bluuebunny/crossref_metadata_2025_split huggingface dataset:
Concomitant use of capecitabine and proton pump inhibitors – Is it safe?
Authors: Cheng Vian , Lemos Mario de , Hunter Nicole , Badry Nadine , Lemos Jane de 
Published: May 2019

Background Capecitabine is a commonly used oral chemotherapy agent. Recent data suggest that concurrent use of proton pump inhibitors may reduce the efficacy of capecitabine by decreasing its absorption through increased gastric pH. Since proton pump inhibitors are widely used, we evaluated the supportive evidence for the probability of occurrence and potential seriousness of this drug interaction. Methods The probability of occurrence was evaluated based on the clinical, pharmacokinetic and in vitro evidence using the Drug Interaction Probability Scale. The possibility of seriousness was assessed based on the potential impact on the therapeutic intent of capecitabine therapy. Results The probability of occurrence of the interaction is doubtful. Clinical findings from two retrospective post hoc analyses showed inconsistent trends towards reduced survival. Pharmacokinetics studies found no significant decrease in systemic capecitabine level with concurrent gastric acid suppression with antacid or food intake. In vitro data do not support the proposed mechanism of reduced capecitabine absorption due to increased gastric pH. The possibility of seriousness varies depending on the treatment intent of capecitabine therapy. The most and least serious possible outcome would be reduced possibility of cure or survival and symptom control, respectively. Conclusion Although the possible outcome may be serious, the probability of interaction between capecitabine and proton pump inhibitors is doubtful. Therefore, we suggest that intervention should be limited to minimal change to existing therapy plan. This may include routinely ascertaining the need for proton pump inhibitor use. Alternate acid suppressing agents may be considered based on the therapeutic intent of capecitabine therapy.
The Odds of Stage IV Melanoma Diagnoses Based on Socioeconomic Factors
Authors: Dick Mary , Aurit Sarah , Silberstein Peter 
Published: May 2019

Background: When diagnosed at stage 0-I, melanoma has a 5-year survival rate of 92% to 100% in comparison with stage IV, which has a 5-year survival rate of 15% to 20%. Objective: The objective of this article is to identify what socioeconomic and demographic factors were associated with increased odds in receiving a delayed melanoma diagnosis. Methods: This study analyzed the odds of 108,628 patients from the National Cancer Database who were diagnosed between 2004 and 2012 with American Joint Committee on Cancer stage 0-I and stage IV based on race, sex, insurance type, income, facility type, and education. Results: We identified significantly ( P < .05) increased odds of stage IV primary melanoma diagnosis in those who had nonprivate insurance, including Medicare (odds ratio [OR] = 1.31, 95% confidence interval [CI]: 1.19-1.45), other government insurance (OR = 2.19, 95% CI: 1.61-2.98), Medicaid (OR = 6.97, 95% CI: 5.98-8.13), or no insurance (OR = 5.10, 95% CI: 4.41-5.91). Increased odds of late-stage melanoma were also associated with male sex (OR = 1.46, 95% CI: 1.36-1.57), race and ethnicity other than non-Hispanic white such as Hispanic whites (OR = 1.49, 95% CI: 1.15-1.92) or African Americans (OR=4.81, 95% CI: 3.75-6.18), and who had decreased education (OR = 1.19, 95% CI: 1.09-1.30). There was not a significant increase in odds of late-stage melanoma in patients from areas with the lowest levels of income compared with areas of highest income. Conclusions: Certain socioeconomic and demographic factors are associated with odds of a later-stage melanoma diagnosis.
Measures of general and abdominal obesity and disability severity in a large population of people with multiple sclerosis
Authors: Fitzgerald Kathryn C , Salter Amber , Tyry Tuula , Fox Robert J , Cutter Gary , Marrie Ruth Ann 
Published: May 2019

