bluuebunny/crossref_metadata_2025_split huggingface dataset:
Stellenwert diagnostischer Verfahren und Risiko von Zweittumoren bei primär kutanen Lymphomen
Authors: Scheu Alexander , Schnabl Saskia Maria , Steiner Daniel Patric , Fend Falko , Berneburg Mark , Yazdi Amir Sadegh 
Published: March 2021

ZusammenfassungHintergrundPrimär kutane Lymphome (PCL) unterscheiden sich oft stark im klinischen Verhalten und in der Prognose von systemischen Lymphomen des gleichen histopathologischen Typs. Ziel der Studie war es, die Verteilung der PCL‐Subtypen, die Zeitspanne von der Krankheitsmanifestation bis zur Diagnosestellung, den Stellenwert diagnostischer Verfahren, das Auftreten von Zweittumoren und die verschiedenen Behandlungsmodalitäten im Rahmen des Krankheitsverlaufs zu untersuchen.Patienten und MethodikRetrospektive Analyse von 152 Patienten mit PCL, die von 2010–2012 an der Universitäts‐Hautklinik Tübingen behandelt wurden.Ergebnisse105 Patienten mit primär kutanem T‐Zell‐Lymphom (CTCL) (69,1 %) und 47 Patienten mit primär kutanem B‐Zell‐Lymphom (CBCL) (30,9 %) wurden eingeschlossen. Die Zeitspanne von der Krankheitsmanifestation bis zur Diagnose betrug durchschnittlich vier Jahre. Mycosis fungoides (MF) (47,4 %) wurde am häufigsten diagnostiziert. Die First‐Line‐Therapien umfassten hier entweder eine alleinige Phototherapie (PUVA, n = 48; UVB 311 nm, n = 7) oder Kombinationstherapien (PUVA mit systemischen Retinoiden, n = 18). Häufigste Second‐Line‐Therapie war Interferon (INF)‐α plus PUVA (n = 15). Der Behandlungsverlauf war insgesamt günstig (45,2 % Remission, 28,6 % stabile Erkrankung, 22,6 % Progress). Maligne Komorbiditäten wurden im Vergleich zu einer gesunden Vergleichsgruppe häufiger beobachtet.SchlussfolgerungenBis zur Diagnosestellung der PCL dauert es oft mehrere Jahre. Der Wert der Staging‐Verfahren ist gering. Die Behandlungsmodalitäten in früheren MF‐Stadien basieren hauptsächlich auf der Phototherapie.
Tropherymawhipplei endocarditis
Authors: Sarvananthan Sajiram , Velissaris Theodore , Miskolczi Szabolcs , Yam TatShing , Shah Benoy N. 
Published: March 2021

AbstractTropheryma whipplei is a bacterium that causes a rare infection called Whipple's disease and can cause devastating effects if left untreated. It is important to recognize that patients with this infection may present with atypical symptoms and are often apyrexial with normal inflammatory markers. Moreover, routine blood cultures often do not isolate these bacteria in conventional growth media. Therefore, it requires a high level of clinical suspicion to make this diagnosis. Here, we present two cases of Tropheryma whipplei aortic valve endocarditis, with atypical presentation and similar unusual but striking echocardiographic images.
Bioimpedance analysis is not superior to clinical assessment in determining hydration status: A prospective randomized‐controlled trial in a Western dialysis population
Authors: Sommerer Claudia , Felten Paul , Toernig Johannes , Zeier Martin , Dikow Ralf 
Published: March 2021

