bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness and safety of nab-paclitaxel/gemcitabine in locally advanced or metastatic pancreatic adenocarcinoma
Authors: Nebot-Villacampa María-José , Zafra-Morales Ricardo , Alfaro-Olea Ascensión , Marín-Gorricho Raquel , Casajús-Navasal Andrea , Uriarte-Pinto Moisés 
Published: July 2019

Background Treatment based on nab-paclitaxel plus gemcitabine is one of the standard treatments for locally advanced or metastatic pancreatic adenocarcinoma. Not much information is available about its use in clinical practice. Looking for prognostic markers may aid in improving treatment plans for patients. Objective To describe the effectiveness and safety profile of nab-paclitaxel/gemcitabine in locally advanced or metastatic pancreatic adenocarcinoma. We also tried to evaluate prognostic markers of response to treatment. Setting Retrospective descriptive study carried out in a tertiary hospital of Spain. Method Patients with locally advanced or metastatic pancreatic adenocarcinoma treated with nab-paclitaxel/gemcitabina between January 2014 and December 2017 were included in the analyses. Main outcome measure Effectiveness was measured in terms of overall survival, progression-free survival and response rate. To evaluate the safety profile, every adverse event from the start of the treatment and up to 10 days after its completion was registered. Results Fifty patients were included. Thirty-three (66%) had metastatic disease. Median overall survival was 8.8 months (95%CI: 5.1–12.5) and the median progression-free survival was 5.6 months (95%CI: 4.3–6.9). Relevance of carbohydrate antigen 19-9 baseline levels as prognostic response marker was confirmed, while neutrophil-to-lymphocyte ratio did not show conclusive results for overall survival. Safety profile was similar to that observed in clinical trials, with a single case of treatment discontinuation due to grade 3 neuropathy. Conclusion The studied schedule for locally advanced or metastatic pancreatic adenocarcinoma seems to be an effective therapeutic option, with an easy to manage toxicity profile, similar to other schedules used in pancreatic adenocarcinoma.
A Rapid Special Staining Technique for Identification of Normal Ureter by Frozen Section in Children With Ureteropelvic Junction Obstruction
Authors: Babu Ramesh , Vittalraj Pavithra , Sundaram Sandhya , Pothankulankara Manjusha Mullappali , Ramanan Venkat , Sai Venkata 
Published: July 2019

Background The exact etiology of ureteropelvic junction obstruction (UPJO) is unknown, and inadequate excision of the narrow segment has been proposed as a cause of failure in 5% to 7% of cases of pyeloplasty. Aims To study whether frozen section can be useful to detect normal ureter distal to UPJO during pyeloplasty. Methods Histological sections from 31 patients with UPJO were analyzed for collagen to muscle ratio (CMR) on conventional (formalin) and rapid (frozen section) Masson’s trichrome staining. Pathological findings were correlated with postoperative outcomes analyzed at 1-year follow-up and expressed as excellent, moderate, or mild improvement, static and deterioration based on ultrasound grade, differential renal function, and renogram drainage pattern. Results There was a very strong positive correlation ( r = .94; P = .001) between CMR by conventional and rapid frozen Masson’s trichrome staining. There was a very strong negative correlation between pyeloplasty outcomes and CMR on conventional staining ( r = −.94; P = .001) or rapid frozen Masson’s trichrome staining ( r = −.91; P = .001). Regression analysis revealed that a CMR of 1.2 or less (95% confidence interval: 1.9–0.7) was associated with a successful outcome. Conclusions It is feasible to intraoperatively identify normal ureter distal to UPJO using CMR analysis on the novel rapid frozen section technique reported.
Monthly Video-Consultation for Children With Type 1 Diabetes Using a Continuous Glucose Monitoring System: Design of ViDiKi, a Multimethod Intervention Study to Evaluate the Benefit of Telemedicine
Authors: Frielitz Fabian-Simon , Müller-Godeffroy Esther , Hübner Joachim , Eisemann Nora , Dördelmann Jana , Menrath Ingo , Katalinic Alexander , Hiort Olaf , von Sengbusch Simone 
Published: July 2019

