bluuebunny/crossref_metadata_2025_split huggingface dataset:
Different Antidiabetic Regimens and the Development of Renal Dysfunction in US Veterans with Type 2 Diabetes Mellitus
Authors: Gosmanova Elvira O. , Canada Robert B. , Wan Jim , Mangold Therese A. , Wall Barry M. 
Published: May 2016

Aim The aim of this study was to evaluate the development of renal dysfunction in veterans with type 2 diabetes mellitus (T2DM) treated with different antidiabetic regimens. Methods A retrospective cohort study involving 1715 patients with T2DM and baseline serum creatinine (SCr) of 1.5 mg/dL or lesser. The development of renal dysfunction, defined as 0.5 mg/dL or greater increase from baseline SCr during 4.8 years of follow-up with monotherapy metformin (M), 2 combination therapy groups: metformin + insulin (MI) and metformin + sulfonylurea (MS) users were compared with changes observed in sulfonylurea monotherapy users (S). Results Both MI and MS groups had higher mean baseline hemoglobin A1C (HbA1C) (9.0 and 8.6%, respectively) and higher rates of baseline macroalbuminuria (17.3 and 12.1%, respectively) as compared with M and S groups (mean HbA1C7.7% in both groups, and proteinuria M-5.1% and S-7.4%). In unadjusted analysis, the development of renal dysfunction was more frequent in MI and MS but not in M group as compared with sulfonylurea monotherapy (unadjusted HRs and [95% confidence interval (CI), 2.1[1.4–3.0], 1.4[1.1–1.9], and 1.0[0.6–1.7], respectively). However, differences in the development of renal dysfunction were not significant between the 4 groups after adjusting for baseline variables. Baseline macroalbuminuria was a strong predictor of Scr elevation of 0.5 mg/dL or greater during follow-up (adjusted HR, 3.1[1.9–4.7]). Unexpectedly, baseline use of renin-angiotensin-aldosterone system blockers was also associated with the development of renal dysfunction (adjusted HR, 1.9[1.3–2.8]). Conclusions In this retrospective cohort study involving US predominantly male veterans with T2DM, baseline macroalbuminuria and use of RAAS blockers were associated with increased risk of development of renal dysfunction, whereas different antidiabetic regimens were not.
Treatment of Malignant Gastric Outlet Obstruction with Metallic Stents
Authors: Cheng Hao-Tsai , Lee Ching-Song , Lin Cheng-Hui , Cheng Chi-Liang , Tang Jui-Hsiang , Tsou Yung-Kuan , Chang Jui-Min , Lee Mu-Hsien , Sung Kai-Feng , Liu Nai-Jen 
Published: May 2016

Objectives Gastric outlet obstruction (GOO) is a late complication of advanced gastric, pancreatic, and duodenal cancer. Palliative treatment of the obstruction is the main aim of therapy for these patients. Self-expandable metal stents are used for treating GOO. From our experience, the placement of the stent across the pylorus is easier and makes the curve of stent better than when the stent is placed within the duodenal area. The purposes of this study were to assess the efficacy of stents placed in either the duodenal area or across the pyloric valve in relieving GOO symptoms and to evaluate whether the location of the stent affects treatment outcomes. Materials and Methods This was a retrospective single-site study of 44 patients with malignant GOO. Expanding metal stents were placed either across the pyloric valve (n = 22; group A) or in the duodenum area (n = 22; group B). Improvement in oral intake was monitored using the Gastric Outlet Obstruction Scoring System (GOOSS). The end of the study was death of the last enrolled patient or 6 months after enrollment of the last patient, or whatever came first. Results Stent implantation similarly improved the patients’ tolerance for food intake from baseline for both groups A and B (median [interquartile range]; 2 [2–3] and 2 [2–3], respectively). Patients in group B who received adjunctive chemotherapy had greater improvement in GOOSS and survival than patients in group B who did not have chemotherapy or any group A patients ( P < 0.05). Stent patency was not affected by stent position or chemotherapy. Conclusion Palliative treatment of GOO with placement of an expandable metal stent improved the tolerability of food intake. The location of stent across the pyloric valve or within the duodenum did not affect the efficacy of the procedure or stent patency.
Insulin Resistance Predicts Steatosis and Fibrosis in Morbidly Obese Patients Undergoing Bariatric Surgery
Authors: Aller Rocio , de Luis Daniel , Pacheco David , Velasco Maria Concepcion , Izaola Olatz , Sagrado Manuel Gonzalez 
Published: May 2016

