nils-herrmann/clean_scirepeval huggingface dataset:
Medical treatment of gastric and duodenal ulcer

Antazida erweisen sich als wirksam — wenn auch nur temporär — bei der Linderung der Ulcusbeschwerden. Den Internisten ist es gelungen, die Heilungsrate beim Ulcus ventriculi durch Rauchverbot sowie durch stationäre Aufnahme und Bettruhe oder Carbenoxolontherapie beim ambulanten Patienten zu erhöhen. Die jüngsten, noch nicht endgültigen Studien mit einigen anderen Arzneimitteln zeigen zwar eine Zunahme in der Heilungsrate von Magenulzera. Es gibt aber keine internistische Therapieform, die in der Lage ist, die hohe Rezidivrate beim gutartigen Magengeschwür zu verhindern. Die spärlichen, gesicherten Daten zeigen, daß eine adäquate, medikamentöse Reduktion der Säuresekretion und eine Erhöhung der Widerstandskraft der Mucosa den Patienten mit einem Ulcus duodeni helfen könnten. Antacids prove ready if only temporary relief of the symptoms of ulcers. Physicians have been able to increase the rate of healing of gastric ulcers by advising patients to stop smoking and then either admit them to hospital for bed-rest, or use carbenoxolone sodium as an outpatient therapy. The early trials of some other drugs have shown increase in rate of healing of gastric ulcer, but there is no medical treatment which will prevent the high recurrence rate of benign gastric ulcer. The limited data indicate that adequate medical reduction in acid secretion and enhancement of mucosal resistance may benefit patients with duodenal ulcer.
Anemia is a significant prognostic factor in local relapse-free survival of premenopausal primary breast cancer patients receiving adjuvant cyclophosphamide/methotrexate/5-fluorouracil chemotherapy.

To determine the effects of anemia on local relapse-free, relapse-free, and overall survival (LRFS, RFS, and OS, respectively) in premenopausal, primary breast cancer patients receiving adjuvant polychemotherapy, and to determine which conventional prognostic factors affected these outcomes.



Four hundred twenty-four premenopausal patients with early-stage primary breast cancer and hormone receptor-expressing tumors were treated with i.v. cyclophosphamide/methotrexate/5-fluorouracil (CMF) polychemotherapy as part of an adjuvant phase III trial (Austrian Breast and Colorectal Cancer Study Group Trial 5). The influence of anemia (hemoglobin <12 g/dL) on LRFS, RFS, and OS was evaluated in a retrospective analysis.



Of 424 patients, 77 (18.2%) developed anemia on CMF chemotherapy. After a median follow-up time of 5 years, 8.9% of nonanemic patients had local relapse compared with 19.6% of anemic patients (P=0.0006). Although mastectomy was associated with anemia (26% versus 13.7% in breast conserving surgery; P=0.002), multivariate analysis did not show mastectomy per se to be a significant risk factor for LRFS. Age, lymph node status, and hemoglobin had an independent significant influence on LRFS (P<0.005). Anemic patients had a relative risk of 2.96 (95% confidence interval, 1.41-6.23) for developing local relapse in comparison with nonanemic patients.



Premenopausal breast cancer patients who developed anemia during the CMF regimen had significantly worse LRFS. In Austrian Breast and Colorectal Cancer Study Group Trial 5, anemia may have contributed to an almost doubled incidence of local recurrence in the chemotherapy arm. Molecular targets associated with tumor hypoxia and distinct from erythropoiesis should receive further attention in experimental and clinical settings.
Inter-scan variability of coronary artery calcium scoring assessed on 64-multidetector computed tomography vs. dual-source computed tomography: a head-to-head comparison.

Coronary artery calcium (CAC) scoring has emerged as a tool for risk stratification and potentially for monitoring response to risk factor modification. Therefore, repeat measurements should provide robust results and low inter-scanner variability for allowing meaningful comparison. The purpose of this study was to investigate inter-scanner variability of CAC for Agatston, volume, and mass scores by head-to-head comparison using two different cardiac computed tomography scanners: 64-detector multislice CT (MSCT) and 64-slice dual-source CT (DSCT).



