bluuebunny/crossref_metadata_2025_split huggingface dataset:
The role of exercise testing in the evaluation and management of heart failure
Authors: Wright D J , Tan L B 
Published: February 2015

Summary
The clinical syndrome of heart failure has been investigated so extensively that it may now almost be regarded as a metabolic disorder. Although an initial insult reduces cardiac pump efficacy, the resultant physiological response culminates in complex neurohormonal dysfunction. This has created confusion and prevented the acceptance of a universal definition of cardiac failure. With much current research concentrating on the pharmacological modification of neuro-endocrine imbalance, it is easy to lose sight of the fundamental principles behind heart failure management, namely, to improve cardiac function. In attempting to achieve this, the issues of morbidity and mortality must be addressed jointly; they are not mutually exclusive entities. Discrepant results between mortality studies and changes in exercise capacity have undermined the value of exercise testing. Because a treatment enhances longevity we should not ignore its effect on symptomatic status, and likewise we should not discard a therapy, which improves function because adverse events result in occasional premature deaths. Informed patient choice must exist.
Historically, exercise testing has been quintessential in our understanding and evaluation of heart failure. Peak oxygen consumption remains the best overall indicator of symptomatic status, exercise capacity, prognosis and hospitalisation. Unfortunately, muddling of surrogate and true end-points has confused many of these issues. Improved comprehension may be gained by applying the concept of cardiac reserve which has been described in a variety of heart conditions and used in cardiac failure patients to provide an indication of prognosis and functional capacity.
A patient with fever and an abdominal aortic aneurysm
Authors: Barlow Gavin D , Green Stephen T 
Published: February 2015

Summary
A 55-year-old man with an abdominal aortic aneurysm presented with fever and abdominal pain 3 weeks after an episode of Salmonella gastroenteritis. His symptoms persisted despite antimicrobial therapy. Two abdominal computed tomography (CT) scans showed no evidence of aortitis. His abdominal pain worsened and further investigation including a third CT scan demonstrated a leaking aortic aneurysm. The wall of the aorta was shown to contain Gram-negative bacilli. This case illustrates the difficulty in diagnosing bacterial aortitis.
A lesson in the management of testicular cancer in a patient with a solitary testis
Authors: Sawyer E J , Oliver R T D , Tobias J S , Badenoch D F 
Published: February 2015

Summary
Five per cent of patients with germ cell tumours of the testis will develop a further tumour in the contralateral testis. Standard treatment in such cases is a second orchidectomy, resulting in infertility, hormone replacement, and psychological morbidity. In this case report we explore the role of testis conservation in these patients and also show that there is a risk of removing a potentially normal testis if a histological diagnosis is not sought prior to orchidectomy.
Aetiology and outcome in 53 cases of native valve staphylococcal endocarditis
Authors: Hricak V , Kovacik J , Marks P , West D , Kromery V 
Published: February 2015

Summary
Within the last 30 years the profile of infective endocarditis has altered considerably with regard to microbiological causation, clinical features, and natural history. A contributory factor has undoubtedly been the development of potent antibiotics and their sometimes indiscriminate use. The increase in intravenous drug abuse in urban centres, the use of immunosuppressive agents, and the use of prosthetic heart valves have also all contributed. Although cardiac surgery in the uninfected heart provides a perfect environment for infective endocarditis, the improved design of prosthetic valves and the enhanced long-term survival and decreased immediate operative risk, means that surgery is viewed as the best option in many cases. In a series of 53 cases of staphylococcal endocarditis from a national endocarditis survey, those risk factors which influenced outcome were analysed. Thirty out of 53 patients had predisposing heart disease. Mortality was 39.6%. Statistical analysis revealed that attributable mortality was significantly associated with skin infection, systemic embolisation, and inappropriate therapy. Interestingly, surgical treatment was associated with better outcome.
Cytomegalovirus retinitis in patients with acquired immune deficiency syndrome
Authors: Eong K G Au , Beatty S , Charles S J 
Published: February 2015

