bluuebunny/crossref_metadata_2025_split huggingface dataset:
Safety of Pregnancy After Cerebral Venous Thrombosis
Authors: Aguiar de Sousa Diana , Canhão Patrícia , Ferro José M. 
Published: January 2016

Background and Purpose—
Pregnancy and puerperium are associated with an increased risk of venous thrombotic events (VTEs), including cerebral venous thrombosis (CVT). We aimed to systematically review, in pregnant woman with previous CVT, (1) the risk of recurrence of CVT or other VTE; (2) the result of pregnancy; and (3) the association of antithrombotic prophylaxis with these outcomes.

Methods—
We searched MEDLINE, Cochrane Database of Systematic Reviews, clinicaltrials.gov (from inception to July 2015), and reference lists of included studies and review articles. We considered observational studies reporting original data on the frequency of CVT or other VTE associated with pregnancy or puerperium in women with history of CVT.

Results—

Thirteen studies were included. A simple pooled analysis of individual patient data and meta-analysis of proportions using a random effect model were performed. (1) 1 CVT recurrences/217 pregnancies (9 per 1000; 95% confidence interval, 3–33) and 5 noncerebral VTE/186 pregnancies (27 per 1000; 95% confidence interval, 12–61). (2) Pregnancy outcome: 33 spontaneous abortions/186 pregnancies (17.7%; 95% confidence interval, 13–24). (3) Data on the risk of CVT/extracerebral VTE according to antithrombotic prophylaxis was limited. Miscarriage did not differ significantly in women undergoing antithrombotic therapy or not (11.3% versus 18.8%;
P
=0.34).

Conclusions—
In women with previous CVT, the absolute risk of pregnancy-related venous thrombosis is low but the relative risk of noncerebral VTE is 16-fold higher and the recurrence of CVT is 80-fold higher than the baseline risk described in general population studies. The rate of miscarriage is not significantly different from that estimated for the general population.
Socially restrictive attitudes towards people with mental illness among the non-psychiatry medical professionals in a university teaching hospital in South India
Authors: Sathyanath Shashwath , Mendonsa Rohan Dilip , Thattil Anitha Maria , Chandran Varikkara Mohan , Karkal Ravichandra S 
Published: January 2016

Background: Unfortunately, stigmatizing attitudes towards mentally ill are common among medical students, nurses as well as doctors. This is a major obstacle in the delivery of mental health services. Aims: To assess the socially restrictive attitudes towards mentally ill among the medical professionals and to investigate the association between such attitudes and relevant variables. Methods: We assessed the attitudes towards people with mental illness among the medical professionals ( N = 130) in a medical university using shortened version of the 40-item Community Attitudes toward the Mentally Ill (CAMI) scale. Results: We found that socially restrictive attitudes were endorsed by quite a number of faculty members and trainees. Significantly higher number of faculty members (22.5%) compared to the trainees (9.1%) endorsed unfavourable attitudes towards previously mentally ill man getting married. Similarly, significantly more number of faculty (22.5%) were averse to the idea of living next door to someone who has been mentally ill compared to the trainees (9.1%). However, significantly lesser number of faculty members (16.1%) compared to the trainees (30.3%) believed that previously mentally ill people should be excluded from taking public office. Personal acquaintance with a mentally ill individual was the only variable that was associated with significantly lesser socially restrictive attitudes among the medical professionals, irrespective of their age, gender and clinical exposure to people with mental illness. Conclusion: Socially restrictive attitudes towards people with mental illness are prevalent among substantial number of medical professionals in a low-income country like India. Personal acquaintance with people who have mental illness appears to be the only significant factor that reduces medical professionals’ socially restrictive attitudes towards them.
Ultrasound-Guided Injection of Platelet-Rich Plasma and Hyaluronic Acid, Separately and in Combination, for Hip Osteoarthritis
Authors: Dallari Dante , Stagni Cesare , Rani Nicola , Sabbioni Giacomo , Pelotti Patrizia , Torricelli Paola , Tschon Matilde , Giavaresi Gianluca 
Published: January 2016

