bluuebunny/crossref_metadata_2025_split huggingface dataset:
Optimum Conditions for the Efficacy and Safety of Cryofiltration Apheresis: An Analysis of Circuit Temperatures Depending on Plasma Flow Rate and Cooling Coil Lengths/Turns
Authors: Nakajima Hirofumi , Kaneko Shuzo , Sato Yukihiro , Takano Tomoo , Hosino Toshihisa 
Published: September 2015

AbstractA system providing both appropriate cooling and warming are needed for the efficacy and safety of cryofiltration (CF) plasmapheresis. We measured some points of CF circuit temperatures with varying plasma flow rates (QP = 10–40 mL/min) and the numbers of connecting cooling coils (one or two) under the conditions of blood flow rate (QB) 100 mL/min with 7700‐mm coil length, 19 turns, and 50‐mL priming volume. We measured the respective temperatures of each point of starting/returning for an extracorporeal circuit (TA/TV), intracooling coil (TC), and post‐plasma fractionator (PF) (TPF). The subtraction of TV from TA (ΔT) was used as an indicator of safe return. There were no significant differences in TC, TPF, or ΔT in accordance with each QP between that of one and two coils. All of the Tc values under the condition QP ≤ 20 mL/min achieved <4°C. The TPF under the condition QP ≥ 20 mL/min was not significantly different compared to that of QP 30 mL/min (the lowest condition). Although the ΔT increased depending on the QP increase, the ΔT under the condition QP ≤ 15 mL/min was not significantly different from that of the control (one‐way double‐filtration plasmapheresis [DFPP]) group. We conclude that (i) one coil is enough for effective cooling in CF, and (ii) an ideal QP that fulfills the required conditions for both effective cooling and sufficient warming of returning fluid does not exist, but QP from 15 to 20 mL/min may be a relevant range.
Idiopathic inflammatory myopathies: from immunopathogenesis to new therapeutic targets
Authors: Haq Syed A. , Tournadre Anne 
Published: September 2015

AbstractPathogenesis of idiopathic inflammatory myositis (IIM) involves strong interactions between dendritic cells (DCs), activated Th1 and Th17 cells, B cells, muscle cells, genes and environment. Local maturation of DCs permit the activation and polarization of CD4+ T cells into TH1 and TH17 that play a key role in maintaining chronic muscle inflammation. T‐cell mediated myocytotoxicity promotes the liberation of specific muscle autoantigens from regenerating muscle cells with production of myositis‐specific autoantibodies. Type I interferon signature is a key characteristic of IIM. Type I IFN that can be induced by immune complexes containing myositis‐specific autoantibodies is produced by scattered plasmacytoid DCs but also by muscle cells particularly regenerating muscle cells. These immature muscle precursors appear to be critical in the pathogenesis of IIM as they up‐regulate muscle autoantigens, type I IFN, HLA class I antigens and TLR3‐7, all together involved in maintaining chronic muscle inflammation. In addition to the role of immune and muscle cells, genome‐wide association studies have confirmed the importance of several MHC and non‐MHC genes in IIM. Environmental factors can contribute to the pathogenesis of IIM. In sIBM, distinct features suggest both degenerative and inflammatory processes. In addition to our better understanding of the pathogenesis, identify molecular pathway leads to consider new targeted therapies including cytokine inhibition, B‐cell and T‐cell costimulation blockade, type I IFN neutralization or inhibition of the ubiquitin proteasome pathway.
The concept of virtual clinics in monitoring patients with age‐related macular degeneration
Authors: Tsaousis Konstantinos T. , Empeslidis Theodoros , Konidaris Vasileios E. , Kapoor Bharat , Deane James 
Published: September 2015

