bluuebunny/crossref_metadata_2025_split huggingface dataset:
How do hand therapists conservatively manage acute, closed mallet finger? A survey of members of the British Association of Hand Therapists
Authors: Cook Samantha , Daniels Nikki , Woodbridge Sarah 
Published: August 2016

Introduction Previous research concerning the conservative management of mallet finger has focused on splint application, with limited representation of supplementary rehabilitation and best practice. This research sought to investigate the practice and opinions of members of the British Association of Hand Therapists regarding their current treatment and to determine whether any specific exercise prescription or rehabilitation protocols are followed. Methods British Association of Hand Therapists members were contacted via e-mail and requested to complete an online survey. Thirty-five responses (5.7% response rate), 30 (4.8% response rate) of which were fully completed were obtained over the eight-week data collection period. The questionnaire consisted of 30 questions (20 quantitative and 10 qualitative) concerning therapists’ roles and condition management. Responses were analysed in terms of response frequencies, percentages and thematic text analysis. Results The results demonstrated current clinical practices in line with available best-evidenced practice. Conservative therapeutic management is diverse and varied. Therapists believe their role to be significant in optimising outcome success. Discussion Exercises and other interventions supplementary to splinting are commonly utilised in the therapeutic management of acute, closed mallet finger. This research found hand therapists implement a diverse range of clinical skills in order to optimise outcome success. Recommendations for best practice and further research are presented.
Antigen-presenting human B cells are expanded in inflammatory conditions
Authors: Shimabukuro-Vornhagen Alexander , García-Márquez María , Fischer Rieke N , Iltgen-Breburda Juliane , Fiedler Anne , Wennhold Kerstin , Rappl Gunter , Abken Hinrich , Lehmann Clara , Herling Marco , Wolf Dominik , Fätkenheuer Gerd , Rubbert-Roth Andrea , Hallek Michael , Theurich Sebastian , von Bergwelt-Baildon Michael 
Published: August 2016

Abstract
Traditionally, B cells have been best known for their role as producers of antibodies. However, in recent years, a growing body of evidence has accumulated showing that B cells fulfill a range of other immunologic functions. One of the functions that has attracted increasing attention is the capacity of B cells to induce antigen-specific activation of T cells through presentation of antigens. However, the analysis of this B cell function has been hampered by the lack of a phenotypically well-defined antigen-presenting B cell subset. Here, we report the identification of a human antigen-presenting B cell subset with strong immunostimulatory properties. This B cell subset is characterized by low expression of CD21 and high expression of the activation marker CD86 and exhibits strong T cell–stimulatory activity, as demonstrated by means of an autologous mixed-lymphocyte reaction. Phenotypically, CD21lowCD86pos immunostimulatory B cells (BAPC) represented CD27+ class-switched IgMnegIgDneg B lymphocytes and displayed a higher expression of cell surface receptors, which mediate the migration from peripheral blood to sites of inflammation. Flow cytometric analysis of peripheral blood obtained from individuals with inflammatory conditions revealed that the BAPC subset was expanded following vaccination and in patients with rheumatoid arthritis. Taken together, our work shows that BAPC represents a strongly immunostimulatory B cell subset, which could be a promising target for immunotherapeutic intervention in inflammatory diseases.
The Amount of Fluid Given During Surgery That Leaks Into the Interstitium Correlates With Infused Fluid Volume and Varies Widely Between Patients
Authors: Nishimura Akiko , Tabuchi Yoko , Kikuchi Mutsumi , Masuda Rikuo , Goto Kinuko , Iijima Takehiko 
Published: August 2016

BACKGROUND:
The revised Starling law suggests that intravenously infused fluid may leak into the interstitium and not remain in the intravascular space. This hypothesis is supported by clinical findings that postoperative weight gain is proportional to the amount of infused fluid. The distribution of intravenously administered fluid between the interstitium and intravascular space deserves evaluation, as postoperative weight gain because of intraoperative infusion is an important risk factor for postoperative adverse events. We quantitatively estimated fluid movement in patients undergoing orthognathic surgery by performing a volume kinetic study using hemoglobin concentration as a marker of dilution.

