bluuebunny/crossref_metadata_2025_split huggingface dataset:
A qualitative study using semi-structured interviews of palliative care patients’ views on corneal donation and the timing of its discussion
Authors: Walker Lucy , Neoh Karen , Gilkes Hazel , Rayment Clare 
Published: July 2018

Background: Corneal transplantation can lead to sight restoration, but globally there is a donor shortage. Many palliative care patients can donate their corneas but think they are ineligible due to comorbidities. Healthcare professionals are reluctant to broach the topic, but studies have shown that relatives would be upset if they were not offered this chance. There is no existing research involving patients. Aim: To understand the views and feelings of patients in palliative care settings towards corneal donation and explore their opinions regarding the timing of its discussion. Design: This is an exploratory study based at one UK palliative care unit. A census sampling method was used. Nine participants took part in semi-structured interviews and thematic analysis was undertaken. Results: Themes found included altruistic motivation and the value of sight. Family views were important, but the influence on final decisions varied. The timing of discussion relative to the illness trajectory was important; patients want to be able to engage fully in conversations and had concerns about not being able to think clearly when closer to death. Participants also associated discussion of donation as an indication of a poor prognosis. Patients prefer face-to-face discussions with someone whom they had a close rapport. Many had misconceptions about eligibility. Conclusion: This is the first study to engage directly with palliative care patients and to establish their views on the timing of corneal donation discussions. Patients are willing to discuss donation, and further exploration of patient views in this area should be undertaken.
Rheumatic manifestations of inflammatory bowel diseases: A study from the Middle East
Authors: Hammoudeh Mohammed , Elsayed Eman , Al-Kaabi Saad , Sharma Manik , Elbadri Mohamed , Chandra Prem , Abu Nahia Niveen , Hammoudeh Samer 
Published: July 2018

Objective To examine the prevalence of rheumatic manifestations among patients with inflammatory bowel disease (IBD). Methods This prospective study enrolled patients with IBD in whom the diagnosis and extent of IBD were confirmed by colonoscopy and histopathology. Patients were interviewed and examined by a rheumatologist. A complete rheumatological examination, X-rays of the lumbosacral and sacroiliac joints and HLA-B27 blood tests were performed. Results A total of 127 adult patients were recruited: 46 (36.2%) with Crohn’s disease (CD) and 81 (63.8%) with ulcerative colitis (UC). Rheumatic manifestations of any type were present in 57.5% (73 of 127 patients) with no significant differences between CD and UC. Peripheral manifestations were present in 43.3% (55 of 127 patients), four patients (3.1%) had axial arthritis alone and 14 patients (11.0%) had both types. Among those with peripheral manifestations, five patients (7.2%) had type 1 arthritis (pauciarticular) and one patient (1.4%) had type 2 arthritis (polyarticular). A higher proportion of patients with CD had axial manifestations with or without peripheral manifestations (eight of 46; 17.4%) compared with patients with UC (10 of 81; 12.3%), but no difference was observed in patients with peripheral manifestations alone. Conclusions Rheumatic manifestations in patients with IBD in Qatar are more prevalent than in other regions of the world. Peripheral manifestations were more prevalent than axial.
Dissemination of cfr-mediated linezolid resistance among Staphylococcus species isolated from a teaching hospital in Beijing, China
Authors: Jian Jiyong , Chen Liang , Xie Zeqiang , Zhang Man 
Published: July 2018

