bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adherence to national exercise guidelines by patients attending emergency departments: A multi‐site survey
Authors: Berlingeri Paul , Cunningham Neil , Taylor David McD , Knott Jonathan , McLean Daniel , Gavan Rex , Plant Luke , Chen Hayley , Weiland Tracey 
Published: March 2017

AbstractObjectiveThe proportion of adults in Australia meeting or exceeding the national guidelines for physical activity has remained relatively static over the past 10 years. The research objective was to measure self‐reported physical activity and sedentary behaviour among ED patients in accordance with Australia's current physical activity and sedentary behaviour guidelines, revised in 2014.MethodsA convenience sample of participants was recruited from three EDs in Melbourne between February and May 2016. Eligible participants were administered the International Physical Activity Questionnaire – Short Form plus researcher‐derived questions. Participants were assessed as whether meeting the physical activity guidelines or not, using pre‐defined criteria.ResultsThe proportion of 18–64 year olds meeting all of the physical activity guidelines was 19.0% (95% confidence interval [CI] 15.2–22.8). A majority of participants (63.1%, 95% CI 58.5–67.7) met the aerobic component of the guidelines although only 28.9% (95% CI 24.5–33.3) of participants reported undertaking strength building exercises two or more times per week. Adults in the oldest age group were found to be less likely to engage in muscle strengthening exercises (23.3%, n = 30) than those in the youngest age group (40.0%, n = 60, P = 0.005). Average daily sitting time (minutes) did not differ between men (median = 300) and women (median = 360, P = 0.118).ConclusionsOverall adherence with physical activity guidelines is low among adults attending the ED. All adults need to be encouraged to undertake muscle strengthening activities, especially adults in older age groups.
Thoracic electrical bioimpedance versus suprasternal Doppler in emergency care
Authors: Elwan Mohammed H , Hue Jeremy , Green Samira J , Eltahan Salah M , Sims Mark R , Coats Timothy J 
Published: March 2017

AbstractObjectiveThere are a number of cardiac output (CO) monitors that could potentially be used in the ED. Two of the most promising methods, thoracic electrical bioimpedance and suprasternal Doppler, have not been directly compared. The aim of this study was to investigate the feasibility of CO monitoring using suprasternal Doppler and bioimpedance in emergency care and compare haemodynamic data obtained from both monitors.MethodsHaemodynamic measurements were made on the same group of patients using bioimpedance (Niccomo, Medis, Germany) and suprasternal Doppler (USCOM, Sydney, Australia).ResultsUsable CO data were obtained in 97% of patients by suprasternal Doppler and 87% by bioimpedance. The median CO obtained by Doppler was 3.4 L/min lower than bioimpedance. The stroke volume median was lower by 51 mL in Doppler.ConclusionsThese two methods of non‐invasive cardiac monitoring are not interchangeable. The results suggest that the choice of non‐invasive cardiac monitor is important, but the grounds on which to make this choice are not currently clear.
Usefulness of laboratory and radiological investigations in the management of supraventricular tachycardia
Authors: Ashok Aadith , Cabalag Miguel , Taylor David McD 
Published: March 2017

AbstractObjectiveAlthoughEDpatients presenting with supraventricular tachycardia (SVT) are commonly investigated, the value of these investigations has been questioned. We aimed to determine the frequency and utility of investigations in patients withSVT.MethodsWe undertook an explicit retrospective medical record audit of patients withSVTwho presented to a singleED(January 2004 to June 2014). Data on demographics, presenting complaints, investigations and outcomes were extracted. The outcomes were nature and utility of investigations.ResultsA total of 633 patients were enrolled (mean [SD] age 55.4 [17.7] years, 62% female). Laboratory investigations were common: electrolytes (83.7% of patients), full blood count (81.2%), magnesium (57.5%), calcium (39.3%) and thyroid function (30.3%). These investigations revealed many mildly abnormal results but resulted in electrolyte supplementation in only 19 patients: eight with mild hypokalaemia (potassium 3.0–3.5 mmol/L) and 11 with mild hypomagnesia (magnesium 0.49–1.1 mmol/L). Troponin was ordered for 302 (47.7%) patients, many of whom had no history or risk factors for cardiac disease, or ischaemic symptoms associated with theirSVT. The troponin was normal, mildly and moderately elevated in 65.2, 24.5 and 10.2% of cases, respectively. Only seven (1.1%) patients were diagnosed with acute myocardial ischemia. Although 190 (30.0%) patients had a chest X‐ray (CXR), it was normal in 78.4% of cases. All CXR abnormalities were incidental and not relevant to the immediateEDmanagement.ConclusionPatients with uncomplicatedSVTare over‐investigated. Guidelines forED SVTinvestigation are recommended. Further research is recommended to determine the indications for each investigation in the setting ofSVT.
Transitions to and from long‐term care facilities and length of completed stay: Reuse of population‐based survey data
Authors: Broad Joanna B , Lumley Thomas , Ashton Toni , Davis Peter B , Boyd Michal , Connolly Martin J 
Published: March 2017

