bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early Coronary Angiography and Survival After Out-of-Hospital Cardiac Arrest
Authors: Vyas Ankur , Chan Paul S. , Cram Peter , Nallamothu Brahmajee K. , McNally Bryan , Girotra Saket 
Published: October 2015

Background—
Although out-of-hospital cardiac arrest is common because of acute myocardial infarction, it is unknown whether early coronary angiography is associated with improved survival in these patients.

Methods and Results—

Using data from the Cardiac Arrest Registry to Enhance Survival (CARES), we identified 4029 adult patients admitted to 374 hospitals after successful resuscitation from out-of-hospital cardiac arrest because of ventricular fibrillation, pulseless ventricular tachycardia, or unknown shockable rhythm between January 2010 and December 2013. Early coronary angiography (occurring within one calendar day of cardiac arrest) was performed in 1953 (48.5%) patients, of whom 1253 (64.2%) received coronary revascularization. Patients who underwent early coronary angiography were younger (59.9 versus 62.0 years); more likely to be men (78.1% versus 64.3%), have a witnessed arrest (84.6% versus 77.4%), and have ST-segment–elevation myocardial infarction (32.7% versus 7.9%); and less likely to have known cardiovascular disease (22.8% versus 35.0%), diabetes mellitus (11.0% versus 17.0%), and renal disease (1.8% versus 5.8%;
P
<0.01 for all comparisons). In analysis of 1312 propensity score–matched pairs, early coronary angiography was associated with higher odds of survival to discharge (odds ratio 1.52 [95% confidence interval 1.28–1.80];
P
<0.0001) and survival with favorable neurological outcome (odds ratio 1.47 [95% confidence interval 1.25–1.71];
P
<0.0001). Further adjustment for coronary revascularization in our models significantly attenuated both odds ratios, suggesting that revascularization was a key mediator of the survival benefit.

Conclusions—
Among initial survivors of out-of-hospital cardiac arrest caused by VF or pulseless VT, we found early coronary angiography was associated with higher odds of survival to discharge and favorable neurological outcome.
Procedural Results and Clinical Outcomes of Transcatheter Aortic Valve Implantation in Switzerland
Authors: Binder Ronald K , Stortecky Stefan , Heg Dik , Tueller David , Jeger Raban , Toggweiler Stefan , Pedrazzini Giovanni , Amann Franz W , Ferrari Enrico , Noble Stephane , Nietlispach Fabian , Maisano Francesco , Räber Lorenz , Roffi Marco , Grünenfelder Jürg , Jüni Peter , Huber Christoph , Windecker Stephan , Wenaweser Peter 
Published: October 2015

Background—
New generation transcatheter heart valves (THV) may improve clinical outcomes of transcatheter aortic valve implantation.

Methods and Results—

In a nationwide, prospective, multicenter cohort study (Swiss Transcatheter Aortic Valve Implantation Registry, NCT01368250), outcomes of consecutive transfemoral transcatheter aortic valve implantation patients treated with the Sapien 3 THV (S3) versus the Sapien XT THV (XT) were investigated. An overall of 153 consecutive S3 patients were compared with 445 consecutive XT patients. Postprocedural mean transprosthetic gradient (6.5±3.0 versus 7.8±6.3 mm Hg,
P
=0.17) did not differ between S3 and XT patients, respectively. The rate of more than mild paravalvular regurgitation (1.3% versus 5.3%,
P
=0.04) and of vascular (5.3% versus 16.9%,
P
<0.01) complications were significantly lower in S3 patients. A higher rate of new permanent pacemaker implantations was observed in patients receiving the S3 valve (17.0% versus 11.0%,
P
=0.01). There were no significant differences for disabling stroke (S3 1.3% versus XT 3.1%,
P
=0.29) and all-cause mortality (S3 3.3% versus XT 4.5%,
P
=0.27).

