bluuebunny/crossref_metadata_2025_split huggingface dataset:
Changes in Gene Expression and Neuroinflammation in the Hippocampus after Focal Brain Ischemia: Involvement in the Long-Term Cognitive and Mental Disorders
Authors: Shishkina Galina T. , Kalinina Tatiana S. , Gulyaeva Natalia V. , Lanshakov Dmitry A. , Dygalo Nikolay N. 
Published: May 2021

Abstract
Ischemic brain injuries are accompanied by the long-term changes in gene expression in the hippocampus, the limbic system structure, involved in the regulation of key aspects of the higher nervous activity, such as cognitive functions and emotions. The altered expression of genes and proteins encoded by them may be related to the development of post-ischemic psycho-emotional and cognitive disturbances. Activation of neuroinflammation following stroke in the hippocampus has been suggested to play an essential role in induction of long-lasting consequences. Identification of changes in the gene expression patterns after ischemia and investigation of the dynamics of these changes in the hippocampus are the necessary first steps toward understanding molecular pathways responsible for the development of post-stroke cognitive impairments and mental pathologies.
AB0615 ASSESSMENT OF THE IMPACT OF OBESITY ON BONE LOSS
Authors: Yasmine M. , Mariem S. , Miladi S. , Fazaa A. , Frigui E. , Souebni L. , Ouenniche K. , Kassab S. , Chekili S. , Ben Abdelghani K. , Laatar A. 
Published: May 2021

Background:Most of the available evidence supports a lower risk of vertebral fracture in obese adults. This belief was partially suggested by the positive correlation between bone mineral density (BMD) and body mass index (BMI).Objectives:We aimed to assess the association of BMI with BMD and to explore their relation with age and gender.Methods:This is a cross-sectional study including Tunisian patients referred for an assessment of BMD through dual-energy X-ray absorptiometry (DXA). BMD was measured using standard methods over the lumbar spine L1-L4, the total proximal femur. The results were expressed as T-scores according to the World Health Organization definition. Patients were sub-grouped according to age (≤50 and >50 years). Association between BMD and age as well as BMI was also assessed (G1: obese patients and G2: non-obese patients). The level of significance was fixed for p<0.05Results:The study included 100 patients with a female predominance (sex ratio =10.1). The mean age for women was 61.9 ±13 [18-83] years and the mean age for men was 59.7± 7.5 [47-72] years. The mean body mass index was 29.1± 5 kg/m2 [15-45] for women and 27.6 ±3.6 Kg/m2 [22.8-32.9] for men. Forty percent of all patients were obese with a mean BMI of 32.9 kg/m2 ± 4.3. Osteopenia was diagnosed in half of the men (55.5%) and most of the women (70%). Twenty-nine percent of patients suffered from osteoporosis. BMD of the spine was similar between men and women (p=0.53). Men had higher BMD of the hip than women (p=0,038). The mainstream of the subjects >50 years had more vertebral fractures, suffered more from osteoporosis and had a higher BMI than those < 50 years (95% % vs 5%; p=0.04), (92.3% vs 77 %; p=0.03) and (82.5% vs 17.5%; p=0.05) respectively. There was no correlation between BMD of the spine and higher BMI (0.94 in G1 vs 0.98 in G2, p=0.3). Similarly, there was no correlation between BMD of the hip and higher BMI (0.9 in G1 vs 0.84 in G2, p=0.2). Moreover, Obese patients had less a vertebral fracture but with no statistically significant correlation (21% in G1 vs 25% in G2; p=0.2).Conclusion:Our study showed that obesity was frequent among Tunisian patients but was not associated with a higher BMD. Older age was directly associated with a lower BMD and higher risk for vertebral fracture.Disclosure of Interests:None declared.
AB0606 IMPACT OF ABDOMINAL AORTIC CALCIFICATION AND SERUM CREATININE-TO-CYSTATIN C RATIO TO BONE FRAGILITY FRACTURE
Authors: Yoshii I. 
