bluuebunny/crossref_metadata_2025_split huggingface dataset:
Colorectal multidisciplinary meetings: how do they affect the timeliness of treatment?
Authors: Nikolovski Zoran , Watters David A. K. , Stupart Douglas , Guest Glenn D. 
Published: April 2015

AbstractBackgroundThe aim of this study is to determine whether multidisciplinary team (MDT) meetings alter the length of time to treatment (LOTT) for patients with colorectal cancer.MethodsWe conducted a retrospective audit of all patients with colorectal cancer from the Geelong Hospital (TGH) mandatory colorectal database from 1 January 2006 to 3 February 2011. To be included, patients had to have had elective surgical intervention for primary colorectal adenocarcinoma. A comparison of historical controls was conducted between patients discussed in MDT meetings and those managed prior to the introduction of MDT meetings (3 October 2006) to determine the LOTT in days from definitive diagnosis (colonoscopy) to definitive management (surgery, radiotherapy or chemotherapy).ResultsIn total, the median LOTT for the historical control and MDT era patient populations were 19.5 and 20 days, respectively. Within the MDT era, we noticed significantly longer times to treatment for patients with rectal cancer who were seen in an MDT meeting prior to definitive management than patients who did not have an intervening MDT meeting (P < 0.001). With a difference of 7.5 days, the clinical significance of these findings remains contentious. However, it is worthwhile recognizing this trend in patients who are exhibiting symptoms due to near obstruction or significant bleeding. The LOTT for colon cancer patients remained unchanged.ConclusionThe introduction of MDT meetings to TGH has prolonged the LOTT for patients with rectal cancer. These findings pave the way for further revision of the efficiency of MDT meeting at TGH.
Incidence and Risk Factor Analysis for Gastrointestinal Bleeding and Pump Thrombosis in Left Ventricular Assist Device Recipients
Authors: Lopilato Alex C. , Doligalski Christina Teeter , Caldeira Christiano 
Published: April 2015

AbstractLeft ventricular assist devices (LVADs) are associated with hemostatic complications. We describe the incidence and risk factors for gastrointestinal bleeding (GIB) and pump thrombosis (PT) to optimize patient selection/management. An IRB‐approved retrospective review of first LVAD implants between October 1, 2011 and September 30, 2013 at a single center was conducted. Endpoints included epidemiological and risk factor analyses for GIB and PT. Descriptive statistics, chi‐squared, and t‐tests were used. Sixty‐four patients received continuous‐flow LVADs. The 12‐month incidence of GIB and PT was 23.4% and 12.5%. Time to first GIB was 72.6 days (9–160). The 1‐, 3‐, and 6‐month rate of PT was 1.6%, 6.25%, and 12.5%, respectively. All PT required pump exchange. Females (50% vs. 16%, P = 0.026) and patients without antiplatelet therapy (12.5% vs. 50%, P = 0.046) were at increased risk of PT. No pre‐implant comorbidities were associated with PT. Infection was not identified as a risk factor in our cohort (25% vs. 51.8%, P = 0.156). Mean INR preceding event was not different from nonevent patients (2.1 vs. 2.24, P = 0.24). Regarding biomarkers preceding event, elevated plasma free hemoglobin (pfHg) did not reach significance (75% vs. 58%, P = 0.383) while lactate dehydrogenase was elevated significantly (744 vs. 298, P < 0.001). Receiver operating characteristic (ROC) analysis demonstrated that an LDH of >500 was highly sensitive and specific for PT. No pre‐implant factors were associated with GIB. Post‐implant risk factors for GIB included infection (80% vs. 38.8%, P = 0.005) and infrequent elevations in pfHg (13.3% vs. 63.3%, P < 0.001). Increased pump speed as a GIB risk factor was confirmed (HeartMate II 9560 rpm vs. 9490 rpm, P < 0.001; HeartWare 2949 rpm vs. 2710 rpm, P < 0.001). Anticoagulation/antiplatelet therapy did not affect GIB: mean INR preceding event was not different from nonevent patients (2.21 vs. 2.27, P = 0.67) and antiplatelet use was not different (46.7% vs. 46.9%, P = 0.985). LVADs are associated with early hemostatic‐related morbidity. Few pre‐implantation risk factors were elucidated; however, post‐implantation factors including antiplatelet therapy, infection, and pump speed were identified.
Adaptation to Phosphene Parameters Based on Multi‐Object Recognition Using Simulated Prosthetic Vision
Authors: Xia Peng , Hu Jie , Peng Yinghong 
Published: April 2015

