bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dietary Vitamin C Deficiency Is Associated With Health-Related Quality of Life and Cardiac Event-free Survival in Adults With Heart Failure
Authors: Wu Jia-Rong , Song Eun Kyeung , Moser Debra K. , Lennie Terry A. 
Published: September 2018

Background:
Vitamin C deficiency is prevalent in adults with heart failure (HF). Little is known about the relationship of dietary vitamin C deficiency with health outcomes in adults with HF.

Objective:
The study’s aim was to determine the relationships of vitamin C deficiency measured at baseline with health-related quality of life (HRQOL) and cardiac event-free survival in patients with HF measured 1 year later.

Method:
A total of 251 patients with HF completed a 4-day food diary. Dietary vitamin C deficiency was defined as daily intake less than the estimated average requirement from the Institute of Medicine of 75 mg/d for men and 60 mg/d for women. Health-related quality of life was assessed using the Minnesota Living with Heart Failure Questionnaire at 12 months. Patients were followed for a median of 1 year to determine time to the first event of cardiac-related hospitalization or death. Data were analyzed by hierarchical linear and Cox proportional hazards regressions.

Results:
One hundred patients (40%) had vitamin C deficiency. Dietary vitamin C deficiency was associated with poorer HRQOL at 12 months (β = 0.16, P = .02) after controlling for demographic and clinical variables. During the follow-up period, 59 patients (24%) had cardiac events. In Cox regression, vitamin C deficiency predicted shorter cardiac event-free survival after adjusting for the same covariates (hazards ratio, 1.95; 95% confidence interval, 1.08–3.51).

Conclusion:
Vitamin C deficiency was associated with poorer HRQOL and shorter cardiac event-free survival in patients with HF. The findings suggest that encouraging patients with HF to consume a diet rich in fruits/vegetables to prevent vitamin C deficiency may lead to better health outcomes.
Translation and Cross-cultural Adaptation of the Chinese Version of the Self-care of Hypertension Inventory in Older Adults
Authors: Zhao Qiao , Guo Yujie , Gu Yu , Yang Lei 
Published: September 2018

Background:
Hypertension is highly prevalent among the older adults. Self-care is an effective method for the secondary prevention of hypertension, but until now, there has been no specialized instrument to evaluate the ability for self-care in elderly Chinese patients with hypertension.

Objectives:
The aims of this study were to cross-culturally translate the Self-care of Hypertension Inventory into Chinese and apply it to elderly patients with preliminary hypertension.

Methods:
This is a methodological study with steps that included translation, synthesis, back-translation, back-translation review, expert committee review, pretesting, and submission to authors. We conducted preliminary psychometric analyses that included content validity, item-total correlation, internal consistency reliability, principal factor analysis, and test/retest reliability.

Results:
The translation equivalence was obtained between the adapted version and the original scale. The item-level content validity index had a range of 0.833 to 1. The scale-level content validity average method and Cronbach α were 0.986 and 0.858 for the total scale, respectively. The test/retest reliability was 0.949. Principal factor analyses showed the presence of 4, 1, and 1 latent factors in 3 separate subscales.

Conclusions:
The Self-care of Hypertension Inventory has been successfully translated and cross-culturally adapted to Chinese. It is suitable for application to elderly Chinese patients with hypertension.
Public Reporting of Cardiac Outcomes for Patients With Acute Myocardial Infarction
Authors: de Cordova Pamela B. , Johansen Mary L. , Riman Kathryn A. , Rogowski Jeannette 
Published: September 2018

Background:
Percutaneous coronary intervention (PCI) is recognized by both the American Heart Association and the American College of Cardiology as an optimal therapy to treat patients experiencing acute myocardial infarction (AMI) with ST-segment elevation myocardial infarction. A health policy aimed at improving outcomes for the patient with AMI is public reporting of whether a patient received a PCI.

Objective:
A systematic review was conducted to evaluate the effect of public reporting for patients with AMI, specifically for those patients who receive PCI.

Methods:
EMBASE, MEDLINE, Academic Search Premier, Google Scholar, and PubMed were searched from inception through August 2017. Articles were selected for inclusion if researchers evaluated public reporting and included an outcome for whether a patient received a PCI during hospitalization for an AMI. Methodological quality of the included studies was evaluated, and findings were synthesized.

