bluuebunny/crossref_metadata_2025_split huggingface dataset:
HER2 Codon 655 G-Allele is Associated with Reductions in Plasma High-Density Lipoprotein Levels in Breast Cancer Patients Treated with Tamoxifen
Authors: Chang Nai-Wen , Chen Dar-Ren , Chen Fei-Na , Lin Chingju , Wu Chen-Teng 
Published: May 2016

Background Retrospective studies have revealed that overexpression of the epidermal growth factor receptor ErbB-2 (HER2) reduced the efficacy of tamoxifen therapy, which is associated with an increased risk for cardiovascular events. The aim of this study was to evaluate the effects of the HER2 I655V polymorphism (ATC/isoleucine to GTC/valine) on lipid profiles after tamoxifen treatment. Methods Thirty-four women diagnosed with breast cancer were recruited in the study and followed up for 6 months. The presence of the HER2 I655V polymorphism and fasting plasma lipid profiles before and after tamoxifen treatment were determined for each subject for the duration of the study. Results In response to tamoxifen therapy, we found that plasma total cholesterol (TC, P = 0.041), low-density lipoprotein-cholesterol (LDL-C, P < 0.001), and high-density lipoprotein-cholesterol (HDL-C, P = 0.012) levels decreased significantly in the A-allele (AA genotype) carriers compared with the baseline measurements. Plasma LDL-C ( P < 0.001) and HDL-C ( P < 0.001) levels decreased significantly, and the TC/HDL-C ( P = 0.027) ratio increased significantly in the G-allele (AG/GG genotypes) carriers. According to the repeated-measures analysis, G-allele carriers had a lower ratio of LDL-C/HDL-C than A-allele carriers did ( P = 0.016). Notably, G-allele carriers had a greater reduction in HDL-C concentration than A-allele carriers ( P = 0.039; G-allele, −12.4 ± 6.8 mg/dL vs A-allele, −5.6 ± 9.5 mg/dL). Conclusions This study shows that the HER2 codon 655 G-allele was associated with a larger reduction in plasma HDL-C levels in breast cancer patients under tamoxifen therapy. Therefore, we suggest that the polymorphism of HER2 655 codon should be considered for the prevention of cardiovascular events in breast cancer patients after tamoxifen therapy.
Levels of Blood Periostin Decrease after Acute Myocardial Infarction and are Negatively Associated with Ventricular Function after 3 Months
Authors: Cheng Chi-Wen , Wang Chao-Hung , Lee Ju-Fang , Kuo Li-Tang , Cherng Wen-Jin 
Published: May 2016

Background A recent study showed that periostin (PN) induced reentry of differentiated cardiomyocytes into the cell cycle and improved heart function after acute myocardial infarction (AMI). This study sought to investigate whether PN levels increase after AMI and whether they provide prognostic value. Methods and Results We recruited 123 patients: 45 with AMI, 45 with stable coronary artery disease (CAD), and 33 healthy controls (CON). Blood PN and N-terminal pro-brain natriuretic peptide (NT-pro-BNP) levels were measured. Echocardiography was repeated 3 months after AMI. In the AMI group, the PN levels 1.3 ± 1.2 days after AMI were significantly lower than those in the CAD and CON groups (175 ± 60, 245 ± 68, and 232 ± 63 ng/mL, respectively, P = 0.001). The NT-pro-BNP levels were significantly higher in the AMI group, compared to the CON and CAD groups (10.07 ± 28.2 [median, 0.70] vs 0.08 ± 0.06 [median, 0.05] and 1.1 ± 4.2 [median, 0.09] ng/mL, respectively; P = 0.02). The PN levels further decreased 8 ± 2 days after AMI (from 175 ± 60 to 143 ± 57 ng/mL; P = 0.003). However, NT-pro-BNP levels did not significantly change. With respect to the echocardiographic parameters 3 months after AMI, the PN levels measured before discharge were negatively associated with the left ventricular ejection fraction ( rs = −0.50; P = 0.001), end diastolic ( rs = 0.42; P = 0.009) and systolic ( rs = 0.46; P = 0.004) diameters. The NT-pro-BNP levels were not significantly correlated with these parameters. Conclusion Acute myocardial infarction is associated with a decrease in blood PN levels, and PN concentrations predict cardiac function 3 months after AMI.
Influence of Upper and Lower Body Adipose Tissue on Insulin Sensitivity in South Asian Men
Authors: Balakrishnan Preetha , Grundy Scott M. , Islam Arsalla , Dunn Fredrick , Vega Gloria Lena 
Published: May 2016

