bluuebunny/crossref_metadata_2025_split huggingface dataset:
Successful switch to oral tacrolimus in a patient with hypersensitivity reaction to parenteral vitamin K, cyclosporine, and tacrolimus: A case report
Authors: Taghvaye-Masoumi Hamidreza , Sadeghi Kourosh , Hadjibabaie Molouk 
Published: August 2019

Introduction Calcineurin inhibitors are widely used for the prevention and treatment of graft versus host disease in patients undergoing allogeneic hematopoietic stem cell transplantation, and successful treatment with calcineurin inhibitors is very important for the management of these cases. Case report A 19-year-old man with thalassemia major experienced hypersensitivity reaction to parenteral vitamin K, cyclosporine, and tacrolimus before hematopoietic stem cell transplantation. All three episodes of reaction appeared a few minutes after administration of offended drugs and cause systemic signs and symptoms of anaphylaxis, i.e. itching, flushing, difficulty in breathing, and hypotension. Management and outcome Hypersensitivity reaction was fully controlled by immediately discontinuing the drug and administering hydrocortisone, chlorpheniramine, epinephrine, and intravenous fluids. During hospitalization, the patient tolerated oral tacrolimus without any complication. Discussion It appears that Cremophor EL (polyoxyethylated castor oil) which acts as a carrier, solubilizer, and emulsifier in intravenous calcineurin inhibitors is responsible for the occurrence of anaphylactic reaction (anaphylaxis); therefore, it is suggested that the administration of cremophor-containing drug should be avoided in patients with a previous history of hypersensitivity reaction to one of these drugs.
Peripheral neuropathy in non-Hodgkin’s lymphoma patients receiving vincristine with and without aprepitant/fosaprepitant
Authors: Edwards Jessi K , Bossaer John B , Lewis Paul O , Sant Ashley 
Published: August 2019

Background Peripheral neuropathy is a common treatment-related adverse effect associated with vincristine. Vincristine is a major CYP3A4 substrate and is often administered alongside the neurokinin-1 (NK-1) receptor antagonists, aprepitant or fosaprepitant, which are moderate CYP3A4 inhibitors. This inhibition may result in increased concentrations of vincristine and an increased incidence of toxicity. Objective The primary objective of this study was to investigate if there is a clinically significant drug interaction between vincristine and aprepitant or fosaprepitant resulting in early-onset peripheral neuropathy. The secondary objective of this study was to investigate the cumulative rate of chemotherapy-induced peripheral neuropathy (CIPN). Methodology This was a single-centered, retrospective, cohort chart review. Patients receiving vincristine-based chemotherapy between 1 July 2010 through 30 June 2018 were identified and reviewed for concomitant use of aprepitant or fosaprepitant and incidence of neuropathy. Early-onset CIPN was defined as neuropathy onset during the first cycle of chemotherapy. Results A total of 115 subjects were retrospectively reviewed over the study period, of whom 71 were included in the aprepitant/fosaprepitant group and 44 were included in the group without a NK-1 receptor antagonist. Of the subjects who received aprepitant/fosaprepitant, 26.7% experienced early-onset peripheral neuropathy as compared to 22.7% in the group without a NK-1 receptor antagonist ( P = 0.627). Overall, CIPN was higher in the group who received aprepitant/fosaprepitant compared to the group without (56% vs. 36%, P = 0.036). Conclusion There appears to be an increased risk of CIPN with the concomitant use of vincristine and aprepitant or fosaprepitant.
Feline ocular post-traumatic sarcomas: Current understanding, treatment and monitoring
Authors: Wood Carrissa , Scott Erin M 
Published: August 2019

