bluuebunny/crossref_metadata_2025_split huggingface dataset:
Home-based subcutaneous immunoglobulin for chronic inflammatory demyelinating polyneuropathy patients: A Swiss cost-minimization analysis
Authors: Perraudin Clémence , Bourdin Aline , Vicino Alex , Kuntzer Thierry , Bugnon Olivier , Berger Jérôme 
Published: November 2020

Purpose
To compare the cost of two patient management strategies with similar efficacies for chronic inflammatory demyelinating polyneuropathy (CIDP) patients in the chronic phase: hospital-based IV immunoglobulin G (IVIg) and home-based subcutaneous immunoglobulin G (SCIg) associated with an interprofessional drug therapy management programme (initial training and follow-up).

Methods
A 48-week model-based cost-minimization analysis from a societal perspective was performed. Resources included immunoglobulin (IVIg: 1 g/kg/3 weeks; SCIg: 0.4 g/kg/week initially and 0.2 g/kg/week in the maintenance phase), hospital charges, time of professionals, infusion material, transport and losses of productivity for patients. Costs were expressed in Swiss francs (CHF) (1 CHF = 0.93€ = US$1.10, www.xe.com, 2020/10/28).

Results
The total costs of IVIg were higher than those of SCIg for health insurance and other payers: 114,747 CHF versus 86,558 CHF and 8,762 CHF versus 2,401 CHF, respectively. The results were sensitive to the immunoglobulin doses, as this was the main cost driver. The SCIg daily cost in the initial phase was higher for health insurance than hospital-based IVIg was, but the additional costs were compensated during the maintenance phase (from week 28). The professional costs associated with the switch were not fully covered by the insurance and were borne by the pharmacist and the nurse.

Conclusions
SCIg for CIDP patients reinforced by an interprofessional drug therapy management programme may be a cost-effective and sustainable alternative to IVIg in the Swiss system context. From an economic perspective, this therapy alternative should be more widely supported by healthcare systems and proposed to eligible patients by professionals.
Ectopic ACTH syndrome of different origin—Diagnostic approach and clinical outcome. Experience of one Clinical Centre
Authors: Paleń-Tytko Joanna Ewelina , Przybylik-Mazurek Elwira Maria , Rzepka Ewelina Joanna , Pach Dorota Magdalena , Sowa-Staszczak Anna Stanisława , Gilis-Januszewska Aleksandra , Hubalewska-Dydejczyk Alicja Bronisława 
Published: November 2020

PurposeEctopic Cushing Syndrome (EAS) is a rare condition responsible for about 5–20% of all Cushing syndrome cases. It increases the mortality of affected patients thus finding and removal of the ACTH-producing source allows for curing or reduction of symptoms and serum cortisol levels. The aim of this study is to present a 20-year experience in the diagnosis and clinical course of patients with EAS in a single Clinical Centre in Southern Poland as well as a comparison of clinical course and outcomes depending on the source of ectopic ACTH production–especially neuroendocrine tumors with other neoplasms.MethodsTwenty-four patients were involved in the clinical study with EAS diagnosed at the Department of Endocrinology between years 2000 and 2018. The diagnosis of EAS was based on the clinical presentation, hypercortisolemia with high ACTH levels, high dose dexamethasone suppression test and/or corticotropin-releasing hormone tests. To find the source of ACTH various imaging studies were performed.ResultsHalf of the patients were diagnosed with neuroendocrine tumors, whereby muscle weakness was the leading symptom. Typical cushingoid appearance was seen in merely a few patients, and weight loss was more common than weight gain. Patients with neuroendocrine tumors had significantly higher midnight cortisol levels than the rest of the group. Among patients with infections, we observed a significantly higher concentrations of cortisol 2400 levels in gastroenteropancreatic neuroendocrine tumors. Chromogranin A correlated significantly with potassium in patients with neuroendocrine tumors and there was a significant correlation between ACTH level and severity of hypokalemia.ConclusionEAS is not common, but if it occurs it increases the mortality of patients; therefore, it should be taken into consideration in the case of coexistence of severe hypokalemia with hypertension and muscle weakness, especially when weight loss occurs. Because the diagnosis of gastroenteropancreatic neuroendocrine tumor worsens the prognosis-special attention should be paid to these patients.
The effect of race/ethnicity on obesity traits in first year university students from Canada: The GENEiUS study
Authors: Sharma Tanmay , Manoharan Baanu , Langlois Christine , Morassut Rita E. , Meyre David 
Published: November 2020

Background
Little is known about the impact of race/ethnicity on weight change at university. The objective of this study is to determine if ethnicity has an impact on obesity traits in a multiethnic cohort of first-year students at McMaster University in Ontario, Canada.

