bluuebunny/crossref_metadata_2025 huggingface dataset:
Dentistry students’ views about mental illness and impact of a targeted seminar on knowledge and attitudes: a mixed-method study
Authors: Patterson Susan , Ford Pauline
Published: October 2014

Purpose

– The purpose of this paper is to inform education of non-mental health professionals who provide care to people with severe mental illness; to describe dentistry students’ knowledge and views about mental illness, including willingness to engage in various social situations with a person hospitalised for mental illness; and to assess and understand the impact of a targeted lecture on views and attitudes.

Design/methodology/approach

– The paper employed mixed methods to examine dental students’ knowledge and views about mental disorder before and after a seminar covering mental disorder, disadvantage and oral health. Findings from a bespoke questionnaire administered to third-year dental students were triangulated with qualitative data gathered in interviews with a subsample.

Findings

– Students understood mental disorder broadly, employing diverse causal models. Although knowledge was typically grounded in media stereotypes, attitudes were benevolent and most students reported willingness to provide dental care to affected individuals. The seminar, especially the consumer delivered section, was valued and associated with increased appreciation of the impact of mental disorder on oral health and need for assertive action to promote access to care. However, students reported being reluctant to disclose their own mental health problems for fear of being considered a professional or personal failure. A minority knew how to seek support if a friend talked of suicide.

Research limitations/implications

– This study highlights the need for further investigation of the knowledge and attitudes of dentistry students pertinent to provision of care to people with mental illness and to examine the links between attitudes and practice. The paper also provides a useful foundation for development of brief educational interventions, particularly the value in integrating the service user perspective, and their evaluation. Research should also examine the impact of mental health education on practice.

Practical implications

– A single inexpensive educational session, such as the one the paper developed may support reconsideration of often unconscious views of mental illness which might affect practice.

Social implications

– If people with mental illness are to receive equitable access to health care, non-mental health professionals should be supported to develop knowledge and attitudes which are conducive to inclusive treatment. An education session such as this could be helpful.

Originality/value

– There is scant literature examining attitudes of dentistry students and no reports of mental health-specific education with this population.
Mental Health Professional Online Development (MHPOD): a web-based training tool for the non-government community mental health workforce
Authors: Ftanou Maria , Machlin Anna , Nicholas Angela , King Kylie , Fletcher Justine , Harvey Carol , Pirkis Jane
Published: October 2014

Purpose

– The purpose of this paper is to evaluate the usefulness and relevance of the Mental Health Professional Online Development (MHPOD) training package in further developing the skills in mental health and recovery-informed practice of the Australian non-government community mental health workforce. MHPOD is an evidence-based, self-paced, online learning resource that consists of 58 mental health topics.

Design/methodology/approach

– A total of 349 e-learners were recruited from seven non-government community mental health services across Australia. E-learners were invited to complete up to twelve online surveys, a baseline survey, a topic completion survey for each completed topic, and a follow-up survey towards the end of the pilot.

Findings

– The majority of e-learners indicated that MHPOD was useful for professional development and relevant to their current employment. E-learners identified that MHPOD led to significant improvement in their knowledge and confidence in their ability. A number of enabling factors such as managerial and organizational supports, technical supports and up-to-date and relevant content materials need to be present for the successful implementation of online programs such as MHPOD.

Originality/value

– Online training packages such MHPOD that a relatively easy to use are helpful in developing knowledge, and confidence in the skills of the mental health workforce. The evaluation findings suggest that MHPOD is a relevant and appropriate training tool for the non-government community mental health sector within Australia.
Education and training for community pharmacists in mental health practice: how to equip this workforce for the future
Authors: Wheeler Amanda , Mey Amary , Kelly Fiona , Hattingh Laetitia , K. Davey Andrew
Published: October 2014

Purpose

– The purpose of this paper is to explore the potential approaches to continuing education and training delivery for community pharmacists to equip them to support mental health consumers and carers with illnesses such as depression and anxiety.

Design/methodology/approach

– Review of national and international literature about community pharmacists’ roles, beliefs and attitudes towards mental health, continuing education delivery for the workforce and training recommendations to equip pharmacy workforce.

Findings

– Training involving consumer educators was effective in reducing stigma and negative attitudes. Interactive and contextually relevant training appeared to be more effective than didactic strategies. Narratives and role-plays (from the perspective of consumers, carers and health professionals) are effective in promoting more positive attitudes and reduce stigma. Flexible on-line delivery methods with video footage of expert and consumer narratives were preferable for a cost-effective programme accessible to a wide community pharmacy workforce.

Originality/value

– There is a clear need for mental health education for community pharmacists and support staff in Australia. Training should target reducing stigma and negative attitudes, improving knowledge and building confidence and skills to improve pharmacy staff's perceived value of working with mental health consumers. The delivery mode should maximise uptake.
Examining an occupational perspective in a rural Canadian age‐friendly consultation process
Authors: Lauckner Heidi M. , Stadnyk Robin L.
Published: October 2014

Background/aim

The age‐friendly community movement is a community‐level approach to promoting seniors’ health that has yet to be thoroughly examined from an occupational perspective. Through the application of the Canadian Practice Process Framework to an age‐friendly consultation process, the authors examined how age‐friendly community consultations may provide strategies for occupational therapists to strengthen their work with communities.

