bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidemiology and risk factors of coronary artery aneurysm in Taiwan: a population based case control study
Authors: Fang Chein-Tang , Fang Yi-Ping , Huang Yaw-Bin , Kuo Chen-Chun , Chen Chung-Yu 
Published: July 2017

ObjectivesCoronary artery aneurysm (CAA) is usually an asymptomatic and rare disease. There are limited epidemiological data for CAA in Asian populations and in the rest of the world.DesignA retrospective case control study.SettingA population based, database study from Taiwan's National Health Insurance Research Database, between 2005 and 2011.ParticipantsCAA patients identified using International Classification of Diseases, ninth revision, clinical modification (ICD-9-CM) code 414.11 with CAA examinations.Outcome measuresThe incidence rate and mortality rate of CAA were calculated. We also matched patients with non-CAA patients according to age, gender and index year at a 1:10 ratio to explore the risk factors for CAA using conditional logistic regression.ResultA total of 1397 CAA patients were identified between 2005 and 2011; 41.9% were paediatric patients and 58.1% were adults. The incidence rate and mortality rate of CAA in Taiwan were 0.87 and 0.05 per 105person-years, respectively. The adjusted odds ratios (aOR) for coronary atherosclerosis, hypertension, dyslipidaemia and diabetes were 7.97, 2.09, 2.48 and 1.51, respectively. Of note, aortic dissection (aOR 6.76), aortic aneurysm (aOR 5.82) and systemic lupus erythematosus (aOR 4.09) were found to be significantly associated with CAA.ConclusionIn Taiwan, CAA patients were distributed across both paediatric and adult populations. Apart from cardiovascular risk factors, aortic diseases and systemic lupus erythematosus need to be investigated further in CAA patients.
Association of prehypertension and cardiovascular risk factor clustering in Inner Mongolia: a cross-sectional study
Authors: Li Guoju , Guo Guanghong , Wang Wenrui , Wang Ke , Wang Hailing , Dong Fen , Qian Yonggang , Gong Haiying , Xu Guodong , Li Yanlong , Pan Li , Zhang Biao , Shan Guangliang 
Published: July 2017

ObjectivesTo assess the clustering of cardiovascular disease (CVD) risk factors in Han and Mongolian adults with prehypertension or hypertension in Northern China.MethodsWe selected 3227 Han and Mongolian participants (20–80 years old) using a multistage cluster sampling method in 2014. The participants were interviewed by standard questionnaires and underwent anthropometric measurement and biochemical testing. Han and Mongolian participants were divided into optimal, prehypertension, and hypertension groups based on blood pressure. A multinomial logit analysis was performed to explore relationships between CVD risk factor clustering and prehypertension or hypertension, and the heterogeneity between Han and Mongolian was evaluated by the Cochran Q test. The differences between the ethnic groups in the proportions of risk factors was tested with the χ2test.ResultsThe clustering of two or three CVD risk factors in the prehypertension or hypertension groups was consistently higher than in the optimal group (Bonferroni, p<0.0167). The odds ratios (ORs) of prehypertension and hypertension increased with the number of CVD risk factors (ptrend<0.0001). In multivariate modelling, the adjusted ORs of one, two, and ≥3 CVD risk factors versus no risk factors was, respectively, 1.95, 2.25, and 2.28 in Han prehypertensive participants, and 1.73, 2.83, and 3.69 in Mongolian prehypertensive participants. In addition, the adjusted ORs were 3.15, 4.75, and 6.49 in Han hypertensive participants, and 1.90, 5.29, and 8.13 in Mongolian hypertensive participants (all p<0.05). There was no significant heterogeneity between Han and Mongolian participants in the prehypertension or hypertension groups. The age-standardised prevalence of ≥3 risk factors was 38.30% in Han men and 39.79% in Mongolian men. The rate was significantly lower in Han women than Mongolian women (9.18% vs 14.55%, p=0.002).ConclusionsThese findings showed clustering of CVD risk factors in prehypertensive Han and Mongolian adults, and showed prehypertension may be a useful target for intervention.
Associations between maternal size and health outcomes for women undergoing caesarean section: a multicentre prospective observational study (The MUM SIZE Study)
Authors: Dennis Alicia Therese , Lamb Karen Elaine , Story David , Tew Michelle , Dalziel Kim , Clarke Philip , Lew Jospeh , Parker Anna , Hessian Elizabeth , Teale Gyln , Simmons Scott , Casalaz Dan 
Published: July 2017

