bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Significance of Acute and Serial Platelet Function Testing in Acute Ischemic Stroke
Authors: Kim Joon‐Tae , Choi Kang‐Ho , Park Man‐Seok , Lee Ji Sung , Saver Jeffrey L. , Cho Ki‐Hyun 
Published: June 2018

Background
We sought to investigate the clinical implications of platelet reactivity to aspirin and the variability in the platelet reactivity to aspirin during acute periods for the risk of vascular events in patients with acute ischemic stroke.

Methods and Results

This was a single‐center, prospective, observational study. The aspirin reaction unit was blindly measured at the following two times: after 3 hours of aspirin loading and on the fifth day of aspirin administration. High on‐aspirin platelet reactivity (
HAPR
) was defined as an aspirin reaction unit ≥550 IU. The primary outcome measure was the 1‐year composite of stroke, myocardial infarction, and vascular death. A total of 805 patients (aged 66±12 years, 61% male) were analyzed in this study. Ninety‐nine of 805 (12.3%) patients and 78 of 558 (14.0%) patients had
HAPR
at the time of the fifth day of aspirin administration and after 3 hours of aspirin loading measurements, respectively. Patients with
HAPR
than normal on‐aspirin platelet reactivity at the fifth day of aspirin administration measurement were more likely to have experienced 1‐year vascular event.
HAPR
at the fifth day of aspirin administration measurement was independently associated with a greater risk of experiencing 1‐year vascular event (hazard ratio, 1.84; 95% confidence interval, 1.07–3.19). Moreover, persistently
HAPR
substantially increased the risk of 1‐year vascular events (hazard ratio, 3.11; 95% confidence interval, 1.23–7.86).

Conclusions

These results suggest that
HAPR
during the acute stage of ischemic stroke increases the risk of subsequent vascular events and that serial aspirin reaction unit measurements may identify patients with acute ischemic stroke who are at a higher risk for vascular events. Additional studies are warranted to determine the appropriate treatments for patients with acute ischemic stroke with
HAPR
.
Phylogeny and conservation status of the Indian egg-eater snake, Elachistodon westermanni Reinhardt, 1863 (Serpentes, Colubridae)
Authors: Mohan Ashwini Venkatanarayana , Visvanathan Avinash C. , Vasudevan Karthikeyan 
Published: June 2018

Abstract
The Indian egg-eater (Elachistodon westermanni) is a monotypic species of the Genus Elachistodon distributed across the Indian sub-continent. In Africa, there are 13 species of egg-eating snakes of the Genus Dasypeltis. These two genera, Elachistodon and Dasypeltis were thought to be closely related due to similar diet specialization, and shared biogeographic history between the Indian sub-continent and the continent of Africa. In our study, we amplified three mitochondrial genes and one nuclear gene from E. westermanni and reconstructed molecular phylogeny utilizing published sequences to understand the evolutionary relationships between the African, and the Indian egg-eating snakes. We used morphological characters to reinforce our inferences on phylogenetic relationships. We show that the Indian egg-eater is sister to cat snakes of the Genus Boiga, and it does not share recent ancestry with the African egg-eating snakes. Morphological character states point at similarities between Elachistodon and Dasypeltis only in characters associated with their feeding behaviour. Elachistodon westermanni was similar to the Boiga spp. in several other morphological characters, and we provisionally assign E. westermanni under the genus Boiga. Compilation of records of E. westermanni across the Indian sub-continent over the years revealed a positive “Lazarus” effect. We conclude that, the egg-eating behaviour and the associated morphological characters in the snake genera Dasypeltis and Elachistodon are a result of convergent evolution. Based on the conservation status of E. westermanni, it could serve as a flagship species to conserve important wildlife habitats that are being lost rapidly in India.
Myth, Ritual, and the Early Development of Shiite Identity
Authors: Hylén Torsten 
Published: June 2018

