bluuebunny/crossref_metadata_2025_split huggingface dataset:
Medication overuse in a subgroup analysis of phase 3 placebo-controlled studies of galcanezumab in the prevention of episodic and chronic migraine
Authors: Dodick David W , Doty Erin G , Aurora Sheena K , Ruff Dustin D , Stauffer Virginia L , Jedynak Jakub , Dong Yan , Pearlman Eric M 
Published: November 2020

Introduction Acute medication overuse is prevalent in patients with migraine. Methods In three phase 3, double-blind, randomized, placebo-controlled studies, patients with episodic migraine (EVOLVE-1 and EVOLVE-2) or chronic migraine (REGAIN) were randomized 2:1:1 to monthly subcutaneous injections of placebo or galcanezumab 120 or 240 mg for 3 or 6 months. This subgroup analysis evaluated mean changes in the number of monthly migraine headache days in each treatment among patients with versus without baseline acute medication overuse via mixing modelling with repeated measures. Results The percentages of patients with baseline medication overuse in placebo, galcanezumab 120-mg and 240-mg groups, respectively, were 19.4%, 17.3%, and 19.3% for EVOLVE-1/-2 (pooled; post hoc), and 63.4%, 64.3%, and 64.1% for REGAIN ( a priori). Both galcanezumab doses demonstrated significant improvement compared with placebo for overall least squares mean change in monthly migraine headache days in patients with baseline medication overuse in both the episodic and chronic migraine studies ( p ≤ 0.001). Furthermore, both galcanezumab doses reduced average monthly medication overuse rates compared to placebo ( p < 0.001) in both patient populations with medication overuse at baseline. Conclusions Galcanezumab appears to be effective for the preventive treatment of episodic and chronic migraine in patients who overuse acute medications. Trial registration: ClinicalTrials.gov Identifiers: NCT02614183, NCT02614196, and NCT02614261
Headache associated with COVID-19: Frequency, characteristics and association with anosmia and ageusia
Authors: Sampaio Rocha-Filho Pedro Augusto , Magalhães João Eudes 
Published: November 2020

Objectives To assess the frequency and characteristics of headache in patients with COVID-19 and whether there is an association between headache and anosmia and ageusia. Methods This was a cross-sectional study. Consecutive patients admitted to hospital with COVID-19, confirmed by reverse transcription polymerase chain reaction (RT-PCR) technique, were assessed by neurologists. Results Seventy-three patients were included in the study, 63% were male; the median age was 58 years (IQR: 47–66). Forty-seven patients (64.4%) reported headaches, which had most frequently begun on the first day of symptoms, were bilateral (94%), presenting severe intensity (53%) and a migraine phenotype (51%). Twelve patients (16.4%) presented with headache triggered by coughing. Eleven (15%) patients reported a continuous headache. Twenty-eight patients (38.4%) presented with anosmia and 29 (39.7%) with ageusia. Patients who reported hyposmia/anosmia and/or hypogeusia/ageusia experienced headache more frequently than those without these symptoms (OR: 5.39; 95% CI:1.66–17.45; logistic regression). Patients with anosmia and ageusia presented headache associated with phonophobia more often compared to those with headache without these complaints (Chi-square test; p < 0.05). Headache associated with COVID-19 presented a migraine phenotype more frequently in those experiencing previous migraine ( p < 0.05). Conclusion Headaches associated with COVID-19 are frequent, are generally severe, diffuse, present a migraine phenotype and are associated with anosmia and ageusia.
Quality of Life Evaluation After Trans-Nasal Endoscopic Surgery for Skull Base Tumors
Authors: Molteni Gabriele , Sacchetto Andrea , Saccardo Tommaso , Gulino Antonio , Marchioni Daniele 
Published: November 2020