METHODS:
Forty-one patients scheduled to undergo orthognathic surgery were enrolled in this study. The arterial hemoglobin concentration was measured at each procedural step. Acute normovolemic hemodilution was induced by withdrawing 400 mL of blood followed by the infusion of a known amount of hydroxyethyl starch, enabling the initial blood volume to be estimated. The dilution rate of the arterial hemoglobin concentration enabled the volume of fluid in the intravascular space to be quantified. The fluid volume that leaked into the interstitium was then calculated based on the change in the estimated intravascular plasma volume.

RESULTS:
The blood volume estimated via this method was close to the value derived from a previously published formula. The mean volume of crystalloid infused as a maintenance fluid was 2062 ± 408 mL, ranging from 1220 to 3050 mL. None of the cases required blood product transfusion. The amount of infused fluid that remained intravascular varied widely from 2.0 to 35.7 mL/kg (mean, 12.0 ± 8.2 mL) after surgery, corresponding to 5.3% to 95.7% of the infused volume. The change in intravascular fluid volume during surgery was not strongly correlated with the infusion amount (Pearson correlation analysis: r = −0.05, P = .75, −0.44 < ρ ≤ 0.35, confidence intervals; Spearman correlation analysis: r = −0.14, P = .38, −0.51 < ρ ≤ 0.27). However, the amount of fluid that leaked into the interstitium during surgery did correlate with the infusion amount (Pearson correlation analysis: r = 0.42, P = .01, 0.03 < ρ ≤ 0.70; Spearman correlation analysis: r =0.45, P = .003, 0.07 < ρ ≤ 0.72).

CONCLUSIONS:
We found that the increase in intravascular fluid volume caused by intravenous fluid administration was not correlated strongly with the volume of infused fluid. Instead, the amount of fluid leakage into the interstitial space depended on the infused fluid volume. This clinical result supports the revised Starling law, which suggests that intravascular fluid may often leak into the interstitium. More work is needed to better understand the factors governing leakage of infused fluid into the interstitial space.
АКТУАЛЬНОСТЬ И НАУЧНЫЕ НАПРАВЛЕНИЯ В ИЗУЧЕНИИ HELICOBACTER PYLORI ИНФЕКЦИИ У ДЕТЕЙ СИБИРИ
Authors: Kasparov Eduard Vilyamovich , Moskalenko Olga Leonidovna 
Published: August 2016

Озабоченность вызывает увеличение заболеваний гастродуоденальной зоны у детей, что чревато ростом патологии среди взрослого населения в дальнейшем, учитывая рецидивирующий характер ее течения. Одно из первоочередных мест среди этиологических факторов в формировании гастродуоденальной патологии отводится H. pylori инфекции, с которой во многом связывают неблагоприятную ситуацию по язвенной болезни, раку желудка в регионах, в частности, в ряде территорий Сибири. В обзоре представлены научные направления и обобщены результаты исследований по изучению различных аспектов H. pylori инфекции у детей сибирского региона. В частности обобщены данные об эпидемиологии инфекции. Представлены данные научных исследований о популяционных особенностях клинического течения H. pylori-ассоциированных заболеваний и о внегастральных проявлениях инфекции у детей Сибири.
ОЦЕНКА НАКОПЛЕНИЯ РТУТИ В ОБЪЕКТАХ ЖИВОЙ И НЕЖИВОЙ ПРИРОДЫ СЕВЕРА ЕВРОПЕЙСКОЙ ТЕРРИТОРИИ РОССИИ
Authors: Ovsepyan Asya Emilyevna , Fedorov Yuri Aleksandrovich , Zimovets Alina Aleksandrovna , Savitsky Vyacheslav Aleksandrovich 
Published: August 2016