Abstract
The developing myth about the events at Karbala, as well as the image of al-Ḥusayn b. ʿAlī and the cult connected with him, were important factors in the shaping of early Shiite identity. In this article, I argue that some of the earliest traces of this process are found in the account of the Tawwābūn, or Penitents, events which took place in the years immediately following the death of al-Ḥusayn at Karbala in 60/680. Important elements of this story originate at least as early as the late first/early eighth century. In the story we see the image of al-Ḥusayn in process of transformation from that of someone merely human to someone ascribed traits that transcend the human. In the same course of events, the story of his death at Karbala is in process of being elevated from a tragic story to a myth with its associated rituals.
“In Truth You are the Polytheist!”: Mythic Elements in Ibn al-ʿArabī’s Teachings on the Divine Names
Authors: Ebstein Michael 
Published: June 2018

Abstract
The following article aims at highlighting the mythic elements inherent in Muḥyī l-Dīn Ibn al-ʿArabī’s teachings on the Divine names. The article begins with a very general introduction to the subject of Divine names in Islamic mysticism and then proceeds to clarify the meaning of the term “mythic” as it is used in this study. The core of the article is devoted to an examination of four main areas in which the Divine names, according to Ibn al-ʿArabī, play a central role: the creation of the world (cosmogony); its management; mystical experiences and knowledge; magic and theurgy. The main claim is that in all four areas, Ibn al-ʿArabī’s discourse is to a great extent mythic. The implications of this claim for the understanding of Akbarian thought and for the study of Islamic mysticism in general are discussed in the concluding paragraph of the essay.
The association of ‘self-monitoring’ with depression in help-seeking Facebook users
Authors: Twomey Conal , O’Reilly Gary 
Published: June 2018

Background: ‘Self-monitoring’ refers to the extent to which people control how they act in social situations. Some evidence suggests that those with various mental health issues engage in less self-monitoring than those without such issues. In the current study, we investigated the association of (offline and online) self-monitoring with depression in help-seeking Facebook users. Methods: We conducted a cross-sectional analysis of an anonymised dataset generated using the myPersonality Facebook application ( N = 1,857). Participants were those who accessed an application for depressive symptom-reporting that was linked to the myPersonality application. Results: The odds of depression were 1.85 times greater in low self-monitors than high self-monitors (odds ratio = 1.85; 95% confidence interval (CI) = [1.50, 2.27]). The association remained significant after adjusting for ‘big five’ personality traits (odds ratio = 1.48; 95% CI = [1.18, 1.86]). In fully adjusted analyses involving different operationalisations of self-monitoring, (1) the odds of depression were 1.38 times greater in low acquisitive self-monitors than high acquisitive self-monitors (odds ratio = 1.38; 95% CI = [1.10, 1.74]) and (2) the odds of depression were 1.48 times greater in low protective self-monitors than high protective self-monitors (odds ratio = 1.48; 95% CI = [1.18, 1.85]). Conclusion: The utility of self-monitoring in interventions for depression is worthy of investigation. Moreover, the assessment of self-monitoring may offer insights into clients’ social skills, motivation and self-awareness.
Cryotherapy
Authors: Laudi M. , Fontana G. 
Published: June 2018

TRUS-guided transcutaneous cryotherapy in the treatment of the prostatic carcinoma is performed by perineal approach, the intraoperatory monitoring of temperatures and a mechanical hydraulic sonorguided separation between prostate and the anterior rectal wall. Six to eight probes are used, the Argon gas in the freezing phase (-10 °C and -40 °C) and Helio gas for heating phase. TRUS-guided cryoterapy is a possible therapeutich option in the treatment of localized or locally advanced prostatic carcinoma and after RT, in case of the relapse in alternative to the rescue prostatectomy. We examined in both procedures the most significant series concerning the oncologic results and morbility. At present, TRUS-guided cryotherapy represents a mininvasive therapeutic option in selected patients (ASA 2–3). For the future an evaluation of the survival years compared with quality of life and randomized studies will be necessary.
Neuroendocrine Differentiation in Prostatic Malignancy
Authors: Alberti C. , Tizzani A. , Greco A. , Piovano M. 
Published: June 2018

