bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Utility of Serum Receptor-Binding Cancer Antigen Expressed on Siso Cells in Gastrointestinal Tract Cancers
Authors: Çoban Şahin , Özkan Hasan , Köklü Seyfettin , Yüksel Osman , Koçkar Muhammed Cem , Akar Tarik , Örmeci Necati 
Published: March 2016

BACKGROUND: Receptor-binding cancer antigen expressed on SiSo cells (RCAS1) is a novel tumour marker that has been described in various kinds of cancer. The majority of observations include immunohistochemical studies; however, there are not enough data about the utility of this antigen as a serum tumour marker and its tumour specificity.AIM: To measure the serum levels of RCAS1 in patients with gastrointestinal (GI) tract cancers and compare them with other GI tract tumour markers.PATIENTS AND METHODS: Sera collected from patients with GI cancers (14 esophagus, 32 gastric and 36 colon) and from healthy volunteers (30 individuals) were analyzed for RCAS1 and compared with carcinoembryonic antigen (CEA) and cancer antigen 19-9. The relationship between serum RCAS1, tumour stage and tumour grade was also evaluated.RESULTS: Mean serum RCAS1 level was higher in patients with GI tract cancers compared with the control group (P=0.001). Among GI tract cancers, RCAS1 had lowest and highest sensitivity for esophagus and colon cancer diagnosis, respectively. Serum RCAS1 had a higher sensitivity for malignancy, except in the colon, and lower specificity in all groups compared with CEA. In comparison with cancer antigen 19-9, serum RCAS1 was more sensitive but less specific for all GI cancer groups. Mean serum RCAS1 levels were not statistically significant among histopathological tumour types (P>0.05). Although serum RCAS1 levels were significantly higher in cases with lymph node involvement compared with lymph node-negative cases (P=0.009), there was no difference between cases with and without serosal involvement, vascular invasion and distant metastasis; no correlation was found between tumour size and RCAS1 levels.CONCLUSIONS: RCAS1 may be used and combined with CEA as a tumour marker in GI tract cancers.
Blood Serum Levels of Proinflammatory Cytokines in Patients with Different Degrees of Biliary Pancreatitis
Authors: Panek Józefa , Karcz Danuta , Pieton Richard , Zasada Jakub , Tusinski Marcin , Dolecki Miroslaw , Winiarski Marek 
Published: March 2016

BACKGROUND: Proinflammatory cytokines play a fundamental role in the local and systemic inflammatory responses in the initial stages of acute biliary pancreatitis (ABP) and in the development of severe forms of the disease.OBJECTIVES: The aim of the present study was to assess the systemic release of proinflammatory cytokines and to characterize differences between patients with mild ABP (MABP) and severe ABP (SABP)PATIENTS AND METHODS: In the current study, 54 patients with MABP were compared with 14 patients with SABP. Serum levels of tumour necrosis factor-alpha, interleukin (IL)-1ß, IL-6, IL-8 and IL-12p40 were measured every second day after admission for one week.RESULTS: The tumour necrosis factor-alpha level was similar in all days of analysis in patients with MABP but was lower compared with SABP patients. The level of IL-1ß was higher at admission in patients with MABP. The level of IL-6 peaked on admission day in both groups, but in patients with SABP, the obtained values were higher. The level of IL-8 on admission day was slightly higher in patients with MABP and systematically decreased when measured on the following days (the third, fifth and seventh days of the study). An increased level of IL-8 during the third, fifth and seventh days of the investigation was seen in SABP patients. The level of IL-12p40 was slightly higher in patients with MABP on the day of admission.CONCLUSIONS: The levels of some proinflammatory cytokines are higher in patients with SABP than in patients with MABP. The most consistent difference between the two groups was that the levels of IL-6 were significantly higher in patients with SABP throughout the study. Serum concentration of IL-6 may be helpful as a marker of severity and outcome of ABP.
Action Plans in Asthma
Authors: Beauchesne Marie-France , Levert Valérie , Tawil Miray El , Labrecque Manon , Blais Lucie 
Published: March 2016