Summary
Cytomegalovirus (CMV) retinitis is the most common intra-ocular infection in patients with acquired immune deficiency syndrome (AIDS), and a leading cause of AIDS-related morbidity. Untreated CMV retinitis in AIDS patients is a progressive and potentially blinding disorder. The diagnosis of CMV retinitis is a clinical one and it is important for physicians to be familiar with the clinical features of the disease. Ophthalmic screening of AIDS sufferers should be undertaken at regular intervals, and this is dictated, in part, by the patient's CD4+ T-lymphocyte (CD4) counts. CMV retinitis may be treated with systemic ganciclovir, foscarnet or cidofovir, or with local (intravitreal) therapy. CMV-related retinal detachment is treated surgically. In some patients with quiescent CMV retinitis receiving highly active anti-retroviral therapy, anti-CMV maintenance therapy may be discontinued in favour of close ophthalmologic observation and CD4 count monitoring.
Primary lymphoma of the bladder treated successfully with mitozantrone gel
Authors: Porter P , Cornaby A J , Al-Hilali M , Chakrabarti A M 
Published: February 2015

Summary
We describe a young man who presented with a short history of painless haematuria. Subsequent investigations and biopsy of lesions found in his bladder at cystoscopy confirmed the diagnosis of primary lymphoma of the bladder. Computed tomography studies confirmed the disease was localised to his bladder. Unfortunately, the tumour was not eradicated by radiotherapy. However, it was successfully treated with intravesical mitozantrone given in a novel gel formation. Three years after diagnosis the patient remains well with no evidence of recurrence.
A variant of pyothorax-associated lymphoma
Authors: Cheung C , Schonell M , Manoharan A 
Published: February 2015

Summary
A case of pleural lymphoma that developed after an episode of empyema is described. This may be a variant presentation of the rare yet distinct condition termed pyothorax-associated lymphoma. This condition was first recognised in Japan; there have been only a few reports in Western countries to date. A feature of this case is the relatively short interval between diagnosis of empyema and subsequent development of lymphoma.
Co-prescription of H2 receptor blockers and proton pump inhibitors with warfarin in general practice
Authors: Hungin A Pali S , Rubin Greg P , O'Flanagan Hilda 
Published: February 2015

Summary
Acid-suppressing drugs and anticoagulants are used increasingly in general practice. Warfarin is potentiated by some acid-suppressing drugs, notably cimetidine and omeprazole, through interference of the cytochrome P450 system. This study aimed to ascertain the extent of co-prescribing of warfarin and acid-suppressing drugs in general practice. We conducted a retrospective survey of the records of all patients prescribed acid-suppressing drugs over a 2-year period to ascertain those who had also taken warfarin; we also made a cross-sectional survey of all patients on warfarin to ascertain those who had taken acid-suppressing drugs. From a general practice population of 45 574 patients in northern England, 3423 (7.5%) had been prescribed acid-suppressing drugs during the previous 24 months. Of 274 patients who had been on warfarin, 44 (16.1%) had also taken acid-suppressing drugs (26 H2 receptor blockers and 18 proton-pump inhibitors). The commonest reasons for anticoagulation were thrombo-embolic disease (40.9%), atrial fibrillation (36.4%), valvular heart disease (18.2%), and surgical prophylaxis (4.5%). The indications for concurrent acid-suppressing drugs were: ‘dyspepsia’ 38.6%, reflux 22.7%, oesophagitis 13.6%, duodenal ulcer 13.6%, gastric ulcer 4.5%, unknown 6.8%. There have been no studies from primary care to evaluate the possible clinical effects of the concomitant use of acid-suppressing drugs and warfarin; some fluctuations in coagulation control, particularly in patients taking the combinations intermittently, may be due to this.
Diagnostic work-up in peripheral neuropathy: an analysis of 171 cases
Authors: Lubec Doris , Müllbacher Wolf , Finsterer Josef , Mamoli Bruno 
Published: February 2015

