bluuebunny/crossref_metadata_2025_split huggingface dataset:
Attachment Dimensions and Young Children’s Response to Pain
Authors: Walsh Trudi M , McGrath Patrick J , Symons Douglas K 
Published: March 2016

BACKGROUND/OBJECTIVE: The present study examined the relationship between attachment dimensions and child pain behaviour following both an everyday pain incident (eg, bumps and scrapes) and acute pain incident (eg, immunization) in 66 five‐year‐old children.METHODS: Secure, avoidant, ambivalent and controlling attachment dimensions were assessed using aggregates of laboratory‐based reunion behaviour, performance on representational measures of attachment and the measure of emotion regulation. Child pain behaviour, during immunization and everyday pain incidents, was rated in terms of reactivity, anger and calming time.RESULTS: The ambivalence and controlling attachment dimensions were differentially related to child pain behaviour. Specifically, children with either more ambivalent or controlling attachment had a relatively greater reaction to both the immunization procedure and everyday pain incident. Children with more controlling attachment also took more time to calm down following the immunization and displayed greater anger. Security and avoidance, however, were not systematically related to child pain behaviour.CONCLUSIONS: Results are discussed in terms of Bowlby’s theory of attachment relationships and pain as an important distress signal to children.
Effects of Smoke Exposure and Other Lifestyle Factors on Pain Response to Electrical Stimulation in Women
Authors: May Wee Joy Yenn , Hopman Wilma M 
Published: March 2016

BACKGROUND: A relationship between smoking and development of pain syndromes has been suggested in the literature. The present study examined associations between smoke exposure and other related variables, and pain response to suprathreshold electrical stimulation.METHODS: Subjects were prospectively recruited from a population referred to an electrodiagnostic clinic. Information about age, smoke exposure, caffeine and alcohol consumption was obtained, as well as documented objective signs of stress through physical assessment. One investigator applied two standardized 0.1 ms electrical stimulations (50 mA followed by 100 mA) to asymptomatic extremities at the beginning of each electrodiagnostic session, using consistent technique. Subjects used a visual analogue scale to indicate the level of pain felt after each stimulation.RESULTS: Two hundred fifteen women were included. Current smokers and those currently exposed to second‐hand smoke had significantly higher pain ratings (P=0.003 for 50 mA, P=0.005 for 100 mA) than those not currently exposed to smoke. Time since exposure was negatively associated with pain ratings. Those with objective signs of stress reported higher levels of pain, which was significant for the 100 mA stimulation (P=0.046). Linear regression modelling indicated that current smoke exposure and alcohol use were associated with higher pain ratings at both 50 mA and 100 mA, while stress was associated with higher pain ratings and older age was associated with lower pain ratings at 100 mA only.INTERPRETATION: Exposure to cigarette smoke is significantly related to higher reported levels of pain experienced in response to electrical stimulation in this study population. Exposure to smoke can add 10 points to the 100‐point visual analogue scale compared with subjects without exposure, with alcohol use adding another eight points. Reported pain decreases as length of time since previous exposure to smoke increases.
Barrett’s Esophagus and Cardiac Intestinal Metaplasia: Two Conditions within the Same Spectrum
Authors: White Nicole , Gabril Manal , Ejeckam Gershon , Mathews Maria , Fardy John , Kamel Fady , Doré Jules , Yousef George M 
Published: March 2016

