bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fetal alcohol spectrum disorder: a systematic review of the cost of and savings from prevention in the United States and Canada
Authors: Greenmyer Jacob R. , Popova Svetlana , Klug Marilyn G. , Burd Larry 
Published: October 2019

AbstractBackground and aimsFetal alcohol spectrum disorder (FASD) is a preventable condition that imposes a significant financial burden on societies. Funding of FASD prevention is a small portion of the total expenditures associated with FASD. This paper aimed to review the literature on the costs of and savings from prevention of FASD and present a model for the United States and Canada of projected savings based on expansion of existing evidence‐based prevention models.MethodsA systematic review of published literature on the cost of FASD prevention was conducted and experts in the field were interviewed. Studies that reported the cost of primary prevention of FASD were eligible for further consideration.ResultsApplying evidenced‐based prevention programs to women at highest risk to have a future child with FASD greatly reduces the cost of prevention. In the United States, one case of FASD can be prevented for as little as USD $20 200 – 47 615. Cost of prevention is considerably less expensive than cost of care for a case of FASD.ConclusionExpansion of risk‐based prevention strategies for fetal alcohol spectrum disorder in the United States and Canada would be an economically efficient and worthwhile investment for society.
Association between atrial fibrillation and hip fractures and the implications for hip fracture patients: a systematic review
Authors: Abu‐Assi Rabieh , Campbell Jed , Bacchi Stephen , Gill Tiffany K. , George Daniel , Chehade Mellick 
Published: October 2019

AbstractBackgroundAtrial fibrillation (AF) and hip fractures are both prevalent in the elderly population. The aim of this study was to systematically review the literature regarding the association between AF and hip fractures, and the impact of AF on hip fracture prognosis.MethodsThe literature search was performed using PubMed, MEDLINE, Embase and Scopus. Inclusion was based upon the application of eligibility criteria in duplicate prior to data extraction with a standardized form.ResultsA total of 42 studies met the inclusion criteria. AF prevalence was found to vary between 6.5% and 35% in cohorts. Large studies with broad inclusion criteria found the prevalence of AF in hip fracture patients to be approximately 12–15%. There were conflicting results as to whether patients with AF have an increased rate of hip fractures, as compared to patients without AF. Several studies demonstrated that hip fracture patients with AF have increased rates of mortality, both as an inpatient and following discharge, and increased readmission rates.ConclusionAF and hip fractures frequently coexist, and there is evidence to suggest AF is associated with increased readmission and mortality rates in hip fracture patients. Elements of the relationship between AF and hip fractures remain uncertain and further prospective studies on AF and hip fracture cohorts may clarify this relationship. Interventional studies targeting hip fracture patients with AF may be beneficial.
Ambient theatre temperature and cement setting time in total knee arthroplasty
Authors: Elliott Ross , Regazzola Gianmarco , Bruce Warwick J. M. 
Published: October 2019

AbstractBackgroundPolymethylmethacrylate cement is used in total knee arthroplasty and plays a significant role in the success of the procedure. Temperature variation is known to influence cement setting time in vitro. Our aim is to evaluate the relationship between ambient theatre temperature and cement setting time in vivo.MethodsTheatre temperature and cement setting time were prospectively recorded during 683 total knee arthroplasties over 8 years using a single cement and vacuum mixing system (Simplex with tobramycin). Setting time was defined as the time until a scalpel blade could not indent the cement surface.ResultsMean temperature was 18.92°C (SD 1.16) and setting time 13.08 min (SD 1.92). A moderate inverse relationship exists between ambient temperature and setting time (Pearson's R = −0.423); however, potential setting times within a given temperature range varied considerably (<19°C: 8–19.1 min, 19–20°C: 7–18 min and >20°C: 7.5–16 min), suggesting that temperature alone cannot reliably predict setting time.ConclusionOur data support the current understanding of bone cement properties in vivo and suggest that surgeons should be mindful in regards to unpredictable cement setting time and optimal theatre environment.
Aspiration and sclerotherapy of hydroceles and spermatoceles/epididymal cysts with 100% alcohol
Authors: Low Li Sian , Nair Shiva M. , Davies Adam J. W. , Akapita Teresa , Holmes Michael A. 
Published: October 2019

