bluuebunny/crossref_metadata_2025_split huggingface dataset:
Which of the fluorine-18 fluorodeoxyglucose positron emission tomography/computerized tomography parameters are better associated with prognostic factors in breast cancer?
Authors: Önner Hasan , Canaz Funda , Dinçer Murat , Işiksoy Serap , Sivrikoz İlknur AK , Entok Emre , Erkasap Serdar 
Published: May 2019

Abstract
The aim of the present study is to evaluate the relationship between the immunohistochemical and histopathological prognostic factors and the metabolic fluorine-18 fluorodeoxyglucose positron emission tomography/computerized tomography (PET/CT) parameters in breast cancer.
A total of 94 female patients diagnosed with primary breast cancer (median age: 54.5 years, 94 lesions with size >15 mm) who underwent PET/CT imaging before any treatment were enrolled to this retrospective study. Maximum and average standardized uptake values (SUVmax and SUVavg), metabolic tumor volume (MTV), total lesion glycolysis (TLG), and tumor/liver uptake ratio (TLR) of the primary tumors were calculated and compared between various histopathological and immunohistochemical prognostic factor groups.
All metabolic parameters were associated with clinical T stage, metabolic M stage, and nuclear grade. The MTV, TLG, and TLR were significantly higher in patients with suspected lymph node metastasis. There were significant differences according to estrogen receptor and human epidermal growth factor-2 status in the metabolic values other than MTV. In case of progesterone receptor, there were significant differences in the metabolic characteristics except for the MTV and TLG values. The Ki-67 labeling index was moderately correlated with SUVmax, SUVavg, and TLR. All metabolic characteristics except MTV were significantly higher in triple negative breast cancer compared with the other molecular subtypes.
The results of the present study suggest that the TLG and TLR values have stronger associations with several prognostic factors in breast cancer (BC) compared with other metabolic parameters.
Congenital chloride losing diarrhea
Authors: Kamal Naglaa M. , Khan Hekmat Yaqoub , El-Shabrawi Mortada H.F. , Sherief Laila M. 
Published: May 2019

Abstract
Congenital chloride losing diarrhea (CCLD) is a rare type of chronic watery diarrhea due to mutations in SLC26A3 gene leading to defective chloride–bicarbonate exchanges with the resultant loss of chloride and retention of bicarbonate.
We aim to define pediatric Saudi CCLD patients’ characteristics to achieve prompt diagnosis, management, follow up with good quality of life, and prevention of complications in these patients.
We carried retrospective data review of demographic, clinical, laboratory, radiographic, and outcome of all pediatric patients fulfilling the criteria of CCLD over 10 years from 2004 to 2014 from a single center in Taif region, Saudi Arabia.
Forty-nine patients fulfilled the criteria of CCLD from 21 families with more than one affected patient in the same family in 90% of them and positive consanguinity in 91% of the cohort. Most patients were born preterm with intrauterine growth restriction and usually neonatal intensive care unit (NICU) admissions with prematurity and its complications. Thirteen patients were discharged without diagnosis of CCLD and 3 were misdiagnosed as intestinal obstruction with unnecessary surgical intervention. Many complications do existed with renal complications being the most common with three patients received renal transplantation.
Prematurity with abdominal distension and stool like urine were the commonest presentation of CCLD in Saudi children. Positive consanguinity and more than one affected sibling are present in most of our cohort.
High index of suspicion by clinicians is a cornerstone for early diagnosis with subsequent favorable outcome.
A multicenter national incidence study of CCLD in KSA and its genetic attributes is recommended. Premarital screening should be implemented specially for consanguineous marriage.
The gut microbiota in type 1 diabetes: friend or foe?
Authors: Gavin Patrick G. , Hamilton-Williams Emma E. 
Published: May 2019

