bluuebunny/crossref_metadata_2025_split huggingface dataset:
Emotional and Neurobehavioural Status in Chronic Pain Patients
Authors: Shuchang He , Mingwei He , Hongxiao Jia , Si Wu , Xing Yang , Antonius Daniel , Opler Mark GA 
Published: March 2016

OBJECTIVE: To investigate the emotional and neurobehavioural status of patients suffering from chronic pain.METHODS: Fifteen male patients with chronic lower back pain and 15 healthy control subjects were studied for approximately six months. Pain was measured using a visual analogue scale. The WHO Neurobehavioral Core Test Battery (NCTB) was used to assess neurobehavioural effects of environmental and occupational exposures.RESULTS: Visual analogue scale results demonstrated a modest range of reported pain (mean [± SD] 62.0±10.8) in chronic pain patients, whereas control subjects reported no measurable pain. With the NCTB, it was found that scores of negative mood state, including anger‐hostility, depression‐dejection, fatigue‐inertia and tension‐anxiety in pain patients were significantly higher than scores in the control subjects. By contrast, scores of positive mood state (vigour‐activity) in chronic pain patients were lower than those in the control group. The NCTB scores of the Santa Ana Dexterity and Pursuit Aiming II tests in chronic lower back pain patients were lower than those of the control group. Scores for other NCTB sub‐tests, including the Digit Span, Benton Visual Retention and Digit Symbol tests, were not significantly different compared with controls.CONCLUSIONS: Chronic lower back pain patients had more negative mood and less positive mood than controls. These patients also demonstrated neuromotor deficits in coordination and reaction time. Further studies are required to examine possible neurological mechanisms and research potential intervention strategies for patients suffering from chronic pain.
Predictors of Respiratory Symptoms in a Rural Canadian Population: A Longitudinal Study of Respiratory Health
Authors: Karunanayake Chandima P , Rennie Donna C , Pahwa Punam , Chen Yue , Dosman James A 
Published: March 2016

BACKGROUND: Predictors of new and long‐term respiratory symptoms for rural residents are not well defined.OBJECTIVE: To identify early predictors of respiratory symptoms in a rural community population.METHODS: The study population consisted of 871 adults living in the rural community of Humboldt, Saskatchewan, who participated in two cross‐sectional respiratory studies conducted in 1993 and 2003. Questionnaire information obtained at both time points included respiratory symptoms (cough, phlegm and wheeze), history of allergy, smoking, and information regarding home and farm environments. Transitional modelling, in which measurement in a longitudinal sequence is described as a function of previous outcomes, was used to predict later outcomes of cough, phlegm and wheeze. Asymptomatic individuals in 1993 were assessed to determine factors associated with the development of symptoms during the study period.RESULTS: The prevalences of cough, phlegm and wheeze in 1993 were 16.1%, 18.1% and 25.5%, respectively. Change in symptoms over time was significant for cough, phlegm and wheeze. The adjusted ORs (95% CI) from separate transitional models for each respiratory outcome in 1993 that predicted the same symptom in 2003 were 6.32 (4.02 to 9.95) for cough, 14.36 (9.01 to 22.89) for phlegm and 6.40 (4.40 to 9.32) for wheeze. For asymptomatic individuals in 1993, home dampness, allergic reaction to inhaled allergens and cigarette smoking were major risk factors associated with respiratory symptoms that were reported in 2003.CONCLUSION: The presence of previous respiratory symptoms, allergies and environmental exposures can predict the occurrence of future respiratory symptoms in adults.
Representations of OxyContin in North American Newspapers and Medical Journals
Authors: Whelan Emma , Asbridge Mark , Haydt Susan 
Published: March 2016

