bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surgical Treatment of Cellulite and its Results
Authors: Lieberman Clara , Cohen Jose A. 
Published: January 2017

Introduction: Studies have demonstrated that the physiopathological cause of cellulite is fibrous “bridges” originating from the herniation of subcutaneous fat into the connective tissue zone that produce irregularities and unsightly patterns on the skin. This paper describes a treatment that separates the fibrosis of connective tissue from the dermis using liposuction cannulas, producing a homogenous tissue by breaking the bridges. Materials and Methods: Twenty Caucasian female patients with cellulite in the superior aspect of the lower extremities, characterized mainly by multiple irregularities and depressions, participated in this study. Six of the patients were obese and 14 were not overweight. The patients' ages ranged from 21 to 50 years, and their weights ranged from 50 to 84 kg (110–185 lb). The 6 overweight patients underwent surgical treatment that involved liposuction of the anterior, posterior, and lateral thighs with the release of the fibrous tissue bridges from the anterior area of the thigh with blunt thin cannulas. The other 14 patients underwent only separation of the bridges, without any fat aspiration. For all patients, liposculpture was performed in all of the deformed and bulging areas. All patients used compression garments, massage therapy, and exercise after the procedure. Results: Of the 20 patients, 14 exhibited clinical disappearance of the visible irregularities of cellulite. In 4 patients, visible but insufficient improvement was seen, and in 2 of the obese patients, the improvement was minimal. For the 6 patients with less-than-satisfactory results, it was necessary to repeat the treatment after 4 months, with removal of more fat, and then optimal results were observed. Discussion: The surgical treatment using liposuction with the release of the fibrous tissue bridges with blunt thin cannulas resolves the cellulite deformity, producing results that are satisfactory to both the physician and the patient. Conclusions: Separation of the fibrosis of connective tissue from the dermis using liposuction cannulas with local tumescent anesthesia is the treatment indicated for cellulite, since it resolves the problem. The procedure is extremely safe and causes no harm. It should be the first choice when treating cellulite.
Prevention and Management of Metabolic Alkalosis
Authors: Friedman Beth S. , Lumb Philip D. 
Published: January 2017

Metabolic alkalosis is the most common acid-base disor der seen in hospitalized patients. There are three types of metabolic alkalosis: chloride responsive, chloride re sistant, and exogenous administration of alkali. Chlo ride-responsive alkalosis is the most common. Metabolic alkalosis can result in numerous metabolic abnormalities as well as cardiovascular and neurological dysfunction. Histamine H2-receptor antagonists are im portant in the prevention, control, and acute treatment of chloride-responsive metabolic alkalosis. In most pa tients chloride-responsive metabolic alkalosis can be managed successfully with fluid therapy and H 2-recep tor antagonists or a carbonic anhydrase inhibitor (for example, acetazolamide).
The short-term efficacy of bortezomib combined with glucocorticoids for the treatment of refractory lupus nephritis
Authors: Zhang H , Liu Z , Huang L , Hou J , Zhou M , Huang X , Hu W , Liu Z 
Published: January 2017

