bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Human papillomavirus among women living with Human Immunodeficiency Virus in Morocco A prospective cross-sectional study
Authors: Ouladlahsen Ahd , Fayssel Naouar , Bensghir Rajaa , Baba Hanâ , Lamdini Hassan , Sodqi Mustapha , Marih Latifa , Essebbani Meryem , Nadifi Sellama , Benjelloun Soumaya , Himmich Hakima , Chakib Abdelfattah , Wakrim Lahcen , Marhoum El Filali Kamal , Ezzikouri Sayeh 
Published: July 2018

Introduction: Women infected with human immunodeficiency virus (HIV) have a higher risk of contracting human papillomavirus (HPV) infections and are more prone to develop cervical cancer. The objective of this study was to determine the prevalence of HPV and its association with risk factors among Moroccan women living with HIV/AIDS.
Methodology: We enrolled 251 HIV-infected non-pregnant women in Morocco from February 2013 to September 2016. Sociodemographic, lifestyles, behavioral and clinical data were collected. Polymerase chain reaction followed by sequencing were performed for molecular detection and HPV genotyping in cervical samples, respectively.
Results: Abnormal cervical smears were found in 34/246 patients (13.82%). The overall prevalence of HPV was 74.50%. HPV 58 was the most prevalent (39.29%) followed by HPV 18 (10.71%), HPV 70 (8.93%), HPV 33 (7.14%), HPV 6 (6.25%) and other genotypes (< 3%). Overall, high-risk HPV (HR-HPV) types were present in 75% (84/112) of patients and the prevalence of HR-HPV types in samples with abnormal Pap was higher than in normal Pap (55/83, 66.27% vs. 28/83, 33.33%, p < 0.0001). Univariate analyses showed that none of the socio-demographic and behaviors factors was associated with HPV infection. Moreover, Pap results were not affected by HPV status (p = 0.532). Whereas, CD4 T-cell counts above 200/mm3 at enrolment were apparently not protective to HPV infection. We found a high prevalence of HPV infection and HR-HPV types among HIV-positive women that significantly associated with abnormal Pap.
Conclusion: Our findings suggest a high prevalence of HPV infection with high-risk types was observed among HIV-positive women warrant to implement a regular screening by Pap smear.
Field accuracy of HIV rapid diagnostic tests for blood donors screening, Bukavu, Eastern Democratic Republic of the Congo
Authors: Kashosi Théophile Mitima , Kyambikwa Céléstin Bisangamo , Mulongo Philémon Mbarabara , Nachega Jean Bisimwa 
Published: July 2018

Introduction: Rapid diagnostic tests (RDTs) are widely used for point-of-care. point-of-care diagnosis of HIV infection in resource-limited settings. However, there are no data about their field diagnostic performance in Eastern Democratic Republic of the Congo (DRC), especially in the context of blood banks screening for transfusion safety purpose.
Methodology: Blood specimens were collected from blood donors in Bukavu, Eastern DRC, from May the 1st to June the 30th, 2015, to evaluate the accuracy of Alere Determine HIV-1/2, Trinity Biotech Uni‑Gold HIV, and DoubleCheckGold Ultra HIV 1& 2 compared to the laboratory-based 4th generation ELISA apDia HIV Ag/Ab assay. Sensitivity, specificity, positive and negative predictive values, and related 95% confidence intervals were calculated using MedCalc statistical software version 15.1. Reliability was evaluated using Cohen’s Kappa Statistic, κ.
Results: Among 312 participants who provided blood bags, 96/312 (30.7%) were female and the mean age (SD) was 31.7 years (± 8.1years). Sensitivity for the three tests was 57.1% (95% CI: 18.4-90.1). The specificity was 99.7% (95% CI: 18.4-90.1) for Alere Determine HIV 1/2, 100% (95% CI: 98.8-100.0) for Uni-Gold HIV, and (100% (95% CI: 98.8-100.0) for DoubleCheckGold Ultra HIV 1&2. Cohen’s Kappa Statistic showed moderate agreement between the 4th generation ELISA apDia HIV Ag/Ab and RDTs Alere Determine HIV 1/2 and Uni-Gold HIV (κ = 0.66; 95% CI: 0.55- 0.76) but good agreement for DoubleCheckGold Ultra HIV1&2 (κ = 0.72; 95% CI: 0.61 – 0.82).
Conclusions: Compared to the laboratory-based ELISA apDia HIV Ag/Ab assay, the currently used 3rd generation HIV RDTs showed poor field accuracy results in a context of blood donors screening. These data support the need for 4th generation Ag-Ab RDTs in transfusion blood qualification.
A Study on the Clinical and Angiographic Spectrum of Spontaneous Extracranial Dissections in the Cerebral Vasculature
Authors: Anadure Ravi K. , Mohimen Aneesh , Saxena Rajeev , Sivasankar Rajeev 
Published: July 2018