Background: The effectiveness of intra-articular platelet-rich plasma (PRP) injections has been evaluated in knee chondroplasty and osteoarthritis (OA); however, little evidence of its efficacy in hip OA exists. Purpose: To compare the therapeutic efficacy of autologous PRP, hyaluronic acid (HA), or a combination of both (PRP+HA) in hip OA. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: Patients aged between 18 and 65 years who were treated with outpatient surgery and who had hip OA and pain intensity at baseline of >20 on a 100-mm visual analog scale (VAS) were recruited for this study. Exclusion criteria were extensive surgery; presence of excessive deformities; or rheumatic, infective, cardiovascular, or immune system disorders. The primary outcome measure was a change in pain intensity as assessed by the VAS at 2, 6, and 12 months after treatment. Secondary outcome measures were the Harris Hip Score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and concentration of growth factors in PRP and their correlation with clinical outcomes. Clinical outcomes were evaluated by assessors and collectors blinded to the type of treatment administered. Results: A total of 111 patients were randomly assigned to 3 groups and received 3 weekly injections of either PRP (44 patients), PRP+HA (31 patients), or HA (36 patients). At all follow-ups, the PRP group had the lowest VAS scores. In particular, at 6-month follow-up, the mean VAS score was 21 (95% CI, 15-28) in the PRP group, 35 (95% CI, 26-45) in the PRP+HA group, and 44 (95% CI, 36-52) in the HA group ( P < .0005 [PRP vs HA] and P = .007 [PRP vs PRP+HA]; F = 0.663). The WOMAC score of the PRP group was significantly better at 2-month follow-up (mean, 73; 95% CI, 68-78) and 6-month follow-up (mean, 72; 95% CI, 67-76) but not at 12-month follow-up. A significant, “moderate” correlation was found between interleukin-10 and variations of the VAS score ( r = 0.392; P = .040). Significant improvements were achieved in reducing pain and ameliorating quality of life and functional recovery. Conclusion: Results indicated that intra-articular PRP injections offer a significant clinical improvement in patients with hip OA without relevant side effects. The benefit was significantly more stable up to 12 months as compared with the other tested treatments. The addition of PRP+HA did not lead to a significant improvement in pain symptoms.
Double-Row Repair Lowers the Retear Risk After Accelerated Rehabilitation
Authors: Franceschi Francesco , Papalia Rocco , Franceschetti Edoardo , Palumbo Alessio , Del Buono Angelo , Paciotti Michele , Maffulli Nicola , Denaro Vincenzo 
Published: January 2016

Background: Recently, an accelerated rehabilitation protocol after rotator cuff (RC) repair has been proposed for patients at risk of postoperative stiffness. Purpose: To investigate, in patients undergoing early accelerated mobilization, whether double-row (DR) repair provides better clinical outcomes and a lower retear rate compared with single-row (SR) configurations. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: A total of 58 patients were randomized to undergo either SR or DR repair. After 2 years of follow-up, 12 men and 13 women (mean age, 61.8 years; range, 52-67 years) in the SR group and 15 men and 10 women (mean age, 58.9 years; range, 51-69 years) in the DR group were evaluated. To assess the retear rate, magnetic resonance imaging of the shoulder was performed at 2-year follow-up. The clinical evaluation was based on the modified University of California, Los Angeles (UCLA) shoulder score and range of motion (ROM) measurements. Results: Magnetic resonance arthrography showed a significantly lower full-thickness retear rate for the DR group than for the SR group (8% vs 24%, respectively; P < .05). Conversely, at both 6-month and 2-year follow-up, there was no statistically significant difference in terms of the rate of stiffness in the SR and DR groups (8% vs 12% and 0% vs 0%, respectively; P > .05). No clinical differences were recorded regarding the UCLA score (SR group: mean, 32.6 [range, 30-35]; DR group: mean, 33.3 [range, 29-35]; P = .61) and ROM. Conclusion: In selected patients at a high risk of shoulder stiffness and therefore necessitating accelerated postoperative rehabilitation, DR repair of the RC could lower retear rates.
Maternal Perceptions and Views About Breastfeeding Practices Among Emirati Mothers
Authors: Radwan Hadia , Sapsford Roger 
Published: January 2016

