bluuebunny/crossref_metadata_2025_split huggingface dataset:
Apelin Compared With Dobutamine Exerts Cardioprotection and Extends Survival in a Rat Model of Endotoxin-Induced Myocardial Dysfunction*
Authors: Chagnon Frederic , Coquerel David , Salvail Dany , Marsault Eric , Dumaine Robert , Auger-Messier Mannix , Sarret Philippe , Lesur Olivier 
Published: August 2016

Objective:
Dobutamine is the currently recommended β-adrenergic inotropic drug for supporting sepsis-induced myocardial dysfunction when cardiac output index remains low after preload correction. Better and safer therapies are nonetheless mandatory because responsiveness to dobutamine is limited with numerous side effects. Apelin-13 is a powerful inotropic candidate that could be considered as an alternative noncatecholaminergic support in the setting of inflammatory cardiovascular dysfunction.

Design:
Interventional controlled experimental animal study.

Setting:
Tertiary care university-based research institute.

Subjects:
One hundred ninety-eight adult male rats.

Interventions:
Using a rat model of “systemic inflammation–induced cardiac dysfunction” induced by intraperitoneal lipopolysaccharide injection (10 mg/kg), hemodynamic efficacy, cardioprotection, and biomechanics were assessed under IV osmotic pump infusions of apelin-13 (0.25 μg/kg/min) or dobutamine (7.5 μg/kg/min).

Measurements and Main Results:
In this model and in both in vivo and ex vivo studies, apelin-13 compared with dobutamine provoked distinctive effects on cardiac function: 1) optimized cardiac energy–dependent workload with improved cardiac index and lower vascular resistance, 2) upgraded hearts’ apelinergic responsiveness, and 3) consecutive downstream advantages, including increased urine output, enhanced plasma volume, reduced weight loss, and substantially improved overall outcomes. In vitro studies confirmed that these apelin-13–driven processes encompassed a significant and rapid reduction in systemic cytokine release with dampening of myocardial inflammation, injury, and apoptosis and resolution of associated molecular pathways.

Conclusions:
In this inflammatory cardiovascular dysfunction, apelin-13 infusion delivers distinct and optimized hemodynamic support (including positive fluid balance), along with cardioprotective effects, modulation of circulatory inflammation and extended survival.
Long-Pulsed 532-Nm Neodymium-Doped Yttrium Aluminium Garnet Laser for Treatment of Facial Plane Warts in 160 Yemeni Patients
Authors: Alshami Mohammad Ali , Mohana Mona Jameel , Alshami Ahlam Mohammad 
Published: August 2016

BACKGROUNDWarts in general and plane warts in particular pose a therapeutic challenge for dermatologists. Many treatment modalities exist, with variable success rates, side effect profiles, and precautions. The long-pulsed 532-nm neodymium-doped yttrium aluminium garnet (LP Nd:YAG) laser has not been previously used for this indication.OBJECTIVEThis study was conducted to assess the efficacy and safety of the LP Nd:YAG laser for treating facial plane warts.MATERIALS AND METHODSA total of 160 Yemeni patients (62 women, 98 men; age range, 5–55 years) were exposed to 1 laser treatment session with the following parameters: wavelength, 532 nm; pulse duration, 20 millisecond; spot size, 2 to 3 mm; and fluence, 25 J/cm2. The end point was graying or whitening of the lesion. Color photographs were taken before and immediately after treatment and at follow-up visits 1, 4, and 16 weeks after the laser session.RESULTSAn overall clearance rate of 92% after only one session was achieved, with minimal and transient side effects.CONCLUSIONThe LP Nd:YAG laser is safe and effective for treating facial plane warts, with a success rate of 92% after only one session.
GSK-3β Inhibitor CHIR-99021 Promotes Proliferation Through Upregulating β-Catenin in Neonatal Atrial Human Cardiomyocytes
Authors: Wang Shoubao , Ye Lincai , Li Minghui , Liu Jinfen , Jiang Chuan , Hong Haifa , Zhu Hongbin , Sun Yanjun 
Published: August 2016

Background:
The renewal capacity of neonate human cardiomyocytes provides an opportunity to manipulate endogenous cardiogenic mechanisms for supplementing the loss of cardiomyocytes caused by myocardial infarction or other cardiac diseases. GSK-3β inhibitors have been recently shown to promote cardiomyocyte proliferation in rats and mice, thus may be ideal candidates for inducing human cardiomyocyte proliferation.

