bluuebunny/crossref_metadata_2025 huggingface dataset:
Proactive therapeutic drug monitoring (TDM) may be helpful in managing long-term treatment with linezolid safely: findings from a monocentric, prospective, open-label, interventional study
Authors: Cojutti Pier Giorgio , Merelli Maria , Bassetti Matteo , Pea Federico
Published: August 2019

Background

Thrombocytopenia may be a dose-dependent adverse effect of linezolid therapy.

Objectives

To assess whether proactive therapeutic drug monitoring (TDM) could be helpful in preventing and/or in recovering from the occurrence of linezolid-induced thrombocytopenia during long-term treatment.

Methods

This was a monocentric, prospective, open-label, interventional study conducted between June 2015 and December 2017 among adult patients receiving >10 days of linezolid therapy and undergoing proactive TDM (desired trough level 2–8 mg/L) and platelet count assessment at day 3–5 and then once weekly up to the end of treatment.

Results

Sixty-one patients were included. Twenty-eight (45.9%) always had desired trough level (group A) and 33 (54.1%) experienced linezolid overexposure (group B) [29/33 transiently (subgroup B1) and 4/33 persistently (subgroup B2)]. No patient experienced linezolid underexposure. Median duration of treatment for the different groups ranged between 19 and 54 days. Thrombocytopenia occurred overall in 14.8% of cases (9/61). The incidence rate of thrombocytopenia was significantly lower (P=0.012) in both group A (10.7%; 3/28) and subgroup B1 (10.3%; 3/29) than in subgroup B2 (75.0%; 3/4). Thrombocytopenic patients belonging to both group A and group B1 recovered from thrombocytopenia without the need for discontinuing therapy. Multivariate linear regression analysis revealed that thrombocytopenia was independently associated with baseline platelet count and with median linezolid trough concentrations.

Conclusions

Proactive TDM of linezolid may be beneficial either in preventing or in recovering from dose-dependent thrombocytopenia, even when treatment lasts for more than 28 days. Larger prospective studies are warranted to confirm our findings.
Tannin-containing legumes and forage diversity influence foraging behavior, diet digestibility, and nitrogen excretion by lambs1,2
Authors: Lagrange Sebastian , Villalba Juan J
Published: August 2019

Diverse combinations of forages with different nutrient profiles and plant secondary compounds may improve intake and nutrient utilization by ruminants. We tested the influence of diverse dietary combinations of tannin- (sainfoin-Onobrichis viciifolia; birdsfoot trefoil-Lotus corniculatus) and non-tannin- (alfalfa-Medicago sativa L.) containing legumes on intake and diet digestibility in lambs. Freshly cut birdsfoot trefoil, alfalfa, and sainfoin were offered in ad libitum amounts to 42 lambs in individual pens assigned to 7 treatments (6 animals/treatment): 1) single forage species (sainfoin [SF], birdsfoot trefoil [BFT], and alfalfa [ALF]), 2) all possible 2-way choices of the 3 forage species (alfalfa-sainfoin [ALF-SF], alfalfa-birdsfoot trefoil [ALF-BFT], and sainfoin-birdsfoot trefoil [SF-BFT]), or 3) a choice of all 3 forages (alfalfa-sainfoin-birdsfoot trefoil [ALF-SF-BFT]). Dry matter intake (DMI) was greater in ALF than in BFT (P = 0.002), and DMI in SF tended to be greater than in BFT (P = 0.053). However, when alfalfa was offered in a choice with either of the tannin-containing legumes (ALF-SF; ALF-BFT), DMI did not differ from ALF, whereas DMI in SF-BFT did not differ from SF (P > 0.10). When lambs were allowed to choose between 2 or 3 legume species, DMI was greater (36.6 vs. 33.2 g/kg BW; P = 0.038) or tended to be greater (37.4 vs. 33.2 g/kg BW; P = 0.067) than when lambs were fed single species, respectively. Intake did not differ between 2- or 3-way choice treatments (P = 0.723). Lambs preferred alfalfa over the tannin-containing legumes in a 70:30 ratio for 2-way choices, and alfalfa > sainfoin > birdsfoot trefoil in a 53:33:14 ratio for the 3-way choice. In vivo digestibility (DMD) was SF > BFT (72.0% vs. 67.7%; P = 0.012) and DMD in BFT tended to be greater than in ALF (64.6%; P = 0.061). Nevertheless, when alfalfa was offered in a choice with either sainfoin or birdsfoot trefoil (ALF-SF; ALF-BFT), DMD was greater than ALF (P < 0.001 and P = 0.007, respectively), suggesting positive associative effects. The SF treatment had lower blood urea nitrogen and greater fecal N/N intake ratios than the ALF, BFT, or ALF-BFT treatments (P < 0.05), implying a shift in the site of N excretion from urine to feces. In conclusion, offering diverse combinations of legumes to sheep enhanced intake and diet digestibility relative to feeding single species, while allowing for the incorporation of beneficial bioactive compounds like condensed tannins into the diet.
Persulphide-responsive transcriptional regulation and metabolism in bacteria
Authors: Shimizu Takayuki , Masuda Shinji
Published: August 2019

