bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lupus nephritis in Latin American patients: 10-year results from a single medical center in Argentina
Authors: Vinicki J P , Paniego F M , De Rosa G , Dubinsky D , Laborde H A , Marini A , Nasswetter G 
Published: August 2015

Introduction Several studies have shown that Hispanic patients generally experience a worse renal prognosis than non-Hispanic white patients with lupus. To date, there is no report on American College of Rheumatology (ACR) renal response criteria (ACR-RRC) in patients from Latin America. Objective To evaluate treatment response in patients with proliferative and membranous lupus nephritis (LN) according to ACR-RRC. Methods A retrospective study (2001–2011) was performed in our hospital and the data collected included clinical information, renal assessment and immunological parameters. Details related to treatment received during induction and maintenance therapy were also recorded. Results The study included forty-three Latin American patients (37 women) from Argentina. Mean follow-up was 54 months. The regimen used for induction therapy included intravenous cyclophosphamide (IV-CYC) for six months in 36 patients and only seven received mycophenolate mofetil (MMF) given twice daily for a total dose of 2.5 ± 0.5 grams a day. For the maintenance period, six patients continued with quarterly IV-CYC, 20 patients received MMF (1.5 ± 0.5 grams a day) and 17 patients received azathioprine (AZA) 1.5 – 2 mg/kg/day. ACR-RRC observed after induction therapy was complete response in 19%, partial response in 9%, improvement in 42%, unchanged in 14%, and 16% had deterioration despite treatment. ACR-RRC observed after maintenance therapy was complete response in 30%, partial response in 23%, improvement in 19%, unchanged in 16%, and 12% had deterioration. Relapse was observed in 11 patients (25%). Ten out of 11 cases (91%) who relapsed did not achieve a complete response at the end of the induction therapy. Conclusion In Latin American patients from Argentina, only 19% could achieve a complete response after induction therapy and 30% achieved a complete response after maintenance therapy. Failing to obtain a complete response after induction therapy was related to an increased risk of relapse during long-term follow-up in our study.
The efficacy of add-on tacrolimus for minor flare in patients with systemic lupus erythematosus: a retrospective study
Authors: Watanabe H , Yamanaka R , Sada K-E , Zeggar S , Katsuyama E , Katsuyama T , Narazaki M T , Tatebe N T , Sugiyama K , Watanabe K S , Wakabayashi H , Kawabata T , Wada J , Makino H 
Published: August 2015

Objective We have assessed the effectiveness of tacrolimus for minor flares in systemic lupus erythematosus (SLE) patients. Methods The medical records of 313 patients were retrospectively reviewed over a period of seven years, from 2006 to 2013. We enrolled patients with minor flare treated with add-on tacrolimus, without glucocorticoid (GC) intensification (tacrolimus group). Minor flare was defined as a ≥1-point increase in a total score between 3 and 11 in the SLE Disease Activity Index (SLEDAI). We enrolled as controls patients who were administered increased doses of GC for minor flare (GC group). All patients were followed for one year. The primary outcome measure was the proportion of responders. Results There were 14 eligible patients in the tacrolimus group and 20 eligible patients in the GC group. The mean SLEDAI at flare tended to be higher in the tacrolimus group than in the GC group (7.5 vs. 6.2, p = 0.085). A mean dose of 1.6 mg tacrolimus/day was administered for flare, while the mean GC dose was 13.7 mg/day in the GC group. The proportion of responders was 86% (12/14) in the tacrolimus group and 75% (15/20) in the GC group ( p = 0.67). The mean dose of GC at 12 months was higher in the GC group than in the tacrolimus group (9.7 mg/day vs. 7.1 mg/day, p < 0.05). Only one patient discontinued tacrolimus because of fatigue after three months. Conclusion Adding tacrolimus without increasing the GC dose may provide an effective treatment option for minor flares in patients with SLE.
Bulge initiation in tubes of time-dependent materials
Authors: Wineman Alan S 
Published: August 2015

