bluuebunny/crossref_metadata_2025 huggingface dataset:
Bronchiectasis Exacerbations: The Role of Atypical Bacteria and Respiratory Syncytial Virus
Authors: Metaxas Eugenios I , Balis Evangelos , Papaparaskevas Joseph , Spanakis Nicholas E , Tatsis Georgios , Tsakris Athanasios
Published: March 2016

BACKGROUND: Aside from the known role of common bacteria, there is a paucity of data regarding the possible role of atypical bacteria and viruses in exacerbations of non-cystic fibrosis bronchiectasis.

OBJECTIVE: To explore the possible role of atypical bacteria (namely,Mycoplasma pneumoniaeandChlamydophila pneumoniae) and respiratory syncytial virus (RSV) as causative agents of bronchiectasis exacerbations.

METHODS: A cohort of 33 patients was studied over a two-year period (one year follow-up for each patient). Polymerase chain reaction for the detection ofM pneumoniae,C pneumoniaeand RSV in bronchoalveolar lavage samples were performed during all visits. Antibody titres (immunoglobulin [Ig]M and IgG) against the aforementioned pathogens were also measured. In addition, cultures for common bacteria and mycobacteria were performed from the bronchoalveolar lavage samples.

RESULTS: Fifteen patients experienced a total of 19 exacerbations during the study period. Although RSV was detected by polymerase chain reaction during stable visits in four patients, it was never detected during an exacerbation.M pneumoniaeandC pneumoniaewere never detected at stable visits or during exacerbations. IgM antibody titres for these three pathogens were negative in all patient visits.

CONCLUSIONS: Atypical pathogens and RSV did not appear to be causative agents of bronchiectasis exacerbations.
Canadian Orofacial Pain Team workshop report on the Global Year Against Orofacial Pain
Authors: Lavigne Gilles J , Sessle Barry J
Published: March 2016

The year 2013–2014 has been designated the Global Year Against Orofacial Pain by the International Association for the Study of Pain. Accordingly, a multidisciplinary Canadian and international group of clinical, research and knowledge‐transfer experts attended a workshop in Montreal, Quebec. The workshop had two aims: to identify new pathways for innovative diagnosis and management of chronic orofacial pain states; and to identify opportunities for further collaborative orofacial pain research and education in Canada.

Three topics related to chronic orofacial pain were explored: biomarkers and pain signatures for chronic orofacial pain; misuse of analgesic and opioid pain medications for managing chronic orofacial pain; and complementary alternative medicine, topical agents and the role of stress in chronic orofacial pain.

It was determined that further research is needed to: identify biomarkers of chronic orofacial post‐traumatic neuropathic pain, with a focus on psychosocial, physiological and chemical‐genetic factors; validate the short‐and long‐term safety (ie, no harm to health, and avoidance of misuse and addiction) of opioid use for two distinct conditions (acute and chronic orofacial pain, respectively); and promote the use of topical medications as an alternative treatment in dentistry, and further document the benefits and safety of complementary and alternative medicine, including stress management, in dentistry. It was proposed that burning mouth syndrome, a painful condition that is not uncommon and affects mainly postmenopausal women, should receive particular attention.
Dysphagia among Adult Patients who Underwent Surgery for Esophageal Atresia at Birth
Authors: Huynh-Trudeau Valérie , Maynard Stéphanie , Terzic Tatjana , Soucy Geneviève , Bouin Mickael
Published: March 2016

BACKGROUND: Clinical experiences of adults who underwent surgery for esophageal atresia at birth is limited. There is some evidence that suggests considerable long-term morbidity, partly because of dysphagia, which has been reported in up to 85% of adult patients who undergo surgery for esophageal atresia. The authors hypothesized that dysphagia in this population is caused by dysmotility and/or anatomical anomalies.

OBJECTIVE: To determine the motor and anatomical causes of dysphagia.

METHODS: A total of 41 adults, followed at the Esophageal Atresia Clinic atHôpital Saint-Luc(Montreal, Quebec), were approached to particpate in the present prospective study. Evaluation was completed using upper endoscopy, manometry and barium swallow for the participants who consented. The medical charts of respondents were systematically reviewed from the neonatal period to 18 years of age to assess medical and surgical history.

RESULTS: All 41 patients followed at the clinic consented and were included in the study. Dysphagia was present in 73% of patients. Esophagogastroduodenoscopy was performed in 32 patients: hiatal hernia was present in 62% (n=20); esophageal diverticulum in 13% (n=4); macroscopic Barrett esophagus in 31% (n=10); and esophagitis in 19% (n=6). Histological esophagitis was present in 20% and intestinal metaplasia in 10%. There were no cases of dysplagia or adenocarcinoma. Esophageal manometry was performed on 56% of the patients (n=23). Manometry revealed hypomotility in 100% of patients and included an insufficient number of peristaltic waves in 96%, non-propagating peristalsis in 78% and low-wave amplitude in 95%. Complete aperistalsis was present in 78%. The lower esophageal sphincter was abnormal in 12 (52%) patients, with incomplete relaxation the most common anomaly. Of the 41 patients, 29 (71%) consented to a barium swallow, which was abnormal in 13 (45%). The anomalies found were short esophageal dilation in 28%, delay in esophageal emptying in 14%, diverticula in 14% and stenosis in 7% of patients. There was more than one anomaly in 14% of patients.

