bluuebunny/crossref_metadata_2025_split huggingface dataset:
Syndrome of inappropriate secretion of antidiuretic hormone associated with angiotensin-converting enzyme inhibitor therapy in the perioperative period
Authors: Nakayama Takashin , Fujisaki Hiroto , Hirai Shintaro , Kawauchi Ruri , Ogawa Kyohei , Mitsui Ayaka , Hirano Keita , Isozumi Kazuo , Takahashi Takayuki , Komatsumoto Satoru 
Published: March 2019

Introduction: Angiotensin-converting enzyme (ACE) inhibitors are one of the most commonly used medications for hypertension. Rarely, ACE inhibitors have the potential to cause a syndrome of inappropriate secretion of antidiuretic hormone (SIADH). Case presentation: A 70-year-old woman with > 10 years ACE inhibitor therapy with normonatremia suddenly developed severe SIADH when she took a liquid diet in the uneventful perioperative period, with hemodynamic stability and no surgical complications. She promptly recovered from SIADH subsequent to discontinuing the ACE inhibitor therapy and changing her diet. Therefore, it was assumed that excess antidiuretic hormone secretion due to an ACE inhibitor and free water load from the liquid diet contributed to hyponatremia in our patient. Conclusion: Patients treated with an ACE inhibitor can latently experience inappropriate secretion of antidiuretic hormone, and rapidly develop severe hyponatremia together with additional factors affecting water or salt homeostasis regardless of the length of the administration duration. Clinicians should monitor serum sodium levels in such patients not only just after the initiation of ACE inhibitors but also upon the appearance of those factors.
Effect of negative-pressure wound therapy on the circulating number of peripheral endothelial progenitor cells in diabetic patients with mild to moderate degrees of ischaemic foot ulcer
Authors: Mu Shichang , Hua Qiaoqiao , Jia Yangyang , Chen Ming-Wei , Tang Yizhong , Deng Datong , He Yong , Zuo Chunlin , Dai Fang , Hu Honglin 
Published: March 2019

Objective To investigate the effect of negative-pressure wound therapy (NPWT) on the circulating number of endothelial progenitor cells (EPCs) in diabetic patients with mild to moderate degrees of ischemic foot ulcer. Methods We selected 84 diabetic patients who had a foot ulcer with a duration of at least four weeks and who had an ankle-brachial index of 0.5–0.9. Patients were assigned to one two groups according to 2:1 randomization: NPWT group ( n = 56) and non-NPWT (patients who did not receive NPWT) group ( n = 28). The control group (NC group) was composed of 18 patients who had normal glucose tolerance and lower extremity ulcer without arteriovenous disease. NPWT was performed on the ulcer after debridement for one week for patients in both the NPWT group and the NC group, and the patients in the non-NPWT group received conventional treatment process. The circulating number of EPCs was measured before and after various treatments, and the factors influencing their changes were analysed. Results After NPWT, the circulating number of EPCs significantly increased in both the NPWT group and the NC group ((85.3 ± 18.1) vs. (34.1 ± 12.5)/106 cells; (119.9 ± 14.4) vs. (66.1 ± 10.6)/106 cells, both P < 0.05). In contrast, the circulating number of EPCs had no significant change in the non-NPWT group ((45.2 ± 19.4) vs. (34.7 ± 16.8)/106 cells, P > 0.05). In addition, the circulating levels of vascular endothelial growth factor (VEGF) and the protein expressions of VEGF and stromal cell-derived factor-1α (SDF-1α) in the granulation tissue significantly increased after NPWT in both the NPWT and the NC group, but there was no significant change in the non-NPWT group. Compared with the non-NPWT group, the changes in VEGF and SDF-1α levels in the sera and granulation tissue were all significantly higher in both the NPWT and NC groups ( P < 0.05, P < 0.01, respectively). There was no significant difference in changes in the circulating number of EPCs in the peripheral blood and levels of VEGF and SDF-1α in the sera and granulation tissue between the NPWT and NC groups. Correlation analysis showed that the change in the circulating number of EPCs was correlated with the changes of VEGF and SDF-1α levels in the sera and granulation of the NPWT and NC groups ( P < 0.05). Conclusion NPWT may increase the circulating number of EPCs in diabetic patients with mild to moderate ischaemic foot ulcer as in non-diabetic controls, which may be attributed to the upregulation of systemic and local VEGF and SDF-1α levels.
The Argos project: The development of a computer‐aided detection system to improve detection of Barrett's neoplasia on white light endoscopy
Authors: de Groof Jeroen , van der Sommen Fons , van der Putten Joost , Struyvenberg Maarten R , Zinger Sveta , Curvers Wouter L , Pech Oliver , Meining Alexander , Neuhaus Horst , Bisschops Raf , Schoon Erik J , de With Peter H , Bergman Jacques J 
Published: March 2019

