bluuebunny/crossref_metadata_2025_split huggingface dataset:
Autologous Chondrocyte Implantation Improves Knee-Specific Functional Outcomes and Health-Related Quality of Life in Adolescent Patients
Authors: Cvetanovich Gregory L. , Riboh Jonathan C. , Tilton Annemarie K. , Cole Brian J. 
Published: August 2016

Background: Existing studies of autologous chondrocyte implantation (ACI) in adolescent patients have primarily reported outcomes that have not been validated for cartilage repair and have failed to include measures of general health or health-related quality of life. Purpose: This study assesses validated knee-specific functional outcomes and health-related quality of life after ACI in adolescent patients. Study Design: Case series; Level of evidence, 4. Methods: Patients younger than 18 years who underwent ACI between 1999 and 2011 with a minimum 2-year clinical follow-up were identified from a prospectively collected database. A total of 37 patients were included in the analysis. Patient demographic data and pre- and postoperative functional outcomes scores were collected and chondral lesion characteristics were assessed. Primary outcome measures were the International Knee Documentation Committee (IKDC) subjective score and the Knee Injury and Osteoarthritis Outcome Score–Quality of Life (KOOS-QOL) subscore; secondary outcome measures were Short Form–12 (SF-12) and other KOOS subscores. In subgroup analyses, we assessed whether primary outcome results differed based on lesion location, concurrent meniscal allograft transplantation (MAT), and subsequent surgery after ACI. Results: Study patients had a mean 4.6 ± 2.4 years of follow-up, a mean age of 16.7 ± 1.5 years, and a mean lesion size of 4.0 ± 2.2 cm2. The IKDC subjective score improved from 34.9 preoperatively to 64.6 postoperatively (mean improvement, 29.7 points [95% CI, 20.7 to 38.7 points]; P < .001) and the KOOS-QOL subscore improved from 24.3 to 55.3 (mean improvement, 31.0 points [95% CI, 21.3 to 40.7 points]; P < .001) at final follow-up. All other KOOS subscales and the SF-12 physical component score also showed significant improvements ( P < .008 in all cases), whereas the SF-12 mental component score showed no improvement ( P = .464). There was a 37.8% rate of subsequent surgery after ACI (most commonly, chondral debridement [54%], meniscectomy [11%], microfracture [9%], and loose body removal [9%]). Subgroup analysis showed no effect of lesion location, concurrent MAT, or subsequent surgery on improvement in IKDC subjective scores and KOOS-QOL subscores ( P > .05 in all cases). Conclusion: ACI is an effective treatment for adolescent patients with symptomatic, large chondral lesions, resulting in significant improvements in knee-specific functional outcome scores and health-related quality of life scores. Although patients must be cautioned on the relatively high reoperation rate (37.8%) and limitations in knee function even after ACI, all patients in this study exhibited improvements over preoperative knee function at the most recent follow-up regardless of ACI location, concurrent MAT, or subsequent surgery.
Public Reporting of Hospital-Specific Breastfeeding Measures
Authors: Jurkowski Janine M. , Svistova Juliana , Nguyen Trang , Dennison Barbara A. 
Published: August 2016

Background: Establishing breastfeeding in the first days of an infant’s life is important for longer term success in breastfeeding. In 2009, New York State (NYS) was the second state to require maternity care facilities to collect infant feeding information and to publicly disseminate hospital-specific infant feeding statistics. Public reporting of these statistics as performance measures is a strategy to prompt hospitals to improve breastfeeding support. Objective: This qualitative study sought to explore how maternity care administrators and clinical staff responded to the mandate for publicly reported performance measures and whether they used this information to improve maternity care practices. Methods: This study used a stratified random sample of NYS hospitals with maternity care units. Participants were recruited by email and telephone calls. A total of 25 hospitals participated in the study, and 37 hospital administrators and staff completed in-depth interviews by telephone. The interviews were analyzed using an explanatory framework in NVivo 8. Results: Publicly reported hospital-specific breastfeeding measures increased attention to breastfeeding performance. Hospital administrators and staff reported comparing their relative rankings to other hospitals in the state. Some hospitals used publicly reported breastfeeding measures to monitor performance, whereas others were prompted to generate additional measures for more frequent monitoring. Hospitals with relatively low breastfeeding statistics took certain actions to improve their maternity care practices to support breastfeeding. Limitations of the usefulness of publicly reported measures were reported by interview participants. Conclusion: Publicly reported, hospital-specific breastfeeding measures may prompt hospitals to monitor and improve maternity care practices related to supporting breastfeeding.
Adaptation and Validation of the Arabic Version of the Infant Breastfeeding Knowledge Questionnaire among Lebanese Women
Authors: Tamim Hani , Ghandour Lilian A. , Shamsedine Lama , Charafeddine Lama , Nasser Fatima , Khalil Yvette , Nabulsi Mona 
Published: August 2016

