bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effective Out-of-Operating Room Airway Management for Physicians Not Traditionally Trained in Airway Management
Authors: Kessler Chad S. , Tristano Jenny M. , Dignan Mary Ann , Xie Hui , Stallings Leonard A. , Albrecht Ronald F. 
Published: May 2016

Background There is a dearth of literature about the safety and practicality of intubation performed by an internal medicine (IM) or any other nonanesthesia, nonemergency physician. Objectives The objectives of the study were to describe abbreviated airway management training guidelines for IM physicians staffing the emergency department and to compare the success rates between intubations performed by anesthesia and IM physicians, respectively. Methods In this study, 272 consecutive out-of-operating room intubations performed by anesthesia and IM physicians were evaluated after creating and implementing an abbreviated intubation training protocol. Results Of 165 intubations attempted by IM physicians and 107 intubations attempted by the anesthesia service, the rates of successful intubation were 93% and 99%, respectively ( P = 0.02). There were no other statistically significant differences in outcomes. Conclusions Procedurally oriented IM fellows could provide a temporary solution to hospitals that currently do not have the resources to provide full-time, in-house anesthesiology or emergency physicians for management of the emergent airway.
The Evaluation of Hypoxia-Inducible Factor 1 in N-Nitro-L-Arginine Methyl Ester Preeclampsia Model of Pregnant Rats
Authors: Kaya Ali , Boztosun Abdullah , Seckin Hulya , Guven Ahmet Sami , Kucukdurmaz Zekeriya , Gulturk Sefa , Cevit Omer 
Published: May 2016

Objective The objective of the study was to evaluate hypoxia-inducible factor 1 (HIF-1), which plays a major role in the stimulation of angiogenesis in placental tissues, by using immunohistochemical staining in preeclampsia model of rats, developed by N-nitro-L-arginine methyl ester (L-NAME) Methods Thirty pregnant rats were randomized into 2 groups (n = 15 in each group) on day 10 of gestation. L-NAME was given to rats in the study group by gavage. On days 0, 10, and 20 of gestation, rats were weighted, and urine protein values and blood pressures were measured. Hypoxia-inducible factor 1 expressions were assessed with immunohistochemical staining by using avidin-biotin peroxidase via selecting preparation. Results Systolic and diastolic blood pressures and urine protein value of L-NAME group on day 20 of gestation were found to be significantly higher than those obtained on days 0 and 10 of gestation in the same group and those obtained on day 20 of gestation in the sham group ( P < 0.05). Maternal weight, number of fetuses, and mean fetal weight of rats in L-NAME group on day 20 of gestation were found to be significantly lower than those obtained from rats in the sham group ( P < 0.05). Regarding HIF-1 expression of placental tissues, mild immunohistochemical staining was found in 2 rats (13.4%) and moderate in 13 rats (86.6%) in the L-NAME group. A significant difference was found in terms of HIF-1 positivity in the maternal placentas of both groups ( P < 0.05). Conclusions L-NAME preeclampsia model of pregnant rats is consistent with human preeclampsia in terms of hypertension, proteinuria, and intrauterine growth retardation; in addition, it also shows evidence of placental hypoxia findings.
Conductive Energy Devices: A Review of Use and Deaths in the United States
Authors: Nugent Kenneth , Bagdure Satish , Otahbachi Mohammad , Cevik Cihan 
Published: May 2016

Background Conductive energy devices (CEDs) have been temporally associated with morbidity and mortality in police work, but the frequency of use and of complications is not certain. Methods This is a literature review using PubMed and Google Scholar searches to identify population-based CED studies, studies reporting morbidity and mortality with CEDs, and studies in healthy volunteers. Results Recent studies indicate that CEDs are used approximately 83 to 338 times per million population per year in the United States. The subjects have a typical profile, including young men with belligerent or bizarre behavior who often have a psychiatric disorder or are intoxicated with drugs. The mortality estimates range from 0.0% to 1.4% of subjects controlled with CEDs. Limited information from autopsy studies indicates that death is frequently associated with confounding factors, especially intoxication with illicit drugs. Conclusions Conductive energy devices are used frequently during police work and are associated with a low but definite mortality rate. The use of CEDs and the management of at-risk subjects need more study.
High Rates of Intestinal Colonization with Extended-Spectrum Lactamase-Producing Enterobacteriaceae among Healthy Individuals
Authors: Abdul Rahman Eiman Mohammed , El-Sherif Rasha Hamed 
Published: May 2016

