bluuebunny/crossref_metadata_2025_split huggingface dataset:
Platelet count recovery and seroreversion in immune HIT despite continuation of heparin: further observations and literature review
Authors: Sheppard Jo-Ann , Warkentin Theodore , Shih Andrew 
Published: August 2017

SummaryOne of the standard distinctions between type 1 (non-immune) and type 2 (immune-mediated) heparin-induced thrombocytopenia (HIT) is the transience of thrombocytopenia: type 1 HIT is viewed as early-onset and transient thrombocytopenia, with platelet count recovery despite continuing heparin administration. In contrast, type 2 HIT is viewed as later-onset (i. e., 5 days or later) thrombocytopenia in which it is generally believed that platelet count recovery will not occur unless heparin is discontinued. However, older reports of type 2 HIT sometimes did include the unexpected observation that platelet counts could recover despite continued heparin administration, although without information provided regarding changes in HIT antibody levels in association with platelet count recovery. In recent years, some reports of type 2 HIT have confirmed the observation that platelet count recovery can occur despite continuing heparin administration, with serological evidence of waning levels of HIT antibodies (“seroreversion”). We now report two additional patient cases of type 2 HIT with platelet count recovery despite ongoing therapeutic-dose (1 case) or prophylactic-dose (1 case) heparin administration, in which we demonstrate concomitant waning of HIT antibody levels. We further review the literature describing this phenomenon of HIT antibody seroreversion and platelet count recovery despite continuing heparin administration. Our observations add to the concept that HIT represents a remarkably transient immune response, including sometimes even when heparin is continued.
The Metabolic Syndrome and Risk of Sudden Cardiac Death: The Atherosclerosis Risk in Communities Study
Authors: Hess Paul L. , Al‐Khalidi Hussein R. , Friedman Daniel J. , Mulder Hillary , Kucharska‐Newton Anna , Rosamond Wayne R. , Lopes Renato D. , Gersh Bernard J. , Mark Daniel B. , Curtis Lesley H. , Post Wendy S. , Prineas Ronald J. , Sotoodehnia Nona , Al‐Khatib Sana M. 
Published: August 2017

Background
Prior studies have demonstrated a link between the metabolic syndrome and increased risk of cardiovascular mortality. Whether the metabolic syndrome is associated with sudden cardiac death is uncertain.

Methods and Results

We characterized the relationship between sudden cardiac death and metabolic syndrome status among participants of the ARIC (Atherosclerosis Risk in Communities) Study (1987–2012) free of prevalent coronary heart disease or heart failure. Among 13 168 participants, 357 (2.7%) sudden cardiac deaths occurred during a median follow‐up of 23.6 years. Participants with the metabolic syndrome (n=4444) had a higher cumulative incidence of sudden cardiac death than those without it (n=8724) (4.1% versus 2.3%,
P
<0.001). After adjustment for participant demographics and clinical factors other than components of the metabolic syndrome, the metabolic syndrome was independently associated with sudden cardiac death (hazard ratio, 1.70, 95% confidence interval, 1.37–2.12,
P
<0.001). This relationship was not modified by sex (interaction
P
=0.10) or race (interaction
P
=0.62) and was mediated by the metabolic syndrome criteria components. The risk of sudden cardiac death varied according to the number of metabolic syndrome components (hazard ratio 1.31 per additional component of the metabolic syndrome, 95% confidence interval, 1.19–1.44,
P
<0.001). Of the 5 components, elevated blood pressure, impaired fasting glucose, and low high‐density lipoprotein were independently associated with sudden cardiac death.

Conclusions
We observed that the metabolic syndrome was associated with a significantly increased risk of sudden cardiac death irrespective of sex or race. The risk of sudden cardiac death was proportional to the number of metabolic syndrome components.
Do psychosocial interventions improve rehabilitation outcomes after anterior cruciate ligament reconstruction? A systematic review
Authors: Coronado Rogelio A , Bird Mackenzie L , Van Hoy Erin E , Huston Laura J , Spindler Kurt P , Archer Kristin R 
Published: August 2017

