bluuebunny/crossref_metadata_2025_split huggingface dataset:
Variations in Smoking Policies on Psychiatric Units
Authors: Hamera Edna , Williams Gail J. , Pelan Jackie M. , Agnew Deborah 
Published: January 2017

BACKGROUND: The high prevalence of smoking among clients with psychiatric disorders and the effect of smoking on metabolism of psychiatric medications has been documented. Implementation of inpatient smoking policies that alter smoking patterns may affect symptom presentation and medication metabolism. OBJECTIVE: Variations in how smoking policies are implemented on psychiatric units are described. DESIGN: A telephone survey of nurses working on 32 psychiatric units was used to collect information about how smoking policies were implemented. RESULTS: Most (n = 23) units allowed smoking only in designated areas outside the facility. Smoking frequency varied widely, ranging from twice a day to anytime, and some units placed restrictions on the number of cigarettes that could be smoked at each opportunity. CONCLUSION: The large variation in how smoking policies are implemented warrants further research. Smoking policies may alter smoking practices that affect psychotropic medication blood levels, side effects, and symptom presentation.
Figurate Erythema: An Unusual Presentation of the Nonbullous Phase of Bullous Pemphigoid
Authors: Mussani Farheen , Siddha Sanjay , Rosen Cheryl F. 
Published: January 2017

Background and Objective: Bullous pemphigoid, an autoimmune disorder, most commonly presents as a bullous eruption in patients over the age of 60. There may be a prodromal urticarial or papular eruption that evolves to bullae. Conclusion: We report a 46-year-old woman with a figurate erythema presentation of bullous pemphigoid.
Lupus Erythematosus–Associated Primary and Secondary Anetoderma
Authors: Haider Mansoor , Alenazi Madallah , Almutawa Abdulmonem , Alfadley Abdullah 
Published: January 2017

Background: Anetoderma (focal loss of dermal elastic tissue) can either be primary, which is an idiopathic occurrence of anetoderma in normal areas of the skin, or secondary, which is preceded by an inflammatory dermatosis in the same location. Objective: Sporadic reports of lupus erythematosus-associated anetoderma have been described in the literature. All reported cases were positive for antiphospholipid antibodies. We present a patient with primary and secondary anetoderma with chronic lupus dermatitis and negative antiphospholipid antibodies. Method and Results: A middle-aged woman presented with a soft nodule with a wrinkled surface on her left arm and an erythematous atrophic plaque with a nodular surface on the chest. Skin biopsy from the left arm showed epidermal atrophy without inflammatory changes. Histologic findings of the lesion on the chest were consistent with chronic lupus dermatitis and secondary anetoderma. Laboratory investigations showed positive antinuclear antibody anti-double-stranded deoxyribonucleic acid (DNA) antibody but negative antiphospholipid antibodies. Conclusion: Primary and secondary anetodermas may occur in patients of lupus dermatitis without positive antiphospholipid antibodies.
Use of Mark-Recapture Techniques to Estimate the Size of Hard-to-Reach Populations
Authors: Bloor Michael , Wood Fiona , Palmer Stephen 
Published: January 2017

Objectives: To review the main problems associated with mark—recapture methods of population estimation, and to indicate some practical strategies for addressing these problems, with illustrations from a study of drug-use prevalence across Wales. Methods: Unnamed identifier data were collected in 1994 on 2610 drug users who were in contact with various agencies across Wales: the police, drug treatment agencies, needle exchanges, probation services, and agencies reporting to the Welsh Drugs Misuse Database. Results: Based on the dependency relationships between different agencies' datasets, different estimates of the ‘hidden’ populations (not in contact with agencies) were modelled for each county, for males and females, for injecting drug users and serious drug users, and for those under 25 and those over 25 years of age. Different models were also constructed for the same subpopulations, using different agency datasets and different criteria of overlap between them, yielding a total of 230 different models. Conclusions: The issues of sample heterogeneity and population definition are particularly intractable in mark—recapture studies. Sample heterogeneity may be partly addressed by separately modelling different subpopulations to check whether they show the same dependency relationships as the main population. Population definition may be partly addressed by restricting modelling to datasets thought to share roughly congruent population definitions.
Acute Appendicitis: The Reliability of Diagnosis by Clinical Assessment Alone
Authors: Kalliakmanis V. , Pikoulis E. , Karavokyros I. G. , Felekouras E. , Morfaki P. , Haralambopoulou G. , Panogiorgou T. , Gougoudi E. , Diamantis T. , Leppäniemi A. , Tsigris C. 
Published: January 2017

