bluuebunny/crossref_metadata_2025_split huggingface dataset:
35‐Year Experience with Surgical Treatment of Hidradenitis Suppurativa
Authors: Burney Richard E. 
Published: June 2017

AbstractBackgroundHidradenitis suppurativa is a painful and disfiguring chronic inflammatory condition affecting both men and women. Medical treatments, such as antibiotics and immunosuppressive agents, are often ineffective. Over time, patients can suffer from recurrent abscesses, chronic purulent drainage, scarring, and contractures that can only be corrected by surgical excision. There is no agreement, however, on the best way for the surgeon to manage this condition. The purpose of this review is to describe the results of surgical treatment of this condition in a large cohort of patients managed by local excision of hidradenitis, healing by secondary intention and reoperation as needed.Study designA retrospective review was conducted of all patients operated on by the author for hidradenitis over a 35‐year period. Specific data abstracted included patient age, weight, admission, length of stay, wound size, type of wound care, number of post‐op visits, time to heal, and recurrence. Most wounds healed by secondary intention and were managed using simple tap water‐moistened plain gauze dressings changed three times a day.ResultsFrom 1979 through 2014, 122 patients (56 men and 66 women), median age 38, underwent 245 operations for hidradenitis suppurativa. Patients underwent from 1 to 10 procedures; 61 patients (50%) underwent two or more procedures; and 26 (21%) underwent three or more. Wound sizes at operation ranged from quite small to over 1500 cm2. Men were older (42 vs 34 years, p < 0.001) and had larger median wound size (98 vs 55 cm2, p < 0.001). A total of 197 wounds healed by secondary intention: 83 of these (median size 159 cm2) were left completely open at the time of surgery; 117 (median size 100 cm2) were partially closed. A total of 30 wounds (median size 38 cm2) were closed primarily; 15 (median size 196 cm2) were closed by skin graft. Patients undergoing 139 procedures were admitted to the hospital for the initial wound care. Their median combined total wound size was 160 cm2; length of stay was 5.5 days; and median time to heal was 60 days. In total, 106 procedures were ambulatory; median wound size was 30 cm2; and median time to heal was 40 days. Recurrent or new disease was common, with some patients requiring multiple procedures over many years to maintain control of symptoms. Although wound healing can take up to several months, patients quickly learned how to care for themselves and were usually pain‐free after the first two or three weeks.ConclusionsSurgical treatment of hidradenitis suppurativa by wide local excision with healing by secondary intention using tap water‐moistened plain gauze dressings changed 2–3 times per day is a simple, practical approach that has good results. Recurrence of disease is common and should not be thought of as a failure of surgical treatment, but rather as a feature of the disease that must be anticipated and managed.
Prolonged survival in patients with breast cancer and a history of brain metastases: results of a preplanned subgroup analysis from the randomized phase III BEACON trial
Authors: Cortés Javier , Rugo Hope S. , Awada Ahmad , Twelves Chris , Perez Edith A. , Im Seock–Ah , Gómez-Pardo Patricia , Schwartzberg Lee S. , Diéras Veronique , Yardley Denise A. , Potter David A. , Mailliez Audrey , Moreno-Aspitia Alvaro , Ahn Jin-Seok , Zhao Carol , Hoch Ute , Tagliaferri Mary , Hannah Alison L. , O’Shaughnessy Joyce 
Published: June 2017

Abstract
Purpose
Conventional chemotherapy has limited activity in patients with breast cancer and brain metastases (BCBM). Etirinotecan pegol (EP), a novel long-acting topoisomerase-1 inhibitor, was designed using advanced polymer technology to preferentially accumulate in tumor tissue including brain metastases, providing sustained cytotoxic SN38 levels.

Methods
The phase 3 BEACON trial enrolled 852 women with heavily pretreated locally recurrent or metastatic breast cancer between 2011 and 2013. BEACON compared EP with treatment of physician’s choice (TPC; eribulin, vinorelbine, gemcitabine, nab-paclitaxel, paclitaxel, ixabepilone, or docetaxel) in patients previously treated with anthracycline, taxane, and capecitabine, including those with treated, stable brain metastases. The primary endpoint, overall survival (OS), was assessed in a pre-defined subgroup of BCBM patients; an exploratory post hoc analysis adjusting for the diagnosis-specific graded prognostic assessment (GPA) index was also conducted.