Background: Valid instruments that can reliably assess maternal breastfeeding knowledge in Arabic-speaking populations are nonexistent. The availability of such an instrument is essential for investigators working in this field. Objective: This study aimed to describe the adaptation and validation of the Arabic Breastfeeding Knowledge Questionnaire (BFK-A) from the original 20-item English version. Methods: A translated version of the 20-item BFK was validated among 417 Lebanese women after pilot testing for clarity, comprehension, length, and cultural appropriateness. Exploratory factor analysis was run to examine dimensionality of the instrument and Kuder-Richardson-20 (KR-20) was used to assess its internal consistency. Results: The BFK-A is a unidimensional scale with acceptable internal consistency reliability (KR-20 = 0.652) after the exclusion of 4 items. Higher breastfeeding knowledge levels were strongly and statistically significantly associated with higher mean scores for the validated Arabic Iowa Infant Feeding Attitude Scale ( P < .001), thus confirming its construct validity. Conclusion: The Arabic 16-item BFK-A has an acceptable reliability, similar to the original instrument. Further studies are encouraged to confirm the validity of the 16-item BFK-A among other Arab populations. There is also a need to develop more reliable instruments to use in lactation research in this context.
Case Report of Calciphylaxis Secondary to Calcium and Vitamin D3 Supplementation
Authors: Storan Eoin R. , O’Gorman Susan M. , Murphy Annette , Laing Mary 
Published: August 2016

Background: Calciphylaxis is a rare disorder that is very unusual outside the setting of end-stage kidney disease. Case Summary: A 64-year-old woman with normal renal function presented with painful leg ulcers. She had previously received 300 000 IU of vitamin D3 followed by daily calcium and vitamin D3 supplementation. A skin biopsy was consistent with calciphylaxis, and she was treated with sodium thiosulphate infusions and wound debridement. Conclusion: Calcium and vitamin D3 supplements are widely prescribed. We report a case of calciphylaxis triggered by calcium and vitamin D3 supplementation in a patient with none of the typical risk factors. Our patient had an excellent response to treatment with sodium thiosulphate.
Popular apps on the medical category targeting patients and the general public in the United Kingdom: Do they conform to the Health On the Net Foundation principles?
Authors: Ben-Mussa Ali , Paget Anthony M 
Published: August 2016

Smartphones with their rising popularity and versatile software ‘apps’ have great potential for revolutionising healthcare services. However, this was soon overshadowed by concerns highlighted by many studies over quality. These were subject and/or discipline specific and mostly evaluated compliance with a limited number of information portrayal standards originally devised for health websites. Hence, this study aimed to take a broader approach by evaluating the most popular apps categorised as medical in the United Kingdom for compliance with all of those standards systematically using the Health On the Net (HON) Foundation principles. The study evaluated top 50 free and paid apps of the ‘medical’ category on both iTunes and Google stores for evidence of compliance with an app-adapted version of the HON Foundation code of conduct. The sample included 64 apps, 34/64 (53%) were on Google Play and 36/64 (56%) were free. None of the apps managed to comply with the entire eight principles. Compliance with seven principles was achieved by only one app (1.6%), and the rest were compliant with three, two, and one (14.7%, 27%, and 38%, respectively). In conclusion, this study demonstrated that most popular apps on the medical category that are available in the United Kingdom do not meet the standards for presenting health information to the public, and this is consistent with earlier studies. Improving the situation would require raising the public awareness, providing tools that would assist in quality evaluation, encouraging developers to use robust development process, and facilitating collaboration and engagement among the stakeholders.
Results of open pararenal abdominal aortic aneurysm repair: single centre series and pooled analysis of literature
Authors: van Lammeren Guus W , Ünlü Çağdaş , Verschoor Sjoerd , van Dongen Eric P , Wille Jan , van de Pavoordt Eric DWM , de Vries-Werson Debbie AB , De Vries Jean-Paul PM 
Published: August 2016