ABSTRACT
Aim: To prospectively study the clinical profile, angiographic features, and functional outcomes, in consecutive cases of extracranial dissection seen at two tertiary stroke care centers in South India. Materials and Methods: In this observational study, spanning 4 years (December 12–December 16), a total of 442 patients presented with an acute ischemic stroke/transient ischemic attack (TIA) at our study centers. 14/546 (3.2%) of these patients had magnetic resonance angiography (MRA)/computed tomography angiography (CTA) evidence of extracranial dissections. All cases underwent detailed clinical evaluation on arrival, and data were recorded on a predesigned stroke pro forma. Contrast MRA was done on arrival in all cases as part of a standard stroke protocol, and CTA was done only if MRA was inconclusive. The pattern of the vessel involved and morphology of vessel dissection was analyzed as per a standard radiology protocol. All the cases were managed with short-term anticoagulation using low-molecular-weight heparin followed by oral anticoagulants for 3–6 months. All cases were followed up for 1–2 years and the functional outcomes were recorded using the modified Rankin Scale (mRS). Results: There were 11 males and 3 females in the study, and the mean age was 45.1 years (range = 27–65 years). Focal neurological symptoms occurred in all these patients (10 patients had a stroke, and 4 had TIA). Nearly 64.2% of these (9/14) were stroke in young (age <45 years). The internal carotid artery was the most common vessel involved in 85.7% (12/14) cases. Of the ten patients with completed stroke, a good functional outcome (mRS 1–2) was seen in 8/10 (80%). Digital subtraction angiography and revascularization procedures were needed only in a minority of cases 3/14 (21%).\ Conclusion: This hospital-based study highlights the importance of suspecting arterial dissections in young strokes of unexplained etiology, and offering optimum anticoagulant therapy in the acute phase, to achieve good long-term outcomes.
Role of Leptin in Acute Ischemic Stroke
Authors: Menon Bindu , Krishnan Ramalingam 
Published: July 2018

ABSTRACT
Purpose: Leptin has been implicated as a pathogenetic contributor to atherosclerosis. We aimed to investigate the association of leptin level with ischemic stroke. Materials and Methods: We prospectively enrolled 52 patients with acute ischemic stroke and measured leptin levels and compared with age- and sex-matched healthy controls. Risk factors, body mass index (BMI), biochemical parameters, intima–media thickness (IMT) on carotid vertebral Doppler and neuroimaging was done. Data were entered into MS-Excel and appropriate statistical analysis was done using SPSS software version 21.0. P = 0.05 was considered statistically significant. Results: Serum leptin was significantly elevated in stroke patients (6598.1 ± 1035.1) compared to controls (3090.7 ± 698.86) (P < 0.01). Patients had higher BMI (26.9 ± 1.7) than controls (26.9 ± 1.7) (P < 0.00). BMI, total cholesterol, low-density lipoprotein (LDL) cholesterol, white blood cell (WBC) count, erythrocyte sedimentation rate (ESR), and C reactive protein (CRP) were significantly elevated in stroke patients than controls. Correlation analysis among patient group showed that serum leptin positively correlated with CRP (r - 0.41, P - <0.05), WBCs (r - 0.28, P - <0.05), ESR (r - 0.429, P - <0.01) total cholesterol (r - 0.31, P - <0.05), LDL-cholesterol (r - 0.19, P - <0.05), and IMT (r - 0.714, P - <0.001). Conclusion: Our study showed high leptin levels in patients with stroke. Stroke patients with high leptin had higher BMI and inflammatory markers. The results of our study indicate that leptin may have a role in atherosclerosis mediated through inflammation. Future research should be directed toward understanding the role of leptin in the pathogenesis of cerebrovascular diseases and its potential role in preventive treatment of ischemic stroke.
Effectivity of combined diffusion-weighted imaging and contrast-enhanced MRI in malignant and benign breast lesions
Authors: Yadav Pratiksha , Chauhan Surbhi 
Published: July 2018