Background The excellent surgical results obtained with transnasal endoscopic approach to the anterior skull base (ASB) are universally recognized; less is known about the quality of life of patients after surgery. Objective The aim of this study is to analyze the quality of life of patients after endoscopic transnasal surgery for the treatment of neoplasms of the ASB. Methods We conducted a retrospective review of patients who underwent transnasal endoscopic surgery for treatment of ASB tumors at the Tertiary Referral Center University Hospital of Verona. All patients were asked to complete the Anterior Skull Base Questionnaire (ASBQ), the Skull Base Inventory (SBI), and the Sino-nasal Outcome Test – 22 Items (SNOT-22) after surgical treatment. The study population was divided into subgroups; a statistical analysis of the overall results and of the different questionnaire domains was performed. Results 51 patients were enrolled in this study. The average score was 3.04 for ASBQ, 4.05 for SBI and 28.88 for SNOT-22. Analysis of the overall results for the ASBQ showed a lower quality of life in patients after recurrent surgery and in female patients. The SBI showed similar results in relation to recurrent surgery and radiotherapy. Similarly, the results for SNOT-22 highlighted the negative impact of recurrent surgery and radiotherapy. Conclusion Our results confirmed that the endoscopic transnasal approach shows excellent results not only in terms of surgical outcome, but also for the possibility of ensuring a good QoL after treatment. Recurrent surgery and radiation treatments were the most important negative prognostic factors.
Clinical and Radiological Outcomes After Autologous Matrix-Induced Chondrogenesis Versus Microfracture of the Knee: A Systematic Review and Meta-analysis With a Minimum 2-Year Follow-up
Authors: Kim Jun-Ho , Heo Jae-Won , Lee Dae-Hee 
Published: November 2020

Background: Microfracture (MFx) is the most common procedure for treating chondral lesions in the knee; however, initial improvements decline after 2 years. Autologous matrix-induced chondrogenesis (AMIC) may overcome this shortcoming by combining MFx with collagen scaffolds. However, the outcomes of AMIC and MFx in the knee have not been compared. Purpose: To compare the clinical and radiological outcomes of AMIC and MFx over a minimum 2-year follow-up. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic search of the MEDLINE, Embase, and Cochrane Library databases identified studies of patients who underwent AMIC or MFx and that reported validated clinical outcome measure and/or radiological evaluation findings at a follow-up of ≥2 years. There were 2 reviewers who performed study selection, a risk of bias assessment, and data extraction. Results: Overall, 29 studies were included in this systematic review. The mean improvement on the Lysholm score, Tegner activity scale, and visual analog scale for pain did not differ significantly between the 2 procedures. The mean improvement on the International Knee Documentation Committee (IKDC) subjective score was significantly greater in the AMIC (45.9 [95% CI, 36.2-55.5]) than in the MFx (27.2 [95% CI, 23.3-31.1]) group ( P < .001). In addition, the mean magnetic resonance observation of cartilage repair tissue score was significantly higher in the AMIC (69.3 [95% CI, 55.1-83.5]) versus MFx (41.0 [95% CI, 27.3-54.7]) group ( P = .005), and the mean adequate defect filling rate on magnetic resonance imaging scans was significantly better in the AMIC (77.3% [95% CI, 66.7%-87.9%]) versus MFx (47.9% [95% CI, 29.2%-66.6%]) group ( P = .008) (odds ratio, 1.58 [95% CI, 1.07-2.33]). Conclusion: No significant differences in clinical outcomes, except for the IKDC subjective score, were found between the AMIC and MFx groups. Greater improvement in IKDC subjective scores and magnetic resonance imaging findings were seen in patients treated with AMIC compared with MFx at a minimum 2-year follow-up.
Anterior Shoulder Instability in the Professional Athlete: Return to Competition, Time to Return, and Career Length
Authors: Dekker Travis J. , Goldenberg Brandon , Lacheta Lucca , P. Horan Marilee , Millett Peter J. 
Published: November 2020