AbstractIntroductionFluid management is an important goal of dialysis treatment. The accurate assessment of fluid status is still a challenge for clinical nephrologists. Bioimpedance analysis (BIA) has been proposed as an objective tool to assess hydration.MethodsThis was a prospective randomized controlled study to compare hydration status measured by clinical assessment compared to BIA using a body composition monitor (BCM). The primary outcome was defined as the decline of cardiac biomarker N‐terminal pro brain natriuretic peptide (NT‐proBNP) from baseline to the end of the study.FindingsAbout 281 chronic hemodialysis patients were assessed for eligibility, and 132 patients provided written informed consent to participate (65 BIA group, 67 clinical group). Predialytic NT‐proBNP, and decline of NT‐proBNP were similar in both groups. The amount of overhydration (2.18 ± 2.11 L vs. 1.29 ± 1.97 L; p 0.016) and the number of patients with severe overhydration (46.0% vs. 30.6%, p = 0.04) were significantly higher in the BIA group at the end of the study. Fluid accumulation in the interdialytic period was significantly lower in the clinical group (p = 0.013). Adverse events occurred more often in the BIA group (p = 0.032). The cumulative number of hypovolemic events was significantly higher in the BIA group (p = 0.002).DiscussionFluid management by BIA does not lead to a better cardiac outcome (appraised by surrogate markers) than fluid management by careful clinical assessment. Adapting the dry weight according to BIA results increases the risk of adverse events, especially hypovolemic episodes. Careful clinical fluid assessment is important for optimal care of chronic hemodialysis patients.
Real‐world hospital mortality of liver cirrhosis inpatients in Japan: a large‐scale cohort study using a medical claims database
Authors: Yatsuhashi Hiroshi , Sano Hiromi , Hirano Takahiro , Shibasaki Yoshiyuki 
Published: March 2021

AbstractAimPrognosis of liver cirrhosis patients is poor when ascites is present and liver function is impaired, but such up‐to‐date information from a large‐scale, real‐world setting is limited in Japan. We aimed to investigate the hospital mortality of Japanese liver cirrhosis inpatients.MethodsThis retrospective cohort study included data on liver cirrhosis inpatients between January 2011 and September 2018 extracted from an administrative claims database. The outcome was in‐hospital mortality. The 1‐ and 3‐year cumulative survival rates were examined for liver cirrhosis etiology, Child–Pugh classification, or ascites presence/absence using Kaplan–Meier analysis. The survival up to 1 year for tolvaptan prescription/nonprescription was examined.ResultsWe analyzed the data of 57 769 inpatients. Survival rates did not substantially differ among etiologies, with a better prognosis for alcohol etiology and poorer prognosis for hepatitis C virus. According to the Child–Pugh classification, the 1‐ and 3‐year survival rates were 90.2% and 75.3% for grade A, 73.5% and 53.9% for grade B, and 41.9% and 28.9% for grade C, respectively. Patients without ascites had a higher survival rate (83.2% and 67.0% at 1 and 3 years, respectively) than those with ascites (51.9% and 36.3%, respectively). Based on examining matched patients with ascites using a propensity score, prognosis was poor in general but was better at 6 months (58.1%) or similar at 1 year (47.1%) in patients prescribed tolvaptan compared to those not prescribed tolvaptan (54.8% and 47.5%, respectively).ConclusionsPoorer prognosis was suggested in inpatients with cirrhosis who had a worse Child–Pugh grade and ascites.
Do health service staff support the implementation of voluntary assisted dying at their workplace?
Authors: Fuscaldo Giuliana , Gwini Stella May , Larsen Richard , Venkataramani Amarita 
Published: March 2021

AbstractBackgroundOn 29 November 2017, the Victorian Parliament passed the Voluntary Assisted Dying (VAD) Act 2017, which came into effect on 19 June 2019.AimsTo investigate whether staff from a large regional health service support the legalisation of VAD and the implementation of VAD at their workplace.MethodsStaff were invited to complete an anonymous online survey comprising both closed‐ and open‐ended questions.ResultsThirty‐eight percent of the workforce (n = 1624) responded to the survey. Most participants supported the legalisation of VAD (88%), the provision of eligibility assessment and/or the administration of VAD within the health service (80%). There were negligible differences in support for VAD by role; however, specialist doctors were significantly less supportive (65%). Approximately half of the respondents expressed concern about monitoring (49%) or implementation (53%) of VAD. Concerns were also raised about assessment of eligibility, support for staff involved in VAD and pressure on both patients and staff to participate. Nearly three‐quarters (71%) of participants agreed that if the health service offers VAD services, a special unit or facility should be available.ConclusionsThis study found that health workers have concerns about the implementation of VAD at their workplace but are generally supportive. This article provides information for health services considering the implementation of VAD, about staff concerns and issues that need to be addressed for the successful introduction of VAD.
In search of biomarkers for leprosy by unraveling the host immune response to Mycobacterium leprae
Authors: van Hooij Anouk , Geluk Annemieke 
Published: March 2021

