bluuebunny/crossref_metadata_2025_split huggingface dataset:
Utilization of Palliative Care for Cardiogenic Shock Complicating Acute Myocardial Infarction: A 15‐Year National Perspective on Trends, Disparities, Predictors, and Outcomes
Authors: Vallabhajosyula Saraschandra , Prasad Abhiram , Dunlay Shannon M. , Murphree Dennis H. , Ingram Cory , Mueller Paul S. , Gersh Bernard J. , Holmes David R. , Barsness Gregory W. 
Published: July 2019

Background

This study sought to evaluate the 15‐year national utilization, trends, predictors, disparities, and outcomes of palliative care services (
PCS
) use in cardiogenic shock complicating acute myocardial infarction.

Methods and Results

A retrospective cohort from January 1, 2000 through December 31, 2014 was analyzed using the National Inpatient Sample database. Administrative codes for acute myocardial infarction–cardiogenic shock and
PCS
were used to identify eligible admissions. The primary outcomes were the frequency, utilization trends, and predictors of
PCS
. Secondary outcomes included in‐hospital mortality and resources utilization. Multivariable regression and propensity‐matching analyses were used to control for confounding. In this 15‐year period, there were 444 253 acute myocardial infarction–cardiogenic shock admissions, of which 4.5% received
PCS
. The cohort receiving
PCS
was older, of white race, female sex, and with higher comorbidity and acute organ failure. The
PCS
cohort received fewer cardiac procedures, but more noncardiac organ support therapies. Older age, female sex, white race, higher comorbidity, higher socioeconomic status, admission to a larger hospital, and admission after 2008 were independent predictors of
PCS
use. Use of
PCS
was independently associated with higher in‐hospital mortality (odds ratio 6.59 [95% CI 6.37–6.83];
P
<0.001). The cohort with
PCS
use had >2‐fold higher in‐hospital mortality, 12‐fold higher use of do‐not‐resuscitate status, lesser in‐hospital resource utilization, and fewer discharges to home. Similar findings were observed in the propensity‐matched cohort.

Conclusions

PCS
use in patients with acute myocardial infarction–cardiogenic shock is low, though there is a trend towards increased adoption. There are significant patient and hospital‐specific disparities in the utilization of
PCS
.
Blood Pressure and Outcome After Mechanical Thrombectomy With Successful Revascularization
Authors: Anadani Mohammad , Orabi Mohamad Y. , Alawieh Ali , Goyal Nitin , Alexandrov Andrei V. , Petersen Nils , Kodali Sreeja , Maier Ilko L. , Psychogios Marios-Nikos , Swisher Christa B. , Inamullah Ovais , Kansagra Akash P. , Giles James A. , Wolfe Stacey Q. , Singh Jasmeet , Gory Benjamin , De Marini Pierre , Kan Peter , Nascimento Fábio A. , Freire Luis Idrovo , Pandhi Abhi , Mitchell Hunter , Kim Joon-Tae , Fargen Kyle M. , Al Kasab Sami , Liman Jan , Rahman Shareena , Allen Michelle , Richard Sébastien , Spiotta Alejandro M. 
Published: July 2019

Background and Purpose—
Successful reperfusion can be achieved in more than two-thirds of patients treated with mechanical thrombectomy. Therefore, it is important to understand the effect of blood pressure (BP) on clinical outcomes after successful reperfusion. In this study, we investigated the relationship between BP on admission and during the first 24 hours after successful reperfusion with clinical outcomes.

Methods—
This was a multicenter study from 10 comprehensive stroke centers. To ensure homogeneity of the studied cohort, we included only patients with anterior circulation who achieved successful recanalization at the end of procedure. Clinical outcomes included 90-day modified Rankin Scale, symptomatic intracerebral hemorrhage (sICH), mortality, and hemicraniectomy.

Results—
A total of 1245 patients were included in the study. Mean age was 69±14 years, and 51% of patients were female. Forty-nine percent of patients had good functional outcome at 90-days, and 4.7% suffered sICH. Admission systolic BP (SBP), mean SBP, maximum SBP, SBP SD, and SBP range were associated with higher risk of sICH. In addition, patients in the higher mean SBP groups had higher rates of sICH. Similar results were found for hemicraniectomy. With respect to functional outcome, mean SBP, maximum SBP, and SBP range were inversely associated with the good outcome (modified Rankin Scale score, 0–2). However, the difference in SBP parameters between the poor and good outcome groups was modest.

