bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lymphocyte Subsets in a Large Cohort of Patients with Systemic Lupus Erythematosus
Authors: Erkeller-Yüksel Feza , Hulstaart Frank , Hannet Irene , Isenberg David , Lydyard Peter 
Published: April 2019

In search of markers of disease activity in patients with SLE we have investigated blood lymphocyte subsets from a large cohort of patient. Seventy-one patients were studied using a well-defined panel of fluorescent monoclonal antibodies which recognize the major T, B and NK lymphocyte subsets and activated cells. Flow cytometry was used with standard automated software. Overall, SLE patients were lymphopenic. The proportion of activated T cells was increased and NK cells were decreased in both proportion and absolute numbers (P < 0.001). This decrease was more pronounced in the more active patients. None of the T cell activation markers was shown to distinguish different degrees of disease activity. However, the percentage of NK cells was significantly reduced in active disease states (P< 0.01). Decreased numbers of NK cells could potentially reduce the resistance of SLE patients to infectious organisms.
Detection of Anti-Phospholipid and Anti-DNA Antibodies and their Idiotypes in Newborns of Mothers with Anti-Phospholipid Syndrome and Sle
Authors: Zurgil N. , Bakimer R. , Tincani A. , Faden D. , Cohen J. , Lorber M. , Valesini G. , Shoenfeld Y. 
Published: April 2019

The titers, isotypes and idiotypes of antiphospholipid and anti-dsDNA antibodies were determined in seven pairs of mothers with antiphospholipid syndrome (APLS) and their offspring, in 11 pairs of SLE mothers and their matched infants and in seven respective pairs of healthy subjects. In addition, maternal as well as fetal sera were evaluated for the presence of anti-SSA (Ro), anti-SSB (La) and anti-70 kd RNP autoantibodies. In the sera from APLS patients, as well as in the sera from their offspring, the mean antibody titer of IgG aCL was found to be significantly higher then the corresponding value in the control group (P < 0.01). Highly significant increased titers of IgG anti-DNA antibodies were found in the sera of SLE mothers and their matched offspring (P < 0.0008). The prevalance of anti-SSA, anti-SSA, and anti-7OKd RNP antibodies was lower then that of antiphospholipid and anti-dsDNA antibodies. Only one of the respective offspring had increased levels of these antibodies. The quantity of maternal antibodies transferd to the fetus was depended on their concentration in the maternal circulation, as well as on their type and specificity. Follow-up of newborn sera showed a progressive decrease in the antiphospholipid antibody titers during 3 months. After 6 months it was undetected. Our results point to a transplacental transfer of aCL and anti-DNA antibodies, a phenomenon which is not necessarily associated with respective clinical manifestations, in contrast to the classical humoral mediated autoimmune diseases (e.g. myasthenia gravis).
Maternal Autoantibodies and Congenital Heart Block: No Evidence for the Existence of a Unique Heart Block-associated Anti-Ro/SS-A Autoantibody Profile
Authors: Meilof J.F. , Frohn-Mulder I.M.E. , Stewart P.A. , Szatmari A. , Hess J. , Veldhoven C.H.A. , Smeenk R.J.T. , Swaak A.J.G. 
Published: April 2019

One of the rare examples of the transfer of autoimmune disease from mother to (unborn) child is the neonatal lupus syndrome. This syndrome comprises the development of fetal heart disease (congenital heart block) or neonatal skin rash and is specifically associated with maternal anti-Ro/SS-A autoantibodies. Previous studies have suggested that especially maternal autoantibody reactivity against the 52 kDa protein of the Ro/SS-A antigen and/or against the La/SS-B antigen is responsible for the development of congenital heart block (CHB). To determine the CHB-associated antibody response in more detail, we analysed the presence of autoantibodies in sera from mothers of children with isolated heart block. All 14 mothers of children with congenital heart block were positive for anti-Ro/SS-A antibodies. Remarkably, their antibody profile, including recognition of different Ro/SS-A proteins and autoantibody levels against these proteins, did not differ from anti-Ro/SS-A positive mothers of healthy children. In contrast, all 8 anti-Ro/SS-A negative mothers had children with acquired heart block. We conclude from our data that maternal anti-Ro/SS-A antibodies are essential for CHB but that fine analysis of this autoantibody response does not predict the occurrence of CHB.
Treatment of primary Sjögren's syndrome with hydroxychloroquine: a retrospective, open-label study
Authors: Fox Ri , Dixon R , Guarrasi V , Krubel S 
Published: April 2019