Results:
Eight studies of high methodological quality were included in the review. Most studies found that, in areas of public reporting, patients were less likely to undergo a PCI and high-risk patients did not undergo a PCI. Researchers also found that patients with AMI had lower in-hospital mortality after the implementation of public reporting, but only if these patients received a PCI.

Conclusions:
Although public reporting may have had intentions of improving care, there is strong evidence that this policy did not result in more timely PCIs or improved mortality of patients with AMI. In fact, public reporting resulted in unintended consequences of not providing care for the most vulnerable patients in fear of an adverse outcome.
The Experiences of Younger Individuals Living With Heart Failure
Authors: Walsh Alison , Kitko Lisa , Hupcey Judith 
Published: September 2018

Background:
Heart failure (HF) impacts 1.7 million Americans between the ages of 20 and 59 years, but limited research exists addressing the issues unique to this age group.

Objective:
The aim of this study was to investigate the experiences of younger persons living with HF.

Methods:
Semistructured interviews (n = 18) were analyzed using a qualitative thematic analysis.

Results:
Six themes emerged: (1) role fulfillment: participants who perceived their roles as a parent, caregiver, spouse, employee, and friend have been negatively affected by HF; (2) autonomy: participants frequently linked their well-being to a sense of independence, productivity, and purpose; (3) financial impact: most of the sample expressed financial instability further complicated by existing disability policies; (4) perception of self: recurrent statements revealed participants feeling judged because of their HF diagnosis and younger age; (5) retrospective life changes: participants reflected on past decisions and often blamed themselves for their current health; and (6) symptom burden: participants reported higher levels of psychosocial symptoms, such as depression, anxiety, and fatigue.

Conclusions:
Younger individuals living with HF reported overwhelmingly poor health-related quality of life that was linked to the 6 themes identified previously. The effect of HF was seen on numerous life events that traditionally occur earlier in the life course such as establishing a career, meaningful relationships, family, and financial security. This directly impacted health-related quality of life by disrupting what each individual perceived as important to them, which took a toll on their overall mental health. To provide holistic care to younger patients living with HF, interventions that address the heavy burden of psychosocial symptoms and policy changes associated with financial burden and disability laws must be developed.
Comparison Between Non–High-Density Lipoprotein Cholesterol and Low-Density Lipoprotein Cholesterol to Estimate Cardiovascular Risk Using a Multivariate Model
Authors: Palazón-Bru Antonio , Carbayo-Herencia Julio Antonio , Simarro-Rueda Marta , Artigao-Ródenas Luis Miguel , Divisón-Garrote Juan Antonio , Molina-Escribano Francisca , Ponce-García Isabel ,   on behalf of GEVA (Group of Vascular Diseases From Albacete)
Published: September 2018

Background:
Although studies exist comparing low-density lipoprotein cholesterol (LDL-C) and non-high-density lipoprotein cholesterol (HDL-C) in the development of cardiovascular disease (CVD), most have limitations in the mathematical models used to evaluate their prognostic power adjusted for the other risk factors (cardiovascular risk).

Objective:
The aim of this study was to compare LDL-C and non-HDL-C in patients with CVD to determine whether both parameters predict CVD similarly.

Methods:
A cohort of 1322 subjects drawn from the general population of a Spanish region was followed between 1992 and 2006. The outcome was time to CVD. Secondary variables were gender, age, hypertension, diabetes, personal history of CVD, current smoker, body mass index, LDL-C, and non-HDL-C. Two CVD prediction models were constructed with the secondary variables, with only the lipid parameter varying (non-HDL-C or LDL-C). In the construction of the models, the following were considered: multiple imputation, events per variable of 10 or more, and continuous predictors as powers. The validation was conducted by bootstrapping obtaining the distribution of the C statistic (discrimination) and the probabilities observed by smooth curves. These results were compared in both models using graphical and analytical testing.

Results:
There were a total of 137 CVD events. The models showed no differences in the distributions of the C statistic (discrimination, P = .536) or in the calibration plot.