Published: May 2021

Background:Relationship between bone fragility fracture (BFF) and abdominal aortic calcification (AAC) has been discussed in recent decade.Objectives:Now we investigated the relationship between the two and a new factor of BFF: serum creatinine-to cystatin C ratio (Cr/CysC).Methods:A total of nine-hundred and thirty one osteoporotic patients were recruited. Diagnosis of osteoporosis was indexed by the criteria of Japanese Primary Osteoporosis Diagnostic Criteria. Patient’s lumbar spine X-ray pictures were taken and dual-energy X-ray absorptiometry (DXA) of lumbar spine and hip joint were tested at the same time, and all of them were followed us for more than one year up to nine years with at least an administration of vitamin D. Anti-osteoporotic drugs were administrated for 660 patients.Vertebral compression fracture (VF) and AAC were evaluated with lateral view of X-ray picture. VF was classified in accordance with Semi-quantified method (SQ), and AAC was classified as follows: Grade0; No calcification, Grade1; Partial calcification not continued over one vertebral height, Grade2; Calcification continuous over one vertebral height. BFF history of the patients except of VF was harvested from the medical record and with interview. Patients’ background at first measurement were measured and Cr/CysC was calculated as well. Prevalence of BFF at the baseline for each grade with SQ was compared according to the grade of AAC. Background factors including bone mineral densities (BMD) of the lumbar spine and hip joint measured using DXA were compared for each AAC grade.Occurrence of BFF was picked up during following up (BFF_F/U) of the patients. Prevalence of BFF_F/U for each ACC grade was statistically compared, and relationship between BFF_F/U and factors at the baseline was statistically evaluated.Results:A total of 219 of Grade0, 428 of Grade1, and 278 of Grade2 were recruited. Prevalence of BFF at baseline for each VF group was 182, 16, 9, and 12 for Grade0, 138, 98, 122, and 70 for Grade1, and 53, 45, 82, and 144 for Grade2, with Grade-0, Grade-1, Grade-2, and Grade-3 by SQ, respectively (p<0.01). Factors that demonstrated significant correlation with occurrence of BFF were sex, age, BMD of the lumbar spine and the hip joint, and Cr/CysC with univariate mode binary logistic regression anaysis. However, Cr/CysC did not demonstrate significant correlation using multivariate model.Occurrence of BFF_F/U for each AAC group was 26, 90, and 82 for Grade0, Grade1, and Grade2, respectively (p<0.01). The only factor that demonstrated significantly correlated with occurrence of BFF_F/U was Cr/CysC in the Grade1 and the Grade2 of the AAC classification.Conclusion:ACC grade significantly correlates with occurrence of BFF. Cr/CysC also significantly correlates with occurrence of BFF after follow up under presence of AAC.Disclosure of Interests:None declared.
AB0607 DO HIP STRUCTURAL ANALYSIS MEASUREMENTS PREDICT FRACTURE RISK IN PATIENTS WITH POLYMYALGIA RHEUMATICA?
Authors: Ark R. , Bukhari M. 