BACKGROUND: Immunostaining for cytokeratin 7 (CK7) and cytokeratin 20 (CK20) has a characteristic pattern in Barrett’s esophagus (BE), but reports regarding its sensitivity and specificity are inconsistent. Intestinal metaplasia of the gastric cardia (CIM) is histologically similar to BE, but with no abnormal endoscopic findings.OBJECTIVES: To evaluate the sensitivity and specificity of a semi-quantitative CK7/CK20 immunostaining pattern for the diagnosis of BE, and to further elucidate the pathogenesis of CIM.METHODS: Tissues were examined by hematoxylin and eosin and periodic acid schiff/alcian blue stains, and then were immunostained with CK7 and CK20 antibodies. Correlations with other clinical parameters were statistically analyzed.RESULTS: When values were revised based on follow-up data and auxiliary testing, all BE cases (100%) displayed the characteristic BE CK7/CK20 immunostaining pattern, compared with 66% of CIM cases. In the subgroup of patients who were endoscopically and immunohistochemistry-positive but histologically negative, all patients except for one had documented BE when clinical history, auxiliary testing and follow-up were evaluated. There were no statistically significant differences between BE and CIM regardingHelicobacter pyloriinfection or the type of metaplasia (complete versus incomplete). The sensitivity of the CK7/CK20 pattern reached 100% in the subgroup of CIM patients with a history of acid reflux. Of 26 cases of CIM where follow-up was available, four cases (15%) progressed to BE, and one developed dysplasia. All four cases showed the BE pattern of CK7/CK20 staining and were negative forH pyloriinfection.CONCLUSIONS: A semiquantitative CK7/CK20 pattern can be used to confirm BE even in the absence of histological evidence. The subgroup of CIM with acid reflux may develop into BE and may need closer follow-up.
The Meaning and Process of Pain Acceptance. Perceptions of Women Living with Arthritis and Fibromyalgia
Authors: LaChapelle Diane L , Lavoie Susan , Boudreau Ainsley 
Published: March 2016

BACKGROUND: Within the past 10 years, cognitive‐behavioural pain management models have moved beyond the traditional focus on coping strategies and perceived control over pain, to incorporate mindfulness‐and acceptance‐based approaches. Pain acceptance is the process of giving up the struggle with pain and learning to live life despite pain. Acceptance is associated with lower levels of pain, disability and psychological distress. Relatively little is known, however, about how patients arrive at a state of acceptance without the aid of therapy.OBJECTIVES: To explore personal definitions of acceptance and the factors that facilitate or hinder acceptance.METHODS: Eleven focus groups, involving a total of 45 women with arthritis and fibromyalgia, were conducted.RESULTS: The qualitative analysis revealed that, while the women rejected the word ‘acceptance’, they did agree with the main components of existing research definitions. The women’s responses revealed that acceptance was a process of realizations and acknowledgements, including realizing that the pain was not normal and help was needed, receiving a diagnosis, acknowledging that there was no cure and realizing that they needed to redefine ‘normal’. Diagnosis, social support, educating self and others, and self‐care were factors that promoted acceptance. Struggling to retain a prepain identity, negative impacts on relationships, others not accepting their pain and the unspoken message that the pain was ‘all in their head’ were barriers to acceptance.CONCLUSION: The implications of these findings, distinctions between the diagnostic groups and recommendations regarding how health professionals can facilitate the process of acceptance are discussed.
Comparison of Liver Biopsy and Transient Elastography based on Clinical Relevance
Authors: Masuzaki Ryota , Tateishi Ryosuke , Yoshida Haruhiko , Goto Eriko , Sato Takahisa , Ohki Takamasa , Goto Tadashi , Yoshida Hideo , Kanai Fumihiko , Sugioka Yosuke , Ikeda Hitoshi , Shiina Shuichiro , Kawabe Takao , Omata Masao 
Published: March 2016

BACKGROUND: Liver stiffness measurement (LSM) by transient elastography has recently been validated for the evaluation of liver fibrosis in chronic liver diseases. The present study focused on cases in which liver biopsy and LSM were discordant.METHODS: Three hundred eighty-six patients with chronic hepatitis C who underwent a liver biopsy between December 2004 and April 2007 were studied. First, the optimal cut-off value of LSM was selected for the determination of cirrhosis based on the receiver operating characteristic curve. Then, the cases in which liver histology and evaluation by LSM were discordant were selected. Laboratory test results such as serum total bilirubin concentration, prothrombin activity, albumin concentration, platelet count and the aspartate aminotransferase to platelet ratio index, together with the presence of esophageal varices, were analyzed.RESULTS: The optimal cut-off value was chosen to be 15.9 kPa for cirrhosis (fibrosis stage [F] 4) determination to maximize the sum of sensitivity (78.9%) and specificity (81.0%). There were 78 discordant cases: 51 patients showed an LSM of 15.9 kPa or higher and a fibrosis stage of F1 to F3 (high LSM group), and 27 patients had an LSM lower than 15.9 kPa and a fibrosis stage of F4 (low LSM group). Esophageal varices were seen in 11 patients in the high LSM group (n=51) and in no patients in the low LSM group (n=27) (P=0.0012). The aspartate aminotransferase to platelet ratio index was significantly higher in the high LSM group (1.49 versus 0.89, P=0.019). Other parameters did not differ significantly. However, platelet count, prothrombin activity and albumin concentration tended to be lower in the high LSM group.CONCLUSIONS: Patients with a high LSM need proper attention for cirrhosis, even if liver biopsy does not reveal cirrhosis.
Outcomes of Peginterferon Alpha-2a and Ribavirin Hepatitis C therapy in Aboriginal Canadians
Authors: Cooper Curtis L , Bailey Robert J , Bain Vince G , Anderson Frank , Yoshida Eric M , Krajden Mel , Marotta Paul , for the Canadian Pegasys Study Group  
Published: March 2016

