bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of Cardiac Involvement in Fabry Disease (FD) with Native T1 Mapping
Authors: Roller Fritz Christian , Fuest Sven , Meyer Marco , Harth Sebastian , Gündüz Dursun , Bauer Pascal , Schneider Christian , Rolfs Arndt , Krombach Gabriele Anja , Tanislav Christian 
Published: February 2019

Purpose Fabry disease (FD) is an X-linked multi-organ disorder of lysosomal metabolism with cardiac disease being the leading cause of death. Identifying early FD-specific pathologies is important in the context of maximum therapeutic benefit in these stages. Therefore, the aim of this study was to investigate the value of quantitative cardiac T1 mapping as a potential disease-specific surrogate.
Methods 16 consecutive FD patients (9 female, 7 male; median age: 54 years, IQR 17) and 16 control patients (9 female, 7 male; median age: 52 years, IQR 20) were investigated at 1.5 Tesla. Native T1 mapping was performed using a modified look locker inversion recovery sequence (MOLLI) and native T1 times were measured within the septal myocardium at the midventricular short-axis section. Also functional parameters, left ventricular morphology, presence of late-gadolinium enhancement, cTnI- and Lyso-Gb3-Levels were evaluated.
Results The median native septal T1 time for FD was 889.0 ms and 950.6 ms for controls (p < 0.003). LGE and positive cTnI values (0.26 ± 0.21) were present in 5 FD patients (31.25 %), and left ventricular hypertrophy (LVH) was present in 4 FD patients (25.00 %). The 4 cTnI and 8 Lyso-Gb3 positive FD patients had significantly lower native T1 values (p < 0.05, respectively p < 0.01). Assuming a T1 cut-off value of 900 ms for the identification of increased cardiac lipid deposit, 9 patients with FD (56.25 %) had pathologic values (4 patients cTnI and 8 patients Lyso-Gb3 positive). Moreover, native septal T1 showed a good negative correlation to Lyso-Gb3 (r = – 0.582; p = 0.018).
Conclusion A pathologic cardiac native T1 time obviously reflects cardiac involvement in the scope of FD at tissue level. In the future native T1 mapping as an imaging biomarker might allow identification of early stages of cardiac involvement in FD before morphological changes are obvious.
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What Role Does Synovitis Play in Craniomandibular Dysfunction (CMD)? A 3T-MRI Study
Authors: Stimmer Herbert , Ritschl Lucas , Goetz Carolin , Kolk Andreas , Hofauer Benedikt , Wirth Markus , Knopf Andreas , Ott Armin , Wolff Klaus-Dietrich 
Published: February 2019

Purpose The purpose of the present study was to investigate the degree and clinical relevance of synovitis in craniomandibular dysfunction.
Materials and Methods In total, 140 temporomandibular joints were examined using a 3 T MRI scanner. Quantitative analysis of synovial enhancement was performed and interrelated with arthrosis deformans, degenerative disc disease, joint effusion, bone marrow edema and restriction of motion.
Results We found a statistically high and significant correlation between the degenerative changes as mentioned above and the intensity of synovial enhancement.
Conclusion The study shows that typical MRI findings in CMD patients are often combined with signs of synovitis. Presumably joint inflammation has an effect on the clinical signs and symptoms and also the prognosis of CMD. These results should be taken into consideration when selecting treatment.
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Postoperative Infection in Cementless and Cemented Total Knee Arthroplasty: A Propensity Score Matched Analysis
Authors: Anis Hiba K. , Ramanathan Deepak , Sodhi Nipun , Klika Alison K. , Piuzzi Nicolas S. , Mont Michael A. , Higuera Carlos A. , Molloy Robert M. 
Published: February 2019

