bluuebunny/crossref_metadata_2025_split huggingface dataset:
Integrative Literature Review of Factors Related to Breastfeeding in African American Women: Evidence for a Potential Paradigm Shift
Authors: DeVane-Johnson Stephanie , Woods-Giscombé Cheryl , Thoyre Suzanne , Fogel Cathie , Williams Ronald 
Published: April 2017

Background: Human milk has widespread health benefits for infants, mothers, and society. However, not all populations of women, particularly African American women, engage in human milk feeding at high rates. Research aim: The purpose of this integrative literature review is twofold: (a) to examine factors that influence low rates of human milk feeding among African American women and (b) to introduce a need for a methodological paradigm shift to develop culturally relevant and effective interventions. Methods: The authors searched four electronic social science databases for peer-reviewed journal articles pertaining to human milk among African American women published from 1990 to 2015. Both coauthors independently assessed these articles using thematic analysis and validation. The database search yielded 47 peer-reviewed articles. Results: Three main themes emerged explaining the human milk feeding disparity: (a) the social characteristics of women likely not to feed human milk (e.g., low socioeconomic status, single); (b) women’s perceptions of human milk feeding; and (c) the quality of human milk feeding information provided by health care providers (i.e., limited human milk information). Conclusion: Current literature does include sociohistorical factors that have shaped current norms. Adding sociohistorical frameworks, paying particular attention to the embodied experience of historical trauma, could lead to the development of new evidence-based, culturally sensitive interventions to enhance human milk feeding in the African American community.
Prognostic Factors for Survival in Node-Negative Gastric Cancer Patients Who Underwent Curative Resection
Authors: Zhou Y. , Cui J.-G. , Huang F. , Zhang A. , Li C. , Zhao Z.-C. , Li W.-D. , Fu W.-H. 
Published: April 2017

Background and Aim: Lymph node involvement is the strongest prognostic factor for patients with gastric cancer; patients with node-negative gastric cancer present with better survival. However, some patients develop recurrent gastric cancer. The aim of this study was to review the clinicopathological characteristics and factors for prognosis in patients with node-negative gastric cancer who underwent curative resection. Methods: Between January 2004 and December 2015, the clinicopathological characteristics of 302 patients with node-negative gastric cancer who underwent curative gastrectomy in our hospital were retrospectively analyzed. Results: The 1-, 3-, and 5-year overall survival rates for patients with node-negative gastric cancer were 80.0%, 69.0%, and 63.0%, respectively. Univariate analysis showed that tumor size, histologic type, and depth of invasion had significant effects on survival (p < 0.05). Multivariate analysis showed that tumor size (hazard ratio: 1.83%, 95.0% confidence interval: 1.13–2.96, p = 0.014), histologic type (hazard ratio: 1.57%, 95.0% confidence interval: 1.01–2.44, p = 0.042), and depth of invasion (hazard ratio: 1.38%, 95.0% confidence interval: 1.14–1.67, p = 0.001) were independent prognostic factors. Conclusion: Tumor size, histologic type, and depth of invasion are important prognostic factors in patients with node-negative gastric cancer. These parameters should be considered to stratify patients for therapy and follow-up strategies.
International Study Group of Pancreatic Surgery Definitions for Postpancreatectomy Complications: Applicability at a High-Volume Center
Authors: Dusch N. , Lietzmann A. , Barthels F. , Niedergethmann M. , Rückert F. , Wilhelm T. J. 
Published: April 2017

