bluuebunny/crossref_metadata_2025_split huggingface dataset:
Active surveillance with telemedicine in patients on anticoagulants during the national lockdown (COVID-19 phase) and comparison with pre-COVID-19 phase
Authors: Singh Gurbhej , Kapoor Samir , Bansal Vasu , Grewal Mehtab , Singh Bhupinder , Goyal Abhishek , Tandon Rohit , Chhabra Shibba Takkar , Aslam Naved , Wander Gurpreet Singh , Mohan Bishav 
Published: October 2020

Abstract
Background
The COVID-19 pandemic brought restriction to the movement of people due to the implementation of lockdown across various regions around the world. In India, most of the patients belong to rural areas and hence were unable to come for a follow-up visit. Hence, we reached out to patients on oral anticoagulation using telemedicine with aim of communicating with the patient concerning drug compliance, titration of dose of anticoagulation, health education, and identification of high-risk patients needing referral to the nearest health facility/our institute. This study was conducted at the Hero DMC heart institute (a tertiary care center for cardiac diseases). The study design is cross-sectional and involves a comparison of the pre-COVID-19 phase with the COVID-19 phase. We asked a five-component (Likert scale) questionnaire from patients for satisfaction after the consult. All symptoms, need for hospitalization and clinical events were recorded. The events were compared in both groups.

Results
We contacted 628 patients through telemedicine and 600 patients gave consent for participation in the study. For comparison, we analyzed data of 614 patients in the pre-COVID-19 phase. The mean age during the pre-COVID-19 phase was 55.27 + 17.09 years and the COVID-19 phase was 56.97 + 15.09 years with males more than females in both groups. There was no significant difference in the number of patients on oral anticoagulants and novel oral anticoagulants (NOAC). However, there were higher number of patients on antiplatelets in the pre-COVID phase (p value0.01). 37% in the pre-COVID-19 phase and 40.31 % in the COVID-19 phase were noted to have out of target range INR (International normalized ratio). There was no difference in the number of bleeding or thromboembolic events seen. Patient response as assessed by a questionnaire (Likert scale) showed that >75% of patients were satisfied.

Conclusion
Through telemedicine, we were able to approach our patients on oral anticoagulation and achieved titration of anti-coagulation, and health education similar to pre-COVID-19 times. During pandemics, telemedicine offers a promising option for patient management with chronic cardiac conditions. It also provides us an opportunity for the management of patients on oral anticoagulation involving titration of drug dosages (anti-coagulation), identification of high-risk patients, and health education.
Chemoradiation in Stage IIIB Cancer of the Uterine Cervix: A Review of the Zimbabwean Experience
Authors: Nyamhunga Albert , Ndlovu Ntokozo , Kadzatsa Webster , Morse Gene D. , Maponga Charles Chiedza 
Published: October 2020

PURPOSE Cervical cancer remains the leading cause of cancer morbidity and mortality among Zimbabwean women. Many patients present with stage IIIB disease. Although definitive concurrent chemoradiation (CCRT) is the standard of care, there is a paucity of data on the effect(s) of this intervention in resource-constrained and high HIV-prevalence settings. We investigated the differences in CCRT initiation practices, tolerability, and outcomes in this group. PATIENTS AND METHODS We performed a retrospective analysis of data from hospital records for patients with stage IIIB disease who were treated over a 2-year period at Parirenyatwa Group of Hospitals. Outcome measures were documented treatment-related adverse events and early clinical tumor response. RESULTS One hundred twenty-eight (37%) of 346 patients received CCRT, and 65 (51%) of 128 patients were infected with HIV. CCRT was prescribed mostly in patients with less extensive disease—not involving lower third vaginal walls, minimal pelvic sidewall involvement ( P = .002), and higher CD4+ count ( P = .02). Eighteen percent of recorded adverse events were high grade (≥ 3). One patient did not complete treatment, and 68.5% achieved complete clinical tumor response at 3 months post-CCRT. A higher proportion of complete clinical tumor response was noted in those patients who were young, HIV uninfected, had less extensive disease, CD4+ of 500 cells/mm3 or greater, received four or more cycles of chemotherapy, received brachytherapy, and had no treatment breaks. CONCLUSION The study revealed that the use of CCRT to treat stage IIIB cervical cancer is low in Zimbabwe. Although several factors contribute, low CCRT uptake is mostly attributed to financial barriers. Well-selected patients tolerate the treatment and have good early clinical tumor response as expected. The role of CCRT for this patient group (and methods to make it available in resource-limited settings) must be further evaluated.
The PNPLA3-I148M Variant Confers an Antiatherogenic Lipid Profile in Insulin-resistant Patients
Authors: Luukkonen Panu K , Qadri Sami , Lehtimäki Tiina E , Juuti Anne , Sammalkorpi Henna , Penttilä Anne K , Hakkarainen Antti , Orho-Melander Marju , Arola Johanna , Yki-Järvinen Hannele 
Published: October 2020

