bluuebunny/crossref_metadata_2025_split huggingface dataset:
Drug use beyond the licence in palliative care: A systematic review and narrative synthesis
Authors: Hagemann Vera , Bausewein Claudia , Remi Constanze 
Published: April 2019

Background: Drug use beyond the licence (off-label use, off-label drug use) is a common practice in palliative care and respective recommendations can often be identified in the literature. It is both risky and offers opportunities at the same time and, therefore, requires special attention in clinical practice. Aim: To determine the prevalence of off-label drug use in palliative care and to identify, evaluate and critically appraise studies describing the clinical practice, healthcare professionals’ awareness, knowledge and attitudes towards off-label-use and management strategies. Design: Systematic literature review following the guidance of the Centre for Reviews and Dissemination. Data sources: Medline, Embase, Web of Science and Current Contents Connect were searched in July 2018 as well as hand searches. The reference lists of pertinent studies were screened for further relevant publications, and citation tracking was performed. Results: Eight studies met the inclusion criteria. Due to the variety in study designs and settings, no meta-analysis or meaningful statistical analysis was possible and a narrative synthesis of the data was performed. Frequency of off-label drug use ranged from 14.5% to 35%. Up to 97% of palliative care units did not have any policy or guidance on handling off-label drug use. About 20% of prescribers never obtain consent in the context of off-label use. Conclusion: Off-label use is common in palliative care with up to one-third of prescriptions affected. Challenges are often related to obtaining informed consent. Little is known about the decision-making process. More information and guidance for the prescribers are needed to enable safe handling of drugs outside their licence in palliative care.
The use of antimalarials in combination with other disease modifying agents in RA – the British experience
Authors: Duncan MR , Capell HA 
Published: April 2019

Antimalarial drugs are effective disease modifying agents in RA with a low incidence of serious toxic effects. Recently, combinations of second-line agents have been used in RA in attempts to treat patients with no response to a number of single agents, or suboptimal response to a single agent. Combinations of drugs have been selected for maximum efficacy and minimum toxicity, but clinical trials are difficult to design and interpret. In particular, ensuring adequate power to detect small differences in response poses a major problem. Antimalarials are an attractive choice for combination therapy due to their efficacy, mechanisms of action and toxicity profile. In this review, the evidence for the use of antimalarials in combination in RA is examined. No advantage has been shown in combining antimalarials with gold, penicillamine or sulphasalazine compared with monotherapeutic regimens. There is some evidence to suggest a beneficial combination of antimalarials with methotrexate, but this is as yet inconclusive. Open non-randomised uncontrolled studies have shown that antimalarials combined with cytotoxic agents are effective but highly toxic. The authors conclude that there is little good evidence to support the introduction of combination second-line drug therapy for RA into widespread therapeutic use.
Effects of dry needling in the sternocleidomastoid muscle on cervical motor control in patients with neck pain: a randomised clinical trial
Authors: Martín-Rodríguez Aida , Sáez-Olmo Esther , Pecos-Martín Daniel , Calvo-Lobo César 
Published: April 2019

Objective:To determine the changes produced by trigger point dry needling (TrP-DN) of sternocleidomastoid in patients with neck pain, and to observe how it might modify cervical motor control (CMC).Design:Single-centre, randomised, double-blinded clinical trial.Setting:Participants were recruited through advertising. The duration of the study was 6 months.Subjects:Thirty-four subjects with non-specific neck pain, aged over 18 years with an active myofascial trigger point in sternocleidomastoid, participated in the study. They were randomly assigned to treatment or control groups.Methods:TrP-DN inside or (1.5 cm) outside of the active myofascial trigger point of sternocleidomastoid.Main outcome measures:CMC, visual analogue scale and cervical range of motion were assessed before treatment, immediately post treatment, and 24 h, 1 week and 1 month after the intervention; the neck disability index was evaluated before treatment and 1 month later.Results:With a confidence interval of 99%, TrP-DN of sternocleidomastoid was associated with a decrease in pain after 1 week and CMC improved 1 month after the intervention (p < 0.001), when compared with baseline measurements, within the experimental group; there were no statistically significant differences between experimental and control groups.Conclusion:The effects of TrP-DN inside and outside of active myofascial trigger points did not differ in this study. Both interventions were associated with a similar temporal effect, specifically a reduction in neck pain at 1 week and an increase CMC at 1 month. However, these findings should be interpreted with caution due to the lack of a contemporaneous untreated control group.
Brake Response Time Recovery After Achilles Tendon Repair
Authors: Reb Christopher W. , McDonald Elizabeth , Shakked Rachel J. , Winters Brian S. , Pedowitz David I. , Raikin Steven M. , Daniel Joseph N. 
Published: April 2019

