bluuebunny/crossref_metadata_2025_split huggingface dataset:
Recognition and Treatment of Adrenal Insufficiency Secondary to Abiraterone: A Case Report and Literature Review
Authors: Baloch Harris M. , Grice-Patil Zachary Joseph , Selig Daniel Jaaron , Hoang Thanh D. , Mai Vinh Q. , Shakir Mohamed K. 
Published: August 2019

<b><i>Objective:</i></b> Abiraterone is a relatively noncytotoxic drug approved by the US Food and Drug Administration in 2011 for the treatment of metastatic prostate cancer (MPC). As an inhibitor of 17α-hydroxylase and C17,20-lyase (CYP17), abiraterone blocks androgen synthesis and glucocorticoid production. Decreased cortisol levels result in an increased ACTH release, which can lead to increased mineralocorticoid levels. While coadministration of abiraterone and glucocorticoids has been effective in reducing an apparent mineralocorticoid excess, adequate replacement of physiologic glucocorticoids, especially in times of acute stress, remains less well-defined. <b><i>Methods:</i></b> A literature search was conducted using the PubMed and Google Scholar databases for abiraterone and adrenal insufficiency. Publications were selected based on the quality of the data and clinical relevance. We reviewed the landmark trials leading to FDA approval and establishment of the standard glucocorticoid replacement dosing. <b><i>Results:</i></b> We present 2 patients with MPC on abiraterone therapy. These 2 patients required modification of the glucocorticoid therapy because of adverse effects. <b><i>Conclusions:</i></b> We found that a standard dose of prednisone of 5 mg/day as recommended previously may be inadequate to achieve physiologic glucocorticoid replacement in some patients with prostate cancer while on abiraterone treatment and as a result adrenal insufficiency due to inadequate dosing might be more common than initially thought. Additionally 10 mg of prednisone daily may cause adverse effects in some patients. Thus clinicians should be aware of the potential for development of adrenal insufficiency or symptoms of glucocorticoid excess in these patients receiving prednisone so that appropriate modifications in glucocorticoid dosing can be instituted without any delay. Prednisone dosing may need to be individualized in each patient receiving abiraterone therapy.
Plant‐Based Diets Are Associated With a Lower Risk of Incident Cardiovascular Disease, Cardiovascular Disease Mortality, and All‐Cause Mortality in a General Population of Middle‐Aged Adults
Authors: Kim Hyunju , Caulfield Laura E. , Garcia‐Larsen Vanessa , Steffen Lyn M. , Coresh Josef , Rebholz Casey M. 
Published: August 2019

Background
Previous studies have documented the cardiometabolic health benefits of plant‐based diets; however, these studies were conducted in selected study populations that had narrow generalizability.

Methods and Results

We used data from a community‐based cohort of middle‐aged adults (n=12 168) in the ARIC (Atherosclerosis Risk in Communities) study who were followed up from 1987 through 2016. Participants’ diet was classified using 4 diet indexes. In the overall plant‐based diet index and provegetarian diet index, higher intakes of all or selected plant foods received higher scores; in the healthy plant‐based diet index, higher intakes of only the healthy plant foods received higher scores; in the less healthy plant‐based diet index, higher intakes of only the less healthy plant foods received higher scores. In all indexes, higher intakes of animal foods received lower scores. Results from Cox proportional hazards models showed that participants in the highest versus lowest quintile for adherence to overall plant‐based diet index or provegetarian diet had a 16%, 31% to 32%, and 18% to 25% lower risk of cardiovascular disease, cardiovascular disease mortality, and all‐cause mortality, respectively, after adjusting for important confounders (all
P
<0.05 for trend). Higher adherence to a healthy plant‐based diet index was associated with a 19% and 11% lower risk of cardiovascular disease mortality and all‐cause mortality, respectively, but not incident cardiovascular disease (
P
<0.05 for trend). No associations were observed between the less healthy plant‐based diet index and the outcomes.

Conclusions
Diets higher in plant foods and lower in animal foods were associated with a lower risk of cardiovascular morbidity and mortality in a general population.
Stereotactic Radiosurgery for Unruptured Versus Ruptured Pediatric Brain Arteriovenous Malformations
Authors: Chen Ching-Jen , Lee Cheng-Chia , Ding Dale , Tzeng Shih-Wei , Kearns Kathryn N. , Kano Hideyuki , Atik Ahmet , Ironside Natasha , Joshi Krishna , Huang Paul P. , Kondziolka Douglas , Mathieu David , Iorio-Morin Christian , Grills Inga S. , Quinn Thomas J. , Siddiqui Zaid , Marvin Kim , Feliciano Caleb , Faramand Andrew , Starke Robert M. , Barnett Gene , Lunsford L. Dade , Sheehan Jason P. ,   on behalf of the International Radiosurgery Research Foundation
Published: August 2019

Background and Purpose—
The effects of prior hemorrhage on stereotactic radiosurgery (SRS) outcomes for pediatric arteriovenous malformations (AVMs) are not well defined. The aim of this multicenter, retrospective cohort study is to compare the SRS outcomes for unruptured versus ruptured pediatric AVMs.

