bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment of Paraquat-Induced Lung Injury With an Anti-C5a Antibody: Potential Clinical Application*
Authors: Sun Shihui , Jiang Yuting , Wang Renxi , Liu Chenfeng , Liu Xiaoling , Song Nianping , Guo Yan , Guo Renfeng , Du Lanying , Jiang Shibo , Li Yan , Qiu Zewu , Zhao Guangyu , Zhou Yusen 
Published: December 2017

Objectives:
Complement activation product C5a plays a critical role in systemic inflammatory response syndrome induced by viruses, bacteria, and toxic agents including paraquat poisoning. This study is to explore the efficiency of anti-C5a–based intervention on systemic inflammatory responses induced by paraquat poisoning.

Design:
Study of cynomolgus macaque model and plasma from paraquat-poisoning patients.

Setting:
Laboratory investigation.

Subjects:
Cynomolgus macaque (n = 12) and samples of plasma from patients (n = 16).

Interventions:
The neutralizing antihuman C5a antibody (IFX-1) was administered to investigate the new treatment strategy for paraquat-induced systemic inflammatory responses in cynomolgus macaque model. In addition, C5a activation in plasma of paraquat patients was blocked by IFX-1 to investigate the blockade role of anti-C5a antibody in activation of inflammatory cells.

Measurements and Main Results:
Dysregulated complement activation and the subsequent cytokine storm were found in patients with acute lung injury and in a primate model of paraquat poisoning. Targeted inhibition of C5a by IFX-1 led to marked alleviation of systemic inflammatory responses and multiple organ damage in the primate model. In addition, blockade of C5a activity in plasma from patients completely inhibited activation of CD11b on blood granulocytes from normal donors, suggesting that IFX-1 may alleviate the excessive activation of inflammatory responses and have clinical utility for patients with acute lung injury.

Conclusions:
Anti-C5a antibodies such as IFX-1 may be used as effective therapeutics for treatment of those suffering from systemic inflammatory responses induced by chemical poisoning like paraquat.
Risk Stratification Using Oxygenation in the First 24 Hours of Pediatric Acute Respiratory Distress Syndrome*
Authors: Yehya Nadir , Thomas Neal J. , Khemani Robinder G. 
Published: December 2017

Objective:
Oxygenation measured 24 hours after acute respiratory distress syndrome onset more accurately stratifies risk, relative to oxygenation at onset, in both children and adults. However, waiting 24 hours is problematic, especially for interventions that are more efficacious early in the disease course. We aimed to delineate whether oxygenation measured at timepoints earlier than 24 hours would retain predictive validity in pediatric acute respiratory distress syndrome.

Design:
Observational cohort study.

Setting:
Two large, academic PICUs.

Patients:
Invasively ventilated children with acute respiratory distress syndrome.

Interventions:
None.

Measurements and Main Results:
Pao2
/Fio2
and oxygenation index (mean airway pressure × Fio2
× 100)/Pao2
) were measured at acute respiratory distress syndrome onset, at 6, 12, 18, and 24 hours after in 459 children at the Children’s Hospital of Philadelphia. Neither Pao2
/Fio2
nor oxygenation index at acute respiratory distress syndrome onset discriminated outcome. Between 6 and 24 hours, both Pao2
/Fio2
(area under receiver operating curve for mortality between 0.57 and 0.62; p = 0.049–0.002) and oxygenation index (area under receiver operating curve, 0.60–0.62; p = 0.006–0.001) showed good discrimination and calibration across multiple outcomes, including mortality, ventilator-free days at 28 days, ventilator days in survivors, and probability of extubation, given competing risk of death. The utility of oxygenation at 12 hours was confirmed in an independent cohort from the Children’s Hospital of Los Angeles.

Conclusion:
Oxygenation measured between 6 and 12 hours of acute respiratory distress syndrome onset accurately stratified outcomes in children. Our results have critical implications for the design of trials, especially for interventions with greater impact in early acute respiratory distress syndrome.
Cutaneous Metaplastic Carcinoma: Report of a Case With Sebaceous Differentiation
Authors: Pazzini Renato , Pereira Gustavo A. , Macarenco Ricardo S. 
Published: December 2017