AbstractRetinal prostheses for the restoration of functional vision are under development and visual prostheses targeting proximal stages of the visual pathway are also being explored. To investigate the experience with visual prostheses, psychophysical experiments using simulated prosthetic vision in normally sighted individuals are necessary. In this study, a helmet display with real‐time images from a camera attached to the helmet provided the simulated vision, and experiments of recognition and discriminating multiple objects were used to evaluate visual performance under different parameters (gray scale, distortion, and dropout). The process of fitting and training with visual prostheses was simulated and estimated by adaptation to the parameters with time. The results showed that the increase in the number of gray scale and the decrease in phosphene distortion and dropout rate improved recognition performance significantly, and the recognition accuracy was 61.8 ± 7.6% under the optimum condition (gray scale: 8, distortion: k = 0, dropout: 0%). The adaption experiments indicated that the recognition performance was improved with time and the effect of adaptation to distortion was greater than dropout, which implies the difference of adaptation mechanism to the two parameters.
Small bowel obstruction caused by endometriosis in a postmenopausal woman
Authors: Izuishi Kunihiko , Sano Takanori , Shiota Atsuko , Mori Hirohito , Ebara Kazuo 
Published: April 2015

AbstractWe report a rare case of small bowel obstruction (SBO) caused by endometriosis in a postmenopausal woman. A 54‐year‐old postmenopausal woman presented with severe abdominal pain and vomiting. Before menopause, she sometimes had abdominal pain associated with menses. Axial multi‐dimensional CT images revealed a SBO with small nodules near the terminal ileum. The obstruction was diagnosed as being caused by small bowel endometriosis. Curved planar reconstruction images showed a complicated obstruction of the small intestine 15 cm from the terminal ileum. Based on the stenotic lesion, a SILS procedure was performed. The patient's SBO diagnosis was histologically confirmed as being caused by small bowel endometriosis. SILS was deemed to be a safe, feasible procedure for treating this bowel obstruction. Curved planar reconstruction images were useful in preoperative imaging and diagnosis of SBO, especially as they were able to highlight the constricting legion.
Neuroendoscopic surgery for ventriculitis and hydrocephalus after shunt infection and malfunction: Preliminary report of a new strategy
Authors: Tabuchi Sadaharu , Kadowaki Mitsutoshi 
Published: April 2015

AbstractIf not controlled in the early stage, ventriculitis is difficult to treat neurosurgically and can lead to serious sequelae, a long course of treatment, and hospitalization. We report two cases of ventriculitis and progressive hydrocephalus after shunt infection. Both were successfully treated by neuroendoscopic septostomy in combination with thorough intraventricular irrigation through a single burr hole followed by single shunt revision. Although surgical intervention has not been established as a first‐choice treatment for ventriculitis, including early‐stage ventriculitis, prompt neuroendoscopic surgery appears effective for the management of ventriculitis and hydrocephalus after shunt infection. The strategy described in this report might be useful to avoid recurrent shunt infections and malfunctions, simplify a shunt, and reduce the overall duration of hospitalization.
Laparoscopic right hemicolectomy for metachronous ascending colon cancer with preservation of an ileal conduit constructed after previous radical cystectomy for bladder cancer
Authors: Okoshi Kae , Hasegawa Suguru , Murakami Teppei , Yamada Masahiro , Hida Koya , Kawada Kenji , Sakai Yoshiharu 
Published: April 2015

AbstractA 79‐year‐old woman who had undergone laparoscopic radical cystectomy and ileal conduit construction for bladder cancer 4 years earlier presented to our hospital with anemia. We diagnosed advanced ascending colon cancer (cT4bN2M1) and documented tumor regression after six courses of folinic acid, 5‐fluorouracil, and oxaliplatin therapy. We then performed laparoscopic right hemicolectomy. Intraoperatively, we found that the right colic artery was the feeding artery of the tumor, whereas the ileocolic artery, which was the main feeder of the conduit, was not. We performed lymph node dissection along the surgical trunk with central vascular ligation of the right colic artery and the right branch of the middle colic artery while preserving the ileal conduit and its blood supply (ileocolic artery and ileal branches). The postoperative course was uneventful, and the patient remains well and cancer‐free 2 years after colonic surgery. We believe that this is the first report of laparoscopic right colectomy in a patient with an ileal conduit.
In vivo assessment of the metabolic activity of CYP2D6 diplotypes and alleles
Authors: Hertz Daniel L. , Snavely Anna C. , McLeod Howard L. , Walko Christine M. , Ibrahim Joseph G. , Anderson Steven , Weck Karen E. , Magrinat Gustav , Olajide Oludamilola , Moore Susan , Raab Rachel , Carrizosa Daniel R. , Corso Steven , Schwartz Garry , Peppercorn Jeffrey M. , Evans James P. , Jones David R. , Desta Zeruesenay , Flockhart David A. , Carey Lisa A. , Irvin William J. 
Published: April 2015