Objective: To examine the role of psychosocial interventions in improving patient-reported clinical outcomes, including return to sport/activity, and intermediary psychosocial factors after anterior cruciate ligament reconstruction. Methods: MEDLINE/PubMed, CINAHL, PsycINFO, and Web of Science were searched from each database’s inception to March 2017 for published studies in patients after anterior cruciate ligament reconstruction. Studies were included if they reported on the effects of a postoperative psychosocial intervention on a patient-reported clinical measure of disability, function, pain, quality of life, return to sport/activity, or intermediary psychosocial factor. Data were extracted using a standardized form and summary effects from each article were compiled. The methodological quality of randomized trials was assessed using the Physiotherapy Evidence Database Scale and scores greater than 5/10 were considered high quality. Results: A total of 893 articles were identified from the literature search. Of these, four randomized trials ( N = 210) met inclusion criteria. The four articles examined guided imagery and relaxation, coping modeling, and visual imagery as postoperative psychosocial interventions. Methodological quality scores of the studies ranged from 5 to 9. There were inconsistent findings for the additive benefit of psychosocial interventions for improving postoperative function, pain, or self-efficacy and limited evidence for improving postoperative quality of life, anxiety, or fear of reinjury. No study examined the effects of psychosocial interventions on return to sport/activity. Conclusion: Overall, there is limited evidence on the efficacy of postoperative psychosocial interventions for improving functional recovery after anterior cruciate ligament reconstruction.
An audit of patient aggression in an adult psychiatric unit: 2013–2014
Authors: Ewing Claire , Phillipou Andrea , Castle David 
Published: August 2017

Objectives: The aim of this study was to determine the rates of patient aggression in a psychiatric unit over 12 months and to determine underlying causes, notably the role of substances. Methods: A retrospective file audit was undertaken of all patients admitted to St Vincent’s psychiatric unit (Melbourne, Australia) in the first half of 2013 and 2014 involved in an aggressive incident. Patient information included demographics, psychiatric, substance and aggression history. The setting and context of aggression and associated mental state findings were also reviewed. Results: There were 26 aggressive incidents in 2013 and 63 in 2014, perpetrated by 11 and 34 patients respectively. No significant differences were found between the groups’ baseline demographics. The 2014 cohort was significantly more likely to have substance use history (odds ratio (OR) 4.83) and have made threats to staff (OR 4.07) but significantly less likely to be distracted by internal stimuli (OR 0.05). There were also (not statistically significant) trends for the 2014 cohort; they were more likely to report a history of alcohol use (OR 3.9); be accompanied to emergency department by police (OR 2.95) and have leave prior to aggression ( χ2 = 7.37). Conclusions: Aggressive incidents more than doubled over 12 months. Substance use appeared to be a major factor associated with aggression. These findings have implications for service provision and training. Further research is needed to better understand and manage substances in psychiatric settings.
Navigating the social synapse: the neurobiology of bedside manner
Authors: Parnas Sophia , Isobel Sophie 
Published: August 2017

Objectives: This paper seeks to explore the application of neurobiology to further understanding the importance of developing, refining and modelling good bedside manner in psychiatry. The concept of a social synapse is used as a framework to understand the impact of verbal and non-verbal information that crosses between two attuned individuals. Research shows that widely distributed cortical and subcortical networks are involved in processing of social information and the perception of safety. Conclusions: Good bedside manner is proposed as the ability of a clinician to navigate the social synapse and make a patient feel at ease. Findings from neurobiology suggest that good bedside manner needs to be a more considered component of effective psychiatric health care.
The trip of a lifetime: hallucinogen persisting perceptual disorder
Authors: Anderson Lauren , Lake Hannah , Walterfang Mark 
Published: August 2017

Objectives: The differential diagnosis of psychotic symptoms is broad and extends beyond primary psychotic and affective disorders. We aim to illustrate that the chronology and phenomenological nature of hallucinatory symptoms may provide clues towards alternative diagnoses, such as hallucinogen persisting perceptual disorder (HPPD). We describe the resurgence of visual pseudo-hallucinations in a young woman in the context of previous substance-induced hallucinatory symptoms and a prior diagnosis of occipital lobe epilepsy. She presented a diagnostic challenge, saw several emergency and specialist doctors and attracted stigmatising diagnoses leading to anxiety and depressive symptoms. Her symptoms were finally recognised as HPPD, and she was treated appropriately with lamotrigine. Conclusions: Patients with perceptual disturbance can present in various clinical settings, and HPPD is an under-recognised diagnostic possibility. Delayed or misdiagnosis prolongs profound functional impairment and social decline, and predisposes the patient to the development of anxiety and depression and related increased risk of suicide.
‘Not quite out of the woods’: potential for misdiagnosis of delayed neurologic syndrome of carbon monoxide poisoning as relapse of mental illness
Authors: Bhagwat Samir , Bruxner George 
Published: August 2017