ObjectivesTo investigate associations between maternal body mass index (BMI) at delivery (using pregnancy-specific BMI cut-off values 5 kg/m2higher in each of the WHO groups) and clinical, theatre utilisation and health economic outcomes for women undergoing caesarean section (CS).DesignA prospective multicentre observational study.SettingSeven secondary or tertiary referral obstetric hospitals.ParticipantsOne thousand and four hundred and fifty-seven women undergoing all categories of CS.Data collectionHeight and weight were recorded at the initial antenatal visit and at delivery. We analysed the associations between delivery BMI (continuous and pregnancy-specific cut-off values) and total theatre time, surgical time, anaesthesia time, maternal and neonatal adverse outcomes, total hospital admission and theatre costs.ResultsMean participant characteristics were: age 32 years, gestation at delivery 38.4 weeks and delivery BMI 32.2 kg/m2. Fifty-five per cent of participants were overweight, obese or super-obese using delivery pregnancy-specific BMI cut-off values. As BMI increased, total theatre time, surgical time and anaesthesia time increased. Super-obese participants had approximately 27% (17 min, p<0.001) longer total theatre time, 20% (9 min, p<0.001), longer surgical time and 40% (11 min, p<0.001) longer anaesthesia time when compared with normal BMI participants. Increased BMI at delivery was associated with increased risk of maternal intensive care unit admission (relative risk 1.07, p=0.045), but no increased risk of neonatal admission to higher acuity care. Total hospital admission costs were 15% higher in super-obese women compared with normal BMI women and theatre costs were 27% higher in super-obese women.ConclusionsIncreased maternal BMI was associated with increased total theatre time, surgical and anaesthesia time, increased total hospital admission costs and theatre costs. Clinicians and health administrators should consider these clinical risks, time implications and financial costs when managing pregnant women.
Barriers and facilitators to adherence to secondary stroke prevention medications after stroke: analysis of survivors and caregivers views from an online stroke forum
Authors: Jamison James , Sutton Stephen , Mant Jonathan , Simoni Anna De 
Published: July 2017

ObjectiveTo identify barriers and facilitators of medication adherence in patients with stroke along with their caregivers.DesignQualitative thematic analysis of posts about secondary prevention medications, informed by Perceptions and Practicalities Approach.SettingPosts written by the UK stroke survivors and their family members taking part in the online forum of the Stroke Association, between 2004 and 2011.Participants84 participants: 49 stroke survivors, 33 caregivers, 2 not stated, identified using the keywords ‘taking medication’, ‘pills’, ‘size’, ‘side-effects’, ‘routine’, ‘blister’ as well as secondary prevention medication terms.ResultsPerceptions reducing the motivation to adhere included dealing with medication side effects, questioning doctors’ prescribing practices and negative publicity about medications, especially in regard to statins. Caregivers faced difficulties with ensuring medications were taken while respecting the patient’s decisions not to take tablets. They struggled in their role as advocates of patient’s needs with healthcare professionals. Not experiencing side effects, attributing importance to medications, positive personal experiences of taking tablets and obtaining modification of treatment to manage side effects were facilitators of adherence. Key practical barriers included difficulties with swallowing tablets, dealing with the burden of treatment and drug cost. Using medication storage devices, following routines and getting help with medications from caregivers were important facilitators of adherence.ConclusionsAn online stroke forum is a novel and valuable resource to investigate use of secondary prevention medications. Analysis of this forum highlighted significant barriers and facilitators of medication adherence faced by stroke survivors and their caregivers. Addressing perceptual and practical barriers highlighted here can inform the development of future interventions aimed at improving adherence to secondary prevention medication after stroke.
Prospective Relation of Circulating Adipokines to Incident Metabolic Syndrome: The Framingham Heart Study
Authors: Zachariah Justin P. , Quiroz Rene , Nelson Kerrie P. , Teng Zhaoyang , Keaney John F. , Sullivan Lisa M. , Vasan Ramachandran S. 
Published: July 2017

Background
Adipokines are elaborated by adipose tissue and are associated with glycemic, lipid, and vascular traits. We hypothesized that in a cross‐sectional analysis circulating adipokines are altered among subsets of obesity stratified by presence versus absence of metabolic syndrome (MetS) and prospectively predict the incidence of MetS.