AbstractThe ongoing debate on fixation in total knee arthroplasty (TKA) has become increasingly relevant with its increased use in a younger patient population and the advent of novel cementless prostheses. Recent literature suggests modern cementless implants are comparable to their cemented counterparts in terms of survivorship and functional outcomes. What has not been well-assessed is whether the two modalities differ with respect to infection rates which was the purpose of this study. Specifically, a propensity score matched study population was used to compare: (1) overall infection; (2) prosthetic joint infection (PJI); and (3) surgical site infection (SSI) rates between cementless and cemented TKAs. Using a large institutional database, 3,180 consecutive primary TKAs were identified. Cementless and cemented TKA patients were propensity score matched by age (p = 0.069), sex (p = 0.395), body mass index (BMI; p = 0.308), and Charlson's comorbidity index (CCI) score (p = 0.616) in a 1:1 ratio. Univariate analysis was performed to compare 2-year overall infection rates. Infections were further analyzed separately as PJIs (deep joint infections requiring surgery) and SSIs (skin/superficial wound infections). Multivariate logistic regression was performed to evaluate infection incidences after adjusting for procedure-related factors (i.e., operative time, hospital volume, and surgeon volume). There were no significant differences between the matched cohorts in terms of overall infection rates (3.8 vs. 2.3%, p = 0.722), as well as when PJI (p = 1.000) and SSI (p = 1.000) rates were analyzed separately. Multivariate analysis revealed no significant differences in overall postoperative infection rates (p = 0.285), PJI rates (p = 0.446), or SSI rates (p = 0.453) even after adjusting for procedure-related factors. There is increasing literature investigating various outcomes demonstrating the comparable efficacies of cementless versus cemented TKAs. To the best of the author's knowledge, this was the first matched case-control study to directly compare their post-operative infection rates. The findings from this study show that post-operative infection rates were similar between fixation modalities even after accounting for a range of patient- and procedure-related factors.
Engineering extracellular vesicles as novel treatment options: exploiting herpesviral immunity in CLL
Authors: Gärtner Kathrin , Luckner Manja , Wanner Gerhard , Zeidler Reinhard 
Published: February 2019

ABSTRACTExtracellular vesicles (EVs) are important mediators of cell–cell communication. Intriguingly, EVs can be engineered and thus exploited for the targeted transfer of functional proteins of interest. Thus, engineered EVs may constitute attractive tools for the development of novel therapeutic interventions, like cancer immunotherapies, vaccinations or targeted drug delivery. Here, we describe a novel experimental immunotherapeutic approach for the adjuvant treatment of chronic lymphocytic leukaemia (CLL) based on engineered EVs carrying gp350, the major glycoprotein of Epstein–Barr virus (EBV), CD40L, a central immune accessory molecule and pp65, an immunodominant antigen of the human cytomegalovirus (CMV). We show that these engineered EVs specifically interact with malignant B cells from CLL patients and render these cells immunogenic to allogeneic and autologous EBV‐ and CMV‐specific CD4+ and CD8+ T cells. Collectively, co‐opting engineered EVs to re‐target the strong herpesviral immunity in CLL patients to malignant cells constitutes an attractive strategy for the adjuvant treatment of a still incurable disease.Abbreviations: CLL: chronic lymphocytic leukaemia; EBV: Epstein‐Barr virus; CMV: cytomegalovirus
Predicting HESI® Exit Exam Success: A Retrospective Study
Authors: Gillespie Maria D. , Nadeau Julie W. 
Published: February 2019

Abstract
Controversy surrounds the use of standardized exit exams to predict and prepare students for NCLEX success. The purpose of this study was to explore the relationships between Kaplan integrated exam scores and the HESI® exit exam score to determine early indicators of success on the exit exam. A retrospective records review was used to explore relationships between performance on integrated tests and the standardized exit exam. A solid Kaplan comprehensive medical surgical exam score was highly correlated with success on the HESI exit exam. Tracking and follow-up resulted in exit exam success for nearly all students.
Letrozole Compared With Clomiphene Citrate for Unexplained Infertility
Authors: Eskew Ashley M. , Bedrick Bronwyn S. , Hardi Angela , Stoll Carolyn R. T. , Colditz Graham A. , Tuuli Methodius G. , Jungheim Emily S. 
Published: February 2019

OBJECTIVE:
To estimate the clinical effectiveness, as determined by positive pregnancy test, of letrozole compared with clomiphene citrate for ovarian stimulation in patients with unexplained infertility.

DATA SOURCES:
We conducted a systematic review and meta-analysis of data from electronic databases including Ovid-MEDLINE, EMBASE, Scopus, Cochrane Database of Systematic Reviews, Cochrane Register of Controlled Trials, Database of Abstracts of Reviews of Effects, and ClinicalTrials.gov.

METHODS:
We searched for concepts of unexplained infertility, letrozole, clomiphene citrate, and clinical outcomes including pregnancy and live birth. Studies were included if they were randomized controlled trials (RCTs) comparing clomiphene citrate with letrozole in patients with unexplained infertility. Eight RCTs including 2,647 patients with unexplained infertility were included. Primary outcome was positive pregnancy test per patient. Secondary outcomes included positive pregnancy test per cycle, clinical pregnancy, live birth, spontaneous miscarriage, twin gestation, mean serum estradiol (E2), endometrial thickness, and number of dominant follicles. The Cochrane Q test and Higgin's I2 were used to assess heterogeneity. Random effects models were used to obtain pooled relative risks (RR) and 95% CIs.

