bluuebunny/crossref_metadata_2025_split huggingface dataset:
Correlation between Osteoprotegerin Serum Level and Coronary Calcification Using Coronary Artery Calcium Score in Patient with Moderate–Severe Cardiovascular Risk Factor
Authors: Widorini Widorini , Nugroho J. 
Published: October 2017

AbstractCoronary artery calcification is a part of atherosclerosis process associated with coronary heart disease. Recently, coronary artery calcification assessment using computed tomography (CT) is still the best noninvasive imaging with high sensitivity and specificity. Osteoprotegerin (OPG) is one of vascular calcification marker that through its role to bind receptor activator of nuclear factor-κβ ligand and inhibit osteoclastogenesis is suspected of playing a role for coronary calcification in atherosclerosis process. The objective of this study was to prove a positive correlation between OPG serum level and coronary calcification using coronary artery calcium (CAC) score in patient with moderate–severe cardiovascular (CV) risk factor. This is a cross-sectional study with purposive sampling technique. Thirty-three subjects participate in this research and each subject underwent a multislice computed tomography (MSCT) examination to assess coronary calcification and their blood samples were collected for OPG measurement. This study is analyzed with Spearman's correlation test. The mean of OPG serum level in this study was 5.89 ± 2.1 pmol/L for moderate-risk Framingham risk score (FRS) and the mean of OPG serum level for high-risk FRS was 7.27 ± 3.4. There was a positive, moderate, and significant correlation between OPG serum level and coronary calcification using CAC score in patient with moderate–severe CV risk factor (r = 0.694; p < 0.001).
Quantitative Evaluation of Joint Space Width in the Lateral Compartment after Medial Unicompartmental Knee Arthroplasty: Comparison of Three Radiographic Views
Authors: Yue Ju'an , Guo Wanshou , Wan Fuyin , Wen Pengfei , Liu Zhaohui , Cheng Liming , Zhang Qidong , Chen Yan 
Published: October 2017

AbstractLateral compartment cartilage deterioration is the most common complication affecting medial unicompartmental knee arthroplasty (UKA) survivorship. The purpose of this study was to determine the best method of judging the degeneration of cartilage in the lateral compartment after medial UKA through analysis of different radiographic views. Forty-two participants were divided into two groups. Patients in Group A were followed for at least 10 months after undergoing a medial UKA (mean: 17.67 ± 7.65 months, range: 10–24 months), whereas those in Group B were evaluated 3 days after surgery. Joint space width in the lateral compartment of all patients was evaluated using three types of knee radiographs: weight-bearing anterior posterior (AP), supine AP, and supine valgus stress. No difference in joint space width in the lateral compartment after medial UKA was found for the three kinds of radiographs in Group A (F = 0.97, p = 0.39) and Group B (F = 1.499, p = 0.233). After evaluating the patients 3 days after surgery or following them for approximately 18 months after medial UKA, we determined that weight-bearing AP, supine AP, and supine valgus stress knee radiographs were comparable when used to assess residual cartilage thickness of the lateral compartment.
Botulinumtoxin A – was gibt es Neues?
Authors: Rzany B. 
Published: October 2017

ZusammenfassungNach über 20 Jahren Anwendung von Botulinumtoxin A in der Ästhetischen Medizin gibt es wenig neue Herausforderungen. Die Standardindikationen, die Standardinjektionspunkte und die Dosierungen sind klar und ermöglichen eine wirksame und sichere Behandlung unserer Patienten. Um die Behandlungszufriedenheit kontinuierlich zu verbessern, müssen individuelle Wünsche und die jeweilige anatomische Konstellation im Injektionsplan berücksichtig werden. Mit jedem neuen Patienten wachsen unsere Erfahrungen. Wir sehen mehr, verstehen mehr und lernen unsere Patienten besser zu behandeln. Mit den neuen Toxinen aus Asien und den vorverdünnten Toxinen wird sich der Markt für Botulinumtoxine in den nächsten Jahren beleben. Die Behandlungen mit Botulinumtoxin werden mit großer Wahrscheinlichkeit durch das vermehrte Angebot der Botulinumtoxine günstiger für unsere Patienten werden.
Das Ganze ist mehr als die Summe seiner
Teile
Authors: Weiler-Wichtl Liesa J. , Schwarzinger Agathe , Schepper Florian , Leiss Ulrike ,   PSAPOH – Psychosoziale Arbeitsgemeinschaft in der pädiatrischen
                        Onkologie und Hämatologie
Published: October 2017

