Kim Tae-Hoon , Uhm Jae-Sun , Kim Jong-Youn , Pak Hui-Nam , Lee Moon-Hyoung , Lip Gregory , Joung Boyoung
Published: January 2019

Background There have been no prior nationwide reports on the prevalence of hypertrophic cardiomyopathy (HCM) among patients suffering from atrial fibrillation (AF). It is also unclear how much stroke risk is attributable to HCM compared with other stroke risks in patients with AF. This study assessed the prevalence of HCM among non-valvular AF (NVAF) patients and to assess the magnitude of increase in stroke risk in NVAF patients with HCM, compared with those without HCM.

Patients and Methods From the Korean National Health Insurance Service database from January 1, 2005 to December 31, 2016, we analysed 979,784 patients with prevalent NVAF aged 18 years or older.

Results The overall HCM prevalence in NVAF patients was 1.1%. Although HCM in these patients is an absolute indication for oral anticoagulant (OAC) prescription, only 1,622 (15.3%) patients were receiving OAC at the time of AF diagnosis. Among OAC-naïve patients with NVAF, compared with those without HCM, those with HCM had the increased risk of ischaemic stroke/systemic embolism with clinical variable adjusted hazard ratio of 1.55 (95% confidential interval, 1.48–1.63; p < 0.001). Ischaemic stroke/systemic embolism rate of NVAF patients with HCM without any non-gender CHA2DS2-VASc stroke risk factors was 4.02 per 100 person-years, and approached to that of NVAF patients without HCM with CHA2DS2-VASc score of 3 (4.07 per 100 person-years).

Conclusion Among all NVAF patients, 1.1% of patient has HCM. The risk of stroke in NVAF with HCM without any CHA2DS2-VASc stroke risk factors was similar to that of those patients without HCM with CHA2DS2-VASc score of 3. Despite this, the actual use of OACs among NVAF patients with HCM was sub-optimal, relative to their high stroke risk.
Microvascular Thrombosis and Ischaemic Limb Losses in Critically Ill Patients
Authors: Warkentin Theodore
Published: January 2019

Relatively little scientific attention has been given to the small subset of critically ill patients with circulatory shock who develop ischaemic limb losses (symmetrical peripheral gangrene [SPG]). The clinical picture consists of acral (distal extremity) tissue necrosis involving lower limbs in a largely symmetrical fashion and with detectable arterial pulses; in one-third of patients the upper extremities are also affected (potential for four-limb amputations). The laboratory picture includes thrombocytopenia, coagulopathy, and normoblastemia (circulating nucleated red blood cells). The explanation for limb losses is microvascular thrombosis caused by disseminated intravascular coagulation usually secondary to cardiogenic or septic shock. A common myth is that vasopressors cause the ischaemic limb injury. However, the more likely explanation is failure of the natural anticoagulant systems (protein C and antithrombin) to downregulate thrombin generation in the microvasculature. This is because more than 90% of patients with SPG have preceding ‘shock liver’, which occurs 2 to 5 days (median, 3 days) prior to ischaemic limb injury, with impaired hepatic production of protein C and antithrombin.
Benign Paroxysmal Vertigo of Childhood
Authors: Pawar Vishal
Published: January 2019

The aim of the article is to describe a case of benign paroxysmal vertigo (BPV) in childhood. It emphasizes the fact that every dizziness is not vertigo and every vertigo is not benign paroxysmal positional vertigo. BPV in childhood often goes unrecognized. This case report aims at creating awareness about this benign and self-limiting disorder.
Osteopetrose
Authors: Kornak U. , Schulz A.
Published: January 2019

Unter der Diagnose Osteopetrose wird eine heterogene Gruppe von seltenen monogenetischen Knochenerkrankungen zusammengefasst, die sich durch eine reduzierte Osteoklasten-Aktivität, eine gesteigerte Knochenmasse und eine gesteigerte Knochenbrüchigkeit auszeichnet. Die Osteopetrosen werden verursacht durch Mutationen in verschiedenen Genen, die in der Osteoklastogenese oder Osteoklasten-Funktion involviert sind. Durch den Verlust der Knochenresorption werden Knochenumbau und -neubildung beeinträchtigt, wodurch sich die Qualität und Architektur des Knochengewebes verschlechtert. Häufige klinische Zeichen sind Osteosklerose, Knochendeformitäten, hämatologische Insuffizienzen durch Verengung der Knochenmarkräume, Sehstörungen durch Verengung der Foramina nervi optici und andere neurologische Störungen. Bis auf eine X-chromosomale Form sind alle infantilen schweren Osteopetrosen autosomal rezessiv vererbt. Die rezessiven Formen verlaufen gewöhnlich ohne Behandlung tödlich im Säuglings- oder Kindesalter, wobei allerdings selten mildere klinische Verläufe als sog. Intermediäre Osteopetrose vorkommen. Die dominante Form ist assoziiert mit Mutationen im CLCN7-Gen und verläuft in der Regel milder. Die meisten schweren Osteopetrosen können durch eine allogene hämatopoetische Stammzelltransplantation (HSZT) behandelt werden, sofern sie Osteoklasten-autonome Ursachen haben und nicht mit einer primären neurologischen Komponente verbunden sind.
A Prospective Comparative Study between Dry and Wet Tympanoplasty
Authors: Pothala Hepsiba , Shukla Sunita , Khan Wasim , Ramalingam Ravi , Ramalingam Kombupalayam
Published: January 2019

Background Tympanoplasty is the well-established procedure for closure of perforations of tympanic membrane.

