bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evolution of soft palate surgery techniques for obstructive sleep apnea patients: A comparative study for single‐level palatal surgeries
Authors: Rashwan Mohamed S. , Montevecchi Filippo , Cammaroto Giovanni , Badr el Deen Mohamed , Iskander Nagi , El Hennawi Diaa , El Tabbakh Mohammed , Meccariello Giuseppe , Gobbi Riccardo , Stomeo Francesco , Vicini Claudio 
Published: November 2017

ObjectivesTo compare the results of tissue preservation techniques of soft palate surgeries including expansion sphincter pharyngoplasty (ESP) and barbed reposition pharyngoplasty (BRP) for patients suffering from obstructive sleep apnoea (OSA) with the traditional uvulopalatopharyngoplasty (UPPP).DesignInterventional comparative study.SettingMorgagni‐Pierantoni Hospital.ParticipantsSeventy‐five patients were included in the study, divided into three groups with 25 patients per group: UPPP, ESP or BRP.Main outcomes measuresPolysomnography was carried out for all patients pre‐ and postoperatively; the postoperative results were recorded at least 6 months after surgery. All patients were assessed preoperatively using drug‐induced sleep endoscopy. Epworth Sleepiness Scale and body mass index (BMI) were registered for all patients before and after surgery.ResultsThe mean of pre‐ and postoperative differences of apnoea‐hypopnoea index values was higher in BRP group than ESP: 15.76 ± 14.5 Vs 10.13 ± 5.3; P < .05 and UPPP groups: 15.76 ± 14.5 vs 6.08 ± 5.5; P < .0005. The mean of differences of oxygen desaturation index values was higher in BRP group than UPPP group: 15.09 ± 17.6 vs 7.13 ± 6.8; P < .0005, but not significantly higher than ESP group: 15.09 ± 17.6 vs 6.48 ± 7.9; P > .05. The mean of differences of ESS values was higher in BRP group than ESP group: 5.52 ± 4.1 vs 4.84 ± 3.3; P < .005 and UPPP groups: 5.52 ± 4.1 vs 1.36 ± 1.9; P < .005. Finally, the pre‐ and postoperative means of differences of lowest oxygen saturation values were not statistically significant among the three groups (P > .05).ConclusionBarbed reposition pharyngoplasty (BRP) can be considered an effective procedure on the basis of the postoperative outcomes. ESP still proves to be a good technique especially when performed by experienced surgeons. Both techniques proved to be superior to UPPP.
Right ventricular systolic function and mechanical dispersion identify patients with arrhythmogenic right ventricular cardiomyopathy
Authors: Åström Aneq Meriam , Maret Eva , Brudin Lars , Svensson Anneli , Engvall Jan 
Published: November 2017

SummaryPurposeTo assess right ventricular (RV) regional and global systolic function using feature tracking (FT) in patients with a definite diagnosis of arrhythmogenic right ventricular cardiomyopathy (ARVC) and to investigate if changes in strain amplitude and mechanical dispersion indicate a propensity for arrhythmia.Materials and MethodsTwenty‐seven patients fulfilling Task Force Criteria for ARVC and 24 healthy volunteers underwent MR at 1·5 Tesla. Steady‐state free precession cine of long‐axis slices and a short‐axis stack of the RV was acquired. Segmental longitudinal systolic strain amplitude and time‐to‐peak (TTP) strain were measured in the four‐ and two‐chamber views of the RV.ResultsCompared to controls, patients with ARVC had lower RV ejection fraction (RVEF), (53% vs 57%, P = 0·012) and lower longitudinal strain amplitude in the RV free wall (‐20·6 vs ‐26·3%, P = 0·014) and in the basal part of the RV (‐22·8 vs ‐31·7%, P<0·001). Mechanical dispersion, defined as the standard deviation (SD) of TTP of RV segments, was larger in patients with ARVC (48 ms [21–74] vs 35 ms [13–66 ms], P = 0·02). Patients with ventricular tachycardia (VT) or non‐sustained VT had lower RVEF (46% vs 55%, P = 0·008), but did not have significantly lower RV strain amplitude (−19·5% vs 21·0%, P = 0·073) and no signs of mechanical dispersion (49 ms vs 48 ms, P = 0·861) compared to patients without arrhythmia.ConclusionARVC patients had lower longitudinal absolute strain amplitude in basal RV segments and increased mechanical dispersion compared to healthy volunteers, but the presence of mechanical dispersion was not predictive of ventricular arrhythmia.
Off‐Label‐Use und Entscheidungen über Anträge auf Kostenübernahme in Deutschland – eine retrospektive Analyse
Authors: Seidenschnur Karin Ellen Katharina , Dressler Corinna , Weller Karsten , Nast Alexander , Werner Ricardo Niklas 
Published: November 2017

