bluuebunny/crossref_metadata_2025_split huggingface dataset:
Do travel clinic visitors read information on sexual risk abroad in travel health brochures?
Authors: Croughs Mieke , de Gouw Annemarie , Remmen Roy , Van den Ende Jef 
Published: September 2016

Background: A substantial proportion of travel clinic visitors have sexual encounters while abroad. Hence, guidelines on travel health recommend discussing sexual risk in a pre-travel consultation. However, previous studies showed that it often is not discussed. Although travel clinic visitors usually do receive written information on sexual risk abroad, few data are available on whether this information is read. Therefore, this prospective cohort study in travel clinic visitors was performed. Methods: Travel clinic visitors were invited to complete a questionnaire after return from their journey. Results: A total of 130 travellers (55%) responded. Half of them recorded they read the information on sexual risk. Male gender (OR 9.94 95% CI 3.12 – 31.63) and ‘travelling with others’ (OR 2.7 95% CI 1.29 – 5.78) were significant independent predictors of reading the information on sexual risk. High risk travellers, i.e. those travelling without a steady partner, were less likely to have read it. Although websites and apps were mentioned as better methods of providing information, none of the participants visited the websites on sexual behaviour and sexually transmitted infections recommended in the travel health brochure. Conclusion: Only half of travel clinic visitors read information on sexual risk in the health brochure received in the clinic and none of them visited the related websites mentioned in the brochure. Further research to identify the most effective way to inform travellers about sexual risk is needed.
Cost and Predictors of Hospitalizations for Ambulatory Care - Sensitive Conditions Among Medicaid Enrollees in Comprehensive Managed Care Plans
Authors: Mkanta William N. , Chumbler Neale R. , Yang Kai , Saigal Romesh , Abdollahi Mohammad 
Published: September 2016

Introduction: Preventable hospitalizations are responsible for increasing the cost of health care and reflect ineffectiveness of the health services in the primary care setting. The objective of this study was to assess expenditure for hospitalizations and utilize expenditure differentials to determine factors associated with ambulatory care - sensitive conditions (ACSCs) hospitalizations. Methods: A cross-sectional study of hospitalizations among Medicaid enrollees in comprehensive managed care plans in 2009 was conducted. A total of 25 581 patients were included in the analysis. Expenditures on hospitalizations were examined at the 50th, 75th, 90th, and 95th expenditure percentiles both at the bivariate level and in the logistic regression model to determine the impact of differing expenditure on ACSC hospitalizations. Results: Compared with patients without ACSC admissions, a larger proportion of patients with ACSC hospitalizations required advanced treatment or died on admission. Overall mean expenditures were higher for the ACSC group than for non-ACSC group (US$18 070 vs US$14 452). Whites and blacks had higher expenditures for ACSC hospitalization than Hispanics at all expenditure percentiles. Patient’s age remained a consistent predictor of ACSC hospitalization across all expenditure percentiles. Patients with ACSC were less likely to have a procedure on admission; however, the likelihood decreased as expenditure percentiles increased. At the median expenditure, blacks and Hispanics were more likely than other race/ethnic groups to have ACSC hospitalizations (odds ratio [OR]: 1.307, 95% confidence interval [CI]: 1.013-1.686 and OR 1.252, 95% CI: 1.060-1.479, respectively). Conclusion: Future review of delivery and monitoring of services at the primary care setting should include managed care plans in order to enhance access and overall quality of care for optimal utilization of the resources.
Metacarpal Cortical Bone Area Predicts Tooth Loss in Men
Authors: Kaye E.K. , Vokonas P. , Garcia R.I. 
Published: September 2016

