bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early Relief of Upper Gastrointestinal Dyspeptic Symptoms: A Survey of Empirical Therapy with Pantoprazole in Canadian Clinical Practice
Authors: Armstrong David , Kazim Farouk , Gervais Marcel , Pyzyk Myron 
Published: March 2016

BACKGROUND: Upper gastrointestinal symptoms attributable to gastroesophageal reflux disease or peptic ulcer are common, but the outcome of proton pump inhibitor therapy in clinical practice is not well documented.AIM: To assess the range of upper gastrointestinal acid-related symptoms in clinical practice and the rapidity of their response to pantoprazole (40 mg daily), after seven days of therapy.METHODS: A total of 726 Canadian physicians (65.3% family physicians) recorded a working diagnosis and alarm features in eligible patients, who then recorded the severity of eight upper gastrointestinal symptoms in a daily symptom diary during the first week of therapy.RESULTS: Complete data were obtained from 2273 (37.3% male) of 3261 patients; physicians diagnosed reflux esophagitis alone (66.9%), peptic ulcer (9.7%), other upper gastrointestinal disorders (12.3%) and reflux esophagitis with another diagnosis (11.1%). Alarm features were common (29.6%), but a history of gastrointestinal blood loss was rare (less than 1%). Mean daytime heartburn scores decreased from 2.59 to 1.40, and epigastric pain scores decreased from 2.54 to 1.56 over the first week (P<0.00001); the proportions of patients who became symptom-free were 68.1% and 55.4%, respectively. Decreased mean symptom scores were also observed for acid regurgitation (2.21 to 1.35), bloating (2.47 to 1.57), nausea (2.03 to 1.36), slow digestion (2.51 to 1.56) and burping (2.56 to 1.69). The percentage of patients with severe or very severe symptoms decreased from 53.5% to 13.8% at day 7. The physician’s initial diagnosis was not predictive of outcome.CONCLUSIONS: In a predominantly primary care population with upper gastrointestinal acid-related symptoms, proton pump inhibitor therapy produces prompt symptomatic relief in most patients. Potential alarm symptoms are common, and further research is required to determine the absolute risk of alarm symptoms and their implications for empirical therapy.
Are Patients Informed When They Consent to ERCP?
Authors: O’Sullivan Sinead , Crippen Craig , Ponich Terry 
Published: March 2016

BACKGROUD: Only the British Society of Gastroenterology has published consent guidelines that are inclusive for endoscopic retrograde cholangiopancreatography (ERCP). Previous research has shown that there are variations in the information discussed with patients who are undergoing ERCP.PURPOSE: To examine the informed consent practices for ERCP in Ontario.METHODS: A self-report questionnaire was sent to ERCP endoscopists in Ontario, who were identified through a pre-existing database. The 14-item questionnaire included questions pertaining to the risks, benefits and alternatives discussed, how consent was obtained and whether the consent process was modified for patients older than 75 years.RESULTS: Of the 82 surveys sent, 36 responses were received, with three respondents indicating that they no longer performed ERCP; the total response rate was 40%. Ninety-four per cent of those who responded noted that they obtained written consent, and 6% obtained verbal consent. When discussing risks with their patients, 91% of respondents always mentioned pancreatitis, 88% always mentioned bleeding, 73% always mentioned perforation and 30% always mentioned the risk of infection; only 24% always mentioned the possibility of being allergic to the contrast agent, and 73% rarely or never mentioned death. When dealing with patients older than 75 years, 38% of respondents tended to be more brief in their explanations, 31% gave the same details in their explanation and 31% gave more detailed information than they gave to younger patients. Seventy-nine per cent mentioned the possibility of diagnostic failure and 82% mentioned the possibility of therapeutic failure, while only 27% mentioned the possibility of missing a diagnosis.CONCLUSIONS: Variability exists in terms of ‘important information’ given to patients undergoing ERCP. Standard informed consent guidelines specific to ERCP may help endoscopists uphold their responsibility to the patient, enhance patient understanding and reduce the risk of liability.
Self-Reported Awareness and Use ofInternational Classification of DiseaseCoding of Inflammatory Bowel Disease Services by Ontario Physicians
Authors: Farrokhyar Forough , McHugh Kevin , Irvine E Jan 
Published: March 2016

