bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Effect of Ozonated Olive Oil on Neovascularizatıon in an Experimental Skin Flap Model
Authors: Kırkıl Cüneyt , Yiğit Mehmet Volkan , Özercan İbrahim Hanifi , Aygen Erhan , Gültürk Barış , Artaş Gökhan 
Published: June 2016

ABSTRACT

OBJECTIVE:
Angiogenesis is an important factor for flap viability. It has been reported that ozonated oil contributed to improved neovascularization in an acute cutaneous wound healing model. This study was undertaken to evaluate the effect of ozonated olive oil on vascular endothelial growth factor (VEGF)–mediated neovascularization of skin flaps in rats.

STUDY DESIGN:
A skin flap model was established in 21 rats and evaluated within 3 groups. No treatment was given to the rats in group 1. Olive oil and ozonated olive oil were topically applied (twice daily) to the flap surface for 7 days in groups 2 and 3, respectively. Immunohistochemical staining was performed to analyze the expressions of VEGF and CD34.

RESULTS:
The mean numbers of VEGF- and CD34-positive staining microvascular structures were 8.86 (SD, 1.35) and 10.29 (SD, 1.80) in group 1, 15.00 (SD, 1.41) and 15.57 (SD, 1.72) in group 2, and 25.14 (SD, 2.41) and 25.00 (SD, 2.16) in group 3. The VEGF and CD34 expressions in group 3 were significantly higher than those in group 2 (P < .001). Their expressions in group 2 were significantly higher than those in group 1 (P < .001).

CONCLUSIONS:
Both ozonated olive oil and olive oil improved neovascularization when they were topically applied on skin flaps. The effect of ozone was more prominent.
The Impact of Venous Leg Ulcers on Body Image and Self-esteem
Authors: Salomé Geraldo Magela , de Almeida Sergio Aguinaldo , de Jesus Pereira Maria Teresa , Massahud Marcelo Renato , de Oliveira Moreira Carmelita Naira , de Brito Maria José Azevedo , Ferreira Lydia Masako 
Published: June 2016

ABSTRACT

OBJECTIVE:
To evaluate self-esteem and body image in patients with venous leg ulcers (VLUs).

DESIGN:
A multicenter, prospective, descriptive, analytical, clinical study.

SETTINGS:
A nursing care and education center of a university hospital, a health center, and an outpatient wound care clinic in Brazil.

PATIENTS:
Fifty-nine consecutive adult patients with VLUs and Doppler ankle-brachial index ranging from 0.8 to 1.0 were recruited for the study. Exclusion criteria were mixed ulcers, arterial ulcers, and diabetic foot ulcers.

MAIN OUTCOME MEASURES:
A questionnaire assessing sociodemographic and clinical characteristics of patients, the Brazilian version of the Body Investment Scale, and the Rosenberg Self-esteem (RSE)/UNIFESP-EPM (São Paulo da Universidade Federal de São Paulo–Escola Paulista de Medicina) scale were administered to all patients.

MAIN RESULTS:
Most participants were women, aged between 60 and 70 years, and smokers; 33 (56%) were divorced, widowed, or single, and 26 (44%) were married. The patients had the ulcer for a mean of 5.42 years. Exudate and foul odor were present in most cases. Twenty-one ulcers (36%) measured 29 cm2 or less in surface area, and 17 (29%) ulcers measured between 30 and 49 cm2 (mean, 3.39 cm2). The mean RSE score was 22.66, indicating low self-esteem. The mean Body Investment Scale total score was 27.49, and the scores on the body image and body touch subscales were also low, indicating negative feelings about the body.

CONCLUSION:
Patients with VLUs had low self-esteem and negative feelings about their bodies.
Dynamic Lower Extremity Deformity in Children With Pseudoachondroplasia
Authors: Gaebe Glen , Kruse Richard , Rogers Kenneth , Mackenzie William G. , Holmes Laurens 
Published: June 2016

Background:
Pseudoachondroplasia is a diverse group of skeletal dysplasias with a common pathway of altered cartilage oligomeric matrix protein (COMP) production. This rhizomelic dwarfism is commonly associated with deformities of the lower extremities, accelerated osteoarthritis, and ligamentous laxity. One of the most common alignment problems is coronal knee angulation which combined with tibial torsion, results in a complex deformity. The outcome of surgical correction of these deformities is variable.