Methods

A consultation with a rural Canadian community was guided by the Age‐Friendly Rural/Remote Communities Initiative. Focus groups were held with 35 older adults to identify age‐friendly features of the community. Twenty key informants who provide services to seniors were also interviewed individually. Following the community consultation, we examined the relationship between the age‐friendly community consultation process and occupational therapy community development practice processes using the Canadian Practice Process Framework.

Results

The steps of the consultation process paralleled the occupational therapy practice process, with occupational issues implicitly identified in the age‐friendly consultation. The age‐friendly consultation process emphasised the importance of collaborative partnerships and the need for occupational therapists to adopt a facilitative rather than leadership role. Skills that enable occupation were used throughout this age‐friendly consultation.

Conclusions

The study suggests that the process of this age‐friendly community consultation has relevance to occupational therapy theory and practice, and can provide a useful framework for collaborative consultative processes when working with communities.
Enterotoxigenic Profiling of Emetic Toxin‐ and Enterotoxin‐Producing Bacillus cereus, Isolated from Food, Environmental, and Clinical Samples by Multiplex PCR
Authors: Forghani Fereidoun , Kim Jung‐Beom , Oh Deog‐Hwan
Published: October 2014

Bacillus cereus comprises the largest group of endospore‐forming bacteria and can cause emetic and diarrheal food poisoning. A total of 496 B. cereus strains isolated from various sources (food, environmental, clinical) were assessed by a multiplex PCR for the presence of enterotoxin genes. The detection rate of nheA, entFM, hblC, and cytK enterotoxin genes among all B. cereus strains was 92.33%, 77.21%, 59.47%, and 47.58%, respectively. Enterotoxigenic profiles were determined in emetic toxin‐ (8 patterns) and enterotoxin‐producing strains (12 patterns). The results provide important information on toxin prevalence and toxigenic profiles of B. cereus from various sources. Our findings revealed that B. cereus must be considered a serious health hazard and Bacillus thuringiensis should be considered of a greater potential concern to food safety among all B. cereus group members. Also, there is need for intensive and continuous monitoring of products embracing both emetic toxin and enterotoxin genes.
Indocyanine green plasma disappearance rate as dynamic liver function test in critically ill patients
Authors: HALLE B. M. , POULSEN T. D. , PEDERSEN H. P.
Published: October 2014

Background

Indocyanine green (ICG) is a water‐soluble fluorescent dye that is bound to plasma protein when administered intravenously. Removal of ICG from the blood depends on hepatic blood flow, function of the parenchymal cells and biliary excretion. ICG elimination is described as a useful dynamic liver function test.

Methods

In this review, we looked at the most recent literature to clarify why ICG is useful in critically ill patients, the validity of the ICG plasma disappearance rate (ICG‐PDR) measured transcutaneously and whether ICG‐PDR has any prognostic value.

Conclusion

In conclusion, measuring ICG‐PDR is a valuable method for dynamic assessment of liver function, and is found to be a valuable prognostic tool in predicting survival for septic patients, patients presenting with acute liver failure and critically ill patients.
Meralgia paresthetica‐like symptoms following epidural analgesia after total knee arthroplasty
Authors: SHIN H. J. , KIM Y. H. , LEE H. W.
Published: October 2014

Meralgia paresthetica (MP) is generally caused by entrapment of the lateral femoral cutaneous nerve (LFCN), and presents with pain and paresthesia in the anterolateral thigh. This paper describes a patient who had MP‐like symptoms as a result of continuous epidural analgesia after total knee arthroplasty. The patient with pre‐existing left foraminal stenosis at L3‐L4 and disc herniations at L4‐5 did not complain of paresthesia or pain during the combined spinal‐epidural anesthetic procedure. However, during epidural analgesia on the second post‐operative day, he complained of paresthesia and pain in the anterolateral thigh of the contralateral leg. Electromyography showed a neurogenic lesion at the level of L3. Although an ultrasound‐guided diagnostic block of the LFCN was performed twice post‐operatively, the patient's symptoms persisted. The symptoms gradually resolved 12 months after the surgery. In our case, we suggest that the continuous epidural infusate caused neural ischemia of the L3 nerve root by a compressive effect.
Gyration of the Feline Brain: Localization, Terminology and Variability
Authors: Pakozdy A. , Angerer C. , Klang A. , König E. H. , Probst A.
Published: October 2014

The terminology of feline brain gyration is not consistent and individual variability has not been systematically examined. The aim of the study was to identify the gyri and sulci of cat brains and describe them using the current terminology. The brains of 15 cats including 10 European shorthairs, 2 Siamese, 2 Maine coons and one Norvegian forest cat without clinical evidence of brain disease were examined post‐mortem and photographed for documentation. For description, the terms of the most recent Nomina Anatomica Veterinaria (NAV, 2012) were used, and comparisons with previous anatomical texts were also performed. In addition to the lack of comparative morphology in the NAV, veterinary and human nomenclature are used interchangeably and inconsistently in the literature. This presents a challenge for neurologists and anatomists in localizing gyri and sulci. A comparative analysis of brain gyration showed only minor individual variability among the cats. High‐quality labelled figures are provided to facilitate the identification of cat brain gyration. Our work consolidates the current and more consistent gyration terminology for reporting the localization of a cortical lesion based on magnetic resonance imaging or histopathology. This will facilitate not only morphological but also functional research using accurate anatomical reporting.
Soluble CD44 and vascular endothelial growth factor levels in patients with acute primary angle closure
Authors: Chen Shida , Huang Wenbin , Wang Jiawei , Zhang Jing , Wang Wei , Zhou Minwen , Gao Xinbo , Zhang Xiulan
Published: October 2014

Purpose

Acute elevation of intraocular pressure (IOP) in acute primary angle closure (APAC) can cause huge damage to the variable cells in the eye; however, the mechanisms that connect the two processes still remain unclear. In this study, we aim to evaluate the levels of soluble CD44 (sCD44) and vascular endothelial growth factor (VEGF) in the aqueous humour of acute primary angle closure patients.

