bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long‐Term Risk of Stroke in Patients With Type 1 and Type 2 Diabetes Following Coronary Artery Bypass Grafting
Authors: Nyström Thomas , Holzmann Martin J. , Sartipy Ulrik 
Published: November 2015

Background
We performed a nationwide population‐based cohort study to investigate the long‐term risk of stroke after coronary artery bypass grafting in patients with type 1 and type 2 diabetes.

Methods and Results

All patients who underwent primary coronary artery bypass grafting in Sweden from 2000 through 2011 were included from the
SWEDEHEART
register. We excluded patients with prior stroke, and patients who had a stroke or died within 30 days of surgery. The National Diabetes Register was used to identify patients with type 1 and type 2 diabetes. Incident stroke (ischemic and hemorrhagic), and all‐cause mortality was obtained by record linkage with the National Patient Register and the Cause of Death register. We used multivariable Cox regression to estimate the risk of stroke in relation to type of diabetes. A total of 53 820 patients (type 1 diabetes [n=714], type 2 diabetes [n=10 054], no diabetes [n=43 052]) were included. During a mean follow‐up of 7.4 years (398 337 person‐years), in total, 8.0% (n=4296) of the patients had a stroke: 7.3% (n=52) in patients with type 1 diabetes, 9.1% (n=915) in patients with type 2 diabetes, and 7.7% (n=3329) in patients with no diabetes. The multivariable adjusted hazard ratio (95% CI) for all stroke was 1.59 (1.20–2.11) in type 1 diabetes, and 1.32 (1.23–1.43) in type 2 diabetes.

Conclusions
The long‐term risk for stroke after coronary artery bypass grafting was increased in patients with type 1 and type 2 diabetes, compared to patients with no diabetes.
Cancer and Its Association With the Development of Coronary Artery Calcification: An Assessment From the Multi‐Ethnic Study of Atherosclerosis
Authors: Whitlock Matthew C. , Yeboah Joseph , Burke Gregory L. , Chen Haiying , Klepin Heidi D. , Hundley W. Gregory 
Published: November 2015

Background

Although cancer and its corresponding therapies are associated with increased ischemic heart disease, the temporal relationship between cancer and the development of coronary artery calcium (
CAC
), a marker of subclinical atherosclerosis, is unknown.

Methods and Results

Among 3122 men and women free of cardiovascular disease and cancer in the Multi‐Ethnic Study of Atherosclerosis trial,
CAC
scoring was performed at baseline (2000–2002) and at follow‐up (2010–2012). Over this 10‐year period, 85 men (age 63.6±8.3 years) and 50 women (age 62.1±9.8 years) were diagnosed with cancer (predominantly breast, lung, or uterine [52%] in women and prostate or colorectal [78%] in men). The other 2987 subjects (age 59.6±9.2 years for men, 59.7±9.4 years for women) remained cancer free. The incidence of new
CAC
(baseline Agatston score of zero converting to detectable
CAC
) was modeled with relative risk regression and compared for cancer versus no cancer. Increase in pre‐existing
CAC
was compared in these groups using linear regression of log transformed
CAC
. The incidence of
CAC
was independently associated with cancer history (relative risk 1.32 [
P
=0.04] and 1.29 [
P
=0.01] for women and men, respectively). In participants with
CAC
at baseline, a clear difference of
CAC
progression was not observed between cancer and noncancer participants (
P
=0.6 for women,
P
=0.2 for men).

Conclusions

A diagnosis of cancer is associated with the development of
CAC
even after accounting for atherosclerotic risk factors. However, in individuals with pre‐existing
CAC
, it is not clear whether the presence of cancer accelerates
CAC
over time.
Coronary Artery Vessel Healing Pattern, Short and Long Term, After Implantation of the Everolimus‐Eluting Bioresorbable Vascular Scaffold
Authors: Kraak Robin P. , de Boer Hans H. , Elias Joëlle , Ambarus Carmen A. , van der Wal Allard C. , de Winter Robbert J. , Wykrzykowska Joanna J. 
Published: November 2015

Background
Although the Absorb bioresorbable vascular scaffold is increasingly used in daily clinical practice for the treatment of coronary artery disease, the exact vascular healing pattern and the resorption process in humans is unknown because histological data are derived only from animal studies.

