bluuebunny/crossref_metadata_2025_split huggingface dataset:
Monitoring and Molecular Characterization of Staphylococcus aureus Isolated from Chronic Wounds
Authors: Pires Bruna Maiara Ferreira Barreto , de Oliveira Fernanda Pessanha , de Oliveira Beatriz Guitton Renaud Baptista , Fuly Patrícia dos Santos Claro , Ferreira-Carvalho Bernadete Teixeira , de Paula Geraldo Renato , Teixeira Lenise Arneiro 
Published: July 2018

ABSTRACT

OBJECTIVE:
Researchers analyzed chronic wounds treated with 2% hydrogel to determine whether the presence of methicillin-resistant Staphylococcus aureus (MRSA) is related to the presence of clinical signs of infection.

METHODS:
Thirty-five patients were recruited for this descriptive study using a quantitative approach. Staphylococcus aureus was identified by matrix-assisted laser desorption ionization time-of-flight mass spectrometry. Antibiotic susceptibility was determined using a disk diffusion test according to Clinical and Laboratory Standards Institute standards. Polymerase chain reaction, pulsed-field gel electrophoresis, and multilocus sequence typing were performed. Statistical analyses were performed using Spearman correlation coefficients for the variables MRSA and clinical signs of infection.

MAIN OUTCOME MEASURES:
The identification of MRSA or methicillin-sensitive S aureus (MSSA), presence or absence of an infection in the wound, and molecular characterization of bacteria were measured.

MAIN RESULTS:
Of the 35 patients analyzed, 8 (22.9%) were classified as having an infection in their wounds. Spearman ρ indicated a strong positive correlation between the increase in the number of clinical signs of infection and MSSA (P =.84), but only a moderate positive correlation with MRSA (P =.60). The S aureus clonal pattern was unique for each of the major bacteria isolated. Global MRSA sequence-type clones (ST-1 and ST-72) were detected in 2 patients.

CONCLUSIONS:
Compared with those colonized by MSSA, chronic wounds colonized by MRSA did not display a strong correlation with the presence of a greater number of clinical signs of infection.
Mirror Therapy for Phantom Limb Pain at a Pediatric Oncology Institution
Authors: Anghelescu Doralina L. , Kelly Cassandra N. , Steen Brenda D. , Wu Jianrong , Wu Huiyun , DeFeo Brian M. , Scobey Kristin , Burgoyne Laura 
Published: July 2018

Background and Purpose/Objective:
Mirror therapy (MT) has not been reported for phantom limb pain (PLP) in pediatric oncology. Our aims are to describe the incidence and duration of PLP postamputation, the duration of follow-up, pain scores and pain medications, and the differences between a group that received MT in addition to the standard treatment and a group that received only the standard treatment (non-MT).

Methods:
A retrospective review of patients' medical records from June 2009 to March 2015 was completed. Data on the demographic characteristics, diagnoses, and types of surgery were collected. The incidence and duration of PLP, duration of pain service follow-up, pain medications, and pain scores were collected and analyzed using the Wilcoxon rank sum test.

Results:
Of 21 patients who underwent amputations (median age = 13 years; range, 8-24 years; most common primary diagnosis osteosarcoma), 18 (85.7%) experienced PLP; 38.9% of them experienced PLP at 1 year postamputation (11.1% of the MT group and 66.7% of the non-MT group). The MT and non-MT groups experienced PLP for a mean (SD) of 246 (200) days and 541 (363) days, respectively (P = .08). The mean (SD) opioid doses (mg/kg per day) in the MT and non-MT groups were 0.81 (0.99) and 0.33 (0.31), respectively; the mean (SD) gabapentin doses (mg/kg per day) were 40.1 (21) for the MT group and 30.5 (11.5) for the non-MT group.

Conclusion:
Mirror therapy in children with cancer-related amputations is associated with lower incidence of PLP at 1 year and shorter duration of PLP.
Psychometric Properties of the Modified Brief Fatigue Inventory and FACIT-Fatigue in Individuals With Cancer of the Head and Neck
Authors: Eden Melissa M. , Kunkel Kevin 
Published: July 2018

Purpose:
The purpose of this study was to establish the test-retest reliability and concurrent validity of the Modified Brief Fatigue Inventory (MBFI) and the Functional Assessment of Chronic Illness Therapy–Fatigue (FACIT-Fatigue) scale in a population of patients treated for cancers of the head and neck.