AbstractObjectiveTo evaluate the efficacy of aspiration and sclerotherapy with 100% alcohol for the primary treatment of benign scrotal cysts.MethodsFrom March 2014 to March 2018, 114 patients were identified who underwent their first aspiration and sclerotherapy procedure (80 hydroceles and 34 spermatoceles/epididymal cysts). The procedure was carried out in the outpatient clinic with local anaesthesia. A 16‐gauge IV catheter is used to puncture the sac under aseptic conditions. The volume of alcohol instilled was 10% of the aspirated volume (maximum of 50 mL). Patients were then observed in the waiting room and completed a questionnaire. Urology clinic follow up was scheduled at 6 weeks.ResultsAt follow up, 54 patients (67.5%) with hydroceles and 25 patients (73.5%) with spermatoceles/epididymal cysts had resolution after a single procedure. A second procedure was offered if fluid collection persisted, of which 71% of patients with hydroceles and 100% of patients with spermatoceles/epididymal cysts had a successful outcome. At a median of 31 months post‐initial procedure, the overall success rate, after at most two procedures, was 80% for hydroceles and 85% for spermatoceles/epididymal cysts. The complication rate was low (6%). Almost all patients were happy to undergo the procedure again, if needed. Persistence following aspiration and sclerotherapy were more likely to occur in younger patients (45.4 versus 61.2 years, P = 0.001). Persistence was not related to the volume of fluid aspirated.ConclusionAspiration and sclerotherapy with alcohol is a reliable, safe and effective technique for treatment of benign scrotal cysts.
The added benefit of transvaginal sonography in the clinical staging of cervical carcinoma
Authors: Goldberg Yael , Siegler Yoav , Segev Yakir , Mandel Rachel , Siegler Efraim , Auslander Ron , Lavie Ofer 
Published: October 2019

AbstractIntroductionPatients diagnosed with cervical cancer face several treatment options, depending on the physical examination and the imaging modality results. Transvaginal sonography (TVS) was proposed as an imaging option to determine local spread of cervical tumors, along with magnetic resonance imaging, also by recently released International Federation of Gynecology and Obstetrics recommendations. We examined whether combined data from physical examination, high‐detail TVS, and positron emission tomography with 18F‐labeled fluoro‐2‐deoxyglucose and computed tomography (18F‐FDG PET/CT) may contribute to triage efficiency of cervical cancer patients.Material and methodsThis is a retrospective study of consecutive women diagnosed with cervical cancer at the Carmel Health Center, Haifa, Israel, during 2010‐2015. Inclusion criteria were histology of cervical cancer and the availability of three modalities—a thorough physical examination, a high‐detail TVS, and positron emission tomography (PET) with 18F‐FDG and computed tomography (18F‐FDG PET/CT). End points were the possibility to predict local invasion to the parametrium and distant lymph node metastasis at the time of triage to surgery or chemoradiation.ResultsSeventy‐three patients with cervical cancer were evaluated. TVS correctly predicted no involvement of the parametrium for the 25 who had a postoperative pathological report. TVS measurement of tumor dimension was also matched by the pathological report in these cases. Only three patients were referred for adjuvant therapy according to postoperative pathology criteria. Among 43 women treated with a combination of chemotherapy and radiotherapy due to advanced disease, and with complete data, at least two modalities were congruent with chemoradiation for 33 (77%). Three patients (7%) were referred to chemoradiation due to TVS result alone.ConclusionsThe combination of high‐detail TVS, directed to predict tumor dimensions and local spread, performed by a trained operator, combined with 18F‐FDG PET/CT and physical examination, can assist in selecting optimal treatment for cervical cancer patients, thus avoiding unnecessary operations.
Rationalizing the management of pregnancies of unknown location: Diagnostic accuracy of human chorionic gonadotropin ratio‐based decision tree compared with the risk prediction model M4
Authors: Nadim Batool , Leonardi Mathew , Infante Fernando , Lattouf Ihab , Reid Shannon , Condous George 
Published: October 2019

