bluuebunny/crossref_metadata_2025_split huggingface dataset:
Visual symptoms and childhood migraine: Qualitative analysis of duration, location, spread, mobility, colour and pattern
Authors: Ahmed Mas , Boyd Catriona , Vavilikolanu Radhika , Rafique Bushra 
Published: April 2018

Aim To examine the characteristics of visual symptoms during attacks of migraine in children and adolescents. Method A qualitative analysis of prospectively collected data over 5 years, on characteristics of visual symptoms during migraine attacks. Diagnosis of migraine and aura was based on the International Classification of Headache Disorders 3rd edition beta version. We also provided the opportunity for patients to illustrate their visual aura symptoms to aid in diagnosis. Results Visual symptoms were reported by 387/1079 (36%) of migraineurs. Of these, 172 (16%) patients fulfilled the International Classification of Headache Disorders Criteria A, B, C iv and D, but missed one (n = 75; 43.5%) or two (n = 97; 56.5%) of the remaining items of criteria C as the visual symptoms were of non-gradual spread (n = 35; 20%), appeared in both visual fields (n = 99; 58%), or lasted less than 5 minutes or more than 60 minutes (n = 129; 75%). Conclusion The International Classification of Headache Disorders 3rd edition beta version criteria are useful in diagnosis of migraine with visual aura in children and adolescents, but visual symptoms varied considerably in duration, pattern, mobility, location, mode of onset and colours. Providing opportunity for patients to illustrate their symptoms can provide additional diagnostic information. The pathophysiology and the clinical concept of typical MVA is still to an extent an assumption and needs further evaluation. Approval The study was approved by the Health Research Authority – London and the local Research and Innovation Department at Barking Havering and Redbridge National Health Service Trust. Formal parental consent was not considered essential for this type of study.
Remission of chronic headache: An 11-year follow-up study. Data from the Nord-Trøndelag Health Surveys 1995–1997 and 2006–2008
Authors: Hagen Knut , Kristoffersen Espen Saxhaug , Winsvold Bendik Slagvold , Stovner Lars Jacob , Zwart John-Anker 
Published: April 2018

Objectives To estimate remission rates of chronic headache and predictors of remission. Methods In this longitudinal population-based cohort study, we used validated headache questionnaire data from the second (1995–1997, baseline; n = 51,856 aged ≥ 20 years, response rate: 55%) and third wave (2006–2008, follow-up, response rate: 42%) of the Nord-Trøndelag Health Study. Chronic headache was defined as ≥15 headache days/month during the last year. Chronic headache remission was defined as headache less than 15 days/month at follow-up. Potential predictors of remission were evaluated using logistic regression. Results At baseline, 1266 (2.4%) participants reported chronic headache. Of these, 605 (48%) answered headache questions at follow-up. Remission was observed in 452 (74.7%), the proportion being almost identical in men and women (74.4% vs. 74.9, p = 0.92). In analyses adjusting for age, gender and education level, remission at follow-up was more than two times more likely among individuals without medication overuse headache (OR = 2.4, 95% CI 1.7–3.6) and without chronic musculoskeletal complaints (OR = 2.9, 95% CI 1.5–5.0) at baseline. Conclusions In this longitudinal population-based cohort study, three-quarters of chronic headache participants remitted from chronic headache. Remission was associated with no medication overuse headache and no chronic musculoskeletal complaints at baseline.
The Diagnostic Dilemma of Traumatic Lumbar Puncture: Current Standing of Cerebrospinal Fluid Leukocyte Corrections and Our Experience With Cerebrospinal Fluid Biomarkers
Authors: Nazir Mudasir , Wani Wasim Ahmad , Kawoosa Khalid , Dar Sheeraz Ahmad , Malik Muzaffar , Mir Naseer Yousuf , Ahmad Ikhlas , Bhat Rais Ahmad , Bhat Javeed Iqbal , Ahmad Qazi Iqbal , Charoo Bashir Ahmad , Ali Syed Wajid 
Published: April 2018