PurposeMammography is the most commonly used diagnostic test for breast lesion detection and evaluation, but in dense breast parenchyma it lowers its sensitivity to detect small lesions. Sensitivity and specificity improves with combined use of contrast-enhanced magnetic resonance imaging (CE-MRI) and diffusion-weighted imaging (DWI) in differentiating benign and malignant breast lesions. The aim of the study was to evaluate the effectivity of combined dynamic CE-MRI and DWI in differentiating benign and malignant lesions, and to calculate the apparent diffusion coefficient (ADC) values of malignant and benign lesions of the breast.Material and methodsFifty-seven patients with 68 lesions were included in the study. MRI of breast using different sequences was acquired on 1.5 Tesla Machine with dedicated breast coils. Dynamic CE-MRI along with DWI was acquired for each patient. Histopathological reports were accepted as the standard of reference.ResultsOut of 68 lesions, 37 were malignant on biopsy (54.4%) and 31 were benign (45.5%). The sensitivity of CE-MRI was 92%, specificity 84.21%, positive predictive values (PPV) 88.46 %, and negative predictive values (NPP) 88.89%. The sensitivity of DWI-MRI was 91.6%, specificity was 90.6%, PPV 91.6%, and NPP 90.6%. The sensitivity of combined DWI-MRI and CE-MRI was 95.0%, specificity was 96.43%, PPV 97.44%, and NPP 93.10%. Mean ADCs of benign lesions (b = 800) was 1.905 ± 0.59 × 10<sup>–3</sup> mm (2)/s, which was significantly higher than those of malignant lesions (b = 800) 1.014 ± 0.47 × 10<sup>–3</sup> mm (2)/s.ConclusionsMulti-parametric MRI is an excellent non-invasive modality with high sensitivity and specificity to differen­tiate malignant from benign breast lesions.
Radiological features of sacrococcygeal teratomas in fetal magnetic resonance imaging and computed tomography – a case report
Authors: Firszt Oliver P. , Myga-Porosiło Jolanta , Pośpieszny Katarzyna , Golus Tomasz , Trzeszkowska-Rotkegel Sylwia , Głowacki Jan , Sraga Wojciech , Kluczewska Ewa 
Published: July 2018

PurposeSacrococcygeal teratomas (SCT) can be detected in ultrasonography as early as in the first trimester. Currently, prenatal ultrasonography enables a thorough examination of tumors, but it is not always sufficient. The purpose of this study was to determine the most important features of SCTs in fetal magnetic resonance imaging and to confront them with postnatal computed tomography (CT).Case reportBetween 2009 and 2013, 5 cases of sacrococcygeal teratomas were diagnosed in our hospital using fetal magnetic resonance imaging (3 female and 2 male infants). Three of the affected newborns underwent postnatal CT before surgery. In each case, tumor size, its content, mass effect, and classification according to the Altman’s criteria were determined and compared with other features. Fetal magnetic resonance imaging (MRI) and postnatal CT were in excellent agreement with respect to tumor classification using the aformentioned criteria. MRI better characterizes tumor content and its extent compared to ultrasound, and enables a precise structural assessment of the central nervous system. Postnatal CT is complementary to fetal MRI and optional.ConclusionsFetal MRI may help in the prenatal diagnosis of SCTs as it overcomes the limitations of obstetric ultrasound. Postnatal computed tomography is useful in determining tumor vascularity or calcifications, and it can depict the surrounding bone structures.
Magnetic resonance diffusion-weighted imaging in diagnostics of primary fallopian tube carcinoma – is it useful?
Authors: Grabowska-Derlatka Laretta , Szeszkowski Wojciech , Sieńko Jacek , Derlatka Paweł 
Published: July 2018

PurposePrimary fallopian tube carcinoma (PFTC) is the rarest form of female genital malignancy. The imaging applied for suspected adnexal masses includes transvaginal ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI), but the vast majority of PFTC is recognised intraoperatively.Material and methodsThe study group consisted of seven women with postoperatively histopathological diagnosis of PFTC. To recognise characteristic findings for PFTC, retrospective analysis of preoperative MRI was performed. All patients underwent MRI of the pelvis and abdomen using a 1.5T MR system. Based on the results of the above imaging, suspected adnexal masses were recognised. MRI protocol contained T2-weighted images, fat-suppressed T2-weighted, T2-TIRM, DW EPI, pre- and postcontrast dynamic 3D T1 GRE in transverse orientation, with diffusion weightings of 0, 50, 100, 150, 200, 400, 800, and 1200 s/mm<sup>2</sup>. Regions of interest were outlined by a radiologist, who documented the character of adnexal masses on diffusion-weighted (DW) images and apparent diffusion coefficient (ADC) maps.ResultsIn all seven patients with PFTC unilateral tumour was found. On all DW images (with β values of 0, 50, 100, 150, 200, 400, 800, and 1200 s/mm<sup>2</sup>) the mean signal intensities of solid parts of tumour were significantly higher than the mean signal intensities of normal ovarian tissue (p = 0.0001). There were no statistically significant differences between eight β values applied for ADC calculations.ConclusionsPreoperative diagnostics of PFTC is difficult and mainly based on morphological features. Previous research did not show characteristics of PFTC in post-contrast dynamic imaging. In our material a clear increasing of signal intensity in DW imaging occurred independently of the β value.
Percutaneous lung needle biopsies – utility and complications in various chest lesions: a single-institution experience
Authors: Jelitto-Gorska Małgorzata , Studniarek Michał , Durawa Agata , Marjanski Tomasz , Szurowska Edyta 
Published: July 2018