AbstractIntroductionThe objective was to compare the diagnostic accuracy of the decision tree analysis prediction model P1, which incorporates the human chorionic gonadotropin (hCG) ratio (hCG 48 hours/hCG 0 hour), and risk prediction model M4 in the management of women with pregnancy of unknown location (PUL).Material and methodsA retrospective diagnostic accuracy study was performed on PUL data collected between August 2011 and September 2018. Women with a PUL were prospectively managed according to the P1 prediction model, which utilizes the hCG ratio and, if necessary, a day (D) 7 hCG. We compared the performance of P1 with the M4 model, a logistic regression mathematical model using initial hCG and hCG ratio, to classify PULs as low risk (failed PUL [failed] or intrauterine pregnancy) or high risk (ectopic pregnancy or persistent PUL). The reference standard was defined as the final PUL outcome.ResultsTransvaginal ultrasound was done in 3847 consecutive women for early pregnancy complications, 437 (11.3%) of whom were classified as PUL. Final analysis comprised 413 cases with complete data. Final PUL clinical outcomes were: 247 (59.8%) failed PUL, 94 (22.7%) intrauterine pregnancy, 49 (11.8%) ectopic pregnancy and 23 (5.5%) persistent PUL. The sensitivity of P1 and M4 in predicting high‐risk PUL were 81.9% (95% confidence interval [CI] 71.1‐90.0) and 80.6% (95% CI 69.5‐88.9), respectively. The specificities were 74.5% (95% CI 69.5‐79.1) and 75.6% (95% CI 70.7‐80.1), respectively.ConclusionsP1 and M4 performed similarly with respect to diagnostic accuracy in predicting PUL outcome. P1 needs to be externally validated.
Histological changes in refractory Helicobacter pylori infection and its relationship with increased levels of resistance to antibiotics and therapeutic regimens: one‐year follow‐up
Authors: Bayati Saeed , Alebouyeh Masoud , Amirmozafari Nour , Ebrahimi Daryani Nasser , Talebi Maliheh , Zali Mohammad Reza 
Published: October 2019

Eradication failure of Helicobacter pylori infection could play a causal role in progression of gastric disorders. In this study, infection with H. pylori was followed in gastric biopsies of symptomatic adult patients at two phases during 1‐year period. Analyses were done to show association of therapeutic regimens with the refractory infection, changes in sequence types (STs) and minimum inhibitory concentration (MIC) values, and progression of histopathological changes. Infection with H. pylori was confirmed in 32.3% (57/170) of the patients. Persistent infection with H. pylori was confirmed in 14 out of the 25 patients (56%) who participated at the second phase of the study. A difference between primary and secondary resistance rates to clarithromycin (49% vs 64.3%), metronidazole (76.36% vs 100%), and ciprofloxacin (45% vs 57.1%) was detected. Although the re‐emerged strains in patients with refractory infection did not show alteration in STs, their MIC50 values showed twofold increases for clarithromycin and ciprofloxacin. While ciprofloxacin containing regimens were more successful, failure of metronidazole containing regimens was detected in 77% of the patients. Consequently, inappropriate medication has an impact on refractory H. pylori infection, which could cause to a rise in resistance levels to antibiotics and progression of pathological disorders.
The first report on epidemiology of oropharyngeal Kingella kingae carriage in Scandinavian children: K. kingae carriage is very common in children attending day care facilities in Western Norway
Authors: Lillebo Kristine , Breistein Rebecca Irene , Aamas Jon Vangdal , Kommedal Oyvind 
Published: October 2019

Kingella kingae colonizes the upper airways in children and has been recognized as the most common causative agent of osteoarticular infections (OAI) in children below 4 years of age. This is the first Scandinavian study to investigate oropharyngeal K. kingae carriage in healthy children. From June 2015 to August 2016, we recruited 198 healthy children aged 11–14 months from routine consultations at health promotion centers in Hordaland County, Norway for a cross‐sectional study. After their parents had provided informed consent; demographic data were registered, and an oropharyngeal swab was collected. The oropharyngeal swab was analyzed with a real‐time PCR assay specific to K. kingae targeting the RTX toxin locus. Results showed an asymptomatic carriage rate of 12.6%. A striking and highly significant difference was observed between the children that had started attending day care facilities as compared with children still being at home (33.33% vs 8.5%; p < 0.001). K. kingae is prevalent in young children in Norway. This study emphasize that K. kingae should be considered an important etiological agent in OAI. Transmission seems to be facilitated in day care facilities. The correlation between oropharyngeal carriage and OAI needs to be further explored.
Gene expression profiling in the hippocampus of adolescent rats after chronic alcohol administration
Authors: Choi Mi Ran , Han Jasmin Sanghyun , Chai Young Gyu , Jin Yeung‐Bae , Lee Sang‐Rae , Kim Dai‐Jin 
Published: October 2019