Objective: To assess the diagnostic efficiency of cerebrospinal fluid markers of procalcitonin, lactate, and cerebrospinal fluid/serum lactate ratio for detecting bacterial meningitis during traumatic lumbar puncture, and to compare these markers with routinely used uncorrected and corrected leukocyte measurements. Methods: Infants aged ≤90 days with traumatic lumbar puncture were prospectively studied. The diagnostic characteristics of cerebrospinal fluid assays of uncorrected and corrected leukocyte count, procalcitonin, lactate, and lactate ratio were described and compared. Results: Considering the area under the curve (95% CI) analysis and standard cutoff values, the lactate-ratio (0.985 [0.964-0.989] at cutoff 1.2) had the best test indexes for identifying meningitis, followed by lactate (0.964 [0.945-0.984] at cutoff 2.2 mmol/L) and procalcitonin (0.939 [0.891-0.986] at cutoff 0.33 ng/mL) measurement, whereas the corrected total leukocyte count assay (0.906 [0.850-0.962] at cutoff 350 cells/mm3) had diagnostic properties moderately superior to uncorrected total leukocyte count measurement (0.870 [0.798-0.943] at cutoff 430 cells/mm3). Conclusion: Cerebrospinal fluid levels of procalcitonin, lactate, and lactate-ratio are reliable markers to diagnose bacterial meningitis in blood-contaminated cerebrospinal fluid.
Evaluation of EMLA cream for relieving pain during needle insertion on totally implantable venous access device
Authors: Yin Lijuan , Jiang Shudi 
Published: April 2018

Purpose: Needle insertion is a routine procedure performed on cancer patients with totally implantable venous access device. Although this procedure is painful for most of the patients, it is regularly performed without topical application of local anesthetics. In our study, we assess the degree of pain associated with different duration times of EMLA cream. Methods: A total of 361 cancer patients with totally implantable venous access devices were randomly divided into three groups: group 1—placebo, group 2—30 min after application of EMLA, and group 3—60 min after application of EMLA. In this double-blinded prospective study, the efficacy of EMLA cream was compared with a placebo cream by comparing the degree of pain experienced by the patient who was evaluated during and after needle insertion on a numeric rating scale. Results: The mean ± standard deviation of pain experienced by the patients was significantly (p < 0.05) lower in group C (0.69 ± 0.98) than groups B (1.11 ± 1.14) and A (1.91 ± 1.40). No significant (p > 0.05) difference was found in mean scores from inexperienced and experienced procedures of needle insertions among three groups. Comparing male patients, the female patients in group 1 and group 2 had lower numeric rating scale (1.59 ± 0.94, 1.39 ± 1.35; p < 0.01). Conclusion: The present results review that the application of EMLA cream for 30 min is suitable, acceptable, and convenient in cancer patients with totally implantable venous access device undergoing needle insertion.
Effect of Protein or Essential Amino Acid Supplementation During Prolonged Resistance Exercise Training in Older Adults on Body Composition, Muscle Strength, and Physical Performance Parameters: A Systematic Review
Authors: Gade Josephine , Pedersen Rie Johanne , Beck Anne Marie 
Published: April 2018

Objectives: Loss of muscle mass and strength with aging, sarcopenia, burdens many older adults, making identification of strategies on how to counteract it very relevant—especially to health care providers working in rehabilitation. The aim of this systematic review was to determine the effect of protein or essential amino acid (EAA) supplementation during prolonged resistance exercise training (RT) in older adults. No known stimulants of muscle protein synthesis, or ingredients with an effect on muscle strength/physical function, were allowed with the supplementation, differentiating this systematic review from others. Data sources and methods: In January 2017, 4 electronic databases and reference lists were searched for randomized controlled trials investigating the effect of protein or EAA supplementation during RT in older adults (mean age >60 years) on outcomes of body composition, muscle strength, and physical performance. Study selection and data extraction were performed by 2 independent reviewers. Results Sixteen studies (1107 participants) fulfilled the eligibility criteria. Methodologic differences between the studies disallowed a meta-analysis. Of the 16 studies, 6 found significant effects on body composition (3 studies), muscle strength (3 studies), and physical performance (2 studies) measures. Conclusions The evidence is weak and inconsistent, as benefit of protein or EAA supplementation during RT in older adults is only shown in some studies. The findings indicate that frail/sarcopenic older adults might benefit more than healthy older adults. Further research is needed to allow an interpretation on the importance of study population and design. Trial registration: PROSPERO, Reg. no.: CRD42017063808. Registered April 14, 2017.
Ticagrelor in Peripheral Artery Disease Endovascular Revascularization (TI-PAD): Challenges in clinical trial execution
Authors: Rogers R Kevin , Hiatt William R , Patel Manesh R , Shishehbor Mehdi H , White Robin , Khan Naeem D , Bhalla Narinder P , Jones W Schuyler , Low Wang Cecilia C 
Published: April 2018

