bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prosthetic Arteriovenous Grafts for Hemodialysis
Authors: Akoh Jacob A. 
Published: January 2018

Introduction Prosthetic arteriovenous (AV) grafts are indicated in patients with failed AV fistula (AVF), exhausted superficial veins or unsuitable vessels. Increasing the proportion of prevalent hemodialysis (HD) patients using autogenous AVF should reduce the need for AV grafts and associated morbidity. This paper reviews the current role of prosthetic AV grafts in vascular access for HD. Technical considerations Prior to the insertion of a prosthetic AV graft, a comprehensive review of previous access procedures and full physical examination in addition to vessel mapping is required. Anastomotic technique should take into account the flow diffuser concept, graft geometry and an anastomotic angle of 15° in order to reduce the incidence of intimal hyperplasia. Results Many authors report 1 and 2-yr cumulative graft patency rates of 59–90% and 50–82%, respectively. The major drawbacks with synthetic grafts include: thrombosis, a five-fold increase in infection risk and steal syndrome. The choice between surgical and percutaneous methods of dealing with blocked AV grafts remains controversial, though percutaneous techniques are assuming an increasingly important role. Percutaneous strategies are successful in declotting access in 67–95% of cases. Stenting of stenotic lesions following thrombectomy improves secondary patency rates. Strategies for dealing with AV graft infection include antibiotic prophylaxis, partial, subtotal or total graft excision and the use of biological prosthesis. Conclusions Though more prone to complications than autogenous AVFs, AV grafts offer a short maturation period and are more amenable to thrombectomy by radiological or surgical means. Complex AV grafts may be appropriate in patients with exhausted access sites.
Eyelid arteriovenous malformation treated with pre-surgical embolization: A case report
Authors: Juszkat Robert , Żabicki Bartosz , Stanistawska Katarzyna , Szepelak Karolina , Kądziołka Bartosz , Sosnowski Piotr , Kocięcki Jarosław 
Published: January 2018

Background Arteriovenous malformations are potentially serious vascular anomalies that are rarely encountered in the eyelid and require a multidisciplinary approach. Objectives We would like to describe the technical and clinical aspects related to the treatment of palpebral arteriovenous malformation with selective embolization, followed by surgical resection. Methods A 40-year-old patient presented with an isolated high-flow palpebral arteriovenous malformation. Transarterial embolization, using a liquid embolic agent (PHIL™), was performed in this patient. Results Angiographic and clinical follow-up revealed good results with clinical regression of the mass. Conclusion Although endovascular treatment of palpebral arteriovenous malformations is technically challenging, good functional and cosmetic result was achieved. Arteriovenous malformation embolization using PHIL™ seems to be very effective and makes subsequent surgical procedure safe and feasible. Level IV Evidence obtained from multiple time series with or without the intervention, such as case studies. Dramatic results in uncontrolled trials might also be regarded as this type of evidence.
Effect of Antibiotic Treatment on Serum PSA and Percent Free PSA Levels in Patients with Biochemical Criteria for Prostate Biopsy and Previous Lower Urinary Tract Infections
Authors: Lorente J.A. , Arango O. , Bielsa O. , Cortadellas R. , Gelabert-Mas A. 
Published: January 2018

