bluuebunny/crossref_metadata_2025_split huggingface dataset:
Circulating Endothelial Cells for Evaluation of Tumor Response in Non-Small Cell lung cancer patients receiving first-line chemotherapy
Authors: Najjar Fadi , Al-Massarani Ghassan , Banat Israa , Alammar Moosheer 
Published: June 2015

Background Circulating endothelial cells (CECs) reflect the neovascularization in the tumor mass. We therefore investigated the potential role of CEC kinetics after first-line chemotherapy in advanced non-small cell lung cancer (NSCLC) patients. Methods Peripheral blood samples were obtained from 45 healthy subjects and 51 naïve patients with advanced NSCLC. Quantification of CD146+ CECs was performed using immunomagnetic separation (IMS). Results Pretreatment and posttreatment CEC levels in NSCLC patients were significantly higher than in healthy subjects (p<0.0001). An objective response was achieved after chemotherapy with partial response (PR) or stable disease (SD) in 26 patients, whereas the remaining 25 patients had progressive disease (PD). Baseline CEC levels were significantly higher in PR/SD patients than in PD patients (p = 0.039). After chemotherapy, CEC count significantly decreased in PR/SD patients (p = 0.014) and increased in patients with PD (p = 0.019). Moreover, there was a significant difference in the percentage change of CEC counts between the 2 groups (p = 0.0016). No significant difference in the median progression-free survival and overall survival (OS) was observed between patients with high baseline CEC counts and those with low baseline CEC levels. However, patients with high percentage change in CEC count had longer OS than those with low percentage change after chemotherapy (p = 0.05). Conclusions Changes in CEC counts after chemotherapy reflect tumor response in advanced NSCLC patients. Moreover, high percentage changes in CEC counts after chemotherapy may predict longer OS in advanced NSCLC. High baseline CEC levels might be an indicator of tumor response in advanced NSCLC patients after first-line chemotherapy.
Serum Cripto-1 as a Clinical Marker for Lung Cancer
Authors: Xu Chun-Hua , Cao Lan , Wei Ying , Yu Li-Ke 
Published: June 2015

Background Cripto-1 (CR-1) plays an important role in angiogenesis related to tumor growth, in concert with vascular endothelial growth factor (VEGF), and enhanced expression of CR-1 has been reported in lung cancer tissue. Methods Patients with lung cancer (n = 156) and healthy volunteers (n = 60) were enrolled in the study. Serum CR-1 and VEGF concentrations were measured using enzyme-linked immunosorbent assay. Results Patients with lung cancer had higher serum CR-1 (4.03 ± 1.49 ng/mL vs. 1.13 ± 0.43 ng/mL, p<0.05) and VEGF (503.62 ± 112.74 pg/mL vs. 398.62 ± 117.84 pg/mL, p<0.05) levels than the control group. With stage progression in non-small cell lung cancer (NSCLC), serum CR-1 levels increased, and patients with distant metastasis had higher levels than those without metastasis (p<0.05). In NSCLC, the low CR-1 group (<1.54 ng/mL) had a better overall survival rate compared with the high CR-1 group (>1.54 ng/mL, p<0.05). Conclusions Our study suggests that serum CR-1 is a useful diagnostic and prognostic marker for NSCLC patients.
Retained Embolized Fragment of Totally Implantable Central Venous Catheter in Right Ventricle: It is Really Necessary to Remove?
Authors: Tazzioli Giovanni , Gargaglia Eleonora , Vecchioni Ilaria , Papi Simona , Di Blasio Petronilla , Rossi Rosario 
Published: June 2015

Introduction Central venous catheters are often required in oncologic patients for long-term safe administration of chemotherapeutic agents, antibiotics, and parenteral nutrition. Rupture of these devices and intracardiac migration is a rare complication. Methods We report one spontaneous rupture and embolization of a totally implantable vascular access device (TIVAD) in an asymptomatic patient. Results A 50-year-old woman received a TIVAD silicone catheter 8 FR for adjuvant chemotherapy. After 3 years of port time in situ, during a follow-up control, a catheter malfunction was found and radiologic investigations showed a rupture and migration of the catheter to the right ventricle. The attempt to remove the fragment under fluoroscopic control using the femoral route was unsuccessful. We did not try a surgical approach because of the complete absence of symptomatology and hemodynamic impairment. Conclusions The catheter rupture and intracardiac embolization is a rare complication associated with totally implantable or tunneled central venous catheters. When such an event happens, the patient should be managed by expert hemodynamists or interventional radiologists making an effort to remove the fragment without surgical measures. When the intravascular percutaneous route fails, the possibility to leave the fragmented catheter in heart chambers should be evaluated, being surgery questionable in asymptomatic patients.
Evaluation of the Correct Position of Peripherally Inserted Central Catheters: Anatomical Landmark vs. Electrocardiographic Technique
Authors: Baldinelli Francesco , Capozzoli Giuseppe , Pedrazzoli Roberta , Marzano Natascia 
Published: June 2015