ObjectiveThis article estimates length of completed stay and resident transitions for RAC residents over 12 months in Auckland.MethodsData from a census‐type survey of nursing home residents (n = 6816) were linked with national mortality data. Transitions described include entry to residential aged care (RAC), movement between RAC facilities and deaths.ResultsWhen reweighted for missing data and adjusted for length bias, an estimated 9676 residents (95% CI 8368–10 985) used care over a 12‐month period. Half of new residents entered RAC via an acute hospital. Median survival was 2.0 years; 17% died within 3 months, and 23% survived over 5 years.ConclusionCross‐sectional survey data, when appropriately adjusted for length‐biased sampling, enable estimates of period prevalence and transition probabilities that are useful for simulation studies. Given population ageing and the costs of ongoing care, these results can inform policy and planning for long‐term care needs of older people.
Association between religious practice and risk of depression in older people in the subacute setting
Authors: Lac Alice , Austin Nicole , Lemke Renata , Poojary Suma , Hunter Peter 
Published: March 2017

ObjectiveTo identify the association between religious practice and risk of depression in older people admitted to a subacute hospital.MethodsA cross‐sectional survey was conducted with 100 patients aged ≥65 years with Mini‐Mental State Examination (MMSE) scores ≥24 consecutively admitted to a subacute hospital. Religious practice was measured using the Duke University Religion Index and risk of depression using the 15‐item Geriatric Depression Scale (GDS).ResultsGeriatric Depression Scale was significantly correlated with intrinsic religiosity (r = −0.21, P = 0.04) and cognition (r = −0.22, P = 0.03).ConclusionThis cross‐sectional study of older people in a subacute setting found depression scores were negatively and independently associated with both intrinsic religiosity and cognition. In conjunction with cognitive assessment, health professionals working with older people may consider taking a spiritual history as part of holistic care.
Long‐term outcomes and cost effectiveness of high‐dose dexamethasone for cardiac surgery: a randomised trial
Authors: Dieleman J. M. , de Wit G. A. , Nierich A. P. , Rosseel P. M. , van der Maaten J. M. , Hofland J. , Diephuis J. C. , de Lange F. , Boer C. , Neslo R. E. , Moons K. G. , van Herwerden L. A. , Tijssen J. G. , Kalkman C. J. , van Dijk D. ,   the DExamethasone for Cardiac Surgery (DECS) Study Group
Published: March 2017