Conclusions—
The use of the new generation S3 balloon-expandable THV reduced the risk of more than mild paravalvular regurgitation and vascular complications but was associated with an increased permanent pacemaker rate compared with the XT. Transcatheter aortic valve implantation using the newest generation balloon-expandable THV is associated with a low risk of stroke and favorable clinical outcomes.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT01368250.
Ticagrelor Versus Clopidogrel in Patients With Acute Coronary Syndromes and Chronic Obstructive Pulmonary Disease: An Analysis From the Platelet Inhibition and Patient Outcomes (PLATO) Trial
Authors: Andell Pontus , James Stefan K. , Cannon Christopher P. , Cyr Derek D. , Himmelmann Anders , Husted Steen , Keltai Matyas , Koul Sasha , Santoso Anwar , Steg Ph. Gabriel , Storey Robert F. , Wallentin Lars , Erlinge David ,   the PLATO Investigators
Published: October 2015

Background

Patients with chronic obstructive pulmonary disease (
COPD
) experiencing acute coronary syndromes (
ACS
) are at high risk for clinical events. In the Platelet Inhibition and Patient Outcomes (
PLATO
) trial, ticagrelor versus clopidogrel reduced the primary endpoint of death from vascular causes, myocardial infarction, or stroke after
ACS,
but increased the incidence of dyspnea, which may lead clinicians to withhold ticagrelor from
COPD
patients.

Methods and Results

In 18 624 patients with
ACS
randomized to treatment with ticagrelor or clopidogrel, history of
COPD
was recorded in 1085 (5.8%). At 1 year, the primary endpoint occurred in 17.7% of patients with
COPD
versus 10.4% in those without
COPD
(
P
<0.001). The 1‐year event rate for the primary endpoint in
COPD
patients treated with ticagrelor versus clopidogrel was 14.8% versus 20.6% (hazard ratio [
HR
]=0.72; 95% confidence interval [
CI
]: 0.54 to 0.97), for death from any cause 8.4% versus 12.4% (
HR
=0.70; 95%
CI
: 0.47 to 1.04), and for
PLATO
‐defined major bleeding rates at 1 year 14.6% versus 16.6% (
HR
=0.85; 95%
CI
: 0.61 to 1.17). Dyspnea occurred more frequently with ticagrelor (26.1% vs. 16.3%;
HR
=1.71; 95%
CI
: 1.28 to 2.30). There was no differential increase in the relative risk of dyspnea compared to non‐
COPD
patients (
HR=
1.85). No
COPD
status‐by‐treatment interactions were found, showing consistency with the main trial results.

Conclusions

In this post‐hoc analysis,
COPD
patients experienced high rates of ischemic events. Ticagrelor versus clopidogrel reduced and substantially decreased the absolute risk of ischemic events (5.8%) in
COPD
patients, without increasing overall major bleeding events. The benefit‐risk profile supports the use of ticagrelor in patients with
ACS
and concomitant
COPD
.

Clinical Trial Registration

URL
:
http://www.clinicaltrials.gov
. Unique identifier:
NCT
00391872.
Risk Factors for Dysplasia in Recurrent Respiratory Papillomatosis in an Adult and Pediatric Population
Authors: Karatayli-Ozgursoy Selmin , Bishop Justin Avery , Hillel Alexander , Akst Lee , Best Simon R.A. 
Published: October 2015

Aim: Recurrent respiratory papillomatosis (RRP) is classically described as a benign neoplasm of the larynx caused by the low-risk human papillomavirus (HPV) viral subtypes. Nevertheless, transformation to dysplasia and invasive carcinoma can occur. We aimed to assess the prevalence of dysplasia and carcinoma-ex-papilloma in both adult-onset and juvenile-onset RRP and identify patient risk factors for this dysplastic transformation. Material and Methods: Ten-year retrospective chart review of a tertiary otolaryngology referral center. Patients with papilloma were identified from a review of a pathology database and clinical records. Patient demographics, pathologic data, and treatment history, including use of cidofovir as an adjunctive therapy for papilloma, were extracted from electronic medical records. Results: One hundred fifty-nine RRP patients were identified, 96 adult-onset (AORRP) and 63 juvenile-onset (JORRP) cases. Of this cohort, 139 (87%) had only benign papilloma as a pathologic diagnosis. In the AORRP cohort, 10 patients (10%) were diagnosed with dysplasia or carcinoma in situ in addition to papilloma, and 5 patients (5%) had malignant transformation to invasive carcinoma-ex-papilloma. There was a significantly higher age of disease onset for those with dysplasia or carcinoma versus those without dysplasia or carcinoma (56 vs 45 years old; P = .0005). Of the 63 JORRP patients, there were no cases of dysplasia but 3 (5%) cases of invasive carcinoma-ex-papilloma, all involving pulmonary disease. The JORRP patients with carcinoma-ex-papilloma had a younger average disease onset (2 vs 6 years old; P = .009) and a higher rate of tracheal involvement than those without carcinoma. Gender, smoking history, number of operations, or use of cidofovir showed no association with the development of dysplasia or carcinoma-ex-papillomatosis in either the AORRP or JORRP population. Conclusion: In a large series of RRP, age of disease onset is the strongest predictor of dysplastic transformation in the adult and pediatric population. Carcinoma-ex-papillomatosis was uniformly associated with pulmonary disease in the JORRP population in this series. No other demographic or behavioral factors, including adjunctive therapy with cidofovir, were statistically associated with dysplasia or carcinoma-ex-papilloma.
A Single Primary Site Obstruction May Lead to Sleep-Disordered Breathing in Multiple Sites
Authors: Lee Myung-Chul , Rhee Chae-Seo , Joe Sam , Yoon In-Young , Kim Jeong-Whun 
Published: October 2015