Methods

This study included 24 eyes of 24 APAC patients (11 eyes with current APAC and 13 eyes with previous APAC) and 15 eyes of 15 cataract subjects. Clinical data were acquired, and aqueous humour was collected. The levels of sCD44 and VEGF in the aqueous humour were determined by ELISA and magnetic bead immunoassay technique.

Results

The concentrations of the sCD44 and VEGF in the current APAC were 9.9 ± 8.8 ng/ml and 2440.2 ± 2107.1 ng/ml, respectively, which were significantly higher when compared to the previous APAC group (p = 0.001) and cataract (p < 0.001); however, there were no significant differences between the group with previous APAC and with cataract. Higher IOP was associated with higher concentration of sCD44 (Rho = 0.617, p = 0.001). The concentration of the VEGF in aqueous humour of APAC patients was closely related to the sCD44 levels (Rho = 0.752, p < 0.001).

Conclusion

After acute increase of IOP in the APAC, the level of sCD44 and VEGF increased significantly in the aqueous humour. The damage due to high IOP may therefore be mediated through the release of sCD44.
Outcome of surgical treatment of primary and secondary glaucoma in young children
Authors: Zetterberg Madeleine , Nyström Alf , Kalaboukhova Lada , Magnusson Gunilla
Published: October 2014

Purpose

To describe a paediatric cohort surgically treated for primary or secondary glaucoma (PG/SG), with regard to incidences, visual outcome and control of intraocular pressure (IOP).

Methods

All children (n = 29, 42 eyes in total) surgically treated for PG or SG at the age of 4 years or younger between January 2002 and December 2010 at Sahlgrenska University Hospital in Mölndal were retrospectively studied through medical records. Median follow‐up time after initial surgery was 5.9 years (range 2.4–11.2 years).

Results

The incidence of primary congenital glaucoma was 4.3 cases per 100 000 live births in the county of Västra Götaland. For glaucoma secondary to cataract surgery, the incidence was 13% with a median postoperative duration to diagnosis of glaucoma of 3.8 months (range 1.6 months to 4.3 years). Preoperative mean IOP was 31.5 (SD 8.1) mmHg, and mean IOP at last visit was 17.1 (SD 4.4) mmHg. For the entire cohort, 30% of the glaucoma eyes required more than two IOP‐lowering surgical procedures during the study period. BCVA was ≥0.3 (decimal) in 45% of glaucomatous eyes at last follow‐up with no statistically significant difference between PG and SG. Analysis of functional visual outcome, that is BCVA in the better eye, showed that 83% of all patients attained a BCVA of ≥0.5.

Conclusions

The incidences and outcome of surgically treated paediatric glaucoma were in accordance with previous studies. Chamber angle surgery, and if necessary, tube implantation without the use of antimetabolites, is a favourable approach leaving most sites needed for future glaucoma surgery unaffected.
Quantifying and Comparing Dynamic Predictive Accuracy of Joint Models for Longitudinal Marker and Time-to-Event in Presence of Censoring and Competing Risks
Authors: Blanche Paul , Proust-Lima Cécile , Loubère Lucie , Berr Claudine , Dartigues Jean-François , Jacqmin-Gadda Hélène
Published: October 2014

Thanks to the growing interest in personalized medicine, joint modeling of longitudinal marker and time-to-event data has recently started to be used to derive dynamic individual risk predictions. Individual predictions are called dynamic because they are updated when information on the subject's health profile grows with time. We focus in this work on statistical methods for quantifying and comparing dynamic predictive accuracy of this kind of prognostic models, accounting for right censoring and possibly competing events. Dynamic area under the ROC curve (AUC) and Brier Score (BS) are used to quantify predictive accuracy. Nonparametric inverse probability of censoring weighting is used to estimate dynamic curves of AUC and BS as functions of the time at which predictions are made. Asymptotic results are established and both pointwise confidence intervals and simultaneous confidence bands are derived. Tests are also proposed to compare the dynamic prediction accuracy curves of two prognostic models. The finite sample behavior of the inference procedures is assessed via simulations. We apply the proposed methodology to compare various prediction models using repeated measures of two psychometric tests to predict dementia in the elderly, accounting for the competing risk of death. Models are estimated on the French Paquid cohort and predictive accuracies are evaluated and compared on the French Three-City cohort.
Increased post‐induction intensification improves outcome in children and adolescents with a markedly elevated white blood cell count (≥200 × 109/l) with T cell acute lymphoblastic leukaemia but not B cell disease: a report from the Children's Oncology Group
Authors: Hastings Caroline , Gaynon Paul S. , Nachman James B. , Sather Harland N. , Lu Xiaomin , Devidas Meenakshi , Seibel Nita L.
Published: October 2014

