bluuebunny/crossref_metadata_2025_split huggingface dataset:
Minimally Invasive Surgery for Pott’s Puffy Tumor: Is It Time for a Paradigm Shift in Managing a 250-Year-Old Problem?
Authors: Leong Samuel C. 
Published: April 2017

Introduction: The aim of this study was to review the clinical outcomes and efficacy of endoscopic sinus surgery (ESS) in the management of Pott’s puffy tumor (PPT). Methods: Literature PubMed review using a combination of MeSH terms and keywords was undertaken, combined with a single surgeon case series of 3 patients. Results: A total of 29 (20 males, median age 25 years) cases were reviewed. The most common etiology was acute frontal sinusitis (62%), followed by a history of chronic rhinosinusitis (28%). Two patients presented with concomitant preseptal cellulitis and cutaneous fistula each, while another had pneumocephalus. The majority of cases (59%) had Draf 1 procedure. Three cases had Draf 3 procedure. Five cases were successfully treated by sinus balloon sinuplasty. Postoperatively, most patients had either oral or intravenous antibiotics of varying duration. There were no further complications following ESS. Both fistulas healed without requiring surgical debridement or closure. Conclusion: Some PPT cases can be managed endoscopically. The availability of powered angled instruments, high-definition video, and image guidance systems have provided the modern otolaryngologists with a credible alternative to traditional techniques. Furthermore, improved bioavailability of modern antibiotics may obviate the need for craniotomy and external drains.
The development of an outcome measures toolkit for spinal cord injury rehabilitation
Authors: Chan Christie W. L. , Miller William C. , Querée Matthew , Noonan Vanessa K. , Wolfe Dalton L. ,   the SCIRE Research Team
Published: April 2017

Background. Spinal cord injury (SCI) is a complex medical condition that can be difficult to monitor. Purpose. This study aimed to establish a common set of validated outcome measures specifically for SCI clinical practice. Method. In a three-round online Delphi process, experts in SCI care across Canada suggested and ranked outcome measures for clinical practice. The facilitators provided feedback between rounds and determined if consensus (at least 75% agreement) was reached on a single outcome measure per clinical area. Findings. One hundred and forty-eight outcome measures were initially considered for inclusion. After three rounds, consensus was reached for 23 out of 30 clinical areas. In the remaining seven, more than one outcome measure was recommended. The final toolkit comprises 33 outcome measures with sufficient measurement properties for use with a SCI population. Implications. An outcome measures toolkit validated specifically for SCI should lead to improved identification of best practice and enable clinicians to monitor client progress effectively.
Voluntarily Reported Immunization Registry Data: Reliability and Feasibility to Predict Immunization Rates, San Diego, California, 2013
Authors: Madewell Zachary J. , Wester Robert B. , Wang Wendy W. , Smith Tyler C. , Peddecord K. Michael , Morris Jessica , DeGuzman Heidi , Sawyer Mark H. , McDonald Eric C. 
Published: April 2017

Objectives: Accurate data on immunization coverage levels are essential to public health program planning. Reliability of coverage estimates derived from immunization information systems (IISs) in states where immunization reporting by medical providers is not mandated by the state may be compromised by low rates of participation. To overcome this problem, data on coverage rates are often acquired through random-digit-dial telephone surveys, which require substantial time and resources. This project tested both the reliability of voluntarily reported IIS data and the feasibility of using these data to estimate regional immunization rates. Methods: We matched telephone survey records for 553 patients aged 19-35 months obtained in 2013 to 430 records in the San Diego County IIS. We assessed concordance between survey data and IIS data using κ to measure the degree of nonrandom agreement. We used multivariable logistic regression models to investigate differences among demographic variables between the 2 data sets. These models were used to construct weights that enabled us to predict immunization rates in areas where reporting is not mandated. Results: We found moderate agreement between the telephone survey and the IIS for the diphtheria, tetanus, and acellular pertussis (κ = 0.49), pneumococcal conjugate (κ = 0.49), and Haemophilus influenzae type b (κ = 0.46) vaccines; fair agreement for the varicella (κ = 0.39), polio (κ = 0.39), and measles, mumps, and rubella (κ = 0.35) vaccines; and slight agreement for the hepatitis B vaccine (κ = 0.17). Conclusions: Consistency in factors predicting immunization coverage levels in a telephone survey and IIS data confirmed the feasibility of using voluntarily reported IIS data to assess immunization rates in children aged 19-35 months.
Implementation of effective, self-sustaining headache services in the Republic of Georgia: Evaluation of their impact on headache-related disability and quality of life of people with headache
Authors: Giorgadze Gvantsa , Mania Maka , Kukava Maka , Dzagnidze Ana , Mirvelashvili Ekaterine , Steiner Timothy J , Katsarava Zaza 
Published: April 2017

