bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tuberculosis in Visceral Leishmaniasis-Human Immunodeficiency Virus Coinfection: An Evidence Gap in Improving Patient Outcomes?
Authors: van Griensven Johan , Mohammed Rezika , Ritmeijer Koert , Burza Sakib , Diro Ermias 
Published: March 2018

AbstractBackgroundVisceral leishmaniasis (VL)-human immunodeficiency virus (HIV) coinfection remains a major problem in Ethiopia, India, and Brazil. Tuberculosis (TB), a treatable factor, could contribute to high mortality (up to 25%) in VL-HIV coinfection. However, the current evidence on the prevalence and clinical impact of TB in VL-HIV coinfection is very limited. In previous reports on routine care, TB prevalence ranged from 5.7% to 29.7%, but information on how and when TB was diagnosed was lacking.MethodsField observations suggest that TB work-up is often not done systematically, and it is only done in patients who do not respond well to VL treatment. Here, we advocate high-quality diagnostic studies in VL-HIV-coinfected patients, during which all patients are systematically screened for TB, including a comprehensive work-up, to obtain reliable estimates.ResultsCost-effective and feasible diagnostic algorithms can be developed for field use, and this can be integrated in VL clinical guidelines.ConclusionsAn accurate diagnosis of TB can allow clinicians to assess its clinical impact and evaluate the impact of early TB diagnosis.
Characterization of Reactions to Laterally Directed Perturbations in People With Chronic Stroke
Authors: Schinkel-Ivy Alison , Aqui Anthony , Danells Cynthia J , Mansfield Avril 
Published: March 2018

Abstract

Background
Reactive balance control is often impaired poststroke. Studies addressing responses to laterally directed perturbations in this population are currently lacking. Given that stroke-related motor impairments are unilateral, a better understanding of reactive balance responses to these types of perturbations is critical.

Objective
This study aimed to quantify differences in reactive balance control in response to laterally directed perturbations in people with chronic stroke, based on perturbation direction and ability to step with either limb.

Design
This study used a cross-sectional design.

Methods
Participants with chronic stroke (N = 19) were divided into groups representing their ability to step with either limb, based on performance on a reactive balance task in a baseline assessment. The preferred stepping limb was also identified during this assessment. Each participant then underwent a series of laterally directed perturbations on a motion platform. Behavioral measures were compared between platform direction and group.

Results
Trials with extra steps, step initiation with the preferred limb, and crossover steps were more common with platform motion toward the preferred limb compared to the nonpreferred limb; the latter effect was only observed for participants with an impaired ability to step with either limb. Side-step sequences were more common in those able to step with either limb when the platform moved toward the preferred limb.

Limitations
The participant sample was likely higher functioning than the general population of stroke survivors due to equipment constraints. Additionally, participants may have developed strategies to use the platform's motion characteristics to aid with balance recovery.

Conclusions
These findings provide an indication of responses to laterally directed perturbations in people with chronic stroke and may help inform strategies for improving reactive balance control during stroke rehabilitation.
Efficacy and Safety of Intravenous Meloxicam in Patients With Moderate-to-Severe Pain Following Bunionectomy
Authors: Pollak Richard A. , Gottlieb Ira J. , Hakakian Fardin , Zimmerman John C. , McCallum Stewart W. , Mack Randall J. , Keller Rosemary , Freyer Alex , Du Wei 
Published: March 2018

Objective:
To evaluate the analgesic efficacy and safety of a novel intravenous (IV) formulation of meloxicam (30 mg) in patients with moderate-to-severe pain following a standardized, unilateral bunionectomy with first metatarsal osteotomy and internal fixation.

Materials and Methods:
Patients who met the criteria for moderate-to-severe postoperative pain were randomized to receive bolus injections of meloxicam IV 30 mg (n=100) or placebo (n=101) administered once daily. The primary efficacy endpoint was the Summed Pain Intensity Difference over 48 hours (SPID48). Secondary efficacy endpoints included sum of time-weighted pain intensity differences (SPID) values at other timepoints/intervals, time to first use of rescue analgesia, and number of rescue doses taken. Safety assessments included the incidence of adverse events (AEs), physical examinations, laboratory tests, 12-lead electrocardiography, and wound healing.