В работе исследуется содержание ртути в различных объектах окружающей среды севера европейской территории России (ЕТР). Цель – оценить накопление ртути в объектах живой и неживой природы севера ЕТР на примере Архангельского региона.В основу работы положены результаты оригинальных исследований, проводившихся авторами с 2004 г. Отбирались и анализировались на содержание ртути пробы снега, дождевых осадков, почв, воды и донных отложений рек, озер, болот, Белого моря, а также различных видов рыб. Привлечены данные по содержанию ртути в хвое ели, эпифитных лишайника. Район исследований включал участки с различной степенью выраженности антропогенного воздействия. Определения концентраций ртути проводились методом атомной абсорбции в холодном паре аттестованной лабораторией Южного федерального университета. Контроль повторяемости получаемых результатов проводился в ФГУГП «Южгеология» и Гидрохимическом институте Росгидромета. Погрешность определения 10-15 %.Получены ряды ранжирования по уровням накопления ртути (по возрастанию): донные отложения озер → донные отложения Белого моря → донные отложения болота Иласское → хвоя ели → почвы → гидробионты устья реки → донные отложения устья р. Северная Двина → эпифитные лишайники; вода озер → дождевые осадки → снеговые осадки → вода устья р. Северная Двина.Выявленное повышенное содержание ртути во всех компонентах речной экосистемы устья Северной Двины демонстрирует превалирующую роль антропогенного поступления загрязненных вод различного происхождения. В целом уровни содержания ртути в регионе сравнимы с другими циркумполярными областями, находящимися под антропогенным воздействием, и превышают подобные значения для фоновых районов субарктики.Результаты могут быть использованы при усовершенствовании сети мониторинга качества окружающей среды, а также разработке научных основ природоохранных мероприятий.
Improving efficiency in the endoscopy unit
Authors: Mohamed Gaafar , Murphy Clodagh , McCarthy Jane , Buckley Martin 
Published: August 2016

The demand for endoscopic services is increasing rapidly, and this necessitates optimal efficiency in the endoscopy unit. Aim: To assess the efficiency of an endoscopy unit, concentrating in the delay pre-and post-procedure. Patients: Outpatient/day ward procedures. Methods: We examined the delay in endoscopic procedures between 19 and 30 May 2014. The procedure process was examined at three different stages: stage 1 is from when the ‘patients arrives to pre-procedure ward’ to ‘ready for procedure’; stage 2 is from ‘where the patient is ready and waiting to be called’ to ‘when the endoscopy procedure commences’; and stage 3 is from ‘when the ward is contacted to collect patient post procedure’ to ‘when the patient is discharged from the ward’. Results: The pathways for 238 endoscopic procedures were assessed. In total, 249 episodes of delay were documented. Stage 1 accounts for 28% of the delays; there is 1.1–1.6 hours of a delay per patient at this stage. Stage 2 accounts for 53% of the delays; there is a delay of 2.5–2.75 hours per patient at this stage. Stage 3 accounts for 19% of the delays; there is a delay of 1.75 – 2 hours per patient at this stage. Conclusion: Delays were a major factor affecting optimal use of available day ward/endoscopy resources. Significant delay can occur pre-and post-procedure. Strategies to reduce peri-procedural delays could have a favourable impact on day ward capacity and the volume of procedures performed in the endoscopy unit.
Patient perceptions of the professional attitudes of radiographers
Authors: Ochonma Ogbonnia , Eze Charles , Eze Bartholomew , Nwankwor Chikezie 
Published: August 2016

Introduction: In Nigeria radiographers practice in both public and private hospitals, yet there are lingering differences in perceptions among patients about the professional conduct of radiographers related to the type of hospital they work in. The purpose of this study was to investigate these differences and make policy recommendations. Methods: A cross-sectional study was undertaken in which 300 respondents (patients) who had received outpatient radiological services in a public and a private hospital answered a questionnaire. Results: The results showed that radiographers in the public facility excelled in five professional areas, including the principle of informed consent and the right of patients or their carers to refuse service or treatment, while radiographers in the private facility performed better in ten professional areas, including the observation of appropriate professional boundaries. Conclusion: Lack of enforcement of professional rules and regulations regarding the conduct of radiographers is a major problem. A monitoring body overseeing the professional conduct of radiographers is highly recommended to improve public trust and confidence in radiological services in public and private hospitals.
A survey of work engagement and psychological capital levels
Authors: Bonner Lynda 
Published: August 2016

