bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ebola or Not? Evaluating the Ill Traveler From Ebola-Affected Countries in West Africa
Authors: Fairley Jessica K. , Kozarsky Phyllis E. , Kraft Colleen S. , Guarner Jeannette , Steinberg James P. , Anderson Evan , Jacob Jesse T. , Meloy Patrick , Gillespie Darria , Espinoza Tamara R. , Isakov Alexander , Vanairsdale Sharon , Baker Esther , Wu Henry M. 
Published: January 2016

Abstract
Background.  The 2014–2015 Ebola epidemic in West Africa had global impact beyond the primarily affected countries of Guinea, Liberia, and Sierra Leone. Other countries, including the United States, encountered numerous patients who arrived from highly affected countries with fever or other signs or symptoms consistent with Ebola virus disease (EVD).
Methods.  We describe our experience evaluating 25 travelers who met the US Centers for Disease Control and Prevention case definition for a person under investigation (PUI) for EVD from July 20, 2014 to January 28, 2015. All patients were triaged and evaluated under the guidance of institutional protocols to the emergency department, outpatient tropical medicine clinic, or Emory's Ebola treatment unit. Strict attention to infection control and early involvement of public health authorities guided the safe evaluation of these patients.
Results.  None were diagnosed with EVD. Respiratory illnesses were common, and 8 (32%) PUI were confirmed to have influenza. Four patients (16%) were diagnosed with potentially life-threatening infections or conditions, including 3 with Plasmodium falciparum malaria and 1 with diabetic ketoacidosis.
Conclusions.  In addition to preparing for potential patients with EVD, Ebola assessment centers should consider other life-threatening conditions requiring urgent treatment, and travelers to affected countries should be strongly advised to seek pretravel counseling. Furthermore, attention to infection control in all aspects of PUI evaluation is paramount and has presented unique challenges. Lessons learned from our evaluation of potential patients with EVD can help inform preparations for future outbreaks of highly pathogenic communicable diseases.
Rumination, Magnification, and Helplessness
Authors: Craner Julia R. , Gilliam Wesley P. , Sperry Jeannie A. 
Published: January 2016

Objectives:
Although there is a large body of research on the relationship between pain catastrophizing and functioning among individuals with chronic pain, little is known about the potential differential impact of specific aspects of pain catastrophizing. The current study evaluates the relationship between the Rumination, Helplessness, and Magnification subscales of the Pain Catastrophizing Scale and pain-related outcomes.

Materials and Methods:
In total, 844 patients who were admitted to a chronic pain rehabilitation program completed survey measures of pain, catastrophizing, quality of life (QOL), and depression.

Results:
A series of analyses were conducted entering the 3 subscales simultaneously in a predictive model after pain intensity and demographic variables (ie, age, sex, pain duration, current opioid use). The Helplessness subscale accounted for unique variance in the prediction of pain severity, pain-related interference, mental and physical health-related QOL, and depressed mood. Magnification was significantly related to physical and mental health-related QOL and depressed mood. The Rumination subscale was not uniquely associated with any of the outcome measures beyond that which was accounted for by pain severity, magnification, or helplessness.

Discussion:
Pain catastrophizing is a multifaceted construct, and different domains of catastrophizing are uniquely related to pain-related outcomes. This study represents the first to evaluate the functioning of these subscales in a large, diagnostically heterogeneous sample of chronic pain patients.
Test-Retest Reliability of Maximal and Submaximal Gas Exchange Variables in Patients With Coronary Artery Disease
Authors: Coeckelberghs Ellen , Buys Roselien , Goetschalckx Kaatje , Pattyn Nele , Vanhees Luc , Cornelissen Véronique 
Published: January 2016

PURPOSE:
Gas exchange variables derived from cardiopulmonary exercise tests (CPETs) need to be reliable for evaluating interventions and clinical decision making. Whereas peak oxygen uptake (

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2) has shown to be a highly reliable parameter in patients with coronary artery disease (CAD), little is known about the reproducibility of these parameters in patients with CAD. Therefore, the purpose of this study was to confirm the reliability of peak

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2 and to investigate the reliability of submaximal CPET variables in patients with CAD.