Objective The aim of the present study was to report the dissemination of cfr and fexA genes mediated by linezolid resistance among Staphylococcus species. Methods Three methicillin-resistant staphylococci that were collected from a teaching hospital in Beijing were identified as linezolid-resistant. These three staphylococci were Staphylococcus aureus, S. haemolyticus, and S. cohnii. Mutations in domain V of 23S ribosomal RNA, ribosomal proteins, and the cfr, fexA, and optrA genes were analysed. Results The three isolates had no mutations of 23S ribosomal RNA, but showed mutations in the cfr and fexA genes. Mutations in the gene for ribosomal protein L3, which resulted in the amino acid exchanges Gly108Glu, Ser158Phe, and Asp159Tyr, were identified in S. cohnii X4535. Conclusions This is the first report of the cfr gene in clinical linezolid-resistant methicillin-resistant S. aureus isolated from Beijing. L3 mutations coupled with the cfr and fexA genes may act synergistically. Potential transmissibility of this agent, even without prior exposure to linezolid, may have serious epidemiological repercussions.
Endovascular treatment of primary mycotic aortic aneurysms: a 7-year single-center experience
Authors: Luo Yudong , Zhu Jiechang , Dai Xiangchen , Fan Hailun , Feng Zhou , Zhang Yiwei , Hu Fanguo 
Published: July 2018

Objective This study was performed to assess the efficacy and outcome of endovascular aneurysm repair (EVAR) for treatment of primary mycotic aortic aneurysms (PMAAs). Methods Fourteen consecutive patients who presented with PMAA from April 2010 to July 2017 were retrospectively reviewed. Preoperative, intraoperative, and postoperative clinical data were recorded, and late infection-related complications and long-term survival were assessed. Results The aneurysms were located in the abdominal aorta in 10 patients and in the left common iliac artery in 4 patients. Positive microbial cultures were found in 12 patients, including Salmonella species in 11 and Streptococcus in 1. The remaining two patients had negative culture results. Ten patients received preoperative antibiotics before elective EVAR for 7 ± 9 days after admission. Four patients who underwent emergent EVAR due to ruptured aneurysms were given their first dose of antibiotics before EVAR. Three patients underwent surgical drainage, and six underwent percutaneous drainage within 30 days after EVAR. No death occurred within 30 days of the initial procedure. The mean follow-up was 34.8 (range, 3–84 months). One patient underwent re-intervention to resolve obstruction of the iliac/femoral artery 5 months postoperatively. Relapse of infection occurred in six patients (42.8%) during follow-up; infection-related death occurred in three of these patients. The other patients recovered with either conversion to open radical surgery or medical therapy. The actuarial 7-year survival after EVAR was 75.7%. Conclusions EVAR and aggressive antibiotic therapy might be suitable for PMAAs. Favorable results may be typical for infection caused by Salmonella.
Effects of Moringa oleifera leaf powder on metabolic syndrome induced in male Wistar rats: a preliminary study
Authors: López Marisa , Ríos-Silva Mónica , Huerta Miguel , Cárdenas Yolitzy , Bricio-Barrios Jaime Alberto , Díaz-Reval María Irene , Urzúa Zorayda , Huerta-Trujillo Miguel , López-Quezada Karla , Trujillo Xóchitl 
Published: July 2018

Objective To evaluate the preventive effects of Moringa oleifera on metabolic syndrome (MS) in male Wistar rats. Methods MS was induced by feeding rats a high-fat diet and drinking water containing 10% fructose for 6 weeks. In the preventive group, M. oleifera was orally administered for 3 weeks prior to the induction of MS, while in the treatment group, M. oleifera was administered for 3 weeks after the onset of MS. The treatment groups were compared with a control group of untreated rats with induced MS. Fasting glucose, oral glucose tolerance, insulin tolerance, total cholesterol, triglycerides, abdominal circumference, and systolic and diastolic blood pressure were measured before and after MS induction and/or M. oleifera treatment. Results After the induction of MS, the control group had higher fasting glucose levels than the preventive group. No significant differences were observed in insulin tolerance, oral glucose tolerance, cholesterol, triglycerides, abdominal circumference, or systolic or diastolic blood pressure. Compared with untreated controls, rats in the treatment group had significantly improved glucose tolerance, triglycerides, and abdominal circumference. Conclusions M. oleifera treatment attenuates MS in Wistar rats.
Prognostic significance of solitary lymph node metastasis in patients with stages IA2 to IIA cervical carcinoma
Authors: Dai Yi-Fang , Xu Mu , Zhong Li-Ying , Xie Xiao-Yan , Liu Zhao-Dong , Yan Ming-Xing , Yi Huan , Lin Dan-Mei 
Published: July 2018