Aim: To evaluate the relationship between work engagement and psychological capital (PsyCap) levels reported by registered nurses. Background: PsyCap is a developable human resource. Research on PsyCap as an antecedent to work engagement in nurses is needed. Methods: A convenience sample of 137 registered nurses participated in this quantitative cross-sectional survey. Questionnaires measured self-reported levels of work engagement and psychological capital. Descriptive and inferential statistics were used for data analysis. Results: There was a statistically significant correlation between work engagement and PsyCap scores (r=0.633, p<0.01). Nurses working at band 5 level reported statistically significantly lower PsyCap scores compared with nurses working at band 6 and 7 levels. Conclusion: Nurses reporting high levels of work engagement also reported high levels of PsyCap. Band 5 nurses might benefit most from interventions to increase their PsyCap. This study supports PsyCap as an antecedent to work engagement.
Antiseptic with modern wound dressings in the treatment of venous leg ulcers: clinical and microbiological aspects
Authors: Sopata M. , Kucharzewski M. , Tomaszewska E. 
Published: August 2016

Objective: To assess the impact of a two-period treatment on the clinical condition, bacteriological changes and results of treatment of venous leg ulcers (VLU) using octenidine dihydrochloride. Method: Patients with a VLU were recruited and treated with octenidine dihydrochloride for one month, after which they were randomised and treated with hydrocolloids or foam dressings. The wounds were clinically assessed for the amount of necrotic tissue, granulation tissue, epithelialisation, amount of exudate and pain level. During the first period, bacterial colonisation and antimicrobial efficacy of octenidine dihydrochloride were also evaluated. In the second period the efficacy of treatment, time of treatment and healing rate were investigated. Results: In the group of 50 VLU patients, all wounds (100%) improved after the first treatment period. No clinical signs of infection were observed. Statistically significant changes were observed in all the clinical parameters studied in the treated groups of VLU patients, including reduction of necrotic tissue, the amount of exudate and of pain, as well as increased granulation and epithelialisation. In the second period including treatment with the two dressings, no differences were observed in treatment efficacy, time of treatment or healing rate. Conclusion: As used in this study, octenidine dihydrochloride proved to be effective and useful, changing the clinical condition of VLU, preparing the wound for future treatment with modern dressings. High microbicidal activity of octenidine was observed, both against Gram-negative and Gram-positive bacteria isolated from the ulcers. Octenidine dihydrochloride caused an eradication of multiresistant strains (88%) as well as of bacteria qualified as alert-pathogens (100%) in the treated wounds after four weeks. However, no differences in the effects, time or rate of healing of VLU with two dressings were found in the second period. No side effects or significant local intolerance reactions used for treatment were observed
Quality of wound dressings: a first step in establishing shared criteria and objective procedures to evaluate their performance
Authors: Mennini N. , Greco A. , Bellingeri A. , De Vita F. , Petrella F. 
Published: August 2016

Objective: There are no well-defined criteria for assessing the efficacy and quality of wound dressings, and evaluation is often simplistic and based on the subjective opinion of the health-care professional. The aim of this study was to identify specific parameters suitable for measuring dressings' performance, and to recommend laboratory tests able to evaluate these specific criteria in an objective manner. Method: After reviewing all tests currently used in Italy and examining the criteria for evaluating the quality of dressings, the authors selected 12 clinically significant parameters. These parameters were measured using standard and non-standard tests, and in some cases, these tests were modified and improved to simulate real-life conditions more accurately. Results: Most of the tests used were able to discriminate well between dressings belonging to different brands, with some tests being more suitable than others for the assessment of specific dressings. Conclusion: These results highlighted some issues in the standard testing procedures, such as the need of a suitable fluid that mimics the real exudate, and the importance of standard temperature and humidity conditions during testing. Our study paves the way for a larger project aimed at a systematic evaluation of dressing quality able to assess every wound dressing on the market.
Exploring nurses' and patients' feelings of disgust associated with malodorous wounds: a rapid review
Authors: Ousey K. , Roberts D. 
Published: August 2016