Background: Anterior shoulder instability is a common condition in professional athletes, yet little is known about the success of surgery. Return to competition (RTC) is a metric indicative of a successful outcome for professional athletes who undergo anterior shoulder stabilization surgery. Purpose: To determine the rate of RTC, time to RTC, recurrence rate, and length of career after surgery in professional athletes who had undergone surgical treatment for anterior shoulder instability. Study Design: Case series; Level of evidence, 4. Methods: We evaluated professional athletes who underwent surgical treatment for anterior shoulder instability by a single surgeon between 2007 and 2018. Data from patients’ medical records, a patient data registry, basic search engines, sports websites, and individual team websites were used to determine length of professional play before injury, duration of career after surgery, and RTC level. Results: Overall, 23 professional athletes (25 shoulders from 12 contact and 13 noncontact athletes) were identified. The mean age at the time of surgery was 24.3 ± 4.9 years (range, 16-35 years). Primary procedures included arthroscopic Bankart repair (76%; 19/25), open Latarjet (20%; 5/25), and bony Bankart repair (4%; 1/25). Of the 23 athletes, 22 returned to their previous level of competition (96%; 95% CI, 78%-100%). The mean time between surgery and RTC was 4.5 months (range, 3-8 months). There was no difference in time to RTC between contact and noncontact athletes (4.1 vs 4.4 months). There was no difference in RTC rates and time to return for players who received a Bankart repair versus a Latarjet procedure (4.6 vs 4.2 months). A total of 12 participants were still actively engaged in their respective sport at an average of 4.3 years since surgery, while 11 athletes went on to retire at an average of 4.8 years. Duration of play after surgery was 3.8 years for contact athletes and 5.8 years for noncontact athletes ( P > .05). Conclusion: In this series, professional athletes who underwent surgical shoulder stabilization for the treatment of anterior glenohumeral instability returned to their presurgical levels of competition at a high rate. No differences in RTC rate or time to RTC were observed for contact versus noncontact athletes or for those who received arthroscopic Bankart repair versus open Latarjet. However, contact athletes had shorter careers after surgery than did noncontact athletes.
Daytime sleepiness and napping in nursing-home eligible community dwelling older adults: A mixed methods study
Authors: McPhillips Miranda V. , Li Junxin , Hodgson Nancy A. , Cacchione Pamela Z. , Dickson Victoria V. , Gooneratne Nalaka S. , Riegel Barbara 
Published: November 2020

Objectives: To describe perceptions and beliefs about daytime sleepiness and napping along with subjective and objective daytime sleep characteristics in nursing-home eligible community dwelling older adults. Methods: A mixed methods study; we conducted semi-structured interviews and measured sleep variables via Actigraphy, sleep diary, and Epworth Sleepiness Scale (ESS). Napping was defined as >10 minutes; anything less was considered dozing. Results: Final sample ( n = 40) was primarily female (85%), Black (100%), with a mean age of 72 ± 9.5 years. Few (25%) reported daytime sleepiness (ESS >10). However, average duration of napping per day was 33.1 ± 11.5 minutes with a nap frequency of 2.5 ± 1.5 naps. Conclusion: Our sample napped frequently throughout the day, yet the majority reported no daytime sleepiness. These older adults did not always recognize napping or how much they napped.
A Case of Grover’s Disease Secondary to Brodalumab Therapy for Psoriasis
Authors: Muzumdar Sonal , Radfar Arash , Payette Michael 
Published: November 2020

Background: Grover’s disease has been associated with a number of medications including sulfadoxine-pyrimethamine, recombinant interleukin (IL)-4, ipilimumab, and BRAF inhibitors. To our knowledge, Grover’s disease has not been reported in association with interleukin-17 inhibitors. Case Description: A 47-year-old female with plaque psoriasis developed Grover’s disease 3 months following initiation of brodalumab. Discontinuation of brodalumab and initiation of certolizumab pegol and methotrexate led to resolution of her rash. Conclusion: This case highlights Grover’s disease as a potential adverse effect of brodalumab therapy. In patients who develop Grover’s disease with brodalumab, modification of therapy may be considered due to the bothersome nature of the rash.
Case Report: Acute Stroke in Young Adult Patient with Moyamoya Syndrome Secondary to Sickle Cell Disease
Authors: Cole Oladipo , Filatov Asia , Khanni Javed , Espinosa Patricio 
Published: November 2020

Moyamoya disease, well described in literature, is a chronic cerebrovascular occlusive disorder. It is characterized by progressive stenosis/occlusion of the terminal portions of the internal carotid arteries (ICA) and the proximal portions of the middle cerebral arteries (MCA). Less frequently described is Moyamoya syndrome, the name given to radiographic findings consistent with Moyamoya disease, but with an identifiable cause. The diseases associated with Moyamoya Syndrome include Sickle Cell Disease (SCD), Thalassemias, and Down's Syndrome to name a few. Common complications of Moyamoya include both ischemic and hemorrhagic strokes. Upon literature review, Moyamoya syndrome caused by SCD is not well described. When it is, the discussion is centered around the pediatric patient population and surgical management. Our case report describes a 22-year-old African American female with SCD who initially presented with Acute Chest Syndrome. Her hospital course was complicated by development of overt debilitating neurologic deficits. Subsequently, she was found to have Moyamoya Syndrome on neuroimaging. She was successfully treated with medical management without any surgical intervention. This case highlights the necessity of thorough examination, differential diagnosis, imaging findings, and consideration of predisposing syndromes in the work-up for Moyamoya syndrome; especially individuals with Sickle Cell Disease.