Objective To investigate the prognostic significance of and risk factors for solitary lymph node metastasis (SLNM) of patients with cervical carcinoma. Methods Clinical data from patients with International Federation of Gynecology and Obstetrics (FIGO) stages IA2 to IIA cervical carcinoma who underwent radical hysterectomy and pelvic lymphadenectomy between January 2003 and December 2010 were analysed retrospectively. Histopathological analysis was used to identify SLNM. Long-term survival and risk factors associated with SLNM were analysed. Results The study enrolled 302 patients with cervical cancer: 48 with SLNM (SLNM group) and 254 patients with no lymph node metastases (nLNM group). FIGO stage, tumour grade, depth of tumour invasion, uterine body involvement, parametrial involvement and lymphovascular invasion differed significantly between the two groups. Logistic regression analysis revealed that FIGO stage, depth of tumour invasion and lymphovascular invasion were independent factors associated with SLNM. The 5-year survival rates of the SLNM and nLNM groups were 54.2% and 87.8%, respectively. Multivariate analysis identified SLNM as an independent factor affecting survival. Conclusions The occurrence of just one solitary lymph node metastasis significantly worsened the prognosis in patients with cervical carcinoma compared with patients without lymph node metastases.
The Natural History of Full-Thickness Rotator Cuff Tears in Randomized Controlled Trials: A Systematic Review and Meta-analysis
Authors: Khatri Chetan , Ahmed Imran , Parsons Helen , Smith Nicholas A. , Lawrence Thomas M. , Modi Chetan S. , Drew Stephen J. , Bhabra Gev , Parsons Nicholas R. , Underwood Martin , Metcalfe Andrew J. 
Published: July 2018

Background:Rotator cuff tears are the most common tendon injury in the adult population, resulting in substantial morbidity. The optimum management for these patients is not known.Purpose:To assess the overall treatment response to all interventions in full-thickness rotator cuff tears among patients enrolled in randomized clinical trials.Study Design:Systematic review and meta-analysis.Methods:Randomized controlled trials (RCTs) were identified from a systematic search of Medline, Embase, CINHAL, and the Cochrane Central Register of Controlled Trials. Patients were aged ≥18 years with a full-thickness rotator cuff tear. The primary outcome measure was change in Constant shoulder score from baseline to 52 weeks. A meta-analysis to assess treatment response was calculated via the standardized mean change in scores.Results:A total of 57 RCTs were included. The pooled standardized mean change as compared with baseline was 1.42 (95% CI, 0.80-2.04) at 3 months, 2.73 (95% CI, 1.06-4.40) at 6 months, and 3.18 (95% CI, 1.64-4.71) at 12 months. Graphic plots of treatment response demonstrated a sustained improvement in outcomes in nonoperative trial arms and all operative subgroup arms.Conclusion:Patients with full-thickness rotator cuff tears demonstrated a consistent pattern of improvement in Constant score with nonoperative and operative care. The natural history of patients with rotator cuff tears included in RCTs is to improve over time, whether treated operatively or nonoperatively.
The Ruptured Achilles Tendon Elongates for 6 Months After Surgical Repair Regardless of Early or Late Weightbearing in Combination With Ankle Mobilization: A Randomized Clinical Trial
Authors: Eliasson Pernilla , Agergaard Anne-Sofie , Couppé Christian , Svensson René , Hoeffner Rikke , Warming Susan , Warming Nichlas , Holm Christina , Jensen Mikkel Holm , Krogsgaard Michael , Kjaer Michael , Magnusson S. Peter 
Published: July 2018