Zusammenfassung
Interdisziplinäre Kooperation aus psychosozialer Sicht Die professionelle
Betreuung von jungen Krebspatienten beeinflusst ihr Wohlbefinden und ihre
psychische Gesundheit während und nach der onkologischen Erkrankung
entscheidend. Diese Betreuung gelingt am besten, wenn alle beteiligten
Disziplinen als Team eng zusammenarbeiten.
Videolaryngoskopie im Notfall sinnvoll einsetzen
Authors: Hossfeld Björn , Bernhard Michael , Knapp Jürgen , Helm Matthias , Kulla Martin 
Published: October 2017

ZusammenfassungDie Bedeutung eines erfolgreichen ersten Intubationsversuchs in der Atemwegssicherung ist in mehreren Studien belegt. Zum Gelingen können neben einer guten Ausbildung und regelmäßigem Training vor allem ein standardisiertes Vorgehen im Team mit ausgiebiger Präoxygenierung und optimaler Lagerung des Patienten sowie eine ausreichend tiefe Narkose mit Verwendung von Muskelrelaxanzien und schließlich der Einsatz eines Videolaryngoskops bereits mit dem ersten Intubationsversuch beitragen. Dieser Artikel beschreibt die Möglichkeiten der Videolaryngoskopie in der prähospitalen Notfallmedizin.
Renin Inhibition by Aliskiren Protects Rats Against Isoproterenol Induced Myocardial Infarction
Authors: Khan Vasim , Hassan Md. , Akhtar Mohd. , Najmi Abul 
Published: October 2017

Abstract
Objective Cardioprotective potential of aliskiren against isoproterenol-induced myocardial infarction was evaluated in this study.
Methods Wistar albino rats (n=36) were randomly divided into six groups. Normal control rats received 1 ml saline, orally for 14 days and 0.1 ml saline, subcutaneously on 13th and 14th treatment day while the toxic group animals were administered with saline orally for 14 days and isoproterenol (85 mg/kg, subcutaneously) on 13th and 14th day. In different pre-treatment groups, aliskiren (30, 50 & 100 mg/kg, orally) was administered for 14 days along with isoproterenol (85 mg/kg, subcutaneously) on the last two days. Per se group animals were given aliskiren (100 mg/kg orally) for 14 days. Twenty-four hours after the last drug treatment, cardiac marker enzymes (creatine kinase-MB and lactate dehydrogenase), apoptotic marker enzyme (caspase-3) and antioxidative enzymes (malondialdehyde, reduced glutathione, superoxide dismutase and catalase) were estimated, along with histopathological analysis of myocardium.
Results Isoproterenol treatment caused a significant increase in cardiac markers, malondialdehyde, and caspase-3 levels with a considerable decrease in reduced glutathione, superoxide dismutase and catalase enzyme levels. Aliskiren at 50 and 100 mg/kg doses significantly alleviated the increase of caspase-3 and cardiac marker enzymes as well as the changes in antioxidant enzymes, which was confirmed by histopathological analysis. Aliskiren (100 mg/kg) produced more pronounced protective effects than its other two doses. Moreover, the changes in per se group were insignificant as compared to normal control group.
Conclusion The present study thus provides an evidence for the protective effects of aliskiren in isoproterenol-induced myocardial infarction.
A blow-up lemma for approximate decompositions
Authors: Kim Jaehoon , Kühn Daniela , Osthus Deryk , Tyomkyn Mykhaylo 
Published: October 2017

We develop a new method for constructing approximate decompositions of dense graphs into sparse graphs and apply it to long-standing decomposition problems. For instance, our results imply the following. Let

G
G

be a quasi-random

n
n

-vertex graph and suppose

H
1

,
…
,

H
s

H_1,\dots ,H_s

are bounded degree

n
n

-vertex graphs with

∑

i
=
1

s

e
(

H
i

)
≤
(
1
−
o
(
1
)
)
e
(
G
)

\sum _{i=1}^{s} e(H_i) \leq (1-o(1)) e(G)

. Then

H
1

,
…
,

H
s

H_1,\dots ,H_s

can be packed edge-disjointly into

G
G

. The case when

G
G

is the complete graph

K
n

K_n

implies an approximate version of the tree packing conjecture of Gyárfás and Lehel for bounded degree trees, and of the Oberwolfach problem.