Thirty patients underwent CAC measurements on both 64-MSCT (GE LightSpeed XT scanner: 120 kV, 70 mAs, 2.5 mm slices) and 64-DSCT (Siemens Somatom Definition: 120 kV, 80 mAs, 3 mm slices) within <100 days (0-97). Retrospective intra-scan comparison revealed an excellent correlation. The excellent intra-scan (inter-observer) agreement was documented by narrow limits of agreement and a correlation coefficient of variation (COV) of r ≥ 0.99 (P < 0.001) for all CAC scores with a low COV for both scanners (64-MSCT/64-DSCT), i.e. Agatston (2.0/2.1%), mass (3.0/2.0%), and volume (4.7/3.9%). Inter-scanner comparison revealed larger Bland-Altman (BA) limits of agreement, despite high correlation (r ≥ 0.97) for all scores, with COV at 15.1, 21.6, and 44.9% for Agatston, mass, and volume scores. The largest BA limits were observed for volume scores (-1552.8 to 574.2), which was massively improved (-241.0 to 300.4, COV 11.5%) after reanalysing the 64-DSCT scans (Siemens) with GE software/workstation (while Siemens software/workstation does not allow cross-vendor analysis). Phantom measurements confirmed overestimation of volume scores by 'syngo Ca-Scoring' (Siemens) software which should therefore be reviewed (vendor has been notified).



Intra- and inter-scan agreement of CAC measurement in a given data set is excellent. Inter-scanner variability is reasonable, particularly for Agatston units in the clinically most relevant range <1000. The use of different software solutions has a greater influence particularly on volume scores than the use of different scanner types.
Investigating strategies to reduce toxicity in stereotactic ablative radiotherapy for central lung tumors.

[corrected] Stereotactic radiotherapy for central lung tumors has a narrower therapeutic index than that for peripheral tumors. Tumor tracking strategies have been proposed to reduce treatment volumes and toxicity, however they need to consider uncertainties in tumor size and shape change throughout respiration to ensure optimal local control. We quantified these uncertainties and explored strategies to account for them.



Ten patients with central tumors, PTV > 100 cm(3), motion > 5 mm and a 10-phase 4DCT without significant artifact in the tumor region were evaluated. Uncertainties were quantified using GTV size in different phases, and the Hausdorff distance (HD) between the phase 50% GTV and other phases after soft-tissue rigid registration. An individualized internal target volume for tracking (ITV(T)) was generated from the union of the GTVs in all phases after rigid registration. This was compared to ITVs generated for tracking based on the phase 50% GTV alone or with isotropic margins of 3 or 5 mm for size and volume overlap.



Median free-breathing PTV size and motion were 162.1 cm(3) (110-210) and 8.9 mm (6.1-14.1). Overall, median GTV size variation and HD were 4.7% (0.2-22.3) and 6.3 mm (3.9-17.6). Tracking using GTV 50% alone resulted in median volume overlap with ITV(T) of 71.7% (range 56.8-85.1). Isotropic margins of 3 or 5mm always resulted in a volume overlap less than 95% or a volume larger than the ITV(T).



Changes in size and shape of central lung tumors are substantial during respiration. These limit the ability to reduce treatment volumes with tracking, especially if isotropic margins are used. An individualized ITV for tracking, such as the ITV(T) is preferred.
Interapy: a controlled randomized trial of the standardized treatment of posttraumatic stress through the internet.

Online therapy offers many advantages over face-to-face therapy. Interapy includes psychoeducation, screening, effect measures, and a protocol-driven treatment via the Internet for people suffering from posttraumatic stress. The present article reports the results of a controlled trial on the Internet-driven treatment of posttraumatic stress and grief in a group of people who manifested mild to relatively severe trauma symptoms. Participants in the treatment condition (n=69) improved significantly more than participants in the waiting-list control condition (n=32) on trauma-related symptoms and general psychopathology. The effect sizes were large. On most subscales, more than 50% of the treated participants showed reliable change and clinically significant improvement, with the highest percentages being found for depression and avoidance.
Predictors of spontaneous reverse remodeling in mild heart failure patients with left ventricular dysfunction.

There are limited data regarding factors associated with spontaneous left ventricular reverse remodeling (S-LVRR) among mildly symptomatic heart failure (HF) patients and its prognostic implications on clinical outcomes.