Background: Understanding women’s breastfeeding perceptions and experiences is increasingly recognized as a vital tool to provide effective support that would encourage the extension of the breastfeeding period. Objective: To identify and explore the perceptions and views that influence the feeding and weaning decisions of Emirati mother. Methods: A qualitative study using indepth interviews was undertaken with a convenience sample of 45 Emirati mothers who had infants aged between 6 months and 2 years. Participants were interviewed in the health centers in 3 cities in United Arab Emirates. Data were recorded through field notes and analyzed thematically using grounded theory analysis. Results: The following themes emerged: influences of others on the decisions to breastfeed, sources of information, infants’ behavior and participants’ views and decisions about when to introduce supplementary feeding, knowledge of and attitudes toward current World Health Organization recommendations, and mothers’ perception of the benefits of breastfeeding. Grandmothers in this study played an important role in the breastfeeding practices of Emirati mothers. They supported breastfeeding, however, some encouraged giving the infants prelacteal feeds for a variety of reasons: colic, hunger, promoting growth, and hydration. Fathers, according to the mothers, either supported or ignored breastfeeding practices. Conclusion: Health promotions and health care facilities failed to deliver the message of exclusive breastfeeding. Mothers in our study were resorting to the expertise of the grandmothers and receiving information and advice about child feeding from them. The findings highlight the need for successful intervention programs to be implemented for mothers and grandmothers through health care providers.
Fludarabine add-on therapy in interferon-beta-treated patients with multiple sclerosis experiencing breakthrough disease
Authors: Greenberg Steven J. , Zivadinov Robert , Lee-Kwen Peterkin , Sharma Jitendra , Planter Margaret , Umhauer Margaret , Glenister Norman , Bakshi Rohit 
Published: January 2016

Background: Patients with relapsing–remitting multiple sclerosis (RRMS) may experience breakthrough disease despite effective interferon beta (IFNβ) therapy. Fludarabine (FLU) is a chemotherapeutic agent used in lymphoproliferative disorders that may be synergistic when combined with immunomodulatory therapy to control active multiple sclerosis (MS). Objective: The objective of this study was to explore the safety and tolerability of FLU versus monthly methylprednisolone (MP) in IFNβ-treated RRMS patients with breakthrough disease. Clinical and MRI effects of IFNβ-1a plus FLU were evaluated. Methods: Eighteen patients with breakthrough disease [⩾2 relapses over the prior year and ⩾1.0-point increase in Expanded Disability Status Scale (EDSS) score sustained for ⩾3 months] after >1 year of IFNβ therapy were enrolled in this prospective, open-label, randomized, proof-of-concept, pilot study. Patients received intravenous (IV) MP 1 g daily for 3 days and then were randomized to receive 3 monthly IV infusions of FLU 25 mg/m2 daily for 5 consecutive days ( n = 10) or MP 1 g ( n = 8). All patients maintained their intramuscular IFNβ-1a treatment throughout the study. Analyses explored safety signals and directional trends; this preliminary study was not powered to detect clinically meaningful differences. Results: Both combination treatments were safe and well tolerated, with all adverse events mild. Patients treated with IFNβ-1a plus FLU had similar relapse rates, EDSS scores, and MS Functional Composite scores, but significantly less acute corticosteroid use for on-study relapses and better responses on some MRI outcomes, versus patients treated with IFNβ-1a plus MP. Conclusions: Further study of FLU for breakthrough disease in patients with RRMS is warranted.
Drug-induced falls in older persons: is there a role for therapeutic drug monitoring?
Authors: Hartholt Klaas A. , Becker Matthijs L. , van der Cammen Tischa J. M. 
Published: January 2016

Background: Falls are the leading cause of injuries among older persons. Because of ageing societies worldwide, falls are expected to become a prominent public health problem. The usage of several types of drugs has been associated with an increased fall and fracture risk. In order to reduce future falls, preventative measures are needed. Therapeutic drug monitoring may help to identify persons who are at risk for falls due to drug use. The aim was to demonstrate how drugs can contribute to falls and the role of therapeutic drug monitoring. Methods: We present a descriptive case series of four patients. Results: All patients were referred to the geriatric outpatient clinic of a university medical center. The presented cases contained different underlying mechanisms contributing to an increased fall risk in older adults, including renal failure, genetic variation, overdose and ageing. Conclusion/discussion: Older adults are more prone to the side effects of drug use, including falls. Therapeutic drug monitoring may be useful to identify the patients who have an increased drug-related fall risk and to prevent future falls by individualizing the drug regime.
Use of exercise testing in the evaluation of interventional efficacy: an official ERS statement
Authors: Puente-Maestu Luis , Palange Paolo , Casaburi Richard , Laveneziana Pierantonio , Maltais François , Neder J. Alberto , O'Donnell Denis E. , Onorati Paolo , Porszasz Janos , Rabinovich Roberto , Rossiter Harry B. , Singh Sally , Troosters Thierry , Ward Susan 
Published: January 2016

