bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnostic accuracy of lipopolysaccharide-binding protein for sepsis in patients with suspected infection in the emergency department
Authors: García de Guadiana Romualdo Luis , Albaladejo Otón María Dolores , Rebollo Acebes Sergio , Esteban Torrella Patricia , Hernando Holgado Ana , Jiménez Santos Enrique , Jiménez Sánchez Roberto , Ortón Freire Alejandro 
Published: January 2017

Background Biomarkers can facilitate the diagnosis of sepsis, enabling early management and improving outcomes. Lipopolysaccharide-binding protein (LBP) has been reported as a biomarker for the detection of infection, but its diagnostic value is controversial. In this study, we assessed the diagnostic accuracy of LBP for sepsis in the emergency department (ED) patients, comparing it with more established biomarkers of sepsis, including procalcitonin (PCT) and C-reactive protein (CRP). Methods LBP and other sepsis biomarkers, including PCT and CRP, were measured on admission in 102 adult patients presenting with suspected infection . Classification of patients was performed using the recently updated definition for sepsis (Sepsis-3). The diagnostic accuracy of LBP, CRP and PCT for sepsis was evaluated by using receiver operating characteristic curve (ROC) analysis. Results A total of 49 patients were classified as having sepsis. In these patients, median (interquartile range) LBP (41.8 [41.1] µg/dL vs. 26.2 [25] µg/dL), CRP (240 [205] mg/L vs. 160 [148] mg/dL) and PCT (5.19 [13.68] µg/L vs. 0.39 [1.09] µg/L) were significantly higher than in patients classified as not having sepsis ( P < 0.001 for all three biomarkers). ROC curve analysis and area under curve (AUC) revealed a value of 0.701 for LBP, similar to CRP (0.707) and lower than that for PCT (0.844) ( P = 0.012). Conclusion In adult ED patients with suspected infection, the diagnostic accuracy for sepsis of LBP is similar to that of CRP but lower than that of PCT.
Mental health and public policies implemented in the Northeast of Brazil: A systematic review with meta-analysis
Authors: Januário Sonilde Saraiva , das Neves Peixoto Florido Sampaio , Lima Nádia Nara Rolim , do Nascimento Vânia Barbosa , de Sousa Danilo Ferreira , Pereira Luz Dayse Christina Rodrigues , da Silva Claúdio Gleidiston Lima , Rolim Neto Modesto Leite 
Published: January 2017

Introduction: Studies about mental disorders are very rare in the Northeast of Brazil, especially when psychopathologies in children and adolescents are considered. The consequence is a small availability of data and an absence of a real epidemiological profile. Methods: This is a systematic review with meta-analysis, following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) protocol, in the period from 2003 to 2015, using the databases LILACS, SciELO and BVS. The analysis comprised the keywords ‘models of primary and secondary healthcare in mental health’, ‘psychiatric reform’ and ‘policies and services in mental health’, using the Boolean operator ‘# AND’. Original texts based on secondary data from the Hospital Information System of the Brazilian Unified Health System were also included via the Citizen Electronic Record System, Instituto Brasileiro de Geografia e Estatística, and Ministry of Health. Grey literature was used by means of hand searching. Results: A combined analysis of the strategies mentioned in the analyzed articles shows a combined odds ratio of 1.291 (confidence interval (CI) = 1.054–1.582), thus it demonstrates the efficacy of using such strategies in the elaboration of institutional apparatus in mental health. The p-value of the chi-square distribution resulted in .9753, which does not reject the hypothesis of association between strategies in mental health and possible development of institutional apparatus in mental health. Conclusions: A combined analysis of all strategies mentioned in the analyzed studies shows efficacy of using strategies to elaborate institutional apparatus in mental health.
Outcomes of a care coordinated service model for persons with severe and persistent mental illness: A qualitative study
Authors: Isaacs Anton N , Sutton Keith , Dalziel Kim , Maybery Darryl 
Published: January 2017

