bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hemophagocytic syndrome masquerading as septic shock: An approach to such dilemma
Authors: Hindi Zakaria , Khaled Abdallah A , Abushahin Ashraf 
Published: December 2017

Introduction: Hemophagocytic syndrome or hemophagocytic lymphohistiocytosis is a rare condition characterized by excessive inflammation that is thought to be caused by the absence of normal downregulation of activated macrophages and lymphocytes. The treatment of hemophagocytic lymphohistiocytosis can depend on whether it is primary or secondary. In secondary hemophagocytic lymphohistiocytosis, the treatment can be directed according to the cause. In general, protocol HLH-94 (which consists of dexamethasone and etoposide in induction and maintenance) has been widely used as it has good outcomes. Hemophagocytic lymphohistiocytosis and septic shock largely overlap which can lead to refractory septic shock and death if not treated. Unfortunately, there is no clear approach for such dilemma. Thereby, we would like to present our case as it has a valuable approach to hemophagocytic lymphohistiocytosis in the setting of sepsis. Case description: A 60-year-old female, with history of hypertension, came with fever, productive cough, and dyspnea; she was admitted for acute exacerbation of chronic obstructive pulmonary disease and was transferred to intensive care unit for septic shock. The patient progressed to refractory septic shock with no focus of infection. After further investigations, detailed history raised the suspicion of hemophagocytic lymphohistiocytosis; a bone marrow biopsy was collected and confirmed the diagnosis. The patient was on methylprednisolone while waiting for other investigation results and improved markedly. After ruling out secondary causes of hemophagocytic lymphohistiocytosis, she was switched to protocol-94 and continued to improve. Conclusion: It should be emphasized that septic shock, with or without focus of infection, overlaps with hemophagocytic lymphohistiocytosis and can consequently lead to refractory septic shock and death. Thus, our aim of this case is to encourage further investigations, specifically for hemophagocytic lymphohistiocytosis in the setting of septic shock of unknown origin, to decrease mortality rate. More importantly, early initiation of immunosuppression therapy may be a crucial step before switching to hemophagocytic lymphohistiocytosis–specific treatment.
A reduced esophageal epithelial integrity in a subgroup of healthy individuals increases with proton pump inhibitor therapy
Authors: Pauwels Ans , Broers Charlotte , Vanuytsel Tim , Pardon Nicolas , Cocca Silvia , Roman Sabine , Zerbib Frank , Tack Jan , Farré Ricard 
Published: December 2017

IntroductionApproximately 30% of healthy volunteers (HVs) show dilated intercellular spaces in the esophageal epithelium suggesting a functionally reduced epithelial integrity. We aimed to evaluate the presence of an altered epithelial integrity in HVs and whether physiological acid could explain such a difference.MethodsBiopsies for Ussing chamber experiments were taken between 3 cm and 5 cm proximal to the gastroesophageal junction. Twenty‐four‐hour impedance‐pH (MII‐pH) monitoring was performed in the same 15 HVs. MII‐pH tracings from 24 HVs before and after treatment with esomeprazole (40 mg b.i.d., two weeks), a proton pump inhibitor, were analyzed. Reflux parameters and impedance baseline (IB) at different levels of the esophagus were calculated.ResultsEpithelial integrity in the distal esophagus presents a large variability in vivo and in vitro (transepithelial electrical resistance 196.9 ± 16.27Ω. cm2; IB measurements 2022 ± 143.5Ω). Esomeprazole highly suppressed the total acid exposure time (AET) (1.9 (0.8–3.1) vs 0 (0–0)%, p < 0.0001). After splitting our participants into “high” and “low” IB, based on the median value, we observed only in the distal esophagus a higher total AET before (2.8 (1.6–4.8) vs 1.0 (0.5–2.2),p = 0.04) and increased IB values after esomeprazole (1620 (1347–1898) vs 2192 (1784‐2503)Ω, p = 0.002) in the “low” IB group.ConclusionA subgroup of HVs presents a low epithelial integrity in the distal esophagus probably due to the increased presence of physiological acid reflux. Whether these individuals have a higher chance to develop gastroesophageal reflux disease is unknown. The role of epithelial integrity in symptom perception needs to be further explored.
A model for predicting effect of treatment on progression-free survival using MRD as a surrogate end point in CLL
Authors: Dimier Natalie , Delmar Paul , Ward Carol , Morariu-Zamfir Rodica , Fingerle-Rowson Günter , Bahlo Jasmin , Fischer Kirsten , Eichhorst Barbara , Goede Valentin , van Dongen Jacques J. M. , Ritgen Matthias , Böttcher Sebastian , Langerak Anton W. , Kneba Michael , Hallek Michael 
Published: December 2017

