bluuebunny/crossref_metadata_2025_split huggingface dataset:
Possible Hepatotoxicity Associated With Daptomycin
Authors: Mo Yoonsun , Nehring Fletcher , Jung Andrew H. , Housman Seth T. 
Published: January 2016

Purpose To report a case of isolated daptomycin-induced acute liver injury without elevations in creatine kinase (CK) levels or kidney dysfunction. Summary A 49-year-old female with a history of pancreatitis, lupus, diabetes, congestive heart failure, hypertension, and chronic pain syndrome presented to the emergency department with alteration in mental status and acute liver failure. The patient had been treated with daptomycin for methicillin-resistant Staphylococcus aureus (MRSA) endocarditis for 3 weeks. After ruling out other possible etiologies, daptomycin was suspected as a cause of acute liver failure. Her liver failure resolved gradually following withdrawal of daptomycin. Conclusion Although hepatic abnormalities caused by daptomycin are rare, a handful of cases with daptomycin-induced liver injury have been reported in the literature. Of note, in most cases, patients on daptomycin therapy developed liver damage with elevations in CK levels. Our case report suggests possible severe liver injury associated with high-dose and long-term daptomycin treatment in the absence of rhabdomyolysis. Future research is warranted to further investigate the relationship between daptomycin use and liver injury, yet it is reasonable to monitor liver function tests at baseline and weekly thereafter along with CK levels, especially in patients requiring long-term daptomycin therapy.
Association between toll-like receptor polymorphisms and systemic lupus erythematosus: a meta-analysis update
Authors: Lee Y H , Choi S J , Ji J D , Song G G 
Published: January 2016

Objective The aim of this study was to determine whether polymorphisms of the Toll-like receptor ( TLR) genes are associated with susceptibility to systemic lupus erythematosus (SLE). Methods The authors conducted a meta-analysis of the relationship between 12 TLR polymorphisms and SLE susceptibility. Results In total, 26 studies that involved 11,984 patients and 14,572 controls were included in the meta-analysis. The meta-analysis showed no association between the two alleles of the rs352140, rs5743836, and rs352139 polymorphisms of TLR9 and SLE, but indicated an association between the two alleles of the rs187084 polymorphism ( TLR9) and SLE in the overall population (OR = 0.869, 95% CI = 0.762–0.992, P = 0.038). No association was detected between rs3764880 ( TLR8) and SLE; however, our meta-analysis indicated an association between rs3764879 ( TLR8) and SLE in Caucasians (OR = 1.414, 95% CI = 1.139–1.756, P = 0.002). An association between rs179008 ( TLR7) and SLE was found in the African (OR = 0.430, 95% CI = 0.238–0.775, P = 0.005), but not in the Caucasian population (OR = 1.206, 95% CI = 0.932–1.614, P = 0.145). Furthermore, our meta-analysis indicated a significant association between rs3853839 ( TLR7) and SLE in the Asian population (OR = 0.773, 95% CI = 0.735, 0.823, P < 1.0 × 10−9). No associations were found between rs5744168 ( TLR5), rs4986791 ( TLR4), rs4986790 ( TLR4), and rs3775291 ( TLR3) polymorphisms and SLE susceptibility. Conclusions Our meta-analysis suggests that TLR7, TLR8, and TLR9 polymorphisms are associated with the development of SLE in Caucasian, Asian, and African populations.
Effectiveness of Percutaneous Celiac Plexus Ablation in the Treatment of Severe Cancer Pain in Upper Abdomen and Evaluation of Health Economics
Authors: Cao Jun , He Yang , Liu Hongqiang , Wang Saibo , Zhao Baocheng , Zheng Xiaohui , Yang Kai , Xie Donghao 
Published: January 2016