AimsA prospectively enrolled patient cohort was used to assess whether the prediction of CYP2D6 phenotype activity from genotype data could be improved by reclassification of diplotypes or alleles.MethodsThree hundred and fifty‐five patients receiving tamoxifen 20 mg were genotyped for CYP2D6 and tamoxifen metabolite concentrations were measured. The endoxifen : N‐desmethly‐tamoxifen metabolic ratio, as a surrogate of CYP2D6 activity, was compared across four diplotypes (EM/IM, EM/PM, IM/IM, IM/PM) that are typically collapsed into an intermediate metabolizer (IM) phenotype. The relative metabolic activity of each allele type (UM, EM, IM, and PM) and each EM and IM allele was estimated for comparison with the activity scores typically assigned, 2, 1, 0.5 and 0, respectively.ResultsEach of the four IM diplotypes have distinct CYP2D6 activity from each other and from the EM and PM phenotype groups (each P < 0.05). Setting the activity of an EM allele at 1.0, the relative activities of a UM, IM and PM allele were 0.85, 0.67 and 0.52, respectively. The activity of the EM alleles were statistically different (P < 0.0001), with the CYP2D6*2 allele (scaled activity = 0.63) closer in activity to an IM than an EM allele. The activity of the IM alleles were also statistically different (P = 0.014).ConclusionThe current systems for translating CYP2D6 genotype into phenotype are not optimally calibrated, particularly in regards to IM diplotypes and the *2 allele. Additional research is needed to improve the prediction of CYP2D6 activity from genetic data for individualized dosing of CYP2D6 dependent drugs.
Dysregulated arginine metabolism and cardiopulmonary dysfunction in patients with thalassaemia
Authors: Morris Claudia R. , Kim Hae‐Young , Klings Elizabeth S. , Wood John , Porter John B. , Trachtenberg Felicia , Sweeters Nancy , Olivieri Nancy F. , Kwiatkowski Janet L. , Virzi Lisa , Hassell Kathryn , Taher Ali , Neufeld Ellis J. , Thompson Alexis A. , Larkin Sandra , Suh Jung H. , Vichinsky Elliott P. , Kuypers Frans A. ,   the Thalassemia Clinical Research Network
Published: April 2015

SummaryPulmonary hypertension (PH) commonly develops in thalassaemia syndromes, but is poorly characterized. The goal of this study was to provide a comprehensive description of the cardiopulmonary and biological profile of patients with thalassaemia at risk for PH. A case–control study of thalassaemia patients at high versus low PH‐risk was performed. A single cross‐sectional measurement for variables reflecting cardiopulmonary status and biological pathophysiology were obtained, including Doppler‐echocardiography, 6‐min‐walk‐test, Borg Dyspnoea Score, New York Heart Association functional class, cardiac magnetic resonance imaging (MRI), chest‐computerized tomography, pulmonary function testing and laboratory analyses targeting mechanisms of coagulation, inflammation, haemolysis, adhesion and the arginine‐nitric oxide pathway. Twenty‐seven thalassaemia patients were evaluated, 14 with an elevated tricuspid‐regurgitant‐jet‐velocity (TRV) ≥ 2·5 m/s. Patients with increased TRV had a higher frequency of splenectomy, and significantly larger right atrial size, left atrial volume and left septal‐wall thickness on echocardiography and/or MRI, with elevated biomarkers of abnormal coagulation, lactate dehydrogenase (LDH) levels and arginase concentration, and lower arginine‐bioavailability compared to low‐risk patients. Arginase concentration correlated significantly to several echocardiography/MRI parameters of cardiovascular function in addition to global‐arginine‐bioavailability and biomarkers of haemolytic rate, including LDH, haemoglobin and bilirubin. Thalassaemia patients with a TRV ≥ 2·5 m/s have additional echocardiography and cardiac‐MRI parameters suggestive of right and left‐sided cardiac dysfunction. In addition, low arginine bioavailability may contribute to cardiopulmonary dysfunction in β‐thalassaemia.
Front‐line, dose‐escalated immunochemotherapy is associated with a significant progression‐free survival advantage in patients with double‐hit lymphomas: a systematic review and meta‐analysis
Authors: Howlett Christina , Snedecor Sonya J. , Landsburg Daniel J. , Svoboda Jakub , Chong Elise A. , Schuster Stephen J. , Nasta Sunita Dwivedy , Feldman Tatyana , Rago Allison , Walsh Kristy M. , Weber Scott , Goy Andre , Mato Anthony 
Published: April 2015

