bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Use of Infliximab for Treatment of Hospitalized Patients with Acute Severe Ulcerative Colitis
Authors: Bressler B , Law JK , Al Nahdi Sheraisher N , Atkinson K , Byrne MF , Chung HV , Fishman M , Partovi N , Pearson D , Penner R , Enns RA 
Published: March 2016

BACKGROUND/AIM: The use of infliximab in severe ulcerative colitis (UC) is established; however, its role in severe acute UC requires clarification. The present multicentre case series evaluated infliximab in hospitalized patients with steroid-refractory severe UC.METHODS: Patients from six hospitals were retrospectively evaluated. Data collection included demographics, duration of disease and previous treatments. The primary end point was response to in-hospital infliximab; defined as discharge without colectomy.RESULTS: Twenty-one patients (median age 26 years) were admitted between May 2006 and May 2008 with severe UC requiring intravenous steroids and given infliximab (median time to infusion eight days). Sixteen (76%) patients were discharged home without colectomy; three of these underwent colectomy at a later date. Of the remaining 13 patients (62%), all but two did not require further courses of steroids; six patients had infliximab as a bridge to azathioprine and seven patients were maintained on regular infliximab. Five patients required in-hospital colectomy after the initial infliximab.CONCLUSIONS: In this real-life experience of infliximab in patients with steroid-refractory severe UC, infliximab appears to be a viable rescue therapy. The majority of patients were discharged without surgery and 62% maintained response either as a bridge to azathioprine or maintenance infliximab.
A Preliminary Guideline for the Assignment of Methicillin‐Resistant Staphylococcus aureus to a Canadian Pulsed‐Field Gel Electrophoresis Epidemic Type Using spa Typing
Authors: Golding George R , Campbell Jennifer L , Spreitzer Dave J , Veyhl Joe , Surynicz Kathy , Simor Andrew , Mulvey Michael R , Canadian Nosocomial Infection Surveillance Program  
Published: March 2016

BACKGROUND: Increasing rates of methicillin‐resistant Staphylococcus aureus (MRSA) infections on a global scale is a major health concern. In Canada, there are 10 known epidemic types of MRSA as determined by pulsed‐field gel electrophoresis (PFGE). Despite the excellent discriminatory power of PFGE, there are several disadvantages of using this technique, such as high degree of labour intensity and the inability to easily develop an MRSA typing database due to the subjective interpretation of results.OBJECTIVES: The purpose of the present study was to determine whether spa typing, an established DNA sequence‐based typing method, could be used as an alternative to PFGE for the typing of Canadian MRSA (CMRSA) epidemic isolates.RESULTS: spa types were determined for 1488 CMRSA isolates, and the method was analyzed for its ability to identify and cluster CMRSA1‐10 strains. Minimal spanning tree analysis of 1452 spa types revealed individual clonal clusters for PFGE epidemic types CMRSA1, 2, 7 and 8, but spa typing could not distinguish CMRSA5 from CMRSA9 and CMRSA10, and CMRSA3 from CMRSA4 and CMRSA6. However, specific spa types were generally associated with only one PFGE epidemic type. Based on these results, a spa typing guideline for CMRSA isolates was developed and tested using the first 300 MRSA isolates received in 2007 through the Canadian Nosocomial Infection Surveillance Program.CONCLUSIONS: The high concordance of spa types with PFGE epidemic types using this guideline demonstrated the feasibility of spa typing as a more rapid and less technically demanding alternative typing method for MRSA in Canada.
Prognosis of Gastric Cancer Patients with Node-Negative Metastasis following Curative Resection: Outcomes of the Survival and Recurrence
Authors: Deng Jingyu , Liang Han , Sun Dan , Zhang Rupeng , Zhan Hongjie , Wang Xiaona 
Published: March 2016