The relationship between bone mineral density and tooth loss in men is unclear. The aim of this retrospective cohort study was to determine if relative metacarpal bone area (MCA) predicts tooth loss in a cohort of 273 male participants in the Dental Longitudinal Study and Normative Aging Study of the Department of Veterans Affairs. Outer and inner cortical bone widths of the middle metacarpal of the nondominant hand were measured on anteroposterior hand radiographs approximately 11 y apart. Baseline MCA was computed and categorized into quartiles. The men were followed from 1971 to 2015. Incident tooth loss during 2 intervals was examined: concurrent with the MCA measurements and long term over the total follow-up (17 ± 7 y). Radiographic alveolar bone loss (ABL) was measured on periapical radiographs as a percentage of the distance from the cementoenamel junction to root apex, and the number of teeth with ABL >40% was computed. Negative binomial generalized linear regression models estimated the mean number of teeth with ABL >40% and the number lost (concurrent and total), controlling for age, smoking, number of teeth at baseline, percentage teeth with ≥1 decayed/filled surface, and years of follow-up. At baseline, MCA was inversely related to number of teeth with >40% ABL. Men in the lowest MCA quartile (Q1) lost the most teeth, both concurrent with MCA measurements and long term, but the association differed by caries level (≤55% or >55% decayed/filled teeth). At the low caries level, the numbers lost in Q1 were 29% greater than in the highest MCA quartile (Q4). At the high caries level, the numbers lost in Q1 were more than twice those in Q4. Associations were attenuated when further controlled for number of teeth with ABL>40%. These findings suggest that systemic bone status plays a role in tooth loss and that the association may be mediated by alveolar bone loss. Knowledge Transfer Statement: Low relative metacarpal bone area was related to loss of alveolar bone and incident tooth loss in men. This information extends previous research, primarily studies of women, showing that osteoporosis adversely affects oral health. Knowledge of a patient’s systemic bone status may be important for managing his or her periodontal disease. Tooth loss in the absence of periodontal inflammation may signify systemic bone loss. Interprofessional communication is central to maintaining optimal oral and bone health.
Infant lung function testing: available and useful methods
Authors: Ljungberg H. , Gustafsson P.M. 
Published: September 2016

Educational aimsTo provide an overview of which aspects of lung function can be measured in infants using currently commercially available equipment.To describe the particular measurement conditions required for infant lung function testing.To provide information concerning some of the, as yet, commercially unavailable methods.SummaryLung and airway function can now be measured in infants using standardised methods, allowing for an almost as complete picture of lung function as routinely obtained in adults. Recording systems are now available from several manufacturers. The tests are done during sleep, commonly after sedation with choral hydrate, and in a strictly standardised manner under standardised conditions. Despite the high frequency of chronic chest problems in infants and young children, facilities for assessment of lung function are lacking in many large paediatric centres worldwide. While infant lung function testing is now emerging as a clinical tool, the precise role and the value of the various tests in different clinical situations remain to be established.
Occupational asthma for the clinician
Authors: Nemery B. 
Published: September 2016

Key pointsOccupational asthma is an important disease.Its prevention is necessary, but difficult.Its diagnosis is not always easy, but within reach of most respiratory or occupational physicians.Its correct management is complex because of the socio-economic consequences.Educational aimsOccupational asthma is a “special” form of asthma that often causes diagnostic and therapeutic problems for busy clinicians. This article aims to help practising pulmonologists to:avoid common pitfalls that lead to the role of occupation being missed in adult patients with asthma;confirm the diagnosis of occupational asthma in patients with suspected occupational asthma;manage patients with occupational asthma.The issues of prevention and surveillance of workers at risk of occupational asthma, however important, will not be addressed here.
Pathological approach to idiopathic interstitial pneumonias: useful points for clinicians
Authors: Colby T.V. 
Published: September 2016