Background: The introduction of continuous glucose monitoring (CGM) implies new challenges for diabetes care. As CGM systems are often directly linked to a web-based software solution, structured telemedicine care using a video-consultation may be a new option for families who care for children with type 1 diabetes mellitus (T1DM). Methods: “ViDiKi” (Virtual Diabetes Outpatient Clinic for Children and Youth) is a multicenter controlled trial carried out in Northern Germany. ViDiKi will examine if monthly telemedical consultations, in addition to regular care, will improve glycemic control and psychosocial outcomes. The primary outcome is glycemic control as measured by a change in glycated hemoglobin (HbA1c). A total of 240 participants aged between one year and 16 years using a CGM with multiple daily injections (MDI) or insulin pump therapy were recruited and assigned to a starter group or a six-month waiting control group. The sample size is designed to detect a between-group difference of 0.5% in HbA1c change at six months. Secondary outcomes are variability of blood glucose, health-related quality of life, self-efficacy, and satisfaction with telemedicine. To gain deeper insight into the experience of using telemedicine, qualitative interviews will be conducted. In a health-economic analysis, the costs of telemedicine and a cost-of-care analysis will be calculated. Conclusions: The results from the ViDiKi study shall give important information on the feasibility and putative benefits of telemedicine in children with T1DM and their caregivers. German Clinical Trails Register (DRKS): DRKS00012645
Subchondroplasty of the Ankle and Hindfoot for Treatment of Osteochondral Lesions and Stress Fractures: Initial Imaging Experience
Authors: McWilliams Geoffrey D. , Yao Lawrence , Simonet Luke B. , Haysbert Connor W. , Giza Eric , Kreulen Christopher D. , Boutin Robert D. 
Published: July 2019

Objective:To describe the imaging findings of patients treated with subchondroplasty (SCP) of the ankle and hindfoot. Materials and Methods: Eighteen patients (10 men, 8 women; age mean 43.1 years [range 20.1-67.7 years]) underwent ankle and hindfoot SCP at a single center over a 14-month period. Imaging data were reviewed retrospectively by 2 radiologists by consensus interpretation, including preoperative radiography (18), computed tomography (CT) (11), and magnetic resonance imaging (MRI) (13) and postoperative radiography (10), CT (4), and MRI (6). Follow-up imaging was acquired 1 month to 1.6 years following SCP. Results: Indications for SCP included symptomatic bone marrow lesions (BMLs) secondary to an osteochondral lesion (OCL) (16/18) or stress fracture (2/18). While focal radiodensity related to the SCP procedure was retrospectively identifiable on postoperative radiography in all except 1 case (10/11), postprocedural findings were not described by the interpreting radiologist in 6/11 cases. On CT, the average injected synthetic calcium phosphate (CaP) volume was 1.15 cm3 (SD = 0.33 cm3); mean CT attenuation of the injectate was 1220 HU (range 1058-1465 HU). In all patients who had pre- and postoperative MRI (5/18), BML size decreased on follow-up MRI. Extra-osseous extrusion of CaP was not seen on postoperative radiography, CT, or MRI. Conclusion: Physicians should be aware of the expanding preoperative indications and postoperative imaging findings of SCP, which is being performed with increasing frequency in the ankle and hindfoot. Levels of Evidence: Diagnostic, Level III: Retrospective cohort study
Twelve-years’ experience in minimal invasive Achilles tendon repair using a suture-guiding device
Authors: Yeung Prisca , Man Lok Pong , Ho Wing Hang Angela 
Published: July 2019

Introduction: Minimal invasive Achilles tendon repair is becoming more and more popular recently. We have evaluated our results in Achilles tendon repair using minimally invasive method by a suture-guiding device. Methods: This is a retrospective review of patients with acute Achilles tendon rupture, which was repaired using minimally invasive method namely the suture-guiding device, that was performed during 2003 to 2015 in our department. Outcome parameters were the incidence of re-rupture, other complications, and the functional outcome. Results: There were 36 men (90%) and 4 women (10%) in this study. Mechanisms of injury were basketball (28%), football (15%), squash (15%), and trauma (13%). The mean operating time was 59 min (range 30–90 min). The mean follow-up time was 8 months (range 3–35 months). The mean duration with casting was 7 weeks. The mean range of movement at 3 months was 8° dorsiflexion and 33° plantar flexion. There was no major complication necessitating surgical re-interventions such as re-ruptures and infections. No patient suffered from dysfunction of the sural nerve or delay wound healing. Conclusion: Minimally invasive Achilles tendon repair using suture-guiding device is a safe and quick procedure with a low rate of re-rupture and a satisfactory short-term and long-term recovery. Level of evidence: IV.
Ophthalmic medication price variation across the United States: Anti-inflammatory medications
Authors: Scott Anthony T. , Pecen Paula E. , Palestine Alan G. 
Published: July 2019