Children and adolescents presenting with a markedly elevated white blood cell (ME WBC) count (WBC ≥200 × 109/l) comprise a unique subset of high‐risk patients with acute lymphoblastic leukaemia (ALL). We evaluated the outcomes of the 251 patients (12% of the study population) with ME WBC treated on the Children's Cancer Group‐1961 protocol. Patients were evaluated for early response to treatment by bone marrow morphology; those with a rapid early response were randomized to treatment regimens testing longer and stronger post‐induction therapy. We found that ME WBC patients have a poorer outcome compared to those patients presenting with a WBC <200 × 109/l (5‐year event‐free survival 62% vs. 73%, P = 0·0005). Longer duration of therapy worsened outcome for T cell ME WBC with a trend to poorer outcome in B‐ALL ME WBC patients. Augmented therapy benefits T cell ME WBC patients, similar to the entire study cohort, however, there appeared to be no impact on survival for B‐ALL ME WBC patients. ME WBC was not a prognostic factor for T cell patients. In patients with high risk features, B lineage disease in association with ME WBC has a negative impact on survival.
A systematic review of experience of 180‐W XPS GreenLight laser vaporisation of the prostate in 1640 men
Authors: Brunken Claus , Seitz Christian , Woo Henry H.
Published: October 2014

Objective

To systematically review the literature regarding clinical outcomes of 180‐W XPS GreenLight® laser (GL) vaporisation for the treatment of lower urinary tract symptoms (LUTS) related to benign prostatic hyperplasia (BPH).

Methods

Recent publications were identified in the field of 180‐W GL vaporisation for the treatment of LUTS due to BPH. We searched for peer‐reviewed original articles in the English language. Search items were: ‘180W lithium triborate laser’ or ‘180W greenlight laser’ or ‘180 watt lithium triborate laser’ or ‘180 watt greenlight laser’ or ‘XPS greenlight laser’. In all, 30 papers published between 2012 and 2014 matched this search. Of these, 10 papers were identified dealing with consecutive cohorts of patients treated with the 180‐W XPS GL

Results

The 10 papers included a total experience of 1640 patients. The only randomised controlled trial in this field compares 180‐W with transurethral resection of the prostate (TURP). Functional outcomes and prostate volume reduction after GL vaporisation were similar to TURP. Catheterisation time and hospital stay were shorter in patients undergoing 180W XPS GL vaporisation (41 and 66 h vs 60 and 97 h, respectively). Four papers compared the 180‐W XPS system to former GL devices showing increased operation time efficiency and comparable postoperative voiding results and adverse events. One paper defined the learning curve to achieve an expert level according to the speed of the procedure and the effectiveness of volume reduction was met after 120 procedures.

Conclusion

The 180‐W XPS GL offers shorter operation times than former devices. In the one randomised controlled trial comparison with TURP, volume reduction and functional results were comparable to those of TURP. Longer term studies are required.
Production of an Antimicrobial Peptide AN5‐1 in Escherichia coli and its Dual Mechanisms Against Bacteria
Authors: Yi Tonghui , Huang Yibing , Chen Yuxin
Published: October 2014

AN5‐1 (YSKSLPLSVLNP) is an antimicrobial peptide isolated from the fermentation broth of Paenibacillus alvei strain AN5 (J Ind Microb Biotechnol 2013; 40: 571–9). In this study, we report the application of ubiquitin fusion technology to the expression and purification of AN5‐1. Minimum inhibitory concentration (MIC) and measurement of hemolytic activity (MHC) were measured to confirm the biological activities of the expressed AN5‐1. Bacterial cell membrane permeabilization was investigated to show the interaction between the AN5‐1 and the bacterial cytoplasmic membrane. Furthermore, intracellular activities of the AN5‐1 were determined by genomic DNA interaction assays. The results revealed AN5‐1 damaging bacterial membranes and binding to bacterial genomic DNA to inhibit cellular functions, suggesting that it has multiple intracellular targets in bacteria. The application of ubiquitin fusion technology may be an excellent approach for industrial production to the expression and purification of antimicrobial peptide. Furthermore, AN5‐1 was demonstrated as an antimicrobial peptide with great potentials, as bacterial resistance to AN5‐1 would be not expected, due to the dual mechanisms of AN5‐1 against bacteria.
Pterygium and conjunctival ultraviolet autofluorescence in young Australian adults: the Raine study
Authors: McKnight Charlotte M , Sherwin Justin C , Yazar Seyhan , Forward Hannah , Tan Alex X , Hewitt Alex W , Smith Elliot , Turton David , Byrd Pippa , Pennell Craig E , Coroneo Minas T , Mackey David A
Published: October 2014

Background

Sun exposure is associated with several ophthalmic diseases, including pterygium which may develop in adolescence. This study reports the prevalence of pterygium and its associations in a large cohort of young Australian adults. Conjunctival ultraviolet autofluorescence, a biomarker of ocular sun exposure, has recently been characterized in some Australian populations.

Design

Cross‐sectional population‐based study.

Participants

One thousand three hundred forty‐four subjects aged 18–22 years in the Western Australian Pregnancy Cohort (Raine) Study.

Methods

Standardized colour and ultraviolet autofluorescence photographs of the nasal and temporal conjunctiva were taken, and assessed for presence of pterygium and area of autofluorescence. Sun exposure and protective factors were assessed by structured questionnaire.

Main Outcome Measures

Area of conjunctival ultraviolet autofluorescence in square millimetre (mm2) and presence of pterygium.