TABULATION, INTEGRATION, AND RESULTS:
In analysis per patient, there was no significant difference in positive pregnancy test between patients treated with letrozole compared with clomiphene citrate (24% vs 23%, pooled RR 1.08, 95% CI 0.85–1.36). Significant heterogeneity was noted between studies (I2=60.8%). There were no significant differences in clinical pregnancy (pooled RR 1.15, 95% CI 0.71–1.85), live birth (pooled RR 0.94, 95% CI 0.83–1.08), spontaneous miscarriage (pooled RR 0.92, 95% CI 0.61–1.38), or twin gestation (pooled RR 0.81, 95% CI 0.39–1.68). Mean serum E2 was significantly lower in the letrozole group than in the clomiphene citrate group.

CONCLUSION:
Although limited by heterogeneity, studies of ovarian stimulation in women with unexplained infertility show no difference in clinical outcomes between letrozole and clomiphene citrate.
17α-Hydroxyprogesterone Caproate and the Risk of Glucose Intolerance in Pregnancy
Authors: Eke Ahizechukwu C. , Sheffield Jeanne , Graham Ernest M. 
Published: February 2019

OBJECTIVE:To evaluate whether 17α-hydroxyprogesterone caproate use in preventing preterm birth increases the risk of gestational diabetes mellitus (GDM).DATA SOURCES:Electronic databases (MEDLINE, Scopus, ClinicalTrials.gov, PROSPERO, EMBASE, Scielo and the Cochrane Central Register of Controlled Trials) were searched for studies published before October 2018. Keywords included “gestational diabetes,” “preterm birth,” “pregnancy,” and “17-hydroxyprogesterone caproate.”METHODS OF STUDY SELECTION:Studies comparing 17α-hydroxyprogesterone caproate with unexposed control groups in women with singleton gestation and a history of a prior spontaneous preterm birth were included. The primary outcome was the development of GDM. Secondary outcomes included abnormal 1-hour, 50-g glucose screen results and mean venous blood glucose levels. Summary estimates were reported as mean differences and 95% CI for continuous variables or relative risk (RR) with 95% CI for dichotomous outcomes. Meta-analysis was performed using the random effects model of DerSimonian and Laird.TABULATION, INTEGRATION AND RESULTS:Six studies, four of which were cohort studies, met inclusion criteria and were included in the final meta-analysis. Of the 5,053 women, 1,538 (30.4%) received 17α-hydroxyprogesterone caproate and 3,515 (69.6%) were in unexposed control groups. The overall rate of GDM in women exposed to 17α-hydroxyprogesterone caproate was 10.9% vs 6.1% in women who were not exposed (RR 1.77, 95% CI 1.22–2.55). After exclusion of the cohort studies, the summary estimate of effect was nonsignificant among women who had been randomly allocated to 17α-hydroxyprogesterone caproate (RR 1.21, 95% CI 0.63–2.36).CONCLUSION:Women with singleton gestations receiving weekly 17α-hydroxyprogesterone caproate for recurrent preterm birth prevention had a significantly higher incidence of abnormal glucose test results and GDM compared with those in unexposed control groups, a finding that did not hold among women who had been randomly allocated to 17α-hydroxyprogesterone caproate.SYSTEMATIC REVIEW REGISTRATION:PROSPERO, CRD42016041694.
Efficacy and Safety of Genotype-Guided Warfarin Dosing in the Chinese Population: A Meta-analysis of Randomized Controlled Trials
Authors: Wang Feifei , Guo Jun , Zhang Aidong 
Published: February 2019

Aims:
To evaluate the efficacy and safety of using genetic information to guide warfarin dosing in the Chinese population.

Methods:
This meta-analysis was conducted among the published, randomized, controlled trials (RCTs) in the Chinese population comparing genotype-guided warfarin dosing (PG group) with clinical or standard warfarin dosing (STD group). RCTs published on or before January 2018 were identified using the PubMed, Embase, Cochrane Library, CNKI, Chinese VIP database, and Chinese Wanfang database.

Result:
Intotal, 2137 participants from 14 RCTs were included in the meta-analysis. Primary analysis showed that both bleeding events [odds ratio (OR) = 0.24; 95% confidence interval (CI), 0.11–0.52; P = 0.0003] and adverse events (OR = 0.60; 95% CI, 0.43–0.83; P = 0.002) were significantly lower in the genotype-guided group than in the clinical or standard group. The percentage of patients who received a warfarin-stable therapeutic dose during follow-up was increased in the genotype-guided group compared with the percentage in the clinical or standard group (OR = 2.68; 95% CI, 1.82–3.95; P < 0.00001). In the genotype-guided group, the time to a stable therapeutic dose (mean difference = −7.98; 95% CI, −9.08 to −6.87; P < 0.00001) and the time to the first target value (mean difference = −1.87; 95% CI, −3.41 to −0.32; P = 0.02) were shortened compared with those of the clinical or standard group, but there was no difference for international normalized ratio >4, between the 2 groups (OR = 0.42; 95% CI, 0.14–1.25; P = 0.12).