Disclosures
No relevant conflicts of interest to declare.
Native T1 Values and Cardiac Involvement in Patients with Thalassemia Major
Authors: Pepe Alessia , Martini Nicola , De Luca Antonio , Positano Vincenzo , Pistoia Laura , Borsellino Zelia , Carrai Valentina , Sanna Maria Grazia , Bitti Pier Paolo , Gentili Sara , Maggio Aurelio , Sinagra Gianfranco , Meloni Antonella 
Published: November 2020

Background.The T2* cardiovascular magnetic resonance (CMR) is the gold standard for the non invasive detection of myocardial iron overload (MIO). The native myocardial T1 mapping has been proposed as a complementary tool, thanks to its higher sensitivity in presence of small amounts of iron, but no data are available in literature about its clinical impact.
Objective:To explore the clinical impact of T1 mapping for detecting cardiac complications in thalassemia major (TM).
Methods.We considered 146 TM patients (87 females, 38.7±11.1 years) consecutively enrolled in the Extension-Myocardial Iron Overload in Thalassemia Network. Three parallel short-axis slices of the left ventricle (LV) were acquired with the Modified Look-Locker Inversion recovery (MOLLI) sequence. The native T1 values in all 16 myocardial segments were obtained and the global value was the mean.
Results.Twenty-one patients had an history of cardiac complications: 11 heart failure, 8 arrhythmias (7 supraventricular and 1 ventricular), and 2 pulmonary hyperthension.
Patients with cardiac complications had significantly lower global heart T1 values (879.3±121.9 ms vs 963.2±98.5 ms; P&lt;0.0001) (Figure) but comparable T2* values (33.32±11.66 ms vs 37.17±9.15 ms; P=0.116). Cardiac complications were more frequent in the group of patients with reduced global heart T1 value (&lt;928 ms for males and &lt;989 ms for females) compared to the group with normal global heart T1 value (71.4% vs 39.5%; P=0.009). Odds ratio (OR) for cardiac complications was 3.8 (95%CI=1.3-10.9) for patients with reduced global heart T1 value versus patients with normal global heart T1 value.
Conclusion:We found out a significant association between decreased native global heart T1 values and a history of cardiac complications, suggesting that an early detection of myocardial iron burden by native T1 can support the clinicians in modifing chelation therapy earlier.
Figure

Disclosures
Pepe: ApoPharma Inc.:Other: no profit support;Bayer:Other: no profit support;Chiesi Farmaceutici S.p.A.:Other: no profit support and speakers' honoraria.Pistoia:Chiesi Farmaceutici S.p.A.:Other: speakers' honoraria.Meloni:Chiesi Farmaceutici S.p.A.:Other: speakers' honoraria.
Association between Native Myocardial T1 Mapping and Cardiac Function and Macroscopic Fibrosis in Thalassemia Major
Authors: Pepe Alessia , Martini Nicola , De Luca Antonio , Positano Vincenzo , Pistoia Laura , Ruffo Giovan Battista , Serra Marilena , Gerardi Calogera , Benni Monica , Argento Crocetta , Maggio Aurelio , Sinagra Gianfranco , Meloni Antonella 
Published: November 2020