Background South Asians have a high prevalence of insulin resistance, which predisposes to type 2 diabetes. Rationale In the current study, we examined whether insulin sensitivity in South Asian men and men of European descent (Europids) relates to truncal and lower body fat, number of adipocytes, and cell size distribution. Results Fifteen South Asian men and 15 Europid young men with comparable body mass indexes completed assessments of insulin sensitivity, body composition analysis by dual-energy x-ray absorptiometry, and measurement of adipocyte cellularity in the subcutaneous abdominal (truncal) and gluteal (lower body) adipose tissue. The South Asians and the Europids had similar total body fat and fat contents in truncal and lower body regions. Compared to the Europids, the South Asians had a greater insulin resistance shown by fasting insulin, area-under-the-curve for postprandial insulin, oral glucose insulin sensitivity, homeostatic model assessment of insulin resistance, β-cell index, and triglyceride-to-high-density lipoprotein ratio. The South Asians had similar number of adipocytes to the Europids, but the South Asians had significantly higher ratios of small-to-larger adipocytes. The South Asians further had a higher fraction of very large adipocytes. In both South Asians and Europids, truncal fat was positively associated with insulin resistance. In the South Asians but not in the Europids, lower body fat was associated with severity of insulin resistance. Conclusions The results suggest first, a higher ratio of small-to-larger adipocytes in the South Asians consistent with a lesser lipid storage capacity of adipose tissue; and second, the positive association of lower body fat with insulin resistance in the South Asians implies that fat in their lower body worsens insulin resistance. This association was not observed in the Europids.
Renal Protection of Losartan 50 mg in Normotensive Chinese Patients with Nondiabetic Chronic Kidney Disease
Authors: Shen Pei-Cheng , He Li-Qun , Yang Xue-Jun , Cao He-Xin 
Published: May 2016

Aims Nondiabetic chronic kidney disease (CKD) is the leading major cause of end-stage renal disease in developing countries including China. Among the 5 stages of CKD, it is critical to retard the progression of stage 3 because renal disorder could accelerate aggravation behind that stage. Data suggest that high dosages of angiotensin receptor blockers (ARBs) could retard the progression of renal disease in hypertensive and/or diabetic patients. Nevertheless, in daily practice of nephrology, quite a number of nondiabetic patients with CKD who are normotensive do not tolerate even moderate dosages of ARBs because of adverse effects such as systemic hypotension, epically for Chinese patients. The aim of this study was to investigate the renoprotective effects of relatively low dosages of ARBs in normotensive Chinese patients with nondiabetic stage 3 CKD. Methods A prospective, randomized, parallel-group, open-label study was performed over a period of 12 months. A total of 238 enrolled patients were randomly allocated to treatment with losartan 50 mg (n = 119) or placebo (n = 119). All patients were followed up at 2-month intervals. At each visit, blood pressure was measured, and urinalysis and serum biochemistry tests were performed. Results Finally, 112 patients given losartan and 114 patients given placebo completed the study. In the losartan group, there was a significant and biphasic time-dependent decline in proteinuria during therapy (1.72 ± 0.47 to 0.99 ± 0.48 g/d; P < 0.001). Conversely, placebo did not simultaneously change the amount of proteinuria (1.73 ± 0.49 to 1.64 ± 0.50 g/d; P = 0.337). Estimated glomerular filtration rate remained stable during the entire study period in the patients given losartan (44.8 ± 8.1 to 44.1 ± 7.7 mL/min per 1.73 m2; P = 0.120) but were significantly reduced in the placebo group (44.5 ± 8.5 to 39.1 ± 7.4 mL/min per 1.73 m2, P < 0.001). The changes in blood pressure were kept constant in the 2 groups. All adverse events were minimal and nonfatal. Conclusions For normotensive patients with nondiabetic stage 3 CKD, therapy with a daily dose of losartan, 50 mg, may perform effective renoprotection without changing blood pressure and be generally safe and well tolerated.
Diagnostic Accuracy of Dual-Source 64-Slice Multidetector Computed Tomography in Evaluation of Coronary Artery Bypass Grafts
Authors: Şahiner Levent , Canpolat Uğur , Yorgun Hikmet , Hazırolan Tuncay , Karçaaltıncaba Muşturay , Sunman Hamza , Kaya Ergün Barış , Aytemir Kudret , Oto Ali 
Published: May 2016

