bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dapagliflozin Versus Glipizide as Add-on Therapy in Patients With Type 2 Diabetes Who Have Inadequate Glycemic Control With Metformin
Authors: Nauck Michael A. , Del Prato Stefano , Meier Juris J. , Durán-García Santiago , Rohwedder Katja , Elze Martina , Parikh Shamik J. 
Published: August 2011

OBJECTIVE
Although initially effective, sulfonylureas are associated with poor glycemic durability, weight gain, and hypoglycemia. Dapagliflozin, a selective inhibitor of sodium-glucose cotransporter 2 (SGLT2), reduces hyperglycemia by increasing urinary glucose excretion independent of insulin and may cause fewer of these adverse effects. We compared the efficacy, safety, and tolerability of dapagliflozin with the sulfonylurea glipizide in patients with type 2 diabetes inadequately controlled with metformin monotherapy.

RESEARCH DESIGN AND METHODS
This 52-week, double-blind, multicenter, active-controlled, noninferiority trial randomized patients with type 2 diabetes (baseline mean HbA1c, 7.7%), who were receiving metformin monotherapy, to add-on dapagliflozin (n = 406) or glipizide (n = 408) up-titrated over 18 weeks, based on glycemic response and tolerability, to ≤10 or ≤20 mg/day, respectively.

RESULTS
The primary end point, adjusted mean HbA1c reduction with dapagliflozin (−0.52%) compared with glipizide (−0.52%), was statistically noninferior at 52 weeks. Key secondary end points: dapagliflozin produced significant adjusted mean weight loss (−3.2 kg) versus weight gain (1.2 kg; P &lt; 0.0001) with glipizide, significantly increased the proportion of patients achieving ≥5% body weight reduction (33.3%) versus glipizide (2.5%; P &lt; 0.0001), and significantly decreased the proportion experiencing hypoglycemia (3.5%) versus glipizide (40.8%; P &lt; 0.0001). Events suggestive of genital infections and lower urinary tract infections were reported more frequently with dapagliflozin compared with glipizide but responded to standard treatment and rarely led to study discontinuation.

CONCLUSIONS
Despite similar 52-week glycemic efficacy, dapagliflozin reduced weight and produced less hypoglycemia than glipizide in type 2 diabetes inadequately controlled with metformin. Long-term studies are required to further evaluate genital and urinary tract infections with SGLT2 inhibitors.
Prevalence of Neuropathy and Peripheral Arterial Disease and the Impact of Treatment in People With Screen-Detected Type 2 Diabetes
Authors: Charles Morten , Ejskjaer Niels , Witte Daniel R. , Borch-Johnsen Knut , Lauritzen Torsten , Sandbaek Annelli 
Published: August 2011

OBJECTIVE
There is limited evidence on how intensive multifactorial treatment (IT) improves outcomes of diabetes when initiated in the lead time between detection by screening and diagnosis in routine clinical practice. We examined the effects of early detection and IT of type 2 diabetes in primary care on the prevalence of diabetic peripheral neuropathy (DPN) and peripheral arterial disease (PAD) 6 years later in a pragmatic, cluster-randomized parallel group trial.

RESEARCH DESIGN AND METHODS
A stepwise screening program in 190 general practices in Denmark was used to identify 1,533 people with type 2 diabetes. General practices were randomized to deliver either IT or routine care (RC) as recommended through national guidelines. Participants were followed for 6 years and measures of DPN and PAD were applied.

RESULTS
We found no statistically significant effect of IT on the prevalence of DPN and PAD compared with RC. The prevalence of an ankle brachial index ≤0.9 was 9.1% (95% CI 6.0–12.2) in the RC arm and 7.3% (5.0–9.6) in the IT arm. In participants tested for vibration detection threshold and light touch sensation, the prevalence of a least one abnormal test was 34.8% (26.7–43.0) in the RC arm and 30.1% (24.1–36.1) in the IT arm.

