bluuebunny/crossref_metadata_2025_split huggingface dataset:
Immunostaining With Immunoglobulin G Subclass Antibody Cocktail for Diagnosis of Type 1 Autoimmune Pancreatitis
Authors: Nakata Rie , Uehara Takeshi , Iwaya Mai , Asaka Shiho , Kobayashi Shota , Sugano Mitsutoshi , Higuchi Kayoko , Kusama Yukiko , Nakazawa Koh , Nakaguro Masato , Kobayashi Mikiko , Tateishi Ayako , Makino Mutsuki , Kawaguchi Kenji , Maejima Toshitaka , Ishii Keiko , Sano Kenji , Shimojo Hisashi , Hori Atsushi , Otsuki Toshiaki , Hamano Hideaki , Kawa Shigeyuki , Ota Hiroyoshi 
Published: May 2020

Background. Immunoglobulin (Ig) G4-related diseases (RDs) are systemic diseases in which serum IgG4 levels are frequently elevated. They can cause diffuse or focal tumor formation, organ swelling, and tissue thickening in organs infiltrated by IgG4 + plasma cells. The diagnostic criteria for IgG4-RDs include an IgG4/IgG ratio >40%, but counting IgG+ cells can be difficult because of the weakness of IgG staining density. We hypothesized that an antibody cocktail of mixed IgG1, IgG2, IgG3, and IgG4 (AC-IgG) might give immunohistochemistry results comparable with those of IgG in IgG4-RD. Methods. We compared AC-IgG reactivity with IgG expression in type 1 autoimmune pancreatitis (AIP), a representative IgG4-RD. We compared immunohistochemistry results using AC-IgG and IgG-only in 10 cases of AIP. The coefficient of variation (Cv) was used to analyze differences between AC-IgG and IgG findings in AIP by 13 board-certified pathologists. Results. Although mean values for IgG+ cells did not significantly differ between AC-IgG (34.3; range = 27.4-37.1) and IgG (30.0; range = 23.0-45.6; P = .6254), Cv was lower for AC-IgG (33.4%) than for IgG (51.4%; regression equation; y[IgG] = 0.988 x + 0.982; correlation coefficient = 0.907). The data showed that the results of both methods were largely consistent. Conclusion. AC-IgG could replace IgG to count IgG+ cells because of its lower Cv.
Radiographic Assessment of Relative First Metatarsal Length Following Modified Lapidus Procedure
Authors: Greeff Wessel , Strydom Andrew , Saragas Nikiforos Pandelis , Ferrao Paulo Norberto Faria 
Published: May 2020

Background: The modified Lapidus is a surgical procedure for managing moderate to severe hallux valgus, especially in the presence of first tarsometatarsal joint arthritis or hypermobility. It has good long-term results but reportedly can lead to transfer metatarsalgia due to inherent shortening of the first metatarsal. Methods: A retrospective analysis of all adult patients who underwent a modified Lapidus procedure during a 3-year period was performed. Clinical notes were evaluated to look for nonunion or any other complications related to the surgery. Pre- and postoperative standard weightbearing radiographs were used to establish the relative metatarsal length (RML), intermetatarsal angle (IMA), hallux valgus angle (HVA), and distal metatarsal articular angle (DMMA). A total of 69 modified Lapidus procedures were identified, with 32 included in the study. Results: The mean pre- and postoperative RMLs were −0.8 and −4.9 mm, respectively. The average RML shortening due to the procedure was −4.1 ( P < .0001). The mean pre- and postoperative IMAs were 15 and 5 degrees, respectively ( P < .0001). The mean pre- and postoperative HVAs were 33 and 9 degrees, respectively ( P < .0001). One patient reported transfer metatarsalgia, which was attributed to elevation of the first metatarsal. Conclusion: We found a statistically significant degree of shortening of the relative length of the first metatarsal without any clinically significant metatarsalgia. The low rate of transfer metatarsalgia following the modified Lapidus procedure could be attributed to the sagittal plane correction and stability obtained by performing a first tarsometatarsal fusion. Level of Evidence: Level IV, retrospective case series.
Clinicopathologic and pathologic characteristics of feline proteinuric kidney disease
Authors: Rayhel Laura H , Quimby Jessica M , Cianciolo Rachel E , Cléroux Andréanne , McLeland Shannon M , Franken Toni 
Published: May 2020

