bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dual Therapy with Vonoprazan and Amoxicillin Is as Effective as Triple Therapy with Vonoprazan, Amoxicillin and Clarithromycin for Eradication of Helicobacter pylori
Authors: Furuta Takahisa , Yamade Mihoko , Kagami Takuma , Uotani Takahiro , Suzuki Takahiro , Higuchi Tomohiro , Tani Shinya , Hamaya Yasushi , Iwaizumi Moriya , Miyajima Hiroaki , Umemura Kazuo , Osawa Satoshi , Sugimoto Ken 
Published: September 2019

Backgrounds/Aims: Vonoprazan (VPZ) is the first clinically available potassium competitive acid blocker. This class of agents provides faster and more potent acid inhibition than proton pump inhibitors. Most strains of Helicobacter pylori are sensitive to amoxicillin. We hypothesized that dual therapy with VPZ and amoxicillin would provide the sufficient eradication rate for H. pylori infection. To evaluate this, we compared the eradication rate by the dual VPZ/amoxicillin therapy with that by the standard triple VPZ/amoxicillin/clarithromycin therapy. Methods: Non-inferiority of the eradication rate of H. pylori by the dual therapy with VPZ 20 mg twice daily (bid) and amoxicillin 500 mg 3 times daily (tid) for 1 week to that by the triple therapy with VPZ 20 mg bid, amoxicillin 750 mg bid and clarithromycin 200 mg bid for 1 week was retrospectively studied. Propensity score matching was performed to improve comparability between 2 regimen groups. Successful eradication was diagnosed using the [13C]-urea breath test at 1–2 months after the end of eradication therapy. Results: The intention-to-treat analysis demonstrated that the eradication rate by the dual therapy (92.9%; 95% CI 82.7–98.0%, 52/56) was not inferior to that of the triple therapy (91.9%; 95% CI 80.4–97.0%, 51/56; OR 1.275, 95% CI 0.324–5.017%, p = 0.728). There were no statistically significant differences in incidences of adverse events between 2 regimens. Conclusion: VPZ-based dual therapy (VPZ 20 mg bid and amoxicillin 500 mg tid for 1 week) provides an acceptable eradication rate of H. pylori infection without the need for second antimicrobial agents, such as clarithromycin.
Peak Growth Hormone Response to Combined Stimulation Test in 315 Children and Correlations with Metabolic Parameters
Authors: Yau Mabel , Chacko Elizabeth , Regelmann Molly O. , Annunziato Rachel , Wallach Elizabeth J. , Chia Dennis , Rapaport Robert 
Published: September 2019

<b><i>Background/Aims:</i></b> Studies are lacking regarding the timing of peak growth hormone (PGH) response. We aim to elucidate the timing of PGH response to arginine and levodopa (A-LD) and evaluate the influence of body mass index (BMI) and other metabolic parameters on PGH. <b><i>Methods:</i></b> During growth hormone (GH) stimulation testing (ST) with A-LD, serum GH was measured at baseline and every 30 min up to 180 min. The PGH cut-off was defined as &amp;#x3c;10 ng/mL. IGF-1, IGF BP3, BMI, and metabolic parameters were obtained in a fasting state at baseline. <b><i>Results:</i></b> In the 315 tested children, stimulated PGH levels occurred at or before 120 min in 97.8% and at 180 min in 2.2%. GH area under the curve (AUC) positively correlated with PGH in all patients and with IGF-1 in pubertal males and females. BMI negatively correlated with PGH in all subjects. GH AUC negatively correlated with HOMA-IR and total cholesterol. <b><i>Conclusion:</i></b> We propose termination of the GH ST with A-LD at 120 min since omission of GH measurement at 180 min did not alter the diagnosis of GH deficiency based on a cut-off of &amp;#x3c; 10 ng/mL. BMI should be considered in the interpretation of GH ST with A-LD. The relationships between GH AUC and metabolic parameters need further study.
Autologous Adrenal Transplantation for the Treatment of Refractory Cushing’s Disease
Authors: Dong Dexin , Ji Zhigang , Li Hanzhong 
Published: September 2019