Results

Median total conjunctival autofluorescence was 44.2 mm2 (interquartile range 20.2–69.8 mm2). Median conjunctival autofluorescence was higher in nasal than in temporal quadrants (23.8 mm2 vs. 18.9 mm2, P < 0.001), but did not differ according to age or gender. Higher body mass index was associated with lower levels of autofluorescence. Total autofluorescence increased with increasing time spent outdoors. Prevalence of pterygium was 1.2% (95% confidence interval 0.6–1.8%), and was associated with male gender (odds ratio 6.71, P = 0.012). Participants with pterygium had significantly more conjunctival autofluorescence than those without (median 73.4 mm2 vs. 44.0 mm2, P = 0.001).

Conclusions

Conjunctival ultraviolet autofluorescence is associated with increased time spent outdoors, and increased prevalence of pterygium. The association of this biomarker with other ophthalmohelioses, including cataract, ocular surface squamous neoplasia and eyelid malignancy, has yet to be determined.
Collagen type IV‐related nephropathies in Portugal: pathogenic COL4A5 mutations and clinical characterization of 22 families
Authors: Nabais Sá M.J. , Sampaio S. , Oliveira A. , Alves S. , Moura C.P. , Silva S.E. , Castro R. , Araújo J.A. , Rodrigues M. , Neves F. , Seabra J. , Soares C. , Gaspar M.A. , Tavares I. , Freitas L. , Sousa T.C. , Henriques A.C. , Costa F.T. , Morgado E. , Sousa F.T. , Sousa J.P. , da Costa A.G. , Filipe R. , Garrido J. , Montalban J. , Ponce P. , Alves R. , Faria B. , Carvalho M.F. , Pestana M. , Carvalho F. , Oliveira J.P.
Published: October 2014

Alport syndrome (AS) is caused by pathogenic mutations in the genes encoding α3, α4 or α5 chains of collagen IV (COL4A3/COL4A4/COL4A5), resulting in hematuria, chronic renal failure (CRF), sensorineural hearing loss (SNHL) and ocular abnormalities. Mutations in the X‐linked COL4A5 gene have been identified in 85% of the families (XLAS). In this study, 22 of 60 probands (37%) of unrelated Portuguese families, with clinical diagnosis of AS and no evidence of autosomal inheritance, had pathogenic COL4A5 mutations detected by Sanger sequencing and/or multiplex‐ligation probe amplification, of which 12 (57%) are novel. Males had more severe and earlier renal and extrarenal complications, but microscopic hematuria was a constant finding irrespective of gender. Nonsense and splice site mutations, as well as small and large deletions, were associated with younger age of onset of SNHL in males, and with higher risk of CRF and SNHL in females. Pathogenic COL4A3 or COL4A4 mutations were subsequently identified in more than half of the families without a pathogenic mutation in COL4A5. The lower than expected prevalence of XLAS in Portuguese families warrants the use of next‐generation sequencing for simultaneous COL4A3/COL4A4/COL4A5 analysis, as first‐tier approach to the genetic diagnosis of collagen type IV‐related nephropathies.
Recurrent Stroke was Associated with Poor Quality of Life in Patients with Transient Ischemic Attack or Minor Stroke: Finding from the CHANCE Trial
Authors: Wang Yi‐Long , Pan Yue‐Song , Zhao Xing‐Quan , Wang David , Johnston S Claiborne , Liu Li‐Ping , Meng Xia , Wang An‐Xin , Wang Chun‐Xue , Wang Yong‐Jun ,   the CHANCE investigators
Published: October 2014

Aims

To examine the health‐related quality of life (HRQOL) in patients with transient ischemic attack (TIA) or minor stroke and assess the impact of recurrent stroke on HRQOL.

Methods

Health‐related quality of life data on patients participated in the Clopidogrel in High‐risk patients with Acute Nondisabling Cerebrovascular Events (CHANCE) trial were analyzed. The available 90‐day EuroQoL data (EQ‐5D) were used to calculate EQ‐5D index score. Poor HRQOL was defined as an EQ‐5D index score ≤0.5. The characteristics of HRQOL and factors predicting poor HRQOL in these patients were then explored.

Results

Among the total 5170 patients enrolled, 90‐day HRQOL data were obtained from 5104 patients for analysis. The mean EQ‐5D index score at day 90 was 0.88 ± 0.21 for all patients, but only 0.42 ± 0.35 for those with recurrent strokes. Poor 90‐day HRQOL was found in 294 (5.8%) patients. Patients with poor HRQOL had more strokes during follow‐up than patients with good HRQOL (94.9 vs. 4.7%, P < 0.001). Age, history of hypertension and diabetes, and NIHSS at baseline were independent risk factors for predicting poor HRQOL. Stroke recurrence, NIHSS at baseline, age, and minor stroke on admission became independent risk factors once stroke recurrence was added into the model.

Conclusions

Stroke recurrence was associated with poor HRQOL in patients with TIA or minor strokes. Interventions focusing on controlling risk factors and prevention of worsening of neurological function may prevent poor HRQOL in these patients.
Relationship between non‐invasive haemodynamic responses and cardiopulmonary exercise testing in patients with coronary artery disease
Authors: Sperling Milena Pelosi Rizk , Caruso Flávia Cristina Rossi , Mendes Renata Gonçalves , Dutra Daniela Bassi , Arakelian Vivian Maria , Bonjorno José Carlos , Catai Aparecida Maria , Arena Ross , Borghi‐Silva Audrey
Published: October 2014

Background

Non‐invasive assessment of haemodynamic function by impedance cardiography (IC) constitutes an interesting approach to monitor cardiac function in patients with coronary artery disease (CAD). However, such measurements are most often performed at rest, whereas symptoms are also possible during exertion, particularly at higher intensities. In addition, the association between IC during exertion and cardiopulmonary exercise testing (CPX) is not well understood in these patients, which was the aim of this study.