There is limited evidence to guide clinical decision-making for antiplatelet therapy in peripheral artery disease (PAD) in the setting of lower extremity endovascular treatment. The Ticagrelor in Peripheral Artery Disease Endovascular Revascularization Study (TI-PAD) evaluated the role of ticagrelor versus aspirin as monotherapy in the management of patients following lower extremity endovascular revascularization. The trial failed to recruit the targeted number of patients, likely due to aspects of the design including the lack of option for dual antiplatelet therapy, and inability to identify suitable patients at study sites. In response, the protocol underwent amendments, but these changes did not adequately stimulate recruitment, and thus TI-PAD was prematurely terminated. This article describes the rationale for TI-PAD and challenges in trial design, subject recruitment and trial operations to better inform the conduct of future trials in PAD revascularization. ClinicalTrials.gov Identifier: NCT02227368
The New National Registry for Gastrointestinal Surgery in Norway: NoRGast
Authors: Lassen K. , Nymo L. S. , Kørner H. , Thon K. , Grindstein T. , Wasmuth H. H. , Moger T. , Bjørnbeth B. A. , Norderval S. , Eriksen M. T. , Viste A. 
Published: April 2018

Background and Aims: There is an increasing demand for high-quality data for the outcome of health care. Diseases of the gastro-intestinal tract involve large patient groups often presenting with serious or life-threatening conditions. Complications may affect treatment outcomes and lead to increased mortality or reduced quality of life. A continuous, risk-adjusted monitoring of major complications is important to improve the quality of health care to patients undergoing gastrointestinal resections. We present the development of the Norwegian Registry for Gastrointestinal Surgery, a national registry for colorectal, upper gastrointestinal, and hepato-pancreato-biliary resections in Norway. Materials and Methods: A narrative and qualitative presentation of the development and current state of the registry. Results: We present the variables and the analysis tools and provide examples for the potential in quality improvement and research. Core characteristics include a strictly limited set of variables to reflect important risk factors, the procedure performed, and the clinical outcomes. Conclusion: A registry with the potential to present complete national cohort data is a powerful tool for quality improvement and research.
Long-Term Survival and Quality of Life After Hypothermic Circulatory Arrest in Aortic Surgery
Authors: Stewart J. A. , Ilkka V. H. , Jokinen J. J. , Vakkuri A. P. , Suojaranta R. T. , Wennervirta J. , Salminen U. -S. 
Published: April 2018

Background and Aims: Hypothermic circulatory arrest carries a high risk of mortality and neurological complications. An important part of assessing surgical treatment is the evaluation of long-term survival and postoperative health-related quality of life. Material and Methods: In this prospective study, 30 patients undergoing hypothermic circulatory arrest during surgery of the thoracic aorta, and 31 comparison patients undergoing elective coronary artery surgery without hypothermic circulatory arrest were evaluated for long-term survival and health-related quality of life, using the RAND 36-Item Health Survey questionnaire. The results were compared to national age- and sex-matched reference populations of the chronically ill and healthy adults. Results: After 4.6–8.0 years, available study (88%) and comparison (59%) patients were interviewed. The life expectancy was similar with 4- and 8-year survival of 90%, and 87% for the study group, and 94%, and 94% for the comparison group, respectively (log rank test, p = 0.62). The RAND-36 scores for study and comparison groups were congruent in all dimensions, describing physical, mental, and social domains. The study patients’ health-related quality of life results were similar to the national reference population with chronic illnesses. Conclusion: After hypothermic circulatory arrest, patients undergoing surgery of the thoracic aorta achieve a similar long-term life expectancy and health-related quality of life as do patients undergoing coronary surgery without hypothermic circulatory arrest, and a health-related quality of life similar to the national reference population with chronic illnesses. These results justify operative treatment in this high-risk patient population.
Aprotinin Impacts 8-Isoprostane after Coronary Artery Bypass Grafting
Authors: Toikkanen V. , Rinne T. , Nieminen R. , Moilanen E. , Laurikka J. , Porkkala H. , Tarkka M. , Mennander A. A. 
Published: April 2018