Objective The treatment of refractory lupus nephritis (LN) remains challenging for clinicians because these patients either do not respond to conventional therapy or relapse during the maintenance treatment period. The aim of this study was to investigate the efficacy and safety of bortezomib combined with glucocorticoids in refractory lupus patients. Methodology Five refractory LN patients aged 21 to 43 years (four females and one male) with biopsy-proven diagnosis (four with type IV and one with type V+IV) were recruited. These patients received bortezomib therapy for four cycles (1.3 mg per square meter of body surface area as an intravenous bolus on days 1, 4, 8, and 11 of 21-day cycles) and glucocorticoids (methylprednisolone 0.5 g/d intravenously for three days, followed by prednisone 0.6 mg/kg/d orally for four weeks, with gradual tapering to 10 mg/d). Proteinuria, serum albumin and creatinine, and immunological parameters were assessed, and adverse effects were also evaluated. Results After two to four bortezomib treatment cycles, four patients achieved partial remission with decreases in SLE disease activity index scores from the range of 12–16 to that of 4–8. The patients also exhibited a decline in proteinuria and an elevation of albumin level after treatment. SCr level was decreased in three of five patients with elevated SCr at baseline. The anti-autoantibodies and complements were also improved. Adverse events were of grades 1–2 and included transient thrombocytopenia, gastrointestinal symptoms and acroesthesia. During a 6- to 24-month follow-up period, three patients achieved complete remission, and one had partial remission. However, one patient received renal replacement therapy. Conclusion Bortezomib combined with glucocorticoids reduces proteinuria, improves renal function and decreases anti-autoantibodies, with good tolerance and mild adverse events, thus representing an alternative therapy for refractory LN and warranting further study.
Incidence of cervical human papillomavirus infection in systemic lupus erythematosus women
Authors: Mendoza-Pinto C , García-Carrasco M , Vallejo-Ruiz V , Méndez-Martínez S , Taboada-Cole A , Etchegaray-Morales I , Muñóz-Guarneros M , Reyes-Leyva J , López-Colombo A 
Published: January 2017

Objectives Our objective was to study the incidence, persistence and clearance of human papillomavirus infection in systemic lupus erythematosus women and assess risk factors for persistence of human papillomavirus infection. Methods We carried out a prospective, observational cohort study of 127 systemic lupus erythematosus women. Patients were evaluated at baseline and at three years. Traditional and systemic lupus erythematosus women-related disease risk factors were collected. Gynaecological evaluations and cervical cytology screening were made. Human papillomavirus detection and genotyping were made by polymerase chain reaction and linear array. Results The cumulative prevalence of human papillomavirus infection increased from 22.8% at baseline to 33.8% at three years; p = < 0.001: 20.1% of patients experienced 43 incident infections. The risk of any human papillomavirus infection was 10.1 per 1000 patient-months. At three years, 47 (88.6%) prevalent infections were cleared. Independent risk factors associated with incident human papillomavirus infection included more lifetime sexual partners (odds ratio = 1.8, 95% confidence interval = 1.11–3.0) and cumulative cyclophosphamide dose (odds ratio = 3.9, 95% confidence interval = 1.2–12.8). Conclusions In systemic lupus erythematosus women, the cumulative prevalence of human papillomavirus infection, including high risk-human papillomavirus and multiple human papillomavirus infections, may increase over time. Most persistent infections were low risk-human papillomavirus. The number of lifetime sexual partners and the cumulative cyclophosphamide dose were independently associated with incident human papillomavirus infection.
Interferon regulatory factor 5 gene polymorphism in Egyptian children with systemic lupus erythematosus
Authors: Hammad A , Mossad Y M , Nasef N , Eid R 
Published: January 2017

Background Increased expression of interferon-inducible genes is implicated in the pathogenesis of systemic lupus erythematosus (SLE). Interferon regulatory factor 5 (IRF5) is one of the transcription factors regulating interferon and was proved to be implicated in the pathogenesis of SLE in different populations. Objectives The objective of this study was to investigate the correlation between polymorphisms of the IRF5 gene and SLE susceptibility in a cohort of Egyptian children and to investigate their association with clinico-pathological features, especially lupus nephritis. Subjects and methods Typing of interferon regulatory factor 5 rs10954213, rs2004640 and rs2280714 polymorphisms were done using polymerase chain reaction-restriction fragment length polymorphism for 100 children with SLE and 100 matched healthy controls. Results Children with SLE had more frequent T allele and TT genotype of rs2004640 ( Pc = 0.003 and 0.024, respectively) compared to controls. Patients with nephritis had more frequent T allele of rs2004640 compared to controls ( Pc = 0.003). However the allele and genotype frequencies of the three studied polymorphisms did not show any difference in patients with nephritis in comparison to those without nephritis. Haplotype GTA of rs10954213, rs2004640 and rs2280714, respectively, was more frequent in lupus patients in comparison to controls ( p = 0.01) while the haplotype GGG was more frequent in controls than lupus patients ( p = 0.011). Conclusion The rs2004640 T allele and TT genotype and GTA haplotype of rs rs10954213, rs2004640, and rs2280714, respectively, can be considered as risk factors for the development of SLE. The presence of the rs2004640 T allele increases the risk of nephritis development in Egyptian children with SLE.
Values Practices and Identity Sustenance in Dual-identity Organizations
Authors: Desai Prarthan B. 
Published: January 2017

