bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relative efficacy and safety of topical non-steroidal anti-inflammatory drugs for osteoarthritis: a systematic review and network meta-analysis of randomised controlled trials and observational studies
Authors: Zeng Chao , Wei Jie , Persson Monica S M , Sarmanova Aliya , Doherty Michael , Xie Dongxing , Wang YiLun , Li Xiaoxiao , Li Jiatian , Long Huizhong , Lei Guanghua , Zhang Weiya 
Published: February 2018

ObjectivesTo compare the efficacy and safety of topical non-steroidal anti-inflammatory drugs (NSAIDs), including salicylate, for the treatment of osteoarthritis (OA).MethodsPubMed, Embase, Cochrane Library and Web of Science were searched from 1966 to January 2017. Randomised controlled trials (RCTs) comparing topical NSAIDs with placebo or each other in patients with OA and observational studies comparing topical NSAIDs with no treatment or each other irrespective of disease were included. Two investigators identified studies and independently extracted data. Bayesian network and conventional meta-analyses were conducted. The primary outcomes were pain relief for RCTs and risk of adverse effects (AEs) for observational studies.Results43 studies, comprising 36 RCTs (7 900 patients with OA) and seven observational studies (218 074 participants), were included. Overall, topical NSAIDs were superior to placebo for relieving pain (standardised mean difference (SMD)=−0.30, 95% CI −0.40 to –0.20) and improving function (SMD=−0.35, 95% CI −0.45 to –0.24) in OA. Of all topical NSAIDs, diclofenac patches were most effective for OA pain (SMD=−0.81, 95% CI −1.12 to –0.52) and piroxicam was most effective for functional improvement (SMD=−1.04, 95% CI −1.60 to –0.48) compared with placebo. Although salicylate gel was associated with higher withdrawal rates due to AEs, the remaining topical NSAIDs were not associated with any increased local or systemic AEs.ConclusionsTopical NSAIDs were effective and safe for OA. Diclofenac patches may be the most effective topical NSAID for pain relief. No serious gastrointestinal and renal AEs were observed in trials or the general population. However, confirmation of the cardiovascular safety of topical NSAIDs still warrants further observational study.
Agalsidase alfa versus agalsidase beta for the treatment of Fabry disease: an international cohort study
Authors: Arends Maarten , Biegstraaten Marieke , Wanner Christoph , Sirrs Sandra , Mehta Atul , Elliott Perry M , Oder Daniel , Watkinson Oliver T , Bichet Daniel G , Khan Aneal , Iwanochko Mark , Vaz Frédéric M , van Kuilenburg André B P , West Michael L , Hughes Derralynn A , Hollak Carla E M 
Published: February 2018

BackgroundTwo recombinant enzymes (agalsidase alfa 0.2 mg/kg/every other week and agalsidase beta 1.0 mg/kg/every other week) have been registered for the treatment of Fabry disease (FD), at equal high costs. An independent international initiative compared clinical and biochemical outcomes of the two enzymes.MethodsIn this multicentre retrospective cohort study, clinical event rate, left ventricular mass index (LVMI), estimated glomerular filtration rate (eGFR), antibody formation and globotriaosylsphingosine (lysoGb3) levels were compared between patients with FD treated with agalsidase alfa and beta at their registered dose after correction for phenotype and sex.Results387 patients (192 women) were included, 248 patients received agalsidase alfa. Mean age at start of enzyme replacement therapy was 46 (±15) years. Propensity score matched analysis revealed a similar event rate for both enzymes (HR 0.96, P=0.87). The decrease in plasma lysoGb3 was more robust following treatment with agalsidase beta, specifically in men with classical FD (β: −18 nmol/L, P<0.001), persisting in the presence of antibodies. The risk to develop antibodies was higher for patients treated with agalsidase beta (OR 2.8, P=0.04). LVMI decreased in a higher proportion following the first year of agalsidase beta treatment (OR 2.27, P=0.03), while eGFR slopes were similar.ConclusionsTreatment with agalsidase beta at higher dose compared with agalsidase alfa does not result in a difference in clinical events, which occurred especially in those with more advanced disease. A greater biochemical response, also in the presence of antibodies, and better reduction in left ventricular mass was observed with agalsidase beta.
Subthalamic stimulation and neuropsychiatric symptoms in Parkinson’s disease: results from a long-term follow-up cohort study
Authors: Abbes Marie , Lhommée Eugénie , Thobois Stéphane , Klinger Hélène , Schmitt Emmanuelle , Bichon Amélie , Castrioto Anna , Xie Jing , Fraix Valérie , Kistner Andrea , Pélissier Pierre , Seigneuret Éric , Chabardès Stéphan , Mertens Patrick , Broussolle Emmanuel , Moro Elena , Krack Paul 
Published: February 2018