Background: Owing to difficulties faced by individuals with severe and persistent mental illness (SPMI) in accessing multiple services, the Australian Government trialed a care coordinated service model called the Partners in Recovery (PIR) initiative. Material: A total of 45 stakeholders in Gippsland were asked what difference the initiative had made. Discussion: The PIR initiative benefited not only clients and carers but also service providers. It addressed an unmet need in service delivery for individuals with SPMI. Conclusion: The PIR initiative has filled a gap in delivery of care for individuals with SPMI in Gippsland.
Heparinized saline versus normal saline for maintaining peripheral venous catheter patency in China: An open-label, randomized controlled study
Authors: Xu Lichun , Hu Yan , Huang Xiaojin , Fu Jianguo , Zhang Jinhui 
Published: January 2017

Objective To evaluate the effects of heparin saline versus normal saline as locking solution for maintaining patency in peripheral venous catheters in Chinese patients. Methods This open-label, randomized controlled study was conducted in two hepatobiliary surgery wards, where patients received identical treatments, at a tertiary referral hospital. Patients were randomly divided into a normal saline group (NS, 3 ml) or a heparin saline group (HS, 50 IU/ml, 3 ml) for catheter sealing. Results The study enrolled 286 patients and 609 peripheral venous catheters were included in the analysis. The patients in the two groups had no local infections or catheter-related bloodstream infections. There were no significant differences between the two groups in terms of the rate of catheter obstruction, duration time, or the rates of phlebitis, infiltration, and accidental catheter removal. Conclusions No significant differences in the peripheral venous catheter sealing effects were observed between normal saline and heparin saline usage in Chinese patients.
Clinical use of nutraceuticals in the adjunctive treatment of depression in mood disorders
Authors: Sarris Jerome 
Published: January 2017

Objectives: The aim of this paper is to detail a summary of the current evidence in this area, to better inform clinical practice. Our recent systematic reviews and meta-analyses of nutrient pharmacotherapies in the treatment unipolar depression revealed primarily positive results for replicated studies testing S-adenosyl methionine (SAMe), methylfolate, omega-3 (EPA or ethyl-EPA), and Vitamin D; with supportive isolated studies found for creatine and an amino acid combination. Mixed results were found for zinc, folic acid, Vitamin C, and tryptophan; and non-significant study results for inositol. In bipolar depression, omega-3 and N-acetyl cysteine (NAC) were found to have supportive evidence, with an isolated study using a chelated mineral formula also displaying efficacy. No major adverse effects were noted in the studies (aside from occasional minor digestive disturbances with omega-3 and NAC). Conclusions: Several clinical considerations are needed when psychiatrists are considering prescribing nutrients, including knowledge of drug interactions, supplement safety and quality issues, individual psychological and biochemical individualities, in addition to cost factors.
Are people with severe mental illness ready for online interventions? Access and use of the Internet in Australian mental health service users
Authors: Thomas Neil , Foley Fiona , Lindblom Katrina , Lee Stuart 
Published: January 2017

Objectives: The Internet is increasingly used in mental health service delivery, but there are significant potential barriers to Internet access for persons with severe mental illness (SMI). There is a need to understand this group’s access to, and confidence with using, the Internet, and current views on using online resources as part of mental healthcare. Method: A survey was conducted of 100 consumers attending a specialist mental health service in Melbourne, Australia. Results: Approximately three-quarters of participants had regular access to the Internet, and two-thirds used the Internet weekly or more. Half of the sample used email at least weekly, and a third were regular users of social networking sites. Internet access was often via mobile devices. Only a minority of participants used the Internet for mental health information, with video streaming and general websites accessed more often than peer forums for mental health content. Most participants were positive about their mental health worker using tablet computers with them in appointments for delivery of mental health materials. Conclusion: Most people with SMI are active Internet users and, therefore, able to use interventions online.
Surgical management of myelopathy caused by a solitary spinal osteochondroma in a young cat
Authors: Heblinski Nikola , Schmökel Hugo 
Published: January 2017