A dual identity organization refers to an organization having two, often mutually conflicting, self-referential definitions of ‘who we are’ as an organization (Albert & Whetten, 1985). Values practices are defined as ‘the sayings and doings in organizations that articulate and accomplish what is normatively right or wrong, good or bad, for its own sake’ (Gehman, Trevino, & Garud, 2013, p. 84). In this paper, I study influence of values practices on sustenance of an organizational identity in dual-identity organizations. I adopted a qualitative approach and single case study method for providing a rich narrative of the phenomenon. I collected data from an Indian software organization involved in both software services and software products businesses. The case data show that values practices manifested inside dual-identity organizations in the form of comparisons of the two identities by internal audiences. The study identifies three types of distinct, but interrelated, values practices: (1) values infusion, (2) collective perceptions of pragmatic alignment and (3) collective expectations of equality and equity. The case data show that ineffective management of these values practices was detrimental to the sustenance of an organizational identity that failed to perform well on conventional performance parameters.
Economic Analysis and Patient Satisfaction Associated With Outpatient Total Ankle Arthroplasty
Authors: Gonzalez Tyler , Fisk Erica , Chiodo Christopher , Smith Jeremy , Bluman Eric M. 
Published: January 2017

Background: Total ankle arthroplasty (TAA) is a rapidly growing treatment for end-stage ankle arthritis that is generally performed as an inpatient procedure. The feasibility of outpatient total ankle arthroplasty (OTAA) has not been reported in the literature. We sought to establish proof of concept for OTAA by comparing outpatient vs inpatient perioperative complications, postoperative emergency department (ED) visits, readmissions, patient satisfaction, and cost analysis. Methods: From July 2010 to September 2015, a total of 36 patients underwent TAA. Patients with prior ankle replacement, prior ankle infections, neuroarthropathy, or osteonecrosis of the talus were excluded from the study. All patient demographics, tourniquet times, estimated blood loss, comorbidities, concomitant procedures, complications, return ED visits, and readmissions were recorded. Patient satisfaction questionnaires were collected. Twenty-one patients had outpatient surgery and 15 had inpatient surgery. The cohorts were matched demographically. Results: The average length of stay for the inpatient group was 2.5 days. The overall cost differential between the groups was 13.4%, with the outpatient group being less costly. This correlates to a cost savings of nearly $2500 per case. One patient in the outpatient group had a return ED visit on postoperative day 1 for urinary retention. There were no 30-day readmissions in either group. Seventy-one percent of the outpatient group and 93% of the inpatient group would not change to a different postoperative admission status if they were to have the procedure again. Conclusion: Our results show that OTAA was a cost-effective and safe alternative with low complication rates and high patient satisfaction. With proper patient selection, OTAA was beneficial to both the patient and the health care system by driving down total cost. It has the capacity to generate substantial savings while providing equal or better value to the patient. Level of Evidence: Level III, retrospective comparative study.
The Benefits of Angiotensin Receptor Blockers in Patients with Chronic Heart Failure and Multiple Co-morbidities
Authors: Erdmann Erland 
Published: January 2017