BACKGROUND: Action plans are recommended for most patients with persistent asthma to reduce the morbidity associated with this chronic disease. Unfortunately, despite these recommendations, this tool remains underused.METHODS: The authors conducted a descriptive study at the asthma clinic of a tertiary care centre to determine the number of asthmatic patients presenting to a respiratory physician (new reference or follow‐up visit) who possessed an individualized, written action plan, and to evaluate the patients’ level of confidence and perceived efficacy toward their plans. In addition, for all patients in the study, the level of confidence in and the perceived efficacy of three different action plans (two traditional tools versus a simplified tool) were compared.RESULTS: A total of 92 asthmatic patients were included in the study. Overall, 46% of the patients possessed an action plan. The patients’ average level of confidence and perceived efficacy toward their action plans were high (4.1 out of five and 3.3 out of four, respectively). When the three different action plans were compared, the level of confidence in and perceived efficacy of the traditional tools were similar, both being superior to the simplified tool.CONCLUSION: The number of asthmatic patients who presented to the asthma clinic and who possessed an action plan was higher than the reported Canadian mean of 10%; however, most of the patients were treated by specialized respiratory physicians, which may explain this improvement. Considering that most patients with persistent asthma should have an individualized, written action plan, the present study confirms that this tool is still not used for all asthmatic patients.
Depression and Cigarette Smoking Independently Relate to Reduced Health-Related Quality of Life among Canadians Living with Hepatitis C
Authors: Balfour Louise , Cooper Curtis , Kowal John , Tasca Giorgio A , Silverman Amy , Kane Marie , Garber Gary 
Published: March 2016

BACKGROUND: Many people living with chronic viral hepatitis C (HCV) report reduced health-related quality of life. The relative contribution of behavioural, psychosocial and HCV disease factors to reduction in HCV health-related quality of life is not well understood. The objectives of the present study were to compare standardized health-related quality of life scores between Canadian HCV patients and age-matched Canadian and American norms, and to examine the relative contribution of biopsychosocial variables (ie, cigarette smoking, alcohol intake and depression) to health-related quality of life scores among Canadian HCV patients.METHODS: HCV RNA-positive patients were recruited during their first visit to the Ottawa Hospital Viral Hepatitis Clinic (Ottawa, Ontario). A questionnaire assessing health behaviours, health-related quality of life and depressed mood was completed. Data on liver studies, liver biopsy findings and HIV serostatus were also collected.RESULTS: A total of 123 participants (71% men) ranging from 20 to 67 years of age were evaluated. All had compensated liver function. Patients reported significantly lower health-related quality of life compared with age-matched Canadian and American normative samples. In a series of hierarchical multiple regression models, depression and smoking were independently related to compromised health-related quality of life scores, even after controlling for sociodemographic variables and health behaviours.DISCUSSION: These results highlight the value of adopting a biopsychosocial model of HCV care. Depressed mood and smoking behaviour should be evaluated in HCV patients. Empirically validated psychological and pharmacological treatments for depression and smoking cessation may improve health-related quality of life in HCV infected patients.
Preservation of Pleural Integrity during Coronary Artery Bypass Surgery Affects Respiratory Functions and Postoperative Pain: A Prospective Study
Authors: Oz Bilgehan Savas , Iyem Hikmet , Akay Hakki Tankut , Yildirim Vedat , Karabacak Kubilay , Bolcal Cengiz , Demirkiliç Ufuk , Tatar Harun 
Published: March 2016

