bluuebunny/crossref_metadata_2025_split huggingface dataset:
The use of arts interventions for mental health and wellbeing in health settings
Authors: Jensen A , Bonde LO 
Published: April 2018

Aims: This literature review aims to illustrate the variety and multitude of studies showing that participation in arts activities and clinical arts interventions can be beneficial for citizens with mental and physical health problems. The article is focused on mental health benefits because this is an emerging field in the Nordic countries where evidence is demanded from national health agencies that face an increasing number of citizens with poor mental health and a need for non-medical interventions and programmes. Methods: A total of 20 articles of interest were drawn from a wider literature review. Studies were identified through the search engines: Cochrane Library, Primo, Ebscohost, ProQuest, Web of Science, CINAHL, PsycINFO, PubMed and Design and Applied Arts Index. Search words included the following: arts engagement + health/hospital/recovery, arts + hospital/evidence/wellbeing, evidence-based health practice, participatory arts for wellbeing, health + poetry/literature/dance/singing/music/community arts, arts health cost-effectiveness and creative art or creative activity + health/hospital/recovery/mental health. The inclusion criteria for studies were (1) peer review and (2) empirical data. Results: The studies document that participation in activities in a spectrum from clinical arts interventions to non-clinical participatory arts programmes is beneficial and an effective way of using engagement in the arts to promote holistic approaches with health benefits. Engagement in specially designed arts activities or arts therapies can reduce physical symptoms and improve mental health issues. Conclusion: Based on the growing evidence of the arts as a tool for enhancing mental health wellbeing, and in line with the global challenges in health, we suggest that participatory arts activities and clinical arts interventions are made more widely available in health and social settings. It is well-documented that such activities can be used as non-medical interventions to promote public health and wellbeing.
The Influence of Diagnosis, Age, and Gender on Surgical Outcomes in Patients With Adult Spinal Deformity
Authors: Ayhan Selim , Yuksel Selcen , Nabiyev Vugar , Adhikari Prashant , Villa-Casademunt Alba , Pellise Ferran , Perez-Grueso Francisco Sanchez , Alanay Ahmet , Obeid Ibrahim , Kleinstueck Frank , Acaroglu Emre ,   European Spine Study Group
Published: April 2018

Study Design: Retrospective review of prospectively collected data from a multicentric database. Objectives: To determine the clinical impact of diagnosis, age, and gender on treatment outcomes in surgically treated adult spinal deformity (ASD) patients. Methods: A total of 199 surgical patients with a minimum follow-up of 1 year were included and analyzed for baseline characteristics. Patients were separated into 2 groups based on improvement in health-related quality of life (HRQOL) parameters by minimum clinically important difference. Statistics were used to analyze the effect of diagnosis, age, and gender on outcome measurements followed by a multivariate binary logistic regression model for these results with statistical significance. Results: Age was found to affect SF-36 PCS (Short From-36 Physical Component Summary) score significantly, with an odds ratio of 1.017 (unit by unit) of improving SF-36 PCS score on multivariate analysis ( P < .05). The breaking point in age for this effect was 37.5 years (AUC = 58.0, P = .05). A diagnosis of idiopathic deformity would increase the probability of improvement in Oswestry Disability Index (ODI) by a factor of 0.219 and in SF-36 PCS by 0.581 times ( P < .05). Gender was found not to have a significant effect on any of the HRQOL scores. Conclusions: Age, along with a diagnosis of degenerative deformity, may have positive effects on the likelihood of improvement in SF-36 PCS (for age) and ODI (for diagnosis) in surgically treated patients with ASD and the breaking point of this effect may be earlier than generally anticipated. Gender does not seem to affect results. These may be important in patient counseling for the anticipated outcomes of surgery.
Accuracy of Inpatient Recall of Interaction With a Pharmacist: A Validation Study From 2 Acute Care Teaching Hospitals
Authors: Sidhu Vaninder K , Bresee Lauren , Kemp Kyle , Koshman Sheri , Pereira Taciana , Neilson Sheena 
Published: April 2018