Hydrogen sulphide (H2S) impacts on bacterial growth both positively and negatively; it is utilized as an electron donor for photosynthesis and respiration, and it inactivates terminal oxidases and iron-sulphur clusters. Therefore, bacteria have evolved H2S-responsive detoxification mechanisms for survival. Sulphur assimilation in bacteria has been well studied, and sulphide:quinone oxidoreductase, persulphide dioxygenase, rhodanese and sulphite oxidase were reported as major sulphide-oxidizing enzymes of sulphide assimilation and detoxification pathways. However, how bacteria sense sulphide availability to control H2S and sulphide metabolism remains largely unknown. Recent studies have identified several bacterial (per)sulphide-sensitive transcription factors that change DNA-binding affinity through persulphidation of specific cysteine residues in response to highly reactive sulphur-containing chemicals and reactive sulphur species (RSS). This review focuses on current understanding of the persulphide-responsive transcription factors and RSS metabolism regulated by RSS sensory proteins.
Sunitinib versus sorafenib for patients with advanced renal cell carcinoma with renal impairment before the immune-oncology therapy era
Authors: Takayama Tatsuya , Kubo Taro , Yamazaki Masahiro , Takeshima Saki , Komatsubara Maiko , Kameda Tomohiro , Kamei Jun , Sugihara Toru , Fujisaki Akira , Ando Satoshi , Kurokawa Shinsuke , Fujimura Tetsuya
Published: August 2019

Objectives

The efficacy and safety of sunitinib versus sorafenib in patients with advanced renal cell carcinoma with renal impairment remains poorly documented.

Patients and methods

We assessed the efficacy and safety of sunitinib and sorafenib in patients with advanced renal cell carcinoma with an estimated glomerular filtration rate of 15–60 mL/min/1.73 m2 by reviewing the medical records of patients treated at Jichi Medical University Hospital, Japan, between May 2008 and August 2016.

Results

Twenty-seven patients were treated with sunitinib and 14 with sorafenib. Median progression-free survival in sunitinib- and sorafenib-treated patients was comparable, at 6.6 vs 5.8 months, respectively (HR, 1.618; 95% CI, 0.689–3.798; P = 0.2691). Median overall survival was also comparable, at 65.9 vs 58.0 months (HR, 0.985; 95% CI, 0.389–2.479; P = 0.9748). Grade 3 or higher adverse events were significantly more frequent in the sunitinib-treated than sorafenib-treated patients (P = 0.0357). Compared to pre-treatment values, estimated glomerular filtration rate at the discontinuation of treatment was not decreased in either group. In contrast, estimated glomerular filtration rate was decreased on long-term treatment, particularly in previously nephrectomized patients.

Conclusions

Sunitinib and sorafenib had similar efficacy in patients with advanced renal cell carcinoma and severe renal impairment. Although renal function was not markedly impaired in either group, close attention to decreased renal function may be necessary in previously nephrectomized patients on long-term treatment.
A posterior approach for curettage in giant cell tumor of bone in the proximal fibula
Authors: Sakamoto Akio , Okamoto Takeshi , Matsuda Shuichi
Published: August 2019

Giant cell tumor of bone (GCTB) is a locally aggressive tumor. En bloc resection to reduce the recurrence rate has a high risk of peroneal nerve paralysis and knee instability associated with collateral ligament resection. In the current report, the posterior approach to curettage is introduced in a 55-year-old male with GCTB in the proximal fibula. The approach makes a wide operative field for curettage of GCTB in the proximal fibula without dissecting the peroneal nerve. The approach would prevent postoperative peroneal nerve palsy and knee instability and possibly reduce recurrences.
Quantifying the power spectrum of small-scale structure in semi-analytic galaxies
Authors: Brennan Sean , Benson Andrew J , Cyr-Racine Francis-Yan , Keeton Charles R , Moustakas Leonidas A , Pullen Anthony R
Published: August 2019

In the cold dark matter (CDM) picture of structure formation, galaxy mass distributions are predicted to have a considerable amount of structure on small scales. Strong gravitational lensing has proven to be a useful tool for studying this small-scale structure. Much of the attention has been given to detecting individual dark matter subhaloes through lens modelling, but recent work has suggested that the full population of subhaloes could be probed using a power spectrum analysis. In this paper, we quantify the power spectrum of small-scale structure in simulated galaxies, with the goal of understanding theoretical predictions and setting the stage for using measurements of the power spectrum to test dark matter models. We use a sample of simulated galaxies generated from the galacticus semi-analytic model to determine the power spectrum distribution first in the CDM paradigm and then in a warm dark matter scenario. We find that a measurement of the slope and amplitude of the power spectrum on galaxy strong lensing scales (k ∼ 1 kpc−1) could be used to distinguish between CDM and alternate dark matter models, especially if the most massive subhaloes can be directly detected via gravitational imaging.
Evolution of star formation rate–density relation over cosmic time in a simulated universe: the observed reversal reproduced
Authors: Hwang Ho Seong , Shin Jihye , Song Hyunmi
Published: August 2019

We use the IllustrisTNG cosmological hydrodynamical simulation to study the evolution of star formation rate (SFR)–density relation over cosmic time. We construct several samples of galaxies at different redshifts from z = 2.0 to z = 0.0, which have the same comoving number density. The SFR of galaxies decreases with local density at z = 0.0, but its dependence on local density becomes weaker with redshift. At z ≳ 1.0, the SFR of galaxies increases with local density (reversal of the SFR–density relation), and its dependence becomes stronger with redshift. This change of SFR–density relation with redshift still remains even when fixing the stellar masses of galaxies. The dependence of SFR on the distance to a galaxy cluster also shows a change with redshift in a way similar to the case based on local density, but the reversal happens at a higher redshift, z ∼ 1.5, in clusters. On the other hand, the molecular gas fraction always decreases with local density regardless of redshift at z = 0.0–2.0 even though the dependence becomes weaker when we fix the stellar mass. Our study demonstrates that the observed reversal of the SFR–density relation at z ≳ 1.0 can be successfully reproduced in cosmological simulations. Our results are consistent with the idea that massive, star-forming galaxies are strongly clustered at high redshifts, forming larger structures. These galaxies then consume their gas faster than those in low-density regions through frequent interactions with other galaxies, ending up being quiescent in the local universe.
A variable-frequency HFQPO in GRS 1915+105 as observed with AstroSat
Authors: Belloni Tomaso M , Bhattacharya Dipankar , Caccese Pietro , Bhalerao Varun , Vadawale Santosh , Yadav J S
Published: August 2019