We provide a more general version of the above approximate decomposition result which can be applied to super-regular graphs and thus can be combined with Szemerédi’s regularity lemma. In particular our result can be viewed as an extension of the classical blow-up lemma of Komlós, Sárkőzy, and Szemerédi to the setting of approximate decompositions.
Approximate linear minimum variance filters for continuous-discrete state space models: convergence and practical adaptive algorithms
Authors: Jimenez Juan Carlos 
Published: October 2017

Abstract
In this article, approximate linear minimum variance (LMV) filters for continuous-discrete state space models are introduced. The filters are derived from a wide class of recursive approximations to the predictions for the first two conditional moments of the state equation between each pair of consecutive observations. The convergence of the approximate filters to the exact LMV filter is proved when the error between the predictions and their approximations decreases no matter the time distance between observations. As particular instance, the order-$\beta$ local linearization filters are presented and expounded in detail. Practical adaptive algorithms are also provided and their performance in simulation is illustrated with various examples. The proposed filters are intended for the recurrent practical situation where a stochastic dynamical system should be identified from a reduced number of partial and noisy observations distant in time.
Impact of an Automatic Hospital Probiotic Protocol on Clostridium difficile Infection Rates and Antibiotic Usage Patterns
Authors: Slain Douglas , Georgulis Amy , Dermitt Ronald , Morris Laura , Colodny Stephen 
Published: October 2017

Abstract

Background
The use of probiotics in hospitalized patients ordered antibiotics has been associated with a preventative effect against Clostridium difficile infection (CDI) in a few small studies and meta-analyses. Starting in 2014, all adult patients admitted to our 330-bed community hospital who were started on an antibiotic automatically received a course of the probiotic Saccharomyces boulardii (SB). Our study provides a much larger experience with which to assess the preventative use of SB in patients receiving concomitant antibiotics.

Methods
Rates of CDI were compared during the 3-year periods before and after the automatic SB protocol implementation. CDI infection rates using ICD-9 code and CDC hospital-associated infection (HAI) definitions were compared. The use of CDI treatment agents (oral vancomycin and oral metronidazole) expressed in DDD/1,000 patient-days, and rates of SB infections/cultures were also assessed. All rates were standardized per hospital census. Clostridium difficile laboratory detection was performed by PCR analysis throughout the study period.

Results
Case rates of CDI using ICD-9 or CDC HAI definitions did not differ before and after protocol implementation (P = 0.165 and P = 0.521, respectively). The use of CDI treatment antibiotics were also similar; oral metronidazole (P = 0.269), oral vancomycin (P = 0.938), total CDI agents (P = 0.633). Positive specimen cultures for SB where identified in two patients prior to protocol and in 27 patients during the protocol years. Actual SB infections from sterile body sites were identified in five patients during the protocol vs. only one case in the pre-protocol years (P = 0.035). The average yearly cost of SB prophylaxis was $63,000.

Conclusion
In our global assessment of this data, the use of an automatic SB protocol at our community hospital was not associated with a protective effect against CDI. The use of SB was associated with an increased risk of SB infections. Further study of SB and other probiotic formulations for CDI prevention are warranted.

Disclosures
All authors: No reported disclosures.
Comparative Effectiveness of β-lactams Vs Azithromycin for Treatment of Outpatient Pediatric Community-acquired Pneumonia
Authors: Handy Lori , Gerber Jeffrey S , Bryan Matthew , Zaoutis Theoklis , Feemster Kristen 
Published: October 2017

Abstract

Background
Guidelines recommend amoxicillin as first-line therapy for mild, community-acquired pneumonia (CAP) in healthy, immunized children because of its effectiveness against S. pneumoniae. However, macrolides, which have inferior anti-pneumococcal activity, are the most commonly prescribed class of antibiotics for outpatient CAP. We aimed to determine the comparative effectiveness of β-lactam vs. macrolide antibiotics for the treatment of CAP.

Methods
We conducted a retrospective cohort study in 31 pediatric primary care practices. Patients 3 months to 18 years of age with CAP diagnosed between January 1, 2009 and December 31, 2013 were identified by ICD-9-CM codes. Clinical data were abstracted electronically. Treatment failure was defined as change in antibiotic by the pediatrician, emergency department (ED) visit, or hospitalization for pneumonia in the 2 weeks following diagnosis. Multivariable logistic regression models including children prescribed monotherapy of amoxicillin, broad-spectrum β-lactam antibiotics, or macrolides were built to determine the association of each class with treatment failure, adjusting for clinical and demographic characteristics.