BACKGROUND: The purpose of the present study was to provide valuable prognostic information on lymph node-negative gastric cancer patients following curative resection.METHODS: Data from 112 lymph node-negative gastric cancer patients who underwent curative resection were reviewed to identify the independent factors of overall survival and recurrence.RESULTS: The five-year survival rate of lymph node-negative gastric cancer patients was 85.7%, and recurrence was identified in 25 patients after curative surgery. The five-year survival rate of lymph node-negative gastric cancer patients was higher than that of lymph node-positive gastric cancer patients (P<0.001). Recurrence in lymph node-negative gastric cancer patients was less than that of lymph node-positive gastric cancer patients (P=0.001). The median survival after recurrence of lymph node-negative gastric cancer patients was longer than that of lymph node-positive gastric cancer patients (P=0.021). Using multivariate analyses, the following results were determined for lymph node-negative gastric cancer patients: sex, operative type and the presence of serosal involvement were independent factors of overall survival; and lymphadenectomy, number of dissected nodes and the presence of serosal involvement were independent factors of recurrence.CONCLUSIONS: The prognosis of lymph node-negative gastric cancer patients was better than that of lymph node-positive gastric cancer patients. Male sex, subtotal gastrectomy and nonserosal involvement should be considered to be the favourable predictors of postoperative long-term survival of lymph node-negative gastric cancer patients. Conversely, limited lymphadenectomy, few dissected nodes and serosal involvement should be considered to be risk factors of postoperative recurrence of lymph node-negative gastric cancer patients.
Opposing Trends in the Prevalence of Health Professional‐Diagnosed Asthma by Sex: A Canadian National Population Health Survey Study
Authors: Ghosh S , Pahwa P , Rennie D , McDuffie HH 
Published: March 2016

BACKGROUND: The prevalence of asthma is on the rise worldwide, with large variations in prevalence existing between and within countries. Little is known regarding the variation in asthma prevalence in adults living in rural and urban settings.OBJECTIVES: Using questionnaire data from the Canadian National Population Health Survey, the prevalence of asthma at four time periods (1994/1995 [cycle 1], 1996/1997 [cycle 2], 1998/1999 [cycle 3] and 2000/2001 [cycle 4]) was compared between rural and urban populations stratified by sex, smoking status and age group. Asthma was defined as a positive response to the question: “Do you have asthma diagnosed by a health professional?”METHODS: To account for the complexity of the survey design, the bootstrap method was used to calculate prevalences and 95% CIs.RESULTS: Overall, the prevalence of asthma increased from 7.3% (cycle 1) to 7.5% (cycle 4). After stratifying by sex, the asthma prevalence decreased among men, but in women, there was a steady increase. Asthma prevalence increased for both the rural population and the urban population. After stratifying each cycle by sex and location (rural or urban), both rural and urban men showed a decrease in asthma prevalence. On dividing according to age groups (0 to 14 years, 15 to 34 years, 35 to 64 years, and 65 years and older), the prevalence of asthma was greatest in the 15‐ to 34‐year age group of urban and rural women.CONCLUSIONS: Asthma prevalence increased among rural and urban women. The prevalence of asthma was highest among female smokers and male nonsmokers when stratified by smoking status. Based on these findings, the rate of increase in asthma prevalence is different for men and women.
Review of the Literature on the Psychoemotional Reality of Women with Vulvodynia: Difficulties Met and Strategies Developed
Authors: Cantin-Drouin Maude , Damant Dominique , Turcotte Daniel 
Published: March 2016

BACKGROUND: Within the past three decades, increased attention has been placed on the study of vulvodynia ‐ an unexplained chronic vulvular discomfort felt without any related pathology. In addition to its physical implications, vulvodynia has a psychosocial dimension.OBJECTIVE: The purpose of the current article is to present a review of the literature on the psychoemotional reality of women with vulvodynia.METHOD: A systematic literature review was conducted in the main social sciences databases, such as Dissertation Abstracts, Current Contents and PsycINFO.RESULTS: Although some discrepancies were found in study results, the review of the literature revealed that women with vulvodynia are often confronted with identity and psychological difficulties, which are, in turn, influenced by social standards regarding sexuality and femininity. To cope with these difficulties, women develop different strategies to decrease the stress related to pain and enhance their psychological well‐being.CONCLUSION: The psychological and relational difficulties experienced by women with vulvodynia are not only due to the physical pain but also to the meaning they attribute to it, often influenced by social expectations related to heterosexuality and femininity. Hence, it is important to assist these women by increasing their knowledge on the psychosocial aspects of their experience while taking into account influences from the social context.
Pain Catastrophizing Scale for Francophone Adolescents: A Preliminary Validation
Authors: Tremblay Isabelle , Beaulieu Yves , Bernier Annie , Crombez Geert , Laliberté Simon , Thibault Pascal , Velly Ana M , Sullivan Michael JL 
Published: March 2016