AbstractIn South Korea, the average age of onset of alcohol drinking is 13.3 years and half of adolescents drink alcohol more than once a month; 8.45% of the Korean adolescent population become future high‐risk alcohol drinkers. Chronic alcohol abuse causes physical and psychiatric health problems such as alcohol addiction, liver disease, stroke and cognitive impairments. This study aimed to investigate the effect of alcohol on gene expression and their function in the hippocampus of adolescent rats. After chronic alcohol administration in male (control, n = 6; alcohol, n = 6) Sprague‐Dawley rats for 6 weeks, we analysed up‐ or down‐regulated genes using RNA‐sequencing technology. We found 83 genes more than 1.5‐fold up‐ or down‐regulated in the alcohol‐treated group. Among them, genes (Dnai1, Cfap206 and Dnah1) associated with cilium movement were up‐regulated in the alcohol‐treated group. Mlf1, related to cell cycle arrest, was also up‐regulated in the alcohol‐treated group. On the other hand, genes (Smad3 and Plk5) involved in negative regulation of cell proliferation were down‐regulated in the hippocampus by chronic alcohol administration. In addition, expression levels of genes associated with oxidative stress (Krt8 and Car3) and migration (Vim) were changed by chronic alcohol administration. These results pave a path for a better understanding of the neuromolecular mechanisms mediated by chronic alcohol exposure in the hippocampus of adolescents and negative pathology due to chronic alcohol abuse.
Pharmaceutical care for adult asthma patients: A controlled intervention one‐year follow‐up study
Authors: Khdour Maher R. , Elyan Sabrin O. , Hallak Hussein O. , Jarab Anan S. , Mukattash Tareq L. , Astal Amr 
Published: October 2019

AbstractAsthma is a clinical problem with social, psychological and economic burdens. To improve patient disease management, different education programmes have been developed. Challenges in asthma management may be partially attributed to non‐adherence or improper use of inhalers. This study aimed to implement and assess hospital‐based pharmaceutical care services for asthmatic patients. A 12‐month, single‐centre, randomized, controlled study was initiated in asthmatic adult patients who had been divided into either a control or intervention group. Patients in the control group received the usual care, and patients in the intervention group received patient counselling per study protocol that covered asthma knowledge, control, adherence to treatment and inhalation techniques. The main variables compared measurements at baseline with those at 6 and 12 months. A total of 192 patients completed the study protocol: 90 in the control group and 102 in the intervention group. The control group included 90 patients, and the intervention group included 102 patients. Over the course of the 12‐month follow‐up period, a significant difference was observed between intervention and control groups with respect to asthma control (38.2% vs 10.0%; P < .001), mean correct inhalation technique (confidence interval [CI]: 8.1, 7.8‐8.5 vs CI: 6.1; 5.6‐6.6; P = .01) and good medication adherence (60.7% vs 50.0%, P = .02). There were 34% and 25% decreases in emergency room visits and hospital admissions, respectively, in the intervention group compared to the control group. This study emphasizes the importance of patient counselling in asthma management and the significant contribution that the pharmacist's intervention can have on asthma control.
Childhood maltreatment and polygenic risk in bipolar disorders
Authors: Aas Monica , Bellivier Frank , Bettella Francesco , Henry Chantal , Gard Sebastien , Kahn Jean‐Pierre , Lagerberg Trine V. , Aminoff Sofie R. , Melle Ingrid , Leboyer Marion , Jamain Stéphane , Andreassen Ole A. , Etain Bruno 
Published: October 2019