Following the approval of OxyContin (Purdue Pharma, Canada) for medical use, the media began to report the use of OxyContin as a street drug, representing the phenomenon as a social problem. Meanwhile, the pain medicine community has criticized the inaccurate and one‐sided media coverage of the OxyContin problem. The authors of this study aimed to contribute to an understanding of both sides of this controversy by analyzing the coverage of OxyContin in newspapers and medical journals. The analyses revealed inconsistent messages about the drug from physicians in the news media and in medical journals, which has likely contributed to the drug’s perception as a social problem. The authors suggest ways to address the lack of medical consensus surrounding OxyContin. The results of this study may help resolve the concerns and conflicts surrounding this drug and other opioids.BACKGROUND: There are public concerns regarding OxyContin (Purdue Pharma, Canada) and charges within the pain medicine community that media coverage of the drug has been biased.OBJECTIVE: To analyze and compare representations of OxyContin in medical journals and North American newspapers in an attempt to shed light on how each contributes to the ‘social problem’ associated with OxyContin.METHODS: Using searches of newspaper and medical literature databases, two samples were drawn: 924 stories published between 1995 and 2005 in 27 North American newspapers, and 197 articles published between 1995 and 2007 in 33 medical journals in the fields of addiction/substance abuse, pain/anesthesiology and general/internal medicine. The foci, themes, perspectives represented and evaluations of OxyContin presented in these texts were analyzed statistically.>RESULTS: Newspaper coverage of OxyContin emphasized negative evaluations of the drug, focusing on abuse, addiction, crime and death rather than the use of OxyContin for the legitimate treatment of pain. Newspaper stories most often conveyed the perspectives of law enforcement and courts, and much less often represented the perspectives of physicians. However, analysis of physician perspectives represented in newspaper stories and in medical journals revealed a high degree of inconsistency, especially across the fields of pain medicine and addiction medicine.CONCLUSION: The prevalence of negative representations of OxyContin is often blamed on biased media coverage and an ignorant public. However, the proliferation of inconsistent messages regarding the drug from physicians plays a role in the drug’s persistent status as a social problem.
Exploring the Association Between Pain Intensity and Facial Display in Term Newborns
Authors: Schiavenato Martin , Butler-O’Hara Meggan , Scovanner Paul 
Published: March 2016

BACKGROUND: Facial expression is widely used to judge pain in neonates. However, little is known about the relationship between intensity of the painful stimulus and the nature of the expression in term neonates.OBJECTIVES: To describe differences in the movement of key facial areas between two groups of term neonates experiencing painful stimuli of different intensities.METHODS: Video recordings from two previous studies were used to select study subjects. Four term neonates undergoing circumcision without analgesia were compared with four similar male term neonates undergoing a routine heel stick. Facial movements were measured with a computer using a previously developed ‘point‐pair’ system that focuses on movement in areas implicated in neonatal pain expression. Measurements were expressed in pixels, standardized to percentage of individual infant face width.RESULTS: Point pairs measuring eyebrow and eye movement were similar, as was the sum of change across the face (41.15 in the circumcision group versus 40.33 in the heel stick group). Point pair 4 (horizontal change of the mouth) was higher for the heel stick group at 9.09 versus 3.93 for the circumcision group, while point pair 5 (vertical change of the mouth) was higher for the circumcision group (23.32) than for the heel stick group (15.53).CONCLUSION: Little difference was noted in eye and eyebrow movement between pain intensities. The mouth opened wider (vertically) in neonates experiencing the higher pain stimulus. Qualitative differences in neonatal facial expression to pain intensity may exist, and the mouth may be an area in which to detect them. Further study of the generalizability of these findings is needed.
Improving the Usefulness of the Multidimensional Pain Inventory
Authors: McKillop Jeffrey M , Nielson Warren R 
Published: March 2016

BACKGROUND: The Multidimensional Pain Inventory (MPI) is a reliable and valid self‐report instrument that measures the impact of pain on an individual’s life, quality of social support and general activity. Criticism of the MPI has focused on this instrument’s internal structure and the stability of its classification taxonomy.OBJECTIVES: To determine whether empirical summary scales could be developed for the MPI based on a large sample of respondents diagnosed with fibromyalgia syndrome. It was hypothesized that summary scales would improve the psychometric quality of the MPI and increase the stability of respondents’ taxonomy profiles across time.METHODS: Respondents completed the MPI on two occasions before their admission to a multidisciplinary pain management program.RESULTS AND CONCLUSIONS: Based on principal components analysis, three summary scales were developed that reflected level of impairment, social support and activity. Summary scales possessed good psychometric qualities and, when cluster analyzed, replicated the MPI taxonomy. Exploratory analyses of the MPI taxonomy revealed that goodness‐of‐fit values generally became less reliable as respondent profiles approached the overall sample mean. When the relative distance between respondents fit to taxonomy profiles and the distance from the sample mean was considered, profile stability using summary scales was predicted with good precision. These results suggest that summary scales may enhance the usefulness of the MPI, and that the traditional method of determining profile fit within the MPI is not stable and needs to be reconsidered.
Association between Proximity to Major Roads and Sputum Cell Counts
Authors: Wallace Julie , D’silva Liesel , Brannan John , Hargreave Frederick E , Kanaroglou Pavlos , Nair Parameswaran 
Published: March 2016

