bluuebunny/crossref_metadata_2025_split huggingface dataset:
Choosing between ticagrelor and clopidogrel following percutaneous coronary intervention
Authors: Guan Wenjun , Lu Hongtao , Yang Keping 
Published: October 2018

Abstract

Background:
Limitations have been observed with the use of clopidogrel following percutaneous coronary intervention (PCI) indicating the urgent need of a more potent anti-platelet agent. We aimed to compare the efficacy and safety of ticagrelor versus clopidogrel following PCI.

Methods:
Online databases were searched for relevant studies (published between the years 2007 and 2017) comparing ticagrelor versus clopidogrel following coronary stenting. Primary outcomes assessed efficacy whereas secondary outcomes assessed safety. Odds ratios (OR) with 95% confidence intervals (CIs) based on a random effect model were calculated and the analysis was carried out by the RevMan 5.3 software.

Results:
A total number of 25,632 patients with acute coronary syndrome (ACS) [12,992 patients with ST segment elevation myocardial infarction (STEMI) and 14,215 patients with non-ST segment elevation myocardial infarction (NSTEMI)] were included in this analysis, of whom 23,714 patients were revascularized by PCI. Results of this analysis did not show any significant difference in all-cause mortality, major adverse cardiac events (MACEs), myocardial infarction, stroke and stent thrombosis observed between ticagrelor and clopidogrel with (OR: 0.83, 95% CI: 0.67–1.03; P = .09), (OR: 0.64, 95% CI: 0.41–1.01; P = .06), (OR: 0.77, 95% CI: 0.57–1.03; P = .08), (OR: 0.85, 95% CI: 0.57–1.26; P = .42) and (OR: 0.70, 95% CI: 0.47–1.05; P =.09).
However, ticagrelor was associated with a significantly higher minor and major bleeding with (OR: 1.57, 95% CI: 1.30–1.89; P = .00001) and (OR: 1.52, 95% CI: 1.01–2.29; P = 0.04) respectively. Dyspnea was also significantly higher in the ticagrelor group (OR: 2.64, 95% CI: 1.87–3.72; P = .00001).

Conclusion:
Ticagrelor and clopidogrel were comparable in terms of efficacy in these patients with ACS. However, the safety outcomes of ticagrelor should further be investigated.
Patterns of nystagmus conversion in sudden sensorineural hearing loss with vertigo
Authors: Kim Chang-Hee , Choi Hye Rang , Choi Seongjun , Lee Yong Sik , Shin Jung Eun 
Published: October 2018

Abstract
The patients with sudden sensorineural hearing loss (SSNHL) may complain of vertigo. Although there have been many reports on SSNHL with vertigo (SSNHL_V), changes in the pattern of nystagmus have not been studied as yet. This study is a retrospective study and aims to investigate the characteristic changes in type of nystagmus and clinical features in patients with SSNHL_V who experienced a change in their nystagmus pattern during follow-up. Among 50 patients with SSNHL_V between January 2012 and December 2015, we identified 15 patients with SSNHL_V whose pattern of nystagmus changed. Initial nystagmus was classified into 5 subgroups: paretic type, irritative type, persistent geotropic direction-changing positional nystagmus (PG-DCPN), persistent apogeotropic direction-changing positional nystagmus (PA-DCPN), and posterior semicircular canal benign paroxysmal positional vertigo. The most common pattern of initial nystagmus was PG-DCPN (n = 7). The change of initial nystagmus pattern occurred on day 2 to 75 from symptom onset, and 2 (of 15) patients showed further conversion. The most common pattern of final nystagmus was PA-DCPN (n = 9). Hearing improvement after treatment was not significantly different (P = .59) between SSNHL_V patients with nystagmus change (25 ± 17 dB, n = 15) and those without nystagmus change (28 ± 18 dB, n = 35). In conclusion, clinician's attention is required in evaluating the vertigo symptom in patients with SSNHL_V because the initial patterns of nystagmus can be converted to another type of nystagmus. The presence of nystagmus change during follow-up may not be a prognosticator for hearing recovery in patients with SSNHL_V.
Pulmonary infection caused by Nocardia cyriacigeorgica in a patient with allergic bronchopulmonary aspergillosis
Authors: Wu Jianyong , Wu Yingping , Zhu Zhiqiang 
Published: October 2018

Abstract

Rationale:

Nocardia species is known as conditional pathogenic bacteria. Among Nocardia species, pulmonary infection caused by Nocardia cyriacigeorgica associated with Aspergillus fumigatus complex lung disease is rarely reported.