Conclusions:
Genotype-guided warfarin-dosing algorithms could improve the efficacy and safety of warfarin anticoagulation in the Chinese population.
The NLRP3 Inflammasome Inhibitor, OLT1177 (Dapansutrile), Reduces Infarct Size and Preserves Contractile Function After Ischemia Reperfusion Injury in the Mouse
Authors: Toldo Stefano , Mauro Adolfo Gabriele , Cutter Zachary , Van Tassell Benjamin W. , Mezzaroma Eleonora , Del Buono Marco Giuseppe , Prestamburgo Andrea , Potere Nicola , Abbate Antonio 
Published: February 2019

Background:
Activation of the NLRP3 inflammasome is a primary driver of sterile inflammation in response to myocardial ischemia reperfusion. Pharmacologic inhibitors of the NLRP3 inflammasome are being developed. We proposed that OLT1177 (dapansutrile), a novel NLRP3 inflammasome inhibitor, could preserve myocardial function after ischemia reperfusion injury in the mouse.

Methods:
We used an experimental murine model of myocardial ischemia reperfusion injury through transient ligation of the left coronary artery and measured the effects of OLT1177 (6, 60, or 600 mg/kg intraperitoneal dose) on infarct size at pathology and on systolic cardiac function at echocardiography. To simulate a clinical scenario, we investigated the time window of therapeutic intervention with OLT1177 (60 mg/kg) administered 60, 120, or 180 minutes after reperfusion.

Results:
OLT1177 was rapidly detectable in the plasma following intraperitoneal injection and had no effect on cardiac function in healthy mice. OLT1177 treatment at reperfusion showed significant dose-dependent reduction in infarct size (−36%, −67%, and −62% for 6, 60, and 600 mg/kg, respectively; P < 0.001 for linear trend, P = 0.010 vs. vehicle for 6 mg/kg, and P < 0.001 vs. vehicle for 60 and 600 mg/kg) and preserved cardiac systolic function measured as left ventricular fractional shortening at 24 hours and 7 days after injury (P = 0.015 for 6 mg/kg and P < 0.01 for 60 and 600 mg/kg). OLT1177 reduced infarct size also when given after 60 minutes of reperfusion (−71%, P < 0.001 vs. vehicle).

Conclusion:
OLT1177 (dapansutrile) limits infarct size and prevents left ventricular systolic dysfunction when given within 60 minutes following ischemia reperfusion injury in the mouse.
Neurological diseases in pregnancy
Authors: Toscano Marika , Thornburg Loralei L. 
Published: February 2019

Purpose of review
To summarize recent research findings and current concepts related to care of neurologic diseases in pregnancy and the risks of pregnancy to the mother–infant dyad. Recent publications related to best practices for neurologic care, risks of pregnancy, rate of relapse during and after pregnancy, as well as medication safety in pregnancy and lactation for more commonly used neurologic medications are reviewed.

Recent findings
Data continues to grow that women with neurologic conditions can experience pregnancy with minimal risks. Additionally, as more data is being published on medication safety in pregnancy and lactation, most medical therapy is now thought to be compatible, improving symptoms and care for women with neurologic conditions who require pharmacologic treatment. However, data remains limited from clinical trials and from more objective studies. Researchers continue to clarify the impact of pregnancy on the course of chronic neurologic diseases such as multiple sclerosis, myasthenia gravis, epilepsy, migraine, and cerebral aneurysms as well as the impact of these diseases on antepartum, labor and delivery, and postpartum management and neonatal course. Acute neurological conditions with pregnancy-associated risk such as stroke, posterior reversible encephalopathy syndrome, and cerebral venous sinus thrombosis are increasingly studied to determine individuals who are most vulnerable to these serious complications.

Summary
Many neurological diseases coexist with pregnancy. Recent research indicates a good prognosis for both mother and neonate. Although research related to neurologic disease in pregnancy is growing, it remains an area that deserves further focus to guide evidence-based care. With advances in research on therapeutic options, some women can achieve a safe pregnancy in the setting of chronic neurological disease.