Methods and Results
We have obtained 4 autopsies (5 scaffolds) since August 2013. Duration of bioresorbable vascular scaffold implantation ranged from 3 to 501 days. All autopsies and histological assessments were performed by dedicated cardiovascular pathologists. At 1 week after bioresorbable vascular scaffold implantation, struts were covered with a fine layer of fibrin and platelets. At 113 days, the scaffold struts were fully covered with smooth muscle cells. Hyaline eosinophilic and proteoglycan material infiltrating the scaffold struts was observed at 501 days after implantation. At all time points, we observed the presence of multinuclear foreign body giant cells adjacent to the scaffold struts.

Conclusions
Resorption and healing processes after bioresorbable vascular scaffold implantation in human patients mirror those observed in porcine models. The presence of multinucleated foreign body giant cells at both short‐ and long‐term follow‐up needs further investigation and may be related to a low‐grade absorptive inflammatory response to the polymer.
Is there a continuing role for traditional surgery?
Authors: Coughlin Patrick A , Berridge David C 
Published: November 2015

Despite recent NICE guidance there remains a definite role for surgery in the management of varicose veins. A lot of the available evidence that has driven the transformation of care towards endovenous treatments is of good quality yet published by enthusiasts. No endovenous studies have reported long term results as far out from intervention as the open studies, yet in the meta-analysis from Murad et al, the authors suggested from their results that when surgery was compared with all endoluminal ablation therapies, surgery was associated with a non-significant reduction in the risk of varicose vein recurrence (RR0.63; 95%CI 0.37--1.07). Much of the longer-term data on recurrence following open surgery for primary varicose veins dates back well over 15 years ago. This is prior to the inclusion of routine duplex assessment and sub-specialty designation. The recent Cochrane review (13 randomised controlled studies, 3081 patients). The overall conclusion was that UGFS, EVLT and RFA were at least as effective as surgery in the treatment of the LSV. This meta-analysis did not include the CLASS (Comparison of LAser, Surgery and foam Sclerotherapy as a treatment for varicose veins) trial in whichmeasures of clinical success were similar among the groups. Only 48% of the patients screened were eligible for the CLASS study and of these, only 24% of the eligible patients agreed to take part in the study. Similarly in the study by Carradice out of a total of 772 patients assessed for suitability, 442 did not meet the inclusion criteria. There is no doubt that endovenous surgery will increasingly become first line treatment for patients with symptomatic superficial venous reflux specifically in patients with SSV reflux. However, given the device related limitations with endothermal techniques specifically with regard to adverse anatomical features allied to the poorer results of UGFS within the treatment of LSV reflux, there is without doubt still a role for more traditional open surgical techniques that can be delivered with good short and long term outcomes and still being delivered in a cost effective manner.
Radiofrequency ablation of varicose veins: Best practice techniques and evidence
Authors: Goodyear Stephen J , Nyamekye Isaac K 
Published: November 2015

Scope of the review This article systematically reviews the practice of radiofrequency ablation of lower limb varicose veins. We present the clinical evidence and best practice techniques for currently available devices. Methods Manufacturer’s instructions-for-use were requested for all radiofrequency devices. The MEDLINE and EMBASE databases were searched using the following keywords: ‘varicose veins’ AND ‘radiofrequency’ OR ‘radio frequency’ OR ‘Venefit’ OR ‘ClosureFAST’ OR ‘RFiTT’ OR ‘EVRF’ OR ‘VeinCLEAR’, generating 240 articles. Titles and abstracts were screened, yielding 63 articles directly relevant to the scope of the review. Reference lists for publications were also searched to identify further manuscripts of relevance. The Cochrane Database and current National Institute for Clinical and Healthcare Excellence guidelines for varicose veins were also searched from relevant articles. Results Four radiofrequency ablation (RFA) systems are currently commercially available. Generic practice methods (common to all RF systems) and device-specific techniques are described. The weight of current evidence relates to the use of Covidien Venefit™ (formerly VNUS ClosureFAST™), which clearly demonstrates clinical advantages over open surgery at least to 2 years follow up. However, contemporary studies of the radiofrequency-induced thermal therapy device (RFiTT®), show that in experienced hands, clinical equivalence to the Venefit™ procedure can be achieved. The evidence base for EVRF® and VeinCLEAR™ devices is currently weak and absent, respectively. Conclusions Despite widespread uptake of RFA and acceptance of its clinical advantages over open surgery there is a paucity of Class 1 A evidence. This results from incongruent reporting of clinical outcome measures within existing literature. Similarly, lack of long-term follow-up studies precludes comparison of the durability of short- and medium-term advantages of RFA with the longer term results of open surgery. There remains scope for a large prospective high-quality trial to assess the clinical, anatomical and cost-effectiveness outcomes for the four commercially available RFA devices, with a particular focus on long-term follow up.
Lesions with unclear malignant potential (B3) after minimally invasive breast biopsy: evaluation of vacuum biopsies performed in Switzerland and recommended further management
Authors: Saladin Camilla , Haueisen Harald , Kampmann Gert , Oehlschlegel Christian , Seifert B , Rageth Luzi , Rageth Christoph , Stadlmann S , Kubik-Huch Rahel A ,   On behalf of the MIBB Group
Published: November 2015