Background: Cost-related nonadherence to medication can impact ophthalmic treatment outcomes. We aimed to determine whether medication prices vary between US cities and between different types of pharmacies within one city. Methods: We conducted a phone survey of eight nationwide and five independent pharmacies in five cities across the United States: Boston, Massachusetts; Charlotte, North Carolina; Denver, Colorado; Detroit, Michigan; and Seattle, Washington. A researcher called each pharmacy asking for price without insurance for four common anti-inflammatory ophthalmic medications: prednisolone acetate, prednisolone sodium phosphate, difluprednate (Durezol™), and loteprednol etabonate (Lotemax™). Results: Prednisolone sodium phosphate price could only be obtained by a small subset of pharmacies (45.2%) and was excluded from additional analysis; however, preliminary data demonstrated lower cost of prednisolone sodium phosphate over prednisolone acetate. Three-way analysis of variance revealed no interaction between pharmacy type (chain versus independent), city, and drug ( F = 0.40, p = 0.92). A significant interaction was identified between pharmacy type and drug ( F = 5.0, p = 0.008), but not city and pharmacy type ( F = 0.66, p = 0.62) or city and drug ( F = 0.27, p = 0.97). Average drug prices were lower at independent pharmacies compared with chain pharmacies for difluprednate (US$211.36 versus US$216.85, F = 1.09, p = 0.297) and significantly lower for loteprednol etabonate (US$255.49 versus US$274.86, F = 14.7, p < 0.001). Prednisolone acetate was cheaper at chain pharmacies, but not statistically significantly cheaper (US$48.82 versus US$51.61, F = 0.34, p = 0.559). Conclusions: Medication prices do not differ significantly between US cities. High variation of drug prices within the same city demonstrates how comparison shopping can provide cost savings for patients and may reduce cost-related nonadherence.
Distinct clinical and biological implications of CUX1 in myeloid neoplasms
Authors: Aly Mai , Ramdzan Zubaidah M. , Nagata Yasunobu , Balasubramanian Suresh K. , Hosono Naoko , Makishima Hideki , Visconte Valeria , Kuzmanovic Teodora , Adema Vera , Nazha Aziz , Przychodzen Bartlomiej P. , Kerr Cassandra M. , Sekeres Mikkael A. , Abazeed Mohamed E. , Nepveu Alain , Maciejewski Jaroslaw P. 
Published: July 2019

AbstractSomatic mutations of the CUT-like homeobox 1 (CUX1) gene (CUX1MT) can be found in myeloid neoplasms (MNs), in particular, in myelodysplastic syndromes (MDSs). The CUX1 locus is also deleted in 3 of 4 MN cases with −7/del(7q). A cohort of 1480 MN patients was used to characterize clinical features and clonal hierarchy associated with CUX1MT and CUX1 deletions (CUX1DEL) and to analyze their functional consequences in vitro. CUX1MT were present in 4% of chronic MNs. CUX1DEL were preferentially found in advanced cases (6%). Most MDS and acute myeloid leukemia (AML) patients with −7/del(7q) and up to 15% of MDS patients and 5% of AML patients diploid for the CUX1 locus exhibited downmodulated CUX1 expression. In 75% of mutant cases, CUX1MT were heterozygous, whereas microdeletions and homozygous and compound-heterozygous mutations were less common. CUXMT/DEL were associated with worse survival compared with CUX1WT. Within the clonal hierarchy, 1 of 3 CUX1MT served as founder events often followed by secondary BCOR and ASXL1 subclonal hits, whereas TET2 was the most common ancestral lesion, followed by subclonal CUX1MT. Comet assay of patients’ bone marrow progenitor cells and leukemic cell lines performed in various experimental conditions revealed that frameshift mutations, hemizygous deletions, or experimental CUX1 knockdown decrease the repair of oxidized bases. These functional findings may explain why samples with either CUX1MT or low CUX1 expression coincided with significantly higher numbers of somatic hits by whole-exome sequencing. Our findings implicate the DNA repair dysfunction resulting from CUX1 lesions in the pathogenesis of MNs, in which they lead to a mutator phenotype.
Vena cava backflow and right ventricular stiffness in pulmonary arterial hypertension
Authors: Marcus J. Tim , Westerhof Berend E. , Groeneveldt Joanne A. , Bogaard Harm Jan , de Man Frances S. , Vonk Noordegraaf Anton 
Published: July 2019