Practical relevance: Ocular tumors in cats are seen uncommonly in general practice. Feline ocular post-traumatic sarcomas (FOPTS) represent a very aggressive type of ocular cancer that occurs in cats with a prior history of trauma or severe intraocular disease. Treatment options are limited and early recognition is imperative for close monitoring of disease progression and prompt enucleation. Clinical challenges: There is often a delay between the initiating ocular trauma and tumor formation, with an average latency of approximately 6–7 years. Therefore, many cases may not be presented with a documented history of a traumatic incident, especially if the event occurred prior to adoption. While a histologic diagnosis is easy to obtain with enucleation, the aggressive and locally invasive behavior of FOPTS may prevent complete surgical resection. Global importance: Cats are the most popular pet in the USA and Western Europe. As there is no breed predisposition for this particular cancer, and males are only slightly over-represented compared with females, a relatively large population of companion animals is at potential risk of developing FOPTS. Audience: While uncommon, the understanding and recognition of this tumor type by general practitioners is important for the feline patient. This allows for close monitoring of cats known to have undergone serious ocular trauma, and prompt referral or early enucleation, as well as client education. Patient group: The typical patient is a middle-aged to older cat with a history of mechanical trauma to the eye, past intraocular surgery or chronic uveitis. Evidence base: Historically, there has been limited clinical evidence upon which to determine the optimal treatment for FOPTS, beyond enucleation of the affected eye. Recommendations are generally based on limited case reports and clinical experience of the practitioner.
Malnutrition diagnosed by controlling nutrition status is a negative predictor of life prognosis in aortic arch aneurysm patients treated with thoracic endovascular aneurysm repair
Authors: Inoue Kentaro , Matsumoto Takuya , Yamashita Sho , Yoshiga Ryosuke , Yoshiya Keiji , Matsubara Yutaka , Matsuda Daisuke , Morisaki Koichi , Furuyama Tadashi , Mori Masaki 
Published: August 2019

Objectives Controlling Nutritional Status (CONUT) is a useful screening tool for malnutrition in patients with various diseases; however, how CONUT-diagnosed malnutrition affects patients with aortic arch aneurysm is unknown. This study aimed to reveal the utility of CONUT for detecting the patients with high-risk aortic arch aneurysm with malnutrition. Methods Sixty patients treated for aortic arch aneurysms with elective thoracic endovascular aneurysm repair from 2009 to 2015 were retrospectively analyzed at a single institution. Preoperative nutrition status was evaluated by CONUT, and a CONUT score ≥ 3 was defined as malnutrition. The influence of malnutrition on the patients’ overall survival, aneurysm-related death-free rates, and prevalence of re-interventions were also analyzed. Results Twenty-three patients were diagnosed with malnutrition. Overall survival was significantly lower in the malnutrition group ( P = 0.0036). The multivariate Cox proportional hazard analysis revealed that age ( P  < 0.0001) and malnutrition ( P  = 0.0457) were negative predictors of overall survival. Conversely, the two groups did not differ significantly in aneurysm-related death-free rates ( P  = 0.7879) and the prevalence of re-interventions ( P  = 0.7879). Conclusions Malnutrition diagnosed by CONUT as well as age is a negative predictor of survival prognosis in patients with aortic arch aneurysm.
Necessity of revascularization for acute mesenteric ischemia in symptomatic patients with spontaneous isolated dissection of the superior mesenteric artery
Authors: Otsuka Hiroyuki , Uehata Atsushi , Sakurai Keiji , Sato Toshiki , Aoki Hiromichi , Nakagawa Yoshihide 
Published: August 2019

Objectives We evaluated the necessity of revascularization for acute mesenteric ischemia in symptomatic patients with spontaneous isolated dissection of the superior mesenteric artery. Methods This retrospective study included 28 consecutive, symptomatic patients with spontaneous isolated dissection of the superior mesenteric artery treated at our hospital between December 2005 and December 2017. Patients with concomitant aortic dissection were excluded. We reviewed the patients’ clinical presentation; laboratory evaluations; computed tomography findings, including the true lumen residual ratio (i.e., the minimum true lumen size compared to the diameter of the transverse section of the dissected artery) at the time of admission; the number of patients who were suspected of having bowel ischemia; and the number of patients who required surgical or endovascular treatment and their outcomes. Additionally, to evaluate the true lumen residual ratio in symptomatic patients with bowel ischemia, the true lumen residual ratio in those with abnormal laboratory data were compared with that in those without abnormal laboratory data. Initial true lumen residual ratio values were also compared with final values. Furthermore, we assessed the clinical details of patients who had bowel necrosis. Categorical variables were compared using the χ2 test or Fisher’s exact test, and continuous values were presented as either the mean ± standard deviation or median (interquartile range 25–75%). Variables were analyzed using Student’s t-test or the Mann–Whitney U test. Results The patients’ age ranged between 41 and 85 years, and 25 were men. Although nine patients were suspected of having acute mesenteric ischemia, only one underwent bowel resection. None of the patients had an indication for revascularization. The true lumen residual ratio of the nine patients with abnormal laboratory data were significantly lower than those of the 19 without abnormal laboratory data (10 [0–25]% vs. 40 [20–50]%, p = 0.005). The patient who underwent bowel resection had a true lumen residual ratio of 10%; however, there was no obvious abnormal laboratory data suggestive of bowel necrosis. Dissections were managed conservatively in all patients. True lumen residual ratio increased from initial value of 30 (10–48)% to 98 (60-100)%at the final imaging study ( p < 0.0001). There were no adverse events related to the mesenteric circulation during the follow-up period of 2–11 years. Conclusions Reintervention is rarely required for spontaneous isolated dissection of the superior mesenteric artery, even in symptomatic patients, and spontaneous resolution of the luminal compromise is the rule.
“Enfermarse aquí es un lujo”: prácticas y perspectivas en la atención de enfermedades entre inmigrantes yucatecos en el sur de California
Authors: Valdez Tah Alba Rocío 
Published: August 2019