CONCLUSION: Dysphagia was a highly prevalent symptom in adults who underwent surgery for esophageal atresia. The present study is the first to demonstrate that motor and anatomical abnormalities may be implicated in causes of dysphagia in this population. Furthermore, these anomalies may be demonstrated with simple investigations such as endoscopy, manometry and barium swallow.
An Educational Forum to Engage Infectious Diseases and Microbiology Residents in Resource Stewardship Modelled after the Choosing Wisely Campaign
Authors: MacFadden Derek R , Gold Wayne L , Al-Busaidi Ibrahim , Craig Jeffrey D , Petrescu Dan , Saltzman Ilana S , Leis Jerome A
Published: March 2016

BACKGROUND: Rising costs present a major threat to the sustainability of health care delivery. Resource stewardship is increasingly becoming an expected competency of physicians. The Choosing Wisely framework was used to introduce resource stewardship at a national educational retreat for infectious disease and microbiology residents.

METHODS: During the 2014 Annual Canadian Infectious Disease and Microbiology Resident Retreat in Toronto, Ontario, infectious disease (n=50) and microbiology (n=17) residents representing 11 Canadian universities from six provinces, were invited to participate in a modified Delphi panel. Participants were asked, in advance of the retreat, to submit up to five practices that infectious disease and microbiology specialists should not routinely perform due to lack of proven benefit(s) and/or potential harm to patients. Submissions were discussed in small and large group forums using an iterative approach involving electronic polling until consensus was reached for five practices. A finalized list was created for both educational purposes and for residents to consider enacting; however, it was not intended to replace formal society‐endorsed statements. A follow‐up survey at two‐months was conducted.

RESULTS: Consensus was reached by the residents regarding five low‐value practices within the purview of infectious diseases and microbiology physicians. After the retreat, 20 participants (32%) completed the follow‐up survey. The majority of respondents (75%) believed that the session was at least as relevant as other sessions they attended at the retreat, including 95% indicating that at least some of the material discussed was new to them. Since returning to their home institutions, nine (45%) respondents have incorporated what they learned into their daily practice; four (20%) reported that they have considered initiating a project related to the session; and one (5%) reported having initiated a project.

CONCLUSIONS: The present educational forum demonstrated that trainees can become actively engaged in the identification and discussion of low‐value practices. Embedding residence training programs with resource stewardship education will be necessary to improve the value of care offered by the future members of our profession.

Erratum to “An Educational Forum to Engage Infectious Diseases and Microbiology Residents in Resource Stewardship Modelled after the Choosing Wisely Campaign” dx.doi.org/10.1155/2015/145172
Surgical Versus Nonsurgical Interventions to Relieve upper Airway Obstruction in Children with Pierre Robin Sequence
Authors: Kam Karen , McKay Meghan , MacLean Joanna , Witmans Manisha B , Spier Sheldon , Mitchell Ian
Published: March 2016

BACKGROUND: Newborns with Pierre Robin sequence (PRS) often experience chronic intermittent hypoxemia/hypoventilation associated with airway obstruction. The heterogeneity of the severity of upper airway obstruction makes management a challenge; the optimal intervention in individual cases is not clear.

OBJECTIVE: To investigate the prevalence of surgical/nonsurgical interventions for PRS at two children’s hospitals. Patient characteristics and outcomes were examined.

METHODS: The present retrospective chart review identified 139 patients with PRS born between 2000 and 2010. Demographic information, mode of airway management, associated anomalies and syndromes, polysomnography results, length of intensive care unit and hospital stay, complications and deaths were extracted.

RESULTS: Interventions included prone positioning (alone [61%]), tongue-lip adhesion (45%), nasopharyngeal intubation (28%), continuous positive airway pressure (20%), tracheostomy (19%) and mandibular distraction osteogenesis (5%). Tracheostomies were more prevalent in syndromic patients (P=0.03). Patients who underwent tracheostomy had a lower birth weight (P=0.03) compared with newborns with other interventions. Patients who underwent surgical interventions had longer intensive care unit stays (P<0.001). No intervention was associated with a statistically significant likelihood of requiring a subsequent intervention. Thirty percent of patients underwent polysomnography, with a higher proportion of these using continuous positive airway pressure (n=15) (P<0.01).

CONCLUSIONS: In the present descriptive study, patients with syndromic PRS or low birth weight underwent early intervention, which included a tracheostomy. Objective measures of airway obstruction were underutilized. Decision making regarding evaluation and management of upper airway obstruction in this population remains clinician and resource dependent. Reporting data obtained from a large cohort of PRS patients is important to compare experiences and motivate future studies investigating this complex condition.
Effectiveness of Phosphodiesterase‐5 Inhibitor Therapy for Portopulmonary Hypertension
Authors: Fisher Jolene H , Johnson Sindhu R , Chau Cathy , Kron Amie T , Granton John T
Published: March 2016

BACKGROUND: Portopulmonary hypertension is associated with significant morbidity and mortality. Phosphodiesterase‐5 inhibitor therapy is efficacious in other causes of WHO group I pulmonary arterial hypertension.

OBJECTIVE: To evaluate the efficacy and safety of phosphodiesterase‐5 inhibitor therapy in patients with portopulmonary hypertension.

METHODS: A single‐centre retrospective cohort study that included patients with a diagnosis of portopulmonary hypertension was performed. The primary outcome was change in pulmonary vascular resistance after six months of phosphodiesterase‐5 inhibitor therapy. A secondary evaluation investigated the effect on other hemodynamic measurements, 6 min walk distance, functional class, safety outcomes and survival.

RESULTS: Of 1385 patients screened, 25 patients with portopulmonary hypertension were identified, of whom 20 received a phosphodiesterase‐5 inhibitor. After six months, there was a significant decrease in pulmonary vascular resistance (−236 dyn·s·cm−5 [95% CI −343 dyn·s·cm−5 to −130 dyn·s·cm−5]; P<0.001), mean pulmonary artery pressure (−8.9 mmHg [95% CI −13.7 mmHg to −4.2 mmHg]; P=0.001) and an increase in Fick cardiac output (0.9 L/min [95% CI 0.1 L/min to 1.6 L/min]; P=0.02). There was no change in 6 min walk distance. The proportion of subjects with a WHO functional class III or IV was significantly reduced at six months compared with baseline (18% versus 61%; P=0.002). Safety outcomes did not reveal any adverse events.

