bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of anticoagulation therapy on outcomes in patients with cardiac implantable resynchronization devices undergoing transvenous lead extraction: A substudy of the ESC‐EHRA EORP ELECTRa (European Lead Extraction ConTRolled) Registry
Authors: Regoli François , Auricchio Angelo , Di Cori Andrea , Segreti Luca , Blomström‐Lunqvist Carina , Butter Christian , Deharo Jean‐Claude , Kennergren Charles , Kutarski Andrzej , Laroche Cecile , Zalevskiy Valery , Luzzi Giovanni , Cano Oscar , Grabowski Marcin , Rinaldi Christopher , Bongiorni Maria Grazia 
Published: April 2019

AbstractIntroductionLittle data are available on anticoagulation (AC) management in patients with cardiac resynchronization (CRT) devices who undergo transvenous lead extraction (TLE) procedure. We investigated the impact of AC on periprocedural complications in CRT patients undergoing TLE, enrolled in the ESC‐EHRA European Lead Extraction ConTrolled (ELECTRa) registry.Methods and ResultsAll CRT patients treated with TLE enrolled in the registry were considered. Perioperative AC management was left to the discretion of the Center. Major and minor intraprocedural and postprocedural complications were compared between patients without AC (Gp1) and patients with AC (Gp2). Regression analyses were performed to identify predictors of complications for Gp2.Out of 734 CRT pts, 328 (44.7%) were under AC (Gp2). Patients from Gp2 presented lower LVEF (Gp2 32.5 ± 10.9 vs Gp1 34.5 ± 11.9%; P = 0.03), more advanced heart failure disease (NYHA III/IV: Gp2 42.0 vs Gp1 31.5%; P = 0.02), and renal impairment (Gp2 39.0 vs Gp1 24.3%; P < 0.001). Perioperative regimens included AC interruption (Gp2A: n = 169, 51.5%), “bridging” (Gp2B: n = 135, 41.2%), or continued AC (Gp2C: n = 24, 7.3%). TLE complete success rates (98% in both groups) and major complication rates were comparable for both groups; minor bleeding events were more frequent in Gp2 (5.5%) compared to Gp1 (2.5%; P = 0.051). No independent predictors were identified for Gp2, but minor complications were associated with “bridging” approach (Gp2B: 16 events vs Gp2A/C: 9 events; P = 0.020).ConclusionCRT patients treated with TLE under AC were more compromised but did not present more major complications compared to patients without AC. More minor complications were associated with “bridging” AC regimen.
First‐line treatment of essential hypertension: A real‐world analysis across four antihypertensive treatment classes
Authors: Stapff Manfred , Hilderbrand Sarah 
Published: April 2019

The relative efficacy of antihypertensive treatment has been assessed primarily by randomized clinical trials (RCTs). The increasing availability of electronic medical records (EMR) allows results from RCT to be compared to data from actual clinical practice. EMR from TriNetX were used to compare patients starting and adhering to antihypertensive treatment on diuretics, beta blockers, angiotensin II or ACE inhibitors, or calcium channel blockers for at least 36 months. Cardiovascular (CV) events as defined by ICD‐10 codes were evaluated for an observation period of three years. Outcomes were assessed with and without propensity score matching for confounding factors. A total of 79 288 patients fulfilled the criteria for first‐line therapy and adherence (17.4% diuretics, 25.9% beta blockers, 45.1% inhibitors of the renin‐angiotensin system, and 11.6% calcium channel blockers). Differences in demography and comorbidities were consistent with expectations based on treatment guidelines. RAS blockers showed the best BP control (28.7% episodes of uncontrolled BP) and, together with diuretics, the lowest rate of CV events (diuretics, 5.2%; RAS blockers, 5.4%). Beta blockers were associated with the highest rate of uncontrolled BP (45.9%) and a high CV event rate (9.5%). These trends remained after matching the cohorts for confounding factors. EMR show that actual prescribing behavior for first‐line treatment of essential hypertension reflects treatment guidelines. Patients taking either RAS blockers or diuretics experienced the lowest CV event rates. Beta blockers, even when adjusted for pre‐existing cardiovascular conditions, do not seem to be as protective against CV events as the three other classes.
Hypertension‐induced subclinical vascular and cognitive changes are reversible—An observational cohort study
Authors: Czuriga‐Kovács Katalin Réka , Szekeres Csilla Cecília , Bajkó Zoltán , Csapó Krisztina , Oláh László , Magyar Mária Tünde , Molnár Sándor , Czuriga Dániel , Kardos László , Bojtor Burainé Andrea , Bereczki Dániel , Soltész Pál , Csiba László 
Published: April 2019