Background: Metabolic comorbidity is overrepresented in people with multiple sclerosis (MS) and is associated with adverse MS outcomes. Excess visceral adiposity, approximated using waist circumference (WC), is a risk factor for metabolic comorbidity and predicts poorer outcomes in other neurologic diseases. Objective: To evaluate the association between WC and clinical and disease characteristics in people with MS. Methods: North American Research Committee on MS (NARCOMS) registry participants reported height and weight (used to calculate body mass index (BMI)) and were mailed a tape measure with instructions to measure WC. We considered WC continuously and used cut-points derived from the abdominal obesity criteria for the metabolic syndrome (men: WC ⩾ 40 in; women: WC ⩾ 35 in). We assessed the association between WC and disability (Patient-Determined Disease Steps) and symptom severity (validated scales) using multivariable-adjusted multinomial models. Results: Of 6367 responders with MS, we included 5832 (92%). Of these, 3181 (55%) reported WC meeting criteria for the abdominal obesity component of metabolic syndrome. In multivariable models adjusting for overall obesity status, WC was associated with 47% increased odds of severe versus mild disability (odds ratio (OR): 1.47; 95% confidence interval (CI): 1.22–1.78). Conclusions: Increased WC is associated with more severe disability, even after adjusting for overall obesity in this large cross-sectional survey.
Predictors of treatment outcome in patients with paediatric onset multiple sclerosis
Authors: Kopp Tine Iskov , Blinkenberg Morten , Chalmer Thor Ameri , Petersen Thor , Ravnborg Mads Henrik , Soelberg Sørensen Per , Magyari Melinda 
Published: May 2019

Background: Disease-modifying therapies (DMT) are increasingly used for children with multiple sclerosis (MS) even though most double-blinded randomized controlled trials evaluating efficacy, safety and dosing strategy of a specific drug have included adults. Objective: To investigate predictors of treatment outcomes in patients with paediatric onset MS treated with DMTs. Methods: Prospective cohort study from the nationwide Danish Multiple Sclerosis Registry including all patients with a MS diagnosis who initiated treatment with an approved DMT before the age of 18 ( N = 137) and followed until their 25th birthday. Selected baseline predictors were tested in univariate and multivariate regression models. Results: Multivariate analyses showed that being female and having disease duration for 2 or more years prior to DMT initiation predicted a higher relapse rate. In addition, disease duration and baseline expanded disability status scale (EDSS) predicted both confirmed disability worsening and improvement. We found no difference in treatment outcome between children with MS onset before and after the age of 13 years. Conclusions: The efficacy of DMT in paediatric onset MS patients is comparable to that seen in adult onset MS patients. Earlier treatment start is associated with a beneficial prognosis in the paediatric cohort.
Illness perceptions of youths with functional disorders and their parents: An interpretative phenomenological analysis study
Authors: Hulgaard Ditte Roth , Rask Charlotte Ulrikka , Risor Mette Bech , Dehlholm Gitte 
Published: May 2019

Background: Functional disorders, defined as disorders with no clear medical explanation, are common and impose a significant burden on youths, their families, healthcare services and society as a whole. Currently, the literature describes resistance among patients and their families towards psychological symptom explanations and treatments. More knowledge about the thoughts and understandings of youths with functional disorders and their parents is needed. The aim of this study was to explore the illness perceptions of youths with severe functional disorders and their parents. Methods: A qualitative interview study using interpretative phenomenological analyses. The study included 11 youths aged 11–15 years with functional disorders and their parents, where interviews were performed at the point of referral from a somatic to a psychiatric treatment setting. Results: Analyses identified three main themes. Themes 1(Ascribing identity to the disorder) and 2 (Monocausal explanations) explore key elements of the participants’ illness perceptions, and theme 3 (Mutable illness perceptions) explores how illness perceptions are influenced by experiences from healthcare encounters. Conclusions: The label ‘functional disorder’ was poorly integrated in the illness perceptions of the youths and their parents. Participants used a monocausal and typically physical explanation rather than a multicausal biopsychosocial explanation for their symptoms.
Trauma team leaders in Canada: A national survey
Authors: Belhumeur Vincent , Malo Christian , Nadeau Alexandra , Hegg-Deloye Sandrine , Gagné Anne-Julie , Émond Marcel 
Published: May 2019