AbstractContextThe I148M (rs738409-G) variant in PNPLA3 increases liver fat content but may be protective against cardiovascular disease. Insulin resistance (IR) amplifies the effect of PNPLA3-I148M on liver fat.ObjectiveTo study whether PNPLA3-I148M confers an antihyperlipidemic effect in insulin-resistant patients.DesignCross-sectional study comparing the impact of PNPLA3-I148M on plasma lipids and lipoproteins in 2 cohorts, both divided into groups based on rs738409-G allele carrier status and median HOMA-IR.SettingTertiary referral center.PatientsA total of 298 obese patients who underwent a liver biopsy during bariatric surgery (bariatric cohort: age 49 ± 9 years, body mass index [BMI] 43.2 ± 6.8 kg/m2), and 345 less obese volunteers in whom liver fat was measured by proton magnetic resonance spectroscopy (nonbariatric cohort: age 45 ± 14 years, BMI 29.7 ± 5.7 kg/m2).Main Outcome MeasuresNuclear magnetic resonance profiling of plasma lipids, lipoprotein particle subclasses and their composition.ResultsIn both cohorts, individuals carrying the PNPLA3-I148M variant had significantly higher liver fat content than noncarriers. In insulin-resistant and homozygous carriers, PNPLA3-I148M exerted a distinct antihyperlipidemic effect with decreased very-low-density lipoprotein (VLDL) and low-density lipoprotein (LDL) particles and their constituents, and increased high-density lipoprotein particles and their constituents, compared with noncarriers. VLDL particles were smaller and LDL particles larger in PNPLA3-I148M carriers. These changes were geometrically opposite to those due to IR. PNPLA3-I148M did not have a measurable effect in patients with lower IR, and its effect was smaller albeit still significant in the less obese than in the obese cohort.ConclusionsPNPLA3-I148M confers an antiatherogenic plasma lipid profile particularly in insulin-resistant individuals.
A multi-centre study of neutrophil-to-lymphocyte ratio in primary aldosteronism
Authors: Libianto Renata , Hu Jinbo , Chee Min R , Hoo Jesse , Lim Yin Y , Shen Jimmy , Li Qifu , Young Morag J , Fuller Peter J , Yang Jun 
Published: October 2020

Abstract

Background
Hypertensive patients with primary aldosteronism (PA) have a higher risk of cardiovascular complications than those with blood pressure-matched essential hypertension. The excess cardiovascular consequences of PA can be attributed to the pro-inflammatory effect of excessive aldosterone and mineralocorticoid receptor activation in a range of peripheral tissues and cell types. The neutrophil-to-lymphocyte ratio (NLR) is a widely available markers of inflammation which has been shown to predict cardiovascular outcome in the general population. This study aims to evaluate the use of NLR as a potential biomarker of PA and PA severity.

Methods
Patients with PA (n=355) were identified from two large PA databases in Australia and China, while controls (n=222) were patients with hypertension who were referred for assessment but did not meet the diagnostic criteria for PA. The NLR was retrospectively collected from routine full blood examination, prior to commencement of targeted treatment for PA.

Results
The NLR did not differ between PA patients and hypertensive controls (median 2.3 and 2.4, p=0.563). However, amongst patients with PA, the NLR was positively correlated with baseline and post-saline aldosterone levels (r=0.22 and p&lt;0.001 for both) and negatively correlated with serum potassium (r=-0.15, p=0.006). Furthermore, in a logistic regression analysis of data from patients with PA, the NLR predicted the presence of co-morbid CKD (defined as eGFR &lt; 60mL/min/1.73m 2) with an odds ratio of 1.5 (p=0.003).

