bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abiraterone acetate and prednisone in the pre- and post-docetaxel setting for metastatic castration-resistant prostate cancer: a mono-institutional experience focused on cardiovascular events and their impact on clinical outcomes
Authors: Cavo Alessia , Rubagotti Alessandra , Zanardi Elisa , Fabbroni Chiara , Zinoli Linda , Di Meglio Antonio , Arboscello Eleonora , Bellodi Andrea , Spallarossa Paolo , Cattrini Carlo , Messina Carlo , Boccardo Francesco 
Published: January 2018

Background: The aim of this work was to to evaluate the incidence and risk factors of adverse events (AEs), focusing on cardiovascular events (CVEs) and hypokalemia, in patients treated with abiraterone acetate (AA) and prednisone (PDN) outside clinical trials, and their association with survival outcomes. Methods: This was a retrospective cohort study of 105 patients treated from 2011 to 2016. Incidence of AEs was descriptively summarized in the whole cohort and by subgroup (pre- versus post-docetaxel). Multivariable Cox proportional hazards models assessed factors associated with progression-free survival (PFS) and overall survival (OS). Results: Overall, median PFS and OS were 14.9 and 24.6 months, respectively. Prostate-specific antigen (PSA) ⩾ 10 ng/ml ( p = 0.007), Gleason Score >7 ( p = 0.008), Eastern Cooperative Oncology Group (ECOG) performance status (PS)1–2 ( p = 0.002), duration of androgen deprivation therapy (ADT) ⩽ 43.2 months ( p = 0.01), and body mass index (BMI) > 25 ( p = 0.03) were associated with worse PFS; presence of pain ( p = 0.01), ECOG PS1–2 ( p = 0.004), duration of ADT ⩽ 43.2 ( p = 0.05), and BMI > 25 ( p = 0.042) were associated with worse OS. Incidence of CVEs was as follows: hypertension 17.1%, fluid retention 4.8%, cardiac disorders 8.6%. 16.2% of patients developed hypokalemia. Age ⩾ 75 years was associated with higher probability of cardiac disorders ( p = 0.001) and fluid retention ( p = 0.03). CVEs did not impact on PFS or OS. Hypokalemia was associated with better median OS ( p = 0.036). Similar associations were observed after stratification by subgroup. Conclusions: Median PFS and OS estimates and incidence of CVEs and hypokalemia in our series are consistent with those of pivotal trials of AA plus PDN, confirming the efficacy and safety of this regimen also in the real-world setting. Elderly patients have higher odds of developing/worsening CVEs. However, regardless of age, CVEs were not associated with worse outcomes. Treatment-related hypokalemia seemed to be associated with longer OS, albeit this finding needs confirmation within larger, prospective series.
Gender difference with the use of percutaneous left ventricular assist device in patients undergoing complex high-risk percutaneous coronary intervention: From pVAD Working Group
Authors: Doshi Rajkumar , Singh Avneet , Jauhar Rajiv , Meraj Perwaiz M 
Published: January 2018

Background:The interventional treatment of complex high-risk indicated patients is technically difficult and can result in poor outcomes. Thus, percutaneous left ventricular assist devices are being increasingly used to provide hemodynamic support. No data is available comparing male and female for Complex High-risk Indicated Patients treated with percutaneous left ventricular assist devices. Our goal was to evaluate in-hospital as well as short term outcomes comparing males and females.Methods:There were 160 complex high-risk indicated patients with percutaneous left ventricular assist device use who were not in cardiogenic shock. A total of 132 male and 28 female patients were included. Ejection fraction below 35% with one additional criterion such as use of atherectomy device or treatment on unprotected left main disease or multi-vessel disease were our inclusion criteria. An Impella 2.5 or Impella CP (Abiomed Inc.) device was used as a left ventricular support device.Results:There was no difference in in-hospital mortality between the genders after performing a propensity score matched analysis (8.3% vs. 12.5%, p=0.54). Secondary outcomes of myocardial infarction, cardiogenic shock, congestive heart failure, dysrhythmia, major adverse cardiac events and composite of all complications were higher in males. Furthermore, 30-day survival was similar in males and females (88.9% vs. 87.5%, p=0.31). In addition, worse complications rates and survival were noted in patients with incomplete revascularization compared with those patients with complete revascularization in both gender.Conclusion:This study demonstrated no gender difference in clinical outcomes when using percutaneous left ventricular assist device support for the treatment of complex high-risk indicated patients. Overall, males had higher secondary outcomes compared with females with no difference in in-hospital mortality or 30-day survival rates.
Results of surveillance in individuals at high‐risk of pancreatic cancer: A systematic review and meta‐analysis
Authors: Signoretti Marianna , Bruno Marco J , Zerboni Giulia , Poley Jan-Werner , Delle Fave Gianfranco , Capurso Gabriele 
Published: January 2018