Background and Aims: This prospective study aimed to review the trustworthiness of the initial clinical assessment in acute appendicitis without employment of imaging modalities, laparoscopy or any other adjunct diagnostic test. Patients and Methods: 717 patients were operated on for appendicitis by six different surgeons. Initial clinical and laboratory examination were evaluated in relation to the intraoperative and the pathological appreciation of the appendiceal inflammation. Results: 598 patients were found to have appendicitis, 34 a different condition, 41 had both appendicitis and an additional condition and 44 no pathology. 6% of the laparotomies and 11 % of the appendectomies were unnecessary. The severity of the inflammation correlated significantly with periumbilical pain, pain migrating to right lower quadrant, loss of appetite, fever, rebound tenderness, local rigidity, polymorphonuclear predominance on deferential, polymorhonucleosis and leukocytosis. Leukocytosis was less frequent in aged patients. All the six surgeons were found to be equally reliable, although they all underestimated the setting compared to the pathologists. Patients with a long duration of symptoms had milder forms of inflammation and increased percentage of unanticipated abdominal conditions. Conclusions: Appendicitis can be reliably diagnosed clinically without employment of adjunct tests. These can be reserved for equivocal cases.
Epidemiologic Aspects of Complete Rectal Prolapse
Authors: Kairaluoma M. V. , Kellokumpu I. H. 
Published: January 2017

Background and Aims: This study was undertaken to find out the incidence of rectal prolapse. Material and Methods: Ninety-nine patients operated on for rectal prolapse at Jyvaskyla Central Hospital were studied. Patients operated between 1988 and 1998 were studied retrospectively from hospital records using chart review and thirty-five patients operated on between 1999 and 2002 were studied prospectively using our proctologic database. Results: The annual incidence of diagnosed complete rectal prolapse in the district of Central Finland was mean 2.5 (range, 0.79–6.08) per 100 000 population. There were ten men (10 percent) and 89 women (90 percent). Median age of the patients was 69 (range, 21–91) years. Forty-eight percent of the patients had concomitant cardiovascular disease and 15 percent psychiatric illness. Anal incontinence affecting quality of life was seen in 64 percent and constipation in 72 percent of patients. Constipation tended to be more attributed to difficult evacuation (72 percent) than to impaired bowel action (18 percent). Conclusion: The annual incidence of rectal prolapse is 2.5 per 100 000 population. Rectal prolapse is associated with anal incontinence and constipation in majority of patients.
What to Do When Evidence is Lacking — Implications on Treatment of Aortic Ulcers, Pseudoaneurysms and Aorto-Enteric Fistulae
Authors: Lindblad B. , Holst J. , Kölbel T. , Ivancev K. ,   The Malmö Vascular Centre Group
Published: January 2017

Present knowledge on natural history and how to treat penetrating aortic ulcers or different forms of pseudoaneurysms with or without infection is limited as there are only case reports and small series of unusual aortic pathology and its treatment available. Material: From our centre we collected 65 patients treated with open (n=15) or endovascular reconstruction (n=50) during a 20-year period in the abdominal aorta. These patients are presented including a review of contemporary treatment. Results: Endovascular reconstructions seem to reduce morbidity and mortality compared to otherwise extensive open surgery. Even for patients with infectious etiology (mycotic aneurysms, aorto-enteric fistula) endovascular treatment may be a first-hand option bridging to a more elective open repair. However, a large proportion of patients being unfit for further open surgery were solely treated endovascularly and had no major infectious complications in the follow-up. Registers of cases with unusual aortic pathology, not only of those treated but also of those managed conservatively, are needed to define who to treat and if endovascular or open repair should be recommended. Conclusion: Endovascular technique is a promising technique for treatment of aortic pseudoaneurysms of different etiologies. We firmly recommend, despite the lack of evidence, that the work up of patients with penetrating aortic ulcers, mycotic or other types of pseudoanerysms as well as aorto-enteric fistulae should enclose both endovascular and open (or combined) treatment modalities. However, our knowledge of the natural history is limited. Therefore, registers of cases with unusual aortic pathology, not only of those treated but also of those managed conservatively, are needed to define who to treat and if endovascular or open repair should be recommended.
A Study of Surgically Resected Peripheral Non-Small Cell Lung Cancer with a Tumor Diameter of 1.0 CM or Less
Authors: Baba T. , Uramoto H. , Kuwata T. , Oka S. , Shigematsu Y. , Nagata Y. , Shimokawa H. , Takenoyama M. , Hanagiri T. , Tanaka F. 
Published: January 2017