BackgroundReports on behavioural outcomes after subthalamic nucleus deep brain stimulation in Parkinson’s disease are controversial and limited to short-term data. Long-term observation in a large cohort allows a better counselling and management.MethodsTo determine whether a long-term treatment with subthalamic stimulation induces or reduces impulse control behaviours, neuropsychiatric fluctuations and apathy, 69 patients treated with subthalamic stimulation are prospectively and retrospectively assessed using Ardouin Scale of Behavior in Parkinson’s Disease before and after 3–10 years of stimulation.ResultsAt a mean follow-up of 6 years, all impulse control disorders and dopaminergic addiction were significantly decreased, apart from eating behaviour and hypersexuality. Neuropsychiatric fluctuations also significantly improved (ON euphoria: 38% of the patients before surgery and 1% after surgery, P<0.01; OFF dysphoria: 39% of the patients before surgery and 10% after surgery, P<0.01). However, apathy increased (25% of the patients after surgery and 3% before, P<0.01). With the retrospective analysis, several transient episodes of depression, apathy, anxiety and impulse control disorders occurred.ConclusionsBilateral subthalamic nucleus stimulation was overall very effective in improving impulse control disorders and neuropsychiatric fluctuations in parkinsonian patients in the long term despite a counteracting frequent apathy. Transient episodes of impulse control disorders still occurred within the follow-up. These findings recommend a close follow-up in parkinsonian patients presenting with neuropsychiatric symptoms before deep brain stimulation surgery.Clinical trial registrationNCT01705418;Post-results.
Differences in experiences of barriers to STI testing between clients of the internet-based diagnostic testing service GetCheckedOnline.com and an STI clinic in Vancouver, Canada
Authors: Gilbert Mark , Thomson Kimberly , Salway Travis , Haag Devon , Grennan Troy , Fairley Christopher K , Buchner Chris , Krajden Mel , Kendall Perry , Shoveller Jean , Ogilvie Gina 
Published: February 2018

ObjectivesInternet-based STI testing programmes may overcome barriers posed by in-clinic testing, though uptake could reflect social gradients. The role these services play in comparison to clinical testing services is unknown. We compared experiences of testing barriers between STI clinic clients to clients of GetCheckedOnline.com (GCO; where clients take a printed lab form to a lab).MethodsOur 10-month cross-sectional study was conducted after GCO was promoted to STI clinic clients and men who have sex with men (MSM). Clinic and GCO clients completed an online survey assessing testing barriers and facilitators; responses were compared using bivariate analysis (level of significance P<0.01; significant results below).ResultsCompared with 321 clinic clients, the 73 GCO clients were more likely to be older (median 35 vs 30 years), MSM (45% vs 16%), be testing routinely (67% vs 39%), have delayed testing for any reason (76% vs 54%) and due to clinic distance (28% vs 9%), report delays due to wait times (50% vs 17%), embarrassment with testing (16% vs 6%), discomfort discussing sexual health where they usually go for testing (39% vs 22%), as well as discomfort discussing sexual history with (19% vs 5%) and fearing judgement from (30% vs 15%) any healthcare provider. GCO clients were less likely to have found clinic hours convenient (59% vs 77%) and clinic appointments easy to make (49% vs 66%), and more likely to report long wait times (50% vs 17%). We found no differences in technology skills/use.ConclusionsIn this urban setting, an internet-based testing service effectively engaged individuals experiencing testing barriers, with few social gradients in uptake. While some testing barriers could be addressed through increasing access to clinical services, others require social and structural changes, highlighting the importance of internet-based STI testing services to increasing test uptake.
Postoperative Infection Related with the Total Elbow Arthroplasty (Kudo’s Prosthesis) in Rheumatoid Arthritis
Authors: Minami Michio , Kondo Makoto , Nishio Yasuhiko , Suzuki Koji , Kato Sadatoshi , Kawamura Sumito , Kato Hiroyuki , Minami Akio 
Published: February 2018

