bluuebunny/crossref_metadata_2025 huggingface dataset:
Folate-conjugated immunoglobulin targets melanoma tumor cells for NK cell effector functions
Authors: Skinner Cassandra C. , McMichael Elizabeth L. , Jaime-Ramirez Alena C. , Abrams Zachary B. , Lee Robert J. , Carson William E.
Published: April 2016

The folate receptor (FR) is overexpressed on the vascular side of cancerous cells including those of the breast, ovaries, testes, and cervix. We hypothesized that a folate-conjugated immunoglobulin (F-IgG) would bind to the FR that is overexpressed on melanoma tumor cells to target these cells for lysis by natural killer (NK) cells. Folate receptor expression was confirmed in the Mel-39 (human melanoma) cell line by flow cytometry and immunoblot analysis using KB (human oral epithelial) and F01 (human melanoma) as a positive and a negative control, respectively. FR-positive and FR-negative cell lines were treated with F-IgG or control immunoglobulin G in the presence or absence of cytokines to determine NK cell ability to lyse FR-positive cell lines. NK cell activation was significantly upregulated and lysis of Mel 39 tumor cells increased following treatment with F-IgG compared with control immunoglobulin G at all effector : target (E : T) ratios (P<0.01). This trend further increased by NK cell stimulation with the activating cytokine interleukin-12. NK cell production of cytokines such as interferon-gamma, macrophage inflammatory protein 1α, and regulated on activation normal T-cell expressed and secreted (RANTES) was also significantly increased in response to costimulation with interleukin-12 stimulation and F-IgG-coated Mel 39 target cells compared with controls (P<0.01). In contrast, F-IgG did not bind to the FR-negative cell line F01 and had no significant effect on NK cell lysis or cytokine production. This research indicates the potential use of F-IgG for its ability to induce an immune response from NK cells against FR-positive melanoma tumor cells, which can be further increased by the addition of cytokines.
Electrical Stimulation Followed by Mesenchymal Stem Cells Improves Anal Sphincter Anatomy and Function in a Rat Model at a Time Remote From Injury
Authors: Sun Li , Yeh Judy , Xie Zhuojun , Kuang Mei , Damaser Margot S. , Zutshi Massarat
Published: April 2016

BACKGROUND:

We have explored cell-based therapy to aid anal sphincter repair, but a conditioning injury is required to direct stem cells to the site of injury because symptoms usually manifest at a time remote from injury.

OBJECTIVE:

We aimed to investigate the effect of local electrical stimulation followed by mesenchymal stem cell delivery on anal sphincter regeneration at a time remote from injury.

DESIGN AND MAIN OUTCOME MEASURES:

With the use of a rat model, electrical stimulation parameters and cell delivery route were selected based on in vivo cytokine expression and luciferase-labeled cell imaging of the anal sphincter complex. Three weeks after a partial anal sphincter excision, rats were randomly allocated to 4 groups based on different local interventions: no treatment, daily electrical stimulation for 3 days, daily stimulation for 3 days followed by stem cell injection on the third day, and daily electrical stimulation followed by stem cell injection on the first and third days. Histology-assessed anatomy and anal manometry evaluated physiology 4 weeks after intervention.

RESULTS:

The electrical stimulation parameters that significantly upregulated gene expression of homing cytokines also achieved mesenchymal stem cell retention when injected directly in the anal sphincter complex in comparison with intravascular and intraperitoneal injections. Four weeks after intervention, there was significantly more new muscle in the area of injury and significantly improved anal resting pressure in the group that received daily electrical stimulation for 3 days followed by a single injection of 1 million stem cells on the third day at the site of injury.

LIMITATION:

This was a pilot study and therefore was not powered for functional outcome.

CONCLUSIONS:

In this rat injury model with optimized parameters, electrical stimulation with a single local mesenchymal stem cell injection administered 3 weeks after injury significantly improved both new muscle formation in the area of injury and anal sphincter pressures.
Early Outcomes of Endoscopic Submucosal Dissection for Colorectal Neoplasms According to Clinical Indications
Authors: Youk Eui-Gon , Sohn Dae Kyng , Hong Chang Won , Lee Seong Dae , Han Kyung Su , Kim Byung Chang , Chang Hee Jin , Kim Mi-Jung
Published: April 2016

BACKGROUND:

Although endoscopic submucosal dissection has been shown to be safe and effective for colorectal tumors, its clinical outcomes vary.

OBJECTIVE:

The aim of this study is to assess the outcomes of endoscopic submucosal dissection according to clinical indications.

DESIGN:

This is a prospective, multicenter, single-arm study.

SETTING:

The study was conducted at special hospitals for colorectal diseases and cancers.

PATIENTS:

The study population included consecutive patients aged 20 to 80 years who underwent colorectal endoscopic submucosal dissection for 1) early colorectal cancer, 2) laterally spreading tumors ≥2 cm in diameter, and 3) submucosal tumors.

INTERVENTIONS:

Procedures were performed by experienced colonoscopists.

MAIN OUTCOME MEASURES:

The primary end points were en bloc and curative resection rates. En bloc resection was defined as endoscopic one-piece resection without tumor fragmentation. Curative resection was defined as en bloc resection and no pathologic requirement for additional surgery. Secondary end points included procedure time, complications, and hospital stay.