Objective: To compare the effectiveness, adverse effects, and cost-effectiveness of percutaneous neurolytic celiac plexus block (NCPB) versus traditional medication strategies for the treatment of patients with advanced cancer having severe upper abdominal cancer pain. Methods: This retrospective study included 81 patients with advanced upper abdominal cancer admitted to The Sixth People’s Hospital Affiliated to Shanghai Jiaotong University between January 2013 and July 2014. The patients were divided into percutaneous NCPB (treatment) and medication for pain (control) groups. The outcomes were measured in terms of Numeric Rating Scale (NRS) score and Karnofsky Performance Status (KPS) score before treatment and on the 3rd, 7th, 14th, and 28th days posttreatment. The effectiveness and cost-effectiveness of the therapy were assessed using analysis of the health economics. Results: The improvements in NRS score (1.42 ± 1.09 vs 4.03 ± 0.96, P < .01) and KPS score (65.55 ± 9.09 vs 63.03 ± 8.961, P < .01) in the treatment group were significantly superior compared to the control group on the 7th day of treatment, followed by no significant difference between the 2 groups on the 14th and the 28th day of treatment. Health economics evaluation revealed that the medicine-specific costs and total health care costs were significantly reduced in the treatment group compared to the control group ( P < .05), but no significant differences between the 2 groups ( P > .05) were seen in the costs of hospitalization, examinations, and treatment. Conclusion: The percutaneous NCPB method shows promising results and better cost-effectiveness for treating patients with advanced cancer having severe upper abdominal pain.
“I Told Myself to Stay Positive” Perceptions of Coping Among Latinos With a Cancer Diagnosis Living in the United States
Authors: Carrion Iraida V. , Nedjat-Haiem Frances , Macip-Billbe Melania , Black Ryan 
Published: January 2016

Purpose: This study contributes to the sparse body of literature examining perceptions of coping among Latino men and women with a cancer diagnosis living in the United States. There are currently 50 million Latinos in the United States and, by 2050, projected to grow to 128 million. Although some research indicates that Latinos have unique sociocultural beliefs that influence their cancer care, very little is known about their perceptions of coping after being diagnosed with cancer. We examined Latino men and women’s perceptions of coping to understand the meaning of their experience with cancer Method: Using criterion sampling technique, 60 immigrant and migrant Latino men and women diagnosed with cancer within the past 5 years were recruited from community-based organizations, clinics, and churches. The study consisted of 60- to 90-minute semistructured interviews asking open-ended questions pertaining to coping. The qualitative design facilitated an understanding of coping within the participants’ social and cultural contexts. Results: Median age of the participants was 55 years. Among the women, 80% had breast cancer; 12% had ovarian cancer; and 8% had throat, thyroid, stomach, or skin cancers. Among the men, 94% had prostate cancer and 6% had brain, colorectal, or lung cancers. Emerging themes associated with the development of coping strategies involved positive reframing, family support, religion and spirituality, and support from health care providers. The term “positive reframing” relates to finding meaning and positive emotions that help sustain the coping process, despite having a cancer diagnosis. In addition, when medical and helping professionals provided tangible support, participants engaged in meaning-based coping. Conclusion: This study provides insights regarding the existing coping strategies which Latinos utilize and provides clinician-tangible information pertaining to participant’s engagement in meaning-based coping. Family support facilitated coping among the Latino men and women. The role of religion and spirituality in the lives of the participants enabled them to cope with the cancer diagnosis. Future research is necessary to examine coping strategies regarding specific cancers at end of life.
Rifampin–sirolimus–voriconazole interaction in a hematopoietic cell transplant recipient
Authors: Wasko Justin A , Westholder James S , Jacobson Pamala A 
Published: January 2016