From the analysis of more than 92 ks of data obtained with the Large Area X-Ray Proportional Counter (LAXPC) instrument onboard AstroSat we have detected a clear high-frequency quasi-periodic oscillation (HFQPO) whose frequency varies between 67.4 and 72.3 Hz. In the classification of variability classes of GRS 1915+105, at the start of the observation period the source was in class ω and at the end the variability was that of class μ: both classes are characterized by the absence of hard intervals and correspond to disc-dominated spectra. After normalization to take into account time variations of the spectral properties as measured by X-ray hardness, the QPO centroid frequency is observed to vary along the hardness–intensity diagram, increasing with hardness. We also measure phase lags that indicate that HFQPO variability at high energies lags that at lower energies and detect systematic variations with the position on the hardness–intensity diagram. This is the first time that (small) variations of the HFQPO frequency and lags are observed to correlate with other properties of the source. We discuss the results in the framework of existing models, although the small (7 per cent) variability observed is too small to draw firm conclusions.
A common origin for the circumnuclear disc and the nearby molecular clouds in the Galactic Centre
Authors: Ballone Alessandro , Mapelli Michela , Trani Alessandro Alberto
Published: August 2019

The origin of the molecular clouds orbiting SgrA* is one of the most debated questions about our Galactic Centre. Here, we present the hydrodynamic simulation of a molecular cloud infalling towards SgrA*, performed with the adaptive-mesh-refinement code ramses. Through such simulation, we propose that the circumnuclear disc and the +20 km s−1 cloud originated from the same tidal disruption episode, occurred less than 1 Myr ago. We also show that recent star formation is to be expected in the +20 km s−1 cloud, as also suggested by recent observations.
Cosmological constraints from Planck galaxy clusters with CMB lensing mass bias calibration
Authors: Zubeldia Íñigo , Challinor Anthony
Published: August 2019

We present a new cosmological analysis of the galaxy clusters in the Planck MMF3 cosmology sample with a cosmic microwave background (CMB) lensing calibration of the cluster masses. As demonstrated by Planck, galaxy clusters detected via the Sunyaev–Zel’dovich (SZ) effect offer a powerful way to constrain cosmological parameters such as Ωm and σ8. Determining the absolute cluster mass scale is, however, difficult, and some recent calibrations have yielded cosmological constraints in apparent tension with constraints in the ΛCDM model derived from the power spectra of the primary CMB anisotropies. In order to calibrate the absolute mass scale of the full Planck cluster sample, we remeasure the masses of all 433 clusters through their weak lensing signature in the CMB temperature anisotropies as measured by Planck. We perform a joint Bayesian analysis of the cluster counts and masses taking as input the estimated cluster masses, SZ signal-to-noise ratios, and redshifts. Our analysis properly accounts for selection effects in the construction of the cluster sample. We find σ8(Ωm/0.33)0.25 = 0.765 ± 0.035 and $1-b_{\rm {SZ}} = 0.71 \pm 0.10$, where the mass bias factor $1-b_{\rm {SZ}}$ relates cluster mass to the SZ mass that appears in the X-ray-calibrated cluster scaling relations. We find no evidence for tension with the Planck primary CMB constraints on ΛCDM model parameters.
Galaxy structural analysis with the curvature of the brightness profile
Authors: Lucatelli Geferson , Ferrari Fabricio
Published: August 2019

In this work, we introduce the curvature of a galaxy brightness profile to identify its structural subcomponents in a non-parametrically fashion. Bulges, bars, discs, lens, rings, and spiral arms are key to understand the formation and evolution path the galaxy undertook. Identifying them is also crucial for morphological classification of galaxies. We measure and analyse in detail the curvature of 14 galaxies with varied morphology. High (low) steepness profiles show high (low) curvature measures. Transitions between components are identified as local peaks oscillations in the values of the curvature. We identify patterns that characterize bulges (pseudo or classic), discs, bars, and rings. This method can be automated to identify galaxy components in large data sets or to provide a reliable starting point for traditional multicomponent modelling of galaxy light distribution.
On the cosmological evolution of long gamma-ray burst properties
Authors: Lloyd-Ronning Nicole M , Aykutalp Aycin , Johnson Jarrett L
Published: August 2019