Objective: To identify primary empirical research related specifically to feelings of disgust associated with malodorous chronic cutaneous wounds. Method: A rapid review of the literature using the key words disgust; wounds; malodour and psychosocial. Results: A total of 163 papers were retrieved with seven being included for the final review. Themes emanating from the review were malodour, health-care professionals coping with malodour and disgust. Malodour is a concern to patients, which can sometimes go unreported by nursing staff; although the reasons for this remain unclear. The coping mechanisms developed by nurses in response to ‘disgusting’ wounds requires further exploration in order for a fuller understanding of these mechanisms to be achieved. This review has identified that both health-care professionals and patients can become distressed at wound odours, yet there is little evidence that is available to guide people as to how to manage these feelings. Conclusion: Hard-to-heal or chronic cutaneous wounds, such as leg ulcers and diabetic foot ulcers, are an increasing global health-care issue. While some research has been undertaken to explore the psychological impact of living with a fungating carcinoma; much less has been written about the management and mitigation of feelings of disgust for patients and families living with a malodorous wound or how health-care professionals can effectively provide psychosocial care.
The management of chronic ulcers with an acidoxidising solution
Authors: Ricci E. 
Published: August 2016

Objective: Chronic ulcers are an intractable problem in many patients and are associated with impaired quality of life and high health-care costs. In an attempt to improve outcome, our centre began cleansing wounds with a novel spray acidoxidising solution (Nexodyn) with unique physicochemical features, pH <3.0; oxidation reduction potential >1000mV; and free chlorine content (>95% HClO). Method: A retrospective analysis was conducted in patients with numerous comorbidities and an unsatisfactory response to standard therapy. The solution was administered for six weeks and the patients' clinical course evaluated using standard measures of wound healing, pain and bioburden. Results: We assessed 20 patients with a mean time since ulcer onset of 23.7 months. Complete resolution of the lesion was achieved in 25% of cases (p=0.005). In the group as a whole, wound size decreased significantly (11% mean reduction versus baseline; p=0.039). In the relatively short six-week observation period, significant reductions versus baseline were also observed in control of wound bioburden (p=0.005) and ulcer-related pain score (p<0.001). Furthermore, the wound bed preparation score suggests an improved wound microenvironment with better wound bed cleansing and the presence of granulation tissue. There were no adverse systemic effects of treatment nor adverse local effects in the wound bed or on healthy periwound skin. Conclusion: Encouraging initial results in a population refractory to standard management provide evidence that this new product may make a helpful contribution to the care of chronic ulcers. The integration of this cleansing solution into standard care contributes to the modulation of local microenvironmental responses that inhibit physiological healing processes while also contributing to the reduction of bacterial load.
Clinical acceptability of a dressing with matrix technology: a multisite evaluation of acute and chronic wounds
Authors: Guthrie J. , Potter R. 
Published: August 2016

Objective: This article will describe the findings of an evaluation on the performance and clinical acceptability of Urgotul Absorb Border (Urgo Medical), a silicone border adhesive foam dressing containing technology lipidocolloid (TLC) healing matrix technology, as either a primary or secondary dressing in the management of acute and chronic wounds in a multisite evaluation. The purpose of the evaluation was to establish the effectiveness of the silicone border dressing for managing exudate, ease of use, patient comfort and acceptability of the clinician for the dressing to meet with treatment objectives Method: The patient experiences given through verbal or written feedback were also documented. Local Health Board evaluation forms were used to capture data and the authors of this article created a data evaluation tool to collate and subsequently report all study findings. Results: A total of 100 patients with wounds considered suitable for the application of the dressing were selected to take part in the study. In less than a four week period, 38 patients achieved wound healing with a further 36 patients demonstrating wound improvements within the same time period. Conclusion: The dressing was found to have met both the clinicians and patients aims when used as either a primary or secondary dressing and was considered suitable for use in both acute and chronic wounds of varying duration.