This document reviews 1) the measurement properties of commonly used exercise tests in patients with chronic respiratory diseases and 2) published studies on their utilty and/or evaluation obtained from MEDLINE and Cochrane Library searches between 1990 and March 2015.Exercise tests are reliable and consistently responsive to rehabilitative and pharmacological interventions. Thresholds for clinically important changes in performance are available for several tests. In pulmonary arterial hypertension, the 6-min walk test (6MWT), peak oxygen uptake and ventilation/carbon dioxide output indices appear to be the variables most responsive to vasodilators. While bronchodilators do not always show clinically relevant effects in chronic obstructive pulmonary disease, high-intensity constant work-rate (endurance) tests (CWRET) are considerably more responsive than incremental exercise tests and 6MWTs. High-intensity CWRETs need to be standardised to reduce interindividual variability. Additional physiological information and responsiveness can be obtained from isotime measurements, particularly of inspiratory capacity and dyspnoea. Less evidence is available for the endurance shuttle walk test. Although the incremental shuttle walk test and 6MWT are reliable and less expensive than cardiopulmonary exercise testing, two repetitions are needed at baseline. All exercise tests are safe when recommended precautions are followed, with evidence suggesting that no test is safer than others.
Outcome of patients with right heart thrombi: the Right Heart Thrombi European Registry
Authors: Koć Marcin , Kostrubiec Maciej , Elikowski Waldemar , Meneveau Nicolas , Lankeit Mareike , Grifoni Stefano , Kuch-Wocial Agnieszka , Petris Antoniu , Zaborska Beata , Stefanović Branislav S. , Hugues Thomas , Torbicki Adam , Konstantinides Stavros , Pruszczyk Piotr 
Published: January 2016

Our aim was the assessment of the prognostic significance of right heart thrombi (RiHT) and their characteristics in pulmonary embolism in relation to established prognostic factors.138 patients (69 females) aged (mean±sd) 62±19 years with RiHT were included into a multicenter registry. A control group of 276 patients without RiHT was created by propensity scoring from a cohort of 963 contemporary patients. The primary end-point was 30-day pulmonary embolism-related mortality; the secondary end-point included 30-day all-cause mortality. In RiHT patients, pulmonary embolism mortality was higher in 31 patients with systolic blood pressure <90 mmHg than in 107 normotensives (42%versus12%, p=0.0002) and was higher in the 83 normotensives with right ventricular dysfunction (RVD) than in the 24 normotensives without RVD (16%versus0%, p=0.038). In multivariable analysis the simplified Pulmonary Embolism Severity Index predicted mortality (hazard ratio 2.43, 95% CI 1.58–3.73; p<0.0001), while RiHT characteristics did not. Patients with RiHT had higher pulmonary embolism mortality than controls (19%versus8%, p=0.003), especially normotensive patients with RVD (16%versus7%, p=0.02).30-day mortality in patients with RiHT is related to haemodynamic consequences of pulmonary embolism and not to RiHT characteristics. However, patients with RiHT and pulmonary embolism resulting in RVD seem to have worse prognosis than propensity score-matched controls.
Interaction between theDNAH9gene and early smoke exposure in bronchial hyperresponsiveness
Authors: Dizier Marie-Hélène , Nadif Rachel , Margaritte-Jeannin Patricia , Barton Sheila J. , Sarnowski Chloé , Gagné-Ouellet Valérie , Brossard Myriam , Lavielle Nolwenn , Just Jocelyne , Lathrop Mark , Holloway John W. , Laprise Catherine , Bouzigon Emmanuelle , Demenais Florence 
Published: January 2016

