bluuebunny/crossref_metadata_2025_split huggingface dataset:
Otomycosis With Tympanic Membrane Perforation: A Review of the Literature
Authors: Koltsidopoulos Petros , Skoulakis Charalampos 
Published: May 2019

Objective: The purpose of the present study was to assess the rate of tympanic membrane perforation in patients with otomycosis and to discuss the literature regarding the difficulties in managing this condition. Data Sources: Literature review from 1999 to 2019, Web of Science, PubMed, and Medline. Study Selection: We searched for eligible articles concerning the clinical entity of tympanic membrane perforation secondary to otomycosis. Case series and clinical trials were the types of articles included for this review. Data Extraction: All the articles described in the study selection were used for this review. Data Synthesis: Statistical techniques were not used. Conclusion: Based on the available literature, it seems that tympanic membrane perforation secondary to otomycosis is not uncommon. The presence of this complication is associated with 2 problems: Antimycotic solutions are irritant to middle ear and may be ototoxic to the cochlea. Although most cases of fungus caused tympanic membrane (TM) perforation resolve with proper medical treatment, in a few patients a tympanoplasty may be required.
When virtue is not an option: Decision making in unhealthy food choices
Authors: Trabold Apadula Lauren , Martins Chrissy M 
Published: May 2019

Background: Health conscious consumers often make choices from constrained sets of food options, such as a restaurant menu, in which healthy options may not be present. Aim: The aim of this research was to examine how different decision strategies, such as selection versus rejection, influence the food option chosen when a choice set is restricted to unhealthy options. The mediating role of anticipated guilt was also explored. Methods: An experiment was conducted using a hypothetical choice scenario, in which participants were randomly assigned to a decision making strategy (select versus reject), health objective (diet versus indulge), and relative preference for the options (choice between two preferred options versus one preferred and one non-preferred option) was manipulated. Results: When using a selection strategy, consumers are more likely to choose their most preferred option, regardless of their health objectives, but when using a rejection strategy, health conscious consumers are more likely to avoid their most preferred option and consume a lesser liked alternative. Further, this effect is driven by reduced feelings of guilt. Important boundary conditions include consumer preference for the food options, as health conscious consumers will not reject their favorite option if they do not like the alternative. Conclusions: Decision making strategy influences health conscious consumers’ choices between unhealthy food options.
Minimally invasive open reduction combined with proximal femoral hollow locking plate in the treatment of Pauwels type III femoral neck fracture
Authors: Wang Gang , Tang Yong , Wang Bin , Yang Huilin 
Published: May 2019

Objective This study was performed to investigate the clinical effects of minimally invasive open reduction and internal fixation with a proximal femoral hollow locking plate on Pauwels type III femoral neck fractures. Methods The clinical data of 45 patients aged 32.0 ± 8.1 years (range, 19–45 years) with Pauwels type III femoral neck fractures treated from March 2012 to August 2016 were retrospectively analyzed. All patients underwent anterolateral minimally invasive open reduction and proximal femoral hollow locking plate fixation of the hip joint. Garden’s index was used to evaluate the quality of fracture reduction. Complications and fracture healing were recorded in all patients. At the last follow-up, the functional outcome was recorded using the Harris hip score. Results No complications such as femoral neck shortening, internal fixation loosening, or refracture occurred. However, three patients required reoperation (one with nonunion and two with femoral head necrosis). At the last follow-up, the mean Harris hip score was 92.1 ± 4.5 (range, 76–98). The rate of excellent and good Harris hip scores was 93.3%. Conclusion The herein-described strategy for Pauwels type III femoral neck fractures is advantageous in terms of high reduction quality, firm fixation, and prevention of neck shortening.
The biological clock in cluster headache: A review and hypothesis
Authors: Naber Willemijn C , Fronczek Rolf , Haan Joost , Doesborg Patty , Colwell Christopher S , Ferrari Michel D , Meijer Johanna H 
Published: May 2019

