bluuebunny/crossref_metadata_2025_split huggingface dataset:
Soziale Verlusterlebnisse und deren Zusammenhang mit Depressionen im hohen Alter – Ergebnisse der Leipziger Langzeitstudie in der Altenbevölkerung (LEILA 75+)
Authors: Stein Janine , Bär Jonathan , König Hans-Helmut , Angermeyer Matthias , Riedel-Heller Steffi 
Published: May 2018

Zusammenfassung
Ziel der Studie Verlusterlebnisse im Alter können mit einer Vielzahl negativer gesundheitlicher Folgen für Betroffene wie Depressionen einhergehen.
Methodik 706 Personen (75+ Jahre) wurden mit einem strukturierten klinischen Interview befragt.
Ergebnisse Es zeigte sich, dass soziale Verlusterlebnisse signifikant mit Depressionen assoziiert waren.
Schlussfolgerung Die vorliegende Arbeit legt erstmalig für Deutschland umfängliche Ergebnisse zu sozialen Verlusterlebnissen im hohen Alter vor und stellt einen wertvollen Ausgangspunkt für zukünftige Forschungsarbeiten dar.
Wie können psychiatrische Kliniken in Österreich vollständig offen geführt werden?
Authors: Steinert Tilman , Scharfetter Joachim 
Published: May 2018

Zusammenfassung
Anliegen Viele psychiatrische Kliniken in Österreich werden offen geführt. Ein Vergleich einer österreichischen und einer deutschen Klinik sollte die Versorgungsbedingungen untersuchen.
Methode Vergleichende Analyse von Versorgungsdaten.
Ergebnisse Die Personalbesetzung war in Österreich in der Pflege besser, bei Ärzten und Psychologen vergleichbar. Freiheitseinschränkende Zwangsmaßnahmen waren in Österreich in Bezug auf die Gesamtzahl der Aufnahmen häufiger, nicht jedoch bezogen auf die gerichtlich Untergebrachten. Bei polizeilichen Fahndungen ergaben sich keine Unterschiede.
Diskussion Die Ergebnisse liefern keine Belege, dass die Öffnung der Stationen in Österreich in wesentlichem Maß durch andere Zwangsmaßnahmen ermöglicht wird.
Safety and efficacy of self-expanding metal stents for biliary drainage in patients receiving neoadjuvant therapy for pancreatic cancer
Authors: Ballard Darren , Rahman Syed , Ginnebaugh Brian , Khan Abdul , Dua Kulwinder 
Published: May 2018

Abstract
Background and study aims Durable biliary drainage is essential during neoadjuvant therapy (NAT) in patients with pancreatic cancer who present with biliary obstruction. Plastic stents (PS) tend to occlude readily, resulting in delay/interruption of treatment. Our aim was to evaluate the safety and efficacy of self-expanding metal stents (SEMS) for biliary drainage in patients receiving NAT for pancreatic cancer.
Patients and methods From 2009 to 2014, all consecutive patients with resectable pancreatic cancer at one tertiary center had SEMS placed for biliary drainage before NAT was started. Data on biliary drainage efficacy, stent malfunction rates and procedural adverse events were collected.
Results One hundred forty-two consecutive patients with pancreatic cancer (mean age 66 ± 9 SD years; 81 male, 61 female; 67 resectable, 75 borderline resectable) were enrolled. Eight-seven patients (61 %) had prior PS exchanged to SEMS and 55 (39 %) had SEMS placed upfront. Median duration from SEMS placement to the end of NAT/surgery was 111 days (range 44 – 282). During NAT, SEMS malfunction requiring reintervention occurred in 16 patients (11.2 %): tissue ingrowth 11, stent occlusion from food 6, stent migration 3, incomplete expansion 1, “tissue cheese-cutter” effect 1, and cystic duct obstruction 1. On subgroup analysis, no correlation between SEMS malfunction and stage of disease, prior PS, or duration of NAT was found (r2 = 0.05, P = 0.34). Presence of SEMS in situ did not affect pancreaticoduodenectomy.
Conclusion SEMS provide safe, effective and durable biliary drainage during NAT for pancreas cancer. Previously placed PS can be exchanged for SEMS. SEMS do not require removal prior to surgery.Meeting presentations: Digestive Disease Week 2015 and 2017
Einfluss der demografischen Alterung auf die Inanspruchnahme der medizinischen Rehabilitation in Deutschland bis 2040
Authors: Nowossadeck Enno 
Published: May 2018