Background: Research has shown that inpatients may not accurately report interacting with a pharmacist. Objective: To determine accuracy of patients’ recollection of meeting with a pharmacist at 2 acute care teaching hospitals in Edmonton, Alberta, Canada. Methods: Retrospective review of 391 surveyed patients discharged from April 2013 to March 2014. Responses to meeting a pharmacist (yes/no) were compared with 2 reference standards: pharmacist documentation in patient charts and pharmacist clinical workload data. Sensitivity, specificity, positive predictive, and negative predictive values were calculated. Results: One hundred ninety-five (49.9%) respondents reported meeting with a pharmacist. Of these, 71 (36.4%) had corresponding pharmacist chart documentation. Of the 196 respondents who reported not speaking with a pharmacist, 73 (37.2%) had documentation present. Compared with patient charts, sensitivity and specificity were 49.3% and 49.8%, respectively. Positive and negative predictive values were 36.4% and 62.8%, respectively. Similar results were seen in comparison with the workload data. Conclusions: Patients often inaccurately reported meeting with a pharmacist in the acute care setting. The results are useful for pharmacist training, patient education, and for refinement of the current survey question.
Methotrexate Update: Mechanism of Action in Psoriasis Therapy
Authors: Law Jennie H. , Koo Bonnie , Koo John Y.M. 
Published: April 2018

Background Long before the advent of the biologic agents, methotrexate was the gold standard for the treatment of moderate to severe psoriasis. Although methotrexate's therapeutic efficacy in the treatment of psoriasis is well-established, the mechanism of action is still poorly understood. Objective This paper reviews the published research on methotrexate's mechanism of action in psoriasis. Methods Studies published with English abstracts between January 1970 and December 2006 identified in MEDLINE with the keywords methotrexate, psoriasis and mechanism were reviewed. Results Methotrexate appears to exert clinical efficacy in psoriasis by interfering with CLA+ T-cell infiltration into lesional skin via multiple mechanisms. Conclusion It is likely that methotrexate interferes with the inflammatory pathways critical to psoriasis pathogenesis by multiple mechanisms. Current evidence suggests that methotrexate works by decreasing the number of circulating CLA+ T cells; decreasing inflammatory infiltrate into the dermis and epidermis by downregulating adhesion molecules in endothelial cells; and downregulating the expression of adhesion molecules on T cells.
Ustekinumab and Marked Clinical Responses in Patients with Moderate to Severe Psoriasis
Authors: Reich Kristian , Shakery Kaweh , Mrowietz Ulrich , Szapary Philippe O. , Wang Yuhua , Hsu Ming-Chun , Langley Richard G. 
Published: April 2018

Background Ustekinumab has demonstrated significant efficacy and favorable safety in patients with moderate to severe psoriasis. Objective Characterization of patients achieving marked clinical responses (Psoriasis Area and Severity Index [PASI] 90 or Physician's Global Assessment [PGA] of cleared) in two double-blind, placebo-controlled, phase III studies. Methods PHOENIX 1 (n=766) and PHOENIX 2 (n=1,230) patients were randomized to receive placebo or ustekinumab 45 or 90 mg at weeks 0 and 4, then every 12 weeks. At week 12, placebo patients crossed over to ustekinumab. Marked responses, defined as PASI 90 or PGA of cleared, are reported. Results A significantly higher proportion of ustekinumab-treated patients in PHOENIX 1 (39.9%) and PHOENIX 2 (47.0%) achieved marked responses at week 12, compared with placebo-treated patients (p<0.001 each). At week 28, approximately 50% of ustekinumab-treated patients achieved marked responses. Conclusion Significant proportions of ustekinumab-treated patients with moderate to severe psoriasis achieved marked clinical responses through week 28. Ustekinumab had a favorable risk-benefit profile through up to 18 months of follow-up.
Identification of the Effect of Amphiregulin on Keratinocytes and T Cells in Psoriasis
Authors: Lu Jun , Squillace Karen , Pittelkow Mark R. 
Published: April 2018