PurposeIt is crucial to obtain a specific diagnosis before treatment of chest pathology is initiated. The purpose of the study is to present the utility of percutaneous biopsies, core and fine-needle aspiration, in various thoracic lesions, and related complications.Material and methodsA total of 593 transthoracic biopsies were performed in the Department of Radiology between 2013 and 2016. Fine-needle aspiration biopsy (FNAB) and core biopsy (CB) were implemented. The procedures were divided into four groups according to the location of the pathology: lung lesions (LL – 540), mediastinal masses (MM – 25), chest wall tumours (CWT – 13), and pleural lesions (PL – 15). The lung lesion group was divided into two subgroups: lung nodules and lung infiltrations. All groups were analysed in respect of diagnostic accuracy, pathological findings, and complication rate.ResultsPathological diagnosis was confirmed in 447 cases after all 593 procedures. The sensitivity of malignancy diagnosis in the group of lung tumours was 75% for FNAB and 89% for CB. The sensitivity in other groups, where CB was a preferable technique, was counted for lung infiltration, mediastinal masses, chest wall tumours, and pleural lesions and amounted to 83.3%, 90.9%, 100%, and 85.7%, respectively. In the group of lung tumours malignancy was confirmed most commonly (79%), while in the lung infiltration group benign processes dominated (83%). There was no statistical difference between the pneumothorax rate after CB and FNAB. Haemoptysis appeared more often after CB.ConclusionsFNAB and CB are useful, safe, and sensitive tools in the diagnostic work-up. They can both be used to diagnose almost all chest pathologies.
Acute hydrocephalus secondary to meningioma with psychiatric symptoms as initial manifestation
Authors: Valentim Marta , Cadena Velez Iván , Teles Neto Catarina , Almeida Sónia , Gameiro Ana , Silva Fernandes Inés 
Published: July 2018

Background: Psychiatric disorders are often difficult to evaluate and sometimes have negative connotations associated. That could be a reason to ignore the correct diagnosis of underlying neurological diseases.Case report: We present a case report of a patient with psychiatric symptomatology, where during the study in the Emergency Department an acute hydrocephalus secondary to a massive meningioma was evidenced.Conclusions: This case exemplifies how psychiatric symptoms, often devalued by the physician, may be the first manifestation of serious neurological disorders, as well as being associated with a medical emergency, as in this case was the acute hydrocephalus.
The European Union’s Strategy on Hybrid Threats
Authors: Górski Sławomir Stanisław 
Published: July 2018

The article discusses and analyses the terminology and gives a description of hybrid threats. Particular emphasis is placed on their diversity, variability and the problematic nature of methods used by an aggressor in order to destabilise the social, political and economic environments against which the hostile activities are targeted. The areas which may be under the influence of hybrid threats have been indicated and many aspects of these threats’ influence on a contemporary countries’ functioning have also been underlined. The main focus of hybrid threats’ considerations is put in the context of the European Union. The related strategic documents have been analysed and the directions of action defined in them, which may prevent or neutralise the consequences of hybrid threats, have been described, as well. Particular attention has been paid to the analysis of the ”Joint Framework on countering hybrid threats”, the strategic document which acts as a map for joint anti-hybrid activities. The directions of action defined in it may, in the
author’s opinion, contribute to building up resistance to hybrid threats. Particularly legitimate are activities which aim at providing an appropriate level of situational knowledge, as well as effective exchange of intelligence information among the European Union’s institutions and its member states. What is more, developing the analytical potential and the transfer of knowledge of hybrid threats, which is carried out by joint centres of excellence, may result in a situation where the influence of these threats on the social, political and economic dimension of the member states’ functioning is smaller. Comparisons between the common strategic solutions to hybrid threats and other instruments of the European Union relating to the internal security (civil protection, solidarity clause) have been made in the article. The summary discusses the directions of antihybrid strategic activities, among which developing the awareness of threats and strengthening the social resilience to hybrid threats have been given special emphasis.
Osteoarthritis‐Related Walking Disability and Arterial Stiffness: Results From a Cross‐Sectional Study
Authors: Joseph Kenth L. , Hagen Kåre B. , Tveter Anne T. , Magnusson Karin , Provan Sella A. , Dagfinrud Hanne 
Published: July 2018