Results
In the trial, 67 BCBM patients were randomized (EP, n = 36; TPC, n = 31). Treatment subgroups were balanced for baseline characteristics and GPA indices. EP was associated with a significant reduction in the risk of death (HR 0.51; P < 0.01) versus TPC; median OS was 10.0 and 4.8 months, respectively. Improvement in OS was observed in both poorer and better GPA prognostic groups. Survival rates at 12 months were 44.4% for EP versus 19.4% for TPC. Consistent with the overall BEACON population, fewer patients on EP experienced grade ≥3 toxicity (50 vs. 70%).

Conclusions
The significant improvement in survival in BCBM patients provides encouraging data for EP in this difficult-to-treat subgroup of patients. A phase three trial of EP in BCBM patients is underway (ClinicalTrials.gov NCT02915744).
Mortality and the relationship of somatic comorbidities to mortality in schizophrenia. A nationwide matched-cohort study
Authors: Bitter I. , Czobor P. , Borsi A. , Fehér L. , Nagy B.Z. , Bacskai M. , Rakonczai P. , Hegyi R. , Németh T. , Varga P. , Gimesi-Országh J. , Fadgyas-Freyler P. , Sermon J. , Takács P. 
Published: June 2017

AbstractAim:We conducted a matched-cohort study to assess mortality in schizophrenia and the relationship of mortality with comorbid somatic conditions and suicide attempts.Method:A full-population register-based prospective matched-cohort study was performed including all eligible patients with schizophrenia in Hungary between 01/01/2005 and 31/12/2013. Control subjects were individually matched to patients with schizophrenia at a 5:1 ratio. The principal outcome measure was death due to any reason. A non-parametric approach was used for descriptive statistical purposes, the Kaplan-Meier model for survival analysis, and the Cox proportional-hazards regression model for inferential statistics.Results:Patients with schizophrenia (n= 65,169) had substantially higher risk of all-cause mortality than the control subjects (n= 325,435) (RR = 2.4;P< 0.0001). Comorbidities and suicide attempts were associated with significantly increased mortality in both groups. As compared to the controls, 20-year old males with schizophrenia had a shorter life expectancy by 11.5 years, and females by 13.7 years; the analogous numbers for 45-year old schizophrenics were 8.1 and 9.6 years, respectively.Conclusions:A significant mortality gap – mainly associated with somatic comorbidities – was detected between patients with schizophrenia and individually matched controls. Improved medical training to address the disparity in mortality, and many other factors including lack of resources, access to and model of medical care, lifestyle, medication side effects, smoking, stigma, need for early intervention and adequate health care organization could help to better address the physical health needs of patients with schizophrenia.
Early Intra‐articular Corticosteroid Injection Improves Pain and Function in Adhesive Capsulitis of the Shoulder: 1‐Year Retrospective Longitudinal Study
Authors: Ahn Jung Hwan , Lee Doo‐Hyung , Kang Hyuncheol , Lee Michael Y. , Kang Dae Ryong , Yoon Seung‐Hyun 
Published: June 2017

AbstractBackgroundIntra‐articular corticosteroid injection is a commonly used therapy for adhesive capsulitis, but not enough studies exist on the optimal timing of the injection.ObjectiveTo determine whether intra‐articular corticosteroid injection has better outcomes in patients with earlier stage than later stage of adhesive capsulitis.Study DesignRetrospective longitudinal studySettingUniversity‐affiliated tertiary care hospital.ParticipantsPrimary adhesive capsulitis patients (n=339) who were unresponsive to at least 1 month of conservative treatment and who had ultrasound‐guided corticosteroid injection.InterventionsNot applicable.Main Outcome MeasurementsVisual analogue scale, Shoulder Pain and Disability Index, and passive range of motion (flexion, abduction, external rotation, and internal rotation and extension) were evaluated at pretreatment, month 1 and 12 after the first injection.ResultsThe result of the multiple regressions, which considered the main and the interaction effect of confounding variables, showed that the differences of all outcomes in both short‐term effect at month 1 and long‐term effect at month 12 are greater when the duration of pain prior to injection is shorter. Among the confounders, the injection number in the difference of internal rotation and extension between month 0 and 12 (IRE Δ(0‐12)) was statistically significant. IRE Δ(0‐12) was also greater when the pain duration was shorter, though the decrease in IRE Δ(0‐12) differed depending on the number of injections.ConclusionsEarly injection improves outcomes of adhesive capsulitis at both short‐ and long‐term follow‐ups. If pain persists despite non‐invasive and conservative treatments, early injection may be considered to shorten its natural history.Level of EvidenceIII
Medical Requirements During a Natural Disaster: A Case Study on WhatsApp Chats Among Medical Personnel During the 2015 Nepal Earthquake
Authors: Basu Moumita , Ghosh Saptarshi , Jana Arnab , Bandyopadhyay Somprakash , Singh Ravikant 
Published: June 2017