Summary
This study was set up to evaluate retrospectively the efficacy of a standard diagnostic procedure, including non-invasive and invasive (spinal tap, nerve/muscle biopsy) investigations, in the diagnosis of peripheral neuropathy. The medical records of 171 in-patients with the final diagnosis of peripheral neuropathy of determined or undetermined cause were reviewed and each individual diagnostic work-up was analysed. Basic investigations included the patient's history, a clinical examination and basic laboratory tests. Depending on the individual presentation, course, and severity, further non-invasive and invasive examinations were added according to the department's standard diagnostic procedure. The aetiology could be clarified in 124 patients (73%) and remained unclear in 47 cases. Excluding cases with acute and chronic inflammatory polyneuropathy (n=14), the number of idiopathic peripheral neuropathies dropped to 33. Non-invasive investigations were sufficient to reveal the underlying aetiology in 114 cases (83 %). It is concluded that, with the application of a standard procedure for the diagnosis of peripheral neuropathy, the aetiology can be clarified in 81% of patients. In the other 19% of patients the aetiology remains idiopathic. In the majority of cases, non-invasive investigations were sufficient for diagnosis.
Visceral leishmaniasis masquerading as tuberculosis in a patient with AIDS
Authors: Yaduvanshi Amitabh , Jain Meenakshi , Jain S K , Jain Shyama , Arora Suneet 
Published: February 2015

Summary
We report a case of visceral leishmaniasis presenting as significant lymphadenopathy in a patient with acquired immune deficiency syndrome. The lymphadenopathy was initially suspected to be tubercular in nature on pathological examination. This report highlights the increasing incidence of acquired immune deficiency syndrome and Leishmania co-infection in India, and the importance of demonstrating tubercle bacilli on culture before suggesting a diagnosis of tuberculosis.
Management of pulmonary thrombo-embolism using catheter manipulation: a report of four cases and review of the literature
Authors: Wong Peter S C , Singh Shyam P , Watson Robert D S , Lip Gregory Y H 
Published: February 2015

Summary
To date the management of pulmonary thrombo-embolism is still largely limited to anticoagulation. Heparin and oral anticoagulation have been shown to be effective in reducing recurrence and death in venous thrombo-embolism. During the acute stage, systemic thrombolytic therapy has also been advocated for the rapid dissolution of the thrombus in patients with haemodynamic instability. We describe four patients with acute pulmonary thrombo-embolism who were managed with catheter-based thrombus manipulation with intrapulmonary thrombolysis. This management strategy should be considered in patients with pulmonary thrombo-embolism who continue to deteriorate despite conventional management with anticoagulation or systemic thrombolysis.
CT dimensions, volumes and densities of normal canine eyes
Authors: Salgüero R. , Johnson V. , Williams D. , Hartley C. , Holmes M. , Dennis R. , Herrtage M. 
Published: February 2015

Although ultrasound and MRI are the imaging modalities of choice for the investigation of ocular diseases, the eyes are included in routine CT examinations of the head and should be examined as part of the complete evaluation. This report describes the dimensions, volumes and densities of the normal canine globe in CT. Forty‐four eyes were studied. The mean axial length of the globe was 2.09 cm and its mean volume was 4.65 cm3. The mean anteroposterior distance of the anterior chamber was 0.4 cm and of the vitreous chamber was 0.96 cm. There was a statistically significant difference between the mean aqueous humour density, 14.76 Hounsfield units (HU), and the mean vitreous humour density, 11.20 HU (P=0.0009). Statistically significant differences were also seen in both humours in precontrast and postcontrast studies. The mean anteroposterior dimension of the lens was 0.74 cm; its mean equatorial distance was 1.15 cm. The mean volume was 0.43 cm3and its mean density was 131.9 HU. There was contrast enhancement of the ciliary body, iris and retina/sclera/choroid complex. This study provides reference values to help in the interpretation of ocular structures on CT scans of the head, where incidental findings can change the medical management of specific cases.
Dynamic Processes, Fixed Points, Endpoints, Asymmetric Structures, and Investigations Related to Caristi, Nadler, and Banach in Uniform Spaces
Authors: Włodarczyk Kazimierz , Plebaniak Robert 
Published: February 2015