ZusammenfassungHintergrund und ZielsetzungenMit dem Begriff „Off‐Label‐Use“ (zulassungsüberschreitende Anwendung) wird die Verordnung pharmazeutischer Präparate außerhalb ihrer zugelassenen Anwendungsgebiete beschrieben. Für seltene Krankheiten sind häufig keine oder kaum zugelassene Therapiealternativen verfügbar. Die Kosten für eine Off‐Label Verordnung werden von der Gesetzlichen Krankenversicherung (GKV) nur unter bestimmten, gesetzlich geregelten Voraussetzungen übernommen. Um Regressforderungen durch die Kostenträger zu vermeiden, kann vor Verordnung ein Antrag auf Kostenübernahme (‘Off‐Label Antrag’) gestellt werden.Patienten und MethodenEs wurde eine retrospektive Auswertung von Off‐Label Anträgen, die im Zeitraum 2010‐2012 in zwei Sprechstunden einer dermatologischen Hochschulambulanz gestellt wurden, durchgeführt (Autoimmun‐Sprechstunde, Urtikaria‐Sprechstunde). Krankenkassen, Bewilligungsraten, Gründe für Ablehnungen und die Bearbeitungsdauer wurden ausgewertet.ErgebnisseDie Auswertung ergab, dass 56,8 % der eingeschlossenen Off‐Label Anträge (n = 44) initial bewilligt wurden. Nach bis zu zweimaligem Widerspruch gegen die Ablehnung einer Kostenübernahme betrug die Bewilligungsrate insgesamt 75 %. Die Dauer zwischen Antragstellung und Bescheid durch die Kostenträger betrug 49 Tage (Median). Bei positivem Bescheid erfolgte die Therapieeinleitung 92 Tage (Median) nach Antragstellung.SchlussfolgerungenDie vorliegende Fallserie zeigt, dass die Kostenträger den beantragten Kostenübernahmen für Off‐Label Therapien im überwiegenden Teil der betrachteten Fälle zustimmten. Ob die identifizierten Probleme durch die gegenwärtigen Veränderungen der gesetzlichen Rahmenbedingungen (GKV‐Versorgungsstrukturgesetz, Patientenrechtegesetz) adäquat adressiert werden, sollte in einer prospektiven Studie untersucht werden.
Sweet‐Syndrom: Revision der diagnostischen Kriterien
Authors: Nofal Ahmad , Abdelmaksoud Ayman , Amer Hala , Nofal Eman , Yosef Ayman , Gharib Khaled , Albalat Waleed , Eldesouky Fatma , Ebrahim Howyda M. , Abdelshafy Ahmed Said , Fayed Hala 
Published: November 2017