Neuroendocrine differentiation in prostatic malignancy is receiving considerable attention; this occurs commonly as a “focal” histological variant and, most rarely, in the form of small cell carcinoma (“oat cell carcinoma”) and carcinoid tumor. In prostate cancer, neuroendocrine differentiation may be the response to androgen deprivation and neuroendocrine products, either biogenic amines or peptides, have been shown to stimulate proliferation of androgen-ablation refractory cancer cells. Serum chromogranins, neuron-specific enolase and other neuroendocrine products as well as 111-In-chromogranin A “three step” immunoscintigraphy and somatostatin-receptor scintigraphy may be useful for predicting tumor behaviour and patient prognosis. Several of the neuroendocrine products, particularly somatostatin analogues, are candidates for new therapeutic approaches. The paper aims to outline the advances in this field on the basis of the review of the literature.
Diagnosis and Uretheroscopy Undeleayed Therapy of Complicated Uretheral Calculosis
Authors: Passavanti G. , Pizzuti V. , Paolini R. , Bartalucci A , Franci L. , Lazzi L. 
Published: June 2018

Diagnosis and therapy of uretheral calculosis have developed considerably with the introduction of new technologies. We attempted to verify whether their combined use can produce a quick and invasive-less solution, to complicated uretheral calculosis (persistent pain, marked hydronefrosis and/or infection). 23 patients showing complicated uretheral calculosis, underwent echography wich revealed medium grade hydronefrosis in 10 of them, and high grade hydronefrosis in 13. 15 had a body temperature higher than 38 °C. We immediately carried out infusional and antibiotic therapy and spiral TC without contrast within 24 hours. TC documented lithiasis of the pelvic urether in 12 cases, lithiasis of the medium lumbar urether in 9, and lithiasis of the proximal urether in 2. Diameter of stones was from 5 to 10 mm. Within the following 24 hours we performed a uretheroscopy with ballistic wave lithotripsy. The uretheral catheter was taken out the next day. After ecographic check 18 patients were given medical therapy and sent home, while 5 patients underwent infusional therapy for 3 days in day-hospital. Clinical, ecographic and radiographic check after one month showed complete regression of pain, hydronefrosis and infection. First choice treatment for uretheral stones is ESWL, however since the machine is not always available and the success rate is about 50–60% we resolved to carry out a combined treatment for complicated uretheral lithiasis, which enabled us to treat complicated colic in 72 hours, which proved effective both in terms of time saving and patients disconfort as opposed to a deferred treatment. We therefore propose this procedure as first choice for this type of sindrome, also taking into account that the necessary endoscopic instrumentation is always readily available.
FISH Assay for THE Detection of Bladder Cancer
Authors: Bassi P.F. , De Marco V. , Lamon C. , Longo F. , Volpe A. , Aragona M. , Gardi M. , Cavazzana A. , Fassina A. 
Published: June 2018

We evaluated the sensitivity and specificity of fluorescence in situ hybridization (FISH) performed on the urine specimens of patients under follow-up for superficial bladder cancer. Thirty-seven patients were enrolled and underwent cystoscopy, urinary cytology or biopsy and FISH examination. Urinary cytology and FISH were evaluated in exfoliated urothelial cells from bladder washings. A mixture of fluorescent labeled probes to the centromere of chromosomes 3, 7 and 17, and locus 9p21 was used to assess urinary cells for chromosomal abnormalities indicative of malignancy. Nine patients (24.3%) showed an abnormal cystoscopy, but only five patients showed transitional cell carcinoma at histology. Eighteen patients (48.6%) showed an abnormal FISH: one patient (2.7%) had a positive cytology, and three patients (8.1%) showed an atypical cytology. Patients with both positive cystoscopy and histological examination had a positive FISH, while only one patient had a positive cytology. Patients with positive cystoscopy and negative histological examination had a negative FISH. Three patients with negative cystoscopy and suspicious cytology had a positive FISH. Ten patients (27%) with both negative cystoscopy and cytology had a positive FISH. The sensitivity of the FISH assay was 100%, 50% for the cytology and 62% for the cystoscopy. The specificity of the FISH assay, cytology and cystoscopy were 66%, 100% and 86%, respectively. The sensitivity of the FISH assay in detecting non-invasive urothelial tumors is worth further studies.
Andro-Sexuologist'S Role in the Sexual Rehabilitation of Patients after Pelvic Surgery
Authors: Bianchessi I. , Christodoulakis K. , Rovereto B. 
Published: June 2018