OBJECTIVE: To evaluate the role of preserved pleural integrity in postoperative pain and respiratory functional status in patients undergoing coronary revascularization.METHODS: Two hundred forty patients undergoing on‐pump coronary artery bypass grafting between March 2004 and February 2005 were included in the present study. The patients were prospectively randomized and divided into either an opened pleura (OP) group (n=120, patients with an OP) or a closed pleura (CP) group (n=120, patients whose pleural integrity was preserved). Preoperative patient characteristics were similar. Postoperative respiratory functions were compared between the groups by chest x‐rays, respiratory functional tests and arterial blood gas analyses. Postoperative pain was compared by using a multidimensional pain score. All the tests were examined by the same blinded clinician.RESULTS: The mean age of the patients was 60.4±8.8 years. Postoperative bleeding and the duration of hospital stay were markedly higher in the OP group than in the CP group. The incidences of atelectasis and pleural effusion were also significantly higher in the OP group (P<0.01). Respiratory functions and postoperative pain scores were better in the CP group (P<0.01 and P=0.008, respectively).CONCLUSIONS: Preserving pleural integrity has beneficial effects on the respiratory functions and postoperative pain after coronary revascularization. The preservation of pleural integrity results in better respiratory function, decreased hospital stay and cost, and as a consequence, a better surgical outcome.
Paper Stamp Checklist Tool Enhances Asthma Guidelines Knowledge and Implementation by Primary Care Physicians
Authors: Renzi PM , Ghezzo H , Goulet S , Dorval E , Thivierge RL 
Published: March 2016

BACKGROUND: The Canadian Clinical Practice Guidelines (CPGs) for the management of asthmatic patients were last published in 1999, with updates in 2001 and June 2004. Large disparities exist in the implementation of these guidelines into clinical practice.OBJECTIVE: The present study evaluated the knowlege of Quebec‐based primary care physicians regarding the CPGs, as well as patient outcomes before and after introducing physicians to a new clinical tool – a memory aid in the form of a self‐inking paper stamp checklist summarizing CPG criteria and guidelines for assessing asthmatic patient control and therapy. The primary objective of the present study was to assess whether the stamp would improve physicians’ knowledge of the CPGs, and as a secondary objective, to assess whether it would decrease patient emergency room visits and hospitalizations.METHODS: A prospective, randomized, controlled study of 104 primary care physicians located in four Quebec regions was conducted. Each physician initially responded to questions on their knowledge of the CPGs, and was then randomly assigned to one of four groups that received information about the CPGs while implementing an intervention (the stamp tool) aimed at supporting their decision‐making process at the point of care. Six months later, the physicians were retested, and patient outcomes for approximately one year were obtained from the Régie de l’assurance maladie du Québec.RESULTS: The stamp significantly improved physicians’ knowledge of the CPGs in all Quebec regions tested, and reduced emergency room visits and hospitalizations in patients who were followed for at least one year.CONCLUSION: A paper stamp summarizing CPGs for asthma can be used effectively to increase the knowledge of physicians and to positively affect patient outcomes.
Health Care Utilization and Changes in Health Status Over Time for Migraineurs
Authors: Chuck Anderson , Jacobs Philip , Ohinmaa Arto , Schopflocher Donald , Rashiq Saifudin , Feroe Raquel 
Published: March 2016

BACKGROUND: Determining how migraineurs manage their condition from the viewpoint of health resource utilization (including both medical and personal resources) may provide insights that could lead to more effective care strategies.OBJECTIVES: To determine the relative importance of modifiable health‐influencing activities for migraineurs, and to compare the effects of these activities between migraineurs and nonmigraineurs in the general population.METHODS: Linear regression analysis was applied to all persons older than 19 years of age with migraine in the Canadian Community Health Survey Cycle 1.1. The dependent variable was reported health status change over time. Explanatory variables were a series of health care utilization, health behaviour and background control variables.RESULTS: Results showed that health status was positively associated with higher levels of physical activity and negatively associated with smoking for both migraineurs and nonmigraineurs, even when controlling for all other variables.CONCLUSION: By modifying controllable resources and behaviours, the reported health status of migraineurs can be improved as effectively as nonmigraineurs.
Antibiotic Availability and the Prevalence of Pediatric Pneumonia During a Physicians’ Strike
Authors: Crocker Ken , Cramer Benvon , Hutchinson James M 
Published: March 2016