Best subsets logistic regression analysis was used to identify factors associated with S-LVRR (defined as ≥15% reduction in left ventricular end-systolic volume at 1-year of follow-up) among 612 patients treated with internal cardioverter defibrillator-only therapy in Multicenter Automatic Defibrillator Implantation Trial-Cardiac Resynchronization Therapy (MADIT-CRT) and to create a score for the prediction of S-LVRR. Cox proportional hazards regression modeling was used to assess the clinical outcome of all internal cardioverter defibrillator-only patients (n=714) with a high S-LVRR score. S-LVRR occurred in 25% of internal cardioverter defibrillator-only patients. Predictors of S-LVRR included systolic blood pressure≥140 mm Hg, serum creatinine<1.0 mg/dL, QRS 130 to 160 ms, and nonischemic cardiomyopathy. Multivariate analysis showed that each 1-point increment in S-LVRR score (range, 0-7) was associated with an 11% (P=0.019) reduction in the risk of HF or death. Treatment with cardiac resynchronization therapy was associated with a significant reduction in the risk of HF or death only among internal cardioverter defibrillator-treated patients with a low (Q1-3) S-LVRR score (hazard ratio=0.55; P<0.001), but not among those with a higher (Q4) score (hazard ratio=1.06; P=0.72).



Our data suggest that approximately one quarter of mild HF patients eligible for biventricular pacing experience S-LVRR. Combined assessment of clinical factors associated with S-LVRR can be used to identify mild HF patients with a low risk for clinical events without cardiac resynchronization therapy intervention.
Predictors of positive growth after traumatic brain injury: a longitudinal study.

To investigate long-term positive psychological growth in individuals with traumatic brain injury (TBI) and to relate growth to injury characteristics and early outcomes.



Longitudinal study.


METHOD AND PROCEDURE
Long-term follow-up of a group of TBI survivors recruited between 1991-1995. In 2004, 240 of the 563 original participants were invited to take part in a follow-up study. At follow-up, survivors completed the Positive Changes in Outlook Questionnaire (CiOP) along with a structured interview/questionnaire which permitted a Glasgow Outcome Scale (GOSE) score to be assigned.



One hundred and sixty-five TBI survivors completed both questionnaire and CiOP. One hundred and three (62%) participants had suffered severe TBI, 24 (15%) moderate and 38 (23%) mild. Mean length of follow-up was 11.5 years post-injury (range 9-25 years). On the GOSE at follow-up, 43 (26%) had severe disability; 72 (44%) moderate disability; and 50 (30%) good recovery. Scores on the CiOP indicated positive psychological growth in over half of the sample, as evidenced by agreement with items such as 'I don't take life for granted anymore' and 'I value my relationships much more now'. CiOP total scores did not correlate with any injury or early outcome variables. However, at long-term follow-up there was a negative correlation between positive growth and anxiety and depression.



Survivors of mild, moderate and severe TBI showed evidence of long-term positive changes in outlook.
Effects of relaxation therapy on psychologic distress and symptom status in older Chinese patients with heart failure.

Previous studies demonstrated the effects of progressive muscle relaxation training (PMRT) on improvements in the health outcomes of cardiac patients. This study examined the effects of PMRT on the psychologic status and symptoms of older Chinese patients with heart failure.



In a longitudinal, randomized, and controlled study, 59 patients were allocated to receive a PMRT program and 62 were provided with the attention placebo. The PMRT program included two PMRT sessions, one revision workshop, twice-daily PMRT home practices, and a biweekly telephone follow-up call. The attention placebo included a regular telephone call at a schedule similar to that made by the interventionist of the PMRT program with the intervention group. Main outcome measures, including psychologic distress, dyspnea, and fatigue, were taken at baseline, the 8th week, and the 14th week.



A medium effect on psychologic distress in favor of the PMRT program was detected. Patients practicing PMRT however only demonstrated a nonsignificant trend of greater improvement in symptom status.



Progressive muscle relaxation training seems to be useful as an adjunctive nonpharmacologic treatment modality in the management of heart failure.
The effect of adding whole body vibration training to strengthening training in the treatment of knee osteoarthritis: A randomized clinical trial.

