bluuebunny/crossref_metadata_2025_split huggingface dataset:
Characterizing Abdominal Pain in Patients With Gastroparesis Into Neuropathic and Nociceptive Components
Authors: Jehangir Asad , Abdallah Rany T. , Parkman Henry P. 
Published: May 2018

Introduction:
The cause of abdominal pain (AP) in gastroparesis (Gp) is often not known; hence, its treatment can be challenging. Preoccupation with or increased attention (hypervigilance) to pain is associated with perceived pain severity and psychosocial disability. The aims of this study were to (1) characterize AP in Gp patients into neuropathic and nociceptive pain components; (2) assess these patients for hypervigilance to pain.

Materials and Methods:
Gp patients with AP as an important symptom, seen from June 2017 to November 2017 were given validated questionnaires to characterize their AP. Carnett’s sign (worsened AP/tenderness on head/shoulder lift and/or leg lift) was assessed on examination.

Results:
Of 32 patients (87% females), 20 had idiopathic Gp, and 9 had diabetic Gp. AP severity using Patient Assessment of Gastrointestinal Symptoms averaged 4.3±0.2 (standard error of mean) for upper AP and 2.3±0.3 for lower AP. AP was typically located in epigastrium (53.1%), and described as sharp (75%). Eleven patients (35.5%) met criteria for neuropathic pain on Neuropathic Pain Questionnaire. Twenty patients (62.5%) had positive Carnett’s sign suggesting somatic pain. Fifteen patients (48.4%) were hypervigilant to pain on Pain Vigilance and Awareness Questionnaire.

Conclusions:
Of Gp patients with AP, over one third have a neuropathic component to their pain whereas nearly two thirds have characteristics of somatic pain. Almost half of the Gp patients with AP are hypervigilant to pain. Determining the underlying cause of AP and hypervigilance to pain in Gp patients may assist in devising appropriate treatment strategies.
Gamma-Delta T Lymphocytes in the Diagnostic Approach of Coeliac Disease
Authors: Nijeboer Petula , van Gils Tom , Reijm Martine , Ooijevaar Rogier , Lissenberg-Witte Birgit I. , Bontkes Hetty J. , Mulder Chris J.J. , Bouma Gerd 
Published: May 2018

Goals:
To validate cut-off values of CD3+ T-cell receptor gamma-delta chain (TCRγδ+) intraepithelial lymphocyte (IEL) in the (differential) diagnosis of celiac disease (CD).

Background:
CD is characterized by an increase in gamma-delta IEL (CD3+TCRγδ+ IEL).

Study:
Percentages were determined by flow cytometric analysis of IELs from small bowel biopsies in 213 CD and 13 potential CD (PCD) patients and in total 112 controls. A cut-off value for percentages of CD3+TCRγδ+ IEL to differentiate active CD and controls was obtained from a receiver operating characteristic curve and implemented in controls and PCD patients.

Results:
Percentage of CD3+TCRγδ+ IEL was significantly increased in the majority of CD patients, irrespective of the presence of villous atrophy. A cut-off value of 14% for CD3+TCRγδ+ IEL resulted in 66.3% sensitivity and 96.6% specificity for CD diagnosis (area under the curve, 88.6%).

Conclusions:
A percentage of ≥14% CD3+TCRγδ+ IEL has a high specificity for CD diagnosis and can be of diagnostic help in cases where diagnosis is not straightforward.
Transcription factors FOXO in the regulation of homeostatic hematopoiesis
Authors: Menon Vijay , Ghaffari Saghi 
Published: May 2018

Purpose of review
Work in the past decade has revealed key functions of the evolutionary conserved transcription factors Forkhead box O (FOXO) in the maintenance of homeostatic hematopoiesis. Here the diverse array of FOXO functions in normal and diseased hematopoietic stem and progenitor cells is reviewed and the main findings in the past decade are highlighted. Future work should reveal FOXO-regulated networks whose alterations contribute to hematological disorders.

Recent findings
Recent studies have identified unanticipated FOXO functions in hematopoiesis including in hematopoietic stem and progenitor cells (HSPC), erythroid cells, and immune cells. These findings suggest FOXO3 is critical for the regulation of mitochondrial and metabolic processes in hematopoietic stem cells, the balanced lineage determination, the T and B homeostasis, and terminal erythroblast maturation and red blood cell production. In aggregate these findings highlight the context-dependent function of FOXO in hematopoietic cells. Recent findings also question the nature of FOXO's contribution to heme malignancies as well as the mechanisms underlying FOXO's regulation in HSPC.