BACKGROUND: Antibiotics are widely believed to be overpre‐scribed for pediatric respiratory infections, yet there are few data available on the effect of a sudden decrease in antibiotic availability on pediatric infectious disease.OBJECTIVE: To determine whether the prevalence of radiographically diagnosed pneumonia changed over a period of decreased physician access and decreased antibiotic availability.DESIGN: A retrospective study was performed which reviewed the number of pediatric respiratory antibiotic prescriptions over a period which included a physicians’ strike. The study examined whether antibiotic availability had been affected by the strike. Pediatric chest radiograph reports were reviewed for the same period to determine whether changes in antibiotic availability had affected the prevalence of radiographically diagnosable pneumonias among children presenting to a pediatric emergency room.RESULTS: While prescriptions for antibiotics fell by a minimum estimate of 28% during the strike, there was no change in the frequency of radiographic diagnoses of pneumonia.CONCLUSIONS: Respiratory antibiotics appear to be available in the community in excess of the amount required to control pneumonia. A 28% decrease in antibiotic availability did not result in a significant increase in respiratory disease.
Cancer Pain and Depression: A Systematic Review of Age‐Related Patterns
Authors: Gagliese Lucia , Gauthier Lynn R , Rodin Gary 
Published: March 2016

BACKGROUND: Pain is a common and debilitating symptom experienced by cancer patients of all ages. Cancer pain is associated with elevated levels of depression; however, age‐related patterns in this relationship remain unclear. This information is important to provide effective palliation of pain and depression to the growing numbers of older cancer patients.OBJECTIVE: To provide a systematic review of the literature regarding age‐related patterns in the intensity or prevalence of depression among cancer patients with pain.METHODS: Medical and psychological literature databases were searched to identify eligible studies. The methodological quality and outcomes of the studies were compiled and systematically reviewed.RESULTS: Five articles, describing four studies, met the inclusion and exclusion criteria. Due to high levels of cross‐study methodological variability, a qualitative review was undertaken. Three of the four studies did not find evidence for age‐related patterns in depression. The fourth study found that depression increased with age.CONCLUSION: The weight of the evidence suggests that younger and older cancer patients with pain report comparable levels of depression. However, this conclusion remains preliminary due to the methodological limitations of the available studies. Research is needed to more adequately address this important issue.
Management of Solitary 1 cm to 2 cm Liver Nodules in Patients with Compensated Cirrhosis: A Decision Analysis
Authors: Bremner Karen E , Bayoumi Ahmed M , Sherman Morris , Krahn Murray D 
Published: March 2016

OBJECTIVES: Current guidelines, based on expert opinion, recommend that suspected 1 cm to 2 cm hepatocellular carcinoma (HCC) detected on screening be biopsied and, if positive, treated (eg, resection or transplantation). Alternative strategies are immediate treatment or observation until disease progression occurs.METHODS: A Markov decision model was developed that compared three management strategies – immediate resection, biopsy and resection if positive, and ultrasound surveillance every three months until disease progression – for a single 1 cm to 2 cm liver nodule suspicious for HCC following ultrasound screening and computed tomography confirmation. The cohort included 55-year-old patients with compensated cirrhosis and no significant comorbidities. The model used in the present study incorporated the probabilities of false-positive and false-negative results, needle-track seeding, HCC recurrence, cirrhosis progression and death. The quality-adjusted life expectancy (LE) and the unadjusted LE were evaluated and the model’s strength was assessed with sensitivity analyses.RESULTS: In the base case analysis, biopsy, resection and surveillance yielded an unadjusted LE of 60.5, 59.7 and 56.6 months, respectively, and a quality-adjusted LE of 46.6, 45.6 and 43.8 months, respectively. In probabilistic sensitivity analyses, biopsy was the preferred strategy 69.5% of the time, resection 30.5% of the time and surveillance never. Resection was the optimal decision if the sensitivity of biopsy was very low (less than 0.45) or if the accuracy of the imaging tests resulted in a high percentage of HCC-positive patients (greater than 76%) in the screened cohort, as with expert interpretation of triphasic computed tomography.CONCLUSIONS: The present model suggests that biopsy is the preferred management strategy for these patients. When postimaging probability of HCC is high or pathology expertise is lacking, resection is the best alternative. Surveillance is never the optimal strategy.
Maintenance Treatment of Gastroesophageal Reflux Disease: An Evaluation of Continuous and On-Demand Therapy with Rabeprazole 20 mg
Authors: Morgan David G , O’Mahony Michael FJ , O’Mahony William F , Roy Jean , Camacho Fernando , Dinniwell Julie , Horbay GLA , Husein-Bhabha Farah A ,   for the RAB-GRD-3002 Study Group
Published: March 2016