Background Histopathological B3 lesions after minimal invasive breast biopsy (VABB) are a particular challenge for the clinician, as there are currently no binding recommendations regarding the subsequent procedure. Purpose To analyze all B3 lesions, diagnosed at VABB and captured in the national central Swiss MIBB database and to provide a data basis for further management in this subgroup of patients. Material and Methods All 9,153 stereotactically, sonographically, or magnetic resonance imaging (MRI)-guided vacuum-assisted breast biopsies, performed in Switzerland between 2009 and 2011, captured in a central database, were evaluated. The rate of B3 lesions and the definitive pathological findings in patients who underwent surgical resection were analyzed. Results The B3 rate was 17.0% (1532 of 9000 biopsies with B classification). Among the 521 lesions with a definitive postoperative diagnosis, the malignancy rate (invasive carcinoma or DCIS) was 21.5%. In patients with atypical ductal hyperplasia, papillary lesions, flat epithelial atypia, lobular neoplasia, and radial scar diagnosed by VABB, the malignancy rates were 25.9%, 3.1%, 18.3%, 26.4%, and 11.1%, respectively. Conclusion B3 lesions, comprising 17%, of all analyzed biopsies, were common and the proportion of malignancies in those lesions undergoing subsequent surgical excision was high (21.5%).
Dyadic Developmental Psychotherapy (DDP): the development of the theory, practice and research base
Authors: Hughes Dan , Golding Kim S , Hudson Julie 
Published: November 2015

Dyadic Developmental Psychotherapy (DDP) is a relationship-focused therapy characterised by a strong therapeutic alliance, empathy and unconditional positive regard. It seeks to treat the complex psychological problems of looked after and adopted children as they struggle to develop a greater measure of stable functioning in their homes. It was developed by Dan Hughes based on his extensive clinical experience of working with children and families together and is rooted in a close study of relevant theory. DDP can help children who have been hurt and/or neglected within their families in their early years by supporting them to recover from previous trauma and to experience attachment security and emotional connection within their current family. As with any developing therapy, questions have been raised about its clinical relevance and effects. One such critique recently appeared in an article by Mercer (2014) and this will be used to demonstrate how misunderstandings, misinterpretations and the selective use of case studies can lead to misguided views of this important innovation. This article particularly addresses inaccuracies in accounts of the development of DDP as an intervention for looked after and adoptive children and their families, how DDP is practised around the world and how theory underpins the model. Although a lack of evidence derived from robust evaluations is acknowledged, the authors discuss the evidence base that is currently available and plans that are in place to strengthen this.
Familial SUNCT in mother and son
Authors: Martins Isabel Pavão , Viana Pedro , Lobo Patricia Pita 
Published: November 2015

Background Trigeminal autonomic cephalalgias comprise a heterogeneous group of lateralized headaches associated with ipsilateral autonomic symptoms. They are usually localized within the territory of one or more rami of the trigeminal nerve, but may be localized outside its cutaneous territory. Although these headaches are considered primary disorders, the evidence supporting their genetic nature is lacking, particularly concerning their neuralgic forms, with the exception of a familial case described partly based on a historical account. Case reports We report on a mother and son with episodic, short-lasting, intense, paroxysmal headaches, with the same localization in the left retroauricular region, associated with prominent conjunctival injection and tearing, which are consistent with the diagnosis of SUNCT (short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing). Discussion These cases corroborate the existence of hereditary forms of this disorder, thus supporting its primary nature.
General lack of use of placebo in prophylactic, randomised, controlled trials in adult migraine. A systematic review
Authors: Hougaard Anders , Tfelt-Hansen Peer 
Published: November 2015