Case summary A 10-month-old, male castrated, domestic shorthair cat was presented with fast-progressing ataxia of the pelvic limbs. MRI and CT were performed, revealing a bony proliferation at T11, with mass effect and laterodorsal compression of the spinal cord. After hemilaminectomy and the removal of the bony mass, the cat recovered uneventfully. At the 1 year follow-up, the cat did not show any neurological deficits or signs of recurrence. Relevance and novel information Solitary osteochondroma as a cause of neurological deficits in the pelvic limb has been described in dogs and humans, but, to the best of our knowledge, there are no reported feline cases described in the literature, in which CT and MRI were performed in combination with the successful removal of the lesion and an excellent outcome for the patient.
CARPAL TUNNEL SYNDROME IN CYCLISTS
Authors: Sousa Daniel , Sassul Nicolás 
Published: January 2017

Objectives: About a group of cyclists, professionals / amateurs, Mountain bike, road and triathlon; achieve a good diagnosis of the disease, with a good clinical examination and sectorized according EGM injury evoked potentials. Methods: Clinical examination and accurate test with different signs of pathology. EGM with evocative potential and conduction velocity. Results: After 25 track cyclists, 18 professionals, 22 male and 3 female; for 24 months. Through good clinical examination and EMG. We got that 70% had direct compression injuries Carpal tunnel for poor support on the handlebars. The rest were cervical praxis, by poor body position on the bike, taking cervico very steep angles / dorsal, during competitions or training for more than 2 hrs. Conclusion: A good prevention work with our teacher / cyclist in the position of deposrtista in ciclo simulador. Work in the gym, on tone and elongation of the upper limb. A good EGM, made with a specialist physiatrist. It leads to the correct diagnosis, leads to a good final treatment; which agreed that:* Cervical praxis, had good results with treatment Conservative / FST / vit.B12.* The Carpal tunnel own injuries, treatment was quirúrg. (Open surgery) with subsequent FST / vit..B12 with satisfactory return in time to sporting activity.
Are Tendinopathies really a common injury in volleyball?
Authors: Bustos Aldo , Locaso Fernando 
Published: January 2017

Objectives: To perform a description of tendinopathies as an injury in volleyball high performance. Methods: An observational and prospective study was conducted from 2014-2016 in the senior Argentinian volleyball team. The same was held by two observers. Moreover, 78 athletes were evaluated. We support Dvorak’s claims that an injury is determined by the loss of at least one training session or a match. Results: 78 players were exposed to 21812 hours of training and matches. As a result 37 injuries were evaluated in 31 players. Taking into account tendinopathies, it can be said that 34 players consulted 412 times, showing a prevalence of 43.5% of the whole enquires but when we refer to the same pathology as injury the average lowers, presenting 8 lesions in 6 players and showing a prevalence of 7.6% as injuries. Incidence of tendon injuries is 0.32 per 1000 hours of exposure Tendon Injuries: 5 were patellar, 2 supraspinatus, 1 aquiles. 5 Slight, 2 moderate, 1 severe. Conclusion: Clearly, tendinopathy is a common problem in this sport but it is not a common cause of injury. This is demonstrated in prevalence rates whereas 43.5 % just consulted and 7,6 % suffer from real injuries. We think this might be due to several factors such as, advances in medical therapy, preventive protocols and increase in thresholds of pain that high-performance athletes can bear. In our experience this pathology was shown to be the third leading cause of injuries. In 2016 we did not deal with any case of injury for tendinopathy.
Results of arthroscopic meniscal repair
Authors: Orlowski María Belén , Arroquy Damián , Chahla Jorge , Guiñazú Jorge , Bisso Martín Carboni , Vilaseca Tomás 
Published: January 2017