RATIONALE: Population and health services research can be performed by linkage analysis of administrative data. However, the robustness of study results is determined by the accuracy of the diagnostic coding.OBJECTIVES: To estimate the awareness, use and accuracy of theInternational Classification of Diseases, Ninth Revision(ICD-9) coding by physicians providing services for patients with Crohn’s disease (CD) and ulcerative colitis (UC).METHODS: All Ontario gastroenterologists and a 10% random sample of internists, pediatricians, pediatric or general surgeons, and family physicians were surveyed by postal questionnaire to estimate the frequency and 95% CI of using codes 555 or 556 when billing for CD- and UC-related services, respectively.Χ2tests were used for between-group comparisons.RESULTS: Of the physicians who were surveyed, 67.7% (416 of 614) responded; 258 of 391 (66%) who were still practising in Ontario saw patients with inflammatory bowel disease (IBD), and 54% had more than 10 IBD patients; 86.5% (95% CI 82.4% to 90.6%) were familiar with ICD-9 codes, and 91.4% (95% CI 88.1% to 95.6%) used the codes 555 (CD) or 556 (UC) for billing. Rates of ICD-9 use did not differ by sex but were used more frequently by those graduating after 1981 (P<0.02). Gastroenterologists used ICD-9 IBD codes 555 or 556 significantly more often than all other physicians (P=0.001). Most (more than 75%) Ontario physicians used ICD-9 IBD codes always or frequently when billing for IBD-related services. Few (10%) used these codes to bill for non-IBD-related problems.CONCLUSIONS: These data suggest that there is acceptable use and accuracy of ICD-9 diagnostic coding for CD and UC services – comparable with results from studies of other diseases. Administrative data may thus be used to undertake epidemiological studies in IBD in Ontario.
Renal Impairment after Spontaneous Bacterial Peritonitis: Incidence and Prognosis
Authors: Coral Gabriela Perdomo , Alves de Mattos Angelo 
Published: March 2016

BACKGROUND/AIMS: Spontaneous bacterial peritonitis (SBP) is an important complication in cirrhotic patients. The aim of the present study was to assess the incidence, predictive factors and prognosis for renal impairment (RI) after SBP in cirrhotic patients from southern Brazil.METHODS: Of the 1030 hospitalizations evaluated, 114 episodes of SBP were diagnosed in 94 patients (mean age 49 years; 76.59% men). SBP diagnosis was established when the ascitic fluid polymorphonuclear cell count was equal to or greater than 250 cells/mm³. Five cases were excluded. The variables assessed as possible predictors of steady or progressive RI were blood urea nitrogen and creatinine levels before the diagnosis of SBP; type of infection, antibiotic prophylaxis, first episode or recurrent SBP, presence of gastrointestinal bleeding and hepatic encephalopathy during hospitalization, SBP resolution, Child-Pugh classification, levels of blood pressure, ascitic fluid and blood polymorphonuclear cell count, bacteriological data (positive and negative ascitic fluid culture), albumin, bilirubin, sodium and prothrombin time at the moment of diagnosis.RESULTS: The incidence of SBP was 11.07%. In 61 (55.96%) episodes, SBP was associated with RI (transient in 57.37%; steady in 19.67%; and progressive in 22.95%). The mortality rate associated with progressive RI was 100%; 58.33% with steady RI; and 2.85% with transient RI. The mortality rate in patients with or without RI was 36.07% and 6.25%, respectively (P<0.001). The level of creatinine (greater than or equal to 1.3mg/dL) before the diagnosis of SBP and the rate of infection resolution were the only predictors of RI in the multivariate analysis.CONCLUSIONS: RI after SBP is a common complication, and indicates a poor prognosis for this infection. High levels of creatinine before infection and the rate of infection resolution are independent predictors of RI.
Octreotide for Enterocutaneous Fistulas of Crohn’s Disease
Authors: Lavy A , Yasin K 
Published: March 2016

Crohn’s disease is a chronic, life-long disease and has many troublesome complications. Fistulas are a part of Crohn’s disease, and although there are many therapeutic modalities used in treating these fistulas they are only partially successful. As we are still very far from being able to cure it, the aim is to improve the patients’ quality of life and to reduce the iatrogenic harm that may be caused by various treatment modalities. Somatostatin is an inhibitor of intestinal secretion and has been used to treat pancreatic and surgical fistulas. Therefore, we decided to treat enterocutaneous fistulas using somatostatin.METHODS: Five patients with Crohn’s disease were treated with four daily injections of 300 µg octreotide. The total period of treatment was eight weeks.RESULTS: Closure of fistulas was achieved in four of the five patients.CONCLUSION: Somatostatin may have a role in treating Crohn’s disease enterocutaneous fistulas and may prevent surgery or prolonged immunosuppressive therapy.
Role of Na+/H+Exchanger Isoform-1 in Human Inflammatory Bowel Disease
Authors: Khan Islam , Siddique Iqbal , Al-Awadi Farida M , Mohan Krishna 
Published: March 2016