A previous genome-wide linkage scan of bronchial hyperresponsiveness (BHR) in the French Epidemiological study on the Genetics and Environment of Asthma (EGEA) families, performed in the presence of a gene×early-life environmental tobacco smoke (ETS) exposure interaction, showed the strongest interaction in the 17p11 region where linkage was detected only among unexposed siblings. Our goal was to conduct fine-scale mapping of 17p11 to identify single nucleotide polymorphisms (SNPs) interacting with ETS that influence BHR.Analyses were performed in 388 French EGEA asthmatic families, using a two-step strategy: 1) selection of SNPs displaying family-based association test (FBAT) association signals (p≤0.01) with BHR in unexposed siblings, and 2) a FBAT homogeneity test between exposed and unexposed siblings plus a robust log-linear interaction test.A single SNP reached the threshold (p≤3×10−3) for significant interaction with ETS using both interaction tests, after accounting for multiple testing. Results were replicated in 253 French-Canadian families, but not in 341 UK families, probably due in part to differences in phenotypic features between datasets.The SNP showing significant interaction with ETS belongs toDNAH9(dynein, axonemal, heavy chain 9), a promising candidate gene involved in respiratory cilia mobility and associated with primary ciliary dyskinesia, a disease associated with abnormalities of pulmonary function.
A review of national guidelines for management of COPD in Europe
Authors: Miravitlles Marc , Vogelmeier Claus , Roche Nicolas , Halpin David , Cardoso João , Chuchalin Alexander G. , Kankaanranta Hannu , Sandström Thomas , Śliwiński Paweł , Zatloukal Jaromir , Blasi Francesco 
Published: January 2016

The quality of care can be improved by the development and implementation of evidence-based treatment guidelines. Different national guidelines for chronic obstructive pulmonary disease (COPD) exist in Europe and relevant differences may exist among them.This was an evaluation of COPD treatment guidelines published in Europe and Russia in the past 7 years. Each guideline was reviewed in detail and information about the most important aspects of patient diagnosis, risk stratification and pharmacotherapy was extracted following a standardised process. Guidelines were available from the Czech Republic, England and Wales, Finland, France, Germany, Italy, Poland, Portugal, Russia, Spain and Sweden. The treatment goals, criteria for COPD diagnosis, consideration of comorbidities in treatment selection and support for use of long-acting bronchodilators, were similar across treatment guidelines. There were differences in measures used for stratification of disease severity, consideration of patient phenotypes, criteria for the use of inhaled corticosteroids and recommendations for other medications (e.g.theophylline and mucolytics) in addition to bronchodilators.There is generally good agreement on treatment goals, criteria for diagnosis of COPD and use of long-acting bronchodilators as the cornerstone of treatment among guidelines for COPD management in Europe and Russia. However, there are differences in the definitions of patient subgroups and other recommended treatments.
Effects of PCV7 and PCV13 on invasive pneumococcal disease and carriage in Stockholm, Sweden
Authors: Galanis Ilias , Lindstrand Ann , Darenberg Jessica , Browall Sarah , Nannapaneni Priyanka , Sjöström Karin , Morfeldt Eva , Naucler Pontus , Blennow Margareta , Örtqvist Åke , Henriques-Normark Birgitta 
Published: January 2016

The effects of pneumococcal conjugated vaccines (PCVs) need to be investigated. In Stockholm County, Sweden, PCV7 was introduced in the childhood immunisation programme in 2007 and changed to PCV13 in 2010.Over 90% of all invasive isolates during 2005–2014 (n=2336) and carriage isolates, 260 before and 647 after vaccine introduction, were characterised by serotyping, molecular typing and antibiotic susceptibility, and serotype diversity was calculated. Clinical information was collected for children and adults with invasive pneumococcal disease (IPD).The IPD incidence decreased post-PCV7, but not post-PCV13, in vaccinated children. Beneficial herd effects were seen in older children and adults, but not in the elderly. The herd protection was more pronounced post-PCV7 than post-PCV13. PCV7 serotypes decreased. IPD caused by PCV13 serotypes 3 and 19A increased post-PCV7. Post-PCV13, serotypes 6A and 19A, but not serotype 3, decreased. The serotype distribution changed in carriage and IPD to nonvaccine types, also in nonvaccinated populations. Expansion of non-PCV13 serotypes was largest following PCV13 introduction. Serotype diversity increased and nonvaccine clones emerged, such as CC433 (serotype 22F) in IPD and CC62 (serotype 11A) in carriage. In young children, meningitis, septicaemia and severe rhinosinusitis, but not bacteraemic pneumonia, decreased.Pneumococcal vaccination leads to expansion of new or minor serotypes/clones, also in nonvaccinated populations.