Purpose The purpose of this study is to verify as early as possible the correct positioning of the peripherally inserted central catheter (PICC) tip in order to reduce complications due to possible malpositioning. The ECG-guided technique proved to be reliable, easy to carry out, straightforward, low-cost and allows us to recognize an incorrect or a suboptimal positioning throughout the procedure. The purpose of this study is to compare two methods used during the PICC insertion so as to prevent catheter malpositioning; the first study estimates the catheter length by the landmark method (based on cutaneous anatomical landmarks, CALs) with the addition of the postprocedural verification of tip location by chest X-Ray (CxR), whereas the second method of intraprocedural tip location is based on the observation of the morphological variations of the P wave (ECG-guided technique) with the addition of the postprocedural verification by CxR. Methods From 2010 to 2012, 90 PICCs were positioned, 48 using the anatomical landmarks and 42 using the ECG technique. Results Twenty-five percent of the catheters positioned with the anatomical landmark technique did not reach the correct position of the tip in SVC; of these, 6.25% were placed in an aberrant position and others in a suboptimal position. Of the 42 PICCs positioned with the ECG technique, only in three cases (equal to 7.14%), a suboptimal position of the tip was observed, whereas there was no case of aberrant positioning. Conclusions The ECG technique represents an accurate, low-cost and safe technique to verify the correct positioning of the tip. The use of the ECG allowed a more correct positioning in terms of catheter tip-carina distance and catheter tip-tracheobronchial angle, and in no patient was it necessary to place a catheter again.
Spontaneous migration of a peripherally inserted central catheter into the azygos vein in esophageal cancer patients during surgery
Authors: Zhang Hanfeng , Jiang Bin , Zhou Hong , Qin Ying , Wang Guorong 
Published: June 2015

Introduction A peripherally inserted central catheter (PICC) is widely used for long chemotherapy regimens or total parenteral nutrition. However, spontaneous migration of the catheter into the azygos vein after satisfactory initial placement has occurred in rare cases. Methods We discuss three such cases in esophageal cancer patients. Results In two patients, the migrated catheters were found during surgery and were repositioned without complications. However, in the third case, the migrated catheter had to be removed to avoid severe complications, as the catheter and the azygos vein were ligatured during operation without notice. Conclusions Migrations might be related to the material properties of silicone PICCs, the short insertion length, the left-sided placement, the changes of thoracic pressure and the intraoperative traction by thoracic surgeons. In conclusion, we recommend routine checks before cutting off the azygos vein during the operations for esophageal cancer patients with left-sided PICCs.
Higher Patency of Transposed Brachio-Basilic Arteriovenous Fistulas Compared to Brachio-Axillary Grafts for Hemodialysis Patients
Authors: Marques Guillaume , Sadaghianloo Nirvana , Fouilhé Laurent , Jean-Baptiste Elixène , Declemy Serge , Clément Claude , Hassen-Khodja Réda 
Published: June 2015