ZusammenfassungDie Diagnose des Sweet‐Syndroms (SS) gründet sich auf eine Reihe von Kriterien, von denen mindestens zwei Haupt‐ und zwei Nebenkriterien erfüllt sein müssen. In einigen Fällen ist die Diagnose aufgrund des Fehlens bestimmter Kriterien jedoch nicht so einfach. Ziel der vorliegenden Studie war es, die klinischen, histopathologischen und Labormerkmale der aktuellen Diagnosekriterien für das SS zu überprüfen und ihre Aussagekraft anhand der publizierten Fälle sowie bei 40 in unserem Institut behandelten Patienten zu beurteilen. Unsere umfassende Prüfung der aktuellen Kriterien für das SS ergab, dass seit seiner Erstbeschreibung im Jahr 1964 die beiden Hauptkriterien bei allen Fällen – einschließlich unserer – durchweg vorhanden waren. Andererseits gab es hinsichtlich der Nebenkriterien deutliche Unterschiede zwischen den verschiedenen Studien und bei vielen Patienten war die Bedingung, dass zwei Nebenkriterien vorhanden sein müssen, nicht erfüllt. Wir schlagen hier zwei Gruppen von revidierten Diagnosekriterien für das SS vor. Dies geschieht mit dem Ziel, die Diagnose zu vereinfachen, Fehldiagnosen zu vermeiden und eine sofortige Behandlung zu ermöglichen. Die erste Gruppe umfasst konstante klinische und histopathologische Merkmale, die vorhanden sein müssen und die per se für die Diagnose eines SS ausreichen. Die zweite Gruppe enthält veränderliche Merkmale, deren Fehlen es nicht erlaubt, ein SS auszuschließen.
Delayed‐type hypersensitivity to oral and parenteral drugs
Authors: Brandt Oliver , Bircher Andreas J. 
Published: November 2017

SummaryAdverse drug reactions of the delayed type rank among the most common dermatoses and are predominantly characterized by exanthematous macular or maculopapular eruptions. However, approximately 2 % of affected individuals develop severe or even life‐threatening systemic immune reactions associated with organ involvement, requiring immediate diagnosis and treatment. Numerous drugs are capable of eliciting delayed‐type hypersensitivity reactions, with antibiotics, anticonvulsant drugs, and the xanthine oxidase inhibitor allopurinol being the most common. Apart from genetic susceptibility, predisposing factors for the development of drug hypersensitivity reactions include high drug doses, polypharmacy, long treatment duration, female gender, as well as acute or chronic infections.
A European, multicentre, retrospective, non‐interventional study (EU‐TREAT) of the effectiveness of insulin degludec after switching basal insulin in a population with type 1 or type 2 diabetes
Authors: Siegmund Thorsten , Tentolouris Nikolaos , Knudsen Søren T. , Lapolla Annunziata , Prager Rudolf , Phan Tra‐Mi , Wolden Michael L. , Schultes Bernd ,   for the EU‐TREAT study group
Published: November 2017

AimsTo evaluate the clinical effectiveness of switching to insulin degludec (IDeg) in insulin‐treated patients with either type 1 diabetes (T1DM) or type 2 diabetes (T2DM) under conditions of routine clinical care.Materials and MethodsThis was a multicentre, retrospective, chart review study. In all patients, basal insulin was switched to IDeg at least 6 months before the start of data collection. Baseline was defined as the most recent recording during the 3‐month period before first prescription of IDeg. Values are presented as mean [95%CI].ResultsT1DM (n = 1717): HbA1c decreased by −2.2 [−2.6; −2.0] mmol/mol (−0.20 [−0.24; −0.17]%) at 6 months vs baseline (P < .001). Rate ratio of overall (0.79 [0.69; 0.89]), non‐severe nocturnal (0.54 [0.42; 0.69]) and severe (0.15 [0.09; 0.24]) hypoglycaemia was significantly lower in the 6‐month post‐switch period vs the pre‐switch period (P < .001 for all). Total daily insulin dose decreased by −4.88 [−5.52; −4.24] U (−11%) at 6 months vs baseline (P < .001). T2DM (n = 833): HbA1c decreased by −5.6 [−6.3; −4.7] mmol/mol (−0.51 [−0.58; −0.43] %) at 6 months vs baseline (P < .001). Rate ratio of overall (0.39 [0.27; 0.58], P < .001), non‐severe nocturnal (0.10 [0.06; 0.16], P < .001) and severe (0.075 [0.01; 0.43], P = .004) hypoglycaemia was significantly lower in the 6‐month post‐switch period vs the pre‐switch period. Total daily insulin dose decreased by −2.48 [−4.24; −0.71] U (−3%) at 6 months vs baseline (P = .006). Clinical outcomes for T1DM and T2DM at 12 months were consistent with results at 6 months.ConclusionsThis study demonstrates that switching patients to IDeg from other basal insulins improves glycaemic control and significantly reduces the risk of hypoglycaemia in routine clinical practice.
Cannabinoid‐1 receptor deletion in podocytes mitigates both glomerular and tubular dysfunction in a mouse model of diabetic nephropathy
Authors: Jourdan Tony , Park Joshua K. , Varga Zoltán V. , Pálóczi János , Coffey Nathan J. , Rosenberg Avi Z. , Godlewski Grzegorz , Cinar Resat , Mackie Ken , Pacher Pal , Kunos George 
Published: November 2017