Methods

Nineteen men (age = 62 ± 6 years) with CAD [left ventricular ejection fraction (LVEF) = 61 ± 10%] underwent a CPX using an incremental protocol on a cycle ergometer, with simultaneous measurement of IC. Cardiac output (CO), stroke volume (SV), cardiac index (CI), peak oxygen consumption (VO2), the oxygen uptake efficiency slope (OUES), circulatory power and ventilatory power were determined.

Results

Pearson product‐moment correlation analysis revealed peak VO2 (r = 0·46) was significantly related to CO. Peak oxygen pulse (0·52) was associated with SV. OUES was associated with resting SV (0·47) and with peak SV (r = 0·52).

Conclusion

These findings suggest that IC indices are associated with certain, but not all, established CPX measures in patients with stable CAD.
Adherence to the Global Initiative for Chronic Obstructive Lung Disease guidelines for management of COPD: a hospital‐base study
Authors: Masoompour Seyed Masoom , Mohammadi Abbas , Mahdaviazad Hamideh
Published: October 2014

Background and Aims

To determine the level of adherence to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines, we compared our inpatient management of exacerbations of chronic obstructive pulmonary disease (COPD) to these guidelines.

Method

This cross‐sectional descriptive study was conducted from January 2011 to April 2012 in a 360‐bed teaching hospital in Shiraz, Iran. We recorded the management data for 96 consecutive patients with COPD exacerbation. SPSS 11.5 software (SPSS Inc., Chicago, IL, USA) was used for all statistical analyses.

Results

The mean (standard deviation) age of our patients was 67.3 (14) years, and more than 75% of them were men. Adherence for starting antibiotics was 84.4%. Most of our patients (82.3%) received oxygen therapy, for a level of adherence to GOLD recommendations of 74%. Nearly 95% received a short‐acting bronchodilator, and 12.5% received a long‐acting bronchodilator. Adherence to the guidelines was 19.8% for oral and 61.4% for inhaled steroids. Adherence to the guidelines was 49% for starting N‐acetylcysteine, 77.1% for antitussives and 13.5% for xanthine derivatives (aminophylline and theophylline). The overall adherence to GOLD guidelines was 67.2% at our hospital.

Conclusion

The level of adherence to GOLD guidelines for the management of COPD exacerbation was suboptimal at our teaching hospital. Further improvements in adherence to these guidelines are needed.
Sertraline hydrochloride treatment for patients with stable chronic obstructive pulmonary disease complicated with depression: a randomized controlled trial
Authors: He Yuanqiang , Zheng Yulong , Xu Chuanqin , Yang Haichen , Wang Ziyu , Zhou Liyang , Wan Yufeng , Zheng Donghui , Zhu Jing
Published: October 2014

Background

There is a lack of randomized controlled trials to assess the effects of pharmacological treatments in patients with stable chronic obstructive pulmonary disease (COPD) complicated with moderate or severe depression.

Aims

To assess the efficacy of sertraline hydrochloride on improving the quality of life of patients with stable COPD complicated with depression.

Methods

This randomized controlled trial, conducted from May to November 2013 in the Huai'an Second Hospital, Huai'an, China, enrolled 120 patients with stable COPD who had moderate or severe depression. Patients were randomly assigned to control and interventional groups (n = 60 in each group). In addition to the treatment for COPD, interventional group also received sertraline hydrochloride tablets 50 mg/day for 6 weeks, while the control group received placebo. The primary end point included COPD assessment test (CAT) scores and the secondary endpoint included 6‐min walk distance and 17‐item Hamilton Depression Rating Scale (HAMD‐17) scores. Parameters of spirometry and adverse events were also observed.

Results

There was no significant difference in improvements in the parameters of spirometry tests before and after the treatment with sertraline hydrochloride tablets between the placebo and interventional groups (P > 0.05). Patients in the sertraline hydrochloride group showed more changes in the HAMD‐17 scores and CAT scores after treatment (P < 0.05) and travelled longer distances in the 6‐min walk test than in the placebo group (P < 0.05).

Conclusion

Antidepressant treatment can improve the quality of life and exercise capacity of patients with depression, and it can also improve depression scores, but not lung function.
A rare case of multinodular pulmonary amyloidosis
Authors: Feng Jizhen , Li Jiamei , Ling Chunxiang , Liu Qingwei
Published: October 2014

Background and Aims

Pulmonary amyloidosis is usually associated with systemic amyloidosis. Localized pulmonary amyloidosis without systemic amyloidosis is even rare. We reported a rare case of multinodular pulmonary amyloidosis to improve the understanding of the disease.

Methods

Report of a case.

Results

We present an unusual case of primary pulmonary multinodular amyloidosis in a middle‐aged woman. She presented our hospital with cough and chest distress only. Results of computed tomography (CT) showed multiple nodules with diffused calcification and thick‐walled cavity in bilateral lung parenchyma. And the diagnosis of nodular amyloidosis was established by a CT‐guided core needle biopsy.