Background. This study evaluated when patients’ brake response time (BRT) recovers after right Achilles repair. Methods. Institutional review board–approved prospective study of 60 patients. Assessments included visual analogue scale pain (VAS) score, Achilles Tendon Total Rupture Score (ATRS), and a driver readiness survey. Emergent brake pedal operation was simulated at 6 weeks postoperatively and repeated until patients achieved a passing BRT. Results. Fifty-seven patients completed the study. At 6 weeks, 54 of 59 (91.5%) patients had a passing BRT with a mean of 0.60 seconds (SD 0.08 seconds). Five (8.5%) patients had a failing BRT with a significantly higher mean of 0.95 seconds (SD 0.13 seconds, P = .01). At first testing, all patients were ambulating in a walking boot with removable heel wedges. Those who passed were using significantly fewer wedges (mean 1.9 vs 2.6 wedges, P = .04). Mean VAS pain scores (Passed: 1.1, SD 1.57, vs Failed: 2.8, SD 3.35, P = .32) were not significantly different. The mean ATRS was significantly lower among those who passed (63.7, SD 16.7, vs 85.4, SD 11.1, P = .01. Three patients repeated testing at a mean 7.3 weeks (range 6.7-8). All achieved passing times (mean 0.68 seconds, range 0.55 to 0.77 seconds). The driving readiness survey was 100% sensitive but 31.3% specific for passing BRT. Its positive predictive value was 80%, and its negative predictive value was 100%. Conclusion. BRT normalizes around 6 to 7 weeks after open right Achilles tendon repair. The ATRS and driver readiness questionnaire corresponded to achieving a passing BRT. Levels of Evidence: Prognostic Level II: Prospective Cohort Study
Application of Manual Therapy for Dysphagia in Head and Neck Cancer Patients: A Preliminary National Survey of Treatment Trends and Adverse Events
Authors: Krisciunas Gintas P , Vakharia Aneri , Lazarus Cathy , Taborda Stephanie Gomez , Martino Rosemary , Hutcheson Katherine , McCulloch Timothy , Langmore Susan E 
Published: April 2019

Background Radiation-associated dysphagia is a common and debilitating consequence of treatment for head and neck cancer (HNC). Since commonly employed dysphagia therapy programs for HNC patients still lack authoritative efficacy, some speech-language pathologists (SLPs) have started employing manual therapy (MT) techniques in an attempt to prevent or rehabilitate dysphagia in this patient population. However, exceptionally little is known about the use of MT in this patient population. Objectives The purpose of this study was to describe practice patterns as well as the rate, type, and severity of adverse events associated with SLP provision of MT to HNC patients. Methods An Internet-based questionnaire geared toward SLPs who practice MT was developed and sent to SLPs practicing in the United States, 3 times, through 3 national listservs (American Speech Language Hearing Association [ASHA] Special Interest Division 13, ASHA Special Interest Division 3, and University of Iowa Voiceserv), over the course of 4 weeks. Results Of the 255 respondents, 116 (45.5%) performed MT on HNC patients. Of these 116 SLPs, 27.6% provided proactive MT during radiation, 62.1% provided 1 to 2 sessions per week, and 94.8% prescribed a MT home program. The rate, type, and severity of reported adverse events were similar between HNC and non-HNC patients. Conclusion This preliminary survey demonstrated that SLPs provide MT to HNC patients during and after cancer treatment, and that reported adverse events paralleled those experienced by noncancer patients. However, these results should be taken with caution, and a well-designed prospective study is needed to formally establish the safety and the preliminary efficacy of this novel clinical intervention.
Quadriceps Recovery After Anterior Cruciate Ligament Reconstruction With Quadriceps Tendon Versus Patellar Tendon Autografts
Authors: Hunnicutt Jennifer L. , Gregory Chris M. , McLeod Michelle M. , Woolf Shane K. , Chapin Russell W. , Slone Harris S. 
Published: April 2019

