bluuebunny/crossref_metadata_2025_split huggingface dataset:
ДЕЩО ПРО ЛЕКСИКУ ЛІКАРІВ
Authors: Kopcha V. S 
Published: April 2019

Мета роботи – проаналізувати професійну лексику лікарів на підставу виявлення алогізмів.
Наведено роздуми автора про численні кліше в медичній документації, які не тільки не логічні, але й часто застарілі, подекуди смішні й неграмотні. Пропонуються замінники таких виразів або усунення їх з ужитку.
Vascular Smooth Muscle Cell Plasticity and Autophagy in Dissecting Aortic Aneurysms
Authors: Clément Marc , Chappell Joel , Raffort Juliette , Lareyre Fabien , Vandestienne Marie , Taylor Annabel L. , Finigan Alison , Harrison James , Bennett Martin R. , Bruneval Patrick , Taleb Soraya , Jørgensen Helle F. , Mallat Ziad 
Published: April 2019

Objective—
Recent studies suggested the occurrence of phenotypic switching of vascular smooth muscle cells (VSMCs) during the development of aortic aneurysm (AA). However, lineage-tracing studies are still lacking, and the behavior of VSMCs during the formation of dissecting AA is poorly understood.

Approach and Results—

We used multicolor lineage tracing of VSMCs to track their fate after injury in murine models of Ang II (angiotensin II)–induced dissecting AA. We also addressed the direct impact of autophagy on the response of VSMCs to AA dissection. Finally, we studied the relevance of these processes to human AAs. Here, we show that a subset of medial VSMCs undergoes clonal expansion and that VSMC outgrowths are observed in the adventitia and borders of the false channel during Ang II–induced development of dissecting AA. The clonally expanded VSMCs undergo phenotypic switching with downregulation of VSMC differentiation markers and upregulation of phagocytic markers, indicative of functional changes. In particular, autophagy and endoplasmic reticulum stress responses are activated in the injured VSMCs. Loss of autophagy in VSMCs through deletion of autophagy protein 5 gene (
Atg5
) increases the susceptibility of VSMCs to death, enhances endoplasmic reticulum stress activation, and promotes IRE (inositol-requiring enzyme) 1α-dependent VSMC inflammation. These alterations culminate in increased severity of aortic disease and higher incidence of fatal AA dissection in mice with VSMC-restricted deletion of
Atg5
. We also report increased expression of autophagy and endoplasmic reticulum stress markers in VSMCs of human dissecting AAs.

Conclusions—
VSMCs undergo clonal expansion and phenotypic switching in Ang II–induced dissecting AAs in mice. We also identify a critical role for autophagy in regulating VSMC death and endoplasmic reticulum stress–dependent inflammation with important consequences for aortic wall homeostasis and repair.
Expandable Lattice Electrode Ablation Catheter
Authors: Barkagan Michael , Leshem Eran , Rottmann Markus , Sroubek Jakub , Shapira-Daniels Ayelet , Anter Elad 
Published: April 2019

Background:
High-current short-duration radiofrequency energy delivery has potential advantages for cardiac ablation. However, this strategy is limited by high current density and narrow safety-to-efficacy window. The objective of this study was to examine a novel strategy for radiofrequency energy delivery using a new electrode design capable of delivering high power at a low current density to increase the therapeutic range of radiofrequency ablation.

Methods:

The Sphere9 is an expandable spheroid-shaped lattice electrode design with an effective surface area 10-fold larger than standard irrigated electrodes (lattice catheter). It incorporates 9 surface temperature sensors with ablation performed in a temperature-controlled mode. Phase I: in 6 thigh muscle preparations, 2 energy settings for atrial ablation were compared between the lattice and irrigated-tip catheters (low-energy: T
max
75°C/5 s versus 25 W/20 s; high-energy: T
max
75°C/7 s versus 30 W/20 s). Phase II: in 8 swine, right atrial lines were created in the posterior and lateral walls using low- and high-energy settings, respectively. Phase III: the safety, efficacy, and durability at 30 days were evaluated by electroanatomical mapping and histopathologic analysis.