Purpose Patients undergoing hematopoietic cell transplantation are treated with multiple medications, potentially complicated by drug–drug interactions. Drug interactions with sirolimus, voriconazole, and rifampin are particularly difficult because of the complex and simultaneous enzyme inhibition and induction mechanisms. We report a hematopoietic cell transplantation patient receiving sirolimus and voriconazole who was given rifampin while being treated for presumed methicillin-resistant Staphylococcus aureus meningitis. Summary A 31 year-old female received a nonmyeloablative allogeneic umbilical cord hematopoietic cell transplantation for myelodysplastic syndrome transformed to acute myeloid leukemia (AML). Her graft versus host disease and antifungal prophylaxis included sirolimus and voriconazole, respectively. Therapeutic drug monitoring prior to admission revealed a stable outpatient sirolimus regimen of 0.4 mg orally daily (trough goal 3–12 mcg/L). She was admitted to the inpatient hematopoietic cell transplantation service and diagnosed with methicillin-resistant Staphylococcus aureus bacteremia and presumed bacterial meningitis 217 days after transplant. Intravenous rifampin and vancomycin were initiated and voriconazole was changed to micafungin. Sirolimus trough concentrations were undetectable two days after starting rifampin. Therapeutic sirolimus concentrations were achieved four days later, at a sirolimus dose of 16–18 mg orally daily. Rifampin was discontinued after nine days and the sirolimus dose was adjusted accordingly, maintaining therapeutic levels throughout follow-up. The patient suffered a flare of chronic skin graft versus host disease requiring etanercept, high-dose systemic steroids, and topical steroids. Conclusion To the best of our knowledge, this is the first report describing the management of sirolimus during the transition from voriconazole inhibition to rifampin induction. Clinicians should be aware of potential drug–drug interactions.
Semen quality and interval to sterility in tom cats treated with a 9.4 mg deslorelin implant
Authors: Romagnoli Stefano , Baldan Anna , Righetti Camilla , Milani Chiara , Mollo Antonio , Stelletta Calogero 
Published: January 2016

Objectives Gonadotropin-releasing hormone (GnRH) agonists like deslorelin are being increasingly used in tom cats for their efficacy in controlling reproductive behaviour and fertility. Deslorelin implants have been widely available in Europe since 2008. Little, if anything, is known about the interval between treatment and onset of sterility, as well as semen quality, after treatment in tom cats. The purpose of this study was to investigate semen quality and interval to sterility in tom cats treated with a 9.4 mg deslorelin implant. Methods Fifteen healthy adult tom cats were treated with a 9.4 mg deslorelin implant (Suprelorin 12). For each cat, semen collection and a GnRH stimulation test (intramuscular administration of 50 μg gonadorelin [Fertagyl], followed by blood sampling 1 h later, to assay serum testosterone) were performed on the first consultation and then repeated every 15 days until complete sterility was achieved. Semen collection was performed by introducing a 14 cm, open-end feline catheter (Argyle) 9 cm into the distal urethra 10 mins after sedation by intramuscular injection of 100 μg/kg medetomidine (Domitor). Results Semen collection was not successful in all cats at each attempt. In the first month after treatment, the semen of only four cats could be evaluated, while the semen of eight cats could be evaluated during the second and third months of the study. Semen quality (ejaculate volume, progressive motility and morphological abnormalities) improved slightly during the first 19–25 days in 2/4 cats, and in 1/4 cats motility was still very high (80%) 25 days post-treatment (PT), but we have no data regarding fertility prior to treatment in this cat. The last cat never produced spermatozoa. Subsequently, semen quality gradually worsened in all cats from 30 days onwards. At 70 days PT, one cat was still potentially fertile. After 72 days all cats were sterile. Conclusions and relevance Semen quality increased slightly in treated cats during the first month after treatment, and then gradually decreased over the following months. Complete sterility was reached within 40–72 days following implantation.
The behaviours that dementia care home staff in South Africa find challenging: An exploratory study
Authors: van Wyk Adele , Manthorpe Jill , Clark Charlotte 
Published: January 2016

BackgroundBehavioural and psychological symptoms of dementia are often the reasons for moving to a care home. Care staff, often with limited dementia training, may have to support residents with distressed behaviour on a daily basis. Evidence about the support of residents with distressed or challenging behaviour in the South African context is lacking. This exploratory study aimed to gain an understanding of what care home staff perceived to be distressed behaviour, their coping strategies and how they learned to work with residents with behavioural symptoms of dementia.MethodsAn exploratory study was conducted among 17 participants working in four care homes in the Western Cape province of South Africa in 2014. Semi-structured interviews were audio-recorded. Data were analysed thematically.FindingsFindings reflected the literature with regard to examples of behavioural symptoms of people with dementia that staff find challenging to manage. Overall, the majority of staff reported holding positive feelings about working with people with dementia. All preferred interpersonal approaches to manage distressed behaviour above medication although a small minority noted the use of medication in some cases. Dementia training was considered by most participants as an unmet need.ConclusionThis exploratory study identified care home workers’ desires for training about dementia and their preferences for interpersonal as opposed to pharmacological approaches to managing residents’ distressed behaviour. The legacy of race and cultural perspectives in South Africa appears to still influence care practice and provision. Staff commitment, their interest in advancing their practice and their aspirations to offer more person-centred care were evident. Dementia training was identified as potentially helpful to care home staff who manage residents’ distressed behaviour. Training should be developed in South Africa to promote good practice.
Intracranial plaque enhancement from high resolution vessel wall magnetic resonance imaging predicts stroke recurrence
Authors: Kim Jeong-Min , Jung Keun-Hwa , Sohn Chul-Ho , Moon Jangsup , Shin Jung-Hwan , Park Jaeseok , Lee Seung-Hoon , Hee Han Moon , Roh Jae-Kyu 
Published: January 2016