METHODS:
Eighty-five patients with CAD (57.6 ± 8.5 years; 79 males) performed 2 CPETs within 10 days before starting a rehabilitation program. Reliability of peak and submaximal exercise variables was assessed by using intraclass correlation coefficients (ICC), coefficients of variation, Pearson correlation coefficients, paired t tests, and Bland-Altman plots.

RESULTS:
Maximal and submaximal exercise parameters showed adequate reliability. Overall, there was a good correlation across both testing occasions (r = 0.63-0.95; P < .05 for all). Peak

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2 (ICC, 0.95; 95% CI, 0.92-0.97) demonstrated excellent reliability. Of the submaximal exercise variables, oxygen uptake efficiency slope (OUES) was as reliable as peak

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2 (ICC, 0.97; 95% CI, 0.95-0.98). The ventilation/carbon dioxide production (

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2) slope showed very good test-retest reliability (ICC, 0.87; 95% CI, 0.80-0.91) and the

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2/work rate slope showed good reliability (ICC, 0.76; 95% CI, 0.64-0.85).

CONCLUSIONS:
Both peak

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2 and OUES show excellent test-retest reliability. Accordingly, in the case of no or unreliable peak

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2 data, we suggest using OUES to evaluate cardiorespiratory fitness in patients with CAD.
Overview of Objective Methods for Assessing Dynamic Changes in Optical Quality
Authors: Koh Shizuka , Higashiura Ritsuko , Maeda Naoyuki 
Published: January 2016

Abstract:Quality of vision has been emphasized in ophthalmologic clinical practice in recent years. The optical or visual performance of the human eye is not static and fluctuates over time. Considering the major origins of temporal fluctuations in optical or visual performance, quantitative assessment of the dynamic changes in the optical quality of the entire eye is important. This review provides an overview of the clinical application of the objective methods for assessing dynamic changes in optical quality, particularly those associated with accommodation, the precorneal tear film, the prelens tear film, and contact lens movement and fitting.
Optical Coherence Tomography Imaging of the Palisades of Vogt to Assist Clinical Evaluation and Surgical Planning in a Case of Limbal Stem-Cell Deficiency
Authors: Espandar Ladan , Steele Jessica F. , Lathrop Kira L. 
Published: January 2016

Purpose:
To describe the use of volumetric optical coherence tomography (OCT) imaging to assist evaluation of a patient referred for autologous limbal stem-cell transplant.

Methods:
This is a case report of a 50-year-old patient presenting with unilateral limbal stem-cell deficiency who was referred for autologous limbal stem-cell transplant. The presence of Salzmann nodules in the donor eye raised questions about the efficacy of transplantation, prompting examination of both eyes using volumetric OCT imaging to determine whether there were palisades of Vogt (POV) present. Image volumes were acquired in all clock hours and were compared against those of an age-matched normal subject.

Results:
Palisades were found in both eyes, although in both eyes there were fewer palisade ridges, and those that were present were not as distinct as those of the normal subject. The OCT volumes also showed that stromal scarring was present only in the anterior stroma of the intended transplant eye. These findings suggested that the patient may be able to sustain a deep anterior lamellar keratoplasty without an autologous transplant, which would spare any insult to the opposing eye and require less surgery to restore vision in the affected eye. Nine months postsurgical follow-up revealed significant improvement in visual acuity and no scar tissue development.