RESULTS:

Of 321 patients, 317 (98.8%) underwent en bloc resection and 231 (72.0%) underwent curative resection. The mean procedure time was 46.2 minutes. Mean hospital stay after the procedure was 3.1 days. Perforation occurred in 2 patients (0.6%), and bleeding occurred in 10 (3.1%) patients. All patients with complications were treated by endoscopic clipping or nonoperative management. Fifteen patients (4.7%) underwent additional radical surgery owing to the risks of lymph node metastasis. Although tumor size was smaller and procedure time shorter in the submucosal tumor group than in the laterally spreading tumor or early colorectal cancer group, there were no differences in clinical outcomes including en bloc and curative resection rates. Submucosal fibrosis was the only factor affecting endoscopic submucosal dissection procedure-related complications.

LIMITATIONS:

Early outcomes in a limited population and the potential for selection bias were limitations of this study.

CONCLUSIONS:

Outcomes of colorectal endoscopic submucosal dissection were acceptable in selected patients, with no difference in outcomes according to clinical indications. Because submucosal fibrosis can increase complications, it should be minimized before endoscopic submucosal dissection.
Benzodiazepine inhibits anxiogenic-like response in cocaine or ethanol withdrawn planarians
Authors: Nayak Sunil , Roberts Adam , Bires Kristofer , Tallarida Christopher S. , Kim Erin , Wu Michael , Rawls Scott M.
Published: April 2016

Planarians spend less time in light versus dark environments. We hypothesized that planarians withdrawn from cocaine or ethanol would spend even less time in the light than drug-naive planarians and that a benzodiazepine would inhibit this response. Planarians pretreated in cocaine or ethanol were placed at the midline of a Petri dish containing spring water that was split evenly into dark and light compartments. Planarians withdrawn from cocaine (1, 10, 100 μmol/l) or ethanol (0.01%) spent less time in the light compartment than water controls; however, this withdrawal response to cocaine (100 μmol/l) or ethanol (0.01%) was abolished by clorazepate (0–100 μmol/l). These data suggest that planarians, similar to rodents, show benzodiazepine-sensitive, anxiogenic-like responses during cocaine or alcohol withdrawal.
Tramadol state-dependent memory: involvement of dorsal hippocampal muscarinic acetylcholine receptors
Authors: Jafari-Sabet Majid , Jafari-Sabet Ali-Reza , Dizaji-Ghadim Ali
Published: April 2016

The effects on tramadol state-dependent memory of bilateral intradorsal hippocampal (intra-CA1) injections of physostigmine, an acetylcholinesterase inhibitor, and atropine, a muscarinic acetylcholine receptor antagonist, were examined in adult male NMRI mice. A single-trial step-down passive avoidance task was used for the assessment of memory retention. Post-training intra-CA1 administration of an atypical μ-opioid receptor agonist, tramadol (0.5 and 1 μg/mouse), dose dependently impaired memory retention. Pretest injection of tramadol (0.5 and 1 μg/mouse, intra-CA1) induced state-dependent retrieval of the memory acquired under the influence of post-training tramadol (1 μg/mouse, intra-CA1). A pretest intra-CA1 injection of physostigmine (1 μg/mouse) reversed the memory impairment induced by post-training administration of tramadol (1 μg/mouse, intra-CA1). Moreover, pretest administration of physostigmine (0.5 and 1 μg/mouse, intra-CA1) with an ineffective dose of tramadol (0.25 μg/mouse, intra-CA1) also significantly restored retrieval. Pretest administration of physostigmine (0.25, 0.5, and 1 μg/mouse, intra-CA1) by itself did not affect memory retention. A pretest intra-CA1 injection of the atropine (1 and 2 μg/mouse) 5 min before the administration of tramadol (1 μg/mouse, intra-CA1) dose dependently inhibited tramadol state-dependent memory. Pretest administration of atropine (0.5, 1, and 2 μg/mouse, intra-CA1) by itself did not affect memory retention. It can be concluded that dorsal hippocampal muscarinic acetylcholine receptor mechanisms play an important role in the modulation of tramadol state-dependent memory.
The association between high-sensitivity C-reactive protein and hypertension in women of the CARDIA study
Authors: Ebong Imo A. , Schreiner Pamela , Lewis Cora E. , Appiah Duke , Ghelani Azmina , Wellons Mellissa
Published: April 2016

Objective:

The aim of this study was to determine the prevalence of hypertension in midlife women, characterize the association between high-sensitivity C-reactive protein (hs-CRP) and hypertension in women, and describe differences in hypertension prevalence by menopausal stage.

Methods:

We included 1,625 women, aged 43 to 55 years, with measurements of hs-CRP and detailed reproductive histories in the Coronary Artery Risk Development in Young Adults study at follow-up year 25. Prevalent hypertension was defined as a systolic blood pressure of 140 mm Hg, or diastolic blood pressure of 90 mm Hg or greater, or use of antihypertensive medications. Logistic regression was used for analysis.

Results:

The prevalence of hypertension was 25.8%, 37.8%, and 39.0% in premenopausal, perimenopausal, and postmenopausal women, respectively. The median (25th and 75th percentiles) of hs-CRP was 3.08 (1.12, 7.98) μg/mL and 1.18 (0.48, 3.15) μg/mL in women with and without hypertension, respectively. After adjusting for confounders, metabolic factors and body mass index, a doubling (100% increment) in hs-CRP levels was significantly associated with hypertension in premenopausal (1.27 [1.01-1.59]), but not in perimenopausal (1.12 [0.99-1.27]) or postmenopausal (1.09 [0.95-1.26]) women.