Introduction: The perioperative morbidity following pancreas surgery remains high due to various specific complications: postoperative pancreatic fistula, postpancreatectomy hemorrhage, and delayed gastric emptying. The International Study Group of Pancreatic Surgery has defined these complications. The aim of this study is to evaluate the clinical applicability, to validate the International Study Group of Pancreatic Surgery definition, and to evaluate the postoperative morbidity. Methods: Between 2004 and 2014, 769 patients underwent resection. Data were collected in a prospective database. Univariate examination was performed using the χ2-test. Continuous data were tested with the Mann–Whitney U-test. Student’s t-tests and Fisher’s exact tests were performed. Results: A total of 542 patients were included in this study. In all, 91 (16.8%) patients developed postoperative pancreatic fistula, 69 of them clinically relevant grades B and C postoperative pancreatic fistula. Grades B and C postoperative pancreatic fistulas were significantly associated with a longer hospital stay. The postoperative pancreatic fistula grade significantly correlated with re-operation. Totally, 32 (5.9%) patients developed postpancreatectomy hemorrhage. Postpancreatectomy hemorrhage grade was significantly associated with re-operation and 30-day mortality. In all, 14 of 19 patients with grade C postpancreatectomy hemorrhage (73.7%) were re-operated; 3 had a simultaneous postoperative pancreatic fistula C. Grade B postpancreatectomy hemorrhage significantly prolonged hospital stay. Grade C postpancreatectomy hemorrhage significantly prolonged intensive care unit stay. Grade C postpancreatectomy hemorrhage led to longer intensive care unit stay but a shorter hospital stay. Delayed gastric emptying occurred in 131 (24.2%) patients. The delayed gastric emptying grade was significantly associated with re-operation. Nine of the re-operated patients had a simultaneous postoperative pancreatic fistula C. Grades A, B, and C delayed gastric emptying were associated with prolonged hospital- and intensive care unit stay. Conclusion: Delayed gastric emptying is the most common specific complication after pancreas resection, followed by postoperative pancreatic fistula and postpancreatectomy hemorrhage. The International Study Group of Pancreatic Surgery definitions are well applicable in clinical routine and the different grades correlate well with severity of clinical condition, length of hospital or intensive care unit stay, and mortality. Their widespread use can contribute to a more reproducible and reliable comparison of surgical outcomes in pancreas surgery.
How should I fixate the subscapularis in total shoulder arthroplasty? A systematic review of pertinent subscapularis repair biomechanics
Authors: Schrock John B. , Kraeutler Matthew J. , Crellin Charles T. , McCarty Eric C. , Bravman Jonathan T. 
Published: April 2017

Background The present study aimed to review the biomechanical outcomes of subscapularis repair techniques during total shoulder arthroplasty (TSA) to assist in clinical decision making. Methods A systematic review of multiple databases was performed by searching PubMed, Scopus, Cochrane Library, Google Scholar, and all databases within EBSCOhost to find biomechanical studies of subscapularis repair techniques in cadaveric models of TSA. Results Nine studies met the inclusion criteria. In the majority of studies, lesser tuberosity osteotomy (LTO) techniques had greater load to failure and less cyclic displacement compared to subscapularis tenotomy or peel methods. LTO repairs with sutures wrapped around the humeral stem demonstrated superior biomechanical outcomes compared to techniques using only a tension band. In terms of load to failure, the strongest repair of any study was a dual-row fleck LTO using four sutures wrapped around the stem. Conclusions Several cadaveric studies have shown superior biomechanical outcomes with LTO techniques compared to tenotomy. In the majority of studies, the strongest subscapularis repair technique in terms of biomechanical outcomes is a compression LTO. Using three or more sutures wrapped around the implant and the addition of a tension suture may increase the biomechanical strength of the LTO repair.
Testosterone Replacement Therapy and Risk of Favorable and Aggressive Prostate Cancer
Authors: Loeb Stacy , Folkvaljon Yasin , Damber Jan-Erik , Alukal Joseph , Lambe Mats , Stattin Pär 
Published: April 2017