Key Points
Meta-analysis of 3 randomized clinical trials shows a statistically significant relationship between treatment effects on PFS and MRD. Meta-regression model supports use of MRD as a primary end point in clinical trials of chemoimmunotherapy in CLL.
Observational long-term follow-up study of rapid food oral immunotherapy with omalizumab
Authors: Andorf Sandra , Manohar Monali , Dominguez Tina , Block Whitney , Tupa Dana , Kshirsagar Rohun A. , Sampath Vanitha , Chinthrajah R. Sharon , Nadeau Kari C. 
Published: December 2017

Abstract
Background
A number of clinical studies focused on treating a single food allergy through oral immunotherapy (OIT) with adjunctive omalizumab treatment have been published. We previously demonstrated safety and tolerability of a rapid OIT protocol using omalizumab in a phase 1 study to achieve desensitization to multiple (up to 5) food allergens in parallel, rapidly (7–36 weeks; median = 18 weeks). In the current long-term, observational study, we followed 34 food allergic participants for over 5 years, who had originally undergone the phase 1 rapid OIT protocol.

Methods
After reaching the maintenance dose of 2 g protein for each of their respective food allergens as a part of the phase 1 study, the long-term maintenance dose was reduced for some participants based on a pragmatic team-based decision. Participants were followed up to 62 months through standard oral food challenges (OFCs), skin prick tests, and blood tests.

Results
Each participant passed the 2 g OFC to each of their offending food allergens (up to 5 food allergens in total) at the end of the long-term follow-up (LTFU) study.

Conclusion
Our data demonstrate the feasibility of long-term maintenance dosing of a food allergen without compromising the desensitized status conferred through rapid-OIT.
Trial registration Registry: Clinicaltrials.gov. Registration numbers: NCT01510626 (original study), NCT03234764 (LTFU study). Date of registration: November 29, 2011 (original study); July 26, 2017 (LTFU study, retrospectively registered)
Feasibility of sustained response through long-term dosing in food allergy immunotherapy
Authors: Andorf Sandra , Manohar Monali , Dominguez Tina , Block Whitney , Tupa Dana , Kshirsagar Rohun A. , Sampath Vanitha , Chinthrajah R. Sharon , Nadeau Kari C. 
Published: December 2017

Abstract
Background
Clinical trials using oral immunotherapy (OIT) for the treatment of food allergies have shown promising results. We previously demonstrated the feasibility of desensitization for up to 5 food allergens simultaneously through OIT. In this observational study, we report the findings of long-term follow-up (LTFU) of the participants treated through a single site OIT phase 1 trial.

Methods
The participants (n = 46) were followed up to 72 months since the time they reached 2 g maintenance dose per food in the initial phase 1 trial. During the long-term maintenance dosing, participants continued or reduced the initial maintenance dose of food allergen protein to high (median 2 g protein) vs. low (median 300 mg protein). Participant follow-up included clinical monitoring, standardized OFCs, and in some cases, skin prick tests and measurement of allergen-specific IgE and IgG4.

Results
Irrespective of the high vs. low long-term maintenance dose during LTFU, all participants were able to ingest 2 g protein of each food allergen protein during OFCs performed at the end of our LTFU.

Conclusion
Our LTFU cohort of food OIT participants from a single site, phase 1 OIT study, supports the feasibility of sustained desensitization through long-term maintenance dosing.
Trial registration Registry: Clinicaltrial.gov. Registration numbers: NCT01490177 (original study); NCT03234764 (LTFU study). Date of registration: November 29, 2011 (original study); July 26, 2017 (LTFU study, registered)
Cognitive Functioning After Hematopoietic Cell Transplantation for Hematologic Malignancy: Results From a Prospective Longitudinal Study
Authors: Sharafeldin Noha , Bosworth Alysia , Patel Sunita K. , Chen Yanjun , Morse Emily , Mather Molly , Sun Canlan , Francisco Liton , Forman Stephen J. , Wong F. Lennie , Bhatia Smita 
Published: December 2017