Background The aim of this study was to compare the diagnostic accuracy of 64-slice multidetector computed tomography (MDCT) with conventional coronary angiography to detect graft patency and stenosis. Methods In this retrospective analysis, we included a total of 284 subjects (210 men, 73.9%; mean ± SD age, 62.6 ± 9.9) and evaluated 684 bypass grafts using a dual-source 64-slice MDCT scanner The mean ± SD time interval between coronary artery bypass grafting operation and MDCT was 30.8 ± 6.2 months. The mean ± SD interval between MDCT angiography and conventional coronary angiography was 14.2 ± 3.6 days. Significant stenosis was defined as lesions causing 50% or greater luminal narrowing. All atherosclerotic lesion components were assessed on per-segment basis. Results All of the 684 grafts (420 venous and 264 arterial grafts) were evaluable and included in the analysis. For the detection of 50% or greater graft stenosis, the sensitivity, specificity, positive predictive value and negative predictive value of MDCT was 98.3%, 99.3%, 98.3%, and 99.3% for venous grafts and 100%, 99.5%, 98.0%, and 100% for arterial grafts. In detection of graft patency, the sensitivity, specificity, positive predictive value, and negative predictive value of MDCT was 99.6%, 97.2%, 99.0%, and 99.0% for venous grafts and 99.5%, 97.5%, 99.5%, and 97.5% for arterial grafts. Diagnostic accuracy for the detection of graft patency was 99% (416/420) and 99.2% (262/264) for venous and arterial grafts, respectively. Conclusion The diagnostic accuracy of dual-source 64-slice MDCT angiography for evaluating coronary artery bypass grafts patency and stenosis was high. Dual-source 64-slice MDCT can be used for the evaluation of patients after coronary artery bypass grafting.
A Retrospective Evaluation of Radiotherapy for the Treatment of Local Esophageal Squamous Cell Carcinoma Recurrence after Initial Complete Surgical Resection
Authors: Zhu Yu-liang , Li Qun , Gao Jian-ming , Li Ji-shi , He Zhen-yu , Xu Jun-jie , Lu Xiao-jun , Liu Yu-meng 
Published: May 2016