Vena cava backflow is a well-recognised clinical hallmark of right ventricular failure in pulmonary arterial hypertension (PAH). Backflow may result from tricuspid regurgitation during right ventricular systole or from impaired right ventricular diastolic filling during atrial contraction. Our aim was to quantify the forward and backward flow in the vena cava and to establish the main cause in PAH.In 62 PAH patients, cardiac magnetic resonance measurements provided volumetric flows (mL·s−1) in the superior and inferior vena cava; time integration of flow gave volume. The “backward fraction” was defined as the ratio of the backward and forward volumes in the vena cava, expressed as a percentage. Time of maximum vena cava backflow was expressed as a percentage of the cardiac cycle. Right ventricular volumes and aortic stroke volume were determined. Right heart catheterisation gave right ventricular and right atrial pressures. Right ventricular end-diastolic stiffness was determined with the single-beat method.The median (interquartile range) backward fraction was 12% (3–24%) and it was >20% in 21 patients. Maximum backflow occurred at near 90% of the cardiac cycle, coinciding with atrial contraction. The backward fraction was associated with maximal right atrial pressure (Spearman's r=0.77), right ventricular end-diastolic stiffness (r=0.65) and right ventricular end-diastolic pressure (r=0.77), and was negatively associated with stroke volume (r= –0.61) (all p<0.001).Significant backward flow in the vena cava was observed in a large group of PAH patients and occurred mostly during atrial contraction as a consequence of impaired right ventricular filling due to right ventricular diastolic stiffness. The backward flow due to tricuspid regurgitation was of significance in only a small minority of patients.
CCR2/CCR5-mediated macrophage–smooth muscle cell crosstalk in pulmonary hypertension
Authors: Abid Shariq , Marcos Elisabeth , Parpaleix Aurélien , Amsellem Valérie , Breau Marielle , Houssaini Amal , Vienney Nora , Lefevre Marine , Derumeaux Genevieve , Evans Steven , Hubeau Cedric , Delcroix Marion , Quarck Rozenn , Adnot Serge , Lipskaia Larissa 
Published: July 2019

Macrophages are major players in the pathogenesis of pulmonary arterial hypertension (PAH).To investigate whether lung macrophages and pulmonary-artery smooth muscle cells (PASMCs) collaborate to stimulate PASMC growth and whether the CCL2-CCR2 and CCL5-CCR5 pathways inhibited macrophage–PASMC interactions and PAH development, we used human CCR5-knock-in mice and PASMCs from patients with PAH and controls.Conditioned media from murine M1 or M2 macrophages stimulated PASMC growth. This effect was markedly amplified with conditioned media from M2 macrophage/PASMC co-cultures. CCR2, CCR5, CCL2 and CCL5 were upregulated in macrophage/PASMC co-cultures. Compared to inhibiting either receptor, dual CCR2 and CCR5 inhibition more strongly attenuated the growth-promoting effect of conditioned media from M2-macrophage/PASMC co-cultures. Deleting either CCR2 or CCR5 in macrophages or PASMCs attenuated the growth response. In mice with hypoxia- or SUGEN/hypoxia-induced PH, targeting both CCR2 and CCR5 prevented or reversed PH more efficiently than targeting either receptor alone. Patients with PAH exhibited CCR2 and CCR5 upregulation in PASMCs and perivascular macrophages compared to controls. The PASMC growth-promoting effect of conditioned media from M2-macrophage/PASMC co-cultures was greater when PASMCs from PAH patients were used in the co-cultures or as the target cells and was dependent on CCR2 and CCR5. PASMC migration toward M2-macrophages was greater with PASMCs from PAH patients and was attenuated by blocking CCR2 and CCR5.CCR2 and CCR5 are required for collaboration between macrophages and PASMCs to initiate and amplify PASMC migration and proliferation during PAH development. Dual targeting of CCR2 and CCR5 may hold promise for treating human PAH.
An aggressive central giant cell granuloma in a pediatric patient: Case report and review of literature
Authors: Wang Yiqiao , Le Andre , El Demellawy Dina , Shago Mary , Odell Michael , Johnson-Obaseki Stephanie 
Published: July 2019