BACKGROUND: Air pollution caused by motor vehicle emissions has been associated with exacerbations of obstructive airway diseases; however, the nature of the resulting bronchitis has not been quantified.OBJECTIVE: To examine whether proximity to major roads or highways is associated with an increase in sputum neutrophils or eosinophils, and to evaluate the effect of proximity to roads on spirometry and exacerbations in patients with asthma.METHODS: A retrospective study of 485 sputum cell counts from patients attending a tertiary chest clinic in Hamilton, Ontario, identified eosinophilic or neutrophilic bronchitis. Patients’ residences were geocoded to the street network of Hamilton using geographic information system software. Associations among bronchitis, lung function, and proximity to major roads and highways were examined using multinomial logistic and multivariate linear regression analyses adjusted for patient age, smoking status and corticosteroid medications.RESULTS: Patients living within 1000 m of highways showed an increased risk of bronchitis (OR 3.8 [95% CI 1.0 to 13.7]; P<0.05), particularly neutrophilic bronchitis (OR 4.7 [95% CI 1.2 to 18.7]; P<0.05) as well as an increased risk of an asthma diagnosis (OR 1.9 [95% CI 1.0 to 3.4]; P<0.05). Patients living within 300 m of a major road were at increased risk for an asthma exacerbation (OR 1.9 [95% CI 1.5 to 15.5]; P<0.01) and lower lung function, particularly in women (P=0.036).CONCLUSION: In patients with airway diseases, living close to a highway or major road was associated with neutrophilic bronchitis, an increased risk of asthma diagnosis, asthma exacerbations and lower lung function.
Update on Anal Fistulae: Surgical Perspectives for the Gastroenterologist
Authors: Tabry Helena , Farrands Paul A 
Published: March 2016

Anal fistulae are common and debilitating; they are characterized by severe pain and discharge. They arise following infection near the anal canal, or as a primary event from an abscess in the abdomen, fistulating into the vagina or perianal skin. The term ‘cryptoglandular’ is given to abscesses arising from the anal glands.For many years, the treatment of choice was to lay open the fistula; however, this risks causing incontinence with potentially devastating consequences. Alternative surgical treatments include setons, fibrin glue, collagen plugs and flaps to cover the internal fistula opening. These have achieved varying degrees of success, as will be discussed. The present review also discusses anal fistulae in light of much recently published literature. Currently, anal fistulae remain challenging and require specialist expertise; however, new treatment options are on the horizon.
Sensitivity to Pain Traumatization: A Higher‐Order Factor Underlying Pain‐Related Anxiety, Pain Catastrophizing and Anxiety Sensitivity among Patients Scheduled for Major Surgery
Authors: Kleiman Valery , Clarke Hance , Katz Joel 
Published: March 2016

BACKGROUND: The present article addresses two related developments in the psychology of pain, and integrates them into a coherent framework to better understand the relationship between pain and trauma. The first is an emerging conceptualization regarding the nature of the hierarchical organization of major pain‐related anxiety constructs. The second is the theoretical rationale and empirical evidence linking pain and symptoms of post‐traumatic stress disorder.OBJECTIVES: To explore the underlying hierarchical factor structure of commonly used pain‐related anxiety measures including the Pain Anxiety Symptoms Scale (PASS‐20), the Pain Catastrophizing Scale (PCS), and the Anxiety Sensitivity Index (ASI); and to relate this structure to post‐traumatic stress disorder in patients scheduled for major surgery.METHODS: Measures were completed by 444 patients scheduled to undergo major surgery. Exploratory factor analysis and subsequent higher‐order analysis using the Schmid‐Leiman transformation were conducted to investigate the underlying factor structure of the ASI, the PCS and the PASS‐20.RESULTS: Twenty items from the ASI, the PASS‐20 and the PCS loaded exclusively on one higher‐order factor. The authors suggest the term ‘sensitivity to pain traumatization’ (SPT) for the underlying construct based in part on the strong, significant positive correlation between SPT scores and scores on the Post‐traumatic Stress Disorder Checklist – Civilian Version. Finally, the total SPT score was significantly higher for patients with a history of pain than for those without a history of pain, both before surgery and one year after surgery. SPT describes the propensity to develop anxiety‐related somatic, cognitive, emotional and behavioural responses to pain that resemble features of a traumatic stress reaction. Together, the results of the present study provide preliminary evidence for the construct validity of SPT.
Timing and Frequency of Bowel Activity in Patients Ingesting Sodium Picosulphate/Magnesium Citrate and Adjuvant Bisacodyl for Colon Cleansing Before Colonoscopy
Authors: Vanner Stephen , Hookey Lawrence C 
Published: March 2016