Introduction Our purpose was to assess the efficacy of radiation therapy in the treatment of locoregional recurrence of esophageal squamous cell carcinoma recurrence after curative resection. Methods Patients with local esophageal squamous cell carcinoma recurrence who were treated at the Cancer Prevention and Treatment Center of Sun Yat-sen University from January 1990 to December 2002 and whose initial treatment was complete surgical resection (N = 152) were included. Of the 152 patients, 60 patients received treatment with radiation therapy, and the others did not receive radiation. None of the included patients received chemotherapy or radiotherapy before surgery. The Kaplan-Meier method was used to calculate the cumulative survival rate. Results The median survival time was 16.0 ± 2.7 months for those who received radiotherapy versus 6.5 ± 1.6 months for those who did not ( P < 0.001). The median survival time was greater (22.3 ± 4.0 months) for patients who receive a dosage greater than 50 Gy compared with those patients who received a dosage of 50 Gy or less (7.7 ± 0.3 months; P = 0.033). The overall 3- and 5-year survival rates were 16.4% and 10.4%, respectively. The 1-, 2-, and 3- year recurrence-free survival rates were 56.1 ± 4.3%, 32.9 ± 4.1%, and 22.0 ± 3.7%, respectively. Conclusion Radiotherapy may help improve the survival rate in patients with local esophageal squamous cell carcinoma recurrence after complete surgical resection who have no history of radiotherapy.
Mean Platelet Volume and Its Relation with Arterial Stiffness in Patients with Normotensive Polycystic Kidney Disease
Authors: Orscelik Ozcan , Kocyigit Ismail , Akpek Mahmut , Dogdu Orhan , Kaya Coskun , Unal Aydin , Sipahioglu Murat , Tokgoz Bulent , Zengin Halit , Oymak Oktay , Kaya Mehmet Gungor 
Published: May 2016

Background Autosomal-dominant polycystic kidney disease (ADPKD) demonstrates cardiovascular manifestations, such as hypertension, myocardial infarction, and increased carotid intimae-media thickness. These complications are the main cause of morbidity and mortality in patients with ADPKD. Platelet activation and arterial stiffness are important manifestations that independently predict cardiovascular events. In the present study, we aimed to investigate the relation between arterial stiffness, mean platelet volume (MPV), and highly sensitive C-reactive protein (hs-CRP) in patients with normotensive polycystic kidney disease. Methods We included 30 normotensive subjects with ADPKD with an estimated glomerular filtration rate (eGFR) of 60 mL or more per minute per 1.73 m2, 30 normotensive subjects with ADPKD with eGFR from 30 to 60 mL/min per 1.73 m2, and 30 healthy controls in our study. Pulse wave velocity (PWV), eGFR, spot urine protein-creatinine ratio, MPV, and hs-CRP levels were measured in all participants. In addition, transthoracic echocardiography and ambulatory blood pressure monitoring were performed. Results Age, sex, biochemical markers, eGFR, hemoglobin level, and platelet count were similar in the ADPKD subjects and the controls. There were significant differences in MPV (9.8 ± 0.7, 8.7 ± 0.8, and 8.0 ± 0.5 femtolitre; P < 0.001) and hs-CRP (6.8 ± 3.0, 5.3 ± 2.7, and 2.6 ± 0.52 mg/L; P < 0.001) in the groups. Additionally, PWV values were increased from healthy subjects to ADPKD patients who have decreased eGFR (5.5 ± 1.1, 8.8 ± 1.6, and 10.8 ± 1.2 m/s; P for trend <0.001). There were significant positive correlations between PWV and MPV ( r = 0.401; P = 0.002) and hs-CRP ( r = 0.343; P = 0.007) in the patients with ADPKD. Additionally, PWV was independently predicted by MPV (β = 0.286; P = 0.007), proteinuria (β = 0.255; P = 0.001), eGFR (β = −0.479; P < 0.001), and hs-CRP (β = 0.379; P < 0.001) in the patients with ADPKD. In addition, eGFR, as a sign of severity of disease, was independently predicted by MPV (β = −0.325; P = 0.003), PWV (β = −0.471; P < 0.001), and hs-CRP (β = −0.269; P = 0.008). Conclusions Our findings suggest that MPV and hs-CRP levels are associated with increased arterial stiffness in patients with early-stage ADPKD and those with late-stage ADPKD. Also, MPV and hs-CRP were independently associated with the severity of ADPKD.
Correlates of Impaired Global Right Ventricular Function in Patients with a Reperfused Acute Myocardial Infarction and without Right Ventricular Infarction
Authors: Hsu Shun-Yi , Chang Shang-Hung , Liu Chih-Jen , Lin Jeng-Feng , Ko Yu-Lin , Cheng Shih-Tsung , Chou Hsin-Hua , Chang Heng-Chia 
Published: May 2016