Zusammenfassung
Hintergrund Der Beitrag untersucht, welchen Einfluss die demografische Alterung auf die künftige Entwicklung der Fallzahlen in der medizinischen Rehabilitation haben wird. Implikationen der Ergebnisse für die Deutsche Rentenversicherung (DRV) und die Gesetzliche Krankenversicherung (GKV) werden diskutiert.
Methodik Es werden 3 Datenbestände herangezogen, die jeweils bestimmte Teilpopulationen der Rehabilitation umfassen, die der DRV, der GKV und die Statistik der Vorsorge- und Rehabilitationseinrichtungen mit mehr als 100 Betten von Destatis. Für jeden dieser Datenbestände erfolgt auf der Basis der 13. koordinierten Bevölkerungsvorausberechnung von Destatis eine Vorausberechnung bis 2040.
Ergebnisse Aufgrund der demografischen Entwicklung werden die Fallzahlen im Bereich der DRV von 961 Tsd. (2015) auf 911 Tsd. im Jahr 2040 sinken (− 5,2%). Für die GKV ergibt sich ein Anstieg von 742 Tsd. (2015) auf 934 Tsd. 2040 (+25,9%). Demografisch bedingt wird die Zahl Älterer in der Rehabilitation (65 Jahre und älter) bis 2040 um ca. ein Drittel steigen.
Schlussfolgerungen Der zu erwartende Anstieg der Älteren in der Rehabilitation betrifft v. a. die GKV. Die damit verbundenen Probleme lauten: Anreizprobleme in der Finanzierung sowie wachsende Bedeutung der Multimorbidität und der geriatrischen Rehabilitation. Für die Rehabilitation im Erwerbsalter ergibt sich ein zunehmendes Auseinanderdriften der demografisch bedingten Entwicklung der Fallzahlen und der Demografie-Komponente des Reha-Budgets der DRV.
Behandlungsverläufe und Nachhaltigkeit der Ambulanten Geriatrischen Komplexbehandlung – eine Analyse von 128 geriatrischen Patienten
Authors: Kiel Simone , Gerhardt Susanne , Meinhold Sabine , Meinhold Andreas , Schmidt Carsten , Chenot Jean-François 
Published: May 2018

Zusammenfassung
Ziel der Studie Die Beobachtungsstudie untersucht den Verlauf klinischer Endpunkte von multimorbiden geriatrischen Patienten, die an einer 4-wöchigen Ambulanten Geriatrischen Komplexbehandlung (AGKB) teilgenommen haben.
Methodik Die Analysen basierten auf Daten von 128 Patienten. Tests des geriatrischen Basisassessments und die EQ5D-Skala wurden vor, unmittelbar nach sowie 6 und 12 Monate nach der AGKB eingesetzt. Analysen erfolgten mittels Multilevel Mixed-Effekt-Regressions Modellen.
Ergebnisse Die AGKB verbesserte die Selbstständigkeit, die Mobilität, das Gleichgewicht, das Sturzrisiko und den allgemeinen Gesundheitszustand. Die kognitive Leistung nahm geringfügig ab.
Schlussfolgerung Die patientenbezogenen klinischen Endpunkte geben Hinweise auf einen positiven Einfluss funktioneller Defizite.
Anti-Diabetic Potential of Murraya Koenigii (L.) and its Antioxidant Capacity in Nicotinamide-Streptozotocin Induced Diabetic Rats
Authors: Husna Fauzul , Suyatna Franciscus , Arozal Wawaimuli , Poerwaningsih Erni 
Published: May 2018

Abstract
Aim and Objective The present study aims to investigate whether the antihyperglycemic effect of Murraya koenigii is mediated by antioxidant properties and insulin mimetic effect.
Methods Thirty Spraque-Dawley rats were induced hyperglycemia by streptozotocin and nicotinamide (STZ-NA). The STZ-NA diabetic rats were treated with an ethanolic extract of Murraya koenigii 200 mg/kg b.w and 400 mg/kg b.w. One group was treated with glibenclamide (1 mg/kg b.w). After the administration of Murraya koenigii extract and glibenclamide for four weeks, the rats were sacrificed. Blood and organ samples were collected under a fasting condition. The body weight and blood glucose levels were measured. Hepatic enzymes were determined using a commercial kit, protein levels were estimated by Bradford’s method, and plasma insulin was assayed by an ELISA kit. Malondialdehyde (MDA) and reduced glutathione (GSH) levels were estimated by the TBA-Wills method and Ellman’s method, respectively.
Results Ethanolic extract of Murraya koenigii showed a significant reduction in blood glucose level at both doses, 200 and 400 mg/kg b.w. In addition, Murraya koenigii exhibited a profound antioxidant effect with decreased MDA level and increased GSH level, particularly at the 200 mg/kg b.w. and significantly decreased the HOMA-IR index.
Conclusions The present study reveals that Murraya koenigii possesses antidiabetic activity and antioxidant effects on STZ-NA induced diabetes mellitus.
Multiple Causes of Pediatric Early Onset Chorea—Clinical and Genetic Approach
Authors: Lerman-Sagie Tally , Westenberger Ana , Ben-Pazi Hilla , Zerem Ayelet , Yosovich Keren , Lev Dorit , Blumkin Lubov 
Published: May 2018