Methods:
Human cardiomyocytes were isolated from right atrial specimens obtained during routine surgery for ventricle septal defect and cultured with either GSK-3β inhibitor (CHIR-99021) or β-catenin inhibitor (IWR-1). Immunocytochemistry was performed to visualize 5-ethynyl-2′-deoxyuridine (EdU)–positive or Ki67-positive cardiomyocytes, indicative of proliferative cardiomyocytes.

Results:
GSK-3β inhibitor significantly increased β-catenin accumulation in cell nucleus, whereas β-catenin inhibitor significantly reduced β-catenin accumulation in cell plasma. In parallel, GSK-3β inhibitor increased EdU-positive and Ki67-positive cardiomyocytes, whereas β-catenin inhibitor decreased EdU-positive and Ki67-positive cardiomyocytes.

Conclusions:
These results indicate that GSK-3β inhibitor can promote human atrial cardiomyocyte proliferation. Although it remains to be determined whether the observations in atrial myocytes could be directly applicable to ventricular myocytes, the current findings imply that Wnt/β-catenin pathway may be a valuable pathway for manipulating endogenous human heart regeneration.
DIFFUSE LARGE B-CELL LYMPHOMA-ASSOCIATED-RETINOPATHY CHARACTERIZED BY MINIMAL MORPHOLOGIC CHANGES AND SEVERE FUNCTIONAL IMPAIRMENT
Authors: Moyal Laura , Zambrowski Olivia , Thirkill Charles , Bottin Caroline , Blanco Rocio , Haioun Corinne , Souied Eric H. 
Published: August 2016

Purpose:
To report the case of a patient whose retinal disease was found to be associated with a diffuse large B-cell lymphoma found 30 years after the apparent successful treatment of a classical Hodgkin lymphoma.

Methods:
Observational case report.

Results:
The authors describe the case of a 69-year-old man referred to their Department because of progressive, bilateral vision loss over the last few months. Deterioration in color vision and intense photophobia were also present. His best-corrected visual acuity was 20/400 in the right eye (RE) and 20/800 in the left eye (LE). Slit lamp and fundus examination failed to show any abnormalities. Spectral domain optical coherence tomography (SD-OCT) detected diffuse attenuation of the ellipsoid layers in addition to a focal subfoveal defect in both eyes. Both fluorescein and indocyanine angiographies (FA and ICGA) were normal. Full flash electroretinogram (ERG) revealed bilateral cone rod dysfunction with decreased amplitudes of both a and b waves.

Conclusion:
Because of the late onset of the disease, poor visual acuity compared with a small macular anatomical lesion and a history of Hodgkin lymphoma 30 years ago, a neoplastic etiology was investigated. Poor performance status and chest pain led to a thoracic CT scan, which identified a massive mediastinal tumor. Serum analysis found an abnormal amount of antibody activity within the 40 kD region of Western blot of retina. The diagnosis of diffuse large B-cell lymphoma was established. Systemic examinations found a Stage IV non-Hodgkin lymphoma.
POSTERIOR POLAR ANNULAR CHOROIDAL DYSTROPHY: A CASE SERIES
Authors: Lenis Tamara L. , Klufas Michael A. , Randhawa Sandeep , Sharma Mithlesh , Sarraf David 
Published: August 2016

Purpose:
To describe the multimodal imaging findings of posterior polar annular choroidal dystrophy (PPACD).