Conclusions—
Higher BP within the first 24 hours after successful mechanical thrombectomy was associated with a higher likelihood of sICH, mortality, and requiring hemicraniectomy.
Hydrological Drought Forecasting Incorporating Climatic and Human-Induced Indices
Authors: Li Min , Zhang Ting , Li Jianzhu , Feng Ping 
Published: July 2019

Abstract
Many drought forecasting methods have been proposed, but only a few have considered the changing environment. The main purpose of this study is to improve the accuracy of drought forecasting models under changing environments by considering the influence of large-scale climate patterns and human activities on hydrological drought. To select the most significant large-scale climatic index that influences drought events in the Luanhe River basin, Spearman’s rho correlation test was applied to detect the relationship between large-scale oceanic–atmospheric circulation patterns and the standardized runoff index (SRI). We also proposed a human activity index (HI) to represent the effect of human activities on hydrological drought. Based on a multivariate normal distribution, we included the above indices in a probabilistic forecasting model, which forecasted the probabilities of transition from the current to a future SRI value. Using the Liying hydrological station as an example, the impacts of a controlled large-scale climatic index (Niño-3.4) and the HI on the transition probabilities were illustrated, and the results showed that the turning point of the Niño-3.4 effect on the transition probabilities occurred within the range from 25.91 to 26.90. Finally, a scoring method was applied to compare the forecasting model performances. The results showed that the inclusion of the large-scale climatic index and HI improved the forecasting accuracy.
The Effects of Endoscopic Sinus Surgery on Voice Characteristics in Chronic Rhinosinusitis Patients
Authors: Jandali Danny B. , Ganti Ashwin , Husain Inna A. , Batra Pete S. , Tajudeen Bobby A. 
Published: July 2019

Objectives: Functional endoscopic sinus surgery (FESS) is a standard treatment modality for patients with chronic rhinosinusitis (CRS) who have failed appropriate medical therapy. However, FESS entails modification of the upper airway tract that may alter phonatory resonance and produce voice changes. The effects of FESS on postoperative voice characteristics in patients with CRS have yet to be quantitatively assessed. Methods: Patients with severe CRS who underwent FESS at a tertiary care referral center between May and October 2017 were prospectively enrolled. The Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) and the Voice Handicap Index (VHI) were used to quantitatively evaluate voice characteristics and quality of life, respectively. Preoperative and postoperative CAPE-V and VHI scores were compared with postoperative scores for each patient. Sino-Nasal Outcome Test (SNOT-22) scores were also obtained to assess changes in patient symptoms. Results: 18 CRS patients undergoing FESS were enrolled. The average preoperative Lund-Mackay score was 14, indicating baseline severe CRS. Postoperative assessments demonstrated a statistically significant decrease in CAPE-V (45-27, p = .005) and VHI (10-4.7, p < .001) scores. These correlated with a statistically significant decrease in SNOT-22 scores (42-13, p < .001). Conclusions: Patients with CRS experience a significant improvement in voice characteristics and vocal quality of life following FESS. Furthermore, this appears to correlate with a significant decrease in self-reported disease severity. These findings may augment the discussion of potential benefits of FESS to a new potential domain for voice quality.
Correlation between adverse events after drug treatment and the MDR1 C3435T polymorphism in advanced non-small cell lung cancer patients in an Asian population: a meta-analysis
Authors: Luo Hua , Qin Guangmei , Yao Caoyuan 
Published: July 2019

Objective To determine the association between the multidrug resistance 1 gene ( MDR1) C3435T polymorphism and adverse drug reactions in advanced non-small cell lung cancer (NSCLC) patients in Asia. Methods Literature about the relationship between the MDR1 C3435T polymorphism and adverse drug reactions in advanced NSCLC patients were collected from three English language databases (PubMed, Cochrane, and Embase) as well as three Chinese databases (Wanfang, China Knowledge Network, and the Chinese Biomedical Literature Database), and summarized by a meta-analysis. Results NSCLC patients with the T allele or TT genotype were significantly more likely to experience diarrhea than those with other genotypes under the allele model (odds ratio [OR] = 1.64, 95% confidence interval [CI]: 1.04–2.61), homozygous model (OR = 3.87, 95% CI: 1.49–10.07), and recessive model (OR = 4.48, 95% CI: 1.88–10.68). Similarly, these patients were significantly more likely to experience skin rash under the allele model (OR = 2.41, 95% CI: 1.24–4.66), homozygous model (OR = 4.77, 95% CI: 1.13–20.15), and dominant model (OR = 1.77, 95% CI: 1.03–3.05). Conclusions Asian NSCLC patients with the MDR1 C3435T T allele or TT genotype are significantly more likely to develop diarrhea and rash after drug treatment.
Association between osteopontin expression and asthma: a meta-analysis
Authors: Xu Hangdi , Lou Wei , Fu Fangfang 
Published: July 2019