Conclusions:
In our population, LDL-C and non-HDL-C were equivalent at predicting CVD. More studies using this methodology are needed to confirm these results.
Electroencephalogram Modifications Associated With Atypical Strict Antipsychotic Monotherapies
Authors: Dias Alves Manuel , Micoulaud-Franchi Jean Arthur , Simon Nicolas , Vion-Dury Jean 
Published: September 2018

Abstract

Background
Antipsychotics produce electroencephalogram (EEG) modifications and increase the risk of epileptic seizure. These modifications remain sparsely studied specifically for atypical antipsychotics. In this context, our study focuses on EEG modifications associated with atypical strict antipsychotic monotherapies.

Methods
Electroencephalogram recordings of 84 psychiatric patients treated with atypical antipsychotics in strict monotherapy (clozapine, n = 22; aripiprazole, n = 22; olanzapine, n = 17; risperidone, n = 9; quetiapine, n = 8; risperidone long-acting injection, n = 4; and paliperidone long-acting injection, n = 2) were analyzed. The modifications were ranked according to both slowing and excitability scores.

Results
Electroencephalogram modifications (in 51 subjects, 60.71%) were graded according to 4 stages combining general slowing and sharp slow waves and/or epileptiform activities. The presence of sharp or epileptiform activities was significantly greater for clozapine (90.9%) compared with other second-generation antipsychotics (aripiprazole, 50%; olanzapine, 58.8%; quetiapine, 37.5%; risperidone, 44.4%). Age, duration of disease progression, and diagnosis were not associated as risk factors. Electroencephalogram modifications were associated with lower doses for treatment with quetiapine but not for specific antipsychotics. Electroencephalogram modifications and severe excitability were associated with higher chlorpromazine equivalent doses.

Conclusions
Atypical antipsychotics (clozapine, aripiprazole, quetiapine, olanzapine, and risperidone) induce EEG modifications, and these are significantly greater for clozapine and appear dependent on chlorpromazine equivalent dose. No encephalopathy was observed in these antipsychotic monotherapies, whatever dose.
Severity, Prevalence, Predictors, and Rate of Identification of Insomnia Symptoms in a Sample of Hospitalized Psychiatric Patients
Authors: Doghramji Karl , Tanielian Maria , Certa Kenneth , Zhan Tingting 
Published: September 2018

Abstract
Insomnia is a risk factor for new onset, exacerbation, and relapse of mental illness. The goal of this study was to examine the prevalence, severity, and predictors of insomnia in hospitalized psychiatric patients. Ninety-seven consecutive psychiatric inpatients were administered the Insomnia Severity Index (ISI) to evaluate the presence and severity of insomnia. Patients' hospital charts were reviewed for demographic and medical information. ISI scores in 79.4% of the patients reached the threshold criterion of 8 for insomnia. Insomnia was not mentioned as a clinical problem in the discharge notes problem list in any of these patients. Multivariate analysis indicated that age (p = 0.009), recent suicide attempt or ideation (P < 0.001), tobacco use (p = 0.024), and recreational drug use during the past month (p = 0.040) were significant predictors of insomnia severity. Insomnia was highly prevalent in this population. Identification and management of insomnia would be an important clinical goal in hospitalized psychiatric patients.
Eating Pathology Among Patients With Anorexia Nervosa and Bulimia Nervosa
Authors: Boucher Katrine , Côté Marilou , Gagnon-Girouard Marie-Pierre , Ratté Carole , Bégin Catherine 
Published: September 2018

Abstract
We sought to deepen our understanding of the relationship between pathological narcissism and eating disorders (ED) by examining specific facets that composed grandiose and vulnerable narcissism while taking into account self-esteem, a well-known and consistent risk factor for ED. Twenty-seven women diagnosed with anorexia nervosa (AN) and 23 women diagnosed with bulimia nervosa (BN) completed standardized measures of pathological narcissism, self-esteem, and dysfunctional eating attitudes and behaviors. Different patterns of associations between the facets of pathological narcissism and eating pathology arose between AN and BN diagnoses. Closer examination of the facets of pathological narcissism revealed that hiding the self, a vulnerable narcissistic facet, contributed significantly to dysfunctional eating attitudes and behaviors over and above self-esteem for women with AN. Hiding the self should continue to be explored in regard to treatment of ED.
Anti–DNase I Antibody
Authors: Griffo Priscilla , Viana Vilma V. S. T. , Pasoto Sandra G. , Leon Elaine P. , Bonfa Eloisa 
Published: September 2018

Background and Objective
Primary Sjögren syndrome (pSS) is a systemic autoimmune rheumatic disease that particularly affects exocrine glands. Dry eye is one of the most important features of this syndrome, and a recent study reported reduced deoxyribonuclease I (DNase I) activity in the tear of patients with dry eye. We therefore postulated that patients with pSS might have antibodies targeting DNAse I.