CONCLUSIONS: Phosphodiesterase‐5 inhibitor therapy improved hemodynamics and functional class at six months in a cohort of patients with portopulmonary hypertension.
Living with Inflammatory Bowel Disease: A Crohn’s and Colitis Canada Survey
Authors: Becker Helen M , Grigat Daniel , Ghosh Subrata , Kaplan Gilaad G , Dieleman Levinus , Wine Eytan , Fedorak Richard N , Fernandes Aida , Panaccione Remo , Barkema Herman W
Published: March 2016

BACKGROUND: Despite improvements in therapies for inflammatory bowel diseases (IBDs), patient quality of life continues to be significantly impacted.

OBJECTIVE: To assess the impact of IBD on patients and families with regard to leisure, relationships, mental well-being and financial security, and to evaluate the quality and availability of IBD information.

METHODS: An online survey was advertised on the Crohn’s and Colitis Canada website, and at gastroenterology clinics at the University of Alberta Hospital (Edmonton, Alberta) and University of Calgary Hospital (Calgary, Alberta).

RESULTS: The survey was completed by 281 IBD patients and 32 family members. Among respondents with IBD, 64% reported a significant or major impact on leisure activities, 52% a significant or major impact on interpersonal relationships, 40% a significant or major impact on financial security, and 28% a significant or major impact on planning to start a family. Patient information needs emphasized understanding disease progression (84%) and extraintestinal symptoms (82%). There was a strong interest in support systems such as health care insurance (70%) and alternative therapies (66%). The most common source of information for patients was their gastroenterologist (70%); however, most (70%) patients preferred to obtain their information from the Crohn’s and Colitis Canada website.

CONCLUSIONS: The impact of IBD on interpersonal relationships and leisure activities was significant among IBD patients and their families. Understanding the disease, but also alternative treatment options, was of high interest. Currently, there is a discrepancy between interest in information topics and their availability. Respondents reported a strong desire to obtain information regarding disease progression, especially extraintestinal symptoms.
Denial of Pain Medication by Health Care Providers Predicts In‐Hospital Illicit Drug Use among Individuals who Use Illicit Drugs
Authors: Ti Lianping , Voon Pauline , Dobrer Sabina , Montaner Julio , Wood Evan , Kerr Thomas
Published: March 2016

BACKGROUND: Undertreated pain is common among people who use illicit drugs (PWUD), and can often reflect the reluctance of health care providers to provide pain medication to individuals with substance use disorders.

OBJECTIVE: To investigate the relationship between having ever been denied pain medication by a health care provider and having ever reported using illicit drugs in hospital.

METHODS: Data were derived from participants enrolled in two Canadian prospective cohort studies between December 2012 and May 2013. Using bivariable and multivariable logistic regression analyses, the relationship between having ever been denied pain medication by a health care provider and having ever reported using illicit drugs in hospital was examined.

RESULTS: Among 1053 PWUD who had experienced ≥1 hospitalization, 452 (44%) reported having ever used illicit drugs while in hospital and 491 (48%) reported having ever been denied pain medication. In a multivariable model adjusted for confounders, having been denied pain medication was positively associated with having used illicit drugs in hospital (adjusted OR 1.46 [95% CI 1.14 to 1.88]).

CONCLUSIONS: The results of the present study suggest that the denial of pain medication is associated with the use of illicit drugs while hospitalized. These findings raise questions about how to appropriately manage addiction and pain among PWUD and indicate the potential role that harm reduction programs may play in hospital settings.
Adult Lactose Digestion Status and Effects on Disease
Authors: Szilagyi Andrew
Published: March 2016

BACKGROUND: Adult assimilation of lactose divides humans into dominant lactase-persistent and recessive nonpersistent phenotypes.

OBJECTIVES: To review three medical parameters of lactose digestion, namely: the changing concept of lactose intolerance; the possible impact on diseases of microbial adaptation in lactase-nonpersistent populations; and the possibility that the evolution of lactase has influenced some disease pattern distributions.

METHODS: A PubMed, Google Scholar and manual review of articles were used to provide a narrative review of the topic.

RESULTS: The concept of lactose intolerance is changing and merging with food intolerances. Microbial adaptation to regular lactose consumption in lactase-nonpersistent individuals is supported by limited evidence. There is evidence suggestive of a relationship among geographical distributions of latitude, sunhine exposure and lactase proportional distributions worldwide.

DISCUSSION: The definition of lactose intolerance has shifted away from association with lactose maldigestion. Lactose sensitivity is described equally in lactose digesters and maldigesters. The important medical consequence of withholding dairy foods could have a detrimental impact on several diseases; in addition, microbial adaptation in lactase-nonpersistent populations may alter risk for some diseases. There is suggestive evidence that the emergence of lactase persistence, together with human migrations before and after the emergence of lactase persistence, have impacted modern-day diseases.

CONCLUSIONS: Lactose maldigestion and lactose intolerance are not synonymous. Withholding dairy foods is a poor method to treat lactose intolerance. Further epidemiological work could shed light on the possible effects of microbial adaptation in lactose maldigesters. The evolutionary impact of lactase may be still ongoing.
Retrospective Study Investigating the Prevalence and Clinical Significance of Hepatitis B Virus Precore and Basal Core Promoter Variants
Authors: O’Brien Meaghan , Casselman Adara , Smart Gerry , Gretchen Ainsley , Kaita Kelly , Kadkhoda Kamran
Published: March 2016

BACKGROUND: Hepatitis B virus (HBV) precore (PC) and basal core promoter (BCP) variants are well known; however, their prevalence in North America is unclear, especially among hepatitis B e antigen-negative patients.