Methods and Results

Participants in the community‐based Framingham Third Generation Cohort who attended examination cycle 1 were included in the study (2002–2005; N=3777, mean age, 40 years; 59% women). Circulating adiponectin, leptin, leptin receptor, fetuin‐A, fatty acid–binding protein 4, and retinol binding protein 4 were assayed and related to incident MetS in follow‐up (mean 6 years). The adipokines were compared among individuals with excess body weight (body mass index ≥25 kg/m
2
) and prevalent MetS, excess body weight without MetS (metabolically healthy obese), and normal‐weight with MetS (metabolically obese, normal‐weight) with normal‐weight participants without MetS as a referent. Metabolically healthy obese individuals (n=1467) had higher circulating levels of fetuin‐A and fatty acid–binding protein 4 but lower levels of leptin, leptin receptor, and adiponectin (
P
<0.001 for all). The adipokine panel was associated with incident MetS (263 new‐onset cases;
P
=0.002). Higher circulating concentrations of retinol‐binding protein 4 and fetuin‐A were associated with incidence of MetS (odds ratio per 1‐
SD
increment log marker, 1.21; 95%
CI
, 1.03–1.41 [
P
=0.02] and 1.17; 95% CI, 1.01–1.34 [
P
=0.03], respectively).

Conclusions
In our community‐based sample of young to middle‐aged adults, metabolically healthy obese individuals demonstrated an adverse adipokine profile. Higher circulating levels of retinol‐binding protein 4 and fetuin‐A marked future cardiometabolic risk.
Client Insights on Knowledge use and Access in Return to Work
Authors: Shaw Lynn , Bondy Karen , Dodman Jillian 
Published: July 2017

Background An emerging trend in work practice is to move knowledge into the hands and minds of the end-users—our clients. Purpose The purpose of this study was to investigate clients’ perspectives on their experiences, needs, and preferences for accessing and using information to make decisions in resuming work and living with disability. Methods Data from a grounded theory study with a sample of 14 participants with chronic disabilities from three regions across Canada were analyzed using the constant comparative method. Findings Barriers revealed the pervasive struggles of clients in accessing and communicating information. Clients need places, resource people as well as access to diverse formats, and material to support knowledge use. Clients engaged themselves in interpreting or acting upon knowledge through planning for contingencies, appraising the self in context, and reflecting and learning from others. Implications Findings advance the conceptual understanding of knowledge translation principles and processes needed to support clients in making decisions about return-to-work. Opportunities for policy change and for occupational therapists to support knowledge brokering and translation are elaborated.
Cervical cancer in developing countries: How can we reduce the burden? Awareness raising, screening, treatment and palliation
Authors: Ansink Anca C 
Published: July 2017

Cervical cancer is an important health problem in developing countries. Most women present with advanced disease, resulting in low cure rates. Screening by Visual Inspection with the Aid of Acetic Acid and optionally HPV DNA detection as a second test is technically feasible. However, the majority of women appear to be reluctant to attend a screening clinic. This is probably due to lack of knowledge and a low priority of women's health in local communities. There is an obvious need to obtain more knowledge on communities’ perceptions and understanding of cervical cancer. Furthermore, we need more information on what issues should be addressed in order to perform cervical cancer screening in an acceptable manner. Treatment of cervical cancer in developing countries is highly dependent on the resources and skills available. Efforts to provide adequate palliation should be enhanced as relief of troublesome symptoms can often be achieved by relatively simple and low-cost measures.
Advance Directives and the Treatment of Patients with Mental Illness: Can an Advance Directive Avert Court Intervention When the Patient Refuses the Administration of Antipsychotic Medication?
Authors: McArdle Edward F. 
Published: July 2017

