bluuebunny/crossref_metadata_2025_split huggingface dataset:
Home Parenteral Nutrition in Adult Patients With Chronic Intestinal Failure: Catheter‐Related Complications Over 4 Decades at the Main Danish Tertiary Referral Center
Authors: Brandt Christopher Filtenborg , Tribler Siri , Hvistendahl Mark , Naimi Rahim M. , Brøbech Per , Staun Michael , Jeppesen Palle Bekker 
Published: November 2016

AbstractBackground/Aims: Catheter‐related complications (CRCs) cause mortality and morbidity in patients dependent on parenteral support at home (HPN) due to intestinal failure (IF). This study describes the incidences of CRCs in an adult IF cohort over 40 years. It illustrates the evolution and consequences of CRCs, their association to demographic characteristics, and potential risk factors in an effort to provide the rationale for preventive precautions to the relevant patients with IF at risk. Methods: All patients with IF discharged with HPN from 1970–2010 were included. Patient and treatment characteristics were extracted from the Copenhagen IF database. The incidences were given per 1000 central venous catheter (CVC) days. Results: The 1715 CRCs occurred in 70% of the 508 patients with IF (56% of the 2191 CVCs). The incidence of catheter‐related bloodstream infections (CRBSIs) was 1.43. Higher age, HPN administration by community home nurses, and prior CRBSIs significantly raised the hazard for CRBSIs. In the 1970s, catheters were generally replaced following CRBSIs, whereas catheter salvage was the norm in the 2000s. The incidences of mechanical complications, tunnel infections, and catheter‐related venous thromboses were 0.80, 0.25, and 0.11, respectively. The overall CRC incidence was 2.58, decreasing the first 3 decades but peaking in the last (2.84). The deaths related to CRCs were low (0.018). Conclusion: Even in an experienced IF center of excellence, the incidence of CRCs increased over the 4 decades. This increase could be explained by the expansion of the indication of HPN to a more elderly and frail patient population.
Whole Body Protein Turnover and Net Protein Balance After Pediatric Thoracic Surgery: A Noninvasive Single‐Dose 15N Glycine Stable Isotope Protocol With End‐Product Enrichment
Authors: Fullerton Brenna S. , Sparks Eric A. , Khan Faraz A. , Fisher Jeremy G. , Anzaldi Rocco , Scoville Michael R. , Yu Yong‐Ming , Wagner David A. , Jaksic Tom , Mehta Nilesh M. 
Published: November 2016

AbstractBackground: We used the 15N glycine urinary end‐product enrichment technique to quantify whole body protein turnover following thoracic surgery. Materials and Methods: A single dose of 15N glycine (2 mg/kg) was administered orally on postoperative day 1 to children (1–18 years) following thoracic surgery. 15N enrichment of ammonia and urea was measured in mixed urine after 12 and 24 hours, respectively, and protein synthesis, breakdown, and net balance determined. Nitrogen balance (dietary intake minus urinary excretion) was calculated. Urinary 3‐methylhistidine:creatinine ratio was measured as a marker of skeletal muscle protein breakdown. Results: We enrolled 19 subjects—median (interquartile range): age, 13.8 years (12.2–15.1); weight, 49.2 kg (38.4–60.8)—who underwent thoracotomy (n = 12) or thoracoscopic (n = 7) surgery. Protein synthesis and breakdown by 15N enrichment were 7.1 (5.5–9) and 7.1 (5.6–9) g·kg−1·d−1 with ammonia (12 hours) as the end product, and 5.8 (3.8–6.7) and 6.7 (4.5–7.6) with urea (24 hours), respectively. Net protein balance by the 15N glycine and urinary urea nitrogen methods were −0.34 (−0.47, −0.3) and −0.48 (−0.65, −0.28) g·kg−1·d−1, respectively (rs = 0.828, P < .001). Postoperative change in 3‐methylhistidine:creatinine ratio did not correlate significantly with protein breakdown or balance. Conclusion: The single‐dose oral administration of 15N glycine stable isotope with measurement of urinary end‐product enrichment is a feasible and noninvasive method to investigate whole body protein turnover in children. After major surgery, children manifest increased protein turnover and net negative balance due to increased protein breakdown.
Outcomes of Vestibular Schwannoma Surgery among the Elderly: Analysis of the National Inpatient Sample
Authors: Sylvester Michael J. , Shastri Darshan N. , Patel Viral M. , Raikundalia Milap D. , Eloy Jean Anderson , Baredes Soly , Ying Yu‐Lan Mary 
Published: November 2016