Background Infections caused by extended-spectrum β-lactamase (ESBL)-producing bacteria become an emerging problem in the community setting in many parts of the world. Objective The objective of the study was to determine fecal carriage of ESBL-producing organisms in a community setting. Methods A total of 632 fecal specimens from healthy individuals were screened for ESBL using the agar screening test with MacConkey agar plates supplemented with 1 μg/mL of cefotaxime for selection of ESBL-producing strains and confirmed by the Clinical Laboratory Standards Institute combined disk method. Results Four hundred isolates (63.3%) were ESBL producers. Two hundred eighty-five isolates (71.25%) of them were Escherichia coli and 96 (24.0%) Klebsiella pneumoniae. Conclusion We concluded that the community could be a reservoir of these ESBL-producing bacteria and enzymes.
Clostridium difficile Infection is Associated with Poor Outcomes in End-Stage Renal Disease
Authors: Pant Chaitanya , Deshpande Abhishek , Anderson Michael P. , Sferra Thomas J. 
Published: May 2016

Objective To investigate the association of Clostridium difficile infection (CDI) with the outcomes of hospitalized patients with end-stage renal disease (ESRD). Methods We extracted all adult cases with a discharge diagnosis of ESRD or CDI from the United States Nationwide Inpatient Sample 2009 database. Outcome variables (mortality, length of hospital stay [LOS], and hospitalization charges), demographic information, and comorbidity data were collected. Data were evaluated by univariate and multiple regression analyses. Results We identified 184,139 cases with ESRD of which 2.8% had CDI. Comparison of patients with ESRD + CDI to those with only ESRD revealed in-hospital mortality (13.2% vs 5.3%; P < 0.001), LOS (17.3 vs 7.1 days; P < 0.001), and charges ($124,846 vs $56,663; P < 0.001) to be more than 2-fold greater. In the ESRD cohort (ESRD only and ESRD + CDI), CDI was independently associated with greater mortality (adjusted odds ratio, 2.15; 95% CI, 2.07–2.24; P < 0.001), longer LOS (mean difference, 9.4 days; 95% CI, 9.2–9.5; P < 0.001), and higher charges (mean difference, $62,824; 95% CI, 61,615–64,033; P < 0.001). Conclusions Clostridium difficile infection is associated with significantly worse outcomes in hospitalized patients with ESRD.
Association of Genetic Polymorphisms in the Paraoxonase 1 Gene with the Risk and Prognosis of Non–Small Cell Lung Cancer in Chinese Han Population
Authors: Wang Hui , Li Lin , Ding Li , Zhang Zijin , Pu Chun 
Published: May 2016

Objective Oxidative stress and free radicals have been indicated to be associated with increased risk of various cancers. Paraoxonase 1 ( PON1) gene, encoding PON1 protein, plays an important role as an endogenous free-radical scavenging molecule. The aim of the present study was to determine whether genetic polymorphisms of the PON1 gene are associated with the risk and prognosis of non–small cell lung cancer (NSCLC). Methods A total of 356 patients with NSCLC and 184 healthy controls were enrolled in this study. Q192R and L55M polymorphisms of the PON1 gene were genotyped using polymerase chain reaction and restriction fragment length polymorphism method. Results As for the Q192R polymorphism, the patients with NSCLC showed higher frequencies of QR and RR genotypes than the normal controls. Unconditional logistic regression analysis revealed that QR and RR genotypes were significantly associated with the presence of NSCLC compared with the QQ genotype. No significant differences were found in the genotypes of the L55M polymorphism between the patients with NSCLC and the healthy controls. The QR and RR genotypes were significantly associated with TNM stage and nodal metastasis. Survival analysis indicated that the patients with NSCLC with the QR and RR genotypes had poorer disease-free survival than those with the QQ genotype ( P = 0.011). Multivariable Cox regression analysis revealed that QR and RR genotypes were an independent factor for the prognosis of NSCLC (hazard ratio, 1.505; 95% confidence interval, 1.004–2.256; P = 0.048). Conclusion The Q192R polymorphism of the PON1 gene may be associated with the risk and prognosis of NSCLC in a Chinese Han population.
Serum Levels of Angiopoietin-Related Growth Factor (AGF) are Increased in Polycystic Ovary Syndrome
Authors: Boztosun Abdullah , Deveci Köksal , Kiliçli Fatih , Söylemez Melike Sinem , Muhtaroğlu Sabahaddin , Müderris &Idot;ptisam &Idot;pek 
Published: May 2016