We examine the relationship between a number of long gamma-ray burst (lGRB) properties (isotropic emitted energy, luminosity, intrinsic duration, jet opening angle) and redshift. We find that even when accounting for conservative detector flux limits, there appears to be a significant correlation between isotropic equivalent energy and redshift, suggesting cosmological evolution of the lGRB progenitor. Analysing a sub-sample of lGRBs with jet opening angle estimates, we find the beaming-corrected lGRB emitted energy does not correlate with redshift, but jet opening angle does. Additionally, we find a statistically significant anticorrelation between the intrinsic prompt duration and redshift, even when accounting for potential selection effects. We also find that, for a given redshift, isotropic energy is positively correlated with intrinsic prompt duration. None of these GRB properties appear to be correlated with galactic offset. From our selection-effect-corrected redshift distribution, we estimate a co-moving rate density for lGRBs, and compare this to the global cosmic star formation rate (SFR). We find the lGRB rate mildly exceeds the global star formation rate between a redshift of 3 and 5, and declines rapidly at redshifts above this (although we cannot constrain the lGRB rate above a redshift of about 6 due to sample incompleteness). We find the lGRB rate diverges significantly from the SFR at lower redshifts. We discuss both the correlations and lGRB rate density in terms of various lGRB progenitor models and their apparent preference for low-metallicity environments.
Sensitivity of temporal artery biopsy in the diagnosis of giant cell arteritis: a systematic literature review and meta-analysis
Authors: Rubenstein Emma , Maldini Carla , Gonzalez-Chiappe Solange , Chevret Sylvie , Mahr Alfred
Published: August 2019

Objectives

Temporal artery biopsy (TAB) is a reference test for the diagnosis of GCA but reveals inflammatory changes only in a subset of patients. The lack of knowledge of TAB sensitivity hampers comparisons with non-invasive techniques such as temporal artery ultrasonography. We performed a systematic literature review and meta-analysis to estimate the sensitivity of TAB in GCA and to identify factors that may influence the estimate.

Methods

A systematic literature review involved searching electronic databases and cross-references. Eligibility criteria included publications reporting at least 30 GCA cases fulfilling the original or modified 1990 ACR classification criteria. The pooled proportion of TAB-positive GCA cases was calculated by using aggregated-data meta-analysis with a random-effects model and assessment of heterogeneity with the I2 statistic. Subgroup analyses and meta-regression were used to examine the effect of patient and study characteristics on TAB positivity.

Results

Among 3820 publications screened, 32 studies (3092 patients) published during 1993–2017 were analysed. The pooled proportion of TAB-positive GCA cases was 77.3% (95% CI: 71.8, 81.9%), with high between-study heterogeneity (I2 = 90%). The proportion of TAB-positive cases was slightly higher in publications before than in 2012 and after (P = 0.001).

Conclusion

The estimated sensitivity of 77% provides indirect evidence that TAB is not less sensitive than temporal artery imaging. The unexplained high between-study heterogeneity could result from differences in TAB sampling, processing or interpretation. The decrease in TAB-positive GCA cases over time could reflect an increasing propensity for clinicians to accept a GCA diagnosis without proof by TAB.
Induction of Gamma-Glutamyltransferase Activity and Consequent Pro-oxidant Reactions in Human Macrophages Exposed to Crocidolite Asbestos
Authors: Corti Alessandro , Bonetti Justine , Dominici Silvia , Piaggi Simona , Fierabracci Vanna , Foddis Rudy , Pompella Alfonso
Published: August 2019

Asbestos is the main causative agent of malignant pleural mesothelioma. The variety known as crocidolite (blue asbestos) owns the highest pathogenic potential, due to the dimensions of its fibers as well as to its content of iron. The latter can in fact react with macrophage-derived hydrogen peroxide in the so called Fenton reaction, giving rise to highly reactive and mutagenic hydroxyl radical. On the other hand, hydroxyl radical can as well originate after thiol-dependent reduction of iron, a process capable of starting its redox cycling. Previous studies showed that glutathione (GSH) is one such thiol, and that cellular gamma-glutamyltransferase (GGT) can efficiently potentiate GSH-dependent iron redox cycling and consequent oxidative stress. As GGT is expressed in macrophages and is released upon their activation, the present study was aimed at verifying the hypothesis that GSH/GGT-dependent redox reactions may participate in the oxidative stress following the activation of macrophages induced by crocidolite asbestos. Experiments in acellular systems confirmed that GGT-mediated metabolism of GSH can potentiate crocidolite-dependent production of superoxide anion, through the production of highly reactive dipeptide thiol cysteinyl-glycine. Cultured THP-1 macrophagic cells, as well as isolated monocytes obtained from healthy donors and differentiated to macrophages in vitro, were investigated as to their expression of GGT and the effects of exposure to crocidolite. The results show that crocidolite asbestos at subtoxic concentrations (50–250 ng/1000 cells) can upregulate GGT expression, which raises the possibility that macrophage-initiated, GSH/GGT-dependent pro-oxidant reactions may participate in the pathogenesis of tissue damage and inflammation consequent to crocidolite intoxication.
Blocking the histone lysine 79 methyltransferase DOT1L alleviates renal fibrosis through inhibition of renal fibroblast activation and epithelial‐mesenchymal transition
Authors: Liu Lirong , Zou Jianan , Guan Yingjie , Zhang Yunhe , Zhang Wei , Zhou Xiaoxu , Xiong Chongxiang , Tolbert Evelyn , Zhao Ting C. , Bayliss George , Zhuang Shougang
Published: August 2019