Chronic heart failure (CHF) is common among the elderly, who typically suffer from multiple co-morbidities.The clinician therefore needs to consider the possibility of interaction between drugs given to treat these underlying conditions and drugs given to treat CHF. Patients who remain symptomatic despite established CHF therapy derive important clinical benefits from the addition of an angiotensin receptor blocker (ARB), irrespective of age, sex, ethnicity and baseline heart failure, as recognised in the recent revision of the European Society of Cardiology guidelines for the treatment of CHF. Rationalisation of concomitant therapy in accordance with guideline recommendations can help to minimise the potential for adverse effects. This case report describes an elderly man with CHF and multiple co-morbidities who remained symptomatic despite established therapy.
Symptomatic despite Multiple Drug Therapy: Where do you Turn Next?
Authors: Pietro Maggioni Aldo 
Published: January 2017

Clinicians may be reluctant to implement evidence-based guideline recommendations because they believe that patients with chronic heart failure (CHF) who are enrolled into clinical trials are not truly representative of those seen in routine practice. Moreover, there may also be perceived safety issues associated with polypharmacy in patients with CHF. Clinicians should strive to implement guideline recommendations for the management of CHF to ensure optimal patient outcome in routine clinical practice. This case report demonstrates that symptom control may require a large number of pharmacological treatments, to be administered in accordance with guidelines.
Smoking has no impact on survival and it is not associated with ACE gene I/D polymorphism in hemodialysis patients
Authors: Kiss István , Kiss Zoltán , Kerkovits Lóránt , Paksy András , Ambrus Csaba 
Published: January 2017

Introduction: The relationship between smoking and mortality in patients on hemodialysis is controversial. Earlier studies showed that the insertion/deletion (I/D) polymorphism of the ACE gene might have an effect on mortality. The aim of this study was to test the impact of smoking on survival and whether this association was influenced by ACE gene I/D polymorphism in patients on maintenance hemodialysis. Participants and methods: In this prospective, multicenter cohort study we analyzed 709 prevalent patients on maintenance hemodialysis. Patients were allocated into groups based on their smoking habit. Outcome data were collected during the 144-month follow-up period. Outcomes of current smokers and lifelong non-smokers were compared. In order to control for interactions between predictor variables, we also identified 160 matched pairs for further sub-analysis. Results: The vast majority of patients (67%) were non-smokers, followed by current smokers (22.2%) and ex-smokers (9.8%). Smoking had no impact on survival in the matched pair analysis ( p = 0.99). After adjustment for ACE I/D polymorphism and other co-variates, smoking had no effect on survival. Conclusion: Our data suggest that smoking has no impact on survival; neither is it associated with ACE gene I/D polymorphism in hemodialysis patients.
Urinary MicroRNA-30c-5p and MicroRNA-192-5p as potential biomarkers of ischemia–reperfusion-induced kidney injury
Authors: Zou Yan-Fang , Wen Dan , Zhao Qian , Shen Ping-Yan , Shi Hao , Zhao Qiang , Chen Yong-Xi , Zhang Wen 
Published: January 2017