OBJECTIVE: To investigate the prevalence of PC/BCP mutations and their clinical significance.

METHODS: One hundred twenty-eight patients positive for both hepatitis B surface antigen and hepatitis B e antibody were selected, and PC/BCP mutations were identified using a line probe assay. The subjects’ charts were reviewed for race/ethnicity, HBV genotype, HBV viral load, sex, liver enzyme levels, imaging and biopsy results up to 10 years before the study.

RESULTS: The prevalence of PC and BCP variants were 47.6% and 62.5%, respectively. Older age was associated with aspartate aminotransferase-to-platelet index ratio (APRI) ≥0.7 (P=0.011) and abnormal imaging/biopsy results (P=0.0008). Although the presence of BCP variant(s) was associated with APRI ≥0.7 (P=0.029), it was not associated with abnormal imaging/biopsy results. The combination of age ≥50 years and the presence of BCP variant(s) was associated with abnormal imaging/biopsy results, suggestive of either cirrhosis or hepatocellular carcinoma (not observed with PC mutation). Neither sex or genotype, or median HBV viral load showed significant influence on any of these outcomes.

CONCLUSIONS: The present study suggests that the prevalence of PC and BCP mutations are higher than what has been previously reported. One potential explanation would be increased immigration in the past decade. Considering the potential public health and clinical implications of these variants, long-term multicentre and prospective studies could further unravel the uncertainty around these variants.
Examining the Clinical Use of Hemochromatosis Genetic Testing
Authors: Lanktree Matthew B , Lanktree Bruce B , Paré Guillaume , Waye John S , Sadikovic Bekim , Crowther Mark A
Published: March 2016

BACKGROUND: Hereditary hemochromatosis leads to an increased lifetime risk for end-organ damage due to excess iron deposition. Guidelines recommend that genetic testing be performed in patients with clinical suspicion of iron overload accompanied by elevated serum ferritin and transferrin saturation levels.

OBJECTIVE: To evaluate guideline adherence and the clinical and economic impact ofHFEgenetic testing.

METHODS: The electronic charts of patients submitted forHFEtesting in 2012 were reviewed for genetic testing results, biochemical markers of iron overload and clinical history of phlebotomy.

RESULTS: A total of 664 samples were sent for testing, with clinical, biochemical and phlebotomy data available for 160 patients. A positive C282Y homozygote or C282Y/H63D compound heterozygote test result was observed in 18% of patients. Patients with an at-riskHFEgenotype had significantly higher iron saturation, serum iron and hemoglobin (P<0.001), without higher ferritin or liver enzyme levels. Fifty percent of patients referred for testing did not have biochemical evidence of iron overload (transferrin saturation >45% and ferritin level >300 μg/L). Patients were four times more likely to undergo phlebotomy if they were gene test positive (RR 4.29 [95% CI 2.35 to 7.83]; P<0.00001).

DISCUSSION: One-half of patients referred for testing did not exhibit biochemical evidence of iron overload. Many patients with biochemical evidence of iron overload, but with negative genetic test results, did not undergo phlebotomy. A requisition to determine clinical indication for testing may reduce the use of theHFEgenetic test. Finally, improvement of current genetic test characteristics would improve rationale for the test.

CONCLUSION: A significant proportion of hemochromatosis genetic testing does not adhere to current guidelines and would not alter patient management.
Assessment of Pain and Stress Intensity among Women with Ovarian Endometriomas versus Teratomas
Authors: Chmaj-Wierzchowska Karolina , Kampioni Małgorzata , Wilczak Maciej , Sajdak Stefan , Opala Tomasz
Published: March 2016

BACKGROUND: In recent years, numerous studies have considered endometriosis to be a subclinical, local inflammatory process in the pelvic peritoneum, the main symptom of which is pain.

OBJECTIVES: To assess pain intensity and pain‐related stress in women with ovarian endometriomas versus teratomas.

METHODS: In total, 860 women (18 to 38 years of age) treated laparoscopically for lesions in the adnexa between September 2006 and November 2013 were included in the present study. After an intraoperative review of their histopathological lesions, the patients were divided into two study groups: group E (n=480), with histopathologically confirmed ovarian endometriomas; and group T (n=380), after laparoscopic treatment of ovarian teratomas. A questionnaire was generated for the study and completed by each group. Statistical analysis was performed using the Mann‐Whitney U test (P≤0.05).

RESULTS: Median pain scores for group E versus group T were as follows: pain during menstruation, 6 versus 3 (P=0.001); pain outside of menstruation (in professional life), 2 versus 2 (P=0.014); and pain during sexual intercourse, 3 versus 1 (P=0.006). Pain‐related stress scores were higher in group T versus group E (5 versus 3; P=0.007).

CONCLUSION: Ovarian endometriomas caused more pain than ovarian teratomas, likely due to the endometrial tissue component and not a mass effect. The assessment of pain and pain‐related stress associated with the pelvis minor showed a high level of pain intensity and lower level of pain‐related stress among patients with ovarian endometriomas.
Cost Effectiveness of ‘On Demand’ Hiv Pre‐Exposure Prophylaxis for Non‐Injection Drug‐Using Men Who Have Sex with Men in Canada
Authors: Ouellet Estelle , Durand Madeleine , Guertin Jason R , LeLorier Jacques , Tremblay Cécile L
Published: March 2016

BACKGROUND: Recent trials report the efficacy of continuous tenofovir‐based pre‐exposure prophylaxis (PrEP) for prevention of HIV infection. The cost effectiveness of ‘on demand’ PrEP for non‐injection drug‐using men who have sex with men at high risk of HIV acquisition has not been evaluated.