Conclusion
Whilst the NLR did not distinguish PA from controls, it was a marker of PA severity, being associated with aldosterone concentration as well as the presence of CKD. A prospective study is needed to further clarify the role of NLR in predicting end-organ damage associated with PA.
A Propensity Score-Matched Cohort Study to Evaluate the Association of Lymph Node Retrieval with Long-Term Overall Survival in Patients with Esophageal Cancer
Authors: van der Werf Leonie R. , Marra Elske , Gisbertz Suzanne S. , Wijnhoven Bas P. L. , van Berge Henegouwen Mark I. 
Published: October 2020

Abstract
Background
Previous studies evaluating the association of lymph node (LN) yield and survival presented conflicting results and many may be influenced by confounding and stage migration.

Objective
This study aimed to evaluate whether the quality indicator ‘retrieval of at least 15 LNs’ is associated with better long-term survival and more accurate pathological staging in patients with esophageal cancer treated with neoadjuvant chemoradiotherapy and resection.

Methods
Data of esophageal cancer patients who underwent neoadjuvant chemoradiotherapy and surgery between 2011 and 2016 were retrieved from the Dutch Upper Gastrointestinal Cancer Audit. Patients with < 15 and ≥ 15 LNs were compared after propensity score matching based on patient and tumor characteristics. The primary endpoint was 3-year survival. To evaluate the effect of LN yield on the accuracy of pathological staging, pathological N stage was evaluated and 3-year survival was analyzed in a subgroup of patients with node-negative disease.

Results
In 2260 of 3281 patients (67%) ≥ 15 LNs were retrieved. In total, 992 patients with ≥ 15 LNs were matched to 992 patients with < 15 LNs. The 3-year survival did not differ between the two groups (57% vs. 54%; p = 0.28). pN+ was scored in 41% of patients with ≥ 15 LNs versus 35% of patients with < 15 LNs. For node-negative patients, the 3-year survival was significantly better for patients with ≥ 15 LNs (69% vs. 61%, p = 0.01).

Conclusions
n this propensity score-matched cohort, 3-year survival was comparable for patients with ≥ 15 LNs, although increasing nodal yield was associated with more accurate staging. In node-negative patients, 3-year survival was higher for patients with ≥ 15 LNs.
Evaluation of the color stability of two different posterior tooth colored restorative materials
Authors: Majeti Chandrakanth , Ravi Ravichandra , Kambhampati Bhargav , Borugadda Roopesh , Athkuri Srividya , Kakani Abhijeet K. 
Published: October 2020

Background: The aim of this in vitro study was to evaluate the color stability of esthetic restorative materials (Cention N, Solare Sculpt) after exposure to different staining solutions (coffee, green tea and Diet Coke). Methods: Cylindrical specimens of both materials (n=40/material) were prepared using 4x8 mm metal molds. They were further divided (n=10) based on the beverages in which they are immersed. The color of each sample was recorded immediately after sample preparation and at 60 days after the staining procedure. Color changes were then analyzed statistically. Results: Color differences (ΔE) were statistically significant between Cention N and Solare sculpt in all beverages with Cention N showing highest staining after 60 days. Among all the beverages, coffee showed the highest level of staining. Conclusions: Staining beverages caused significant discolorations for both test materials. Cention N showed greater color variations with all beverages compared to Solare Sculpt. Coffee showed the highest staining with both materials, followed by Diet Coke then green tea.
Increase in IL-15 levels in patients with alopecia areata
Authors: Madras Dominika Katarzyna , Rocka Agata , Piędel Faustyna , Psiuk Dominika , Nowak Emilia 
Published: October 2020

