bluuebunny/crossref_metadata_2025_split huggingface dataset:
Progression of a solitary plasmacytoma to multiple myeloma. A population‐based registry of the northern Netherlands
Authors: de Waal Esther G. M. , Leene Marnix , Veeger Nic , Vos Hanneke J. , Ong Francisca , Smit Wilma G. J. M. , Hovenga Sjoerd , Hoogendoorn Mels , Hogenes Marieke , Beijert Max , Diepstra Arjan , Vellenga Edo 
Published: September 2016

Plasmacytoma is characterized by a local accumulation of monoclonal plasma cells without criteria for multiple myeloma (MM). The current treatment regimen is local radiotherapy. However, more than 50% of patients develop MM within 2 years after treatment. A population‐based registry was consulted for the diagnosis of solitary plasmacytoma between 1988 and 2011. Progression to MM and prognostic features for progression to MM were scored, including hypoxia inducible factors (HIF), vascular endothelial growth factor (VEGF, also termed VEGFA) and micro‐vessel density (MVD) expression in biopsy material. A total of 76 patients were included, 34% having extramedullary plasmacytoma (EMP) while 66% had a solitary plasmacytoma of the bone (SBP). Median follow‐up was 89 months, (7–293 months). In Seventy per cent of SBP patients developed MM with a median time to progression of 19 months (5–293). Three patients (12%) with EMP developed MM. High expression of VEGF and HIF‐2α (also termed EPAS1) was demonstrated in conjunction with an increased MVD in 66% of the patients. No association could be shown between angiogenesis parameters and progression to MM. In conclusion, this population‐based study demonstrates that SBP patients have a higher risk of developing MM following local radiotherapy, indicating that this group might benefit from added systemic chemotherapy.
Sitagliptin and risk of fractures in type 2 diabetes: Results from the TECOS trial
Authors: Josse Robert G. , Majumdar Sumit R. , Zheng Yinggan , Adler Amanda , Bethel M. Angelyn , Buse John B. , Green Jennifer B. , Kaufman Keith D. , Rodbard Helena W. , Tankova Tsvetalina , Westerhout Cynthia M. , Peterson Eric D. , Holman Rury R. , Armstrong Paul W. ,   on behalf of the TECOS Study Group
Published: September 2016

AimTo examine fracture incidence among participants in the Trial Evaluating Cardiovascular Outcomes with Sitagliptin (TECOS).Research design and methodsWe used data from 14 671 participants in the TECOS study who were randomized double‐blind to sitagliptin (n = 7332) or placebo (n = 7339). Cumulative fracture incidence rates were calculated and their association with study treatment assignment was examined using multivariable Cox proportional hazards regression.ResultsThe baseline mean (standard deviation) participant age was 65.5 (8.0) years, diabetes duration was 11.6 (8.1) years and glycated haemoglobin level was 7.2 (0.5)% [55.2 (5.5) mmol/mol], and 29.3% of participants were women and 32.1% were non‐white. During 43 222 person‐years’ follow‐up, 375 (2.6%; 8.7 per 1000 person‐years) had a fracture; 146 were major osteoporotic fractures (hip, n = 34; upper extremity, n = 81; and clinical spine, n = 31). Adjusted analyses showed fracture risk increased independently with older age (P < .001), female sex (P < .001), white race (P < .001), lower diastolic blood pressure (P < .001) and diabetic neuropathy (P = .003). Sitagliptin, compared with placebo, was not associated with a higher fracture risk [189 vs 186 incident fractures: unadjusted hazard ratio (HR) 1.01, 95% confidence interval (CI) 0.82 to 1.23, P = .944; adjusted HR 1.03, P = .745], major osteoporotic fractures (P = .673) or hip fractures (P = .761). Insulin therapy was associated with a higher fracture risk (HR 1.40, 95% CI 1.02‐1.91; P = .035), and metformin with a lower risk (HR 0.76, 95% CI 0.59‐0.98; P = .035).ConclusionFractures were common among people with diabetes in the TECOS study, but were not related to sitagliptin therapy. Insulin and metformin treatment were associated with higher and lower fracture risks, respectively.
Self‐regeneration of hairy vetch (Vicia villosa Roth) as affected by seedling density and soil tillage method in a semi‐arid agroecosystem
Authors: Renzi J. P. , Chantre G. R. , Cantamutto M. A. 
Published: September 2016