Purpose of reviewEvidence is mounting that disturbances in the gut microbiota play a role in the rising incidence of type 1 diabetes (T1D) and new technologies are expanding our ability to understand microbial function and host interactions. Longitudinal data from large cohorts of children at risk of T1D are nor solidifying our understanding of the function of the microbiota in this disease.Recent findingsAlthough taxonomic changes in the gut microbiota associated with T1D are relatively modest, a functional defect in production of short-chain fatty acids (SCFAs) remains as a unifying feature across multiple studies and populations. Dysbiosis of the microbiota in T1D has been linked to decreased gut barrier and exocrine pancreas function. We explore factors contributing to the disturbed microbiota in T1D such as infant diet, probiotic use and genetic risk linked to defective immune regulation. We also discuss the interplay between immunotherapy, the gut immune response and the microbiota.SummaryFunctional alterations in the microbiota are linked to pathogenesis of T1D and these findings provide a rationale for future investigations aimed at establishing a healthy microbiota and promoting SCFA production and prevention of T1D.
Pleiotropic roles of the insulin-like growth factor axis in type 1 diabetes
Authors: Shapiro Melanie R. , Atkinson Mark A. , Brusko Todd M. 
Published: May 2019

Purpose of review
We review studies demonstrating lowered levels of insulin-like growth factors (IGFs) in patients with recent-onset type 1 diabetes (T1D) and discuss their potential roles in the disorder's pathogenesis.

Recent findings
IGFs have long been recognized as a class of hormones that promote growth, development, and cellular metabolism throughout the human body. More recently, studies have noted an association between reduced pancreatic weight/volume and T1D. Thus, we believe it is important to understand pancreatic regulation of IGF expression and bioavailability, as well as the impact of IGFs on pancreatic growth and islet health. Additional studies of IGFs have been extended to their influence on the inflammatory/regulatory balance of monocytes, B cells, and T cells; features which have been previously established to show dysregulation in settings of T1D.

Summary
These data suggest that IGFs may prevent known impairments in the pancreas and immune system in T1D and underscore the need to extend these studies, some of which were performed in health or other autoimmune diseases, toward T1D specifically. Collectively, the work emphasized here support the potential therapeutic use of IGFs in T1D prevention efforts as pancreatic growth factors and/or immunoregulatory agents.
Inflammatory joint diseases and atherosclerosis: time to look beyond the ‘lipid paradox’
Authors: Mackey Rachel H. , Kuller Lewis H. , Moreland Larry W. 
Published: May 2019

Purpose of reviewUncertainty persists about the contribution of lipids to the increased risk of cardiovascular disease (CVD) among rheumatoid arthritis and other inflammatory joint disease (IJD) patients. In reviewing recent research, we consider potential insights gained by quantifying lipoprotein particles directly, rather than by their lipid content.Recent findingsAlthough inflammation often decreases LDL cholesterol (LDL-C), and anti-inflammatory medications often increase LDL-C, both inflammation and anti-inflammatory medications can increase atherogenic Apolipoprotein B (ApoB)-containing lipoprotein particles, attenuated by statins. CVD risk factors, that is, smoking, obesity, ApoB, may increase years prior to IJD diagnosis. Increased risks of nonatherosclerotic myocardial and pulmonary disease, heart failure and mortality may be directly related to disease activity, inflammation, and possibly to HDL particles and function.SummaryFor IJD patients, higher cumulative lifetime exposure to CVD risk factors accelerates atherosclerosis and subsequent CVD risk that is underestimated by current risk factor levels. CVD risk reduction in IJD requires aggressive and earlier reduction in CVD risk factors (ApoB lipoproteins, smoking, hypertension, diabetes, lack of physical activity), in addition to control of disease activity and inflammation. Lipid-lowering medications can attenuate anti-inflammatory medication-induced increases in ApoB and LDL-C, but can also reduce CVD risk due to cumulative lifetime exposure.
Impact of Pharmacist-Driven Heart Failure in-Home Counseling on 30-Day Readmission Rates
Authors: Berman Tova , Clark Nicole , Lemieux Amy A. 
Published: May 2019

Purpose/Objective:
This study examines the impact of a pharmacist-driven intervention specific to heart failure patients with the goal of reducing readmission rates and improving quality of life in this population.