Disruptor of telomeric silencing‐1 like (DOT1L) protein specifically catalyzes the methylation of histone H3 on Lys79 (H3K79) and is implicated in tumors. But its role in tissue fibrosis remains unclear. Here we demonstrated that injury to the kidney increased DOT1L expression and H3K79 dimethylation in renal tubular epithelial cells and myofibroblasts in a murine model of unilateral ureteral obstruction. Administration of EPZ5676, a highly selective inhibitor of DOT1L, attenuated renal fibrosis. Treatment with EPZ5676 or DOT1L small interfering RNA also inhibited TGF‐p1 and serum‐induced activation of renal interstitial fibroblasts and epithelial‐mesenchymal transition (EMT) in vitro. Moreover, blocking DOT1L abrogated injury‐induced epithelial G2/M arrest; reduced expression of Snail, Twist, and Notch1; and inactivated several profibrotic signaling molecules in the injured kidney, including Smad3, epidermal growth factor receptor, platelet‐derived growth factor receptor, signal transducer and activator of transcription 3, protein kinase B, and NF‐κB. Conversely, DOT1L inhibition increased expression of phosphatase and tensin homolog, a protein associated with dephosphorylation of tyrosine kinase receptors, and prevented decline in levels of Klotho and Smad7,2 renoprotective factors. Thus, our data indicate that targeting DOT1L attenuates renal fibrosis through inhibition of renal fibroblasts and EMT by suppressing activation of multiple profibrotic signaling pathways while retaining expression of renoprotective factors.—Liu, L., Zou, J., Guan, Y., Zhang, Y., Zhang, W., Zhou, X., Xiong, C., Tolbert, E., Zhao, T. C., Bayliss, G., Zhuang, S. Blocking the histone lysine 79 methyltransferase DOT1L alleviates renal fibrosis through inhibition of renal fibroblast activation and epithelial‐mesenchymal transition. FASEB J. 33, 11941‐11958 (2019). www.fasebj.org
Preoperative imaging of traumatic anterior shoulder instability: Diagnostic effectiveness of magnetic resonance arthrography and comparison with conventional magnetic resonance imaging and arthroscopy
Authors: Haroun Haitham , Abd rabu Ahmed , Kotb Ahmed , Awad Fath Allah
Published: August 2019

Background:

Associated injuries of traumatic anterior shoulder dislocations play an important role in predicting recurrent instability. MRI has proved popular for imaging of suspected abnormalities. MR arthrography (MRA) has been suggested to be more sensitive than MRI in the detection of labral tears and other capsular lesions. In this study, we aimed to assess prospectively the diagnostic effectiveness of MRA in the preoperative planning of traumatic anterior shoulder instability compared with conventional MRI and arthroscopy.

Methods:

Shoulder MRI and MRA in 100 patients (73 men and 27 women; mean age, 27 yr) with shoulder dislocations were evaluated by two musculoskeletal radiologists who were blinded to arthroscopic findings, which represented the reference standard. An arthroscopic surgeon blinded to the imaging findings evaluated the osseous abnormalities involving the humeral head and glenoid, anterior labroligamentous lesions, and capsular lesions. Sensitivity, specificity, accuracy, and positive and negative predictive values of each imaging study were calculated for each elemental lesion and compared using a paired McNemar test.

Results:

When comparing the sensitivity and accuracy values of the MRA and MRI for the detection of these elemental lesions, all values of MRA were higher than those of MRI (P<0.01). However, when comparing the specificity values, both MRI and MRA were highly specific (100%) in diagnosing bony Bankart lesions and anterior labroligamentous periosteal sleeve avulsions. MRI missed Perthes lesions, humeral avulsions of the anterior glenohumeral ligament, and glenoid avulsions of the anterior glenohumeral ligament.

Conclusions:

Despite being invasive, MRA is considerably more useful in the identification and categorization of different elemental lesions of traumatic chronic anterior shoulder instability.
The Influence of Conflicts of Interest on Outcomes in the Lumbar Disc Arthroplasty Literature
Authors: Guntin Jordan A. , Patel Dil V. , Cardinal Kaitlyn L. , Haws Brittany E. , Khechen Benjamin , Yoo Joon S. , Block Andrew M. , Lalehzarian Simon P. , Singh Kern
Published: August 2019

Study Design.

A systematic review.

Objective.

The aim of this study was to determine the association between study outcomes and the presence of a conflict of interest (COI) in the lumbar disc arthroplasty (LDA) literature.

Summary of Background Data.

Previous studies have evaluated the efficacy of LDA as a surgical alternative to arthrodesis. As investigators may have financial relationships with LDA device companies, it is important to consider the role of COI on study outcomes.

Methods.

A systematic review was performed to identify articles reporting clinical outcomes of LDA. Any financial COIs disclosed were recorded and confirmed through Open Payments and ProPublica databases. Study outcomes were graded as favorable, unfavorable, or equivocal. Pearson Chi-squared analysis was used to determine an association between COI and study outcomes. Favorable outcomes were tested for an association with study characteristics using Poisson regression with robust error variance.

Results.

Fifty-seven articles were included, 30 had a financial COI, while 27 did not. Ninety percent of the conflicted studies disclosed their COI in the article. Studies with United States authors were more likely to be conflicted (P = 0.019). A majority of studies reported favorable outcomes for LDA (n = 39). Conflicted studies were more likely to report favorable outcomes than nonconflicted studies (P = 0.020). Articles with COIs related to consultant fees (P = 0.003), research funding (P = 0.002), and stock ownership (P < 0.001) were more likely to report favorable outcomes.

Conclusion.

This study highlights the importance for authors to accurately report conflicting relationships with industry. As such, orthopedic surgeons should critically evaluate study outcomes with regard to potential conflicts before recommending LDA as a surgical option to their patients.