<b><i>Objective:</i></b> To report our management of bilateral adrenalectomy with autologous adrenal gland transplantation for persistent Cushing’s disease, and to discuss the feasibility of autologous adrenal transplantation for the treatment of refractory Cushing’s disease. <b><i>Material and Methods:</i></b> A retrospective analysis was performed in 4 patients (3 females, aged 14–36 years) who underwent autologous adrenal transplantation for persistent Cushing’s disease after endonasal transsphenoidal resection of a pituitary tumor. The procedure was performed by implanting a vascularized adrenal graft into the left iliac fossa with direct and indirect anastomoses. Postoperative follow-up was performed in 1, 1.5, 8, and 10 years, and an over 8-year long-term follow-up was reached in 2 out of the 4 cases. Hormone replacement dosage was guided by clinical symptoms and endocrine results including serum cortisol (F), 24 h urine-free cortisol, and adrenocorticotrophic hormone levels. <b><i>Results:</i></b> All 4 patients with symptomatic Cushing’s disease experienced resolution of symptoms after autotransplantation without Nelson Syndrome. Functional autografts were confirmed through clinical evaluation and endocrine results. One year after transplantation, adrenal function and hormone replacement dosage remained stable without adrenal hyperplasia. After long-term follow-up, dosages of hormone replacement were reduced in all patients. <b><i>Conclusions:</i></b> In this series of 4 patients, we demonstrate the long-term efficacy of bilateral adrenalectomy with autologous adrenal transplantation and propose this procedure as a viable treatment option for refractory Cushing’s disease.
High Prevalence of Dystonia in the Faroe Islands: A Population-Based Study
Authors: Louis Elan D. , Eliasen Eina H. , Kim Christine Y. , Ferrer Monica , Gaini Shahin , Petersen Maria Skaalum 
Published: September 2019

<b><i>Background:</i></b> There are fewer than 5 population-based studies of dystonia worldwide. Only one utilized a movement disorders neurologist. Given the potential for founder effects, and the highly genetic nature of dystonia, the Faroe Islands provide a particularly interesting setting to study the prevalence of dystonia. <b><i>Objective:</i></b> To estimate the prevalence of dystonia. <b><i>Methods:</i></b> We used a 2-phase, population-based design, screening 1,334 randomly selected Faroese individuals aged ≥40 years from which a subsample of 227 participated in an in-person clinical evaluation. Dystonia was assessed by 2 movement disorder neurologists using videotaped examinations. <b><i>Results:</i></b> Two of 227 (0.88%, 95% CI –0.33 to 2.09%) were diagnosed with cervical or segmental dystonia. An unusual form of thumb flexion dystonia was noted in 75 more, yielding a combined prevalence of 33.92% (95% CI 27.73–40.11%). <b><i>Conclusions:</i></b> The prevalence of cervical or segmental dystonia was as high as in one prior population-based study using similar methods. Furthermore, an unusual form of thumb flexion dystonia was uncovered, which yielded an extraordinarily high prevalence of dystonia in this population. Although our methods likely contributed to more complete capture of subtle dystonia, founder effects are highly likely to have been an additional major contributor to these findings.
Safety and Efficacy of Tinzaparin Anticoagulation during Nocturnal Hemodialysis
Authors: Bugeja Ann , Harris Sophie , McCormick Brendan , Brown Pierre-Antoine , Liberty Channing , Krepelka Theresa , St-Cyr Guylaine , Akbari Ayub 
Published: September 2019

<b><i>Background:</i></b> The safety and efficacy of low-molecular-weight heparin in the prevention of extracorporeal dialysis circuit clotting among in-center extended duration nocturnal hemodialysis (INHD) patients are unknown. The aim of this study was to determine the safety and efficacy of 2 doses of tinzaparin, among INHD patients receiving 6–8 h hemodialysis, 3 times per week. <b><i>Methods:</i></b> We conducted a retrospective cohort study to examine antifactor Xa levels at time 0, 2 h, 4 h mid-hemodialysis (mid-HD), 6 h, and at end of each INHD session for 4 weeks and to determine extracorporeal dialysis circuit clotting and bleeding events after switching from unfractionated heparin to tinzaparin, using a standard protocol of tinzaparin delivery at the initiation and midpoint of HD. <b><i>Results:</i></b> All 16 patients in The Ottawa Hospital INHD program were converted to tinzaparin and followed for 177 INHD sessions. Mean antifactor Xa level at 2 h of HD was 0.41 ± 0.21 (SD) IU/mL, at 4 h (mid-HD) 0.19 ± 0.17 IU/mL, at 6 h 0.44 ± 0.21 IU/mL, and at dialysis end 0.26 ± 0.14 IU/mL. Antifactor Xa levels were undetectable at the start of INHD, suggesting no tinzaparin accumulation. Five patients required an increase in tinzaparin due to extracorporeal dialysis circuit clotting. There were no bleeding events. One patient required a switch to fondaparinux due to an adverse reaction. <b><i>Conclusion:</i></b> Tinzaparin was safe and efficacious for most INHD patients without accumulation or bleeding. The conversion from unfractionated heparin to tinzaparin required an increased tinzaparin dose for 31% of INHD patients.
Incidence and Predictors of Deep Vein Thrombosis in Patients with Elevated Serum D-Dimer Prior to Surgery for Urologic Malignancy
Authors: Fujiwara Ryo , Numao Noboru , Ishikawa Yudai , Inoue Toru , Ogawa Masahiro , Masuda Hitoshi , Yuasa Takeshi , Yamamoto Shinya , Fukui Iwao , Yonese Junji 
Published: September 2019