Key pointsIPF has been narrowed down to a more homogeneous group of patients with a very poor prognosis (median survival <3 yrs) and (by definition) the histological pattern of UIP.Histological evaluation of IIPs in general (and cases formerly interpreted clinically as IPF in particular) has resulted in subclassification into prognostically significant histopathological groupings.Histopathological classification of interstitial pneumonias generally requires a surgical lung biopsy (exceptions: some cases of COP and AIP); clinical diagnosis may not always require a biopsy (see below).Histological classification of interstitial pneumonias requires (by definition) histopathology. HRCT is a surrogate for surgical lung biopsy in some settings, especially UIP. The other histological patterns have less distinctive HRCT features. In all the categories, there remain cases that are hard to classify.Educational aimsTo highlight the pathological features of the IIPs.To show the correlation of histology and radiology in the IIPs.To improve understanding of when to get a biopsy and what type of biopsy to get in the setting of an IIP.SummaryMost of the IIPs are diagnosed histologically on the basis of patterns of inflammation and fibrosis. Most require open lung biopsy for definitive histological diagnosis. There is good histological/radiological (HRCT) correlation among the IIPs, but both have their limitations. Radiology gives the overview of gross pathology, but the resolution is limited, whereas biopsy shows the histological features but is limited by sampling; the two modalities are complementary. Histology is not always the gold standard. Histology is a relative gold standard that is modified by other findings (particularly those of HRCT). The new ATS/ERS classification of IIPs is based on clinical-radiological-pathological correlations. Coordinating clinicalradiological-pathological data in the diagnosis of IIP is significantly better than the sum of the individual data. NSIP is still evolving.
Prognosis of wheezing and asthma presenting in early childhood
Authors: Helms P.J. , Amin S.S. 
Published: September 2016

Key pointsChildhood asthma and wheezing illness encompass a wide clinical spectrum.Most children with asthma first present before the age of 3 years.Coexistent atopy and initial disease severity carry a poor long-term prognosis.A switch from male to female predominance occurs at puberty.Good prognostic factors include presentation before 2 years of age and exclusively virally induced episodes.CME article: educational aimsTo identify the different types of wheezing illness in asthma that present in childhood.To aid healthcare professionals in the discussion of medium- to long-term prognosis with parents of children presenting with wheezing illness.To place prophylactic therapy in the context of the natural history of the disease.SummaryChildhood asthma covers a wide spectrum, ranging from mild-intermittent to severe-persistent disease, with different natural histories. Female sex, age at presentation, atopic constitution, parental atopy, and severity and frequency of attacks can all be identified as risk factors for persistence into adult life, while others, including maternal smoking, prematurity and bronchiolitis of infancy, do not appear to be associated to such an extent. The use of prognostic features alongside assessment of disease severity should inform long-term clinical management and be useful in counselling the child and her/his family.
Postgraduate Course ERS Glasgow 2004: Antibiotics
Authors: Cazzola M. , Korppi M. 
Published: September 2016

Educational aimsTo explain the importance of pulmonary deposition of antimicrobials.To show that drugs that penetrate well and remain at the pulmonary sites of infection for long periods often induce therapeutic responses greater than expected on the basis ofin vitrodata.To illustrate why the interrelationship between pharmacokinetics and pharmacodynamics determines the dosing duration and total dose required for optimal antimicrobial activity.To examine the real effect of the interrelationship between pulmonary pharmacokinetics and pharmacodynamics on clinical and microbiological outcomes.SummaryAn important determinant of clinical outcome of a LRTI may be sterilisation of the infected lung, which is dependent on sustained antibiotic concentrations achieved in the lung. For this reason, recently, there has been increased interest in measuring the concentration of antimicrobial agents at different potential sites of infection in the lung. In patients with acute bronchitis, acute exacerbation of chronic bronchitis, bronchiectasis or cystic fibrosis, the infection develops within the airway lumen on the surface of mucus cells and in the mucosa itself. In patients with bacterial pneumonia, the site of infection is in the alveolar spaces or in the pulmonary interstitium. This article, adapted from the European Respiratory Society (ERS) School Course on “New perspectives in pneumonia treatment and prophylaxis”, held at the 2005 ERS conference in Glasgow, discusses the pharmacokinetics and pharmacodynamics of antibiotics with respect to clinical and microbiological outcomes.
Spirometry: then and now
Authors: Gibson G.J. 
Published: September 2016

