bluuebunny/crossref_metadata_2025_split huggingface dataset:
Plasma LncRNA MALAT1 Expressions Are Negatively Associated with Disease Severity of Postmenopausal Osteoporosis
Authors: Qian Tie-Yong , Wan Hui , Huang Ci-You , Hu Xiao-Jing , Yao Wei-Feng 
Published: January 2022

Abstract

Background
Long noncoding RNA metastasis-associated lung adenocarcinoma transcript 1 (LncRNA MALAT1) has been proven to promote osteogenesis in different health conditions. However, the role of plasma MALAT1 in postmenopausal osteoporosis (PMOP) has not been investigated.

Objective
To investigate whether plasma MALAT1 expressions are associated with severity of PMOP.

Methods
A total of 126 patients with PMOP and 126 healthy female control individuals were drafted into study participation. Plasma MALAT1 was detected using RT-PCR. Bone formation marker bone-specific alkaline phosphatase plasma concentration was determined using chemiluminescence immunoassay. Levels of bone absorption marker cross-linked N-telopeptidases of type I collagen were measured in duplicate using enzyme immunoassay. Bone mineral density (BMD) was examined in the total hips, femoral neck, and lumbar (L1–L4) spine using dual-energy x-ray absorptiometry. We used Genant semiquantitative (GSQ) criteria to assess the degree of vertebral deformity and fracture. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the potential diagnostic value of MALAT1 with regard to the GSQ grading. We used the Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) to evaluate the symptomatic severity in and functional ability of the study participants.

Results
Plasma MALAT1 expressions were significantly lower in patients with PMOP, compared with healthy controls. Plasma MALAT1 expressions in patients with PMOP were positively associated with total hip, femoral neck, and lumbar (L1–L4) spine BMD. In total, 95 patients experienced vertebral deformity or fracture (VF), and 31 had no fractures. Plasma MALAT1 expressions were markedly decreased in patients with VF, compared with patients without fractures. Plasma MALAT1 expressions were negatively related to GSQ grading in patients with VF. ROC curve analysis demonstrated that decreased plasma MALAT1 expression exhibits decent diagnostic value with regard to GSQ grading. Finally, we discovered that plasma MALAT1 expression was also negatively associated with VAS and ODI.

Conclusion
Plasma MALAT1 expressions are negatively associated with severity of PMOP.
A Pregnant Pause
Authors: Marcelin Jasmine R. , Yao Joseph D. 
Published: January 2022

Abstract
Current guidelines recommend universal HIV screening of all patients aged 13 to 65 years. The risk of perinatal transmission of HIV has decreased with the implementation of universal screening during pregnancy. The current fourth-generation HIV-1 antibody and antigen screening tests are highly sensitive and specific. Early HIV infection can be asymptomatic, and acute retroviral syndrome can present with fever, viral respiratory-like symptoms, lymphadenopathy, and multiple nonspecific symptoms. Viral load testing should be pursued if the screening and supplemental serologic assays show discordant results.
What a Headache!
Authors: Tan Eugene M. , Marcelin Jasmine R. , Temesgen Zelalem 
Published: January 2022

Abstract
Cryptococcus neoformans is a facultative, intracellular yeast that when inhaled, can cause a primary pulmonary infection; the infection can remain latent but may be activated when the host becomes immunocompromised. C neoformans then disseminates and traverses the blood-brain barrier to cause cryptococcal meningitis. Typical symptoms include fever, weight loss, night sweats, headache, and altered mental status. Cryptococcosis tends to occur in immunocompromised patients with HIV/AIDS, solid-organ transplant, or hematologic malignancy. Treatment regimens for patients can differ, depending on whether they have HIV/AIDS, are receiving immunosuppressive medications, or are immunocompetent.
Kidney Disease and HIV
Authors: Tan Eugene M. , Marcelin Jasmine R. , Rizza Stacey A. 
Published: January 2022