ObjectiveTo compare comorbidities and in‐hospital complications between elderly and nonelderly patients undergoing vestibular schwannoma (VS) surgery. To examine average length of stay (LOS) and hospital charges among elderly patients.Study DesignPopulation‐based inpatient registry analysis.SettingAcademic medical center.Subjects and MethodsRetrospective analysis of the National Inpatient Sample for patients undergoing VS surgery from 2002 to 2010: 4137 patients met inclusion criteria, with 519 (12.5%) in the elderly cohort (≥65 years). Outcomes of elderly and nonelderly (<65 years) patient cohorts were compared.ResultsCompared with the nonelderly cohort, the elderly cohort had more comorbidities, including diabetes mellitus, hypertension, and pulmonary disease (all P <. 001). Elderly patients had longer LOS (6.5 vs 5.4 days; P =. 001) but did not incur significantly greater hospital charges. Rates of cerebrospinal fluid leak, meningitis, and facial nerve injury did not vary significantly between groups. The elderly cohort experienced higher rates of in‐hospital complications, including acute cardiac events, iatrogenic cerebrovascular infarction/hemorrhage, postoperative bleeding (hemorrhage/hematoma), and in‐hospital mortality (all P <. 05). In binary logistic regression, correcting for patient demographics and presence of comorbidities, elderly status was associated with 1.848 (95% confidence interval, 1.167‐2.927; P =. 009) greater odds of medical complications and 13.188 (95% confidence interval, 1.829‐95.113; P =. 011) greater odds of in‐hospital mortality.ConclusionElderly patients undergoing VS surgery have more comorbidities, in‐hospital complications, and longer LOS than nonelderly patients. The elderly cohort had a greater rate of in‐hospital mortality, though rare. Interestingly, elderly patients did not have a higher rate of many known complications associated with VS surgery and did not incur more hospital charges.
Three‐Dimensional Printing and Its Applications in Otorhinolaryngology–Head and Neck Surgery
Authors: Crafts Trevor D. , Ellsperman Susan E. , Wannemuehler Todd J. , Bellicchi Travis D. , Shipchandler Taha Z. , Mantravadi Avinash V. 
Published: November 2016

ObjectiveThree‐dimensional (3D)‐printing technology is being employed in a variety of medical and surgical specialties to improve patient care and advance resident physician training. As the costs of implementing 3D printing have declined, the use of this technology has expanded, especially within surgical specialties. This article explores the types of 3D printing available, highlights the benefits and drawbacks of each methodology, provides examples of how 3D printing has been applied within the field of otolaryngology–head and neck surgery, discusses future innovations, and explores the financial impact of these advances.Data SourcesArticles were identified from PubMed and Ovid MEDLINE.Review MethodsPubMed and Ovid Medline were queried for English articles published between 2011 and 2016, including a few articles prior to this time as relevant examples. Search terms included 3‐dimensional printing, 3D printing, otolaryngology, additive manufacturing, craniofacial, reconstruction, temporal bone, airway, sinus, cost, and anatomic models.ConclusionsThree‐dimensional printing has been used in recent years in otolaryngology for preoperative planning, education, prostheses, grafting, and reconstruction. Emerging technologies include the printing of tissue scaffolds for the auricle and nose, more realistic training models, and personalized implantable medical devices.Implications for PracticeAfter the up‐front costs of 3D printing are accounted for, its utilization in surgical models, patient‐specific implants, and custom instruments can reduce operating room time and thus decrease costs. Educational and training models provide an opportunity to better visualize anomalies, practice surgical technique, predict problems that might arise, and improve quality by reducing mistakes.
Predictors of Recovery from Depression and Anxiety in Women: A Longitudinal Study from Childbirth to 6 Years
Authors: Shankar Radhika , Badker Rinette , Brain Ursula , Oberlander Tim F. , Misri Shaila 
Published: November 2016