Study Design This study was a prospective comparative study.

Objective The objective of this study was to compare the hearing improvement and graft uptake rate between dry and wet tympanoplasty performed on tubotympanic type of chronic suppurative otitis media.

Materials and Methods One hundred forty patients with tubotympanic type of chronic otitis media were selected and categorized into dry and wet ears. Tympanoplasty was performed using temporalis fascia by underlay technique in all cases. Postoperatively, graft uptake rate and hearing improvement were analyzed.

Results The graft uptake rate was equal in both dry and wet ears, which was statistically insignificant. There was no statistically significant difference in the hearing improvement between the dry ears and wet ears (χ – 2.39, p = 0.122).

Conclusion Factors such as age, sex, and status of the contralateral ear and wet ear did not have any impact on the postoperative graft uptake of tympanoplasty. There was no difference in the graft uptake between the dry and wet ears and there was no statistically significant difference between hearing improvement in both and wet ears.
SMOFlipid Protects Preterm Neonates against Perinatal Nutrition–Associated Cholestasis
Authors: Kasirer Yair , Bin-Nun Alona , Raveh Ateret , Schorrs Irina , Mimouni Francis B. , Hammerman Cathy
Published: January 2019

Objective Intravenous lipid infusions improve both short- and long-term outcomes of premature neonates. However, prolonged infusion of lipids has been implicated in the development of parenteral nutrition-associated cholestasis (PNAC). We speculated that the multicomponent SMOFlipid would be hepatoprotective against PNAC.

Study Design This is a retrospective review comparing the incidence and severity of direct hyperbilirubinemia in preterm infants <1,500 g who were hospitalized for a minimum of 2 weeks during a 20-month period in which all preterm infants on total parenteral nutrition (TPN) received fat as Lipofundin with the following 20-month period in which all preterm infants on TPN received SMOFlipid.

Results Infants in the SMOFlipid period had a lower incidence of PNAC (6 vs. 13%; p = 0.022), lower peak direct bilirubin levels (3.2 vs. 7.1 mg/dL; p = 0.018), and a shorter length of stay (51 vs. 60 days; p = 0.019). The relative risk of developing direct hyperbilirubinemia during the Lipofundin period was 2.22 (1.1–4.3) as compared with period 1; p = 0.018; NNT-14.

Conclusion SMOFlipid was hepatoprotective in our population of preterm neonates <1,500 g receiving long-term TPN as compared with those receiving Lipofundin, despite similar levels of exposure to both intravenous lipid load and duration in the two groups.
Deep Vein Thrombosis is Modulated by Inflammation Regulated via Sirtuin 1/NF-κB Signalling Pathway in a Rat Model
Authors: Yao Xiaolan , Chen Wenpei , Liu Jin , Liu Han , Zhan Janis , Guan Shixia , Lu Ziqi , Tang Ping , Li Peng , Lin Baoqin
Published: January 2019

Background Inflammation plays an important role in thrombus formation, and Sirtuin 1 (SIRT1) negatively regulates inflammation via deacetylating nuclear factor-kappa B. However, the relationship between SIRT1-regulated inflammation and deep vein thrombosis (DVT) is still unknown.

Objective The aim of this study was to investigate whether SIRT1 plays a critical role in inferior vena cava (IVC) stenosis-induced DVT.

Materials and Methods Thrombus weight and histopathologic analysis of IVC were evaluated at different time points after IVC stenosis in rats. Serum levels of inflammatory cytokines and protein expressions of SIRT1, acetylated p65 (Ace-p65), phosphorylated p65 (p-p65) and tissue factor (TF) in thrombosed IVC were assessed. Besides, the effects of resveratrol (RES, a SIRT1 agonist) and EX527 (a selective SIRT1 inhibitor) on DVT were evaluated.

Results Thrombus weight was increased from 1 to 3 days after IVC stenosis, and then was decreased afterwards. Leukocytes infiltration appeared and serum levels of cytokines were significantly increased in rats of IVC stenosis. SIRT1 protein expression was significantly down-regulated at 1 hour and 1 day after stenosis, while p-p65, Ace-p65 and TF protein expressions appeared a contrary trend. RES reduced thrombus weight, leukocytes infiltration, levels of tumour necrosis factor-α and interleukin-1β and protein expressions of Ace-p65 and TF as well. Moreover, RES significantly increased the protein and messenger ribonucleic acid expressions of SIRT1, while EX527 abolished the protective effects of RES.