CONCLUSIONS
In a population with screen-detected type 2 diabetes, we did not find that screening followed by IT led to a statistically significant difference in the prevalence of DPN and PAD 6 years after diagnosis. However, treatment levels were high in both groups.
Fluoride Release, Recharge and Mechanical Property Stability of Various Fluoride-containing Resin Composites
Authors: Naoum S , Ellakwa A , Martin F , Swain M 
Published: August 2011

Clinical Relevance
Fluoride containing resin composites and especially those containing pre reacted glass ionomer fillers could be employed to great benefit in treating high caries risk patients in situations where glass ionomers may be unsuitable; particularly in high load bearing or aesthetically critical locations.
Fracture Resistance of Cuspal Coverage of Endodontically Treated Maxillary Premolars with Combined Composite-Amalgam Compared to Other Techniques
Authors: Shafiei F , Memarpour M , Karimi F 
Published: August 2011

Clinical RelevanceCombined composite-amalgam for cuspal coverage of endodontically treated premolars was similar to direct composite coverage in strengthening restored teeth; however, composite onlay had the highest fracture resistance.
Acidophilous oak forests of the Wielkopolska region (West Poland) against the background of Central Europe
Authors: Kasprowicz Marek 
Published: August 2011

Acidophilous oak forests of the Wielkopolska region (West Poland) against the background of Central Europe
This monograph gives the phytosociological characteristics of acidophilous oak forests from the class Quercetea robori-petraeae (Aulacomnio androgyni-Quercetum, Molinio caeruleae-Quercetum, and Calamagrostio arundinaceae-Quercetum) and the closely related forest communities from the classes Querco-Fagetea (Potentillo albae-Quercetum and acidophilous forms of Galio sylvatici-Carpinetum) and Vaccinio-Piceetea (Querco roboris-Pinetum and Serratulo-Pinetum) in the Wielkopolska region and adjacent areas. The report is based on 1655 relevés selected from 59 published or unpublished studies. The analysed and revised syntaxa are described in accordance with the International Code of Phytosociological Nomenclature. The distribution of the documented localities of all associations and subassociations in the study area is shown in cartograms on the ATPOL grid (squares of 10 km x 10 km). The classical phytosociological methods are complemented with multivariate ordination methods (detrended correspondence analysis and/or principal component analysis) and analyses taking into account Ellenberg indicator values. The natural geographical and site differentiation of all the plant associations is presented, and stages of degeneration are distinguished in some of them. The separation of degenerated forms and substitute forest communities has allowed a clearer classification of the studied syntaxa. This study shows that the analysed associations can be subdivided into 16 subassociations and 23 variants. For 5 subassociations, nomenclatural types are designated here. The most common association in the study area is Calamagrostio arundinaceae-Quercetum, but most of its relevés represent various stages of degeneration. Among communities from the order Quercetalia roboris, patches of Aulacomnio androgyni-Quercetum and Molinio caeruleae-Quercetum are rare. On the basis of this detailed study, a coherent system of classification of acidophilous oak forests from the order Quercetalia roboris in Central Europe is proposed. The results are important for biodiversity conservation and sustainable forest management.
Epilepsy after subarachnoid hemorrhage: the frequency of seizures after clip occlusion or coil embolization of a ruptured cerebral aneurysm
Authors: Hart Yvonne , Sneade Mary , Birks Jacqueline , Rischmiller Joan , Kerr Richard , Molyneux Andrew 
Published: August 2011

Object
The aim of this study was to determine the probability of seizures after treatment of a ruptured cerebral aneurysm by clip occlusion and coil embolization, and to identify the risks and predictors of seizures over the shortand long-term follow-up period.

Methods
The study population included 2143 patients with ruptured intracranial aneurysms who were enrolled in 43 centers and randomly assigned to clip application or coil placement. Those patients suffering a seizure were identified prospectively at various time points after randomization, as follows: before treatment; after treatment and before discharge; after discharge to 1 year; and annually thereafter.

Results
Two hundred thirty-five (10.9%) of the 2143 patients suffered a seizure after randomization; 89 (8.3%) of 1073 and 146 (13.6%) of 1070 in the endovascular and neurosurgical allocations, respectively (p = 0.014). In 19 patients the seizure was associated with a rehemorrhage. Of those patients who underwent coil placement alone, without additional procedures, 52 suffered a seizure, and in the group with clip occlusion alone, 91 patients suffered a seizure.
The risk of a seizure after discharge in the endovascular group was 3.3% at 1 year and 6.4% at 5 years. In the neurosurgical group it was 5.2% at 1 year and 9.6% at 5 years. The risk of seizure was significantly greater in the neurosurgical group at both 2 years and at up to 14 years (p = 0.005 and p = 0.013, respectively). The significant predictors of increased risk were as follows: neurosurgical treatment allocation, hazard ratio (HR) 1.64 (95% CI 1.19–2.26); younger age, HR 1.54 (95% CI 1.14–2.13); Fisher grade > 1 on CT scans, HR 1.34 (95% CI 0.62–2.87); delayed ischemic neurological deficit due to vasospasm, HR 2.10 (95% CI 1.49–2.94); and thromboembolic complication, HR 5.08 (95% CI 3.00–8.61). A middle cerebral artery (MCA) aneurysm location was also a significant predictor of increased risk in both groups; the HR was 2.23 (95% CI 1.57–3.17), with the probability of seizure at 6.1% and 11.5% at 1 year in the endovascular and neurosurgery groups, respectively.