Objective Osteopontin (OPN) plays an important role in chronic airway remodeling and bronchial hyperresponsiveness. The association between OPN protein expression and asthma has been investigated extensively, but the results of these studies are inconsistent. The aim of this meta-analysis was to determine the relationship between OPN protein expression and asthma. Methods A systematic search was performed to identify published studies regarding the association between OPN protein expression and asthma. Studies with quantitative data were analyzed, and standardized mean differences were determined with 95% confidence intervals. Results Nine studies were included in this analysis, involving 706 patients with asthma and 332 healthy controls. The pooled data from these studies demonstrated that OPN protein expression was significantly higher in patients with asthma than in controls. There was no significant difference in OPN protein between allergic asthma and nonallergic asthma. Moreover, there was no obvious relationship between OPN protein expression and the severity of asthma. Conclusion The results of this meta-analysis suggested that OPN protein expression is significantly upregulated in patients with asthma, but that it does not correlate with the type or severity of asthma.
Hemoglobin Levels and Acute Radiotherapy-Induced Toxicity
Authors: Barón Ricardo Escó , Julve Javier Valencia , Jaime Sonia Polo , Santaló Natividad Bascón , Millán Carmen Velilla , Mata Miriam López 
Published: July 2019

Aims and background To analyze the possible correlation between hemoglobin concentration and the appearance of acute radiotherapy-induced toxicity. Methods We prospectively studied hemoglobin levels and acute radiotherapy-induced toxicity in 86 patients treated for 3 months. Both sexes were considered to have anemia if their hemoglobin level was ≤12 g/dL. No patient received corrective treatment for hemoglobin levels. Acute toxicity was analyzed weekly during radiotherapy and 45 days after therapy ended. The possible relationship between anemia and toxicity was analyzed, as was the correlation between hemoglobin values and the degree of toxicity. Results The findings were similar for all prognostic factors in patients with and without anemia. Hemoglobin concentration was ≤12 g/dL in 24 patients (27.9%; mean, 10.93 ± 0.78 g/dL). At the end of radiotherapy, hemoglobin levels were ≤12 g/dL in 18 patients (20.9%; mean, 11.26 ± 1.06 g/dL). The correlation between pretherapy and posttherapy hemoglobin concentration was significant at r = 0.729 (P = 0.01). The correlation between absolute hemoglobin values and the degree of toxicity, and the possible relationship between hemoglobin concentration and the appearance or the degree of toxicity after radiotherapy, was not significant. Conclusions The relationship between hemoglobin concentration and oxygenation of the tumor and healthy tissues was not linear. This may account for the influence of hemoglobin levels on control of the disease as reported in earlier studies, but it does not account for their influence on acute toxicity after radiotherapy.
High Plasma Levels of Human Chromogranin a and Adrenomedullin in Patients with Pheochromocytoma
Authors: Cotesta Dario , Caliumi Chiara , Alò Piero , Petramala Luigi , Reale Maria Gabriella , Masciangelo Raffaele , Signore Alberto , Cianci Rosario , D'Erasmo Emilio , Letizia Claudio 
Published: July 2019