In uniform spacesX, Dwith symmetric structures determined by theD-families of pseudometrics which define uniformity in these spaces, the new symmetric and asymmetric structures determined by theJ-families of generalized pseudodistances onXare constructed; using these structures the set-valued contractions of two kinds of Nadler type are defined and the new and general theorems concerning the existence of fixed points and endpoints for such contractions are proved. Moreover, using these new structures, the single-valued contractions of two kinds of Banach type are defined and the new and general versions of the Banach uniqueness and iterate approximation of fixed point theorem for uniform spaces are established. Contractions defined and studied here are not necessarily continuous. One of the main key ideas in this paper is the application of our fixed point and endpoint version of Caristi type theorem for dissipative set-valued dynamic systems without lower semicontinuous entropies in uniform spaces with structures determined byJ-families. Results are new also in locally convex and metric spaces. Examples are provided.
Astrocyte Overexpression of Heme Oxygenase-1 Improves Outcome After Intracerebral Hemorrhage
Authors: Chen-Roetling Jing , Song Wei , Schipper Hyman M. , Regan Christopher S. , Regan Raymond F. 
Published: February 2015

Background and Purpose—
Heme oxygenase-1 (HO-1) catalyzes the rate-limiting reaction of heme breakdown and may have both antioxidant and pro-oxidant effects. In previous studies, HO-1 overexpression protected astrocytes from heme-mediated injury in vitro. In the present study, we tested the hypothesis that selective astrocyte overexpression of HO-1 improves outcome after intracerebral hemorrhage.

Methods—
Male and female transgenic mice overexpressing human HO-1 driven by the GFAP promoter (GFAP.HMOX1) and wild-type controls received striatal injections of autologous blood (25 μL). Blood–brain barrier disruption was assessed by Evans blue assay and striatal cell viability by methylthiazolyldiphenyl-tetrazolium bromide assay. Neurological deficits were quantified by digital analysis of spontaneous cage activity, adhesive removal, and elevated body swing tests.

Results—
Mortality rate for wild-type mice was 34.8% and was similar for males and females; all GFAP.HMOX1 mice survived. Striatal Evans blue leakage at 24 hours was 23.4±3.2 ng in surviving wild-type mice, compared with 10.9±1.8 ng in transgenics. Perihematomal cell viability was reduced to 61±4% of contralateral at 3 days in wild-type mice, versus 80±4% in transgenics. Focal neurological deficits were significantly reduced and spontaneous cage activity was increased in GFAP.HMOX1 mice.

Conclusions—
Selective HO-1 overexpression in astrocytes reduces mortality, blood–brain barrier disruption, perihematomal cell injury, and neurological deficits in an autologous blood injection intracerebral hemorrhage model. Genetic or pharmacological therapies that acutely increase astrocyte HO-1 may be beneficial after intracerebral hemorrhage.
Constraining Supersaturation and Transport Processes in a South American Cold-Air Outbreak Using Stable Isotopologues of Water Vapor
Authors: Galewsky Joseph 
Published: February 2015

Abstract
In situ measurements of water vapor isotopic composition from the subtropical Chilean Andes, supported by mesoscale model simulations and diagnostic analyses, document the processes governing the transport of dry air and isotopically depleted water vapor from the midlatitudes into the subtropics during a South American cold-air surge in July 2014. On 23 July 2014, temperatures on the Chajnantor Plateau reached −18°C, among the lowest temperatures on record for the site. On 26 July 2014, water vapor δD and δ18O reached a low of −538 ± 1.6‰ and −71.7 ± 0.2‰, among the lowest values on record. Numerical simulations show that the dynamics of the event were consistent with previous studies of South American cold-air outbreaks. Back-trajectory analyses show that the isotopically depleted water vapor that reached Chajnantor on July 26 was last saturated over the South Pacific on July 23 at 300 hPa at a temperature of about −50°C under ice supersaturation with RHice of about 110%. The water vapor traveled to Chajnantor along a nearly isentropic path following saturation. Modeling of the isotopic data require condensation at temperatures between −50°C and −53°C under supersaturation with RHice between 112% and 118%, followed by less than 25% moistening during transport. These results show that measurements of water vapor isotopic composition can provide observational constraints on in-cloud processes that influence the humidity of the subtropics.
Analysis of the Relative Operating Characteristic and Economic Value Using the LAPS Ensemble Prediction System in Taiwan
Authors: Chang Hui-Ling , Yang Shu-Chih , Yuan Huiling , Lin Pay-Liam , Liou Yu-Chieng 
Published: February 2015