BackgroundComputer‐aided detection (CAD) systems might assist endoscopists in the recognition of Barrett's neoplasia.AimTo develop a CAD system using endoscopic images of Barrett's neoplasia.MethodsWhite light endoscopy (WLE) overview images of 40 neoplastic Barrett's lesions and 20 non‐dysplastic Barret's oesophagus (NDBO) patients were prospectively collected. Experts delineated all neoplastic images.The overlap area of at least four delineations was labelled as the ‘sweet spot’. The area with at least one delineation was labelled as the ‘soft spot’. The CAD system was trained on colour and texture features. Positive features were taken from the sweet spot and negative features from NDBO images. Performance was evaluated using leave‐one‐out cross‐validation. Outcome parameters were diagnostic accuracy of the CAD system per image, and localization of the expert soft spot by CAD delineation (localization score) and its indication of preferred biopsy location (red‐flag indication score).ResultsAccuracy, sensitivity and specificity for detection were 92, 95 and 85%, respectively. The system localized and red‐flagged the soft spot in 100 and 90%, respectively.ConclusionThis uniquely trained and validated CAD system detected and localized early Barrett's neoplasia on WLE images with high accuracy. This is an important step towards real‐time automated detection of Barrett's neoplasia.
Long-Term Results of Bay Window Technique for Coronary Translocation in the Arterial Switch Operation
Authors: Yashima Masafumi , Yamagishi Masaaki , Yaku Hitoshi 
Published: March 2019

Background: Accurate coronary translocation is very important for a successful arterial switch operation (ASO) for transposition of the great arteries (TGA) and to provide good long-term outcomes. We have previously reported the “bay window” technique as a useful option for coronary translocation with excellent midterm results. However, the long-term results of this technique and the morphological changes in the coronary channel have not yet been reported. Patients and Methods: Between September 2001 and December 2012, 33 patients with TGA underwent coronary translocation using the bay window technique concomitantly with ASO. The diagnoses were TGA with intact ventricular septum in 21, TGA with ventricular septal defect in 7, and Taussig-Bing anomaly in 5. The median age of the patients at operation was 12 days, and their median body weight was 2.93 kg. Coronary artery patterns were as follows: Shaher and Puddu’s type 1 in 23, single coronary artery in 4, intramural type in 1, and others in 5. Results: The median follow-up period was 4.5 years. There were no operative deaths, but there was one late death because of sepsis 13 months after ASO. Coronary artery evaluation with angiography, computed tomography, or myocardial scintigraphy was performed in 22 patients. There was no abnormal coronary morphology or perfusion. Coronary channel dilatation was not observed. Three patients underwent reoperation for pulmonary stenosis. Conclusions: The bay window technique provides excellent long-term results in ASO for TGA. Three-dimensional computed tomography revealed no aneurysmal changes in the bay window channel at nine-year follow-up examination.
Total Anomalous Pulmonary Venous Connection Beyond the First Decade of Life
Authors: Talwar Sachin , Arora Yatin , Gupta Saurabh Kumar , Kothari Shyam Sunder , Ramakrishnan Sivasubramanian , Saxena Anita , Choudhary Shiv Kumar 
Published: March 2019

