bluuebunny/crossref_metadata_2025_split huggingface dataset:
Skeletal alkaline phosphatase as a serum marker of bone metastases in the follow-up of patients with breast cancer
Authors: Reale M.G. , Santini D. , Marchei G.G. , Manna A. , Del Nero A. , Bianco V. , Marchei P. , Frati L. 
Published: March 2018

Immunoradiometric determination of the bone isoenzyme of alkaline phosphatase with a method provided by Hybritech Inc., San Diego CA (USA) was carried out in 145 female patients, 97 of whom with radically operated breast cancer and 48 with benign mammary cysts, in order to evaluate the correlation of serum levels with the metabolic process of bone rearrangement in patients with bone metastases. This study shows that skeletal ALP, having high specificity (86.48%) and sensitivity (78.6%) for early progression (the average anticipation time compared to scintigraphic detection was 101 days) could represent a valid marker for bone metastases in association with mucinous markers in the follow-up of patients operated for breast cancer. In addition, dynamic serum determination of skeletal ALP could be a valid help in monitoring the efficacy of therapy in patients with bone progression.
Determination of tissue polypeptide-specific antigen in pleural fluid and serum from patients with pleural effusion
Authors: Villena V. , Echave-Sustaeta J. , Lopez-Encuentra A. , Martin-Escribano P. , Estenoz-Alfaro J. , Ortuño-De-Solo B. 
Published: March 2018

As a tool for differentiating malignant and benign pleural effusions, we evaluated the diagnostic value of the assay of tissue polypeptide-specific antigen (TPS) in pleural fluid and serum, and of the pleural fluid TPS/serum TPS ratio in patients with pleural effusion. We studied prospectively 147 consecutive patients who had pleural effusions: 43 malignant pleural effusions and 104 benign pleural effusions. TPS levels were measured by RIA. The sensitivity and specificity of these measurements were: TPS in pleural fluid (cutoff 20,000 U/L): 0.21 and 0.98; TPS in serum (cutoff 300 U/L): 0.31 and 0.96; pleural fluid TPSI serum TPS ratio (cutoff 1200): 0.07 and 0.99. All these values enhanced the sensitivity of cytologic analysis of pleural fluid. However, we conclude that TPS assay in pleural fluid and serum, and the pleural fluid TPSI serum TPS ratio have limited diagnostic value in patients with pleural effusion.
Development of a new Prolifigen TPA IRMA assay using monoclonal anti-cytokeratin antibodies
Authors: Sundström B. E. , D'amico Y. , Brundell J. 
Published: March 2018

A new immunoassay for TPA determination has been developed in which anti-cytokeratin monoclonal antibodies are used. A three-MAb combination with different anti-cytokeratin antibody specificities has been selected to mimic the complex pattern found for the polyclonal anti-TPA antibody. The accuracy of the assay is good, as judged from analytical recovery experiments, analysis of quality-assessment samples and comparison with the polyclonal Prolifigen TPA IRMA. No significant interferences or cross-reactivities have been identified. The lower limit of detection of the assay (mean + 3 SD of the zero standard) is below 15 U/L and the imprecision in low, giving a working range of 15-4000 UIL. The improved handling of the assay, including a single incubation step of 2 hours with shaking at room temperature, results in a narrower normal distribution, thereby giving a better separation of normal and pathological samples.
Analysis of the Temporal Compressibility of Breast Tumour Marker Assays: Development of a “Near Patient” Assay
Authors: Murray A. , Robertson J. F. R. , Price M. R. 
Published: March 2018

The aim of this study was to investigate whether immunoassays for circulating MUC1 antigen in breast cancer could be compressed in time so that serum level results would be made available during the time of the patient's visit to clinic. Two assays were used: - The EMCA (Euro DPC) is a liquid phase immunoassay and the ELSA CA15-3 (CIS) is a double determinant solid phase immunoradiometric assay. The effects of shortened incubation times were investigated by assaying standards and unknown samples and comparing the results with those using the standard kit protocols. The binding kinetics of the monoclonal antibodies employed in the assays were analysed separately. We conclude that the EMCA assay can be shortened to 35 min and we have attributed this to the fast binding kinetics inherent in a liquid phase assay. This shortened assay may produce the basis for a useful “near patient” assay. By comparison, the solid phase ELSA CA15-3 assay cannot be compressed without loss in assay performance.
The Value of Pretreatment Clinical and Biochemical Parameters in Staging and Prognostic Stratification of Patients with Newly Diagnosed Prostate Carcinoma
Authors: Stokkel M.P.M. , Zwinderman A. H. , Zwartendijk J. , Pauwels E.K.J. , Van Eck-Smit B.L.F. 
Published: March 2018