BACKGROUND: Na+/H+exchanger (NHE) is responsible for a net uptake of sodium chloride and water from the gastrointestinal tract and maintains electrolyte and water homeostasis. However, its status in human inflammatory bowel disease such as ulcerative colitis (UC) and Crohn’s disease (CD) remains poorly understood.OBJECTIVES: To investigate the role of NHE-1 isoform in human CD and UC.METHODS: Expression of NHE-1 protein and messenger ribonucleic acid and sodium pump activity were examined in the colonic biopsy samples taken from UC (n=11) and CD (n=13) patients using enhanced chemiluminescence-Western blot analysis, reverse transcription polymerase chain reaction and spectrophotometry. Subjects presenting with abdominal pain and endoscopically normal colon served as normal controls (n=11). Myeloperoxidase (MPO) activity and histology were performed to confirm tissue inflammation.RESULTS: MPO activity increased significantly (P<0.05) in both UC and CD patients compared with the normal controls. Parallel to MPO activity profile, there was also a significantly higher infiltration of inflammatory cells in both cases. P-nitrophenylphosphatase activity, a marker of the sodium pump, remained unchanged in CD but increased significantly (P<0.05) in UC compared with the normal controls. On the contrary, the level of NHE-1 protein and messenger ribonucleic acid was significantly decreased (P<0.05) in both cases, whereas the internal control, a-actin remained unaltered.CONCLUSIONS: These findings demonstrate a transcriptionally regulated suppression of NHE-1 in both UC and CD. This NHE-1 suppression may reduce an uptake of sodium chloride and water from the inflamed colonic lumen and thus contribute to diarrhea and neuromuscular alterations in these conditions.
Use of LARA-urea Breath Test in diagnosis ofHelicobacter pyloriInfection in Children and Adolescents: A Preliminary Study
Authors: Day Andrew S , van Zanten Sander Veldhuyzen , Otley Anthony R , Best Linda , Griffiths AnneMarie , Sherman Philip M 
Published: March 2016

BACKGROUND: An accurate diagnosis ofHelicobacter pyloriinfection in children currently relies upon histological assessment or culture of gastric biopsies obtained at endoscopy. Noninvasive testing would permit simpler assessment of children with dyspeptic symptoms. The primary aim of the present study was to prospectively evaluate a novel urea breath testing method in children undergoing diagnostic assessment of dyspeptic symptoms and secondarily to consider the roles of other noninvasive tests in these children.METHODS: Laser associated ratio analysis (LARA)-13C urea breath testing was performed on children presenting with upper gastrointestinal symptoms for diagnostic endoscopy. Serum and stool were collected for performance of serology and stool antigen testing, respectively. Histology and culture of endoscopic biopsies of the gastric antrum were used to establishH pyloriinfection status.RESULTS: Eight (36%) of 22 children wereH pylori-positive by histology or culture of gastric biopsies. Urea breath testing showed a sensitivity of 75%, but specificity of 100%. The deletion of a test meal from the urea breath test protocol in eight patients did not alter the utility of the test. Serology provided sensitivity of 87.5%, but a specificity of only 75%. Stool antigen testing in eight available samples provided sensitivity of 50% and specificity of 100%.CONCLUSIONS: The LARA-urea breath testing method provided less sensitivity in this group of children than suggested from previous studies. However, urea breath testing in children is easy to complete and provides rapid noninvasive results. Breath testing protocols require standardization; for instance, the addition of a test meal may not be necessary in older children. Although noninvasive tests for the presence ofH pyloriin children may provide accurate results and can be considered for use in the initial assessment of dyspeptic children, further work is required to establish the most accurate testing methods.
THE IMPORTANCE OF COST MANAGEMENT IN A MANUFACTURING COMPANY OF HYDROELECTRIC PLANTS - A CASE STUDY
Authors: Mello Mario Fernando , Santos Amanda Barbosa 
Published: March 2016