Purpose The association between exposure to testosterone replacement therapy (TRT) and prostate cancer risk is controversial. The objective was to examine this association through nationwide, population-based registry data. Methods We performed a nested case-control study in the National Prostate Cancer Register of Sweden, which includes all 38,570 prostate cancer cases diagnosed from 2009 to 2012, and 192,838 age-matched men free of prostate cancer. Multivariable conditional logistic regression was used to examine associations between TRT and risk of prostate cancer (overall, favorable, and aggressive). Results Two hundred eighty-four patients with prostate cancer (1%) and 1,378 control cases (1%) filled prescriptions for TRT. In multivariable analysis, no association was found between TRT and overall prostate cancer risk (odds ratio [OR], 1.03; 95% CI, 0.90 to 1.17). However, patients who received TRT had more favorable-risk prostate cancer (OR, 1.35; 95% CI, 1.16 to 1.56) and a lower risk of aggressive prostate cancer (OR, 0.50; 95% CI, 0.37 to 0.67). The increase in favorable-risk prostate cancer was already observed within the first year of TRT (OR, 1.61; 95% CI, 1.10 to 2.34), whereas the lower risk of aggressive disease was observed after > 1 year of TRT (OR, 0.44; 95% CI, 0.32 to 0.61). After adjusting for previous biopsy findings as an indicator of diagnostic activity, TRT remained significantly associated with more favorable-risk prostate cancer and lower risk of aggressive prostate cancer. Conclusion The early increase in favorable-risk prostate cancer among patients who received TRT suggests a detection bias, whereas the decrease in risk of aggressive prostate cancer is a novel finding that warrants further investigation.
Vasectomy and Prostate Cancer Risk in the European Prospective Investigation Into Cancer and Nutrition (EPIC)
Authors: Smith Karl , Byrne  , Castaño Jose Maria , Chirlaque Maria Dolores , Lilja Hans , Agudo Antonio , Ardanaz Eva , Rodríguez-Barranco Miguel , Boeing Heiner , Kaaks Rudolf , Khaw Kay-Tee , Larrañaga Nerea , Navarro Carmen , Olsen Anja , Overvad Kim , Perez-Cornago Aurora , Rohrmann Sabine , Sánchez Maria José , Tjønneland Anne , Tsilidis Konstantinos K. , Johansson Mattias , Riboli Elio , Key Timothy J. , Travis Ruth C. 
Published: April 2017

Purpose Vasectomy is a commonly used form of male sterilization, and some studies have suggested that it may be associated with an increased risk of prostate cancer, including more aggressive forms of the disease. We investigated the prospective association of vasectomy with prostate cancer in a large European cohort, with a focus on high-grade and advanced-stage tumors, and death due to prostate cancer. Patients and Methods A total of 84,753 men from the European Prospective Investigation into Cancer and Nutrition (EPIC), aged 35 to 79 years, provided information on vasectomy status (15% with vasectomy) at recruitment and were followed for incidence of prostate cancer and death. We estimated the association of vasectomy with prostate cancer risk overall, by tumor subtype, and for death due to prostate cancer, using multivariable-adjusted Cox proportional hazards models. Results During an average follow-up of 15.4 years, 4,377 men were diagnosed with prostate cancer, including 641 who had undergone a vasectomy. Vasectomy was not associated with prostate cancer risk (hazard ratio [HR], 1.05; 95% CI, 0.96 to 1.15), and no evidence for heterogeneity in the association was observed by stage of disease or years since vasectomy. There was some evidence of heterogeneity by tumor grade ( P = .02), with an increased risk for low-intermediate grade (HR, 1.14; 95% CI, 1.01 to 1.29) but not high-grade prostate cancer (HR, 0.83; 95% CI, 0.64 to 1.07). Vasectomy was not associated with death due to prostate cancer (HR, 0.88; 95% CI, 0.68 to 1.12). Conclusion These findings from a large European prospective study show no elevated risk for overall, high-grade or advanced-stage prostate cancer, or death due to prostate cancer in men who have undergone a vasectomy compared with men who have not.
Idarubicin Dose Escalation During Consolidation Therapy for Adult Acute Myeloid Leukemia
Authors: Bradstock Kenneth F. , Link Emma , Di Iulio Juliana , Szer Jeff , Marlton Paula , Wei Andrew H. , Enno Arno , Schwarer Anthony , Lewis Ian D. , D’Rozario James , Coyle Luke , Cull Gavin , Campbell Phillip , Leahy Michael F. , Hahn Uwe , Cannell Paul , Tiley Campbell , Lowenthal Ray M. , Moore John , Cartwright Kimberly , Cunningham Ilona , Taper John , Grigg Andrew , Roberts Andrew W. , Benson Warwick , Hertzberg Mark , Deveridge Sandra , Rowlings Philip , Mills Anthony K. , Gill Devinder , Bardy Peter , Campbell Lynda , Seymour John F. ,   on behalf of the Australasian Leukaemia & Lymphoma Group
Published: April 2017

