bluuebunny/crossref_metadata_2025_split huggingface dataset:
Retrospective comparison of first‐line adjuvant anthracycline vs metronomic‐based chemotherapy protocols in the treatment of stage I and II canine splenic haemangiosarcoma
Authors: Treggiari Elisabetta , Borrego Juan F. , Gramer Irina , Valenti Paola , Harper Aaron , Finotello Riccardo , Toni Cristina , Laomedonte Priscilla , Romanelli Giorgio 
Published: October 2019

AbstractSplenectomy followed by adjuvant chemotherapy is commonly used to treat canine splenic haemangiosarcoma (HSA), although it is unclear if different treatment protocols may have a similar efficacy. The objective of this retrospective study was to assess outcome in dogs with stage I and II splenic HSA treated with either first‐line adjuvant anthracycline (AC) or metronomic (MC)‐based chemotherapy protocols, by comparing median time to progression (TTP) and median survival time (MST). Medical records of nine institutions were searched for dogs diagnosed with stage I and II splenic HSA that underwent adjuvant treatment with AC‐ or MC‐based protocols following splenectomy. Patients treated with MC following AC were included in an additional group (AMC). Ninety‐three dogs were included: 50 in the AC group, 23 in the AMC group and 20 in the MC group. The overall MST was 200 days (range 47‐3352) and the overall median TTP was 185 days (range 37‐1236). The median TTP of stage I dogs was significantly longer compared to stage II dogs (338 vs 151 days, respectively, P = .028). When adjusting for treatment type, the MST was 154 days for the AC group (range 47‐3352 days), 338 days for the AMC group (range 79‐1623 days) and 225 days for the MC group (range 57‐911 days). The difference in MST and median TTP was not found to be statistically significant between treatment groups. This study suggests that adjuvant MC in canine splenic HSA may result in a similar outcome when compared to other treatment protocols. Further studies are warranted to confirm these findings.
The Effectiveness of Parenting Interventions on Psychosocial Adjustment in Parents of Children and Adolescents with Type 1 Diabetes: A Meta‐Analysis
Authors: Zhao Xiaolei , Ai Zhongping , Chen Yanhua , Wang Jiaxiang , Zou Shufang , Zheng Silin 
Published: October 2019

AbstractAimsParenting interventions in this review refer to supportive parenting training provided for parents or primary caregivers of children and adolescents with type 1 diabetes mellitus (T1DM). The review aimed to synthesize evidence about parenting interventions in parents or caregivers of children and adolescents with T1DM, and to evaluate the effect of interventions in reducing parents’ or caregivers’ psychological distress, helping them share diabetes management responsibility, seek social support, and improve their quality of life.MethodsWe searched PubMed, MEDLINE, EMBASE, CINAHL, Cochrane, and Web of Science from January 1978 to October 2018. Randomized controlled trials (RCTs) comparing an intervention group of parenting programs with a control group of usual care were included. The primary outcomes were stress, family responsibility and conflict, and social support. Secondary outcomes included other psychological index and quality of life. Pooled effect sizes of weighted mean difference (WMD) were calculated.ResultsA total of 17 RCTs with 962 participants met the inclusion criteria. Findings of the meta‐analysis showed parenting interventions could significantly reduce parents’ depression (WMD = −5.78, 95% CI: −6.23 to −5.33, I2 = 0%) and distress (WMD = −5.28, 95% CI: −10.31 to −.25, I2 = 0%), and help them ask for positive social support (WMD = .83, 95% CI: .03 to 1.64, I2 = 0%). No beneficial changes of other outcomes were found.Linking Evidence to ActionParents of children and adolescents with T1DM need support from the multidisciplinary team in health care, especially in mental health, family management of childhood diabetes, and social support. Parenting interventions may help parents reduce psychological distress and depression and assist them to ask for social support. Future research should include well‐designed RCTs with large samples, appropriate measures with clear definitions, objective assessment, and separation of effects on mothers and fathers.
Teaching ultrasound guided femoral nerve block in the emergency department
Authors: Pek Jen Heng , Chia Wen Jie Dennis , Kaliannan Sathya , Wong Yin Theng , Chan Kim Poh 
Published: October 2019