Background: Treatment strategies for Achilles tendon rupture vary considerably, and clinical outcome may depend on the magnitude of tendon elongation after surgical repair. The aim of this project was to examine whether tendon elongation, mechanical properties, and functional outcomes during rehabilitation of surgically repaired acute Achilles tendon ruptures were influenced by different rehabilitation regimens during the early postsurgical period. Hypothesis: Restricted early weightbearing that permits only limited motion about the ankle in the early phase of tendon healing limits tendon elongation and improves functional outcome. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: 75 consecutive patients with an acute Achilles tendon rupture were included. They underwent surgical repair, and tantalum beads were placed in the distal and proximal parts of the tendon; thereafter, the patients were randomized into 3 groups. The first group was completely restricted from weightbearing until week 7. The second group was completely restricted from weightbearing until week 7 but performed ankle joint mobilization exercises. The first and second groups were allowed full weightbearing after week 8. The third group was allowed partial weightbearing from day 1 and full weightbearing from week 5. All patients received the same instructions in home exercise guidelines starting from week 9. Results: The rehabilitation regimen in the initial 8 weeks did not significantly influence any of the measured outcomes including tendon elongation. Achilles tendon elongation and tendon compliance continued for up to 6 months after surgery, and muscle strength, muscle endurance, and patient-reported functional scores did not reach normal values at 12 months. Conclusion: Differences in rehabilitation loading pattern in the initial 8 weeks after the repair of an Achilles tendon rupture did not measurably alter the outcome. The time to recover full function after an Achilles tendon rupture is at least 12 months. Registration: NCT02422004 ( ClinicalTrials.gov identifier).
Primary Care Providers’ Awareness of Physical Activity-Related Intensive Behavioral Counseling Services for Cardiovascular Disease Prevention
Authors: Omura John D. , Watson Kathleen B. , Loustalot Fleetwood , Fulton Janet E. , Carlson Susan A. 
Published: July 2018

Purpose: The US Preventive Services Task Force recommends that adults at risk for cardiovascular disease (CVD) be offered or referred to intensive behavioral counseling interventions to promote a healthful diet and physical activity for CVD prevention. We assessed primary care providers’ (PCPs) awareness of local physical activity-related behavioral counseling services, whether this awareness was associated with referring eligible patients, and the types and locations of services to which they referred. Design: Cross-sectional survey. Setting: Primary care providers practicing in the United States. Subjects: 1256 respondents. Measures: DocStyles 2016 survey assessing PCPs’ awareness of and referral to physical activity-related behavioral counseling services. Analysis: Calculated prevalence and adjusted odds ratios (aORs). Results: Overall, 49.9% of PCPs were aware of local services. Only 12.6% referred many or most of their at-risk patients and referral was associated with awareness of local services (aOR = 2.81, [95% confidence interval: 1.85-4.25]). Among those referring patients, services ranged from a health-care worker within their practice or group (25.4%) to an organized program in a medical facility (41.2%). Primary care providers most often referred to services located outside their practice or group (58.1%). Conclusion: About half of PCPs were aware of local behavioral counseling services, and referral was associated with awareness. Establishing local resources and improving PCPs’ awareness of them, especially using community–clinical linkages, may help promote physical activity among adults at risk for CVD.
Exploring the Quality of Anticoagulant Prescribed for Patients With Atrial Fibrillation at the St John of God Hawkesbury District Health Centre, New South Wales, Australia
Authors: Wertheimer Graeme , Bereznicki Luke R. 
Published: July 2018

Background: Limited data are available on the clinical management of atrial fibrillation (AF) and its outcomes from an Australian perspective. Objective: To describe the appropriateness of antithrombotic prescribing for patients who presented with a diagnosis of AF to the Hawkesbury St John of God Hospital, New South Wales, Australia. Methods: This retrospective observational study reviewed patients admitted to St John of God Hawkesbury Hospital with AF between June 2016 and June 2017. We calculated stroke risk using the CHA2DS2-VASc score based on medical records and reviewed the appropriateness of oral anticoagulant (OAC) prescribing compared to the 2016 European Society of Cardiology guidelines. Patients were excluded if they had only 1 episode of AF that reverted either spontaneously or upon cardioversion without any documented recurrences. Results: A total of 200 patients (18 years) were included, with 180 (90%) deemed eligible for anticoagulation. Of these 72.8% (n = 131) were prescribed an OAC. A total of 40.0% of patients at low risk of stroke and 68.4% at intermediate risk were prescribed an OAC, respectively. Apixaban was the direct OAC of choice with 36.6% of patients prescribed an OAC receiving apixaban. Warfarin was prescribed for 25.1% of the patients who were prescribed an OAC. Conclusions: The underutilization of anticoagulant medication in high-risk groups and over utilization in low-risk groups remains an ongoing issue in contemporary AF management, and it highlights the need to improve AF-related stroke prevention in our jurisdiction.
From the Lab to the Clinic: Activation of an Alpha-2 agonist Pathway is Neuroprotective in Models of Retinal and Optic Nerve Injury
Authors: Wheeler L.A. , Lai R. , Woldemussie E. 
Published: July 2018