Level of Evidence: 3
Perceptions and Experiences of Hospital Nurses During Transition to an Electronic Handover Informatics System
Authors: Lee Chia-Lun , Lin Wei-Ting , Lin Shu-Yuan
Published: August 2019

An effective patient transfer, or handover, among healthcare professionals can help prevent communication-related medical errors, and a reliable electronic handover informatics system can standardize the handoff process. Adapting to a new handover system may cause stress for nurses. This descriptive qualitative study aimed to explore the perceptions and transition experiences of hospital nurses in adopting and adapting to a new handover informatics system. Thirty-eight nurses at a medical center in Taiwan participated in the study from December 2016 to January 2017. The researcher conducted five focus group interviews and analyzed all responses using content analysis. Results showed three major themes: “Perceptions of challenges and barriers related to the transition to a new handover informatics system,” “Perceptions of benefits and strategies to the transition to a new handover informatics system,” and “Suggestions for successful implementation of a new handover informatics system.” Five subthemes emerged from the first theme, and six subthemes emerged from the second theme. The results of this study could enhance our understanding of nurses' perceptions and experiences with transition to a new handover informatics system and could provide a reference for hospitals to develop individualized strategies to facilitate the implementation of a handover informatics system.
Chronic rhinosinusitis with nasal polyps
Authors: Cattano Davide , Citardi Martin J.
Published: August 2019

Chronic rhinosinusitis (CRS) is a complex disease and can present with different stages of disease progression, depending on etiology and comorbidities. One important feature of a specific subset of CRS are nasal polyps (CRSwNP). Medical treatment options for patients with CRSwNP remain limited, often making surgery necessary. Functional endoscopic sinus surgery with navigation is the preferred treatment of CRSwNP, offering the safety of computed tomography guided navigation with minimally invasive resection of the tumors. It is paramount for the anesthesiologist to know the most commonly encountered surgical perioperative complications of functional endoscopic sinus surgery: ethmoidal artery injury (bleeding, optic nerve damage), penetration of the ethmoid roof or lamina papyracea (cerebrospinal leak), nasolacrimal duct damage or direct optic nerve damage. Anticipation of surgical (bleeding, nerve or brain injury) and anesthetic complications (lost airway, hypoxia, and anaphylaxis) is fundamental to patient safety. Anesthesia management for cases with complete nasal airway obstruction relies on a careful preoperative assessment of the patient’s anatomy and symptoms, clinical presentation, and associated comorbidities. Airway compromise can result in a dangerous cannot ventilate/cannot intubate situation, a risk complicated by patient refusal for awake intubation. A proper plan should not only be established for the intubation, but also for the extubation. Important factors in proper anesthesia management are also based on accurate preoperative assessment of the patient, evaluation of associated comorbidities (obstructive sleep apnea, morbid obesity, aspirin-exacerbated respiratory disease, IgE related CRS, fungus, etc.) as well as planning of the procedure with attention to directed management and therapy (controlled hypotension, pain control, airway management, admission status).
Long-Term Results of the Surgical Management of the Upper Eyelids in “Ablepharon”-Macrostomia Syndrome
Authors: Cruz Antonio Augusto V. , Quiroz Doris , Boza Tatiana , Wambier Sarah P. F. , Akaishi Patricia S.
Published: August 2019

The upper eyelids in ablepharon-macrostomia syndrome can be permanently lengthened with full thickness skin grafts over Müller muscle.

Purpose:

To describe the late results of the placement of skin graft over conjunctiva-Müller muscle complex in 3 patients with ablepharon-macrostomia syndrome (AMS) and to review the procedures used to manage the upper eyelids in AMS.

Methods:

The authors searched the Pubmed database for all articles that used the term “ablepharon-macrostomia syndrome” in any field. Data collection included description of eyelid changes, age at surgery, status of the cornea before surgery, type of eyelid repair, and final outcome. Two previously reported siblings were reevaluated 10 and 15 years after a single reconstructive operation. A new case from Peru is also described.

Results:

Only 15 patients with AMS have been described in 12 articles. In 60% of the cases, the lids were described as absent. The surgical modalities employed to reconstruct the upper eyelids were quite variable, including local flaps, lid sharing procedures, and even a masquerade flap. At long-term follow-up, all 3 cases who underwent upper eyelid lengthening with full thickness skin grafts placed over Müller muscle had clear corneas with a small amount of lagophthalmos.

Conclusions:

The lids in AMS are not absent and should not be managed with complex reconstructive techniques. Full thickness skin grafts placed over the inner aspect of the palpebral conjunctiva allow permanent eye protection.
Screen Time and Cardiovascular Risks Among Middle-Aged Women
Authors: Ham Ok Kyung , Lee Bo Gyeong
Published: August 2019

Background

Screen time is a marker of sedentary behavior that threatens the health of women. Extended screen time is associated with depression, insomnia, cardiovascular disease, and decreased quality of life.

Objective

In this study, we examined the factors associated with screen time and whether screen time is associated with the physiological and psychosocial health of middle-aged women. We applied a psycho-socioeconomic biobehavioral model of health and studied the outcomes of cardiometabolic biomarkers, insomnia, and quality of life.

Methods

Secondary data analysis was performed using data from a cross-sectional study conducted with 423 women between 40 and 65 years of age. Socioeconomic, physiological, psychosocial, and behavioral characteristics were measured. Self-reported screen time during the past week was measured using an ordinal scale. The data were analyzed using multivariate analysis of covariance, analysis of covariance, and logistic regression analysis.

Results

Twenty-four percent of subjects had at least 3 hours per day of screen time on weekdays, whereas 30.7% had at least 3 hours per day on weekends. Older women, unemployed women, and those who do not perform regular exercise were more likely to have at least 3 hours per day of screen time (P < .05). Screen time was associated with total cholesterol and low-density lipoprotein cholesterol levels, insomnia, and menopause-specific quality of life (P < .05).