Methods—
The International Radiosurgery Research Foundation pediatric AVM database from 1987 to 2018 was reviewed retrospectively. Favorable outcome was defined as AVM obliteration, no post-SRS hemorrhage, and no permanently symptomatic radiation-induced changes. Associations between prior hemorrhage and outcomes were adjusted for baseline differences, inverse probability weights, and competing risks.

Results—

The study cohort comprised 153 unruptured and 386 ruptured AVMs. Favorable outcome was achieved in 48.4% and 60.4% of unruptured and ruptured AVMs, respectively (adjusted odds ratio, 1.353;
P
=0.190). Cumulative AVM obliteration probabilities were 51.2%, 59.4%, 64.2%, and 70.0% for unruptured and 61.0%, 69.3%, 74.0%, and 79.3% for ruptured AVMs at 4, 6, 8, and 10 years, respectively (subhazard ratio, 1.311;
P
=0.020). Cumulative post-SRS hemorrhage probabilities were 4.5%, 5.6%, 5.6%, and 9.8% for unruptured and 4.7%, 6.1%, 6.1%, and 10.6% for ruptured AVMs at 4, 6, 8, and 10 years, respectively (subhazard ratio, 1.086;
P
=0.825). Probabilities of AVM obliteration (adjusted subhazard ratio, 0.968;
P
=0.850) and post-SRS hemorrhage (adjusted subhazard ratio, 1.663;
P
=0.251) were comparable between the 2 cohorts after inverse probability weight adjustments. Symptomatic (15.8% versus 8.1%; adjusted odds ratio, 0.400;
P
=0.008) and permanent (9.2% versus 5.0%; adjusted odds ratio, 0.441;
P
=0.045) radiation-induced change were more common in unruptured AVMs.

Conclusions—
The overall outcomes after SRS for unruptured versus ruptured pediatric AVMs are comparable. However, symptomatic and permanent radiation-induced change occur more frequently in pediatric patients with unruptured AVMs.
An Improved Estimate of the Coupled Arctic Energy Budget
Authors: Mayer Michael , Tietsche Steffen , Haimberger Leopold , Tsubouchi Takamasa , Mayer Johannes , Zuo Hao 
Published: August 2019

Abstract
This study combines state-of-the-art reanalyses such as the fifth-generation European Re-Analysis (ERA5) and the Ocean Reanalysis System 5 (ORAS5) with novel observational products to present an updated estimate of the coupled atmosphere–ocean–sea ice Arctic energy budget, including flux and storage terms covering 2001–17. Observational products provide independent estimates of crucial budget terms, including oceanic heat transport from unique mooring-derived data, radiative fluxes from satellites, and sea ice volume from merged satellite data. Results show that the time averages of independent estimates of radiative, atmospheric, and oceanic energy fluxes into the Arctic Ocean domain are remarkably consistent in the sense that their sum closely matches the observed rate of regional long-term oceanic heat accumulation of ~1 W m−2. Atmospheric and oceanic heat transports are found to be stronger compared to earlier assessments (~100 and ~16 W m−2, respectively). Data inconsistencies are larger when considering the mean annual cycle of the coupled energy budget, with RMS values of the monthly budget residual between 7 and 15 W m−2, depending on the employed datasets. This nevertheless represents an average reduction of ~72% of the residual compared to earlier work and demonstrates the progress made in data quality and diagnostic techniques. Finally, the budget residual is eliminated using a variational approach to provide a best estimate of the mean annual cycle. The largest remaining sources of uncertainty are ocean heat content and latent heat associated with sea ice melt and freeze, which both suffer from the lack of observational constraints. More ocean in situ observations and reliable sea ice thickness observations and their routinely assimilation into reanalyses are needed to further reduce uncertainty.
Influency of pentoxifylline treatment for neonatal sepsis: A meta‐analysis of randomized controlled studies
Authors: Peng Peiyun , Xia Yunfeng 
Published: August 2019