AbstractBeside the well‐known complications of poorly controlled, long‐standing hypertension, milder abnormalities induced by early‐stage hypertension have also been described. In our study, the authors examined the reversibility of changes induced by early‐stage hypertension. The authors performed laboratory testing, ambulatory blood pressure monitoring, carotid intima‐media thickness (IMT) measurement, evaluation of stiffness parameters, assessment of various cardiac and cerebral hemodynamic parameters during head‐up tilt table (HUTT) testing, and neuropsychological examinations in 49 recently diagnosed hypertensive patients. Following baseline assessment, antihypertensive therapy was commenced. After one year of therapy, lower IMT values were found. Pulse wave velocity showed a borderline significant decrease. During HUTT, several hemodynamic parameters improved. The patients performed better on neuropsychological testing and reached significantly lower scores on questionnaires evaluating anxiety. The present study shows that early vascular changes and altered cognitive function observed in newly diagnosed hypertensive patients may improve with promptly initiated antihypertensive management.
Left ventricular cardiac geometry and ambulatory blood pressure in children
Authors: Shilly Steffi , Merchant Kumail , Singer Pamela , Frank Rachel , Gurusinghe Shari , Infante Lulette , Sethna Christine B. 
Published: April 2019

AbstractLimited information is available regarding the relationship between ambulatory blood pressure monitoring (ABPM) and cardiac geometry in hypertensive children. ABPM and 2D‐echocardiography were retrospectively reviewed in children and adolescents <21 years old with primary hypertension. A total of 119 participants (median age 15.0 [IQR 12, 16] years) with hypertension were included. Left ventricular hypertrophy was diagnosed in 39.5% of participants. Normal geometry was found in 47.1%, concentric remodeling (CR) in 13.4%, concentric hypertrophy (CH) in 15.1%, and eccentric hypertrophy (EH) in 24.4% of children. After adjustment for age, sex, and body mass index z‐score, awake systolic blood pressure (BP) index (BPi) (OR 1.07, 95% CI: 1.001‐1.14, P = 0.045), awake diastolic BPi (OR 1.04, 95% CI: 1.00‐1.09, P = 0.048), awake systolic BP load (OR 1.02, 95% CI: 1.000‐1.04, P = 0.047), and sleep systolic BP load (OR 1.02, 95% CI: 1.001‐1.04, P = 0.03) were directly associated with CH. No ABPM parameters were significant predictors of EH. In conclusion, ABPM parameters were found to be independent predictors of cardiac geometry, specifically CH.
Diversity of dermal fibroblasts as major determinant of variability in cell reprogramming
Authors: Sacco Anna Maria , Belviso Immacolata , Romano Veronica , Carfora Antonia , Schonauer Fabrizio , Nurzynska Daria , Montagnani Stefania , Di Meglio Franca , Castaldo Clotilde 
Published: April 2019

AbstractInduced pluripotent stem cells (iPSCs) are adult somatic cells genetically reprogrammed to an embryonic stem cell‐like state. Notwithstanding their autologous origin and their potential to differentiate towards cells of all three germ layers, iPSC reprogramming is still affected by low efficiency. As dermal fibroblast is the most used human cell for reprogramming, we hypothesize that the variability in reprogramming is, at least partially, because of the skin fibroblasts used. Human dermal fibroblasts harvested from five different anatomical sites (neck, breast, arm, abdomen and thigh) were cultured and their morphology, proliferation, apoptotic rate, ability to migrate, expression of mesenchymal or epithelial markers, differentiation potential and production of growth factors were evaluated in vitro. Additionally, gene expression analysis was performed by real‐time PCR including genes typically expressed by mesenchymal cells. Finally, fibroblasts isolated from different anatomic sites were reprogrammed to iPSCs by integration‐free method. Intriguingly, while the morphology of fibroblasts derived from different anatomic sites differed only slightly, other features, known to affect cell reprogramming, varied greatly and in accordance with anatomic site of origin. Accordingly, difference also emerged in fibroblasts readiness to respond to reprogramming and ability to form colonies. Therefore, as fibroblasts derived from different anatomic sites preserve positional memory, it is of great importance to accurately evaluate and select dermal fibroblast population prior to induce reprogramming.
Clinical polyneuropathy does not increase with prediabetes or metabolic syndrome in the Japanese general population
Authors: Kurisu Seigo , Sasaki Hideyuki , Kishimoto Shohei , Hirayasu Kazuhiro , Ogawa Kinichi , Matsuno Shohei , Furuta Hiroto , Arita Mikio , Naka Keigo , Nanjo Kishio , Akamizu Takashi 
Published: April 2019