Summary‘Double‐hit lymphomas’ (DHL), defined by concurrent MYC and BCL2 (or, alternatively, BCL6) rearrangements, have a very poor outcome compared to standard‐risk, diffuse large B‐cell lymphomas (DLBCL). Consequently, dose‐intensive (DI) therapies and/or consolidation with high‐dose therapy and transplant have been explored in DHL, although benefit has been debated. This meta‐analysis compared survival outcomes in DHL patients receiving dose‐escalated regimens [DI: R‐Hyper‐CVAD (rituximab, cyclophosphamide, vincristine, doxorubicin, dexamethasone) or R‐CODOX‐M/IVAC (rituximab, cyclophosphamide, doxorubicin, vincristine, methotrexate/ifosfamide, etoposide, high dose cytarabine); or intermediate‐dose: R‐EPOCH (rituximab, etoposide, doxorubicin, cyclophosphamide, vincristine, prednisone)] versus standard‐dose regimens (R‐CHOP; rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) in the first‐line setting. Data were synthesized to estimate hazard ratios of dose‐escalated treatments versus R‐CHOP using a Weibull proportional hazards model within a Bayesian meta‐analysis framework. Eleven studies examining 394 patients were included. Patients were treated with either front‐line R‐CHOP (n = 180), R‐EPOCH (n = 91), or R‐Hyper‐CVAD/rituximab, methotrexate, cytarabine (R‐M/C), R‐CODOX‐M/R‐IVAC (DI) (n = 123). Our meta‐analysis revealed that median progression‐free survival (n = 350) for the R‐CHOP, R‐EPOCH and DI groups was 12·1, 22·2, and 18·9 months, respectively. First‐line treatment with R‐EPOCH significantly reduced the risk of a progression compared with R‐CHOP (relative risk reduction of 34%; P = 0·032); however, overall survival (n = 374) was not significantly different across treatment approaches. A subset of patients might benefit from intensive induction with/without transplant. Further investigation into the role of transplant and novel therapy combinations is necessary.
Retrograde transport of radiolabelled botulinum neurotoxin type A to the CNS after intradetrusor injection in rats
Authors: Papagiannopoulou Dionysia , Vardouli Lina , Dimitriadis Fotios , Apostolidis Apostolos 
Published: April 2015

ObjectiveTo investigate the potential distribution of radiolabelled botulinum neurotoxin type A (BoNT/A) in the CNS after bladder injection in normal rats, by using the gamma‐emitting radionuclide technetium‐99 m (99mTc).Materials and MethodsBoNT/A was radiolabelled by pretreatment with 2‐iminothiolane and incubation with 99mTc‐gluconate. The labelled toxin 99mTc‐BoNT/A was purified using size exclusion HPLC. Twenty‐four female Wistar rats were evenly injected in the bladder wall with either 99mTc‐ΒοΝΤ/Α (n = 12) or free 99mTc (n = 12). Four rats from each group were killed at 1, 3 and 6 h after injection, respectively. The bladder, L6‐S1 spinal cord segment and L6‐S1 dorsal root ganglia (DRG) were harvested and their radioactivity counted in a gamma scintillation detector. Results were calculated as % injected dose (I.D.) per gram of tissue. The paired t‐test was used for comparison of means of 99mTc‐ΒοΝΤ/Α radioactivity vs free 99mTc in the tissues of interest.ResultsRadiolabelled BoNT/A had a high radiochemical stability of 70% after 24 h. Gradual accumulation of 99mTc‐ΒοΝΤ/Α was observed in the DRG up to 6 h after injection (P = 0.04 and P = 0.029 compared with 1 h and 3 h, respectively), while no accumulation was detected for free 99mTc. Consequently, 99mTc‐ΒοΝΤ/Α radioactivity in the DRG was higher than free 99mTc radioactivity (3.18 ± 0.67% I.D./g vs 0.19 ± 0.10% I.D./g [P = 0.002] 6 h after injection). Values for 99mTc‐ΒοΝΤ/Α radioactivity in the spinal cord were higher than those for free 99mTc, but not significantly. The bladder retained higher dosages of 99mTc‐ΒοΝΤ/Α than free 99mTc at all time points.ConclusionsSignificant accumulation of the radiolabelled toxin in the lumbosacral DRG, together with a less significant uptake in the respective spinal cord segment as opposed to free radioactivity provide first evidence of the retrograde transport of BoNT/A to the CNS after bladder injection in rats.
Crosstalk of EGFR signalling with Notch and Hippo pathways to regulate cell specification, migration and proliferation in cockroach panoistic ovaries
Authors: Elshaer Nashwa , Piulachs Maria‐Dolors 
Published: April 2015