Purpose To determine whether it is possible to select patients in whom and for what reason bone scintigraphy should be performed or not, a retrospective study was performed of 161 consecutive patients with newly diagnosed prostate cancer. Materials and methods Follow-up varied from 1 to 88 months during which 67 patients died. Bone scans were classified from 0 (= normal) to 3 (typical pattern of metastases) and were correlated with age, alkaline phosphatase (AP), prostate specific antigen (PSA), tumor grade, TNM-stage and survival. For survival, 68 patients who were not referred for bone scintigraphy were also evaluated. Results All parameters demonstrated a correlation with the incidence of a positive bone scan, but PSA was the best overall predictor in this (p<0.0001). None of the patients with PSA ≤ 20 ng/ml (n=64) showed metastases, whereas 8 of 9 patients with PSA > 1000 ng/ml and patients with PSA values between 20 and 1000 ng/ml in combination with AP >90 U/L (n=24) had bone metastases. Furthermore, a class 3 bone scan was found to be the most important parameter in assessing prognosis and survival (p<0.0001), whereas no differences were found in patients with a class 0, 1 and 2 scintigram. Conclusions For staging and prognostic stratification purposes, bone scintigraphy and additional roentgenograms are of value in a selected group of patients. In contrast with a typical pattern of metastases on bone scintigraphy, an abnormal scan (class 1 and 2) at the time of diagnosis is not a poor prognostic parameter of the risk of death. Bone scintigraphy can be omitted in patients with PSA values < 20 ng/ml. In patients with PSA levels > 1000 ng/ml or less increased levels combined with alkaline phosphatase levels > 90 U/L, bone scintigraphy seems to be of no value in staging disease.
Urinary Excretion of Free and Acetylated Polyamines in Hepatocellular Carcinoma
Authors: Antoniello S. , Auletta M. , Magri P. , Pardo F. 
Published: March 2018

Polyamines (putrescine, spermidine and spermine) are essential for the proliferation of normal and neoplastic cells, and have been repeatedly recommended as tumor markers, with contrasting and elusive results. In the present study the urinary excretion of free and acetylated polyamines was measured in patients with hepatocellular carcinoma (HCC), cirrhotics and control subjects. Separation and quantification of dansyl-derivatives of free, acetylated and total polyamines was performed by reverse-phase high-performance liquid chromatography. The results show that the urinary excretion of total, free, and acetylated polyamines is significantly higher in HCC patients than in cirrhotics and controls (p<0.001). The N1/N8 acetyl-spermidine molar ratio was found to be higher in HCC patients than in cirrhotics and controls (p<0.001). No correlation was found between urinary excretion of polyamines and serum alpha-fetoprotein, tumor size and severity of liver cirrhosis. The results show that increased urinary excretion of free and acetylated polyamines, as well as an altered N1/N8-acetyl-spermidine molar ratio, is a sensible but not specific feature of HCC patients; polyamines may play a role in human carcinogenesis, but their determination does not seem reliable for the early detection of liver cancer.
Preoperative Carbohydrate Antigen 195 (CA195) and CEA Serum Levels as Prognostic Factors in Patients with Colorectal Cancer
Authors: Andicoechea A. , Vizoso F. , Alexandre E. , Cuesta E. , Díez M. Cruz , Riera L. , García-Muñiz J.L. , Martínez E. , Ruibal A. 
Published: March 2018

We evaluated in 214 patients with primary colorectal cancer the prognostic value of the preoperative serum levels of CEA and CA195. For CEA these levels were above the cutoff of 6 ng/ml in 31.3% of patients, whereas for CA195 they were higher than 12 U/ml in 35.9% of patients. The simultaneous use of both antigens increased the sensitivity to 49%, which was significantly higher than that of CEA (p<0.001) and CA195 (p<0.01) taken singly. The mean preoperative CEA levels were significantly (p<0.001) correlated with Dukes’ stage only, while there was a significant correlation between preoperative serum levels of CA195 and Dukes’ stage (p<0.001), grade of differentiation (p<0.01) and tumor location (p<0.05). The results indicated that high preoperative serum levels of CEA and CA195 were associated with a shorter overall survival (p<0.0001). In addition, separate Cox multivariate analysis showed that preoperative CA195 was, after Dukes’ stage, the strongest factor to predict overall survival (p<0.0001).
Utility of Tumor Marker CA 72.4 in Patients with Chronic Renal Failure
Authors: Vitores A. Ma. González , Duró G. Encabo , Fraile B. Bermejo , Miró A. Olmos , Carrasco M. Armengol 
Published: March 2018