<b><i>Objectives:</i></b> To analyze the incidence and predictors of deep vein thrombosis (DVT) in patients with elevated D-dimer prior to surgery for urologic malignancy. <b><i>Methods:</i></b> Between January 2015 and September 2017, 987 consecutive patients underwent surgery for urologic malignancy under general anesthesia in our institution. Of these, 191 patients underwent preoperative venous ultrasonography of the lower extremities for DVT due to elevated D-dimer. We analyzed the incidence and predictors of DVT in these patients. <b><i>Results:</i></b> The median age was 69 years. DVT was detected in 18% of patients (35/191). Multivariate analysis showed that the primary site of urologic malignancy (<i>p</i> &#x3c; 0.01) and older age (<i>p</i> &#x3c; 0.01) were independent predictors of DVT. Patients with bladder cancer had the highest incidence of DVT. When bladder cancer and age of 70 or older were defined as predictors for DVT, the incidence of DVT in zero, 1, and 2 predictors was 3.4% (3/89), 29% (22/77), and 44% (11/25), respectively. <b><i>Conclusions:</i></b> DVT was found in 18% of patients with elevated D-dimer prior to surgery for urologic malignancy. Bladder cancer patients and older patients in whom D-dimer has been elevated should undergo careful early examination for DVT.
Continuous Renal Replacement Therapy Might Mask Immobilization-Induced Hypercalcemia in Critically Ill Patients
Authors: Madureira Ricardo Mondoni , Callas Silvia Helena , Caires Renato Antunes , Ferraz Crispilho Shirley , Ayroza Galvão Paulo César , Moysés Rosa Maria Affonso 
Published: September 2019

Immobilization and prolonged bed rest are harmful to the skeleton, which suffers increased resorption, and contribute to reducing survival rates among patients in critical care units. We report a patient who presented hypercalcemia 10 days after continuous venovenous hemofiltration has ended. Investigative tests showed an increase of serum C-terminal telopeptide of type I collagen (CTx), with suppressed parathormone and calcitriol. Denosumab was administered with a significant response, decreasing ionized calcium and CTx levels. The calcium infusion rate during dialysis procedures, used for citrate anticoagulation compensation, has progressively decreased, suggesting that endogenous calcium was taking part in the citrate chelation. In this report, we highlight the challenges in early diagnosis of immobilization-induced hypercalcemia among patients who are on continuous renal replacement therapy undergoing citrate anticoagulation.
Spoilt for Choice: A Survey of Current Practices of Surgical Urinary Stone Treatment and Adherence to Evidence-Based Guidelines among Swiss Urologists
Authors: Betschart Patrick , Zumstein Valentin , Jichlinski Patrice , Herrmann Thomas R.W. , Knoll Thomas , Engeler Daniel Stephan , Müllhaupt Gautier , Schmid Hans-Peter , Abt Dominik 
Published: September 2019

<b><i>Introduction:</i></b> Urologists have to master a variety of techniques to be able to offer the most appropriate surgical stone treatment for each individual patient. Therefore, we performed a survey among board-certified Swiss urologists to assess the availability of the different surgical methods, the current practices of surgical treatment of urolithiasis and the adherence to evidence-based guideline recommendations in Switzerland. <b><i>Methods:</i></b> A 14-question survey assessed the working environment, equipment, perioperative settings and decision trees for specific stone scenarios. Data was analyzed using descriptive statistics and chi-square tests to determine differences between frequencies of answers. <b><i>Results:</i></b> Hundred and five members of <i>Swiss Urology</i> (38%) completed the survey. All treatment modalities are available for the majority of respondents. Ureterorenoscopy was found to have the highest availability (100%) and was the preferred choice in the majority of stone scenarios. A high adherence to the guidelines was found for the treatment of ureteral stones &#x3c;10 mm (100% proximal and distal), and &#x3e;10 mm (69% proximal, 94% distal). All respondents answered in accordance with the guidelines regarding the treatment of middle and upper pole stones &#x3c;10 mm, 10–20 mm and lower pole stones 10–20 mm. Guideline adherence was 99% for lower pole stones &#x3c;10 mm, 78% for lower pole stones &#x3e;20 mm, and 63% for middle/upper pole stones &#x3e;20 mm. <b><i>Conclusion:</i></b> This survey provides a detailed insight into current stone treatment practices in Switzerland. The full spectrum of urinary stone treatment options is available for the majority of Swiss urologists. The choice of treatment shows a high accordance with evidence-based guidelines and a preference for retrograde endoscopic surgery in the majority of stone scenarios.
Configuring LES Based on Dropsonde Data in Sparsely Sampled Areas in the Subtropical Atlantic
Authors: Reilly Stephanie , Gesso Sara Dal , Neggers Roel 
Published: September 2019