This article reviews the use of advance directives in the treatment of mental illness and finds that they hold untapped potential to improve outcomes while reducing time spent in court and damage to the physician–patient relationship resulting from litigation. Most state advance-directives laws apply to mental health treatment. However, their use in the treatment of mental illness has lagged behind their use in other medical conditions. Although there are unique risks to the use of advance directives in treating mental illness, they retain a legitimacy and persuasiveness in the wake of a later rejection by an impaired-capacity patient. Concerns that patients will seek to override directives or to use them to affirmatively refuse later treatment can largely be overcome; however, their possible use to avoid later treatment underscores the need for state law protections to ensure a patient's competency at the time the proxy is signed. Anecdotal evidence suggests that advance directives hold value in psychiatry. Clinicians need to explore their use before an assessment can be made of whether the overall success of advance directives will carry over to the treatment of mental illness.
Investigation and treatment of thyroglossal cysts in children
Authors: Brewis C , Mahadevan M , Bailey C M , Drake D P 
Published: July 2017

Summary Thyroglossal cysts are the commonest midline neck masses in children. To evaluate current practice questionnaires were sent to all ear, nose and throat (ENT) and paediatric surgeons in the UK and 72% responded. The commonest investigation requested was an ultrasound scan (54%) and the commonest operation was a variant of Sistrunk's procedure (78%). Paediatric surgeons did fewer investigations than ENT surgeons and tended to excise more of the thyroglossal tract. Review of the published work suggests that ultrasound scanning and Sistrunk's procedure are the best management policy. The scan can avoid inadvertent excision of an ectopic thyroid gland. Extensive thyroglossal tract excisions give lower recurrence rates.
Elder abuse: Do general practitioners know or care?
Authors: Mccreadie Claudine , Bennett Gerry , Gilthorpe Mark S , Houghton Guy , Tinker Anthea 
Published: July 2017

A pilot survey in Tower Hamlets, London, indicated that many general practitioners (GPs) might not be recognizing abuse of elderly patients through lack of training. The survey was replicated on a large scale in Birmingham, to allow further analysis. 561 Birmingham GPs were mailed questionnaires and responses from 291 were analysed, providing data from 95% of the practices. The findings were similar to those in Tower Hamlets: just under half had diagnosed elder abuse in the previous year. Regression analysis of the combined data-sets (n=363) indicated that the strongest factor predicting GP diagnosis of abuse was knowledge of 5 or more risk situations (odds ratio 6.77, 95% confidence interval 4.19, 10.93). The findings of these surveys suggest that research-based education and training would help GPs to become better at identifying and managing elder abuse.
Hospital referrals for low back pain: More coherence needed
Authors: Silman Alan J , Jayson Malcolm I V , Papageorgiou Ann C , Croft Peter R 
Published: July 2017

Summary Low back pain is a common reason for hospital referral but little is known of the resulting workload in different specialties. All new outpatient attendances for conditions with low back pain were recorded over one month in a teaching hospital and a district general hospital. The patients were seen in at least ten specialties and two-fifths of them had been seen previously with the same symptom in another department. In the two hospitals, low back pain accounted for 15% and 12% of all new outpatient attendances. A more coherent referral policy is needed.
Sonoclot coagulation analysis of in-vitro haemodilution with resuscitation solutions
Authors: Brazil E V , Coats T J 
Published: July 2017

Summary The colloid and crystalloid solutions used for resuscitation should preferably be free from effects on coagulation. In 10 volunteers, the effects of haemodilution with various concentrations of 0.9% sodium chloride and 4% succinylated gelatin were assessed by Sonoclot analysis, which describes the whole coagulation process. Small and moderate haemodilution (up to 40%) with 0.9% sodium chloride promoted coagulation. Similar haemodilution with 4% succinylated gelatin impaired coagulation, and at 60% haemodilution coagulation was very poor. These findings need to be confirmed in vivo and their clinical relevance determined.
Sexual health—what are users’ views?
Authors: Belfield Toni 
Published: July 2017