Summary
FOXO are safeguards of homeostatic hematopoiesis. FOXO networks and their regulators and coactivators in HSPC are greatly complex and less well described. Identifications and characterizations of these FOXO networks in disease are likely to uncover disease-promoting mechanisms.
An update on PCOS in adolescents
Authors: Fitzgerald Shannon , DiVasta Amy , Gooding Holly 
Published: May 2018

Purpose of review
Polycystic ovarian syndrome (PCOS) is a common endocrinopathy which can be difficult to treat in adolescents. Fortunately, early identification and treatment can help mitigate some of the metabolic complications. In this review, we reflect on recent literature regarding PCOS diagnosis, associated complications, and treatment options.

Recent findings
Although there are three well known criteria to diagnose PCOS, they can be difficult to translate to adolescence. Newer diagnostic tools under study include anti-Mullerian hormone and revised ultrasound criteria. More is known about the many complications associated with PCOS, and new treatment options are on the horizon.

Summary
PCOS frequently will present during adolescence. These young women may already have symptoms of metabolic comorbidities. Providers caring for these patients must be aware of the many related complications and common treatment options. Newer diagnostic techniques and treatment options are under active study in adults, and may soon be translated to adolescence. A comprehensive approach allows treatment of patients’ concerns, and also prevention of metabolic complications.
Breastfeeding: uncovering barriers and offering solutions
Authors: Sayres Stephanie , Visentin Lisa 
Published: May 2018

Purpose of review
The Centers for Disease Control and Prevention and the American Academy of Pediatrics recommend exclusive breastfeeding for 6 months after an infant is born. Although the recommendations are well known, mothers face barriers that make breastfeeding difficult. This article reviews the recent literature on barriers to breastfeeding as well as strategies for pediatricians to use to help women overcome them.

Recent findings
The mode of delivery, mother's socioeconomic status, return to work, and prenatal breastfeeding education have been reported as factors that influence breastfeeding. Family-centered models for breastfeeding, peer support groups, and technology have been studied as potential ways to help women meet their breastfeeding goals.

Summary
Pediatricians are the first providers to care for babies after hospital discharge and are likely the first doctors that mothers see after childbirth. These early visits create opportunities for pediatricians to learn about the barriers that their patients face and open the doors to addressing these barriers.
The Efficacy of Regional Anesthesia Techniques to Control Postoperative Pain After Total Knee Arthroplasty
Authors: Otten Cecilia , Dunn Karen S. 
Published: May 2018

BACKGROUND:
Choosing the most effective type of anesthesia for controlling postoperative pain is paramount for improving patient outcomes and patient satisfaction. Most often, the type of anesthesia selected is dependent on the duration and type of surgical procedure and anesthesiologist/surgeon preference. Using a combination of regional anesthesia techniques, however, remains the cornerstone of multimodal analgesia for postoperative pain management after total knee arthroplasty.

PURPOSE:
The purpose of this study was to determine what regional anesthesia techniques and/or combinations of regional anesthesia techniques provided the best postoperative pain control in patients who had undergone a total knee arthroplasty.

METHODS:
Retrospective chart review.

RESULTS:
Patients who received a single-shot regional anesthetic reported significantly more postoperative opiate consumption and requested pain medication significantly sooner than patients who received multimodal techniques of regional analgesia.

CONCLUSION:
This study found support for the use of multimodal analgesia techniques for optimum postoperative pain management after total knee arthroplasty.
Suspecting Hyperferritinemic Sepsis in Iron-Deficient Population: Do We Need a Lower Plasma Ferritin Threshold?*
Authors: Ghosh Swarup , Baranwal Arun K. , Bhatia Prateek , Nallasamy Karthi 
Published: May 2018

Objectives:
Hyperferritinemia is being suggested to identify patients with sepsis-induced macrophage activation syndrome for early intervention. However, data among iron-deficient children are scarce. This study was planned to explore the biological behavior of plasma ferritin in children from communities with a high frequency of iron deficiency with septic shock and its association with the outcome.

Design:
Prospective observational study.

Setting:
Tertiary care teaching hospital in a low-middle income economy of South Asia.