Purpose We compared outcomes of transposed brachio-basilic arteriovenous fistulas (BBAVF) with brachio-axillary prosthetic grafts (BAPG) for hemodialysis. Methods All consecutive patients who underwent creation of a BBAVF or a BAPG, in one of the two institutions, between January 2008 and December 2013 were retrospectively identified. We assessed functional patency and compared complication rates. Patency was also compared between one-stage and two-stage creation procedures for the BBAVF group. Results Two hundred and thirty-eight patients underwent the creation of a BBAVF (N = 136) or a BAPG (N = 102). Median follow-up was 17 months (range, 1-79). At 6, 12 and 24 months, patients in the BBAVF group had significantly higher primary patency (80%, 69%, 56% vs. 77%, 56%, 37%, respectively; p = 0.005), assisted primary patency (90%, 80%, 71% vs. 80%, 66%, 48%; p<0.0001) and secondary patency (93%, 84%, 72% vs. 94%, 87%, 62%; p = 0.006). Two-stage BBAVF had a significantly higher secondary patency (98%, 92%, 78% vs. 90%, 80%, 68%; p = 0.04) than one-stage BBAVF. The rate of infectious complications was significantly lower in the BBAVF group than in the BAPG group (0.8% vs. 6.9%; p = 0.03). Conclusions In this large cohort, BBAVF had a higher functional patency and lower rate of infectious complications than BAPG. After exhaustion of cephalic veins, we suggest creation of a BBAVF instead of BAPG, whenever anatomically feasible. The superiority of one-stage or two-stage BBAVF creation procedure must be further investigated.
Focused Simulation Training: Emergency Department Nurses’ Confidence and Comfort Level in Performing Ultrasound-Guided Vascular Access
Authors: Adhikari Srikar , Schmier Charles , Marx Jared 
Published: June 2015

Study objectives The objective of this study is to assess Emergency Department (ED) nurses’ confidence, comfort level, and competency in performing ultrasound-guided vascular access after a focused ultrasound simulation training session. Methods A cross-sectional study at an academic medical center. A simulation-based ultrasound training module was used to train ED nurses in ultrasound-guided intravenous (IV) access. The training module consisted of didactics followed by hands-on practice on human models and Blue Phantom ultrasound training block model. All subjects completed a questionnaire after completing the training module. Results A total of 40 nurses were enrolled. All subjects successfully demonstrated competency during the training session by identifying upper extremity sonographic vascular anatomy on a human model and performing real-time ultrasound-guided IV access on Blue Phantom ultrasound training block model. On a scale of 1-10, the average confidence level in performing the ultrasound-guided vascular access was 6.9 [95% confidence interval (95% CI) 6.3-7.46], with 98% (95% CI, 92-102%) reporting no difficulty in recognizing upper limb vascular anatomy on ultrasound. Ninety-two percent (95% CI, 84-100%) agreed that focused training in ultrasound-guided IV access was adequate to learn the procedure. Conclusions After a focused simulation training session, ED nurses had a high level of comfort using ultrasound for vascular access. Despite having a moderate degree of confidence, ED nurses were accurate in identifying vascular anatomy and performing ultrasound-guided vascular access.
Reduction of Risk of Dying from Tobacco-related Diseases after Quitting Smoking in Italy
Authors: Carreras Giulia , Pistelli Francesco , Falcone Franco , Carrozzi Laura , Martini Andrea , Viegi Giovanni , Gorini Giuseppe 
Published: June 2015

Aims and Background The aims of this paper are to compute the risks of dying of ischemic heart disease (IHD), lung cancer (LC), stroke, and chronic obstructive pulmonary disease (COPD) for Italian smokers by gender, age and daily number of cigarettes smoked, and to estimate the benefit of stopping smoking in terms of risk reduction. Methods Life tables by sex and smoking status were computed for each smoking-related disease based on Italian smoking data, and risk charts with 10-year probabilities of death were computed for never, current and former smokers. Results Men aged 45-49 years, current smokers, have a 8, 10, 3 and 1 in 1,000 chance of dying of IHD, LC, stroke and COPD, respectively, whereas women with the same characteristics have a 2, 6, 3 and 1 in 1,000 chance, respectively, for all smokers combined, i.e., independent of the smoking intensity. The risk reduction rates from quitting smoking are remarkable: a man who quits smoking at 45-49 years can reduce the risk of dying of IHD, LC, stroke and COPD in the next 10 years by 43%, 53%, 57% and 55%, respectively; a woman by 49%, 49%, 59% and 57%, respectively. Conclusions Estimates of risk reduction by quitting smoking are useful to provide a sounder scientific basis for public health messages and clinical advice.
Bevacizumab Treatment for Vestibular Schwannoma in a Patient with Neurofibromatosis Type 2: Hearing Improvement and Tumor Shrinkage
Authors: Sponghini Andrea P. , Platini Francesca , Rondonotti David , Soffietti Riccardo 
Published: June 2015