AbstractAims/IntroductionThe prevalence of clinical polyneuropathies (ClinPNs) or nerve conduction abnormality (NCA) in the groups stratified by glucose tolerance, individual components of metabolic syndrome (metabolic syndrome [MetS] components: hypertension, dyslipidemia, obesity) and MetS defined by the International Diabetes Federation consensus was investigated in the Japanese general population. Factors associated with ClinPN and NCA were also identified.Materials and MethodsA total of 625 examinees of regional medical checkup programs were recruited to this cross‐sectional study. ClinPNs were diagnosed by the Toronto Consensus. NCA was judged by at least one bilateral abnormality of sural nerve action potential amplitude or conduction velocity measured by a point‐of‐care nerve conduction device (DPNCheck). Clinical factors associated with ClinPNs or NCA were examined by multiple logistic regression analysis. Deteriorating factors of sural nerve action potential amplitude or conduction velocity values were also investigated in participants without diabetes (n = 550).ResultsAs for glucose tolerance, ClinPNs or NCA significantly increased only in known diabetes patients compared with other groups. There was no difference between prediabetes and the normal group. The prevalence of ClinPNs and NCA was not significantly related to MetS or MetS’ components, except for frequent NCA in obesity. The factors significantly associated with both NCA and ClinPNs were smoking and known diabetes. In non‐diabetic participants, aging, tall height and hypertension were significant deteriorating factors of nerve conduction functions.ConclusionsIn Japan, ClinPNs and NCA were increased in known diabetes patients, but did not increase in participants with prediabetes, MetS and MetS’ components. Smoking and known diabetes were factors significantly associated with ClinPNs or NCA. Hypertension might be a modifiable deteriorating factor of nerve function.
Formulation evaluation of ketoconazole microemulsion‐loaded hydrogel with nigella oil as a penetration enhancer
Authors: Amra Kesrin , Momin Munira 
Published: April 2019

AbstractBackgroundOnychomycosis is an opportunistic fungal infection often infecting people with compromised immune system. Currently available treatment interventions such as physical, surgical, and chemical‐based approaches are successful in treating the condition, however, are painful and nonpatient complaint. Moreover, dermal creams with antifungal agents do not penetrate nail plate as required; hence, there is a necessity of developing a novel formulation with enhanced penetration.AimsThe aim of the present research work was to develop ketoconazole microemulsion‐loaded hydrogel formulation containing nigella oil as permeation enhancer for the treatment of onychomycosis.MethodsScreening of oils, surfactants, and cosurfactants were done based on solubility studies followed by the construction of pseudo‐ternary phase diagrams with 2% ketoconazole. The microemulsion was characterized for globule size, zeta potential, viscosity, and thermodynamic stability. Ex‐vivo studies were carried out using Franz diffusion cells using porcine skin membrane. The antifungal activity of microemulsion‐loaded hydrogel was evaluated using cup plate method using Candida albicans and Aspergillus niger.ResultsThe optimized microemulsion had a composition of 54.97% Capryol:Nigella (2:1), 36.07% Transcutol:Propylene glycol (2:1), and 7.13% water and was later incorporated into polymeric gel base. The microemulsion‐loaded hydrogel exhibited a 10 hours sustained release profile as compared to the marketed cream and an enhanced activity against marketed ketoconazole cream and compared with marketed ketoconazole formulation.ConclusionThe thermodynamic stability, sustained drug release with greater permeation, and enhanced activity due to the presence of nigella oil in microemulsion‐loaded hydrogel warrant its application as an excellent vehicle for treating fungal infections.
Effective noninvasive body contouring by using a combination of cryolipolysis, injection lipolysis, and shock waves
Authors: Faulhaber Jörg , Sandhofer Matthias , Weiss Christel , Sattler Gerhard , Sadick Neil S. 
Published: April 2019