Conclusion SIRT1 activation attenuated IVC stenosis-induced DVT via anti-inflammation in rats. Therefore, SIRT1 may be a potential therapeutic target that could ameliorate DVT.
The “Dual-Plane” DIEP Flap: Measuring the Effects of Superficial Arterial and Venous Flow Augmentation on Clinical Outcomes
Authors: Sbitany Hani , Lentz Rachel , Piper Merisa
Published: January 2019

Background Deep inferior epigastric perforator (DIEP) flaps are routinely elevated on a single dominant perforator from the deep epigastric vascular system. However, the single perforator may not always perfuse an entire flap adequately, particularly suprascarpal tissue. We often perform “dual-plane” single perforator DIEP flaps by rerouting the superficial (SIEA/V) system directly into a branch of the deep (DIEA/V) vascular system pedicle, thus allowing both systems to contribute and enhance flap perfusion.

Methods A prospectively collected database of patients undergoing microvascular breast reconstruction was reviewed for patients undergoing “dual-plane” DIEP flaps. These were matched to a similar cohort of patients undergoing “traditional” single perforator DIEP free flaps over the same time period. Treatment demographics and flap-specific morbidity outcomes were assessed, including performance in the setting of radiation.

Results Over 2 years, 23 “dual-plane” DIEP flaps were performed (15 patients), compared with 35 single-perforator “traditional” DIEP flaps (23 patients). Rates of delayed healing were similar between both cohorts (2.9 vs. 4.3%, p = 0.28). Rates of palpable fat necrosis were significantly lower in “dual-plane” DIEP flaps compared with “traditional” flaps (0 vs. 14.3%, p = 0.03). Rates of clinically palpable fat necrosis following radiation were significantly lower in the “dual-plane” flaps (4.3 vs. 40%, p = 0.02).

Conclusion The “dual-plane” DIEP flap is one we routinely consider in our algorithm, as it allows for full preservation of functional abdominal musculature, and offers enhanced flap perfusion by incorporating both the deep and superficial (dominant) vascular systems. This results in lower fat necrosis rates, particularly in the setting of post-reconstruction radiation.
How to Optimize Activated Partial Thromboplastin Time (APTT) Testing: Solutions to Establishing and Verifying Normal Reference Intervals and Assessing APTT Reagents for Sensitivity to Heparin, Lupus Anticoagulant, and Clotting Factors
Authors: Kershaw Geoffrey , Mohammed Soma , Lippi Giuseppe , Favaloro Emmanuel
Published: January 2019

The activated partial thromboplastin time (APTT) assay is a very common coagulation test, used for several reasons. The test is conventionally used for assessing the contact factor (intrinsic) pathway of blood coagulation, and thus for screening deficiencies in this pathway, most typically factors VIII, IX, and XI. The APTT is also sensitive to contact factor deficiencies, including factor XII, prekallikrein, and high-molecular-weight kininogen. The APTT may also be elevated in a variety of conditions, including liver disease, vitamin K deficiency, and disseminated intravascular coagulation. The APTT can also be used for monitoring unfractionated heparin (UFH) therapy, as well as for screening lupus anticoagulant (LA) or for assessing thrombosis risk. Which of these separate uses is important to a given laboratory or clinician depends on the laboratory and the clinical context. For example, UFH sensitivity is important in hospital-based laboratories, where UFH therapy is used, but not in hospital-based laboratories where low-molecular-weight heparin (LMWH) is largely employed or where UFH may be assessed by anti-factor Xa testing, or in private/community laboratories not associated with a hospital system. High sensitivity to (low levels of) factors VIII, IX, and XI is generally preferred, as their deficiencies are clinically significant. Also preferred, but not usually achieved, is low sensitivity to factor XII and other contact factors, as these deficiencies are usually asymptomatic. Nevertheless, a good knowledge of factor sensitivity is usually needed, if only to help explain the reasons for a prolonged APTT in a given patient, or whether factor testing or other investigation is required. A good working knowledge of reagents sensitivity to LA is also advisable, especially when the reagent is used as part of a LA test panel, or else as a “general-purpose screening reagent.” The current report is aimed at providing some guidance around these questions, and is intended as a kind of “how to” guide, that will enable laboratories to assess APTT reagents in regard to their sensitivity to heparin, LA, and clotting factors. The report also provides some advice on generation of normal reference ranges, as well as solutions for troubleshooting prolonged APTTs, when performing factor testing or searching for inhibitors.
Platelet Functions are Decreased in Obesity and Restored after Weight Loss: Evidence for a Role of the SERCA3-Dependent ADP Secretion Pathway
Authors: Elaïb Ziane , Lopez Jose , Coupaye Muriel , Zuber Kevin , Becker Yann , Kondratieff Aurélie , Repérant Christelle , Pépin Marion , Salomon Laurence , Teillet France , Msika Simon , Denis Cécile , de Prost Dominique , Rosa Jean-Philippe , Bobe Régis , Stépanian Alain
Published: January 2019