Results:
Patients randomized to meloxicam IV 30 mg exhibited a statistically significant difference in SPID48 versus the placebo group (P=0.0034). Statistically significant differences favoring meloxicam IV over placebo were also observed for secondary efficacy endpoints, including SPID at other times/intervals (SPID6: P=0.0153; SPID12: P=0.0053; SPID24: P=0.0084; and SPID24-48: P=0.0050) and first use of rescue medication (P=0.0076). Safety findings indicated that meloxicam IV 30 mg was generally well tolerated; no serious AEs or bleeding events were observed. Most AEs were assessed by the investigator to be mild in intensity, and no patients discontinued due to AEs. There were no meaningful differences between the study groups in vital signs, electrocardiographic findings, or laboratory assessments. In most cases, investigators found that wound healing followed a normal course and mean wound-healing satisfaction scores were similar for meloxicam IV 30 mg and placebo.

Discussion:
Meloxicam IV doses of 30 mg provided effective pain relief when administered once daily by bolus injection to patients with moderate-to-severe pain following bunionectomy, and had an acceptable safety profile.
Comparison of 6-year Follow-up Result of Hybrid Surgery and Anterior Cervical Discectomy and Fusion for the Treatment of Contiguous Two-segment Cervical Degenerative Disc Diseases
Authors: Xiong Yang , Xu Lin , Yu Xing , Yang Yongdong , Zhao Dingyan , Hu Zhengguo , Li Chuanhong , Zhao He , Duan Lijun , Zhang Bingbing , Chen Sixue , Liu Tao 
Published: March 2018

Study Design.
A retrospective study.

Objective.
To compare the mid-term outcomes of hybrid surgery (HS) and anterior cervical discectomy and fusion (ACDF) for the treatment of contiguous two-segment cervical degenerative disc diseases.

Summary of Background Data.
HS has become one of the most controversial subjects in spine communities, and the comparative studies of HS and ACDF in the mid- and long-term follow-up are rarely reported.

Methods.
From 2009 to 2012, 42 patients who underwent HS (n = 20) or ACDF (n = 22) surgery for symptomatic contiguous two-level cervical degenerative disc diseases were included. Clinical and radiological records, including Japanese Orthopedic Association (JOA), Neck Disability Index (NDI), Visual Analogue Scale (VAS), local cervical lordosis, and range of motion (ROM), were reviewed retrospectively. Complications were recorded and evaluated.

Results.
Mean follow-up was 77.25 and 79.68 months in HS group and ACDF group, respectively (P > 0.05). Both in HS group and ACDF group, significant improvement for the mean JOA, NDI, and VAS scores was found at 2-week postoperation and at the last follow-up (P < 0.05). However, there were no significant differences between the two groups (P > 0.05). At the last follow-up, the range of motion (ROM) of superior adjacent segments in ACDF group was significantly larger than HS group (P < 0.05), while the ROM of C2-C7 was significantly smaller (P < 0.05). In the HS group, two (10%) sagittal wedge deformities, one (5%) heterotopic ossification, and one (5%) anterior migration of the Byran disc prosthesis were found. No symptomatic adjacent segment degeneration occurred in two groups.

Conclusion.
HS appears to be an acceptable option in the management of contiguous two-segment cervical degenerative disc diseases. It yielded similar mid-term clinical improvement to ACDF, and demonstrated better preservation of cervical ROM. The incidence of postoperative sagittal wedge deformity was low; however, it can significantly reduce the cervical lordosis.

Level of Evidence: 4
Effects of High Salt-Low Potassium Diet on Blood Pressure and Vascular Reactivity in Male Sprague Dawley Rats
Authors: Mokotedi Lebogang , Michel Frederic S. , Woodiwiss Angela J. , Norton Gavin R. , Millen Aletta M. E. 
Published: March 2018