Key pointsThe spirometric measurements of most clinical value are FEV1and VC.FEV1and VC are used for diagnosis, assessment of severity, and monitoring progress and response to treatment.FEV1and VC are a valuable guide in the prognosis of many diseases, not only respiratory.The greatest clinical value of maximum flow–volume curves is the recognition of central (upper) airway narrowing.Educational aimsTo outline the historical development and rationale of the measurements commonly made during forced expiration.To review the diagnostic specificity of these measurements and their continuing value in clinical respiratory medicine.To review the prognostic information conveyed by measurements of FEV1and VC in various respiratory and non-respiratory diseases.SummaryMeasurements of VC were first made in the 18th Century, and they had been reported in large numbers of healthy subjects and patients with respiratory disease (tuberculosis) by the middle of the 19th Century. However, little use was made of the VC in clinical medicine until the second half of the 20th Century. The FEV1was first described about 50 years ago. Although used widely by respiratory physicians, the value of both these simple measurements remains under-appreciated by non-specialists. Their main roles are in aiding diagnosis by pattern recognition, assessing severity of disease, and monitoring progress and/or the effects of treatment. The valuable prognostic information conveyed by FEV1and VC has been demonstrated in several conditions, both respiratory and nonrespiratory.
Sleep apnoea syndrome
Authors: McNicholas W.T. 
Published: September 2016

Key pointsOSAS, with a prevalence of 4% in adults, represents the most common chronic respiratory disorder after asthma.The condition is fundamentally caused by an inability of the UA-dilating muscles to withstand the collapsing forces generated during inspiration.Patients typically present with a triad of symptoms: snoring, witnessed apnoea and daytime sleepiness, in addition to other clinical features.The most common physical morbidity of OSAS is cardiovascular disease, and successful therapy improves these outcomes.While the gold-standard diagnosis is sleep laboratory-based polysomnography, increasing attention is being focused on limited cardiorespiratory studies, particularly in the home.Most patients with OSAS are best managed by nasal CPAP, particularly in moderate to severe cases, and the improvements achieved can be dramatic, particularly in daytime alertness.Educational aimsTo provide a broad overview of OSAS, particularly from a clinical perspective.To review the basic mechanisms of the disorder and provide a brief introduction to some of the emerging concepts concerning molecular mechanisms of cardiac dysfunction in OSAS patients.To provide practical information for the clinician on the optimum approach to diagnosis and treatment of the disorder.SummaryOSAS is characterised by recurring episodes of UA obstruction during sleep. Apnoeas are usually terminated by brief arousals, which result in marked sleep fragmentation, and contribute significantly to the symptoms of EDS and cognitive dysfunction. OSAS is also an independent risk factor for cardiovascular disease. The prevalence of OSAS is in the region of 2–4% of the adult population, and this high prevalence creates logistical difficulties in diagnosis.This review aims to a give a broad overview of OSAS for the clinician, whilst providing practical information concerning the diagnosis and treatment of the disease, including nasal CPAP for the management of moderate to mild OSAS, and weight loss, alcohol avoidance, relief of nasal congestion and keeping the patient off their back in milder cases. The possibility of using a mandibular-advancement device is also discussed.
Postgraduate Course ERS Glasgow 2004: Surgical approach to multiresistant cavitary mycobacteriosis
Authors: Halezeroglu S. 
Published: September 2016

Educational aimsTo explain the present importance of surgery in TB management.To describe the indications for surgery.To discuss the different stages of surgery, along with important points to consider.To present examples of data from one institution to help demonstrate the issues to be considered in surgical management.SummarySurgery remains an important adjunctive method in the treatment of MDR-TB. In this article, adapted from the European Respiratory Society (ERS) School Course on “Multi-resistant tuberculosis and atypical mycobacterial disease”, held at the 2004 ERS congress in Glasgow, the indications for surgical management in patients with MDR-TB are discussed, together with data from 75 patients with MDR-TB operated on in the Sureyyapasa Thoracic and Cardiovascular Diseases Teaching Hospital, Turkey, between 1993 and 2003.
Complementary and alternative treatment of asthma
Authors: Bjermer L. 
Published: September 2016