AbstractVicia villosa Roth is a forage legume with the capability for biological N fixation and natural reseeding, which could contribute to sustainability in semi‐arid regions. This study aimed to determine (i) the relationship between vetch density, seed production and spontaneous seed dispersal; (ii) the impact of the post‐dispersal tillage treatment over the soil seedbank dynamics; and (iii) potential predation of the seedbank by feral pigeons. A density range between 50 and 200 plants m−2 did not influence seed production or seed dispersal. Shallow disc tillage (SDT) clearly favoured self‐regeneration, resulting in higher amount of emerged seedlings during autumn compared to no tillage (NT). Based on observed emergence data, the percentage of emerged seedlings under SDT and NT were 38 and 6% of the seedbank, respectively, during 18 months after plot harvest. The lowest emergence values registered under NT could be associated with higher pressure from natural predators, soil‐borne pathogens, seed decay by ageing and false breaks. The feral pigeon (Columba livia var.) might be considered the main cause of vetch seedbank depletion in this study. Under controlled conditions, a single pigeon is able to consume, on average, between 184 and 768 seeds per day, depending on seed exposure and alternative food sources availability.
Results of Daily Hemodialysis in Catanzaro: 12‐Year Experience With 22 Patients Treated For More Than One Year
Authors: Pinciaroli Angela Rosa 
Published: September 2016

Since 1985, we have been treating patients with daily hemodialysis (D‐HD). We report our results with 22 patients treated on D‐HD and daily home hemodialysis (DHHD) for a long‐term period. Patients had very good survival of native forearm arteriovenous fistula access, and upper arm access with superficialized basilic vein. One access survived 18 years: 8 years on standard hemodialysis (STND‐HD) and 10 years on D‐HD. Only two fistulas failed. Blood pressure control in 12 hypertensive patients was obtained without antihypertensive drugs in 8 and with fewer medications in 4. Hematocrit and hemoglobin improved in all patients. Cardiothoratic index decreased in all patients, and we noticed a reduction in the most important echocardiographic indices in 12 patients with cardiac hypertrophy: intraventricular septum thickness, left ventricle posterior wall thickness, left ventricle internal diastolic diameter, and left atrium diameter. Data also showed improvement in nutritional status. For the most part, the levels of hormones normalized, with regular menstrual cycles in women and good sexual function in men.In our experience both elderly and young patients with severe cardiovascular diseases, severe hypertension or hypotension, anemia, and nutritional problems can, with D‐HD, achieve good quality of life and start work again. D‐HD, in our opinion, is the treatment of choice for patients without comorbid conditions, because good metabolic control, good nutrition, and a more normal hormonal status allow them to feel well and to have an almost normal lifestyle.
Early, Frequent, and Efficient Hemodialysis: A New Trend or Déjà Vu From the 1970s?
Authors: Bonomini Vittorio , Scolari Maria Piera , Colì Luigi , Feliciangeli Giorgio 
Published: September 2016

After more than a quarter century of dialysis, two factors are still present in dialysis treatment of chronic renal failure patients: inadequacy of technology (the artificial kidney acts as an artificial glomerulus) and inadequate use of technology in terms of dialysis initiation and frequency. This paper presents the results of two less unphysiological dialysis programs, introduced in Bologna at the beginning of the 1960s, which proved their clinical value and are now becoming trendy, at the end of this century. Features of these programs are twofold: (1) daily dialysis, which aims at making treatment more biologically suited to the patient; its validity relies on lower intra‐ and interdialytic osmotic fluctuations; (2) early dialysis, which aims at making the patient more biologically suited to the treatment. After more than 25 years it is evident that this treatment has fulfilled its original expectations versus late dialysis. There is a 40% improvement in survival, a 35% decrease in morbidity, and a 24% improvement in the cost/benefit ratio.This report is based on a retrospective analysis of our overall experience and clinical results of chronic hemodialysis carried out in 224 patients on early dialysis and 1210 patients on late dialysis in Bologna from 1967 to 1997. Based on this experience, the following should be regarded as particularly important indications for early dialysis: adequate dialysis facilities; symptomatic patients despite renal creatinine clearances between 15 and 20 mL/min; patients unable to comply with dietary measures; children, to allow for adequate development; patients with diabetes mellitus; candidates for renal transplantation.
Prevention and Treatment of Thrombosis Associated With Long‐Term Hemodialysis Catheters
Authors: Twardowski Zbylut J. 
Published: September 2016