AbstractPurposeTo present clinical results regarding the treatment of patients with age‐related macular degeneration (neovascular form) after the implementation of a ‘virtual’ type of follow‐up in a single retina service centre.MethodsRetrospective study based on the clinical records of the Leicester Royal Infirmary Retina department. Two periods were compared, the 2‐year period of 2011–2012 and the following one of 2012–2013 when the ‘virtual’ clinics model applied in the department. Primary outcomes were as follows: the time between two appointments, follow‐up or treatment and the number of patients with significant (>15 letters) improvement of their best corrected distance visual acuity. Secondary parameters of interest were as follows: mean number of injections per patient/year and the average duration of a ‘virtual’ vs. a regular visit.ResultsThe mean time interval between two appointments was 5.3 weeks following the implementation of the ‘virtual’ clinics compared to 6.9 weeks in the previous period of regular appointments. Mean visual acuity improvement >15 letters was achieved in 6.9% of the patients compared to 23.1% of the ‘virtual’ appointments period. The results regarding injections/patient/year were as follows: 5.6 before the model of ‘virtual’ appointments and 5.9 after the implementation. The average time a patient spent for a conventional visit was 71.4 ± 24.1 min, and the respective time needed in the virtual clinic was 47.3 ± 18.6 min.ConclusionThe model of ‘virtual’ (without actual consultation) follow‐up appointments assisted our service to contend with the increased number of patient. In general, the specific pattern of patients' management could be widely considered obviously after comprehensive and all‐embracing assessment of its safety and efficiency.
Genotype–phenotype heterogeneity of ganglion cell and inner plexiform layer deficit in autosomal‐dominant optic atrophy
Authors: Rönnbäck Cecilia , Nissen Claus , Almind Gitte J. , Grønskov Karen , Milea Dan , Larsen Michael 
Published: September 2015

AbstractPurposeTo describe the thickness of the combined ganglion cell and inner plexiform layers (GC‐IPL) and the peripapillary retinal nerve fibre layer (RNFL) in patients with OPA1 c.983A>G or c.2708_2711delTTAG autosomal‐dominant optic atrophy (ADOA).MethodsThe study included 20 individuals with c.983A>G and nine individuals with c.2708_2711delTTAG. Data for comparison were drawn from 49, previously published, individuals with OPA1 c.2826_2836delinsGGATGCTCCA and 51 individuals with no OPA1 mutation. Subjects underwent refraction, best‐corrected visual acuity assessment, axial length measurement and high‐definition optical coherence tomography.ResultsThere was overlap in GC‐IPL thickness in subjects younger than 20–30 years between the two new groups of ADOA patients and controls. Numerical decreases in GC‐IPL thickness with age did not reach statistical significance in individuals with c.983A>G (p = 0.18) or in healthy controls (p = 0.22), but it did in individuals with c.2708_2711delTTAG (p = 0.02). Visual acuity decreased with decreasing GC‐IPL thickness (p = 0.0006 in c.983A>G and p = 0.0084 in c.2708_2711delTTAG). Unlike c.2826_2836delinsGGATGCTCCA, individuals with c.983A>G or c.2708_2711delTTAG did not show a pattern of maximum GC‐IPL deficit inferonasal of the fovea.ConclusionGenotype–phenotype heterogeneity in OPA1 ADOA is evident when inner retinal atrophy is examined as a function of age. Thus, a pronounced decline with age in GC‐IPL thickness is observed in c.2708_2711delTTAG ADOA, an intermediate decline with age is observed in c.983A>G ADOA, whereas little or no change with age is observed in c.2826_2836delinsGGATGCTCCA ADOA. This genotype–phenotype heterogeneity may explain why some patients have progressive visual loss while others have a relatively stable prognosis.
Hollow needle cataract aspiration in antiquity
Authors: Pérez‐Cambrodí Rafael J. , Ascaso Francisco J. , Diab Fathi , Alzamora‐Rodríguez Antonio , Grzybowski Andrzej 
Published: September 2015