Methods:
This study used 3-dimensional gait analysis to describe the kinematic deformities in 12 children (aged 3 to 15 y) and compared them to the static deformities measured on standing anteroposterior radiograph.

Results:
Both gait analysis and radiographs showed large variability in the coronal deformities but strong correlation to each other. Gait analysis showed mean varus alignment of the knee to be 13.5±13.1 degrees; that mean is not statistically different from radiographs, which showed a mean varus of 16.2±17.1 degrees. The correlation coefficient between radiographic and kinematic measurement was 0.70. The kinematic internal tibial torsion measured an average 15±19 degrees, which was moderately correlated to knee varus (r=0.45, P<0.01).

Conclusions:
Measurements of varus-valgus alignment correlated well between gait analysis and radiographs. Tibial torsion correlated with varus. In the absence of gait analysis, anteroposterior standing leg length radiographs with the patella facing foreward can be used to assess deformity. As this study does not correlate these measurements to postoperative results, an appropriately powered prospective study and further investigation of biological effects of altered cartilage oligomeric matrix protein production are needed to explain the variable surgical outcomes.

Level of Evidence:
Level IV—case series without control group).
A Novel Classification System Based on Dissemination of Musculoskeletal Infection is Predictive of Hospital Outcomes
Authors: Mignemi Megan E. , Benvenuti Michael A. , An Thomas J. , Martus Jeffrey E. , Mencio Gregory A. , Lovejoy Stephen A. , Copley Lawson A. , Williams Derek J. , Thomsen Isaac P. , Schoenecker Jonathan G. 
Published: June 2016

Background:
Musculoskeletal infections (MSKIs) are a common cause of pediatric hospitalization. Children affected by MSKI have highly variable hospital courses, which seem to depend on infection severity. Early stratification of infection severity would therefore help to maximize resource utilization and improve patient care. Currently, MSKIs are classified according to primary diagnoses such as osteomyelitis, pyomyositis, etc. These diagnoses, however, do not often occur in isolation and may differ widely in severity. On the basis of this, the authors propose a severity classification system that differentiates patients based on total infection burden and degree of dissemination.

Methods:
The authors developed a classification system with operational definitions for MSKI severity based on the degree of dissemination. The operational definitions were applied retrospectively to a cohort of 202 pediatric patients with MSKI from a tertiary care children’s hospital over a 5-year period (2008 to 2013). Hospital outcomes data [length of stay (LOS), number of surgeries, positive blood cultures, duration of antibiotics, intensive care unit LOS, number of days with fever, and number of imaging studies] were collected from the electronic medical record and compared between groups.

Results:
Patients with greater infection dissemination were more likely to have worse hospital outcomes for LOS, number of surgeries performed, number of positive blood cultures, duration of antibiotics, intensive care unit LOS, number of days with fever, and number of imaging studies performed. Peak C-reactive protein, erythrocyte sedimentation rate, white blood cell count, and temperature were also higher in patients with more disseminated infection.

Conclusions:
The severity classification system for pediatric MSKI defined in this study correlates with hospital outcomes and markers of inflammatory response. The advantage of this classification system is that it is applicable to different types of MSKI and represents a potentially complementary system to the previous practice of differentiating MSKI based on primary diagnosis. Early identification of disease severity in children with MSKI has the potential to enhance hospital outcomes through more efficient resource utilization and improved patient care.

Level of Evidence:
Level II—prognostic study.
Symptoms and effects of physical factors in Japanese middle-aged women
Authors: Yokota Megumi , Makita Kazuya , Hirasawa Akira , Iwata Takashi , Aoki Daisuke 
Published: June 2016

Abstract

Objective:
The aim of the study was to clarify the prevalence and severity rates of symptoms and investigate whether symptoms varied in relation to body mass index (BMI).

Methods:
The study group composed of 1,969 women, aged 40 to 60 years, who presented at our department from 1993 through 2014. The participation rate was 98%. The presence or absence of symptoms was evaluated by having the participants complete the Keio Questionnaire, a self-administered questionnaire. To allow the results to be compared according to ovarian function, serum levels of follicle-stimulating hormone and estradiol were measured. Participants were classified into three groups according to BMI: underweight, normal weight, and overweight. Symptoms were also compared among these subgroups.