This work considers the inflation and extension of an elastomeric tubular membrane when its material exhibits a time-dependent response. Three different models for time-dependent response are considered: finite linear viscoelasticity, Pipkin–Rogers non-linear viscoelasticity, and thermally induced chemorheological degradation. The first two are based on different assumptions about stress relaxation effects while the third accounts for time-dependent microstructural changes due to simultaneous scission and re-cross-linking of macromolecular network junctions. Each of these models describes a material response that softens with time. It is shown that the constitutive equations for all three models are included in a general non-linear single-integral constitutive equation. In previous work, for elastic membranes, the material is fixed and a localized bulge may form as the load increases. In this work, the load is specified, and a localized bulge may form as the membrane material undergoes a time-dependent response. It is assumed that the extension and inflation histories are initially uniform, but there may be a time when a localized bulge-like deformation starts to form. This is treated as branching from the uniform extension and inflation history. For times beyond this ‘branching time’, the governing equations are satisfied by both the continuation of the initial uniform deformation history and the branched deformation history for the bulge. A unified condition for determining this branching time, applicable to all three models, is derived in terms of the general non-linear single-integral constitutive equation. Post-branching response is not considered here.
Postpartum uterus involution observed by real-time ultrasound scanning and vaginal cytology in Van cats
Authors: Sendag Sait , Alan Muhammet , Eski Funda , Uslu Sema , Uslu Baris A , Wehrend Axel 
Published: August 2015

Objectives The objective was to investigate postpartum uterus involution by real-time ultrasonography and vaginal cytology in Van cats. Methods This study included 15 healthy Van cats belonging to the Van Cat Research Centre (Yuzuncu Yil University, Van, Turkey). Starting 24 h postpartum, ultrasonographic measurements were performed on the placental and interplacental uterine horn regions every day. Decreases in the diameters and uterine content were considered as criteria for uterine involution. Vaginal discharge samples were collected every day for 4 weeks postpartum. The smears were stained with Papanicolaou stain. Results The average diameters of placental and interplacental regions (IPRs) in the uterine horns were 3.12 ± 0.29 cm and 2.36 ± 0.43 cm, respectively, at 24 h postpartum. Placental regions (PRs) shrank faster than IPRs. At 48 h postpartum, it became difficult to distinguish PRs from IPRs in the uterine horns. The uterine horns could be seen in the abdominal cavity up to 5.60 ± 0.99 days postpartum. The mean of the last assessable diameter of the uterine horns from days 4 to 7 in all cats was 0.49 ± 0.07 cm. The vaginal epithelial cells appeared to be under the effect of oestrogen for 4 weeks postpartum. Conclusions and relevance The morphological involution of the uterus completes, to a large extent, within the first 48 h postpartum in Van cats. A more detailed hormonal analysis would contribute greatly to the understanding of the physiological processes involved in this period. Although postpartum involution appeared complete by 5.60 ± 0.99 days after parturition in Van cats, histological verification of this finding is needed.
Dystocia in the cat evaluated using an insurance database
Authors: Holst Bodil Ström , Axnér Eva , Öhlund Malin , Möller Lotta , Egenvall Agneta 
Published: August 2015

Objectives The aim of this study was to describe the incidence of feline dystocia with respect to breed. Methods The data used were reimbursed claims for veterinary care insurance and/or life insurance claims in cats registered in a Swedish insurance database from 1999–2006. Results The incidence rates for dystocia were about 22 cats per 10,000 cat-years at risk, 67 per 10,000 for purebred cats and seven per 10,000 for domestic shorthair cats. The median age was 2.5 years. A significant effect of breed was seen. An incidence rate ratio (IRR) that was significantly higher compared with other purebred cats was seen in the British Shorthair (IRR 2.5), the Oriental group (IRR 2.2), Birman (IRR 1.7), Ragdoll (IRR 1.5) and the Abyssinian group (IRR 1.5). A significantly lower IRR was seen in the Norwegian Forest Cat (IRR 0.38), the Maine Coon (IRR 0.48), the Persian/Exotic group (IRR 0.49) and the Cornish Rex (IRR 0.50). No common factor among the high-risk breeds explained their high risk for dystocia. There was no effect of location; that is, the incidence rate did not differ depending on whether the cat lived in an urban or rural area. Caesarean section was performed in 56% of the cats with dystocia, and the case fatality was 2%. Conclusions and relevance The incidence rate for dystocia was of a similar magnitude in purebred cats as in dogs. The IRR varied significantly among breeds, and the main cause for dystocia should be identified separately for each breed. A selection for easy parturitions in breeding programmes is suggested.
Blood pressure reduction and control with fixed-dose combination perindopril/amlodipine: A Pan-Hellenic prospective observational study
Authors: Manolis Athanasios , Grammatikou Violetta , Kallistratos Manolis , Zarifis John , Tsioufis Konstantinos 
Published: August 2015