Objectives To determine whether patients with primary Sjögren's syndrome (SS), diagnosed according to San Diego criteria, had improvement in their laboratory or clinical features during treatment with hydroxychloroquine (6–7 mg/kg/day) for at least two years., Methods: The study population included 50 consecutive patients with primary SS who were diagnosed according to San Diego criteria, and in whom hydroxychloroquine was suggested as treatment. This group included 10 patients who were early dropouts (side effects or desire not to take antimalarial drugs) and 40 patients who received drugs for at least two years (range 24-48 months). In a subset of SS patients, values for ESR (westergren) and quantitative immunoglobulins were available for comparison. Improvement with therapy was defined as: (a) ≥20% improvement in variables of tear flow (Schirmer's test I) or corneal integrity (rose Bengal): (b) ≥20% salivary function (flow rate); and (c) improvement in at least two of the following measures: physicians assessment of global disease activity by ≥ 20%, patient assessment of improvement in pain or fatigue by ≥20%, and ESR improved by ≥20mm/ hr. Results In a retrospective study of SS patients who completed the trial, a significant improvement was noted in ocular symptoms (pain and dryness) in patients (55 and 57%) and improved corneal integrity (rose Bengal straining) in 53% of patients. The Schirmer's test was improved by ≥ 2 mm/5 minutes in 50% in patients. Improvement was noted in oral symptoms (pain and dryness) in patients (57 and 60%) and salivary flow rate was increased in 82% of patients. In a subset of SS patients evaluated, the ESR improved by ≥20mm/hr in 17/32 patients (53%) and quantitative IgG level by ≥20% in 8/13 patients (61%). Physician global assessment of overall patient status and patient assessment of overall status indicated improvement in over 62% of patients. Conclusion In a retrospective study of patients fulfilling San Diego Criteria for SS, we found: (a) sustained improvement of local symptoms (painful eyes, painful mouth) and improvement of systemic manifestations (arthralgias and myalgias) after treatment with hydroxychloroquine 6-7 mg/kg/day over mean three-year follow-up; (b) laboratory analysis showed a significant improvement in their ESR and their quantitative IgG levels; (c) no significant late toxicity was observed in this study cohort. A prospective study of hydroxychloroquine in patients fulfilling San Diego criteria for SS is indicated.
Binocular treatment in adult amblyopia is based on parvocellular or magnocellular pathway
Authors: Shuai Liu , Leilei Zou , Wen Wen , Shu Wang , Gangsheng Liu , Yinglong Li , Guoke Yang , Xinrong Chang , Hong Liu , Rongfeng Liao 
Published: April 2019

Introduction: Amblyopia is speculated to be an untreatable disease in the patient, who is beyond the critical period of vision; however, currently, it is treatable in adults. Purpose: This study aimed to elucidate whether the treatment is useful in both anisometropic amblyopia and strabismic amblyopia. In addition, the differences were detected between anisometropic amblyopia and strabismic amblyopia after the same perceptual treatment and whether the suppression in anisometropic amblyopia or strabismic amblyopia could be decreased before and after the treatment. Methods: A binocular perceptual learning was applied for the treatment, the suppression was measured, and the patients were followed up for 2 months after training. Anisometropic amblyopia and strabismic amblyopia groups were subjected to the assessment of stereo, visual acuity, contrast sensitivity, and suppression before and after the training. Results: After 6 weeks of “Diploma Gabor Orientation Coherence” training, in the anisometropic amblyopia group, the outcomes of visual acuity (t = 3.114, p = 0.026) and contrast sensitivity (t = 7.786, p = 0.001) were increased significantly. While in the strabismic amblyopia group, the outcomes of stereo (t = 2.987, p = 0.040) and contrast sensitivity (t = 3.638, p = 0.022) were increased significantly. Conclusion: After Diploma Gabor Orientation Coherence training in the same frequency and in the same duration, the anisometropic amblyopia group got an improvement in visual acuity, but the strabismic amblyopia group got an improvement in stereo. As there are evidences to show that anisometropic amblyopia and strabismic amblyopia were injured in different pathways, we think the diverse results might come from the different pathway injury in anisometropic amblyopia and strabismic amblyopia.
Serum Soluble ST2 and Adverse Left Ventricular Remodeling in Patients With ST-Segment Elevation Myocardial Infarction
Authors: Kercheva Maria , Ryabova Tamara , Gusakova Anna , Suslova Tatiana E , Ryabov Vyacheslav , Karpov Rostislav S 
Published: April 2019