Resumen: Este estudio se enfoca en cómo un grupo de inmigrantes originarios del estado de Yucatán, en México, y quienes viven en el sur de California, atienden las enfermedades que les aquejan y cómo articulan sus prácticas de atención con sus condiciones socioeconómicas, su estatus migratorio y acceso a los servicios de salud institucionales. La metodología elegida fue de corte cualitativo, a través de entrevistas se recopilaron datos etnográficos analizados con el software MAXQDA12. Las modalidades de las trayectorias en la búsqueda de atención son complejas al ser articulaciones a través de las cuales los entrevistados enfrentan las barreras estructurales para acceder a servicios médicos, y por constituirse al mismo tiempo como una síntesis dinámica de los sistemas de conocimiento científico y del saber popular. Las limitantes estructurales son mayormente prevalentes en el acceso de servicios médicos a partir del segundo nivel y son más profundas entre los participantes indocumentados. El trabajo reflexiona sobre el impacto estructural de la política pública en salud y de la política migratoria sobre las modalidades de atención, sobre las condiciones de salud de los participantes, y sobre las implicaciones de los hallazgos en las estrategias de promoción a la salud en el contexto de migración internacional.
Mobile technology and cumulative trauma symptomology among millennials
Authors: Short Nathan , Blair Madison , Crowell Chloe , Loewenstein Abby , Lynch Annie , Nakum Ravina , Warner Allyson 
Published: August 2019

Introduction Technology use among the millennial population is increasing and related postural compromise may lead to cumulative trauma disorder symptomology. The aim of this study was to explore trends of hand-held mobile technology use and upper extremity cumulative trauma disorder symptomology among a sample of millennials. Methods A convenience sample of graduate students ( n = 42) was used for the study. Demographic and technology use information was obtained through self-report using the smartphone screen time tracking feature. Cumulative trauma disorder symptomology was assessed through administration of various orthopedic special tests. Results On average, participants spent 2 h and 23 min per day using hand-held mobile devices. Out of 42 participants, 54.8% tested positive for at least one orthopedic special test. The symptomatic group spent 2 h and 29 min using hand-held mobile devices, while the asymptomatic group spent 2 h and 4 min. The most common positive orthopedic special tests were Finkelstein’s test ( n = 19; 36%), hyperabduction (Wright’s) test ( n = 13; 25%), and the elbow flexion test ( n = 10; 18.9%), indicating symptoms associated with De Quervain’s tenosynovitis, thoracic outlet syndrome, and cubital tunnel syndrome, respectively. Discussion Results were consistent with prior research on time spent using hand-held mobile technology and cumulative trauma disorder among millennials. Additionally, a difference in mean time spent using mobile technology between the asymptomatic and symptomatic groups was found, suggesting a relationship which warrants further research.
High prevalence of cardiac dysfunction or overt heart failure in 71-year-old men: A 21-year follow-up of “The Study of men born in 1943”
Authors: Chen Xiaojing , Thunström Erik , Hansson Per-Olof , Rosengren Annika , Mandalenakis Zacharias , Zhong You , Ergatoudes Constantinos , Caidahl Kenneth , Fu Michael 
Published: August 2019