Objectives: This study aimed to investigate the dynamic upper airway changes occurring in an obstructive sleep apnea (OSA) rabbit model using dynamic computerized tomography (CT). Methods: In this study, 2.5 U of botulinum toxin type A was injected into the genioglossus to paralyze the tongue in the OSA group (n = 7). The control group was injected with normal saline (n = 7). Apnea-hypopnea index was measured using ApneaLink at baseline and at 1, 2, 3, 4, 6, and 8 weeks post-injection. Anterior to posterior (AP) and transverse diameters at the levels of the palate and tongue base were measured using a dynamic CT at baseline and at 1 and 2 weeks post-injection. Results: The success rate of OSA induction was higher in the OSA group ( P = .02). In the OSA group, transverse and AP diameters at the palate level and AP diameter at the tongue base level significantly decreased 2 weeks post-injection ( P = .01). Conclusions: A single obstruction site may constitute the primary pathogenesis in some OSA patients, even when the involvement of multiple sites is indicated. These findings may contribute to the identification of OSA pathogenesis and improve the planning of treatment based on the primary cause of OSA.
Development of a human papillomavirus vaccination intervention for Australian adolescents
Authors: Cooper Spring C , Davies Cristyn , McBride Kate , Blades Joanna , Stoney Tanya , Marshall Helen , Skinner S Rachel 
Published: October 2015

Objective: Australia has implemented a nation-wide programme providing a human papillomavirus (HPV) vaccine to girls and boys through school-based programmes. Previous research has identified three distinct areas for attention: (1) lack of understanding about HPV and HPV vaccination, (2) young people’s desire for involvement in decision-making about HPV vaccination and (3) fear of HPV vaccination. We aimed to develop an intervention to address young people’s low levels of understanding, to promote their involvement in consent and reduce vaccination-related fear and anxiety. Design, Setting, Methods: Formative qualitative research was conducted in six public, private and Catholic schools in the Sydney metropolitan area. Girls who were offered the vaccine in a school programme and aged 12–13 years were interviewed in focus groups. Piloting of materials was conducted in three private schools across Sydney with both girls and boys, and changes and additions were made to the materials in accordance with feedback. Results: We developed an educational intervention aimed at addressing gaps in young people’s knowledge and understanding, and offering strategies to improve confidence with vaccination and reduce needle-related anxiety. Components of the final intervention include film chapters, a magazine, a website, an app and teacher support materials. The intervention is designed for teachers and/or nurses to deliver and is linked to the school-based HPV vaccination programme. Conclusions: This is the first educational intervention designed for young people in HPV school-based vaccination, to be developed from empirical data with the involvement of young people themselves.
Dipeptidyl Peptidase-4 Inhibitors in Diverse Patient Populations With Type 2 Diabetes
Authors: Hinnen Deborah 
Published: October 2015