AbstractMycobacterium leprae, the causative agent of leprosy, is still actively transmitted in endemic areas reflected by the fairly stable number of new cases detected each year. Recognizing the signs and symptoms of leprosy is challenging, especially at an early stage. Improved diagnostic tools, based on sensitive and specific biomarkers, that facilitate diagnosis of leprosy are therefore urgently needed. In this review, we address the challenges that leprosy biomarker research is facing by reviewing cell types reported to be involved in host immunity to M leprae. These cell types can be associated with different possible fates of M leprae infection being either protective immunity, or pathogenic immune responses inducing nerve damage. Unraveling these responses will facilitate the search for biomarkers. Implications for further studies to disentangle the complex interplay between host responses that lead to leprosy disease are discussed, providing leads for the identification of new biomarkers to improve leprosy diagnostics.
The lab In A box: A take‐out practical experience for an online invertebrate biology course
Authors: Novo Marta , Sánchez Nuria , Gutiérrez López Mónica , Cánovas Rosario G. , Pardos Fernando , Trigo Dolores , Díaz Cosín Darío 
Published: March 2021

AbstractHands‐on experience is critical to teaching invertebrate zoology, as students are unfamiliar with many animals and theoretical concepts are sometimes difficult to assimilate. As part of a fully online course, we decided to give students a box of take‐home materials so that they could do hands‐on work in their homes under the guidance of the teacher or at their own pace following the lecture scripts and presentations. The box contained whole specimens fixed in ethanol for observation and dissection, dried material such as skeletons and shells, and microscope slides. We also included a USB digital microscope to facilitate visualization of details and slides. The experience was very satisfying and proved to be not only a good alternative for mandatory online classes in times of pandemic, but also an interesting resource to supplement face‐to‐face classes.
Alterations in atrial electrogram amplitude as steady sinus rhythm transitions to paroxysmal atrial fibrillation during continuous monitoring in patients with implantable cardiac devices: Insights from the IMPACT study
Authors: Kantharia Bharat K. , Lip Gregory Y. H. , Martin David T. 
Published: March 2021

AbstractObjectivesWe aimed to evaluate whether device measured amplitudes of atrial electrogram (AEGM) would change when measured in sinus rhythm (SR) transitioning to paroxysmal atrial fibrillation (AF) from previous steady SR, and significance of such change.MethodsFrom the IMPACT trial's database we selected two groups; (A) those who developed AF (n = 164), and (B) propensity‐matched control (n = 459) who stayed in SR during continuous Home Monitoring (HM) to compare AEGMs amplitudes at baseline SR and transition phase.ResultsDuring 420.0 ± 349.2 days (mean ± SD) from first postenrollment HM transmission to AF event transmission in Group A, and corresponding 515.3 ± 407.0 days in Group B, baseline and transition AEGM amplitude were 2.88 ± 1.146 and 2.74 ± 1.186 mV, respectively, for Group A (p = .1), and 2.88 ± 1.155 and 2.79 ± 1.145, respectively, for Group B (p < .005). Comparison of differences of AEGM amplitude, 0.14 ± 1.072 mV in Group A and 0.09 ± 0.893 mV in Group B were insignificant (p = .3). Age, sex, and hypertension identified as confounders had no association to AEGM changes (p = NS).ConclusionsIndependent of age, sex, and hypertension, AEGMs amplitudes decline over a long period of time in patients with defibrillators and substrate for AF. The significance of such change remains unclear as it occurs whether patients develop AF or not, but raises a possibility of progressive atrial myopathy that patients with substrate for AF may be predisposed to.
Secular trends in severe periodontitis incidence, prevalence and disability‐adjusted life years in five Asian countries: A comparative study from 1990 to 2017
Authors: Luo Li‐Sha , Luan Hang‐Hang , Wu Lan , Shi Yu‐Jie , Wang Yong‐Bo , Huang Qiao , Xie Wen‐Zhong , Zeng Xian‐Tao 
Published: March 2021