Objective: To assess the dynamics of serum levels of soluble isoform of suppression of tumorigenicity 2 (sST2) and N-terminal pro-brain natriuretic peptide (NT-proBNP) and their correlations with the development of adverse left ventricular remodeling (LVR) through 6 months in patients with primary myocardial infarction with ST-segment elevation (STEMI). Methods: Subjects were 31 patients with STEMI (median age: 58 years), who underwent percutaneous coronary intervention (PCI) during the first 24 hours of the onset of myocardial infarction (MI). Blood samples and parameters of echocardiography were assessed at days 1, 3, 7, and 14 and 6 months after STEMI. Results: Serum levels of sST2 and NT-proBNP decreased during the 6-month period. Levels of sST2 decreased by 48% from admission to day 7, and levels of NT-proBNP decreased by 40% from day 7 to 6 months after STEMI. Serum levels of sST2 at day 1 ( r = 0.5, P < .05) and day 3 ( r = 0.4, P < .05) were associated with adverse LVR by 6 months after STEMI. Logistic regression analysis showed that a high concentration of sST2 at day 7 increased the risk of adverse LVR (95% confidence interval [CI], 0.5-0.9; areas under curve [AUC] = 0.8; P = .002), with 92% sensitivity and 70% specificity. A multivariate analysis model revealed that adverse LVR was associated with the level of sST2 ( P = .003) and with complete revascularization ( P = .01) at the admission. Conclusions: The dynamics of serum levels of sST2 and NT-proBNP were different. The level of sST2 normalized by the 7th day; NT-proBNP decreased only by the end of the 6-month period after MI. Increased serum levels of sST2 by the 7th day of MI were associated with the development of adverse LVR by the end of the 6-month period.
Impact of race/ethnicity on insulin resistance and hypertriglyceridaemia
Authors: Raygor Viraj , Abbasi Fahim , Lazzeroni Laura C , Kim Sun , Ingelsson Erik , Reaven Gerald M , Knowles Joshua W 
Published: April 2019

Objective: Insulin sensitivity affects plasma triglyceride concentration and both differ by race/ethnicity. The purpose of this study was to provide a comprehensive assessment of the variation in insulin sensitivity and its relationship to hypertriglyceridaemia between five race/ethnic groups. Research design and methods: In this cross-sectional study, clinical data for 1025 healthy non-Hispanic White, Hispanic White, East Asian, South Asian and African American individuals were analysed. Insulin-mediated glucose disposal (a direct measure of peripheral insulin sensitivity) was measured using the modified insulin suppression test. Statistical analysis was performed using analysis of co-variance. Results: Of the study participants, 63% were non-Hispanic White, 9% were Hispanic White, 11% were East Asian, 11% were South Asian and 6% were African American. Overall, non-Hispanic Whites and African Americans displayed greater insulin sensitivity than East Asians and South Asians. Triglyceride concentration was positively associated with insulin resistance in all groups, including African Americans. Nevertheless, for any given level of insulin sensitivity, African Americans had the lowest triglyceride concentrations. Conclusion: Insulin sensitivity, as assessed by a direct measure of insulin-mediated glucose disposal, and its relationship to triglyceride concentration vary across five race/ethnic groups. Understanding these relationships is crucial for accurate cardiovascular risk stratification and prevention.
Bariatric surgery as a model to explore the basis and consequences of the Reaven hypothesis: Small, dense low-density lipoprotein and interleukin-6
Authors: Adam Safwaan , Liu Yifen , Siahmansur Tarza , Ho Jan H , Dhage Shaishav S , Yadav Rahul , New John P , Donn Rachelle , Ammori Basil J , Syed Akheel A , Malik Rayaz A , Soran Handrean , Durrington Paul N 
Published: April 2019