Objectives The aim of this study was to describe the causes, clinicopathologic features and outcomes of feline protein-losing nephropathy (proteinuria secondary to glomerular disease [PLN]). Methods Kidney biopsy/necropsy samples from proteinuric cats submitted to the International Veterinary Renal Pathology Service were retrospectively reviewed. Diagnoses based on histopathology were categorized by primary disease compartment. Clinicopathologic variables at diagnosis, development of hypoalbuminemia, anemia, hypertension, azotemia and effusion/edema, and survival were compared between cats with immune-complex glomerulonephritis (ICGN) and other causes of PLN. Results Fifty-eight percent (n = 31/53) of proteinuric cats had ICGN and 74% (n = 31/42) of cats with PLN had ICGN. Cats with glomerular diseases other than ICGN had a higher median urine protein:creatinine ratio than ICGN cats (14.5 vs 6.5; P <0.001). Onset of PLN occurred at a young age; median age at diagnosis was 3.5 years in ICGN cats vs 1.3 years in cats with other glomerular diseases ( P = 0.026). Development of complications such as hypoalbuminemia, anemia, hypertension, azotemia and effusion/edema were common, regardless of the cause of PLN, and were not different between ICGN and cats with other glomerular diseases. Male cats were over-represented in the ICGN group ( P = 0.003). Median survival time (MST) for all cats with PLN was 94 days (range 3–1848 days). Survival was not different between cats with ICGN and cats with other glomerular diseases. MST in ICGN cats that developed effusion was shorter (94 days) than cats that did not (700 days; P = 0.035). MST in IGCN cats that received immunosuppressive medications was longer (244 days) than cats that did not (17 days, P = 0.039). Conclusions and relevance Taken together, these data suggest that clinical suspicion for glomerular proteinuria should increase in young, male cats with higher degrees of proteinuria, and immune-mediated disease is common. Further studies are needed to determine the effect of immunosuppression on morbidity and mortality in cats with ICGN.
Impact of the New McGill Undergraduate Medical Curriculum on Medical Students' Diagnostic Accuracy of Common Dermatoses Encountered in Primary Care
Authors: Cheung Wai Kiu Larry , Pehr Kevin 
Published: May 2020

Background The McGill Faculty of Medicine implemented a new undergraduate medical curriculum in 2013 with additional preclinical lectures in dermatology. At the time of writing, no Canadian prospective study has been published on undergraduate dermatology training in the context of a complete curricular renewal. Objectives Our study was designed to determine the impact of increasing preclinical teaching in dermatology on medical students’ diagnostic accuracy and learning retention of common dermatoses encountered in primary care. Methods A standardized questionnaire was administered to the Classes of 2015, 2016, 2017, and 2018 in 6 versions for a total of 6 times over their 4 years of training. Each version featured 10 photographs of common dermatoses encountered in primary care. Students were invited to participate anonymously and on a voluntary basis. Results A small absolute, but statistically significant difference, of 3% was detected in the fourth and final year of training between the old curriculum (average score = 70%, standard deviation = 15%) and the new curriculum (average score = 73%, standard deviation = 15%), P = .03. Furthermore, the Class of 2018’s performance improved year by year over the entire 4 years of the new curriculum. Conclusions Additional preclinical lectures in dermatology do improve medical students’ diagnostic accuracy of common dermatoses encountered in primary care. Furthermore, they do retain their learning throughout the preclinical and clerkship years.
The road to fusion: The evolution of bilingual speech across three generations of speakers in Gibraltar
Authors: Goria Eugenio 
Published: May 2020