Patients or Subjects:
Patients (6 mo to 12 yr) (n = 42) with septic shock and their healthy siblings as controls (n = 36). Patients/controls with blood transfusion/iron supplement during last 6 months or with any chronic disease were excluded.

Interventions:
None.

Measurements and Main Results:
Ferritin was measured in patients at enrollment and then at 1 month of hospital discharge while they were not on iron supplementation and in controls as indicative of baseline level. Patients’ median age was 30 months (13.5–87 mo), 31% were malnourished, majority (86%) had anemia, and two thirds had microcytic hypochromic red cells. Ferritin at admission was 763 ng/mL (480–1,820 ng/mL) in nonsurvivors, whereas 415 ng/mL (262–852 ng/mL) in survivors (p = 0.11). Pediatric Logistic Organ Dysfunction score and C-reactive protein correlated positively with plasma ferritin (p = 0.03 and p = 0.01, respectively) at enrollment. Elevated ferritin of greater than 500 ng/mL (relative risk, 2.48; 95% CI, 0.95–6.43) and greater than 1,000 ng/mL (relative risk, 1.94; 95% CI, 0.94–4.02) were associated with higher mortality but not independently. Among survivors, the 1-month follow-up ferritin fell significantly to 97 ng/mL (16–118 ng/mL) (p = 0.001). However, it was still significantly higher than that in sibling controls (19 ng/mL [10–54 ng/mL]) (p = 0.003).

Conclusions:
Ferritin rises significantly in septic shock patients despite iron deficiency and seems to correlate with the severity of inflammation and organ dysfunction. Even a lower threshold (of 500 or 1,000 ng/mL) could predict higher mortality. It may suggest the need for redefining the plasma ferritin threshold for suspecting hyperferritinemic sepsis and sepsis-induced macrophage activation syndrome in these patients. Larger studies with frequent ferritin measurements are desirable to validate these initial observations.
Organizational Supports for Research Evidence Use in State Public Health Agencies: A Latent Class Analysis
Authors: Hu Hengrui , Allen Peg , Yan Yan , Reis Rodrigo S. , Jacob Rebekah R. , Brownson Ross C. 
Published: May 2018

Objective:
Use of research evidence in public health decision making can be affected by organizational supports. Study objectives are to identify patterns of organizational supports and explore associations with research evidence use for job tasks among public health practitioners.

Design:
In this longitudinal study, we used latent class analysis to identify organizational support patterns, followed by mixed logistic regression analysis to quantify associations with research evidence use.

Setting:
The setting included 12 state public health department chronic disease prevention units and their external partnering organizations involved in chronic disease prevention.

Participants:
Chronic disease prevention staff from 12 US state public health departments and partnering organizations completed self-report surveys at 2 time points, in 2014 and 2016 (N = 872).

Main Outcome Measures:
Latent class analysis was employed to identify subgroups of survey participants with distinct patterns of perceived organizational supports. Two classify-analyze approaches (maximum probability assignment and multiple pseudo-class draws) were used in 2017 to investigate the association between latent class membership and research evidence use.

Results:
The optimal model identified 4 latent classes, labeled as “unsupportive workplace,” “low agency leadership support,” “high agency leadership support,” and “supportive workplace.” With maximum probability assignment, participants in “high agency leadership support” (odds ratio = 2.08; 95% CI, 1.35-3.23) and “supportive workplace” (odds ratio = 1.74; 95% CI, 1.10-2.74) were more likely to use research evidence in job tasks than “unsupportive workplace.” The multiple pseudo-class draws produced comparable results with odds ratio = 2.09 (95% CI, 1.31-3.30) for “high agency leadership support” and odds ratio = 1.74 (95% CI, 1.07-2.82) for “supportive workplace.”

Conclusions:
Findings suggest that leadership support may be a crucial element of organizational supports to encourage research evidence use. Organizational supports such as supervisory expectations, access to evidence, and participatory decision making may need leadership support as well to improve research evidence use in public health job tasks.
Case Reports and Consent for Publishing in Rheumatology Journals
Authors: Pineda Carlos , Sandoval Hugo 
Published: May 2018