Soft, cuffed, central vein hemodialysis catheters are used in about 20% of chronic hemodialysis patients in the United States, because long‐term arteriovenous blood access cannot be maintained in an aging patient population with a large proportion of diabetics. The most frequent complication of these catheters is thrombosis.The treatment of catheter‐related thrombosis is difficult and expensive; thus the emphasis should be on prevention. The preferred material for a long‐term catheter is silicone rubber, since it is the least thombogenic. Anticoagulation should be more vigorous during “catheter dialysis” than during “fistula dialysis.” Heparin is the least expensive and most convenient anticoagulant, suitable for over 99% of chronic dialysis patients. The dose of heparin for sufficient anticoagulation depends on many factors, varies widely, and should be established for each patient based on activated clotting time (ACT). ACT should be kept over 270 sec throughout dialysis.Recently we introduced a method of locking catheter lumina with a predetermined amount of heparin; this heparin is not discarded before the next dialysis, but serves as a loading dose. This saves a number of connections/ disconnections and decreases dialysis‐associated blood losses. To prevent catheter thrombosis, over 60% of patients require warfarin in sufficient doses to keep the international normalized ratio (INR) between 1.5 and 2.5.The most common catheter‐related thrombus is a periluminal fibrin sleeve. Locking the catheter with urokinase to dissolve the clot is of little value, because the bulk of the thrombus is outside the catheter. We have found a high‐dose (250 000 U or more) intradialytic urokinase infusion through the venous chamber to be a very efficient and convenient method for dissolving clots. Cumulative success of up to three infusions is over 99%. This obviates the need of catheter stripping or replacement, which is more cumbersome and expensive.
Concentrated Sodium Citrate (23%) for Catheter Lock
Authors: Ash Stephen R. , Mankus Rita A. , Sutton James M. , Criswell Ruth E. , Crull Carol C. , Velasquez Katherine A. , Smeltzer Brian D. , Ing Todd S. 
Published: September 2016

For chronic central venous dialysis catheters, the standard method for maintaining catheter patency between treatments is to instill (lock) catheters with 5000 – 10 000 units of heparin in each lumen. Sodium citrate (citrate) is an anticoagulant with intrinsic antibacterial activity (at 20% concentration or higher). Citrate has only transient anticoagulant effects if accidentally infused to the patient. Prior studies of citrate as a catheter lock solution have utilized citrate concentrations of 1% in combination with 27 mg/mL gentamicin. We changed clinical protocols for catheter locks using various solutions, including concentrated citrate, in a dialysis unit with 50% of patients having chronic central venous catheters [40 catheters total, mostly Ash Split Cath (Medcomp, Harleysville, PA, U.S.A.) but some Tesio (Medcomp) and Hickman (BARD, Salt Lake City, UT, U.S.A.) catheters]. At 3‐ to 4‐month intervals, the standard catheter lock solution for the unit was varied on the following schedule: heparin; 10% citrate with 3 mg/mL gentamicin; 20% citrate with 3 mg/mL gentamicin; heparin; and 23% citrate. Catheters were not routinely removed during treatment of bacteremia.Incidence of bacteremia in patients with catheters using heparin as catheter lock was 4.32 episodes per 3000 patient‐days (equivalent to percent of patients with catheters having bacteremia per month). The incidence of bacteremia decreased to 1.68 using 20% citrate/gentamicin as catheter lock (p < 0.05) and to 0% with 47% citrate (p < 0.05). Incidence of bacteremia increased on return to heparin and decreased again with use of 23% citrate to 1.79 (p < 0.05). Use of urokinase for occluded catheters also significantly decreased with citrate during the time that it was available (p = 0.02). Life table analysis indicated an 83% survival of Ash Split Cath catheters at 1 year, in this unit. Concentrated citrate is an effective catheter lock solution that may provide prolonged central venous catheter use with a diminution in catheter‐related infections and occlusion.
Continuous Blood Volume Monitoring and Ultrafiltration Control
Authors: Lopot František , Nejedlý Bohdan , Sulková Sylvie 
Published: September 2016