In obesity, platelets are described as hyperactive, mainly based on increased platelet size and presence of pro-thrombotic plasmatic molecules. We explored platelet functions, including calcium signalling in obesity, and the effect of weight loss. We included 40 obese patients (women with body mass index [BMI] of ≥ 35 kg/m2) who were to undergo gastric bypass surgery and 40 healthy lean subjects (women with BMI of < 25 kg/m2) as a control group. Approximately 1 year after surgery, the obese patients lost weight (75% had a BMI < 35 kg/m2). They were explored a second time with the same healthy control for the same platelet experiments. Compared with controls, obese patients' platelets displayed reduced sensitivity to thrombin (aggregation EC50 increased by 1.9 ± 0.3-fold, p = 0.005) and a lower Ca2+ response (70 ± 7% decrease, p < 10−4). In 17 pairs of patients, we performed additional experiments: in obese patients' platelets, thrombin-induced αIIbβ3 activation was significantly lower (p = 0.003) and sarco-endoplasmic reticulum Ca2+ATPase (SERCA3) expression was decreased (48 ± 6% decrease, p < 10−4). These differences were abolished after weight loss. Interestingly, pharmacological inhibition of SERCA3 activity in control group's platelets mimicked similar alterations than in obese patients' platelets and was associated with defective adenosine diphosphate (ADP) secretion. Addition of ADP to agonist restored platelet functions in obese patients and in SERCA3-inhibited control platelets (five experiments) confirming the direct involvement of the SERCA3-dependent ADP secretion pathway. This is the first study demonstrating that platelets from obese patients are hypo-reactive, due to a deficiency of SERCA3-dependent ADP secretion. Weight loss restores SERCA3 activity and subsequent calcium signalling, αIIbβ3 activation, platelet aggregation and ADP secretion.
Comparison of Insertion Depth and Hearing Preservation Results between HiFocus 1j and HiFocus Mid-Scala Electrodes in Pediatric Population
Authors: Deshpande Shweta , Vaid Neelam , Gazibegovic Dzemal , KM Ajimsha
Published: January 2019

Background Various electrodes are available with a range of features and designs to fulfil anatomical and geometrical variations of the cochlea. The HiFocus 1j (1j) electrode developed by Advanced Bionics LLC is a lateral wall electrode designed to cover up to 1.5 turns or approximately 540° of the cochlea. The HiFocus Mid-Scala (HFms) was recently introduced and designed for structure preservation with a target insertion depth of 420°.

Objective To evaluate the average insertion depth and variation, and to assess the potential for hearing preservation with 1j and HFms electrodes in children.

Method A group of prelingually deafened children with regular anatomy who received the HiRes90K implant (either 1j or HFms electrode) underwent a plain radiography investigation shortly after the surgery to determine the angular insertion depth. The median age in each group was 3.6 years (1j) and 4.3 years (HFms). The amount of residual hearing was measured through audiometry prior surgery and then monitored at device activation and 1,3, 6, and 12 months later.

Results Seventeen subjects were included for calculation of insertion depth. The median insertion depth and the variation for the 1j electrode was higher than for the HFms electrode (1j 476°; 443°–540°, HFms 413°; 390°–468°). Only eleven subjects were assessed for hearing preservation. Complete hearing preservation was achieved in seven subjects (five HFms and two 1j) and partial loss was observed in two subjects (one HFms and one 1j).

Conclusion Both 1j and HFms electrodes are suitable for young children. Their flexible design allows round window insertions. The HFms group showed higher rates of hearing preservation (HP) than the 1j group.
26. Jahrestagung der DGSM: Schlaf ist der Kundendienst im Körper
Authors: Held Romy
Published: January 2019

„Schlafstörungen gelten mittlerweile als Volkskrankheit, so weit verbreitet sind sie“, stellte der Past President der Deutschen Gesellschaft für Schlafforschung und Schlafmedizin (DGSM), Dr. Alfred Wiater, gleich zu Beginn der Pressekonferenz anlässlich der 26. Jahrestagung der Gesellschaft im Oktober in Nürnberg klar. Im Gegensatz dazu stünden die erheblichen Defizite in der Versorgung von Patienten mit Schlafstörungen. „Tagtäglich erleben wir das als Schlafmediziner, zum Beispiel bei der Schlafapnoe. Die Ausschreibungspraxis der Krankenkassen ist hier weit entfernt von der qualitativ gebotenen Patientenversorgung. Eine adäquate Versorgung ist so nur unter erheblichen Einschränkungen möglich, eine individuelle Versorgung jedoch gar nicht“, so Wiater. Dabei ist eine individuelle Behandlung wünschenswert und es gibt mittlerweile eine breite Therapiepalette. „Doch auch das wird von unserem Gesundheitssystem alles andere als gefördert“, fasst Dr. Wiater die Sachlage zusammen.
Immunmodulatorische Effekte sportlicher Aktivität
Authors: Hinze C. H. , Peitz J.
Published: January 2019

Sportliche Aktivität und Bewegung sind wesentliche Bestandteile unserer Homöostase. Durch Sport werden immunologische Abläufe im Körper beeinflusst. Wir stellen in diesem Artikel die komplexen Auswirkungen von Sport und Bewegung auf verschiedene Organsysteme und insbesondere das Immunsystem dar. In Zusammenschau der Ergebnisse kann Sport als wichtige Therapie von Autoimmunerkrankungen und insbesondere der juvenilen idiopathischen Arthritis gesehen werden und hat mit großer Wahrscheinlichkeit sogar präventiven Charakter. Weitere Studien in diese Richtung sind nötig, um diese Hypothesen zu stützen und neue therapeutische Herangehensweisen zu etablieren.
ADHS-Diagnose und Stimulanzientherapie bei einem Patienten mit Multipler Sklerose
Authors: Kölle M. , Senel M. , Heckel K. , Grön G.
Published: January 2019