Methods
183 first year students from the three most represented ethnic groups (South Asian, East Asian, and white-Caucasian) in our study sample were followed longitudinally with data collected early in the academic year and towards the end of the year. Obesity parameters including body weight, body mass index (BMI), waist and hip circumference, and waist hip ratio (WHR) were analyzed. The Wilcoxon signed-rank test was used for pairwise comparison of traits from the beginning to the end of the year in the absence of adjustments. Linear regression was used with covariate adjustments to investigate the effect of ethnicity on obesity traits.

Results
A significant increase in weight by 1.49 kg (95%CI: 1.13–1.85) was observed over the academic year in the overall analyzed sample. This was accompanied by significant gains in BMI, waist and hip circumferences, and WHR. Ethnicity stratified analysis indicated significant increase in all investigated obesity traits in East Asians and all traits, but WHR, in South Asians. White-Caucasians only displayed significant increases in weight and BMI. Body weight and hip circumference were significantly lower in East Asians compared to white-Caucasians at baseline. However, East Asians displayed a significantly larger increase in mean BMI and weight compared to white-Caucasians after first-year. South Asians displayed larger waist circumference at baseline compared to East Asians and larger WHR compared to white-Caucasians.

Conclusion
Our findings demonstrate that ethnicity has an impact on obesity traits in first-year university students. Universities should take ethnicity into account while implementing effective obesity prevention programs to promote healthy and active lifestyles for students.
Undercarboxylated osteocalcin is associated with vascular function in female older adults but does not influence vascular function in male rabbit carotid artery ex vivo
Authors: Tacey Alexander , Smith Cassandra , Woessner Mary N. , Chubb Paul , Neil Christopher , Duque Gustavo , Hayes Alan , Zulli Anthony , Levinger Itamar 
Published: November 2020

Background
There are conflicting reports on the association of undercarboxylated osteocalcin (ucOC) in cardiovascular disease development, including endothelial function and hypertension. We tested whether ucOC is related to blood pressure and endothelial function in older adults, and if ucOC directly affects endothelial-mediated vasodilation in the carotid artery of rabbits.

Methods
In older adults, ucOC, blood pressure, pulse wave velocity (PWV) and brachial artery flow-mediated dilation (BAFMD) were measured (n = 38, 26 post-menopausal women and 12 men, mean age 73 ± 0.96). The vasoactivity of the carotid artery was assessed in male New Zealand White rabbits following a four-week normal or atherogenic diet using perfusion myography. An ucOC dose response curve (0.3–45 ng/ml) was generated following incubation of the arteries for 2-hours in either normal or high glucose conditions.

Results
ucOC levels were higher in normotensive older adults compared to those with stage 2 hypertension (p < 0.05), particularly in women (p < 0.01). In all participants, higher ucOC was associated with lower PWV (p < 0.05), but not BAFMD (p > 0.05). In rabbits, ucOC at any dose did not alter vasoactivity of the carotid artery, either following a normal or an atherogenic diet (p > 0.05).

Conclusion
Increased ucOC is associated with lower blood pressure and increased arterial stiffness, particularly in post-menopausal women. However, ucOC administration has no direct short-term effect on endothelial function in rabbit arteries. Future studies should explore whether treatment with ucOC, in vivo, has direct or indirect effects on blood vessel function.
Epidemiology of thyroid disorders in the Lifelines Cohort Study (the Netherlands)
Authors: Wouters Hanneke J. C. M. , Slagter Sandra N. , Muller Kobold Anneke C. , van der Klauw Melanie M. , Wolffenbuttel Bruce H. R. 
Published: November 2020