Video abstract

http://links.lww.com/COOG/A45.
Magnesium sulfate use for fetal neuroprotection
Authors: Brookfield Kathleen F. , Vinson Abigail 
Published: February 2019

Purpose of review
The aim of this review is to describe the proposed mechanisms of action of magnesium sulfate for fetal neuroprotection, different dosing regimens of the drug that have shown benefit, and to review recent pharmacokinetic studies of the drug to better inform clinicians regarding expected benefits and remaining research questions.

Recent findings
Retrospective secondary analysis of the beneficial effects of antenatal magnesium sulfate trial database and prospective pharmacokinetic/pharmacodynamic modeling indicate magnesium sulfate administration for duration longer than 18 h, given within 12 h of delivery, and maintaining a maternal serum level of 4.1 mg/dl may maximize the neuroprotective benefits of the drug.

Summary
Magnesium sulfate in some dosage given before very preterm pregnancy delivery is beneficial for fetal neuroprotection. The exact dose, duration, and timing of administration to maximize this benefit may be more precisely studied using pharmacokinetic/pharmacodynamic modeling techniques before conducting larger randomized trials.
Treatment of Hidradenitis Suppurativa with Extensive Resection of the Lesion and Coverage with Perforator Flaps of the Lateral Thoracic Wall (Lateral Thoracic Artery, Thoracodorsal Artery Perforators)
Authors: Rodriguez Jorge M. , Rodriguez Felipe , Rivera Daniel , Naranjo Karol 
Published: February 2019

Summary:
Stage IV hidradenitis suppurativa in the axilla is a chronic disease in which the removal of the affected area and a reconstruction with disease free skin is the definitive treatment; however there is some controversy about the technique to be used in this reconstruction. Studies show superiority in wide resections, and coverage with flaps rather than grafts. The use of pedicle flaps of lateral thoracic artery perforators and thoracodorsal artery perforators has demonstrated superior performance to other techniques in postsurgical follow-up. This article describes the cases of 2 patients with chronic HS in which lesions were resected with disease-free margins and the reconstruction of the defect is carried out with lateral thoracic wall perforator flaps and the subsequent improvement in their life quality after surgery.
Radiation Dose Due to Naturally Occurring Radionuclides in Soils from Varying Geological Environments
Authors: Huang Feng-Yun J. , Hsu Fang-Yuh , Chen Tzung-Yuang , Chao Jiunn-Hsing 
Published: February 2019

Abstract
Field radiation monitoring and radionuclide analysis of soils were performed at various geological areas in Taiwan. The field-observed dose rate was 0.031–0.107 μGy h−1. The dose rate ascribed to naturally occurring radionuclides in soils that were geologically characterized varied from 0.002 to 0.079 μGy h−1. A linear correlation was observed between the activity-derived and field-observed dose, which indicated that the absorbed dose rate from the cosmic rays is almost constant (0.030 μGy h−1) throughout the flat area on the island.
Emergency Department Observation Unit Utilization Among Older Patients With Chest Pain
Authors: Madsen Troy , Perkins Rachelle , Holt Brennen , Carlson Margaret , Steenblik Jacob , Bossart Philip , Hartsell Stephen 
Published: February 2019

Background:Although some emergency department observation units (EDOUs) may exclude patients over 65 years old, our EDOU accepts patients up to 79 years old. We assessed the utilization of our EDOU by older patients (those 65–79 years old).Methods:We prospectively enrolled emergency department (ED) patients with chest pain. We gathered baseline data at the time of ED presentation and tracked outcomes related to the ED stay, EDOU, and/or inpatient admission. Our primary outcome included EDOU placement among older patients. Our secondary outcome was the rate of major adverse cardiac events [MACE: myocardial infarction, stent, coronary artery bypass graft, and death].Results:Over the 5-year study period, we evaluated 2242 ED patients with chest pain, of whom 19.4% (95% confidence interval, 17.8%–21.1%) were 65–79 years old. Older patients were more likely to be placed in the EDOU after the ED visit (45.8% vs. 36.6%;P= 0.001) and more likely to be admitted to an inpatient unit from the ED (31.8% vs. 17.9%;P< 0.001) than those under 65 years old. The overall MACE rate was similar between admitted older patients and those in the EDOU: 5.9% versus 4.3% (P= 0.57). Of the admitted older patients, 30.4% (95% confidence interval, 22.3%–39.9%) were low risk and there were no cases of MACE in this group.Conclusions:In an EDOU that allows older patients, we noted substantial utilization by these patients for the evaluation of chest pain. The characteristics of admitted older patients suggest the potential for even greater EDOU utilization in this group.