Purpose Neurofibromatosis type 2 (NF2) is a dominantly inherited genetic condition that clinically manifests through the appearance of multiple meningiomas, ependymomas and bilateral vestibular schwannomas (acoustic neuromas) which lead to progressive hearing loss. Neovascularization is necessary for tumor growth and is driven by tumor-produced angiogenic factors such as vascular endothelial growth factor (VEGF). Bevacizumab is a humanized monoclonal antibody that neutralizes the activity of VEGF. Recent data have shown that VEGF is produced by schwannoma tumor cells. Bevacizumab treatment in patients with NF2 who were considered poor candidates for surgery and radiation therapy was found to result in clinically meaningful hearing improvement and tumor volume reduction in previous studies. Methods We report the case of a 40-year-old woman with sudden right-sided hearing loss. Magnetic resonance imaging (MRI) revealed multiple meningiomas and neurinomas (C2 and L5 lesions) and a right-sided acoustic neurinoma, confirming the diagnosis of NF2. Bevacizumab was given as infusion every 2 weeks at a dose of 5.0 mg/kg body weight with MRI monitoring every 6 months. Results After 6 months from the start of therapy the patient reported progressive improvement of hearing response in audiometry, word recognition and face-to-face conversation. MRI evidenced reduction of the volume of the right vestibular schwannoma and the multiple meningiomas as well as attenuation of brain stem compression. Conclusions At the time of writing the patient is continuing treatment with bevacizumab without adverse events. She has good functional status and quality of life.
Proteomic Analysis of a Nasopharyngeal Carcinoma Cell Line and a Nasopharyngeal Epithelial Cell Line
Authors: Huang Pei-Yu , Zeng Ting-Ting , Li Meng-Qing , Ban Xiaojiao , Zhu Ying-Hui , Zhang Bao-Zhu , Mai Hai-Qiang , Zhang Li , Guan Xin-Yuan , Li Yan 
Published: June 2015

Background Nasopharyngeal carcinoma (NPC) is an epithelial malignancy exhibiting a strong geographic preference and a close association with Epstein-Barr virus (EBV). The aim of this study was to investigate the precise mechanism of nasopharyngeal epithelial-to-NPC tumorigenesis and to identify possible biomarkers and targets for therapy. Methods Proteomic analysis was performed on the immortalized nasopharyngeal epithelial cell line NP69 and the NPC cell line C666. Results A comparative analysis of total lysates from the cell lines using 2-D gel electrophoresis–mass spectrometry resulted in the identification of 87 different protein spots. The different proteins were grouped into 5 main categories: (i) energy production and general metabolism, (ii) adaptation/stress tolerance, (iii) cell proliferation, (iv) cell structure and (v) epithelial-mesenchymal transition. The detection of metabolism-related proteins indicated that the NPC cells relied on aerobic glycolysis, with reduced use of the citric acid cycle. Glucose uptake and lactate secretion increased in the medium of C666 compared with NP69. Conclusions The present study revealed that glycolysis was up-regulated in the NPC cell lines compared with nasopharyngeal epithelial cells. A number of molecules involved in metabolism were identified, and further investigations will be needed to validate these potential biomarkers or targets.
Giant Cemento-ossifying Fibroma of the Maxilla
Authors: Unal Adnan , Yurtsever Kum Nurcan , Kum Rauf Oguzhan , Erdogan Aysun , Ciliz Deniz Sozmen , Guresci Servet , Ozcan Muge 
Published: June 2015

Introduction Fibro-osseous lesions of the skull and facial bones are benign tumors, but they can be mistaken for malignant tumors due to their clinically aggressive behavior. Cemento-ossifying fibroma (COF) is a benign fibro-osseous lesion characterized by slow growth and fibrous and calcified tissue content. COFs are locally destructive lesions causing deformities in the bones. The recurrence risk is high if they are not completely removed. Case Report In this case report we describe a giant COF mimicking chondrosarcoma in the oral cavity of a 55-year-old woman causing significant facial deformity and feeding problems. Conclusions Giant COF occurs rarely in the jaws and given that this lesion has similar imaging and clinical features to several other tumors, the diagnosis is always a challenge for clinicians, radiologists and pathologists.
Normativity and Expressive Agency in Hegel, Nietzsche, and Deleuze
Authors: Bowden Sean 
Published: June 2015