Abstract
Patients are considered to have chronic kidney disease (CKD) when markers of kidney damage are present for longer than 3 months. HIV is a risk factor for CKD. The 2 major categories of HIV-related kidney disease include HIV-associated nephropathy and HIV-associated immune complex kidney disease. Various antiretroviral therapy (ART) regimens may affect renal function. Patients with HIV should be monitored with a creatinine-based estimated glomerular filtration rate, urinalysis, and quantitative measure of albuminuria or proteinuria whenever ART is initiated or changed. In patients with stable HIV, serum creatinine should be obtained twice yearly and urinalysis should be obtained annually.
Acute Respiratory Failure in a Patient With a Methicillin-Resistant Staphylococcus aureus Bloodstream Infection
Authors: Lin Erica , Abu Saleh Omar M. , O’Connor Christina G. 
Published: January 2022

Abstract
Acute eosinophilic pneumonia (AEP) is characterized by pulmonary infiltrates and an excess of eosinophils with a bronchoalveolar lavage differential cell count or lung biopsy. The pathophysiology of medication-induced AEP is still unknown. Diagnosis of AEP is established on the basis of the following criteria: acute onset of febrile illness with respiratory manifestations, hypoxemia, diffuse infiltrates on imaging, an excess of eosinophilia with either greater than 25% eosinophils with a bronchoalveolar lavage differential cell count, or eosinophilic pneumonia on biopsy, in the absence of other causes. Management includes withdrawal of the inciting agent and close observation.
Raised, Purplish, Papular Mass in the Oral Cavity of a Patient Receiving Therapy for HIV/AIDS
Authors: Abeykoon Jithma P. , Abu Saleh Omar M. , Sanchez Jose J. 
Published: January 2022

Abstract
Kaposi sarcoma (KS) is an angioproliferative disease that requires human herpes virus 8 infection (HHV-8). The development of KS appears to depend on the viral homologs of human genes that are carried by HHV-8. Skin lesions such as angiomas, hematomas, pyogenic granuloma, and nevi should also be considered in the differential diagnosis. Biopsy of the lesion should be performed when possible. The diagnosis of KS is confirmed if the biopsy specimen shows the HHV-8 latency-associated nuclear antigen. The main treatment for AIDS-associated KS is combination antiretroviral therapy.
Complicated Urinary Tract Infection With a Multidrug-Resistant Organism
Authors: Narayanan Prasanna P. , Abu Saleh Omar M. , O’Horo John C. 
Published: January 2022

Abstract
In the early 2000s, carbapenem-resistant Enterobacteriaceae (CRE) emerged as a new public health threat. The most common types often are resistant to carbapenems and multiple additional antibiotic classes. Outcomes of these infections are poor, with mortality rates approaching 44%. Carbapenemase-producing bacteria are generally identified through cultures and susceptibility testing. Current antimicrobial options for CRE infections are limited. Aminoglycosides, colistin, polymyxin B, and tigecycline are commonly used when in vitro testing shows susceptibility. Combination therapy may be used, although high-quality data about treatment outcomes are lacking. Newer antibiotics are in development to combat CRE infections: ceftazidime-avibactam, aztreonam-avibactam, cefiderocol, and cefepime-zidebactam.
When Transplant Goes Viral: The Perils of Overimmunosuppression
Authors: Abad Cybele L. , Razonable Raymund R. 
Published: January 2022

Abstract
Donor cytomegalovirus (CMV) seropositivity and recipient seronegativivty status and overimmunosuppression are interrelated factors that predispose patients who have undergone transplant to CMV disease. Antiviral prophylaxis is one of the recommended methods of preventing CMV disease in recipients of solid organ transplants. The standard treatment recommendation for CMV disease is intravenous ganciclovir; for mild to moderate cases, oral valganciclovir is appropriate. Foscarnet is the main choice for treating CMV disease due to a UL97-variant virus. Cidofovir is another option for ganciclovir-resistant CMV. Treatment options for drug-resistant CMV are limited. Novel drugs such as maribavir and letermovir are currently under clinical investigation.
Patient With Diplopia and Thoracic Pain
Authors: Higgins Alexandra S. , Hoversten Patrick S. , Enzler Mark J. 
Published: January 2022

Abstract
Lyme disease is caused most frequently by Borrelia burgdorferi. The nervous system is the third most common site of involvement for Borrelia infections, and 10% to 15% of patients with Lyme disease have neurologic involvement. Lyme disease that is associated with the triad of lymphocytic meningitis, cranial neuropathy, and radiculoneuritis is termed Bannwarth syndrome. Lyme disease serologic testing consists of 2-tiered antibody testing that starts with an enzyme immunoassay and, if positive or indeterminate, is followed by a confirmatory immunoglobulin M and G Western blot for antibodies against B burgdorferi to increase the specificity of initial testing. Treatment consists of intravenous ceftriaxone or doxycycline.
Integrating Resistance
Authors: Zeuli John D. 
Published: January 2022