Background Intracranial atherosclerosis is associated with frequent stroke recurrence. High resolution vessel wall magnetic resonance imaging (HRMRI) can provide atheroma information related to its vulnerability. Aims We performed HRMRI in stroke patients with intracranial atherosclerosis to determine whether plaque characteristics from vessel wall imaging can predict future stroke recurrence. Methods Between July 2011 and June 2013, acute stroke patients with symptomatic intracranial atherosclerosis were prospectively enrolled and 3-tesla HRMRI was performed on the relevant artery. The plaque enhancement was visually determined from T1 post-gadolinium enhancement image. Stroke recurrence was monitored after index event and multivariate Cox proportional hazards model was constructed to identify factors related to future stroke recurrence. Results A total of 138 patients were included with a median follow-up of 18 months. There were 39 stroke recurrences. Plaque enhancement was detected in 108 patients (78.3%), and 37 of them experienced stroke recurrence. Among 30 stroke patients without plaque enhancement, two patients experienced stroke recurrence. Kaplan–Meier curves demonstrated a significant difference in event free survival between the patients with plaque enhancement and those patients without plaque enhancement (event rates at year 1: 30.3% vs. 6.8%, log-rank test, p = 0.004). Multivariate Cox-regression analysis showed that the plaque enhancement from HRMRI was independently associated with stroke recurrence (hazard ratio: 7.42, 95% confidence interval: 1.74–31.75, p = 0.007). Conclusion Intracranial plaque enhancement from HRMRI is associated with stroke recurrence among the patients with symptomatic intracranial atherosclerosis.
Quality adjusted life year gains associated with administration of recombinant tissue-type plasminogen activator for treatment of acute ischemic stroke: 1998–2011
Authors: Lubeck Deborah P , Danese Mark D , Duryea Jennifer , Halperin Marc , Tayama Darren , Yu Elaine , Lalla Deepa , Grotta James C 
Published: January 2016

Background Intravenous recombinant tissue-type plasminogen activator (r-tPA) is an approved treatment for select patients with acute ischemic stroke (AIS). Data indicate r-tPA improves functional outcome three months after AIS compared with placebo. This study models the increase in quality adjusted life years (QALYs) associated with r-tPA compared with similar patients not treated with r-tPA. Methods Hospital discharge data for AIS and r-tPA were obtained from the Nationwide Inpatient Sample from 1998 to 2011. Discharge location (home, rehabilitation, long-term care, death) was mapped to modified Rankin Scale (mRS) scores based on National Institute of Neurological Disorders and Stroke (NINDS) Study Group Part 1 and 2 clinical studies. The mRS scores were mapped to relative risk of death and QALYs obtained from the literature. The model estimated expected survival and QALYs by age, gender and mRS for patients receiving r-tPA. Life expectancy and QALYs for patients not receiving r-tPA were estimated based on discharge location and mRS for placebo patients in the NINDS study. Results AIS discharges declined from over 635,000 in 1998 to over 593,000 in 2011. A total of 183,235 patients received r-tPA. Utilization of r-tPA increased from 1% of AIS patients in 1998 to over 4% in 2011. Estimated projections for QALYs gained from utilization of r-tPA to QALYS without r-tPA were just under 240,000 for the 13 years and with no discounting, and just over 165,000 assuming 3% annual discounting. In the most conservative scenario, assuming no difference in proportional discharge status (i.e. patients not treated with r-tPA are discharged in the same manner as r-tPA patients), the estimated life years gained are approximately 35,000 and QALYS gained are approximately 90,000. Conclusions r-tPA for AIS has resulted in estimated gains in quality-adjusted life years due to reduction in disability and improvement in functioning since its introduction in 1998.
Effect of B-vitamins on stroke risk among individuals with vascular disease who are not on antiplatelets: A meta-analysis
Authors: Park Jong-Ho , Saposnik Gustavo , Ovbiagele Bruce , Markovic Daniela , Towfighi Amytis 
Published: January 2016

