bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnosis, risk factors and management of diabetes mellitus in HIV-infected persons in France: A real-life setting study
Authors: Kousignian Isabelle , Sautereau Aurélie , Vigouroux Corinne , Cros Agnès , Kretz Sandrine , Viard Jean Paul , Slama Laurence 
Published: May 2021

Background
Diabetes mellitus (DM) is a major and increasing public health problem that may be underdiagnosed and undertreated among persons living with HIV (PLWH).

Objective
To describe the diagnosis, treatment and follow-up of DM among PLWH.

Methods
This study was performed inside a monocentric cohort of 1494 PLWH. DM was defined as having a FG ≥126 mg/dL twice or a HbA1c ≥6.5%, or a history of diabetes, or receiving antidiabetic treatment. The first visit mentioning a diagnosis of DM was considered as the baseline visit. Chi-Square or Fisher exact test were used to examine the association between categorical variables and DM, Wilcoxon or Student t-test were used for continuous variables.

Results
156 PLWH with DM were included. Compared to non-diabetic participants, they were more likely to be native of Sub Saharan Africa (31.6% vs. 22.4%, p = 0.027) and older (54.6 vs. 49.9 years, p<0.001), to have a higher BMI (> 25 for 46.1% vs. 35.3%, p = 0.020) and a poorer control of HIV (HIV RNA<50 copies/mL: 80.1% vs. 89.5%, p<0.001). The diagnosis of DM was missed in 37.8% of PLWH, and 47.2% of PLWH treated for DM did not reach a HbA1c<7%. PLWH with DM were more frequently on antihypertensive and/or lipid-lowering medications: 94.2% had a LDL-cholesterol <70 mg/dL and 60.9% had a blood pressure <140/90 mmHg.

Conclusion
In a setting of HIV-control, HIV care providers should focus on metabolic issues. The management of DM and associated risk factors is mandatory to prevent cardiovascular disease in PLWH.
Implementation of GeneXpert MTB/Rif proficiency testing program: A Case of the Uganda national tuberculosis reference laboratory/supranational reference laboratory
Authors: Kabugo Joel , Namutebi Joanita , Mujuni Dennis , Nsawotebba Andrew , Kasule George William , Musisi Kenneth , Kigozi Edgar , Nyombi Abdunoor , Lutaaya Pius , Kangave Fredrick , Joloba Moses L. 
Published: May 2021

Background
Following the WHO’s endorsement of GeneXpert MTB/RIF assay for tuberculosis diagnosis in 2010, Uganda’s ministry of health introduced the assay in its laboratory network in 2012. However, assessing the quality of the result produced from this technique is one of its major implementation challenges. To bridge this gap, the National tuberculosis reference laboratory (NTRL) introduced the GeneXpert MTB/RIF proficiency testing (PT) Scheme in 2015.

Methods
A descriptive cross-sectional study on the GeneXpert PT scheme in Uganda was conducted between 2015 and 2018. Sets of panels each comprising four 1ml cryovial liquid samples were sent out to enrolled participants at preset testing periods. The laboratories’ testing accuracies were assessed by comparing their reported results to the expected and participants’ consensus results. Percentage scores were assigned and feedback reports were sent back to laboratories. Follow up of sites with unsatisfactory results was done through “on and off-site support”. Concurrently, standardization of standard operating procedures (SOPs) and practices to the requirements of the International Organization for Standardization (ISO) 17043:2010 was pursued.

Results
Participants gradually increased during the program from 56 in the pilot study to 148 in Round 4 (2018). Continual participation of a particular laboratory yielded an odd of 2.5 [95% confidence interval (CI), 1.22 to 4.34] times greater for achieving a score of above 80% with each new round it participated. The “on and off-site” support supervision documented improved performance of failing laboratories. Records of GeneXpert MTB/RIF PT were used to achieve accreditation to ISO 17043:2010 in 2018.

Conclusion
Continued participation in GeneXpert MTB/RIF PT improves testing accuracy of laboratories. Effective implementation of this scheme requires competent human resources, facility and equipment, functional quality management system, and adherence to ISO 17043:2010.
Association of maternal birth weight with the risk of low birth weight and small-for-gestational-age in offspring: A prospective single-center cohort study
Authors: Shibata Megumi , Ogawa Kohei , Kanazawa Seiji , Kawasaki Maki , Morisaki Naho , Mito Asako , Sago Haruhiko , Horikawa Reiko , Arata Naoko 
Published: May 2021