Background: Reaven originally described the clustering of insulin resistance/hyperinsulinaemia, obesity (particularly visceral), altered cytokine levels, glucose intolerance, hypertriglyceridaemia and low high-density lipoprotein cholesterol. Subsequently, a potentially highly atherogenic small, dense low-density lipoprotein was also reported. We have studied the effect of bariatric surgery on this and other risk factors for atherosclerosis. Methods: Forty patients (20 with type 2 diabetes mellitus) undergoing bariatric surgery were studied before and 1 year after bariatric surgery. Results: Twelve months after bariatric surgery, median body mass index had decreased from 49.5 to 36.5 kg/m2, fasting insulin from 21.3 to 7.8 mU/L and insulin resistance (homeostatic model assessment of insulin resistance) from 5.9 to 1.8 (all p < 0.001). Thirteen out of 20 patients had remission from type 2 diabetes mellitus. Highly sensitive C-reactive protein, interleukin-6, fasting triglycerides ( p < 0.001) and small, dense low-density lipoprotein ( p < 0.001) decreased, while high-density lipoprotein cholesterol increased ( p < 0.001) significantly, irrespective of having type 2 diabetes mellitus and/or being treated with statin therapy before surgery. Conclusion: The association between marked weight loss and change in insulin resistance and hyperinsulinaemia with the change in small, dense low-density lipoprotein and interleukin-6 warrants further investigation. Bariatric surgery provides a model for investigating the mechanisms linking insulin resistance/hyperinsulinaemia to atherosclerosis.
Smartphone-Based Interventions to Foster Simple Activity and Personal Satisfaction in People With Advanced Alzheimer’s Disease
Authors: Lancioni Giulio E. , Singh Nirbhay N. , O’Reilly Mark F. , Sigafoos Jeff , D’Amico Fiora , Turnone Barbara , Laporta Dominga , Scordamaglia Antonella , Pinto Katia 
Published: April 2019

Objectives: This study assessed a smartphone-based program to promote practical and mildly demanding arm responses and personal satisfaction and increase physical exertion (heart rates) in people with advanced Alzheimer’s disease. Methods: The program relied on a Samsung Galaxy A3 smartphone with Android 6.0 operating system. Two groups of 10 and 11 participants, respectively, were assigned different responses (ie, placing cards into an elevated box and moving bottles with water from a table into a container). Responses activated the smartphone, which produced brief periods of preferred stimulation. Lack of responding led the smartphone to produce a verbal prompt. Results: All participants had significant increases in independent response frequencies, level of personal satisfaction, and heart rates during program sessions as opposed to baseline or control sessions. Conclusion: A smartphone-based program may help people with advanced Alzheimer’s disease increase independent occupation with possible benefits in terms of satisfaction and physical condition.
Infection-relapse and a potentially surgical stratification model for the treatment of mycotic aortic aneurysms: A propensity-matched pilot study
Authors: Liu Mingyuan , Liu Peng , Liu Bin , Che Haijie , Liu Junjun , Sun Anqiang , Li Wei , Zhang Xiaoming ,   on behalf of the Chinese Collaborator Group for Mycotic Aortic Aneurysms
Published: April 2019

Objective This study evaluates the overall survival and the infection-relapse after endovascular repair (Endo) vs. open surgery (Open) for mycotic aortic aneurysms and the potential influence of perioperative severity of infection to the decision-making on the long-term survival. Design A multicenter, retrospective analysis of 5247 consecutive aortic aneurysm repair performed from January 2003 to December 2017 at five tertiary medical centers was conducted. Among the study population, 257 patients with mycotic aortic aneurysms s were identified. Methods: Finally, 73 patients were enrolled in the cohort after exclusion and a 1:1 propensity-matched analysis. The study cohort drawn from matched data included 37 patients in the Endo group and 36 patients in the Open group. The primary endpoint was overall survival. Secondary endpoints included infection-relapse during the follow-up. Univariate and multivariate Cox regression analyses were used to assess predictors for late mortality. Results The mean follow-up time for the entire cohort was 41 months (range, 1 to 135 months). Among propensity-matched patients, there was no significant difference in baseline characteristics. There was no difference in overall survival ( P = 0.083) between the groups at five years, but Open group was associated with a lower infection-relapse incidence during the follow-up ( P = 0.011). Subgroup analysis revealed a better survival rate for Open in patients with severe infection ( P = 0.003) or small periaortic abscess ( P = 0.049). Conclusion There were no significant differences between Endo and Open in overall survival. However, Open was a more definite option with less infection-relapse and had potential advantages for patients with severe infection or with a small periaortic abscess.
An audit of research productivity in clinical biochemistry revisited
Authors: Reynolds Tim M , Wierzbicki Anthony S 
Published: April 2019