BACKGROUND: In adults, it is well known that high levels of pain catastrophizing are related to increased pain and disability as well as to heightened anxiety and depression. However, due to the lack of a measure of pain catastrophizing adapted for francophone adolescents, little is known about the role of catastrophizing in this population.OBJECTIVES: To adapt the French version of the Pain Catastrophizing Scale (PCS) and to examine the psychometric properties and factorial structure of the PCS for Francophone Adolescents (PCS‐Ado).METHODS: The French version of the PCS was modified by a group of experts. The format of the questions was modified to be appropriate for adolescents aged between 12 and 18 years. To assess the psychometric properties of the PCS‐Ado, 345 adolescents completed the PCS‐Ado and questionnaires measuring depression, anxiety and intensity of pain. Twelve to 16 weeks later, participants completed the questionnaires again to examine the test‐retest reliability of the PCS‐Ado.RESULTS: Results revealed a three‐factor solution similar to the original PCS. In addition, results revealed that PCS‐Ado had good internal consistency (PCS‐Ado total: 0.85; rumination: 0.72; magnification: 0.66; helplessness: 0.74), and high test‐retest reliability (r=0.73). Finally, significant correlations among catastrophizing, depression, anxiety and pain intensity support the construct validity of the PCS‐Ado.CONCLUSIONS: The results suggest that the PCS‐Ado is valid and reliable with francophone adolescents. Further research is required to assess the validity of the PCS‐Ado in clinical settings.
Pediatric Infective Endocarditis: Has Staphylococcus aureus Overtaken Viridans Group Streptococci as the Predominant Etiological Agent?
Authors: Alshammary Aisha , Hervas-Malo Marilou , Robinson Joan L 
Published: March 2016

BACKGROUND: Viridans group streptococci (VGS) have traditionally been the most common etiological agents of infective endocarditis (IE). Advances in cardiovascular surgery and the increasing use of long‐term central venous catheters may have altered the epidemiology of pediatric IE.METHODS: A chart review of children younger than 17 years of age with IE was completed at the Stollery Children’s Hospital (Edmonton, Alberta) between 1985 and 2004. The literature was reviewed to look for changes over time in the most common etiological agents of pediatric IE.RESULTS: There were 31 cases of definite IE and nine cases of possible IE at the Stollery Children’s Hospital, 19 of which were nosocomial. Thirty cases (75%) had congenital heart disease. The etiological agents were Staphylocccus aureus (n=16), VGS (n=5), coagulase‐negative staphylococci (n=3), enterococcus (n=3), other streptococci (n=8), Enterobacter cloacae (n=1) and Stenotrophomonas maltophilia (n=1), while three cases were culture negative. Two deaths were due to S aureus IE. Review of the literature identified an increasing number of case series in which S aureus was the predominant etiological agent, but VGS still predominated in some recent series.CONCLUSION: Congenital heart disease remains the primary risk factor for pediatric IE. Prospective population‐based studies are required to determine whether S aureus has become the predominant pathogen.
Use of Allopurinol with Low-Dose 6-Mercaptopurine in Inflammatory Bowel Disease to Achieve Optimal Active Metabolite Levels: A Review of Four Cases and the Literature
Authors: Witte Todd N , Ginsberg Allen L 
Published: March 2016

BACKGROUND: At least one-third of patients with inflammatory bowel disease do not respond or are intolerant to therapy with 6-mercaptopurine (6-MP). A subgroup fails to attain optimal levels of 6-thioguanine nucleotide (6-TGN) and instead shunts to 6-methylmercaptopurine nucleotide (6-MMPN).PATIENTS AND METHODS: A retrospective chart review was conducted, and four patients are described who had been previously unable to achieve optimal 6-TGN metabolite levels until allopurinol was added to their treatment.RESULTS: All four patients achieved optimal 6-TGN levels and undetectable 6-MMPN with a mean 6-MP dose of 0.49 mg/kg. Three achieved steroid-free clinical remission. Two of those three patients had normalization of liver enzymes; one patient had baseline normal liver enzymes despite an initial 6-MMPN level of 27,369 pmol/8×108red blood cells. Two patients experienced reversible leukopenia.CONCLUSIONS: Combination allopurinol and low-dose 6-MP is an effective means to achieve optimal metabolite levels and steroid-free clinical remission in previously refractory patients. Caution is advised.
Once‐Daily, Controlled‐Release Tramadol and Sustained‐Release Diclofenac Relieve Chronic Pain due to Osteoarthritis: A Randomized Controlled Trial
Authors: Beaulieu André D , Peloso Paul M , Haraoui Boulos , Bensen William , Thomson Glen , Wade John , Quigley Patricia , Eisenhoffer John , Harsanyi Zoltan , Darke Andrew C 
Published: March 2016