BackgroundAlthough low birth weight in Japan has slightly increased over the past several decades, the association between maternal birth weight and pregnancy outcomes remains poorly understood.MethodsIn this hospital-based, prospective cohort study conducted at the National Center for Child Health and Development, we obtained information on pregnant women’s birth weight via their maternal and child health handbook. We analyzed 944 women born at term after dividing them into five categories according to their birth weight: <2500 g, 2500–2999 g, 3000–3499 g, 3500–3999 g, and ≥4000 g. Multivariate logistic regression analysis and trend analysis were used to elucidate the extent to which maternal birth weight was associated with small-for-gestational-age and low birth weight in offspring, as well as with hypertensive disorders of pregnancy.ResultsCompared with women with a birth weight of 3000–3499 g, those born with a birth weight <2500 g had a significantly higher risk of low birth weight (adjusted odds ratio: 5.39, 95% confidence interval: 2.06–14.1) and small-for-gestational-age (adjusted odds ratio: 9.11, 95% confidence interval: 3.14–26.4) infants. No significant association was found between the incidence of hypertensive disorders of pregnancy and preterm birth. A linear relationship was observed between the lower birth weight categories and a higher risk of low birth weight and small-for-gestational-age (p-values for trends: 0.009 and <0.001, respectively), but no linear relationship was observed for the risk of preterm birth and hypertensive disorders of pregnancy (p-value for trends: 0.317 and 0.157, respectively).ConclusionsOur findings suggest that lower maternal birth weight is associated with small-for-gestational-age and low birth weight in offspring of women born at term.
Determinants of healthcare worker turnover in intensive care units: A micro-macro multilevel analysis
Authors: Daouda Oumou Salama , Hocine Mounia N. , Temime Laura 
Published: May 2021

Background
High turnover among healthcare workers is an increasingly common phenomenon in hospitals worldwide, especially in intensive care units (ICUs). In addition to the serious financial consequences, this is a major concern for patient care (disrupted continuity of care, decreased quality and safety of care, increased rates of medication errors, …).

Objective
The goal of this article was to understand how the ICU-level nurse turnover rate may be explained from multiple covariates at individual and ICU-level, using data from 526 French registered and auxiliary nurses (RANs).

Methods
A cross-sectional study was conducted in ICUs of Paris-area hospitals in 2013. First, we developed a small extension of a multi-level modeling method proposed in 2007 by Croon and van Veldhoven and validated its properties using a comprehensive simulation study. Second, we applied this approach to explain RAN turnover in French ICUs.

Results
Based on the simulation study, the approach we proposed allows to estimate the regression coefficients with a relative bias below 7% for group-level factors and below 12% for individual-level factors. In our data, the mean observed RAN turnover rate was 0.19 per year (SD = 0.09). Based on our results, social support from colleagues and supervisors as well as long durations of experience in the profession were negatively associated with turnover. Conversely, number of children and impossibility to skip a break due to workload were significantly associated with higher rates of turnover. At ICU-level, number of beds, presence of intermediate care beds (continuous care unit) in the ICU and staff-to-patient ratio emerged as significant predictors.

Conclusions
The findings of this research may help decision makers within hospitals by highlighting major determinants of turnover among RANs. In addition, the new approach proposed here could prove useful to researchers faced with similar micro-macro data.
Esophageal fistula after definitive concurrent chemotherapy and intensity modulated radiotherapy for esophageal squamous cell carcinoma
Authors: Pao Tzu-Hui , Chen Ying-Yuan , Chang Wei-Lun , Chang Jeffrey Shu-Ming , Chiang Nai-Jung , Lin Chia-Ying , Lai Wu-Wei , Tseng Yau-Lin , Yen Yi-Ting , Chung Ta-Jung , Lin Forn-Chia 
Published: May 2021

Background
The literature regarding esophageal fistula after definitive concurrent chemotherapy and intensity modulated radiotherapy (IMRT) for esophageal squamous cell carcinoma (ESCC) remains lacking. We aimed to investigate the risk factors of esophageal fistula among ESCC patients undergoing definitive concurrent chemoradiotherapy (CCRT) via IMRT technique.

Methods
A total of 129 consecutive ESCC patients receiving definitive CCRT with IMRT between 2008 and 2018 were reviewed. The cumulative incidence of esophageal fistula and survival of patients were estimated by the Kaplan–Meier method and compared between groups by the log-rank test. The risk factors of esophageal fistula were determined with multivariate Cox proportional hazards regression analysis.