Background and Aims: The widespread use of high resolution computed tomography has increased the number of small peripheral lung cancers. This study reviewed the clinicopathological features of the patients with non-small cell lung cancer (NSCLC) with a tumor diameter of 1 cm or less, in order to explore the adequate management of such small sized lung cancers. Material and Methods: This study was a retrospective analysis of consecutive 58 patients (5.3% out of 1095 patients) who underwent a complete resection for a peripheral NSCLC with a diameter of 1.0 cm or less. The clinical features and outcomes were compared with 203 patients with NSCLC with a diameter between 1.1 and 2.0 cm. Results: The mean age was 64.5 years and there were 26 males and 32 females. Clinical stage was IA in 57 (98%) and IIIA in 1. Lobectomy was performed in 39 patients, segmentectomy in nine, and nonanatomic wedge resection in ten. Two patients, who underwent systemic lymph node dissection, had mediastinal lymph node metastasis and were diagnosed as pathological stage IIIA; however they did not relapse after surgery. One patient with pathological stage IA papillary adenocarcinoma died due to brain metastases. The five-year overall survival rate and disease free survival rate was 95.0% and 95.3%, respectively. Patients with NSCLC of 1.0 cm or less showed significantly better survival than those with tumors measuring 1.1–2.0 cm in size (p = 0.048). Discussion: The indications for avoiding systemic lymph node dissection for operable NSCLC should not be based on the size of the tumor. A small-sized lung cancer might be surgically treated before the tumor enlarges to more than 1.0 cm in size.
Magnetic Resonance Imaging of Acute Scrotum
Authors: Mäkelä E. , Lahdes-Vasama T. , Ryymin P. , Kähärä V. , Suvanto J. , Kangasniemi M. , Kaipia A. 
Published: January 2017

Background and Aims: The aim of the pilot study was to evaluate the feasibility of dynamic contrast enhanced (CE)-magnetic resonance imaging (MRI) in the detection of testicular ischemia and its ability to differentiate testicle torsion from other causes of acute scrotum. Material and Methods: Seventeen boys or young men with an acute scrotum were included in the prospective study during the time period from October 2001 to December 2005. The median age of the patients was 16,4 (7–44) years. The duration of the symptoms preceding the MRI study varied from six hours to 30 days. The study protocol included physical examination by a surgeon, laboratory tests and Doppler ultrasound (DUS) and finally testicles were imaged by using a 1,5 T MRI scanner; T1-weighted and diffusion weighted images were produced. The gadolinium uptake, reported as the region of interest (ROI) perfusion values and presented as curves, was compared between the affected and contralateral testicle. In testicles with normal blood circulation the ROI values increased during the imaging time. Nine patients were operated on, because the spermatic cord torsion could not be excluded by clinical or DUS findings. Results and Conclusions: All the normal testicles gave increasing ROI values meanwhile all three testicles with torsion gave constantly low values referring to no perfusion. Other causes of acute scrotum, such as epididymitis and torsion of testicular appendage seemed to be related with normal perfusion. Dynamic CE-MRI seems to show reliably ischemia of testicle and thus it may be helpful in selecting patients with acute scrotum for urgent operation.
Predictors of Organ Donation Behavior among Hispanic Americans
Authors: Alvaro Eusebio M. , Jones Sara Pace , Robles Antonio Santa Maria , Siegel Jason T. 
Published: January 2017