Key pointsCurrently, there are no reliable data documenting the effects of CAM treatment on asthma, although this does not automatically mean that CAM is worthless.In most studies, it is difficult to sift out exactly what it is in the treatment that is effective, as most therapists tend to treat each subject in a unique manner.Scientifically well-controlled, randomised CAM trials are possible and should be performed.Educational aimsTo review the range of complementary and alternative (CAM) treatments currently available.To provide information about the systematic overviews in the Cochrane database concerning CAM and asthma.SummaryAsthma and allergies are chronic conditions that cause considerable distress. In most cases, the use of modern medical therapy can control these conditions; however, there is still no cure for asthma. Therefore, many patients and, in the case of children, many parents seek CAM. This is often, but not always, concealed from the doctor treating the patient. Traditionally, there has been an antagonistic relationship between CAM and orthodox medicine, and this is why many patients do not inform their doctors that they are seeking CAM. This study aims to assess the current clinical medical value of CAM.
Non-invasive ventilation: a year in review
Authors: Nava S. 
Published: September 2016

Educational aimsTo present four innovative papers from the field on non-invasive ventilation published in 2004 and to discuss the important points and conclusions from each.SummaryThis paper summarises the findings of four important papers that have been published over the last year.The first paper reports data on the success rate of NIV in patients with early onset of ARF due to SARS. Furthermore, the paper discusses how NIV may be used in patients affected by highly contagious diseases in a way which is safe for healthcare workers.The second paper concentrates on dying at end-stage disease and the limits of medical care. It studies the use of NIV treatment in patients with CHF and COPD affected by ARF who have signed a DNI order.The next article investigates the use of both CPAP and NIV delivered by face mask in patients with CPE, when compared with the use of oxygen alone, and their effect on physiological parameters and avoiding intubation.Finally, the last paper reviewed reports on the use of NIV to treat an episode of post-extubation respiratory failure in “unselected” patients.This review article aims to keep the reader updated on the most recent and some of the important advancements in this field over the last year.
Chest physical therapy in surgery: a theoretical model about who to treat
Authors: Fagevik Olsén M. 
Published: September 2016

Key pointThe major high-risk factors for developing PPC include: Advanced age Smoking Obesity Obstructive pulmonary diseaseEducational aimsTo highlight high- and low-risk factors for PPC.To present overview data showing how the respiratory system is affected by different surgical interventions.To present a model to determine which treatment is most suitable for each individual patient.SummaryChest physiotherapy is common for patients undergoing different types of surgery in order to avoid PPC. However, do all patients require treatment, is it possible to predict those patients at risk and is it possible to select the optimal treatment for each patient? This paper aims to address these questions and to propose a model that can be utilised for determining how much physical therapy is needed.
Postgraduate Course ERS Glasgow 2004 Large cell carcinoma
Authors: Brambilla E. 
Published: September 2016

Educational aimsTo explain the importance of discriminating between different histological types of NSCLC.To explain the differences between large cell carcinoma (NOS) and their variants.To link precise histopathological class with prognosisSummaryThe histopathological classification of lung cancer was revised in 1999, and, in addition, descriptions of their phenotypic and genetic abnormalities were reported in 2004. Several changes have occurred that increased the clinical significance of lung cancer histopathological classification. These include the subclassification of large cell carcinoma, which was defined on a negative basis (on exclusion criteria), into variants which are defined on objective histopathological positive criteria that endowed them with a strong clinical significance.
ERS School Course Cystic Fibrosis
Authors: Bush A. , Elborn S. , Götz I. 
Published: September 2016

Educational aimsTo identify patients with advanced and rapidly progressive lung disease.To discuss how to best optimise standard therapies.To understand the different approaches appropriate to patients who have and have not decided that lung transplantation is an option.To detail innovative strategies which may be worth attempting if conventional means failure.SummaryMore than 90% of CF patients will eventually die of advanced lung disease, despite everything that has been attempted. This article will discuss strategies that can be adopted when a patient is doing badly.