Methods:
The MBFI and the FACIT-Fatigue were administered to 65 participants in a tertiary medical center with a diagnosis of head and neck cancer (HNC), skin cancer, and thyroid cancer who had undergone surgery within the past 3 months and/or were currently receiving radiation and/or chemotherapy treatments. Test-retest reliability, internal consistency, and concurrent validity are reported.

Results:
For the HNC group, the MBFI had an intraclass correlation coefficient (ICC) of 0.825 (0.68-0.91) and an internal consistency of 0.828. The FACIT-Fatigue ICC was 0.866 (0.75-0.93) and internal consistency was 0.874. The MBFI ICC for the skin and thyroid cancer groups was 0.932 (0.76-0.98) and 0.880 (0.60-0.97), and internal consistency of 0.929 and 0.880, respectively. The FACIT-Fatigue ICC for the skin and thyroid cancer groups was 0.945 (0.81-0.99) and 0.941 (0.81-0.98), and the internal consistency was 0.945 and 0.941, respectively. The Spearman ρ correlation coefficient for concurrent validity of the MBFI and FACIT-Fatigue was −0.871 for HNC, −0.838 for skin cancer, and −0.903 for thyroid cancer.

Conclusions:
The MBFI and the FACIT-Fatigue demonstrate good test-retest reliability, internal consistency, and concurrent validity for all subgroups. The FACIT-Fatigue demonstrates a slight advantage over the MBFI with respect to test-retest reliability and internal consistency.
The Effect of Bone-Loading Exercise on Bone Mineral Density in Women Following Treatment for Breast Cancer: A Systematic Review and Meta-analysis
Authors: Zerzan Sarah , Smoot Betty , Lee Jeannette Q. , Lui Andrew , Allen Diane D. 
Published: July 2018

Purpose:
The purpose of this systematic review and meta-analysis was to synthesize the current literature on the effects of bone-loading exercise on bone mineral density (BMD) in women after treatment of breast cancer (BC).

Methods:
PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Physiotherapy Evidence Database (PEDro), and Web of Science databases were searched through March 31, 2016. A combination of MeSH terms and key words was used: (physical therapy OR physiotherapy OR resistance training OR weight training OR aerobic OR exercise) AND (bone density OR osteoporosis) AND breast cancer. Search terms for PEDro were as follows: (breast cancer AND bone breast cancer) and (breast cancer AND osteoporosis). Studies included were experimental studies that compared any type of bone-loading exercise intervention with a comparison group and reported dual-energy x-ray absorptiometry for assessment of BMD of the lumbar spine and/or proximal femur (femoral neck, trochanter, and/or total hip). Between-group BMD effect sizes and 95% confidence intervals (CIs) were calculated for each study (bone-loading exercise vs usual care/non–bone-loading exercise) and pooled across studies. Risk of bias in and across studies was addressed using the PEDro scale.

Results:
Five randomized controlled studies were included. Pooled effect sizes were statistically significant, favoring the bone-loading exercise group for proximal femur (d = 0.15; 95% CI, 0.03-0.28) and for lumbar spine BMD (d = 0.14; 95% CI, 0.01-0.27).

Conclusion:
Results provide modest evidence that bone-loading exercise interventions have statistically and clinically significant effects on proximal femur and lumbar spine BMD in women treated for BC. Further research is warranted to determine the most effective types and intensities of exercise for improving BMD in BC survivors.
Description of a Community-Based Exercise Program for Children With Cancer: A Sustainable, Safe, and Feasible Model
Authors: Chamorro Viña Carolina , Guilcher Gregory M.T. , Schulte Fiona , De Vries Alexander , Schwanke Jenna , Culos-Reed Susan Nicole 
Published: July 2018

Background:
Physical activity has emerged as a promising intervention to decrease the severity of cancer side effects. To date, only a few community-based exercise programs have been described in the literature. Of these, none have been designed to be sustainable and available as programs for pediatric cancer survivors on an ongoing basis.

Methods:
This article aims to describe a safe, feasible, and sustainable community-based exercise program for children with cancer. The program is offered to children on/off treatment and their siblings, between 3 and 18 years old. A multidisciplinary team developed this evidence-based program, and it is facilitated by trained volunteers. A parent survey was conducted to evaluate the quality of the program.