Methods:
Retrospective case series of 2 patients diagnosed with PPACD. Spectral-domain optical coherence tomography, fundus autofluorescence, and fluorescein angiography findings of PPACD are described. Electroretinography results are also presented.

Results:
Both patients presented with bilateral peripapillary atrophy extending to involve the temporal arcades in an annular, foveal sparing pattern. Both cases demonstrated outer retinal atrophy with foveal sparing on spectral-domain optical coherence tomography, and fluorescein angiography illustrated corresponding window defects with late staining. Fundus autofluorescence showed hypoautofluorescence in the center of atrophic areas but hyperautofluorescence at the leading edge. Electroretinography findings included cone loss with rod preservation. Inflammatory and infectious workup was unremarkable in both cases.

Conclusion:
This report describes the multimodal imaging findings of a rare and poorly described chorioretinal disorder, PPACD, and will serve to guide clinicians regarding the evaluation and management of this elusive condition.
NEUROSARCOIDOSIS MASQUERADING AS A CENTRAL NERVOUS SYSTEM TUMOR
Authors: Elia Maxwell , Kombo Ninani , Huang John 
Published: August 2016

Purpose:
To report a case of neurosarcoidosis with an isolated brain lesion mimicking a low-grade glioma.

Methods:
A 38-year-old woman presented with 2 weeks of blurry vision in the left eye. Ophthalmic examination, visual field testing, fluorescein angiography, laboratory testing, and MRI of the brain were performed.

Results:
Ophthalmic examination revealed left-sided optic nerve infiltration, and MRI of the brain demonstrated a solitary lesion in the brain. The visual symptoms and ophthalmic examination improved significantly with initiation of high-dose oral prednisone. Because the MRI appearance was concerning for malignancy, a brain biopsy was performed. Pathology demonstrated gliosis consistent with a low-grade central nervous system (CNS) glioma. One year later, after initial loss to ophthalmic follow-up, the right optic nerve became involved, and the patient was again treated successfully for presumed ocular sarcoidosis. At this time, serial neuroimaging demonstrated enlargement of the CNS lesion, prompting rebiopsy. Rebiopsy demonstrated a noncaseating granuloma, confirming the diagnosis of neurosarcoidosis. The patient was treated with 20 mg of methotrexate weekly and a prednisone taper with improvement in visual and neurologic symptoms.

Conclusion:
The authors present an unusual case of neurosarcoidosis masquerading as a CNS glioma. In cases of solitary CNS granulomas, radiographically differentiating neurosarcoidosis from a glioma can be challenging. In this case, serial ophthalmic examination identifying sequential involvement of both optic nerves helped to identify the underlying cause of the CNS disease as sarcoidosis.
GRAFT-VERSUS-HOST DISEASE PANUVEITIS AND BILATERAL SEROUS DETACHMENTS: MULTIMODAL IMAGING ANALYSIS
Authors: Jung Jesse J. , Chen Michael H. , Rofagha Soraya , Lee Scott S. 
Published: August 2016

Purpose:
To report the multimodal imaging findings and follow-up of a case of graft-versus-host disease–induced bilateral panuveitis and serous retinal detachments after allogenic bone marrow transplant for acute myeloid leukemia.

Methods:
A 75-year-old black man presented with acute decreased vision in both eyes for 1 week. Clinical examination and multimodal imaging, including spectral domain optical coherence tomography, fundus autofluorescence, fluorescein angiography, and swept-source optical coherence tomography angiography (Investigational Device; Carl Zeiss Meditec Inc) were performed.