Background Influence of adipokines and insulin resistance on liver histology is an unclear area in morbidly obese patients. Objective The aim of our study was to study the influence of insulin resistance and adipokines in the grade of liver steatosis and fibrosis in morbidly obese patients undergoing bariatric surgery. Setting Tertiary hospital. Materials and Methods A sample of 36 morbidly obese patients undergoing bariatric surgery was analyzed in a cross-sectional study. A liver biopsy was performed. Weights, basal glucose, insulin, insulin resistance (homeostasis model assessment for insulin resistance [HOMA-IR]), total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, and adipokine blood levels were measured. Results Seventeen patients (47.2%) had low-grade steatosis, and 19 patients (52.8%) had high-grade steatosis. Sixteen patients (44.4%) did not have liver fibrosis, and 20 patients (56.6%) had liver fibrosis. Only insulin levels, HOMA-IR, and aspartate aminotransferase activity were higher in the patients with high-grade steatosis. Insulin levels and HOMA-IR were higher in patients with fibrosis. In the logistic regression analysis with a dependent dichotomous variable (grades of steatosis: low vs high), the HOMA-IR remained in the model, with an odds ratio to develop high-grade steatosis of 1.33 (95% confidence interval, 1.09–1.86). In the second logistic regression analysis with a dependent dichotomy variable (grades of fibrosis: present vs absent), the HOMA-IR remained in the model, with an odds ratio to develop fibrosis of 1.53 (95% confidence interval, 1.13–2.51). Conclusion Insulin resistance determined with HOMA-IR model is associated with high-grade steatosis and liver fibrosis in obese patients before bariatric surgery.
Long-Acting Beta 2 Agonists Suppress IP-10 Expression in Human Bronchial Epithelial Cells
Authors: Chien Jien-Wen , Chu Yu-Te , Yang San-Nan , Kuo Chang-Hung , Wang Wei-Li , Kuo Po-Lin , Jong Yuh-Jyh , Hung Chih-Hsing 
Published: May 2016

Background Interferon-γ-inducible protein (IP)-10 (CXCL10) is an important chemokine secreted by the airway epithelium that functions as a biomarker for virus-induced asthma. Long-acting beta 2 (β2) agonists (LABAs) are frequently used as inhaled medication for asthma and chronic obstructive pulmonary disease. However, previous research failed to investigate the effects of LABAs on IP-10 in bronchial epithelial cells. Objective To study the effects and signaling pathways of formoterol and salmeterol on polyriboinosinic polyribocytidylic acid (poly I:C)-induced IP-10 expression in BEAS-2B cells. Methods BEAS-2B cells were pretreated with formoterol and salmeterol for 2 hours before poly I:C stimulation. ICI 118551 (β2 adrenoreceptor antagonist) or mitogen-activated protein kinase (MAPK) inhibitors were added 30 minutes before LABAs were added. Enzyme-linked immunosorbent assay and real-time polymerase chain reaction were used to measure IP-10 protein and messenger RNA levels. Mitogen-activated protein kinase inhibitors and Western blotting were used to identify MAPK pathways, whereas bioassay revealed the MAPK functions. Results Long-acting β2 agonists significantly down-regulated the poly I:C-induced IP-10 protein and messenger RNA expression in BEAS-2B cells. ICI 118551 reversed this effect. Forskolin, a cyclic adenosine monophosphate activator, produced a similar inhibitory effect. Western blotting showed that formoterol suppressed poly I:C-induced IP-10 expression via the c-Jun N-terminal kinase–c-Jun pathway. Conclusion Long-acting β2 agonists down-regulate poly I:C-induced IP-10 expression in BEAS-2B cells via the β2 adrenoreceptor–cyclic adenosine monophosphate and c-Jun N-terminal kinase/c-Jun pathways. Long-acting β2 agonists also inhibit IP-10 production in bronchial epithelial cells and may prolong viral elimination.
Polymorphism G80A in the Reduced Folate Carrier Gene and its Relationship to Survival and Risk of Relapse in Acute Lymphoblastic Leukemia
Authors: Leyva-Vázquez Marco Antonio , Organista-Nava Jorge , Gómez-Gómez Yazmín , Contreras-Quiroz Adriana , Flores-Alfaro Eugenia , Illades-Aguiar Berenice 
Published: May 2016

