bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diabetes Modifies the Clinic Presentation of Cutaneous Leishmaniasis
Authors: Lago Alexsandro S , Lima Filipe R , Carvalho Augusto M , Sampaio Camilla , Lago Neuza , Guimarães Luiz H , Lago Jamile , Machado Paulo R L , Carvalho Lucas P , Arruda Sérgio , Carvalho Edgar M 
Published: October 2020

AbstractBackgroundCutaneous leishmaniasis (CL) caused by L. braziliensis is characterized by 1 or multiple well-limited ulcerated lesions. Diabetes mellitus (DM) impairs neutrophil and monocyte function, and there is a report of vegetative lesions in a patient with both diseases in Morocco. Here we evaluate the influence of DM on clinical manifestations, immune response, and in the treatment of CL.MethodsThe participants were 36 DM patients with CL and 36 patients with CL without DM, matched by age and gender. The diagnosis of CL was performed by documentation of DNA of L. braziliensis by polymerase chain reaction in the lesion biopsy and histopathologic findings. All patients were treated with Glucantime (Sanofi-Aventis) 20 mg/kg of weight per day for 20 days.ResultsThere was no difference in the majority of the clinical variables between the groups, and the cure rate in patients with CL and DM (67%) was similar to that observed in CL patients (56%; P ˃ .05). The most important finding was the documentation that 36% of the patients with DM and CL had atypical cutaneous lesions characterized by large superficial ulcers without defined borders. High levels of interferon-γ, tumor necrosis facor, and interleukin-1β were detected in the supernatants of mononuclear cells stimulated with Leishmania antigen in patients with DM and atypical CL. Moreover, while cure was observed in only 33% of the patients with DM and atypical CL lesions, it was observed in 85% of patients with typical lesions (P &lt; .05).ConclusionsDM modifies the clinical presentation of CL, enhances pro-inflammatory cytokine production, and impairs response to antimony therapy.
OccultTalaromyces marneffeiInfection Unveiled by the Novel Mp1p Antigen Detection Assay
Authors: Ly Vo Trieu , Thanh Nguyen Tat , Thu Nguyen Thi Mai , Chan Jasper , Day Jeremy N , Perfect John , Nga Cao Ngoc , Vinh Chau Nguyen Van , Le Thuy 
Published: October 2020

AbstractTalaromyces marneffei causes fatal invasive mycosis in Southeast Asia. Diagnosis by culture has limited sensitivity and can result in treatment delay. We describe the use of a novel Mp1p enzyme immunoassay (EIA) to identify blood culture–negative talaromycosis, subsequently confirmed by bone marrow cultures. This EIA has the potential to speed diagnosis, enabling early therapy initiation.
Cladoceran body size distributions along temperature and trophic gradients in the conterminous USA
Authors: Beaver John R , Tausz Claudia E , Black Katherine M , Bolam Benjamin A 
Published: October 2020

Abstract
Body size is an important functional trait that can be indicative of ecosystem structure and constraints on growth. Both increasing temperatures and eutrophication of lakes have been associated with a shift toward smaller zooplankton taxa. This is important in the context of climate change, as most aquatic habitats are expected to warm over the coming decades. Our study uses data from over 1000 lakes surveyed across a range of latitudes (26–49°N) and surface temperatures (10–35°C) in the USA during the spring/summer of 2012 to characterize pelagic cladoceran body size distributions. We used univariate and multiple regression modeling to determine which environmental parameters were strongly correlated to cladoceran body size. A strong positive correlation was observed between cladoceran body size and latitude, while a strong negative correlation was observed between cladoceran body size and water temperature. The ratio of zooplankton to phytoplankton, as well as relative total biomass contributions by cladocerans, decreased as trophic state increased. Multiple regression identified temperature-related variables and water clarity as significantly affecting cladoceran body size. These observations demonstrate the dual threat of climate change and eutrophication on lake ecosystems and highlight potential changes in biogeographical patterns of zooplankton as lakes warm.
Mechanism of a methylxanthine drug theophylline-induced Ca2+ signaling and cytotoxicity in AML12 mouse hepatocytes
Authors: Sun Gwo-Ching , Liang Wei-Zhe 
Published: October 2020