Findings/Conclusions:
A total of 21 patients were included in the study. Twelve patients were female and 9 were male. The mean age was 76 years with a range of 65–93 years. Two of the 21 patients were readmitted within 30 days. One of the 2 readmitted patients died soon after admission was in the final stages of his or her disease and passed away soon after; it is unlikely for a home visit to have altered their path. This study did not meet the goal sample size due to some unforeseen limitations. However, the limited data that were obtained suggest a strong basis for further research.

Implications for Case Management Practice:
During a patient's transition in care from hospital to home, he or she is most vulnerable for complications and readmission. Intervention during this time will not only improve patient care and quality of life but also contribute to a notable cost savings for each prevented readmission. Pharmacist intervention, as part of the health care team, during this tenuous time has shown to make a valuable impact.
The Impact of Case Management on Reducing Readmission for Patients Diagnosed With Heart Failure and Diabetes
Authors: McCants Khalilah M. , Reid Kathryn B. , Williams Ishan , Miller D. Elise , Rubin Richard , Dutton Suzanne 
Published: May 2019

Purpose of the Study:
To determine the impact of integrated case management services versus treatment as usual (TAU) for patients diagnosed with diabetes and concomitant heart failure.

Primary Setting:
This medical chart review was conducted at a single-site facility. The retrospective study design can be implemented at other facilities with a similar landscape.

Methods:
A retrospective, descriptive, comparative analysis of integrated case management services compared with TAU from a medical chart review of 68 patients from September 1, 2015, through July 31, 2017. A medical chart review was conducted to generate the study sample for data collection and analysis. The data were organized, cleaned, and prepared and then analyzed. The data were analyzed using SPSS and verified with SAS and R. Applied were descriptive statistics and statistical tests—t test, χ2 test, Mann–Whitney U test, and Logistic Regression.

Results:
For the integrated case management group, there were 18.4% who readmitted whereas 81.6% did not. For the TAU group, there were 52.6% who readmitted and 47.4% who did not. The association between readmission and case management was χ2 (1, n = 68) = 6.372, p = .012.

Nursing Implications:
Integrated case management services were statistically significant in reducing readmission for the sample. Demographics tested in this study were not significant predictors for readmission. Extending length of stay for patients who are not medically ready for discharge should be considered because there is a cost difference, as there is evidence of readmission reduction. Policy and procedural amendments can be obtained from this study.
Factors Associated With Increased Syphilis Screening Among People Living With Human Immunodeficiency Virus
Authors: Hixson Lindsay K. , Drach Linda , Maher Julie E. , Knapp Alicia T. , Ferrer Joshua S. , Menza Timothy W. 
Published: May 2019

Background
Antiretroviral therapy effectively reduces the risk of human immunodeficiency virus transmission, but in the context of undetectable equals untransmittable and decreased condom use, rates of syphilis are increasing. In Oregon, syphilis has risen over 20-fold in the past decade, from less than 30 to approximately 600 cases annually during 2016 and 2017. Although many cases are among people living with human immunodeficiency virus infection (PLWH), screening for syphilis among PLWH is often lacking. The objective of this study was to estimate the prevalence of past-year syphilis testing among PLWH in Oregon to identify facility-level and individual-level factors associated with testing.

Methods
We examined 2015 to 2016 Medical Monitoring Project interview and medical records data in Oregon and conducted supplemental interviews with participants' medical providers. We used generalized mixed effects models to identify factors associated with syphilis screening.

Results
Sixty-nine percent of Medical Monitoring Project participants had past-year syphilis screening. Patients receiving care from facilities with written sexually transmitted infection screening policies were far more likely to be screened than those receiving care from facilities without written policies (94% vs. 43%, P < 0.001). Participants who identified as male were more likely to have been tested, even after adjusting for facility-level characteristics. Clustering within facility accounted for about 15% of the unexplained variability in the adjusted mixed effects models.