Background Retrospective analyses of randomized controlled trials suggest that antiplatelet therapy may modify the potential cerebrovascular benefits of lowering homocysteine with B-vitamins among individuals with cardiovascular disease. We evaluated the effects of B-vitamin supplementation on risk of subsequent stroke among high cardiovascular risk individuals who are not taking antiplatelet medications. Methods We systematically searched the Cochrane Central Register of controlled trials, PubMed, the Internet Stroke Center stroke trials, and the clinical trials.gov website from 1966 to April 2015. Inclusion criteria included: randomized controlled trials of homocysteine-lowering therapy with B-vitamins; high cardiovascular risk population and follow-up ≥1 year. We considered stroke as the primary outcome. Among 11 randomized controlled trials meeting inclusion criteria, three studies assessed stroke as an outcome and reported event rates according to whether or not individuals were taking antiplatelets: Vitamin Intervention for Stroke Prevention (VISP), VITAmins TO Prevent Stroke (VITATOPS), and Heart Outcomes Prevention Evaluation 2 (HOPE-2). Results A total of 4643 high vascular risk subjects not taking antiplatelets were evaluated. The overall effect size across studies was summarized using the fixed effects model after confirming there was no significant heterogeneity. Heterogeneity was assessed using the Cochran’s Q and I2 statistics. Compared with the control group, those taking B-vitamin supplementation had a lower risk of recurrent stroke (HR 0.86, 95% CI 0.62 to 1.19 for VISP; 0.65, 0.46 to 0.91 for VITATOPS; and 0.60, 0.39 to 0.92 for HOPE-2; overall HR 0.71, 0.58 to 0.88). Conclusion Homocysteine lowering with B-vitamins among high vascular risk patients who are not taking antiplatelet therapy is related to a significant reduction (29%) in overall stroke risk. A clinical trial of B-vitamins in this group may be warranted.
Unclear-onset stroke: Daytime-unwitnessed stroke vs. wake-up stroke
Authors: Kim Yeon-Jung , Joon Kim Bum , Kwon Sun U , Kim Jong S , Kang Dong-Wha 
Published: January 2016

Background and purpose The onset of wake-up stroke and daytime-unwitnessed stroke is unclear. Though the clinical importance is similar by both being excluded from reperfusion therapy, the characteristics of daytime-unwitnessed stroke are less known than that of wake-up stroke. Here, we compared the characteristics between daytime-unwitnessed stroke and wake-up stroke. Methods Unclear-onset (i.e., last-known normal time ≠ first-found abnormal time) stroke patients admitted within 24 h of recognition of stroke between February 2011 and October 2013 were reviewed. Demographics and clinical and imaging variables were compared between patients with daytime-unwitnessed stroke and those with wake-up stroke. Results Among the 762 ischemic stroke patients, 276 (36.2%) had unclear-onset stroke (104 daytime-unwitnessed stroke and 172 wake-up stroke). Compared to wake-up stroke, daytime-unwitnessed stroke patients had a higher prevalence of cardioembolic stroke and more frequently presented altered mental status ( p < 0.001) and/or aphasia ( p < 0.001) with more severe neurological deficit ( p < 0.001). However, the time from symptom recognition to hospital arrival was shorter ( p < 0.001), and diffusion-weighted image–fluid-attenuated inversion recovery image mismatch ( p = 0.02) and perfusion–diffusion mismatch ( p = 0.001) were also more frequently observed in daytime-unwitnessed stroke. Finally, the proportion of patients eligible for thrombolysis ( p < 0.001) was higher in daytime-unwitnessed stroke patients. Conclusions Clinical and imaging characteristics of daytime-unwitnessed stroke significantly differ from those of wake-up stroke. Daytime-unwitnessed stroke patients are more likely to receive reperfusion therapy, as they arrive at the hospital earlier after symptom recognition, compared to wake-up stroke patients.