SummaryProphylactic intra‐operative administration of dexamethasone may improve short‐term clinical outcomes in cardiac surgical patients. The purpose of this study was to evaluate long‐term clinical outcomes and cost effectiveness of dexamethasone versus placebo. Patients included in the multicentre, randomised, double‐blind, placebo‐controlledDExamethasone for Cardiac Surgery (DECS) trial were followed up for 12 months after their cardiac surgical procedure. In theDECStrial, patients received a single intra‐operative dose of dexamethasone 1 mg.kg−1(n = 2239) or placebo (n = 2255). The effects on the incidence of major postoperative events were evaluated. Also, overall costs for the 12‐month postoperative period, and cost effectiveness, were compared between groups. Of 4494 randomised patients, 4457 patients (99%) were followed up until 12 months after surgery. There was no difference in the incidence of major postoperative events, the relative risk (95%CI) being 0.86 (0.72‐1.03); p = 0.1. Treatment with dexamethasone reduced costs per patient by £921 [€1084] (95%CI£−1672 to −137; p = 0.02), mainly through reduction of postoperative respiratory failure and duration of postoperative hospital stay. The probability of dexamethasone being cost effective compared with placebo was 97% at a threshold value of £17,000 [€20,000] per quality‐adjusted life year. We conclude that intra‐operative high‐dose dexamethasone did not have an effect on major adverse events at 12 months after cardiac surgery, but was associated with a reduction in costs. Routine dexamethasone administration is expected to be cost effective at commonly accepted threshold levels for cost effectiveness.
Trends in the surgical treatment of benign prostatic hyperplasia in a tertiary hospital
Authors: Ow Darren , Papa Nathan , Perera Marlon , Liodakis Peter , Sengupta Shomik , Clarke Stephen , Bolton Damien M. , Lawrentschuk Nathan 
Published: March 2017

BackgroundTo assess current treatment trends and perioperative outcomes of transurethral resection of the prostate (TURP) and photoselective vaporization of the prostate (PVP) in a tertiary institution.MethodsWe prospectively collected a database of all patients undergoing TURP and PVP for benign prostatic hyperplasia (BPH) at a tertiary hospital between January 2011 and December 2013. Patient characteristics such as length of stay, readmission, anticoagulation status, American Society of Anesthesiologists (ASA) score and need for blood transfusion were recorded and analysed.ResultsIn total, 560 cases were included: 204 (36.4%) underwent TURP and 356 (63.6%) PVP. Patients undergoing PVP had higher ASA scores (P < 0.001) and were more frequently on continuing anticoagulant therapy (P < 0.001). With regards to non‐aspirin/asasantin coagulation therapy, 61 (17.1%) patients underwent PVP with their anticoagulants continued while no patients who received TURP continued anticoagulation. Blood transfusion percentages were similar at 1.0% for TURP and 1.7% for PVP but readmission proportions were higher after PVP (32 patients, 9.0%) compared to TURP (10 patients, 4.9%). These differences were attenuated when excluding patients continuing anticoagulation during the procedure.ConclusionAt our institution, the use of PVP has been increasing on a year‐by‐year basis. The results of the current study demonstrated that PVP is safe in patients with increased anaesthetic risk or on active anticoagulation when compared to traditional TURP. While this makes PVP an attractive alternative to TURP in high‐risk anticoagulated patients, these patients may have complex post‐discharge issues that should be addressed during the informed consent process.
Blue nevus‐like and blue nevus‐associated melanoma: a comprehensive review of the literature
Authors: Borgenvik Thore L. , Karlsvik Tina M. , Ray Saikat , Fawzy Monica , James Nick 
Published: March 2017

BackgroundMalignant blue nevus, blue nevus‐associated melanoma and blue nevus‐like melanoma are all terms used to describe malignant melanomas arising from, in association with, or resembling blue nevi. This review is aimed at summarizing the available literature to reduce the confusion surrounding this rare malignancy, and aid the surgeon in choosing further diagnostic or therapeutic measures.MethodsWe conducted a search of Medline, Embase, Science Direct, Scopus and the Cochrane Library for all full text articles published in English that reported on a malignant melanoma arising from, in association with, or resembling a blue nevus.ResultsWe identified 91 cases that fit the criteria above. The mean age at diagnosis was 45 years, with a slight male predominance (males: 48; females: 43). Metastatic cases were reported in 55% (n = 50), of which 16 were metastatic at the time of diagnosis, 16 developed metastases within the first year and 18 within 5 years of initial diagnosis. The mean Breslow thickness was 6.8 mm at the time of diagnosis (n = 39).ConclusionsThe histological criteria for diagnosing this malignancy are very poorly defined, and may contribute to the substantial confusion surrounding the terminology. There is no consensus on which prognostic indicators predictive of outcome in ‘conventional’ malignant melanoma are applicable to blue nevus‐like melanoma/blue nevus‐associated melanoma. However, two larger case series have demonstrated a significant association between Breslow thickness (or largest tumour dimension when non‐epidermal) and recurrence‐free survival, as well as rate of local recurrence, but larger studies are needed to confirm this.
The effects of pregnancy on the pharmacokinetics of infliximab and adalimumab in inflammatory bowel disease
Authors: Seow C. H. , Leung Y. , Vande Casteele N. , Ehteshami Afshar E. , Tanyingoh D. , Bindra G. , Stewart M. J. , Beck P. L. , Kaplan G. G. , Ghosh S. , Panaccione R. 
Published: March 2017