Background Controversy exists as to the influence of inflammatory foci on total and free prostate-specific antigen (PSA) concentrations. The objective was to analyze the biological variations of PSA and percent free PSA (%f-PSA) in patients with biochemical criteria for prostate biopsy (PSA higher than 4 ng/mL and normal rectal examination) and compare them with the variation induced by antibiotic treatment in a cohort of patients with a history of lower urinary tract infections and no clinical evidence of prostatitis. Methods Ninety patients with a history of lower urinary tract infections, non-suspicious digital rectal examination and PSA between 4 and 20 ng/mL were analyzed. PSA concentration and %f-PSA were determined. Forty-five patients were treated with three weeks of ofloxacin, following which marker determination was repeated. All patients underwent ultrasound-controlled transrectal six-core prostate biopsy. Results Sixty-seven patients presented benign prostatic hyperplasia (BPH) (30 with prostatitic foci) and 23 cancer. Significant variations in PSA (6.97 ng/mL vs. 5.82 ng/mL, p=0.001) and %f-PSA (14.84% vs. 17.53%, p=0.01) were found only in the treated patients. These differences were significant for patients with BPH-associated prostatitic foci and not for patients with BPH or cancer. The tendency was for PSA to decrease (15 treated patients with PSA <4 ng/mL vs. six non-treated patients) and for %f-PSA to increase. The median variation of %f-PSA was greater than that of PSA. When the cutoff for %f-PSA was set at 25%, 18.9% of unnecessary biopsies after the first determination and 20% after the second could be avoided. By associating the reduction in PSA, up to 46% could be avoided in treated patients. Conclusion Biochemical criteria for prostate biopsy may be modified in patients with a history of lower urinary tract infections due to variations greater than those explained by intraindividual biological variations, and may be influenced by the antibiotic treatment. These results suggest that subclinical inflammatory foci may influence PSA and %f-PSA.
Osteoprotegerin and Receptor Activator of Nuclear Factor-κB Ligand (RANKL) in the Serum of Healthy Adults
Authors: Jung K. , Lein M. , Hösslin K. v. , Grosse A. , Roth S. , Possinger K. , Lüftner D. 
Published: January 2018

Aims Osteoprotegerin and the receptor activator of the nuclear factor-κB ligand (RANKL) are decisive factors for maintaining the balance between bone formation and bone resorption. As new, sensitive ELISAs have been developed recently, reference serum ranges should be established to use these analytes for possible diagnostic purposes. Methods Measurements were performed in serum samples of 142 healthy adults (82 women, 60 men) between 20 and 70 years of age (mean age: 46 years) using ELISA kits from Immundiagnostik, Bensheim, Germany. Results Serum concentrations of osteoprotegerin were age and gender independent and showed a Gaussian distribution, while RANKL concentrations were also age independent but differed between males and females, with a non-Gaussian distribution. For osteoprotegerin a gender-independent upper 97.5 percentile limit of 3.6 pmol/L was calculated while the corresponding limits for RANKL and the ratio of RANKL to osteoprotegerin amounted to 3.29 pmol/L and 2.78 in women and 1.66 pmol/L and 2.18 in men, respectively. Conclusions Both osteoprotegerin and RANKL were quantifiable in serum of healthy adults, which means that these compounds can be used as potential diagnostic tools.
Negative CEA values in Metastatic Colorectal Carcinoma and the Likelihood of Complete Chemotherapy Response
Authors: Tomasevic Z. , Jelic S. , Nikolic L. , Filipovic I. , Stamatovic L. , Radosavljevic D. 
Published: January 2018

Introduction Experimental results reported in the literature have suggested that CEA might inhibit host defense mechanisms and that immunotolerance to CEA could play an important role in the development of metastases in colorectal carcinoma. It might therefore be assumed that negative CEA values during metastatic disease represent a favorable prognostic factor. Surprisingly, there are very few data available about negative CEA. The aim of this study was to determine the significance of negative initial CEA values in patients with metastatic colorectal carcinoma. Patients and Methods Initial CEA values were determined in 114 patients with metastatic colorectal carcinoma. The patients were divided into three groups according to these values: I (n=22) <5 ng/mL; II (n=33) 5-100 ng/mL; III (n=59) >100 ng/mL. Results Seven/114 complete responses (CR), 22/114 partial responses (PR), 45/114 instances of stable disease (SD) and 38/114 of progressive disease (PD) were registered, while two patients were not evaluable. There were six long-lasting CRs (median 24 months, range 10–37 months) in the CEA-negative patient subset, while in the CEA-positive subset there was only one CR, in a patient with an initial CEA level of 18 ng/mL. The mean initial CEA values in the different response categories were: CR: 4.0 ng/mL; PR: 436 ng/mL; SD: 1442 ng/mL; PD: 6071 ng/mL. The likelihood of response, in particular CR, was highly dependent upon CEA levels (Fisher's exact test, 0.00001). The median survival decreased significantly with increased values of CEA (p=0.006). Conclusion Negative CEA in metastatic disease was the main characteristic of the patient subset capable of attaining CR. When relapsing, all patients but one became CEA positive.
CD44v10: An Antimetastatic Membrane Glycoprotein for Pancreatic Cancer
Authors: Navaglia F. , Fogar P. , Greco E. , Basso D. , Stefani A.L. , Mazza S. , Zambon C.-F. , Habeler W. , Altavilla G. , Amadori A. , Cecchetto A. , Plebani M. 
Published: January 2018