AbstractThe dislocation of the crystalline lens or couching technique was the predominant procedure to surgically remove cataracts until the 18th century A.D. However, in the Middle Ages, some Arab physicians tried to aspirate the opaque lens by means of a glass tube following a paracentesis. Some literary sources attributed the origins of this technique to Antyllus of Alexandria, a Greek surgeon who lived in the 2nd century A.D. in the Roman Empire. Nevertheless, this statement remains unclear and is probably the consequence of posterior interpretations or incorrect translations of the manuscripts. In recent years, the discovery of the hollow needles from Montbellet (France) and Viladamat (Spain), in archaeological settlements dated between the 1st century and 3rd century A.D., has reopened the possibility of cataract extraction as an option in the surgical management of soft cataracts in the antiquity. In any case, these findings are exceptional, and thus, probably this technique was not widely practised and very likely disparaged by the medical community.
No Untoward Effect of Long‐Term Ketoconazole Administration on Electrocardiographic QT Interval in Patients with Cushing's Disease
Authors: De Martin Martina , Toja Paola Maria , Goulene Karine , Radaelli Piero , Cavagnini Francesco , Stramba‐Badiale Marco , Pecori Giraldi Francesca 
Published: September 2015

AbstractKetoconazole is listed among drugs that prolong QT interval and may increase the risk of torsade de pointes, a severe ventricular arrhythmia. This compound has recently been approved for treatment of Cushing's syndrome, a severe endocrine disorder. These patients harbour several risk factors for prolonged QT interval, for example hypokalaemia and left ventricular hypertrophy, but no study has evaluated whether administration of ketoconazole affects their QT interval. The aim of this study was to assess the QT interval in patients with Cushing's disease during long‐term administration of ketoconazole. Electrocardiograms from 15 patients with Cushing's disease (12 women, 3 men, age: 37.8 ± 2.66 years) on ketoconazole treatment (100 mg–800 mg qd) for 1 month to 12 years were reviewed retrospectively. QT interval was measured and corrected for heart rate (QTc). Measurements before and during ketoconazole treatment were compared and any abnormal QTc value recorded. Concurrent medical therapies were also documented. On average, QTc was superimposable before and during ketoconazole treatment (393.2 ± 7.17 versus 403.3 ± 6.05 msec. in women; 424.3 ± 23.54 versus 398.0 ± 14.93 msec. in men, N.S.). QTc normalized on ketoconazole in one man with prolonged QTc prior to treatment; no abnormal QTc was observed in any other patient during the entire observation period, even during concurrent treatment with other QT‐prolonging drugs. In conclusion, long‐term ketoconazole administration does not appear to be associated with significant prolongation of QT interval in patients with Cushing's disease. ECG monitoring can follow recommendations drawn for other low‐risk QT‐prolonging drugs with attention to specific risk factors, for example hypokalaemia and drug interactions.
A report on older‐age bipolar disorder from the International Society for Bipolar Disorders Task Force
Authors: Sajatovic Martha , Strejilevich Sergio A , Gildengers Ariel G , Dols Annemiek , Al Jurdi Rayan K , Forester Brent P , Kessing Lars Vedel , Beyer John , Manes Facundo , Rej Soham , Rosa Adriane R , Schouws Sigfried NTM , Tsai Shang‐Ying , Young Robert C , Shulman Kenneth I 
Published: September 2015

ObjectivesIn the coming generation, older adults with bipolar disorder (BD) will increase in absolute numbers as well as proportion of the general population. This is the first report of the International Society for Bipolar Disorder (ISBD) Task Force on Older‐Age Bipolar Disorder (OABD).MethodsThis task force report addresses the unique aspects of OABD including epidemiology and clinical features, neuropathology and biomarkers, physical health, cognition, and care approaches.ResultsThe report describes an expert consensus summary on OABD that is intended to advance the care of patients, and shed light on issues of relevance to BD research across the lifespan. Although there is still a dearth of research and health efforts focused on older adults with BD, emerging data have brought some answers, innovative questions, and novel perspectives related to the notion of late onset, medical comorbidity, and the vexing issue of cognitive impairment and decline.ConclusionsImproving our understanding of the biological, clinical, and social underpinnings relevant to OABD is an indispensable step in building a complete map of BD across the lifespan.
Prostate cancer detection on transrectal ultrasonography‐guided random biopsy despite negative real‐time magnetic resonance imaging/ultrasonography fusion‐guided targeted biopsy: reasons for targeted biopsy failure
Authors: Cash Hannes , Günzel Karsten , Maxeiner Andreas , Stephan Carsten , Fischer Thomas , Durmus Tahir , Miller Kurt , Asbach Patrick , Haas Matthias , Kempkensteffen Carsten 
Published: September 2015