Sowohl bei Aufmerksamkeitsdefizit-/Hyperaktivitätssyndromen als auch bei chronisch entzündlichen ZNS-Erkrankungen (z. B. Multiple Sklerose) können Beeinträchtigungen der Aufmerksamkeit und pathologische Impulsivität auftreten. Liegen sowohl eine entsprechende Psychopathologie als auch eine hirnorganische Schädigung vor, sind die möglichen Ursachen von Aufmerksamkeitsstörung und Hyperaktivität/Impulsivität nicht leicht zu differenzieren. Wir berichten den Fall eines Patienten mit den Symptomen einer ADHS seit dem Grundschulalter und der Erstdiagnose einer MS im Erwachsenenalter. Bei dem Patienten wurde die Diagnose ADHS auf der Grundlage des klinischen Querschnitts, der Vorgeschichte seit der Grundschule, der positiven Familienanamnese bezüglich ADHS-Symptomen und der entsprechenden Fragebogen-Scores gestellt. Eine Stimulanzientherapie zeigte trotz vorhandener hirnorganischer Läsionen eine gute Wirksamkeit und Verträglichkeit über einen Zeitraum von inzwischen drei Jahren. Ebenso wurden verschiede Schubprophylaxe-Strategien gemeinsam mit Methylphenidat verordnet, ohne dass es zu Interaktionen oder Wirkbeeinträchtigungen kam.
Vergleich zweier Instrumente zur Gefäßversiegelung bei der laparaskopisch-assistierten Ovariohysterektomie der Hündin
Authors: Heblinski Nikola , Brückner Michael
Published: January 2019

Gegenstand und Ziel: Diese Studie hatte zum Ziel, zwei verschiedene Instrumente zur Gefäßversiegelung bei der laparoskopisch-assistierten Ovariohysterektomie von Hunden zu vergleichen. Material und Methoden: In diese randomisierte, prospektive klinische Studie wurden 12 nacheinander vorgestellte gesunde, intakte Hündinnen aus Privatbesitz unterschiedlicher Rassen einbezogen. Die zur geplanten laparoskopisch-assistierten Ovariohysterektomie vorgestellten Hündinnen wurden randomisiert einer von zwei Behandlungsgruppen zugeteilt. In der einen Gruppe wurde das Gefäßversiegelungsinstrument LigaSure™ benutzt (n = 6), in der anderen der Caiman® (n = 6). Dokumentierte Parameter waren die Dauer aller chirurgischen Einzelschritte, die zur Abtrennung eines jeden Ovars notwendige Anzahl der Versiegelungen, wie häufig das jeweilige Gefäßversiegelungsinstrument bereits verwendet wurde sowie aufgetretene Komplikation, die mit dem Instrument in Zusammenhang standen. Ergebnisse: Der Einsatz des Caiman® erforderte signifikant weniger Versiegelungen, um ein Ovar abzusetzen. Die Zeit des gesamten chirurgischen Eingriffs reduzierte sich dadurch jedoch nicht signifikant. Intraoperative Blutungen wurden in beiden Gruppen beobachtet, traten aber beim LigaSure™ häufiger auf. Eine Konversion zu einer Laparotomie musste bei keinem Tier vorgenommen werden. Schlussfolgerung und klinische Relevanz: Der Caiman® kann sicher für die laparoskopisch-assistierte Ovariohysterektomie des Hundes genutzt werden. Im Vergleich mit dem LigaSure™ waren beim Caiman® weniger Versiegelungen zum Absetzen eines Ovars notwendig. Dies ist auf die verlängerte Verschlussfläche zurückzuführen und die Tatsache, dass die Spitze des Versiegelungsstücks zuerst schließt.
Lebenselixier Schlaf
Authors: Joechner Ann-Kathrin , Hödlmoser Kerstin
Published: January 2019

Schlaf ist ein Grundbedürfnis und Lebenselixier. Wer zu wenig schläft, schadet
nicht nur seinem Immunsystem, sondern wird auch anfälliger für Verletzungen, ist
unkonzentriert und entwickelt leichter chronische Schmerzen. Die Autorinnen
fassen aktuelle Studienergebnisse zusammen.
Comparative Study of Early Health Care Use after Forearm Corrective Osteotomy
Authors: Shrouder-Henry Jason , Novak Christine , Jackson Timothy , Baltzer Heather
Published: January 2019

Background Bone reconstruction is frequently required for corrective osteotomy of the forearm long bones. Studies have evaluated long term outcomes but not the impact of these procedures on early postoperative complications and health care utilization.

Questions/Purposes This study evaluated the early postoperative health care utilization following corrective osteotomy of the radius and/or ulna.

Patients and Methods The American College of Surgeons' National Surgical Quality Improvement Program (NSQIP) was the primary data source to perform a comparative statistical analysis of the bone autograft and nonautograft (allograft, graft substitute, or no graft) procedures. We performed a review of the NSQIP database (2005–2013) to evaluate patients who underwent a corrective osteotomy of the radius and/or ulna.