Conclusions

Based on a psycho-socioeconomic biobehavioral framework, we found that screen time is associated with the physiological and psychosocial health of women independent of socioeconomic and biobehavioral variables. Efforts to reduce the amount of screen time targeting middle-aged women will help improve cardiometabolic biomarkers and quality of life.
Distinct Factors Associated With Better Self-care in Heart Failure Patients With and Without Mild Cognitive Impairment
Authors: Lee Kyoung Suk , Choi Jin-Oh , Jeon Eun-Seok , Park Jae-Hyeong , Jung Mi Sook , Lee Zian , Lee Hyeong Suk , Yoo Hye Jin
Published: August 2019

Background

A decline in cognition may limit patients' ability to effectively engage in self-care in those with heart failure (HF). However, several studies have shown no difference in self-care between HF patients with and without cognitive impairment. This may indicate that there are more salient factors associated with self-care in HF patients with cognitive impairment compared with those without cognitive impairment.

Objective

The aim of this study was to explore which factors are related to self-care based on the presence and absence of mild cognitive impairment (MCI) among patients with HF.

Methods

Patients with HF were recruited from outpatient settings. The Montreal Cognitive Assessment was used to screen for MCI. Self-care was measured with the Self-care of HF Index v.6.2. Two separate stepwise linear regressions were performed to identify which factors (HF knowledge, perceived control, functional status, multimorbidity, executive function, and social support) predicted self-care in HF patients with and without MCI.

Results

Of the 132 patients in this study, 36 (27.3%) had MCI. Self-care maintenance and management were associated with social support (β = 0.489) and executive function (β = 0.484), respectively, in patients with MCI. Perceived control was associated with both self-care maintenance and management in patients without MCI (βs = 0.404 and 0.262, respectively).

Conclusion

We found that social support and executive function were associated with self-care in HF patients with MCI, whereas perceived control was associated with self-care in HF patients with intact cognition. Clinicians should develop tailored interventions to enhance self-care by considering the distinct factors associated with self-care based on the presence or absence of MCI.
Active Physical Activity Patterns Are Associated With Improved Quality of Life and Depression Status in Taiwanese Women With Metabolic Syndrome
Authors: Chiang Li-Chi , Chiang Shang-Lin , Tzeng Wen-Chii , Lee Meei-Shyuan , Hung Yi-Jen , Lin Chia-Huei
Published: August 2019

Background:

Metabolic syndrome (MetS), health-related quality of life (HRQL), and depression status are independently associated with cardiac health. Therefore, understanding the associations between MetS, HRQL, and depression status and determining factors related to improved HRQL and depression status in people with MetS may help in cardiovascular disease prevention.

Objective:

The aim of this study was to examine whether there are differences in HRQL and depression status between Taiwanese women with and without MetS and whether physical activity patterns are associated with HRQL and depression status in this population.

Methods:

A cross-sectional study of 326 Taiwanese middle-aged and older women (≥40 years) was conducted. Metabolic syndrome was determined based on the National Cholesterol Education Program Adult Treatment Panel III definition. Health-related quality of life and depression status were collected using the Short Form 36 Health Survey and Beck Depression Inventory. Univariate and multivariate linear regression analyses were conducted.

Results:

Women with MetS had lower HRQL (P < .001) and higher depression status (P = .002) than those without MetS. Participants with active physical activity patterns had higher HRQL (P < .001) and lower depression status (P = .046) than those with sedentary patterns. Among women with MetS, those with active physical activity patterns had higher HRQL (P = .001) and lower depression status (P = .007) than those with sedentary patterns.

Conclusions:

Metabolic syndrome is related to lower HRQL and higher depression status in women 40 years and older. Active physical activity patterns are associated with better HRQL and reduced depression status in middle-aged and older women (≥40 years) with MetS.
Self-management Among Elderly Patients With Hypertension and Its Association With Individual and Social Environmental Factors in China
Authors: Zhang Xiao-Nan , Qiu Chen , Zheng Yu-Zhi , Zang Xiao-Ying , Zhao Yue
Published: August 2019

Background:

The hypertension control rate in China is much lower than that in developed countries. Self-management among elderly patients with hypertension can improve blood pressure control; thus, it is necessary to explore its association with individual and social environmental factors.

Objective:

Our objective was to investigate self-management among elderly patients with hypertension in China and its association with individual and social environmental factors based on the social ecological model.

Methods:

A total of 301 elderly patients with hypertension were recruited to do a questionnaire survey based on the social ecological model, which included the General Demographic Information Questionnaire, Hypertension Patients Self-Management Behavior Rating Scale, World Health Organization Well-Being Index, Family APGAR Index, and Social Support Rating Scale.

Results:

The lowest level of self-management behaviors was in exercise management, and the highest was in medication management. The results of multiple linear regression analysis showed that well-being, family function, sex, education level, and age were pivotal individual and social environmental factors influencing self-management behaviors among elderly patients with hypertension.

Conclusions:

There is a need to develop and test interventions that improve self-management in elderly patients with hypertension. Specifically, individualized interventions to promote exercise among elderly persons with hypertension who are single and living alone are needed. Male patients with a lower education level, poor well-being, poor family function, and the lowest self-management levels are a key population to target.
Pleural Fluid Cytokine Levels at Baseline and Over Time are Associated With Time to IPC Removal
Authors: Grosu Horiana B. , Lu Wei , Ost David E. , Vial Macarena R. , Hernandez Mike , Ghosh Natasha , Noor Laila , Hasan Arain M. , Bashoura Lara , Faiz Saadia , Balachandran Dave , Casal Roberto , Eapen George , Shannon Vickie , Sheshadri Ajay , Tang Ximing , Rahman Najib , Wistuba Ignacio I.
Published: August 2019

Background:

The behavior of pleural fluid cytokine (PFCs) levels and their association with pleurodesis after indwelling pleural catheter (IPC) placement is unknown.