Background Headache disorders are widespread and disabling. They are common in Georgia, especially headache on ≥15 days/month (HA ≥ 15), but there are no headache services. Objective We established headache services meeting local needs, investigating feasibility, consumer uptake and satisfaction, and cost, with an exit strategy bequeathing effective, self-sustaining services that could be rolled out nationwide. Methods We created headache centres in Tbilisi and Gori offering free expert care for three visits over three months, and affordable medication thereafter. The primary outcome measure was the percentage of patients using the service beyond the free period – a measure of both satisfaction and sustainability. Results Of 1,445 patients (age 43.7 ± 12.4 years; 10.5% male), 49.8% had episodic migraine, 22.5% episodic tension-type headache, 25.7% HA ≥ 15 (24.5% overusing medication) and 2.0% trigeminal autonomic cephalalgias. Only 454 (31.4%) and 51 (3.5%) returned for second and third visits; in these, headache improved and treatment costs decreased. As information about the service spread, five other headache clinics opened in Tbilisi and Kutaisi (western Georgia). Pharmaceutical companies reduced prices (sumatriptan 100 mg from US$7 to US$1). Conclusion The study failed to achieve its primary outcome, but sustainable headache services operating to international standards were successfully implemented nonetheless, with demand increasing.
Comparison of two sedation protocols for short electroretinography in cats
Authors: Del Sole María J , Nejamkin Pablo , Cavilla Verónica , Schaiquevich Paula , Moreno Laura 
Published: April 2017

Objectives The objectives were to compare two different sedative combinations, xylazine–ketamine and dexmedetomidine–ketamine, for the short electroretinography (ERG) protocol and their impact on sedative effect, reversal times and physiological variables in cats. Methods Six healthy spayed female domestic cats were sedated using one of two ketamine-containing protocols: intramuscular xylazine hydrochloride (1 mg/kg) plus ketamine hydrochloride (3 mg/kg) (XK), and dexmedetomidine hydrochloride (5 µg/kg) plus ketamine hydrochloride (3 mg/kg) (DK). A short ERG protocol was recorded from the left eye of each cat under XK and DK sedation. Thirty minutes later, the effects were reversed with yohimbine or atipamezole for the XK and DK treatment, respectively. The cats were evaluated for time to recumbency, time to head elevation, and time to standing position after reversal treatments. Other variables recorded were: systolic blood pressure, cardiac rhythm, heart rate, pulse oximetry and respiratory rate. Recorded ERG variables included a- and b-wave amplitudes and implicit times under photopic, scotopic and scotopic mixed ERG conditions. Results Time to lateral recumbency with XK was shorter than for DK ( P <0.05). After reversal, head elevation and standing position times were significantly longer for the XK than the DK group ( P <0.05). Heart rate increased and systolic blood pressure decreased from baseline in both groups ( P <0.05), but there were no significant differences between treatment groups. The b-wave amplitude recorded in the photopic study of cats treated with XK was lower than in animals treated with DK ( P <0.05). No other significant differences in ERG variables were observed between treatment groups ( P >0.05). Conclusions and relevance The present study shows that XK and DK treatments are chemical restraint alternatives for ERG recording in cats, with significant differences only in the photopic b-wave amplitude.
Exposure to advertising and perception, interest, and use of e-cigarettes among adolescents: findings from the US National Youth Tobacco Survey
Authors: Pu Jia , Zhang Xiao 
Published: April 2017

