bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bismuth-Based Quadruple Therapy with Bismuth Subcitrate, Metronidazole, Tetracycline and Omeprazole in the Eradication ofHelicobacter pylori
Authors: Lahaie Raymond , Farley Alain , Dallaire Chrystian , Archambault André , Fallone Carlo A , Ponich Terry , Hunt Richard , Oravec Michael , Whitsitt Paul , Van Zanten Sander Veldhuyzen , Marcon Norman , Bailey Robert , Dumont André , Nguyen Bich , Desrochers Sylvain , Spénard Jean 
Published: March 2016

BACKGROUND: A previous study showed that 14 days of qid bismuth-based triple therapy with tetracycline 500 mg, metronidazole 250 mg and colloidal bismuth subcitrate 120 mg resulted in excellentHelicobacter pylorieradication rates (89.5%). The present study looked at a shorter treatment period by adding omeprazole and by reducing the dose of tetracycline.METHODS: One hundred sixty-one patients withH pyloriconfirmed by histology and13carbon urea breath test were included in the study. They were treated for seven days with bismuth subcitrate 120 mg plus metronidazole 250 mg plus tetracycline 250 mg qid plus omeprazole 20 mg bid (OBMT). Patients were 18 to 75 years of age and had dyspepsia with or without a history of peptic ulcer. Patients with irritable bowel syndrome, active ulcer or previous attempt at eradication, or those who had used antibiotics or antiulcer drugs in the previous 30 days were excluded. Eradication was determined by two13carbon urea breath tests done one and three months, respectively, after treatment. Strains with minimal inhibitory concentrations of 8 µg/mL or higher were considered to be resistant to metronidazole.RESULTS: The overall per protocol eradication rate was 84% - 89.5% in metronidazole-sensitive and 70.8% in metronidazole-resistant strains. Modified intent-to-treat analysis resulted in a 80% eradication rate - 82.5% in metronidazole-sensitive and 66.7% in metronidazole-resistant strains. Only one patient discontinued treatment because of adverse events.CONCLUSIONS: The OBMT regimen used in this study is safe and effective against metronidazole-sensitiveH pyloristrains.
Oral Pantoprazole for Acid Suppression in the Treatment of Patients with Zollinger-Ellison Syndrome
Authors: Désir Barbara , Poitras Pierre 
Published: March 2016

BACKGROUND: The management of patients with gastric acid hypersecretion due to gastrinoma, usually recognized as Zollinger-Ellison syndrome (ZES), was radically changed 10 years ago by the use of proton pump inhibitors. Surgical treatment now concentrates on tumour excision, and in the majority of patients, gastrectomy is no longer required to prevent complications of acid hypersecretion that can be managed pharmacologically.AIMS: To verify the ability of pantoprazole to control gastric acid hypersecretion and the clinical effects of acid hypersecretion in seven patients with documented ZES.METHODS: Pantoprazole was administered at an initial dose of 80 mg daily for seven days before basal acid output (BAO) was measured at 08:00, ie, 1 h before the next dose of pantoprazole was normally ingested. A lower (40 mg) or higher (120 mg or more) dose of pantoprazole was then used to keep the BAO in the therapeutic range (between 0.1 and 10 mmol/h) and to control clinical symptoms such as acid-related pain or diarrhea.RESULTS: BAO and clinical symptoms were controlled with pantoprazole 40 mg daily in one patient, 80 mg daily in two patients, 120 mg daily in three patients and 160 mg daily in one patient.CONCLUSIONS: Pantoprazole was able to control acid hypersecretion in ZES patients when administered in doses between 40 and 160 mg daily. An initial dose of 120 mg given before further titration of the drug regimen appears to be a reasonable therapeutic strategy.
Frequency of Use and Standards of Care for the Use of Azathioprine and 6-Mercaptopurine in Treatment of Inflammatory Bowel Disease: A Systematic Review of the Literature and a Survey of Canadian Gastroenterologists
Authors: Wallace Thomas M , Veldhuyzen van Zanten Sander JO 
Published: March 2016