Background The frequency and clinical correlates of global right ventricular (RV) dysfunction in patients treated with primary percutaneous coronary intervention for a first acute ST-elevation myocardial infarction (STEMI) without a coexisting RV infarction is not well known. Materials and Methods One hundred seven consecutive patients underwent conventional echocardiography and pulsed-wave tissue Doppler imaging (TDI) within 72 hours after a successful primary percutaneous coronary intervention to assess their RV function. Global RV function was quantified with the RV myocardial performance index (MPI) by pulsed-wave TDI. An abnormal TDI-derived RV MPI was defined as greater than the upper reference limit of 0.55. Results Global RV dysfunction was present in 18 (17%) of the 107 patients enrolled. The patients with global RV dysfunction had significantly higher glucose levels on admission (216 ± 102 vs 163 ± 86 mg/dL; P = 0.027), higher peak creatine kinase (4027 ± 2171 vs 2660 ± 1980 IU/L; P = 0.014), and more frequently had anterior infarcts (89% vs 58%; P = 0.016) than those without RV dysfunction. Patients with global RV dysfunction also had a significantly lower left ventricular (LV) ejection fraction (45.1 ± 10.8% vs 51.1 ± 9.7%; P = 0.021), a higher global wall motion score index (1.9 ± 0.3 vs 1.7 ± 0.4; P = 0.007), and greater LV MPI (0.65 ± 0.19 vs 0.47 ± 0.11; P = 0.001) than patients without. With the use of multivariate regression analysis, TDI-derived LV MPI (odds ratio [OR], 3.40; 95% confidence interval [CI], 1.20–9.67; P = 0.022), the ratio of transmitral peak early ( E) to late diastolic filling ( A) velocities ( E/ A ratio) (OR, 0.41; 95% CI, 0.18–0.92; P = 0.031), and admission plasma glucose level (OR, 1.01; 95% CI, 1.0–1.02; P = 0.039) were independently associated with the presence of global RV dysfunction. Conclusions In patients with a first acute STEMI without an associated RV infarction, depressed global LV function reflected by increased TDI-derived LV MPI, a lower mitral E/ A ratio, and a higher glucose level on admission are independent correlates of early global RV dysfunction. Routine assessment of global RV function should be implemented in patients with STEMI with these characteristics.
Altered Mental Status in Cirrhosis: Etiologies and Outcomes
Authors: Rahimi Robert S. , Elliott Alan C. , Rockey Don C. 
Published: May 2016

Background Cirrhotic patients admitted with altered mental status (AMS) represent a clinical challenge, as many potentially life-threatening diseases must be considered. Although many patients with AMS have hepatic encephalopathy (HE), other causes of AMS occur, and we hypothesized that these may have different outcomes. Aim We aimed to understand the causes of AMS in cirrhotic patients admitted to the hospital and investigate their associated outcomes. Methods We performed a retrospective cohort study in 1218 inpatients with cirrhosis. Altered mental status was defined a priori (HE, sepsis/infectious, metabolic, exogenous drugs/toxins, structural lesions, or psychiatric abnormalities). Results Patients with AMS had higher levels of serum bilirubin, international normalized ratio, blood urea nitrogen, creatinine, and lower levels of albumin and platelets than those with normal mental status (NMS) ( P = < 0.001). The most common cause of AMS was HE, accounting for nearly half of all patients. Other causes of AMS included the following: sepsis/infection (23%), metabolic disorders (8%), drugs/toxins (7%), structural lesions (5%), psychiatric disorders (1%), or multiple causes (8%). Mortality in patients with AMS was 35% compared to 16% in those with NMS ( P < 0.0001). Patients with sepsis/infection, structural lesions, or multiple disorders causing AMS had the highest mortality (61%, 68%, and 79%, respectively). Conclusions Nearly one third of admissions in cirrhotic patients were due to AMS, most commonly caused by HE. The overall mortality of patients admitted with AMS was greater than with NMS, particularly for those with infection or structural lesions, emphasizing the importance of a search for these causes of AMS in all patients with cirrhosis.
Effects of Ivabradine on 6-Minute Walk Test and Quality of Life in Patients with Previously Implanted CRT-D
Authors: Ates Ismail , Yavuz Asuman H. , Doğru Mehmet , Genç Ahmet , Ulucan Şeref , Sarıkaya Metin , Çetinkaya Ramazan , Keser Ahmet , Akpek Mahmut , Kaya Mehmet G. 
Published: May 2016