Abstract
First-generation integrase strand transfer inhibitors (INSTIs) have a lower genetic barrier to resistance than second-generation INSTIs. Primary resistance against raltegravir usually develops via 3 mutually exclusive pathways (N155, Q148, Y143). Elvitegravir often develops primary resistance via T66, E92, N155, or Q148 mutation development. First-generation INSTIs share a high level of cross-resistance. Second-generation INSTIs have in vitro activity against many first-generation INSTI mutations, with bictegravir and dolutegravir showing comparable activities and cabotegravir having less activity for some combinations. Dolutegravir at an increased dose has clinical data to support its use in a combination regimen for patients with first-generation INSTI failure and resistance.
Accountability
Authors: Witvliet Charlotte V. O. , Peteet John R. 
Published: January 2022

Abstract
Accountability is widely recognized as important in a number of disciplines, yet it has received limited attention in mental health. We propose that accountability to others for fulfilling relational responsibilities facilitates flourishing mental health. Conversely, difficulties in appropriately responding to others with answerability or impairments in self-regulation to carry out relational commitments pose challenges for flourishing. We begin by considering the personality, neurobiological, and developmental aspects of accountability. We then consider the importance of the virtue for clinical practice, professionalism, and growth. Flourishing is likely to emerge not only when people become more autonomous, but also when they develop the capacity of accountability—to seek out and respond well to feedback in order to fulfill responsibilities in relationships.
Equanimity
Authors: Tom Michael R. , Vago David R. 
Published: January 2022

Abstract
Equanimity consists of an accepting and unattached disposition, and it facilitates more rapid physiological and emotional recovery following an acute stressor. Mindfulness and meditation practices, in general, are well-established methods of cultivating equanimity and exposure to such practices has been shown to correlate with self-reported, neuroimaging, and molecular indices of relevant clinical change. For example, mindfulness has been shown to promote equanimity through skills that improve distress tolerance and emotion regulation. Equanimity is valued in a range of cultures, faiths, and psychotherapies. Yet, mindfulness has come to the forefront in third-wave cognitive-behavioral therapies such as dialectical behavior therapy, mindfulness-based cognitive therapy, mentalization-based treatment, and it is also apparent in psychodynamic psychotherapy. Equanimity can also be promoted through psychopharmacology in addition to psychotherapy, as we discuss in several clinical cases. We suggest that equanimity is valuable in a variety of clinical contexts, for both the patient and the psychiatrist.
Compassion
Authors: Gilbert Paul 
Published: January 2022

Abstract
The concept of compassion as a virtue is thousands of years old. The last 20 to 30 years have seen a major growth of scientific research on exploring compassion’s psychological, physiological and social processes. This chapter traces compassion back to its evolutionary roots in child parent caring and attachment systems and explores how “motives to care” evolved to texture many forms of caring behavior. Humans are different from other animals to the extent that we have advanced cognitive competencies that allow for high-level forms of reasoning, self-awareness, and mindfulness. It is when the motivation to care is channeled through these competencies and is wisely and intentionally pursued that caring becomes compassion, and thus a virtue, partly because it can be chosen and cultivated.
Care of the patient with cardiac arrhythmias
Authors: Lee Geraldine , Fålun Nina , Angus Neil , Hendriks Jeroen , Norekvål Tone M. , Berg Selina Kikkenborg , Fitzsimons Donna 
Published: January 2022

Abstract
Cardiac arrhythmia is a common complication of acute coronary syndrome, cardiomyopathy, and inherited cardiac conditions. Other regulatory imbalances such as electrolyte disturbance, thyroid dysfunction, or drug interactions can also predispose to arrhythmias. Patients can be asymptomatic, but in many cases palpitations, dyspnoea, chest pain, or syncope are experienced. Some arrhythmias can be life-threatening and require emergency intervention. Cardiac monitoring and interpretation of the 12-lead electrocardiogram is the cornerstone of diagnosis. There are a variety of therapies, devices, and interventions available to manage arrhythmia. However, the psychosocial impact and lifestyle implications of cardiac arrhythmia can be challenging for patients and their families. Nursing care should focus on education and support to facilitate shared decision-making and adherence to selected therapies.
Hormones Across the Lifespan
Authors: Gibney James , Banerjee Indraneel , Ho Ken K.Y. 
Published: January 2022