Objective: US adolescents are exposed to high levels of advertisements for electronic cigarettes (e-cigarettes). This study aimed to examine the associations between exposure to e-cigarette advertisements and perception, interest, and use of e-cigarettes among US middle school and high school students. Methods: Data from the 2014 cross-sectional National Youth Tobacco Survey were used. Logistic regressions were conducted to model four outcomes, including perception of reduced harmfulness compared to regular cigarettes, perception of reduced addictiveness, intention to use, and current use of e-cigarettes. Main predictors were exposure to e-cigarette advertisements via four sources, including Internet, newspaper/magazines, retail stores, and TV. Results: When all the four sources of e-cigarette advertisements exposure were evaluated jointly, exposure via the Internet was associated with elevated likelihood of reporting all four outcomes related to e-cigarettes, while exposure via retail stores was associated with higher likelihood of current e-cigarette use and perception of reduced harmfulness of e-cigarettes compared to regular cigarettes ( p < .05). However, exposure via newspaper/magazines and TV was associated with lower likelihood of perceiving e-cigarettes to be less harmful or addictive ( p < .05). Conclusion: Exposure to e-cigarette advertisements via the Internet and retail stores may play a significant role in adolescents’ use and perception of e-cigarettes. The results call for more research on the influence of different sources of advertising exposure on e-cigarette use to help public health programmes curtail the fast growing use of e-cigarette products among youth.
Bacterial infections in acute variceal hemorrhage despite antibiotics—a multicenter study of predictors and clinical impact
Authors: Lee Stephen , Saxinger Lynora , Ma Mang , Prado Verónica , Fernández Joaquin , Kumar Deepali , Gonzalez‐Abraldes Juan , Keough Adam , Bastiampillai Ravin , Carbonneau Michelle , Fernandez Javier , Tandon Puneeta 
Published: April 2017

Background and aimsCurrent guidelines recommend antibiotic prophylaxis in all patients presenting with cirrhosis and acute variceal hemorrhage (AVH). We aimed to evaluate the characteristics and clinical impact of “early” infections (developing within 14 days) of AVH in a real‐world setting.MethodsWe analyzed retrospective data from a cohort of 371 adult patients with cirrhosis and AVH all of whom had received antibiotic prophylaxis (74% men; mean age 56 years), admitted to tertiary care hospitals in Edmonton, Alberta, Canada, and Barcelona, Spain. Sensitivity analyses were presented for culture‐positive (confirmed) infections.ResultsThe mean MELD was 16. Fifty‐two percent of patients received quinolones, 45% third‐generation cephalosporins and 3% other antibiotics. Fourteen percent (51/371) developed an infection within 14 days of AVH. Seventy‐five percent of infections were culture positive and occurred at a mean of six days from AVH. When all infections were considered, respiratory infections were the most common (53%) followed by urinary tract infections (17%) and bacteremia (16%). Resistance patterns differed between countries. Outpatient antibiotic prophylaxis (OR 5.4) and intubation (OR 2.6) were independent predictors of bacterial infection. Bacterial infection (OR 2.6) and the MELD (OR 1.2) were independent predictors of six‐week mortality.ConclusionsEarly bacterial infections develop in 14% of cirrhotic patients with AVH despite antibiotic prophylaxis, and have a negative impact on six‐week mortality. Intubation and outpatient antibiotic prophylaxis are associated with increased risk of early bacterial infections. Patients at risk should be followed closely with prompt infection workup and local antibiogram‐based expansion of antibiotic therapy in case of clinical decline.
Brazilian Society for Food and Nutrition position statement: nutrigenetic tests
Authors: Cominetti Cristiane , Horst Maria Aderuza , Rogero Marcelo Macedo 
Published: April 2017

AbstractPosition statement: The Brazilian Society for Food and Nutrition (SBAN) bases the following position statement on a critical analysis of the literature on nutritional genomics and nutrigenetic tests: (1) Nutrigenetic tests are predictive and not diagnostic, should not replace other evaluations required to treatment, and should only be used as an additional tool to nutritional prescription; (2) Nutritionists/registered dietitians and other health professionals must be able to interpret the nutrigenetic tests and properly guide their patients, as well as build their professional practice on general ethical principles and those established by regulatory authorities; (3) It is extremely important to highlight that the misinterpretation of nutrigenetic tests can cause psychological and health problems to the patient; (4) Currently, there is insufficient scientific evidence for the recommendation of dietary planning and nutritional supplementation based only on nutrigenetic tests. This position statement has been externally reviewed and approved by the board of SBAN and has not gone through the journal’s standard peer review process.
Death Within 1 Month of Diagnosis in Childhood Cancer: An Analysis of Risk Factors and Scope of the Problem
Authors: Green Adam L. , Furutani Elissa , Ribeiro Karina Braga , Rodriguez Galindo Carlos 
Published: April 2017