OBJECTIVE: The present study was a randomized, parallel, double‐blind comparison between controlled‐release (CR) tramadol and sustained‐release (SR) diclofenac in patients with chronic pain due to osteoarthritis of the hips and/or knees.METHODS: Patients with at least moderate pain intensity, and having received analgesics over the past three months, underwent a two‐to seven‐day washout of current analgesics before initiation of 200 mg CR tramadol or 75 mg SR diclofenac. During the eight‐week study, patients returned to the clinic biweekly. CR tramadol doses were titrated to a maximum of 200 mg, 300 mg or 400 mg per day. SR diclofenac doses were titrated to 75 mg or 100 mg once daily, or 75 mg twice a day based on pain relief and the presence of side effects. For rescue analgesic, patients took acetaminophen as needed, up to 650 mg three times a day.RESULTS: Forty‐five patients on CR tramadol and 52 patients on SR diclofenac were evaluable. Significant improvements from prestudy treatment were shown for visual analogue scale pain (P=0.0001), stiffness (P<0.0005) and physical function (P=0.0001) scores for both treatments. There were no significant differences between the two treatments in the Western Ontario and McMaster Universities subscales, overall pain, pain and sleep, or the clinical effectiveness evaluation. Overall incidence of adverse events was similar in both groups, with more opioid‐related adverse events with CR tramadol, and two serious adverse events occurring with the use of SR diclofenac.CONCLUSIONS: CR tramadol is as effective as SR diclofenac in the treatment of pain due to knee or hip osteoarthritis, with the potential for fewer of the serious side effects that characterize nonsteroidal anti‐inflammatory drug administration.
Clinical Manifestations of Hemochromatosis inHFEC282Y Homozygotes Identified by Screening
Authors: McLaren Gordon D , McLaren Christine E , Adams Paul C , Barton James C , Reboussin David M , Gordeuk Victor R , Acton Ronald T , Harris Emily L , Speechley Mark R , Sholinsky Phyliss , Dawkins Fitzroy W , Snively Beverly M , Vogt Thomas M , Eckfeldt John H ,   for the Hemochromatosis and Iron Overload Screening (HEIRS) Study Research Investigators
Published: March 2016

BACKGROUND: Patients with hemochromatosis may suffer organ damage from iron overload, often with serious clinical consequences.OBJECTIVE: To assess prevalences of self-reported symptoms and clinical signs and conditions in persons homozygous for the hemochromatosis gene (HFE)mutation (C282Y) identified by screening.METHODS: Participants were adults 25 years of age or older enrolled in the Hemochromatosis and Iron Overload Screening (HEIRS) Study. C282Y homozygotes (n=282) were compared with control participants without theHFEC282Y or H63D alleles (ie, wild type/wild type; n=364).RESULTS: Previously diagnosed C282Y homozygotes and newly diagnosed homozygotes with elevated serum ferritin levels had higher prevalences of certain symptoms such as chronic fatigue (OR 2.8; 95% CI 1.34 to 5.95, and OR 2.0; 95% CI 1.07 to 3.75, respectively), and had more hyperpigmentation on physical examination (OR 4.7; 95% CI 1.50 to 15.06, and OR 3.7; 95% CI 1.10 to 12.16, respectively) and swelling or tenderness of the second and third metacarpophalangeal joints (OR 4.2; 95% CI 1.37 to 13.03, and OR 3.3; 95% CI 1.17 to 9.49, respectively) than control subjects. Joint stiffness was also more common among newly diagnosed C282Y homozygotes with elevated serum ferritin than among control subjects (OR 2.7; 95% CI 1.38 to 5.30). However, the sex- and age-adjusted prevalences of self-reported symptoms and signs of liver disease, heart disease, diabetes and most other major clinical manifestations of hemochromatosis were similar in C282Y homozygotes and control subjects.CONCLUSIONS: Some symptoms and conditions associated with hemochromatosis were more prevalent among C282Y homozygotes identified by screening than among control subjects, but prevalences of most outcomes were similar in C282Y homozygotes and controls in this primary care-based study.
Does Classification of Persons with Fibromyalgia into Multidimensional Pain Inventory Subgroups Detect Differences in Outcome after a Standard Chronic Pain Management Program?
Authors: Verra Martin L , Angst Felix , Brioschi Roberto , Lehmann Susanne , Keefe Francis J , Staal J Bart , de Bie Rob A , Aeschlimann André 
Published: March 2016