Conclusion:
The OCT evaluation of the POV provides detailed information to the clinician that may assist in diagnosis and evaluation of patients before transplantation. Further development of this technique is necessary to make it clinically available.
Chest Pain in the Setting of Altered Mental Status
Authors: Tjoeng Yuen Lie , Mickley Megan , Prentiss Kimball 
Published: January 2016

Abstract
We report on a young adult female presenting with altered mental status and chest pain. Timely review of her electronic medical record revealed a history of panhypopituitarism with poor medication adherence, although this was unknown at the time of her initial evaluation.
The patient required hormone replacement and significant fluid resuscitation, followed by definitive treatment with a pericardiocentesis. She was discharged home on hospital day 4, with normalization of her diminished left ventricular ejection fraction at her 1-month follow-up.
Although panhypopituitarism and cardiac tamponade are rare diagnoses, we highlight the management of severe hypothyroidism, the importance of early administration of hydrocortisone for panhypopituitarism, and the need for aggressive volume expansion to maintain preload in cardiac tamponade.
Subcutaneous Granuloma Annulare
Authors: Pederiva Federica , Paloni Giulia , Berti Irene 
Published: January 2016

Abstract
Subcutaneous granuloma annulare is an inflammatory lesion occurring in otherwise healthy children. We present 3 pediatric patients with different diagnostic-therapeutic paths depending on the ward they were referred to. The lesions regress spontaneously, and medical or surgical treatments are generally not necessary.
Adolescent Presents With Altered Mental Status and Elevated Anion Gap After Suicide Attempt by Ethylene Glycol Ingestion
Authors: Schoen Jessica C. , Cain Meghan R. , Robinson Jeffrey A. , Schiltz Brenda M. , Mannenbach Mark S. 
Published: January 2016

Abstract
We report the case of a 16-year-old healthy adolescent male who presented to the local emergency department with altered mental status. En route to a tertiary care facility, he began to decompensate and was found to be markedly acidotic. Further investigation revealed an elevated anion gap, and physical examination showed only abdominal pain and decreased level of consciousness. A broad differential diagnosis was considered at the time of the patient's presentation at the tertiary care center including ingestion of a volatile alcohol, sepsis, and an abdominal catastrophe. Although fomepizole and emergent dialysis were being initiated, laboratory tests confirmed ethylene glycol poisoning. This case demonstrates the importance of early recognition of potential ingestions in patients with altered mental status and supportive laboratory findings.
Under the Sea
Authors: Hansen Callie E. , Ascher David P. , Kim Hannah S. , Schwartz Richard H. 
Published: January 2016

Abstract
Traumatic abrasions on human extremities as a result of direct contact with sea, lake, river, or aquarium animals or from traumatic injuries sustained in seawater may develop into solitary or linear granulomatous lesions. One of the more common microbial etiologies for such infections is Mycobacterium marinum. An astute pediatrician, family physician, or nurse practitioner should have a high index of suspicion and obtain specific cultures to support the growth of Mycobacterium species. Mycobacterium marinum infections will not respond to antibiotics typically chosen to treat simple skin and soft tissue infections. Rather, M. marinum infections are best treated by prolonged antimicrobial treatment regimens for 3 to 6 months and, in some cases, may require polypharmacologic therapy. We present the case of a 6-year-old girl who suffered a traumatic abrasion on her right ankle in seawater. For 10 days, the skin infection morphed from cellulitis, papules, pustules, and eventually into sporotrichoid linear granuloma. After several failed antibiotic trials, M. marinum was eventually identified from the depth of her lesions. The patient improved after a 3-month course of clarithromycin. This case report is the first to include pictures demonstrating the clinical progression and resolution of M. marinum infection.
Plantar and Pedal Puncture Wounds in Children
Authors: Volk Angela , Zebda Mohamed , Abdelgawad Amr A. 
Published: January 2016

Objectives
The purpose of this study was to describe our experience in treatment of pediatric patient presenting with pedal puncture wound to our level I trauma center and describe our results for the need for hospitalization and/or surgery for these patients.

Methods
Children and adolescents 18 years and younger presenting with pedal puncture wounds from September 2009 to December of 2013 were retrospectively studied. Exclusion criteria included adult patients, wounds related to animal bites, lacerations associated with a motor vehicle collision or all-terrain vehicle accidents, gunshot wounds, degloving injuries, or injuries resulting in complex lacerations to the foot.