Objective: The aim of this paper is to provide an overview of the delayed neurologic syndrome of carbon monoxide poisoning and its clinical importance in psychiatric settings. Method: A brief review of carbon monoxide poisoning is presented with a focus on the delayed neurologic syndrome and a case of deliberate self- poisoning is described. Results: As in the case described, the delayed manifestations of carbon monoxide poisoning can resemble a relapse of psychiatric illness. Conclusions: In cases of carbon monoxide poisoning it is important to consider the delayed neurologic syndrome as misdiagnosis could lead to inappropriate treatment and worsened outcome.
Modified Broström Procedure Using Distal Fibular Periosteal Flap Augmentation vs Anatomic Reconstruction Using a Free Tendon Allograft in Patients Who Are Not Candidates for Standard Repair
Authors: Choi Hong Joon , Kim Dae Wook , Park Jea Seok 
Published: August 2017

Background: The modified Broström procedure (MBP) is widely accepted as the primary operative treatment for chronic lateral ankle instability (CLAI). However, the MBP does not produce good clinical results in all patients, and anatomic reconstruction using a free tendon graft may be considered in those patients. The purpose of this study was to evaluate the efficacy of the MBP using distal fibular periosteal flap augmentation for CLAI in patients who were not candidates for standard repair. Methods: Thirty-eight patients (39 ankles) who underwent surgery for CLAI were retrospectively analyzed. The patients were divided into 2 groups: an anatomic lateral ligament reconstruction group (reconstruction group) consisting of 17 ankles and an MBP group using distal fibular periosteal flap augmentation (augmentation group) consisting of 22 ankles. Preoperative and postoperative clinical evaluations were performed using the visual analog scale (VAS), American Orthopaedic Foot & Ankle Society (AOFAS), and Karlsson-Peterson (Karlsson) scores. Results: The mean VAS, AOFAS, and Karlsson scores significantly improved from 4.0 to 1.8, 54.7 to 92.9, and 46.4 to 92.7, respectively, in the reconstruction group ( P < .001, P < .001, P < .001), and from 4.1 to 1.5, 60.1 to 94.9, and 52.6 to 94.1, respectively, in the augmentation group ( P < .001, P < .001, P < .001). There were no significant differences in the mean postoperative AOFAS and Karlsson scores between the groups ( P = .214, P = .299). Conclusion: The MBP using distal fibular periosteal flap augmentation was also an effective option for CLAI in cases of generalized ligament laxity, severe attenuation of the soft tissue, previous failed surgery, high demand activity, and obesity. Level of Evidence: Level III, comparative series.
Long-Term Results of Ulnar-Basilic Fistula Versus Radiocephalic Fistula for Maintenance Hemodialysis Access
Authors: Zhen Yanan , Liu Peng , Ye Zhidong , Zheng Xia , Ma Bo , Fan Guohui , Yang Yuguang 
Published: August 2017

Objective: The aim of this study is to compare the rate of primary patency and secondary patency achieved by ulnar-basilic arteriovenous fistula (UBAVF) and radiocephalic arteriovenous fistula (RCAVF) in the maintenance of hemodialysis access. Methods: This retrospective analysis consists of 365 patients who had a forearm UBAVF or RCAVF between January 2012 and December 2015. Of these patients, 44 patients were treated with UBAVF, while 321 patients were treated with RCAVF. Demographics, primary patency, and secondary patency were documented and compared. Results: Primary patency rates at 1 and 2 years were 77.2% and 63.9% in group UBAVF and 88.1% and 71.3% in group RCAVF, respectively. Secondary patency rates at 1 and 2 years were 93.0% and 78.8% in group UBAVF and 98.7% and 80.9% in group RCAVF, respectively. The Kaplan-Meier analysis showed that the primary and secondary patency rates were all without statistical difference between the 2 groups. Conclusion: Given the similar patency rate between UBAVF and RCAVF, the UBAVF could be considered as a reliable alternative when an RCAVF is not possible.
Comparison of propaten heparin-bonded vascular graft with distal anastomotic patch versus autogenous saphenous vein graft in tibial artery bypass
Authors: Kaisar Jeremy , Chen Aaron , Cheung Mathew , Kfoury Elias , Bechara Carlos F , Lin Peter H 
Published: August 2017