ABSTRACTObjectiveThe objective of this study was to explore a log of WhatsApp messages exchanged among members of the health care group Doctors For You (DFY) while they were providing medical relief in the aftermath of the Nepal earthquake in April 2015. Our motivation was to identify medical resource requirements during a disaster in order to help government agencies and other responding organizations to be better prepared in any upcoming disaster.MethodsA large set of WhatsApp (WhatsApp Inc, Mountain View, CA) messages exchanged among DFY members during the Nepal earthquake was collected and analyzed to identify the medical resource requirements during different phases of relief operations.ResultsThe study revealed detailed phase-wise requirements for various types of medical resources, including medicines, medical equipment, and medical personnel. The data also reflected some of the problems faced by the medical relief workers in the earthquake-affected region.ConclusionsThe insights from this study may help not only the Nepalese government, but also authorities in other earthquake-prone regions of the world to better prepare for similar disasters in the future. Moreover, real-time analysis of such online data during a disaster would aid decision-makers in dynamically formulating resource-mapping strategies. (Disaster Med Public Health Preparedness. 2017;11:652–655).
WHO Parents Skills Training (PST) programme for children with developmental disorders and delays delivered by Family Volunteers in rural Pakistan: study protocol for effectiveness implementation hybrid cluster randomized controlled trial
Authors: Hamdani S. U. , Akhtar P. , Zill-e-Huma  , Nazir H. , Minhas F. A. , Sikander S. , Wang D. , Servilli C. , Rahman A. 
Published: June 2017

Background.Development disorders and delays are recognised as a public health priority and included in the WHO mental health gap action programme (mhGAP). Parents Skills Training (PST) is recommended as a key intervention for such conditions under the WHO mhGAP intervention guide. However, sustainable and scalable delivery of such evidence based interventions remains a challenge. This study aims to evaluate the effectiveness and scaled-up implementation of locally adapted WHO PST programme delivered by family volunteers in rural Pakistan.Methods.The study is a two arm single-blind effectiveness implementation-hybrid cluster randomised controlled trial. WHO PST programme will be delivered by ‘family volunteers’ to the caregivers of children with developmental disorders and delays in community-based settings. The intervention consists of the WHO PST along with the WHO mhGAP intervention for developmental disorders adapted for delivery using the android application on a tablet device. A total of 540 parent-child dyads will be recruited from 30 clusters. The primary outcome is child's functioning, measured by WHO Disability Assessment Schedule – child version (WHODAS-Child) at 6 months post intervention. Secondary outcomes include children's social communication and joint engagement with their caregiver, social emotional well-being, parental health related quality of life, family empowerment and stigmatizing experiences. Mixed method will be used to collect data on implementation outcomes. Trial has been retrospectively registered at ClinicalTrials.gov (NCT02792894).Discussion.This study addresses implementation challenges in the real world by incorporating evidence-based intervention strategies with social, technological and business innovations. If proven effective, the study will contribute to scaled-up implementation of evidence-based packages for public mental health in low resource settings.Trial registration.Registered with ClinicalTrials.gov as Family Networks (FaNs) for Children with Developmental Disorders and Delays. Identifier: NCT02792894 Registered on 6 July 2016.
Comparable reductions in hyperpnoea-induced bronchoconstriction and markers of airway inflammation after supplementation with 6·2 and 3·1 g/d of long-chainn-3 PUFA in adults with asthma
Authors: Williams Neil C. , Hunter Kirsty A. , Shaw Dominick E. , Jackson Kim G. , Sharpe Graham R. , Johnson Michael A. 
Published: June 2017

