bluuebunny/crossref_metadata_2025_split huggingface dataset:
Juvenile systemic lupus erythematosus in Turkey: demographic, clinical and laboratory features with disease activity and outcome
Authors: Sahin S , Adrovic A , Barut K , Canpolat N , Ozluk Y , Kilicaslan I , Caliskan S , Sever L , Kasapcopur O 
Published: December 2017

Objectives This paper aims to assess in a retrospective fashion the clinical and laboratory features, severity and outcome of juvenile systemic lupus erythematosus (jSLE) from a referral center in Turkey. Methods We have included all jSLE patients ( n = 92) diagnosed according to the revised American College of Rheumatology 1997 criteria between January 2004 and January 2017. Results The most prevalent clinical feature in our cohort was mucocutaneous manifestations (97.8%), followed by constitutional (81.5%), hematological (59.8%) and musculoskeletal manifestations (56.5%). Renal involvement was observed in 38% ( n = 35) of the patients, whereas biopsy-proven lupus nephritis was detected in 29.3% ( n = 27) of the cohort. Neurologic involvement was seen in 15 (16.3%) individuals. Among the patients positive for anticardiolipin IgM and/or IgG ( n = 11, 12%), only three developed antiphospholipid antibody syndrome. The mean SLEDAI-2K scores at disease onset (10.5 ± 4.8) showed a substantial decrease at last visit (4.3 ± 4.6). One-quarter of the patients (26.1%, n = 24) had damage according to the PedSDI criteria with a mean score of 0.45 ± 1.0 (range 0–7). When the PedSDI damage items were evaluated individually, growth failure was the most frequent damage criterion ( n = 6), followed by seizure ( n = 5). Two patients died during the designated study period of end-stage renal disease. The five-year and 10-year survival rate of our cohort was 100% and 94.4%, respectively. Conclusions Given the lower frequency of nephritis and central nervous system disease and lower basal disease activity and damage scores, we could conclude that children with jSLE in Turkey have a more favorable course compared to Asian and African American children, as expected from Caucasian ethnicity.
Retrospective study of the presentation, diagnosis and management of 16 cats with otitis media not due to nasopharyngeal polyp
Authors: Swales Nicola , Foster Aiden , Barnard Natalie 
Published: December 2017

Objectives The aim of this study was to analyse retrospectively cats diagnosed with otitis media (OM) not due to nasopharyngeal polyp, and to review the clinical outcome with surgical and medical management. Methods Patient records were searched for cats diagnosed with OM. The diagnosis of OM was based on the presence of clinical signs, including neurological signs, respiratory signs and signs of otitis externa, and on the basis of evidence of thickened or irregular bullae walls, or the presence of fluid within the tympanic cavity in those that had diagnostic imaging. In those that did not have imaging, the diagnosis was made on the basis of the presence of fluid in the bulla or organisms cultured using myringotomy. These records were analysed retrospectively. Results Of 16 cats, one had a total ear canal ablation, five had ventral bulla osteotomy surgery and 11 were medically managed. Of the cats that were medically managed, using either topical products, systemic antimicrobials or a combination of both, eight had complete resolution of clinical signs. Conclusions and relevance This small cohort shows that some cats with OM can be successfully managed medically. Surgery is invasive and may not necessarily be required if appropriate medical management is undertaken. This is the first study of OM treatment in cats and provides the basis for further studies, which should aim to establish specific infectious causes of OM and how they can potentially be managed with medical therapies.
Evaluating the Prognostic Accuracy of Biomarkers for Glioblastoma Multiforme Using The Cancer Genome Atlas Data
Authors: Hu Nan , Cheng Haojie , Zhang Kevin , Jensen Randy 
Published: December 2017