Published: May 2021

Background:Polymyalgia Rheumatica (PMR) is an inflammatory condition which commonly affects the elderly. Risk of fracture is higher in this group of patients compared to the general population and can lead to increased morbidity and mortality (1). Hip structural analysis (HSA) is a technique that uses dual-energy X-ray absorptiometry (DEXA) images to assess hip bone structure (2).Objectives:To identify whether HSA measurements help predict fracture in patients with PMR.Methods:Data were collected from June 2004 to October 2010 from PMR patients who had a DEXA scan at a District General Hospital. This included hip axis length (HAL), cross-sectional area (CSA), cross-sectional moment of inertia (CSMI), distance from centre of femoral head to centre of femoral neck (D1) and to inter-trochanteric line (D2), mean femoral neck diameter (D3), shaft angle (A) neck/shaft angle (Θ) and proximal femur strength index (SI) and distance from centre of mass of femoral neck to superior neck margin (Y). Fracture was predicted by a series of binomial logistic regression models, adjusted for age and sex. Odds ratios with 95% confidence intervals and area under the receiver operating characteristic curve (AUC) were calculated.Results:714 patients with PMR were identified, 182 were male and the mean age was 70.5. HAL, CSMI, D1, D2, D3, A, Θ, SI and Y were not significant predictors of fracture in regression models; odds ratios are included in Table 1. CSA predicted fracture risk; odds ratio was 0.988 with a 95% confidence interval of 0.980-0.997. The AUC for the CSA regression model was 0.6739.Table 1.Odds ratios of fracture for different HSA parametersHSA ParameterOdds Ratio (95% confidence interval)HAL1.008 (0.982 - 1.035)CSMI1.000 (0.999 - 1.000)CSA0.988 (0.980 - 0.997)D11.029 (0.972 - 1.089)D21.010 (0.981 - 1.040)D31.033 (0.962 - 1.109)Y1.087 (0.966 - 1.223)A0.983 (0.940 - 1.029)Θ1.007 (0.975 - 1.039)SI0.683 (0.406 - 1.150)Conclusion:These data suggest that CSA helps predict the risk of fracture in patients with PMR. HAL, CSMI, D1, D2, D3, A, Θ, SI and Y do not predict fracture risk. Limitations of the study are that it was retrospective and only studied patients who underwent DEXA scans. The study may have been underpowered to detect the impact of some HSA measurements on fracture risk.References:[1]Chatzigeorgiou C, Mackie SL. Comorbidity in polymyalgia rheumatica. Reumatismo. 2018; 70 1:35-43. Available from: http://eprints.whiterose.ac.uk/132109/\\.[2]Kaptoge S, Beck TJ, Reeve J, Stone KL, Hillier TA, Cauley JA, et al. Prediction of Incident Hip Fracture Risk by Femur Geometry Variables Measured by Hip Structural Analysis in the Study of Osteoporotic Fractures. Journal of Bone and Mineral Research. 2008; 23 (12): 1892-1904. Available from: doi: https://doi.org/10.1359/jbmr.080802Disclosure of Interests:None declared.
AB0751 JUVENILE UVEİTİS: THE 3RD LEVEL EXPERIENCE
Authors: Tigrak S. N. , Çekiç Ş. , Yalcinbayir O. , Kilic S. S. 
Published: May 2021

Background:Uveitis is the inflammation of the uveal components of the eye (iris, choroid and retina) and is the third leading cause of blindness in the world. It is less common in children than adults. Young children are usually diagnosed late, as they cannot express their complaints.Objectives:With this work; We aimed to contribute to the literature by determining the underlying primary diagnosis and evaluating the treatment response in patients who were followed up in our clinic with a diagnosis of non-infectious uveitis, mostly juvenile idiopathic arthritis.Methods:93 patients under 18 years of age who were followed up with a diagnosis of non-infectious uveitis were included in the study. The data of the patients were scanned retrospectively. According to the last biomicroscopic examinations, the patients were classified as remission, inactive period and active disease. Clinical characteristics, laboratory findings, family history, drugs used during the disease and duration of treatment were examined.Results:The male to female ratio was 1,06 (48/45). The mean age at diagnosis of childhood uveitis was found to be 10±4.02. 49 Patients (52.6%) were diagnosed with idiopathic uveitis, 33 (33.5%)with juvenile idiopathic arthritis, 11 (11.7%) with Behçet’s, 2 (2.2%) with FMF. Juvenile idiopathic arthritis was the most common systemic disease in the patient group. The mean age of patients with uveitis to be diagnosed with rheumatological disease was 10.1±5.32. ANA test was positive in 30 (32.2%) patients. 23 (69.7%) of juvenile idiopathic arthritis patients were oligoartricular type. Anterior uveitis was present in 37 (39.8%) of the patients. Anterior uveitis was most common in the juvenile idiopathic arthritis cases. Of the patients with uveitis, 24 (25.8%) were intermediate, 11 (11.8%) were posterior, 21 (22.6%) were panuveitis. Anti-TNFα agents were administered to patients with unresponsiveness to immunosuppressive therapy and high risk of vision loss. Most used anti-TNFα agents were infliximab and adalimumab. Glaucoma, cataract, and posterior synechiae were common complications in the patients during follow-up.Conclusion:The most common systemic disease that cause noninfectious uveitis in children is juvenile idiopathic arthritis. In juvenile idiopathic arthritis, the most common involvement of the eye was the anterior segment, and it was thought that the location of the eye involvement could be useful in determining the underlying systemic disease. It is important to ensure regular eye examination in patients with rheumatologic symptoms.Disclosure of Interests:None declared
AB0605 ACTIGRAPHY-BASED PHYSICAL ACTIVITY MONITORING IN PATIENTS WITH KNEE OSTEOARTHRITIS AND COMORBID FIBROMYALGIA
Authors: Dzekan O. 