Introduction:Pentoxifylline may be an important approach to treat neonatal sepsis. However, its use has not been well established. We conduct a systematic review and meta‐analysis to evaluate the efficacy of pentoxifylline treatment for neonatal sepsis.Methods:PubMed, Embase, and the Cochrane Central Register of Controlled Trials are searched. Randomized controlled trials assessing the influence of pentoxifylline treatment on neonatal sepsis are included. Two investigators independently have searched articles, extracted data, and assessed the quality of included studies. This meta‐analysis is performed using the random‐effect model.Results:Seven randomized controlled trials involving 439 patients are included in the meta‐analysis. Compared with control intervention for neonatal sepsis, pentoxifylline treatment is associated with reduced hospital stay (standard mean differences = −0.61; 95% confidence interval = −0.93 to −0.29; p = 0.0002) and metabolic acidosis (risk ratio = 0.38; 95% confidence interval = 0.22 to 0.66; p = 0.0006), but has no remarkable impact on mortality (risk ratio = 0.59; 95% confidence interval = 0.30 to 1.16; p = 0.13), serum tumor necrosis factor‐α (standard mean differences = −0.38; 95% confidence interval = −1.29 to 0.52; p = 0.41), serum C‐reactive protein (standard mean differences = −0.25; 95% confidence interval = −0.92 to 0.42; p = 0.47), plasma interleukin‐6 (standard mean differences = −0.13; 95% confidence interval = −0.41 to 0.15; p = 0.37), disseminated intravascular coagulopathy (risk ratio = 0.55; 95% confidence interval = 0.25 to 1.21; p = 0.14), and oliguria/anuria (risk ratio = 0.77; 95% confidence interval = 0.28 to 2.16; p = 0.62).Conclusion:Pentoxifylline treatment may be associated with reduced mortality and hospital stay in neonatal sepsis with caution.
The American Academy of Pediatrics hypertension guidelines identify obese youth at high cardiovascular risk among individuals non-hypertensive by the European Society of Hypertension guidelines
Authors: Di Bonito Procolo , Licenziati Maria Rosaria , Baroni Marco G , Maffeis Claudio , Morandi Anita , Manco Melania , Miraglia del Giudice Emanuele , Di Sessa Anna , Campana Giuseppina , Moio Nicola , Gilardini Luisa , Chiesa Claudio , Pacifico Lucia , de Simone Giovanni , Valerio Giuliana ,   for the CARITALY Study on the behalf of the Childhood Obesity Study Group of the Italian Society of Pediatric Endocrinology and Diabetology
Published: August 2019

Abstract

Background
Two different systems for the screening and diagnosis of hypertension (HTN) in children currently coexist, namely, the guidelines of the 2017 American Academy of Pediatrics (AAP) and the 2016 European Society for Hypertension (ESH). The two systems differ in the lowered cut-offs proposed by the AAP versus ESH.

Objectives
We evaluated whether the reclassification of hypertension by the AAP guidelines in young people who were defined non-hypertensive by the ESH criteria would classify differently overweight/obese youth in relation to their cardiovascular risk profile.

Methods
A sample of 2929 overweight/obese young people (6–16 years) defined non-hypertensive by ESH (ESH–) was analysed. Echocardiographic data were available in 438 youth.

Results
Using the AAP criteria, 327/2929 (11%) young people were categorized as hypertensive (ESH–/AAP+). These youth were older, exhibited higher body mass index, Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), triglycerides, total cholesterol to high-density lipoprotein cholesterol (TC/HDL-C) ratio, blood pressure, left ventricular mass index and lower HDL-C (p &lt;0.025–0.0001) compared with ESH–/AAP–. The ESH–/AAP+ group showed a higher proportion of insulin resistance (i.e. HOMA-IR ≥3.9 in boys and 4.2 in girls) 35% vs. 25% (p &lt;0.0001), high TC/HDL-C ratio (≥3.8 mg/dl) 35% vs. 26% (p = 0.001) and left ventricular hypertrophy (left ventricular mass index ≥45 g/h2.16) 67% vs. 45% (p = 0.008) as compared with ESH–/AAP–.