Background and Aims: The lungs participate in the modulation of the circulating inflammatory factors induced by coronary artery bypass grafting. We investigated whether aprotinin—which has been suggested to interact with inflammation—influences lung passage of key inflammatory factors after coronary artery bypass grafting. Material and Methods: A total of 40 patients undergoing coronary artery bypass grafting were randomized into four groups according to aprotinin dose: (1) high dose, (2) early low dose, (3) late low dose, and (4) without aprotinin. Pulmonary artery and radial artery blood samples were collected for the evaluation of calculated lung passage (pulmonary artery/radial artery) of the pro-inflammatory factors interleukin 6 and interleukin 8, 8-isoprostane, myeloperoxidase and the anti-inflammatory interleukin 10 immediately after induction of anesthesia (T1), 1 min after releasing aortic cross clamp (T2), 15 min after releasing aortic cross clamp (T3), 1 h after releasing aortic cross clamp (T4), and 20 h after releasing aortic cross clamp (T5). Results: Pulmonary artery/radial artery 8-isoprostane increased in patients with high aprotinin dose as compared with lower doses (1.1 range 0.97 vs 0.9 range 1.39, p = 0.001). The main effect comparing high aprotinin dose with lower doses was significant (F(1, 38) = 7.338, p = 0.01, partial eta squared = 0.16) further supporting difference in the effectiveness of high aprotinin dose for pulmonary artery/radial artery 8-isoprostane. Conclusion: According to the pulmonary artery/radial artery equation, the impact of aprotinin on 8-isoprostane after coronary artery bypass grafting is dose dependent. Aprotinin may aid the lung passage of circulating factors toward a beneficial anti-inflammatory milieu.
Aerobic exercise training differentially affects ACE C- and N-domain activities in humans: Interactions with ACE I/D polymorphism and association with vascular reactivity
Authors: Alves Cléber Rene , Fernandes Tiago , Lemos José Ribeiro , Magalhães Flávio de Castro , Trombetta Ivani Credidio , Alves Guilherme Barreto , Mota Glória de Fátima Alves da , Dias Rodrigo Gonçalves , Pereira Alexandre Costa , Krieger José Eduardo , Negrão Carlos Eduardo , Oliveira Edilamar Menezes 
Published: April 2018