OBJECTIVE: To conduct an economic evaluation of the societal costs of HIV in Canada and evaluate the potential benefits of this PrEP strategy.

METHODS: Direct HIV costs comprised outpatient, inpatient and emergency department costs, psychosocial costs and antiretroviral costs. Resource consumption estimates were derived from the Centre Hospitalier de l’Université de Montréal HIV cohort. Estimates of indirect costs included employment rate and work absenteeism. Costs for ‘on demand’ PrEP were modelled after an ongoing clinical trial. Cost‐effectiveness analysis compared costs of ‘on demand’ PrEP to prevent one infection with lifetime costs of one HIV infection. Benefits were presented in terms of life‐years and quality‐adjusted life‐years.

RESULTS: The average annual direct cost of one HIV infection was $16,109 in the least expensive antiretroviral regimen scenario and $24,056 in the most expensive scenario. The total indirect cost was $11,550 per year. Total costs for the first year of HIV infection ranged from $27,410 to $35,358. Undiscounted lifetime costs ranged from $1,439,984 ($662,295 discounted at 3% and $448,901 at 5%) to $1,482,502 ($690,075 at 3% and $485,806 at 5%). The annual cost of PrEP was $12,001 per participant, and $621,390 per infection prevented. The PrEP strategy was cost‐saving in all scenarios for undiscounted and 3% discounting rates. At 5% discounting rates, the strategy is largely cost‐effective: according to least and most expensive scenarios, incremental cost‐effectiveness ratios ranged from $60,311 to $47,407 per quality‐adjusted life‐year.

CONCLUSION: This ‘on demand’ PrEP strategy ranges from cost‐saving to largely cost‐effective. The authors believe it represents an important public health strategy for the prevention of HIV transmission.
Delftia Acidovorans: A Rare Pathogen in Immunocompetent and Immunocompromised Patients
Authors: Bilgin Huseyin , Sarmis Abdurrahman , Tigen Elif , Soyletir Guner , Mulazimoglu Lutfiye
Published: March 2016

Delftia acidovorans is an aerobic, nonfermenting Gram‐negative bacillus. It is usually a nonpathogenic environmental organism and is rarely clinically significant. Although D acidovorans infection most commonly occurs in hospitalized or immunocompromised patients, there are also several reports documenting the infection in immunocompetent patients. The present article describes a B cell lymphoblastic leukemia patient with D acidovorans pneumonia who was successfully treated with antibiotic therapy. The present report indicates that unusual pathogens may be clinically significant in both immunocompromised and immunocompetent patients. D acidovorans is often resistant to aminoglycosides; therefore, rapid detection of this microorganism is important.
Dispositional Affect in Unique Subgroups of Patients with Rheumatoid Arthritis
Authors: Rice Danielle B. , Mehta Swati , Pope Janet E. , Harth Manfred , Shapiro Allan , Teasell Robert W.
Published: March 2016

Background. Patients with rheumatoid arthritis may experience increased negative outcomes if they exhibit specific patterns of dispositional affect.Objective. To identify subgroups of patients with rheumatoid arthritis based on dispositional affect. The secondary objective was to compare mood, pain catastrophizing, fear of pain, disability, and quality of life between subgroups.Methods. Outpatients from a rheumatology clinic were categorized into subgroups by a cluster analysis based on dispositional affect. Differences in outcomes were compared between clusters through multivariate analysis of covariance.Results. 227 patients were divided into two subgroups. Cluster 1 (n=85) included patients reporting significantly higher scores on all dispositional variables (experiential avoidance, anxiety sensitivity, worry, fear of pain, and perfectionism; allp<0.001) compared to patients in Cluster 2 (n=142). Patients in Cluster 1 also reported significantly greater mood impairment, pain anxiety sensitivity, and pain catastrophizing (allp<0.001). Clusters did not differ on quality of life or disability.Conclusions. The present study identifies a subgroup of rheumatoid arthritis patients who score significantly higher on dispositional affect and report increased mood impairment, pain anxiety sensitivity, and pain catastrophizing. Considering dispositional affect within subgroups of patients with RA may help health professionals tailor interventions for the specific stressors that these patients experience.
The Need for Improved Management of Painful Diabetic Neuropathy in Primary Care
Authors: Sobhy Teresa
Published: March 2016

The provision of care for patients with type II diabetes in primary care must involve assessing patients for peripheral neuropathy of the feet.Objectives.This paper will demonstrate that painful diabetic neuropathy (PDN) is poorly assessed for and treated in primary care.Methods.A critical analysis of research will be conducted to identify the prevalence and impact of PDN among individuals with type II diabetes.Results.Research evidence and best practice guidelines are widely available in supporting primary care practitioners to better assess for and treat PDN. However, the lack of knowledge, awareness, and implementation of such research and guidelines prevents patients with PDN from receiving appropriate care.Discussion.Much international research exists on the prevalence and impact of PDN in primary care; however, Canadian research is lacking. Furthermore, the quantity and quality of research on treatment modalities for PDN are inadequate. Finally, current research and guidelines on PDN management are inadequately implemented in the clinical setting.Conclusion.The undertreatment of PDN has significant implications on the individual, family, and society. Healthcare practitioners must be more aware of and better implement current research and guidelines into practice to resolve this clinical issue.
Altered Esophageal Mucosal Structure in Patients with Celiac Disease
Authors: Pinto-Sánchez María Inés , Nachman Fabio D. , Fuxman Claudia , Iantorno Guido , Hwang Hui Jer , Ditaranto Andrés , Costa Florencia , Longarini Gabriela , Wang Xuan Yu , Huang Xianxi , Vázquez Horacio , Moreno María L. , Niveloni Sonia , Bercik Premysl , Smecuol Edgardo , Mazure Roberto , Bilder Claudio , Mauriño Eduardo C. , Verdu Elena F. , Bai Julio C.
Published: March 2016