BACKGROUND: There is little published information on baseline characteristics and therapeutic outcomes in hepatitis C virus (HCV)-infected Aboriginal Canadians. It is unclear what proportion of HCV-infected Aboriginal people receive therapy relative to other populations.METHODS: Adults with chronic HCV infection, quantifiable serum HCV-RNA levels and compensated liver disease were assigned, at the physician’s discretion, to either 24 or 48 weeks of treatment with peginterferon alpha-2a 180 μg/week plus ribavirin at a dose of 800 mg/day, or 1000 mg/day or 1200 mg/day in an open-label, expanded access program. The primary outcome was sustained virological response, defined as undetectable HCV-RNA by qualitative polymerase chain reaction (less than 50 IU/mL) at the end of 24 weeks of untreated follow-up. Baseline characteristics and outcomes in Aboriginal and non-Aboriginal patients were compared.RESULTS: A total of 2614 patients were eligible for the analysis; 44 individuals (1.7%) self-identified as being of Aboriginal heritage. The baseline characteristics of these two groups were similar. An overall sustained virological response was achieved in 47.7% and 46.5% of Aboriginal and non-Aboriginal patients, respectively. The overall frequencies of adverse events and laboratory abnormalities were similar between the two groups, although cytopenias occurred less frequently in Aboriginal patients.INTERPRETATION: Aboriginal patients were greatly under-represented in the present ‘community’-based treatment program, yet viral responses were similar to those of a non-Aboriginal cohort. To increase the uptake of HCV therapy in the Aboriginal population, clarification of the obstacles to treatment is warranted.
Working Out the Kinks: Testing the Feasibility of an Electronic Pain Diary for Adolescents with Arthritis
Authors: Stinson Jennifer N , Petroz Guy C , Stevens Bonnie J , Feldman Brian M , Streiner David , McGrath Patrick J , Gill Navreet 
Published: March 2016

BACKGROUND: Current approaches to evaluating pain in children with chronic arthritis suffer from methodological problems. A real‐time data capture approach using electronic diaries has been proposed as a new standard for pain measurement. However, there is limited information available regarding the development and feasibility of this approach in children.OBJECTIVES: The aim of the present study was to pilot test the e‐Ouch electronic pain diary in terms of compliance and acceptability in adolescents with arthritis to further refine the prototype.METHODS: A descriptive study design – with two iterative phases of testing, modifying the prototype and retesting – was used. A purposive sample of 13 adolescents with mild to severe pain and disability was drawn from a large rheumatology clinic in a university‐affiliated pediatric tertiary care centre in Canada over a four‐week period in December 2004. Participants were signalled with an alarm to use the diary three times per day for a two‐week period. Adolescents completed an electronic diary acceptability questionnaire.RESULTS: Overall mean compliance rates for phases 1 and 2 were 72.9% and 70.5%, respectively. Compliance was affected by the timing of data collection and technical difficulties. Children rated the diary as highly acceptable and easy to use. Phase 1 testing revealed aspects of the software program that affected compliance, which were subsequently altered and tested in phase 2. No further technical difficulties arose in phase 2 testing.CONCLUSIONS: Feasibility testing is a crucial first step in the development of electronic pain measures before use in clinical and research practice.
Endoscopic Management of Gastric Varices: Efficacy and Outcomes of Gluing with N-Butyl-2-Cyanoacrylate in a North American Patient Population
Authors: Belletrutti PJ , Romagnuolo J , Hilsden RJ , Chen F , Kaplan B , Love J , Beck PL 
Published: March 2016