Results There were 362 cases; autograft (n = 117) and nonautograft (n = 245). There were no significant differences with demographics or comorbidities. The majority of cases were outpatient surgeries and there were no significant differences in anesthesia time, operative time, or hospital length of stay. Overall, the average length of stay was 0.6 days, readmission rate was 2%, and the total complication rate was 1% and there was no statistically significant difference between reconstruction groups. Harvesting of autograft was not associated with the overall 30-day complications and specific markers of health care utilization.

Conclusions Our results are derived from the heterogeneous hospital setting of NSQIP contributing centers. The health care utilization and 30-day complications are low following corrective osteotomy of forearm long bones and autograft harvest did not influence the health care utilization.

Level of Evidence Therapeutic Level II.
Magenkarzinom
Authors: Krome Dr. Susanne
Published: January 2019

Bei den meisten Patienten mit Magenkarzinomen und Malignomen des gastroösophagealen Übergangs liegt bereits bei der Erstdiagnose ein fortgeschrittenes Stadium vor. Die Behandlungsmöglichkeiten nach einer Erst- und Zweitlinientherapie sind sehr begrenzt. In KEYNOTE-059 verlängerte der PD1-Inhibitor Pembrolizumab das progressionsfreie Überleben (PFS) und das Gesamtüberleben (OS).
Metastasiertes Nierenzellkarzinom
Authors: Krome Dr. Susanne
Published: January 2019

Vor Einführung der zielgerichteten Behandlungen verlängerte die zytoreduktive Nephrektomie vor einer Immuntherapie das Überleben. Studien ergaben einen Überlebensvorteil, wenn Nephrektomien bei einer Sunitinibtherapie verzögert stattfanden. Die prospektive Phase-III-Studie CARMENA (Cancer du Rein Metastatique Nephrectomie et Antiangiogeniques) zeigte nun, dass ein Verzicht auf die Operation möglich ist.
Glioblastome
Authors: Kretzschmar Dr. Alexander
Published: January 2019

Eine spezifische Signatur von miRNAs könnte helfen, die Dauer des Gesamtüberlebens (OS) von Patienten mit Glioblastomen vorherzusagen. Mehrere Arbeitsgruppen haben in den vergangenen zwei Jahren spezifische miRNA-Signaturen von Kurz- und Langzeitüberlebern gefunden. Das Problem: Die Ergebnisse der drei Studien stimmen nicht überein. Es fehlt eine Standardisierung der Forschungspattform.
Experiment study on a spiral-cup shaped TMF contact
Authors: Wang Ting , Xiu Shixin , Liu Zixi , Zhang Yanzhe , Zhao Li
Published: January 2019

In this paper, combined with the characteristics of spiral-shaped transverse magnetic field (TMF) contacts and cup-shaped TMF contacts, a new structure of spiral-cup shaped contacts was designed. Firstly, experiments were carried out on two kinds of TMF contacts – the traditional cup shaped contacts and the new spiral-cup shaped contacts. Arc behaviors were recorded and the arc motion were studied. The experimental results indicated that the arc motion between new contacts was better than that between the traditional cup-shaped contacts. Here, we paid particular attention to the arc characteristics between spiral-cup shaped TMF contacts. The duration and threshold current of different stages with different tested currents were discussed, and the arc characteristics during arc motion stage was analyzed. Moreover, electromagnetic field simulation was conducted on above two kinds of TMF contacts, and the distributions of magnetic field and the electromagnetic forces acted on arc were compared. According to the simulation results, some experimental phenomena were explained theoretically. In addition, the spiral-cup shaped structure proposed here makes it possible to research on arc movement mechanism without considering the complex mechanism of arc stepping over slots.
The varying characteristics of C5F10O decomposition components at 300 K - 3500 K with a chemical kinetic model
Authors: Fu Yuwei , Wang Xiaohua , Yang Aijun , Rong Mingzhe
Published: January 2019

The variation characteristics of C5F10O decomposition components at 300 K – 3500 K are studied with a chemical kinetic model considering neutral reactions. Three chemical kinetic models of SF6 breakdown are built to verify the model adopted (model C) and the results show that ion/electron participated reactions slightly change the molar fractions, which are lower than 10-14 with little influence on the insulating performance of SF6. Therefore, model C is reasonable to study the varying characteristics of C5F10O decomposition components and thus the molar fractions of C5F10O decomposition products under different temperature decreasing curves and pressures are calculated. The results show that the molar fraction of C5F10O grows to approximately one as temperature declining to 1,500 K and the temperature decreasing rates have similar affects on the relaxation time of the reactions generating C5F10O. And high pressure promotes species recombining to C5F10O by increasing the molar fractions of C5F10O decomposition components. The results can be used to evaluate C5F10O insulating performance.
Molecular hydrophobicity at a macroscopically hydrophilic surface
Authors: Cyran Jenée D. , Donovan Michael A. , Vollmer Doris , Siro Brigiano Flavio , Pezzotti Simone , Galimberti Daria R. , Gaigeot Marie-Pierre , Bonn Mischa , Backus Ellen H. G.
Published: January 2019