Methods
We have evaluated in a cross-sectional study 85 patients with pSS (2002 American-European Consensus Group Criteria), 50 rheumatoid arthritis (RA) patients (1987 American College of Rheumatology Criteria) without sicca symptoms, and 88 healthy volunteers. IgG anti–DNase I was detected by enzyme-linked immunosorbent assay using as antigen bovine pancreas enzyme and confirmed by immunoblotting.

Results
Age and sex were alike in the 3 groups (p > 0.05). Anti–DNase I was detected in 43.5% of the pSS patients. In contrast, this reactivity was absent in all RA patients (p = 0.0001). Additional comparison of pSS patients with (n = 37) or without (n = 48) anti–DNase I showed that the former group had higher IgG serum levels (2293.2 ± 666.2 vs 1483.9 ± 384.6 mg/dL, p = 0.0001) and greater rate of non–drug-induced leukopenia (43% vs 19%, p = 0.02). A multivariate logistic regression analysis identified that only IgG levels were independently associated with anti–DNase I.

Conclusions
We describe a high frequency of anti–DNase I antibodies in pSS patients associated with higher serum IgG levels. The lack of this reactivity in RA patients without sicca symptoms suggests that this antibody may be helpful in the differential diagnosis of these diseases.
Atypical Chronic Inflammatory ANCA-Positive Deforming Arthritis After Cocaine-Levamisole Exposure
Authors: Emil N. Suzanne , Cisneros David R. , Penmetsa Santhi , Duchesne Joshua H. , Sibbitt Wilmer L. , Gibb James I. , Noronha Leonard E. , Fangtham Monthida , Fields Roderick A. , Bankhurst Arthur D. 
Published: September 2018

Background/ObjectiveImmunostimulatory drugs including immune checkpoint inhibitors and levamisole can induce inflammatory disease including vasculitis, rashes, tissue necrosis, and arthritis.MethodsThis prospective cohort study determined the 5-year outcomes of cocaine-levamisole–induced inflammatory disease as to outcomes and survival. Thirty-one consecutive cocaine-levamisole autoimmune patients and 45 primary vasculitis patients were characterized as to clinical differentiating features, antineutrophil cytoplasmic antibody (ANCA) status, treatment, the presence of acute and chronic arthritis, and 5-year outcome.ResultsSeventy-one percent (22/31) of cocaine-levamisole vasculopathy cases were ANCA positive (86% p-ANCA and 14% c-ANCA), whereas 53% (23/45) of the primary vasculitis were ANCA positive (p= 0.04). The ANCA-positive cocaine-levamisole cohort at onset were characterized by younger age (45 ± 12 vs 53 ± 14 years,p= 0.04), superficial skin necrosis (82% vs 54%,p= 0.036), depressed complement C3 (27% vs 4%,p= 0.33), antiphospholipid antibodies (50% vs 4%,p< 0.001), neutropenia (18% vs 0%,p= 0.044), and elevated antimyeloperoxidase (MPO) antibody levels (100% vs 67%,p< 0.001). Chronic cocaine-levamisole disease was characterized by severe cicatrical deformities of the face and extremities (45.5% vs 8.3%,p= 0.005). Arthralgias (71% vs 82%,p= 0.19) and acute arthritis (33% vs 32%,p= 0.25) were similar between the 2 groups. However, a substantial proportion cocaine-levamisole–induced autoimmune patients (18% vs 0%,p= 0.045) developed a chronic deforming inflammatory arthritis that was rheumatoid factor, anti–cyclic-citrillinated antibody antibody, and HLA-B27 negative, but p-ANCA-and MPO antibody positive.ConclusionsPatients exposed to cocaine-levamisole may develop serious chronic sequelae including cicatrical cutaneous and facial deformities and an atypical seronegative, p-ANCA and MPO antibody–positive, HLA-B27–negative chronic deforming inflammatory arthritis.
68Ga-PSMA-11 PET/CT in Newly Diagnosed Prostate Adenocarcinoma
Authors: Ergül Nurhan , Yilmaz Güneş Burçak , Yücetaş Uğur , Toktaş Mahmut Gökhan , Çermik Tevfik Fikret 
Published: September 2018

Introduction
Prostate-specific membrane antigen (PSMA) ligand PET/CT is an emerging modality to detect the metastatic disease, especially in intermediate- and high-risk prostate cancer (PCa). In this study, we analyzed the contribution of 68Ga-PSMA-11 PET/CT in staging and therapy management of newly diagnosed PCa.