Conclusions:

Hypertension was common in midlife women. The association of hs-CRP and hypertension was consistent across menopausal stages. The association of hs-CRP with hypertension was independent of body mass index in premenopausal but not in perimenopausal or postmenopausal women.
Pigmented Villonodular Synovitis of the Temporomandibular Joint: A Unique Presentation
Authors: Pianosi Kiersten , Rigby Matthew , Hart Robert , Trites Jonathan , Taylor S. Mark
Published: April 2016

Pigmented villonodular synovitis (PVNS) is a rare and benign proliferative disorder of synovium with potentially locally aggressive growth and invasion of the bone. Occurring within the joints, tendon sheaths, and bursae, it is most commonly a monoarticular disease affecting large joints. In particular, most cases of PVNS occur in the knee. PVNS of the temporomandibular joint (TMJ) is a highly rare disorder, with approximately 60 cases reported. Herein, we present a unique case of an elderly male presenting with ear pain and subsequently diagnosed with PVNS of the TMJ with a history of trauma to the area. Initial imaging of the TMJ and the surrounding region looked concerning for invasive and/or malignant disease, but an open biopsy confirmed PVNS.
Measuring the Cervical Length
Authors: MARKHAM KARA B. , IAMS JAY D.
Published: April 2016

An important step toward the goal of eradicating spontaneous preterm birth was achieved with the advent of cervical sonography, a tool that advanced our knowledge of the entity of preterm parturition, improved our ability to detect women at risk for early delivery, and allowed us to prevent some of these premature births. We will describe here the correct technique for obtaining such measurements and will review the literature regarding the use of this tool in specific pregnant populations.
Success of Rigid Gas Permeable Contact Lens Fitting
Authors: Ortiz-Toquero Sara , Martin Mario , Rodriguez Guadalupe , de Juan Victoria , Martin Raul
Published: April 2016

Objectives:

To assess the percentage of successful rigid gas permeable (GP) contact lenses (CLs) fit for both refractive and therapeutic reasons.

Methods:

New CLs (soft or GP) fittings were retrospectively analyzed and divided into refractive and therapeutic prescriptions. A standardized fitting protocol that included complete CLs information after a first eye examination, a diagnostic fitting visit, a dispensing visit, and a prescribing visit was used in all fittings. A GP fitting was defined as successful if full-time wear and optimal ocular surface physiology were both achieved at the review assessment 2 to 3 weeks after lens dispensing.

Results:

Of 232 new CLs fittings analyzed, 166 were refractive fittings (71.6%) and 66 were therapeutic (28.4%). Of the refractive fittings, 88 subjects (53%) were initially fitted with GP CLs and 61 (69.3%) of these met the criteria for successful GP fitting. Within this group, a different percentage of successful fits were found for neophyte (72%), previous soft lens wearers (62%), and previous GP wearers (92.3%). Of the therapeutic fittings, 61 subjects (92.4%) were initially fitted with GP CLs and 59 (96.7%) of these met the criteria for successful GP fitting.

Conclusions:

Following a standardized CLs fitting protocol, a relatively high percentage of successful GP fits was achieved for refractive (7/10 subjects) and therapeutic (9/10 subjects) prescriptions. These results will improve the information available to patients and aid in their CL choices by providing them with a realistic attitude. It will also help eye care practitioners in their clinical activities by providing evidence-based information.
Local and Regional Spread of Primary Conjunctival Squamous Cell Carcinoma
Authors: Desai Shilpa J. , Pruzan Noelle L. , Geske Michael J. , Jeng Bennie H. , Bloomer Michele M. , Vagefi M. Reza
Published: April 2016

Two cases of biopsy-proven conjunctival squamous cell carcinoma (SCC) that developed local and regional spread are described. The cases involved a 65-year-old woman and a 79-year-old man who were initially treated at outside institutions for SCC of the conjunctiva. The patients did not have a history of immune compromise. The female patient presented with direct extension into the lacrimal gland but deferred recommended exenteration. Despite eventual exenteration, she developed metastasis to a neck node 6 months later, which was treated with radiotherapy. The male patient presented with local recurrence and a parotid node metastasis treated with exenteration, parotidectomy, selective neck dissection, and postoperative radiotherapy. Review of the outside pathology of both cases revealed positive tumor margins at the time of original resection. Local control of conjunctival SCC is of critical importance to reduce the risk of orbital extension and regional spread.
Correction of Lower Eyelid Retraction Using Acellular Human Dermis During Orbital Decompression
Authors: Kim Kang Yoon , Woo Young Jun , Jang Sun Young , Lee Eun Jig , Yoon Jin Sook
Published: April 2016

Purpose:

To investigate the surgical outcome of grafting acellular human dermis compared with concurrent lower eyelid retractor recession during swinging eyelid orbital decompression for correction of lower eyelid retraction in patients with Graves’ orbitopathy.

Methods:

Institutional Review Board-approved retrospective nonrandomized study of 54 Graves’ orbitopathy patients (95 eyes) from 2008 to 2012. Patients who received decompression were divided into 3 groups: Group 1 with conjunctival lengthening using 0.3-mm thickness AlloDerm (36 eyes), Group 2 with inferior retractor recession (33 eyes), and Group 3 with decompression only (26 eyes). Outcome measures included lower eyelid height, inferior sclera show, cosmetic appearance, and complications.

Results:

Baseline clinical characteristics and the degree of improvement of exophthalmos were not different between groups. Preoperative MRD2 was higher in group 1 (8.0 mm) than in groups 2 (6.9 mm, p < 0.001) and 3 (6.6 mm, p < 0.001). Mean improvement of MRD2 as well as postoperative improvement of inferior scleral show at postoperative 4 to 6 months were significantly higher in group 1 (2.7 mm) than in groups 2 (1.8 mm, p < 0.001) and 3 (1.2 mm, p < 0.001).