Results:
The PEER (Pediatric cancer patients and survivors Engaging in Exercise for Recovery) program is a safe, feasible, and sustainable community-based exercise program for children with cancer. From the parent satisfaction survey, all of the parents would strongly recommend the PEER program to other families.

Conclusion:
PEER provides an example of a community-based exercise program that has a strong pedagogical focus, is evidence-based, and is individualized, safe, feasible, and sustainable for children with cancer. On the basis of the benefit of exercise described in the literature, we believe this model of an evidence-based community intervention might decrease the burden of cancer side effects and promote the reintegration of children affected by cancer into physical activity programming in their community.
Results of a Pilot Yoga Intervention to Improve Pediatric Cancer Patients' Quality of Life and Physical Activity and Parents' Well-being
Authors: Orsey Andrea D. , Park Crystal L. , Pulaski Regan , Shankar Nilani L. , Popp Jill M. , Wakefield Dorothy 
Published: July 2018

Background and Purpose:
Yoga is increasingly proving beneficial in improving distress, pain, physical activity, and health-related quality of life (QOL) in adult patients with cancer, but few studies have examined the efficacy of yoga therapy for pediatric patients with cancer. We aimed to study the feasibility and preliminary efficacy of a yoga intervention for pediatric cancer patients in active treatment and for their families.

Methods:
We conducted 2 separate studies: (1) a survey of 20 patients and parents regarding preferences (eg, convenient days and times), experiences, and expectations regarding yoga (including barriers and positive expectancies); and (2) an 8-week single-arm clinical trial of a yoga intervention in 10 children and their family members. Targeted outcomes of the clinical trial were patients' fatigue, QOL, and physical activity. Secondary outcomes were caregivers' well-being (QOL and burden).

Results:
Study 1 demonstrated fairly high levels of interest from patients and family members. Study 2 demonstrated improved patients' and parents' QOL pre- to post–yoga intervention.

Conclusions:
Parents and patients found the intervention highly acceptable. Conducting the intervention in the context of active cancer treatment proved feasible. Despite limited statistical power, QOL of patients doing yoga improved. Our findings support the notion that yoga for pediatric cancer patients during active treatment is feasible and potentially helpful in improving both patients' and parents' well-being.
Respiratory Muscle Training Improves Exercise Performance and Quality of Life in Cancer Survivors: A Pilot Study
Authors: Ray Andrew D. , Williams Brian T. , Mahoney Martin C. 
Published: July 2018

Background:
Respiratory muscle weakness represents one of the potential mechanisms contributing to exertional dyspnea and reduced exercise performance in lung and breast cancer survivors.

Purpose/Objective:
Pilot study of a respiratory muscle training (RMT) program to improve exercise capacity and quality of life (QOL) and reduce dyspnea in breast and lung cancer survivors.

Methods:
Participants performed 3 sets of 15 repetitions against spring-loaded inspiratory and expiratory valves, 3 days per week, for 4 weeks, with weekly increases in resistance. Maximal expiratory (MEP) and inspiratory pressures (MIP), exercise tests (

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2peak, submaximal cycling endurance at 70% of peak, and Six-Minute Walk Test [6MWT]) along with questionnaires (Baseline Dyspnea Index and SF-36 [36-Item Short Form Health Survey]) were completed pre- and post-RMT.

Design:
Single-arm pilot study.

Setting:
University research and academic medical center.

Patients:
Lung and breast cancer survivors with the presence of mild-to-moderate dyspnea symptoms not attributed to cardiopulmonary disease.

Results:
Post-RMT, MIP and MEP increased 29% ± 21% and 34% ± 32%, respectively (P < .001). Submaximal endurance time (16.9 ± 7.4 minutes vs 31.4 ± 7.7 minutes, P = .001), the distance covered in the 6MWT (427 ± 84 m vs 471 ± 95 m, P = .005), dyspnea index (6.4 ± 1.0 vs 7.6 ± 1.3, P = .02), and QOL (total 85.3 ± 9.4 vs 97.8 ± 12.7, P = .014) were all significantly improved post-RMT.

Limitations:
Limited sample size and short duration of follow-up.