BackgroundData on surveillance for pancreatic ductal adenocarcinoma (PDAC) in high‐risk individuals (HRIs) with “familial pancreatic cancer” (FPC) and specific syndromes are limited and heterogeneous.ObjectiveWe conducted a systematic review and meta‐analysis of PDAC surveillance studies in HRIs.MethodsPrevalence of solid/cystic pancreatic lesions and of lesions considered a successful target of surveillance (proven resectable PDAC and high‐grade precursors) was pooled across studies. The rate of lesions diagnosed by endoscopic ultrasonography (EUS)/magnetic resonance imaging (MRI) and across different HRI groups was calculated.ResultsSixteen studies incorporating 1588 HRIs were included. The pooled prevalence of pancreatic solid and cystic lesions was 5.8% and 20.2%, respectively. The pooled prevalence of patients with lesions considered a successful target of surveillance was 3.3%, being similar to EUS or MRI and varying across subgroups, being 3% in FPC, 4% in hereditary pancreatitis, 5% in familial melanoma, 6.3% in hereditary breast/ovarian cancer, and 12.2% in Peutz‐Jeghers syndrome. The pooled estimated rate of lesions considered a successful target of surveillance during follow‐up was 5/1000 person‐years.ConclusionSurveillance programs identify successful target lesions in 3.3% of HRIs with a similar yield of EUS and MRI and an annual risk of 0.5%. A higher rate of target lesions was reported in HRIs with specific DNA mutations.
Mechanical Circulatory Support for the Failing Fontan: Conversion to Assisted Single Ventricle Circulation—Preliminary Observations
Authors: Peer Syed M. , Deatrick Kristopher B. , Johnson Thomas J. , Haft Jonathan W. , Pagani Francis D. , Ohye Richard G. , Bove Edward L. , Rojas-Peña Alvaro , Si Ming-Sing 
Published: January 2018

Background: Mechanical circulatory support (MCS) of a failing Fontan circulation remains challenging. We hypothesized that MCS can be provided by converting the Fontan circulation into a mechanically assisted single ventricle parallel circulation (MASVC). Methods: A porcine model of functionally univentricular circulation was created under cardiopulmonary bypass (CPB) by performing an atrial septectomy, tricuspid valvectomy, and interrupting antegrade pulmonary blood flow. A centrifugal flow pump was placed with inflow from the common atrium. Eight millimeter Dacron grafts anastomosed to the ascending aorta and main pulmonary artery supplied systemic (Qs) and pulmonary (Qp) blood flow. Ultrasonic flow probes were used to measure Qs and Qp after weaning from CPB. The Qp/Qs ratio was regulated using an adjustable clamp. Hemodynamic and laboratory data were recorded. Results: All four animals were successfully weaned from CPB onto the MASVC for a duration of two hours. Mechanically assisted single ventricle parallel circulation achieved satisfactory hemodynamics. As anticipated, the arterial oxygen saturation and partial pressure of oxygen in arterial blood were lower in the MASVC compared to baseline biventricular circulation. At the conclusion of the study, there was a trend towards a decrease in the mixed venous saturation with increasing oxygen extraction compared to the baseline. Serum lactate levels increased after weaning from CPB and did not return to baseline after two hours of support. Conclusion: Mechanically assisted single ventricle parallel circulation can be established in a single ventricle animal model. This strategy could potentially provide MCS of a single ventricle circulation. Studies with longer duration of support are required to assess adequacy of support and long-term sustainability.
Evaluation of Factors Associated With Achievement of Biventricular Repair After Bilateral Pulmonary Artery Banding in Patients With Interrupted Aortic Arch
Authors: Hirano Yasuhiro , Inamura Noboru , Kawazu Yukiko , Aoki Hisaaki , Kayatani Futoshi , Iwai Shigemitsu , Kawata Hiroaki 
Published: January 2018