Results
Median follow-up was 14.9 months (IQR, 7.0–28.8). Esophageal perforation was identified in 20 (15.5%) patients, resulting in esophago-pleural fistula in nine, esophago-tracheal fistula in seven, broncho-esophageal fistula in two, and aorto-esophageal fistula in two patients. The median interval from IMRT to the occurrence of esophageal fistula was 4.4 months (IQR, 3.3–10.1). Patients with esophageal fistula had an inferior median overall survival (10.0 vs. 17.2 months, p = 0.0096). T4 (HR, 3.776; 95% CI, 1.383–10.308; p = 0.010) and esophageal stenosis (HR, 2.601; 95% CI, 1.053–6.428; p = 0.038) at baseline were the independent risk factors for esophageal fistula. The cumulative incidence of esophageal fistula was higher in patients with T4 (p = 0.018) and pre-treatment esophageal stenosis (p = 0.045). There was a trend toward better survival after esophageal fistula among patients receiving repair or stenting for the fistula than those only undergoing conservative treatments (median survival, 5.9 vs. 0.9 months, p = 0.058).

Conclusions
T4 and esophageal stenosis at baseline independently increased the risk of esophageal fistula in ESCC treated by definitive CCRT with IMRT. There existed a trend toward improved survival after the fistula among patients receiving repair or stenting for esophageal perforation.
Is there a role for neuregulin 4 in human nonalcoholic fatty liver disease?
Authors: De Munck Toon J. I. , Boesch Markus , Verhaegh Pauline , Masclee Ad A. M. , Jonkers Daisy , van Pelt Jos F. , du Plessis Johannie , Korf Hannelie , Nevens Frederik , Koek Ger H. , Van der Merwe Schalk , Verbeek Jef 
Published: May 2021

Background
Neuregulin 4 (Nrg4), a novel adipokine enriched in brown adipose tissue has been observed to negatively regulate de novo hepatic lipogenesis and limit nonalcoholic fatty liver disease (NAFLD) progression to nonalcoholic steatohepatitis (NASH) in rodents. However, the role of Nrg4 in human NAFLD remains unclear to date. We analysed Nrg4 plasma levels and its association with liver disease severity together with the transcriptional profile of the Nrg4 pathway in liver and visceral adipose tissue (VAT) of NAFLD patients.

Methods
Plasma Nrg4 levels were measured in 65 NAFLD patients and 43 healthy controls (HC). Hepatic steatosis and fibrosis were diagnosed and quantified with chemical shift MRI and transient elastography respectively. Furthermore, blood lipid levels, HOMA-IR and systemic pro-inflammatory cytokines (TNF-α, IL-6 and IFN-γ) were analysed. Microarray analyses to assess differences in the Nrg4 and its receptor family ErbB pathway in liver and VAT from an independent patient group with biopsy proven NAFL (simple steatosis) (n = 4), NASH (n = 5) and normal liver (n = 6) were performed.

Results
Plasma Nrg4 levels were not significantly different between NAFLD patients and HC (p = 0.622). Furthermore, plasma Nrg4 levels did not correlate with the hepatic fat fraction (r = -0.028, p = 0.829) and were not significantly different between NAFLD patients with or without hepatic fibrosis (p = 0.087). Finally, the expression profile of 82 genes related to the Nrg4-ErbB pathway in liver and VAT was not significantly different between NAFL, NASH or obese controls.

Conclusion
Our study does not support a role for Nrg4 in the pathophysiology of human NAFLD.
Severe Erosive Esophagitis Secondary to Gastric Outlet Obstruction Related to Pseudomyxoma Peritonei
Authors: Braun David S. , Bushe Bryce , Lytvak Irina , Kedia Prashant 
Published: May 2021

ABSTRACT
Pseudomyxoma peritonei (PMP) is a rare clinical condition characterized by a mucin-producing tumor. PMP tumor cells migrate to abdominal and pelvic sites, eventually enveloping intra-abdominal organs and compressing the gastrointestinal tract. Patients with PMP are often asymptomatic in early stages of the disease, but in later stages develop symptoms including abdominal pain, acute abdomen, increased abdominal girth, vomiting, and bowel obstruction. Nonspecific symptoms combined with a relatively modest accuracy of imaging modalities frequently lead to delay in PMP diagnosis and treatment, thereby increasing morbidity. We present a case demonstrating severe erosive esophagitis as a result of PMP-associated gastric antrum compression.
Management of a Gastrobronchial Fistula Presenting 5 Years After a One-Loop Gastric Bypass
Authors: Saber Toufic , Backi Saleem Abdel , Aoun Charbel , Ghabi Elie , El Rassi Ziad 
Published: May 2021