Objectives Endovascular treatment of pararenal abdominal aortic aneurysm has gained terrain over the past decade, despite the substantial need for reinterventions during follow-up. However, open repair is still a well-established treatment option. With the current study we report the results of a consecutive series of elective primary open pararenal abdominal aortic aneurysm repair in a tertiary vascular referral centre, combined with an overview of current literature and pooled data analysis of perioperative mortality of open and endovascular pararenal abdominal aortic aneurysm repair. Methods A retrospective analysis of a prospective database of all elective open pararenal abdominal aortic aneurysm repairs in the St. Antonius Hospital between 2005 and 2014 was performed. Primary endpoint was 30-day mortality. Secondary endpoints were 30-day morbidity, new onset dialysis, reintervention free survival, and overall survival during follow-up. Results Between 2005 and 2014, 214 consecutive patients underwent elective open pararenal abdominal aortic aneurysm repair. Mean age was 69.8 (±7.1) years, 82.7% (177/214) were men, and mean abdominal aortic aneurysm diameter was 62 (±11) mm. Thirty-day mortality was 3.4%. Thirty-day morbidity was 27.1%, which predominantly consisted of pneumonia (18.7% (40/214)), cardiac events (3.3% (7/214)), and new onset dialysis (2.8% (6/214)). Estimated five-year overall survival rate was 74.2%. 0.9% (2/214) of patients required abdominal aortic aneurysm-related reintervention, and an additional 2.3% (5/214) required surgical repair of an incisional hernia. Pooled analysis of literature revealed a 30-day mortality of 3.0% for open pararenal repair and 1.9% for fenestrated endovascular repair. Conclusion Open pararenal abdominal aortic aneurysm repair in the era of increasing endovascular options results in acceptable perioperative morbidity and mortality rates. Mid-term reintervention rate is low compared to fenestrated endovascular aneurysm repair. Expertise with open repair still remains essential for treatment of pararenal abdominal aortic aneurysms in the near future, especially for those patients that are declined for endovascular treatment.
Outcome of partial repair of massive rotator cuff tears with and without human tissue allograft bridging repair
Authors: Pandey Radhakant , Tafazal Suhayl , Shyamsundar Srinivasan , Modi Amit , Singh Harvinder Pal 
Published: August 2016

Background The surgical management of massive rotator cuff tears remains a challenge. It is suggested that, even in a massive tear that appears irreparable, attempting to repair it as much as possible can be helpful in improving functional outcomes. However the results can be short term and variable. The purpose of our study was to determine if human tissue allograft bridged repair of massive irreparable rotator cuff tears to achieve a complete repair produces similar outcomes compared to partial repair alone. Methods We prospectively reviewed outcome scores in 13 patients who underwent partial repair alone for massive irreparable rotator cuff tears and compared them to 13 patients who had partial repairs bridged with allograft. Oxford and Constant scores were compared pre-operatively and at a minimum follow-up of 2 years (range 2 years to 5 years). Results The mean improvement in the Constant score at final follow-up compared to pre-operative scores was 27.7 points in the partial repair group and 42.8 points in the allograft group ( p < 0.01). The Oxford Shoulder Score improved mean of 19.3 points in the partial repair group and 29 points in the allograft group ( p < 0.02) at 2 years. Conclusions Human tissue matrix allograft provides a better outcome for open bridging of irreparable rotator cuff tears than partial repair alone.
Significance and Reliability of MARD for the Accuracy of CGM Systems
Authors: Reiterer Florian , Polterauer Philipp , Schoemaker Michael , Schmelzeisen-Redecker Guenther , Freckmann Guido , Heinemann Lutz , del Re Luigi 
Published: August 2016