Introduction Heparin-bonded expanded polytetrafluoroethylene grafts (Propaten, WL Gore, Flagstaff, AZ, USA) have been shown to have superior patency compared to standard prosthetic grafts in leg bypass. This study analyzed the outcomes of Propaten grafts with distal anastomotic patch versus autogenous saphenous vein grafts in tibial artery bypass. Methods A retrospective analysis of prospective collected data was performed during a recent 15-year period. Sixty-two Propaten bypass grafts with distal anastomotic patch (Propaten group) were compared with 46 saphenous vein graft (vein group). Pertinent clinical variables including graft patency and limb salvage were analyzed. Results Both groups had similar clinical risk factors, bypass indications, and target vessel for tibial artery anastomoses. Decreased trends of operative time (196 ± 34 min vs. 287 ± 65 min, p = 0.07) and length of hospital stay (5.2 ± 2.3 days vs. 7.5 ± 3.6, p = 0.08) were noted in the Propaten group compared to the vein group. Similar primary patency rates were noted at four years between the Propaten and vein groups (85%, 71%, 64%, and 57%, vs. 87%, 78%, 67%, and 61% respectively; p = 0.97). Both groups had comparable secondary patency rates yearly in four years (the Propaten group: 84%, 76%, 74%, and 67%, respectively; the vein group: 88%, 79%, 76%, and 72%, respectively; p = 0.94). The limb salvage rates were equivalent between the Propaten and vein group at four years (84% vs. 92%, p = 0.89). Multivariate analysis showed active tobacco usage and poor run-off score as predictors for graft occlusion. Conclusions Propaten grafts with distal anastomotic patch have similar clinical outcomes compared to the saphenous vein graft in tibial artery bypass. Our data support the use of Propaten graft with distal anastomotic patch as a viable conduit of choice in patients undergoing tibial artery bypass.
Evaluation of the renal function using serum Cystatin C following open and endovascular aortic aneurysm repair
Authors: Ilic Nikola S , Opacic Dragan , Mutavdzic Perica , Koncar Igor , Dragas Marko , Jovicic Snezana , Markovic Miroslav , Davidovic Lazar 
Published: August 2017

Objectives Controversies regarding renal function impairment after open and endovascular aortic aneurysm repair still exist. The purpose of this study was to evaluate the renal function following open repair and endovascular aneurysm repair using Cystatin C. Methods This prospective, observational case–control study was conducted in tertiary referral centre over 3 years, starting from 2012. In total, 60 patients operated due to infrarenal AAA either by means of open repair (30 patients) or endovascular aneurysm repair (30 patients) were included in the study. Biochemical markers of renal function (sCr, urea, potassium) were recorded pre-operatively and at these specific time points, immediately after the operation and at discharge, home (third postoperative day, endovascular aneurysm repair group) or from intensive care unit (third postoperative day, open repair group). Multivariate and propensity score adjustments were used to control for the baseline differences between the groups. Results Creatinine levels in serum remained unchanged during the hospital stay in both groups without significant differences at any time point. Cystatin C levels in endovascular aneurysm repair patients significantly increased postoperatively and restored to values comparable to baseline at the discharge (0.865 ± 0.319 vs. *0.962 ± 0.353 vs. 0.921 ± 0.322, * p < 0.001). Cystatin C levels in patients treated with the open surgery was decreasing over time but not statistically significant comparing to Cystatin C values at the admission. However, decrease in Cystatin C serum levels in patients treated with conventional surgery resulted in statistically significant lower values compared to endovascular aneurysm repair patients both postoperatively and at the time of discharge (0.760 ± 0.225 vs. 0.962 ± 0.353, p < 0.05; 0.750 vs. 0.156, p < 0.05). Both multivariate linear regression models and propensity score adjustment confirm that, even after correction for previously observed intergroup differences, type of surgery, i.e. endovascular aneurysm repair is independently associated with the higher levels of Cystatin C both postoperatively and at the discharge. Conclusions Dynamics of Cystatin C levels have been proven as a more vulnerable marker of renal dysfunction. Endovascular aneurysm repair is associated with higher levels of kidney injury markers.
Primary pulmonary arterial hypertension with preserved right ventricular function leads to lower extremity venous insufficiency
Authors: Aldemir Mustafa , Emren Sadık Volkan , Balçık Çınar , Onrat Ersel , Gürsoy Merve 
Published: August 2017