Objective: This study prospectively examined maternal biopsychosocial predictors of recovery from comorbid depression and anxiety from 25 weeks’ gestation to 6 years postbirth. Specifically, the study investigated the influence of 1) maternal factors and 2) the child’s behaviours and physical health on the course of the mother’s depressed mood and anxiety. Methods: Eighty-six women diagnosed with antenatal depression/anxiety were recruited through the Reproductive Mental Health Program and family practices in Vancouver. Based on the trajectory and status of their symptom remission, participants were categorised into 3 groups: full recovery, partial recovery, and no recovery. The following measures were completed over 6 years: Hamilton Anxiety Rating Scale (HAM-A) and Hamilton Depression Rating Scale (HAM-D) at baseline; Parental Stress Index (PSI) added at 6 months postpartum; Beck Anxiety Inventory (BAI), Beck Depression Inventory II (BDI-II), and Child Behavior Checklist (CBCL) at 3 years postbirth; and HAM-A, HAM-D, MacArthur Health and Behavior Questionnaire (HBQ-P), and PSI at 6 years postbirth. Results: Factors that predicted full recovery from depression included the absence of maternal health concerns, low total parental stress, and few child behavioural issues, whereas low levels of spousal stress were a significant factor in achieving full recovery from anxiety. Conclusion: A variety of maternal and child-related factors govern full recovery or sustained remission of depression/anxiety in the postpartum up to 6 years postbirth. Early awareness of these predictors could lead to timely interventions, ensuring long-term maternal-child well-being.
Variation in Definitions of Immobility in Pharmacological Thromboprophylaxis Clinical Trials in Medical Inpatients: A Systematic Review
Authors: Ye Fan , Bell Lauren N. , Mazza Joseph , Lee Arthur , Yale Steven H. 
Published: November 2016

Background: Although immobility is a common risk factor for venous thromboembolism (VTE) in medical inpatients, lack of a consistent definition of this term may limit accurate assessment of VTE risk for thromboprophylaxis. Objective: To examine various definitions of immobility used in recent pharmacological thromboprophylaxis clinical trials. Data Sources: PubMed and relevant references from articles/reviews from 2008 to 2016 were searched. Randomized controlled trials (RCTs) and other clinical studies involving adult hospitalized medical patients in acute care hospital settings that used the term immobility were selected. Two investigators independently abstracted data in duplicate, and accuracy was checked by a third investigator. Results: Twenty-one clinical studies were included. There was heterogeneity among individual VTE risk factors, with respect to the definition of immobility in medical inpatients in these trials. Thirteen studies utilized objective criteria to define “immobility” including duration (12 studies) and distance or time walked (6 studies). In contrast, 7 studies focused principally on subjective definitions (ie, describing the nature of immobility rather than specifying its quantitative measurement). Three RCTs vaguely defined the level of patient’s immobility after hospitalization. Conclusion: Despite the well-known effectiveness of pharmacological thromboprophylaxis for the prevention of VTE in acutely ill medical patients, there is no current consensus on how to define immobility. The heterogeneous nature of definitions of immobility has led to uncertainty about the importance of immobility in VTE risk assessment models. Although clinical studies have incorporated varying definitions of immobility into their inclusion criteria, immobility as a specific VTE risk factor has not been clearly defined.
Intensity-Modulated Radiation Therapy Improves the Target Coverage Over 3-D Planning While Meeting Lung Tolerance Doses for All Patients With Malignant Pleural Mesothelioma
Authors: Ulger Sukran , Cetin Eren , Catli Serap , Sarac Hilal , Kilic Diclehan , Bora Huseyin 
Published: November 2016