Patient concerns:
A 55-year-old female with a history of productive cough with recurrent expectoration for 20 years presented with increasing cough for 12 months. The patient presented complaining of respiratory symptoms including increasing cough with yellow phlegm, poor appetite, and generalized fatigue for a week prior to admission.

Diagnoses:

Nocardia cyriacigeorgica pneumonia was identified by matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) and 16S rRNA gene sequencing.

Interventions:
Combined treatments (trimethoprim-sulfamethoxazole and meropenem) were administered after identification of N cyriacigeorgica.

Outcomes:
The respiratory symptoms of the patient had improved both clinically and radiologically after 4 weeks of antibacterial therapy.

Lessons:
Early precise diagnosis and prompt combined therapy are of vital importance in severe Nocardia pulmonary infection.
Frequency distribution and risk factors of hepatitis B virus and hepatitis C virus infections among thalassemia patients: a regional study
Authors: Shah Tariq , Hussain Wajid , Ali Niyaz , Sardar Sadia , Ishaq Muhammad , Ur Rahman Mujaddad , Ding Luming , Qayyum Sadia , Khan Ibrar 
Published: October 2018

Background
Thalassemia is a group of inherited hematological disorders caused by mutation in globin’s genes. Regular blood transfusion lengthens the life of thalassemia patients but it carries a definite risk of the infections of blood-borne diseases.

Aim/Objective
The current study was carried out for the frequency distributions and risk factors of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections among thalassemia patients in Hazara regions, Pakistan.

Methods
A total of 324 enrolled thalassemia major patients were diagnosed in five different centers of Hazara regions. The study participants were screened for HBV and HCV using the immunochromatographic techniques test and real-time PCR for immunochromatographic technique-positive specimens.

Results
Out of the 324 major thalassemia patients, 24 (7.41%) were diagnosed with HBV and HCV infections. In total, 206 were male patients and the rate of HBV and HCV infections was 0.97% (two patients) and 3.88% (eight patients), respectively. Similarly, 118 were female patients and the rate of HBV-positive patients was 3.39% (four patients) and HCV was 8.47% (10 patients). The results also showed that 50% of HBV and HCV infections were found in the age group of 26–30 years, while 1.81% was found in the age group of 11–15 years. The positive HBV and HCV samples were also verified with the band size of 242 and 227 bp, respectively.

Conclusion
Thus, to reduce the incidence of HBV and HCV in thalassemia patients, we must call for critical look on the transfusion practices as well as adoption of stricter donor selection.
Are All Breast‐fed Infants Equal? Clustering Metabolomics Data to Identify Predictive Risk Clusters for Childhood Obesity
Authors: Kirchberg Franca Fabiana , Grote Veit , Gruszfeld Dariusz , Socha Piotr , Closa‐Monasterolo Ricardo , Escribano Joaquin , Verduci Elvira , Mariani Benedetta , Langhendries Jean‐Paul , Poncelet Pascale , Koletzko Berthold , Hellmuth Christian ,   European Childhood Obesity Trial Study Group
Published: October 2018

ABSTRACTObjectives:Fetal and early life represent a period of developmental plasticity during which metabolic pathways are modified by environmental and nutritional cues. Little is known on the pathways underlying this multifactorial complex. We explored whether 6 months old breast‐fed infants could be clustered into metabolically similar groups and that those metabotypes could be used to predict later obesity risk.Methods:Plasma samples were obtained from 183 breast‐fed infants aged 6 months participating in the European multicenter Childhood Obesity Project study. We measured amino acids along with polar lipid concentrations (acylcarnitines, lysophosphatidylcholines, phosphatidylcholines, sphingomyelins). We determined the metabotypes using a Bayesian agglomerative clustering method and investigated the properties of these clusters with respect to clinical, programming, and metabolic factors up to 6 years of age.Results:We identified 20 metabolite clusters comprising 1 to 39 children. Phosphatidylcholines predominantly influenced the clustering process. In the largest clusters (n ≥ 14), large differences existed for birth length (unadjusted P < 0.0001) and length and weight at 6 months (unadjusted P < 0.0001 and P = 0.012, respectively). Infants tended to cluster together by country (unadjusted P < 0.001). The body mass index (BMI) z score at 6 years of age tended to differ (unadjusted P = 0.07).Conclusions:Our exploratory study provided evidence that breast‐fed infants are not metabolically homogeneous and that variation in metabolic profiles among infants may provide insight into later development and health. This work highlights the potential of metabotypes for identifying inter‐individual differences that may form the basis for developing personalized early preventive strategies.
Insulinoma-associated Protein 1 (INSM1) in Thoracic Tumors is Less Sensitive but More Specific Compared With Synaptophysin, Chromogranin A, and CD56
Authors: Kriegsmann Katharina , Zgorzelski Christiane , Kazdal Daniel , Cremer Martin , Muley Thomas , Winter Hauke , Longuespée Rémi , Kriegsmann Jörg , Warth Arne , Kriegsmann Mark 
Published: October 2018