Background Knowledge about long-term risk factors and the prevalence of heart failure stages in general population is limited. We aimed to study the prevalence of cardiac dysfunction and heart failure in 71-year-old men and potential risk factors in the past two decades. Design This research was based on a randomized selected population study with longitudinal follow-up. Methods A random sample of men born in 1943 in Gothenburg, Sweden were examined in 1993 (at 50 years of age) and re-examined 21 years later in 2014 (at 71 years of age). Cardiac dysfunction or heart failure was classified into four stages (A–D) according to American Heart Association/American College of Cardiology guidelines on heart failure. Results Of the 798 men examined in 1993 (overall cohort), 535 (67%) were re-examined in 2014 (echo cohort). In the echo cohort 122 (23%) men had normal cardiac function, 135 (25%) were at stage A, 207 (39%) men were at stage B, 66 (12%) men were at stage C, and five (1%) men were at stage D. Multivariable logistic regression demonstrated that elevated body mass index at 50 years old was the only independent risk factor for developing heart failure/cardiac dysfunction during the subsequent 21 years. For each unit (1 kg/m2) of increased body mass index, the odds ratio for stages C/D heart failure vs no heart failure/stage A increased by 1.20 (95% confidence interval, 1.11–1.31, p < 0.001), after adjustment for smoking, sedentary life style, systolic blood pressure, diabetes, and hyperlipidemia. Conclusion In a random sample of men at 71 years of age, half presented with either cardiac dysfunction or clinical heart failure. High body mass index was associated with an increased risk for developing cardiac dysfunction or heart failure over a 21-year period.
Prognostic comparison of the FRIEND and Wasserman/Hansen peak VO2 equations applied to a submaximal walking test in outpatients with cardiovascular disease
Authors: Chiaranda Giorgio , Myers Jonathan , Arena Ross , Kaminsky Leonard , Sassone Biagio , Pasanisi Giovanni , Mandini Simona , Mazzoni Gianni , Grazzi Giovanni 
Published: August 2019

Abstract

Aims
The aim of this study was to determine the ability to predict all-cause mortality using established per cent-predicted (%PRED) equations for peak oxygen consumption (VO2peak) estimated by a submaximal walk test in outpatients with cardiovascular disease.

Methods
Male patients (N = 1491) aged 62 ± 10 years at baseline underwent a moderate and perceptually regulated (11–13 on the 6–20 Borg scale) 1-km treadmill-walking test to estimate VO2peak. %PRED was derived from the Fitness Registry and the Importance of Exercise: A National Data Base (FRIEND) and the Wasserman/Hansen equations.

Results
There were 215 deaths during a median 9.4-year follow-up. The FRIEND prediction equation provided better prognostic information with receiver operating curve analysis showing significantly different areas under the curve (0.72 and 0.69 for the FRIEND and the Wasserman/Hansen equations respectively, p = 0.001). Overall mortality rate was higher across decreasing tertiles of %PRED using FRIEND, with 26%, 11% and 5% for the least fit, intermediate and high fit tertiles, respectively (p for trend &lt; 0.0001). Compared with the least fit tertile, the adjusted hazard ratios for the second and third tertiles were 0.54 (95% confidence interval 0.34–0.87, p = 0.01) and 0.45 (95% confidence interval 0.25–0.81, p = 0.008), respectively. Each 1% increase in %PRED conferred a 3% improvement in survival (p = 0.0004).

Conclusion
Low %PRED VO2peak in cardiac outpatients determined by the FRIEND equation was associated with a high mortality rate independent of traditional cardiovascular risk factors and clinical history. The FRIEND equation may provide a suitable normal standard when applied to clinically stable outpatients with cardiovascular disease.
Sex differences in crude mortality rates and predictive value of intensive care unit-based scores when applied to the cardiac intensive care unit
Authors: Herscovici Romana , Mirocha James , Salomon Jed , Merz Noel B , Cercek Bojan , Goldfarb Michael 
Published: August 2019

Background:
Limited data exists regarding sex differences in outcome and predictive accuracy of intensive care unit-based scoring systems when applied to cardiac intensive care unit patients.