Conclusion:

Simultaneous correction of lower eyelid retraction using thin AlloDerm during swinging eyelid orbital decompression maximizes improvement of lower eyelid retraction compared with concurrent inferior retractor recession.
Legionnaires' Disease
Authors: Castillo Natalia E. , Rajasekaran Arun , Ali Sayed K.
Published: April 2016

Almost 40 years ago, Legionella pneumophila was initially recognized as the cause of a major respiratory outbreak. Since the first description of Legionnaires' disease, surveillance schemes have been implemented worldwide; however, legionellosis is still an underdiagnosed and underreported entity. Legionella pneumophila causes a severe inflammatory pneumonia that primarily affects susceptible patients as a result of advanced age, underlying debilitating conditions, and immunosuppression. Organ-specific and extrapulmonary manifestations have also been described. Cooling towers and water systems in buildings and hospitals have been reported to be environmental reservoirs that commonly harbor this pathogen. Numerous prevention guidelines vary in scope, and effective surveillance and detection systems are required for early clinical intervention. Various diagnostic tests are available, but they do not offer the desired sensitivity. To date, urinary antigen testing is still the most rapid and inexpensive method used in the diagnosis of Legionella infection. Culture and isolation of L. pneumophila from clinical specimens are not as cost-effective as other diagnostic methods, but they continue to be the criterion standard for the diagnosis of Legionnaires' disease. The newer macrolides and respiratory tract fluoroquinolones are highly effective in the treatment of Legionella infection. Current understanding of Legionnaires' disease is crucial in the identification and management of major outbreaks.
Infections Leading to Broncholithiasis
Authors: Shenoy Rahul , Nanjappa Sowmya , Toloza Eric M. , Greene John N.
Published: April 2016

Broncholithiasis is a condition where there is a presence of broncholiths or calcified masses in the airways. The broncholiths commonly are calcified peribronchial lymph nodes that are formed in response to chronic granulomatous infections. The calcified masses either compress the bronchi or erode through the walls into the lumen. They then may be aspirated or expectorated (lithoptysis). Infections with bacteria and fungi have been associated with the development of broncholiths. We present a case of histoplasma infection leading to the formation of broncholiths that were surgically resected along with a literature review of other infectious and noninfectious causes of broncholiths.
Affective instability in patients with chronic pain: a diary approach
Authors: Rost Silke , Van Ryckeghem Dimitri M.L. , Koval Peter , Sütterlin Stefan , Vögele Claus , Crombez Geert
Published: April 2016

Affective instability, conceptualized as fluctuations in mood over time, has been related to ill-health and psychopathology. In this study, we examined the role of affective instability on daily pain outcomes in 70 patients with chronic pain (Mage = 49.7 years; 46 females) using an end-of-day diary. During a baseline phase, patients completed self-reported questionnaires of pain severity, pain duration, disability, depression, and anxiety. During a subsequent diary phase, patients filled out an electronic end-of-day diary over 14 consecutive days assessing daily levels of pain severity, disability, cognitive complaints, negative affect (NA) and positive affect. Affective instability was operationalized as the mean square of successive differences in daily mood (separately for NA and positive affect), which takes into account the size of affective changes over consecutive days. Results indicated that NA instability was positively associated with daily disability, beyond the effects of daily pain severity. Furthermore, NA instability moderated the relationship between daily pain severity and daily disability and the relationship between daily pain severity and daily cognitive complaints. Positive affect instability, however, showed to be unrelated to all outcomes. Current findings extend previous results and reveal the putative role of affective instability on pain-related outcomes and may yield important clinical implications. Indeed, they suggest that targeting NA instability by improving emotion regulation skills may be a strategy to diminish disability and cognitive complaints in patients with chronic pain.
Cognitive behavioral training reverses the effect of pain exposure on brain network activity
Authors: Kucyi Aaron , Salomons Tim V. , Davis Karen D.
Published: April 2016

Repeated sensory exposures shape the brain's function and its responses to environmental stimuli. An important clinical and scientific question is how exposure to pain affects brain network activity and whether that activity is modifiable with training. We sought to determine whether repeated pain exposure would impact brain network activity and whether these effects can be reversed by cognitive behavioral therapy (CBT)-based training. Healthy subjects underwent 8 experimental sessions on separate days on which they received painful thermal stimuli. They were randomly assigned to groups receiving either CBT-based training (regulate group, n = 17) or a non–pain-focused treatment (control group, n = 13). Before and after these sessions, participants underwent functional magnetic resonance imaging (fMRI) during painful stimulation and at rest. The effect of repeated pain over time in the control group was a decrease in the neurotypical pain-evoked default mode network (DMN) deactivation. The regulate group did not show these DMN effects but rather had decreased deactivation of the right ventrolateral prefrontal cortex (R vlPFC) of the executive control network. In the regulate group, reduced pain-evoked DMN deactivation was associated with greater individual reduction in pain intensity and unpleasantness over time. Finally, the regulate group showed enhanced resting functional connectivity between areas of the DMN and executive control network over time, compared with the control group. Our study demonstrates that trainable cognitive states can alter the effect of repeated sensory exposure on the brain. The findings point to the potential utility of cognitive training to prevent changes in brain network connectivity that occur with repeated experience of pain.
Gender Differences in Cognitive Test Performance in Adults With Heart Failure
Authors: Rochette Amber D. , Spitznagel Mary Beth , Sweet Lawrence H. , Cohen Ronald A. , Josephson Richard , Hughes Joel , Gunstad John
Published: April 2016

Background:

Cognitive deficits are found in up to 73% of persons with heart failure (HF) and are associated with increased mortality and other poor clinical outcomes. It is known that women have better memory test performance than men do in healthy samples, but gender differences in cognitive performance in the context of HF are not well understood and may have important clinical implications.