Conclusions
The risk of seizures after coil embolization is significantly lower than that after clip occlusion. An MCA aneurysm location increased the risk of seizures in both groups.
Hospital costs, incidence, and inhospital mortality rates of traumatic subdural hematoma in the United States
Authors: Kalanithi Paul , Schubert Ryan D. , Lad Shivanand P. , Harris Odette A. , Boakye Maxwell 
Published: August 2011

Object
This study provides the first US national data regarding frequency, cost, and mortality rate of traumatic subdural hematoma (SDH), and identifies demographic factors affecting morbidity and death in patients with traumatic SDH undergoing surgical drainage.

Methods
A retrospective analysis was conducted by querying the Nationwide Inpatient Sample, the largest all-payer database of nonfederal community hospitals. All cases of traumatic SDH were identified using ICD-9 codes. The study consisted of 2 parts: 1) trends data, which were abstracted from the years 1993–2006, and 2) univariate analysis and multivariate logistic regression of demographic variables on inhospital complications and deaths for the years 1993–2002.

Results
Admissions for traumatic SDH increased 154% from 17,328 in 1993 to 43,996 in 2006. Inhospital deaths decreased from 16.4% to 11.6% for traumatic SDH. Average costs increased 67% to $47,315 per admission. For the multivariate regression analysis, between 1993 and 2002, 67,864 patients with traumatic SDH underwent operative treatment. The inhospital mortality rate was 14.9% for traumatic SDH drainage, with an 18% inhospital complication rate. Factors affecting inhospital deaths included presence of coma (OR = 2.45) and more than 2 comorbidities (OR = 1.60). Increased age did not worsen the inhospital mortality rate.

Conclusions
Nationally, frequency and cost of traumatic SDH cases are increasing rapidly.
Fibromatosis: a potential sequela of neuromuscular choristoma
Authors: Hébert-Blouin Marie-Noëlle , Scheithauer Bernd W. , Amrami Kimberly K. , Durham Susan R. , Spinner Robert J. 
Published: August 2011

Object
Neuromuscular choristoma (NMC) is a rare peripheral nerve lesion in which mature skeletal muscle fibers lie within the nerve and its fascicles. Given limited follow-up, its natural history is poorly understood. The occurrence of aggressive fibromatosis in one of the authors' patients and its occurrence in reported cases suggests an etiological relationship between the 2 lesions. This study attempts to explain the association and its frequency.

Methods
All cases of NMCs seen in consultation or treated at the Mayo Clinic were identified. Demographic and clinical data were reviewed in cases with coexistent aggressive fibromatosis. Pathology and neuroimaging studies were reexamined. In addition, an extensive literature review was performed to explore the association of NMC with aggressive fibromatosis, with special attention given to pathological and imaging characteristics and the development of aggressive fibromatosis.

Results
The authors identified 10 patients with a diagnosis of NMC who were treated at the Mayo Clinic between 1992 and 2010. Four of 5 with adequate follow-up had developed a definite or suspected aggressive fibromatosis. A review of the initial pathological specimens in these cases revealed no evidence of fibromatosis, but all of the lesions exhibited accompanying hypocellular collagenous tissue. On MR images, all cases showed areas of low signal intensity, which significantly differed from muscle, nerve, and NMC components. On available serial MR imaging studies, aggressive fibromatosis seemed to originate in such lower-intensity regions. In the 18 previously reported cases of NMC, 5 patients developed recurrent masses diagnosed as either definite (2 cases) or possible (3 cases) fibromatosis. Review of the published imaging studies in these cases suggests the presence of lower intensity areas similar to those observed in the 10 patients treated at the Mayo Clinic.