AimsTo determine the specific role of podocyte‐expressed cannabinoid‐1 receptor (CB1R) in the development of diabetic nephropathy (DN), relative to CB1R in other renal cell types.Material and methodsWe developed a mouse model with a podocyte‐specific deletion of CB1R (pCB1Rko) and challenged this model with streptozotocin (STZ)‐induced type‐1 DN. We also assessed the podocyte response to high glucose in vitro and its effects on CB1R activation.ResultsHigh glucose exposure for 48 hours led to an increase in CB1R gene expression (CNR1) and endocannabinoid production in cultured human podocytes. This was associated with podocyte injury, reflected by decreased podocin and nephrin expression. These changes could be prevented by Cnr1‐silencing, thus identifying CB1R as a key player in podocyte injury. After 12 weeks of chronic hyperglycaemia, STZ‐treated pCB1Rko mice showed elevated blood glucose similar to that of their wild‐type littermates. However, they displayed less albuminuria and less podocyte loss than STZ‐treated wild‐type mice. Unexpectedly, pCB1Rko mice also have milder tubular dysfunction, fibrosis and reduction of cortical microcirculation compared to wild‐type controls, which is mediated, in part, by podocyte‐derived endocannabinoids acting via CB1R on proximal tubular cells.ConclusionsActivation of CB1R in podocytes contributes to both glomerular and tubular dysfunction in type‐1 DN, which highlights the therapeutic potential of peripheral CB1R blockade.
Right heart function in impaired left ventricular diastolic function: 2D speckle tracking echocardiography–based and Doppler tissue imaging–based analysis of right atrial and ventricular function
Authors: Brand Anna , Bathe Marny , Oertelt‐Prigione Sabine , Seeland Ute , Rücke Mirjam , Regitz‐Zagrosek Vera , Stangl Karl , Knebel Fabian , Stangl Verena , Dreger Henryk 
Published: November 2017

AimThe aim of our study was to describe right atrial (RA) and right ventricular (RV) function, assessed by Doppler tissue imaging and 2D speckle tracking echocardiography (2DSTE), in women with signs of early impaired left ventricular diastolic function (DD).Methods and ResultsIn a cross‐sectional trial, standard parameters of diastolic and right heart function were investigated in 438 women of the Berlin Female Risk Evaluation (BEFRI) study. In a subset of women, average peak systolic RA strain (RAS), as well as the average peak systolic RV strain of the free wall (RVS free wall) and of all RV segments (average RV strain; RVS Avg), was analyzed using 2DSTE. Compared to women with normal diastolic function (DD0), RAS, RVS free wall and RVS Avg were significantly reduced in DD (43.1% ± 11.9%, −26.7% ± 5.6%, and −23.3% ± 3.5% in DD0; vs 35.1% ± 10.4%, −23.9% ± 5.5%, and −20.6% ± 3.8% in DD; P < .01). Peak RV myocardial velocity (RV‐IVV) and acceleration during isovolumetric contraction (RV‐IVA) were markedly higher in DD (15.0 ± 3.9 cm/s and 3.1 ± 1.0 m/s² in DD vs 11.9 ± 3.2 cm/s and 2.8 ± 0.8 m/s² in DD0; P < .05). RAS and RV‐IVV were significantly associated with DD after adjustment to age, BMI, and left atrial strain in multivariate regression analysis.ConclusionSystolic right heart function is significantly altered in DD. DTI as well as 2DSTE constitute sensitive echocardiographic tools that enable the diagnosis of impaired right heart mechanics in early‐staged DD.
Study of bone metabolism and angiogenesis in patients undergoing high‐dose chemotherapy/autologous hematopoietic stem cell transplantation
Authors: Boutsikas Georgios , Terpos Evangelos , Papatheodorou Athanasios , Tsirkinidis Pantelis , Tsirigotis Panayiotis , Meletiou Anastasia , Lalou Eleni , Telonis Vasileios , Zannou Anna , Kanellopoulos Alexander , Galani Zacharoula , Stefanou Angeliki , Tsaftaridis Panayiotis , Viniou Nora‐Athina , Panayiotidis Panayiotis , Kyrtsonis Marie‐Christine , Meletis John , Vassilakopoulos Theodoros P. , Angelopoulou Maria K. 
Published: November 2017