Aims and objectives: This article analyses English–Spanish code-mixing in Gibraltar. I describe the distribution of clause-peripheral alternation patterns in order to demonstrate that there is a correlation between single age-groups and particular types of bilingual patterns. This is interpreted as a case of fusion. Methodology: By seeking a correlation between age groups and particular instances of bilingual speech, this study adopts an apparent-time perspective. Furthermore, it tries to combine the quantitative methodology adopted in sociolinguistic studies with the theoretical tools of the sociology of language that are involved in the description of linguistic repertoires. This provides an important key for the interpretation of fusion in this scenario. Data and analysis: The study was based on a corpus of nearly 20 h of interviews with bilingual speakers belonging to three age-groups. After identifying three qualitatively different bilingual patterns, which mainly differed in the presence or absence of pragmatic functions, I took into account their distribution across age groups. Findings and conclusions: The results showed that elderly speakers were associated with pragmatically motivated code-switching, while younger speakers were associated with cases of single-word peripheral switches that were not related to any discourse- or participant-related function. This may be interpreted as incipient fusion in the periphery of the clause, possibly determined by recent changes in the linguistic repertoire. Originality: This is the first study to have applied the fusion framework to the case of Gibraltar and is also one of the few that has analysed code-mixing in this scenario from a quantitative corpus-based perspective. Significance: The data presented here shed new light on the early stages of the fusion process, highlighting the correlation between the onset of this phenomenon and macro-sociolinguistic processes involving the community.
Exercise therapy in routine management of peripheral arterial disease and intermittent claudication: a scoping review
Authors: Abaraogu Ukachukwu O. , Abaraogu Onyinyechukwu D. , Dall Philippa M. , Tew Garry , Stuart Wesley , Brittenden Julie , Seenan Chris A. 
Published: May 2020

Background: Little is known about the extent to which routine care management of peripheral arterial disease (PAD) and intermittent claudication (IC) align with best practice recommendations on exercise therapy. We conducted a scoping review to examine the published literature on the availability and workings of exercise therapy in the routine management of patients with PAD and IC, and the attitude and practice of health professionals and patients. Methods: A systematic search was conducted in February 2018. The Cumulative Index of Nursing and Allied Health Literature, Ovid MEDLINE, Allied and Complementary Medicine Database, ScienceDirect, Web of Science and the Directory of Open Access Repositories were searched. Hand searching of reference lists of identified studies was also performed. Inclusion criteria were based on study aim, and included studies that reported on the perceptions, practices, and workings of routine exercise programs for patients with IC, their availability, access, and perceived barriers. Results: Eight studies met the eligibility criteria and were included in the review. Studies conducted within Europe were included. Findings indicated that vascular surgeons in parts of Europe generally recognize supervised exercise therapy as a best practice treatment for IC, but do not often refer their patients for supervised exercise therapy due to the unavailability of, or lack of access to supervised exercise therapy programs. Available supervised exercise therapy programs do not implement best practice recommendations, and in the majority, patients only undergo one session per week. Some challenges were cited as the cause of the suboptimal program implementation. These included issues related to patients’ engagement and adherence as well as resource constraints. Conclusion: There is a dearth of published research on exercise therapy in the routine management of PAD and IC. Available data from a few countries within Europe indicated that supervised exercise is underutilized despite health professionals recognizing the benefits. Research is needed to understand how to improve the availability, access, uptake, and adherence to the best exercise recommendations in the routine management of people with PAD and IC.
Pazopanib as a possible option for the treatment of metastatic non-clear cell renal carcinoma patients: a systematic review
Authors: Bersanelli Melissa , Brunelli Matteo , Gnetti Letizia , Maestroni Umberto , Buti Sebastiano 
Published: May 2020

Background: Effective systemic treatment of non-clear cell renal carcinoma (nccRCC) is still an unmet clinical need, with few studies to support an evidence-based approach. To date, the only recommended standard first-line treatment is sunitinib. Pazopanib may also be used in nccRCC but its place in therapy is not clearly established. It has comparable efficacy and better tolerability than sunitinib in clear cell renal carcinoma. Our objective was to review the use of pazopanib in metastatic nccRCC. Methods: We conducted a systematic review according to PRISMA guidelines. Any type of study reporting the use of pazopanib in metastatic renal cell carcinoma including cases with non-clear cell histology was eligible. Results: In all, 15 studies were included in our analysis, including a total of 318 nccRCC patients treated with pazopanib. Most studies were retrospective ( n = 12); three were prospective trials. The specific outcomes of nccRCC patients were reported by four studies. Pazopanib alone as first-line treatment gave overall response rates ranging from 27% to 33%, disease control rates of 81–89%, median progression free survival of 8.1–16.5 months and median overall survival of 17.3–31.0 months. Grade 3–4 adverse events rates were 21–55%. Conclusion: The present review provides for the first time a systematic summary of evidence about the possible use of pazopanib as first-line treatment for nccRCC, with a favorable outcome despite the low strength of evidence. Pazopanib could be considered as a possible therapeutic option in this setting.
Anticholinergic burden in middle-aged women and recurrent falls in later life: findings from the Aberdeen prospective osteoporosis screening study (APOSS)
Authors: Neal Samuel R. , Wood Adrian D. , Ablett Andrew D. , Gregory Jenny S. , Guillot Jordan , Macdonald Helen M. , Reid David M. , Myint Phyo K. 
Published: May 2020