Purpose Despite advances in childhood cancer care, some patients die soon after diagnosis. This population is not well described and may be under-reported. Better understanding of risk factors for early death and scope of the problem could lead to prevention of these occurrences and thus better survival rates in childhood cancer. Methods We retrieved data from SEER 13 registries on 36,337 patients age 0 to 19 years diagnosed with cancer between 1992 and 2011. Early death was defined as death within 1 month of diagnosis. Socioeconomic status data for each individual’s county of residence were derived from Census 2000. Crude and adjusted odds ratios and corresponding 95% CIs were estimated for the association between early death and demographic, clinical, and socioeconomic factors. Results Percentage of early death in the period was 1.5% (n = 555). Children with acute myeloid leukemia, infant acute lymphoblastic leukemia, hepatoblastoma, and malignant brain tumors had the highest risk of early death. On multivariable analysis, an age younger than 1 year was a strong predictor of early death in all disease groups examined. Black race and Hispanic ethnicity were both risk factors for early death in multiple disease groups. Residence in counties with lower than median average income was associated with a higher risk of early death in hematologic malignancies. Percentages of early death decreased significantly over time, especially in hematologic malignancies. Conclusion Risk factors for early death in childhood cancer include an age younger than 1 year, specific diagnoses, minority race and ethnicity, and disadvantaged socioeconomic status. The population-based disease-specific percentages of early death were uniformly higher than those reported in cooperative clinical trials, suggesting that early death is under-reported in the medical literature. Initiatives to identify those at risk and develop preventive interventions should be prioritized.
Use of Adjuvant Bisphosphonates and Other Bone-Modifying Agents in Breast Cancer: A Cancer Care Ontario and American Society of Clinical Oncology Clinical Practice Guideline
Authors: Dhesy-Thind Sukhbinder , Fletcher Glenn G. , Blanchette Phillip S. , Clemons Mark J. , Dillmon Melissa S. , Frank Elizabeth S. , Gandhi Sonal , Gupta Rasna , Mates Mihaela , Moy Beverly , Vandenberg Ted , Van Poznak Catherine H. 
Published: April 2017

Purpose To make recommendations regarding the use of bisphosphonates and other bone-modifying agents as adjuvant therapy for patients with breast cancer. Methods Cancer Care Ontario and ASCO convened a Working Group and Expert Panel to develop evidence-based recommendations informed by a systematic review of the literature. Results Adjuvant bisphosphonates were found to reduce bone recurrence and improve survival in postmenopausal patients with nonmetastatic breast cancer. In this guideline, postmenopausal includes patients with natural menopause or that induced by ovarian suppression or ablation. Absolute benefit is greater in patients who are at higher risk of recurrence, and almost all trials were conducted in patients who also received systemic therapy. Most studies evaluated zoledronic acid or clodronate, and data are extremely limited for other bisphosphonates. While denosumab was found to reduce fractures, long-term survival data are still required. Recommendations It is recommended that, if available, zoledronic acid (4 mg intravenously every 6 months) or clodronate (1,600 mg/d orally) be considered as adjuvant therapy for postmenopausal patients with breast cancer who are deemed candidates for adjuvant systemic therapy. Further research comparing different bone-modifying agents, doses, dosing intervals, and durations is required. Risk factors for osteonecrosis of the jaw and renal impairment should be assessed, and any pending dental or oral health problems should be dealt with prior to starting treatment. Data for adjuvant denosumab look promising but are currently insufficient to make any recommendation. Use of these agents to reduce fragility fractures in patients with low bone mineral density is beyond the scope of the guideline. Recommendations are not meant to restrict such use of bone-modifying agents in these situations. Additional information at www.asco.org/breast-cancer-adjuvant-bisphosphonates-guideline , www.asco.org/guidelineswiki , https://www.cancercareontario.ca/guidelines-advice/types-of-cancer/breast .
Differences in Treatment Effect Size Between Overall Survival and Progression-Free Survival in Immunotherapy Trials: A Meta-Epidemiologic Study of Trials With Results Posted at ClinicalTrials.gov
Authors: Tan Aidan , Porcher Raphael , Crequit Perrine , Ravaud Philippe , Dechartres Agnes 
Published: April 2017