Objective This article elucidates a clinical and genetic approach to pediatric early-onset chorea in patients with normal neuroimaging.
Methods We retrospectively studied patients with onset hyperkinetic movement disorders. Only children with onset of chorea in the first 3 years of life were included, those with an abnormal magnetic resonance imaging (MRI) or electroencephalogram (EEG) were excluded.We studied the movement disorder phenotype by clinical examination and by interpretation of videos and compared our data to the literature.
Results Four patients, aged 2 to 13 years, were diagnosed. Abnormal involuntary movements appeared between the ages of 6 months to 3 years in association with developmental delay. One patient has a close relative with NKX2.1-related chorea. One patient is from Iraqi-Jewish origin. Facial twitches and nocturnal dyskinetic attacks were observed in one.The unique clinical presentation and family history enabled genetic diagnosis by molecular analysis of a specific mutation in two (NKX2.1, OPA3) and Sanger sequencing of a target gene in one (ADCY5). One patient was diagnosed by whole-exome sequencing (WES) (GNAO1).
Conclusion By carefully recording the phenotype and genetic background, a single gene can be suspected in some cases. In the rest, we suggest multigene panels or WES study.
Giant Cell Tumor of the Lateral Skull Base: Diagnostic and Management Options
Authors: Gamboa Nicholas , Ronna Brenden , Gamboa Christina , Palmer Cheryl , Park Min , Gurgel Richard , Couldwell William , Kalani M. 
Published: May 2018

AbstractGiant cell tumor of bone (GCTB) is a rare, benign, osteolytic neoplasm that most commonly occurs in early adulthood and often involves the long bones of the body. Although GCTB largely affects the epiphyses of long bones, several reports of GCTB involvement of the cranial and facial bones exist in the literature. In addition to reviewing other reported cases of GCTBs of the lateral skull base in the literature, the authors report here on the clinical presentation, radiographic findings, and neurosurgical management of a patient found to have a GCTB of the middle and infratemporal fossae, which was treated by aggressive en bloc resection of the lateral skull base.
Ophthalmology Residents' Internship Selection and Initial Trainee Confidence: An Observational Study
Authors: Logothetis Hercules , Pyatetsky Dmitry , Baqai Jeanine , Volpe Nicholas 
Published: May 2018

Purpose In this study, we set out to better understand the factors that influenced current ophthalmology residents' internship selection. We then tested the hypothesis that certain clinical or research experiences in medical school and internship may influence residents' confidence upon entering ophthalmology residency. Furthermore, we investigated whether completing internship at the same program as one's residency is correlated with confidence at the start of residency.
Design Observational, cross-sectional, multicenter survey.
Participants U.S. ophthalmology residents (Post Graduate Year 2/3) belonging to the class of 2018. Eighty surveys were submitted of which 63 were analyzed based on established inclusion criteria.
Methods Residents responded to a 22-question online survey addressing how residents chose their internship, internship curriculum, exposure to ophthalmology in medical school and during internship, confidence level entering ophthalmology residency, confidence in managing various ocular pathologies, and factors that built confidence prior to ophthalmology residency. A Likert scale format was used for the majority of survey questions. Kruskal–Wallis testing and Fisher's exact testing were used to compare outcome variables among three groups defined by sense of confidence entering ophthalmology training.
Main Outcome Measures Level of confidence at the start of ophthalmology residency.
Results Quality of life and geographic location were found to be the most important factors in choosing internship programs, while obtaining ophthalmology skills was least. Although 32.3% of residents either agreed or strongly agreed that they felt confident at the start of ophthalmology residency, 42.9% disagreed or strongly disagreed. Residents who felt most confident for ophthalmology training spent more time on ophthalmology rotations in medical school (p = 0.05) or internship (p = 0.02) and worked up patients independently during their internship ophthalmology rotation (s) (0.01). Completing one's internship at the same institution as one's ophthalmology residency did not correlate with confidence entering residency.
Conclusions Residents chose internships based on quality-of-life factors rather than enhancing ophthalmology training. Residents who felt confident at the start of ophthalmology residency had more hands on clinical ophthalmology experience than residents who did not feel confident. No statistically significant correlation was found between completion of internship at the same institution as one's ophthalmology residency and confidence entering residency.
Variants in the ATP1A3 Gene Mutations within Severe Apnea Starting in Early Infancy: An Observational Study of Two Cases with a Possible Relation to Epileptic Activity
Authors: Holze Niklas , Baalen Andreas , Stephani Ulrich , Helbig Ingo , Muhle Hiltrud 
Published: May 2018