Background: At our institution, we perform bilateral pulmonary artery banding (BPAB) as the first-stage palliation for interrupted aortic arch (IAA) with low birth weight or severe subaortic stenosis (SAS). The present study aimed to identify factors that may influence the decision regarding the type of second-stage operation, that is, univentricular palliation or biventricular repair, in these patients. Methods: Cardiac catheterization and angiographic data of nine patients with IAA who underwent initial BPAB and subsequent univentricular or biventricular repair were retrospectively analyzed. Results: Between 2004 and 2014, of nine patients with IAA who underwent initial BPAB, biventricular repair was subsequently performed in six patients (group B) and univentricular repair in three patients (group U). All patients survived. There was no significant intergroup difference in IAA classification, location of ventricular septal defect, presence of 22q11.2 deletion, presence of aberrant right subclavian artery, band diameter, or post-BPAB pulmonary artery pressure and index. Timing of BPAB and the body weight at the time of BPAB, however, differed significantly between the groups ( P = .02). Catheter data before BPAB were not significantly different between the groups, with the exception of the degree of subaortic stenosis (or hypoplasia of the left ventricular outflow tract) expressed as percentage of the normal end-systolic aortic valve annular diameter for patient body surface area. This metric (%SAS before BPAB) was significantly higher in group B (60%-68%) than in group U (47%-60%; P = .04). Among patients for whom baseline %SAS was < 60%, the %SAS did not increase after BPAB. Conclusion: The most important factor that allowed biventricular repair was not the pulmonary artery pressure or diameter but the degree of SAS. Patients who initially had more severe SAS ultimately underwent univentricular repair due to lack of substantial improvement in dimensions of the left ventricular outflow tract after BPAB.
Endotoxin Activity in Neonates Undergoing Cardiac Surgery: Cohort Study
Authors: Ricci Zaccaria , Benegni Simona , Garisto Cristiana , Favia Isabella , Haiberger Roberta , Di Chiara Luca 
Published: January 2018

Background: Endotoxemia in pediatric cardiac surgical patients is poorly understood. The endotoxin activity assay (EAA) levels were examined in neonates undergoing cardiac surgery in order to assess their reference levels and their association with other pre-, intra-, and postoperative risk factors for gut hypoperfusion. We finally observed if refeeding was associated with modification of endotoxin levels. Methods: In a prospective cohort study, neonates undergoing surgery for correction or palliation were enrolled. Preterm birth, weight below 1.5 kg, the need for extracorporeal membrane oxygenation, and urgent surgery were exclusion criteria. Results: Among the 26 enrolled neonates, 12 underwent on-pump and 14 off-pump surgery, 22 received a preoperative infusion of prostaglandin E2. Overall, 11 patients were surgically corrected and 15 received a palliation. Endotoxin activity assay baseline levels were inversely correlated with age at surgery ( r = −.50, P = .006) and they increased to postoperative day2 ( P = .002). On-pump versus off-pump surgery ( P =.36) and surgical palliation with a Blalock-Taussig shunt versus correction ( P = .45) did not predict increase in EAA levels. Aortic clamping for coarctation repair was associated with the lowest levels ( P = .04). Systolic, mean, and diastolic pressures were associated with EAA levels ( r = −.55, P = .01; r = −.45, P = .02; r = −.37, P = .04, respectively). Endotoxin activity assay levels after refeeding were similar to baseline levels. Patients with abdominal distension and feeding intolerance showed higher median peak EAA levels (0.7, 0.66-1.11) than asymptomatic patients (0.53, 0.35-0.64; P = .01). Conclusions: Endotoxin activity assay levels increase after elective neonatal surgery and are not modified by refeeding. High postoperative levels may predict feeding intolerance.
Prognostic factors in pontine haemorrhage: A systematic review
Authors: Behrouz Réza 
Published: January 2018