Introduction and purpose: Alopecia areata (AA) is a condition that causes non-scarring hair loss (often with acute onset). Alopecia areata in the population occurs in 0.1-0.2% of people, with a similar frequency in men and women. Alopecia areata is an example of an autoimmune disease of the hair follicle. Hair loss in alopecia areata is caused by lymphocytic infiltration around the hair follicle and IFN-γ. IgG antibodies against hair follicle cells are also found in people suffering from alopecia areata. Recent studies have shown a significant increase in IL-15 in AA. The aim of the study was to review the current knowledge on the use of IL-15 in the treatment of alopecia areata.A brief description of the state of knowledge: Interleukin-15 (IL-15) is a pleiotropic cytokine that exhibits multidirectional biological effects on various cell types. It affects the functions of the immune system, both innate and acquired, and therefore plays an important role in inflammation and during the immune response to infections and infestations. In the AA mouse model, antibody-mediated blockade of IFN-γ, interleukin-2 (IL-2), or interleukin-15 receptor β (IL-15Rβ) prevented disease progression by minimizing the accumulation of CD8 (+) NKG2D (+) T cells in the skin and reducing the cutaneous IFN response. The concentration of IL-15 in patients with alopecia areata was significantly higher than in the control group. Moreover, the concentration of IL-15 increased in direct proportion to the area of alopecia, the highest value in patients with total alopecia.For this reason, it is important to search for new medical treatments that will enable patients to stay physically healthy, and what is equally important, to remain mental health. Conclusions: In addition, studies have shown an increase in IL-15 levels in patients with alopecia areata, which correlated with the duration of the disease. However, too few studies conducted so far do not allow conclusions to be drawn regarding the use of IL-15 as a therapeutic point.
Neoadjuvant chemotherapy for IIIC stage ovarian cancer - case report
Authors: Obuchowska Aleksandra , Standyło Arkadiusz , Ozga Alicja , Wójcik Justyna , Obuchowska Karolina , Skorupski Paweł 
Published: October 2020

Introduction: Ovarian cancer accounts only for 4.7% of female malignancies in Poland but has the worst prognosis among gynaecological neoplasms. Due to non-specific and scant symptoms the disease is diagnosed in nearly 70% of cases in stages III and IV (FIGO). The primary goal of surgical treatment is complete cytoreduction with no residual disease left after surgery involving hysterectomy, bilateral adnexectomy, omentectomy and removal of all metastatic foci from the peritoneum and abdominal organs. If it is not possible to achieve the complete cytoreduction, patients may be qualified for neoadjuvant chemotherapy (NACT) and surgery after achieving complete or partial remission.Purpose: Description of NACT protocol used for the treatment of stage IIIC ovarian cancer. Comparison of treatment results of advanced ovarian cancer using NACT and primary debulking surgery (PDS).Case report: A 58-year-old female patient was hospitalized with the diagnosis of the pelvic mass. Her predominant signs were abdominal pain on the right flank and flatulence. Laboratory tests and imaging studies indicated a high risk of metastatic ovarian cancer. Initial diagnosis was confirmed on the laparoscopy. Ovarian cancer matched stage IIIC with Fagotti score of 8 points. The inspection of the abdominal organs revealed tumors in both adnexa, miliary spread on the parietal peritoneum, the surface of the small intestine and the diaphragm and the thick infiltration of greater omentum. Multiple specimens for the pathology were collected and left adnexectomy was done. Due to the inability to achieve complete cytoreduction, the patient was qualified to NACT. Following 6 cycles of standard protocol paclitaxel and carboplatin chemotherapy, laparotomy with hysterectomy, bilateral adnexectomy and omentecomy was done. Residual disease was found only within greater omentum but complete cytoreduction was achieved. The patient was discharged in good condition.Summary: Clinical data indicates that patients with advanced ovarian cancer treated with NACT and surgery have similar prognosis to those treated by primary cytoreductive surgery. The advantages of NACT are reduced perioperative morbidity and mortality, lower complication rate and shorter hospital stay. In the described patient, the implementation of the NACT protocol has resulted in complete surgical cytoreduction which is the main factor permitting prolongation of life expectancy in woman with advanced ovarian cancer.
Is pressurized intraperitoneal aerosol chemotherapy safe and effective in the treatment of peritoneal metastases from pancreatic adenocarcinoma?
Authors: Smoluchowski Krzysztof , Sekuła Michał , Świerczyńska Blanka , Undziakiewicz Adrian , Suchodolska Magdalena 
Published: October 2020