Purpose We aimed to compare treatment effect sizes between overall survival (OS) and progression-free survival (PFS) in trials of US Food and Drug Administration–approved oncology immunotherapy drugs with results posted at ClinicalTrials.gov . Methods We searched ClinicalTrials.gov for phase II to IV cancer trials of Food and Drug Administration–approved immunotherapy drugs and selected those reporting results for both OS and PFS. For each trial, we extracted the hazard ratios (HRs) with 95% CIs for both outcomes and evaluated the differences by a ratio of HRs (rHRs): the HR for PFS to that for OS. We performed a random effects meta-analysis across trials to obtain a summary rHR. We also evaluated surrogacy of PFS for OS by the coefficient of determination and the surrogacy threshold effect, the minimal value of HR for PFS to predict a non-null effect on OS. Results We identified 51 trials assessing 14 drugs across 15 conditions. Treatment effect sizes were 17% greater, on average, with PFS than with OS (rHR, 0.83; 95% CI, 0.79 to 0.88; I2 = 34.4%; P = .01; τ2 = 0.0129). Nearly one half of the trials (n = 23, 45%) showed statistically significant benefits for PFS but not for OS. Differences were great for trials of obinutuzumab (rHR, 0.21; 95% CI, 0.08 to 0.54), bevacizumab (rHR, 0.75; 95% CI, 0.67 to 0.84), and rituximab (rHR, 0.79; 95% CI, 0.64 to 0.98). The coefficient of determination was 38% and the surrogacy threshold effect was 0.50. Conclusion Treatment effect sizes in trials of immunotherapy drugs were greater for PFS than for OS, with important differences for some drugs, which is consistent with surrogacy metrics. Caution must be taken when interpreting PFS in the absence of OS data.
Can a web-based tracking and feedback tool improve breast cancer care at safety-net hospitals?
Authors: Bickell Nina A. , Castaldi Maria , Shah Ajay , Sickles Alan , Lewis Theophilus , Arora Shalini , Clarke Kevin , Pappas Peter J , Kemeny Margaret , Srinivasan Anitha , Franco Rebeca , Fei Kezhen , Parides Michael , McAlearney Ann Scheck 
Published: April 2017

107 Background: System failures, a cause of underuse in which doctors order care, patients don’t refuse but care doesn’t ensue, tend to happen more at safety net hospitals (SNH). Tracking & follow-up approaches that close referral loops in SNHs may reduce underuse. In a randomized trial, we tested a Tracking & Feedback (T&F) tool to reduce underuse of adjuvant breast cancer treatment. Methods: We recruited 5 community & 5 municipal SNHs that serve a large proportion of minorities in the NYC metropolitan area. We implemented rapid case ascertainment, a T&F tool and trained point persons at each site to determine if women with newly operated stage 1-3 breast cancer, connected with the oncologist since such connections are associated with getting treated. The tool created a daily “to do” reminder for point persons to ascertain if patients were seen by the oncologist. Point persons then relayed this information to surgeons to follow through as they deemed necessary. Underuse includes: no RT after lumpectomy or mastectomy with > 4 positive nodes; no chemo for HR- and no hormonal therapy for HR+ tumors > 1cm; no trastuzumab for Her2+ tumors. We interviewed key informants about tool usefulness. We conducted intention to treat and pre-post analyses to assess tool and implementation effectiveness, respectively. Results: Pre-intervention, despite randomizing hospitals, intervention (INT) hospitals had fewer whites (4% vs 14%; p = 0.0005), poorer follow-up approaches (0.68 vs 0.80; p = 0.07), less Medicaid & uninsured patients (36% vs 62%; p < .0001) and more underuse (28% vs 15%; p = 0.002) compared to control (CNTL) hospitals; comorbidities and stage were similar. The RCT found no difference in underuse rates (9% at INT & 11% at CNTL hospitals; p = 0.8). Because randomization did not result in equivalent distributions, we modeled pre- (N = 403) and post (N = 191) populations controlling for time period and clustering & found that hospitals with better follow-up (OR = 0.82; 95% CI: 0.71-0.96) had less underuse. In settings with poor follow-up & tracking approaches, key informants found the tool useful. Conclusions: While the RCT findings were negative, they suggest a T&F tool may help reduce underuse in SNHs with poor follow-up capabilities. Clinical trial information: NCT01544374.