Purpose Cognitive impairment is well-recognized after myeloablative allogeneic hematopoietic cell transplantation (HCT). However, cognitive functioning after reduced-intensity allogeneic or autologous HCT remains unclear. Methods A total of 477 HCT recipients (236 autologous, 128 reduced-intensity allogeneic, 113 myeloablative allogeneic) underwent standardized neuropsychologic testing before HCT and at 6 months and 1, 2, and 3 years after HCT. Ninety-nine frequency-matched healthy controls underwent testing at commensurate time points. Primary outcomes of the study were practice effect–adjusted domain-specific T scores and global deficit scores. Piecewise generalized estimating equation models were used to compare groups and to identify associated variables and post-HCT trends of cognitive impairment. Results Median age was 52 years (range, 18 to 74 years) for HCT recipients and 55 years (range, 19 to 73 years) for controls. Post-HCT scores were comparable between controls and autologous and reduced-intensity HCT recipients. Myeloablative HCT recipients had significantly lower ( P < .001) post-HCT scores than controls for executive function, verbal speed, processing speed, auditory memory, and fine motor dexterity. Pre-HCT to 6 months post-HCT scores did not change after reduced-intensity HCT but declined significantly for fine motor dexterity ( P < .001) after myeloablative HCT. However, pre-HCT to 3 years post-HCT scores declined significantly ( P < .003) in reduced-intensity HCT recipients for executive function, verbal fluency, and working memory. Older age, male sex, and lower education, income, and cognitive reserve were associated with post-HCT cognitive impairment. At 3 years post-HCT, global cognitive impairment was present in 18.7% of autologous and 35.7% of allogeneic HCT recipients. Conclusion Myeloablative allogeneic HCT recipients showed significant cognitive decline compared with healthy controls. Reduced-intensity allogeneic HCT recipients showed evidence of delayed decline. Cognitive functioning in autologous HCT recipients generally was spared. The study identified vulnerable subpopulations that could benefit from targeted interventions.
Risk of Hematologic Malignancies After Radioiodine Treatment of Well-Differentiated Thyroid Cancer
Authors: Molenaar Remco J. , Sidana Surbhi , Radivoyevitch Tomas , Advani Anjali S. , Gerds Aaron T. , Carraway Hetty E. , Angelini Dana , Kalaycio Matt , Nazha Aziz , Adelstein David J. , Nasr Christian , Maciejewski Jaroslaw P. , Majhail Navneet S. , Sekeres Mikkael A. , Mukherjee Sudipto 
Published: December 2017

Purpose To investigate the risk and outcomes of second hematologic malignancies (SHMs) in a population-based cohort of patients with well-differentiated thyroid cancer (WDTC) treated or not with radioactive iodine (RAI). Methods Patients with WDTC were identified from SEER registries. Competing risk regression analysis was performed to calculate the risks of SHMs that occurred after WDTC treatment and outcomes after SHM development were assessed. Results Of 148,215 patients with WDTC, 53% received surgery alone and 47% received RAI. In total, 783 patients developed an SHM after a median interval of 6.5 years (interquartile range, 3.3 to 11.2 years) from WDTC diagnosis. In multivariable analysis, compared with those undergoing thyroidectomy alone, RAI treatment was associated with an increased early risk of developing acute myeloid leukemia (AML; hazard ratio, 1.79; 95% CI, 1.13 to 2.82; P = .01) and chronic myeloid leukemia (CML; hazard ratio, 3.44; 95% CI, 1.87 to 6.36; P < .001). This increased risk of AML and CML after RAI treatment was seen even in low-risk and intermediate-risk WDTC tumors. Occurrence of AML but not CML in patients with WDTC was associated with shorter median overall survival compared with matched controls (8.0 years v 31.0 years; P = .001). In addition, AML developing after RAI trended toward inferior survival compared with matched controls with de novo AML (median overall survival, 1.2 years v 2.9 years; P = .06). Conclusion Patients with WDTC treated with RAI had an increased early risk of developing AML and CML but no other hematologic malignancies. AML that arises after RAI treatment has a poor prognosis. RAI use in patients with WDTC should be limited to patients with high-risk disease features, and patients with WDTC treated with adjuvant RAI should be monitored for myeloid malignancies as part of cancer surveillance.
The effect of uncertainty and cooperative behavior on operational performance: Evidence from Brazilian firms
Authors: Brito Eliane Pereira Zamith , Sambiase Marta Fabiano , Ferreira Fernando Coelho Martins , Da Silva Adilson Aderito 
Published: December 2017