ABSTRACT
Anastomotic leaks and gastric fistulas are recognized complications after sleeve gastrectomy and Roux-en-Y gastric bypass. They are, however, almost unheard of following a one-anastomosis gastric bypass. A gastrobronchial fistula, an exceedingly rare complication after bariatric surgery, has to date never been described following a one-anastomosis gastric bypass. Furthermore, there is no consensus regarding the management of this challenging complication. In our case, we present a patient who was discovered to have a gastrobronchial fistula 5 years after a one anastomosis gastric bypass. After 2 failed attempts at endoscopic stent placement, the patient was successfully managed with a laparoscopic Roux-en-Y gastrojejunostomy over the fistula.
A Case Series of Extrapulmonary Mycobacterium in Liver Transplant Recipients
Authors: Lamm Kevin , Jacobs Carl , Russo Mark W. 
Published: May 2021

ABSTRACT
Liver transplant recipients are at increased risk of infection because of the immunosuppression required after transplantation. Infection by Mycobacterium species increases the morbidity and mortality of liver transplant recipients. The prompt recognition and diagnosis of opportunistic infection is necessary for good outcomes, particularly during periods of increased immunosuppression. The balance of immunosuppressive therapies during prolonged treatment with hepatotoxic medications has not been well studied and should be tailored for the unique clinical setting of each patient. The goal of treatment in these patients is to eradicate the disease and preserve allograft function.
Endoscopic Ultrasound–Directed Transgastric Endoscopic Retrograde Cholangiopancreatography for Removal of Cystic Duct Coils: A Novel Application of an Emerging Technique
Authors: Parvataneni Swetha , Kumar Vikas S. , Khan Yakub I. , Deivert Duane E. , Obuch Joshua , Khara Harshit S. 
Published: May 2021

ABSTRACT
The altered anatomy of patients after Roux-en-Y gastric bypass (RYGB) surgery creates technical challenges for endoscopic and surgical treatment of gallstones. We present a unique case of a post-RYGB patient with complicated gallbladder surgery requiring coiling and embolization of the cystic duct for bile leak. The cystic duct coils migrated out into the bile duct forming a nidus for infection and biliary obstruction, which was resolved using the novel endoscopic ultrasound–directed transgastric routine endoscopic retrograde cholangiopancreatography technique, with successful transpapillary removal of cystic duct coils in RYGB anatomy.
Systemic Immunoglobulin Light Chain Amyloidosis Involving the Large Intestine
Authors: Swaminathan Renugadevi , Igbinedion Samuel , Pandit Sudha 
Published: May 2021

ABSTRACT
Amyloidosis is characterized by extracellular tissue deposition of fibrils resulting in disruption of tissue structure and function. Gastrointestinal amyloidosis commonly results from chronic inflammatory disorders (amyloid A amyloidosis) and is less commonly seen in immunoglobulin light chain amyloidosis. We present a rare case of a 50-year-old man with a history of immunoglobulin light chain amyloidosis who presented with abdominal pain, blood in stool, diarrhea, and weight loss. Colonoscopy and biopsies revealed amyloid deposits in the colon. The patient subsequently was referred to colorectal surgery for evaluation of total colectomy with further plans for chemotherapy and subsequent hematopoietic cell transplantation.
Dropped Gallstone-Related Right Subhepatic and Parietal Wall Abscess: A Rare Complication After Laparoscopic Cholecystectomy
Authors: Ray Sukanta , Kumar Dilip , Garai Dibyendu , Khamrui Sujan 
Published: May 2021

ABSTRACT
Gallbladder perforation and stone spillage is a common intraoperative problem during laparoscopic cholecystectomy. Most of these stones are retrieved intraoperatively. The incidence of lost or unretrieved stones is approximately 2%, and very few patients may develop complication. Most common complication of dropped or spilled gallstones is abscess, particularly around the abdominal wall port sites and in the perihepatic space. We report a case of dropped stone-related right subhepatic and parietal wall abscess 39 months after laparoscopic cholecystectomy. The patient was treated successfully by operative drainage of the abscess along with complete removal of stones. The patient was asymptomatic at 6-month follow-up.
Hepatitis-Induced Porphyria: Are Direct-Acting Antiviral Agents the Way of the Future?
Authors: John Jason J. , Sterling Richard K. 
Published: May 2021