ABSTRACT
This article synthesizes several different studies of Hegel's and Nietzsche's expressive conceptions of action and agency and identifies a related account in Deleuze's Logic of Sense. It argues that such conceptions not only challenge familiar voluntarist accounts of action and agency; they also demand a reassessment of standard approaches to the relation between norms and action. For the voluntarist, an agent's action is caused by the separate, prior intention of the agent. For expressivists, an agent's intention is inseparable from the action expressing it and nonisolatable from the expression of this intention-action in interpretative activity. For the voluntarist, the norms governing action can be thought of as more or less freestanding, entering into the prior formation of the agent's intention. For the expressivist, the norm or principle on which an agent acts will be produced over time, through the unfolding of the action expressing it, as well as through interpretative struggle over the meaning of that action, all of which takes place in a social space governed by more basic norms concerning the offering of act-descriptions, recognition, and social and hermeneutical struggle. A number of important differences among Hegel's, Nietzsche's, and Deleuze's accounts are identified, and their significance is explored.
Concentratietoezicht ACM in de ziekenhuissector
Authors: Kemp Ron , Leijh-Smit Marie-Louise , Schep Krijn 
Published: June 2015

Concentratietoezicht ACM in de ziekenhuissector
In dit artikel gaan wij in op het beoordelingskader van ACM bij fusies tussen ziekenhuizen. Wij bespreken de marktafbakening, de disciplineringsmogelijkheden van zorgverzekeraars en de rol van patiënten. Wij reflecteren hierop aan de hand van onze persoonlijke ervaringen. Het doel hiervan is om een beter beeld te geven van het toezicht van ACM en de afwegingen die daarin een rol spelen. Wij concluderen dat het toezicht op ziekenhuisfusies baat kan hebben bij: (1) meer inzicht in de effecten van fusies, (2) een betere onderbouwing van de inbreng van vooral zorgverzekeraars en (3) betere beschikbaarheid van kwaliteitsinformatie over ziekenhuizen.
The words of prevention, part II: ten terms in the realm of quaternary prevention
Authors: Jamoulle Marc , Gavilán Enrique , Cardoso Raquel Vaz , Mariño María Ana , Pizzanelli Miguel , Grosjean Julien , Darmoni Stéfan J. 
Published: June 2015

Objective: This part II article about the ‘words of prevention’ presents in a terminological way the content of ten current concepts used in the prevention domain which are closely linked to quaternary prevention: (1) overinformation, (2) overdiagnosis, (3) medically unexplained symptoms, (4) overmedicalisation, (5) incidentaloma, (6) overscreening, (7) overtreatment, (8) shared decision making, (9) deprescribing, and (10) disease mongering. Methods: with the support of the laboratory team of the University of Rouen, France, which is dedicated to medical terminology and semantic relationships, it was possible to utilize a graphic user interface (called DBGUI) allowing the construction of links for each of chosen terms, and making automatic links to MeSH, if any. Those concepts are analyzed in their environment in current literature, as well as in their MeSH counterparts, if any, and related semantic online terminologies. Results and Discussion: The rules in terminological development aspire to cover the whole field of a concept and in the meantime, it helps to avoid the noise due to proxy and not exactly related issues. This refers to exhaustivity and specificity in information retrieval. Our finds show that referring to MeSH only in information retrieval in General Practice/Family medicine can induce much noise and poor adequacy to the subject investigated. Conclusion: Gathering concepts in specially prepared terminologies for further development of ontologies is a necessity to enter in the semantic web area and the era of distributed data.
Promoting Organ Donation through Challenge Campaigns
Authors: Feeley Thomas Hugh , Kruegler Joan 
Published: June 2015

Context— Four challenge campaigns in 2012 and 2013 were undertaken to promote organ donor registrations in New York State. Challenge campaigns relied on community advocates statewide to initiate month-long outreach efforts with top teams earning monetary rewards and public recognition. Objective— To significantly increase the number and proportion of New York residents who have consented to donation through the electronic registry. Design— Four month-long campaigns undertaken in fall and spring of 2012 and 2013. Setting— Statewide recruitment efforts organized by New York Alliance for Donation and the 4 organ procurement organizations in New York State. Participants— Adult residents of New York State. Intervention— Project staff recruited team leaders across New York State and used online and offline resources to recruit teams, educate team leaders, and bolster outreach efforts. Main Outcome Measures— Number of completed registration forms within month-long campaign periods. Also investigated were statistics on website use (eg, page views, new visitors) and interviews with team leaders regarding campaign activities after the campaign. Results— Across 4 campaigns, 107 teams were recruited and 2286 persons registered their consent to donate through the state system. Each team recruited a mean of 21 persons; 40% of teams registered 0 persons.