Conclusions:
These preliminary results support the continued investigation of a respiratory muscle-training program to improve respiratory muscle strength, exercise performance, and QOL, as well as to decrease dyspnea symptoms among cancer survivors.
Effects of an Individualized Aerobic Exercise Program in Individuals With a Brain Tumor Undergoing Inpatient Rehabilitation: A Feasibility Study
Authors: Ayotte Sarah L. , Harro Cathy C. 
Published: July 2018

Background/Objective:
To investigate the feasibility of aerobic exercise training in patients with brain tumors and its effects on aerobic function, strength, fatigue, and functional outcomes.

Methods:

Design: Prospective study, single cohort design. Setting: Phase 1: inpatient rehabilitation hospital; phase 2: outpatient setting. Patients: Patients with primary or metastatic brain tumors. Twenty qualified participants enrolled, 16 participants (9 men, 7 women; mean age = 56.6 years) completed phase 1. One participant completed phase 2. Intervention: Individualized aerobic training on a recumbent cycle ergometer. Phase 1: 5 days per week; phase 2: 3 days per week. Training goal was 20 minutes of continuous cycling at moderate intensity for a duration of 6 weeks including phase 1 and phase 2. Measurements: Aerobic capacity (graded submaximal cycling test), Six-Minute Walk Test (6MWT), Functional Independence Measure, lower-extremity composite strength, and the Functional Assessment of Chronic Illness Therapy–Fatigue; measures were assessed pretraining, at inpatient discharge, and posttraining. Feasibility determined by (1) adherence to training program, (2) training responsiveness, and (3) ability to achieve training goals.

Results:
Statistically significant changes in all outcome measures found during phase 1, with moderate gains in aerobic capacity and the 6MWT. All participants reached the training goal of 20 minutes of continuous cycling at moderate intensity and adherence to 5 training sessions per week in phase 1. No adverse events reported.

Limitations:
Lack of a control group and limited participation in phase 2; therefore, training responsiveness assessed only during inpatient phase.

Conclusion:
Study supports the feasibility and effectiveness of an individualized aerobic exercise program for individuals with brain tumors.
Oncology Section EDGE Task Force on Urogenital Cancer Outcomes: Clinical Measures of Lymphedema—A Systematic Review
Authors: Cohn Joy C. , Geyer Hannah , Lee Jeannette , Fisher Mary Insana 
Published: July 2018

Background:
Valid and reliable tools to assess lymphedema are necessary to accurately evaluate status and to objectively document and measure the results of interventions. Understanding the advantages and disadvantages of each measure can inform the clinician's choice of the appropriate tool to be used in the clinic or research setting.

Purpose:
To identify reliable and valid measurement techniques that are sensitive to change for assessing edema volume or soft tissue change in the lower extremities or genital region of patients with lymphedema.

Methods:
A systematic review of the literature was conducted to assess the published psychometric properties and clinical feasibility of each method identified. Task Force members independently reviewed each measure using the Cancer EDGE Rating Form.

Results:
Both water displacement and circumferential measurement methods by tape measure were rated as Highly Recommended to quantify lower-extremity limb volume. Water displacement was determined to be the criterion standard by which all other assessments of volume are benchmarked. Both optoelectric volumetry and bioelectric impedance analysis were rated as Recommended, and ultrasound was rated Not Recommended.

Conclusion:
The Urogenital Cancer EDGE Task Force highly recommends water displacement and circumferential tape measurement for use as reliable methods for assessment and documentation of change of limb volume in this patient population. Early detection of subclinical lower-extremity lymphedema in this patient population remains challenging, as there is no “index” limb that can be proven to be uninvolved in a patient population with documented pelvic node dissection/irradiation. No articles were found to support valid and reliable genital lymphedema volume measurement.
Best Practices for Public Policies for Palliative Care Physical Therapy: A Critical Review of the Literature
Authors: Baldwin Amber , Wilson Christopher 
Published: July 2018

Background and Purpose:
In comparison with the volume of patients living with a chronic disease or life-threatening illness, there remains insufficient availability and affordability of both palliative care (PC) and physical therapy (PT) services. The purpose of this critical review of the literature was to examine the factors impacting integration of PT within PC and identify opportunities to improve public policy initiatives to facilitate integration of PT and PC.

Methods:
Peer-reviewed articles regarding PT within PC as it relates to public policy and health care reform were retrieved through a critical review of the literature.

Results:
Twenty articles were identified and synthesized that described a variety of aspects of the effect of public policy and health care reform on the integration of PT and PC.