Background The reduced folate carrier ( RFC1) is a major methotrexate transporter whose impaired function was recognized as a frequent mechanism of antifolate resistance. Recently, a G80A polymorphism has been described in the RFC1. This study evaluated the effect of the G80A polymorphism in the RFC1 gene on survival and risk of relapse of acute lymphoblastic leukemia. Methods and Results Seventy patients with acute lymphoblastic leukemia were genotyped by polymerase chain reaction restriction fragment length polymorphism method. An association between the polymorphism and risk of relapse was found ( P < 0.05). Patients with the G/A genotype have 3.97 (95% confidence interval, 1.12–14.06) and carriers of the A/A genotype have 7.84 (95% confidence interval, 1.66–37.10) higher chance of a relapse. Other variables such as age and leukocyte count were associated ( P < 0.05) with the risk of relapse of disease. Individuals with G/A or A/A genotypes had poorer survival (log-rank test, P = < 0.05). Conclusions These data suggest a role of the polymorphism G80A in the risk of relapse and the mortality risk in patients with acute lymphoblastic leukemia from the State of Guerrero, Mexico.
Early Elevation of Serum Tumor Necrosis Factor-α is Associated with Poor Outcome in Subarachnoid Hemorrhage
Authors: Chou Sherry H.-Y. , Feske Steven K. , Atherton Juli , Konigsberg Rachael G. , De Jager Philip L. , Du Rose , Ogilvy Christopher S. , Lo Eng H. , Ning MingMing 
Published: May 2016

Objective Subarachnoid hemorrhage (SAH) is associated with inflammation that may mediate poor outcome in SAH. We hypothesize that elevated serum tumor necrosis factor α (TNF-α) and interleukin 6 (IL-6) are associated with vasospasm and poor outcome in SAH. Methods In 52 consecutive SAH subjects, we compared TNF-α and IL-6 levels on post-SAH days 0 to 1, 2 to 3, 4 to 5, 6 to 8, and 10 to 14 with respect to vasospasm and to poor outcome at 3 and 6 months. Vasospasm was defined as more than 50% reduction in vessel caliber on angiography. Poor outcome was defined as modified Rankin score greater than 2. Results Elevated TNF-α on post-SAH days 2 to 3 was associated with poor 3-month outcome ( P = 0.0004). Global elevation of TNF-α over time (post-SAH days 0–14) was independently associated with poor 3-month outcome after adjusting for Hunt-and-Hess grade and age ( P = 0.02). Neither cross-sectional nor IL-6 levels over time were associated with outcome. Neither TNF-α nor IL-6 levels were associated with vasospasm. Conclusions Elevation in serum TNF-α on post-SAH days 2 to 3 and global elevation of TNF-α over time are associated with poor outcome but not with angiographic vasospasm in this small cohort. Future studies are needed to define the role of TNF-α in SAH-related brain injury and its potential as a SAH outcome biomarker.
Combined Effects of Peroxisome Proliferator–Activated Receptor Alpha and Apolipoprotein E Polymorphisms on Risk of Breast Cancer in a Taiwanese Population
Authors: Wu Chen Teng , Cheng Ya-Hsin , Chen Fei-Na , Chen Dar-Ren , Wei Ming Feng , Chang Nai-Wen 
Published: May 2016

Background The peroxisome proliferator–activated receptor alpha (PPARA) and apolipoprotein E (APOE) proteins are reported to be correlated with lipid metabolism, cardiovascular disease, and breast cancer. Methods We screened APOE and PPARA ( S24F and V227A) polymorphisms in 306 breast cancer patients and 300 noncancer controls and determined the relationship between their genetic polymorphisms and breast cancer risk. Interactions with clinical characteristics were also examined. Results We found that the risk of breast cancer was associated with APOE genotypes ( P = 0.014) but not with PPARA S24F or V227A genotypes. The combined effects of F24/ APOE genotypes ( P = 0.003) on breast cancer risk were more significant than the individual effect of APOE genotypes ( P = 0.014). F24/ [Latin Small Letter Open E]4 carriers had a higher tendency to develop breast cancer than F24/ [Latin Small Letter Open E]3 carriers ( P = 0.013), and this effect is stronger than with individual [Latin Small Letter Open E]4 carriers ( P = 0.029). In addition, both F24/ [Latin Small Letter Open E]4 and V227/ [Latin Small Letter Open E]4 carriers were significantly enriched in the human epidermal growth factor receptor 2/neu negative status. Conclusions These findings suggest that the APOE [Latin Small Letter Open E]4 genotype plays a major role in the prediction of breast cancer, but the PPARA F24 mutation enhances this outcome. The combined effects of F24/ [Latin Small Letter Open E]4 genotypes are positively associated with risk of breast cancer.
Effect of Serum Gamma-Glutamyl Transferase Levels on Myocardial Perfusion and Long-Term Prognosis after Primary Angioplasty in Patients with Acute ST-Elevation Myocardial Infarction
Authors: Ozcan Firat , Karakas Mehmet Fatih , Ozlu Mehmet Fatih , Akcay Adnan Burak , Buyukkaya Eyup , Kurt Mustafa , Erden Gonul , Yuzgecer Huseyin , Yildirimkaya Metin , Hajro Edjon , Balbay Yucel , Koc Mevlut , Yazici Huseyin Ugur , Sen Nihat 
Published: May 2016