Results
Of 10,470 children who received antibiotics for pneumonia, 4252 (40.6%) received amoxicillin, 4459 (42.6%) received macrolides, and 1759 (16.8%) received broad-spectrum β-lactams. The groups differed by age category, proportion of black patients, insurance type, documented fever, ordering of a chest X-ray, and prior antibiotic exposure. Treatment failure occurred in 633 children (6.1%); 418 required a change in antibiotic by the pediatrician, 169 required an ED visit, and 47 required hospitalization. In the adjusted model, macrolide prescribing was associated with a decreased odds of treatment failure in children &lt;5 years old (aOR = 0.52, 95% CI 0.34, 0.78) and in children ≥5 years old (aOR = 0.32, 95% CI 0.25, 0.41). In practices with the lowest macrolide use, this relationship persisted (OR 0.46; 95% CI 0.23, 0.92).

Conclusion
While rates of treatment failure in children diagnosed with CAP in the outpatient setting were low, macrolides were associated with a lower failure rate than treatment with β-lactams. This may be due to residual confounding by indication or changing epidemiology of outpatient pneumonia.

Disclosures
T. Zaoutis, Astellas: Consultant, Consulting fee; Merck: Grant Investigator, Research grant; nabriva: Consultant, Consulting fee.
Comprehensive Detection of Pathogens in Immunocompromised Children with Bloodstream Infections by Next-generation Sequencing
Authors: Horiba Kazuhiro , Kawada Jun-Ichi , Okuno Yusuke , Tetsuka Nobuyuki , Suzuki Takako , Ando Shotaro , Kamiya Yasuko , Torii Yuka , Yagi Tetsuya , Takahashi Yoshiyuki , Ito Yoshinori 
Published: October 2017

Abstract

Background
Bloodstream infection (BSI) is a severe complication in immunocompromised patients. Prompt identification of causative microorganisms would improve the outcome of BSI due to optimization of antimicrobial treatment. Next-generation sequencing (NGS) allows us to analyze comprehensively and quantitatively all microorganisms present in a clinical sample in comparison with blood culture. However, there are currently no established methods to identify causative pathogens by NGS.

Methods
BSI was defined by the following criteria: (i) pathogen isolated from blood culture and (ii) fever ≥38.0°C or C-reactive protein &gt;1.0mg/dl. Thirty-five pediatric patients (12 with BSI and 23 with suspected BSI/negative blood culture) were enrolled. Plasma/serum samples were used for sequencing and the results were compared with those from blood culture. The bacterial reads per million reads of the sequence depth (BR) and relative importance values of the dominant bacteria (P1) were applied to identify causative pathogens.

Results
Sequencing reads of bacteria isolated in blood culture were identified by NGS in all plasma/serum samples at the onset of BSI. Additionally, bacteria isolated in blood culture were identical to the dominant bacteria by NGS in 8 of 12 patients with BSI. Causative microorganisms were detected when the NGS results fulfilled the criteria of BR &gt;200 and P1 &gt;0.5. In two patients with catheter-related BSI, causative bacteria were detected in the plasma/serum at 7 days before disease onset. Causative pathogens (Tatlockia micdadei, Escherichia coli, and human adenovirus 2) were identified in three of 23 patients in the suspected BSI group. A total of 62 resistance genes were detected in nine patients with sequences covering 5–100% of references.

Conclusion
An NGS-based approach has great potential for analysis of causative microorganisms in BSI and may help to diagnose a disease before disease onset. Antimicrobial resistance genes can also be found through sequence data processing.

Disclosures
All authors: No reported disclosures.
Passive Immunization with Anti-Pertussis Toxin Humanized Monoclonal Antibody Mitigates Clinical Signs of Pertussis Infection in Newborn Baboons
Authors: Maynard Jennifer , Nguyen Annalee , Wolf Roman , Papin James , Connelly Sheila , Kaleko Michael 
Published: October 2017

Abstract

Background
Pertussis is a significant mortality risk in the developing world, killing up to 200,000 infants annually. Maternal vaccination as a strategy to protect newborns has shown some success, but is unlikely to capture all eligible mothers. Hu1B7 is a monoclonal antibody (mAb) that potently neutralizes pertussis toxin. Hu1B7, when administered as part of a binary mAb cocktail, demonstrated therapeutic efficacy in pertussis-infected weanling baboons. Here, the prophylactic potential of hu1B7 to protect infants during their first few months, when mortality risk is highest, was evaluated.