Results:

In the thigh model, the lattice catheter resulted in wider lesions at both low- and high-energy settings (18.7±3.3 versus 12.2±1.7 mm,
P
<0.0001; 19.4±2.4 versus 12.3±1.7 mm,
P
<0.0001). Atrial lines created with the lattice were wider (posterior: 14.7±3.4 versus 9.2±4.0 mm,
P
<0.0001; lateral: 15.8±4.2 versus 5.7±4.2 mm,
P
<0.0001) and required 85% shorter ablation time (12.4 versus 79.8 s/cm-line). While current squared (I
2
) was higher with Sphere9 (7.0±0.04 versus 0.2±0.002 A
2
;
P
<0.0001), the current density was lower (9.6±0.9 versus 16.9±0.09 mA/mm
2
;
P
<0.0001). At 30 days, 100% of ablation lines created with the lattice catheter remained contiguous compared with only 14.3% lines created with a standard irrigated catheter. This was achieved without steam pops or collateral tissue damage.

Conclusions:
In this preclinical model, a novel, high-current low-density radiofrequency ablation strategy created contiguous and durable ablation lines in significantly less ablation time and a comparable safety profile.
Abstract 172: Improving Heart Failure Outcome, a Team Based Approach
Authors: Saadat Mohsen , Mostamand Mariam 
Published: April 2019

Description:
About 5.7 million adults in the United States have heart failure (HF), costing the nation an estimated $30.7 billion each year. In the first half of 2017, The Internal Medicine service at San Joaquin General Hospital (SJGH) notices an increase in admissions and emergency room visits for patients with HF. The department moved the HF clinic for cardiology to the primary care clinic and changed the format into a multidisciplinary clinic, to include a wider variety of providers, such as clinical pharmacist, physicians, health coaches, dietician, registered nurse manager and a case manager from the local health plan payer.

Project’s Aim:

• To reduce HF related hospital admissions and emergency room visits.
• To increase adherence to Guideline Directed Medical Therapy (GDMT)
• Increase access to care
• Encourage patient engagement and empowerment

Methods:
Patients with at least one visit to the HF clinic between 8/1/17 to 7/31/18, (n=107) were included in the study. During the same year period there were a total of 958 HF related ED visits and 621 HF related admissions.

Data was collected on the following measures:

• Difference in ED visits before and after a patient’s first visit to the clinic
• Difference in hospital admissions before and after a patient’s first visit to the clinic
• Difference in length of stay (LOS) before and after a patient’s first visit to the clinic

Finding and Conclusion:
Patients with at least one visit to the new HF clinic had:

• 40% reduction in ED visits (P=0.069)
• 63% reduction in admissions (P=0.0001)
• 54% reduction in LOS (P=0.0001)

Future Direction:

• Engaging the two local managed care plans to provide uber/lyft to appointments, pharmacy, and grocery stores
• Leveraging technology, such as: blue tooth wearables, telemedicine/e-consult to improve access
• Utilize available technology within electronic health record to enable virtual care management
Intraocular pressure control after trans-scleral intraocular lens fixation in glaucoma patients
Authors: Belkin Avner , Einan-Lifshitz Adi , Mathew David J , Sorkin Nir , Buys Yvonne M , Trope Graham E , Rootman David S 
Published: April 2019

Background: Intraocular lens fixation surgery is associated with fluctuations in intraocular pressure. This may be significantly relevant in glaucoma patients. Objectives: To assess short- and medium-term intraocular pressure control after trans-scleral intraocular lens fixation surgery in glaucoma patients. Methods: The charts of all glaucoma patients who underwent trans-scleral intraocular lens fixation surgery with at least 6 months follow-up by a single surgeon between the years 2004 and 2017 were reviewed. Primary outcomes were intraocular pressure at 1 day and 6 months after surgery. Secondary outcome measures were hypotensive medication use and the need for further intraocular pressure lowering interventions. Results: Eleven eyes of 10 patients were included in the analysis. Mean follow-up post intraocular lens fixation surgery was 54.6 months. Mean intraocular pressure before, 6 months, and last follow-up after intraocular lens fixation surgery was 15.8 ± 5.3 mmHg (range 10.6–25.3), 13.5 ± 3.8 mmHg (range 8–21, p = 0.2), and 11.8 ± 5.6 (range 6–21, p = 0.09) on a mean of 2.3 ± 1.6, 2 ± 1.6 (p = 0.23), and 1.7 ± 1.5 (p = 0.08) hypotensive medications, respectively. A pressure spike was noted in 5 of the 11 eyes on the first post-operative day (mean spike 15.2 mmHg, range 6–23). Four of 11 eyes in the study (36%) needed additional interventions to control intraocular pressure by the 6-month point. One eye required the addition of two classes of topical medications, one eye required laser trabeculoplasty, and two eyes required trabeculectomy. Conclusion: Over a third of glaucomatous eyes required a change in the management of their disease in the early post-operative period. Close follow-up of patients undergoing trans-scleral intraocular lens fixation surgery is warranted.
Establishing an indwelling peritoneal catheter as a standard procedure for hospitalized patients with ascites: Retrospective data on feasibility, effectiveness and safety
Authors: Stratmann Katharina , Fitting Daniel , Zeuzem Stefan , Bojunga Jörg , Trebicka Jonel , Friedrich-Rust Mireen , Dultz Georg 
Published: April 2019