Background Gamma-glutamyl transferase (GGT) level was found to be elevated in plasma of patients with cardiovascular risk factors. The aim of our study was to assess the relationship between serum GGT levels and the occurrence of no-reflow as well as to evaluate the prognostic value of GGT in ST-segment elevation myocardial infarction (STEMI) population. Methods and Results One hundred sixty-eight consecutive patients with STEMI who underwent percutaneous coronary intervention (PCI) were enrolled in the study. Patients with STEMI were grouped into tertiles according to their admission serum GGT levels. No-reflow after PCI was assessed both angiographically (thrombolysis in myocardial infarction [TIMI] flow and myocardial blush grade) and electrocardiographically (ST resolution). Gamma-glutamyl transferase levels were higher in patients with STEMI compared to the elective PCI group subjects. Patients with angiographically (TIMI flow ≤2 or TIMI flow 3 with final myocardial bush grade ≤2 after PCI) and electrocardiographically (ST resolution <30%) detected no-reflow were increased in number across the GGT tertiles. In addition, 1-year mortality rates showed a significant increase across the tertile groups (4% vs 11% vs 23%, P < 0.01). Multivariable logistic regression analysis revealed that GGT levels on admission were a significant predictor of long-term mortality of myocardial blush grade–detected no-reflow phenomenon. High GGT level on admission was a significant predictor for long-term mortality and major adverse cardiac events. Conclusions In patients with STEMI undergoing primary PCI, high GGT levels at admission were found to be associated with no-reflow phenomenon and increased long-term mortality.
Effect of Fatty Acid–Binding Protein 2 Ala54Thr Genotype on Weight Loss and Cardiovascular Risk Factors after a High–Polyunsaturated Fat Diet in Obese Patients
Authors: de Luis Daniel , Aller Rocio , Izaola Olatz , Sagrado Manuel Gonzalez , de la Fuente Beatriz , Conde Rosa , Primo David 
Published: May 2016

Background It has been found that the expression of fatty acid-binding protein 2 messenger RNA is under dietary control. The aim of our study was to investigate the influence of Thr54 polymorphism in the FABP2 gene on weight loss and secondarily in cardiovascular risk factors and serum adipokine after an enriched polyunsaturated fat hypocaloric diet in obese patients. Design A sample of 111 obese patients was analyzed. The enriched polyunsaturated fat hypocaloric diet during 3 months’ intervention consisted of 1459 kcal, 45.7% carbohydrates, 34.4% lipids, and 19.9% proteins. The distribution of fats was as follows: 21.8% saturated fats, 55.5% monounsaturated fats, and 22.7% polyunsaturated fats. Level of significance was P < 0.05. Results In Ala54Ala genotype, body mass index (−1.6 ± 1.5 kg/m2), weight (−3.2 ± 3.3 kg), fat mass (−3.1 ± 3.5 kg), and waist circumference (−3.3 ± 2.1 cm) decreased. In carriers of the Thr54 allele, body mass index (−1.9 ± 1.6 kg/m2), weight (− 4.7 ± 1.4 kg), and waist circumference (−3.9 ± 3.7 cm) decreased. These changes were significantly higher in the carriers of the Thr54 allele than noncarriers. Only in the carriers of Thr54 allele, total cholesterol levels (−11.4 ± 20.6 mg/dl), low-density lipoprotein cholesterol levels (−5.4 ± 10.6 mg/dL), insulin (−2.6 ± 3.4 MUI/L), and the level of homeostasis model assessment for insulin sensitivity (−0.9 ± 1.7 U) decreased. Conclusion Carriers of Thr54 allele have a better metabolic response than obese carriers with Ala54Ala genotype, with a decrease of total cholesterol, low-density lipoprotein cholesterol, insulin levels, leptin levels, and homeostasis model assessment for insulin sensitivity.
Echocardiographic Evaluation of Asymptomatic Patients Affected by Rheumatoid Arthritis
Authors: Vizzardi Enrico , Cavazzana Ilaria , Bazzani Chiara , Pezzali Natalia , Ceribelli Angela , Bonadei Ivano , Franceschini Franco , D'Aloia Antonio , Metra Marco , Tincani Angela , Cas Livio Dei 
Published: May 2016