Background Polycystic ovary syndrome (PCOS) is a frequent reproductive and metabolic disorder associated with insulin resistance. Recently, angiopoietins were identified in the systemic circulation and have been designated angiopoietinlike proteins (ANGPTL). More recently, it is shown that angiopoietin-related growth factor (AGF, also called ANGPTL6) directly regulate lipid, glucose, and energy metabolism independent of angiogenic effects in animal studies. The aim of this study was to determine whether there is an association between AGF and PCOS. Methods The study included 35 patients with PCOS and 30 healthy control women. We analyzed serum levels of AGF and other biochemical and anthropometric markers in all the subjects. Results This study showed that serum AGF levels were significantly higher in the subjects with PCOS (102.28 ng/mL) than those in the healthy control group (63.08 ng/mL; P < 0.001). Body mass index (24.33 vs 22.11 kg/m2; P = 0.017), free testosterone (2.81 vs 2.17 pmol/L; P = 0.009), androstenedione (3.28 vs 2.92 nmol/L; P = 0.033), 17-hydroxyprogesterone (2.72 vs 2.09 ng/mL; P = 0.039), homeostasis model of assessment-insulin resistance (2.65 vs 1.9; P = 0.016), and fasting glucose (107.09 vs 96.18 mmol/L; P = 0.001) were found significantly higher in PCOS group than in control group. But there was no correlation between AGF and these parameters in PCOS group. In addition, no correlation between the AGF and other distinctive features of PCOS was found. Conclusions Serum AGF levels were paradoxically increased in patients with PCOS in comparison with data of animal experiments. Further studies are needed to better elucidate the physiologic significance of circulating AGF in human disease.
Serum Cytokines and Cancer in Involuntary Weight Loss
Authors: Baicus Cristian , Caraiola Simona , Rimbas Mihai , Patrascu Ruxandra , Baicus Anda 
Published: May 2016

Background Tumor necrosis factor α (TNF-α), interleukin 1β (IL-1β), and IL-6 may be associated with involuntary weight loss in patients with and without cancer. However, results of previous studies have been conflicting. We evaluated patients who had involuntary weight loss to determine cytokine levels and the correlation of these cytokines with weight loss, the association with inflammation, and the potential for use in cancer diagnosis. Materials and Methods In 290 consecutive patients with involuntary weight loss (74 patients [26%] with cancer and 216 patients [74%] without cancer), erythrocyte sedimentation rate (ESR), and serum levels of C-reactive protein, TNF-α, IL-1β, and IL-6 were determined. Results Higher ESR and levels of C-reactive protein, TNF-α, IL-1β, and IL-6 were associated with cancer. The levels of TNF-α, IL-1β, and IL-6 did not correlate with the amount of weight loss. In multivariable analysis, only ESR was associated with cancer. Conclusions In patients with involuntary weight loss, TNF-α, IL-1β, and IL-6 were associated with cancer but were not weight loss mediators.
Effect of Insulin versus Triple Oral Therapy on the Progression of Hepatic Steatosis in Type 2 Diabetes
Authors: Lingvay Ildiko , Roe Erin D. , Duong Jonathan , Leonard David , Szczepaniak Lidia S. 
Published: May 2016

Background Hyperinsulinemia has been associated with hepatic fat deposition and ensuing insulin resistance. It is unknown if treatment with exogenous insulin in patients with type 2 diabetes, who are most prone to hepatic fat accumulation, would promote the occurrence or worsening of nonalcoholic fatty liver disease. Methods Patients with treatment-naive type 2 diabetes (N = 16) were treated with insulin and metformin for a 3-month lead-in period, then assigned triple oral therapy (metformin, glyburide, and pioglitazone) or continued treatment with insulin and metformin. Hepatic triglyceride content (HTC)—measured by magnetic resonance spectroscopy, serum lipids, glucose, liver function tests, and inflammatory and thrombotic biomarkers were followed for a median of 31 months. Results The 45% decline in HTC during the lead-in period persisted through the follow-up period with no difference between treatment groups at the end of the study (5.26 ± 4.21% in the triple oral therapy vs 7.47 ± 7.40% for insulin/metformin), whereas glycemic control was comparable. Conclusions Improvements in HTC with initial insulin/metformin therapy persisted through the median 31-month follow-up period regardless of the treatment. More importantly, insulin-based treatment did not appear to promote or worsen nonalcoholic fatty liver disease.
MicroRNA-30b-5p is Involved in the Regulation of Cardiac Hypertrophy by Targeting CaMKIIδ
Authors: He Juan , Jiang Shan , Li Feng-lan , Zhao Xue-jiao , Chu Er-fu , Sun Mei-na , Chen Ming-zi , Li Hui 
Published: May 2016