AbstractTheophylline is a methylxanthine drug used in therapy for respiratory diseases. However, the impact of theophylline on Ca2+ signaling has not been explored in liver cells. This study examined whether theophylline affected Ca2+ homeostasis and its related cytotoxicity in AML12 mouse hepatocytes. Cell viability was measured by the cell viability reagent (WST-1). Cytosolic Ca2+ concentration ([Ca2+]i) was measured by the Ca2+-sensitive fluorescent dye fura-2. Theophylline (25–125 μM) induced [Ca2+]i rises and cause cytotoxicity in AML12 cells. This cytotoxic response was reversed by chelation of cytosolic Ca2+ with BAPTA/AM. In Ca2+-free medium, treatment with the endoplasmic reticulum Ca2+ pump inhibitor thapsigargin abolished theophylline-induced [Ca2+]i rises. Conversely, treatment with theophylline also abolished thapsigargin-induced [Ca2+]i rises. However, inhibition of PLC failed to alter theophylline-evoked [Ca2+]i rises. In Ca2+-containing medium, modulators of store-operated Ca2+ channels inhibited 30% of the [Ca2+]i rises, whereas the PKC modulators had no effect. Furthermore, theophylline-induced Ca2+ influx was confirmed by Mn2+-induced quench of fura-2 fluorescence. Together, in AML12 cells, theophylline caused Ca2+-associated cytotoxicity and induced Ca2+ entry through PLC-independent Ca2+ release from the endoplasmic reticulum and PKC-insensitive store-operated Ca2+ channels. BAPTA-AM with its protective effects may be a potential compound for prevention of theophylline-induced cytotoxicity.
Physical Activity and Exercise in Women With Ovarian Cancer: A Systematic Review
Authors: Jones Tamara L. , Sandler Carolina X. , Spence Rosalind R. , Hayes Sandra C. 
Published: October 2020

(Abstracted from Gynecol Oncol 2020;158:803–811)
Treatment for epithelial ovarian cancer may involve debulking surgery, a carboplatin-paclitaxel chemotherapy combination, or more novel approaches such as immunotherapy. There is a significant body of evidence supporting an association between physical activity (PA) and improved quality of life (QOL), physical morbidity, fatigue, depression, and anxiety among patients diagnosed with cancer.
Progression to Type 2 Diabetes in Women With a Known History of Gestational Diabetes: Systematic Review and Meta-analysis
Authors: Vounzoulaki Elpida , Khunti Kamlesh , Abner Sophia C. , Tan Bee K. , Davies Melanie J. , Gillies Clare L. 
Published: October 2020

(Abstracted from BMJ 2020;369:m1361)
Gestational diabetes mellitus (GDM) is an established risk factor for the future development of type 2 diabetes mellitus (T2DM). Systematic reviews of studies that have highlighted the increased risk of developing T2DM after GDM are more than a decade old.
Botulinum Toxin Injection for Chronic Pelvic Pain: A Systematic Review
Authors: Luo Fang Yuan , Nasr-Esfahani Maryam , Jarrell John , Robert Magali 
Published: October 2020

(Abstracted from Acta Obstet Gynecol Scand 2020; doi: 10.1111/aogs.13946)
The therapeutic benefits of botulinum toxin (BTX) in alleviating pain in several myofascial disorders such as focal dystonia and spasticity are well established. There is an expanding potential for benefits in chronic pelvic pain (CPP).
The Influence of an Opioid Use Disorder on Initiating Physical Therapy for Low Back Pain: A Retrospective Cohort
Authors: Magel John S. , Gordon Adam J. , Fritz Julie M. , Kim Jaewhan 
Published: October 2020

Objectives:
Low back pain (LBP) is common among patients with an opioid use disorder (OUD). The extent to which patients with an OUD initiate physical therapy for LBP is unknown. The aim of this study was to examine the association between a history of an OUD and initiation of physical therapy for LBP within 60 days of a primary care provider (PCP) visit for this condition.

Methods:
Claims from a single state-wide all payer claims database from June 30, 2013 and August 31, 2015 were used to establish a retrospective cohort of patients who consulted a PCP for a new episode of LBP. The outcome measure was patients who had at least 1 physical therapy claim within 60-days after the PCP visit. After propensity score matching on covariates, logistic regression was used to compare the outcome of patients with a history of an OUD to patients without an OUD.