Abstract:
Sodium (Na+) intake increases vascular reactivity. Whether low potassium (K+) intake affects vascular reactivity–associated blood pressure (BP) changes is uncertain. This study aimed to determine whether Na+-induced increases in BP and vascular reactivity are altered by low K+ intake. Male Sprague Dawley rats were assigned to 3 dietary groups for 6 weeks: a standard Na+-K+ diet (control, n = 12), a high Na+-normal K+ diet (HS-NormK, n = 12), and a high Na+-low K+ diet (HS-LowK, n = 12). BP was measured at baseline and after the dietary intervention. Na+ and K+ excretions and vascular reactivity were measured after the dietary intervention. The Na+/K+ ratio was significantly higher in the HS-LowK compared with the other groups. Systolic and diastolic BPs increased significantly in the HS-NormK and HS-LowK groups. In mesenteric arteries, the dose–response curves for phenylephrine-induced contractions shifted to the left and the EC50 (mean ± SD) was significantly lower in the HS-NormK (0.51 ± 0.17 μM, P = 0.003) and HS-LowK (0.69 ± 0.14 μM, P = 0.005) groups compared with the control (3.24 ± 0.79 μM). Systolic (r = −0.58 P = 0.002) and diastolic (r = −0.61 P = 0.001) BPs were associated with the EC50 of phenylephrine-induced contraction in mesenteric arteries. High Na+ intake induces increased alpha-1 receptor responsiveness in mesenteric arteries, which may be responsible for the increase in BP and is not affected by low dietary K+ intake.
PANRETINAL RITONAVIR-INDUCED RETINOPATHY: A REPORT OF LONG-TERM USE
Authors: Mesquita Leonardo R. C. , da Fonseca Maria L. G. , da Silva Rodrigo M. , Morizot Eduardo H. 
Published: March 2018

Purpose:
To report a case involving a patient with presumed panretinal ritonavir-induced retinopathy.

Methods:
A 52-year-old, HIV-positive patient, with no criteria for AIDS associated with the use of ritonavir for more than 10 years, underwent clinical examination, fundus photography, spectral domain optical coherence tomography, and fundus autofluorescence imaging.

Results:
Fundus examination revealed areas of atrophy and hypertrophy in the retinal pigment epithelium throughout the retina. Laboratory tests for other diseases were all negative.

Conclusion:
HIV-positive patients undergoing ritonavir therapy should be carefully followed in the presence of low-acuity vision complaints and retinal changes.
Quantitative Assessment of Aqueous Flare After Descemet Membrane Endothelial Keratoplasty for Fuchs Endothelial Dystrophy
Authors: Baydoun Lamis , Lam Fook Chang , Schaal Sontje , Hsien Shugi , Oellerich Silke , van Dijk Korine , Melles Gerrit R. J. 
Published: March 2018

Purpose:To assess aqueous flare as a measure of subclinical inflammation after Descemet membrane endothelial keratoplasty (DMEK) for Fuchs endothelial dystrophy.Methods:In this prospective cross-sectional and longitudinal case series at a tertiary referral center, 173 DMEK eyes of 169 patients and 19 age-matched healthy control eyes were included. Aqueous flare [photon count per millisecond (ph/ms)] was assessed by laser flare photometry at 1 day, 1 week, and 1 month after DMEK in group I (evaluation of postsurgical blood–aqueous barrier recovery; n = 25) and on average 28 (±19) months (range, 3–86 months) after DMEK in group II (evaluation of long-term inflammation; n = 148).Results:In group I, flare levels decreased from 1 day to 1 week [25.1 (±9.1) ph/ms vs. 13.4 (±4.8) ph/ms;P= 0.003] and remained stable up to 1 month after DMEK [12.1 (±3.2) ph/ms;P= 0.387]. However, average flare at 1 month was higher than that in healthy controls (P< 0.001). The long-term flare value after DMEK (group II) was 9.6 (±4.2) ph/ms and was higher in eyes associated with allograft rejection (n = 6) versus those without rejection [16.7 (±7.8) ph/ms vs. 9.3 (±3.8) ph/ms, respectively,P< 0.001]. All eyes associated with rejection had flare values above 10 ph/ms.Conclusions:Aqueous flare after DMEK quickly decreased within the first postoperative month, indicating fast recovery of the blood–aqueous barrier. Long-term flare levels were higher in eyes associated with rejection, suggesting persistent subclinical inflammation. A flare level above 10 ph/ms may be used as a threshold for identifying eyes associated with or at risk of allograft rejection after DMEK.
Early workplace dialogue in physiotherapy practice improved work ability at 1-year follow-up—WorkUp, a randomised controlled trial in primary care
Authors: Sennehed Charlotte P. , Holmberg Sara , Axén Iben , Stigmar Kjerstin , Forsbrand Malin , Petersson Ingemar F. , Grahn Birgitta 
Published: March 2018