Introduction: Hypertension guidelines recommend fixed-dose combinations for enhanced blood pressure (BP) reduction and compliance. The objective of this study was to assess the effectiveness and safety of fixed-dose perindopril/amlodipine combination in reducing and controlling BP in Greek hypertensive patients, as well as the effect of baseline BP and added cardiovascular risk on BP reduction. Methods: This 6-month prospective observational study included male or female patients ⩾18 years with essential hypertension prescribed fixed-dose combination perindopril/amlodipine. BP was measured at baseline and 3 and 6 months. Baseline cardiovascular risk and treatment compliance were also assessed. Results: In 2231 per protocol patients, mean systolic BP decreased from 157.0±15.4 mm Hg to 129.0±7.9 mm Hg after 6 months, and diastolic BP from 91.5±10.1 to 78.8±6.7 mm Hg (both p < 0.001). BP control was achieved in 84.8% at 6 months. Patients with higher baseline added cardiovascular risk or BP had greater BP reduction ( p < 0.001). Compliance was good (97.1% took treatment “every day” or “quite often”) and few ( n = 27; 1.2%) discontinued treatment prematurely due to adverse events. Conclusions: Fixed-dose perindopril/amlodipine safely and effectively reduced high BP in real-life practice, achieving BP control in most patients. About half of Greek hypertensive patients have high/very high added cardiovascular risk.
ACE polymorphisms and the acute response of blood pressure to a walk in medicated hypertensive patients
Authors: Goessler Karla F , Cornelissen Véronique A , de Oliveira Edilamar M , de F Mota Glória , Polito Marcos D 
Published: August 2015

Hypothesis/Introduction: Polymorphisms of the angiotensin converting enzyme (ACE) gene can interfere with exercise-induced acute blood pressure (BP) reduction. This cross-over study investigated the acute effect of a single walk on BP and tested whether polymorphisms of the ACE gene might explain the variation in BP responses. Materials and methods: Thirty-four healthy medicated individuals were randomized to one control and one walking session at 60–75% of heart rate reserve. Subjects left the laboratory wearing an ambulatory BP monitor until waking the next morning. Results: Overall, systolic BP was somewhat lower following the walking session ( p=.06), which could be attributed to a consistently lower systolic BP for 5 h after exercise ( p-interaction<.04) compared with control rest. Similarly, II/ID individuals had a lower systolic BP ( p-interaction=.02) and diastolic BP ( p-interaction<.01) for 5 h after walking compared with control rest. Among DD individuals, a single walk did not induce a reduction in BP ( p-interaction>.05). Conclusions: Our results showed that postexercise hypotension can occur after a walk at moderate intensity in carriers of the I allele; we were not able to demonstrate this in DD individuals. Our results suggest that genetic variation in the ACE gene might affect the BP response to exercise, although more research is needed to confirm these findings.
Effect of postprandial hyperglycaemia on coronary flow reserve in patients with impaired glucose tolerance and type 2 diabetes mellitus
Authors: Ikeda Hiroyuki , Uzui Hiroyasu , Morishita Tetsuji , Fukuoka Yoshitomo , Sato Takehiko , Ishida Kentaro , Kaseno Kenichi , Arakawa Kenichiro , Amaya Naoki , Tama Naoto , Shiomi Yuichiro , Lee Jong-Dae , Tada Hiroshi 
Published: August 2015