Background In addition to its fundamental functions in mediating the survival, proliferation, and migration of keratinocytes, increasing evidence suggests that the amphiregulin-epidermal growth factor receptor pathway has a major impact on cutaneous inflammation. Transgenic expression of amphiregulin in the epidermis of mice induces skin pathology with striking phenotypic similarity to that of psoriasis. Prominent T-cell and dendritic cell infiltrates are observed in the lesional skin from these mice. Objective In this study, we aimed to identify more fully the effect of amphiregulin on keratinocytes and T cells during cutaneous inflammation through examining relevant cytokines in the lesional skin as well as in human keratinocyte culture. Methods Using a multicytokine enzyme-linked immunosorbent assay, we found that amphiregulin directly induces the production of monocyte chemoattractant protein-1, interleukin-α, and interleukin-8 from keratinocytes in vitro. In addition, we examined the cutaneous expression of T-cell cytokines in amphiregulin transgenic mice compared with wild-type mice using quantitative polymerase chain reaction, which demonstrated upregulation of interferon-γ, vascular endothelial growth factor, and interleukin-4 in amphiregulin transgenic mice. Results and Conclusion Our study suggested that amphiregulin in the epidermis not only induces keratinocyte proliferation but also induces T-cell activation through a complex circuit of proinflammatory cytokines. Elucidating the role of amphiregulin on the generation, interactions, and balance among T-cell subsets will advance the understanding of psoriasis pathogenesis.
Cardiovascular Risk in Psoriatic Arthritis: Search for New Biological Markers
Authors: Korotaeva Tatiana V. , Loginova Elena Yu , Novikova Diana S. , Klimova Nadezhda V. , Novikov Aleksandr A. , Denisov Lev N. , Firsov Nikolay N. , Erdes Shandor 
Published: April 2018

Objective We investigated the relationships between the risk for coronary heart disease (CHD), psoriatic arthritis activity, and red blood cell aggregation (RBCA). Methods Our study comprised 130 patients with psoriatic arthritis (mean age, 41.7 ± 9.8) whose mean duration of psoriatic arthritis was 7 (IQ-range, 2.5–13) years and disease activity score (DAS) was 3.86 (IQ-range 2.72–5.14). We measured psoriatic arthritis DAS, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), time to formation of linear aggregates formation (T1 [s]), strength of the largest aggregates (la2.5[%]), hydrodynamic strength of aggregates (β [s−1]), velocity of aggregates formation (Kt [r.u.]), relative risk of CHD (RR CHD), and 10-year absolute risk (AR) of total and hard CHD in all patients. Statistical analysis was performed with Spearman correlation (R). Results Significant correlations were found between RBCA (T1/la2.5 /Kt) and DAS (R = −0.32/0.32/0.33), CRP (R = −0.34/0.41/0.47), and ESR (R = −0.34/0.35/0.42). RBCA (T1/Kt) significantly correlated with RR CHD (R = −0.32/0.35), total CHD (R = −0.32/0.31), and hard CHD risks (R = −0.31/0.30); no correlation was found between risk for CHD and psoriatic arthritis activity. Conclusion RBCA may be useful for assessment of psoriatic arthritis activity and CHD risk.
Does Simultaneous Methotrexate Treatment Improve Dead Sea Climatotherapy Outcomes in Plaque Psoriasis?
Authors: Czarnowicki Tali , Ingber Arieh , Ruzicka Thomas , Novack Lena , Harari Marco 
Published: April 2018

Background Dead Sea climatotherapy is a proven and useful option for the treatment of plaque psoriasis. However, combination with methotrexate treatment has not been studied. Objective We sought to evaluate the added benefit of Dead Sea climatotherapy in patients with psoriasis vulgaris receiving methotrexate treatment and compare their results with those of patients not receiving this therapy. Methods In this retrospective comparative study, 40 patients with psoriatic vulgaris were recruited at the Deutsches Medizinisches Zentrum Medical Center in Ein Bokek, Israel, between 2003 and 2005. Twenty (50%) patients were also treated with methotrexate (group 1), and 20 (50%) patients were not (group 2). A five-item scale, equivalent to Psoriasis Area and Severity Index (PASI) scores, was used to evaluate clinical response. Logistic regression using an exact method was performed on demographic and clinical parameters. Results Ten (50%) patients in group 1 and 13 (65%) patients in group 2 were totally plaque free on leaving the Dead Sea. Five (25%) patients in group 1 and four (20%) patients in group 2 were almost cleared (<5% involvement, 95%–99% PASI improvement), and five patients (25%) in group 1 and three patients (15%) in group 2 were markedly improved (>50% clearance, 50%–94% PASI improvement) at the end of Dead Sea climatotherapy (adjusted OR 1.43; 95% CI 0.2–16.6). Conclusion Dead Sea climatotherapy did not show better results in patients treated simultaneously with methotrexate. No side effects were observed from this combination therapy. However, the study design and the small sample size do not allow conclusions about methotrexate withdrawal before natural phototherapy.
The Role of Stress in Children with Psoriasis
Authors: Manolache Liana , Petrescu-Seceleanu Dana , Benea Vasile 
Published: April 2018