Background Central giant cell granulomas are benign tumours of the mandible, presenting in children and young adults. Divided into non- and aggressive subtypes, the aggressive subtype is relatively rare and can occasionally progress rapidly, resulting in significant morbidity. Case presentation We present a case of an aggressive central giant cell granuloma (CGCG) in a six year-old female. The lesion originated in the right mandibular ramus and progressed rapidly to involve the condyle. Diagnosis was made using a combination of imaging and pathology. A timely en bloc resection of the hemi-mandible was performed with placement of a reconstructive titanium plate and condylar prosthesis. Conclusion Our case demonstrates the importance of considering CGCG in the differential diagnosis of rapidly progressive mandibular lesions in the pediatric population. Prompt diagnosis and management can greatly improve long-term outcomes.
Understanding the Signaling Pathways Related to the Mechanism and Treatment of Diabetic Peripheral Neuropathy
Authors: Tang He-yong , Jiang Ai-juan , Ma Jun-long , Wang Fan-jing , Shen Guo-ming 
Published: July 2019

AbstractWorldwide, the most prevalent metabolic disorder is diabetes mellitus (DM), an important condition that has been widely studied. Diabetic peripheral neuropathy (DPN), a complication that can occur with DM, is associated with pain and can result in foot ulcers and even amputation. DPN treatments are limited and mainly focus on pain management. There is a clear need to develop treatments for DPN at all stages. To make this progress, it is necessary to understand the molecular signaling pathways related to DPN. For this review, we aimed to concentrate on the main signaling cascades that contribute to DPN. In addition, we provide information with regard to treatments that are being explored.
Regulation of the ERK signalling pathway in the developing mouse blastocyst
Authors: Azami Takuya , Bassalert Cécilia , Allègre Nicolas , Valverde Estrella Lorena , Pouchin Pierre , Ema Masatsugu , Chazaud Claire 
Published: July 2019

ABSTRACT
Activation of the ERK signalling pathway is essential for the differentiation of the inner cell mass (ICM) during mouse preimplantation development. We show here that ERK phosphorylation occurs in ICM precursor cells, in differentiated primitive endoderm (PrE) cells as well as in the mature, formative state epiblast (Epi). We further show that DUSP4 and ETV5, factors often involved in negative-feedback loops of the FGF pathway, are differently regulated. Whereas DUSP4 presence clearly depends on ERK phosphorylation in PrE cells, ETV5 localises mainly to Epi cells. Unexpectedly, ETV5 accumulation does not depend on direct activation by ERK but requires NANOG activity. Indeed ETV5, like Fgf4 expression, is not present in Nanog mutant embryos. Our results lead us to propose that in pluripotent early Epi cells, NANOG induces the expression of both Fgf4 and Etv5 to enable the differentiation of neighbouring cells into the PrE while protecting the Epi identity from autocrine signalling.
Use of preoperative mammography, ultrasonography, and MRI to predict nipple areolar complex involvement in breast cancer
Authors: Lim Soyeoun , Park Gyeongmin , Choi Hye-jeong , Kwon Woon Jung , Kang Byeong Seong , Bang Minseo 
Published: July 2019

Objective:
To identify the predictive factors of cancer invading into the nipple.

Methods:
Patients with breast cancer undergoing mastectomy between May 2009 and March 2019 were reviewed retrospectively. Of these, those with breast cancer within 2 cm of the nipple areolar complex on ultrasonography were included in this study. Clinicopathological data of the primary tumor and imaging findings from mammography, ultrasonography, and MRI were compared between cases with and without nipple involvement by cancer.

Results:
In total, 156 of the 821 patients identified were included in the analysis. Of them, 29 had nipple involvement by cancer. Univariate analysis revealed that the following imaging results were significantly associated with nipple involvement: perineural invasion, lymphovascular invasion, lymph node metastasis; relation type between the tumor and the nipple on ultrasonography; periareolar skin thickening on mammography; and short tumor-nipple distance, continuous enhancement between the nipple and tumor, skin enhancement, and nipple enhancement on MRI. However, on multivariate logistic regression analysis, only invasion type of tumor on ultrasonography and nipple enhancement and short tumor-nipple distance on MRI were significantly correlated with nipple involvement by cancer.

Conclusion:
Imaging findings on preoperative mammography, ultrasonography and MRI are effective predictors for nipple involvement by cancer.

Advances in knowledge:
Preoperative mammography, ultrasonography, and MRI help predict nipple involvement by breast cancer.