Abstract
Measurement of the usefulness of numerical weather prediction considers not only the forecast quality but also the possible economic value (EV) in the daily decision-making process of users. Discrimination ability of an ensemble prediction system (EPS) can be assessed by the relative operating characteristic (ROC), which is closely related to the EV provided by the same forecast system.
Focusing on short-range probabilistic quantitative precipitation forecasts (PQPFs) for typhoons, this study demonstrates the consistent and strongly related characteristics of ROC and EV based on the Local Analysis and Prediction System (LAPS) EPS operated at the Central Weather Bureau in Taiwan. Sensitivity experiments including the effect of terrain, calibration, and forecast uncertainties on ROC and EV show that the potential EV provided by a forecast system is mainly determined by the discrimination ability of the same system. The ROC and maximum EV (EVmax) of an EPS are insensitive to calibration, but the optimal probability threshold to achieve the EVmax becomes more reliable after calibration. In addition, the LAPS ensemble probabilistic forecasts outperform deterministic forecasts in respect to both ROC and EV, and such an advantage grows with increasing precipitation intensity. Also, even without explicitly knowing the cost–loss ratio, one can still optimize decision-making and obtain the EVmax by using ensemble probabilistic forecasts.
The Predictive Power of Merger Analysis
Authors: Kirkwood John B. 
Published: February 2015

This article looks first at the process courts use to resolve merger challenges and finds that in the area of product market definition, merger analysis is reasonably strong. Market definition remains complex and subjective, however, and could be improved, or avoided altogether, through econometric techniques such as merger simulation. Judicial analysis of entry is much weaker. Courts ask whether the market is protected by entry barriers but rarely ask whether the barriers are high enough to make entry unprofitable. The article also examines the results of “marginal” mergers, mergers that would have been blocked had the government and courts been somewhat more aggressive. Measured in this way, merger analysis is not seriously off target: the merger retrospectives find that very few transactions led to sharp price changes. They also find, however, that a large proportion of marginal mergers resulted in small price increases, which suggests that in appropriate cases, enforcement agencies and courts should be more willing to predict anticompetitive effects.
A systematic review: Identifying the prevalence rates of psychiatric disorder in Australia’s Indigenous populations
Authors: Black Emma B , Ranmuthugala Geetha , Kondalsamy-Chennakesavan Srinivas , Toombs Maree R , Nicholson Geoffrey C , Kisely Steve 
Published: February 2015

Objective: This review aimed to draw on published literature to identify the prevalence rates of psychiatric disorders in Australia’s Indigenous populations, Aboriginal and Torres Strait Islander peoples. Method: A systematic review following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) model was conducted using the following electronic databases: PubMed, Scopus, Web of Science, MEDLINE, PsycINFO, PsycARTICLES, and Informit Indigenous and Health Collections. Studies were included for analysis if they were empirical quantitative studies reporting prevalence rates for any psychiatric disorder in Indigenous people. Results: Of the 1584 papers extracted by the search strategy, 17 articles met the eligibility criteria and were reviewed in detail. Methodology, sampling strategy and study design varied greatly across these 17 studies. Prevalence rates varied by disorder and are as follows: major depressive disorder (4.3–51%); mood disorders (7.7–43.1%); post-traumatic stress disorder (14.2–55.2%); anxiety disorders (17.2–58.6%); substance dependence (5.9%–66.2%); alcohol dependence (21.4–55.4%); and psychotic disorders (1.68–25%). While the number of studies on community-based Indigenous populations was limited, available evidence suggested that prevalence rates are higher in prison populations compared with community-based studies. Conclusions: It was identified that there is limited evidence on the occurrence of psychiatric disorders for Indigenous people in the general community. More research in this area is essential to provide accurate and reliable estimates and to provide a baseline for evaluating the effectiveness of programs aimed at reducing the high mental health burden experienced by Indigenous Australians. Future research needs to ensure that standardised and validated methods are used to accurately estimate the prevalence of psychiatric disorders among Indigenous Australians.