Abstract: Changes in the global market happen at all times and the update of the companies must be constant and rapid, thus it is necessary that managers are aware of the current status of the organization and its projects, mainly in cost sector. This paper aims to demonstrate the importance of cost managements and proposes a design methodology, through an applicative program for an appropriate management of costs in the studied company. The research occurred in the hydro sector on an assembly company of hydroelectric plants in the state of Rio Grande do Sul, Brazil. The survey results showed the importance of cost control in each project and this topic is part of the company financial policy. The results of this study show that a methodological structuring of cost control is vital for managers to have reports at hand in a proper sequence information, that is relevant to make decisions.
Study on correlation between combined femoral and acetabular anteversion in patients undergoing total hip arthroplasty using CT scan
Authors: Murthy Harish , Reddy T. V. S. 
Published: March 2016

<p class="abstract"><strong>Background:</strong> The concept of hip Arthroplasty started as a very simple rudimentary idea of excising the hip joint (excision Arthroplasty), through to fusion of the hip, to actual replacement of the joint surfaces with various artificial substances ranging from glass, plastic, pig's bladder, ivory, ceramic polyethylene (PE) and more recently to actual metal-on metal hip replacement. Hip replacement is usually considered only after other therapies, such as physical therapy and pain medications, have failed. To determine the combined femoral and acetabular anteversion in patients undergoing total hip arthroplasty using CT scan.</p><p class="abstract"><strong><span lang="EN-US">Methods:</span></strong><span lang="EN-US"> Patients admitted in hospital who underwent total hip arthroplasty from July 2013 to July 2015 were included in the study.</span></p><p class="abstract"><strong><span lang="EN-US">Results:</span></strong><span lang="EN-US"> The study comprised of 40 patients, there were 15 (37.5%) females and 25 (62.5%) males. There were 7(17.5%) patients with less than 30º femoral component anteversion, 26 (65%) patients were in the range of 30º - 50º anteversion and 7 (17.5%) patients were in the range of more than 50º anteversion. There were 10 (25%) patients with less than 40 º combined anteversion, 23 (57.5%) patients were in the range of 40 º - 70 º anteversion and 7 (17.5 %) patients were in the range of more than 70 º anteversion.</span></p><p class="abstract"><strong><span lang="EN-US">Conclusions:</span></strong><span lang="EN-US"> The functional outcome of the patients was better when the combined anteversion was between 4-7ff as compared to the functional outcome when the combined anteversion was either less than 40 " or more than 70'. However, we required larger group of study to validate the findings.</span></p>
A prospective randomized comparative study between trochanteric versus piriformis entry portal for intramedullary interlock nailing in the treatment of femoral shaft fracture
Authors: Meena Kanta Prasad , Yadav Mahendra Kumar , Devatheya Deepak 
Published: March 2016

<p class="abstract"><strong>Background:</strong> In case of close nailing for femoral shaft fractures, the nail is inserted into the medullary cavity through the proximal femur without disturbing the periosteal blood supply of at the fracture site. The piriformis fossa and greater trochanter has been commonly described as starting points for antegrade femoral nailing. The purpose of this study was to compare results of two entry ports being used for intramedullary nailing for femoral shaft fractures.</p><p class="abstract"><strong><span lang="EN-US">Methods:</span></strong><span lang="EN-US"> This study was conducted during a period of one year. The patients admitted with femoral diaphyseal fractures for antegrade nailing were divided in two groups alternatively for piriformis fossa entry point and greater trochanter entry point. Total number of patient in each group was 25 (n = 25). Functional outcome were analyzed at final follow up using Hari’s hip score.</span></p><p class="abstract"><strong><span lang="EN-US">Results:</span></strong><span lang="EN-US"> There was no significant difference clinical and functional output in both group but intraoperative time and fluoroscopic time was significant (P &lt;0.001).</span></p><p class="abstract"><strong><span lang="EN-US">Conclusions:</span></strong><span lang="EN-US"> Femoral nailing through the greater trochanter entry portal with specifically designed nails should be considered a rational alternative to femoral nailing compared to Piriformis fossa entry portal with the benefit of reduced requirement for fluoroscopy and decreased operative time in obese patients. Statistically no significant difference (&gt;0.005) in clinical and Functional outcome based on Hari’s hip score.</span></p>
Performance econômica e ambiental de agricultura agroflorestal e convencional no município de Nova Olinda-CE
Authors: Silva T. T. , Drumond M. A. , Bakke I. A. , Silva S. M. 
Published: March 2016