Abstract:
In this study, a case of a 56-year-old woman with cutaneous metaplastic carcinoma in the neck is reported. It harbored basal cell carcinoma, squamous cell carcinoma, and sebaceous carcinoma, as well as osteosarcoma (with fibroblastic, osteoblastic, aneurysmal bone cyst-like, and chondroblastic patterns). To our knowledge, the literature does not mention sebaceous carcinoma in cutaneous metaplastic carcinoma. Epidemiology and intact mismatch repair proteins of this case support sporadic pathogenesis for this neoplasm. The patient has been followed up for 3 years after surgery with free margins, and no local recurrence or distant metastases have been observed.
Naked Hair Shafts as a Marker of Cicatricial Alopecia
Authors: Doytcheva Kristina , Tan Timothy , Guitart Joan , Gerami Pedram , Yazdan Pedram 
Published: December 2017

Abstract:
Naked hair shafts (NHS) are free-floating hair shafts devoid of surrounding epithelium, supporting structures, and/or embedded in inflammation that may result from destruction of hair follicles by scarring processes such as inflammation and fibroplasia. Extensive examination of NHS has not been performed in scalp biopsies of alopecia. We retrospectively evaluated 622 scalp biopsies of alopecia [345 cicatricial alopecias (central centrifugal cicatricial alopecia, lichen planopilaris, discoid lupus erythematosus, acne keloidalis nuchae, and folliculitis decalvans] and 277 non–cicatricial alopecias [alopecia areata, androgenic alopecia, telogen effluvium, and psoriatic alopecia)] for the presence of NHS. NHS occurred in 0.72% (2/277) of non–cicatricial alopecias (1/102 of alopecia areata, 1/150 of androgenic alopecia, 0/17 of telogen effluvium, and 0/8 of psoriatic alopecia) and 20% (72/345) of cicatricial alopecias (27/118 of central centrifugal cicatricial alopecia, 29/109 of lichen planopilaris, 2/75 of discoid lupus erythematosus, 11/16 of acne keloidalis nuchae, and 3/27 of folliculitis decalvans). The presence of NHS was significantly increased in cicatricial alopecias in comparison with non–cicatricial alopecias; P value <0.0001. Among the cicatricial alopecias, 26% (92/345) had mild inflammation and/or fibrosis, of which 9% (9/92) had NHS. There were 73% (253/345) that had moderate to severe inflammation and/or fibrosis, of which 24% (63/253) had NHS, indicating that as the severity of inflammation and fibrosis increases, so does the presence of NHS. NHS rarely occurs in non–cicatricial alopecias. This variation may result from destruction of hair follicles by the inflammatory and scarring processes. The presence of NHS may be a useful adjunctive histopathologic feature in the diagnosis of cicatricial alopecia.
Cuticular Poroma: A Poroma Mostly Composed of Cuticular Cells (Cuticuloma)
Authors: Alegría-Landa Victoria , Kutzner Heinz , Requena Luis 
Published: December 2017

Abstract:
Poromas are benign cutaneous adnexal neoplasms with differentiation toward excretory ducts of eccrine and apocrine glands. They are mainly composed of solid aggregates of small, monomorphous, round, and basophilic poroid cells, with a lower proportion of larger, squamous, eosinophilic cuticular cells, which are lining ductal structures with an eosinophilic luminal cuticle. In most cases of poromas, cuticular cells represent a small proportion of the neoplastic aggregates. We report 2 poromas mostly composed of cuticular cells, and on the basis of these findings, we have named cuticuloma to this histopathologic variant of poroma.
SUBRETINAL TRANSPLANTATION OF AN AUTOLOGOUS RETINAL FREE FLAP FOR CHRONIC RETINAL DETACHMENT WITH PROLIFERATIVE VITREORETINOPATHY WITH AND WITHOUT MACULAR HOLE
Authors: Thomas Akshay S. , Mahmoud Tamer H. 
Published: December 2017

Purpose:
To describe the surgical technique for subretinal transplantation of an autologous retinal free flap in cases of chronic retinal detachment with proliferative vitreoretinopathy with and without a macular hole.

Methods:
Descriptive case series.

Results:
Two patients with recurrent retinal detachment with proliferative vitreoretinopathy were referred for surgical evaluation. The first patient had high myopia and a macular hole. Acuity at the last time of sustained retinal reattachment was 20/400 for the first patient and counting fingers for the second patient and, in both cases, declined to light perception in the months after redetachment. Despite membrane/internal limiting membrane peeling, surgical repair required an inferior retinectomy in both cases. A retinal free flap was placed subfoveally. In the first patient, the flap was placed with the photoreceptors facing bare retinal pigment epithelium. In the second patient, the flap was inverted so its photoreceptors faced residual macular photoreceptors. The retina was flattened over the flap. Postoperatively, vision improved to 20/160 and 20/400 in the first and second patient respectively.