Published: May 2021

Background:Low physical activity (PA) levels are common in patients with diseases associated with pain syndrome, such as osteoarthritis (OA) of the knee joints. Recent studies show that OA may be accompanied by concomitant fibromyalgia (FM) – a chronic pain syndrome associated with sedentary behavior [1]. As far as low PA levels are associated with poor quality of life and higher all-cause mortality, PA measurement in patients with knee OA and concomitant FM is of considerable interest [2,3].Objectives:The aim of this study was to investigate and compare physical activity measured by an actigraph in knee OA patients with and without comorbid FM.Methods:A total of 70 patients with painful knee osteoarthritis (OA) – 35 subjects - (30 females and 5 males) with concomitant fibromyalgia (FM) aged 59.8±14.9 (M±SD) years and 35 patients (30 females and 5 males) without concomitant FM aged 58.5±15.7 (M±SD) years were enrolled in the study. 35 healthy controls of the same age and gender underwent the same investigation. OA diagnosis was established according to ACR 1986 Osteoarthritis Knee Criteria. FM was diagnosed if both modified 2010 ACR diagnostic criteria and 2016 Fibromyalgia Diagnostic Criteria were met. All participants wore an actigraph (GT3X model accelerometer) on the wrist for the period of 5 working days. Average daily minutes in light, moderate and vigorous PA were calculated.Results:All OA patients with and without FM spent significantly less time in vigorous PA compared to controls. Obtained results did not indicate significant difference between time in vigorous activity in OA patients with and without FM. Patients with OA alone showed insignificant decrease in time in moderate activity in comparison with healthy subjects. OA patients with comorbid FM showed significantly less time in moderate activity compared to OA patients without FM and healthy individuals.Conclusion:Our study results revealed that patients with painful knee OA and comorbid FM have greater activity limitations than patients with painful knee OA alone and healthy individuals.References:[1]Mahgoub MY, Elnady BM, Abdelkader HS, Abdelhalem RA, HassanWA. Comorbidity of Fibromyalgia in Primary Knee Osteoarthritis: Potential Impact on Functional Status and Quality of Life. Open Access Rheumatol. 2020;12: 55—63.[2]Ali K. Q. Al-Rubaye, Klara Johansson, Laith Alrubaiy. The association of health behavioral risk factors with quality of life in northern Sweden—A cross-sectional survey. J Gen Fam Med. 2020 Sep; 21(5): 167–177.[3]GBD 2017 Mortality Collaborators. Global, regional, and national age-sex-specific mortality and life expectancy, 1950–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018;392(10159):1684–735. pmid:30496102Disclosure of Interests:None declared.