Aims and background The aim of our study was to investigate the plasma chromogranin A (CgA) and adrenomedullin (AM) levels in patients with pheochromocytomas. Methods and study design We collected blood samples for measurement of plasma CgA and AM in 21 patients with pheochromocytomas, 43 healthy subjects and 26 patients with solid non-functioning adrenocortical adenomas. In 11 patients with pheochromocytomas plasma CgA and AM were measured again four weeks after tumor removal. CgA and AM were measured by means of a novel solid-phase two-site immunoradiometric assay based on monoclonal antibodies (CgA-RIA CT, CIS bio international) and by a specific radioimmunoassay (RIA, Phoenix Pharm. Inc.), respectively. Results The mean plasma CgA level (±SD) in patients with pheochromocytomas (204 ± 147.9 ng/mL) was significantly higher (P <0.001) than that in healthy subjects (41.6 ± 10.7 ng/mL) and in patients with non-functioning adrenocortical adenomas (47.3 ± 17.6 ng/mL). The mean plasma AM concentration (±SD) in patients with pheochromocytomas (27.5 ± 10.4 pg/mL) was significantly higher (P <0.001) than that in HS (13.8 ± 4.5 pg/mL) and in patients with non-functioning adrenocortical adenomas (16.6 ± 7.3 pg/mL). Plasma CgA levels correlated with plasma AM levels (r = 0.501; P <0.02) and with plasma metanephrine levels (r = 0.738; P <0.0001) in patients with pheochromocytomas. In 11 patients with pheochromocytomas plasma CgA and AM concentrations significantly decreased after tumor removal (P <0.001 for both). Circulating CgA and AM had a sensitivity of 76.2% and 81%, a specificity of 97.7% and 90.7%, and an accuracy of 91% and 88%, respectively. Conclusion This study demonstrates that circulating CgA and AM levels are increased in pheochromocytoma patients compared with healthy subjects and patients with non-functioning adrenocortical adenomas. Moreover, at the time of diagnosis plasma CgA levels correlated with plasma AM levels and with plasma metanephrine levels in all patients with pheochromocytomas. In conclusion, plasma CgA and AM concentrations may represent additional biochemical parameters for clinical monitoring of patients with pheochromocytomas.
The Role of Quantitative Polymerase Chain Reaction in the Management of Follicular Lymphoma Patients
Authors: Perego Roberto A , Cairoli Roberto , Cornacchini Giorgia , Bianchi Cristina , Corizzato Matteo , Tresoldi Elisabetta , Morra Enrica 
Published: July 2019

Aims and background In order to increase the prognostic significance of polymerase chain reaction (PCR) data it has been suggested that quantitative PCR can be used to measure tumor burden. However, this option has not yet been definitely supported or refuted in patients with follicular lymphoma (FL). We decided to evaluate whether knowledge of the quantitative level of minimal residual disease and its variations can be of use in the management of FL patients. Methods We used qualitative and competitive PCR to study 11 patients with refractory or relapsed FL harboring the t(14;18) translocation who underwent autologous (nine patients) or allogeneic (two patients) stem cell transplantation (SCT). Competitive PCR was performed with a multiple competitor carrying specific sequences including Bcl2/lgH MBR and mcr, and the β-globin gene. Results After a median post-SCT follow-up of 44 months (range, 12-62), overall survival was 91% and disease-free survival 82%. The quantitative PCR data showed that: 1) effective chemotherapy before SCT substantially (1-2 log) reduced the tumor burden in the bone marrow (BM); 2) the increase in rearranged DNA detected in BM was associated with disease progression and relapse; 3) a PCR-negative autograft seemed to lead to lasting molecular remission even when it was performed in patients with a low level of BM infiltration before transplant; and 4) allo-SCT made and maintained the BM PCR negative even in the presence of a greater tumor burden before SCT. Six of the nine patients having CR after SCT (four auto and two allo) are in continuous molecular remission. Conclusions In FL patients qualitative and quantitative PCR may provide data that can be helpful for the prognostic evaluation of tumor progression and the early detection of impending relapse by highlighting biological features such as the quality of the infused material, the tumor burden at transplant, and the behavior of tumor cells after transplant.
Efficacy of Imatinib Mesylate in a Patient with Idiopathic Hypereosinophilic Syndrome and Severe Heart Involvement
Authors: Anghel Gabriel , De Rosa Luca , Ruscio Carla , Petti Nicola , Riccardi Massimo , Severino Alessandro , Majolino Ignazio 
Published: July 2019