AbstractAimsTo investigate secular trends in severe periodontitis incidence, prevalence and disability‐adjusted life year (DALY) rates in China, India, Japan, South Korea and Thailand from 1990 to 2017.Materials and MethodsData were obtained from the “Global Burden of Disease Study” 2017. The annual percentage change and average annual percentage change were calculated using Joinpoint regression analysis. The independent age, period and cohort effects were estimated by age–period–cohort analysis.ResultsFrom 1990 to 2017, the overall age‐standardized incidence, prevalence and DALY rates increased in China, Japan and India, while decreasing in South Korea and Thailand. The highest incidence, prevalence and DALY rates were in India. By APC analysis, the age effect presented increase in 20–59 years in China, Japan and South Korea, 20–54 years in India and 20–64 years in Thailand; the period effect showed progressive increases in five countries, with the most significant increase shown in China; the cohort effect showed monotonic decreases with birth cohort in five countries.ConclusionsSevere periodontitis poses a serious burden in Asian countries, especially China and India. We suggest raising people's awareness of periodontal health and providing professional interventions in these countries, especially for high‐risk groups, such as younger people aged ≤65 years.
Dermoscopic and trichoscopic features of primary cutaneous lymphomas – systematic review
Authors: Sławińska M. , Sokołowska‐Wojdyło M. , Olszewska B. , Nowicki R.J. , Sobjanek M. , Zalaudek I. 
Published: March 2021

AbstractDermoscopy and trichoscopy are non‐invasive methods used as auxiliary tools in diagnostics of different dermatoses. To date, no systematic review concerning the utility of dermoscopy and trichoscopy in the diagnostics of primary cutaneous lymphomas has been published. The aim of this study was to summarize the current state of knowledge on this topic based on systematic search of PubMed database and related references published before 8th of August 2020. Besides dermoscopic features, type of dermoscope, polarization mode, magnification, number of cases and histopathological correlation were analysed. A total of 34 records were included into the final analysis, evaluating 141 patients diagnosed with primary cutaneous T‐cell lymphomas and 70 patients with primary cutaneous B‐cell lymphomas. Most of the analysed records evaluated dermoscopic features (n = 206); trichoscopy was analysed in only 5 cases. Structures most commonly observed in classical mycosis fungoides (n = 108) were fine short linear vessels/linear vessels, spermatozoa‐like vessels and orange‐yellow patchy areas. In folliculotropic mycosis fungoides (n = 12), most frequently observed were comedonal lesions/comedo openings/central keratotic plugs and white halo around hair follicles/perifollicular accentuation. Primary cutaneous marginal zone B‐cell lymphoma (n = 42) and primary cutaneous follicle centre lymphoma (n = 20) most commonly presented with salmon‐coloured background and fine short/linear irregular/serpentine vessels. For other PCL, with less than 10 cases reported in the analysed records, details have been provided in the article. Most observations analysed in this systematic review rely on findings from case reports/case series (with the level of evidence V) and lack a control group. A few studies provided information concerning technical aspects of dermoscopic/trichoscopic examination. The role of dermoscopy/trichoscopy in diagnostics of cutaneous lymphomas requires further studies, especially in entities where dermoscopic features have been described in only single or a few cases. However, it seems that this practical, accessory tool in future may provide additional clues during clinical assessment.
Performance assessments and techno and enviro‐economic analyses on forced convection mixed mode solar dryer
Authors: Ekka Jasinta Poonam , Palanisamy Muthukumar 
Published: March 2021

AbstractSolar drying is an energy‐efficient and eco‐friendly process, and it is extensively used in low‐temperature drying. In this paper, the year around performance and techno enviro‐economic assessments of a forced convection mixed‐mode solar dryer (MSD) are presented. The developed MSD has been tested throughout the year for the drying of various agricultural products such as jackfruit, red chili, turmeric, and ginger. The drying temperature of MSD was maintained 15–33°C higher than the ambient air temperature. The economic evaluation was done based on the net present worth, payback period, life cycle saving, and internal rate of return. The payback period was estimated as 0.9 years. The internal rate of return of 130% was obtained on the initial capital investment of the MSD. The effect of the embodied energies of the developed MSD on the environment was investigated based on equivalent thermal energy. The energy payback time (EPBT) of the developed dryer was 3.75 years, and the net CO2 mitigation potential over the life span of the dryer was 8.4 t. The developed MSD dries the agricultural products under hygienic conditions and provides economic viability to the potential users.Practical applicationThe developed mixed‐mode solar drying system is used for drying various agricultural products. The moisture content of the product is removed at a much faster rate compared to the traditional sun‐drying method. The performance test for various agricultural products dried during their harvesting season shows its efficient performance throughout the year. The main focus of this work is to analyze the techno and enviro‐economic of the designed mixed‐mode solar dryer. The economic analysis shows a higher internal rate of return for the various products dried over the life span of the dryer. Drying in the solar dryer will enhance product quality, reduce post‐harvest losses, carbon emission and establish economic feasibility, helping the farmers get a good return on their produce.
Diffusion tensor imaging‐based magnetic resonance imaging‐guided focused ultrasound thalamotomy for tremor recurrence after radiofrequency thalamotomy: A case report
Authors: Ito Hisashi , Yamamoto Kazuaki , Fukutake Shigeru , Taira Takaomi , Yamaguchi Toshio 
Published: March 2021