Results
A total of 147 children presented to emergency department (ED) with a pedal puncture wound. Average age was 9.8 years. Prophylactic antibiotic therapy was administered in 107 cases (72.8%). Fifteen patients (10%) were treated with intravenous or intramuscular antibiotics in the ED or after hospital admission, 81 patients (55%) were treated with oral medications (prescribed for them to be taken after discharge), and 35 patients (24%) received topical antibiotic treatment. Of the 147 patients included in the study, 9 patients (6%) required the need for hospitalization. Two patients were admitted for parenteral antibiotic treatment only, and 7 patients required formal surgical debridement in the operating room in addition to parenteral antibiotic therapy.

Conclusions
The majority of pediatric patients with pedal puncture wounds were treated in the ED with only a small percentage of patients requiring admission for either parenteral antibiotic treatment or formal surgical debridement.
Procalcitonin as a Marker of Bacteremia in Patients With Fever and Acute Lymphoblastic Leukemia
Authors: Vyles David , Gnagi Forrest , Bulloch Blake , Muenzer Jared , Hu Chengcheng 
Published: January 2016

Background
Children undergoing treatment for acute lymphoblastic leukemia (ALL) often present to the emergency department (ED) with a fever. They are at high risk of bacteremia secondary to being immunocompromised. Recent reports indicate that procalcitonin (PCT) is a useful marker of bacteremia in children.

Objective
Our objective was to evaluate the clinical utility of PCT as a rapid marker of bacteremia in children with ALL presenting to the ED with a fever. In addition, we compared the results of PCT with white blood cell (WBC) count, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP).

Methods
Retrospective chart reviews were conducted of 492 patients with a total of 735 visits presenting to the ED from January 2009 to June 2012 with fever and a history of ALL where a PCT and a blood culture (BC) were obtained,. Positive BCs determined to be contaminants were excluded. The predictive powers of PCT, WBC, ESR, and CRP for bacteremia were evaluated using the area under the receiver operating characteristic curve with 95% confidence intervals (CI). In addition, each of the 4 markers were also examined in a logistic regression model as a potential predictor of the BC result.

Results
A total of 735 PCT values were correlated with BC results. There were 76 (10.3%) true-positive BCs. The area under the receiver operating characteristic curve was 0.729 (95% CI, 0.661–0.792) for PCT, 0.685 (95% CI, 0.531–0.823) for ESR, 0.622 (95% CI, 0.460–0.796) for CRP, and 0.567 (95% CI, 0.483–0.649) for WBC. When logistic regression was used, the transformation log PCT was significantly associated with BC result whereas each of the other 3 markers, after appropriate transformation to remove heavy skewness, was not significant (all P > 0.1). A doubling of PCT was associated with an odds ratio of 1.32 for positive BCs (95% CI, 1.15–1.53).

Conclusions
Procalcitonin value was significantly associated with positive BC (P < 0.0001). The diagnostic performance of PCT was better than the other markers of inflammation. Its use in the ED in a select population of patients may be of significant value in identifying bacteremia. This has the potential to lead to a decrease in unwarranted use of antibiotics, hospital length of stay, and health care expenditures.
Aortic Root Size by Echocardiogram Compared With Computed Tomography in Adolescents With Pectus Excavatum
Authors: Arevalo Alejandro , Haddad Lauren , Johnson Jason , Jones Tamekia L. , Joshi Vijaya 
Published: January 2016

Purpose:
Aortic root dilation is a risk factor for aneurysm and dissection. Echocardiography (echo) is the most frequently used initial screening method for the aortic root, but computed tomography (CT) is a preferred modality because of the ability to reformat the images and obtain measurements without the technical limits of echo image acquisition. There are limited data comparing the 2 modalities in measuring the aortic root.