Objective:
Recognition of neuroendocrine differentiation is important for tumor classification and treatment stratification. To detect and confirm neuroendocrine differentiation, a combination of morphology and immunohistochemistry is often required. In this regard, synaptophysin, chromogranin A, and CD56 are established immunohistochemical markers. Insulinoma-associated protein 1 (INSM1) has been suggested as a novel stand-alone marker with the potential to replace the current standard panel. In this study, we compared the sensitivity and specificity of INSM1 and established markers.

Materials and Methods:
A cohort of 493 lung tumors including 112 typical, 39 atypical carcinoids, 77 large cell neuroendocrine carcinomas, 144 small cell lung cancers, 30 thoracic paragangliomas, 47 adenocarcinomas, and 44 squamous cell carcinomas were selected and tissue microarrays were constructed. Synaptophysin, chromogranin A, CD56, and INSM1 were stained on all cases and evaluated manually as well as with an analysis software. Positivity was defined as ≥1% stained tumor cells in at least 1 of 2 cores per patient.

Results:
INSM1 was positive in 305 of 402 tumors with expected neuroendocrine differentiation (typical and atypical carcinoids, large cell neuroendocrine carcinomas, small cell lung cancers, and paraganglioma; sensitivity: 76%). INSM1 was negative in all but 1 of 91 analyzed non-neuroendocrine tumors (adenocarcinomas, squamous cell carcinomas; specificity: 99%). All conventional markers, as well as their combination, had a higher sensitivity (97%) and a lower specificity (78%) for neuroendocrine differentiation compared with INSM1.

Conclusions:
Although INSM1 might be a meaningful adjunct in the differential diagnosis of neuroendocrine neoplasias, a general uncritical vote for replacing the traditional markers by INSM1 may not be justified.
Diagnostic Approach to Traumatic Axonal Injury of the Optic Radiation in Mild Traumatic Brain Injury
Authors: Jang Sung Ho , Lee Han Do 
Published: October 2018

Abstract
We describe a diffusion tensor tractography–based diagnostic approach to traumatic axonal injury of the optic radiation in a patient who showed visual field defect after mild traumatic brain injury. A 43-yr-old female patient experienced head trauma during a motor vehicle accident. After the head trauma, she noticed visual disturbance. Peripheral field defects were detected in both eyes on the Humphrey visual field test. After diffusion tensor tractography–based reconstruction of the optic radiation, We determined the fractional anisotropy and fiber number of each whole optic radiation. Four regions of interest were placed on the optic radiations based on diffusion tensor tractography configuration. The right optic radiation showed narrowing, and the left optic radiation revealed partial tearing in the posterior portion. The fiber number of the right optic radiation was more than two standard deviations lower than the control mean. The fractional anisotropy values of the regions of interest 2 (the narrowed area of the right optic radiation) and regions of interest 3 (the partially torn area of the left optic radiation) were more than two standard deviations lower than the control mean. Our results suggest that analysis of the configuration and parameters of the optic radiation based on three-dimensionally reconstructed diffusion tensor tractography results is a useful technique in the detection of traumatic axonal injury of the optic radiation in individual patients with mild traumatic brain injury.
Reverse Anterolateral Thigh Flap for Complex Scalp Reconstruction
Authors: Spitz Jamie A. , Payne Rachael M. , Ellis Marco F. 
Published: October 2018