Aims: Patients with hip fracture are often not given adequate analgesia in the Emergency Department. Ultrasound guided femoral nerve block is an effective option but it is not commonly used due to limited experience, inadequate training and infrequent clinical exposure. We aimed to develop a workshop to bridge the current gap in the training of ultrasound guided femoral nerve block.Material and methods: A 3-hour workshop was developed in accordance to guidelines for education and training in ultrasound-guided regional anesthesia. The components included an online learning module for pre-reading, as well as team-based learning and simulation practice during the session. Evaluation of the participants was performed and feedbackof the course was collected.Results: The workshop was conducted successfully for a total of 30 participants. All participants achieved the minimum standard required. Across all domains, the mean scores for the workshop were more than 4.7 out of 5 on the Likert scale. Participants were satisfied with the workshop and would recommend it to a colleague.Conclusion: This workshop met its educational objectives and various principles of medical education were used effectively in the delivery of the content. Further research is necessary to demonstrate the impact of this educational effort on clinical practice and patient outcomes.
Conjunctival intraepithelial neoplasia and carcinoma: distinct clinical and histological features in relation to human papilloma virus status
Authors: Ramberg Ingvild , Toft Peter Bjerre , Georgsen Jeanette Bæhr , Siersma Volkert Dirk , Funding Mikkel , Jensen David Hebbelstrup , von Buchwald Christian , Heegaard Steffen 
Published: October 2019

AimsHuman papillomavirus (HPV) is considered a causative agent for the development of a broad range of human carcinomas. The role of HPV in the development of conjunctival intraepithelial neoplasia (CIN) and carcinoma (cSCC) remains unclear. The purpose of the present study was to investigate the HPV prevalence in a nationwide cohort and to describe clinical and histopathological features in relation to HPV status.MethodsAll cases of CIN and cSCC in Denmark from 1980 to 2016 were included. We combined p16 immunohistochemistry (IHC), RNA in situ hybridisation (RNA ISH) and HPV DNA PCR to detect HPV. The results were correlated to clinical and histopathological parameters.ResultsOne hundred twelve primary tumours and 33 recurrent tumours were included for HPV analysis. Twenty-four (21%) of the primary tumours were HPV positive by PCR. Eighteen of out 19 HPV-positive tumours were positive by RNA ISH. HPV16 was the most prevalent genotype (n=18, 75%). The patients with HPV-positive tumours were significantly younger (mean difference 11.5 years, 95% CI 5.2 to 17.9, p=0.0005) and had a higher recurrence compared with patients with HPV-negative tumours (HR 2.30, 95% CI 1.02 to 5.21, p=0.046). The HPV-positive tumours were associated with a positive p16 IHC and a non-keratinising morphology.ConclusionWe describe distinct clinical and histopathological features associated with HPV status in cSCC. The finding of transcriptionally active HPV in this material lends support to a causal role of HPV in a subset of cSCC.
Stress related disorders and subsequent risk of life threatening infections: population based sibling controlled cohort study
Authors: Song Huan , Fall Katja , Fang Fang , Erlendsdóttir Helga , Lu Donghao , Mataix-Cols David , Fernández de la Cruz Lorena , D’Onofrio Brian M. , Lichtenstein Paul , Gottfreðsson Magnús , Almqvist Catarina , Valdimarsdóttir Unnur A 
Published: October 2019