Background: Total Elbow Arthroplasty (TEA) for the rheumatoid arthritis (RA) has been popularized since 1980s. The outcomes of TEA using any type of implant design for RA has been satisfactory. On the other hand, many orthopedicians experience several postoperative complications. Among them, postoperative infection has still being the most troublesome and difficult to treat. This study is to clarify the causes of postoperative infection of TEA using Kudo’s prosthesis for RA and discuss how to manage and prevent infection.Methods: 421 TEAs were performed for 405 cases with RA at the authors’ institute during the period between 1982 and 2007. They were followed up for 1~25 years (Av. 12.3 years). The authors examined pain, the range of motion, roentgenograms and complications postoperatively. We were able to start treatment within 4 weeks after occurrence of infection. For surgical management of infected TEAs, debridement of the synovium and removal of the prosthesis with loosening were performed for all cases. In addition, all cases have been regularly and strictly followed-up with the elbow protector to prevent recurrence of infection since 2008.Results: There were 98 TEAs with the postoperative complications (23.3%). Eight out of 98 TEAs were infected (1.9%). Five of eight infected TEAs were primarily at the surgical scar site infection (SSSI) (60%), unknown causes in two, hematogenous course in 1. It’s obvious that surgical scar site infection (SSSI) was the leading cause of postoperative infection in this study. Thus, the authors made the elbow proctor to avoid injuries of the skin around surgical scar site (SSS). Since 2008, all of the TEAs and revised TEAs have been applied with this protector.Conclusions: The authors reported 8 infected TEAs: 5 cases were revised, 2 with the brace, 1 had above the elbow amputated. The regular and meticulous follow up and application of the elbow protector were useful to prevent infection of post-TEAs using Kudo’s prosthesis in RA. Since 2008, there have been no infection of post TEAs and revised TEAs.
Examination of muscle composition and motor unit behavior of the first dorsal interosseous of normal and overweight children
Authors: Miller Jonathan D. , Sterczala Adam J. , Trevino Michael A. , Herda Trent J. 
Published: February 2018

We examined differences between normal weight (NW) and overweight (OW) children aged 8–10 yr in strength, muscle composition, and motor unit (MU) behavior of the first dorsal interosseous. Ultrasonography was used to determine muscle cross-sectional area (CSA), subcutaneous fat (sFAT), and echo intensity (EI). MU behavior was assessed during isometric muscle actions at 20% and 50% of maximal voluntary contraction (MVC) by analyzing electromyography amplitude (EMGRMS) and relationships between mean firing rates (MFR), recruitment thresholds (RT), and MU action potential amplitudes (MUAPsize) and durations (MUAPtime). The OW group had significantly greater EI than the NW group ( P = 0.002; NW, 47.99 ± 6.01 AU; OW, 58.90 ± 10.63 AU, where AU is arbitrary units) with no differences between groups for CSA ( P = 0.688) or MVC force ( P = 0.790). MUAPsizewas larger for NW than OW in relation to RT ( P = 0.002) and for MUs expressing similar MFRs ( P = 0.011). There were no significant differences ( P = 0.279–0.969) between groups for slopes or y-intercepts from the MFR vs. RT relationships. MUAPtimewas larger in OW ( P = 0.015) and EMGRMSwas attenuated in OW compared with NW ( P = 0.034); however, there were no significant correlations ( P = 0.133−0.164, r = 0.270−0.291) between sFAT and EMGRMS. In a muscle that does not support body mass, the OW children had smaller MUAPsizeas well as greater EI, although anatomical CSA was similar. This contradicts previous studies examining larger limb muscles. Despite evidence of smaller MUs, the OW children had similar isometric strength compared with NW children.NEW & NOTEWORTHY Ultrasound data and motor unit action potential sizes suggest that overweight children have poorer muscle composition and smaller motor units in the first dorsal interosseous than normal weight children. Evidence is presented that suggests differences in action potential size cannot be explained by differences in subcutaneous fat alone.
Opposing effects of 2-deoxy-d-glucose on interictal- and ictal-like activity when K+currents and GABAAreceptors are blocked in rat hippocampus in vitro
Authors: Nedergaard Steen , Andreasen Mogens 
Published: February 2018