Significance

Silica, the most abundant mineral on Earth, is exploited in many technologies and naturally occurring geological and atmospheric processes. The physical and chemical interactions between silica and water are the fundamental driving forces for water purification systems, oil extraction, and coatings. Characterizing the silica/water interface is therefore important to improve existing technologies, in particular for silica coatings, which rely on wettability and thermal-resistant properties to remain effective. We investigated the silica/water interface using a mixture of macroscopic and microscopic techniques, including experimental and theoretical surface-specific sum frequency generation spectroscopy and contact angle measurements. Strikingly, we observed the presence of water molecules non–hydrogen bonded to the nominally hydrophilic silica surface.
Contemporary views of translation in China
Authors: Chan Leo Tak-hung
Published: January 2019

After a brief summary of the classical theories, this report discusses contemporary notions of translation in China with reference to their international and national dimensions. The first section deals with recent conceptualizations that have merged in response to China’s rise as an economic and political power; the concern for promoting outward translations of the Chinese classics in recent years underlines the attempt to “send out” Chinese culture. Section two notes how, in response to the forces of globalization, translation has also been increasingly thought of as language service, the provision of which will allow China to take up a greater share of the worldwide translation market. The final section surveys how translation “manages” the dialectical relationship between the majority language (Chinese) and the minority languages of non-Han communities in the country. Three keywords sum up the turn-of-the-century Chinese thinking on translation: waishu (exportation), canye (industry) and hexie (harmony).
Traditions of translation in Hebrew culture
Authors: Ben-Ari Nitsa , Levin Shaul
Published: January 2019

Throughout most of the history of Jewish communities worldwide, diglossia has been the rule rather than the exception. The history of Hebrew translation is hereby told from this special angle of Hebrew’s diglossic existence, encompassing both ‘classical’, genetically related diglossia (Hebrew/Aramaic, Hebrew/Arabic) and ‘extended’, non-genetically related diglossia (Hebrew/Greek, Hebrew/non-semitic Jewish Languages). Accordingly, the following overview is divided into two unequal parts: the first presents traditions of translation into Hebrew in its long-held diglossic state since biblical times to the end of Haskala, and the second, traditions originating and carried out in its ongoing non-diglossic state begun with the return to Eretz Israel in the late 19th century. It is within this context that the attitude towards translation as well as the significance of translation for Hebrew culture will be viewed.
Translation tradition throughout South African history
Authors: Botha Maricel , Beukes Anne-Marie
Published: January 2019

In this report South African translation history is approached from the perspective of asymmetrical power relations with a view to revealing various functions and conceptualisations of translation throughout the country’s notoriously turbulent past. Translation is viewed in a reciprocal relationship with social forces, being stimulated and shaped by them and affecting them in return. Translation is considered from its earliest documented practice by Khoikhoi interpreters in communications with colonists in the 17th century until the present. Changes and trends in the practice and conceptualisation of translation are investigated ranging from translation’s use in manipulating and controlling people under colonialism and apartheid to its use in bringing about transformation in contemporary democratic South Africa. Translation is not only used to bridge communicative barriers according to traditional views, but is seen to extract information and intellectually subjugate, culturally and religiously convert, culturally elevate, manipulate, control, separate, resist and transform. This proves that translation analysed as socially contextualised communication unveils various covert functions of translation, contributing fresh insights to its conceptualisation.
The culture(s) of translation in Russia
Authors: Baer Brian James , Tyulenev Sergey
Published: January 2019

This chapter traces the development of the Russian concept of translation and its relationship to practice across four historical periods, each with its own distinct culture of translation, which shaped the texts selected for translation, who translated them, and how they were translated. These cultures are perhaps more sharply defined than in other European cultures due to the fact that they were brought about by dramatic and radical change from the top, such as the reforms of Peter the Great in the early eighteenth century and the Bolshevik Revolution in the early twentieth. The cultures covered extend from Kievan Rus to the reforms of Peter the Great, the long eighteenth century, the long nineteenth century, ending with the Bolshevik Revolution, and the communist and post-communist periods.
The history of translation in Brazil through the centuries
Authors: Silva-Reis Dennys , Milton John
Published: January 2019

This report attempts to give an overview of the history of translation and interpretation in Brazil from the 16th century to the present. It seeks to show important historical characters, works and processes in Translation Studies in Portuguese America in order to discover a possible Brazilian translation tradition. The main paradigms of the History of Brazilian translation are also found in the historical events that took place during each century. In brief, the essay is a panoramic and critical view for non-specialists of the history of the Brazilian tradition of interpretation and translation.
Matrix complementizers in Italo-Romance
Authors: Colasanti Valentina , Silvestri Giuseppina
Published: January 2019

Based on uncharted evidence from Italo-Romance, we describe and discuss three types of matrix clauses, i.e. jussives, concessives and optatives, which reveal a certain degree of consistency but also display different patterns of microvariation. We show how such clauses may be introduced by complementizers, whose insertion is strictly dependent on the utterance of speech-act material at the outset of the sentence. The variation in the overt realization of the complementizers and the utterance of initial interjections convey different pragmatic information. We finally interpret the morpho-syntactic behaviour of jussive, concessive and optative matrix clauses through the interplay of three semantico-syntactic variables, i.e. beyond-Force, Mood and Modality.
Genotype-Guided Thiopurine Dosing Does not Lead to Additional Costs in Patients With Inflammatory Bowel Disease
Authors: Sluiter Reinier L , van Marrewijk Corine , de Jong Dirk , Scheffer Hans , Guchelaar Henk-Jan , Derijks Luc , Wong Dennis R , Hooymans Piet , Vermeulen Sita H , Verbeek André L M , Franke Barbara , van der Wilt Gert Jan , Kievit Wietske , Coenen Marieke J H
Published: January 2019

Background and Aims

Decreased thiopurine S-methyltransferase [TPMT] enzyme activity increases the risk of haematological adverse drug reactions [ADRs] in patients treated with thiopurines. Clinical studies have shown that in patients with inflammatory bowel disease [IBD], pharmacogenetic TPMT-guided thiopurine treatment reduces this risk of ADRs. The aim of this study was to investigate whether this intervention impacts on healthcare costs and/or quality of life.