Strengthening training (ST) and whole body vibration training (WBV) alone may improve symptoms of osteoarthritis of the knee. In this study, we investigated the effect of adding WBV training to quadriceps and hamstring muscles strengthening training on functional activity, pain, quality of life and muscle strength in patients with knee osteoarthritis. 28 volunteers were randomly allocated to two groups; 1) quadriceps and hamstring muscles strengthening training (ST group, 13 patients) and 2) quadriceps and hamstring muscles strengthening training along with WBV training (ST + WBV group, 15 patients). The treatment protocol for both groups involved 3 sessions per week for 8 weeks. All measurements were performed before and after intervention. The measurements included: pain by means of a visual analogue scale (VAS), quality of life by means of the WOMAC scale, functional activity by the 2 min walking test (2MWT), time up & go test (TUGT) and 50-foot walking test (50FWT) and the muscle peak torque (MPT), total work (TW) and muscle power (MP) as muscle performance of quadriceps and hamstring muscles by an Isokinetic Biodex machine. After intervention, the comparison of mean changes between two groups showed improvement in the WBV + ST group in terms of 2MWT, MPT, TW and MP variables (P < 0.05). However, no significant difference was found between the experimental groups in term of pain, quality of life, TUGT and 50FWT. These results suggest that adding whole body vibration training to strengthening training may provide better treatment effects for patients with knee osteoarthritis.
Therapeutic efficacy assessment of weak variable magnetic fields with low value of induction in patients with drug-resistant depression.

The aim of this prospective study was to verify whether magnetostimulation with weak variable magnetic fields with low value of induction could enhance the effects of pharmacological therapy in drug-resistant depression.



Thirty patients, 26 women and 4 men, with drug-resistant depression were enrolled in the study. The subjects from Group No. I (14 patients) were given fluvoxamine and treated with weak variable magnetic field using the VIOFOR JPS device; the subjects from Group No. II (16 patients) were also given fluvoxamine but they were treated with the VIOFOR JPS device in placebo mode. Changes in depressive symptoms were estimated with the 21-point Hamilton Depression Scale (HDRS), Montgomery-Asberg Depression Scale (MADRS) and Beck Depression Inventory (BDI) questionnaire.



After 15 days of treatment highly significant differences were revealed between the patients treated with magnetic field and the patients treated with placebo: the final HDRS score was 53% of the initial value for the group receiving combined treatment, and 86% in the placebo group (p<0.001); for MADRS score the values were 51% and 88% (p<0.001), respectively, and for BDI 60% and 87% (p<0.001). Thus, the average effect of placebo applied with fluvoxamine was a ca. 15% reduction of symptoms, while the concurrent application of magnetic field and SSRI treatment resulted in a 40-50% improvement.



Our study indicates that adding a two-week low-induction variable magnetic field stimulation to a classical pharmacologic therapy reduces the intensity of symptoms in patients with drug-resistant depressive disorders.
Quantitative evaluation of acute renal transplant dysfunction with low-dose three-dimensional MR renography.

To assess prospectively the ability of quantitative low-dose three-dimensional magnetic resonance (MR) renography to help identify the cause of acute graft dysfunction.



This HIPAA-compliant study was approved by the institutional review board, and written informed consent was obtained. Between December 2001 and May 2009, sixty patients with transplanted kidneys (41 men and 19 women; mean age, 49 years; age range, 22-71 years) were included. Thirty-one patients had normal function and 29 had acute dysfunction due to acute rejection (n = 12), acute tubular necrosis (ATN) (n = 8), chronic rejection (n = 6), or drug toxicity (n = 3). MR renography was performed at 1.5 T with three-dimensional gradient-echo imaging. With use of a multicompartment renal model, the glomerular filtration rate (GFR) and the mean transit time (MTT) of the tracer for the vascular compartment (MTT(A)), the tubular compartment (MTT(T)), and the collecting system compartment (MTT(C)) were calculated. Also derived was MTT for the whole kidney (MTT(K) = MTT(A) + MTT(T) + MTT(C)) and fractional MTT of each compartment (MTT(A/K) = MTT(A)/MTT(K), MTT(T/K) = MTT(T)/MTT(K), MTT(C/K) = MTT(C)/MTT(K)). These parameters were compared in patients in the different study groups. Statistical analysis was performed by using analysis of covariance.



There were significant differences in GFR and MTT(K) between the acute dysfunction group (36.4 mL/min ± 20.8 [standard deviation] and 177.1 seconds ± 46.8, respectively) and the normal function group (65.9 mL/min ± 27.6 and 140.5 seconds ± 51.8, respectively) (P < .001 and P = .004). The MTT(A/K) was significantly higher in the acute rejection group (mean, 12.7% ± 2.9) than in the normal function group (mean, 8.3% ± 2.2; P < .001) or in the ATN group (mean, 7.1% ± 1.4; P < .001). The MTT(T/K) was significantly higher in the ATN group (mean, 83.2% ± 9.2) than in the normal function group (mean, 72.4% ± 10.2; P = .031) or in the acute rejection group (mean, 69.2% ± 6.1; P = .003).