Background The Clinical Trials Subcommittee of the International Headache Society (IHS) recommends that a placebo arm is included in comparative randomised clinical trials (RCTs) of multiple prophylactic drugs due to the highly variable placebo response in migraine prophylaxis studies. The use of placebo control in such trials has not been systematically assessed. Methods We performed a systematic review of all comparative RCTs of prophylactic drug treatment of migraine published in English from 2002 to 2014. PubMed was searched using the Cochrane Highly Sensitive Search Strategy for identifying reports of RCTs. Results A placebo arm was used in <10% (three of 31) of prophylactic RCTs in migraine. In only 7.1% (two of 28) of the comparative RCTs without placebo was one drug superior to another drug. Thus in 26 RCTs, including one study requiring more than 75,000 patient days, no difference was identified across treatment arms and conclusions regarding drug superiority could not be drawn. Conclusions The majority of comparative, prophylactic migraine RCTs do not include a placebo arm. Failure to include a placebo arm may result in failure to demonstrate efficacy of potentially effective migraine-prophylactic agents. In order to benefit current and future patients, the current strong tendency to omit placebo-controls in these RCTs should be replaced by adherence to the guidelines of the IHS.
Acceptability of Novel Small-Quantity Lipid-Based Nutrient Supplements for Complementary Feeding in a Peri-Urban South African Community
Authors: Rothman Marinel , Berti Cristiana , Smuts Cornelius M. , Faber Mieke , Covic Namukolo 
Published: November 2015

Background: Small-quantity lipid-based nutritional supplements (SQ-LNS) may potentially be used for home fortification in poor settings, where low nutrient-dense complementary foods are commonly used for infant feeding. However, they need to be acceptable to succeed. Objective: This study assessed the acceptability of 2 novel, SQ-LNS (A and B) for supplementing complementary foods among infants aged 6 to 12 months in a peri-urban South African community. Methods: Both supplements were soy-based pastes and contained micronutrients and essential fatty acids. In addition, supplement B contained docosahexaenoic acid, arachidonic acid, phytase and l-lysine. Mother–infant pairs were enrolled in a 2-part trial. Part 1 ( n = 16) was a test-feeding trial with a crossover randomized design, and a 5-point hedonic scale was used for sensory evaluation ( disagree = 1, agree = 5). Part 2 ( n = 38) was a 2-week, home-use trial followed by focus group discussions. Results: In part 1, more than 70% of mothers reported a score ≥4 on sensory attributes for both SQ-LNSs indicating that both supplements were well perceived. In part 2, the mean reported consumption over the 2-week period was 65.3% ± 34.2% and 62.0% ± 31.3% of the 20 g daily portion for supplements A and B, respectively. Focus group discussions confirmed a positive attitude toward the supplements in the study population. Conclusion: This study showed acceptance of both SQ-LNSs in terms of sensory characteristics as well as in terms of practicality for home use.
Intralesional Mycobacterium w Vaccine Versus Cryotherapy in Treatment of Refractory Extragenital Warts
Authors: Dhakar Ashok K. , Dogra Sunil , Vinay Keshavamurthy , Sarangal Rishu , Kanwar Amrinder J. , Singh Mini P. 
Published: November 2015

Background: Initial reports of immunotherapy using intralesional Mycobacterium w (Mw) vaccine have documented its useful role in treatment of genital and extragenital warts. Objectives: To compare the efficacy and safety of intralesional Mw vaccine versus cryotherapy in the treatment of refractory extragenital warts. Methods: This was a prospective, randomized, comparative study of 66 patients. The outcome was assessed in terms of complete clearance of warts and change in Dermatology Life Quality Index (DLQI) score. Results: Complete clearance of treated warts was seen in 66.7% (20/30) and 65.5% (19/29) of patients in the Mw and cryotherapy groups, respectively ( P = .769). Clearance of distant warts was significantly ( P = .004) high in the Mw group. Improvement in DLQI was greater in the Mw group. Both treatment modalities were well tolerated, and no major side effects occurred. Conclusions: Mw vaccine and cryotherapy are equally efficacious in treatment of refractory extragenital warts. Mw vaccine has an added advantage of clearance of distant warts.
Pilot Study to Evaluate the Efficacy and Safety of Oral Tacrolimus in Adult Patients With Refractory Severe Plaque Psoriasis
Authors: Mittal Ankit , Dogra Sunil , Narang Tarun , Sharma Aman 
Published: November 2015

