bluuebunny/crossref_metadata_2025_split huggingface dataset:
Analgesic Potentials of Preoperative Oral Pregabalin, Intravenous Magnesium Sulfate, and their Combination in Acute Postthoracotomy Pain
Authors: Salah Abdelgalil Ahmed , Shoukry Aktham A. , Kamel Mahmoud A. , Heikal Ashraf M.Y. , Ahmed Naglaa A. 
Published: November 2018

Objectives:
The objective of this study was to investigate the effects of the preoperative combination of oral Pregabalin and intravenous (IV) magnesium sulfate as analgesic adjuvants in postthoracotomy pain.

Patients and Methods:
One hundred twenty patients with American Society of Anesthesiologists physical status II were allocated randomly into 1 of 4 groups. Group MP received 300 mg pregabalin orally and an IV infusion of magnesium sulfate 50 mg/kg mixed with 200 mL normal saline (NS); group P received 300 mg pregabalin orally and 200 mL NS infusion; group M received an IV infusion of magnesium sulfate 50 mg/kg mixed with 200 mL NS and a placebo capsule; and group C received placebo capsule and an IV infusion of 200 mL NS. All medications were given 1 hour before surgery in all groups. In the first 24 hours postoperatively, total morphine consumption, the Visual Analog Scale (0 to 10)—used as a pain measurement tool—and postoperative nausea and vomiting were assessed.

Results:
The total morphine consumption in the first 24 hours postoperatively decreased significantly in group MP (28.47±5.76 mg) compared with group P (33.97±6.34 mg), group M (40.87±4.4 mg), and group C (42.2±6.1 mg), respectively. VAS scores were in the accepted range (≤4) in the 4 groups throughout the first 24 hours, as all patients were on patient-controlled analgesia. However, there was a statistically significant difference at 0 and 4 hours postoperatively in favor of groups MP and P. Postoperative nausea and vomiting decreased significantly in groups MP, P, and M in comparison with group C (P<0.001).

Conclusions:
The combined preoperative single dose of pregabalin and magnesium sulfate is an effective method for attenuating postoperative pain and total morphine consumption in patients undergoing thoracotomy.
Cognitive Biases Toward Pain
Authors: Rusu Adina C. , Gajsar Hannah , Schlüter Michael-Christian , Bremer Yara-Inken 
Published: November 2018

Objectives:
Information-processing biases such as attentional, interpretation, and memory biases are supposed to play a role in the exacerbation and maintenance of chronic pain. Current research in the area of cognitive biases shows that all these biases seem to have an influence on attention to, interpretation of, and recall of pain and can lead to maladaptive strategies and the exacerbation of pain.

Methods:
We conducted a narrative literature review, considering evidence extracted from various databases including PubMed, MEDLINE, Science Direct, and ProQuest. Search terms included cognitive biases, neurocognitive processing, chronic pain, and depression.

Results:
The literature on attentional, interpretative, and memory biases in experimental and chronic pain, as well as their neuronal underpinnings, suggests that the depression of chronic pain patients may differ from the depression of patients without pain. Depressed pain patients show a recall bias for illness-related and health-related stimuli, whereas depressed patients without pain show a bias for depression-related stimuli. In addition, research has shown that catastrophizing, helplessness/hopelessness, and thought suppression as psychological responses to pain are mediators of the relationship between chronic pain and depression.

Conclusions:
Current research supports the importance of individual diagnosis of chronic pain patients and their response patterns of pain, psychological processing, and information processing. This leads to the conclusion that depressed pain patients need other clinical interventions when compared with depressed patients without pain. Previous research showed that a combination of a cognitive-behavioral therapy with mindfulness meditation seems to be a promising approach.
Efficacy and Safety of Pregabalin in Neuropathic Pain Followed Spinal Cord Injury
Authors: Yu Xiaobing , Liu Tao , Zhao Dewei , Yang Ke , Zhang Xiuzhi , Zhang Meng , Zhang Shuo , Huang Wei , Wu Baolin , Li Junlei 
Published: November 2018

Objective:
Pregabalin has been approved for the treatment of the neuropathic pain following spinal cord injury (SCI). We performed a systemic review and meta-analysis of randomized, controlled, multicenter trials to evaluate the efficacy and safety of pregabalin for SCI-induced neuropathic pain.