Background informationEpidermal growth factor receptor (EGFR) signalling is crucial for the regulation of multiple developmental processes. Its function in relation to insect oogenesis has been thoroughly studied in the fly Drosophila melanogaster, which possesses ovaries of the highly modified meroistic type. Conversely, studies in other insect species with different ovary types are scarce. We have studied EGFR functions in the oogenesis of the cockroach Blattella germanica, a phylogenetically basal insect with panoistic ovaries.ResultsIn this cockroach, depletion of EGFR expression aborts oocyte maturation and prevents oviposition, as affects the distribution of F‐actins in the follicular cells of the basal ovarian follicle, which triggers premature apoptosis. In the younger ovarian follicles within the ovariole, depletion of EGFR expression reduces the number of follicular cells, possibly because the Hippo pathway is altered; moreover, the concomitant reduction of Notch expression results in the absence of stalk. Finally, depletion of EGFR determines an increase in the number of germinal cells.ConclusionsIn the panoistic ovary of B. germanica, EGFR plays a role in the control of cell proliferation through interaction with Hippo and Notch pathways.
African Bioethics vs. Healthcare Ethics in Africa: A Critique of Godfrey Tangwa
Authors: Fayemi Ademola K. 
Published: April 2015

AbstractIt is nearly two decades now since the publication of Godfrey Tangwa's article, ‘Bioethics: African Perspective’, without a critical review. His article is important because sequel to its publication in Bioethics, the idea of ‘African bioethics’ started gaining some attention in the international bioethics literature. This paper breaks this relative silence by critically examining Tangwa's claim on the existence of African bioethics. Employing conceptual and critical methods, this paper argues that Tangwa's account of African bioethics has some conceptual, methodic and substantive difficulties, which altogether do not justify the idea of African bioethics, at least for now. Contra Tangwa, this article establishes that while African bioethics remains a future possibility, it is more cogent that current efforts in the name of ‘African bioethics’ be primarily re‐intensified towards ‘Healthcare ethics in Africa’.
Favourable response to ketogenic dietary therapies: undiagnosed glucose 1 transporter deficiency syndrome is only one factor
Authors: Schoeler Natasha E , Cross Judith Helen , Drury Suzanne , Lench Nicholas , McMahon Jacinta M , MacKay Mark T , Scheffer Ingrid E , Sander Josemir W , Sisodiya Sanjay M 
Published: April 2015

AimWe aimed to determine whether response to ketogenic dietary therapies (KDT) was due to undiagnosed glucose transporter type 1 deficiency syndrome (GLUT1‐DS).MethodTargeted resequencing of the SLC2A1 gene was completed in individuals without previously known GLUT1‐DS who received KDT for their epilepsy. Hospital records were used to obtain demographic and clinical data. Response to KDT at various follow‐up points was defined as seizure reduction of at least 50%. Seizure freedom achieved at any follow‐up point was also documented. Fisher's exact and gene‐burden association tests were conducted using the PLINK/SEQ open‐source genetics library.ResultsOf the 246 participants, one was shown to have a novel variant in SLC2A1 that was predicted to be deleterious. This individual was seizure‐free on KDT. Rates of seizure freedom in cases without GLUT1‐DS were below 8% at each follow‐up point. Two cases without SLC2A1 mutations were seizure‐free at every follow‐up point recorded. No significant results were obtained from Fisher's exact or gene‐burden association tests.InterpretationA favourable response to KDT is not solely explained by mutations in SLC2A1. Other genetic factors should be sought to identify those who are most likely to benefit from dietary treatment for epilepsy, particularly those who may achieve seizure freedom.