Purpose The selective alpha-2 agonist brimonidine was used as a pharmacological probe to activate α2 receptor-mediated neuroprotective signaling pathways and quantitate the enhancement of retinal ganglion cell survival and function in animals with ischemic retinal and optic nerve injury. Methods Two animal models were used to achieve different methods of neuronal insult. The first model involved mechanical injury of the rat optic nerve after treatment with a single intraperitoneal (IP) dose of brimonidine or a control vehicle. The second model involving acute retinal ischemic/reperfusion injury was used in a variety of experiments in which rats were treated with either intraperitoneal brimonidine or single dose topical brimonidine at various strengths. In all cases retinal ischemia was induced and maintained followed by reperfusion. In some cases, TUNEL staining was performed on histologic sections of the retinas of rats that had been sacrificed after 24 hours. To examine the activation of neuronal survival pathways at the molecular level, rats were injected with IP brimonidine followed by the isolation of mRNAs from whole retinas 24 hours after ischemic injury. Results Intraperitoneal brimonidine enhanced rat RGC survival and function in the partial crush injury model, and neuroprotection was dose-dependent. Topical application of brimonidine 1 hour before injury was effective in decreasing ischemic retinal injury. Ischemic retinas treated with brimonidine resulted with a large decrease in TUNEL staining. Conclusions Treatment with the α2 adrenoreceptor agonist brimonidine was found to confer neuroprotection to retinal ganglion cells in two distinct models of neuronal injury resulting from acute retinal ischemia/reperfusion and calibrated optic nerve compression.
Electrophysiological and Histological Measures of Retinal Injury in Chronic Ocular Hypertensive Monkeys
Authors: Hare W. , Ton H. , Woldemussie E. , Ruiz G. , Feldmann B. , Wijono M. 
Published: July 2018

Purpose This study was performed to determine whether components of the standard ERG (electroretinogram), multifocal ERG, and flash VECP (visually-evoked cortical potential) response might provide a sensitive measure of retinal ganglion cell injury in a monkey model for chronic ocular hypertension. Methods Argon laser treatment of the aqueous outflow tissue was used to induce chronic elevation of intraocular pressure (IOP) in the right eye of 18 young adult cynomolgous monkeys. At 15 months post- IOP elevation, standard methods were used to record ERG and VECP responses. Multifocal ERG responses were also recorded at this time. Loss of retinal ganglion cells due to ocular hypertensive injury was determined by histological analysis of all retinas. Results Ocular hypertensive retinal injury was associated with a loss of retinal ganglion cells. There was no histological or electrophysiological evidence for injury to any other retinal cell type. Correlation of electrophysiological response amplitudes with histological measures of retinal ganglion cell loss/survival yielded results which suggest that activity in retinal ganglion cells makes a substantial contribution to components of the 30 Hz flicker ERG, the flash VECP, and both first and second order multifocal ERG responses. Of the electrophysiological measures used in this study, multifocal ERG response amplitude had the greatest sensitivity to retinal ganglion cell loss. Conclusions Components of the multifocal ERG provide a sensitive measure of ganglion cell injury in a monkey model of chronic ocular hypertension. These same measures may have utility in the clinical diagnosis and management of glaucoma.