Background We aimed to evaluate clinical effects of additional heart rate control by ivabradine on life quality score and 6-minute walking test in patients with previously implanted biventricular cardiac resynchronization therapy defibrillator (CRT-D) with ischemic heart failure under regular treatment. Methods Fifteen men and 14 women with a median age of 63 years (range, 48–79 years) were studied. Twenty-one patients were in New York Heart Association class II (8 patients were in class III), CRT-D implanted previously, and with resting heart rates greater than 70 beats per minute with sinus rhythm despite conventional medication. Patients were given 2.5- to 7.5-mg ivabradine orally twice a day, and drug dosage was titrated to decrease the patients’ average heart rate to 70 beats per minute. Before and 3 months after ivabradine treatment, all patients underwent extensive clinical, echocardiographic, and laboratory evaluation. Results Ivabradine treatment produced dose-dependent reductions in heart rate at rest and at peak exercise (91.9 ± 6.3 to 71.7 ± 4.8 and 114.4 ± 7.6 to 96.8 ± 4.8; P = 0.001 and P = 0.001, respectively). There were also significant improvements in life quality score (52.4 ± 9.5 to 37.9±7.8; P = 0.001) and 6-minute walking distance (278.7 ± 85.8 to 373.3 ± 94.0; P = 0.001) of patients. All patients with New York Heart Association class III became class II after 3 months of ivabradine treatment. Conclusion Heart rate reduction in a short-term period by ivabradine produced significant improvements in exercise capacity and life quality in patients with CRT-D and conventional therapy.
Long-Term Outcome of Patients with Aortic Aneurysms Taking Low-Dose Aspirin
Authors: Chen Chung-Yu , Huang Jiann-Woei , Tzu-Chi Lee Charles , Lai Wen-Ter , Huang Yaw-Bin 
Published: May 2016

Background Limited studies evaluated the association between low-dose aspirin use and abdominal aortic aneurysm (AAA), thoracoabdominal aortic aneurysm (TAAA), and thoracic aortic aneurysm (TAA) treatment. We conducted this study to investigative the association of low-dose aspirin in terms of preventing death and exacerbation of different aortic aneurysms. Methods This retrospective study identified aortic aneurysm cases between 1999 and 2006 from the National Health Insurance Research Database and used time-dependent methods to determine whether the use of low-dose aspirin reduced the risk of outcomes. Primary outcomes, including a composite outcome of death, aortic dissection, a rupture event, an unruptured event, or surgical repair, and secondary outcomes, the composite end point of death and readmission for aortic aneurysm events, were estimated separately. Results Two hundred eighty-seven cases were identified. The hazard ratio for the primary outcome in patients taking low-dose aspirin in AAA/TAAA patients at each 90-day interval based on the time-dependent analysis was 1.000 (95% confidence interval [CI], 0.994–1.005), and in TAA patients 1.010 (95% CI, 0.994–1.026) compared with those with no exposure. In terms of the secondary outcomes, the hazard ratio for all-cause mortality was 0.995 (95% CI, 0.988–1.003) for AAA/TAAA patients and 1.008 (95% CI, 0.991–1.026) for TAA patients. Conclusions From a national population database, we did not find an association between low-dose aspirin exposure and mortality or exacerbation in different aortic aneurysms by using time-dependent analysis. However, adjustments for aneurysms size and smoking status could not be made, which may limit the validity of the study.