Aims The aims of this study were 1) to investigate the mRNA pattern of CD44 variants in three primary (MIA PaCa 2, PANC-1, PSN-1) and two metastatic (CAPAN-1, SUIT-2) pancreatic cancer (PC) cell lines; 2) to ascertain whether the genetic transfer of CD44s and CD44v10 modifies the adhesion of PC cells to the extracellular matrix (ECM) in vitro and their metastatic behavior in vivo. Methods CD44 mRNA analysis was done by means of RT-PCR. Adhesion to ECM the was assessed using coated microtiter plates. For the study of CD44v10 insertion in the CAPAN-1 line, liposome-mediated DNA transfer was used. SCID mice were employed for in vivo experiments. Results CD44v10 mRNA was not expressed by the CAPAN-1 nor by four of the six SUIT-2-derived clones. The stable expression of CD44v10 by modified CAPAN-1 significantly enhanced fibronectin adhesion. Mice without either liver or pancreatic metastases were more frequently found among the animals injected with modified (CD44v10 expressing) than with non-modified CAPAN-1. Conclusions 1) It is possible to differentiate between metastatic and non-metastatic PC cells on the basis of CD44v10 expression; 2) CD44v10 seems to be involved in mediating fibronectin adhesion in vitro and in counteracting metastases in vivo.
Epidermal Growth Factor Receptor and c-erbB-2 Contents in Unresectable (UICC R1 or R2) Gastric Cancer
Authors: García I. , Del Casar J.M. , Corte M.D. , Allende M.T. , García-Muñiz J.L. , Vizoso F. 
Published: January 2018

Background Epidermal growth factor receptor (EGFR) and c-erbB-2 are membrane receptors expressed in a variety of solid human cancers and directly correlated with poor prognosis. The objective of this work was to evaluate the EGFR and c-erbB-2 levels in non-resectable gastric carcinomas, their possible relationship with a variety of clinicopathological tumor parameters, and their prognostic significance. Methods This was a prospective analysis of 65 patients with unresectable gastric carcinomas (UICC R1 or R2), who underwent palliative surgery and were followed up for a median period of 13 months. Membranous EGFR levels were examined by radioligand binding assays and cytosolic c-erbB-2 levels by means of an immunoenzymatic assay. Results There was a wide variability in EGFR (80.3-2910 fmol/mg of protein) and c-erbB-2 (0.4-10071 NHU/mg of protein) levels in neoplastic tissues from patients with unresectable gastric carcinomas. Median c-erbB2 was significantly higher in tumors of the intestinal type than in tumors of the diffuse type (p=0.035) and in R2 than in R1 tumors (p=0.016). Statistical analysis showed that there was no relationship between tumor c-erbB-2 or EGFR content and any other patient or tumor characteristics. However, high levels of EGFR were significantly associated with a shorter overall survival (p=0.01). Conclusion Our data suggest a role of both transmembrane proteins in the progression of gastric cancer. EGFR and c-erbB-2 contents in unresectable gastric cancer could be utilized as appropriate biological markers for selecting candidates for treatment based on EGFR and/or c-erbB-2 inhibition.
Cytosolic Levels of An Estrogen-Induced Breast Cancer-Associated Peptide (TFF1/pS2) in Colorectal Cancer: Clinical Significance and Relationship with Steroid Receptors
Authors: Vizoso F.J. , Fagilde M.C. , Corte M.D. , Corte M.G. , Gava R. , Bongera M. , Allende M.T. , García-Muñiz J.L. 
Published: January 2018