Abstract
The endocrine system plays a central role in growth, development, metabolism, reproduction, and physical well-being throughout life. The profiles of hormones of the major pituitary axes across the lifespan are distinct, although all are subject to different configurations of feedback regulation. Fetal factors, maternal environment, and placental function shape the status and profile of each axis differently at birth. Developmental programming during life’s transitions can bring dramatic changes of pattern relationships between pituitary and target gland profiles. The hormone profiles are characterized by an orderly rhythmicity that is unique for each axis and which cannot readily be discerned from single hormone measurements. The profiles of pituitary hormones provide a key insight into regulation of the endocrine system across the human lifespan. Understanding of the attributes of each axis is critical for identifying disease and implementing appropriate treatment.
Endocrine Autoimmunity
Authors: Pearce Simon H.S. , Owen Catherine J. 
Published: January 2022

Abstract
The elucidation of the molecular basis for the rare monogenic polyendocrinopathy syndromes including autoimmune polyendocrinopathy type 1, has also allowed novel insights into key points of normal immune homeostasis such as thymic T-lymphocyte antigen receptor selection and the role of peripheral regulatory T cells. These fundamental advances have had far-reaching implications beyond those for endocrine patients. In contrast, the common, complex autoimmune endocrinopathies have been shown to be determined by numerous genetic variants within immune system receptors and signalling pathways along with a small number of variants in the target tissue antigens. A variety of environmental risk factors have been identified for several of these conditions, but it remains to be clarified how these impact pathogenesis at a molecular level. Moreover, the mainstay of therapies for these conditions is hormone replacement and there remains a ‘translational gap’ whereby information about disease pathogenesis has yet to be converted to useful patient advances.
Common Features of Endocrine Tumours
Authors: Jouinot Anne , Bonnet-Serrano Fidéline , Bertherat Jérôme 
Published: January 2022

Abstract
This chapter focuses on endocrine tumours arising from endocrine glands, as defined by the World Health Organization 2017 classification: tumours of the pituitary, the thyroid, the parathyroid, the adrenal cortex, the adrenal medulla, and extra-adrenal paraganglia, and the neuroendocrine pancreas. These tumours share specific features in terms of pathophysiology, diagnosis work-up, and clinical management. Genetic background is frequent and includes genetic predispositions to one specific tumour type, such as pituitary adenoma (AIP), primary bilateral macronodular hyperplasia (ARMC5), or pheochromocytoma/paraganglioma (SDH genes), or to multiple endocrine neoplasias (MEN1 and RET). Hormonal work-up, with basal and dynamic assays, and radiological as well as nuclear imaging based on hormone membrane receptors, are the key steps of the diagnosis process, to evaluate the amount and origin of hormonal secretion, as well as the tumour extension. Management of endocrine tumours should associate both the treatment of the tumour mass, in most cases primarily with surgery, and the control of hormone secretion.
Prevention in Endocrinology
Authors: Valabhji Jonathan , Agha-Jaffar Rochan 
Published: January 2022

Abstract
Changing epidemiology has led to a clear shift in focus in endocrinology disease prevention. Iodine deficiency disorders and congenital hypothyroidism were examples of conditions, which when left untreated had severe consequences including impaired neurological development. However, introduction of appropriate health policies has successfully increased early recognition and treatment, thereby reducing the associated health burden. The epidemic of type 2 diabetes has now superseded these and presents one of the greatest public health challenges. In some countries, national policies are being implemented to tackle the increasing prevalence with strategies focusing on improving the obesogenic environment, a significant modifiable contributor to type 2 diabetes, as well as strategies that aim to prevent high-risk individuals progressing through to type 2 diabetes, such as the National type 2 diabetes Prevention Programme in England. The potential for prevention in other areas including gestational diabetes, type 1 diabetes, and osteoporosis will also be explored in this chapter.
Adult Growth Hormone Deficiency
Authors: Jørgensen Jens O.L. 
Published: January 2022