Conclusions

The case clearly shows it is difficult to distinguish parenchymal nodular amyloidosis from malignant primary lung neoplasm in radiology because of their similar images. Thus, the role of CT‐guided core needle biopsy in diagnosis of pulmonary mutinodular amyloidosis is very important.
Autoimmune symptoms in idiopathic pulmonary fibrosis: clinical significance
Authors: Alhamad Esam Hamad , Cal Joseph Galindo , AlBoukai Ahmad Amer , Shaik Shaffi Ahmed , Omair Mohammed Ahmed
Published: October 2014

Background and Aims

Information regarding autoimmune symptoms that do not meet the diagnostic criteria for connective tissue disease in patients with idiopathic pulmonary fibrosis (IPF) is limited. The aim of the present study was to investigate differences in the clinical characteristics and prognosis of IPF patients with and without autoimmune symptoms.

Methods

Consecutive patients diagnosed with IPF (N = 96) from January 2008 to December 2012 were included. We compared the clinical characteristics of patients with and without autoimmune symptoms. Survival was compared by log‐rank and Cox proportional hazard analyses.

Results

Thirty‐six (38%) patients reported autoimmune symptoms. There were no significant differences in clinical characteristics between those with and without autoimmune symptoms. Patients with autoimmune symptoms had a better survival rate than those without symptoms [hazard ratio (HR) 0.27; 95% confidence interval (CI) 0.09–0.82; P = 0.020]. After adjusting for age, gender and smoking status, the presence of autoimmune symptoms was associated with improved survival (HR 0.29, 95% CI 0.09–0.89; P = 0.032). However, after adjusting for other covariates, including per cent predicted forced vital capacity and high‐resolution computed tomography total extent score, the presence of autoimmune symptoms did not influence survival (HR 0.49, 95% CI 0.15–1.61; P = 0.240). The median follow‐up period for the studied cohort was 31.5 months.

Conclusion

It appears that autoimmune symptoms are associated with better prognosis among IPF patients. However, future studies are needed to validate our findings.
Measurement of eNO with portable analyser might improve the management of persistent cough at primary care practice in Japan
Authors: Watanabe Keisuke , Shinkai Masaharu , Shinoda Masahiro , Hara Yu , Yamaguchi Nobuhiro , Rubin Bruce K. , Ishigatsubo Yoshiaki , Kaneko Takeshi
Published: October 2014

Background and Aims

There are some controversial reports that investigated the usefulness of exhaled nitric oxide (eNO) to predict the efficacy of inhaled corticosteroids (ICS) in chronic cough patients. Therefore, we retrospectively analysed the usefulness of eNO measurement with portable analyser to predict the requirement of ICS therapy in persistent cough (defined as lasting for 3 weeks or more) patients in Japan and investigated whether it might improve the management of persistent cough at primary care practice.

Methods

We retrospectively reviewed the clinical records of adult patients who had been referred to our hospital for persistent cough from 1 June 2009 to 30 April 2011.

Results

Forty‐two patients had the requirement of ICS (group S) and 35 patients had no requirement of ICS (group N). Forty‐three per cent of the patients who required ICS had not received ICS, and 29% of the patients who did not required ICS had received ICS. In the steroid‐naive patients without current smoking, mean eNO level was significantly higher in group S [60.6 ± 14.1 perts per billion (ppb) vs 22.2 ± 2.3 ppb, P = 0.001] and the sensitivity and the specificity of eNO for predicting the requirement of ICS were 78.6% and 80.0%, respectively. The rate of the patients who received inappropriate treatment about ICS tended to be reduced from 41% to 21% if the eNO was used to predict the requirement of ICS with cut‐off value of eNO 26.5 ppb (P = 0.118).

Conclusion

Measurement of eNO could be one of the management tools for persistent cough at primary care practice.
Surgical management of early and late ureteral complications after renal transplantation: techniques and outcomes
Authors: Berli Jens U. , Montgomery John R. , Segev Dorry L. , Ratner Lloyd E. , Maley Warren R. , Cooper Matthew , Melancon Joseph K. , Burdick James , Desai Niraj M. , Dagher Nabil N. , Lonze Bonnie E. , Nazarian Susanna M. , Montgomery Robert A.
Published: October 2014

Background

In this study, we present our experience with ureteral complications requiring revision surgery after renal transplantation and compare our results to a matched control population.

Methods

We performed a retrospective analysis of our database between 1997 and 2012. We divided the cases into early (<60 d) and late repairs. Kaplan–Meier and Cox proportional hazards models were used to compare graft survival between the intervention cohort and controls generated from the Scientific Registry of Transplant Recipients data set.

Results

Of 2671 kidney transplantations, 51 patients were identified as to having undergone 53 ureteral revision procedures; 43.4% of cases were performed within 60 d of the transplant and were all associated with urinary leaks, and 49% demonstrated ureteral stenosis. Reflux allograft pyelonephritis and ureterolithiasis were each the indication for intervention in 3.8%; 15.1% of the lesions were located at the anastomotic site, 37.7% in the distal segment, 7.5% in the middle segment, 5.7% proximal ureter, and 15.1% had a long segmental stenosis. In 18.9%, the location was not specified. Techniques used included ureterocystostomy (30.2%), ureteroureterostomy (34%), ureteropyelostomy (30.1%), pyeloileostomy (1.9%), and ureteroileostomy (3.8%). No difference in overall graft survival (HR 1.24 95% CI 0.33–4.64, p = 0.7) was detected when compared to the matched control group.