OBJECTIVE: To identify the frequency of use and appropriate monitoring guidelines for the adverse effects of azathioprine and 6-mercaptopurine (6-MP) in the therapy of patients with inflammatory bowel disease (IBD).METHODS: Surveys were sent to all physician members of the Canadian Association of Gastroenterology. Physicians were asked to describe their monitoring practices for IBD patients receiving azathioprine or 6-MP. A systematic literature search was also performed using MEDLINE for articles published in English between 1966 and 1999 using the MeSH terms 'azathioprine', '6-mercaptopurine', 'inflammatory bowel disease' and 'drug monitoring'.RESULTS: Azathioprine and 6-MP were used to treat an average of 7% of patients - a surprisingly low number given the proven efficacy of these agents. All respondents reported monitoring complete blood counts (CBC), while liver enzyme and pancreatic enzyme levels were monitored by 62% and 29% of respondents, respectively. The most commonly reported initial CBC testing frequencies were weekly (42%), monthly (26%) and biweekly (23%). From the literature, it was determined that severe leukopenia (less than 2.10 g/L) occurs in less than 2% of cases and is sometimes associated with serious outcomes, including death. Most cases of severe leukopenia occurred abruptly, early in treatment. Other reported adverse effects and incidences were pancreatitis (3% to 5%), hepatotoxicity (less than 1%) and hypersensitivity (2% to 3%). Data concerning an increased risk of non-Hodgkin's lymphoma were equivocal.CONCLUSIONS: Use of azathioprine or 6-MP is low in pa 6, 8 and 12, with subsequent testing every eight weeks for the duration of azathioprine or 6-MP treatment. The evidence in support of pancreatic and hepatic monitoring is weak. The risk of non-Hodgkin's lymphoma is likely low.
Dll4 Inhibition plus Aflibercept Markedly Reduces Ovarian Tumor Growth
Authors: Huang Jie , Hu Wei , Hu Limin , Previs Rebecca A. , Dalton Heather J. , Yang Xiao-Yun , Sun Yunjie , McGuire Michael , Rupaimoole Rajesha , Nagaraja Archana S. , Kang Yu , Liu Tao , Nick Alpa M. , Jennings Nicholas B. , Coleman Robert L. , Jaffe Robert B. , Sood Anil K. 
Published: March 2016

Abstract
Delta-like ligand 4 (Dll4), one of the Notch ligands, is overexpressed in ovarian cancer, especially in tumors resistant to anti-VEGF therapy. Here, we examined the biologic effects of dual anti-Dll4 and anti-VEGF therapy in ovarian cancer models. Using Dll4-Fc blockade and anti-Dll4 antibodies (murine REGN1035 and human REGN421), we evaluated the biologic effects of Dll4 inhibition combined with aflibercept or chemotherapy in orthotopic mouse models of ovarian cancer. We also examined potential mechanisms by which dual Dll4 and VEGF targeting inhibit tumor growth using immunohistochemical staining for apoptosis and proliferation markers. Reverse-phase protein arrays were used to identify potential downstream targets of Dll4 blockade. Dual targeting of VEGF and Dll4 with murine REGN1035 showed superior antitumor effects in ovarian cancer models compared with either monotherapy. In the A2780 model, REGN1035 (targets murine Dll4) or REGN421 (targets human Dll4) reduced tumor weights by 62% and 82%, respectively; aflibercept alone reduced tumor weights by 90%. Greater therapeutic effects were observed for Dll4 blockade (REGN1035) combined with either aflibercept or docetaxel (P &lt; 0.05 for the combination vs. aflibercept). The superior antitumor effects of REGN1035 and aflibercept were related to increased apoptosis in tumor cells compared with the monotherapy. We also found that GATA3 expression was significantly increased in tumor stroma from the mice treated with REGN1035 combined with docetaxel or aflibercept, suggesting an indirect effect of these combination treatments on the tumor stroma. These findings identify that dual targeting of Dll4 and VEGF is an attractive therapeutic approach. Mol Cancer Ther; 15(6); 1344–52. ©2016 AACR.
Clinical impact and course of major bleeding with edoxaban versus vitamin K antagonists
Authors: Brekelmans Marjolein , Bleker Suzanne , Bauersachs Rupert , Boda Zoltan , Büller Harry , Choi Youngsook , Gallus Alex , Grosso Michael , Middeldorp Saskia , Oh Doyeun , Raskob Gary , Schwocho Lee , Cohen Alexander 
Published: March 2016