Objective To review and discuss the putative role of light, sleep, and the biological clock in cluster headache. Discussion Cluster headache attacks are believed to be modulated in the hypothalamus; moreover, the severe pain and typical autonomic cranial features associated with cluster headache are caused by abnormal activity of the trigeminal-autonomic reflex. The temporal pattern of cluster headache attacks suggests involvement of the biological clock, and the seasonal pattern is influenced by the number of daylight hours. Although sleep is often reported as a trigger for cluster headache attacks, to date no clear correlation has been established between these attacks and sleep stage. Conclusions We hypothesize that light, sleep, and the biological clock can change the brain’s state, thereby lowering the threshold for activating the trigeminal-autonomic reflex, resulting in a cluster headache attack. Understanding the mechanisms that contribute to the daily and seasonal fluctuations in cluster headache attacks may provide new therapeutic targets.
Secondary Meniscal Tears in Patients With Anterior Cruciate Ligament Injury: Relationship Among Operative Management, Osteoarthritis, and Arthroplasty at 18-Year Mean Follow-up
Authors: Hagmeijer Michella H. , Hevesi Mario , Desai Vishal S. , Sanders Thomas L. , Camp Christopher L. , Hewett Timothy E. , Stuart Michael J. , Saris Daniel B.F. , Krych Aaron J. 
Published: May 2019

Background: Anterior cruciate ligament (ACL) injury is one of the most frequent orthopaedic injuries and reasons for time loss in sports and carries significant implications, including posttraumatic osteoarthritis (OA). Instability associated with ACL injury has been linked to the development of secondary meniscal tears (defined as tears that develop after the initial ACL injury). To date, no study has examined secondary meniscal tears after ACL injury and their effect on OA and arthroplasty risk. Purpose: To describe the rates and natural history of secondary meniscal tears after ACL injury and to determine the effect of meniscal tear treatment on the development of OA and conversion to total knee arthroplasty (TKA). Study Design: Cohort study; Level of evidence, 3. Methods: A geographic database of >500,000 patients was reviewed to identify patients with primary ACL injuries between January 1, 1990, and December 31, 2005. Information was collected with regard to ACL injury treatment, rates/characteristics of the secondary meniscal tears, and outcomes, including development of OA and conversion to TKA. Kaplan-Meier and adjusted multivariate survival analyses were performed to test for the effect of meniscal treatment on survivorship free of OA and TKA. Results: Of 1398 primary ACL injuries, the overall rate of secondary meniscal tears was 16%. Significantly lower rates of secondary meniscal tears were noted among patients undergoing acute ACL reconstruction within 6 months (7%) as compared with patients with delayed ACL reconstruction (33%, P < .01) and nonoperative ACL management (19%, P < .01). Of the 235 secondary meniscal tears identified (196 patients), 11.5% underwent repair, 73% partial meniscectomy, and 16% were treated nonoperatively. Tears were most often medial in location (77%) and complex in morphology (56% of medial tears, 54% of lateral tears). At the time of final follow-up, no patient undergoing repair of a secondary meniscal tear (0%) underwent TKA, as opposed to 10.9% undergoing meniscectomy and 6.1% receiving nonoperative treatment ( P = .28). Conclusion: Secondary meniscal tears after ACL injury are most common among patients undergoing delayed surgical or nonoperative treatment of their primary ACL injuries. Secondary tears often present as complex tears of the medial meniscus and result in high rates of partial meniscectomy.
Safety and efficacy of direct oral anticoagulants for venous thromboembolism and stroke prophylaxis in patients with hematologic malignancies
Authors: Kim Stephanie , Namba Jennifer , Goodman Aaron M , Nguyen Thi , Saunders Ila M 
Published: May 2019