Materials and Methods:
Research searching was performed in PubMed and EMBASE databases and the Cochrane library in May 2018. Clinical controlled trials using pregabalin for the pain treatment following SCI in adults (18 y old and above) were included. Pain and safety-related adverse events were considered as outcomes. Meta-analysis was conducted using Revman 5.0 software.

Results:
Five publications (pregabalin, patients=261, placebo, patients=216) were included in our study. After at least 4-week’s treatment with pregabalin (flexible dose, 150 to 600 mg/d), pregabalin-treated patients showed reduced pain −1.54, 95% confidence interval (CI) (−2.33, −0.75), P=0.0001; improved >30% 1.83, 95% CI (1.37, 2.46), P<0.0001 and >50% pain relief 2.40, 95% CI (1.53, 3.77), P=0.0001; increased adverse events 1.36, 95% CI (1.18, 1.577), P<0.0001; and reduced Hospital Anxiety and Depression Scale - anxiety −1.50, 95% CI (−2.99, −0.00), P=0.05 and - depression −0.34, 95% CI (−0.55, −0.12), P=0.002 scores compared with placebo-treated patients. Stratified meta-analysis showed there was no difference in primary adverse events (drowsiness, dizziness, peripheral edema, and dry mouth) between pregabalin and placebo groups (P≥0.05).

Conclusions:
Our results showed pregabalin was efficacious and might be safe treatment for chronic pain followed SCI.
Sleep and Intensive Care Unit–Acquired Weakness in Critically Ill Older Adults
Authors: Elías Maya N. , Munro Cindy L. , Liang Zhan , Calero Karel , Ji Ming 
Published: November 2018

Background
Older adults in the intensive care unit (ICU) often experience sleep disturbances, which may stem from life-threatening illness, the ICU environment, medications/sedation, or psychological stress. Two complementary endocrinological responses occur as a result of compromised sleep and consequently could exacerbate ICU-acquired weakness: a decrease in anabolic hormones leading to decreased protein synthesis and an increase in catabolic hormones leading to increased protein degradation. Age-associated decreases in anabolic hormones, such as insulin-like growth factor 1, testosterone, and growth hormone, may inhibit protein synthesis. Likewise, age-associated increases in insulin resistance, glucocorticoids, and myostatin can stimulate muscle atrophy and further reduce protein synthesis. Thus, perhaps, sleep promotion in the ICU may attenuate muscle atrophy among critically ill older adults who are at risk for ICU-acquired weakness and subsequent functional decline.

Objectives
The aim of this study was to discuss the hypothesized theoretical underpinnings of the relationship between sleep disturbances and ICU-acquired weakness among critically ill older adults.

Methods
A search of research literature published from 1970 to 2018 and indexed in MEDLINE, Embase, CINAHL, and Ovid was undertaken, and relevant sources were selected to build an informed discussion.

Results
Nurses must be mindful of secondary sleep disturbances that occur throughout the acute phase of critical illness and their probable links to ICU-acquired weakness. Targeted interventions to promote functional outcomes in elderly patients should consider this relationship.

Discussion
Improved sleep may have the potential to decrease the severity of muscle atrophy and ICU-acquired weakness. Future research must explore this hypothesis and the underlying mechanisms of the association between sleep disturbances and ICU-acquired weakness in critically ill older adults.
Influence of Anastomotic Leak After Elective Colorectal Cancer Resection on Survival and Local Recurrence: A Propensity Score Analysis
Authors: Zimmermann Markus S. , Wellner Ulrich , Laubert Tilman , Ellebrecht David B. , Bruch Hans-Peter , Keck Tobias , Schlöricke Erik , Benecke Claudia R. 
Published: November 2018

BACKGROUND:
The occurrence of anastomotic leakage is still a life-threatening complication for patients after colorectal surgery. In literature not only an impact on the short-term outcome but also on long-term survival and local recurrence of colorectal cancer patients is discussed.

OBJECTIVE:
This study aimed to investigate the impact of anastomotic leakage on long-term survival and local recurrence.

DESIGN:
A total of 1122 patients with resections for colorectal cancer were analyzed. In 94 patients (8.4%) there was clinical proof of anastomotic leakage. A reference group was defined as the 1028 patients without anastomotic leakage using 1:1 propensity score-matching according to the following criteria: age, sex, International Union Against Cancer stage, Karnofsky index, tumor site, and grading, as well as adjuvant chemotherapy. A calculation of overall survival, disease-free survival, and local recurrence rate was performed for both groups.