AbstractAlthough high dosen-3 PUFA supplementation reduces exercise- and hyperpnoea-induced bronchoconstriction (EIB/HIB), there are concurrent issues with cost, compliance and gastrointestinal discomfort. It is thus pertinent to establish the efficacy of lowern-3 PUFA doses. Eight male adults with asthma and HIB and eight controls without asthma were randomly supplemented with twon-3 PUFA doses (6·2 g/d (3·7 g EPA and 2·5 g DHA) and 3·1 g/d (1·8 g EPA and 1·3 g DHA)) and a placebo, each for 21 d followed by 14 d washout. A eucapnic voluntary hyperpnoea (EVH) challenge was performed before and after treatments. Outcome measures remained unchanged in the control group. In the HIB group, the peak fall in forced expiratory volume in 1 s (FEV1) after EVH at day 0 (−1005 (sd520) ml, −30 (sd18) %) was unchanged after placebo. The peak fall in FEV1was similarly reduced from day 0 to day 21 of 6·2 g/dn-3 PUFA (−1000 (sd460) ml, −29 (sd17) %v. −690 (sd460) ml, −20 (sd15) %) and 3·1 g/dn-3 PUFA (−970 (sd480) ml, −28 (sd18) %v. −700 (sd420) ml, −21 (sd15) %) (P<0·001). Baseline fraction of exhaled nitric oxide was reduced by 24 % (P=0·020) and 31 % (P=0·018) after 6·2 and 3·1 g/dn-3 PUFA, respectively. Peak increases in 9α, 11βPGF2after EVH were reduced by 65 % (P=0·009) and 56 % (P=0·041) after 6·2 and 3·1 g/dn-3 PUFA, respectively. In conclusion, 3·1 g/dn-3 PUFA supplementation attenuated HIB and markers of airway inflammation to a similar extent as a higher dose. Lower doses ofn-3 PUFA thus represent a potentially beneficial adjunct treatment for adults with asthma and EIB.
Nutritional support for low birth weight infants: insights from animal studies
Authors: Li Na , Wang Wei , Wu Guoyao , Wang Junjun 
Published: June 2017

AbstractInfants born with low birth weights (<2500 g, LBW), accounting for about 15 % of newborns, have a high risk for postnatal growth failure and developing the metabolic syndromes such as type 2 diabetes, CVD and obesity later in life. Improper nutrition provision during critical stages, such as undernutrition during the fetal period or overnutrition during the neonatal period, has been an important mediator of these metabolic diseases. Considering the specific physiological status of LBW infants, nutritional intervention and optimisation during early life merit further attention. In this review, the physiological and metabolic defects of LBW infants were summarised from a nutritional perspective. Available strategies for nutritional interventions and optimisation of LBW infants, including patterns of nutrition supply, macronutrient proportion, supplementation of amino acids and their derivatives, fatty acids, nucleotides, vitamins, minerals as well as hormone and microbiota manipulators, were reviewed with an aim to provide new insights into the advancements of formulas and human-milk fortifiers.
Therapeutic efficacy ofArtemisia absinthiumagainstHymenolepis nana: in vitroandin vivostudies in comparison with the anthelmintic praziquantel
Authors: Beshay E.V.N. 
Published: June 2017