Objective:

The objective of this study was to examine possible gender differences in cognitive function in a sample of individuals with HF (98.9% New York Heart Association class II and III).

Methods:

A total of 183 adults with HF (116 men and 67 women) completed a neuropsychological test battery as part of a larger project. Measures were chosen to assess functioning in attention/executive function and memory.

Results:

After controlling for demographic and medical factors, multivariate analysis of covariance revealed that men and women differed on memory test performance (λ= 0.90,F4, 169= 4.76,P= .001). Post hoc comparisons revealed that women performed better on California Verbal Learning Test Learning, Short Recall, and Delayed Recall. No differences emerged on tests of attention/executive function (λ= 0.97,F5, 168= 0.96,P= .44).

Conclusions:

In this sample of persons with HF, men exhibited poorer performance on memory measures than women did. Future studies are needed to determine the underlying mechanisms for this pattern and its possible influence on daily function.
Short article: Negative small-bowel cross-sectional imaging does not exclude capsule retention in high-risk patients
Authors: Rondonotti Emanuele , Soncini Marco , Girelli Carlo M. , Russo Antonio , de Franchis Roberto
Published: April 2016

Background and aims

Both Agile patency capsule (PC) and small-bowel cross-sectional imaging (SBCSI) techniques have been used to assess small-bowel patency in patients at high risk of capsule retention. The present study aimed to compare capsule retention rates in high-risk patients with negative PC or SBCSI.

Materials and methods

Between January 2011 and December 2013, consecutive patients undergoing small-bowel capsule endoscopy (SBCE) in the Lombardia region were prospectively entered into a dedicated registry. They were classified as being at high or low risk of capsule retention by the local investigator according to predefined clinical criteria. High-risk patients underwent either PC or SBCSI depending on local expertise and availability; those who tested negative underwent SBCE.

Results

Out of 3117 patients (male/female: 1667/1450, mean age: 63.1±17.7), 2942 (94.4%) were classified as being at low risk and 175 (5.6%) were classified as being at high risk for capsule retention. Among 175 high-risk patients, 151 (86.3%) had negative PC and 24 (13.7%) had negative SBCSI: capsule retention occurred in two patients with negative SBCSI (8.3%) and in one patient (0.7%) with negative PC (P=0.049). The capsule retention rates in high-risk patients with negative PC and in low-risk patients (20/2942; 0.7%) were comparable (P=1.0).

Conclusion

The capsule retention rate is similar in low-risk and negative PC high-risk patients. Conversely, high-risk patients with negative SBCSI have a significantly higher capsule retention rate. Our data suggest that in high-risk patients, negative SBCSI examination is not reassuring and, when SBCE is indicated, PC should be performed.
Alendronate for the Treatment of Osteoporosis in Men: A Meta-Analysis of Randomized Controlled Trials
Authors: Xu Zhiguo
Published: April 2016

Background:

Alendronate has been widely used in the treatment of osteoporosis. However, the effect of alendronate in the male osteoporosis remains controversial.

Study Question:

We conducted a meta-analysis to assess the efficacy of alendronate in the treatment of men with osteoporosis.

Study Design:

PubMed, Embase, and Web of Science were searched from their inception to October 25, 2015. Eligible studies were randomized controlled trials that evaluated the effect of alendronate in the male osteoporosis.

Measures and Outcomes:

The outcomes included mean percentage changes in bone mineral density (BMD) of lumbar spine, femoral neck, total hip, trochanter, and total body, and the incidence of new vertebral fractures. Results were expressed with weighted mean difference (WMD), and risk ratio with 95% CIs. A fixed-effects model or random-effects model was used for the meta-analysis according to heterogeneity.

Results:

Eight studies involving 988 patients met the inclusion criteria. Alendronate significantly increased the mean percentage BMD at the lumbar spine (WMD = 4.95, 95% CI, 2.40–7.49; P < 0.001), femoral neck (WMD = 2.59, 95% CI, 1.52–3.66; P < 0.001), and total hip (WMD = 2.39, 95% CI, 1.05–3.27; P < 0.001), but not at the trochanter (WMD = 1.76, 95% CI, −0.69 to 4.21; P = 0.158) and total body (WMD = 3.29, 95% CI, −0.04 to 6.62; P = 0.053). Moreover, alendronate was also decreased the incidence of vertebral fractures (risk ratio = 0.46, 95% CI, 0.28–0.77; P = 0.003). Subgroup analysis showed that among the male osteoporosis, greater increase in the lumbar spine BMD (WMD = 5.99, 95% CI, 3.42–8.56; P < 0.001) and femoral neck BMD (WMD = 3.66, 95% CI, 2.57–4.76; P = 0.023) was observed when the alendronate was administrated with a dose of 10 mg.

Conclusion:

Based on current evidence, alendronate shows beneficial effect on the lumbar spine, femoral neck, and total hip BMD, and the incidence of new vertebral fractures.
Temporal Trends in the Use of Investigations After Stroke or Transient Ischemic Attack
Authors: Ng Vivian T. , Bayoumi Ahmed M. , Fang Jiming , Burton Kirsteen R. , Stamplecoski Melissa , Edwards Jodi D. , Kapral Moira K.
Published: April 2016

Background:

Guidelines recommend that patients with stroke or transient ischemic attack (TIA) undergo neuroimaging and cardiac investigations to determine etiology and guide treatment. It is not known how the use of these investigations has changed over time and whether there have been associated changes in management.