<p>Inúmeras experiências agrícolas alternativas surgiram no sertão nordestino. Com bons resultados, essas experiências agroflorestais expandiram-se para outras áreas, como, por exemplo, a Chapada do Araripe, no Ceará, Brasil. Este estudo teve como objetivo comparar os benefícios econômicos e ambientais de um sistema agroflorestal (SAF) em relação à agricultura convencional, no município de Nova Olinda-CE. A pesquisa foi realizada em uma propriedade que desenvolve o SAF comparando com uma que emprega a agricultura convencional. Utilizou-se, no estudo, a análise descritiva. Nos aspectos econômicos, foram avaliados: Valor Bruto de Produção (VBP), Custos na produção (CP), Lucro Bruto (LB) e Relação Benefício/Custo (B/C). Na performance ambiental, utilizaram-se os parâmetros do Guia do Meio Ambiente para o Produtor Rural, elaborado pelo Banco do Nordeste. Para o teor de fertilidade do solo, foram colhidas amostras de solos de acordo com a metodologia da Embrapa Os resultados mostraram que o SAF possibilita melhor convivência com as adversidades climáticas do semiárido. O SAF estudado superou, em viabilidade econômica, a agricultura convencional. Onde é desenvolvido o SAF, possui boa performance ambiental, na agricultura convencional, essa performance é baixa.</p><p> </p><p align="center"><strong><em>Economic and environmental performance of agroforestry and conventional agriculture in the city of Nova Olinda-CE</em></strong></p><p><strong>Abstract: </strong>Numerous alternative agricultural experiments emerged in the northeastern backlands. With good results, these agroforestry experiences have expanded to other areas, for example, the Chapada do Araripe, in Ceara, Brazil. This study has as objective to compare the economic and environmental benefits of an agroforestry system (AFS) in relation to the conventional agriculture in the city of Nova Olinda-CE. This study was carried out on a property which develops the AFS comparing to another property which uses the conventional agriculture. Descriptive analysis was used in this research. Considering the economic aspects, Gross Production Value (GPV) Costs in the Production (CP) Gross Profit (GP) and Benefit-Cost ratio (B-C) were evaluated. Regarding the environmental performance, parameters from the Environmental Guide for the Rural Producer, which were designed by the Brazilian bank named Banco do Nordeste, were utilized. For the soil fertility content, soil samples were collected according to Embrapa methodology. The results showed that the AFS enables better interaction with climatic adversities of the semi-arid. The studied AFS surpassed conventional agriculture in economic viability. The performance found where AFS is developed is good; however in the conventional agriculture, this performance is low.</p>
Influence of body composition profile on outcomes following colorectal cancer surgery
Authors: Malietzis G , Currie A C , Athanasiou T , Johns N , Anyamene N , Glynne-Jones R , Kennedy R H , Fearon K C H , Jenkins J T 
Published: March 2016

Abstract

Background
Muscle depletion is characterized by reduced muscle mass (myopenia), and increased infiltration by intermuscular and intramuscular fat (myosteatosis). This study examined the role of particular body composition profiles as prognostic markers for patients with colorectal cancer undergoing curative resection.

Methods
Patients with colorectal cancer undergoing elective surgical resection between 2006 and 2011 were included. Lumbar skeletal muscle index (LSMI), visceral adipose tissue (VAT) surface area and mean muscle attenuation (MA) were calculated by analysis of CT images. Reduced LSMI (myopenia), increased VAT (visceral obesity) and low MA (myosteatosis) were identified using predefined sex-specific skeletal muscle index values. Univariable and multivariable Cox regression models were used to determine the role of different body composition profiles on outcomes.

Results
Some 805 patients were identified, with a median follow-up of 47 (i.q.r. 24·9–65·6) months. Multivariable analysis identified myopenia as an independent prognostic factor for disease-free survival (hazard ratio (HR) 1·53, 95 per cent c.i. 1·06 to 2·39; P = 0·041) and overall survival (HR 1·70, 1·25 to 2·31; P &lt; 0·001). The presence of myosteatosis was associated with prolonged primary hospital stay (P = 0·034), and myopenic obesity was related to higher 30-day morbidity (P = 0·019) and mortality (P &lt; 0·001) rates.

Conclusion
Myopenia may have an independent prognostic effect on cancer survival for patients with colorectal cancer. Muscle depletion may represent a modifiable risk factor in patients with colorectal cancer and needs to be targeted as a relevant endpoint of health recommendations.