Low-dose MR renography analyzed by using a multicompartmental tracer kinetic renal model may help to differentiate noninvasively between acute rejection and ATN after kidney transplantation.
Regional variation in patient risk factors and mortality after coronary artery bypass grafting.

Geographic variations in patient risk factors and operative mortality after coronary artery bypass graft surgery have not been well studied.



Using The Society of Thoracic Surgeons National Cardiac Database, a retrospective cohort study was performed of patients undergoing isolated coronary artery bypass graft surgery from 2004 to 2007 (n = 504,608). Records were sorted into four major geographic regions (Northeast, Midwest, South, and West) and compared with respect to patient risk profiles and outcomes. Using marginal and hierarchical logistic regression, risk-adjusted operative mortality rates were compared across regions and variation assessed within regions, states and hospital referral regions.



Patient risk profiles in the Northeast and West appeared similar, as did profiles in the Midwest and South. Risk-adjusted mortality rates were as follows: Northeast 1.63%, Midwest 2.01%, South 2.25%, and West 1.82%. Compared with the Northeast, mortality rates in the Midwest and South were higher, with the following odds ratios (95% confidence intervals): Midwest 1.26 (1.12 to 1.42), South 1.44 (1.27 to 1.62), and West 1.12 (0.98 to 1.28). Major geographic regions accounted for 16.5% of the variation observed in mortality rates; states and hospital referral regions accounted for 17.8% and 65.7%, respectively.



Variations in absolute coronary artery bypass graft surgery mortality rates across large regions were subtle, although rates within the Northeast were comparatively lower. Most of the variation was seen at the hospital referral region level. Given that geographic location has not been routinely incorporated into statistical risk model predictions, additional research appears warranted to identify regional "best care" practices and to advance nationwide improvements in cardiac surgical patient outcomes.
Gene expression analysis in serial liver fine needle aspirates.

No method with low morbidity presently exists for obtaining serial hepatic gene expression measurements in humans. While hepatic fine needle aspiration (FNA) has lower morbidity than core needle biopsy, applicability is limited due to blood contamination, which confounds quantification of gene expression changes. The aim of this study was to validate FNA for assessment of hepatic gene expression. Liver needle biopsies and FNA procedures were simultaneously performed on 17 patients with chronic hepatitis C virus infection with an additional FNA procedure 1 week later. Nine patients had mild/moderate fibrosis and eight advanced fibrosis. Gene expression profiling was performed using Affymetrix microarrays and TaqMan qPCR; pathway analysis was performed using Ingenuity. We developed a novel strategy that applies liver-enriched normalization genes to determine the percentage of liver in the FNA sample, which enables accurate gene expression measurements overcoming biases derived from blood contamination. We obtained almost identical gene expression results (ρ = 0.99, P < 0.0001) comparing needle biopsy and FNA samples for 21 preselected genes. Gene expression results were also validated in dogs. These data suggest that liver FNA is a reliable method for serial hepatic tissue sampling with potential utility for a variety of preclinical and clinical applications.
High incidence of diagnosis with syphilis co-infection among men who have sex with men in an HIV cohort in Ontario, Canada

The re-emergence of syphilis among HIV-positive gay and other men who have sex with men (MSM) requires vigilance. We estimated incidence of and risk factors for first and subsequent syphilis diagnoses among MSM in HIV care in Ontario, Canada.



We analyzed data from 2,280 MSM under follow-up from 2006 to 2010 in the Ontario HIV Treatment Network Cohort Study (OCS), a multi-site clinical cohort. We obtained syphilis serology results via record linkage with the provincial public health laboratory. Rates were calculated using Poisson regression.



First syphilis diagnoses occurred at a rate of 2.0 per 100 person-years (95 % CI 1.7, 2.4; 121 cases) whereas the re-diagnosis rate was 7.5 per 100 person-years (95 % CI 6.3, 8.8; 136 cases). We observed higher rates over time and among men who were aged <30 years, receiving care in the two largest urban centers, or had a previous syphilis diagnosis. Syphilis diagnosis was less common among Indigenous men, men with higher CD4 cell counts, and, for first diagnoses only, among men with less than high school education.



Compared to reported cases in the general male population, incidence of a new syphilis diagnosis was over 300 times greater among HIV-positive MSM but year-to-year changes reflected provincial trends. Re-diagnosis was common, suggesting treatment failure or re-infection. Novel syphilis control efforts are needed among HIV-positive MSM.