SummaryEdoxaban is a once-daily direct oral anticoagulant (DOAC). The Hokusai-VTE study revealed that, after initial treatment with heparin, edoxaban was non-inferior to and safer than vitamin K antagonists (VKA) in the prevention of recurrent deep-vein thrombosis and pulmonary embolism. This is the first report on the clinical relevance and management of bleeding events with edoxaban. All major bleeding events were classified blindly by three study-independent adjudicators. Predefined criteria were used to classify severity of clinical presentation and, separately, the clinical course and outcome into four categories. Major bleeding occurred in 56 patients treated with edoxaban and 65 patients treated with VKA. The severest categories (3 or 4) of the clinical presentation were assigned to 46 % of the major bleeding episodes in edoxaban recipients versus 58 % of the major bleeds in VKA recipients (odds ratio [OR] 0.62, 95 % confidence interval [CI] 0.30–1.27, p = 0.19). Clinical course was classified as severe (category 3 or 4) in 23 % of the edoxaban and 29 % of the VKA associated bleeds (OR 0.73, 95 % CI 0.32–1.66, p = 0.46). In conclusion, edoxaban associated major bleeding events have a comparable clinical presentation and course to major bleeds with VKA in patients treated for venous thromboembolism in the Hokusai-VTE study. These results may assure physicians that it is safe to prescribe this medication. If a major bleeding during edoxaban treatment occurs, its clinical presentation and clinical course are not worse than in VKA-treated patients.
Hyponatremia and Worsening Sodium Levels Are Associated With Long‐Term Outcome in Patients Hospitalized for Acute Heart Failure
Authors: Lu Dai‐Yin , Cheng Hao‐Min , Cheng Yu‐Lun , Hsu Pai‐Feng , Huang Wei‐Ming , Guo Chao‐Yu , Yu Wen‐Chung , Chen Chen‐Huan , Sung Shih‐Hsien 
Published: March 2016

Background

Hyponatremia predicts poor prognosis in patients with acute heart failure (
AHF
). However, the association of the severity of hyponatremia and changes of serum sodium levels with long‐term outcome has not been delineated.

Methods and Results

The study population was drawn from the
HARVEST
registry (
H
eart F
a
ilure
R
egistry of Taipei
Ve
teran
s
General Hospi
t
al), so that patients hospitalized for acute heart failure (
AHF)
composed this study. The National Death Registry was linked to identify the clinical outcomes of all‐cause mortality and cardiovascular death, with a follow‐up duration of up to 4 years. Among a total of 2556 patients (76.4 years of age, 67% men), 360 had on‐admission hyponatremia, defined as a serum sodium level of <135 mEq/L on the first day of hospitalization. On‐admission hyponatremia was a predictor for all‐cause mortality (hazard ratio and 95%
CI
: 1.43, 1.11–1.83) and cardiovascular mortality (1.50, 1.04–2.17), independent of age, sex, hematocrit, estimated glomerular filtration rate, left ventricular ejection fraction, and prescribed medications. Subjects with severe hyponatremia (<125 mEq/L) would even have worse clinical outcomes. During hospitalization, a drop of sodium levels of >3 mEq/L was associated with a marked increase of mortality than those with minimal or no drop of sodium levels. In addition, subjects with on‐admission hyponatremia and drops of serum sodium levels during hospitalization had an incremental risk of death (2.26, 1.36–3.74), relative to those with normonatremia at admission and no treatment‐related drop of serum sodium level in the fully adjusted model.

Conclusions

On‐admission hyponatremia is an independent predictor for long‐term outcomes in patients hospitalized for
AHF
. Combined the on‐admission hyponatremia with drops of serum sodium levels during hospitalization may make a better risk assessment in
AHF
patients.
The Role of the European Parliament President in Parliamentary Diplomacy
Authors: Gianniti Luigi , Lupo Nicola 
Published: March 2016

Summary
This contribution argues, counterintuitively, that the most important functions exercised by the European Parliament’s President are the external ones, which are expressly laid down in Rule 22(4) of the European Parliament’s Rules of Procedure. Among these, specific attention is devoted to the President’s ‘diplomatic functions’. This article analyses the presidencies of Jerzy Buzek and Martin Schulz and argues that these ‘diplomatic functions’ have been reinforced because of intensification of the European Union’s international activities as well as the European Parliament’s enhanced post-Lisbon Treaty powers in eu foreign policy. It is also observed that these functions are exercised differently depending on the personal and political preferences of each President. While Jerzy Buzek’s Presidency was oriented more towards the eastern European Union, the two consecutive Presidencies of Martin Schulz veered more towards the European Union’s south.
The treatment of venous malformations with percutaneous sclerotherapy at a single academic medical center
Authors: Ali Sumera , Weiss Clifford R , Sinha Amitasha , Eng John , Mitchell Sally E 
Published: March 2016