Purpose Low-molecular-weight heparins are currently the recommended antithrombotic therapy for treatment and prevention of malignancy-related venous thromboembolism. Currently, the evidence evaluating direct oral anticoagulants versus low-molecular-weight heparins or a vitamin K antagonist in cancer patients with hematologic malignancies is limited. We evaluated the safety and efficacy of direct oral anticoagulants for venous thromboembolism treatment or stroke prevention for non-valvular atrial fibrillation in patients with hematologic malignancies. Methods This was a retrospective evaluation of adult patients with hematologic malignancies who received at least one dose of the Food and Drug Administration-approved direct oral anticoagulant for venous thromboembolism treatment or stroke prevention. We determined the frequency of major bleeding events, non-major bleeding events, stroke, systemic embolism, appropriateness of initial direct oral anticoagulant doses, holding practices prior to procedures, and the rate of all-cause mortality. An analysis was also performed to compare the incidence of bleeding between patients with a history of hematopoietic stem cell transplant to non-transplant patients. Results A total of 103 patients were identified, with the majority of patients receiving rivaroxaban for venous thromboembolism treatment. Major bleeding events occurred in four patients and no fatal bleeding events occurred. Non-major bleeding occurred in 29 patients, most commonly epistaxis and bruising. Two patients experienced a systemic embolism while on direct oral anticoagulant therapy. Conclusion Direct oral anticoagulants may be a safe and effective alternative for anticoagulation therapy in patients with hematologic malignancies. However, larger prospective studies comparing direct oral anticoagulants to low-molecular-weight heparins or vitamin K antagonists are warranted to compare efficacy and safety outcomes in this patient population.
Late onset left ventricular dysfunction and cardiomyopathy induced with ibrutinib
Authors: Gülsaran Sedanur K , Baysal Mehmet , Demirci Ufuk , Baş Volkan , Kirkizlar Hakkı O , Umit Elif , Demir Ahmet M 
Published: May 2019

Introduction Ibrutinib, an oral inhibitor of Bruton’s tyrosine kinase, has altered the treatment perspective of chronic lymphocytic leukemia and showed modest activity against several types of non-Hodgkin’s lymphomas. According to phase studies and real-world data, reported serious adverse effects included atrial fibrillation, diarrhea, and bleeding diathesis. However, heart failure was not reported to be a probable adverse effect linked with ibrutinib. Case report In this paper, we present a 66-year-old female chronic lymphocytic leukemia patient who developed significant and symptomatic left ventricular dysfunction at the 13th month of ibrutinib treatment. Management and outcome Following cessation of ibrutinib, ejection fraction and clinical findings of the left ventricular dysfunction alleviated. Discussion Although the use of ibrutinib is generally well tolerated, cardiac functions should be monitored occasionally in all patients.
Arteriovenous access practices in Australian and New Zealand dialysis units
Authors: Smyth Brendan , Kotwal Sradha , Gallagher Martin , Gray Nicholas A , Polkinghorne Kevan R 
Published: May 2019

Background: The creation and maintenance of dialysis vascular access is associated with significant morbidity. Structured management pathways can reduce this morbidity, yet practice patterns in Australia and New Zealand are not known. We aimed to describe the arteriovenous access practices in dialysis units in Australia and New Zealand. Methods: An online survey comprising 51 questions was completed by representatives from dialysis units from both countries. In addition to descriptive analysis, responses were compared between units inside and outside of major cities. Results: Of 64 contacted units, 48 (75%) responded (Australia 43, New Zealand 5), representing 38% of dialysis units in Australia and New Zealand. While 94% of units provided pre-dialysis education, only 60% reported a structured pre-dialysis pathway and 69% had a dedicated vascular access nurse. Most units routinely monitored fistula/graft function using flow rate measurement (73%) or recirculation studies (63%). A minority used routine ultrasound (35%). Thrombectomy, fistuloplasty and peritoneal dialysis catheter insertion were rarely performed by nephrologists (4%, 4% and 17% of units, respectively). Units outside of a major city were less likely to have access to a local vascular access surgeon (6/13 (46%) vs 35/35 (100%), P < 0.001). There were no other significant differences between units on the basis of location. Conclusion: Much variation exists in unit management of arteriovenous access. Structured pre-dialysis pathways and dedicated vascular access nurses may be underutilised in Australia and New Zealand. The use of regular access blood flow measurement and ultrasound is common in both countries despite a lack of data supporting its effectiveness. There is room for both practice improvement and a need for further evidence to ensure optimal arteriovenous access care.
A proof-of-concept application of a novel scoring approach for personalized medicine in multiple sclerosis
Authors: Pellegrini Fabio , Copetti Massimiliano , Bovis Francesca , Cheng David , Hyde Robert , de Moor Carl , Kieseier Bernd C , Sormani Maria Pia 
Published: May 2019