Conclusions
This study confirms that the development of aggressive fibromatosis in patients with NMC has been underreported. A direct relationship between the NMC and the development of aggressive fibromatosis is suggested by pathological and neuroimaging evidence.
Emergency department predictors of tracheostomy in patients with isolated traumatic brain injury requiring emergency cranial decompression
Authors: Shamim Muhammad Shahzad , Qadeer Mohsin , Murtaza Ghulam , Enam S. Ather , Farooqi Najiha B. 
Published: August 2011

Object
Patients with severe traumatic brain injury (TBI) frequently require a tracheostomy for prolonged mechanical ventilation and/or pulmonary toilet. It is now proven that the earlier the procedure is done, the more beneficial it is to the patient. The present study was carried out to determine if the requirement of a tracheostomy can be predicted on arrival of a patient to the emergency department. The prediction can potentially aid in combining the procedure with cranial decompression. In this study, the authors' aim was to determine the emergency department predictors of tracheostomy in patients with isolated TBI requiring emergency cranial decompression.

Methods
The authors performed a retrospective chart review of all patients who underwent surgery for isolated TBI and required more than 4 days of mechanical ventilation. Multivariate logistic regression analysis was used for predictive indicators.

Results
In patients with isolated severe TBI, a patient age of 31–50 years, the presence of preexisting medical comorbid conditions, a delay in emergency department arrival exceeding 1.5 hours, an abnormal pupil response on arrival, and a preoperative neurological worsening during hospital stay were independent predictors of the requirement for tracheostomy. These findings were validated in a small cohort of patients and were found to be significant.

Conclusions
Requirement of a tracheostomy can be predicted in patients with severe TBI on arrival to the emergency department. These results were validated in a small cohort of patients, and it was found that the positive predictive value of requirement of tracheostomy was directly proportional to the number of predictors present. Larger prospective studies with appropriate control groups are further recommended to validate the authors' findings.
Current comprehensive management of cranial base chordomas: 10-year meta-analysis of observational studies
Authors: Di Maio Salvatore , Temkin Nancy , Ramanathan Dinesh , Sekhar Laligam N. 
Published: August 2011

Object
The role of surgery and adjuvant radiation therapy for cranial base chordomas is not well established. This meta-analysis measures the relationship of complete resection and type of adjuvant radiation therapy to 5-year progression-free survival (PFS) and overall survival (OS) of cranial base chordomas.

Methods
A systematic MEDLINE search (1999–present) yielded 23 observational studies and 807 patients who fit inclusion criteria. The following analyses were performed: 1) Kaplan-Meier 5-year PFS and OS compared based on the extent of resection and type of adjuvant radiation therapy using the log-rank method; 2) a random-effects model comparing 5-year PFS with complete or incomplete resection; and 3) paired z-test comparisons of weighted average 5-year OS and PFS grouped by type of adjuvant radiation therapy.

Results
The weighted average follow-up was 53.6 months. The weighted average 5-year PFS and OS were 50.8% and 78.4%, respectively. Complete resection conferred a higher 5-year PFS than incomplete resection from the random effects model (mean difference in PFS 20.7%; 95% CI 6.57%–34.91%). Patients with incomplete resection were 3.83 times more likely to experience a recurrence (95% CI 1.63–9.00) and 5.85 times more likely to die (95% CI 1.40–24.5) at 5 years versus patients with complete resection. There was no difference in 5-year OS by type of adjuvant radiation, although 5-year PFS was lower in patients receiving Gamma Knife surgery relative to carbon ion radiotherapy (p = 0.042) on paired z-test. No survival difference occurred between radiation therapy techniques on Kaplan-Meier analysis of compiled patient data.

Conclusions
Patients with complete resection of cranial base chordomas have a prolonged 5-year PFS and OS. Adjuvant proton-beam, carbon ion, and modern fractionated photon radiation therapy techniques offered a similar rate of PFS and OS at 5 years.
Predictors of seizure freedom in the surgical treatment of supratentorial cavernous malformations
Authors: Englot Dario J. , Han Seunggu J. , Lawton Michael T. , Chang Edward F. 
Published: August 2011

Object
Seizures are the most common presenting symptom of supratentorial cerebral cavernous malformations (CCMs) and progress to medically refractory epilepsy in 40% of patients. Predictors of seizure freedom in the resection of CCMs are incompletely understood.

Methods
The authors systematically reviewed the published literature on seizure freedom following the resection of supratentorial CCMs in patients presenting with seizures. Seizure outcomes were stratified across 12 potential prognostic variables. A total of 1226 patients with supratentorial CCMs causing seizures were identified across 31 predominantly retrospective studies; 361 patients had medically refractory epilepsy.