Methods
Neonatal baboons of normal gestational age (180 days ± 10), normal birth weight (~1.0kg), and anti-Fha titer &lt; 5 IU/ml (verifying no prior exposure to Bordetella species) were recruited into the study. At 2 days of age, treated baboons received hu1B7 (40mg/kg, IV), while control animals were untreated. Serum levels of hu1B7 were followed for 5 weeks, at which time the animals were infected with 108 cfu of B. pertussis strain D420. Animals were monitored for clinical signs of disease.

Results
Six controls and seven treated animals were evaluated. All animals were heavily colonized with B. pertussis during the first week after infection. Controls developed significant leukocytosis, most coughed, and three required euthanasia. In contrast, white blood cell counts for all treated animals remained within the normal range, coughing was virtually absent, and all animals maintained normal activity. As expected for a humanized mAb in a nonhuman primate, hu1B7 had an elimination half-life of 11.8±3.4 days.

Conclusion
Protection of newborn baboons from pertussis was achieved by mAb administration 5 weeks prior to pertussis infection. Hu1B7, when systemically present, mitigated the clinical signs of pertussis, including leukocytosis and coughing, but did not prevent bacterial colonization. Assuming a half-life in humans of 3 weeks, mAb administration at birth could potentially provide 4 months of prophylaxis and is a viable strategy to complement maternal vaccination. Moreover, strategies that extend the mAb half-life and lower the dose could further support developing world application.

Disclosures
J. Maynard, Synthetic Biologics, Inc.: Collaborator, Research support; A. Nguyen, Synthetic Biologics, Inc.: Collaborator, Research support; R. Wolf, Synthetic Biologics, Inc.: Collaborator, Research support;; J. Papin, Synthetic Biologics, Inc.: Collaborator, Research support; S. Connelly, Synthetic Biologics, Inc.: Employee, Salary; M. Kaleko, Synthetic Biologics, Inc.: Employee and Shareholder, Salary and stock options
Epidemiology and Trends of Pertussis among Infants: United States, 2000–2015
Authors: Bozio Catherine , Skoff Tami , Pondo Tracy , Liang Jennifer 
Published: October 2017

Abstract

Background
Pertussis, a cyclic respiratory disease, causes the greatest morbidity and mortality among infants, particularly those too young to be vaccinated. Following a resurgence of pertussis in the 1990s, a recommendation was made in 2012 to vaccinate during every pregnancy in order to prevent infant disease. We describe pertussis trends from 2000–2015 among U.S. infants aged &lt;1 year.

Methods
We analyzed infant pertussis cases reported through the National Notifiable Diseases Surveillance System from 2000 to 2015. Incidence rates (cases per 100,000 population) among various age groups (&lt;2, 2– &lt;4, 4– &lt;6, and 6–&lt;12 months) were calculated using National Center for Health Statistics population estimates as denominators. Negative binomial regression was used to estimate the annual average percent change with a linear trend; P &lt; 0.05 was significant.

Results
From 2000 to 2015, 48,909 infant pertussis cases and 255 deaths were reported; infants aged &lt;2 months accounted for 38.7% of cases. The age distribution of infant cases was stable from 2000 to 2009 but changed from 2010 to 2015 (Fig. 1), as the proportion of cases aged 4–&lt;12 months increased annually on average by 4.7% (P &lt; 0.001). Annual incidence was highest among &lt;2 month olds; however, rates increased among older infants (Fig. 2): 7% average annual increase among infants aged 4–&lt;6 months and 11% among infants aged 6–&lt;12 months (P &lt; 0.001 for each). The proportion of infants hospitalized decreased over time in each age group (P &lt; 0.001 for all) with the largest annual average declines among 4–&lt;6 (−5.1%) and 6–&lt;12 month (−5.9%) olds. For all age groups, hospitalization rates were relatively stable, but non-hospitalization rates increased (P &lt; 0.05 for all). The case–fatality ratio (CFR) was highest among &lt;2 month olds (1.6%); CFRs decreased over time among &lt;2 and 2–&lt; 4 month olds (P &lt; 0.05 for each).

Conclusion
Pertussis incidence remains highest among infants aged &lt;4 months, although the age distribution appears to be changing. Decreasing proportions of infants hospitalized may suggest a true decline in disease severity or an increase in reporting of less severe disease. Ongoing monitoring of infant pertussis is needed to better understand the impact of vaccinating pregnant women to prevent pertussis in young infants.

Disclosures
All authors: No reported disclosures.