Objectives:

To evaluate temporal trends in the use of brain and vascular imaging, echocardiography, and antithrombotic and surgical therapy after stroke or TIA.

Research Design:

We analyzed 42,738 patients with stroke or TIA presenting to any of the 11 regional stroke centers in Ontario, Canada between 2003 and 2012 using the Ontario Stroke Registry database. The study period was divided into 1-year intervals and we used the Cochran-Armitage test to determine trends over time.

Results:

Between 2003/2004 and 2011/2012, the proportion of patients undergoing brain imaging increased from 96% to 99%, as did the proportion receiving ≥3 brain scans (21%–39%), magnetic resonance imaging (13%–50%), vascular imaging (62%–88%), or echocardiography (52%–70%) (P<0.0001 for all comparisons). There was an increase in the proportion receiving any antithrombotic therapy (83%–91%, P<0.0001) but no change in use of anticoagulation (25% overall and 68% in subgroup with atrial fibrillation) or carotid revascularization (1.4%–1.5%, P=0.49).

Conclusions:

The use of investigations after stroke has increased over time without concomitant changes in medical or surgical management. Although initial neurovascular imaging is in accordance with practice guidelines, the use of multiple imaging procedures and routine echocardiography are of uncertain clinical effectiveness.
Diet, lipids, and cardiovascular disease
Authors: Siri-Tarino Patty W. , Krauss Ronald M.
Published: April 2016

Purpose of review

Modulation of diet is the primary lifestyle approach for reducing cardiovascular disease (CVD) risk, with a major focus of current guidelines being to lower LDL cholesterol by reducing intake of saturated fatty acids. However, dietary effects on lipid-related CVD risk factors extend beyond LDL cholesterol, with growing emphasis on the prevention and management of atherogenic dyslipidemia, which includes elevated triglyceride, small dense LDL, and reduced HDL cholesterol, and which is associated with excess adiposity and insulin resistance. We here review recent studies of dietary macronutrient effects on CVD risk that may act through effects on plasma lipid and lipoprotein metabolism.

Recent findings

Effects of reducing saturated fatty acids on CVD risk have been evaluated both in terms of the replacement macronutrient(s) and the food and dietary context in which the macronutrients are consumed. Although weight loss remains the most important goal for reducing cardiometabolic risk among overweight and obese individuals, a variety of lines of evidence support limitation of added sugars and processed starches for improving features of atherogenic dyslipidemia.

Increasing understanding of the complexity of nutrient–disease relationships has shifted the framework for CVD prevention from a focus on macronutrient content of diets to foods and dietary patterns.
Coagulation Gene Expression Profiling in Infants With Necrotizing Enterocolitis
Authors: Giuliani Stefano , Tan Yew‐Wei , Zheng Dongling , Petropoulou Evmorfia , Sohail Ali , Bradley Sarah , Richards Justin , Kennea Nigel , Jamshidi Yalda
Published: April 2016

Objectives:

Coagulopathy and mesenteric thrombosis are common in premature neonates with necrotizing enterocolitis (NEC). This pilot study aimed to investigate the hypothesis that there are changes in the gene expression related to the coagulation and anticoagulation systems in NEC.

Methods:

Consecutive neonates (n = 11) with NEC (Bell stages 2–3) were recruited. Two comparison groups, matched for birth weight and corrected gestational age, were selected based on the absence of inflammation and coagulopathy (healthy control, n = 10), or the presence of a confirmed blood infection (sepsis control, n = 12). A pathway‐specific quantitative polymerase chain reaction array was used to determine the expression of 94 genes involved in human blood coagulation and anticoagulation cascade.

Results:

Twelve genes of the coagulation and anticoagulation systems were significantly altered in the patients with NEC compared with healthy controls. In particular, neutrophil elastase, CD63, PROS1, HGF, and F12 were significantly upregulated (mean fold changes [FCs] +2.74, P < 0.05) with an overall procoagulant effect; MFGE8, factor II (thrombin) receptor‐like 1 (F2RL1), FGL2, PLAT, PROCR, SERPIND1, and HNF4A were significantly downregulated (mean FCs −2.45, P < 0.05) with a reduction in fibrinolysis and endothelial regeneration. In the comparison between NEC and sepsis, we did observe a significant difference in expression of F2RL1 (FC −2.50, P = 0.01).

Conclusions:

We have identified potential biomarkers associated with coagulopathy and disease progression in NEC. In particular, the overall procoagulant status, at the transcriptional level, should be further investigated to unveil molecular mechanisms leading to intestinal necrosis, multiorgan failure, and death.
Prevention of Vitamin K Deficiency Bleeding in Newborn Infants
Authors:   ESPGHAN Committee on Nutrition, Mihatsch Walter A. , Braegger Christian , Bronsky Jiri , Campoy Cristina , Domellöf Magnus , Fewtrell Mary , Mis Nataša F. , Hojsak Iva , Hulst Jessie , Indrio Flavia , Lapillonne Alexandre , M⊘lgaard Christian , Embleton Nicholas , van Goudoever Johannes
Published: April 2016