Methods:
We reviewed medical records of patients admitted to cardiac intensive care unit from 1 January 2011–31 December 2016. Sex differences in mortality rates and the performance of intensive care unit-based scoring systems in predicting in-hospital mortality were analyzed. Calibration was assessed by the Hosmer-Lemeshow test and locally weighted scatterplot smoothing curves. Discrimination was assessed using the c statistic and receiver-operating characteristic curve.

Results:
Among 6963 patients, 2713 (39%) were women. Overall in-hospital and cardiac intensive care unit mortality rates were similar in women and men (9.1% vs 9.4%, p=0.67 and 5.9% vs 6%, p=0.88, respectively) and in age and major diagnosis subgroups. Of the scoring systems, Acute Physiology and Chronic Health Evaluation III and Sequential Organ Failure Assessment had poor calibration (Hosmer-Lemeshow p value &lt;0.001), while Simplified Acute Physiology Score II performed better (Hosmer-Lemeshow p value 0.09), in both women and men. All scores had good discrimination (C statistics &gt;0.8). In the subgroups of acute myocardial infarction and heart failure patients, all scores had good calibration (Hosmer-Lemeshow p&gt;0.001) and discrimination (C statistic &gt;0.8) while in diagnosis subgroups with highest mortality, the calibration varied among scores and by sex, and discrimination was poor.

Conclusions:
No sex differences in mortality were seen in cardiac intensive care unit patients. The mortality predictive value of intensive care unit-based scores is limited in both sexes and variable among different subgroups of diagnoses.
The prevalence of headaches, pain, and other associated symptoms in different Persian Gulf deployment periods and deployment durations
Authors: Lei Karen , Metzger-Smith Valerie , Golshan Shahrokh , Javors Jennifer , Leung Albert 
Published: August 2019

Objectives: This study aims to assess (1) the difference in the prevalence of headaches, pain, and other associated symptoms between Gulf War I (1990–1991) and Post-Gulf War I (1992–2015) veterans who served as active military personnel in the Persian Gulf and (2) how the durations of deployment may affect the prevalence of those symptoms. Methods: With institutional human subject committee approval, veterans who were accepted to the Gulf War Registry at the VA San Diego Healthcare System between July 2013 and June 2015 ( N = 367) were included in this retrospective chart review study and grouped according to the Gulf War period they served under or how long they were deployed to the Persian Gulf. Chi-square was used for categorical data analyses and analysis of variance was conducted for continuous outcomes. All analyses were two-tailed, where applicable, with α = 0.05 and Bonferroni for pairwise group comparisons. Results: Veterans who served during Post-Gulf War I or both Gulf War I and Post-Gulf War I exhibited more pain and neurological symptoms than Gulf War I veterans ( p = 0.005, p = 0.003). In addition, veterans who served ⩾12 months reported more overall pain symptoms and analgesic use than those who served less time ( p < 0.001, p = 0.024). Conclusion: The findings suggest that the length of deployment and Persian Gulf deployment period may play a role in acquiring headaches, pain, and other associated symptoms with increased analgesic consumption.
A qualitative study of chronic obstructive pulmonary disease patient perceptions of the barriers and facilitators to adopting digital health technology
Authors: Slevin Patrick , Kessie Threase , Cullen John , Butler Marcus W. , Donnelly Seamas C , Caulfield Brian 
Published: August 2019

Objective Non-adherence to self-management plans in chronic obstructive pulmonary disease (COPD) results in poorer outcomes for patients. Digital health technology (DHT) promises to support self-management by enhancing the sense of control patients possess over their disease. COPD digital health studies have yet to show significant evidence of improved outcomes for patients, with many user-adoption issues still present in the literature. To help better address the adoption needs of COPD patients, this paper explores their perceived barriers and facilitators to the adoption of DHT. Methods A sample of convenience was chosen and patients ( n = 30) were recruited from two Dublin university hospitals. Each patient completed a qualitative semi-structured interview. Thematic analysis of the data was performed using NVivo 12 software. Results Barrier sub-themes included lack of perceived usefulness, digital literacy, illness perception, and social context; facilitator sub-themes included existing digital self-efficacy, personalised education, and community-based support. Conclusion The findings represent a set of key considerations for researchers and clinicians to inform the design of patient-centred study protocols that aim to account for the needs and preferences of patients in the development of implementation and adoption strategies for DHT in COPD.