Purpose The purpose of this review is to discuss the clinical evidence for dipeptidyl peptidase-4 (DPP-4) inhibitors and to better define their use in treating type 2 diabetes mellitus (T2DM), including in special populations, such as the elderly. DPP-4 inhibitors are incretin-based therapies that can be used as monotherapy or in combination with other antidiabetes medications to treat T2DM. As monotherapy, DPP-4 inhibitors have demonstrated a modest and comparable glycated hemoglobin-lowering effect. As initial dual therapy with other antidiabetes agents, DPP-4 inhibitors significantly improved glycated hemoglobin when compared with monotherapy arms. Similarly, in triple combinations, DPP-4 inhibitors consistently provided additive glycemic benefits. In patients who were continuing insulin, glycemic parameters were improved with the addition of a DPP-4 inhibitor, and they required less insulin uptitration. In clinical trials, the overall occurrence of adverse events was similar between DPP-4 inhibitor groups and controls, and a low occurrence of hypoglycemia was observed, except when used in combination with a sulfonylurea. A neutral effect on weight was maintained, even in combination with insulin. Similar to outcomes observed in younger patients, DPP-4 inhibitors significantly improved glycemic efficacy in older patients, without increasing the risk for hypoglycemia. Efficacy and safety in patients with renal insufficiency are also documented. Conclusion DPP-4 inhibitors are therapeutically beneficial for a diverse population of patients with T2DM, including elderly patients, based on demonstrated efficacy, tolerability, and a low risk for hypoglycemia.
The impact of 2013 UK NICE guidelines on the management of varicose veins at the Heart of England NHS Foundation Trust, Birmingham, UK
Authors: Davies Huw OB , Popplewell Matthew , Bate Gareth , Kelly Lisa , Darvall Katy , Bradbury Andrew W 
Published: October 2015

Objective Although varicose veins are a common cause of morbidity, the UK National Health Service and private medical insurers have previously sought to ration their treatment in a non-evidence based manner in order to limit health-care expenditure and reimbursement. In July 2013, the UK National Institute for Health and Care Excellence published new national Clinical Guidelines (CG168) to promote evidence-based commissioning and management of varicose veins. The aim of this study was to evaluate the impact of CG168 on the referral and management of varicose veins at the Heart of England NHS Foundation Trust, Birmingham, UK. Methods Interrogation of a prospectively gathered database, provided by the Heart of England NHS Foundation Trust Performance Unit, of patients undergoing interventions for varicose veins since 1 January 2012. Patients treated before (group 1) and after (group 2) publication of CG168 were compared. Results There were 253 patients, 286 legs (48% male, mean (range) age 54 (20–91) years) treated in group 1, and 417 patients, 452 legs, (46% male, mean (range) age 54 (14–90) years) treated in group 2, an increase of 65%. CG168 was associated with a significant reduction in the use of surgery (131 patients (52%) group 1 vs. 127 patients (30%) group 2, p = 0.0003, χ2), no change in endothermal ablation (30 patients (12%) group 1 vs. 45 patients (11%) group 2), a significant increase in ultrasound-guided foam sclerotherapy (92 patients (36%) group 1 and 245 patients (59%) group 2, p = 0.0001, χ2) and an increase in treatment for C2/3 disease (53% group 1 and 65.2% group 2, p = 0.0022, χ2). Conclusions Publication of National Institute for Health and Care Excellence CG168 has been associated with a significant increase (65%) in the number of patients treated, referral at an earlier (CEAP C) stage and increased use of endovenous treatment. CG 168 has been highly effective in improving access to, and quality of care, for varicose veins at Heart of England NHS Foundation Trust.
Near Point of Convergence After a Sport-Related Concussion
Authors: Pearce Kelly L. , Sufrinko Alicia , Lau Brian C. , Henry Luke , Collins Michael W. , Kontos Anthony P. 
Published: October 2015