BackgroundThyroid hormone plays a pivotal role in human metabolism. In epidemiologic studies, adequate registration of thyroid disorders is warranted. We examined the prevalence of thyroid disorders, reported thyroid medication use, thyroid hormone levels, and validity of thyroid data obtained from questionnaires in the Lifelines Cohort Study.MethodsWe evaluated baseline data of all 152180 subjects (aged 18–93 years) of the Lifelines Cohort Study. At baseline, participants were asked about previous thyroid surgery and current and previous thyroid hormone use. At follow-up (n = 136776, after median 43 months), incident thyroid disorders could be reported in an open, non-structured question. Data on baseline thyroid hormone measurements (TSH, FT4 and FT3) were available in a subset of 39935 participants.ResultsOf the 152180 participants, mean (±SD) age was 44.6±13.1 years and 58.5% were female. Thyroid medication was used by 4790 participants (3.1%); the majority (98.2%) used levothyroxine, and 88% were females. 59.3% of levothyroxine users had normal TSH levels. The prevalence of abnormal TSH levels in those not using thyroid medication was 10.8%; 9.4% had a mildly elevated (4.01–10.0 mIU/L), 0.7% had suppressed (<0.40 mIU/L), while 0.7% had elevated (>10.0 mIU/L) TSH levels. Over 98% of subjects with TSH between 4 and 10 mIU/L had normal FT4. Open text questions allowing to report previous thyroid surgery and incident thyroid disorders proved not to be reliable and severely underestimated the true incidence and prevalence of thyroid disorders.ConclusionsUndetected thyroid disorders were prevalent in the general population, whereas the prevalence of thyroid medication use was 3.1%. Less than 60% of individuals using levothyroxine had a normal TSH level. The large group of individuals with subclinical hypothyroidism (9.4%) offers an excellent possibility to prospectively follow the natural course of this disorder. Both structured questions as well as linking to G.P.’s and pharmacists’ data are necessary to improve the completeness and reliability of Lifelines’ data on thyroid disorders.
Feasibility Study on Functionalization of Mesoporous Titanium Dioxide by Electron Beam Irradiation for Smart Delivery of Oncology Drugs
Authors: Ghafoorzadeh S. , Askarbioki M. , Shirmardi S. P. , Khakshournia S. , Kargar S. , Amooee A. , Ranjbar Jamalabadi R. , Saniei E. 
Published: November 2020

Abstract
Titanium oxide (TiO2) is used as a heterogeneous catalyst in many chemical processes. Because of its high surface area and uniform channels, titania is also used for material transfer in reactions and targeted drug delivery systems, particularly hematology and oncology drugs. This study aims to functionalize titania by electron beam irradiation and achieve optimal irradiation dose conditions for the smart delivery of hematology drugs. Functionalized TiO2 with 3-aminopropyl-trimethoxysilane (APTS), 3-methoxybenzyl alcohol, 2-nitrobenzyl alcohol, 2,4-dinitrobenzyl alcohol 4-nitrobenzyl alcohol is a suitable compound for medical and intelligent drug delivery purposes. To this end, TiO2 was first synthesized by the sol-gel method, and then using Fourier-transform spectroscopy, the functionalization of the mentioned compounds and the effects of different irradiation doses and reactants were investigated. The irradiation dose and the type of alcohol are very important factors for the functionalization of TiO2, which are discussed in this article, and finally, the optimal dose and the functionalization reaction mechanisms are proposed. In optimum irradiation conditions, 3-APTS, 3-methoxybenzyl alcohol, 2-nitrobenzyl alcohol, 2,4-dinitrobenzyl alcohol 4-nitrobenzyl alcohol were successfully grafted onto TiO2, which can be used successfully as controlled hematology drugs delivery systems. The use of an electron irradiation technique for the functionalization of mesoporous titania compounds has many advantages over similar chemical methods such as higher reaction speed, higher efficiency, and lower chemical contamination.
EKG-gyöngyszem: akcelerációdependens bal oldali septalis fasciculusblokk
Authors: Tomcsányi János 
Published: November 2020

Összefoglaló. A bal oldali septalis fasciculusblokk
EKG-manifesztációja a magas, keskeny R-hullám a V1–2-elvezetésekben.
Egy eset kapcsán ennek frekvenciafüggő megjelenése kerül bemutatásra. A hazai
szakirodalomban még nem ismert a bal oldali septalis fasciculusblokk,
irodalmilag is ritka ennek frekvenciafüggő megjelenése. Orv Hetil. 2020;
161(47): 2011–2013.
Summary. Electrocardiogram with dominant R wave in the right
precordial leads (V1–2) are the most important ECG manifestations of
left septal fascicular block. A case is presented with acceleration-dependent
left septal fascicular block. Its a rare manifestation of the tetrafascicular
conduction system, not published in the Hungarian medical records. Orv Hetil.
2020; 161(47): 2011–2013.
Arrhythmiarizikó és cardialis szövődmények áramütéses balesetet követően
Authors: Pilecky Dávid , Kovács Enikő , Zima Endre 
Published: November 2020