Continuous blood volume monitoring (CBVM) is believed to be a promising method for making the determination of patients' “dry weight” more objective, and ultrafiltration (UF) control more appropriate. Although blood volume response to UF and the interrelation between blood volume changes and changes in hemodynamic parameters are highly individual, certain principles of this response and interrelation can be identified and exploited for effective use of CBVM. The present work summarizes the authors' findings from practical CBVM application over the past 5 years and their opinions on the future development of this method.Four distinct types of blood volume response to constant UF rate were identified: Type 1, flat line throughout the whole session; Type 2, flat line during the first part of dialysis, followed by a linear decrease during the remaining time; Type 3, linear decrease right from dialysis start; and Type 4, linear decrease first, followed by a flat line during the remaining time. The possibility of a shift from one type to the other was verified. Blood volume reduction due to UF was found to have a static and a dynamic component. The most important factors affecting both components were found to be, by sensitivity analysis of a three‐pool kinetic model, degree of overhydration, vascular system compliance, and UF volume (for the static component); and UF coefficient of the capillary wall and UF rate (for the dynamic component).Type 3 response, induced by more vigorous UF, was found to significantly decrease the volume of residual daily diuresis on the first postdialysis day. If confirmed, this finding may serve as a basis for the response type choice in patients with still significant residual renal function.Exploitation of the existence of dynamic blood volume reduction component for the first generation of automated biofeedback UF controllers may be complemented by automated identification of patient's plasma refilling capacity and/or position of his/her point on the Guytonian pressure/volume characteristics curves, and thus may more advanced “intelligent” UF controllers be constructed in the future.
The Progression of Uremic Polyneuropathy in Patients on Hemodialysis and Hemofiltration: A Two‐Year Study
Authors: Mourvati Efthimia P. , Passadakis Ploumis S. , Thodis Elias D. , Panagoutsos Stelios A. , Galtsidopoulos Omiros G. , Vargemezis Vassilis A. 
Published: September 2016

Uremic polyneuropathy is one of the major complications of long‐term end‐stage renal disease. In the present study, we performed an electrophysiologic evaluation in 17 patients having a mean age of 49 ± 11 years. The patients were divided into two groups according to dialysis method. Group A included 9 patients who were undergoing conventional hemodialysis (mean age, 44.2 ± 12.5 years; mean duration on dialysis, 21.7 ± 4.3 months); group B included 8 patients undergoing hemofiltration (mean age, 55.2 ± 5.2 years; mean duration on treatment, 27 ± 7.6 months). Measurements of the distal latency time of the sensory fibers (median, ulnar, and sural nerves), and measurements of the distal latency time and peripheral conduction velocity of the motor fibers (median and peroneal nerves) were performed. In addition, we recorded somatosensory evoked potentials after peripheral stimulation of the median and peroneal nerves. The electrophysiologic evaluations were repeated two times at intervals of 12 months.In group A, a statistically significant worsening of motor and sensory conductance in the upper and lower limbs was observed; in group B, a statistically significant improvement was found. These findings suggest that hemofiltration has a more beneficial effect on motor and sensory conductivity than does conventional hemodialysis.
Serum collagenase‐2 and BMI levels in pregnant women with striae gravidarum
Authors: Ozturk Perihan , Kıran Hakan , Kurutas Ergul Belge , Mulayim Kamil , Avcı Fazıl 
Published: September 2016

SummaryObjectiveStriae gravidarum is a form of scarring on the skin observed during pregnancy and can cause serious cosmetic problems. Striae gravidarum may be influenced by hormonal changes, although the etiology is not clear. The aim of this study was to investigate whether body mass index (BMI) and serum collagenase‐2 levels in pregnant women are related to the development of striae gravidarum.MethodsThirty pregnant women with striae, 30 pregnant women without striae, and 32 health controls were enrolled in the study.ResultsBMI and serum collagenase‐2 levels were measured in the participants.ConclusionPregnant women with striae gravidarum had increased serum collagenase‐2 and BMI levels when compared to pregnant women without striae gravidarum and healthy controls (P < 0.05). The increase in serum collagenase‐2 levels was related to the development of striae gravidarum alone, or secondary to BMI increase.
Effects of PTEN gene silencing on invasion and EMT in oral squamous carcinoma Tca8113 cells
Authors: Lu Zhiyuan , Guo Hui , Lin Yanzhu , Shen Lijia , Yin Cao , Xie Siming 
Published: September 2016