Cancer patients are special patients: time is the most important factor of their life. The choice of the appropriate moment to talk about their sexuality represents a fundamental step, which cannot coincide with talking about cancer. For the patient and his family cancer means anguish and death; sex needs relaxation and joy (life). Patient self-filled questionnaires are important and useful tools for physicians but not for patients; interviews with patients and their partners cannot be replaced by questionnaires that do not take into account a patient's cultural background and feelings of the moment. Answers can be sincere but untrue. It could be better to interview both partners before performing biopsy; later on the physician alone could fill in a simple form including the partner's opinions. Partners are normally involved in all interviews from the beginning, as well as in the choice of treatment drugs; they undergo a full immersion in a behavioural or dynamic rehabilitation of the couple. Therapy timing plays an essential role; the couple should be as relaxed as possible. Stomized patients need special caring by the whole therapeutic team. We studied behavioural changes and differences among patients treated between 1999 and 2004 in our clinic. We then propose some tips for a good sexual rehabilitation, which respects the couple sexuality helping to rediscover joy of love.
Effects of surgery, medical therapy and combined therapeutical approach on spermatogenesis in patients suffering from varicocele: a prospective and comparative analysis
Authors: Fischietti G. , Di Crosta G. 
Published: June 2018

The definite mechanisms through which varicocele affects spermatogenesis are still not completely understood, and consequently the exact role of the various approaches available for its treatment is still under debate. In this study a comparison of medical treatment, surgery and combined approach is reported. Material and Methods. The study was conducted as a prospective evaluation of 189 patients suffering from varicocele and oligoasthenospermia. Patients were randomized in three groups on the basis of the different therapeutic approach: group A, treated only with varicocelectomy; group B, treated with varicocelectomy associated with hormonal therapy; group C, treated only with hormonal therapy. Randomization criteria were based on patient's preference. Spermiogram tests were carried out at baseline and after 3, 6 and 12 months from therapy. Results. Our results show that patients undergoing a combined therapeutical approach (surgery associated with hormonal therapy) and medical therapy alone achieve a greater improvement of seminal parameters than patients treated by surgery only. Conclusion. Data reported in this study are in accordance with Literature review. Furthermore, the association between varicocelectomy and early use of hormonal therapy seems to improve testis functional rehabilitation with a early evidence of sperm parameters improvement. In the light of these results of ours, we should conclude that surgical treatment is not effective for the spermatogenesis improvement.
Perception of chronic pelvic pain in women: predictors and clinical implications
Authors: Graziottin A. 
Published: June 2018

Pain is a complex subjective experience, associated with neurovegetative, affective and cognitive rapid changes. Biological, psychosocial and contextual factors may contribute. Chronic inflammation, of whatever cause, is the leading contributor to chronic pain. The mast cell directs both the inflammatory process and the shift to chronic pain, mediating through the production of Nerve Growth Factor (NGF) and other neurotrophic molecules. Women, in the fertile age, are biologically more vulnerable to chronic inflammation, as fluctuations of estrogens are agonist factors of mast cells degranulation, mostly in the premenstrual phase. Pain is defined as “nociceptive” when it indicates an ongoing damage; “neuropathic” when it becomes a disease per se. Chronic Pelvic Pain (CPP) indicates an invalidating, persistent or recurrent pelvic pain, persisting for more than 6 months. CPP is the main complaint of 10–15% of gynaecologic consultations, leading to 40% of diagnostic laparoscopies and 15% of hysterectomies. Comorbidity, i.e. the coexistence of pathologies and painful syndromes in different pelvic organs, is another common feature. Cystitis, vulvar vestibulitis, endometriosis, irritable bowel syndrome all play an important role and contribute to identifying the hyperactive mast cell and related chronic inflammation as the common pathophysiologic factor. The paper reviews nociception characteristics, the emerging role of mast cells, the pathophysiology of comorbidity, biological, psychosexual and contextual predictors, and stresses the need to move from a “hyperspecialistic” perspective to a multisystemic reading of CPP, with special attention to the urologic perspective.
A 7-case anatomopathology revision in the presence of renal relapse after conservative therapy: implications on surgical technique
Authors: Antonelli A. , Tardanico R. , Zani D. , Perucchini L. , Zanotelli T. , Cozzoli A. , Cunico S. Cosciani , Simeone C. 
Published: June 2018