Objectives: Currently the arthroscopic treatment of meniscal pathology has become one of the most common procedures in orthopedic practice and although in most cases meniscectomy is done, meniscal sutures are the treatment of choice when a reparable lesion is diagnosed, especially in young patients. It has been reported that the meniscal repair leads to a lower incidence of developing degenerative changes in the long-term when compared with meniscectomy and nonsurgical treatment of meniscal injuries. The aim of this study was to determine the success rate of meniscal repair achieved in our sports medicine practice. Methods: Between 2006 and 2015, 62 meniscal tears in 58 patients with a mean age of 31 years (range 15-58) were repaired. Mean follow-up was 52 months (range 6-120 months). In 16 patients (28%) was associated with arthroscopic ACL reconstruction. The repair techniques used included outside-in sutures, inside-out sutures, all-inside sutures and a combination of techniques. Failure of the repair was defined by the requirement for repeat knee arthroscopy and partial or subtotal meniscectomy. The indication of arthroscopic revision was based on the presence of mechanical symptoms, after the suture. Results: Failure of meniscus repair occurred in four patients (failure rate: 6.45%), one case was associated with ACL reconstruction (failure rate: 6.25%) and 3 had undergone isolated meniscal suture (failure rate: 8%). The average time for the reoperation was 15 months (4-24). We had no intraoperative complications. Conclusion: The reported failure rate of meniscal repair in stable knees varies between 12% and 43%, with reports that demonstrate a clinical success rate of 100%. In this study, we obtained a success rate of 93.5%. These results are slightly higher than those in the literature, which can be attributed to careful selection of patients and the fact that clinical success tends to be better than the assessed arthroscopically. In summary, we consider the meniscal repair as a successful option in the treatment of meniscal rupture. Due to the importance it has recovered in the last time preserving the meniscus, in the future we should greatly increase our rate of meniscal suture. We hold that careful selection of patients and the type of injury to repair, optimizes the success of meniscal repairs.
Anterior Cruciate Ligament Reconstruction with cadaveric graft in Adolescents with Active Growth Cartilage
Authors: Mantilla Ronnald , Rosell Italo , Pedregal Carlos , Revoredo Rafael , Makino Arturo 
Published: January 2017

The immature skeleton ACL reconstruction is controversial, due to the possibility of injuring the physis, producing discrepancies in length and angular deformities. The purpose of this study, is presenting our experience of 11 cases, describing the surgical technique Arthroscopic intra-articular respecting them physis. Objectives: The purpose of this study is to present our surgical technique, control and monitoring in patients with active growth cartilage. Material and Methods: Between 2010 and 2015 treated 11 patients from 12 to 16 years, with a injury of the ACL with active growth cartilage evaluated clinically and radiologically. We use a scale of Tanner, x-ray of wrist and MRI for evaluation. They showed no tibial spine avulsions. The acute injury was inclusive criterion. We indicate Arthroscopic cadaveric graft reconstruction, without passing through the physis. We use rehabilitation protocol, immobilizer and crutches. Tracking through scale IKDC and resonance. Description of the surgical technique: Arthroscopic portals habitual plus supramedial accesory portal, identified the injury of the ACL; using fluoroscopy identified the physis active, put kirschner’s pins as guides without crossing them physis, drilled tunnels, check indemnity of the physis, spent the graft, fixing femoral with endobutton and tibial with biodegradable screw. Results: Of the 11 patients, there were 3 meniscal injuries, only 1 sutured. We didn’t have cartilaginous lesions. One patient presented surface Erythema that solved with antibiotic. Slight pain according to scale of pain. Not instability was present. The 60% had sport return without complications. There were no failures of the graft or comorbidities. They showed no growth disorders. Conclusion: The discussion is in repair without producing complications, considering that the natural evolution will lead to a potential damage. Authors show reports of shortening by perforation of the physis, our series presents one more technique to cosider to not alter bone growth by closing early the physis in addition to avoid instability.
Juvenile Osteochondritis Dissecans of the Knee. About A Case
Authors: Astore Ignacio , Agotegaray Juan Ignacio , Comba Ignacio , Bisiach Luciana 
Published: January 2017

Introduction: Juvenile osteochondritis dissecans is a pathology that affects the superficial articular cartilage and subchondral bone in patients with open physes. Treatment of this disease is based on patient’s age and the stage of the disease. Methods: 16-year-old patient, athlete, with a history of knee pain on the right side of acute onset, without traumatic history. A physical examination shows pain in the external compartment of the knee. MRI shows a stable lesion that involves the external femoral condyle, over a posterior area of 16 mm by 20mm. Crutches are indicate for walking without body burden. Symptoms continue for six months and there are no changes in MRI. It is decided to do a stabilization with a Herbert type screw. After the surgery, pain persists and in x-ray controls, osteointegration is not observed. Osteosynthesis material is extracted and mosaicplasty is performed. We used Guhl’s intraoperative classification. Results: In this case, for a young patient with Guhl’s lesion type III, the reduction with a Herbert type screw was indicated, as the lesion was stable, of a significant size and congruent. Lesion progressed to type IV in 6 months. Thus, mosaicplasty was performed, obtaining a good functional result according to the physical exam, with a complete range of flexion and extension. A second-look arthroscopic assessment was carried out 2 months after surgery, showing osteointegration and stability of the allogenic graft. Conclusion: The variable of stability of the fragment is very important when determining the treatment. Most of the stable lesions can be successfully treated with a conservative treatment. Also, it has been demonstrated that young patients have a higher rate of healing. Instead, unstable lesions require surgical treatment.
Our Experience with Patello femoral joint replacement
Authors: Ramos Pablo , Arteaga Gonzalo , Vargas Medardo , Naranjo Juan 
Published: January 2017