Early detection of acute kidney injury is difficult due to lack of known biomarkers; previous studies have tried to identify new biomarkers for detecting acute kidney injury at an early stage. MicroRNA, a 21-23 nucleotide noncoding RNA molecule, has emerged as a desirable marker in the diagnosis and prognosis of various diseases. This study aims to identify the expression profile of microRNA in ischemia–reperfusion-induced kidney injury and determine the possibility of using the candidate microRNA as biomarker for the detection of I/R-induced kidney injury. Based on the established rat model of I/R-induced kidney injury, a microarray analysis of rat urine was performed at the beginning of operation (0 h) as well as 72 h post operation. To validate the results, urine samples from 71 patients who underwent cardiac surgery were collected, after which urinalysis was conducted to determine the microRNA concentration. An alternative expression profile of microRNAs was detected in rat urine. The quantitative validation of microRNA showed that the expression of miR-30c-5p, miR-192-5p, and miR-378a-3p was elevated significantly in urine post operation, which was consistent with those of the microarray analysis and earlier than kidney injury molecule-1 (KIM-1). In patients with acute kidney injury, increased levels of miR-30c-5p and miR-192-5p were also detected 2 h post operation, and miR-30c-5p showed preferable diagnostic value compared with protein-based biomarkers. In conclusion, an aberrant expression profile of microRNA was detected in rat urine based on the established ischemia–reperfusion animal model. Both miR-30c-5p and miR-192-5p served as important potential diagnostic markers for I/R-induced kidney injury. Impact statement Firstly, one differentiating factor in our study is that the candidate miRNAs were screened in a controlled animal model rather than in patients with acute kidney injury (AKI) to ensure the purity of the cause of disease and to avoid possible effects of comorbidities on the spectrum of urine miRNA. This ensured the presence of only the relevant candidate miRNA (that associated with I/R injury); and what’s more, the alterative expression of miR-192-5p and miR-30c-5p in animal model, patients with AKI, and cell model was confirmed simultaneously, which is likely to be more convincing. Secondly, the candidate miRNAs were screened sequentially at regular time points, which covered the initiation, progression, and partial repair stages, thus ensuring that no significant miRNAs were omitted in the screening process, and miR-biomarkers in 2 h post operation showed preferable diagnostic performance.
PEGylated long-circulating liposomes deliver homoharringtonine to suppress multiple myeloma cancer stem cells
Authors: Li Miao , Shi Fangfang , Fei Xiong , Wu Songyan , Wu Di , pan Meng , Luo Shouhua , Gu Ning , Dou Jun 
Published: January 2017

The goal of this investigation was to evaluate the inhibiting effect of high proportion polyethyleneglycol of long-circulating homoharringtonine liposomes on RPMI8226 multiple myeloma cancer stem cells. The CD138−CD34− multiple myeloma cancer stem cells isolated from RPMI8226 cell line using magnetic activated cell sorting system were, respectively, incubated with the optimized formulation of polyethyleneglycol of long-circulating homoharringtonine liposomes and the homoharringtonine in vitro, and the multiple myeloma cancer stem cell proliferation, colony formation, and cell cycle were analyzed. The inhibition of the multiple myeloma CD138−CD34− cancer stem cell growth was investigated in non-obese-diabetic/severe-combined-immunodeficiency mice that were implanted with multiple myeloma RPMI 8226 cancer stem cells and treated with the LCL-HHT-H-PEG. The results showed that the polyethyleneglycol of long-circulating homoharringtonine liposomes significantly inhibited MM cancer stem cell proliferation, colony formation, and induced cancer stem cell apoptosis in vitro as well as MM cancer stem cell growth in non-obese-diabetic/severe-combined-immunodeficiency mice compared with the homoharringtonine. In addition, the mouse bone mineral density and the red blood cell count were significantly increased in polyethyleneglycol of long-circulating homoharringtonine liposomes group. In conclusion, the data demonstrated that the developed polyethyleneglycol of long-circulating homoharringtonine liposomes formulation may serve as an efficient therapeutic drug for suppressing CD138−CD34− multiple myeloma cancer stem cell growth by inducing cancer stem cell apoptosis in non-obese-diabetic/severe-combined-immunodeficiency mouse model. Impact statement Multiple myeloma (MM) remains largely incurable until now. One of the main reasons is that there are cancer stem cells (CSCs) in MM, which are responsible for MM’s drug resistance and relapse. In this study, we wanted to extend our previous investigation22 that whether we developed the LCL-HHT-H-PEG formulation have an inhibitory effect on MM CD138−CD34−CSCs in MM CSC engrafted NOD/SCID mouse model. Our data from the present study have demonstrated the therapeutic effect of LCL-HHT-H-PEG on MM-bearing mouse model. The study represents the first attempt to demonstrate that the LCL-HHT-H-PEG formulation is available for treatment MM patients in clinic. Therefore, this finding is important and deserves publication in Experimental Biology and Medicine.