BACKGROUND: Despite the wealth of research investigating bowel cleansing efficacy, there are very little data on the timing or frequency of bowel movements after each agent is ingested.OBJECTIVE: To examine the effect of each component of a three-day combined sodium picosulphate/magnesium citrate (PSLX) and bisacodyl regimen on the timing and frequency of bowel activity in patients undergoing colonoscopy.METHODS: Outpatients booked for colonoscopy were asked to complete a diary of their bowel preparation that tracked the timing of bowel movements. Bowel preparation quality was assessed using the Ottawa Bowel Preparation Scale. Bowel activity was compared with baseline and correlated with colon cleansing. Subgroup analysis was performed examining the effect of timing of the procedure and split-dose regimens.RESULTS: One hundred patients undergoing colon cleansing received bisacodyl 10 mg at 17:00 three days and two days before the day of colonoscopy. In one group, both sachets of PSLX were given the night before colonoscopy, while the second group, whose colonoscopies were scheduled after 11:00, ingested one sachet the night before and the second sachet at 06:00 on the day of colonoscopy. Patients had a mean of 1.7 bowel movements per day in the seven days before starting the cleansing regimen. Both doses of bisacodyl tablets resulted in a significant increase in the mean number of bowel movements compared with baseline (3.3/day first dose; 3.8/day second dose [P=0.03 and 0.001, respectively]). Each dose of PSLX also resulted in a significant increase in bowel movement frequency compared with baseline, with means of 4.4, 6.3 and 4.5 bowel movements after each dose. The mean time to the final bowel movement following the second sachet of PSLX was 8.9 h when taken the night before, and 3.9 h when taken the morning of the procedure. Bowel preparation quality significantly correlated with bowel frequency when total bowel movements were considered and when only the effects of bisacodyl were accounted for (P<0.01 for each).DISCUSSION: These data demonstrate that the addition of bisacodyl before PSLX ingestion has a significant additive effect on bowel frequency and correlates with bowel cleansing quality. The timing of the resulting bowel movements have practical implications for sleep and travel times to endoscopy suites.
Genetic and Antigenic Analysis of Invasive Serogroup C Neisseria meningitidis in Canada: A Decrease in the Electrophoretic Type (Et)‐15 Clonal Type and an Increase in the Proportion of Isolates Belonging to the Et‐37 (But Not Et‐15) Clonal Type During the Period from 2002 to 2009
Authors: Zhou Jianwei , Jamieson Frances , Dolman Sharon , Hoang Linda MN , Rawte Prasad , Tsang Raymond SW 
Published: March 2016