AbstractWorkplace involvement in rehabilitation for patients with musculoskeletal pain may improve work ability. Convergence Dialogue Meeting (CDM) is a model aimed at helping the patient, the care giver, and the employer to support work ability and return-to-work. Our aim was to study the effect on work ability when adding a workplace dialogue according to CDM in physiotherapy practice for patients with pain in ordinary primary care. We conducted a prospective pairwise cluster randomised controlled trial (ClinicalTrials.gov ID: NCT02609750) in primary care involving 20 primary care rehabilitation units with 1-year follow-up. Adult patients with acute/subacute neck and back pain, worked ≥4 weeks past year and not currently on sick leave or no more than 60 days of sick leave and considered at-risk of sick leave were included (n = 352). All patients received structured physiotherapy and the intervention was the addition of CDM, delivered by the treating physiotherapist. The main confirmatory outcome, work ability (defined as working at least 4 consecutive weeks at follow-up), was assessed by a weekly short text message question on number of sick leave days past week. Work ability was reached by significantly more patients in the intervention group (108/127, 85%) compared with the reference group (127/171, 74%) (P= 0.02). The intervention increased the odds of having work ability at 1-year follow-up, also after adjustment for baseline health-related quality of life (odds ratio 1.85, confidence interval 1.01-3.38). We conclude that an early workplace dialogue in addition to structured physiotherapy improved work ability significantly.
Apolipoprotein C-III in triglyceride-rich lipoprotein metabolism
Authors: Ramms Bastian , Gordts Philip L.S.M. 
Published: March 2018

Purpose of review
Apolipoprotein (apo) C-III is a key player in triglyceride-rich lipoprotein metabolism and strongly associated with elevated plasma triglyceride levels. Several new studies added important insights on apoC-III and its physiological function confirming its promise as a valid therapeutic target.

Recent findings

APOC3 is expressed in liver and intestine and regulates triglyceride-rich lipoprotein (TRL) catabolism and anabolism. The transcriptional regulation in both organs requires different regulatory elements. Clinical and preclinical studies established that apoC-III raises plasma triglyceride levels predominantly by inhibiting hepatic TRL clearance. Mechanistic insights into missense variants indicate accelerated renal clearance of apoC-III variants resulting in enhanced TRL catabolism. In contrast, an APOC3 gain-of-function variant enhances de novo lipogenesis and hepatic TRL production. Multiple studies confirmed the correlation between increased apoC-III levels and cardiovascular disease. This has opened up new therapeutic avenues allowing targeting of specific apoC-III properties in triglyceride metabolism.

Summary
Novel in vivo models and APOC3 missense variants revealed unique mechanisms by which apoC-III inhibits TRL catabolism. Clinical trials with Volanesorsen, an APOC3 antisense oligonucleotide, report very promising lipid-lowering outcomes. However, future studies will need to address if acute apoC-III lowering will have the same clinical benefits as a life-long reduction.
Long noncoding RNAs in lipid metabolism
Authors: van Solingen Coen , Scacalossi Kaitlyn R. , Moore Kathryn J. 
Published: March 2018

Purpose of review
Noncoding RNAs have emerged as important regulators of cellular and systemic lipid metabolism. In particular, the enigmatic class of long noncoding RNAs have been shown to play multifaceted roles in controlling transcriptional and posttranscriptional gene regulation. In this review, we discuss recent advances, current challenges and future opportunities in understanding the roles of lncRNAs in the regulation of lipid metabolism during health and disease.

Recent findings
Despite comprising the majority of the transcriptionally active regions of the human genome, lncRNA functions remain poorly understood, with fewer than 1% of human lncRNAs functionally characterized. Broadly defined as nonprotein coding transcripts greater than 200 nucleotides in length, lncRNAs execute their functions by forming RNA–DNA, RNA–protein, and RNA–RNA interactions that regulate gene expression through diverse mechanisms, including epigenetic remodeling of chromatin, transcriptional activation or repression, posttranscriptional regulation of mRNA, and modulation of protein activity. It is now recognized that in lipid metabolism, just as in other areas of biology, lncRNAs operate to regulate the expression of individual genes and gene networks at multiple different levels.