Conclusions
The reclassification of hypertension by the AAP guidelines in young people overweight/obese defined non-hypertensive by the ESH criteria identified a significant number of individuals with high blood pressure and abnormal cardiovascular risk. Our data support the need of a revision of the ESH criteria.
Activin A–Induced Cachectic Wasting Is Attenuated by Systemic Delivery of Its Cognate Propeptide in Male Mice
Authors: Walton Kelly L , Chen Justin L , Arnold Quinn , Kelly Emily , La Mylinh , Lu Louis , Lovrecz George , Hagg Adam , Colgan Timothy D , Qian Hongwei , Gregorevic Paul , Harrison Craig A 
Published: August 2019

AbstractIn cancer, elevated activin levels promote cachectic wasting of muscle, irrespective of tumor progression. In excess, activins A and B use the myostatin signaling pathway in muscle, triggering a decrease in protein synthesis and an increase in protein degradation, which ultimately leads to atrophy. Recently, we demonstrated that local delivery of engineered activin and myostatin propeptides (natural inhibitors of these growth factors) could induce profound muscle hypertrophy in healthy mice. Additionally, the expression of these propeptides effectively attenuated localized muscle wasting in models of dystrophy and cancer cachexia. In this study, we examined whether a systemically administered recombinant propeptide could reverse activin A–induced cachectic wasting in mice. Chinese hamster ovary cells stably expressing activin A were transplanted into the quadriceps of nude mice and caused an 85-fold increase in circulating activin A levels within 12 days. Elevated activin A induced a rapid reduction in body mass (−16%) and lean mass (−10%). In agreement with previous findings, we demonstrated that adeno-associated virus–mediated delivery of activin propeptide to the tibialis anterior muscle blocked activin-induced wasting. In addition, despite massively elevated levels of activin A in this model, systemic delivery of the propeptide significantly reduced activin-induced changes in lean and body mass. Specifically, recombinant propeptide reversed activin-induced wasting of skeletal muscle, heart, liver, and kidneys. This is the first study to demonstrate that systemic administration of recombinant propeptide therapy effectively attenuates tumor-derived activin A insult in multiple tissues.
Contemporary Debates in Adult Papillary Thyroid Cancer Management
Authors: McLeod Donald S A , Zhang Ling , Durante Cosimo , Cooper David S 
Published: August 2019

AbstractAn ever-increasing population of patients with papillary thyroid cancer is engaging with health care systems around the world. Numerous questions about optimal management have arisen that challenge conventional paradigms. This is particularly the case for patients with low-risk disease, who comprise most new patients. At the same time, new therapies for patients with advanced disease are also being introduced, which may have the potential to prolong life. This review discusses selected controversial issues in adult papillary thyroid cancer management at both ends of the disease spectrum. These topics include: (i) the role of active surveillance for small papillary cancers; (ii) the extent of surgery in low-risk disease (lobectomy vs total thyroidectomy); (iii) the role of postoperative remnant ablation with radioiodine; (iv) optimal follow-up strategies in patients, especially those who have only undergone lobectomy; and (v) new therapies for advanced disease. Although our current management is hampered by the lack of large randomized controlled trials, we are fortunate that data from ongoing trials will be available within the next few years. This information should provide additional evidence that will decrease morbidity in low-risk patients and improve outcomes in those with distant metastatic disease.
Denosumab in Patients With Fibrous Dysplasia Previously Treated With Bisphosphonates
Authors: Majoor Bas C J , Papapoulos Socrates E , Dijkstra P D Sander , Fiocco Marta , Hamdy Neveen A T , Appelman-Dijkstra Natasha M 
Published: August 2019

AbstractContextFibrous dysplasia/McCune-Albright syndrome (FD/MAS) is a rare bone disorder commonly treated with bisphosphonates, but clinical and biochemical responses may be incomplete.ObjectiveTo evaluate the efficacy and tolerability of the receptor activator of nuclear factor-κB ligand inhibitor denosumab in the treatment of patients with FD/MAS refractory to bisphosphonate therapy.DesignCase series.SettingAcademic center of expertise for rare bone diseases.PatientsData were collected from 12 consecutive patients with FD/MAS with persistent pain and increased biochemical markers of bone turnover (BTMs) after long-term treatment with bisphosphonates (median, 8.8 years) and were treated with subcutaneous denosumab 60 mg at 3- or 6-month intervals with a follow-up for at least 12 months.Main outcome(s)Sustained reduction of BTMs and bone pain.ResultsA 60 mg dose of denosumab once every 3 months, but not once every 6 months, induced a sustained reduction of BTMs. After a median treatment period of 15.5 months (range, 12 to 19) serum alkaline phosphatase activity and propeptide of type 1 procollagen levels were respectively reduced from 212 ± 39.4 IU/L to 79 ± 6.0 IU/L (P = 0.004) and from 346.2 ± 111.1 ng/mL to 55.7 ± 16.6 ng/mL (P = 0.023) and normalized in 70% and 75% of patients, respectively. Although not quantitavely measured, 10 patients reported a reduction in bone pain of whom 6 reported complete elimination of pain. Treatment with denosumab was well tolerated.ConclusionOur results indicate that 60 mg of denosumab every 3 months is a promising, well-tolerated treatment of most patients with FD/MAS refractory to bisphosphonate therapy. These results together with those of previously published case reports provide the necessary background for the design of a larger, controlled study.
The Incremental Risk of Pancreatic Cancer According to Fasting Glucose Levels: Nationwide Population-Based Cohort Study
Authors: Koo Dong-Hoe , Han Kyung-Do , Park Cheol-Young 
Published: August 2019

Abstract

Context
It has been unclear whether the risk of pancreatic cancer is different according to glucose levels.