Objective: We report our experience with surgery for total anomalous pulmonary venous connection (TAPVC) beyond first decade of life. Methods: Between January 1987 and July 2017, 98 patients ≥ten years underwent TAPVC repair. Their detailed case-records were analyzed. Results: Mean age was 19.05 (± 12.8; median 18) years. Anatomic subtypes were supracardiac (n = 62), cardiac (n = 20), and mixed (n = 16). An atrial septal defect (ASD) was present in all. Severe tricuspid valve regurgitation was present in four patients and severe rheumatic mitral regurgitation was present in one. On preoperative cardiac catheterization, mean pulmonary artery pressure was 67 ± 15.6 mm Hg (median 58; range 37-96). Mean pulmonary vascular resistance was 5.6 ± 3.9 Woods units·m2 (median 4.7, range 2.9-11.8). Twenty-five patients had moderate and eight had severe pulmonary arterial hypertension. Right ventricular dysfunction was present in eight patients. At repair, a small ASD was left open in 87 patients while in 11 patients, the ASD was closed using a unidirectional valved patch. Follow-up was available for 90 (92%) patients. There were no late deaths over a mean follow-up of 163 ± 103.98 months (median 163, range 1-362). Eighty-two patients were in NYHA class I and eight were in class II. Right ventricular function normalized in 82 patients while 80 patients had reduction in pulmonary artery pressure. Event-free survival was 94.2% at 5 years, 92.3% at 10 years, and 90% at 20 and 30 years. Conclusions: Outcomes of surgical repair for TAPVC beyond first decade of life are satisfactory. Close follow-up, however, is necessary for possible persistence of pulmonary arterial hypertension.
Effect of long-term corticosteroid treatment on microRNA and gene-expression profiles in COPD
Authors: Faiz Alen , Steiling Katrina , Roffel Mirjam P. , Postma Dirkje S. , Spira Avrum , Lenburg Marc E. , Borggrewe Malte , Eijgenraam Tim R. , Jonker Marnix R. , Koppelman Gerard H. , Pouwels Simon D. , Liu Gang , Alekseyev Yuriy O. , Lam Stephen , Hiemstra Pieter S. , Sterk Peter J. , Timens Wim , Brandsma Corry-Anke , Heijink Irene H. , van den Berge Maarten 
Published: March 2019

The aim was to investigate whether microRNA (miRNA) expression is modulated by inhaled corticosteroid (ICS) treatmentWe performed genome-wide miRNA analysis on bronchial biopsies of 69 moderate/severe chronic obstructive pulmonary disease (COPD) patients at baseline and after 6- and 30-month treatment with the ICS fluticasone propionate or placebo. The effect of ICS on miRNA expression was validated in differentiated primary bronchial epithelial cultures, and functional studies were conducted in BEAS-2B cells. MiRNAs affected by ICS and their predicted targets were compared to an independent miRNA dataset of bronchial brushings from COPD patients and healthy controls.Treatment with ICS for both 6 and 30 months significantly altered the expression of four miRNAs, including miR-320d, which was increased during ICS treatment compared with placebo. The ICS-induced increase of miR-320d was confirmed in primary airway epithelial cells. MiR-320d negatively correlated targets were enriched for pro-inflammatory genes and were increased in the bronchial brushes of patients with lower lung function in the independent dataset. Overexpression of miR-320d in BEAS-2B cells dampened cigarette smoke extract-induced pro-inflammatory activityviainhibition of nuclear factor-κB.Collectively, we identified miR-320d as a novel mediator of ICS, regulating the pro-inflammatory response of the airway epithelium.
Analysis of the MILES cohort reveals determinants of disease progression and treatment response in lymphangioleiomyomatosis
Authors: Gupta Nishant , Lee Hye-Seung , Young Lisa R. , Strange Charlie , Moss Joel , Singer Lianne G. , Nakata Koh , Barker Alan F. , Chapman Jeffrey T. , Brantly Mark L. , Stocks James M. , Brown Kevin K. , Lynch Joseph P. , Goldberg Hilary J. , Downey Gregory P. , Taveira-DaSilva Angelo M. , Krischer Jeffrey P. , Setchell Kenneth , Trapnell Bruce C. , Inoue Yoshikazu , McCormack Francis X. 
Published: March 2019