Introduction The availability, composition and activation criteria for trauma teams vary across different health care systems, but little is known about these features in the Canadian health system. The aim of this study is to provide a description of the current trauma team available in Level 1 and 2 centres across Canada. Methods In 2017, using a modified Dillman technique, a survey was sent to 210 health professionals across all Canadian trauma care facilities, including questions that focused on (1) the presence and the composition of a trauma team, (2) the established criteria to activate this team and (3) the initial patient care. Results Overall, 107 (57%) completed surveys were received. Only 22 (11.7%) were from Level 1 or 2 centre and considered for compilation. Seventeen respondents have a trauma team in their centre, and they all shared their criteria for activating their team (1–27 different indications). The suspected injuries, the judgment of the emergency physician, the systolic blood pressure, the Glasgow Coma Score and the respiratory rate were the most frequently mentioned items. In the presence of a pre-hospital care warning, the initial assessment of a severely injured patient is exclusively completed by a member of the trauma team for only 35.1% of the respondents. For 11.8% of respondents, trauma team coordinates airway management. For 64.7% of participants, the trauma team leader is the dedicated care provider to accompany patients until the final destination. Conclusions The results suggest a great variability across Canada, regarding the roles assumed by the trauma team but also regarding the activation criteria leading them to take action.
Assessment of health-related quality of life in patients prior to carotid body tumor resection
Authors: García-Alva Ramón , Lozano-Corona Rodrigo , Anaya-Ayala Javier E , Lizola Rene , Lopez-Rocha Sabsil , Cuen-Ojeda Cesar , Laparra-Escareno Hugo , Hinojosa Carlos A 
Published: May 2019

Background Carotid body tumors represent approximately 0.5% of the total head and neck tumors, and the most common presentation form is an asymptomatic cervical mass. Despite of being most of them asymptomatic the quality of life could be impacted; however, the literature remains silent about this matter. The Short Form 36 (SF-36) is a health-related quality of life (HRQoL) instrument that includes eight domains to assess physical and emotional function in different diseases. The aim of this study was to compare HRQoL in preoperative patients with carotid body tumor and a control paired group. The secondary objective was to compare HRQoL between carotid body tumor patients according to the volume tumor and Shamblin classification. Methods A cross-sectional study that included 23 patients diagnosed with carotid body tumor prior to resection and 23 control patients paired by age and gender was conducted from January 2017 to December 2018. The SF-36 questionnaire was applied in 46 patients. Three-dimensional volume reconstruction and estimation (3DVR) was obtained from a preoperative computed tomography angiography (CTA). Descriptive statistical analysis was performed for demographics and categorical variables were reported by frequencies and percentages. Continuous variables were summarized using median with interquartile ranges (IQR) with 95% confidence interval (CI) and were compared. Differences between medians were analyzed with the Mann–Whitney U test and all statistical tests were two-sided. Results In the carotid body tumor group, the mean age was 55 years, females were more frequently affected 19 (83%). Shamblin I was identified in 9% of patients, Shamblin II in 52% and Shamblin III in 39%. Carotid body tumor laterality were 57% right, 34% left and 9% bilateral tumors. The eight domains that comprise the SF-36 questionnaire were statistically significant when compared to the control group. Conclusion Significant differences were found in all SF-36 domains in carotid body tumor patients in comparison to control subjects, confirming that this neoplasm has negative impact in the general HRQoL.
Perioperative nurses’ experiences of caring for donation after cardiac death organ donors and their family within the operating room
Authors: Smith Zaneta 
Published: May 2019

Background Worldwide, operating rooms have seen the re-emergence of donation after cardiac death organ donors to increase the number of available organs. There is limited information on the issues perioperative nurses encounter when caring for donor patients after cardiac death who proceed to organ procurement surgery. Objectives The purpose of this paper is to report a subset of findings derived from a larger study highlighting the difficulties experienced by perioperative nurses when encountering donation after cardiac death organ donors and their family within the operating room during organ procurement surgery from an Australian perspective. Methods A qualitative grounded theory method was used to explore perioperative nurses’ (n = 35) experiences of participating in multi-organ procurement surgery. Results This paper reports a subset of findings of the perioperative nurses’ experiences directly related to donation after cardiac death procedures drawn from a larger grounded theory study. Participants revealed four aspects conceptualised as: ‘witnessing the death of the donation after cardiac death donor’; ‘exposure to family’; ‘witnessing family grief’ and ‘stepping into the family’s role by default’. Conclusion Perioperative nurses’ experiences with donation after cardiac death procedures are complex, challenging and demanding. Targeted support, education and training will enhance the perioperative nurses’ capabilities and experiences of caring for the donation after cardiac death donor and their family with the operating room context.
Pressurized intraperitoneal aerosol chemotherapy with low-dose cisplatin and doxorubicin (PIPAC C/D) in patients with gastric cancer and peritoneal metastasis: a phase II study
Authors: Struller Florian , Horvath Philipp , Solass Wiebke , Weinreich Frank-Jürgen , Strumberg Dirk , Kokkalis Marios K. , Fischer Imma , Meisner Christoph , Königsrainer Alfred , Reymond Marc A. 
Published: May 2019