Idiopathic hypereosinophilic syndrome (HES) is a rare, chronic hematological disease mainly characterized by unexplained prolonged eosinophilia, with frequent evidence of secondary organ damage. Treatment with steroids, chemotherapy, interferon-alpha (IFN-α), or imatinib-mesylate may improve the prognosis. Here we describe the case of a young male patient with a six-year history of HES and severe heart involvement who, after unsuccessful treatment attempts with steroids, hydroxyurea and IFN-α, had a prompt, clinical and hematological complete remission following administration of imatinib. As his cardiac function also markedly improved, he was considered for heart transplant. However, seven years after the onset of the disease and four months after the termination of imatinib treatment the patient died of a cerebral hemorrhage that occurred during an episode of acute respiratory sepsis. Imatinib has been previously reported to be effective in some hematological conditions with no evidence of the BCR/ABL transcript. The mechanisms that are probably involved in the response to imatinib in HES are also discussed.
Primary Malignant Melanoma of the Small Bowel a Case Report and Review of the Literature
Authors: Krüger Stefan , Noack Frank , Blöchle Christian , Feller Alfred C 
Published: July 2019

Although small bowel involvement by malignant melanoma is most frequently metastatic, a primary origin at this site has been reported in rare cases. The biological and clinical features of these cases have not yet been summarized. Here, another case of small bowel melanoma is described, and a review of the existing literature is given. An 81-year-old man presented with anemia and gastrointestinal bleeding. A tumor of the ileum was detected by video capsule endoscopy and removed by segment resection. Histological examination revealed a malignant melanoma of the ileum. Another primary site could be excluded by clinical and radiographic examination. The patient felt well five months after surgery. Only 18 cases of primary small bowel melanoma (including the present one) have been reported to date. A literature review reveals that this rare neoplasm is associated with a slight predilection for the male gender, a predilection for the ileum and a poor prognosis.
Primary Orbital Liposarcoma in Li-Fraumeni Cancer Family Syndrome: A Case Report
Authors: Poli Tito , Laganà Francesco , Caradonna Luigi , Gobbi Roberta , Corradi Domenico , Sesenna Enrico 
Published: July 2019

Aims and background The aim of this study was to describe a case of primary orbital liposarcoma in Li-Fraumeni syndrome. Methods and study design In July 1998 a 20-year-old woman with a histological diagnosis of orbital myxoid liposarcoma underwent surgical treatment in our department. Since the patient's family pedigree met the clinical criteria for the diagnosis of LFS, molecular analysis was performed, which resulted in a molecular profile consistent with Li-Fraumeni syndrome. Results The patient underwent orbital exenteration extended to the upper eyelid; surgical reconstructive steps were performed to permit placement of an orbital prosthesis. Two years after primary surgery the patient underwent a quadrantectomy with lymphadenectomy of the right axilla because of the presence of a nodule of 1.5 cm in diameter in the upper-lateral quadrant of the right breast. One year after the last surgery, the patient is disease free. Conclusion The diagnosis of an orbital malignancy in a young patient with a family history of cancer should suggest the presence of an underlying genetic disorder like LFS; with molecular analysis we can now determine the genetic disorder and the exact location of the mutation, and also obtain important prognostic data using specific cellular markers. More prognostic information increases the chances of adequate personalized treatment.
Study of Sunbathing in Children: The Preliminary Evaluation of a Prevention Program
Authors: Manganoni Ausilia Maria , Cainelli Tullio , Zumiani Giuseppe , Bufalino Rosaria , Calzavara-Pinton Piergiacomo , Camerini Tiziana , Tucci Giovanna , Baldi Marzia , Venturini Marina , Marini Giovanni , Cascinelli Natale 
Published: July 2019

Aims and background Sunburn during childhood is associated with an increased risk for developing melanoma in an adult age. The aim of the present study was to define the validity of our educational program in order to teach the positive effects and risks of sun exposure during childhood. Patients and methods We conducted a population-based, case-control study in primary schools of three towns in Northern Italy (Brescia, Bergamo and Trento) between 2001 and 2002. The study was carried out on 1945 pupils (aged 8-9 years) and included 1309 case children who received an educational program before the summer to increase awareness towards sun exposure and 636 control children who did not. Parents of case and control children were interviewed using a questionnaire about their children's skin characteristics, sun protective behavior and sunburns. The questionnaire was completed twice, before and after the summer, to verify the changes of sun exposure habits. Results A significant decrease in sunburns was demonstrated in the group of subjects who received the educational program, indicating the validity of our operative procedure (from 14.6% to 10%, P = 4 × 10−4). Conclusions Our educational melanoma program may be important to disseminate in a wider range of children a correct education on sun exposure during childhood.