IntroductionThe Multicenter International Lymphangioleiomyomatosis (LAM) Efficacy of Sirolimus (MILES) trial revealed that sirolimus stabilised lung function in patients with moderately severe LAM. The purpose of this study was to further examine the MILES cohort for the effects of racial, demographic, clinical and physiological patient characteristics on disease progression and treatment response in LAM.MethodsMILES subjects were stratified on the basis of menopausal status (pre-menopausal/post-menopausal), race (Asian/Caucasian), bronchodilator responsiveness (present/absent), initial forced expiratory volume in 1 s (FEV1; 51–70%versus≤50% predicted) and tuberous sclerosis complex (TSC) association (yes/no). A linear mixed effects model was used to compare slope differences, and nonparametric tests were used to compare medians and proportions between treatment groups in each stratum.ResultsIn the MILES placebo group, pre-menopausal patients declined 5-fold faster than post-menopausal patients (mean±seFEV1slope −17±3versus−3±3 mL·month−1; p=0.003). Upon treatment with sirolimus, both the pre-menopausal (−17±3versus−1±2 mL·month−1; p<0.0001) and post-menopausal patients (−3±3versus6±3 mL·month−1; p=0.04) exhibited a beneficial response in mean±seFEV1slope compared with the placebo group. Race, LAM subtype, bronchodilator responsiveness or baseline FEV1did not impact the rate of disease progression in the placebo group or treatment response in the sirolimus group. Menopausal status and race had differential effects on the adverse event profile of sirolimus. Baseline serum vascular endothelial growth factor (VEGF)-D >600 pg·mL−1identified subgroups of patients who were more likely to decline on placebo and respond to treatment with sirolimus.ConclusionsIn LAM patients, treatment with sirolimus is beneficial regardless of menopausal status, race, bronchodilator responsiveness, baseline FEV1or TSC association. Serum VEGF-D and menopausal status can help inform therapeutic decisions.
Pulmonary arterial hypertension associated with protein kinase inhibitors: a pharmacovigilance–pharmacodynamic study
Authors: Cornet Lucie , Khouri Charles , Roustit Matthieu , Guignabert Christophe , Chaumais Marie-Camille , Humbert Marc , Revol Bruno , Despas Fabien , Montani David , Cracowski Jean-Luc 
Published: March 2019

The pathophysiology of pulmonary arterial hypertension (PAH) induced by protein kinase inhibitors (PKIs) remains unclear. To gain knowledge into this rare and severe pathology we performed a study combining a pharmacovigilance approach and the pharmacodynamic properties of PKIs.A disproportionality analysis on the World Health Organization pharmacovigilance database VigiBase using the reporting odds ratio (ROR) and 95% confidence interval was first performed. Then, we identified the most relevant cellular targets of interest through a systematic literature review and correlated the pharmacovigilance signals with the affinity for the different PKIs. We further performed a hierarchical cluster analysis to assess patterns of binding affinity.A positive disproportionality signal was found for dasatinib, bosutinib, ponatinib, ruxolitinib and nilotinib. Five non-receptor protein kinases significantly correlate with disproportionality signals: c-Src (r=0.79, p=0.00027), c-Yes (r=0.82, p=0.00015), Lck (r=0.81, p=0.00046) and Lyn (r=0.80, p=0.00036), all belonging to the Src protein kinase family, and TEC (r=0.85, p=0.00006). Kinases of the bone morphogenetic protein signalling pathway also seem to play a role in the pathophysiology of PKI-induced PAH. Interestingly, the dasatinib affinity profile seems to be different from that of other PKIs in the cluster analysis.The study highlights the potential role of the Src protein kinase family and TEC in PAH induced by PKIs. This approach combining pharmacovigilance and pharmacodynamics data allowed us to generate some hypotheses about the pathophysiology of the disease; however, the results have to be confirmed by further studies.
PACE: Analysis of acute toxicity in PACE-B, an international phase III randomized controlled trial comparing stereotactic body radiotherapy (SBRT) to conventionally fractionated or moderately hypofractionated external beam radiotherapy (CFMHRT) for localized prostate cancer (LPCa).
Authors: Van As Nicholas John , Brand Douglas , Tree Alison , Ostler Peter James , Chu William , Loblaw Andrew , Ford Daniel , Tolan Shaun P. , Jain Suneil , Martin Alexander Stephen , Staffurth John , Brown Stephanie , Burnett Stephanie M. , Duffton Aileen , Griffin Clare , Hinder Vicki , Morrison Kirsty , Naismith Olivia Frances , Hall Emma ,   On behalf of the PACE investigators
Published: March 2019