The ketogenic diet (KD), a high-fat, carbohydrate-restricted diet, is used as an alternative treatment for drug-resistant epileptic patients. Evidence suggests that compromised glucose metabolism has a significant role in the anticonvulsant action of the KD; however, it is unclear what part of the glucose metabolism that is important. The present study investigates how selective alterations in glycolysis and oxidative phosphorylation influence epileptiform activity induced by blocking K+currents and GABAAand NMDA receptors in the hippocampal slice preparation. Blocking glycolysis with the glucose derivative 2-deoxy-d-glucose (2-DG; 10 mM) gave a fast reduction of the frequency of interictal discharge (IED) consistent with findings in other in vitro models. However, this was followed by the induction of seizure-like discharges in area CA1 and CA3. Substituting glucose with sucrose (glucopenia) had effects similar to those of 2-DG, whereas substitution with l-lactate or pyruvate reduced the IED but had a less proconvulsant effect. Blockade of ATP-sensitive K+channels, glycine or adenosine 1 receptors, or depletion of the endogenous anticonvulsant compound glutathione did not prevent the actions of 2-DG. Baclofen (2 μM) reproduced the effect of 2-DG on IED activity. The proconvulsant effect of 2-DG could be reproduced by blocking the oxidative phosphorylation with the complex I toxin rotenone (4 μM). The data suggest that inhibition of IED, induced by 2-DG and glucopenia, is a direct consequence of impairment of glycolysis, likely exerted via a decreased recurrent excitatory synaptic transmission in area CA3. The accompanying proconvulsant effect is caused by an excitatory mechanism, depending on impairment of oxidative phosphorylation.NEW & NOTEWORTHY This study reveals two opposing effects of 2-deoxy-d-glucose (2-DG) and glucopenia on in vitro epileptiform discharge observed during combined blockade of K+currents and GABAAreceptors. Interictal-like activity is inhibited by a mechanism that selectively depends on impairment of glycolysis and that results from a decrease in the strength of excitatory recurrent synaptic transmission in area CA3. In contrast, 2-DG and glucopenia facilitate ictal-like activity by an excitatory mechanism, depending on impairment of mitochondrial oxidative phosphorylation.
ОСОБЛИВОСТІ КОМУНІКАТИВНОЇ ВЗАЄМОДІЇ МЕДИЧНОЇ СЕСТРИ ТА ГЕРІАТРИЧНИХ ХВОРИХ
Authors: Ivanchuk O. V. , Bob A. O. 
Published: February 2018

Мистецтво спілкування є невід'ємною частиною діяльності медичної сестри, що потребує ретельного вивчення та постійного вдосконалення. Робота з геріатричними хворими потребує високого професіоналізму в сфері встановлення комунікативного зв'язку. Формування комунікативної культури майбутнього медика починається з ознайомлення із теоретичним матеріалом, вивчення правил етики та деонтології, а й своєчасного виявлення труднощів у професійному спілкуванні.
Weakly or Strongly Nonlinear Mesoscale Dynamics Close to the Tropopause?
Authors: Li Qiang , Lindborg Erik 
Published: February 2018

Abstract
Recently, it has been discussed whether the mesoscale energy spectra in the upper troposphere and lower stratosphere are generated by weakly or strongly nonlinear dynamics. A necessary condition for weak nonlinearity is that the Rossby number Ro ≡ |ζz|/f ≪ 1, where ζz is the vertical vorticity and f is the Coriolis parameter. First, it is shown that Ro can be estimated by integration of the rotational wavenumber energy spectrum Er. Then divergence and rotational energy spectra and their ratio, R ≡ Ed/Er, are calculated from the Measurement of Ozone and Water Vapor by Airbus In-Service Aircraft (MOZAIC) dataset, and it is shown that at least 1000 flight segments are needed to obtain converged results. It is found that R &lt; 1 in the upper troposphere, ruling out the hypothesis that the spectra are produced by inertia–gravity waves with frequencies larger than f. In the lower stratosphere R is slightly larger than unity. An analysis separating between land and ocean data shows that Ed and temperature spectra have somewhat larger magnitude over land compared to ocean in the upper troposphere—a signature of orographically or convectively forced gravity waves. No such effect is seen in the lower stratosphere. At midlatitudes the Rossby number is on the order of unity and at low latitudes it is larger than unity, indicating that strong nonlinearities are prevalent. Also the temperature spectra, when converted into potential energy spectra, have larger magnitude than predicted by the weakly nonlinear wave hypothesis.
Study of thermal-sensitive alginate-Ca2+/poly(N-isopropylacrylamide) hydrogels supported by cotton fabric for wound dressing applications
Authors: Li Bing , Li Dapeng , Yang Yanni , Zhang Lu , Xu Ke , Wang Jiping 
Published: February 2018