Abstract
It is common for patients diagnosed with severe traumatic brain injury or intracranial tumors to undergo multiple craniotomy and cranioplasty procedures. In the setting of infection, these patients can develop scalp wounds with no local options. A reverse flow anterolateral thigh (ALT) flap for coverage of a complex multifocal scalp wound in a patient with exposed cranioplasty mesh and multiple prior operations without necessitating vein grafts was presented. This might be the first reverse flow free ALT flap to be reported in head and neck reconstruction.
Innovations and Contributions to Craniofacial Surgery in Japan
Authors: Fujino Toyomi 
Published: October 2018

Abstract
I look back at my decades in the field of plastic and reconstructive and craniofacial surgery, knowing I was the driving force behind its inception in Japan. However, behind me in turn, supporting me, teaching me, and encouraging me during my formative plastic surgery years in the United States and Europe have been many of the true giants in this field, and I will always accord them my total respect and deepest gratitude. Without their knowledge and technique, which they selflessly taught me and my peers, I would certainly never have been able to accomplish so much in the field of plastic and reconstructive surgery, and in particular, craniofacial surgery.
Parent Cognitive Satisfaction and Demand Research of Neonatal Hearing Screening
Authors: Chen Qia-Xin , Liu Yi , Huang Ping-Ting , Deng Meng-Xia , Zhang Xin-Li , Mai Fei , Zhang Tao 
Published: October 2018

Abstract
The primary aim of the present study was to investigate parent cognitive satisfaction and demand by using a valid and reliable questionnaire developed for this purpose (Parent Cognitive Satisfaction and Demand Questionnaire with Neonatal Hearing Screening Program, PCSDQ-NHSP). About 1000 parents whose children received hearing screening participated in this study. The satisfaction questionnaire was found to be a useful instrument for identifying service shortfalls, and the routine use of the PCSDQ-NHSP in other neonatal hearing screening programs is recommended. Overall, parents focused their attention to the neonatal hearing screening results and had high levels of expectations. They also longed for more information about relevant knowledge. Screening ability differed in different areas of Guangdong province where grass-roots hospitals had poor ability to perform this well. More preappointment information leaflets or brochures should be sent to parents. Regular training for neonatal hearing screening test is needed in primary hospitals. We can establish a neonatal hearing screening network to link as many hospitals as possible, and develop a standardized neonatal hearing screening system.
The incidence and associations of acute kidney injury in trauma patients admitted to critical care: A systematic review and meta-analysis
Authors: Haines Ryan W. , Fowler Alex J. , Kirwan Christopher J. , Prowle John R. 
Published: October 2018

BACKGROUND
As more patients are surviving the initial effects of traumatic injury clinicians are faced with managing the systemic complications of severe tissue injury. Of these, acute kidney injury (AKI) may be a sentinel complication contributing to adverse outcomes.

OBJECTIVE
To establish the incidence of AKI in patients admitted to critical care after major trauma, to explore any risk factors and to evaluate the association of AKI with outcomes.

DATA SOURCES
Systematic search of MEDLINE, Excerpta Medica database and Cochrane library from January 2004 to April 2018.

STUDY SELECTION
Studies of adult major trauma patients admitted to critical care that applied consensus AKI criteria (risk injury failure loss end stage [RIFLE], AKI network, or kidney disease improving global outcomes) and reported clinical outcomes were assessed (PROSPERO Registration: CRD42017056781). Of the 35 full-text articles selected from the screening, 17 (48.6%) studies were included.

DATA EXTRACTION AND SYNTHESIS
We followed the PRISMA guidelines and study quality was assessed using the Newcastle-Ottawa score. The pooled incidence of AKI and relative risk of death were estimated using random-effects models.

MAIN OUTCOMES AND MEASURES
Incidence of AKI was the primary outcome. The secondary outcome was study-defined mortality.

RESULTS
We included 17 articles describing AKI outcomes in 24,267 trauma patients. The pooled incidence of AKI was 20.4% (95% confidence interval [CI], 16.5–24.9). Twelve studies reported the breakdown of stages of AKI with 55.7% of patients classified as RIFLE-R or stage 1, 30.3% as RIFLE-I or stage 2, and 14.0% as RIFLE-F or stage 3. The pooled relative risk of death with AKI compared was 3.6 (95% CI, 2.4–5.3). In addition, there was a concordant increase in odds of death among six studies that adjusted for multiple variables (adjusted odds ratio, 2.7; 95% CI, 1.9–3.8; p = <0.01).

CONCLUSION
Acute kidney injury is common after major trauma and associated with increased mortality. Future research is warranted to reduce the potential for harm associated with this subtype of AKI.