Background: Quadriceps tendon (QT) autografts are being increasingly used for anterior cruciate ligament reconstruction (ACLR). A paucity of studies exist that compare QT autografts with alternative graft options. Additionally, concerns exist regarding quadriceps recovery after graft harvest insult to the quadriceps muscle-tendon unit. Purpose/Hypothesis: The purpose of this study was to compare quadriceps recovery and functional outcomes in patients with QT versus bone–patellar tendon–bone (BPTB) autografts. The hypothesis was that those with QT autografts would demonstrate superior outcomes. Study Design: Cohort study; Level of evidence, 3. Methods: Active patients with a history of primary, unilateral ACLR with soft tissue QT or BPTB autografts participated. Quadriceps recovery was quantified using variables of strength, muscle size, and activation. Knee extensor isometric and isokinetic strength was measured bilaterally with an isokinetic dynamometer and normalized to body weight. Quadriceps activation was measured with the superimposed burst technique. The maximal cross-sectional area of each quadriceps muscle was measured bilaterally using magnetic resonance imaging. Assessors of muscle size were blinded to the graft type and side of ACLR. Functional tests included hop tests and step length symmetry during walking, measured via spatiotemporal gait analysis. Self-reported function was determined with the International Knee Documentation Committee (IKDC) questionnaire. Neuromuscular and functional outcomes were expressed as limb symmetry indices (LSIs: [surgical limb/nonsurgical limb]*100%). Wilcoxon rank-sum tests were used to compare the LSIs and IKDC scores between groups. Results: There were 30 study participants (19 male, 11 female; median age, 22 years [range, 14-41 years]; median time since surgery, 8 months [range, 6-23 months]), with 15 patients in each group. There were no significant between-group differences in demographic variables or outcomes. LSIs were not significantly different between the QT versus BPTB group, respectively: knee extensor isokinetic strength at 60 deg/s (median, 70 [range, 41-120] vs 68 [range, 37-83]; P = .285), activation (median, 95 [range, 85-111] vs 92 [range, 82-105]; P = .148), cross-sectional area of the vastus medialis (median, 79 [range, 62-104] vs 77 [range, 62-95]; P = .425), single-leg hop test (median, 88 [range, 35-114] vs 77 [range, 49-100]; P = .156), and step length symmetry (median, 99 [range, 93-104] vs 98 [range, 92-103]; P = .653). The median IKDC scores between the QT and BPTB groups were also not significantly different: 82 (range, 67-94) versus 83 (range, 54-94); respectively ( P = .683). Conclusion: Patients with QT autografts demonstrated similar short-term quadriceps recovery and postsurgical outcomes compared with patients with BPTB autografts.
REPRESENTAÇÕES DO FEMININO NO DEBATE EDUCACIONAL DA DÉCADA DE 1920: a presença das mulheres no espaço público e o projeto de modernização do país
Authors: Iamashita Léa Maria Carrer 
Published: April 2019

Resumo O artigo trata das representações do feminino e da mulher brasileira no espaço público e privado, inseridas no debate educacional da década de 1920. A reflexão sobre o papel das mulheres na modernização do país ocorria concomitante às demandas do movimento feminista. É da resposta a essas demandas feministas que trataremos aqui. Palavras-Chave: Modernização. Representações. Movimento Feminista.REPRESENTATIONS OF THE FEMININE IN THE EDUCATIONAL DEBATE IN THE 1920s: the presence of women in the public space and the project of Brazil's modernization Abstract The article focuses on the representations of the feminine and Brazilian women in both public and private realms embedded in the educational debate of the 1920s. The reflection about the role of women along the modernization of the country occurred in parallel to demands of feminist movements. It is about an answer to these demands that we addressÂ here.Keywords: Modernization. Representations. Feminist Movement.
“Nutrizes fracas, crianças fracas”
Authors: Rocha Ariza Maria 
Published: April 2019

RESUMO
Este artigo discute a inserção dos suplementos alimentares, tais como: as vitaminas, tonificantes, alimentos naturais e industrializados, na propaganda higienista e nas imagens publicitárias do jornal O Estadão (1901-1940) como recomendação à saúde da lactante e do lactente pela propaganda higienista e publicidade alimentar brasileira.
Palavras-Chave: alimentação infantil, higienista, Jornal “O Estadão”.
PALAVRAS-CHAVE:Alimentação Infantil, Higienista, Jornal “O Estadão”.
The Indigenous Governor of Tlaxcala and Acceptable Indigenousness in the Porfirian Regime
Authors: Sumner Jaclyn Ann 
Published: April 2019