Conclusion:
Subretinal placement of a retinal flap is possible in eyes with retinal detachment and proliferative vitreoretinopathy with and without macular hole. Whether such a flap results in superior visual and anatomical outcomes remains to be seen.
Improving Time to Antibiotics for Pediatric Oncology Patients With Suspected Infections
Authors: Yoshida Hiromi , Leger Kasey J. , Xu Min , Migita Russell T. , Rutledge Joe C. , Pollard Jessica A. , Kroon Leah , Mazor Suzan S. , Moon Andres , Rutman Lori E. 
Published: December 2017

Objective
Studies in pediatric patients with fever and neutropenia demonstrate that shorter time to antibiotics is associated with a decrease in pediatric intensive care unit admissions and in-hospital mortality. In 2012, a 2-phase quality improvement intervention was implemented in a pediatric emergency department (ED) to improve care for this high-risk patient population.
The objective was to determine if the introduction of (1) a rapid absolute neutrophil count (ANC) test and (2) a standardized prearrival process decreased time to antibiotics for febrile hematology/oncology(heme/onc) patients presenting to the ED.

Methods
The rapid ANC test introduced in February 2012 decreased turn-around-times in the laboratory from 60 to 10 minutes. The standardization of the prearrival communication between the heme/onc team and ED was implemented in August 2012 as part of a clinical standard work pathway for heme/onc patients who presented to the ED with fever and possible neutropenia. Time from arrival to the ED to administration of first antibiotic was measured.
Data from January 2011 to December 2013 were analyzed using statistical process control.

Results
Seven hundred eighteen encounters for 327 patients were included. After the rapid ANC test, the proportion of patients who received antibiotics within 60 minutes of arrival increased from 47% to 60%. There was further improvement to 69% with implementation of the clinical standard work pathway. Mean time to antibiotics decreased from 83 to 65 minutes (21% decrease).

Conclusion
This 2-phase quality improvement intervention increased the proportion of patients who received antibiotics within 60 minutes of arrival to the ED. Similar processes may be implemented in other pediatric EDs to improve timeliness of antibiotic administration.
Low Doses of Etanercept Can Be Effective to Maintain Remission in Psoriatic Arthritis Patients
Authors: de Stefano Renato , Frati Elena , de Quattro Davide , de Stefano Ludovico 
Published: December 2017

Objectives
We realized a longitudinal open-label study to determine if increasing intervals between etanercept (ETN) administration could be effective in maintaining remission with a stable dose in a patient population affected by psoriatic arthritis (PsA) who had achieved sustained remission with ETN 25 mg biweekly.

Methods
Fifty-four PsA patients were recruited at the Rheumatology Unit of Azienda Ospedaliera Universitaria Senese. Patients, who were in clinical sustained remission with biweekly ETN 25 mg at weeks 12 and 16, and were switched to a weekly regimen. If clinical remission persists at weeks 24 and 28, patients were switched to an every-other-week regimen, continuing with this administration schedule for the entire duration of the study if at weeks 36 and 40 clinical remission was maintained. If, on the contrary, in one of the check there was an increase in disease activity, the therapeutic scheme returned to the previous one.

Results
The results of our study indicate that a consistent percentage (72%) of subjects with PsA, achieving a sustained remission with ETN 25 mg biweekly, maintains a remission, after a year of starting therapy, despite a progressive dose reduction by an increase in the dosing interval, 21% with a weekly regimen and 51% with an every-other-week regimen.

Conclusions
Our results show that the main reasons that hinder the dosing interval increase in ETN in PsA patients in sustained clinical remission at standard doses are peripheral polyarthritis pattern and exacerbation of cutaneous manifestations.
Ectopic Undescended Parathyroid Adenoma—SPECT/CT Avoids False-Negative Interpretation on 99mTc-MIBI Dual-Phase Scintigraphy
Authors: Mahajan Sonia , Schoder Heiko 
Published: December 2017