Objective
To determine the association between fasting glucose levels and pancreatic cancer risk using prospectively collected nationwide population-based cohort data in Korea.

Design
The National Health Insurance Service database of claims and preventive health check-up data recorded was used between 2009 and 2015.

Setting and Participants
A total of 25.4 million patients who had participated in a preventive health check-up between 2009 and 2013 were evaluated for pancreatic cancer incidence rates according to fasting glucose level.

Main Outcomes Measures
The cumulative incidence rate for pancreatic cancer was calculated after grouping according to fasting glucose levels as follows: (i) low normal (<90 mg/dL), (ii) high normal (90 to 99 mg/dL), (iii) prediabetes level 1 (100 to 109 mg/dL), (iv) prediabetes level 2 (110 to 125 mg/dL), (v) diabetes (≥126 mg/dL), and (vi) diabetes on anti-diabetic medications.

Results
The 5-year cumulative incidence rates (per 100,000) were as follows: (i) low normal = 32; (ii) high normal = 41; (iii) prediabetes level 1 = 50; (iv) prediabetes level 2 = 64; (v) diabetes = 75; and (vi) on anti-diabetic medications = 121. The risk of pancreatic cancer increased continuously with elevating fasting glucose levels (P < 0.0001). The incidence of pancreatic cancer increased significantly with increasing fasting blood glucose levels even after adjusting for age, sex, smoking, drinking, exercise, body mass index, and diabetes duration (P < 0.0001).

Conclusions
The cumulative incidence rate of pancreatic cancer significantly increased as the fasting glucose level elevated, even in populations with a normal glucose level range.
The Steroid Profile of Adrenal Incidentalomas: Subtyping Subjects With High Cardiovascular Risk
Authors: Di Dalmazi Guido , Fanelli Flaminia , Zavatta Guido , Ricci Bitti Silvia , Mezzullo Marco , Repaci Andrea , Pelusi Carla , Gambineri Alessandra , Altieri Paola , Mosconi Cristina , Balacchi Caterina , Golfieri Rita , Cosentino Eugenio Roberto , Borghi Claudio , Vicennati Valentina , Pasquali Renato , Pagotto Uberto 
Published: August 2019

Abstract

Context
Steroid profiling by mass spectrometry has shown implications for diagnosis and subtyping of adrenal tumors.

Objectives
To investigate steroid profiles and their cardiovascular correlates in a large cohort of patients with nonsecreting (NS) adrenal incidentalomas and autonomous cortisol secretion (ACS).

Design
Cohort study.

Setting
University hospital.

Patients
Patients (n = 302) with incidentally discovered adrenal masses, divided into unilateral adenoma and hyperplasia with ACS (n = 46 and n = 52, respectively) and NS (n = 120 and n = 84, respectively). Post–dexamethasone suppression test (DST) cortisol <50 or >50 nmol/L defined NS and ACS, respectively.

Intervention
Analysis of 10-steroid panel by liquid chromatography–tandem mass spectrometry (LC-MS/MS) and clinical data (mean follow-up 39 months).

Main Outcome Measures
Difference in baseline and post-DST steroid profiles between groups. Correlation with cardiovascular profile.

Results
Patients with unilateral adenomas and ACS showed higher cortisol, 11-deoxycortisol, and corticosterone and lower dehydroepiandrosterone than those with NS adenomas. Patients with ACS hyperplasia showed higher cortisol and lower androgens in women than those with NS. Patients with ACS had reduced suppression of post-DST cortisol, 11-deoxycortisol, and corticosterone, irrespective of adrenal morphology. Post-DST cortisol and corticosterone were associated with higher prevalence of severe/resistant hypertension. Patients with ACS unilateral adenomas showed higher incidence of worsening of hypertensive disease and novel cardiovascular events than those with NS, with post-DST cortisol [hazard ratio (HR) 1.02; 95% CI, 1.01 to 1.03; P < 0.001] and baseline corticosterone (HR 1.06; 95% CI, 1.01 to 1.12; P = 0.031) among the main predictors.

Conclusions
Patients with adrenal incidentalomas showed different steroid profiles, depending on functional status and adrenal morphology, with implications for their cardiovascular status.