Methods

An a priori defined cost-effectiveness analysis was conducted in the Thiopurine response Optimization by Pharmacogenetic testing in Inflammatory bowel disease Clinics [TOPIC] trial, a randomized controlled trial performed in 30 Dutch hospitals. Patients diagnosed with IBD [age ≥18 years] were randomly assigned to the intervention [i.e. pre-treatment genotyping] or control group. Total costs in terms of volumes of care, and effects in quality-adjusted life years [QALYs], based on EuroQol-5D3L utility scores, were measured for 20 weeks. Mean incremental cost savings and QALYs with confidence intervals were calculated using non-parametric bootstrapping with 1000 replications.

Results

The intervention group consisted of 381 patients and the control group 347 patients. The mean incremental cost savings were €52 per patient [95% percentiles −682, 569]. Mean incremental QALYs were 0.001 [95% percentiles −0.009, 0.010]. Sensitivity analysis showed that the results were robust for potential change in costs of screening, costs of biologicals and costs associated with productivity loss.

Conclusions

Genotype-guided thiopurine treatment in IBD patients reduced the risk of ADRs among patients carrying a TPMT variant, without increasing overall healthcare costs and resulting in comparable quality of life, as compared to standard treatment.
CD4+ Tissue-resident Memory T Cells Expand and Are a Major Source of Mucosal Tumour Necrosis Factor α in Active Crohn’s Disease
Authors: Bishu Shrinivas , El Zaatari Mohammed , Hayashi Atsushi , Hou Guoqing , Bowers Nicole , Kinnucan Jami , Manoogian Beth , Muza-Moons Michelle , Zhang Min , Grasberger Helmut , Bourque Charlie , Zou Weiping , Higgins Peter D R , Spence Jason R , Stidham Ryan W , Kamada Nobuhiko , Kao John Y
Published: January 2019

Background and Aims

Tumour necrosis factor [TNF]α- and IL-17A-producing T cells are implicated in Crohn’s disease [CD]. Tissue-resident memory T [TRM] cells are tissue-restricted T cells that are regulated by PR zinc finger domain 1 [PRDM1], which has been implicated in pathogenic Th17 cell responses. TRM cells provide host defence but their role in CD is unknown. We thus examined CD4+ TRM cells in CD.

Methods

Colon samples were prospectively collected at endoscopy or surgery in CD and control subjects. Flow cytometry and ex vivo assays were performed to characterise CD4+ TRM cells.

Results

CD4+ TRM cells are the most abundant memory T cell population and are the major T cell source of mucosal TNFα in CD. CD4+ TRM cells are expanded in CD and more avidly produce IL-17A and TNFα relative to control cells. There was a unique population of TNFα+IL-17A+ CD4+ TRM cells in CD which are largely absent in controls. PRDM1 was highly expressed by CD4+ TRM cells but not by other effector T cells. Suppression of PRDM1 was associated with impaired induction of IL17A and TNFA by CD4+ TRM cells

Conclusions

CD4+ TRM cells are expanded in CD and are a major source of TNFα, suggesting that they are important in CD. PRDM1 is expressed by TRM cells and may regulate their function. Collectively, this argues for prospective studies tracking CD4+ TRM cells over the disease course.
Grandparents’ Financial Contributions to Grandchildren in Rural China: The Role of Remittances, Household Structure, and Patrilineal Culture
Authors: Silverstein Merril , Zhang Wencheng
Published: January 2019

Objectives

This investigation examined predictors of monetary transfers made by grandparents for the benefit of their grandchildren in rural China. Predictors included family factors related to financial supply (remittances received from the parents of grandchildren), household demand (living in a skipped-generation household), and patrilineal culture (targeting sons and grandsons).

Method

The 2015 wave of the Longitudinal Study of Older Adults in Anhui Province was used to study financial transfers made by 831 grandparents to grandchildren in the families of 1,633 parents. Two-part random-effects regression was used to predict whether a transfer was made and the value of transfers, given that one occurred.

Results

Grandparents provided higher value transfers to grandchildren whose parents provided greater remittances and with whom they coresided in skipped-generation households. The likelihood of making a transfer fully followed the male lineage, and was greatest to grandson-only families in which parents were first-born sons.

Discussion

Results show that economic, household, and cultural factors are independently associated with the largesse of grandparents. We conclude that grandparents’ economic contributions to grandchildren in rural China are shaped by family demands in a highly mobile society, intergenerational interdependence, and a persistent patrilineal gender system that reaches to the level of grandchildren.