Background: Glioblastoma multiforme (GBM) is the most common and aggressive primary brain tumor. Previous studies on GBM biomarkers focused on the effect of the biomarkers on overall survival (OS). Until now, no study has been published that evaluates the performance of biomarkers for prognosing OS. We examined the performance of microRNAs, gene expressions, gene signatures, and methylation that were previously identified to be prognostic. In addition, we investigated whether using clinical risk factors in combination with biomarkers can improve the prognostic performance. Methods: The Cancer Genome Atlas, which provides both biomarkers and OS information, was used in this study. The time-dependent receiver operating characteristic (ROC) curve was used to evaluate the prognostic accuracy. Results: For prognosis of OS by 2 years from diagnosis, the area under the ROC curve (AUC) of microRNAs, Mir21 and Mir222, was 0.550 and 0.625, respectively. When age was included in the risk prediction score of these biomarkers, the AUC increased to 0.719 and 0.701, respectively. The SAMSN1 gene expression attains an AUC of 0.563, and the “8-gene” signature identified by Bao achieves an AUC of 0.613. Conclusions: Although some biomarkers are significantly associated with OS, the ability of these biomarkers for prognosing OS events is limited. Incorporating clinical risk factors, such as age, can greatly improve the prognostic performance.
Bioinformatic Analysis of Circadian Expression of Oncogenes and Tumor Suppressor Genes
Authors: Salavaty Adrian , Mohammadi Niloufar , Shahmoradi Mozhdeh , Naderi Soorki Maryam 
Published: December 2017

Background: Circadian rhythms are physiological and behavioral cycles with a period of approximately 24 hours that control various functions including gene expression. Circadian disruption is associated with a variety of diseases, especially cancer. Although some of the oncogenes and tumor suppressor genes (TSGs) are known as clock-controlled genes (CCGs), the analysis and annotation of circadian expression of most human oncogenes and TSGs are still lacking. This study aims to investigate the circadian expression of a list of human oncogenes and TSGs. Methods: A bioinformatic analysis was conducted on a gene library comprising 120 genes to investigate the circadian expression of human oncogenes and TSGs. To achieve this purpose, the genotranscriptomic data were retrieved from COSMIC and analyzed by R statistical software. Furthermore, the acquired data were analyzed at the transcriptomic and proteomic levels using several publicly available databases. Also, the significance of all analyses was confirmed statistically. Results: Altogether, our results indicated that 7 human oncogenes/TSGs may be expressed and function in a circadian manner. These oncogenes/TSGs showed a circadian expression pattern at CircaDB database and associated with at least one of the circadian genes/CCGs based on both genotranscriptomic and correlation analyses. Conclusions: Although 4 of 7 finally outputted genes have been previously reported to be clock controlled, heretofore there is no report about the circadian expression of 3 other genes. Considering the importance of oncogenes/TSGs in the initiation and progression of cancer, further studies are suggested for the identification of exact circadian expression patterns of these 3 human oncogenes/TSGs.
Practice patterns to improve pre and post-transplant medication adherence in heart transplant centres: a secondary data analysis of the international BRIGHT study
Authors: Senft Yuliya , Kirsch Monika , Denhaerynck Kris , Dobbels Fabienne , Helmy Remon , Russell Cynthia L , Berben Lut , De Geest Sabina ,   on behalf of the BRIGHT study team, Crespo-Leiro Maria G , Cupples Sandra , De Simone Paolo , Groenewoud Albert , Kugler Christiane , Ohler Linda , Van Cleemput Johan , Poncelet Alain Jean , Sebbag Laurent , Michel Magali , Bernard Andrée , Doesch Andreas , Livi Ugolino , Manfredini Valentina , Brossa-Loidi Vicens , Segovia-Cubero Javier , Almenar-Bonet Luis , Saint-Gerons Carmen Segura , Mohacsi Paul , Horvath Eva , Riotto Cheryl , Parry Gareth , Firouzi Ashi , Kozuszko Stella , Haddad Haissam , Kaan Annemarie , Fisher Grant , Miller Tara , Flattery Maureen , Ludrosky Kristin , Coleman Bernice , Trammell Jacqueline , St Clair Katherine , Kao Andrew , Molina Maria , Canales Karyn Ryan , de Almeida Samira Scalso , Ayoub Andrea Cotait , Barone Fernanda , Harkess Michelle , Maddicks-Law Joanne 
Published: December 2017