Abstract
Undescended parathyroid adenomas are rare, and they are easily missed during neck exploration surgery in patients with hyperparathyroidism. Few reports have described ectopic parathyroid adenomas along the carotid arteries at or near the carotid bifurcation. These may be missed on planar 99mTc-MIBI dual-phase scintigraphy because of overlapping submandibular gland activity. Our case demonstrates the potential advantage of SPECT/CT in parathyroid scintigraphy to overcome this limitation.
18F-FDG PET/CT Imaging of Necrotizing Crescentic Glomerulonephritis With Anti–Glomerular Basement Membrane Disease
Authors: Holt Emily , Gough Andrew , Prasad Padmini , Chowdhury Fahmid U. 
Published: December 2017

Abstract
A 30-year-old woman presented with lethargy, night sweats, and fever with raised inflammatory markers. Anti–neutrophil cytoplasmic antibody was negative. Abdominopelvic CT was unremarkable. Subsequently, she underwent FDG PET/CT showing globally enlarged kidneys with diffuse hypermetabolic activity within the renal parenchyma bilaterally. Renal biopsies showed morphologic features of an active necrotizing crescentic glomerulonephritis, which was confirmed clinically and treated. This case demonstrates the role that FDG PET/CT can play in inflammatory conditions, such as glomerulonephritis, where it may be clinically useful when the presentation is atypical.
201Tl Myocardial Perfusion Imaging in a Case of Double-Inlet Left Ventricle
Authors: Chang Ming-Che , Lee Meng-Luen , Yang Po-Ta 
Published: December 2017

Abstract
Double-inlet left ventricle (DILV) is a congenital heart disease that only a single left ventricle and a rudimentary right ventricle are developed. Because of lack of anatomic landmark, interpretation of 201Tl myocardial perfusion imaging in DILV is essentially challenging for unusual anomaly. We report the case of a 44-year-old woman with DILV who presented exertional dyspnea and tachycardia and underwent 201Tl SPECT. The anatomic characteristics of cardiac 201Tl SPECT are correlated with MRI. To obtain accurate interpretation in DILV, it is absolutely necessary to realize the anatomy relationship between perfusion imaging and anatomic imaging such as CT or MRI.
Bronchiectasis as a Cause of Elevated CA-19-9 Demonstrated on 18F-FDG PET/CT
Authors: Mikhail Paul , Le Ken , Bui Chuong , Mansberg Robert 
Published: December 2017

Abstract
A 64-year-old woman with a history of weight loss and a markedly elevated serum carbohydrate antigen 19-9 level of 560 U/mL was referred for an 18F-FDG PET study to evaluate for occult malignancy. In addition to the weight loss, she had suffered from a chronic cough secondary to bronchiectasis and had been investigated for a suspected gastrointestinal malignancy. Multiple FDG-avid foci were detected throughout both lungs on FDG PET, corresponding to areas of bronchiectasis on CT with no obvious suspicious FDG-avid foci elsewhere. This supported an inflammatory process causing her elevated carbohydrate antigen 19-9 rather than malignancy.
Hydrogen-Rich Saline Regulates Intestinal Barrier Dysfunction, Dysbiosis, and Bacterial Translocation in a Murine Model of Sepsis
Authors: Ikeda Mitsunori , Shimizu Kentaro , Ogura Hiroshi , Kurakawa Takashi , Umemoto Eiji , Motooka Daisuke , Nakamura Shota , Ichimaru Naotsugu , Takeda Kiyoshi , Takahara Shiro , Hirano Shin-ichi , Shimazu Takeshi 
Published: December 2017

ABSTRACT
Bacterial translocation is a major cause of multiple organ dysfunction syndrome in critical illness, and its management is an important therapeutic strategy. In this study, we focused on the key factors responsible for bacterial translocation including the intestinal microbiome and investigated the impact of molecular hydrogen therapy as a countermeasure against bacterial translocation in a murine model of sepsis. The experimental protocols were divided into the sham, saline treatment (control), and hydrogen treatment (H2) groups. In the H2 group, 15 mL/kg of hydrogen-rich saline (7 ppm) was gavaged daily for 7 days following cecal ligation and puncture (CLP). In the control group, normal saline was gavaged in the same way. In the results, the 7-day survival rate was significantly improved in the H2 group versus the control group (69% vs. 31%, P < 0.05). The incidence of bacterial translocation at 24 h after CLP as assessed by cultivation of mesenteric lymph nodes and blood was significantly decreased in the H2 group versus the control group. Administration of hydrogen-rich saline also prevented the expansion of facultative anaerobic Enterobacteriaceae and ameliorated intestinal hyperpermeability at 24 h after CLP. Intestinal tissue levels of inflammatory mediators such as inducible nitric oxide synthases, tumor necrosis factor α, interleukin (IL)-1β, IL-6, and oxidative stress marker malondialdehyde at 6 h after CLP were down-regulated in the H2 group. These results suggest luminal administration of hydrogen-rich saline, which prevents intestinal dysbiosis, hyperpermeability, and bacterial translocation, could potentially be a new therapeutic strategy in critical illness.
Metabolomic Profile of ARDS by Nuclear Magnetic Resonance Spectroscopy in Patients With H1N1 Influenza Virus Pneumonia
Authors: Izquierdo-Garcia Jose L. , Nin Nicolas , Jimenez-Clemente Jorge , Horcajada Juan P. , Arenas-Miras Maria del Mar , Gea Joaquim , Esteban Andres , Ruiz-Cabello Jesus , Lorente Jose A. 
Published: December 2017