Materials and Methods
A total of 78 patients with biopsy-proven PCa who were referred for 68Ga-PSMA-11 PET/CT for primary staging were retrospectively analyzed. The patients were divided into risk groups according to the D'Amico risk stratification criteria. All of the patients had undergone pelvic MRI, and 65 patients had bone scintigraphy also. The findings of 68Ga-PSMA-11 PET/CT were compared with these conventional imaging (CI) methods for staging of the disease. The relations between SUVmax of the primary tumors and Gleason scores (GSs), prostate-specific antigen (PSA) levels, and metastatic extent of the disease were analyzed.

Results
Of 78 patients, 5 patients were in low-risk group, 18 patients were in intermediate-risk group, and 55 patients were in high-risk group. Metastatic disease was found in 40 (51.2%) of 78 patients in 68Ga-PSMA-11 PET/CT. Ten patients had regional lymph node metastases, and 30 patients had distant metastases. 68Ga-PSMA-11 PET/CT changed the staging in 44 (56.4%) of 78 patients compared with CI. There was significant difference between the SUVmax of the tumors with GSs of 6 and 7 compared with GSs of 8, 9, and 10 (P = 0.003). The SUVmax were significantly different between the patients with no metastasis (n = 38) and patients with regional lymph node metastases or distant metastases (n = 40; 16.1 ± 10.9, 28.7 ± 25.8, P = 0.003, respectively). There was significant difference between the SUVmax of patients with PSA level less than 10 ng/mL compared with patients with PSA level of 10 or greater and less than 20 ng/mL and PSA 20 ng/mL or greater (P = 0.009). A weak correlation between PSA and primary tumor SUVmax was also found (r = 0.21).

Conclusions

68Ga-PSMA-11 PET/CT is an important imaging modality for primary evaluation of newly diagnosed PCa changing the disease stage substantially. Also the SUVmax of the primary tumor has a relation with GS, metastatic extent of disease, and PSA levels defining the prognosis.
Increased Activity Due to Fractures Does Not Significantly Affect the Accuracy of 68Ga-DOTATATE PET/CT in the Detection of Culprit Tumor in the Evaluation of Tumor-Induced Osteomalacia
Authors: Ding Jie , Hu Guilan , Wang Ling , Li Fang , Huo Li 
Published: September 2018

Objective

68Ga-DOTATATE PET/CT is currently the most common imaging modality in localizing culprit tumors, which can result in tumor-induced osteomalacia (TIO). Fracture, which is one of the most common consequences of the TIO, can also lead to increased 68Ga-DOTATATE activity and potentially affect the accuracy of 68Ga-DOTATATE PET/CT imaging. The aim of this investigation is to evaluate whether the increased 68Ga-DOTATATE activity at the sites of the fracture will cause interpretation difficulty in the localizing the culprit tumor causing TIO.

Method
The images of 68Ga-DOTATATE PET/CT scan from a total of 54 patients who had multiple foci of increased 68Ga-DOTATATE PET/CT on PET/CT were retrospectively analyzed. Not only was the intensity of the activity on PET but also the appearance of the activity on CT taken into consideration when the interpretation of the images occurred. The results from imaging analysis were compared with the clinical chart record. All patients had tentative clinical diagnosis of TIO.

Results
The causative tumors in 53 patients were eventually identified. In 1 patient, the causative tumor was not identified. Among the 53 patients with confirmed TIO, 52 tumors were accurately localized.

Conclusions
Mild activity at the sites of fracture is not a major challenging factor in the interpretation of 68Ga-DOTATATE PET/CT in the evaluation of TIO when both intensity on PET and morphology on CT were assessed.