Results:
The most common symptom was general fatigue. Vasomotor symptoms differed significantly between pre- and postmenopause status. When symptoms were analyzed according to BMI, the severity rates of the following symptoms were significantly higher in the overweight group than in the normal weight and underweight groups: hot flushes, sweats, joint pain, numbness, and incontinence. On the contrary, the underweight group had significantly higher severities of cold constitution, nervousness, and wrinkled skin than did the other groups. In addition, an increase in BMI was associated with an increased severity of vasomotor symptoms.

Conclusions:
The prevalence and severities of shoulder stiffness, considered a characteristic symptom in Japanese women, were high. Increased BMI was shown to be associated with a higher severity of vasomotor symptoms, joint pain, nervousness, and urinary symptoms.
Longtime napping is associated with cardiovascular risk estimation according to Framingham risk score in postmenopausal women
Authors: Li Feng , Sun Kan , Lin Diaozhu , Qi Yiqin , Li Yan , Yan Li , Ren Meng 
Published: June 2016

Abstract

Objective:
Menopause can affect the physiological timing system, which could result in circadian rhythm changes and development of napping habits. Whether longtime napping in postmenopausal women is associated with cardiovascular disease is, however, still debated. The present study aims to investigate this association.

Methods:
We conducted a population-based study in 4,616 postmenopausal Chinese women. Information on sleep duration was self-reported. The Framingham General Cardiovascular Risk Score was calculated and used to identify participants at high risk of coronary heart disease (CHD).

Results:
Increased daytime napping hours were positively associated with cardiovascular disease risk factors in postmenopausal women, such as age, waist circumference, systolic blood pressure, triglycerides, fasting glucose, postload glucose, and hemoglobin A1C (all P for trend <0.05). The prevalence of high risk of CHD increased with daytime napping hours, and was 3.7%, 4.3%, and 6.9% in the no daytime napping group, the 0.1 to 1 hour group, and the more than 1 hour group, respectively (P for trend = 0.005). Compared with the no daytime napping group, postmenopausal women with daytime napping more than 1 hour had higher risk of CHD in both univariate (odds ratio 1.94, 95% CI, 1.29-2.95) and multivariate (odds ratio 1.61, 95% CI, 1.03-2.52) logistic regression analyses. No statistically significant association was detected between night sleeping hours and high risk of CHD in postmenopausal participants.

Conclusions:
Daytime napping is positively associated with estimated 10-year CHD risk in postmenopausal Chinese women.
Media and education of the consumer
Authors: Shapiro Marla 
Published: June 2016

Abstract
The landscape has changed in how consumers get their health information. A shift to the Internet and social media are now the way many consumers obtain their health and medical information. In addition, the highly complex information in medicine and science separates health journalism from other forms of journalism. In this article, the question of the role of media in educating consumers is examined. It is clear that knowledge translation is complex and begs the cooperation of scientists and journalists alike.
An Inexpensive Bismuth-Petrolatum Dressing for Treatment of Burns
Authors: Chattopadhyay Arhana , Chang Kathleen , Nguyen Khoa , Galvez Michael G. , Legrand Anais , Davis Christopher , McGoldrick Rory , Long Chao , Pham Hung , Chang James 
Published: June 2016

Background:
Xeroform remains the current standard for treating superficial partial-thickness burns but can be prohibitively expensive in developing countries with prevalent burn injuries. This study (1) describes the production of an alternative low-cost dressing and (2) compares the alternative dressing and Xeroform using the metrics of cost-effectiveness, antimicrobial activity, and biocompatibility in vitro, and wound healing in vivo.

Methods:
To produce the alternative dressing, 3% bismuth tribromophenate powder was combined with petroleum jelly by hand and applied to Kerlix gauze. To assess cost-effectiveness, the unit costs of Xeroform and components of the alternative dressing were compared. To assess antimicrobial properties, the dressings were placed on agar plated with Escherichia coli and the Kirby-Bauer assay performed. To assess biocompatibility, the dressings were incubated with human dermal fibroblasts and cells stained with methylene blue. To assess in vivo wound healing, dressings were applied to excisional wounds on rats and the rate of re-epithelialization calculated.