Results:
Propensity score matching resulted in 1360 matched pairs of participants. The mean age was 47.2 years (15.9) and 55.9% were female. Compared to patients without an OUD, patients with an OUD were less likely to initiate physical therapy for LBP (adjusted odds ratio  = 0.65, 95% confidence intervals:0.49–0.85)

Conclusions:
After a visit to a PCP for a new episode of care for LBP, patients with a history of an OUD are less likely to initiate physical therapy.
Hidden sources of fluids, sodium and potassium in stabilised Swedish ICU patients
Authors: Nihlén Sandra , Kawati Rafael , Rasmusson Johan , Rylander Christian , Pikwer Andreas , Castegren Markus , Belin Anton , Lipcsey Miklos 
Published: October 2020

BACKGROUND
Fluid overload in ICU patients is associated with increased morbidity and mortality. Although studies report on optimisation of resuscitation fluids given to ICU patients, increasing evidence suggests that maintenance fluids and fluids used to administer drugs are important sources of fluid overload.

OBJECTIVES
We aimed to evaluate the volume of maintenance fluids and electrolytes on overall fluid balance and their relation to mortality in stabilised ICU patients.

DESIGN
Multicentre retrospective observational study.

SETTING
Six mixed surgical and medical ICUs in Sweden.

PATIENTS
A total of 241 adult patients who spent at least 7 days in the ICU during 2018.

MAIN OUTCOME MEASURES
The primary endpoint was the volume of maintenance, resuscitation and drug diluent fluids administered on days 3 to 7 in the ICU. Secondary endpoints were to compare dispensed amounts of maintenance fluids and electrolytes with predicted requirements. We also investigated the effects of administered fluids and electrolytes on patient outcomes.

RESULTS
During ICU days 3 to 7, 56.4% of the total fluids given were maintenance fluids, nutritional fluids or both, 25.4% were drug fluids and 18.1% were resuscitation fluids. Patients received fluids 1.29 (95% confidence interval 1.07 to 1.56) times their estimated fluid needs. Despite this, 93% of the cohort was treated with diuretics or renal replacement therapy. Patients were given 2.17 (1.57 to 2.96) times their theoretical sodium needs and 1.22 (0.75 to 1.77) times their potassium needs. The median [IQR] volume of fluid loss during the 5-day study period was 3742 [3156 to 4479] ml day−1, with urine output the main source of fluid loss. Death at 90 days was not associated with fluid or electrolyte balance in this cohort.

CONCLUSION
Maintenance and drug fluids far exceeded resuscitative fluids in ICU patients beyond the resuscitative phase. This excess fluid intake, in conjunction with high urinary output and treatment for fluid offload in almost all patients, suggests that a large volume of the maintenance fluids given was unnecessary.

TRIAL REGISTRATION
ClinicalTrials.org NCT03972475
Comparison of adequacy of anaesthesia monitoring with standard clinical practice monitoring during routine general anaesthesia
Authors: Gruenewald Matthias , Harju Jarkko , Preckel Benedikt , Molnár Zsolt , Yli-Hankala Arvi , Rosskopf Florian , Koers Lena , Orban Agnes , Bein Berthold 
Published: October 2020

BACKGROUND
Previous studies have suggested that monitoring the levels of both hypnosis and antinociception could reduce periods of inadequate anaesthesia. However, the evidence regarding associated benefits of this monitoring is still limited.

OBJECTIVE
The primary objective of this study was to confirm that guidance of anaesthesia by depth of hypnosis and antinociception monitoring decreases the number of inadequate anaesthesia events in comparison with standard clinical practice.

DESIGN
A multicentre, single-blinded, randomised controlled trial.

SETTING
The study was conducted in four European University hospitals in four different countries between December 2013 and November 2016.

PATIENTS
The study population consisted of a total of 494 adult patients undergoing elective surgery requiring tracheal intubation.

INTERVENTIONS
The patients were allocated to one of two groups. The first group was treated using Entropy for depth of hypnosis and surgical pleth index to determine depth of antinociception (adequacy of anaesthesia group; AoA group). The second group was monitored using standard monitoring alone (control group). Anaesthesia was conducted with target-controlled infusions of propofol and remifentanil.

MAIN OUTCOME MEASURES
The primary outcome of the study was the number of total unwanted events for example signs of inadequately light or unintentionally deep anaesthesia.