Discussion:
The evidence for the importance of PT in PC stems from multiple factors such as better symptom management, reduction in cost, decreased length of stay, fewer hospital readmissions, improved patient/provider satisfaction, and an increase in quality of life. Further integration of PT within PC and the associated benefits are heavily influenced by choices made in public policy.

Conclusion:
Public policies that should be addressed include regulation reform of payment and reimbursement, modernization of legislation for access and referrals to PT, institutional support of education for key PT and PC stakeholders, and increased funding for support of PT involvement in PC.
Physical Therapy–Based Interventions Improve Balance, Function, Symptoms, and Quality of Life in Patients With Chemotherapy-Induced Peripheral Neuropathy: A Systematic Review
Authors: Brayall Patrick , Donlon Erin , Doyle Lisa , Leiby Renee , Violette Katelyn 
Published: July 2018

Background:
Chemotherapy-induced peripheral neuropathy (CIPN) involves damage to peripheral nerves. It can cause weakness, loss of dexterity, pain, sensory disturbances, and decreased ankle proprioception. These impairments lead to decreased balance, increased risk of falls, difficulty with activities of daily living, and difficulty walking at home and in the community. These functional limitations also contribute to decreased quality of life (QOL) and participation restrictions. There is a lack of evidence related to physical therapy (PT) interventions and outcomes in patients with CIPN.

Objective:
To systematically review the evidence to determine whether adults with CIPN benefit from PT interventions to improve balance, function, and QOL.

Methods:
A database search was performed in January 2017 for articles dated in the last 15 years. Search terms used were as follows: chemotherapy, peripheral, neuropathy, prevalence, management, falling, strength, and balance training. This yielded 300 studies, with another 98 studies found through other methods. Inclusion criteria were as follows: adults with diagnosis of CIPN, balance or functional mobility issues due to CIPN, and studies involving PT interventions. Articles were excluded if they were pharmacological intervention based, if they did not include patients with documented CIPN, and if they did not involve PT interventions. Articles were appraised using the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) criteria. A total of 5 articles met the criteria, including 3 experimental studies and 2 randomized control trials, and were included in this review.

Results:
Lower limb closed kinetic chain exercises showed a decrease in tingling sensation, decrease in pain, and improved balance. Interactive sensor-based balance training showed increasing tandem stance balance with eyes open. Studies involving strength and endurance training showed positive effects for balance, lower extremity strength, function, and QOL, as measured using the McGill QOL Questionnaire and the European Organization for Research and Treatment in Cancer Quality-of-Life Questionnaire (EORTC QLQ-C30).

Conclusion:
PT interventions are beneficial for individuals with CIPN demonstrating improved static and dynamic balance, increased lower extremity strength, and reduction in CIPN symptoms such as pain and paresthesia. This could lead to a decreased risk of falls and has been shown to correlate to an improved QOL. Larger sample sizes, more specific outcome measures and interventions, and better defined inclusion criteria will further inform best practice with this patient population.
Clinical Implementation of the Clinical Practice Guidelines for Diagnosing Upper-Quadrant Lymphedema Secondary to Cancer
Authors: Perdomo Marisa , Ryans Kathryn , Levenhagen Kimberly , Davies Claire C. , Gilchrist Laura 
Published: July 2018

Background:
The Oncology Section of the APTA recently published a clinical practice guideline (CPG) for diagnosing secondary upper-quadrant lymphedema (SUQL) related to cancer. Application of any CPGs may be challenging depending upon clinical setting, patient population, and clinical expertise.

Purpose:
The purpose of this article is to assist the clinician in integrating the evidence from the CPG into clinical practice. The authors present the recommendations from the CPG using a systematic approach that will enable integration of the appropriate diagnostic tools for SUQL based on presentation and stage during the patient evaluation.

Conclusion:
Although this article provides the clinician with recommendations for integrating the CPG into their practice, it is beneficial for the clinician to refer back to the original CPG to understand its scope and limitations. The SUQL CPG was based on a review of the literature from 2000 to 2015. The authors acknowledge that some additional literature may have emerged since its development that may now either support or refute the use of some measures evaluated and recommended. Further collaborative research is needed between researchers and clinicians to develop and evaluate appropriate assessment and diagnostic tools to aid in early diagnosis of SUQL in body regions such as the trunk, breast, hand, head, and neck.