The tumor marker CA 72.4 is composed of two monoclonal antibodies, B 72.3 and cc49, which detect the glycoprotein TAG 72 present in tumor cells. The levels of CA 72.4 may be modified depending on the route of excretion of the antigen TAG 72. The objective of this study was to evaluate the behavior of CA 72.4 in healthy subjects and to assess the influence of chronic renal failure (CRF) on the levels of this tumor marker. Random serum samples were collected in 181 individuals (148 healthy volunteers and 33 patients with CRF) and 214 determinations of CA 72.4 were performed. We also performed 66 determinations of plasma creatinine. In healthy subjects the cutoff value of CA 72.4 was established at 3 U/mL, with a sensitivity of 53% and a specificity of 85.8%. In the CRF patients we found no statistically significant differences when we compared the values of CA 72.4 predialysis and postdialysis (p=0.197). However, a statistically significant difference was found in the plasma creatinine levels (p<0.001). Chronic renal failure does not affect the result of CA 72.4 determinations; this tumor marker may therefore be useful in the monitoring of patients with cancer, independent of their renal function.
Chromogranin-A as a Serum Marker for Neuroendocrine Tumors: Comparison with Neuron-Specific Enolase and Correlation with Immunohistochemical Findings
Authors: Giovanella L. , la Rosa S. , Ceriani L. , Uccella S. , Erba P. , Garancini S. 
Published: March 2018

Background Chromogranin-A (Cg-A) is a 439-amino-acid protein contained in secretory granules of neuroendocrine cells, in addition to specific hormone peptides or neuropeptides. Since Cg-A is co-released with peptide hormones its serum concentration can be used as a marker of neuroendocrine tumors. Aim Evaluation of the analytical performance of a new IRMA method for Cg-A assay and of the clinical value of serum Cg-A and neuron-specific enolase (NSE) in neuroendocrine tumors. In addition, we compared the diagnostic usefulness of both Cg-A and NSE serum levels and their relationship to tissue expression. Patients and methods Initially we evaluated the analytical performance (intra- and interassay imprecision, dilution test and detection limit) of the Cg-A RIACT method (CIS Bio-International, Gifsur-Yvette, France). We selected 50 patients affected by various histologically confirmed neuroendocrine tumors (NETs): 111In-pentetreotide scan and helical computed tomography were employed to assess tumor extent. Cg-A and NSE were measured before surgery in serum samples of patients and 50 age-matched controls by IRMA methods. After surgery immunohistochemical stains for Cg-A and NSE were performed on surgical specimens of tumor tissue. Results Cg-A levels were significantly higher (p<0.0001) in patients with NETs than in healthy controls and we found a positive correlation between serum and tissue expression (p<0.05). Serum levels of Cg-A were also related to tumor extent (p<0.05) but in some cases we observed significant elevation of serum Cg-A in small, intensely immunoreactive NETs. ROC curve analysis showed better accuracy for serum Cg-A compared to NSE in the diagnosis of NETs, while no significant relationship was found between serum expression and immunostaining for NSE. Discussion Our results confirmed the biological and clinical significance of circulating Cg-A as an expression of granular content in neuroendocrine tissues and supported the complementary usefulness of serum Cg-A in the diagnosis and evaluation of NETs together with imaging modalities.
Differential immunological profiles herald magnetic resonance imaging-defined perioperative cerebral infarction
Authors: Fanning Jonathon P. , See Hoe Louise E. , Passmore Margaret R. , Barnett Adrian G. , Rolfe Barbara E. , Millar Jonathan E. , Wesley Allan J. , Suen Jacky , Fraser John F. 
Published: March 2018