Results:
Clinical examination of the patient revealed anterior and posterior inflammation and bilateral serous retinal detachments. Ultra-widefield fundus autofluorescence demonstrated hyperautofluorescence secondary to subretinal fluid; and fluorescein angiography revealed multiple areas of punctate hyperfluorescence, leakage, and staining of the optic discs. Spectral domain and enhanced depth imaging optical coherence tomography demonstrated subretinal fluid, a thickened, undulating retinal pigment epithelium layer, and a thickened choroid in both eyes. En-face swept-source optical coherence tomography angiography did not show any retinal vascular abnormalities but did demonstrate patchy areas of decreased choriocapillaris flow. An extensive systemic infectious and malignancy workup was negative and the patient was treated with high-dose oral prednisone immunosuppression. Subsequent 6-month follow-up demonstrated complete resolution of the inflammation and bilateral serous detachments after completion of the prednisone taper over a 3-month period.

Conclusion:
Graft-versus-host disease panuveitis and bilateral serous retinal detachments are rare complications of allogenic bone marrow transplant for acute myeloid leukemia and can be diagnosed with clinical and multimodal imaging analysis. This form of autoimmune inflammation may occur after the recovery of T-cell activity within the donor graft targeting the host. Infectious and recurrent malignancy must be ruled out before initiation of immunosuppression, which can affectively treat this form of graft-versus-host disease.
A NEW MACULAR DYSTROPHY SECONDARY TO A NOVEL MUTATION IN THE PROMININ 1 (PROM1) GENE
Authors: Randhawa Sandeep , Sharma Mithlesh 
Published: August 2016

Purpose:
To report a case of a new macular dystrophy caused by a novel mutation in the PROM1 gene.

Methods:
History and clinical examination, fluorescein angiography, optical coherence tomography, autofluorescence, electrophysiology, and genetics.

Results:
We report a case of a 51-year-old man with progressive central visual loss in both his eyes. On fundus examination and imaging, there were asymmetric atrophic macular lesions in both his eyes. Electrophysiology revealed a bilateral macular atrophy; genetic testing revealed a novel PROM1 mutation as the probable cause.

Conclusion:
A novel PROM1 mutation as the cause of a new bilateral macular atrophy is revealed.
Complete Obliteration of the Left Atrial Appendage an Analysis of Epicardial Excision and Novel Pericardial Patch Exclusion
Authors: Malakouti-Nejad Bayan B. , Winkler Eliot J. , Johnson Marjorie I. , Catrip Jorge , Losenno Katie L. , Kiaii Bob B. , Chu Michael W. A. 
Published: August 2016

Objective Conventional epicardial excision is believed to be the most effective method of surgically obliterating the left atrial appendage (LAA), although incomplete resection and residual LAA volume may undermine its effectiveness. We sought to compare the impact of conventional epicardial excision with a novel LAA pericardial patch exclusion on residual LAA volume. Methods We performed LAA obliteration using pericardial patch exclusion, followed by conventional epicardial excision, in 27 cadaveric hearts. After each procedure, residual LAA volume was measured by two different techniques and compared with baseline volume. There was no difference in baseline LAA volume between each procedure. Results Procedural success was achieved in all hearts. Conventional epicardial excision left a residual LAA volume of 0.95 mL (24%), as compared with pericardial patch exclusion, which left a residual volume of 0.17 mL (4%, P = 0.0001). Further analysis of fixed and fresh hearts showed that reduction of LAA volume was more pronounced in the fresh hearts, suggesting effectiveness in live patients. Neither technique resulted in any significant change in the endocardial shape of the LAA orifice or injury to the circumflex artery. Conclusions Conventional epicardial excision of the LAA results in significantly more residual LAA volume, which may have important implications in persistent stroke risk. Pericardial patch exclusion seems to achieve near-total elimination of the LAA and may be a superior surgical option.
Prevalence of atlE, ica, mecA, and mupA Genes in Staphylococcus epidermidis Isolates
Authors: Mirzaei Rasoul , Sadeghi Javad , Talebi Malihe , Irajian Gholamreza 
Published: August 2016

Background
Coagulase-negative staphylococcus (CoNS) bacteria, particularly Staphylococcus epidermidis, are one of the major causes of nosocomial infections. This study evaluated the prevalence of atlE, ica, mecA, and mupA genes in S. epidermidis isolates.