Abstract
The best-known effect of growth hormone (GH) is stimulation of longitudinal growth in children, but GH hormone secretion continues in adulthood and exerts well-characterized metabolic effects. Growth hormone deficiency in adult hypopituitary patients (GHDA) is associated with excess morbidity and mortality from cardiovascular disease and the phenotype includes fatigue, reduced aerobic exercise capacity, abdominal obesity, reduced lean body mass, and osteopaenia. Several of these features reverse and normalize with GH replacement. Known side effects are fluid retention and insulin resistance, which are reversible and dose dependent. The dose requirement declines with age and is higher in women. Epidemiological surveys show that mortality in GH replaced patients is reduced compared to untreated patients.
Prolactinomas and Hyperprolactinaemia (Including Macroprolactinaemia)
Authors: Tritos Nicholas A. , Klibanski Anne 
Published: January 2022

Abstract
Prolactin is secreted by pituitary lactotrophs and has an important role in reproduction and lactation. There are many causes of hyperprolactinemia, including physiologic states, medications, systemic conditions, and pituitary lesions. Prolactin-secreting pituitary adenomas (prolactinomas) represent the most common type of secreting pituitary tumours. Hyperprolactinemia may lead to central hypogonadism, infertility, and bone loss. In addition, galactorrhoea may occur, particularly in women, and gynaecomastia may occasionally develop in men. Sellar lesions associated with hyperprolactinemia may cause mass effect, including headache or visual field defects. The diagnosis of hyperprolactinemia can be made by measuring serum prolactin concentration by immunoassays. Macroprolactinaemia and the hook effect may confound the interpretation of test results. Dopamine agonist therapy represents the cornerstone of management of hyperprolactinemia and prolactinomas. Transsphenoidal pituitary surgery is generally second-line therapy for patients with prolactinomas. Radiation therapy can be recommended for patients whose tumours cannot be controlled with medical therapy and surgery.
Clinically Non-Functioning Pituitary Tumours and Gonadotropinomas
Authors: Biermasz Nienke , van Furth Wouter R. 
Published: January 2022

Abstract
Clinically non-functioning pituitary adenomas (NFPAs) usually present with mass effects. Transsphenoidal surgery is the cornerstone of treatment once there is an indication for decompression. In smaller NFPAs, a wait-and-scan policy is usually considered. After surgery tumour remnants are closely followed with MRI and ophthalmological evaluation. Adjuvant radiotherapy can be performed in case there is a remnant, however, given the slow growth tendency a wait and scan policy and postponing radiotherapy is an alternative approach, especially in patients with normal pituitary function. Recent years there are some innovations with respect to medical treatment. Cabergoline may help with tumour stabilization in a subset of patients and temozolomide can be attempted in aggressive forms of pituitary adenoma.
Lymphocytic Hypophysitis and other Inflammatory Conditions of the Pituitary
Authors: Molitch Mark E. , Kravarusic Jelena 
Published: January 2022

Abstract
Inflammatory conditions of the pituitary are very rare, and in presentation similar to adenomas by symptoms of expanding sellar mass, visual disturbances, and pituitary hormone deficiencies. They can be of various origin, autoimmune such as lymphocytic hypophysitis, secondary, as a part of immune-related adverse effects, or a part of a systemic disease such as IgG4-related disease. Due to their uncommon occurrence, pathogenesis is still largely unknown and therapies are not well established. However, as there is increase in awareness, the rate of diagnosis is increasing. This chapter outlines current knowledge on these rare conditions, approach to diagnosis with careful attention to epidemiology which often helps guide prioritization of the differential diagnosis and summarizes therapeutic approaches as they are developing.
Non-Thyroidal Illness (NTI)
Authors: Peeters Robin P. , Boelen Anita 
Published: January 2022

Abstract
Already a few hours after the onset of acute illness, marked changes in serum thyroid hormone levels occur. This is referred to as non-thyroidal illness (NTI) also known as the low T3 syndrome and the euthyroid sick syndrome. The most characteristic and persistent abnormality is a low serum T3. Nevertheless, patients usually have no clinical signs of thyroid dysfunction. A low T3 in euthyroid patients is also seen during caloric deprivation. Both in NTI and in fasting there is a negative energy balance in the majority of cases. Therefore, the low levels of T3 during NTI and starvation have been interpreted as an attempt to save energy expenditure, which does not need intervention. However, this remains controversial and has been a debate for many years.