1 Background: External beam radiotherapy (EBRT) is a curative treatment for LPCa. Large randomised controlled trials (RCTs) have shown moderately hypofractionated regimens (2.5–3 Gy/fraction(f)) as non-inferior to conventionally fractionated regimens (2 Gy/f). PACE-B aims to demonstrate non-inferiority of SBRT compared to CFMHRT for biochemical or clinical failure. Compared to CFMHRT, SBRT reduces patient (pt) attendances but compressed overall treatment time may influence acute toxicity severity. Methods: PACE is a phase III open-label multiple-cohort RCT. Men with LPCa, stage T1-T2, ≤ Gleason 3 + 4, PSA ≤ 20 ng/mL, unsuitable for surgery or preferring EBRT, were eligible for the PACE-B cohort. Between 08/12-01/18, 874 pts (38 centres) were randomised (1:1) to SBRT or CFMHRT. SBRT dose was 36.25 Gy/5f in 1-2 weeks (wks), CFMHRT as 78 Gy/39f over 7.5 wks, or 62 Gy/20f in 4 wks. Androgen deprivation therapy was not permitted. Clinician reported acute toxicity was assessed at baseline, 2-weekly during CFMHRT and at 2, 4, 8 & 12 wks post-treatment. Key toxicity outcomes were worst grade 2+ Radiation Therapy Oncology Group (RTOG) genitourinary (GU) and gastrointestinal (GI) acute toxicities, compared by Chi-square test with alpha 0.05 divided between the two measures. Results: By per protocol analysis n=430 received CFMHRT, n=414 received SBRT. Key characteristics seen in the CFMHRT and SBRT groups respectively were: mean age: 69.5 vs 69.3 years; T-stage ≥T2b: 51.8% vs 56.6%; Gleason Score 3+4: 80.2% vs 85.0%; PSA 10-20 ng/mL: 30.9% vs 31.6%. RTOG G2+ toxicity was not significantly different for GI events (CMFHRT 52/430 (12.1%) vs SBRT 42/414 (10.1%), p=0.368), nor GU events (CFMHRT 117/430 (27.2%) vs SBRT 96/414 (23.2%), p=0.179). Conclusions: Despite an accelerated treatment schedule, RTOG assessments show similar rates of acute GI and GU toxicity for SBRT and CFHFRT. Pt follow-up in PACE-B continues and results of late toxicity and biochemical/clinical failure are awaited. Clinical trial information: NCT01584258.
Brachytherapy use for favorable-risk prostate cancer continues to decline in both academic and community centers despite superior survival compared to dose-escalated external beam radiation therapy.
Authors: Nguyen Kevin H. , Patel Sagar Anil , Lee Alan K. , Venkat Puja , Chang Albert 
Published: March 2019