BACKGROUND: Gastric variceal bleeding is associated with significant morbidity and mortality in patients with portal hypertension. Outside of North America, gastric variceal injection of N-butyl-2-cyanoacrylate has been shown to be safe and effective. The majority of studies on this mode of therapy are in Asian populations in which the etiology of portal hypertension differs from North America.AIM: To assess the safety and efficacy of gastric variceal glue injection in a North American population.METHODS: Consecutive patients that underwent glue injection of gastric varices in the Calgary Health Region from 2001 to 2006 were assessed.RESULTS: Thirty-four patients (19 men, 15 women) underwent a total of 47 separate gluing procedures. Of those presenting with active bleeding at endoscopy, immediate hemostasis was achieved in 93.8% of patients. Rebleeding within 48 h of gluing was observed after four procedures. Gastric varices were eradicated in 84.0% of cases. Complications included superior mesenteric vein thrombosis in one patient. Twenty-eight (82.4%) patients were alive at the end of follow-up. The treatment failure-related mortality rate was 2.1%.CONCLUSIONS: The present study is one of the few to assess the role of gastric variceal gluing in a North American population. Glue injection with cyanoacrylate is safe and effective in the treatment of bleeding gastric varices.
Cryptococcus gattii: An Emerging Cause of Pulmonary Nodules
Authors: Dewar Gary J , Kelly James K 
Published: March 2016

BACKGROUND: Since the fall of 1999, a new endemic focus of Cryptococcus gattii serotype B infection has emerged on Vancouver Island (Victoria, British Columbia), with infections occurring in both animals and humans. In the human cases, symptoms have manifested as pulmonary nodules, meningitis or both. This organism has added a new nonmalignant cause of pulmonary nodules to the literature, resulting in a change in the management of these nodules by health care professionals.METHODS: A search of the number of cases recorded and treated in hospitals of the Vancouver Island Health Authority, along with a review of the literature regarding this emerging organism, was undertaken. The pathology, epidemiology and clinical course of this previously uncommon fungus was determined, and representative cases were chosen for illustration.RESULTS: More than 130 cases were recorded in the six‐year period from late 1999 to mid‐July 2006. The number of cases increased steadily over this period, but appears to be levelling off. Representative cases with medical imaging, along with photos of the pathology, are included. Recommendations for diagnosis, treatment and follow‐up are outlined.CONCLUSIONS: The emergence of cryptococcal lung and central nervous system lesions on Vancouver Island have made it important to include travel to or residence of the island as part of the history in patients with pulmonary nodules. A registry of patients from Vancouver Island has been established, and it may be of value to include nonisland patients who are found to be infected with this organism.
Low Prevalence ofHelicobacter PyloriInfection in Canadian Children: A Cross-Sectional Analysis
Authors: Segal Idit , Otley Anthony , Issenman Robert , Armstrong David , Espinosa Victor , Cawdron Ruth , Morshed Muhammad G , Jacobson Kevan 
Published: March 2016