Abstract
Case reports have a long-standing tradition in the current rheumatology literature. We aimed to present the main points of view regarding the importance, meaning, and barriers of consent for publishing under the comprehensive protection of patients' rights within this genre. We encourage Latin American editors and authors of rheumatology journals to adopt the best ethical practices in the field, avoiding security and legal liabilities from a regional perspective.
The Profile of Serum Transferrin Isoforms in Rheumatoid Arthritis
Authors: Gudowska Monika , Gruszewska Ewa , Wrona Alicja , Gindzienska-Sieskiewicz Ewa , Domyslawska Izabela , Lipartowska-Klimuk Karina , Cylwik Bogdan , Sierakowski Stanislaw , Chrostek Lech 
Published: May 2018

Introduction
Transferrin, a microheterogeneous iron-transporting N-glycoprotein, is an optimal model for the analysis of the glycosylation profile in rheumatoid arthritis (RA). The aim of this study was to assess the transferrin isoforms profile in RA patients at the time of diagnosis and then look into their associations with disease activity.

Methods
Serum samples were collected from 48 patients with RA. The patients were males (6) and females (42) (age range: 33–85 years). Control group consisted of 30 healthy volunteers. Transferrin isoforms were analysed by capillary electrophoresis on MINICAP electrophoretic system.

Results
There was a significant decrease in the relative concentrations of trisialo- (mean ± SD; 2.130 ± 1.112) and pentasialotransferrin (13.562 ± 3.088), and significant increase in tetrasialotransferrin (83.640 ± 3.165) in RA patients when compared to the control group (3.615 ± 1.156; 76.840 ± 5.621; 18.610 ± 6.027, respectively) (U Mann–Whitney test: p < 0.001 for all comparisons). There were no significant changes in the disialotransferrin concentrations in RA patients. Trisialotransferrin concentration correlated with RA activity expressed as DAS 28 in RA patients (p < 0.001). The low trisialotransferrin concentration was also associated with high platelet count and high ESR (p < 0.001 for both). Disialo-, tetrasialo- and pentasialotransferrin concentrations did not correlate with DAS 28.

Conclusions
In patients with RA the serum profile of transferrin isoforms is altered. We predict that the levels of trisialylated isoforms of transferrin will serve as a useful biochemical marker of the RA activity.
Clinical Profile of Levamisole-Adulterated Cocaine-Induced Vasculitis/Vasculopathy
Authors: Muñoz-Vahos Carlos Horacio , Herrera-Uribe Sebastián , Arbeláez-Cortés Álvaro , Jaramillo-Arroyave Daniel , González-Naranjo Luis Alonso , Vásquez-Duque Gloria , Restrepo-Escobar Mauricio , Correa-Londoño Luis Alfonso , Arias-Restrepo Luis Fernando , Vanegas-García Adriana Lucía 
Published: May 2018

Objectives
The aims of this study were to describe clinical and laboratory manifestations of patients with levamisole-adulterated cocaine-induced vasculitis/vasculopathy and to propose a skin classification according to the distribution and severity of lesions.

Methods
We report the characteristics of 30 patients admitted with levamisole-adulterated cocaine-induced vasculitis/vasculopathy in 4 high-complexity institutions in Colombia, from December 2010 to May 2017. We compare our findings with the main published series.

Results
Median age was 31 years (interquartile range, 27–38 years) with a male-to-female ratio of 5:1. Eighty-three percent of the patients had retiform purpura affecting the limbs, buttocks, face, or abdomen; 73% had ear necrosis, 50% cutaneous ulcers, 17% genital necrosis, 13% oral ulcers, and 10% digital necrosis. Cutaneous involvement was classified according to the frequency of the compromised corporal area, and purpuric lesions were stratified in 4 grades of severity. Anti–neutrophil cytoplasmic autoantibodies were positive in 85% of the cases, lupus anticoagulant in 73%, and antinuclear autoantibodies in 57%; rheumatoid factor was negative in all cases. We found nephritis in 17 cases (57%). Prednisolone was used in most of the patients (70%), with other immunosuppressive agents being used in a lower percentage. Improvement was observed in 93% of the patients, but symptoms recurred in 40%, attributed to relapses in consumption. End-stage chronic renal disease developed in 10% of the cases, and 1 patient died.

Conclusions
Because of rising cocaine consumption and levamisole adulteration frequency, levamisole-adulterated cocaine-induced vasculitis/vasculopathy is becoming more common. Detailed characterization of skin involvement coupled with multiple antibody positivity is essential for a diagnosis. Renal involvement is frequent, clinically and histologically heterogeneous, and potentially serious.
Nailfold Videocapillaroscopy Changes Are Associated With the Presence and Severity of Systemic Sclerosis–Related Interstitial Lung Disease
Authors: Caetano Joana , Paula Filipe S. , Amaral Marta , Oliveira Susana , Alves José D. 
Published: May 2018

Objective
The aim of this study was to evaluate the association of nailfold videocapillaroscopy (NVC) changes and the presence and severity of interstitial lung disease (ILD) in systemic sclerosis.