Background: Tacrolimus, a congener of cyclosporine, has replaced cyclosporine as a first-line treatment for most transplant patients due to its superior efficacy and safety. Tacrolimus has not been extensively studied for the treatment of psoriasis. Objectives: To study the efficacy and safety of oral tacrolimus in adult patients with severe refractory plaque psoriasis. Methods: This was an open-label pilot study. Patients with severe plaque type psoriasis who were unresponsive to at least 1 systemic treatment were treated with oral tacrolimus. Results: Thirty patients were treated. After 12 weeks, improvement in mean Psoriasis Area Severity Index (PASI) score was 80.37% ( P < .001), PASI 75 was observed in 19 of 26 (73.1%) patients, and PASI 90 was observed in 11 of 26 (42.3%) patients. No severe side effects were noted. Conclusion: Oral tacrolimus is an effective and safe option for the short-term treatment of severe plaque psoriasis.
Impaired growth of the cerebellum in pediatric-onset acquired CNS demyelinating disease
Authors: Weier Katrin , Fonov Vladimir , Aubert-Broche Bérengère , Arnold Douglas L , Banwell Brenda , Collins D Louis 
Published: November 2015

Background: Acquired demyelinating syndromes (ADS) have the potential to negatively impact cerebellar growth, given the proclivity for infratentorial lesions in pediatric-onset multiple sclerosis (MS) and ADS. Objective: To investigate cerebellar growth longitudinally in pediatric ADS. Methods: Cerebellar volumes from 472 magnetic resonance imaging (MRI) scans of 98 patients with monophasic ADS (monoADS), monophasic acute disseminated encephalomyelitis (ADEM), and MS (49 girls; mean age: 11.4 years at first scan, mean follow-up: 3.1 years) imaged serially from onset and 897 MRI scans of 418 healthy children (223 girls, mean age: 11.3 years, mean follow-up: 2.9 years) were segmented automatically, analyzed with mixed-effect models, and compared with cerebral volume. Results: Cerebellar developmental trajectories followed a U-shaped curve, showing larger volumes in boys ( p < 0.001). Cerebellar volumes in all three patient groups failed to reach age-expected trajectories, leading to significantly smaller volumes, notably in the posterior lobes. Cerebellar volume reductions were of a similar magnitude to cerebral volume reductions. Cerebellar white matter volume declined in MS and ADEM patients over time, while in monoADS patients it remained similar to controls. Cerebellar volumes did not correlate either with lesion volumes at onset or with physical disability. Conclusion: MonoADS, ADEM, and MS in childhood lead to impaired age-expected growth of the cerebellum.
Optimal detection of infratentorial lesions with a combined dual-echo MRI sequence: “PT2”
Authors: Gaitán María I , Yañes Paulina , Sati Pascal , Romero Carlos , Reich Daniel S , Correale Jorge 
Published: November 2015

Background: The infratentorial compartment is cardinal for multiple sclerosis (MS) diagnosis. T2-weighted (T2) and proton density–weighted (PD) magnetic resonance imaging (MRI) can visualize infratentorial lesions, but only suboptimally. Objective: To combine PD and T2 for better lesion assessment. Methods: T2 and PD from 35 cases were averaged to form “PT2” images. Two raters counted infratentorial lesions and qualitatively assessed their conspicuity. Results: PT2 showed 244 infratentorial lesions, of which 94% and 74% were seen in PD and T2. PT2 received higher grades for image quality and lesion conspicuity ( p < 0.001 for all comparisons). Conclusion: PT2 could improve our ability to diagnose and monitor MS.
Seronegative neuromyelitis optica spectrum disorder patients diagnosed using new diagnostic criteria
Authors: Uzawa Akiyuki , Mori Masahiro , Uchida Tomohiko , Masuda Hiroki , Ohtani Ryohei , Kuwabara Satoshi 
Published: November 2015

Background: Recently, new diagnostic criteria for neuromyelitis optica spectrum disorders (NMOSD) were published. Objective: Our primary aim was to evaluate the usefulness of the new diagnostic criteria in anti-aquaporin 4 (AQP4) antibody-negative cases. Methods: Consecutive 471 patients whose anti-AQP4 antibody was measured at Chiba University were reviewed. Results: Four anti-AQP4 antibody negative-patients, who fulfilled the new diagnostic criteria for NMOSD but not 2006 diagnostic criteria for neuromyelitis optica (NMO), were identified. They showed high cerebrospinal fluid interleukin-6 and glial fibrillary acidic protein levels, an absence of oligoclonal bands and/or cloud-like enhancement on magnetic resonance imaging, which are compatible findings for NMO. Conclusion: The new diagnostic criteria are clinically useful in seronegative NMOSD.