Background MicroRNAs (miRNAs) participate in the regulation of cardiac hypertrophy. However, it remains largely unknown as to how miRNAs are integrated into the hypertrophic program. Ca2+/calmodulin-dependent protein kinase II (CaMKII) is a hypertrophic signaling marker. It is not yet clear which miRNAs can regulate CaMKIIδ. Purpose In this study, we identified which miRNAs could regulate CaMKIIδ and how to regulate CaMKIIδ. Methods Through computational and expression analyses, miR-30b-5p was identified as a candidate regulator of CaMKIIδ. Quantitative expression analysis of hypertrophic models demonstrated significant down-regulation of miR-30b-5p compared with control groups. Luciferase reporter assay showed that miR-30b-5p could significantly inhibit the expression of CaMKIIδ. Moreover, through gain-of-function and loss-of-function approaches, we found miR-30b-5p could negatively regulate the expression of CaMKIIδ and miR-30b-5p was a regulator of cardiac hypertrophy. Conclusion Our study demonstrates that the expression of miR-30b-5p is down-regulated in cardiac hypertrophy, and restoration of its function inhibits the expression of CaMKIIδ, suggesting that miR-30b-5p may act as a hypertrophic suppressor.
Fasting Glucose Level Modulates Cell Surface Expression of CD11b and CD66b in Granulocytes and Monocytes of Patients with Type 2 Diabetes
Authors: Horvath Peter , Oliver Stacy R. , Ganesan Goutham , Zaldivar Frank P. , Radom-Aizik Shlomit , Galassetti Pietro R. 
Published: May 2016

Introduction Cardiovascular complications are the leading cause of mortality in type 2 diabetes (T2DM), in which onset and progression of atherosclerosis is linked to chronic inflammation. Activation status of innate immune cells (granulocytes [Gc], monocytes [Mc]), as reflected by increased CD11b, CD66b, and other surface markers, increases their endothelial and cytokines/chemokines release. Whereas this inflammatory activation seems inversely related to poor glycemic control, the effect of acute spontaneous hyperglycemia on innate immune cell activation remains unclear. Methods Expression of key markers (CD11b, CD14, CD16, CD62L, and CD66b) was therefore determined by flow cytometry on whole blood of healthy subjects and patients with T2DM with spontaneous fasting euglycemia or hyperglycemia both at baseline and after 30, 90, and 240 minutes of incubation at room temperature. Results Hyperglycemic patients with T2DM had significantly higher Gc and Mc CD11b and Gc CD66b surface mean fluorescence intensity compared with the euglycemic patients with T2DM whose values were similar to those of the healthy controls. CD16 expression in CD14+CD16+ Mc was elevated in all patients with T2DM, regardless of glycemic levels. Conclusion Our data suggest that whereas the presence of diabetes per se may have a proinflammatory effect, hyperglycemia seems to further acutely exacerbate innate cell inflammatory status and their consequent endothelial adhesion and vascular damage potential.
Trends in Hospitalizations of Children with Inflammatory Bowel Disease within the United States from 2000 to 2009
Authors: Pant Chaitanya , Anderson Michael P. , Deshpande Abhishek , Grunow John E. , O'Connor Judith A. , Philpott Jessica R. , Sferra Thomas J. 
Published: May 2016

Background The incidence and prevalence of pediatric inflammatory bowel disease (IBD) seems to be increasing in North America and Europe. Our objective was to evaluate hospitalization rates in children with IBD in the United States during the decade 2000 to 2009. Methods We analyzed cases with a discharge diagnosis of Crohn disease (CD) and ulcerative colitis (UC) within the Healthcare Cost and Utilization Project Kids’ Inpatient Database, Agency for Healthcare Research and Quality. Results We identified 61,779 pediatric discharges with a diagnosis of IBD (CD, 39,451 cases; UC, 22,328 cases). The number of hospitalized children with IBD increased from 11,928 to 19,568 (incidence, 43.5–71.5 cases per 10,000 discharges per year; P < 0.001). For CD, the number increased from 7757 to 12,441 (incidence, 28.3–45.0; P < 0.001) and for UC, 4171 to 7127 (15.2–26.0; P < 0.001). Overall, there was a significant increasing trend for pediatric hospitalizations with IBD, CD, and UC ( P < 0.001). In addition, there was an increase in IBD-related complications and comorbid disease burden ( P < 0.01). Conclusion There was a significant increase in the number and incidence of hospitalized children with IBD in the United States from 2000 to 2009.
Risk Factors for Obesity in Children and Adults
Authors: Siddarth Divya 
Published: May 2016