This article examines how Próspero Cahuantzi, governor of Tlaxcala from 1885–1911, claimed his Indigenous heritage. Cahuantzi asserted his Indigenousness by contributing to the Porfirian administration’s nation-building campaigns, which glorified Mexico’s Indigenous past. The article traces how Cahuantzi collected, disseminated, and protected Indigenous artifacts and history. Through his actions, which included giving speeches in Nahuatl at the Eleventh International Congress of Americanists (Mexico City, 1895), Cahuantzi ingratiated himself to national and international elites. Thus, the article shows how Cahuantzi’s Indigenousness helped him to secure a permanent political position in Porfirio Díaz’s dictatorship (1876–1910).
Este artículo examina la manera en que Próspero Cahuantzi, gobernador de Tlaxcala entre 1885 y 1911, reclamó para sí su legado indígena. Cahuantzi afirmó su carácter indígena colaborando con las campañas de construcción nacional del gobierno porfiriano que glorificaban el pasado indígena de México. En el artículo se revisa cómo Cahuantzi recolectó, difundió y protegió los objetos y la historia indígenas. Mediante sus acciones, entre las que se contó pronunciar discursos en náhuatl en el Décimo Primer Congreso Internacional de Americanistas (ciudad de México, 1895), Cahuantzi se congració con las élites nacionales e internacionales. Así, el artículo muestra cómo la condición indígena de Cahuantzi le ayudó a mantener un puesto político permanente en la dictadura de Porfirio Díaz (1876–1910).
Common Starling Sturnus vulgaris expansion in South Africa
Authors: Ivanova Ielyzaveta M. , Symes Craig T. 
Published: April 2019

The Common Starling Sturnus vulgaris has progressively expanded its range in South Africa since its introduction into Cape Town in the late 19th century. In the past few decades it has extended this range into Gauteng province. Using data from the Southern African Bird Atlas Project 2, this paper examines the spread and relative abundance changes for the species across South Africa over the past 10 years, with a detailed look at the recently-colonised Gauteng. Across South Africa, the Common Starling's distribution has shifted, and grown. As it spreads north along the coastline and northwards inland, some of the former range has been lost. In Gauteng, the species has shown a range and abundance expansion over the same period. If the observed trends are to continue, this species is likely to eventually become a prominent species across the entire country, and further north into the sub-region. However, the potential impact that this species has on indigenous avifauna is unknown and, in the face of rapid anthropogenic change, remains to be investigated.
U.S. Food and Drug Administration Benefit-Risk Assessment of Nilotinib Treatment Discontinuation in Patients with Chronic Phase Chronic Myeloid Leukemia in a Sustained Molecular Remission
Authors: Pulte E. Dianne , Wroblewski Tanya , Bloomquist Erik , Tang Shenghui , Farrell Ann , Deisseroth Albert , McKee Amy E. , Pazdur Richard 
Published: April 2019

Abstract

On December 22, 2017, the U.S. Food and Drug Administration (FDA) updated the product label for nilotinib to include information for providers on how to discontinue this drug in certain patients. With the updated dosing recommendations, select patients with chronic phase myeloid leukemia (CML) taking nilotinib for 3 years or more and whose leukemia has responded with sustained molecular remission (MR4.5, BCR-ABL transcripts of ≤0.0032%) as determined by a FDA-approved test may be eligible to discontinue nilotinib. The updated dosing regimen was based on the efficacy results from two trials that measured how long patients could stop taking nilotinib without the leukemia returning (treatment-free remission). Trial results demonstrated that, among selected patients who received nilotinib as first-line therapy or after transition from imatinib, approximately 50% continued to be in remission at 96 weeks after stopping therapy. Relapses continued to occur throughout the study, indicating that long-term monitoring is needed for safety and disease monitoring. Discontinuation of treatment was associated with an increased risk of low grade musculoskeletal adverse events, some of which were prolonged. Overall, the results support the approval of updates to the dosing recommendations with regard to treatment discontinuation in selected patients who have received nilotinib for at least 3 years, are in a sustained molecular remission, and who can undergo appropriate monitoring.
Tendência temporal da hanseníase em Aracaju, Sergipe, Brasil
Authors: Moreira Rebeca Silva , Costa João Santos , Moreira-Junior Vicente Trindade , Góes Marco Aurélio De Oliveira 
Published: April 2019