SETTINGS:
The study was conducted using a retrospective matched-pairs analysis, based on a prospectively maintained institutional colorectal cancer database.

PATIENTS:
Ninety-four patients with anastomotic leakage and 94 matched control subjects from a total of 1122 patients with resections for colorectal cancer were studied.

MAIN OUTCOME MEASURES:
Overall survival, disease-free survival, and local recurrence rate for patients with colorectal cancer with and without anastomotic leakage were measured.

RESULTS:
The propensity score matching successfully created 2 groups with no significant differences in the matching criteria. Survival analysis disclosed no significant differences between the groups in terms of overall survival, disease-free survival, and local recurrence rate. Univariate analysis identified age, Karnofsky index, International Union Against Cancer stage, and lymph node metastasis as significant prognostic factors. Multivariable analysis of these variates revealed age and positive lymph nodes as independent predictors of overall survival and disease-free survival.

LIMITATIONS:
The study was limited by nature of being a retrospective analysis and monocentric study.

CONCLUSIONS:
This matched-pairs analysis, comparing patients with colorectal cancer with and without anastomotic leakage, revealed no significant differences in overall survival, disease-free survival, and local recurrence rate. Contrary results in the literature might be caused by nonbalanced settings in nonmatched collectives. See Video Abstract at http://links.lww.com/DCR/A811.
The Association Between Income and Psychotropic Drug Purchases: Individual Fixed Effects Analysis of Annual Longitudinal Data in 2003–2013
Authors: Junna Liina , Moustgaard Heta , Tarkiainen Lasse , Martikainen Pekka 
Published: November 2018

Background:
Previous cross-sectional studies show that low income is associated with poor mental health. However, longitudinal research has produced varying results. We assess whether low income is associated with increased psychotropic drug use after accounting for confounding by observed time-varying, and unobserved stable individual differences.

Methods:
The longitudinal register-based data comprises an 11% nationally representative random sample of Finnish residents aged 30–62 years between the years 2003 and 2013. The analytic sample includes 337,456 individuals (2,825,589 person–years). We estimate the association between annual income and psychotropic purchasing using ordinary-least-squares and fixed effects models, the latter controlling for all unobserved time-invariant individual characteristics.

Results:
The annual prevalence of psychotropic purchasing was 15%; 13% among men and 18% among women. Adjusted for age squared, sex and calendar year, the doubling of income decreased the probability of purchases by 4 percentage points (95% confidence interval: 4,4) in the ordinary-least-squares model. We observed no association after further adjusting for observed sociodemographic characteristics and unobserved individual differences in the fixed effects specification.

Conclusions:
Following adjustment for an extensive set of confounders, no contemporaneous association between variations in annual individual income and psychotropic drug purchasing was observed. Similar results were obtained irrespective of baseline income level and sex. The results imply that indirect selection based on preexisting individual characteristics plays a major role in explaining the association between variations in income measured over the short term, and psychotropic drug purchases. The association appears largely attributable to unobserved, stable individual characteristics. See video abstract at, http://links.lww.com/EDE/B463.
Advances in osteoporosis from 1970 to 2018
Authors: Gallagher J. Christopher 
Published: November 2018

Abstract
In 1970, there were no drugs under study for osteoporosis. Estrogen was used, but little was known about the correct dose for preventing bone loss. At that time, fractures were not even recognized as a disease, but regarded as part of normal aging. From 1970 to this year (2018), there have been extensive advances in the osteoporosis field ranging from fracture epidemiology to the remarkable invention of bone density measurements. There have been major advances in therapeutic options available for patients for prevention and treatment of osteoporosis. In parallel, the advances in the laboratory helped elucidate the process of bone remodeling, not only at the macroscopic level but also at the cellular level. This led to rapid advances in translational research from cellular biology to new therapies exemplified by the development of monoclonal antibodies for osteoporosis. Further understanding of the signaling pathways in bone cells will lead to new small molecules made for osteoporosis treatment, perhaps causing less adverse events. University-based research throughout the world has been a leader in most of these advances, and Pharma support for phase 1 to 4 studies helped bring these discoveries to patients. In the osteoporosis field alone, one sees the tremendous value of grant support for university research by National funding agencies such as the National Institute of Health in this country and similar agencies in other countries. There are clinical challenges that have to be solved with long-term compliance with osteoporosis medication if we want to reduce fracture incidence in the long term.
Electrical Stun Gun and Modern Implantable Cardiac Stimulators
Authors: Mattei Eugenio , Censi Federica , Calcagnini Giovanni 
Published: November 2018