Objectives The purpose of this study was to determine whether modifiable lifestyle factors such as eating habits, physical activity, and screen-viewing time, as well as ethnicity, sex, and family income level, were associated with obesity in children and adults and whether the associations differed across age groups. Participants The data were drawn from the National Health and Nutrition Examination Survey 2009–2010. Results Multivariable logistic regression analyses were used, with obesity (defined as a body mass index of >30 kg/m2 for adults and ≥95th percentile for children of the same age and sex) as the outcome variable. For children, screen-viewing (TV/computer) time was the only significant factor; in contrast, for adolescents, eating habits were the only significant predictor. For young and middle-aged adults, lack of physical exercise and time spent in sedentary activities were the determinants of obesity, whereas for older adults, both eating habits and physical activity measures were related to obesity. Conclusions Distinct lifestyle factors have significant associations with obesity in different age groups, and this study underscores the need for age-specific intervention programs to address the obesity epidemic.
Classification of LDL Phenotypes by 4 Methods of Determining Lipoprotein Particle Size
Authors: Sninsky John J. , Rowland Charles M. , Baca Arthur M. , Caulfield Michael P. , Superko Harold Robert 
Published: May 2016

Background Low-density lipoprotein cholesterol (LDL-C) lowering is the primary objective of patient management for cardiovascular disease. However, large numbers of patients who have achieved their LDL-C goal remain at risk for cardiovascular events. Low-density lipoprotein subfractions may provide insight into this residual risk. Thus, LDL subfraction standardization and consistency are critical to these efforts. Aim This study aimed to determine the agreement of the analytical results among 4 methods commonly used for LDL subfractionation, namely, segmented gradient gel electrophoresis (sGGE), ultracentrifugation-vertical auto profile (VAP), nuclear magnetic resonance (NMR), and ion mobility (IM). Methods Blood samples were collected from 228 apparently healthy adults and sent to 4 clinical reference laboratories for analysis. The LDL phenotype was reported as pattern A (larger, less dense particles) or pattern B (smaller, more dense particles), respectively, and was the primary measure of comparison. An intermediate pattern (A/B) was also reported for sGGE and VAP. Results We observed complete agreement in the LDL phenotype among the 4 methods in 64% of subjects and agreement among at least 3 of the 4 methods in 87% of subjects. Agreement among pairs of methods ranged from 73% to 98% depending on how differences in reporting of subjects with intermediate results were considered. When subjects having intermediate A/B pattern were excluded, sGGE and IM had the highest agreement (98%) of any pair of methods. Conclusions We found substantial agreement in the reported LDL phenotype among 4 LDL subfraction measurement technologies as performed by different clinical reference laboratories.
Association of Asef and Cdc42 Expression to Tubular Injury in Diseased Human Kidney
Authors: Cheng Hui-Teng , Juang I Pu , Chen Liang-Chin , Lin Lih-Yuan , Chao Cheng-Han 
Published: May 2016

Background Cdc42 is a small guanosine-5′-triphosphatase of the Rho family and plays essential roles in the establishment of cellular polarity and tight junctions in epithelial cells. Adenomatous polyposis coli-associated exchange factor (Asef) is a canonical guanine nucleotide exchange factor of Cdc42 and renders Cdc42 to be guanosine-5′-triphosphate bound and activated. The expression patterns and their significance in human renal diseases are unknown. Methods We examined the expression of Cdc42 and Asef in kidney biopsy specimens of 15 patients and in normal kidney tissue using immunofluorescence and correlated the expression patterns with the clinical characteristics. We also analyzed the coexpression pattern of Ki-67, a marker indicating cell division, and Asef in selected patients. Results Expression of Asef and Cdc42 together was associated with tubular injury with 100% specificity. Expression of Asef, regardless of Cdc42, also showed a significant diagnostic odds ratio for the presence of the injury. Expression of Asef was associated with lower estimated glomerular filtration rate at the time of biopsy and larger area of interstitial fibrosis. All Ki-67–expressing tubular cells expressed Asef. Conclusions Induction of Asef and Cdc42 in the renal tubules is a cellular response to injury. Asef induction seems a necessary step for injured tubular cells to enter cell cycle.