RESULTS
Evidence of inadequate anaesthesia had an incidence of around 0.7 events per patient in both groups with no difference between groups (P = 0.519). In the AoA group, the overall consumption of propofol was significantly reduced (6.9 vs. 7.5 mg kg−1 h−1, P = 0.008) in comparison with the control group. The consumption of remifentanil was equal in both groups. The times to emergence [8.0 vs. 9.6 min (P = 0.005)] and full recovery in the postanaesthesia care unit (P = 0.043) were significantly shorter in the AoA group. No differences were seen in postoperative pain scores or in the use of analgesics.

CONCLUSION
In the current study, the guidance of total intravenous anaesthesia by Entropy and surgical pleth index in comparison with standard monitoring alone was not able to validate reduction of unwanted anaesthesia events. However, there was a reduction in the use of propofol, and shorter times for emergence and time spent in the postanaesthesia care unit.

TRIAL REGISTRATION
at ClinicalTrials.gov NCT01928875.
Comparison of Right Colon Adenoma Miss Rates Between Water Exchange and Carbon Dioxide Insufflation
Authors: Cheng Chi-Liang , Kuo Yen-Lin , Hsieh Yu-Hsi , Tang Jui-Hsiang , Leung Felix W. 
Published: October 2020

Goals:
To test the hypothesis that water exchange (WE), when compared with carbon dioxide (CO2) insufflation, significantly reduces the right colon adenoma miss rate (rAMR) in a blinded randomized controlled trial with cap-assisted colonoscopy.

Background:
The unblinded consecutive group observational data showed that WE significantly decreased rAMR. The unblinded data are limited by potential bias.

Study:
Consecutive patients aged 45 years or more were randomized to undergo insertion with WE or CO2. Withdrawal and polypectomy were performed with CO2 in both groups to the hepatic flexure. The colonoscope was reinserted to the cecum. A second colonoscopist re-examined the right colon. The second colonoscopist was unaware, but made a guess, of the initial insertion method. The number of additional adenomas divided by the total number detected in both examinations equaled rAMR.

Results:
Among 262 patients (131/group), demographic variables were similar. The body mass index was significantly higher in the WE group. Compared with CO2, WE significantly decreased rAMR [18.0% (33/183) vs. 34.6% (62/179), P=0.0025] and right colon serrated polyp miss rate [17.4% (27/155) vs. 39.3% (33/84), P=0.002]. Multivariate logistic regression analysis showed that WE was an independent predictor of rAMR (odds ratio, 0.42; 95% confidence interval, 0.21-0.86), and so was ≥2 adenomas in the right colon (odds ratio, 2.35; 95% confidence interval, 1.17-4.76). Whether the second colonoscopist guessed the insertion method correctly or not, and demographic and procedure variables were not associated with rAMR.

Conclusions:
The randomized controlled trial validated unblinded observational data showing that WE significantly decreased rAMR and right colon serrated polyp miss rate (clinical trial registration number: NCT03845933).
Gut‐Brain Axis Exploration
Authors: Tezza Giovanna , Paiola Giulia , Zoccante Leonardo , Gandolfi Marialuisa , Smania Nicola , Ciceri Marco Luigi , Boner Attilio , Piacentini Giorgio , Banzato Claudia 
Published: October 2020

ABSTRACTObjective:The pathophysiology of functional gastrointestinal disorders (FGIDs) is associated with dysfunction at various levels of the gut‐brain axis. Hypervigilance can result in an increased tendency to report pain. In the present study, we aimed to explore whether hypervigilance can influence attentional processing in postural control in children with FGIDs.Patients and Methods:Fifty‐nine participants classified into healthy subjects, those with FGIDs, and those with organic diseases (Org) based on Rome IV criteria were enrolled. Postural control under 6 sensory conditions was evaluated using a stabilometric platform. The mean velocity of the center of pressure (CoP) displacement in the anteroposterior direction and the mediolateral direction, the length of the CoP trajectory, and the sway area were also measured.Results:With visual and somatosensorial normal inputs, participants with FGIDs showed a higher number of anteroposterior (FGIDs: 4[interquartile range [IQR] 3–7], control [Cntl] 3 [IQR 3–4], P < 0.05) latero‐lateral oscillations (FGIDs: 3 [IQR 3–6], Cntl 3 [IQR 2–3], P < 0.05) and a higher perimeter value (FGIDs: 148 [IQR 121–240], Cntl 124 [IQR 111–140], P = 0.056) compared to healthy subjects. With normal visual but altered somatosensorial input, subjects with FGIDs showed higher values of all parameters (anteroposterior: FGIDs 6[IQR 5–8], Cntl and Org 5 [IQR 4–6], P < 0.05; latero‐lateral FGIDs 6 [IQR 4–8], Cntl 4 [IQR 4–5], Org 4[IQR 3–5], P < 0.05; perimeter FGIDs 253 [IQR 167–305], Cntl 185 [IQR 161–217], Org 176 [IQR 142–219], P < 0.05; area FGIDs 98 [IQR 81–233], Cntl 86 [IQR 59–114], Org 56 [IQR 41–97], P < 0.05).Conclusions:The higher number of oscillations in subjects with FGIDs who had normal visual input could be expression of alteration in attention and therefore hypervigilance as hypothesized in the context of gut‐brain axis alterations.
Pentosan Polysulfate–Associated Macular Disease in Patients With Interstitial Cystitis
Authors: Lyons Riley J. , Ahmad Samera , Ansari Sana , Foote Jenelle E. , Jain Nieraj 
Published: October 2020