Results:
The alternative dressing costs 34% of the least expensive brand of Xeroform. Antimicrobial assays showed that both dressings had similar bacteriostatic effects. Biocompatibility assays showed that there was no statistical difference (P < 0.05) in the cytotoxicity of Xeroform, alternative dressing, and Kerlix gauze. Finally, the in vivo healing model showed no statistical difference (P < 0.05) in mean re-epithelialization time between Xeroform (13.0 ± 1.6 days) and alternative dressing (13.5 ± 1.0 days).

Conclusions:
Xeroform is biocompatible, reduces infection, and enhances healing of burn wounds by preventing desiccation and mechanical trauma. Handmade petrolatum gauze may be a low-cost replacement for Xeroform. Future studies will focus on clinical trials in burn units.
Awareness of Glaucoma and Eye Health Services Among Faith-based Communities in Kumasi, Ghana
Authors: Murdoch Calum , Opoku Kennedy , Murdoch Ian 
Published: June 2016

Purpose:
To determine awareness of glaucoma, “hinta anifraye” and available eye health services among urban communities in Kumasi, Ghana. “Hinta anifraye” is a recently developed term for glaucoma in the local Twi language.

Materials and Methods:
Convenience sampling was used to survey the communities of 4 churches and 2 mosques in Kumasi, recruiting participants as they arrived to attend religious services. Ten interviewers collected data by quantitative, interviewer-administered questionnaires. An awareness grading system was devised to categorize participant knowledge from level 0 to 4.

Results:
Of a total 484 respondents, 269 (56%; 95% confidence interval, 52%-60%) had heard of glaucoma, and 284 (60%; 95% confidence interval, 56%-64%) had heard of either glaucoma or hinta anifraye. Only 142 (29%) had disease-specific knowledge of symptoms or causes. TV and radio were the main reported sources of information. Education, religious community, English language, male sex, and older age were all found to be significant indicators of awareness, with education shown to be a key confounding factor. Overall 436 (90%) mentioned either a hospital or doctor as a place they knew they could seek help for an eye problem.

Conclusions:
Awareness of glaucoma is higher than previously suggested from similar studies, but still very low from a global perspective. The findings suggest that media is a useful tool in disseminating health messages. Awareness of professional care was found to be remarkably high. Eye health promotion is recommended to raise awareness of glaucoma among this population.
Reduced thermal sensitivity and increased opioidergic tone in the TASTPM mouse model of Alzheimer's disease
Authors: Aman Yahyah , Pitcher Thomas , Simeoli Raffaele , Ballard Clive , Malcangio Marzia 
Published: June 2016

Abstract
Individuals with Alzheimer's disease (AD) are in susceptible patient groups in which pain is an important clinical issue that is often underdiagnosed. However, it is unclear whether decreased pain complaints in patients with AD result from elevated pain tolerance or an impaired ability to communicate sensations. Here, we explored if AD-related pathology is present in key regions of the pain pathway and assessed whether nociceptive thresholds to acute noxious stimulation are altered in the double-mutant APPswe × PS1.M146V (TASTPM) transgenic mouse model of AD. TASTPM mice exhibited an age-dependant cognitive deficit at the age of 6 months, but not at 4 months, a deficit that was accompanied by amyloid plaques in the cortex, hippocampus, and thalamus. In the spinal cord, β-amyloid (APP/Aβ) immunoreactivity was observed in dorsal and ventral horn neurons, and the expression of vesicular glutamate transporter 2 (VGLUT2) was significantly reduced, while the expression of the inhibitory peptides enkephalins was increased in TASTPM dorsal horn, consistent with an increased inhibitory tone. TASTPM mice displayed reduced sensitivity to acute noxious heat, which was reversed by naloxone, an opioid antagonist. This study suggests that increased inhibition and decreased excitation in the spinal cord may be responsible for the reduced thermal sensitivity associated with AD-related pathology.
A Pharmacokinetic Study Examining Acetazolamide as a Novel Adherence Marker for Clinical Trials
Authors: Hampson Aidan J. , Babalonis Shanna , Lofwall Michelle R. , Nuzzo Paul A. , Krieter Phillip , Walsh Sharon L. 
Published: June 2016

Rationale
Accurate assessment of medication adherence is critical for determination of medication efficacy in clinical trials, but most current methods have significant limitations. This study tests a subtherapeutic (microdose) of acetazolamide as a medication ingestion marker because acetazolamide is rapidly absorbed and excreted without metabolism in urine and can be noninvasively sampled.