Materials and Methods:
This was a retrospective cohort study comparing echo with CT in measuring the aortic root and was conducted at a children’s hospital. Forty adolescents (range, 10 to 18 y) with pectus excavatum were evaluated.

Results:
In the majority of patients (68%), echo underestimated the aortic root size compared with the CT measurement by at least 1 SD. The average difference between the 2 modalities was 2.5 mm. There was a trend for a greater difference between modalities as the aortic root increased. The severity of the deformity by Haller index did not correlate with greater underestimation of the aortic root size. The shape of the aortic root, ranging from circular to ovoid, also did not contribute to the underestimation of aortic root size by echo.

Conclusions:
Echo can be used as a screening method for the aortic root, but it can underestimate the aortic root size when compared with CT measurements in pediatric patients with pectus excavatum. This difference was more profound as the diameter of the aortic root increased. Patients with dilated aortic roots on echocardiogram may benefit from biorthogonal measurements offered by other imaging modalities such as CT or magnetic resonance imaging.
Comparative analysis of treatment conditions upon psychiatric severity levels at two years among justice involved persons
Authors: Majer John M , Chapman Hannah M , Jason Leonard A 
Published: January 2016

Purpose
– The purpose of this paper is to compare the effects of two types of community-based, residential treatment programs among justice involved persons with dual diagnoses.

Design/methodology/approach
– A randomized clinical trial examined treatment conditions among justice involved persons with substance use disorders who reported high baseline levels of psychiatric severity indicative of diagnosable psychiatric comorbidity. Participants (n=39) were randomly assigned to one of three treatment conditions upon discharge from inpatient treatment for substance use disorders: a professionally staffed, integrated residential treatment setting (therapeutic community), a self-run residential setting (Oxford House), or a treatment-specific aftercare referral (usual care). Levels of psychiatric severity, a global estimate of current psychopathological problem severity, were measured at two years as the outcome.

Findings
– Participants randomly assigned to residential conditions reported significant reductions in psychiatric severity whereas those assigned to the usual care condition reported significant increases. There were no significant differences in psychiatric severity levels between residential conditions.

Research limitations/implications
– Findings suggest that cost-effective, self-run residential settings such as Oxford Houses provide benefits comparable to professionally run residential integrated treatments for justice involved persons who have dual diagnoses.

Social implications
– Results support the utilization of low-cost, community-based treatments for a highly marginalized population.

Originality/value
– Little is known about residential treatments that reduce psychiatric severity for this population. Results extend the body of knowledge regarding the effects of community-based, residential integrated treatment and the Oxford House model.
Drug therapy in ADHD in people with intellectual disabilities
Authors: Courtenay Kenneth , Elstner Samuel 
Published: January 2016

Purpose– Attention disorders in people with intellectual disabilities (ID) is common. Current drug treatments are based on the literature in people without ID. The purpose of this paper is to present a review of the drug treatment of Attention Deficit Hyperactivity Disorder (ADHD) in people with ID in the German and English languages literature with the aim of exploring the current evidence base.Design/methodology/approach– The paper provides a general review of the evidence base on drug treatment of ADHD in people with ID from the German and English language literature.Findings– Studies and practice guidance on ADHD in both languages are similar with more information published in English. Much of the evidence on drug therapy to treat ADHD in people with ID is based on studies in children. The literature on ADHD in children without ID is helpful but not specific to all people with ID who have ADHD. The response rates to medication to treat ADHD in people with ID are lower than in people without ID. The occurrence of side effects from medication is more common in people with ID. Co-morbid disorders are often present in people with ADHD that could affect study findings.Practical implications– Medication used to treat ADHD is effective when treating ADHD in people with ID. Prescribers should be aware of guidelines on medication and their potential drug interactions and side effects. Newer drugs could offer more effective treatments because of fewer adverse effects than current medications.Originality/value– The general review offers an insight in to the literature in German and English on ADHD in ID comparing what is published in both languages.