Results
Seventy-five percent of the patients were seizure free after microsurgical lesion removal, whereas 25% continued to have seizures. All patients had had preoperative seizures and > 6 months of postoperative follow-up. Modifiable predictors of postoperative seizure freedom included gross-total resection (OR 36.6, 95% CI 8.5–157.5) and surgery within 1 year of symptom onset (OR 1.83, 95% CI 1.30–2.58). Additional prognostic indicators of a favorable outcome were a CCM size < 1.5 cm (OR 15.4, 95% CI 5.2–45.4), the absence of multiple CCMs (OR 2.02, 95% CI 1.13–3.60), medically controlled seizures (OR 2.38, 95% CI 1.29–4.39), and the lack of secondarily generalized seizures (OR 3.33, 95% CI 2.09–5.30). Other factors, including extended resection of the hemosiderin ring, were not significantly predictive.

Conclusions
In the surgical treatment of supratentorial CCMs, gross-total resection and early operative intervention may improve seizure outcome. While surgery should not be considered the first-line treatment for CCM-related epilepsy, it is important to understand the variables associated with seizure freedom in CCM resection given the considerable morbidity and diminished quality of life associated with epilepsy.
Interobserver variability in the interpretation of computed tomography following aneurysmal subarachnoid hemorrhage
Authors: Ibrahim George M. , Weidauer Stefan , Macdonald R. Loch 
Published: August 2011

Object
Numerous abnormal findings may be evident on CT scans after aneurysmal subarachnoid hemorrhage (SAH). Here, the authors assess the interobserver variability in the radiological interpretation of the initial CT scan following SAH.

Methods
Two experienced reviewers, a neurosurgeon and a neuroradiologist, independently prospectively reviewed the initial CT scans of 413 patients enrolled in the CONSCIOUS-1 trial. Measured variables included SAH, intraventricular hemorrhage, intracerebral hemorrhage, subdural hematoma, chronic infarction, midline shift, and hydrocephalus. To assess interobserver variability, weighted kappa values and intraclass correlation coefficients (ICCs) were calculated and Bland-Altman analysis was performed.

Results
Moderate to substantial agreement was found for most of the CT scanning findings. There was fair to moderate interobserver agreement between reviewers when determining the extent of SAH based on a descriptive categorical classification (kappa 0.41; 95% CI 0.33–0.49), and better agreement when a semiquantitative scale was used (ICC 0.56; 95% CI 0.49–0.62). There was poor agreement between reviewers for the presence of hydrocephalus (kappa 0.34; 95% CI 0.20–0.48), but substantial to near perfect agreement on ventriculocranial ratio measurements (ICC 0.77; 95% CI 0.72–0.81).

Conclusions
The authors' findings suggest that there is considerable interobserver variability in the interpretation of CT scans after SAH. Quantitative measures may reduce interobserver variability in comparison with qualitative or categorical scales. Variability in interpretation of CT scans has implications for patient care and conduct of clinical trials. It may be beneficial to develop standardized assessments to ensure consistent evaluation of measured variables.
Cardiac troponins and oxidative stress markers in non-pregnant, pregnant and preeclampsia women
Authors: Pasupathi Palanisamy , Manivannan Uma , Manivannan Perisamy , Deepa Mathiyalagan 
Published: August 2011

Free radicals play an important role in the pathogenesis of tissue damage in many clinical disorders, including atherosclerosis. This study was to investigate lipids and oxidative stress markers among women with 50 healthy non-pregnant compare with 50 healthy pregnant and 50 pregnancy-induced hypertensive subjects and correlate with cardiac troponin I (cTnI) and troponin T (cTnT). The level of plasma thiobarbituric acid reactive substances (TBARS), cTnI and cTnT levels significantly increase in pregnancy-induced hypertension compare with other groups. The level of lipids significantly altered in pregnancy-induced hypertension. Conversely, the activities of both enzymatic and non-enzymatic antioxidants were significantly decreased in pregnancy-induced hypertension compared to non-pregnant and healthy pregnant. Our data suggest that there is an imbalance between lipoperoxidation and antioxidants levels during pregnancy and preeclampsia. Serum cTnI and cTnT are elevated in women with pregnancy-induced hypertension indicating some degree of cardiac myofibrillar damage and cardiac dysfunction.Online: 11 July 2010DOI: http://dx.doi.org/10.3329/bmrcb.v36i1.4806Bangladesh Med Res Counc Bull 2010; 36: 4-9