Background: The perioperative period is associated with a high risk for human ischaemic stroke. Although inflammatory mechanisms are known to have an important role in cerebral infarction in the nonoperative setting, their role in modulating perioperative risk remains unclear. Methods: In this prospective case-control study, we compared 10 patients (cases) who developed magnetic resonance imaging (MRI) evidence of cerebral infarction following transcatheter aortic valve implantation with 10 patients (controls) who underwent the same procedure without neurological complication. Blood sampling was performed preoperatively (baseline) and at 24 h, 48 h and 72 h postoperatively and analysed for specific cytokines, chemokines and complement factors. Results: Baseline serum assessments identified significant differences between the two cohorts for levels of complement C3, complement C4b, granulocyte-macrophage colony-stimulating factor, interleukin-15 and macrophage inflammatory protein-1β. Longitudinal regression analysis and best-fit polynomial curves of postoperative analyte profiles identified significantly higher levels of complement C3 and matrix metalloproteinase-9, and lower levels of interferon-γ and macrophage inflammatory protein-1β levels in cases versus controls. Conclusions: These results support a potentially important role for inflammatory mechanisms in MRI-defined perioperative stroke and reveal a potentially important role for complement components in this process.
Calcaneal Osteotomy Safe Zone to Prevent Neurological Damage: Fact or Fiction?
Authors: Wills Bradley , Lee Sung Ro , Hudson Parke William , SahraNavard Bahman , de Cesar Netto Cesar , Naranje Sameer , Shah Ashish 
Published: March 2018

Background. Calcaneal osteotomy is a commonly used surgical option for the correction of hindfoot malalignment. A previous cadaveric study described a neurological “safe zone” for calcaneal osteotomy. We performed a retrospective chart review to evaluate the presence of neurological injuries following calcaneal osteotomies and the location of the osteotomy in relation to the reported safe zone. Methods. In this retrospective study, we reviewed charts of patients who underwent calcaneal osteotomy at our institution from 2011 to 2015. All immediate postoperative radiographs were examined and the shortest distance between the calcaneal osteotomy line and a reference line connecting the posterior superior apex of the calcaneal tuberosity to the origin of the plantar fascia was measured. If the osteotomy line was positioned within an area 11.2 mm anterior to the reference line, it was considered to be inside the neurological safe zone. We correlated the positioning of the osteotomy with the presence of postoperative neurological complications. Results. We identified 179 calcaneal osteotomy cases. Of the 174 (97.2%) nerve injury-free cases, 62.6% (109/174) were performed inside the defined “safe zone” while 37.4% (65/174) outside. A total of 5 (2.8%) nerve complications were identified: 3 (60%) were inside the safe zone and 2 (40%) outside the safe zone. Osteotomies outside the safe zone had a 1.114 relative risk of nerve injury with a 95% CI of 0.191 to 6.500 and showed no statistically significant difference ( P = .9042). Conclusion. Our findings suggest that the clinical “safe zone” in calcaneal osteotomies may not actually exist, likely because of wide anatomical variation of the implicated nerves, as described in prior studies. Patients should be properly counseled preoperatively on the low, but seemingly fixed, risk of nerve injury before undergoing calcaneal osteotomy. Levels of Evidence: Level III: Retrospective comparative study
The Ability of Fluorescence Angiography to Detect Local Ischemia in Patients With Heel Ulceration
Authors: Marmolejo Valerie S. , Arnold Jonathan F. 
Published: March 2018

Heel ulcerations are a significant burden of care in both hospital and long-term care settings. The presence of peripheral arterial disease as a contributing factor to delayed healing is often not recognized, resulting in prolonged healing and high patient morbidity and mortality. Formal vascular evaluation and intervention is often not performed as these patients can have palpable pedal pulses while having localized ischemia of the heel. As routine noninvasive vascular studies can be affected by medial calcinosis and collateralization and do not specifically assess tissue perfusion to the heel, a false sense of security of adequate perfusion for healing can result. Indocyanine green fluorescence angiography (ICGFA) allows for real-time visualization and objective assessment of site specific tissue perfusion not limited by the factors that can make routine noninvasive vascular studies unreliable or unobtainable. A retrospective medical record review of a subset of patients with chronic heel ulceration from a prospective institutional review board–approved study in which serial ICGFA was performed during their treatment course was performed. ICGFA was able to identify local heel ischemia and expedite vascular intervention. ICGFA should be considered as an additional vascular study in patients presenting with chronic, nonhealing heel ulcerations. Levels of Evidence: Level IV: Diagnostic, Case series
A comparison of the National Institute for Health and Care Excellence (NICE) and European Association of Urology (EAU) guidelines for the assessment and management of urinary incontinence in women
Authors: Warner Ross M , Greenwell Tamsin J 
Published: March 2018