AbstractBackgroundChildhood maltreatment is a well‐known risk factor for developing a more severe and complex form of bipolar disorders (BD). However, knowledge is scarce about the interactions between childhood maltreatment and underlying genetic vulnerability on the clinical expression of BD.MethodWe assigned a BD‐polygenic risk score (BD‐PRS), calculated from the Psychiatric Genomics Consortium, to each individual in a sample of 402 cases with BD. The lifetime clinical expression of BD was characterized using structured interviews and patients completed the Childhood Trauma Questionnaire (CTQ) to assess the severity of childhood maltreatment.ResultsCases who reported more severe childhood maltreatment had a lower BD‐PRS (rho = −0.12, P = .01), especially when considering emotional abuse (rho = −0.16, P = .001). An interaction between BD‐PRS and childhood maltreatment was observed for the risk of rapid cycling (P = .01). No further interactions between BD‐PRS and childhood maltreatment were observed for other clinical characteristics (age at onset, suicide attempts, number of mood episodes, mixed features, substance use disorders and psychotic symptoms).ConclusionOur study is the first to show that less genetic risk may be needed to develop a more unstable form of BD when exposed to childhood maltreatment. Our study supports childhood trauma as an independent risk factor for BD.
Efficacy and safety of cariprazine in bipolar I depression: A double‐blind, placebo‐controlled phase 3 study
Authors: Earley Willie R. , Burgess Maria V. , Khan Barbara , Rekeda Ludmyla , Suppes Trisha , Tohen Mauricio , Calabrese Joseph R. 
Published: October 2019

AbstractObjectiveTo assess the efficacy, safety, and tolerability of cariprazine in the treatment of the depressed phase of bipolar I disorder in adults (NCT02670538).MethodsIn this phase 3 double‐blind placebo‐controlled study, adult patients with bipolar I disorder according to the Diagnostic and Statistical Manual — 5th Edition criteria and a current depressive episode were randomized to placebo (n = 167), cariprazine 1.5 mg/day (n = 168) or cariprazine 3.0 mg/day (n = 158). Efficacy parameters were changes in the Montgomery‐Åsberg Depression Rating Scale (MADRS) total scores (primary) and Clinical Global Impressions — Severity (CGI‐S) scores (secondary) from baseline to Week 6 compared to placebo. A mixed‐model for repeated measures was used to estimate the least‐squares mean differences (LSMD); P‐values were adjusted for multiplicity. Adverse events (AEs), laboratory results, vital signs, and suicide risk were monitored.ResultsCariprazine 1.5 mg/day significantly reduced depressive symptoms on the primary (MADRS LSMD = −2.5; adjusted P = .0417) and secondary (CGI‐S LSMD = −0.3; adjusted P = .0417) efficacy parameters vs placebo; differences were not statistically significant for cariprazine 3.0 mg/day. Common treatment‐emergent AEs (≥5% in either cariprazine group and at least twice the incidence of placebo) were akathisia, restlessness, nausea, and fatigue. Mean metabolic parameter changes were low and generally comparable among groups; mean weight increases were ≤0.5 kg for all groups.ConclusionsCariprazine 1.5 mg/day significantly reduced depressive symptoms in adults with bipolar I depression compared to placebo, but differences were not significant for cariprazine 3.0 mg/day. The safety and tolerability profiles were similar to previous studies of cariprazine.
Relationship between serum lithium concentration and kidney damage in a preclinical model
Authors: Ossani Georgina P. , Uceda Ana M. , Lago Néstor R. , Martino Diego J. 
Published: October 2019

AbstractObjectivesThe aim of the present study was to assess whether there is a relationship between serum lithium concentrations and the magnitude of kidney damage in a preclinical model.MethodsThirty Wistar male rats were randomized into three groups: control group fed ad libitum powered standard diet for 3 months; and experimental groups fed ad libitum the same diet supplemented with 30 or 60 mmol/kg diet for 3 months (LowLi and HighLi groups respectively). Laboratory parameters were assessed at months 1 and 3 and histopathological changes were evaluated after 3 months.ResultsSerum lithium levels in experimental rats were within therapeutic range used in humans throughout the entire experiment. After 3 months of treatment, lithium levels were statistically higher in HighLi group. Rats of the LowLi group showed dilation of cortical tubules although with similar clearance of creatinine. Rats from the HighLi group had greater histopathological damage in addition to lower creatinine clearance than the other two groups.ConclusionsOur study suggests that during long‐term treatments, even with serum lithium levels within the therapeutic range used in humans, the risk of kidney damage could increase proportionally to the serum lithium concentration.