Purpose Higher doses of the anthracycline daunorubicin during induction therapy for acute myeloid leukemia (AML) have been shown to improve remission rates and survival. We hypothesized that improvements in outcomes in adult AML may be further achieved by increased anthracycline dose during consolidation therapy. Patients and Methods Patients with AML in complete remission after induction therapy were randomly assigned to receive two cycles of consolidation therapy with cytarabine 100 mg/m2 daily for 5 days, etoposide 75 mg/m2 daily for 5 days, and idarubicin 9 mg/m2 daily for either 2 or 3 days (standard and intensive arms, respectively). The primary end point was leukemia-free survival (LFS). Results Two hundred ninety-three patients 16 to 60 years of age, excluding those with core binding factor AML and acute promyelocytic leukemia, were randomly assigned to treatment groups (146 to the standard arm and 147 to the intensive arm). Both groups were balanced for age, karyotypic risk, and FLT3–internal tandem duplication and NPM1 gene mutations. One hundred twenty patients in the standard arm (82%) and 95 patients in the intensive arm (65%) completed planned consolidation ( P < .001). Durations of severe neutropenia and thrombocytopenia were prolonged in the intensive arm, but there were no differences in serious nonhematological toxicities. With a median follow-up of 5.3 years (range, 0.6 to 9.9 years), there was a statistically significant improvement in LFS in the intensive arm compared with the standard arm (3-year LFS, 47% [95% CI, 40% to 56%] v 35% [95% CI, 28% to 44%]; P = .045). At 5 years, the overall survival rate was 57% in the intensive arm and 47% in the standard arm ( P = .092). There was no evidence of selective benefit of intensive consolidation within the cytogenetic or FLT3–internal tandem duplication and NPM1 gene mutation subgroups. Conclusion An increased cumulative dose of idarubicin during consolidation therapy for adult AML resulted in improved LFS, without increased nonhematologic toxicity.
An evaluation of the breast cancer Well Follow-up Care Initiative using administrative databases: A new model of analysis.
Authors: Mittmann Nicole , Earle Craig , Beglaryan Hasmik , Liu Ning , Gilbert Julie , Rahman Farah , Seung Soo Jin , LeBlanc Dominique , De Rossi Stefanie , Liberty Jacqueline , Zwicker Victoria , Sussman Jonathan 
Published: April 2017

1 Background: Cancer Care Ontario (CCO) implemented the Well Follow-up Care Initiative (WFCI) to transition low-risk breast cancer (BC) survivors from oncologist to primary care providers. The objective of this work was to compare both the health system resources utilized and their associated costs, among women in the WFCI (cases) and women who were not transitioned (controls). Methods: Cases were linked to provincial administrative databases and matched to a control group based on year of diagnosis, cancer stage, age, comorbidity, income, geographic area of residence, and prior health system use. Health system resource utilization (physician, hospitalization, diagnostics, medication, and homecare) was ascertained per group. The annual mean and median costs (CAD 2014) per patient were determined. Annualized incremental costs between cases and controls were estimated using generalized estimating equations, accounting for matched pairs. Results: Results are based on 2,324 cases and 2,324 controls (mean age 64.4 and 64.9 years, respectively). During an average of 2.5 years of follow-up since the transition date, there were significant differences between the two groups for mean annual visits per patient with a medical oncologist (0.4 vs. 1.3, p<0.001) and radiation oncologist (0.2 vs. 0.4, p<0.001). There was no significant difference in mean annual family physician visits per patient (7.4 vs. 7.9, p=0.082). The intervention group had fewer inpatient hospitalizations (75.6% vs. 79.9%) and cancer clinic visits (84.9% vs. 94.0%). While there was a higher number of mammograms for cases compared to controls, other diagnostic tests (bone scan, CT, MRI, ultrasound, and x-rays) were done less frequently. The model was associated with a 39.3% reduction in mean annual costs ($6,575 among cases and $10,832 among controls) and a 22.1% reduction in median annual costs ($2,261 among cases and $2,903 among controls). Conclusions: Transitioning BC survivors to primary care was associated with fewer health system resources and had a lower annual mean cost per patient than women who were not transitioned.
Qualitative themes underlying potentially avoidable terminal oncology ICU hospitalizations.
Authors: Daly Robert Michael , Hantel Andrew , Polite Blase N. 
Published: April 2017