AbstractHymenolepis nanais a common intestinal tapeworm that affects humans. Drugs are available for the treatment of this infection, including praziquantel (PZQ), nitazoxanide and niclosamide. Although the drug of choice is praziquantel, due to its high cure rates, indicators of the development of PZQ resistance by different parasites have begun to appear over recent decades. Therefore, this study was a trial to find an alternative to PZQ by assessing the activity of the crude aqueous extract of the medicinal herbArtemisia absinthiumagainstH. nana.In vitro,the extract was used against adult worms at concentrations of 1 and 5 mg/ml, in comparison with 1 mg/ml of PZQ. The times of worm paralysis and death were determined. Ultrastructural morphological changes were studied using transmission electron microscopy (TEM). For thein vivostudy, infected mice were divided into untreated, PZQ-treated andA. absinthium-treated groups (400 mg/kg and 800 mg/kg). Pre- and post-treatment egg counts per gram of faeces (EPG) were performed; then, the reduction percentages of the EPG and worm burden were calculated. The best results were obtained with praziquantel.Artemisia absinthiuminduced worm paralysis, death and ultrastructural alterations, such as tegumental damage, lipid accumulation, and destruction of the nephridial canal and the intrauterine eggs, in a dose-dependent manner. Additionally, significant reductions in the EPG and worm burden were recorded inA. absinthium-treated mice. Although the results obtained withA. absinthiumwere promising and comparable to PZQ, further studies using different extracts, active ingredients and concentrations against different parasites should be conducted.
Early establishment and survival of the neotropical dry deciduous forest treeLysiloma microphyllumfrom mountainous Bajio Queretano, Mexico
Authors: Hernández-Oria José Guadalupe , Hawkins Richard I. Yeaton , Tostado Eduardo Castaño , Barradas Víctor L. 
Published: June 2017

Abstract:The tropical dry deciduous forest (TDF) of the semi-arid region of Bajio in Mexico is dominated by successional communities, in whichLysiloma microphyllumis irregularly distributed, however the environmental factors influencing its establishment have been poorly studied. We conducted field experiments to isolate the impact of three factors on the early life-history stages of this tree. Over a 2-y period, we monitored the effects of (1) predation, (2) understorey light and (3) aspect on germination, seed-to-seedling transition (establishment) and seedling survival, and we found that open space negatively affected germination (14.9 ± 1.5% vs 96 ± 1.5% in shade; mean ± SE), while shade increased seedling establishment and survival (36.9 ± 8.2% vs 4.7 ± 3.8% in open sites). Predation decreased survival and was strongest in open conditions (0 vs 62.7 ± 9.4% in shaded exclosures). In contrast, aspect had little influence on germination and survival. The results suggest that shaded microsites positively affect the early life stages ofL. microphyllum, a key process in TDF recovery.
Prescribing an automated external defibrillator for children at increased risk of sudden arrhythmic death
Authors: McLeod Karen A. , Fern Eileen , Clements Fiona , McGowan Ruth 
Published: June 2017

AbstractBackgroundAutomated external defibrillators can be life-saving in out-of-hospital cardiac arrest.ObjectiveOur aim was to review our experience of prescribing automated external defibrillators for children at increased risk of sudden arrhythmic death.MethodsWe reviewed all automated external defibrillators issued by the Scottish Paediatric Cardiac Electrophysiology Service from 2005 to 2015. All parents were given resuscitation training according to the Paediatric Resuscitation Guidelines, including the use of the automated external defibrillator.ResultsA total of 36 automated external defibrillators were issued to 36 families for 44 children (27 male). The mean age at issue was 8.8 years. Diagnoses at issue included long QT syndrome (50%), broad complex tachycardia (14%), hypertrophic cardiomyopathy (11%), and catecholaminergic polymorphic ventricular tachycardia (9%). During the study period, the automated external defibrillator was used in four (9%) children, and in all four the automated external defibrillator correctly discriminated between a shockable rhythm – polymorphic ventricular tachycardia/ventricular fibrillation in three patients with one or more shocks delivered – and non-shockable rhythm – sinus rhythm in one patient. Of the three children, two of them who received one or more shocks for ventricular fibrillation/polymorphic ventricular tachycardia survived, but one died as a result of recurrent torsades de pointes. There were no other deaths.ConclusionParents can be taught to recognise cardiac arrest, apply resuscitation skills, and use an automated external defibrillator. Prescribing an automated external defibrillator should be considered for children at increased risk of sudden arrhythmic death, especially where the risk/benefit ratio of an implantable defibrillator is unclear or delay to defibrillator implantation is deemed necessary.
Massive aortic root aneurysm in an infant with the Loeys–Dietz syndrome
Authors: Molina-Sánchez Tatiana , Calderón-Colmenero Juan , Sandoval Juan Pablo 
Published: June 2017

AbstractA 10-month-old girl with type I Loeys–Dietz syndrome developed a conspicuous aortic root aneurysm that was well demonstrated on chest X-ray/CT reconstruction. She underwent successful valve-spare repair of the ascending aorta.