Background Stress could be involved as a precipitating or aggravating factor in psoriasis. In the literature, few sources refer to this subject in the pediatric field and even fewer to case-control studies. Objective The purpose of the study was to note any stressful situations that occur before the onset or extension of psoriasis in children aged 16 years and younger. Methods The study comprised 41 children (23 girls, 18 boys) with psoriasis who were enrolled in a comparative study. Results Between March 2001 and December 2007, 9,940 children (≤16 years old) were examined. The incidence of psoriasis among new dermatologic conditions was 0.43%. The mean age of the children was 11.97 years. There was a family history of the disease in 29.26% of cases; 31% of children with psoriasis had onset of psoriasis less than 3 months before the evaluation, and 38% had recent extensions or recurrence. In 14.6% of psoriasis cases, an inflammatory focus was identified. Stressful events had occurred in 41% of the psoriasis group, compared with 17% of controls. The difference was statistically significant (χ2 = 4.77, P = .028). The odds ratio was 3.44 (95% CI, 1.23–9.57). Most of these children had mentioned one event that may have had an impact on the development of psoriasis. Girls with psoriasis vulgaris and boys with guttate lesions were most often affected by stressful situations. Family problems (death, illnesses, disputes, parents working abroad, financial restrictions) were more often described in psoriatic cases. Also, school situations were often mentioned as influencing the psoriatic lesions. Conclusions The recollection of past events within the patient's family or by the patient and the dimensions of the sample could be considered limitations of the study. However, the presence of stressful events could be taken in consideration as influencing the onset, recurrence, or extension of psoriasis in children.
Juvenile Psoriasis: A Systematic Review of Comorbid Diseases
Authors: Chase Elizabeth P. , Armstrong April W. 
Published: April 2018

Objective To systematically summarize the literature examining comorbidities associated with juvenile psoriasis. Data Sources Ovid MEDLINE articles published between January 1, 1946, and January 21, 2012, and a manual search. Results were limited to English publications and human, “all child” patients, ages 0 to 18 years. Study Selection All investigations that examined the presence or prevalence of comorbidities associated with juvenile psoriasis were included. Data Extraction Study design, patient characteristics, psoriasis comorbidities, relevant outcomes, and measures of association were extracted. Data Synthesis The search resulted in 20 articles. Obesity, hyperlipidemia, hypertension, diabetes, depression, and Crohn's disease occur more frequently in patients with juvenile psoriasis than in their disease-free counterparts. Although the overall rate of comorbidities among patients with juvenile psoriasis appears twice that of children without psoriasis, this rate does not include psychiatric diseases. Conclusion The literature exploring relationships between juvenile psoriasis and comorbid conditions is sparse, and the evidence for these associations is lacking. The strongest evidence supports an association between obesity and juvenile psoriasis. Support for many other comorbidities was predominantly anecdotal. Additional research assessing physical and psychiatric comorbid conditions among the juvenile psoriasis population is required if clinicians are to make recommendations regarding prevention and management of comorbidities associated with juvenile psoriasis.
Successful and Rapid Treatment of Nail Psoriasis Using Topical Indigo Naturalis Oil Extract
Authors: Rosen Jamie M. , Stern Dana K. 
Published: April 2018