Purpose We report a retrospective analysis of venous malformation patients treated with percutaneous sclerotherapy, describing their clinical manifestations, therapeutic outcomes and procedural complications. Materials and methods We reviewed our Vascular Anomalies database for all patients who underwent percutaneous sclerotherapy for venous malformation between January 2005 and July 2011 and retrieved 186 patients, out of which 116 were included in the final analysis. The majority of patients were treated using 100% alcohol (72%) and the rest were treated with <100% alcohol, Sodium Tetradecyl Sulfate or combination of these therapies. The most common location was the lower extremity in 67 patients (58%), followed by the head and neck in 27 (23%) and the upper extremity in 11 (9%). Retrospective review of medical records was performed. Outcomes were classified on an improvement scale based on clinical therapeutic effects. Results Two-hundred and forty-five sclerotherapy procedures were performed in 116 patients, of which 52 patients (45%) underwent a single procedure, 32 (28%) had two procedures and 32 (28%) underwent ≥3 procedures. Median follow-up period from the last procedure was 2.5 months (interquartile range of 2.0 to 6.75 months). Significant improvement was seen in 37 patients (32%), moderate improvement in 31 (27%), mild improvement in 20 (17%), no improvement in 21 (18%) and worse than before in 7 (6%) patients. Major post-procedural complications were nerve injuries in 6 patients (5%), deep vein thrombosis in 5 (4%), muscle contracture in 2 (2%), infection in 3 (3%), skin necrosis in 4 (3%) and other complications in 3 (3%). Conclusion Our study demonstrated that 76% of our patients with venous malformation had some level of improvement in symptoms with majority (72%) undergoing only one or two percutaneous sclerotherapy procedure/s. Although major complications occurred in 20% of the patients, majority (74%) of the complications either resolved spontaneously or were successfully treated.
Solar-Powered Drip Irrigation Impacts on Crops Production Diversity and Dietary Diversity in Northern Benin
Authors: Alaofè Halimatou , Burney Jennifer , Naylor Rosamond , Taren Douglas 
Published: March 2016

Background: Meeting the food needs of Africa's growing population will require innovative and appropriate technologies whose effectiveness needs to be assessed. Objective: To evaluate the impact of Solar Market Gardens (SMGs) on crops production diversity and dietary diversity in the Kalalé district of Northern Benin. Methods: In 2007, SMGs were installed in 2 villages for women's agricultural groups as a strategy for enhancing food and nutrition security. Data were collected through interviews at installation and 1 year later from all women's group households (30–35 women/group) and from a random representative sample of 30 households in each village, for both treatment and matched-pair comparison villages. Results: Comparison of baseline and endline data indicated increases in the variety of fruits and vegetables produced and consumed by SMG women's groups compared to other groups. The proportion of SMG women’s group households engaged in vegetable and fruit production significantly increased by 26% and 55%, respectively ( P < .05). After controlling for baseline values, SMG women's groups were 3 times more likely to increase their fruit and vegetable consumption compared with comparison non-women's groups ( P < .05). In addition, the percentage change in corn, sorghum, beans, oil, rice and fish purchased was significantly greater in the SMG women’s groups compared to other groups. At endline, 57% of the women used their additional income on food, 54% on health care, and 25% on education. Conclusions: Solar Market Gardens have the potential to improve household nutritional status through direct consumption and increased income to make economic decisions.
Microgames for Situated Learning
Authors: Lukosch Heide , Kurapati Shalini , Groen Daan , Verbraeck Alexander 
Published: March 2016