LEVEL OF EVIDENCE
Systematic review and meta-analysis, level III.
Optimal timing of delayed excretory phase computed tomography scan for diagnosis of urinary extravasation after high-grade renal trauma
Authors: Keihani Sorena , Putbrese Bryn E. , Rogers Douglas M. , Patel Darshan P. , Stoddard Gregory J. , Hotaling James M. , Nirula Raminder , Luo-Owen Xian , Mukherjee Kaushik , Morris Bradley J. , Majercik Sarah , Piotrowski Joshua , Dodgion Christopher M. , Schwartz Ian , Elliott Sean P. , DeSoucy Erik S. , Zakaluzny Scott , Sherwood Brenton G. , Erickson Bradley A. , Baradaran Nima , Breyer Benjamin N. , Fick Cameron N. , Smith Brian P. , Okafor Barbara U. , Askari Reza , Miller Brandi , Santucci Richard A. , Carrick Matthew M. , Kocik Jurek F. , Hewitt Timothy , Burks Frank N. , Heilbrun Marta E. , Myers Jeremy B. 
Published: October 2018

BACKGROUND
Excretory phase computed tomography (CT) scan is used for diagnosis of renal collecting system injuries and accurate grading of high-grade renal trauma. However, optimal timing of the excretory phase is not well established. We hypothesized that there is an association between excretory phase timing and diagnosis of urinary extravasation and aimed to identify the optimal excretory phase timing for diagnosis of urinary extravasation.

METHODS
The Genito-Urinary Trauma Study collected data on high-grade renal trauma (grades III-V) from 14 Level I trauma centers between 2014 and 2017. The time between portal venous and excretory phases at initial CT scans was recorded. Poisson regression was used to measure the association between excretory phase timing and diagnosis of urinary extravasation. Predictive receiver operating characteristic analysis was used to identify a cutoff point optimizing detection of urinary extravasation.

RESULTS
Overall, 326 patients were included; 245 (75%) had excretory phase CT scans for review either initially (n = 212) or only at their follow-up (n = 33). At initial CT with excretory phase, 46 (22%) of 212 patients were diagnosed with urinary extravasation. Median time between portal venous and excretory phases was 4 minutes (interquartile range, 4–7 minutes). Time of initial excretory phase was significantly greater in those diagnosed with urinary extravasation. Increased time to excretory phase was positively associated with finding urinary extravasation at the initial CT scan after controlling for multiple factors (risk ratio per minute, 1.15; 95% confidence interval, 1.09–1.22; p < 0.001). The optimal delay for detection of urinary extravasation was 9 minutes.

CONCLUSION
Timing of the excretory phase is a significant factor in accurate diagnosis of renal collecting system injury. A 9-minute delay between the early and excretory phases optimized detection of urinary extravasation.

LEVEL OF EVIDENCE
Diagnostic tests/criteria study, level III.
Targeting endogenous retrovirus gene transcription in human cancers
Authors: Lin Audrey T. , Santander Cindy G. , Marchi Emanuele , Karamitros Timokratis , Katzourakis Aris , Magiorkinis Gkikas 
Published: October 2018

AbstractEndogenous retroviruses (ERVs) are remnants of ancient retroviral infections that make up to 8% of the human genome. Although these elements are mostly fragmented and inactive, many proviruses belonging to the HERV-K (HML-2) family, the only lineage still proliferating in the genome after the human-chimpanzee split, have intact open reading frames, some encoding for accessory genes callednp9andrecthat interact with oncogenic pathways. Many studies have established that the transient expression of ERVs are in both stem cells and cancers results in aberrant self-renewal and uncontrolled proliferation.The wealth of high-quality genomic and transcriptomic Illumina sequence data available from The Cancer Genome Atlas (TCGA) that are sequenced from a diversity of different tumour types makes it a valuable resource in cancer research. However, there is currently no universal computational method for inferring expression of specific repetitive elements from RNA-seq data, such as genes encoded by HERV-K (HML-2).This study presents a novel and a highly specific pipeline that is able to capture and measure transcription ofnp9andrecencoded by proviruses that share great sequence similarity, and are transcribed at very low levels. We show by using our novel methodology thatnp9andrecare overexpressed in breast cancer, germ cell tumours, skin melanoma, lymphoma, ovarian cancer, and prostate cancer compared to non-diseased tissues. We also show thatnp9andrecare specifically expressed in the 8 and 16-cell stage in human preimplantation embryos.