This study aims to examine the effect of managers’ uncertainty on cooperative behavior in interorganizational relationships, and how this affects operational performance. We conducted a survey with 225 Brazilian managers, and analyzed data using confirmatory factor analysis and structural equation modelling. Results present: a) a negative influence of uncertainty of state on operational performance; b) a positive influence of uncertainty of effect on uncertainty of response; c) a significant influence of uncertainty of response on cooperative behavior; and d) a positive influence of cooperative behavior on performance. The results indicated that cooperation and uncertainty accounted for 18.8% of the variability of operational performance. Considering the uncertainty that plagues Latin societies, this study can help to create more efficient ways to deal with the phenomenon. Rather than turning a blind eye to uncertainty, our study underscores it and treats it like another business environment issue.
Positive bias for European men in peer reviewed applications for faculty position at Karolinska Institutet
Authors: Holst Sarah , Hägg Sara 
Published: December 2017

Background: Sweden is viewed as an egalitarian country, still most of the professors are Swedish and only 25% are women. Research competence is evaluated using peer review, which is regarded as an objective measure in the meritocracy system. Here we update the investigation by Wold & Wennerås (1997) on women researcher’s success rate for obtaining a faculty position, by examining factors (gender, nationality, productivity, etc.) in applications for an Assistant Professorship in 2014 at Karolinska Institutet. Methods: Fifty-six applications, 26 Swedish and 21 women applicants, were scored both on merits and projects by six external reviewers. Additional variables, including grants and academic age, calculated as the number of years since PhD excluding parental or sick leave, were gathered. Productivity was assessed by calculating a composite bibliometric score based on six factors (citations, publications, first/last authorships, H-index, high impact publication). Results: Overall, academic age was negatively correlated with scores on merits, as assessed by peer review, although not reaching statistical significance. In men, associations between scores on merits and productivity (P-value=0.0004), as well as having received grants (P-value=0.009) were seen. No associations were found for women. Moreover, applicants with a background from the Middle East were un-proportionally found in the lowest quartile (Fisher exact test P-value=0.007). Conclusions: In summary, the gender inequality shown in peer review processes in Sweden 20 years ago still exists. Furthermore, a bias for ethnicity was found. In order to keep the best scientific competence in academia, more efforts are needed to avoid selection bias in assessments to enable equal evaluations of all researchers.
Early life adiposity and telomere length across the life course: a systematic review and meta-analysis
Authors: Guyatt Anna L. , Rodriguez Santiago , Gaunt Tom R. , Fraser Abigail , Anderson Emma L. 
Published: December 2017

Background: The relationship between adiposity at birth and in childhood, and telomere length is yet to be determined. We aimed to systematically review and meta-analyse the results of studies assessing associations between neonatal and childhood adiposity, and telomere length. Methods: We searched Medline, EMBASE and PubMed for studies reporting associations between adiposity measured in the neonatal period or childhood, and leucocyte telomere length, measured at any age via quantitative polymerase chain reaction, or terminal restriction fragment analysis, either cross-sectionally, or longitudinally. Papers published before April 2017 were included. Results: Out of 230 abstracts assessed, 23 papers (32 estimates) were retained, from which 19 estimates were meta-analysed (15 cross-sectional, four longitudinal). Of the 15 cross-sectional estimates, seven reported on neonates: four used binary exposures of small-for-gestational-age vs. appropriate-for-gestational age (or appropriate- and large-for-gestational age), and three studied birth weight continuously. Eight estimates reported on childhood measures; five estimates were from studies of binary exposures (overweight/obese vs. non-obese children), and three studies used continuous measures of body mass index. All four longitudinal estimates were of neonatal adiposity, with two estimates for small-for-gestational-age vs. appropriate-for-gestational age neonates, and two estimates of birth weight studied continuously, in relation to adult telomere (49-61 years). There was no strong evidence of an association between neonatal or childhood adiposity, and telomere length. However, between study heterogeneity was high, and there were few combinable studies. Conclusions: Our systematic review and meta-analysis found no strong evidence of an association between neonatal or childhood adiposity and telomere length.
Immediate management of the single-unit extracted tooth in the anterior aesthetic zone – temporizing/stabilizing tissues
Authors: Bryce Graeme E , MacBeth Neil D , Hemmings Ken W 
Published: December 2017