Background: Stratified medicine methodologies based on subgroup analyses are often insufficiently powered. More powerful personalized medicine approaches are based on continuous scores. Objective: We deployed a patient-specific continuous score predicting treatment response in patients with relapsing-remitting multiple sclerosis (RRMS). Methods: Data from two independent randomized controlled trials (RCTs) were used to build and validate an individual treatment response (ITR) score, regressing annualized relapse rates (ARRs) on a set of baseline predictors. Results: The ITR score for the combined treatment groups versus placebo detected differential clinical response in both RCTs. High responders in one RCT had a cross-validated ARR ratio of 0.29 (95% confidence interval (CI) = 0.13–0.55) versus 0.62 (95% CI = 0.47–0.83) for all other responders (heterogeneity p = 0.038) and were validated in the other RCT, with the corresponding ARR ratios of 0.31 (95% CI = 0.18–0.56) and 0.61 (95% CI = 0.47–0.79; heterogeneity p = 0.036). The strongest treatment effect modifiers were the Short Form-36 Physical Component Summary, age, Visual Function Test 2.5%, prior MS treatment and Expanded Disability Status Scale. Conclusion: Our modelling strategy detects and validates an ITR score and opens up avenues for building treatment response calculators that are also applicable in routine clinical practice.
Reproductive history of the Danish multiple sclerosis population: A register-based study
Authors: Moberg Julie Yoon , Laursen Bjarne , Thygesen Lau Caspar , Magyari Melinda 
Published: May 2019

Background: A diagnosis of multiple sclerosis (MS) may impact the choice of parenthood. Objective: To investigate the number of live births, abortions and ectopic pregnancies among persons with MS. Methods: From the Danish Multiple Sclerosis Registry, we extracted data from all persons diagnosed with MS from 1960 to 1996 and matched each MS person with four reference persons. We used a negative binomial regression model for the live births and Poisson regression model for abortions and ectopic pregnancies. The total fertility rate (TFR) during 1960–2016 and the annual number of live births in the MS population were analysed. Results: Persons with MS had fewer children than reference persons. Fewer women with MS had elective abortions after diagnosis (incidence rate ratio (IRR) = 0.88; 95% confidence interval (CI) = 0.78–1.00) than reference persons. There was no difference regarding the number of elective abortions, spontaneous abortions or ectopic pregnancies after onset. The TFR was lower for women with MS than for reference persons, and the number of annual live births by MS persons increased during 1960–2016. Conclusion: MS seems to considerably impact reproductive choices, especially after clinical diagnosis, resulting in the MS population having fewer children than the general population.
Should frequent MRI monitoring be performed in natalizumab-treated MS patients? A contribution to a recent debate
Authors: Scarpazza Cristina , Signori Alessio , Cosottini Mirco , Sormani Maria Pia , Gerevini Simonetta , Capra Ruggero 
Published: May 2019