AbstractObjectiveTo assess whether severe psychiatric reactions to trauma and other adversities are associated with subsequent risk of life threatening infections.DesignPopulation and sibling matched cohort study.SettingSwedish population.Participants144 919 individuals with stress related disorders (post-traumatic stress disorder (PTSD), acute stress reaction, adjustment disorder, and other stress reactions) identified from 1987 to 2013 compared with 184 612 full siblings of individuals with a diagnosed stress related disorder and 1 449 190 matched individuals without such a diagnosis from the general population.Main outcome measuresA first inpatient or outpatient visit with a primary diagnosis of severe infections with high mortality rates (ie, sepsis, endocarditis, and meningitis or other central nervous system infections) from the Swedish National Patient Register, and deaths from these infections or infections of any origin from the Cause of Death Register. After controlling for multiple confounders, Cox models were used to estimate hazard ratios of these life threatening infections.ResultsThe average age at diagnosis of a stress related disorder was 37 years (55 541, 38.3% men). During a mean follow-up of eight years, the incidence of life threatening infections per 1000 person years was 2.9 in individuals with a stress related disorder, 1.7 in siblings without a diagnosis, and 1.3 in matched individuals without a diagnosis. Compared with full siblings without a diagnosis of a stress related disorder, individuals with such a diagnosis were at increased risk of life threatening infections (hazard ratio for any stress related disorder was 1.47 (95% confidence intervals1.37 to 1.58) and for PTSD was 1.92 (1.46 to 2.52)). Corresponding estimates in the population based analysis were similar (1.58 (1.51 to 1.65) for any stress related disorder, P=0.09 for difference between sibling and population based comparison, and 1.95 (1.66 to 2.28) for PTSD, P=0.92 for difference). Stress related disorders were associated with all studied life threatening infections, with the highest relative risk observed for meningitis (sibling based analysis 1.63 (1.23 to 2.16)) and endocarditis (1.57 (1.08 to 2.30)). Younger age at diagnosis of a stress related disorder and the presence of psychiatric comorbidity, especially substance use disorders, were associated with higher hazard ratios, whereas use of selective serotonin reuptake inhibitors in the first year after diagnosis of a stress related disorder was associated with attenuated hazard ratios.ConclusionIn the Swedish population, stress related disorders were associated with a subsequent risk of life threatening infections, after controlling for familial background and physical or psychiatric comorbidities.
Transmissibility and potential for disease progression of drug resistantMycobacterium tuberculosis: prospective cohort study
Authors: Becerra Mercedes C , Huang Chuan-Chin , Lecca Leonid , Bayona Jaime , Contreras Carmen , Calderon Roger , Yataco Rosa , Galea Jerome , Zhang Zibiao , Atwood Sidney , Cohen Ted , Mitnick Carole D , Farmer Paul , Murray Megan 
Published: October 2019

AbstractObjectiveTo measure the association between phenotypic drug resistance and the risk of tuberculosis infection and disease among household contacts of patients with pulmonary tuberculosis.Setting106 district health centers in Lima, Peru between September 2009 and September 2012.DesignProspective cohort study.Participants10 160 household contacts of 3339 index patients with tuberculosis were classified on the basis of the drug resistance profile of the patient: 6189 were exposed to drug susceptible strains ofMycobacterium tuberculosis, 1659 to strains resistant to isoniazid or rifampicin, and 1541 to strains that were multidrug resistant (resistant to isoniazid and rifampicin).Main outcome measuresTuberculosis infection (positive tuberculin skin test) and the incidence of active disease (diagnosed by positive sputum smear or chest radiograph) after 12 months of follow-up.ResultsHousehold contacts exposed to patients with multidrug resistant tuberculosis had an 8% (95% confidence interval 4% to 13%) higher risk of infection by the end of follow-up compared with household contacts of patients with drug sensitive tuberculosis. The relative hazard of incident tuberculosis disease did not differ among household contacts exposed to multidrug resistant tuberculosis and those exposed to drug sensitive tuberculosis (adjusted hazard ratio 1.28, 95% confidence interval 0.9 to 1.83).ConclusionHousehold contacts of patients with multidrug resistant tuberculosis were at higher risk of tuberculosis infection than contacts exposed to drug sensitive tuberculosis. The risk of developing tuberculosis disease did not differ among contacts in both groups. The evidence invites guideline producers to take action by targeting drug resistant and drug sensitive tuberculosis, such as early detection and effective treatment of infection and disease.Trial registrationClinicalTrials.govNCT00676754.
Comparative effectiveness of risk mitigation strategies to prevent fetal exposure to mycophenolate
Authors: Sarayani Amir , Albogami Yasser , Elkhider Mohannad , Hincapie-Castillo Juan M , Brumback Babette A , Winterstein Almut G 
Published: October 2019