AbstractObjectivesAs the interaction between hematopoietic stem cells (HSCs) and endosteal and endothelial niches in HSCs homing is essential, we aimed to study bone turnover and angiogenesis in 29 patients with lymphoma/multiple myeloma undergoing hematopoietic stem cell transplantation (HSCT).MethodsSerum samples were collected before high‐dose chemotherapy (HDT), at the end of HDT, after HSC infusion, at the nadir of myelotoxicity, and at engraftment. Bone metabolism (CTX, TRACP‐5b, bALP, OC, DKK1, RANKL, OPG), and angiogenesis (Ang1, Ang2) markers were measured. These markers were also measured in 21 control patients before and after conventional chemotherapy.Results and ConclusionsBone resorption declined during HSCT (decrease in TRACP‐5b [P < .001] and CTX [P = .006]). Bone formation declined as well (decrease in bALP and OC [P < .001 for both]). RANKL/OPG ratio, an indicator of osteoclastic activation, did not change significantly (P = .5). Ang1/Ang2 ratio, a vessel equilibrium marker, decreased significantly (P < .001) suggesting endothelial destabilization. The changes observed in the control group were similar except of bALP and RANKL/OPG ratio. Moreover, Ang1/Ang2 ratio on the day after HSC infusion strongly correlated with time to neutrophil and platelet engraftment (P < .001 for both). Conclusively, bone turnover and vessel destabilization represent important events during HSCT probably reflecting the effect of chemotherapy.
Cost–effectiveness analysis of interventions for prevention of invasive aspergillosis among leukemia patients during hospital construction activities
Authors: Combariza Juan F. , Toro Luis F. , Orozco John J. , Arango Marcos 
Published: November 2017

AbstractObjectivesInvasive Aspergillosis (IA) is a serious problem among hematological patients and it is associated with high mortality. This situation can worsen at times of hospital construction, however there are several preventive measures available. This work aims to define the cost‐effectiveness of some of these interventions.Patients and methodsA decision tree model was used, it was divided into four arms according to each 1 of the interventions performed. A cost‐effectiveness incremental analysis comparing environmental control measures, high efficiency particulate absorption (HEPA) filter installation and prophylaxis with posaconazole was done. Probabilistic and deterministic sensitivity analyses were also carried out.ResultsAmong 86 patients with 175 hospitalization episodes, the incidence of IA with environmental protection measures, antifungal prophylaxis and hospitalization in rooms with HEPA filters was 14.4%, 6.3% and 0%, respectively. An Incremental Cost Effectiveness Ratio analysis was performed and it was found that HEPA filtered rooms and environmental protection measures are cost saving interventions when compared with posaconazole prophylaxis (−$2665 vs −$4073 vs $42 531 US dollars, respectively) for IA episode prevented.ConclusionThe isolation of inpatients with acute leukemia during hospital construction periods in HEPA filtered rooms could reduce the incidence of IA and might be a cost‐effective prevention strategy.
Predictors of symptomatic intracranial haemorrhage in off‐label thrombolysis: an analysis of the Safe Implementation of Treatments in Stroke registry
Authors: Mundiyanapurath S. , Hees K. , Ahmed N. , Wahlgren N. , Uhlmann L. , Kieser M. , Ringleb P. A. , Hacke W. , Nagel S. 
Published: November 2017