Background The Trefoil Factor 1 (TFF1/pS2), a peptide consisting of 60 amino acids, is the most abundant estrogen-induced messenger RNA in MCF-7 breast cancer cells and is also expressed by colorectal carcinomas. The objective of this work was to evaluate the cytosolic TFF1 content in colorectal carcinomas, its possible relationship with estrogen and progesterone receptors as well as with clinicopathological tumor parameters, and its potential prognostic significance. Methods Cytosolic TFF1 levels were examined by immunoradiometric assay in 178 patients with resectable colorectal cancer. The mean follow-up period was 32 months. Results There was a wide variability of cytosolic TFF1 levels in tumor-surrounding mucosa samples (0.09-42.5 ng/mg protein) as well as in tumors (0.01-270 ng/mg protein). Comparison of paired mucosa and carcinoma samples showed significantly higher TFF1 levels in tumors (mean: 17.1 ng/mg protein) than in mucosa samples (10 ng/mg protein) (p=0.027). TFF1 levels were significantly higher in mucosa samples surrounding distal colon and rectal tumors (p=0.0001) and in tumor samples obtained from older patients (p=0.007). However, there were no significant differences in tumor TFF1 levels with respect to clinicopathological parameters such as the patient's sex, tumor location, stage, histological grade, ploidy, S-phase, or tumor estrogen and progesterone receptors. In addition, there was no significant relationship between tumor TFF1 levels and disease outcome. Conclusions TFF1 may play an as yet undetermined role in the tumorigenesis of colorectal carcinomas. However, cytosolic levels of TFF1 do not seem to have any prognostic significance in colorectal carcinomas.
Prognostic value of Carcinoma-associated Antigen MK-1 in Urinary Bladder Carcinoma
Authors: EL-Kenawy A. EL-Meghawry , El-kott A.F. , Hamed S.M. , Kuroki M. 
Published: January 2018

Background The present study has been performed to evaluate the expression of MK-1 in schistosomiasis-associated squamous cell carcinoma of the urinary bladder and to correlate this new marker with the conventional histopathological parameters. Patients and methods Paraffin sections of 5-μm thickness from 81 cases were prepared for hematoxylin and eosin staining and immunohistochemical analysis of MK-1 expression was carried out. Results Forty-six cases (56.8%) were positive for MK-1 protein expression. Significant correlations between MK-1 expression and tumor grade (p=0.004), schistosoma (p=0.031), DNA ploidy (p=0.001), and tumor recurrence (p<0.001) were observed. MK-1, sex, tumor grade, stage, schistosoma, DNA ploidy, and recurrence were evaluated in relation to outcome. Univariate and multivariate analysis of survival were performed. The overall 5-year survival was 51.85%. In univariate analysis, MK-1 expression, tumor grade, DNA ploidy, and recurrence had a significant impact on the survival of these patients. In a Cox proportional hazards model, recurrence maintained its significant impact on survival. Conclusions These findings suggest that MK-1 is a prognostic marker for recurrence: 34 (87.2%) of 39 recurrent cases were positive for MK-1 expression. However, only recurrence was an independent prognostic factor in patients with schistosomiasis-associated squamous cell carcinoma of the bladder.
Nephrology eConsults for Primary Care Providers: Original Investigation
Authors: Keely Erin , Li Jennifer , Magner Peter , Afkham Amir , Liddy Clare 
Published: January 2018

Background: The Champlain BASE™ (Building Access to Specialists through eConsultation) eConsult service allows primary care providers (PCPs) to submit patient-specific clinical questions to specialists via a secure web service. Objective: Our objective was to describe the types of nephrology questions asked through an eConsult service based in eastern Ontario and assess the service’s impact on the need for face-to-face consultations. Design: Cross-sectional study using descriptive statistics was conducted using nephrology cases submitted between May 2011 and January 2015. Specialist response times and referral avoidance were collected. Validated taxonomies were used to categorize cases based on question type and content. Setting: Patient cases were collected from PCPs in Ottawa, Ontario, and its surrounding communities and submitted to nephrologists at the Ottawa Hospital. Patients: During the study period, 155 eConsults were submitted to nephrology. Measurement: Utilization and survey data were collected for all eConsults. Questions were categorized by subject matter and question type. Results: A traditional consult visit was avoided in 45% of cases based on the specialist’s advice; 21% cases required referral. Thirty-two percent of eConsults took specialists less than 10 minutes to complete, 55% took 10 to 15 minutes, 11% took 15 to 20 minutes, and only 2% took more than 20 minutes. Twenty-five percent of cases were related to proteinuria, 18% to chronic kidney disease (CKD), 17% to imaging, and 12% to drug use in CKD. Common question types included general management (37%), interpretation of laboratory test (17%), interpretation of an image report (13%), and need for nephrology referral (11%). Limitations: Some consults contained multiple categories and question types. Our analyses required a single classification, which may underestimate the number of questions in each category. Our study had a small sample size using cases completed in a single health jurisdiction, limiting generalizability. Conclusions: The Champlain BASE™ eConsult service provided guidance to PCPs and reduced the number of face-to-face nephrology consultations.
Prevalence of Anaplasma phagocytophilum infection in feral cats in Massachusetts
Authors: Galemore Erin R , Labato Mary A , O’Neil Elizabeth 
Published: January 2018