Methods
Two hundred thirty samples were collected from 2 hospitals (Ali Asghar and Hazrat Rasoul) in Tehran, Iran. One hundred twenty-three (53%) of isolates were identified as S. epidermidis. These isolates were tested for prevalence of atlE, ica, mecA, and mupA genes by using multiplex polymerase chain reaction.

Results
The prevalence of atlE, ica, mecA, and mupA were 94%, 78%, 76%, and 30% for clinical, 90%, 28%, 51%, and 13% for flora, and 94%, 29%, 51%, and 3% for environmental isolates, respectively.

Conclusions
Multiplex polymerase chain reaction revealed that occurrence of atlE, ica, mecA, and mupA in our isolates was relatively high. The growing problem of staphylococci especially S. epidermidis in Iran requires further cautious surveillance.
Mycobacterium bovis Aneurysm
Authors: Nandavaram Sravanthi , Al Twal Abdullah , Jacoby Helen , Lenox Robert 
Published: August 2016

Abstract
Bacillus Calmette-Guerin (BCG) is the attenuated strain of Mycobacterium bovis. Intravesicular live attenuated BCG is one of the well-known effective treatments for transitional cell carcinoma of the bladder. Severe disseminated mycobacterial infections in such patients are uncommon. Here, we present a case of M. bovis mycotic aneurysm of the left femoral artery, diagnosed 14 months after initiation of intravesical BCG immunotherapy for bladder cancer. Although rare, given the significant morbidity and mortality associated with mycotic aneurysms, physicians should be aware of this complication in appropriate clinical scenarios and should have high index of suspicion; appropriate treatment should be initiated promptly.
Lactose Breath Test in Children: Relationship Between Symptoms During the Test and Test Results
Authors: Glatstein Miguel , Reif Shimon , Scolnik Dennis , Rom Liat , Yerushalmy-Feler Anat , Dali-Levy Margalit , Cohen Shlomi 
Published: August 2016

Background:
Lactose malabsorption affects 70% of the world population. The hydrogen breath test (HBT) is used clinically to test for this condition. The aim of our study was to describe the relationship between symptoms experienced before and during the HBT and test results.

Methods:
We included children who underwent the HBT in the pediatric gastroenterology unit at Dana-Dwek Children's Hospital during a 6-month period. Previous symptoms and those experienced before and after the HBT were assessed using a questionnaire and a validated pain scale.

Results:
Ninety-five children were included in the study, and 66.3% had a positive HBT. Diarrhea and flatulence during the test were significantly more frequent in the group with a positive HBT compared to those with a negative test (31.7% vs. 9.4%, P = 0.016 and 69.8% vs. 40.6%, P = 0.006, respectively). The frequency of abdominal pain and bloating was similar.

Conclusions:
Diarrhea and flatulence during the HBT are the most specific symptoms of lactose intolerance. Abdominal pain should not be automatically attributed to lactose intolerance even in the presence of lactose malabsorption. Coupling the HBT with a real-time questionnaire facilitates interpretation of results and subsequent recommendations.
Limitations of Sacubitril/Valsartan in the Management of Heart Failure
Authors: Yandrapalli Srikanth , Aronow Wilbert S. , Mondal Pratik , Chabbott David R. 
Published: August 2016

Background:
The PARADIGM-HF (Prospective comparison of ARNI with ACEI to Determine Impact on Global Mortality and morbidity in Heart Failure) trial was a double-blind trial that randomized 8442 patients with heart failure (HF) with reduced ejection fraction (HFrEF) to receive twice daily dosing of either 200 mg of LCZ696 or 10 mg of enalapril in addition to standard medical therapy for HF.