Vitamin K deficiency bleeding (VKDB) due to physiologically low vitamin K plasma concentrations is a serious risk for newborn and young infants and can be largely prevented by adequate vitamin K supplementation. The aim of this position paper is to define the condition, describe the prevalence, discuss current prophylaxis practices and outcomes, and to provide recommendations for the prevention of VKDB in healthy term newborns and infants. All newborn infants should receive vitamin K prophylaxis and the date, dose, and mode of administration should be documented. Parental refusal of vitamin K prophylaxis after adequate information is provided should be recorded especially because of the risk of late VKDB. Healthy newborn infants should either receive 1 mg of vitamin K1 by intramuscular injection at birth; or 3 × 2 mg vitamin K1 orally at birth, at 4 to 6 days and at 4 to 6 weeks; or 2 mg vitamin K1 orally at birth, and a weekly dose of 1 mg orally for 3 months. Intramuscular application is the preferred route for efficiency and reliability of administration. The success of an oral policy depends on compliance with the protocol and this may vary between populations and healthcare settings. If the infant vomits or regurgitates the formulation within 1 hour of administration, repeating the oral dose may be appropriate. The oral route is not appropriate for preterm infants and for newborns who have cholestasis or impaired intestinal absorption or are too unwell to take oral vitamin K1, or those whose mothers have taken medications that interfere with vitamin K metabolism. Parents who receive prenatal education about the importance of vitamin K prophylaxis may be more likely to comply with local procedures.
Transanal Irrigation in the Treatment of Children With Intractable Functional Constipation
Authors: Koppen Ilan J.N. , Kuizenga‐Wessel Sophie , Voogt Heleen W. , Voskeuil Marijke E. , Benninga Marc A.
Published: April 2016

Objectives:

The aim of the study was to assess the treatment efficacy of transanal irrigation and parental satisfaction in children with intractable functional constipation (FC) treated with Peristeen.

Methods:

Cross‐sectional survey study among parents of children (age 0–18 years) treated with Peristeen for FC (based on the Rome III criteria). Anonymous questionnaires were sent out to parents via mail, these consisted of 25 self‐developed, multiple‐choice questions regarding the use of Peristeen, current gastrointestinal symptoms, adverse effects of Peristeen, concomitant medication use, and parental satisfaction.

Results:

Out of 91 invited families, 67 (74%) returned the questionnaire. In total, 84% of patients experienced fecal incontinence prior to treatment. Out of all children who still used Peristeen at the time of survey (n = 49), fecal incontinence had resolved completely in 41%, 12% experienced occasional episodes of fecal incontinence (<1 episode per week) and the remaining 47% still experienced episodes of fecal incontinence regularly (≥1 time per week). A total of 28 children (42%) experienced pain during rectal irrigation, especially during insertion of the catheter, inflating the balloon, or during irrigation. Overall, 86% of the parents were satisfied with the result of transanal irrigation and 67% reported that they would continue using transanal irrigation for the treatment of their child's symptoms.

Conclusions:

Transanal irrigation may be effective in the treatment of children with FC and renders a high parental satisfaction. Future prospective studies, preferably RCTs, are necessary to further evaluate this treatment option.
Effect of kinesio tape application on hemiplegic shoulder pain and motor ability: a pilot study
Authors: Kalichman Leonid , Frenkel-Toledo Silvi , Vered Elisha , Sender Iris , Galinka Tal , Alperovitch-Najenson Deborah , Ratmansky Motti , Treger Iuly
Published: April 2016

The aim of our single-group pre–post design pilot study was to evaluate the short-term effect of kinesio taping (KT) application on pain and motor ability of hemiplegic shoulder pain (HSP) patients. Eleven poststroke patients with HSP hospitalized in the Department of Neurology C, Loewenstein Rehabilitation Hospital, Raanana, Israel, received a KT application in addition to their usual rehabilitation protocol. KT, consisting of one to three strips according to a predefined algorithm, was applied to the painful shoulder region. A 10 cm Visual Analog Scale of shoulder pain at rest and at arm movement, active and passive pain-free abduction range of motion, Box & Blocks, and Fugl-Meyer upper extremity motor assessment were performed before treatment and 24 h after wearing the KT. After applying the KT, there was no significant change in any variables. Short-term KT application, used in our study, produced no change in shoulder pain, range of motion, or ability of upper limb in HSP patients. Additional studies should evaluate the effect of long-term application and different types of KT applications on HSP.
Nurses’ Perceptions of Diagnosis and Prognosis-Related Communication
Authors: Newman Amy R.
Published: April 2016

Background:

Disclosure of diagnostic and prognostic information has become the standard in the United States and increasingly around the world. Disclosure is generally identified as the responsibility of the physician. However, nurses are active participants in the process both intentionally and inadvertently. If not included in initial discussions regarding diagnosis and prognosis, the nurse may find it challenging to openly support the patient and family.

Objective:

The aim of this study is to synthesize published literature regarding nurses’ perceptions and experiences with diagnosis and prognosis-related communication.

Methods:

The Whittemore and Knafl method guided the integrative review process. Electronic databases including Cumulative Index to Nursing and Allied Health Literature, Health Sciences in ProQuest, PubMed, and Web of Science were used to review the literature from 2000 to 2015. Constant comparison methods were used to analyze the data and develop themes.

Results:

Thirty articles met all of the inclusion criteria and were included in this review. Several themes emerged from the data, including the nurse’s role in the process of diagnosis and prognosis-related communication, barriers and difficulties related to communication, and positive and negative outcomes.