Background/Aim. Reflux symptoms (RS) are common in patients with celiac disease (CD), a chronic enteropathy that affects primarily the small intestine. We evaluated mucosal integrity and motility of the lower esophagus as mechanisms contributing to RS generation in patients with CD.Methods. We enrolled newly diagnosed CD patients with and without RS, nonceliac patients with classical reflux disease (GERD), and controls (without RS). Endoscopic biopsies from the distal esophagus were assessed for dilated intercellular space (DIS) by light microscopy and electron microscopy. Tight junction (TJ) mRNA proteins expression for zonula occludens-1 (ZO-1) and claudin-2 and claudin-3 (CLDN-2; CLDN-3) was determined using qRT-PCR.Results. DIS scores were higher in patients with active CD than in controls, but similar to GERD patients. The altered DIS was found even in CD patients without RS and normalized after one year of a gluten-free diet. CD patients with and without RS had lower expression of ZO-1 than controls. The expression of CLDN-2 and CLDN-3 was similar in CD and GERD patients.Conclusions. Our study shows that patients with active CD have altered esophageal mucosal integrity, independently of the presence of RS. The altered expression of ZO-1 may underlie loss of TJ integrity in the esophageal mucosa and may contribute to RS generation.
Indium-Free PTB7/PC71BM Polymer Solar Cells with Solution-Processed Al:ZnO Electrodes on PET Substrates
Authors: Fuchs P. , Paracchino A. , Hagendorfer H. , Kranz L. , Geiger T. , Romanyuk Y. E. , Tiwari A. N. , Nüesch F.
Published: March 2016

Inverted PTB7/PC71BM polymer solar cells are prepared on solution-processed Al:ZnO transparent contacts on PET substrates. Al:ZnO is deposited by a low temperature chemical bath deposition route (T< 100°C at any step) to comply with the temperature sensitive substrate. A maximum conversion efficiency of 6.4% and 6.9% is achieved for the indium-free solar cells on PET and glass substrates, respectively. The devices are relatively stable in air whereby an initial efficiency loss in the order of 15% after storage for 15 days can be fully recovered by light soaking.
Using Small RNA Deep Sequencing Data to Detect Human Viruses
Authors: Wang Fang , Sun Yu , Ruan Jishou , Chen Rui , Chen Xin , Chen Chengjie , Kreuze Jan F. , Fei ZhangJun , Zhu Xiao , Gao Shan
Published: March 2016

Small RNA sequencing (sRNA-seq) can be used to detect viruses in infected hosts without the necessity to have any prior knowledge or specialized sample preparation. The sRNA-seq method was initially used for viral detection and identification in plants and then in invertebrates and fungi. However, it is still controversial to use sRNA-seq in the detection of mammalian or human viruses. In this study, we used 931 sRNA-seq runs of data from the NCBI SRA database to detect and identify viruses in human cells or tissues, particularly from some clinical samples. Six viruses including HPV-18, HBV, HCV, HIV-1, SMRV, and EBV were detected from 36 runs of data. Four viruses were consistent with the annotations from the previous studies. HIV-1 was found in clinical samples without the HIV-positive reports, and SMRV was found in Diffuse Large B-Cell Lymphoma cells for the first time. In conclusion, these results suggest the sRNA-seq can be used to detect viruses in mammals and humans.
SREQP: A Solar Radiation Extraction and Query Platform for the Production and Consumption of Linked Data from Weather Stations Sensors
Authors: Sánchez-Cervantes José Luis , Radzimski Mateusz , Rodriguez-Enriquez Cristian Aaron , Alor-Hernández Giner , Rodríguez-Mazahua Lisbeth , Sánchez-Ramírez Cuauhtémoc , Rodríguez-González Alejandro
Published: March 2016

Nowadays, solar radiation information is provided from sensors installed in different geographic locations and platforms of meteorological agencies. However, common formats such as PDF files and HTML documents to provide solar radiation information do not offer semantics in their content, and they may pose problems to integrate and fuse data from multiple resources. One of the challenges of sensors Web is the unification of data from multiple sources, although this type of information facilitates interoperability with other sensor Web systems. This research proposes architecture SREQP (Solar Radiation Extraction and Query Platform) to extract solar radiation data from multiple external sources and merge them on a single and unique platform. SREQP makes use of Linked Data to generate a set of triples containing information about extracted data, which allows final users to query data through a SPARQL endpoint. The conceptual model was developed by using known vocabularies, such as SSN or WGS84. Moreover, an Analytic Hierarchy Process was carried out for the evaluation of SREQP in order to identify and evaluate the main features of Linked-Sensor-Data and the sensor Web systems. Results from the evaluation indicated that SREQP contained most of the features considered essential in Linked-Sensor-Data and sensor Web systems.
Pain Catastrophizing Correlates with Early Mild Traumatic Brain Injury Outcome
Authors: Chaput Geneviève , Lajoie Susanne P. , Naismith Laura M. , Lavigne Gilles
Published: March 2016