BackgroundThe use of an indwelling peritoneal catheter system in hospitalized patients with ascites could facilitate patient management by the prevention of repetitive abdominal paracentesis. Despite these possible benefits, the use of indwelling catheters is not widely established.ObjectiveThis retrospective study aimed to evaluate the feasibility, effectiveness and safety of the use of an indwelling catheter for ascites drainage in the clinical routine.MethodsThis retrospective study included all indwelling peritoneal catheter placements in our department in hospitalized patients with cirrhosis between 2014 and 2017.ResultsA total of 324 indwelling catheter placements for ascites in 192 hospitalized patients with cirrhosis were included. The catheter (7F, 8 cm) was placed ultrasound‐assisted bed‐side on the hospital ward. The technical success rate of the catheter placement was 99.7% (323/324). In 17.5% (64/324) the catheter was placed to optimize ascitic drainage prior to an abdominal intervention (e.g. transjugular intrahepatic portosystemic shunt). The median time of catheter retention was 48 hours (8–168 hours) and the median cumulative amount of drained ascites 8000 ml (550–28,000). The most common adverse event was acute kidney injury (49/324, 15.1%); the risk was particularly higher in patients with a Model for End‐Stage Liver Disease (MELD) score ≥ 16 (p = 0.028; odds ratio 2.039). Ascitic fistula after catheter removal was observed in 9.6% (31/324). Catheter‐related infections occurred in 4.3% (14/324), and bleeding was documented in three cases (0.8%) with one major bleeding (0.3%).ConclusionThe placement of an indwelling catheter for repetitive ascitic drainage in hospitalized patients with cirrhosis can be established in the clinical routine, facilitating patient management. High‐MELD patients especially have to be monitored for acute kidney injury.
Surgical management of urolithiasis in octogenarians
Authors: Whiting Danielle , Arican Irem , Farrag Khaled , Anjum Faqar , Sriprasad Seshadri , Nariculam Joseph 
Published: April 2019

Objective: The objective of this study was to report the outcomes of octogenarians undergoing surgical treatment for urolithiasis. Materials and methods: We performed a retrospective review of patients aged over 80 years who underwent surgical management for urolithiasis over 8.5 years. Data was collected for patient demographics, procedure, stone size, position, composition and clearance, urine cultures, complications and length of stay. Results: Sixty patients had 111 surgical procedures: 89 elective procedures (80.2%) and 22 emergency procedures (19.8%). Median age was 83 years (81–85), ASA grade 3 and stone size 8 mm (6–10). Clinical presentation was varied, with only 17 patients (28.3%) presenting with ureteric colic/flank pain. Ureterorenoscopy was performed in 74 procedures (66.7%). A ureteric stent was left in 91 procedures (82.0%). The median length of stay for the emergency patients was 6 nights (3–9.5 nights) and for the elective patients was 1 night (1–3 nights). The complication rate varied depending on the primary procedure performed. The overall complication rate was 19.8%: three (2.7%) Clavien I (urinary retention); 11 (9.9%) Clavien II (blood transfusion/urinary tract infection/urosepsis); two (1.8%) Clavien IIIb (stent insertion/bleeding); three (2.7%) Clavien IV (urosepsis) and three (2.7%) Clavien V (two patients urosepsis and one patient pneumonia). The stone-free rate was 68.3%. Conclusion: Octogenarian patients with urolithiasis have a variable presentation, and in patients with sepsis of unknown origin urolithiasis should be considered. We demonstrate that surgical treatment, in particular ureterorenoscopy, can be safely and effectively performed in octogenarians with appropriate surgical planning. Level of evidence: 4 Case series
Metabolic reprogramming and redox adaptation in sorafenib‐resistant leukemia cells: detected by untargeted metabolomics and stable isotope tracing analysis
Authors: You Xin , Jiang Weiye , Lu Wenhua , Zhang Hui , Yu Tiantian , Tian Jingyu , Wen Shijun , Garcia‐Manero Guillermo , Huang Peng , Hu Yumin 
Published: April 2019