ABSTRACT

Purpose:
The integrated analysis of changes in the metabolic profile could be critical for the discovery of biomarkers of lung injury, and also for generating new pathophysiological hypotheses and designing novel therapeutic targets for the acute respiratory distress syndrome (ARDS). This study aimed at developing a nuclear magnetic resonance (NMR)-based approach for the identification of the metabolomic profile of ARDS in patients with H1N1 influenza virus pneumonia.

Methods:
Serum samples from 30 patients (derivation set) diagnosed of H1N1 influenza virus pneumonia were analyzed by unsupervised principal component analysis to identify metabolic differences between patients with and without ARDS by NMR spectroscopy. A predictive model of partial least squares discriminant analysis (PLS-DA) was developed for the identification of ARDS. PLS-DA was trained with the derivation set and tested in another set of samples from 26 patients also diagnosed of H1N1 influenza virus pneumonia (validation set).

Results:
Decreased serum glucose, alanine, glutamine, methylhistidine and fatty acids concentrations, and elevated serum phenylalanine and methylguanidine concentrations, discriminated patients with ARDS versus patients without ARDS. PLS-DA model successfully identified the presence of ARDS in the validation set with a success rate of 92% (sensitivity 100% and specificity 91%). The classification functions showed a good correlation with the Sequential Organ Failure Assessment score (R = 0.74, P < 0.0001) and the PaO2/FiO2 ratio (R = 0.41, P = 0.03).

Conclusions:
The serum metabolomic profile is sensitive and specific to identify ARDS in patients with H1N1 influenza A pneumonia. Future studies are needed to determine the role of NMR spectroscopy as a biomarker of ARDS.
Association of BDNF Val66Met Polymorphism and Brain BDNF levels with Major Depression and Suicide
Authors: Youssef Mariam M. , Underwood Mark D. , Huang Yung-Yu , Hsiung Shu-chi , Liu Yan , Simpson Norman R. , Bakalian Mihran J. , Rosoklija Gorazd B. , Dwork Andrew J. , Arango Victoria , Mann J. John 
Published: December 2017

ABSTRACTBrain-derived neurotrophic factor (BDNF) is implicated in the pathophysiology of major depressive disorder (MDD) and suicide. Both are partly caused by early life adversity (ELA) and ELA reduces both BDNF protein and gene expression. This study examines the association of BDNF Val66Met polymorphism and brain BDNF levels with depression and suicide. We hypothesized that both MDD and ELA would be associated with the Met allele and lower brain BDNF levels. Such an association would be consistent with low BDNF mediating the effect of ELA on adulthood suicide and MDD. BDNF Val66Met polymorphism was genotyped in postmortem brains of 37 suicide decedents and 53 non-suicides. Additionally, BDNF protein levels were determined by Western blot in dorsolateral prefrontal cortex (Brodmann area 9; BA9), anterior cingulate cortex (ACC; BA24), caudal brainstem and rostral brainstem. The relationships between these measures and major depression, death by suicide and reported childhood adversity were examined. Depressed subjects had an excess of the Met allele and lower BDNF levels in ACC and caudal brainstem compared with non-depressed subjects. No effect of history of suicide death or early life adversity was observed with genotype, but lower BDNF levels in ACC were found in subjects who had been exposed to early life adversity and/or died by suicide compared to nonsuicide decedents and no reported childhood adversity. This study provides further evidence for low BDNF in major depression related to the BDNF met risk allele. Future studies should seek to determine how altered BDNF expression contributes to MDD and suicide.