ObjectiveTo compare the 6‐minute walking distance (6MWD) in a population‐based cohort of patients with osteoarthritis (OA) with that in matched peers from the general population, and to explore the associations between walking ability and risk of cardiovascular disease (CVD) in the OA cohort.MethodsThis cross‐sectional study included individuals (ages 40–80 years) who had self‐reported OA (n = 500) in a previous population‐based study and age‐ and sex‐matched peers from the general population (n = 235). Clinical examinations of the patients with OA included classification according to the American College of Rheumatology criteria, blood sampling, and measuring arterial stiffness (PWV; pulse wave velocity). Group differences in the 6MWD were calculated with t‐tests. The association between walking ability and CVD risk in the OA cohort was examined using multivariate regression models.ResultsIn the age‐stratified analyses, the largest mean difference in the 6MWD was observed in the youngest age groups (40–49 years); female patients in the OA group walked 84.6 fewer meters compared with the reference group (579.4 meters and 663.9 meters, respectively; P < 0.001), and male patients walked 88.3 fewer meters compared with the reference group (619.9 meters and 708.3 meters, respectively; P = 0.001). In the OA group, the 6MWD was significantly associated with PWV in the adjusted analysis (P = 0.001); an increase in the walking distance of 100 meters corresponded to a reduction in PWV of 0.3 meters/second.ConclusionEven at age 40 years, patients with OA had a significantly shorter mean walking distance compared with their matched peers, underlining the importance of an early clinical approach to OA. Furthermore, in the OA group, the 6MWD was significantly associated with arterial stiffness, suggesting that walking ability is important for the CVD risk profile in patients with OA.
Copper‐Catalyzed [4+2] Cycloaddition Using N‐(2‐Pyridyl)ketimines and Terminal Alkynes
Authors: Tatsumi Kenta , Fujihara Tetsuaki , Terao Jun , Tsuji Yasushi 
Published: July 2018

AbstractCopper‐catalyzed [4+2] cycloaddition of N‐(2‐pyridyl)ketimines and terminal alkynes has been achieved. Ketimines bearing a trifluoromethyl group reacted with various terminal alkynes to produce pyrido[1,2‐a]pyrimidines in good to high yields. This reaction proceeded through a propargylamine intermediate and the corresponding product was obtained via 6‐endo‐dig cyclization.magnified image
Meta-analysis of the cumulative risk of endometrial malignancy and systematic review of endometrial surveillance in extended tamoxifen therapy
Authors: Fleming C A , Heneghan H M , O'Brien D , McCartan D P , McDermott E W , Prichard R S 
Published: July 2018

Abstract

Background
Optimal management of the endometrium in patients with oestrogen receptor-positive breast cancer taking extended tamoxifen therapy (for 10 years) remains uncertain. A meta-analysis was performed to determine the cumulative risk ratio (RR) for endometrial malignancy following extended compared with standard tamoxifen treatment. A systematic review was undertaken to identify whether routine endometrial surveillance in patients receiving tamoxifen is associated with earlier detection and reduced incidence of endometrial malignancy.

Methods
Two independent searches were undertaken in the Cochrane Library, PubMed and MEDLINE. A meta-analysis was performed of RCTs reporting on endometrial malignancy risk in extended tamoxifen therapy. A systematic review included prospective studies investigating the benefit of endometrial surveillance during tamoxifen therapy.

Results
Four RCTs reported on endometrial risk in extended tamoxifen therapy. The cumulative risk of endometrial malignancy increased twofold from 1·5 to 3·2 per cent with extended therapy compared with the standard 5 years of tamoxifen (RR 2·29, 95 per cent c.i. 1·60 to 3·28; P &lt; 0·001). Four studies analysed the value of endometrial screening in 5-year cohorts. Endometrial cancer rates of up to 2 per cent were reported, which is higher than rates in the large extended tamoxifen trials.

Conclusion
Extended adjuvant tamoxifen is associated with an increase in endometrial cancer. No clear benefit has been shown for routine endometrial surveillance in asymptomatic patients on tamoxifen therapy.