Context Hispanic Americans have a substantial need for organ transplants and are underrepresented among organ donors, yet little is known about predictors of organ donation outcomes in this population. Objective To assess factors that may function as significant predictors of organ donation behavior among Hispanic Americans. Design A random-digit-dial computer-assisted telephone-interview survey. Setting Pima and Maricopa counties in Arizona. Participants 1200 Hispanic Americans. Main Outcome Measures Family discussion of organ donation and willingness to be an organ donor. Results Significant predictors of family discussion of organ donation include knowing someone willing to be an organ donor and disagreeing that carrying a donor card results in inadequate medical care. Willingness to be a donor is also predictive of family discussion. Significant predictors of willingness to be an organ donor are knowing someone willing to be an organ donor, being female, and disagreeing that thoughts about donation leads to thoughts about one's own mortality. Having a family discussion about organ donation is also predictive of willingness to be an organ donor. Conclusion The data provide a springboard for larger studies encompassing the diversity and geographical dispersion of Hispanic Americans. The data also highlight the importance of educational efforts to make Hispanic Americans aware of people in their community who have donated in the past or who are now potential donors.
Longitudinal Impact of Mindfulness Meditation on Illness Burden in Solid-Organ Transplant Recipients
Authors: Kreitzer Mary Jo , Gross Cynthia R. , Ye Xin , Russas Valerie , Treesak Charoen 
Published: January 2017

Background In 2001, more than 24000 solid-organ transplant surgeries were performed in the United States. Although survival rates have steadily risen over the past 2 decades, transplant recipients commonly experience a myriad of symptoms after transplantation that compromise quality of life. Anxiety, depression, and insomnia frequently occur despite excellent function of the transplanted organ. Use of complementary and alternative medicine has risen sharply over the past 10 years, particularly among people with chronic illnesses. Methods Twenty solid-organ transplant recipients were enrolled in a clinical trial of mindfulness-based stress reduction. During the 8-week course, subjects learned various forms of meditation and gentle hatha yoga. Participants were given audiotapes for home practice and maintained practice diaries. Longitudinal analysis focused on the impact of mindfulness-based stress reduction on symptom management, illness intrusion, and transplant-related stressors. Results Significant improvements in the quality and duration of sleep continued for 6 months after completion of the mindfulness-based stress reduction course. Improvements after the completion of the course were also noted in self-report measures of anxiety and depression. Conclusions Mindfulness-based stress reduction is an effective treatment in improving the quality and duration of sleep. Because sleep is highly correlated with positive mental health and overall well-being, these findings suggest that mindfulness-based stress reduction has the potential of being an effective, accessible and low-cost intervention that could significantly change transplant recipients' overall health and well-being.
An Intelligent Catheter System Robotic Controlled Catheter System
Authors: Negoro M. , Tanimoto M. , Arai F. , Fukuda T. , Fukasaku K. , Takahashi I. , Miyachi S. 
Published: January 2017

We have developed a novel catheter system, an intelligent catheter system, which is able to control a catheter by an externally-placed controller This system has made from master-slave mechanism and has following three components; 1) a joy stick as a master (for operators) 2) a catheter controller as a slave (for a patient), 3) a micro force sensor as a sensing device. This catheter tele-guiding system has abilities to perform intravascular procedures from the distant places. It may help to reduce the radiation exposures to the operators and also to help train young doctors.
Long Term Angiographical Follow-up of Cerebral Aneurysms after Coil Embolization
Authors: Kaku Y. , Hayashi K. , Sawada M. , Sakai N. 
Published: January 2017

We evaluated long-term angiographical follow-up of cerebral aneurysms treated with detachable platinum coils with special reference to the long-term morphological outcomes of incompletely obliterated aneurysms. Serial long-term follow-up cerebral angiograms (>1 year) were obtained in 47 cases out of 134 cases treated with GDCs or IDCs from 1994 to 1999. In 47 patients, intial angiographical results demonstrated ten complete aneurysmal occlusion, seven aneurysms with a small neck remnant, twenty aneurysms with body filling and ten aneurysms with both of neck remnant and body filling. In the ten completely obliterated aneurysms, follow-up angiograms revealed no aneurysmal recanalization. In seven aneurysms with neck remnant, three remained unchanged, four showed enlargement of contrast filling in the part of the neck of the aneurysm. In twenty aneurysms with body filling, five had developed into complete obliteration, three remained unchanged, 11 had recanalization, and one aneurysm displayed regrowth. In ten aneurysms with both of neck remnant and body filling, two remained unchanged, five had recanalization, and three aneurysms displayed regrowth. Long-term angiographical follow-up results are less satisfactory in cases involving incompletely obliterated lesions. A higher incidence of recanalizations were promoted in cases with neck remnant and/or body filling. Strict follow-up angiography is mandatory when a complete obliteration is not achieved.
Stent Assisted Coil Embolization: The Treatment of Wide-Necked, Dissecting, and Fusiform Aneurysms
Authors: Irie K. , Negoro M. , Hayakawa M. , Eayashi J. , Kanno T. 
Published: January 2017