BackgroundIn 2012, the US Food and Drug Administration approved a Risk Evaluation and Mitigation Strategy (REMS) programme including mandatory prescriber training and a patient/provider acknowledgement form to prevent fetal exposure to mycophenolate. Prior to the REMS, the teratogenic risk was solely mitigated via written information (black box warning, medication guide (MG period)). To date, there is no evidence on the effectiveness of the REMS.MethodsWe used a national private health insurance claims database to identify women aged 15–44 who filled ≥1 mycophenolate prescription. To compare fetal exposure during REMS with the MG period, we estimated the prevalence of pregnancy at treatment initiation in a pre/post comparison (analysis 1) and the rate of conception during treatment in a retrospective cohort study (analysis 2). Pregnancy episodes were measured based on diagnosis and procedure codes for pregnancy outcomes or prenatal screening. We used generalised estimating equation models with inverse probability of treatment weighting to calculate risk estimates.ResultsThe adjusted proportion of existing pregnancy per 1000 treatment initiations was 1.7 (95% CI 1.0 to 2.9) vs 4.1 (95% CI 3.2 to 5.4) during the REMS and MG period. The adjusted prevalence ratio and prevalence difference were 0.42 (95% CI 0.24 to 0.74) and −2.4 (95% CI −3.8 to −1.0), respectively. In analysis 2, the adjusted rate of conception was 12.5 (95% CI 8.9 to 17.6) vs 12.9 (95% CI 9.9 to 16.9) per 1000 years of mycophenolate exposure time in the REMS versus MG periods. The adjusted risk ratio and risk difference were 0.97 (95% CI 0.63 to 1.49) and −0.4 (95% CI −5.9 to 5.0), respectively. Sensitivity analyses on the estimated conception date demonstrated robustness of our findings.ConclusionWhile the REMS programme achieved less pregnancies at treatment initiation, it failed to prevent the onset of pregnancy during treatment. Enhanced approaches to ensure effective contraception during treatment should be considered.
What older people want from emergency care: a systematic review
Authors: van Oppen James David , Keillor Lisa , Mitchell Áine , Coats Timothy John , Conroy Simon Paul 
Published: October 2019

ObjectivesTo evaluate the expectations and preferred outcomes from emergency care among older people or their caregivers.MethodsA review protocol was registered. Medline, Embase, CINAHL, PsychInfo, BNI, AgeInfo and the Cochrane Database of Systematic Reviews were searched in their full date ranges to September 2018. Included articles were hand-searched for further citations. Citations were screened for (1) older people aged over 65 years, (2) ED settings and (3) reporting expectations or preferred outcomes for emergency care (as opposed to experience or satisfaction). Quality appraisal and data extraction of eligible articles were undertaken by two reviewers. Themes were synthesised through content analysis and described narratively.ResultsOlder people wished to have prompt waiting times, efficient care, clear communication and comfortable environments. They had additional and unique expectations for holistic care and support in decision-making. The ED provoked a sense of vulnerability among older people who were likely to have had frailty.ConclusionThe lack of dominant themes among included studies suggests that older people should be treated as individuals rather than a homogenous group. Establishing individuals’ preferred outcomes could improve person-centred care.PROSPERO registration numberCRD42018107050.
Justification of direct Sanger sequencing application for detection ofKITandPDGFRαgene mutations in formalin-fixed, paraffin-embedded samples from gastrointestinal stromal tumours
Authors: Kiwerska Katarzyna , Wroblewska Joanna , Kaluzna Apolonia , Marszalek Andrzej 
Published: October 2019

AimsThe knowledge concerning genetic background of gastrointestinal stromal tumours (GISTs) is well recognised, and the accurate detection ofKITandPDGFRαmutations is of great importance for the process of disease diagnosis and patient’s treatment. In this study, we compare the usefulness of real-time PCR-based techniques and Sanger sequencing to detect mutations of both genes in 41 formalin-fixed, paraffin-embedded GIST samples.MethodsThe analysis encompassed most frequently mutated coding regions ofKIT(exons 9, 11, 13 and 17) andPDGFRα(exons 12, 14 and 18) genes. The GIST Mutation Detection Kit (EntroGen), direct Sanger sequencing and high-resolution melting (HRM) analysis were applied to conduct the study.ResultsWith the application of EntroGen kit, we found alterations in 22/38 samples, with Sanger sequencing variants were found in 36/41 samples. The concordant results for both methods were observed in 19/38 samples. With subsequently applied HRM analysis, we have confirmed that all samples, except one, harboured alterations in the regions indicated by Sanger sequencing.ConclusionsOur results show that in GIST samples, carrying a broad spectrum of deletions, Sanger sequencing is a better, more sensitive method for mutational analysis ofKITandPDGFRαgenes.
Left transradial access for cerebral angiography
Authors: Barros Guilherme , Bass David I , Osbun Joshua W , Chen Stephanie H , Brunet Marie-Christine , Peterson Eric C , Walker Melanie , Kelly Cory M , Levitt Michael R 
Published: October 2019