Methods
In a double-blind, placebo-controlled, residential study, 10 volunteers received 15 mg oral acetazolamide for 4 consecutive days. Acetazolamide pharmacokinetics were assessed on day 3, and its pharmacokinetic and pharmacodynamic interactions with a model medication (30 mg oxycodone) were examined on day 4. The rate of acetazolamide elimination into urine was followed for several days after dosing cessation.

Results
Erythrocyte sequestration (half-life = 50.2 ± 18.5 h, mean ± SD, n = 6), resulted in the acetazolamide microdose exhibiting a substantially longer plasma half-life (24.5 ± 5.6 hours, n = 10) than previously reported for therapeutic doses (3-6 hours). After cessation of dosing, the rate of urinary elimination decreased significantly (F
3,23 = 247: P < 0.05, n = 6) in a predictable manner with low intersubject variability and a half-life of 16.1 ± 3.8 h (n = 10). For each of 4 consecutive mornings after dosing cessation, the rates of urinary acetazolamide elimination remained quantifiable.
There was no overall effect of acetazolamide on the pharmacodynamics, Cmax, Tmax, or elimination half-life of the model medication tested. Acetazolamide may have modestly increased overall oxycodone exposure (20%, P < 0.05) compared with one of the 2 days when oxycodone was given alone, but there were no observed effects of acetazolamide on oxycodone pharmacodynamic responses.

Conclusions
Coformulation of a once-daily trial medication with an acetazolamide microdose may allow estimation of the last time of medication consumption for up to 96 hours postdose. Inclusion of acetazolamide may therefore provide an inexpensive new method to improve estimates of medication adherence in clinical trials.
Measuring Mortality Performance
Authors: Jiang H. Joanna , Reiter Kristin L. , Wang Jia 
Published: June 2016

Background:
Safety-net hospitals (SNHs) tend to be weaker in financial condition than other hospitals, leading to a concern about how the quality of care at these hospitals would compare to other hospitals.

Objectives:
To assess mortality performance of SNHs using all-payer databases and measures for a broad range of conditions and procedures.

Design:
Longitudinal analysis of hospitals from 2006 through 2011 with data from the Healthcare Cost and Utilization Project State Inpatient Databases, the American Hospital Association Annual Survey, and the Area Health Resources File.

Subjects:
A total of 1891 urban, nonfederal, general acute hospitals from 31 states.

Methods:
SNHs were identified by the percentage of Medicaid and uninsured patients. Hospital mortality performance was measured by 2 composites covering 6 common medical conditions and 4 surgical procedures with risk adjustment for patient characteristics. Differences in each composite between SNHs and non-SNHs were estimated through generalized estimating equations to control for hospital factors and community resources.

Results:
Inpatient mortality rates declined over time for all hospitals. Small differences in risk-adjusted mortality rates between SNHs and non-SNHs were found only among teaching hospitals. After controlling for hospital factors, these differences were substantially reduced and remained significant only for surgical mortality rates. The small gap in surgical mortality rates diminished in later years.

Conclusions:
SNHs appeared to perform equally well as other hospitals in medical and surgical mortality measures. Policymakers should continue to monitor the quality of care at SNHs and ensure that it would not decline under the current value-based purchasing program.
Percutaneous Transhepatic Cholangioplasty to Treat Multiple Intrahepatic Biliary Strictures After Hepatoportoenterostomy
Authors: Weidner Melissa , Mitchell Sally , Schwarz Kathleen 
Published: June 2016

ABSTRACTIn children with biliary atresia, hepatoportoenterostomy (HP) is recommended to improve bile flow. Biliary strictures are known potential complications after HP, which can again impair bile flow often leading to biliary cirrhosis and liver transplantation. In patients who are status post HP and have biliary strictures, nonsurgical therapeutic options such as endoscopic dilation can pose technical difficulties due to altered anatomy. Percutaneous transhepatic cholangiography with cholangioplasty is a valuable tool for obstructive cholangiopathies, but to our knowledge this has not been previously demonstrated to be successful in patients with multiple intrahepatic biliary strictures status post HP. Herein, we present 3 patients status post HP who presented with multiple intrahepatic biliary strictures and underwent successful percutaneous transhepatic cholangiography with cholangioplasty.