In this study, direct deposition, 1,2,3,4-butanetetracarboxylic acid (BTCA) crosslinking, chelating and ultraviolet (UV) photo-grafting methods were employed to bond alginate-Ca2+/poly( N-isopropylacrylamide) (PNIPAAm) interpenetrating network hydrogel onto cotton fabric surface for wound dressing applications. Infrared spectroscopy confirmed the presence of alginate-Ca2+/PNIPAAm hydrogels on the cotton fabrics. Scanning electron microscopy was used to investigate surface and cross-section morphologies. Differential scanning calorimetry and three-dimensional video microscopy indicated that fabric-supported hydrogels maintained the thermal-sensitive property with a lower critical solution temperature (LCST) of around 34–35℃. The results of water vapor permeation revealed that the water vapor transmission rate at 37℃ was significantly higher than that at 25℃ for the shrink and collapse of the hydrogels above the LCST. Moreover, the breaking stress of the fabric-supported hydrogels was similar to that of the original cotton fabrics, but much larger than the hydrogels by themselves. The UV photo-grafting provided the strongest peel strength, followed by the BTCA crosslinking, the chelating and the direct deposition method. The cotton fabric-supported alginate-Ca2+/PNIPAAm hydrogels were stiffer than the original cotton fabric due to the high glass transition temperature of PNIPAAm (about 140℃). The in vitro drug release experiment confirmed that the cumulative release amount was much higher at around 37℃ (above the LCST) than at 25℃ (below the LCST). This showed that the fabric-supported thermal-sensitive hydrogels had functions of keeping the wound area breathable and comfortable, and provided controlled drug release with good mechanical properties, indicating a great potential and significance for wound dressing applications.
Video-assisted thoracoscopic thymectomy for thymoma: a single-center experience
Authors: Nguyen Giang Truong , Nguyen Trung Ngoc , Nguyen Nam Van , Nguyen Kien Trung , Le Anh Viet 
Published: February 2018

Background Thymoma is a primary tumor derived from the epithelial cells of the thymus, which is commonly seen in the mediastinum. Surgical thymectomy is the radical treatment for thymoma. The recent introduction of video-assisted thoracoscopic surgery has improved the quality of thymectomy surgery. The clinical characteristics of thymoma and the outcomes of video-assisted thoracoscopic thymectomy in Vietnamese patients are still lacking. The objectives of this study were to investigate the clinical and laboratory characteristics of thymoma and to evaluate the early results of video-assisted thoracoscopic thymectomy for thymoma in Vietnamese patients. Methods All 53 thymoma patients with or without myasthenia gravis who underwent video-assisted thoracoscopic thymectomy in Military Hospital 103, Vietnam, from October 2013 to July 2017 were included. Results The mean age was 46.5 7.1 years, and the female/male ratio was 1.2:1. Myasthenia gravis, mostly stage IIA, was present in 84.9% of patients. There was no hospital mortality or major postoperative complication. The mean operative time was 65 min, intensive care unit stay was 22 ± 5 h, and postoperative hospital stay was 7.5 ± 1.7 days. Conclusion Thoracoscopic thymectomy for thymoma in Vietnamese patients achieved improved cosmesis and was safe for both non-myasthenia gravis and myasthenia gravis patients.
Detecting stent geometry changes after venous recanalization using duplex ultrasound
Authors: Barbati Mohammad E , Gombert Alexander , Toonder Irwin , van Vuuren Timme MAJ , Schleimer Karina , Grommes Jochen , Wittens Cees HA , Jalaie Houman 
Published: February 2018

Background Patients with post-thrombotic syndrome due to chronic venous obstruction and resistant to conservative management can benefit from endovenous revascularization. The current study investigated the usefulness of duplex ultrasound in monitoring the stent changes over the time. Method All duplex ultrasound images of treated patients were reviewed retrospectively. The stent diameter and area during the follow-up visits have been analyzed. Result A total of 210 stents were placed in 137 limbs. Duplex ultrasound findings showed a decrease in area of stent in all patients (mean: 0.69 cm2). Reduction of stent area over the time was a predictor of stent patency (odds ratio: 0.910; confidence interval: 0.832–0.997). Conclusion Duplex ultrasound has sufficient accuracy in detection of stent changes and its patency. There is a discrepancy between diameter of the stent lumen in vitro and after deployment in all patients. Stent occlusion is related to reduction of stent lumen over the time rather than the percent of the stenosis.