AbstractWe report a 42‐year‐old, left‐handed woman with tremor recurrence after radiofrequency right ventral intermediate nucleus (Vim) thalamotomy for an intractable essential tremor. The recurring tremor of the left hand disappeared on conducting magnetic resonance imaging‐guided focused ultrasound (MRgFUS) right Vim thalamotomy based on diffusion tensor imaging (DTI). Referring the location of rubro‐thalamic‐cortical tract, we set the target medial to the prior lesion. Pre‐treatment evaluation with DTI could be important for an accurate targeting and a better outcome. Furthermore, MRgFUS Vim thalamotomy could become one of the options for tremor recurrence after surgical intervention.
Sex‐specific associations of human milk long‐chain polyunsaturated fatty acids and infant allergic conditions
Authors: Miliku Kozeta , Richelle Jacqueline , Becker Allan B. , Simons Elinor , Moraes Theo J. , Stuart Turvey E. , Mandhane Piush J. , Sears Malcolm R. , Subbarao Padmaja , Field Catherine J. , Azad Meghan B. 
Published: March 2021

AbstractBackgroundPolyunsaturated fatty acids (PUFAs) may influence immune development. We examined the association of PUFAs in human milk with food sensitization and atopic dermatitis among breastfed infants.MethodsIn a selected subgroup of 1109 mother‐infant dyads from the CHILD Cohort Study, human milk was analyzed by gas‐liquid chromatography to quantify PUFAs including arachidonic acid (ARA) and docosahexaenoic acid (DHA). At 1 year of age, food sensitization was determined by skin‐prick testing for egg, peanut, cow's milk, and soybean, and atopic dermatitis was diagnosed by pediatricians. Logistic regression analyses controlled for breastfeeding exclusivity, family history of atopy, and other potential confounders.ResultsOverall, 184 infants (17%) were sensitized to one or more food allergens and 160 (14%) had atopic dermatitis. Sex‐specific associations were observed between these conditions and milk PUFAs. Girls receiving human milk with lower proportions of DHA had lower odds of food sensitization (aOR 0.35; 95% CI 0.12, 0.99 for lowest vs highest quintile), and a clear dose‐dependent association was observed for the ARA/DHA ratio (aOR 2.98; 95% CI 1.10, 8.06 for lowest vs highest quintile). These associations were not seen in boys. Similar sex‐specific tendencies were observed for atopic dermatitis.ConclusionsHuman milk PUFA proportions and their ratios are associated with infant atopic conditions in a sex‐specific manner. In female infants, a higher ratio of ARA/DHA may reduce the risk of food sensitization and atopic dermatitis. Further research is needed to determine the underlying mechanisms and clinical relevance of this sex‐specific association.
Continuous renal replacement therapy and extended indications
Authors: Ronco Claudio , Reis Thiago 
Published: March 2021

AbstractExtracorporeal blood purification (EBP) techniques provide support for critically ill patients with single or multiple organ dysfunction. Continuous renal replacement therapy (CRRT) is the modality of choice for kidney support for those patients and orchestrates the interactions between the different artificial organ support systems. Intensive care teams should be familiar with the concept of sequential extracorporeal therapy and plan on how to incorporate new treatment modalities into their daily practices. Importantly, scientific evidence should guide the decision‐making process at the bedside and provide robust arguments to justify the costs of implementing new EBP treatments. In this narrative review, we explore the extended indications for CRRT as an adjunctive treatment to provide support for the heart, lung, liver, and immune system. We detail practicalities on how to run the treatments and how to tackle the most frequent complications regarding each of the therapies, whether applied alone or integrated. The physicochemical processes and technologies involved at the molecular level encompassing the interactions between the molecules, membranes, and resins are spotlighted. A clinical case will illustrate the timing for the initiation, maintenance, and discontinuation of EBP techniques.