Background: Efficacy of second-line systemic chemotherapy in recurrent gastric cancer with peritoneal metastasis (RGCPM) is limited. We assessed the feasibility, safety and possible efficacy of pressurized intraperitoneal aerosol chemotherapy (PIPAC) in patients with RGCPM after ⩾1 line of palliative intravenous chemotherapy. Methods: In this open-label, single-arm, monocentric phase II ICH-GCP clinical trial, patients were scheduled for three courses of PIPAC with cisplatin 7.5 mg/m2 and doxorubicin 1.5 mg/m2 (PIPAC C/D) every 6 weeks. Patients with bowel obstruction or extraperitoneal metastasis were ineligible. The primary endpoint was clinical benefit rate (CBR) by Response Evaluation Criteria in Solid Tumors based on clinical records. Secondary endpoints included overall survival (OS), median time to progression (TTP), peritoneal carcinomatosis index (PCI), histological regression and ascites volume. Safety and tolerability were assessed by Common Terminology Criteria for Adverse Events (CTCAE) version 4, quality of life (QoL) by EORTC-QLQ30 questionnaire. Results: A total of 25 patients were enrolled and available for the analysis of the primary endpoint. Of those 25 patients, 10 (40%) had a radiological complete, partial response or stable disease. Median OS [intention to treat (ITT)] was 6.7 months, median TTP was 2.7 months. Complete or major regression on histology were observed in 9/25 patients (36%, ITT) or 6/6 [100%, per protocol (PP)] patients. There were no suspected unexpected serious adverse reactions, no treatment-related deaths, no CTCAE grade 4 toxicity and three (12%) grade 3 toxicities. Changes in the QLQ-C30 scores during PIPAC C/D therapy were small and not significant. Conclusions: PIPAC C/D was well tolerated and active in patients with RGCPM. Survival was encouraging. Randomized controlled trials should now be designed in this indication.
Oxygen therapy in suspected acute myocardial infarction and concurrent normoxemic chronic obstructive pulmonary disease: a prespecified subgroup analysis from the DETO2X-AMI trial
Authors: Andell Pontus , James Stefan , Östlund Ollie , Yndigegn Troels , Sparv David , Pernow John , Jernberg Tomas , Lindahl Bertil , Herlitz Johan , Erlinge David , Hofmann Robin 
Published: May 2019

Background:
The DETermination of the role of Oxygen in suspected Acute Myocardial Infarction (DETO2X-AMI) trial did not find any benefit of oxygen therapy compared to ambient air in normoxemic patients with suspected acute myocardial infarction. Patients with chronic obstructive pulmonary disease may both benefit and be harmed by supplemental oxygen. Thus we evaluated the effect of routine oxygen therapy compared to ambient air in normoxemic chronic obstructive pulmonary disease patients with suspected acute myocardial infarction.

Methods and results:
A total of 6629 patients with suspected acute myocardial infarction were randomly assigned in the DETO2X-AMI trial to oxygen or ambient air. In the oxygen group (n=3311) and the ambient air group (n=3318), 155 and 141 patients, respectively, had chronic obstructive pulmonary disease (prevalence of 4.5%). Patients with chronic obstructive pulmonary disease were older, had more comorbid conditions and experienced a twofold higher risk of death at one year (chronic obstructive pulmonary disease: 32/296 (10.8%) vs. non-chronic obstructive pulmonary disease: 302/6333 (4.8%)). Oxygen therapy compared to ambient air was not associated with improved outcomes at 365 days (chronic obstructive pulmonary disease: all-cause mortality hazard ratio (HR) 0.99, 95% confidence interval (CI) 0.50–1.99, Pinteraction=0.96); cardiovascular death HR 0.80, 95% CI 0.32–2.04, Pinteraction=0.59); rehospitalisation with acute myocardial infarction or death HR 1.27, 95% CI 0.71–2.28, Pinteraction=0.46); hospitalisation for heart failure or death HR 1.08, 95% CI 0.61–1.91, Pinteraction=0.77]); there were no significant treatment-by-chronic obstructive pulmonary disease interactions.