Background Pontine haemorrhage comprises approximately 10% of intracerebral haemorrhages. There is a common presumption that pontine haemorrhage is inherently associated with poor outcome. Purpose The aim of the review was to identify chief predictors of prognosis in (pontine haemorrhage) through systematic review of published literature. Methods A query of PubMed/MEDLINE was conducted in search of studies in English language since, 1980 focusing specifically on outcome in pontine haemorrhage. References for each publication were reviewed for additional studies not detected by the PubMed/MEDLINE probe. Surgical outcome studies were excluded from the review. Findings The query identified 7867 titles, after removal of duplicates and irrelevant studies, 20 titles were included in the review. In a total of 1437 pontine haemorrhage patients included in the 20 studies, the overall rate for early all-cause mortality was 48.1%. Level of consciousness on admission and haemorrhage size were the most consistent predictors of mortality in patients with pontine haemorrhage. Haemorrhage localisation within the pons was also a prognostic factor, but not consistently. Age and intraventricular extension were not found to be powerful prognostic predictors. Discussion/Conclusion Based on this review, level of consciousness on admission and haemorrhage size were the most influential prognostic factors in pontine haemorrhage, whereas age, haemorrhage localisation, and intraventricular haemorrhage did not consistently predict prognosis.
Casein kinase 1 is a therapeutic target in chronic lymphocytic leukemia
Authors: Janovska Pavlina , Verner Jan , Kohoutek Jiri , Bryjova Lenka , Gregorova Michaela , Dzimkova Marta , Skabrahova Hana , Radaszkiewicz Tomasz , Ovesna Petra , Vondalova Blanarova Olga , Nemcova Tereza , Hoferova Zuzana , Vasickova Katerina , Smyckova Lucie , Egle Alexander , Pavlova Sarka , Poppova Lucie , Plevova Karla , Pospisilova Sarka , Bryja Vitezslav 
Published: January 2018

Key PointsCK1 inhibition significantly blocks microenvironmental interactions of CLL cells. CK1 inhibition slows down development of CLL-like disease in the Eμ-TCL1 mouse model.
3D geostatistical inversion of induced polarization data and its application to coal seam fires
Authors: Soueid Ahmed Abdellahi , Revil André , Jardani Abdel , Chen Rujun 
Published: January 2018

We applied the principal component geostatistical approach (PCGA) to the inversion of time-domain induced polarization data in terms of resistivity and chargeability distributions. The PCGA presents two major advantages over standard methods: (1) It avoids the storage of the usually large covariance matrix, which contains the geostatistical information, by factorizing it in a product of low-rank matrices. (2) It does not assemble the Jacobian matrix per se. We determine the robustness of this approach with three examples. We first reconstruct the electrical conductivity and chargeability fields of two synthetic models generated using the geostatistical software Stanford Geostatistical Modeling Software. The PCGA approach performs better than the Tikhonov-based regularization approach when the true fields are very heterogeneous and the amount of data is limited. The third example is devoted to a field study over the former Lewis coal mine in Colorado (USA). We perform a 3D localization of the burning front of this coal seam fire by applying our geostatistical inverse methodology to a time-domain induced-polarization data set. In this case, the horizontal components of the semivariogram are determined from a self-potential map and the correlation length scale for the vertical component is determined from the known thickness of the coal bed. The tomogram presents a high normalized chargeability associated with the burning front. We evaluate the high normalized chargeability of the burning front in terms of the physical mechanism associated with the cation exchange capacity of the coal and the effect of temperature. This demonstrates the potential of the geostatistical inversion and its suitability for inverting geophysical data, especially when the data density is sparse. In the case of coal seam fires, we determine the suitability of the induced polarization method to localize the burning front and the effect of temperature on the normalized chargeability.
Psychotherapeutic interventions and contemporary developments: common and specific factors
Authors: Burbridge-James William , Iwanowicz Maciej 
Published: January 2018