Background: Anticholinergic burden (ACB) is a recognised risk factor for falls in older people; however, whether ACB in middle age predicts falls in later life is unknown. Methods: We examined this association in the middle-aged women of the Aberdeen Prospective Osteoporosis Screening Study (APOSS). ACB was calculated at the second health visit (1997–1999, study baseline) using the Anticholinergic Cognitive Burden Scale. Outcomes were incidence of 1 fall and recurrent falls (⩾2 falls) during the 12 months prior to follow up 2007–2011. Multinomial logistic regression analyses adjusted for potential confounders including demographics, comorbidities and falls history. Results: A total of 2125 women {mean age (standard deviation [SD]): 54.7 (2.2) years at baseline and 66.0 (2.2) years at follow up} were included. Prevalence of baseline ACB score of 0, 1 and ⩾2 was 87.1%, 7.3% and 5.6%, respectively. Compared with no ACB, ACB ⩾2 was associated with recurrent falls in the previous 12 months [adjusted odds ratio (OR): 2.34, 95% confidence interval (CI): 1.31, 4.19] at an average of 11 years after initial exposure. No such association was found for an ACB score of 1. Conclusions: These findings highlight the potential negative effects of anticholinergic medications in middle age. While cautious use of anticholinergic medications is advisable, further longitudinal research should be conducted to confirm these findings before any specific clinical recommendations can be made. Lay summary Effect of medicines that block the chemical acetylcholine on falls in women in later life In this paper we describe the link between medicines that block the chemical acetylcholine and falls in later life in women. We used data from a large study in Scotland and we found that there may be a link between such medicines and recurrent falls in later life.
The association of nadir CD4-T cell count and endothelial dysfunction in a healthy HIV cohort without major cardiovascular risk factors
Authors: Mogadam Emad , King Kevin , Shriner Kimberly , Chu Karen , Sondergaard Anders , Young Kristal , Naghavi Morteza , Kloner Robert A 
Published: May 2020

Objectives: HIV-infected population may have increased risk of cardiovascular disease. The prevalence of traditional cardiovascular disease risk factors such as hypertension, diabetes and dyslipidemia in HIV-infected individuals has made it difficult to assess the direct effects of HIV and immune factors on endothelial dysfunction and associated increased risk of atherosclerosis. The purpose of this study was to investigate indicators of endothelial dysfunction in an HIV cohort without hypertension and diabetes. Methods: We studied 19 HIV-infected patients between the ages of 25–76 years old with effectively suppressed viral load and without diagnosis of hypertension or diabetes. Endothelial function was measured by digital thermal monitoring of vascular reactivity using the VENDYS technique. Endothelial function was reported as vascular reactivity index. Systolic blood pressure and diastolic blood pressure at the time of VENDYS test were measured and latest lipid panels were recorded. The association between vascular reactivity index and CD4-T cells count, different antiretroviral therapy types (non-nucleoside reverse transcriptase, nucleoside reverse transcriptase, protease inhibitors, integrase inhibitors), vitamins use, systolic blood pressure, diastolic blood pressure, high-density lipoprotein cholesterol and low-density lipoprotein cholesterol was investigated. Results: Mean vascular reactivity index was 1.87 ± 0.53. Vascular reactivity index, marker of endothelial dysfunction, showed a significant correlation with lower nadir CD4 count (p = 0.003) as well as low-density lipoprotein cholesterol (p = 0.02). No additional significant correlation between vascular reactivity index and the rest of the investigated variables was found. Conclusion: Vascular reactivity index, a clinical predictor of endothelial dysfunction, is associated with lower nadir CD4-T cell and low-density lipoprotein cholesterol in HIV-infected men with no history of hypertension or diabetes and before clinical evidence of cardiovascular disease.
Suspected phenobarbital-induced pancytopenia in a cat
Authors: Lyraki Maria , Wilson Helen 
Published: May 2020