AbstractBackgroundInternal tandem duplications (ITD) within the juxtamembrane domain of FMS‐like tyrosine kinase 3 (FLT3) represent a poor prognostic indicator in acute myeloid leukemia (AML). Therapeutic benefits of tyrosine kinase inhibitors, such as sorafenib, are limited due to the emergence of drug resistance. While investigations have been conducted to improve the understanding of the molecular mechanisms underlying the resistance to this FLT3 inhibitor, a profile of cell functioning at the metabolite level and crosstalk between metabolic pathways has yet to be created. This study aimed to elucidate the alteration of metabolomic profile of leukemia cells resistant to the FLT3 inhibitor.MethodsWe established two sorafenib‐resistant cell lines carrying FLT3/ITD mutations, namely the murine BaF3/ITD‐R and the human MV4‐11‐R cell lines. We performed a global untargeted metabolomics and stable isotope‐labeling mass spectrometry analysis to identify the metabolic alterations relevant to the therapeutic resistance.ResultsThe resistant cells displayed fundamentally rewired metabolic profiles, characterized by a higher demand for glucose, accompanied by a reduction in glucose flux into the pentose phosphate pathway (PPP); and by an increase in oxidative stress, accompanied by an enhanced glutathione synthesis. We demonstrated that the highest scoring network of altered metabolites in resistant cells was related to nucleotide degradation. A stable isotope tracing experiment was performed and the results indicated a decrease in the quantity of glucose entering the PPP in resistant cells. Further experiment suggested that the inhibition of major enzymes in the PPP consist of glucose‐6‐phosphate dehydrogenase deficiency (G6PD) in the oxidative arm and transketolase (TKT) in the non‐oxidative arm. In addition, we observed that chronic treatment with sorafenib resulted in an increased oxidative stress in FLT3/ITD‐positive leukemia cells, which was accompanied by decreased cell proliferation and an enhanced antioxidant response.ConclusionsOur data regarding comparative metabolomics characterized a distinct metabolic and redox adaptation that may contribute to sorafenib resistance in FLT3/ITD‐mutated leukemia cells.
Clinical Prognostic Factors and Outcome in Pediatric Osteosarcoma: Effect of Delay in Local Control and Degree of Necrosis in a Multidisciplinary Setting in Lebanon
Authors: Abou Ali Bilal , Salman Mayssa , Ghanem Khaled M. , Boulos Fouad , Haidar Rachid , Saghieh Said , Akel Samir , Muwakkit Samar A. , El-Solh Hassan , Saab Raya , Tamim Hani , Abboud Miguel R. 
Published: April 2019

PURPOSE Outcomes in pediatric osteosarcoma have dramatically improved over the past few decades, with overall survival rates of 70% and 30% for patients with localized and metastatic disease, respectively. PATIENTS AND METHODS We retrospectively reviewed clinical characteristics and outcomes of 38 patients treated between 2001 and 2012 at a single institution in Lebanon. All patients received a uniform three-drug chemotherapy regimen consisting of cisplatin, doxorubicin, and methotrexate. Ifosfamide and etoposide were added to the adjuvant treatment regimen in case of metastatic disease and/or poor degree of tumor necrosis (< 90%). RESULTS After a median follow-up of 61 months (range, 8 to 142 months), patients with localized disease had 5-year overall and event-free survival rates of approximately 81% and 68%, respectively, whereas for metastatic disease, they were approximately 42%. The most common primary site was the long bones around the knee (n = 34; 89.5%). Six patients (15.8%) had metastatic disease to lungs, and three (7.9%) had synchronous multifocal bone disease with lung metastases. Adverse prognostic factors included nonlower extremity sites, metastasis, poor degree of necrosis, and delay of more than 4 weeks in local control. In bivariable analysis, only degree of necrosis was a prognostic predictor for survival and disease recurrence. CONCLUSION Treatment of pediatric osteosarcoma in a multidisciplinary cancer center in Lebanon resulted in survival similar to that in developed countries. Delay in local control was associated with worse outcome. The only statistically significant inferior outcome predictor was poor degree of necrosis at the time of local control.
Potentially Avoidable Hospital Readmissions in Patients With Advanced Cancer
Authors: Johnson P. Connor , Xiao Yian , Wong Risa L. , D'Arpino Sara , Moran Samantha M.C. , Lage Daniel E. , Temel Brandon , Ruddy Margaret , Traeger Lara N. , Greer Joseph A. , Hochberg Ephraim P. , Temel Jennifer S. , El-Jawahri Areej , Nipp Ryan D. 
Published: April 2019