105 Background: Several studies have highlighted the decline in brachytherapy (BT) utilization for localized prostate cancer, possibly due to reduced reimbursement, decreased provider efficiency, and decline in operative training. We sought to evaluate the most contemporary trends in BT versus dose-escalated external beam radiation therapy (DE-EBRT) use, as well as its impact on survival. Methods: We identified 134,713 men in the National Cancer Database with favorable risk prostate cancer (Gleason 6-7, clinical stage T1-2, and PSA < 20 ng/mL) who were treated with BT or DE-EBRT alone from 2004 to 2014. Multivariable logistic regression was used to identify independent determinants of treatment modality. Overall survival (OS) was compared between modalities using Kaplan-Meier and log-rank tests in propensity score-matched cohorts adjusted for age, race, comorbidities, year of diagnosis, and treatment facility. Results: The 10-year OS rate was higher for BT compared to DE-EBRT (BT 74.5%, DE-EBRT 68.2%, P< .0001). However, consistent with prior analyses, BT use decreased significantly from 59.3% in 2004 to 34.7% in 2014 ( P value for trend < .0001), with a corresponding rise in EBRT. The rate of decline was similar in academic and community centers; however, BT was consistently more often utilized in the community (63% in 2004, 61% in 2014). On multivariable analysis, BT was least likely to be used in men who were black (vs. white or Asian), treated at an academic (vs. community) center, and insured by Medicaid (vs. Medicare or private). Conclusions: Nationally, despite its superior survival and cost-effectiveness, prostate brachytherapy continues to be superseded by DE-EBRT in favorable risk prostate cancer, especially in men treated at academic centers and insured by Medicaid, with striking racial disparities. Payment reform, patient/provider education, and more robust resident training in prostate brachytherapy are urgently needed to help reverse this trend and ensure equal access to this efficacious treatment modality.
MRI-TRUS fusion-guided biopsy in obese patients: Does it reduce risk of prostate cancer upgrade on final pathology compared to systematic 12-core biopsy?
Authors: Gold Samuel A , Bloom Jonathan , Lebastchi Amir H , Hale Graham , Mehralivand Sherif , Sanford Thomas , Choyke Peter L. , Turkbey Baris , Pinto Peter A. 
Published: March 2019

110 Background: Epidemiologic data suggests a link between obesity and increased risk of aggressive prostate cancer (PCa). Therefore, the accurate detection of prostate cancer is paramount in obese men. We sought to characterize the PCa lesions seen on multiparametric magnetic resonance imaging (mpMRI) in both obese (OB) and non-obese (nOB) patients. In addition, we examined whether obesity affects the accuracy of fusion biopsy (FBx) versus systematic biopsy (SBx). Methods: Data from patients who underwent FBx, SBx, or both, and subsequent prostatectomy at a single institution between 2007-2017 were reviewed. Men were stratified into three groups based on body mass index (BMI): normal weight (18.5-24.9), overweight (25.0-29.9), and obese (≥30.0). mpMRIs were analyzed to determine prostate size, lesion size, lesion location, and evidence of ≥T3 disease. FBx and SBx were compared to prostatectomy specimens. These variables were then analyzed between the OB and nOB groups. Results: 487 patients were included: 109 (19%) normal weight, 266 (48%) overweight, and 185 (33%) obese. No statistical differences were noted in age, PSA, or clinical stage. mpMRI showed similar prostate size, index and total lesion diameter, lesion location, and Prostate Imaging Reporting and Data System (PIRADS) score between BMI categories. In OB patients, FBx was better able to predict final Gleason score (GS) than SBx, 60% vs 47%, p = 0.0474, OR 1.67 (1.00-2.80). The rate of upgrading after SBx was higher for OB men versus nOB men, 44% vs 34%, p = 0.034, OR 1.52 (1.01-2.29). However, risk of upgrading returned to that of nOB men with FBx, 20% vs 17%, p = 0.538, OR 1.21 (0.658-2.23). Conclusions: FBx is a more accurate measure of the true GS in OB patients than SBx, and there is a significantly greater risk of underrepresenting PCa on SBx in OB patients. These findings were not associated with differences in prostate sizes and lesion characteristics on mpMRI. This suggests that obesity may cause technical challenges with prostate biopsies that may be overcome by improved visualization and targeting of FBx.