Conclusions
Written sexually transmitted infection screening policies at medical facilities appear to be an important tool for ensuring syphilis screening occurs as recommended to prevent the continued rise in syphilis.
Differences in the Mitochondrial and Lipid Droplet Morphology in Female Office Workers With Trapezius Myalgia, Compared With Healthy Controls
Authors: De Meulemeester Kayleigh , Cagnie Barbara , Van Dorpe Jo , Lammens Martin , Petrovic Mirko , Calders Patrick 
Published: May 2019

Objective
Trapezius myalgia or, more specifically, myofascial dysfunction of the upper trapezius mainly affects women performing jobs requiring prolonged low level activation of the muscle. This continuous low muscle load can be accompanied by a shift to a more anaerobic energy metabolism, causing pain. The aim of the study was to investigate whether morphological signs of an impaired aerobic metabolism are present in female office workers with trapezius myalgia.

Design
Muscle biopsy analysis, using electron and light microscopy, was performed to compare mitochondrial and fat droplet morphology, and irregular muscle fibers, between female office workers with (n = 17) and without (n = 15) work-related trapezius myalgia.

Results
The patient group showed a significantly higher mean area (P = 0.023) and proportion (P = 0.029) for the subsarcolemmal and intermyofibrillar mitochondria respectively, compared with the control group. A significantly lower mean area of subsarcolemmal lipid droplets was found in the patient group (P = 0.015), which also displayed a significantly higher proportion of lipid droplets touching the mitochondria (P = 0.035). A significantly higher amount of muscle fibers with cytochrome c oxidase–deficient areas were found in the patient group (P = 0.030).

Conclusions
The results of the present study may be indicative for an impaired oxidative metabolism in work-related trapezius myalgia. However, additional research is necessary to confirm this hypothesis.
Cardiac Computed Tomography for Atrial Fibrillation Patients Undergoing Ablation
Authors: Ebersberger Ullrich , Bernard Michael L. , Schoepf U. Joseph , Wince William Benjamin , Litwin Sheldon E. , Wang Yining , Blanke Philipp , Makowski Marcus R. , McQuiston Andrew D. , Silverman Justin R. , Gray J.C. , Tesche Christian , Duguay Taylor M. , Schmidt Martin , Wharton John Marcus , Bayer Richard R. 
Published: May 2019

Objective:
The objective of this study was to correlate early recurrence of atrial fibrillation (AF) after ablation with noninvasive imaging using cardiac computed tomography (CT).

Methods:
CT image data of 260 patients who had undergone wide area circumferential ablation (WACA) between October 2005 and August 2010 as well as from 30 subjects in sinus rhythm without a history of AF (control group) were retrospectively analyzed. To evaluate early outcome of AF ablation, all AF patients underwent follow-up with a 30-day event monitor 3 to 4 months after ablation. In addition, a cardiac CT was also performed 3 to 4 months after ablation to exclude pulmonary vein (PV) stenosis. The presence of early AF was correlated with anatomic and functional PV and left atrial parameters, as assessed by cardiac CT.

Results:
A total of 70 patients (26.9%) were found to have early recurrence of AF. However, we found no association between PV or left atrial anatomic or functional parameters derived from cardiac imaging with early AF recurrence. Furthermore, no correlation (P>0.05) between AF recurrence and coronary artery stenosis, anatomic origin of the sinoatrial, or atrioventricular nodal arteries was observed. Finally, PV contraction did not predict AF recurrence. However, when comparing PV contraction in WACA patients with the control group, a significant (P<0.05) reduction in left superior PV and right superior PV contractility was found in patients after radiofreqency ablation.

Conclusions:
In our relatively large cohort, cardiac CT did not yield any anatomic or functional markers for the prediction of early AF recurrence after undergoing WACA. However, our data may provide insights into functional changes that occur following ablation procedures.
Resuscitative endovascular balloon occlusion of the aorta induced myocardial injury is mitigated by endovascular variable aortic control
Authors: Beyer Carl A. , Hoareau Guillaume L. , Tibbits Emily M. , Davidson Anders J. , DeSoucy Erik D. , Simon Meryl A. , Grayson John Kevin , Neff Lucas P. , Williams Timothy K. , Johnson Michael Austin 
Published: May 2019

BACKGROUND
The cardiac effects of resuscitative endovascular balloon occlusion of the aorta (REBOA) are largely unknown. We hypothesized that increased afterload from REBOA would lead to cardiac injury, and that partial flow using endovascular variable aortic control (EVAC) would mitigate this injury.