Conclusion

Using a variety of techniques designed to re‐establish effective urinary flow, we have been able to salvage a high percentage of these allografts. When performed by an experienced team, a ureteric complication does not significantly impact graft survival or function as compared to a matched control group.
The metastatic cycle: metastatic niches and cancer cell dissemination
Authors: Géraud Cyrill , Koch Philipp S , Damm Friederike , Schledzewski Kai , Goerdt Sergij
Published: October 2014

The concept of a unidirectional cascade of metastatic events has been replaced in recent years by the metastatic cycle – the concept of a dynamic feed forward cycle of metastatic niches that evolve upon reciprocal interactions with the primary tumor and disseminating cancer cells. Primary tumors interact with pre‐metastatic sites preparing organ‐specific pre‐metastatic niches. Metastasis‐initiating cells home to and succumb to interactions with developing organ‐specific metastatic niches, and secondary recirculating cancer cells interact back with the primary. Metastatic tropism as well as metastatic disease progression are a result of this feed forward cycle of dynamic, reciprocal interactions of cancer cells with their diverse metastatic niches. A better understanding of the multifaceted contributions of the organ‐specific metastatic niches and their complex changes on cancer cell dissemination and of the mutual effects of the cellular and molecular mechanisms involved will open new avenues to better therapies for hitherto intractable progressive disease states of cancer patients and for adjuvant treatment options preventing relapses in tumor‐free patients.
Using phylogenetic diversity to identify ancient rain forest refugia and diversification zones in a biodiversity hotspot
Authors: Costion Craig M. , Edwards Will , Ford Andrew J. , Metcalfe Daniel J. , Cross Hugh B. , Harrington Mark G. , Richardson James E. , Hilbert David W. , Lowe Andrew J. , Crayn Darren M.
Published: October 2014

Aim

The plight of the world's biodiversity hotspots has been paralleled by a debate over how to best prioritize or maximize gain of biodiversity for conservation. Approaches to date have focused on quantifying species, habitat, phylogenetic or other types of diversity. The importance of preserving evolutionary distinctiveness or phylogenetic diversity (PD) has gained popularity due to its ability to identify evolutionary patterns in the landscape that traditional taxon richness measures cannot. Here, we expand upon the application ofPDas a biodiversity index and incorporate data on historical biogeography to understand the processes that shaped the assembly of a tropical flora.

Location

Tropical north‐east Queensland, Australia.

Methods

We generated a genus‐level molecular phylogeny for the bioregion to calculatePD. We then integrated data on historical biogeography into a model to explain the distribution ofPDand thePDresiduals and further tested for a correlation between rain forest stability through time and community assembly.

Results

We identified a strong correlation betweenPDresiduals and the biogeographic origin of the lineages in the extant flora. Areas with higherPDthan expected based on generic richness (GR) contain a higher proportion of immigrant plant lineages dispersed into northern Australia mostly from Southeast Asia within the past few million years. Areas with lowerPDthan predicted by genus richness are rich in ancient Australian relict lineages and are correlated with previously identified rain forest refugia that have remained stable throughout the last glacial cycle.

Main conclusions

MaximizingPDwithout historical interpretation may yield unintended or undesirable conservation outcomes such as deprioritizing ancient refugia with lowerPDvalues. By understanding the biome assembly of a region, better‐informed decisions can be made to ensure different stages of a region's evolutionary history are preserved.
Prognostic superiority of the National Comprehensive Cancer Network International Prognostic Index over pretreatment whole‐body volumetric–metabolic FDG‐PET/CT metrics in diffuse large B‐cell lymphoma
Authors: Adams Hugo J.A. , de Klerk John M.H. , Fijnheer Rob , Heggelman Ben G.F. , Dubois Stefan V. , Nievelstein Rutger A.J. , Kwee Thomas C.
Published: October 2014

Purpose

This study aimed to determine the prognostic value of whole‐body maximum standardized uptake value (SUVmax), whole‐body metabolic tumor volume (MTV), and whole‐body total lesion glycolysis (TLG) at pretreatment 18F‐fluoro‐2‐deoxy‐d‐glucose positron emission tomography/computed tomography (FDG‐PET/CT) in patients with newly diagnosed diffuse large B‐cell lymphoma (DLBCL).

Materials and Methods

Seventy‐three patients with newly diagnosed DLBCL who had undergone FDG‐PET/CT before rituximab, cyclophosphamide, hydroxydaunorubicin, oncovin, and prednisolone (R‐CHOP) immunochemotherapy were retrospectively included. All FDG‐avid lesions in each patient were segmented using semi‐automated software to calculate whole‐body SUVmax, whole‐body MTV, and whole‐body TLG values. Cox regression analyses were used to determine the associations of whole‐body SUVmax, whole‐body MTV, whole‐body TLG, and dichotomized National Comprehensive Cancer Network International Prognostic Index (NCCN‐IPI) risk group (low risk vs. high risk) with progression‐free survival (PFS) and overall survival (OS).

Results

On univariate Cox regression analysis, only the NCCN‐IPI was a significant predictor of PFS (P = 0.024), and only the NCCN‐IPI and whole‐body MTV were significant predictors of OS (P = 0.039 and P = 0.043, respectively). In the multivariate Cox proportional hazards model, only the NCCN‐IPI remained an independent predictive factor of PFS (P = 0.024) and OS (P = 0.039).

Conclusion

Whole‐body SUVmax, whole‐body MTV, and whole‐body TLG do not provide any prognostic information in DLBCL beyond that which can already be obtained by the NCCN‐IPI. Therefore, the NCCN‐IPI remains the most important prognostic tool in this disease.