Background:As medication non-adherence is a major risk factor for poor post-transplant outcomes, we explored how adherence is assessed, enhanced and integrated across the transplant continuum.Aim:The aim of this study was to study practice patterns regarding pre- and post-transplant medication adherence assessment and interventions in international heart transplant centres.Methods:We used data from the Building Research Initiative Group: chronic illness management and adherence in heart transplantation (BRIGHT) study, a cross-sectional study conducted in 36 heart transplant centres in 11 countries. On a 27-item questionnaire, 100 clinicians (range one to five per centre) reported their practice patterns regarding adherence assessment and intervention strategies pre-transplant, immediately post-transplant, less than one year, and one or more year post-transplant. Educational/cognitive, counselling/behavioural and psychosocial/affective strategies were assessed. Clinicians’ responses (intervention present vs. absent; or incongruence in reporting intervention) were aggregated at the centre level.Results:The adherence assessment method most commonly used along the transplant continuum was questioning patients (range 75–88.9%). Pre-transplant, all three categories of intervention strategy were applied. Providing reading materials (82.9%) or instructions (68.6%), involving family or support persons in education (91.4%), and establishing partnership (91.4%) were used most frequently. Post-transplant, strategies closely resembled those employed pre-transplant. Training patients (during recovery) and cueing were more often applied during hospitalisation (74.3%). After the first year post-transplant, except for motivational interviewing (25.7–28.6%), the number of strategies decreased.Conclusions:Across the transplant continuum, diverse adherence interventions are implemented; however, post-transplant, the frequency of adherence interventions decreases. Therefore, increased investment is necessary in long-term adherence interventions.
Multimedia Education Reduces Anxiety in Lung Transplant Patients
Authors: Gerity Sandra L. , Silva Susan G. , Reynolds John M. , Hoffman Benson , Oermann Marilyn H. 
Published: December 2017

Context: A significant contribution to the success of lung transplantation is the recipient’s ability to self-manage a multidrug regimen and follow complex instructions. Effective education has always been an integral component of the process of preparing patients to care for themselves post lung transplant. Impaired cognition, anxiety, and psychological distress, however, can decrease the retention of posttransplant care information provided during education sessions. Objective: This quality improvement project evaluated whether a multimedia education method compared to standard education method improves posttransplant care knowledge, anxiety, and satisfaction with the education experience in lung transplant patients and their caregivers. Methods: Two education methods groups, comprised of transplant patients and their primary caregivers, were compared: (1) historic control group who received the standard education (n = 19 dyads) and (2) multimedia group who received the new multimedia education (n = 18 dyads). Knowledge of posttransplant care was evaluated in both groups before and after receiving the education. A satisfaction survey was administered at the end of the education program. Results: A significantly higher percentage of patients receiving the multimedia method reported gains in posttransplant care knowledge ( P = .05), less anxiety about the transplant surgery ( P = .02), and satisfaction with the education method ( P = .02) when compared to those receiving the standard method. Caregivers and transplant team member also indicated that the multimedia method was more effective than the standard method. Conclusion: Multimedia methods decrease anxiety and increase satisfaction with the education experience when preparing patients for lung transplantation.
The Need for Accurate Records
Authors: Pirie Susan 
Published: December 2017

Dear AfPP I have recently obtained a senior post in a hospital that is in a different part of the UK in relation to where I have always worked. I have become aware of differing practices, many of which are improving patient care. However, I am concerned that in this perioperative environment, there is no permanent record of items used during each case. The only records of the items used in any one case are those that are recorded on the swab board and the signatures of the staff who undertake the final count in the theatre register. In some of my previous jobs, we have recorded the count on a separate sheet that was then filed in the patients' notes by the scrub practitioner of the case, thus providing a permanent record of the count in the patients' notes. Can AfPP advise on whether a record in the patients' notes is necessary? Concerned from County Armagh
Mentorship: The Experiences of a Tutor in a Pre-registration Operating Department Practice Education Programme
Authors: Hinton Jean 
Published: December 2017