Background: Convergence insufficiency (CI) is a common binocular vision deficit after a sport-related concussion (SRC). CI may result in visual discomfort and vision-mediated functional difficulties such as slowed reading and compromised attention, leading to impaired academic, work, and sport performance. Purpose: To test the reliability of repeated near point of convergence (NPC) measurements in a sample of athletes after an SRC; compare the symptoms and cognitive impairment of athletes with normal NPC to those with CI after an SRC; and explore the relationship among age, sex, learning disability, migraine history, and CI. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 78 athletes (mean age, 14.31 ± 2.77 years) who were seen a mean 5.79 ± 5.63 days after an SRC were administered 3 trials of an NPC assessment, along with neurocognitive (Immediate Post-Concussion Assessment and Cognitive Testing [ImPACT]) and symptom assessments. Patients were divided into normal NPC (NPC ≤5 cm; n = 45) and CI (NPC >5 cm; n = 33) groups. Intraclass correlation coefficients (ICCs) and repeated-measures analyses of variance (ANOVAs) assessed the consistency of NPC across the 3 trials. The ANOVAs were employed to examine differences on neurocognitive composites and symptoms between the normal NPC and CI groups. Stepwise regressions (controlling for age and symptom scores on the Post-Concussion Symptom Scale [PCSS]) were conducted to evaluate the predictive utility of the NPC distance for neurocognitive impairment. Results: Groups did not differ on demographic or injury characteristics. NPC differed between trial 1 and trials 2 ( P = .02) and 3 ( P = .01) for the CI group but not the normal NPC group. Internal consistency was high across NPC measurements (ICC range, 0.95-0.98). Patients with CI performed worse on verbal memory ( P = .02), visual motor speed ( P = .02), and reaction time ( P = .001, η2 = .13) and had greater total symptom scores ( P = .02) after the injury. Results of hierarchical regression revealed that the NPC distance contributed significantly to the model for reaction time ( P < .001). Conclusion: CI was common (~42%) in athletes evaluated within 1 month after an SRC. Athletes with CI had worse neurocognitive impairment and higher symptom scores than did those with normal NPC. Clinicians should consider routinely screening for NPC as part of a comprehensive concussion evaluation to help inform treatment recommendations, academic accommodations, and referrals for vision therapy.
Transfer of Methamphetamine (MA) into Breast Milk and Urine of Postpartum Women who Smoked MA Tablets during Pregnancy
Authors: Chomchai Chulathida , Chomchai Summon , Kitsommart Ratchada 
Published: October 2015

Background: Methamphetamine (MA) use by pregnant women remains a growing problem in South East Asia. After delivery, a negative maternal urine MA assay is assumed to reflect the absence of MA in breast milk and marks breastfeeding initiation. To date, no data exist that describe the relationship between the peripartum and postpartum transfer of MA into breast milk and its urinary excretion in women, following recreational use by smoking. Objective: This study aimed to determine the pharmacokinetic of smoked MA in breast milk and its relationship to urinary MA excretion in postpartum women who tested positive for MA before delivery. Methods: Timed urine and breast milk samples of 33 women who had positive urine drug screens for MA prior to delivery were analyzed for MA using Acquity Ultra Performance Liquid Chromatography (Waters, Milford, Massachusetts, USA) with the ACQUITY UPLC Photodiode Array Detector (Waters). Those participants with 4 or more timed breast milk samples were included for pharmacokinetic calculation using log-linear trapezoidal rule. Results: Pharmacokinetic data from 2 women were analyzed. The half-life values for MA in the breast milk were 11.3 and 40.3 hours. The absolute infant doses were 21.3 and 51.7 µg/kg/day. Methamphetamine disappears from breast milk approximately 1 day before the maternal urine MA becomes negative. Conclusion: Smoked MA shows a similar breast milk pharmacokinetic pattern to previously reported intravenous MA. Breastfeeding can be safely initiated in mothers whose urine MA screen has turned negative for ≥ 24 hours. However, concurrent maternal substance use treatment and screening is necessary for continued promotion of lactation.
Prognostic implications of active discoid lupus erythematosus and malar rash at the time of diagnosis of systemic lupus erythematosus: Results from a prospective cohort study
Authors: Drucker A M , Su J , Mussani F , Siddha S K , Gladman D D , Urowitz M B 
Published: October 2015

Objective Cutaneous lupus erythematosus (CLE) may have prognostic implications for systemic lupus erythematosus (SLE). We aimed to determine the impact of discoid lupus erythematosus (DLE) and malar rash on SLE disease activity. Methods Data were analyzed from the Toronto Lupus Clinic prospective cohort study. We compared SLE patients with active DLE or malar rash at SLE diagnosis to SLE patients who never developed CLE. Outcomes were assessed at one and five years, including Adjusted Mean Systemic Lupus Erythematosus Disease Activity Index 2000 (AMS). Results A total of 524 SLE patients (284 without CLE, 65 with DLE, and 175 with malar rash) were included. Mean AMS scores in patients without CLE at one and five years were 5.96 ± 5.06 and 4.00 ± 3.52, which did not differ significantly from scores at one (6.93 ± 5.31, p = 0.17) and five years (4.29 ± 2.62, p = 0.63) in the DLE group. In patients with malar rash, AMS scores at one (8.30 ± 6.80, p < 0.001) and five years (5.23 ± 3.06, p = 0.004) were higher than controls without CLE. Conclusions Malar rash may be a marker of more severe systemic disease over time, while DLE has no significant impact on general SLE disease activity.