ObjectiveTo examine the value of additional transrectal ultrasonography (TRUS)‐guided random biopsy (RB) in patients with negative magnetic resonance imaging (MRI)/ultrasonography (US) fusion‐guided targeted biopsy (TB) and to identify possible reasons for TB failure.Patients and MethodsWe conducted a subgroup analysis of 61 men with prostate cancer (PCa) detected by 10‐core RB but with a negative TB, from a cohort of 408 men with suspicious multiparametric magnetic resonance imaging (mpMRI) between January 2012 and January 2015. A consensus re‐reading of mpMRI results (using Prostate Imaging Reporting and Data System [PI‐RADS] versions 1 and 2) for each suspicious lesion was performed, with the image reader blinded to the biopsy results, followed by an unblinded anatomical correlation of the lesion on mpMRI to the biopsy result. The potential reasons for TB failure were estimated for each lesion. We defined clinically significant PCa according to the Epstein criteria and stratified patients into risk groups according to the European Association of Urology guidelines.ResultsOur analysis showed that RB detected significant PCa in 64% of patients (39/61) and intermediate‐/high‐risk PCa in 57% of patients (35/61). The initial mpMRI reading identified 90 suspicious lesions in the cohort. Blinded consensus re‐reading of the mpMRI led to PI‐RADS score downgrading of 45 lesions (50%) and upgrading of 13 lesions (14%); thus, negative TB could be explained by falsely high initial PI‐RADS scores for 32 lesions (34%) and sampling of the target lesion by RB in the corresponding anatomical site for 36 out of 90 lesions (40%) in 35 of 61 patients (57%). Sampling of the target lesion by RB was most likely for lesions with PI‐RADS scores of 4/5 and Gleason scores (GS) of ≥7. A total of 70 PCa lesions (67% with GS 6) in 44 patients (72%) were sampled from prostatic sites with no abnormalities on mpMRI.ConclusionIn cases of TB failure, RB still detected a high rate of significant PCa. The main reason for a negative TB was a TB error, compensated for by positive sampling of the target lesion by the additional RB, and the second reason for TB failure was a falsely high initial PI‐RADS score. The challenges that arise for both MRI diagnostics and prostate lesion sampling are evident in our data and support the integration of RB into the TB workflow.
The comparative political economy of the location of industry
Authors: Wiberg Magnus 
Published: September 2015

AbstractThis paper studies location decisions of firms in an economic geography model with endogenous regional policy. Policy is determined by probabilistic voting under proportional and majoritarian elections. Different electoral competition give rise to different location incentives. Under plausible assumptions, the smaller region has a higher fraction of ideologically independent swing voters than the larger region. Majoritarian voting, by focusing electoral competition into swing districts containing the most policy‐responsive voters, therefore allocates more subsidies to firms in the smaller region. Compared to proportional voting, this leads to more firms in the region with fewer consumers. Proportional voting thus welfare‐dominates majoritarian election.
Real‐life experience of tolvaptan use in the treatment of severe hyponatraemia due to syndrome of inappropriate antidiuretic hormone secretion
Authors: Tzoulis Ploutarchos , Waung Julian A. , Bagkeris Emmanouil , Carr Helen , Khoo Bernard , Cohen Mark , Bouloux Pierre Marc 
Published: September 2015