Background: Brain magnetic resonance imaging (MRI) is the most effective surveillance tool for the detection of asymptomatic progressive multifocal leukoencephalopathy (PML). However, the optimal frequency for routine MRI surveillance is under-investigated. Objective: To understand whether, upon their first MRI appearance, PML lesions present a difference in volume when comparing patients who frequently underwent MRI surveillance (3/4 months) with those who were assessed at longer intervals (6/12 months) and to understand the impact of the volume of lesions on clinical outcome. Methods: The data of patients included in the Italian PML cohort were retrospectively analysed. Patients who had all the pre-diagnostic MRI scans available ( n = 37) were included. The volume of PML lesion was calculated by manually outlining the PML lesion. Results: Compared with patients who underwent MRI examination at least every 4 months, patients who were assessed less frequently had a lesion of significantly higher volume (median: 2567 (883–3583) vs. 664 mm3 (392–963) p = 0.006) and suffered a higher rate of disability (median: 2.25 expanded disability status scale points (–2.5 to 8) vs. 0.5 (–1 to 2.5) p = 0.004). Conclusion: The positive clinical outcome of patients undergoing frequent MRI surveillance and the small volume of the PML lesion upon first appearance justify a frequent surveillance using MRI in patients at high risk of PML.
A study of community mortality at the weekend versus during the week. Is there a correlation with in-hospital mortality?
Authors: Beaumont Oliver , Willett Matthew , Dutton Susan , Vadher Karen 
Published: May 2019

Objective A so-called ‘weekend effect’ has been described in which mortality among those admitted to hospital at a weekend is higher than among those admitted on weekdays. The causes for the weekend effect remain unclear. This study examined patterns of community mortality to explore whether a shift from the community to hospital may account for observed differences in hospital mortality rates across the week. Methods The annual number of deaths in the community was compared to that in hospitals in England and Wales during 2012 to 2014 using data from the Office for National Statistics. Analyses included the mean annual deaths, by age group and by cause of death in the community and hospital and comparison of the proportion of deaths on each day of the week to the expected number of deaths. Results The observed and expected total number of deaths in the community were broadly similar on the weekend and weekday ( P = 0.386). There was no difference between observed and expected rates when comparing average daily weekday deaths to the average daily weekend deaths in the community ( P = 0.434). In addition, there was no difference in the proportion of deaths in the community on the weekend when compared to the expected rate for those aged under 65, 75–84 and 85+ years. People were more likely to die on the weekend (rather than the weekday) in the community from neoplasms ( P = 0.009) but less likely to die from cardiovascular disease ( P = 0.012) or those aged 65–74 years. Conclusion We found no evidence of a significant difference in the risk of dying in the community at the weekend compared to during the week, or between the observed and expected deaths on each day. The lower risk of dying in the community at the weekend from cardiovascular diseases and among those aged 65–74 years and the higher risk for neoplasms are of interest but marginal. We found no evidence of a shift in deaths from the community to hospital at weekends.
Policy and practice supports for young people transitioning from out-of-home care: An analysis of six recent inquiries in Australia
Authors: Mendes Philip , McCurdy Samone 
Published: May 2019

Summary Government and parliamentary inquiries into child protection have historically exerted a significant impact on policy and practice reform. Yet to date, there has been no analysis of the impact of such inquiries on programme and service supports for young people transitioning from out-of-home care (often termed leaving care). This article uses a content analysis methodology to critically examine and compare the findings of six recent Australian child protection inquiries (five at state and territory level and one Commonwealth) in relation to their discrete sections on leaving care. Attention is drawn to how the policy issue is framed including key terminology, the major concerns identified, the local and international research evidence cited and the principal sources of information including whether or not priority is given to the lived experience of care leavers. Findings All six inquiries identified major limitations in leaving care legislation, policy and practice including poor outcomes in key areas such as housing, education and employment. There was a consensus that post-18 assistance should be expanded, and most of the reports agreed that greater attention should be paid to the specific cultural needs of the large number of Indigenous care leavers. Applications Care leavers universally are a vulnerable group; leaving care policy should be informed by the lived experience and expertise of care leavers; governments have a responsibility to provide ongoing supports beyond 18 years of age, particularly in areas such as housing and education, training and employment