PURPOSE: Patients with cancer often prefer to avoid time in the hospital; however, data are lacking on the prevalence and predictors of potentially avoidable readmissions (PARs) among those with advanced cancer. METHODS: We enrolled patients with advanced cancer from September 2, 2014, to November 21, 2014, who had an unplanned hospitalization and assessed their patient-reported symptom burden (Edmonton Symptom Assessment System) at the time of admission. For 1 year after enrollment, we reviewed patients’ health records to determine the primary reason for every hospital readmission and we classified readmissions as PARs using adapted Graham’s criteria. We examined predictors of PARs using nonlinear mixed-effects models with binomial distribution. RESULTS: We enrolled 200 (86.2%) of 232 patients who were approached. For these 200 patients, we reviewed 277 total hospital readmissions and identified 108 (39.0%) of these as PARs. The most common reasons for PARs were premature discharge from a prior hospitalization (30.6%) and failure of timely follow-up (28.7%). PAR hospitalizations were more likely than non-PAR hospitalizations to experience symptoms as the primary reason for admission (28.7% v 13.0%; P = .001). We found that married patients were less likely to experience PARs (odds ratio, 0.30; 95% CI, 0.15 to 0.57; P < .001) and that those with a higher physical symptom burden were more likely to experience PARs (odds ratio, 1.03; 95% CI, 1.01 to 1.05; P = .012). CONCLUSION: We observed that a substantial proportion of hospital readmissions are potentially avoidable and found that patients’ symptom burdens predict PARs. These findings underscore the need to assess and address the symptom burden of hospitalized patients with advanced cancer in this highly symptomatic population.
Synovial fluid interleukin-16, interleukin-18, and CRELD2 as novel biomarkers of prosthetic joint infections
Authors: Chen M-F. , Chang C-H. , Yang L-Y. , Hsieh P-H. , Shih H-N. , Ueng S. W. N. , Chang Y. 
Published: April 2019

ObjectivesProsthetic joint infection (PJI) diagnosis is a major challenge in orthopaedics, and no reliable parameters have been established for accurate, preoperative predictions in the differential diagnosis of aseptic loosening or PJI. This study surveyed factors in synovial fluid (SF) for improving PJI diagnosis.MethodsWe enrolled 48 patients (including 39 PJI and nine aseptic loosening cases) who required knee/hip revision surgery between January 2016 and December 2017. The PJI diagnosis was established according to the Musculoskeletal Infection Society (MSIS) criteria. SF was used to survey factors by protein array and enzyme-linked immunosorbent assay to compare protein expression patterns in SF among three groups (aseptic loosening and first- and second-stage surgery). We compared routine clinical test data, such as C-reactive protein level and leucocyte number, with potential biomarker data to assess the diagnostic ability for PJI within the same patient groups.ResultsCut-off values of 1473 pg/ml, 359 pg/ml, and 8.45 pg/ml were established for interleukin (IL)-16, IL-18, and cysteine-rich with EGF-like domains 2 (CRELD2), respectively. Receiver operating characteristic curve analysis showed that these factors exhibited an accuracy of 1 as predictors of PJI. These factors represent potential biomarkers for decisions associated with prosthesis reimplantation based on their ability to return to baseline values following the completion of debridement.ConclusionIL-16, IL-18, and CRELD2 were found to be potential biomarkers for PJI diagnosis, with SF tests outperforming blood tests in accuracy. These factors could be useful for assessing successful debridement based on their ability to return to baseline values following the completion of debridement. Cite this article: M-F. Chen, C-H. Chang, L-Y. Yang, P-H. Hsieh, H-N. Shih, S. W. N. Ueng, Y. Chang. Synovial fluid interleukin-16, interleukin-18, and CRELD2 as novel biomarkers of prosthetic joint infections. Bone Joint Res 2019;8:179–188. DOI: 10.1302/2046-3758.84.BJR-2018-0291.R1.
Two Intellectual Giants of the American Left
Authors: Buhle Paul 
Published: April 2019

Instead of theory, early U.S. radicals excelled in reportage, like John Reed's Ten Days That Shook the World, or fiction, like Upton Sinclair's packing-house shocker The Jungle. To Europeans American thought seemed impermeable to the difficult ideas of Marxism. That changed with the founding of Monthly Review in 1949, which marked a newly realized if not entirely new trend in American Marxist thought.
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