AbstractThis study explores the question of how field campaign data, gathered over a large area that is poorly sampled, can be used to make large-eddy simulation (LES) realizations more representative of the local conditions. To this purpose, dropsonde data recorded during the first Next-Generation Aircraft Remote Sensing for Validation Studies (NARVAL)-South campaign, in the marine subtropical North Atlantic, are blended into the forcing data. Control simulations are driven by time-dependent forcings derived from a combination of analyses and short-range weather forecasts, using weak nudging to prevent excessive model drift. A second set of simulations is driven by forcing data with dropsonde profiles included at the time points of their release. Metrics are designed to (i) quantify the impact on the boundary layer vertical profiles as a result of nudging toward the dropsondes and (ii) use a probabilistic method to allow a fair comparison of the inversion strengths in the simulations and observations. The simulations show strong time variation in the cloud-layer depth on relatively short time scales, which is commensurate with recent observational studies in the area. Nudging toward dropsondes improves the representation of the atmospheric profiles throughout the depth of the boundary layer in all simulations. However, the impact on the inversion strength is less pronounced. All impacts persist for some time after the dropsonde time point, depending on the intensity of the nudging and the nudging time window. The sensitivity of the results to nudging details and vertical resolution is assessed.
An Observational Study of a Coastal Barrier Jet Induced by a Landfalling Typhoon
Authors: Kao Yu-Cheng , Jong-Dao Jou Ben , Chan Johnny C. L. , Lee Wen-Chau 
Published: September 2019

Abstract
In this study, the structure and evolution of a coastal barrier jet (CBJ) along the east coast of Taiwan is documented using operational Doppler radars. The formation of the CBJ was controlled by the flow regime associated with the approaching Typhoon Haitang (2005). The CBJ persisted for 6 h and was approximately 140 km long and 25 km wide. The northern branch of the CBJ had stronger winds with maximum wind speed 49–52 m s−1, a greater vertical extent with jet core between 1.0 and 2.5 km in height, and a more persistent jet signal than the southern branch with maximum wind speed 43–46 m s−1 and jet core between 1.0 and 2.0 km. We investigated the terrain blocking effect leading to the CBJ formation using an idealized simulation. A vortex resembling Haitang is constructed based on circulation retrieved from generalized velocity track display (GVTD) technique. The result of a no-terrain simulation reveals wind speed 10–22 m s−1 lower than the observed Doppler velocity. The difference suggests the enhanced wind speed along the coast was most likely due to the terrain blocking effect.
Evaluating literacy levels of patient education materials for a sickle cell transition group education programme
Authors: Johnson Robin , Edwards Ronisha , Rivers Angela , Patil Crystal , Walsh Susan 
Published: September 2019

Objective: A multidisciplinary team from a US midwestern urban medical centre developed written patient education materials for a group education programme designed to prepare adolescents and emerging adults with sickle cell disease for transition to adult care. We evaluated the literacy levels of these materials and demonstrate how to revise the patient education materials to meet literacy standards. Method: Six tools were used to evaluate literacy levels of the patient education materials. Based on the literacy level scores of the materials, including readability, grade level, understandability and actionability, recommendations and revisions were made to improve literacy levels. The revised materials were again assessed using the same six tools. Results: Initial literacy levels of the patient education materials were higher than recommended standards. Adjustments were made to meet literacy standards. Not all standards were met. Conclusion: Patient education materials should conform as much as possible to recommended literacy standards for optimum understandability. However, not all patient education materials can fully meet all evidence-based literacy standards. Recommendations for evaluating literacy standards when creating or providing previously developed patient education materials are discussed. Extra efforts to achieve acceptable literacy standards are recommended when medically complex educational materials are necessary.
Perspectives of consumers in India on factors affecting recovery from schizophrenia
Authors: Gandhi Sailaxmi , Jose Diksy , Desai Geetha 
Published: September 2019