Purpose: To investigate high conformality on target coverage and the ability on creating strict lung dose limitation of intensity-modulated radiation therapy in malignant pleural mesothelioma. Patients and Methods: Twenty-four radiation therapy plannings were evaluated and compared with dosimetric outcomes of conformal radiation therapy and intensity-modulated radiation therapy. Hemithoracal radiation therapy was performed on 12 patients with a fraction of 1.8 Gy to a total dose of 50.4 Gy. All organs at risk were contoured. Radiotherapy plannings were differed according to the technique; conformal radiation therapy was planned with conventionally combined photon–electron fields, and intensity-modulated radiation therapy was planned with 7 to 9 radiation beam angles optimized in inverse planning. Strict dose–volume constraints were applied. Results: Intensity-modulated radiation therapy was statistically superior in target coverage and dose homogeneity (intensity-modulated radiation therapy-planning target volume 95 mean 100%; 3-dimensional conformal radiation therapy-planning target volume 95 mean 71.29%, P = .0001; intensity-modulated radiation therapy-planning target volume 105 mean 11.14%; 3-dimensional conformal radiation therapy-planning target volume 105 mean 35.69%, P = .001). The dosimetric results of the remaining lung was below the limitations on intensity-modulated radiation therapy planning data (intensity-modulated radiation therapy-lung mean dose mean 7.5 [range: 5.6%-8.5%]; intensity-modulated radiation therapy-lung V5 mean 55.55% [range: 47%-59.9%]; intensity-modulated radiation therapy-lung V20 mean 4.5% [range: 0.5%-9.5%]; intensity-modulated radiation therapy-lung V13 mean 13.43% [range: 4.2%-22.9%]). Conclusion: With a complex and large target volume of malignant pleural mesothelioma, intensity-modulated radiation therapy has the ability to deliver efficient tumoricidal radiation dose within the safe dose limits of the remaining lung tissue.
Golimumab pharmacokinetics in ulcerative colitis: a literature review
Authors: Harzallah Ines , Rigaill Josselin , Williet Nicolas , Paul Stephane , Roblin Xavier 
Published: November 2016

Golimumab (GLM) is the latest anti-tumor necrosis factor (TNF) that gained its marketing license. Thanks to the PURSUIT induction and maintenance trials, it was approved for the treatment of ulcerative colitis (UC) in 2013. The other anti-TNF drugs available are infliximab and adalimumab. These two drugs have validated algorithms concerning prescription and therapeutic drug monitoring (TDM) but little is known about GLM. The available data on GLM’s exposure–response relationship in UC are from the PURSUIT trials and are recently published. The data reveal all the factors that may impact the pharmacokinetic (PK) parameters: dosage, body weight (BW), concomitant drugs, the presence of anti-drug antibodies (ADAbs), sex and age. In addition, the GLM trough level at steady-state appears to be correlated with the patient’s improvement which may make it a precious indicator to predict the clinical response. There is, however, no consensus on a possible therapeutic level or cutoff associated with clinical response, remission, or any other outcome measure such as endoscopic healing in UC. This lack of a threshold value, and its validation with different assay techniques, makes it difficult to use GLM TDM in clinical practice. As with other anti-TNF agents, GLM is associated with development of ADAbs, of which the prevalence and effects are still insufficiently described. The objective of this review is to describe current data and understanding of the PK of GLM including serum concentrations of GLM and ADAbs in UC patients. Better understanding of these parameters could lead to improved patient care with GLM.
Time to commencement of active exercise predicts total active range of motion 6 weeks after proximal phalanx fracture fixation: A retrospective review
Authors: Miller Lauren Gai , Ada Louise , Crosbie Jack , Wajon Anne 
Published: November 2016

Introduction Whether baseline characteristics influence range of motion outcomes following proximal phalanx fracture remains unclear. The aim of this review was to investigate whether fixation type, time to commencement of active finger exercise, location of fracture or which finger is injured predict total active range of motion 6 weeks after surgical fixation. Methods A retrospective cohort of 49 patients with finger proximal phalanx fracture was analysed. Putative predictors investigated were fixation type, time to commencement of active exercise, location of fracture and injured finger. The outcome of interest was total active finger range of motion 6 weeks post-operatively. Results Multiple regression analysis found that time to commencement of active exercise was the only significant independent predictor of total active range of motion 6 weeks post-operatively. The main influence on time to commencement of active exercise was fixation type, with fractures repaired using Kirschner wire fixation associated with a delay of nearly 2 weeks, compared with fractures repaired using open reduction and internal fixation. Discussion Patients who commence active exercise early following surgical fixation of a proximal phalanx fracture may expect greater total active range of motion 6 weeks post-operatively than if exercise is delayed.
Informing Healthcare Waiting Area Design Using Transparency Attributes: A Comparative Preference Study
Authors: Jiang Shan , Powers Matthew , Allison David , Vincent Ellen 
Published: November 2016