Background: There is a need to assess the accuracy of continuous glucose monitoring (CGM) systems for several uses. Mean absolute relative difference (MARD) is the measure of choice for this. Unfortunately, it is frequently overlooked that MARD values computed with data acquired during clinical studies do not reflect the accuracy of the CGM system only, but are strongly influenced by the design of the study. Thus, published MARD values must be understood not as precise values but as indications with some uncertainty. Data and Methods: Data from a recent clinical trial, Monte Carlo simulations, and assumptions about the error distribution of the reference measurements have been used to determine the confidence region of MARD as a function of the number and the accuracy of the reference measurements. Results: The uncertainty of the computed MARD values can be quantified by a newly introduced MARD reliability index (MRI), which independently mirrors the reliability of the evaluation. Thus MARD conveys information on the accuracy of the CGM system, while MRI conveys information on the uncertainty of the computed MARD values. Conclusions: MARD values from clinical studies should not be used blindly but the reliability of the evaluation should be considered as well. Furthermore, it should not be ignored that MARD does not take into account the key feature of CGM sensors, the frequency of the measurements. Additional metrics, such as precision absolute relative difference (PARD) should be used as well to obtain a better evaluation of the CGM performance for specific uses, for example, for artificial pancreas.
Five-Year Follow-up of Knee Joint Distraction: Clinical Benefit and Cartilaginous Tissue Repair in an Open Uncontrolled Prospective Study
Authors: van der Woude Jan-Ton A.D. , Wiegant Karen , van Roermund Peter M. , Intema Femke , Custers Roel J.H. , Eckstein Felix , van Laar Jaap M. , Mastbergen Simon C. , Lafeber Floris P.J.G. 
Published: August 2016

Objective In end-stage knee osteoarthritis, total knee arthroplasty (TKA) may finally become inevitable. At a relatively young age, this comes with the risk of future revision surgery. Therefore, in these cases, joint preserving surgery such as knee joint distraction (KJD) is preferred. Here we present 5-year follow-up data of KJD. Design Patients ( n = 20; age <60 years) with conservative therapy resistant tibiofemoral osteoarthritis considered for TKA were treated. Clinical evaluation was performed by questionnaires. Change in cartilage thickness was quantified on radiographs and magnetic resonance images (MRI). The 5-year changes after KJD were evaluated and compared with the natural progression of osteoarthritis using Osteoarthritis Initiative data. Results Five-years posttreatment, patients still reported clinical improvement from baseline: ΔWOMAC (Western Ontario and McMaster Universities Arthritis Index) +21.1 points (95% CI +8.9 to +33.3; P = 0.002), ΔVAS (visual analogue scale score) pain −27.6 mm (95%CI −13.3 to −42.0; P < 0.001), and minimum radiographic joint space width (JSW) of the most affected compartment (MAC) remained increased as well: Δ +0.43 mm (95% CI +0.02 to +0.84; P = 0.040). Improvement of mean JSW (x-ray) and mean cartilage thickness (MRI) of the MAC, were not statistically different from baseline anymore (Δ +0.26 mm; P = 0.370, and Δ +0.23 mm; P = 0.177). Multivariable linear regression analysis indicated that KJD treatment was associated with significantly less progression in mean and min JSW (x-ray) and mean cartilage thickness (MRI) compared with natural progression (all Ps <0.001). Conclusions KJD treatment results in prolonged clinical benefit, potentially explained by an initial boost of cartilaginous tissue repair that provides a long-term tissue structure benefit as compared to natural progression. Level of evidence, II.
Magnetic Resonance Imaging Score and Classification System (AMADEUS) for Assessment of Preoperative Cartilage Defect Severity
Authors: Jungmann Pia M. , Welsch Götz H. , Brittberg Mats , Trattnig Siegfried , Braun Sepp , Imhoff Andreas B. , Salzmann Gian M. 
Published: August 2016