Introduction The author is a theatre nurse with more than twenty years experience of perioperative care. For the majority of her time in clinical practice the author was involved in the training and education of both student nurses and student operating department practitioners (ODPs). This involvement started, following training, as a mentor and assessor for both groups of students, leading to the position of internal verifier for the NVQ programmes for ODPs and perioperative health support workers. This experience in education and training led to promotion as training co-ordinator for the critical care directorate of a busy district general hospital. For the past seven years the author has been employed as a senior lecturer on a three year ODP pre-registration programme at a North West university.
Thyroid Eye Disease
Authors: Modi Neil C , James Jennifer , Sleep Tamsin 
Published: December 2017

Introduction Thyroid eye disease (TED), also known as Graves opthalmopathy is the most common orbital disease and affects 25–50% of patients with Graves' disease (Kuryan et al 2008). Most patients are only mildly affected, suffering ocular irritation with redness and watering, ‘staring eyes' due to retraction of the eyelids, exophthalmos (protrusion of the eyeballs) and periorbital swelling (Figure 1). A minority of patients (around 28%) will develop ocular motility problems, leading to diplopia (double vision), exposure/damage to the cornea and optic neuropathy (Kumar & Clarke 2002, Forbes & Jackson 2003, Meyer 2006).
Perioperative Care Planning for a Down's Syndrome Patient
Authors: Hayes Julie 
Published: December 2017

Introduction This article will be looking specifically at caring for a Down's syndrome patient, and will focus on the specialist care that they may require throughout the perioperative environment. This article will therefore explain Down's syndrome and include the related characteristics and health problems associated with this condition, which will then be used to highlight specific areas of care which may need to be improvised in order to accommodate this condition within the operating theatre.
Preoperative Starvation in Elective General Surgery
Authors: Khoyratty Saleem , Modi Bhavik N , Ravichandran Duraisamy 
Published: December 2017

Objective Study preoperative fasting times of adult elective surgical patients. Methods Fasting times for food and clear fluids, and the information used by patients to decide when to start fasting were studied. Results Among 200 patients, median fasting times were 2–4 times the guideline recommendations. Most patients used hospital written instructions but many started fasting substantially earlier than the instructions stipulated. Discussion Improved communication with patients could improve fasting times.
Coming to a Theatre near you Soon ‘A Witnessed Cpr Event’
Authors: Turton Karen 
Published: December 2017

A current review of the last thirty years is indicative of improvement in outcome across surgical specialities with the implementation of safer working practices and initiatives in enhanced recovery, preparing patients to be ‘fit’ for surgery. The focus of training for nurses and operating department practitioners lies with assuring technical competence and the drive is to establish best practice based on evidence. Once qualified, training for professionals within the perioperative environment is developed to enable participation in areas of anaesthesia, surgery and recovery roles. Advanced, intermediate and basic life support as well as advanced scrub practitioner courses are available, further aspects for patient safety have been implemented and pathways developed.
… It's about the Journey!
Authors: Paduraru A 
Published: December 2017

The aim of this article is to discuss: the importance of effective communication, the importance of maintaining confidentiality and equality for all individuals, the importance of maintaining a secure, safe and hygienic environment within the operating department, the principles of maintaining sterility and controlling infection, and the resulting hazards if these are not maintained. A paediatric patient was followed through her perioperative journey to find out if routinely, at the author's trust, the values of the NHS constitution – the six Cs – are being upheld.
Vulnerability in Perioperative Patients: A Qualitative Study
Authors: Cousley A 
Published: December 2017

The study aimed to explore perioperative practitioners’ knowledge, awareness and experiences of perioperative vulnerability in clinical practice. A qualitative descriptive design was used; data was obtained by conducting semi-structured interviews with ten perioperative practitioners over a two week period in July 2014. The study found that perioperative practitioners were aware of the concept of perioperative vulnerability and had varied experience of it in practice. Data analysis identified three main themes in relation to vulnerability: labels, recognition and management. We conclude that the concept of perioperative vulnerability exists in practice and that perioperative practitioners manage the concept effectively using strategies that promote positive outcomes. Please note: the term ‘practitioner’ and ‘nurse’ are used interchangeably and denote a professional who provides care in the perioperative clinical situation.
Topical Negative Pressure Therapy: Current Concepts and Practice
Authors: Malahias M , Hindocha S , Saedi F , Mcarthur P 
Published: December 2017