Objectives Pulmonary hypertension with heart failure is related to venous insufficiency. However, there is no clear data whether pulmonary arterial hypertension with preserved right ventricular function cause venous insufficiency. In this study, we aim to investigate the relation between pulmonary arterial pressure with venous insufficiency in pulmonary arterial hypertension patients with preserved right ventricular function. Methods Between January 2012 and October 2014, 38 patients with a diagnosis of pulmonary arterial hypertension and 47 control group patients were included. Venous disability score and venous segmental disease score of both groups were calculated in order to measure venous insufficiency. The relationship between venous disability score and venous segmental disease scores and mean pulmonary arterial pressure and World Heart Organization functional capacity was examined. Results Total venous segmental disease score (5 ± 3.9 vs. 2 ± 1.8 p < 0.001), right venous segmental disease score (2.6 ± 2.2 vs. 1 ± 0.9 p < 0.001), left venous segmental disease score (2.4 ± 2.2 vs. 1 ± 0.9 p < 0.001), and venous disability scores (2.2 ±1 vs. 1.6 ± 0.7 p < 0.001) of patients with pulmonary arterial hypertension were higher than the control group. While the total venous segmental disease score was highly related to mean pulmonary arterial pressure (r = 0.829, p < 0.001), the venous disability score was only weakly related (r = 0.343, p = 0.037). Total venous segmental disease score (r = 0.606, p < 0.001) and venous disability scores (r = 0.601, p < 0.001) were moderately related with World Health Organization functional capacity intensity. Conclusions The degree of venous insufficiency increase in accordance with the mean pulmonary arterial pressure even in patients with preserved right ventricular function.
Toll-like receptors 2 and 4 modulate intestinal IL-10 differently in ileum and colon
Authors: Latorre Eva , Layunta Elena , Grasa Laura , Pardo Julián , García Santiago , Alcalde Ana I , Mesonero José E 
Published: August 2017

Background Inflammatory bowel diseases are consequence of an intestinal homeostasis breakdown in which innate immune dysregulation is implicated. Toll-like receptor (TLR)2 and TLR4 are immune recognition receptors expressed in the intestinal epithelium, the first physical-physiological barrier for microorganisms, to inform the host of the presence of Gram-positive and Gram-negative organisms. Interleukin (IL)-10 is an essential anti-inflammatory cytokine that contributes to maintenance of intestinal homeostasis. Aim Our main aim was to investigate intestinal IL-10 synthesis and release, and whether TLR2 and TLR4 are determinants of IL-10 expression in the intestinal tract. Methods We used Caco-2 cell line as an enterocyte-like cell model, and also ileum and colon from mice deficient in TLR2, TLR4 or TLR2/4 to test the involvement of TLR signaling. Results Intestinal epithelial cells are able to synthesize and release IL-10 and their expression is increased after TLR2 or TLR4 activation. IL-10 regulation seems to be tissue specific, with IL-10 expression in the ileum regulated by a compensation between TLR2 and TLR4 expression, whereas in the colon, TLR2 and TLR4 affect IL-10 expression independently. Conclusions Intestinal epithelial cells could release IL-10 in response to TLR activation, playing an intestinal tissue-dependent and critical intestinal immune role.
The impact of host language proficiency across the immigrants’ earning distribution in Spain
Authors: Budría Santiago , Martinez de Ibarreta Carlos , Swedberg Pablo 
Published: August 2017

AbstractThis paper explores the impact of Spanish language proficiency on immigrant earnings in Spain using an instrumental variable quantile regression approach. The impact is on average roughly 17.2% but varies substantially across the earning distribution. The return to destination language proficiency actually ranges from zero at the bottom quantiles to 30% at the top quantile of the earning distribution. These findings suggest that the benefits derived from host language knowledge are particularly important among individuals with stronger unobserved abilities and marketable skills and that language training policies targeted at specific immigrant population categories may be ineffective from a labor market earning perspective.JEL Classification:F22, J24, J61