Objective: The objective of this paper is to identify the similarities and key differences between the National Institute for Health and Care Excellence (NICE) and European Association of Urology (EAU) guidelines on the management of urinary incontinence (UI) in women. Methods: We reviewed the most recent iterations of both full guidelines to identify all key recommendations and their associated level/grade of evidence. Guidance on the management of urinary incontinence in men and neuropathic patients was excluded. Results: There is a significant overlap in the recommendations of both guidelines. Key differences include the indications for performing urodynamics, pharmacological agents in stress UI, the dose of botulinum toxin A (200 units by NICE, 100 units by EAU), the hierarchy of surgical options for primary stress UI and the role of the multi-disciplinary team (MDT). Conclusion: This review provides the various stakeholders involved in the management of female UI with a summary of the strength of evidence supporting the recommendations by these two key guidelines. We have provided an evidence-based framework to support clinical experience from which to base management decisions.
Comparative study on clinical results of arthroscopic repair of anteroinferior, superior, and combined glenoid labral tear
Authors: Zhu Meng , Chen Jerry Yongqiang , Chong Hwei Chi , Cheng Paul Chang Chee , Tjoen Denny Lie Tijauw 
Published: March 2018

Background: The purpose of this prospective study is to compare and correlate the clinical results of arthroscopic repair of a combined anteroinferior and superior labral lesion with those of an isolated anteroinferior labral lesion or type II superior labral tear from anterior to posterior (SLAP) lesion. Methods: A comparative study involving patients who underwent arthroscopic labral repairs in a tertiary hospital between 2010 and 2014 was conducted. A total of 96 patients were divided into three groups: Group A consisted of 61 patients with the anteroinferior labral lesion, group B consisted of 16 patients with the type II SLAP lesion, and group C consisted of 19 patients with the combined anteroinferior and superior labral lesion. Patient demographics, preoperative and postoperative pain scores, shoulder functional scores (Constant Shoulder Score, UCLA (University of California at Los Angeles) Shoulder Score, and Oxford Instability Score), and shoulder ranges of motion were measured and compared. Results: Except that patients from group B were generally older (28.8 vs. 22.2 for group A and 22.0 for group C, p = 0.04) at the time of surgery, no significant differences exist among the three groups in patient demographics and relevant clinical data. Preoperative and 2-year postoperative clinical outcomes, as well as the improvements, were comparable among the three groups. Low failure rates were observed for all three groups (6% vs. 10% vs. 11%, p = 0.999). Conclusions: Patients with the type II SLAP lesion underwent surgery at an older age. With appropriate surgical procedures, equivalent postoperative results can be expected for combined anteroinferior and superior labral lesion repair compared to isolated labral lesion repair.
Safety and Efficacy of Dolutegravir Plus Rilpivirine in Treatment-Experienced HIV-Infected Patients: The DORIVIR Study
Authors: Palacios Rosario , Mayorga M. , González-Domenech C. M. , Hidalgo-Tenorio C. , Gálvez C. , Muñoz-Medina L. , de la Torre J. , Lozano A. , Castaño M. , Omar M. , Santos Jesús 
Published: March 2018

Objectives: To analyze the efficacy and safety of dolutegravir/rilpivirine (DTG/RPV) in HIV-infected patients who switched from any other antiretroviral therapy (ART). Methods: Open-label, multicenter study including patients who switched to DTG/RPV between February 2015 and February 2016. Efficacy (HIV RNA <50 copies/mL), adverse events, and metabolic changes at 24 weeks were analyzed. Results: A total of 104 participants were included, who switched for the following reasons: toxicity/intolerance (42.3%), convenience (27.8%), and drug interactions (17.3%). Prior regimens are protease inhibitor (56.7%), integrase strand transfer inhibitor (26.9%), and non-nucleoside reverse transcriptase inhibitor (16.3%). Efficacy at 24 weeks was 88.4% (intention to treat) and 96.8% (per protocol). Triglyceride levels were reduced, on average, by 12.7% and a mean decrease of 9.0% in the glomerular filtration rate was observed as well ( P values of .003 and .002, respectively), whereas total cholesterol, HDL cholesterol, LDL cholesterol, creatinine, and glutamic-pyruvic transaminase remained unchanged. No patient discontinued due to adverse events. Conclusions: Dolutegravir/RPV is effective and safe in long-term HIV-infected patients under any prior ART. Toxicity, convenience, and interactions were the main reasons for changing. At 24 weeks, the lipid profile improved with a decrease in triglycerides.