Conclusions:
Although chronic obstructive pulmonary disease patients had twice the mortality rate compared to non-chronic obstructive pulmonary disease patients, this prespecified subgroup analysis from the DETO2X-AMI trial on oxygen therapy versus ambient air in normoxemic chronic obstructive pulmonary disease patients with suspected acute myocardial infarction revealed no evidence for benefit of routine oxygen therapy consistent with the main trial’s findings.

Clinical Trials Registration:
NCT02290080
Fragment-specific fixation of trimalleolar fractures utilizing the posterolateral approach: A preliminary experience
Authors: Gupta Sandeep , Virk Jagandeep Singh , Malhotra Anubhav , Garg Sudhir Kumar 
Published: May 2019

Introduction: Ankle fractures involving posterior malleolus are disabling injuries if not managed properly. Clinical and functional outcome of ankle fractures involving posterior tibial plafond is significantly worse. Although the surgical approach and techniques to reduce and fix this fracture are well described in the literature, there still seems to be divided consensus among orthopedic surgeons regarding the same. Methods: In this case series of eight patients with trimalleolar fractures, a posterolateral approach was used for fixation of posterior malleolus in all the cases. A preoperative computed tomography scan formed an integral part of management of such injuries. The Olerud and Molendar scoring system was employed at 12 months of follow-up to assess the functional outcome. Weight-bearing X-rays were taken to assess for any ankle arthritis. Results: The average age of patients was 48.8 years. The most common mode of sustaining injury was twisting of the ankle joint ( n = 5). The average time to union and full weight-bearing was 12.8 weeks (range 10–16 weeks). An excellent functional outcome in four patients and a good outcome in the rest of the four patients were obtained at the end of 12 months of follow-up. No significant ankle arthritis or complications were encountered. Conclusion: Appropriate preoperative imaging evaluation is an integral part of planning for these complex injuries. The posterolateral approach provides good exposure for appropriate visualization. Stable fixation of posterior malleolus in trimalleolar fractures plays a vital role in obtaining a positive clinical and functional outcome.
The Gut Microbiome Influences Host Endocrine Functions
Authors: Rastelli Marialetizia , Cani Patrice D , Knauf Claude 
Published: May 2019

AbstractThe gut microbiome is considered an organ contributing to the regulation of host metabolism. Since the relationship between the gut microbiome and specific diseases was elucidated, numerous studies have deciphered molecular mechanisms explaining how gut bacteria interact with host cells and eventually shape metabolism. Both metagenomic and metabolomic analyses have contributed to the discovery of bacterial-derived metabolites acting on host cells. In this review, we examine the molecular mechanisms by which bacterial metabolites act as paracrine or endocrine factors, thereby regulating host metabolism. We highlight the impact of specific short-chain fatty acids on the secretion of gut peptides (i.e., glucagon-like peptide-1, peptide YY) and other metabolites produced from different amino acids and regulating inflammation, glucose metabolism, or energy homeostasis. We also discuss the role of gut microbes on the regulation of bioactive lipids that belong to the endocannabinoid system and specific neurotransmitters (e.g., γ-aminobutyric acid, serotonin, nitric oxide). Finally, we review the role of specific bacterial components (i.e., ClpB, Amuc_1100) also acting as endocrine factors and eventually controlling host metabolism. In conclusion, this review summarizes the recent state of the art, aiming at providing evidence that the gut microbiome influences host endocrine functions via several bacteria-derived metabolites.
Novel Mobile Device-Based Tool to Document Sideline Evaluation of Athletes
Authors: Apple Rachel Price , Karpinos Ashley Rowatt , Bellamy Dennis Mitchell 
Published: May 2019

Abstract
We describe the implementation of the Athletic Injury Database (AID), a mobile device-based tool for documenting sideline encounters with athletes. Primary measures of the implementation process were: 1) patterns of AID use, 2) nature of sideline encounters captured, and 3) providers’ reported satisfaction. Over 2 yr, the AID captured 6237 sideline encounters by athletic trainers and physicians. Most encounters were among athletes participating in football (51%), soccer (15%), and basketball (12%). Knee and ankle injuries were most common. A total of 77% of sports medicine providers were satisfied with the AID. Providers can use information gleaned from a tool like the AID to improve documentation of care provided to athletes.