Introduction and purpose: Pancreatic adenocarcinoma (PAC) is the third most common cancer of the gastrointestinal tract in the Western population. Peritoneal metastases (PM) affect 5-10% patients with PAC at the moment of diagnosis and 50% of patients who experience a recurrence after a successful resection. This review aims to evaluate the efficacy of pressurized intraperitoneal aerosol chemotherapy (PIPAC) in the treatment of PM from PAC based on the literature available on PubMed websiteBrief description of the state of knowledge: PIPAC is a relatively new method of treatment and the number of studies investigating its application in the treatment of PM from PAC is scarce. Nevertheless, initial findings suggest that PIPAC is linked to 15,6 months of the median overall survival, while standard intravenous chemotherapy reaches only 7,6 months . Furthermore, PIPAC seems to be a fairly safe method, as no grade 3 or grade 4 complications (according to CTCAE v4.0) occurred. However, all of the studies involved an unrepresentative number of patients and they were not free from a selection bias. Moreover, due to the novelty of the PIPAC procedure, it still needs to be properly standardised. Conclusions: Available data concerning the application of PIPAC in the treatment of PM from PDAC is limited. Large prospective studies consisting of control groups are still lacking. Nevertheless, the results of accessible studies displaying a median OS of participants reaching 14-16,8 months, with no G3 and G4 complications, are encouraging and justify further research.
Preeclampsia as a risk factor of the cardiovascular complications development
Authors: Ozga Alicja Maria , Obuchowska Aleksandra , Wójcik Justyna , Standyło Arkadiusz , Obuchowska Karolina , Kimber-Trojnar Żaneta , Leszczyńska-Gorzelak Bożena 
Published: October 2020

Introduction:The term “preeclampsia” (PE) refers to a multisystem disorder occurring after 20 weeks of pregnancy; it includes a new onset of hypertension and proteinuria and affects from 2 to 8% of all pregnancies. Cardiovascular disease (CVD) is a group of pathologies, which present significant mortality rate all over the world. The literature implicates that both disorders are linked in a sense of further cardiovascular complications in women who had preeclamptic pregnancy.Purpose:Evaluation of the relationship between pre-eclampsia and the risk of future potential maternal cardiovascular complications and proposal of the possible causes of this association.Materials and methods:We performed the database research using Pubmed, Springer Link and ResearchGate and we made review and meta-analysis of relevant studies. We searched for studies analyzing the relationship between preeclampsia and future maternal cardiovascular risk.Results:Systematic reviews and cohort studies qualified for the purpose of this review showed the relationship between preeclampsia and future cardiovascular diseases in mothers. The possible explanations include endothelium dysfunction enduring after delivery and the co-existence of common risk factors for both diseases.Conclusions:Preeclampsia is a risk factor predisposing to cardiovascular diseases and may lead to cardiac complications later in life. The course of pregnancies is very important for the future maternal health.Key words: preeclampsia; pregnancy; hypertension; cardiovascular disease
Assessment of severity of cystic fibrosis in children depending on the vitamin D status
Authors: Dudnyk Veronika , Demianyshyna Valeriia 
Published: October 2020

Introduction.Severity of CF depends on speed of lung disease progression which depend on many factors. Patients with CF suffer from vitamin D deficiency that could contribute to decreasing of lung function due to anti-inflammatory and antimicrobial activity. Correction of vitamin D3 level may be a potentially effective way to keep pulmonary function in such patients.Purpose. Evaluation of severity of CF in children depending on the vitamin D3 level in blood serum.Materials and methods. 84 children suffering from CF have been examined. Level of 25 (ОН) D3 in blood serum measured with immunosorbent assay. Patients were performed spirometry and the bacteriograms of sputum coughed up by children were analyzed.Results. Measurement of serum vitamin D3 among children with cystic fibrosis showed that 58,3% of subjects had insufficiency. Children who suffered from severe CF had significant lower serum 25 (OH) D3 concentrations. It was shown that children with insufficient level of 25 (OH) D3 had higher risk of FEV1 rate decreasing less than 64 %, and significant association with Ps. aeruginosa-positive culture was detected. Subjects with sufficient 25 (OH) D3 had strong association with higher rates of FEV1 and risk of Ps. aeruginosa-positive culture was also decreased.Conclusions. Vitamin D insufficiency is common among children with cystic fibrosis. It was found that there is a relationship between the content of 25 (OH) D3 and the severity of the disease. Children with low levels of 25 (OH) D3 are associated with lower FEV1 rates and have a higher risk of positive culture of Ps. aeruginosa.