SUMMARYIn this article we start with the effectiveness paradox between different psychotherapeutic modalities, considering common factors, before moving on to give a brief overview of the three main psychotherapeutic approaches – psychoanalytic, cognitive–behavioural and humanistic – and their developments. We conclude that it is the therapeutic relationship – considered in the context of the above – that is core to all therapeutic engagement, medical or otherwise.LEARNING OBJECTIVES•Refresh knowledge of three main psychotherapies•Understand the equivalence paradox: common and specific factors•Understand the development of contemporary psychotherapeutic approachesDECLARATION OF INTERESTNone
Psychodynamic approaches to suicide and self-harm
Authors: Yakeley Jessica , Burbridge-James William 
Published: January 2018

SUMMARYRates of suicide and self-harm are rising in many countries, and it is therapeutically important to explore the personal stories and relationships that underlie this behaviour. In this article psychoanalytic and psychodynamic principles and concepts in relation to violence towards the self are introduced and the various unconscious meanings of suicide and self-harm are explored within a relational context and attachment framework. We describe how a psychodynamic approach may enhance the risk assessment and treatment of patients presenting with self-harm and suicidality, particularly examining the role of transference and countertransference within the therapeutic relationship.LEARNING OBJECTIVES•Understand historical and contemporary psychoanalytic theories and concepts regarding the aetiology of suicide and self-harm•Understand the different meanings and expressions of acts of suicide and self-harm•Understand the use of countertransference in the risk assessment and management of self-harm and suicide attemptsDECLARATION OF INTERESTNone.
Chaining, culture and values: ethical issues in research in middle- and low-income countries
Authors: Hughes Julian C. 
Published: January 2018

SummaryA paper in this month'sBritish Journal of Psychiatryreports on research from Ghana where some participants were exposed to chaining, which raises ethical concerns. Strict boundaries need to exist between researchers and cruel, inhuman or degrading treatment. Nevertheless, there may be things we can learn from other cultures about our own values.Declaration of interestNone.
Guardianship under the Mental Health Act 1983
Authors: Shaw Jenny , Hatfield Barbara , Evans Sherrill 
Published: January 2018

Aims and MethodTo describe the extent and variation in the use of Guardianship nationally. The Directors of Social Services were asked to provide details about Guardianship cases on two separate occasions one year apart.ResultsThere were 428 new Guardianship cases in 12 months. At the second enumeration, 73% of cases were within the mental illness category and 47% of these had serious mental illness.Clinical ImplicationsThere is much variation in the use of Guardianship. Further developments of this study will explore the reasons for this variation and will ascertain clinicians' views on Guardianship, supervised discharge and other community treatment orders.
Pressure on adult acute psychiatric beds
Authors: Greengross Peter , Hollander Doris , Stanton Richard 
Published: January 2018

Aims And MethodTo quantify perceived problems with psychiatric bed availability nationally using a questionnaire survey of all 210 UK mental health trusts.ResultsOne hundred and seventy-three (82%) trusts replied. Thirty (17%) are often over-occupied, 21 (15%) often have problems with bed availability. Ten (7%) often use extra-contractual referrals (ECRs). Frequent over-occupancy is associated with deprivation. Frequent use of ECRs is associated with relatively few beds.Clinical ImplicationsProblems with bed availability are found nationwide, but outside southern England are relatively infrequent. Such problems are less pronounced than in Greater London.
An audit of anti-muscarinic drug use at the State Hospital
Authors: Steele Jonathan , Duncan Janice , Short Angela 
Published: January 2018

Aims and MethodThis paper is based on two audits carried out in 1996 and 1998 atThe State Hospital, Carstairs. Each audit looked at anti-muscarinic drug use within the hospital, in relation to approved prescribing standards issued in 1996. All patients within the hospital on anti-muscarinic drugs were identified at the timeof each audit. These prescriptions were compared with the approved prescribing standards. In the 1998 audit additional information was obtained from the case notes and the consultants, when the approved standards were not met.ResultsThe percentage of patients on regular anti-muscarinic drugs, falling outwith the prescribing standards, reduced between the two audits. However, in 1998 a small number of patients were still outwith the approved prescribing standards set in 1996.ConclusionsAn improvement in the prescribing practice of anti-muscarinics occurred following the introduction of prescribing guidelines. However, the guidelines were not fully met in the 1998 audit. This demonstrates the need for further audit and continued monitoring of anti-muscarinic prescription at the State Hospital.