Background: Ten to fifteen percent of knee arthritis is reported to be isolated patellofemoral arthritis. Total knee arthroplasty is not recommended for isolated patella femoral arthritis particularly in young patients. We present the retrospective review our series in 7 years. Objectives: The aim of this presentation is to describe our experience in the management of patellofemoral osteoarthritis with the use of the partial patellofemoral arthroplasty, as well as to delineate the pitfalls and causes of revision in our initial series of 153 cases. Methods: between 2009 and 2016, our group performed 157 patellofemoral arthroplasties (PFA) 74% being in women, and 26% in men, the mean age for women was 58 yrs. And 38 yrs. for men, our initial 13 cases were managed with the Avon prosthesis (Stryker Corporation Kalamazoo, Michigan), and then we switched to the Vanguard PF (Zimmer-Biomet Warsaw In), both systems are an On-Lay design that is more flexible for addressing dysplastic trochleas that are more common in our population. Results: We performed a Knee Osteoarthritis Outcome Score (KOOS) for the assessment of the success of the procedure and obtained 87% of patients with excellent results (95 to 100), 10% with fair results (70 to 90) and 3% with poor outcomes (50), we performed a total of 3 revisions due to pain or progress to global arthritis. Conclusion: The PFA is a successful, safe and reproducible surgery that can be used in the group of patients that have isolated patellofemoral osteoarthritis. It requires a thorough knowledge of the patello femoral joint biomechanics, and physiopathology.
Mycotic Infection post ACL Reconstruction
Authors: Costa-Paz Matias , Ayerza Miguel , Carbo Lisandro , Sanchez Marisa , Yacuzzi Carlos , Muscolo Luis 
Published: January 2017

Objectives: There are several studies in literature of septic arthritis after the ACL arthroscopic reconstruction related to bacterial germs. However, fungi infection is likely infrequent generating a massive bone loss with a catastrophic result. The purpose of this study was to describe preventive measures to decrease the mycotic infection after ACL reconstruction. Methods: Since 2005, we have diagnosed and treated 22 immunocompetent patients who underwent a surgery of an ACL lesion in other institutions in the country. Form these cases, we analyzed 19 which developed mycotic infection and an oncologic debridement was performed to control the pathology. In this series, we considered the initial surgery, the number of toilettes performed until their referral, magnitude of bone loss and final outcome. There were 5 other patients who consulted for mucormycosis, who finally were treated in other hospitals. Results: Epidemiology of mucormycosis is not clear. The exact cause is unknown due to heterogeneous data, different places and surgeons, facilities and type of surgical instruments in this series. In spite of not knowing the cause of the infection, several alternatives were evaluated in a non systematic way. Most of them related to the surgery room, sterilization place of the surgical tools, use of sterilizing liquids, cleanliness of lumen and cannulated bits. Instruments used during surgery were also evaluated: fields, shaver blades, drill types, ACL reconstruction fixation method. It is doubtful if the type of graft to reconstruct the ACL had any relation with infections. Among ideal preventive measures, the following are described: Surgery room with temperature and humidity control. Not using sterilizing liquids. Optimal preparation of surgical tools with adequate cleanliness of lumen and cannulated bits performed by adequate personnel. Sterilize in the same place where the surgery will be performed. Use of adequate instruments. The use of the central third of the patellar tendon had less incidence of infection. Conclusion: Taking into account these preventive measures, the incidence of this aggressive and devastating complication should be decreased.