Background.Identifying which patients are most likely to be at risk of chronic pain and other postconcussion symptoms following mild traumatic brain injury (MTBI) is a difficult clinical challenge.Objectives.To examine the relationship between pain catastrophizing, defined as the exaggerated negative appraisal of a pain experience, and early MTBI outcome.Methods.This cross-sectional design included 58 patients diagnosed with a MTBI. In addition to medical chart review, postconcussion symptoms were assessed by self-report at 1 month (Time 1) and 8 weeks (Time 2) after MTBI. Pain severity, psychological distress, level of functionality, and pain catastrophizing were measured by self-report at Time 2.Results.The pain catastrophizing subscales of rumination, magnification, and helplessness were significantly correlated with pain severity (r=.31to.44), number of postconcussion symptoms reported (r=.35to.45), psychological distress (r=.57to.67), and level of functionality (r=-.43to-.29). Pain catastrophizing scores were significantly higher for patients deemed to be at high risk of postconcussion syndrome (6 or more symptoms reported at both Time 1 and Time 2).Conclusions.Higher levels of pain catastrophizing were related to adverse early MTBI outcomes. The early detection of pain catastrophizing may facilitate goal-oriented interventions to prevent or minimize the development of chronic pain and other postconcussion symptoms.
Circulating Angiogenic T Cells and Their Subpopulations in Patients with Systemic Lupus Erythematosus
Authors: Miao Jinlin , Qiu Feng , Li Tingting , Zhao Peng , Zhang Kui , Lv Minghua , Wan Jun , Qi Xiaokun , Zhu Ping
Published: March 2016

Objective. Systemic lupus erythematosus (SLE) is associated with accelerated atherosclerosis and increased cardiovascular risk. Angiogenic T cells (Tang), a specific T cell subset, have been identified and involved in the repair of damaged endothelium. This study aimed to analyze the Tang cell subsets in relation to disease specific features from SLE patients.Methods. Tang cell subsets were assessed in peripheral blood samples from 41 SLE patients and 22 healthy controls (HC) by flow cytometry on the basis of CD31 and CXCR4 expression on CD3+, CD4+, and CD8+ T cells.Results. The percentage of circulating CD8+CD31+CXCR4+ T cells (CD8+ Tang), but not CD3+CD31+CXCR4+ T cells (Tang) and CD4+CD31+CXCR4+ T cells (CD4+ Tang), in SLE was higher than HC. The percentages of Tang cell subsets in anti-dsDNA-positive SLE patients were significantly increased as compared to their negative counterparts and HC. Additionally, the levels of circulating Tang cell subsets were negatively correlated with age at sampling and at diagnosis, but not disease duration or disease activity.Conclusion. Anti-dsDNA-positivity may identify a group of SLE patients with increased Tang cell subsets and circulating CD8+ Tang cells may be viewed as a potentially useful biomarker of endothelial damage and cardiovascular risk in SLE.
Ethanol Extract of Sanguisorbae Radix Inhibits Mast Cell Degranulation and Suppresses 2,4-Dinitrochlorobenzene-Induced Atopic Dermatitis-Like Skin Lesions
Authors: Yang Ju-Hye , Yoo Jae-Myung , Cho Won-Kyung , Ma Jin Yeul
Published: March 2016

Sanguisorbae Radix (SR) is well known as herbal medicine named “Zi-Yu” in Korea, which is the dried roots ofSanguisorba officinalisL. (Rosacease). We investigated the underlying mechanism on the inhibition of atopic dermatitis (AD) of an ethanol extract of SR (ESR) using 2,4-dinitrochlorobenzene- (DNCB-) induced AD mice model. Oral administration of ESR significantly suppressed DNCB-induced AD-like symptoms such as scratching behavior, ear thickness, epidermal thickness, and IgE levels. To investigate the effects of ESR treatment on degranulation of IgE/Ag-activated mouse bone marrow-derived mast cells (BMMCs), we measured the release ofβ-hexosaminidase (β-HEX, degranulation marker). ESR decreased the infiltration of eosinophils and mast cells into the AD skin lesions. Furthermore, ESR significantly inhibited degranulation of IgE/Ag-activated BMMCs. We have demonstrated that ESR decreased AD symptoms in mice and inhibits degranulation of IgE/Ag-activated mast cells. Our study suggests that ESR may serve as a potential therapeutic candidate for the treatment of AD symptoms.
Crack Closure Effects on Fatigue Crack Propagation Rates: Application of a Proposed Theoretical Model
Authors: Correia José A. F. O. , De Jesus Abílio M. P. , Moreira Pedro M. G. P. , Tavares Paulo J. S.
Published: March 2016

Structural design taking into account fatigue damage requires a thorough knowledge of the behaviour of materials. In addition to the monotonic behaviour of the materials, it is also important to assess their cyclic response and fatigue crack propagation behaviour under constant and variable amplitude loading. Materials whenever subjected to fatigue cracking may exhibit mean stress effects as well as crack closure effects. In this paper, a theoretical model based on the same initial assumptions of the analytical models proposed by Hudak and Davidson and Ellyin is proposed to estimate the influence of the crack closure effects. This proposal based further on Walker’s propagation law was applied to the P355NL1 steel using an inverse analysis (back-extrapolation) of experimental fatigue crack propagation results. Based on this proposed model it is possible to estimate the crack opening stress intensity factor,Kop, the relationship betweenU=ΔKeff/ΔKquantity and the stress intensity factor, the crack length, and the stress ratio. This allows the evaluation of the influence of the crack closure effects for different stress ratio levels, in the fatigue crack propagation rates. Finally, a good agreement is found between the proposed theoretical model and the analytical models presented in the literature.
RF-Phos: A Novel General Phosphorylation Site Prediction Tool Based on Random Forest
Authors: Ismail Hamid D. , Jones Ahoi , Kim Jung H. , Newman Robert H. , KC Dukka B.
Published: March 2016