Anatomopathology revision of the cases which underwent second surgery because of a renal neoplasm relapsing after conservative surgery in order to find possible relations with the surgical technique. Materials and Methods. At our institution, Nephron-sparing surgery (NSS) is currently indicated as elective technique for neoplasms smaller than 4cm in diameter. The technique involves the removal of the neoplasm with a margin of healthy parenchyma and with the perilesional fat. The patients are monitored with a first CT check after 4 months and then with ultrasound/CT checks every 6 months in the first 2 years and then once a year. In the present study we analyze the records of the cases in the period 1994–2005 undergoing a second operation for a renal tumor relapsing in the operated kidney after NSS. All specimens were reviewed by a single experienced uro-pathologist, who determined the size of the surgical margins and the relations between the seat of recidivism and the seat of the preceding enucleoresection. Results. Seven cases with renal relapse were found out of 267 undergoing conservative surgery in the same period (incidence: 2.6%). The diagnosis had always been made lacking any other disease localizations at a complete re-staging; the average relapse latency was 19.4 months (8–46 months). In 5 cases the second tumor was found in the seat of the previous NSS: for these cases the minimum margin of the enucleoresection was lower than 3mm (median minimum margin: 1.6 mm). Differently, in the remaining 2 cases, both with a wider surgical margin (median minimum margin: 12.0 mm), the seat of the first and that of the second neoplasm were distant. In particular, in one case a multifocal relapse with a spread microvascular embolization was found, while in the other the two neoplasms showed a different histotype. Discussion and Conclusions. In the 5 cases with a little resection margin and relapsing tumor in the seat of the enucleoresection, the persistence of a peritumoral microscopic neoplastic disease can be assumed. In the other 2 cases showing a wider surgical margin the relapse can be attributed to the widespread microscopic multifocality in one case, and to the development of a second de novo neoplasm in the other case. The extension of the surgical margin seems then to have played a role in determining a relapse in the seat of enucleoresection.
Echo-assisted percutaneous nephrolithotomy in the supine position. Technical notes
Authors: Turci A. 
Published: June 2018

The adoption of supine position in percutaneous nephrolithotomy and the routine use of echography during the procedure allow for a reduction of surgical time, radiological exposure of patient and surgeons, and of anaesthesiological risks; moreover, it permits a combined anterograde-retrograde approach to the kidney in case of very complex lithiasis. The urologist's knowledge and experience of echography devices allows for a high lowering of the learning curve time.
Stone Cone® in ureteroscopic ballistic lithotripsy of proximal ureteral stones
Authors: Arancio M. , Guglielmetti S. , Delsignore A. , Landi A. , Marchetti C. , Mina A. , Marcato M. , Martinengo C. 
Published: June 2018

Stone Cone® (Microvasive-Boston Scientific Corp, USA) is a device which prevents retrograde calculus migration during endoscopic ureterolithotripsy. We have studied the safety and efficacy of this device in endoscopic ureterolithotripsy with ballistic energy in proximal ureteral stones. Materials and Methods. From 01/02/2006 to 01/02/2008 we carried out 36 ureterorenoscopies (URS) for proximal ureteral stones (average age: 46, range: 15–73). A ballistic energy was used for stones fragmentation. In 18 patients (Group A) we carried out URS with the aid of Stone Cone®, which was not used in the other 18 patients (Group B). Semirigid 8 Ch or 10 Ch Storz ureteroscope and ballistic lithotriptor Swiss Lithoclast Master EMS® were used. In cases of migration, edema, and ureteral damage, a ureteral stent was used. Results. In Group B patients (URS performed without Stone Cone®) the migration of the whole stone, or of clinically significant fragments, occurred 8 times (45%). All of these patients underwent external shockwave lithotripsy (ESWL) at a center equipped with a lithotriptor. A ureteral stent was placed in 14 cases (78%). In Group A, the migration of a stone requiring ESWL treatment occurred only once (5%). The ureteral stent was placed 8 times (45%). We had no significant complications during the procedure. Conclusions. The Stone Cone® is a safe and easy-to-use device. The cost of this device can be balanced by the reduction of postoperative ESWL treatments for lithiasic fragments pushing up into the kidneys (p<0.01), and of ureteral stent applications at the end of the procedure (p<0.05).