Abstract
The aim of the study is to investigate systematically the possible interactions between two types of stun guns and last-generation pacemakers and implantable defibrillators. Experimental measurements were performed on pacemakers and implantable defibrillators from five leading manufacturers, considering the effect of stun gun dart positioning, sensing modality, stun gun shock duration, and defibrillation energy level. More than 300 measurements were collected. No damage or permanent malfunction was observed in either pacemakers or implantable defibrillators. During the stun gun shock, most of the pacemakers entered into the noise reversion mode. However, complete inhibition of the pacing activity was also observed in some of the pacemakers and in all the implantable defibrillators. In implantable defibrillators, standard stun gun shock (duration 5 s) caused the detection of a shockable rhythm and the start of a charging cycle. Prolonged stun gun shocks (10–15 s) triggered the inappropriate delivery of defibrillation therapy in all the implantable defibrillators tested. Also in this case, no damage or permanent malfunction was observed. For pacemakers, in most cases, the stun guns caused them either to switch to the noise reversion mode or to exhibit partial or total pacing inhibition. For implantable defibrillators, in all cases, the stun guns triggered a ventricular fibrillation event detection. No risks resulted when the stun gun was used by a person wearing a pacemaker or an implantable defibrillator. This work provides novel and up-to-date evidence useful for the evaluation of risks to pacemaker/implantable defibrillator wearers due to stun guns.
A Purely Poisson-based Approach to Estimating Audible Scan Survey Sensitivities
Authors: Justus Alan L. 
Published: November 2018

Abstract
Several attempts have been made over the years to estimate the sensitivity of audible scan surveys. Some estimates involved certain factors of the background count rate, while others involved calculations utilizing parameters pulled from the normal (Gaussian) distribution, regardless of background count rate. This paper discusses the results of a purely Poisson-based calculational method for the determination of appropriate decision levels and affiliated detection limits associated with health physics audible scan surveys. Comparisons are made to the other approaches and to empirical tests, where available. Although agreement with previous estimates can be had over limited ranges of background count rate, order-of-magnitude differences are possible outside of those ranges. The previous estimates are generally conservative at the higher count rates but quite nonconservative at the lowest count rates. Several real-life operational examples are provided that illustrate the approach.
Radiation Field Strengths Near Cylindrical Volume Sources Via Point-source Correction Factors
Authors: Steward Palmer G. 
Published: November 2018

Abstract
Due to the ease with which the radiation field strength is determined for a point source, the field strength emanating from radiopharmaceutical therapy patients is sometimes estimated by using the point source approximation with a correction factor. It is inevitable that the correction factor will occasionally be used under conditions that do not precisely match those for which the factor was originally derived. The difficulty is that the boundary of the correction factor’s domain of acceptability is usually unclear. The purpose of this paper is to address this issue. The patient is modeled as a cylinder containing the radionuclide administered to the patient. From first principles, the expression for converting the radiation field strength of an unshielded point source to that of the extended cylindrical volume source is derived. This expression is analytically separated into the component depicting geometric dispersion of the source material into the volume and the component depicting self-absorption (absorption characteristics of 131I in water are used). These components, along with their composite, are presented showing their dependence on patient size, distance from the patient, and various dispersion patterns of the source material within the patient. Correlation of theory and measurement is demonstrated, and a conceptual grasp is conveyed regarding field strength variations around volume sources with changes in shape, size, distance, and other parameters. Using data presented, the radiation field strength emanating from a radiopharmaceutical therapy patient can be estimated from the point source approximation and customized for patient size and presumed internal radionuclide distribution.
A Comparison of High‐Dose Cytarabine During Induction Versus Consolidation Therapy in Newly Diagnosed AML
Authors: Schwarer Anthony P. , Butler Jason , Jackson Kathryn , Beligaswatte Ashanka , Martin Louisa , Kennedy Glen , Daniela Zantomio , Lewis Ian , Hiwase Devendra , Wight Joel , He Simon , Grigg Andrew , Morris Kirk , Mollee Peter , Marlton Paula 
Published: November 2018