The loss of a tooth within the aesthetic zone presents surgical and restorative challenges to the clinician. The immediate management of the extraction site must meet the patients' aesthetic aspirations whilst optimizing the healing of the alveolar bone and gingival tissues, to facilitate future definitive prosthetic replacement. Arrays of clinical approaches have been proposed to promote optimal tissue healing with these techniques often combining alveolar ridge preservation techniques, soft tissue grafting and transitional prosthodontic stages. The aim of this article is to update the dental clinician on the socket-healing process, provide guidance on the surgical and prosthodontic options available to the clinician and offer insight into differences in outcome. CPD/Clinical Relevance: This article is relevant to dental clinicians aiming to extract and restore single-tooth units.
Serendipity on bitewing radiographs
Authors: Celine Gregory , Wong Susan , Anthonappa Robert , King Nigel M 
Published: December 2017

An odontoma is described as a hamartoma, which is usually classified as a benign tumour. This clinical report will describe an unusual presentation of an odontoma in the mandibular primary molar region and highlight the importance of a comprehensive clinical and radiographic examination. A systematic approach to reading bitewing radiographs will also be described. CPD/Clinical Relevance: This clinical report serves as a good example to highlight the importance of thorough radiographic examination to enable detection of tooth abnormalities and facilitate timely interventions; thus preventing or reducing the severity of the potential complications.
Articaine-only buccal infiltrations for mandibular molar extractions: an alternative to inferior dental nerve blocks
Authors: Awal Danyal H , Yilmaz Zehra , Osailan Samira , Renton Tara 
Published: December 2017

This article assesses the efficacy of the articaine-only buccal infiltration technique (AOBIT) in providing LA for adult mandibular molar extractions. In 112 patients the AOBIT effectiveness was judged against the need for repeat or supplemental infiltrations and rescue 2% lidocaine inferior dental blocks (IDBs). Sufficient anaesthesia was achieved in 57% of patients using the AOBIT, with another 27% requiring an additional dose via the AOBIT. The remaining 16% required a rescue 2% lidocaine IDB. The AOBIT could be a suitable alternative to 2% lidocaine IDBs for routine adult mandibular molar extractions, and may subsequently reduce the incidence of LA-related nerve injury. CPD/Clinical Relevance: Debilitating nerve injury in relation to the administration of IDBs may be more common than we think. This article assesses the articaine-only buccal infiltration technique (AOBIT) as an alternative in providing local anaesthesia for routine adult mandibular molar extractions.
The immune system: basis of so much health and disease: 7. antibodies
Authors: Scully Crispian , Georgakopoulou Eleni A , Hassona Yazan 
Published: December 2017

The immune system is the body's primary defence mechanism against infections, and disturbances in the system can cause disease if the system fails in defence functions (in immunocompromised people), or if the activity is detrimental to the host (as in auto-immune and auto-inflammatory states). A healthy immune system is also essential to normal health of dental and oral tissues. This series presents the basics for the understanding of the immune system; this article covers antibodies. Clinical Relevance: Modern dental clinicians need a basic understanding of the immune system as it underlies health and disease.
Dentofacial features of ‘en coup de sabre’ – a case report
Authors: Deans Jamie AB , Jones Jonathan , Merrett Sarah J 
Published: December 2017

‘En coup de sabre’ or morphea, is a linear scleroderma that typically affects the frontoparietal region of patients resulting in a band-like scar that looks like a sword cut across the face. This case report describes a 13-year-old male patient with a history of ‘en coup de sabre’ referred to a dental department because of facial and dental involvement. To the authors' knowledge this has only previously been described on one occasion. The clinical presentation, clinical findings and a brief discussion of management, including the complicating effects of ‘en coup de sabre’ are discussed. CPD/Clinical Relevance: By describing the facial and dental features of this rare condition to the dental community, the authors wish to increase awareness of the condition.
CONSTRUINDO E APRENDENDO COM O TRABALHO
Authors: Oliveira Anselmo Gomes de , Silveira Dâmaris 
Published: December 2017

Ao publicarmos o último número do volume 29, out-dez 2017, estamos encerrando mais um ano de atividades do periódico Infarma – Ciências Farmacêutica. E gostaríamos de registrar nossos agradecimentos a todos - autores, revisores, editores associados e membros do corpo editorial - que contribuíram decisivamente para que esse trabalho se concretizasse durante o ano.