AimTo investigate the impact of silencing of the PTEN gene using siRNA on the invasion, proliferation, cell cycle, and epithelial‐mesenchymal transition of the Tca8113 cell line.MethodsThe established Tca8113 cell model with siRNA interference to silence the PTEN gene was used. The transfection efficiency was examined by RT‐qPCR and Western blot analysis. CCK‐8 assay was utilized to analyze the proliferation of Tca8113 cells and cell invasion was evaluated using a transwell assay. The cell cycle distribution was analyzed by flow cytometry. The protein expression levels of the epithelial‐mesenchymal transition (EMT) markers E‐cadherin and Vimentin and the EMT‐related proteins β‐catenin and TGF‐β1 were analyzed by Western blot.ResultsThe expression level of PTEN was significantly reduced in the PTEN‐siRNA group. The invasiveness and proliferation rate of Tca8113 cells in the PTEN‐siRNA group were significantly greater than those of the control and negative control groups. The expression levels of E‐cadherin and β‐catenin were reduced, whereas the expression levels of vimentin and TGFβ‐1 were elevated in the PTEN‐siRNA group compared with those of control and negative groups. These results were significantly different.ConclusionThe silencing of PTEN by siRNA increased the proliferation and promoted cell invasion of Tca8113 cells. PTEN gene silencing may accelerate the EMT in Tca8113 cells.
Epizootics in Industrial Livestock Production: Preventable Gaps in Biosecurity and Biocontainment
Authors: Leibler J. H. , Dalton K. , Pekosz A. , Gray G. C. , Silbergeld E. K. 
Published: September 2016

SummaryWhile technological advances in animal husbandry have facilitated increases in global meat production, the high density and geographic concentration of food animal production facilities pose risks of infectious disease transmission. The scale of the 2014–2015 highly pathogenic avian influenza H5N2 outbreak in the United States demonstrates the challenges in achieving pathogen control within and around industrial animal facilities using existing technologies. We discuss gaps in current practice in two specific systems within these facilities – ventilation and waste management – which are under‐recognized as important drivers of microbial porosity. The development of innovative ventilation systems to reduce influx and efflux of pathogens is critically needed, and cross‐sectoral partnerships should be incentivized to do so. Adapting current human biosolid treatment technologies for farm applications, reducing animal stocking density and shifting waste management responsibility from farmer to corporation would reduce risk from current manure management systems. While innovative approaches to functionally altering the industrial food animal production system remain important priorities to promote sustainability, our intention here is to identify gaps within the current system that allow for pathogen emergence and transmission and address specific areas in which technological, administrative or policy changes are necessary to mitigate these risks.
Guidance on the Selection of Appropriate Indicators for Quantification of Antimicrobial Usage in Humans and Animals
Authors: Collineau L. , Belloc C. , Stärk K. D. C. , Hémonic A. , Postma M. , Dewulf J. , Chauvin C. 
Published: September 2016

SummaryAn increasing variety of indicators of antimicrobial usage has become available in human and veterinary medicine, with no consensus on the most appropriate indicators to be used. The objective of this review is therefore to provide guidance on the selection of indicators, intended for those aiming to quantify antimicrobial usage based on sales, deliveries or reimbursement data. Depending on the study objective, different requirements apply to antimicrobial usage quantification in terms of resolution, comprehensiveness, stability over time, ability to assess exposure and comparability. If the aim is to monitor antimicrobial usage trends, it is crucial to use a robust quantification system that allows stability over time in terms of required data and provided output; to compare usage between different species or countries, comparability must be ensured between the different populations. If data are used for benchmarking, the system comprehensiveness is particularly crucial, while data collected to study the association between usage and resistance should express the exposure level and duration as a measurement of the exerted selection pressure. Antimicrobial usage is generally described as the number of technical units consumed normalized by the population at risk of being treated in a defined period. The technical units vary from number of packages to number of individuals treated daily by adding different levels of complexity such as daily dose or weight at treatment. These technical units are then related to a description of the population at risk, based either on biomass or number of individuals. Conventions and assumptions are needed for all of these calculation steps. However, there is a clear lack of standardization, resulting in poor transparency and comparability. By combining study requirements with available approaches to quantify antimicrobial usage, we provide suggestions on the most appropriate indicators and data sources to be used for a given study objective.