Összefoglaló. Az áramütés súlyos esetben hirtelen halállal vagy több
szervrendszer kiterjedt károsodásával járhat. A magasfeszültségű áramütés
(>1000 V) általában súlyosabb égési sérülésekkel és magasabb kórházi
mortalitással jár, mint az alacsonyfeszültségű, de a sérülések súlyosságát a
feszültségen kívül a test ellenállása, az áramexpozíció ideje, az áram fajtája,
erőssége és útja is befolyásolja. A kritikus állapotú vagy súlyos égési
sérüléseket szenvedett betegek sürgősségi ellátása komplex és
multidiszciplináris szemléletet igényel. A súlyos szövődményekkel járó
áramütéses balesetek ugyanakkor a fejlett országokban ritkák: az áramütés
következtében sürgősségi osztályon jelentkező betegek döntő többsége
panaszmentesen vagy minor panaszokkal kerül felvételre. A ritmuszavarok az
áramütéses balesetek messze leggyakoribb cardialis szövődményei, és rendszerint
közvetlenül az áramütés után jelentkeznek. Az elektromos áram kamrafibrillációt
vagy asystoliát is kiválthat, mely a baleset helyszínén ellátás nélkül halálhoz
vezethet. Bár sok helyen elterjedt gyakorlat az áramütést szenvedett betegek
rutinszerű monitorozása, a klinikailag releváns arrhythmiák összességében
ritkák, és a felvételi EKG alapján diagnosztizálhatók, ezért EKG-monitorozás
csak meghatározott rizikófaktorok esetén szükséges. Jelen munkánk célja
összefoglalni az áramütést szenvedett betegek optimális sürgősségi ellátásával
kapcsolatos legfontosabb szempontokat, különös tekintettel az áramütéses
balesetet követően fellépő cardialis szövődményekre és arrhythmiákra, valamint
az EKG-monitorozás indikációira. Orv Hetil. 2020; 161(47): 1979–1988.
Summary. Electrical accidents (EA) may cause sudden death or severe
injuries of multiple organs. High voltage injuries (>1000 V) are associated
with more severe burn injuries and higher in-hospital mortality than low voltage
injuries, however, the severity of complications depends on several other
factors like resistance of the body, duration of current exposition, intensity,
type and pathway of current. Critically ill patients with severe burns and/or
other injuries require a multidisciplinary intensive treatment. However, such
complications are rare in the developed countries: most patients present in the
emergency department with no or minor symptoms and do not require hospital
admission. Arrhythmias are the most frequent cardiac complications after EA.
Electrical current may cause ventricular fibrillation or asystolia which can
lead to death on the scene. In patients presenting in the emergency department,
clinically relevant arrhythmias are rare and can be diagnosed by a 12-lead ECG,
therefore a systematic monitoring may not be indicated. Aim of our work is to
review the most frequent complications after an electrical accident with special
focus on cardiac complications and arrhythmias. The other aim of the manuscript
is to summarize the most important aspects of emergency treatment and indication
for ECG monitoring after electrical accident. Orv Hetil. 2020; 161(47):
1979–1988.
Well-Log-Based Velocity and Density Models for the Montney Unconventional Resource Play in Northeast British Columbia, Canada, Applicable to Induced Seismicity Monitoring and Research
Authors: Babaie Mahani Alireza , Malytskyy Dmytro , Visser Ryan , Hayes Mark , Gaucher Michelle , Kao Honn 
Published: November 2020

AbstractWe present detailed velocity and density models for the Montney unconventional resource play in northeast British Columbia, Canada. The new models are specifically essential for robust hypocenter determination in the areas undergoing multistage hydraulic-fracturing operations and for detailed analysis of induced seismicity processes in the region. For the upper 4 km of the sedimentary structure, we review hundreds of well logs and select sonic and density logs from 19 locations to build the representative models. For depths below 4 km, we extend our models using data from the southern Alberta refraction experiment (Clowes et al., 2002). We provide one set of models for the entire Montney play along with two separated sets for the southern and northern areas. Specifically, the models for the southern and northern Montney play are based on logs located in and around the Kiskatinaw Seismic Monitoring and Mitigation Area and the North Peace Ground Motion Monitoring area, respectively. To demonstrate the usefulness of our detailed velocity model, we compare the hypocenter location of earthquakes that occurred within the Montney play as determined with our model and the simple two-layered model (CN01) routinely used by Natural Resources Canada. Locations obtained by our velocity model cluster more tightly with the majority of events having root mean square residual of &lt;0.2  s compared with that of &lt;0.4  s when the CN01 model is used. Cross sections of seismicity versus depth across the area also show significant improvements in the determination of focal depths. Our model results in a reasonable median focal depth of ∼2  km for events in this area, which is consistent with the completion depths of hydraulic-fracturing operations. In comparison, most solutions determined with the CN01 model have fixed focal depths (0 km) due to the lack of depth resolution.
Study of pulmonary function tests in multitransfused children with beta thalassemia major: an observational study
Authors: Shivaswamy Kavya , Chikkanna Somashekhar , Singh Jagdish , Gubbari Keerthana T. N. 
Published: November 2020