Objective To design a simple magnetic resonance (MR)–based assessment system for quantification of osteochondral defect severity prior to cartilage repair surgery at the knee. Design The new scoring tool was supposed to include 3 different parameters: (1) cartilage defect size, (2) depth/morphology of the cartilage defect, and (3) subchondral bone quality, resulting in a specific 3-digit code. A clearly defined numeric score was developed, resulting in a final score of 0 to 100. Defect severity grades I through IV were defined. For intra- and interobserver agreement, defects were assessed by 2 independent readers on preoperative knee MR images of n = 44 subjects who subsequently received cartilage repair surgery. For statistical analyses, mean values ± standard deviation (SD), interclass correlation coefficients (ICC), and linear weighted kappa values were calculated. Results The mean total Area Measurement And DEpth & Underlying Structures (AMADEUS) score was 48 ± 24, (range, 0-85). The mean defect size was 2.8 ± 2.6 cm2. There were 36 of 44 full-thickness defects. The subchondral bone showed defects in 21 of 44 cases. Kappa values for intraobserver reliability ranged between 0.82 and 0.94. Kappa values for interobserver reliability ranged between 0.38 and 0.85. Kappa values for AMADEUS grade were 0.75 and 0.67 for intra- and interobserver agreement, respectively. ICC scores for the AMADEUS total score were 0.97 and 0.96 for intra- and interobserver agreement, respectively. Conclusions The AMADEUS score and classification system allows reliable severity encoding, scoring and grading of osteochondral defects on knee MR images, which is easily clinically applicable in daily practice.
Reduction of psycho-spiritual distress of an elderly with advanced congestive heart failure by life review interview in a palliative care day center
Authors: Chan Kwok-Ying , Lau Vikki Wai-Kee , Cheung Ka-Chi , Chang Richard Shek-Kwan , Chan Man-Lui 
Published: August 2016

Objectives: Major depression is common in patients hospitalized with congestive heart failure and is independently associated with increased re-hospitalization and mortality. Methods: Hereby, we report the treatment for an elderly congestive heart failure patient with frequent emergency department visits having major depression and hopelessness. Results: Treatment outcomes measured showed that depressed scores of psychosocial needs were reduced with life review interview therapy in a palliative care day center. Conclusion: We hypothesize that multidisciplinary team’s approach to treatment was important for this case.
Unexpected improvement in core autism spectrum disorder symptoms after long-term treatment with probiotics
Authors: Grossi Enzo , Melli Sara , Dunca Delia , Terruzzi Vittorio 
Published: August 2016

Objectives: Autism spectrum disorder is a neurodevelopmental condition that typically displays socio-communicative impairment as well as restricted stereotyped interests and activities, in which gastrointestinal disturbances are commonly reported. We report the case of a boy with Autism Spectrum Disorder (ASD) diagnosis, severe cognitive disability and celiac disease in which an unexpected improvement of autistic core symptoms was observed after four months of probiotic treatment. Method: The case study refers to a 12 years old boy with ASD and severe cognitive disability attending the Villa Santa Maria Institute in resident care since 2009. Diagnosis of ASDs according to DSM-V criteria was confirmed by ADOS-2 assessment (Autism Diagnostic Observation Schedule). The medication used was VSL#3, a multi-strain mixture of ten probiotics. The treatment lasted 4 weeks followed by a four month follow-up. The rehabilitation program and the diet was maintained stable in the treatment period and in the follow up. ADOS-2 was assessed six times: two times before starting treatment; two times during the treatment and two times after interruption of the treatment. Results: The probiotic treatment reduced the severity of abdominal symptoms as expected but an improvement in Autistic core symptoms was unexpectedly clinically evident already after few weeks from probiotic treatment start. The score of Social Affect domain of ADOS improved changing from 20 to 18 after two months treatment with a further reduction of 1 point in the following two months. The level 17 of severity remained stable in the follow up period. It is well known that ADOS score does not fluctuate spontaneously along time in ASD and is absolutely stable. Conclusions: The appropriate use of probiotics deserves further research, which hopefully will open new avenues in the fight against ASD.
Ungual fibroma in 12-year-old boy with hypomelanotic macules, intellectual disability and attention deficit hyperactivity disorder—possible tuberous sclerosis
Authors: Glavan Nedeljka , Ljubičić-Bistrović Ivana , Grahovac Blaženka , Traven Luka , Sasso Anton , Jonjić Nives 
Published: August 2016

Objective: To report a case of a 12-year-old boy with intellectual disability and attention deficit hyperactivity disorder, who came to surgery for an examination due to a minor bulge on the left thumb, which had been growing for the previous month. His mother denied any trauma. Methods: After the removal of the clinically ambiguous bulge and a pathohistological confirmation that it was a periungual fibroma, complete patient analysis was performed due to the presence of hypomelanotic macules and a suspected tuberous sclerosis. Results: Considering the presence of hypomelanotic macules, as one of the main criteria, possible TS diagnosis was set. Conclusion: Early detection of the symptoms of TS enables a timely provision of protocols for further patient monitoring, which affects the patient’s morbidity and mortality.