Strict glycaemic control in very low birthweight infants using a continuous glucose monitoring system: a randomised controlled trial
Authors: Perri Alessandro , Tiberi Eloisa , Giordano Lucia , Sbordone Annamaria , Patti Maria Letizia , Iannotta Rossella , Pianini Teresa , Cota Francesco , Maggio Luca , Vento Giovanni 
Published: May 2021

ObjectiveTo evaluate the efficacy of a strict glycaemic control protocol using a continuous glucose monitoring (CGM) in infants at high risk of dysglycaemia with the aim of reducing the number of dysglycaemic episodes.DesignRandomised controlled trial.SettingNeonatal intensive care unit, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome.PatientsAll infants <1500 g fed on parental nutrition (PN) since birth were eligible. A total of 63 infants were eligible and 48 were randomised.InterventionAll participants wore a CGM sensor and were randomised in two arms with alarms set at different cut-off values (2.61–10 mmol/L (47–180 mg/dL) vs 3.44–7.78 mmol/L (62–140 mg/dL)), representing the operative threshold requiring modulation of glucose infusion rate according to an innovative protocol.Main outcome measuresThe primary outcome was the number of severe dysglycaemic episodes (<2.61 mmol/L (47 mg/dL) or >10 mmol/L (180 mg/dL)) in the intervention group versus the control group, during the monitoring time.ResultsWe enrolled 47 infants, with similar characteristics between the two arms. The number of dysglycaemic episodes and of infants with at least one episode of dysglycaemia was significantly lower in the intervention group (strict group): respectively, 1 (IQR 0–2) vs 3 (IQR 1–7); (p=0.005) and 12 (52%) vs 20 (83%); p=0.047. Infants managed using the strict protocol had a higher probability of having normal glycaemic values: relative risk 2.87 (95% CI 1.1 to 7.3). They spent more time in euglycaemia: 100% (IQR 97–100) vs 98% (IQR 94–99), p=0.036. The number needed to treat to avoid dysglycaemia episodes is 3.2 (95% CI 1.8 to 16.6).ConclusionWe provide evidence that CGM, combined with a protocol for adjusting glucose infusion, can effectively reduce the episodes of dysglycaemia and increase the percentage of time spent in euglycaemia in very low birthweight infants receiving PN in the first week of life.
Autologous stem cell therapy in knee osteoarthritis: a systematic review of randomised controlled trials
Authors: Wiggers Tom GH , Winters Marinus , Van den Boom Noortje AC , Haisma Hidde J , Moen Maarten H 
Published: May 2021

ObjectiveStem cell therapy is increasingly used for knee osteoarthritis (KOA). We aimed to review the evidence of autologous mesenchymal stem cell therapy on pain, function and severity on imaging in KOA.DesignSystematic review of randomised controlled trials (RCTs).Eligibility criteriaRCTs evaluating autologous mesenchymal stem cell (MSC) therapy on patient-reported outcome measures and disease severity.Data sourcesSeven databases were searched until 31 December 2020.Risk of bias and data synthesisRisk of bias was assessed using the ROB V.2. We used Grading of Recommendations Assessment, Development and Evaluation to appraise the certainty of the evidence. Data were synthesised descriptively.ResultsFourteen RCTs were included. A total of 408 patients with KOA received MSC therapy derived from bone marrow, adipose tissue or activated peripheral blood. After 1 year, 19 of 26 (73%) clinical outcome measures improved with MSCs compared with control. In the MSC group, patients improved by 1.8–4.4 points on the Visual Analogue Scale (0–10) and 18–32 points of the Knee Osteoarthritis Outcome Score (0–100). Four studies showed better disease severity on imaging after MSC compared with control at 1 year. Ten of 14 (71%) RCTs were at high risk of bias on all outcomes. No serious adverse events were reported after MSC therapy during a maximum of 4 years follow-up.ConclusionWe found a positive effect of autologous MSC therapy compared with control treatments on patient-reported outcome measures, and disease severity. The certainty of this evidence was low to very low.PROSPERO registration numberCRD42019120506