Conclusions:

Nurses play an integral role in the process of diagnostic and prognostic disclosure. Further exploration of both physician and patient perceptions of the nurse’s role are needed. Interprofessional training regarding diagnosis and prognosis-related communication is essential to promote collaboration and better empower nurses in this process.

Implications for Practice:

Nurses should aim to purposefully partner with physician colleagues to plan and participate in diagnostic and prognostic discussions. Nurses should identify opportunities to improve their knowledge, understanding, and comfort with challenging conversations.
Penis Cancer
Authors: Gordon Hyacinth , LoBiondo-Wood Geri , Malecha Ann
Published: April 2016

Background:

This qualitative study examined the experiences of men with penis cancer. Cancer of the penis is a rare and debilitating disease, affecting 1 in 100 000 men in Western countries. Although much has been written about the medical treatment of the disease, little has been published about the experiences of men who have penis cancer.

Objective:

The aim of this study is to gain an understanding of the lived experiences of men with cancer of the penis.

Methods:

Using face-to-face audio-taped interviews with a semi-structured guide, the researcher recruited a purposive sample of 13 men who had been treated for penile cancer. Heidegger’s hermeneutic phenomenology served as the philosophical underpinning and Colazzi’s method was used to analyze the data.

Results:

Six main themes emerged from the data: Misdiagnosis, Secrecy, “Cancer is cancer,” Sexual Issues, Support, and Awareness and Prevention.

Conclusions:

Men diagnosed and treated for penis cancer reported numerous issues related to misdiagnosis, delayed treatment, and reluctance to share experience with family, friends, and coworkers.

Implications for Practice:

Gaining more knowledge of the experiences of men with penile cancer will provide additional insights for healthcare providers to create holistic practice guidelines for the care of men and their loved ones who are affected. It is recommended to change the terminology to penis cancer, instead of penile cancer, to promote public awareness, education, prevention, and early treatment.
The Effectiveness of Hologram Bracelets in Reducing Chemotherapy-Induced Nausea and Vomiting Among Adult Patients With Cancer
Authors: Akhu-Zaheya Laila M. , Khater Wejdan A. , Lafi Asma Y.
Published: April 2016

Background:

Chemotherapy-induced nausea and vomiting (CINV) affects cancer patients’ quality of life, despite the provision of antiemetic medication.

Objectives:

The aim of this study is to assess the clinical effectiveness of the hologram bracelet in the management of CINV among adult patients with cancer.

Methods:

An experimental, double-blinded design spanning 3 courses of chemotherapy was used; 175 oncology patients were randomly assigned to 3 groups: placebo (n = 53), control (n = 54), and intervention (hologram bracelet) (n = 68). Daily diaries were used to detect the severity and the frequency of CINV and to detect the frequency of using antiemetic medications. The Functioning Living Index–Emesis was used to examine the impact of CINV on the activities of daily living.

Results:

Significant CINV differences existed between groups. The mean total Functioning Living Index–Emesis score was significantly lower in the intervention group for total vomiting and total nausea.

Conclusion:

Hologram bracelet use among patients with cancer had a positive effect on CINV. The level of CINV decreased and activity of daily living scores increased. However, effects varied among the types of CINV.

Implications for Practice:

Further study is recommended to explore the benefits of the bracelet.
Are Specific Early-Life Adversities Associated With Specific Symptoms of Psychosis?
Authors: Wickham Sophie , Bentall Richard
Published: April 2016

Epidemiological studies have suggested that there may be associations between specific adversities and specific psychotic symptoms. There is also evidence that beliefs about justice may play a role in paranoid symptoms. In this study, we determined whether these associations could be replicated in a patient sample and whether beliefs about a just world played a specific role in the relationship between adversity and paranoia. We examined associations between childhood trauma, belief in justice, and paranoia and hallucinatory experiences in 144 individuals: 72 individuals with a diagnosis of schizophrenia spectrum disorders and 72 comparison controls. There was a dose-response relationship between cumulative trauma and psychosis. When controlling for comorbidity between symptoms, childhood sexual abuse predicted hallucinatory experiences, and experiences of childhood emotional neglect predicted paranoia. The relationship between neglect and paranoia was mediated by a perception of personal injustice. The findings replicate in a patient sample previous observations from epidemiological research.
Inflammatory Cell Upregulation of the Lid Wiper in Contact Lens Dry Eye
Authors: Alzahrani Yahya , Colorado Luisa , Pritchard Nicola , Efron Nathan
Published: April 2016

Purpose

To determine if Langerhans cells in the lid wiper are upregulated in contact lens-induced dry eye (CLIDE).

Methods

The lid wiper of one eye of 17 participants with CLIDE (assessed using the CLDEQ-8) and 29 without CLIDE (NO-CLIDE) was examined using a Heidelberg laser scanning confocal microscope after 6 months wear of daily disposable hydrogel contact lenses (Biomedics 1 day Extra). Twenty non–contact-lens-wearing controls were also examined. Langerhans cell density (LCD) in each participant was taken as the mean cell count calculated manually from six clear, randomly selected images of known dimensions.

Results

There were significant overall differences in LCD in the lid wiper among the three groups (p < 0.001). LCD was significantly greater in the lid wiper in CLIDE (17 ± 10 cells/mm2) compared to controls (8 ± 4 cells/mm2) (p < 0.001); however, there was no difference in LCD between NO-CLIDE (10 ± 5 cells/mm2) and controls (p = 0.489). LCD was significantly greater in CLIDE than NO-CLIDE (p = 0.002).

Conclusions

Langerhans cells in the lid wiper are upregulated in CLIDE, suggesting an inflammatory component in the etiology of this condition.