OBJECTIVE: To evaluate continuous therapy (COT) and on-demand therapy (ODT) with rabeprazole 20 mg for maintenance in uninvestigated gastroesophageal reflux disease (GERD).METHODS: This randomized, open-label study enrolled 331 GERD (heartburn-predominant) patients with a pre-existing proton pump inhibitor history of one month or longer, to an acute four-week trial with 20 mg rabeprazole daily for heartburn management. Patients who achieved satisfactory heartburn control during the acute phase (three days or less of heartburn, with no more than one episode rated as moderate, and heartburn rated satisfactorily or completely controlled with minimal rescue antacid use in the seven days preceding randomization) were randomly assigned to six months of rabeprazole 20 mg given as either daily COT or daily ODT, which was initiated upon symptom recurrence and stopped upon symptom resolution. Rescue antacid usage was permitted and tracked. Primary efficacy was measured as the proportion of heartburn-free days over six months.RESULTS: For the 268 patients, the mean percentage of heartburn-free days for the COT group and for the ODT group were 90.3%±14.8% and 64.8%±22.3%, respectively (P<0.0001). COT was associated with an increased number of medication intake days (154±40.2) versus ODT (68±46.1), with less heartburn episodes observed with COT versus ODT, respectively (n=7, n=26, P<0.0001). Ninety-two per cent of COT patients and 79% of ODT patients were either ‘satisfied’ or ‘very satisfied’ with treatment. The mean usage of antacids was low and similar in both groups. COT and ODT regimens were safe and well-tolerated, with a similar incidence of adverse events.CONCLUSION: Results based on symptom assessments favour COT with rabeprazole 20 mg for maintenance therapy in patients with uninvestigated GERD; however, both therapy types are safe and acceptable treatment options for selected patients.
Canadian Home Total Parenteral Nutrition Registry: Preliminary Data on the Patient Population
Authors: Raman Maitreyi , Gramlich Leah , Whittaker Scott , Allard Johane P 
Published: March 2016

BACKGROUND: Long-term administration of home total parenteral nutrition (HTPN) has permitted patients with chronic intestinal failure to survive for prolonged periods of time. However, HTPN is associated with numerous complications, all of which increase morbidity and mortality. In Canada, a comprehensive review of the HTPN population has never been performed.OBJECTIVES: To report on the demographics, current HTPN practice and related complications in the Canadian HTPN population.METHODS: This was a cross-sectional study. Five HTPN programs in Canada participated. Patients’ data were entered by the programs’ TPN team into a Web site-based registry. A unique confidential record was created for each patient. Data were then downloaded into a Microsoft Excel (Microsoft Corp, USA) spreadsheet and imported into SPSS (SPSS Inc, USA) for statistical analysis.RESULTS: One hundred fifty patients were entered into the registry (37.9% men and 62.1% women). The mean (± SD) age was 53.0±14 years and the duration requiring HTPN was 70.1±78.1 months. The mean body mass index before the onset of HTPN was 19.8±5.0 kg/m2. The primary indication for HTPN was short bowel syndrome (60%) secondary to Crohn’s disease (51.1%), followed by mesenteric ischemia (23.9%). Complications: over one year, 62.7% of patients were hospitalized at least once, with 44% of hospitalizations related to TPN. In addition, 28.6% of patients had at least one catheter sepsis (double-lumen more than single-lumen; P=0.025) and 50% had at least one catheter change. Abnormal liver enzymes were documented in 27.4% of patients and metabolic bone disease in 60% of patients, and the mean Karnofsky score was 63.CONCLUSIONS: In the present population sample, the data suggest that HTPN is associated with significant complications and health care utilization. These results support the use of a Canadian HTPN registry to better define the HTPN population, and to monitor complications for quality assurance and future research.