AbstractBackgroundTransplacental transfer of infliximab and adalimumab results in detectable drug levels in the cord blood and infant.AimTo determine if pregnancy influenced the pharmacokinetics of anti‐TNF agents in women with inflammatory bowel disease.MethodsTwenty‐five women from the University of Calgary inflammatory bowel disease(IBD) pregnancy clinic on maintenance infliximab or adalimumab were recruited prospectively with serum bio‐banking performed each trimester. Infliximab trough and adalimumab steady‐state levels were the outcomes of interest and were analysed using the ANSER infliximab and adalimumab assays. Multivariate linear mixed‐effects models were constructed to assess infliximab and adalimumab drug levels during pregnancy adjusting for the clinical covariates of albumin, BMI and CRP.ResultsFifteen women (eight Crohn's disease, seven ulcerative colitis) received infliximab and 10 women with 11 pregnancies were treated with adalimumab. Median age was 29.6 years (IQR: 27.6–31.2 years). Median disease duration was 9.2 years (IQR: 3.16–15.0 years). Median trough infliximab concentrations were 8.50 μg/mL (IQR: 7.23–10.07 μg/mL), 10.31 μg/mL (IQR: 7.66–15.63 μg/mL) and 21.02 μg/mL (IQR: 16.01–26.70 μg/mL) at trimesters 1, 2 and 3 respectively. Significant changes in albumin and BMI (P < 0.05) but not CRP (P > 0.05) were documented throughout pregnancy. After adjusting for albumin, BMI and CRP, infliximab trough levels increased during pregnancy, by 4.2 μg/mL per trimester (P = 0.02), while adalimumab drug levels remained stable (P > 0.05).ConclusionsInfliximab levels rise during pregnancy, whereas adalimumab levels remain stable after accounting for changes in albumin, BMI and CRP. Therapeutic drug monitoring in the second trimester may be useful in guiding dosing in the third trimester.
Retracted: Systematic review: benefits and harms of transarterial embolisation for treating hepatocellular adenoma
Authors: Zhao C. , Pei S. ‐L. , Cucchetti A. , Tong T. ‐J. , Ma Y. ‐L. , Zhong J. ‐H. , Li L. ‐Q. 
Published: March 2017

The above article1 from Alimentary Pharmacology & Therapeutics, published online on 20 March 2017 in Wiley OnlineLibrary (www.onlinelibrary.wiley.com) has been retracted by agreement between the Authors, the Editor‐in‐Chief, R.E. Pounder, and John Wiley & Sons Ltd. The retraction has been agreed due to the inclusion of data accessible only during peer review for another journal.REFERENCE1. Zhao C, Pei S‐L, Cucchetti A, et al. Systematic review: benefits and harms of transarterial embolisation for treating hepatocellular adenoma. Aliment Pharmacol Ther. 2017. https://doi.org/10.1111/apt.14044
Baclofen and Alcohol‐Dependent Patients: A Real Risk of Severe Self‐Poisoning
Authors: Boels David , Victorri‐Vigneau Caroline , Grall‐Bronnec Marie , Touré Ali , Garnier Anais , Turcant Alain , Le Roux Gaël 
Published: March 2017