INTRODUCTION: The present study aimed to replicate and validate the empirically derived subgroup classification based on the Multidimensional Pain Inventory (MPI) in a sample of highly disabled fibromyalgia (FM) patients. Second, it examined how the identified subgroups differed in their response to an intensive, interdisciplinary inpatient pain management program.METHODS: Participants were 118 persons with FM who experienced persistent pain and were disabled. Subgroup classification was conducted by cluster analysis using MPI subscale scores at entry to the program. At program entry and discharge, participants completed the MPI, Medical Outcomes Study Short Form‐36, Hospital Anxiety and Depression Scale and Coping Strategies Questionnaire.RESULTS: Cluster analysis identified three subgroups in the highly disabled sample that were similar to those described by other studies using less disabled samples of FM. The dysfunctional subgroup (DYS; 36% of the sample) showed the highest level of depression, the interpersonally distressed subgroup (ID; 24%) showed a modest level of depression and the adaptive copers subgroup (AC; 38%) showed the lowest depression scores in the MPI (negative mood), Medical Outcomes Study Short Form‐36 (mental health), Hospital Anxiety and Depression Scale (depression) and Coping Strategies Questionnaire (catastrophizing). Significant differences in treatment outcome were observed among the three subgroups in terms of reduction of pain severity (as assessed using the MPI). The effect sizes were 1.42 for DYS, 1.32 for AC and 0.62 for ID (P=0.004 for pairwise comparison of ID‐AC and P=0.018 for ID‐DYS).DISCUSSION: These findings underscore the importance of assessing individuals’ differences in how they adjust to FM.
Survival in Cystic Neoplasms of the Pancreas
Authors: Cadili Ali , Bazzerelli Amy , Garg Sipi , Bailey Robert 
Published: March 2016

BACKGROUND: The natural history of pancreatic cystic neoplasms remains poorly understood despite growing evidence on the subject. Pancreatic cysts display a wide spectrum of pathological phenotypes, each associated with a different prognostic implication. Many pancreatic cysts are of undetermined malignant potential at presentation and remain so until surgically resected. While the survival rates of patients with malignant cysts are known to be poor, survival rates in patients with undetermined pancreatic cysts are unknown.OBJECTIVE: To identify the factors associated with survival in a group of patients diagnosed with a pancreatic cyst(s).METHODS: The present study was a retrospective multicentre review of pancreatic cystic neoplasms. All patients with a diagnosis of a neoplastic pancreatic cyst from 1994 to 2003 were identified at five different institutions in Edmonton, Alberta. The data collected included patient age, sex, imaging modality, cyst location, cyst size, number of cysts, comorbid illnesses, history of upper abdominal surgery, previous cancer, previous or concurrent metastases, symptoms (pain, upper gastrointestinal bleeding, signs of biliary obstruction, nausea/vomiting), remarkable radiological features, elevated amylase or lipase, type of pancreatic surgery, final pathology (benign or malignant) and overall survival. Survival models were used to assess whether any covariates were predictors of the survival time. Patient data were plotted using the Kaplan-Meier method. The resulting plot was used to calculate survival in the cohort.RESULTS: In total, 64 patients were identified as having neoplastic pancreatic cysts from 1994 to 2003 at the five institutions. The median overall patient survival time was 86 months. The median age at diagnosis for the patient population was 73 years, with 40 patients being women. Univariate analysis revealed that the risk of death was associated with patient age, sex and history of major comorbid illness. Multivariate models identified increased patient age and male sex as the factors that correlated most strongly with decreased overall survival.CONCLUSION: Overall survival in patients with neoplastic pancreatic cysts is determined by patient factors (ie, age and sex) rather than factors descriptive of the cyst such as size and morphology. No conclusions could be made regarding the relationship between cyst pathology and patient survival.