Multicentre external validation of the Canadian Syncope Risk Score to predict adverse events and comparison with clinical judgement
Authors: Solbiati Monica , Talerico Giovanni , Villa Paolo , Dipaola Franca , Furlan Raffaello , Furlan Ludovico , Fiorelli Elisa Maria , Rabajoli Filippo , Casagranda Ivo , Cazzola Katia , Ramuscello Susanna , Vicenzi Andrea , Casazza Giovanni , Costantino Giorgio 
Published: May 2021

BackgroundThe Canadian Syncope Risk Score (CSRS) has been proposed for syncope risk stratification in the emergency department (ED). The aim of this study is to perform an external multicenter validation of the CSRS and to compare it with clinical judgement.MethodsUsing patients previously included in the SyMoNE database, we enrolled subjects older than 18 years who presented reporting syncope at the ED. For each patient, we estimated the CSRS and recorded the physician judgement on the patients’ risk of adverse events. We performed a 30-day follow-up.ResultsFrom 1 September 2015 to 28 February 2017, we enrolled 345 patients; the median age was 71 years (IQR 51–81), 174 (50%) were men and 29% were hospitalised. Serious adverse events occurred in 43 (12%) of the patients within 30 days. The area under the curve of the CSRS and clinical judgement was 0.75 (95% CI 0.68 to 0.81) and 0.68 (95% CI 0.61 to 0.74), respectively. The risk of adverse events of patients at low risk according to the CSRS and clinical judgement was 6.7% and 2%, with a sensitivity of 70% (95% CI 54% to 83%) and 95% (95% CI 84% to 99%), respectively.ConclusionThis study represents the first validation analysis of CSRS outside Canada. The overall predictive accuracy of the CSRS is similar to the clinical judgement. However, patients at low risk according to clinical judgement had a lower incidence of adverse events as compared with patients at low risk according to the CSRS. Further studies showing that the adoption of the CSRS improve patients’ outcomes is warranted before its widespread implementation.
Endovascular treatment strategy, technique, and outcomes for dural arteriovenous fistulas of the marginal sinus region
Authors: Caton Michael Travis , Narsinh Kazim H , Baker Amanda , Hetts Steven W , Cooke Daniel L , Higashida Randall T , Dowd Christopher F , Halbach Van V , Amans Matthew R 
Published: May 2021

BackgroundDural arteriovenous fistulas (AVF) of the foramen magnum region (FMR) are technically challenging lesions to treat. Transvenous (TV), transarterial (TA), and surgical approaches have been described, but the optimum treatment strategy is not defined.ObjectiveTo report treatment strategies and outcomes for FMR-AVF at a single, high-volume referral center.MethodsA retrospective review from January 2010 to August 2020 identified patients with FMR-AVF at a single referral center. Angiographic features, treatment (observation, endovascular, surgical), and follow-up of angiographic and clinical results were recorded. The technical aspects of TV embolization are then presented in detail.Results29 FMR-AVF were identified in 28 patients. Of these, 24/29 (82.8%) were treated and 5/29 (17.2%) were observed. Treatment was endovascular in 21/24 (87.5%), combined (endovascular+surgical) in 2/24 (8.3%), and surgical in 1/24 (4.2%). Endovascular treatments were 76.2% TV, 14.3% TA, and 9.5% combined TV/TA. Sufficient follow-up data were available for 20/28 (71.4%) with mean follow-up of 16.8 months. No AVF recurrence was seen for TA/TV, combined endovascular/surgical, or surgical groups, and there was one recurrence (7.1%) in the TV group. Symptomatic improvement was seen in all groups: TV (71.4% complete, 28.6% partial), TA (66.7% complete, 33.3% no follow-up), TV+TA (100% partial), endovascular/surgical (100% complete), and surgical (100% partial). Minor non-neurologic complications included 1/14 (7.1%) in the TV group and 1/3 (33.3%) in the TA/TV group.ConclusionEndovascular treatment is safe and effective for most FMR-AVF. TV embolization has a high cure rate with few complications.