AbstractBaclofen is often prescribed in high doses to fight cravings experienced by alcohol‐dependent patients. Such an increase in the availability of baclofen is concerning. This study aimed to determine the change in number and profile of self‐poisoning with baclofen over time, as baclofen has become increasingly popular, in order to describe the severity of self‐poisoning with baclofen and to focus on co‐existing alcohol use disorders, and psychiatric illnesses determine predictors of severity. This was a retrospective study of self‐poisoning with baclofen as reported by the western France Poison Control Center (PCC), which represents a population of more than 12 million people from January 2008 to March 2014. One hundred and eleven cases of self‐poisoning with baclofen were reported to the western France PCC (62 males and 49 females; average age 39 ± 12). Poisoning severities were as follows: ‘null’ (nine cases), ‘minor’ (37 cases), ‘moderate’ (19 cases) and ‘high’ (46 cases, including four deaths). The most frequently reported symptoms were neurological (45%) and cardiovascular (27%). The severity was significantly associated with psychiatric disorders (OR = 2.9; p = 0.03). Baclofen, prescribed in high doses, may lead to severe poisoning, particularly in patients with psychiatric illnesses. Authorities should put forward a new policy for prescribing the drug as a treatment for alcohol dependence.
Monoclonal antibodies in the treatment of multiple sclerosis: emergence of B‐cell‐targeted therapies
Authors: Nguyen Ai‐Lan , Gresle Melissa , Marshall Tessa , Butzkueven Helmut , Field Judith 
Published: March 2017

AbstractMultiple sclerosis (MS) is a chronic inflammatory disease of the CNS, and one of the most common causes of disability in young adults. Over the last decade, new disease‐modifying therapies have emerged, including monoclonal antibodies (mAbs) that provide highly targeted therapies with greater efficacy than platform therapies. In particular, monoclonal antibodies directed against CD20‐positive B cells have shown remarkable results in recent clinical trials and renewed interest in the mechanism of B cell‐depleting therapies to ameliorate relapse activity and progression in MS. Here, we review the mechanisms of action and clinical evidence of approved and emerging mAbs, with a focus on B cell‐targeted therapies.
Immunization of looked‐after children and young people: a review of the literature
Authors: Walton S. , Bedford H. 
Published: March 2017

AbstractBackgroundNumbers of looked‐after children and young people (LACYP) in the UK have risen over the last seven years. Looked‐after children and young people should receive regular health assessments, including establishing immunization status and, if needed, developing a health plan to achieve full immunization. The Department for Education publish data on immunizations among LACYP to monitor both how well they are immunized and service performance.MethodsA literature review was conducted using four databases (PubMed, Embase, Scopus and Web of Science) on immunization status of LACYP, factors affecting uptake and challenges to immunization, and interventions to improve immunization rates.ResultsThirty‐two papers were identified, 16 of which were UK based. Looked‐after children and young people are less likely to be ‘up‐to‐date’ with their immunizations than children in the general population. Looked‐after children and young people are less likely to receive timely immunizations, and older LACYP are less likely to be ‘up‐to‐date’ than younger LACYP. Barriers to immunization include failure to attend health checks, absence from school and frequent placement moves. Unknown and discrepant immunization histories, name changes, sharing of information between organizations and obtaining consent for immunizations are also challenges.ConclusionsIn recent years, immunization of LACYP has been given a higher priority. However, the immunization figures produced by the Department for Education are problematic because of challenges in determining whether the child is ‘up‐to‐date’, and data are not comparable with the general population; ideally, this should be changed to correspond to routine immunization data. In the interim, for reporting purposes, the use of a tool to assist with determining a child's immunization status would be beneficial. When a child's immunization status is incomplete or unknown, Public Health England's algorithm for vaccination of individuals with uncertain or incomplete status should be used. Practice to improve immunization uptake amongst LACYP needs to be evaluated to develop evidence‐based recommendations.
Exploring Children's Perceptions of their Local Environment in Relation to Time Spent Outside
Authors: Hayball Felicity , McCrorie Paul , Kirk Alison , Gibson Ann‐Marie , Ellaway Anne 
Published: March 2017

This study aims to understand how children perceive their environment, exploring the affordances children perceive to influence their physical activity (PA) behaviour when outside. Participants included boys and girls aged 10–12 years (n = 15) living in Scotland. Children's visual and verbal representations of their perceived environment were analysed to assess environmental determinants of PA. The findings suggested that physical affordances that offer a sense of risk were important to children's play spaces. Social affordances influenced where the children went in their environment and the features they utilised as part of play behaviour; strangers were considered threatening depending on whether the activity was recognised.