AbstractBackgroundCryolipolysis combined with shockwave therapy has been previously shown to have synergistic effects in body contouring results.ObjectiveThis open‐label, prospective, multicenter, comparative study investigated the safety and efficacy of combined cryolipolysis, shockwave therapy with cryolipolysis, shockwave therapy, and injection polyenylphosphatidylcholine‐based lipolysis.MethodsEnrolled patients were treated in the abdominal or flank area with cryolipolysis, shockwave therapy and injection lipolysis (n = 10) or cryolipolysis and shockwave therapy (n = 4). All treatments were conducted the same day. Evaluations were conducted 3 months after treatment and included histological analysis, standardized photography, blinded‐investigator efficacy, and safety ratings, as well as patient ratings of satisfaction and tolerance.ResultsCompared to baseline, the 3‐month follow‐up histological analysis revealed a more profound subcutaneous adipose tissue reaction with the triple combination therapy (cryolipolysis, injection lipolysis, radial shock wave) than with the double combination with regard to adipocyte damage and grade of inflammation. Waist circumference was significantly reduced in patients of both groups, but patients in the triple combination group were shown to have a significantly more pronounced reduction in subcutaneous fat. Factors that were shown to influence treatment outcome included baseline BMI and waist circumference. Age and gender had no effect. The abdominal area reacted better to the treatment compared to flanks. No significant side effects or adverse events were reported. The procedure was well‐tolerated, and the majority of patients were satisfied with the treatment results.ConclusionsCombination of cryolipolysis, radial shockwave, and injection lipolysis is a safe, well‐tolerated treatment for reduction in subcutaneous fat.
Treatment and monitoring of children with chronic hepatitis C in the Pre‐DAA era: A European survey of 38 paediatric specialists
Authors: Indolfi Giuseppe , Bailey Heather , Serranti Daniele , Giaquinto Carlo , Thorne Claire ,   The PENTAHep Study Group
Published: April 2019

AbstractThe burden of paediatric Hepatitis C virus (HCV) infection across Europe is unknown, as are current policies regarding monitoring and treatment. This collaborative study aimed to collect aggregate data to characterise the population of ≤18‐year‐olds with HCV infection in specialist follow up in a 12‐month period (2016) across the PENTAHep European consortium, and investigate current policies around monitoring and treatment. A cross‐sectional, web‐based survey was distributed in April 2017 to 50 paediatricians in 19 European countries, covering patients' profile, and monitoring and treatment practices. Responses were received from 38/50 clinicians collectively caring for 663 children with chronic HCV infection of whom three‐quarters were aged ≥6 years and 90% vertically infected. HCV genotype 1 was the most common (n 380; 57.3%), followed by genotype 3, 4 and 2. Seventeen children (3%) with chronic HCV infection were diagnosed with cirrhosis, and six were reported to have received liver transplantation for HCV‐related liver disease. The majority (n 425; 64.1%) of the European children with HCV infection remained treatment‐naive in 2016. Age affected clinicians' attitudes towards treatment; 94% reported being willing to use direct‐acting antivirals, if available, in adolescents (aged ≥11 years), 78% in children aged 6‐10 and 42% in those 3‐5 years of age (Pearson correlation coefficient −0.98; P 0.0001). This survey provides the largest characterisation of the population of children in clinical follow‐up for chronic HCV infection in Europe, alongside important contextual information on their management and treatment. Discussion is needed around strategies and criteria for use of direct‐acting antivirals in these children.
Parallel introgression and selection on introduced alleles in a native species
Authors: Bay Rachael A. , Taylor Eric B. , Schluter Dolph 
Published: April 2019