Areas of Uncertainty:
Limitations of this trial include (1) sacubitril has not been tested by itself in the treatment of HFrEF; (2) the maximum recommended dose of valsartan for the treatment of HFrEF was used in this trial, but the maximum recommended dose of enalapril for the treatment of HFrEF was not used; (3) a run-in phase was used in this trial to test the tolerability of LCZ696, and patients who had adverse effects in this period were excluded from randomization; (4) the percent of blacks enrolled in this trial was only 5%; (5) LCZ696 caused a 14% incidence of hypotension; (6) neprilysin inhibition might favor the development of Alzheimer dementia, which was not assessed in the PARADIGM-HF trial; (7) patients with severe symptomatic HF were underrepresented in this trial; (8) major exclusions from this trial included an acute coronary event in the last 3 months, severe pulmonary disease, hepatic impairment, and an estimated glomerular filtration rate <30 mL per minute per 1.73 m2.

Data Sources:
Review of the PARADIGM-HF trial.

Results:
At 27-month follow-up, the PARADIGM-HF trial showed that compared with enalapril, LCZ696 reduced the composite of cardiovascular death or hospitalization for HF 20% (absolute risk reduction 4.7%, P < 0.001).

Conclusions:
The numerous limitations discussed under the areas of uncertainty should be considered when prescribing LCZ696 for the treatment of HFrEF.
Association of Dyslipidemia and Glucose Abnormalities With Antiretroviral Treatment in a Cohort of HIV-Infected Latin American Children
Authors: Paganella Machline P. , Cohen Rachel A. , Harris Donald R. , de Souza Kuchenbecker Ricardo , Sperhacke Rosa D. , Kato Sergio K. , Oliveira da Silva Carmem L. , Sturzbecher Fernanda T. , Oliveira Ricardo H. S. , Pavía-Ruz Noris , Hazra Rohan ,   for the NISDI PLACES Protocol
Published: August 2016

Objective:
To estimate the incidence of lipid and glucose abnormalities and assess their association with exposure to antiretroviral (ARV) regimens among perinatally HIV-infected Latin American children.

Design:
Longitudinal cohort study.

Methods:
Data were analyzed from the Eunice Kennedy Shriver National Institute of Child Health and Human Development International Site Development Initiative Pediatric Latin American Countries Epidemiologic Study. The incidence of dyslipidemia [total cholesterol >200 mg/dL, HDL < 35 mg/dL, LDL ≥ 130 mg/dL, triglycerides > 110 mg/dL (age < 10 years) or >150 mg/dL (≥10 years)] and fasting glucose abnormalities [homeostasis model assessment of insulin resistance >2.5 (Tanner stage 1) or >4.0 (Tanner stage > 1); impaired glucose: 110 to <126 mg/dL; diabetes: ≥126 mg/dL] was estimated. Proportional hazards regression was used to evaluate the risk of abnormalities associated with ARV regimen, adjusted for covariates.

Results:
There were 385 children eligible for analysis (mean age 6.6 years). Incident cholesterol abnormalities were reported in 18.1% of participants [95% confidence interval (CI): 14.1% to 22.8%], HDL and LDL cholesterol abnormalities in 19.6% (15.1%–24.7%) and 15.0% (11.3%–19.5%), respectively, and triglyceride abnormalities in 44.2% (37.7%–50.8%). In multivariable analysis, ARV regimen was only associated with triglyceride abnormalities; participants receiving a protease inhibitor (PI)-containing regimen were 3.6 times as likely to experience a triglyceride abnormality as those receiving no ARVs (95% CI: 1.3 to 10.5; P = 0.0167). The cumulative incidence of insulin resistance was 3.8% (1.8%–7.1%); there were no incident cases of diabetes and only 2 of impaired fasting glucose.

Conclusions:
Children receiving PI-containing regimens were at increased risk of developing triglyceride abnormalities. Continued monitoring of lipid levels in children receiving PI-containing regimens appears warranted.