Introduction: Previous studies have linked angiotensin-converting enzyme ( ACE) insertion (I)/deletion (D) polymorphism (II, ID and DD) to physical performance. Moreover, ACE has two catalytic domains: NH2 (N) and COOH (C) with distinct functions, and their activity has been found to be modulated by ACE polymorphism. The aim of the present study is to investigate the effects of the interaction between aerobic exercise training (AET) and ACE I/D polymorphism on ACE N- and C-domain activities and vascular reactivity in humans. Materials and methods: A total of 315 pre-selected healthy males were genotyped for II, ID and DD genotypes. Fifty completed the full AET (II, n = 12; ID, n = 25; and DD, n = 13), performed in three 90-minute sessions weekly, in the four-month exercise protocol. Pre- and post-training resting heart rate (HR), peak O2 consumption (VO2 peak), mean blood pressure (MBP), forearm vascular conduction (FVC), total circulating ACE and C- and N-domain activities were assessed. One-way ANOVA and two -way repeated-measures ANOVA were used. Results: In pre-training, all variables were similar among the three genotypes. In post-training, a similar increase in FVC (35%) was observed in the three genotypes. AET increased VO2 peak similarly in II, ID and DD (49±2 vs. 57±1; 48±1 vs. 56±3; and 48±5 vs. 58±2 ml/kg/min, respectively). Moreover, there were no changes in HR and MBP. The DD genotype was also associated with greater ACE and C-domain activities at pre- and post-training when compared to II. AET decreased similarly the total ACE and C-domain activities in all genotypes, while increasing the N-domain activity in the II and DD genotypes. However, interestingly, the measurements of N-domain activity after training indicate a greater activity than the other genotypes. These results suggest that the vasodilation in response to AET may be associated with the decrease in total ACE and C-domain activities, regardless of genotype, and that the increase in N-domain activity is dependent on the DD genotype. Conclusions: AET differentially affects the ACE C- and N-domain activities, and the N-domain activity is dependent on ACE polymorphism.
Validation of Living Donor Nephrectomy Codes
Authors: Lam Ngan N. , Lentine Krista L. , Klarenbach Scott , Sood Manish M. , Kuwornu Paul J. , Naylor Kyla L. , Knoll Gregory A. , Kim S. Joseph , Young Ann , Garg Amit X. 
Published: April 2018

Background: Use of administrative data for outcomes assessment in living kidney donors is increasing given the rarity of complications and challenges with loss to follow-up. Objective: To assess the validity of living donor nephrectomy in health care administrative databases compared with the reference standard of manual chart review. Design: Retrospective cohort study. Setting: 5 major transplant centers in Ontario, Canada. Patients: Living kidney donors between 2003 and 2010. Measurements: Sensitivity and positive predictive value (PPV). Methods: Using administrative databases, we conducted a retrospective study to determine the validity of diagnostic and procedural codes for living donor nephrectomies. The reference standard was living donor nephrectomies identified through the province’s tissue and organ procurement agency, with verification by manual chart review. Operating characteristics (sensitivity and PPV) of various algorithms using diagnostic, procedural, and physician billing codes were calculated. Results: During the study period, there were a total of 1199 living donor nephrectomies. Overall, the best algorithm for identifying living kidney donors was the presence of 1 diagnostic code for kidney donor (ICD-10 Z52.4) and 1 procedural code for kidney procurement/excision (1PC58, 1PC89, 1PC91). Compared with the reference standard, this algorithm had a sensitivity of 97% and a PPV of 90%. The diagnostic and procedural codes performed better than the physician billing codes (sensitivity 60%, PPV 78%). Limitations: The donor chart review and validation study was performed in Ontario and may not be generalizable to other regions. Conclusions: An algorithm consisting of 1 diagnostic and 1 procedural code can be reliably used to conduct health services research that requires the accurate determination of living kidney donors at the population level.
Delayed intestinal perforation secondary to blunt force abdominal trauma in a cat
Authors: Taylor A , Cooper E , Ham K 
Published: April 2018

Case summary A 7-month-old intact male domestic shorthair cat was presented 4 h after being hit by a car. It had bilateral inguinal hernias and a mesenteric rent that were repaired surgically and a hematoma in the left retroperitoneal space. No other intra-abdominal abnormalities were identified on abdominal surgical exploration. Approximately 72 h after presentation, the cat started vomiting and developed severe abdominal discomfort. A sudden decrease in mentation and elevation of respiratory rate and effort ensued. Abdominal radiographs showed loss of detail in the abdominal cavity, and abdominocentesis confirmed septic peritonitis. The cat was euthanized, and post-mortem evaluation of the bowel revealed two 1 cm perforations of the jejunum. Relevance and novel information To our knowledge, delayed intestinal perforation secondary to blunt force abdominal trauma has not previously been reported in cats. It has been reported in dogs, but the pathophysiology resulting in perforation is poorly understood. Delayed intestinal injury secondary to blunt force abdominal trauma has been reported in people, especially in children, as a result of motor vehicle accidents.