101 Background: ICU admissions in the last 30 days of life is a quality measure endorsed by the National Quality Forum. Our prior research has demonstrated that nearly half of terminal oncology ICU hospitalizations are potentially avoidable. Methods: This was a retrospective care series of patients cared for in an academic medical center’s ambulatory oncology practice who died in an ICU during July 1, 2012 to June 30, 2013. Using a standardized assessment tool, an oncologist, intensivist, and hospitalist reviewed each patient’s electronic health record from 3 months prior to hospitalization until death and made a clinical determination of avoidability. Two investigators, blinded to the specialty of the reviewer, used a grounded theory approach to extract clinical themes associated with avoidability from the reviewers’ assessments. Results: The primary themes for avoidability identified and percent by specialty were as follows: failure to initiate appropriate advance care planning in the outpatient setting (68% oncologists, 55% intensivists, 65% hospitalists), failure to integrate understanding of limited prognosis from underlying cancer within the context of acute hospitalization (23% oncologists, 24% intensivists, 26% hospitalists), failure of clinical management (6% oncologists, 21% intensivists, 6% hospitalists), failure to recognize futility of outside hospital transfer (3% oncologists, 0% intensivists, 0% hospitalists), and failure of care coordination (0% oncologists, 0% intensivists, 3% hospitalists). A failure to educate and integrate surrogates into timely medical decision making was a prominent secondary theme for oncologists (22%), intensivists (18%), and hospitalists (29%). Conclusions: The themes identified suggest potential interventions to prevent avoidable terminal oncology ICU hospitalizations, including improved advance care planning in the outpatient setting, inpatient multidisciplinary communication to gain a better understanding of the patient’s underlying malignancy within the context of the acute hospitalization and prevent failures in clinical management, and better education and integration of surrogates in medical decision making.
No news, bad news? A deeper examination of the correlation between patient functional status and level of postoperative telephone communication with the surgical team.
Authors: Baksh Adrienne Nicole Hawkins , Shahrokni Armin 
Published: April 2017

102 Background: In attempts to improve outcomes for and survival of geriatric oncology patients, studies have demonstrated the utility of phone communication as a tool for post-operative care. However, very little data is available to determine if this method of care is reaching the most vulnerable patients. The purpose of this study is to compare patient-surgical team phone communication for geriatric cancer patients of higher and lower preoperative functional status. Methods: This is a retrospective review of data from an internal geriatric assessment questionnaire and phone log data as recorded in the EHR at a single institution. Patients were stratified into two groups: those who had at least one recorded postoperative care phone call (PC) and those with no postoperative care phone call (NPC). Quantitative analysis of the data was performed, assessing the correlation between preoperative functional status and patient-surgical service communication in the first 30 postoperative days. Results: NPC group patients were more likely to be amongst the more frail patients, with lower preoperative functional status and a higher level of distress. Specifically, patients in the NPC group were more likely to be dependent for ADLs (61.0% vs. 50.8%, P = 0.013) and IADLs (59.6% VS. 44.7%, P = 0.001), and have a lower Karnofsky Performance Scale score (46.2% vs. 39.1%, P = 0.048) and also reported a higher level of distress (4.5 vs. 4.00, P = 0.001). There was a trend toward more cognitive impairment among the NPC group compared to the PC group (18.2% vs. 12.1%, P = 0.058). Conclusions: Our study highlights a disparity in the utilization of patient-surgical team phone calls as a method for postoperative care for more frail patients. Despite significant number of phone calls initiated during the postoperative period, mainly by surgical nurses, frail and distressed patients are more likely not to participate in a call. Future studies of postoperative phone communication with geriatric oncology patients should assess the utility of this tool for more frail patients and seek measures that will increase access and participation among this population.