Background: Identifying patient perspectives about recovery may help the service providers to enhance active participation of patients in their recovery. Aim: This study aimed to explore patients’ perspectives about factors affecting recovery from schizophrenia. Methods: A semi-structured interview schedule was used to explore the perceptions of 18 patients diagnosed with schizophrenia. The interviews were recorded, transcribed and analysed. Codes were identified and similar codes were grouped together and main themes were identified. Results: Nine main themes on facilitators and barriers of recovery from schizophrenia were derived. Conclusion: Deeper understanding of patients’ perspectives of recovery from schizophrenia can help mental health professionals to plan appropriate recovery-oriented services.
A small bifurcated self-expanding metallic stent for malignant bronchial fistula or severe stenosis around the upper left carina
Authors: Bi Yonghua , Li Jindong , Wu Gang , Yu Zepeng , Han Xinwei , Ren Jianzhuang 
Published: September 2019

Background Bifurcated self-expanding metallic stents have mainly been primarily used for the treatment of airway disease around the main carina, but few studies have reported the use of small bifurcated stents to treat malignant bronchial fistula or severe stenosis around the upper left carina. Purpose We aimed to determine the safety, feasibility, and efficacy of small metallic bifurcated stent placement in the upper left carina. Material and Methods Twenty-two patients with malignant bronchial disease were treated with small bifurcated stents. All bifurcated stents were custom-designed according to the measurement of CT measurements and placed under local anesthesia with fluoroscopic guidance. Clinical outcomes and CT imaging data were retrospectively analyzed. Results A total of 27 stents were used in 22 patients, with two stents removed immediately after placement due to stent insufficient dilation and failure of sealing fistula. Twenty patients underwent successful treatment, with a technical success of 90.9%. Thirteen complications were found in 9 (40.9%) patients. Five patients underwent successful stent removal due to failure of sealing fistula (n = 2) or because they were effectively cured (n = 3) during the follow-up period. Ten patients died of cancer, one patient died of chronic renal failure, and one died of myocardial infarction. The one-, three-, and five-year survival rates were 48.0%, 40.0%, and 32.0%, respectively. The median survival was 12.7 months. Conclusion Small bifurcated self-expanding metallic stents are a safe and effective treatment option for malignant bronchial fistula or severe stenosis around the upper left carina, but complications are relatively high. Further prospective studies are needed to evaluate alternative treatment options.
Proposed new diagnostic criteria for chronic migraine
Authors: Chalmer Mona Ameri , Hansen Thomas Folkmann , Lebedeva Elena R , Dodick David W , Lipton Richard B , Olesen Jes 
Published: September 2019

Introduction ICHD-3 criteria for chronic migraine (CM) include a mixture of migraine and tension-type-like headaches and do not account for patients who have a high frequency of migraine but no other headaches. Materials and methods Patients from the Danish Headache Center and their relatives with ICHD-3 defined CM were compared with patients with high frequency episodic migraine (HFEM). Danish registries were used to compare the socioeconomic impact in these two groups. A Russian student population was used to determine the generalizability of the number of patients fulfilling CM and the proposed diagnostic criteria for CM. Results There was no difference in the demographic profile between the two groups in the Danish cohort. The number of lifelong or annual attacks ( p > 0.3), comorbid diseases, or self-reported effect of triptans ( p = 1) did not differ. HFEM patients purchased more triptans than CM patients ( p = 0.01). CM patients received more early pension ( p = 0.00135) but did not differ from HFEM patients with regard to sickness benefit ( p = 0.207), cash assistance ( p = 0.139), or rehabilitation benefit ( p = 1). Discussion Patients with HFEM are comparable to CM patients with regard to chronicity and disability. We therefore suggest classifying CM as ≥ 8 migraine days per month (proposed CM), disregarding the need for ≥ 15 headache days per month. The proposed diagnostic criteria for CM approximately doubled the number of patients with CM in both the Danish and the Russian materials. Extending the definition of CM to include patients with HFEM will ensure that patients with significant disease burden and unmet treatment needs are identified and provided appropriate access to the range of treatment options and resources available to those with CM. Conclusion Patients with migraine on eight or more days but not 15 days with headache a month are as disabled as patients with ICHD-3 defined CM. They should be included in revised diagnostic criteria for chronic migraine.