Background: Thalassemia is a hemoglobinopathy requiring multiple blood transfusions leading to iron deposition in various organs. Abnormalities in pulmonary function in thalassemia major patients have been found in various studies. Our aim was to study pulmonary function tests (PFT) in multitransfused children with beta thalassemia major.Methods: PFT was done in forty beta thalassemia major (TM) patients and forty normal healthy age and sex matched individuals and the results were analyzed.Results: Out of 40 thalassemia major patients, 20 (50%) had normal PFT and the rest 20 (50%) had an abnormal PFT out of which 18 (90%) had restrictive PFT and 2 (10%) had obstructive PFT. Out of 40 controls, all 40 (100%) had normal PFT.Conclusions: Alteration of pulmonary function can be seen even in well-chelated TM patients. The respiratory system should be evaluated annually by PFTs even in asymptomatic patients to prevent pulmonary sequelae.
Azithromycin and ceftriaxone in uncomplicated typhoid fever in paediatric patients: a prospective, comparative and randomized open labelled trail
Authors: Rao K. Narayan , Pratyusha R. , Acharya Anand 
Published: November 2020

Background: Typhoid fever is a life-threatening infection caused by the bacterium Salmonella typhi. There are limited options for treatment of typhoid fever in children. Carbapenems and azithromycin are two drugs which is available for treatment of infection caused by extensively drug-resistant (XDR) strain of Salmonella typhi.Methods: This is a prospective, comparative, randomized open labelled trail conducted in the department of paediatrics Konaseema institute of medical science, Amalapuram, Andhra Pradesh. Blood sample was obtained from each patient before start of treatment for determination of complete blood count and differential count at baseline. Everyday each patient was evaluated clinically.Results: The mean duration of fever after start of treatment was 4.41.46 days in group treated by azithromycin and 3.95+1.02 days in group treated by ceftriaxone which is little early without statistical significance.Conclusions: From present study we can conclude that azithromycin 20 mg/kg/day is as effective as ceftriaxone 75 mg/kg/day for the treatment of typhoid fever in children. Clinical and microbiological cure was comparable in both groups. There was no incidence of relapse of fever in azithromycin treatment group. Diarrhoea was common in patients treated with ceftriaxone and nausea and vomiting was more common in patient treated with azithromycin.
A study on intra-operative and post-operative effects of dexmedetomidine on haemodynamic stress responses to surgeries
Authors: Kaladhar S , Korukonda Viditha 
Published: November 2020

Stress response usually involves hormonal and metabolic changes which follow injury or trauma. Many of the manoeuvres, such as laparoscopic surgeries, laryngoscopies, tracheal intubation and extubation involve sympathetic stimulation. Dexmedetomidine is a specific and short acting alpha-2 adrenoceptor agonist and a potent drugwhich decreases sympathetic tone, with attenuation of the neuroendocrine and hemodynamic responses to anaesthesia and surgery; reduces anaesthetic and opioid requirements; and causes sedation and analgesia.100 patients between the ages of 18-60 years, with ASA score of I and II and scheduled for surgery under general anaesthesia were included in the study and divided into 2 groups of 50 each. Group I was given saline solution as Placebo and Group II was given 100 μg/ml of Dexmedetomidine hydrochloride. The data collection was performed every 2 minutes during induction of anaesthesia and for 10 minutes after tracheal intubation. The need for post operative analgesia was decided according to the visual analogue scale. Dexmedetomidine reduced the heart rate significantly (P&#60;0.05) in comparison to the baseline values at 15 and 30 minutes, and compared to the control group. The heart rate values recorded after 15, 60,120,180 minutes, in PACU were significantly less in Dexmedetomidine group in comparison to control group.The perioperative infusion of Dexmedetomidine appears to be effective to attenuate stress induced haemodynamic fluctuation, reduced Propofol requirements, decreased the intra and post-operative narcotic analgesic administration, produced perioperative sedation in patients.