SummaryObjectiveEuropean guidelines do not recommend tolvaptan for treatment of syndrome of inappropriate antidiuretic hormone secretion (SIADH), principally owing to concerns about risk of overly rapid correction of hyponatraemia. This study evaluated the real‐life effectiveness and safety of tolvaptan.DesignConsecutive case series.PatientsInpatients treated with tolvaptan for SIADH in 2 UK hospitals over a 3‐year period.MeasurementsThe primary outcome measures were serum sodium (sNa) correction at 24 and 48 h after tolvaptan therapy.ResultsThis case series included 61 patients aged 74·4 ± 15·3 years with (mean ± SD) sNa 119·9 ± 5·5 mmol/l. The mean sNa increase 24 h after tolvaptan initiation was 9 ± 3·9 mmol/l. Excessive correction of hyponatraemia was observed in 23% of patients with all these patients having baseline sNa <125 mmol/l, but no cases of osmotic demyelination syndrome were recorded. At the end of tolvaptan therapy, sNa increase was 13·5 ± 5·9 mmol/l with 96·7% of patients having sNa increase ≥5 mmol/l in 48 h. There was a negative significant correlation (P = 0·012) between baseline sNa and 24‐h change; for every 1 mmol/l reduction in baseline value, sNa increased by an additional 0·23 mmol/l (95% CI 0·05–0·41).ConclusionsTolvaptan is effective in correcting hyponatraemia. Without rigorous electrolyte monitoring, tolvaptan carries a significant risk of overly rapid sodium correction, especially in patients with starting sNa <125 mmol/l. Tolvaptan should be used with great caution under close electrolyte monitoring.
Diverse genetic aetiologies and clinical outcomes of paediatric hypoparathyroidism
Authors: Kim Ja Hye , Shin Young‐Lim , Yang Seung , Cheon Chong Kun , Cho Ja Hyang , Lee Beom Hee , Kim Gu‐Hwan , Lee Jin Ok , Seo Eul Joo , Choi Jin‐Ho , Yoo Han‐Wook 
Published: September 2015

SummaryContextHypoparathyroidism is characterized by hypocalcaemia, hyperphosphataemia, and low or inappropriately normal parathyroid hormone (PTH) levels. Idiopathic or genetic drivers are the predominant causes of hypoparathyroidism in paediatric‐age patients.ObjectiveThis study investigated the aetiology and clinical course of primary hypoparathyroidism in infancy and childhood.Subjects and measurementsThis study included 37 patients (23 males, 14 females) with primary hypoparathyroidism diagnosed prior to 18 years of age. We analysed aetiologies, initial presentation, age at diagnosis, endocrine and radiological findings, and outcomes.ResultsThe median age at presentation was 1·7 months (range 1 day–17 years), and the mean follow‐up duration was 7·0 ± 5·3 years (range 0·5–16·8 years). Our cohort included 22 cases (59·5%) of 22q11·2 microdeletion syndrome. Other aetiologies included hypoparathyroidism–deafness–renal dysplasia syndrome (5/37, 13·5%) and one patient each with autoimmune polyglandular syndrome type 1, Kearns–Sayre syndrome and Kenny–Caffey syndrome. The remaining 7 (18·9%) patients were classified as idiopathic hypoparathyroidism cases. Among the 15 patients who underwent brain imaging, 5 (33·3%) had basal ganglia calcification. Among the 26 patients examined by renal imaging, 5 (19·2%) had either nephrocalcinosis or a renal stone. After 11 months of calcium or calcitriol supplementation, 16 patients (43·2%) discontinued medication. The final PTH levels were significantly higher in patients with transient hypoparathyroidism than those with permanent hypoparathyroidism.ConclusionsIdentification of the genetic aetiologies of hypoparathyroidism makes it possible to predict patient outcomes and provide appropriate genetic counselling. Long‐term treatment with calcium and calcitriol necessitates monitoring for renal complications.
Assessing perioperative body weight changes in patients thyroidectomized for a benign nontoxic nodular goitre
Authors: Lang Brian H.‐H. , Zhi Helen , Cowling Benjamin J. 
Published: September 2015