Summary
The complexity revealed by recent studies showing how lncRNAs can alter systemic and cell-type-specific cholesterol and triglyceride metabolism make it clear that we have entered a new frontier for discovery that is both daunting and exciting.
Poststatin era in atherosclerosis management: lessons from epidemiologic and genetic studies
Authors: Yvan-Charvet Laurent , Cariou Bertrand 
Published: March 2018

Purpose of review
Cardiovascular diseases (CVD) are the leading cause of death worldwide with over 17 million deaths every year and represent a major public health challenge. The last decade has seen the emergence of novel antiatherogenic therapies.

Recent findings
Despite intensive lipid and blood pressure interventions, the burden of CVD is expected to markedly progress because of the global aging of the population and increasing exposure to detrimental lifestyle-related risk. Epidemiologic and genetic studies helped to better apprehend the biology of atherosclerosis and allowed pharmaceutical innovation and recent translational successes. This includes the development of novel lipid and glucose-lowering therapies and the leverage of anti-inflammatory therapies.

Summary
Here, we discuss promises and expectations of emerging scientific and pharmaceutical innovations and translational successes to meet the global therapeutic demand.
Management of pilonidal disease
Authors: Kallis Michelle P. , Maloney Caroline , Lipskar Aaron M. 
Published: March 2018

Purpose of review
Pilonidal disease, and the treatment associated with it, can cause significant morbidity and substantial burden to patients’ quality of life. Despite the plethora of surgical techniques that have been developed to treat pilonidal disease, discrepancies in technique, recurrence rates, complications, time to return to work/school and patients’ aesthetic satisfaction between treatment options have led to controversy over the best approach to this common acquired disease of young adults.

Recent findings
The management of pilonidal disease must strike a balance between recurrence and surgical morbidity. The commonly performed wide excision without closure has prolonged recovery, while flap closures speed recovery time and improve aesthetics at the expense of increased wound complications. Less invasive surgical techniques have recently evolved and are straightforward, with minimal morbidity and satisfactory results.

Summary
As with any surgical intervention, the ideal treatment for pilonidal disease would be simple and cost-effective, cause minimal pain, have a limited hospital stay, low recurrence rate and require minimal time off from school or work. Less invasive procedures for pilonidal disease may be favourable as an initial approach for these patients reserving complex surgical treatment for refractory disease.
Symptomatic Cerebral Sinovenous Thrombosis Associated With l-Asparaginase In Children With Acute Lymphoblastic Leukemia: A Single Institution Experience Over 17 Years
Authors: Malhotra Payal , Jain Sandeep , Kapoor Gauri 
Published: March 2018

Background:
Cerebral sinovenous thrombosis (CSVT) is a rare, yet important complication of acute lymphoblastic leukemia (ALL) therapy, associated with significant morbidity and mortality. Paucity of data from India prompted us to report our experience with CSVT over a period of 17 years.

Materials and Methods:
This is a retrospective analysis of 500 consecutive ALL patients, below 18 year of age, treated between January 1998 and December 2014, who developed symptomatic CVST.

Results:
Seven of the 467 eligible patients developed symptomatic CVST with an incidence of 1.5% (7/467). Six of the CVST events, occurred during induction and 1 during reinduction. Median time to symptoms was 21 days (range, 2 to 27 d) from first exposure to l-asparaginase therapy. Management included low–molecular-weight heparin (enoxaparin sodium) at a dose of 1 mg/kg twice a day for at least 3 months along with supportive care. There were 2 thrombosis-attributable deaths. The remaining patients tolerated rechallenge with l-asparaginase uneventfully during reinduction, under cover of heparin prophylaxis. Complete neurological recovery was observed in all surviving patients.

Conclusions:
Incidence of symptomatic l-asparaginase associated CSVT during ALL treatment was 1.5% with high case fatality rate (28%). It is noteworthy that full neurological recovery is likely in surviving patients, and rechallenge with l-asparaginase is safe with heparin prophylaxis. Currently available screening methods are not practically implementable in resource-limited settings.