AbstractAs humans cause the redistribution of species ranges, hybridization between previously allopatric species is on the rise. Such hybridization can have complex effects on overall fitness of native species as new allelic combinations are tested. Widespread species introductions provide a unique opportunity to study selection on introgressed alleles in independent, replicated populations. We examined selection on alleles that repeatedly introgressed from introduced rainbow trout (Oncorhynchus mykiss) into native westslope cutthroat trout (Oncorhynchus clarkii lewisi) populations in western Canada. We found that the degree of introgression of individual single nucleotide polymorphisms from the invasive species into the native is correlated between independent watersheds. A number of rainbow trout alleles have repeatedly swept to high frequency in native populations, suggesting parallel adaptive advantages. Using simulations, we estimated large selection coefficients up to 0.05 favoring several rainbow trout alleles in the native background. Although previous studies have found reduced hybrid fitness and genome‐wide resistance to introgression in westslope cutthroat trout, our results suggest that some introduced genomic regions are strongly favored by selection. Our study demonstrates the utility of replicated introductions as case studies for understanding parallel adaptation and the interactions between selection and introgression across the genome. We suggest that understanding this variation, including consideration of beneficial alleles, can inform management strategies for hybridizing species.
Satellite tracking of gulls and genomic characterization of faecal bacteria reveals environmentally mediated acquisition and dispersal of antimicrobial‐resistant Escherichia coli on the Kenai Peninsula, Alaska
Authors: Ahlstrom Christina A. , Bonnedahl Jonas , Woksepp Hanna , Hernandez Jorge , Reed John A. , Tibbitts Lee , Olsen Björn , Douglas David C. , Ramey Andrew M. 
Published: April 2019

AbstractGulls (Larus spp.) have frequently been reported to carry Escherichia coli exhibiting antimicrobial resistance (AMR E. coli); however, the pathways governing the acquisition and dispersal of such bacteria are not well described. We equipped 17 landfill‐foraging gulls with satellite transmitters and collected gull faecal samples longitudinally from four locations on the Kenai Peninsula, Alaska to assess: (a) gull attendance and transitions between sites, (b) spatiotemporal prevalence of faecally shed AMR E. coli, and (c) genomic relatedness of AMR E. coli isolates among sites. We also sampled Pacific salmon (Oncorhynchus spp.) harvested as part of personal‐use dipnet fisheries at two sites to assess potential contamination with AMR E. coli. Among our study sites, marked gulls most commonly occupied the lower Kenai River (61% of site locations) followed by the Soldotna landfill (11%), lower Kasilof River (5%) and upper Kenai River (<1%). Gulls primarily moved between the Soldotna landfill and the lower Kenai River (94% of transitions among sites), which were also the two locations with the highest prevalence of AMR E. coli. There was relatively high spatial and temporal variability in AMR E. coli prevalence in gull faeces and there was no evidence of contamination on salmon harvested in personal‐use fisheries. We identified E. coli sequence types and AMR genes of clinical importance, with some isolates possessing genes associated with resistance to as many as eight antibiotic classes. Our findings suggest that gulls acquire AMR E. coli at habitats with anthropogenic inputs and subsequent movements may represent pathways through which AMR is dispersed.
Tinea capitis in adults: A 18‐year retrospective, single‐centre study in Korea
Authors: Park Su‐Kyung , Park Sang‐Woo , Yun Seok‐Kweon , Kim Han‐Uk , Park Jin 
Published: April 2019

SummaryBackgroundTinea capitis (TC) is a dermatophyte infection involving hair and scalp and occurs primarily in prepubertal children. However, data on adults are limited.ObjectivesThe aim of this study was to evaluate epidemiological, clinical and mycological characteristics of TC in adults in Korea.Patients/MethodsWe retrospectively evaluated 82 adults (44.3%) among 185 TC patients at a tertiary hospital during June 2000‐2017.ResultsMean patient age was 66.9 ± 15.8 (20‐90) years with female predominance; mean disease duration until mycological diagnosis, 22.5 (1‐144) weeks; and misdiagnosis rate, 65.9%. Most common presumptive initial diagnoses were seborrhoeic dermatitis (24.4%) and bacterial folliculitis (18.3%). Chronic systemic illness and accompanying alopecia were found in 61 (74.4%) and 46 (56.1%) patients, respectively. Pustular type was found in 26.8% patients, followed by seborrhoeic dermatitis–like 25.6%, grey patch 23.2%, kerion celsi 22.0% and black dot 2.4%. Forty‐eight patients (58.5%) had tinea infection at other skin areas. Microsporum canis (56.5%) and Trichophyton rubrum (21.7%) were the most common causative organisms; 92.7% patients achieved complete resolution, and seven patients (9.2%) had a recurrence.ConclusionsWe report the largest, most recent series of case studies of adult TC. Adult TC is not an uncommon problem, especially in elderly women, and has distinctive epidemiological and clinicomycological characteristics compared to those in prepubertal children. Recognising adult TC profile will help clinicians avoid misdiagnosis and provide appropriate treatment.