Stent assisted coil embolization is a useful therapeutic modality for wide-necked and geometrically difficult aneurysms, as the stent provide a buttress that allows for coil deposition while preventing coil haerniation into the parent vessel lumen, and placement of an endovascular stent within the parent artery across the aneurysm neck may divert the blood from the aneurysm inflow tract and promote intra-aneurysm stasis and thrombosis. We report herein a 3 patients treated with endovascular stent-assisted coil embolization for symptomatic or enlarging wide-necked, dissecting, and fusiform aneurysms of the carotid and vertebrobasilar arteries. One patient had intracranial mass effect, the second had subarachnoid haemorrhage, and the third had angiographic evidence of enlarging aneurysm. The aneurysm was located in the petrous segment of internal carotid artery in one patient and in the intracranial vertebral artery in the other two patients. For all patients, we used balloon expandable stent (such as GFX, S-670) in this technique. Complete obliteration of the aneurysms could be achieved in all cases, with preservation of distal circulation.
Treatment of Carotid Cavernous Fistula Secondary to Rupture of a Giant Intracavernous Carotid Aneurysm
Authors: Kam C.K. , Alvarez H. , Lasjaunias P. 
Published: January 2017

Carotid cavernous fistula secondary to ruptured giant intracavernous aneurysm of the internal carotid artery is rare. We report a case of direct carotid cavernous fistula secondary to rupture of a giant intracavernous ICA aneurysm. The presence of mirror or twin aneurysms of bilateral ophthalmic arteries raises therapeutic challenge. Coiling of the intracavernous aneurysm could partially occlude the fistula. Complete closure of the fistula was facilitated by secondary carotid compression.
Endovascular Treatment of Brain Arteriovenous Malformations Using Onyx: Preliminary Results of a Prospective Multicenter Study
Authors: Pierot L. , Januel A. C. , Herbreteau D. , Barreau X. , Drouineau J. , Berge J. , Sourour N. , Cognard C. 
Published: January 2017

The main final goal of the treatment of brain AVMs is to prevent bleeding and to obtain a complete occlusion of the nidus. The strategy of treatment of brain arteriovenous malformations (AVM) has to be defined by a multidisciplinary team and will usually combine several modalities (surgery, radiosurgery, embolization). Embolization is generally the first step of treatment. Occasionally embolization is able to completely occlude a small AVM. Otherwise embolization is the first step before surgery or radiosurgery. Several embolic agents have been proposed for embolization of brain AVMs like particles or cyanoacrylates. The main disadvantage of particles is the high frequency of recanalization. The cyanoacrylates are probably more appropriate, providing a permanent occlusion. However, due to the polymerizing characteristics of the glue, the time of injection is relatively short (few seconds or minutes) and a complete or substantial occlusion of the nidus is difficult to obtain, especially in the case of medium or largesized AVMs. Onyx is a nonadhesive liquid polymer made of a mixture of ethylene-vinyl-alcohol copolymer and dimethylsulfoxide. The theoretical advantage of a nonadhesive liquid is to eliminate the risk of gluing the microcatheter and subsequently to perform a more durable injection with a larger amounts of agent delivered in a single injection. Several French centers have undertaken a prospective, multicentric study to evaluate the clinical value of Onyx in embolization of brain AVMs. As required, 50 patients were included. Preliminary results are presented regarding the first 48 patients, the last 2 patients being included after writing of this paper. The treatment is now completed in 15 patients. As expected, it was possible with Onyx to perform long duration injections (5 to 70 minutes with a mean of 34 minutes). Volumes injected per session were also important (0.25 to 6 ml with a mean of 1.6 ml). According to the clinical experience of the centers, duration and volume injected were most important with Onyx than with cyanoacrylates. Out of the 15 patients for whom embolization is now completed, 14 had a percentage of occlusion of the nidus greater than 60% (with 2 complete occlusion).