AbstractThe proportion of patients with acute myeloid leukemia (AML) cured is increased by administering high‐dose cytarabine (HiDAC). It remains uncertain whether to administer HiDAC as induction or consolidation, and whether ≥1 cycle of HiDAC is required. Our retrospective study of 416 adult AML patients, excluding good risk cytogenetics, compared a single cycle of HiDAC‐based therapy followed by 2 cycles of standard‐dose cytarabine (SDAC) (HiDAC induction cohort) with SDAC‐based chemotherapy followed by 2 cycles of HiDAC‐based chemotherapy (HiDAC consolidation cohort). Complete remission (CR) rate was greater in the HiDAC induction cohort (90% vs 78%, P < 0.01) which did not lead to an improved overall survival (48% vs 43%, P = 0.18) or disease‐free survival (DFS) (39% vs 45%, P = 0.95). We noted that, after censoring for allogeneic hematopoetic stem cell transplant (alloHSCT) in CR1, the cumulative incidence of relapse was lower in the HiDAC consolidation cohort in patients with intermediate risk cytogenetics (68% vs 44%, P = 0.01), which lead to a greater DFS (30% vs 47%, P = 0.095). In the patients with adverse risk cytogenetics, the RR was numerically greater in the HiDAC consolidation cohort (52% vs 80%, P = 0.60) which lead to a lower DFS (27% vs 4%, P = 0.11). Our data show that, although the HiDAC induction cohort (1 cycle of HiDAC) achieved a greater CR rate, there were no overall survival differences between the 2 cohorts, and that the HiDAC consolidation cohort (2 cycles of HiDAC) had a lower RR and greater DFS in those patients with intermediate risk cytogenetics who did not undergo alloHSCT in CR1.
Integrated Safety Profile of a New Approved, Fully Liquid DTaP5-HB-IPV-Hib Vaccine
Authors: Xu Jin , Stek Jon E. , Ziani Eddy , Liu G. Frank , Lee Andrew W. 
Published: November 2018

Background:
DTaP5-HB-IPV-Hib is a fully liquid, hexavalent vaccine containing a 5-antigen pertussis component, approved since 2016 in Europe [Vaxelis; DTaP5-HB-IPV-Hib vaccine: Diphtheria, tetanus, pertussis (5 acellular components: pertussis toxoid [PT], filamentous haemagglutinin [FHA], pertactin (PRN), and fimbriae Types 2 and 3 [FIM]), hepatitis B (recombinant DNA: rDNA), poliomyelitis (inactivated) and Haemophilus influenzae type b conjugate vaccine (adsorbed); MCM Vaccine B.V., The Netherlands] for primary and booster vaccination in infants and toddlers against diphtheria, tetanus, pertussis, hepatitis B, poliomyelitis and invasive diseases caused by Haemophilus influenzae type b. The comparator vaccine (control) was INFANRIX hexa (GlaxoSmithKline Biologics S.A., Rixensart, Belgium) (DTaP3-IPV-HepB/Hib) in European studies and PENTACEL (DTaP5-IPV/Hib) (Sanofi Pasteur, Swiftwater, PA) in US studies.

Methods:
Data from 6 studies were integrated and analyzed to provide a comprehensive safety profile. Numbers and proportions of subjects with adverse events (AEs) were summarized by treatment group. Group differences in proportion of AEs were calculated.

Results:
Among the DTaP5-HB-IPV-Hib (N = 5223) and 2295 control (N = 2295) groups, solicited injection-site and systemic AEs were very common. Serious AEs were reported by 3.9% of DTaP5-HB-IPV-Hib and 3.7% of control subjects. Vaccine-related serious AEs occurred infrequently, 0.2% for both groups. Most AEs were mild-to-moderate and did not lead to subject withdrawal. Group differences for solicited systemic AEs were small (<3%) and not statistically significant, except for pyrexia (estimated difference 9.4% [95% CI: 6.7%–12%]). The difference was driven by the 2 US studies where the PENTACEL control group had a lower fever rate. Among European studies, there was no significant difference in rates of pyrexia between DTaP5-HB-IPV-Hib and INFANRIX hexa.

Conclusions:
The safety of DTaP5-HB-IPV-Hib is consistent with the safety profile of its components and similar to comparator vaccines, including INFANRIX hexa. The vaccine provides a new, fully liquid and convenient hexavalent vaccination option for use with various vaccination schedules in Europe.