IntroductionTransradial access is increasingly used among neurointerventionalists as an alternative to the transfemoral route. Currently available data, building on the interventional cardiology experience, primarily focus on right radial access. However, there are clinical scenarios when left-sided access may be indicated. The purpose of this study was to evaluate the technical feasibility of left transradial access to cerebral angiography across three institutions.MethodsA retrospective chart review was performed for patients who underwent cerebral angiography accessed via the left radial artery at three institutions between January 2018 and July 2019. The outcome variables studied were successful catheterization, vascular complications, and fluoroscopic time.ResultsNineteen patients underwent a total of 25 cerebral angiograms via left transradial access for cerebral aneurysms (n=15), basilar occlusion (n=1), carotid stenosis (n=1), arteriovenous malformation (n=1), and cervical neurofibroma (n=1). There were 12 diagnostic angiograms and 13 interventional angiograms. The left transradial approach was chosen due to left vertebrobasilar pathology (n=22), right subclavian stenosis (n=2), and previous right arm amputation (n=1). There was one instance of radial artery spasm, which resolved after catheter removal, and one conversion to transfemoral access in an interventional case due to lack of distal catheter support. There were no procedural complications.ConclusionsLeft transradial access in diagnostic and interventional cerebral angiography is a technically feasible, safe, and an effective alternative when indicated, and may be preferable for situations in which pathology locations or anatomic limitations preclude right-sided radial access.
The serratus plane block for postoperative analgesia in breast and thoracic surgery: a systematic review and meta-analysis
Authors: Chong Matthew , Berbenetz Nicolas , Kumar Kamal , Lin Cheng 
Published: October 2019

Background and objectives
The serratus plane block (SPB) is a novel chest wall interfascial plane block. Its analgesic efficacy compared with non-block care and paravertebral block (PVB) is unestablished.

Methods
We conducted a random-effects meta-analysis of randomized controlled trials (RCTs) recruiting adult surgical patients that compared a SPB to non-block care or PVB for postoperative analgesia. Visual analog scale pain scores were the primary outcome. Database sources were Medline, Embase, the Cochrane Library, and Google Scholar searched up to July 29, 2019 without language restriction. Risk of bias was assessed using Cochrane methodology.

Results

Nineteen RCTs that comprised 1260 patients were included. Six trials involved thoracic surgery patients and 13 studied breast surgery patients. SPB reduced pain scores 0 hour postoperatively (−1.62 cm; 99% CI −2.43 to −0.81; p<0.001; I
2
=92%), at 2–4 hours (−1.29 cm; 99% CI −2.08 to −0.49; p<0.001; I
2
=92%), at 6 hours (−1.69 cm; 99% CI −3.19 to −0.20; p=0.004; I
2
=99%), and up to 24 hours compared with non-block care. SPB also prolonged the time to first analgesic request (193.2 min; 95% CI 7.2 to 379.2 min; p=0.04; I
2
=99%), reduced 24-hour postoperative opioid consumption (−11.27 mg of IV morphine equivalent; −17.36 to −5.18 mg; p<0.001), and reduced postoperative nausea and vomiting (RR 0.51; 95% CI 0.38 to 0.68; p<0.001; I
2
=12%). In contrast, no meaningful differences were detected in any of the outcomes for the SPB versus PVB data.

Conclusions
SPB reduced postoperative pain scores (Grading of Recommendations Assessment, Development, and Evaluation rating: low; due to heterogeneity and deficiencies in blinding) in breast and thoracic surgery patients compared with non-block care. Based on five trials only, SPB was not appreciably different from PVB.