Methods
This was a cross-sectional analysis of 48 systemic sclerosis patients (21 patients with ILD). The NVC characteristics considered were capillary organization, capillary loss (CL), avascular areas, enlarged and giant capillaries, hemorrhages, abnormally shaped capillaries, edema, and intermittent flux.
We analyzed the association between NVC findings and (1) presence and extension of ILD and (2) percent predicted of forced vital capacity (FVC) and the carbon monoxide diffusing capacity (DLCO).

Results
Capillary loss and avascular areas showed a significant association with the presence of ILD (odds ratio, 18.57; 95% confidence interval [CI], 2.17–158.72 [p = 0.008]; and odds ratio, 4.64; 95% CI, 1.35–15.91 [p = 0.015], respectively). Receiver operating characteristic (ROC) curve analysis confirmed the association between CL and ILD (area under the ROC curve, 90.1%; 95% CI, 81.8–91.4). Avascular areas and CL were associated with a worse pulmonary function (FVC −18.1% [p = 0.034], DLCO −14.0% [p = 0.013]; and FVC −15.3% [p = 0.086], DLCO −12.3% [p = 0.049], respectively). No association was found between other NVC findings and ILD or lung function.

Conclusions
Capillary loss and avascular area showed a significant association with the presence of ILD, supported by ROC curve analysis. These results may reinforce a prognostic role for NVC and a physiopathology mechanism for ILD based on vascular damage.
Sociodemographic Factors Affecting the Disease Acceptance and the Quality of Life in Patients With Parkinson's Disease: A Preliminary Study
Authors: Rosińczuk Joanna , Pytel Aleksandra , Kołtuniuk Aleksandra 
Published: May 2018

Abstract

Purpose
Parkinson’s disease (PD) significantly affects functioning of patients, thereby lowering their quality of life. The aim of this study was to evaluate the influence of sociodemographic variables on illness acceptance and quality of life in patients with idiopathic PD.

Design
This is a cross-sectional research study.

Methods
The study was conducted with 50 patients with PD. The diagnostic survey method was applied for the purposes of this study with the use of the Parkinson's Disease Questionnaire, the Acceptance of Illness Scale, and a study-specific demographic questionnaire that included questions about sociodemographic data. Multivariable logistic regression was derived to define independent predictors of quality of life.

Findings
Men assessed quality of life in the bodily discomfort domain as significantly worse than women (p = .0214). Age negatively and significantly affected the assessment of quality of life in particular domains. Professionally active respondents significantly more often accepted their disease than others (p = .0070).

Conclusions and Clinical Relevance
Being professionally active, living in urban areas, and having higher education and higher financial status increase subjective assessment of quality of life in patients with PD. Knowing the impact of sociodemographic variables on quality of life allows rehabilitation nurses to plan nursing and rehabilitation activities more effectively and in line with the capacity of a patient and caregivers.
The Therapeutic Relationship: Enhancing Referrals
Authors: Coyle Mary Kathleen 
Published: May 2018

Abstract

Purpose
This article focuses on the ways rehabilitation nurses use the therapeutic relationship to lessen barriers some veterans experience when a referral to mental health treatment is recommended.

Design
Veterans presenting with posttraumatic stress symptoms are discussed, and possible interventions within the therapeutic relationship are proposed.

Method
Veterans’ perception of mental health stigma, building a collaborative therapeutic relationship, recommending a referral and assessments of stress responses, posttraumatic stress symptoms, suicide risk, and intervention strategies are proposed.

Findings
When changes in functioning and suicidality occur in veterans with posttraumatic stress disorder symptoms, it is important to screen and engage veterans at risk.

Conclusions and Clinical Relevance
When veterans in the rehabilitation process present with a need for mental health referral, barriers to treatment may include the stigma of mental health treatment. Rehabilitation nurses using the therapeutic relationship act as change agents to assist veterans in overcoming these barriers to treatment. The therapeutic relationship provides nurses with a foundation to provide opportunities for veterans to be supported and to seek treatment.