METHODS
Eighteen anesthetized swine underwent controlled 25% blood volume hemorrhage. Animals were randomized to either Zone 1 REBOA, Zone 1 EVAC, or no intervention (control) for 45 minutes. Animals were then resuscitated with shed blood, observed during critical care, and euthanized after a 6-hour total experimental time. Left ventricular function was measured with a pressure-volume catheter, and blood samples were drawn at routine intervals.

RESULTS
The average cardiac output during the intervention period was higher in the REBOA group (9.3 [8.6–15.4] L/min) compared with the EVAC group (7.2 [5.8–8.0] L/min, p = 0.01) and the control group (6.8 [5.8–7.7] L/min, p < 0.01). At the end of the intervention, the preload recruitable stroke work was significantly higher in both the REBOA and EVAC groups compared with the control group (111.2 [102.5–148.6] and 116.7 [116.6–141.4] vs. 67.1 [62.7–87.9], p = 0.02 and p < 0.01, respectively). The higher preload recruitable stroke work was maintained throughout the experiment in the EVAC group, but not in the REBOA group. Serum troponin concentrations after 6 hours were higher in the REBOA group compared with both the EVAC and control groups (6.26 ± 5.35 ng/mL vs 0.92 ± 0.61 ng/mL and 0.65 ± 0.38 ng/mL, p = 0.05 and p = 0.03, respectively). Cardiac intramural hemorrhage was higher in the REBOA group compared with the control group (1.67 ± 0.46 vs. 0.17 ± 0.18, p = 0.03), but not between the EVAC and control groups.

CONCLUSION
In a swine model of hemorrhagic shock, complete aortic occlusion resulted in cardiac injury, although there was no direct decrease in cardiac function. EVAC mitigated the cardiac injury and improved cardiac performance during resuscitation and critical care.
Unfractionated heparin attenuates histone-mediated cytotoxicity in vitro and prevents intestinal microcirculatory dysfunction in histone-infused rats
Authors: Zhu Chengrui , Liang Yingjian , Li Xu , Chen Ning , Ma Xiaochun 
Published: May 2019

BACKGROUND
Extracellular histones are major mediators of organ dysfunction and death in sepsis, and they may cause microcirculatory dysfunction. Heparins have beneficial effects in sepsis and have been reported to bind to histones and neutralize their cytotoxicity. The aim of this study was to investigate the impact of histones on intestinal microcirculation and the intestinal endothelium and to discuss the protective effect of unfractionated heparin (UFH) on the endothelial cytotoxicity and microcirculatory dysfunction induced by histones.

METHODS
Anesthetized rats were infused with 30 mg/kg calf thymus histones, and UFH was administered intravenously at a concentration of 100 IU/kg per hour. The intestinal microcirculation was visualized and measured with incident dark field microscope. Plasma von Willebrand factor (vWF) and soluble thrombomodulin were detected, and structural changes in the rat intestinal microvascular endothelium were examined. The effects of histones and UFH on cell survival rates, vWF release and calcium influx were investigated in human intestinal microvascular endothelial cells (HIMECs).

RESULTS
Histone infusion caused severe intestinal microcirculatory dysfunction in the absence of obvious hemodynamic changes, and UFH protected intestinal microcirculation in histone-infused rats. Concentrations of the plasma endothelial injury markers vWF and soluble thrombomodulin were elevated, and structural abnormalities were found in the intestinal microvascular endothelium in the histone-infused rats. These events were attenuated by UFH. In vitro, UFH significantly reduced the histone-induced cytotoxicity of HIMECs, reduced the release of vWF from the cytoplasm into the culture medium, and inhibited calcium influx into HIMECs.

CONCLUSION
Histones induce intestinal microcirculatory dysfunction followed by direct injury to the endothelial cells; UFH protects the intestinal microcirculation partly by antagonizing the endothelial toxicity of histones.