Objective:

A prospective exploratory study was conducted to obtain preliminary data on PFC levels after IPC placement.

Methods:

The PFC panel consisted of 4 cytokines [interleukin -8 (IL-8), vascular endothelial growth factor, total (but not activated) transforming growth factor betas, and basic fibroblast growth factor], measured across 5 time points (T0: insertion; T1: 24 to 48 h; T2: 72 to 96 h; T3: 1 wk; and T4: 2 wk). Profile plots were used to identify patterns of change of PFC levels. Correlation matrices for each PFC over time were computed, and area under the curve (AUC) categories were used to compare the cumulative incidence of IPC removal. Auto pleurodesis was defined as elective catheter removal because of decreased drainage within 90 days of insertion.

Results:

A total of 22 patients provided complete data. Except for IL-8, the majority of PFCs demonstrated strong positive correlations across measurement time points. Patients with high AUCs for IL-8, basic fibroblast growth factor, and vascular endothelial growth factor had a higher cumulative incidence of IPC removal by 90 days than did patients with low AUCs.

Conclusion:

This is the first study to evaluate longitudinal changes of pleural cytokine levels with respect to the likelihood of IPC removal and provide early evidence that the cytokine profile may be associated with the outcome of pleurodesis induced by IPCs. However, this is an exploratory study and further studies are needed to assess if these findings can be validated in further studies.
Efficacy of the Combination of Pinaverium Bromide 100 mg Plus Simethicone 300 mg in Abdominal Pain and Bloating in Irritable Bowel Syndrome: A Randomized, Placebo-controlled Trial
Authors: Schmulson Max J. , Chiu-Ugalde Jazmin , Sáez-Ríos Adolfo , López-Colombo Aurelio , Mateos-Pérez Gualberto J. , Remes-Troche José María , Sobrino-Cossio Sergio , Soto-Pérez Julio C. , Tamayo de la Cuesta José L. , Teramoto-Matsubara Oscar T. , López-Alvarenga Juan C.
Published: August 2019

Goals:

We aimed to evaluate the efficacy and safety of PB+S (pinaverium bromide 100 mg plus simethicone 300 mg) in patients with irritable bowel syndrome (IBS).

Background:

IBS is a multifactorial disorder; thus, combination therapy with different mechanisms of action is expected to be useful. PB+S has shown effectiveness in an open-label clinical study in IBS. However, there are no placebo-controlled trials.

Materials and Methods:

IBS-Rome III patients with abdominal pain/discomfort for at least 2 days within the week prior to baseline assessment were included in this 12-week, randomized, double-blind, placebo-controlled study of PB+S versus placebo, bid. The primary endpoint was overall symptom improvement, evaluated weekly by the patient (Likert Scale). Secondary endpoints included the weekly improvement in the severity of abdominal pain and bloating assessed both by patients (10-cm Visual Analogue Scale) and investigators (Likert Scale); frequency of Bristol Scale stool types (consistency) evaluated by patients and the IBS Quality of Life scores.

Results:

A total of 285 patients (female: 83%; 36.5±8.9 y old) received at least 1 dose of PB+S (n=140) or placebo (n=145). No difference was observed in overall symptom improvement between the groups (P=0.13). However, PB+S was superior in abdominal pain (effect size: 31%, P=0.038) and bloating (33%, P=0.019). Patients with IBS-C and IBS-M showed the best improvement in the frequency of stool types with PB+S. No differences were observed in IBS Quality of Life scores and adverse events.

Conclusions:

PB+S was superior to placebo in improving abdominal pain and bloating in patients with active IBS. The effect on the frequency of stool consistency was particularly significant in IBS-C and IBS-M.
Obesity and dyslipidemia in patients with psoriasis
Authors: Miao Chaoyang , Li Jing , Li Ying , Zhang Xiaoyan
Published: August 2019

The aim of this study was to conduct a more comprehensive analysis of the association between psoriasis and abnormal lipid metabolism.

The case–control study included 222 psoriatic patients and 445 non-psoriatic control patients matched for age and gender. Clinical parameters included age, gender, and body mass index (BMI). Serum lipid levels were recorded and included cholesterol (CHO), triglycerides (TG), low-density lipoprotein (LDL), high density lipoprotein (HDL), phospholipids (PLIP), free fatty acids (FFA), lipoprotein (a) [Lp(a)], and apolipoproteins (apoA1, apoB, and apoE). Statistical analysis was carried out through the IBM Statistical Package for the Social Studies version 23.0.

Compared with controls, levels of BMI and the prevalence of obesity were significantly higher in psoriatic patients. The results revealed that when compared to controls, significant elevation of serum TG (P <.001) and Lp(a) (P = .022) was observed. Levels of HDL (P <.001) and apoA1 (P <.001) were significantly lower in psoriatic patients. There was no significant difference in CHO (P = .367), LDL (P = .400), apoB (P = .294), apoE (P = .05), PLIP (P = .931) and FFA (P = .554) between patients and controls. The levels of CHO, TG, PLIP, FFA, and apoE were positively correlated with BMI level.

Dyslipidemia was more common in psoriatic patients, compared with non-psoriatic controls.