BACKGROUND: Serogroup C meningococcal disease has been endemic in Canada since the early 1990s, with periods of hyperendemic disease documented in the past two decades. The present study characterized invasive serogroup C meningococci in Canada during the period from 2002 to 2009.METHODS: Serogroup C meningococci were serotyped using monoclonal antibodies. Their clonal types were identified by either multilocus enzyme electrophoresis or multilocus sequence typing.RESULTS: The number of invasive serogroup C Neisseria meningitidis isolates received at the National Microbiology Laboratory (Winnipeg, Manitoba) for characterization has dropped from a high of 173 isolates in 2001 to just 17 in 2009, possibly related to the introduction of the serogroup C meningococcal conjugate vaccine. Before 2006, 80% to 95% of all invasive serogroup C meningococci belonged to the electrophoreic type (ET)‐15 clonal type, and the ET‐37 (but not ET‐15) type only accounted for up to 5% of all isolates. However, beginning in 2006, the percentage of the ET‐15 clonal type decreased while the ET‐37 (but not ET‐15) type increased from 27% in 2006 to 52% in 2009. The percentage of invasive serogroup C isolates not belonging to either ET‐15 or ET‐37 also increased. Most ET‐15 isolates expressed the antigenic formula of C:2a:P1.7,1 or C:2a:P1.5. In contrast, the ET‐37 (but not ET‐15) isolates mostly expressed the antigens of C:2a:P1.5,2 or C:2a:P1.2.CONCLUSION: A shift in the antigenic and clonal type of invasive serogroup C meningococi was noted. This finding suggests vigilance in the surveillance of meningoccocal disease is warranted.
An Audit of Influenza Vaccination Status in Adults with Inflammatory Bowel Disease
Authors: Narula Neeraj , Dhillon Amit S , Chauhan Usha , Marshall John K 
Published: March 2016

BACKGROUND Several guidelines recommend influenza vaccination for high-risk patients, including those on immune-suppressing medications (IS).OBJECTIVE: To assess the vaccination status and immunization history of an outpatient inflammatory bowel disease (IBD) population for H1N1 and seasonal influenza.RESULTS: Among 250 patients, 104 (41.6%) had been immunized against H1N1 and 62 (24.8%) against seasonal influenza, and 158 (63.2%) were taking IS (azathioprine, 6-mercaptopurine, infliximab, adalimumab, methotrexate, cyclosporine or prednisone). Among subjects on IS, the presence of comorbidities warranting vaccination was associated with higher likelihood of H1N1 immunization (62.5% versus 35.8%; P=0.022) but not of seasonal influenza vaccination (25.0% versus 17.2%; P=0.392). Among patients without comorbidities warranting vaccination, IS was associated with a decreased likelihood of vaccination against seasonal influenza (17.2% versus 30.7%; P=0.036) but not H1N1 (35.8% versus 41.3%; P=0.46). The frequency of H1N1 vaccination was significantly higher among patients who visited a general practitioner at least once yearly (45.7% versus 20%; P=0.0027), with a similar trend for seasonal influenza vaccination (27.1% versus 12.5%; P=0.073). Among 91 patients on IS who declined vaccination, 39.6% reported fear of immediate side effects, 29.7% reported concerns about developing serious medical complications, 15.4% reported concerns about activating IBD and 15.4% were not aware that vaccination was indicated.CONCLUSIONS: Current strategies for vaccinating IBD patients on IS are inadequate. Primary care provider education, incentive programs and regular primary care contact may improve immunization uptake.
Pulmonary Involvement in Brucellosis
Authors: Uluğ Mehmet , Can-Uluğ Nuray 
Published: March 2016

BACKGROUND: Brucellosis is a zoonotic disease caused by a Gram‐negative bacillus of the Brucella genus with multisystem involvement, primarily affecting the reticuloendothelial system, joints, heart and kidneys. Although the disease can be spread by inhalation, pulmonary involvement is rare.OBJECTIVE: To report a case of brucellosis with pulmonary involvement.CASE PRESENTAION: A previously healthy 36‐year‐old woman was admitted with complaints of fever, weakness, night sweats, dry cough and bilateral chest pain. She hed been diagnosed with pneumonia 20 days previously and was started on a course of ampicillin for 14 days, with no response. Her chest auscultation revealed diminished breath sounds and scattered crackles and rhonchi over the inferior zone of the right hemithorax. Wright and Coombs testing resulted in titres of 1:1280 and 1:640, respectively. Chest radiography revealed an area of confluent lobar consolidation in the right lower lobe. Treatment was started with a six‐week course of oral doxycycline 200 mg/day and rifampicin 600 mg/day. This treatment regimen rapidly improved the patient’s condition. Follow‐up after one year showed no residual effects from the infection.CONCLUSION: Pulmonary involvement is a rare event in the course of brucellosis, but the rate could be higher than currently estimated. In endemic regions, brucellosis should be considered as a causative agent in patients with pulmonary symptoms.