Protein phosphorylation is one of the most widespread regulatory mechanisms in eukaryotes. Over the past decade, phosphorylation site prediction has emerged as an important problem in the field of bioinformatics. Here, we report a new method, termed Random Forest-based Phosphosite predictor 2.0 (RF-Phos 2.0), to predict phosphorylation sites given only the primary amino acid sequence of a protein as input. RF-Phos 2.0, which uses random forest with sequence and structural features, is able to identify putative sites of phosphorylation across many protein families. In side-by-side comparisons based on 10-fold cross validation and an independent dataset, RF-Phos 2.0 compares favorably to other popular mammalian phosphosite prediction methods, such as PhosphoSVM, GPS2.1, and Musite.
Hepatoprotective Activity of Herbal Composition SAL, a Standardize Blend Comprised ofSchisandra chinensis,Artemisia capillaris, andAloe barbadensis
Authors: Yimam Mesfin , Jiao Ping , Moore Breanna , Hong Mei , Cleveland Sabrina , Chu Min , Jia Qi , Lee Young-Chul , Kim Hyun-Jin , Nam Jeong-Bum , Kim Mi-Ran , Hyun Eu-Jin , Jung Gayoung , Do Seon Gil
Published: March 2016

Some botanicals have been reported to possess antioxidative activities acting as scavengers of free radicals rendering their usage in herbal medicine. Here we describe the potential use of “SAL,” a standardized blend comprised of three extracts fromSchisandra chinensis,Artemisia capillaris, andAloe barbadensis, in mitigating chemically induced acute liver toxicities. Acetaminophen and carbon tetrachloride induced acute liver toxicity models in mice were utilized. Hepatic functional tests from serum collected at T24 and hepatic glutathione and superoxide dismutases from liver homogenates were evaluated. Histopathology analysis and merit of blending 3 standardized extracts were also confirmed. Statistically significant and dose-correlated inhibitions in serum ALT ranging from 52.5% (p=0.004) to 34.6% (p=0.05) in the APAP and 46.3% (p<0.001) to 29.9% (p=0.02) in the CCl4models were observed for SAL administered at doses of 400–250 mg/kg. Moreover, SAL resulted in up to 60.6% and 80.2% reductions in serums AST and bile acid, respectively. The composition replenished depleted hepatic glutathione in association with an increase of hepatic superoxide dismutase. Unexpected synergistic protection from liver damage was also observed. Therefore, the composition SAL could be potentially utilized as an effective hepatic-detoxification agent for the protection from liver damage.
Er‐Xian Decoction Stimulates Osteoblastic Differentiation of Bone Mesenchymal Stem Cells in Ovariectomized Mice and Its Gene Profile Analysis
Authors: Liu Shufen , Huang Jianhua , Wang Jing , Zhao Yongjian , Lu Sheng , Wang Yongjun , Bian Qin
Published: March 2016

We studied the bone mesenchymal stem cells (bMSCs) and gene profiles regulated by Er-Xian Decoction (EXD), a traditional Chinese herbal formula widely used for postmenopausal osteoporosis treatment. Six‐month‐old female Imprinting Control Region mice that underwent ovariectomy were treated with EXD. After 3 months, bone mass was evaluated by μCT and histological and immunohistochemical detection. The self‐renewal and differentiation capacities of bMSCs were evaluated by colony‐forming unit‐fibroblastic, colony‐forming unit‐adipocyte, and alkaline phosphatase staining. In addition, the expression of 26991 genes of bMSCs ex vivo at 2 weeks after EXD‐treatment or of bMSCs in vitro after exposure to conditioned serum from EXD‐treated rats was measured and analyzed using NimbleGen Gene Expression Profiling and Cluster and pathway analysis. EXD treatment increased bone mass, elevating osteocalcin protein levels in vivo and facilitating the self‐renewal and osteoblastic differentiation of bMSCs ex vivo. EXD rescued several gene expressions that were dysregulated by OVX. These genes overlapped and their functions were involved in ten pathways between ex vivo and in vitro experiments. EXD exerts an osteogenic effect on bMSCs in OVX induced osteoporotic mice. Our results contribute to further study of its molecular mechanism and traditional use in the treatment of postmenopausal osteoporosis.
Description of a Rare Case of Nodular Fasciitis of the Apical Aspect of the Upper Buccal Sulcus
Authors: Souza Ana Amélia , Cariri Neto Eldon Guttenberg , de Araújo Vera Cavalcanti , Passador-Santos Fabricio , Alves Maria Teresa de Seixas , Soares Andresa Borges
Published: March 2016

This report describes a rare case of nodular fasciitis (NF) of the oral cavity, discussing the clinical, histological, and immunohistochemical characteristics. Histopathologic diagnosis of this type of lesion can be challenging due to its differential diagnosis, which principally includes sarcoma. The patient presented with a painless, well-defined nodule, reported as increasing in size, located at the apical aspect of the upper left buccal sulcus. Histologically, the lesion revealed spindle cell proliferation arranged in fascicles, while immunohistochemistry demonstrated positivity for smooth muscle actin. Eight months after complete surgical excision, no signs of local recurrence have been observed.
Cell‐Based Therapy for Silicosis
Authors: Lopes-Pacheco Miquéias , Bandeira Elga , Morales Marcelo M.
Published: March 2016

Silicosis is the most common pneumoconiosis globally, with higher prevalence and incidence in developing countries. To date, there is no effective treatment to halt or reverse the disease progression caused by silica‐induced lung injury. Significant advances have to be made in order to reduce morbidity and mortality related to silicosis. In this review, we have highlighted the main mechanisms of action that cause lung damage by silica particles and summarized the data concerning the therapeutic promise of cell‐based therapy for silicosis.