BACKGROUND: The incidence and prevalence rates of childhoodHelicobacter pyloriinfection vary greatly by nation, with infection rates of 8.9% to 72.8% reported in developed and developing countries, respectively. To date, few studies have assessed the prevalence ofH pyloriin Canadian children, with studies limited to Aboriginal communities and single tertiary care centres from Ontario and Quebec.OBJECTIVES: To determine the prevalence ofH pyloriin consecutive children referred to three Canadian tertiary care academic centres for upper gastrointestinal (GI) endoscopy due to upper GI symptoms, and to determine the sensitivity and specificity of the carbon-13-labelled urea breath test, the rapid urease test and theH pyloristool monoclonal antigen test.RESULTS: Two hundred four patients were recruited. The prevalence ofH pyloriwas 7.1%. Of theH pylori-positive patients, 41.7% were male, with a mean age of 10.3 years. Ethnic minorities accounted for 42% of theH pylori-positive patients. Consistent with previous observations, the sensitivity and specificity of the carbon-13-labelled urea breath test were 1.0 and 0.98, respectively. The sensitivity and specificity of the rapid urease test were 1.0 and 0.99, respectively. Stool samples were collected from 34 patients from one centre, with a sensitivity and specificity of 1.0 and 0.68, respectively. No defining symptoms ofH pyloriinfection were evident and no peptic ulcer disease was demonstrated.CONCLUSION:H pyloriinfection rates in Canadian children with upper GI symptoms are low, and are lower than those reported for other developed countries. Further studies are required in Canada to determine the prevalence in the general population and specifically in the populations at risk.
Hepatitis A and Hepatitis B Vaccination Responses in Persons with Chronic Hepatitis C Infections: A Review of the Evidence and Current Recommendations
Authors: Buxton Jane A , Kim Jin Hee 
Published: March 2016

In persons with chronic hepatitis C virus (HCV) infections, superinfection by hepatitis A virus (HAV) or hepatitis B virus (HBV) can cause serious complications, including fulminating hepatitis or increased severity of hepatitis. Therefore, it is important to adequately protect persons with chronic HCV infections by immunization. Suboptimal response to vaccines has been reported in patients with chronic liver disease. The present article reviews HAV and HBV vaccine responses reported in the literature when administered to individuals with chronic HCV infection, and reviews current national and international recommendations.RESULTS: Persons with chronic HCV respond well to HAV vaccine, but studies exploring HBV vaccine efficacy in this population have equivocal results. Vaccine schedules and participant characteristics differ among studies, and most do not adjust for confounders. Some studies found no difference in HBV vaccine response between patients with chronic HCV and controls. However, HBV vaccine response was generally reduced in those with cirrhosis and HCV genotype 1. Organizations recommend HAV and HBV vaccines for persons with chronic HCV, but do not suggest alterations in schedule or dose.RECOMMENDATIONS: Because HAV vaccine response is good and routine laboratory testing may not detect lower levels of vaccine‐induced anti‐HAV, the standard HAV vaccine schedule is recommended without postimmunization testing. HBV vaccine should be administered early in the course of chronic HCV infection because response may be lower in patients with cirrhosis. Reflex testing of anti‐HCV reactive sera for anti‐HAV and hepatitis B surface antibody can facilitate appropriate follow‐up and timely immunization. Determination of postimmunization hepatitis B surface antibody, especially in patients with cirrhosis or genotype 1, will allow HBV vaccine boosters to be offered.
Childhood Asthma Surveillance using Administrative Data: Consistency between Medical Billing and Hospital Discharge Diagnoses
Authors: Labrèche France , Kosatsky Tom , Przybysz Raymond 
Published: March 2016

BACKGROUND: The absence of ongoing surveillance for childhood asthma in Montreal, Quebec, prompted the present investigation to assess the validity and practicality of administrative databases as a foundation for surveillance.OBJECTIVE: To explore the consistency between cases of asthma identified through physician billings compared with hospital discharge summaries.METHODS: Rates of service use for asthma in 1998 among Montreal children aged one, four and eight years were estimated. Correspondence between the two databases (physician billing claims versus medical billing claims) were explored during three different time periods: the first day of hospitalization, during the entire hospital stay, and during the hospital stay plus a one‐day margin before admission and after discharge (‘hospital stay ± 1 day’).RESULTS: During 1998, 7.6% of Montreal children consulted a physician for asthma at least once and 0.6% were hospitalized with a principal diagnosis of asthma. There were no contemporaneous physician billings for asthma ‘in hospital’ during hospital stay ± 1 day for 22% of hospitalizations in which asthma was the primary diagnosis recorded at discharge. Conversely, among children with a physician billing for asthma ‘in hospital’, 66% were found to have a contemporaneous in‐hospital record of a stay for ‘asthma’.CONCLUSIONS: Both databases of hospital and medical billing claims are useful for estimating rates of hospitalization for asthma in children. The potential for diagnostic imprecision is of concern, especially if capturing the exact number of uses is more important than establishing patterns of use.