Background: This study investigated whether postprandial hyperglycaemia has an adverse effect on coronary microvascular function and left ventricular diastolic function. Methods: In all, 28 patients with type 2 diabetes mellitus with no significant stenosis in left anterior descending artery were enrolled. In all subjects, plasma 1,5-anhydroglucitol was measured, and coronary flow reserve in the left anterior descending artery was evaluated using a Doppler wire. Membrane type-1 matrix metalloproteinase expression on circulating peripheral blood mononuclear cells was measured by flow cytometry. Correlation analyses were performed for coronary flow reserve and 1,5-anhydroglucitol, other coronary risk factors, membrane type-1 matrix metalloproteinase and E/e′. Results: Strong correlations were found only between 1,5-anhydroglucitol and coronary flow reserve and membrane type-1 matrix metalloproteinase. On multiple regression analysis, 1,5-anhydroglucitol remained an independent predictor of coronary flow reserve (β = 0.38, p = 0.048). Conclusion: Postprandial hyperglycaemia appears to have an adverse effect on coronary microvascular function, suggesting that improvement of postprandial hyperglycaemia may contribute to the improvement of coronary microvascular dysfunction.
The effect of disease-modifying therapies on brain atrophy in patients with clinically isolated syndrome: a systematic review and meta-analysis
Authors: Tsivgoulis Georgios , Katsanos Aristeidis H. , Grigoriadis Nikolaos , Hadjigeorgiou Georgios M. , Heliopoulos Ioannis , Papathanasopoulos Panagiotis , Dardiotis Efthimios , Kilidireas Constantinos , Voumvourakis Konstantinos ,   on behalf of HELANI (Hellenic Academy of Neuroimmunology)
Published: August 2015

Objectives: Brain atrophy is associated with cognitive deficits in patients with clinically isolated syndrome (CIS) and can predict conversion to clinical definite multiple sclerosis. The aim of the present meta-analysis was to evaluate the effect of disease-modifying drugs (DMDs) on brain atrophy in patients with CIS. Methods: Eligible placebo-control randomized clinical trials of patients with CIS that had reported changes in brain volume during the study period were identified by searching the MEDLINE, SCOPUS, and Cochrane Central Register of Controlled Trials (CENTRAL) databases. This meta-analysis adopted the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for systematic reviews and meta-analyses. Results: Three eligible studies were identified, comprising 1362 patients. The mean percentage change in brain volume was found to be significantly lower in DMD-treated patients versus placebo-treated subgroups (standardized mean difference [SMD]: = −0.13, 95% confidence interval [CI]: −0.25, 0.01; p = 0.04). In the subgroup analysis of the two studies that provided data on brain-volume changes for the first (0–12 months) and second (13–24 months) year of treatment, DMD attenuated brain-volume loss in comparison with placebo during the second year (SMD = −0.25; 95% CI: −0.43, −0.07; p < 0.001), but not during the first year of treatment (SMD = −0.01; 95% CI: −0.27, 0.24; p = 0.93). No evidence of heterogeneity was found between estimates, while funnel-plot inspection revealed no evidence of publication bias. Conclusions: DMDs appear to attenuate brain atrophy over time in patients with CIS. The effect of DMDs on brain-volume loss is evident after the first year of treatment.
Quantifying patient bacterial exposure risk from reusable phlebotomy tourniquets in a New Zealand secondary level hospital
Authors: Schauer Cameron KMW , Hammer David A 
Published: August 2015

Aim: This study aimed to assess for the presence of multi-drug resistant organisms (MDROs) on tourniquets and quantify the number of bacteria to which patients might be exposed with each blood collection episode. Methods: Tourniquets were randomly sampled in a 246-bed, secondary level, New Zealand hospital, which is currently non-endemic for MDROs. A 6-cm length of each tourniquet sampled was applied to the surface of an agar plate and the colony forming units (CFUs) were enumerated. All colonies were then screened for MDROs using standard methods. CFU counts per linear centimetre were multiplied by a range of patient arm circumference measurements. Comparison was also made between non-disinfected tourniquets left on the wards and phlebotomy service tourniquets after daily decontamination with a proprietary disinfectant. Results: The median exposure risk from non-disinfected tourniquets was 173 CFUs per collect (95% CI, 104–861). None of the general ward tourniquets grew any MDROs but four out of five dedicated, single-patient reusable isolation room tourniquets grew MRSA. Disinfected tourniquets had few if any CFUs and CFU counts were significantly lower than non-disinfected tourniquets ( P = 0.0001). Conclusion: The quantitative risk from reusable tourniquets appears low in the setting of MDRO non-endemicity, with the application of standard infection control practices.
Using of Group-Modeling in Predesign Phase of New Healthcare Environments
Authors: Elf Marie , Eldh Ann Catrine , Malmqvist Inga , Öhrn Kerstin , von Koch Lena 
Published: August 2015