(Abstracted from Obstet Gynecol 2020;135:1091–1094)
As the approved oral agent for interstitial cystitis, pentosan polysulfate sodium (PPS) has been widely used since its approval in 1996. Historically recognized adverse effects of PPS are not serious.
Adult Dismembered Body With Myositis Ossificans
Authors: Shinkawa Norihiro , Kakizaki Eiji , Sonoda Ai , Yukawa Nobuhiro 
Published: October 2020

Abstract
A case involving an adult dismembered body with myositis ossificans (MO) is described. A woman in her 20s was found dead in her cohabitants' room. The body had dismembered into 15 pieces. Computed tomography showed ectopic mineralization in the bilateral upper arms and thighs. On autopsy, the skin and soft tissue were in the process of adipocere formation. Darkened areas that appeared to be subcutaneous hemorrhage were distributed on the face, left chest, and back. Bilateral upper arms and thighs showed organized granulations adherent to underlying bone. Microscopically, these organized lesions represented mature bone tissue in the periphery, cartilage tissue in the middle layer, and fibrotic tissue in the central part. These were typical findings of MO. Myositis ossificans and subcutaneous hemorrhage seemed to be evidence of antemortem repetitive physical abuse. In cases of dismemberment, the absence of organs and parts of the body provide limitations to determining cause of death. In forensic fields, adult autopsy cases involving MO are rare. This is an unusual case in which MO revealed antemortem physical abuse despite dismemberment of the body.
Evolution of Surgical Management of Sagittal Synostosis
Authors: Bradford Perry S. , Ishaque Mariam , Shaffrey Ellen , Schaeffer Christine V. , Jr John A. Jane , Syed Hasan , Black Jonathan 
Published: October 2020

Abstract
Numerous methods for surgical correction of sagittal synostosis have been described in the literature, yielding similar outcomes. At the authors’ institution, surgical approaches to correct this condition have evolved over the past few decades, including Π, H-type craniectomies (Renier), endoscopic suturectomy, and our current technique, the FLAG procedure. Our aim is to review the evolution of these surgical techniques at our institution and compare patient outcomes. A retrospective review was performed on consecutive patients undergoing correction for craniosynostosis from 2008 to 2018. All patients with a diagnosis of nonsyndromic isolated sagittal craniosynostosis were included and classified into one of 4 groups by the type of surgical correction performed (H-type, FLAG, endoscopic, other). The authors identified 166 consecutive patients with a mean age at time of surgery of 6.7 ± 4.0 months. 91 (54.8%) carried a diagnosis of nonsyndromic sagittal synostosis. 63 patients underwent H-type procedures, 9 underwent FLAG procedures, 5 underwent endoscopic procedures, and 14 were classified as other (distraction or other implant). Perioperatively, the FLAG group had the shortest ICU stay (1.3 days, P < 0.05), postoperative transfusion requirement (42cc pRBC, P < 0.001), and complication rate (0.0%). The endoscopic group had the shortest surgical time at 2.00 hours (p < 0.001). No statistically significant difference in cranial index or revision procedures between the four groups was identified. Overall, the mean length of follow-up was 25.3 months. All procedures had similar results for cranial index with decreased surgical time, transfusion volume, and hospital stay seen in FLAG and endoscopic groups.