Objective: This study aimed to explore people’s visual preference for waiting areas in general hospital environments designed with transparency attributes that fully integrate nature. Background: Waiting can be a tedious and frustrating experience among people seeking healthcare treatments and negatively affect their perception of the quality of care. Positive distractions and supportive designs have gained increasing attraction to improve people’s waiting experience. Nature, which has shown therapeutic effects according to a growing amount of evidence, could be a distinguished positive distraction in waiting areas. Additionally, the theory of transparency was operationalized to indicate a spatial continuity between the external nature and the built interiors in general healthcare waiting area design. Method: A survey method was adopted in the study. Twenty-one images of general healthcare waiting areas depicting three design typologies were preselected following a strict procedure, including designs with (a) no window views, (b) limited window views to nature, and (c) transparent spaces with maximum natural views. Ninety-five student participants rated the images based on their visual preference using a Likert-type scale. Results and Conclusions: The results showed that transparent waiting areas were significantly preferred. A significant positive relationship existed between the level of transparency and people’s preference scores. The factor analysis indicated additional supportive features that may affect people’s preferences, including daylight, perceived warmth, noninstitutional furniture arrangement, visual orientation, and the use of natural materials for interior design. However, these tentative results need to be furthered tested with the real patient population as the next step of this study.
Hypersensitivity reaction associated with subcutaneous glargine insulin therapy in a cat
Authors: Murphy Lisa A , Zuendt Greg F , Nakamura Reid K , Gambardella Paul 
Published: November 2016

Case summary A 14-year-old, domestic shorthair cat was treated for transient diabetes mellitus for 3 months with glargine insulin, which was discontinued when the diabetes mellitus resolved. Approximately 36 months later the diabetes mellitus recurred and glargine insulin was restarted. Within 2–3 mins of the first injection the cat collapsed, developed profuse vomiting and diarrhea, as well as facial swelling and diffuse erythema. A hypersensitivity reaction was suspected and the cat was treated with antihistamines, aggressive fluid therapy and gastrointestinal support. The cat made a full recovery and was discharged 3 days later. Six months later the cat re-presented for relapse of its diabetes mellitus and an intradermal skin challenge with 1:20 diluted insulin was performed confirming a hypersensitivity to glargine. The cat continues to be well regulated on porcine zinc insulin without any hypersensitivity reactions noted. Relevance and novel information Hypersensitivity reactions to insulin administration are rarely described in human medicine. This is the first reported case of a hypersensitivity reaction secondary to glargine insulin in a cat. Clinicians should be aware of this potential complication, particularly in animals with a previous history of insulin administration and the potential to utilize intradermal testing with insulin.
Cerebral pyogranulomatous encephalitis caused by Cladophialophora bantiana in a 15-week-old domestic shorthair kitten
Authors: Russell Elise B , Gunew Marcus N , Dennis Michelle M , Halliday Catriona L 
Published: November 2016

Case summary A case of cerebral phaeohyphomycosis caused by Cladophialophora bantiana is described in a 15-week-old domestic shorthair kitten. Relevance and novel information Cerebral phaeohyphomycosis is a rare condition in cats caused by dematiaceous fungi. This report describes the clinical and histopathological findings in the youngest case documented in a feline, provides a brief review of aetiology, diagnosis, treatment and prognosis of cerebral phaeohyphomycosis and demonstrates the importance of molecular diagnostics in accurate mycotic species identification.
Myeloid malignancies and the microenvironment
Authors: Korn Claudia , Méndez-Ferrer Simón 
Published: November 2016

Abstract
Research in the last few years has revealed a sophisticated interaction network between multiple bone marrow cells that regulate different hematopoietic stem cell (HSC) properties such as proliferation, differentiation, localization, and self-renewal during homeostasis. These mechanisms are essential to keep the physiological HSC numbers in check and interfere with malignant progression. In addition to the identification of multiple mutations and chromosomal aberrations driving the progression of myeloid malignancies, alterations in the niche compartment recently gained attention for contributing to disease progression. Leukemic cells can remodel the niche into a permissive environment favoring leukemic stem cell expansion over normal HSC maintenance, and evidence is accumulating that certain niche alterations can even induce leukemic transformation. Relapse after chemotherapy is still a major challenge during treatment of myeloid malignancies, and cure is only rarely achieved. Recent progress in understanding the niche-imposed chemoresistance mechanisms will likely contribute to the improvement of current therapeutic strategies. This article discusses the role of different niche cells and their stage- and disease-specific roles during progression of myeloid malignancies and in response to chemotherapy.