Background and purposeIntravenous thrombolysis (IVT) is the only approved pharmacological treatment for acute ischemic stroke. Off‐label IVT for ischemic stroke is common. We aimed to analyse its safety in a large database.MethodsThis was a retrospective analysis of the safe implementation of treatments in stroke (SITS) thrombolysis registry with regard to 11 off‐label criteria according to the European licence for alteplase. Symptomatic intracranial haemorrhage (SICH) according to SITS was defined as primary safety endpoint and SICH according to the European Cooperative Acute Stroke Study (ECASS II) definition and the National Institute of Neurological Disorders and Stroke definition as secondary safety endpoints. Multivariable logistic regression analyses after replacing missing values using multiple imputations were performed.ResultsPatients from 793 centres in 44 countries were included, mainly (95%) in Europe. A total of 56 258 patients who were treated with intravenous alteplase were included. Median age was 71 (IQR 61–78) years and median National Institutes of Health Stroke Scale score was 12 (IQR 7–17). A total of 16 740 (30%) patients received off‐label IVT and 1037 (1.8%) patients suffered from SICH according to the SITS definition (SICH SITS). Median percentage of missing values per variable was 0.4%. The only two off‐label criteria constituting independent positive and negative predictors for SICH SITS were high blood pressure (odds ratio, 1.39; 95% confidence interval, 1.08–1.80; P = 0.012) and minor stroke (odds ratio, 0.51; 95% confidence interval, 0.33–0.78; P = 0.002). Very severe stroke, previous stroke and diabetes, age and high glucose levels were additional independent predictors of SICH according to the ECASS II and National Institute of Neurological Disorders and Stroke definitions.ConclusionsThrombolysis appears to be safe with regard to SICH for most of the off‐label criteria, especially for minor stroke, but is risky in patients with high blood pressure. Individual risk–benefit evaluation should be performed.
Methodological standards for in vitro models of epilepsy and epileptic seizures. A TASK1‐WG4 report of the AES/ILAE Translational Task Force of the ILAE
Authors: Raimondo Joseph V. , Heinemann Uwe , de Curtis Marco , Goodkin Howard P. , Dulla Chris G. , Janigro Damir , Ikeda Akio , Lin Chou‐Ching K. , Jiruska Premysl , Galanopoulou Aristea S. , Bernard Christophe 
Published: November 2017

SummaryIn vitro preparations are a powerful tool to explore the mechanisms and processes underlying epileptogenesis and ictogenesis. In this review, we critically review the numerous in vitro methodologies utilized in epilepsy research. We provide support for the inclusion of detailed descriptions of techniques, including often ignored parameters with unpredictable yet significant effects on study reproducibility and outcomes. In addition, we explore how recent developments in brain slice preparation relate to their use as models of epileptic activity.
Harmonization in preclinical epilepsy research: A joint AES/ILAE translational initiative
Authors: Galanopoulou Aristea S. , French Jacqueline A. , O'Brien Terence , Simonato Michele 
Published: November 2017

SummaryAmong the priority next steps outlined during the first translational epilepsy research workshop in London, United Kingdom (2012), jointly organized by the American Epilepsy Society (AES) and the International League Against Epilepsy (ILAE), are the harmonization of research practices used in preclinical studies and the development of infrastructure that facilitates multicenter preclinical studies. The AES/ILAE Translational Task Force of the ILAE has been pursuing initiatives that advance these goals. In this supplement, we present the first reports of the working groups of the Task Force that aim to improve practices of performing rodent video–electroencephalography (vEEG) studies in experimental controls, generate systematic reviews of preclinical research data, and develop preclinical common data elements (CDEs) for epilepsy research in animals.