ABSTRACT
Porphyria cutanea tarda (PCT) is the most common porphyria and has a strong association with hepatitis C virus (HCV) infection and iron overload. Previous HCV treatment regimens, including interferon with or without ribavirin, may precipitate PCT relapse. Few case reports have shown that newer oral therapies, such as direct-acting antiviral agents, can successfully treat PCT parallel with HCV treatment. We present a case of a patient with non–iron-associated mixed porphyria that dramatically improved with direct-acting antiviral agent therapy for his HCV supporting the association of porphyria with chronic HCV.
Hepatitis B Virus/Hepatitis D Virus–Coinfected Liver Transplant Candidate Receiving Hepatitis B Virus-Deoxyribonucleic Acid–Positive Allograft and Treated With High-Dose Hepatitis B Immune Globulin
Authors: Hammami Muhammad Baraa , Kohli Ruhail , Woreta Tinsay , Sulkowski Mark S. , Hamilton James P. , Toman Lindsey , Saberi Behnam , Laurin Jacqueline , Wang Jacqueline Garonzik , Philosophe Benjamin , Cameron Andrew M. , Gurakar Ahmet 
Published: May 2021

ABSTRACT
Liver transplantation (LT) for patients with hepatitis D virus (HDV) and hepatitis B virus (HBV) coinfection is uncommon in the United States. Previous case reports described poor outcomes when hepatitis B surface antigen (HBsAg)-positive grafts are transplanted in HBV/HDV-coinfected recipients. However, LT from an HBsAg-negative/HBV-deoxyribonucleic acid–positive donor in an HBV/HDV-coinfected recipient has not been reported. We describe the clinical course and management of an HBV/HDV-coinfected recipient who had LT from an HBsAg-negative/HBV-deoxyribonucleic acid–positive deceased donor and was treated with high-dose hepatitis B immune globulin in combination with an oral tenofovir alafenamide.
Discordant Pathological and Endoscopic Diagnosis: Consider Floaters
Authors: Sapp Abby R. , Wander Praneet , Ali Usman , Gong Yulan , Milano Reza V. , Bartel Michael J. 
Published: May 2021

ABSTRACT
A tissue floater or extraneous cross-contamination tissue on a microscopic slide is rare; however, it is a potential cause of diagnostic error. Occasionally, on collecting and processing of specimens, cross-contamination of tissue occurs leading to pathologic findings that are inconsistent with endoscopic findings. If the extraneous tissue is neoplastic, it can lead to a false-positive diagnosis. We present a case of discordant pathological and endoscopic diagnosis of invasive squamous carcinoma of the esophagus.
Risk Stratification Score Improves Sensitivity for Advanced Colorectal Neoplasia in Colorectal Cancer Screening: The Oshima Study Workgroup
Authors: Sekiguchi Masau , Kakugawa Yasuo , Ikematsu Hiroaki , Hotta Kinichi , Konda Kenichi , Tanaka Yusaku , Takamaru Hiroyuki , Yamada Masayoshi , Sakamoto Taku , Saito Yutaka , Imai Kenichiro , Ito Sayo , Koga Yoshikatsu , Iwasaki Motoki , Murakami Yoshitaka , Matsuda Takahisa 
Published: May 2021

INTRODUCTION:
Noninvasive colorectal cancer (CRC) screening methods with higher sensitivity for advanced colorectal neoplasia (ACN) than the fecal immunochemical test (FIT) alone are warranted. This study aimed to elucidate the diagnostic performance of a risk stratification score calculated using baseline individual characteristics and its combination with FIT for detecting ACN.

METHODS:
This cross-sectional analysis of data from a prospective cohort in Izu Oshima, Japan, included asymptomatic individuals age 40–79 years who underwent both 2-day quantitative FIT and screening colonoscopy. The 8-point risk score, calculated based on age, sex, CRC family history, body mass index, and smoking history, was assessed. Colonoscopy results were used as reference.

RESULTS:
Overall, 1,191 individuals were included, and 112 had ACN. The sensitivity and specificity of the 1-/2-day FIT (cutoff: 50–200 ng Hb/mL) for ACN were 17.9%–33.9% (4.9%–22.0% for right-sided ACN) and 91.8%–97.6%, respectively. The risk score's c-statistic for ACN was 0.66, and combining the score (cutoff: 5 points) with 1-/2-day FIT (cutoff: 50–200 ng Hb/mL) yielded a sensitivity and specificity for ACN of 46.4%–56.3% (43.9%–48.8% for right-sided ACN) and 76.6%–80.8%, respectively. The specificity of the risk score and FIT combination for all adenomatous lesions was 82.4%–86.4%.

DISCUSSION:
The 8-point risk score remarkably increased the sensitivity for ACN, particularly for right-sided ACN. Although the specificity decreased, it was still maintained at a relatively high level. The risk score and FIT combination has the potential to become a viable noninvasive CRC screening option.