AbstractMutations in the ATP1A3 gene are known to cause alternating hemiplegia of childhood (AHC) and rapid-onset dystonia parkinsonism (RDP). Both conditions are childhood-onset neurological disorders with distinct symptoms and different times of onset. ATP1A3 has also been associated with CAPOS syndrome (cerebellar ataxia, areflexia, pes cavus, optic atrophy, and sensorineural hearing loss). Within the various ATP1A3-related neurological syndromes, a specific genotype–phenotype correlation is starting to emerge. Several mutations such as the relatively common p.E815K pathogenic variant have been shown to strongly correlate with AHC, while others may cause both AHC and RDP. A significant subset of patients with AHC and RDP are reported to have epileptic seizures. Even though detailed clinical descriptions of seizures in childhood are rare, seizures involving apneic events seem to be frequent in ATP1A3-related neurological disorders. Here, we describe two children with unexplained severe apnea beginning around the first year of life and pathogenic variants in ATP1A3. We hypothesize that the symptoms are early-onset autonomic seizures related to the underlying pathogenic ATP1A3 variants.
Growth Hormone Deficiency in Congenital Toxoplasmosis
Authors: Natsheh Juma , Abu-Libdeh Bassam , Abu-Libdeh Abdulsalam 
Published: May 2018

AbstractCongenital toxoplasmosis represents the second most commonly recognized congenital infection. Ocular and neurological abnormalities are considered the most frequent sequelae. Endocrinological manifestations are rare and have received little attention. We report a 3.5-month-old female infant who presented with failure to thrive and recurrent hypoglycemic attacks, diagnosed as growth hormone deficiency due to sequelae of congenital toxoplasmosis. Although endocrinological sequelae of congenital toxoplasmosis are uncommon, they represent potentially treatable conditions. Here, we stress on the importance of monitoring pituitary function and growth in children in particular, with congenital toxoplasmosis, keeping in mind other possible, potentially treatable, endocrinological manifestations.
Statin Induced Dysuria- A Case Report
Authors: Soanker Radhika , Jyothi Arun , ram Sita 
Published: May 2018

AbstractStatins are a class of hypolipidemic drugs, that are primarily used for the treatment of dyslipidemia and the prevention of cardiovascular disease. ATP III guidelines, 2002, recommends that LDL cholesterol be the primary target of therapy, and lipid lowering therapy may be initiated based on evaluation of short term and long term cardiovascular risk(1). We are report a case of dysuria follow statin group of drugs, which is not enlisted in the side effect of these drugs. In the present case after re-challenge with similar group of drug patient again developed the symptoms. Underlying hyperlipidemia was effectively controlled with Fenofibrates.
Does Ratio of Width to Length of Left Atrial Appendage Determine the Occurrence of Cerebrovascular Stroke Event in Both Genders?
Authors: Harish Oruganti , Srinivas Mantha ,   Jabeen
Published: May 2018

AbstractObjective : To see the Left atrial appendage size (width and length) in ischemic cerebrovascular accident (CVA) patients.Design and method: Transesophageal echocardiography (TEE) was done in ischemic CVA patients after initial stabilization. We compared width length ratio(WLR) calculated from the average of width and length of LAA observed in earlier study by John P et al as controls. We chose this autopsy study as controls, as it is not possible to have TEE data in normal subjects.Results : Study group includes 143 patients (F:M::37:106) and control group was 400 subjects (F:M::200:200) from the previous study. The mean ± std of width and length of LAA in females and males in study group were 1.99±0.67, 2.397±0.58 and 2.19±0.73, 2.49±0.66 respectively. In females, WLR is more (0.83 ± 0.37) in study group than in control group (0.66±0.26) which is statistically significant (z=4.06, P < 0.000001). So also for males (study group: control group :: 0.88 ±0.39 : 0.71±0.28) which is also statistically significant (z=7.03, P < 0.000001). So, broad and short LAA could determine the formation and dislodgement of thrombus resulting in embolic stroke in both sexes.In conclusion, higher the width length ratio of left atrial appendage greater chances of embolic stoke.
Gender Difference in Risk Factor Profiles in Patients Referred for Coronary Angiogram
Authors: Deepti Gali , Kiran Ravi , Bharathi Vanaparthi 
Published: May 2018