Research into topical negative pressure therapy (TNPT) started in 1989 with Dr Louis Argenta and Prof Michael Morykwas of Wake Forest University School of Medicine in North Carolina, USA. In 1997, Morykwas and Argenta concluded that TNPT both enhanced granulation tissue formation and helped bacterial clearance, through the actions of negative pressure Armstrong and Lavery confirmed this in 2005, concluding that TNPT therapy was promoting the development of granulation tissue Numerous other studies have proved that TNPT is beneficial for a myriad of other wounds including: sternotomy wounds, extensive de-gloving injuries, various soft tissue injuries prior to surgical closure), skin grafting, pressure sores, leg ulcers, sacral pressure ulcers, acute traumatic soft tissue defects, and soft tissue defects following rigid stabilisation of lower extremity fractures. This review aims to summarise the clinical and scientific concepts of TNPT and its future applications.
The Power of Elaine's Story: A Personal Reflection
Authors: Kamensky J 
Published: December 2017

There will be few perioperative students (nursing, ODP) or surgical and anaesthetic trainees, who will not have heard of the tragic case of Mrs Elaine Bromiley. A 37 year old mother of two, admitted for an elective endoscopic sinus surgery and septoplasty, Elaine suffered major complications during the induction of general anaesthesia that resulted in her death due to hypoxic brain damage (Harmer 2005). As a student ODP, watching the DVD of the reconstruction of the events that contributed to Elaine's death, I am conscious of the profound impact it had on me and the key learning points for practice.
Highly Virulent Pathogens - a Post Antibiotic Era?
Authors: Domin Michael A 
Published: December 2017

The spectrum of infectious diseases is changing rapidly. Emerging infectious agents present an intriguing constellation of nosocomial challenges. Antimicrobial resistance results in increased morbidity, mortality and costs of health care. Resistance to antimicrobial agents has been recorded since 1940 with penicillin resistant Escherichia coli (E coli) (Abraham and Chain 1940). A similar pencillin resistance was reported in 1944 in Staphylococus aureus (S. aureus) (Kirby 1944) Even before the widespread global use of penicillin, resistance had already been detected in both grampositive and gram-negative organisms. The 1990s herald the era of multiple drug resistance. To grasp further the enormity and complexity of our modern antimicrobial resistance problem, one only needs to think about how many - how fast -and in how many settings (hospitals, clinics, outpatients nursing and long term facilities, etc), these pathogens have developed antimicrobial resistance: Multiple drug-resistant Mycobacterium tuberculosis, penicillin-resistant Streptococcus pneumonia, fluconzole-resistant Candida, methicillin-resistant S. aureus (MRSA), vancomycin-resistant Enterococci (VRE) and now S. aureus with reduced susceptibility to vancomycin. Given the dramatic increase in the incidence of multiple drug-resistant organisms - and now - the mounting evidence of resistance transfer from one organism to another, we will certainly witness a combined growth of nosocomial pathogens, for which there are no antibiotic solutions. Appropriate infection control measures for such resistant strains depend, in part, on the mechanisms of genetic information exchanged among micro-organisms. Clearly we need to strengthen the basic tenets of infection prevention and control; hygiene, engineering and microbial barriers, to prevent transinfection. We need to control horizontal nosocomial transmission of organisms. Contaminated environmental surfaces are a reservoir for resistant organisms such as MRSA (Boyce et al 1997) and VRE (Karanfil et al 1992). Stringent infection control policies need to be developed and implemented. A comprehensively applied infection control programme will reduce the dissemination of resistant strains. Each patient care setting must examine its current practices and review the outcome efficacy. A consensus development conference to develop centres for disease control (CDC) formal guidelines against vancomycin intermediate-level resistant staphylococcus aureus (VISA) and vancomycin-resistant staphylococcus aureus (VRSA) may take a year or more to convene. This paper will examine the basic considerations currently offered by the CDC which may be valuable starting points for the enhancement of current infection control practices. Perspectives of the Society for Healthcare Epidemiology of America (SHEA) will also be included.