Objectives The primary objective of this study was to determine the prevalence of Anaplasma phagocytophilum infection and exposure in adult feral cats in Massachusetts, an endemic area for A phagocytophilum and its tick vector Ixodes scapularis. The secondary objective was to determine if there were correlations between A phagocytophilum infection and the presence of anemia and thrombocytopenia. Methods Blood samples were collected between June and December 2015 from 175 apparently healthy adult feral cats that were presented to trap and release spay/neuter centers in Massachusetts. Complete blood count, blood smear evaluation, SNAP 4Dx Plus test (IDEXX) and A phagocytophilum PCR were performed on all samples to document acute infection (PCR-positive and/or inclusions observed on blood smear) and exposure to A phagocytophilum (SNAP 4Dx Plus-positive for A phagocytophilum antibodies). Results The prevalence of exposure to A phagocytophilum in feral cats in Massachusetts was 9.7%, whereas the prevalence of acute infection was 6.9%. All blood smears were negative for Anaplasma species inclusions; therefore, acute infection was defined as testing positive on PCR analysis. No statistically significant correlations were identified for cats that were positive for A phagocytophilum on PCR analysis or SNAP 4Dx Plus test and the presence of anemia or thrombocytopenia. Conclusions and relevance The prevalence of A phagocytophilum exposure in feral cats approaches 10% and is higher than the previously reported national average prevalence of 4.3% in the USA. A phagocytophilum infection may be an emerging infectious disease in cats. Further research is needed to determine the prevalence of clinical illness associated with A phagocytophilum infection in cats living in endemic areas.
Scapular Dyskinesis in Young, Asymptomatic Elite Swimmers
Authors: Preziosi Standoli Jacopo , Fratalocchi Francesco , Candela Vittorio , Preziosi Standoli Tiziano , Giannicola Giuseppe , Bonifazi Marco , Gumina Stefano 
Published: January 2018

Background: Overhead athletes are at a greater risk of developing scapular dyskinesis (SD). Although swimming is considered an overhead sport, information regarding SD in these athletes is scarce. Purpose: To determine the prevalence of SD in young, asymptomatic elite swimmers. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 661 asymptomatic elite swimmers were enrolled in this study (344 male, 317 female; mean age, 15.83 ± 2.20 years). Anthropometric characteristics, training routine, and stroke specialty were recorded. SD was assessed using a dynamic test consisting of an examination of the shoulder blades throughout synchronous forward flexion motion in the sagittal plane and was deemed to be either present or absent. Each movement was repeated 5 times. These evaluations were performed with athletes at rest, before any training or competition. Statistical analysis was performed. Results: SD was detected in 56 (8.5%) participants. Type I SD was the most common (46.5%); male participants were 2 times as likely to have SD as female participants (39 male, 17 female; P < .01). No correlation was found between the dominant limb and side affected ( P = .258); rather, a correlation was found between the breathing side and side affected, in that swimmers with a preferred breathing side were more prone to develop SD in the opposite shoulder ( P < .05). Swimmers involved in long-distance races were found to have a greater risk of developing SD ( P = .01). Conclusion: SD may be an asymptomatic condition in elite young swimmers and is present in 8.5% of these athletes. Early diagnosis may be useful for asymptomatic athletes with SD and to avoid its possible evolution to a symptomatic condition.