Background Nail psoriasis, characterized by chronic inflammation, is a debilitating disease that affects many patients worldwide. Currently, we are lacking standardized therapeutic treatment regimens for controlling and remitting nail psoriasis because delivering sufficient concentrations of drugs into the nail plate and nail bed is difficult. Observation This case describes a 43-year-old female with an 8-year history of refractory nail bed psoriasis. The patient was treated unsuccessfully with a variety of therapies (e.g., corticosteroids, intralesional injections, phototherapy). The patient responded well to topical application of indigo naturalis oil extract, achieving significant improvement of the onycholysis and splinter hemorrhages and complete recovery in subungual hyperkeratosis of the affected fingernails. Conclusion While additional studies are needed, indigo naturalis oil extract appears to be a safe and effective alternative treatment for nail psoriasis. Indigo naturalis oil extract is an inexpensive, easy to use, and low-risk therapy that demonstrates improved patient compliance and outcomes.
How Insurers Attempt to Discourage Biologic Therapy for Psoriasis
Authors: Rutter Russell D. , Haddican Madelaine M. , Rigel Darrell S. 
Published: April 2018

Background Biologic therapy for psoriasis is costly, and insurance companies vary in the pre-authorization procedures required for these treatments. Methods A survey was performed of more than 300 of the approximately 600 practicing dermatologists at the Fall Clinical Dermatology Conference. Results More than 80% of those surveyed prescribe biologic therapies for psoriasis. Sixty percent have to obtain prior authorizations more than 80% of the time before prescribing biologics. For many patients, prior authorizations have to be repeated every three months. The median amount of time spent on prior authorizations was between 30 and 60 minutes and 50% of dermatologists require at least one-quarter of a full-time employee to deal with the paperwork. Eighty percent of dermatologists thought that reimbursement hurdles prevent them from using ideal therapies for psoriasis. Conclusion The paperwork associated with prescribing biologic agents generates unreimbursed expenses and may interfere with ideal treatments for patients with psoriasis.
Merits of Mycophenolate Mofetil for Psoriasis: Is It Effective?
Authors: Sheinin Renee , Au Shiu-Chung , Gottlieb Alice 
Published: April 2018

Background Mycophenolate mofetil (MMF) is a widely used immune suppressant. It is derived from mycophenolic acid, which was once used as an anti-psoriatic agent, but was discontinued due to adverse effects. MMF has a lower incidence of adverse effects and could be a therapeutic option for psoriasis patients. Objective To review the current literature on the safety and efficacy of MMF as a treatment for psoriasis. Methods We searched PubMed and the Cochrane Library using the search terms “psoriasis” and “mycophenolate mofetil” for articles evaluating the efficacy and safety of MMF in patients with psoriasis. Results Studies showed that MMF reduced disease severity and had minimal adverse effects. However, most studies had a small sample size. Conclusions There is available evidence supporting MMF as a well-tolerated, effective treatment of psoriasis. Further studies in the form of randomized control trials should be considered to confirm these limited data.
A Reduction in Dosage of Acitretin to 17.5 mg/day Maintains Efficacy While Improving Tolerability
Authors: Frankel Amylynne J. , Ormerod Jennifer , Lebwohl Mark 
Published: April 2018

Background Oral acitretin 25 mg/day combined with a phototherapy regimen is a standard treatment for severe plaque-type psoriasis. Retinoid-related adverse events include alopecia, dry mucus membranes, pruritus, photosensitivity, elevation of liver enzymes, elevation of serum triglycerides and cholesterol and decrease of HDL, arthralgias, myalgias, eye irritation, blepharitis, photophobia, conjunctivitis, headaches, nausea, and anemia. Objective This single-center open label study evaluated the efficacy and tolerability of a reduced acitretin dose in patients with severe plaque-type psoriasis undergoing phototherapy treatment who were experiencing at least one retinoid-related adverse event. Results Of patients treated with 17.5 mg/day of acitretin, 89% demonstrated improved or comparable psoriasis area-and-severity index scores at week 12; 79% showed improvement in adverse events reported at baseline through week 12. Conclusion There is a role for a lower dose of acitretin in patients who are experiencing retinoid-related side effects and who are stabilized on a phototherapy regimen.