Justificativa e Objetivos: A hanseníase é uma doença infectocontagiosa crônica, com potencial incapacitante que mantém altas as taxas de incidência mesmo com tratamento eficaz e gratuito. Desta forma, este estudo objetiva analisar os dados epidemiológicos e operacionais da hanseníase em Aracaju-SE, a fim de diagnosticar a tendência da endemia e orientar o aprimoramento de políticas públicas que visem à sua eliminação. Métodos: Trata-se de um estudo ecológico, tipo série temporal, que analisou indicadores epidemiológicos e operacionais da Hanseníase no município de Aracaju, capital do estado de Sergipe,de 2003 a 2017. Resultados: Entre 2003 e 2017, a taxa de detecção da hanseníase manteve-se decrescente, com tendência anual de queda de 8,63% na população geral e 9,32% em menores de 15 anos. Durante este período, houve tendência a aumento do diagnóstico e tratamento da hanseníase pela Atenção Primária. A cura dos casos manteve-se estável e a proporção de contatos examinados apresentou um significativo incremento, saindo de 20,6%, em 2003, para 82,9%, em 2017. Identifica-se também uma tendência progressiva da queda na detecção das formas paucibacilares em detrimento das multibacilares. Conclusão: Há uma tendência de redução da detecção da hanseníase em Aracaju em todas as faixas etárias, porém, a região ainda é considerada de alta endemicidade. É possível perceber o crescimento do papel da Atenção Primária entre 2003 e 2017, além do aumento significativo do exame dos contatos, ferramenta importante no diagnóstico e tratamento precoce. Embora os indicadores de saúde tenham mostrado melhorias, esse avanço permanece insuficiente para adequado controle da doença.
Descritores: Epidemiologia. Indicadores de Saúde. Hanseníase. Saúde Pública.
ESQUELETOS, CATRINAS Y JUDAS EN EL UNIVERSO DECORATIVO DE DIEGO RIVERA</p> <p>Skeletons, Skulls (Calacas) and Judas in the Decorative Universe of Diego Rivera
Authors: Ruiz Gómez Ariadna Lorea 
Published: April 2019

El artista mexicano Diego Rivera encarga dos viviendas para él y Frida Kahlo al arquitecto Juan O´Gorman. Quién les realiza un proyecto completamente moderno, usando un lenguaje lecorbusiano basado en un funcionalismo radical, de paramentos lisos, sin decoración. En el interior sigue las mismas premisas y diseña desde el fregadero de la cocina a los muebles, todo dentro de una estética minimalista y sencilla.Lo que sorprende al estudiar el mobiliario y los elementos decorativos del estudio de Rivera es que, han perdurado los muebles de metal que diseñó O´Gorman, además de los que el muralista fue comprando, la mayoría realizados por artesanos mexicanos y de una estética tradicional. Pero sobre todo nos llama la atención, y es en este punto en el que centramos nuestra investigación, el que Rivera adornó de manera profusa su estudio, con mas de 140 enormes piezas, algunas de más de dos metros de altura, realizadas en cartón, que representan esqueletos y figuras de judas.
Perbandingan Efektivitas Terapi Zink dengan Tanpa Zink Pada Pasien Diare Anak Rawat Inap Di RSD Idaman Kota Banjarbaru
Authors: Wati Helmina , Rahmatullah Satrio Wibowo , Hepriatna Muhamad 
Published: April 2019

ABSTRAK Diare merupakan masalah utama kesehatan masyarakat, WHO dan UNICEF merekomendasikan penatalaksanaan diare pada pasien anak dengan penambahan suplemen zink. penelitian ini bertujuan untuk mengetahui perbandingan efektivitas terapi Zink dengan Tanpa zink terhadap pasien anak di rawat inap rumah sakit Idaman Banjarbaru. metode penelitian menggunakan dekriptif cross sectional dengan studi retrospektif. penelitian ini menggunakan 2 kelompok yaitu kelompok I, pasien yang mendapatkan terapi standar tanpa diberikan zink, kelompok II, pasien yang mendapatkan terapi standar dengan pemberian zink. hasil penelitian menunjukkan bahwa rata-rata lama waktu diare pada kelompok I selama 3 hari dibandingkan dengan kelompok II selama 4.4 hari. Hasil Spps menyatakan bahwa terdapat perbedaan yang signifikan antara kelompok I dan kelompok II (p<0,05). Kata kunci : Diare, Zink, tanpa Zink ABSTRACT Diarrhea is a major public health problem, WHO and UNICEF recommend management of diarrhea in pediatric patients with the addition of zinc supplements. This study aims to determine the comparison of the effectiveness of Zink therapy with no zinc on pediatric patients inpatient in Banjarbaru ideal hospital. The research method uses cross sectional descriptive with a retrospective study. This study used 2 groups, group I, patients who received standard therapy without zinc, group II, patients who received standard therapy with zinc. The results showed that the average length of time for diarrhea in group I was 3 days compared to group II for 5 days. The Spps results stated that there were significant differences between group I and group II (p <0.05). Keyword: Diarrea, Zink, Without Zink