AbstractBackground & ObjectiveCoronary artery disease (CAD) is a leading cause of death of women and men worldwide. Expected burden of athero-thrombotic CAD in India will surpass other regions of the world by the year 2020. It is better to control the risk factors for CAD to prevent this crisis. So, we want to study the gender difference in risk factor profiles in patients referred for coronary angiogram (CAG).Materials & MethodsWe did is a prospective observational study for risk factors profile in patients referred for CAG over 24 months (2013 to 2015) to the Nizam's institute of medical sciences. We collected the demographic, clinical and lab parameters including CAG finding in these patients.ResultsWe analyzed the data of 3232 patients who undergone CAG during the study period. F: M::1081: 2151. 706 (65.3%) of female patients and 1312 (60.9%) of males patients had hypertension (HTN). 496 (45.9%) of females and 950 (44.1%) of males had Diabetes mellitus (DM). More males were presented with ACS (Acute coronary syndrome) whereas more females were presented with CSA (chronic stable angina). 203 (18.8%) female patients and 673 (31.3%) had lv dysfunction. Serum creatinine and Hemoglobin was low in females than males which were statistically significant. Total cholesterol was significantly higher in female CAD patients than male CAD patients (p=0.03). Both atherogenic (LDL) and protective (HDL) cholesterol were more in females than males with normal coronaries, but this difference was seen in patients with CAD in both sexes.543 females and 551 males had normal coronaries. Overall prevalence of normal coronaries is more in females (p=0.00). Prevalence of diabetes showed a tendency more in females with normal coronaries than with males (p=0.063). Overall prevalence of risk factors in patients with normal coronaries is more in females compared to males (p=0.03). 782 (48.87%) males and 301(55.94%) females with CAD had diabetes. Prevalence of HTN (p=0.00) and DM (p=0.005) is more in females with CAD than males (p=0.00). Both DM & HTN was present in 647 (40.43%) of males and 273 (50.74%) of females, which is also is statistically significant.ConclusionOverall prevalence of normal coronaries is significantly more in females than males (p=0.00). Incidence of ACS is significantly more in males whereas CSA incidence more in females. Even though statistically significant more prevalence HTN in females, there was no statistical significant difference in prevalence of DM & HTN in between both sexes in patients with normal coronaries. But there was significantly high prevalence of DM & HTN in females with CAD compared to males.
Role of Tissue Doppler Echocardiography in the Diagnosis of Early Left Ventricular Dysfunction in Rheumatoid Arthritis
Authors: Arigondam Ashok , Prasad Vara , Rajasekhar Liza 
Published: May 2018

AbstractObjective: Rheumatoid arthritis (RA) is a systemic disease involving many organ systems and is frequently accompanied by cardiac alterations. The purpose of our study is the usefulness of Tissue Doppler echocardiography to detect the nature and extent of cardiac involvement in RA patients with no symptoms of cardiac disease, in comparison with a control sample.Methods: We selected 21 patients affected by rheumatoid arthritis. No patient had any symptoms of cardiac disease. As a control group we studied 21 volunteers, randomly selected among a larger group of subjects who had come for routine check-up. All were in sinus rhythm and without any cardiac symptom. Standard two-dimensional, M-mode and Doppler echocardiographic examination was carried out on each subject.Results: out of 21 RA patients, 16 females 5 males with an average age of 38±9 years. Both the study group and control were matched with respect to age and sex. In RA patients we found a higher prevalence of several tissue Doppler parameters abnormalities. Patients with RA showed significantly higher tricuspid annular plane systolic ejection (TAPSE) 2.49±0.19 vs. 2.36±0.22 (p= 0.04), isovolumetric contraction time (IVCT) 48.8±11.7 vs. 41.2±7.7 msec, (p=0.02), isovolumetric velocity (IVV) 12.26±2.23 vs. 15.71±1.89 m/sec ( p = 0.00) acceleration time (AT) 0.43±0.05 vs. 0.35+0.05 msec (p = 0.00) lower isovolumetric acceleration (IVA) 28.68±6.57 vs. 45.8±10.1 m/sec2 (p = 0.00) early diastolic velocity (E)′ 10.48±1.99 vs. 13.02±1.54 cm/sec (p = 0.00). No significant difference was noted with IVRT (isovolumetric relaxation time) and A′ (late diastolic velocity). Duration of RA did not affect the significance of these parameters.Conclusion: There was subclinical LV systolic and diastolic dysfunction with normal EF, detected by tissue Doppler imaging in Rheumatoid arthritis patients.