This article is the fifth in a series of articles on sexuality and sexual health. People's understanding of and needs in sexual health are complex. In recognition of this, fpa—with funding from the Department of Health—published The Handbook of Sexual Health in Primary Care in 2006.a This multi-authored book is written by practising professionals working in sexual health providing evidence-guided and accessible information to support practice. This article is adapted from Chapter 10 and published with permission from fpa.
Wheelchair Use: A Physical Sign in Gastroenterological Practice
Authors: Chiotakakou-Faliakou E , Dave U , Forbes A 
Published: July 2017

Diagnosis of functional abdominal pain requires exclusion of organic causes, and many patients undergo considerable investigation. A positive physical sign supporting a functional diagnosis could therefore be of benefit. Wheelchair use specifically for abdominal symptoms was suspected to represent such a sign. Review of 300 consecutive new referrals to a gastroenterology clinic revealed 10 wheelchair users. In four women the chair was used because of the abdominal condition. The final diagnosis (with follow-up to at least 12 months) was functional abdominal pain in each of these cases. All four had had surgery without symptom relief, and all had used their chairs intermittently (mainly for social occasions and hospital visits) for at least 12 months. They believed that normal walking was rendered impossible by abdominal pain whereas the other six wheelchair users gave a clear account of lower limb pain or weakness. Secondary gain with reinforcement of the ‘sick role’ was felt to be the probable explanation for wheelchair use in the former group. Wheelchair attendance at the gastroenterology clinic, in the absence of lower limb symptoms, is a rare observation but one that may usefully be added to criteria for diagnosis of a functional disorder.
Multiple Use of Disposable Syringe Units by Insulin-Dependent Diabetics
Authors: Turner Joan G. , Lancaster Jeanette 
Published: July 2017

Previous research on reuse of disposable syringe and needle units has reported no incidence of inflammation at subjects' injection sites. Even though many diabetic individ uals may reuse insulin syringe and needle units without the approval and/or knowledge of their physician, there have been few studies to document the actual incidence of reuse. This study examined reuse practices among 302 ambu latory insulin-dependent persons. A total of 134 subjects reported reusing syringe units for 3 to 10 times before dis carding the syringe unit. Subjects who reused disposable syringe units were female more often than male, black rather than white, and tended to be older than their non- reuse counterparts. Those who reused the units typically had been insulin dependent over five years. Individuals who reused syringe units were comparable to non-reusers in their ability to correctly and aseptically self-administer insulin. Inflammation at injection sites in subjects retrospectively over a five year period of time amounted to a rate of 9.93%. Reusers demonstrated a slightly higher rate of inflammation at injection sites, but there was no statistically significant difference between groups at an alpha of .05.
Salicylate, mefenamate, meclofenamate, and quinine on cochlear potentials
Authors: Fuel Jean‐Luc , Bobbin Richard P. , Fallon Maureen 
Published: July 2017

The perilymphatic spaces of guinea pig cochleae were perfused with artificial perilymph, with and without drug, at a rate of 2.5 μl/minute for 10 minutes. The compound action potential of the auditory nerve, cochlear microphonics, and the summating potential evoked by 10 kHz tone bursts of varying intensities were recorded from a wire inserted in the basal turn scala vestibull. The endocochlear potential was recorded from the scala media. Sodium salicylate (1.25 to 10 mmol/L) reduced the magnitude of the compound action potential evoked by low‐sound intensities without affecting the compound action potential evoked by high‐sound intensities. Sodium salicylate also reduced cochlear microphonics and had no effect on summating potential. Cochlear perfusions of prostaglandin synthesis inhibitors, mefenamate (200 μmol/L), and meclofenamate (200 μmol/L), had no effect on the cochlear potentials. Quinine (10 to 100 μmol/L) reduced the compound action potential input‐output function in a parallel fashion rather than selectively affecting the low‐intensity compound action potential. Quinine (100 μmol/L) reduced cochlear microphonics and summating potential. Neither quinine (100 μmol/L) nor salicylate (5 mmol/L) affected endocochlear potential. These results suggest that salicylate‐induced hearing loss is not caused by either antagonism of the hair cell transmitter or cyclooxygenase inhibition, nor is it caused by the same mechanism that causes quinine‐induced hearing loss.