Background Rheumatoid arthritis (RA) is associated with increased mortality and morbidity because of accelerated atherosclerosis. The study assessed the prevalence of left and right ventricle diastolic and systolic dysfunction in outpatients with RA. Methods The study included 93 outpatients with RA. In all patients and control group, echocardiographic conventional and tissue Doppler (TDI) studies were conducted. Results In the group of RA patients, we found high prevalence of left ventricular systolic and diastolic dysfunction and right diastolic dysfunction compared with controls (13.5% vs 5.5 %, 76.3% vs 48.8% and 41.9% vs 6.6%, respectively; P < 0.001). Rheumatoid arthritis patients and controls showed significant differences about mitral, tricuspid, and pulmonary flow velocity curves; tissue Doppler curves of the lateral and the septal myocardial walls of the left ventricle; and basal myocardial free wall of the right ventricle. There were not any correlations between inflammatory and functional disease parameters and variables of systolic and diastolic function. Conclusions Our study shows a high prevalence of left ventricular systolic and diastolic dysfunction in a population of outpatients affected by rheumatoid arthritis.
Effect of Vitamin D Replacement on Insulin Sensitivity in Subjects with Vitamin D Deficiency
Authors: Simha Vinaya , Mahmood Muhammad , Ansari Mohammmed , Spellman Craig W. , Shah Pankaj 
Published: May 2016

Background and Objective Low vitamin D levels correlate with measures of insulin resistance and prevalence of diabetes mellitus, but there are limited and conflicting data on changes in insulin resistance after vitamin D replacement. The objective of the current study was to examine whether vitamin D replacement improves insulin sensitivity. Methods In this randomized double-blind placebo-controlled study, 12 healthy subjects with plasma 25-hydroxy vitamin D (25[OH]D) levels of less than 20 ng/mL were treated with ergocalciferol, 50,000 units, orally once a week for 8 weeks or matching placebo. The main outcome measure was insulin-stimulated glucose infusion rate during the last 20 minutes of a hyperinsulinemic-euglycemic glucose clamp study. Results At baseline, plasma 25(OH)D levels were similar between the ergocalciferol and placebo groups (13.3 ± 3.8 and 15.7 ± 2.4 ng/mL, respectively; P = 0.3) but were higher in the ergocalciferol group at 8 weeks (18.8 ± 5 vs 12.5 ± 2.2 ng/mL; P = 0.02). Glucose infusion rate was similar between the 2 groups both at baseline and after 8 weeks of treatment. Changes in plasma 25(OH)D levels did not correlate with change in glucose infusion rate. Conclusion Administration of ergocalciferol, 50,000 units, weekly for 8 weeks in subjects with low vitamin D levels improves 25(OH)D levels but does not improve insulin sensitivity.
Heart-Brain Signaling in Patent Foramen Ovale–Related Stroke
Authors: Lopez Mary F. , Sarracino David A. , Vogelsang Maryann , Sutton Jennifer N. , Athanas Michael , Krastins Bryan , Garces Alejandra , Prakash Amol , Peterman Scott , Demirjian Zareh , Inglessis-Azuaje Ignacio , Feeney Kathleen , Elia Mikaela , McMullin David , William Dec G. , Palacios Igor , Lo Eng H. , Buonanno Ferdinand , Ning MingMing 
Published: May 2016

Patent foramen ovale (PFO) is highly prevalent and associated with more than 150,000 strokes per year. Traditionally, it is thought that PFOs facilitate strokes by allowing venous clots to travel directly to the brain. However, only a small portion of PFO stroke patients have a known tendency to form blood clots, and the optimal treatment for this multiorgan disease is unclear. Therefore, mapping the changes in systemic circulation of PFO-related stroke is crucial in understanding the pathophysiology to individualize the best clinical treatment for each patient. We initiated a study using a novel quantitative, 2-pass discovery workflow using high-resolution liquid chromatography–mass spectrometry/mass spectrometry coupled with label-free analysis to track protein expression in PFO patients before and after endovascular closure of the PFO. Using this approach, we were able to demonstrate quantitative differences in protein expression between both PFO-related and non–PFO-related ischemic stroke groups as well as before and after PFO closure. As an initial step in understanding the molecular landscape of PFO-related physiology, our methods have yielded biologically relevant information on the synergistic and functional redundancy of various cell-signaling molecules with respect to PFO circulatory physiology. The resulting protein expression patterns were related to canonical pathways including prothrombin activation, atherosclerosis signaling, acute-phase response, LXR/RXR activation, and coagulation system. In particular, after PFO closure, numerous proteins demonstrated reduced expression in stroke-related canonical pathways such as acute inflammatory response and coagulation signaling. These findings demonstrate the feasibility and robustness of using a proteomic approach for biomarker discovery to help gauge therapeutic efficacy in stroke.