Background: Current research shows a relationship between healthcare architecture and patient-related outcomes. The planning and designing of new healthcare environments is a complex process. The needs of the various end users of the environment must be considered, including the patients, the patients’ significant others, and the staff. The aim of this study was to explore the experiences of healthcare professionals participating in group modeling utilizing system dynamics in the predesign phase of new healthcare environments. We engaged healthcare professionals in a series of workshops using system dynamics to discuss the planning of healthcare environments in the beginning of a construction and then interviewed them about their experience. Methods: An explorative and qualitative design was used to describe participants’ experiences of participating in the group-modeling projects. Participants ( N = 20) were recruited from a larger intervention study using group modeling and system dynamics in planning and designing projects. The interviews were analyzed by qualitative content analysis. Results: Two themes were formed, representing the experiences in the group-modeling process: “Participation in the group modeling generated knowledge and was empowering” and “Participation in the group modeling differed from what was expected and required the dedication of time and skills.” Conclusions: The method can support participants in design teams to focus more on their healthcare organization, their care activities, and their aims rather than focusing on detailed layout solutions. This clarification is important when decisions about the design are discussed and prepared and will most likely lead to greater readiness for future building process.
Development of the My Medicines and Me (M3Q) side effect questionnaire for mental health patients: a qualitative study
Authors: Ashoorian Deena M. , Davidson Rowan M. , Rock Daniel J. T. , Seubert Liza J. , Clifford Rhonda M. 
Published: August 2015

Objective: The objective of this study was to assess the acceptability, content validity and usability of the My Medicines and Me (M3Q) self-report side effect questionnaire. Methods: Eight focus groups consisting of mental health patients, carers, general practitioners, psychiatrists, mental health nurses and pharmacists were conducted, involving 78 participants. Two researchers independently examined the transcriptions and analysed the data thematically using an inductive method. Results: The findings supported changes to the formatting, length and phrasing of questions in the original version of the questionnaire. Although the groups provided differing views on the usability of the M3Q in clinical practice, the patient and carer groups were unconditionally in favour of such a tool to be used systematically to describe patients’ subjective experiences with side effects. Conclusion: The differing contribution made by all groups involved in the administration and completion of the M3Q assisted with content validity of the questionnaire. The acceptability and usability of this novel side effect questionnaire was also explored, with many participants agreeing it was a necessary tool for a patient centred approach to treatment. Following implementation of the changes to the current format of the questionnaire, investigation into the uptake and use in clinical practice should be carried out.
CT texture analysis in colorectal liver metastases: A better way than size and volume measurements to assess response to chemotherapy?
Authors: Rao Sheng‐Xiang , Lambregts Doenja MJ , Schnerr Roald S , Beckers Rianne CJ , Maas Monique , Albarello Fabrizio , Riedl Robert G , Dejong Cornelis HC , Martens Milou H , Heijnen Luc A , Backes Walter H , Beets Geerard L , Zeng Meng‐Su , Beets‐Tan Regina GH 
Published: August 2015

BackgroundResponse Evaluation Criteria In Solid Tumors (RECIST) are known to have limitations in assessing the response of colorectal liver metastases (CRLMs) to chemotherapy.ObjectiveThe objective of this article is to compare CT texture analysis to RECIST‐based size measurements and tumor volumetry for response assessment of CRLMs to chemotherapy.MethodsTwenty‐one patients with CRLMs underwent CT pre‐ and post‐chemotherapy. Texture parameters mean intensity (M), entropy (E) and uniformity (U) were assessed for the largest metastatic lesion using different filter values (0.0 = no/0.5 = fine/1.5 = medium/2.5 = coarse filtration). Total volume (cm3 ) of all metastatic lesions and the largest size of one to two lesions (according to RECIST 1.1) were determined. Potential predictive parameters to differentiate good responders (n  = 9; histological TRG 1–2) from poor responders (n  = 12; TRG 3–5) were identified by univariable logistic regression analysis and subsequently tested in multivariable logistic regression analysis. Diagnostic odds ratios were recorded.ResultsThe best predictive texture parameters were Δuniformity and Δentropy (without filtration). Odds ratios for Δuniformity and Δentropy in the multivariable analyses were 0.95 and 1.34, respectively. Pre‐ and post‐treatment texture parameters, as well as the various size and volume measures, were not significant predictors. Odds ratios for Δsize and Δvolume in the univariable logistic regression were 1.08 and 1.05, respectively.ConclusionsRelative differences in CT texture occurring after treatment hold promise to assess the pathologic response to chemotherapy in patients with CRLMs and may be better predictors of response than changes in lesion size or volume.