Case summary A 3-year-old neutered male domestic shorthair cat developed pancytopenia 6 months after starting phenobarbital for treatment of recurrent seizures. The cat was switched from phenobarbital to levetiracetam and complete resolution of the pancytopenia was documented within 10 weeks, consistent with phenobarbital-induced pancytopenia. Relevance and novel information While phenobarbital is frequently used as the first-line treatment for seizures in cats, phenobarbital-induced feline pancytopenia has not been documented in the veterinary literature before. Based on this case, regular monitoring of the complete blood count in cats receiving long-term phenobarbital treatment should be considered. In cases of persistent or severe haematological abnormalities, further investigations are required and treatment discontinuation may be needed in the absence of other causes of pancytopenia.
Topical chemotherapy with mitomycin C in a feline corneal squamous cell carcinoma
Authors: Delgado Esmeralda Costa 
Published: May 2020

Case summary A 9-year-old cat was presented with a right globe lesion of 6 months’ duration. A large pink elevated mass covering two-thirds of the right cornea was detected. The corneal mass was surgically removed by superficial keratectomy and diagnosed by histopathology as a squamous cell carcinoma (SCC). The surgical procedure led to a relatively transparent cornea, but recurrence was likely. To avoid relapse, 1 month after surgery three cycles of mitomycin C 0.04% eye drops were applied q8h for 15 days on/15 days off. No local or systemic side effects were seen, and no recurrence was detected after 1 year of follow-up. Topical mitomycin C was successfully used as adjuvant local chemotherapy agent and prevented relapses owing to its cytostatic effect. Relevance and novel information SCCs are relatively common in feline patients, especially in the non-pigmented extremities of the nose, ears and eyelids, but with the cornea being a rare location. They rarely metastasise and they seldom relapse locally after surgical excision. Surgical-free margins of 2 cm are advisable to prevent relapses. Corneal tumours are rare, as the cornea is avascular; corneal transparency is essential to assure clear vision. In corneal SCC this margin is impossible to achieve without enucleation. In the present report, surgical removal of the neoplasm was combined with topical administration of the anticancer drug mitomycin C and a good prognosis was obtained. This combined treatment may be an appropriate therapeutic option for feline corneal SCC.
Relationship Between Balance, Gait, and Activities of Daily Living in Older Adults With Dementia
Authors: Lee Nam Gi , Kang Tae Woo , Park Hyun Ju 
Published: May 2020

Introduction: Gait characteristics are closely associated with executive functions including basic and high-level cognitive processes such as attention, working memory, decision-making, and problem-solving. Impaired cognitive function resulting from dementia is associated with loss of balance and poor activities of daily living (ADLs). If associations between gait parameters, balance, and ADLs are observed, then quantitative gait analysis may be optimal for reinforcing balance and ADL assessments in people with dementia. This study aimed to determine the association between balance, gait, and ADLs in older adults with dementia. Materials and Methods: A cross-sectional study was conducted in 46 older adults who have been diagnosed with dementia. Measurements including the Mini-Mental Statement Examination-Korean version (MMSE-K), Berg Balance Scale (BBS), 10-meter walk test (10MWT), Modified Barthel index (MBI), and GAITRite were used to assess cognitive function, balance, walking speed, ADLs, and gait parameters, respectively. The Pearson product correlation coefficient ( r) was used for correlation analysis. Results and Discussion: Among the gait parameters, velocity was positively associated with the BBS, 10MWT, and MBI ( r = 0.341-0.516, P > .05). Step length ( r = 0.301-0.586, P > .05), stride length ( r = 0.329-0.580, P > .05), and walk ratio ( r = 0.324-0.556, P > .05) were positively associated with the MMSE-K, BBS, 10MWT, and MBI. A moderate positive association between single support time and MBI was observed ( r = 0.308, P = .039). Additionally, a moderate negative association between double support time and the MBI was observed ( r = −0.349, P = .019). This study presents the first empirical evidence on the association between balance, gait, and ADLs in older adults with dementia. Conclusions: This study identified important associations between balance, gait, and ADL assessments in people with dementia. Further studies involving targeted interventions addressing gait parameters and improving balance and functional performance in people with dementia are required in the future.