Objective To investigate recent (2011–2015) research productivity in clinical biochemistry and compare it with a previous audit (1994–1998). Design A retrospective audit of peer-reviewed academic papers published in Medline listed journals. Setting UK chemical pathology/clinical biochemistry laboratories and other clinical scientific staff working in departments of pathology. Participants Medically qualified chemical pathologists and clinical scientists. Main outcome measures Publications were identified from electronic databases for individuals and sites. Analyses were conducted for individuals, sites and regional educational groups. Results Clinical scientific staff numbers fell by 3.9% and medical staff by 17.4% from 1998 to 2015. Publication rates declined as publication count centiles rose between 1998 and 2015 (e.g. n = 5; 67th→84th centile; p < 0.001). A reduction in productivity was seen in medically qualified staff but less from clinical scientists. Regional staffing was 77 ± 37 (range 30–150) with university hospital laboratory staff accounting for 58 ± 19% (range 30–92%). Medically qualified staff comprised 20 ± 4% of staff with lowest numbers in some London regions. Publication rates varied widely with a median of 155 papers per region (range 98–1035) and 2.82 (1.21–8.62) papers/individual. The skew was attenuated, increasing the publication rate to 6.0 ± 2.73 papers (range 2.29–11.76)/individual after correction for the number of university hospital sites per region and was not related to numbers of trainees. High publication rates were associated with the presence of one highly research-active individual. Their activity correlated over their careers from recruitment to today (r2 = 0.45; p = 0.05). The productivity rates of recent cohorts of trainees are inferior to previous cohorts. Conclusions Research remains a minority interest in clinical biochemistry. A small and decreasing proportion of individuals publish 90% of the work. A reduction was seen in clinical scientist and especially medical research productivity. No correlation of training activity with research productivity was seen implying weak links with translational medicine.
Internet videoconferencing for patient–clinician consultations in long-term conditions: A review of reviews and applications in line with guidelines and recommendations
Authors: Ignatowicz Agnieszka , Atherton Helen , Bernstein Celia Janine , Bryce Carol , Court Rachel , Sturt Jackie , Griffiths Frances 
Published: April 2019

Background The use of internet videoconferencing in healthcare settings is widespread, reflecting the normalisation of this mode of communication in society and current healthcare policy. As the use of internet videoconferencing is growing, increasing numbers of reviews of literature are published. Methods The authors conducted a review of the existing reviews of literature relating to the use of internet videoconferencing for consultations between healthcare professionals and patients with long-term conditions in their own home. The review was followed with an assessment of United Kingdom National Institute for Health and Clinical Excellence guidelines for patient care in the context of common long-term illnesses to examine where videoconferencing could be implemented in line with these recommendations. Results The review of reviews found no formal evidence in favour of or against the use of internet videoconferencing. Patients were satisfied with the use of videoconferencing but there was limited evidence that it led to a change in health outcomes. Evidence of healthcare professional satisfaction when using this mode of communication with patients was limited. The review of guidelines suggested a number of opportunities for adoption and expansion of internet videoconferencing. Implementing videoconferencing in line with current evidence for patient care could offer support and provide information on using a communication channel that suits individual patient needs and circumstances. The evidence base for videoconferencing is growing, but there is still a lack of data relating to cost, ethics and safety. Conclusions While the current evidence base for internet videoconferencing is equivocal, it is likely to change as more research is undertaken and evidence published. With more videoconferencing services added in more contexts, research needs to explore how internet videoconferencing can be implemented in ways that it is valued by patients and clinicians, and how it can fit within organisational and technical infrastructure of the healthcare services.