SummaryBackgroundFollowing thyroidectomy, patients often complain of weight gain. Our study aimed to evaluate the extent of weight change in patients thyroidectomized for a nontoxic benign goitre after adjusting for patient demographics and pre‐operative weight changes.MethodsThree different patient groups were studied. The first comprised 898 patients who underwent thyroidectomy for benign nontoxic nodular goitre (group I). The second comprised 179 patients who had benign nontoxic goitre but did not undergo thyroidectomy (group II), and the third comprised 80 patients who underwent a simple excision of a parathyroid adenoma (group III). All patients were weighed 12 months preceding baseline, at baseline and 6 months after baseline.ResultsBaseline characteristics were comparable between groups. Patients in Group I who gained the least weight in the year leading to surgery gained the most weight 12 months after surgery (P = 0·030). After adjusting for demographics and pre‐operative weight changes, Group I gained significantly more weight at post 6 and 12 months (0·71 (95% CI=0·46–0·95) kg and 1·21 (95% CI = 0·96–1·46) kg, respectively). Weight gain at post 12 months appeared similar between hemithyroidectomy and total thyroidectomy (1·32 vs 1·16 kg, P = 0·197). Younger age (ß coefficient −0·100, 95% CI = −0·030 to 0·003, P = 0·015) and higher baseline thyroid stimulating hormone (ß coefficient −0·315, 95% CI = −1·468 to 0·134, P = 0·020) were significant factors for weight gain at post 12 months.ConclusionsCompared to nonthyroidectomized patients, thyroidectomized patients experienced significant weight increases at post 6 and 12 months. The extent of thyroidectomy did not affect the extent of weight gain. Younger age and higher baseline thyroid stimulating hormone were significant factors of weight gain at post 12 months.
Association of low baseline free thyroxin levels with progression of coronary artery calcification over 4 years in euthyroid subjects: the Kangbuk Samsung Health Study
Authors: Park Hye‐Jeong , Kim Jihyun , Han Eun Jin , Park Se Eun , Park Cheol‐Young , Lee Won‐Young , Oh Ki‐Won , Park Sung‐Woo , Rhee Eun‐Jung 
Published: September 2015

SummaryObjectiveOvert and subclinical hypothyroidism are risk factors for atherosclerosis and cardiovascular diseases. It is unclear whether thyroid hormone levels within the normal range are also associated with atherosclerosis measured by coronary artery calcium (CAC).ContextThis study aimed to examine the relationship between normal variations in thyroid function and changes in CAC.MeasurementsWe conducted a 4‐year retrospective study of 2173 apparently healthy men and women with normal thyroid hormone levels. Their free thyroxin (FT4), free triiodothyronin (FT3) and thyroid‐stimulating hormone (TSH) levels were measured by electrochemiluminescent immunoassay. The CAC score (CACS) of each subject was measured by multidetector computed tomography in both 2010 and 2014. Progression of CAC was defined as a CACS change over 4 years > 0.ResultsThe mean CACS changes over 4 years by quartiles of baseline FT4 level (lowest to highest) were 12·9, 8·43, 7·82 and 7·81 (P = 0·028). CAC progression was not significantly associated with either the baseline FT3 or TSH levels. The odds ratios (OR) for CAC progression over 4 years (highest vs lowest quartile for baseline FT4) were 0·647 (95% confidence interval (CI) 0·472–0·886) after adjustment for confounding factor, which were attenuated with further adjustment for lipid profiles, homoeostasis model assessment of insulin resistance, high‐sensitivity C‐reactive protein and hypertension [0·747 (95% CI 0·537–1·038)]. Quartiles of baseline FT3 or TSH level did not show any increased OR for CAC progression after adjustment for confounding factors.ConclusionsIn this cohort of euthyroid men and women, a low baseline FT4 level was associated with a high risk of CACS progression over 4 years.