Background. Complex, dynamic systems require flexible workforces with skills and attitudes responding to the dynamic work environment. Traditional, formal classroom-oriented learning approaches often do not sufficiently support the development of such skills and attitudes and do not provide situated learning activities. Aim and Method. We propose the concept of Microgames as an active, situated learning approach. A Microgame is a simulation game that can be played in a short time period and that starts from a specific problem in the organization defined by a problem owner. To illustrate the concept, we introduce a case study with a Microgame called Yard Crane Scheduler. Results. The study’s results indicate that the Microgame used in our study represented an engaging experiential experience. It was able to foster the awareness of the players for interdependent planning tasks. Due to its shortness, the game’s reality is somewhat limited. To compensate for this limitation, a structured debriefing phase enables players to exchange information on successful planning strategies, enhancing the learning experience by a social learning activity. Conclusions. Microgames are a novel approach towards situated, experiential learning. Its limitations, mainly caused by the constrained time for game play, have to be taken into account when defining learning goals. Despite this limitation, the Yard Crane Scheduler Microgame has been evaluated as an engaging and valid tool. Further research will investigate distinct design decisions and learning effects associated with the concept of Microgames.
Therapeutic effect of renin angiotensin system inhibitors on liver fibrosis
Authors: Zhu Qianqian , Li Na , Li Fang , Zhou Zhihua , Han Qunying , Lv Yi , Sang Jiao , Liu Zhengwen 
Published: March 2016

Background and objective: Currently, there is no effective therapy available for liver fibrosis. This study aims to evaluate the efficacy of renin angiotensin system inhibitors on liver fibrosis. Method: Full-text randomized controlled trials in patients with liver fibrosis were identified and included in the meta-analysis. The primary outcome measure was the histological fibrosis score of the liver. Secondary outcome measures included fibrosis area of the liver, serological levels of fibrosis markers, adverse events, and withdrawals. Results: From 6973 non-duplicated entries by systematic search, four randomized controlled trials with 210 patients were identified. The renin angiotensin system inhibitors therapy resulted in a marginally significant reduction in liver fibrosis score (MD = -0.30; 95% CI: -0.62–0.02, p = 0.05) and a significant reduction in liver fibrosis area (MD = -2.36%; 95% CI: -4.22%–-0.50%, p = 0.01) as compared with control. The therapy was well tolerated and there was no significant difference in withdrawals between treatment and control groups (RD = 0.00; 95% CI: -0.06–0.06, p = 0.97). Conclusions: Renin angiotensin system inhibitor therapy results in a reduction in liver fibrosis score and liver fibrosis area in patients with hepatic fibrosis with good safety profile. However, randomized controlled trials of high-quality will clarify the effectiveness of renin angiotensin system inhibitors on liver fibrosis.
Evaluation of subacute change in RAAS activity (as indicated by urinary aldosterone:creatinine, after pharmacologic provocation) and the response to ACE inhibition
Authors: Ames Marisa K , Atkins Clarke E , Lantis Andrea C , zum Brunnen James 
Published: March 2016

Objective: The objective of this study was to evaluate subacute changes in renin–angiotensin–aldosterone system (RAAS) activity during angiotensin-converting enzyme inhibitor (ACEI) therapy in dogs with experimental RAAS activation. Methods: Analysis of data (urine aldosterone:creatinine ratio (UAldo:C) and serum angiotensin-converting enzyme activity), in 31 healthy dogs with furosemide or amlodipine-activated RAAS that received an ACEI. When furosemide or amlodipine activation of RAAS preceded ACEI administration, incomplete RAAS blockade (IRB) was defined as a UAldo:C greater than (a) the dog’s ‘activated’ baseline value or (b) a population-derived cut-off value (mean + 2 SD (>1.0 μg/g) of pretreatment UAldo:C from our population of research dogs). In studies where RAAS activation occurred concurrently with ACEIs, IRB was defined as (a) a UAldo:C greater than either twofold the dog’s prestimulation baseline value or (b) 1.0 µg/g. Dogs were followed for 7–17 days. Results: Serum angiotensin-converting enzyme activity was measured in 19 dogs and was significantly reduced ( P<0.0001) after ACEI administration. The overall incidence of IRB, when RAAS activation preceded ACEI administration, was 33% and 8% for definitions (a) and (b), respectively. The overall incidence of IRB, when ACEIs were concurrent with RAAS activation, was 65% and 61% for definitions (a) and (b), respectively. Conclusion: Increases in UAldo:C, despite ACEI administration, is evidence of IRB in this subacute model of experimental RAAS activation and suppression.