Background.Cardiovascular magnetic resonance (CMR) is the only available technique for the non-invasive quantification of MIO. The native T1 mapping has recently been proposed as an alternative to the universally adopted T2* technique, due to the higher sensitivity for detection of changes associated with mild or early iron overload.
Objective.To study the association between T1 values and left ventricular (LV) function in thalassemia major (TM) and to evaluate for the first time if T1 measurements quantifying MIO are influenced by macroscopic myocardial fibrosis.
Methods.146 TM patients (87 females, 38.7±11.1 years) consecutively enrolled in the Extension-Myocardial Iron Overload in Thalassemia Network underwent CMR. Native T1 values were obtained by Modified Look-Locker Inversion recovery (MOLLI) sequence in all 16 myocardial segments and the global value was the mean. LV function parameters were quantified by cine images. Late gadolinium enhancement (LGE) technique was used to detect macroscopic myocardial fibrosis.
Results.No correlation was detected between global heart T1 values and LV volume indexes, LV mass index, or LV ejection fraction.
Foourteen (9.6%) patients had an abnormal LV motion (13 hypokinesia and 1 dyskinesia) and they showed significantly lower global heart T1 values than patients without LV motion abnormalities (883.8±139.7 ms vs 959.0±91.3 ms; P=0.049).
LGE images were acquired in 88 patients (60.3%) and macroscopic myocardial fibrosis was detected in 36 patients (40.9%). The 72.2% of patients had two or more foci of fibrosis. Patients with macroscopic myocardial fibrosis had significantly lower global heart T1 values (921.3±100.3 ms vs 974.5±72.7 ms; P=0.027) (Figure 1A). Data about the LGE was present for 1408 segments (88 patients x 16 segments) and 105 (7.5%) were positive. Segments with LGE had significantly lower T1 values than segments LGE-negative (905.6±110.6 ms vs 956.9±103.8 ms; P&lt;0.0001) (Figure 1B).
Conclusion.No correlation between T1 values and LV function parameters was detected, probably because the majority of the patients had normal or mild abnormal LV parameters. TM patients with macroscopic myocardial fibrosis showed significantly lower T1 values suggesting that T1 measurements for quantifying MIO are not influenced by macroscopic myocardial fibrosis and an association between myocardial iron and macroscopic fibrosis, previously detected only in pediatric TM patients.
Figure

Disclosures
Pepe: Chiesi Farmaceutici S.p.A.:Other: no profit support and speakers' honoraria;Bayer:Other: no profit support;ApoPharma Inc.:Other: no profit support.Pistoia:Chiesi Farmaceutici S.p.A.:Other: speakers' honoraria.Meloni:Chiesi Farmaceutici S.p.A.:Other: speakers' honoraria.
Association of Circulating Tumor DNA from the Cerebrospinal Fluid with High-Risk CNS Involvement in Patients with Diffuse Large B-Cell Lymphoma
Authors: Wang Xiaoxiao , Gao Yan , Shan Changguo , Lai Mingyao , He Haixia , Bai Bing , Ping Li-qin , Rong Qixiang , Ai Ruyu , Wen Lei , Zhou Zhaoming , Yu Ruoying , Ou Qiuxiang , Wu Xue , Wang Xiaoxia , Shao Yang , Cai Linbo , Huang Hui-qiang 
Published: November 2020

Diffuse large B-cell lymphoma (DLBCL) patients with central nervous system (CNS) involvement have dismal outcomes. The detection sensitivity of conventional diagnosis of lymphoma through cerebrospinal fluid (CSF) cytology (CC) and flow cytometry (FCM) is restricted. CSF-ctDNA has shown to be an important method of liquid biopsy in patients with CNS cancers. To assess the correlation between CSF-ctDNA and CNS involvement in DLBCL, targeted mutational profiling was performed on CSF- and plasma -derived ctDNA together with matched systemic tumor tissues in 67 DLBCL patients clinically diagnosed as high risk for CNS relapse, using a validated panel of more than 400 genes. We found that ctDNA concentration in CSF but not in plasma correlated with CNS-IPI score in DLBCL patients. In CSF-positive high-risk DLBCL patients, eighty-six gene alterations(GAs) were shared between tumor tissue and CSF while ninety-five were shared between tumor tissue and plasma. Interestingly, forty-eight GAs(CSF-CNS GAs) were identified including 24 GAs exclusively in CSF and 24GAs shared by plasma which enriched in apoptosis/cell cycle related pathway and immunity-related pathway. To better screen for CNS-related molecular features in CSF, GAs in brain tumor tissue and CSF from a PCNSL-DLBCL cohort of 10 patients were sequenced and compared to that in high-risk group. Moreover, GAs in tumor samples from an additional cohort of 40 DLBCL patients clinically diagnosed as low-risk for CNS relapse were sequenced and compared to that in high-risk group to screen out non-CNS-related features. The number of alterations in five CSF-CNS genes including BTG2, PIM1, DUSP2, ETV6, CXCR4 in CSF was found to be associated with CNS risk in DLBCL patients. Our data supported the feasibility of using CSF-ctDNA as a complementary source for early detection of CNS involvement in DLBCL. The association between GAs in five CSF-CNS genes and CNS involvement deserved further investigation to determine their relevance in patient treatment and outcome.

Disclosures
Yu: Geneseeq Technology Inc: Current Employment. Ou:Geneseeq Technology Inc: Current Employment. Wang:Nanjing Geneseeq Technology Inc: Current Employment. Shao:Nanjing Geneseeq Technology Inc: Current Employment.